Age and sex differences in steadiness of elbow flexor muscles with imposed cognitive demand

Wrist rotation metrics as digital biomarkers for detecting physio-cognitive decline syndrome in older adults

INTRODUCTION

Physio-cognitive decline syndrome (PCDS) is a reversible condition affecting physical and cognitive health in older adults. Early detection is essential to facilitate timely interventions. This study aimed to evaluate wrist rotation metrics as potential biomarkers for PCDS and explore their applicability in digital health tools.

METHODS

This pilot study recruited 50 community-dwelling individuals aged 50 years or older from Yi-Lan County, Taiwan, including 19 with PCDS and 31 robust participants. Wrist rotation movements were assessed using a custom device, and statistical analyses, including logistic regression and receiver operating characteristic (ROC) curve analysis, were performed to evaluate the diagnostic accuracy of the metrics.

RESULTS

Two rotation metrics, Rotate (60°-30°) and the ratio Rotate (30°-90°)/Rotate (60°-90°), were significantly associated with PCDS. The ratio metric demonstrated high sensitivity, making it suitable for initial screening, while Rotate (60°-30°) exhibited high specificity, supporting its use as a confirmatory test. These complementary roles highlight the potential of these metrics in tiered diagnostic frameworks.

CONCLUSIONS

Wrist rotation metrics show promise as scalable and non-invasive tools for detecting PCDS. These findings support their integration into digital platforms, such as smartphone applications, for early screening and intervention. Further studies are needed to validate these findings in larger, diverse populations and to assess their utility in monitoring disease progression and guiding interventions to improve physical and cognitive health.

Effects of Motor and Cognitive Dual-Task Demands on Ankle Dorsiflexor and Plantarflexor Force Control in Older Adults

BACKGROUND

Force steadiness can be impaired under dual-task conditions in older adults. Since this impairment is attributed to their limited attentional resources, we hypothesized that the degree of cortical activity involved in muscle contraction would affect force steadiness under dual-task conditions. To test this hypothesis, based on the premise that dorsiflexion requires more cortical resources than plantarflexion, we compared the effects of additional motor and cognitive task demands on force steadiness between dorsiflexion and plantarflexion contractions in young and older adults.

METHOD

Eighteen young and eighteen older adults performed a force tracking task by applying either isometric dorsiflexion or plantarflexion force concurrently with and without (control) secondary upper-limb motor or cognitive task.

RESULTS

Force steadiness was impaired by both secondary upper-limb motor and cognitive tasks for the dorsiflexors and plantarflexors in older adults. While force steadiness was impaired similarly by additional task demands regardless of the secondary task type for the dorsiflexors, the impairment effect was larger in the secondary cognitive than motor task for the plantarflexors.

CONCLUSION

The effects of dual-task demand on force steadiness could depend on the degree of cortical activity involved in muscle contraction in older adults.

Age-related differences in eye movements and the association with Archimedes spiral tracing performance in young and older adults

Age-related hand motor impairments may critically depend on visual information though few studies have examined eye movements during tasks of hand function in older adults. The purpose of this study was to assess eye movements and their association with performance while tracing on a touchscreen in young and older adults. Eye movements of 21 young (age 20-38 years; 12 females, 9 males) and 20 older (65-85 years; 10 females, 10 males) adults were recorded while performing an Archimedes spiral tracing task, a common clinical assessment sensitive to age-associated impairments in hand function. Participants traced an Archimedes spiral template on a touchscreen as accurately as possible under three conditions, using (1) a stylus, (2) the index finger, and (3) the index finger while performing a visuospatial dual task. Older adults made fewer total fixations than young adults, and participants made fewer fixations when tracing parts of the spiral where vision of the spiral template was likely more obstructed by the hand. Inter-fixation distance and inter-fixation distance variability were greater in older compared to young adults. A relationship between increased inter-fixation distance and increased spiral tracing error demonstrates the association between age-related changes in eye movements and spiral tracing performance in older adults. Results contribute novel findings of age-associated changes in ocuomotor behavior during a common clinical assessment and offer insight into motor control in older adults.

Explaining the influence of practice on the grooved pegboard times of older adults: role of force steadiness

The purpose was to identify the variables that can explain the variance in the grooved pegboard times of older adults categorized as either fast or slow performers. Participants (n = 28; 60-83 years) completed two experimental sessions, before and after 6 practice sessions of the grooved pegboard test. The 2 groups were identified based on average pegboard times during the practice sessions. Average pegboard time during practice was 73 ± 11 s for the fast group and 85 ± 13 s for the slow group. Explanatory variables for the pegboard times before and after practice were the durations of 4 peg-manipulation phases and 12 measures of force steadiness (coefficient of variation [CV] for force) during isometric contractions with the index finger abductor and wrist extensor muscles. Time to complete the grooved pegboard test after practice decreased by 25 ± 11% for the fast group and by 28 ± 10% for the slow group. Multiple regression models explained more of the variance in the pegboard times for the fast group before practice (Adjusted R2 = 0.85) than after practice (R2 = 0.51), whereas the variance explained for the slow group was similar before (Adjusted R2 = 0.67) and after (Adjusted R2 = 0.64) practice. The explanatory variables differed between before and after practice for the fast group but only slightly for the slow group. These findings indicate that performance-based stratification of older adults can identify unique adjustments in motor function that are independent of chronological age.

Influence of visual feedback and cognitive challenge on the age-related changes in force steadiness

Force steadiness can be influenced by visual feedback as well as presence of a cognitive tasks and potentially differs with age and sex. This study determined the impact of altered visual feedback on force steadiness in the presence of a difficult cognitive challenge in young and older men and women. Forty-nine young (19-30 yr; 25 women, 24 men) and 25 older (60-85 yr; 15 women; 10 men) performed low force (5% of maximum) static contractions with the elbow flexor muscles in the presence and absence of a cognitive challenge (counting backwards by 13) either with low or high visual feedback gain. The cognitive challenge reduced force steadiness (increased force fluctuation amplitude) particularly in women (cognitive challenge × sex: P < 0.05) and older individuals (cognitive challenge × age: P < 0.05). Force steadiness improved with high-gain visual feedback compared with low-gain visual feedback (P < 0.01) for all groups (all interactions: P > 0.05). Manipulation of visual feedback had no influence on the reduced force steadiness in presence of the cognitive challenge for all groups (all P > 0.05). These findings indicate that older individuals and women have greater risk of impaired motor performance of the upper extremity if steadiness is required during a low-force static contraction. Manipulation of visual feedback had minimal effects on the reduced force steadiness in presence of a difficult cognitive challenge.

