After-effects of repetitive stimulation at low frequency on fast-contracting motor units of cat muscle

Acute and prolonged competing effects of activation history on human motor unit firing rates during contractile impairment and recovery

The purpose of this study was to investigate the effect of inducing post-activation potentiation (PAP) during prolonged low-frequency force depression (PLFFD) on motor unit (MU) firing rates. In 10 participants, grouped firing rates of 3027 MUs from the tibialis anterior were recorded with tungsten microelectrodes. Baseline MU firing rates at 25% isometric maximal voluntary contraction (MVC) were ∼14 Hz. A 1 min dorsiflexion MVC reduced torque and maximal MU firing rates (36 Hz) by 49% and 52%, respectively. Following task completion, firing rates at 25% of baseline MVC torque and torque in response to electrically evoked (single twitch, 10 Hz and 50 Hz) stimulation were assessed before and after a 5 s MVC (to induce PAP) every 10 min for 60 min. From 10 to 60 min after task completion, the torque ratios (twitch:50 Hz and 10:50 Hz) were depressed (∼30%) relative to baseline (P < 0.001), indicating PLFFD; and firing rates were higher by ∼15% relative to baseline (P < 0.001). This occurred despite recovery of MVC rates (∼99%) and torque (∼95%) by 10 min (P > 0.3). Inducing PAP during PLFFD increased both low to high torque ratios (twitch and 10:50 Hz) by ∼200% and ∼135%, respectively (P < 0.001) and firing rates were ∼18% lower relative to PLFFD rates (P < 0.001), despite a speeding of evoked contractile properties (P = 0.001). Thus, firing rates appear strongly matched to alterations in torque, rather than contractile speed when modified by contractile history, and lower rates during PAP may be a mechanism to mitigate effects of PLFFD. The effect of activation history on contractile function demonstrates acute compensatory responses of motoneuron output. KEY POINTS: Prolonged low frequency force depression (PLFFD) following a sustained 1 min isometric maximal voluntary contraction causes an increase in submaximal mean motor unit (MU) firing rates. Inducing post-activation potentiation (PAP) during PLFFD, however, causes a reduction in mean submaximal MU firing rates to a level below those at baseline. The mean firing rate reduction during PAP occurs despite a speeding of evoked contractile properties and thus firing rates are more strongly matched to alterations in torque, rather than contractile speed when modified by various contractile histories. The reductions in firing rates during PAP may mitigate the effects of PLFFD during voluntary contractions. These results demonstrate that firing rates are highly responsive to opposing influences on the contractile state and can make rapid compensatory rate adjustments dependent on the active state of the muscle.

Frequency dependent coexistence of muscle fatigue and potentiation assessed by concentric isotonic contractions in human plantar flexors

The purpose was to investigate whether post-activation potentiation (PAP) mitigates power (i.e., torque x angular velocity) loss during dynamic fatiguing contractions and subsequent recovery by enhancing either muscle torque or angular velocity in human plantar flexors. In 12 participants, electrically stimulated (1, 10 and 50 Hz) dynamic contractions were done during a voluntary isotonic fatiguing protocol (20 and 50% voluntary decreases) until a 75% loss in voluntary peak power, and throughout 30 minutes of recovery. At the initial portion of fatigue (20% decrease), power responses of evoked low frequencies (1 and 10 Hz) were enhanced due to PAP (156 and 137%, respectively, P<0.001), while voluntary maximal efforts were depressed due to fatiguing mechanisms. Following the fatiguing task, prolonged low-frequency force depression (PLFFD) was evident by reduced 10:50 Hz peak power ratios (21 - 24%) from 3-min onwards during the 30-min recovery (P<0.005). Inducing PAP with maximal voluntary contractions during PLFFD enhanced the peak power responses of low frequencies (1 and 10 Hz) by 128 - 160 %, P<0.01. This PAP response mitigated the effects of PLFFD as the 1:50 (P<0.05) and 10:50 (P>0.4) Hz peak power ratios were greater or not different from the pre-fatigue values. Additionally, PAP enhanced peak torque more than peak angular velocity during both baseline and fatigue measurements (P<0.03). These results indicate that PAP can ameliorate PLFFD acutely when evaluated during concentric isotonic contractions and that peak torque is enhanced to a greater degree compared to peak angular velocity at baseline and in a fatigued state.

Firing rate trajectories of human motor units during activity-dependent muscle potentiation

During activity-dependent potentiation (ADP) motor unit firing rates (MUFRs) are lower, however, the mechanism for this response is not known. During increasing torque isometric contractions at low contraction intensities, MUFR trajectories initially accelerate and saturate demonstrating a non-linear response due to the activation of persistent inward currents (PICs) at the motoneuron. The purpose was to assess whether PICs are a factor in the reduction of MUFRs during ADP. To assess this, MUFR trajectories were fit with competing functions of linear regression and a rising exponential (i.e., acceleration and saturation). Using fine-wire electrodes, discrete MU potential trains were recorded in the tibialis anterior during slowly increasing dorsiflexion contractions to 10% of maximal voluntary contraction following both voluntary (post-activation potentiation; PAP) and evoked (post-tetanic potentiation; PTP) contractions. In 8 participants, 25 MUs were recorded across both ADP conditions and compared to the control with no ADP effect. During PAP and PTP, the average MUFRs were 16.4% and 9.2% lower (both P≤ 0.001), respectively. More MUFR trajectories were better fit to the rising exponential during control (16/25) compared to PAP (4/25, P<0.001) and PTP (8/25, P=0.03). The MU samples that had a rising exponential MUFR trajectory during PAP and PTP displayed an ~11% lower initial acceleration compared to control (P<0.05). Thus, synaptic amplification and MUFR saturation due to PIC properties are attenuated during ADP regardless of the type of conditioning contraction. This response may contribute to lower MUFRs and likely occurred because synaptic input is reduced when contractile function is enhanced.

