High-frequency fatigue in rat skeletal muscle: role of extracellular ion concentrations

Potassium-induced potentiation of subtetanic force in rat skeletal muscles: influences of β2-activation, lactic acid, and temperature

Moderate elevations of extracellular K+ concentration ([K+]o) occur during exercise and have been shown to potentiate force during contractions elicited with subtetanic frequencies. Here, we investigated whether lactic acid (reduced chloride conductance), β2-adrenoceptor activation, and increased temperature would influence the potentiating effect of potassium in slow- and fast-twitch muscles. Isometric contractions were elicited by electrical stimulation at various frequencies in isolated rat soleus and extensor digitorum longus (EDL) muscles incubated at normal (4 mM) or elevated K+, in combination with salbutamol (5 μM), lactic acid (18.1 mM), 9-anthracene-carboxylic acid (9-AC; 25 μM), or increased temperature (30-35°C). Elevating [K+]o from 4 mM to 7 mM (soleus) and 10 mM (EDL) potentiated isometric twitch and subtetanic force while slightly reducing tetanic force. In EDL, salbutamol further augmented twitch force (+27 ± 3%, P < 0.001) and subtetanic force (+22 ± 4%, P < 0.001). In contrast, salbutamol reduced subtetanic force (-28 ± 6%, P < 0.001) in soleus muscles. Lactic acid and 9-AC had no significant effects on isometric force of muscles already exposed to moderate elevations of [K+]o. The potentiating effect of elevated [K+]o was still well maintained at 35°C. Addition of salbutamol exerts a further force-potentiating effect in fast-twitch but not in slow-twitch muscles already potentiated by moderately elevated [K+]o, whereas lactic acid, 9-AC, or increased temperature does not exert any further augmentation. However, the potentiating effect of elevated [K+]o was still maintained in the presence of these, thus emphasizing the positive influence of moderately elevated [K+]o for contractile performance during exercise.

Muscle Ionic Shifts During Exercise: Implications for Fatigue and Exercise Performance

Exercise causes major shifts in multiple ions (e.g., K⁺ , Na⁺ , H⁺ , lactate^- , Ca²⁺ , and Cl^- ) during muscle activity that contributes to development of muscle fatigue. Sarcolemmal processes can be impaired by the trans-sarcolemmal rundown of ion gradients for K⁺ , Na⁺ , and Ca²⁺ during fatiguing exercise, while changes in gradients for Cl^- and Cl^- conductance may exert either protective or detrimental effects on fatigue. Myocellular H⁺ accumulation may also contribute to fatigue development by lowering glycolytic rate and has been shown to act synergistically with inorganic phosphate (Pi) to compromise cross-bridge function. In addition, sarcoplasmic reticulum Ca²⁺ release function is severely affected by fatiguing exercise. Skeletal muscle has a multitude of ion transport systems that counter exercise-related ionic shifts of which the Na⁺ /K⁺ -ATPase is of major importance. Metabolic perturbations occurring during exercise can exacerbate trans-sarcolemmal ionic shifts, in particular for K⁺ and Cl^- , respectively via metabolic regulation of the ATP-sensitive K⁺ channel (K_ATP ) and the chloride channel isoform 1 (ClC-1). Ion transport systems are highly adaptable to exercise training resulting in an enhanced ability to counter ionic disturbances to delay fatigue and improve exercise performance. In this article, we discuss (i) the ionic shifts occurring during exercise, (ii) the role of ion transport systems in skeletal muscle for ionic regulation, (iii) how ionic disturbances affect sarcolemmal processes and muscle fatigue, (iv) how metabolic perturbations exacerbate ionic shifts during exercise, and (v) how pharmacological manipulation and exercise training regulate ion transport systems to influence exercise performance in humans. © 2021 American Physiological Society. Compr Physiol 11:1895-1959, 2021.

Effects of extracellular potassium on calcium handling and force generation in a model of excitation-contraction coupling in skeletal muscle

It is well-established that extracellular potassium (K_o⁺) accumulation reduces muscle fiber excitability, however the effects of K_o⁺ on the excitation-contraction coupling (ECC) pathway are less understood. In vivo and in vitro studies following fatiguing stimulation protocols are limited in their ability to capture the effects of K_o⁺ on force production in combination with other simultaneously changing factors. To address this, a computational model of ECC for slow and fast twitch muscle is presented to explore the relative contributions of excitability-induced and metabolic-induced changes in force generation in response to increasing [Formula: see text] . The model incorporates mechanisms previously unexplored in modelling studies, including the effects of extracellular calcium on excitability, calcium-dependent inhibition of calcium release, ATP-dependent ionic pumping, and the contribution of ATP hydrolysis to intracellular phosphate accumulation rate. The model was able to capture the frequency-dependent biphasic Force- [Formula: see text] response observed experimentally. Force potentiation for moderately elevated [Formula: see text] was driven by increased action potential duration, myoplasmic calcium potentiation, and phosphate accumulation rate, while attenuation of force at higher [Formula: see text] was due to action potential failure resulting in reduced calcium release. These results suggest that altered calcium release and phosphate accumulation work together with elevated K_o⁺ to affect force during sustained contractions.

Power loss is attenuated following a second bout of high-intensity eccentric contractions due to the repeated bout effect's protection of rate of torque and velocity development

High-intensity unaccustomed eccentric contractions result in weakness and power loss because of fatigue and muscle damage. Through the repeated bout effect (RBE), adaptations occur, then damage and weakness are attenuated following a subsequent bout. However, it is unclear whether the RBE protects peak power output. We investigated the influence of the RBE on power production and estimated fatigue- and damage-induced neuromuscular impairments following repeated high-intensity eccentric contractions. Twelve healthy adult males performed 5 sets of 30 maximal eccentric elbow flexions and repeated an identical bout 4 weeks later. Recovery was tracked over 7 days following both bouts. Reduced maximum voluntary isometric contraction torque, and increased serum creatine kinase and self-reported soreness indirectly inferred muscle damage. Peak isotonic power, time-dependent measures - rate of velocity development (RVD) and rate of torque development (RTD) - and several electrophysiological indices of neuromuscular function were assessed. The RBE protected peak power, with a protective index of 66% 24 h after the second eccentric exercise bout. The protection of power also related to preserved RVD (R² = 0.61, P < 0.01) and RTD (R² = 0.39, P < 0.01). Furthermore, the RBE's protection against muscle damage permitted the estimation of fatigue-associated neuromuscular performance decrements following eccentric exercise. Novelty: The repeated bout effect protects peak isotonic power. Protection of peak power relates to preserved rates of torque and velocity development, but more so rate of velocity development. The repeated bout effect has little influence on indices of neuromuscular fatigue.

Moderately elevated extracellular [K+] potentiates submaximal force and power in skeletal muscle via increased [Ca2+]i during contractions

The extracellular K+ concentration ([K+]o) increases during physical exercise. We here studied whether moderately elevated [K+]o may increase force and power output during contractions at in vivo-like subtetanic frequencies and whether such potentiation was associated with increased cytosolic free Ca2+ concentration ([Ca2+]i) during contractions. Isolated whole soleus and extensor digitorum longus (EDL) rat muscles were incubated at different levels of [K+]o, and isometric and dynamic contractility were tested at various stimulation frequencies. Furthermore, [Ca2+]i at rest and during contraction was measured along with isometric force in single mouse flexor digitorum brevis (FDB) fibers exposed to elevated [K+]o. Elevating [K+]o from 4 mM up to 8 mM (soleus) and 11 mM (EDL) increased isometric force at subtetanic frequencies, 2–15 Hz in soleus and up to 50 Hz in EDL, while inhibition was seen at tetanic frequency in both muscle types. Elevating [K+]o also increased peak power of dynamic subtetanic contractions, with potentiation being more pronounced in EDL than in soleus muscles. The force-potentiating effect of elevated [K+]o was transient in FDB single fibers, reaching peak after ~4 and 2.5 min in 9 and 11 mM [K+]o, respectively. At the time of peak potentiation, force and [Ca2+]i during 15-Hz contractions were significantly increased, whereas force was slightly decreased and [Ca2+]i unchanged during 50-Hz contractions. Moderate elevation of [K+]o can transiently potentiate force and power during contractions at subtetanic frequencies, which can be explained by a higher [Ca2+]i during contractions.

