The skeletal muscle microbiopsy method in exercise and sports science research: A narrative and methodological review

The skeletal muscle microbiopsy protocol was introduced to the Exercise and Sports Science (ESS) research field in 1999 and has been used as a protocol to directly examine muscular structural and biochemical changes. There is much variation in the reporting of the microbiopsy protocol and its related pre- and post-procedure for participant care and sample collection. The purpose of this narrative and methodological review is to compare the microbiopsy to the traditional Bergström protocol used in the ESS field, identify and summarize all related microbiopsy protocols used in previous ESS studies and determine the most frequently used microbiopsy protocols aspects and associated pre- and post-biopsy procedures.

A review of literature up to January 2022 was used following the PRISMA and Cochrane Methodological Review Guide to determine frequently used methods that may facilitate optimal and potential recommendations for muscle microbiopsy needle gauge (G), concentration or dose (% or ml) and administration of local anesthetic, co-axial/cannula introducer gauge (G), muscle depth (cm), muscle sample size collected (mg), passes to collect samples, time points of muscle sampling, and promotion of participant compliance and minimization of adverse events.

Eighty-five articles were selected based on the inclusionary requirements related to the ESS field or methodological considerations. The most frequently reported aspects in previous research to suggest the location of the vastus lateralis is the midpoint between the patella and the greater trochanter of the femur or 1/3 or 2/3 the distance from the patella to anterior superior iliac spine, 14 G biopsy needle, subcutaneous injected lidocaine administration (2 ml, 1%), 13 G co-axial/cannula, 1-2 cm muscle depth, 10-20 mg of muscle sample, ~3-time points, and 2-3 passes.

There is much variation in the reporting of the microbiopsy protocol and its related pre- and post-biopsy procedures. Standardization in reporting may promote recommendations to optimize data integrity, participant safety, participant adherence to the study design, and increase reproducibility. Recommendations are made for the microbiopsy procedure based on frequently reported characteristics.