Lack of Evidence for Non-Local Muscle Fatigue and Performance Enhancement in Young Adults

Post-activation performance enhancement (PAPE) is an improvement to voluntary muscle performance following a conditioning activity. There is evidence of fatigue resistance deficits in non-exercised muscles following unilateral fatiguing exercise of a contralateral muscle. The purpose of this study was to determine if a unilateral conditioning exercise protocol could induce PAPE in a contralateral, non-exercised muscle in young healthy adults. Thirty-two recreationally trained (n = 16) and athletically trained (n = 16) participants (16 males; age: 22.9 ± 2.03 years; height: 1.81 ± 0.06 m; weight: 82.8 ± 9.43 kg, and 16 females; age: 23.1 ± 2.80 years; height: 1.67 ± 0.07 m; weight: 66.4 ± 11.09 kg) were randomly allocated into two groups (dominant or non-dominant limb intervention). The experimental intervention, involved a conditioning exercise (4-repetitions of 5-seconds knee extension maximal voluntary isometric contractions: MVIC) with either the dominant (DOM) (n = 16) or non-dominant (ND) (n = 16) knee extensors with testing of the same (exercised) or contralateral (non-exercised) leg as well as a control (no conditioning exercise: n = 32) condition. Testing was performed before, 1-minute and 10-minutes after a high intensity, low volume, conditioning protocol (2 sets of 2x5-s MVIC). Pre- and post-testing included MVIC force and F100 (force developed in the first 100 ms: a proxy measure of rate of force development) and unilateral drop jump (DJ) height and contact time. There were no significant MVIC peak force or EMG nor DJ height or contact time interactions (intervention x limb dominance x time). The pre-test (0.50 ± 0.13) dominant leg MVIC F100 forces exceeded (p = 0.02) both post-test and post-10 min by a small magnitude 8.7% (d = 0.31). There was also a significant (p = 0.02) time x intervention leg x testing leg intervention, although it was observed that the control condition was as likely to demonstrate small to large magnitude changes as were the dominant and non-dominant legs. Following the conditioning activity, there was no significant evidence for non-local improvements (PAPE), or performance decreases.

Response to Three Weeks of Sprint Interval Training Cannot Be Explained by the Exertional Level

Background and Objectives: The all-out mode of sprint interval training (SIT) has been shown to be an efficient method for improving sports performance, exercise capacity, and aerobic fitness. Although the benefits of SIT are well described, the mechanisms underlying the different degrees of response remain largely unexplored. We aimed to assess the effects of exertion on the responsiveness to SIT. Materials and Methods: The participants were 28 young untrained men (mean ± SD age 25.7 ± 6.03 years) who exhibited either a large or small increase in Wingate test average power in response to nine SIT sessions performed over three weeks. Each training session comprised four-six bouts of 30 s all-out cycling interspaced with 4 min of rest. Individual responses were assessed using heart rate (HR) during exercise for all nine sessions, as well as blood lactate concentration up to 1 h, and the decrement in maximal voluntary knee extension torque (MVC) up to 24 h after the first and last training sessions. Peak oxygen uptake (VO₂peak) and maximum HR were measured before and after training during an incremental cycling test to exhaustion. Results: Although all participants showed benefits of SIT such as increased VO₂peak, the increase in anaerobic cycling power varied between participants. We identified 17 high responders and nine low responders, whose average power outputs were 0.80 ± 0.22 and 0.22 ± 0.19 W/kg, respectively. The HR achieved during any of the training sessions did not differ between high and low responders. The lactate kinetics did not differ between groups before and after the intervention. Training resulted in a more rapid recovery of MVC without any discernible differences between the high and low responders. Conclusion: The differences in the responses to SIT are not dependent on the exertion level during training.

Distributed stimulation increases force elicited with functional electrical stimulation

OBJECTIVE

The maximum muscle forces that can be evoked using functional electrical stimulation (FES) are relatively modest. The reason for this weakness is not fully understood but could be partly related to the widespread distribution of motor nerve branches within muscle. As such, a single stimulating electrode (as is conventionally used) may be incapable of activating the entire array of motor axons supplying a muscle. Therefore, the objective of this study was to determine whether stimulating a muscle with more than one source of current could boost force above that achievable with a single source.

APPROACH

We compared the maximum isometric forces that could be evoked in the anterior deltoid of anesthetized monkeys using one or two intramuscular electrodes. We also evaluated whether temporally interleaved stimulation between two electrodes might reduce fatigue during prolonged activity compared to synchronized stimulation through two electrodes.

MAIN RESULTS

We found that dual electrode stimulation consistently produced greater force (~50% greater on average) than maximal stimulation with single electrodes. No differences, however, were found in the fatigue responses using interleaved versus synchronized stimulation.

SIGNIFICANCE

It seems reasonable to consider using multi-electrode stimulation to augment the force-generating capacity of muscles and thereby increase the utility of FES systems.

Modulation of Skeletal Muscle Contraction by Myosin Phosphorylation

The striated muscle sarcomere is a highly organized and complex enzymatic and structural organelle. Evolutionary pressures have played a vital role in determining the structure-function relationship of each protein within the sarcomere. A key part of this multimeric assembly is the light chain-binding domain (LCBD) of the myosin II motor molecule. This elongated "beam" functions as a biological lever, amplifying small interdomain movements within the myosin head into piconewton forces and nanometer displacements against the thin filament during the cross-bridge cycle. The LCBD contains two subunits known as the essential and regulatory myosin light chains (ELC and RLC, respectively). Isoformic differences in these respective species provide molecular diversity and, in addition, sites for phosphorylation of serine residues, a highly conserved feature of striated muscle systems. Work on permeabilized skeletal fibers and thick filament systems shows that the skeletal myosin light chain kinase catalyzed phosphorylation of the RLC alters the "interacting head motif" of myosin motor heads on the thick filament surface, with myriad consequences for muscle biology. At rest, structure-function changes may upregulate actomyosin ATPase activity of phosphorylated cross-bridges. During activation, these same changes may increase the Ca2+ sensitivity of force development to enhance force, work, and power output, outcomes known as "potentiation." Thus, although other mechanisms may contribute, RLC phosphorylation may represent a form of thick filament activation that provides a "molecular memory" of contraction. The clinical significance of these RLC phosphorylation mediated alterations to contractile performance of various striated muscle systems are just beginning to be understood. © 2017 American Physiological Society. Compr Physiol 7:171-212, 2017.

