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Muscle fatigue monitoring using wavelet decomposition of surface EMG.

Monitoring the local muscle fatigue in maximum voluntary isometric contraction is successful using median frequency and mean power frequency of the surface EMG. However, it has very limited success in maximum voluntary dynamic contraction. We showed that the relaxation electromechanical delay was a reliable fatigue indicator during the maximum voluntary isokinetic concentric contraction. In this paper, we use wavelet decomposition to generate fatigue indicators including contraction delay (WCD), relaxation delay (WRD), and the power ratio related to high frequency and low frequency regions (HF/LF) of the power spectrum of surface electromyogram (SEMG). Eight subjects were asked to perform right knee isokinetic contractions at two angular velocities (120 and 240 degrees/sec). Total work (TW), knee angle, and four channels of quadriceps SEMGs were sampled simultaneously. The results indicate that the initial slopes of WCD and WRD increase and are correlated with TW significantly, the initial slope of HF/LF declines and is correlated with TW significantly, and the WRD is more stable than the WCD. It concludes that wavelet decomposition enhances the features of surface EMG, and that power ratio (HF/LF) and contraction and relaxation delays obtained with the EMG wavelet decomposition can be used to monitor the muscle fatigue during the maximum voluntary isokinetic concentric contraction.

Electromyography↗

The consequences of diaphragmatic muscle fatigue in the newborn infant.

We have previously demonstrated that diaphragmatic muscle fatigue can be diagnosed in infants from spectral frequency analysis of the surface diaphragmatic electromyogram. This requires a digital computer, but the analysis takes several days. Spectral frequency changes, however, can be accurately reflected by band pass filtering and expressing the ratio of high-frequency power to low-frequency power. A fall in this ratio of greater than 20% indicates muscle fatigue. Using a simple analog device to obtain this ratio permits the results to be immediately available; we have used this method to study weaning from mechanical ventilators in ten infants. With a successful weaning step there is no significant change in the ratio, whereas an unsuccessful weaning step invariably leads to a decrease in the ratio of greater than 20%, which precedes CO2 retention and clinical deterioration. These data indicate that diaphragmatic muscle fatigue plays an important role in the infant's response to lung disease. Monitoring of the high/low frequency ratio may be helpful in weaning infants from assisted ventilation.

Computers, Analog↗

Dissociation between diaphragmatic and rib cage muscle fatigue.

To assess rib cage muscle fatigue and its relationship to diaphragmatic fatigue, we recorded the electromyogram (EMG) of the parasternal intercostals (PS), sternocleidomastoid (SM), and platysma with fine wire electrodes and the EMG of the diaphragm (DI) with an esophageal electrode. Six normal subjects were studied during inspiratory resistive breathing. Two different breathing patterns were imposed: mainly diaphragmatic or mainly rib cage breathing. The development of fatigue was assessed by analysis of the high-to-low (H/L) ratio of the EMG. To determine the appropriate frequency bands for the PS and SM, we established their EMG power spectrum by Fourier analysis. The mean and SD for the centroid frequency was 312 +/- 16 Hz for PS and 244 +/- 48 Hz for SM. When breathing with the diaphragmatic patterns, all subjects showed a fall in H/L of the DI and none had a fall in H/L of the PS or SM. During rib cage emphasis, four out of five subjects showed a fall in H/L of the PS and five out of six showed a fall in H/L of the SM. Four subjects showed no fall in H/L of the DI; the other two subjects were unable to inhibit diaphragm activity to a substantial degree and did show a fall in H/L of the DI. Activity of the platysma was minimal or absent during diaphragmatic emphasis but was usually strong during rib cage breathing. We conclude that fatigue of either the diaphragm or the parasternal and sternocleidomastoid can occur independently according to the recruitment pattern of inspiratory muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Recent advances in the understanding of skeletal muscle fatigue.

Prolonged or repeated contractions of skeletal muscles lead to impaired muscle function, fatigue develops. Fatigue may be caused by factors within the muscle cells (peripheral fatigue) and diminished activation from the central nervous system (central fatigue). The relative importance of peripheral central fatigue depends on the type of physical activity. Central fatigue may be more prominent in elderly subjects. Increased concentration of inorganic phosphate seems to be of major importance for acute peripheral fatigue. There is frequently a long-lasting depression of force production after fatiguing muscle activity, especially at low stimulation frequencies. This low-frequency fatigue seems to be due to "structural" changes in proteins involved in intracellular Ca handling. Contractions in which the muscle is stretched (eccentric contractions) cause muscle weakness and damage. The initial defect induced by eccentric contractions is overstretched sarcomeres, but these appear to cause localized membrane tears that subsequently contribute to muscle weakness and damage.

