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Published in: Current Geriatrics Reports 3/2016

01-09-2016 | Physical Therapy and Rehabilitation (O Addison, Section Editor)

The Effects of Performance Fatigability on Postural Control and Rehabilitation in the Older Patient

Authors: Evan V. Papa, Mahdi Hassan, Nicoleta Bugnariu

Published in: Current Geriatrics Reports | Issue 3/2016

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Abstract

Fatigue is common in older adults and has a significant effect on quality of life. Despite the high prevalence of fatigue in older individuals, several aspects are poorly understood. It is important to differentiate subjective fatigue complaints from fatigability of motor performance because the two are independent constructs with potentially distinct consequences on mobility. Performance fatigability is the magnitude of change in a performance criterion over a given time of task performance. Performance fatigability is a compulsory element of any strength training program, yet strength training is an important component of rehabilitation programs for older adults. The consequences of fatigability for older adults suggest that acute exercise of various types may result in acute impairments in postural control. The effects of performance fatigability on postural control in older adults are evaluated here to aid the rehabilitation clinician in making recommendations for evaluation of fall risks and exercise prescription.
Literature
1.
go back to reference Wijeratne C, Hickie I, Brodaty H. The characteristics of fatigue in an older primary care sample. J Psychosom Res. 2007;62(2):153–8.CrossRefPubMed Wijeratne C, Hickie I, Brodaty H. The characteristics of fatigue in an older primary care sample. J Psychosom Res. 2007;62(2):153–8.CrossRefPubMed
2.
3.••
go back to reference Enoka RM, Duchateau J. Translating fatigue to human performance. Med Sci Sports Exerc, 2016. A case is made for a unified definition of fatigue to facilitate its management in health and disease. Enoka RM, Duchateau J. Translating fatigue to human performance. Med Sci Sports Exerc, 2016. A case is made for a unified definition of fatigue to facilitate its management in health and disease.
4.
go back to reference Deluca J. Fatigue as a Window to the Brain. Cambridge: MIT Press; 2005. Deluca J. Fatigue as a Window to the Brain. Cambridge: MIT Press; 2005.
5.
go back to reference Gandevia S, McComas A, Stuart D, Thomas C. Fatigue: Neural and Muscular Mechanisms. New York: Plenum; 1995.CrossRef Gandevia S, McComas A, Stuart D, Thomas C. Fatigue: Neural and Muscular Mechanisms. New York: Plenum; 1995.CrossRef
6.
7.
go back to reference Gandevia SC. Spinal and supraspinal factors in human muscle fatigue. Physiol Rev. 2001;81(4):1725–89.PubMed Gandevia SC. Spinal and supraspinal factors in human muscle fatigue. Physiol Rev. 2001;81(4):1725–89.PubMed
8.•
go back to reference Helbostad JL, Sturnieks DL, Menant J, Delbaere K, et al. Consequences of lower extremity and trunk muscle fatigue on balance and functional tasks in older people: a systematic literature review. BMC Geriatr. 2010;10:56.CrossRefPubMedPubMedCentral Helbostad JL, Sturnieks DL, Menant J, Delbaere K, et al. Consequences of lower extremity and trunk muscle fatigue on balance and functional tasks in older people: a systematic literature review. BMC Geriatr. 2010;10:56.CrossRefPubMedPubMedCentral
9.
go back to reference Shumway-Cook A, WM. Motor control: theory and practical applications 2nd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2001. Shumway-Cook A, WM. Motor control: theory and practical applications 2nd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2001.
10.
go back to reference Horak F, Kuo A. Postural adaptations for altered environments, tasks, and intentions. In: Winters JM, Crago PE, editors. Biomechanics and neural control of posture and movement. New York: Springer; 2000. p. 683. Horak F, Kuo A. Postural adaptations for altered environments, tasks, and intentions. In: Winters JM, Crago PE, editors. Biomechanics and neural control of posture and movement. New York: Springer; 2000. p. 683.
11.
go back to reference Paillard T. Effects of general and local fatigue on postural control: a review. Neurosci Biobehav Rev. 2012;36(1):162–76.CrossRefPubMed Paillard T. Effects of general and local fatigue on postural control: a review. Neurosci Biobehav Rev. 2012;36(1):162–76.CrossRefPubMed
12.••
