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Muscle Fatigue (muscle + fatigue)

Distribution by Scientific Domains

Medical Sciences	60%
Life Sciences	33%
2 Other Domains	7%

Selected Abstracts

The Characterization of Contractile and Myoelectric Activities in Paralyzed Tibialis Anterior Post Electrically Elicited Muscle Fatigue

ARTIFICIAL ORGANS, Issue 4 2010
Nan-Ying Yu
Abstract This study aimed to understand the myoelectric and mechanical characteristics of muscle recovering from electrically elicited fatigue. A modified Burke fatigue protocol was delivered to activate the tibialis anterior of 13 spinal cord injured subjects for 4 min. Before and after the fatigue protocol, a series of pulse trains was delivered to induce three twitches and a fused contraction at 0, 1, 3, and 5 min and then followed every 5 min for 60 min. The recovery processes of the ankle dorsiflexion torque and the evoked electromyography (EMG) parameters were analyzed and characterized by a first-order exponential equation. The recovery process was found to be faster in regard to tetanic muscle contraction. Factors relating to low-frequency fatigue, postfatigue potentiation, and the quickly normalized relaxation rate were taken into account for the discussion of this result. During the recovery process, the disassociation was found not only between twitch and tetanic contractions but also between mechanical and myoelectric activities. After the complete normalization of EMG parameters from about 15 min post fatigue, the tetanic force recovered incompletely to an asymptotic level. [source]

Electromyographic and kinematic indicators of fatigue in horses: a pilot study

EQUINE VETERINARY JOURNAL, Issue S33 2001
G. R. COLBORNE
Summary Muscle fatigue can be quantified using Fourier analysis of the recorded EMG signal. Median frequency is the frequency at which the Fourier profile is bisected, and this measure typically shifts to smaller values during fatigue. This technique was combined with kinematic analysis to describe the time course of fatigue in horses galloping on an inclined treadmill. It was hypothesised that EMG median frequency would decrease in tandem with changes in kinematic variables through the exercise test. Three fit Thoroughbred horses had retroreflective markers placed on their hooves and withers. Surface electrodes were attached to the skin over the forelimb deltoid muscle. After warm-up at walk and trot, each horse galloped at 110% VO2max on a treadmill inclined to 7.5% until fatigue onset. Kinematic data were recorded at 200 Hz for 5 s at 30s intervals, and raw EMG data were recorded at 1024 Hz for 3 s at 15 s intervals. Fatigue onset was the point in time when the horse could not keep up with the treadmill speed with minimal encouragement. One horse performed the entire exercise test on the same lead, while the other 2 horses changed leads periodically, interrupting the changes in both the EMG and kinematic measurements. Overall, through the course of the trials, mean stride length increased by 0.34 m and stride duration increased by 0.03 s. Vertical excursion of the trunk marker increased by 0.03 m. For the horse that did not change lead, median frequency of the EMG signal decreased by 36%. In the other 2 horses, lead changes were interspersed between smaller decreases in median frequency, whereupon median frequency recovered to starting levels immediately following a lead change. The median frequency decreased by 12-20% between lead changes. Kinematic changes are more global indictors of fatigue, while the EMG indicators are dependent upon lead changes. [source]

Transient improvement induced by motor fatigue in focal occupational dystonia: The handgrip test

MOVEMENT DISORDERS, Issue 6 2001
Alessandra Pesenti MD
Abstract Muscle fatigue induced by a previous sustained contraction temporarily decreases the motor output, transiently worsening motor performance. Whether muscle fatigue alters motor performance also in dystonia,a disorder whose main pathophysiological abnormality is motor overflow,remains unknown. To assess the effects of muscle fatigue in patients with focal occupational upper limb dystonia, we studied the effect of a previous maximum fatiguing voluntary contraction on motor performance in 10 musicians with focal occupational dystonia, in 3 musicians with hand motor impairment due to non-dystonic disorders, and in 5 normal musicians. The fatiguing task consisted of grasping a spring handgrip as long as possible until the task failed. In dystonic musicians, a fatiguing contraction significantly improved motor performance. The improvement lasted less than 5 minutes and appeared only after fatigue of the affected upper limb. In contrast, in musicians with non-dystonic motor impairment, motor performance remained unchanged or worsened, and normal musician performance consistently worsened. © 2001 Movement Disorder Society. [source]

On functional motor adaptations: from the quantification of motor strategies to the prevention of musculoskeletal disorders in the neck,shoulder region

