Comparative analysis of skeletal muscle oxidative capacity in children and adults: a 31P-MRS study

Differences in time to task failure and fatigability between children and young adults: A systematic review and meta-analysis

The transition from childhood to adulthood is characterized by many physiological processes impacting exercise performance. Performance fatigability and time to task failure are commonly used to capture exercise performance. This review aimed to determine the differences in fatigability and TTF between youth (including both children and adolescents) and young adults, and to evaluate the influence of exercise modalities (i.e., exercise duration and type of exercise) on these differences. Medline, SPORTDiscus and Cochrane Library were searched. Thirty-four studies were included. The meta-analyses revealed that both children (SMD −1.15; p < 0.001) and adolescents (SMD −1.26; p = 0.022) were less fatigable than adults. Additional analysis revealed that children were less fatigable during dynamic exercises (SMD −1.58; p < 0.001) with no differences during isometric ones (SMD –0.46; p = 0.22). Children (SMD 0.89; p = 0.018) but not adolescents (SMD 0.75; p = 0.090) had longer TTF than adults. Additional analyses revealed 1) that children had longer TTF for isometric (SMD 1.25; p < 0.001) but not dynamic exercises (SMD −0.27; p = 0.83), and 2) that TTF differences between children and adults were larger for short- (SMD 1.46; p = 0.028) than long-duration exercises (SMD 0.20; p = 0.64). Children have higher endurance and are less fatigable than adults. These differences are influenced by the exercise modality, suggesting distinct physiological functioning during exercise between children and adults. The low number of studies comparing these outcomes between adolescents versus children and adults prevents robust conclusions and warrants further investigations in adolescent individuals.

Oxygen Uptake in Repeated Cycling Sprints Against Different Loads Is Comparable Between Men and Preadolescent Boys

Children recover faster than adults in repeated sprints, but it is unclear if their aerobic responses differ.

Purpose

This study tested the hypothesis that aerobic response (VO2) during repeated sprints is greater in preadolescent boys than in men. Further, this study compared normalization with conventional ratio-scaling and scaling with the use of body mass (BM) as a covariate.

Methods

Nine boys (age: 11.8 ± 0.6 years, swimmers) and 11 men (age: 21.7 ± 0.6 years, recreational athletes) performed 10 maximal 6-s cycling sprints separated by 24-s of passive recovery, against two loads (optimum and 50% of optimum). Oxygen uptake (VO2) was measured continuously.

Results

Men’s mean power output (MPO) was greater than boys in each sprint, both in absolute (unscaled) values ( p < 0.05) and when adjusted for lean leg volume ( p < 0.05). Children had lower absolute VO2 ( p < 0.05) than men, but when it was adjusted for BM or power-output, VO2 was comparable between men and boys. Thus, most of the difference in VO2 between men and boys was due to body size and power-output differences.

Conclusion

Our results suggest that men and boys have similar VO2 during repeated sprints when appropriately adjusted to body mass or power output. Results highlight the importance of using appropriate scaling methods to compare adults’ and children’s aerobic responses to high-intensity exercise.

The influence of maturation on exercise-induced cardiac remodelling and haematological adaptation

KEY POINTS

It has long been hypothesised that cardiovascular adaptation to endurance training is augmented following puberty. We investigated whether differences in cardiac and haematological variables exist, and to what extent, between endurance-trained vs. untrained, pre- and post-peak height velocity (PHV) children, and how these central factors relate to maximal oxygen consumption. Using echocardiography to quantify left ventricular (LV) morphology and carbon monoxide rebreathing to determine blood volume and haemoglobin mass, we identified that training-related differences in LV morphology are evident in pre-PHV children, with haematological differences also observed between pre-PHV girls. However, the breadth and magnitude of cardiovascular remodelling was more pronounced post-PHV. Cardiac and haematological measures provide significant predictive models for maximal oxygen consumption in children that are much stronger post-PHV, suggesting that other important determinants within the oxygen transport chain could account for the majority of variance in before puberty.

ABSTRACT

Cardiovascular and haematological adaptations to endurance training facilitate greater maximal oxygen consumption, and such adaptations maybe augmented following puberty. Therefore, we compared left ventricular (LV) morphology (echocardiography), blood volume, haemoglobin (Hb) mass (CO-rebreathe) and in endurance-trained and untrained boys (n = 42, age = 9.0-17.1 years, = 61.6±7.2 mL∙kg∙min, and n = 31, age = 8.0-17.7 years, O_2max = 46.5±6.1 mL∙kg∙min, respectively) and girls (n = 45, age = 8.2-17.0 years, O_2max = 51.4±5.7 mL∙kg∙min and n = 36, age = 8.0-17.6 years, O_2max = 39.8±5.7 mL∙kg∙min, respectively). Pubertal stage was estimated via maturity offset, with participants classified as pre- or post-peak height velocity (PHV). Pre-PHV, only a larger LV end-diastolic volume/lean body mass (EDV/LBM) for trained boys (+0.28 mL∙kg^LBM , P = 0.007) and a higher Hb mass/LBM for trained girls (+1.65 g∙kg^LBM , P = 0.007) were evident compared to untrained controls. Post-PHV, LV mass/LBM (boys:+0.50 g∙kg^LBM , P = 0.0003; girls:+0.35 g∙kg^LBM , P = 0.003), EDV/LBM (boys:+0.35 mL∙kg^LBM , P<0.0001; girls:+0.31 mL∙kgLBM, P = 0.0004), blood volume/LBM (boys:+12.47 mL∙kg^LBM , P = 0.004; girls:+13.48 mL∙kg^LBM , P = 0.0002.) and Hb mass/LBM (boys:+1.29 g∙kg^LBM , P = 0.015; girls:+1.47 g∙kg^LBM , P = 0.002) were all greater in trained vs. untrained groups. Pre-PHV, EDV (R² _adj = 0.224, P = 0.001) in boys, and Hb mass and interventricular septal thickness (R² _adj = 0.317, P = 0.002) in girls partially accounted for the variance in O_2max . Post-PHV, stronger predictive models were evident via the inclusion of LV wall thickness and EDV in boys (R² _adj = 0.608, P<0.0001), and posterior wall thickness and Hb mass in girls (R² _adj = 0.490, P<0.0001). In conclusion, cardiovascular adaptation to exercise training is more pronounced post-PHV, with evidence for a greater role of central components for oxygen delivery. Abstract figure legend: Schematic diagram depicting cardiac structural and haematological differences between trained and untrained boys and girls, pre-peak height velocity (PHV) and post-PHV alongside cardiac and haematological variables contributions to the variance in O_2max . Cardiac and haematological variables are greater in trained vs. untrained pre-pubertal children, and a greater number and magnitude of differences are observed at post-PHV. These variables provide significant predictive models for maximal oxygen consumption in children and are much stronger post-PHV, suggesting that other important determinants within the oxygen transport chain could account for the majority of variance in O_2max before puberty. This article is protected by copyright. All rights reserved.

