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Task dependency in back muscle fatigue--correlations between two test methods.

BACKGROUND: Various test methods which engage the back muscles in different tasks have been used in studies of back muscle fatigue with electromyography. The present objective was to study task dependency in lumbar muscle fatigue by comparing two test methods. METHODS: In this cross-sectional study, 22 healthy subjects performed a seated (45s) and a prone test (to the limit of endurance) of back muscle fatigue in randomised order. Fatigue of the lumbar muscles was assessed using electromyography spectral variables and ratings of back muscle fatigue (Borg scale). Linear regression of the median frequency during contraction, and conventional statistical tests of group differences and correlations were used. FINDINGS: Significant differences (P<0.001) between the seated and the prone test were found for the initial median frequency, the slope, the median frequency decrease during the whole contraction, and for the ratings. However, correlation coefficients between the seated and the prone test were low for the median frequency decrease (r=0.42), absent for the slopes of median frequency (r=-0.08), higher for the Borg ratings (r(s)=0.51; P<0.05) and highest for the initial median frequency (r=0.69; P<0.05). Within each test, correlations between the Borg ratings and the electromyography variables were essentially absent (r<0.19). INTERPRETATION: Electromyography variables assessed in one type of task in a fatiguing test may not be valid for other types of fatiguing tasks, for example in daily life work situations. Thus task dependency has to be considered when using surface electromyography in determining lumbar muscle fatigue. Ratings of fatigue, however, seem to be less task dependent than the electromyography variables.

Adult↗

Time-frequency methods applied to muscle fatigue assessment during dynamic contractions.

This paper discusses the assessment of the electrical manifestations of muscle fatigue during dynamic contractions. In the past, the study of muscle fatigue was restricted to isometric constant force contractions because, in this contraction paradigm, the myoelectric signal may be considered as wide sense stationary over epochs lasting up to two or three seconds, and hence classic spectral estimation techniques may be applied. Recently, the availability of spectral estimation techniques specifically designed for nonstationary signal analysis made it possible to extend the employment of muscle fatigue assessment to cyclic dynamic contractions, thus increasing noticeably its possible clinical applications. After presenting the basics of time-frequency distributions, we introduce instantaneous spectral parameters well suited to tracking spectral changes due to muscle fatigue, discuss the issues of quasi-stationarity and quasi-cyclostationarity, and present different strategies of signal analysis to be utilized with cyclic dynamic contractions. We present preliminary results obtained by analyzing data collected from paraspinal muscles during repetitive lift movements, from the first dorsal interosseus during abduction-adduction movements of the index finger, and from knee flexors and extensors during isokinetic exercise. In conclusion, data herein reported demonstrate that the described techniques allow for evidencing the electrical manifestations of muscle fatigue in different paradigms of cyclic dynamic contractions. We believe that the extension of the objective assessment of the electrical manifestations of muscle fatigue from static to dynamic contractions may increase considerably the interest of researchers and clinicians and open new application fields, as ergonomics and sports medicine.

Electromyography↗

Issues in relation to the repeatability of and correlation between EMG and Borg scale assessments of neck muscle fatigue.

INTRODUCTION: The repeatability of subjective and objective assessments of neck muscle fatigue is very important with regard to the clinical applicability of these methods. METHOD: To establish between-days reliability, 33 healthy volunteers performed a 60% maximum voluntary isometric contraction test from a standing position in all neck movements. Cervical muscle fatigue was assessed on three separate occasions from the spectral (median frequency, MF) and amplitude (root mean square, RMS) analysis of the electromyogram (EMG) signal recorded from the cervical paraspinal group, splenius capitis, levator scapulae and sternocleidomastoid. Subjective assessment of fatigue was rated by employing the Borg scale. Intraclass correlation coefficient ICC((1,1)), standard error of measurement (SEM), smallest detectable difference (SDD) indices and Pearson's correlation co-efficient were calculated for the analysis of the results. RESULTS: Normalised median frequency (MF) slope had low repeatability and large between-day error (ICC((1,1))=0.28-0.61; SEM=0.33-0.60%/s; SDD=132.7-703.2%) for the protagonist muscles of each movement. Initial median frequency (IMF) had moderate to good reliability and small error (ICC((1,1))=0.64-0.81; SEM=2.8-8.8Hz; SDD=19.9-38.5%). The RMS slope yielded also poor repeatability. The Borg assessment was more reliable than the EMG estimate though variability between sessions was still quite high (SDD=29.2-136.5%). No correlation was found between the EMG and Borg assessment of neck muscle fatigue (r=-0.01-0.39). CONCLUSION: The protocol used for assessing neck muscle fatigue proved to be reliable only for the IMF but the clinical usefulness of this measure remains questionable. The lack of correlation between objective and subjective estimation of neck muscle fatigue was possibly a consequence of the poor measurement repeatability. Further research is needed to identify the factors responsible for these results on neck area.

