Effect of exercise-induced fatigue on postural control of the knee

Age-related effects of neuromuscular fatigue and acute recovery responses on maximal and rapid torque measures of the leg extensors and flexors

PURPOSE

To examine the effects of neuromuscular fatigue and recovery on maximal and rapid torque characteristics in young and old men for the leg extensors and flexors.

METHODS

Twenty-one young (age = 24.8 years) and 19 old (72.1 years) men performed maximal voluntary contractions (MVCs) before and at 0, 7, 15, and 30 min following an intermittent submaximal fatigue task. Outcome measures included endurance time, maximal (peak torque; PT) and rapid (absolute and normalized rate of torque development; RTD and nRTD) torque characteristics.

RESULTS

The old men had greater endurance times than the young men. Differential recovery patterns were observed for PT, and early and late RTD phases between the leg extensor and flexor muscle groups such that the early rapid torque variables and the flexors demonstrated slower recovery compared to later rapid torque variables and the extensors. The normalized RTD variables were reduced less after the fatigue task and differential muscle and age effects were observed where the flexors were reduced more at the early phase (nRTD1/6) compared to the extensors, however, for the later phase (nRTD2/3) the young men exhibited a greater reduction compared to the old men.

CONCLUSIONS

Dissimilar fatigue recovery patterns across different phases of RTD, lower limb muscles, and age groups may have important fatigue-related performance and injury risk implications across the adult lifespan.

Ebbing Strength, Fading Power: Unveiling the Impact of Persistent Fatigue on Muscle Performance in COVID-19 Survivors

The total number of confirmed cases of COVID-19 caused by SARS-CoV-2 virus infection is over 621 million. Post-COVID-19 syndrome, also known as long COVID or long-haul COVID, refers to a persistent condition where individuals experience symptoms and health issues after the acute phase of COVID-19. The aim of this study was to assess the strength and fatigue of skeletal muscles in people recovered from COVID-19. A total of 94 individuals took part in this cross-sectional study, with 45 participants (referred to as the Post-COVID Cohort, PCC) and 49 healthy age-matched volunteers (Healthy Control Cohort, HCC). This research article uses the direct dynamometry method to provide a detailed analysis of post-COVID survivors' strength and power characteristics. The Biodex System 4 Pro was utilized to evaluate muscle strength characteristics during the fatigue test. The fatigue work in extensors and flexors was significantly higher in the PCC. The PCC also showed significantly less power in both extensors and flexors compared to the HCC. In conclusion, this study provides compelling evidence of the impact of post-COVID-19 fatigue on muscle performance, highlighting the importance of considering these effects in the rehabilitation and care of individuals recovering from the virus. PCC achieved lower muscle strength values than HCC.

Postural balance disorders in sarcopenia based on surface electromyography

Background

Sarcopenia is an intrinsic factor that leads to balance disorders and falls in older adults. However, the characterization of sarcopenia-related postural balance deficits remains unclear.

Aims

This study aimed to explore the balance performance and postural control strategy in older adults with sarcopenia during static stance tasks using force platforms and surface electromyography.

Methods

Older adults with right-sided dominance were recruited, including 27 adults with sarcopenia and 27 healthy counterparts. Postural sway was measured with eyes open/closed on rigid/compliant surfaces. The time- and frequency-domain indexes of bilateral lower extremity muscle activity were simultaneously recorded.

Results

The postural sway and activity of multiple lower extremity muscles in the sarcopenia group were increased (P < 0.05). The amplitude contribution ratio of the right tibialis anterior muscle (larger in sarcopenia), co-contraction ratio of right ankle dorsiflexion (smaller in sarcopenia), and mean power frequency and median frequency of the left gluteus maximus muscle (smaller in sarcopenia) had main effects of grouping (P < 0.001, η2p = 0.06-0.10). All of them had discrimination for sarcopenia (area under the curve = 0.639-0.657, P < 0.001) and were correlated with balance function measurement in sarcopenia (|rs| = 0.22-0.44, P < 0.05).

