Mechanical & sEMG manifestations of fatigue in subjects with anorexia nervosa

Purpose: Aim of this work is to compare mechanical and myoelectric manifestations of fatigue during an isometric contraction at 80% of maximal voluntary contraction (MVC) in a population of eight anorexic female patients (AN: 24.9 ± 6.5 years, mean ± SD) with respect to a group of seven healthy female subjects (CO: 30.0 ± 6.6 years, mean ± SD). Methods: sEMG signals were recorded, using a linear electrode array (eight channels, 10 mm apart), from vastus lateralis muscle of the dominant side. MVC, endurance time, initial value and rate of change of the EMG variables [conduction velocity (CV), mean power frequency (MNF), average rectified value (ARV)] were studied during the fatiguing contractions. Results: Absolute and relative (normalized with respect to the body weight) knee torque values and endurance times were found not statistically different between the two groups. Similarly, EMG amplitude initial values and rate of change and MNF initial values were found not significantly different between the two groups. CV initial values and CV rate of change were found greater in healthy than in pathological subjects (AN CV: 3.74 ± 0.86 m/s, CO CV: 4.96 ± 0.64 m/s, p = 0.004; AN CV rate of change: 0.006 ± 0.015 m/s2, CO CV rate of change: _0.006 ± 0.007 m/s2, p = 0.006, mean ± SD). Contrary to expectations MNF rate of changes in the AN group (_0.35 ± 0.16 Hz/s) was found greater than in the CO group (_0.17 ± 0.13 Hz/s, p = 0.004, Mann–Whitney U test, mean ± SD). Conclusions: CV values and their rate of change were compatible with a predominance of type I fibres (and/or with an hypotrophy of type II fibres) and/or with a lower sub-cutaneous tissue thickness with respect to CO group, as described in the literature with this pathology. The behaviour of MNF during sustained contractions, opposite to that of CV, suggests an altered central control strategy aimed to increase mechanical force output increasing the level of synchronization of motor units. This study confirms the capability of sEMG to assess muscle condition during severe malnutrition suggesting further studies to assess if sEMG can be used to monitor the effect of refeeding and rehabilitation treatments.