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Yunoki K, Watanabe T, Matsumoto T, Kuwabara T, Horinouchi T, Ito K, Ishida H, Kirimoto H. Cutaneous information processing differs with load type during isometric finger abduction. PLoS One 2022; 17:e0279477. [PMID: 36548285 PMCID: PMC9778995 DOI: 10.1371/journal.pone.0279477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
During submaximal isometric contraction, there are two different load types: maintenance of a constant limb angle while supporting an inertial load (position task) and maintenance of a constant force by pushing against a rigid restraint (force task). Previous studies demonstrated that performing the position task requires more proprioceptive information. The purpose of this study was to investigate whether there would be a difference in cutaneous information processing between the position and force tasks by assessing the gating effect, which is reduction of amplitude of somatosensory evoked potentials (SEPs), and cutaneomuscular reflex (CMR). Eighteen healthy adults participated in this study. They contracted their right first dorsal interosseous muscle by abducting their index finger to produce a constant force against a rigid restraint that was 20% maximum voluntary contraction (force task), or to maintain a target position corresponding to 10° abduction of the metacarpophalangeal joint while supporting a load equivalent to 20% maximum voluntary contraction (position task). During each task, electrical stimulation was applied to the digital nerves of the right index finger, and SEPs and CMR were recorded from C3' of the International 10-20 system and the right first dorsal interosseous muscle, respectively. Reduction of the amplitude of N33 component of SEPs was significantly larger during the force than position task. In addition, the E2 amplitude of CMR was significantly greater for the force than position task. These findings suggest that cutaneous information processing differs with load type during static muscle contraction.
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Affiliation(s)
- Keisuke Yunoki
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tatsunori Watanabe
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Faculty of Health Sciences, Aomori University of Health and Welfare, Aomori, Japan
| | - Takuya Matsumoto
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Fellow of Japan Society for the Promotion of Science, Chiyoda-ku, Japan
| | - Takayuki Kuwabara
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Rehabilitation, Uonuma Kikan Hospital, Minamiuonuma, Niigata, Japan
| | - Takayuki Horinouchi
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kanami Ito
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruki Ishida
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hikari Kirimoto
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- * E-mail:
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Larabee FJ, Gibson JC, Rivera MD, Anderson PSL, Suarez AV. Muscle fatigue in the latch-mediated spring actuated mandibles of trap-jaw ants. Integr Comp Biol 2022; 62:icac091. [PMID: 35689666 DOI: 10.1093/icb/icac091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Muscle fatigue can reduce performance potentially affecting an organism's fitness. However, some aspects of fatigue could be overcome by employing a latch-mediated spring actuated system (LaMSA) where muscle activity is decoupled from movement. We estimated the effects of muscle fatigue on different aspects of mandible performance in six species of ants, two whose mandibles are directly actuated by muscles and four that have LaMSA "trap-jaw" mandibles. We found evidence that the LaMSA system of trap-jaw ants may prevent some aspects of performance from declining with repeated use, including duration, acceleration and peak velocity. However, inter-strike interval increased with repeated strikes suggesting that muscle fatigue still comes into play during the spring loading phase. In contrast, one species with directly actuated mandibles showed a decline in bite force over time. These results have implications for design principles aimed at minimizing the effects of fatigue on performance in spring and motor actuated systems.
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Affiliation(s)
- Fredrick J Larabee
- Department of Evolution, Ecology and Behavior
- Department of Entomology, National Museum of Natural History, Smithsonian Institution, 1000 Constitution Ave., Washington DC
| | - Josh C Gibson
- Department of Entomology
- Beckman Institute for Advanced Science and Technology. University of Illinois Urbana Champaign. 515 Morrill Hall. 505 S. Goodwin Ave., Urbana, IL. 61801
| | | | - Philip S L Anderson
- Department of Evolution, Ecology and Behavior
- Beckman Institute for Advanced Science and Technology. University of Illinois Urbana Champaign. 515 Morrill Hall. 505 S. Goodwin Ave., Urbana, IL. 61801
| | - Andrew V Suarez
- Department of Evolution, Ecology and Behavior
- Department of Entomology
- Program in Ecology, Evolution and Conservation Biology
- Beckman Institute for Advanced Science and Technology. University of Illinois Urbana Champaign. 515 Morrill Hall. 505 S. Goodwin Ave., Urbana, IL. 61801
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3
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Dech S, Bittmann FN, Schaefer LV. Muscle oxygenation and time to task failure of submaximal holding and pulling isometric muscle actions and influence of intermittent voluntary muscle twitches. BMC Sports Sci Med Rehabil 2022; 14:55. [PMID: 35354469 PMCID: PMC8966203 DOI: 10.1186/s13102-022-00447-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/23/2022] [Indexed: 08/30/2023]
Abstract
Background Isometric muscle actions can be performed either by initiating the action, e.g., pulling on an immovable resistance (PIMA), or by reacting to an external load, e.g., holding a weight (HIMA). In the present study, it was mainly examined if these modalities could be differentiated by oxygenation variables as well as by time to task failure (TTF). Furthermore, it was analyzed if variables are changed by intermittent voluntary muscle twitches during weight holding (Twitch). It was assumed that twitches during a weight holding task change the character of the isometric muscle action from reacting (≙ HIMA) to acting (≙ PIMA). Methods Twelve subjects (two drop outs) randomly performed two tasks (HIMA vs. PIMA or HIMA vs. Twitch, n = 5 each) with the elbow flexors at 60% of maximal torque maintained until muscle failure with each arm. Local capillary venous oxygen saturation (SvO2) and relative hemoglobin amount (rHb) were measured by light spectrometry. Results Within subjects, no significant differences were found between tasks regarding the behavior of SvO2 and rHb, the slope and extent of deoxygenation (max. SvO2 decrease), SvO2 level at global rHb minimum, and time to SvO2 steady states. The TTF was significantly longer during Twitch and PIMA (incl. Twitch) compared to HIMA (p = 0.043 and 0.047, respectively). There was no substantial correlation between TTF and maximal deoxygenation independently of the task (r = − 0.13). Conclusions HIMA and PIMA seem to have a similar microvascular oxygen and blood supply. The supply might be sufficient, which is expressed by homeostatic steady states of SvO2 in all trials and increases in rHb in most of the trials. Intermittent voluntary muscle twitches might not serve as a further support but extend the TTF. A changed neuromuscular control is discussed as possible explanation. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-022-00447-9.
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Affiliation(s)
- Silas Dech
- Department of Sport and Health Sciences, Regulative Physiology and Prevention, Human Science Faculty, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14479, Potsdam, Germany.
| | - Frank N Bittmann
- Department of Sport and Health Sciences, Regulative Physiology and Prevention, Human Science Faculty, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14479, Potsdam, Germany
| | - Laura V Schaefer
- Department of Sport and Health Sciences, Regulative Physiology and Prevention, Human Science Faculty, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14479, Potsdam, Germany
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Kunugi S, Holobar A, Kodera T, Toyoda H, Watanabe K. Motor unit firing patterns on increasing force during force and position tasks. J Neurophysiol 2021; 126:1653-1659. [PMID: 34669517 DOI: 10.1152/jn.00299.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Different neurophysiological strategies are used to perform angle adjustments during motor tasks such as car driving and force-control tasks using a fixed-rigid pedal. However, the difference in motor unit behavior in response to an increasing exerted force between tasks is unknown. This study aimed to investigate the difference in motor unit responsiveness on increasing force between force and position tasks. Twelve healthy participants performed ramp and hold contractions during ankle plantarflexion at 20% and 30% of the maximal voluntary contraction using a rigid pedal (force task) and a free pedal with an inertial load (position task). High-density surface electromyograms were recorded of the medial gastrocnemius muscle and decomposed into individual motor unit firing patterns. Ninety and hundred and nine motor units could be tracked between different target torques in each task. The mean firing rate increased and firing rate variability decreased on 10% maximal voluntary contraction force gain during both force and position tasks. There were no significant differences in these responses between the two tasks. Our results suggest that the motor unit firing rate is similarly regulated between force and position tasks in the medial gastrocnemius muscle with an increase in the exerted force.NEW & NOTEWORTHY Different neurophysiological strategies are used to perform a force control task and angle adjustment task. Our results showed that motor unit firing rate is similarly regulated between the two tasks in the medial gastrocnemius muscle with an increase in the exerted force. Although it is reported that position tasks contribute to early fatigue, it does not seem to be a particular problem for the increase in force.
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Affiliation(s)
- Shun Kunugi
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, grid.411620.0Chukyo University, Aichi, Japan
| | - Aleš Holobar
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
| | | | | | - Kohei Watanabe
- Laboratory of Neuromuscular Biomechanics, School of Health and Sport Sciences, grid.411620.0Chukyo University, Aichi, Japan
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Rakshit R, Xiang Y, Yang J. Functional muscle group- and sex-specific parameters for a three-compartment controller muscle fatigue model applied to isometric contractions. J Biomech 2021; 127:110695. [PMID: 34454329 DOI: 10.1016/j.jbiomech.2021.110695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 02/06/2023]
Abstract
The three-compartment controller with enhanced recovery (3CC-r) model of muscle fatigue has previously been validated separately for both sustained (SIC) and intermittent isometric contractions (IIC) using different objective functions, but its performance has not yet been tested against both contraction types simultaneously using a common objective function. Additionally, prior validation has been performed using common parameters at the joint level, whereas applications to many real-world tasks will require the model to be applied to agonistic and synergistic muscle groups. Lastly, parameters for the model have previously been derived for a mixed-sex cohort not considering the differece in fatigabilities between the sexes. In this work we validate the 3CC-r model using a comprehensive isometric contraction database drawn from 172 publications segregated by functional muscle group (FMG) and sex. We find that prediction errors are reduced by 19% on average when segregating the dataset by FMG alone, and by 34% when segregating by both sex and FMG. However, minimum prediction errors are found to be higher when validated against both SIC and IIC data together using torque decline as the outcome variable than when validated sequentially against hypothesized SIC intensity-endurance time curves with endurance time as the outcome variable and against raw IIC data with torque decline as the outcome variable.
