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Case-control (left) and intervention (right) results of peak force (top), rate of force development (RFD) (mid), and rate of force relaxation (RFR) (bottom). *Significant group effect; P<0.001 and P<0.01.
Source publication
Aim:
This study investigates consequences of chronic neck pain on muscle function and the rehabilitating effects of contrasting interventions.
Methods:
Women with trapezius myalgia (MYA, n = 42) and healthy controls (CON, n = 20) participated in a case-control study. Subsequently MYA were randomized to 10 weeks of specific strength training (SST...
Citations
... Zhou (1996) and Zhou et al. (1998) reported a similar fatigue-related decline in MVC (57 and 55%, respectively) versus peak RFD (56 and 53%, respectively), after 25 maximal isometric contractions of the knee extensors (KE) muscles. Likewise, Andersen et al. (2014) showed a hyperbolic and relatively similar behavior between torque and RTD (66% MVC) during 100 MVC of shoulder elevation. However, Viitasalo and Komi (1981) demonstrated that 100 explosive isometric contractions of the KE muscles decreased MVC and peak Communicated by Toshio Moritani. ...
... The influence of neuromuscular fatigue in the ascending part of the torque-time curve during a voluntary contraction has frequently appeared in the literature from the original observations of Royce (1962), Clarke (1964) and Willems (1973). Recently, Andersen et al. (2014) demonstrated that the RTD behavior was hyperbolic and, apparently, reached an asymptote at relative values similar to torque (~ 66% MVC) during 100 intermittent isometric MVC of shoulder elevations (2 s on-2 s off). In a literature review, D'Emanuele et al. (2021) have arbitrarily compared the magnitude of neuromuscular fatigue between RTD (peak, early and late) versus MVC, and showed that the classic exercise-induced change in RTDlate (− 19%) was similar to MVC (− 19%), and slightly greater for RTDpeak (− 25%) and RTDearly (− 23%). ...
... In a literature review, D'Emanuele et al. (2021) have arbitrarily compared the magnitude of neuromuscular fatigue between RTD (peak, early and late) versus MVC, and showed that the classic exercise-induced change in RTDlate (− 19%) was similar to MVC (− 19%), and slightly greater for RTDpeak (− 25%) and RTDearly (− 23%). In line with these studies (Andersen et al. 2014 andD'Emanuele et al. 2021), it was observed in the present study that RTD presented a hyperbolic behavior, which was relatively similar to torque during 60 intermittent isometric MVC of the KE and PF muscles. This suggests that the mechanisms responsible for the inability to produce and maintain maximal torque during the process of neuromuscular fatigue contribute in a relatively similar way to the inability to produce and maintain a certain rate of torque development during voluntary muscle contraction. ...
The objective of this study was to test the hypothesis that neuromuscular fatigue influences the rate of torque development (RTD) in a similar manner to isometric torque. Nine men participated in this study and performed 5-min all-out isometric tests for knee extensors (KE) and plantar flexors (PF) muscles, to determine the end-test torque (ET) and the critical rate of torque development (critical RTD). Additionally, participants performed submaximal constant-torque tests to task failure for KE and PF muscles. Both maximal voluntary contraction and RTD exhibited hyperbolic behavior and reached an asymptote at the end of the 5-min all out isometric test with similar relative values (KE 29.5 ± 5.6% MVC and PF 50.9 ± 2.9% MVC and KE 25.1 ± 3.6 to 28.5 ± 4.4% RTD and PF 48.4 ± 6.5 to 52.4 ± 5.8% RTD). However, both % MVC and % RTD were statistically different between muscle groups (P < 0.05), even when normalized by muscle volume (P < 0.05). Torque and RTD after the constant-torque test were similar to the values of ET and critical RTD (P > 0.05), respectively. In this study, it was observed that neuromuscular fatigue affects RTD and torque similarly, with the magnitude of this effect varying according to the muscle size.
... Clinical relevance HIT has already been found feasible and effective in decreasing disability in moderate CLBP 18 and in several other chronic disorders such as chronic neck pain, axial Spondyloarthritis, multiple sclerosis, and chronic lung and heart diseases. [65][66][67][68][69] However, this is the first clinical study to evaluate the impact of HIT in a larger spectrum of persons with severe CLBP in a rehabilitation centre setting, and this study is essential to increase the external Open access validity of HIT as a general rehabilitation strategy. Results will be transferable to different chronic pain populations, and this could potentially be a big step forward in the future biopsychosocial treatment of chronic pain. ...
