The development of localized muscle fatigue has classically been described by the nonlinear intensity - endurance time (ET) curve (Rohmert, 1960; El Ahrache et al., 2006). These empirical intensity-ET relationships have been well-documented and vary between joint regions. Xia and Frey Law (2008) previously proposed a three-compartment biophysical fatigue model, consisting of compartments (i.e. states) for active (MA), fatigued (MF), and resting (MR) muscle, to predict the decay and recovery of muscle force. However the model had yet to be validated for static or intermittent isometric tasks. The purpose of this thesis was to provide validation to the biophysical model. The first goal of this thesis was to determine optimal model parameter values, fatigue (F) and recovery (R), which define the "flow rate" between muscle states and to evaluate the model's accuracy for estimating expected intensity - ET curves. Using a grid-search approach with modified Monte Carlo simulations, over 1 million F and R permutations were used to predict the maximum ET for sustained isometric tasks at 9 intensities ranging from 10 - 90% of maximum in 10% increments (over 9 million simulations total). Optimal F and R values ranged from 0.00589 (Fankle) and 0.0182 (Rankle) to 0.00058 (Fshoulder) and 0.00168 (Rshoulder) , reproducing the intensity-ET curves with low mean RMS errors: shoulder (2.7s), hand/grip (5.6s), knee (6.7s), trunk (9.3s), elbow (9.9s), and ankle (11.2s). Testing the model at different task intensities (15 - 95% maximum in 10% increments) produced slightly higher errors, but largely within the 95% prediction intervals expected for the intensity-ET curves. The second goal of this thesis was to conduct a meta-analysis of available percent torque decline data as a function of duty cycle and intensity from literature. For comparison across studies, decay in MVC (% decline) was extracted at a selected range of time points: 30, 60, 90, and 120 seconds across all joints (shoulder, hand/grip, knee, trunk, elbow, and ankle). Searches of the following databases were performed: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Knowledge, and Google Scholar. The inclusion criteria included: studies with healthy human subjects, ages between 18-55 years old, intermittent tasks with force/torque data, a task time of at least 30 seconds, and published in English. Exclusion criteria included: dynamic contractions, simultaneous multi-joint testing (e.g. squat lifts), functional tasks, body/limb weight as primary resistance, and electrically stimulated contractions. The database search strategy resulted in a total of 2781 potential publications. Of these articles 44 met the required inclusion and exclusion criteria. Since there were so few publications that fit the required inclusion and exclusion criteria, static fatigue papers that were used in (Frey Law and Avin, 2010) meta-analysis and fit the inclusion requirements for this study were used to fill in points at the extreme of the surface (DC=1). Of the 194 publications that were used in the prior meta-analysis, only 3 fit the required inclusion and exclusion criteria for this analysis, for a total of 47 studies (torque decline was typically the limiting factor). From these 47 studies, empirical % decline models could be developed for the joint regions with 3 or more data points (ankle, knee, elbow, and hand/grip) and a general model for each of the 4 discrete time points. The total sample size for each joint ranged from 125 (elbow) to 306 (hand/grip). The total number of data points for each joint ranged from 28 (elbow) -to 68 (hand/grip) with a total of 193 data points extracted. The third goal of this thesis was to compare the empirical models developed from the meta-analysis to the predicted surfaces produced by the biophysical model. Each surface was compared to its empirical counterpart qualitatively and quantitatively. Qualitatively the predicted surfaces reasonable resembled the empirical models. Quantitative analysis was performed by calculating the mean RMS and relative errors between the surfaces. The predicted surfaces had reasonably low range of mean RMS errors across each time point: hand/grip (92.66-238s), knee (73.60-186.25s), elbow (23.62-96.31s), and ankle (34.02-129.63s). The quantitative analysis also showed that the percent of the data points found by the meta-analysis that fell within the predicted 95% confidence interval was reasonably high: 52%(hand/grip; 120s) to 100% (elbow; 60, 90, & 120s). This thesis concluded that this three-compartment fatigue model can be used to accurately represent joint-specific static intensity-ET curves and 3D surfaces of percent torque decline as a function of intensity and duty cycle for short intermittent tasks (i.e. <120 seconds). While the intensity-ET curves are currently used for ergonomics analysis. The relative torque decline surfaces for intermittent tasks that were developed in this thesis provide further insight into what occurs at the muscle level (i.e. decline in muscle force production) during intermittent work cycles. This insight could provide a new method for developing rest-work cycles or job rotation cycles in industry.

