Fatigability during repetitive maximal knee extensions in 14-year-old boys

Differences in time to task failure and fatigability between children and young adults: A systematic review and meta-analysis

The transition from childhood to adulthood is characterized by many physiological processes impacting exercise performance. Performance fatigability and time to task failure are commonly used to capture exercise performance. This review aimed to determine the differences in fatigability and TTF between youth (including both children and adolescents) and young adults, and to evaluate the influence of exercise modalities (i.e., exercise duration and type of exercise) on these differences. Medline, SPORTDiscus and Cochrane Library were searched. Thirty-four studies were included. The meta-analyses revealed that both children (SMD −1.15; p < 0.001) and adolescents (SMD −1.26; p = 0.022) were less fatigable than adults. Additional analysis revealed that children were less fatigable during dynamic exercises (SMD −1.58; p < 0.001) with no differences during isometric ones (SMD –0.46; p = 0.22). Children (SMD 0.89; p = 0.018) but not adolescents (SMD 0.75; p = 0.090) had longer TTF than adults. Additional analyses revealed 1) that children had longer TTF for isometric (SMD 1.25; p < 0.001) but not dynamic exercises (SMD −0.27; p = 0.83), and 2) that TTF differences between children and adults were larger for short- (SMD 1.46; p = 0.028) than long-duration exercises (SMD 0.20; p = 0.64). Children have higher endurance and are less fatigable than adults. These differences are influenced by the exercise modality, suggesting distinct physiological functioning during exercise between children and adults. The low number of studies comparing these outcomes between adolescents versus children and adults prevents robust conclusions and warrants further investigations in adolescent individuals.

Age-related changes in isolated mouse skeletal muscle function are dependent on sex, muscle, and contractility mode

The present study aimed to simultaneously examine the age-related, muscle-specific, sex-specific, and contractile mode-specific changes in isolated mouse skeletal muscle function and morphology across multiple ages. Measurements of mammalian muscle morphology, isometric force and stress (force/cross-sectional area), absolute and normalized (power/muscle mass) work-loop power across a range of contractile velocities, fatigue resistance, and myosin heavy chain (MHC) isoform concentration were measured in 232 isolated mouse (CD-1) soleus, extensor digitorum longus (EDL), and diaphragm from male and female animals aged 3, 10, 30, 52, and 78 wk. Aging resulted in increased body mass and increased soleus and EDL muscle mass, with atrophy only present for female EDL by 78 wk despite no change in MHC isoform concentration. Absolute force and power output increased up to 52 wk and to a higher level for males. A 23–36% loss of isometric stress exceeded the 14–27% loss of power normalized to muscle mass between 10 wk and 52 wk, although the loss of normalized power between 52 and 78 wk continued without further changes in stress ( P > 0.23). Males had lower power normalized to muscle mass than females by 78 wk, with the greatest decline observed for male soleus. Aging did not cause a shift toward slower contractile characteristics, with reduced fatigue resistance observed in male EDL and female diaphragm. Our findings show that the loss of muscle quality precedes the loss of absolute performance as CD-1 mice age, with the greatest effect seen in male soleus, and in most instances without muscle atrophy or an alteration in MHC isoforms.

Exercise-induced fatigue in young people: advances and future perspectives

PURPOSE

In recent decades, the interest for exercise-induced fatigue in youth has substantially increased, and the effects of growth on the peripheral (muscular) and central (neural) mechanisms underpinning differences in neuromuscular fatigue between healthy children and adults have been described more extensively. The purpose of this review is to retrieve, report, and analyse the findings of studies comparing neuromuscular fatigue between children and adults. Objective measures of the evaluation of the physiological mechanisms are discussed.

METHOD

Major databases (PubMed, Ovid, Scopus and Web of Science) were systematically searched and limited to English language from inception to September 2017.

RESULT

Collectively, the analyzed studies indicate that children experience less muscular and potentially more neural fatigue than adults. However, there are still many unknown aspects of fatigue regarding neural (supraspinal and spinal) and peripheral mechanisms that should be more thoroughly examined in children.