Chronic low back pain (CLBP) is one of the most common chronic musculoskeletal disorders worldwide. Guidelines recommend exercise therapy (ET) in CLBP management, but more research is needed to investigate specific ET modalities and their underlying mechanisms. The primary goal of this study is to evaluate the short-term and long-term effectiveness of a time-contingent individualised high-intensity training (HIT) protocol on disability compared with a time-contingent moderate-intensity training (MIT) as used in usual care, in persons with severely disabling CLBP. Additionally, the effectiveness on central effects, the added value of prolonged training at home and technology support, and the cost-effectiveness are evaluated. In this randomised controlled trial, CLBP patients will be randomly divided into three groups of 56 participants. Group 1, ‘TechnoHIT’, receives HIT with technology-support in the home-phase. Group 2, ‘HIT’, receives HIT without technology support. Group 3, ‘MIT’, receives MIT, reflecting training intensity as used in usual care. The primary outcome is patient-reported disability, measured by the Modified Oswestry Disability Index. Secondary outcomes include quantitative sensory testing, psychosocial factors, broad physical fitness, quality of life, cost-effectiveness, adherence and usability of technology. Trial registration number NCT06491121.
... This can be related to the strength gain previously stated, which not only influences fatigue and endurance but also functional performance. 63 Interestingly, both fatigue and functional performance significantly improved for the FE group. This is in line with the relationship that has been shown between these variables, thus muscular fatigue is associated with an impairment in motor performance both in relation to task difficulty and the ability to maintain force production. ...
Objective:
The aim of this study was to compare the short-term clinical effects of 2 telerehabilitation programs, functional versus aerobic exercises, both combined with breathing techniques, regarding the improvement of long COVID-19 symptoms.
Methods:
A randomized controlled trial was conducted. The participants were assigned randomly to either the functional exercise (FE) group or aerobic exercise (AE) group, both including breathing techniques. The interventions lasted for 8 weeks with 3 sessions per week, and they were conducted through the Fisiotrack mobile phone application. Assessments were performed at baseline and after treatment, including testing fatigue (Fatigue Assessment Scale), dyspnea (London Chest Activity of Daily Living Scale), functional performance (30 Seconds Standing Test), perceived stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Questionnaire), and quality of life (European Quality of Life Scale). The perceived change after treatment (Patient Global Impression of Change Scale), the usability of the application (System Usability Scale), and the adherence to treatment were also examined after treatment.
Results:
In total, 43 participants (FE group, n = 21; AE group, n = 22; mean age = 42.4 [SD = 6.5] y) completed the study. In the intragroup comparison, the FE group showed improved fatigue (−6.7 points; 95% CI = −11.9 to −1.3), functional capacity (2.6 repetitions; 95% CI = 0.3 to 4.9), and perceived stress (−4.9 points; 95% CI = −9.1 to 0.8), while the AE group showed improved perceived stress (−6.2 points; 95% CI = −10.3 to −2.1). No significant differences in the intergroup effect were identified for the studied variables. Significant differences were observed in the Patient Global Impression of Change Scale in favor of the FE group compared to the AE group, and quality of life reached the minimal clinically important difference for both groups. The ease of use of the telerehabilitation tool was rated excellent in both groups.
Conclusions:
Both telerehabilitation exercise modalities are effective at improving stress symptoms and quality of life in patients with long COVID-19. For improving fatigue and functional performance, functional exercise shows more promising results.
Impact:
Functional exercise or aerobic exercise may be recommended depending on patients’ symptoms, and both may improve quality of life and stress symptoms in patients with long COVID-19. Telerehabilitation may be an optimal intervention modality for the prescription of physical exercise in patients with long COVID-19.
... A relationship between chronic pain and disability has been previously found in chronic conditions such as fibromyalgia [32], low back pain [33,34] or whiplash-associated disorders [35]. Keefe et al. [36] suggested that patient' beliefs about the cause and treatment of pain may mediate changes in physical disability following participation in a multidisciplinary pain management program, not only physical measures which are clearly related to chronic musculoskeletal pain [37,38]. ...