Sex differences in the fractal dynamics of force control during maximal handgrip

This work examines the temporal structure of force fluctuations during maximal handgrip with detrended fluctuation analysis (DFA α). Here, we assess the influence of fatigue and sex on force complexity during unimanual handgrip for the fatigued and the contralateral, non-fatigued hand. Participants randomly completed experimental sessions requiring fatiguing handgrip contractions or control measurements only. Maximal unimanual forces of both hands were measured before and after the fatigue trial or a time-matched control visit. DFA revealed substantially lower alpha values for females (PRE = 1.15, POST = 1.25) compared to males (PRE = 1.30, POST = 1.33) regardless of fatigue (p < 0.01, d = 0.738) for the dominant hand with a similar pattern observed for the contralateral, non-fatigued hand (p = 0.045, d = 0.561). Females also showed greater alpha changes (Δ = 0.09) versus males (Δ = 0.01) following fatigue (p = 0.028, ηp2 = 0.151). The data provide evidence of reduced force complexity during successive maximal handgrip contractions for females, but not males. Our findings highlight task-specific factors involving force control and demonstrate the utility of complexity analyses to provide insights regarding the influence of sex on motor control strategies.

Visual feedback and declines in attention are associated with altered visual strategy during a force-steadiness task in older adults

Greater heterogeneity exists in older adults relative to young adults when performing highly skilled manual tasks. The purpose of this study was to assess the influence of visual feedback and attentional demand on visual strategy during a submaximal force-steadiness task in young and older adults. Eye movements of 21 young (age 20-38 yr; 11 females, 10 males) and 21 older (age 65-90 yr; 11 females, 10 males) adults were recorded during a pinch force-steadiness task while viewing feedback with higher and lower gain and while performing a visuospatial task. For the visuospatial task, participants imagined a star moving around four boxes and reported the final location after a series of directions. Performance on standardized tests of attention was measured. All participants gazed near the target line and made left-to-right saccadic eye movements during the force-steadiness tasks without the visuospatial task. Older adults made fewer saccades than young adults (21.0 ± 2.9 and 23.6 ± 4.4 saccades, respectively) and with higher versus lower gain (20.9 ± 4.0 and 23.7 ± 3.5 saccades, respectively). Most participants used the same visual strategy when performing the visuospatial task though seven older adults used an altered strategy; gaze did not stay near the target line nor travel exclusively left to right. Performance on standardized measures of attention was impaired in this subset compared with older adults who did not use the altered visual strategy. Results indicate that visual feedback influences visual strategy and reveals unique eye movements in some older adults when allocating attention across tasks.NEW & NOTEWORTHY This study contributes novel findings of age-related changes in visual strategy and associations with attentional deficits during hand motor tasks. Older adults used fewer saccades than young adults and with higher versus lower gain visual feedback during a force-steadiness task. A subset of older adults used an altered visual strategy when allocating attention across multiple tasks. Given that this subset demonstrated attentional deficits, the altered visual strategy could serve to indicate motor and/or cognitive impairments.

Sex differences in torque steadiness, accuracy and activation of the shoulder girdle muscles during isometric shoulder scaption

Females present more neck/shoulder musculoskeletal disorders and have different activation strategies of the shoulder girdle muscles than males. However, the sensorimotor performance and potential sex differences are still largely unexplored. The aim of this study was to investigate sex differences in torque steadiness and accuracy during isometric shoulder scaption. We also examined the amplitude and variability of the activation of the trapezius, serratus anterior (SA), and anterior deltoid muscles during torque output evaluation. Thirty-four asymptomatic adults (17 females) participated. Torque steadiness and accuracy were evaluated during submaximal contractions at 20 % and 35 % of peak torque (PT). There was no sex difference in torque coefficient of variation, but females had significantly lower torque standard deviation (SD) values than males at the two intensities evaluated (p < 0.001) and lower torque median frequency values compared to males, regardless of intensity (p < 0.01). Females had significantly lower absolute error values than males for torque output at 35 %PT (p < 0.01) and lower constant error values compared to males, regardless of intensity (p = 0.01). Females had significantly higher muscle amplitude values than males, except for SA (p = 0.10) and in general, females showed higher muscle activation SD values compared to males (p < 0.05). Females may require more complex muscle activation patterns to achieve a more stable and accurate torque output. Therefore, these sex differences may reflect control mechanisms that may also be at play when explaining the greater risk of neck/shoulder musculoskeletal disorders in females than males.

Cognitive challenge as a probe to expose sex- and age-related differences during static contractions

Despite activities of daily living being frequently performed simultaneously with a cognitive task, motor function is often investigated in isolation, which can hinder the applicability of findings. This brief review presents evidence that 1) performing a cognitive challenge simultaneously with a motor task can negatively impact force steadiness and fatigability of limb muscles during a static contraction, 2) the negative impact on old adults (>65 years old), particularly older women is greater than young when a cognitive challenge is simultaneously performed with a static motor task, 3) age-related mechanisms potentially explain impairments in motor performance in the presence of a cognitive challenge, and 4) the mechanisms for the age-related decrements in motor performance can be distinct between men and women. These observations are highly relevant to the older adults, given the increased risk of accidents and injury when a motor task is performed with a high cognitive-demand task, especially in light of the expanding reliance on an aging workforce.

Effects of Combining Occupationally Relevant Physical and Cognitive Tasks. A Systematic Review

OBJECTIVES

Physical and cognitive tasks occur together in many occupations. Previous reviews of combined tasks have mainly focused on their effects in a sports context. This review investigated to which extent combinations (concurrent or alternating) of occupationally relevant physical and cognitive tasks influence responses reflecting biomechanical exposure, stress, fatigue, performance, and well-being.

METHODS

We searched Scopus, Pubmed, Cinahl, and Psychinfo for controlled experiments investigating the effects of combinations of occupationally relevant physical and cognitive tasks in participants aged 18 to 70. In total, we identified 12 447 records. We added recent papers that had cited these studies (n = 573) to arrive at a total of 13 020 publications. After screening for relevance, 61 studies remained, of which 57 were classified to be of medium or high quality. Of the 57 studies, 51 addressed concurrent tasks, 5 alternating tasks, and 1 both concurrent and alternating tasks.

RESULTS

Most studies of concurrent physical and cognitive tasks reported negative effects, if numerically small, on indicators of biomechanical exposure, fatigue, and performance, compared to a physical task alone. Results were mixed for stress indicators, and well-being was too little studied to justify any conclusions. Effects depended on the tasks, including their intensity and complexity. Alternating physical and cognitive tasks did not appear to influence outcomes much, compared to having passive breaks in-between physical tasks.

CONCLUSIONS

The reviewed evidence indicated that concurrent physical and cognitive work tasks have negative, yet small effects on biomechanical indicators, fatigue and performance, compared to performing the physical task alone, but only if the physical task is intense, and the cognitive task is complex. Alternating between physical and cognitive tasks may have similar effects as breaking up physical tasks by passive breaks, but studies were few. Future studies should address ecologically valid combinations of physical and cognitive tasks, in particular in controlled field studies devoted to the long-term effects of combined work.

