Effect of low frequency fatigue on human muscle strength and fatigability during subsequent stimulated activity

Fatiguing contractions of the adductor pollicis muscle were produced by intermittent supramaximal stimulation of the ulnar nerve in a set frequency pattern, in six normal subjects. At the end of an initial fatiguing contraction series, low frequency fatigue (LFF) had been induced and persisted at 15 min of recovery. Stimulated fatiguing activity was then repeated in an identical fashion to the initial series. At high frequencies, declines in force were similar for both series. At low frequencies, declines in force were greater during the second series despite similar changes in compound muscle action potential amplitude. This confirmation that LFF persists during subsequent stimulated activity, and reduces low but not high frequency fatigue resistance, suggests that the impaired endurance of fatigued muscle during voluntary activity primarily results from peripheral changes at low frequency. These findings also have implications for therapeutic electrical stimulation of muscle.     

Supraspinal fatigue does not explain the sex difference in muscle fatigue of maximal contractions.

Young women are less fatigable than young men for maximal and submaximal contractions, but the contribution of supraspinal fatigue to the sex difference is not known. This study used cortical stimulation to compare the magnitude of supraspinal fatigue during sustained isometric maximal voluntary contractions (MVCs) performed with the elbow flexor muscles of young men and women. Eight women (25.6 +/- 3.6 yr, mean +/- SD) and 9 men (25.4 +/- 3.8 yr) performed six sustained MVCs (22-s duration each, separated by 10 s). Before the fatiguing contractions, the men were stronger than the women (75.9 +/- 9.2 vs. 42.7 +/- 8.0 N.m; P < 0.05) in control MVCs. Voluntary activation measured with cortical stimulation before fatigue was similar for the men and women during the final control MVC (95.7 +/- 3.0 vs. 93.3 +/- 3.6%; P > 0.05) and at the start of the fatiguing task (P > 0.05). By the end of the six sustained fatiguing MVCs, the men exhibited greater absolute and relative reductions in torque (65 +/- 3% of initial MVC) than the women (52 +/- 9%; P < 0.05). The increments in torque (superimposed twitch) generated by motor cortex stimulation during each 22-s maximal effort increased with fatigue (P < 0.05). Superimposed twitches were similar for men and women throughout the fatiguing task (5.5 +/- 4.1 vs. 7.3 +/- 4.7%; P > 0.05), as well as in the last sustained contraction (7.8 +/- 5.9 vs. 10.5 +/- 5.5%) and in brief recovery MVCs. Voluntary activation determined using an estimated control twitch was similar for the men and women at the start of the sustained maximal contractions (91.4 +/- 7.4 vs. 90.4 +/- 6.8%, n = 13) and end of the sixth contraction (77.2 +/- 13.3% vs. 73.1 +/- 19.6%, n = 10). The increase in the area of the motor-evoked potential and duration of the silent period did not differ for men and women during the fatiguing task. However, estimated resting twitch amplitude and the peak rates of muscle relaxation showed greater relative reductions at the end of the fatiguing task for the men than the women. These results indicate that the sex difference in fatigue of the elbow flexor muscles is not explained by a difference in supraspinal fatigue in men and women but is largely due to a sex difference of mechanisms located within the elbow flexor muscles.     

Localized muscular fatigue duration, EMG parameters and accuracy of rapid limb movements

While much is known about the physiological basis of local muscular fatigue, little is known about the kinematic and electromyographic (EMG) consequences of brief fatiguing isometric contractions. Five male subjects performed a horizontal elbow flexion-extension reversal movement over 90° in 250 ms to reversal before and after one of five single maximal isometric elbow flexions ranging in duration from 15–120 s. Surface EMG signals were recorded from the biceps brachii, the long head of the triceps, the clavicular portion of the pectoralis major, and the posterior deltoid. Spatial and temporal errors were computed from potentiometer output. During the fatiguing bouts, maximum voluntary force dropped linearly an average of 4% in the 15 s condition and 58% in the 120 s condition relative to maximum force. The associated biceps rectified-integrated EMG signal increased from the onset of each fatigue bout for 15–30 s, then decreased over the remainder of the longer bouts. Following the fatigue bout, subjects undershot the target distance on the first movement trial in all conditions. Following short fatigue durations (i.e. 15–30 s), the peak biceps EMG amplitude was disrupted and movement velocity decreased, but both measures recovered within seconds. As fatigue duration increased, progressive decreases in peak velocity occurred with increased time to reversal, reduced EMG amplitude, and longer recovery times. However, the relative timing of the EMG pattern was maintained suggesting the temporal structure was not altered by fatigue. The findings suggest that even short single isometric contractions can disrupt certain elements of the motor control system.     

