Sex differences and mechanisms of task-specific muscle fatigue

Planning Health Services for Seniors: Can We Use Patient's Own Perception?

OBJECTIVES

The objectives of this study were to identify needs and to estimate whether self-reported health can be used as an indicator of service needs among seniors.

METHODS

This was a cross-sectional survey. Age- and sex-adjusted logistic regression was used to estimate the link between functional status indicators and fair or poor self-reported health. Forward stepwise logistic regression was performed to identify the strongest contributors of poor health. Positive predictive value (PPV), sensitivity, and specificity were calculated to identify whether health perception could be used to identify people in need of physical rehabilitation services.

RESULTS

142 seniors agreed to answer the survey, yielding a response rate of 73%. Among the respondents (mean age 79±7; 60% women), 40% rated their health as fair or poor. Seniors perceiving their health as fair or poor had higher odds of reporting impairments, activity limitations, and participation restrictions (OR ranging from 2.37 95%CI: 1.03-5-45 to 12.22 95%CI: 2.68-55.78) in comparison to those perceiving their health as good or better. The strongest contributors for poor/fair health were depression, difficulty performing household tasks, pain, and dizziness (c-statistic = 0.91 and a maximum adjusted r-squared of 0.60). Self-rated health used as single-item showed a positive predictive value (PPV) of 1, sensitivity of 52%, and specificity of 100%.

CONCLUSION

Our results indicate that all seniors participating in this study and reporting fair or poor health have indicators of need for further rehabilitation services. Asking patients to rate their own health may be an alternate way of querying about need, as many older persons are afraid to report disability because of fear of further institutionalization.

Gonad-related factors promote muscle performance gain during postnatal development in male and female mice

To better define the role of male and female gonad-related factors (MGRF, presumably testosterone, and FGRF, presumably estradiol, respectively) on mouse hindlimb skeletal muscle contractile performance/function gain during postnatal development, we analyzed the effect of castration initiated before puberty in male and female mice. We found that muscle absolute and specific (normalized to muscle weight) maximal forces were decreased in 6-mo-old male and female castrated mice compared with age- and sex-matched intact mice, without alteration in neuromuscular transmission. Moreover, castration decreased absolute and specific maximal powers, another important aspect of muscle performance, in 6-mo-old males, but not in females. Absolute maximal force was similarly reduced by castration in 3-mo-old muscle fiber androgen receptor (AR)-deficient and wild-type male mice, indicating that the effect of MGRF was muscle fiber AR independent. Castration reduced the muscle weight gain in 3-mo mice of both sexes and in 6-mo females but not in males. We also found that bone morphogenetic protein signaling through Smad1/5/9 was not altered by castration in atrophic muscle of 3-mo-old mice of both sexes. Moreover, castration decreased the sexual dimorphism regarding muscle performance. Together, these results demonstrated that in the long term, MGRF and FGRF promote muscle performance gain in mice during postnatal development, independently of muscle growth in males, largely via improving muscle contractile quality (force and power normalized), and that MGFR and FGRF also contribute to sexual dimorphism. However, the mechanisms underlying MGFR and FGRF actions remain to be determined.

Strength Training with Repetitions to Failure does not Provide Additional Strength and Muscle Hypertrophy Gains in Young Women

This study investigated the effects of a 10-week resistance training to failure on neuromuscular adaptations in young women. Eighty-nine active young women were randomly assigned to one of three groups: 1) repetitions to failure (RF; three sets of repetitions to failure); 2) repetitions not to failure with equalized volume (RNFV; four sets of 7 repetitions); and 3) repetitions not to failure (RNF; three sets of 7 repetitions). All groups performed the elbow flexor exercise (bilateral biceps curl) and trained 2 days per week using 70% of 1RM. There were significant increases (p<0.05) in muscle strength after 5 (15.9% for RF, 18.4% for RNF, and 19.9% for RNFV) and 10 (28.3% for RF, 26.8% for RNF, and 28.3% for RNFV) weeks of training, with no significant differences between groups. Additionally, muscular endurance increased after 5 and 10 weeks, with no differences between groups. However, peak torque (PT) increased significantly at 180°.s-1 in the RNFV (13.7%) and RNF (4.1%) groups (p<0.05), whereas no changes were observed in the RF group (-0.5%). Muscle thickness increased significantly (p<0.05) in the RF and RNFV groups after 5 (RF: 8.4% and RNFV: 2.3%) and 10 weeks of training (RF: 17.5%, and RNFV: 8.5%), whereas no significant changes were observed in the RNF group (3.9 and 2.1% after 5 and 10 weeks, respectively). These data suggest that short-term training of repetitions to failure do not yield additional overall neuromuscular improvements in young women.

Exercise-induced quadriceps muscle fatigue in men and women: effects of arterial oxygen content and respiratory muscle work

KEY POINTS

High work of breathing and exercise-induced arterial hypoxaemia (EIAH) can decrease O₂ delivery and exacerbate exercise-induced quadriceps fatigue in healthy men. Women have a higher work of breathing during exercise, dedicate a greater fraction of whole-body V̇O2 towards their respiratory muscles and develop EIAH. Despite a greater reduction in men's work of breathing, the attenuation of quadriceps fatigue was similar between the sexes. The degree of EIAH was similar between sexes, and regardless of sex, those who developed the greatest hypoxaemia during exercise demonstrated the most attenuation of quadriceps fatigue. Based on our previous finding that women have a greater relative oxygen cost of breathing, women appear to be especially susceptible to work of breathing-related changes in quadriceps muscle fatigue.

