Muscle fatigue: what, why and how it influences muscle function

Adiponectin and Nitric Oxide Deficiency-Induced Cognitive Impairment in Fatigued Home-Resident in Mature and Older Adults: A Case-Control Study

Objective

The present study explores the underlying factors of cognitive abilities in relation to the expression of adiponectin and nitric oxide, fatigue, and other cofounder variables such as physical activity, diabetes, and adiposity status in healthy home-resident mature and older adults.

Background

Fatigue has been shown to be correlated with many metabolic and psychiatric conditions, such as cognitive, neurological, musculoskeletal, and hormonal disorders, as well as physical and unhealthy lifestyles.

Methods

A total of 85 home residents aged 50-85 years participated in this case-control study. Mental, fatigue, and pain status were assessed by the cognitive assessment (LOTCA), fatigue questionnaire (CIS20r), and pain score (0-10). VO2 max and the prevalidated global physical activity questionnaire were used to estimate physical status. The levels of adiponectin, nitric oxide (NO), and variables related to diabetes, such as blood sugar and glycated hemoglobin (HbA1c %), were assessed using ELISA and spectrophotometric immunoassays.

Results

The participants were classified according to the CIS-fatigue score into two groups: the healthy group (n = 40) and the fatigue group (n = 45). In fatigued subjects, LOTCA scores as a measure of cognitive performance significantly decreased (65.97 ± 7.17; P = 0.01) as compared with healthy subjects (LOTCA scores, 94.2 ± 7.5). The results of cognitive performance domains (LOTCA seven-subset scores) showed a significant decrease in the scores of orientation, visual perception, spatial perception, motor praxis, vasomotor organization, thinking operations, attention, and concentration in older subjects with fatigue compared with healthy subjects. In addition, pain scores significantly increased, and the expression of both nitric oxide (NO) and adiponectin significantly reduced in older adults with fatigue as compared with healthy controls. The decline in cognitive abilities among older adults with fatigue is significantly associated with the CIS-fatigue score, sedentary lifestyle, obesity, pain status, diabetes, and reduction in the levels of nitric oxide (NO), and adiponectin. Moreover, in fatigued cases, the expression of both NO and adiponectin was significantly correlated with CIS-fatigue score, physical activity, obesity, and diabetes, which indicates its availability as diagnostic markers for cognition in mature and older adults with fatigue.

Conclusion

In the present study, the data concluded that cognitive abilities were significantly associated with the lower expression of adiponectin and NO as endothelial vascular markers in association with fatigue among home-resident older adults. In addition, the reduction in cognition was significantly affected by other parameters, such as diabetes, obesity, and unhealthy sedentary life activities. Moreover, the results might recommend the use of cellular adiponectin and NO as diagnostic indicators of cognitive abilities in fatigued mature and older adults. However, more studies on larger sample sizes are required.

Disparate Mechanisms of Fatigability in Response to Prolonged Running versus Cycling of Matched Intensity and Duration

INTRODUCTION

Running and cycling represent two of the most common forms of endurance exercise. However, a direct comparison of the neuromuscular consequences of these two modalities after prolonged exercise has never been made. The aim of this study was to compare the alterations in neuromuscular function induced by matched-intensity and duration cycling and running exercise.

METHODS

During separate visits, 17 endurance-trained male participants performed 3 h of cycling and running at 105% of the gas exchange threshold. Neuromuscular assessments were taken are preexercise, midexercise, and postexercise, including knee extensor maximal voluntary contractions (MVC), voluntary activation (VA), high- and low-frequency doublets (Db100 and Db10, respectively), potentiated twitches (Qtw,pot), motor evoked potentials (MEP), and thoracic motor evoked potentials (TMEP).

RESULTS

After exercise, MVC was similarly reduced by ~25% after both running and cycling. However, reductions in VA were greater after running (-16% ± 10%) than cycling (-10% ± 5%; P < 0.05). Similarly, reductions in TMEP were greater after running (-78% ± 24%) than cycling (-15% ± 60%; P = 0.01). In contrast, reductions in Db100 (running vs cycling, -6% ± 21% vs -13% ± 6%) and Db10:100 (running vs cycling, -6% ± 16% vs -19% ± 13%) were greater for cycling than running (P ≤ 0.04).

CONCLUSIONS

Despite similar decrements in the knee extensor MVC after running and cycling, the mechanisms responsible for force loss differed. Running-based endurance exercise is associated with greater impairments in nervous system function, particularly at the spinal level, whereas cycling-based exercise elicits greater impairments in contractile function. Differences in the mechanical and metabolic demands imposed on the quadriceps could explain the disparate mechanisms of neuromuscular impairment after these two exercise modalities.

The Effects of Fatigue on Muscle Synergies in the Shoulders of Baseball Players

BACKGROUND

Muscle synergies are defined as the central nervous system's organizational structure for movement. Muscle synergies change after muscular fatigue, with certain synergies assuming the primary role to compensate for fatigue within another muscle synergy. Owing to the high eccentric forces imposed upon the external rotators (ie, posterior rotator cuff), pitchers that continue to throw while fatigued are at a significantly higher risk of shoulder and/or elbow injury; however, the neuromuscular compensation strategies of baseball players in response to fatigue are currently unknown.

HYPOTHESIS

Players would utilize the same muscle synergy structure following external rotation (ER) fatigue; however, muscle coefficients of nonfatigued muscles would increase (ie, compensate for the external rotators) after fatigue.

STUDY DESIGN

Cross-sectional study conducted in a controlled, laboratory setting.

METHODS

Nine players from an intercollegiate competitive club baseball team voluntarily participated in this study. Surface electromyography was used on 14 muscles of the glenohumeral and scapulothoracic joints of the dominant arm during a reaching protocol. Players completed a baseline reaching protocol (prefatigue), then an ER fatigue protocol until maximum concentric ER was reduced by 40%, and finally repeated the same reaching protocol (postfatigue). Principal component analysis was used to extract muscle synergies, the variance accounted for (VAF) of each synergy, and muscle coefficients. Prefatigue was compared with postfatigue using paired t tests for all dependent variables.

RESULTS

Four muscle synergies were extracted for both pre- and postfatigue. The VAF for the ER/abduction synergy decreased significantly (prefatigue, 34.6%; postfatigue, 32.4%; P = 0.03), showing a decreased reliance on ER/abduction during the reaching task after fatigue. Within synergy 1, the pectoralis major muscle coefficient (-0.489 vs -0.552; P = 0.01; effect size = 1.68) decreased significantly from prefatigue to postfatigue, indicating that the pectoralis major assumed more of an antagonist role during ER/abduction. Within synergy 2 (forward reaching), there were no significant changes in VAF or muscle coefficients observed. For the third synergy, muscle coefficients increased for the serratus anterior (P = 0.02) and middle deltoid (P = 0.01), whereas in the fourth synergy, the pectoralis major (P = 0.01) increased and teres major (P = 0.01) and biceps brachii (P = 0.05) muscle coefficients decreased.

CONCLUSION

The decreased VAF of the ER/abduction synergy after fatigue indicate that other muscles within that synergy could not fully compensate to maintain function. Interestingly, the changes in muscle coefficients suggest that players relied less on the internal rotation (IR) synergy and more on the cross-body synergy following fatigue. This may be due to imbalances between ER and IR while maintaining balance between cross-abduction and adduction.

CLINICAL RELEVANCE

Clinicians may consider implementing low-load, high-repetition training programs to develop posterior shoulder endurance and prolong the onset of muscular fatigue.

Exploring the role of the left DLPFC in fatigue during unresisted rhythmic movements

Understanding central fatigue during motor activities is important in neuroscience and different medical fields. The central mechanisms of motor fatigue are known in depth for isometric muscle contractions; however, current knowledge about rhythmic movements and central fatigue is rather scarce. In this study, we explored the role of an executive area (left dorsolateral prefrontal cortex [DLPFC]) in fatigue development during rhythmic movement execution, finger tapping (FT) at the maximal rate, and fatigue after effects on the stability of rhythmic patterns. Participants (n = 19) performed six sets of unresisted FT (with a 3 min rest in‐between). Each set included four interleaved 30 s repetitions of self‐selected (two repetitions) and maximal rate FT (two repetitions) without rest in‐between. Left DLPFC involvement in the task was perturbed by transcranial static magnetic stimulation (tSMS) in two sessions (one real and one sham). Moreover, half of the self‐selected FT repetitions were performed concurrently with a demanding cognitive task, the Stroop test. Compared with sham stimulation, real tSMS stimulation prevented waning in tapping frequency at the maximal rate without affecting perceived levels of fatigue. Participants' engagement in the Stroop test just prior to maximal FT reduced the movement amplitude during this mode of execution. Movement variability at self‐selected rates increased during Stroop execution, especially under fatigue previously induced by maximal FT. Our results indicate cognitive‐motor interactions and a prominent role of the prefrontal cortex in fatigue and the motor control of simple repetitive movement patterns. We suggest the need to approach motor fatigue including cognitive perspectives.

We show the fundamental role of executive areas in fatigue caused by very simple repetitive movements. Fatigue developed less during the maximal frequency of movement production, while the left DLPFC received magnetic stimulation (in right‐handers). The role of cognitive‐motor interaction in fine motor control was also clear when participants engaged in cognitive tasks. At the clinical level, our work reinforces the need to treat fatigue from a comprehensive perspective.

