Bioenergetic basis of skeletal muscle fatigue

[Enhancement algorithm for surface electromyographic-based gesture recognition based on real-time fusion of muscle fatigue features]

This study aims to optimize surface electromyography-based gesture recognition technique, focusing on the impact of muscle fatigue on the recognition performance. An innovative real-time analysis algorithm is proposed in the paper, which can extract muscle fatigue features in real time and fuse them into the hand gesture recognition process. Based on self-collected data, this paper applies algorithms such as convolutional neural networks and long short-term memory networks to provide an in-depth analysis of the feature extraction method of muscle fatigue, and compares the impact of muscle fatigue features on the performance of surface electromyography-based gesture recognition tasks. The results show that by fusing the muscle fatigue features in real time, the algorithm proposed in this paper improves the accuracy of hand gesture recognition at different fatigue levels, and the average recognition accuracy for different subjects is also improved. In summary, the algorithm in this paper not only improves the adaptability and robustness of the hand gesture recognition system, but its research process can also provide new insights into the development of gesture recognition technology in the field of biomedical engineering.

From Simulation to Reality: Predicting Torque With Fatigue Onset via Transfer Learning

Muscle fatigue impacts upper extremity function but is often overlooked in biomechanical models. The present work leveraged a transfer learning approach to improve torque predictions during fatiguing upper extremity movements. We developed two artificial neural networks to model sustained elbow flexion: one trained solely on recorded data (i.e., direct learning) and one pre-trained on simulated data and fine-tuned on recorded data (i.e., transfer learning). We simulated muscle activations and joint torques using a musculoskeletal model and a muscle fatigue model (n = 1,701 simulations). We also recorded static subject-specific features (e.g., anthropometric measurements) and dynamic muscle activations and torques during sustained elbow flexion in healthy young adults (n = 25 subjects). Using the simulated dataset, we pre-trained a long short-term memory neural network (LSTM) to regress fatiguing elbow flexion torque from muscle activations. We concatenated this pre-trained LSTM with a feedforward architecture, and fine-tuned the model on recorded muscle activations and static features to predict elbow flexion torques. We trained a similar architecture solely on the recorded data and compared each neural network's predictions on 5 leave-out subjects' data. The transfer learning model outperformed the direct learning model, as indicated by a decrease of 24.9% in their root-mean-square-errors (6.22 Nm and 8.28 Nm, respectively). The transfer learning model and direct learning model outperformed analogous musculoskeletal simulations, which consistently underpredicted elbow flexion torque. Our results suggest that transfer learning from simulated to recorded datasets can decrease reliance on assumptions inherent to biomechanical models and yield predictions robust to real-world conditions.

Acute psycho-physiological responses to submaximal constant-load cycling under intermittent hypoxia-hyperoxia vs. hypoxia-normoxia in young males

Background

Hypoxia and hyperoxia can affect the acute psycho-physiological response to exercise. Recording various perceptual responses to exercise is of particular importance for investigating behavioral changes to physical activity, given that the perception of exercise-induced pain, discomfort or unpleasure, and a low level of exercise enjoyment are commonly associated with a low adherence to physical activity. Therefore, this study aimed to compare the acute perceptual and physiological responses to aerobic exercise under intermittent hypoxia-hyperoxia (IHHT), hypoxia-normoxia (IHT), and sustained normoxia (NOR) in young, recreational active, healthy males.

Methods

Using a randomized, single-blinded, crossover design, 15 males (age: 24.5 ± 4.2 yrs) performed 40 min of submaximal constant-load cycling (at 60% peak oxygen uptake, 80 rpm) under IHHT (5 × 4 min hypoxia and hyperoxia), IHT (5 × 4 min hypoxia and normoxia), and NOR. Inspiratory fraction of oxygen during hypoxia and hyperoxia was set to 14% and 30%, respectively. Heart rate (HR), total hemoglobin (tHb) and muscle oxygen saturation (SmO2) of the right vastus lateralis muscle were continuously recorded during cycling. Participants' peripheral oxygen saturation (SpO2) and perceptual responses (i.e., perceived motor fatigue, effort perception, perceived physical strain, affective valence, arousal, motivation to exercise, and conflict to continue exercise) were surveyed prior, during (every 4 min), and after cycling. Prior to and after exercise, peripheral blood lactate concentration (BLC) was determined. Exercise enjoyment was ascertained after cycling. For statistical analysis, repeated measures analyses of variance were conducted.

Results

No differences in the acute perceptual responses were found between conditions (p ≥ 0.059, ηp 2 ≤ 0.18), while the physiological responses differed. Accordingly, SpO2 was higher during the hyperoxic periods during the IHHT compared to the normoxic periods during the IHT (p < 0.001, ηp 2 = 0.91). Moreover, HR (p = 0.005, ηp 2 = 0.33) and BLC (p = 0.033, ηp 2 = 0.28) were higher during IHT compared to NOR. No differences between conditions were found for changes in tHb (p = 0.684, ηp 2 = 0.03) and SmO2 (p = 0.093, ηp 2 = 0.16).

Conclusion

IHT was associated with a higher physiological response and metabolic stress, while IHHT did not lead to an increase in HR and BLC compared to NOR. In addition, compared to IHT, IHHT seems to improve reoxygenation indicated by a higher SpO2 during the hyperoxic periods. However, there were no differences in perceptual responses and ratings of exercise enjoyment between conditions. These results suggest that replacing normoxic by hyperoxic reoxygenation-periods during submaximal constant-load cycling under intermittent hypoxia reduced the exercise-related physiological stress but had no effect on perceptual responses and perceived exercise enjoyment in young recreational active healthy males.

The effects of low vs. high rating of perceived exertion clamp exercise on performance, neuromuscular, and muscle oxygen saturation responses in females

PURPOSE

This study examined the time course of changes in force, relative to critical force (CF), electromyographic amplitude (EMG AMP), neuromuscular efficiency (NE), and muscle oxygen saturation (SmO2), as well as time to task failure (TTF) and performance fatigability (PF) during isometric handgrip holds to failure (HTF) anchored to the rating of perceived exertion (RPE) at 3 and 7.

METHODS

Ten females completed pre-test maximal voluntary isometric contractions (MVICs), submaximal HTF at four percentages of MVIC, an HTF at RPE = 3 and 7, and post-test MVICs. Analyses included paired samples t-tests, repeated measures ANOVAs and planned comparisons.

RESULTS

TTF was not different between RPE 3 (540.4 ± 262.1 s) and 7 (592.2 ± 299.6 s), but PF for RPE 7 (42.1 ± 19.1%) was greater than RPE 3 (33.5 ± 15.4%) (p < 0.05). There were RPE-dependent decreases in force, EMG AMP, and NE across three discernable phases during the HTF (p < 0.01), but there were no significant changes in SmO2 across time.

CONCLUSION

Although there were overall similar patterns across time for force, neuromuscular, and muscle metabolic responses between the RPE holds, the greater PF at RPE 7 than RPE 3 may be explained by the longer sustained time above CF at RPE 7, resulting in greater accumulation of intramuscular metabolites and afferent feedback. Throughout each trial, it is possible that force was adjusted to avoid the sensory tolerance limit, and the task was ended when force could no longer be reduced to maintain the assigned RPE, resulting in a similar TTF for RPE 7 and RPE 3.

Gulf War Illness Is Associated with Host Gut Microbiome Dysbiosis and Is Linked to Altered Species Abundance in Veterans from the BBRAIN Cohort

Gulf War Illness (GWI) is a debilitating condition marked by chronic fatigue, cognitive problems, pain, and gastrointestinal (GI) complaints in veterans who were deployed to the 1990-1991 Gulf War. Fatigue, GI complaints, and other chronic symptoms continue to persist more than 30 years post-deployment. Several potential mechanisms for the persistent illness have been identified and our prior pilot study linked an altered gut microbiome with the disorder. This study further validates and builds on our prior preliminary findings of host gut microbiome dysbiosis in veterans with GWI. Using stool samples and Multidimensional Fatigue Inventory (MFI) data from 89 GW veteran participants (63 GWI cases and 26 controls) from the Boston biorepository, recruitment, and integrative network (BBRAIN) for Gulf War Illness, we found that the host gut bacterial signature of veterans with GWI showed significantly different Bray-Curtis beta diversity than control veterans. Specifically, a higher Firmicutes to Bacteroidetes ratio, decrease in Akkermansia sp., Bacteroides thetaiotamicron, Bacteroides fragilis, and Lachnospiraceae genera and increase in Blautia, Streptococcus, Klebsiella, and Clostridium genera, that are associated with gut, immune, and brain health, were shown. Further, using MaAsLin and Boruta algorithms, Coprococcus and Eisenbergiella were identified as important predictors of GWI with an area under the curve ROC predictive value of 74.8%. Higher self-reported MFI scores in veterans with GWI were also significantly associated with an altered gut bacterial diversity and species abundance of Lachnospiraceae and Blautia. These results suggest potential therapeutic targets for veterans with GWI that target the gut microbiome and specific symptoms of the illness.