Sex-specific maturation of muscle metabolites carnosine, creatine, and carnitine over puberty: a longitudinal follow-up study

Due to the invasiveness of a muscle biopsy, there is fragmentary information on the existence and possible origin of a sexual dimorphism in the skeletal muscle concentrations of the energy delivery-related metabolites carnosine, creatine, and carnitine. As these metabolites can be noninvasively monitored by proton magnetic resonance spectroscopy, this technique offers the possibility to investigate if sexual dimorphisms are present in an adult reference population and if these dimorphisms originated during puberty using a longitudinal design. Concentrations of carnosine, creatine, and carnitine were examined using proton magnetic resonance spectroscopy in the soleus and gastrocnemius muscles of an adult reference population of female (n = 50) and male adults (n = 50). For the longitudinal follow-up over puberty, 29 boys and 28 girls were scanned prepuberty. Six years later, 24 boys and 24 girls were rescanned postpuberty. A sexual dimorphism was present in carnosine and creatine, but not carnitine, in the adult reference population. Carnosine was 28.5% higher in the gastrocnemius (P < 0.001) and carnosine and creatine were respectively 19.9% (P < 0.001) and 18.2% (P < 0.001) higher in the soleus of male when compared with female adults. Through puberty, carnosine increased more in male subjects compared with female subjects, both in the gastrocnemius (+10.43% and -10.83%, respectively; interaction effect: P = 0.002) and in the soleus (+24.30% and +5.49%, respectively; interaction effect: P = 0.012). No significant effect of puberty was found in either creatine (interaction effect: P = 0.307) or carnitine (interaction effect: P = 0.066). A sexual dimorphism in the adult human muscle is present in carnosine and creatine, but not in carnitine.NEW & NOTEWORTHY This is the first study to investigate sexual dimorphisms in skeletal muscle carnosine, creatine, and carnitine concentrations in a substantial adult reference population (n = 100). A sexual dimorphism is present in both carnosine and creatine at adult age. The origin of the sexual dimorphisms is investigated using a longitudinal design over puberty in 24 males and 24 females. The sexual dimorphism in carnosine originated partly during puberty for carnosine, but not for creatine.

Eccentric Resistance Training in Youth: Perspectives for Long-Term Athletic Development

The purpose of this narrative review is to discuss the role of eccentric resistance training in youth and how this training modality can be utilized within long-term physical development. Current literature on responses to eccentric exercise in youth has demonstrated that potential concerns, such as fatigue and muscle damage, compared to adults are not supported. Considering the importance of resistance training for youth athletes and the benefits of eccentric training in enhancing strength, power, speed, and resistance to injury, its inclusion throughout youth may be warranted. In this review we provide a brief overview of the physiological responses to exercise in youth with specific reference to the different responses to eccentric resistance training between children, adolescents, and adults. Thereafter, we discuss the importance of ensuring that force absorption qualities are trained throughout youth and how these may be influenced by growth and maturation. In particular, we propose practical methods on how eccentric resistance training methods can be implemented in youth via the inclusion of efficient landing mechanics, eccentric hamstrings strengthening and flywheel inertia training. This article proposes that the use of eccentric resistance training in youth should be considered a necessity to help develop both physical qualities that underpin sporting performance, as well as reducing injury risk. However, as with any other training modality implemented within youth, careful consideration should be given in accordance with an individual's maturity status, training history and technical competency as well as being underpinned by current long-term physical development guidelines.

Relationship between (non)linear phase II pulmonary oxygen uptake kinetics with skeletal muscle oxygenation and age in 11-15 year olds

NEW FINDINGS

What is the central question of this study? Do the phase II parameters of pulmonary oxygen uptake ( V ̇ O 2 ) kinetics display linear, first-order behaviour in association with alterations in skeletal muscle oxygenation during step cycling of different intensities or when exercise is initiated from an elevated work rate in youths. What is the main finding and its importance? Both linear and non-linear features of phase II V ̇ O 2 kinetics may be determined by alterations in the dynamic balance between microvascular O₂ delivery and utilization in 11-15 year olds. The recruitment of higher-order (i.e. type II) muscle fibres during 'work-to-work' cycling might be responsible for modulating V ̇ O 2 kinetics with chronological age.

ABSTRACT

This study investigated in 19 male youths (mean age: 13.6 ± 1.1 years, range: 11.7-15.7 years) the relationship between pulmonary oxygen uptake ( V ̇ O 2 ) and muscle deoxygenation kinetics during moderate- and very heavy-intensity 'step' cycling initiated from unloaded pedalling (i.e. U → M and U → VH) and moderate to very heavy-intensity step cycling (i.e. M → VH). Pulmonary V ̇ O 2 was measured breath-by-breath along with the tissue oxygenation index (TOI) of the vastus lateralis using near-infrared spectroscopy. There were no significant differences in the phase II time constant ( τ V ̇ O 2 p ) between U → M and U → VH (23 ± 6 vs. 25 ± 7 s; P = 0.36); however, the τ V ̇ O 2 p was slower during M → VH (42 ± 16 s) compared to other conditions (P < 0.001). Quadriceps TOI decreased with a faster (P < 0.01) mean response time (MRT; i.e. time delay + τ) during U → VH (14 ± 2 s) compared to U → M (22 ± 4 s) and M → VH (20 ± 6 s). The difference (Δ) between the τ V ̇ O 2 p and MRT-TOI was greater during U → VH compared to U → M (12 ± 7 vs. 2 ± 7 s, P < 0.001) and during M → VH (23 ± 15 s) compared to other conditions (P < 0.02), suggesting an increased proportional speeding of fractional O₂ extraction. The slowing of the τ V ̇ O 2 p during M → VH relative to U → M and U → VH correlated positively with chronological age (r = 0.68 and 0.57, respectively, P < 0.01). In youths, 'work-to-work' transitions slowed microvascular O₂ delivery-to-O₂ utilization with alterations in phase II V ̇ O 2 dynamics accentuated between the ages of 11 and 15 years.