The effect of low back pain on neuromuscular control in cyclists

This study was designed to identify neuromuscular adaptations of low back pain (LBP) cyclists , and the impact of a cycling effort on spinal shrinkage. Forty-eight trained cyclists rode their road bike on a smart trainer for 1-hour. Surface electromyography (EMG) recorded muscle activity of the lumbar erector spinae (LES), 3D motion analysis system recorded kinematic of the trunk, and stadiometry measured spinal height. Statistical comparisons were made using repeated measure ANOVAs. The LBP group presented increase in pain levels throughout the effort (p < 0.001). A significant group difference was only observed for the thoracic angle (p = 0.03), which was less flexed for LBP. The one-hour cycling effort (time effect) significantly increased the trunk flexion (p < 0.001) and thoracic flexion (p < 0.001) for both groups. Significant lower LES activation (35% less) was observed at the end of the effort  as well as a decrease in spinal height (p = 0.01) for both groups. Neuromuscular adaptations to cycling effort is identified by a decrease in LES EMG amplitude and an increase flexion of the trunk. Adaptation to pain is seen by an increase in thoracic flexion. Despite these adaptations, LBP cyclists could not ride their bike pain-free.

Effects of a 6-Min Treadmill Walking Test on Dual-Task Gait Performance and Prefrontal Hemodynamics in People With Multiple Sclerosis

Fatigue is one of the most limiting symptoms in people with multiple sclerosis (pwMS) and can be subdivided into trait and state fatigue. Activity-induced state fatigue describes the temporary decline in motor and/or cognitive performance (motor and cognitive performance fatigability, respectively) and/or the increase in the perception of fatigue (perceived fatigability) in response to motor or cognitive tasks. To the best of our knowledge, the effects of a 6-min walk test (6MWT), which was often used to assess motor performance fatigability in pwMS, on motor-cognitive dual-task performance (i.e., walking + arithmetic task) and prefrontal cortex (PFC) hemodynamics are not well-known. This is of importance, since daily activities are often performed as multitasks and a worse dual-task walking performance is associated with an increased risk of falling. Consequently, we investigated the effect of a fast 6MWT (comfort velocity + 15%) performed on a treadmill on motor-cognitive performance fatigability (spatio-temporal gait parameters/accuracy during the arithmetic task) and perceived fatigability measures (rating of perceived exhaustion; RPE) as well as PFC hemodynamics recorded during dual-task walking in pwMS and healthy controls (HCs). Twenty pwMS (48.3 ± 9.0 years; 13 females/7 males; expanded disability status scale 2.7 ± 1.0, first diagnosis 13.8 ± 8.8 years) and 24 HC with similar age and sex (48.6 ± 7.9 years; 17 females/7 males) were included. Only cognitive performance fatigability (increased error rate) during dual-task walking was found after the fast 6MWT on the treadmill in pwMS. However, the changes in gait parameters did not indicate motor performance fatigability, although both the groups reported perceived fatigability (increased RPE) after the fast 6MWT. Moreover, no change in the PFC activation was detected in both groups. Our results suggest that the intensity and/or duration of the fast 6MWT was not sufficient to induce motor performance fatigability in pwMS. These factors should be addressed by future studies on this topic, which should also consider further parameters, e.g., muscular oxygenation and/or myoelectrical activity, to verify that exercise intensity and/or duration was appropriate to induce motor performance fatigability in pwMS.

Acute Effects of Different Intensities during Bench Press Exercise on the Mechanical Properties of Triceps Brachii Long Head

This study aimed to analyze acute changes in the muscle mechanical properties of the triceps brachii long head after bench press exercise performed at different external loads and with different intensities of effort along with power performance. Ten resistance-trained males (age: 27.7 ± 3.7 yr, body mass: 90.1 ± 17.1 kg, height: 184 ± 4 cm; experience in resistance training: 5.8 ± 2.6 yr, relative one-repetition maximum (1RM) in the bench press: 1.23 ± 0.22 kg/body mass) performed two different testing conditions in a randomized order. During the experimental session, participants performed four successive sets of two repetitions of the bench press exercise at: 50, 70, and 90% 1RM, respectively, followed by a set at 70% 1RM performed until failure, with a 4 min rest interval between each set. Immediately before and after each set, muscle mechanical properties of the dominant limb triceps brachii long head were assessed via a Myoton device. To determine fatigue, peak and average barbell velocity were measured at 70% 1RM and at 70% 1RM until failure (only first and second repetition). In the control condition, only muscle mechanical properties at the same time points after the warm-up were assessed. The intraclass correlation coefficients indicated “poor” to “excellent” reliability for decrement, relaxation time, and creep. Therefore, these variables were excluded from further analysis. Three-way ANOVAs (2 groups × 2 times × 4 loads) indicated a statistically significant group × time interaction for muscle tone (p = 0.008). Post hoc tests revealed a statistically significant increase in muscle tone after 70% 1RM (p = 0.034; ES = 0.32) and 90% 1RM (p = 0.011; ES = 0.56). No significant changes were found for stiffness. The t-tests indicated a significant decrease in peak (p = 0.001; ES = 1.02) and average barbell velocity (p = 0.008; ES = 0.8) during the first two repetitions of a set at 70% 1RM until failure in comparison to the set at 70% 1RM. The results indicate that low-volume, high-load resistance exercise immediately increases muscle tone but not stiffness. Despite no significant changes in the mechanical properties of the muscle being registered simultaneously with a decrease in barbell velocity, there was a trend of increased muscle tone. Therefore, further studies with larger samples are required to verify whether muscle tone could be a sensitive marker to detect acute muscle fatigue.

Surface Electromyography Thresholds as a Measure for Performance Fatigability During Incremental Cycling in Patients With Neuromuscular Disorders

In healthy persons, there is an excellent relation between the timing of the (two) surface electromyography (sEMG) thresholds and the (two) ventilatory thresholds during exercise. The primary aim of this study was to determine the relative timing of both sEMG and ventilatory thresholds in patients with neuromuscular disorders compared with healthy subjects during a maximal ergospirometry cycling test. We hypothesized that in patients with neuromuscular disorders, the sEMG thresholds would occur relatively earlier in time than the ventilatory thresholds, compared to healthy subjects, because performance fatigability occurs more rapidly. In total, 24 healthy controls and 32 patients with a neuromuscular disorder performed a cardiopulmonary exercise test on a bicycle using a 10-min ramp protocol, during which we collected ergospirometry data: power at both ventilatory and sEMG thresholds, and sEMG data of lower leg muscles. In line with our hypothesis, normalized values for all thresholds were lower for patients than healthy subjects. These differences were significant for the first ventilatory (p = 0.008) and sEMG threshold (p &lt; 0.001) but not for the second sEMG (p = 0.053) and ventilatory threshold (p = 0.238). Most parameters for test–retest reliability of all thresholds did not show any fixed bias, except for the second ventilatory threshold. The feasibility of the sEMG thresholds was lower than the ventilatory thresholds, particularly of the first sEMG threshold. As expected, the sEMG thresholds, particularly the first threshold, occurred relatively earlier in time than the ventilatory thresholds in patients compared with healthy subjects. A possible explanation could be (a combination of) a difference in fiber type composition, disuse, and limited muscle-specific force in patients with neuromuscular disorders. sEMG measurements during submaximal dynamic exercises are needed to generalize the measurements to daily life activities for future use in prescribing and evaluating rehabilitation interventions.

Three Simulated Goalball Games in the Same Day Cause Central Fatigue and Can Impair Game Technical Performance

The purpose of this study was to investigate the effects of three simulated goalball games on neuromuscular, physiological, perceptual, and technical parameters. Ten male players underwent assessments before and immediately after each game. Heart rate was recorded at rest and during all games that were entirely filmed for further technical performance analysis. Exercise significantly decreased knee extensor muscles peak force and percentage of voluntary activation after the second and third games, indicating the presence of central fatigue. Heart rate responses remained predominantly in a range equivalent to moderate activity intensity in all games. In addition, perceptual parameters were associated with reduced frequency of throws and density of actions. These findings suggest significant implications for the management of physical training, game strategy during a competition, and fixture change from three to two games per day.

The effect of prolonged walking on muscle fatigue and neuromuscular control in children with cerebral palsy

BACKGROUND

Muscle fatigue of the lower limbs is considered a main contributor to the perceived fatigue in children with cerebral palsy (CP) and is expected to occur during prolonged walking. In adults without disabilities, muscle fatigue has been proposed to be associated with adaptations in complexity of neuromuscular control.

RESEARCH QUESTION

What are the effects of prolonged walking on signs of muscle fatigue and complexity of neuromuscular control in children with CP?

METHODS

Ten children with CP and fifteen typically developing (TD) children performed a standardised protocol on an instrumented treadmill consisting of three stages: six-minutes walking at preferred speed (6 MW), moderate-intensity walking (MIW, with two minutes at heart rate > 70% of predicted maximal heart rate) and four-minutes walking at preferred speed (post-MIW). Electromyography (EMG) data were analysed for eight muscles of one leg during three time periods: 6 MW-start, 6 MW-end and post-MIW. Signs of muscle fatigue were quantified as changes in EMG median frequency and EMG root mean square (RMS). Complexity of neuromuscular control was quantified by total variance accounted for by one synergy (tVAF1). Muscle coactivation was assessed for antagonistic muscle pairs.

RESULTS

EMG median frequency was decreased at 6 MW-end and post-MIW compared to 6 MW-start in children with CP (p < 0.05), but not in TD children. In both groups, EMG-RMS (p < 0.01) and muscle coactivation (p < 0.01) were decreased at 6 MW-end and post-MIW compared to 6 MW-start. tVAF1 decreased slightly at 6 MW-end and post-MIW compared to 6 MW-start in both groups (p < 0.05). Changes were most pronounced from 6 MW-start to 6 MW-end.

SIGNIFICANCE

Children with CP presented signs of muscle fatigue after prolonged walking, while no effects were found for TD. Both groups showed minimal changes in tVAF1, suggesting signs of muscle fatigue are not associated with changes in complexity of neuromuscular control.