ABSTRACT

Reducing the work of breathing or eliminating exercise-induced arterial hypoxaemia (EIAH) during exercise decreases the severity of quadriceps fatigue in men. Women have a greater work of breathing during exercise, dedicate a greater fraction of whole-body V̇O2 towards their respiratory muscles, and demonstrate EIAH, suggesting women may be especially susceptible to quadriceps fatigue. Healthy subjects (8 male, 8 female) completed three constant load exercise tests over 4 days. During the first (control) test, subjects exercised at ∼85% of maximum while arterial blood gases and work of breathing were assessed. Subsequent constant load exercise tests were iso-time and iso-work rate, but with EIAH prevented by inspiring hyperoxic gas or work of breathing reduced via a proportional assist ventilator (PAV). Quadriceps fatigue was assessed by measuring force in response to femoral nerve stimulation. For both sexes, quadriceps force was equally reduced after the control trial (-27 ± 2% baseline) and was attenuated with hyperoxia and PAV (-18 ± 1 and -17 ± 2% baseline, P < 0.01, respectively), with no sex difference. EIAH was similar between the sexes, and regardless of sex, subjects with the lowest oxyhaemoglobin saturation during the control test had the greatest quadriceps fatigue attenuation with hyperoxia (r²  = 0.79, P < 0.0001). For the PAV trial, despite reducing the work of breathing to a greater degree in men (men: 60 ± 5, women: 75 ± 6% control, P < 0.05), the attenuation of quadriceps fatigue was similar between the sexes (36 ± 4 vs. 37 ± 7%). Owing to a greater relative V̇O2 of the respiratory muscles in women, less of a change in work of breathing is needed to reduce quadriceps fatigue.

Alterations in peak torque occur without hematological changes after muscle fatigue

ABSTRACT Introduction: Muscular fatigue during voluntary muscle contractions is a complex and multifactorial phenomenon associated with central changes and adaptations of the neuromuscular system. Objective: The aim of this study was to analyze the changes in both peak torque and hematological parameters in active and inactive healthy subjects following a muscular fatigue protocol. Methods: Twenty-one healthy adult males performed a muscle fatigue protocol (10 sets, 10 repetitions of knee extension at 75% of the maximal isometric torque (MIT), 120º s-1 and 40 seconds of rest). Hematocrit (Ht), red blood cells (RBC) and leukocytes (L) analysis were evaluated before (B) and after (A) a fatigue test. Results: The inactive group presented impairment only in concentric muscular action of -41±4% in relation to the active (-23±3%) group. No differences were found in hematological parameters in inactive group (Ht, B: 45.00±0.01 vs. A: 47.00±0.01; RBC, B: 442±40 vs. A: 487±41; L, B: 7,565±2,878 vs. A: 8,015±4,224) and the active group (Ht, B: 45.00±0.63 vs. A: 47.00±0.01; RBC, B: 477±30 vs. A: 559±37; L, B: 6,418±3,557 vs. A: 6,632±4,460). Conclusion: Differences were found only in concentric actions between groups. Additionally, there were no relationships found in hematological parameters between groups.

Inter-Gender sEMG Evaluation of Central and Peripheral Fatigue in Biceps Brachii of Young Healthy Subjects

Purpose

The purpose of the present study was to evaluate inter-arm and inter-gender differences in fractal dimension (FD) and conduction velocity (CV) obtained from multichannel surface electromyographic (sEMG) recordings during sustained fatiguing contractions of the biceps brachii.

Methods

A total of 20 recreationally active males (24±6 years) and 18 recreationally active females (22±9 years) performed two isometric contractions at 120 degrees elbow joint angle: (1) at 20% maximal voluntary contraction (MVC) for 90 s, and (2) at 60% MVC until exhaustion the time to perform the task has been measured. Signals from sEMG were detected from the biceps brachii using bidimensional arrays of 64 electrodes and initial values and rate of change of CV and FD of the sEMG signal were calculated.

Results

No difference between left and right sides and no statistically significant interaction effect of sides with gender were found for all parameters measured. A significant inter-gender difference was found for MVC (p<0.0001). Initial values of CV were higher in females than in males at both force levels (20% MCV: p<0.0001; 60% MCV: p<0.05) whereas a lower initial estimate of FD was observed in females compared to males (20% MCV: p<0.05; 60% MCV: p<0.0001). No difference in CV and FD slopes was found at 20% MVC between genders. At 60% MVC significantly lower CV and FD slopes (CV and FD: p<0.05) and a more protracted time to exhaustion were found in females than in males (p<0.0001). When considering time to exhaustion at both levels of contraction no difference in percentage change (Δ%) of CV and FD slopes was found between genders (p>0.05). During the sustained 60% MVC no statistical correlation was found between MVC and CV or FD initial estimates nor between MVC and CV or FD slopes both in males and females whereas. A significant positive correlation between CV and FD slopes was found in both genders (males: r = 0,61; females: r = 0,55).

Conclusions

Fatigue determines changes in FD and CV values in biceps brachii during sustained contractions at 60% MVC. In particular males show greater increase in the rate of change of CV and FD than females whereas no difference in percentage change of these sEMG descriptors of fatigue was found. A significant correlation between FD and CV slopes found in both genders highlights that central and peripheral myoelectric components of fatigue may interact during submaximal isometric contractions.

Effect of sex on torque, recovery, EMG, and MMG responses to fatigue

OBJECTIVE

The purpose of the present investigation was to examine the effect of sex on maximal voluntary isometric contraction (MVIC) torque and the EMG and MMG responses as a result of fatiguing, intermittent, submaximal (65% of MVIC), isometric elbow flexion muscle contractions.

METHODS

Eighteen men and women performed MVIC trials before (pretest), after (posttest), and 5-min after (5-min recovery) performing 50 intermittent, submaximal isometric muscle contractions. Surface electromyographic (EMG) and mechanomyographic (MMG) signals were simultaneously recorded from the biceps brachii muscle.

RESULTS

As a result of the fatiguing workbout torque decreased similarly from pretest to posttest for both the men (24.0%) and women (23.3%). After 5-min of recovery, torque had partially recovered for the men, while torque had returned to pretest levels for the women. For both sexes, from pretest to posttest EMG mean power frequency and MMG amplitude decreased, but returned to pretest levels after 5-min of recovery.

CONCLUSIONS

In the present study, there were sex-related differences in muscle fatigue that were not associated with the EMG or MMG responses.

Muscle- and Mode-Specific Responses of the Forearm Flexors to Fatiguing, Concentric Muscle Actions

BACKGROUND

Electromyographic (EMG) and mechanomyographic (MMG) studies of fatigue have generally utilized maximal isometric or dynamic muscle actions, but sport- and work-related activities involve predominately submaximal movements. Therefore, the purpose of the present investigation was to examine the torque, EMG, and MMG responses as a result of submaximal, concentric, isokinetic, forearm flexion muscle actions.

METHODS

Twelve men performed concentric peak torque (PT) and isometric PT trials before (pretest) and after (posttest) performing 50 submaximal (65% of concentric PT), concentric, isokinetic (60°·s^-1), forearm flexion muscle actions. Surface EMG and MMG signals were simultaneously recorded from the biceps brachii and brachioradialis muscles.