Aging↗

Mechanisms underlying the reduction of isometric force in skeletal muscle fatigue.

A decline of isometric force production is one characteristic of skeletal muscle fatigue. In fatigue produced by repeated short tetani, this force decline can be divided into two components: a reduction of the cross-bridges' ability to generate force, which comes early; and a reduction of the sarcoplasmic reticulum Ca2+ release, which develops late in fatigue. Acidification due to lactic acid accumulation has been considered as an important cause of the reduced cross-bridge force production. However, in mammalian muscle it has been shown that acidification has little effect on isometric force production at physiological temperatures. By exclusion, in mammalian muscle fatigue, the reduction of force due to impaired cross-bridge function would be caused by accumulation of inorganic phosphate ions, which results from phosphocreatine breakdown. The reduction of sarcoplasmic reticulum Ca2+ release in late fatigue correlates with a decline of ATP and we speculate that the reduced Ca2+ release is caused by a local increase of the ADP/ATP ratio in the triads.

Animals↗

The effects of acute stretching on hamstring muscle fatigue and perceived exertion.

The aim of this study was to examine the effects of an acute stretching regime on hamstring muscle fatigue and rating of perceived exertion during a dynamic, sub-maximal bout of resistance exercise. Sixteen healthy males (age 25.7 +/- 4.3 years, height 1.81 +/- 0.06 m, body mass 87.5 +/- 15.1 kg; mean +/- s) and 16 healthy females (age 24.9 +/- 4.5 years, height 1.67 +/- 0.06 m, body mass 62.9 +/- 9.4 kg) volunteered to participate in two experimental sessions. After establishing their one-repetition maximum for the hamstring curl, the participants were assigned at random to one of two groups. Group 1 performed three bouts of 20 s hamstring stretches with the assistance of one of the investigators, while group 2 did not perform the stretches; instead, they sat resting for 3 min. Then, after stretching or resting, the participants performed as many hamstring curls as they could at 60% of their one-repetition maximum established earlier. All participants were assessed for their perceived exertion using a modified Borg category ratio (CR-10) scale. The participants returned within 1 week to complete the experiment. This time group 1 did not perform hamstring stretches, whereas group 2 did. As on the first occasion, all participants performed hamstring curls after stretching or resting. The participants in group 1 were able to perform more curls on the second day of testing than their counterparts in group 2. There were no significant differences between males and females or between the stretch and non-stretch conditions. There was a significantly higher first repetition rating of perceived exertion for the stretch condition (2.88 +/- 1.01) than for the non-stretch condition (2.50 +/- 0.95); there was no significant difference in the median ratings of perceived exertion between the stretch and non-stretch conditions. Significantly higher power function exponents were exhibited in the non-stretch (0.57 +/- 0.16) than in the stretch condition (0.51 +/- 0.12). In addition, females exhibited significantly higher power function exponents than males, irrespective of stretch condition and day (females: 0.59 +/- 0.12; males: 0.49 +/- 0.11). In conclusion, we found a small but statistically significant effect of an acute bout of stretching on ratings of perceived exertion during fatiguing hamstring muscle resistance exercise.

Adult↗

Effect of exercise-induced arterial hypoxemia on quadriceps muscle fatigue in healthy humans.

