Are the myoelectric manifestations of fatigue distributed regionally in the human medial gastrocnemius muscle?

Myoelectric fatigue typically manifests as variations in the amplitude and spectrum of surface electromyograms (EMGs). Interestingly, these variations seem to be represented locally in different muscles. In this study, we ask whether such a regional distribution of myoelectric fatigue extends to the medial gastrocnemius (MG) muscle. If the MG muscle is activated locally during fatiguing contractions, or if the most fatigable MG fibers are located at distinct muscle regions, then, the myoelectric manifestations of MG fatigue are expected to appear locally in a grid of surface electrodes. With a matrix of surface electrodes (7 × 15 single-differential EMGs) we show that myoelectric fatigue, indeed, manifests regionally in the MG muscle of 12 subjects, who exerted intermittent, fatiguing plantar flections at 50% of their maximal effort. Contrary to the root mean square amplitude, the median frequency of surface EMGs varied consistently across subjects throughout the plantar flections (P = 0.002). On average, changes in EMG spectrum were represented at 78–93 (interquartile interval) out of the 105 channels in the matrix, though with different degrees across channels. For all participants, about 29% of the channels detected significantly greater reductions in median frequency when compared to all channels in the matrix (P < 0.003). Strikingly, these channels were not sparsely distributed; they rather occupied localized skin regions across subjects. Physiologically, our results suggest that, during sub-maximal fatiguing tasks, myoelectric manifestations of MG fatigue are represented in spatially localized muscle regions. Technically, the possibility of studying myoelectric fatigue in the MG muscle appears to depend on the electrode location.     

The effect of cement creep and cement fatigue damage on the micromechanics of the cement–bone interface

The cement–bone interface provides fixation for the cement mantle within the bone. The cement–bone interface is affected by fatigue loading in terms of fatigue damage or microcracks and creep, both mostly in the cement. This study investigates how fatigue damage and cement creep separately affect the mechanical response of the cement–bone interface at various load levels in terms of plastic displacement and crack formation. Two FEA models were created, which were based on micro-computed tomography data of two physical cement–bone interface specimens. These models were subjected to tensile fatigue loads with four different magnitudes. Three deformation modes of the cement were considered: ‘only creep’, ‘only damage’ or ‘creep and damage’. The interfacial plastic deformation, the crack reduction as a result of creep and the interfacial stresses in the bone were monitored. The results demonstrate that, although some models failed early, the majority of plastic displacement was caused by fatigue damage, rather than cement creep. However, cement creep does decrease the crack formation in the cement up to 20%. Finally, while cement creep hardly influences the stress levels in the bone, fatigue damage of the cement considerably increases the stress levels in the bone. We conclude that at low load levels the plastic displacement is mainly caused by creep. At moderate to high load levels, however, the plastic displacement is dominated by fatigue damage and is hardly affected by creep, although creep reduced the number of cracks in moderate to high load region.     

Performance and fatigue during repeated sprints: what is the appropriate sprint dose?

When testing the ability of sportsmen to repeat maximal intensity efforts, or when designing specific training exercises to improve it, fatigue during repeated sprints is usually investigated through a number of sprints identical for all subjects, which induces a high intersubject variability in performance decrement in a typical heterogeneous group of athletes (e.g., team sport group, students, and research protocol volunteers). Our aim was to quantify the amplitude of the reduction in this variability when individualizing the sprint dose, that is, when requiring subjects to perform the number of sprints necessary to reach a target level of performance decrement. Fifteen healthy men performed 6-second sprints on a cycle ergometer with 24 seconds of rest until exhaustion or until 20 repetitions in case no failure occurred. Peak power output (PPO) was measured and a fatigue index (FI) computed. The variability in PPO decrement was compared between the 10th sprint and the sprint at which subject reached the target FI of 10%. Individual FI values after the 10th sprint were 14.6 ± 6.9 vs. 11.1 ± 1.2%, when individualizing the sprint dose, which corresponded to coefficients of interindividual variability of ～47.3 and ～10.8%, respectively. Individualizing the sprint dose substantially reduced intersubject variability in performance decrement, enabling a more standardized state of fatigue in repeated-sprints protocols designed to induce fatigue and test or train this specific repeated-sprint ability in a heterogeneous group of athletes. A direct feedback on the values of performance parameters is necessary between each sprint for the experimenter to set this individualized sprint dose.     