Tremor, finger and hand dexterity and force steadiness, do not change after mental fatigue in healthy humans

The effects of mental fatigue have been studied in relation to specific percentages of maximal aerobic or anaerobic efforts, maximal voluntary contractions or the performance of sport specific skills. However, its effects on tremor, dexterity and force steadiness have been only marginally explored. The present work aimed at filling this gap. In twenty-nine young individuals, measurement of postural, kinetic and isometric tremor, pinch force steadiness and finger and hand dexterity were performed before and after either 100 min of mental fatigue or control tasks. During the interventions blood pressure, oxygen saturation and heart rate and perceived effort in continuing the task were recorded every 10 minutes. Tremor was analysed in both time (standard deviation) and frequency domain (position, amplitude and area of the dominant peak) of the acceleration signal. Finger dexterity was assessed by Purdue pegboard test and hand dexterity in terms of contact time in a buzz wire exercise. Force steadiness was quantified as coefficient of variation of the force signal. Postural, kinetic and isometric tremors, force steadiness and dexterity were not affected. Higher oxygen saturation values and higher variability of heart rate and blood pressure were found in the intervention group during the mental fatigue protocol (p < .001). The results provide no evidence that mental fatigue affects the neuromuscular parameters that influence postural, kinetic or isometric tremor, force steadiness and dexterity when measured in single-task conditions. Increased variability in heart rate may suggest that the volunteers in the intervention group altered their alert/stress state. Therefore, it is possible that the alterations that are commonly observed during mental fatigue, and that could have affected tremor, steadiness and dexterity only last for the duration of the cognitive task and are not detectable anymore soon after the mental task is terminated.

Ageing and skeletal muscle force control: current perspectives and future directions

During voluntary muscle contractions, force output is characterized by constant inherent fluctuations, which can be quantified either according to their magnitude or temporal structure, that is, complexity. The presence of such fluctuations when targeting a set force indicates that control of force is not perfectly accurate, which can have significant implications for task performance. Compared to young adults, older adults demonstrate a greater magnitude and lower complexity in force fluctuations, indicative of decreased steadiness, and adaptability of force output, respectively. The nature of this loss‐of‐force control depends not only on the age of the individual but also on the muscle group performing the task, the intensity and type of contraction and whether the task is performed with additional cognitive load. Importantly, this age‐associated loss‐of‐force control is correlated with decreased performance in a range of activities of daily living and is speculated to be of greater importance for functional capacity than age‐associated decreases in maximal strength. Fortunately, there is evidence that acute physical activity interventions can reverse the loss‐of‐force control in older individuals, though whether this translates to improved functional performance and whether lifelong physical activity can protect against the changes have yet to be established. A number of mechanisms, related to both motor unit properties and the behavior of motor unit populations, have been proposed for the age‐associated changes in force fluctuations. It is likely, though, that age‐associated changes in force control are related to increased common fluctuations in the discharge times of motor units.

Mind over body: A neuroergonomic approach to assessing motor performance under stress in older adults

Stress impairs motor performance, which is exacerbated with age. Stress also impairs brain activity in the prefrontal cortex, which communicates with the motor areas of the brain to regulate exercise and motor performance. To develop ergogenic strategies for the aging workforce, mind (brain)-body mechanisms behind the effect of stress on neuromuscular performance need to be well understood. This study investigated the influence of social stress on motor performance and information flow between the frontal and motor regions of the brain during intermittent handgrip contractions among older adults. Thirty older adults, balanced by gender, performed intermittent handgrip contractions at 30% of maximum strength before and after being subjected to a social stressor. Force steadiness, strength loss, root mean square electromyogram (EMG) activity, activation of the brain regions, and functional and effective connectivity between the frontal and motor brain regions were computed for pre- and post-stressor handgrip contractions. Older men exhibited improved motor performance after the stressor and concomitant reduction in functional connectivity between the frontal-motor brain regions ipsilateral to the contracting hand. Additionally, while both sexes exhibited significant causal information flow, i.e., effective connectivity, from the frontal to the motor regions of the brain, irrespective of the stressor, older women exhibited a bidirectional effective connectivity between the frontal-motor brain regions after the stressor. Stress had a facilitative effect on the motor performance of older men through compensatory brain network reorganization. Older women exhibited comparable motor performance pre/post stress, despite showing an increase in bidirectional information flow between the frontal-motor areas. Employing brain hemodynamics can facilitate better understanding of the impact of stress on neuromuscular performance and its differential impacts on brain network reorganization between the sexes.

Sex and limb comparisons of neuromuscular function in the morning versus the evening

The time-of-day influence on neuromuscular function is well-documented, but important details remain elusive. It is currently unknown whether males and females differ in their diurnal variation for optimal neuromuscular performance. The purpose of this study is to identify the time-of-day influence on neuromuscular function between sexes and determine whether these responses differ for the upper versus lower limbs. A group of males (n = 12) and females (n = 15) completed neuromuscular performance testing in the morning (07:00-09:00) and evening (17:00-19:00) on separate days in a randomized order. Maximal force, the normalized rate of force development, EMG, normalized EMG rise, and submaximal force steadiness were compared between morning and evening hours. The main findings show that maximal force was greater in the evening for the knee extensors (d = 0.570, p < 0.01) but not the elbow flexors (d = 0.212, p = 0.281), whereas maximal muscle excitation was greater in the evening for the biceps brachii (d = 0.348, p < 0.01) but not the vastus lateralis (d = 0.075, p = 0.526) with no influence of sex. However, force steadiness during knee extension was superior in the evening versus the morning for males (d = 0.734, p = 0.025) and compared to evening values for females (g = 1.19, p = 0.032). Overall, these findings show that time-of-day affects the knee extensors more than the elbow flexors and that diurnal variability between sexes appears to be task-dependent.

A Methodological Framework to Capture Neuromuscular Fatigue Mechanisms Under Stress

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

Fatigue, Stress, and Performance during Alternating Physical and Cognitive Tasks-Effects of the Temporal Pattern of Alternations

In occupational life, performing cognitive work tasks in between fatiguing physical work tasks may allow recovery and reduce stress without losing productive working time. The temporal pattern of such alternations is likely a determinant of the recovery effect, influencing both stress and fatigue; the difficulty of the cognitive task (CT) would also be a likely determinant. The aim of this study was to determine to what extent the temporal pattern of alternations between a repetitive physical task and a CT of different difficulties influenced perceived fatigability, performance fatigability, stress-related outcomes, and performance. Fifteen women performed four work sessions comprising 110 min of repeated bouts of a repetitive physical task (pipetting), alternating with a CT (n-back). Sessions differed in bout cycle time (short: 7 + 3 min versus long: 14 + 6 min) and CT difficulty (CTdiff; easy versus difficult). Fatigue was assessed from recordings of maximal voluntary contraction force in shoulder elevations and handgrip pre- and post-work, electromyography (EMG) from the right trapezius and right forearm extensors during work, and repeated self-ratings of fatigue and pain throughout the session. Stress was assessed using electrocardiography (heart rate variability), salivary alpha-amylase, and self-reports. Perceived fatigue increased significantly over time for all protocols and more in long-cycle than short-cycle conditions. EMG activity did not increase markedly over time in any condition. Neither objective nor subjective indicators suggested that stress increased over time, regardless of the temporal pattern. Pipetting performance remained stable in all conditions. Cognitive performance, measured by the proportions of correct positive and false positive answers, differed between CTdiff levels but remained stable over time, with no significant difference between temporal patterns. In summary, temporal patterns of alternating tasks influenced fatigue to some extent but had no obvious influence on stress indicators or performance. Thus, designing job rotation with alternating physical and cognitive work should consider the temporal patterns of alternations to minimize fatigue.

