Is fatigue all in your head? A critical review of the central governor model

Autonomic dysfunction and exercise intolerance in post-COVID-19 - An as yet underestimated organ system?

Individuals recovering from COVID-19 often present with persistent symptoms, particularly exercise intolerance and low cardiorespiratory fitness. Put simply, the Wasserman gear system describes the interdependence of heart, lungs, and musculature as determinants of cardiorespiratory fitness. Based on this system, recent findings indicate a contribution of peripheral, cardiovascular, and lung diffusion limitations to persistent symptoms of exercise intolerance and low cardiorespiratory fitness. The autonomic nervous system as an organ system involved in the pathophysiology of exercise intolerance and low cardiorespiratory fitness, has received only little attention as of yet. Hence, our article discusses contribution of the autonomic nervous system through four potential pathways, namely alterations in (1) cerebral hemodynamics, (2) afferent and efferent signaling, (3) central hypersensitivity, and (4) appraisal and engagement in physical activity. These pathways are summarized in a psycho-pathophysiological model. Consequently, this article encourages a shift in perspective by examining the state of the pulmonary and cardiovascular system, the periphery, and auxiliary, the autonomic nervous system as potential underlying mechanisms for exercise intolerance and low cardiorespiratory fitness in patients with post-COVID-19.

Effect of Neuromuscular Fatigue on the Countermovement Jump Characteristics: Basketball-Related High-Intensity Exercises

ABSTRACT

Yoshida, N, Hornsby, WG, Sole, CJ, Sato, K, and Stone, MH. Effect of neuromuscular fatigue on the countermovement jump characteristics: basketball related high-intensity exercises. J Strength Cond Res 38(1): 164-173, 2024-The purpose of this study was to investigate basketball specific neuromuscular (NM) fatigue effect on countermovement jump (CMJ) force-time (F-T) curve characteristics. Eleven male college-level basketball athletes performed 6 CMJ trials at 3 baseline (pre) and 6 postexercise time points. The fatiguing protocol consisted of high-intensity basketball related exercises commensurate with basketball game or practice. Typical CMJ (CMJ-TYP) and phase-specific CMJ variables were derived from the F-T curve. Meaningful differences in CMJ performance were examined using effect size (ES) compared with baseline and previous postexercise time point. Baseline with 3 separated measurements demonstrated suitable CMJ variables reproducibility (CV, coefficient of variation). Most CMJ-TYP output and performance variables displayed substantial alterations immediately postexercise (0 hour) and returned to baseline at 24 hours postexercise, whereas the time and rate-related CMJ-TYP and CMJ-phase variables tended to display delayed decline peaked at 2 hours and delayed recovery to baseline at 48 hours postexercise. In conjunction with the return of the time and rate-related variables, CMJ performance displayed supercompensation at 72 hours postexercise. The results indicate altered NM functions with desired CMJ performance, such as jump height, which imply an altered movement strategy at early stage of recovery process. Full recovery may take 48-72 hours. Practitioners are, therefore, advised to monitor variables reflecting NM functions for precise manipulation of the intensity and volume of exercise to avoid prolonging the recovery from NM fatigue.

Central and Peripheral Fatigue in Physical Exercise Explained: A Narrative Review

The study of the origin and implications of fatigue in exercise has been widely investigated, but not completely understood given the complex multifactorial mechanisms involved. Then, it is essential to understand the fatigue mechanism to help trainers and physicians to prescribe an adequate training load. The present narrative review aims to analyze the multifactorial factors of fatigue in physical exercise. To reach this aim, a consensus and critical review were performed using both primary sources, such as scientific articles, and secondary ones, such as bibliographic indexes, web pages, and databases. The main search engines were PubMed, SciELO, and Google Scholar. Central and peripheral fatigue are two unison constructs part of the Integrative Governor theory, in which both psychological and physiological drives and requirements are underpinned by homeostatic principles. The relative activity of each one is regulated by dynamic negative feedback activity, as the fundamental general operational controller. Fatigue is conditioned by factors such as gender, affecting men and women differently. Sleep deprivation or psychological disturbances caused, for example, by stress, can affect neural activation patterns, realigning them and slowing down simple mental operations in the context of fatigue. Then, fatigue can have different origins not only related with physiological factors. Therefore, all these prisms must be considered for future approaches from sport and clinical perspectives.

Acute Effects of Aerobic Exercise on Muscle Strength and Power in Trained Male Individuals: A Systematic Review with Meta-analysis

BACKGROUND

Concurrent training can be an effective and time-efficient method to improve both muscle strength and aerobic capacity. A major challenge with concurrent training is how to adequately combine and sequence strength exercise and aerobic exercise to avoid interference effects. This is particularly relevant for athletes.

OBJECTIVE

We aimed to examine the acute effects of aerobic exercise on subsequent measures of muscle strength and power in trained male individuals.

DESIGN

We performed a systematic review with meta-analysis.

DATA SOURCES

Systematic literature searches in the electronic databases PubMed, Web of Science, and Google Scholar were conducted up to July 2021.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies were included that applied a within-group repeated-measures design and examined the acute effects of aerobic exercise (i.e., running, cycling exercise) on subsequent measures of lower limb muscle strength (e.g., maximal isometric force of the knee extensors) and/or proxies of lower limb muscle power (e.g., countermovement jump height) in trained individuals.

RESULTS

Fifteen studies met the inclusion criteria. Aerobic exercise resulted in moderate declines in muscle strength (standardized mean difference [SMD] = 0.79; p = 0.003). Low-intensity aerobic exercise did not moderate effects on muscle strength (SMD = 0.65; p = 0.157) while moderate-to-high intensity aerobic exercise resulted in moderate declines in muscle strength (SMD = 0.65; p = 0.020). However, the difference between subgroups was not statistically significant (p = 0.979). Regarding aerobic exercise duration, large declines in muscle strength were found after > 30 min (SMD = 1.02; p = 0.049) while ≤ 30 min of aerobic exercise induced moderate declines in muscle strength (SMD = 0.59; p = 0.013). The subgroup difference was not statistically significant (p = 0.204). Cycling exercise resulted in significantly larger decrements in muscle strength (SMD = 0.79; p = 0.002) compared with running (SMD = 0.28; p = 0.035). The difference between subgroups was statistically significant (p < 0.0001). For muscle power, aerobic exercise did not result in any statistically significant changes (SMD = 0.04; p = 0.846).

CONCLUSIONS

Aerobic exercise induced moderate declines in measures of muscle strength with no statistically significant effects on proxies of muscle power in trained male individuals. It appears that higher compared with lower intensity as well as longer compared with shorter aerobic exercise duration exacerbate acute declines in muscle strength. Our results provide evidence for acute interference effects when aerobic exercies is performed before strength exercises. These findings may help practitioners to better prescribe single training sessions, particularly if environmental and/or infrastructural reasons (e.g., availability of training facilities) do not allow the application of strength training before aerobic exercise.