Two studies were conducted to determine if Hsp70 is able to protect human skeletal muscle from muscle mechanical damage and alterations in SERCA activity associated with prolonged concentric exercise. In the first study, one-legged isometric knee extension exercise at 40% MVC and a duty cycle of 50% (5 sec contraction followed by 5 sec of relaxation) was used to induce a heat shock response in one leg only. Participants were followed over six recovery days to determine the time course of Hsp70 induction and decay. Results showed fiber type specific increases in Hsp70 that persisted in one leg only throughout six days of recovery. These increases in Hsp70 occurred with only transient changes in Ca2+ uptake and muscular force. With the exception of minor decreases in low frequency force, there were no apparent reductions in muscular force or SERCA activity by the third recovery day. Therefore an exercise protocol was established which was able to induce a heat shock response with only minor alterations in muscle mechanical function and SERCA activity. In the second study, the same isometric exercise was employed, however, on the day corresponding to recovery day 3 in the first study, participants were asked to complete a one hour cycling protocol at 70% VO2 max. The goal was to cause similar one-legged increases in Hsp70 as the first study and to then challenge SERCA activity and muscular force in the presence of elevated Hsp70 by using cycling exercise. Results showed cycling induced reductions in maximal Ca2+ ATPase activity, muscular force, rates of muscle relaxation, and rates of muscle force development were attenuated by the preconditioning (isometric) exercise. These studies confirm the idea that preconditioning exercise is able to attenuate subsequent exercise induced insults to SERCA activity and muscular force, likely through an Hsp70 mediated mechanism.

Two studies were conducted to determine if Hsp70 is able to protect human skeletal muscle from muscle mechanical damage and alterations in SERCA activity associated with prolonged concentric exercise. In the first study, one-legged isometric knee extension exercise at 40% MVC and a duty cycle of 50% (5 sec contraction followed by 5 sec of relaxation) was used to induce a heat shock response in one leg only. Participants were followed over six recovery days to determine the time course of Hsp70 induction and decay. Results showed fiber type specific increases in Hsp70 that persisted in one leg only throughout six days of recovery. These increases in Hsp70 occurred with only transient changes in Ca2+ uptake and muscular force. With the exception of minor decreases in low frequency force, there were no apparent reductions in muscular force or SERCA activity by the third recovery day. Therefore an exercise protocol was established which was able to induce a heat shock response with only minor alterations in muscle mechanical function and SERCA activity. In the second study, the same isometric exercise was employed, however, on the day corresponding to recovery day 3 in the first study, participants were asked to complete a one hour cycling protocol at 70% VO2 max. The goal was to cause similar one-legged increases in Hsp70 as the first study and to then challenge SERCA activity and muscular force in the presence of elevated Hsp70 by using cycling exercise. Results showed cycling induced reductions in maximal Ca2+ ATPase activity, muscular force, rates of muscle relaxation, and rates of muscle force development were attenuated by the preconditioning (isometric) exercise. These studies confirm the idea that preconditioning exercise is able to attenuate subsequent exercise induced insults to SERCA activity and muscular force, likely through an Hsp70 mediated mechanism.

Lic.-avh. (sammanfattning) Stockholm : Karolinska institutet, 2008. / Härtill 3 uppsatser.