Conclusion

The results of this study suggest that older adults with sarcopenia have decreased balance function and increased cost of electrophysiology. They were found to prefer the postural strategy of dominant ankle dorsiflexion and demonstrated overactivity of the dominant tibialis anterior muscles and fatigue vulnerability of the nondominant gluteus maximus. Improvements in these postural features may have balance benefits.

Reduction of Fatigue and Musculoskeletal Complaints in Garment Sewing Operator through a Combination of Stretching Brain Gym® and Touch for Health

The purpose of this study was to assess the effect of using a combination of stretching and Brain Gym^®(BG) + Touch for Health (TfH) movements to reduce fatigue and musculoskeletal complaints (MSCs) in garment-sewing operators. A quasi-experimental study was performed on 53 respondents with two sessions of stretching movements and BG + TfH movements of 5 min duration, three times a week for four weeks. Fatigue was measured using a reaction timer and MSCs were measured using a Nordic Body Map questionnaire. Wilcoxon and Mann–Whitney U tests were performed to examine the differences of pre/post and between the intervention group (IG) and control group (CG). A significant difference was found in IG for pre- and post-fatigue (p < 0.001) and MSCs (p < 0.001), while in CG there was no difference in fatigue (p = 0.200) and MSCs (p = 0.086). Significant differences were found between the IG and CG groups in terms of fatigue (p = 0.046), as well as in MSCs (p < 0.001). A significant decrease in MSCs per part body in IG was found on the left wrist, left hand, and left knee. The percentage of MSC severity decreased in all parts of the body, except the right shoulder, left elbow, and right thigh.

The Influence of Physical Load on Dynamic Postural Control-A Systematic Replication Study

Dynamic postural control is challenged during many actions in sport such as when landing or cutting. A decrease of dynamic postural control is one possible risk factor for non-contact injuries. Moreover, these injuries mainly occur under loading conditions. Hence, to assess an athlete's injury risk properly, it is essential to know how dynamic postural control is influenced by physical load. Therefore, the study's objective was to examine the influence of maximal anaerobic load on dynamic postural control. Sixty-four sport students (32 males and 32 females, age: 24.11 ± 2.42, height: 175.53 ± 8.17 cm, weight: 67.16 ± 10.08 kg) were tested with the Y-Balance Test before and after a Wingate Anaerobic Test on a bicycle ergometer. In both legs, reach distances (anterior) and composite scores were statistically significantly reduced immediately after the loading protocol. The values almost returned to pre-load levels in about 20 min post-load. Overall, findings indicate an acute negative effect of load on dynamic postural control and a higher potential injury risk during a period of about 20 min post-load. To assess an athlete's sports-specific injury risk, we recommend testing dynamic postural control under loaded conditions.

Toward more reliable stability measurements in stance: recommendations for number of measurements, foot position and feedback -- a cross-sectional study among servicemen

BACKGROUND

In the military, insufficient postural stability is a risk factor for developing lower extremity injuries. Postural stability training programs are effective in preventing these injuries. However, an objective method for the measurement of postural stability in servicemen is lacking. The primary objective of this study was to assess the influence of the number of repetitions, different foot positions and real-time visual feedback on postural stability, as well as their effects on the intrasession reliability of postural stability measurements in servicemen. The secondary objective was to assess the concurrent validity of the measurements.

METHODS

Twenty healthy servicemen between 20 and 50 years of age and in active duty were eligible for this quantitative, cross-sectional study. The measurements took place on a force plate, measuring the mean velocity of the center of pressure. The participants were asked to stand as still as possible in three different foot positions (wide stance, small stance, and on one leg), five times each for 45 s each time, and the measurements were performed with and without real-time visual feedback.

RESULTS

We observed a significant main effect of foot position (P < 0.001), but not of visual feedback (P = 0.119) or repetition number (P = 0.915). Postural stability decreased in the more challenging foot positions. The ICC estimates varied from 0.809 (one repetition in wide stance) to 0.985 (five repetitions on one leg). The common variance (R²) between different foot positions without feedback varied between 0.008 (wide stance) and 0.412.