Effect of acute caffeine supplementation before intermittent high-intensity exercise on cytokine levels and psychobiological parameters: A randomized, cross-over, placebo-controlled trial

The present study aimed to verify the effects of caffeine supplementation on psychobiological parameters and its relationship with inflammatory cytokines in non-athlete subjects. We hypothesized that IL-10 may be responsible for the reduction in fatigue perception in response to caffeine supplementation. It was a randomized, double-blinded, cross-over, placebo-controlled study. Ten non-athlete subjects (26.9 ± 4.01 years old; 73.44 ± 9.57 kg; 15.94 ± 4.32 body fat kg) were evaluated. Sixty-min after caffeine (6 mg^-1.kg^-1 body mass) or placebo supplementation, high-intensity interval exercise test (1 min at 90% of W_max and 2 min at 50% of W_max) was performed to maximum voluntary exhaustion. Cytokine concentrations and psychobiological parameters were evaluated before (BE), immediately after (post-PE) and 1 h after exercise (1 h post-PE). We verify that IL-6 (0.35; 95% CI: 0.13 to 0.56; z = 3.24; p = 0.001; d = 1.14) and IL-10 (9.06; 95% CI 0.41 to 17.70; z = 2.05; p = 0.04; d = 1.12) increases post-PE in CAF group versus PLA group. Still, IL-10 levels were higher in CAF group 1 h post-PE (25.04; 95% CI: 8.95 to 41.31; z = 3.05; p = 0.002; d = 1.9) than PLA group. Moreover, 1 h post-PE vigor level was higher in the CAF group versus PLA group (4.53; 95% CI: 1.27 to 7.80; z = 2.72; p = 0.006; d = 0.46), and fatigue was lower in CAF group than PLA group (-5.08; 95% CI: -9.93 to -0.227; z = -2.05; p = 0.040; d = 0.67). We conclude that 1 h post-PE caffeine was able to decrease fatigue and increase vigor perception. IL-10 levels were higher 1 h post-PE in CAF group, suggesting, according to our hypothesis, that IL-10 may be associated with decrease fatigue perceptions after exercise.

A Head-to-Head Comparison of an Isometric and a Concentric Fatigability Protocol and the Association With Fatigue and Walking in Persons With Multiple Sclerosis

Background. Fatigue is one of the most frequent symptoms in persons with multiple sclerosis (MS). Distinction is made between subjective perceptions of fatigue and objective measures of fatigability. Fatigability can be measured by different protocols. Yet no studies have compared isometric and concentric contraction protocols of the lower extremities head-to-head. Therefore, the purpose of the present study was to (1) compare 2 such protocols head-to-head and (2) to investigate the association between fatigability evoked by the 2 protocols and measures of fatigue and walking. Methods. A total of 45 patients with MS had their walking capacity measured objectively by the 6-minute walk test (6MWT) and subjectively by the 12-item Multiple Sclerosis Walking Scale (MSWS-12). Fatigue was measured by the Modified Fatigue Impact Scale (MFIS) and fatigability by 2 knee extension protocols: sustained isometric and concentric. Results. The sustained isometric protocol induced a higher degree of fatigability than the concentric protocol ( P < .01). Regression analyses revealed that sustained isometric fatigability was not associated with either measures of fatigue or walking (all r2 = 0.00; P = .85-.99), whereas the concentric protocol was significantly associated with fatigue ( r2 = 0.20; P < .01), 6MWT ( r2 = 0.09; P < .05), and MSWS-12 ( r2 = 0.16; P < .01). Furthermore, after adjusting for maximal strength and sex, concentric fatigability remained a strong and significant predictor of fatigue (β = 0.49) and walking (6MWT: β = −0.26; MSWS: β = 0.37). Conclusion. This study provides the first evidence that a lower-extremity concentric fatigability protocol provides superior reflection of both fatigue and walking when compared with a sustained isometric protocol. We suggest that concentric protocols should be the focus of future studies investigating fatigability.

The effects of military style ruck marching on lower extremity loading and muscular, physiological and perceived exertion in ROTC cadets

Military ruck marching with load carriage increases ground reaction forces, which are related to bone stress injuries (BSI). This study's purpose was to examine whether a ruck march increases impact loading and to describe muscular, physiological and perceived exertion in Army Reserve Officer Training Corps (ROTC) cadets. Secondary purposes examined relationships among loading changes after the ruck march and baseline characteristics. Fifteen Army ROTC cadets performed a 4-mile march. Lower extremity loading and muscular, physiological and perceived exertion were measured pre- and post-march. Results indicated significant increases in peak impact force and loading rate and decreases in ankle dorsiflexion and plantarflexion strength. Factors that might have been related to changes seen in lower extremity loading did not yield any compelling relationships to explain those changes. In conclusion, the ruck march led to increased peak impact force and loading rate, which have been shown to be related to the risk of BSI. Practitioner summary: This study examined ROTC cadets ankle strength and lower extremity loading before and after a ruck march. We found that lower extremity loading increased after the march, and ankle dorsiflexion (DF) strength decreased, despite the cadets not feeling fatigued. These changes are consistent with risk factors for bone stress injuries. Abbreviations: BSI: bone stress injury; ROTC: Reserve Officer Training Corps; PIF: peak impact force; LR: loading rate; RPE: rate of perceived exertion; APFT: Army physical fitness test; DF: dorsiflexors; PF: plantar-flexors; INV: invertors; EV: evertors; HHD: handheld dynamometer; %HRmax: percentage of maximum heart rate.

Assessing the brain 'on the line': An ecologically-valid assessment of the impact of repetitive assembly line work on hemodynamic response and fine motor control using fNIRS

To investigate neural correlates of repetitive assembly tasks in ecologically-valid empirical settings, this study measured bilateral prefrontal (PFC) and motor activations when participants performed a carburetor assembly task using functional near-infrared spectroscopy (fNIRS). Participants worked for one hour at a typical (low-) pace and at an accelerated high-pace. Before and after the task, a test was conducted to assess motion stability and fine motor control. The behavioral data revealed decreased motion stability after the assembly work in both conditions, with a significantly higher reduction after the high-pace task. The fNIRS data also revealed reduced activations in bilateral prefrontal and motor regions in both conditions over time. However, the low-pace task led to significantly greater activity decreases compared with the high-pace. Activity decrease in prefrontal and motor regions within the low pace also significantly related to minimal motion stability impairment, suggesting that the brain activation decreases in this and, potentially, findings of higher alpha in past repetitive-task studies using EEG, may be a result of not fatigue but worker adaptation or increasing efficiency.

