Age-related resistance to skeletal muscle fatigue is preserved during ischemia

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.

The addition of blood flow restriction during resistance exercise does not increase prolonged low-frequency force depression

At a given exercise intensity, blood flow restriction (BFR) reduces the volume of exercise required to impair post-exercise neuromuscular function. Compared to traditional exercise, the time course of recovery is less clear. After strenuous exercise, force output assessed with electrical muscle stimulation is impaired to a greater extent at low versus high stimulation frequencies, a condition known as prolonged low-frequency force depression (PLFFD). It is unclear if BFR increases PLFFD after exercise. This study tested if BFR during exercise increases PLFFD and slows recovery of neuromuscular function compared to regular exercise. Fifteen physically active participants performed six low-load sets of knee-extensions across four conditions: resistance exercise to task failure (RETF), resistance exercise to task failure with BFR applied continuously (BFRCONT) or intermittently (BFRINT), and resistance exercise matched to the lowest exercise volume condition (REVM). Maximal voluntary contraction (MVC) force output, voluntary activation and a force-frequency (1-100 Hz) curve were measured before and 0, 1, 2, 3, 4 and 24 h after exercise. Exercise to task failure caused similar reductions at 0 h for voluntary activation (RETF = 81.0 ± 14.2%, BFRINT = 80.9 ± 12.4% and BFRCONT = 78.6 ± 10.7%) and MVC force output (RETF = 482 ± 168 N, BFRINT = 432 ± 174 N, and BFRCONT = 443 ± 196 N), which recovered to baseline values between 4 and 24 h. PLFFD occurred only after RETF at 1 h supported by a higher frequency to evoke 50% of the force production at 100 Hz (1 h: 17.5 ± 4.4 vs. baseline: 15 ± 4.1 Hz, P = 0.0023), BFRINT (15.5 ± 4.0 Hz; P = 0.03), and REVM (14.9 ± 3.1 Hz; P = 0.002), with a trend versus BFRCONT (15.7 ± 3.5 Hz; P = 0.063). These findings indicate that, in physically active individuals, using BFR during exercise does not impair the recovery of neuromuscular function by 24 h post-exercise.

Muscle fatigue, bioenergetic responses and metabolic economy during load- and velocity-based maximal dynamic contractions in young and older adults

We evaluated whether task-dependent, age-related differences in muscle fatigue (contraction-induced decline in normalized power) develop from differences in bioenergetics or metabolic economy (ME; mass-normalized work/mM ATP). We used magnetic resonance spectroscopy to quantify intracellular metabolites in vastus lateralis muscle of 10 young and 10 older adults during two maximal-effort, 4-min isotonic (20% maximal torque) and isokinetic (120°s-1 ) contraction protocols. Fatigue, inorganic phosphate (Pi), and pH (p ≥ 0.213) differed by age during isotonic contractions. However, older had less fatigue (p ≤ 0.011) and metabolic perturbation (lower [Pi], greater pH; p ≤ 0.031) than young during isokinetic contractions. ME was lower in older than young during isotonic contractions (p ≤ 0.003), but not associated with fatigue in either protocol or group. Rather, fatigue during both tasks was linearly related to changes in [H+ ], in both groups. The slope of fatigue versus [H+ ] was 50% lower in older than young during isokinetic contractions (p ≤ 0.023), consistent with less fatigue in older during this protocol. Overall, regardless of age or task type, acidosis, but not ME, was the primary mechanism for fatigue in vivo. The source of the age-related differences in contraction-induced acidosis in vivo remains to be determined, as does the apparent task-dependent difference in the sensitivity of muscle to [H+ ].

Age-related differences in the neuromuscular performance of fatigue-provoking exercise under severe whole-body hyperthermia conditions

PURPOSE

The purpose of this study was to determine if aging would lead to greater decline in neuromuscular function during a fatiguing task under severe whole-body hyperthermia conditions.

METHODS

Twelve young (aged 19-21 years) and 11 older (aged 65-80 years) males were enrolled in the study, which comprised a randomized control trial under a thermoneutral condition at an ambient temperature of 23°C (CON) and an experimental trial with passive lower body heating in 43°C water (HWI-43°C). Changes in neuromuscular function and fatigability, and physical performance-influencing factors such as psychological, thermoregulatory, neuroendocrine, and immune responses to whole-body hyperthermia were measured.

RESULTS

A slower increase in rectal temperature, and a lower heart rate, thermal sensation, and sweating rate were observed in older males than young males in response to HWI-43°C trial (p < 0.05). Nevertheless, prolactin increased more in response to hyperthermia in young males, while interleukin-6 and cortisol levels increased more in older males (p < 0.05). Peripheral dopamine levels decreased in older males and increased in young males in response to hyperthermia (p < 0.05). Surprisingly, older males demonstrated greater neuromuscular fatigability resistance and faster maximal voluntary contraction (MVC) torque recovery after a 2-min sustained isometric MVC task under thermoneutral and severe hyperthermic conditions (p < 0.05).

CONCLUSION

Neuromuscular performance during fatigue-provoking sustained isometric exercise under severe whole-body hyperthermia conditions appears to decline in both age groups, but a lower relative decline in torque production for older males may relate to lower psychological and thermophysiological strain along with a diminished dopamine response and prolactin release.