Resting Tendon Cross-Sectional Area Underestimates Biceps Brachii Tendon Stress: Importance of Measuring During a Contraction

Force produced by the muscle during contraction is applied to the tendon and distributed through the cross-sectional area (CSA) of the tendon. This ratio of force to the tendon CSA is quantified as the tendon mechanical property of stress. Stress is traditionally calculated using the resting tendon CSA; however, this does not take into account the reductions in the CSA resulting from tendon elongation during the contraction. It is unknown if calculating the tendon stress using instantaneous CSA during a contraction significantly increases the values of in vivo distal biceps brachii (BB) tendon stress in humans compared to stress calculated with the resting CSA. Nine young (22 ± 1 years) and nine old (76 ± 4 years) males, and eight young females (21 ± 1 years) performed submaximal isometric elbow flexion tracking tasks at force levels ranging from 2.5 to 80% maximal voluntary contraction (MVC). The distal BB tendon CSA was recorded on ultrasound at rest and during the submaximal tracking tasks (instantaneous). Tendon stress was calculated as the ratio of tendon force during contraction to CSA using the resting and instantaneous measures of CSA, and statistically evaluated with multi-level modeling (MLM) and Johnson–Neyman regions of significance tests to determine the specific force levels above which the differences between calculation methods and groups became statistically significant. The tendon CSA was greatest at rest and decreased as the force level increased (p < 0.001), and was largest in young males (23.0 ± 2.90 mm²) followed by old males (20.87 ± 2.0 mm²) and young females (17.08 ± 1.54 mm²) (p < 0.001) at rest and across the submaximal force levels. Tendon stress was greater in the instantaneous compared with the resting CSA condition, and young males had the greatest difference in the values of tendon stress between the two conditions (20 ± 4%), followed by old males (19 ± 5%), and young females (17 ± 5%). The specific force at which the difference between the instantaneous and resting CSA stress values became statistically significant was 2.6, 6.6, and 10% MVC for old males, young females, and young males, respectively. The influence of using the instantaneous compared to resting CSA for tendon stress is sex-specific in young adults, and age-specific in the context of males. The instantaneous CSA should be used to provide a more accurate measure of in vivo tendon stress in humans.

Characteristics of rectus femoris activation and rectus femoris-hamstrings coactivation during force-matching isometric knee extension in subacute stroke

The spectral properties of surface electromyographic (EMG) signal in the rectus femoris (RF) and the coactivation in the medial hamstrings (MH) were investigated in 45 stroke subjects (22 ± 12 days post-onset) and 30 age-matched healthy controls who performed unilateral knee extensions at maximum effort (100% MVC) and during 5-s force-matching tasks (10, 30, 50% MVC). The spectral properties were obtained through a power spectrum analysis based on Fast Fourier Transform. The coactivation was measured as the MH amplitude (%max) and MH/RF amplitude ratio. Force variability was expressed as the coefficient of variation. Both knee extensors and flexors were weaker in the paretic leg than the non-paretic and control legs (p < 0.001). A significantly higher relative power in the 5-13 and 13-30 Hz bands was found in the paretic than the non-paretic leg across all force levels (p ≤ 0.001) without changes in the 30-60 and 60-100 Hz bands or the mean and median frequencies. Regarding the antagonist coactivation, MH amplitude in the paretic leg was higher than in the non-paretic leg (submaximal levels, p < 0.0001) and the control leg (all force levels, p = 0.0005) with no differences between legs in the MH/RF ratio. The steadiness of the knee extension force was not related to the spectral properties of the agonist EMG or antagonistic coactivation. Greater coactivation was associated with weaker paretic knee flexors (p ≤ 0.0002). The overall results suggest variably altered agonist activation and antagonistic coactivation over the range of isometric knee extension contractions in subacute stroke.

Age and sex-related decline of muscle strength across the adult lifespan: a scoping review of aggregated data

Muscle strength is sex-related and declines with advancing age; yet, a comprehensive comparative evaluation of age-related strength loss in human females and males has not been undertaken. To do so, segmented piecewise regression analysis was performed on aggregated data from studies published from 1990 to 2018 and are available in CINAHL, EMBASE, MEDLINE, and PsycINFO databases. The search identified 5613 articles that were reviewed for physical assessment results stratified by sex and age. Maximal isometric and isokinetic 60°·s-1 knee extension (KE) and knee flexion (KF) contractions from 57 studies and 15 283 subjects (N = 7918 females) had sufficient data reported on females and males for meaningful statistical evaluation to be undertaken. The analysis revealed that isometric KE and KF strength undergo similar rapid declines in both sexes late in the sixth decade of life. Yet, there is an abrupt age-related decline in KE 60°·s-1 peak torque earlier in females (aged 41.8 years) than males (aged 66.7 years). In the assessment of KF peak torque, an age-related acceleration in strength loss was only identified in males (aged 49.3 years). The results suggest that age-related isometric strength loss is similar between sexes while the characteristics of KE and KF peak torque decline are sex-related, which likely explains the differential rate of age-related functional decline. Novelty Inclusion of muscle strength and torque of KE and KF data from >15 000 subjects. Isometric KE and KF strength loss are similar between sexes. Isokinetic 60°·s-1 KE torque decline accelerates 25 years earlier in females and female age-related KF peak torque decline does not accelerate with age.

Force control during submaximal isometric contractions is associated with walking performance in persons with multiple sclerosis

Individuals with multiple sclerosis (MS) experience progressive declines in movement capabilities, especially walking performance. The purpose of our study was to compare the amount of variance in walking performance that could be explained by the functional capabilities of lower leg muscles in persons with MS and a sex- and age-matched control group. Participants performed two walking tests (6-min walk and 25-ft walk), strength tests for the plantar flexor and dorsiflexor muscles, and steady submaximal (10% and 20% maximum) isometric contractions. High-density electromyography (EMG) was recorded during the steady contractions, and the signals were decomposed to identify the discharge times of concurrently active motor units. There were significant differences between the two groups in the force fluctuations during the steady contractions (force steadiness), the strength of the plantar flexor and dorsiflexor muscles, and the discharge characteristics during the steady contractions. Performance on the two walking tests by the MS group was moderately associated with force steadiness of the plantar flexor and dorsiflexor muscles; worse force steadiness was associated with poorer walking performance. In contrast, the performance of the control group was associated with muscle strength (25-ft test) and force steadiness of the dorsiflexors and variance in common input of motor units to the plantar flexors (6-min test). These findings indicate that a reduction in the ability to maintain a steady force during submaximal isometric contractions is moderately associated with walking performance of persons with MS.NEW & NOTEWORTHY The variance in walking endurance and walking speed was associated with force control of the lower leg muscles during submaximal isometric contractions in individuals with multiple sclerosis (MS). In contrast, the fast walking speed of a sex- and age-matched control group was associated with the strength of lower leg muscles. These findings indicate that moderate declines in the walking performance of persons with MS are more associated with impairments in force control rather than decreases in muscle strength.