Efficacy of laser therapy for exercise-induced fatigue: A meta-analysis

BACKGROUND

Laser therapy is widely used for exercise-induced fatigue, while the effect among different studies remains controversial. The present study was to summary available randomized controlled trials (RCTs) to evaluate the effect of laser therapy in subjects with exercise-induced fatigue.

METHODS

PubMed, Embase, and Cochrane Library were searched to identify the potential RCTs from inception to October 2017. The weighted mean difference (WMD) with 95% confidence intervals (CIs) was calculated using a random-effects model.

RESULTS

Twenty RCTs involving a total of 394 individuals were included in final analysis. No significant differences were observed between the laser therapy and control for the outcomes of lactate (WMD: -0.19; 95%CI: -0.52 to 0.13; P = .244), repetitions (WMD: 4.44; 95%CI: -1.43 to 10.32; P = .138), work load (WMD: 3.38; 95%CI: -1.15 to 7.91; P = .144), time taken to perform the exercise tests (WMD: 4.42; 95%CI: -2.33 to 11.17; P = .199), creatine kinase (WMD: -41.80; 95%CI: -168.78 to 85.17; P = .519), maximum voluntary contraction (WMD: 23.83; 95%CI: -7.41 to 55.07; P = .135), mean peak forces (WMD: 2.87; 95%CI: -1.01 to 6.76; P = = .147), and visual analog scale (VAS) (WMD: -1.91; 95%CI: -42.89 to 39.08; P = = .927). The results of sensitivity analysis suggested that laser therapy might play an important role on the levels of lactate (WMD: -0.30; 95%CI: -0.59 to -0.01; P = = .040), maximum voluntary contraction (WMD: 33.54; 95%CI: 1.95 to 65.12; P = = .037), and VAS (WMD: -21.00; 95%CI: -40.78 to -1.22; P = = .037). The results of subgroup analyses indicated no significant differences between the laser therapy and placebo for lactate and repetitions when stratified by study design, mean age, gender, and study quality.

CONCLUSIONS

The findings of this meta-analysis did not indicate any significant differences between the laser therapy and placebo.

Effects of Acute Normobaric Hypoxia on Non-linear Dynamics of Cardiac Autonomic Activity During Constant Workload Cycling Exercise

Aim

Measurements of Non-linear dynamics of heart rate variability (HRV) provide new possibilities to monitor cardiac autonomic activity during exercise under different environmental conditions. Using detrended fluctuation analysis (DFA) technique to assess correlation properties of heart rate (HR) dynamics, the present study examines the influence of normobaric hypoxic conditions (HC) in comparison to normoxic conditions (NC) during a constant workload exercise.

Materials and Methods

Nine well trained cyclists performed a continuous workload exercise on a cycle ergometer with an intensity corresponding to the individual anaerobic threshold until voluntary exhaustion under both NC and HC (15% O₂). The individual exercise duration was normalized to 10% sections (10-100%). During exercise HR and RR-intervals were continuously-recorded. Besides HRV time-domain measurements (meanRR, SDNN), fractal correlation properties using short-term scaling exponent alpha1 of DFA were calculated. Additionally, blood lactate (La), oxygen saturation of the blood (SpO₂), and rating of perceived exertion (RPE) were recorded in regular time intervals.

Results

We observed significant changes under NC and HC for all parameters from the beginning to the end of the exercise (10% vs. 100%) except for SpO₂ and SDNN during NC: increases for HR, La, and RPE in both conditions; decreases for SpO₂ and SDNN during HC, meanRR and DFA-alpha1 during both conditions. Under HC HR (40-70%), La (10-90%), and RPE (50-90%) were significantly-higher, SpO₂ (10-100%), meanRR (40-70%), and DFA-alpha1 (20-60%) were significantly-lower than under NC.

Conclusion

Under both conditions, prolonged exercise until voluntary exhaustion provokes a lower total variability combined with a reduction in the amplitude and correlation properties of RR fluctuations which may be attributed to increased organismic demands. Additionally, HC provoked higher demands and loss of correlation properties at an earlier stage during the exercise regime, implying an accelerated alteration of cardiac autonomic regulation.

Cancer-Related Fatigue: Perception of Effort or Task Failure?

CONTEXT

Patient's rating of perceived effort (RPE) is used to assess central fatigue. Cancer-related fatigue (CRF) is believed to be of central origin. The increased RPE with a motor task, such as the Finger-Tapping Test (FTT), can easily be measured in the clinical setting.

OBJECTIVES

To correlate the FTT, RPE and the Brief Fatigue Inventory (BFI) rated fatigue severity in patients with cancer.

METHODS

Subjective fatigue was assessed in adult patients with cancer by the BFI. Participants performed a modified FTT with the index finger of the dominant hand: 15 seconds × 2, 30 seconds × 2, and 60 seconds × 2 with 1 minute of rest between each time trial. Rating of perceived effort at the end of task was measured by the Borg 10 scale.

EXCLUSIONS

Brain metastasis, history of brain radiation, Parkinson disease, Huntington Chorea, multiple sclerosis, delirium, and depression. Pearson correlation coefficients were used to describe the relationships between BFI, FTT, and Borg 10 scale.

RESULTS

Thirty patients participated. Mean age was 56.2. Sixteen were females (53.3%). The mean BFI mean was 4.1, median 4.4. Tapping rate did not correlate with fatigue severity. The RPE correlated with the mean BFI: r _s 0.438, P = .0155. These correlations persisted after adjustment for age.

CONCLUSION

An increased RPE in the absence of task failure suggests that the origin of CRF is central. The performance of an FTT with RPE helps to improve our understanding of fatigue in the clinical setting.

The effect of body size on countermovement jump kinetics in children aged 7-11 years

The purpose this study was to examine the effect of body size on countermovement jump (CMJ) kinetics in children. Participants (n = 160) aged 7-11 years, divided equally by sex and into primary school year groups (years 3, 4, 5 and 6), each performed one CMJ on a force platform. The variables bodyweight (BW), peak force (Fmax), in-jump minimum force (IMF), in-jump vertical force range (IFR) and basic rate of force development (BRFD) were attained from the force-time history and then subsequently scaled to account for body size. A significant age, sex and interaction effect were found for the absolute variables BW, IMF, Fmax and IFR (P < 0.05) between school year groups 3 and 4 against year's 5 and 6. Simple main effects highlighted no significant sex differences between the boys and girls for all variables (P > 0.05). No significant age or sex differences were observed for normalised or allometrically scaled values (P > 0.05). The results indicate that girls and boys can be grouped together but that body size must be accounted for to enable accurate conclusions to be drawn independent of growth. Body size significantly effects the representation of CMJ kinetic results and therefore, future studies should report both absolute and scaled values. Future research should develop an age-appropriate criterion method for children in order to determine processed CMJ variables to further investigate the neuromuscular performance of children.