Effects of β-alanine supplementation on the onset of neuromuscular fatigue and ventilatory threshold in women

Summary. This study examined the effects of 28 days of β-alanine supplementation on the physical working capacity at fatigue threshold (PWC_FT), ventilatory threshold (VT), maximal oxygen consumption ( O_2-MAX), and time-to-exhaustion (TTE) in women. Twenty-two women (age ± SD 27.4 ± 6.1 yrs) participated and were randomly assigned to either the β-alanine (CarnoSyn™) or Placebo (PL) group. Before (pre) and after (post) the supplementation period, participants performed a continuous, incremental cycle ergometry test to exhaustion to determine the PWC_FT, VT, O_2-MAX, and TTE. There was a 13.9, 12.6 and 2.5% increase (p < 0.05) in VT, PWC_FT, and TTE, respectively, for the β-alanine group, with no changes in the PL (p > 0.05). There were no changes for O_2-MAX (p > 0.05) in either group. Results of this study indicate that β-alanine supplementation delays the onset of neuromuscular fatigue (PWC_FT) and the ventilatory threshold (VT) at submaximal workloads, and increase in TTE during maximal cycle ergometry performance. However, β-alanine supplementation did not affect maximal aerobic power ( O_2-MAX). In conclusion, β-alanine supplementation appears to improve submaximal cycle ergometry performance and TTE in young women, perhaps as a result of an increased buffering capacity due to elevated muscle carnosine concentrations.     

Factors related to the fatigue of relief workers in areas affected by the Great East Japan Earthquake: survey results 2.5 years after the disaster

Background

After the Great East Japan Earthquake (March 11, 2011), the fatigue of relief workers became a major problem in affected areas. In the present study, we conducted a questionnaire survey 2.5 years post-disaster identifying factors related to the fatigue of relief workers.

Methods

This survey was cross-sectional and participants (N?=?119) were relief workers living in affected areas. We used a self-administered questionnaire which included participants’ current problems, sources of strong feeling of loss, psychological distress and compassion fatigue. Based on answers (Yes/No) to the fatigue item, we created 2 groups; a Fatigue-group and a Non-fatigue group. We employed bivariate analysis on items with significant differences between the two groups and entered them into a multivariable logistic regression model.

Results

Fifty-seven (48%) reported that they were “very tired” and were assigned to the Fatigue group. The total score of the 6-item Kessler Psychological Distress Scale (K6) and each subscale score (burnout, secondary trauma, and compassion satisfaction) of the Professional Quality of Life measure (Pro-QOL) in the Fatigue group were significantly higher than those in the Non-fatigue group. There were significant differences between the two groups for 11 items relating to current problems and sources of strong feelings of loss, and the following items were extracted as factors related to the fatigue of relief workers: loss of trust in others (adjusted OR, 10.03: 95%CI, 2.30–43.79), no confidence to continue work (adjusted OR, 6.27: 95%CI, 1.72–22.83), loss of important person(s) (adjusted OR, 5.58: 95%CI, 2.05–15.19), and sleep disturbance (adjusted OR, 5.14: 95%CI, 1.93–13.67).

Conclusion

Many relief workers who reported fatigue had experienced various losses and current problems. Adequate consideration and care systems for local relief workers with fatigue should be given for a long-period after a disaster and it is important for the workers themselves to continue accepting support from others and maintaining self-care habits.

     

Can persistent Epstein-Barr virus infection induce chronic fatigue syndrome as a Pavlov reflex of the immune response?

Chronic fatigue syndrome is a protracted illness condition (lasting even years) appearing with strong flu symptoms and systemic defiances by the immune system. Here, by means of statistical mechanics techniques, we study the most widely accepted picture for its genesis, namely a persistent acute mononucleosis infection, and we show how such infection may drive the immune system towards an out-of-equilibrium metastable state displaying chronic activation of both humoral and cellular responses (a state of full inflammation without a direct 'causes-effect' reason). By exploiting a bridge with a neural scenario, we mirror killer lymphocytes T(K) and B cells to neurons and helper lymphocytes [Formula: see text] and [Formula: see text] to synapses, hence showing that the immune system may experience the Pavlov conditional reflex phenomenon: if the exposition to a stimulus (Epstein-Barr virus antigens) lasts for too long, strong internal correlations among B,T(K) and T(H) may develop ultimately resulting in a persistent activation even though the stimulus itself is removed. These outcomes are corroborated by several experimental findings.     

HSP70 expression: does it a novel fatigue signalling factor from immune system to the brain?

Integrative physiology studies have shown that immune system and central nervous system interplay very closely towards behavioural modulation. Since the 70-kDa heat shock proteins (HSP70s), whose heavy expression during exercise is well documented in the skeletal muscle and other tissues, is also extremely well conserved in nature during all evolutionary periods of species, it is conceivable that HSP70s might participate of physiologic responses such as fatigue induced by some types of physical exercise. In this way, increased circulating levels of extracellular HSP70 (eHSP70) could be envisaged as an immunomodulatory mechanism induced by exercise, besides other chemical messengers (e.g. cytokines) released during an exercise effort, that are able to binding a number of receptors in neural cells. Studies from this laboratory led us to believe that increased levels of eHSP70 in the plasma during exercise and the huge release of eHSP70 from lymphocytes during high-load exercise bouts may participate in the fatigue sensation, also acting as a danger signal from the immune system.     