Exploring Localized Muscle Fatigue Responses at Current Upper-Extremity Ergonomics Threshold Limit Values

OBJECTIVE

The purpose of this study was to evaluate localized muscle fatigue responses at three upper-extremity ergonomics threshold limit value (TLV) duty cycles.

BACKGROUND

Recently, a TLV equation was published to help mitigate excessive development of localized muscle fatigue in repetitive upper limb tasks. This equation predicts acceptable levels of maximal voluntary contraction (% MVC) for a given duty cycle (DC). Experimental validation of this TLV curve has not yet been reported, which can help guide utilization by practitioners.

METHOD

Eighteen participants performed intermittent isometric elbow flexion efforts, in three separate counter-balanced sessions, at workloads defined by the American Conference of Governmental Industrial Hygenists' (ACGIH) TLV equation: low DC (20% DC, 29.6% MVC), medium DC (40% DC, 19.7% MVC), and high DC (60% DC, 13.9% MVC). Targeted localized muscle fatigue (LMF) of the biceps brachii was tracked across numerous response variables, including decline in strength (MVC), electromyography (EMG) amplitude and mean power frequency (MnPF), and several psychophysical ratings.

RESULTS

At task completion, biceps MnPF and MVC (strength) were significantly different between each TLV workload, with the high DC condition eliciting the largest declines in MnPF and MVC.

CONCLUSION

Findings demonstrate that working at different DCs along the ACGIH TLV curve may not be equivalent in preventing excessive LMF. Higher DC workloads elicited a greater LMF response across several response variables.

APPLICATION

High DC work of the upper extremity should be avoided to mitigate excess LMF development. Current TLVs for repetitive upper-extremity work may overestimate acceptable relative contraction thresholds, particularly at higher duty cycles.

Toward the Personalization of Biceps Fatigue Detection Model for Gym Activity: An Approach to Utilize Wearables' Data from the Crowd

Nowadays, wearables-based Human Activity Recognition (HAR) systems represent a modern, robust, and lightweight solution to monitor athlete performance. However, user data variability is a problem that may hinder the performance of HAR systems, especially the cross-subject HAR models. Such a problem may have a lesser effect on the subject-specific model because it is a tailored model that serves a specific user; hence, data variability is usually low, and performance is often high. However, such a performance comes with a high cost in data collection and processing per user. Therefore, in this work, we present a personalized model that achieves higher performance than the cross-subject model while maintaining a lower data cost than the subject-specific model. Our personalization approach sources data from the crowd based on similarity scores computed between the test subject and the individuals in the crowd. Our dataset consists of 3750 concentration curl repetitions from 25 volunteers with ages and BMI ranging between 20-46 and 24-46, respectively. We compute 11 hand-crafted features and train 2 personalized AdaBoost models, Decision Tree (AdaBoost-DT) and Artificial Neural Networks (AdaBoost-ANN), using data from whom the test subject shares similar physical and single traits. Our findings show that the AdaBoost-DT model outperforms the cross-subject-DT model by 5.89%, while the AdaBoost-ANN model outperforms the cross-subject-ANN model by 3.38%. On the other hand, at 50.0% less of the test subject's data consumption, our AdaBoost-DT model outperforms the subject-specific-DT model by 16%, while the AdaBoost-ANN model outperforms the subject-specific-ANN model by 10.33%. Yet, the subject-specific models achieve the best performances at 100% of the test subjects' data consumption.

The Effects of Passive Simulated Jogging on Parameters of Explosive Handgrip in Nondiabetics and Type 2 Diabetics: A Single Arm Study

Aims

Type 2 diabetes (T2D) is associated with sarcopenia and decreased muscle strength. Explosive and isometric voluntary handgrip strengths (EHGS and HGS) are frequently utilized methods to ascertain health status and a marker of overall muscle strength. We have previously shown that a portable, motorized device, which produces effortless, rapid stepping in place (passive simulated jogging device (JD)), improves glucose homeostasis. This study quantitatively evaluated the effects of JD in modifying parameters of the modified EHGS curve in T2D and nondiabetic (ND) subjects.

Methods

Twenty-one adult participants (11 ND and 10 T2D) (mean age: 41.3 ± 13.5 yr) performed a modified explosive handgrip strength (EHGS) test on study day 1 followed by daily use of JD (90 min per day) for 7 days. The EHGS was repeated after 3 and 7 days' use of JD (JD3 and JD7) and 3 days after completion of JD (Carryover). EHGS curves were analyzed for the following: maximal peak force value (MAX); rate of force development at 25%,75%, and 90% of maximum force; and maximum force (RFD_25%, RFD_75%, RFD_90%, and RFD_max); time to 90%, 75%, and 25% of maximal force (t₉₀, t₇₅, t₂₅) and time to maximal force (t_max); and the integrated area under the curve for force vs. time until task failure (iAUC_TF); and fatigue resistance times at 50% and 25% of maximal force (FR₅₀ and FR25) and fatigue resistance time to task failure (FR_TF).

Results

At baseline, T2D had lower MAX compared to ND. There were no differences at baseline for force development time or fatigue resistance time between T2D and ND. In both T2D and ND, 7 days of JD increased FR₂₅ and FR_TF and iAUC_TF compared to baseline.

Conclusion

JD for at least 7 days prior to EHGS increased time to task failure (fatigue resistance) and iAUC_TF of the force-time curve. JD is a reasonable intervention to decrease sedentary behavior and improve muscle fatigue resistance under various clinical and nonclinical scenarios. This trial is registered with NCT03550105 (08-06-2018).

A comprehensive review of ethnopharmacology, phytochemistry, pharmacology, and pharmacokinetics of Schisandra chinensis (Turcz.) Baill. and Schisandra sphenanthera Rehd. et Wils

ETHNOPHARMACOLOGICAL RELEVANCE

Schisandra chinensis (called bei-wuweizi in Chinese, S. chinensis) and Schisandra sphenanthera (called nan-wuweizi in Chinese, S. sphenanthera) are two highly similar plants in the Magnoliaceae family. Their dried ripe fruits are commonly used as traditional Chinese medicine in the treatment of coughs, palpitation, spermatorrhea, and insomnia. They also are traditionally used as tonics in Russia, Japan, and Korea.

AIM OF THE REVIEW

S. chinensis and S. sphenanthera are similar in appearance, traditional applications, ingredient compositions, and therapeutic effects. This review, therefore, aims to provide a systematic insight into the botanical background, ethnopharmacology, phytochemistry, pharmacology, pharmacokinetics, quality control, and toxicology of S. chinensis and S. sphenanthera, and to explore and present the similarities and differences between S. chinensis and S. sphenanthera.

MATERIALS AND METHODS

A comprehensive literature search regarding S. chinensis and S. sphenanthera was collected by using electronic databases including PubMed, SciFinder, Science Direct, Web of Science, CNKI, and the online ethnobotanical database.

RESULTS

In the 2020 Edition of Chinese Pharmacopoeia (ChP), there were 100 prescriptions containing S. chinensis, while only 11 contained S. sphenanthera. Totally, 306 and 238 compounds have been isolated and identified from S. chinensis and S. sphenanthera, respectively. Among these compounds, lignans, triterpenoids, essential oils, phenolic acid, flavonoids, phytosterols are the major composition. Through investigation of pharmacological activities, S. chinensis and S. sphenanthera have similar therapeutic effects including hepatoprotection, neuroprotection, cardioprotection, anticancer, antioxidation, anti-inflammation, and hypoglycemic effect. Besides, S. chinensis turns out to have more effects including reproductive regulation and immunomodulatory, antimicrobial, antitussive and antiasthmatic, anti-fatigue, antiarthritic, and bone remodeling effects. Both S. chinensis and S. sphenanthera have inhibitory effects on CYP3A and P-gp, which can mediate metabolism or efflux of substrates, and therefore interact with many drugs.

CONCLUSIONS

S. chinensis and S. sphenanthera have great similarities. Dibenzocyclooctadiene lignans are regarded to contribute to most of the bioactivities. Schisandrin A-C, schisandrol A-B, and schisantherin A, existing in both S. chinensis and S. sphenanthera but differing in the amount, are the main active components, which may contribute to the similarities and differences. Study corresponding to the traditional use is needed to reveal the deep connotation of the use of S. chinensis and S. sphenanthera as traditional Chinese medicine. In addition, a joint study of S. chinensis and S. sphenanthera can better show the difference between them, which can provide a reference for clinical application. It is worth mentioning that the inhibition of S. chinensis and S. sphenanthera on CYP3A and P-gp may lead to undesirable drug-drug interactions.

Chronic Adaptations of Shoulder Muscle Synergies in Healthy Baseball Players

BACKGROUND

Previous research has demonstrated that muscle synergy structure can adapt owing to training and injury; however, muscle synergies have not been evaluated in baseball players.

HYPOTHESIS

The throwing arm would have a similar muscle synergy structure but different levels of individual muscle activity within each synergy, relative to the nonthrowing arm.

STUDY DESIGN

Cross-sectional study in a controlled laboratory setting.

METHODS

Fourteen healthy competitive baseball players were included. Participants were tested bilaterally during a center-out planar reaching task using the KINARM robot, where kinematic data and surface electromyography data from 14 glenohumeral and scapular muscles were synchronized. Principal component analysis was used to extract muscle synergies, the variance accounted for (VAF) of each synergy, and individual muscle coefficients. The dominant (DOM) arm was compared with the nondominant (NDOM) arm using paired t tests for all dependent variables.