Dynamics of pleasure-displeasure at the limit of exercise tolerance: conceptualizing the sense of exertional physical fatigue as an affective response

The search for variables involved in the regulation and termination of exercise performance has led to integrative models that attribute a central role to the brain and utilize an array of psychological terms (e.g. sensation, perception, discomfort, tolerance). We propose that theorizing about exercise regulation would benefit from establishing cross-disciplinary bridges to research fields, such as affective psychology and neuroscience, in which changes along the dimension of pleasure-displeasure are considered the main channel via which homeostatic perturbations enter consciousness and dictate corrective action (slowing down or stopping). We hypothesized that ratings of pleasure-displeasure would respond to the severity of homeostatic perturbation and would be related to time to exhaustion during exercise performed at an unsustainable intensity. In a within-subjects experiment (N=15, 13 men and 2 women, age 23.4±2.2 years; maximal oxygen uptake 46.0±8.0 ml kg^-1 min^-1), we compared the slope of ratings of pleasure-displeasure (acquired every 1 min) during cycling exercise at a power output 10% above critical power until volitional termination under glycogen-loaded and glycogen-depleted conditions. As hypothesized, ratings of pleasure-displeasure declined more steeply under glycogen depletion (P=0.009, d=0.70) and correlated closely with time to exhaustion under both glycogen-loaded (r=0.85; P<0.001) and glycogen-depleted conditions (r=0.83; P<0.001). We conclude that in exercise, as in other domains, changes in pleasure-displeasure may be the main channel via which homeostatic perturbations enter consciousness. This proposal may have important implications for conceptualizing and identifying the neurobiological mechanisms of the sense of exertional physical fatigue.

Components of Fatigue: Mind and Body

Carriker, CR. Components of fatigue: mind and body. J Strength Cond Res 31(11): 3170-3176, 2017-Maximal intensity exercise requires significant energy demand. Subsequently, prolonged high-intensity effort eventually initiates volitional cessation of the event; often preceeded by a sensation of fatigue. Those examining the basis of fatigue tend to advocate either a peripheral or central model to explain such volitional failure. Practitioners and athletes who understand the tenants of fatigue can tailor their exercise regimens to target areas of potential physical or mental limitation. This review examines the rationale surrounding 2 separate models which postulate the origination of fatigue. Although the peripheral model suggests that fatigue occurs at the muscles, others have suggested a teloanticipatory cognitive component which plays a dominant role. Those familiar with both models may better integrate practice-based evidence into evidence-based practice. The highly individual nature of human performance further highlights the compulsion to comprehend the spectrum of fatigue, such that the identification of insufficiencies should mandate the development of a training purview for peak human performance.

Lessons from a broad view of science: a response to Dr Robergs' article

Dr Robergs suggested that the central governor model (CGM) is not a well-worded theory, as it deviated from the tenant of falsification criteria. According to his view of science, exercise researches with the intent to prove rather than disprove the theory contribute little to new knowledge and condemn the theory to the label of pseudoscience. However, exercise scientists should be aware of limitations of the falsification criteria. First, the number of potential falsifiers for a given hypothesis is always infinite so that there is no mean to ensure asymmetric comparison between theories. Thus, assuming a competition between CGM and dichotomised central versus peripheral fatigue theories, scientists guided by the falsification principle should know, a priori, all possible falsifiers between these two theories in order to choose the finest one, thereby leading to an oversimplification of the theories. Second, the failure to formulate refutable hypothesis may be a simple consequence of the lack of instruments to make crucial measurements. The use of refutation principles to test the CGM theory requires capable technology for online feedback and feedforward measures integrated in the central nervous system, in a real-time exercise. Consequently, falsification principle is currently impracticable to test CGM theory. The falsification principle must be applied with equilibrium, as we should do with positive induction process, otherwise Popperian philosophy will be incompatible with the actual practice in science. Rather than driving the scientific debate on a biased single view of science, researchers in the field of exercise sciences may benefit more from different views of science.

Athletes with Brain Injury: Pathophysiologic and Medical Challenges

Participation in elite sporting activities is becoming increasingly popular for individuals with brain injury. This article outlines the types of brain injury and the associated movement dysfunctions. In addition, specific pathophysiologic and medical challenges facing athletes with brain injury are discussed. Further research conducted using athletes with brain injury will add to the existing literature indicating the benefits of athletic training in this population. Increased scientific study within this area stands to further improve understanding of the complex interaction between neuromuscular impairment and athletic performance.

Exploring the Relationship of Task Performance and Physical and Cognitive Fatigue During a Daylong Light Precision Task

OBJECTIVE

Our aim was to explore the relationship between fatigue and operation system performance during a simulated light precision task over an 8-hr period using a battery of physical (central and peripheral) and cognitive measures.

BACKGROUND

Fatigue may play an important role in the relationship between poor ergonomics and deficits in quality and productivity. However, well-controlled laboratory studies in this area have several limitations, including the lack of work relevance of fatigue exposures and lack of both physical and cognitive measures. There remains a need to understand the relationship between physical and cognitive fatigue and task performance at exposure levels relevant to realistic production or light precision work.

METHOD

Errors and fatigue measures were tracked over the course of a micropipetting task. Fatigue responses from 10 measures and errors in pipetting technique, precision, and targeting were submitted to principal component analysis to descriptively analyze features and patterns.

RESULTS

Fatigue responses and error rates contributed to three principal components (PCs), accounting for 50.9% of total variance. Fatigue responses grouped within the three PCs reflected central and peripheral upper extremity fatigue, postural sway, and changes in oculomotor behavior.

CONCLUSION

In an 8-hr light precision task, error rates shared similar patterns to both physical and cognitive fatigue responses, and/or increases in arousal level.

APPLICATION

The findings provide insight toward the relationship between fatigue and operation system performance (e.g., errors). This study contributes to a body of literature documenting task errors and fatigue, reflecting physical (both central and peripheral) and cognitive processes.

Sensitivity, reliability and the effects of diurnal variation on a test battery of field usable upper limb fatigue measures

Fatigue has been linked to deficits in production quality and productivity and, if of long duration, work-related musculoskeletal disorders. It may thus be a useful risk indicator and design and evaluation tool. However, there is limited information on the test-retest reliability, the sensitivity and the effects of diurnal fluctuation on field usable fatigue measures. This study reports on an evaluation of 11 measurement tools and their 14 parameters. Eight measures were found to have test-retest ICC values greater than 0.8. Four measures were particularly responsive during an intermittent fatiguing condition. However, two responsive measures demonstrated rhythmic behaviour, with significant time effects from 08:00 to mid-afternoon and early evening. Action tremor, muscle mechanomyography and perceived fatigue were found to be most reliable and most responsive; but additional analytical considerations might be required when interpreting daylong responses of MMG and action tremor. Practitioner Summary: This paper presents findings from test-retest and daylong reliability and responsiveness evaluations of 11 fatigue measures. This paper suggests that action tremor, muscle mechanomyography and perceived fatigue were most reliable and most responsive. However, mechanomyography and action tremor may be susceptible to diurnal changes.

