Fatigability Compared Men and Women Induced According to the Distance Traveled on an Ultra-marathon in the Mountains

Study Overview
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Brief Summary
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Acute physiological consequences of ultra-marathon running are still unknown, particularly in women. Some studies have suggested that the proportion of fatigue attributable to peripheral and central mechanisms varies between males and females; however, results are contradictory. The results from the investigators of the present experiment in two studies conducted in 2009 and 2012 showed that: A large part of fatigue induced by a mountain ultra-marathon could be attributed to central fatigue in males and that, Females exhibited less peripheral fatigue in the plantar flexors than males did after a 110-km ultra-trail-running race. According to the literature, there seems to be a plateau in fatigue after 12-15 hours of running.

Detailed Description
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Thus, the main purpose of the present project is to investigate whether sex differences in neuromuscular fatigue in plantar flexors depend on the distance (> 100 km vs < 60 km).

Official Title
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Fatigability Compared Men and Women Induced According to the Distance Traveled on an Ultra-marathon in the Mountains

Conditions
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Ultra-marathon Runners

Intervention / Treatment
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* Other: Neuromuscular tests in isometric mode
* Device: Transcranial Magnetic Stimulation (TMS)
* Other: Neuromuscular fatigue assessment test
* Other: treadmill
* Biological: Blood sample
* Biological: Urinary sample


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subject listed in the race 2019 Mont Blanc Ultra Trail Affiliates or beneficiaries of social security scheme Signed consent Exclusion Criteria: Subject having been injured in the previous 3 months Pregnant woman Chronic joint diseases Chronic or central neurological pathologies Taking neuroactive substances that can alter corticospinal excitability Contraindication to experimental procedures including Transcranial Magnetic Stimulation (TMS) Taking corticosteroids in the previous 3 months

