Role of phosphate and calcium stores in muscle fatigue

Ionic medicine: Exploiting metallic ions to stimulate skeletal muscle tissue regeneration

The regeneration of healthy and functional skeletal muscle at sites of injuries and defects remains a challenge. Mimicking the natural environment surrounding skeletal muscle cells and the application of electrical and mechanical stimuli are approaches being investigated to promote muscle tissue regeneration. Likewise, chemical stimulation with therapeutic (biologically active) ions is an emerging attractive alternative in the tissue engineering and regenerative medicine fields, specifically to trigger myoblast proliferation, myogenic differentiation, myofiber formation, and ultimately to promote new muscle tissue growth. The present review covers the specialized literature focusing on the biochemical stimulation of muscle tissue repair by applying inorganic ions (bioinorganics). Extracting information from the literature, different ions and their potential influence as chemical cues on skeletal muscle regeneration are discussed. It is revealed that different ions and their varied doses have an individual effect at different stages of muscle cellular development. The dose-dependent effects of ions, as well as applications of ions alone and in combination with biomaterials, are also summarized. Some ions, such as boron, silicon, magnesium, selenium and zinc, are reported to exhibit a beneficial effect on skeletal muscle cells in carefully controlled doses, while the effects of other ions such as iron and copper appear to be contradictory. In addition, calcium is an essential regulatory ion for the differentiation of myoblasts. On the other hand, some ions such as phosphate have been shown to inhibit muscle cell behavior. This review thus provides a complete overview of the application of ionic stimulation for skeletal muscle tissue engineering applications, highlighting the importance of inorganic ions as an attractive alternative to the application of small molecules and growth factors to stimulate muscle tissue repair. STATEMENT OF SIGNIFICANCE: Ionic medicine (IM) is emerging as a promising and attractive approach in the field of tissue engineering, including muscle tissue regeneration. IM is based on the delivery of biologically active ions to injury sites, acting as stimulants for the repair process. This method offers a potentially simpler and more affordable alternative to conventional biomolecule-based regulators such as growth factors. Different biologically active ions, depending on their specific doping concentrations, can have varying effects on cellular development, which could be either beneficial or inhibitory. This literature review covers the field of IM in muscle regeneration with focus on the impact of various ions on skeletal muscle regeneration. The paper is thus a critical summary for guiding future research in ionic-related regenerative medicine, highlighting the potential and challenges of this approach for muscle regeneration.

Alcohol ink-modified microfluidic paper-based analytical devices for enhanced white detection in simultaneous determination of multiple water quality indicators

White detection remains a critical limitation in using colorimetry to determine substances with microfluidic paper-based analytical devices (µPADs). Here, we introduced a simple, safe alcohol ink-modified µPAD for the straightforward and facile detection of white color in precipitation reactions. Although absolute alcohol ink was found to cause device leakage, dilution of the ink with water was the key to successfully precoat wax-created µPADs. Device utility was demonstrated through simultaneous detection of sulfate, phosphate, and water hardness via precipitation reactions. While phosphate interfered with sulfate detection by Ba2+, in situ distance-based quantification of phosphate was implemented. Aside from anions, the modified µPADs could be extended to detect cationic analytes such as total hardness. The limits of detection (LODs) for sulfate, phosphate, and hardness were 0.005 mmol L-1, 0.005 mmol L-1, and 0.5 mmol L-1, respectively, with the linear ranges of 0.01-10.0 mmol L-1, 0.005-1.0 mmol L-1, and 0.001-0.5 mol L-1. The µPADs were applied to real water samples, demonstrating results that were consistent with standard methods at a 95% confidence level. By incorporating white detection, these alcohol ink-modified µPADs offer enhanced versatility for addressing a broader array of analytical challenges in real-world settings.

Pi-based biochemical mechanism of endurance-training-induced improvement of running performance in humans

PURPOSE

Endurance training improves running performance in distances where oxidative phosphorylation (OXPHOS) is the main ATP source. Here, a dynamic computer model is used to assess possible biochemical mechanisms underlying this improvement.

METHODS

The dynamic computer model is based on the "Pi double-threshold" mechanism of muscle fatigue, according to which the additional ATP usage appears when (1) inorganic phosphate (Pi) exceeds a critical value (Picrit); (2) exercise is terminated because of fatigue, when Pi reaches a peak value (Pipeak); (3) the Pi increase and additional ATP usage increase mutually stimulate each other.

RESULTS

The endurance-training-induced increase in oxidative phosphorylation (OXPHOS) activity attenuates the reaching of Pipeak by Pi (and thus of V ˙ O2max by V ˙ O2) at increased power output. This in turn allows a greater work intensity, and thus higher speed, to be achieved before exercise is terminated because of fatigue at the end of the 1500 m run. Thus, identical total work is performed in a shorter time. Probably, endurance training also lowers Pipeak, which improves the homeostasis of "bioenergetic" muscle metabolites: ADP, PCr, Pi and H+ ions.

CONCLUSIONS

The present dynamic computer model generates clear predictions of metabolic changes that limit performance during 1500 m running. It contributes to our mechanistic understanding of training-induced improvement in running performance and stimulates further physiological experimental studies.

Fatigue Alleviation by Low-Level Laser Preexposure in Ischemic Neuromuscular Electrical Stimulation

PURPOSE

Despite its susceptibility to muscle fatigue, combined neuromuscular electrical stimulation (NMES) and blood flow restriction (BFR) are effective regimens for managing muscle atrophy when traditional resistance exercises are not feasible. This study investigated the potential of low-level laser therapy (LLLT) in reducing muscle fatigue after the application of combined NMES and BFR.

METHODS

Thirty-six healthy adults were divided into control and LLLT groups. The LLLT group received 60 J of 850-nm wavelength LLLT before a training program of combined NMES and BFR of the nondominant extensor carpi radialis longus (ECRL). The control group followed the same protocol but received sham laser therapy. Assessments included maximal voluntary contraction, ECRL mechanical properties, and isometric force tracking for wrist extension.

RESULTS

The LLLT group exhibited a smaller normalized difference in maximal voluntary contraction decrement (-4.01 ± 4.88%) than the control group (-23.85 ± 7.12%) ( P < 0.001). The LLLT group demonstrated a smaller decrease in muscle stiffness of the ECRL compared with the control group, characterized by the smaller normalized changes in frequency ( P = 0.002), stiffness ( P = 0.002), and relaxation measures ( P = 0.011) of mechanical oscillation waves. Unlike the control group, the LLLT group exhibited a smaller posttest increase in force fluctuations during force tracking ( P = 0.014), linked to the predominant recruitment of low-threshold MU ( P < 0.001) without fatigue-related increases in the discharge variability of high-threshold MU ( P > 0.05).

CONCLUSIONS

LLLT preexposure reduces fatigue after combined NMES and BFR, preserving force generation, muscle stiffness, and force scaling. The functional benefits are achieved through fatigue-resistant activation strategies of motor unit recruitment and rate coding.

A novel kinetic model to demonstrate the independent effects of ATP and ADP/Pi concentrations on sarcomere function

Understanding muscle contraction mechanisms is a standing challenge, and one of the approaches has been to create models of the sarcomere-the basic contractile unit of striated muscle. While these models have been successful in elucidating many aspects of muscle contraction, they fall short in explaining the energetics of functional phenomena, such as rigor, and in particular, their dependence on the concentrations of the biomolecules involved in the cross-bridge cycle. Our hypothesis posits that the stochastic time delay between ATP adsorption and ADP/Pi release in the cross-bridge cycle necessitates a modeling approach where the rates of these two reaction steps are controlled by two independent parts of the total free energy change of the hydrolysis reaction. To test this hypothesis, we built a two-filament, stochastic-mechanical half-sarcomere model that separates the energetic roles of ATP and ADP/Pi in the cross-bridge cycle's free energy landscape. Our results clearly demonstrate that there is a nontrivial dependence of the cross-bridge cycle's kinetics on the independent concentrations of ATP, ADP, and Pi. The simplicity of the proposed model allows for analytical solutions of the more basic systems, which provide novel insight into the dominant mechanisms driving some of the experimentally observed contractile phenomena.