ACTA PHYSIOLOGICA, Issue 2010
P. Madeleine
Abstract Background:, Occupations characterized by a static low load and by repetitive actions show a high prevalence of work-related musculoskeletal disorders (WMSD) in the neck,shoulder region. Moreover, muscle fatigue and discomfort are reported to play a relevant initiating role in WMSD. Aims: To investigate relationships between altered sensory information, i.e. localized muscle fatigue, discomfort and pain and their associations to changes in motor control patterns. Materials & Methods:, In total 101 subjects participated. Questionnaires, subjective assessments of perceived exertion and pain intensity as well as surface electromyography (SEMG), mechanomyography (MMG), force and kinematics recordings were performed. Results:, Multi-channel SEMG and MMG revealed that the degree of heterogeneity of the trapezius muscle activation increased with fatigue. Further, the spatial organization of trapezius muscle activity changed in a dynamic manner during sustained contraction with acute experimental pain. A graduation of the motor changes in relation to the pain stage (acute, subchronic and chronic) and work experience were also found. The duration of the work task was shorter in presence of acute and chronic pain. Acute pain resulted in decreased activity of the painful muscle while in subchronic and chronic pain, a more static muscle activation was found. Posture and movement changed in the presence of neck,shoulder pain. Larger and smaller sizes of arm and trunk movement variability were respectively found in acute pain and subchronic/chronic pain. The size and structure of kinematics variability decreased also in the region of discomfort. Motor variability was higher in workers with high experience. Moreover, the pattern of activation of the upper trapezius muscle changed when receiving SEMG/MMG biofeedback during computer work. Discussion:, SEMG and MMG changes underlie functional mechanisms for the maintenance of force during fatiguing contraction and acute pain that may lead to the widespread pain seen in WMSD. A lack of harmonious muscle recruitment/derecruitment may play a role in pain transition. Motor behavior changed in shoulder pain conditions underlining that motor variability may play a role in the WMSD development as corroborated by the changes in kinematics variability seen with discomfort. This prognostic hypothesis was further, supported by the increased motor variability among workers with high experience. Conclusion:, Quantitative assessments of the functional motor adaptations can be a way to benchmark the pain status and help to indentify signs indicating WMSD development. Motor variability is an important characteristic in ergonomic situations. Future studies will investigate the potential benefit of inducing motor variability in occupational settings. [source]

Potassium-transporting proteins in skeletal muscle: cellular location and fibre-type differences

ACTA PHYSIOLOGICA, Issue 2 2010
M. Kristensen
Abstract Potassium (K+) displacement in skeletal muscle may be an important factor in the development of muscle fatigue during intense exercise. It has been shown in vitro that an increase in the extracellular K+ concentration ([K+]e) to values higher than approx. 10 mm significantly reduce force development in unfatigued skeletal muscle. Several in vivo studies have shown that [K+]e increases progressively with increasing work intensity, reaching values higher than 10 mm. This increase in [K+]e is expected to be even higher in the transverse (T)-tubules than the concentration reached in the interstitium. Besides the voltage-sensitive K+ (Kv) channels that generate the action potential (AP) it is suggested that the big-conductance Ca2+ -dependent K+ (KCa1.1) channel contributes significantly to the K+ release into the T-tubules. Also the ATP-dependent K+ (KATP) channel participates, but is suggested primarily to participate in K+ release to the interstitium. Because there is restricted diffusion of K+ to the interstitium, K+ released to the T-tubules during AP propagation will be removed primarily by reuptake mediated by transport proteins located in the T-tubule membrane. The most important protein that mediates K+ reuptake in the T-tubules is the Na+,K+ -ATPase ,2 dimers, but a significant contribution of the strong inward rectifier K+ (Kir2.1) channel is also suggested. The Na+, K+, 2Cl, 1 (NKCC1) cotransporter also participates in K+ reuptake but probably mainly from the interstitium. The relative content of the different K+ -transporting proteins differs in oxidative and glycolytic muscles, and might explain the different [K+]e tolerance observed. [source]

The use of neuroimaging in the diagnosis of mitochondrial disease

DEVELOPMENTAL DISABILITIES RESEARCH REVIEW, Issue 2 2010
Seth D. Friedman
Abstract Mutations in nuclear and mitochondrial DNA impacting mitochondrial function result in disease manifestations ranging from early death to abnormalities in all major organ systems and to symptoms that can be largely confined to muscle fatigue. The definitive diagnosis of a mitochondrial disorder can be difficult to establish. When the constellation of symptoms is suggestive of mitochondrial disease, neuroimaging features may be diagnostic and suggestive, can help direct further workup, and can help to further characterize the underlying brain abnormalities. Magnetic resonance imaging changes may be nonspecific, such as atrophy (both general and involving specific structures, such as cerebellum), more suggestive of particular disorders such as focal and often bilateral lesions confined to deep brain nuclei, or clearly characteristic of a given disorder such as stroke-like lesions that do not respect vascular boundaries in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode (MELAS). White matter hyperintensities with or without associated gray matter involvement may also be observed. Across patients and discrete disease subtypes (e.g., MELAS, Leigh syndrome, etc.), patterns of these features are helpful for diagnosis. However, it is also true that marked variability in expression occurs in all mitochondrial disease subtypes, illustrative of the complexity of the disease process. The present review summarizes the role of neuroimaging in the diagnosis and characterization of patients with suspected mitochondrial disease. © 2010 Wiley-Liss, Inc. Dev Disabil Res Rev 2010;16:129,135. [source]

Considerations for pacing of the cricoarytenoid dorsalis muscle by neuroprosthesis in horses