RESULTS

The same number of muscle synergies were extracted on the DOM and NDOM arms, along with no differences in VAF. In the first synergy, the infraspinatus (DOM 0.798 vs NDOM 0.587, P = 0.038) and lower trapezius (DOM 0.872 vs NDOM 0.480, P = 0.005) muscle coefficients significantly increased on the DOM arm. The second synergy had a significantly increased anterior deltoid (DOM 0.764 vs NDOM 0.374, P = 0.003) and a significantly decreased posterior deltoid (DOM -0.069 vs NDOM 0.197, P = 0.041) muscle coefficient on the DOM arm.

CONCLUSION

The DOM shoulder exhibits a higher proportion of infraspinatus and lower trapezius muscle activation during the external rotation and abduction synergy. Also, the DOM shoulder has increased muscle activation of the teres major and latissimus dorsi during the internal rotation synergy, and increased muscle activation of the pectoralis major during the cross-body adduction synergy, compared with the NDOM shoulder.

CLINICAL RELEVANCE

By exploring these neuromuscular adaptations, the improved understanding of muscle synergy adaptations in baseball players will help optimize injury prevention and rehabilitation techniques.

Effects of Kinesio taping on forearm supination/pronation performance fatigability

Background

Repetitive exertion in supination/pronation could increase the risk of forearm diseases due to fatigue. Kinesio taping (KT) is a physical therapy technique that decreases muscle tone and musculoskeletal disorders (MSDs) risk. Many assumptions about taping have been made and several studies have considered the taping applications; however, the effect of KT on strength and fatigue of the forearm supination/pronation remains unclear. The purpose of this study was to evaluate the effect of KT on forearm performance fatigability.

Methods

A screwing test was constructed to measure the forearm force loss and screwing efficiency during repetitive supination/pronation. Data from 18 healthy adults who underwent both KT and no taping (NT) sessions were used to investigate the forearm strength change in terms of grip force (GF), driving torque (DT), and push force (PF). The maximal isometric forces before and after the screwing test and force decreasing rate (efficiency) during screwing were evaluated to assess the performance fatigability in KT and NT conditions.

Results

A statistically significant force loss (FL) in maximal isometric GF (p = 0.039) and maximal isometric DT (p = 0.044); however, no significant difference was observed in maximal isometric PF (p = 0.426) between NT and KT. KT provides greater screwing efficiency than NT.

Conclusions

KT could not improve FL in the maximal muscle strength of the forearm in healthy subjects. KT on the forearm was associated with a lesser decline in DT efficiency than NT, implying that KT could decrease the loss rate of muscle strength and delay the development of fatigue; however, the KT did not yield improvements in PF while performing screwing tasks.

Effects of unilateral and bilateral lower extremity fatiguing exercises on postural control during quiet stance and self-initiated perturbation

Postural control can be more difficult during muscle fatigue. Anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) are the two main postural strategies controlled by the central nervous system. Unchanged or early anticipatory onset together with altered activation magnitude during the APAs phase is observed in the trunk and thigh muscles following unilateral and bilateral fatiguing exercises. Thus far, no studies have compared the effect of such exercises on APAs and CPAs. This study compared the effects of these exercises performed at the same relative workload on center of pressure (COP)-based postural stability measures during quiet stance and electromyography (EMG)-based APAs and CPAs during self-initiated perturbation. Fifteen young male subjects completed the two separated fatiguing sessions; 50% of maximal voluntary contraction force obtained from the unilateral (dominant) and bilateral legs with five sets of 20 times lower limb exercise was respectively applied as unilateral and bilateral fatiguing protocols. Spatio-temporal COP parameters (sway velocity, total displacement, and envelope area) were used to evaluate postural stability, and spectral analysis was performed to estimate the distributions in COP power spectrum. EMG activities of transversus abdominis/internal oblique (TrA/IO) and lumbar multifidus (LMF) were recorded and analyzed during the APAs and CPAs phases. Increased sway velocity and total displacements occurred following both unilateral and bilateral fatiguing exercises; however, the envelope area was not affected. Further, early anticipatory onset of TrA/IO was found after bilateral than after unilateral fatiguing exercise. Co-activation index of the TrA/IO-LMF muscle pair during the CPAs phase increased following both fatiguing sessions. The results partly confirmed previously reported fatigue effects induced by unilateral and bilateral exercises on postural stability. It was observed that APAs onsets were altered differently following a unilateral or bilateral fatiguing exercise, whereas the alterations of CPAs were independent of fatigue conditions. Repetitive unilateral or bilateral fatiguing exercises in patients or athletes may differently alter the anticipatory component of postural control.

Analysis of the Stability of the Body in a Standing Position When Shooting at a Stationary Target-A Randomized Controlled Trial

Postural stability of the body depends on many factors. One of them is physical activity. It is especially important in the case of sports or professional work, which combine mobility with the accuracy of a shot in a standing position. The smaller the body fatigue, the more accurate the shot. The aim of the study was the assessment of the impact of physical effort on the center of gravity deflection and length of the COP (center of pressure) path, as well as the reaction of ground forces in people who do not engage in systematic physical activity. The study group included 139 people (23.1 ± 5.2 yr; M: 46.8%; F: 53.2%). The test consisted of performing a static test twice, shooting at the target in a multimedia shooting range. Group X performed the Harvard test between the static tests. Group Y made no effort. The reaction parameters of the ground forces were assessed using the Zebris PDM-L Platform. In Group X performing the Harvard test, an increase in the average COP, VCOP, and 95% confidence ellipse area was noted. The path length and the average velocity of COP speed increased. There were no differences in Group Y (p > 0.05). Physical effort significantly affected the postural stability of the studied people, increasing the average parameters assessing balance when adopting static firing position.

Shoulder electromyography-based indicators to assess manifestation of muscle fatigue during laboratory-simulated manual handling task

Muscle fatigue is a risk factor for developing shoulder musculoskeletal disorders. The aim of this study was to identify shoulder electromyographic indicators that are most indicative of muscle fatigue during a laboratory simulated manual handling task. Thirty-two participants were equipped with electromyographic electrodes on 10 shoulder muscles and moved boxes for 45-minutes. The modified rate of perceived exertion (mRPE) was assessed every 5-minutes and multivariate linear regressions were performed between myoelectric manifestation of fatigue (MMF) and the mRPE scores. During a manual handling task representative of industry working conditions, spectral entropy, median frequency, and mobility were the electromyographic indicators that explained the largest percentage of the mRPE. Overall, the deltoids, biceps and upper trapezius were the muscles that most often showed significant changes over time in their electromyographic indicators. The combination of these three indicators may improve the accuracy for the assessment of MMF during manual handling. Practitioner Summary: To date, muscle fatigue has primarily been assessed during tasks done to exhaustion, which are not representative of typical working conditions. During a manual handling task representative of industry working conditions, EMG-derived spectral entropy, and median frequency, both extracted from time-frequency analysis, and mobility extracted from time domain, were the best indicators of the manifestation of muscle fatigue.

Do age and work pace affect variability when performing a repetitive light assembly task?

This study examined whether a repetitive light assembly task could be performed according to different movement sequences identified as ways of doing (WoD), and whether the age of the participants or the work pace affected the number of WoDs selected by each participant, or the kinematic parameters for each WoDs. For two work paces, 62 right-handed men in 3 age-groups were asked to fix a handle on a base with 2 nuts without discontinuity for a period of 20 min; no assembly procedure was demonstrated. The WoDs were characterized by a cross tabulation video coding method, and by measuring vertical force applied and the parameters of upper limb kinematics, as well as these measures' approximate entropy (ApEN). Five main different WoDs were used. Although most participants varied their WoD, neither participant age nor work pace affected the number of WoD they used. However, the WoDs differed from each other by the sequence of movements and by the level of ApEn of their kinematic variables without interfering with the production rate. Allowing operators to vary their WoDs when performing repetitive tasks could reduce strain on the locomotor system.

Physiological Demands and Muscle Activity of “Track-Work” Riding in Apprentice Jockeys

Purpose: To enhance performance in race riding, knowledge of current training workload is required. The objectives of this study were to quantify the physiological demands and profile the muscle activity of jockeys riding track-work. Methods: Ten apprentice jockeys and 48 horses were instrumented with heart-rate monitors, accelerometers, and a surface electromyography BodySuit (recording 8 muscle groups: quadriceps, hamstrings, gluteal, lower back, obliques, abdominal, trapezial, and pectoral) that recorded continuously while riding their normal morning track-work. Data were extracted and time matched into 200-m sections for analysis once the jockey reached steady-state canter (6.9 m·s−1). Results: Jockeys rode a mean (±SD) of 6 (1) horses each morning over 2.5 hours, spending ∼30 minutes at a canter (8.8  [ 0.7] m·s−1), with mean heart rate of 129 (11) beats·min–1 and ratings of perceived exertion representing easy-/moderate-intensity exercise. Mean magnitude of horse (0.17 [0.01] m) and jockey center of mass (0.16 [0.02] m) displacement per stride differed from that of the jockey’s head (0.11 [0.01] m, P < .05). The majority of horse oscillation was damped in the upper body with a 3-fold reduction in the medio/lateral and fore/aft planes (P < .05), to minimize jockey head movement. Lower-body muscles absorbed horse motion, with core and upper-body muscles important for postural stabilization. Conclusions: The physiological demands of riding track-work were low, with no evidence of fatigue. Future research on jockeys in races as comparison would identify the specific requirements of a jockey-specific physical conditioning program.

