Central and peripheral manipulations of perceived exertion and endurance performance

Perception of effort, defined as “the conscious sensation of hard, heavy and strenuous exercise”, is known to regulate endurance performance and human behaviour. Perception of effort has recently been shown to be exacerbated by mental exertion and is also known to be a main feature of fatigue. However, to date, not only its neurophysiology but also how manipulations of perceived exertion might impact endurance performance remain poorly understood. The main aim of this thesis was to investigate how manipulations of perceived exertion might impact endurance performance. This thesis is divided in two parts: central and peripheral manipulations of perceived exertion. In each part, three experimental chapters aimed to get a better insight in the neurophysiology of perceived exertion and its impact on endurance performance. In the first part (central manipulations), we firstly investigated the impact of exacerbating perceived exertion via mental exertion involving the response inhibition process on self-paced running endurance performance. This study demonstrated that as with time to exhaustion tests, time trial performance is impaired following mental exertion leading to mental fatigue. Secondly, we investigated whether mental exertion leading to mental fatigue could alter the rate of central fatigue development during constant load whole-body exercise. This study demonstrated that the exacerbated perception of effort in presence of mental fatigue does not reflect an altered rate of central fatigue development, but is likely to be due to i) an impaired central motor command and/or ii) an alteration of the central processing of the corollary discharge. Thirdly, we investigated whether mental exertion could impact the repeatability of maximal voluntary contraction of the knee extensors. We found that contrary to submaximal exercise, force production capacity is not altered by mental exertion. Finally, these three studies demonstrated that i) mental exertion negatively impacts submaximal exercise but not maximal exercise and that ii) mental fatigue differs from central fatigue. In the second part (peripheral manipulation), we firstly developed and tested the reliability of a new endurance exercise model non-limited by the cardiorespiratory system (one leg dynamic exercise), which will be of benefits for future researches aiming to manipulate feedback from group III-IV muscle afferents. Secondly, we described neuromuscular alterations induced by this exercise and tested a new methodology to indirectly measure feedback from group III-IV muscle afferents. This study demonstrated that one leg dynamic exercise induced central and peripheral fatigue and also a decrease in spinal excitability associated with an increase in cortical excitability. Furthermore, this study also suggests that monitoring cardiovascular responses during muscle occlusion might be a suitable tool to indirectly measure feedback from group III-IV muscle afferents. Thirdly, we tested the corollary discharge and afferent feedback model of perceived exertion with electromyostimulation. This study demonstrated for the first time that for the same force output, perception of effort generation is independent of muscle afferents and reflects the magnitude of the central motor command (manipulated by electromyostimulation). All together, these findings provide further evidence in support of the corollary discharge model of perceived exertion, and provide a new exercise model to investigate and manipulate perception of effort. This thesis, when integrating both experimental parts, provides new insight on how perception of effort regulates endurance performance. Specifically, it demonstrates how muscle fatigue is a contributor of the continuous increase in perception of effort during endurance exercise, but also that other contributors play a role in this increase in perception of effort. Indeed, we demonstrated for the first time that i) perception of effort alterations in the presence of mental fatigue is independent of any alterations of the neuromuscular system, and ii) muscle afferents does not directly impact perception of effort, but may influence it indirectly via their role in motor control

“Ready-to-use” two-week home exercise program targeting depressive symptoms: pilot study

Exercise is an evidence-based treatment for depressive symptoms, yet it often requires specialised knowledge, equipment, or professional supervision. Lay people in certain contexts, for example in remote locations or under pandemic restrictions, often lack these resources and thus cannot use exercise to manage their depressive symptoms. We developed a two-week home exercise program that bypasses these barriers and tested it in university students during pandemic restrictions. In an online study, we recruited 49 participants to complete a week of baseline symptom monitoring then follow the exercise program for 2 weeks (6 sessions) at home. The exercise program involved aerobic and resistance training; each session lasted approximately 45 min. After 2 weeks of the intervention, participants reported lower depressive (standardised β = −0.71 [−1.05, −0.38]) and anxiety (β = −0.87 [−1.19, −0.55]) symptoms. Although we cannot make causal conclusions, our results suggest that the brief home exercise program may have potential to reduce depressive symptoms in young adults

Application of the Facial Feedback Hypothesis to Endurance Performance– Does Frowning Modulate Perception of Effort?