The effect of prior knowledge of test endpoint on non-local muscle fatigue

INTRODUCTION

If the work duration or volume is known, it is common for individuals to anticipate this challenge by pursuing a strategy that may decrease the initial force output and maintain a force level that ensures a force reserve towards the end of the task. However, it is unknown whether this is a global strategy that is transferred to a non-exercised muscle following fatigue of a contralateral homologous muscle.

METHODS

To clarify if prior knowledge of task endpoint has an effect on non-local muscle fatigue (NLMF), 15 male participants (22.4 ± 3.8 years) completed four conditions: (1) KNtest > fatigue (known endpoint after fatigue), (2) UNKtest > fatigue (unknown endpoint after fatigue), (3) KNtest > control (known endpoint without fatigue), (4) UNKtest > control (unknown endpoint without fatigue). For fatigue conditions, a maximal intensity, unilateral knee extension protocol was completed (two sets of 100 s maximal voluntary isometric contractions (MVIC) with 60 s rest between), whereas the control condition involved rest (260 s). The participants were either informed (known (KN) conditions) or not informed (unknown (UNK) conditions) of the duration of a post-intervention strength-endurance test (contralateral knee extension MVIC, ≥30 s).

RESULTS

During the strength-endurance test, the UNKtest > fatigue displayed meaningful decreases in force (UNKtest > fatigue 10-12% over first 30 s), which was largest at the 25-30-s period (UNKtest > fatigue 7.4-41.1% from 25 to 1930s) compared to KNtest > fatigue and KNtest > control conditions, respectively.

CONCLUSION

Prior knowledge of task endpoint can modify NLMF and affect pacing strategies.

The Nature of Self-Regulatory Fatigue and "Ego Depletion": Lessons From Physical Fatigue

Self-regulation requires overriding a dominant response and leads to temporary self-regulatory fatigue. Existing theories of the nature and causes of self-regulatory fatigue highlight physiological substrates such as glucose, or psychological processes such as motivation, but these explanations are incomplete on their own. Historically, theories of physical fatigue demonstrate a similar pattern of useful but incomplete explanations, as recent views of physical fatigue emphasize the roles of both physiological and psychological factors. In addition to accounting for multiple inputs, these newer views also explain how fatigue can occur even in the presence of sufficient resources. Examining these newer theories of physical fatigue can serve as a foundation on which to build a more comprehensive understanding of self-regulatory fatigue that integrates possible neurobiological underpinnings of physical and self-regulatory fatigue, and suggests the possible function of self-regulatory fatigue.

Intensity-dependent EMG response for the biceps brachii during sustained maximal and submaximal isometric contractions

PURPOSE

There have been recent attempts to characterize the mechanisms associated with fatigue-induced task failure. We compared the time to failure and the corresponding changes in the surface electromyogram (EMG) during sustained maximal and submaximal isometric force tasks.

METHODS

EMG activity was measured from the biceps brachii of 18 male participants as they sustained either a maximal or submaximal (60 % MVC) isometric contraction of the dominant elbow flexors until force could not be maintained above 55 % MVC.

RESULTS

Intensity-dependent patterns of change were observed for EMG amplitude and mean power frequency (MNF) between the two force tasks. Interestingly, the only significant predictor of failure time was the rate of change in EMG MNF during the submaximal task (r (2) = 0.304). In addition, EMG amplitude at submaximal failure was significantly lower (p < 0.05) than the values obtained during MVC.

CONCLUSIONS

The patterns of EMG response emphasize the basis of neuromuscular fatigue and task dependency. Additionally, our data suggest that the EMG MNF should be used when monitoring the progression of local muscle fatigue.

The Central Governor Model of Exercise Regulation Teaches Us Precious Little about the Nature of Mental Fatigue and Self-Control Failure

Self-control is considered broadly important for many domains of life. One of its unfortunate features, however, is that it tends to wane over time, with little agreement about why this is the case. Recently, there has been a push to address this problem by looking to the literature in exercise physiology, specifically the work on the central governor model of physical fatigue. Trying to explain how and why mental performance wanes over time, the central governor model suggests that exertion is throttled by some central nervous system mechanism that receives information about energetic bodily needs and motivational drives to regulate exertion and, ultimately, to prevent homeostatic breakdown, chiefly energy depletion. While we admire the spirit of integration and the attempt to shed light on an important topic in psychology, our concern is that the central governor model is very controversial in exercise physiology, with increasing calls to abandon it altogether, making it a poor fit for psychology. Our concerns are threefold. First, while we agree that preservation of bodily homeostasis makes for an elegant ultimate account, the fact that such important homeostatic concerns can be regularly overturned with even slight incentives (e.g., a smile) renders the ultimate account impotent and points to other ultimate functions for fatigue. Second, despite the central governor being thought to take as input information about the metabolic needs of the body, there is no credible evidence that mental effort actually consumes inordinate amounts of energy that are not already circulating in the brain. Third, recent modifications of the model make the central governor appear like an all-knowing homunculus and unfalsifiable in principle, thus contributing very little to our understanding of why people tend to disengage from effortful tasks over time. We note that the latest models in exercise physiology have actually borrowed concepts and models from psychology to understand physical performance.

Fatigue and pacing in high-intensity intermittent team sport: an update

With the advancements in player tracking technology, the topic of fatigue and pacing in team sport has become increasingly popular in recent years. Initially based upon a pre-conceived pacing schema, a central metabolic control system is proposed to guide the movement of players during team sport matches, which can be consciously modified based on afferent signals from the various physiological systems and in response to environmental cues. On the basis of this theory, coupled with the collective findings from motion-analysis research, we sought to define the different pacing strategies employed by team sport players. Whole-match players adopt a 'slow-positive' pacing profile (gradual decline in total running intensity), which appears to be global across the different team sports. High-intensity movement also declines in a 'slow-positive' manner across most team sport matches. The duration of the exercise bout appears to be important for the selected exercise intensity, with the first introduction to a match as a substitute or interchange player resulting in a 'one bout, all out' strategy. In a limited interchange environment, a second introduction to the match results in a 'second-bout reserve' strategy; otherwise, the 'one bout, all out' strategy is likely to be adopted. These pacing profiles are proposed to reflect the presence of a central regulator that controls the movement intensity of the player to optimize performance, as well as avoiding the harmful failure of any physiological system. The presence of 'temporary fatigue' reflects this process, whereby exercise intensity is consciously modulated from within the framework of a global pacing schema.