Detection and prediction of FES-induced fatigue

The estimation of externally elicited muscle forces is important for the better control of a functional electrical stimulation (FES)-assistive system. Various techniques of signal processing are presented, all with only one aim, to determine the correlation between the decrease of muscle force after continuous stimulation and surface recordings of the evoked potentials. Wrist flexor muscles were stimulated under isometric conditions, and surface electromyography (sEMG) was used to record wrist joint torque in both able-bodied and spinal cord injured volunteers. The joint torque was determined from recordings of the force generated by the wrist flexors, with the forearm immobilized. The sEMG was recorded utilizing a preamplifier with a stimulation artefact suppression circuitry. The signal was processed in the time and frequency domains, and analysed vs time, as well as in the state space formed by the wrist torque and evoked potential. The torque vs sEMG curves were used to establish the relationship that can be used for detection of the decrease of the force associated with FES-induced muscle fatigue. Among seven different techniques of sEMG processing the best correlation was found between the median frequency and force changes. The phase plane plot was fitted with an exponential curve, and the parameters obtained from the fitting were used to determine two events: prediction of the onset of fatigue and detection of fatigue. This suggests that it is possible to use the processed sEMG as a trigger signal to change the pattern of stimulation and allow the muscle to recover while resting, or to inform the user that the muscle force will soon drop rapidly. The recovery of the muscle force and sEMG was also analysed to learn more about the mechanisms that may be responsible for FES-induced fatigue. This technique offers simple on-off type feedback capability for fatigue detection in FES applications.

The effects of fatigue on the torque-frequency curve of the human paralysed soleus muscle

An advanced understanding of the torque-generating properties of the chronically paralysed soleus muscle may be instrumental in developing improved methods to activate human paralysed muscle. We established the shape of the torque-frequency curve before and after fatigue of the human paralysed soleus muscle. After fatigue, the normalized torque-frequency curve was shifted to the right, suggesting a higher frequency was required to generate the same relative torque. Low frequency fatigue (LFF) consisting of reduced torques at low frequencies and normal torques at higher frequencies was demonstrated. Conversely, the acutely paralysed soleus muscle was found to be fatigue-resistant and showed no shift in the torque-frequency curve. The muscle activation history (potentiation), LFF, and changing contractile speeds may affect the torque-frequency curve after fatigue. These factors may also play an important role in the development of optimal methods to activate paralysed muscle to attenuate fatigue.

Postactivation potentiation and muscular endurance training

INTRODUCTION

The aim of this study was to investigate muscle twitch force potentiation after voluntary conditioning contractions (CC) of various intensities and the CC duration necessary to achieve maximal potentiation before and after muscular endurance training.

METHODS

Fourteen healthy men and women (23.6 ± 0.96 years of age) performed repeated CCs of 25%, 50%, and 100% maximal voluntary contraction of the adductor pollicis muscle until maximal potentiation. CCs were followed by electrically evoked twitches. The training group performed a fatigue task and endurance trained for 8 weeks.

RESULTS

Endurance time increased by 79.8 ± 22.5% posttraining. Potentiation occurred after all CC intensities and was greater after training. The CC duration needed to achieve maximal potentiation decreased as CC intensity increased. Potentiation was greater during the fatigue task after compared to before training and was correlated with endurance time.

CONCLUSION

An increase in muscle force potentiation may function as a mechanism to prolong muscular endurance.

Effects of chronic sepsis on contractile properties of fast twitch muscle in an experimental model of critical illness neuromyopathy in the rat

OBJECTIVE

Critical illness polyneuromyopathy has been extensively studied in various animal models regarding electrophysiological aspects or molecular mechanisms involved in its physiopathology; however, little data are available on its main clinical feature, that is, muscular weakness. We have studied the effects of chronic sepsis in rats with special consideration to contractile and neuromuscular blockade properties in relation with the level of messenger RNA (mRNA) coding for ryanodine and acetylcholine receptors.

DESIGN

This was an experimental animal study.

SETTING

This study was conducted at a university laboratory.

SUBJECTS

Subjects consisted of Wistar rats.

INTERVENTIONS

Chronic sepsis was achieved by cecal ligation and needle perforation. Ten days after surgery, fast twitch extensor digitorum longus was excised for extraction and assays of mRNA coding for ryanodine and acetylcholine receptor subunits and contralateral muscle was tested in vivo on a mechanical bench. A fatigability index was measured and neuromuscular blockade properties using atracurium were evaluated.

MEASUREMENTS AND MAIN RESULTS

A decrease in active force developed by extensor digitorum longus associated with an increase in passive force is induced by chronic sepsis. Maximal force at optimal length during twitch contraction was significantly reduced (0.25 +/- 0.09 N vs. 0.17 +/- 0.06 N); contraction and relaxation speeds were higher as shown by the decrease of respective time constants (3.75 +/- 0.01 msec vs. 2.70 +/- 0.0 msec, 10.76 +/- 0.03 msec vs. 7.62 +/- 0.03 msec) in the control group compared with the septic group. Fatigability index was significantly lower (23 +/- 0.11% vs. 59 +/- 0.19%) in septic rats. These rats also showed quicker blockade and shorter recovery after atracurium administration. Sepsis induced a significant increase of the expression of ryanodine receptor (RyR) RyR1 along with a steady expression of RyR3 mRNA, leading to a 5.6-fold increase of RyR1/RyR3 ratio with a steadiness of mRNA corresponding to acetylcholine-receptors.

CONCLUSIONS

Chronic inflammation and sepsis induced a decrease in contractile performances of extensor digitorum longus along with accelerated kinetics of atracurium possibly induced by modified expression of RyR1 receptors and not acetylcholine-receptors.

Postfatigue potentiation of the paralyzed soleus muscle: evidence for adaptation with long-term electrical stimulation training

Understanding the torque output behavior of paralyzed muscle has important implications for the use of functional neuromuscular electrical stimulation systems. Postfatigue potentiation is an augmentation of peak muscle torque during repetitive activation after a fatigue protocol. The purposes of this study were 1) to quantify postfatigue potentiation in the acutely and chronically paralyzed soleus and 2) to determine the effect of long-term soleus electrical stimulation training on the potentiation characteristics of recently paralyzed soleus muscle. Five subjects with chronic paralysis (>2 yr) demonstrated significant postfatigue potentiation during a repetitive soleus activation protocol that induced low-frequency fatigue. Ten subjects with acute paralysis (<6 mo) demonstrated no torque potentiation in response to repetitive stimulation. Seven of these acute subjects completed 2 yr of home-based isometric soleus electrical stimulation training of one limb (compliance = 83%; 8,300 contractions/wk). With the early implementation of electrically stimulated training, potentiation characteristics of trained soleus muscles were preserved as in the acute postinjury state. In contrast, untrained limbs showed marked postfatigue potentiation at 2 yr after spinal cord injury (SCI). A single acute SCI subject who was followed longitudinally developed potentiation characteristics very similar to the untrained limbs of the training subjects. The results of the present investigation support that postfatigue potentiation is a characteristic of fast-fatigable muscle and can be prevented by timely neuromuscular electrical stimulation training. Potentiation is an important consideration in the design of functional electrical stimulation control systems for people with SCI.

