Assessment of muscle fatigue during exercise in chronic obstructive pulmonary disease

Contractile fatigue is associated with exercise intolerance in patients with chronic obstructive pulmonary disease (COPD). Contractile fatigue may be assessed by quantifying the decline in strength after a fatiguing protocol but this may pose practical problems. The purpose of this study was to investigate the relationship between the decline in quadriceps strength, quadriceps electrical activity, perception of leg fatigue, and arterial lactate level in patients with COPD during constant work‐rate cycling exercise. The decline in quadriceps strength was significantly associated with the decrease in electromyographic median frequency (r = 0.606), leg fatigue perception (r = 0.453), and arterial lactate level (r = 0.384). Using the receiver‐operating‐characteristic curve, it was found that a 4% decline in electromyographic median frequency had a 94% sensitivity and a 75% specificity to predict contractile fatigue. We conclude that contractile fatigue commonly occurs during cycling exercise in COPD. The electromyographic median frequency appears to be a valuable indirect marker to predict contractile leg fatigue. Muscle Nerve, 2006

[1]  M. Tobin,et al.  Does resistive loading decrease diaphragmatic contractility before task failure? , 1998, Journal of applied physiology.

[2]  F. Maltais,et al.  Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease--2003. , 2003, Canadian respiratory journal.

[3]  G. Kwakkel,et al.  Quadriceps muscle endurance in patients with chronic obstructive pulmonary disease , 2004, Muscle & nerve.

[4]  M. Mador,et al.  Comparison of potentiated and unpotentiated twitches as an index of muscle fatigue , 2002, Muscle & nerve.

[5]  S. Andreassen,et al.  Muscle fibre conduction velocity in motor units of the human anterior tibial muscle: a new size principle parameter. , 1987, The Journal of physiology.

[6]  H. van Mameren,et al.  Skeletal muscle fibre-type shifting and metabolic profile in patients with chronic obstructive pulmonary disease , 2002, European Respiratory Journal.

[7]  Björn Gerdle,et al.  Surface electromyography and peak torque of repetitive maximum isokinetic plantar flexions in relation to aspects of muscle morphology. , 2006, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[8]  M. Polkey,et al.  Quadriceps strength and fatigue assessed by magnetic stimulation of the femoral nerve in man , 1995, Muscle & nerve.

[9]  F. Maltais,et al.  Peripheral muscle endurance and the oxidative profile of the quadriceps in patients with COPD , 2004, Thorax.

[10]  M. Bryce.  Muscles Alive: Their Functions Revealed by Electromyography , 1963 .

[11]  M. Poulain,et al.  Effect of acute hyperoxia during exercise on quadriceps electrical activity in active COPD patients. , 2004, Acta physiologica Scandinavica.

[12]  P. Sacco,et al.  Loss of power during fatigue of human leg muscles. , 1995, The Journal of physiology.

[13]  F. Maltais,et al.  Oxidative capacity of the skeletal muscle and lactic acid kinetics during exercise in normal subjects and in patients with COPD. , 1996, American journal of respiratory and critical care medicine.

[14]  Y. Jammes,et al.  Electromyographic changes in vastus lateralis during dynamic exercise , 1997, Muscle & nerve.

[15]  M. Belman,et al.  Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease. , 1991, The American review of respiratory disease.

[16]  M. Decramer,et al.  Peripheral muscle weakness contributes to exercise limitation in COPD. , 1996, American journal of respiratory and critical care medicine.

[17]  T. Kufel,et al.  Quadriceps fatigue after cycle exercise in patients with chronic obstructive pulmonary disease. , 2000, American journal of respiratory and critical care medicine.

[18]  M. Poulain,et al.  Electrophysiologic changes during exercise testing in patients with chronic obstructive pulmonary disease , 2003, Muscle & nerve.

[19]  S. C. Gandevia,et al.  Changes in muscle afferents, motoneurons and motor drive during muscle fatigue , 2000, European Journal of Applied Physiology.

[20]  F. Maltais,et al.  Contractile leg fatigue after cycle exercise: a factor limiting exercise in patients with chronic obstructive pulmonary disease. , 2003, American journal of respiratory and critical care medicine.