RESULTS

The results of the present study indicated similar decreases during both the concentric PT and isometric PT measurements for torque, EMG mean power frequency (MPF), and MMG MPF following the fatiguing workbout, but no changes in EMG amplitude (AMP) or MMG AMP.

CONCLUSIONS

These findings suggest that decreases in torque as a result of fatiguing, dynamic muscle actions may have been due to the effects of metabolic byproducts on excitation⁻contraction coupling as indicated by the decreases in EMG MPF and MMG MPF, but lack of changes in EMG AMP and MMG AMP from both the biceps brachii and brachioradialis muscles.

Rate modulation of human anconeus motor units during high-intensity dynamic elbow extensions

Investigations of high-intensity isometric fatiguing protocols report decreases in motor unit firing rates (MUFRs), but little is known regarding changes in MUFRs following fatigue induced by high-intensity dynamic contractions. Our purpose was to evaluate MUFRs of the anconeus (an accessory elbow extensor) and elbow extension power production as a function of time to task failure (TTF) during high-velocity fatiguing concentric contractions against a moderately heavy resistance. Fine-wire intramuscular electrode pairs were inserted into the anconeus to record MUs in 12 male participants (25 ± 3 yr), over repeated sessions on separate days. MUs were tracked throughout a three-stage, varying load dynamic elbow extension protocol designed to extend the task duration for >1 min thereby inducing substantial fatigue. Mean MUFRs and peak power were calculated for three relative time ranges: 0-15% TTF (beginning), 45-60% TTF (middle) and 85-100% TTF (end). Mean duration of the overall fatigue protocol was ∼80 s. Following the protocol, isometric maximum voluntary contraction (MVC), highest velocity at 35% MVC load, and peak power decreased 37, 60, and 64% compared with baseline, respectively. Data from 20 anconeus MUs tracked successfully throughout the protocol indicated a reduction in MUFRs in relation to power loss from 36 Hz/160 W (0-15% TTF) to 28 Hz/97 W (45-60% TTF) to 23 Hz/43 W (85-100% TTF). During these high-intensity maximal effort concentric contractions, anconeus MUFRs decreased substantially (>35%). Although the absolute MUFRs were higher in the present study than those reported previously for other muscles during sustained high-intensity isometric tasks, the relative decrease in MUFRs was similar between the two tasks.

Predictive Neuromuscular Fatigue of the Lower Extremity Utilizing Computer Modeling

This paper studies the modeling of lower extremity muscle forces and their correlation to neuromuscular fatigue. Two analytical fatigue models were combined with a musculoskeletal model to estimate the effects of hamstrings fatigue on lower extremity muscle forces during a side step cut. One of the fatigue models (Tang) used subject-specific knee flexor muscle fatigue and recovery data while the second model (Xia) used previously established fatigue and recovery parameters. Both fatigue models were able to predict hamstrings fatigue within 20% of the experimental data, with the semimembranosus and semitendinosus muscles demonstrating the largest (11%) and smallest (1%) differences, respectively. In addition, various hamstrings fatigue levels (10-90%) on lower extremity muscle force production were assessed using one of the analytical fatigue models. As hamstrings fatigue levels increased, the quadriceps muscle forces decreased by 21% (p < 0.01), while gastrocnemius muscle forces increased by 36% (p < 0.01). The results of this study validate the use of two analytical fatigue models in determining the effects of neuromuscular fatigue during a side step cut, and therefore, this model can be used to assess fatigue effects on risk of lower extremity injury during athletic maneuvers. Understanding the effects of fatigue on muscle force production may provide insight on muscle group compensations that may lead to altered lower extremity motion patterns as seen in noncontact anterior cruciate ligament (ACL) injuries.

Kinesio taping of the deltoid does not reduce fatigue induced deficits in shoulder joint position sense

BACKGROUND

Muscle fatigue is known to decrease shoulder proprioceptive acuity, potentially contributing to injuries. It has been suggested that Kinesio taping can improve proprioception. Therefore, the aim of this study was to investigate the effects of Kinesio taping on shoulder joint position sense after muscle fatigue.

METHODS

Twenty-four healthy subjects were evaluated in a randomized, crossover, single-blind study design. Shoulder joint position sense was assessed during active repositioning tests at the target angles of 50°, 70° and 90° of arm elevation in scapular plane, in three sessions: control (no taping), Kinesio taping (Kinesio taping applied over the deltoid muscle with tension) and sham (Kinesio taping applied over deltoid without tension). Joint position sense was assessed three times: before taping; following taping application or rest, in the control session; and following a fatigue protocol. The constant error (repositioned angle-target angle) was considered for statistical analysis, using a 3-way repeated-measure ANOVA (within subject factors: taping, time and target angle).

FINDINGS

There was no interaction or main effect involving taping. An interaction between time and angle was found and the simple effect showed that the constant error increased following fatigue at 70° and 90°, but not at 50°.

INTERPRETATION

The results of this study does not support the use of Kinesio taping applied over the deltoid muscle for compensating or preventing shoulder joint position sense deficits caused by muscle fatigue of shoulder abductors.

Quadriceps muscle function after exercise in men and women with a history of anterior cruciate ligament reconstruction

CONTEXT

Sex differences in lower extremity neuromuscular function have been reported after anterior cruciate ligament reconstruction (ACLR). Research evidence supports different levels of fatigability in men and women and between patients with ACLR and healthy controls. The influence of sex on the response to continuous exercise in patients with ACLR is not clear.

OBJECTIVE

To compare quadriceps neuromuscular function after exercise between men and women with ACLR.

DESIGN

Descriptive laboratory study.

SETTING

Laboratory.

PATIENTS OR OTHER PARTICIPANTS

Twenty-six active volunteers (13 men [50%]: age = 24.1 ± 4.4 years, height = 179.1 ± 9.8 cm, mass = 80.1 ± 9.4 kg, months since surgery = 43.5 ± 37.0; 13 women [50%]: age = 24.2 ± 5.6 years, height = 163.0 ± 5.9 cm, mass = 62.3 ± 8.3 kg, months since surgery = 45.8 ± 42.7) with a history of unilateral primary ACLR at least 6 months earlier.

INTERVENTION(S)

Thirty minutes of continuous exercise comprising 5 separate 6-minute cycles, including 5 minutes of uphill walking and 1 minute of body-weight squatting and step-ups.