Interaction between age and fatigue on antagonist muscle coactivation during an acute post-fatigue recovery phase

This study investigated the age-related changes in antagonist muscle coactivation of the biceps femoris (BF) during an acute recovery period following a leg extensor fatiguing protocol. Twenty-three young (mean ± SD: age = 25.1 ± 3.0 years) and twenty-three old men (age = 71.5 ± 3.9 years) participated. Surface electromyography (sEMG) was recorded from the BF muscles for antagonist muscle coactivation. Testing involved participants performing leg extension isometric maximal voluntary contractions (MVCs) and isokinetic MVCs at 240°·s^-1 at baseline (Pre) and again after the fatigue protocol at 0 (Post0), 7 (Post7), 15 (Post15), and 30 (Post30) minutes post fatigue. Root mean square (RMS) values were computed from the BF sEMG and were calculated as the first 200 ms from onset for the isometric (IsomCoact200ms) and dynamic isokinetic 240°·s^-1 (DynCoact200ms) MVCs, and for the final 10° of the leg extension (DynCoact10°) on the isokinetic 240°·s^-1 MVCs. Two-way ANOVAs [age group (young vs. old) × time (Pre vs. Post0 vs. Post7 vs. Post15 vs. Post30)] showed that DynCoact200ms had an effect for time (p = 0.018), with greater antagonist coactivation in Pre than Post0 (p = 0.009) and recovering by Post7 (p = 0.011) with no group differences. DynCoact10° had no age × time interaction (p = 0.070), but had a main effect for time (p = 0.020) with the Post0 being lower than the Pre. However, for this variable the young group showed a more severe Pre to Post0 fatigue decline (-45.9%) than the old group (-6.7%) indicating this may be a more sensitive variable for capturing age-related antagonist coactivation post-fatigue responses. Leg extensor fatigue affects some BF coactivation sEMG variables more than others, and any altered post-fatigue coactivation response recovers rapidly (<7 min) from baseline levels.

Submaximal isometric fatiguing exercise of the elbow flexors has no age-related effect on GABAB mediated inhibition

Age-related changes in the neuromuscular system can result in differences in fatigability between young and older adults. Previous research has shown that single joint isometric fatiguing exercise of small muscle results in an age-related compensatory decrease in GABA_B mediated inhibition. However, this has yet to be established in a larger muscle group. In 15 young (22 ± 4 years) and 15 older (65 ± 5 years) adults, long interval cortical inhibition (LICI; 100 ms ISI) and corticospinal silent period (SP) were measured in the biceps brachii during a 5% EMG contraction using transcranial magnetic stimulation (TMS) before, during and after a submaximal contraction (30% MVC force) held intermittently to task failure. Both age groups developed similar magnitude of fatigue (~24% decline in MVC; P = 0.001) and ~28% decline in LICI (P = 0.001) post fatiguing exercise. No change in SP duration was observed during and immediately following fatigue (P = 0.909) but ~ 6% decrease was seen at recovery in both age groups (P<0.001)." Contrary to previous work in a small muscle, these findings suggest no age-related differences in GABA_B mediated inhibition following single joint isometric fatiguing exercise of the elbow flexors, indicating that GABA_B modulation with ageing may be muscle group dependent. Furthermore, variations in SP duration and LICI modulation during and post fatigue in both groups suggest that these measures are likely mediated by divergent mechanisms.

Muscle architecture, voluntary activation, and low-frequency fatigue do not explain the greater fatigue of older compared with young women during high-velocity contractions

Although high-velocity contractions elicit greater muscle fatigue in older than young adults, the cause of this difference is unclear. We examined the potential roles of resting muscle architecture and baseline contractile properties, as well as changes in voluntary activation and low-frequency fatigue in response to high-velocity knee extensor work. Vastus lateralis muscle architecture was determined in quiescent muscle by ultrasonography in 8 young (23.4±1.8 yrs) and 8 older women (69.6±1.1). Maximal voluntary dynamic (MVDC) and isometric (MVIC), and stimulated (80Hz and 10Hz, 500ms) isometric contractions were performed before and immediately after 120 MVDCs (240°^.s^-1, one every 2s). Architecture variables did not differ between groups (p≥0.209), but the half-time of torque relaxation (T_1/2) was longer in older than young women at baseline (151.9±6.0 vs. 118.8±4.4 ms, respectively, p = 0.001). Older women fatigued more than young (to 33.6±4.7% vs. 55.2±4.2% initial torque, respectively; p = 0.004), with no evidence of voluntary activation failure (ΔMVIC:80Hz torque) in either group (p≥0.317). Low-frequency fatigue (Δ10:80Hz torque) occurred in both groups (p<0.001), as did slowing of T_1/2 (p = 0.001), with no differences between groups. Baseline T_1/2 was inversely associated with fatigue in older (r² = 0.584, p = 0.045), but not young women (r² = 0.147, p = 0.348). These results indicate that differences in muscle architecture, voluntary activation, and low-frequency fatigue do not explain the greater fatigue of older compared with young women during high-velocity contractions. The inverse association between baseline T_1/2 and fatigue in older women suggests that factors related to slower muscle contractile properties may be protective against fatigue during fast, repetitive contractions in aging.

Single joint fatiguing exercise decreases long but not short-interval intracortical inhibition in older adults

Ageing is accompanied by neuromuscular changes which may alter fatigue in older adults. These changes may include changes in corticospinal excitatory and inhibitory processes. Previous research has suggested that single joint fatiguing exercise decreases short-(SICI) and long-(LICI) interval intracortical inhibition in young adults. However, this is yet to be established in older adults. In 19 young (23 ± 4 years) and 18 older (69 ± 5 years) adults, SICI (2 ms interstimulus interval; ISI) and LICI (100 ms ISI) were measured in a resting first dorsal interosseous (FDI) muscle using transcranial magnetic stimulation (TMS) before and after a 15 min sustained submaximal contraction at 25% of their maximum EMG. Subsequent ten 2-min contractions held at 25% EMG were also performed to sustain fatigue for a total of 30 min, while SICI and LICI were taken immediately after each contraction. There was no change in SICI post-fatiguing exercise compared to baseline in both young and older adults (P = 0.4). Although there was no change in LICI post-fatiguing exercise in younger adults (P = 1.0), LICI was attenuated in older adults immediately post-fatiguing exercise and remained attenuated post-fatigue (PF)1 and PF2 (P < 0.05). Contrary to previous studies, the lack of change in SICI and LICI in young adults following a sustained submaximal EMG contraction suggests that GABA modulation may be dependent on the type of fatiguing task performed. The reduction in LICI in older adults post-fatiguing exercise suggests an age-related decrease in GABA_B-mediated activity with sustained submaximal fatiguing exercise.

