Sex Differences in Mechanisms of Recovery after Isometric and Dynamic Fatiguing Tasks

Effects of Different Recovery Periods Following a Very Intense Interval Training Session on Strength and Explosive Performance in Elite Female Ice Hockey Players

ABSTRACT

Petré, H, Tinmark, F, Rosdahl, H, and Psilander, N. Effects of different recovery periods following a very intense interval training session on strength and explosive performance in elite female ice hockey players. J Strength Cond Res XX(X): 000-000, 2024-This study investigates how different recovery periods after high-intensity interval training (HIIT) affects strength and explosive performance during a power training (PT) session. Fifteen female elite ice hockey players (22.5 ± 5.2 years) performed PT, including 6 sets of 2 repetitions (reps) of isometric leg press (ILP) and 6 sets of 3 reps of countermovement jump (CMJ), following a rested state and 10 minutes, 6 hours, or 24 hours after HIIT (3 sets of 8 × 20 seconds at 115% of power output at maximal oxygen consumption on a cycle ergometer). Peak force (PF) and peak rate of force development (pRFD) were measured during the ILP. Peak jump height (PJH), concentric phase duration (ConDur), eccentric phase duration, total duration, peak power (PP), velocity at peak power (V@PP), and force at peak power were measured during CMJ. The following variables were significantly reduced when only a 10-minute recovery period was allowed between HIIT and PT: PF was reduced by 7% (p < 0.001), pRFD by 17% (p < 0.001), PJH by 4% (p < 0.001), ConDur by 4% (p = 0.018), PP by 2% (p = 0.016), and V@PP by 2% (p = 0.007). None of the measured variables were reduced when PT was performed 6 and 24 hours after HIIT. We conclude that strength and explosive performance of elite female ice hockey players is reduced 10 minutes after HIIT but not negatively affected if a rest period of at least 6 hours is provided between HIIT and PT.

Relationship between maximal oxygen uptake, within-set fatigue and between-set recovery during resistance exercise in resistance-trained men and women

BACKGROUND

The primary aim of this study was to examine the relationship between maximal oxygen update (V̇O2max) and within-set fatigue and between-set recovery during resistance exercise in men and women.

METHODS

We examined the relationship between V̇O2max and various indices of fatigue and recovery during parallel squats (3 sets, 90 s rest, 70% of 1RM to failure) and isokinetic knee extensions (3 × 10 maximal repetitions at 60 deg/s, 45 s rest) in 28 (age 27.0 ± 3.6 years) resistance-trained subjects (14 men and 14 women). We also examined whether there were sex differences in within-set fatigue and between-set recovery.

RESULTS

V̇O2max was weakly related to recovery and fatigue in both men and women (range of P-values for V̇O2max as a covariate; 0.312-0.998, range of R-values, 0.005-0.604). There were no differences between the sexes in fatigue within a set for the squat, but men showed less within-set fatigue than women in the first set of the isokinetic knee extension exercise (~ 8% torque loss difference, main effect of sex P = 0.034). Regarding recovery between sets, men showed greater relative peak power (P = 0.016) and peak torque (P = 0.034) loss between sets in both exercises, respectively, compared to women. Women also tended to complete more repetitions than men (main effect of sex, P = 0.057). Loss of peak torque between sets in knee extension was evident in both absolute and relative (%) values in men but not in women.

CONCLUSIONS

Our study suggests that aerobic capacity is weakly associated with within-set fatigue and between-set recovery in resistance training in both men and women. Women and men show comparable levels of within-set fatigue in the multi-joint squat, but women show more within-set fatigue during the single-joint isokinetic knee extension compared with men. In contrast, women recover better than men between sets in both exercises.

Females show less decline in contractile function than males after repeated all-out cycling

Females demonstrate greater fatigue resistance during a range of exercise modalities; however, this may be confounded by the lower mechanical work completed. Accordingly, this study examined the sex-specific peripheral and central fatigue mechanisms during repeated all-out cycling and whether they are affected by total mechanical work performed. A total of 26 healthy young adults (12 females) performed 10 × 10 s all-out cycling interspersed by 30 s passive recovery. Metabolic responses, peripheral and central fatigue, were quantified via changes in pre- to post-exercise blood lactate, potentiated quadriceps twitch force (and contractile properties) evoked via supramaximal electrical stimulation of the femoral nerve, and voluntary activation of the knee extensors, respectively. During exercise, mechanical work, vastus lateralis muscle activation (via surface electromyography), and deoxygenation (via near-infrared spectroscopy) were recorded. Sex comparison analyses were performed before and after statistically controlling for total mechanical work (via ANCOVA). Mechanical work and muscle activation plateaued at similar sprint repetition (sprint 5) and voluntary activation change (pre vs. post) was similar between the sexes. Females, however, showed lower %work decrement (i.e., fatigability; P = 0.037) and peripheral responses as evident by lower reductions in quadriceps twitch force (P < 0.001) and muscle deoxygenation (P = 0.001). Adjusting for total mechanical work did not change these sex comparison results. We show that females' greater fatigue resistance during repeated all-out cycling may not be attributed to the greater total mechanical work performed but could be mediated by lower peripheral fatigue in the knee extensor muscles.

Sex differences in fatigability and recovery following a 5 km running time trial in recreationally active adults

ABSTRACTFemales demonstrate greater fatigue resistance compared to males in tasks ranging from single-limb contractions to whole-body exercise, including running. Many of the studies investigating sex differences in fatigability following running, however, occur after long duration, low-intensity tasks and it is unknown whether there is a sex difference in fatigability following high-intensity running. This study compared fatigability and recovery following a 5 km running time trial in young males and females. Sixteen recreationally active participants (8 males, 8 females, age: 23 ± 4 years) completed a familiarisation and experimental trial. Knee-extensor maximal voluntary contractions (MVCs) were performed before and up to 30 min after a 5 km time trial on a treadmill. Heart rate and rating of perceived exertion (RPE) were recorded after every kilometre during the time trial. Although not significantly different, males completed the 5 km time trial 15% faster than females (p = 0.095). Heart rate (p = 0.843) and RPE (p = 0.784) were similar between the sexes during the trial. Prior to running, males had larger MVCs (p = 0.014). The relative decrease in MVC force was less in females than males immediately post-exercise (-4.6 ± 2.4% vs. -15.1 ± 3.0%, p < 0.001) and at 10-minutes post-exercise (p = 0.018). At 20- and 30-minutes recovery, however, relative MVC force was not different between the sexes (p ≥ 0.129). These data demonstrate that females experienced less fatigability of the knee extensors than males following a high-intensity 5 km running time trial. The findings highlight the need to understand responses to exercise in both sexes and have implications for recovery from training and exercise prescription.Highlights Data regarding sex differences in fatigability following high-intensity running is relatively sparse.Therefore, this study quantified the decrease in knee-extensor maximum voluntary contraction force (MVC) following a 5-km self-paced running time trial.Despite similar heart rates and ratings of perceived exertion, the percentage decrease in MVC was three times greater in males compared to females.Relative MVCs remained greater in females compared to males until 20 min post-exercise.

The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine

ABSTRACT

Biological sex is a primary determinant of athletic performance because of fundamental sex differences in anatomy and physiology dictated by sex chromosomes and sex hormones. Adult men are typically stronger, more powerful, and faster than women of similar age and training status. Thus, for athletic events and sports relying on endurance, muscle strength, speed, and power, males typically outperform females by 10%-30% depending on the requirements of the event. These sex differences in performance emerge with the onset of puberty and coincide with the increase in endogenous sex steroid hormones, in particular testosterone in males, which increases 30-fold by adulthood, but remains low in females. The primary goal of this consensus statement is to provide the latest scientific knowledge and mechanisms for the sex differences in athletic performance. This review highlights the differences in anatomy and physiology between males and females that are primary determinants of the sex differences in athletic performance and in response to exercise training, and the role of sex steroid hormones (particularly testosterone and estradiol). We also identify historical and nonphysiological factors that influence the sex differences in performance. Finally, we identify gaps in the knowledge of sex differences in athletic performance and the underlying mechanisms, providing substantial opportunities for high-impact studies. A major step toward closing the knowledge gap is to include more and equitable numbers of women to that of men in mechanistic studies that determine any of the sex differences in response to an acute bout of exercise, exercise training, and athletic performance.