Acute performance fatigability following continuous versus intermittent cycling protocols is not proportional to total work done

Classical training theory postulates that performance fatigability following a training session should be proportional to the total work done (TWD); however, this notion has been questioned. This study investigated indices of performance and perceived fatigability after primary sessions of high-intensity interval training (HIIT) and constant work rate (CWR) cycling, each followed by a cycling time-to-task failure (TTF) bout. On separate days, 16 participants completed an incremental cycling test, and, in a randomized order, (i) a TTF trial at 80% of peak power output (PPO), (ii) an HIIT session, and (iii) a CWR session, both of which were immediately followed by a TTF trial at 80% PPO. Central and peripheral aspects of performance fatigability were measured using interpolated twitch technique, and perceptual measures were assessed prior to and following the HIIT and CWR trials, and again following the TTF trial. Despite TWD being less following HIIT (P = 0.029), subsequent TTF trial was an average of 125 s shorter following HIIT versus CWR (P < 0.001), and this was accompanied by greater impairments in voluntary and electrically evoked forces (P < 0.001), as well as exacerbated perceptual measures (P < 0.001); however, there were no differences in any fatigue measure following the TTF trial (P ≥ 0.149). There were strong correlations between the decline in TTF and indices of peripheral (r = 0.70) and perceived fatigability (r ≥ 0.80) measured at the end of HIIT and CWR. These results underscore the dissociation between TWD and performance fatigability and highlight the importance of peripheral components of fatigability in limiting endurance performance during high-intensity cycling exercise.

The Stiffness of the Ascending Aorta Has a Direct Impact on Left Ventricular Function: An In Silico Model

During systole, longitudinal shortening of the left ventricle (LV) displaces the aortic root toward the apex of the heart and stretches the ascending aorta (AA). An in silico study (Living Left Heart Human Model, Dassault Systèmes Simulia Corporation) demonstrated that stiffening of the AA affects myocardial stress and LV strain patterns. With AA stiffening, myofiber stress increased overall in the LV, with particularly high-stress areas at the septum. The most pronounced reduction in strain was noted along the septal longitudinal region. The pressure-volume loops showed that AA stiffening caused a deterioration in LV function, with increased end-systolic volume, reduced systolic LV pressure, decreased stroke volume and effective stroke work, but elevated end-diastolic pressure. An increase in myofiber contractility indicated that stroke volume and effective stroke work could be recovered, with an increase in LV end-systolic pressure and a decrease in end-diastolic pressure. Longitudinal and radial strains remained reduced, but circumferential strains increased over baseline, compensating for lost longitudinal LV function. Myofiber stress increased overall, with the most dramatic increase in the septal region and the LV apex. We demonstrate a direct mechanical pathophysiologic link between stiff AA and reduced longitudinal left ventricular strain which are common in patients with HFpEF.

Profiling the Biomechanical Responses to Workload on the Human Myocyte to Explore the Concept of Myocardial Fatigue and Reversibility: Rationale and Design of the POWER Heart Failure Study

It remains unclear why some patients develop heart failure without evidence of structural damage. One theory relates to impaired myocardial energetics and ventricular-arterial decoupling as the heart works against adverse mechanical load. In this original study, we propose the novel concept of myocardial fatigue to capture this phenomenon and aim to investigate this using human cardiomyocytes subjected to a modern work-loop contractility model that closely mimics in vivo cardiac cycles. This proof-of-concept study (NCT04899635) will use human myocardial tissue samples from patients undergoing cardiac surgery to develop a reproducible protocol to isolate robust calcium-tolerant cardiomyocytes. Thereafter, work-loop contractility experiments will be performed over a range of preload, afterload and cycle frequency as a function of time to elicit any reversible reduction in contractile performance (i.e. fatigue). This will provide novel insight into mechanisms behind heart failure and myocardial recovery and serve as a valuable research platform in translational cardiovascular research.

A Tutorial on Skeletal Muscle Metabolism and the Role of Blood Lactate: Implications for Speech Production

PURPOSE

The purpose of this tutorial is threefold: (a) present relevant exercise science literature on skeletal muscle metabolism and synthesize the limited available research on metabolism of the adult human speech musculature in an effort to elucidate the role of metabolism in speech production; (b) introduce a well-studied metabolic serum biomarker in exercise science, lactate, and the potential usefulness of investigating this metabolite, through a well-established exercise science methodology, to better understand metabolism of the musculature involved in voice production; and (c) discuss exercise physiology considerations for future voice science research that seeks to investigate blood lactate and metabolism in voice physiology in an ecologically valid manner.

METHOD

This tutorial begins with relevant exercise science literature on the basic cellular processes of muscle contraction that require energy and the metabolic mechanisms that regenerate the energy required for task execution. The tutorial next synthesizes the available research investigating metabolism of the adult human speech musculature. This is followed by the authors proposing a hypothesis of speech metabolism based on the voice science literature and the application of well-studied exercise science principles of muscle physiology. The tutorial concludes with a discussion and the potential usefulness of lactate in investigations to better understand the metabolism of the musculature involved in vocal demand tasks.

CONCLUSION

The role of metabolism during speech (respiratory, laryngeal, and articulatory) is an understudied yet critical aspect of speech physiology that warrants further study to better understand the metabolic systems that are used to meet vocal demands.

The effectiveness of fatigue on repositioning sense of lower extremities: systematic review and meta-analysis

INTRODUCTION

An injury can significantly harm both individual and team performance. One of the most important risk factors for sports-related injuries, especially non-collision injuries, is fatigue. It seems that poor proprioception may play an essential role to impose athletes to further injuries. This systematic review and meta-analysis aimed to examine the effectiveness of fatigue on the repositioning sense of the lower extremity joints.

METHOD

The electronic databases, including PubMed, Web of Science, Scopus, and Google Scholar were systematically searched from inception to 11January 2024. The obtained records were exported to the EndNote Software version 8. Then, two investigators examined the records independently to find eligible studies based on the inclusion/exclusion criteria. In the case of disagreements, a consequence method was utilized. The quality of the eligible studies was evaluated using the Downs and Black checklist. Comprehensive Meta-Analysis (CMA) software ver. 3 software was used for statistical analysis. Q-test and I2 were employed to examine the data homogeneity. In addition, considering the risk of bias, the Funnel Plot and trim-and-fill method were used.

RESULTS

After reviewing the titles and abstracts of 3883 studies found in the selected databases, 43 articles were found to be eligible to include in meta-analyses. The results showed that fatigue led to a significant increase in the active absolute error of the knee (SDM = 0.524, 95% CI = 0.406-0.841), ankle in the horizontal plane (SDM = 0.541, 95% CI = 0.367-0.715), ankle in the sagittal plane (SDM = 0.443, 95% CI = 0.088-0.798), and hip (SDM = 0.988, 95% CI = 0.135-1.841). However, fatigue had no significant effects on the passive absolute error of the knee and ankle in horizontal plane and relative angular error of the knee.

CONCLUSION

Fatigue can diminish the active joint position sense of the lower extremities and thus may increase the risk of injury by reducing proprioception. Therefore, future research could be conducted to investigate the potential impact of integrated fatigue-mitigating exercises into athletes' training programs, with the aim of reducing the incidence of sports-related injuries.

Enhanced capacity for CaMKII signaling mitigates calcium release related contractile fatigue with high intensity exercise

BACKGROUND

We tested whether enhancing the capacity for calcium/calmodulin-dependent protein kinase type II (CaMKII) signaling would delay fatigue of excitation-induced calcium release and improve contractile characteristics of skeletal muscle during fatiguing exercise.

METHODS

Fast and slow type muscle, gastrocnemius medialis (GM) and soleus (SOL), of rats and mouse interosseus (IO) muscle fibers, were transfected with pcDNA3-based plasmids for rat α and β CaMKII or empty controls. Levels of CaMKII, its T287-phosphorylation (pT287-CaMKII), and phosphorylation of components of calcium release and re-uptake, ryanodine receptor 1 (pS2843-RyR1) and phospholamban (pT17-PLN), were quantified biochemically. Sarcoplasmic calcium in transfected muscle fibers was monitored microscopically during trains of electrical excitation based on Fluo-4 FF fluorescence (n = 5-7). Effects of low- (n = 6) and high- (n = 8) intensity exercise on pT287-CaMKII and contractile characteristics were studied in situ.