Objectives: People frown during strenuous exercise. Research on the facial feedback hypothesis raises the intriguing possibility that frowning may modulate (i.e., amplify/soften) perception of effort during endurance performance and therefore play a causal role in endurance performance. This study examined whether intentionally frowning throughout a cycling time-to-exhaustion test increased perception of effort and, consequently, reduced time to exhaustion. This study also examined the effects of frowning on affective states experienced during performance and after exhaustion. Design: A randomised, controlled, crossover experimental design was used to compare (within-subjects) the effects of frowning with control conditions. Methods: Ten recreational endurance athletes performed cycling time-to-exhaustion tests in three conditions. In a frowning condition, participants frowned throughout the time-to-exhaustion test. In a matched-workload control condition, participants pressed their thumb against the ergometer handlebar throughout the test. Electromyography biofeedback was used to deliver these interventions. There was also a no-intervention control condition. Perception of effort and exercise-related affect were measured throughout the time-to-exhaustion test, and positive and negative affective states were measured before and after the test. Results: Intentionally frowning did not affect perception of effort, affective states experienced while cycling or after exhaustion, or time to exhaustion. Conclusions: Frowning may not modulate perception of effort or affective responses during endurance exercise to exhaustion. Although additional research using different methods would allow firmer conclusions to be drawn, these findings suggest that interventions that target the expression of a frown would be unlikely to offer an efficacious method of improving endurance performance

Ischemic preconditioning of the muscle reduces the metaboreflex response of the knee extensors

Purpose: This study investigated the effect of ischemic preconditioning (IP) on metaboreflex activation following dynamic leg extension exercise in a group of healthy participants. Method: Seventeen healthy participants were recruited. IP and SHAM treatments (3 × 5 min cuff occlusion at 220 mmHg or 20 mmHg, respectively) were administered in a randomized order to the upper part of exercising leg’s thigh only. Muscle pain intensity (MP) and pain pressure threshold (PPT) were monitored while administrating IP and SHAM treatments. After 3 min of leg extension exercise at 70% of the maximal workload, a post-exercise muscle ischemia (PEMI) was performed to monitor the discharge group III/IV muscle afferents via metaboreflex activation. Hemodynamics were continuously recorded. MP was monitored during exercise and PEMI. Results: IP significantly reduced mean arterial pressure compared to SHAM during metaboreflex activation (mean ± SD, 109.52 ± 7.25 vs. 102.36 ± 7.89 mmHg) which was probably the consequence of a reduced end diastolic volume (mean ± SD, 113.09 ± 14.25 vs. 102.42 ± 9.38 ml). MP was significantly higher during the IP compared to SHAM treatment, while no significant differences in PPT were found. MP did not change during exercise, but it was significantly lower during the PEMI following IP (5.10 ± 1.29 vs. 4.00 ± 1.54). Conclusion: Our study demonstrated that IP reduces hemodynamic response during metaboreflex activation, while no effect on MP and PPT were found. The reduction in hemodynamic response was likely the consequence of a blunted venous return

Mental fatigue induced by prolonged self-regulation does not exacerbate central fatigue during subsequent whole-body endurance exercise

It has been shown that the mental fatigue induced by prolonged self-regulation increases perception of effort and reduces performance during subsequent endurance exercise. However, the physiological mechanisms underlying these negative effects of mental fatigue are unclear. The primary aim of this study was to test the hypothesis that mental fatigue exacerbates central fatigue induced by whole-body endurance exercise. Twelve subjects performed 30 min of either an incongruent Stroop task to induce a condition of mental fatigue or a congruent Stroop task (control condition) in a random and counterbalanced order. Both cognitive tasks (CTs) were followed by a whole-body endurance task (ET) consisting of 6 min of cycling exercise at 80% of peak power output measured during a preliminary incremental test. Neuromuscular function of the knee extensors was assessed before and after CT, and after ET. Rating of perceived exertion (RPE) was measured during ET. Both CTs did not induce any decrease in maximal voluntary contraction (MVC) torque (p = 0.194). During ET, mentally fatigued subjects reported higher RPE (mental fatigue 13.9 ± 3.0, control 13.3 ± 3.2, p = 0.044). ET induced a similar decrease in MVC torque (mental fatigue -17 ± 15%, control -15 ± 11%, p = 0.001), maximal voluntary activation level (mental fatigue -6 ± 9%, control -6 ± 7%, p = 0.013) and resting twitch (mental fatigue -30 ± 14%, control -32 ± 10%, p < 0.001) in both conditions. These findings reject our hypothesis and confirm previous findings that mental fatigue does not reduce the capacity of the central nervous system to recruit the working muscles. The negative effect of mental fatigue on perception of effort does not reflect a greater development of either central or peripheral fatigue. Consequently, mentally fatigued subjects are still able to perform maximal exercise, but they are experiencing an altered performance during submaximal exercise due to higher-than-normal perception of effort

Web-Based Physical Activity Interventions Are Feasible and Beneficial Solutions to Prevent Physical and Mental Health Declines in Community-Dwelling Older Adults During Isolation Periods.