CONCLUSION

Suitable methods, such as transcranial magnetic stimulation, transcranial electrical stimulation, functional magnetic resonance imaging, near-infrared spectroscopy, tendon vibration, H-reflex, and ultrasound are recommended in the research field of fatigue in youth. By designing studies that test the fatigue effects in movements that replicate daily activities, new knowledge will be acquired. The linkage and interaction between physiological, cognitive, and psychological aspects of human performance remain to be resolved in young people. This can only be successful if research is based on a foundation of basic research focused on the mechanisms of fatigue while measuring all three above aspects.

[High-intensity interval training for young athletes]

A computer-based literature research during July 2013 using the electronic databases PubMed, MEDLINE, SPORTDiscus and Web of Science was performed to assess the effect of the high intensity interval training (HIIT) on sport performance in healthy children and adolescents. Studies examining the effect of HIIT on aerobic and anaerobic performance pre and post to HIIT-Interventions in children and adolescents (9-18 years) were included. The results indicate increased aerobic and anaerobic performance following two or three HIIT sessions per week for a period of five to ten weeks, additional to normal training. Results regarding long term effects following HIIT have not been documented so far. In addition, due to the physiological characteris-tics during HIIT protocols improved fatigue resistance has been demonstrated in children as compared to adults, which may be interpreted as a prerequisite for the applicability of HIIT in children.

Skeletal muscle fatigue

Skeletal muscle fatigue is defined as the fall of force or power in response to contractile activity. Both the mechanisms of fatigue and the modes used to elicit it vary tremendously. Conceptual and technological advances allow the examination of fatigue from the level of the single molecule to the intact organism. Evaluation of muscle fatigue in a wide range of disease states builds on our understanding of basic function by revealing the sources of dysfunction in response to disease.

Muscle fatigue during repetitive voluntary contractions: a comparison between children with cerebral palsy, typically developing children and young healthy adults

AIM

To combine peak torque and EMG analyses to investigate the hypothesis that 1) children with cerebral palsy (CP) have lower muscle fatigability than typically developing children (TD) and whether 2) muscle fatigue correlates with muscle strength.

METHODS

Seven CP children, eight TD children and ten young healthy adults (YHA) performed an all-out fatigue test of 35 maximal concentric knee extension and flexion contractions on an isokinetic dynamometer. Angular velocity was set at 60°/s. Peak torque (PT) was determined per repetition and either normalized to bodyweight or maximum voluntary torque. Surface-EMG of quadriceps and hamstring muscles was measured to obtain changes in median frequency (EMG-mf) and smooth rectified EMG amplitude per contraction.

RESULTS

Decline in PT differed between all groups for extensors and flexors, where YHA showed the largest decline and CP children the smallest decline over the course of the test. YHA showed a larger decline in EMG-mf of all quadriceps and hamstrings than TD and CP children, while TD children showed a larger decline in EMG-mf of m.rectus femoris and m.vastus lateralis than CP children.

INTERPRETATION

Results confirm that children with CP show lower fatigability than TD children and that the lower fatigability coincides with lower maximal muscle strength.

Muscle energetics changes throughout maturation: a quantitative 31P-MRS analysis

We quantified energy production in 7 prepubescent boys (11.7 ± 0.6 yr) and 10 men (35.6 ± 7.8 yr) using (31)P-magnetic resonance spectroscopy to investigate whether development affects muscle energetics, given that resistance to fatigue has been reported to be larger before puberty. Each subject performed a finger flexions exercise at 0.7 Hz against a weight adjusted to 15% of their maximal voluntary strength for 3 min, followed by a 15-min recovery period. The total energy cost was similar in both groups throughout the exercise bout, whereas the interplay of the different metabolic pathways was different. At the onset of exercise, children exhibited a higher oxidative contribution (50 ± 15% in boys and 25 ± 8% in men, P < 0.05) to ATP production, whereas the phosphocreatine breakdown contribution was reduced (40 ± 10% in boys and 53 ± 12% in men, P < 0.05), likely as a compensatory mechanism. The anaerobic glycolysis activity was unaffected by maturation. The recovery phase also disclosed differences regarding the rates of proton efflux (6.2 ± 2.5 vs. 3.8 ± 1.9 mM · pH unit(-1) · min(-1), in boys and men, respectively, P < 0.05), and phosphocreatine recovery, which was significantly faster in boys than in men (rate constant of phosphocreatine recovery: 1.3 ± 0.5 vs. 0.7 ± 0.4 min(-1); V(max): 37.5 ± 14.5 vs. 21.1 ± 12.2 mM/min, in boys and men, respectively, P < 0.05). Our results obtained in vivo clearly showed that maturation affects muscle energetics. Children relied more on oxidative metabolism and less on creatine kinase reaction to meet energy demand during exercise. This phenomenon can be explained by a greater oxidative capacity, probably linked to a higher relative content in slow-twitch fibers before puberty.