EQUINE VETERINARY JOURNAL, Issue 6 2010
N. G. DUCHARME
Summary Reasons for performing study: The success rate of prosthetic laryngoplasty is limited and may be associated with significant sequelae. Nerve muscle pedicle transplantation has been attempted but requires a year before function is restored. Objective: To determine the optimal parameters for functional electrical stimulation of the recurrent laryngeal nerve in horses. Methods: An experimental in vivo study was performed on 7 mature horses (2,21 years). A nerve cuff was placed on the distal end of the common trunk of the recurrent laryngeal nerve (RLN). In 6 horses the ipsilateral adductor branch of RLN was also transected. The electrodes were connected to programmable internal stimulator. Stimulation was performed using cathodic phase and then biphasic pulses at 24 Hz with a 0.427 ms pulse duration. Stimulation-response experiments were performed at monthly intervals, from one week following implantation. The study continued until unit failure or the end of project (12 months). Two of the horses were stimulated continuously for 60 min to assess onset of fatigue. Results: Excellent arytenoid cartilage abduction (mean arytenoid angle of 52.7°, range 48.5,56.2°) was obtained in 6 horses (laryngeal grades I or II (n = 3) and III (n = 2). Poor abduction was obtained in grade IV horses (n = 2). Arytenoid abduction was maintained for up to a year in one horse. Technical implant failure resulted in loss of abduction in 6 horses at one week to 11 months post operatively. Mean tissue impedance was 1.06 kOhm (range 0.64,1.67 kOhm) at one week, twice this value at 2 months (mean 2.32, range 1.11,3.75 kOhm) and was stable thereafter. Maximal abduction was achieved at a stimulation range of 0.65,7.2 mA. No electrical leakage was observed. Constant stimulation of the recurrent laryngeal nerve for 60 min led to full abduction without evidence of muscle fatigue. Conclusions: Functional electrical stimulation of the recurrent laryngeal nerve leading to full arytenoid abduction can be achieved. The minimal stimulation amplitude for maximal abduction angle is slightly higher than those for man and dogs. Clinical relevance: This treatment modality could eventually be applicable to horses with recurrent laryngeal neuropathy. [source]

Superficial digital flexor tendon lesions in racehorses as a sequela to muscle fatigue: A preliminary study

EQUINE VETERINARY JOURNAL, Issue 6 2007
M. T. Butcher
Summary Reasons for performing study: Racing and training related lesions of the forelimb superficial digital flexor tendon are a common career ending injury to racehorses but aetiology and/or predisposing causes of the injury are not completely understood. Objectives: Although the injury takes place within the tendon, the lesion must be considered within the context of the function of the complete suspensory system of the distal limb, including the associated muscles. Methods: Both muscle and tendon function were investigated in vivo using implanted strain gauges in 3 Thoroughbred horses walking, trotting and cantering on a motorised treadmill. These data were combined with assessments of muscle architecture and fibre composition to arrive at an overview of the contribution of each muscle-tendon unit during locomotion. Results: The superficial digital flexor muscle has fatigue-resistant and high force production properties that allow its tendon to store and return elastic energy, predominantly at the trot. As running speed increases, deep digital flexor tendon force increases and it stabilises hyperextension of the fetlock, thus reinforcing the superficial digital flexor in limb load support. The deep digital flexor muscle has fast contracting properties that render it susceptible to fatigue. Conclusion: Based on these measurements and supporting evidence from the literature, it is proposed that overloading of the superficial digital flexor tendon results from fatigue of the synergistic, faster contracting deep digital flexor muscle. Potential relevance: Future research investigating distal limb system function as a whole should help refine clinical diagnostic procedures and exercise training approaches that will lead to more effective prevention and treatment of digital flexor tendon injuries in equine athletes. [source]

Substrate Channelling in a Creatine Kinase System of Rat Skeletal Muscle Under Various pH Conditions

EXPERIMENTAL PHYSIOLOGY, Issue 1 2003
M. Gregor
The aim of this study was to evaluate myofibrillar creatine kinase (CK) activity and to quantify the substrate channelling of ATP between CK and myosin ATPase under different pH conditions within the integrity of myofibrils. A pure myofibrillar fraction was prepared using differential centrifugation. The homogeneity of the preparation and the purity of the fraction were confirmed microscopically and by enzymatic assays for contaminant enzyme activities. The specific activity of myofibrillar CK reached 584 ± 33 nmol PCr min,1 mg,1 at pH 6.75. Two methods were used to detect CK activity: (1) measurement of direct ATP production, and (2) measurement of PCr consumption. This method of evaluation has been tested in experiments with isolated creatine kinase. No discrepancy in CK activity between the methods was observed in the pH range tested (6.0-7.5). However, the same procedures resulted in a significant discrepancy between the amounts of reacted PCr and produced ATP within the pure myofibrillar fraction. This discrepancy represents the portion of ATP produced by the CK reaction, which is preferentially channelled to the myosin ATPase before diffusing into the bulk solution. The maximum evaluated difference reached 42.3 % at pH 6.95. The substrate channelling between myofibrillar-bound CK and myosin ATPase was evaluated under various pH levels within the physiological range and it reached a maximum value in a slightly acidic environment. These results suggest that ATP/ADP flux control by the CK system is more important at lower pH, corresponding to the physiological state of muscle fatigue. [source]

Multichannel surface electromyography in ergonomics: Potentialities and limits

HUMAN FACTORS AND ERGONOMICS IN MANUFACTURING & SERVICE INDUSTRIES, Issue 4 2010
Marco Gazzoni
Abstract The prevention of work-related musculoskeletal disorders is one of the main goals in ergonomics. Among others, surface electromyography (sEMG) is an important tool for the evaluation of risks related to work activity. Three main issues have been approached in ergonomics via sEMG: 1) the analysis of muscle activation, 2) the analysis of exerted forces and torques, and 3) the analysis of muscle fatigue. Many studies have been carried out in static conditions. In ergonomics, however, it is more relevant to study muscle activity and fatigue during real tasks that are, in general, dynamic. From isometric to dynamic contractions, the complexity of the interpretation of sEMG signals increases considerably. Changes in sEMG signals are related to the continuous modifications in force output, muscle fiber length, and relative position of surface electrodes and sources. To increase the reliability of the information extracted from sEMG, multichannel detection systems have been applied, showing the possibility of overcoming some limits of the standard technique. Some illustrative laboratory and field studies are reported in this work to illustrate the potentialities and the open problems in the use of multichannel sEMG in ergonomics. Case 1 is a laboratory study investigating the myoelectric manifestations of fatigue in the biceps brachii (BB) during dynamic elbow flexion/extension. Case 2 is a laboratory study investigating the myoelectric manifestations of fatigue during a repetitive lifting task. Case 3 is a field study, carried out in an automotive plant, investigating muscle activation during the welding of a car door. Many factors play a leading role in the correct interpretation of information provided by sEMG. Even though multichannel sEMG provides information able to improve the estimation of force and/or fatigue during working tasks, many problems related to the signal acquisition and interpretation are still open. Further improvements are necessary to develop multichannel sEMG into an effective tool supporting other methodologies for the evaluation of work-related risks. © 2010 Wiley Periodicals, Inc. [source]