Adult↗

Increased metabolic muscle fatigue is caused by some but not all mitochondrial mutations.

CONTEXT: Excessive muscle fatigue occurs in patients with a mitochondrial encephalomyopathy (MEM), but it is also a frequent problem in patients with other neuromuscular disorders (ONMD). OBJECTIVE: To determine whether, and to what extent, metabolic muscle fatigue specifically occurs in patients with an MEM. DESIGN: Metabolic muscle fatigue was assessed in a series of 21 patients with an MEM, including 13 patients with chronic progressive external ophthalmoplegia and 8 patients with various mitochondrial point mutations; 27 patients with ONMD; and 25 healthy controls. Isometric twitch force of the ankle dorsiflexors was measured after supramaximal stimulation of peroneal nerves. Six trains of stimuli (of 1 minute's duration with rates from 0.2 to 5 stimuli per second) were given to each subject. RESULTS: An abnormal decrement of the twitch amplitude that occurred during a stimulation train was found in patients with MEM and in those with ONMD. The decrement of the twitch amplitude of controls and of patients with ONMD was strongly influenced by their muscle force (P<.001). After subtraction of the influence of the muscle force, specific fatigue was notably higher in patients with chronic progressive external ophthalmoplegia than in patients with ONMD and in controls, and it correlated well with elevations of serum lactate. Specific fatigue was also abnormal in a patient with a mitochondrial G7497A mutation, but normal in patients with an A3243G or a G11778A mutation. The heteroplasmy of mitochondrial DNA in muscle correlated neither with the force measures nor with the serum lactate levels. CONCLUSIONS: Generally, metabolic muscle fatigue accompanies muscular weakness. Specifically, some but not all mitochondrial mutations cause excessive metabolic muscle fatigue.

Action Potentials↗

Assessment of skeletal muscle fatigue in men with coronary artery disease using surface electromyography during isometric contraction of quadriceps muscles.

OBJECTIVE: To evaluate whether using surface electromyography to assess skeletal muscle fatigue during an isometric exercise has the potential to be clinically useful in patients with coronary artery disease (CAD). DESIGN: Double sample comparative study. SETTING: Cardiac rehabilitation service in France. PARTICIPANTS: Sixteen men with documented CAD and 9 age-matched healthy men. INTERVENTIONS: Assessment of quadriceps skeletal muscle fatigue on an isokinetic apparatus with surface electromyography measurements and a symptom-limited exercise test in a laboratory. MAIN OUTCOME MEASURES: The maximal voluntary isometric force (MVIF) of the quadriceps was quantified as a measure of muscle strength and isometric endurance was defined as the time required to sustain a contraction at 50% of MVIF until exhaustion. Surface electromyography signals were recorded from the vastus lateralis, rectus femoris, and vastus medialis during isometric endurance. The root mean square (RMS) and the median frequency (MF) were directly calculated on a computer and then normalized (as a percentage of the initial value). RESULTS: Muscle strength did not differ significantly between the patients with CAD and the healthy subjects (229+/-21N/m vs 228+/-52N/m), but isometric endurance was reduced (64+/-17s vs 90+/-7s, P <.01). The RMS values showed a significantly higher increase in the healthy subjects versus the patients with CAD for the vastus lateralis and vastus medialis ( P <.001). The MF values were significantly lower for the vastus lateralis, rectus femoris ( P <.01), and vastus medialis ( P <.05) in patients with CAD compared with the healthy subjects. CONCLUSIONS: Skeletal muscle fatigue occurs sooner in men with CAD relative to matched healthy men, despite similar muscle strength. This finding may be the result of an abnormality of skeletal muscle function and may play an important role in measuring functional capacity. In addition, it may be a useful tool to assess the efficacy of cardiac rehabilitation interventions.

Coronary Artery Disease↗

Central basis of muscle fatigue in chronic fatigue syndrome.

We studied whether muscle fatigue, metabolism, or activation are abnormal in the chronic fatigue syndrome (CFS). Subjects performed both an intermittent submaximal and a sustained maximal voluntary isometric exercise protocol of the tibialis anterior muscle. The extent of fatigue, metabolic response, and changes in both M-wave amplitude and twitch tension during exercise were similar in patients and controls. The response to systemic exercise was also normal in the patients. However, voluntary activation of the tibialis was significantly lower in the patients during maximal sustained exercise. The results indicate that patients with CFS have (1) normal fatigability and metabolism at both the intracellular and systemic levels, (2) normal muscle membrane function and excitation-contraction coupling, and (3) an inability to fully activate skeletal muscle during intense, sustained exercise. This failure of activation was well in excess of that found in controls, suggesting an important central component of muscle fatigue in CFS.