Age- and sex-associated differences in isokinetic knee muscle endurance between young children and adults

The purpose of this study was to examine the age- and sex-associated differences of repeated isokinetic knee extension and flexion. Fifty one participants, 30 young children (16 boys and 14 girls; aged 11 and 12 years) and 21 adults (9 males and 12 females; aged 18-35 years), agreed to participate in the study. Isokinetic concentric peak knee extension (PET) and flexion (PFT) torque were measured using a calibrated Biodex System 3. Participants performed 4 concentric extension-flexion cycles with maximum effort; after a 2 min rest, 50 continuous concentric cycles were performed at 1.56 rad.s-1. Total work of the extensors (WKEX) and flexors (WKFL) for the complete 50 repetitions was recorded. Average peak torque and average work for the first and last 3 repetitions were calculated to represent the percentage decline in torque and work. There were no significant differences between groups in the peak torque generated during the pretrial and endurance task, suggesting that participants gave a maximal effort at the start of the endurance task. There was a significant interaction effect in the total work done for both extensors and flexors, with adult males producing the greatest amount of work (6622 and 3444 J, respectively). When total work was divided by body mass, there were no significant sex effects, only main effects for group. The percentage decline for PET (40% vs. 60%), PFT (50% vs. 65%), WKET (43% vs. 61%), and WKFL (60% vs. 69%) demonstrated significant main effects for group, with greater fatigue in adults. We found no significant sex effect for fatigue. This study concludes that females do not resist fatigue from repeated isokinetic muscle actions to a greater extent than males, and that the greater fatigue in adults than in children is probably a product of greater initial torque production and work performed.

Fatigue resistance during high-intensity intermittent exercise from childhood to adulthood in males and females

This study examined the maturation pattern of fatigue resistance (FR) from childhood to adulthood in females and males during high-intensity intermittent exercise and compared FR between females and males in childhood and adolescence. Thirty males (boys 11.3 +/- 0.5 years, teen-males 14.7 +/- 0.3 years, men 24.0 +/- 2.1 years) and 30 females (girls 10.9 +/- 0.6 years, teen-females 14.4 +/- 0.7 years, women 25.2 +/- 1.4) participated in this study. They performed high-intensity intermittent exercise (4 x 18 maximal knee flexions and extensions with 1-min rest) on an isokinetic dynamometer at 120 degrees s(-1). Peak torque of flexors (PTFL) and extensors (PTEX), and total work (TW) were measured. FR was calculated as % of PTEX, PTFL, and TW in 4th versus 1st set. FR was greater (P < 0.05) in boys versus teen-males and men, and in teen-males versus men. In females, FR was greater (P < 0.05) in girls versus teen-females and women, but not different between teen-females and women. FR was not different in boys versus girls and in teen-males versus teen-females. FR for PTFL, PTEX, and TW correlated negatively (P < 0.001) with the respective peak values (r = -0.68 to -0.84), and FR for TW with peak lactate (r = -0.58 to -0.69). In addition, age correlated (P < 0.01) with FR for males (r = -0.75) and females (r = -0.55). In conclusion, FR during high-intensity intermittent exercise undergoes a gradual decline from childhood to adulthood in males, while in females the adult profile establishes at mid-puberty (14-15 years). The maturation profile of FR in males and females during development appears to reflect the maturation profiles of peak torque, short-term muscle power, and lactate concentration after exercise.