Force Control and Motor Unit Firing Behavior Following Mental Fatigue in Young Female and Male Adults

Purpose: The neuromuscular mechanisms leading to impaired motor performance in the presence of mental fatigue remain unclear. It is also unknown if mental fatigue differentially impacts motor performance in males and females. The purpose of this study was to assess the impact of mental fatigue on force production and motor unit (MU) firing behavior in males and females.

Methods: Nineteen participants performed 10-s isometric dorsiflexion (DF) contractions at 20 and 50% maximum voluntary contraction (MVC) before, during, and after completing 22 min of the psychomotor vigilance task (PVT), to induce mental fatigue. The DF force and indwelling MU firing behavior of the tibialis anterior (TA) was measured before and immediately following the PVT and within the first and final minutes of the PVT.

Results: Force steadiness and motor unit firing rate (MUFR) variability did not change during or following the PVT at either contraction intensity (p ≥ 0.16). Overall, females had more variability than males in MUFR during the 20% MVCs (15.98 ± 2.19 vs. 13.64 ± 2.19%, p = 0.03), though no sex differences were identified during the 50% MVCs (p = 0.20). Mean MUFR decreased following mental fatigue in both sexes in the 20% MVC condition (14.79 ± 3.20 vs. 12.92 ± 2.53 Hz, p = 0.02), but only in males during the 50% MVC condition (18.65 ± 5.21 vs. 15.03 ± 2.60 Hz, p = 0.01).

Conclusions: These results suggest possible sex and contraction intensity-specific neuromuscular changes in the presence of mental fatigue.

Oscillations in neural drive and age-related reductions in force steadiness with a cognitive challenge

A cognitive challenge when imposed during a low-force isometric contraction will exacerbate sex- and age-related decreases in force steadiness, but the mechanism is not known. We determined the role of oscillations in the common synaptic input to motor units on force steadiness during a muscle contraction with a concurrent cognitive challenge. Forty-nine young adults (19-30 yr; 25 women, 24 men) and 36 old adults (60-85 yr; 19 women, 17 men) performed a cognitive challenge (counting backward by 13) during an isometric elbow flexion task at 5% of maximal voluntary contraction. Single-motor units were decomposed from high-density surface EMG recordings. For a subgroup of participants, motor units were matched during control and cognitive challenge trials, so the same motor unit was analyzed across conditions. Reduced force steadiness was associated with greater oscillations in the synaptic input to motor units during both control and cognitive challenge trials ( r = 0.45-0.47, P < 0.01). Old adults and young women showed greater oscillations in the common synaptic input to motor units and decreased force steadiness when the cognitive challenge was imposed, but young men showed no change across conditions (session × age × sex, P < 0.05). Oscillations in the common synaptic input to motor units is a potential mechanism for altered force steadiness when a cognitive challenge is imposed during low-force contractions in young women and old adults. NEW & NOTEWORTHY We found that oscillations in the common synaptic input to motor units were associated with a reduction in force steadiness when a cognitive challenge was imposed during low-force contractions of the elbow flexor muscles in young women and old men and women but not young men. Age- and sex-related muscle weakness was associated with these changes.

Is there sufficient evidence to explain the cause of sexually dimorphic behaviour in force steadiness?

Neuromuscular noise is a determining factor in the control of isometric force steadiness (FS), quantified as coefficient of variation (CV) of force around a preestablished target output. In this paper we examine sex-related differences of neural, muscular, and tendon influences on neuromuscular noise to understand FS in females and males. We use evidence from the literature to identify that CV of force is higher in females compared with males in the upper and lower body, with sex-related differences becoming less apparent with increasing age. Evaluation of sex-related physiology in tandem with results from FS studies indicate that differences in fibre type, contractile properties, and number of motor units (MUs) are unlikely contributors to differences in FS between females and males. MU type, behaviour of the population (inclusive of number of active MUs from the population), agonist–antagonist activity, maximal strength, and tendon mechanics are probable contributors to sexually dimorphic behaviour in FS. To clearly determine underlying causes of sex-related differences in FS, further study and reporting between females and males is required. Females and males are included in many studies; however, rich data on sexually dimorphic behaviour is lost when data are collapsed across sex or identified as nonsignificant without supporting values. This poses a challenge to identifying the underlying cause of females having higher CV of force than males. This review provides evidence of sexually dimorphic behaviour in FS and suggests that physiological differences between females and males effect neuromuscular noise, and in-turn contribute to sex-related differences in FS.

Force Steadiness During a Cognitively Challenging Motor Task Is Predicted by Executive Function in Older Adults

Motor performance and cognitive function both decline with aging. Older adults for example are usually less steady for a constant-force task than young adults when performing low-intensity contractions with limb muscles. Healthy older adults can also show varying degrees of cognitive decline, particularly in executive function skills. It is not known, however, whether age-related changes in steadiness of low-force tasks and cognitive function are independent of one another. In this study, we determined if executive function skills in aging are associated with the steadiness during a low-force muscle contraction performed with and without the imposition of a cognitive challenge. We recruited 60 older adults (60–85 years old, 34 women, 26 men) and 48 young adults (19–30 years old, 24 women, 24 men) to perform elbow flexor muscle contractions at 5% of maximal voluntary contraction (MVC) force in the presence and absence of a difficult mental-math task (counting backward by 13 from a four-digit number). Force steadiness was quantified as the coefficient of variation (CV) of force and executive function was estimated with the Trail-making Test part A and B. The cognitive challenge increased the CV of force (i.e., decreased force steadiness) with greater changes in older adults than young adults (5.2 vs. 1.3%, respectively, cognitive challenge × age: P < 0.001). Older adults were 35% slower in both parts A and B of the Trail-making Test (P < 0.001), and to eliminate the effects of age and education on this variable, all further analyses were performed with the age-corrected z-scores for each individual using established normative values. Hierarchical regression models indicated that decreased force steadiness during a cognitive challenge trial was in part, explained by the performance in the Trail-making Test part A and B in older (r = 0.53 and 0.50, respectively, P < 0.05), but not in young adults (P > 0.05). Thus, healthy community-dwelling older adults, who have poorer executive function skills, exhibit reduced force steadiness during tasks when also required to perform a high cognitive demand task, and are likely at risk of reduced capacity to perform daily activities that involve cognitively challenging motor tasks.