Sex differences in the intensity-duration relationships of the severe- and extreme-intensity exercise domains

Extreme-intensity exercise is described by W'ext (analogous to J' for isometric exercise) that is smaller than W' of severe-intensity exercise (W'sev) in males. Sex differences in exercise tolerance appear to diminish at near-maximal exercise, however, there is evidence of greater contributions of peripheral fatigue (i.e. potentiated twitch force; Qpot) in males during extreme-intensity exercise. Therefore, the current study tested the hypotheses that J'ext would not be different between males and females, however, males would exhibit a greater reduction in neuromuscular function (i.e. maximal voluntary contraction, MVC; Qpot) following extreme-intensity exercise. Seven males and 7 females completed three severe- (Tlim: 2-4 min, S3; 5-8 min, S2; 9-15 min, S1) and three extreme-intensity (70, 80, 90%MVC) knee-extension bouts. MVC and Qpot relative to baseline were compared at task failure and at 150 s of recovery. J'ext was significantly less than J'sev in males (2.4 ± 1.2kJ vs 3.9 ± 1.3kJ; p = 0.03) and females (1.6 ± 0.8kJ vs 2.9 ± 1.7kJ; p = 0.05); however, there were no sex differences in J'ext or J'sev. MVC (%Baseline) was greater at task failure following extreme-intensity exercise (76.5 ± 20.0% vs 51.5 ± 11.5% in males, 75.7 ± 19.4% vs 66.7 ± 17.4% in females), but was not different at 150 s of recovery (95.7 ± 11.8% in males, 91.1 ± 14.2% in females). Reduction in Qpot, however, was greater in males (51.9 ± 16.3% vs 60.6 ± 15.5%) and was significantly correlated with J'ext (r2 = 0.90, p < 0.001). Although there were no differences in the magnitude of J'ext, differences in MVC and Qpot are evidence of sex-specific responses and highlight the importance of appropriately characterizing exercise intensity regarding exercise domains when comparing physiological responses in males and females.Highlights We have previously shown evidence that extreme-intensity dynamic exercise is described by W'ext in males and smaller than W'sev. We currently tested for potential sex differences in J'ext (isometric analogue to W') and neuromuscular responses (i.e. maximal voluntary contraction, MVC; potentiated twitch force, Qpot) during extreme-intensity exercise.J'ext and extreme-intensity exercise tolerance was not different between males and females. The reduction in MVC was not different across extreme-intensity exercise across males and females, whereas the reduction in Qpot was greater in males following all extreme-intensity exercises, although not after exercise at 90%MVC.Together, although extreme-intensity exercise tolerance is not different, these data highlight differences in the contributing mechanisms of fatigue during severe- and extreme-intensity exercise between males and females.

Acute Effects of Complex Conditioning Activities on Athletic Performance and Achilles Tendon Stiffness in Male Basketball Players

The goal of this study was to compare the effects of a bilateral conditioning activity consisting of back squats and drop jumps with a unilateral one consisting of split squats and depth jumps to lateral hop over sequentially performed countermovement jump (CMJ), modified t-agility test (MAT), and Achilles tendon stiffness. Twenty-six basketball players participated in this study and were randomly and equally assigned to one of two different test groups: bilateral (B - CA) or unilateral (U - CA) conditioning activity group. The B - CA group completed 2 sets of 4 repetitions of back squats at 80% of one-repetition maximum (1RM), then 10 drop jumps, while the U - CA group performed 2 sets of 2 repetitions of split squats on each leg at 80%1RM, followed by 5 depth jumps to lateral hop on each leg as conditioning activity (CA) complexes. After a warm-up and 5 min before the CA the baseline Achilles tendon stiffness, CMJ, and MAT time measurement were performed. In the 6th min after the CA, all tests were re-tested in the same order. The two-way repeated measures mixed ANOVAs revealed that both B - CA and U - CA failed to produce significant improvements in CMJ and MAT performance. In addition, a significant increase in Achilles stiffness was demonstrated with both protocols (a main effect of time: p = 0.017; effect size = 0.47; medium). This study revealed that combining back squats and drop jumps, as well as split squats and depth jumps to a lateral hop, had no effect on subsequent CMJ and MAT performance in basketball players. Based on these results, it can be assumed that combinations of exercises, even if they have similar movement patterns, may cause excessive fatigue, resulting in no PAPE effect.

Performance fatigability during isometric vs. concentric quadriceps fatiguing tasks in men and women

In the present study, we aimed to provide a robust comparison of the fatigability of the knee extensors following isometric (ISO) and concentric (CON) tasks. Twenty young adults (25 ± 4 yr, 10 women) randomly performed the ISO and CON quadriceps intermittent fatigue test, consisting of ten (5 s on/5-s off, ISO) or one-hundred (0.5-s on/0.5-s off, CON) contractions with 10 % increments per stage until exhaustion. Performance fatigability was quantified as maximal isometric (MVIC) and concentric (MVCC) torque loss. Voluntary activation and contractile function (peak-twitch) were investigated using peripheral nerve stimulation. Number of stages (6.2 ± 0.7 vs. 4.9 ± 0.8; P < 0.001) and torque-time integral (20,166 ± 7,821 vs. 11,285 ± 4,933 Nm.s; P < 0.001) were greater for ISO than CON. MVIC, MVCC and voluntary activation decreased similarly between sessions (P > 0.05) whereas peak-twitch amplitude decreased more for CON (P < 0.001). The number of contractions was similar across sexes (ISO: men = 62 ± 8, women = 61 ± 5; CON: men = 521 ± 67, women = 458 ± 76, P > 0.05). MVCC was more reduced in women for both sessions (all P < 0.05), while MVIC loss was similar between sexes. We concluded that, despite greater torque-time integral and duration for ISO, both sessions induced a similar performance fatigability at exhaustion. Contractile function was more altered in CON. Finally, sex-related difference in fatigability depends on the contraction mode used during testing.

Age-related performance fatigability: a comprehensive review of dynamic tasks

Adult ageing is associated with a myriad of changes within the neuromuscular system, leading to reductions in contractile function of old adults. One of the consequences of these age-related neuromuscular adaptations is altered performance fatigability, which can limit the ability of old adults to perform activities of daily living. Whereas age-related fatigability of isometric tasks has been well characterized, considerably less is known about fatigability of old adults during dynamic tasks involving movement about a joint, which provides a more functionally relevant task compared to static contractions. This review provides a comprehensive summary of age-related fatigability in dynamic contractions, where the importance of task specificity is highlighted with a brief discussion of the potential mechanisms responsible for differences in fatigability between young and old adults. The angular velocity of the task is critical for evaluating age-related fatigability, as tasks which constrain angular velocity (i.e., isokinetic) produce equivocal age-related differences in fatigability, whereas tasks involving unconstrained velocity (i.e., isotonic-like) consistently induce greater fatigability of old compared to young adults. These unconstrained velocity tasks, that are more closely associated with natural movements, offer an excellent model to uncover the underlying age-related mechanisms of increased fatigability. Future work evaluating the mechanisms of increased age-related fatigability of dynamic tasks should be evaluated using task-specific contractions (i.e., dynamic), particularly for assessment of spinal and supra-spinal components. Advancing our understanding of age-related fatigability is likely to yield novel insights and approaches for improving mobility limitations in old adults.

Considerations for Sex-Cognizant Research in Exercise Biology and Medicine

As the fields of kinesiology, exercise science, and human movement developed, the majority of the research focused on male physiology and extrapolated findings to females. In the medical sphere, basing practice on data developed in only males resulted in the removal of drugs from the market in the late 1990s due to severe side effects (some life-threatening) in females that were not observed in males. In response to substantial evidence demonstrating exercise-induced health benefits, exercise is often promoted as a key modality in disease prevention, management, and rehabilitation. However, much like the early days of drug development, a historical literature knowledge base of predominantly male studies may leave the exercise field vulnerable to overlooking potentially key biological differences in males and females that may be important to consider in prescribing exercise (e.g., how exercise responses may differ between sexes and whether there are optimal approaches to consider for females that differ from conventional approaches that are based on male physiology). Thus, this review will discuss anatomical, physiological, and skeletal muscle molecular differences that may contribute to sex differences in exercise responses, as well as clinical considerations based on this knowledge in athletic and general populations over the continuum of age. Finally, this review summarizes the current gaps in knowledge, highlights the areas ripe for future research, and considerations for sex-cognizant research in exercise fields.

Differences in muscle energy metabolism and metabolic flexibility between sarcopenic and nonsarcopenic older adults

BACKGROUND

Metabolic flexibility is the ability of skeletal muscle to adapt fuel utilization to the demand for fuel sources [carbohydrates (CHO) and fats (FAT)]. The purpose of this study was to explore muscle energy metabolism and metabolic flexibility under various conditions in sarcopenic (S) versus nonsarcopenic (NS) older adults.

