Comparison Between Isometric and Concentric Motor Fatigability in Persons With Multiple Sclerosis and Healthy Controls - exploring central and peripheral contributions of motor fatigability

Background. Motor fatigability (i.e. contraction-induced reduction in muscle strength) from a concentric task associatestronger to walking and perception of fatigue in persons with multiple sclerosis (pwMS), compared with an isometric task.However, the central and peripheral contributions of motor fatigability between these tasks have not been investigated.Objective. Compare the central and peripheral contributions of motor fatigability in the knee extensors in a sustainedisometric fatigability protocol versus a concentric fatigability protocol and in pwMS versus healthy controls (HCs).Methods. Participants (n=31 pwMS; n=15 HCs) underwent neuromuscular testing before and immediately after twoknee extensor fatigability tasks (sustained isometric and concentric) in an isokinetic dynamometer. Neuromuscular testingof fatigability consisted of maximal voluntary contraction, voluntary activation (central/neural contributor), and restingtwitch (peripheral/muscular contributor) determined by the interpolated twitch technique. Results. Sustained isometricand concentric fatigability protocols resulted in motor fatigability for both pwMS and HCs, with no between-protocolsdifferences for either group. Regression analysis showed that motor fatigability variance in pwMS was mainly attributedto central fatigability in the sustained isometric protocol and to both central and peripheral fatigability in the concentricprotocol. In HCs, the variance in sustained isometric and concentric fatigability were attributed to both peripheral andcentral fatigability. Conclusion. Central and peripheral contributions of motor fatigability differed between sustainedisometric and concentric protocols as well as between pwMS and HCs. These between-protocol differences in pwMSprovide a neuromuscular dimension to the reported difference in the strength of associations of concentric and isometrictasks to walking and perception of fatigue in pwMS. BACKGROUND: Motor fatigability (i.e. contraction-induced reduction in muscle strength) from a concentric task associate stronger to walking and perception of fatigue in persons with multiple sclerosis (pwMS), compared with an isometric task. However, the central and peripheral contributions of motor fatigability between these tasks have not been investigated.OBJECTIVE: Compare the central and peripheral contributions of motor fatigability in the knee extensors in a sustained isometric fatigability protocol versus a concentric fatigability protocol and in pwMS versus healthy controls (HCs).METHODS: Participants (n=31 pwMS; n=15 HCs) underwent neuromuscular testing before and immediately after two knee extensor fatigability tasks (sustained isometric and concentric) in an isokinetic dynamometer. Neuromuscular testing of fatigability consisted of maximal voluntary contraction, voluntary activation (central/neural contributor), and resting twitch (peripheral/muscular contributor) determined by the interpolated twitch technique.RESULTS: Sustained isometric and concentric fatigability protocols resulted in motor fatigability for both pwMS and HCs, with no between-protocols differences for either group. Regression analysis showed that motor fatigability variance in pwMS was mainly attributed to central fatigability in the sustained isometric protocol and to both central and peripheral fatigability in the concentric protocol. In HCs, the variance in sustained isometric and concentric fatigability were attributed to both peripheral and central fatigability.CONCLUSION: Central and peripheral contributions of motor fatigability differed between sustained isometric and concentric protocols as well as between pwMS and HCs. These between-protocol differences in pwMS provide a neuromuscular dimension to the reported difference in the strength of associations of concentric and isometric tasks to walking and perception of fatigue in pwMS.