Background:
Chronic shoulder pain is a very prevalent condition causing disability and functional impairment. The purpose of the study was to evaluate the relationship between pain intensity, physical variables, psychological vulnerability, pronociceptive pain modulation profile and disability in older people with chronic shoulder pain.
Methods:
A cross-sectional study was carried out. A total of 56 participants with non-specific chronic shoulder pain of the "Complejo Hospitalario Universitario" (Granada) and 56 healthy controls were included. The outcomes evaluated were pain intensity (visual analogue scale), physical factors (dynamometry for grip strength), psychological vulnerability (Fear-Avoidance Beliefs Questionnaire and Tampa Scale of Kinesiophobia), pronociceptive pain modulation profile (pain pressure algometry) and disability (Quick Disability Arm Shoulder Hand questionnaire).
Results:
Disability showed a positive correlation with pain and psychological vulnerability (p < 0.05) and a negative correlation with pronociceptive pain variables and dynamometry (p < 0.001). Psychological vulnerability also presented a strong negative correlation with proprioceptive pain variables and dynamometry and a positive correlation with pain (p < 0.05). In regard to the pronociceptive pain modulation profile, a strong negative correlation with pain (p < 0.001) and a positive moderate correlation with dynamometry (p < 0.001) were shown.
Conclusions:
Our results support a strong association between disability, psychological vulnerability and pronociceptive pain modulation profile in older adults with chronic shoulder pain.
... Studies assessing the effects of strengthening exercises, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] ...
Objective: Specific neck exercises targeting deep cervical flexors and extensors are commonly used for the treatment of nonspecific neck pain (NSNP). However, whether specific neck exercises are more effective than alternative exercise interventions remains unclear. Furthermore, it has been postulated that specific neck exercises may be most effective when they are tailored and targeted to patients with evidence of motor control dysfunction, yet this notion also remains unproven. The objectives of this study were to compare the effectiveness of specific neck exercises with that of alternative exercise interventions for reducing pain and disability in people with NSNP and to assess whether the effectiveness of specific neck exercises is increased when the exercises are tailored and provided to patients with evidence of motor control dysfunction.
Methods: For this systematic review with meta-analysis, Medline, Web of Science, Scopus, and Physiotherapy Evidence Database were searched. Eligibility criteria included randomized controlled trials evaluating the effectiveness of specific neck exercises against that of alternative exercise interventions in people with NSNP. Meta-analysis included subgroup analyses to determine the effect of exercise tailoring and participant selection criteria on the effectiveness of specific neck exercises.
Results: Twelve studies were included. Meta-analysis revealed greater effectiveness of specific neck exercises in the short to medium term for reducing pain (pooled standardized mean difference [SMD] = −0.41; 95% CI = −0.76 to −0.06; P = .02) and disability (pooled SMD = −0.41; 95% CI = −0.78 to −0.04; P = .03) but no differences in the long term for pain (pooled SMD = −1.30; 95% CI = −3.35 to 0.75; P = .21) and disability (pooled SMD = −1.81; 95% CI = −4.29 to 0.67; P = .15), although evidence was limited for the latter. The effectiveness of specific neck exercises was not superior in studies that included only participants with motor control dysfunction or when exercises were tailored to each participant. Overall, the studies were of low quality. Grading of Recommendations Assessment, Development and Evaluation revealed low certainty, serious risk of bias, and inconsistency of findings for short- to medium-term effects and very low certainty, serious risk of bias, and very serious inconsistency for long-term effects.
Conclusion: The preferential use of specific neck exercises may be recommended to achieve better short- to medium-term outcomes, although the low quality of evidence affects the certainty of these findings. Currently used strategies for selecting patients and tailoring specific neck exercises are not supported by the evidence and therefore cannot be recommended for clinical practice.
Impact: Specific neck exercises are more effective than alternative exercise interventions for reducing pain and disability in patients with nonspecific neck pain in the short to medium term, but overall evidence is of low quality, affecting the certainty of the findings. Tests of muscle dysfunction (mostly the craniocervical flexion test) currently used in studies to select patients and tailor specific neck exercises do not result in greater effectiveness of these exercises.