Sex differences in long bone fatigue using a rat model

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 10 2006
Luisa D. Moreno
Abstract Stress fractures can occur because of prolonged exercise and are associated with cyclic loading. Fatigue is the accumulated damage that results from cyclic loading and bone fatigue damage is of special concern for athletes and army recruits. Existing literature shows that the rates of stress fracture for female athletes and female army recruits are higher than their male counterparts. In this study, we used an ex vivo rat model to investigate the fatigue response of female and male bones. We determined the strain versus number of cycles to failure (S/N) for each sex and found that for a certain initial strain (5,000,7,000 µ,) female bones have shorter fatigue life. To further characterize the bone response to fatigue, we also determined the creep that occurred during the fatigue test. From the creep data, for a certain strain range, female bones accumulated greater residual strains and reached the critical strain at a faster rate. In summary, this study demonstrates that female rat bones have a lower resistance to fatigue in the absence of a physiological response such as muscle fatigue or osteogenic adaptation. From these results, we hypothesized that creep was the underlying mechanism that accounted for the fast deterioration of female bones during fatigue. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 24:1926,1932, 2006 [source]

Dynamic graciloplasty for fecal incontinence

MICROSURGERY, Issue 6 2001
Cor G.M.I. Baeten M.D.
Fecal incontinence is a socially incapacitating condition with associated high treatment costs. The most common cause of fecal incontinence is trauma during childbirth followed by surgical interventions. After unsuccessful conventional treatment, muscle transposition is the next treatment option. Two local muscles are used for this purpose: the gluteus and the gracilis muscles. With both muscles, long-term muscle contractions are difficult to maintain due to muscle fatigue. The gracilis muscle, however, is technically much easier to transfer and most activities of daily living and even sports are still possible. Experimental studies have shown that electrical stimulation of skeletal muscles can transform fatigue-prone muscles into fatigue-resistant muscles. In 1986, we started to perform graciloplasty procedures with intramuscular electrodes connected to an electrical stimulator. To date, 200 patients have been treated in our institution using dynamic graciloplasty. All patients had severe incontinence without control of liquid or solid feces, most of them had previously received unsuccessful treatment using other techniques. The mean age was 48 years, the average time that patients had been incontinent was 12.4 years, and the cause of incontinence were trauma (n = 99), congenital (n = 28), pudendopathy (n = 58), and low motor neurological lesions (n = 15). Of these patients, 76% were considered to have successful outcomes. Patients whose cause of incontinence was trauma or pudendopathy tended to respond better to this treatment than patients with anal atresia. © 2001 Wiley-Liss, Inc. MICROSURGERY 21:230,234 2001. [source]

Transient improvement induced by motor fatigue in focal occupational dystonia: The handgrip test

The inhibitory effect of a chewing task on a human jaw reflex

MUSCLE AND NERVE, Issue 6 2010
Pauline Maillou BDS
Abstract This study was undertaken to investigate whether an inhibitory jaw reflex could be modulated by experimentally controlled conditions that mimicked symptoms of temporomandibular disorders. Reflecting on previous work, we anticipated that these conditions might suppress the reflex. Electromyographic recordings were made from a masseter muscle in 18 subjects, while electrical stimuli were applied to the upper lip. An inhibitory reflex wave (mean latency 47 ms) was identified and quantified. Immediately following an accelerated chewing task, which in most cases produced muscle fatigue and/or pain, the size of the reflex wave decreased significantly by about 30%. The suppression of inhibitory jaw reflexes by fatigue and pain may result in positive feedback, which may contribute to the symptoms of temporomandibular disorders. Future studies of temporomandibular disorder sufferers will help to determine whether such reflex changes reflect the underlying etiology and/or are a result of the temporomandibular disorder itself. Muscle Nerve, 2010 [source]

Effects of stimulation frequency and pulse duration on fatigue and metabolic cost during a single bout of neuromuscular electrical stimulation

MUSCLE AND NERVE, Issue 5 2010
Julien Gondin PhD
Abstract We have investigated the effects of stimulation frequency and pulse duration on fatigue and energy metabolism in rat gastrocnemius muscle during a single bout of neuromuscular electrical stimulation (NMES). Electrical pulses were delivered at 100 Hz (1-ms pulse duration) and 20 Hz (5-ms pulse duration) for the high (HF) and low (LF) frequency protocols, respectively. As a standardization procedure, the averaged stimulation intensity, the averaged total charge, the initial peak torque, the duty cycle, the contraction duration and the torque-time integral were similar in both protocols. Fatigue was assessed using two testing trains delivered at a frequency of 100 Hz and 20 Hz before and after each protocol. Metabolic changes were investigated in vivo using 31P-magnetic resonance spectroscopy (31P-MRS) and in vitro in freeze-clamped muscles. Both LF and HF NMES protocols induced the same decrease in testing trains and metabolic changes. We conclude that, under carefully controlled and comparable conditions, the use of low stimulation frequency and long pulse duration do not minimize the occurrence of muscle fatigue or affect the corresponding stimulation-induced metabolic changes so that this combination of stimulation parameters would not be adequate in the context of rehabilitation. Muscle Nerve, 2010 [source]

