The Relevance of Sex Differences in Performance Fatigability

Performance fatigability differs between men and women for a range of fatiguing tasks. Women are usually less fatigable than men, and this is most widely described for isometric fatiguing contractions and some dynamic tasks. The sex difference in fatigability is specific to the task demands so that one mechanism is not universal, including any sex differences in skeletal muscle physiology, muscle perfusion, and voluntary activation. However, there are substantial knowledge gaps about the task dependency of the sex differences in fatigability, the involved mechanisms, and the relevance to clinical populations and with advanced age. The knowledge gaps are in part due to the significant deficits in the number of women included in performance fatigability studies despite a gradual increase in the inclusion of women for the last 20 yr. Therefore, this review 1) provides a rationale for the limited knowledge about sex differences in performance fatigability, 2) summarizes the current knowledge on sex differences in fatigability and the potential mechanisms across a range of tasks, 3) highlights emerging areas of opportunity in clinical populations, and 4) suggests strategies to close the knowledge gap and understanding the relevance of sex differences in performance fatigability. The limited understanding about sex differences in fatigability in healthy and clinical populations presents as a field ripe with opportunity for high-impact studies. Such studies will inform on the limitations of men and women during athletic endeavors, ergonomic tasks, and daily activities. Because fatigability is required for effective neuromuscular adaptation, sex differences in fatigability studies will also inform on optimal strategies for training and rehabilitation in both men and women

Performance Fatigability: Mechanisms and Task Specificity

Performance fatigability is characterized as an acute decline in motor performance caused by an exercise-induced reduction in force or power of the involved muscles. Multiple mechanisms contribute to performance fatigability and originate from neural and muscular processes, with the task demands dictating the mechanisms. This review highlights that (1) inadequate activation of the motoneuron pool can contribute to performance fatigability, and (2) the demands of the task and the physiological characteristics of the population assessed, dictate fatigability and the involved mechanisms. Examples of task and population differences in fatigability highlighted in this review include contraction intensity and velocity, stability and support provided to the fatiguing limb, sex differences, and aging. A future challenge is to define specific mechanisms of fatigability and to translate these findings to real-world performance and exercise training in healthy and clinical populations across the life span

Sex Differences in Fatigability of Dynamic Contractions

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

Sex Differences and Mechanisms of Task-Specific Muscle Fatigue

Women can be less fatigable than men due to sex-related differences within the neuromuscular system that impact physiological adjustments during a fatiguing task. The involved mechanism(s) for the sex difference, however, is task specific. This review explores the novel hypothesis that variation of the task will alter the magnitude of the sex-difference in muscle fatigue and the contribution of involved mechanisms

Conditioned Pain Modulation Predicts Exercise-Induced Hypoalgesia in Healthy Adults

Introduction: Conditioned pain modulation (CPM) is the concept that pain inhibits pain and has potential rehabilitation implications for exercise prescription. The purpose of this study was to determine whether changes in pressure pain perception after a thermal conditioning stimulus (i.e., CPM) was attenuated with aging and whether CPM predicted pain relief after exercise (exercise-induced hypoalgesia (EIH)) in healthy young and older adults. Methods: Twenty young (21.9 ± 3.3 yr, 10 men) and 19 older (72.0 ± 4.5 yr, 10 men) adults participated in three sessions: one familiarization and two experimental (EIH and CPM) sessions. Pressure pain perception was assessed using a weighted Lucite edge placed on the right index finger for 1 min. EIH was determined by measuring pressure pain perception before and after prolonged submaximal isometric contraction of the elbow flexors. CPM was assessed by measuring pressure pain perception at the finger while the foot was immersed in neutral water versus painful ice water. Results: Young, but not older, adults reported a decrease in pressure pain at the finger while their foot was immersed in the ice water bath compared with the neutral bath (i.e., CPM, trial–age: P = 0.001). Pressure pain ratings decreased after exercise (P = 0.03) that was perceived as painful (peak arm pain, 7.0 ± 3.3) for both young and older adults. Regression analysis showed that after controlling for age and baseline pain, CPM predicted EIH (model adjusted R2 = 0.23, P = 0.007). Conclusions: CPM was attenuated in older adults, as measured with a noxious pressure stimulus after a thermal conditioning stimulus, and adults with greater CPM were more likely to report greater EIH

Spreading of a surfactant monolayer on a thin liquid film: Onset and evolution of digitated structures

We describe the response of an insoluble surfactant monolayer spreading on the surface of a thin liquid film to small disturbances in the film thickness and surfactant concentration. The surface shear stress, which derives from variations in surfactant concentration at the air–liquid interface, rapidly drives liquid and surfactant from the source toward the distal region of higher surface tension. A previous linear stability analysis of a quasi-steady state solution describing the spreading of a finite strip of surfactant on a thin Newtonian film has predicted only stable modes. [Dynamics in Small Confining Systems III, Materials Research Society Symposium Proceedings, edited by J. M. Drake, J. Klafter, and E. R. Kopelman (Materials Research Society, Boston, 1996), Vol. 464, p. 237; Phys. Fluids A 9, 3645 (1997); O. K. Matar Ph.D. thesis, Princeton University, Princeton, NJ, 1998]. A perturbation analysis of the transient behavior, however, has revealed the possibility of significant amplification of disturbances in the film thickness within an order one shear time after the onset of flow [Phys. Fluids A 10, 1234 (1998); "Transient response of a surfactant monolayer spreading on a thin liquid film: Mechanism for amplification of disturbances," submitted to Phys. Fluids]. In this paper we describe the linearized transient behavior and interpret which physical parameters most strongly affect the disturbance amplification ratio. We show how the disturbances localize behind the moving front and how the inclusion of van der Waals forces further enhances their growth and lifetime. We also present numerical solutions to the fully nonlinear 2D governing equations. As time evolves, the nonlinear system sustains disturbances of longer and longer wavelength, consistent with the quasi-steady state and transient linearized descriptions. In addition, for the parameter set investigated, disturbances consisting of several harmonics of a fundamental wavenumber do not couple significantly. The system eventually singles out the smallest wavenumber disturbance in the chosen set. The summary of results to date seems to suggest that the fingering process may be a transient response which nonetheless has a dramatic influence on the spreading process since the digitated structures redirect the flux of liquid and surfactant to produce nonuniform surface coverage

Functional Implications of Impaired Control of Submaximal Hip Flexion Following Stroke

Introduction: We quantified sub-maximal torque regulation during low to moderate intensity isometric hip flexion contractions in individuals with stroke and the associations with leg function. Methods: 10 participants with chronic stroke and 10 controls performed isometric hip flexion contractions at 5%, 10%, 15%, 20%, and 40% of maximal voluntary contraction (MVC) in paretic, non-paretic, and control legs. Results: Participants with stroke had larger torque fluctuations (coefficient of variation, CV), for both the paretic and non-paretic legs, than controls (Pr2 =0.45) and Berg Balance Score (r2=0.38). At 5% MVC, there were larger torque fluctuations in the contralateral leg during paretic contractions compared with the control leg. Conclusions: Impaired low-force regulation of paretic leg hip flexion can be functionally relevant and related to control versus strength deficits post stroke