Lay Summary: Evidence suggests specific neck exercises are more effective than other forms of exercise, although evidence is overall of low quality. Use of the craniocervical flexion test in isolation to select participants and/or tailor specific neck exercises can not be recommended.
... Two more studies indicated the same after RT of 8 weeks in young males with a significant increase in muscle endurance during a submaximal task performed till momentary failure (Hong, Hong, and Shin, 2014;Schoenfeld et al., 2019). Increase in fatigue tolerance observed in the present study could be attributed to local muscular factors, such as increased capillarization and myofiber hypertrophy (Andersen et al., 2014) and a shift toward an increased proportion of fatigue-resistant fast-twitch fibers resulting in a more fatigue-resistant muscle fiber profile post-RT (Farup et al., 2014). In addition, RT has also shown to enhance glucose metabolism and increase oxidative enzymes (Groennebaek and Vissing, 2017) and reduce glycolytic muscle enzymes (Tesch, Komi, and Häkkinen, 1987), which might have reduced fatigue in the present experiment. ...
Background
Type 2 diabetes mellitus (T2DM) is often accompanied with several neuromuscular complications of which muscle fatigue is one of the scantily studied and less-explored complication of this disease.
Objective
To investigate the effects of resistance training (RT) on muscle fatigue markers from electromyography (EMG) and capillary blood in T2DM patients.
Methods
Forty T2DM patients were randomized to either RT (n = 20) or control group (n = 20). They were assessed for EMG indices of muscle fatigue along with blood lactate (at three time points: Lactatepre, Lactatepeak, Lactatepost) during a dynamic fatigue protocol. Dynamic fatigue protocol consisted of 5 sets of leg press exercise at 10 repetition maximum intensity. RT group performed moderate intensity (65%–75% 1 repetition maximum) RT 3 times/week for 12 weeks. Control group followed usual routine.
Results
Findings revealed that EMG amplitude (root mean square) and Dimitrov’s muscle fatigue index (FInsmk) decreased significantly while median frequency (MF) increased significantly during the dynamic fatigue protocol for both vastus medialis (Root mean square, p = .02; FInsmk, p = .001; MF, p < .001) and vastus lateralis muscle (Root mean square, p= .04,FInsmk,p = .01; MF, p < .001) post-RT. Blood lactate responses did not change after RT (Lactatepre, p = .55; Lactatepeak, p = .91; Lactatepost, p = .33).
Conclusions
Findings of the present study illustrated that moderate intensity RT led to a significant reduction muscle fatigue in knee extensor muscles of T2DM patients. These results reinforce the utilization of RT in patients with T2DM.
... In the case of physical risk factors, research has consistently shown an association between neck pain and decreased neck muscle strength [11][12][13][14][15][16]. Further, several randomized studies have reported a decrease in neck pain as a result of neck musclestrengthening rehabilitation programs [17][18][19][20]. Similarly, patients with neck pain have shown a decreased cervical range of motion compared with persons without neck pain [11,[21][22][23][24]. ...
Background
Neck pain has been associated with weaker neck muscle strength and decreased cervical spine range of motion. However, whether neck muscle strength or cervical spine mobility predict later neck disability has not been demonstrated. In this 16-year prospective study, we investigated whether neck muscle strength and cervical spine mobility are associated with future neck pain and related disability in women pain-free at baseline.
Methods
Maximal isometric neck muscle strength and passive range of motion (PROM) of the cervical spine of 220 women (mean age 40, standard deviation (SD) 12 years) were measured at baseline between 2000 and 2002. We conducted a postal survey 16 years later to determine whether any subjects had experienced neck pain and related disability. Linear regression analysis adjusted for age and body mass index was used to determine to what extent baseline neck strength and PROM values were associated with future neck pain and related disability assessed using the Neck Disability Index (NDI).
Results
The regression analysis Beta coefficient remained below 0.1 for all the neck strength and PROM values, indicating no association between neck pain and related disability. Of the 149 (68%) responders, mean NDI was lowest (3.3, SD 3.8) in participants who had experienced no neck pain ( n = 50), second lowest (7.7, SD 7.1) in those who had experienced occasional neck pain ( n = 94), and highest (19.6, SD 22.0) in those who had experienced chronic neck pain ( n = 5).
