Remodeling of Muscle to Match
Function
All the
muscles of the body are continually being remodeled to match the functions that
are required of them. Their diameters are altered, their lengths are altered,
their strengths are altered, their vascular sup-plies are altered, and even the
types of muscle fibers are altered at least slightly. This remodeling process
is often quite rapid, within a few weeks. Indeed, experiments in animals have
shown that muscle contractile proteins in some smaller, more active muscles can
be replaced in as little as 2 weeks.
Muscle Hypertrophy and Muscle Atrophy. When the totalmass of a muscle increases, this
is called muscle hyper-trophy. When
it decreases, the process is called
muscle atrophy.
Virtually
all muscle hypertrophy results from an increase in the number of actin and
myosin filaments in each muscle fiber, causing enlargement of the individ-ual
muscle fibers; this is called simply fiber
hypertrophy. Hypertrophy occurs to a much greater extent when the muscle is
loaded during the contractile process. Only a few strong contractions each day
are required to cause significant hypertrophy within 6 to 10 weeks.
The
manner in which forceful contraction leads to hypertrophy is not known. It is
known, however, that the rate of synthesis of muscle contractile proteins is
far greater when hypertrophy is developing, leading also to progressively
greater numbers of both actin and myosin filaments in the myofibrils, often
increasing as much as 50 per cent. In turn, some of the myofibrils themselves
have been observed to split within hypertrophying muscle to form new
myofibrils, but how important this is in usual muscle hypertrophy is still
unknown.
Along
with the increasing size of myofibrils, the enzyme systems that provide energy
also increase. This is especially true of the enzymes for glycolysis, allowing
rapid supply of energy during short-term forceful muscle contraction.
When a
muscle remains unused for many weeks, the rate of decay of the contractile
proteins is more rapid than the rate of replacement. Therefore, muscle atrophy
occurs.
Adjustment of Muscle Length. Another type of hyper-trophy occurs when
muscles are stretched to greater than normal length. This causes new sarcomeres
to be added at the ends of the muscle fibers, where they attach to the tendons.
In fact, new sarcomeres can be added as rapidly as several per minute in newly
developing muscle, illustrating the rapidity of this type of hypertrophy.
Conversely,
when a muscle continually remains short-ened to less than its normal length,
sarcomeres at the ends of the muscle fibers can actually disappear. It is by
these processes that muscles are continually remodeled to have the appropriate
length for proper muscle contraction.
Hyperplasia of Muscle Fibers.
Under rare conditions ofextreme muscle force
generation, the actual number of muscle fibers has been observed to increase
(but only by a few percentage points), in addition to the fiber hypertrophy
process. This increase in fiber number is called fiber hyperplasia. When it does occur, the mech-anism is linear
splitting of previously enlarged fibers.
Effects of Muscle Denervation. When a muscle loses itsnerve supply, it no
longer receives the contractile signals that are required to maintain normal
muscle size. Therefore, atrophy begins almost immediately. After about 2
months, degenerative changes also begin to appear in the muscle fibers
themselves. If the nerve supply to the muscle grows back rapidly, full return
of function can occur in as little as 3 months, but from that time onward, the
capability of functional return becomes less and less, with no further return
of function after 1 to 2 years.
In the
final stage of denervation atrophy, most of the muscle fibers are destroyed and
replaced by fibrous and fatty tissue. The fibers that do remain are composed of
a long cell membrane with a lineup of muscle cell nuclei but with few or no
contractile properties and little or no capability of regenerating myofibrils
if a nerve does regrow.
The
fibrous tissue that replaces the muscle fibers during denervation atrophy also
has a tendency to con-tinue shortening for many months, which is called con-tracture. Therefore, one of the most
important problemsin the practice of physical therapy is to keep atrophying
muscles from developing debilitating and disfiguring contractures. This is
achieved by daily stretching of the muscles or use of appliances that keep the
muscles stretched during the atrophying process.
Recovery of Muscle
Contraction in Poliomyelitis: Devel-opment of Macromotor Units. When some but not allnerve fibers to a muscle
are destroyed, as commonly occurs in poliomyelitis, the remaining nerve fibers
branch off to form new axons that then innervate many of the paralyzed muscle
fibers. This causes large motor units called macromotor units, which can contain as many as five times the
normal number of muscle fibers for each motoneuron coming from the spinal cord.
This decreases the fineness of control one has over the muscles but does allow
the muscles to regain varying degrees of strength.
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