peer reviewed[en] BACKGROUND: Periods of prolonged lockdown increase the risk of physical inactivity, which can contribute to physical decline among older adults. Online technology could be an innovative solution to promote physical activity (PA) habits in this context. The goal of this study was to examine and compare the acceptability, feasibility, and potential benefits of 2 modalities of web-based PA interventions in older adults during the coronavirus disease 2019 lockdown. METHODS: Eighty-three nonphysically active community-dwelling older adults (aged 60 and older) were randomized to a 12-week web-based PA intervention delivered either in a live group (LG; n = 38) or a recorded group (RG; n = 45). Acceptability, feasibility as well as functional capacities, physical performance, quality of life, and PA level were assessed pre and postintervention. RESULTS: There were fewer dropouts in the LG than RG (LG: 16% vs RG: 46%). However, adherence rate (LG: 89%; RG: 81%), level of satisfaction (LG: 77% vs RG: 64%), and enjoyment (LG: 68% vs RG: 62%) were similar across groups, even if the participants found the intervention slightly difficult (LG: 58% vs RG: 63%). Both groups significantly improved on functional capacities, physical performance, and quality of life. Only the LG showed significant improvements in perceived health and PA level. The LG showed greater improvements in physical performance and quality of life than the RG. CONCLUSION: Web-based PA interventions are feasible, acceptable, and beneficial for improving functional capacities and physical performance during periods of lockdown. However, the interactive web and live modalities appear to be more effective for promoting some of these outcomes than recorded and individual modalities

Early liver transplantation for severe alcohol-related hepatitis not responding to medical treatment: a prospective controlled study

peer reviewedBackground: Early liver transplantation for severe alcohol-related hepatitis is an emerging treatment option. We aimed to assess the risk of alcohol relapse 2 years after early liver transplantation for alcohol-related hepatitis compared with liver transplantation for alcohol-related cirrhosis after at least 6 months of abstinence. Methods: We conducted a multicentre, non-randomised, non-inferiority, controlled study in 19 French and Belgian hospitals. All participants were aged 18 years or older. There were three groups of patients recruited prospectively: patients with severe alcohol-related hepatitis who did not respond to medical treatment and were eligible for early liver transplantation according to a new selection scoring system based on social and addiction items that can be quantified in points (early transplantation group); patients with alcohol-related cirrhosis listed for liver transplantation after at least 6 months of abstinence (standard transplantation group); patients with severe alcohol-related hepatitis not responding to medical treatment not eligible for early liver transplantation according to the selection score (not eligible for early transplantation group), this group did not enter any further liver transplantation processes. We also defined a historical control group of patients with severe alcohol-related hepatitis unresponsive to medical therapy and non-transplanted. The primary outcome was the non-inferiority of 2-year rate of alcohol relapse after transplantation in the early transplantation group compared with the standard transplantation group using the alcohol timeline follow back (TLFB) method and a prespecified non-inferiority margin of 10%. Secondary outcomes were the pattern of alcohol relapse, 2-year survival rate post-transplant in the early transplantation group compared with the standard transplantation group, and 2-year overall survival in the early transplantation group compared with patients in the not eligible for early transplantation group and historical controls. This trial is registered with ClinicalTrials.gov, NCT01756794. Findings: Between Dec 5, 2012, and June 30, 2016, we included 149 patients with severe alcohol-related hepatitis: 102 in the early transplantation group and 47 in the not eligible for early transplantation group. 129 patients were included in the standard transplantation group. 68 patients in the early transplantation group and 93 patients in the standard transplantation group received a liver transplant. 23 (34%) patients relapsed in the early transplantation group, and 23 (25%) patients relapsed in the standard transplantation group; therefore, the non-inferiority of early transplantation versus standard transplantation was not demonstrated (absolute difference 9·1% [95% CI –∞ to 21·1]; p=0·45). The 2-year rate of high alcohol intake was greater in the early transplantation group than the standard transplantation group (absolute difference 16·7% [95% CI 5·8–27·6]) The time spent drinking alcohol was not different between the two groups (standardised difference 0·24 [95% CI −0·07 to 0·55]), but the time spent drinking a large quantity of alcohol was higher in the early transplantation group than the standard transplantation group (standardised difference 0·50 [95% CI 0·17–0·82]). 2-year post-transplant survival was similar between the early transplantation group and the standard transplantation group (hazard ratio [HR] 0·87 [95% CI 0·33–2·26]); 2-year overall survival was higher in the early transplantation group than the not eligible for early transplantation group and historical controls (HR 0·27 [95% CI 0·16–0·47] and 0·21 [0·13–0·32]). Interpretation: We cannot conclude non-inferiority in terms of rate of alcohol relapse post-transplant between early liver transplantation and standard transplantation. High alcohol intake is more frequent after early liver transplantation. This prospective controlled study confirms the important survival benefit related to early liver transplantation for severe alcohol-related hepatitis; and this study provides objective data on survival and alcohol relapse to tailor the management of patients with severe alcohol-related hepatitis. Funding: The present study has been granted by the French Ministry of Health—Programme Hospitalier de Recherche Clinique 2010

Perception of effort in Exercise Science: Definition, measurement and perspectives

International audiencePerception of effort, also known as perceived exertion or sense of effort, can be described as a cognitive feeling of work associated with voluntary actions. The aim of the present review is to provide an overview of what is perception of effort in Exercise Science. Due to the addition of sensations other than effort in its definition, the neurophysiology of perceived exertion remains poorly understood. As humans have the ability to dissociate effort from other sensations related to physical exercise, the need to use a narrower definition is emphasised. Consequently, a definition and some brief guidelines for its measurement are provided. Finally, an overview of the models present in the literature aiming to explain its neurophysiology, and some perspectives for future research are offered