The effect of exercise-induced arterial hypoxemia (EIAH) on quadriceps muscle fatigue was assessed in 11 male endurance-trained subjects [peak O2 uptake (VO2 peak) = 56.4 +/- 2.8 ml x kg(-1) x min(-1); mean +/- SE]. Subjects exercised on a cycle ergometer at >or=90% VO2 peak) to exhaustion (13.2 +/- 0.8 min), during which time arterial O2 saturation (Sa(O2)) fell from 97.7 +/- 0.1% at rest to 91.9 +/- 0.9% (range 84-94%) at end exercise, primarily because of changes in blood pH (7.183 +/- 0.017) and body temperature (38.9 +/- 0.2 degrees C). On a separate occasion, subjects repeated the exercise, for the same duration and at the same power output as before, but breathed gas mixtures [inspired O2 fraction (Fi(O2)) = 0.25-0.31] that prevented EIAH (Sa(O2) = 97-99%). Quadriceps muscle fatigue was assessed via supramaximal paired magnetic stimuli of the femoral nerve (1-100 Hz). Immediately after exercise at Fi(O2) 0.21, the mean force response across 1-100 Hz decreased 33 +/- 5% compared with only 15 +/- 5% when EIAH was prevented (P < 0.05). In a subgroup of four less fit subjects, who showed minimal EIAH at Fi(O2) 0.21 (Sa(O2) = 95.3 +/- 0.7%), the decrease in evoked force was exacerbated by 35% (P < 0.05) in response to further desaturation induced via Fi(O2) 0.17 (Sa(O2) = 87.8 +/- 0.5%) for the same duration and intensity of exercise. We conclude that the arterial O2 desaturation that occurs in fit subjects during high-intensity exercise in normoxia (-6 +/- 1% DeltaSa(O2) from rest) contributes significantly toward quadriceps muscle fatigue via a peripheral mechanism.

Adult↗

Development of muscle fatigue assessed by using superposition of evoked and volitional myoelectric potentials.

We studied muscle fatigue development using evoked myoelectrical potentials superimposed on volitional ones. The instantaneous frequency of superim posed M-waves and mean power frequencies of volitional electromyography (EMG) declined during sustained contraction, indicating that fatigue progressed. We divided fatigue into 3 phases, with 20 frames in each fatigue phase, corresponding to one-third of the total sample. The instantaneous frequency of superimposed M-waves and mean power frequencies of volitional EMG were correlated during early intensive isometric voluntary contractions and became increasingly uncorrelated as contraction proceeded. The coefficient between the mean power frequency and instantaneous frequency correlation was also greater at the first peak than at the second peak of the superimposed M-wave, indicating that the motor unit action potential was distorted. Distortion in the motor unit action potential shape depends on elongation of the depolarization zone of muscle fiber, because the superimposed M-wave is a peripheral indicator elicited by electrical stimulation. These results suggest that muscle fatigue develops based on the reduction of the conduction velocity of muscle fiber and on the elongation of the depolarization zone of muscle fiber.

Adult↗

Metabolic basis for inspiratory muscle fatigue in normal humans.

Inspiratory muscle fatigue, a common event in patients in the intensive care unit, is under multifactorial control. To test the hypothesis that systemic oxygenation is a factor in this event, we subjected five healthy males (age 42 +/- 3 yr) to continuous inspiratory pressure (75% of maximal inspiratory pressure, -95 +/- 5 cmH2O) with the use of a controlled breathing pattern while they breathed normoxic (21% O2), hyperoxic (30% O2), and hypoxic (13% O2) mixtures. Inspiratory muscle endurance (IME; time that pressure could be maintained) and other cardiorespiratory parameters were monitored. Room air IME (3.3 +/- 0.4 min) was shortened (P < 0.05) during 13% O2 breathing (1.6 +/- 0.4 min) but was unaffected during 30% O2 breathing (4.0 +/- 0.6 min). Inspiratory loading lowered the respiratory exchange ratio (RER) during the 21 and 30% O2 trials (1.02 +/- 0.01 to 0.80 +/- 0.03% and 1.05 +/- 0.05 to 0.69 +/- 0.01%, respectively) but not during the 13% O2 trials (1.03 +/- 0.03 to 1.06 +/- 0.07%). At the point of fatigue during the 13% O2 trials, RER was lower compared with the same time point during the 21 and 30% O2 trials. A significant relationship was observed between IME and RER (r = -0.73, P = 0.002) but not between IME and any of the other measured variables. We conclude that 1) hypoxemia impairs the ability of the inspiratory muscles to sustain a mechanical challenge and 2) substrate utilization of the respiratory muscles shifts toward a greater reliance on lipid metabolism when O2 is readily available; this shift was not observed when the O2 supply was reduced.

Adult↗

Retardation of skeletal muscle fatigue by the two phenylpropanoid glycosides: verbascoside and martynoside from Pedicularis plicata maxim.