Muscle strength, size, and neuromuscular function before and during adolescence

PURPOSE

To compare measurements of muscle strength, size, and neuromuscular function among pre-adolescent and adolescent boys and girls with distinctly different strength capabilities.

METHODS

Fifteen boys (mean age ± confidence interval: 13.0 ± 1.0 years) and 13 girls (12.9 ± 1.1 years) were categorized as low strength (LS, n = 14) or high strength (HS, n = 14) based on isometric maximal voluntary contraction strength of the leg extensors. Height (HT), seated height, and weight (WT) determined maturity offset, while percent body fat and fat-free mass (FFM) were estimated from skinfold measurements. Quadriceps femoris muscle cross-sectional area (CSA) was assessed from ultrasound images. Isometric ramp contractions of the leg extensors were performed while surface electromyographic amplitude (EMG_RMS) and mechanomyographic amplitude (MMG_RMS) were recorded for the vastus lateralis (VL). Neuromuscular efficiency from the EMG and MMG signals (NME_EMG and NME_MMG, respectively) and log-transformed EMG and MMG vs. torque relationships were also used to examine neuromuscular responses.

RESULTS

HS was 99-117% stronger, 2.3-2.8  years older, 14.0-15.7 cm taller, 20.9-22.3 kg heavier, 2.3-2.4 years more biologically mature, and exhibited 39-43% greater CSA than LS (p ≤ 0.001). HS exhibited 74-81% higher NME_EMG than LS (p ≤ 0.022), while HS girls exhibited the highest NME_MMG (p ≤ 0.045). Even after scaling for HT, WT, CSA, and FFM, strength was still 36-90% greater for HS than LS (p ≤ 0.031). The MMG_RMS patterns in the LS group displayed more type I motor unit characteristics.

CONCLUSIONS

Neuromuscular adaptations likely influence strength increases from pre-adolescence to adolescence, particularly when examining large, force-producing muscles and large strength differences explained by biological maturity, rather than simply age.

Children Exhibit a More Comparable Neuromuscular Fatigue Profile to Endurance Athletes Than Untrained Adults

The present study compared neuromuscular fatigue profiles between children, untrained adults and adult endurance athletes during repeated maximal muscle contractions. Eighteen prepubertal boys, 19 untrained men and 13 endurance male athletes performed 5-s maximal voluntary isometric knee extensor contractions (MVICs) interspersed with 5-s recovery until MVIC reached 60% of its initial value. Single and doublet magnetic stimulations were delivered to the femoral nerve to quantify the time course of potentiated twitch amplitude (T_tw,pot), high-frequency torque (T_{100 Hz}) and the low-to-high frequency torque ratio (T_{10 Hz}/T_{100 Hz}), i.e., indicators of peripheral fatigue. M-wave-normalized EMG amplitudes (EMG/M) and the maximal voluntary activation level (VA) were calculated to quantify central fatigue. Adults (15.9 ± 3.9 repetitions) performed fewer MVICs than children (40.4 ± 19.7) and endurance athletes (51.7 ± 19.6), however, no difference was observed between children and athletes (P = 0.13). T_tw,pot (∼52%, P < 0.001), T_{100 Hz} (∼39%, P < 0.001) and T_{10 Hz}/T_{100 Hz} (∼23%, P < 0.001) decreased only in adults. Similar decrements in vastus medialis and vastus lateralis EMG/M were observed in children and endurance athletes (range: 40-50%), and these were greater than in adults (∼15%). Whilst VA decreased more in children (-38.4 ± 22.5%, P < 0.001) than endurance athletes (-20.3 ± 10.1%, P < 0.001), it did not change in adults. Thus, children fatigued more slowly than adults and as much as endurance athletes. They developed less peripheral and more central fatigue than adults and, although central fatigue appeared somewhat higher in children than endurance athletes, both children and endurance athletes experienced greater decrements than adults. Therefore, children exhibit a more comparable neuromuscular fatigue profile to endurance athletes than adults.

Child-adult differences in neuromuscular fatigue are muscle-dependent

The aim of this study was to compare the development and etiology of neuromuscular fatigue of the knee extensor (KE) and plantar flexor (PF) muscles during repeated maximal voluntary isometric contractions (MVIC) between children and adults. Twenty-one prepubertal boys (9-11 years) and 24 men (18-30 years) performed two fatigue protocols consisting in a repetition of 5-s isometric MVIC of the KE or PF muscles interspersed with 5-s passive recovery periods until MVIC reached 60% of its initial value. The etiology of neuromuscular fatigue of the KE and PF muscles was investigated by means of non-invasive methods such as the surface electromyography, single and doublet magnetic stimulation, twitch interpolation technique and NIRS. The number of repetitions performed was significantly lower in men (15.4 ± 3.8) than boys (38.7 ± 18.8) for the KE fatigue test. In contrast, no significant difference was found for the PF muscles between boys and men (12.1 ± 4.9 and 13.8 ± 4.9 repetitions, respectively). Boys displayed a lower reduction in potentiated twitch torque, low-frequency fatigue and muscle oxygenation than men whatever the muscle group considered. In contrast, voluntary activation level and normalized EMG data decreased to a greater extent in boys than men for both muscle groups. To conclude, boys experienced less peripheral and more central fatigue during repeated MVICs than men whatever the muscle group considered. However, child-adult differences in neuromuscular fatigue were muscle-dependent since boys fatigued similarly to men with the PF muscles and to a lower extent with the KE muscles than men.