METHODS

Twenty-two older adults aged 65 years or older were categorized as NS [n = 11; mean ± standard deviation (SD); age = 73.5 ± 6.0 years (males, n = 5; females, n = 6)] or S [n = 11; 81.2 ± 10.5 years (males, n = 6; females, n = 5) based on handgrip strength, body composition and physical performance. Indirect calorimetry was recorded before and after consumption of a high-CHO meal and during aerobic and anaerobic exercise. Respiratory quotient (RQ), CHO and FAT oxidation were assessed. Venous blood samples were collected for glucose and insulin concentrations.

RESULTS

At rest, compared with NS, S exhibited a 5-8% higher RQ at 0 (0.72 vs. 0.76) and 120 (0.77 vs. 0.82), 150 (0.76 vs. 0.80), and 180 min (0.74 vs. 0.80) (P = 0.002-0.025); 59-195% higher CHO oxidation at 0, 120, and 180 min (0.0004-0.002 vs. 0.001-0.002 g·min^-1 ·kg^-1) (P = 0.010-0.047); and 20-31% lower FAT oxidation at 0, 15, and 90-180 min (0.0009-0.0022 vs. 0.0011-0.002 g·min^-1 ·kg^-1 ) (P = 0.004-0.038). Glucose levels were significantly elevated in S versus NS at 0, 60 and 75 min (144.64-202.78 vs. 107.70-134.20 mg·dL^-1 ) but not insulin. During aerobic exercise, RQ was 5% greater (0.90 vs. 0.86) (P = 0.039), and FAT oxidation was 35% lower at 6-8 min (0.003 vs. 0.005 g·min^-1 ·kg^-1 ) (P = 0.033) in S versus NS. During anaerobic exercise, CHO oxidation was 31% greater in NS versus S at 60-80% time to exhaustion (0.011 vs. 0.007 g·min^-1 ·kg^-1 ) (P = 0.015). Per cent contribution to energy expenditure was greater in S for CHO but lower for FAT at 0 (CHO: 22% vs. 10%; FAT: 78% vs. 91%) and 120-180 min (CHO: 35-42% vs. 17-25%; FAT: 58-65% vs. 75%-84%) (P = 0.003-0.046) at rest and 6-8 min during aerobic exercise (CHO: 70% vs. 57%; FAT: 30% vs. 45%) (P = 0.046).

CONCLUSIONS

The data show differences in skeletal muscle energy metabolism and substrate utilization between S and NS at rest, transitioning from fasted to fed state, and during exercise. Compared with NS, S displayed a diminished ability to adapt fuel utilization in response to feeding and exercise, reflecting metabolic inflexibility. Impaired metabolic flexibility could be a mechanism underlying the losses of strength and physical function accompanying sarcopenia.

Coactivation does not contribute to fatigue-induced decreases in torque during reciprocal, isokinetic muscle actions

BACKGROUND: Studies of coactivation have typically utilized single movement isometric or isokinetic fatiguing muscle actions. OBJECTIVE: The purpose of the current study was to examine coactivation of the biceps brachii (BB) and triceps brachii (TB) in response to a maximal, reciprocal, isokinetic fatiguing task of the forearm flexors and extensors at slow (60∘/s) and moderate (180∘/s) isokinetic velocities in men. METHODS: Ten men (mean ± SD: age = 21.6 ± 1.3 years) completed 50 consecutive, maximal, reciprocal, isokinetic muscle actions of the right forearm flexors and extensors at 60 and 180∘/s. The amplitude (AMP) and mean power frequency (MPF) contents of the electromyographic (EMG) and mechanomyographic (MMG) signals from the BB and TB were recorded simultaneously throughout the fatiguing task. Repeated measures ANOVAs with Tukey post hocs were used to determine mean differences for the torque and neuromuscular parameters across repetitions. RESULTS: The torque analyses indicated greater fatigability at 180∘/s, compared to 60∘/s (p= 0.02). There were no significant changes in EMG AMP for either muscle during flexion or extension at 60∘/s (p> 0.05). At 180∘/s, there were significant increases in agonist EMG AMP (p= 0.01 to 0.004), however, no changes in antagonist EMG AMP (p> 0.05). For EMG MPF, there were significant decreases during flexion and extension (p< 0.001 to p= 0.02) at both velocities, collapsed across Muscle. There were no significant (p> 0.05) changes across repetition for MMG AMP or MPF. CONCLUSIONS: This study indicated velocity-specific responses to fatigue, with a greater magnitude of fatigability at 180∘/s. Furthermore, despite increases in EMG AMP of the agonist muscles at 180∘/s only, it was not sufficient to alter the ratio of coactivation, likely due to common neural drive between muscles. Thus, the decreases in torque in the present study were not attributable to increases in coactivation.

Neuromuscular recovery from severe- and extreme-intensity exercise in men and women

Maximal voluntary contraction force (MVC), potentiated twitch force (Q_pot), and voluntary activation (%VA) recover to baseline within 90 s following extreme-intensity exercise. However, methodological limitations mask important recovery kinetics. We hypothesized reductions in MVC, Q_pot, and %VA at task failure following extreme-intensity exercise would be less than following severe-intensity exercise, and Q_pot and MVC following extreme-intensity exercise would show significant recovery within 120 s but remain depressed following severe-intensity exercise. Twelve subjects (6 men) completed 2 severe-intensity (40, 50% MVC) and 2 extreme-intensity (70, 80% MVC) isometric knee-extension exercise bouts to task failure (T_lim). Neuromuscular function was measured at baseline, T_lim, and through 150 s of recovery. Each intensity significantly reduced MVC and Q_pot compared with baseline. MVC was greater at T_lim (p < 0.01) and at 150 s of recovery (p = 0.004) following exercise at 80% MVC compared with severe-intensity exercise. Partial recovery of MVC and Q_pot were detected within 150 s following T_lim for each exercise intensity; Q_pot recovered to baseline values within 150 s of recovery following exercise at 80% MVC. No differences in %VA were detected pre- to post-exercise or across recovery for any intensity. Although further analysis showed sex-specific differences in MVC and Q_pot, future studies should closely examine sex-dependent responses to extreme-intensity exercise. It is clear, however, that these data reinforce that mechanisms limiting exercise tolerance during extreme-intensity exercise recover quickly. Novelty: Severe- and extreme-intensity exercise cause independent responses in fatigue accumulation and the subsequent recovery time courses. Recovery of MVC and Q_pot occurs much faster following extreme-intensity exercise in both men and women.

No sex differences in evoked contractile properties after fatiguing isometric and isotonic exercise for the plantar flexors

OBJECTIVES

Females tend to fatigue less than males after isometric exercise, but less is clear for isotonic exercise. Further, there have been relatively few sex comparisons for fatigability of the plantar flexors (PFs). We sought to investigate potential sex differences in contractile properties after a sustained maximal voluntary isometric contraction (MVIC) and isotonic contractions.

METHODS

Twenty-seven physically active males (n=14; 22±2 yrs) and females (n=13; 21±2 yrs) randomly performed a 2 min MVIC and 120 concentric isotonic (30% MVIC) contractions for the PFs on separate visits. Before and after each fatiguing task, muscle activation was obtained from brief MVICs, which was followed (~2 sec) by tibial nerve stimulation at rest. Contractile properties including peak twitch, absolute and normalized time to peak twitch, and half relaxation time were calculated.

RESULTS

No sex differences existed for fatigue-induced changes in muscle activation (p=0.09-0.41; d=0.33-0.69) or contractile properties (p=0.19-0.96; d=0.06-0.94).

CONCLUSIONS

Peripheral fatigue, as indicated by contractile parameters, did not differ between sexes after isometric or isotonic exercise. The PFs similar fiber type proportions between sexes or greater fiber type heterogeneity may explain why sex differences in fatigability, though common in other muscle groups (e.g., knee extensors), were not expressed in this muscle group.