Muscle fatigue: conduction or mechanical failure?

It is well documented that repeated voluntary activity or electrical stimulation of skeletal muscle results in a decline in force production or power output. However, the precise physiological causes of "muscle fatigue" are not yet well understood. It is conceivable that the mechanism(s) may lie either in the conduction of action potentials in the central and peripheral nervous systems or in the transformation of the electrical event into mechanical force production by the muscle itself. In fact, none of the components of the electrical pathway from generation of impulses in the brain to their conduction over the neuron and the excitable membranes of the muscle can as yet be ruled out as potential contributors to the fatigue process. Relative to that on conduction failure, more information exists concerning the possibility that a defect in the excitation contraction coupling process in skeletal muscle, e.g., intracellular acidosis, inadequate supply of energy for contraction, or a disruption in Ca2+ homeostasis may also be significant in compromising force production following sustained activity. Despite this, the amount of conflicting data derived from these experiments has hindered the resolution of this question. In the future more attention must be given to such issues as the type of activity used to elicit fatigue and the fiber composition of the muscles studied. This is imperative as these factors clearly impact the nature of correlations between the biochemical and physiological events in muscle that are required to support prospective fatigue mechanisms.     

Does rib cage-abdominal paradox signify respiratory muscle fatigue?

Studies suggesting that abnormal motion of the rib cage (RC) and abdomen (Ab) may indicate respiratory muscle fatigue have not separated the influence of respiratory load from that of fatigue in its pathogenesis. We hypothesized that abnormalities on RC-Ab motion are primarily related to increased load rather than fatigue. We tested this hypothesis in subjects breathing against resistive loads while maintaining 30 and 60% of maximum mouth pressure (Pmmax). RC-Ab asynchrony and paradox and the degree of variation in compartmental contribution to tidal volume were measured by inductive plethysmography and quantitated by the Konno-Mead method of analysis. Comparing measurements of base line and 30 and 60% of Pmmax indicated that the degree of asynchrony, paradox, and variation in compartmental contribution were significantly related to the level of the load; significant abnormalities were observed at even 30% of Pmmax, a target pressure that can be sustained indefinitely. In another group of subjects, fatigue was induced by sustaining 60% of Pmmax to the limits of tolerance. Indexes of abnormal RC-Ab motion increased from base line during the 1st min of loaded breathing but displayed no progression from the beginning to the end of the fatigue run. Immediately on discontinuation of the load, the indexes returned to levels similar to base line despite persistence of the fatigue state. These results in healthy subjects breathing against severe resistances indicate that RC-Ab asynchrony and paradox and variation in compartmental contribution to tidal volume are predominantly due to increases in respiratory load rather than muscle fatigue.     

Assessment of the validity of the Biering-Sørensen test for measuring back muscle fatigue based on EMG median frequency characteristics of back and hip muscles

The aims of the present study were (1) to investigate the differences in median frequency characteristics between back and hip muscles of healthy subjects during a Biering-Sørensen test, (2) to determine if the Biering-Sørensen test is a valid test for measuring back muscle fatigue, and (3) to standardise the Biering-Sørensen test by using objective movement analysis when defining endurance time, and compare this to the original method based on tactile feedback. Twenty healthy subjects participated in this experiment. The electromyographic activity of eight back and hip muscles was bilaterally measured. In addition three-dimensional data of the lumbar region were collected with an ultrasound movement analysis system. Median frequencies were computed from the EMG power spectra. Two methods of determining the endurance time of the Biering-Sørensen test yielded highly correlated but significantly different normalized median frequency slope values (NMF_slope). Significant differences in NMF_slope values between several back and hip muscles could be demonstrated. Low to moderate correlation coefficients were shown between NMF_slope values and endurance time. Multiple stepwise linear regression analyses revealed that only NMF_slope of the thoracic part of the iliocostalis lumborum muscle could significantly predict the test endurance time. The findings of the present study support the validity of the Biering-Sørensen test for measuring back muscle fatigue.     

Do microcracks decrease or increase fatigue resistance in cortical bone?

