Abstract
Purpose
Cancer-related fatigue (CRF) is the most reported side effect of cancer and its treatments. Mechanisms of CRF are multidimensional, including neuromuscular alterations leading to decreased muscle strength and endurance (i.e., fatigability). Recently, exercise fatigability and CRF have been related, while fatigability mechanisms remain unclear. Traditionally, fatigability is assessed from maximal voluntary contractions (MVC) decrease, but some authors hypothesized that the rate of force development (RFD) determined during a rapid contraction could also be an interesting indicator of functional alterations. However, to our knowledge, no study investigated RFD in cancer patients. The purpose of this study was to determine whether RFD, fatigability amplitude, and etiology are different between fatigued and non-fatigued cancer patients.
Methods
Eighteen participants with cancer, divided in fatigued or non-fatigued groups according their CRF level, completed a 5-min all-out exercise in ankle plantar flexor muscles composed of 62 isometric MVC of 4 s with 1 s rest, to assess fatigability amplitude as the force–time relationship asymptote (FA). Before and after exercise, fatigability etiologies (i.e., voluntary activation (VA) and evoked forces by electrical stimulation (Db100)) were assessed as well as RFD in 50 and 100 ms (RFD50 and RFD100, respectively) during rapid contractions.
Results
FA is significantly lower in fatigued group. Significant differences were found between pre- and post-exercise VA, Db100, RFD50, and RFD100 for both groups, with no statistical difference between groups.
Conclusion
During treatments, fatigability is higher in fatigued patients; however, the mechanisms of fatigability and RFD alterations are similar in both groups.
Trial registration
ClinicalTrials.gov, NCT04391543, May 2020.
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Data availability
The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- ANOVA:
-
Analysis of variance
- BMI:
-
Body mass index
- CAR:
-
Central activation ratio
- CRF:
-
Cancer-related fatigue
- Db10 :
-
10-Hz doublet electrical stimulation
- Db100 :
-
100-Hz doublet electrical stimulation
- EORTC:
-
European Organization for Research and Treatment of Cancer
- F A :
-
Force–time relationship asymptote
- F peak :
-
Peak force occurring during a muscular contraction
- FS:
-
Force when the superimposed electrical stimulation was applied
- MVC:
-
Maximal voluntary contraction
- RFD:
-
Rate of force development
- SD:
-
Standard deviation
- ST:
-
Difference between the force produced during a maximal voluntary contraction and the force induced by a superimposed electrical stimulation applied on this later
- VA:
-
Voluntary activation
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Acknowledgements
The authors thank all participants for the time allowed and their involvement in this study.
Funding
This work was supported by La Ligue contre le Cancer (thesis scholarship from the first author) and La Région Pays de la Loire (BIOCARE FActory project).
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MC, AR, and BM conceived and designed research. MC and SL conducted experiments. MC, AR, and BM analyzed data. MC wrote the manuscript. All authors read and approved the manuscript.
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Communicated by Michalis G Nikolaidis.
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Chartogne, M., Rahmani, A., Landry, S. et al. Comparison of neuromuscular fatigability amplitude and etiologies between fatigued and non-fatigued cancer patients. Eur J Appl Physiol 124, 1175–1184 (2024). https://doi.org/10.1007/s00421-023-05347-5
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DOI: https://doi.org/10.1007/s00421-023-05347-5