MAIN OUTCOME MEASURE(S)

Normalized knee-extension maximal voluntary isometric contraction torque, quadriceps superimposed-burst torque, and quadriceps central activation ratio before and after exercise. We performed separate 2 (sex: men, women) × 2 (time: preexercise, postexercise) repeated-measures analyses of variance for the 3 variables. Separate, independent-samples t tests were calculated to compare preexercise with postexercise change in all dependent variables between sexes.

RESULTS

A significant group-by-time interaction was present for knee-extension torque (P = .04). The percentage reduction in knee-extension maximal voluntary isometric contraction torque (men = 1.94%, women = -10.32%; P = .02) and quadriceps central activation ratio (men = -1.45%, women = -8.69%; P = .03) experienced by men was less than that observed in women.

CONCLUSIONS

In the presence of quadriceps dysfunction, female participants experienced greater-magnitude reductions in quadriceps function after 30 minutes of exercise than male participants. This indicates a reduced ability to absorb knee-joint loads, which may have significant implications for reinjury and joint osteoarthritis in women after ACLR.

Sex differences with aging in the fatigability of dynamic contractions

This study determined the sex difference with aging in fatigability of the elbow flexor muscles during a dynamic fatiguing task, and explored the associated mechanisms. We compared fatigability of the elbow flexor muscles in 18 young (20.2 ± 1 years: 9 men) and 36 old adults (73.5 ± 1 years: 16 men) during and in recovery from repeated dynamic contractions (~60°/s) with a load equivalent to 20% of maximal voluntary isometric contraction (MVIC) torque until failure. Transcranial magnetic stimulation (TMS) was used to assess supraspinal fatigue (an increase in the superimposed twitch, SIT) and the peak rate of muscle relaxation. Time to failure was briefer for the men than the women (6.1 ± 2.1 vs. 9.7 ± 5.5 min, respectively; P=0.02) with no difference between young and old adults (7.2 ± 2.9 vs. 8.4 ± 5.2 min, respectively, P=0.45) and no interaction (P>0.05). The relative decline in peak relaxation rate with fatigability was similar for young and old adults (P=0.11), but greater for men than women (P=0.046). Supraspinal fatigue increased for all groups and was associated with the time to failure (P<0.05). Regression analysis however, indicated that the time to failure was best predicted by the peak relaxation rate (baseline values and slowing with fatigability) (r(2)=0.55). Rate-limiting contractile mechanisms (e.g. excitation-contraction coupling) were responsible for the increased fatigability of the elbow flexors of men compared with women for a dynamic fatiguing task of slow angular velocity, and this sex difference was maintained with aging. The age difference in fatigability for the dynamic task was diminished for both sexes relative to what is typically observed with isometric fatiguing contractions.

A high-intensity, intermittent exercise protocol and dynamic postural control in men and women

CONTEXT

Deficits in dynamic postural control predict lower limb injury. Differing fatiguing protocols negatively affect dynamic postural control. The effect of high-intensity, intermittent exercise on dynamic postural control has not been investigated.

OBJECTIVE

To investigate the effect of a high-intensity, intermittent exercise protocol (HIIP) on the dynamic postural control of men and women as measured by the Star Excursion Balance Test (SEBT).

DESIGN

Descriptive laboratory study.

SETTING

University gymnasium.

PATIENTS OR OTHER PARTICIPANTS

Twenty male (age = 20.83 ± 1.50 years, height = 179.24 ± 7.94 cm, mass = 77.67 ± 10.82 kg) and 20 female (age = 20.45 ± 1.34 years, height = 166.08 ± 5.83 cm, mass = 63.02 ± 6.67 kg) athletes.

INTERVENTION(S)

We recorded SEBT measurements at baseline, pre-HIIP, and post-HIIP. The HIIP consisted of 4 repetitions of 10-m forward sprinting with a 90° change of direction and then backward sprinting for 5 m, 2 repetitions of 2-legged jumping over 5 hurdles, 2 repetitions of high-knee side stepping over 5 hurdles, and 4 repetitions of lateral 5-m shuffles. Participants rested for 30 seconds before repeating the circuit until they reported a score of 18 on the Borg rating of perceived exertion scale.

MAIN OUTCOME MEASURE(S)

A mixed between- and within-subjects analysis of variance was conducted to assess time (pre-HIIP, post-HIIP) × sex interaction effects. Subsequent investigations assessed the main effect of time and sex on normalized maximal SEBT scores. We used intraclass correlation coefficients to determine the test-retest reliability of the SEBT and paired-samples t tests to assess the HIIP effect on circuit times.

RESULTS

We found a time × sex effect (F(8,69) = 3.5; P range, <.001-.04; η(2) range, 0.057-0.219), with women less negatively affected. We also noted a main effect for time, with worse normalized maximal SEBT scores postfatigue (F(8,69) = 22.39; P < .001; η(2) range, 0.324-0.695), and for sex, as women scored better in 7 SEBT directions (F(8,69) = 0.84; P range, <.001-008; η(2) range, 0.088-0.381). The intraclass correlation coefficients demonstrated high (0.77-0.99) test-retest repeatability. Paired-samples t tests demonstrated increases in circuit time post-HIIP (P < .001).

CONCLUSIONS

The HIIP-induced fatigue negatively affected normalized maximal SEBT scores. Women had better scores than men and were affected less negatively by HIIP-induced fatigue.

Ergonomic task reduction prevents bone osteopenia in a rat model of upper extremity overuse

We evaluated the effectiveness of ergonomic workload reduction of switching rats from a high repetition high force (HRHF) lever pulling task to a reduced force and reach rate task for preventing task-induced osteopenic changes in distal forelimb bones. Distal radius and ulna trabecular structure was examined in young adult rats performing one of three handle-pulling tasks for 12 wk: (1) HRHF, (2) low repetition low force (LRLF); or (3) HRHF for 4 wk and than LRLF thereafter (HRHF-to-LRLF). Results were compared to age-matched controls rats. Distal forelimb bones of 12-wk HRHF rats showed increased trabecular resorption and decreased volume, as control rats. HRHF-to-LRLF rats had similar trabecular bone quality as control rats; and decreased bone resorption (decreased trabecular bone volume and serum CTX1), increased bone formation (increased mineral apposition, bone formation rate, and serum osteocalcin), and decreased osteoclasts and inflammatory cytokines, than HRHF rats. Thus, an ergonomic intervention of HRHF-to-LRLF prevented loss of trabecular bone volume occurring with prolonged performance of a repetitive upper extremity task. These findings support the idea of reduced workload as an effective approach to management of work-related musculoskeletal disorders, and begin to define reach rate and load level boundaries for such interventions.