Predictive Analytic Techniques to Identify Hidden Relationships between Training Load, Fatigue and Muscle Strains in Young Soccer Players

This study aimed to analyze different predictive analytic techniques to forecast the risk of muscle strain injuries (MSI) in youth soccer based on training load data. Twenty-two young soccer players (age: 13.5 ± 0.3 years) were recruited, and an injury surveillance system was applied to record all MSI during the season. Anthropometric data, predicted age at peak height velocity, and skeletal age were collected. The session-RPE method was daily employed to quantify internal training/match load, and monotony, strain, and cumulative load over the weeks were calculated. A countermovement jump (CMJ) test was submitted before and after each training/match to quantify players' neuromuscular fatigue. All these data were used to predict the risk of MSI through different data mining models: Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM). Among them, SVM showed the best predictive ability (area under the curve = 0.84 ± 0.05). Then, Decision tree (DT) algorithm was employed to understand the interactions identified by the SVM model. The rules extracted by DT revealed how the risk of injury could change according to players' maturity status, neuromuscular fatigue, anthropometric factors, higher workloads, and low recovery status. This approach allowed to identify MSI and the underlying risk factors.

Muscle Fatigue Revisited – Insights From Optically Pumped Magnetometers

So far, surface electromyography (sEMG) has been the method of choice to detect and evaluate muscle fatigue. However, recent advancements in non-cryogenic quantum sensors, such as optically pumped magnetometers (OPMs), enable interesting possibilities to flexibly record biomagnetic signals. Yet, a magnetomyographic investigation of muscular fatigue is still missing. Here, we simultaneously used sEMG (4 surface electrode) and OPM-based magnetomyography (OPM-MMG, 4 sensors) to detect muscle fatigue during a 3 × 1-min isometric contractions of the left rectus femoris muscle in 7 healthy participants. Both signals exhibited the characteristic spectral compression distinctive for muscle fatigue. OPM-MMG and sEMG slope values, used to quantify the spectral compression of the signals, were positively correlated, displaying similarity between the techniques. Additionally, the analysis of the different components of the magnetic field vector enabled speculations regarding the propagation of the muscle action potentials (MAPs). Altogether these results show the feasibility of the magnetomyographic approach with OPMs and propose a potential alternative to sEMG for the study of muscle fatigue.

Influence of muscle fatigue on motor task performance of the hand and wrist: A systematic review

Muscle fatigue is represented as a reduction in force production capability; however, fatigue does not necessarily result in performance impairments. As the distal upper limb serves as the end effector when interacting or manipulating objects, it is important to understand how muscle fatigue may impact motor functionality. The aim of this study was to systematically review the literature to identify how various aspects of motor performance of the distal upper limb are impaired following muscle fatigue. Four databases were searched using 23 search terms describing the distal upper limb, muscle fatigue, and various performance metrics. A total of 4561 articles were screened with a total of 28 articles extracted and critically appraised. Evidence extracted indicates that muscle fatigue results in unique impairments based on the type of motor performance being evaluated. Furthermore, much data suggests that muscle fatigue does not result in consistent, predictable performance impairments, particularly while performing submaximal tasks. Additionally, magnitude of fatigue does not directly correlate with reductions in performance outcomes at the hand and wrist. Fatiguing protocols used highlighted the importance of fatigue specificity. When fatiguing and performance tasks are similar, performance impairment is likely to be observed. The numerous muscles found in the hand and wrist, often considered redundant, play a critical role in maintaining task performance in the presence of muscle fatigue. The presence of motor abundance (e.g. multiple muscles with similar function) is shown to reduce the impairment in multiple performance metrics by compensating for reduced function of fatigued muscles. Continued exploration into various fatiguing protocols (i.e. maximal or submaximal) will provide greater insights into performance impairments in the distal upper limb.

A Methodological Framework to Capture Neuromuscular Fatigue Mechanisms Under Stress

Neuromuscular fatigue is exacerbated under stress and is characterized by shorter endurance time, greater perceived effort, lower force steadiness, and higher electromyographic activity. However, the underlying mechanisms of fatigue under stress are not well-understood. This review investigated existing methods of identifying central mechanisms of neuromuscular fatigue and the potential mechanisms of the influence of stress on neuromuscular fatigue. We found that the influence of stress on the activity of the prefrontal cortex, which are also involved in exercise regulation, may contribute to exacerbated fatigue under stress. We also found that the traditional methods involve the synchronized use of transcranial magnetic stimulation, peripheral nerve stimulation, and electromyography to identify the contribution of supraspinal fatigue, through measures such as voluntary activation, motor evoked potential, and silent period. However, these popular techniques are unable to provide information about neural alterations upstream of the descending drive that may contribute to supraspinal fatigue development. To address this gap, we propose that functional brain imaging techniques, which provide insights on activation and information flow between brain regions, need to be combined with the traditional measures of measuring central fatigue to fully understand the mechanisms behind the influence of stress on fatigue.

Evaluation of Lower Limb Muscle Electromyographic Activity during 400 m Indoor Sprinting among Elite Female Athletes: A Cross-Sectional Study

The purpose of this cross-sectional study was to analyze changes in normalized surface electromyography (sEMG) signals for the gastrocnemius medialis, biceps femoris, gluteus maximus, tibialis anterior, and vastus lateralis muscles occurring during a 400 m indoor sprint between subsequent curved sections of the track. Ten well-trained female sprinters (age: 21 ± 4 years; body mass: 47 ± 5 kg; body height: 161 ± 7 cm; 400 m personal best: 52.4 ± 1.1 s) performed an all-out 400 m indoor sprint. Normalized sEMG signals were recorded bilaterally from the selected lower limb muscles. The two-way ANOVA (curve × side) revealed no statistically significant interaction. However, the main effect analysis showed that normalized sEMG signals significantly increased in subsequent curves run for all the studied muscles: gastrocnemius medialis (p = 0.003), biceps femoris (p < 0.0001), gluteus maximus (p = 0.044), tibialis anterior (p = 0.001), and vastus lateralis (p = 0.023), but differences between limbs were significant only for the gastrocnemius medialis (p = 0.012). The results suggest that the normalized sEMG signals for the lower limb muscles increased in successive curves during the 400 m indoor sprint. Moreover, the gastrocnemius medialis of the inner leg is highly activated while running curves; therefore, it should be properly prepared for high demands, and attention should be paid to the possibility of the occurrence of a negative adaptation, such as asymmetries.

Comparison of Muscle Activity During 200 m Indoor Curve and Straight Sprinting in Elite Female Sprinters

The purpose of this study was to assess whether peak surface electromyography (sEMG) amplitude of selected lower limb muscles differed during a) curve and straight sprinting, b) sprinting in inside and outside lanes between lower limbs. Eleven well-trained female sprinters (personal best: 24.1 ± 1.1 s) were included in a randomized within-subject design study, in which participants underwent two experimental conditions: all-out 200 m indoor sprints in the innermost and outermost lane. Peak sEMG amplitude was recorded bilaterally from gastrocnemius medialis, biceps femoris, gluteus maximus, tibialis anterior, and vastus lateralis muscles. Left gastrocnemius medialis peak sEMG amplitude was significantly higher than for the right leg muscle during curve (p = 0.011) and straight sprinting (p < 0.001) when sprinting in the inside lane, and also significantly higher when sprinting in the inside vs. outside lane for both curve and straight sprinting (p = 0.037 and p = 0.027, respectively). Moreover, left biceps femoris peak sEMG amplitude was significantly higher during straight sprinting in the inside vs. outside lane (p = 0.006). Furthermore, right and left vastus lateralis peak sEMG amplitude was significantly higher during curve sprinting in the inside lane (p = 0.001 and p = 0.004, respectively) and for the left leg muscle peak sEMG amplitude was significantly higher during curve compared to straight sprinting in the outside lane (p = 0.024). Results indicate that curve sprinting creates greater demands mainly for the gastrocnemius medialis of the inner than the outer leg, but the degree of these requirements seems to depend on the radius of the curve, thus significant changes were noted during sprinting in the inside lane, but not in the outside lane.

The Reliability of Potential Fatigue-Monitoring Measures in Elite Youth Soccer Players

ABSTRACT

Fitzpatrick, JF, Hicks, KM, Russell, M, and Hayes, PR. The reliability of potential fatigue-monitoring measures in elite youth soccer players. J Strength Cond Res 35(12): 3448-3452, 2021-Monitoring fatigue is of vital importance to practitioners; however, logistics and concerns about reliability may impede the use of certain measures. This study aimed to quantify the reliability of potential measures of fatigue; a subjective wellness questionnaire, jump performance tests, and tri-axial accelerometer variables derived during submaximal shuttle running in elite youth soccer players. A secondary aim was to establish the minimum test duration that could be used for the submaximal shuttle run while maintaining good reliability. Seventeen male youth team players (age: 17.4 ± 0.5 years) were assessed on 2 occasions, spaced 7 days apart. Typical error, coefficient of variation (CV%), interclass correlation (ICC), and minimum detectable change were calculated for a subjective wellness questionnaire, countermovement jump (CMJ), squat jump (SJ) and drop jump contact time (DJ-CT), drop jump height (DJ-JH), and reactive strength (DJ-RSI). A novel submaximal shuttle running test was also used to assess tri-axial accelerometer data reliability. Results suggest that CMJ, SJ, DJ-CT, and DJ-RSI have good test-retest reliability (CV% = 4.5-7.7; ICC = 0.80-0.88); however DJ-JH did not show acceptable reliability (CV% = 6.0; ICC = 0.76). Good reliability was found for all tri-axial accelerometer variables during a 3-minute (2-minute analysis) submaximal shuttle run (CV% = 2.4-8.0; ICC = 0.81-0.95), except for % PlayerLoad anterior-posterior (%PLAP) (CV% = 7.2; ICC = 0.63). The subjective wellness questionnaire demonstrated poor reliability for all items (CV% = 11.2-30.0; ICC = 0.00-0.78). The findings from this study provide practitioners with valuable information about the reliability of a range of potential fatigue-monitoring measures. This can be used to help make accurate decisions about the magnitude of change in these assessments when used in practice.