RESULTS

Co-transfection with αCaMKII-pcDNA3/βCaMKII-pcDNA3 increased α and βCaMKII levels in SOL (+45.8 %, +250.5 %) and GM (+40.4 %, +89.9 %) muscle fibers compared to control transfection. High-intensity exercise increased pT287-βCaMKII and pS2843-RyR1 levels in SOL (+269 %, +151 %) and GM (+354 %, +119 %), but decreased pT287-αCaMKII and p17-PLN levels in GM compared to SOL (-76 % vs. +166 %; 0 % vs. +128 %). α/β CaMKII overexpression attenuated the decline of calcium release in muscle fibers with repeated excitation, and mitigated exercise-induced deterioration of rates in force production, and passive force, in a muscle-dependent manner, in correlation with pS2843-RyR1 and pT17-PLN levels (|r| > 0.7).

CONCLUSION

Enhanced capacity for α/β CaMKII signaling improves fatigue-resistance of active and passive contractile muscle properties in association with RyR1- and PLN-related improvements in sarcoplasmic calcium release.

Quadriceps fatigue during hypoxic and ischemic knee-extension exercise is similar in males and females

Hypoxia is known to increase muscle fatigue via both central and peripheral mechanisms. Females are typically less fatigable than males during isometric fatiguing contractions due to greater peripheral blood flow. However, sex differences in fatigue are blunted during dynamic fatiguing tasks. Thus, this study determined the interactions of sex and hypoxia on knee extensor muscle contractile function during a dynamic, ischemic fatiguing contraction. Electrical stimulation was used to determine contractile properties of the knee extensor muscles in eight males and eight females before and after an ischemic, dynamic fatiguing task while inspiring room air or a hypoxic gas mixture (10% O2:90% N2). Fatigue (assessed as time-to-task failure) was ∼10% greater during the hypoxic condition (94.3 ± 33.4 s) compared with normoxic condition (107.0 ± 42.8 s, P = 0.041) and ∼40% greater for females than males (77.1 ± 18.8 vs. 124.2 ± 38.7, P < 0.001). Immediately after the dynamic fatiguing task, there were reductions in maximal voluntary contraction force (P = 0.034) and electrically evoked twitch force (P < 0.001), and these reductions did not differ based on sex or inspirate. Cerebral tissue oxygenation showed a significant interaction of time and inspirate (P = 0.003) whereby it increased during normoxia and remained unchanged in hypoxia. No sex-related differences in the changes of cerebral tissue oxygenation were observed (P = 0.528). These data suggest that acute hypoxia increases central fatigue during ischemic single-leg exercise resulting in earlier exercise termination, but the effect does not differ based on sex.NEW & NOTEWORTHY Hypoxia exacerbates fatigue via central mechanisms after ischemic single-leg exercise. The greater fatigue observed during ischemic dynamic fatiguing exercise with hypoxia inspirate did not differ between the sexes. Hypoxia-induced central limitations are present in acute ischemic exercise and do not appear different in males and females.

Can Hypoxia Alter the Anaerobic Capacity Measured by a Single Exhaustive Exercise?

The present study aimed to compare the MAODALT in situations of hypoxia and normoxia to confirm the method validity. Seventeen healthy and physically active men participated in this study, aged 25.2±3.2 years. All participants underwent four days of evaluation. The first day was performed a body composition test, an incremental test to exhaustion to determine the maximum oxygen uptake, familiarizing the hypoxia (H) and normoxia (N) situation and the equipment used. On the second, third and fourth days, supramaximal efforts were performed until exhaustion at 110% of maximum oxygen uptake, in a situation of hypoxia (FIO2=14.0%) and normoxia (FIO2=20.9%). The anaerobic capacity was considered the sum of energy supply of the alactic and lactic systens. The absolute or relative anaerobic capacity values were not different (H=3.9±1.1 L, N=3.8±0.9 L, p=0.69), similarly no differences were found for the alactic contribution (H=1.7±0.5 L, N=1.5±0.5 L, p=0.30) and lactic contribution (H=2.3±0.9 L, N=2.3±0.7 L, p=0.85). It can be concluded that the anaerobic capacity measured by a single exhaustive effort is not altered by hypoxia.

Are there differences in anaerobic relative muscle power between upper and lower limbs in adolescent swimmers: A blinded study

Success in speed swimming depends on the efficiency of the anaerobic system for the production of cellular energy, especially during muscle power production. In the adolescent athletes much is unknown with regards to the relationships between relative power of upper and lower limbs with speed swimming performance. The aim the present study was to identify differences in relative muscle power of upper and lower limbs in adolescent swimmers and relate these to speed swimming performances. Sixty adolescents, of both sexes (50% female, 50% male, 30 swimmers and 30 controls), were recruited. The relative upper limb power (ULP[W/kg]) was assessed by a medicine ball test and the relative lower limbs power (LLP[W/kg]) by a jump test on a jumping platform. Lean mass of the upper and lower limbs was assessed by dual-energy X-ray absorptiometry (DXA) (g). Sport performance was assessed during national level competition (50-m swimming time [in seconds]). Biological maturation (BM) was indexed by years from attainment of peak height velocity. ULP(W/kg) was higher than LLP(W/kg) in both groups (p ​< ​0.05). Upper and lower limb lean mass (g) correlated significantly with ULP(W/kg) and LLP(W/kg) in both groups (p ​< ​0.05). ULP(W/kg) and LLP(W/kg) correlated with 50-m swimming performance (s), in both sexes (p ​< ​0.05). Advanced BM was associated with ULP(W/kg) and LLP(W/kg) in both groups (p ​< ​0.05), and with 50-m swimming performance (s) in both sexes (p ​< ​0.05). We concluded that ULP(W/kg) is higher than LLP (W/kg) in adolescent swimmers. Upper and lower limb lean mass and BM were both positively associated with increased ULP (W/kg) and LLP (W/kg).

Effect of Lactate Minimum Speed-Guided Training on the Fluid, Electrolyte and Acid-Base Status of Horses

The effect of lactate minimum speed (LMS)-guided training on horses' homeostasis is still unknown. Thus, this study aimed to evaluate the effect of an LMS-guided training program on the fluid, electrolyte and acid-base status of horses. Ten untrained Arabian horses were submitted to an LMS test on a treadmill before and after six weeks of training. The training intensity was 80% of the LMS in the first three sessions and 100% of the LMS in the other sessions. The venous blood was collected before (T-1) and after (T-2) training at rest, during and after the LMS test for lactate, pH, pCO2, HCO3-, and electrolyte measurements. The LMS and strong ion difference (SID4) were calculated. A mild increase in the mean values (p > 0.05) was observed at rest in T-2 in comparison with T-1 in the following variables: pH (from 7.436 ± 0.013 to 7.460 ± 0.012), pCO2 (from 42.95 ± 1.58 to 45.06 ± 0.81 mmHg), HCO3- (from 27.01 ± 1.02 to 28.91 ± 0.86 mmol/L), and SID4 (from 33.42 ± 1.45 to 35.06 ± 2.94 mmol/L). During T-2, these variables were more stable than during T-1. Despite the improvement in fitness, the LMS did not indicate a significant difference (from 5.40 ± 0.55 to 5.52 ± 0.20 m/s). The results confirmed that the LMS-guided training program had a positive impact on the horses' acid-base status, although some adaptations are still required to improve their fitness.

Effect of moxibustion on knee joint stiffness characteristics in recreational athletes pre- and post-fatigue

Objective

Joint stiffness results from the coupling of the nervous system and joint mechanics, and thus stiffness is a comprehensive representation of joint stability. It has been reported that moxibustion can alleviate general weakness and fatigue symptoms and subsequently may influence joint stiffness. This study investigated whether moxibustion could enhance knee joint stiffness in recreational athletes pre- and post-fatigue.

Methods

Eighteen participants were randomized into intervention (5 males: 20.6 ± 1.5 yr; 4 females: 20.8 ± 1.5 yr) and control groups (5 males: 19.4 ± 0.9 yr; 4 females: 20.5 ± 0.6 yr). The intervention group received indirect moxibustion applied to acupoints ST36 (bilateral) and CV4 for 30 min every other day for 4 consecutive weeks. The control group maintained regular exercise without moxibustion. Peak torque (PT) of right knee extensor, relaxed and contracted muscle stiffness (MS) of vastus lateralis, and knee extensor musculoarticular stiffness (MAS) was assessed with an isokinetic dynamometer (IsoMed 2000), myometer, and free oscillation technique, respectively. Measurements were taken at three time points: pre-intervention, post-intervention/pre-fatigue, and post-fatigue.