Age-related Deficits in Voluntary Activation: A Systematic Review and Meta-analysis

Whether there are age-related differences in neural drive during maximal effort contractions is not clear. This review determined the effect of age on voluntary activation during maximal voluntary isometric contractions. The literature was systematically reviewed for studies reporting voluntary activation quantified with the interpolated twitch technique (ITT) or central activation ratio (CAR) during isometric contractions in young (18-35 yr) and old adults (>60 yr; mean, ≥65 yr). Of the 2697 articles identified, 54 were eligible for inclusion in the meta-analysis. Voluntary activation was assessed with electrical stimulation and transcranial magnetic stimulation on five different muscle groups. Random-effects meta-analysis revealed lower activation in old compared with young adults (d = -0.45; 95% confidence interval, -0.62 to -0.29; P < 0.001), with moderate heterogeneity (52.4%). To uncover the sources of heterogeneity, subgroup analyses were conducted for muscle group, calculation method (ITT or CAR), and stimulation type (electrical stimulation or transcranial magnetic stimulation) and number (single, paired, or train stimulations). The age-related reduction in voluntary activation occurred for all muscle groups investigated except the ankle dorsiflexors. Both ITT and CAR demonstrated an age-related reduction in voluntary activation of the elbow flexors, knee extensors, and plantar flexors. ITT performed with paired and train stimulations showed lower activation for old than young adults, with no age difference for the single electrical stimulation. Together, the meta-analysis revealed that healthy older adults have a reduced capacity to activate some upper and lower limb muscles during maximal voluntary isometric contractions; however, the effect was modest and best assessed with at least paired stimulations to detect the difference.

Is there an intermuscular relationship in voluntary activation capacities and contractile kinetics?

PURPOSE

The force-generating capacities of human skeletal muscles are interrelated, highlighting a common construct of limb strength. This study aimed to further determine whether there is an intermuscular relationship in maximal voluntary activation capacities and contractile kinetics of human muscles.

METHODS

Twenty-six young healthy individuals participated in this study. Isometric maximal voluntary contraction (MVC) torque, voluntary activation level (VAL), and doublet twitch contractile kinetics (contraction time and half-relaxation time) evoked by a paired supramaximal peripheral nerve stimulation at 100 Hz were obtained in elbow flexors, knee extensors, plantar flexors and dorsiflexors of the dominant limb.

RESULTS

Peak MVC torque had significant positive correlations between all muscle group pairs (all P values < 0.01). A significant positive correlation for VAL was found only between knee extensors and plantar flexors (r = 0.60, P < 0.01). There were no significant correlations between all muscle group pairs for doublet twitch contraction time and doublet twitch half-relaxation time.

DISCUSSION

These results show that there is a partial common construct of maximal voluntary activation capacities that only concerns muscle groups that have incomplete activation during MVC (i.e., knee extensors and plantar flexors). This suggests that the common construct of MVC strength between these two muscle groups is partly influenced by neural mechanisms. The lack of intermuscular relationship of contractile kinetics showed that there is no common construct of muscle contractile kinetics, as assessed in vivo by investigating the time-course of evoked doublet twitch contractions.

Torque steadiness and neuromuscular responses following fatiguing concentric exercise of the knee extensor and flexor muscles in young and older individuals

The purpose of this study was to investigate the age-related alterations in the ability to exert maximal and to sustain submaximal isometric muscle torques after a fatiguing concentric exercise conducted with knee extensor (KE) and flexor (KF) muscles. Sixteen young (aged 19-30 years; 8 women) and 17 older (aged 65-75 years; 9 women) volunteers participated. The following tasks were performed before and immediately after 22 maximal concentric efforts of the right KE and KF at 1.05 rad/s: (1) a maximal voluntary isometric contraction (MVIC) task involving both KE and KF; and (2) a KE torque-steadiness task at a submaximal target contraction intensity (20% MVIC). During the dynamometric tests, surface EMG was recorded simultaneously from the KE and KF muscles. Fatigue-induced reductions in knee extension MVIC were similar (~15%) between groups, but young participants showed more pronounced declines in agonist (i.e. quadriceps) EMG responses in both time (RMS amplitude; ~15% vs. ~10%, p < 0.001) and frequency (median frequency; ~14% vs. ~8%, p < 0.01) domains. Torque steadiness exhibited a similar post-fatigue decrease in the two age groups (p < 0.01), but interestingly agonist activation (~17%; p < 0.001) and antagonist (i.e. hamstrings) co-activation (~16%; p < 0.001) declined only in the older participants. These findings suggest that the fatiguing concentric KE and KF exercise results in similar relative reductions (%) in maximal torque and steadiness of the KE in young and older individuals, but they are sustained by different age-related neuromuscular strategies.

Modification of a three-compartment muscle fatigue model to predict peak torque decline during intermittent tasks

This study aimed to test whether adding a rest recovery parameter, r, to the analytical three-compartment controller (3CC) fatigue model (Xia and Frey Law, 2008) will improve fatigue estimates during intermittent contractions. The 3CC muscle fatigue model uses differential equations to predict the flow of muscle between three muscle states: Resting (MR), Active (MA), and Fatigued (MF). This model uses a feedback controller to match the active state to target loads and two joint-specific parameters: F, fatigue rate controlling flow from active to fatigued compartments) and R, the recovery rate controlling flow from the fatigued to the resting compartments. This model does well to predict intensity-endurance time curves for sustained isometric tasks. However, previous studies find when rest intervals are present that the model over predicts fatigue. Intermittent rest periods would allow for the occurrence of subsequent reactive vasodilation and post-contraction hyperemia. We hypothesize a modified 3CC-r fatigue model will improve predictions of force decay during intermittent contractions with the addition of a rest recovery parameter, r, to augment recovery during rest intervals, representing muscle re-perfusion. A meta-analysis compiling intermittent fatigue data from 63 publications reporting decline in peak torque (% torque decline) were used for comparison. The original model over-predicted fatigue development from 19 to 29% torque decline; the addition of a rest multiplier significantly improved fatigue estimates to 6-10% torque decline. We conclude the addition of a rest multiplier to the three-compartment controller fatigue model provides a physiologically consistent modification for tasks involving rest intervals, resulting in improved estimates of muscle fatigue.