Intraneural microstimulation of motor axons in the study of human single motor units

Single motor unit activity has been studied in depth since the first intramuscular electrodes were developed more than 70 years ago. Many techniques have been combined or used in isolation since then. Intraneural motor axon microstimulation allows the detailed study of single motor units in awake human subjects in a manner most analogous to that used in reduced animal preparations. A microelectrode, inserted percutaneously into a peripheral nerve, stimulates the axon of a single alpha-motoneuron at a site remote from the contracting muscle, allowing detailed analyses of the contractile properties of a single motor unit in an otherwise quiescent muscle, that is, without interference of simultaneously active motor units or the presence of an electrode within the muscle. The methods and results obtained using this technique are described and compared to those of other studies of single motor units in human subjects. Differences have been found between human and animal motor units and between motor units of various muscles. Studying human and animal motor units using an analogous technique provides insight into the interpretation of human data when results differ from animal data, and when human motor units cannot be examined in the same way, or at a similar level of detail, as animal motor units.

Interaction of fibre type, potentiation and fatigue in human knee extensor muscles

AIM

To examine the effect of fibre type on potentiation and fatigue.

METHODS

Young men (n = 4 per group) with a predominance of type I [61.4 +/- 6.9% (SD), group I (GI)] or type II [71.8 +/- 9.2%, group II (GII)] fibres in vastus lateralis, performed a fatigue protocol of sixteen 5-s maximal voluntary isometric contractions (MVCs) of the right knee extensors. Maximal twitches and corresponding muscle action potentials (M-waves) were evoked before the first MVC, during the 3-s rest period after each MVC and at intervals during the 5-min recovery period after the last MVC.

RESULTS

Group II [49.3 +/- 2.6% (SE)] had a greater decrease in MVC force than GI (22.8 +/- 6.2%) during the fatigue protocol. Group II (126.4 +/- 13.6%) showed greater twitch force potentiation early in the fatigue protocol than GI (38.2 +/- 2.3%), but greater depression at the end (33.7 +/- 13.7% vs.17.4 +/- 3.4%). Twitch time-to-peak torque (TPT) and half relaxation time (HRT) initially decreased but then increased as the fatigue protocol progressed; GII had a greater increase in HRT. During a 5-min recovery period twitch force increased above the prefatigue level and remained so until the end of the recovery period; the pattern was similar in GI and GII. Twitch TPT and HRT remained elevated during recovery. M-wave area increased throughout the fatigue protocol and the first part of recovery before returning to baseline values in GII, whereas there were no significant changes in GI. The interaction between potentiation and fatigue was amplified in GII early in the fatigue protocol with concurrently greater twitch and M-wave potentiation, and greater MVC force decrease and HRT increase. Late in the protocol, GII had a greater decrease in twitch and MVC force combined with greater M-wave potentiation.

CONCLUSION

It is concluded that fibre type distribution influences potentiation and fatigue of the twitch, and potentiation of the M-wave during fatiguing exercise.

Length-dependent twitch contractile characteristics of skeletal muscle

The length dependence of force development of mammalian skeletal muscles was evaluated during twitch, double-pulse, and tetanic contractions, and the relation between muscle length and the time-dependent characteristics of twitch and double-pulse contractions were determined. In situ isometric contractions of the rat gastrocnemius muscle were analyzed at seven different lengths, based on a reference length at which the maximal response to double-pulse contractions occurred (Lopt-2P). Twitch and double-pulse contractions were analyzed for developed tension (DT), contraction time (tC), average rate of force development (DT-tC(-1)), half-relaxation time (t50%R), peak rate of relaxation (DT x dtmin(-1)), and 90%-relaxation time (t90%R). Considering the length at which maximal tetanic DT occurred to be the optimal length (Lo-TET), the peak DT for twitch contractions and double-pulse contractions was observed at Lo-TET + 0.75 mm (p < 0.05) and Lo-TET + 0.1 mm (p > 0.05), respectively. When measured at the length for which maximal twitch and double-pulse contractions were obtained, tetanic DT was 95.2 +/- 3 and 99.0 +/- 2% of the maximal value, respectively. These observations suggest that double-pulse contractions are more suitable for setting length for experimental studies than twitch contractions. Twitch and double-pulse contraction tC were 15.53 +/- 1.14 and 25.0 +/- 0.6 ms, respectively, at Lopt-2P, and increased above Lopt-2P and decreased below Lopt-2P. Twitch t50%R was 12.18 +/- 0.90 ms at Lopt-2P, and increased above Lopt-2P and below Lopt-2P. Corresponding changes for double-pulse contractions were greater. Stretching the muscle leads to slower twitch contractions and double-pulse contractions, but the mechanisms of this change in time course remain unclear.

Factors in fatigue during intermittent electrical stimulation of human skeletal muscle

During an electrically elicited isometric contraction, the metabolic cost of attaining is greater than of maintaining force. Thus fatigue produced during such stimulation may not simply be a function of the force-time integral (FTI), as previously suggested. The goal of the present study was to evaluate fatigue produced in human medial gastrocnemius by intermittent, isometric electrical stimulation with trains of different frequencies (20, 40, or 80 Hz) and durations (300, 600, or 1,200 ms) that produced different peak forces and FTIs. Each subject (n = 10) participated in a total of six sessions. During each session, subjects received a pre- and postfatigue testing protocol and a different, 150-train fatiguing protocol. Each fatiguing protocol used only a single frequency and duration. The fatigue produced by the different protocols was correlated to the initial peak force of the fatiguing protocols (r2= 0.74-0.85) but not to the initial or total FTI. All of the protocols tested produced a proportionately greater impairment of force in response to low- vs. high-frequency stimulation (i.e., low-frequency fatigue). There was no effect of protocol on low-frequency fatigue, suggesting that all the protocols produced comparable levels of impairment in excitation-contraction coupling. These results suggest that, for brief stimulated contractions, peak force is a better predictor of fatigue than FTI, possibly because of the different metabolic demands of attaining and maintaining force.