Fatigability of the knee extensor muscles during high-load fast and low-load slow resistance exercise in young and older adults

Resistance exercise training is a cornerstone in preventing age-related declines in muscle mass and strength, and fatigability of limb muscle is important to this adaptive response. It is unknown, however, whether fatigability and the underlying mechanisms differ between different resistance exercise protocols in young and older adults. The purpose of this study was to quantify the fatigability of the knee extensors and identify the mechanisms in 20 young (22.2 ± 1.3 yr, 10 women) and 20 older adults (73.8 ± 5.4 yr, 10 women) elicited by a single session of high- and low-load resistance exercise. One leg completed a high-load protocol with contractions performed as fast as possible (HL-fast, ~80% 1 Repetition Max, 1RM), and the contralateral leg a low-load protocol performed with slow contractions (LL-slow, ~30% 1RM, 6 s concentric, 6 s eccentric). Each exercise involved four sets of eight repetitions. Before and immediately following each set, maximal voluntary isometric contractions (MVC) were performed, and voluntary activation and contractile properties quantified using electrical stimulation. The reduction in MVC was greater following the LL-slow (20%) than the HL-fast (12%, P = 0.004), with no age or sex differences. Similarly, the reduction in the amplitude of the involuntary electrically-evoked twitch was greater in the LL-slow (14%) than the HL-fast (7%, P = 0.014) and correlated with the reduction in MVC (r = 0.546, P < 0.001), whereas voluntary activation decreased only for the LL-slow protocol (5%, P < 0.001). Thus, low-load resistance exercise with slow contractions induced greater fatigability within the muscle than a more traditional high-load resistance protocol for both young and older men and women.

The single-leg heel raise does not predict maximal plantar flexion strength in healthy males and females

Introduction

The single-leg heel raise test (SLHR) is commonly used in clinical settings to approximate plantar flexor strength, yet this is neither validated nor supported physiologically. The purposes of this study were to: determine (1) associations between SLHR repetitions, maximal plantar flexor strength, and reductions in strength; and (2) whether sex differences exist in performance of the SLHR.

Methods

Twenty-eight young, healthy participants (14 males,14 females, 19–30 years) performed repeated single-leg heel raises to task failure. Pre- and post-task measures included maximal voluntary isometric contractions (MVIC), and voluntary activation and contractile properties of the plantar flexor muscles, assessed using peripheral electrical stimulation of the tibial nerve. Surface electromyography was recorded for the medial and lateral gastrocnemius, soleus, and anterior tibialis muscles.

Results

The SLHR resulted in 20.5% reductions in MVIC torque (p<0.001). However, the number of SLHR repetitions was not correlated with either the baseline MVIC (maximal strength; p = 0.979) or the reduction in MVIC following the SLHR (p = 0.23). There were no sex differences in either the number of SLHR repetitions (p = 0.14), baseline MVIC torque (p = 0.198), or the reduction of MVIC (p = 0.14). MVIC decline was positively associated with the reduction in voluntary activation (r = 0.841, p<0.001), but was not associated with the change in twitch amplitude (p = 0.597).

Conclusions

The SLHR was similar in young males and females yet was a poor predictor of maximal plantar flexor strength but evaluates performance fatigability of the lower extremity specific to dynamic contractions. The reduction in maximal strength at task failure was explained by reduced neural drive to the plantar flexor muscles in both males and females.

Impact statement

SLHR performance is not a clinical assessment of plantar flexor strength but assesses dynamic lower extremity fatigability that is similar in males and females. Alternate clinical measures for maximal plantar flexion strength need to be developed.

Functional reserve and sex differences during exercise to exhaustion revealed by post-exercise ischaemia and repeated supramaximal exercise

KEY POINTS

Females have lower fatigability than males during single limb isometric and dynamic contractions, but whether sex-differences exist during high-intensity whole-body exercise remains unknown. This study shows that males and females respond similarly to repeated supramaximal whole-body exercise, and that at task failure a large functional reserve remains in both sexes. Using post-exercise ischaemia with repeated exercise, we have shown that this functional reserve depends on the glycolytic component of substrate-level phosphorylation and is almost identical in both sexes. Metaboreflex activation during post-exercise ischaemia and the O₂ debt per kg of active lean mass are also similar in males and females after supramaximal exercise. Females have a greater capacity to extract oxygen during repeated supramaximal exercise and reach lower P ETC O 2 , experiencing a larger drop in brain oxygenation than males, without apparent negative repercussion on performance. Females had no faster recovery of performance after accounting for sex differences in lean mass.

ABSTRACT

The purpose of this study was to ascertain what mechanisms explain sex differences at task failure and to determine whether males and females have a functional reserve at exhaustion. Exercise performance, cardiorespiratory variables, oxygen deficit, and brain and muscle oxygenation were determined in 18 males and 18 females (21-36 years old) in two sessions consisting of three bouts of constant-power exercise at 120% of V ̇ O 2 max until exhaustion interspaced by 20 s recovery periods. In one of the two sessions, the circulation of both legs was occluded instantaneously (300 mmHg) during the recovery periods. Females had a higher muscle O₂ extraction during fatiguing supramaximal exercise than males. Metaboreflex activation, and lean mass-adjusted O₂ deficit and debt were similar in males and females. Compared to males, females reached lower P ETC O 2 and brain oxygenation during supramaximal exercise, without apparent negative consequences on performance. After the occlusions, males and females were able to restart exercising at 120% of V ̇ O 2 max , revealing a similar functional reserve, which depends on glycolytic component of substrate-level phosphorylation and its rate of utilization. After ischaemia, muscle O₂ extraction was increased, and muscle V ̇ O 2 was similarly reduced in males and females. The physiological response to repeated supramaximal exercise to exhaustion is remarkably similar in males and females when differences in lean mass are considered. Both sexes fatigue with a large functional reserve, which depends on the glycolytic energy supply, yet females have higher oxygen extraction capacity, but reduced P ETC O 2 and brain oxygenation.

Greater fatigability and motor unit discharge variability in human type 2 diabetes

This study determined the discharge characteristics of motor units from two lower limb muscles before and after fatiguing exercise in people with type 2 diabetes (T2D) with no symptoms of polyneuropathy and activity‐matched controls. Seventeen people with T2D (65.0 ± 5.6 years; 8 women) and 17 controls (63.6 ± 4.5 years; 8 women) performed: (a) intermittent, isometric contractions at 50% maximal voluntary isometric contraction (MVIC) sustained to failure with the ankle dorsiflexors, and (b) a dynamic fatiguing task (30% MVIC load) for 6 min with the knee extensors. Before and after the fatiguing tasks, motor unit characteristics (including coefficient of variation (CV) of interspike intervals (ISI)) were quantified from high‐density electromyography and muscle contractile properties were assessed via electrical stimulation. Fatigability was ~50% greater for people with T2D than controls for the dorsiflexors (time‐to‐failure: 7.3 ± 4.1 vs. 14.3 ± 9.1 min, p = .010) and knee extensors (power reduction: 56.7 ± 11.9 vs. 31.5 ± 25.5%, p < .001). The CV of ISI was greater for the T2D than control group for the tibialis anterior (23.1 ± 11.0 vs. 21.3 ± 10.7%, p < .001) and vastus lateralis (27.8 ± 20.2 vs. 24.5 ± 16.1%, p = .011), but these differences did not change after the fatiguing exercises. People with T2D had greater reductions in the electrically evoked twitch amplitude of the dorsiflexors (8.5 ± 5.1 vs. 4.0 ± 3.4%·min^‐1, p = .013) and knee extensors (49.1 ± 10.0 vs. 31.8 ± 15.9%, p = .004) than controls. Although motor unit activity was more variable in people with T2D than controls, the greater fatigability of the T2D group for lower limb muscles was due to mechanisms involving disruption of contractile function of the exercising muscles rather than motor unit behavior.

Isometric versus isotonic contractions: Sex differences in the fatigability and recovery of isometric strength and high-velocity contractile parameters

The purpose of this study was to investigate potential sex differences in the fatigue‐ and recovery‐induced responses of isometric strength and power, as well as select dynamic contractile parameters after isometric and isotonic plantar flexor (PF) contractions. Healthy males (n = 12; age = 21.8 ± 2.2 years) and females (n = 14; age = 21.4 ± 2.5 years) performed a 2‐min maximal voluntary isometric contraction and 120 concentric isotonic (30% peak isometric torque) contractions of the PFs on separate visits. Isometric strength, isotonic power, as well as torque‐ and velocity‐related parameters were recorded before, immediately after, and throughout 10 min of recovery. Rate of EMG rise (RER) for the medial gastrocnemius (MG) and soleus was also obtained. All measures responded similarly between sexes after both fatiguing modalities (p > 0.05), except RER of the MG which, in males demonstrated both, a greater decrease during isotonic contractions (p = 0.038, ηp2 = 0.174) and more rapid recovery after isometric exercise (p = 0.043, ηp2 = 0.166). Although not significant, a nearly large effect size was demonstrated for the fatigue‐induced decrease in isometric strength (p = 0.061; d = 0.77) due to relative decreases tending to be greater in males (−29% vs. −17%). Regardless of fatiguing modality, sex differences were minimal for fatigue and recovery‐related responses in muscle function for the PFs, although the difference for RER may indicate a unique origin of fatigue. Further support for the disassociation between the response in isometric strength and power after fatiguing exercise was also demonstrated.