[21]  M. Mador,et al.  Quadriceps Fatigue After Cycle Exercise in Patients with COPD Compared with Healthy Control Subjects. , 2003, Chest.

[22]  N. Jones,et al.  Exercise capacity and ventilatory, circulatory, and symptom limitation in patients with chronic airflow limitation. , 1992, The American review of respiratory disease.

[23]  F. Maltais,et al.  Peripheral muscle weakness in patients with chronic obstructive pulmonary disease. , 1998, American journal of respiratory and critical care medicine.

[24]  E. Kaplan.  Muscles Alive. Their Functions Revealed by Electromyography. J. V. Basmajian. Baltimore, The Williams and Wilkins Co., 1962. $8.50 , 1962 .

[25]  N. Jones,et al.  Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. , 1995, American journal of respiratory and critical care medicine.

[26]  R. Casaburi.  Skeletal muscle dysfunction in chronic obstructive pulmonary disease. , 1999, Medicine and science in sports and exercise.

[27]  J E Frijters,et al.  A short questionnaire for the measurement of habitual physical activity in epidemiological studies. , 1982, The American journal of clinical nutrition.

[28]  M. Mador,et al.  Effect of pulmonary rehabilitation on quadriceps fatiguability during exercise. , 2001, American journal of respiratory and critical care medicine.

[29]  M. Becklake,et al.  Respiratory function tests; normal values at median altitudes and the prediction of normal results. , 1959, American review of tuberculosis.

[30]  M. Decramer,et al.  Muscle weakness is related to utilization of health care resources in COPD patients. , 1997, The European respiratory journal.

[31]  M. Poulain,et al.  Endurance training improves skeletal muscle electrical activity in active COPD patients , 2003, Muscle & nerve.

[32]  F. Maltais,et al.  Contractile fatigue, muscle morphometry, and blood lactate in chronic obstructive pulmonary disease. , 2005, American journal of respiratory and critical care medicine.

[33]  B. Massie,et al.  Neurophysiological Assessment of Skeletal Muscle Fatigue in Patients With Congestive Heart Failure , 1992, Circulation.

[34]  A. Varray,et al.  Impaired skeletal muscle endurance related to physical inactivity and altered lung function in COPD patients. , 1998, Chest.

[35]  A. Benabid,et al.  Metabolism and aerobic capacity of skeletal muscle in chronic respiratory failure related to chronic obstructive pulmonary disease. , 1992, The European respiratory journal.

[36]  Susan M Sigward,et al.  The influence of gender on knee kinematics, kinetics and muscle activation patterns during side-step cutting. , 2006, Clinical biomechanics.

[37]  F. Hug,et al.  Influence of chronic hypoxemia on peripheral muscle function and oxidative stress in humans , 2004, Clinical physiology and functional imaging.

[38]  P. Deurenberg,et al.  A physical activity questionnaire for the elderly. , 1991, Medicine and science in sports and exercise.

[39]  G. Borg.  Psychophysical bases of perceived exertion. , 1982, Medicine and science in sports and exercise.

[40]  F. Maltais,et al.  Histochemical and morphological characteristics of the vastus lateralis muscle in patients with chronic obstructive pulmonary disease. , 1998, Medicine and science in sports and exercise.

[41]  M. Polkey,et al.  Symptoms and quadriceps fatigability after walking and cycling in chronic obstructive pulmonary disease. , 2003, American journal of respiratory and critical care medicine.

[42]  H. van Mameren,et al.  Muscle fiber type IIX atrophy is involved in the loss of fat-free mass in chronic obstructive pulmonary disease. , 2002, The American journal of clinical nutrition.

[43]  M Badier,et al.  Correlation between surface electromyogram, oxygen uptake and blood lactate concentration during dynamic leg exercises. , 1998, Respiration physiology.

[44]  C. D. De Luca,et al.  Frequency Parameters of the Myoelectric Signal as a Measure of Muscle Conduction Velocity , 1981, IEEE Transactions on Biomedical Engineering.

[45]  M. Lebowitz,et al.  The maximal expiratory flow-volume curve. Normal standards, variability, and effects of age. , 1976, The American review of respiratory disease.

[46]  Phillips Yy,et al.  Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986. , 1987, The American review of respiratory disease.