Variation in limb support influences the time to task failure for a postural contraction

Multiple measures of muscle function influence Sorensen Test performance in individuals with recurrent low back pain

BACKGROUND

Sorensen Test time-to-task-failure (TTF) predicts several low back pain (LBP) clinical outcomes, including recurrence. Because the test is described as a measure of trunk extensor (TE) muscle endurance, LBP rehabilitation programs often emphasize endurance training, but the direct role of TE muscle function on Sorensen Test-TTF remains unclear.

OBJECTIVE

To assess the discriminative and associative properties of multiple markers of isolated TE performance with regard to Sorensen Test-TTF in individuals with recurrent LBP.

METHOD

Secondary analysis of baseline measures from participants in a registered (NCT02308189) trial (10 men; 20 women) was performed. Participants were classified by Sorensen Test-TTF as high, moderate or low risk for subsequent LBP episodes, and compared to determine if classification could discriminate differences in TE function. Correlations between Sorensen Test-TTF and isolated TE performance, anthropometrics and disability were investigated.

RESULTS

Individuals at risk of subsequent LBP episodes had greater perceived disability and fat mass/TE strength ratios (P⩽ 0.05) than those not at risk. Modest, significant (r= 0.36-0.42, P⩽ 0.05) associations were found between Sorensen Test-TTF, TE endurance and fat mass/TE strength. Exploratory analyses suggested possible sex-specific differences related to Sorensen Test-TTF.

CONCLUSIONS

Isolated TE muscle endurance is only one of several factors with similar influence on Sorensen Test-TFF, thus LBP rehabilitation strategies should consider other factors, including TE strength, anthropometrics and perceived disability.

Performance Fatigability: Mechanisms and Task Specificity

Performance fatigability is characterized as an acute decline in motor performance caused by an exercise-induced reduction in force or power of the involved muscles. Multiple mechanisms contribute to performance fatigability and originate from neural and muscular processes, with the task demands dictating the mechanisms. This review highlights that (1) inadequate activation of the motoneuron pool can contribute to performance fatigability, and (2) the demands of the task and the physiological characteristics of the population assessed, dictate fatigability and the involved mechanisms. Examples of task and population differences in fatigability highlighted in this review include contraction intensity and velocity, stability and support provided to the fatiguing limb, sex differences, and aging. A future challenge is to define specific mechanisms of fatigability and to translate these findings to real-world performance and exercise training in healthy and clinical populations across the life span.

Precision markedly attenuates repetitive lift capacity

This study investigated the effect of precision on time to task failure in a repetitive whole-body manual handling task. Twelve participants were required to repetitively lift a box weighing 65% of their single repetition maximum to shoulder height using either precise or unconstrained box placement. Muscle activity, forces exerted at the ground, 2D body kinematics, box acceleration and psychophysical measures of performance were recorded until task failure was reached. With precision, time to task failure for repetitive lifting was reduced by 72%, whereas the duration taken to complete a single lift and anterior deltoid muscle activation increased by 39% and 25%, respectively. Yet, no significant difference was observed in ratings of perceived exertion or heart rate at task failure. In conclusion, our results suggest that when accuracy is a characteristic of a repetitive manual handling task, physical work capacity will decline markedly.

PRACTITIONER SUMMARY

The capacity to lift repetitively to shoulder height was reduced by 72% when increased accuracy was required to place a box upon a shelf. Lifting strategy and muscle activity were also modified, confirming practitioners should take into consideration movement precision when evaluating the demands of repetitive manual handling tasks.

Sex differences in human fatigability: mechanisms and insight to physiological responses

Sex-related differences in physiology and anatomy are responsible for profound differences in neuromuscular performance and fatigability between men and women. Women are usually less fatigable than men for similar intensity isometric fatiguing contractions. This sex difference in fatigability, however, is task specific because different neuromuscular sites will be stressed when the requirements of the task are altered, and the stress on these sites can differ for men and women. Task variables that can alter the sex difference in fatigability include the type, intensity and speed of contraction, the muscle group assessed and the environmental conditions. Physiological mechanisms that are responsible for sex-based differences in fatigability may include activation of the motor neurone pool from cortical and subcortical regions, synaptic inputs to the motor neurone pool via activation of metabolically sensitive small afferent fibres in the muscle, muscle perfusion and skeletal muscle metabolism and fibre type properties. Non-physiological factors such as the sex bias of studying more males than females in human and animal experiments can also mask a true understanding of the magnitude and mechanisms of sex-based differences in physiology and fatigability. Despite recent developments, there is a tremendous lack of understanding of sex differences in neuromuscular function and fatigability, the prevailing mechanisms and the functional consequences. This review emphasizes the need to understand sex-based differences in fatigability to shed light on the benefits and limitations that fatigability can exert for men and women during daily tasks, exercise performance, training and rehabilitation in both health and disease.