Ipsilateral and contralateral responses following unimanual fatigue with and without illusionary mirror visual feedback

Illusionary mirror visual feedback alters interhemispheric communication and influences cross-limb interactions. Combining forceful unimanual contractions with the mirror illusion is a convenient way to provoke robust alterations within ipsilateral motor networks. It is unknown, however, if the mirror illusion affects cross-limb fatigability. We examine this concept by comparing the ipsilateral and contralateral handgrip force and electromyographic (EMG) responses following unimanual fatigue with and without illusionary mirror visual feedback. Participants underwent three experimental sessions (mirror, no-mirror, and control), performing a unimanual fatigue protocol with and without illusionary mirror visual feedback. Maximal handgrip force and EMG activity were measured before and after each session for both hands during maximal unimanual and bimanual contractions. The associated EMG activity from the inactive forearm during unimanual contraction was also examined. The novel findings demonstrate greater relative fatigability during bimanual versus unimanual contraction following unimanual fatigue (-31.8% vs. -23.4%, P < 0.01) and the mirror illusion attenuates this difference (-30.3% vs. -26.3%, P = 0.169). The results show no evidence for a cross-over effect of fatigue with (+0.62%, -2.72%) or without (+0.26%, -2.49%) the mirror illusion during unimanual or bimanual contraction. The mirror illusion resulted in significantly lower levels of associated EMG activity in the contralateral forearm. There were no sex differences for any of the measures of fatigability. These results demonstrate that the mirror illusion influences contraction-dependent fatigue during maximal handgrip contractions. Alterations in facilitatory and inhibitory transcallosal drive likely explain these findings.NEW & NOTEWORTHY Illusionary mirror visual feedback is a promising clinical tool for motor rehabilitation, yet many features of its influence on motor output are unknown. We show that maximal bimanual force output is compromised to a greater extent than unimanual force output following unimanual fatigue, yet illusionary mirror visual feedback attenuates this difference. The mirror illusion also reduces the unintended EMG activity of the inactive, contralateral forearm during unimanual contraction.

Sex differences in muscle fatigue following isokinetic muscle contractions

Muscle fatigue is a limiting factor of human performance. It is unclear whether sex-based differences in fatigability exist during dynamic exercise of varying velocities of contraction. We aimed at exploring sex differences in muscle fatigue elicited by maximal isokinetic muscle contractions performed at different angular velocities. Twenty-six healthy participants (13 men: 23.2 ± 1.5; 13 women: 21.9 ± 3.0 years) were tested for concentric knee-extension at slow, moderate and fast angular isokinetic velocity (60, 180 and 300º.s^-1, respectively), on non-consecutive days. The impact of sex on fatigue resistance and consecutive recovery for each isokinetic condition was explored by calculating the percent change in maximal voluntary isometric contraction (MVIC) and in rate of torque development (RTD), from pre- to post-isokinetic exercise (30 repetitions). The isokinetic fatigue index was also determined. No sex differences were obtained in response to isokinetic contractions completed at 60º.s^-1. After performing muscle contractions at 300º.s^-1, women had a significantly greater loss in MVIC than men (- 18.4 ± 5.5 vs. - 12.9 ± 3.8%; p = 0.009) and larger decreases in work output during isokinetic exercise (- 34.2 ± 8.9 vs - 27.5 ± 10.6%; p = 0.017). Recovery of initial MVIC strength was greater for women post-exercise at 180º.s^-1 (15.6 ± 4.1% vs. 6.7 ± 9.5; p = 0.003). No differences were found between sexes in any condition for RTD from pre- to post-fatigue. These results suggest the presence of a sexually dimorphic fatigability in response to dynamic (isokinetic) contractions favouring men at higher absolute velocities of contraction.

Performance fatigability and the bilateral deficit during maximal, isokinetic leg extensions in men and women

BACKGROUND: Few studies have examined sex differences in performance fatigability and the bilateral deficit in a dynamic modality. OBJECTIVES: The purpose of this study was to examine: 1) Leg-, mode-, and sex-specific differences in performance fatigability during maximal, dynamic leg extension muscle actions and; 2) the time course of fatigue-induced changes in the bilateral deficit for both men and women. METHODS: Eleven men and 11 women participated in 3 test visits consisting of 50 maximal, concentric, isokinetic leg extensions at 60∘/s. Each visit was randomized to perform either unilateral right leg only (RL), unilateral left leg only (LL), or bilateral (BL) leg extensions. RESULTS: The BL performance fatigability was significantly (p< 0.001) less than RL and LL. Both men and women demonstrated significant (p< 0.001) declines in moment and an attenuation of the bilateral deficit throughout the fatiguing task. There were no differences between sex for performance fatigability (p= 0.128) or the bilateral deficit (p= 0.102). CONCLUSIONS: Unilateral muscle actions were more susceptible to fatigue than BL muscle actions. Men exhibited an earlier decline in moment than women, however, men and women exhibited similar magnitudes and patterns of decline in the bilateral deficit.

Physiological sex differences affect the integrative response to exercise: acute and chronic implications

NEW FINDINGS

What is the topic of this review? We review sex differences within physiological systems implicated in exercise performance; specifically, how they integrate to determine metabolic thresholds and fatigability. Thereafter, we discuss the implications that these sex differences might have for long-term adaptation to exercise. What advances does it highlight? The review collates evidence from recent physiological studies that have investigated sex as a biological variable, demonstrating that the physiological response to equivalent 'dosages' of exercise is not the same in males and females; thus, highlighting the need to research diversity in physiological responses to interventions.

ABSTRACT

The anatomical and physiological differences between males and females are thought to determine differences in the limits of human performance. The notion of studying sex as a biological variable has recently been emphasized in the biosciences as a vital step in enhancing human health. In this review, we contend that the effects of biological sex on acute and chronic responses must be studied and accounted for when prescribing aerobic exercise, much like any intervention targeting the optimization of physiological function. Emerging evidence suggests that the response of physiological systems to exercise differs between males and females, potentially mediating the beneficial effects in healthy and clinical populations. We highlight evidence that integrative metabolic thresholds during exercise are influenced by phenotypical sex differences throughout many physiological systems. Furthermore, we discuss evidence that female skeletal muscle is more resistant to fatigue elicited by equivalent dosages of high-intensity exercise. How the different acute responses affect the long-term trainability of males and females is considered, with discussion about tailoring exercise to the characteristics of the individual presented within the context of biological sex. Finally, we highlight the influence of endogenous and exogenous sex hormones on physiological responses to exercise in females. Sex is one of many mediating influences on the outcomes of exercise, and with careful experimental designs, physiologists can advance the collective understanding of diversity in physiology and optimize outcomes for both sexes.

Sex differences in soleus muscle H-reflex and V-wave excitability

NEW FINDINGS

 What is the central question of this study? How do H-reflex and V-wave excitability compare between men and women engaging in similar levels of physical activity?  What is the main finding and its importance? H-reflex excitability is lower in women than in men because of their greater level of antagonist co-activation during sustained plantar flexion isometric exercise. In addition, supraspinal drive is similar between men and women independently of their differences in H-reflex excitability and antagonist muscle co-activation.

ABSTRACT

We compared H-reflex and V-wave excitability between men and women engaging in similar levels of physical activity. We also explored whether differences in antagonist muscle co-activation between sexes might partially explain sexual dimorphism in the excitability of the H-reflex and V-wave. Fifty-seven young participants were included (29 men: 21.7 ± 2.3 years; 28 women: 22.4 ± 3.3 years). Soleus M- and H-recruitment curves were constructed on a tonic background muscle activation. V-waves were elicited during maximal voluntary contraction (MVC). Besides being stronger than women, men achieved greater H_max /M_max values and presented a steeper slope of the ascending limb of the H-reflex recruitment curve (P < 0.05). The current intensity required to elicit H_max was lower for men (P < 0.05). The co-activation of the tibialis anterior muscle during the sustained plantar flexions was greater in women (ratio between tibialis and soleus normalized EMG: 20.5 vs. 8.3%, P < 0.05). Covariance analysis showed that sexual dimorphism in H-reflex excitability was dissipated when controlling for antagonist co-activation. V-wave normalized amplitude was similar between sexes even after controlling for the effects of H_max /M_max and antagonist co-activation as covariates. Thus, women exhibit lower H-reflex excitability than men and this is dependent on their higher level of antagonist muscle co-activation. While sex differences in antagonist co-activation persist during MVCs, this is not the case for V-wave normalized amplitude. Thus, although the efficacy of the transmission between Ia afferent fibres to α-motoneurons is lower in women because of a greater level of antagonist co-activation, our findings are consistent with similar supraspinal drive between sexes.