Physiological validation of the decomposition of surface EMG signals

Advances in technology have ushered in a new era in the measurement and interpretation of surface-recorded electromyographic (EMG) signals. These developments have included improvements in detection systems, the algorithms used to decompose the interference signals, and the strategies used to edit the identified waveforms. To evaluate the validity of the results obtained with this new technology, the purpose of this review was to compare the results achieved by decomposing surface-recorded EMG signals into the discharge times of single motor units with what is known about the rate coding characteristics of single motor units based on recordings obtained with intramuscular electrodes. The characteristics compared were peak discharge rate, saturation of discharge rate during submaximal contractions, rate coding during fast contractions, the association between oscillations in force and discharge rate, and adjustments during fatiguing contractions. The comparison indicates that some decomposition methods are able to replicate many of the findings derived from intramuscular recordings, but additional improvements in the methods are required. Critically, more effort needs to be focused on editing the waveforms identified by the decomposition algorithms. With adequate attention to detail, this technology has the potential to augment our knowledge on motor unit physiology and to provide useful approaches that are being translated into clinical practice.

Elevation of extracellular osmolarity improves signs of myotonia congenita in vitro: a preclinical animal study

KEY POINTS

During myotonia congenita, reduced chloride (Cl- ) conductance results in impaired muscle relaxation and increased muscle stiffness after forceful voluntary contraction. Repetitive contraction of myotonic muscle decreases or even abolishes myotonic muscle stiffness, a phenomenon called 'warm up'. Pharmacological inhibition of low Cl- channels by anthracene-9-carboxylic acid in muscle from mice and ADR ('arrested development of righting response') muscle from mice showed a relaxation deficit under physiological conditions compared to wild-type muscle. At increased osmolarity up to 400 mosmol L-1 , the relaxation deficit of myotonic muscle almost reached that of control muscle. These effects were mediated by the cation and anion cotransporter, NKCC1, and anti-myotonic effects of hypertonicity were at least partly antagonized by the application of bumetanide.

ABSTRACT

Low chloride-conductance myotonia is caused by mutations in the skeletal muscle chloride (Cl- ) channel gene type 1 (CLCN1). Reduced Cl- conductance of the mutated channels results in impaired muscle relaxation and increased muscle stiffness after forceful voluntary contraction. Exercise decreases muscle stiffness, a phenomena called 'warm up'. To gain further insight into the patho-mechanism of impaired muscle stiffness and the warm-up phenomenon, we characterized the effects of increased osmolarity on myotonic function. Functional force and membrane potential measurements were performed on muscle specimens of ADR ('arrested development of righting response') mice (an animal model for low gCl- conductance myotonia) and pharmacologically-induced myotonia. Specimens were exposed to solutions of increasing osmolarity at the same time as force and membrane potentials were monitored. In the second set of experiments, ADR muscle and pharmacologically-induced myotonic muscle were exposed to an antagonist of NKCC1. Upon osmotic stress, ADR muscle was depolarized to a lesser extent than control wild-type muscle. High osmolarity diminished myotonia and facilitated the warm-up phenomenon as depicted by a faster muscle relaxation time (T90/10 ). Osmotic stress primarily resulted in the activation of the NKCC1. The inhibition of NKCC1 with bumetanide prevented the depolarization and reversed the anti-myotonic effect of high osmolarity. Increased osmolarity decreased signs of myotonia and facilitated the warm-up phenomenon in different in vitro models of myotonia. Activation of NKCC1 activity promotes warm-up and reduces the number of contractions required to achieve normal relaxation kinetics.

Effects of Constant and Doublet Frequency Electrical Stimulation Patterns on Force Production of Knee Extensor Muscles

This study compared knee extensors’ neuromuscular fatigue in response to two 30-minute stimulation patterns: constant frequency train (CFT) and doublet frequency train (DFT). Fifteen men underwent two separate sessions corresponding to each pattern. Measurements included torque evoked by each contraction and maximal voluntary contractions (MVC) measured before and immediately after the stimulation sessions. In addition, activation level and torque evoked during doublets (Pd) and tetanic contractions at 80-Hz (P80) and 20-Hz (P20) were determined in six subjects. Results indicated greater mean torque during the DFT stimulation session as compared with CFT. But, no difference was obtained between the two stimulation patterns for MVC and evoked torque decreases. Measurements conducted in the subgroup depicted a significant reduction of Pd, P20 and P80. Statistical analyses also revealed bigger P20 immediate reductions after CFT than after DFT. We concluded that DFT could be a useful stimulation pattern to produce and maintain greater force with quite similar fatigue than CFT.

Repeated sprint ability in young soccer players at different game stages

The purpose of this study was to determine the repeated sprint ability (RSA) of young (16.9 ± 0.5 years) soccer players at different game stages. Players performed repeated sprint test (RST) (12 × 20 m) after warm-up before a game, at half-time, and after a full soccer game, each on a different day, in a random order. The ideal (fastest) sprint time (IS) and total (accumulative) sprint time (TS) were significantly slower at the end of the game compared with those after the warm-up before the game (p < 0.01 for each). Differences between IS and TS after the warm-up before the game and at half-time, and between half-time and end of the game, were not statistically significant. There was no significant difference in the performance decrement during the RST after warm-up before the game, at half-time, or the end of the game. Significant negative correlation was found between predicted V[Combining Dot Above]O2 and the difference between TS after the warm-up before the game and the end of the game (r = -0.52), but not between predicted V[Combining Dot Above]O2 and the difference in any of the RST performance indices between warm-up before the game and half-time, or between half-time and the end of the game. The findings indicate a significant RSA reduction only at the end but not at the half-time of a soccer game. The results also suggest that the contribution of the aerobic system to soccer intensity maintenance is crucial, mainly during the final stages of the game.

Extracellular Ca2+-induced force restoration in K+-depressed skeletal muscle of the mouse involves an elevation of [K+]i: implications for fatigue

We examined whether a Ca(2+)-K(+) interaction was a potential mechanism operating during fatigue with repeated tetani in isolated mouse muscles. Raising the extracellular Ca(2+) concentration ([Ca(2+)]o) from 1.3 to 10 mM in K(+)-depressed slow-twitch soleus and/or fast-twitch extensor digitorum longus muscles caused the following: 1) increase of intracellular K(+) activity by 20-60 mM (raised intracellular K(+) content, unchanged intracellular fluid volume), so that the K(+)-equilibrium potential increased by ∼10 mV and resting membrane potential repolarized by 5-10 mV; 2) large restoration of action potential amplitude (16-54 mV); 3) considerable recovery of excitable fibers (∼50% total); and 4) restoration of peak force with the peak tetanic force-extracellular K(+) concentration ([K(+)]o) relationship shifting rightward toward higher [K(+)]o. Double-sigmoid curve-fitting to fatigue profiles (125 Hz for 500 ms, every second for 100 s) showed that prior exposure to raised [K(+)]o (7 mM) increased, whereas lowered [K(+)]o (2 mM) decreased, the rate and extent of force loss during the late phase of fatigue (second sigmoid) in soleus, hence implying a K(+) dependence for late fatigue. Prior exposure to 10 mM [Ca(2+)]o slowed late fatigue in both muscle types, but was without effect on the extent of fatigue. These combined findings support our notion that a Ca(2+)-K(+) interaction is plausible during severe fatigue in both muscle types. We speculate that a diminished transsarcolemmal K(+) gradient and lowered [Ca(2+)]o contribute to late fatigue through reduced action potential amplitude and excitability. The raised [Ca(2+)]o-induced slowing of fatigue is likely to be mediated by a higher intracellular K(+) activity, which prolongs the time before stimulation-induced K(+) efflux depolarizes the sarcolemma sufficiently to interfere with action potentials.

The differential effect of metabolic alkalosis on maximum force and rate of force development during repeated, high-intensity cycling

The purpose of this investigation was to assess the influence of sodium bicarbonate supplementation on maximal force production, rate of force development (RFD), and muscle recruitment during repeated bouts of high-intensity cycling. Ten male and female ( n = 10) subjects completed two fixed-cadence, high-intensity cycling trials. Each trial consisted of a series of 30-s efforts at 120% peak power output (maximum graded test) that were interspersed with 30-s recovery periods until task failure. Prior to each trial, subjects consumed 0.3 g/kg sodium bicarbonate (ALK) or placebo (PLA). Maximal voluntary contractions were performed immediately after each 30-s effort. Maximal force (Fmax) was calculated as the greatest force recorded over a 25-ms period throughout the entire contraction duration while maximal RFD (RFDmax) was calculated as the greatest 10-ms average slope throughout that same contraction. Fmax declined similarly in both the ALK and PLA conditions, with baseline values (ALK: 1,226 ± 393 N; PLA: 1,222 ± 369 N) declining nearly 295 ± 54 N [95% confidence interval (CI) = 84–508 N; P < 0.006]. RFDmax also declined in both trials; however, a differential effect persisted between the ALK and PLA conditions. A main effect of condition was observed across the performance time period, with RFDmax on average higher during ALK (ALK: 8,729 ± 1,169 N/s; PLA: 7,691 ± 1,526 N/s; mean difference between conditions 1,038 ± 451 N/s, 95% CI = 17–2,059 N/s; P < 0.048). These results demonstrate a differential effect of alkalosis on maximum force vs. maximum rate of force development during a whole body fatiguing task.