Is sitting worse than static standing? How a gender analysis can move us toward understanding determinants and effects of occupational standing and walking

The Yant Award was established in 1964 to honor the contributions of William P. Yant, the first president of the American Industrial Hygiene Association. It is presented annually for outstanding contributions in industrial hygiene or allied fields to an individual residing outside the United States. The 2014 award recipient is Dr. Karen Messing, Professor emeritus, Department of Biological Sciences, Université du Québec à Montréal and Researcher, CINBIOSE Research Centre. Gender (socially determined) differences in occupations, employment, and working conditions, task assignments, and work methods that affect exposure to health risks are increasingly documented. Interactions of (biologically influenced) sex differences with workplace parameters may also influence exposure levels. During field studies, ergonomists learn a lot about gender and sex that can be important when generating and testing hypotheses about the mechanisms that link workplace exposures to health outcomes. Prolonged standing is common in North America; almost half (45%) of Québec workers spend more than three-quarters of their working time on their feet and 40% of these cannot sit at will. This posture has been linked to chronic back pain and musculoskeletal disorders (MSDs) in the lower limbs, but many health professionals suggest workers should stand rather than sit at work. We ask: (1) Given the fact that roughly the same proportion of men and women stand at work, what does a gender-sensitive analysis add to our ability to detect and thus prevent work-related MSDs?; (2) How does ergonomics research inform gender-sensitive analysis of occupational health data?; and (3) What do researchers need to know to orient interventions to improve general working postures? We have sought answers to these questions through collaborative research with specialists in epidemiology, occupational medicine, biomechanics, and physiology, carried out in partnership with public health organisations, community groups, and unions. We conclude that failure to characterize prolonged static standing and to apply gender-sensitive analysis can confuse assessment of musculoskeletal and circulatory effects of working postures. We suggest that prolonged static sitting and standing postures can and should be avoided by changes to workplace organization and environments. Research is needed to define optimal walking speeds and arrive at optimal ratios of sitting, standing, and walking in the workplace.

Sex-specific responses to self-paced, high-intensity interval training with variable recovery periods

This study examined sex-specific responses during self-paced, high-intensity interval training (HIIT). Sixteen (8 men and 8 women) individuals completed a peak oxygen uptake test and 3 treadmill HIIT sessions on separate days. The HIIT sessions consisted of six 4-minute intervals performed at the highest self-selected intensity individuals felt they could maintain. Recovery between intervals was counterbalanced and consisted of 1-, 2-, or 4-minute recovery during each trial. Relative measures of intensity, including percentage of velocity at VO2peak (vVO2peak), %VO2peak, %HRmax, and blood lactate concentration ([La]), were observed during the trials. Perceived readiness was recorded immediately before and ratings of perceived exertion (RPE) were recorded at the end of each interval with session RPE recorded after each trial. Results revealed a significant effect of sex on %vVO2peak (p < 0.01) and %HRmax (p < 0.01). Data show that across trials, men self-select higher %vVO2peak (84.5 vs. 80.7%), whereas women produce higher %HRmax (96.9 vs. 92.1%) and %VO2peak (89.6 vs. 86.1%) with no difference in [La] or perceptual responses. These findings support the notion that women may demonstrate improved recovery during high-intensity exercise, as they will self-select intensities resulting in greater cardiovascular strain. Moreover, results confirm previous findings suggesting that a 2:1 work-to-rest ratio is optimal during HIIT for both men and women.

Knowledge of repetitions range affects force production in trained females

Most studies have examined pacing strategies with cyclical activities (running and cycling). It has been demonstrated that males employ different pacing strategies during repeated maximal voluntary contractions (MVCs) dependent upon a known endpoint. Since different fatiguing mechanisms have been identified between the genders, it is not known if females use comparable pacing strategies. The purpose of this study was to examine if informing female subjects regarding the number of MVCs to perform would affect force and electromyography (EMG). Twenty well-trained females completed 3 fatiguing protocols in a randomized order. In the control condition participants were informed they would perform twelve MVCs and then actually completed twelve. In the unknown condition they were not told how many MVCs to perform but were stopped after twelve. In the deception condition they were initially informed to perform 6 MVCs, but after the 6(th) MVC they were asked to perform a few more MVCs and were stopped after twelve. During the first 6 MVCs, forces in the deception condition were greater compared to the unknown (p = 0.021, ES = 0.65, 5%) and control (p = 0.022, ES = 0.42, 3%) conditions. No differences were found between conditions in the last 6 MVCs. A main effect for repetitions showed force deficits during the first 6 MVCs (p = 0.000, ES = 1.81, 13%) and last 6 MVCs (p = 0.05, ES = 0.34, 3%). No differences were found between conditions in biceps and triceps EMG. However, EMG decreased during the first 6 MVCs for biceps (p = 0.001, ES = 1.0, 14%) and triceps (p = 0.001, ES = 0.76, 14%) across conditions. No differences were found in the last 6 MVCs. The anticipation of performing fewer MVCs led to increased force, whereas no endpoint led to decreased force production. Key pointsPacing strategies occur during repeated (fatiguing) MVCs as a function of end point expectations.Females use similar pacing strategies as previously published results with males.Without a known end point, females will tend to pace themselves by decreasing force output even when asked to perform maximal contractions.

Effect of 16 weeks of resistance training on fatigue resistance in men and women

The purpose of this study was to investigate the effect of hypertrophy-type resistance training (RT) on upper limb fatigue resistance in young adult men and women. Fifty-eight men (22.7±3.7 years, 70.6±9.3 kg, and 176.8±6.4 cm) and 65 women (21.6±3.7 years, 58.8±11.9 kg, and 162.6±6.2 cm) underwent RT for 16 weeks. Training consisted of 10–12 whole body exercises with 3 sets of 8–12 repetitions maximum performed 3 times per week. Before and after the RT intervention participants were submitted to 1RM testing, as well as a fatigue protocol consisting of 4 sets at 80% 1RM on bench press (BP) and arm curl (AC). The sum of the number of repetitions accomplished in the 4 sets in each exercise was used to indicate fatigue resistance. There was a significant (p<0.05) time-by-group interaction in 1RM BP (men=+16%, women=+26%), however in 1RM AC no significant time-by-group interaction was observed (men=+14%, women=+23%). For the total number of repetitions, men and women showed a significant increase in BP (men=+16.3%, women=+10.5%) with no time-by-group interaction. The results suggest that the adaptation in maximal strength is influenced by sex in BP. On the other hand, for fatigue resistance, the individual’s sex does not seem to influence outcomes either in BP or AC.