Fatigue of mouse diaphragm muscle in isometric and isotonic contractions

Fatiguabilities of mouse diaphragm muscle in vitro in isometric and isotonic contractions were compared in this study. Isolated mouse diaphragm muscle was stimulated repetitively to induce fatigue during both isometric and isotonic contractions. The supramaximal electrical stimulation used was a train of 100-Hz, 0.5-ms pulses delivered to the muscle every 2 s for 0.5 s. The percentage decrease in isometric tension from beginning to end of the fatiguing process was used as the index of fatigue. The experiments were carried out at different PO2 levels in both normal and zero-glucose Ringer solutions. It was found that fatigue developed more rapidly in isotonic contractions than in isometric ones. Also, the extracellular glucose level demonstrated little effect on the muscle's short-term fatiguability, whereas reductions in the extracellular PO2 exerted a profound effect, especially in the case of isotonic fatigue.     

Variable stimulation patterns in younger and older thenar muscle

Neuromuscular electrical stimulation (NMES) is typically used with older adults receiving rehabilitation therapies, but little is known about the stimulation patterns that maximize force output and minimize fatigue in this population. The purpose of this study was to apply variable patterns of stimulation to the thenar muscles of the hand in younger and older adults to determine if force production and neuromuscular fatigue effects were similar. Three submaximal stimulation patterns were administered: A 20Hz constant frequency pattern, a pattern that increased from 20 to 40Hz, and a pattern that incorporated two closely spaced (5ms) doublet pulses. The doublet stimulation produced significantly higher average forces and force-time integrals (FTIs) than the constant frequency and increasing frequency patterns in both age groups. Additionally, older adults showed less fatigue than the younger group during isometric contractions performed after the fatiguing stimulation patterns. These results suggest that variable pulse NMES patterns enhance force production in the hand in both younger and older individuals better than constant frequency patterns, which are typically used in clinical applications. Also, greater fatigue resistance to electrical stimulation protocols may exist in the older population; this is critical information for the design and application of NMES rehabilitation regimens used with older adults.     

Effects of stimulation frequency versus pulse duration modulation on muscle fatigue.

During functional electrical stimulation (FES), both the frequency and intensity can be increased to increase muscle force output and counteract the effects of muscle fatigue. Most current FES systems, however, deliver a constant frequency and only vary the stimulation intensity to control muscle force. This study compared muscle performance and fatigue produced during repetitive electrical stimulation using three different strategies: (1) constant pulse-duration and stepwise increases in frequency (frequency-modulation); (2) constant frequency and stepwise increases in pulse-duration (pulse-duration-modulation); and (3) constant frequency and pulse-duration (no-modulation). Surface electrical stimulation was delivered to the quadriceps femoris muscles of 12 healthy individuals and isometric forces were recorded. Muscle performance was assessed by measuring the percent changes in the peak forces and force-time integrals between the first and the last fatiguing trains. Muscle fatigue was assessed by measuring percent declines in peak force between the 60Hz pre- and post-fatigue testing trains. The results showed that frequency-modulation showed better performance for both peak forces and force-time integrals in response to the fatiguing trains than pulse-duration-modulation, while producing similar levels of muscle fatigue. Although frequency-modulation is not commonly used during FES, clinicians should consider this strategy to improve muscle performance.     