Skeletal Muscle Injury in Chronic Kidney Disease-From Histologic Changes to Molecular Mechanisms and to Novel Therapies

Chronic kidney disease (CKD) is associated with significant reductions in lean body mass and in the mass of various tissues, including skeletal muscle, which causes fatigue and contributes to high mortality rates. In CKD, the cellular protein turnover is imbalanced, with protein degradation outweighing protein synthesis, leading to a loss of protein and cell mass, which impairs tissue function. As CKD itself, skeletal muscle wasting, or sarcopenia, can have various origins and causes, and both CKD and sarcopenia share common risk factors, such as diabetes, obesity, and age. While these pathologies together with reduced physical performance and malnutrition contribute to muscle loss, they cannot explain all features of CKD-associated sarcopenia. Metabolic acidosis, systemic inflammation, insulin resistance and the accumulation of uremic toxins have been identified as additional factors that occur in CKD and that can contribute to sarcopenia. Here, we discuss the elevation of systemic phosphate levels, also called hyperphosphatemia, and the imbalance in the endocrine regulators of phosphate metabolism as another CKD-associated pathology that can directly and indirectly harm skeletal muscle tissue. To identify causes, affected cell types, and the mechanisms of sarcopenia and thereby novel targets for therapeutic interventions, it is important to first characterize the precise pathologic changes on molecular, cellular, and histologic levels, and to do so in CKD patients as well as in animal models of CKD, which we describe here in detail. We also discuss the currently known pathomechanisms and therapeutic approaches of CKD-associated sarcopenia, as well as the effects of hyperphosphatemia and the novel drug targets it could provide to protect skeletal muscle in CKD.

Recovery markers in elite climbers after the national boulder climbing championship

This study aimed to investigate recovery markers among elite climbers following the National Boulder Championship. We assessed maximum isometric hand grip strength (HS), forearm swelling (circumference), delayed soreness in forearm muscles, tiredness, and exercise readiness at several time points: pre-competition, immediately post-competition (within 4 min after their last effort), and 12, 24, 48, and 60 h post-competition. Maximum isometric hand grip strength decreased by 6.38 ± 1.32% (p = 0.006) post-12 h, returning to pre-competition values post-24 h (all p > 0.05). Forearm circumference (FC) increased 1.78 ± 1.77% (p < 0.001) post-competition, returning to pre-competition values post-12 h (all p > 0.05). Forearm pain (FP) increased post-competition (p = 0.002) and post-12 h (p < 0.001), returning to pre-competition values post-24 h (all p > 0.05). Tiredness increased post-competition (p < 0.001), post-12 h (p < 0.001), and post-24 h (p < 0.001), returning to pre-competition values post-48 h (all p > 0.05). Climbing readiness was reduced post-competition (p < 0.001), post-12 h (p < 0.001), post-24 h (p < 0.001), and post-48 h (p = 0.005), only returning to pre-competition values post-60 h (p = 0.189). Visual analysis of individual data pointed out a relatively small variability in the HS and FC markers, while FP, tiredness, and readiness exhibited larger individual variations. These findings indicate that different recovery patterns exist for the analyzed markers, suggesting that athletes may require up to 60 h after a competition to fully recover and regain their ability to face new competitive challenges.

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.

Training-Induced Increase in V·O2max and Critical Power, and Acceleration of V·O2 on-Kinetics Result from Attenuated Pi Increase Caused by Elevated OXPHOS Activity

Computer simulations using a dynamic model of the skeletal muscle bioenergetic system, involving the Pi-double-threshold mechanism of muscle fatigue, demonstrate that the training-induced increase in V·O2max, increase in critical power (CP) and acceleration of primary phase II of the V·O2 on kinetics (decrease in t0.63) is caused by elevated OXPHOS activity acting through a decrease in and slowing of the Pi (inorganic phosphate) rise during the rest-to-work transition. This change leads to attenuation of the reaching by Pi of Pipeak, peak Pi at which exercise is terminated because of fatigue. The delayed (in time and in relation to V·O2 increase) Pi rise for a given power output (PO) in trained muscle causes Pi to reach Pipeak (in very heavy exercise) after a longer time and at a higher V·O2; thus, exercise duration is lengthened, and V·O2max is elevated compared to untrained muscle. The diminished Pi increase during exercise with a given PO can cause Pi to stabilize at a steady state less than Pipeak, and exercise can continue potentially ad infinitum (heavy exercise), instead of rising unceasingly and ultimately reaching Pipeak and causing exercise termination (very heavy exercise). This outcome means that CP rises, as the given PO is now less than, and not greater than CP. Finally, the diminished Pi increase (and other metabolite changes) results in, at a given PO (moderate exercise), the steady state of fluxes (including V·O2) and metabolites being reached faster; thus, t0.63 is shortened. This effect of elevated OXPHOS activity is possibly somewhat diminished by the training-induced decrease in Pipeak.

Taurine supplementation enhances anaerobic power in elite speed skaters: A double-blind, randomized, placebo-controlled, crossover study

Taurine (2-aminoethanesulfonic acid) is a semi-essential sulphur-containing amino acid abundant in skeletal muscle. Taurine supplementation is popular among athletes and has been purported to enhance exercise performance. This study aimed to investigate the ergogenic effects of taurine supplementation on anaerobic (Wingate; WanT) performance, blood lactate, ratings of perceived exertion (RPE), and countermovement vertical jump (CMJ) in elite athletes. For this study, randomized, double-blind, placebo-controlled crossover designs were used. Thirty young male speed skaters were randomly assigned to either taurine (TAU; single dose of 6 g) or placebo (PLAC; single dose of 6 g) 60 minutes before testing. Following a 72-hour washout, period participants completed the opposite condition. TAU improved peak (Δ% = 13.41, p < 0.001, d = 1.71), mean (Δ% = 3.95, p = 0.002, d = 1.04), and minimum power output (Δ% = 7.89, p = 0.034, d = 0.48) compared to placebo. Further, RPE (Δ% = -10.98, p = 0.002, d = 0.46) was significantly lower following the WanT in the TAU condition compared to placebo. There were no differences between conditions for the countermovement vertical jump. In conclusion, acute TAU supplementation augments anaerobic performance in elite speed skaters.

V̇O2 (non-)linear increase in ramp-incremental exercise vs. V̇O2 slow component in constant-power exercise: Underlying mechanisms

A computer model of the skeletal muscle bioenergetic system involving the P_i double-threshold mechanism of muscle fatigue was used to study the V̇O₂ (non-)linear increase in time in ramp-incremental exercise as compared to the V̇O₂ slow component in constant-power exercise. The P_i double-threshold mechanism applies to both constant-power and ramp-incremental exercise. The additional ATP usage is initiated at a significantly higher ATP usage activity (power output), determining the moderate/heavy exercise border, in ramp-incremental, than in constant-power exercise. A significantly lowered additional ATP usage activity or elevated glycolysis stimulation at the highest power outputs in ramp-incremental exercise in relation to constant-power exercise can additionally explain the much smaller (or zero) V̇O₂ non-linearity in ramp-incremental exercise, than V̇O₂ slow component in constant-power exercise. The V̇O₂ (non-)linearity in ramp-incremental exercise and V̇O₂ slow component in constant-power exercise is a derivative of a balance between the additional ATP usage and ATP production by anaerobic glycolysis.

Store-operated calcium entry: From physiology to tubular aggregate myopathy

Store-Operated Ca²⁺ entry (SOCE) is recognized as a key mechanism in muscle physiology necessary to refill intracellular Ca²⁺ stores during sustained muscle activity. For many years the cell structures expected to mediate SOCE in skeletal muscle fibres remained unknown. Recently, the identification of Ca²⁺ Entry Units (CEUs) in exercised muscle fibres opened new insights into the role of extracellular Ca²⁺ in muscle contraction and, more generally, in intracellular Ca²⁺ homeostasis. Accordingly, intracellular Ca²⁺ unbalance due to alterations in SOCE strictly correlates with muscle disfunction and disease. Mutations in proteins involved in SOCE (STIM1, ORAI1, and CASQ1) have been linked to tubular aggregate myopathy (TAM), a disease that causes muscle weakness and myalgia and is characterized by a typical accumulation of highly ordered and packed membrane tubules originated from the sarcoplasmic reticulum (SR). Achieving a full understanding of the molecular pathways activated by alterations in Ca²⁺ entry mechanisms is a necessary step to design effective therapies for human SOCE-related disorders.