Adult↗

Electrical manifestations of muscle fatigue during concentric and eccentric isokinetic knee flexion-extension movements.

The quantification of the progression of muscle fatigue during a sustained contraction is a valuable tool in several clinical applications, ranging from the evaluation of functional impairment to the development of specific rehabilitative and training protocols. In these fields, great importance is given to isokinetic contractions. The aim of this paper was twofold: first, to propose signal processing methods for assessing the spectral changes of the surface myoelectric signal due to fatigue during isokinetic concentric and eccentric knee flexion-extension movements at a given angular velocity (60 degrees/s); second, to analyze the electrical manifestations of muscle fatigue of four thigh muscles (vastus lateralis, vastus medialis, rectus femoris, and biceps femoris) in the two contraction modalities (i.e. concentric versus eccentric). We demonstrated that, when considering concentric contractions, localized muscle fatigue can be assessed by computing the mean frequency of the frequency marginal of the time-frequency distribution derived from the surface myoelectric signal collected during each contraction cycle. Stronger nonstationarities were observed in the surface myoelectric data recorded within each cyclical movement of the studied eccentric exercise. Thus we propose the computation of the instantaneous mean frequency of the signal based on an original cross-time-frequency algorithm, which proved more sensitive than the frequency marginal in tracking the spectral changes associated with localized muscle fatigue. We derived the average fatigue pattern of the investigated muscles from experimental data recorded from a sample population consisting of twenty healthy subjects and we statistically compared the two contraction modalities. Our results showed that the electrical manifestations of muscle fatigue during concentric contractions were higher than those found during eccentric contractions, although in the latter modality the torque exerted and the mechanical work produced by the subjects were larger than those recorded during the concentric exercise. The results presented in this paper have potential clinical application and they could play an important future role in investigations of muscle behavior during dynamic, highly fatiguing contractions.

Adult↗

A comparison of the effects of agonist and antagonist muscle fatigue on performance of rapid movements.

The aim of this study was to investigate the effects of agonist and antagonist muscle fatigue on the performance of rapid, self-terminating movements. Six subjects performed rapid, consecutive elbow flexion and extension movements between two targets prior to and after fatiguing either the elbow flexor or elbow extensor muscles. The experiments demonstrated consistent results. Agonist muscle fatigue was associated with a decrease in peak velocity and peak deceleration, while a decrease in peak acceleration was particularly prominent. Antagonist muscle fatigue, however, was associated with a decrease in peak deceleration, while a decrease in both the peak velocity and peak acceleration was modest and, in some tests, non-significant. The relative acceleration time (i.e. acceleration time as a proportion of the total movement time) increased when agonists were fatigued, but decreased when antagonists were fatigued. Taken together, these results emphasize the mechanical roles of the agonist and antagonist muscles; namely, the fatigue of each muscle group particularly affected the movement phase in which that group accelerated a limb, while changes of the movement kinematics pattern provided more time for action of the fatigued muscles. In addition, the results presented suggest that agonist muscle fatigue affects movement velocity more than antagonist muscle fatigue, even in movements that demonstrate prominently both mechanical and myoelectric activity of the antagonist muscles, such as rapid, self-terminating movements.

Adult↗

[Relationship of respiratory muscle fatigue and respiratory effort sensation: mechanisms and treatment].

We investigated whether fatigue of the expiratory muscle may account for a change in the respiratory effort sensation in normal subjects. We also examined the effects of inspiratory muscle training (IMT) and a beta 2-agonist, fenoterol, on respiratory effort sensation during loaded breathing. Experiment 1: Expiratory threshold loading was performed until exhaustion or 30 min, to induce expiratory muscle fatigue. The respiratory effort sensation was scored using a modified Borg scale. The maximum static expiratory pressure during loading (PEmaxload) decreased with time, and the Borg score rose with time. The relationship between the sensory score and PEmaxload was virtually linear. Experiment 2: Twice daily, IMT was performed using a pressure threshold device for 15 min in each session. The inspiratory threshold was set to 30% of each subject's maximum inspiratory pressure (Plmax) and IMT was continued for 4 weeks. Respiratory sensation (Borg score) was evaluated during a progressive exercise test. IMT increased inspiratory muscle pressure by 30%. However, there was no change in Borg score during the exercise test. Experiment 3: Fenoterol (5 mg) was given 2 hours before the inspiratory threshold loading, and then threshold loaded breathing was continued until exhaustion or 60 min. Endurance time increased by 50% in fenoterol group compared to placebo group. The increase in Borg score with time was less in fenoterol group than in placebo group. The decrease in respiratory muscle strength after loading was comparable in both groups. We conclude that the increased respiratory effort sensation during expiratory threshold loading is closely related to expiratory muscle fatigue as indicated by the decrease in expiratory muscle force.(ABSTRACT TRUNCATED AT 250 WORDS)