Acute effect of different exercise intensities and differences related to age on muscle performance in young and older women

BACKGROUND

The aim of this study was to compare the acute effect of different exercise intensities on the number of repetitions and total volume and differences related to age on the fatigue index.

METHODS

Twelve young women (19.0±1.6 years) and ten older women (66.6±5.8 years) performed two experimental sessions for the elbow flexor muscles in a balanced cross-over design. In one experimental session, the participants performed three sets to concentric muscle failure at 100% of 10-12 maximum repetitions (RM). In the other experimental session, the participants performed two sets of 12 repetitions and one final set until concentric muscle failure at 90% of 10-12 RM. A 90-second rest interval was adopted between sets.

RESULTS

The session performed at 90% of 10-12 RM showed a higher number of repetitions in the second and third sets and a greater total volume, compared to the session at 100% of 10-12 RM for both young and older women (all P<0.05). However, significant no differences were observed in the fatigue index between the young and older women for the sessions performed at 90% or 100% of 10-12 RM (P>0.05).

CONCLUSIONS

These findings suggest that a 10% load reduction promotes a greater number of repetitions and higher total volume in young and older adults. Moreover, the results indicate that young and older women present the same Fatigue Index for the elbow flexor muscles.

Skeletal muscle performance and ageing

The world population is ageing rapidly. As society ages, the incidence of physical limitations is dramatically increasing, which reduces the quality of life and increases healthcare expenditures. In western society, ~30% of the population over 55 years is confronted with moderate or severe physical limitations. These physical limitations increase the risk of falls, institutionalization, co-morbidity, and premature death. An important cause of physical limitations is the age-related loss of skeletal muscle mass, also referred to as sarcopenia. Emerging evidence, however, clearly shows that the decline in skeletal muscle mass is not the sole contributor to the decline in physical performance. For instance, the loss of muscle strength is also a strong contributor to reduced physical performance in the elderly. In addition, there is ample data to suggest that motor coordination, excitation-contraction coupling, skeletal integrity, and other factors related to the nervous, muscular, and skeletal systems are critically important for physical performance in the elderly. To better understand the loss of skeletal muscle performance with ageing, we aim to provide a broad overview on the underlying mechanisms associated with elderly skeletal muscle performance. We start with a system level discussion and continue with a discussion on the influence of lifestyle, biological, and psychosocial factors on elderly skeletal muscle performance. Developing a broad understanding of the many factors affecting elderly skeletal muscle performance has major implications for scientists, clinicians, and health professionals who are developing therapeutic interventions aiming to enhance muscle function and/or prevent mobility and physical limitations and, as such, support healthy ageing.

Effects of age and sex on fatigability and recovery from a sustained maximal isometric voluntary contraction

The aim was to assess the effects of sex and age on fatigability and recovery from sustained maximal voluntary contraction (MVC) of the knee extensor muscles. The central (central activation ratio (CAR) and electrical activity amplitude) and peripheral (electrically evoked torque and muscle contractile properties) factors contributing to fatigue and recovery of 24 young adults (12 males) aged 23.2±3.6years and 20 older adults (12 males) aged 70.6±4.4years were compared. The increase in central and peripheral fatigue was greater (p⩽0.01) in the young adults vs the older adults. Sex differences (p=0.002) regarding MVC were attributed to the greater (p<0.01) peripheral fatigue of males vs females. The recovery rate of MVC was greater (p<0.001) in the young adults vs the older adults, with no sex effect. The recovery of MVC was correlated with the CAR in older adults (p=0.001). Thus, the greater endurance observed with age is caused by differences in central and peripheral mechanisms, whereas the greater endurance in females is caused by a difference in a mechanism located within the muscle. The impaired recovery from fatigue in older adults relied more on the recovery of central factors.

Mechanisms of in vivo muscle fatigue in humans: investigating age-related fatigue resistance with a computational model

KEY POINTS

Muscle fatigue can be defined as the transient decrease in maximal force that occurs in response to muscle use. Fatigue develops because of a complex set of changes within the neuromuscular system that are difficult to evaluate simultaneously in humans. The skeletal muscle of older adults fatigues less than that of young adults during static contractions. The potential sources of this difference are multiple and intertwined. To evaluate the individual mechanisms of fatigue, we developed an integrative computational model based on neural, biochemical, morphological and physiological properties of human skeletal muscle. Our results indicate first that the model provides accurate predictions of fatigue and second that the age-related resistance to fatigue is due largely to a lower reliance on glycolytic metabolism during contraction. This model should prove useful for generating hypotheses for future experimental studies into the mechanisms of muscle fatigue.

ABSTRACT

During repeated or sustained muscle activation, force-generating capacity becomes limited in a process referred to as fatigue. Multiple factors, including motor unit activation patterns, muscle fibre contractile properties and bioenergetic function, can impact force-generating capacity and thus the potential to resist fatigue. Given that neuromuscular fatigue depends on interrelated factors, quantifying their independent effects on force-generating capacity is not possible in vivo. Computational models can provide insight into complex systems in which multiple inputs determine discrete outputs. However, few computational models to date have investigated neuromuscular fatigue by incorporating the multiple levels of neuromuscular function known to impact human in vivo function. To address this limitation, we present a computational model that predicts neural activation, biomechanical forces, intracellular metabolic perturbations and, ultimately, fatigue during repeated isometric contractions. This model was compared with metabolic and contractile responses to repeated activation using values reported in the literature. Once validated in this way, the model was modified to reflect age-related changes in neuromuscular function. Comparisons between initial and age-modified simulations indicated that the age-modified model predicted less fatigue during repeated isometric contractions, consistent with reports in the literature. Together, our simulations suggest that reduced glycolytic flux is the greatest contributor to the phenomenon of age-related fatigue resistance. In contrast, oxidative resynthesis of phosphocreatine between intermittent contractions and inherent buffering capacity had minimal impact on predicted fatigue during isometric contractions. The insights gained from these simulations cannot be achieved through traditional in vivo or in vitro experimentation alone.