CONCLUSIONS

To yield reliable data, wide-stance measurements should be conducted three times, and small-stance measurements and measurements on one leg should be conducted two times. The scores of a measurement in a particular foot position cannot predict the scores of measurements in other foot positions.

Effects of Small-Sided Game Variation on Changes in Hamstring Strength

Madison, G, Patterson, SD, Read, P, Howe, L, and Waldron, M. Effects of small-sided game variation on changes in hamstring strength. J Strength Cond Res 33(3): 839-845, 2019-Small-sided games (SSGs) are commonly used by soccer practitioners to condition players. This form of exercise can result in fatigue, potentially exposing the muscle to injury risk. The purpose of this study was to determine the effects of SSG variations on hamstring torque in semiprofessional soccer players. In a counterbalanced cross-over design, 10 male semiprofessional soccer players took part in both small relative area (3 vs. 3; 300 m) and large relative area (4 vs. 4; 1000 m) SSGs. The games comprised 6 × 4-minute bouts, with 90-second recovery. Both movement and heart rate responses were monitored by global positioning systems (GPS) and hamstring isometric torque was measured pre-training and post-training using a NordBord. There were differences (p < 0.05) between the small and large relative area games for peak hamstring force decrement (5.78 N and -13.62 N, respectively) and mean hamstring force decrement at 90° (11.11 N and -4.78 N, respectively). The number of accelerations was related to (r = 0.46, p = 0.039) reduced hamstring peak torque at 90°. In conclusion, larger relative area SSGs elicited the greatest internal and external loads, resulting in decrements in hamstring force. The number of accelerations performed in the session increases the likelihood of hamstring fatigue and can be controlled with the relative pitch area.

Effects of table tennis multi-ball training on dynamic posture control

Background

Prior to the 2017 table tennis season, each participant performed the anterior, posteromedial, and posterolateral the star excursion balance test (SEBT) reach distances in a randomized order. The aim of this study was to assess the effects of table tennis multi-ball training and dynamic balance on performance measures of the SEBT for the male and female.

Methods

The limb lengths of the 12 table tennis athletes were measured bilaterally in the study. Besides warm-up end, the data of this study were recorded at a regular interval at approximately 16 min for the entire multi-ball training session, and they were defined as Phase I, Phase II, Phase II, respectively. The Borg rating of perceived exertion (RPE) scale was used to document the degree of physical strain.

Results

Reaching distances showed a decrease with training progression in all directions. Compared with the male table tennis athletes, the females showed poorer dynamic posture control, particularly when the free limb was considered with the right-leg stance toward posterolateral and posteromedial directions in phase I.

Discussion

This study suggests that during table tennis multi-ball training the male should have a regulatory protocol to compensate the deficit observed in phase II, but the females should be given the protocol in phase I.

Effects of Recreational Ski Mountaineering on Cumulative Muscle Fatigue - A Longitudinal Trial

Sport is known to have many positive effects on mental and physical health. High-intensity exercise is considered to decrease muscle strength and induce muscle fatigue, which is associated with a higher risk of injury. In recreational alpine skiers, a decrease of eccentric peak hamstring torque, as an indication of muscle fatigue, occurs even after 1 day of skiing. The popularity of ski mountaineering is increasing enormously, but no studies are available on its effects on muscle strength. Therefore, the present study examined the consequences of ski mountaineering on muscle fatigue of the concentric/eccentric quadriceps and/or hamstrings. In addition, a possible role of myofascial foam rolling in reducing muscle fatigue was evaluated. Fifty recreational ski mountaineers (27 males, 23 females) completed five consecutive tours of ski mountaineering within 1 week. After each day of skiing, participants underwent an isokinetic muscle test assessing the concentric and eccentric muscle strength of both thighs. One group completed an additional session of myofascial foam rolling. Right and left concentric quadriceps peak torque, left hamstrings peak torque, left eccentric quadriceps peak torque, as well as right and left hamstring peak torque, were reduced after a single day of ski mountaineering (p ≤ 0.016 for all). However, no cumulative muscle fatigue was detected and we could not demonstrate any effect of myofascial foam rolling. The results show conclusively that a single day of ski mountaineering leads to a significant decrease of concentric and eccentric quadriceps and hamstring strength. Therefore, in order to improve muscle strength for the ski mountaineering season, a physical training program including concentric and eccentric methods can be recommended.

