Sex Differences in Neuromuscular Fatigability of the Knee Extensors Post-Stroke

Overview

Journal Brain Sci

Publisher MDPI

Date 2017 Jan 14

PMID 28085089

Citations 1

Authors

Meghan Kirking

Reivian Berrios Barillas

Philip Andrew Nelson

Sandra Kay Hunter

Allison Hyngstrom

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Despite the implications of optimizing strength training post-stroke, little is known about the differences in fatigability between men and women with chronic stroke. The purpose of this study was to determine the sex differences in knee extensor muscle fatigability and potential mechanisms in individuals with stroke.

Methods: Eighteen participants (10 men, eight women) with chronic stroke (≥6 months) and 23 (12 men, 11 women) nonstroke controls participated in the study. Participants performed an intermittent isometric contraction task (6 s contraction, 3 s rest) at 30% of maximal voluntary contraction (MVC) torque until failure to maintain the target torque. Electromyography was used to determine muscle activation and contractile properties were assessed with electrical stimulation of the quadriceps muscles.

Results: Individuals with stroke had a briefer task duration (greater fatigability) than nonstroke individuals (24.1 ± 17 min vs. 34.9 ± 16 min). Men were more fatigable than women for both nonstroke controls and individuals with stroke (17.9 ± 9 min vs. 41.6 ± 15 min). Individuals with stroke had less fatigue-related changes in muscle contractile properties and women with stroke differed in their muscle activation strategy during the fatiguing contractions.

Conclusions: Men and women fatigue differently post-stroke and this may be due to the way they neurally activate muscle groups.

Citing Articles

The Relevance of Sex Differences in Performance Fatigability.

Hunter S Med Sci Sports Exerc. 2016; 48(11):2247-2256.

PMID: 27015385 PMC: 5349856. DOI: 10.1249/MSS.0000000000000928.

References

Wust R, Morse C, de Haan A, Jones D, Degens H . Sex differences in contractile properties and fatigue resistance of human skeletal muscle. Exp Physiol. 2008; 93(7):843-50. DOI: 10.1113/expphysiol.2007.041764. View

Keller-Ross M, Pereira H, Pruse J, Yoon T, Schlinder-DeLap B, Nielson K . Stressor-induced increase in muscle fatigability of young men and women is predicted by strength but not voluntary activation. J Appl Physiol (1985). 2014; 116(7):767-78. PMC: 3972745. DOI: 10.1152/japplphysiol.01129.2013. View

Kuhnen H, Rybar M, Onushko T, Doyel R, Hunter S, Schmit B . Stroke-related effects on maximal dynamic hip flexor fatigability and functional implications. Muscle Nerve. 2014; 51(3):446-8. PMC: 4484723. DOI: 10.1002/mus.24520. View

Hunter S, Butler J, Todd G, Gandevia S, Taylor J . Supraspinal fatigue does not explain the sex difference in muscle fatigue of maximal contractions. J Appl Physiol (1985). 2006; 101(4):1036-44. DOI: 10.1152/japplphysiol.00103.2006. View

Gandevia S . Spinal and supraspinal factors in human muscle fatigue. Physiol Rev. 2001; 81(4):1725-89. DOI: 10.1152/physrev.2001.81.4.1725. View

Nadeau S, Gravel D, Arsenault A, Bourbonnais D . Plantarflexor weakness as a limiting factor of gait speed in stroke subjects and the compensating role of hip flexors. Clin Biomech (Bristol). 2000; 14(2):125-35. DOI: 10.1016/s0268-0033(98)00062-x. View

van de Port I, Kwakkel G, Bruin M, Lindeman E . Determinants of depression in chronic stroke: a prospective cohort study. Disabil Rehabil. 2007; 29(5):353-8. DOI: 10.1080/09638280600787047. View

Sibley K, Tang A, Patterson K, Brooks D, McIlroy W . Changes in spatiotemporal gait variables over time during a test of functional capacity after stroke. J Neuroeng Rehabil. 2009; 6:27. PMC: 2717983. DOI: 10.1186/1743-0003-6-27. View

Kamper D, Fischer H, Cruz E, Rymer W . Weakness is the primary contributor to finger impairment in chronic stroke. Arch Phys Med Rehabil. 2006; 87(9):1262-9. DOI: 10.1016/j.apmr.2006.05.013. View

10.

Enoka R, Duchateau J . Translating Fatigue to Human Performance. Med Sci Sports Exerc. 2016; 48(11):2228-2238. PMC: 5035715. DOI: 10.1249/MSS.0000000000000929. View

11.

Roth D, Sheehan O, Huang J, Rhodes J, Judd S, Kilgore M . Medicare claims indicators of healthcare utilization differences after hospitalization for ischemic stroke: Race, gender, and caregiving effects. Int J Stroke. 2016; 11(8):928-934. PMC: 5518936. DOI: 10.1177/1747493016660095. View

12.

Russ D, Kent-Braun J . Sex differences in human skeletal muscle fatigue are eliminated under ischemic conditions. J Appl Physiol (1985). 2003; 94(6):2414-22. DOI: 10.1152/japplphysiol.01145.2002. View

13.

Schepers V, Visser-Meily A, Ketelaar M, Lindeman E . Poststroke fatigue: course and its relation to personal and stroke-related factors. Arch Phys Med Rehabil. 2006; 87(2):184-8. DOI: 10.1016/j.apmr.2005.10.005. View

14.

Sibley K, Tang A, Brooks D, McIlroy W . Effects of extended effortful activity on spatio-temporal parameters of gait in individuals with stroke. Gait Posture. 2007; 27(3):387-92. DOI: 10.1016/j.gaitpost.2007.05.007. View

15.

Hunter S . The Relevance of Sex Differences in Performance Fatigability. Med Sci Sports Exerc. 2016; 48(11):2247-2256. PMC: 5349856. DOI: 10.1249/MSS.0000000000000928. View

16.

Hyngstrom A, Onushko T, Heitz R, Rutkowski A, Hunter S, Schmit B . Stroke-related changes in neuromuscular fatigue of the hip flexors and functional implications. Am J Phys Med Rehabil. 2011; 91(1):33-42. PMC: 3940208. DOI: 10.1097/PHM.0b013e31823caac0. View

17.

Hunter S, Critchlow A, Shin I, Enoka R . Men are more fatigable than strength-matched women when performing intermittent submaximal contractions. J Appl Physiol (1985). 2004; 96(6):2125-32. DOI: 10.1152/japplphysiol.01342.2003. View

18.

Kent-Braun J, Fitts R, Christie A . Skeletal muscle fatigue. Compr Physiol. 2013; 2(2):997-1044. DOI: 10.1002/cphy.c110029. View

19.

Miller A, MacDougall J, Tarnopolsky M, Sale D . Gender differences in strength and muscle fiber characteristics. Eur J Appl Physiol Occup Physiol. 1993; 66(3):254-62. DOI: 10.1007/BF00235103. View

20.

Hoffmann G, Conrad M, Qiu D, Kamper D . Contributions of voluntary activation deficits to hand weakness after stroke. Top Stroke Rehabil. 2015; 23(6):384-392. DOI: 10.1179/1945511915Y.0000000023. View