Effects of high-frequency stimulation and doublets on dynamic contractions in rat soleus muscle exposed to normal and high extracellular [K(+)]

The development of maximal velocity and power in muscle depends on the ability to transmit action potentials (AP) at very high frequencies up to about 400 Hz. However, for every AP there is a small loss of K⁺ to the interstitium, which during intense exercise, may build up to a point where excitability is reduced, thus limiting the intensity of further exercise. It is still unknown how the muscle responds to high-frequency stimulation when exposed to high [K⁺]. Contractile parameters of the muscles (force [F], velocity [V], power [P], rate of force development [RFD], and work) were examined during dynamic contractions, performed in vitro using rat soleus muscles incubated in buffers containing 4 or 8 mmol/L K⁺ and stimulated with constant trains of tetanic or supratetanic frequency or with trains initiated by a high-frequency doublet, followed by tetanic or subtetanic trains. At 4 mmol/L K⁺, an increase in frequency increased P_max when using constant train stimulation. When stimulating with trains containing high-frequency doublets an increase in 120-msec work was seen, however, no increase in P_max was observed. At 8 mmol/L K⁺, no differences were seen for either P_max or 120-msec work when increasing frequency or introducing doublets. In all experiments where the frequency was increased or doublets applied, an increase in RFD was seen in both normal and high [K⁺]. The results indicate that stimulation with supratetanic frequencies can improve dynamic muscle contractility, but improvements are attenuated when muscles are exposed to high extracellular [K⁺].

Alteration of synergistic muscle activity following neuromuscular electrical stimulation of one muscle

The aim of the study was to determine muscle activation of the m. triceps surae during maximal voluntary contractions (MVCs) following neuromuscular electrical stimulation (NMES) of the m. gastrocnemius lateralis (GL). The participants (n = 10) performed three MVC during pretest, posttest, and recovery, respectively. Subsequent to the pretest, the GL was stimulated by NMES. During MVC, force and surface electromyography (EMG) of the GL, m. gastrocnemius medialis (GM), and m. soleus (SOL) were measured. NMES of GL induced no significant decline (3%) in force. EMG activity of the GL decreased significantly to 81% (P < 0.05), whereas EMG activity of the synergistic SOL increased to 112% (P < 0.01). The GM (103%, P = 1.00) remained unaltered. Decreased EMG activity in the GL was most likely caused by failure of the electrical propagation at its muscle fiber membrane. The decline of EMG activity in GL was compensated by increased EMG activity of SOL during MVC. It is suggested that these compensatory effects are caused by central contributions induced by NMES.

Effects of membrane depolarization and changes in extracellular [K(+)] on the Ca (2+) transients of fast skeletal muscle fibers. Implications for muscle fatigue

Repetitive activation of skeletal muscle fibers leads to a reduced transmembrane K⁺ gradient. The resulting membrane depolarization has been proposed to play a major role in the onset of muscle fatigue. Nevertheless, raising the extracellular K⁺ (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{K}}_{\text{o}}^{ + } $$\end{document}) concentration (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ [ {\text{K}}^{ + } ]_{\text{o}} $$\end{document}) to 10 mM potentiates twitch force of rested amphibian and mammalian fibers. We used a double Vaseline gap method to simultaneously record action potentials (AP) and Ca²⁺ transients from rested frog fibers activated by single and tetanic stimulation (10 pulses, 100 Hz) at various \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ [ {\text{K}}^{ + } ]_{\text{o}} $$\end{document} and membrane potentials. Depolarization resulting from current injection or raised \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ [ {\text{K}}^{ + } ]_{\text{o}} $$\end{document} produced an increase in the resting [Ca²⁺]. Ca²⁺ transients elicited by single stimulation were potentiated by depolarization from −80 to −60 mV but markedly depressed by further depolarization. Potentiation was inversely correlated with a reduction in the amplitude, overshoot and duration of APs. Similar effects were found for the Ca²⁺ transients elicited by the first pulse of 100 Hz trains. Depression or block of Ca²⁺ transient in response to the 2nd to 10th pulses of 100 Hz trains was observed at smaller depolarizations as compared to that seen when using single stimulation. Changes in Ca²⁺ transients along the trains were associated with impaired or abortive APs. Raising \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ [ {\text{K}}^{ + } ]_{\text{o}} $$\end{document} to 10 mM potentiated Ca²⁺ transients elicited by single and tetanic stimulation, while raising \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ [ {\text{K}}^{ + } ]_{\text{o}} $$\end{document} to 15 mM markedly depressed both responses. The effects of 10 mM \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{K}}_{\text{o}}^{ + } $$\end{document} on Ca²⁺ transients, but not those of 15 mM \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{K}}_{\text{o}}^{ + } $$\end{document}, could be fully reversed by hyperpolarization. The results suggests that the force potentiating effects of 10 mM \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{K}}_{\text{o}}^{ + } $$\end{document} might be mediated by depolarization dependent changes in resting [Ca²⁺] and Ca²⁺ release, and that additional mechanisms might be involved in the effects of 15 mM \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$ {\text{K}}_{\text{o}}^{ + } $$\end{document} on force generation.

Myostatin regulates fiber-type composition of skeletal muscle by regulating MEF2 and MyoD gene expression

Myostatin (Mstn) is a secreted growth factor belonging to the tranforming growth factor (TGF)-β superfamily. Inactivation of murine Mstn by gene targeting, or natural mutation of bovine or human Mstn, induces the double muscling (DM) phenotype. In DM cattle, Mstn deficiency increases fast glycolytic (type IIB) fiber formation in the biceps femoris (BF) muscle. Using Mstn null (−/−) mice, we suggest a possible mechanism behind Mstn-mediated fiber-type diversity. Histological analysis revealed increased type IIB fibers with a concomitant decrease in type IIA and type I fibers in the Mstn−/−tibialis anterior and BF muscle. Functional electrical stimulation of Mstn−/−BF revealed increased fatigue susceptibility, supporting increased type IIB fiber content. Given the role of myocyte enhancer factor 2 (MEF2) in oxidative type I fiber formation, MEF2 levels in Mstn−/−tissue were quantified. Results revealed reduced MEF2C protein in Mstn−/−muscle and myoblast nuclear extracts. Reduced MEF2-DNA complex was also observed in electrophoretic mobility-shift assay using Mstn−/−nuclear extracts. Furthermore, reduced expression of MEF2 downstream target genes MLC1F and calcineurin were found in Mstn−/−muscle. Conversely, Mstn addition was sufficient to directly upregulate MLC promoter-enhancer activity in cultured myoblasts. Since high MyoD levels are seen in fast fibers, we analyzed MyoD levels in the muscle. In contrast to MEF2C, MyoD levels were increased in Mstn−/−muscle. Together, these results suggest that while Mstn positively regulates MEF2C levels, it negatively regulates MyoD expression in muscle. We propose that Mstn could regulate fiber-type composition by regulating the expression of MEF2C and MyoD during myogenesis.

Do multiple ionic interactions contribute to skeletal muscle fatigue?

During intense exercise or electrical stimulation of skeletal muscle the concentrations of several ions change simultaneously in interstitial, transverse tubular and intracellular compartments. Consequently the functional effects of multiple ionic changes need to be considered together. A diminished transsarcolemmal K(+) gradient per se can reduce maximal force in non-fatigued muscle suggesting that K(+) causes fatigue. However, this effect requires extremely large, although physiological, K(+) shifts. In contrast, moderate elevations of extracellular [K(+)] ([K(+)](o)) potentiate submaximal contractions, enhance local blood flow and influence afferent feedback to assist exercise performance. Changed transsarcolemmal Na(+), Ca(2+), Cl(-) and H(+) gradients are insufficient by themselves to cause much fatigue but each ion can interact with K(+) effects. Lowered Na(+), Ca(2+) and Cl(-) gradients further impair force by modulating the peak tetanic force-[K(+)](o) and peak tetanic force-resting membrane potential relationships. In contrast, raised [Ca(2+)](o), acidosis and reduced Cl(-) conductance during late fatigue provide resistance against K(+)-induced force depression. The detrimental effects of K(+) are exacerbated by metabolic changes such as lowered [ATP](i), depleted carbohydrate, and possibly reactive oxygen species. We hypothesize that during high-intensity exercise a rundown of the transsarcolemmal K(+) gradient is the dominant cellular process around which interactions with other ions and metabolites occur, thereby contributing to fatigue.