Effects of age and muscle action type on acute strength and power recovery following fatigue of the leg flexors

Short-term strength and power recovery patterns following fatigue have received little research attention, particularly as they pertain to age-specific responses, and the leg flexors (i.e., hamstrings) muscle group. Thus, research is warranted addressing these issues because both age-related alterations in the neuromuscular system and mode of muscle action (e.g., eccentric, concentric, isometric) may differentially influence recovery responses from fatigue. The aim of this study was to investigate the strength and power recovery responses for eccentric, concentric, and isometric muscle actions of the leg flexors in young and older men following an isometric, intermittent fatigue-inducing protocol. Nineteen young (age = 25 ± 3 years) and nineteen older (71 ± 4) men performed maximal voluntary contractions (MVCs) for eccentric, concentric, and isometric muscle actions followed by a fatigue protocol of intermittent (0.6 duty cycle) isometric contractions of the leg flexors at 60% of isometric MVC. MVCs of each muscle action were performed at 0, 7, 15, and 30 min following fatigue. Peak torque (PT) and mean power values were calculated from the MVCs and the eccentric/concentric ratio (ECR) was derived. For PT and mean power, young men showed incomplete recovery at all time phases, whereas the older men had recovered by 7 min. Eccentric and isometric muscle actions showed incomplete recovery at all time phases, but concentric recovered by 7 min, independent of age. The ECR was depressed for up to 30 min following fatigue. More rapid and pronounced recovery in older men and concentric contractions may be related to physiological differences specific to aging and muscle action motor unit patterns. Individuals and clinicians may use these time course responses as a guide for recovery following activity-induced fatigue.

Intensity-dependent effect of ageing on fatigue during intermittent contractions of the human calf muscle in males and females

Ageing reduces fatigue during submaximal intermittent contractions, but the influence of intensity on this ageing effect in males and females is not clear. Younger males (n = 8; 23 ± 2 years), younger females (n = 8; 22 ± 1 years), older males (n = 8; 67 ± 5 years) and older females (n = 10; 64 ± 7 years) completed intermittent calf contractions at four submaximal intensities (30-70 %MVC) for up to 20 min. MVC was assessed during exercise at 30-60 s intervals and its linear rate of decline represented fatigue. Individual relationships between intensity and fatigue (%MVC min(-1)) were fitted to a biphasic function consisting of a linear and nonlinear component. There was no age × sex × intensity interaction for fatigue (3-way ANOVA, P = 0.46). However, there were significant interactive effects of age and sex on endurance at 70 %MVC, fatigue at 70 %MVC and the linear component of the intensity-fatigue relationship. Endurance was lower and fatigue and its linear component were greater (P < 0.05) in younger males compared with other groups, but not different between younger and older females. This suggests that there is an intensity-dependent effect of human ageing on fatigue during submaximal exercise that is specific to males.

Skeletal muscle fatigue

Skeletal muscle fatigue is defined as the fall of force or power in response to contractile activity. Both the mechanisms of fatigue and the modes used to elicit it vary tremendously. Conceptual and technological advances allow the examination of fatigue from the level of the single molecule to the intact organism. Evaluation of muscle fatigue in a wide range of disease states builds on our understanding of basic function by revealing the sources of dysfunction in response to disease.

Factors contributing to the fatigue-related reduction in active dorsiflexion joint range of motion

Reductions in active joint range of motion (ROM) are responsible for decreased work-generating capacity during fatiguing repetitive isotonic shortening contractions. Factors responsible for impairing the joint-angle-specific net torque developed during muscle shortening could include fatigue-induced torque loss, shortening-induced torque depression in the agonist muscle, and opposing passive tension of the antagonists, but these have not been systematically explored. Nine men (aged 25.8 ± 2.0 years) performed a maximal-effort fatiguing task that consisted of repetitive loaded shortening dorsiflexions through a 40° ankle joint ROM until active ROM decreased by 50%. Torque developed during contractile shortening, as well as passive opposing tension, was quantified before and after the reduction in active ROM. Before fatigue, and compared with maximum voluntary isometric contraction torque at the terminal ROM, shortening-induced torque depression in the agonist muscle and passive tension from the antagonists reduced net torque developed at the end of contractile shortening by ∼42% and ∼19%, respectively. After fatigue, a steepened ascending joint torque–angle relationship remained during contractile shortening, but neither muscle coactivation nor contractile slowing contributed to the fatigue-induced torque loss. Fatigue-induced torque loss, shortening-induced torque depression in the agonist, and passive tension in the antagonist greatly depressed net torque developed at the end of contractile shortening. These contributed to the fatigue-induced reduction in active ROM by impairing the ability of the dorsiflexors to generate sufficient torque to overcome the imposed load at the end of contractile shortening.

What is dynapenia?

Dynapenia (pronounced dahy-nuh-pē-nē-a, Greek translation for poverty of strength, power, or force) is the age-associated loss of muscle strength that is not caused by neurologic or muscular diseases. Dynapenia predisposes older adults to an increased risk for functional limitations and mortality. For the past several decades, the literature has largely focused on muscle size as the primary cause of dynapenia; however, recent findings have clearly demonstrated that muscle size plays a relatively minor role. Conversely, subclinical deficits in the structure and function of the nervous system and/or impairments in the intrinsic force-generating properties of skeletal muscle are potential antecedents to dynapenia. This review highlights in the contributors to dynapenia and the etiology and risk factors that predispose individuals to dynapenia. In addition, we address the role of nutrition in the muscular and neurologic systems for the preservation of muscle strength throughout the life span.

Age-related changes in motor cortical properties and voluntary activation of skeletal muscle

Aging is associated with dramatic reductions in muscle strength and motor control, and many of these agerelated changes in muscle function result from adaptations in the central nervous system. Aging is associated with widespread qualitative and quantitative changes of the motor cortex. For example, advancing age has been suggested to result in cortical atrophy, reduced cortical excitability, reduced cortical plasticity, as well as neurochemical abnormalities.The associated functional effects of these changes likely influence numerous aspects of muscle performance such as muscle strength and motor control. For example, there is evidence to suggest that the muscle weakness associated with aging is partially due to impairments in the nervous system's ability to fully activate motor neurons- particularly in the larger proximal muscle groups. In this review article we discuss age-related changes in the motor cortex, as well as the abilityor lack thereof- of older adults to voluntarily activate skeletal muscle. We also provide perspectives on scientific and clinical questions that need to be addressed in the near future.