go back to reference Papa EV, Foreman KB, Dibble LE. Effects of age and acute muscle fatigue on reactive postural control in healthy adults. Clinical Biomechanics, 2015;30(10):1108–13. Timeline of recovery of postural control from performance fatigability is reported. Papa EV, Foreman KB, Dibble LE. Effects of age and acute muscle fatigue on reactive postural control in healthy adults. Clinical Biomechanics, 2015;30(10):1108–13. Timeline of recovery of postural control from performance fatigability is reported.
13.
go back to reference Fleck SJ Kraemer W. Designing resistance training programs, 4th Ed. Champaign, IL: Human Kinetics; 2014. Fleck SJ Kraemer W. Designing resistance training programs, 4th Ed. Champaign, IL: Human Kinetics; 2014.
14.
go back to reference Medicine ACoS. ACSM’s guidelines for exercise testing and prescription. 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. Medicine ACoS. ACSM’s guidelines for exercise testing and prescription. 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013.
15.
go back to reference Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994;330(25):1769–75.CrossRefPubMed Fiatarone MA, O’Neill EF, Ryan ND, Clements KM, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med. 1994;330(25):1769–75.CrossRefPubMed
16.
go back to reference Trappe S, Williamson D, Godard M. Maintenance of whole muscle strength and size following resistance training in older men. J Gerontol A Biol Sci Med Sci. 2002;57(4):B138–43.CrossRefPubMed Trappe S, Williamson D, Godard M. Maintenance of whole muscle strength and size following resistance training in older men. J Gerontol A Biol Sci Med Sci. 2002;57(4):B138–43.CrossRefPubMed
17.
go back to reference Fried LP, Tangen CM, Walston J, Newman AB, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.CrossRefPubMed Fried LP, Tangen CM, Walston J, Newman AB, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.CrossRefPubMed
18.
go back to reference Davis M, Fitts R. In: Roitman J, editor. Mechanisms of muscular fatigue, in ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription. Philadelphia, PA: Lippincott Williams & Wilkins; 2001. p. 184. Davis M, Fitts R. In: Roitman J, editor. Mechanisms of muscular fatigue, in ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription. Philadelphia, PA: Lippincott Williams & Wilkins; 2001. p. 184.
19.
go back to reference Stackhouse SK, Stevens JE, Lee SC, Pearce KM, et al. Maximum voluntary activation in nonfatigued and fatigued muscle of young and elderly individuals. Phys Ther. 2001;81(5):1102–9.PubMed Stackhouse SK, Stevens JE, Lee SC, Pearce KM, et al. Maximum voluntary activation in nonfatigued and fatigued muscle of young and elderly individuals. Phys Ther. 2001;81(5):1102–9.PubMed
20.
go back to reference Allman BL, Rice CL. Incomplete recovery of voluntary isometric force after fatigue is not affected by old age. Muscle Nerve. 2001;24(9):1156–67.CrossRefPubMed Allman BL, Rice CL. Incomplete recovery of voluntary isometric force after fatigue is not affected by old age. Muscle Nerve. 2001;24(9):1156–67.CrossRefPubMed
21.
go back to reference Smolander J, Aminoff T, Korhonen I, Tervo M, et al. Heart rate and blood pressure responses to isometric exercise in young and older men. Eur J Appl Physiol Occup Physiol. 1998;77(5):439–44.CrossRefPubMed Smolander J, Aminoff T, Korhonen I, Tervo M, et al. Heart rate and blood pressure responses to isometric exercise in young and older men. Eur J Appl Physiol Occup Physiol. 1998;77(5):439–44.CrossRefPubMed
22.
go back to reference Ditor DS, Hicks AL. The effect of age and gender on the relative fatigability of the human adductor pollicis muscle. Can J Physiol Pharmacol. 2000;78(10):781–90.CrossRefPubMed Ditor DS, Hicks AL. The effect of age and gender on the relative fatigability of the human adductor pollicis muscle. Can J Physiol Pharmacol. 2000;78(10):781–90.CrossRefPubMed
23.
go back to reference Bemben MG, Massey BH, Bemben DA, Misner JE, et al. Isometric intermittent endurance of four muscle groups in men aged 20–74 yr. Med Sci Sports Exerc. 1996;28(1):145–54.CrossRefPubMed Bemben MG, Massey BH, Bemben DA, Misner JE, et al. Isometric intermittent endurance of four muscle groups in men aged 20–74 yr. Med Sci Sports Exerc. 1996;28(1):145–54.CrossRefPubMed
24.
go back to reference Bilodeau M, Erb MD, Nichols JM, Joiner KL, et al. Fatigue of elbow flexor muscles in younger and older adults. Muscle Nerve. 2001;24(1):98–106.CrossRefPubMed Bilodeau M, Erb MD, Nichols JM, Joiner KL, et al. Fatigue of elbow flexor muscles in younger and older adults. Muscle Nerve. 2001;24(1):98–106.CrossRefPubMed