Results

MAS (P = 0.006) and PT (P = 0.007) in the intervention group increased more from pre-to post-intervention compared with the control group. Post-fatigue MAS (P = 0.016) and PT (P = 0.031) increased more in the intervention group than in the control group.

Conclusion

Moxibustion enhanced PT and knee MAS, suggesting that this intervention could be used in injury prevention and benefit fatigue resistance in young recreational athletes.

IFN-γ and androgens disrupt mitochondrial function in murine myocytes

The effect of cytokines on non-traditional immunological targets under conditions of chronic inflammation is an ongoing subject of study. Fatigue is a symptom often associated with autoimmune diseases. Chronic inflammatory response and activated cell-mediated immunity are associated with cardiovascular myopathies which can be driven by muscle weakness and fatigue. Thus, we hypothesize that immune dysfunction-driven changes in myocyte mitochondria may play a critical role in fatigue-related pathogenesis. We show that persistent low-level expression of IFN-γ in designated IFN-γ AU-Rich Element deletion mice (ARE mice) under androgen exposure resulted in mitochondrial and metabolic deficiencies in myocytes from male or castrated ARE mice. Most notably, echocardiography unveiled that low ejection fraction in the left ventricle post-stress correlated with mitochondrial deficiencies, explaining how heart function decreases under stress. We report that inefficiencies and structural changes in mitochondria, with changes to expression of mitochondrial genes, are linked to male-biased fatigue and acute cardiomyopathy under stress. Our work highlights how male androgen hormone backgrounds and active autoimmunity reduce mitochondrial function and the ability to cope with stress and how pharmacological blockade of stress signal protects heart function. These studies provide new insight into the diverse actions of IFN-γ in fatigue, energy metabolism, and autoimmunity. © 2023 The Pathological Society of Great Britain and Ireland. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

Myocardial Fatigue at a Glance

Expanding on the modern lexicon of heart failure (HF), the novel mechano-energetic concept of myocardial fatigue describes a transiently energy-depleted myocardium with impaired contractility and relaxation in the face of adverse haemodynamic load. It encompasses established concepts of ventricular-arterial decoupling, deranged cardiac energetics and impaired myocardial efficiency, offering an alternative explanation for functional causes of HF.

Acute performance, physiological, and perceptual changes in response to repeated cycling sprint exercise combined with systemic and local hypoxia in young males

This study investigated the acute performance, physiological, and perceptual changes during repeated sprint exercise (RSE) under normobaric hypoxia and with blood flow restriction (BFR). Fourteen active males completed standardized RSE (6 × 10s cycling sprints with 30s passive rest) in three randomized conditions: under normobaric hypoxia (F_iO₂∼14.4%, HYP), normoxia (F_iO₂∼20.9%, SHAM), and with BFR (40% arterial occlusion pressure). The percentage decrement score of power output (S_dec) was used to quantify motor performance fatigue. During RSE, muscle oxygenation and activity of the right quadriceps were measured. Perceived motor fatigue, physical strain, affective valence, and arousal were queried after each sprint. Blood lactate concentration (BLC) and peripheral oxygenation (S_pO₂) were measured before and after RSE. S_dec was greater in HYP and BFR compared to SHAM (p≤0.008). BFR decreased mean power output (p<0.001) and muscle activity (p=0.027) compared to SHAM. Muscle oxygenation was lower in BFR during each rest (p≤0.005) and in HYP during rest 4 (p=0.006) compared to SHAM. HYP increased BLC and decreased S_pO₂ compared to BFR (p<0.001) and SHAM (p=0.002). There were no differences between conditions for any rating scale (p≥0.060). HYP and BFR increased motor performance fatigue but with different physiological responses, whereas perceptual responses were unaffected during RSE.

Shorter High-Intensity Cycling Intervals Reduce Performance and Perceived Fatigability at Work-Matched but Not Task Failure

INTRODUCTION

The intensity, duration, and distribution of work and recovery phases during high-intensity interval training (HIIT) modulate metabolic perturbations during exercise and subsequently influence the development of performance fatigability and exercise tolerance. This study aimed to characterize neuromuscular, perceptual, and cardiorespiratory responses to work-to-rest ratio-matched HIIT protocols differing in work and rest interval duration.

METHODS

Twelve healthy individuals (six women) first completed a ramp incremental test to determine 90% of peak power output, and then in three randomized visits, they completed three cycling protocols to task failure at 90% of peak power output: (i) 3- to 3-min work-to-passive rest ratio HIIT (HIIT 3min ), (ii) 1- to 1-min work-to-passive rest ratio HIIT (HIIT 1min ), and (iii) constant load (CL). Interpolated twitch technique, including maximal voluntary isometric knee extensions and femoral nerve electrical stimuli, was performed at baseline, every 6 min of work, and task failure. Perceptual and cardiorespiratory responses were recorded every 3 min and continuously across the exercises, respectively.

RESULTS

The work completed during HIIT 1min (8447 ± 5124 kJ) was considerably greater than HIIT 3min (1930 ± 712 kJ) and CL (1076 ± 356) ( P < 0.001). At work-matched, HIIT 1min resulted in a lesser decline in maximal voluntary contraction and twitch force compared with HIIT 3min and CL ( P < 0.001). Perceived effort, pain, and dyspnea were least in HIIT 1min and HIIT 3min compared with CL ( P < 0.001). At task failure, HIIT 1min resulted in less voluntary activation than HIIT 3min ( P = 0.010) and CL ( P = 0.043), and engendered less twitch force decline than CL ( P = 0.021).

CONCLUSIONS

Overall, the mitigated physiological and perceptual responses during shorter work periods (HIIT 1min ) enhance exercise tolerance in comparison to longer work intervals at the same intensity (HIIT 3min , CL).

The Anti-Fatigue Effect of Glycoprotein from Hairtail Fish (Trichiurus lepturus) on BALB/c Mice

Fatigue is related to a variety of chronic diseases and has become a hot research topic in recent years. Various bioactive components have been extracted from hairtail fish (Trichiurus lepturus); however, none of these studies involved the anti-fatigue activity of hairtail fish glycoprotein (HGP). Thus, antioxidant experiments were conducted in vitro, and the anti-fatigue activity of HGP was further evaluated in BALB/c mice. The effects of HGP on the behavior of BALB/c mice were verified by classical behavioral experiments, and the indicators related to anti-fatigue activity were detected. The results showed that the antioxidant capacity in vitro of HGP increased gradually in the concentration range of 10 to 100 mg/mL. HGP improved the exercise ability of the mice. HGP was also found to significantly (p < 0.05) reduce the serum levels of lactate dehydrogenase (LDH), blood lactic acid (BLA), blood urea nitrogen (BUN), and creatine kinase (CK). The contents of liver glycogen (LG) and muscle glycogen (MG) were also significantly (p < 0.05) increased by HGP. Malondialdehyde (MDA) content in the serum and brains of the mice was significantly (p < 0.05) reduced and catalase (CAT), glutathione peroxidase (GPX), and superoxide dismutase (SOD) were significantly (p < 0.05) increased by HGP, especially in the middle- and high-dose groups. These results enhance our understanding of the anti-fatigue function of HGP and lay an important foundation for the further development and utilization of hairtail fish resources.

Blood flow restriction during high-intensity interval cycling exacerbates psychophysiological responses to a greater extent in females than males

This study aimed to characterize neuromuscular, perceptual, and cardiorespiratory responses to high-intensity interval training (HIIT) with superimposed blood flow restriction in males and females. Twenty-four, healthy individuals (n = 12 females) completed two cycling HIIT protocols to task failure (1-min work phases at 90% of peak power output interspersed by 1-min rest phases). The blood flow restriction (BFR) and control (CON) protocols were identical except for the presence and absence of BFR during rest phases, respectively. The interpolated twitch technique, including maximal voluntary isometric knee extension (MVC) and femoral nerve electrical stimuli, was performed at baseline, every six intervals, and task failure. Perceptual and cardiorespiratory responses were recorded every three intervals and continuously during exercise, respectively. Bayesian inference was used to obtain the joint posterior distribution for all parameters and evidence of an effect was determined via the marginal posterior probability (PP). The BFR shortened task duration by 57.3% compared with CON (PP > 0.99), without a sex difference. The application of BFR exacerbated the rate of decline in neuromuscular measures (MVC and twitch force output), increase of perceptual responses (perceived effort, pain, dyspnea, fatigue), and development of cardiorespiratory parameters (minute ventilation and heart rate), compared with CON (PP > 0.95). In addition, BFR exacerbated the neuromuscular, perceptual, and cardiorespiratory responses to a greater extent in females than males (PP > 0.99). Our results suggest that superimposition of blood flow restriction exacerbates psychophysiological responses to a HIIT protocol to a greater extent in females than males.NEW & NOTEWORTHY To our knowledge, no study has explored sex differences in the neuromuscular, perceptual, and cardiorespiratory indices characterizing exercise tolerance during high-intensity interval training (HIIT) with blood flow restriction (BFR) applied only during rest periods. Our results suggest that BFR elicited a decline in exercise performance that could be attributed to integration of psychophysiological responses. However, this integration was sex-dependent where females demonstrated an exacerbated rate of change in these responses compared with males.