Effects of age and localized muscle fatigue on ankle plantar flexor torque development

BACKGROUND AND PURPOSE

Older adults often experience age-related declines in strength, which contribute to fall risk. Such age-related levels of fall risk may be compounded by further declines in strength caused by acute muscle fatigue. Both age- and fatigue-related strength reductions likely impact the ability to quickly develop joint torques needed to arrest falls. Therefore, the purpose of this study was to investigate the combined effects of age and localized muscle fatigue on lower extremity joint torque development.

METHODS

Young (mean age, 26 (2.5) years) and older (mean age, 71 (2.8) years) healthy male adults performed an isometric ankle plantar flexion force control task before and after an ankle plantar flexor fatiguing exercise. Force control performance was quantified using onset time, settling time, and rate of torque development.

RESULTS

Age-related increases and decreases were observed for onset time and rate of torque development, respectively. A fatigue-related decrease in rate of torque development was observed in young, but not older adults.

DISCUSSION

The results suggest performance declines that may relate to older adults' reduced ability to prevent falls. A fatigue-related performance decline was observed among young adults, but not older, suggesting the presence of age-related factors such as motor unit remodeling and alterations in perceived exertion.

CONCLUSIONS

Older adults demonstrated an overall reduction in the ability to quickly produce ankle torque, which may have implications for balance recovery and fall risk among older adults.

Evolving concepts on the age-related changes in "muscle quality"

The deterioration of skeletal muscle with advancing age has long been anecdotally recognized and has been of scientific interest for more than 150 years. Over the past several decades, the scientific and medical communities have recognized that skeletal muscle dysfunction (e.g., muscle weakness, poor muscle coordination, etc.) is a debilitating and life-threatening condition in the elderly. For example, the age-associated loss of muscle strength is highly associated with both mortality and physical disability. It is well-accepted that voluntary muscle force production is not solely dependent upon muscle size, but rather results from a combination of neurologic and skeletal muscle factors, and that biologic properties of both of these systems are altered with aging. Accordingly, numerous scientists and clinicians have used the term "muscle quality" to describe the relationship between voluntary muscle strength and muscle size. In this review article, we discuss the age-associated changes in the neuromuscular system-starting at the level of the brain and proceeding down to the subcellular level of individual muscle fibers-that are potentially influential in the etiology of dynapenia (age-related loss of muscle strength and power).

Effect of old age on human skeletal muscle force-velocity and fatigue properties

It is generally accepted that the muscles of aged individuals contract with less force, have slower relaxation rates, and demonstrate a downward shift in their force-velocity relationship. The factors mediating age-related differences in skeletal muscle fatigue are less clear. The present study was designed to test the hypothesis that age-related shifts in the force-velocity relationship impact the fatigue response in a velocity-dependent manner. Three fatigue protocols, consisting of intermittent, maximum voluntary knee extension contractions performed for 4 min, were performed by 11 young (23.5 ± 0.9 yr, mean ± SE) and 10 older (68.9 ± 4.3) women. The older group fatigued less during isometric contractions than the young group (to 71.1 ± 3.7% initial torque and 59.8 ± 2.5%, respectively; P = 0.02), while the opposite was true during contractions performed at a relatively high angular velocity of 270°·s(-1) (old: 28.0 ± 3.9% initial power, young: 52.1 ± 6.9%; P < 0.01). Fatigue was not different (P = 0.74) between groups during contractions at an intermediate velocity, which was selected for each participant based on their force-velocity relationship. There was a significant association between force-velocity properties and fatigue induced by the intermediate-velocity fatigue protocol in the older (r = 0.72; P = 0.02) and young (r = 0.63; P = 0.04) groups. These results indicate that contractile velocity has a profound impact on age-related skeletal muscle fatigue resistance and suggest that changes in the force-velocity relationship partially mediate this effect.

Age-related differences in muscle fatigue vary by contraction type: a meta-analysis

BACKGROUND

During senescence, despite the loss of strength (force-generating capability) associated with sarcopenia, muscle endurance may improve for isometric contractions.

PURPOSE

The purpose of this study was to perform a systematic meta-analysis of young versus older adults, considering likely moderators (ie, contraction type, joint, sex, activity level, and task intensity).

DATA SOURCES

A 2-stage systematic review identified potential studies from PubMed, CINAHL, PEDro, EBSCOhost: ERIC, EBSCOhost: Sportdiscus, and The Cochrane Library.

STUDY SELECTION

Studies reporting fatigue tasks (voluntary activation) performed at a relative intensity in both young (18-45 years of age) and old (≥ 55 years of age) adults who were healthy were considered.

DATA EXTRACTION

Sample size, mean and variance outcome data (ie, fatigue index or endurance time), joint, contraction type, task intensity (percentage of maximum), sex, and activity levels were extracted.

DATA SYNTHESIS

Effect sizes were (1) computed for all data points; (2) subgrouped by contraction type, sex, joint or muscle group, intensity, or activity level; and (3) further subgrouped between contraction type and the remaining moderators. Out of 3,457 potential studies, 46 publications (with 78 distinct effect size data points) met all inclusion criteria.

LIMITATIONS

A lack of available data limited subgroup analyses (ie, sex, intensity, joint), as did a disproportionate spread of data (most intensities ≥ 50% of maximum voluntary contraction).

CONCLUSIONS

Overall, older adults were able to sustain relative-intensity tasks significantly longer or with less force decay than younger adults (effect size=0.49). However, this age-related difference was present only for sustained and intermittent isometric contractions, whereas this age-related advantage was lost for dynamic tasks. When controlling for contraction type, the additional modifiers played minor roles. Identifying muscle endurance capabilities in the older adult may provide an avenue to improve functional capabilities, despite a clearly established decrement in peak torque.

Systematic review and meta-analysis of skeletal muscle fatigue in old age

Despite intense interest in understanding how old age may alter skeletal muscle fatigability, a quantitative examination of the impact of study design on age-related differences in muscle fatigue does not exist.