Dyspnea↗

Vibration-induced muscle fatigue, a possible contribution to musculoskeletal injury.

Localized muscle fatigue resulting from 30-min sustained and intermittent grip exertions of 5% maximal voluntary contraction (MVC) with and without hand-vibration exposure (10 Hz, 7 mm displacement amplitude) was investigated. Muscle fatigue was quantified by the magnitude of the twitch force elicited in the right flexor digitorum superficialis muscle of the long finger using the low-frequency fatigue (LFF) method. The influence of vibration in the sustained grip exertion condition exacerbates fatigue as seen with the reduction in twitch force 30-60 min post-work task. Intermittent low grip force exertion conditions with and without vibration exposure show negligible fatigue, suggesting the benefit of rest in the work cycle. Perception of muscle fatigue was dissociated from the objective measure of twitch force, suggesting that LFF was not perceived. The presence of LFF and the lack of perception of LFF may increase the risk for the development of musculoskeletal disorders. The findings of this study may apply to the design of the work cycles and tasks that require the use of vibratory tools.

Adult↗

Respiratory muscle fatigue and ventilatory failure.

In this review emphasis is placed on some major mechanisms involved in inspiratory muscle fatigue. It is certain that respiratory muscle fatigue is a clinical entity, with broad implication in internal medicine. As yet its prevalence is largely unknown. There is reasonable certainty of some of the mechanisms leading to fatigue, for example the effect of loads and circulation. However, the cellular mechanisms, both chemical and electrophysiological, remain obscure. In detecting respiratory muscle fatigue various tests already represent windows from which we can see the malfunction of some mechanisms, unfortunately often not understood. The ideal test to evaluate respiratory muscle fatigue (easy to perform, sensitive, specific, and reliable) has not been developed yet. The clinical identification of respiratory muscle fatigue is still developing, and only tentative guidelines for its treatment can be proposed at this stage. Clearly, much research is required to determine prevalence, establish the diagnosis, and evaluate therapy.

Diaphragm↗

Influence of synchronous and sequential stimulation on muscle fatigue.

In acute experiments the sciatic nerve of the rat is electrically stimulated to induce fatigue in the medial Gastrocnemius muscle. Fatigue tests are carried out using intermittent stimulation of different compartments (sequential) or a single compartment (synchronous) of the sciatic nerve. The activation of different compartments is achieved by dividing nerve fibres into subbundles and placing them in separate grooves in a multigroove electrode. The aim of the investigation is to quantify the effect of sequential contra synchronised stimulation in reducing muscle fatigue, with no overlap between compartments. Overlap between two compartments is calculated using the combined and individual forces from both compartments. Sequential stimulation of two and three compartments is investigated. There is a significant decrease of fatigue in sequential stimulation compared to synchronous. After 2 min of intermittent stimulation the force time level is significantly increased in sequential stimulation, than in synchronous stimulation. The rate of force time decrease is significantly slower in sequential stimulation than in synchronous stimulation. With sequential stimulation it takes significantly longer before the maximal force time is reached than with synchronous stimulation.

Animals↗

Back extensor muscle fatigue in patients with lumbar disc herniation. Pre-operative and post-operative analysis of electromyography, endurance time and subjective factors.

We investigated back muscle fatigue and endurance in patients with lumbar disc herniation before and after surgery, and established the degree of association between perceived fatigue and objectively measured fatigue. Additionally, the relationships between muscle fatigue and endurance time on the one hand, and activity, participation, self-efficacy and health on the other, were investigated to clarify the grades of association between these factors. Forty-three consecutive patients with lumbar disc herniation were tested before surgery and 4 weeks after surgery. The protocol comprised an isometric endurance test (modified Sørensen's test) with concomitant measures of electromyography, and Borg ratings of pain and fatigue. To measure activity, participation, self-efficacy and health, the patients also filled in questionnaires. Results showed a post-operatively significant improvement in lumbar muscle fatigue expressed as a flatter L5 slope for the men. No significant improvement was found for endurance times or for Borg ratings. Endurance time correlated with questionnaire answers on physical activity, the Roland-Morris, the Oswestry, self-efficacy and some items of the SF-36 with correlation coefficients ranging from 0.52 to 0.91. The L5 slope correlated with the Roland-Morris, the Oswestry and some items of the SF-36 only in women with correlation coefficients between 0.53 and 0.77. We conclude that the effects of surgery reduced muscle fatigue for the men. There is an association between muscle fatigue and endurance with activity limitations, participation restrictions, self-efficacy and health in patients undergoing surgery for lumbar disc herniation.