During sustained voluntary contractions, the variability in motor unit interspike intervals increases with fatigue. This increase in variability may represent an adaptive mechanism to prevent fatigue. We investigated whether randomly modulating interpulse intervals (IPI) in a constant frequency stimulation protocol reduces force loss over time compared to a non-modulated constant frequency protocol. A second purpose of this study was to investigate the role of the M-wave in force generation during evoked contractions. Eight healthy subjects participated in three 3-minute fatigue protocols of the thenar muscles elicited by supramaximal stimulation of the median nerve. All three protocols had a mean IPI of 33.3ms and only differed in the type of modulation. One protocol consisted of 0% modulation ('Constant'), another protocol consisted of uniformly distributed modulation of [plus or minus]20% ('Variable'), and a third protocol consisted of ramped modulation from 0 to [plus or minus]20% ('Ramp'). There was no significant difference between overall force-time integrals for the three protocols. There was a significant reduction in M-wave amplitude for all three protocols; however, the M-wave immediately following the 'Ramp' protocol was significantly larger than the M-wave immediately following the 'Constant' protocol. We conclude that modulation is ineffective at preserving force output and somewhat effective at preserving the M-wave amplitude. The varied reductions in fatigued M-waves suggest that it is not necessarily a limiting factor in force output and that it was not necessarily linked to the force loss in this experiment. / text

Introdução: Fadiga é uma manifestação clínica importante na artrite reumatoide (AR). Atualmente, a avaliação de fadiga em AR é realizada através de questionários subjetivos, incluindo aspectos emocionais e sociais. No entanto, sabe-se que a fadiga pode estar acentuada no plano periférico e esta abordagem é pouco estudada nestes pacientes. Objetivo: Avaliar a relação entre a percepção de fadiga e fadiga muscular em pacientes com artrite reumatoide. Métodos: Trinta e oito pacientes do sexo feminino com AR foram incluídos. Os pacientes foram estratificados por DAS-28 e por três grupos etários (grupo I: 32-48 anos; grupo II: 49-54 anos de idade, e grupo III: 55-65 anos de idade). A fadiga muscular [avaliado por mudanças na magnitude (root mean square-RMS) e freqüência (média de freqüência-MDF) de ativação muscular durante os 60s do teste de força de quadríceps] e percepção de fadiga (FACIT-F) foram avaliadas. Além disso, dados demográficos [duração idade e doença, calculado pelo tempo decorrido a partir de diagnóstico], hemoglobina (g/ dL), DAS-28, HAQ, qualidade de vida (SF-36) e International Physical Activity Questionnaire (IPAQ, versão longa) foram medidos. A significância foi assumida quando p≤0.05. Resultados: Nenhuma associação foi observada quando os pacientes foram estratificados por DAS-28 e quando os pacientes foram estratificados por idade no grupo III. Moderada correlações estatisticamente significativas entre MDF e FACIT-F e FACIT-TOI (r = 0,6; p = 0,03 e r = 0,5; 0,04, respectivamente) foram encontrados no grupo I. No grupo II foram encontradas moderadas correlações estatisticamente significativas entre FACIT-TOTAL e RMS e MDF (r = 0,6; p = 0,01 e r = -0,5; p = 0,04, respectivamente). Conclusão: Moderada relação entre fadiga muscular e percepção de fadiga sugere que ambas as estratégias de avaliação podem ser complementares e têm um efeito benéfico sobre comorbidades AR. / Introduction: Fatigue is a major clinical manifestation in rheumatoid arthritis (RA). Actually, the assessment of fatigue in RA is realized through to subjective questionnaires, including emotional and socials aspects. However, known to that fatigue may be sharp in peripheral plane and this approach is little studied in these patients. Objective: To assess the relationship between perception of fatigue and muscle fatigue in patients with RA. Methods: Thirty eight female patients with RA were included. Patients were stratified by DAS-28 and by three age groups (group I: 32-48 years old; group II: 49-54 years old; group III: 55-65 years old). Muscle fatigue [assessed by changes in magnitude (i.e. root mean square-RMS) and frequency (i.e. median frequency-MDF) of muscle activation during a 60-s quadriceps strength test] and perception of fatigue (FACIT-F) were assessed. In addition, demographic data [age and disease duration, calculated by elapsed time from diagnostic], hemoglobin (Hb-g/dL), DAS-28, HAQ, quality of life (SF-36) and International Physical Activity Questionnaire (IPAQ, long version) were measured. Significance was assumed when p≤0.05. Results: No association was observed when patients were stratified by DAS-28 and when patients were stratified by age in group III. Moderate statistically significant correlations between MDF and FACIT-F e FACIT-TOI (r=0.6;p=0.03 and r=0.5;0.04, respectively) were found in group I. In group II moderate statistically significant correlations were found between FACIT-TOTAL and RMS and MDF (r=0.6;p=0.01 and r=-0.5;p=0.04, respectively). Conclusion: Moderate relationship between muscle fatigue and perception of fatigue suggests that both evaluation strategies can be complementary and have a beneficial effect on RA comorbidities.