Reliability and fatigue characteristics of a standing hip isometric endurance protocol

Muscle fatigue is a common consideration when evaluating and rehabilitating athletic injuries. The presence of muscular fatigue has been previously determined by quantifying median frequency (MF) through a power spectral analysis on EMG signals collected throughout an endurance task. Research has not yet determined if a prolonged isometric test in a standing position generates muscular fatigue of the hip. The purpose of this study was to determine the reliability and fatigue characteristics of a standing hip isometric endurance test. Twenty healthy participants completed one 60-s Maximum Voluntary Isometric Contraction of standing hip flexion, extension, adduction, and abduction. MF of the participants' dominant limb rectus femoris (RF), biceps femoris (BF), gluteus maximus (GMax), gluteus medius (GMed) and adductor longus (ADD) was determined via surface electromyography during two sessions, 30-min apart. Reliability values (ICC2,1) were moderate-to-excellent for all time intervals of each action (FlexionRF: >0.80; ExtensionBF: >0.89; ExtensionGMax: >0.60; AdductionADD: >0.78; AbductionGMed: >0.60) and MF significantly decreased over time for all actions. Results suggest the endurance test is a reliable technique to generate muscular fatigue for hip flexion, extension, adduction and abduction. It can be used as a time efficient fatigue protocol specific to the RF, BF, GMax, ADD and GMed.

Pacing and decision making in sport and exercise: the roles of perception and action in the regulation of exercise intensity

In pursuit of optimal performance, athletes and physical exercisers alike have to make decisions about how and when to invest their energy. The process of pacing has been associated with the goal-directed regulation of exercise intensity across an exercise bout. The current review explores divergent views on understanding underlying mechanisms of decision making in pacing. Current pacing literature provides a wide range of aspects that might be involved in the determination of an athlete's pacing strategy, but lacks in explaining how perception and action are coupled in establishing behaviour. In contrast, decision-making literature rooted in the understanding that perception and action are coupled provides refreshing perspectives on explaining the mechanisms that underlie natural interactive behaviour. Contrary to the assumption of behaviour that is managed by a higher-order governor that passively constructs internal representations of the world, an ecological approach is considered. According to this approach, knowledge is rooted in the direct experience of meaningful environmental objects and events in individual environmental processes. To assist a neuropsychological explanation of decision making in exercise regulation, the relevance of the affordance competition hypothesis is explored. By considering pacing as a behavioural expression of continuous decision making, new insights on underlying mechanisms in pacing and optimal performance can be developed.

Knowledge of repetitions range affects force production in trained females

Most studies have examined pacing strategies with cyclical activities (running and cycling). It has been demonstrated that males employ different pacing strategies during repeated maximal voluntary contractions (MVCs) dependent upon a known endpoint. Since different fatiguing mechanisms have been identified between the genders, it is not known if females use comparable pacing strategies. The purpose of this study was to examine if informing female subjects regarding the number of MVCs to perform would affect force and electromyography (EMG). Twenty well-trained females completed 3 fatiguing protocols in a randomized order. In the control condition participants were informed they would perform twelve MVCs and then actually completed twelve. In the unknown condition they were not told how many MVCs to perform but were stopped after twelve. In the deception condition they were initially informed to perform 6 MVCs, but after the 6(th) MVC they were asked to perform a few more MVCs and were stopped after twelve. During the first 6 MVCs, forces in the deception condition were greater compared to the unknown (p = 0.021, ES = 0.65, 5%) and control (p = 0.022, ES = 0.42, 3%) conditions. No differences were found between conditions in the last 6 MVCs. A main effect for repetitions showed force deficits during the first 6 MVCs (p = 0.000, ES = 1.81, 13%) and last 6 MVCs (p = 0.05, ES = 0.34, 3%). No differences were found between conditions in biceps and triceps EMG. However, EMG decreased during the first 6 MVCs for biceps (p = 0.001, ES = 1.0, 14%) and triceps (p = 0.001, ES = 0.76, 14%) across conditions. No differences were found in the last 6 MVCs. The anticipation of performing fewer MVCs led to increased force, whereas no endpoint led to decreased force production. Key pointsPacing strategies occur during repeated (fatiguing) MVCs as a function of end point expectations.Females use similar pacing strategies as previously published results with males.Without a known end point, females will tend to pace themselves by decreasing force output even when asked to perform maximal contractions.

Prior low- or high-intensity exercise alters pacing strategy, energy system contribution and performance during a 4-km cycling time trial

We analyzed the influence of prior exercise designed to reduce predominantly muscle glycogen in either type I or II fibers on pacing and performance during a 4-km cycling time trial (TT). After preliminary and familiarization trials, in a randomized, repeated-measures crossover design, ten amateur cyclists performed: 1) an exercise designed to reduce glycogen of type I muscle fibers, followed by a 4-km TT (EX-FIB I); 2) an exercise designed to reduce glycogen of type II muscle fibers, followed by a 4-km TT (EX-FIB II) and; 3) a 4-km TT, without the prior exercise (CONT). The muscle-glycogen-reducing exercise in both EX-FIB I and EX-FIB II was performed in the evening, ∼12 h before the 4-km TT. Performance time was increased and power output (PO) was reduced in EX-FIB I (432.8±8.3 s and 204.9±10.9 W) and EX-FIB II (428.7±6.7 s and 207.5±9.1 W) compared to CONT (420.8±6.4 s and 218.4±9.3 W; P<0.01), without a difference between EX-FIB I and EX-FIB II (P>0.05). The PO was lower in EX-FIB I than in CONT at the beginning and middle of the trial (P<0.05). The mean aerobic contribution during EX-FIB I was also significantly lower than in CONT (P<0.05), but there was no difference between CONT and EX-FIB II or between EX-FIB I and EX-FIB II (P>0.05). The integrated electromyography was unchanged between conditions (P>0.05). Performance may have been impaired in EX-FIB I due a more conservative pacing at the beginning and middle, which was associated with a reduced aerobic contribution. In turn, the PO profile adopted in EX-FIB II was also reduced throughout the trial, but the impairment in performance may be attributed to a reduced glycolytic contribution (i.e. reduced lactate accumulation).