Sensitivity of electrophysiological tests for upper and lower motor neuron dysfunction in ALS: A six-month longitudinal study

MUSCLE AND NERVE, Issue 2 2010
Mamede de Carvalho MD
Abstract By following a group of amyotrophic lateral sclerosis (ALS) patients longitudinally using lower motor neuron (LMN) and upper motor neuron (UMN) markers of dysfunction it may be possible to better understand the functional relationships between these motor systems in this disease. We used neurophysiological techniques to follow UMN and LMN dysfunction in a group of 28 patients with ALS, in comparison with the ALS functional rating scale (ALS-FRS) score and the forced vital capacity (FVC). We used motor unit number estimation (MUNE), compound muscle action potential (CMAP) amplitude, and the Neurophysiological Index (NI) to quantify the LMN disorder, and transcranial motor stimulation to study cortical motor threshold, motor-evoked response amplitude, central motor conduction time, and cortical silent period (CSP). The patients were studied shortly after diagnosis and then 6 months later, using both abductor digiti minimi muscles (ADM); ADM strength was initially >MRC 3 (Medical Research Council, UK). The NI and MUNE changed more than any other variable. CSP increased by about 30%, a change more marked than the slight increase observed in the cortical motor threshold (9%). The normal increase of CSP after acute muscle fatigue was preserved during disease progression. The CSP increase correlated with the MUNE rate of decay but not to the NI reduction, perhaps because NI includes F-wave frequency in itscalculation. There was no definite correlation between UMN and LMNdysfunction or progression, but there was a link between CSP and LMN changes in ALS. The CSP may be a useful variable in following UMN dysfunction in clinical practice and in clinical trials. Muscle Nerve, 2010 [source]

Breakdown of adenine nucleotide pool in fatiguing skeletal muscle in McArdle's disease: A noninvasive 31P-MRS and EMG study

MUSCLE AND NERVE, Issue 6 2003
Jochen Zange PhD
Abstract Energy metabolism and electrical muscle activity were studied in the calf muscles of 19 patients with proven McArdle's disease and in 25 healthy subjects. Phosphorus magnetic resonance spectroscopy and surface electromyography (S-EMG) were performed during two isometric muscle contractions of 3 min at 30% maximum voluntary contraction, one performed during normal perfusion and the other during applied ischemia. After about 1 min of ischemic muscle contraction in diseased muscle a significant acceleration in phosphocreatine breakdown was observed, along with a significant decrease in adenosine triphosphate. During both contractions the absence of glycolysis was shown by a significant alkalinization. Furthermore, in patients we observed a greater increase in the S-EMG amplitude than in control subjects. We conclude that early on during moderate exercise, a small number of muscle fibers reach metabolic depletion, indicated by a reduction in the adenine nucleotide pool. An increasing number of motor units, which are still in a high-energy state, are continuously recruited to compensate for muscle fatigue. This functional compartmentation may contribute to the pathophysiology of exercise intolerance in McArdle's disease. Muscle Nerve 27: 728,736, 2003 [source]

Functional Electrical Stimulation-Supported Interval Training Following Sensorimotor-Complete Spinal Cord Injury: A Case Series

NEUROMODULATION, Issue 3 2009
Jack Crosbie PhD
ABSTRACT Objective.,To investigate the effect of interval training supported by Functional Electrical Stimulation (FES) on ambulation ability in complete spinal cord injury (SCI). Methods.,We trained four men with sensorimotor-complete (ASIA A) SCI, who achieved gait through FES of the quadriceps femoris, gluteus maximus, and common peroneal nerve on each side on a motorized treadmill. Training involved progressive interval walking exercise, consisting of periods of activity followed by equal periods of rest, repeated until muscle fatigue. We used time to muscle fatigue during continuous treadmill ambulation as the primary outcome measure. We also recorded the patterns of incremental stimulation for all training and testing sessions. Results.,All subjects increased their ambulation capacity; however, the responses varied from subject to subject. Some subjects increased the total distance walked by as much as 300% with progressive improvement over the entire training period; however, others made more modest gains and appeared to reach a performance plateau within a few training sessions. Conclusions.,FES-supported interval training offers a useful and effective strategy for strength-endurance improvement in the large muscle groups of the lower limb in motor-complete SCI. We believe that this training protocol offers a viable alternative to that of continuous walking training in people with SCI using FES to aid ambulation. [source]

Development and Experimental Identification of a Biomechanical Model of the Trunk for Functional Electrical Stimulation Control in Paraplegia

