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Physiological Reviews, Vol. 81, No. 4, October 2001, pp. 1725-1789
Copyright ©2001 by the American Physiological Society
Prince of Wales Medical Research Institute, Prince of Wales Hospital and University of New South Wales, Sydney, Australia
Gandevia, S. C.
Spinal and Supraspinal Factors in Human Muscle Fatigue. Physiol. Rev. 81: 1725-1789, 2001.
Muscle
fatigue is an exercise-induced reduction in maximal voluntary
muscle force. It may arise not only because of peripheral changes at
the level of the muscle, but also because the central nervous system
fails to drive the motoneurons adequately. Evidence for "central"
fatigue and the neural mechanisms underlying it are reviewed, together
with its terminology and the methods used to reveal it. Much data
suggest that voluntary activation of human motoneurons and muscle
fibers is suboptimal and thus maximal voluntary force is commonly less
than true maximal force. Hence, maximal voluntary strength can often be
below true maximal muscle force. The technique of twitch interpolation
has helped to reveal the changes in drive to motoneurons during
fatigue. Voluntary activation usually diminishes during maximal
voluntary isometric tasks, that is central fatigue develops, and motor
unit firing rates decline. Transcranial magnetic stimulation over the
motor cortex during fatiguing exercise has revealed focal changes in
cortical excitability and inhibitability based on electromyographic
(EMG) recordings, and a decline in supraspinal "drive" based on
force recordings. Some of the changes in motor cortical behavior can be
dissociated from the development of this "supraspinal" fatigue.
Central changes also occur at a spinal level due to the altered input
from muscle spindle, tendon organ, and group III and IV muscle
afferents innervating the fatiguing muscle. Some intrinsic adaptive
properties of the motoneurons help to minimize fatigue. A number of
other central changes occur during fatigue and affect, for example,
proprioception, tremor, and postural control. Human muscle fatigue does
not simply reside in the muscle.
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