Fatigue resistance during a voluntary performance task is associated with lower levels of mobility in cerebral palsy

OBJECTIVES

To investigate muscle fatigue of the knee flexors and extensors in people with cerebral palsy (CP) compared with those without motor disability during performance of a voluntary fatigue protocol and to investigate the relationship with functional mobility.

DESIGN

A case-control study.

SETTING

A biomechanics laboratory.

PARTICIPANTS

Ambulatory subjects with CP (n=18; mean age, 17.5 y) in Gross Motor Function Classification System (GMFCS) levels I, II, and III and a comparison group of age-matched subjects (n=16) without motor disability (mean age, 16.6 y).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The voluntary muscle fatigue protocol consisted of concentric knee flexion and extension at 60 degrees a second for 35 repetitions on an isokinetic dynamometer. Peak torque for each repetition was normalized by the maximum peak torque value. Muscle fatigue was calculated as the rate of decline in normalized peak torque across all repetitions, represented by the slope of the linear regression. Self-selected and fast gait velocities were measured as well as the Pediatric Outcomes Data Collection Instrument (PODCI).

RESULTS

Greater fatigability (slope) was observed in the comparison group for both knee flexors and extensors than in the group with CP. Within CP, lower knee extensor fatigue (slope) was associated with lower functioning GMFCS levels and lower levels of activity and participation as measured by the PODCI transfers and basic mobility.

CONCLUSIONS

Even after adjusting for maximum peak torque, the knee flexors and extensors of participants with CP were observed to be less fatigable than age-matched peers without motor disability. The lower rate of muscle fatigue was also associated with lower functional mobility in CP. These results may be related to strength or activation differences and/or muscle property alterations. Future investigations are warranted.

Voluntary activation of the triceps surae in prepubertal children

The activation capacities and neuromuscular efficiency (NME) of the triceps surae (TS) of prepubescent children (7-11 years) and adults were evaluated during submaximal and maximal (MVC) isometric plantarflexion to determine whether they varied with age. TS-EMG were obtained by summing-up the rectified electromyograms of the soleus and gastrocnemii muscles; these data were quantified using a sliding average method and normalized with reference to the TS maximal compound action potential (TS-M-wave). The maximal EMG increased significantly with age in the children, but less than MVC, what led to a significant increase in NME(Max) (MVC/TS-EMG(max) ratio). The EMG-torque relationship indicated an age-related overactivation of TS at low torque, what led to a lower NME(Sub-max) (inverse of the slope of the EMG-torque relationship) for the youngest children. The overactivation of TS was accompanied by contraction of the TA, which decreased with age. The youngest children were also less able to maintain a target torque and muscle activation. Finally, the twitch interpolated method revealed an age-dependant activation deficit. We conclude that central mechanisms are the main cause of the lower torques developed by children and they appear to vary with age in prepubertal children.

Children are more susceptible to central fatigue than adults

Performance in high-intensity exercise is dependent on the ability to activate motor units. The main aim of this study was to test the hypothesis that adult men and women (age 19-27 years) are able to maintain higher levels of voluntary activation (VA) in knee extensor muscles than boys and girls (age 12-14 years). The volunteers (n = 7 in each group) performed three 5-s maximal voluntary contractions (MVCs) and a continuous 2-min MVC. The VA and fatigue of the muscles was assessed by applying 250-ms 100-HZ test tetani (TT100HZ). During brief MVCs girls showed lower VA than women, but the difference between boys and men was not significant. During the 2-min MVC, VA in boys and girls was more depressed than in adults. The end-exercise values of the relative TT100HZ torque correlated with the average VA during the exercise. Thus, the results of the study support the hypothesis that children are more susceptible to central fatigue than adults. This should be taken into account when evaluating results of fitness tests that require high levels of motor unit activation.

