Chatain Cyril, Vallier Jean-Marc, Paleiron Nicolas, Cucchietti Waltz Fanny, Ramdani Sofiane, Gruet Mathieu
Laboratoire Jeunesse-Activité Physique et Sportive-Santé (J-AP2S), Université de Toulon, La Garde, France.
Service de Pneumologie, Hôpital d'Instruction des Armées Saint-Anne, Toulon, France.
Eur J Appl Physiol. 2025 Feb;125(2):409-428. doi: 10.1007/s00421-024-05608-x. Epub 2024 Sep 21.
Recent studies suggest that, compared to healthy individuals, people with chronic obstructive pulmonary disease (pwCOPD) present a reduced capacity to perform cognitive-motor dual-task (CMDT). However, these studies were focused on short-duration CMDT offering limited insight to prolonged CMDT inducing fatigue, which can be encountered in daily life. The present study aimed to explore the effect of adding a cognitive task during repeated muscle contractions on muscle endurance, neuromuscular fatigability, and cognitive control in pwCOPD compared to healthy participants.
Thirteen pwCOPD and thirteen age- and sex-matched healthy participants performed submaximal isometric contractions of the knee extensors until exhaustion in two experimental sessions: (1) without cognitive task and (2) with a concurrent working memory task (i.e., 1-back task). Neuromuscular fatigability (as well as central and peripheral components measured by peripheral magnetic stimulation), cognitive performance, and perceived muscle fatigue were assessed throughout the fatiguing tasks.
Independently to the experimental condition, pwCOPD exhibited lower muscle endurance compared to healthy participants (p = 0.039), mainly explained by earlier peripheral fatigue and faster attainment of higher perceived muscle fatigue (p < 0.05). However, neither effect of cognitive task (p = 0.223) nor interaction effect (group × condition; p = 0.136) was revealed for muscle endurance. Interestingly, cognitive control was significantly reduced only in pwCOPD at the end of CMDT (p < 0.015), suggesting greater difficulty for patients with dual tasking under fatigue.
These findings provide novel insights into how and why fatigue develops in COPD in dual-task context, offering a rationale for including such tasks in rehabilitation programs.
近期研究表明，与健康个体相比，慢性阻塞性肺疾病患者（pwCOPD）执行认知 - 运动双重任务（CMDT）的能力有所下降。然而，这些研究主要集中在短时间的CMDT，对于日常生活中可能出现的长时间CMDT导致疲劳的情况提供的见解有限。本研究旨在探讨与健康参与者相比，在重复肌肉收缩过程中添加认知任务对pwCOPD患者肌肉耐力、神经肌肉疲劳性和认知控制的影响。
13名pwCOPD患者和13名年龄及性别匹配的健康参与者在两个实验环节中进行膝关节伸肌的次最大等长收缩，直至疲劳：（1）无认知任务；（2）同时进行工作记忆任务（即1 - 回溯任务）。在疲劳任务过程中评估神经肌肉疲劳性（以及通过外周磁刺激测量的中枢和外周成分）、认知表现和感知到的肌肉疲劳。
无论实验条件如何，与健康参与者相比，pwCOPD患者的肌肉耐力较低（p = 0.039），这主要是由于外周疲劳更早出现以及更快达到更高的感知肌肉疲劳（p < 0.05）。然而，对于肌肉耐力，未发现认知任务的影响（p = 0.223）和交互作用（组×条件；p = 0.136）。有趣的是，仅在pwCOPD患者中，CMDT结束时认知控制显著降低（p < 0.015），这表明疲劳状态下患者进行双重任务的难度更大。
这些发现为双重任务背景下COPD患者疲劳如何以及为何发展提供了新的见解，为在康复计划中纳入此类任务提供了理论依据。