High-frequency fatigue of skeletal muscle: role of extracellular Ca(2+)

The present study evaluated whether Ca(2+) entry operates during fatigue of skeletal muscle. The involvement of different skeletal muscle membrane calcium channels and of the Na(+)/Ca(2+) exchanger (NCX) has been examined. The decline of force was analysed in vitro in mouse soleus and EDL muscles submitted to 60 and 110 Hz continuous stimulation, respectively. Stimulation with this high-frequency fatigue (HFF) protocol, in Ca(2+)-free conditions, caused in soleus muscle a dramatic increase of fatigue, while in the presence of high Ca(2+) fatigue was reduced. In EDL muscle, HFF was not affected by external Ca(2+) levels either way, suggesting that external Ca(2+) plays a general protective role only in soleus. Calciseptine, a specific antagonist of the cardiac isoform (alpha1C) of the dihydropyridine receptor, gadolinium, a blocker of both stretch-activated and store-operated Ca(2+) channels, as well as inhibitors of P2X receptors did not affect the development of HFF. Conversely, the Ca(2+) ionophore A23187 increased the protective action of extracellular Ca(2+). KB-R7943, a selective inhibitor of the reverse mode of NCX, produced an effect similar to that of Ca(2+)-free solution. These results indicate that a transmembrane Ca(2+) influx, mainly through NCX, may play a protective role during HFF development in soleus muscle.

Skeletal Muscle Fatigue: Cellular Mechanisms

Repeated, intense use of muscles leads to a decline in performance known as muscle fatigue. Many muscle properties change during fatigue including the action potential, extracellular and intracellular ions, and many intracellular metabolites. A range of mechanisms have been identified that contribute to the decline of performance. The traditional explanation, accumulation of intracellular lactate and hydrogen ions causing impaired function of the contractile proteins, is probably of limited importance in mammals. Alternative explanations that will be considered are the effects of ionic changes on the action potential, failure of SR Ca2+release by various mechanisms, and the effects of reactive oxygen species. Many different activities lead to fatigue, and an important challenge is to identify the various mechanisms that contribute under different circumstances. Most of the mechanistic studies of fatigue are on isolated animal tissues, and another major challenge is to use the knowledge generated in these studies to identify the mechanisms of fatigue in intact animals and particularly in human diseases.

Muscle K+, Na+, and Cl− disturbances and Na+-K+ pump inactivation: implications for fatigue

Membrane excitability is a critical regulatory step in skeletal muscle contraction and is modulated by local ionic concentrations, conductances, ion transporter activities, temperature, and humoral factors. Intense fatiguing contractions induce cellular K+ efflux and Na+ and Cl− influx, causing pronounced perturbations in extracellular (interstitial) and intracellular K+ and Na+ concentrations. Muscle interstitial K+ concentration may increase 1- to 2-fold to 11–13 mM and intracellular K+ concentration fall by 1.3- to 1.7-fold; interstitial Na+ concentration may decline by 10 mM and intracellular Na+ concentration rise by 1.5- to 2.0-fold. Muscle Cl− concentration changes reported with muscle contractions are less consistent, with reports of both unchanged and increased intracellular Cl− concentrations, depending on contraction type and the muscles studied. When considered together, these ionic changes depolarize sarcolemmal and t-tubular membranes to depress tetanic force and are thus likely to contribute to fatigue. Interestingly, less severe local ionic changes can also augment subtetanic force, suggesting that they may potentiate muscle contractility early in exercise. Increased Na+-K+-ATPase activity during exercise stabilizes Na+ and K+ concentration gradients and membrane excitability and thus protects against fatigue. However, during intense contraction some Na+-K+ pumps are inactivated and together with further ionic disturbances, likely precipitate muscle fatigue.

A mathematical model of fatigue in skeletal muscle force contraction

The ability for muscle to repeatedly generate force is limited by fatigue. The cellular mechanisms behind muscle fatigue are complex and potentially include breakdown at many points along the excitation-contraction pathway. In this paper we construct a mathematical model of the skeletal muscle excitation-contraction pathway based on the cellular biochemical events that link excitation to contraction. The model includes descriptions of membrane voltage, calcium cycling and crossbridge dynamics and was parameterised and validated using the response characteristics of mouse skeletal muscle to a range of electrical stimuli. This model was used to uncover the complexities of skeletal muscle fatigue. We also parameterised our model to describe force kinetics in fast and slow twitch fibre types, which have a number of biochemical and biophysical differences. How these differences interact to generate different force/fatigue responses in fast- and slow- twitch fibres is not well understood and we used our modelling approach to bring new insights to this relationship.

Stimulation pulse characteristics and electrode configuration determine site of excitation in isolated mammalian skeletal muscle: implications for fatigue

We examined whether electrical field stimulation with varying characteristics could excite isolated mammalian skeletal muscle through different sites. Supramaximal (20-V, 0.1-ms) pulse stimulation with transverse wire or parallel plate electrodes evoked similar forces in nonfatigued slow-twitch soleus and fast-twitch extensor digitorum longus (EDL) muscles from mice. d-tubocurarine shifted the twitch force-stimulation strength relationship toward higher pulse strengths with both electrode configurations in soleus muscle, suggesting that weaker pulses excite muscle via neuromuscular transmission. With wire stimulation, movement of the recording electrode along the muscle caused a delay between the stimulus artifact and the peak of the action potential, consistent with action potential propagation along the sarcolemma. TTX abolished all contractions evoked with 20-V, 0.1-ms pulses, suggesting that excitation occurred via voltage-dependent Na+ channels and, hence, muscle action potentials. TTX did not prevent force development with ≥0.4-ms pulses in soleus or 1-ms pulses in EDL muscle. Furthermore, myoplasmic Ca2+ (i.e., the fura 2 ratio) and sarcomere shortening were greater during tetanic stimulation with 2.0-ms than with 0.5-ms pulses in flexor digitorum brevis fibers from rats. TTX prevented all shortening and Ca2+ release with 0.5-ms, but not 2.0-ms, pulses, indicating that longer pulses can directly trigger Ca2+ release. Hence, proper interpretation of mechanistic studies requires precise understanding of how muscles are excited; otherwise, incorrect conclusions can be made. Using this new understanding, we showed that disrupted propagation of action potentials along the surface membrane is a major cause of fatigue in soleus muscle that is focally and continuously stimulated at 125 Hz.

Transverse tubular system depolarization reduces tetanic force in rat skeletal muscle fibers by impairing action potential repriming

When muscle fibers are repeatedly stimulated, they may become depolarized and force output decline. Excitation of the transverse tubular system (T-system) is critical for activation, but its role in muscle fatigue is poorly understood. Here, mechanically skinned fibers from rat fast-twitch muscle were used, because the sarcolemma is absent but the T-system retains normal excitability and its properties can be studied in isolation. The T-system membrane was fully polarized by bathing the skinned fiber in an internal solution with 126 mM K+ (control solution) or set at partially depolarized levels (approximately −63 and −58 mV) in solutions with 66 or 55 mM K+, respectively, and action potentials (APs) were triggered in the sealed T-system by field stimulation. Prolonged depolarization of the T-system reduced tetanic force proportionately more than twitch force, with greater effect at higher stimulation frequency (responses at 20 and 100 Hz reduced to 71 and 62% in 66 mM K+ and to 54 and 35% in 55 mM K+, respectively). Double-pulse stimulation showed that depolarization increased the repriming period (estimated minimum time before a second AP can be produced) from ∼4 ms to ∼7.5 and 15 ms in the 66 and 55 mM K+ solutions, respectively. These results demonstrate that T-system depolarization reduces tetanic force by impairing AP repriming, rather than by preventing AP generation per se or by inactivating the T-system voltage sensors. The findings also explain why it is advantageous to reduce the rate of motoneuron stimulation to muscles during repeated or prolonged periods of activity.