The effects of the phenylpropanoid glycosides verbascoside and martynoside from Pedicularis plicata were investigated on muscle contractility in Bufo gastrocnemius muscle electrically stimulated in vitro. The maximum amplitude and maintained time of contraction were mechanically recorded and used as indices of muscle contractility. After 30 min pretreatment of the muscle, verbascoside at 20.0 microM resisted muscle fatigue significantly while martynoside at 80.0 microM improved muscle contractility only slightly. These two glycosides resisted muscle fatigue depending on their antioxidative activities, which is in agreement with the role of reactive oxygen species (ROS) in promoting fatigue in skeletal muscle.

Animals↗

Free radicals may contribute to oxidative skeletal muscle fatigue.

We used mouse soleus in vitro (n = 30) and canine gastrocnemius-plantaris preparations (n = 20) pump-perfused at the animal's blood pressure to establish if free radicals contribute to fatigue in oxidative skeletal muscle. The soleus from each leg contracted for 200 ms (70 Hz) once every minute for 60 min in Hepes buffer gassed with 100% oxygen at 27 degrees C. When contracting in Hepes alone, both muscles fatigued at 0.9 mN/mm2.min over the 60 min. The addition of purines to the bath increased the rate to 1.4 mN/mm2.min and the addition of xanthine oxidase to generate free radicals increased the rate again to 1.9 mN/mm2.min. Thus free radicals appeared to attenuate oxidative skeletal muscle function. Each canine muscle contracted isometrically at 4 Hz for 30 min and then rested for 45 min before contracting for a second 30 min at 4 Hz. In each experiment, we infused saline at 0.76 mL/min into resting muscle and at 1.91 mL/min during the first contraction period. During the remainder of the experiment, we infused, at the same rates, saline (n = 4), 10 microM dimethyl sulfoxide (DMSO) (n = 4) to identify the effect of scavenging hydroxyl radicals, 1 mM allopurinol to establish the effect of blocking xanthine oxidase (n = 4), or 200 microM desferoxamine to determine the effect of chelating iron (n = 4). With saline, the fatigue rate over the 30 min of contractions increased from 5.0 +/- 0.2 to 6.3 +/- 0.5 N/kg.min from the first to the second stimulation period. The fatigue rate was slower in the second period with each of the three experimental substances (DMSO, 5.9 +/- 0.8 to 3.2 +/- 0.3; allopurinol, 7.3 +/- 1.1 to 4.6 +/- 0.6; desferoxamine, 6.8 +/- 0.8 to 4.4 +/- 0.8 N/kg.min). The fatigue rate was the same as control when DMSO was infused only during the second contraction period. Therefore, free radicals appeared to contribute to fatigue in oxidative skeletal muscle.

Animals↗

Muscle fatigue during dynamic contractions assessed by new spectral indices.

PURPOSE: The aim of the present study was to test the applicability and sensitivity of new electromyography (EMG) spectral indices in assessing peripheral muscle fatigue during dynamic knee-extension exercise. METHODS: Seven subjects completed 10 sets of 15 repetitions of right knee-extension exercise lifting 50% of their one-repetition maximum. Torque (T), knee-joint angle, and the interference EMG of rectus femoris muscle were recorded simultaneously. Maximal voluntary isometric contraction (MVC) was tested before and after exercise. Median spectral frequency (Fmed) and new spectral indices of muscle fatigue (FInsmk) were calculated for each repetition. RESULTS: The rate and range of FInsmk- and Fmed-relative changes against the first repetition of the corresponding set increased gradually across successive repetitions within the set, reflecting accumulation of peripheral muscle fatigue. The maximal change of FInsmk observed in the present experiment was approximately eightfold, whereas that of Fmed was only 32%. Significant between-subject variability in the range of FInsmk changes (P < 0.0001) was found, so a hierarchical cluster analysis of muscle fatigue indices was conducted. Three distinct subgroups of subjects were identified: high (N = 1, FInsmk change > 400%), medium (N = 4, 200% < FInsmk change < 400%), and low (N = 2, FInsmk change < 200%) muscle fatigability. The changes in muscle performance during (last vs first repetition peak T, P = 0.03) and after (post- vs preexercise MVC, P = 0.012) exercise were significantly different between clusters (one-way ANOVA). The rate of fatigue development was also significantly different between clusters (linear regression analysis of Fmed and FInsmk changes). CONCLUSIONS: The new spectral indices are a valid and reliable tool for assessment of muscle fatigability irrespective of EMG signal variability caused by dynamic muscle contractions, and these indices are more sensitive than those traditionally used.