Effects of fatigue on balance and ankle proprioception during drop landing among individuals with and without chronic ankle instability

This study aimed to explore the effects of fatigue on the balance and ankle proprioception during drop landing of individuals with chronic ankle instability (CAI). A total of 35 participants with unilateral CAI and 35 healthy participants participated in this study. A static balance test, dynamic balance test, and ankle proprioception test were conducted before and after fatigue. Fatigue was induced with turn back runs and vertical jumps protocol. Sway distance of the center of pressure (COP), root mean square of the COP (RMS), total excursions (TOTEX), mean velocity (MVELO), 95% confidence ellipse area of the COP movements (95% AREA), Normalise Reach Distance in the anterior (ANT), posteromedial (PM), and posterolateral (PL) directions, and the area under the curve (AUC) were calculated and analyzed. There were significant group by fatigue interactions for static balance variables, normalise reach distance in the PM and PL directions, and AUC. Fatigue reduced balance and ankle proprioception in individuals with CAI. After fatigue, static and dynamic balance and ankle proprioception during drop landing were significantly worse in the CAI group than in the control group. Fatigue had a significant negative effect on balance and ankle proprioception in CAI patients. Therefore, fatigue may be an important factor causing repeated ankle sprain in CAI patients.

Performance fatigability and recovery after dynamic multi-joint maximal exercise in elbow flexors versus knee extensors

Elbow flexors (EF) and knee extensors (KE) have shown differences in performance fatigability and recovery of neuromuscular function after isometric and isotonic single-joint fatiguing contractions. However, dynamic multi-joint movements are more representative of real-world activities. The aim of the study was to assess central and peripheral mechanisms of fatigability after either arm-cranking or cycling. Ten physically-active men performed maximal incremental arm-cranking and cycling until task-failure. Maximal voluntary isometric contraction (MVIC) and electrically-evoked forces of both EF and KE were assessed before (PRE) and 1 (POST) and 20 (POST20) min after exercise. At POST, MVIC decreased similarly to 76 ± 8% and 81 ± 7% (both P < 0.001) of PRE for EF and KE, respectively. MVIC force remained lower than PRE at POST20 for both EF and KE (85 ± 8% vs. 95 ± 3% of PRE, P ≤ 0.033), having recovered less in EF than KE (P = 0.003). Electrically-evoked forces decreased similarly from PRE to POST in EF and KE (all P > 0.05). At POST20, the ratio of low-to-high frequency doublets was lowerin EF than KE (75 ± 13% vs. 85 ± 10% of PRE; P ≤ 0.034). Dynamic maximal incremental exercise acutely induced similar magnitudes of MVIC and evoked forces loss in EF and KE. However, at POST20, impaired MVIC recovery and lower ratio of low-to-high frequency doublets in EF compared to KE suggests the recovery of neuromuscular function after dynamic maximal exercises is specific to and dependent on changes within the muscles investigated.

Cardiovascular Effects of Whole-Body Cryotherapy in Non-professional Athletes

Objectives:

The study aimed to investigate changes in heart rate, blood pressure, respiratory rate, oxygen saturation, and body temperature in non-professional trained runners during whole body cryotherapy (WBC).

Methods

Ten middle-distance runners received 3 once-a-day sessions of WBC. Subjects underwent BP measurements and ECG recorded before and immediately after the daily WBC session. During WBC we recorded a single lead trace (D1) for heart rhythm control. In addition, the 5 vital signs Blood pressure, heart rate, respiratory rate, oxygen saturation, and body temperature were monitored before, during, and after all WBC session.

Results

We did not report significant changes in ECG main intervals (PR, QT, and QTc). Mean heart rate changed from 50.98 ± 4.43 bpm (before) to 56.83 ± 4.26 bpm after WBC session (p < 0.05). The mean systolic blood pressure did not change significantly during and after WBC [b baseline: 118 ± 5 mmHg, changed to 120 ± 3 mmHg during WBC, and to 121 ± 2 mmHg after session (p < 0.05 vs. baseline)]. Mean respiratory rate did not change during WBC as well as oxygen saturations (98 vs. 99%). Body temperature was slightly increased after WBC, however it remains within physiological values

Conclusion

In non-professional athletes WBC did not affect cardiovascular response and can be safely used. However, further studies are required to confirm these promising results of safety in elderly non-athlete subjects.

Effects of Resistance Training in Hypobaric vs. Normobaric Hypoxia on Circulating Ions and Hormones

Hypobaric hypoxia (HH) seems to lead to different responses compared to normobaric hypoxia (NH) during physical conditioning. The aim of the study was to analyze the hormonal and circulating ion responses after performing high-intensity resistance training with different inter-set rest under HH and NH condition. Sixteen male volunteers were randomly divided into two training groups. Each group completed two counterbalanced resistance training sessions (three sets × ten repetitions, remaining two repetitions in reserve), with both one- and two-minute inter-set rest, under HH and NH. Blood samples were obtained to determine hormones and circulating ions (Ca²⁺, Pi, and HCO₃⁻) at baseline and after training sessions (5, 10, and 30 min). Resistance training with one-minute rest caused greater hormonal stress than with two-minute rest in cortisol and growth hormone, although the hypoxic environmental condition did not cause any significant alterations in these hormones. The short inter-set rest also caused greater alterations in HCO₃⁻ and Pi than the longer rest. Additionally, higher levels of Ca²⁺ and Pi, and lower levels of HCO₃⁻, were observed after training in HH compared to NH. Metabolic and physiological responses after resistance training are mediated by inter-set rest intervals and hypoxic environmental condition. According to the alterations observed in the circulating ions, HH could cause greater muscular fatigue and metabolic stress than NH.

Role of parvalbumin in fatigue-induced changes in force and cytosolic calcium transients in intact single mouse myofibers

One of the most important cytosolic Ca²⁺ buffers present in mouse fast-twitch myofibers, but not in human myofibers, is parvalbumin (PV). Previous work using conventional PV knockout mice suggests that lifelong PV ablation increases fatigue resistance, possibly due to compensations in mitochondrial volume. In this work, PV gene ablation was induced only in adult mice (PV-KO), and contractile and cytosolic Ca²⁺ responses during fatigue were studied in isolated muscle and intact single myofibers. Results were compared to control littermates (PV-Ctr). We hypothesized that the reduced myofiber cytosolic Ca²⁺ buffering developed only in adult PV-KO mice leads to a larger cytosolic free Ca²⁺ concentration ([Ca²⁺]_c) during repetitive contractions, increasing myofiber fatigue resistance. Extensor digitorum longus (EDL) muscles from PV-KO mice had higher force in unfused stimulations (~50%, P<0.05) and slowed relaxation (~46% higher relaxation time, P<0.05) vs PV-Ctr, but muscle fatigue resistance or fatigue-induced changes in relaxation were not different between genotypes (P>0.05). In intact single myofibers from flexor digitorum brevis (FDB) muscles, basal and tetanic [Ca²⁺]_c during fatiguing contractions were higher in PV-KO (P<0.05), accompanied by a greater slowing in estimated sarcoplasmic reticulum (SR) Ca²⁺ pumping vs PV-Ctr myofibers (~84% reduction, P<0.05), but myofiber fatigue resistance was not different between genotypes (P>0.05). Our results demonstrate that although the estimated SR Ca²⁺ uptake was accelerated in PV-KO, the total energy demand by the major energy consumers in myofibers, the cross-bridges and SR Ca²⁺ ATPase, were not altered enough to affect the energy supply for contractions, and therefore fatigue resistance remained unaffected.

The W' Balance Model: Mathematical and Methodological Considerations

Since its publication in 2012, the W' balance model has become an important tool in the scientific armamentarium for understanding and predicting human physiology and performance during high-intensity intermittent exercise. Indeed, publications featuring the model are accumulating, and it has been adapted for popular use both in desktop computer software and on wrist-worn devices. Despite the model's intuitive appeal, it has achieved mixed results thus far, in part due to a lack of clarity in its basis and calculation. Purpose: This review examines the theoretical basis, assumptions, calculation methods, and the strengths and limitations of the integral and differential forms of the W' balance model. In particular, the authors emphasize that the formulations are based on distinct assumptions about the depletion and reconstitution of W' during intermittent exercise; understanding the distinctions between the 2 forms will enable practitioners to correctly implement the models and interpret their results. The authors then discuss foundational issues affecting the validity and utility of the model, followed by evaluating potential modifications and suggesting avenues for further research. Conclusions: The W' balance model has served as a valuable conceptual and computational tool. Improved versions may better predict performance and further advance the physiology of high-intensity intermittent exercise.