27.
go back to reference Neumann DA. Kinesiology of the musculoskeletal system : foundations for rehabilitation. 2nd ed. St. Louis, Mo: Mosby/Elsevier; 2010. p. 725. Neumann DA. Kinesiology of the musculoskeletal system : foundations for rehabilitation. 2nd ed. St. Louis, Mo: Mosby/Elsevier; 2010. p. 725.
28.•
go back to reference Papa EV, Garg H, Dibble LE. Acute effects of muscle fatigue on anticipatory and reactive postural control in older individuals: a systematic review of the evidence. J Geriatr Phys Ther, 2015;38(1):40–8. Systematic review of effects of fatigability on different aspects of postural control, including anticipatory and reactive mechanisms. Papa EV, Garg H, Dibble LE. Acute effects of muscle fatigue on anticipatory and reactive postural control in older individuals: a systematic review of the evidence. J Geriatr Phys Ther, 2015;38(1):40–8. Systematic review of effects of fatigability on different aspects of postural control, including anticipatory and reactive mechanisms.
29.
go back to reference Hsiao-Wecksler ET. Biomechanical and age-related differences in balance recovery using the tether-release method. J Electromyogr Kinesiol. 2008;18(2):179–87.CrossRefPubMed Hsiao-Wecksler ET. Biomechanical and age-related differences in balance recovery using the tether-release method. J Electromyogr Kinesiol. 2008;18(2):179–87.CrossRefPubMed
30.
go back to reference Toebes MJ, Hoozemans MJ, van Dieen JH DJ. Effects of unilateral leg muscle fatigue on balance control in perturbed and unperturbed gait in healthy elderly. Gait Posture. 2014;40(1):215–9.CrossRefPubMed Toebes MJ, Hoozemans MJ, van Dieen JH DJ. Effects of unilateral leg muscle fatigue on balance control in perturbed and unperturbed gait in healthy elderly. Gait Posture. 2014;40(1):215–9.CrossRefPubMed
31.
32.
go back to reference Bisson EJ, Lajoie Y, Bilodeau M. The influence of age and surface compliance on changes in postural control and attention due to ankle neuromuscular fatigue. Exp Brain Res. 2014;232(3):837–45.CrossRefPubMed Bisson EJ, Lajoie Y, Bilodeau M. The influence of age and surface compliance on changes in postural control and attention due to ankle neuromuscular fatigue. Exp Brain Res. 2014;232(3):837–45.CrossRefPubMed
33.
go back to reference Arvin M, Hoozemans MJ, Burger BJ, Rispens SM, et al. Effects of hip abductor muscle fatigue on gait control and hip position sense in healthy older adults. Gait Posture. 2015;42(4):545–9.CrossRefPubMed Arvin M, Hoozemans MJ, Burger BJ, Rispens SM, et al. Effects of hip abductor muscle fatigue on gait control and hip position sense in healthy older adults. Gait Posture. 2015;42(4):545–9.CrossRefPubMed
34.••
go back to reference Parreira RB, Amorim CF, Gil AW, Teixeira DC, et al. Effect of trunk extensor fatigue on the postural balance of elderly and young adults during unipodal task. Eur J Appl Physiol. 2013;113(8):1989–96. Timeline of recovery of postural control from performance fatigability is reported.CrossRefPubMed Parreira RB, Amorim CF, Gil AW, Teixeira DC, et al. Effect of trunk extensor fatigue on the postural balance of elderly and young adults during unipodal task. Eur J Appl Physiol. 2013;113(8):1989–96. Timeline of recovery of postural control from performance fatigability is reported.CrossRefPubMed
35.
go back to reference Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35 Suppl 2:ii37–41.PubMed Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35 Suppl 2:ii37–41.PubMed
36.
go back to reference Hatton AL, Menant JC, Lord SR, Lo JC, et al. The effect of lower limb muscle fatigue on obstacle negotiation during walking in older adults. Gait Posture. 2013;37(4):506–10.CrossRefPubMed Hatton AL, Menant JC, Lord SR, Lo JC, et al. The effect of lower limb muscle fatigue on obstacle negotiation during walking in older adults. Gait Posture. 2013;37(4):506–10.CrossRefPubMed
37.
38.
go back to reference Doheny EP, Greene BR, Foran T, Cunningham C, et al. Diurnal variations in the outcomes of instrumented gait and quiet standing balance assessments and their association with falls history. Physiol Meas. 2012;33(3):361–73.CrossRefPubMed Doheny EP, Greene BR, Foran T, Cunningham C, et al. Diurnal variations in the outcomes of instrumented gait and quiet standing balance assessments and their association with falls history. Physiol Meas. 2012;33(3):361–73.CrossRefPubMed
39.