Impaired cardiac and skeletal muscle bioenergetics in children, adolescents, and young adults with Barth syndrome

Barth syndrome (BTHS) is an X‐linked condition characterized by altered cardiolipin metabolism and cardioskeletal myopathy. We sought to compare cardiac and skeletal muscle bioenergetics in children, adolescents, and young adults with BTHS and unaffected controls and examine their relationships with cardiac function and exercise capacity. Children/adolescents and young adults with BTHS (n = 20) and children/adolescent and young adult control participants (n = 23, total n = 43) underwent ³¹P magnetic resonance spectroscopy (³¹P‐MRS) of the lower extremity (calf) and heart for estimation of skeletal muscle and cardiac bioenergetics. Peak exercise testing (VO_2peak) and resting echocardiography were also performed on all participants. Cardiac PCr/ATP ratio was significantly lower in children/adolescents (BTHS: 1.5 ± 0.2 vs. Control: 2.0 ± 0.3, P < 0.01) and adults (BTHS: 1.9 ± 0.2 vs. Control: 2.3 ± 0.2, P < 0.01) with BTHS compared to Control groups. Adults (BTHS: 76.4 ± 31.6 vs. Control: 35.0 ± 7.4 sec, P < 0.01) and children/adolescents (BTHS: 71.5 ± 21.3 vs. Control: 31.4 ± 7.4 sec, P < 0.01) with BTHS had significantly longer calf PCr recovery (τPCr) postexercise compared to controls. Maximal calf ATP production through oxidative phosphorylation (Qmax‐lin) was significantly lower in children/adolescents (BTHS: 0.5 ± 0.1 vs. Control: 1.1 ± 0.3 mmol/L per sec, P < 0.01) and adults (BTHS: 0.5 ± 0.2 vs. Control: 1.0 ± 0.2 mmol/L sec, P < 0.01) with BTHS compared to controls. Blunted cardiac and skeletal muscle bioenergetics were associated with lower VO_2peak but not resting cardiac function. Cardiac and skeletal muscle bioenergetics are impaired and appear to contribute to exercise intolerance in BTHS.

Are Prepubertal Children Metabolically Comparable to Well-Trained Adult Endurance Athletes?

It is well acknowledged that prepubertal children have smaller body dimensions and a poorer mechanical (movement) efficiency, and thus a lower work capacity than adults. However, the scientific evidence indicates that prepubertal children have a greater net contribution of energy derived from aerobic metabolism in exercising muscle and reduced susceptibility to muscular fatigue, which makes them metabolically comparable to well-trained adult endurance athletes. For example, the relative energy contribution from oxidative and non-oxidative (i.e. anaerobic) sources during moderate-to-intense exercise, the work output for a given anaerobic energy contribution and the rate of acceleration of aerobic metabolic machinery in response to submaximal exercise are similar between prepubertal children and well-trained adult endurance athletes. Similar conclusions can be drawn on the basis of experimental data derived from intra-muscular measurements such as type I fibre percentage, succinate dehydrogenase enzyme activity, mitochondrial volume density, post-exercise phosphocreatine re-synthesis rate and muscle by-product clearance rates (i.e. H⁺ ions). On a more practical level, prepubertal children also experience similar decrements in peak power output as well-trained adult endurance athletes during repeated maximal exercise bouts. Therefore, prepubertal children have a comparable relative oxidative contribution to well-trained adult endurance athletes, but a decrease in this relative contribution occurs from childhood through to early adulthood. In a clinical context, this understanding may prove central to the development of exercise-based strategies for the prevention and treatment of many metabolic diseases related to mitochondrial oxidative dysfunction (e.g. in obese, insulin-resistant and diabetic patients), which are often accompanied by muscular deconditioning during adolescence and adulthood.

Recovery of upper-body muscle power after short intensive exercise: comparing boys and men

PURPOSE

Boys' lower-body muscle power generation (PO) recovers faster than men's following intensive exercise. The purpose of this study was to examine whether boys differ from adult men in recovering from upper-body muscle power generation following intensive exercise.

METHODS

Fifteen prepubertal boys (M ± SD age 10.6 ± 1.0 years) and 13 men (31.1 ± 5.0 years) performed two upper-body Wingate Anaerobic Tests (WAnT), separated by either 2-min or 10-min recovery intervals. WAnT parameters, pre-and post-WAnT heart rates (HR), and blood lactate ([La]) were measured during recovery from the WAnTs.

RESULTS

Boys' mean power (MP) of the repeated WAnT (WAnT₂) following 2- and 10-min recoveries was 97.3 ± 7.2% and 99.4 ± 3.9%, respectively, compared to MP of the first test (WAnT₁) (p > 0.05 for both tests). In contrast, in men's MP of the WAnT₂ following the 2-min recovery, was significantly lower than that of the WAnT₁ (84.4 ± 6.7%, p = 0.0001). While boys' and men's HR recovery after 2 min differed significantly (p = 0.046), no between-group differences were found following the 10-min recovery. Peak [La] in boys was 37-44% lower than that in men (p = 0.002).

CONCLUSIONS

The faster recovery of PO in boys after supra-maximal upper-body exercise is partially explained by the lower power generated by boys, attributed in part to a lower anaerobic capacity and to the greater relative contribution of aerobic processes to performance and recovery from anaerobic-type tasks. Further research is needed to determine the physiologic, neurologic and biochemical basis of the rapid muscle power recovery in children.

Metabolic and Fatigue Profiles Are Comparable Between Prepubertal Children and Well-Trained Adult Endurance Athletes

The aim of this study was to determine whether prepubertal children are metabolically comparable to well-trained adult endurance athletes and if this translates into similar fatigue rates during high-intensity exercise in both populations. On two different occasions, 12 prepubertal boys (10.5 ± 1.1 y), 12 untrained men (21.2 ± 1.5 y), and 13 endurance male athletes (21.5 ± 2.7 y) completed an incremental test to determine the power output at VO_2max (PVO_2max) and a Wingate test to evaluate the maximal anaerobic power (P_max) and relative decrement in power output (i.e., the fatigue index, FI). Furthermore, oxygen uptake (VO₂), heart rate (HR), and capillary blood lactate concentration ([La]) were measured to determine (i) the net aerobic contribution at 5-s intervals during the Wingate test, and (ii) the post-exercise recovery kinetics of VO₂, HR, and [La]. The P_max-to-PVO_2max ratio was not significantly different between children (1.9 ± 0.5) and endurance athletes (2.1 ± 0.2) but lower than untrained men (3.2 ± 0.3, p < 0.001 for both). The relative energy contribution derived from oxidative metabolism was also similar in children and endurance athletes but greater than untrained men over the second half of the Wingate test (p < 0.001 for both). Furthermore, the post-exercise recovery kinetics of VO₂, HR, and [La] in children and endurance athletes were faster than those of untrained men. Finally, FI was comparable between children and endurance athletes (-35.2 ± 9.6 vs. -41.8 ± 9.4%, respectively) but lower than untrained men (-51.8 ± 4.1%, p < 0.01). To conclude, prepubertal children were observed to be metabolically comparable to well-trained adult endurance athletes, and were thus less fatigable during high-intensity exercise than untrained adults.