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Affiliation(s)
- Ritwik Rakshit
- Human-Centric Design Research Lab, Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79409, USA
| | - Yujiang Xiang
- School of Mechanical and Aerospace Engineering, Oklahoma State University, Stillwater, OK 74078, USA
| | - James Yang
- Human-Centric Design Research Lab, Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79409, USA.
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McGing JJ, Radford SJ, Francis ST, Serres S, Greenhaff PL, Moran GW. Review article: The aetiology of fatigue in inflammatory bowel disease and potential therapeutic management strategies. Aliment Pharmacol Ther 2021; 54:368-387. [PMID: 34228817 DOI: 10.1111/apt.16465] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/30/2020] [Accepted: 05/20/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Fatigue is the inability to achieve or maintain an expected work output resulting from central or peripheral mechanisms. The prevalence of inflammatory bowel disease (IBD) fatigue can reach 86% in active disease, persisting in 50%-52% of patients with mild to inactive disease. Fatigue is the commonest reason for work absence in IBD, and patients often report fatigue burden to be greater than that of primary disease symptoms. Relatively few evidence-based treatment options exist, and the aetiology is poorly understood. AIM To review the available data and suggest a possible aetiology of IBD fatigue and to consider the efficacy of existing management strategies and highlight potential future interventions. METHODS We reviewed fatigue-related literature in IBD using PubMed database. RESULTS Disease related factors such as inflammation and pharmacological treatments negatively impact skeletal muscle and brain physiology, likely contributing to fatigue symptoms. Secondary factors such as malnutrition, anaemia, sleep disturbance and psychological comorbidity are potential determinants. Immune profile, faecal microbiota composition and physical fitness differ significantly between fatigued and non-fatigued patients, suggesting these may be aetiological factors. Solution-focused therapy, high-dosage thiamine supplementation and biological therapy may reduce fatigue perception in IBD. The effect of physical activity interventions is inconclusive. CONCLUSIONS A multimodal approach is likely required to treat IBD fatigue. Established reversible factors like anaemia, micronutrient deficiencies and active disease should initially be resolved. Psychosocial intervention shows potential efficacy in reducing fatigue perception in quiescent disease. Restoring physical deconditioning by exercise training intervention may further improve fatigue burden.
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Affiliation(s)
- Jordan J McGing
- School of Medicine, University of Nottingham, Nottingham, UK.,Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Shellie Jean Radford
- School of Medicine, University of Nottingham, Nottingham, UK.,National Institute of Health Research Nottingham Biomedical Research Centre (NIHR), Nottingham University Hospitals and University of Nottingham, Nottingham, UK
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK.,National Institute of Health Research Nottingham Biomedical Research Centre (NIHR), Nottingham University Hospitals and University of Nottingham, Nottingham, UK
| | - Sébastien Serres
- School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Paul L Greenhaff
- National Institute of Health Research Nottingham Biomedical Research Centre (NIHR), Nottingham University Hospitals and University of Nottingham, Nottingham, UK.,MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Gordon W Moran
- School of Medicine, University of Nottingham, Nottingham, UK.,National Institute of Health Research Nottingham Biomedical Research Centre (NIHR), Nottingham University Hospitals and University of Nottingham, Nottingham, UK
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7
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Enoka RM, Farina D. Force Steadiness: From Motor Units to Voluntary Actions. Physiology (Bethesda) 2021; 36:114-130. [DOI: 10.1152/physiol.00027.2020] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Voluntary actions are controlled by the synaptic inputs that are shared by pools of spinal motor neurons. The slow common oscillations in the discharge times of motor units due to these synaptic inputs are strongly correlated with the fluctuations in force during submaximal isometric contractions (force steadiness) and moderately associated with performance scores on some tests of motor function. However, there are key gaps in knowledge that limit the interpretation of differences in force steadiness.
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Affiliation(s)
- Roger M. Enoka
- Department of Integrative Physiology, University of Colorado Boulder, Colorado
| | - Dario Farina
- Department of Bioengineering, Faculty of Engineering, Imperial College London, London, United Kingdom
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Matsumoto T, Watanabe T, Kuwabara T, Yunoki K, Chen X, Kubo N, Kirimoto H. Excitability of the Ipsilateral Primary Motor Cortex During Unilateral Goal-Directed Movement. Front Hum Neurosci 2021; 15:617146. [PMID: 33679346 PMCID: PMC7925409 DOI: 10.3389/fnhum.2021.617146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Previous transcranial magnetic stimulation (TMS) studies have revealed that the activity of the primary motor cortex ipsilateral to an active hand (ipsi-M1) plays an important role in motor control. The aim of this study was to investigate whether the ipsi-M1 excitability would be influenced by goal-directed movement and laterality during unilateral finger movements. Method Ten healthy right-handed subjects performed four finger tapping tasks with the index finger: (1) simple tapping (Tap) task, (2) Real-word task, (3) Pseudoword task, and (4) Visually guided tapping (VT) task. In the Tap task, the subject performed self-paced simple tapping on a touch screen. In the real-word task, the subject tapped letters displayed on the screen one by one to create a Real-word (e.g., apple). Because the action had a specific purpose (i.e., creating a word), this task was considered to be goal-directed as compared to the Tap task. In the Pseudoword task, the subject tapped the letters to create a pseudoword (e.g., gdiok) in the same manner as in the Real-word task; however, the word was less meaningful. In the VT task, the subject was required to touch a series of illuminated buttons. This task was considered to be less goal-directed than the Pseudoword task. The tasks were performed with the right and left hand, and a rest condition was added as control. Single- and paired-pulse TMS were applied to the ipsi-M1 to measure corticospinal excitability and short- and long-interval intracortical inhibition (SICI and LICI) in the resting first dorsal interosseous (FDI) muscle. Results We found the smaller SICI in the ipsi-M1 during the VT task compared with the resting condition. Further, both SICI and LICI were smaller in the right than in the left M1, regardless of the task conditions. Discussion We found that SICI in the ipsi-M1 is smaller during visual illumination-guided finger movement than during the resting condition. Our finding provides basic data for designing a rehabilitation program that modulates the M1 ipsilateral to the moving limb, for example, for post-stroke patients with severe hemiparesis.
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Affiliation(s)
- Takuya Matsumoto
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Tatsunori Watanabe
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takayuki Kuwabara
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keisuke Yunoki
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Xiaoxiao Chen
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nami Kubo
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hikari Kirimoto
- Department of Sensorimotor Neuroscience, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Bittmann FN, Dech S, Aehle M, Schaefer LV. Manual Muscle Testing-Force Profiles and Their Reproducibility. Diagnostics (Basel) 2020; 10:E996. [PMID: 33255648 PMCID: PMC7759939 DOI: 10.3390/diagnostics10120996] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/04/2022] Open
Abstract
The manual muscle test (MMT) is a flexible diagnostic tool, which is used in many disciplines, applied in several ways. The main problem is the subjectivity of the test. The MMT in the version of a "break test" depends on the tester's force rise and the patient's ability to resist the applied force. As a first step, the investigation of the reproducibility of the testers' force profile is required for valid application. The study examined the force profiles of n = 29 testers (n = 9 experiences (Exp), n = 8 little experienced (LitExp), n = 12 beginners (Beg)). The testers performed 10 MMTs according to the test of hip flexors, but against a fixed leg to exclude the patient's reaction. A handheld device recorded the temporal course of the applied force. The results show significant differences between Exp and Beg concerning the starting force (padj = 0.029), the ratio of starting to maximum force (padj = 0.005) and the normalized mean Euclidean distances between the 10 trials (padj = 0.015). The slope is significantly higher in Exp vs. LitExp (p = 0.006) and Beg (p = 0.005). The results also indicate that experienced testers show inter-tester differences and partly even a low intra-tester reproducibility. This highlights the necessity of an objective MMT-assessment. Furthermore, an agreement on a standardized force profile is required. A suggestion for this is given.
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Affiliation(s)
| | | | | | - Laura V. Schaefer
- Division Regulative Physiology and Prevention, Department Sports and Health Sciences, University of Potsdam, 14476 Potsdam, Germany; (F.N.B.); (S.D.); (M.A.)
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10
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Caron KE, Burr JF, Power GA. The Effect of a Stretch-Shortening Cycle on Muscle Activation and Muscle Oxygen Consumption: A Study of History-Dependence. J Strength Cond Res 2020; 34:3139-3148. [PMID: 33105364 DOI: 10.1519/jsc.0000000000003815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Caron, KE, Burr, JF, and Power, GA.. The effect of a stretch-shortening cycle on muscle activation and muscle oxygen consumption: a study of history-dependence. J Strength Cond Res 34(11): 3139-3148, 2020-Stretch-shortening cycles (SSCs) are observed in a variety of human movements and are associated with increases in performance. Few studies have considered the effects of stretch-induced residual force enhancement (rFE) and shortening-induced residual force depression (rFD) during an SSC, and none have considered these properties during voluntary contractions. With force matched via a robotically resisted Smith machine, we hypothesized that in the isometric steady-state following an SSC (a) muscle activation (electromyography) of the knee and hip extensors would be greater and (b) muscle oxygen consumption be higher than the reference isometric condition (ISO), but less than the rFD condition. Subjects (n = 20, male, 24.9 ± 3.9 year) performed a squat exercise over 100-140° knee angle and a matched ISO at the top and bottom of the squat. After active shortening, the vastus medialis (VM), vastus lateralis (VL), and gluteus maximus (GM) showed activation increase in the rFD-state compared with ISO (∼15%, ∼11%, and ∼25% respectively). During the isometric steady-state following the SSC, there was no difference in activation as compared with ISO for VM, VL, but GM showed an activation increase of ∼15%. VM and VL showed an activation increase in the rFD-state compared with the isometric steady-state following SSC (∼16 and ∼10% respectively). Muscle oxygen consumption (tissue saturation index) was not different during the isometric steady-states following rFD and SSC compared with ISO. During a voluntary SSC exercise, the activation increase expected in the FD-state was attenuated, with no change in muscle oxygen consumption. The concomitant role of rFE and rFD during a voluntary position-matched SSC seems to counteract shortening-induced activation increase and may optimize movement economy.