Conclusions
This 16-year prospective study found no evidence for an association between either neck muscle strength or mobility and the occurrence in later life of neck pain and disability. Therefore, screening healthy subjects for weaker neck muscle strength or poorer cervical spine mobility cannot be recommended for preventive purposes.
... Other studies have examined maximal voluntary contraction of shoulder and neck muscles among females with musculoskeletal disorders compared to healthy females. These studies found females with musculoskeletal disorders (including pain) to have lower maximal voluntary contraction compared to healthy controls [36][37][38][39] . Likewise, several studies have found strength training to decrease pain in lower back, spine, neck, and upper extremities in various populations [12][13][14][15][16][17] , the lack of any association between muscle strength and pain severity in the present study was surprising, but is likely related to the amount of missing data. ...
Objectives: The risk of musculoskeletal pain increases when there is an imbalance between work demands and physical capacity. Work in elder care requires frequent periods of high mechanical loading. Body weight can further amplify this load, while muscle strength may lessen the relative strain on the musculoskeletal system. The purpose of this study was to assess the correlation between body composition, muscular strength and localized musculoskeletal pain intensity in overweight female health care professionals. Methods: A sample of 139 overweight female health care professionals working in elder care were included in the analyses. Associations between BMI, fat percentage, waist circumference, muscle strength and localized pain intensity were assessed using Kendall’s rank correlation. Results: Significant associations were found between musculoskeletal pain in the right shoulder and BMI (rτ=0.194; p=0.035), whereas upper back pain was associated with fat percentage and waist circumference (rτ=0.212; p=0.023 and rτ=0.212; p=0.024, respectively). Conclusions: Results indicate high BMI, fat percentage, and waist circumference may be contributing factors of localized musculoskeletal pain intensity of the upper body in overweight female health care professionals. These results may help guide the design of future workplace health promotion programmes.
... Las dolencias de tipo musculoesquelético representan uno de los mayores problemas en el ámbito laboral, siendo una de las principales causas de ausencia del trabajo por motivos de salud. Por este motivo, numerosos estudios han analizado los posibles beneficios de la actividad física sobre el dolor lumbar y cervical, entre otros, en diferentes poblaciones de trabajadores; dichos estudios han observado mejoras significativas en la percepción del dolor tras la implementación de diferentes programas de entrenamiento de la fuerza con intensidades de esfuerzo predominantemente altas (37). ...
... Los efectos beneficiosos de la AF sobre la prevención y el tratamiento de la mayoría de las enfermedades crónicas son bien conocidos (29). En general, la exposición a mayores niveles de AF global ha sido asociada a menores niveles de ALE tanto de corta como de baja duración (59,86), y las intervenciones con programas de ejercicio orientados, de manera específica, al tratamiento de determinadas condiciones crónicas, han resultado efectivos (37,69). Se han sugerido asociaciones dosis-respuesta al producirse mayores reducciones de ALE con AF de intensidad vigorosa que con intensidad moderada (63). ...
... In the study by Losina et al., PA is measured by accelerometry (34) , whereas in the rest of the studies, PA is self-reported. The objective measurement of PA through accelerometry, instead of being taken by questionnaires, has been suggested by several authors as a necessity to improve quality research on this field (12,37) . Regarding absenteeism, only two studies include company reports (33,36) and the rest self-report this variable through not validated questionnaires, which points to a possible measurement risk of bias of sickness absenteeism. ...
Sickness absence is a multicausal phenomenon influenced by the working environment, job role and lifestyle. Its high cost is supported by companies and public institutions in accordance with the current legislation and represents a substantial part of the budget for many
countries. Nevertheless, this is not only an economic issue but also a public health issue; longterm sickness absence has been associated to experience disability pension, as well as mortality
risk. Both chronic conditions and diseases have been pointed at among its main relevant causes, occasionally, linked to specific occupational classes. Thus, back pain (i.e. low back pain and neck
pain), mental disorders (i.e. anxiety and depression) and different cardiovascular diseases have been observed among the most prevalent in workers experiencing long-term sickness absence.