Adult↗

A pilot study to investigate shoulder muscle fatigue during a sustained isometric wheelchair-propulsion effort using surface EMG.

OBJECTIVE: The primary aim of this pilot study was to develop a testing protocol for gathering shoulder muscle surface electromyography (EMG) data during a sustained submaximal isometric wheelchair-propulsion effort. Of special interest was analysis of the median frequency of the surface EMG signal power spectrum; a negative median frequency shift during a sustained effort is an indicator of muscle fatigue. The long-term goal is to improve our understanding of how fatigue and muscle imbalance might play a role in the development of a broad array of upper-extremity overuse syndromes. METHOD: Participants were a convenience sample of seven male manual-wheelchair users with spinal cord injury and 14 able-bodied males. Surface EMG in six right-side shoulder muscles was recorded while subjects resisted a static force equal to 60% of their maximum wheelchair-propulsion strength until fatigued. Percent of maximum voluntary contraction and the median frequency shift for each muscle were analyzed. RESULTS: The able-bodied group used a higher percent of maximum than the manual-wheelchair group (p< .05), and a more pronounced negative median frequency shift was evident in the able-bodied group (p < .10). CONCLUSION: Patterns that emerged suggest that spectral analysis of the surface electromyographhic signal has promise as a clinically useful tool to authenticate muscle fatigue in the upper extremities during occupational performance. Such data in the future could be used to justify the need for and benefits of adapted performance techniques and assistive technology.

Adult↗

Neck muscle fatigue and spatial orientation during stepping in place in humans.

Neck proprioceptive input, as elicited by muscle vibration, can produce destabilizing effects on stance and locomotion. Neck muscle fatigue produces destabilizing effects on stance, too. Our aim was to assess whether neck muscle fatigue can also perturb the orientation in space during a walking task. Direction and amplitude of the path covered during stepping in place were measured in 10 blindfolded subjects, who performed five 30-s stepping trials before and after a 5-min period of isometric dorsal neck muscle contraction against a load. Neck muscle electromyogram amplitude and median frequency during the head extensor effort were used to compute a fatigue index. Head and body kinematics were recorded by an optoelectronic system, and stepping cadence was measured by sensorized insoles. Before the contraction period, subjects normally stepped on the spot or drifted forward. After contraction, some subjects reproduced the same behavior, whereas others reduced their forward progression or even stepped backward. The former subjects showed minimal signs of fatigue and the latter ones marked signs of fatigue, as quantified by the dorsal neck electromyogram index. Head position and cadence were unaffected in either group of subjects. We argue that the abnormal fatigue-induced afferent input originating in the receptors transducing the neck muscle metabolic state can modulate the egocentric spatial reference frame. Notably, the effects of neck muscle fatigue on orientation are opposite to those produced by neck proprioception. The neck represents a complex source of inputs capable of modifying our orientation in space during a locomotor task.

Adaptation, Physiological↗

Mouth pressure twitches induced by cervical magnetic stimulation to assess inspiratory muscle fatigue.

This study aimed at determining whether twitch mouth pressure (TwPmo) induced by cervical magnetic stimulation (CMS) was sensitive to inspiratory muscle fatigue produced by whole body exercise (WBE) in normal subjects. Twenty subjects performed one or two of the following protocols: (i). cycling at 85% V(O(2),max) until exhaustion; (ii). inspiratory resistive load (IRL) breathing at 62% of maximal inspiratory pressure until task failure. In eight subjects, oesophageal (TwPoes), gastric (TwPga) and transdiaphragmatic (TwPdi) pressures were recorded. The TwPmo was significantly reduced (P<0.05) 20 min after both WBE and IRL, from 17.5+/-4.4 to 15.9+/-3.9 cmH(2)O and from 19.4+/-4.9 to 17.7+/-4.5 cmH(2)O, respectively. Subsequently to IRL, the TwPdi decrease was associated with a reduction in TwPoes/TwPga ratio; not after WBE. Independently of the mode of ventilatory loading, inspiratory muscle fatigue was detected. Thus, inspiratory muscle fatigue after WBE can be assessed in normal subjects with a noninvasive technique.

Adult↗

Assessment of the reliability of high-intensity quadriceps femoris muscle fatigue.

