Mechanisms of Neuromuscular Fatigability in People with Cancer-related Fatigue

Brownstein, Callum G., Twomey, Rosemary, Temesi, John, Medysky, Mary E., Culos-Reed, S. Nicole and Millet, Guillaume Y. (2022) Mechanisms of Neuromuscular Fatigability in People with Cancer-related Fatigue. Medicine & Science in Sports & Exercise. ISSN 0195-9131 (In Press)

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Official URL: https://doi.org/10.1249/MSS.0000000000002919

Abstract

Introduction
Cancer-related fatigue (CRF) is a debilitating symptom that affects around one-third of people for months or years after cancer treatment. In a recent study, we found that people with post-treatment CRF have greater performance fatigability. The aim of this secondary analysis was to examine the aetiology of performance fatigability in people with post-treatment CRF.
Methods
Ninety-six people who had completed cancer treatment were dichotomized into two groups (fatigued and non-fatigued) based on a clinical cut-point for fatigue. Alterations in neuromuscular function (maximal voluntary contraction peak force, MVC; voluntary activation, VA; potentiated twitch force, Qtw,pot; electromyography, EMG) in the knee extensors were assessed across three common stages of an incremental cycling test. Power outputs during the fatigability test were expressed relative to gas exchange thresholds to assess relative exercise intensity.
Results
The fatigued group had a more pronounced reduction in MVC peak force and Qtw,pot throughout the common stages of the incremental cycling test (main effect of group: p < 0.001, ηp2 = 0.18 and p = 0.029, ηp2 = 0.06, respectively). Electromyography was higher during cycling in the fatigued group (main effect of group: p = 0.022, ηp2 = 0.07). Although the relative intensity of cycling was higher in the fatigued group at the final common stage of cycling, this was not the case during the initial two stages, despite the greater impairments in neuromuscular function.
Conclusions
Our results suggest that the rapid impairments in performance fatigability in people with CRF was primarily due to disturbances at the level of the muscle, rather than the central nervous system. This could impact the ability to tolerate daily physical activities.

Item Type: Article
Uncontrolled Keywords: contractile function, cycling, electromyography, voluntary activation
Subjects: B900 Others in Subjects allied to Medicine
C600 Sports Science
Department: Faculties > Health and Life Sciences > Sport, Exercise and Rehabilitation
Depositing User: John Coen
Date Deposited: 25 Apr 2022 11:48
Last Modified: 25 Apr 2022 12:00
URI: http://nrl.northumbria.ac.uk/id/eprint/48969

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