On the other hand, moderate and high levels of physical activity, particularly when they are performed during leisure or when commuting to work, have been associated with lower
sickness absence, as well as lower of the most common chronic diseases among both general and specific populations of workers. In addition, this inverse association has been observed to
be more pronounced with higher leisure-time physical activity.
The aim of these studies was to widen knowledge about the physical activity and sickness absence relationship, focusing on its observation among different samples of Spanish and Danish workers, specific population of workers, as well as chronic conditions and diseases
associated with these situations.
Observational studies examining samples of both Spanish and Danish workers were carried out. Manuscripts II and III analysed two samples of university workers (n=1025 and
n=757). Manuscripts IV and VI followed up a general (n=10427) as well as a specific sample of Danish workers (n=4699). Manuscripts V, VII and VIII investigated samples of general populations of Spanish workers (n=9512 y n=9885).
Tools such as International Physical Activity Questionnaire (IPAQ) were used to estimate physical activity levels, while sickness absence was assessed through either a question included
in the questionnaires or the Danish Registry for Evaluation of Marginalization (DREAM). Analyses were adjusted for different control variables appointed by literature and collected in the questionnaires.
Results of the present Thesis showed an inverse association between physical activity and sickness absence in Spanish workers. Such association was observed stronger with higher levels of physical activity and certain subgroups of workers. Similarly, an inverse association between physical activity and certain conditions (i.e. chronic back pain, depression, anxiety, hypertension, diabetes, work-related stress, and usual activity limitations). Moreover, leisuretime physical activity reduced the risk of long-term sickness among Danish workers.
In conclusion, the results suggest that higher levels of physical activity associates with lower prevalence and risk of sickness absence. Strategies based on promoting physical activity during leisure might be beneficial for reducing sickness absence.
... 40 strengthening the spine-stabilizing musculature may thus counteract any disturbances in muscle activation patterns, weakness and fatigability inducing and/ or resulting from the experience of back pain. 12,[41][42][43][44] An unexpected finding was that although exercising at a higher intensity was more effective, higher subjective perceived physical exertion levels during the exercise sessions intensified back pain. This ostensible contradiction might be explained by a combination of physiological and psychological effects. ...
Background:
Exercise is considered an effective intervention to relieve chronic back pain. However, it is still unknown whether specific exercise patterns vary in terms of their efficiency and effectiveness.
Aim:
To investigate the differential health and economic effects of intensity, specificity and degree of subjective perceived physical exertion across five exercise patterns (endurance, gymnastics, fitness, back gymnastics, multimodal back exercise) in adults with back pain.
Design:
Longitudinal observational cohort study over a period of 24 months.
Setting:
Various non-therapeutic exercise facilities (e.g., outdoor, fitness centres, health insurance programmes, sports clubs) across one federal state of Germany (Baden- Wuerttemberg).
Population:
Adults with back pain (N = 2,542, Mean = 46.9 years, 66% females, Graded Chronic Back pain GCPS 1= 40.5%, GCPS 2= 27.3 %, GCPS 3= 20.7 %, GCPS 4= 11.5 %).
Methods:
Self-reported back pain (functional restrictions and pain = Back Pain Function Score, BPFS) and characteristics of exercising behaviour (frequency, duration, type, physical exertion) were assessed at baseline and at 6, 12, 18 and 24 months. Direct medical costs for back disorders (International Classification of Diseases, Dorsopathies: M40 - M54) were compiled from health insurance records.
Results:
Moderate- to high-intensity exercise patterns were effective in reducing back pain, particularly at lower levels of subjective perceived physical exertion. At these intensity levels, multimodal back exercise (i.e., exercising the spine-stabilizing muscles specifically, ergonomic training) was 14.5 times more effective than non-backspecific fitness exercise in reducing back pain (BPFS). The beneficial effects of both exercise types increased with the initial severity of back pain. However, only multimodal back exercise (moderate- to high-intensity/high back specificity) was associated with a significant decrease in direct medical costs for back pain.
Conclusions:
Targeted exercise of the spine-stabilizing musculature at moderate to high intensities without maximum perceived exertion is effective and efficient in reducing back pain.