Fatigue of cortical bone produces microcracks; it has been hypothesized that these cracks are analogous to those occurring in engineered composite materials and constitute a similar mechanism for fatigue resistance. However, the numbers of these linear microcracks increase substantially with age, suggesting that they contribute to increased fracture incidence among the elderly. To test these opposing hypotheses, we fatigued 20 beams of femoral cortical bone from elderly men and women in load-controlled four point bending having initial strain ranges of 3000 or 5000 microstrain. Loading was stopped at fracture or 10(6) cycles, whichever occurred first, and microcrack density and length were measured in the loaded region and in a control region that was not loaded. We studied the dependence of fatigue life and induced microdamage on initial microdamage, cortical region, subject gender and age, and several other variables. When the effect of modulus variability was controlled, longer fatigue life was associated with higher rather than lower initial crack density, particularly in the medial cortex. The increase in crack density following fatigue loading was greater in specimens from older individuals and those initially having longer microcracks. Crack density increased as much in specimens fatigued short of the failure point as in those that fractured, and microcracks were, on average, shorter in specimens with greater numbers of resorption spaces, a measure of remodeling rate.     

Free radicals in chronic fatigue syndrome: cause or effect?

We have demonstrated that certain morphological and biochemical changes occur in chronic fatigue syndrome (CFS) and in rheumatoid arthritis (RA). These changes in RA can be explained by the well-established inappropriate increase in free radical generation. The similar changes in CFS suggest a similar explanation and a possible role for free radicals in the aetiology of this condition.     

A chronic fatigue syndrome – related proteome in human cerebrospinal fluid

Background  

Chronic Fatigue Syndrome (CFS), Persian Gulf War Illness (PGI), and fibromyalgia are overlapping symptom complexes without objective markers or known pathophysiology. Neurological dysfunction is common. We assessed cerebrospinal fluid to find proteins that were differentially expressed in this CFS-spectrum of illnesses compared to control subjects.     

A five-year prospective study of fatigue in primary Sjögren's syndrome

Introduction  

Fatigue is prevalent in primary Sj?gren's syndrome (pSS), and contributes to the considerably reduced health related quality of life in this disease. The symptom is included in proposed disease activity and outcome measures for pSS. Several studies indicate that there is an inflammatory component of fatigue in pSS and other chronic inflammatory rheumatic diseases. The purpose of this study was to investigate fatigue change in pSS in a longitudinal study, and explore whether any clinical or laboratory variables at baseline, including serum cytokines, were associated with a change in fatigue scores over time.     

Does methocarbamol affect fatigue markers in the low-back electromyogram?

Many low-back patients undergo electromyography (EMG)-based evaluations of muscle performance but present to the clinic after being prescribed muscle relaxants. The question that needed to be addressed was, do centrally acting muscle relaxants (methocarbamol; Robaxin®) affect the EMG spectral indices of muscle fatigue that are often used to assess muscle performance. Participants performed an isometric spine extension protocol involving a 30 s fatigue exertion trial, then 1 min rest, and finally a 10 s long repeat exertion trial, at a 60% maximum voluntary contraction (MVC) level of exertion. Seven men were tested on two separate days (approximately 3–7 days apart), one day while medicated (six doses) with Robaxin and on another while not medicated. Specifically, the following parameters were studied in the bilateral multifidus (L5), lower erector spinae (L3) and upper erector spinae (T9): the slope of median power frequencies (MPFs) over the duration of the trial and the initial y-intercept of the MPF. The results generally suggest that methocarbamol (Robaxin) does not have any significant affect on the EMG median power frequency of the extensors during a fatiguing contraction followed by a repeat exertion, at least in normal people (one exception was observed—one side of multifidus at L5). However, given that this appears to be the first study of its kind, and that a relatively small number of subjects were used in this study, further investigation is needed to make a definitive conclusion about the effects of this drug on the several features of the electromyogram, over a broad spectrum of the clinical population performing a wider variety of tasks.     

Cervical flexion–relaxation response to neck muscle fatigue in males and females

In this study the effect of muscle fatigue on the cervical spine flexion–relaxation response was studied. Twenty healthy participants (10 males and 10 females) were recruited for data collection. The Sorenson protocol was utilized to induce neck muscle fatigue. Surface electromyography and optical motion capture systems were used to measure neck muscle activation and head–neck posture, respectively. A post-fatigue reduction in the Flexion–Relaxation Ratio (FRR) and higher FRR for females compared to males were observed. A post-fatigue decrease was also observed in the onset and offset angles resulting in an expansion of the myoelectric silence period. Gender had no effect on the onset and offset angles of the silence period. Post-fatigue shift in the onset and offset angles and the expansion of the silence period indicate an increased contribution by the passive viscoelastic tissues in stabilizing the cervical spine under fatigued condition.     

A laboratory approach for characterizing chronic fatigue: what does metabolomics tell us?

Metabolomics - Pre-eclampsia is a hypertensive gestational disorder that affects approximately 5% of all pregnancies. As the pathophysiological processes of pre-eclampsia are still uncertain, the...