Muscular, skeletal, and neural adaptations following spinal cord injury

Spinal cord injury is associated with adaptations to the muscular, skeletal, and spinal systems. Experimental data are lacking regarding the extent to which rehabilitative methods may influence these adaptations. An understanding of the plasticity of the muscular, skeletal, and spinal systems after paralysis may be important as new rehabilitative technologies emerge in the 21st century. Moreover, individuals injured today may become poor candidates for future scientific advancements (cure) if their neuromusculoskeletal systems are irreversibly impaired. The primary purpose of this paper is to explore the physiological properties of skeletal muscle as a result of spinal cord injury; secondarily, to consider associated changes at the skeletal and spinal levels. Muscular adaptations include a transformation to faster myosin, increased contractile speeds, shift to the right on the torque-frequency curve, increased fatigue, and enhanced doublet potentiation. These muscular adaptations may be prevented in individuals with acute paralysis and partially reversed in individuals with chronic paralysis. Moreover, the muscular changes may be coordinated with motor unit and spinal circuitry adaptations. Concurrently, skeletal adaptations, as measured by bone mineral density, show extensive loss within the first six months after paralysis. The underlying science governing neuromusculoskeletal adaptations after paralysis will help guide professionals as new rehabilitation strategies evolve in the future.

The effects of length on fatigue and twitch potentiation in human skeletal muscle

Fatigue is the decrease in active force that happens after repeated muscle stimulation, and post tetanic twitch potentiation (PTP) is the increase in twitch force observed after repeated muscle stimulation. This study investigated the effects of length on the interaction between fatigue and PTP, as these two forms of force regulation are length-dependent and may coexist. A total number of 14 subjects were tested in 3 days, in which fatigue and PTP were induced in the knee extensor muscles in three different knee angles (30 degrees, 60 degrees and 90 degrees; full extension = 0 degree). PTP was evaluated in rested and fatigued muscles with twitch contractions elicited before and after 10 s maximal voluntary contraction (MVC), and fatigue was evaluated with nine 50 Hz electrically elicited contractions (5 s duration, 5 s interval between contractions). Fatigue was length-dependent, with force values that were (mean +/- SEM) 59 +/- 5, 56 +/- 3 and 38 +/- 1% of maximal force at 90 degrees, 60 degrees and 30 degrees, respectively. PTP was also length-dependent. Rested muscles showed PTP of 39 +/- 4, 47 +/- 2 and 68 +/- 5% at 90 degrees, 60 degrees and 30 degrees, respectively. Fatigued muscles showed PTP of 44 +/- 3, 55 +/- 6 and 68 +/- 5%, at 90 degrees, 60 degrees and 30 degrees, respectively. This study shows that fatigue and PTP may represent independent mechanisms, as they regulate force in opposite directions and are both enhanced in short muscle lengths.

Coexistence of potentiation and fatigue in skeletal muscle

Twitch potentiation and fatigue in skeletal muscle are two conditions in which force production is affected by the stimulation history. Twitch potentiation is the increase in the twitch active force observed after a tetanic contraction or during and following low-frequency stimulation. There is evidence that the mechanism responsible for potentiation is phosphorylation of the regulatory light chains of myosin, a Ca2+-dependent process. Fatigue is the force decrease observed after a period of repeated muscle stimulation. Fatigue has also been associated with a Ca2+-related mechanism: decreased peak Ca2+ concentration in the myoplasm is observed during fatigue. This decrease is probably due to an inhibition of Ca2+ release from the sarcoplasmic reticulum. Although potentiation and fatigue have opposing effects on force production in skeletal muscle, these two presumed mechanisms can coexist. When peak myoplasmic Ca2+ concentration is depressed, but myosin light chains are relatively phosphorylated, the force response can be attenuated, not different, or enhanced, relative to previous values. In circumstances where there is interaction between potentiation and fatigue, care must be taken in interpreting the contractile responses.

Variable-frequency trains offset low-frequency fatigue in human skeletal muscle

Variable-frequency trains that exploit the catchlike property of skeletal muscle can augment force production in fatigued skeletal muscle. The present study is the first to examine the effect of such trains during recovery. The quadriceps femoris muscles of 12 healthy individuals were fatigued using six-pulse, 14.3-Hz trains delivered at a rate of 1/s for 3 min. The force-generating ability of the muscle was tested with several constant-frequency trains (8.3-100 Hz) and a variable-frequency train before and after fatigue and at 2, approximately 13, and approximately 38 min of recovery. The variable-frequency train produced significant augmentation of force versus the best constant-frequency train (12.5 Hz) in acute fatigue and during recovery. The fatiguing protocol also induced low-frequency fatigue (LFF); the time courses of the degree of LFF and the amount of variable-frequency train force augmentation were inversely related (r = 0.629; F = 38.024; P </= 0.001), suggesting a common mechanism between the two phenomena. These results suggest that clinical use of variable-frequency trains (e.g., functional electrical stimulation) will enable the muscle to generate more force during acute fatigue and offset, at least partially, the long-term effects of LFF.

Sag during unfused tetanic contractions in rat triceps surae motor units

Contractile properties and conduction velocity were studied in 202 single motor units of intact rat triceps surae muscles activated by intra-axonal (or intra-myelin) current injection in L5 or L6 ventral root to assess the factors that determine the expression of sag (i.e., decline in force after initial increase during unfused tetanic stimulation). Sag was consistently detected in motor units with unpotentiated twitch contraction times <20 ms. However, the range of frequencies at which sag was expressed varied among motor units such that there was no single interstimulus interval (ISI), with or without adjusting for twitch contraction time, at which sag could be detected reliably. Further analysis indicated that using the absence of sag as a criterion for identifying slow-twitch motor units requires testing with tetani at several different ISIs. In motor units with sag, the shape of the force profile varied with tetanic frequency and contractile properties. Simple sag force profiles (single maximum reached late in the tetanus followed by monotonic decay) tended to occur at shorter ISIs and were observed more frequently in fatigue-resistant motor units with long half-relaxation times and small twitch amplitudes. Complex sag profiles reached an initial maximum early in the tetanus, tended to occur at longer ISIs, and were more common in fatigue-sensitive motor units with long half-relaxation times and large twitch amplitudes. The differences in frequency dependence and force maximum location suggested that these phenomena represented discrete entities. Successive stimuli elicited near-linear increments in force during tetani in motor units that never exhibited sag. In motor units with at least one tetanus displaying sag, tetanic stimulation elicited large initial force increments followed by rapidly decreasing force increments. That the latter force envelope pattern occurred in these units even in tetani without sag suggested that the factors responsible for sag were expressed in the absence of overt sag. The time-to-peak force (TTP) of the individual contractions during a tetanus decreased in tetani with sag. Differences in the pattern of TTP change during a tetanus were consistent with the differences in force maximum location between tetani exhibiting simple and complex sag. Tetani from motor units that never exhibited sag did not display a net decrease in TTP during successive contractions. These data were consistent with the initial force decrement of sag resulting from a transient reduction in the duration of the contractile state.