OBJECTIVE: The purpose of this study was to evaluate test-retest reliability of two different measures of isokinetic quadriceps muscle fatigue. METHODS: Subjects for this study included 16 healthy, college age volunteers. Each subject performed 30 maximal, concentric repetitions on the Biodex System II Isokinetic Dynamometer at a preset angular velocity of 180 degrees.s(-1) for both the dominant and nondominant legs. Quadriceps work was evaluated between an angular range of 10 degrees and 60 degrees of flexion for each repetition. Quadriceps muscle fatigue was calculated through a fatigue index (work performed last 5 repetitions/work performed first five repetitions x 100) and the linear slope (beta) across the 30 repetitions. The subjects participated in two test sessions separated by one to two weeks. Intraclass correlation coefficients (ICC) and standard errors of measurements (SEM) were calculated for each fatigue measure on both legs. RESULTS: The findings demonstrated moderate to high ICCs for the nondominant leg (ICC = 0.78--0.92) and high ICCs for the slope and y-intercept for the dominant leg (ICC = 0.82 and 0.89, respectively). The fatigue index for the dominant leg was found to be low (ICC = 0.26). CONCLUSIONS: The findings of this study suggest that the quantification of muscle fatigue during high-intensity, short-term exercise is more reliably described by the slope, which is related to the magnitude of force output.

Adult↗

Localized muscle fatigue decreases the acuity of the movement sense in the human shoulder.

PURPOSE: The purpose of this study was to investigate alterations in the movement sense acuity during localized muscle fatigue in the human dominant shoulder. METHODS: Fourteen healthy volunteers (8 males and 6 females) with a mean age 23 +/- 2 yr participated in the study. The subjects' ability to discriminate movement velocity relative to a reference velocity imposed over the dominant shoulder was tested following two experimental conditions: 1) Light exercise (LE), repetitive isokinetic horizontal flexion/extensions at the shoulder, ranging from 85 degrees to 20 degrees relative to the frontal plane, at 10% of maximal voluntary contraction (MVC) and 2) Hard exercise (HE), same movements as in LE, but performing MVC to fatigue. RESULTS: The results showed that subjects had a lower probability of distinguishing between different movement velocities following HE as compared with those during the LE condition (P < 0.001). When genders were compared, female subjects had a lower probability of distinguishing correctly than male subjects (P < 0.001). CONCLUSIONS: The acuity of the movement sense in the dominant shoulder is reduced in the presence of shoulder muscle fatigue. The possible influence of muscle fatigue via peripheral muscle receptors on movement sense is discussed.

Adult↗

Back muscle fatigue during intermittent prone back extension exercise.

UNLABELLED: The purpose of this study was to estimate the level of muscular activation and muscle fatigue of the low back muscles during the performance of an intermittent prone back extension (PBE) exercise. Forty-one healthy students (24 males and 17 females) lying prone on a bench with the legs fixed performed two maximal voluntary contractions (MVC) in extension, a maximum of 100 repetitions of an intermittent PBE exercise immediately followed by a final MVC in extension. In addition, 12 subjects (11 males and one female) repeated the PBE exercise but with the addition of a 45-N weight on the back. The PBE exercise consisted of a task broken into four 1-s segments, while lying prone on a bench (10 degrees below horizontal): (1) raising the trunk to a horizontal position; (2) holding the trunk in the static phase (10 degrees above horizontal); (3) returning to the original position; and (4) resting on the bench. Electromyography (EMG) was used to measure the level of muscle activity (erector spinae (ES), gluteus maximus (GM), hamstrings (HA)) relative to the maximum voluntary EMG (MVE). RESULTS: Most of the subjects (34 out of 41) completed the 100 repetitions without excessive muscle fatigue according to the post-exercise MVC values. The intermittent PBE increased fatigue in the lumbar and hip extensor muscles in terms of: (1) a decrease in the MVC; (2) an increase in the level of muscle activation; and (3) a decline of the median frequency (MF). There was no gender difference in all EMG measurements. The level of muscle activation in the hip extensors (GM and HA) was associated with task failure (number of repetitions <100) for some subjects and the addition of a weight of 45 N had more impact on HA than ES. In conclusion, the PBE exercise as performed in the present study (including rest intervals), although not very strenuous for our healthy subjects, seems an adequate exercise to measure and train the aerobic capacity of the back muscles. However, to train specifically the back muscles, the exercise must be adjusted to avoid task failure due to possible hip extensor fatigue.

Adult↗