Postactivation performance enhancement: Does conditioning one arm augment performance in the other?

The purpose was to determine whether postactivation performance enhancement is specific to the muscle being conditioned or if it is also observed within the homologous muscles of the contralateral limb (after accounting for the warm-up and random error). We also investigated whether this differed based on training status or muscle size. One hundred seven participants (75 untrained; 32 trained) participated in four sessions. Visit 1 included baseline measurements and familiarization. Visits 2-4 included the completion of one of the three experimental conditions: (a) control, (b) same side and (c) crossover completed in a randomized order. The control condition completed all testing except for the conditioning contraction. The same side condition completed the conditioning contraction on the same side as the strength test. The crossover condition completed the conditioning on the arm opposite to the strength test. The variable of interest was the change from baseline in isokinetic strength. Our analysis indicated that of the hypotheses compared, the posterior probabilities (posterior probability of 0.506) favoured the hypothesis that the effect was local and greatest in those who were resistance trained [mean (SD) of 1.4 (2.2) Nm over the control in those resistance trained]. We found no relationship between muscle size and postactivation performance enhancement. In conclusion, there is an influence of training status pertaining to the postactivation performance enhancement effect but no influence from baseline muscle size. It appears unlikely that the effect is due to a systemic mechanism.

Changes in Fatigue Are the Same for Trained Men and Women after Resistance Exercise

PURPOSE

To measure changes in fatigue and knee-extensor torque in the 48 h after trained men and women completed a full-body resistance exercise session.

METHODS

Eight trained women (mean ± SD: age, 25.6 ± 5.9 yr; height, 1.68 ± 0.06 m; mass, 71.0 ± 8.6 kg) and eight trained men (age, 25.5 ± 6.2 yr; height, 1.79 ± 0.05 m; mass, 86.4 ± 9.8 kg) performed a full-body resistance exercise session based on real-world athletic practice. Measurements were performed before and after the exercise session, as well as 1, 24, and 48 h after the session. Fatigue and pain were measured with standardized self-report measures. Maximal isometric contractions with the knee extensors and superimposed femoral nerve stimulation were performed to examine maximal torque, rate of torque development, voluntary activation, and muscle contractility. Two sets of 10 isokinetic contractions (60°·s) with the knee extensors were performed during the protocol with use of near-infrared spectroscopy to assess muscle oxygenation. EMG were recorded from two quadriceps muscles during all isometric and isokinetic contractions.

RESULTS

Fatigue was increased from baseline for both sexes until 48 h after training (P < 0.001). Maximal torque and evoked twitch amplitudes were similarly reduced after exercise for men and women (P < 0.001). Voluntary activation and EMG amplitudes were unchanged after the training session. Muscle oxygenation was 13.3% ± 17.4% (P = 0.005) greater for women during the isokinetic repetitions, and the values were unchanged after the training session.

CONCLUSIONS

This is the first study to show similar changes in the fatigue reported by trained men and women in the 48 h after a training session involving full-body resistance exercises. Sex differences in muscle oxygenation during exercise do not influence the reductions in muscle force, activation, or contractility after the training session.

Differential changes in muscle architecture and neuromuscular fatigability induced by isometric resistance training at short and long muscle-tendon unit lengths

We evaluated the effects of differential muscle architectural adaptations on neuromuscular fatigue resistance. Seven young males and six females participated in this study. Using a longitudinal within-subject design, legs were randomly assigned to perform isometric training of the tibialis anterior (TA) three times per week for 8 wk at a short (S-group) or long muscle-tendon unit length (L-group). Before and following training, fascicle length (FL) and pennation angle (PA) of the TA were assessed. As well, fatigue-related time course changes in isometric maximal voluntary contraction (MVC) torque and isotonic peak power (20% MVC resistance) were determined before, immediately after, and 1, 2, 5, and 10 min following task failure. The fatiguing task consisted of repeated maximal effort isotonic (20% MVC resistance) contractions over a 40° range of motion until the participant reached a 40% reduction in peak power. Although there was no clear improvement in neuromuscular fatigue resistance following training in either group (P = 0.081; S-group: ∼20%; L-group: ∼51%), the change in neuromuscular fatigue resistance was related positively to the training-induced increase in PA (∼6%, P < 0.001) in the S-group (r = 0.739, P = 0.004) and negatively to the training-induced increase in FL (∼4%, P = 0.001) in the L-group (r = -0.568, P = 0.043). Both groups recovered similarly for MVC torque and peak power after the fatiguing task as compared with before training. We suggest that the relationships between the changes in muscle architecture and neuromuscular fatigue resistance depend on the muscle-tendon unit lengths at which the training is performed.NEW & NOTEWORTHY Eight weeks of isometric training at a long or short muscle-tendon unit length increased and did not change fascicle length, respectively. The "width" of the torque-angle relationship plateau became broader following isometric training at the long length. Despite marked differences in muscle architecture and functional adaptations between the groups, there was only a small-magnitude improvement in neuromuscular fatigue resistance, which was surprisingly negatively related to increased fascicle length in the long length-training group.

INDICATORS OF NEUROMUSCULAR FATIGUE IN LEG PRESS EXERCISE IN MEN AND WOMEN

ABSTRACT Introduction Muscle fatigue is characterized by reduced ability to produce maximum strength or power, and may differ between men and women. Changes in velocity of movement during exercise, and in the ability to produce strength after exercise, may help when comparing fatigue in men and women. Objective To analyze the differences between men and women in relation to number of repetitions, kinetics, kinematics and isometric force-time curve performance, and their respective muscle activation in horizontal leg press exercises. Methods Fifteen men and fifteen women underwent isometric force-time curve (Cf-t) and electromyographic (EMG) assessments before and after performing horizontal leg press exercises. The exercises were performed in three sets until voluntary exhaustion, at 70% maximal repetition. During the exercises, kinetic and kinematic variables were obtained by means of two force transducers, a linear position potentiometer and accelerometer adapted for the horizontal leg press and synchronized by a signal conditioning plate. Results The mean propulsive velocity significantly reduced between the first and last repetition of each series, with a similar reduction for men (-12.4 to -29.2%) and women (-29.2 to -35.6%). The same pattern was observed for the other kinetic and kinematic variables. The maximum voluntary contraction and peak force development rate also decreased for both men (-15.1 ± 8.7% and -26.9 ± 21.2%, respectively) and women (-13.9 ± 10.4% and -28.2 ± 11.5%, respectively). Conclusion Based on the different variables used to quantify the effect of fatigue during and after horizontal leg press exercises, the research found practically no differences between men and women. Level of evidence II; Comparative prospective study.

Sex differences in muscle activity emerge during sustained low-intensity contractions but not during intermittent low-intensity contractions

Sex differences in motor performance may arise depending on the mode of contraction being performed. In particular, contractions that are held for long durations, rather than contractions that are interspersed with rest periods, may induce greater levels of fatigue in men compared to women. The purpose of this study was to examine fatigue responses in a cohort of healthy men (n = 7, age [mean] = 21.6 ± [SD] 1.1 year) and women (n = 7, age: 22.0 ± 2.0 year) during sustained isometric and intermittent isometric contractions. Two contraction protocols were matched for intensity (20% MVC) and total contraction time (600-s). Biceps brachii EMG and elbow flexion torque steadiness were examined throughout each protocol, and motor nerve stimulation was used to quantify central and peripheral fatigue. Overall, there were few sex-related differences in the fatigue responses during intermittent contractions. However, men exhibited progressively lower maximal torque generation (39% versus 27% decrease), progressively greater muscle activity (220% versus 144% increase), progressively greater declines in elbow flexion steadiness (354% versus 285% decrease), and progressively greater self-perception of fatigue (Borg scale: 8.8 ± 1.2 versus 6.3 ± 1.1) throughout the sustained contractions. The mechanism underlying fatigue responses had a muscle component, as voluntary activation of the biceps brachii did not differ between sexes, but the amplitude of resting twitches decreased throughout the sustained contractions (m: 32%, w: 10% decrease). As generating large sustained forces causes a progressive increase in intramuscular pressure and mechanical occlusion-which has the effect of enhancing metabolite accumulation and peripheral fatigue-it is likely that the greater maximal strength of men contributed to their exacerbated levels of fatigue.