Contractile properties of cat skeletal muscle after repetitive stimulation

The isometric and force-velocity properties of the fast-twitch flexor digitorum longus (FDL) and slow-twitch soleus muscles were investigated immediately after and during recovery from a fatiguing stimulus regime (40 Hz for 330 ms every second for 180 s) in the anesthetized cat. The amplitude of the isometric twitch of FDL was unaffected but in soleus it remained depressed for much of the recovery period. Immediately after stimulation the twitch time to peak of FDL increased to 140% of the control (prefatigue) value and then reverted to control values. The maximum isometric tetanic tension (Po) developed by FDL was reduced to 67% of control values immediately after the stimulus regime, whereas soleus declined to 93% of control. Recovery of maximum force development was achieved after 45 min in FDL and after 15 min in soleus. The maximum speed of shortening of FDL was reduced to 63% of control values immediately after fatigue; despite some recovery within the first 30 min, it remained depressed during the remainder of the recovery period (up to 300 min). Maximum speed of shortening was unaltered in soleus. The a/Po value transiently increased to 176% of control values in FDL immediately after the fatigue regime but promptly returned to control values. Force-velocity properties of soleus were not affected by the stimulus regime. It is concluded that in FDL changes in the maximum speed of shortening and maximum isometric tension as a result of the stimulus regime are attributable to changes in the intrinsic behavior of cross-bridges and the metabolic status of the fibers, particularly in the fast-twitch fatigue-resistant fibers.     

Fatigability of rat hindlimb muscles after acute irreversible acetylcholinesterase inhibition.

The purpose of this study was to investigate the functional impact of acute irreversible inhibition of acetylcholinesterase (AChE) on the fatigability of medial gastrocnemius and plantaris muscles of Sprague-Dawley rats. After treatment with methanesulfonyl fluoride (a lipid-soluble anticholinesterase), which reduced their AChE activity by >90%, these muscles were subjected to an in situ indirect stimulation protocol, including a series of isolated twitch and tetanic contractions preceding a 3-min fatigue regimen (100-ms trains at 75 Hz applied every 1.5 s). During the first minute of the fatigue regimen, the effects of AChE inhibition were already near maximal, including marked reductions in peak tension and the force-time integral (area), as well as a decrement of compound muscle action potential amplitudes within a stimulus train. Neuromuscular transmission failure was the major contributor of the force decreases in the AChE-inhibited muscles. However, despite this neuromuscular transmission failure, muscles of which all AChE molecular forms were nearly completely inhibited were still able to function, although abnormally, during 3 min of intermittent high-frequency nerve stimulation.     

Rate of fatigue during repeated submaximal contractions of human quadriceps muscle.

Our purpose was to determine the effect of eight different combinations of contraction intensity, duration, and rest on the rate of fatigue in vastus lateralis muscle. A single combination consisted of contractions at 30 or 70% maximal voluntary contraction (MVC), held for 3 or 7 s with 3- or 7-s rest intervals. Contractions were repeated until the subject could not hold the force for the requisite duration. At regular intervals during each experiment, a brief MVC, a single twitch, and the response to eight stimulation pulses at 50 Hz were elicited. The rate of fatigue was the rate of decline of MVC calculated from regression analysis. Mean rate of fatigue (n = 8) ranged from 0.3 to 25% MVC/min and was closely related (r = 0.98) to the product of the relative force and the duty cycle. Force from 50 Hz stimulation fell linearly and in parallel with MVC. Twitch force was first potentiated and then fell twice as fast as 50 Hz stimulation and MVC (p less than 0.05). Differentiated twitch contraction and relaxation rates were higher at potentiation and lower at the limit of endurance, compared with control values (p less than 0.05). The maximal electromyogram decreased 25% and the submaximal EMG increased to maximal by the end of the protocol, indicating that the entire motor unit pool had been recruited. The close relation between rate of fatigue and the force x time product probably reflects the off-setting interaction of contraction amplitude, duration, and rest interval. This occurs despite the changes in twitch characteristics and the apparent recruitment of fast fatiguing motor units.     

The effects of isotonic contractions on the rate of fatigue development and the resting membrane potential in the sartorius muscle of the frog, Rana pipiens.

The goal of this study was to characterize how isotonic contractions affect the rate of fatigue development. Muscle bundles dissected from frog sartorius muscles were stimulated with 100-ms long train of pulses (0.5 ms, 6 V, 140 Hz). To measure the effect of the isotonic contractions, isometric tetanus were elicited at regular time intervals during the stimulation to fatigue. In general, isotonic contractions caused a faster decrease in tetanic force than isometric contractions. The difference in tetanic force between an isotonic and isometric fatigue increased gradually over a 20-min period to 7.9 and 13.5% at 0.04 and 0.1 trains/s (TPS), respectively. At 0.2, 0.5, and 1.0 TPS, the decrease in tetanic force was also faster during an isotonic fatigue, which resulted in an initial difference in tetanic force between the two types of fatigue. The difference did not exceed 18.5% and did not persist throughout the stimulation period; i.e., the difference disappeared before the end of the fatigue stimulation. The half-relaxation time was prolonged during fatigue development, and the prolongation was greater during an isotonic fatigue, except at 0.04 TPS. The increases in the half-relaxation time at 0.2, 0.5, and 1.0 TPS were followed by a decrease, and the decreases were especially pronounced during an isotonic fatigue at 0.5 and 1.0 TPS. The results showed for the first time that isotonic contractions cause a faster rate of fatigue development in frog sartorius muscles, and this effect depends on the frequency of stimulation.     