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Affiliation(s)
- Kevin E Caron
- Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph Ontario, Canada
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11
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Hibino H, Gorniak SL. Effects of aging on rapid grip force responses during bimanual manipulation of an active object. Exp Brain Res 2020; 238:2161-2178. [PMID: 32661648 PMCID: PMC10103105 DOI: 10.1007/s00221-020-05865-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022]
Abstract
Rapid grip force responses to unexpected pulling loads on the fingertips are deteriorated in older adults due to, in part, age-related declines in somatosensory function. Such reports are limited to one-hand conditions despite the higher frequency of using two hands together in daily living activities of older adults. Unexpected perturbations during bimanual movements elicit goal-oriented and cortically-meditated bilateral rapid motor responses. Since aging is associated with declined somatosensory and cognitive functions, we hypothesized that bilateral rapid motor responses differ between young and older adults, such that older adults exert stronger grip forces following perturbation and the unperturbed hand is more involved in stabilizing the object in older adults. We tested our hypothesis by comparing the rapid grip force responses of both hands in young and older adults. A total of 13 right-handed young individuals (24.2 ± 4.0 years old, 5 men) and 13 right-handed older individuals (68.7 ± 7.1 years old, 5 men) were recruited. Tactile detection threshold, fingertip friction, and the rapid grip force responses of both hands triggered by unpredicted pulling loads during grip-lift movements were assessed. Older adults had higher tactile detection thresholds and lower fingertip friction compared to young adults. Regardless of age, rapid motor responses were found in both the perturbed (right) hand and the indirectly perturbed (left) hand at 73 ms and 135 ms after the perturbation, respectively, while magnitudes of the responses depended on perturbation magnitudes. Higher values in maximum grip force and maximum grip force rate were found in older adults as compared to young adults. In older adults, the indirectly perturbed (left) hand was more involved in stabilizing the object as compared to young healthy adults. The current study suggests that age-related changes in the peripheral and central nervous systems contribute to the greater involvement of the indirectly perturbed hand in older adults.
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Affiliation(s)
- Hidetaka Hibino
- Department of Health and Human Performance, University of Houston, 3855 Holman St., Garrison 104, Houston, TX, 77204-6015, USA
| | - Stacey L Gorniak
- Department of Health and Human Performance, University of Houston, 3855 Holman St., Garrison 104, Houston, TX, 77204-6015, USA.
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12
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Jeon S, Miller WM, Ye X. A Comparison of Motor Unit Control Strategies between Two Different Isometric Tasks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082799. [PMID: 32325707 PMCID: PMC7215511 DOI: 10.3390/ijerph17082799] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/12/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022]
Abstract
Background: This study examined the motor unit (MU) control strategies for non-fatiguing isometric elbow flexion tasks at 40% and 70% maximal voluntary isometric contraction. Methods: Nineteen healthy individuals performed two submaximal tasks with similar torque levels: contracting against an immovable object (force task), and maintaining the elbow joint angle against an external load (position task). Surface electromyographic (EMG) signals were collected from the agonist and antagonist muscles. The signals from the agonist were decomposed into individual action potential trains. The linear regression analysis was used to examine the MU recruitment threshold (RT) versus mean firing rates (MFR), and RT versus derecruitment threshold (DT) relationships. Results: Both agonist and antagonist muscles’ EMG amplitudes did not differ between two tasks. The linear slopes of the MU RT versus MFR and RT versus DT relationships during the position task were more negative (p = 0.010) and more positive (p = 0.023), respectively, when compared to the force task. Conclusions: To produce a similar force output, the position task may rely less on the recruitment of relatively high-threshold MUs. Additionally, as the force output decreases, MUs tend to derecruit at a higher force level during the position task.
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Affiliation(s)
| | | | - Xin Ye
- Correspondence: ; Tel.: +1-662-915-1630
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Rashid DMS, Faraj SMS, Hedayatpour N. The effect of triceps brachii fatigue on shot accuracy of male and female basketball players. INT J PERF ANAL SPOR 2020. [DOI: 10.1080/24748668.2020.1736410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | - Nosratollah Hedayatpour
- Center for Biomechanics and Motor Control (BMC), Department of Sport Science, University of Bojnord, Bojnord, Iran
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14
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Differentiation of the Strength of Back Muscle Contraction Under Fatigue: Does Force Feedback Play a Role? J Sport Rehabil 2019; 29:897-903. [PMID: 31593928 DOI: 10.1123/jsr.2018-0496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/16/2019] [Accepted: 08/11/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study investigates the ability of subjects to differentiate the strength of back muscle contraction with and without feedback information on force produced under fatigue and nonfatigue conditions. DESIGN Controlled laboratory study. SETTING Research laboratory environment. PARTICIPANTS A group of 52 healthy young men participated in the study. INTERVENTION Subjects self-estimated 50% of the maximal voluntary isometric contraction of back muscles either on their own volition or on the basis of information about the actual force, before and after the Sørensen fatigue test. MAIN OUTCOME MEASURES The force was measured by means of the FiTRO Back Dynamometer. RESULTS The self-estimated 50% maximal voluntary isometric contraction was significantly higher than the one calculated from maximal voluntary isometric contraction during 10 trials in 2 repeated sessions (8.3% and 10.0%, P < .05). However, when feedback on the force produced was provided, significantly higher values were observed during an initial trial in both sessions (8.5%, P = .04 and 12.1%, P = .01). Subjects were able to estimate the target force during the following trials. Fatigue induced a decrease in peak force (7.7%, P = .04), whereas the ability to regulate the prescribed force was not compromised. Constant error was lower with than without force feedback during both measurements (2.15% and 6.85%; 3.06% and 8.56%). However, constant and variable errors were greater under fatigue than nonfatigue conditions (8.43% and 5.55%; 0.41% and 0.37%). Similarly, root mean square error decreased with force feedback (from 6.88% to 3.48% and from 8.74% to 5.09%) and increased under fatigue (from 5.87% to 8.67%). CONCLUSIONS These findings indicate that force feedback plays a role in the differentiation of the strength of back muscle contraction, regardless of fatigue. It contributes to a more precise regulation of force produced during voluntary isometric contraction of back muscles. This promising method awaits further experimentation to be applied for individuals with low back pain.
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15
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Magalhães FH, Mello EM, Kohn AF. Association Between Plantarflexion Torque Variability In Quiet Stance And During Force And Position Tasks. Somatosens Mot Res 2019; 36:241-248. [PMID: 31583939 DOI: 10.1080/08990220.2019.1673720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study examined the association between plantarflexion torque variability during quiet bipedal standing (QS) and during plantarflexion force- and position-matching tasks (FT and PT, respectively). In QS, participants stood still over a force plate, and the mean plantarflexion torque level exerted by each subject in QS (divided by 2 to give the torque due to a single leg) served as the target torque level for right leg FT and PT (performed with the participants seated with their right knee fully extended). During FT participants controlled the force level exerted by the foot against a rigid restraint, while during PT they controlled the angular position of the ankle when sustaining equivalent inertial loads. Standard deviation (SD) of plantarflexion torque was computed from torque signals acquired during periods with and without visual feedback. Significant correlations were found between plantarflexion torque variability in QS and FT (r = 0.8615, p < 0.0001 and r = 0.8838, p = 0.0003 for visual and no visual conditions, respectively) as well as between QS and PT (r = 0.8046, p = 0.003 and r = 0.7332, p = 0.0103 for visual and no visual conditions, respectively), regardless of vision availability. No significant differences were found between the correlations for Qs vs FT and QS vs PT (t(8) = 0.4778, p = 0.6455 and t(8) = 1.6819, p = 0.1310 for visual and no visual conditions, respectively), as assessed by "Hotelling-Williams" tests for equality among dependent correlations. The results indicate that simple measurements of plantarflexion torque fluctuations during FT and PT may be used to estimate balance ability. From a practical standpoint, it is suggested that rehabilitation protocols designed to regain/improve balance function may be based on the performance of FTs or PTs executed in a seated position.
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Affiliation(s)
- Fernando Henrique Magalhães
- School of Arts, Sciences and Humanities, Universidade de São Paulo, EACH-USP, São Paulo, Brazil.,Biomedical Engineering Laboratory and Neuroscience Program, Universidade de São Paulo, EPUSP, PTC, São Paulo, Brazil
| | - Emanuele Moraes Mello
- Biomedical Engineering Laboratory and Neuroscience Program, Universidade de São Paulo, EPUSP, PTC, São Paulo, Brazil
| | - André Fabio Kohn
- Biomedical Engineering Laboratory and Neuroscience Program, Universidade de São Paulo, EPUSP, PTC, São Paulo, Brazil
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16
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Tomko PM, Colquhoun RJ, Banks NF, Magrini MA, Muddle TWD, Jenkins NDM. Maximal contraction methods influence the magnitude and reliability of global electromyographic signal characteristics. J Electromyogr Kinesiol 2019; 48:121-127. [PMID: 31344640 DOI: 10.1016/j.jelekin.2019.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 06/11/2019] [Accepted: 07/06/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE The purpose was two-fold: (1) to examine differences in maximal voluntary isometric torque (MVIT) production, and electromyographic signal amplitude (EMGAMP) and mean power frequency (EMGMPF) values obtained during traditional (MVICTRAD), rapid (MVICRAPID), and ramp (MVICRAMP) maximal voluntary isometric contractions, and (2) to determine if there were differences in the reliability of MVIT, EMGAMP and EMGMPF among the three MVIC types. APPROACH Twenty-two young males and females completed MVICTRAD, MVICRAPID, and MVICRAMP muscle actions on two separate visits separated by 48 h. During all MVICs, MVIT and EMGAMP and EMGMPF of the vastus lateralis (VL) and rectus femoris (RF) were quantified. MAIN RESULTS MVIT was greater during MVICTRAD and MVICRAPID than during MVITRAMP (both p < 0.001). VL and RF EMGAMP were greater during MVICRAMP than during MVICRAPID (p = 0.02 and 0.004). For EMGMPF, there were no significant differences among MVIC types. Although all MVIC types generally resulted in reliable measurements of MVIT and EMGAMP, reliability was stronger for EMGMPF quantified during the MVICRAMP. SIGNIFICANCE Investigators may choose MVIC type based on preference or equipment availability. However, investigators should note that MVICRAMP contractions will likely yield the greatest EMGAMP values and more reliable measurements of VL and RF EMGMPF.