Effects of activation frequency and force on low-frequency fatigue in human skeletal muscle

No comparison of the amount of low-frequency fatigue (LFF) produced by different activation frequencies exists, although frequencies ranging from 10 to 100 Hz have been used to induce LFF. The quadriceps femoris of 11 healthy subjects were tested in 5 separate sessions. In each session, the force-generating ability of the muscle was tested before and after fatigue and at 2, approximately 13, and approximately 38 min of recovery. Brief (6-pulse), constant-frequency trains of 9.1, 14.3, 33.3, and 100 Hz and a 6-pulse, variable-frequency train with a mean frequency of 14.3 Hz were delivered at 1 train/s to induce fatigue. Immediately postfatigue, there was a significant effect of fatiguing protocol frequency. Muscles exhibited greater LFF after stimulation with the 9.1-, 14.3-, and variable-frequency trains. These three trains also produced the greatest mean force-time integrals during the fatigue test. At 2, approximately 13, and approximately 38 min of recovery, however, the LFF produced was independent of the fatiguing protocol frequency. The findings are consistent with theories suggesting two independent mechanisms behind LFF and may help identify the optimal activation pattern when functional electrical stimulation is used.

Force-frequency and fatigue properties of motor units in muscles that control digits of the human hand

Modulation of motor unit activation rate is a fundamental process by which the mammalian nervous system encodes muscle force. To identify how rate coding of force may change as a consequence of fatigue, intraneural microstimulation of motor axons was used to elicit twitch and force-frequency responses before and after 2 min of intermittent stimulation (40-Hz train for 330 ms, 1 train/s) in single motor units of human long finger flexor muscles and intrinsic hand muscles. Before fatigue, two groups of units could be distinguished based on the stimulus frequency needed to elicit half-maximal force; group 1 (n = 8) required 9.1 +/- 0.5 Hz (means +/- SD), and group 2 (n = 5) required 15.5 +/- 1.1 Hz. Twitch contraction times were significantly different between these two groups (group 1 = 66. 5 ms; group 2 = 45.9 ms). Overall 18% of the units were fatigue resistant [fatigue index (FI) > 0.75], 64% had intermediate fatigue sensitivity (0.25 </= FI </= 0.75), and 18% were fatigable (FI < 0. 25). However, fatigability and tetanic force were not significantly different among groups. Therefore unlike findings in some other mammals, fast-contracting motor units were neither stronger nor more susceptible to fatigue than slowly contracting units. Fatigue, however, was found to be greatest in those units that initially exerted the largest forces. Despite significant slowing of contractile responses, fatigue caused the force-frequency relation to become displaced toward higher frequencies (44 +/- 41% increase in frequency for half-maximal force). Moreover, the greatest shift in the force-frequency relation occurred among those units exhibiting the largest force loss. A selective deficit in force at low frequencies of stimulation persisted for several minutes after the fatigue task. Overall, these findings suggest that with fatigue higher activation rates must be delivered to motor units to maintain the same relative level of force. Questions regarding classification of motor units and possible mechanisms by which fatigue-related slowing might coexist with a shift in the force-frequency curve toward higher frequencies are discussed.

Muscle resistance to slow ramp weakly depends on activation level

The mechanical response of human m. flexor pollicis longus to slow (3.2 degrees/s) linear stretch by 5.5 degrees was measured during sustained (45-60 s, 9-13.5 p.p.s.) unfused tetanus evoked by electrical stimulation. The stiffness increased during unfused tetanus. At the late phase of unfused tetanus it was 1.8 +/- 0.2 (mean +/- S.D.) times greater than at the early phase. The sensitivity of the isometric tension level to a short change in a stimulation frequency also increased. At the late phase of unfused tetanus force oscillations increased 1.2 +/- 0.2-fold during slow stretch or shortening and immediately reached a smaller amplitude after the cessation of length change. This was probably related to the friction and thixotropy in muscles. Muscle resistance to slow ramp depended only weakly on activation level. In the late phase of unfused tetanus the stiffness per unit force was 1.5 +/- 0.4 times greater at 9-13.5 p.p.s. than at 20-25 p.p.s. Thus, the relative value of muscle stiffness was greater for smaller activation levels typical for maintenance of posture. The enhancement of muscle stiffness during sustained unfused tetanus and a weak stiffness dependence on the activation level indicated a non-additivity of processes occurring in active muscle.

Effects of electrically induced fatigue on the twitch and tetanus of paralyzed soleus muscle in humans

We analyzed the twitch and summated torque (tetanus) during repetitive activation and recovery of the human soleus muscle in individuals with spinal cord injury. Thirteen individuals with complete paralysis (9 chronic, 4 acute) had the tibial nerve activated every 1,500 ms with a 20-Hz train (7 stimuli) for 300 ms and a single pulse at 1,100 ms. The stimulation protocol lasted 3 min and included 120 twitches and 120 tetani. Minimal changes were found for the acute group. The chronic group showed a significant reduction in the torque and a significant slowing of the contractile speeds of both the twitch and tetanus. The decrease in the peak twitch torque was significantly greater than the decrease in the peak tetanus torque early during the fatigue protocol for the chronic group. The twitch time to peak and half relaxation time were prolonged during fatigue, which was associated with improved fusion of the tetanus torque. At the end of the fatigue protocol, the decrease in the peak twitch torque was not significantly different from the decrease in the peak tetanus torque. After 5 min of rest, the contractile speeds recovered causing the tetanus to become unfused, but the tetanus torque became less depressed than the twitch torque. The differential responses for the twitch and the tetanus suggest an interplay between optimal fusion created from contractile speed slowing and excitation contraction coupling compromise. These issues make the optimal design of functional electrical stimulation systems a formidable task.

Neuromuscular frequency-coding and fatigue

In daily life, muscle fatigue often becomes noticeable as an apparent decline in the efficiency of force production by central commands, making it necessary to increase drive (or "effort") to produce a constant motor output. Such aspects of fatigue may be caused by changes in the way in which synaptic messages arriving at the motoneurons are translated into forces by the muscle fibers. Therefore, an understanding of these neuromuscular gradation mechanisms is essential for any analysis of motor fatigue. A brief general review is given of 1) how muscle fibers transduce motoneuronal discharge rates into force; 2) how synaptic currents are transduced into motoneuronal discharge rates; 3) how activity-dependent changes in the neuromuscular transduction mechanisms contribute to neuromuscular fatigue; and 4) how the matching between the transduction mechanisms of motoneurons and those of their muscle fibers may help to optimize neuromuscular gradation efficiency and decrease the severity of fatigue.