Strength and Electromyographic Responses of Upper and Lower Limbs During Maximal Intermittent Contractions in Males and Females

Carr, JC and Ye, X. Strength and electromyographic responses of upper and lower limbs during maximal intermittent contractions in males and females. J Strength Cond Res XX(X): 000-000, 2020-This study examined the strength and electromyographic (EMG) responses of upper vs. lower limb muscles during intermittent maximal contractions in both sexes. Twenty subjects (n = 7 women) performed a fatiguing protocol (6, 30-second intermittent maximal isometric contractions with a 50% duty cycle) with either the elbow flexors or the knee extensors on separate visits. Bipolar surface EMG signals were detected from the biceps brachii and vastus lateralis muscles (n = 5 women retained). Women maintained more of their maximal force than men (Δforce: men vs. women = -55.0 ± 12.8% vs. -43.3 ± 9.9%, p = 0.042). Although force loss was similar between the elbow flexors and knee extensors, the EMG responses showed greater reductions for the biceps brachii than those for the vastus lateralis (Δamplitude: biceps brachii vs. vastus lateralis: -32.0 ± 22.3% vs. -18.9 ± 28.9%; Δmedian frequency: biceps brachii vs. vastus lateralis: -31.1 ± 14.5% vs. -10.3 ± 17.0%). During a series of maximal intermittent isometric contractions with 30 seconds of recovery between work bouts, women are more fatigue resistant than men. In addition, the greater electrophysiological fatigue exhibited by the biceps brachii than that by the vastus lateralis suggests that high-intensity contractions involving elbow flexion will have a greater rate of fatigue progression than those involving knee extension.

Differential contributions of fatigue-induced strength loss and slowing of angular velocity to power loss following repeated maximal shortening contractions

The purpose of this study was to investigate the relationship between fatigue-induced reductions in isometric torque and isotonic power and to quantify the extent to which the decreases in angular velocity and dynamic torque can explain the power loss immediately following an isotonic fatiguing task and throughout recovery in seven young males and six young females. All measurements were performed with both legs. For dorsiflexion, fatigue-related time-course changes in isometric maximal voluntary contraction (MVC) torque, angular velocity, dynamic torque, and power production following repeated maximal isotonic contractions (load: 20% MVC) were investigated before, immediately after, and 1, 2, 5 and 10 min after a fatiguing task. There were no relationships between the fatigue-related reductions in isometric MVC torque and peak power at any timepoint, suggesting that fatigue-induced reductions in isometric MVC torque does not entirely reflect fatigue-induced changes in dynamic performance. The relative contribution of fatigue-related reduction in dynamic torque on power loss was greater immediately following the task, and lower throughout recovery than the corresponding decrease in angular velocity. Thus, power loss immediately following the task was more strongly related to the decline in dynamic torque; however, this relationship shifted throughout recovery to a greater dependence on slowing of angular velocity for power loss.

Are There Sex-Specific Neuromuscular or Force Responses to Fatiguing Isometric Muscle Actions Anchored to a High Perceptual Intensity?

Keller, JL, Housh, TJ, Hill, EC, Smith, CM, Schmidt, RJ, and Johnson, GO. Are there sex-specific neuromuscular or force responses to fatiguing isometric muscle actions anchored to a high perceptual intensity? J Strength Cond Res XX(X): 000-000, 2019-The purpose of this study was to use the ratings of perceived exertion (RPE) clamp model to examine sex-specific changes in neuromuscular responses and force after a sustained isometric leg extension muscle action anchored to RPE = 8. Twenty adults (10 men and 10 women) performed sustained, isometric leg extension muscle actions at RPE = 8. Electromyographic (EMG) and mechanomyographic signals were recorded from the dominant leg. Neuromuscular and force values resulting from the sustained muscle action were normalized to pretest maximal voluntary isometric contractions (MVICs). The level of significance set for the study was p ≤ 0.05. The pretest MVIC was significantly (p < 0.001) greater (averaged across sex) than posttest MVIC force (55.5 ± 10.0 vs. 47.6 ± 11.1 kg). There was a significant (p < 0.01) decrease from pretest (95.4 ± 7.7 Hz) to posttest (76.2 ± 5.9 Hz) in EMG mean power frequency (MPF) for the men. The normalized force (averaged across sex) decreased significantly (p < 0.001) from the initial timepoint (57.1 ± 16.4%) to the final timepoint (44.3 ± 15.7%) of the sustained muscle action. Normalized EMG MPF (averaged across sex) decreased significantly (p = 0.001) from the initial timepoint (96.4 ± 17.5%) to final timepoint (87.8 ± 18.1%). The men and women exhibited similar fatigue-induced changes in force and neuromuscular parameters; therefore, these findings did not indicate different sex-specific responses after the fatiguing task anchored to a high perception of exertion. The force corresponding to RPE = 8 did not match the anticipated value; so, RPE and percentages of MVIC cannot be used interchangeably, and sustained isometric muscle actions anchored to RPE may elicit unique neuromuscular adaptations.

Sex difference in fatigability of knee extensor muscles during sustained low-level contractions

This study investigated whether the sex difference in fatigability of the knee extensors (KE) is explained by the sex difference in fatigue-induced changes in the shear modulus of one or more muscles of KE in 18 young men and 23 young women. The shear moduli of the resting rectus femoris and medial and lateral vastus muscles (VL) were measured before and after a sustained contraction at 20% peak torque during a maximal voluntary isometric contraction of KE until the endurance limit, in addition to evoked torque and voluntary activation (VA%). The fatigue-induced decrease in maximal muscle strength was more prominent in men than in women. Only the VL shear modulus for men increased after the fatiguing task, and a sex difference was observed in the percentage change in the VL shear modulus before and after the fatiguing task. The fatigue-induced decreased ratio was greater for men than for women in evoked torque, but not in VA%. These results suggest that although peripheral and central fatigue both influenced the fatigue-induced decrease in maximal muscle strength regardless of sex, the sex difference in KE fatigability is explained by that in peripheral fatigue, particularly the degree of peripheral VL fatigue.

Sex differences in fatigability and recovery relative to the intensity-duration relationship

KEY POINTS

Females demonstrate greater fatigue resistance than males during contractions at intensities relative to maximum force. However, previous studies have not accounted for the influence of metabolic thresholds on fatigability. This study is the first to test whether sex differences in fatigability exist when exercise intensity is normalised relative to a metabolic threshold: the critical intensity derived from assessment of the intensity-duration relationship during intermittent, isometric knee extensor contractions. We show that critical intensity in females occurred at a higher percentage of maximum force compared to males. Furthermore, females demonstrated greater fatigue resistance at exercise intensities above and below this metabolic threshold. Our data suggest that the sex difference was mediated by lesser deoxygenation of the knee extensors during exercise. These data highlight the importance of accounting for metabolic thresholds when comparing fatigability between sexes, whilst emphasising the notion that male data are not generalisable to female populations.

ABSTRACT

Females are less fatigable than males during isometric exercise at intensities relative to maximal voluntary contraction (MVC); however, whether a sex difference in fatigability exists when exercise is prescribed relative to a critical intensity is unknown. This study established the intensity-duration relationship, and compared fatigability and recovery between sexes following intermittent isometric contractions normalised to critical intensity. Twenty participants (10 females) completed four intermittent isometric knee extension trials to task failure to determine critical intensity and the curvature constant (W'), followed by fatiguing tasks at +10% and -10% relative to critical intensity. Neuromuscular assessments were completed at baseline and for 45 min post-exercise. Non-invasive neurostimulation, near-infrared spectroscopy, and non-invasive haemodynamic monitoring were used to elucidate the physiological mechanisms responsible for sex differences. Females demonstrated a greater critical intensity relative to MVC than males (25 ± 3 vs. 21 ± 2% MVC, P = 0.003), with no sex difference for W' (18,206 ± 6331 vs. 18,756 ± 5762 N s, P = 0.850). Time to task failure was greater for females (62.37 ± 17.25 vs. 30.43 ± 12.75 min, P < 0.001) during the +10% trial, and contractile function recovered faster post-exercise (P = 0.034). During the -10% trial females experienced less contractile dysfunction (P = 0.011). Throughout the +10% trial, females demonstrated lesser decreases in deoxyhaemoglobin (P = 0.007) and an attenuated exercise pressor reflex. These data show that a sex difference in fatigability exists even when exercise is matched for critical intensity. We propose that greater oxygen availability during exercise permits females to sustain a higher relative intensity than males, and is an explanatory factor for the sex difference in fatigability during intermittent, isometric contractions.