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Affiliation(s)
- Patrick M Tomko
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, United States
| | - Ryan J Colquhoun
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, United States
| | - Nile F Banks
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, United States
| | - Mitchel A Magrini
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, United States
| | - Tyler W D Muddle
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, United States
| | - Nathaniel D M Jenkins
- Applied Neuromuscular Physiology Laboratory, Oklahoma State University, United States.
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17
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Dideriksen JL, Farina D. Amplitude cancellation influences the association between frequency components in the neural drive to muscle and the rectified EMG signal. PLoS Comput Biol 2019; 15:e1006985. [PMID: 31050667 PMCID: PMC6519845 DOI: 10.1371/journal.pcbi.1006985] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 05/15/2019] [Accepted: 03/27/2019] [Indexed: 12/11/2022] Open
Abstract
The rectified surface EMG signal is commonly used as an estimator of the neural drive to muscles and therefore to infer sources of synaptic input to motor neurons. Loss of EMG amplitude due to the overlap of motor unit action potentials (amplitude cancellation), however, may distort the spectrum of the rectified EMG and thereby its correlation with the neural drive. In this study, we investigated the impact of amplitude cancelation on this correlation using analytical derivations and a computational model of motor neuron activity, force, and the EMG signal. First, we demonstrated analytically that an ideal rectified EMG signal without amplitude cancellation (EMGnc) is superior to the actual rectified EMG signal as estimator of the neural drive to muscle. This observation was confirmed by the simulations, as the average coefficient of determination (r2) between the neural drive in the 1–30 Hz band and EMGnc (0.59±0.08) was matched by the correlation between the rectified EMG and the neural drive only when the level of amplitude cancellation was low (<40%) at low contraction levels (<5% of maximum voluntary contraction force; MVC). This correlation, however, decreased linearly with amplitude cancellation (r = -0.83) to values of r2 <0.2 at amplitude cancellation levels >60% (contraction levels >15% MVC). Moreover, the simulations showed that a stronger (i.e. more variable) neural drive implied a stronger correlation between the rectified EMG and the neural drive and that amplitude cancellation distorted this correlation mainly for low-frequency components (<5 Hz) of the neural drive. In conclusion, the results indicate that amplitude cancellation distorts the spectrum of the rectified EMG signal. This implies that valid use of the rectified EMG as an estimator of the neural drive requires low contraction levels and/or strong common synaptic input to the motor neurons. The rectified surface EMG signal is commonly used to analyze the neural activation of muscles. However, since this signal is most often exposed to so-called amplitude cancellation (loss of EMG amplitude due to overlap of positive and negative phases of different motor unit action potentials), the frequency content of the rectified EMG may not fully reflect that of the neural drive to the muscle. In this study we prove this notion analytically and demonstrate, using simulations, that the rectified EMG signal accurately reflects the neural drive to the muscle only in a limited set of conditions. Specifically, these conditions include low contraction levels and/or high variability of the neural drive. In other conditions, the rectified EMG signal from a muscle is a poor predictor of its neural input. This finding has potentially large implications for the way neural drive to muscles and neural connectivity (e.g. across muscles or between the brain and a muscle) should be analyzed.
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Affiliation(s)
| | - Dario Farina
- Department of Bioengineering, Imperial College London, London, United Kingdom
- * E-mail:
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18
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Enoka RM. Physiological validation of the decomposition of surface EMG signals. J Electromyogr Kinesiol 2019; 46:70-83. [PMID: 31003192 DOI: 10.1016/j.jelekin.2019.03.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/15/2019] [Accepted: 03/20/2019] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Roger M Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.
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19
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Jeon S, Ye X, Miller WM. Sex comparisons of agonist and antagonist muscle electromyographic parameters during two different submaximal isometric fatiguing tasks. Physiol Rep 2019; 7:e14022. [PMID: 30839175 PMCID: PMC6401663 DOI: 10.14814/phy2.14022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/03/2019] [Accepted: 02/11/2019] [Indexed: 02/03/2023] Open
Abstract
To examine the task failure time of the force- and position-based submaximal elbow flexion fatiguing tasks for both sexes, twelve men and eight women visited the laboratory for two separate experimental occasions. During the experiment, they pulled against a rigid restraint for the force task and maintained a constant elbow joint angle to support an equivalent inertial load for the position task. For both fatiguing tasks (50% of the isometric strength at the elbow joint angle of 135 degree), the task failure time, along with the surface electromyographic (EMG) amplitude and mean frequency (MNF) were measured. The average failure time was longer for the force task than that for the position task (sexes combined: 39.6 ± 16.6 sec vs. 33.9 ± 14.9 sec, P = 0.033). In addition, men were overall less fatigable than women (tasks combined: 42.0 ± 14.7 sec vs. 28.7 ± 10.3 sec, P = 0.020). The multiple regression analyses showed that the task failure time in women was solely predicted by the rate of change of the triceps EMG MNF. Thus, more fatigability of women in this study was likely due to the quicker fatiguing rate of the antagonist triceps brachii muscle. Different from most previous studies that have used 90-degree elbow joint angle, the current 135-degree joint angle setup might have created a situation where greater muscle activity from the related muscles (e.g., the antagonist) were required for women than for men to stabilize the joint, thereby resulting in a shorter task failure time.
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Affiliation(s)
- Sunggun Jeon
- Department of Health, Exercise Science, and Recreation ManagementThe University of MississippiUniversityMississippi
| | - Xin Ye
- Department of Health, Exercise Science, and Recreation ManagementThe University of MississippiUniversityMississippi
| | - William M. Miller
- Department of Health, Exercise Science, and Recreation ManagementThe University of MississippiUniversityMississippi
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20
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Tomko PM, Colquhoun RJ, Magrini MA, Muddle TW, Jenkins ND. Global electromyographic signal characteristics depend on maximal isometric contraction method in the knee extensors. J Electromyogr Kinesiol 2018; 42:111-116. [DOI: 10.1016/j.jelekin.2018.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/11/2018] [Accepted: 07/09/2018] [Indexed: 11/30/2022] Open
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21
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Garcia MG, Läubli T, Martin BJ. Muscular and Vascular Issues Induced by Prolonged Standing With Different Work-Rest Cycles With Active or Passive Breaks. HUMAN FACTORS 2018; 60:806-821. [PMID: 29648891 DOI: 10.1177/0018720818769261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the long-lasting motor, behavioral, physiological, and perceptual effects of prolonged standing work in three work-rest cycle conditions including passive or active rest breaks. BACKGROUND Muscle fatigue has been evidenced after prolonged standing work through physiological and neuromotor measures. It has been postulated that muscle fatigue induced by prolonged work could be attenuated by appropriate scheduling of work and rest periods. However, investigations in this domain remain limited. METHOD Thirty participants simulated standing work for 5 hr with work-rest cycles of short, medium, or long standing periods including passive or active breaks. Lower-leg muscle twitch force (MTF), muscle oxygenation, lower-leg volume, postural stability, force control, and discomfort perception were quantified on 2 days. RESULTS Prolonged standing induced significant changes in all measures immediately after 5 hr of work, indicating a detrimental effect in long-lasting muscle fatigue, performance, discomfort, and vascular aspects. Differences in the measures were not significant between work cycles and/or break type. CONCLUSION Similar physiological and motor alterations were induced by prolonged standing. The absence of difference in the effects induced by the tested work-rest cycles suggests that simply altering the work-rest cycle may not be sufficient to counteract the effects of mainly static standing work. Finally, standing for 3 hr or more shows clear detrimental effects. APPLICATION Prolonged standing is likely to contribute to musculoskeletal and vascular symptoms. A limitation to less than 3 hr of mostly static standing in occupational activities could avoid alterations leading to these symptoms.
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22
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Effect of Task Failure on Intermuscular Coherence Measures in Synergistic Muscles. Appl Bionics Biomech 2018; 2018:4759232. [PMID: 29967654 PMCID: PMC6008706 DOI: 10.1155/2018/4759232] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 02/21/2018] [Indexed: 12/01/2022] Open
Abstract
The term “task failure” describes the point when a person is not able to maintain the level of force required by a task. As task failure approaches, the corticospinal command to the muscles increases to maintain the required level of force in the face of a decreased mechanical efficacy. Nevertheless, most motor tasks require the synergistic recruitment of several muscles. How this recruitment is affected by approaching task failure is still not clear. The increase in the corticospinal drive could be due to an increase in synergistic recruitment or to overlapping commands sent to the muscles individually. Herein, we investigated these possibilities by combining intermuscular coherence and synergy analysis on signals recorded from three muscles of the quadriceps during dynamic leg extension tasks. We employed muscle synergy analysis to investigate changes in the coactivation of the muscles. Three different measures of coherence were used. Pooled coherence was used to estimate the command synchronous to all three muscles, pairwise coherence the command shared across muscle pairs and residual coherence the command peculiar to each couple of muscles. Our analysis highlights an overall decrease in synergistic command at task failure and an intensification of the contribution of the nonsynergistic shared command.