Made available in DSpace on 2014-06-11T19:22:49Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-02-10Bitstream added on 2014-06-13T20:09:54Z : No. of bitstreams: 1 silva_cr_me_prud.pdf: 377360 bytes, checksum: 38ec03183b67a69d80d817be978919e6 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / São encontradas na literatura várias propostas de processamento do sinal eletromiográfico (EMG) com o objetivo de determinar índices aplicados à monitoração do processo de fadiga muscular localizada. Em comum, todos os índices são baseados na análise de algum parâmetro do sinal monitorado durante o exercício. A avaliação conjunta do comportamento das variáveis extraídas no domínio do tempo e da frequência do sinal eletromiográfico (EMG) não é uma tarefa trivial. Diante disso, os objetivos do estudo foram: i) identificar por meio do comportamento da frequência mediana (Fmed) e da raiz quadrada da média (RMS) do sinal EMG o momento de instalação da fadiga muscular localizada (MF); ii) determinar a reprodutibilidade entre dias da Fmed, RMS, e bandas de baixa (20-45 Hz), média (46-95 Hz) e alta (96-400 Hz) frequência do sinal EMG e iii) aplicar uma análise estatística multivariada nas variáveis extraídas do sinal EMG durante o início, MF e final do teste. Dezoito sujeitos saudáveis foram avaliados em dois dias diferentes, sendo registrados os sinais EMG dos músculos vasto medial (VM), reto femoral (RF) e vasto lateral (VL) durante contrações isométricas a 20% e 70% da contração voluntária isométrica máxima (CVIM), realizada até a exaustão. Por meio das análises realizadas no comportamento da Fmed e do RMS ao longo dos testes foi possível identificar o MF para o VM e VL em ambas as intensidades de carga... / Various proposals are found in the literature of electromiographic signal (EMG) processing with the purpose of determining indices applied to monitoring the localized muscle fatigue. In common, all indexes are based on analysis of some signal parameter monitored during the exercise. The joint evaluation of the behavior of variables extracted in the time and frequency domain of the EMG signal is not a trivial task. That said, the objectives of the study were: i) identify through the behavior of median frequency (MFreq) and the root mean square (RMS) of EMG signal in the moment of installation of localized muscle fatigue (MF); ii) determining the reproducibility between days of MFreq, RMS, and low bands (20-45 Hz), average (46-95 Hz) and high (96-400 Hz) frequency of EMG signal and iii) applying a multivariate statistical analysis in variables extracted from EMG signal during the beginning, MF and end of test. Eighteen healthy subjects were evaluated in two different days, being recorded the EMG muscle signals of vastus medialis (VM), rectus femoris (RF) and vastus lateralis (VL) during isometric contractions at 20% and 70% of maximum isometric voluntary contraction (MIVC), held until exhaustion. The analysis of MFreq and RMS behavior over the tests was possible to identify the MF for VM and VL in both load intensities. There were... (Complete abstract click electronic access below)

Orientador: Fábio Mícolis de Azevedo / Banca: Neri Alves / Banca: Fernando Henrique Magalhães / Resumo: São encontradas na literatura várias propostas de processamento do sinal eletromiográfico (EMG) com o objetivo de determinar índices aplicados à monitoração do processo de fadiga muscular localizada. Em comum, todos os índices são baseados na análise de algum parâmetro do sinal monitorado durante o exercício. A avaliação conjunta do comportamento das variáveis extraídas no domínio do tempo e da frequência do sinal eletromiográfico (EMG) não é uma tarefa trivial. Diante disso, os objetivos do estudo foram: i) identificar por meio do comportamento da frequência mediana (Fmed) e da raiz