PURPOSE

The purpose of this study was to conduct a systematic review of the differences in muscle fatigue between young and older adults, with specific examination of moderator variables suggested to contribute to discrepancies across studies: contraction intensity, contraction mode, duty cycle, fatigue index, sex, muscle group, and contraction type.

METHODS

The standardized effect of age on muscle fatigue was computed for 37 studies (60 standardized effects). Standardized effects were coded as positive when less fatigue was reported in older individuals compared with young individuals.

RESULTS

The overall standardized effect of age on muscle fatigue was positive (0.56). In studies using dynamic contractions or using muscle power as the index of fatigue, the standardized effect was negative (-0.12 and -2.5, respectively). The standardized effect for all other moderator categories was positive (range = 0.09-0.90), indicating less fatigue in older adults under all other methodological conditions.

CONCLUSION

This review provides the first quantitative analysis of the effect of study design on age-related differences in muscle fatigue. The results indicate that older individuals develop less muscle fatigue than young individuals, particularly during isometric contractions of the elbow flexor and knee extensor muscles. However, the results also suggest that older adults develop greater fatigue during dynamic contractions, particularly when the decline in power is assessed. Studies that verify this latter outcome are needed, as are studies designed to elucidate the mechanisms of fatigue.

Age, muscle fatigue, and walking endurance in pre-menopausal women

Aging is associated with loss of endurance; however, aging is also associated with decreased fatigue during maximal isometric contractions. The aims of this study were to examine the relationship between age and walking endurance (WE) and maximal isometric fatigue (MIF) and to determine which metabolic/fitness components explain the expected age effects on WE and MIF. Subjects were 96 pre-menopausal women. Oxygen uptake (walking economy) was assessed during a 3-mph walk; aerobic capacity and WE by progressive treadmill test; knee extension strength by isometric contractions, MIF during a 90-s isometric plantar flexion (muscle metabolism measured by (31)P MRS). Age was related to increased walking economy (low VO(2), r = -0.19, P < 0.03) and muscle metabolic economy (force/ATP, 0.34, P = 0.01), and reduced MIF (-0.26, P < 0.03). However, age was associated with reduced WE (-0.28, P < 0.01). Multiple regression showed that muscle metabolic economy explained the age-related decrease in MIF (partial r for MIF and age -0.13, P = 0.35) whereas walking economy did not explain the age-related decrease in WE (partial r for WE and age -0.25, P < 0.02). Inclusion of VO(2max) and knee endurance strength accounted for the age-related decreased WE (partial r for WE and age = 0.03, P > 0.80). In premenopausal women, age is related to WE and MIF. In addition, these results support the hypothesis that age-related increases in metabolic economy may decrease MIF. However, decreased muscle strength and oxidative capacity are related to WE.

Bedside-to-Bench conference: research agenda for idiopathic fatigue and aging

The American Geriatrics Society, with support from the National Institute on Aging and the John A. Hartford Foundation, held its fifth Bedside-to-Bench research conference, "Idiopathic Fatigue and Aging," to provide participants with opportunities to learn about cutting-edge research developments, draft recommendations for future research, and network with colleagues and leaders in the field. Fatigue is a symptom that older persons, especially by those with chronic diseases, frequently experience. Definitions and prevalence of fatigue may vary across studies, across diseases, and even between investigators and patients. The focus of this review is on physical fatigue, recognizing that there are other related domains of fatigue (such as cognitive fatigue). Many definitions of fatigue involve a sensation of "low" energy, suggesting that fatigue could be a disorder of energy balance. Poor energy utilization efficiency has not been considered in previous studies but is likely to be one of the most important determinants of fatigue in older individuals. Relationships between activity level, capacity for activity, a tolerable rate of activity, and a tolerable fatigue threshold or ceiling underlie a notion of fatiguability. Mechanisms probably contributing to fatigue in older adults include decline in mitochondrial function, alterations in brain neurotransmitters, oxidative stress, and inflammation. The relationships between muscle function and fatigue are complex. A number of diseases (such as cancer) are known to cause fatigue and may serve as models for how underlying impaired physiological processes contribute to fatigue, particularly those in which energy utilization may be an important factor. A further understanding of fatigue will require two key strategies: to develop and refine fatigue definitions and measurement tools and to explore underlying mechanisms using animal and human models.

Consequences of lower extremity and trunk muscle fatigue on balance and functional tasks in older people: a systematic literature review

Background

Muscle fatigue reduces muscle strength and balance control in young people. It is not clear whether fatigue resistance seen in older persons leads to different effects. In order to understand whether muscle fatigue may increase fall risk in older persons, a systematic literature review aimed to summarize knowledge on the effects of lower extremity and trunk muscle fatigue on balance and functional tasks in older people was performed.

Methods

Studies were identified with searches of the PUBMED and SCOPUS data bases.

Papers describing effects of lower extremity or trunk muscle fatigue protocols on balance or functional tasks in older people were included. Studies were compared with regards to study population characteristics, fatigue protocol, and balance and functional task outcomes.

Results

Seven out of 266 studies met the inclusion criteria. Primary findings were: fatigue via resistance exercises to lower limb and trunk muscles induces postural instability during quiet standing; induced hip, knee and ankle muscle fatigue impairs functional reach, reduces the speed and power of sit-to-stand repetitions, and produces less stable and more variable walking patterns; effects of age on degree of fatigue and rate of recovery from fatigue are inconsistent across studies, with these disparities likely due to differences in the fatigue protocols, study populations and outcome measures.

Conclusion

Taken together, the findings suggest that balance and functional task performance are impaired with fatigue. Future studies should assess whether fatigue is related to increased risk of falling and whether exercise interventions may decrease fatigue effects.

Voluntary activation of the infraspinatus muscle in nonfatigued and fatigued states

HYPOTHESIS

Failure of voluntary activation is an important source of weakness in several different muscles after injury or surgery. Despite the high prevalence of shoulder rotator cuff disorders and associated weakness, no test currently exists to identify voluntary activation deficits for the rotator cuff. The purpose of this study was to develop a test to quantify voluntary activation of the infraspinatus. We hypothesized that there would be a consistent relationship between the voluntary activation level and different force levels and that reduced voluntary activation would partially account for reduced force with fatigue.