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23
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Abstract
Performance fatigability is characterized as an acute decline in motor performance caused by an exercise-induced reduction in force or power of the involved muscles. Multiple mechanisms contribute to performance fatigability and originate from neural and muscular processes, with the task demands dictating the mechanisms. This review highlights that (1) inadequate activation of the motoneuron pool can contribute to performance fatigability, and (2) the demands of the task and the physiological characteristics of the population assessed, dictate fatigability and the involved mechanisms. Examples of task and population differences in fatigability highlighted in this review include contraction intensity and velocity, stability and support provided to the fatiguing limb, sex differences, and aging. A future challenge is to define specific mechanisms of fatigability and to translate these findings to real-world performance and exercise training in healthy and clinical populations across the life span.
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Affiliation(s)
- Sandra K Hunter
- Exercise Science Program, Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin 53201
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24
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EMG amplitude, fatigue threshold, and time to task failure: A meta-analysis. J Sci Med Sport 2018; 21:736-741. [DOI: 10.1016/j.jsams.2017.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/02/2017] [Accepted: 11/05/2017] [Indexed: 11/23/2022]
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25
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Ebner-Karestinos D, Flament B, Arnould C, Thonnard JL, Bleyenheuft Y. Precision grip control while walking down a step in children with unilateral cerebral palsy. PLoS One 2018; 13:e0191684. [PMID: 29390012 PMCID: PMC5794097 DOI: 10.1371/journal.pone.0191684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/09/2018] [Indexed: 01/01/2023] Open
Abstract
Aim To compare grip force (GF) and load force (LF) coordination while walking down a step between children with unilateral cerebral palsy (UCP) and typically developing (TD) children. Methods Twenty-five children with UCP (age 9.3±1.7 y) and 25 TD controls (age 9.4±2.1 y) walked down a step while holding a grip-lift manipulandum. Dynamic and temporal variables were analyzed. The maximum voluntary contraction (MVC) was also assessed. Results The temporal course was perturbed mainly in the more affected hand of children with UCP when compared to TD children because the increases in GF and LF onset occurred in a reversed order. Compared with the TD controls, the children with UCP presented higher LF values on both hands and a higher GF on the less affected hand. In children with UCP, the GF to LF adaptation was adequate on the less affected hand but overestimated on the more affected hand. Furthermore, children with UCP presented a lower MVC in the more affected hand, leading to a higher percentage of MVC used during the task. Interpretation Our findings highlight an anticipatory control of precision grip during a stepping down task in children with UCP that is adequate for the less affected hand but altered for the more affected hand.
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Affiliation(s)
| | - Benoît Flament
- Physical and Occupational Therapy Departments, Paramedical Category, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium
| | - Carlyne Arnould
- Physical and Occupational Therapy Departments, Paramedical Category, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium
| | - Jean-Louis Thonnard
- Institute of Neuroscience (IoNS), Université catholique de Louvain, Brussels, Belgium
- Physical and Rehabilitation Medicine Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Yannick Bleyenheuft
- Institute of Neuroscience (IoNS), Université catholique de Louvain, Brussels, Belgium
- * E-mail:
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26
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Enoka RM, Duchateau J. Rate Coding and the Control of Muscle Force. Cold Spring Harb Perspect Med 2017; 7:cshperspect.a029702. [PMID: 28348173 DOI: 10.1101/cshperspect.a029702] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The force exerted by a muscle during a voluntary contraction depends on the number of motor units recruited for the action and the rates at which they discharge action potentials (rate coding). Over most of the operating range of a muscle, the nervous system controls muscle force by varying both motor unit recruitment and rate coding. Except at relatively low forces, however, the control of muscle force depends primarily on rate coding, especially during fast contractions. This review provides five examples of how the modulation of rate coding influences the force exerted by muscle during voluntary actions. The five examples comprise fast contractions, lengthening and shortening contractions, steady isometric contractions, fatiguing contractions, and contractions performed after a change in the daily level of physical activity.
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Affiliation(s)
- Roger M Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado 80309-0354
| | - Jacques Duchateau
- Laboratory of Applied Biology and Neurophysiology, Neuroscience Institute, Université Libre de Bruxelles, 1070 Brussels, Belgium
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27
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Dideriksen JL, Feeney DF, Almuklass AM, Enoka RM. Control of force during rapid visuomotor force-matching tasks can be described by discrete time PID control algorithms. Exp Brain Res 2017; 235:2561-2573. [PMID: 28555275 DOI: 10.1007/s00221-017-4995-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 05/23/2017] [Indexed: 11/30/2022]
Abstract
Force trajectories during isometric force-matching tasks involving isometric contractions vary substantially across individuals. In this study, we investigated if this variability can be explained by discrete time proportional, integral, derivative (PID) control algorithms with varying model parameters. To this end, we analyzed the pinch force trajectories of 24 subjects performing two rapid force-matching tasks with visual feedback. Both tasks involved isometric contractions to a target force of 10% maximal voluntary contraction. One task involved a single action (pinch) and the other required a double action (concurrent pinch and wrist extension). 50,000 force trajectories were simulated with a computational neuromuscular model whose input was determined by a PID controller with different PID gains and frequencies at which the controller adjusted muscle commands. The goal was to find the best match between each experimental force trajectory and all simulated trajectories. It was possible to identify one realization of the PID controller that matched the experimental force produced during each task for most subjects (average index of similarity: 0.87 ± 0.12; 1 = perfect similarity). The similarities for both tasks were significantly greater than that would be expected by chance (single action: p = 0.01; double action: p = 0.04). Furthermore, the identified control frequencies in the simulated PID controller with the greatest similarities decreased as task difficulty increased (single action: 4.0 ± 1.8 Hz; double action: 3.1 ± 1.3 Hz). Overall, the results indicate that discrete time PID controllers are realistic models for the neural control of force in rapid force-matching tasks involving isometric contractions.
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Affiliation(s)
- Jakob Lund Dideriksen
- SMI, Department of Health Science and Technology, Aalborg University, Fredrik Bajersvej 7-D3, 9220, Aalborg Ø, Denmark.
| | - Daniel F Feeney
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Awad M Almuklass
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA.,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Roger M Enoka
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
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Russ DW, Ross AJ, Clark BC, Thomas JS. The Effects of Task Type on Time to Task Failure During Fatigue: A Modified Sørensen Test. J Mot Behav 2017; 50:96-103. [DOI: 10.1080/00222895.2017.1286628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- David W. Russ
- School of Rehabilitation and Communication Sciences, Division of Physical Therapy, Ohio University, Athens
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens
| | - Andrew J. Ross
- School of Rehabilitation and Communication Sciences, Division of Physical Therapy, Ohio University, Athens
| | - Brian C. Clark
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens
| | - James S. Thomas
- School of Rehabilitation and Communication Sciences, Division of Physical Therapy, Ohio University, Athens
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens
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29
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Gould JR, Cleland BT, Mani D, Amiridis IG, Enoka RM. Motor unit activity in biceps brachii of left-handed humans during sustained contractions with two load types. J Neurophysiol 2016; 116:1358-65. [PMID: 27334949 DOI: 10.1152/jn.00147.2016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 06/18/2016] [Indexed: 11/22/2022] Open
Abstract
The purpose of the study was to compare the discharge characteristics of single motor units during sustained isometric contractions that required either force or position control in left-handed individuals. The target force for the two sustained contractions (24.9 ± 10.5% maximal force) was identical for each biceps brachii motor unit (n = 32) and set at 4.7 ± 2.0% of maximal voluntary contraction (MVC) force above its recruitment threshold (range: 0.5-41.2% MVC force). The contractions were not sustained to task failure, but the duration (range: 60-330 s) was identical for each motor unit and the decline in MVC force immediately after the sustained contractions was similar for the two tasks (force: 11.1% ± 13.7%; position: 11.6% ± 9.9%). Despite a greater increase in the rating of perceived exertion during the position task (task × time interaction, P < 0.006), the amplitude of the surface-recorded electromyogram for the agonist and antagonist muscles increased similarly during the two tasks. Nonetheless, mean discharge rate of the biceps brachii motor units declined more during the position task (task × time interaction, P < 0.01) and the variability in discharge times (coefficient of variation for interspike interval) increased only during the position task (task × time interaction, P < 0.008). When combined with the results of an identical study on right-handers (Mottram CJ, Jakobi JM, Semmler JG, Enoka RM. J Neurophysiol 93: 1381-1392, 2005), the findings indicate that handedness does not influence the adjustments in biceps brachii motor unit activity during sustained submaximal contractions requiring either force or position control.
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Affiliation(s)
- Jeffrey R Gould
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado; and
| | - Brice T Cleland
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado; and
| | - Diba Mani
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado; and
| | - Ioannis G Amiridis
- Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, Serres, Greece
| | - Roger M Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado; and
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Lauber B, Keller M, Leukel C, Gollhofer A, Taube W. Force and Position Control in Humans - The Role of Augmented Feedback. J Vis Exp 2016. [PMID: 27404742 DOI: 10.3791/53291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
During motor behaviour, humans interact with the environment by for example manipulating objects and this is only possible because sensory feedback is constantly integrated into the central nervous system and these sensory inputs need to be weighted in order meet the task specific goals. Additional feedback presented as augmented feedback was shown to have an impact on motor control and motor learning. A number of studies investigated whether force or position feedback has an influence on motor control and neural activation. However, as in the previous studies the presentation of the force and position feedback was always identical, a recent study assessed whether not only the content but also the interpretation of the feedback has an influence on the time to fatigue of a sustained submaximal contraction and the (inhibitory) activity of the primary motor cortex using subthreshold transcranial magnetic stimulation. This paper describes one possible way to investigate the influence of the interpretation of feedback on motor behaviour by investigating the time to fatigue of submaximal sustained contractions together with the neuromuscular adaptations that can be investigated using surface EMG. Furthermore, the current protocol also describes how motor cortical (inhibitory) activity can be investigated using subthreshold TMS, a method known to act solely on the cortical level. The results show that when participants interpret the feedback as position feedback, they display a significantly shorter time to fatigue of a submaximal sustained contraction. Furthermore, subjects also displayed an increased inhibitory activity of the primary cortex when they believed to receive position feedback compared when they believed to receive force feedback. Accordingly, the results show that interpretation of feedback results in differences on a behavioural level (time to fatigue) that is also reflected in interpretation-specific differences in the amount of inhibitory M1 activity.