Adjustments in Torque Steadiness During Fatiguing Contractions Are Inversely Correlated With IQ in Persons With Multiple Sclerosis

Fatigue is one of the most debilitating symptoms of multiple sclerosis (MS), and the underlying mechanisms are poorly understood. When exposed to a physical or cognitive challenge, individuals with MS tend to exhibit greater declines in task performance (performance fatigability) and increased levels of self-reported fatigue (perceived fatigability), but these effects may be attenuated by greater intellectual capacity. The purpose of our study was to examine the influence of intelligence on fatigability in persons with MS. We hypothesized that greater intellectual capacity confers some protection against heightened levels of fatigue and fatigability associated with MS. Twelve adults with relapsing-remitting MS were compared with 12 control (CO) subjects who were matched for age, sex, and premorbid intellectual capacity. Performance fatigability was measured as the decline in maximal voluntary contraction (MVC) torque after 60 isometric contractions (10 s contraction at 25% MVC, 5 s rest) performed with the knee extensor muscles. Perceived fatigability was assessed with the modified fatigue impact scale (MFIS) questionnaire (trait fatigability) and the Borg rating of perceived exertion (RPE, state fatigability). Persons with MS reported greater MFIS scores (MS: 43 ± 14; CO: 11 ± 8, P ≤ 0.001). Initial MVC torque for the knee extensors did not differ between the groups (MS: 112 ± 38 N⋅m; CO: 107 ± 44 N⋅m) and the decline (performance fatigability) was similar for both groups (MS: -16 ± 19 N⋅m; CO: -13 ± 16 N⋅m). RPE increased during the fatiguing contraction for both groups (P < 0.001) but was significantly greater in magnitude (main effect for group, P = 0.03) and increased more for the MS group (group × time interaction, P = 0.05). Torque steadiness declined during the fatiguing contractions (main effect for time, P = 0.05) and was less steady for the MS group (main effect for group, P = 0.02). Performance and full-4 IQ was correlated with the decline in torque steadiness for the MS group (r = -0.63, P < 0.05; r = -0.64, P < 0.05). Intellectual capacity was not associated with fatigability in persons with MS but was associated with adjustments in muscle activation during the fatiguing contractions.

Influence of forearm orientation on biceps brachii tendon mechanics and elbow flexor force steadiness

Achilles tendon mechanics influence plantar flexion force steadiness (FS) and balance. In the upper limb, elbow flexor FS is greater in supinated and neutral forearm orientations compared to pronated, with contributions of tendon mechanics remaining unknown in position-dependent FS. This study investigated whether distal biceps brachii (BB) tendon mechanics across supinated, neutral and pronated forearm orientations influence position-dependent FS of the elbow flexors. Eleven males (23 ± 3 years) performed submaximal isometric elbow flexion tasks at low (5, 10% maximal voluntary contraction (MVC)) and high (25, 50, 75% MVC) force levels in supinated, neutral and pronated forearm orientations. Distal BB tendon elongation and CSA were recorded on ultrasound to calculate mechanics of tendon stress, strain and stiffness. Relationships between FS, calculated as coefficient of variation (CV) of force, and tendon mechanics were evaluated with multiple regressions. Supinated and neutral were ∼50% stronger and ∼60% steadier than pronated (p < 0.05). Tendon stress was ∼52% greater in supinated and neutral compared to pronated, tendon strain was ∼36% greater in neutral than pronated (p < 0.05), while tendon stiffness (267.4 ± 78.9 N/mm) did not differ across orientations (p > 0.05). At low forces, CV of force was predicted by MVC (r²: 0.52) in supinated, and MVC and stress in neutral and pronated (r²: 0.65-0.81). At high force levels, CV of force was predicted by MVC and stress in supinated (r²: 0.49), and MVC in neutral (r²: 0.53). Absolute strength and tendon mechanics influence the ability of the BB tendon to distribute forces, and thus are key factors in position-dependent FS.

Handgrip force steadiness in young and older adults: a reproducibility study

Background

Force steadiness is a quantitative measure of the ability to control muscle tonus. It is an independent predictor of functional performance and has shown to correlate well with different degrees of motor impairment following stroke. Despite being clinically relevant, few studies have assessed the validity of measuring force steadiness. The aim of this study was to explore the reproducibility of handgrip force steadiness, and to assess age difference in steadiness.

Method

Intrarater reproducibility (the degree to which a rating gives consistent result on separate occasions) was investigated in a test-retest design with seven days between sessions. Ten young and thirty older adults were recruited and handgrip steadiness was tested at 5%, 10% and 25% of maximum voluntary contraction (MVC) using Nintendo Wii Balance Board (WBB). Coefficients of variation were calculated from the mean force produced (CVM) and the target force (CVT). Area between the force curve and the target force line (Area) was also calculated. For the older adults we explored reliability using intraclass correlation coefficient (ICC) and agreement using standard error of measurement (SEM), limits of agreement (LOA) and smallest real difference (SRD).

Results

A systematic improvement in handgrip steadiness was found between sessions for all measures (CVM, CVT, Area). CVM and CVT at 5% of MVC showed good to high reliability, while Area had poor reliability for all percentages of MVC. Averaged ICC for CVM, CVT and Area was 0.815, 0.806 and 0.464, respectively. Averaged ICC on 5%, 10%, and 25% of MVC was 0.751, 0.667 and 0.668, respectively. Measures of agreement showed similar trends with better results for CVM and CVT than for Area. Young adults had better handgrip steadiness than older adults across all measures.

Conclusion

The CVM and CVT measures demonstrated good reproducibility at lower percentages of MVC using the WBB, and could become relevant measures in the clinical setting. The Area measure had poor reproducibility. Young adults have better handgrip steadiness than old adults.

A busy day has minimal effect on factors associated with falls in older people: An ecological randomised crossover trial

Fatigue is a common complaint in older people. Laboratory-induced muscle fatigue has been found to affect physical functions in older populations but these protocols are rigorous and are unlikely to accurately reflect daily activities. This study used an ecological approach to determine the effects of a busy day on self-reported fatigue and fall-related measures of physical and cognitive function in older people. Fifty community-dwelling adult volunteers, aged 60-88 (mean 73) years participated in this randomised crossover trial. Participants undertook assessments of balance, strength, gait, mobility, cognitive function and self-reported fatigue, before and after a planned rest day and a planned busy day (randomly allocated) at least one week apart. Participants wore an activity monitor on both the rest and busy days. On average, participants undertook twice as many steps and 2.5 times more minutes of activity on the busy, compared with the rest day. Participants had a significant increase in self-reported fatigue on the afternoon of the busy day and no change on the rest day. Repeated measures ANOVAs found no significant day (rest/busy) × time (am/pm) interaction effects, except for the timed up and go test of mobility, resulting from relatively improved mobility performance over the rest day, compared with the busy day. This study showed few effects of a busy day on physical and cognitive performance tests associated with falls in older people.

