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BMJ. 1988 October 22; 297(6655): 1014–1017.
PMCID: PMC1834796

Normal muscle strength and fatigability in patients with effort syndromes.

Abstract

To examine fatigue mechanisms in an unselected series of patients with excess fatigue ("effort syndromes") their muscle function was compared with that of normal subjects. Voluntary performance was assessed with a cycle ergometer to exhaustion and by maximal isometric contractions of the quadriceps femoris. The mean maximal heart rate in patients during ergometry was 89% of the predicted rate, and quadriceps strength was either normal or was inappropriate for the available muscle, which suggested submaximal effort. Contractile performance was examined in the absence of volition with stimulated contractions of the adductor pollicis. During stimulated fatiguing activity patients were neither weaker nor more fatigable than controls; thus the excess fatigue experienced by the patients was not due to a defect of the contractile apparatus. The increased perception of effort must therefore be due to impairment of central rather than peripheral mechanisms. The optimal approach to treatment of effort syndromes combines physical and psychological techniques.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Newham D, Edwards RH. Effort syndromes. Physiotherapy. 1979 Feb;65(2):52–56. [PubMed]
  • Edwards RH. Muscle fatigue and pain. Acta Med Scand Suppl. 1986;711:179–188. [PubMed]
  • Behan PO, Behan WM, Bell EJ. The postviral fatigue syndrome--an analysis of the findings in 50 cases. J Infect. 1985 May;10(3):211–222. [PubMed]
  • Yousef GE, Bell EJ, Mann GF, Murugesan V, Smith DG, McCartney RA, Mowbray JF. Chronic enterovirus infection in patients with postviral fatigue syndrome. Lancet. 1988 Jan 23;1(8578):146–150. [PubMed]
  • Jamal GA, Hansen S. Electrophysiological studies in the post-viral fatigue syndrome. J Neurol Neurosurg Psychiatry. 1985 Jul;48(7):691–694. [PMC free article] [PubMed]
  • David AS, Wessely S, Pelosi AJ. Postviral fatigue syndrome: time for a new approach. Br Med J (Clin Res Ed) 1988 Mar 5;296(6623):696–699. [PMC free article] [PubMed]
  • MERTON PA. Voluntary strength and fatigue. J Physiol. 1954 Mar 29;123(3):553–564. [PubMed]
  • Edwards RH, Young A, Hosking GP, Jones DA. Human skeletal muscle function: description of tests and normal values. Clin Sci Mol Med. 1977 Mar;52(3):283–290. [PubMed]
  • Cooper RG, Edwards RH, Gibson H, Stokes MJ. Human muscle fatigue: frequency dependence of excitation and force generation. J Physiol. 1988 Mar;397:585–599. [PubMed]
  • Cooper RG, Stokes MJ, Edwards RH, Stark RD. Absence of excess peripheral muscle fatigue during beta-adrenoceptor blockade. Br J Clin Pharmacol. 1988 Apr;25(4):405–415. [PMC free article] [PubMed]
  • Wiles CM, Young A, Jones DA, Edwards RH. Relaxation rate of constituent muscle-fibre types in human quadriceps. Clin Sci (Lond) 1979 Jan;56(1):47–52. [PubMed]
  • Edwards RH. Physiological analysis of skeletal muscle weakness and fatigue. Clin Sci Mol Med. 1978 May;54(5):463–470. [PubMed]
  • Edwards RH, Hill DK, Jones DA, Merton PA. Fatigue of long duration in human skeletal muscle after exercise. J Physiol. 1977 Nov;272(3):769–778. [PubMed]
  • Basmajian JV. Reeducation of vastus medialis: a misconception. Arch Phys Med Rehabil. 1970 Apr;51(4):245–247. [PubMed]
  • Stokes M, Young A. The contribution of reflex inhibition to arthrogenous muscle weakness. Clin Sci (Lond) 1984 Jul;67(1):7–14. [PubMed]
  • Woods JJ, Furbush F, Bigland-Ritchie B. Evidence for a fatigue-induced reflex inhibition of motoneuron firing rates. J Neurophysiol. 1987 Jul;58(1):125–137. [PubMed]
  • Ho-Yen DO, Carrington D, Armstrong AA. Myalgic encephalomyelitis and alpha-interferon. Lancet. 1988 Jan 16;1(8577):125–125. [PubMed]
  • Friman G, Schiller HH, Schwartz M. Distubed neuromuscular transmission in viral infections. Scand J Infect Dis. 1977;9(2):99–103. [PubMed]
  • Friman G. Effect of acute infectious disease on isometric muscle strength. Scand J Clin Lab Invest. 1977 Jun;37(4):303–308. [PubMed]
  • Friman G. Effect of acute infectious disease on human isometric muscle endurance. Ups J Med Sci. 1978;83(2):105–108. [PubMed]
  • EDWARDS RG, LIPPOLD OC. The relation between force and integrated electrical activity in fatigued muscle. J Physiol. 1956 Jun 28;132(3):677–681. [PubMed]
  • Komi PV, Viitasalo JT. Changes in motor unit activity and metabolism in human skeletal muscle during and after repeated eccentric and concentric contractions. Acta Physiol Scand. 1977 Jun;100(2):246–254. [PubMed]
  • Gandevia SC, McCloskey DI. Interpretation of perceived motor commands by reference to afferent signals. J Physiol. 1978 Oct;283:493–499. [PubMed]

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