go back to reference Boulgarides LK, McGinty SM, Willett JA, Barnes CW. Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Phys Ther. 2003;83(4):328–39.PubMed Boulgarides LK, McGinty SM, Willett JA, Barnes CW. Use of clinical and impairment-based tests to predict falls by community-dwelling older adults. Phys Ther. 2003;83(4):328–39.PubMed
40.
go back to reference Tromp AM, Pluijm SM, Smit JH, Deeg DJ, et al. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol. 2001;54(8):837–44.CrossRefPubMed Tromp AM, Pluijm SM, Smit JH, Deeg DJ, et al. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol. 2001;54(8):837–44.CrossRefPubMed
41.
go back to reference Bonen A, Belcastro AN. Comparison of self-selected recovery methods on lactic acid removal rates. Med Sci Sports. 1976;8(3):176–8.PubMed Bonen A, Belcastro AN. Comparison of self-selected recovery methods on lactic acid removal rates. Med Sci Sports. 1976;8(3):176–8.PubMed
42.
go back to reference Gisolfi C, Robinson S, Turrell ES. Effects of aerobic work performed during recovery from exhausting work. J Appl Physiol. 1966;21(6):1767–72.PubMed Gisolfi C, Robinson S, Turrell ES. Effects of aerobic work performed during recovery from exhausting work. J Appl Physiol. 1966;21(6):1767–72.PubMed
43.
go back to reference Harkins KM, Mattacola CG, Uhl TL, Malone TR, et al. Effects of 2 ankle fatigue models on the duration of postural stability dysfunction. J Athl Train. 2005;40(3):191–4.PubMedPubMedCentral Harkins KM, Mattacola CG, Uhl TL, Malone TR, et al. Effects of 2 ankle fatigue models on the duration of postural stability dysfunction. J Athl Train. 2005;40(3):191–4.PubMedPubMedCentral
44.
go back to reference Yaggie JA, McGregor SJ. Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits. Arch Phys Med Rehabil. 2002;83(2):224–8.CrossRefPubMed Yaggie JA, McGregor SJ. Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits. Arch Phys Med Rehabil. 2002;83(2):224–8.CrossRefPubMed
45.
go back to reference Rybar MM, Walker ER, Kuhnen HR, Ouellette DR, et al. The stroke-related effects of hip flexion fatigue on over ground walking. Gait Posture. 2014;39(4):1103–8.CrossRefPubMedPubMedCentral Rybar MM, Walker ER, Kuhnen HR, Ouellette DR, et al. The stroke-related effects of hip flexion fatigue on over ground walking. Gait Posture. 2014;39(4):1103–8.CrossRefPubMedPubMedCentral
46.
go back to reference Papa E, Foreman B, Dibble L. “Going backwards”: effects of age and muscle fatigue on postural control during posterior-directed falls in persons with Parkinson disease. Physiotherapy. 2015;101:e1170–1.CrossRef Papa E, Foreman B, Dibble L. “Going backwards”: effects of age and muscle fatigue on postural control during posterior-directed falls in persons with Parkinson disease. Physiotherapy. 2015;101:e1170–1.CrossRef
47.
go back to reference Hunter SK, Critchlow A, Enoka RM. Influence of aging on sex differences in muscle fatigability. J Appl Physiol (1985). 2004;97(5):1723–32.CrossRef Hunter SK, Critchlow A, Enoka RM. Influence of aging on sex differences in muscle fatigability. J Appl Physiol (1985). 2004;97(5):1723–32.CrossRef
48.
go back to reference Law LAF, Avin KG. Endurance time is joint-specific: a modelling and meta-analysis investigation. Ergonomics. 2010;53(1):109–29.CrossRefPubMedCentral Law LAF, Avin KG. Endurance time is joint-specific: a modelling and meta-analysis investigation. Ergonomics. 2010;53(1):109–29.CrossRefPubMedCentral
49.
go back to reference Hunter S. Aging and mechanisms of task-dependent muscle fatigue. Advances in neuromuscular physiology of motor skills and muscle fatigue. Kerala, India: Research Signpost; 2009. p. 391–414. Hunter S. Aging and mechanisms of task-dependent muscle fatigue. Advances in neuromuscular physiology of motor skills and muscle fatigue. Kerala, India: Research Signpost; 2009. p. 391–414.
50.
go back to reference Bazzucchi I, Marchetti M, Rosponi A, Fattorini L, et al. Differences in the force/endurance relationship between young and older men. Eur J Appl Physiol. 2005;93(4):390–7.CrossRefPubMed Bazzucchi I, Marchetti M, Rosponi A, Fattorini L, et al. Differences in the force/endurance relationship between young and older men. Eur J Appl Physiol. 2005;93(4):390–7.CrossRefPubMed
Metadata
Title
The Effects of Performance Fatigability on Postural Control and Rehabilitation in the Older Patient
Authors
Evan V. Papa
Mahdi Hassan
Nicoleta Bugnariu
Publication date
01-09-2016
Publisher
Springer US
Published in
Current Geriatrics Reports / Issue 3/2016
Electronic ISSN: 2196-7865
DOI
https://doi.org/10.1007/s13670-016-0179-4

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