Exercise-induced fatigue in young people: advances and future perspectives

PURPOSE

In recent decades, the interest for exercise-induced fatigue in youth has substantially increased, and the effects of growth on the peripheral (muscular) and central (neural) mechanisms underpinning differences in neuromuscular fatigue between healthy children and adults have been described more extensively. The purpose of this review is to retrieve, report, and analyse the findings of studies comparing neuromuscular fatigue between children and adults. Objective measures of the evaluation of the physiological mechanisms are discussed.

METHOD

Major databases (PubMed, Ovid, Scopus and Web of Science) were systematically searched and limited to English language from inception to September 2017.

RESULT

Collectively, the analyzed studies indicate that children experience less muscular and potentially more neural fatigue than adults. However, there are still many unknown aspects of fatigue regarding neural (supraspinal and spinal) and peripheral mechanisms that should be more thoroughly examined in children.

CONCLUSION

Suitable methods, such as transcranial magnetic stimulation, transcranial electrical stimulation, functional magnetic resonance imaging, near-infrared spectroscopy, tendon vibration, H-reflex, and ultrasound are recommended in the research field of fatigue in youth. By designing studies that test the fatigue effects in movements that replicate daily activities, new knowledge will be acquired. The linkage and interaction between physiological, cognitive, and psychological aspects of human performance remain to be resolved in young people. This can only be successful if research is based on a foundation of basic research focused on the mechanisms of fatigue while measuring all three above aspects.

Fatigue-related differences in erector spinae between prepubertal children and young adults using surface electromyographic power spectral analysis

BACKGROUND

The erector spinae is more resistant to fatigue in adult women than men. However, no study has reported the sex differences in back muscle fatigue in children.

OBJECTIVE

The aim of this study was to evaluate the fatigability of erector spinae in prepubertal children and adults, in both males and females.

METHODS

Fourteen prepubertal boys, 13 prepubertal girls, 14 adult men, and 13 adult women performed the Sørensen back isometric endurance test until exhaustion. The results of electromyographic (EMG) power spectral analysis of erector spinae were compared between both age groups and sexes.

RESULTS

The slopes of EMG power spectral median and mean power frequency were significantly higher in males than in females, in both age groups. Furthermore, the slopes were significantly lower in prepubertal children than in adults, in both males and females.

CONCLUSIONS

Our results showed major differences in the fatigue threshold of the erector spinae between boys and girls and children and adults. The muscle fatigued faster in prepubertal boys and adult men than in prepubertal girls and adult women. In both sexes, a lower slope of EMG power spectrum parameters of the erector spinae was noted during endurance test in prepubertal children compared to adults.

Method for controlled mitochondrial perturbation during phosphorus MRS in children

Insulin resistance is increasingly prevalent in children and may be related to muscle mitochondrial dysfunction, necessitating development of mitochondrial assessment techniques. Recent studies used phosphorus magnetic resonance spectroscopy (P-MRS), a noninvasive technique appealing for clinical research. P-MRS requires exercise at a precise percentage of maximum volitional contraction (MVC). MVC measurement in children, particularly in those with a disease, is problematic because of variability in perception of effort and motivation. We therefore developed a method to predict MVC using maximal calf muscle cross-sectional area (MCSA) to assure controlled and reproducible muscle metabolic perturbations.

METHODS

Data were collected from 66 sedentary 12- to 20-yr-old participants. Plantarflexion MVC was assessed using an MRI-compatible exercise treadle device. MCSA of the calf muscles were measured from magnetic resonance images. Data from the first 26 participants were used to model the relation between MVC and MCSA (predicted MVC = 24.763 + 0.0047 MCSA). This model was then applied to the subsequent 40 participants.

RESULTS

MVC versus model-predicted mean MVC was 43.9 ± 0.8 kg versus 44.2 ± 1.81 (P = 0.90). P-MRS results when predicted and MVC were similar showed expected changes during MVC-based exercise. In contrast, MVC was markedly lower than predicted in four participants and produced minimal metabolic perturbation. Upon repeat testing, these individuals could perform their predicted MVC with coaching, which produced expected metabolic perturbations.

CONCLUSIONS

Compared with using MVC testing alone, using magnetic resonance imaging to predict muscle strength allows for a more accurate and standardized P-MRS protocol during exercise in children. This method overcomes a major obstacle in assessing mitochondrial function in youths. These studies have importance as we seek to determine the role of mitochondrial function in youths with insulin resistance and diabetes and response to interventions.

Energetics of endurance exercise in young horses determined by nuclear magnetic resonance metabolomics

Long-term endurance exercise severely affects metabolism in both human and animal athletes resulting in serious risk of metabolic disorders during or after competition. Young horses (up to 6 years old) can compete in races up to 90 km despite limited scientific knowledge of energetic metabolism responses to long distance exercise in these animals. The hypothesis of this study was that there would be a strong effect of endurance exercise on the metabolomic profiles of young horses and that the energetic metabolism response in young horses would be different from that of more experienced horses. Metabolomic profiling is a powerful method that combines Nuclear Magnetic Resonance (NMR) spectrometry with supervised Orthogonal Projection on Latent Structure (OPLS) statistical analysis. ¹H-NMR spectra were obtained from plasma samples drawn from young horses (before and after competition). The spectra obtained before and after the race from the same horse (92 samples) were compared using OPLS. The statistical parameters showed the robustness of the model (R2Y = 0.947, Q2Y = 0.856 and cros-validated ANOVA p < 0.001). For confirmation of the predictive value of the model, a test set of 104 sample spectra were projected by the model, which provided perfect predictions as the area under the receiving-operator curve was 1. The metabolomic profile determined with the OPLS model showed that glycemia after the race was lower than glycemia before the race, despite the involvement of lipid and protein catabolism. An OPLS model was calculated to compare spectra obtained on plasma taken after the race from 6-year-old horses and from experienced horses (cross-validated ANOVA p < 0.001). The comparison of metabolomic profiles in young horses to those from experienced horses showed that experienced horses maintained their glycemia with higher levels of lactate and a decrease of plasma lipids after the race.

Muscle metabolism changes with age and maturation: How do they relate to youth sport performance?

AIM

To provide an evidence-based review of muscle metabolism changes with sex-, age- and maturation with reference to the development of youth sport performance.