Influence of biceps brachii tendon mechanical properties on elbow flexor force steadiness in young and old males

Elbow flexor force steadiness (FS) depends on strength and decreases with age. Achilles tendon mechanics effect standing balance and isometric plantarflexion FS. This study investigated the influence of distal biceps brachii (BB) tendon mechanics and elbow flexor strength on age-related decline in FS. Nine young (23 ± 2 years) and nine old (77 ± 5 years) males performed submaximal isometric elbow flexion tasks at low (2.5%, 5%, 10% maximal voluntary contraction (MVC)) and high (20%, 40%, 60%, 80%MVC) forces in a neutral forearm position. Distal BB tendon elongation and cross-sectional area (CSA) were recorded on ultrasound to calculate mechanics of strain, stress, and stiffness. Coefficient of variation (CV) of force was used to assess relationship of FS to tendon mechanics and strength. Young were 22% stronger and 41% steadier than old (P < .05). Tendon stiffness (170.1 ± 132.9 N/mm; 113.0 ± 55.1 N/mm) did not differ with age (P > .05). Young had 40% less strain compared to old at 5% MVC, but 42% greater strain at 60% and 80% MVC (P ≤ .05). Stress was ~18% greater in young at 10%, 20%, and 80% MVC (P ≤ .05). At low forces, CV of force was predicted by stress (r²  = 0.56) in young, and stress and MVC (r²  = 0.641) in old. At high forces for both age groups, CV of force was predicted by MVC and stress (r²  = 0.39-0.43). Stress and strain is greater in young compared with old males. Because strength influences tendon mechanics and is also associated with FS, absolute strength is a large and modifiable contributor to age-related decline in FS.

Differential effects of a visuospatial attention task on measures of postural control in young and older adults

The purpose of this study was to examine the influence of a visuospatial attention task on three measures of postural control in young and older adults. 20 young (19-36  years) and 20 older (67-91 years) adults performed a choice stepping response time (CSRT) task, a submaximal dorsiflexion force steadiness task, and quiet standing in 3 bilateral stances. All tasks were performed with and without a visuospatial (VS) attention task that involved visualizing a star moving within a 2 × 2 grid. CSRT increased with the addition of the VS task in both groups (p  < .001), with a larger increase for older adults than young adults (p < .001). Older adults were less steady while performing the dorsiflexion task with the VS task (p  < .001), while the VS task did not influence steadiness in young adults (p = .235). Performance during quiet standing was not influenced by the VS task in any stance (p  > .084). The findings suggest that visuospatial attention differentially affects postural control in young and older adults and the effect is task-specific. These findings suggest the need to include stepping and force control tasks to further determine what role visuospatial attention plays in postural control.

Voluntary activation and variability during maximal dynamic contractions with aging

Whether reduced supraspinal activation contributes to age-related reductions in maximal torque during dynamic contractions is not known. The purpose was to determine whether there are age differences in voluntary activation and its variability when assessed with stimulation at the motor cortex and the muscle during maximal isometric, concentric, and eccentric contractions. Thirty young (23.6 ± 4.1 years) and 31 old (69.0 ± 5.2 years) adults performed maximal isometric, shortening (concentric) and lengthening (eccentric) contractions with the elbow flexor muscles. Maximal isometric contractions were performed at 90° elbow flexion and dynamic contractions at a velocity of 60°/s. Voluntary activation was assessed by superimposing an evoked contraction with transcranial magnetic stimulation (TMS) or with electrical stimulation over the muscle during maximal voluntary contractions (MVCs). Old adults had lower MVC torque during isometric (- 17.9%), concentric (- 19.7%), and eccentric (- 9.9%) contractions than young adults, with less of an age difference for eccentric contractions. Voluntary activation was similar between the three contraction types when assessed with TMS and electrical stimulation, with no age group differences. Old adults, however, were more variable in voluntary activation than young (standard deviation 0.99 ± 0.47% vs. 0.73 ± 0.43%, respectively) to both the motor cortex and muscle, and had greater coactivation of the antagonist muscles during dynamic contractions. Thus, the average voluntary activation to the motor cortex and muscle did not differ with aging; however, supraspinal activation was more variable during maximal dynamic and isometric contractions in the old adults. Lower predictability of voluntary activation may indicate subclinical changes in the central nervous system with advanced aging.

Electromyographic Activity of the Upper Limb in Three Hand Function Tests

Objective/Background

Occupational therapists usually assess hand function through standardised tests, however, there is no consensus on how the scores assigned to hand dexterity can accurately measure hand function required for daily activities and few studies evaluate the movement patterns of the upper limbs during hand function tests. This study aimed to evaluate the differences in muscle activation patterns during the performance of three hand dexterity tests.

Methods

Twenty university students underwent a surface electromyographic (sEMG) assessment of eight upper limb muscles during the performance of the box and blocks test (BEST), nine-hole peg test (9HPT), and functional dexterity test (FDT). The description and comparison of each muscle activity during the test performance, gender differences, and the correlation between individual muscles’ sEMG activity were analysed through appropriate statistics.

Results

Increased activity of proximal muscles was found during the performance of BEST (p < .001). While a higher activation of the distal muscles occurred during the FDT and 9HPT performance, no differences were found between them. Comparisons of the sEMG activity revealed a significant increase in the muscle activation among women (p = .05). Strong and positive correlations (r > .5; p < .05) were observed between proximal and distal sEMG activities, suggesting a coordinate pattern of muscle activation during hand function tests.

Conclusion

The results suggested the existence of differences in the muscle activation pattern during the performance of hand function evaluations. Occupational therapists should be aware of unique muscle requirements and its impact on the results of dexterity tests during hand function evaluation.

Age-specific neural strategies to maintain motor performance after an acute social stress bout

Stress due to cognitive demands and fatigue have shown to impair motor performance in older adults; however, the effect of social stress and its influence on prefrontal cortex (PFC) functioning in older adults during upper extremity motor performance tasks is not known. The present study explored the after-effects of an acute social stress bout on neural strategies, measured using PFC and hand/arm muscle activation, and adopted by younger and older adults to maintain handgrip force control. Nine older [74.1 (6.5) years; three men, six women] and ten younger [24.2 (5.0) years, four men, six women] adults performed handgrip force control trials at 30% maximum voluntary contractions before and after the Trier Social Stress Test (TSST). PFC activity was measured using functional near infrared spectroscopy and muscle activity from the flexor and extensor carpi radialis (FCR/ECR) was measured using electromyography. In general, aging was associated with decreased force steadiness and force complexity with a concomitant increase in bilateral PFC activity. While motor performance remained comparable before and after the TSST stress session in both age groups, the associated neural strategies differed between groups. While the stress condition was associated with lower FCR and ECR activity in younger adults despite no change in the PFC activation, stress was associated with increases in FCR activity in older adults. This stress-related compensatory neural strategy of increasing hand/arm muscle activation, potentially via the additional recruitment of the stress-motor neural circuitry, may have played a role in maintaining motor performance in older adults.

The aging neuromuscular system and motor performance

Age-related changes in the basic functional unit of the neuromuscular system, the motor unit, and its neural inputs have a profound effect on motor function, especially among the expanding number of old (older than ∼60 yr) and very old (older than ∼80 yr) adults. This review presents evidence that age-related changes in motor unit morphology and properties lead to impaired motor performance that includes 1) reduced maximal strength and power, slower contractile velocity, and increased fatigability; and 2) increased variability during and between motor tasks, including decreased force steadiness and increased variability of contraction velocity and torque over repeat contractions. The age-related increase in variability of motor performance with aging appears to involve reduced and more variable synaptic inputs that drive motor neuron activation, fewer and larger motor units, less stable neuromuscular junctions, lower and more variable motor unit action potential discharge rates, and smaller and slower skeletal muscle fibers that coexpress different myosin heavy chain isoforms in the muscle of older adults. Physical activity may modify motor unit properties and function in old men and women, although the effects on variability of motor performance are largely unknown. Many studies are of cross-sectional design, so there is a tremendous opportunity to perform high-impact and longitudinal studies along the continuum of aging that determine 1) the influence and cause of the increased variability with aging on functional performance tasks, and 2) whether lifestyle factors such as physical exercise can minimize this age-related variability in motor performance in the rapidly expanding numbers of very old adults.