MATERIALS AND METHODS

Twenty healthy volunteers underwent assessment of voluntary activation using an electrical stimulus applied to the infraspinatus muscle during active isometric external rotation. Voluntary activation was assessed across several levels of external rotation effort and during fatigue.

RESULTS

The voluntary activation-percent force relationship was best fit using a curvilinear model, and the fatigue test reduced both force and voluntary activation by 46%.

DISCUSSION

In the nonfatigued state, the voluntary activation-percent force relationship is similar to that reported for the quadriceps. After fatigue, however, greater failure of voluntary activation was observed compared with reported values for other upper and lower extremity muscles, which may have implications for the understanding and treatment of rotator cuff pathology.

CONCLUSION

A measure of voluntary activation for the infraspinatus varied with the percent maximum force in a predictable manner that is consistent with the literature. The infraspinatus may be more susceptible to failure of voluntary activation during fatigue than other muscles.

Lower energy cost of skeletal muscle contractions in older humans

Recent studies suggest that the cost of muscle contraction may be reduced in old age, which could be an important mediator of age-related differences in muscle fatigue under some circumstances. We used phosphorus magnetic resonance spectroscopy and electrically elicited contractions to examine the energetic cost of ankle dorsiflexion in 9 young (Y; 26 +/- 3.8 yr; mean +/- SD) and 9 older healthy men (O; 72 +/- 4.6). We hypothesized that the energy cost of twitch and tetanic contractions would be lower in O and that this difference would be greater during tetanic contractions at f(50) (frequency at 50% of peak force from force-frequency relationship) than at 25 Hz. The energy costs of a twitch (O = 0.13 +/- 0.04 mM ATP/twitch, Y = 0.18 +/- 0.06; P = 0.045) and a 60-s tetanus at 25 Hz (O = 1.5 +/- 0.4 mM ATP/s, Y = 2.0 +/- 0.2; P = 0.01) were 27% and 26% lower in O, respectively, while the respective force.time integrals were not different. In contrast, energy cost during a 90-s tetanus at f(50) (O = 10.9 +/- 2.0 Hz, Y = 14.8 +/- 2.1 Hz; P = 0.002) was 49% lower in O (1.0 +/- 0.2 mM ATP/s) compared with Y (1.9 +/- 0.2; P < 0.001). Y had greater force potentiation during the f(50) protocol, which accounted for the greater age difference in energy cost at f(50) compared with 25 Hz. These results provide novel evidence of an age-related difference in human contractile energy cost in vivo and suggest that intramuscular changes contribute to the lower cost of contraction in older muscle. This difference in energetics may provide an important mechanism for the enhanced fatigue resistance often observed in older individuals.

Age-related fatigue resistance in the knee extensor muscles is specific to contraction mode

The question of whether skeletal muscle fatigue is preserved or enhanced in older adults is a point of controversy. Disparate findings may be attributed to differences in subject population and study protocols, including contraction mode. The purpose of this study was to test the hypotheses that healthy older (65-80 years of age, 8 males and 8 females) adults who were matched to young adults (21-35 years of age; 8 males and 8 females) with similar physical activity levels would: (1) fatigue less during isometric knee extensor (KE) contractions, but (2) would show similar fatigue during dynamic KE contractions performed at 120 degrees s(-1). Fatigue was induced with 4 minutes of intermittent, isometric, or dynamic maximal voluntary contractions, performed on separate days. Electrically stimulated contractions were used to evaluate central activation during both fatigue protocols. Older subjects maintained a higher percentage of baseline maximum voluntary contraction (MVC) torque than young subjects during isometric contractions (mean +/- SE: 71 +/- 3% and 57 +/- 3%, respectively, P < 0.01). In contrast, there was no difference between age groups in torque maintenance during dynamic contractions (43 +/- 3% and 44 +/- 3%, respectively, P = 0.86). For both groups, changes in electrically stimulated and voluntary contractions followed similar trends, suggesting that central activation did not play a role in the age-related differences in fatigue. Fatigue during the isometric protocol was associated with fatigue during the dynamic protocol in the young group only (r = 0.62, P = 0.01), suggesting that distinct mechanisms influence fatigue during isometric and dynamic contractions in older adults. Muscle Nerve 39: 692-702, 2009.

Skeletal muscle fatigue in old age: whose advantage?

The results of recent studies indicate that in healthy men and women aged beyond approximately 65 years, the energy-producing pathways in skeletal muscle may combine with changes in motor unit behavior and muscle contractile properties to provide a unique environment for resisting muscle fatigue under some conditions.

Recovery from supraspinal fatigue is slowed in old adults after fatiguing maximal isometric contractions

This study compared the contribution of supraspinal fatigue to muscle fatigue in old and young adults. Transcranial magnetic stimulation (TMS) of motor cortex was used to assess voluntary activation during maximal voluntary contractions (MVCs) of elbow flexor muscles in 17 young adults (25.5 +/- 3.6 yr; mean +/- SD) and 7 old adults (73.0 +/- 3.3 yr). Subjects performed a fatigue task involving six sustained MVCs (22-s duration, separated by 10 s). Young adults exhibited greater reductions in maximal voluntary torque (67 +/- 15% of baseline) than the old (37 +/- 6%; P < 0.001). Increments in torque (superimposed twitch) generated by TMS during sustained MVCs increased for the young and old (P < 0.001) but were larger for the old adults at the start of the sustained contractions and during recovery (P < 0.05). Voluntary activation was less for the old adults at the start of some sustained contractions and during recovery (P = 0.02). Motor-evoked potential area increased similarly with age during the fatiguing task but was greater for the old adults than young during recovery. Silent period duration lengthened less for the old adults during the fatigue task. At the end of the fatiguing task, peak relaxation rate of muscle fibers had declined more in the young than the old adults. The greater endurance with age is largely due to a difference in mechanisms located within the muscle. However, recovery from the fatiguing exercise is impaired for old adults because of greater supraspinal fatigue than in the young.