Activities of Daily Living↗

The effects of estradiol and progesterone on plantarflexor muscle fatigue in ovariectomized mice.

The aim of this study was to examine specific and interactional effects of estradiol and progesterone on the time-to-fatigue of eccentrically contracted plantarflexor muscles and on the percent of plantarflexor isometric torque remaining immediately after an eccentric contraction (EC) protocol. Ovariectomized 6- to 8-week-old C57BL/6 mice were implanted with 21-day 0.05 mg-placebo, 0.05 mg-17-beta estradiol (OE), 15 mg-progesterone (OP), or estradiol and progesterone pellets (OEP). On the 16th day of hormone treatment, the isometric torque of the left plantarflexor muscles was measured. The left plantarflexor muscles then underwent 1 set of 150 ECs followed by 2 immediate post-EC isometric torque measurements. A group of ovarian-intact female mice of a similar age underwent the same isometric torque measurements and EC protocol. Plantarflexor muscle fatigue during ECs took 30%-41% longer to occur in the OP group (n = 9) than it did in the intact (n = 8, P = 0.02), OC (n = 11, P = 0.003), and OEP (n = 9, P = 0.007) groups. Peak active isometric torque had decreased immediately after ECs at 2 time points (M1 and M2). The OP group exhibited the greatest percent of isometric torque remaining immediately after ECs (M1, P = 0.03; M2, P = 0.04). These findings suggest that progesterone reduces muscle fatigue in response to ECs and that this progesterone effect is blunted when estradiol also is present. Therefore, ovarian hormone status may need to be considered when evaluating a response to physical activities, especially those activities involving ECs.

Analysis of Variance↗

[Methods applied to muscle fatigue assessment using surface myoelectric signals].

Surface myoelectric signal analysis has proved effective for assessing the electrical manifestations of localized muscle fatigue. In the past, the analysis of muscle fatigue was restricted to isometric, constant force contractions due to the limitation of signal processing technique. The development and recent availability of spectral estimation techniques specifically designed for nonstationary signal analysis have made it possible to extend the employment of muscle fatigue assessment to dynamic contractions, thus opening new application fields such as ergonomics rehabilitation and sports medicine. This paper reviews the current study achievements of using surface myoelectric signals in muscle fatigue assessment, particularly in that during dynamic contractions. The conclusions provide theoretical bases for encouraging further studies on the mechanisms of muscle fatigue.

Electromyography↗

Effects of muscle fatigue induced by low-level clenching on experimental muscle pain and resting jaw muscle activity: gender differences.

The purpose of this study was to investigate the effects of jaw-muscle fatigue evoked by low-level tooth-clenching followed by the induction of experimental muscle pain by injection of glutamate on the perception of fatigue and pain and on the resting electromyographic (EMG) activity. In addition, the role of gender on these interactions was studied. The EMG activities of bilateral masseter (MAL, MAR) and temporalis (TAL, TAR) muscles in 11 healthy young women and 12 men were measured before (Baseline) and after tooth-clenching for 30 min at 10% of maximal force (Post1), after subsequent glutamate (Glu) or isotonic saline (Iso) injection into the MAL following the tooth-clenching (Post2) and 60 min after tooth-clenching (Post3). The intensities of fatigue, fatigue-related muscle pain and headache-like symptoms were scored on 0-10 cm visual analog scales (VAS). The glutamate-evoked pain was continuously scored on an electronic VAS. Sustained low-level tooth-clenching consistently produced fatigue sensation, fatigue-related muscle pain and headache-like symptoms in both genders with significantly higher fatigue VAS scores in men than in women, while the accompanying increase in the resting EMG activity appears higher in women than in men in the masseter muscles. In this study no gender differences were found for the perceived amount of experimental pain induced by glutamate injection. Additional increases of the resting EMG activity after injections occurred only in men in the injected masseter muscle and non-injected temporalis muscles. The present findings provide new information on the complex influence of gender on sensory-motor integration in the trigeminal system which may contribute to differences in susceptibility to develop musculoskeletal pain problems.

Adult↗