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: female subjects involved in races over 100 km (F>100)<br>Female subjects involved in races over 100 km (F>100) will be included. They will have neuromuscular tests in isometric mode, Transcranial Magnetic Stimulation (TMS), neuromuscular fatigue assessment test, treadmill, blood sample and urinary sample. | Other: Neuromuscular tests in isometric mode<br>* Protocol for neuromuscular tests in isometric mode will be assessed by the composite of these measures : Voluntary maximum forces plantar flexors and knee extensors Electrically evoked forces ElectroMyoGraphic activity (EMG) Three-Modality Evoked Potentials (TMEPs)<br>Device: Transcranial Magnetic Stimulation (TMS)<br>* Measure of supraspinal activation level and cortical excitation by Transcranial Magnetic Stimulation (TMS).<br>Other: Neuromuscular fatigue assessment test<br>* Neuromuscular fatigue assessment test in dynamic mode will be assessed by the Force/Velocity Profile (FVP) measure: 2 sprints of 8 seconds on a cycle ergometer.<br>Other: treadmill<br>* 2 sessions of treadmill will be realized: 8 and 10 km.h-1 for level running and 7 km.h-1 with 10% slope for graded running.<br>Biological: Blood sample<br>* Blood sample will be realized to measure hemorrheologic and hematologic parameters.<br>Biological: Urinary sample<br>* Urinary sample will be realized to measure hemorrheologic and hematologic parameters.<br>|
| Experimental: female subjects involved in races less than 60 km (F<60)<br>Female subjects involved in races less than 60 km (F<60) will be included. They will have neuromuscular tests in isometric mode, Transcranial Magnetic Stimulation (TMS), neuromuscular fatigue assessment test, treadmill, blood sample and urinary sample. | Other: Neuromuscular tests in isometric mode<br>* Protocol for neuromuscular tests in isometric mode will be assessed by the composite of these measures : Voluntary maximum forces plantar flexors and knee extensors Electrically evoked forces ElectroMyoGraphic activity (EMG) Three-Modality Evoked Potentials (TMEPs)<br>Device: Transcranial Magnetic Stimulation (TMS)<br>* Measure of supraspinal activation level and cortical excitation by Transcranial Magnetic Stimulation (TMS).<br>Other: Neuromuscular fatigue assessment test<br>* Neuromuscular fatigue assessment test in dynamic mode will be assessed by the Force/Velocity Profile (FVP) measure: 2 sprints of 8 seconds on a cycle ergometer.<br>Other: treadmill<br>* 2 sessions of treadmill will be realized: 8 and 10 km.h-1 for level running and 7 km.h-1 with 10% slope for graded running.<br>Biological: Blood sample<br>* Blood sample will be realized to measure hemorrheologic and hematologic parameters.<br>Biological: Urinary sample<br>* Urinary sample will be realized to measure hemorrheologic and hematologic parameters.<br>|
| Experimental: male subjects involved in races over 100 km (H>100)<br>Male subjects involved in races over 100 km (H>100) will be included. They will have neuromuscular tests in isometric mode, Transcranial Magnetic Stimulation (TMS), neuromuscular fatigue assessment test, treadmill, blood sample and urinary sample. | Other: Neuromuscular tests in isometric mode<br>* Protocol for neuromuscular tests in isometric mode will be assessed by the composite of these measures : Voluntary maximum forces plantar flexors and knee extensors Electrically evoked forces ElectroMyoGraphic activity (EMG) Three-Modality Evoked Potentials (TMEPs)<br>Device: Transcranial Magnetic Stimulation (TMS)<br>* Measure of supraspinal activation level and cortical excitation by Transcranial Magnetic Stimulation (TMS).<br>Other: Neuromuscular fatigue assessment test<br>* Neuromuscular fatigue assessment test in dynamic mode will be assessed by the Force/Velocity Profile (FVP) measure: 2 sprints of 8 seconds on a cycle ergometer.<br>Other: treadmill<br>* 2 sessions of treadmill will be realized: 8 and 10 km.h-1 for level running and 7 km.h-1 with 10% slope for graded running.<br>Biological: Blood sample<br>* Blood sample will be realized to measure hemorrheologic and hematologic parameters.<br>Biological: Urinary sample<br>* Urinary sample will be realized to measure hemorrheologic and hematologic parameters.<br>|
| Experimental: male subjects involved in races less than 60 km (H<60)<br>Male subjects involved in races less than 60 km (H<60) will be included. They will have neuromuscular tests in isometric mode, Transcranial Magnetic Stimulation (TMS), neuromuscular fatigue assessment test, treadmill, blood sample and urinary sample. | Other: Neuromuscular tests in isometric mode<br>* Protocol for neuromuscular tests in isometric mode will be assessed by the composite of these measures : Voluntary maximum forces plantar flexors and knee extensors Electrically evoked forces ElectroMyoGraphic activity (EMG) Three-Modality Evoked Potentials (TMEPs)<br>Device: Transcranial Magnetic Stimulation (TMS)<br>* Measure of supraspinal activation level and cortical excitation by Transcranial Magnetic Stimulation (TMS).<br>Other: Neuromuscular fatigue assessment test<br>* Neuromuscular fatigue assessment test in dynamic mode will be assessed by the Force/Velocity Profile (FVP) measure: 2 sprints of 8 seconds on a cycle ergometer.<br>Other: treadmill<br>* 2 sessions of treadmill will be realized: 8 and 10 km.h-1 for level running and 7 km.h-1 with 10% slope for graded running.<br>Biological: Blood sample<br>* Blood sample will be realized to measure hemorrheologic and hematologic parameters.<br>Biological: Urinary sample<br>* Urinary sample will be realized to measure hemorrheologic and hematologic parameters.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Variation (%) of the amplitudes of the electric shock | Measured by the electrically evoked force after contraction in isometric mode of the plantar flexors | 5 or 6 day before the race and 1 hour after | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Voluntary maximum forces plantar flexors | Analysis : Quantification of neuromuscular fatigue assessment; Evolution of race mechanics and the energy cost between males and females depending on the distance of the race. Measured by voluntary maximum forces plantar flexors test (seat type Cybex) in percentage (%). | 5 or 6 day before the race and 1 hour after | 
| Voluntary maximum forces knee extensors | Analysis : Quantification of neuromuscular fatigue assessment; Evolution of race mechanics and the energy cost between males and females depending on the distance of the race. Voluntary maximum forces knee extensors measures by seat type Cybex in percentage (%). | 5 or 6 day before the race and 1 hour after | 
| Electrically evoked forces | Analysis : Quantification of neuromuscular fatigue assessment; Evolution of race mechanics and the energy cost between males and females depending on the distance of the race. Electrically evoked forces measures by neurostimulator in percentage (%). | 5 or 6 day before the race and 1 hour after | 
| ElectroMyoGraphic activity (EMG) | Analysis : Quantification of neuromuscular fatigue assessment; Evolution of race mechanics and the energy cost between males and females depending on the distance of the race. ElectroMyoGraphic activity (EMG) measures by electromyography. The EMG signal will be recorded with pairs of electrodes fixed with an adhesive tape bilaterally over the muscular belly. | 5 or 6 day before the race and 1 hour after | 
| Three-Modality Evoked Potentials (TMEPs) | Analysis : Quantification of neuromuscular fatigue assessment; Evolution of race mechanics and the energy cost between males and females depending on the distance of the race. Three-Modality Evoked Potentials (TMEPs) measures by magnetic stimulator in percentage (%). | 5 or 6 day before the race and 1 hour after | 
| Transcranial Magnetic Stimulation (TMS) | Analysis : Quantification of neuromuscular fatigue assessment; Evolution of race mechanics and the energy cost between males and females depending on the distance of the race. Measured supraspinal activation level and cortical excitation by Transcranial Magnetic Stimulation (TMS) in percentage (%). | 5 or 6 day before the race and 1 hour after | 
| Force/Velocity Profile (FVP) | Analysis: Quantification of neuromuscular fatigue assessment; Evolution of race mechanics and the energy cost between males and females depending on the distance of the race. Measured Force/Velocity Profile (FVP) test: 2 sprints of 8 seconds on a cycle ergometer. | 5 or 6 day before the race and 1 hour after | 
| Blood viscosity | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| Number of red blood cell | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| Number of platelets | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| Number of white blood cells | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| Rate of hemoglobin (%) | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| creatinine (mg/L) | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| C reactive protein (CRP) (mg/L) | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| urea (g/L) | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| uric acid (mg/L) | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| lactate (mg/L) | Measured by blood sample. | 5 or 6 day before the race and 1 hour after | 
| Proteinuria-density urinary (mg/24h) | Measured by urinary sample. | 5 or 6 day before the race and 1 hour after | 
| Kinematic variable | Measured by treadmill result. | 5 or 6 day before the race and 1 hour after | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sex differences, Ultra-endurance running, Mont Blanc Ultra Trail, Transcranial Magnetic Stimulation (TMS), Neuromuscular tests, Plantar flexors, Knee extensors, Force/Velocity Profile (FVP)