Muscle fatigue is an exercise-induced reduction in maximal voluntary muscle force. It may arise not only because of peripheral changes at the level of the muscle, but also because the central nervous system fails to drive the motoneurons adequately. Evidence for “central” fatigue and the neural mechanisms underlying it are reviewed, together with its terminology and the methods used to reveal it. Much data suggest that voluntary activation of human motoneurons and muscle fibers is suboptimal and thus maximal voluntary force is commonly less than true maximal force. Hence, maximal voluntary strength can often be below true maximal muscle force. The technique of twitch interpolation has helped to reveal the changes in drive to motoneurons during fatigue. Voluntary activation usually diminishes during maximal voluntary isometric tasks, that is central fatigue develops, and motor unit firing rates decline. Transcranial magnetic stimulation over the motor cortex during fatiguing exercise has revealed focal cha...

Spinal and Supraspinal Factors in Human Muscle Fatigue

Mammalian skeletal muscle comprises different fiber types, whose identity is first established during embryonic development by intrinsic myogenic control mechanisms and is later modulated by neural and hormonal factors. The relative proportion of the different fiber types varies strikingly between species, and in humans shows significant variability between individuals. Myosin heavy chain isoforms, whose complete inventory and expression pattern are now available, provide a useful marker for fiber types, both for the four major forms present in trunk and limb muscles and the minor forms present in head and neck muscles. However, muscle fiber diversity involves all functional muscle cell compartments, including membrane excitation, excitation-contraction coupling, contractile machinery, cytoskeleton scaffold, and energy supply systems. Variations within each compartment are limited by the need of matching fiber type properties between different compartments. Nerve activity is a major control mechanism of the fiber type profile, and multiple signaling pathways are implicated in activity-dependent changes of muscle fibers. The characterization of these pathways is raising increasing interest in clinical medicine, given the potentially beneficial effects of muscle fiber type switching in the prevention and treatment of metabolic diseases.

Fiber types in mammalian skeletal muscles.

The first suggestion that physical exercise results in free radical-mediated damage to tissues appeared in 1978, and the past three decades have resulted in a large growth of knowledge regarding exercise and oxidative stress. Although the sources of oxidant production during exercise continue to be debated, it is now well established that both resting and contracting skeletal muscles produce reactive oxygen species and reactive nitrogen species. Importantly, intense and prolonged exercise can result in oxidative damage to both proteins and lipids in the contracting myocytes. Furthermore, oxidants can modulate a number of cell signaling pathways and regulate the expression of multiple genes in eukaryotic cells. This oxidant-mediated change in gene expression involves changes at transcriptional, mRNA stability, and signal transduction levels. Furthermore, numerous products associated with oxidant-modulated genes have been identified and include antioxidant enzymes, stress proteins, DNA repair proteins, and mitochondrial electron transport proteins. Interestingly, low and physiological levels of reactive oxygen species are required for normal force production in skeletal muscle, but high levels of reactive oxygen species promote contractile dysfunction resulting in muscle weakness and fatigue. Ongoing research continues to probe the mechanisms by which oxidants influence skeletal muscle contractile properties and to explore interventions capable of protecting muscle from oxidant-mediated dysfunction.

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Exercise-induced oxidative stress: cellular mechanisms and impact on muscle force production

The extracellular matrix (ECM), and especially the connective tissue with its collagen, links tissues of the body together and plays an important role in the force transmission and tissue structure maintenance especially in tendons, ligaments, bone, and muscle. The ECM turnover is influenced by physical activity, and both collagen synthesis and degrading metalloprotease enzymes increase with mechanical loading. Both transcription and posttranslational modifications, as well as local and systemic release of growth factors, are enhanced following exercise. For tendons, metabolic activity, circulatory responses, and collagen turnover are demonstrated to be more pronounced in humans than hitherto thought. Conversely, inactivity markedly decreases collagen turnover in both tendon and muscle. Chronic loading in the form of physical training leads both to increased collagen turnover as well as, dependent on the type of collagen in question, some degree of net collagen synthesis. These changes will modify the mechanical properties and the viscoelastic characteristics of the tissue, decrease its stress, and likely make it more load resistant. Cross-linking in connective tissue involves an intimate, enzymatical interplay between collagen synthesis and ECM proteoglycan components during growth and maturation and influences the collagen-derived functional properties of the tissue. With aging, glycation contributes to additional cross-linking which modifies tissue stiffness. Physiological signaling pathways from mechanical loading to changes in ECM most likely involve feedback signaling that results in rapid alterations in the mechanical properties of the ECM. In developing skeletal muscle, an important interplay between muscle cells and the ECM is present, and some evidence from adult human muscle suggests common signaling pathways to stimulate contractile and ECM components. Unaccostumed overloading responses suggest an important role of ECM in the adaptation of myofibrillar structures in adult muscle. Development of overuse injury in tendons involve morphological and biochemical changes including altered collagen typing and fibril size, hypervascularization zones, accumulation of nociceptive substances, and impaired collagen degradation activity. Counteracting these phenomena requires adjusted loading rather than absence of loading in the form of immobilization. Full understanding of these physiological processes will provide the physiological basis for understanding of tissue overloading and injury seen in both tendons and muscle with repetitive work and leisure time physical activity.

