Influence of sex on performance fatigability of the plantar flexors following repeated maximal dynamic shortening contractions

The influence of sex on activity in voluntary wheel running, forced treadmill running, and open field testing

Introduction

Physical activity is commonly used for both measuring and treating dysfunction. While preclinical work has been historically biased towards males, the use of both male and female animals is gaining popularity after multiple NIH initiatives. With increasing inclusion of both sexes, it has become imperative to determine sex differences in common behavioral assays. The purpose of this study was to determine baseline sex differences in 3 activity assays: voluntary wheel running, forced treadmill running, and open field testing.

Methods

This was a secondary analysis of sex differences in healthy mice in 3 different assays: Separate mice were used for each assay. Specifically, 16 mice underwent 28 days of voluntary wheel running, 178 mice underwent forced treadmill running, and 88 mice underwent open field testing. Differences between sex across several activity parameters were examined for each assay.

Results

In voluntary wheel running, sex differences with larger effect sizes were observed in distance run, running time, and bout duration, with smaller effect size differences in speed, and no difference in total bouts. In forced treadmill running, differences were shown in time to exhaustion, but no difference in max speed attained. In open field, there were sex differences in active time but not in distance and speed in data aggregated over 30 minutes; however, distance and speed in male mice showed a downward trajectory over the final 20 minutes of testing, whereas females maintained the same trajectory.

Conclusion

These data suggest that male mice demonstrate comparable activity intensity as female mice but do not match female's duration of activity, especially for volitional tasks. Researchers utilizing these assays should account for sex differences as they could potentially mask true findings in an experiment.

Plain English Summary

Physical activity is a common measure to examine function in human subjects with and without disease. Animal models often use measures of physical activity to assess function, yet most of these measures have been done in males only, making interpretation and translation to females and humans difficult. Several measures have been used to measure activity in animals, including those examining voluntary running behavior, maximum capacity, and general activity levels; sex differences between these measures are unclear. We discovered sex differences throughout each of three activity tests. In voluntary running behavior there were large differences between sexes with females running a greater distance and spending more time running. There were small differences in the maximum capacity with females running for a longer period at high intensity. General activity levels showed small differences with females being less active than males. Thus, the greatest differences were found for voluntary running and small differences were found for maximum capacity and general activity levels; differences observed were dependent on the task. Researchers utilizing these assays should account for sex differences as they could potentially mask true findings in an experiment.

"There just isn't any other option-so we just have to put up with it": mental health in women's cycling and the necessity of structural change

Historically, bicycle riding connoted freedom, independence, and enhanced mental and physical wellbeing for women. Persevering through criticism and moral panic, female cyclists have been competitive since the late 19th century-many earning substantial prize money and prestige. Unfortunately, this progress was not linear in its trajectory and contemporary professional women's cycling continues to be pervaded by structural and cultural challenges, which can have deleterious effects on athlete mental health. Notably, socioeconomic pressures endure, like unstable employment terms, limited team support, and role conflicts. Furthermore, sexual harassment, body shaming, and manipulation may characterize women's experiences with their coaches and teams. Sizable investment gaps between men's and women's teams and competitions often underpin these scenarios of disadvantage. Alongside hindering the development of women's cycling, these adverse circumstances may induce psychosocial risk factors. Within this context, by highlighting sport-specific and sex-specific considerations, the emerging subdiscipline of sports psychiatry can be valuable for protecting and promoting athlete welfare in women's cycling. Raising awareness about extant symptoms, vulnerabilities, contributing behaviours, and systemic issues, can bolster efforts to develop better conditions and care equivalence. To that end, this perspective article draws upon anecdotal and scholarly evidence to provide an overview of psychiatric concerns in women's professional cycling. This informs recommended strategies to improve mental health and advance equality within the sport, which should involve actions from several stakeholders, such as athletes, teams, and governing bodies.

Eccentric exercise-induced muscle weakness abolishes sex differences in fatigability during sustained submaximal isometric contractions

BACKGROUND

Females are typically less fatigable than males during sustained isometric contractions at lower isometric contraction intensities. This sex difference in fatigability becomes more variable during higher intensity isometric and dynamic contractions. While less fatiguing than isometric or concentric contractions, eccentric contractions induce greater and longer lasting impairments in force production. However, it is not clear how muscle weakness influences fatigability in males and females during sustained isometric contractions.