Analysis of the training load during a hypertrophy-type resistance training programme in men and women

The purpose of this study was to analyze the specific training load during a resistance training (RT) programme designed to increase muscular hypertrophy in men and women. Thirty-four women (22.7 ± 4.1 years, 58.8 ± 11.9 kg, 162.6 ± 6.2 cm and 22.1 ± 3.6 kg.m(-2)) and 30 men (22.7 ± 4.4 years, 68.4 ± 9.0 kg, 174.5 ± 6.6 cm and 22.5 ± 2.4 kg.m(-2)) underwent a supervised RT programme that was divided into two phases of 8 weeks each. Training consisted of 10-12 exercises performed with three sets of 8-12 repetitions at repetition maximum resistances performed 3 times per week on nonconsecutive days. There was a significant (P < 0.05) main effect for gender by time interaction for average training load of all the exercises performed in the first 8 weeks of RT with women showing a higher relative increase than men (+43.6% vs. +32.5%, respectively). This result was not observed during the second 8-week phase of the RT programme during which no significant gender by time interaction (P > 0.05) was shown with both genders having a similar relative increase (+28.7% vs. +24.3%, respectively). Women had a higher increase than men in specific average training load of the upper limb exercises during both the first 8 weeks of training (+30.2% vs. +26.6%, respectively) and the second 8 weeks of training (+31.1% vs. +25.3%, respectively). We conclude that the adaptation in specific training load is influenced by gender.

Effect of the time of day on central and peripheral fatigue during 2-min maximal voluntary contractions in persons with multiple sclerosis: gender differences

There is a lack of data on fatigue changes within 24h among patients with multiple sclerosis. The purpose of this study was to evaluate the effect of time of day on central and peripheral fatigue during a continuous 2-min maximal voluntary contraction of the quadriceps muscle in women and men with multiple sclerosis (MS). We studied age-matched MS patients (range, 40-50years). The inclusion criteria for patients were: a Kurtzke Expanded Disability Status score and a Fatigue Severity Scale score. We found a significant gender difference in central activation ratio (CAR) in the evening. At the end of the 2-min maximal voluntary contraction (MVC), the voluntary torque decreased by about 65% in men and women with MS in both the morning and evening. We also observed that, in women, CAR decreased markedly during the first 30s in the evening test. The most interesting finding of our study is that central fatigue increased, whereas peripheral fatigue decreased markedly in the evening only in women. It remains unclear why women's central fatigue is greater in the evening than in the morning.

Sex differences in human fatigability: mechanisms and insight to physiological responses

Sex-related differences in physiology and anatomy are responsible for profound differences in neuromuscular performance and fatigability between men and women. Women are usually less fatigable than men for similar intensity isometric fatiguing contractions. This sex difference in fatigability, however, is task specific because different neuromuscular sites will be stressed when the requirements of the task are altered, and the stress on these sites can differ for men and women. Task variables that can alter the sex difference in fatigability include the type, intensity and speed of contraction, the muscle group assessed and the environmental conditions. Physiological mechanisms that are responsible for sex-based differences in fatigability may include activation of the motor neurone pool from cortical and subcortical regions, synaptic inputs to the motor neurone pool via activation of metabolically sensitive small afferent fibres in the muscle, muscle perfusion and skeletal muscle metabolism and fibre type properties. Non-physiological factors such as the sex bias of studying more males than females in human and animal experiments can also mask a true understanding of the magnitude and mechanisms of sex-based differences in physiology and fatigability. Despite recent developments, there is a tremendous lack of understanding of sex differences in neuromuscular function and fatigability, the prevailing mechanisms and the functional consequences. This review emphasizes the need to understand sex-based differences in fatigability to shed light on the benefits and limitations that fatigability can exert for men and women during daily tasks, exercise performance, training and rehabilitation in both health and disease.

Swing kinematics of male and female skilled golfers following prolonged putting practice

Given that males and females respond differently to endurance-based tasks, prolonged putting practice may provide an avenue to examine gender-related differences in golf swing kinematics. The aim of this project was to determine if 40 min of putting affects thorax and pelvis kinematics during the full swing of males and females. Three-dimensional trunk kinematics were collected during the swings of 19 male (age: 26 ± 7 years, handicap: 0.6 ± 1.1) and 17 female (age: 24 ± 7 years, handicap: 1.4 ± 1.7) golfers before and after 40 min of putting. Angular displacement at address, top of backswing and ball contact for the pelvis, thorax, and pelvis-thorax interaction were calculated, in addition to the magnitude of peak angular velocity and repeatability of continuous segment angular velocities. Female golfers had less pelvis and thorax anterior-posterior tilt at address, less thorax and thorax-pelvis axial rotation at top of backswing, and less pelvis and thorax axial rotation and pelvis lateral tilt at ball contact pre- to post-putting. Analysis of peak angular velocities revealed that females had significantly lower thorax-pelvis lateral tilt velocity pre- to post-putting. In conclusion, an endurance-based putting intervention affects females' thorax and pelvis orientation angles and velocities to a greater extent than males.

Human neuromuscular structure and function in old age: A brief review

Natural adult aging is associated with many functional impairments of the human neuromuscular system. One of the more observable alterations is the loss of contractile muscle mass, termed sarcopenia. The loss of muscle mass occurs primarily due to a progressive loss of viable motor units, and accompanying atrophy of remaining muscle fibers. Not only does the loss of muscle mass contribute to impaired function in old age, but alterations in fiber type and myosin heavy chain isoform expression also contribute to weaker, slower, and less powerful contracting muscles. This review will focus on motor unit loss associated with natural adult aging, age-related fatigability, and the age-related differences in strength across contractile muscle actions.