Retentive capacity of power output and linear versus non-linear mapping of power loss in the isotonic muscular endurance test

The limit of dynamic endurance during repetitive contractions has been referred to as the point of muscle fatigue, which can be measured by mechanical and electrophysiological parameters combined with subjective estimates of load tolerance for revealing the human real-world capacity required to work continuously. In this study, an isotonic muscular endurance (IME) testing protocol under a psychophysiological fatigue criterion was developed for measuring the retentive capacity of the power output of lower limb muscles. Additionally, to guide the development of electrophysiological evaluation methods, linear and non-linear techniques for creating surface electromyography (sEMG) models were compared in terms of their ability to estimate muscle fatigue. Forty healthy college-aged males performed three trials of an isometric peak torque test and one trial of an IME test for the plantar flexors and knee and hip extensors. Meanwhile, sEMG activity was recorded from the medial gastrocnemius, lateral gastrocnemius, vastus medialis, rectus femoris, vastus lateralis, gluteus maximus, and biceps femoris of the right leg muscles. Linear techniques (amplitude-based parameters, spectral parameters, and instantaneous frequency parameters) and non-linear techniques (a multi-layer perception neural network) were used to predict the time-dependent power output during dynamic contractions. Two mechanical manifestations of muscle fatigue were observed in the IME tests, including power output reduction between the beginning and end of the test and time-dependent progressive power loss. Compared with linear mapping (linear regression) alone or a combination of sEMG variables, non-linear mapping of power loss during dynamic contractions showed significantly higher signal-to-noise ratios and correlation coefficients between the actual and estimated power output. Muscular endurance required in real-world activities can be measured by considering the amount of work produced or the activity duration via the recommended IME testing protocol under a psychophysiological termination criterion. Non-linear mapping techniques provide more powerful mapping of power loss compared with linear mapping in the IME testing protocol.

Influence of central and peripheral motor unit properties on isometric muscle force entropy: A computer simulation study

Approximate entropy of isometric force is a popular measure to characterize behavioral changes across muscle contraction conditions. The degree to which force entropy characterizes the randomness of the motor control strategy, however, is not known. In this study, we used a computational model to investigate the correlation between approximate entropy of the synaptic input to a motor neuron pool, the neural drive to muscle (cumulative spike train; CST), and the force. This comparison was made across several simulation conditions, that included different synaptic command signal bandwidths, motor neuron pool sizes, and muscle contractile properties. The results indicated that although force entropy to some degree reflects the entropy of the synaptic command to motor neurons, it is biased by changes in motor unit properties. As a consequence, there was a low correlation between approximate entropy of force and the motor neuron input signal across all simulation conditions (r² = 0.13). Therefore, force entropy should only be used to compare motor control strategies across conditions where motor neuron properties can be assumed to be maintained. Instead, we recommend that the entropy of the descending motor commands should be estimated from CSTs comprising spike trains of multiple motor units.

Effect of Neck Muscle Fatigue on Hand Muscle Motor Performance and Early Somatosensory Evoked Potentials

Even on pain free days, recurrent neck pain alters sensorimotor integration (SMI) measured via somatosensory evoked potentials (SEPs). Neck muscle fatigue decreases upper limb proprioception, and thus may interfere with upper limb motor task acquisition and SMI. This study aimed to determine the effect of cervical extensor muscle (CEM) fatigue on upper limb motor acquisition and retention; and SMI, measured via early SEPs. Twenty-four healthy right-handed individuals were randomly assigned to control or CEM fatigue. Baseline SEPs were elicited via median nerve stimulation at the wrist. Participants then lay prone on a padded table. The fatigue group supported a 2 kg weight until they could no longer maintain the position. The control group rested their neck in neutral for 5 min. Participants completed pre- and post-motor skill acquisition while seated, SEPs were again collected. Task retention was measured 24 h later. Accuracy improved post acquisition and at retention for both groups (p < 0.001), with controls outperforming the fatigue group (p < 0.05). The fatigue group had significantly greater increases in the N24 (p = 0.017) and N30 (p = 0.007) SEP peaks. CEM fatigue impaired upper limb motor learning outcomes in conjunction with differential changes in SEP peak amplitudes related to SMI.

Effect of Vibration Massage and Passive Rest on Recovery of Muscle Strength after Short-Term Exercise

Background: The aim of the study was to compare the effect of vibration massage and passive rest on accelerating the process of muscle recovery after short-term intense exercise. Methods: Eighty-four healthy men aged 20 to 25 years participated in the study. Study participants performed isometric (ISO-M Group) and auxotonic (AUX-M group) contraction exercise in the lower limbs. Vibration massage was administered after exercise in the first recovery period. In the same period, controls rested passively, without the support of vibration massage. To assess the effectiveness of the applied vibration, a 4-fold measurement of the maximum force of the muscles involved in the exercise was performed under conditions of isometric contractions on a leg press machine set at an angle of 45° degrees upwards. Results: Differences in maximum strength during isometric contraction were found compared to baseline in favor of the groups subjected to the experimental vibration massage. Differences were demonstrated in muscle strength between the study groups (p < 0.005). The second period of passive rest in all groups did not bring significant changes in the values of maximal lower limb strength. Conclusions: Properly selected characteristics of the vibration effect can be an effective method in accelerating recovery and regaining lost motor capabilities of muscle groups fatigued by exercise. This offers the potential to shorten rest periods between sets of repetitions in training or between training units.

Establishing Task-Relevant MVC Protocols for Modelling Sustained Isometric Force Variability: A Manual Control Study

The present study examined how prevalent methods for determining maximal voluntary contraction (MVC) impact the experimentally derived functions of graded force-force variability. Thirty-two young healthy subjects performed continuous isometric force tracking (20 s trials) at 10 target percentages (5-95% MVC) normalized to a conventional discrete-point (n = 16), or sustained (n = 16) MVC calculation. Distinct rates and magnitudes of change were observed for absolute variability (standard deviation (SD), root mean squared error (RMSE)), tracking error (RMSE, constant error (CE)), and complexity (detrended fluctuation analysis (DFA)) (all p < 0.05) of graded force fluctuations between the MVC groups. Differential performance strategies were observed beyond ~65% MVC, with the discrete-point group minimizing their SD at force values below that of the criterion target (higher CE/RMSE). Moreover, the sustained group's capacity to minimize SD/RMSE/CE corresponded to a more complex structure in their force fluctuations. These findings reveal that the time component of MVC estimation has a direct influence on the corrective strategies supporting near-maximal manual force control. While discrete MVC protocols predominate in the study of manual strength/endurance/precision, a 1:1 MVC-task mapping appears more to be ecologically valid if visuo-motor precision outcomes are of central importance.

Vertical Jumping as a Monitoring Tool in Endurance Runners: A Brief Review

Jumping performance (e.g., countermovement jump [CMJ]), as a measure of neuromuscular performance, has been suggested as an easy-to-use tool which simultaneously provides neuromuscular and metabolic information and, thereby, allows coaches to confidently monitor the status of their athletes during a workout. This hypothesis has been satisfactorily tested with sprint athletes. However, the rationale for the use of CMJ height loss as an index to monitor the workload during an endurance running session is not sufficiently evidence-based. First, it is assumed that a CMJ height loss occurs during typical interval training for endurance runners. Second, it is also assumed that a significant relationship between metabolic stress and the neuromuscular strain induced during these endurance workouts exists. These two assumptions will be questioned in this review by critically analyzing the kinetics of CMJ performance during and after running workouts, and the relationship between neuromuscular and physiological stress induced during different protocols in endurance runners. The current evidence shows that fatigue induced by common running workouts for endurance runners does not counterbalance the potentiation effect in the CMJ height. Additionally, the findings reported among different studies are consistent regarding the lack of association between CMJ height loss and physiological stress during interval sessions in endurance runners. In practical terms, the authors suggest that this marker of neuromuscular fatigue may not be used to regulate the external training load during running workouts in endurance runners. Nevertheless, the analysis of CMJ height during running workouts may serve to monitor chronic adaptations to training in endurance runners.

REDUCED PERIPHERAL AND INSPIRATORY MUSCLE ENDURANCE IN PATIENTS WITH LIVER CIRRHOSIS: A CROSS-SECTIONAL STUDY

BACKGROUND

Liver cirrhosis (LC) causes several musculoskeletal changes.

OBJECTIVE

To test the hypothesis that the peripheral and inspiratory muscle endurance are reduced in patients with liver cirrhosis.

METHODS

Twenty-one patients with LC (LC group; 61±14 years) and 18 age-matched subjects (control group; 56±17 years) had accepted to participate in this cross-sectional observational study. To assess peripheral muscle endurance, all volunteers performed a rhythmic handgrip exercise at 45% of their maximum voluntary contraction. A metronome was used to control the contraction-relaxation cycles at 60/min. The inspiratory muscle endurance was assessed using PowerBreath®. Participants underwent inspiratory muscle exercise at 60% of their maximal inspiratory muscle strength. The time until failure characterized the muscle endurance for both handgrip and inspiratory muscle exercises. Additionally, the quality of life of the participants was assessed.

RESULTS

The muscle endurance was lower in the LC group when compared to the control group for both handgrip (67 vs 130 s, P<0.001) and inspiratory muscle exercises (40 vs 114 s, P<0.001). The peripheral muscle endurance was directly correlated with the total quality of life score (r=0.439, P=0.01) and to the following domains: fatigue (r=0.378 e P=0.030), activity (r=0.583, P=0.001), systemic symptoms (r=0.316, P=0.073) and preoccupation (r=0.370, P=0.034). The inspiratory muscle endurance was inversely correlated with the total quality of life score (r=0.573, P=0.001) and the following domains: fatigue (r=0.503, P=0.002), activity (r=0.464, P=0.004), systemic symptoms (r=0.472, P=0.004), abdominal symptoms (r=0.461, P=0.005), emotional function (r=0.387, P=0.02) and preoccupation (r=0.519, P=0.001).