Isotonic contractile impairment due to genetic CLC-1 chloride channel deficiency in myotonic mouse diaphragm muscle

The hallmark of genetic CLC-1 chloride channel deficiency in myotonic humans, goats and mice is delayed muscle relaxation resulting from persistent electrical discharges. In addition to the ion channel defect, muscles from myotonic humans and mice also have major changes in fibre type and myosin isoform composition, but the extent to which this affects isometric contractions remains controversial. Many muscles, including the diaphragm, shorten considerably during normal activities, but shortening contractions have never been assessed in myotonic muscle. The present study tested the hypothesis that CLC-1 deficiency leads to an impairment of muscle isotonic contractile performance. This was tested in vitro on diaphragm muscle from SWR/J-Clcn1(adr-mto)/J myotonic mice. The CLC-1-deficient muscle demonstrated delayed relaxation, as expected. During the contractile phase, there were significant reductions in power and work across a number of stimulation frequencies and loads in CLC-1-deficient compared with normal muscle, the magnitude of which in many instances exceeded 50%. Reductions in shortening and velocity of shortening occurred, and were more pronounced when calculated as a function of absolute than relative load. However, the maximal unloaded shortening velocity calculated from Hill's equation was not altered significantly. The impaired isotonic contractile performance of CLC-1-deficient muscle persisted during fatigue-inducing stimulation. These data indicate that genetic CLC-1 chloride channel deficiency in mice not only produces myotonia but also substantially worsens the isotonic contractile performance of diaphragm muscle.

Fatigue in soccer: A brief review

This review describes when fatigue may develop during soccer games and the potential physiological mechanisms that cause fatigue in soccer. According to time-motion analyses and performance measures during match-play, fatigue or reduced performance seems to occur at three different stages in the game: (1) after short-term intense periods in both halves; (2) in the initial phase of the second half; and (3) towards the end of the game. Temporary fatigue after periods of intense exercise in the game does not appear to be linked directly to muscle glycogen concentration, lactate accumulation, acidity or the breakdown of creatine phosphate. Instead, it may be related to disturbances in muscle ion homeostasis and an impaired excitation of the sarcolemma. Soccer players' ability to perform maximally is inhibited in the initial phase of the second half, which may be due to lower muscle temperatures compared with the end of the first half. Thus, when players perform low-intensity activities in the interval between the two halves, both muscle temperature and performance are preserved. Several studies have shown that fatigue sets in towards the end of a game, which may be caused by low glycogen concentrations in a considerable number of individual muscle fibres. In a hot and humid environment, dehydration and a reduced cerebral function may also contribute to the deterioration in performance. In conclusion, fatigue or impaired performance in soccer occurs during various phases in a game, and different physiological mechanisms appear to operate in different periods of a game.

Differential regulation of myofilament protein isoforms underlying the contractility changes in skeletal muscle unloading

Weight-bearing skeletal muscles change phenotype in response to unloading. Using the hindlimb suspension rat model, we investigated the regulation of myofilament protein isoforms in correlation to contractility. Four weeks of continuous hindlimb unloading produced progressive atrophy and contractility changes in soleus but not extensor digitorum longus muscle. The unloaded soleus muscle also had decreased fatigue resistance. Along with the decrease of myosin heavy chain isoform I and IIa and increase of IIb and IIx, coordinated regulation of thin filament regulatory protein isoforms were observed: gamma- and beta-tropomyosin decreased and alpha-tropomyosin increased, resulting in an alpha/beta ratio similar to that in normal fast twitch skeletal muscle; troponin I and troponin T (TnT) both showed decrease in the slow isoform and increases in the fast isoform. The TnT isoform switching began after 7 days of unloading and TnI isoform showed detectable changes at 14 days while other protein isoform changes were not significant until 28 days of treatment. Correlating to the early changes in contractility, especially the resistance to fatigue, the early response of TnT isoform regulation may play a unique role in the adaptation of skeletal muscle to unloading. When the fast TnT gene expression was upregulated in the unloaded soleus muscle, alternative RNA splicing switched to produce more high molecular weight acidic isoforms, reflecting a potential compensation for the decrease of slow TnT that is critical to skeletal muscle function. The results demonstrate that differential regulation of TnT isoforms is a sensitive mechanism in muscle adaptation to functional demands.

Physical and metabolic demands of training and match-play in the elite football player

In soccer, the players perform intermittent work. Despite the players performing low-intensity activities for more than 70% of the game, heart rate and body temperature measurements suggest that the average oxygen uptake for elite soccer players is around 70% of maximum (VO(2max). This may be partly explained by the 150 - 250 brief intense actions a top-class player performs during a game, which also indicates that the rates of creatine phosphate (CP) utilization and glycolysis are frequently high during a game. Muscle glycogen is probably the most important substrate for energy production, and fatigue towards the end of a game may be related to depletion of glycogen in some muscle fibres. Blood free-fatty acids (FFAs) increase progressively during a game, partly compensating for the progressive lowering of muscle glycogen. Fatigue also occurs temporarily during matches, but it is still unclear what causes the reduced ability to perform maximally. There are major individual differences in the physical demands of players during a game related to physical capacity and tactical role in the team. These differences should be taken into account when planning the training and nutritional strategies of top-class players, who require a significant energy intake during a week.

Genetic CLC-1 chloride channel deficiency modifies diaphragm muscle isometric contractile properties

Genetic deficiency of the muscle chloride channel CLC-1 leads to myotonia congenita in humans as well as myotonia in mice and goats. The hallmark of myotonia is delayed muscle relaxation due to persistent electrical discharges in the muscle. The present study tested the hypothesis that performance of CLC-1 deficient diaphragm muscle is also altered during the contractile phase of the contraction-relaxation cycle. Diaphragm of CLC-1 deficient and wild type mice underwent in vitro isometric contractility testing. Myotonia was easily demonstrable during contractions elicited by train stimulation, but was not seen during twitch stimulation or during train stimulation preceded by a series of twitch stimulations. Twitch force was reduced from 16.7+/-2.5 N/cm(2) in normal muscle to 7.2+/-1.9 N/cm(2) in CLC-1 deficient muscle (P<0.002). Isometric twitch contraction time was shortened from 19.6+/-0.9 to 15.7+/-1.0 ms (P<0.002). During repetitive 25 Hz stimulation, force/area was lower for diseased than normal muscle, whereas force as a percent of initial values declined at a faster rate for normal than diseased muscle. The latter could be accounted for by a rightward shift in the force-frequency relationship of CLC-1 deficient relative to normal muscle, as use of stimulation frequencies which elicited comparable force levels as a percentage of maximum 100 Hz tetanic force led to similar rates of fatigue. These findings indicate that genetic CLC-1 deficiency not only affects muscle relaxation (myotonia) but also modulates diaphragm performance during the contractile phase of the contraction-relaxation cycle.

Tubular system excitability: an essential component of excitation–contraction coupling in fast-twitch fibres of vertebrate skeletal muscle

The tubular (t-) system is the main interface between the myoplasm and the extracellular environment and is responsible for the rapid inward spread of excitation from the sarcolemma to the inner parts of the skeletal muscle fibre as well as for signal transfer to the sarcoplasmic reticulum to release Ca2+ that, in turn, activates the contractile apparatus. In this review, I explore the insights provided by the mechanically skinned muscle fibre preparation to the better understanding of the importance of the t-system excitability in determining the force response under physiologically relevant conditions. In the mechanically skinned muscle fibre, the t-system seals off after is physically separated from the sarcolemma and its excitability can be investigated by electrical stimulation under controlled conditions. Parameters that can be assessed include the threshold for action potential generation, specific electrical resistance and time constant of the tubular wall, quantity of charge transferred during an action potential, refractory period, length constant and velocity of excitation propagation. Results obtained with mechanically skinned fibres from fast-twitch muscles show that decreased t-system excitability does not necessarily translate into reduced force output, but for any particular set of physiologically relevant conditions there is a level below which a further decrease in t-system excitability markedly decreases the force output. There are several built-in mechanisms linked to the metabolic/energetic state of the muscle fibre which prevent complete action potential failure in the t-system, thus allowing the muscle to respond to nerve stimulation, even if the response becomes markedly attenuated.