Peak power is reduced following lengthening contractions despite a maintenance of shortening velocity

Following repetitive lengthening contractions, power (the product of torque and velocity) is impaired during shortening contractions. However, the relative contribution of each component to power loss and the underlying factors are unclear. We investigated neuromuscular properties of the dorsiflexors in 8 males (27 ± 3 years) and 8 females (26 ± 4 years) for a potential sex-related difference before, during, and after 150 unaccustomed maximal lengthening actions. Velocity-dependent power was determined from shortening contractions at 8 levels (1 N·m to 70% of maximum voluntary isometric contraction (MVC)) before, after, and throughout recovery assessed at 0–30 min, 24 h, and 48 h. Immediately following task termination, both sexes displayed similar impairments of 30%, 4%, and 10% in MVC torque, shortening velocity, and overall peak power, respectively (P < 0.05). Peak rate of isometric torque development (RTD) was reduced by 10% in males, but females exhibited a 35% reduction (P < 0.05). Rate of torque development for the MVC remained depressed in both sexes throughout the 30 min recovery period; however, the RTD returned to normal by 24 h in males but did not recover by 48 h in females. Power was reduced preferentially at higher loads (i.e., 60% MVC), with a greater loss in females (65%) than males (45%). For lower loads (<20% MVC), power was impaired minimally (4%–8%; P < 0.05) and recovered within 30 min in both groups. The reduction in maximal angular velocity persisted until 30 min of recovery, and peak power did not recover until 24 h for both sexes. Unaccustomed lengthening contractions decreased power preferentially at higher loads, whereas peak power was reduced minimally owing to maintenance of maximal shortening velocity.

Ventilation and respiratory mechanics

During dynamic exercise, the healthy pulmonary system faces several major challenges, including decreases in mixed venous oxygen content and increases in mixed venous carbon dioxide. As such, the ventilatory demand is increased, while the rising cardiac output means that blood will have considerably less time in the pulmonary capillaries to accomplish gas exchange. Blood gas homeostasis must be accomplished by precise regulation of alveolar ventilation via medullary neural networks and sensory reflex mechanisms. It is equally important that cardiovascular and pulmonary system responses to exercise be precisely matched to the increase in metabolic requirements, and that the substantial gas transport needs of both respiratory and locomotor muscles be considered. Our article addresses each of these topics with emphasis on the healthy, young adult exercising in normoxia. We review recent evidence concerning how exercise hyperpnea influences sympathetic vasoconstrictor outflow and the effect this might have on the ability to perform muscular work. We also review sex-based differences in lung mechanics.

Sex comparisons for relative peak torque and electromyographic mean frequency during fatigue

PURPOSE

This study compared the relative peak torque and normalized electromyographic (EMG) mean frequency (MNF) responses during fatiguing isokinetic muscle actions for men versus women.

METHOD

Twenty men (Mage +/- SD = 22 +/- 2 years) and 20 women (Mage +/- SD = 22 +/- 1 years) performed 50 maximal concentric isokinetic muscle actions of the leg extensors at a velocity of 180 degrees/s while surface EMG signals were detected from the vastus lateralis, rectus femoris, and vastus medialis. The dependent variables were initial, final, and average peak torque; percent decline; the estimated percentage of fast-twitch fibers for the vastus lateralis; and the linear slope coefficients and y-intercepts for normalized EMG MNF versus repetition number. The data were analyzed with independent-samples t tests and 2-way mixed-factorial analyses of variance.

RESULTS

The mean initial, final, and average peak torque values for men were greaterthan those for women. There were no mean differences for percent decline and the estimated percentage of fast-twitch fibers for the vastus lateralis. There were also no sex differences for the linear slope coefficients, but there were differences among the muscles (vastus medialis > vastus lateralis > rectus femoris). The mean y-intercept for the vastus lateralis for men was greater than that for women.

CONCLUSIONS

Men demonstrated greater peak torque values than those for women, but the declines in peak torque and normalized EMG MNF were similar between thesexes. The vastus medialis was more fatigue-resistant than both the vastus lateralis and rectus femoris.

Fatigue and recovery from dynamic contractions in men and women differ for arm and leg muscles

INTRODUCTION

Whether there is a gender difference in fatigue and recovery from maximal velocity fatiguing contractions and across muscles is not understood.

METHODS

Sixteen men and 19 women performed 90 isotonic contractions at maximal voluntary shortening velocity (maximal velocity concentric contractions, MVCC) with the elbow flexor and knee extensor muscles (separate days) at a load equivalent to 20% maximal voluntary isometric contraction (MVIC).

RESULTS

Power (from MVCCs) decreased similarly for men and women for both muscles (P > 0.05). Men and women had similar declines in MVIC of elbow flexors, but men had greater reductions in knee extensor MVIC force and MVIC electromyogram activity than women (P < 0.05). The decline in MVIC and power was greater, and force recovery was slower for the elbow flexors compared with knee extensors.

CONCLUSIONS

The gender difference in muscle fatigue often observed during isometric tasks was diminished during fast dynamic contractions for upper and lower limb muscles.

Biomechanics of the heel-raise test performed on an incline in two knee flexion positions

BACKGROUND

Although single-legged heel-raise cycles are often performed on an incline in different knee flexion positions to discriminate the relative contribution of the triceps surae muscles, detailed kinematic and kinetic analyses of this procedure are not available. Our study characterizes and compares the biomechanics and clinical outcomes of single-legged heel-raise cycles performed to volitional exhaustion on an incline with the knee straight (0°) and bent (45°), considering the effect of sex and age.

METHODS

Fifty-six male and female volunteers, with equal numbers of younger (20 to 40 years of age) and older (40 to 60 years of age) individuals, completed a maximal number of heel-raise cycles on an incline at both nominal knee angles. Kinematic and kinetic data were acquired during testing using a 3D motion capturing system and multi-axial force plate. The impact of fatigue on performance was quantified using changes in maximal voluntary isometric contraction force and biomechanical performance of cycles.

FINDINGS

Overall, participants completed three more cycles and maintained better biomechanical performance with 45° than 0° of knee flexion. More precisely, the decreases in maximal heel-raise heights, plantar-flexion angles at maximal height and ranges of ankle motion per cycle were all smaller with the knee bent. However, several outcomes indicated similar plantar-flexion fatigue at both knee angles. Males demonstrated a more rapid decline in peak ground reaction forces during testing; but otherwise, neither sex nor age significantly impacted outcomes.