quadrada da média (RMS) do sinal EMG o momento de instalação da fadiga muscular localizada (MF); ii) determinar a reprodutibilidade entre dias da Fmed, RMS, e bandas de baixa (20-45 Hz), média (46-95 Hz) e alta (96-400 Hz) frequência do sinal EMG e iii) aplicar uma análise estatística multivariada nas variáveis extraídas do sinal EMG durante o início, MF e final do teste. Dezoito sujeitos saudáveis foram avaliados em dois dias diferentes, sendo registrados os sinais EMG dos músculos vasto medial (VM), reto femoral (RF) e vasto lateral (VL) durante contrações isométricas a 20% e 70% da contração voluntária isométrica máxima (CVIM), realizada até a exaustão. Por meio das análises realizadas no comportamento da Fmed e do RMS ao longo dos testes foi possível identificar o MF para o VM e VL em ambas as intensidades de carga... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Various proposals are found in the literature of electromiographic signal (EMG) processing with the purpose of determining indices applied to monitoring the localized muscle fatigue. In common, all indexes are based on analysis of some signal parameter monitored during the exercise. The joint evaluation of the behavior of variables extracted in the time and frequency domain of the EMG signal is not a trivial task. That said, the objectives of the study were: i) identify through the behavior of median frequency (MFreq) and the root mean square (RMS) of EMG signal in the moment of installation of localized muscle fatigue (MF); ii) determining the reproducibility between days of MFreq, RMS, and low bands (20-45 Hz), average (46-95 Hz) and high (96-400 Hz) frequency of EMG signal and iii) applying a multivariate statistical analysis in variables extracted from EMG signal during the beginning, MF and end of test. Eighteen healthy subjects were evaluated in two different days, being recorded the EMG muscle signals of vastus medialis (VM), rectus femoris (RF) and vastus lateralis (VL) during isometric contractions at 20% and 70% of maximum isometric voluntary contraction (MIVC), held until exhaustion. The analysis of MFreq and RMS behavior over the tests was possible to identify the MF for VM and VL in both load intensities. There were... (Complete abstract click electronic access below) / Mestre

Introdução: Fadiga é uma manifestação clínica importante na artrite reumatoide (AR). Atualmente, a avaliação de fadiga em AR é realizada através de questionários subjetivos, incluindo aspectos emocionais e sociais. No entanto, sabe-se que a fadiga pode estar acentuada no plano periférico e esta abordagem é pouco estudada nestes pacientes. Objetivo: Avaliar a relação entre a percepção de fadiga e fadiga muscular em pacientes com artrite reumatoide. Métodos: Trinta e oito pacientes do sexo feminino com AR foram incluídos. Os pacientes foram estratificados por DAS-28 e por três grupos etários (grupo I: 32-48 anos; grupo II: 49-54 anos de idade, e grupo III: 55-65 anos de idade). A fadiga muscular [avaliado por mudanças na magnitude (root mean square-RMS) e freqüência (média de freqüência-MDF) de ativação muscular durante os 60s do teste de força de quadríceps] e percepção de fadiga (FACIT-F) foram avaliadas. Além disso, dados demográficos [duração idade e doença, calculado pelo tempo decorrido a partir de diagnóstico], hemoglobina (g/ dL), DAS-28, HAQ, qualidade de vida (SF-36) e International Physical Activity Questionnaire (IPAQ, versão longa) foram medidos. A significância foi assumida quando p≤0.05. Resultados: Nenhuma associação foi observada quando os pacientes foram estratificados por DAS-28 e quando os pacientes foram estratificados por idade no grupo III. Moderada correlações estatisticamente significativas entre MDF e FACIT-F e FACIT-TOI (r = 0,6; p = 0,03 e r = 0,5; 0,04, respectivamente) foram