Task-dependent nature of fatigue in single motor units

The loss of force production during sustained activity presents the CNS a unique control problem. Different tasks stress the neuromuscular system at different sites and times, and involve different cellular mechanisms. The functional organization of muscles and their motor units has evolved to avoid fatigue processes that impair motor performance. The purpose of this brief review is to examine the fatigue properties of type-identified motor units and to speculate what these properties reveal about the organization and control of muscle.

Relations among motor unit types, generated forces and muscle length in single motor units of anaesthetized cat peroneus longus muscle

The active length-tension curves of identified single motor units (MUs) belonging to peroneus longus muscle (PL) of anaesthetized adult cats were obtained by eliciting isometric single twitches and tetani. The recorded responses were evaluated by measuring the peak tension amplitude and the tension-time area at muscle lengths extending throughout the physiological length range of the muscle (mean 5.5 mm, standard deviation +/- 0.8). The muscle lengths at which each tested MU developed its maximal twitch (Ltw) and tetanic (Lte) tensions were determined and compared with the muscle length (Lo) at which the stimulation of all the alpha-axons, innervating PL and contained in L7 ventral root, developed their maximal twitch tension. The mean of single MU Ltw values was at Lo +1.08 +/- 1.1 mm. Slow MUs showed the longest values of Ltw (Lo +1.6 +/- 1.0 mm). Single MUs stimulated at tetanic frequencies presented their Lte at values shorter than Lo (Lo - 2.8 +/- 1.7 mm). Slow MUs had the shortest Lte (Lo - 3.4 +/- 1.5 mm). For all the units Lte was shorter than Ltw. Ltw and Lte were, respectively, negatively and positively correlated with the developed tension. Optimal length values also appeared to be related to the MU types. The possibility is discussed that the muscle and tendon compliances and the high non-linearities to the applied forces are the main factors which can determine the differences among Lo, Ltw and Lte values. The relationships between MU type and optimal length values are suggested to be, at least partly, an epiphenomenon due to the different contraction strengths of the various MU types.(ABSTRACT TRUNCATED AT 250 WORDS)

Impairment of neuromuscular propagation during human fatiguing contractions at submaximal forces

1. The purpose of the study was to examine the dependence of neuromuscular propagation impairment on the level of isometric force sustained to the endurance limit. The task involved human volunteers sustaining a submaximal abduction force with the index finger by activating the first dorsal interosseous muscle as long as possible. 2. The submaximal force was sustained at one of three levels (20, 35 or 65% of maximum) by increasing motor unit activity, as indicated by the electromyogram (EMG), during the fatiguing contraction. Although the EMG increased during the fatiguing contraction, the EMG was significantly less than maximum at the endurance limit for all subjects (deficit of 19-55% of maximum). This deficit was inversely related to the level of the sustained submaximal force. 3. The maximum voluntary contraction and twitch forces were significantly reduced following the fatiguing contraction. As with the EMG, the degree of force reduction was greatest for the subjects who sustained the low target forces. 4. The fatiguing contraction caused a 12-23% decline in M wave amplitude, a 33-51% increase in M wave duration, and no change in M wave area. The decline in M wave amplitude, which is an index of neuromuscular propagation impairment, was greatest among the subjects who sustained the low target forces. 5. The mean power frequency of the EMG decreased by a similar amount (50-57%) during the fatiguing contraction for all three groups of subjects. 6. A model representing the interaction of processes that enhance and impair force was developed to explain the recovery of twitch force following the sustained contractions at different target forces. 7. We conclude that the fatigue experienced by a subject when force is sustained at a submaximal value does involve an impairment of neuromuscular propagation. This impairment is one factor that limits muscle excitation during a submaximal, fatiguing contraction and contributes to the diminished force capability by the end of the fatigue task.

Prolonged depression of force developed by single motor units after their intermittent activation in adult cats

The fatigue of fast-twitch, glycolytic mammalian motor units [i.e., type FF; nomenclature of (3)] is dependent, in part, on the stimulation regimen (total number of stimuli, frequency, duty cycle, temporal patterning of stimuli, etc.) used to induce fatigue. To study the effect of the temporal pattern of the stimulus train on the rate and extend of fatigue in single FF units, one theoretically acceptable approach would be to use each motor unit as its own control: i.e., a sequential testing with two fatigue tests that differ only in the temporal organization of their stimuli. The purpose of this communication is to provide evidence that such an approach is not feasible when studying FF units, due to the delayed recovery of force following their repetitive activation. It was shown that 1/s activation of single FF units for only 15 or 45 s with intermittent 40-Hz, 300-ms duration trains significantly reduced their force response to a double-pulse shock for several hours. This finding suggests that in studies designed to test for the effects of different stimulation patterns on the fatigue of single motor units, deeply anaesthetized, reduced animal preparations are not appropriate models for the sequential application of different stimulation regimens to fast-twitch, glycolytic, mammalian motor units.

The effect of the stimulation pattern on the fatigue of single motor units in adult cats

1. The main purpose of this study was to examine the effects of two subtly different stimulus patterns on the force developed by fast-twitch, fatiguable motor units in a cat hindlimb muscle during control (pre-fatigue) and fatiguing contractions. 2. The peak force and the force-time integral responses of nineteen high fatigue (FF) and three intermediate fatigue (FI) motor units of the tibialis posterior muscle in five deeply anaesthetized adult cats were measured at selected times during the course of a 360-s fatigue test. 3. The fatigue test involved a pseudo-random alternation of two patterns of stimulation. One pattern (regular) was composed of a train of stimuli with constant interpulse intervals, set at 1.8 x the twitch contraction time of each unit (interval range, 27-51 ms), and delivered for 500 (or 400) ms. For the total (FF + FI) motor-unit sample, the mean (+/- S.D.) stimulation frequency was 26 +/- 4 Hz (range, 19-37 Hz). The other stimulus pattern (optimized) consisted of three initial stimuli with short (10 ms) interpulse intervals, followed by a constant interpulse-interval train that was adjusted (interval range, 29-62 ms; frequency, 23 +/- 5 Hz; frequency range, 16-36 Hz) such that the total train had the same number of pulses, and the same average frequency and duration as the regular train. 4. The stimulus trains were delivered at 1 s-1 for 360 s, using three-train sequences of each pattern, randomly alternating with one another. The response of the third train in each sequence was selected for the force measurements. The force profile obtained from the fatigue test was subsequently decomposed into two profiles: one attributable to regular and one to optimized stimulation. 5. During the initial responses to the fatigue test, the optimized stimulus pattern produced significantly more force than the regular stimulus pattern. For FF units, the mean increase in peak force (141%) was significantly greater than the increase in the force-time integral (59%). 6. All motor units exhibited an initial potentiation of peak force with the regular stimulation pattern, whereas peak force declined monotonically with the optimized pattern. In contrast, the force-time integral potentiated in the first 30 s for both regular and optimized stimulus patterns. 7. Each motor unit maintained an increased force response to optimized stimulation during the fatigue test, with the greatest relative increase occurring about 120 s into the test, well after the potentiation effect had subsided.(ABSTRACT TRUNCATED AT 400 WORDS)