METHODS

A narrative review of data from both invasive and non-invasive studies, from 1970 to 2015, founded on personal databases supported with computer searches of PubMed and Google Scholar.

RESULTS

Youth sport performance is underpinned by sex-, age- and maturation-related changes in muscle metabolism. Investigations of muscle size, structure and metabolism; substrate utilisation; pulmonary oxygen uptake kinetics; muscle phosphocreatine kinetics; peak anaerobic and aerobic performance; and fatigue resistance; determined using a range of conventional and emerging techniques present a consistent picture. Age-related changes have been consistently documented but specific and independent maturation-related effects on muscle metabolism during exercise have proved elusive to establish. Children are better equipped for exercise supported primarily by oxidative metabolism than by anaerobic metabolism. Sexual dimorphism is apparent in several physiological variables underpinning youth sport performance. As young people mature there is a progressive but asynchronous transition into an adult metabolic profile.

CONCLUSIONS

The application of recent developments in technology to the laboratory study of the exercising child and adolescent has both supplemented existing knowledge and provided novel insights into developmental exercise physiology. A sound foundation of laboratory-based knowledge has been established but the lack of rigorously designed child-specific and sport-specific testing environments has clouded the interpretation of the data in real life situations. The primary challenge remains the translation of laboratory research into the optimisation of youth sports participation and performance.

The kinetics of blood lactate in boys during and following a single and repeated all-out sprints of cycling are different than in men

This study characterized the impact of high-intensity interval training on the kinetics of blood lactate and performance in trained boys and men. Twenty-one boys (11.4 ± 0.8 years) and 19 men (29.4 ± 5.0 years) performed a set of four 30-s sprints with 2-min of rest and a single 30-s sprint on 2 separate occasions (randomized order) with assessment of performance. Blood lactate was assayed after each sprint and during 30 min of recovery from both tests. The individual time-curves of blood lactate concentration were fitted to the biexponential function as follows: [Formula: see text], where the velocity parameters γ1 and γ2 reflect the capacity to release lactate from the previously active muscle into the blood and to subsequently eliminate lactate from the organism, respectively. In both tests, peak blood lactate concentration was significantly lower in the boys (four 30-s sprints: 12.2 ± 3.6 mmol·L(-1); single 30-s sprint: 8.7 ± 1.8 mmol·L(-1)) than men (four 30-s sprints: 16.1 ± 3.3 mmol·L(-1); single 30-s sprint: 11.5 ± 2.1; p < 0.001). The boys exhibited faster γ1 (1.4531 ± 0.65 min; p < 0.001) and γ2 (0.059 ± 0.023 min; p = 0.01) in the single 30-s sprint and faster γ2 (0.049 ± 0.016 min; p = 0.01) in the four 30-s sprints. The worsening of performance from the first to the last of the four 30-s sprints was less pronounced in boys (9.2% ± 13.9%) than men (19.2% ± 11.5%; p = 0.01). In the present study boys, when compared with men, exhibited lower Peak blood lactate concentration; less pronounced decline in performance during the sprints concomitantly with more rapid release and elimination during the single 30-s sprint; and faster elimination of lactate following the four 30-s sprints.

Muscle metabolism during fatiguing isometric quadriceps exercise in adolescents and adults

Children and adolescents are less susceptible to muscle fatigue during repeated bouts of high-intensity exercise than adults, but the physiological basis for these differences is not clear. The purpose of the current investigation was to investigate the muscle metabolic responses, using 31-phosphorus magnetic resonance spectroscopy, during fatiguing isometric quadriceps exercise in 13 adolescents (7 females) and 14 adults (8 females). Participants completed 30 maximal voluntary contractions (6-s duration) separated by 6 s of rest. Fatigue was quantified as the relative decrease in force over the test. Fatigue was not significantly different with age (p = 0.20) or sex (p = 0.63). Metabolic perturbation (change in phosphocreatine, inorganic phosphate, and ADP concentrations) was significantly greater in adults compared with adolescents; no sex effects were present. Muscle pH did not differ with age or sex. Phosphocreatine recovery following exercise was not significantly different with age (p = 0.27) or sex (p = 0.97) but a significant interaction effect was present (p = 0.04). Recovery tended to be faster in boys than men but slower in girls than women, though no significant group differences were identified. The results of this study show that at a comparable level of muscle fatigue, the metabolic profile is profoundly different between adolescents and adults.

Effects of exercise-induced intracellular acidosis on the phosphocreatine recovery kinetics: a 31P MRS study in three muscle groups in humans

Little is known about the metabolic differences that exist among different muscle groups within the same subjects. Therefore, we used (31)P-magnetic resonance spectroscopy ((31)P-MRS) to investigate muscle oxidative capacity and the potential effects of pH on PCr recovery kinetics between muscles of different phenotypes (quadriceps (Q), finger (FF) and plantar flexors (PF)) in the same cohort of 16 untrained adults. The estimated muscle oxidative capacity was lower in Q (29 ± 12 mM min(-1), CV(inter-subject) = 42%) as compared with PF (46 ± 20 mM min(-1), CV(inter-subject) = 44%) and tended to be higher in FF (43 ± 35 mM min(-1), CV(inter-subject) = 80%). The coefficient of variation (CV) of oxidative capacity between muscles within the group was 59 ± 24%. PCr recovery time constant was correlated with end-exercise pH in Q (p < 0.01), FF (p < 0.05) and PF (p < 0.05) as well as proton efflux rate in FF (p < 0.01), PF (p < 0.01) and Q (p = 0.12). We also observed a steeper slope of the relationship between end-exercise acidosis and PCr recovery kinetics in FF compared with either PF or Q muscles. Overall, this study supports the concept of skeletal muscle heterogeneity by revealing a comparable inter- and intra-individual variability in oxidative capacity across three skeletal muscles in untrained individuals. These findings also indicate that the sensitivity of mitochondrial respiration to the inhibition associated with cytosolic acidosis is greater in the finger flexor muscles compared with locomotor muscles, which might be related to differences in permeability in the mitochondrial membrane and, to some extent, to proton efflux rates.

Changes in phosphocreatine concentration of skeletal muscle during high-intensity intermittent exercise in children and adults

PURPOSE

The aim of the present study was to test the hypotheses that a greater oxidative capacity in children results in a lower phosphocreatine (PCr) depletion, a faster PCr resynthesis and a lower muscle acidification during high-intensity intermittent exercise compared to adults.