Association of Serum Phosphate with Low Handgrip Strength in Patients with Advanced Chronic Kidney Disease

Muscle wasting and hyperphosphatemia are becoming increasingly prevalent in patients who exhibit a progressive decline in kidney function. However, the association between serum phosphate (Pi) level and sarcopenia in advanced chronic kidney disease (CKD) patients remains unclear. We compared the serum Pi levels between advanced CKD patients with (n = 51) and those without sarcopenia indicators (n = 83). Low appendicular skeletal muscle mass index (ASMI), low handgrip strength, and low gait speed were defined per the standards of the Asian Working Group for Sarcopenia. Mean serum Pi level was significantly higher in advanced CKD patients with sarcopenia indicators than those without sarcopenia indicators (3.88 ± 0.86 vs. 3.54 ± 0.73 mg/dL; p = 0.016). Univariate analysis indicated that serum Pi was negatively correlated with ASMI, handgrip strength, and gait speed. Multivariable analysis revealed that serum Pi was significantly associated with handgrip strength (standardized β = -0.168; p = 0.022) and this association persisted even after adjustments for potential confounders. The optimal serum Pi cutoff for predicting low handgrip strength was 3.65 mg/dL, with a sensitivity of 82.1% and specificity of 56.6%. In summary, low handgrip strength is common in advanced CKD patients and serum Pi level is negatively associated with handgrip strength.

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.

Effects of Blood Flow Restriction on O2 Muscle Extraction and O2 Pulmonary Uptake Kinetics During Heavy Exercise

This study aimed to determine the effects of three levels of blood flow restriction (BFR) onV ˙ O 2 and O 2 extraction kinetics during heavy cycling exercise transitions. Twelve healthy trained males completed two bouts of 10 min heavy intensity exercise without BFR (CON), with 40% or 50% BFR (BFR40 and BFR50, respectively).V ˙ O 2 and tissue saturation index (TSI) were continuously measured and modelled using multiexponential functions. The time constant of theV ˙ O 2 primary phase was significantly slowed in BFR40 (26.4 ± 2.0s; p < 0.001) and BFR50 (27.1 ± 2.1s; p = 0.001) compared to CON (19.0 ± 1.1s). The amplitude of theV ˙ O 2 slow component was significantly increased (p < 0.001) with BFR in a pressure-dependent manner 3.6 ± 0.7, 6.7 ± 0.9 and 9.7 ± 1.0 ml·min-1·kg-1 for CON, BFR40, and BFR50, respectively. While no acceleration of the primary component of the TSI kinetics was observed, there was an increase (p < 0.001) of the phase 3 amplitude with BFR (CON -0.8 ± 0.3% VS BFR40 -2.9 ± 0.9%, CON VS BFR50 -2.8 ± 0.8%). It may be speculated that BFR applied during cycling exercise in the heavy intensity domain shifted the working muscles to an O 2 dependent situation. The acceleration of the extraction kinetics could have reached a plateau, hence not permitting compensation for the slowdown of the blood flow kinetics, and slowingV ˙ O 2 kinetics.

Long-term wheel-running prevents reduction of grip strength in type 2 diabetic rats

Diabetic skeletal muscles show reduced contractile force and increased fatigability. Hands are a target for several diabetes-induced complications. Therefore, reduced handgrip strength often occurs as a consequence of diabetes. The aim of this study was to examine whether long-term exercise can prevent reduction of grip strength in type 2 diabetes mellitus (T2DM) model OLETF rats, and to explore the mechanisms underlying diabetes-induced grip strength reduction. Ten 5-week-old OLETF rats were used as experimental animals, and five non-diabetic LETO rats as controls of OLETF rats. Half OLETF rats performed daily voluntary wheel-running for 17 months (OLETF + EXE), and the rest of OLETF and LETO rats were sedentary. Grip strength was higher in OLETF + EXE and LETO groups than in OLETF group. OLETF group with hyperglycemia showed an increase in HbA1c, serum TNF-α, and muscle SERCA activity, but a decrease in circulating insulin. Each fiber area, total fiber area, and % total fiber area in type IIb fibers of extensor digitorum longus muscles were larger in OLETF + EXE and LETO groups than in OLETF group. There was a positive correlation between grip strength and the above three parameters concerning type IIb fiber area. Therefore, type IIb fiber atrophy may be the major direct cause of grip strength reduction in OLETF group, although there seems multiple etiological mechanisms. Long-term wheel-running may have blocked the diabetes-induced reduction of grip strength by preventing type IIb fiber atrophy. Regular exercise may be a potent modality for preventing not only the progression of diabetes but muscle dysfunction in T2DM patients.

Hydroxyapatite Nanorods Function as Safe and Effective Growth Factors Regulating Neural Differentiation and Neuron Development

Neural stem cell (NSC) transplantation is one of the most promising therapeutic strategies for neurodegenerative diseases. However, the slow spontaneous differentiation of NSCs often hampers their application in neural repair. Although some biological growth factors accelerate the differentiation of NSCs, their high cost, short half-life, and unpredictable behavior in vivo, as well as the complexity of the operation, hinder their clinical use. In this study, it is demonstrated that hydroxyapatite (HAp), the main component of bone, in the form of nanorods, can regulate the neural differentiation of NSCs and maturation of the newly differentiated cells. Culturing NSCs with HAp nanorods leads to the differentiation of NSCs into mature neurons that exhibit well-defined electrophysiological behavior within 5 days. The state of these neurons is much better than when culturing the cells without HAp nanorods, which undergo a 2-week differentiation process. Furthermore, RNA-sequencing data reveal that the neuroactive ligand-receptor interaction pathway is dominant in the enriched differentiated neuronal population. Hence, inorganic growth factors like HAp act as a feasible, effective, safe, and practical tool for regulating the differentiation of NSCs and can potentially be used in the treatment of neurodegenerative diseases.

The Theory of Effort Minimization in Physical Activity

Although the automatic attraction to effort minimization has been evidenced in multiple fields, its potential role in explaining the pandemic of physical inactivity has been overlooked. The theory of effort minimization in physical activity (TEMPA) fills this gap. TEMPA seeks to obtain a more accurate understanding of the neuropsychological determinants of movement-based behaviors.

Short-distance versus long-distance deep-seaport container truck drivers' prevalence and perceived discomfort of musculoskeletal symptoms in the Thailand Eastern Economic Corridor

Objectives. This research aimed to study the prevalence and perceived discomfort of musculoskeletal (MSK) symptoms among short-distance and long-distance deep-seaport truck drivers. Methods. Cross-sectional analysis using a standardized modified version of the Nordic musculoskeletal questionnaire (NMQ) was carried out using direct interviews with 25 male participants: 15 short-distance and 10 long-distance truck drivers. Results. As much as 88% was reported for the existence of MSK symptoms in the past 12 months. Considering all truck groups, regardless of short or long distance, the lower back was found with the highest prevalence (72%) followed by the neck (32%). The χ² test showed long-distance truck drivers had statistically significantly more prevalence in the neck (p = 0.028) than short-distance drivers. Perceived discomfort by the Borg CR10 scale confirmed the lower back had the highest score (2.4) followed by the neck (1.44). The Kruskal-Wallis test revealed that long-distance truck drivers had significantly higher scores on the lower back and neck (p = 0.039 and p = 0.009, respectively). Conclusion. Longer exposure to prolonged non-natural working postures, vibration, traffic conditions and working stress could be the judicial causes. To minimize this problem, integrated interventions need to be implemented with particular measures among short-distance and long-distance truck drivers.

Taurine in sports and exercise

BACKGROUND

Taurine has become a popular supplement among athletes attempting to improve performance. While the effectiveness of taurine as an ergogenic aid remains controversial, this paper summarizes the current evidence regarding the efficacy of taurine in aerobic and anaerobic performance, metabolic stress, muscle soreness, and recovery.

METHODS

Google Scholar, Web of Science, and MedLine (PubMed) searches were conducted through September 2020. Peer-reviewed studies that investigated taurine as a single ingredient at dosages of < 1 g - 6 g, ranging from 10 to 15 min-to-2 h prior to exercise bout or chronic dose (7 days- 8 weeks) of consumption were included. Articles were excluded if taurine was not the primary or only ingredient in a supplement or food source, not published in peer-reviewed journals, if participants were older than 50 years, articles published before 1999, animal studies, or included participants with health issues. A total of 19 studies met the inclusion criteria for the review.