Environmental heat stress, hyperammonemia and nucleotide metabolism during intermittent exercise

This study investigated the influence of environmental heat stress on ammonia (NH3) accumulation in relation to nucleotide metabolism and fatigue during intermittent exercise. Eight males performed 40 min of intermittent exercise (15 s at 306+/-22 W alternating with 15 s of unloaded cycling) followed by five 15 s all-out sprints. Control trials were conducted in a 20 degrees C environment while heat stress trials were performed at an ambient temperature of 40 degrees C. Muscle biopsies and venous blood samples were obtained at rest, after 40 min of exercise and following the maximal sprints. Following exercise with heat stress, the core and muscle temperatures peaked at 39.5+/-0.2 and 40.2+/-0.2 degrees C to be approximately 1 degrees C higher (P<0.05) than the corresponding control values. Mean power output during the five maximal sprints was reduced from 618+/-12 W in control to 558+/-14 W during the heat stress trial (P<0.05). During the hot trial, plasma NH3 increased from 31+/-2 microM at rest to 93+/-6 at 40 min and 151+/-15 microM after the maximal sprints to be 34% higher than control (P<0.05). In contrast, plasma K+ and muscle H+ accumulation were lower (P<0.05) following the maximal sprints with heat stress compared to control, while muscle glycogen, CP, ATP and IMP levels were similar across trials. In conclusion, altered levels of "classical peripheral fatiguing agents" does apparently not explain the reduced capacity for performing repeated sprints following intermittent exercise in the heat, whereas the augmented systemic NH3 response may be a factor influencing fatigue during exercise with superimposed heat stress.

Quadriceps femoris electromyogram during concentric, isometric and eccentric phases of fatiguing dynamic knee extensions

The objective of this study was to examine the superficial quadriceps femoris (QF) muscle electromyogram (EMG) during fatiguing knee extensions. Thirty young adults were evaluated for their one-repetition maximum (1RM) during a seated, right-leg, inertial knee extension. All subjects then completed a single set of repeated knee extensions at 50% 1RM, to failure. Subjects performed a knee extension (concentric phase), held the weight with the knee extended for 2s (isometric phase), and lowered the weight in a controlled manner (eccentric phase). Raw EMG of the vastus medialis (VM), vastus lateralis (VL) and rectus femoris (RF) muscles were full-wave rectified, integrated and normalized to the 1RM EMG, for each respective phase and repetition. The EMG median frequency (f(med)) was computed during the isometric phase. An increase in QF muscle EMG was observed during the concentric phase across the exercise duration. VL EMG was greater than the VM and RF muscles during the isometric phase, in which no significant changes occurred in any of the muscles across the exercise duration. A significant decrease in EMG across the exercise duration was observed during the eccentric phase, with the VL EMG greater than the VM and RF muscles. A greater decrease in VL and RF muscle f(med) during the isometric phase, than the VM muscle, was observed with no gender differences. The findings demonstrated differential recruitment of the superficial QF muscle, depending on the contraction mode during dynamic knee extension exercise, where VL muscle dominance appears to manifest across the concentric-isometric-eccentric transition.

Protective role of extracellular chloride in fatigue of isolated mammalian skeletal muscle

A possible role of extracellular Cl(-) concentration ([Cl(-)](o)) in fatigue was investigated in isolated skeletal muscles of the mouse. When [Cl(-)](o) was lowered from 128 to 10 mM, peak tetanic force was unchanged, fade was exacerbated (wire stimulation electrodes), and a hump appeared during tetanic relaxation in both nonfatigued slow-twitch soleus and fast-twitch extensor digitorum longus (EDL) muscles. Low [Cl(-)](o) increased the rate of fatigue 1) with prolonged, continuous tetanic stimulation in soleus, 2) with repeated intermittent tetanic stimulation in soleus or EDL, and 3) to a greater extent with repeated tetanic stimulation when wire stimulation electrodes were used rather than plate stimulation electrodes in soleus. In nonfatigued soleus muscles, application of 9 mM K(+) with low [Cl(-)](o) caused more rapid and greater tetanic force depression, along with greater depolarization, than was evident at normal [Cl(-)](o). These effects of raised [K(+)](o) and low [Cl(-)](o) were synergistic. From these data, we suggest that normal [Cl(-)](o) provides protection against fatigue involving high-intensity contractions in both fast- and slow-twitch mammalian muscle. This phenomenon possibly involves attenuation of the depolarization caused by stimulation- or exercise-induced run-down of the transsarcolemmal K(+) gradient.

Potassium kinetics in human muscle interstitium during repeated intense exercise in relation to fatigue

Accumulation of K+ in skeletal muscle interstitium during intense exercise has been suggested to cause fatigue in humans. The present study examined interstitial K+ kinetics and fatigue during repeated, intense, exhaustive exercise in human skeletal muscle. Ten subjects performed three repeated, intense (61.6+/-4.1 W; mean+/-SEM), one-legged knee extension exercise bouts (EX1, EX2 and EX3) to exhaustion separated by 10-min recovery periods. Interstitial [K+] ([K+]interst) in the vastus lateralis muscle were determined using microdialysis. Time-to-fatigue decreased progressively (P<0.05) during the protocol (5.1+/-0.4, 4.2+/-0.3 and 3.2+/-0.2 min for EX1, EX2 and EX3 respectively). Prior to these bouts, [K+]interst was 4.1+/-0.2, 4.8+/-0.2 and 5.2+/-0.2 mM, respectively. During the initial 1.5 min of exercise the accumulation rate of interstitial K+ was 85% greater (P<0.05) in EX1 than in EX3. At exhaustion [K+]interst was 11.4+/-0.8 mM in EX1, which was not different from that in EX2 (10.4+/-0.8 mM), but higher (P<0.05) than in EX3 (9.1+/-0.3 mM). The study demonstrated that the rate of accumulation of K+ in the muscle interstitium declines during intense repetitive exercise. Furthermore, whilst [K+]interst at exhaustion reached levels high enough to impair performance, the concentration decreased with repeated exercise, suggesting that accumulation of interstitial K+ per se does not cause fatigue when intense exercise is repeated.

Changes of action potentials and force at lowered [Na+]o in mouse skeletal muscle: implications for fatigue

We examined 1) whether the effects of lowered trans-sarcolemmal Na+ gradient on force differed between nonfatigued fast- and slow-twitch muscles of mice and 2) whether effects on action potentials could explain the decrease of force. The Na+ gradient was reduced by lowering the extracellular [Na+] ([Na+]o). The peak force-[Na+]o relationships for the twitch and tetanus were the same in nonfatigued extensor digitorum longus and soleus muscles: force was maintained over a large range of [Na+]o and then decreased abruptly over a much smaller range. However, fatigue was significantly exacerbated at a lowered [Na+]o that had little effect in nonfatigued soleus muscle. This finding suggests that substantial differences exist in the Na+ effect on force between nonfatigued and fatigued muscle. The reduced contractility in nonfatigued muscles at lowered [Na+]o was largely due to 1) an increased number of inexcitable fibers and threshold for action potentials, 2) a reduction of action potential amplitude, and 3) a reduced capacity to generate action potentials throughout trains.

Na+-K+ Pump Regulation and Skeletal Muscle Contractility

Clausen, Torben. Na+-K+ Pump Regulation and Skeletal Muscle Contractility. Physiol Rev 83: 1269-1324, 2003; 10.1152/physrev.00011.2003.—In skeletal muscle, excitation may cause loss of K+, increased extracellular K+ ([K+]o), intracellular Na+ ([Na+]i), and depolarization. Since these events interfere with excitability, the processes of excitation can be self-limiting. During work, therefore, the impending loss of excitability has to be counterbalanced by prompt restoration of Na+-K+ gradients. Since this is the major function of the Na+-K+ pumps, it is crucial that their activity and capacity are adequate. This is achieved in two ways: 1) by acute activation of the Na+-K+ pumps and 2) by long-term regulation of Na+-K+ pump content or capacity. 1) Depending on frequency of stimulation, excitation may activate up to all of the Na+-K+ pumps available within 10 s, causing up to 22-fold increase in Na+ efflux. Activation of the Na+-K+ pumps by hormones is slower and less pronounced. When muscles are inhibited by high [K+]o or low [Na+]o, acute hormone- or excitation-induced activation of the Na+-K+ pumps can restore excitability and contractile force in 10-20 min. Conversely, inhibition of the Na+-K+ pumps by ouabain leads to progressive loss of contractility and endurance. 2) Na+-K+ pump content is upregulated by training, thyroid hormones, insulin, glucocorticoids, and K+ overload. Downregulation is seen during immobilization, K+ deficiency, hypoxia, heart failure, hypothyroidism, starvation, diabetes, alcoholism, myotonic dystrophy, and McArdle disease. Reduced Na+-K+ pump content leads to loss of contractility and endurance, possibly contributing to the fatigue associated with several of these conditions. Increasing excitation-induced Na+ influx by augmenting the open-time or the content of Na+ channels reduces contractile endurance. Excitability and contractility depend on the ratio between passive Na+-K+ leaks and Na+-K+ pump activity, the passive leaks often playing a dominant role. The Na+-K+ pump is a central target for regulation of Na+-K+ distribution and excitability, essential for second-to-second ongoing maintenance of excitability during work.