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Affiliation(s)
- Benedikt Lauber
- Department of Sport Science, University of Freiburg; Department of Medicine, Movement and Sport Science, University of Fribourg;
| | - Martin Keller
- Department of Medicine, Movement and Sport Science, University of Fribourg
| | - Christian Leukel
- Department of Sport Science, University of Freiburg; Bernsteincenter Freiburg
| | | | - Wolfgang Taube
- Department of Medicine, Movement and Sport Science, University of Fribourg
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Magalhães FH, Elias LA, da Silva CR, de Lima FF, de Toledo DR, Kohn AF. D1 and D2 Inhibitions of the Soleus H-Reflex Are Differentially Modulated during Plantarflexion Force and Position Tasks. PLoS One 2015; 10:e0143862. [PMID: 26599909 PMCID: PMC4658029 DOI: 10.1371/journal.pone.0143862] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 11/10/2015] [Indexed: 01/05/2023] Open
Abstract
Presynaptic inhibition (PSI) has been shown to modulate several neuronal pathways of functional relevance by selectively gating the connections between sensory inputs and spinal motoneurons, thereby regulating the contribution of the stretch reflex circuitry to the ongoing motor activity. In this study, we investigated whether a differential regulation of Ia afferent inflow by PSI may be associated with the performance of two types of plantarflexion sensoriomotor tasks. The subjects (in a seated position) controlled either: 1) the force level exerted by the foot against a rigid restraint (force task, FT); or 2) the angular position of the ankle when sustaining inertial loads (position task, PT) that required the same level of muscle activation observed in FT. Subjects were instructed to maintain their force/position at target levels set at ~10% of maximum isometric voluntary contraction for FT and 90° for PT, while visual feedback of the corresponding force/position signals were provided. Unconditioned H-reflexes (i.e. control reflexes) and H-reflexes conditioned by electrical pulses applied to the common peroneal nerve with conditioning-to-test intervals of 21 ms and 100 ms (corresponding to D1 and D2 inhibitions, respectively) were evoked in a random fashion. A significant main effect for the type of the motor task (FT vs PT) (p = 0.005, η2p = 0.603) indicated that PTs were undertaken with lower levels of Ia PSI converging onto the soleus motoneuron pool. Additionally, a significant interaction between the type of inhibition (D1 vs D2) and the type of motor task (FT vs PT) (p = 0.038, η2p = 0.395) indicated that D1 inhibition was associated with a significant reduction in PSI levels from TF to TP (p = 0.001, η2p = 0.731), whereas no significant difference between the tasks was observed for D2 inhibition (p = 0.078, η2p = 0.305). These results suggest that D1 and D2 inhibitions of the soleus H-reflex are differentially modulated during the performance of plantarflexion FT and PT. The reduced level of ongoing PSI during PT suggests that, in comparison to FT, there is a larger reliance on inputs from muscle spindles primary afferents when the neuromuscular system is required to maintain position-controlled plantarflexion contractions.
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Affiliation(s)
- Fernando Henrique Magalhães
- School of Arts, Sciences and Humanities, Universidade de São Paulo, EACH-USP, São Paulo, SP, Brazil.,Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, Avenida Professor Luciano Gualberto, Travessa 3, n.158, São Paulo, SP, Brazil.,Neuroscience Program, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Leonardo Abdala Elias
- Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, Avenida Professor Luciano Gualberto, Travessa 3, n.158, São Paulo, SP, Brazil.,Department of Biomedical Engineering, School of Electrical and Computer Engineering, University of Campinas, Campinas, SP, Brazil
| | - Cristiano Rocha da Silva
- Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, Avenida Professor Luciano Gualberto, Travessa 3, n.158, São Paulo, SP, Brazil.,Neuroscience Program, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Felipe Fava de Lima
- Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, Avenida Professor Luciano Gualberto, Travessa 3, n.158, São Paulo, SP, Brazil
| | - Diana Rezende de Toledo
- Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, Avenida Professor Luciano Gualberto, Travessa 3, n.158, São Paulo, SP, Brazil
| | - André Fabio Kohn
- Biomedical Engineering Laboratory, Universidade de São Paulo, EPUSP, Avenida Professor Luciano Gualberto, Travessa 3, n.158, São Paulo, SP, Brazil.,Neuroscience Program, Universidade de São Paulo, São Paulo, SP, Brazil
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Poortvliet PC, Tucker KJ, Finnigan S, Scott D, Sowman P, Hodges PW. Cortical activity differs between position- and force-control knee extension tasks. Exp Brain Res 2015; 233:3447-57. [DOI: 10.1007/s00221-015-4404-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/03/2015] [Indexed: 11/24/2022]
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Experimental pain has a greater effect on single motor unit discharge during force-control than position-control tasks. Clin Neurophysiol 2015; 126:1378-86. [DOI: 10.1016/j.clinph.2014.10.139] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 10/04/2014] [Accepted: 10/12/2014] [Indexed: 11/22/2022]
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Kirimoto H, Tamaki H, Suzuki M, Matsumoto T, Sugawara K, Kojima S, Onishi H. Sensorimotor modulation differs with load type during constant finger force or position. PLoS One 2014; 9:e108058. [PMID: 25233353 PMCID: PMC4169486 DOI: 10.1371/journal.pone.0108058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 08/23/2014] [Indexed: 11/19/2022] Open
Abstract
During submaximal isometric contraction, there are two different load types: production of a constant force against a rigid restraint (force task), and maintenance of position against a constant load (position task). Previous studies reported that the time to task failure during a fatigue task was twice as long in the force task compared with the position task. Sensory feedback processing may contribute to these differences. The purpose of the current study was to determine the influence of load types during static muscle contraction tasks on the gating effect, i.e., attenuation of somatosensory-evoked potentials (SEPs) and the cortical silent period (cSP). Ten healthy subjects contracted their right first dorsal interosseus muscle by abducting their index finger for 90 s, to produce a constant force against a rigid restraint that was 20% of the maximum voluntary contraction (force task), or to maintain a constant position with 10° abduction of the metacarpophalangeal joint against the same load (position task). Somatosensory evoked potentials (SEPs) were recorded from C3' by stimulating either the right ulnar or median nerve at the wrist while maintaining contraction. The cortical silent period (cSP) was also elicited by transcranial magnetic stimulation. Reduction of the amplitude of the P45 component of SEPs was significantly larger during the position task than during the force task and under control rest conditions when the ulnar nerve, but not the median nerve, was stimulated. The position task had a significantly shorter cSP duration than the force task. These results suggest the need for more proprioceptive information during the position task than the force task. The shorter duration of the cSP during the position task may be attributable to larger amplitude of heteronymous short latency reflexes. Sensorimotor modulations may differ with load type during constant finger force or position tasks.
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Affiliation(s)
- Hikari Kirimoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Hiroyuki Tamaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Makoto Suzuki
- School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Takuya Matsumoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan
| | - Kazuhiro Sugawara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Syo Kojima
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan
- Tokyo Bay Rehabilitation Hospital, Chiba, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
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Abd Razak NA, Abu Osman NA, Gholizadeh H, Ali S. Biomechanics principle of elbow joint for transhumeral prostheses: comparison of normal hand, body-powered, myoelectric & air splint prostheses. Biomed Eng Online 2014; 13:134. [PMID: 25208636 PMCID: PMC4228154 DOI: 10.1186/1475-925x-13-134] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 09/04/2014] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Understanding of kinematics force applied at the elbow is important in many fields, including biomechanics, biomedical engineering and rehabilitation. This paper provides a comparison of a mathematical model of elbow joint using three different types of prosthetics for transhumeral user, and characterizes the forces required to overcome the passive mechanical of the prosthetics at the residual limb. METHODS The study modeled the elbow as a universal joint with intersecting axes of x-axis and y-axis in a plain of upper arm and lower arm. The equations of force applied, torque, weight and length of different type of prosthetics and the anthropometry of prosthetics hand are discussed in this study. The study also compares the force, torque and pressure while using all three types of prosthetics with the normal hand. RESULTS The result was measured from the elbow kinematics of seven amputees, using three different types of prosthetics. The F-Scan sensor used in the study is to determine the pressure applied at the residual limb while wearing different type of prostheses. CONCLUSION These technological advances in assessment the biomechanics of an elbow joint for three different type of prosthetics with the normal hand bring the new information for the amputees and prosthetist to choose the most suitable device to be worn daily.
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Affiliation(s)
- Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603 Malaysia
| | - Noor Azuan Abu Osman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603 Malaysia
| | - Hossein Gholizadeh
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603 Malaysia
| | - Sadeeq Ali
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, 50603 Malaysia
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Hunter SK. Sex differences in human fatigability: mechanisms and insight to physiological responses. Acta Physiol (Oxf) 2014; 210:768-89. [PMID: 24433272 DOI: 10.1111/apha.12234] [Citation(s) in RCA: 330] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/29/2013] [Accepted: 01/08/2014] [Indexed: 12/17/2022]
Abstract
Sex-related differences in physiology and anatomy are responsible for profound differences in neuromuscular performance and fatigability between men and women. Women are usually less fatigable than men for similar intensity isometric fatiguing contractions. This sex difference in fatigability, however, is task specific because different neuromuscular sites will be stressed when the requirements of the task are altered, and the stress on these sites can differ for men and women. Task variables that can alter the sex difference in fatigability include the type, intensity and speed of contraction, the muscle group assessed and the environmental conditions. Physiological mechanisms that are responsible for sex-based differences in fatigability may include activation of the motor neurone pool from cortical and subcortical regions, synaptic inputs to the motor neurone pool via activation of metabolically sensitive small afferent fibres in the muscle, muscle perfusion and skeletal muscle metabolism and fibre type properties. Non-physiological factors such as the sex bias of studying more males than females in human and animal experiments can also mask a true understanding of the magnitude and mechanisms of sex-based differences in physiology and fatigability. Despite recent developments, there is a tremendous lack of understanding of sex differences in neuromuscular function and fatigability, the prevailing mechanisms and the functional consequences. This review emphasizes the need to understand sex-based differences in fatigability to shed light on the benefits and limitations that fatigability can exert for men and women during daily tasks, exercise performance, training and rehabilitation in both health and disease.