Decreases in motor unit firing rate during sustained maximal-effort contractions in young and older adults

Previous studies have suggested that older adults may be more resistant to muscular fatigue than young adults. We sought to determine whether motor unit firing rate might be a factor that determines the response to fatiguing exercise in young and older subjects. Motor unit recordings and muscular forces were obtained from the tibialis anterior (TA) muscle of 11 young and 8 older individuals. Maximal voluntary force was first measured during maximal-effort dorsiflexion contractions. Each subject then performed a series of 15 maximal isometric contractions, with each contraction lasting 30 s. A 10-s rest period separated the fatiguing contractions. As a result of the fatiguing exercise, both subject groups demonstrated a significant loss in maximal force. The force decline was less in the older adults (20.4%) than in the young adults (33.8%). As expected, prior to muscle fatigue, maximal firing rates in the TA muscle were greater in the young (28.1 ± 5.8 imp/s) than in the older adults (22.3 ± 4.8 imp/s). The decrease in motor unit firing rate with fatigue was also greater in the young adults (34.9%), than in the older adults (22.0%). These results suggest that the greater fatigue-resistance exhibited by older individuals might be explained by the fact that the decline in motor unit firing rate during fatigue is greater in young persons than it is in older adults.     

Heat shock does not attenuate low-frequency fatigue.

Whole-body hyperthermia or heat shock confers protection to myocardial contractility against reperfusion-induced injury. The purpose of this study was to determine whether heat shock could provide similar protection to skeletal muscle contractility against low-frequency fatigue. Male Sprague-Dawley rats (6 rats/group) were heat shocked at 41.5 degrees C for 15 min either 24 h or 4 days prior to fatiguing stimulation to compare the contractile responses of the plantaris muscle with those of a nonheated group. Both 24 h and 4 days after heat shock, the 72-kDa heat shock protein (HSP72) was elevated above control levels. There were no differences between the heat-shocked and non-heat-shocked animals in measures of contractility prior to fatiguing contractions or in resistance to fatigue. Heat-shock preconditioning did not lead to improved postfatigue force recovery above control responses and, in fact, delayed the recovery of force. This study does not support the use of heat-shock therapy to improve skeletal muscle contractile performance under fatiguing conditions.     

Threshold effects of respiratory muscle work on limb vascular resistance

The purpose of this study was to determine whether the human diaphragm, like limb muscle, has a threshold of force output at which a metaboreflex is activated causing systemic vasoconstriction. We used Doppler ultrasound techniques to quantify leg blood flow (Q(L)) and utilized the changes in mouth twitch pressure (DeltaP(M)T) in response to bilateral phrenic nerve stimulation to quantify the onset of diaphragm fatigue. Six healthy male subjects performed four randomly assigned trials of identical duration (8 +/- 2 min) and breathing pattern [20 breaths/min and time spent on inspiration during the duty cycle (time spent on inspiration/total time of one breathing cycle) was 0.4] during which they inspired primarily with the diaphragm. For trials 1-3, inspiratory resistance and effort was gradually increased [30, 40, and 50% maximal inspiratory pressure (MIP)], diaphragm fatigue did not occur, and Q(L), limb vascular resistance (LVR), and mean arterial pressure remained unchanged from control (P > 0.05). The fourth trial utilized the same breathing pattern with 60% MIP and caused diaphragm fatigue, as shown by a 30 +/- 12% reduction in P(M)T with bilateral phrenic nerve stimulation. During the fatigue trial, Q(L) and LVR were unchanged from baseline at minute 1, but LVR rose 36% and Q(L) fell 25% at minute 2 and by 52% and 30%, respectively, during the final minutes of the trial. Both LVR and Q(L) returned to control within 30 s of recovery. In summary, voluntary increases in inspiratory muscle effort, in the absence of fatigue, had no effect on LVR and Q(L), whereas fatiguing the diaphragm elicited time-dependent increases in LVR and decreases in Q(L). We attribute the limb vasoconstriction to a metaboreflex originating in the diaphragm, which reaches its threshold for activation during fatiguing contractions.     