Single muscle fibre contractile function with ageing

Ageing is accompanied by decrements in the size and function of skeletal muscle that compromise independence and quality of life in older adults. Developing therapeutic strategies to ameliorate these changes is critical but requires an in-depth mechanistic understanding of the underlying physiology. Over the past 25 years, studies on the contractile mechanics of isolated human muscle fibres have been instrumental in facilitating our understanding of the cellular mechanisms contributing to age-related skeletal muscle dysfunction. The purpose of this review is to characterize the changes that occur in single muscle fibre size and contractile function with ageing and identify key areas for future research. Surprisingly, most studies observe that the size and contractile function of fibres expressing slow myosin heavy chain (MHC) I are well-preserved with ageing. In contrast, there are profound age-related decrements in the size and contractile function of the fibres expressing the MHC II isoforms. Notably, lifelong aerobic exercise training is unable to prevent most of the decrements in fast fibre contractile function, which have been implicated as a primary mechanism for the age-related loss in whole-muscle power output. These findings reveal a critical need to investigate the effectiveness of other nutritional, pharmaceutical or exercise strategies, such as lifelong resistance training, to preserve fast fibre size and function with ageing. Moreover, integrating single fibre contractile mechanics with the molecular profile and other parameters important to contractile function (e.g. phosphorylation of regulatory proteins, innervation status, mitochondrial function, fibre economy) is necessary to comprehensively understand the ageing skeletal muscle phenotype.

Effect of Mental Task on Sex Differences in Muscle Fatigability: A Review

Previous research demonstrated that there are observable sex differences in developing muscle fatigue when mental task during fatiguing activity is present; however, there is no available review on this matter. Therefore, this review aimed to summarize the findings of previous studies investigating the effect of mental task on muscle fatigue in men and women. To conduct the review, we utilized searches using the electronic databases Web of Science, PubMed, Scopus, and EBSCO Cinahl Ultimate. The studies included had no limited publication date and examined the effects of mental task on muscle fatigue in a healthy adult population of any age. The evaluation was performed using the following criteria: time to failure, or subjective scale in various modifications (visual analog scale-VAS, rate of perceived effort-RPE, rate of perceived fatigue-RPF, rate of perceived discomfort-RPD). A total of seven studies met the set criteria, which were subsequently analyzed. Heavy mental task (more demanding math tasks) can reduce the time to failure for both men and women, with the reduction being more pronounced for women than for men. For light mental task (simple math tasks), no reduction in time to failure was observed to a great extent. The mental task in any of the included studies did not affect the subjective perception of fatigue, effort, discomfort, or pain. Although the studies investigating the effect of mental task on sex differences in muscle fatigability are limited, based on our findings we can assume that in jobs requiring heavier mental task, women may be more prone to the faster development of muscle fatigue; thus, employers might consider paying attention to the possibility of adequate rest.

Time Course of Performance Fatigability during Exercise below, at, and above the Critical Intensity in Females and Males

PURPOSE

This study aimed to investigate the time course and amplitude of performance fatigability during cycling at intensities around the maximal lactate steady state (MLSS) until task failure (TTF).

METHODS

Ten females and 11 males were evaluated in eight visits: 1) ramp incremental test; 2-3) 30-min constant power output (PO) cycling for MLSS determination; and 4-8) cycling to TTF at PO relative to the MLSS of (i) -15%, (ii) -10 W, (iii) at MLSS, and (iv) +10 W, and (v) +15%. Performance fatigability was characterized by femoral nerve electrical stimulation of knee extensors at baseline; minutes 5, 10, 20, and 30; and TTF. Oxygen uptake, blood lactate concentration, muscle oxygen saturation, and perceived exertion were evaluated.

RESULTS

Approximately 75% of the total performance fatigability occurred within 5 min of exercise, independently of exercise intensity, followed by a further change at minute 30. Contractile function declined more in males than females (all P < 0.05). At task failure, exercise duration declined from MLSS -15% to MLSS +15% (all P < 0.05), accompanied by a greater rate of decline after MLSS +15% and MLSS +10 compared with MLSS, MLSS -10 , and MLSS -15% for voluntary activation (-0.005 and -0.003 vs -0.002, -0.001 and -0.001%·min -1 , respectively) and contractile function (potentiated single twitch force, -0.013 and -0.009 vs -0.006, -0.004 and -0.004%·min -1 , respectively).

CONCLUSIONS

Whereas the time course of performance fatigability responses was similar regardless of exercise intensity and sex, the total amplitude and rate of change were affected by the distinct metabolic disturbances around the MLSS, leading to different performance fatigability etiologies at task failure.

Potential Biophysiological Mechanisms Underlying Vocal Demands and Vocal Fatigue

Patients with complaint of vocal fatigue have perceptual, acoustic, and aerodynamic outcomes that are heterogeneous in nature. One reason may be due to different underlying biophysiological mechanisms that lead to these heterogeneous clinical presentations. Five potential mechanisms are proposed: neuromuscular, metabolic, vocal tissue, afferent, and central neural. Analytical frameworks and study designs to study these mechanisms are also addressed. A better understanding of biophysiological mechanisms of vocal fatigue can improve precision of therapeutic approaches. It can also help shift management from symptom-based to etiology-focused approaches for vocal fatigue.

Age-related performance fatigability: a comprehensive review of dynamic tasks

Adult ageing is associated with a myriad of changes within the neuromuscular system, leading to reductions in contractile function of old adults. One of the consequences of these age-related neuromuscular adaptations is altered performance fatigability, which can limit the ability of old adults to perform activities of daily living. Whereas age-related fatigability of isometric tasks has been well characterized, considerably less is known about fatigability of old adults during dynamic tasks involving movement about a joint, which provides a more functionally relevant task compared to static contractions. This review provides a comprehensive summary of age-related fatigability in dynamic contractions, where the importance of task specificity is highlighted with a brief discussion of the potential mechanisms responsible for differences in fatigability between young and old adults. The angular velocity of the task is critical for evaluating age-related fatigability, as tasks which constrain angular velocity (i.e., isokinetic) produce equivocal age-related differences in fatigability, whereas tasks involving unconstrained velocity (i.e., isotonic-like) consistently induce greater fatigability of old compared to young adults. These unconstrained velocity tasks, that are more closely associated with natural movements, offer an excellent model to uncover the underlying age-related mechanisms of increased fatigability. Future work evaluating the mechanisms of increased age-related fatigability of dynamic tasks should be evaluated using task-specific contractions (i.e., dynamic), particularly for assessment of spinal and supra-spinal components. Advancing our understanding of age-related fatigability is likely to yield novel insights and approaches for improving mobility limitations in old adults.

Is the maximal lactate steady state concept really relevant to predict endurance performance?

PURPOSE

There is no convincing evidence for the idea that a high power output at the maximal lactate steady state (PO_{_MLSS}) and a high fraction of [Formula: see text]O_2max at MLSS (%[Formula: see text]O_{2_MLSS}) are decisive for endurance performance. We tested the hypotheses that (1) %[Formula: see text]O_{2_MLSS} is positively correlated with the ability to sustain a high fraction of [Formula: see text]O_2max for a given competition duration (%[Formula: see text]O_{2_TT}); (2) %[Formula: see text]O_{2_MLSS} improves the prediction of the average power output of a time trial (PO_{_TT}) in addition to [Formula: see text]O_2max and gross efficiency (GE); (3) PO_{_MLSS} improves the prediction of PO_{_TT} in addition to [Formula: see text]O_2max and GE.