METHODS

We investigated the effects of eccentric exercise-induced muscle weakness on time to task failure (TTF) during a sustained submaximal isometric contraction in young (18-30 years) healthy males (n = 9) and females (n = 10). Participants performed a sustained isometric contraction of the dorsiflexors at 35° plantar flexion by matching a 30% maximal voluntary contraction (MVC) torque target until task failure (i.e., falling below 5% of their target torque for ≥2 s). The same sustained isometric contraction was repeated 30 min after 150 maximal eccentric contractions. Agonist and antagonist activation were assessed using surface electromyography over the tibialis anterior and soleus muscles, respectively.

RESULTS

Males were ∼41% stronger than females. Following eccentric exercise both males and females experienced an ∼20% decline in maximal voluntary contraction torque. TTF was ∼34% longer in females than males prior to eccentric exercise-induced muscle weakness. However, following eccentric exercise-induced muscle weakness, this sex-related difference was abolished, with both groups having an ∼45% shorter TTF. Notably, there was ∼100% greater antagonist activation in the female group during the sustained isometric contraction following exercise-induced weakness as compared to the males.

CONCLUSION

This increase in antagonist activation disadvantaged females by decreasing their TTF, resulting in a blunting of their typical fatigability advantage over males.

Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations

ABSTRACT

Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.

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

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

Power attenuation from restricting range of motion is minimized in subjects with fast RTD and following isometric training

Time-dependent measures consisting of rate of torque development (RTD), rate of velocity development (RVD), and rate of neuromuscular activation can be used to evaluate explosive muscular performance, which becomes critical when performing movements throughout limited ranges of motion (ROM). Using a HUMAC NORM dynamometer, seven males (27 ± 7 years) and six females (22 ± 3 years) underwent 8 weeks of maximal isometric dorsiflexion training 3 days/week. One leg was trained at 0° (short-muscle tendon unit (MTU) length) and the other at 40° of plantar flexion (long-MTU length). RTD and rate of neuromuscular activation were evaluated during 'fast' maximal isometric contractions. Power, RVD, and rate of neuromuscular activation were assessed during maximal isotonic contractions in four conditions (small (40° to 30° of plantar flexion) ROM at 10 and 50% MVC; large (40° to 0° of plantar flexion) ROM at 10 and 50% MVC) for both legs, pre- and post-training. Despite no change in rate of neuromuscular activation following training, peak power, RTD, and RVD increased at both MTU lengths (p < 0.05). Strong relationships (R²=0.73) were observed between RTD and peak power in the small ROM, indicating that fast time-dependent measures are critical for optimal performance when ROM is constrained. Meanwhile, strong relationships (R²=0.90) between RVD and power were observed at the 50% load, indicating that RVD is critical when limited by load and ROM is not confined. Maximal isometric dorsiflexion training can be used to improve time-dependent measures (RTD, RVD) to minimize power attenuation when ROM is restricted.

Rate of Force Development as an Indicator of Neuromuscular Fatigue: A Scoping Review

Because rate of force development (RFD) is an emerging outcome measure for the assessment of neuromuscular function in unfatigued conditions, and it represents a valid alternative/complement to the classical evaluation of pure maximal strength, this scoping review aimed to map the available evidence regarding RFD as an indicator of neuromuscular fatigue. Thus, following a general overview of the main studies published on this topic, we arbitrarily compared the amount of neuromuscular fatigue between the “gold standard” measure (maximal voluntary force, MVF) and peak, early (≤100 ms) and late (>100 ms) RFD. Seventy full-text articles were included in the review. The most-common fatiguing exercises were resistance exercises (37% of the studies), endurance exercises/locomotor activities (23%), isokinetic contractions (17%), and simulated/real sport situations (13%). The most widely tested tasks were knee extension (60%) and plantar flexion (10%). The reason (i.e., rationale) for evaluating RFD was lacking in 36% of the studies. On average, the amount of fatigue for MVF (−19%) was comparable to late RFD (−19%) but lower compared to both peak RFD (−25%) and early RFD (−23%). Even if the rationale for evaluating RFD in the fatigued state was often lacking and the specificity between test task and fatiguing exercise characteristics was not always respected in the included studies, RFD seems to be a valid indicator of neuromuscular fatigue. Based on our arbitrary analyses, peak RFD and early phase RFD appear even to be more sensitive to quantify neuromuscular fatigue than MVF and late phase RFD.