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Affiliation(s)
- S. K. Hunter
- Exercise Science Program; Department of Physical Therapy; Marquette University; Milwaukee WI USA
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Williams PS, Hoffman RL, Clark BC. Cortical and spinal mechanisms of task failure of sustained submaximal fatiguing contractions. PLoS One 2014; 9:e93284. [PMID: 24667484 PMCID: PMC3965562 DOI: 10.1371/journal.pone.0093284] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 03/04/2014] [Indexed: 01/19/2023] Open
Abstract
In this and the subsequent companion paper, results are presented that collectively seek to delineate the contribution that supraspinal circuits have in determining the time to task failure (TTF) of sustained submaximal contractions. The purpose of this study was to compare adjustments in supraspinal and spinal excitability taken concurrently throughout the performance of two different fatigue tasks with identical mechanical demands but different TTF (i.e., force-matching and position-matching tasks). On separate visits, ten healthy volunteers performed the force-matching or position-matching task at 15% of maximum strength with the elbow flexors to task failure. Single-pulse transcranial magnetic stimulation (TMS), paired-pulse TMS, paired cortico-cervicomedullary stimulation, and brachial plexus electrical stimulation were delivered in a 6-stimuli sequence at baseline and every 2-3 minutes throughout fatigue-task performance. Contrary to expectations, the force-matching task TTF was 42% shorter (17.5 ± 7.9 min) than the position-matching task (26.9 ± 15.11 min; p<0.01); however, both tasks caused the same amount of muscle fatigue (p = 0.59). There were no task-specific differences for the total amount or rate of change in the neurophysiologic outcome variables over time (p>0.05). Therefore, failure occurred after a similar mean decline in motorneuron excitability developed (p<0.02, ES = 0.35-0.52) coupled with a similar mean increase in measures of corticospinal excitability (p<0.03, ES = 0.30-0.41). Additionally, the amount of intracortical inhibition decreased (p<0.03, ES = 0.32) and the amount of intracortical facilitation (p>0.10) and an index of upstream excitation of the motor cortex remained constant (p>0.40). Together, these results suggest that as fatigue develops prior to task failure, the increase in corticospinal excitability observed in relationship to the decrease in spinal excitability results from a combination of decreasing intracortical inhibition with constant levels of intracortical facilitation and upstream excitability that together eventually fail to provide the input to the motor cortex necessary for descending drive to overcome the spinal cord resistance, thereby contributing to task failure.
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Affiliation(s)
- Petra S. Williams
- Ohio Musculoskeletal & Neurological Institute (OMNI), Ohio University, Athens, Ohio, United States of America
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, Arizona, United States of America
| | - Richard L. Hoffman
- Ohio Musculoskeletal & Neurological Institute (OMNI), Ohio University, Athens, Ohio, United States of America
| | - Brian C. Clark
- Ohio Musculoskeletal & Neurological Institute (OMNI), Ohio University, Athens, Ohio, United States of America
- Department of Biomedical Sciences, Ohio University, Athens, Ohio, United States of America
- Department of Geriatric Medicine and Gerontology, Ohio University, Athens, Ohio, United States of America
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Rudroff T, Kalliokoski KK, Block DE, Gould JR, Klingensmith WC, Enoka RM. PET/CT imaging of age- and task-associated differences in muscle activity during fatiguing contractions. J Appl Physiol (1985) 2013; 114:1211-9. [PMID: 23412899 DOI: 10.1152/japplphysiol.01439.2012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The study compared positron emission tomography/computed tomography (PET/CT) of [(18)F]-2-fluoro-2-deoxy-D-glucose ([(18)F]-FDG) uptake by skeletal muscles and the amount of muscle activity as indicated by surface electromyographic (EMG) recordings when young and old men performed fatiguing isometric contractions that required either force or position control. EMG signals were recorded from thigh muscles of six young men (26 ± 6 yr) and six old men (77 ± 6 yr) during fatiguing contractions with the knee extensors. PET/CT scans were performed immediately after task failure. Glucose uptake in 24 leg muscles, quantified as standardized uptake values, was greater for the old men after the force task and differed across tasks for the young men (force, 0.64 ± 0.3 g/ml; position, 0.73 ± 0.3 g/ml), but not the old men (force, 0.84 ± 0.3 g/ml; position, 0.79 ± 0.26 g/ml) (age × task interaction; P < 0.001). In contrast, the rate of increase in EMG amplitude for the agonist muscles was greater for the young men during the two contractions and there was no difference for either group of subjects in the rate of increase in EMG amplitude across the two tasks. The imaging estimates of glucose uptake indicated age- and task-dependent differences in the spatial distribution of [(18)F]-FDG uptake by skeletal muscles during fatiguing contractions. The findings demonstrate that PET/CT imaging of [(18)F]-FDG uptake, but not surface EMG recordings, detected the modulation of muscle activity across the fatiguing tasks by the young men but not the old men.
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Affiliation(s)
- Thorsten Rudroff
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado 80523-1582, USA.
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Poortvliet PC, Tucker KJ, Hodges PW. Changes in constraint of proximal segments effects time to task failure and activity of proximal muscles in knee position-control tasks. Clin Neurophysiol 2012; 124:732-9. [PMID: 23102994 DOI: 10.1016/j.clinph.2012.09.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 09/24/2012] [Accepted: 09/30/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Maintenance of a limb position against external load (position-control) fails earlier (time to task failure: TTF) than maintenance of identical force against rigid restraint (force-control). Although possibly explained by physiological differences between contractions, we investigated whether less constraint of movements in other planes and proximal segments (commonly less in position-control tasks) shortens TTF. METHODS Seventeen adults (32±7 years) contracted knee extensor muscles to task failure in a position-control task, with and without constraint of motion in other planes and proximal segments, and a force-control task with constraints. Electromyography of knee extensors, their antagonist and hip muscles was recorded with force/position. RESULTS TTF was shorter for position-control without (161±55 s) than with constraint (184±51 s). Despite identical constraint, TTF was shorter in position- than force-control (216±56 s). Muscle activity and position variability at failure was greater without constraint. CONCLUSION Constraint of motion of proximal segments and other planes increases position-control TTF with less muscle activity and variability. As TTF differed between force- and position-control, despite equivalent constraint, other factors contribute to shorter position-control TTF. SIGNIFICANCE Results clarify that differences in the TTF between position- and force-control tasks are partly explained by unmatched restriction of motion in other planes and proximal segments.
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Affiliation(s)
- Peter C Poortvliet
- The University of Queensland, Centre for Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, Brisbane, Australia
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Gordon NM, Rudroff T, Enoka JA, Enoka RM. Handedness but not dominance influences variability in endurance time for sustained, submaximal contractions. J Neurophysiol 2012; 108:1501-10. [DOI: 10.1152/jn.01144.2011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to compare endurance time and accompanying neuromuscular adjustments when left- and right-handed subjects used the dominant and nondominant arms to sustain submaximal contractions that required either force or position control. Ten left-handed and 10 right-handed healthy adults (21 ± 5 yr) participated in the study. Each subject exerted a similar net torque about the elbow joint during the force and position tasks to achieve a target force of 20% maximal voluntary contraction (MVC) force (56 ± 18 N). MVC force declined to a similar level immediately after task failure for left- and right-handed subjects (27 ± 13 vs. 25 ± 15%, P = 0.9). Endurance time for the position task was similar for the dominant and nondominant arms (task × dominance interaction, P = 0.17). Although the difference in endurance time between the two tasks was similar for left-handed (136 ± 165 s) and right-handed individuals (92 ± 73 s, task × handedness interaction, P = 0.38), there was greater variance in the ratio of the endurance times for the force and position tasks for left-handed (0.77) than right-handed subjects (0.13, P < 0.001; see Fig. 2 ). Furthermore, endurance time for the force and position tasks was significantly correlated for right-handed subjects ( r2 = 0.62, P < 0.001), but not for left-handed subjects ( r2 = 0.004, P = 0.79). Multiple regression analyses identified sets of predictor variables for each endurance time, and these differed with handedness and task. Hand dominance, however, did not influence endurance time for either group of subjects. These findings indicate that endurance times for the elbow flexors when performing submaximal isometric contractions that required either force or position control were not influenced by hand dominance but did depend on handedness.