METHODS

Sixteen children (9.4 ± 0.5 years) and 16 adults (26.1 ± 0.3 years) completed a protocol consisting of a dynamic plantar flexion (10 bouts of 30-s exercise at 25 % of one repetition maximum separated by 20-s recovery), followed by 10 min of passive recovery. Changes of PCr, ATP, inorganic phosphate, and phosphomonoesters were measured by means of (31)Phosphorous-magnetic resonance spectroscopy during and post-exercise.

RESULTS

Average PCr (percentage of [PCr] at initial rest (%[PCr]i)) at the end of the exercise (adults 17 ± 12 %[PCr]i, children 38 ± 17 %[PCr]i, P < 0.01) and recovery periods (adults 37 ± 14 %[PCr]i, children 57 ± 17 %[PCr]i, P < 0.01) was significantly lower in adults compared to children, induced by a stronger PCr decrease during the first exercise interval (adults -73 ± 10 %[PCr]i, children -55 ± 15 %[PCr]i, P < 0.01). End-exercise pH was significantly higher in children compared to adults (children 6.90 + 0.20, -0.14; adults 6.67 + 0.23, -0.15, P < 0.05).

CONCLUSIONS

From our results we suggest relatively higher rates of oxidative ATP formation in children's muscle for covering the ATP demand of high-intensity intermittent exercise compared to adults, enabling children to begin each exercise interval with significantly higher PCr concentrations and leading to an overall lower muscle acidification.

Fatigue and recovery in children and adults during sustained contractions at 2 different submaximal intensities

The purpose of this study was to examine the effects of submaximal sustained contractions on fatigue and recovery properties in untrained prepubescent boys (n = 14) and men (n = 14). All participants performed, in random order, an isometric plantar flexion at 20% and 60% of their maximal voluntary contraction (MVC) until exhaustion (20%fatigue and 60%fatigue, respectively). During both fatigue protocols, surface electromyogram (sEMG) of the soleus and tibialis anterior muscles was recorded. Before and after the fatigue protocol, MVCs and blood lactate concentration were obtained. During 20%fatigue and 60%fatigue, agonist and antagonist sEMG increased gradually to a similar extent in both groups. Immediately after fatigue, MVC torque decreased in both groups, compared with prefatigue values, and boys recovered faster than men in both fatigue protocols. The reduction in agonist sEMG during MVC after fatigue was not significantly different between men and boys (p < 0.05), independent of the fatigue protocol. sEMG of boys recovered to baseline values 3 min after the 20%fatigue and 60%fatigue protocols, whereas men did not recover. Lactate concentration increased immediately after the end of the fatigue protocols, compared with the prefatigue values (p < 0.05). This increase was higher for the 60%fatigue than for 20%fatigue protocol, and did not differ between boys and men. It is concluded that low- and middle-intensity submaximal sustained isometric fatigue protocols induce similar fatigue effects in boys and men. Furthermore, it was shown that boys can recover faster than men, independent of the contraction intensity that induces fatigue.

Training effects on peripheral muscle oxygenation and performance in children with congenital heart diseases

We investigated the effect of training on peripheral muscular performance and oxygenation during exercise and recovery in children with congenital heart diseases (CHD). Eighteen patients with CHD aged 12 to 15 years were randomly assigned into either an individualized 12-week aerobic cycling training group (TG) or a control group (CG). Maximal voluntary contraction (MVC) and endurance at 50% MVC (time to exhaustion, Tlim) of the knee extensors were measured before and after training. During the 50% MVC exercise and recovery, near-infrared spectroscopy (NIRS) was used to assess the fall in muscle oxygenation, i.e., deoxygenation ([Formula: see text]) of the vastus lateralis, the mean rate of decrease in muscle oxygenation, the half time of recovery (T1/2R), and the recovery speed to maximal oxygenation (RS). There was no effect of time on any parameter in the CG. After training, significant improvements were observed in TG for MVC (101.6 ± 14.0 vs. 120.2 ± 19.4 N·m, p < 0.01) and Tlim (66.2 ± 22.6 vs. 86.0 ± 23.0 s, p< 0.01). Increased oxygenation (0.20 ± 0.13 vs. 0.15 ± 0.07 a.u., p < 0.01) and faster mean rate of decrease in muscle oxygenation were also shown after training in TG (1.22 ± 0.45 vs. 1.71 ± 0.78%·s–1, p < 0.001). Moreover, a shorter recovery time was observed in TG after training for T1/2R (27.2 ± 6.1 vs. 20.8 ± 4.2 s, p < 0.01) and RS (63.1 ± 18.4 vs. 50.3 ± 11.4 s, p < 0.01). A significant relationship between the change in [Formula: see text] and both MVC (r = 0.95, p < 0.001) and Tlim (r = 0.90, p < 0.001) in TG was observed. We concluded that exercise training improves peripheral muscular function by enhancing strength and endurance performance in children with CHD. This improvement was associated with increased oxygenation of peripheral muscles and faster recovery.

Quantitative in vivo magnetic resonance spectroscopy using synthetic signal injection

Accurate conversion of magnetic resonance spectra to quantitative units of concentration generally requires compensation for differences in coil loading conditions, the gains of the various receiver amplifiers, and rescaling that occurs during post-processing manipulations. This can be efficiently achieved by injecting a precalibrated, artificial reference signal, or pseudo-signal into the data. We have previously demonstrated, using in vitro measurements, that robust pseudo-signal injection can be accomplished using a second coil, called the injector coil, properly designed and oriented so that it couples inductively with the receive coil used to acquire the data. In this work, we acquired nonlocalized phosphorous magnetic resonance spectroscopy measurements from resting human tibialis anterior muscles and used pseudo-signal injection to calculate the Pi, PCr, and ATP concentrations. We compared these results to parallel estimates of concentrations obtained using the more established phantom replacement method. Our results demonstrate that pseudo-signal injection using inductive coupling provides a robust calibration factor that is immune to coil loading conditions and suitable for use in human measurements. Having benefits in terms of ease of use and quantitative accuracy, this method is feasible for clinical use. The protocol we describe could be readily translated for use in patients with mitochondrial disease, where sensitive assessment of metabolite content could improve diagnosis and treatment.