CONCLUSION

Both peripheral and inspiratory muscle endurance were lower in LC patients when compared to the control group.

The Wearable Physical Fitness Training Device Based on Fuzzy Theory

Mobile Edge Computing and Communication (MECC) can be deployed in close proximity with sensing devices and act as middleware between cloud and local networks. The health and fitness movement has become extremely popular recently. Endurance activities, such as marathons, triathlons, and cycling have also grown in popularity. However, with more people participating in these activities, more accidents and injuries occur—ranging from heat stroke, to heart attacks, shock, or hypoxia. All physical training activities include a risk of injury and accidents. Therefore, any research that offers a means of reducing injury risk will significantly contribute to the personal fitness field. Moreover, with the growing popularity of wearable devices and the rise of the MECC, the development and application of wearable devices that can connect to the MECC has become widespread, producing many new innovations. Although many wearable devices, such as wrist straps and smart watches, are available and able to detect individual physiological data, they cannot monitor the human body in a state of motion. Therefore, this study proposes a set of monitoring parameters for a novel wearable device connected to the MECC based on fitness management to assist fitness trainers in effective prompted strength training, and to offer timely warnings in the event of an injury risk. The data collected by the monitoring device using fuzzy theory include risk factor, body temperature, heart rate, and blood oxygen concentration. The proposed system can display in real-time the current physiological state of a wearer/user. The introduction of this device will hopefully enable trainers to immediately and effectively control and monitor the intensity of a training session, while increasing training safety, and offer crucial and immediate diagnostic information so that the correct treatment can be applied without delay in the event of injury.

Comparison between cryotherapy and photobiomodulation in muscle recovery: a systematic review and meta-analysis

The purpose of this study is to compare the effect of photobiomodulation therapy (PBMT) and cryotherapy (CRT) on muscle recovery outcomes. These searches were performed in PubMed, PEDro, CENTRAL, and VHL (which includes the Lilacs, Medline, and SciELO database) from inception to June 2021. We included randomized clinical trials involved healthy human volunteers (> 18 years) underwent an intervention of PBMT and CRT, when used in both isolated form post-exercise. Standardized mean differences (SMD) or mean difference (MD) with 95% confidence interval were calculated and pooled in a meta-analysis for synthesis. The risk of bias and quality of evidence were assessed through Cochrane risk-of-bias tool and GRADE system. Four articles (66 participants) with a high to low risk of bias were included. The certainty of evidence was classified as moderate to very low. PBMT was estimated to improve the muscle strength (SMD = 1.73, CI 95% 1.33 to 2.13, I² = 27%, p < 0.00001), reduce delayed onset muscle soreness (MD: - 25.69%, CI 95% - 34.42 to - 16.97, I² = 89%, p < 0.00001), and lower the concentration of biomarkers of muscle damage (SMD =  - 1.48, CI 95% - 1.93 to - 1.03, I² = 76%, p < 0,00,001) when compared with CRT. There was no difference in oxidative stress and inflammatory levels. Based on our findings, the use of PBMT in muscle recovery after high-intensity exercise appears to be beneficial, provides a clinically important effect, and seems to be the best option when compared to CRT.

Effects of handle height and load on the endurance time for simulated demolition tasks

BACKGROUND

Manual demolition tasks are heavy physical demanding tasks which involve forceful exertion of sustained pushing. They result in muscle fatigue which could lead to musculoskeletal disorders. Assessments of maximum endurance time (MET) are essential in understanding the developing of muscle fatigue for these tasks.

OBJECTIVE

The objectives of this study were to determine the effects of handle height and load conditions on the MET, and to establish MET models for the simulated demolition tasks.

METHODS

Twenty three male participants performed simulated demolition tasks under three loads and three handle heights conditions until they could not do so any longer. Their METs and ratings of perceived exertion were recorded and analyzed.

RESULTS

The results showed that both load and handle height were significant (p < 0.0001) factors affecting the MET. Regression models to predict the MET under handle height and load conditions were established. The mean absolute deviations of these models were between 1.91 and 4.84 min.

CONCLUSION

The MET models established may be used to estimate the MET which may be adopted in work/rest arrangement for demolition tasks using a handheld demolition hammer.

Dynamic contraction and fatigue analysis in biceps brachii muscles using synchrosqueezed wavelet transform and singular value features

In this study, the dynamic contractions and the associated fatigue condition in biceps brachii muscle are analysed using Synchrosqueezed Wavelet Transform (SST) and singular value features of surface Electromyography (sEMG) signals. For this, the recorded signals are decomposed into time-frequency matrix using SST. Two analytic functions namely Morlet and Bump wavelets are utilised for the analysis. Singular Value Decomposition method is applied to this time-frequency matrix to derive the features such as Maximum Singular Value (MSV), Singular Value Entropy (SVEn) and Singular Value Energy (SVEr). The results show that both these wavelets are able to characterise nonstationary variations in sEMG signals during dynamic fatiguing contractions. Increase in values of MSV and SVEr with the progression of fatigue denotes the presence of nonstationarity in the sEMG signals. The lower values of SVEn with the progression of fatigue indicate the randomness in the signal. Thus, it appears that the proposed approach could be used to characterise dynamic muscle contractions under varied neuromuscular conditions.

Is there Evidence for the Suggestion that Fatigue Accumulates Following Resistance Exercise?

It has been suggested that improper post-exercise recovery or improper sequence of training may result in an 'accumulation' of fatigue. Despite this suggestion, there is a lack of clarity regarding which physiological mechanisms may be proposed to contribute to fatigue accumulation. The present paper explores the time course of the changes in various fatigue-related measures in order to understand how they may accumulate or lessen over time following an exercise bout or in the context of an exercise program. Regarding peripheral fatigue, the depletion of energy substrates and accumulation of metabolic byproducts has been demonstrated to occur following an acute bout of resistance training; however, peripheral accumulation and depletion appear unlikely candidates to accumulate over time. A number of mechanisms may contribute to the development of central fatigue, postulating the need for prolonged periods of recovery; however, a time course is difficult to determine and is dependent on which measurement is examined. In addition, it has not been demonstrated that central fatigue measures accumulate over time. A potential candidate that may be interpreted as accumulated fatigue is muscle damage, which shares similar characteristics (i.e., prolonged strength loss). Due to the delayed appearance of muscle damage, it may be interpreted as accumulated fatigue. Overall, evidence for the presence of fatigue accumulation with resistance training is equivocal, making it difficult to draw the conclusion that fatigue accumulates. Considerable work remains as to whether fatigue can accumulate over time. Future studies are warranted to elucidate potential mechanisms underlying the concept of fatigue accumulation.

Acute Neuromuscular Response to Team Sports-specific Running, Resistance, and Concurrent Training: A Cross-over Study

PURPOSE

To examine the changes in muscle contractile function, voluntary activation, and muscle damage following lower limb resistance training (RT), intermittent sprint exercise and concurrent training (CT).

METHODS

Ten male, recreational team sport athletes with a history of RT participated in a randomised cross-over study involving an intermittent sprint protocol (ISP), lower limb RT and CT (ISP and RT separated by 1 h). Prior to (PRE), immediately post (POST), 24 h and 48 h following each exercise condition, quadriceps muscle activation, voluntary activation, muscle contractile function (evoked twitch responses), creatine kinase (CK), muscle soreness and POMS-fatigue were recorded.

RESULTS

Quadriceps contractile function was hampered in all conditions, with a significantly greater decline observed POST RT (58.4 ± 18.0%) and CT (54.8 ± 8.6%) compared to ISP (35.9 ± 10.7%; p < 0.05), recovering at 48 h following all exercise conditions. POMS-fatigue ratings increased at POST in all conditions with CT and ISP eliciting the greatest increase, returning to baseline 48 h following all exercise conditions. Quadriceps muscle soreness remained elevated from PRE at 48 h following all exercise conditions. No changes across time were observed for voluntary activation and quadriceps surface EMG amplitude following any exercise condition. The volume and load lifted in the RT session was unaffected by prior intermittent exercise (ISP) in CT.

CONCLUSION

RT impairs contractile function which is not exacerbated when performed 1 h following the ISP. Contractile function following all exercise conditions displayed the same recovery profile (48 h) despite the post-exercise decrement being smaller following the ISP compared to RT and CT. Prior intermittent sprint exercise does not negatively impact the volume of exercise performed in a lower limb RT session.

Evidence of movement variability patterns during a repetitive pointing task until exhaustion

Human movement is characterized by its variability: the same task is never performed twice in exactly the same way. This variability is believed to play a functional role in movement performance and adaptability, as well as in preventing musculoskeletal damage. This article focuses on the time-evolution of movement variability throughout a repetitive pointing task until exhaustion. The kinematics of 13 subjects performing the pointing task is analyzed. Principal Component Analysis of joint angles identifies joint coordinations for each pointing cycle, and cycle-by-cycle comparison highlights movement variability. Non-supervised clustering reveals that subjects adopt successive coordination patterns at an intra-individual level. Inter-individual variability is characterized by the number and type of such patterns: from 3 to 5 patterns, mobilizing the trunk, the shoulder and the upper limbs differently. Movement variability exists even in a seemingly basic and constrained task. It appears in the very early stages of fatigue onset, and may correspond to adaptative coordination responses throughout task performance. This observation should encourage workstation designers to better account for movement variability in order to preserve operators' health and safety.