INTERPRETATION

It is concluded that the differences discerned here in the biomechanics of single-legged heel-raise cycles performed at 0° and 45° of knee flexion to volitional exhaustion on an incline may be too small to identify in clinical settings or reflect substantial alterations in the relative contribution of the triceps surae muscles.

Reduced motor unit discharge rates of maximal velocity dynamic contractions in response to a submaximal dynamic fatigue protocol

Fatigability is highly task dependent wherein motor unit (MU) discharge rates and recruitment thresholds are affected differently depending on whether contractions are performed at maximal or submaximal intensities. Although much is described for isometric tasks, the behavior of MU properties during the production of maximal velocity dynamic contractions following submaximal fatiguing contractions is unknown. In seven young men, we evaluated changes in MU recruitment thresholds and MU discharge rates of the anconeus muscle during both submaximal and maximal dynamic elbow extensions following a submaximal dynamic fatiguing protocol of moderate intensity to velocity task failure. Velocity and power of the maximal dynamic contractions declined ∼45 and ∼55%, respectively, but these variables were unchanged for the submaximal target velocity contractions. Discharge rates of the 12 MUs at task failure were unchanged for submaximal dynamic contractions, but were decreased ∼20% for maximal dynamic and ballistic isometric contractions at task failure. MU recruitment thresholds of submaximal dynamic contractions decreased 52% at task failure, but were similar throughout the fatiguing protocol for maximal contractions. These findings support the concept of a common neural mechanism responsible for the relative declines in MU discharge rate associated with submaximal fatigability in both isometric and dynamic contractions.

Supraspinal fatigue is similar in men and women for a low-force fatiguing contraction

PURPOSE

This study determined the contribution of supraspinal fatigue to the sex difference in neuromuscular fatigue for a low-intensity fatiguing contraction. Because women have greater motor responses to arousal than men, we also examined whether cortical and motor nerve stimulation, techniques used to quantify central fatigue, would alter the sex difference in muscle fatigue.

METHODS

In study 1, cortical stimulation was elicited during maximal voluntary contractions (MVC) before and after a submaximal isometric contraction at 20% MVC with the elbow flexor muscles in 29 young adults (20 ± 2.6 yr, 14 men). In study 2, 10 men and 10 women (19.1 ± 2.9 yr) performed a fatiguing contraction in the presence and absence of cortical and motor nerve stimulation.

RESULTS

Study 1: Men had a briefer time to task failure than women (P = 0.009). Voluntary activation was reduced after the fatiguing contraction (P < 0.001) similarly for men and women. Motor-evoked potential area and the EMG silent period increased similarly with fatigue for both sexes. Peak relaxation rates, however, were greater for men than women and were associated with time to task failure (P < 0.05). Force fluctuations, RPE, HR, and mean arterial pressure increased at a greater rate for men than for women during the fatiguing contraction (P < 0.05). Study 2: Time to task failure, force fluctuations, and all other physiological variables assessed were similar for the control session and stimulation session (P > 0.05) for both men and women.

CONCLUSIONS

Supraspinal fatigue was similar for men and women after the low-force fatiguing contraction, and the sex difference in muscle fatigue was associated with peripheral mechanisms. Furthermore, supraspinal fatigue can be quantified in both men and women without influencing motor performance.

Supraspinal fatigue impedes recovery from a low-intensity sustained contraction in old adults

This study determined the contribution of supraspinal fatigue and contractile properties to the age difference in neuromuscular fatigue during and recovery from a low-intensity sustained contraction. Cortical stimulation was used to evoke measures of voluntary activation and muscle relaxation during and after a contraction sustained at 20% of maximal voluntary contraction (MVC) until task failure with elbow flexor muscles in 14 young adults (20.9 ± 3.6 yr, 7 men) and 14 old adults (71.6 ± 5.4 yr, 7 men). Old adults exhibited a longer time to task failure than the young adults (23.8 ± 9.0 vs. 11.5 ± 3.9 min, respectively, P < 0.001). The time to failure was associated with initial peak rates of relaxation of muscle fibers and pressor response (P < 0.05). Increments in torque (superimposed twitch; SIT) generated by transcranial magnetic stimulation (TMS) during brief MVCs, increased during the fatiguing contraction (P < 0.001) and then decreased during recovery (P = 0.02). The increase in the SIT was greater for the old adults than the young adults during the fatiguing contraction and recovery (P < 0.05). Recovery of MVC torque was less for old than young adults at 10 min post-fatiguing contraction (75.1 ± 8.7 vs. 83.6 ± 7.8% of control MVC, respectively, P = 0.01) and was associated with the recovery of the SIT (r = -0.59, r(2) = 0.35, P < 0.001). Motor evoked potential (MEP) amplitude and the silent period elicited during the fatiguing contraction increased less for old adults than young adults (P < 0.05). The greater fatigue resistance with age during a low-intensity sustained contraction was attributable to mechanisms located within the muscle. Recovery of maximal strength after the low-intensity fatiguing contraction however, was impeded more for old adults than young because of greater supraspinal fatigue. Recovery of strength could be an important variable to consider in exercise prescription of old populations.

A critical review on physical factors and functional characteristics that may explain a sex/gender difference in work-related neck/shoulder disorders

The objective of this paper is to critically review recent literature on physical and functional sex/gender (s/g) differences, with focus on physical determinants associated with neck/shoulder musculoskeletal injuries. It is well known that there are s/g differences in anthropometrical and functional body characteristics (e.g. size and strength). However, s/g differences may be wrongly attributed if data analysis does not include appropriate corrections (e.g. by strength for endurance). Recent literature on motor control shows that there may indeed be s/g differences in muscle coordination and movement strategies during upper limb tasks that are not currently explained by methodological inadequacies. Moreover, recent studies have shown differences between men and women in sensory hypersensitivity characteristics associated with neck/shoulder injuries. Taken together, the literature points to the importance of accounting for possible s/g differences at all levels of the biopsychosocial system in order to better understand sex- and gender-specific issues relevant to workplace health.

PRACTITIONER SUMMARY

This article critically reviews recent literature and a conceptual model highlighting s/g differences in physical and functional characteristics related to neck/shoulder musculoskeletal disorders (NSMSD). Findings have implications on understanding how personal factors may affect NSMSD risk. With better understanding, practitioners can make more appropriate decisions to prevent work-related NSMSD.