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Affiliation(s)
- Nicole M. Gordon
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado
| | - Thorsten Rudroff
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado
| | - Joel A. Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado
| | - Roger M. Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado
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Booghs C, Baudry S, Enoka R, Duchateau J. Influence of neural adjustments and muscle oxygenation on task failure during sustained isometric contractions with elbow flexor muscles. Exp Physiol 2012; 97:918-29. [DOI: 10.1113/expphysiol.2011.064303] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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42
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Lauber B, Leukel C, Gollhofer A, Taube W. Time to task failure and motor cortical activity depend on the type of feedback in visuomotor tasks. PLoS One 2012; 7:e32433. [PMID: 22427836 PMCID: PMC3302870 DOI: 10.1371/journal.pone.0032433] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Accepted: 01/29/2012] [Indexed: 11/29/2022] Open
Abstract
The present study aimed to elucidate whether the type of feedback influences the performance and the motor cortical activity when executing identical visuomotor tasks. For this purpose, time to task failure was measured during position- and force-controlled muscular contractions. Subjects received either visual feedback about the force produced by pressing a force transducer or about the actual position between thumb and index finger. Participants were instructed to either match the force level of 30% MVC or the finger position corresponding to the thumb and index finger angle at this contraction intensity. Subjects demonstrated a shorter time to task failure when they were provided with feedback about their joint position (11.5±6.2 min) instead of force feedback (19.2±12.8 min; P = 0.01). To test differences in motor cortical activity between position- and force-controlled contractions, subthreshold transcranial magnetic stimulation (subTMS) was applied while executing submaximal (20% MVC) contractions. SubTMS resulted in a suppression of the first dorsal interosseus muscle (FDI) EMG in both tasks. However, the mean suppression for the position-controlled task was significantly greater (18.6±9.4% vs. 13.3±7.5%; P = 0.025) and lasted longer (13.9±7.5 ms vs. 9.3±4.3 ms; P = 0.024) compared to the force-controlled task. The FDI background EMG obtained without stimulation was comparable in all conditions. The present results demonstrate that the presentation of different feedback modalities influences the time to task failure as well as the cortical activity. As only the feedback was altered but not the mechanics of the task, the present results add to the body of evidence that suggests that the central nervous system processes force and position information in different ways.
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Affiliation(s)
- Benedikt Lauber
- Department of Sport Science, University of Freiburg, Freiburg, Germany.
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43
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Dideriksen JL, Enoka RM, Farina D. Neuromuscular adjustments that constrain submaximal EMG amplitude at task failure of sustained isometric contractions. J Appl Physiol (1985) 2011; 111:485-94. [PMID: 21596915 DOI: 10.1152/japplphysiol.00186.2011] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The amplitude of the surface EMG does not reach the level achieved during a maximal voluntary contraction force at the end of a sustained, submaximal contraction, despite near-maximal levels of voluntary effort. The depression of EMG amplitude may be explained by several neural and muscular adjustments during fatiguing contractions, including decreased net neural drive to the muscle, changes in the shape of the motor unit action potentials, and EMG amplitude cancellation. The changes in these parameters for the entire motor unit pool, however, cannot be measured experimentally. The present study used a computational model to simulate the adjustments during sustained isometric contractions and thereby determine the relative importance of these factors in explaining the submaximal levels of EMG amplitude at task failure. The simulation results indicated that the amount of amplitude cancellation in the simulated EMG (∼ 40%) exhibited a negligible change during the fatiguing contractions. Instead, the main determinant of the submaximal EMG amplitude at task failure was a decrease in muscle activation (number of muscle fiber action potentials), due to a reduction in the net synaptic input to motor neurons, with a lesser contribution from changes in the shape of the motor unit action potentials. Despite the association between the submaximal EMG amplitude and reduced muscle activation, the deficit in EMG amplitude at task failure was not consistently associated with the decrease in neural drive (number of motor unit action potentials) to the muscle. This indicates that the EMG amplitude cannot be used as an index of neural drive.
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Affiliation(s)
- Jakob L Dideriksen
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Baudry S, Maerz AH, Gould JR, Enoka RM. Task- and time-dependent modulation of Ia presynaptic inhibition during fatiguing contractions performed by humans. J Neurophysiol 2011; 106:265-73. [PMID: 21543747 DOI: 10.1152/jn.00954.2010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Presynaptic modulation of Ia afferents converging onto the motor neuron pool of the extensor carpi radialis (ECR) was compared during contractions (20% of maximal force) sustained to failure as subjects controlled either the angular position of the wrist while supporting an inertial load (position task) or exerted an equivalent force against a rigid restraint (force task). Test Hoffmann (H) reflexes were evoked in the ECR by stimulating the radial nerve above the elbow. Conditioned H reflexes were obtained by stimulating either the median nerve above the elbow or at the wrist (palmar branch) to assess presynaptic inhibition of homonymous (D1 inhibition) and heteronymous Ia afferents (heteronymous Ia facilitation), respectively. The position task was briefer than the force task (P = 0.001), although the maximal voluntary force and electromyograph for ECR declined similarly at failure for both tasks. Changes in the amplitude of the conditioned H reflex were positively correlated between the two conditioning methods (P = 0.02) and differed between the two tasks (P < 0.05). The amplitude of the conditioned H reflex during the position task first increased (129 ± 20.5% of the initial value, P < 0.001) before returning to its initial value (P = 0.22), whereas it increased progressively during the force task to reach 122 ± 17.4% of the initial value at failure (P < 0.001). Moreover, changes in conditioned H reflexes were associated with the time to task failure and force fluctuations. The results suggest a task- and time-dependent modulation of presynaptic inhibition of Ia afferents during fatiguing contractions.
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Affiliation(s)
- Stéphane Baudry
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado, USA.
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45
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Thomas JS, Ross AJ, Russ DW, Clark BC. Time to task failure of trunk extensor muscles differs with load type. J Mot Behav 2011; 43:27-9. [PMID: 21186461 DOI: 10.1080/00222895.2010.530305] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Time to task failure of trunk extensor muscles during seated submaximal isometric exertions was assessed in 18 healthy participants using 2 different load types. One required supporting an inertial load (position-matching task) whereas the 2nd required maintaining an equivalent torque against a rigid restraint (force-matching task). Time to task failure was significantly longer for position-matching tasks compared to the force-matching tasks. This finding is opposite to that reported for the appendicular muscles. A subset of 4 individuals completed a 2nd experiment to test the time to task failure of the elbow flexors in the position- and force-matching tasks. Time to task failure of the elbow flexors was significantly longer for the force-matching tasks compared to position matching. Thus, the same population shows that the effects of load type on time to task failure are opposite for the appendicular and axial muscles. This could be an important issue in understanding the mechanisms of task failure, and the endurance capacity of the trunk extensor muscles.
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Affiliation(s)
- James S Thomas
- School of Rehabilitation and Communication Sciences, Division of Physical Therapy, Ohio University, Athens 45701, USA.
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46
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Distribution of motor unit potential velocities in the biceps brachii muscle of sprinters and endurance athletes during prolonged dynamic exercises at low force levels. J Electromyogr Kinesiol 2010; 20:1115-24. [DOI: 10.1016/j.jelekin.2010.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 05/19/2010] [Accepted: 05/19/2010] [Indexed: 11/19/2022] Open
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47
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Distribution of motor unit potential velocities in the biceps brachii muscle of sprinters and endurance athletes during short static contractions at low force levels. J Electromyogr Kinesiol 2010; 20:1107-14. [DOI: 10.1016/j.jelekin.2010.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 05/19/2010] [Accepted: 05/19/2010] [Indexed: 11/22/2022] Open
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Enoka RM, Baudry S, Rudroff T, Farina D, Klass M, Duchateau J. Unraveling the neurophysiology of muscle fatigue. J Electromyogr Kinesiol 2010; 21:208-19. [PMID: 21071242 DOI: 10.1016/j.jelekin.2010.10.006] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 10/13/2010] [Indexed: 11/16/2022] Open
Abstract
Despite 100years of research since the seminal work of Angelo Mosso (1846-1910), our understanding of the interactions between the nervous system and muscle during the performance of fatiguing contractions remains rather rudimentary. Although the nervous system simply needs to provide an activation signal that will elicit the net muscle torque required for a prescribed action, changes in the number and diversity of synaptic inputs that must be integrated by the spinal motor neurons to accommodate the changes in the force-producing capabilities of the muscle fibers complicate the process of generating the requisite activation signal. This brief review examines two ways in which the activation signal can be compromised during sustained contractions and thereby contribute to the rate at which the muscles fatigue. These examples provide insight on the types of adjustments that occur in the nervous system during fatiguing contractions, but emphasize that much remains to be learned about the physiological processes that contribute to the phenomenon known as muscle fatigue.
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Affiliation(s)
- Roger M Enoka
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA.
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49
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Rudroff T, Justice JN, Holmes MR, Matthews SD, Enoka RM. Muscle activity and time to task failure differ with load compliance and target force for elbow flexor muscles. J Appl Physiol (1985) 2010; 110:125-36. [PMID: 21030676 DOI: 10.1152/japplphysiol.00605.2010] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The primary purpose of this study was to determine the influence of load compliance on time to failure during sustained isometric contractions performed with the elbow flexor muscles at four submaximal target forces. Subjects pulled against a rigid restraint during the force task and maintained a constant elbow angle, while supporting an equivalent inertial load during the position task. Each task was sustained for as long as possible. Twenty-one healthy adults (23 ± 6 yr; 11 men) participated in the study. The maximal voluntary contraction (MVC) force was similar (P = 0.95) before the subjects performed the force and position tasks at each of the four target forces: 20, 30, 45, and 60% of MVC force. The time to task failure was longer for the force tasks (576 ± 80 and 325 ± 70 s) than for the position tasks (299 ± 77 and 168 ± 35 s) at target forces of 20 and 30% (P < 0.001), but was similar for the force tasks (178 ± 35 and 86 ± 14 s) and the position tasks (132 ± 29 and 87 ± 14 s) at target forces of 45 and 60% (P > 0.19). The briefer times to failure for the position task at the lower forces were accompanied by greater rates of increase in elbow flexor muscle activity, mean arterial pressure, heart rate, and rating of perceived exertion. There was no difference in the estimates of external mechanical work at any target force. The dominant mechanisms limiting time to failure of sustained isometric contractions with the elbow flexor muscles appear to change at target forces between 30 and 45% MVC, with load compliance being a significant factor at lower forces only.
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Affiliation(s)
- Thorsten Rudroff
- Department of Integrative Physiology, University of Colorado, Boulder, Colorado, USA.
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50
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Bojsen-Møller J, Schwartz S, Magnusson SP. Limited difference in time to failure between sustained force and position control contractions with the knee extensors. Scand J Med Sci Sports 2010; 21:e48-55. [PMID: 20561276 DOI: 10.1111/j.1600-0838.2010.01148.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J Bojsen-Møller
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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