METHODS

Twenty-one recreationally active participants performed stepwise incremental tests on the first and final testing day to measure GE and check for potential test-related training effects in terms of changes in the minimal lactate equivalent power output (∆PO_LEmin), 30-min constant load tests to determine MLSS, a ramp test and verification bout for [Formula: see text]O_2max, and 20-min time trials for %[Formula: see text]O_{2_TT} and PO_{_TT}. Hypothesis 1 was tested via bivariate and partial correlations between %[Formula: see text]O_{2_MLSS} and %[Formula: see text]O_{2_TT}. Multiple regression models with [Formula: see text]O_2max, GE, ∆PO_LEmin, and %[Formula: see text]O_{2_MLSS} (Hypothesis 2) or PO_{_MLSS} instead of %[Formula: see text]O_{2_MLSS} (Hypothesis 3), respectively, as predictors, and PO_{_TT} as the dependent variable were used to test the hypotheses.

RESULTS

%[Formula: see text]O_{2_MLSS} was not correlated with %[Formula: see text]O_{2_TT} (r = 0.17, p = 0.583). Neither %[Formula: see text]O_{2_MLSS} (p = 0.424) nor PO_{_MLSS} (p = 0.208) did improve the prediction of PO_{_TT} in addition to [Formula: see text]O_2max and GE.

CONCLUSION

These results challenge the assumption that PO_{_MLSS} or %[Formula: see text]O_{2_MLSS} are independent predictors of supra-MLSS PO_{_TT} and %[Formula: see text]O_{2_TT}.

Effects of a Single Dose of a Creatine-Based Multi-Ingredient Pre-workout Supplement Compared to Creatine Alone on Performance Fatigability After Resistance Exercise: A Double-Blind Crossover Design Study

Background

This study aims to investigate the acute effects of a single oral administration of a creatine-based multi-ingredient pre-workout supplement (MIPS) on performance fatigability and maximal force production after a resistance exercise protocol (REP).

Methods

Eighteen adult males (age: 23 ± 1 years; body mass: 76.4 ± 1.5 kg; height: 1.77 ± 0.01 m) were enrolled in a randomized, double-blind, crossover design study. Subjects received a single dose of a MIPS (3 g of creatine, 2 g of arginine, 1 g of glutamine, 1 g of taurine, and 800 mg of β-alanine) or creatine citrate (CC) (3 g of creatine) or a placebo (PLA) in three successive trials 1 week apart. In a randomized order, participants consumed either MIPS, CC, or PLA and performed a REP 2 h later. Before ingestion and immediately after REP, subjects performed isometric contractions of the dominant biceps brachii: two maximal voluntary contractions (MVCs), followed by a 20% MVC for 90 s and a 60% MVC until exhaustion. Surface electromyographic indices of performance fatigability, conduction velocity (CV), and fractal dimension (FD) were obtained from the surface electromyographic signal (sEMG). Time to perform the task (TtT), basal blood lactate (BL), and BL after REP were also measured.

Results

Following REP, statistically significant (P < 0.05) pre–post mean for ΔTtT between MIPS (−7.06 s) and PLA (+0.222 s), ΔCV slopes (20% MVC) between MIPS (0.0082%) and PLA (−0.0519%) and for ΔCV slopes (60% MVC) between MIPS (0.199%) and PLA (−0.154%) were found. A pairwise comparison analysis showed no statistically significant differences in other variables between groups and condition vs. condition.

Conclusion

After REP, a creatine-enriched MIPS resulted in greater improvement of sEMG descriptors of performance fatigability and TtT compared with PLA. Conversely, no statistically significant differences in outcomes measured were observed between CC and PLA or MIPS and CC.

Efficiency of cycling exercise: Quantification, mechanisms, and misunderstandings

The energetics of cycling represents a well-studied area of exercise science, yet there are still many questions that remain. Efficiency, broadly defined as the ratio of energy output to energy input, is one key metric that, despite its importance from both a scientific as well as performance perspective, is commonly misunderstood. There are many factors that may affect cycling efficiency, both intrinsic (e.g., muscle fiber type composition) and extrinsic (e.g., cycling cadence, prior exercise, and training), creating a complex interplay of many components. Due to its relative simplicity, the measurement of oxygen uptake continues to be the most common means of measuring the energy cost of exercise (and thus efficiency); however, it is limited to only a small proportion of the range of outputs humans are capable of, further limiting our understanding of the energetics of high-intensity exercise and any mechanistic bases therein. This review presents evidence that delta efficiency does not represent muscular efficiency and challenges the notion that the slow component of oxygen uptake represents decreasing efficiency. It is noted that gross efficiency increases as intensity of exercise increases in spite of the fact that fast-twitch fibers are recruited to achieve this high power output. Understanding the energetics of high-intensity exercise will require critical evaluation of the available data.

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

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

Fatigability of the knee extensor muscles during high-load fast and low-load slow resistance exercise in young and older adults

Resistance exercise training is a cornerstone in preventing age-related declines in muscle mass and strength, and fatigability of limb muscle is important to this adaptive response. It is unknown, however, whether fatigability and the underlying mechanisms differ between different resistance exercise protocols in young and older adults. The purpose of this study was to quantify the fatigability of the knee extensors and identify the mechanisms in 20 young (22.2 ± 1.3 yr, 10 women) and 20 older adults (73.8 ± 5.4 yr, 10 women) elicited by a single session of high- and low-load resistance exercise. One leg completed a high-load protocol with contractions performed as fast as possible (HL-fast, ~80% 1 Repetition Max, 1RM), and the contralateral leg a low-load protocol performed with slow contractions (LL-slow, ~30% 1RM, 6 s concentric, 6 s eccentric). Each exercise involved four sets of eight repetitions. Before and immediately following each set, maximal voluntary isometric contractions (MVC) were performed, and voluntary activation and contractile properties quantified using electrical stimulation. The reduction in MVC was greater following the LL-slow (20%) than the HL-fast (12%, P = 0.004), with no age or sex differences. Similarly, the reduction in the amplitude of the involuntary electrically-evoked twitch was greater in the LL-slow (14%) than the HL-fast (7%, P = 0.014) and correlated with the reduction in MVC (r = 0.546, P < 0.001), whereas voluntary activation decreased only for the LL-slow protocol (5%, P < 0.001). Thus, low-load resistance exercise with slow contractions induced greater fatigability within the muscle than a more traditional high-load resistance protocol for both young and older men and women.

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

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

Review article: The aetiology of fatigue in inflammatory bowel disease and potential therapeutic management strategies

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.

A Convergent Functional Genomics Analysis to Identify Biological Regulators Mediating Effects of Creatine Supplementation

Creatine (Cr) and phosphocreatine (PCr) are physiologically essential molecules for life, given they serve as rapid and localized support of energy- and mechanical-dependent processes. This evolutionary advantage is based on the action of creatine kinase (CK) isozymes that connect places of ATP synthesis with sites of ATP consumption (the CK/PCr system). Supplementation with creatine monohydrate (CrM) can enhance this system, resulting in well-known ergogenic effects and potential health or therapeutic benefits. In spite of our vast knowledge about these molecules, no integrative analysis of molecular mechanisms under a systems biology approach has been performed to date; thus, we aimed to perform for the first time a convergent functional genomics analysis to identify biological regulators mediating the effects of Cr supplementation in health and disease. A total of 35 differentially expressed genes were analyzed. We identified top-ranked pathways and biological processes mediating the effects of Cr supplementation. The impact of CrM on miRNAs merits more research. We also cautiously suggest two dose-response functional pathways (kinase- and ubiquitin-driven) for the regulation of the Cr uptake. Our functional enrichment analysis, the knowledge-based pathway reconstruction, and the identification of hub nodes provide meaningful information for future studies. This work contributes to a better understanding of the well-reported benefits of Cr in sports and its potential in health and disease conditions, although further clinical research is needed to validate the proposed mechanisms.