Muscle fatigue during high-intensity exercise in children

Children are able to resist fatigue better than adults during one or several repeated high-intensity exercise bouts. This finding has been reported by measuring mechanical force or power output profiles during sustained isometric maximal contractions or repeated bouts of high-intensity dynamic exercises. The ability of children to better maintain performance during repeated high-intensity exercise bouts could be related to their lower level of fatigue during exercise and/or faster recovery following exercise. This may be explained by muscle characteristics of children, which are quantitatively and qualitatively different to those of adults. Children have less muscle mass than adults and hence, generate lower absolute power during high-intensity exercise. Some researchers also showed that children were equipped better for oxidative than glycolytic pathways during exercise, which would lead to a lower accumulation of muscle by-products. Furthermore, some reports indicated that the lower ability of children to activate their type II muscle fibres would also explain their greater resistance to fatigue during sustained maximal contractions. The lower accumulation of muscle by-products observed in children may be suggestive of a reduced metabolic signal, which induces lower ratings of perceived exertion. Factors such as faster phosphocreatine resynthesis, greater oxidative capacity, better acid-base regulation, faster readjustment of initial cardiorespiratory parameters and higher removal of metabolic by-products in children could also explain their faster recovery following high-intensity exercise.From a clinical point of view, muscle fatigue profiles are different between healthy children and children with muscle and metabolic diseases. Studies of dystrophic muscles in children indicated contradictory findings of changes in contractile properties and the muscle fatigability. Some have found that the muscle of boys with Duchenne muscular dystrophy (DMD) fatigued less than that of healthy boys, but others have reported that the fatigue in DMD and in normal muscle was the same. Children with glycogenosis type V and VII and dermatomyositis, and obese children tolerate exercise weakly and show an early fatigue. Studies that have investigated the fatigability in children with cerebral palsy have indicated that the femoris quadriceps was less fatigable than that of a control group but the fatigability of the triceps surae was the same between the two groups. Further studies are required to elucidate the mechanisms explaining the origins of muscle fatigue in healthy and diseased children. The use of non-invasive measurement tools such as magnetic resonance imaging and magnetic resonance spectroscopy in paediatric exercise science will give researchers more insight in the future.

The effect of a complex training and detraining programme on selected strength and power variables in early pubertal boys

Complex training, a combination of resistance training and plyometrics is growing in popularity, despite limited support for its efficacy. In pre- and early pubertal children, the study of complex training has been limited, and to our knowledge an examination of its effect on anaerobic performance characteristics of the upper and lower body has not been undertaken. Furthermore, the effect of detraining after complex training requires clarification. The physical characteristics (mean+/-s) of the 54 male participants in the present study were as follows: age 12.3 +/- 0.3 years, height 1.57 +/- 0.07 m, body mass 50.3 +/- 11.0 kg. Participants were randomly assigned to an experimental (n = 33) or control group (n = 21). The training, which was performed three times a week for 12 weeks, included a combination of dynamic constant external resistance and plyometrics. After training, participants completed 12 weeks of detraining. At baseline, after training and after detraining, peak and mean anaerobic power, dynamic strength and athletic performance were assessed. Twenty-six participants completed the training and none reported any training-related injury. Complex training was associated with small increases (< or =5.5%) in peak and mean power during training, followed by decreases of a similar magnitude (< or = -5.9%) during detraining (P < 0.05). No changes or minor, progressive increases (< or =1.5%) were evident in the control group (P > 0.05). In the experimental group, dynamic strength was increased by 24.3 - 71.4% (dependent on muscle group; P < 0.01), whereas growth-related changes in the control group varied from 0 to 4.4% (P > 0.05). For 40-m sprint running, basketball chest pass and vertical jump test performance, the experimental group saw a small improvement (< or =4.0%) after training followed by a decline (< or = -4.4%) towards baseline during detraining (P < 0.05), whereas the control group experienced no change (P > 0.05). In conclusion, in pre- and early pubertal boys, upper and lower body complex training is a time-effective and safe training modality that confers small improvements in anaerobic power and jumping, throwing and sprinting performance, and marked improvements in dynamic strength. However, after detraining, the benefits of complex training are lost at similar rates to other training modalities.