NEUROMODULATION, Issue 4 2008
Ingenieur Michele Vanoncini
ABSTRACT Objectives., Theoretic modeling and experimental studies suggest that functional electrical stimulation (FES) can improve trunk balance in spinal cord injured subjects. This can have a positive impact on daily life, increasing the volume of bimanual workspace, improving sitting posture, and wheelchair propulsion. A closed loop controller for the stimulation is desirable, as it can potentially decrease muscle fatigue and offer better rejection to disturbances. This paper proposes a biomechanical model of the human trunk, and a procedure for its identification, to be used for the future development of FES controllers. The advantage over previous models resides in the simplicity of the solution proposed, which makes it possible to identify the model just before a stimulation session (taking into account the variability of the muscle response to the FES). Materials and Methods., The structure of the model is based on previous research on FES and muscle physiology. Some details could not be inferred from previous studies, and were determined from experimental data. Experiments with a paraplegic volunteer were conducted in order to measure the moments exerted by the trunk-passive tissues and artificially stimulated muscles. Data for model identification and validation also were collected. Results., Using the proposed structure and identification procedure, the model could adequately reproduce the moments exerted during the experiments. The study reveals that the stimulated trunk extensors can exert maximal moment when the trunk is in the upright position. In contrast, previous studies show that able-bodied subjects can exert maximal trunk extension when flexed forward. Conclusions., The proposed model and identification procedure are a successful first step toward the development of a model-based controller for trunk FES. The model also gives information on the trunk in unique conditions, normally not observable in able-bodied subjects (ie, subject only to extensor muscles contraction). [source]

Hypercapnia: what is the limit in paediatric patients?

PEDIATRIC ANESTHESIA, Issue 7 2004
A case of near-fatal asthma successfully treated by multipharmacological approach
Summary We describe a case of prolonged severe hypercapnia with respiratory acidosis occurring during an episode of near-fatal asthma in an 8-year-old boy, followed by complete recovery. After admission to the intensive care unit, despite treatment with maximal conventional bronchodilatative therapy, the clinical picture deteriorated with evident signs of respiratory muscle fatigue. The child was sedated, intubated and mechanically ventilated. Magnesium sulphate, ketamine and sevoflurane were gradually introduced together with deep sedation, curarization and continuous bronchodilatative therapy. Ten hours after admission, arterial pCO2 reached 39 kPa (293 mmHg), pH was 6.77 and pO2 8.6 kPa (65 mmHg). Chest radiograph showed severe neck subcutaneous emphysema, with signs of mediastinal emphysema. No episode of haemodynamic instability was seen despite severe prolonged hypercapnia lasting more than 14 h. Oxygenation was maintained and successful recovery followed without neurological or cardiovascular sequelae. This case shows the cardiovascular and neurological tolerance of a prolonged period of supercarbia in a paediatric patient. The most important lesson to be learned is the extreme importance of maintaining adequate tissue perfusion and oxygenation during an asthma attack. The second lesson is that when conventional bronchodilators fail, the intensivist may resort to the use of drugs such as ketamine, magnesium sulphate and inhalation anaesthesia. In this context deep sedation and curarization are important not only to improve oxygenation, but also to reduce cerebral metabolic requirements. [source]

The response to paired motor cortical stimuli is abolished at a spinal level during human muscle fatigue

THE JOURNAL OF PHYSIOLOGY, Issue 23 2009
Chris J. McNeil
During maximal exercise, supraspinal fatigue contributes significantly to the decline in muscle performance but little is known about intracortical inhibition during such contractions. Long-interval inhibition is produced by a conditioning motor cortical stimulus delivered via transcranial magnetic stimulation (TMS) 50,200 ms prior to a second test stimulus. We aimed to delineate changes in this inhibition during a sustained maximal voluntary contraction (MVC). Eight subjects performed a 2 min MVC of elbow flexors. Single test and paired (conditioning,test interval of 100 ms) stimuli were delivered via TMS over the motor cortex every 7,8 s throughout the effort and during intermittent MVCs in the recovery period. To determine the role of spinal mechanisms, the protocol was repeated but the TMS test stimulus was replaced by cervicomedullary stimulation which activates the corticospinal tract. TMS motor evoked potentials (MEPs) and cervicomedullary motor evoked potentials (CMEPs) were recorded from biceps brachii. Unconditioned MEPs increased progressively with fatigue, whereas CMEPs increased initially but returned to the control value in the final 40 s of contraction. In contrast, both conditioned MEPs and CMEPs decreased rapidly with fatigue and were virtually abolished within 30 s. In recovery, unconditioned responses required <30 s but conditioned MEPs and CMEPs required ,90 s to return to control levels. Thus, long-interval inhibition increased markedly as fatigue progressed. Contrary to expectations, subcortically evoked CMEPs were inhibited as much as MEPs. This new phenomenon was also observed in the first dorsal interosseous muscle. Tested with a high intensity conditioning stimulus during a fatiguing maximal effort, long-interval inhibition of MEPs was increased primarily by spinal rather than motor cortical mechanisms. The spinal mechanisms exposed here may contribute to the development of central fatigue in human muscles. [source]

Is peripheral locomotor muscle fatigue during endurance exercise a variable carefully regulated by a negative feedback system?

THE JOURNAL OF PHYSIOLOGY, Issue 7 2008
Samuele Marcora
No abstract is available for this article. [source]

Combating muscle fatigue: extracellular lactic acidosis and catecholamines

THE JOURNAL OF PHYSIOLOGY, Issue 2 2007
M. I. Lindinger
No abstract is available for this article. [source]