Muscle energetics changes throughout maturation: a quantitative 31P-MRS analysis

We quantified energy production in 7 prepubescent boys (11.7 ± 0.6 yr) and 10 men (35.6 ± 7.8 yr) using (31)P-magnetic resonance spectroscopy to investigate whether development affects muscle energetics, given that resistance to fatigue has been reported to be larger before puberty. Each subject performed a finger flexions exercise at 0.7 Hz against a weight adjusted to 15% of their maximal voluntary strength for 3 min, followed by a 15-min recovery period. The total energy cost was similar in both groups throughout the exercise bout, whereas the interplay of the different metabolic pathways was different. At the onset of exercise, children exhibited a higher oxidative contribution (50 ± 15% in boys and 25 ± 8% in men, P < 0.05) to ATP production, whereas the phosphocreatine breakdown contribution was reduced (40 ± 10% in boys and 53 ± 12% in men, P < 0.05), likely as a compensatory mechanism. The anaerobic glycolysis activity was unaffected by maturation. The recovery phase also disclosed differences regarding the rates of proton efflux (6.2 ± 2.5 vs. 3.8 ± 1.9 mM · pH unit(-1) · min(-1), in boys and men, respectively, P < 0.05), and phosphocreatine recovery, which was significantly faster in boys than in men (rate constant of phosphocreatine recovery: 1.3 ± 0.5 vs. 0.7 ± 0.4 min(-1); V(max): 37.5 ± 14.5 vs. 21.1 ± 12.2 mM/min, in boys and men, respectively, P < 0.05). Our results obtained in vivo clearly showed that maturation affects muscle energetics. Children relied more on oxidative metabolism and less on creatine kinase reaction to meet energy demand during exercise. This phenomenon can be explained by a greater oxidative capacity, probably linked to a higher relative content in slow-twitch fibers before puberty.

Age- and sex-related differences in muscle phosphocreatine and oxygenation kinetics during high-intensity exercise in adolescents and adults

The aim of this investigation was to examine the adaptation of the muscle phosphates (e.g. phosphocreatine (PCr) and ADP) implicated in regulating oxidative phosphorylation, and oxygenation at the onset of high intensity exercise in children and adults. The hypotheses were threefold: primary PCr kinetics would be faster in children than adults; the amplitude of the PCr slow component would be attenuated in children; and the amplitude of the deoxyhaemoglobin/myoglobin (HHb) slow component would be reduced in children. Eleven children (5 girls, 6 boys, 13 +/- 1 years) and 11 adults (5 women, 6 men, 24 +/- 4 years) completed two to four constant work rate exercise tests within a 1.5 T MR scanner. Quadriceps muscle energetics during high intensity exercise were monitored using (31)P-MRS. Muscle oxygenation was monitored using near-infrared spectroscopy. The time constant for the PCr response was not significantly different in boys (31 +/- 10 s), girls (31 +/- 10 s), men (44 +/- 20 s) or women (29 +/- 14 s, main effects: age, p = 0.37, sex, p = 0.25). The amplitude of the PCr slow component relative to end-exercise PCr was not significantly different between children (23 +/- 23%) and adults (17 +/- 13%, p = 0.47). End-exercise [PCr] was significantly lower, and [ADP] higher, in females (18 +/- 4 mM and 53 +/- 16 microM) than males (23 +/- 4 mM, p = 0.02 and 37 +/- 11 microM, p = 0.02), but did not differ with age ([PCr]: p = 0.96, [ADP]: p = 0.72). The mean response time for muscle tissue deoxygenation was significantly faster in children (22 +/- 4 s) than adults (27 +/- 7 s, p = 0.01). The results of this study show that the control of oxidative metabolism at the onset of high intensity exercise is adult-like in 13-year-old children, but that matching of oxygen delivery to extraction is more precise in adults.

Age- and sex-associated differences in isokinetic knee muscle endurance between young children and adults

The purpose of this study was to examine the age- and sex-associated differences of repeated isokinetic knee extension and flexion. Fifty one participants, 30 young children (16 boys and 14 girls; aged 11 and 12 years) and 21 adults (9 males and 12 females; aged 18-35 years), agreed to participate in the study. Isokinetic concentric peak knee extension (PET) and flexion (PFT) torque were measured using a calibrated Biodex System 3. Participants performed 4 concentric extension-flexion cycles with maximum effort; after a 2 min rest, 50 continuous concentric cycles were performed at 1.56 rad.s-1. Total work of the extensors (WKEX) and flexors (WKFL) for the complete 50 repetitions was recorded. Average peak torque and average work for the first and last 3 repetitions were calculated to represent the percentage decline in torque and work. There were no significant differences between groups in the peak torque generated during the pretrial and endurance task, suggesting that participants gave a maximal effort at the start of the endurance task. There was a significant interaction effect in the total work done for both extensors and flexors, with adult males producing the greatest amount of work (6622 and 3444 J, respectively). When total work was divided by body mass, there were no significant sex effects, only main effects for group. The percentage decline for PET (40% vs. 60%), PFT (50% vs. 65%), WKET (43% vs. 61%), and WKFL (60% vs. 69%) demonstrated significant main effects for group, with greater fatigue in adults. We found no significant sex effect for fatigue. This study concludes that females do not resist fatigue from repeated isokinetic muscle actions to a greater extent than males, and that the greater fatigue in adults than in children is probably a product of greater initial torque production and work performed.

Reinforcing value of interval and continuous physical activity in children

During play children engage in short bouts of intense activity, much like interval training. This natural preference for interval-type activity may have important implications for prescribing the most motivating type of physical activity, but the motivation of children to be physically active in interval or continuous fashion has not yet been examined. In the present study, ventilatory threshold (VT) and VO2 peak were determined in boys (n=16) and girls (n=16) age 10+/-1.3 years. Children sampled interval and continuous constant-load physical activity protocols on a cycle ergometer at 20% <VT on one day and 5% >VT on another day. The physical activity protocols were matched for energy expenditure. Children then completed an operant button pressing task using a progressive fixed ratio schedule to assess the relative reinforcing value (RRV) of interval versus continuous physical activity. The number of button presses performed to gain access in interval or continuous physical activity and output maximum (O(max)) were the primary outcome variables. Children performed more button presses (P<0.005) and had a greater O(max) (P<0.005) when working to gain access to interval compared to continuous physical activity at intensities >VT and <VT. This suggests that interval-type physical activity was more reinforcing than continuous constant-load physical activity for children when exercising both >VT and <VT. Children likely participate in short-duration bouts of activity at a high-rate during natural play because it is more reinforcing than longer, continuous activity.