Isometric versus isotonic contractions: Sex differences in the fatigability and recovery of isometric strength and high-velocity contractile parameters

The purpose of this study was to investigate potential sex differences in the fatigue‐ and recovery‐induced responses of isometric strength and power, as well as select dynamic contractile parameters after isometric and isotonic plantar flexor (PF) contractions. Healthy males (n = 12; age = 21.8 ± 2.2 years) and females (n = 14; age = 21.4 ± 2.5 years) performed a 2‐min maximal voluntary isometric contraction and 120 concentric isotonic (30% peak isometric torque) contractions of the PFs on separate visits. Isometric strength, isotonic power, as well as torque‐ and velocity‐related parameters were recorded before, immediately after, and throughout 10 min of recovery. Rate of EMG rise (RER) for the medial gastrocnemius (MG) and soleus was also obtained. All measures responded similarly between sexes after both fatiguing modalities (p > 0.05), except RER of the MG which, in males demonstrated both, a greater decrease during isotonic contractions (p = 0.038, ηp2 = 0.174) and more rapid recovery after isometric exercise (p = 0.043, ηp2 = 0.166). Although not significant, a nearly large effect size was demonstrated for the fatigue‐induced decrease in isometric strength (p = 0.061; d = 0.77) due to relative decreases tending to be greater in males (−29% vs. −17%). Regardless of fatiguing modality, sex differences were minimal for fatigue and recovery‐related responses in muscle function for the PFs, although the difference for RER may indicate a unique origin of fatigue. Further support for the disassociation between the response in isometric strength and power after fatiguing exercise was also demonstrated.

Power loss is attenuated following a second bout of high-intensity eccentric contractions due to the repeated bout effect's protection of rate of torque and velocity development

High-intensity unaccustomed eccentric contractions result in weakness and power loss because of fatigue and muscle damage. Through the repeated bout effect (RBE), adaptations occur, then damage and weakness are attenuated following a subsequent bout. However, it is unclear whether the RBE protects peak power output. We investigated the influence of the RBE on power production and estimated fatigue- and damage-induced neuromuscular impairments following repeated high-intensity eccentric contractions. Twelve healthy adult males performed 5 sets of 30 maximal eccentric elbow flexions and repeated an identical bout 4 weeks later. Recovery was tracked over 7 days following both bouts. Reduced maximum voluntary isometric contraction torque, and increased serum creatine kinase and self-reported soreness indirectly inferred muscle damage. Peak isotonic power, time-dependent measures - rate of velocity development (RVD) and rate of torque development (RTD) - and several electrophysiological indices of neuromuscular function were assessed. The RBE protected peak power, with a protective index of 66% 24 h after the second eccentric exercise bout. The protection of power also related to preserved RVD (R² = 0.61, P < 0.01) and RTD (R² = 0.39, P < 0.01). Furthermore, the RBE's protection against muscle damage permitted the estimation of fatigue-associated neuromuscular performance decrements following eccentric exercise. Novelty: The repeated bout effect protects peak isotonic power. Protection of peak power relates to preserved rates of torque and velocity development, but more so rate of velocity development. The repeated bout effect has little influence on indices of neuromuscular fatigue.

Changes in Fatigue Are the Same for Trained Men and Women after Resistance Exercise

PURPOSE

To measure changes in fatigue and knee-extensor torque in the 48 h after trained men and women completed a full-body resistance exercise session.

