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Quantification of Neuromuscular Fatigue: What Do We Do Wrong and Why?
Sports Medicine ( IF 9.8 ) Pub Date : 2020-03-01 , DOI: 10.1007/s40279-019-01203-9
Nicolas Place 1 , Guillaume Y Millet 2, 3
Affiliation  

Neuromuscular fatigue (NMF) is usually assessed non-invasively in healthy, athletic or clinical populations with the combination of voluntary and evoked contractions. Although it might appear relatively straightforward to magnetically or electrically stimulate at different levels (cortical/spinal/muscle) and to measure mechanical and electromyographic responses to quantify neuromuscular adjustments due to sustained/repeated muscle contractions, there are drawbacks that researchers and clinicians need to bear in mind. The aim of this opinion paper is to highlight the pitfalls inevitably faced when NMF is quantified. The first problem might arise from the definition of fatigue itself and the parameter(s) used to measure it; for instance, measuring power vs. isometric torque may lead to different conclusions. Another potential limitation is the delay between exercise termination and the evaluation of neuromuscular function; the possible underestimation of exercise-induced neural and contractile impairment and misinterpretation of fatigue etiology will be discussed, as well as solutions recently proposed to overcome this problem. Quantification of NMF can also be biased (or not feasible) because of the techniques themselves (e.g. results may depend on stimulation intensity for transcranial magnetic stimulation) or the way data are analyzed (e.g. M wave peak-to-peak vs first phase amplitude). When available, alternatives recently suggested in the literature to overcome these pitfalls are considered and recommendations about the best practices to assess NMF (e.g. paying attention to the delay between exercise and testing, adapting the method to the characteristics of the population to be tested and considering the limitations associated with the techniques) are proposed.

中文翻译:

神经肌肉疲劳的量化:我们做错了什么,为什么做?

通常在健康,运动或临床人群中通过自愿性和诱发性收缩相结合的方式对神经肌肉疲劳(NMF)进行无创评估。尽管在不同水平(皮层/脊柱/肌肉)上进行磁刺激或电刺激并测量机械和肌电图反应以量化由于持续/反复的肌肉收缩而引起的神经肌肉调节似乎相对简单,但研究人员和临床医生仍需承担一些缺点心里。本意见书的目的是强调量化NMF时不可避免地面临的陷阱。第一个问题可能来自疲劳本身的定义以及用于测量疲劳的参数。例如,测量功率与等距扭矩可能会得出不同的结论。另一个潜在的限制是运动终止和神经肌肉功能评估之间的延迟。讨论了运动诱发的神经和收缩损伤的可能低估以及对疲劳病因学的误解,以及最近提出的克服该问题的解决方案。由于技术本身(例如,结果可能取决于经颅磁刺激的刺激强度)或分析数据的方式(例如,M波峰峰值与第一相振幅),NMF的量化也可能有偏差(或不可行)。 。在可行的情况下,会考虑使用文献中最近提出的克服这些陷阱的替代方法,并提供有关评估NMF的最佳做法的建议(例如,注意运动和测试之间的延迟,
更新日期:2019-11-13
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