RESULTS

Key results include improvements in the following: VO2max, time to exhaustion (TTE; n = 5 articles), 3 or 4 km time-trial (n = 2 articles), anaerobic performance (n = 7 articles), muscle damage (n = 3 articles), peak power (n = 2 articles), recovery (n = 1 article). Taurine also caused a change in metabolites: decrease in lactate, creatine kinase, phosphorus, inflammatory markers, and improved glycolytic/fat oxidation markers (n = 5 articles). Taurine dosing appears to be effective at ~ 1-3 g/day acutely across a span of 6-15 days (1-3 h before an activity) which may improve aerobic performance (TTE), anaerobic performance (strength, power), recovery (DOMS), and a decrease in metabolic markers (creatine kinase, lactate, inorganic phosphate).

CONCLUSIONS

Limited and varied findings prohibit definitive conclusions regarding the efficacy of taurine on aerobic and anaerobic performance and metabolic outcomes. There are mixed findings for the effect of taurine consumption on improving recovery from training bouts and/or mitigating muscle damage. The timing of taurine ingestion as well as the type of exercise protocol performed may contribute to the effectiveness of taurine as an ergogenic aid. More investigations are needed to better understand the potential effects of taurine supplementation on aerobic and anaerobic performance, muscle damage, metabolic stress, and recovery.

Towards Detecting Biceps Muscle Fatigue in Gym Activity Using Wearables

Fatigue is a naturally occurring phenomenon during human activities, but it poses a bigger risk for injuries during physically demanding activities, such as gym activities and athletics. Several studies show that bicep muscle fatigue can lead to various injuries that may require up to 22 weeks of treatment. In this work, we adopt a wearable approach to detect biceps muscle fatigue during a bicep concentration curl exercise as an example of a gym activity. Our dataset consists of 3000 bicep curls from twenty middle-aged volunteers at ages between 27 to 30 and Body Mass Index (BMI) ranging between 18 to 28. All volunteers have been gym-goers for at least 1 year with no records of chronic diseases, muscle, or bone surgeries. We encountered two main challenges while collecting our dataset. The first challenge was the dumbbell's suitability, where we found that a dumbbell weight (4.5 kg) provides the best tradeoff between longer recording sessions and the occurrence of fatigue on exercises. The second challenge is the subjectivity of RPE, where we average the reported RPE with the measured heart rate converted to RPE. We observed from our data that fatigue reduces the biceps' angular velocity; therefore, it increases the completion time for later sets. We extracted a total of 33 features from our dataset, which have been reduced to 16 features. These features are the most overall representative and correlated with bicep curl movement, yet they are fatigue-specific features. We utilized these features in five machine learning models, which are Generalized Linear Models (GLM), Logistic Regression (LR), Random Forests (RF), Decision Trees (DT), and Feedforward Neural Networks (FNN). We found that using a two-layer FNN achieves an accuracy of 98% and 88% for subject-specific and cross-subject models, respectively. The results presented in this work are useful and represent a solid start for moving into a real-world application for detecting the fatigue level in bicep muscles using wearable sensors as we advise athletes to take fatigue into consideration to avoid fatigue-induced injuries.

ISB clinical biomechanics award winner 2019: Knee extensor fatigue resistance in individuals following anterior cruciate ligament reconstruction

BACKGROUND

Individuals following anterior cruciate ligament reconstruction demonstrate quadriceps weakness throughout the post-operative recovery and at the time of returning to sport. This is often accompanied with patterns of quadriceps fatigue resistance. As such, fatigue may be an identifier of individuals with delayed recovery. The purpose was to assess quadriceps fatigue in anterior cruciate ligament reconstructed patients at the time of return to sport in comparison to healthy controls.

METHODS

A total of 215 individuals, 120 following anterior cruciate ligament reconstruction (21.0 (2.9) years, 63 Female, 5.96 (0.48) months post-surgery) and 95 healthy controls (21.5 (8.4) years, 49 Female), participated in this study. All participants completed a 30-s knee extensor maximum voluntary isometric contraction. Knee extensor strength, limb symmetry index, and fatigue (%) were compared between groups. Between-limb fatigue comparisons were made through the Fatigue Index Limb Difference = [(Involved Limb Fatigue Index) - (Uninvolved Limb Fatigue Index)].

FINDINGS

Individuals following anterior cruciate ligament reconstruction (18.7 (10.9)%, -5.6 (11.2)) demonstrated lower values of unilateral fatigue and Fatigue Index Limb Difference compared to healthy participants (22.5 (8.2)%, P = .002; 2.2 (7.9), P < .001). For anterior cruciate ligament reconstructed patients, there was a weak, negative, significant relationship between the involved limb strength and fatigue (r = -0.184, P = .048). There was no relationship between limb symmetry and Fatigue Index Limb Difference (r = 0.137, P = .142). For Healthy individuals, there was a positive, moderate relationship between limb symmetry and Fatigue Index Limb Difference (r = 0.400, P < .001).

INTERPRETATION

Individuals following anterior cruciate ligament reconstruction demonstrate fatigue resistance compared to healthy active controls and greater resistance to fatigue in their involved limb compared to their contralateral limb.

Effects of whole-body vibrations on neuromuscular fatigue: a study with sets of different durations

BACKGROUND

Whole body vibrations have been used as an exercise modality or as a tool to study neuromuscular integration. There is increasing evidence that longer WBV exposures (up to 10 minutes) induce an acute impairment in neuromuscular function. However, the magnitude and origin of WBV induced fatigue is poorly understood.

PURPOSE

The study aimed to investigate the magnitude and origin of neuromuscular fatigue induced by half-squat long-exposure whole-body vibration intervention (WBV) with sets of different duration and compare it to non-vibration (SHAM) conditions.

METHODS

Ten young, recreationally trained adults participated in six fatiguing trials, each consisting of maintaining a squatting position for several sets of the duration of 30, 60 or 180 seconds. The static squatting was superimposed with vibrations (WBV30, WBV60, WBV180) or without vibrations (SHAM30, SHAM60, SHAM180) for a total exercise exposure of 9-minutes in each trial. Maximum voluntary contraction (MVC), level of voluntary activation (%VA), low- (T20) and high-frequency (T100) doublets, low-to-high-frequency fatigue ratio (T20/100) and single twitch peak torque (TWPT) were assessed before, immediately after, then 15 and 30 minutes after each fatiguing protocol.

RESULT

Inferential statistics using RM ANOVA and post hoc tests revealed statistically significant declines from baseline values in MVC, T20, T100, T20/100 and TWPT in all trials, but not in %VA. No significant differences were found between WBV and SHAM conditions.

CONCLUSION

Our findings suggest that the origin of fatigue induced by WBV is not significantly different compared to control conditions without vibrations. The lack of significant differences in %VA and the significant decline in other assessed parameters suggest that fatiguing protocols used in this study induced peripheral fatigue of a similar magnitude in all trials.

Factors determining training-induced changes in V̇O2max, critical power, and V̇O2 on-kinetics in skeletal muscle

Computer simulations, using the "P_i double-threshold" mechanism of muscle fatigue postulated previously (the first threshold initiating progressive reduction in work efficiency and the second threshold resulting in exercise intolerance), demonstrated that several parameters of the skeletal muscle bioenergetic system can affect maximum oxygen consumption (V̇O_2max), critical power (CP), and oxygen consumption (V̇O₂) on-kinetics in skeletal muscle. Simulations and experimental observations together demonstrate that endurance exercise training increases oxidative phosphorylation (OXPHOS) activity and/or each-step activation (ESA) intensity, the latter, especially in the early stages of training. Here, new computer simulations demonstrate that an endurance training-induced increase in OXPHOS activity and decrease in peak P_i (Pi_peak), at which exercise is terminated because of exercise intolerance, result in increased V̇O_2max and CP, speeding of the primary phase II of V̇O₂ on-kinetics, and decreases V̇O₂ slow component magnitude, consistent with their observed behavior in vivo. It is possible, but remains unknown, whether there is a contribution to this behavior of an increase in the critical P_i (Pi_crit), above which the additional ATP usage underlying the slow component begins, and a decrease in the activity of the additional ATP usage (k_add). Thus, we offer a mechanism, involving P_i accumulation, Pi_crit and Pi_peak, of the training-induced adaptations in V̇O_2max, CP, and the primary and slow component phases of V̇O₂ on-kinetics that was absent in the literature.NEW & NOTEWORTHY A mechanism of the training-induced changes in V̇O_2max, critical power, and V̇O₂ on-kinetics in skeletal muscle reported in the literature is postulated. It involves the self-driving "P_i double-threshold" mechanism of muscle fatigue underlying exercise inefficiency, the slow component of the V̇O₂ on-kinetics, and termination of exercise. It is proposed that an increase in OXPHOS activity and decrease in peak P_i at which exercise terminates are responsible for the training-induced changes in the muscle bioenergetic system.