Re-evaluation of muscle wisdom in the human adductor pollicis using physiological rates of stimulation

Motor unit discharge rates decline by about 50 % over 60 s of a sustained maximum voluntary contraction (MVC). It has been suggested that this decline in discharge rate serves to maintain force by protecting against conduction failure and by optimizing the input to motor units as their contractile properties change. This hypothesis, known as muscle wisdom, is based in part on studies in which muscle force was shown to decline more rapidly when stimulation was maintained at a high rate than when stimulus rate was reduced over time. The stimulus rates used in those studies, however, were higher than those normally encountered during MVCs. The purpose of this study was to compare force loss under constant and declining stimulus rate conditions using rates similar to those that occur during voluntary effort. Isometric force and surface EMG signals were recorded from human adductor pollicis muscles in response to supramaximal stimuli delivered to the ulnar nerve at the elbow. Three fatigue protocols, each 60 s in duration, were carried out on separate days on each of 10 subjects: (1) continuous stimulation at 30 Hz, (2) stimulation at progressively decreasing rates from 30 to 15 Hz and (3) sustained MVC. The relative force-time integral (endurance index) was significantly smaller for the sustained MVC (0.75 +/- 0.08) and decreasing stimulus rate conditions (0.76 +/- 0.16) compared to the condition in which stimulus rate was maintained at 30 Hz (0.90 +/- 0.13). These findings suggest that decreases in discharge rate may contribute to force decline during a sustained MVC.

Differences in energy metabolism and neuromuscular transmission between 30-Hz and 100-Hz stimulation in rat skeletal muscle

OBJECTIVE

To examine differences in energy metabolism and neuromuscular transmission failure in rat hindlimb muscles subjected to electric stimulation at different frequencies.

DESIGN

Experimental animal study.

SETTING

Bioenergetic Research Center at Otsuka Pharmaceutical Company, Otsuka, Japan.

ANIMALS

Thirty-two 25-week-old male Wistar-Kyoto rats.

INTERVENTIONS

With the rat under general anesthesia, the sciatic nerve was electrically stimulated at 30Hz and 100Hz to induce muscle contraction.

MAIN OUTCOME MEASURES

Energy level and intracellular pH of muscles by phosphorus-31 magnetic resonance spectroscopy ((31)P-MRS); M-wave amplitude of muscles by electromyography.

RESULTS

During the first 4 minutes under stimulation at 30Hz and at 100Hz, energy level and intracellular pH dropped to their lowest values (p <.05 or p <.01); the values then recovered with time. Recovery rates of energy level and intracellular pH during stimulation at 100Hz were greater than those observed during stimulation at 30Hz. The M-wave amplitude during 100-Hz stimulation was permanently and significantly lower than that measured during 30-Hz stimulation (p <.01), and the recovery rate of M-wave amplitude after stimulation at 100Hz was slower than that after stimulation at 30Hz.

CONCLUSION

Neuromuscular transmission failure was greater with 100-Hz stimulation than with 30-Hz stimulation. This finding may account for the rapid recovery of energy level and intracellular pH that occurs with stimulation at 100Hz.

Age, fatigue, and excitation-contraction coupling in masseter muscles of rats

The purpose of this study was to determine if masseter muscle endurance changes with increasing age and, if so, to examine mechanisms of fatigue. Characteristics of fatigue were measured under isometric conditions using high-frequency stimulation of anterior deep masseter (ADM) muscles of male Fischer 344 rats, 5 to 24 months old, and fed a hard (HD) or a soft (SD) diet. Potentiating effects of caffeine on ADM muscle performance in vitro were also examined. Fatigability increased by 48% with age in muscles of HD rats. Muscles of SD rats were highly fatigable at all ages. Increased HD fatigability was associated with significantly decreased concentrations of Na+/K+-adenosine triphosphatase (22%) and decreased responsiveness to caffeine postfatigue (29%). The pH levels decreased similarly in fatigued muscles of all groups. We conclude that the age-related increase in fatigability is associated with alterations in excitation-contraction coupling mechanisms. However, differences between SD and HD on ADM muscles represent possible fiber-type transitions.

Generation of tension by skinned fibers and intact skeletal muscles from desmin-deficient mice

We have investigated the physiological role of desmin in skeletal muscle by measuring isometric tension generated in skinned fibres and intact skeletal muscles from desmin knock-out (DES-KO) mice. About 80% of skinned single extensor digitorum longus (EDL) fibres from adult DES-KO mice generated tensions close to that of wild-type (WT) controls. Weights and maximum tensions of intact EDL but not of soleus (SOL) muscles were lowered in DES-KO mice. Repeated contractions with stretch did not affect subsequent isometric tension in EDL muscles of DES-KO mice. Tension during high frequency fatigue (HFF) declined faster and this deficiency was compensated in DES-KO EDL muscles by 5 mM caffeine which had no influence on HFF in WT EDL. Furthermore, caffeine evoked twitch potentiation was higher in DES-KO than in WT muscles. We conclude that desmin is not essential for acute tensile strength but rather for optimal activation of intact myofibres during E-C coupling.

Dynamics and consequences of potassium shifts in skeletal muscle and heart during exercise

Since it became clear that K(+) shifts with exercise are extensive and can cause more than a doubling of the extracellular [K(+)] ([K(+)](s)) as reviewed here, it has been suggested that these shifts may cause fatigue through the effect on muscle excitability and action potentials (AP). The cause of the K(+) shifts is a transient or long-lasting mismatch between outward repolarizing K(+) currents and K(+) influx carried by the Na(+)-K(+) pump. Several factors modify the effect of raised [K(+)](s) during exercise on membrane potential (E(m)) and force production. 1) Membrane conductance to K(+) is variable and controlled by various K(+) channels. Low relative K(+) conductance will reduce the contribution of [K(+)](s) to the E(m). In addition, high Cl(-) conductance may stabilize the E(m) during brief periods of large K(+) shifts. 2) The Na(+)-K(+) pump contributes with a hyperpolarizing current. 3) Cell swelling accompanies muscle contractions especially in fast-twitch muscle, although little in the heart. This will contribute considerably to the lowering of intracellular [K(+)] ([K(+)](c)) and will attenuate the exercise-induced rise of intracellular [Na(+)] ([Na(+)](c)). 4) The rise of [Na(+)](c) is sufficient to activate the Na(+)-K(+) pump to completely compensate increased K(+) release in the heart, yet not in skeletal muscle. In skeletal muscle there is strong evidence for control of pump activity not only through hormones, but through a hitherto unidentified mechanism. 5) Ionic shifts within the skeletal muscle t tubules and in the heart in extracellular clefts may markedly affect excitation-contraction coupling. 6) Age and state of training together with nutritional state modify muscle K(+) content and the abundance of Na(+)-K(+) pumps. We conclude that despite modifying factors coming into play during muscle activity, the K(+) shifts with high-intensity exercise may contribute substantially to fatigue in skeletal muscle, whereas in the heart, except during ischemia, the K(+) balance is controlled much more effectively.

Quadriceps activation and perceived exertion during a high intensity, steady state contraction to failure

The ability to sustain a high-intensity, steady-state muscle contraction may have differential effects on neuromuscular activation and perceived exertion. The purpose of this study was to examine changes in neuromuscular activation and perceived exertion at a near-maximal steady-state contraction of the quadriceps in healthy men. Seventeen healthy, college-aged male volunteers were studied during isometric contractions equivalent to 80% of the maximum voluntary contraction (MVC). Perceived exertion was measured with a modified category-ratio scale (CR-10). The CR-10 scale was anchored with one high anchor at 100% MVC and one low anchor at 10% MVC. Subjects then performed an 80% MVC for as long as they could sustain it. Subjects were asked to rate the feelings in their quadriceps every 5 s during the contraction. The results demonstrated significant increases in neuromuscular activation of the vastus medialis and vastus lateralis muscles (P < 0.05) during the 80% MVC, but there were no significant muscle by time interactions. The results also demonstrated a significant increase (P < 0.05) in perceived exertion during the 80% MVC. Neuromuscular activation of both muscles, and perceived exertion, were found to increase in linear (P < 0.05) and quadratic (P < 0.05) trends. Alterations in motor unit discharge properties or impairments in muscle fiber membrane excitability may account for nonlinear increases in vastii muscle activation and perceived exertion.