Neuroscience of exercise: from neurobiology mechanisms to mental health

The neuroscience of exercise is a growing research area that is dedicated to furthering our understanding of the effects that exercise has on mental health and athletic performance. The present study examined three specific topics: (1) the relationship between exercise and mental disorders (e.g. major depressive disorder, dementia and Parkinson's disease), (2) the effects of exercise on the mood and mental health of athletes, and (3) the possible neurobiological mechanisms that mediate the effects of exercise. Positive responses to regular physical exercise, such as enhanced functional capacity, increased autonomy and improved self-esteem, are frequently described in the recent literature, and these responses are all good reasons for recommending regular exercise. In addition, physical exercise may improve both mood and adherence to an exercise program in healthy individuals and might modulate both the performance and mental health of athletes. Exercise is associated with the increased synthesis and release of both neurotransmitters and neurotrophic factors, and these increases may be associated with neurogenesis, angiogenesis and neuroplasticity. This review is a call-to-action that urges researchers to consider the importance of understanding the neuroscience of physical exercise and its contributions to sports science.

Pacing strategies during repeated maximal voluntary contractions

PURPOSE

Pacing strategies have been reported to occur during continuous cyclical exercises. However, currently no studies have examined if pacing takes place during repeated maximal voluntary muscle contractions (MVCs). Accordingly, the purpose of this study was to examine if informing subjects on the number of MVCs they would perform would affect force and root mean squared electromyography (EMG), during similar fatiguing protocols.

METHODS

Thirty well-trained male subjects completed three fatiguing protocols in a randomized order. In the control condition participants were informed they would perform 12 MVCs, and then completed all 12. In the unknown condition they were not told how many MVCs they would perform, but were stopped after 12. Lastly, in the deception condition they were initially told they would perform only 6 MVCs, but after the 6 contractions they were asked to perform a few more repetitions and were stopped after 12.

RESULTS

Compared to the unknown condition, subjects demonstrated greater forces (p < 0.05, ES = 0.35-1.14, 2-7.5%) and biceps EMG (p < 0.05, ES = 0.6, 6%) in the deception condition during the first six MVCs. Additionally, under all conditions subjects applied greater forces in the last repetition (#12) relative to the previous one (#11) (p < 0.06, ES = 0.36-0.5, 2.8-3.8%).

CONCLUSIONS

The anticipation of performing a certain number of MVCs led the subjects to utilize different pacing strategies. The results also question the assumption that subjects followed the instruction to exert maximal effort during repeated MVCs.

Effects of pre-irradiation of low-level laser therapy with different doses and wavelengths in skeletal muscle performance, fatigue, and skeletal muscle damage induced by tetanic contractions in rats

This study aimed to evaluate the effects of low-level laser therapy (LLLT) immediately before tetanic contractions in skeletal muscle fatigue development and possible tissue damage. Male Wistar rats were divided into two control groups and nine active LLLT groups receiving one of three different laser doses (1, 3, and 10 J) with three different wavelengths (660, 830, and 905 nm) before six tetanic contractions induced by electrical stimulation. Skeletal muscle fatigue development was defined by the percentage (%) of the initial force of each contraction and time until 50 % decay of initial force, while total work was calculated for all six contractions combined. Blood and muscle samples were taken immediately after the sixth contraction. Several LLLT doses showed some positive effects on peak force and time to decay for one or more contractions, but in terms of total work, only 3 J/660 nm and 1 J/905 nm wavelengths prevented significantly (p < 0.05) the development of skeletal muscle fatigue. All doses with wavelengths of 905 nm but only the dose of 1 J with 660 nm wavelength decreased creatine kinase (CK) activity (p < 0.05). Qualitative assessment of morphology revealed lesser tissue damage in most LLLT-treated groups, with doses of 1-3 J/660 nm and 1, 3, and 10 J/905 nm providing the best results. Optimal doses of LLLT significantly delayed the development skeletal muscle performance and protected skeletal muscle tissue against damage. Our findings also demonstrate that optimal doses are partly wavelength specific and, consequently, must be differentiated to obtain optimal effects on development of skeletal muscle fatigue and tissue preservation. Our findings also lead us to think that the combined use of wavelengths at the same time can represent a therapeutic advantage in clinical settings.

Effect of phototherapy (low-level laser therapy and light-emitting diode therapy) on exercise performance and markers of exercise recovery: a systematic review with meta-analysis

Recent studies have explored if phototherapy with low-level laser therapy (LLLT) or narrow-band light-emitting diode therapy (LEDT) can modulate activity-induced skeletal muscle fatigue or subsequently protect against muscle injury. We performed a systematic review with meta-analysis to investigate the effects of phototherapy applied before, during and after exercises. A literature search was performed in Pubmed/Medline database for randomized controlled trials (RCTs) published from 2000 through 2012. Trial quality was assessed with the ten-item PEDro scale. Main outcome measures were selected as: number of repetitions and time until exhaustion for muscle performance, and creatine kinase (CK) activity to evaluate risk for exercise-induced muscle damage. The literature search resulted in 16 RCTs, and three articles were excluded due to poor quality assessment scores. From 13 RCTs with acceptable methodological quality (≥6 of 10 items), 12 RCTs irradiated phototherapy before exercise, and 10 RCTs reported significant improvement for the main outcome measures related to performance. The time until exhaustion increased significantly compared to placebo by 4.12 s (95% CI 1.21-7.02, p < 0.005) and the number of repetitions increased by 5.47 (95% CI 2.35-8.59, p < 0.0006) after phototherapy. Heterogeneity in trial design and results precluded meta-analyses for biochemical markers, but a quantitative analysis showed positive results in 13 out of 16 comparisons. The most significant and consistent results were found with red or infrared wavelengths and phototherapy application before exercises, power outputs between 50 and 200 mW and doses of 5 and 6 J per point (spot). We conclude that phototherapy (with lasers and LEDs) improves muscular performance and accelerate recovery mainly when applied before exercise.

Exercise duration and blood lactate concentrations following high intensity cycle ergometry

The aim of this study was to investigate differences in blood lactate accumulation following 10 and 20 sec of maximal cycle ergometer exercise. Body mass, stature, and age of the group was determined prior to testing (82.57 ± 5.94 kg 177 ± 5.94 cm and 21.42 ± 1.61 yrs, respectively). Eight male rugby union players performed two maximal sprints in a random fashion of 10 and 20 sec duration on a cycle ergometer. During the 10 and 20 sec trial, blood lactate levels measured were as follows 1.58 ± 0.78, 4.43 ± 1.4, and 3.5 ± 1.2 mmol.l⁻¹ vs. 1.72 ± 0.65, 6.14 ± 2, and 5.68 ± 2.22 mmol.l⁻¹, respectively. Differences were found (P < 0.01) from rest to 5 and 10 min postexercise in both groups. Differences in concentration also were found between groups at both postexercise stages (P < 0.01). The reduction in blood lactate concentrations observed between the 5 to 10 min recovery stages were 0.91 ± 0.58 mmol.l⁻¹ vs. 0.46 ± 0.48 mmol.l⁻¹ following 10 and 20 sec of maximal exercise, respectively (P > 0.05). The concentrations observed are interesting and may influence recovery time and subsequent exercise performance.

