Effects of Mode of Contraction on Neuromuscular Fatigue

Study Overview
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Brief Summary
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Aging is associated with multiple deteriorations of the neuromuscular system. Given the increase in life expectancy, the investigators can now distinguish old adults (>60 years old) who conserve their neuromuscular capacities with regular physical activity and very old adults (>80 years old) who suffer from an inexorable decline, even if the number of octogenarians and their quality of life are progressively increasing. However, the most part of the literature on fatigue and neuromuscular capacity with aging focused on isometric tasks. The results showed a significant decrease in maximal force production capacity and a greater resistance to fatigue for old people compared to the young population. When fatigue is induced trough dynamic contractions, greater fatigability was observed in old adults compared to young adults. Investigations performed on the population aged over 80 years old are rare, showing greater fatigability in octogenarians than old men (aged 60-80 years old) during isometric tasks. The knowledge about the effects of dynamic contractions in this population are limited, and performed uniquely in single leg isokinetic mode. Evaluations that require the use of both legs and higher muscle mass involved in the task (cycloergometer) are needed. Understanding neuromuscular fatigue and fatigability across different exercise modalities is necessary to set adapted physical activity programs aimed to maintain autonomy in older individuals.

Official Title
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Effects of Mode of Contraction on Neuromuscular Fatigue in Young People Aged 18 to 35, Aged 60 to 80 and Very Old People Aged Over 80

Conditions
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Volunteers

Intervention / Treatment
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* Behavioral: Mini Mental State Examination
* Diagnostic Test: 6 Minutes Walk Test
* Diagnostic Test: Timed up and go
* Diagnostic Test: Isokinetic Body weight-based quadriceps intermittent fatigue test (BW-QIF Test)
* Diagnostic Test: Cycloergometer body weight-based quadriceps intermittent fatigue test (BW-QIF Test)
* Diagnostic Test: Isometric BW-QIF Test (Body weight-based quadriceps intermittent fatigue test)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Belong to a defined age group: young (18 to 35 years old inclusive), old (60 to 80 years old inclusive) and very old (81 to 95 years old inclusive), Signed written consent form Being affiliated to social security Exclusion Criteria: Pathology or surgery resulting in a locomotor disorder, within 6 months prior to the study, Chronic neurological, motor or psychological pathologies Use of neuro-active substances likely to alter cortico-spinal excitability (hypnotics, antiepileptics, psychotropic drugs, muscle relaxants) for the duration of the study. Contraindication to magnetic stimulation: Cardiac or respiratory insufficiency. Cardiac pacemaker. Cardiac valve wear and serious cardiovascular diseases. Presence of prosthetic material or ferromagnetic foreign bodies in the head. Presence of cochlear implants or ocular prosthetic material. History of neurosurgical interventions. Neurological diseases that may affect brain structures and cognitive abilities (e.g., intracranial tumour, multiple sclerosis, history of stroke or traumatic brain injury). History of comitiality, contralateral knee pathology or pathology of the musculoskeletal system. Mini Mental State Examination < 20