Creatine Enhances the Effects of Cluster-Set Resistance Training on Lower-Limb Body Composition and Strength in Resistance-Trained Men: A Pilot Study

Creatine monohydrate (CrM) supplementation has been shown to improve body composition and muscle strength when combined with resistance training (RT); however, no study has evaluated the combination of this nutritional strategy with cluster-set resistance training (CS-RT). The purpose of this pilot study was to evaluate the effects of CrM supplementation during a high-protein diet and a CS-RT program on lower-limb fat-free mass (LL-FFM) and muscular strength. Twenty-three resistance-trained men (>2 years of training experience, 26.6 ± 8.1 years, 176.3 ± 6.8 cm, 75.6 ± 8.9 kg) participated in this study. Subjects were randomly allocated to a CS-RT+CrM (n = 8), a CS-RT (n = 8), or a control group (n = 7). The CS-RT+CrM group followed a CrM supplementation protocol with 0.1 g·kg-1·day-1 over eight weeks. Two sessions per week of lower-limb CS-RT were performed. LL-FFM corrected for fat-free adipose tissue (dual-energy X-ray absorptiometry) and muscle strength (back squat 1 repetition maximum (SQ-1RM) and countermovement jump (CMJ)) were measured pre- and post-intervention. Significant improvements were found in whole-body fat mass, fat percentage, LL-fat mass, LL-FFM, and SQ-1RM in the CS-RT+CrM and CS-RT groups; however, larger effect sizes were obtained in the CS-RT+CrM group regarding whole body FFM (0.64 versus 0.16), lower-limb FFM (0.62 versus 0.18), and SQ-1RM (1.23 versus 0.75) when compared to the CS-RT group. CMJ showed a significant improvement in the CS-RT+CrM group with no significant changes in CS-RT or control groups. No significant differences were found between groups. Eight weeks of CrM supplementation plus a high-protein diet during a CS-RT program has a higher clinical meaningfulness on lower-limb body composition and strength-related variables in trained males than CS-RT alone. Further research might study the potential health and therapeutic effects of this nutrition and exercise strategy.

The time to peak blood bicarbonate (HCO3-), pH, and the strong ion difference (SID) following sodium bicarbonate (NaHCO3) ingestion in highly trained adolescent swimmers

The timing of sodium bicarbonate (NaHCO₃) supplementation has been suggested to be most optimal when coincided with a personal time that bicarbonate (HCO₃^–) or pH peaks in the blood following ingestion. However, the ergogenic mechanisms supporting this ingestion strategy are strongly contested. It is therefore plausible that NaHCO₃ may be ergogenic by causing beneficial shifts in the strong ion difference (SID), though the time course of this blood acid base balance variable is yet to be investigated. Twelve highly trained, adolescent swimmers (age: 15.9 ± 1.0 years, body mass: 65.3 ± 9.6 kg) consumed their typical pre-competition nutrition 1–3 hours before ingesting 0.3 g∙kg BM^-1 NaHCO₃ in gelatine capsules. Capillary blood samples were then taken during seated rest on nine occasions (0, 60, 75, 90, 105, 120, 135, 150, 165 min post-ingestion) to identify the time course changes in HCO₃^–, pH, and the SID. No significant differences were found in the time to peak of each blood measure (HCO₃^–: 130 ± 35 min, pH: 120 ± 38 min, SID: 98 ± 37 min; p = 0.08); however, a large effect size was calculated between time to peak HCO₃^– and the SID (g = 0.88). Considering that a difference between time to peak blood HCO₃^– and the SID was identified in adolescents, future research should compare the ergogenic effects of these two individualized NaHCO₃ ingestion strategies compared to a traditional, standardized approach.

Muscle Performance Changes with Age in Active Women

The purpose of this study was to examine age-related differences in muscle performance in women divided into young (YW, 20–39 years, n = 29) middle-aged (MAW, 40–59 years, n = 33), and older (OW, ≥60 years, n = 40) age groups. Methods: Hand grip strength, vertical jump performance, and knee extensor (KE) strength (0 deg/s, 60 deg/s, and 240 deg/s), speed of movement (SoM; at 1 Nm, 20%, 40%, and 60% isometric strength), and endurance (30-repetition test at 60 degs/s and 240 deg/s) were assessed. Computed tomography-acquired muscle cross-sectional area (mCSA) was measured and included to determine specific strength (KE strength/mCSA). Results: Hand grip strength was similar across groups, while jump performance declined with age (YW and MAW > OW, p < 0.001). KE strength declined significantly with age (all conditions p < 0.01), while specific strength was similar across groups. SoM was significantly higher for YW and MAW compared to OW (both p < 0.01). An age × velocity interaction revealed YW KE endurance was similar between conditions, whereas MAW and OW displayed significantly better endurance during the 60 deg/s condition. OW displayed impaired KE endurance at 240 deg/s (vs. YW and MAW, p < 0.01) but improved at 60 deg/s (vs. YW, p < 0.01). Dynamic torque decline increased with age (YW < OW, p = 0.03) and was associated with intramuscular adipose tissue (r = 0.21, p = 0.04). Conclusions: Performance declines were most evident among OW, but few performance deficits had emerged in MAW. Interestingly, strength declines disappeared after normalizing to mCSA and endurance appears to be velocity-dependent.

Dynamic Changes of Performance Fatigability and Muscular O2 Saturation in a 4-km Cycling Time Trial

PURPOSE

The current study characterized the performance fatigability etiology, immediately after exercise cessation, and its relation to the dynamic changes in muscle O2 saturation (SmO2) at different TT phases.

METHODS

Twelve males performed three separated TT of different distances, in a crossover counterbalanced design, until the end of the fast-start (FS, 827 ± 135 m), even-pace (EP, 3590 ± 66 m), or end-spurt (ES, 4000 m) TT phases. Performance fatigability was characterized by using isometric maximal voluntary contractions (IMVC), whereas the maximal voluntary activation (VA) and contractile function of knee extensors (e.g., peak torque of potentiated twitches [TwPt]) were evaluated using electrically evoked contractions performed before and immediately after each exercise bouts. SmO2, power output (PO), and EMG were also recorded.

RESULTS

Immediately after the FS phase, there were lower values for IMVC (-23%), VA (-8%), and TwPt (-43%) (all P < 0.001), but no further changes were measured after EP (IMVC, -28%; VA, -8%; TwPt, -38%). After the ES phase, IMVC (-34%) and TwPt (-59%) further decreased compared with the previous phases (P < 0.05). There were lower SmO2 and higher EMG/PO values during FS and ES compared with EP phase.

CONCLUSION

FS and EP phases had similar performance fatigability etiology, but ES showed further impairments in contractile function. This later finding might be due to the abrupt changes in SmO2 and EMG/PO because of the high exercise intensity during the ES, which elicited maximal decline in contractile function at the finish line.

Prior Upper Body Exercise Impairs 4-km Cycling Time-Trial Performance Without Altering Neuromuscular Function

Purpose: This study investigated the effects of previous exhaustive upper body exercise on performance and neuromuscular fatigue following a 4-km cycling time-trial (4-km TT). Methods: Eight recreational cyclists performed a 4-km TT with (ARM_PRE) or without (CONTR) a previous arm-crank maximal incremental test. In each experimental session, neuromuscular fatigue was evaluated with a series of electrically evoked and maximal voluntary isometric contractions (MVC). Oxygen uptake ( V ˙ O₂), heart rate, electromyographic muscle activity (EMG_RMS) and rating of perceived exertion (RPE) were also recorded throughout the 4-km TT. Results: The average power output during the 4-km TT was reduced (P = .027) for the ARM_PRE (299 ± 59 W) group, compared with CONTR (310 ± 59 W) and overall performance in 4-km TT was impaired (P = .021) in ARM_PRE (382 ± 28 s) compared with CONTR (376 ± 27 s). The decrease observed in MVC (P = .033) and potentiated peak twitch force (P = .004) at post-TT were similar between the ARM_PRE and CONTR conditions (P = .739 and P = .493, respectively). There was no (P = .619) change in voluntary activation at post-TT between conditions. V ˙ O₂, EMG_RMS and RPE measured throughout the 4-km TT were not significantly different between the conditions (P = .558, P = .558 and P = .940, respectively). The rate of RPE change relative to power output average and heart rate was higher (P = .030 and P = .013, respectively) in ARM_PRE (0.031 ± 0.018 AU/W and 168 ± 8 bpm) than CONTR (0.022 ± 0.010 AU/W and 161 ± 7 bpm). Conclusion: These results suggest that impaired performance in ARM_PRE was mostly due to pronounced perception of effort rather than neuromuscular fatigue.

The 4R's Framework of Nutritional Strategies for Post-Exercise Recovery: A Review with Emphasis on New Generation of Carbohydrates

Post-exercise recovery is a broad term that refers to the restoration of training capacity. After training or competition, there is fatigue accumulation and a reduction in sports performance. In the hours and days following training, the body recovers and performance is expected to return to normal or improve. ScienceDirect, PubMed/MEDLINE, and Google Scholar databases were reviewed to identify studies and position declarations examining the relationship between nutrition and sports recovery. As an evidence-based framework, a 4R’s approach to optimizing post-exercise recovery was identified: (i) Rehydration—a fundamental process that will depend on the athlete, environment and sports event; (ii) Refuel—the consumption of carbohydrates is not only important to replenish the glycogen reserves but also to contribute to the energy requirements for the immune system and tissue reparation. Several bioengineered carbohydrates were discussed but further research is needed; (iii) Repair—post-exercise ingestion of high-quality protein and creatine monohydrate benefit the tissue growth and repair; and (iv) Rest—pre-sleep nutrition has a restorative effect that facilitates the recovery of the musculoskeletal, endocrine, immune, and nervous systems. Nutritional consultancy based on the 4R’s is important for the wise stewardship of the hydration, feeding, and supplementation strategies to achieve a timely recovery.