METHODS

Eight trained women (mean ± SD: age, 25.6 ± 5.9 yr; height, 1.68 ± 0.06 m; mass, 71.0 ± 8.6 kg) and eight trained men (age, 25.5 ± 6.2 yr; height, 1.79 ± 0.05 m; mass, 86.4 ± 9.8 kg) performed a full-body resistance exercise session based on real-world athletic practice. Measurements were performed before and after the exercise session, as well as 1, 24, and 48 h after the session. Fatigue and pain were measured with standardized self-report measures. Maximal isometric contractions with the knee extensors and superimposed femoral nerve stimulation were performed to examine maximal torque, rate of torque development, voluntary activation, and muscle contractility. Two sets of 10 isokinetic contractions (60°·s) with the knee extensors were performed during the protocol with use of near-infrared spectroscopy to assess muscle oxygenation. EMG were recorded from two quadriceps muscles during all isometric and isokinetic contractions.

RESULTS

Fatigue was increased from baseline for both sexes until 48 h after training (P < 0.001). Maximal torque and evoked twitch amplitudes were similarly reduced after exercise for men and women (P < 0.001). Voluntary activation and EMG amplitudes were unchanged after the training session. Muscle oxygenation was 13.3% ± 17.4% (P = 0.005) greater for women during the isokinetic repetitions, and the values were unchanged after the training session.

CONCLUSIONS

This is the first study to show similar changes in the fatigue reported by trained men and women in the 48 h after a training session involving full-body resistance exercises. Sex differences in muscle oxygenation during exercise do not influence the reductions in muscle force, activation, or contractility after the training session.

Differential changes in muscle architecture and neuromuscular fatigability induced by isometric resistance training at short and long muscle-tendon unit lengths

We evaluated the effects of differential muscle architectural adaptations on neuromuscular fatigue resistance. Seven young males and six females participated in this study. Using a longitudinal within-subject design, legs were randomly assigned to perform isometric training of the tibialis anterior (TA) three times per week for 8 wk at a short (S-group) or long muscle-tendon unit length (L-group). Before and following training, fascicle length (FL) and pennation angle (PA) of the TA were assessed. As well, fatigue-related time course changes in isometric maximal voluntary contraction (MVC) torque and isotonic peak power (20% MVC resistance) were determined before, immediately after, and 1, 2, 5, and 10 min following task failure. The fatiguing task consisted of repeated maximal effort isotonic (20% MVC resistance) contractions over a 40° range of motion until the participant reached a 40% reduction in peak power. Although there was no clear improvement in neuromuscular fatigue resistance following training in either group (P = 0.081; S-group: ∼20%; L-group: ∼51%), the change in neuromuscular fatigue resistance was related positively to the training-induced increase in PA (∼6%, P < 0.001) in the S-group (r = 0.739, P = 0.004) and negatively to the training-induced increase in FL (∼4%, P = 0.001) in the L-group (r = -0.568, P = 0.043). Both groups recovered similarly for MVC torque and peak power after the fatiguing task as compared with before training. We suggest that the relationships between the changes in muscle architecture and neuromuscular fatigue resistance depend on the muscle-tendon unit lengths at which the training is performed.NEW & NOTEWORTHY Eight weeks of isometric training at a long or short muscle-tendon unit length increased and did not change fascicle length, respectively. The "width" of the torque-angle relationship plateau became broader following isometric training at the long length. Despite marked differences in muscle architecture and functional adaptations between the groups, there was only a small-magnitude improvement in neuromuscular fatigue resistance, which was surprisingly negatively related to increased fascicle length in the long length-training group.

Differential contributions of fatigue-induced strength loss and slowing of angular velocity to power loss following repeated maximal shortening contractions

The purpose of this study was to investigate the relationship between fatigue-induced reductions in isometric torque and isotonic power and to quantify the extent to which the decreases in angular velocity and dynamic torque can explain the power loss immediately following an isotonic fatiguing task and throughout recovery in seven young males and six young females. All measurements were performed with both legs. For dorsiflexion, fatigue-related time-course changes in isometric maximal voluntary contraction (MVC) torque, angular velocity, dynamic torque, and power production following repeated maximal isotonic contractions (load: 20% MVC) were investigated before, immediately after, and 1, 2, 5 and 10 min after a fatiguing task. There were no relationships between the fatigue-related reductions in isometric MVC torque and peak power at any timepoint, suggesting that fatigue-induced reductions in isometric MVC torque does not entirely reflect fatigue-induced changes in dynamic performance. The relative contribution of fatigue-related reduction in dynamic torque on power loss was greater immediately following the task, and lower throughout recovery than the corresponding decrease in angular velocity. Thus, power loss immediately following the task was more strongly related to the decline in dynamic torque; however, this relationship shifted throughout recovery to a greater dependence on slowing of angular velocity for power loss.