Dantrolene sodium and fatigue of long duration

A long-lasting impairment of muscular force generation follows fatiguing exercise (fatigue of long duration), the physiological basis of which is not well understood. To investigate the role of reduced calcium release in long-lasting fatigue, we examined the effects of dantrolene sodium, which selectively decreases calcium release from the sarcoplasmic reticulum. The drug impaired muscle function in a pattern identical to that of long-lasting fatigue. The results are consistent with either independent effects of dantrolene and exercise at the same site in the excitation-contraction coupling chain, or independent actions at separate serial sites.

Immobilization-induced changes in motor unit force and fatigability in the cat

The purpose of this study was to examine the effects of 3 weeks of immobilization on the mechanical properties of motor units in a cat hindlimb muscle. The muscle, tibialis posterior, was immobilized in a shortened position. Motor units were classified as type FF, F(int), FR, or S. Force, axonal conduction velocity, fatigability, and proportions of motor unit types were compared in control and immobilized muscles. All properties exhibited some change after immobilization, including slower axonal conduction velocities, greater twitch forces, slower twitch contraction times, and greater tetanic forces. In addition, most motor units were less fatigable after immobilization. The number of motor units that could not be included in one of the four classification categories increased significantly after immobilization; these units exhibited normal axon conductivity but failed to produce measurable force or associated EMG. Short-term immobilization induced a variety of physiological adaptations in neuromuscular processes that varied with motor unit type.

Motor-unit force potentiation in adult cats during a standard fatigue test

1. The purpose of this study was to examine the time course of tetanic force during a standard fatigue test and to distinguish between the appearance of potentiation and fatigue among the four motor-unit types of a cat hindlimb muscle. 2. Motor units of the tibialis posterior muscle in the adult cat were assigned to four categories (i.e. types S, FR, FI, FF) based on conventional criteria (Burke, Levine, Tsairis & Zajac, 1973). The mean (+/- S.D.) time course of peak force was constructed for each motor-unit type and, within each type, for those units that potentiated (a greater than 3% increase in peak force compared to the initial value) and those that did not potentiate. 3. The average time courses of force differed between motor-unit types. There was, however, considerable variability within each motor-unit type. For the same relative force output, the forces exerted by slow-twitch units were less variable than those exerted by fast-twitch units. In addition, the variability among slow-twitch units was relatively constant during the fatigue test while variability among fast-twitch units either increased or decreased with time. 4. For a given motor-unit type, the average time course of force did not depend on whether force in each tetanus was expressed as a peak value, an average peak value, or a force-time integral. 5. Some motor units within each type exhibited potentiation. Most of the variability in the time course of the peak force for each motor-unit type could be accounted for by the potentiating units. Motor units that exhibited only force decline (i.e. fatigue), regardless of unit type, had less variable time courses of peak force. Since potentiation was transient in some unit types, it was assumed that at least two opposing processes (i.e. fatigue and potentiation) occurred simultaneously in these units (see also, Krarup, 1981; Rankin, Enoka, Volz & Stuart, 1988; Garner, Hicks & McComas, 1989). 6. It is concluded that the expression of force potentiation throughout a fatiguing regimen is variable among motor units and that this is not related to conventional motor-unit types. This dissociation suggests that the mechanisms that form the basis for the conventional distinction between motor-unit types are different from those which lead to force potentiation.

Prolongation of twitch potentiating mechanism throughout muscle fatigue and recovery

Measurements have been made of twitch amplitudes in human ankle dorsiflexor muscles during and following fatiguing electrical stimulation. In six subjects, studied with the arterial circulation occluded, the twitch was observed to undergo an early potentiation (mean, 99 +/- 50%) followed by complete disappearance. A second, smaller phase of potentiation (mean, 25 +/- 30%) occurred during recovery and gave way to prolonged depression of the twitch. A comparison of these results with those obtained with an intact circulation suggested that the four phases in the behavior of the twitch were the net result of two processes, potentiation and fatigue, with different time courses. Provided they are timed appropriately, observations of twitch amplitude can provide useful information concerning the development of, and recovery from, muscle fatigue.

Activation of cat motor units by paired stimuli at short intervals

1. In adult cats, paired stimulations at short intervals were applied in ventral root filaments to single motor axons innervating the peroneus tertius muscle. Paired impulses were recorded from the muscle nerve simultaneously with the electrical and mechanical responses of the muscle portion of the motor unit (muscle unit). The interstimulus interval was gradually reduced in order to determine the minimum compatible with a full activation of the muscle unit by the second impulse. 2. For motor units of all physiological types, this minimum stimulus interval was the shortest interval allowing initiation and conduction of two impulses in the axon, that is, the absolute refractory period for conduction. Its duration ranged between 0.58 and 0.88 ms, displaying no correlation with the axonal conduction velocity. 3. The amount of tension enhancement produced by paired stimulations at the shortest interval varied with the type of the motor unit: it was largest for fast-fatigable units, intermediate for fast-resistant units and smallest for slow units. 4. Paired impulses elicited by paired stimulations at the shortest possible interval arrived near the muscle at a longer interval because the second impulse was conducted at a slower velocity. The minimum interval between arrival of impulses at the muscle depended on conduction velocity and on conduction distance. 5. In motor axons to peroneus tertius, paired impulses leaving the spinal cord at a mean interval of 0.78 ms arrived near the muscle separated by a mean interval of 1.90 ms. Since such an interval always allowed full activation of the muscle unit by the second impulse, this interval is longer than the refractory period of motor units in this muscle.