Effects of whole-body cryotherapy on the innate and adaptive immune response in cyclists and runners

The study aimed to identify the effects of whole-body cryotherapy (WBC) on immunological, hormonal, and metabolic responses of non-professional male athletes. Ten cyclists and ten middle-distance runners received 3 once-a-day sessions of WBC. Before initiating and after the final WBC session, a full set of hematologic parameters, serum chemistry profile, hormones, circulating mitochondrial (mt) DNA levels, cytokines, and chemokines concentration were evaluated. The phenotype of monocyte, T cells, and B cells was analyzed. mRNA expression of 6 genes involved in inflammasome activation (NAIP, AIM2, NLRP3, PYCARD, IL-1β, and IL-18) was quantified. WBC reduced glucose and C and S protein and increased HDL, urea, insulin-like growth factor (IGF)-1, follicle-stimulating hormone, IL-18, IL-1RA, CCL2, and CXCL8. Intermediate and non-classical monocyte percentages decreased, and the CD14, CCR5, CCR2, and CXCR4 expressions changed in different subsets. Only IL-1β mRNA increased in monocytes. Finally, a redistribution of B and T cell subsets was observed, suggesting the migration of mature cells to tissue. WBC seems to induce changes in both innate and adaptive branches of the immune system, hormones, and metabolic status in non-professional male athletes, suggesting a beneficial involvement of WBC in tissue repair.

Biomechanical conditioning of the motor unit transitory force decrease following a reduction in stimulation rate

BACKGROUND

The biomechanical background of the transitory force decrease following a sudden reduction in the stimulation frequency under selected experimental conditions was studied on fast resistant motor units (MUs) of rat medial gastrocnemius in order to better understand the mechanisms of changes in force transmission.

METHODS

Firstly, MUs were stimulated with three-phase trains of stimuli (low-high-low frequency pattern) to identify patterns when the strongest force decrease (3-36.5%) following the middle high frequency stimulation was observed. Then, in the second part of experiments, the MUs which presented the largest force decrease in the last low-frequency phase were alternatively tested under one of five conditions to analyse the influence of biomechanical factors of the force decrease: (1) determine the influence of muscle stretch on amplitude of the force decrease, (2) determine the numbers of interpulse intervals necessary to evoke the studied phenomenon, (3) study the influence of coactivation of other MUs on the studied force decrease, (4) test the presence of the transitory force decrease at progressive changes in stimulation frequency, (5) and perform mathematical analysis of changes in twitch-shape responses to individual stimuli within a tetanus phase with the studied force decrease.

RESULTS

Results indicated that (1) the force decrease was highest when the muscle passive stretch was optimal for the MU twitch (100 mN); (2) the middle high-frequency burst of stimuli composed of at least several pulses was able to evoke the force decrease; (3) the force decrease was eliminated by a coactivation of 10% or more MUs in the examined muscle; (4) the transitory force decrease occured also at the progressive decrease in stimulation frequency; and (5) a mathematical decomposition of contractions with the transitory force decrease into twitch-shape responses to individual stimuli revealed that the force decrease in question results from the decrease of twitch forces and a shortening in contraction time whereas further force restitution is related to the prolongation of relaxation.

CONCLUSIONS

High sensitivity to biomechanical conditioning indicates that the transitory force decrease is dependent on disturbances in the force transmission predominantly by collagen surrounding active muscle fibres.

Forearm muscular strength and performance fatigability in orthopaedic surgeons when performing bone screw fixations

This study investigated the muscle strength and performance fatigability of the forearms in eight male orthopaedic surgeons when performing bone screw fixations. Each surgeon performed an eight-bone screws operations in a porcine femur model to simulate fractural fixation using plating technique. The pre- and post-fatigue maximum isometric forces and corresponding electromyography responses were measured to assess the forearm muscle strength loss and fatigue due to screwing. Results showed that after eight bone screws were inserted, the maximal grip force, maximal driving torque and maximal push force losses were approximately 29%, 20% and 23%, respectively. While the grip force and/or driving torque acting, both the brachioradialis and extensor carpi ulnaris had a higher percentage change of EMG than the biceps brachii. The driving forces decreased with the number of screw insertions; however, the insertion time increased parabolically with the number of screws and significantly decreased the insertion rate of the screws, indicating that forearm muscle fatigue may occur in surgeons who treat fracture fixation using more than eight bone screws.

Immediate Effect of Balance Taping Using Kinesiology Tape on Dynamic and Static Balance after Ankle Muscle Fatigue

The objective of this study was to investigate whether ankle balance taping (ABT) applied after muscle fatigue-inducing exercise can cause immediate improvements in dynamic and static balance. A total of 31 adults (16 males and 15 females) met the inclusion criteria. The experiment was designed using a single-blinded, randomized controlled trial. Changes in static and dynamic balance were measured before and after inducing muscle fatigue in the ankles and after ABT or ankle placebo taping (APT). After ankle muscle fatigue-inducing exercise, both the ABT and APT groups showed significant increases in surface area ellipses in the static state with eyes open (p < 0.05), and significant increases in surface area ellipses in the static and dynamic states with eyes closed (both p < 0.05). After taping of the fatigued ankle, surface area ellipses decreased significantly when eyes were open and closed in the static and dynamic states, but only in the ABT group (p < 0.05). Static balance was significantly different between groups (eyes open, 36.2 ± 86; eyes closed, 22.9 ± 46.7). Dynamic balance was significantly different between groups (eyes open, 68.6 ± 152.1; eyes closed, 235.8 ± 317.6). ABT may help prevent ankle injuries in individuals who experience muscle fatigue around the ankles after sports and daily activities.

Exceeding a "critical" muscle Pi: implications for [Formula: see text] and metabolite slow components, muscle fatigue and the power-duration relationship

PURPOSE

The consequences of the assumption that the additional ATP usage, underlying the slow component of oxygen consumption ([Formula: see text]) and metabolite on-kinetics, starts when cytosolic inorganic phosphate (P_i) exceeds a certain "critical" P_i concentration, and muscle work terminates because of fatigue when P_i exceeds a certain, higher, "peak" P_i concentration are investigated.

METHODS

A previously developed computer model of the myocyte bioenergetic system is used.

RESULTS

Simulated time courses of muscle [Formula: see text], cytosolic ADP, pH, PCr and P_i at various ATP usage activities agreed well with experimental data. Computer simulations resulted in a hyperbolic power-duration relationship, with critical power (CP) as an asymptote. CP was increased, and phase II [Formula: see text] on-kinetics was accelerated, by progressive increase in oxygen tension (hyperoxia).

CONCLUSIONS

P_i is a major factor responsible for the slow component of the [Formula: see text] and metabolite on-kinetics, fatigue-related muscle work termination and hyperbolic power-duration relationship. The successful generation of experimental system properties suggests that the additional ATP usage, underlying the slow component, indeed starts when cytosolic P_i exceeds a "critical" P_i concentration, and muscle work terminates when P_i exceeds a "peak" P_i concentration. The contribution of other factors, such as cytosolic acidification, or glycogen depletion and central fatigue should not be excluded. Thus, a detailed quantitative unifying mechanism underlying various phenomena related to skeletal muscle fatigue and exercise tolerance is offered that was absent in the literature. This mechanism is driven by reciprocal stimulation of P_i increase and additional ATP usage when "critical" P_i is exceeded.

Inverse Correlation Between Grip Strength and Serum Phosphorus: A Retrospective Observational Study in Japanese Elderly with Poorly Controlled Type 2 Diabetes

The aim of this study was to investigate factors associated with sarcopenia among elderly patients with poorly controlled diabetes mellitus (DM). We retrospectively analyzed 41 patients with type 2 DM, aged ≥65 years who required diabetes education hospitalization. Patients were classified into two groups according to the presence or absence of a weakened hand grip, and clinical characteristics were compared. Patients with a weakened hand grip (n = 21) scored worse on a mini-mental state examination (24.3 vs. 26.5, p = 0.04), showed a higher prevalence of diabetic peripheral neuropathy (76% vs. 40%, p = 0.03), and had a higher serum phosphorus concentration (3.8 vs. 3.3 mg/dL, p < 0.01) compared to those without a weakened hand grip (n = 20). The serum phosphorus concentration was inversely correlated to hand grip strength (r = -0.501, p < 0.001) among the total of 41 patients. This inverse association was also confirmed after adjusting the effects of estimated glomerular filtration rate, age, and glycated hemoglobin. Thus, cognitive impairment, diabetic peripheral neuropathy, and high serum phosphorus concentrations are associated with hand grip weakness in elderly patients with type 2 DM.