Exercise-induced muscle fatigue in the unaffected knee joint and its influence on postural control and lower limb kinematics in stroke patients

This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants (20 stroke patients, 20 age-matched healthy participants) were recruited. To induce fatigue, maximum voluntary isometric contractions were performed in the unaffected knee joint in a Leg Extension Rehab exercise machine using the pneumatic resistance. We measured static and dynamic balance and lower-limb kinematics during gait. Changes in postural control parameters anteroposterior sway speed and total center of pressure distance differed significantly between the stroke and control groups. In addition, changes in gait kinematic parameters knee and ankle angles of initial contact differed significantly between stroke (paretic and non-paretic) and control groups. Muscle fatigue in the unaffected knee and ankle impaired postural control and debilitates kinematic movement of ipsilateral and contralateral lower limbs, and may place the fatigued stroke patients at greater risk for falls.

Changes in Balance Strategy and Neuromuscular Control during a Fatiguing Balance Task-A Study in Perturbed Unilateral Stance

Fatigue impairs sensorimotor performance, reduces spinal reflexes and affects the interaction of antagonistic muscles in complex motor tasks. Although there is literature dealing with the interference of fatigue and postural control, the interpretation is confounded by the variety of paradigms used to study it. This study aimed to evaluate the effects of postural fatigue on balance control and strategy, as well as on neuromuscular modulation, in response to postural perturbation (PERT) during a fatiguing balance task. A fatigue protocol consisting of continuous exposure to perturbations until exhaustion was executed in 24 subjects. Number of failed attempts, paths of center of pressure displacement (COP), ankle, knee, and hip joint kinematics, electromyographic activity of the soleus (SOL), tibialis anterior (TA), rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF), and gluteus maximus muscles (GM) and spinal excitability of SOL at the peak of the short-latency responses (SLR) were recorded after posterior PERT. The co-contraction index (CCI) was calculated for TA_SOL, VL_BF and RF_GM. (1) The number of failed attempts significantly increased while COP amplitude and velocity, as well as angular excursion at the ankle, knee and hip joints, decreased with fatigue (P < 0.05). (2) Concomitantly, CCI of SOL_TA, VL_BF and RF_GM increased and spinal excitability in SOL declined. (3) Adaptations progressively augmented with progressing exhaustion and occurred in the distal prior to proximal segment. Distinctly deteriorated balance ability was accompanied by a modified neuromuscular control—the increase in co-contraction reflected by simultaneously activated antagonists is accompanied by smaller knee and hip joint excursions, indicating an elevated level of articular stiffness. These changes may be associated with an exaggerated postural rigidity and could have caused the delayed and reduced postural reactions that are reflected in the changes in COP displacement when compensating for sudden PERT. The reduction in spinal excitability may either be caused by fatigue itself or by an increase in reciprocal inhibition due to augmented TA activity.