Fatigue and recovery contractile properties of young and elderly men

The 24 h recovery pattern of contractile properties of the triceps surae muscle, following a period of muscle fatigue, was compared in physically active young (25 years, n = 10) and elderly (66 years, n = 7) men. The fatigue test protocol consisted of 10 min of intermittent submaximal 20 Hz tetani. The maximal twitch (Pt) and tetanic force at 3 frequencies (10, 20 and 50 Hz) were determined at baseline and at 15 min, 1, 4 and 24 h after fatiguing the muscle. Maximal voluntary contraction (MVC) and vertical jump (MVJ) were also assessed. The loss of force during the fatigue test was not significantly different between the young (18 +/- 13%) and elderly (22 +/- 15%). Both groups showed similar and significant reductions of Pt (15%), tetanic force (10 to 35%) and rate of force development (dp/dt) (20%) 15 min and 1 h into recovery. The loss of force was greater at the lower stimulation frequencies of 10 and 20 Hz. Time-to-peak tension was unchanged from baseline during recovery in either group. The average rate of relaxation of twitch force (-dPt/dt) was decreased (p less than 0.05) and half-relaxation time significantly increased at 15 min and 1 h in the elderly but not the young. The findings indicate that after fatiguing contractions, elderly muscle demonstrates a slower return to resting levels of the rate and time course of twitch relaxation compared to the young.     

The effect of muscle fatigue on the isometric contractile characteristics of skeletal muscle in the cat

The rise time of an isometric twitch, the tetanic tension, the twitch tetanus ratio, the frequency-tension relationship, and the height of the MUAP (motor unit action potential) were measured in fast twitch (medial gastrocnemius) and slow twitch (soleus) muscles of the cat immediately before, in the middle, and immediately after fatiguing isometric contractions at tensions of 30, 50 and 80% of each muscle's initial strength (tetanic tension recorded from the unfatigued muscle). Although the twitch-tetanus ratio was always less for the soleus than for the medial gastrocnemius muscles, the twitch-tetanus ratio for any one muscle was constant throughout the duration of fatiguing isometric contractions at any of the tensions examined. In contrast, the twitch tension and tetanic tension of the muscles were both less after the contractions, the largest reduction occurring for both muscles during contractions sustained at the lowest isometric tensions. The time to peak tension of an isometric twitch was prolonged for both muscles following the contractions. This was associated with a corresponding shift in the frequency tension relationship such that at the point of muscular fatigue, the muscles tetanized at lower frequencies of stimulation than did the unfatigued muscle. In contrast, the amplitude of the MUAP showed only a modest reduction throughout the duration of the fatiguing contractions.     

Intramuscular pressure and EMG relate during static contractions but dissociate with movement and fatigue.

Intramuscular pressure (IMP) and electromyography (EMG) mirror muscle force in the nonfatigued muscle during static contractions. The present study explores whether the constant IMP-EMG relationship with increased force may be extended to dynamic contractions and to fatigued muscle. IMP and EMG were recorded from shoulder muscles in three sessions: 1). brief static arm abductions at angles from 0 to 90 degrees, with and without 1 kg in the hands; 2). dynamic arm abductions at angular velocities from 9 to 90 degrees /s, with and without 1 kg in the hands; and 3). prolonged static arm abduction at 30 degrees for 30 min followed by recovery. IMP and EMG increased in parallel with increasing shoulder torque during brief static tasks. During dynamic contractions, peak IMP and EMG increased to values higher than those during static contractions, and EMG, but not IMP, increased significantly with speed of abduction. In the nonfatigued supraspinatus muscle, a linear relationship was found between IMP and EMG; in contrast, during fatigue and recovery, significant timewise changes of the IMP-to-EMG ratio occurred. The results indicate that IMP should be included along with EMG when mechanical load sharing between muscles is evaluated during dynamic and fatiguing contractions.     