The Effect of Shortening-induced Torque Depression on Fatigue-related Sex Differences

Residual torque depression (rTD) is the decrease in isometric (ISO) torque after active shortening of skeletal muscle compared with a purely ISO contraction performed at the same muscle length and level of activation. Performance fatigability is defined as any exercise-induced reduction in voluntary force or power, and females are typically more fatigue resistant than males at low-intensity ISO contractions.

PURPOSE

This study investigated performance fatigability in males and females during ISO contractions and ISO contractions after active shortening (rTD).

METHODS

Fourteen females (22 ± 2 yr) and 14 males (23 ± 2 yr) performed three baseline maximal voluntary contractions (MVCs) of the dorsiflexors. The MVCs were used to determine a 30% submaximal torque target, which participants matched as steadily as possible until task failure. The ISO fatigue task was performed at 10° plantar flexion. In the rTD session, the participants' ankle was rotated from 40° to 10° plantar flexion before performing the same fatigue task. MVCs were performed immediately after task failure, 30 s, and 1, 2, 3, 4, 5, 10, 20, and 30 min after task failure to track recovery.

RESULTS

The baseline MVC torque amplitude for males (32.1 ± 6.6 N·m) was 31% greater than that for females (22.3 ± 3.1 N·m; P < 0.001, ηp = 0.490). Females' time to task failure was 44% longer than that of males in the ISO state (P = 0.032, ηp = 0.164). However, there was no sex difference in the rTD state (P = 0.142).

CONCLUSION

It seems that the sex differences in fatigue resistance observed in a low-intensity ISO task are abolished in the ISO state after an active shortening contraction.

Sex Differences in Mechanisms of Recovery after Isometric and Dynamic Fatiguing Tasks

PURPOSE

The purpose of this study was to determine whether supraspinal mechanisms contribute to the sex difference in fatigability during and recovery from a dynamic and isometric fatiguing task with the knee extensors.

METHODS

Transcranial magnetic stimulation and electrical stimulation were used to determine voluntary activation and contractile properties of the knee extensors in 14 men and 17 women (20.8 ± 1.9 yr) after a 1) 60-s sustained, maximal voluntary isometric contraction (MVIC), and 2) dynamic fatiguing task involving 120 maximal voluntary concentric contractions with a 20% MVIC load.

RESULTS

There were no differences between men and women in the reduction of maximal torque during the sustained MVIC (54.4% ± 18.9% vs 55.9% ± 11.2%, P = 0.49) or in the decrease in power during the dynamic fatiguing task (14.7% ± 20.1% vs 14.2% ± 18.5%, P = 0.92). However, MVIC torque recovered more quickly for women than men after the sustained MVIC and the dynamic task (P < 0.05). The transcranial magnetic stimulation-elicited superimposed twitch was larger for men than for women during the sustained MVIC and in recovery (immediately post, R0.1: 4.7% ± 3.3% vs 2.4% ± 1.9% MVIC; P = 0.02), with no sex difference after the dynamic task (P = 0.35). The reduction in resting twitch amplitude was larger for men than for women immediately after the dynamic task (37% ± 22% vs 23% ± 18%; P = 0.016) with no sex difference after the sustained MVIC (64% ± 16% vs 67% ± 11%; P = 0.46).

CONCLUSIONS

Supraspinal fatigue contributed to fatigability of the knee extensors more for men than for women after a maximal isometric task, whereas contractile mechanisms explained the sex difference in torque recovery after the fast-velocity dynamic task. The mechanisms for the sex difference in fatigability are task dependent.