Can neuromuscular fatigue explain running strategies and performance in ultra-marathons?: the flush model

While the industrialized world adopts a largely sedentary lifestyle, ultra-marathon running races have become increasingly popular in the last few years in many countries. The ability to run long distances is also considered to have played a role in human evolution. This makes the issue of ultra-long distance physiology important. In the ability to run multiples of 10 km (up to 1000 km in one stage), fatigue resistance is critical. Fatigue is generally defined as strength loss (i.e. a decrease in maximal voluntary contraction [MVC]), which is known to be dependent on the type of exercise. Critical task variables include the intensity and duration of the activity, both of which are very specific to ultra-endurance sports. They also include the muscle groups involved and the type of muscle contraction, two variables that depend on the sport under consideration. The first part of this article focuses on the central and peripheral causes of the alterations to neuromuscular function that occur in ultra-marathon running. Neuromuscular function evaluation requires measurements of MVCs and maximal electrical/magnetic stimulations; these provide an insight into the factors in the CNS and the muscles implicated in fatigue. However, such measurements do not necessarily predict how muscle function may influence ultra-endurance running and whether this has an effect on speed regulation during a real competition (i.e. when pacing strategies are involved). In other words, the nature of the relationship between fatigue as measured using maximal contractions/stimulation and submaximal performance limitation/regulation is questionable. To investigate this issue, we are suggesting a holistic model in the second part of this article. This model can be applied to all endurance activities, but is specifically adapted to ultra-endurance running: the flush model. This model has the following four components: (i) the ball-cock (or buoy), which can be compared with the rate of perceived exertion, and can increase or decrease based on (ii) the filling rate and (iii) the water evacuated through the waste pipe, and (iv) a security reserve that allows the subject to prevent physiological damage. We are suggesting that central regulation is not only based on afferent signals arising from the muscles and peripheral organs, but is also dependent on peripheral fatigue and spinal/supraspinal inhibition (or disfacilitation) since these alterations imply a higher central drive for a given power output. This holistic model also explains how environmental conditions, sleep deprivation/mental fatigue, pain-killers or psychostimulants, cognitive or nutritional strategies may affect ultra-running performance.

Red (660 nm) and infrared (830 nm) low-level laser therapy in skeletal muscle fatigue in humans: what is better?

In animal and clinical trials low-level laser therapy (LLLT) using red, infrared and mixed wavelengths has been shown to delay the development of skeletal muscle fatigue. However, the parameters employed in these studies do not allow a conclusion as to which wavelength range is better in delaying the development of skeletal muscle fatigue. With this perspective in mind, we compared the effects of red and infrared LLLT on skeletal muscle fatigue. A randomized double-blind placebo-controlled crossover trial was performed in ten healthy male volunteers. They were treated with active red LLLT, active infrared LLLT (660 or 830 nm, 50 mW, 17.85 W/cm², 100 s irradiation per point, 5 J, 1,785 J/cm² at each point irradiated, total 20 J irradiated per muscle) or an identical placebo LLLT at four points of the biceps brachii muscle for 3 min before exercise (voluntary isometric elbow flexion for 60 s). The mean peak force was significantly greater (p < 0.05) following red (12.14%) and infrared LLLT (14.49%) than following placebo LLLT, and the mean average force was also significantly greater (p < 0.05) following red (13.09%) and infrared LLLT (13.24%) than following placebo LLLT. There were no significant differences in mean average force or mean peak force between red and infrared LLLT. We conclude that both red than infrared LLLT are effective in delaying the development skeletal muscle fatigue and in enhancement of skeletal muscle performance. Further studies are needed to identify the specific mechanisms through which each wavelength acts.

Interactive processes link the multiple symptoms of fatigue in sport competition

Muscle physiologists often describe fatigue simply as a decline of muscle force and infer this causes an athlete to slow down. In contrast, exercise scientists describe fatigue during sport competition more holistically as an exercise-induced impairment of performance. The aim of this review is to reconcile the different views by evaluating the many performance symptoms/measures and mechanisms of fatigue. We describe how fatigue is assessed with muscle, exercise or competition performance measures. Muscle performance (single muscle test measures) declines due to peripheral fatigue (reduced muscle cell force) and/or central fatigue (reduced motor drive from the CNS). Peak muscle force seldom falls by >30% during sport but is often exacerbated during electrical stimulation and laboratory exercise tasks. Exercise performance (whole-body exercise test measures) reveals impaired physical/technical abilities and subjective fatigue sensations. Exercise intensity is initially sustained by recruitment of new motor units and help from synergistic muscles before it declines. Technique/motor skill execution deviates as exercise proceeds to maintain outcomes before they deteriorate, e.g. reduced accuracy or velocity. The sensation of fatigue incorporates an elevated rating of perceived exertion (RPE) during submaximal tasks, due to a combination of peripheral and higher CNS inputs. Competition performance (sport symptoms) is affected more by decision-making and psychological aspects, since there are opponents and a greater importance on the result. Laboratory based decision making is generally faster or unimpaired. Motivation, self-efficacy and anxiety can change during exercise to modify RPE and, hence, alter physical performance. Symptoms of fatigue during racing, team-game or racquet sports are largely anecdotal, but sometimes assessed with time-motion analysis. Fatigue during brief all-out racing is described biomechanically as a decline of peak velocity, along with altered kinematic components. Longer sport events involve pacing strategies, central and peripheral fatigue contributions and elevated RPE. During match play, the work rate can decline late in a match (or tournament) and/or transiently after intense exercise bursts. Repeated sprint ability, agility and leg strength become slightly impaired. Technique outcomes, such as velocity and accuracy for throwing, passing, hitting and kicking, can deteriorate. Physical and subjective changes are both less severe in real rather than simulated sport activities. Little objective evidence exists to support exercise-induced mental lapses during sport. A model depicting mind-body interactions during sport competition shows that the RPE centre-motor cortex-working muscle sequence drives overall performance levels and, hence, fatigue symptoms. The sporting outputs from this sequence can be modulated by interactions with muscle afferent and circulatory feedback, psychological and decision-making inputs. Importantly, compensatory processes exist at many levels to protect against performance decrements. Small changes of putative fatigue factors can also be protective. We show that individual fatigue factors including diminished carbohydrate availability, elevated serotonin, hypoxia, acidosis, hyperkalaemia, hyperthermia, dehydration and reactive oxygen species, each contribute to several fatigue symptoms. Thus, multiple symptoms of fatigue can occur simultaneously and the underlying mechanisms overlap and interact. Based on this understanding, we reinforce the proposal that fatigue is best described globally as an exercise-induced decline of performance as this is inclusive of all viewpoints.