Malignant hyperthermia: fatigue characteristics of skeletal muscle

Although the defects in cellular Ca(2+) homeostasis associated with malignant hyperthermia (MH) have been extensively studied, the functional consequences of the MH mutation are not clear. We used continuous and intermittent high-frequency stimulation to determine whether this mutation might alter the fatigue resistance of muscle from MH susceptible (MHS) pigs. Force decline with 10 s continuous stimulation (150 Hz) was significantly less in MHS muscle (58.4 +/- 1.0%) than in normal muscle (50.5 +/- 3.0%). With intermittent stimulation, there was no significant difference in tension decline between muscle types. Post-stimulation twitch and tetanus responses were similar in MHS and normal muscles except: 1) twitch potentiation was significantly greater in normal muscle after continuous stimulation, and 2) recovery of tetanic tension was slowed in MHS muscle. Although the MH defect does not cause major functional abnormalities, subtle differences in MHS muscle response to fatiguing stimulation are apparent. Therefore, it is unlikely the work capacity of MH patients would be limited by any MH associated defect within the muscle.

Measurement of force and both surface and deep M wave properties in isolated rat soleus muscles

In isolated soleus muscles of 4-wk-old rats, M wave parameters were recorded with surface and deep recording electrodes and examined in relation to both twitch and tetanic force. Addition of ouabain (10(-5) M for 16 min) to isolated muscles caused an approximately 40% decrease in twitch amplitude and area (P < 0.01) that was associated with a 98% decrease in surface M wave amplitude, a 78% decrease in deep M wave amplitude (both P < 0.001), a 98% decrease in surface M wave area (P < 0.01), 48% of which occurred within 60 s of addition of ouabain (P < 0.05), and a 55% decrease in deep M wave area (P < 0.05). The decrease in twitch parameters on addition of ouabain was most closely correlated with deep M wave area (r = 0.92). Direct tetanic stimulation at a frequency of 30 Hz resulted in an initial potentiation of M waves, which was not seen at a frequency of 90 Hz. Instead, 90 Hz stimulation resulted in a prompt decrease in tetanic force that was correlated with a decrease in both deep M wave amplitude (r = 0.94; P < 0.01) and deep M wave area (r = 0.96; P < 0.01). It is concluded that simultaneous surface and deep recordings involving area and amplitude are fundamental to analysis of the effects of pharmacological agents on muscle performance and the use of M waves as predictors of muscle excitability.

Nuclear microscopy of normal and necrotic skeletal muscle fibers: an intracellular elemental microanalysis

The in situ total elemental composition and elemental concentrations present in mouse soleus (type I) and gastrocnemius (type IIA) muscle fibers were analyzed by using nuclear microscopy (NM). Elemental changes in necrotic fibers, induced by intramuscular injection with snake venom (Pseudechis australis), were also studied 3 h post-injection. Nuclear microscopy is a new method based on nuclear technology that utilizes the interaction between a million-electron-volt nuclear particle beam and the muscle sample (in the case of the present study). Elemental analysis was done at the parts per million (ppm) level of sensitivity on unfixed, rapidly frozen and unstained single fast- and slow-twitch muscle fibers with imaging capabilities of micron spatial resolution and in multi-elemental mode. In total, 12 different intracellular elements were mapped, co-localized and analyzed in single normal and necrotic skeletal muscle fibers from mice. Elements such as potassium, sulfur, phosphorus, chlorine and sodium were found in concentrations from 1000 to 18,000 ppm. Unlike conventional electron-probe X-ray microanalysis, NM also detected and analyzed the trace elements such as magnesium, calcium, iron and zinc that were found in concentrations of 50 to 1000 ppm. Other elements--copper, manganese and rubidium--were also detected in concentrations of less than 50 ppm. The trace elements calcium, iron and zinc were more abundant in the soleus than the gastrocnemius (the level of iron was statistically significant). Calcium, sodium and chlorine were significantly elevated in venom-induced necrotic soleus muscle fibers.

Fiber atrophy, but not changes in acetylcholine receptor expression, contributes to the muscle dysfunction after immobilization

OBJECTIVES

Muscle weakness associated with critical illness can be due to the illness itself, immobilization associated with it, and/or to concomitant use of drugs that affect neuromuscular transmission. This study investigated the contribution of immobilization per se to the muscle dysfunction, as well as the associated morphologic and biochemical changes.

DESIGN

Prospective, laboratory study.

SETTING

Hospital research laboratory.

SUBJECTS

Adult, male, Sprague-Dawley rats, weighing 200 to 250 g, were randomly allocated to three experimental groups, depending on the duration (7, 14, or 28 days) of limb immobilization (n = 9 to 11 per group) or sham immobilization (n = 5 to 6 per group).

INTERVENTIONS

Chronic, unilateral immobilization (disuse) of the tibialis cranialis muscle was produced by fixing the knee and ankle joints at 90 degrees flexion. The contralateral unimmobilized leg and a separate group of sham-immobilized legs served as controls.

MEASUREMENTS AND MAIN RESULTS

After 7, 14, or 28 days of disuse of the tibialis muscles, the peak isometric twitch (Pt) and tetanic (Po) tensions, as well as fatigability during 5 secs of nerve stimulation at 50, 100, and 150 Hz, were measured simultaneously in situ in the immobilized group and in its contralateral control, and in the sham-immobilized group and in its contralateral control. Muscle fiber and endplate morphologies were determined by histochemical methods; membrane acetylcholine receptors (AChRs) were determined by 125I alpha-bungarotoxin assay; and the level of expression of AChR subunit transcripts was determined by reverse transcriptase-polymerase chain reaction. Immobilization reduced Pt, Po, fatigability, muscle mass, and fiber cross-sectional area (p<.001 vs. controls), but did not decrease tension per unit muscle mass, fiber oxidative capacity, or motor endplate size. Muscle mass correlated with fiber cross-sectional area. Changes in fiber cross-sectional area accounted for 23% and 46% (p< or =.043) of the variability in Pt and Po, respectively. Pt and Po correlated poorly with total AChR protein and expression of epsilon- and gamma-subunit messenger RNA.

CONCLUSION

To the extent that the immobilization model simulates the disuse-induced muscle dysfunction of critical illness, the results suggest that disuse per se may contribute to the muscle weakness, and that the muscle weakness is explained, almost exclusively, by the fiber atrophy and not by the qualitative or quantitative changes in AChR expression.

Role of extracellular [Ca2+] in fatigue of isolated mammalian skeletal muscle

The possible role of altered extracellular Ca2+ concentration ([Ca2+]o) in skeletal muscle fatigue was tested on isolated slow-twitch soleus and fast-twitch extensor digitorum longus muscles of the mouse. The following findings were made. 1) A change from the control solution (1.3 mM [Ca2+]o) to 10 mM [Ca2+]o, or to nominally Ca2+-free solutions, had little effect on tetanic force in nonfatigued muscle. 2) Almost complete restoration of tetanic force was induced by 10 mM [Ca2+]o in severely K+-depressed muscle (extracellular K+ concentration of 10-12 mM). This effect was attributed to a 5-mV reversal of the K+-induced depolarization and subsequent restoration of ability to generate action potentials (inferred by using the twitch force-stimulation strength relationship). 3) Tetanic force depressed by lowered extracellular Na+ concentration (40 mM) was further reduced with 10 mM [Ca2+]o. 4) Tetanic force loss at elevated extracellular K+ concentration (8 mM) and lowered extracellular Na+ concentration (100 mM) was partially reversed with 10 mM [Ca2+]o or markedly exacerbated with low [Ca2+]o. 5) Fatigue induced by using repeated tetani in soleus was attenuated at 10 mM [Ca2+]o (due to increased resting and evoked forces) and exacerbated at low [Ca2+]o. These combined results suggest, first, that raised [Ca2+]o protects against fatigue rather than inducing it and, second, that a considerable depletion of [Ca2+]o in the transverse tubules may contribute to fatigue.

Events of the excitation-contraction-relaxation (E-C-R) cycle in fast- and slow-twitch mammalian muscle fibres relevant to muscle fatigue

The excitation-contraction-relaxation cycle (E-C-R) in the mammalian twitch muscle comprises the following major events: (1) initiation and propagation of an action potential along the sarcolemma and transverse (T)-tubular system; (2) detection of the T-system depolarization signal and signal transmission from the T-tubule to the sarcoplasmic reticulum (SR) membrane; (3) Ca2+ release from the SR; (4) transient rise of myoplasmic [Ca2+]; (5) transient activation of the Ca2+-regulatory system and of the contractile apparatus; (6) Ca2+ reuptake by the SR Ca2+ pump and Ca2+ binding to myoplasmic sites. There are many steps in the E-C-R cycle which can be seen as potential sites for muscle fatigue and this review explores how structural and functional differences between the fast- and slow-twitch fibres with respect to the E-C-R cycle events can explain to a great extent differences in their fatiguability profiles.