Exhaustion of Skeletal Muscle Fibers Within Seconds: Incorporating Phosphate Kinetics Into a Hill-Type Model

Initiated by neural impulses and subsequent calcium release, skeletal muscle fibers contract (actively generate force) as a result of repetitive power strokes of acto-myosin cross-bridges. The energy required for performing these cross-bridge cycles is provided by the hydrolysis of adenosine triphosphate (ATP). The reaction products, adenosine diphosphate (ADP) and inorganic phosphate (P i ), are then used-among other reactants, such as creatine phosphate-to refuel the ATP energy storage. However, similar to yeasts that perish at the hands of their own waste, the hydrolysis reaction products diminish the chemical potential of ATP and thus inhibit the muscle's force generation as their concentration rises. We suggest to use the term "exhaustion" for force reduction (fatigue) that is caused by combined P i and ADP accumulation along with a possible reduction in ATP concentration. On the basis of bio-chemical kinetics, we present a model of muscle fiber exhaustion based on hydrolytic ATP-ADP-P i dynamics, which are assumed to be length- and calcium activity-dependent. Written in terms of differential-algebraic equations, the new sub-model allows to enhance existing Hill-type excitation-contraction models in a straightforward way. Measured time courses of force decay during isometric contractions of rabbit M. gastrocnemius and M. plantaris were employed for model verification, with the finding that our suggested model enhancement proved eminently promising. We discuss implications of our model approach for enhancing muscle models in general, as well as a few aspects regarding the significance of phosphate kinetics as one contributor to muscle fatigue.

Immediate effect of patellar kinesiology tape application on quadriceps peak moment following muscle fatigue: A randomized controlled study

OBJECTIVE

To investigate the immediate effect of horseshoe taping for patellar superior and inferior gliding (HTPSG and HTPIG, respectively) using kinesiology tape on the peak moment of fatigued quadriceps.

METHODS

Twenty-eight adults were divided into the HTPSG (experimental) and HTPIG (control) groups. The peak moment of the dominant quadriceps of the participants was measured using Biodex System 4 prior to the experiment and after inducing quadriceps fatigue. The peak moment of the quadriceps was measured after separate application of HTPSG and HTPIG using kinesiology tape.

RESULTS

After kinesiology tape application, the peak moment of the quadriceps muscle was significantly increased in both groups (p<.05); however, the peak moment of the fatigued quadriceps muscle was significantly higher in the HTPSG group than in the HTPIG group (p<.05).

CONCLUSIONS

The application of HTPSG using kinesiology tape would more be helpful for immediate recovery after exercise-induced quadriceps fatigue.

Impact of stimulation frequency on neuromuscular fatigue

PURPOSE

The aim of the present study was to examine the frequency effects (20 Hz and 100 Hz) on neuromuscular fatigue using stimulation parameters favoring an indirect motor unit recruitment through the afferent pathway.

METHODS

Nineteen subjects were divided into two groups: 20 Hz (n = 10) and 100 Hz (n = 9). The electrical stimulation session consisted of 25 stimulation trains (20 s ON/20 s OFF, pulse width: 1 ms) applied over the tibial nerve and delivered at an intensity evoking 10% maximal voluntary isometric contraction (MVIC). Before and after these protocols, MVIC was assessed, while neural changes were evaluated by the level of activation (VAL) and muscle changes were evaluated by the twitch associated with the maximal M-wave (Pt). For all stimulation trains, the real and the theoretical values of the torque-time integral (TTIr and TTIth, respectively) were calculated. The TTIr/TTIth ratio of the first train was calculated to evaluate the presence of extra torque.

RESULTS

The main results showed a similar decrease in MVIC torque after both protocols accompanied by neural and muscle changes, as evidenced by the decrease in VAL and Pt. TTIr values across the 20-Hz trains remained constant, whereas they significantly decreased during the 100-Hz stimulation trains. The relative MVIC decrease was negatively correlated with TTIr/TTIth.

CONCLUSION

Results give evidence of an identical neuromuscular fatigue development between protocols, while lower stimulation frequency permitted preservation of a given torque level during the stimulation trains. The negative correlation between this fatigue development and TTIr/TTIth suggests that extra torque production induces greater voluntary torque losses.

The impact of lactic acid and medium chain triglyceride on blood glucose, lactate and diurnal motor activity: A re-examination of a treatment of major depression using lactic acid

While investigating the effect of alternative energy substrates on extracellular brain glucose or lactate, Béland-Millar (2017) noted a reduction of physical activity after intraperitoneal administration of lactate and ketone bodies. These observations were similar to an older study that examined the impact of drinking a sodium lactate/lactic acid solution before sleep in hospitalized patients with major depression. Patients and control participants self-reported drowsiness, early sleep onset and better overall sleep after consumption. Some patients showed improved mood after several days of treatment. We re-evaluated the effects of the solution used (0.59 g/kg) as well as several smaller doses (0.47, 0.35, 0.24 and 0.12 g/kg) on blood lactate and glucose in CD-1 mice and on sleep onset associated activity reduction. Because of adverse effects with the lactate/lactic acid solution, we also examined the effects of a medium chain triglyceride (MCT) solution (10, 5, 2.5, and 1 ml/kg) on blood lactate and glucose. Oral gavage administration of lactic acid/lactate produced adverse effects particularly for the largest doses. However consumption of 10 and 5 ml/kg volumes of MCT oils significantly increased blood lactate concentration to levels comparable to Lowenbach's solution without piloerection indicative of adverse effects. To evaluate pre-sleep activity reduction produced by lactate, mice were intraperitoneally administered diluted sodium lactate (2.0 g/kg, 1.0 g/kg, 0.5 g/kg, 0.25 g/kg, or saline) for 6 days, 120 min before their sleep period and their running activity was measured. Larger lactate doses reduced pre-sleep running each day up to 60 min post injection. Smaller doses reduced running after a single treatment only. These results suggest that the modulation of blood lactate levels may be useful in treating sleep onset problems associated with depression.

Pi-induced muscle fatigue leads to near-hyperbolic power-duration dependence

PURPOSE

Consequences of combining three ideas proposed previously by other authors: (1) that there exists a critical power (CP), above which no steady state in [Formula: see text]O₂ (oxygen consumption) and metabolites can be achieved in voluntary constant-power exercise; (2) that muscle fatigue is related to decreased exercise efficiency (increased [Formula: see text]O₂/power output ratio); and (3) that P_i (inorganic phosphate) is the main fatigue-related metabolite are investigated.

METHODS

A previously-developed computer model of the skeletal muscle bioenergetic system is used. It was assumed in computer simulations that skeletal muscle work terminates when cytosolic P_i (inorganic phosphate) exceeds a certain critical level.

RESULTS

Simulated changes in muscle [Formula: see text]O₂, cytosolic ADP, pH, PCr and P_i as a function of time at various ATP usage activities (corresponding to power outputs) agreed well with experimental data. Computer simulations resulted in a fourth previously-published idea: (4) that the power-duration relationship describing the dependence of power output (PO) on the time to exhaustion of voluntary constant-power exercise at a given PO has a (near-)hyperbolic shape.

CONCLUSIONS

P_i is a major factor contributing to muscle fatigue, as such an assumption leads to a (near-)hyperbolic shape of the power-duration relationship, at least for exercise duration of ~ 1-10 min. Thus, a potential mechanism underlying the power-duration relationship shape is offered that was absent in the literature. Other factors/mechanisms, such as cytosol acidification, glycogen stores depletion and central fatigue can contribute to this relationship, especially in longer exercises.

Influence of adiposity and fatigue on the scapular muscle recruitment order

Background

Several authors have indicated that excess body weight can modify the electromyographic (EMG) amplitude due to the accumulation of subcutaneous fat. This accumulation of adipose tissue around the muscle would affect the metabolic capacity during functional activities. On the other hand, some authors have not observed differences in the myoelectric manifestations of fatigue between normal weight and obese people. Furthermore, these manifestations have not been investigated regarding EMG onset latency, which indicates a pattern of muscle activation between different muscles. The objective of this study was to determine whether an increase in body weight, skinfolds, and muscle fatigue modify the trapezius and serratus anterior (SA) onset latencies and to determine the scapular muscle recruitment order in fatigue and excess body weight conditions.