Effects of hypoxia on diaphragmatic fatigue in highly trained athletes

THE JOURNAL OF PHYSIOLOGY, Issue 1 2007
Ioannis Vogiatzis
Previous work suggests that exercise-induced arterial hypoxaemia (EIAH), causing only moderate arterial oxygen desaturation (: 92 ± 1%), does not exaggerate diaphragmatic fatigue exhibited by highly trained endurance athletes. Since changes in arterial O2 tension have a significant effect on the rate of development of locomotor muscle fatigue during strenuous exercise, the present study investigated whether hypoxia superimposed on EIAH exacerbates the exercise-induced diaphragmatic fatigue in these athletes. Eight trained cyclists (: 67.0 ± 2.6 ml kg,1 min,1; mean ±s.e.m.) completed in balanced order four 5 min exercise tests leading to different levels of end-exercise (64 ± 2, 83 ± 1, 91 ± 1 and 96 ± 1%) via variations in inspired O2 fraction (: 0.13, 0.17, 0.21 and 0.26, respectively). Measurements were made at corresponding intensities (65 ± 3, 80 ± 3, 85 ± 3 and 90 ± 3% of normoxic maximal work rate, respectively) in order to produce the same tidal volume, breathing frequency and respiratory muscle load at each . The mean pressure time product of the diaphragm did not differ across the four exercise tests and ranged between 312 ± 28 and 382 ± 22 cmH2O s min,1. Ten minutes into recovery, twitch transdiaphragmatic pressure (Pdi,tw) determined by bilateral phrenic nerve stimulation, was significantly (P= 0.0001) reduced after all tests. After both hypoxic tests (: 0.13, 0.17) the degree of fall in Pdi,tw (by 26.9 ± 2.7 and 27.4 ± 2.6%, respectively) was significantly greater (P < 0.05) than after the normoxic test (by 20.1 ± 3.4%). The greater amount of diaphragmatic fatigue in hypoxia at lower leg work rates (presumably requiring smaller leg blood flow compared with normoxia at higher leg work rates), suggests that when ventilatory muscle load is similar between normoxia and hypoxia, hypoxia exaggerates diaphragmatic fatigue in spite of potentially greater respiratory muscle blood flow availability. [source]

Effect of ADP on slow-twitch muscle fibres of the rat: implications for muscle fatigue

THE JOURNAL OF PHYSIOLOGY, Issue 1 2006
W. A. Macdonald
Slow-twitch mechanically skinned fibres from rat soleus muscle were bathed in solutions mimicking the myoplasmic environment but containing different [ADP] (0.1 ,m to 1.0 mm). The effect of ADP on sarcoplasmic reticulum (SR) Ca2+ -content was determined from the magnitude of caffeine-induced force responses, while temporal changes in SR Ca2+ -content allowed determination of the effective rates of the SR Ca2+ -pump and of the SR Ca2+ -leak. The SR Ca2+ -pump rate, estimated at pCa (,log10[Ca2+]) 7.8, was reduced by 20% as the [ADP] was increased from 0.1 to 40 ,m, with no further alteration when the [ADP] was increased to 1.0 mm. The SR Ca2+ -leak rate constant was not altered by increasing [ADP] from 0.1 to 40 ,m, but was increased by 26% when the [ADP] was elevated to 1.0 mm. This ADP-induced SR Ca2+ -leak was insensitive to ruthenium red but was abolished by 2,5-di(tert-butyl)-1,4-hydroquinone (TBQ), indicating that the leak pathway is via the SR Ca2+ -pump and not the SR Ca2+ -release channel. The decrease in SR Ca2+ -pump rate and SR Ca2+ -leak rate when [ADP] was increased led to a 40% decrease in SR Ca2+ -loading capacity. Elevation of [ADP] had only minor direct effects on the contractile apparatus of slow-twitch fibres. These results suggest that ADP has only limited depressing effects on the contractility of slow-twitch muscle fibres. This is in contrast to the marked effects of ADP on force responses in fast-twitch muscle fibres and may contribute to the fatigue-resistant nature of slow-twitch muscle fibres. [source]

Role of phosphate and calcium stores in muscle fatigue

THE JOURNAL OF PHYSIOLOGY, Issue 3 2001
D. G. Allen
Intensive activity of muscles causes a decline in performance, known as fatigue, that is thought to be caused by the effects of metabolic changes on either the contractile machinery or the activation processes. The concentration of inorganic phosphate (Pi) in the myoplasm ([Pi]myo) increases substantially during fatigue and affects both the myofibrillar proteins and the activation processes. It is known that a failure of sarcoplasmic reticulum (SR) Ca2+ release contributes to fatigue and in this review we consider how raised [Pi]myo contributes to this process. Initial evidence came from the observation that increasing [Pi]myo causes reduced SR Ca2+ release in both skinned and intact fibres. In fatigued muscles the store of releasable Ca2+ in the SR declines mirroring the decline in SR Ca2+ release. In muscle fibres with inoperative creatine kinase the rise of [Pi]myo is absent during fatigue and the failure of SR Ca2+ release is delayed. These results can all be explained if inorganic phosphate can move from the myoplasm into the SR during fatigue and cause precipitation of CaPi within the SR. The relevance of this mechanism in different types of fatigue in humans is considered. [source]

Physiologic Features of Vocal Fatigue: Electromyographic Spectral-Compression in Laryngeal Muscles

THE LARYNGOSCOPE, Issue 6 2006
Victor J. Boucher PhD
Abstract Objectives: This study addresses the problem of defining observable attributes of "vocal fatigue" as a physiologic condition. The aim was to determine the applicability of electromyography (EMG) spectral compression in observing fatigue in laryngeal muscles arising from prolonged vocal effort. Study Design: Single institution, nonrandomized, prospective analysis of subjects evaluated in an academic, tertiary care center. Methods: In adapting EMG techniques, we report pretest observations that bear on the choice of voicing tasks serving to induce and estimate muscle fatigue and the selection of muscles that are particularly involved in effortful vocalization. On this basis, an experiment was designed where intramuscular EMG was used to record lateral cricoarytenoid potentials of seven subjects at regular intervals across a 12 to 14 hour period (50 samples per subject). Between each of these samples, the participants were required to produce loud speech for 3 minutes with peaks of 74 dBA at 1 meter. Results: The results show fatigue-related spectral compression for all subjects and nonlinear changes across time indicating critical values beyond which fatigue is persistent. Conclusion: Spectral compression appears to present a robust attribute of fatigue-related changes in muscles involved in vocalization. There are several implications with respect to research on the prevention of acquired voice pathologies. [source]