encontrados no grupo I. No grupo II foram encontradas moderadas correlações estatisticamente significativas entre FACIT-TOTAL e RMS e MDF (r = 0,6; p = 0,01 e r = -0,5; p = 0,04, respectivamente). Conclusão: Moderada relação entre fadiga muscular e percepção de fadiga sugere que ambas as estratégias de avaliação podem ser complementares e têm um efeito benéfico sobre comorbidades AR. / Introduction: Fatigue is a major clinical manifestation in rheumatoid arthritis (RA). Actually, the assessment of fatigue in RA is realized through to subjective questionnaires, including emotional and socials aspects. However, known to that fatigue may be sharp in peripheral plane and this approach is little studied in these patients. Objective: To assess the relationship between perception of fatigue and muscle fatigue in patients with RA. Methods: Thirty eight female patients with RA were included. Patients were stratified by DAS-28 and by three age groups (group I: 32-48 years old; group II: 49-54 years old; group III: 55-65 years old). Muscle fatigue [assessed by changes in magnitude (i.e. root mean square-RMS) and frequency (i.e. median frequency-MDF) of muscle activation during a 60-s quadriceps strength test] and perception of fatigue (FACIT-F) were assessed. In addition, demographic data [age and disease duration, calculated by elapsed time from diagnostic], hemoglobin (Hb-g/dL), DAS-28, HAQ, quality of life (SF-36) and International Physical Activity Questionnaire (IPAQ, long version) were measured. Significance was assumed when p≤0.05. Results: No association was observed when patients were stratified by DAS-28 and when patients were stratified by age in group III. Moderate statistically significant correlations between MDF and FACIT-F e FACIT-TOI (r=0.6;p=0.03 and r=0.5;0.04, respectively) were found in group I. In group II moderate statistically significant correlations were found between FACIT-TOTAL and RMS and MDF (r=0.6;p=0.01 and r=-0.5;p=0.04, respectively). Conclusion: Moderate relationship between muscle fatigue and perception of fatigue suggests that both evaluation strategies can be complementary and have a beneficial effect on RA comorbidities.

abstract: The use of electromyography (EMG) signals to characterize muscle fatigue has been widely accepted. Initial work on characterizing muscle fatigue during isometric contractions demonstrated that its frequency decreases while its amplitude increases with the onset of fatigue. More recent work concentrated on developing techniques to characterize dynamic contractions for use in clinical and training applications. Studies demonstrated that as fatigue progresses, the EMG signal undergoes a shift in frequency, and different physiological mechanisms on the possible cause of the shift were considered. Time-frequency processing, using the Wigner distribution or spectrogram, is one of the techniques used to estimate the instantaneous mean frequency and instantaneous median frequency of the EMG signal using a variety of techniques. However, these time-frequency methods suffer either from cross-term interference when processing signals with multiple components or time-frequency resolution due to the use of windowing. This study proposes the use of the matching pursuit decomposition (MPD) with a Gaussian dictionary to process EMG signals produced during both isometric and dynamic contractions. In particular, the MPD obtains unique time-frequency features that represent the EMG signal time-frequency dependence without suffering from cross-terms or loss in time-frequency resolution. As the MPD does not depend on an analysis window like the spectrogram, it is more robust in applying the timefrequency features to identify the spectral time-variation of the EGM signal. / Dissertation/Thesis / M.S. Electrical Engineering 2012