Role of Extracellular Matrix in Adaptation of Tendon and Skeletal Muscle to Mechanical Loading

Exercise-induced muscle injury in humans frequently occurs after unaccustomed exercise, particularly if the exercise involves a large amount of eccentric (muscle lengthening) contractions. Direct measures of exercise-induced muscle damage include cellular and subcellular disturbances, particularly Z-line streaming. Several indirectly assessed markers of muscle damage after exercise include increases in T2 signal intensity via magnetic resonance imaging techniques, prolonged decreases in force production measured during both voluntary and electrically stimulated contractions (particularly at low stimulation frequencies), increases in inflammatory markers both within the injured muscle and in the blood, increased appearance of muscle proteins in the blood, and muscular soreness. Although the exact mechanisms to explain these changes have not been delineated, the initial injury is ascribed to mechanical disruption of the fiber, and subsequent damage is linked to inflammatory processes and to changes in excitation-contraction coupling within the muscle. Performance of one bout of eccentric exercise induces an adaptation such that the muscle is less vulnerable to a subsequent bout of eccentric exercise. Although several theories have been proposed to explain this "repeated bout effect," including altered motor unit recruitment, an increase in sarcomeres in series, a blunted inflammatory response, and a reduction in stress-susceptible fibers, there is no general agreement as to its cause. In addition, there is controversy concerning the presence of sex differences in the response of muscle to damage-inducing exercise. In contrast to the animal literature, which clearly shows that females experience less damage than males, research using human studies suggests that there is either no difference between men and women or that women are more prone to exercise-induced muscle damage than are men.

Exercise-induced muscle damage in humans.

Monozygous twin pairs (two female and four male) were used in a strength training study so that one member of each pair served as training subject (TS) and the other members as nonexercising controls (CS). TS trained four times a week for 12 weeks with maximal isometric knee extensions of the right leg. The parameters studied included muscle strength, endurance time, electromyographic activity, and activities of several key enzymes in nonoxidative and oxidative muscle metabolism. The results disclosed that in addition to a 20% increase in isometric knee extension strength in the trained leg of TS, an average increase of 11% was observed in strength of TS untrained leg. CS did not demonstrate any change in muscle strength. Training also included an improvement in the maintenance of a static load of 60% of the pretraining maximum. Increase in the maximum integrated electromyographic activity (IEMG) of the rectus femoris muscle occurred concomitantly with the knee extension strength. Training also caused reduction in the IEMG/tension ratio at submaximal loads indicating a more economical usage of the rectus femoris muscle. Muscle biopsies taken from the vastus lateralis muscle showed that the enzyme activities of MDH, SDH, and HK were higher, and LDH and CPK lower in the trained leg as compared to the nontrained control leg of TS or to the values of the untrained member of the twin pair. It is concluded that isometric strength training as used in the present study can cause increased recruitment of the available motor unit pool, improved efficiency at submaximal loads, and surprisingly also enchancement of the oxidative metabolism in the muscle.

Effect of isometric strength training on mechanical, electrical and metabolic aspects of muscle function

Specific antibodies against structural proteins of muscle fibres (actin, desmin, dystrophin) and extracellular matrix (fibronectin) were used to study the effect of eccentrically biased downhill running exercise (13,5 degrees, 17 m min(-1), 130 min) on the magnitude and properties of myofibre injury in the quadriceps femoris muscle of male and female rats. Muscle beta-glucuronidase activity, a quantitative indicator of muscle damage, showed clearly smaller increase in female than in male rats during the 4-day period following exercise. A similar course of histopathological changes was observed in both sexes, although females showed slower and less marked changes than males. In males, discontinuous or even lost submembrane protein dystrophin staining was observed in some swollen fibres immediately after exercise, before the loss of desmin and staining of disorganized actin, i.e. before the disruption of the cytoskeletal system and the contractile apparatus. The observation that no dramatic changes in the microarchitecture of the muscle fibres were detected immediately or even 6 h after the exercise in females compared with males may indicate that the sarcolemma of the females might be strengthened against membrane damage by a still unknown stabilizing compound.