The antioxidative function, preventive action on disease and utilization of proanthocyanidins

BIOFACTORS, Issue 1-4 2004
Toshiaki Ariga
Abstract Proanthocyanidins, which belong to a class of polyphenols, are widely distributed throughout the plant kingdom. Most people ingest trace amounts of proanthocyanidins through foods such as red wine and cranberry juice. However, the functional properties of proanthocyanidins have been little understood. Since 1983, we have studied the antioxidative functions, preventive actions on diseases and utilization of proanthocyanidins. The antioxidative activities of proanthocyanidins were found to be much stronger than vitamin C or vitamin E in aqueous systems. The mechanisms for their antioxidative actions were shown to involve radical scavenging, quenching, and enzyme-inhibiting actions. The preventive actions of proanthcyanidins on diseases relating to reactive oxygen species was examined using animal tests. Proanthocyanidin-rich grape seed extract was showed to have preventive actions on diseases such as atherosclerosis, gastric ulcer, large bowel cancer, cataracts and diabetes. In human intervention trials, grape seed extract was shown to have preventive effects on the increase in lipid peroxides in human plasma after exercise and on muscle fatigue after training. The uses and manufacturing techniques of proanthocyanidin products were subsequently developed. The products were launched as antioxidants in food additives, ingredients in nutritional supplements, and cosmetics. [source]

Monozygous twins with neuromuscular transmission defects at opposite sides of the motor endplate

ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2009
A. R. Punga
Disorders affecting the postsynaptic side of the neuromuscular junction include autoimmune myasthenia gravis (MG) as well as some of the congenital myasthenic syndromes (CMS). Lambert-Eaton myasthenic syndrome (LEMS) is an acquired autoimmune neuromuscular disorder in which autoantibodies are directed against the presynaptic calcium channels. Here we describe two monozygous twin brothers: case 1 was diagnosed with an indeterminate form of acquired postsynaptic neuromuscular junction defect at age 32 and case 2 with LEMS at age 47. Case 1 presented clinically with mild generalized myasthenic weakness, neurophysiological examination revealed disturbed neuromuscular transmission along with probable myositis and serum analysis regarding antibodies against the acetylcholine receptor and muscle-specific tyrosine kinase was negative. Case 2 presented with proximal muscle fatigue accompanied by areflexia at rest and antibodies against the P/Q-type voltage-gated calcium channels were present. Neurophysiologically, case 2 had reduced baseline compound motor action potential amplitudes on neurography, decrement on low-frequency repetitive nerve stimulation (RNS) and pathological increment on high frequency RNS. To our knowledge this is the first case report of its kind and adds an intriguing contrast to the more common diagnosis of CMS in monozygous twins. [source]

SKELETAL MUSCLE FUNCTION: ROLE OF IONIC CHANGES IN FATIGUE, DAMAGE AND DISEASE

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 8 2004
DG Allen
SUMMARY 1.,Repeated activity of skeletal muscle causes a variety of changes in its properties: muscles become weaker with intense use (fatigue), may feel sore and weak after repeated contractions involving stretch and can degenerate in some disease conditions. The present review considers the role of early ionic changes in the development of each of these conditions. 2.,Single fibre preparations of mouse muscle were used to measure ionic changes following activity induced changes in function. Single fibres were dissected with intact tendons and stimulated to produce force. Fluorescent indicators were microinjected into the fibres to allow simultaneous ionic measurements with determination of mechanical performance. 3.,One theory to explain muscle fatigue is that fatigue is caused by the accumulation of lactic acid, producing an intracellular acidosis that inhibits the myofibrillar proteins. In contrast, we found that during repeated tetani there was little or no pH change, but that failure of calcium release was a major contributor to fatigue. Currently, it is proposed that precipitation of calcium and phosphate in the sarcoplasmic reticulum contributes to the failure of calcium release. 4.,Muscles can be used to shorten and produce force or they can be used to de-accelerate loads (stretched or eccentric contractions). One day after intense exercise involving stretched contractions, muscles are weak, sore and tender, and this damage can take a week to recover. In this condition, sarcomeres are disorganized and there are increases in resting intracellular Ca2+ and Na+. Recently, we demonstrated that the elevation of Na+ occurs through a stretch-activated channel that can be blocked by either gadolinium or streptomycin. Preventing the increase in [Na+]i with gadolinium also prevented part of the muscle weakness after stretched contractions. 5.,Duchenne muscular dystrophy is a lethal degenerative disease of muscles in which the protein dystrophin is absent. Dystrophic muscles are more susceptible to stretch-induced muscle damage and the stretch-activated channel seems to be one pathway for the increases in intracellular Ca2+ and Na+ that are a feature of this disease. We have shown recently that blockers of the stretch-activated channel can minimize some of the short-term damage in muscles from the mdx mouse, which also lacks dystrophin. Currently, we are testing whether blockers of the stretch-activated channels given systemically to mdx mice can protect against some features of the disease. [source]