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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Young people<br>Men or Women under 35 years old | Diagnostic Test: 6 Minutes Walk Test<br>* a standardized test of an individual's functional ability that involves walking the greatest distance a person can walk in six minutes. This walking may be limited by shortness of breath or fatigability.<br>Diagnostic Test: Timed up and go<br>* A simple test used to assess a person's mobility and requires both static and dynamic balance. It uses the time it takes for a person to get up from a chair, walk three metres, turn around, walk to the chair and sit down.<br>Diagnostic Test: Isokinetic Body weight-based quadriceps intermittent fatigue test (BW-QIF Test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The isokinetic BW-QIF test blocks consist in 100 contractions at 120° deg.s-1 and 60° of range of motion (0.5-s contraction /0.5-s rest).<br>Diagnostic Test: Cycloergometer body weight-based quadriceps intermittent fatigue test (BW-QIF Test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The BW-QIF test blocks on the cycloergometer consist in 100 s of cycling at 60 Revolution Per Minute (RPM).<br>Diagnostic Test: Isometric BW-QIF Test (Body weight-based quadriceps intermittent fatigue test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The isometric BW-QIF test blocks consist in 10 contractions (5-s contraction / 5-s rest).<br>|
| Experimental: Old people<br>Men or Women between 60 and 80 years old | Diagnostic Test: 6 Minutes Walk Test<br>* a standardized test of an individual's functional ability that involves walking the greatest distance a person can walk in six minutes. This walking may be limited by shortness of breath or fatigability.<br>Diagnostic Test: Timed up and go<br>* A simple test used to assess a person's mobility and requires both static and dynamic balance. It uses the time it takes for a person to get up from a chair, walk three metres, turn around, walk to the chair and sit down.<br>Diagnostic Test: Isokinetic Body weight-based quadriceps intermittent fatigue test (BW-QIF Test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The isokinetic BW-QIF test blocks consist in 100 contractions at 120° deg.s-1 and 60° of range of motion (0.5-s contraction /0.5-s rest).<br>Diagnostic Test: Cycloergometer body weight-based quadriceps intermittent fatigue test (BW-QIF Test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The BW-QIF test blocks on the cycloergometer consist in 100 s of cycling at 60 Revolution Per Minute (RPM).<br>Diagnostic Test: Isometric BW-QIF Test (Body weight-based quadriceps intermittent fatigue test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The isometric BW-QIF test blocks consist in 10 contractions (5-s contraction / 5-s rest).<br>|
| Experimental: Very old people<br>Men or Women over 80 years old | Behavioral: Mini Mental State Examination<br>* test for evaluating a person's cognitive functions and memory capacity<br>Diagnostic Test: 6 Minutes Walk Test<br>* a standardized test of an individual's functional ability that involves walking the greatest distance a person can walk in six minutes. This walking may be limited by shortness of breath or fatigability.<br>Diagnostic Test: Timed up and go<br>* A simple test used to assess a person's mobility and requires both static and dynamic balance. It uses the time it takes for a person to get up from a chair, walk three metres, turn around, walk to the chair and sit down.<br>Diagnostic Test: Isokinetic Body weight-based quadriceps intermittent fatigue test (BW-QIF Test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The isokinetic BW-QIF test blocks consist in 100 contractions at 120° deg.s-1 and 60° of range of motion (0.5-s contraction /0.5-s rest).<br>Diagnostic Test: Cycloergometer body weight-based quadriceps intermittent fatigue test (BW-QIF Test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The BW-QIF test blocks on the cycloergometer consist in 100 s of cycling at 60 Revolution Per Minute (RPM).<br>Diagnostic Test: Isometric BW-QIF Test (Body weight-based quadriceps intermittent fatigue test)<br>* The BW-QIF test is an interval incremental contraction test including blocks of discontinuous 100-s effort. Neuromuscular evaluation of the knee extensors between blocks (duration 25 s) includes one maximal voluntary contraction, one contraction at the 60% of the actual maximal force and at the 80% of the actual maximal force. During each contraction, transcranial magnetic stimulation over the motor cortex will be delivered to assess corticospinal voluntary activation (central fatigue). Single-twitch electrical stimulations will be delivered on the femoral nerve during the maximal voluntary contraction and at rest to evaluate peripheral fatigue. The isometric BW-QIF test blocks consist in 10 contractions (5-s contraction / 5-s rest).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of Maximum Voluntary Contraction (%) - all participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Immediately after pedalling on an ergocycle | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of Maximum Voluntary Contraction (%) - 18-35 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after pedalling on an ergocycle | 
| Percentage of Maximum Voluntary Contraction (%) - 60-80 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after pedalling on an ergocycle | 
| Percentage of Maximum Voluntary Contraction (%) - more than 80 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after pedalling on an ergocycle | 
| Percentage of Maximum Voluntary Contraction (%) - more than 80 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after isometric contractions | 
| Percentage of Maximum Voluntary Contraction (%) - 60-80 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after isometric contractions | 
| Percentage of Maximum Voluntary Contraction (%) - 18-35 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after isometric contractions | 
| Percentage of Maximum Voluntary Contraction (%) - 18-35 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after concentric isokinetic contractions | 
| Percentage of Maximum Voluntary Contraction (%) - 60-80 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after concentric isokinetic contractions | 
| Percentage of Maximum Voluntary Contraction (%) - more than 80 years old participants | The measurement of the maximum voluntary contraction is carried out at rest with the instruction to contract the extensor muscles of the knee as hard as possible by pushing against a fixed pedal. This force is measured by an isokinetic ergometer. | Before and immediately after concentric isokinetic contractions | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neuromuscular performance, central fatigue, peripheral fatigue, dynamic, Aging