Methods

This cross-sectional study was carried out in a university laboratory. The participants were randomly assigned to the no-fatigue group (17 participants) or the fatigue (17 participants) group. The body mass index, skinfold thickness (axillary, pectoral, and subscapular), and percentage of body fat were measured. In addition, the onset latency of the scapular muscles [lower trapezius (LT), middle trapezius (MT), upper trapezius (UT), and SA] was assessed by surface EMG during the performance of a voluntary arm raise task. A multiple linear regression model was adjusted and analyzed for the additive combination of the variables, percentage body fat, skinfold thickness, and fatigue. The differences in onset latency between the scapular muscles were analyzed using a three-way repeated measure analysis of variance. In all the tests, an alpha level <0.05 was considered statistically significant.

Results

For the MT, LT, and SA onset latencies, the body mass index was associated with a delayed onset latency when it was adjusted for the additive combination of percentage of body fat, skinfold thickness, and fatigue. Of these adjustment factors, the subscapular skinfold thickness (R ² = 0.51; β = 10.7; p = 0.001) and fatigue (R ² = 0.86; β = 95.4; p = 0.001) primarily contributed to the increase in SA onset latency. A significant muscle ×body mass index ×fatigue interaction (F = 4.182; p = 0.008) was observed. In the fatigue/excess body weight condition, the UT was activated significantly earlier than the other three scapular muscles (p < 0.001) and SA activation was significantly delayed compared to LT (p < 0.001).

Discussion

Excess body weight, adjusted for skinfold thickness (axillary and subscapular) and fatigue, increases the onset latency of the MT, LT, and SA muscles and modifies the recruitment order of scapular muscles. In fact, the scapular stabilizing muscles (MT, LT, and SA) increase their onset latency in comparison to the UT muscle. These results were not observed when excess body weight was considered as an individual variable or when adjusted by the percentage body fat.

Activin type IIB receptor blockade does not limit adenosine triphosphate supply in mouse skeletal muscle in Vivo

INTRODUCTION

Postnatal activin/myostatin type IIB receptor (ActRIIB) blockade increases skeletal muscle mass and strength but also increases muscle fatigability and impairs oxidative metabolism. The objective of this study was to determine in vivo whether this increased fatigability is due to energy supply limitation.

METHODS

The impact of 8-week ActRIIB blockade with soluble receptor (sActRIIB-Fc) on muscle function and adenosine triphosphate (ATP) fluxes was investigated noninvasively by using multimodal magnetic resonance and indirect calorimetry measurements in wild-type mice.

RESULTS

Activin/myostatin type IIB receptor blockade reduced (-41%) the muscle apparent mitochondrial capacity and increased (+11%) the basal body energy expenditure. During a fatiguing exercise, ActRIIB blockade decreased both oxidative ATP production rate (-32%) and fatigue resistance (-36%), but these changes affected neither the total ATP production rate nor the contractile ATP cost.

DISCUSSION

These findings demonstrate that the increased fatigability after ActRIIB blockade is not due to limitation in energy supply and/or disturbance in contractile ATP cost. Muscle Nerve 58:834-842, 2018.

Bioenergetic basis of skeletal muscle fatigue

Energetic demand from high-intensity exercise can easily exceed ATP synthesis rates of mitochondria leading to a reliance on anaerobic metabolism. The reliance on anaerobic metabolism results in the accumulation of intracellular metabolites, namely inorganic phosphate (P_i) and hydrogen (H⁺), that are closely associated with exercise-induced reductions in power. Cellular and molecular studies have revealed several steps where these metabolites impair contractile function demonstrating a causal role in fatigue. Elevated P_i or H⁺ directly inhibits force and power of the cross-bridge and decreases myofibrillar Ca²⁺ sensitivity, whereas P_i also inhibits Ca²⁺ release from the sarcoplasmic reticulum (SR). When both metabolites are elevated, they act synergistically to cause marked reductions in power, indicating that fatigue during high-intensity exercise has a bioenergetic basis.

Pre-Exercise Rehydration Attenuates Central Fatigability during 2-Min Maximum Voluntary Contraction in Hyperthermia

Background and objectives: Hyperthermia with dehydration alters several brain structure volumes, mainly by changing plasma osmolality, thus strongly affecting neural functions (cognitive and motor). Here, we aimed to examine whether the prevention of significant dehydration caused by passively induced whole-body hyperthermia attenuates peripheral and/or central fatigability during a sustained 2-min isometric maximal voluntary contraction (MVC). Materials and Methods: Ten healthy and physically active adult men (21 ± 1 years of age) performed an isometric MVC of the knee extensors for 2 min (2-min MVC) under control (CON) conditions, after passive lower-body heating that induced severe whole-body hyperthermia (HT, T_re > 39 °C) with dehydration (HT-D) and after HT with rehydration (HT-RH). Results: In the HT-D trial, the subjects lost 0.94 ± 0.15 kg (1.33% ± 0.13%) of their body weight; in the HT-RH trial, their body weight increased by 0.1 ± 0.42 kg (0.1% ± 0.58%). After lower-body heating, the HT-RH trial (vs. HT-D trial) was accompanied by a significantly lower physiological stress index (6.77 ± 0.98 vs. 7.40 ± 1.46, respectively), heart rate (47.8 ± 9.8 vs. 60.8 ± 13.2 b min⁻¹, respectively), and systolic blood pressure (−12.52 ± 5.1 vs. +2.3 ± 6.4, respectively). During 2-min MVC, hyperthermia (HT-D; HT-RH) resulted in greater central fatigability compared with the CON trial. The voluntary activation of exercising muscles was less depressed in the HT-RH trial compared with the HT-D trial. Over the exercise period, electrically (involuntary) induced torque decreased less in the HT-D trial than in the CON and HT-RH trials. Conclusions: Our results suggest that pre-exercise rehydration might have the immediate positive effect of reducing physiological thermal strain, thus attenuating central fatigability even when exercise is performed during severe (T_re > 39 °C) HT, induced by passive warming of the lower body.

Elongated mitochondrial constrictions and fission in muscle fatigue

Mitochondria respond to stress and undergo fusion and fission at variable rates, depending on cell status. To understand mitochondrial behavior during muscle fatigue, we investigated mitochondrial ultrastructure and expression levels of a fission- and stress-related protein in fast-twitch muscle fibers of mice subjected to fatigue testing. Mice were subjected to running at increasing speed until exhaustion at 45 min-1 h. In further experiments, high-intensity muscle stimulation through the sciatic nerve simulated the forced treadmill exercise. We detected a rare phenotype characterized by elongated mitochondrial constrictions (EMCs) connecting two separate segments of the original organelles. EMCs are rare in resting muscles and their frequency increases, albeit still at low levels, in stimulated muscles. The constrictions are accompanied by elevated phosphorylation of Drp1 (Dnm1l) at Ser 616, indicating an increased translocation of Drp1 to the mitochondrial membrane. This is indicative of a mitochondrial stress response, perhaps leading to or facilitating a long-lasting fission event. A close apposition of sarcoplasmic reticulum (SR) to the constricted areas, detected using both transmission and scanning electron microscopy, is highly suggestive of SR involvement in inducing mitochondrial constrictions.

ESTIMATING FATIGUE LEVEL OF FEMORAL AND GASTROCEMIUS MUSCLES BASED ON SURFACE ELECTROMYOGRAPHY IN TIME AND FREQUENCY DOMAIN

This paper presents a new method for estimating muscle fatigue level based on surface electromyography (EMG) of femoral and gastrocnemius muscles during repetitive motions with various load. The relationship between fatigue level and EMG signals was examined through repetitive movements of the femoral and gastrocnemius muscles with the use of leg extension and squat machines. The fatigue level was based on the maximum voluntary contraction (MVC) levels with various loads. The integrated EMG (IEMG) value and the mean frequency value for each load cycle were obtained through the surface EMG signal. This work presents a global EMG index map by using the new analytical technique based on the relationship between the average IEMG and mean power frequency (MPF) values. The proposed method enables simultaneous estimation of muscle fatigue level and force using real-time EMG signals from the femoral and gastrocnemius muscles.