Exercise-induced hyperemia is associated with knee extensor fatigability in adults with type 2 diabetes

The aim of this study was to compare fatigability, contractile function, and blood flow to the knee extensor muscles after dynamic exercise in patients with type 2 diabetes mellitus (T2DM) and controls. The hypotheses were that patients with T2DM would demonstrate greater fatigability than controls, and greater fatigability would be associated with a lower exercise-induced increase in blood flow and greater impairments in contractile function. Patients with T2DM ( n = 15; 8 men; 62.4 ± 9.0 yr; 30.4 ± 7.7 kg/m²; 7,144 ± 3,294 steps/day) and 15 healthy control subjects (8 men, 58.4 ± 6.9 yr; 28.4 ± 4.6 kg/m²; 7,893 ± 2,323 steps/day) were matched for age, sex, body mass index, and physical activity. Fatigability was quantified as the reduction in knee extensor power during a 6-min dynamic exercise. Before and after exercise, vascular ultrasonography and electrical stimulation were used to assess skeletal muscle blood flow and contractile properties, respectively. Patients with T2DM had greater fatigability (30.0 ± 20.1% vs. 14.6 ± 19.0%, P < 0.001) and lower exercise-induced hyperemia (177 ± 90% vs. 194 ± 79%, P = 0.04) than controls but similar reductions in the electrically evoked twitch amplitude (37.6 ± 24.8% vs. 31.6 ± 30.1%, P = 0.98). Greater fatigability of the knee extensor muscles was associated with postexercise reductions in twitch amplitude ( r = 0.64, P = 0.001) and lesser exercise-induced hyperemia ( r = -0.56, P = 0.009). Patients with T2DM had greater lower-limb fatigability during dynamic exercise, which was associated with reduced contractile function and lower skeletal muscle blood flow. Thus, treatments focused on enhancing perfusion and reversing impairments in contractile function in patients with T2DM may offset lower-limb fatigability and aid in increasing exercise capacity. NEW & NOTEWORTHY Although prior studies compare patients with type 2 diabetes mellitus (T2DM) with lean controls, our study includes controls matched for age, body mass, and physical activity to more closely assess the effects of T2DM. Patients with T2DM demonstrated no impairment in macrovascular endothelial function, evidenced by similar flow-mediated dilation to controls. However, patients with T2DM had greater fatigability and reduced exercise-induced increase in blood flow (hyperemia) after a lower-limb dynamic fatiguing exercise compared with controls.

Mechanisms for the increased fatigability of the lower limb in people with type 2 diabetes

Fatiguing exercise is the basis of exercise training and a cornerstone of management of type 2 diabetes mellitus (T2D); however, little is known about the fatigability of limb muscles and the involved mechanisms in people with T2D. The purpose of this study was to compare fatigability of knee extensor muscles between people with T2D and controls without diabetes and determine the neural and muscular mechanisms for a dynamic fatiguing task. Seventeen people with T2D [ten men and seven women: 59.6 (9.0) yr] and twenty-one age-, body mass index-, and physical activity-matched controls [eleven men and ten women: 59.5 (9.6) yr] performed one hundred twenty high-velocity concentric contractions (one contraction/3 s) with a load equivalent to 20% maximal voluntary isometric contraction (MVIC) torque with the knee extensors. Transcranial magnetic stimulation (TMS) and electrical stimulation of the quadriceps were used to assess voluntary activation and contractile properties. People with T2D had larger reductions than controls in power during the fatiguing task [42.8 (24.2) vs. 26.4 (15.0)%; P < 0.001] and MVIC torque after the fatiguing task [37.6 (18.2) vs. 26.4 (12.1)%; P = 0.04]. People with T2D had greater reductions than controls in the electrically evoked twitch amplitude after the fatiguing task [44.0 (20.4) vs. 35.4 (12.1)%, respectively; P = 0.01]. However, the decrease in voluntary activation was similar between groups when assessed with electrical stimulation [12.1 (2.6) vs. 12.4 (4.4)% decrease; P = 0.84] and TMS ( P = 0.995). A greater decline in MVIC torque was associated with larger reductions of twitch amplitude ( r2 = 0.364, P = 0.002). Although neural mechanisms contributed to fatigability, contractile mechanisms were responsible for the greater knee extensor fatigability in men and women with T2D compared with healthy controls.

NEW & NOTEWORTHY Transcranial magnetic stimulation and percutaneous muscle stimulation were used to determine the contributions of neural and contractile mechanisms of fatigability of the knee extensor muscles after a dynamic fatiguing task in men and women with type 2 diabetes (T2D) and healthy age-, body mass index-, and physical activity-matched controls. Although neural and contractile mechanisms contributed to greater fatigability of people with T2D, fatigability was primarily associated with impaired contractile mechanisms and glycemic control.

Women show similar central and peripheral fatigue to men after half-marathon

Women are known to be less fatigable than men in single-joint exercises, but fatigue induced by running has not been well understood. Here we investigated sex differences in central and peripheral fatigue and in rate of force development (RFD) in the knee extensors after a half-marathon run. Ten male and eight female amateur runners (aged 25-50 years) were evaluated before and immediately after a half-marathon race. Knee extensors forces were obtained under voluntary and electrically evoked isometric contractions. Maximal voluntary isometric contraction (MVC) force and peak RFD were recorded. Electrically doublet stimuli were delivered during the MVC and at rest to calculate the level of voluntary activation and the resting doublet twitch. After the race, decreases in MVC force (males: -11%, effect size [ES] 0.52; females: -11% ES 0.33), voluntary activation (males: -6%, ES 0.87; females: -4%, ES 0.72), and resting doublet twitch (males: -6%, ES 0.34; females: -8%, ES 0.30) were found to be similar between males and females. The decrease in peak RFD was found to be similar between males and females (males: -14%, ES 0.43; females: -15%, ES 0.14). Half-marathon run induced both central and peripheral fatigue, without any difference between men and women. The maximal and explosive strength loss was found similar between sexes. Together, these findings do not support the need of sex-specific training interventions to increase the tolerance to neuromuscular fatigue in half-marathoners.

Sex differences in fatigability of dynamic contractions

NEW FINDINGS

What is the topic of this review? Women are usually less fatigable than men for isometric fatiguing contractions of similar intensity, but whether this occurs for dynamic tasks is less clear. This review presents evidence that the sex difference in muscle fatigue of repeated dynamic contractions is specific to the task requirements, including the velocity of shortening and the muscle group involved. What advances does it highlight? Contractile mechanisms are responsible for the sex differences in muscle fatigue for slow-velocity and low-load dynamic tasks. The variability of the sex difference in fatigability among dynamic tasks has implications for fatiguing contractions prescribed in training and rehabilitation to men and women. Women are usually less fatigable than men during single-limb isometric contractions, primarily because of sex-related differences in contractile mechanisms. It is less clear whether these sex differences in muscle fatigue occur for dynamic fatiguing tasks. This review highlights new findings that the sex difference in fatigability for dynamic shortening contractions with a single limb is dependent on the contraction velocity and the muscle group involved. Recent studies demonstrate that women are less fatigable than men for a dynamic task as follows: (i) the elbow-flexor muscles at slow- but not high-velocity contractions; and (ii) the knee-extensor muscles when muscle fatigue was quantified as a reduction in the maximal voluntary isometric contraction force after the dynamic fatiguing task. Contractile mechanisms are responsible for the sex difference in muscle fatigue of the dynamic contractions, with no evidence for a sex difference in the reduction in voluntary activation (i.e. central fatigue). Thus, these findings indicate that the sex difference in muscle fatigue of dynamic contractions is task specific. These data also challenge the assumption that men and women respond in a similar manner to training and rehabilitation that involve fatiguing contractions to overload the neuromuscular system. There is, however, a tremendous opportunity for conducting high-impact studies to gain insight into those factors that define the sex-based differences in muscle fatigue during dynamic tasks. Such studies can define the boundaries to human performance in both men and women during athletic endeavours, ergonomic tasks and rehabilitation.