Muscle fatigue characteristics in paralyzed muscle after spinal cord injury

Study design:The study design used is cross-sectional.Objectives:The aim of this study is to examine muscle contractile and excitability characteristics during fatigue of the tibialis anterior in six individuals with chronic spinal cord injury (SCI) and matched able-bodied (AB) controls.Setting:McMaster University, Hamilton, ON, Canada.Methods:Muscle compound action potential (M-wave) characteristics, muscle twitch properties, and summated force were examined during a 2 min fatigue protocol of intermittent bursts at 30 Hz (4 s tetanus, 2 s rest) or maximal voluntary contraction (MVC). Evoked twitch responses were followed during a recovery period.Results:M-wave amplitude was smaller in SCI (2.5±1.6 mV in SCI, 5.7±3.2 mV in AB) at baseline, but there was no change in M-wave amplitude or area during fatigue in either group. There was an increase in M-wave duration toward the end of recovery in the SCI group. Peak torque (PT) was not different between groups at baseline (3.8±1.8 Nm in SCI, 3.7±0.6 Nm in AB); PT potentiated significantly during fatigue in the AB, but not SCI group. There was significantly greater fatigue of both PT (43% decline) and summated force (57% decline) in the SCI group compared with the AB group (13% increase and 22% decline for PT and MVC, respectively).Conclusion:The dorsiflexor muscles in people with SCI are significantly more fatiguable than those in AB controls, but decreases in muscle excitability do not seem to be an important contributor to the increased fatiguability. The mechanisms behind the increased fatigue must lie distal to the muscle membrane.