Effects of activation frequency and force on low-frequency fatigue in human skeletal muscle.

No comparison of the amount of low-frequency fatigue (LFF) produced by different activation frequencies exists, although frequencies ranging from 10 to 100 Hz have been used to induce LFF. The quadriceps femoris of 11 healthy subjects were tested in 5 separate sessions. In each session, the force-generating ability of the muscle was tested before and after fatigue and at 2, approximately 13, and approximately 38 min of recovery. Brief (6-pulse), constant-frequency trains of 9.1, 14.3, 33.3, and 100 Hz and a 6-pulse, variable-frequency train with a mean frequency of 14.3 Hz were delivered at 1 train/s to induce fatigue. Immediately postfatigue, there was a significant effect of fatiguing protocol frequency. Muscles exhibited greater LFF after stimulation with the 9.1-, 14.3-, and variable-frequency trains. These three trains also produced the greatest mean force-time integrals during the fatigue test. At 2, approximately 13, and approximately 38 min of recovery, however, the LFF produced was independent of the fatiguing protocol frequency. The findings are consistent with theories suggesting two independent mechanisms behind LFF and may help identify the optimal activation pattern when functional electrical stimulation is used.     

Evidence of long term muscle fatigue following prolonged intermittent contractions based on mechano- and electromyograms.

The focus of the present study is the long term element of muscle fatigue provoked by prolonged intermittent contractions at submaximal force levels and analysed by force, surface electromyography (EMG) and mechanomyogram (MMG). It was hypothesized that fatigue related changes in mechanical performance of the biceps muscle are more strongly reflected in low than in high force test contractions, more prominent in the MMG than in the EMG signal and less pronounced following contractions controlled by visual compared to proprioceptive feedback. Further, it was investigated if fatigue induced by 30 min intermittent contractions at 30% as well as 10% of maximal voluntary contraction (MVC) lasted more than 30 min recovery. In six male subjects the EMG and MMG were recorded from the biceps brachii muscle during three sessions with fatiguing exercise at 10% with visual feedback and at 30% MVC with visual and proprioceptive feedback. EMG, MMG, and force were evaluated during isometric test contractions at 5% and 80% MVC before prolonged contraction and after 10 and 30 min of recovery. MVC decreased significantly after the fatiguing exercise in all three sessions and was still decreased even after 30 min of recovery. In the time domain significant increases after the fatiguing exercise were found only in the 5% MVC tests and most pronounced for the MMG. No consistent changes were found for neither EMG nor MMG in the frequency domain and feedback mode did not modify the results. It is concluded that long term fatigue after intermittent contractions at low force levels can be detected even after 30 min of recovery in a low force test contraction. Since the response was most pronounced in the MMG this may be a valuable variable for detection of impairments in the excitation-contraction coupling.     

Changes in muscle activation can prolong the endurance time of a submaximal isometric contraction in humans.

Fourteen young subjects (7 men and 7 women) performed a fatiguing isometric contraction with the elbow flexor muscles at 20% of maximal voluntary contraction (MVC) force on three occasions. Endurance time for session 3 [1,718 +/- 1,189 (SD) s] was longer than for session 1 (1,225 +/- 683 s) and session 2 (1,410 +/- 977 s). Five men and four women increased endurance time between session 1 and 3 by 60 +/- 28% (responders), whereas two men and three women did not (-3 +/- 11%; nonresponders). The MVC force was similar for the responders and nonresponders, both before and after the fatiguing contraction. Fatiguing contractions were characterized by an increase in the electromyogram (EMG) amplitude and number of bursts during the fatiguing contractions. The responders achieved a similar level of EMG at exhaustion but a reduced rate of increase in the EMG across sessions. The rate of increase in EMG across sessions declined for the nonresponders, but it remained greater than that of the responders. The increase in burst rate during the contractions declined across sessions with a negative relation between burst rate and endurance time (r = -0.42). Normalized force fluctuations increased during the fatiguing contractions, and there was a positive relation (r = 0.60) between the force fluctuations and burst rate. Changes in mean arterial pressure and heart rate during the fatiguing contraction were similar for the responders and nonresponders across the three sessions. The results indicate that those subjects who increased the endurance time of a submaximal contraction across three sessions did so by altering the level and pattern of muscle activation.