Protective effects of diet containing rutin against trichlorfon-induced muscle bioenergetics disruption and impairment on fatty acid profile of silver catfish Rhamdia quelen

Trichlorfon is an organophosphate insecticide that is widely used on fish farms to control parasitic infections. It has been detected in freshwater ecosystems as well as in fishery products. There is a growing body of evidence to suggest that certain feed additives may reduce or prevent pesticide-induced toxicity in fish. The aim of the present study was to determine whether acute exposure to trichlorfon would alter bioenergetic homeostasis and alter fatty acid profiles in muscles of silver catfish (Rhamdia quelen). We also sought to determine whether rutin prevents or reduces these effects. Cytosolic and mitochondrial creatine kinase (CK) and activities of complexes II-III and IV in muscle were significantly inhibited by exposure to 11 mg/L trichlorfon for 48 h compared to effects in the unexposed group. Total content of polyunsaturated fatty acids (omega-3 and omega-6) were significantly lower in muscle of silver catfish exposed to 11 mg/L trichlorfon for 48 h than in the unexposed group. Addition of 3 mg rutin/kg feed increased CK activity and prevented inhibition of complex IV activity, as well as preventing all alterations of muscle fatty acid profiles elicited by exposure to trichlorfon. No significant differences were observed between groups with respect to muscle adenylate kinase or pyruvate kinase activities, as well as total content of saturated and monounsaturated fatty acids. Our findings suggest that exposure (48 h) to 11 mg trichlorfon/L water inhibits cytosolic and mitochondrial CK activity in muscle. Trichlorfon also affects activities of complexes II-III and IV in respiratory chain, with important consequences for adenosine triphosphate production. The pesticide alters fatty acid profiles in the fish and endangers human consumers of the product. The most important finding of the present study is that inclusion of rutin improves bioenergetic homeostasis and muscle fatty acid profiles, suggesting that it reduces trichlorfon-induced muscle damage.

Would creatine supplementation augment exercise performance during a low carbohydrate high fat diet?

Low carbohydrate high fat (LCHF) diets are emerging in popularity. Several athletics have adopted LCHF diets in an attempt to improve exercise performance and body composition by enhancing fat utilization. However, these diets impair maximal and supramaximal exercise performance due to limited glycogen stores as well as increasing ratings of perceived exertion (RPE). All of these factors may impact training volume and compliance, leading to less optimal training adaptations over time. In contrast, LCHF diets is an effective strategy for weight and fat mass loss and is beneficial for a variety of metabolic processes. One potential nutritional strategy to off-set the negative aspects of a LCHF is creatine (Cr). Creatine supplementation has been shown to increase muscle power output and reduce the rate of fatigue; thereby allowing individuals to work at a higher intensity for a greater duration. Furthermore, Cr supplementation may positively enhance body composition (gains in muscle mass and possibly aid in fat mass loss). Despite the popularity of both LCHF and creatine supplementation, there is no data available investigating the effects of Cr supplementation on exercise performance and body composition during LCHF diets in humans. We would hypothesize that Cr supplementation may augment exercise performance (anerobic power and strength) during a LCHF diet compared to a LCHF diet and placebo. In addition, combining Cr with a LCHF diet would further increase body fat loss and improve body composition compared to a LCHF diet and/or low-fat diets (LFDs) placebo. Our hypotheses would be under the assumption that total caloric intake and protein intake are matched. Future research is warranted to examine chronic exercise with LCHF diets with and without creatine and compare performance and body composition changes to high carbohydrate diets.

Fatigability and Cardiorespiratory Impairments in Parkinson's Disease: Potential Non-Motor Barriers to Activity Performance

Parkinson's disease (PD) is the second most common neurodegenerative condition after Alzheimer's disease, affecting an estimated 160 per 100,000 people 65 years of age or older. Fatigue is a debilitating non-motor symptom frequently reported in PD, often manifesting prior to disease diagnosis, persisting over time, and negatively affecting quality of life. Fatigability, on the other hand, is distinct from fatigue and describes the magnitude or rate of change over time in the performance of activity (i.e., performance fatigability) and sensations regulating the integrity of the performer (i.e., perceived fatigability). While fatigability has been relatively understudied in PD as compared to fatigue, it has been hypothesized that the presence of elevated levels of fatigability in PD results from the interactions of homeostatic, psychological, and central factors. Evidence from exercise studies supports the premise that greater disturbances in metabolic homeostasis may underly elevated levels of fatigability in people with PD when engaging in physical activity. Cardiorespiratory impairments constraining oxygen delivery and utilization may contribute to the metabolic alterations and excessive fatigability experienced in individuals with PD. Cardiorespiratory fitness is often reduced in people with PD, likely due to the combined effects of biological aging and impairments specific to the disease. Decreases in oxygen delivery (e.g., reduced cardiac output and impaired blood pressure responses) and oxygen utilization (e.g., reduced skeletal muscle oxidative capacity) compromise skeletal muscle respiration, forcing increased reliance on anaerobic metabolism. Thus, the assessment of fatigability in people with PD may provide valuable information regarding the functional status of people with PD not obtained with measures of fatigue. Moreover, interventions that target cardiorespiratory fitness may improve fatigability, movement performance, and health outcomes in this patient population.

Preclinical pharmacological in vitro investigations on low chloride conductance myotonia: effects of potassium regulation

In myotonia, reduced Cl^- conductance of the mutated ClC-1 channels causes hindered muscle relaxation after forceful voluntary contraction due to muscle membrane hyperexcitability. Repetitive contraction temporarily decreases myotonia, a phenomena called "warm up." The underlying mechanism for the reduction of hyperexcitability in warm-up is currently unknown. Since potassium displacement is known to reduce excitability in, for example, muscle fatigue, we characterized the role of potassium in native myotonia congenita (MC) muscle. Muscle specimens of ADR mice (an animal model for low gCl^- conductance myotonia) were exposed to increasing K⁺ concentrations. To characterize functional effects of potassium ion current, the muscle of ADR mice was exposed to agonists and antagonists of the big conductance Ca²⁺-activated K⁺ channel (BK) and the voltage-gated Kv7 channel. Effects were monitored by functional force and membrane potential measurements. By increasing [K⁺]₀ to 5 mM, the warm-up phenomena started earlier and at [K⁺]₀ 7 mM only weak myotonia was detected. The increase of [K⁺]₀ caused a sustained membrane depolarization accompanied with a reduction of myotonic bursts in ADR mice. Retigabine, a Kv7.2-Kv7.5 activator, dose-dependently reduced relaxation deficit of ADR myotonic muscle contraction and promoted the warm-up phenomena. In vitro results of this study suggest that increasing potassium conductivity via activation of voltage-gated potassium channels enhanced the warm-up phenomena, thereby offering a potential therapeutic treatment option for myotonia congenita.

Force-frequency relationship during fatiguing contractions of rat medial gastrocnemius muscle

The force–frequency relationship presents the amount of force a muscle can produce as a function of the frequency of activation. During repetitive muscular contractions, fatigue and potentiation may both impact the resultant contractile response. However, both the apparent fatigue observed, and the potential for activity-dependent potentiation can be affected by the frequency of activation. Thus, we wanted to explore the effects that repetitive stimulation had on the force–frequency relationship. The force–frequency relationship of the rat medial gastrocnemius muscle was investigated during consecutive bouts of increasing fatigue with 20 to 100 Hz stimulation. Force was measured prior to the fatiguing protocol, during each of three levels of fatigue, and after 30 min of recovery. Force at each frequency was quantified relative to the pre-fatigued 100 Hz contractions, as well as the percentage reduction of force from the pre-fatigued level at a given frequency. We observed less reduction in force at low frequencies compared to high frequencies, suggesting an interplay of fatigue and potentiation, in which potentiation can “protect” against fatigue in a frequency-dependent manner. The exact mechanism of fatigue is unknown, however the substantial reduction of force at high frequency suggests a role for reduced force per cross-bridge.