Differences in fatigability between the sexes during a sustained submaximal contraction protocol in prepubertal children

The aim of this study was to determine whether there are differences in the fatigability of plantar flexor muscles during sustained submaximal contractions in prepubertal boys and girls. Fifteen boys (age 10.0 +/- 1.0 years) and 15 girls (age 9.8 +/- 0.9 years) participated in the study. The fatigue protocol consisted of a 10 min isometric plantar flexion at 20% of the maximal voluntary contraction. Immediately after this, five maximal isometric contractions were performed with a 3 min interval between contractions. During the experiment, electromyograms of the agonist muscles soleus and medial gastrocnemius and antagonist tibialis anterior were recorded. We observed no differences between the sexes (P < 0.05) in the decrease in torque or in the recovery rate after the fatigue protocol. Nor were there any differences between the sexes (P < 0.05) in agonist or antagonist muscle activation during the fatigue protocol and recovery period. The results indicate that there are no differences in fatigability between prepubertal boys and girls during submaximal sustained contractions, probably because the agonist and antagonist muscles were activated similarly in both sexes.

Recovery during High-Intensity Intermittent Anaerobic Exercise in Boys, Teens, and Men

PURPOSE

This study examined the effects of age on recovery of peak torque of knee extensors (PTEX) and flexors (PTFL), and total work (TW) during high-intensity intermittent 30-s (HI30) and 60-s (HI60) exercise in boys (N=19; age, 11.4+/-0.5 yr), teens (N=17; age, 14.7+/-0.4 yr), and men (N=18; age, 24.1+/-2.0 yr).

METHODS

Each age group's subjects were subdivided to participate in an HI30 or an HI60 protocol. The HI30 involved 4x18 maximal knee extensions and flexions (1-min rest between sets), and the HI60 comprised of 2x34 reps (2-min rest). PTEX (N.m.kg), PTFL (N.m.kg), and TW (J.kg) were recorded at each set. The percent recovery of PTEX, PTFL, and TW was calculated as percent of the value achieved in the first set.

RESULTS

In HI60, the percent recovery for PTEX, PTFL, and TW after the first set was higher in boys compared with teens and men (P<0.01). In HI30, the percent recovery for PTEX, PTFL, and TW was higher in boys compared with men in all sets (P<0.01), and in teens compared with men in the last two sets (P<0.05). The percent recovery of PTFL and TW was higher in boys compared with teens in the last two sets (P<0.05). Lactate increase was most pronounced in men, less pronounced in teens, and least pronounced in boys (P<0.01). Heart rate recovered faster in boys compared with teens and men in both protocols (P<0.05).

CONCLUSIONS

The recovery was faster in boys than in teens and men during HI30 and HI60, as evident by the greater percent recovery in boys for a given time. Furthermore, it appears that the rate of recovery during HI30 and HI60 anaerobic exercise is maturity dependent.

Neuromuscular response of young boys versus men during sustained maximal contraction

PURPOSE

This study was designed to compare neuromuscular response between boys and men during sustained maximal voluntary contraction (MVC).

METHODS

Fifteen boys (YB, 10.5 +/- 0.9 yr) and 12 men (AM, 21.5 +/- 4.5 yr) participated in the experiment. Arm's cross sectional area (CSA) and maximal force (F(max)) of elbow flexor were measured before subjects performed a 30-s sustained MVC. Mean power frequency (MPF) and muscle fiber conduction velocity (MFCV) were calculated from myoelectric signals of the biceps brachii. F(max)/CSA, MPF, and MFCV changes were expressed by slopes of linear regressions. Maximal MPF (I-MPF) and MFCV (I-MFCV) were derived from the intercept of each regression.

RESULTS

AM had significantly greater F(max)/CSA (P < 0.05), I-MPF (P < 0.05), and I-MFCV (P < 0.01) than YB. F(max)/CSA (P < 0.001), MPF (P < 0.001), and MFCV (P < 0.01) declined significantly more for AM than YB. MPF/MFCV ratio increased, i.e., MPF decreased more than MFCV, for both groups but this was significantly (P < 0.001) more pronounced for AM.

CONCLUSION

Taken together, those results suggest that more fatigable Type II motor units are involved in men, resulting in greater lactic acid and ions accumulations during fatigue. This difference in muscle's metabolic and ionic state could be responsible for a greater reflex-induced decrease of motor units firing rates in men compared with boys. This firing rate decrease could be explained using the "muscular wisdom" hypothesis and would express a nervous command adaptation to sustain a maximal contraction.