Age-related motor unit remodeling in the Tibialis Anterior

Limited studies exist on the use of surface electromyogram (EMG) signal features to detect age-related motor unit remodeling in the Tibialis Anterior. Motor unit remodeling leads to declined muscle strength and force steadiness during submaximal contractions which are factors for risk of falls in the elderly. This study investigated the remodeling phenomena in the Tibialis Anterior using sample entropy and higher order statistics. Eighteen young (26.1 ± 2.9 years) and twelve elderly (68.7 ± 9.0 years) participants performed isometric dorsiflexion of the ankle at 20% maximal voluntary contraction (MVC) and their Tibialis Anterior (TA) EMG was recorded. Sample entropy, Gaussianity and Linearity Test statistics were calculated from the recorded EMG for each MVC. Shapiro-Wilk test was used to determine normality, and either a two-tail student t-test or Wilcoxon rank sum test was performed to determine significant difference in the EMG features between the young and old cohorts. Results show age-related motor unit remodeling to be depicted by decreased sample entropy (p <; 0.1), increased non-Gaussianity (p <; 0.05) and lesser degree of linearity in the elderly. This is due to the increased sparsity of the MUAPs as a result of the denervation-reinnervation process, and the decrease in total number of motor units.

The effect of cognitive fatigue on prefrontal cortex correlates of neuromuscular fatigue in older women

BACKGROUND

As the population of adults aged 65 and above is rapidly growing, it is crucial to identify physical and cognitive limitations pertaining to daily living. Cognitive fatigue has shown to adversely impact neuromuscular function in younger adults, however its impact on neuromuscular fatigue, and associated brain function changes, in older adults is not well understood. The aim of the study was to examine the impact of cognitive fatigue on neuromuscular fatigue and associated prefrontal cortex (PFC) activation patterns in older women.

METHODS

Eleven older (75.82 (7.4) years) females attended two sessions and performed intermittent handgrip exercises at 30 % maximum voluntary contraction (MVC) until voluntary exhaustion after a 60-min control (watching documentary) and 60-min cognitive fatigue (performing Stroop Color Word and 1-Back tests) condition. Dependent measures included endurance time, strength loss, PFC activity (measured using fNIRS), force fluctuations, muscle activity, cardiovascular responses, and perceived discomfort.

RESULTS

Participants perceived greater cognitive fatigue after the 60-min cognitive fatigue condition when compared to the control condition. While neuromuscular fatigue outcomes (i.e., endurance time, strength loss, perceived discomfort), force fluctuations, and muscle activity were similar across both the control and cognitive fatigue conditions, greater decrements in PFC activity during neuromuscular fatigue development after the cognitive fatigue condition were observed when compared to the control condition.

CONCLUSION

Despite similar neuromuscular outcomes, cognitive fatigue was associated with blunted PFC activation during the handgrip fatiguing exercise that may be indicative of neural adaptation with aging in an effort to maintain motor performance. Examining the relationship between cognitive fatigue and neuromuscular output by imaging other motor-related brain regions are needed to provide a better understanding of age-related compensatory adaptations to perform daily tasks that involve some levels of cognitive demand and physical exercise, especially when older adults experience them sequentially.

Sex Differences in Arm Muscle Fatigability With Cognitive Demand in Older Adults

BACKGROUND

Muscle fatigability can increase when a stressful, cognitively demanding task is imposed during a low-force fatiguing contraction with the arm muscles, especially in women. Whether this occurs among older adults (>60 years) is currently unknown.

QUESTIONS/PURPOSES

We aimed to determine if higher cognitive demands, stratified by sex, increased fatigability in older adults (>60 years). Secondarily, we assessed if varying cognitive demand resulted in decreased steadiness and was explained by anxiety or cortisol levels.

METHODS

Seventeen older women (70±6 years) and 13 older men (71±5 years) performed a sustained, isometric, fatiguing contraction at 20% of maximal voluntary contraction until task failure during three sessions: high cognitive demand (high CD=mental subtraction by 13); low cognitive demand (low CD=mental subtraction by 1); and control (no subtraction).

RESULTS

Fatigability was greater when high and low CD were performed during the fatiguing contraction for the women but not for the men. In women, time to failure with high CD was 16±8 minutes and with low CD was 17±4 minutes, both of which were shorter than time to failure in control contractions (21±7 minutes; high CD mean difference: 5 minutes [95% confidence interval {CI}, 0.78-9.89], p=0.02; low CD mean difference: 4 minutes [95% CI, 0.57-7.31], p=0.03). However, in men, no differences were detected in time to failure with cognitive demand (control: 13±5 minutes; high CD mean difference: -0.09 minutes [95% CI, -2.8 to 2.7], p=1.00; low CD mean difference: 0.75 minutes [95% CI, -1.1 to 2.6], p=0.85). Steadiness decreased (force fluctuations increased) more during high CD than control. Elevated anxiety, mean arterial pressure, and salivary cortisol levels in both men and women did not explain the greater fatigability during high CD.

CONCLUSIONS

Older women but not men showed marked increases in fatigability when low or high CD was imposed during sustained static contractions with the elbow flexor muscles and contrasts with previous findings for the lower limb. Steadiness decreased in both sexes when high CD was imposed.

CLINICAL RELEVANCE

Older women are susceptible to greater fatigability of the upper limb with heightened mental activity during sustained postural contractions, which are the foundation of many work-related tasks.

The Effect of Antagonist Muscle Sensory Input on Force Regulation

The purpose of this study was to understand how stretch-related sensory feedback from an antagonist muscle affects agonist muscle output at different contraction levels in healthy adults. Ten young (25.3 ± 2.4 years), healthy subjects performed constant isometric knee flexion contractions (agonist) at 6 torque levels: 5%, 10%, 15%, 20%, 30%, and 40% of their maximal voluntary contraction. For half of the trials, subjects received patellar tendon taps (antagonist sensory feedback) during the contraction. We compared error in targeted knee flexion torque and hamstring muscle activity, with and without patellar tendon tapping, across the 6 torque levels. At lower torque levels (5%, 10%, and 15%), subjects produced greater knee torque error following tendon tapping compared with the same torque levels without tendon tapping. In contrast, we did not find any difference in torque output at higher target levels (20%, 30%, and 40%) between trials with and without tendon tapping. We also observed a load-dependent increase in the magnitude of agonist muscle activity after tendon taps, with no associated load-dependent increase in agonist and antagonist co-activation, or reflex inhibition from the antagonist tapping. The findings suggest that at relatively low muscle activity there is a deficiency in the ability to correct motor output after sensory disturbances, and cortical centers (versus sub-cortical) are likely involved.