Inducing Expectations for Health: Effects of Verbal Suggestion and Imagery on Pain, Itch, and Fatigue as Indicators of Physical Sensitivity

Research into placebo effects has convincingly shown that inducing positive outcome expectations can reduce pain and other physical sensations. However, the comparative effects of different expectation inductions, such as verbal suggestion or mental imagery, and their generic effects on physical sensitivity, to different sensations such as pain, itch, and fatigue, are still largely unknown. In the current study, we assessed the individual and combined effects of verbal suggestion and imagery on pain, itch, and fatigue as indicators of physical sensitivity in a randomized study design. Healthy participants (n = 116) were given an inert (placebo) capsule that was said to be effective for reducing physical sensitivity in either the majority (positive verbal suggestion) or the minority (control verbal suggestion) of users. Subsequently, they imagined either their best possible health (positive imagery) or a typical day (control imagery). Sensitivity to pain, itch, and fatigue was tested using a cold pressor test, histamine iontophoresis, and a bicycle test, respectively. Heart rate and skin conductance were recorded continuously. Results showed that positive verbal suggestion and imagery successfully induced positive expectations, but they did not affect physical sensitivity, as indicated by sensitivity to pain, itch, or fatigue, or concurrent physiological responses. These results could indicate that the specificity and concreteness of expectation inductions might be important for their applicability in the treatment of physical symptoms.

Isolated Hamstrings Fatigue Alters Hip and Knee Joint Coordination during a Cutting Maneuver

The aim of this study was to determine the effects of hamstrings fatigue on lower extremity joint coordination variability during a sidestep cutting maneuver. Twenty female recreational athletes performed five successful trials of a sidestep cutting task preand postfatigue. Each participant completed an isolated hamstrings fatigue protocol consisting of isokinetic maximum effort knee flexion and passive extension contractions. Vector coding was used to examine hip and knee joint couplings (consisting of various planar motions) during the impact and weight acceptance phases of the sidestep cut stance phase. Pairedttests were used to analyze differences of each phase as an effect of fatigue, where alpha was set a priori at .05. The hip rotation/knee rotation coupling exhibited a significant decrease in coordination variability as a function of fatigue in both the impact (P= .015) and weight acceptance phases (P= .043). Similarly, the hip adduction-abduction/knee rotation coupling exhibited a significant decrease in coordination variability in the weight acceptance phase (P= .038). Hamstrings fatigue significantly decreased coordination variability within specific lower extremity joint couplings that included knee rotation. Future studies should be conducted to determine if this decrease in coordination variability is related to lower extremity injury mechanisms.

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.

Incidence and Nature of Medical Attendance Injuries in English Community Rugby Union

BACKGROUND

Previous research has identified injury patterns during community-level rugby union match play, but none have investigated the frequency and reasons for on-field injury management.

PURPOSE

To establish the frequency, reasons, and patterns of on-field injury management in English community rugby, including differences between different levels of play.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

Over 3 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), and 76 (2011-2012) English community clubs (Rugby Football Union [RFU] levels 3-9). Club injury management staff reported information for all medical attendances during match play, including details on the injury site and type, playing position (seasons 2010-2011 and 2011-2012 only), and whether the player was removed from play. Clubs were subdivided into groups A (RFU levels 3 and 4 [mainly semiprofessional]; n = 39), B (RFU levels 5 and 6 [mainly amateur]; n = 71), and C (RFU levels 7-9 [social and recreational]; n = 79) to differentiate playing levels.

RESULTS

The overall medical attendance incidence was 229 per 1000 player-match hours (95% CI, 226-232), with 45 players removed per 1000 player-match hours (95% CI, 44-46). Attendance incidence for group A (294 per 1000 player-match hours; 95% CI, 287-301) was higher compared with group B (213; 95% CI, 208-218; P < .001) and C (204; 95% CI, 200-209; P < .001). There was a higher incidence of attendances to forwards (254; 95% CI, 249-259) compared with backs (191; 95% CI, 187-196; P < .001). The head was the most common specific site of injury (55 per 1000 player-match hours; 95% CI, 53-57) but the lower limb region overall accounted for most attendances (87; 95% CI, 85-89) and the greatest chance of removal from the pitch (22; 95% CI, 21-23).

CONCLUSION

With the likelihood of 1 injury for each team per match severe enough for the player to leave the pitch and with at least 1 attendance for a head injury per match, there is clear evidence that pitch side staff should be trained to recognize potentially serious injuries.