Cortical and spinal mechanisms of task failure of sustained submaximal fatiguing contractions

In this and the subsequent companion paper, results are presented that collectively seek to delineate the contribution that supraspinal circuits have in determining the time to task failure (TTF) of sustained submaximal contractions. The purpose of this study was to compare adjustments in supraspinal and spinal excitability taken concurrently throughout the performance of two different fatigue tasks with identical mechanical demands but different TTF (i.e., force-matching and position-matching tasks). On separate visits, ten healthy volunteers performed the force-matching or position-matching task at 15% of maximum strength with the elbow flexors to task failure. Single-pulse transcranial magnetic stimulation (TMS), paired-pulse TMS, paired cortico-cervicomedullary stimulation, and brachial plexus electrical stimulation were delivered in a 6-stimuli sequence at baseline and every 2-3 minutes throughout fatigue-task performance. Contrary to expectations, the force-matching task TTF was 42% shorter (17.5 ± 7.9 min) than the position-matching task (26.9 ± 15.11 min; p<0.01); however, both tasks caused the same amount of muscle fatigue (p = 0.59). There were no task-specific differences for the total amount or rate of change in the neurophysiologic outcome variables over time (p>0.05). Therefore, failure occurred after a similar mean decline in motorneuron excitability developed (p<0.02, ES = 0.35-0.52) coupled with a similar mean increase in measures of corticospinal excitability (p<0.03, ES = 0.30-0.41). Additionally, the amount of intracortical inhibition decreased (p<0.03, ES = 0.32) and the amount of intracortical facilitation (p>0.10) and an index of upstream excitation of the motor cortex remained constant (p>0.40). Together, these results suggest that as fatigue develops prior to task failure, the increase in corticospinal excitability observed in relationship to the decrease in spinal excitability results from a combination of decreasing intracortical inhibition with constant levels of intracortical facilitation and upstream excitability that together eventually fail to provide the input to the motor cortex necessary for descending drive to overcome the spinal cord resistance, thereby contributing to task failure.

Changes in constraint of proximal segments effects time to task failure and activity of proximal muscles in knee position-control tasks

OBJECTIVE

Maintenance of a limb position against external load (position-control) fails earlier (time to task failure: TTF) than maintenance of identical force against rigid restraint (force-control). Although possibly explained by physiological differences between contractions, we investigated whether less constraint of movements in other planes and proximal segments (commonly less in position-control tasks) shortens TTF.

METHODS

Seventeen adults (32±7 years) contracted knee extensor muscles to task failure in a position-control task, with and without constraint of motion in other planes and proximal segments, and a force-control task with constraints. Electromyography of knee extensors, their antagonist and hip muscles was recorded with force/position.

RESULTS

TTF was shorter for position-control without (161±55 s) than with constraint (184±51 s). Despite identical constraint, TTF was shorter in position- than force-control (216±56 s). Muscle activity and position variability at failure was greater without constraint.

CONCLUSION

Constraint of motion of proximal segments and other planes increases position-control TTF with less muscle activity and variability. As TTF differed between force- and position-control, despite equivalent constraint, other factors contribute to shorter position-control TTF.

SIGNIFICANCE

Results clarify that differences in the TTF between position- and force-control tasks are partly explained by unmatched restriction of motion in other planes and proximal segments.

Task- and time-dependent modulation of Ia presynaptic inhibition during fatiguing contractions performed by humans

Presynaptic modulation of Ia afferents converging onto the motor neuron pool of the extensor carpi radialis (ECR) was compared during contractions (20% of maximal force) sustained to failure as subjects controlled either the angular position of the wrist while supporting an inertial load (position task) or exerted an equivalent force against a rigid restraint (force task). Test Hoffmann (H) reflexes were evoked in the ECR by stimulating the radial nerve above the elbow. Conditioned H reflexes were obtained by stimulating either the median nerve above the elbow or at the wrist (palmar branch) to assess presynaptic inhibition of homonymous (D1 inhibition) and heteronymous Ia afferents (heteronymous Ia facilitation), respectively. The position task was briefer than the force task (P = 0.001), although the maximal voluntary force and electromyograph for ECR declined similarly at failure for both tasks. Changes in the amplitude of the conditioned H reflex were positively correlated between the two conditioning methods (P = 0.02) and differed between the two tasks (P < 0.05). The amplitude of the conditioned H reflex during the position task first increased (129 ± 20.5% of the initial value, P < 0.001) before returning to its initial value (P = 0.22), whereas it increased progressively during the force task to reach 122 ± 17.4% of the initial value at failure (P < 0.001). Moreover, changes in conditioned H reflexes were associated with the time to task failure and force fluctuations. The results suggest a task- and time-dependent modulation of presynaptic inhibition of Ia afferents during fatiguing contractions.

Age and load compliance alter time to task failure for a submaximal fatiguing contraction with the lower leg

The purpose of this study was to compare the time to failure and muscle activation of young and old adults for a sustained isometric submaximal contraction with the dorsiflexor muscles when the foot was restrained to a force transducer (force-control task) compared with supporting an equivalent inertial load unrestrained in the sagittal plane (position-control task). Seventeen young (23.6+/-6.5 yr) and 12 old (70.0+/-5.0 yr) adults performed the force-control and position-control tasks at 30% maximal voluntary contraction (MVC) until task failure on separate days. Despite the similar load torque for each task, time to failure was longer for the force-control than position-control task (10.4+/-4.5 vs. 8.6+/-3.4 min, P=0.03) for the young and old adults. The old adults, however, had a longer time to task failure than the young adults for both tasks (11.4+/-4.4 vs. 8.1+/-2.1 min, P=0.01), with no interaction of age and task (P=0.83). The rate of increase in agonist and antagonist root-mean-square EMG, agonist EMG bursting activity, mean arterial pressure, and heart rate during the fatiguing contraction was greater for the position-control than force-control task for the young and old adults. The old adults had a less rapid rate of increase in EMG activity, fluctuations in motor output, and cardiovascular measures than the young adults for both tasks. Development of fatigue can be manipulated in young and old adults by providing greater support to the foot and less ankle compliance during daily and ergonomic tasks that require prolonged activation of the lower leg. Minimizing load compliance to one degree of freedom during a position-control task maintained the greater fatigue resistance with age for an isometric contraction.