Gender differences in skeletal muscle fibre damage after eccentrically biased downhill running in rats.

Diabetes alters microvascular structure and function and is a major risk factor for cardiovascular diseases. In diabetic skeletal muscle, impaired angiogenesis and reduced VEGF-A expression have been observed, whereas in healthy muscle exercise is known to have opposite effects. We studied the effects of type 1 diabetes and combined exercise training on angiogenic mRNA expression and capillarization in mouse skeletal muscle. Microarray and real-time PCR analyses showed that diabetes altered the expression of several genes involved in angiogenesis. For example, levels of proangiogenic VEGF-A, VEGF-B, neuropilin-1, VEGFR-1, and VEGFR-2 were reduced and the levels of antiangiogenic thrombospondin-1 and retinoblastoma like-2 were increased. Exercise training alleviated some of these changes, but could not completely restore them. VEGF-A protein content was also reduced in diabetic muscles. In line with the reduced levels of VEGF-A and other angiogenic factors, and increased levels of angiogenesis inhibitors, capillary-to-muscle fiber ratio was lower in diabetic mice compared to healthy controls. Exercise training could not restore capillarization in diabetic mice. In conclusion, these data illustrate that type 1 diabetes is associated with reduced skeletal muscle capillarization and the dysregulation of complex angiogenesis pathways.

Effects of experimental type 1 diabetes and exercise training on angiogenic gene expression and capillarization in skeletal muscle

Selected estimates of the lipid peroxidative capacity were assayed in the red and white skeletal muscles of control and endurance-trained mice. Endurance training decreased the lipid peroxidation rate in vitro in both muscle types. The concentration of lipids susceptible to Fe2+-induced lipid peroxidation was greater in the red than in the white skeletal muscle and increased after endurance training in the red muscle. Endurance training, however, decreased highly significantly the sensitivity of red muscle to in vitro stimulated lipid peroxidation. The activity of catalase and the concentration of vitamin E were considerably higher in the red muscle, whereas the activity of glutathione peroxidase was slightly higher in the white muscle. Endurance training caused no changes in these antioxidants. Endurance training increased the concentrations of reduced and total non-protein glutathione in the red skeletal muscle but not in the white muscle. The total sulfhydryl group contents were unaffected. Our results suggest that endurance training may increase the resistance of skeletal muscle to injuries caused by lipid peroxidation.

Endurance training reduces the susceptibility of mouse skeletal muscle to lipid peroxidation in vitro.

Anaerobic performance characteristics of the whole body and at muscle tissue level were studied in 89 athletes and 31 reference subjects. The main parameters were vertical velocity during running up the stairs, maximal isometric force of leg extensor muscles, blood lactate concentration after maximal treadmill running test, percentage of fast twitch muscle fibers (% FT fibers), lactate dehydrogenase (LDH) and creatine phosphokinase (CPK) activity in vastus lateralis muscle. These parameters tended to divide the athletes and their sport events into neuromuscular, anaerobic and aerobic types. The specific needs of the different sport events might have masked the expected characteristics of energy and power utilization. However, a high percentage of FT fibers might be a prerequisite for a successful athlete in certain neuromuscular-anaerobic type events ("power events"). The main parameters describing the anaerobic performance capacity of the whole body (vertical velocity, leg force, blood lactate) were found to be related to muscle fiber composition (% FT fibers). The running velocity rather than muscle strength seemed to be more influenced by activity of enzymes LDH and CPK.

Veikko Vihko

Papers

Effect of isometric strength training on mechanical, electrical and metabolic aspects of muscle function

Gender differences in skeletal muscle fibre damage after eccentrically biased downhill running in rats.

Effects of experimental type 1 diabetes and exercise training on angiogenic gene expression and capillarization in skeletal muscle

Endurance training reduces the susceptibility of mouse skeletal muscle to lipid peroxidation in vitro.

Anaerobic performance capacity in athletes.