Effect of warm-up and muscle fatiguing exercise on knee joint sounds in motion by vibroarthrography: A randomized crossover trial

Vibroarthrography measures joint sounds caused by sliding of the joint surfaces over each other. and can be affected by joint health, load and type of movement. Since both warm-up and muscle fatigue lead to local changes in the knee joint (e.g., temperature increase, lubrication of the joint, muscle activation), these may impact knee joint sounds. Therefore, this study investigates the effects of warm-up and muscle fatiguing exercise on knee joint sounds during an activity of daily living. Seventeen healthy, physically active volunteers (25.7 ± 2 years, 7 males) performed a control and an intervention session with a wash-out phase of one week. The control session consisted of sitting on a chair, while the intervention session contained a warm-up (walking on a treadmill) followed by a fatiguing exercise (modified sit-to-stand) protocol. Knee sounds were recorded by vibroarthrography (at the medial tibia plateau and at the patella) at three time points in each session during a sit-to-stand movement. The primary outcome was the mean signal amplitude (MSA, dB). Differences between sessions were determined by repeated measures ANOVA with intra-individual pre-post differences for the warm-up and for the muscle fatigue effect. We found a significant difference for MSA at the medial tibia plateau (intervention: mean 1.51 dB, standard deviation 2.51 dB; control: mean -1.28 dB, SD 2.61 dB; F = 9.5; p = .007; η² = .37) during extension (from sit to stand) after the warm-up. There was no significant difference for any parameter after the muscle fatiguing exercise (p > .05). The increase in MSA may mostly be explained by an increase in internal knee load and joint friction. However, neuromuscular changes may also have played a role. It appears that the muscle fatiguing exercise has no impact on knee joint sounds in young, active, symptom-free participants during sit to stand.

Biomechanical Response of the Lower Extremity to Running-Induced Acute Fatigue: A Systematic Review

Objective: To investigate (i) typical protocols used in research on biomechanical response to running-induced fatigue, (ii) the effect of sport-induced acute fatigue on the biomechanics of running and functional tests, and (iii) the consistency of analyzed parameter trends across different protocols.

Methods: Scopus, Web of Science, Pubmed, and IEEE databases were searched using terms identified with the Population, Interest and Context (PiCo) framework. Studies were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and appraised using the methodological index for non-randomized studies MINORS scale. Only experimental studies with at least 10 participants, which evaluated fatigue during and immediately after the fatiguing run were included. Each study was summarized to record information about the protocol and parameter trends. Summary trends were computed for each parameter based on the results found in individual studies.

Results: Of the 68 included studies, most were based on in-lab (77.9%) protocols, endpoint measurements (75%), stationary measurement systems (76.5%), and treadmill environment (54.4%) for running. From the 42 parameters identified in response to acute fatigue, flight time, contact time, knee flexion angle at initial contact, trunk flexion angle, peak tibial acceleration, CoP velocity during balance test showed an increasing behavior and cadence, vertical stiffness, knee extension force during MVC, maximum vertical ground reaction forces, and CMJ height showed a decreasing trend across different fatigue protocols.

Conclusion: This review presents evidence that running-induced acute fatigue influences almost all the included biomechanical parameters, with crucial influence from the exercise intensity and the testing environment. Results indicate an important gap in literature caused by the lack of field studies with continuous measurement during outdoor running activities. To address this gap, we propose recommendations for the use of wearable inertial sensors.

Effects of Various Physical Interventions on Reducing Neuromuscular Fatigue Assessed by Electromyography: A Systematic Review and Meta-Analysis

Introduction: Various interventions have been applied to improve recovery from muscle fatigue based on evidence from subjective outcomes, such as perceived fatigue and soreness, which may partly contribute to conflicting results of reducing muscle fatigue. There is a need to assess the effectiveness of various intervention on reducing neuromuscular fatigue assessed by a quantitative outcome, such as electromyography (EMG). The objective of this review and meta-analysis was to evaluate the effectiveness of different interventions and intervention timing for reducing fatigue rates during exercise. Methods: The literature was searched from the earliest record to March 2021. Eighteen studies with a total of 87 data points involving 281 participants and seven types of interventions [i.e., active recovery (AR), compression, cooling, electrical stimulation (ES), light-emitting diode therapy (LEDT), massage, and stretching] were included in this meta-analysis. Results: The results showed that compression (SMD = 0.28; 95% CI = -0.00 to 0.56; p = 0.05; I ² = 58%) and LEDT (SMD = 0.49; 95% CI = 0.11 to 0.88; p = 0.01; I ² = 52%) have a significant recovery effect on reducing muscle fatigue. Additionally, compression, AR, and cooling have a significant effect on reducing muscle fatigue when conducted during exercise, whereas a non-effective trend when applied after exercise. Discussion: This meta-analysis suggests that compression and LEDT have a significant effect on reducing muscle fatigue. The results also suggest that there is a significant effect or an effective trend on reducing muscle fatigue when compression, AR, cooling, and ES are applied during exercise, but not after exercise.

Continuous, integrated sensors for predicting fatigue during non-repetitive work: demonstration of technique in the operating room

Surface electromyography (sEMG) can monitor muscle activity and potentially predict fatigue in the workplace. However, objectively measuring fatigue is challenging in complex work with unpredictable work cycles where sEMG may be influenced by the dynamically changing posture demands. This study proposes a multi-modal approach integrating sEMG with motion sensors and demonstrates the approach in the live surgical work environment. Seventy-two exposures from twelve participants were collected, including self-reported musculoskeletal discomfort, sEMG, and postures. Posture sensors were used to identify time windows where the surgeon was static and in non-demanding positions, and mean power frequencies (MPF) were then calculated during those time windows. In 57 out of 72 exposures (80%), participants experienced an increase in musculoskeletal discomfort. Integrated (multi-modality) measurements showed better performance than single-modality (sEMG) measurements in detecting decreases in MPF, a predictor of fatigue. Based on self-reported musculoskeletal discomfort, sensor-based thresholds for identifying fatigue are proposed for the trapezius and deltoid muscle groups. Practitioner summary Work-related fatigue is one of the intermediate risk factors to musculoskeletal disorders. This article presents an objective integrated approach to identify musculoskeletal fatigue using wearable sensors. The presented approach could be implemented by ergonomists to identify musculoskeletal fatigue more accurately and in a variety of workplaces. Abbreviations: sEMG: surface electromyography; IMU: inertia measurement unit; MPF: mean power frequency; ACGIH: American Conference of Governmental Industrial Hygienists; SAGES: Society of American Gastrointestinal and Endoscopic Surgeons; LD: left deltoid; LT: left trapezius; RD: right deltoid; RT: right trapezius.

The single-leg heel raise does not predict maximal plantar flexion strength in healthy males and females

Introduction

The single-leg heel raise test (SLHR) is commonly used in clinical settings to approximate plantar flexor strength, yet this is neither validated nor supported physiologically. The purposes of this study were to: determine (1) associations between SLHR repetitions, maximal plantar flexor strength, and reductions in strength; and (2) whether sex differences exist in performance of the SLHR.

Methods

Twenty-eight young, healthy participants (14 males,14 females, 19–30 years) performed repeated single-leg heel raises to task failure. Pre- and post-task measures included maximal voluntary isometric contractions (MVIC), and voluntary activation and contractile properties of the plantar flexor muscles, assessed using peripheral electrical stimulation of the tibial nerve. Surface electromyography was recorded for the medial and lateral gastrocnemius, soleus, and anterior tibialis muscles.

Results

The SLHR resulted in 20.5% reductions in MVIC torque (p<0.001). However, the number of SLHR repetitions was not correlated with either the baseline MVIC (maximal strength; p = 0.979) or the reduction in MVIC following the SLHR (p = 0.23). There were no sex differences in either the number of SLHR repetitions (p = 0.14), baseline MVIC torque (p = 0.198), or the reduction of MVIC (p = 0.14). MVIC decline was positively associated with the reduction in voluntary activation (r = 0.841, p<0.001), but was not associated with the change in twitch amplitude (p = 0.597).

Conclusions

The SLHR was similar in young males and females yet was a poor predictor of maximal plantar flexor strength but evaluates performance fatigability of the lower extremity specific to dynamic contractions. The reduction in maximal strength at task failure was explained by reduced neural drive to the plantar flexor muscles in both males and females.

Impact statement

SLHR performance is not a clinical assessment of plantar flexor strength but assesses dynamic lower extremity fatigability that is similar in males and females. Alternate clinical measures for maximal plantar flexion strength need to be developed.

"Going Backward": Effects of age and fatigue on posterior-directed falls in Parkinson disease

BACKGROUND

Nearly half of persons with Parkinson disease (PD) report fatigue as a factor in their fall history. However, it is unknown whether these self-reported falls are caused by a sensation of fatigue or performance fatigue.

OBJECTIVE

We sought to investigate the influences of performance fatigue and age on postural control in persons with PD.

METHODS

Individuals with PD (n = 14) underwent postural control assessments before (T0) and immediately after (T1) fatiguing exercise. Biomechanical data were gathered on participants completing a treadmill-induced, posterior-directed fall. Performance fatigue was produced using lower extremity resistance exercise on an isokinetic ergometer. Repeated measures ANCOVAs were used with age as a covariate to determine the effects of performance fatigue on biomechanical variables.

RESULTS

After adjustment for age, there was a statistically significant difference in peak center of pressure (COP) latency during the support phase of recovery. Pairwise comparisons demonstrated a decrease in peak ankle displacement from T0 to T1. Age was also found to be significantly related to reaction time and peak knee displacement while participants were fatigued.

CONCLUSIONS

The decreased peak COP latency, along with decreased ankle angular displacement, suggest that persons with PD adopt a stiffening strategy in response to backward directed falls. Postural stiffening is not uncommon in persons with PD and could be a risk factor for falls. Older individuals with PD demonstrate slower mobility scores and decreased reaction times in the setting of fatigue, suggesting a combined effect of the aging and fatigue processes.