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Quantifying Arms and Legs Contributions during Repetitive Electrically-Assisted Sit-To-Stand Exercise in Paraplegics: A Pilot Study

Abd Aziz M, Hamzaid NA, Hasnan N

J Vis Exp, 2022 Nov 11.
PMID: 36440840 DOI: 10.3791/63149

Execution of Sit-to-Stand (SitTS) in incomplete spinal cord injury (SCI) patients involves motor function in both upper and lower extremities. The use of arm support, in particular, is a significant assistive factor while executing SitTS movement in SCI population. In addition, the application of functional electrical stimulation (FES) onto quadriceps and gluteus maximus muscles is one of the prescribed management for incomplete SCI to improve muscle action for simple lower limb movements. However, the relative contribution of upper and lower extremities during SitTS has not been thoroughly investigated. Two motor incomplete SCI paraplegics performed repetitive SitTS to fatigue exercise challenge. Their performance was investigated as a mixed-method case-control study comparing SitTS with and without the assistance of FES. Three sets of SitTS tests were completed with 5-min resting period allocated in between sets, with mechanomyography (MMG) sensors attached over the rectus femoris muscles bilaterally. The exercise was separated into 2 sessions; Day 1 for voluntary SitTS and Day 2 for FES-assisted SitTS. Questionnaires were conducted after every session to gather the participants' input about their repetitive SitTS experience. The analysis confirmed that a SitTS cycle could be divided into three phases; Phase 1 (Preparation to stand), Phase 2 (Seat-off), and Phase 3 (Initiation of hip extension), which contributed to 23% ± 7%, 16% ± 4% and 61% ± 6% of the SitTS cycle, respectively. The contribution of arms and legs during SitTS movement varied in different participants based on their legs' Medical Research Council (MRC) muscle grade. In particular, the applied arm forces start to increase clearly when the leg forces start to decline during standing. This finding is supported by the significantly reduced MMG signal indicating leg muscle fatigue and their reported feeling of tiredness.

Matched MeSH terms: Muscle Fatigue/physiology
Prevalence and Trajectories of Post-COVID-19 Neurological Manifestations: A Systematic Review and Meta-Analysis

Giussani G, Westenberg E, Garcia-Azorin D, Bianchi E, Yusof Khan AHK, Allegri RF, et al.

Neuroepidemiology, 2024;58(2):120-133.
PMID: 38272015 DOI: 10.1159/000536352

INTRODUCTION: The aim of this systematic review and meta-analysis was to evaluate the prevalence of thirteen neurological manifestations in people affected by COVID-19 during the acute phase and at 3, 6, 9 and 12-month follow-up time points.
METHODS: The study protocol was registered with PROSPERO (CRD42022325505). MEDLINE (PubMed), Embase, and the Cochrane Library were used as information sources. Eligible studies included original articles of cohort studies, case-control studies, cross-sectional studies, and case series with ≥5 subjects that reported the prevalence and type of neurological manifestations, with a minimum follow-up of 3 months after the acute phase of COVID-19 disease. Two independent reviewers screened studies from January 1, 2020, to June 16, 2022. The following manifestations were assessed: neuromuscular disorders, encephalopathy/altered mental status/delirium, movement disorders, dysautonomia, cerebrovascular disorders, cognitive impairment/dementia, sleep disorders, seizures, syncope/transient loss of consciousness, fatigue, gait disturbances, anosmia/hyposmia, and headache. The pooled prevalence and their 95% confidence intervals were calculated at the six pre-specified times.
RESULTS: 126 of 6,565 screened studies fulfilled the eligibility criteria, accounting for 1,542,300 subjects with COVID-19 disease. Of these, four studies only reported data on neurological conditions other than the 13 selected. The neurological disorders with the highest pooled prevalence estimates (per 100 subjects) during the acute phase of COVID-19 were anosmia/hyposmia, fatigue, headache, encephalopathy, cognitive impairment, and cerebrovascular disease. At 3-month follow-up, the pooled prevalence of fatigue, cognitive impairment, and sleep disorders was still 20% and higher. At six- and 9-month follow-up, there was a tendency for fatigue, cognitive impairment, sleep disorders, anosmia/hyposmia, and headache to further increase in prevalence. At 12-month follow-up, prevalence estimates decreased but remained high for some disorders, such as fatigue and anosmia/hyposmia. Other neurological disorders had a more fluctuating occurrence.
DISCUSSION: Neurological manifestations were prevalent during the acute phase of COVID-19 and over the 1-year follow-up period, with the highest overall prevalence estimates for fatigue, cognitive impairment, sleep disorders, anosmia/hyposmia, and headache. There was a downward trend over time, suggesting that neurological manifestations in the early post-COVID-19 phase may be long-lasting but not permanent. However, especially for the 12-month follow-up time point, more robust data are needed to confirm this trend.

Matched MeSH terms: Fatigue/epidemiology
2024 Update of the RECOVER-Adult Long COVID Research Index

Geng LN, Erlandson KM, Hornig M, Letts R, Selvaggi C, Ashktorab H, et al.

JAMA, 2025 Feb 25;333(8):694-700.
PMID: 39693079 DOI: 10.1001/jama.2024.24184

IMPORTANCE: Classification of persons with long COVID (LC) or post-COVID-19 condition must encompass the complexity and heterogeneity of the condition. Iterative refinement of the classification index for research is needed to incorporate newly available data as the field rapidly evolves.
OBJECTIVE: To update the 2023 research index for adults with LC using additional participant data from the Researching COVID to Enhance Recovery (RECOVER-Adult) study and an expanded symptom list based on input from patient communities.
DESIGN, SETTING, AND PARTICIPANTS: Prospective, observational cohort study including adults 18 years or older with or without known prior SARS-CoV-2 infection who were enrolled at 83 sites in the US and Puerto Rico. Included participants had at least 1 study visit taking place 4.5 months after first SARS-CoV-2 infection or later, and not within 30 days of a reinfection. The study visits took place between October 2021 and March 2024.
EXPOSURE: SARS-CoV-2 infection.
MAIN OUTCOMES AND MEASURES: Presence of LC and participant-reported symptoms.
RESULTS: A total of 13 647 participants (11 743 with known SARS-CoV-2 infection and 1904 without known prior SARS-CoV-2 infection; median age, 45 years [IQR, 34-69 years]; and 73% were female) were included. Using the least absolute shrinkage and selection operator analysis regression approach from the 2023 model, symptoms contributing to the updated 2024 index included postexertional malaise, fatigue, brain fog, dizziness, palpitations, change in smell or taste, thirst, chronic cough, chest pain, shortness of breath, and sleep apnea. For the 2024 LC research index, the optimal threshold to identify participants with highly symptomatic LC was a score of 11 or greater. The 2024 index classified 20% of participants with known prior SARS-CoV-2 infection and 4% of those without known prior SARS-CoV-2 infection as having likely LC (vs 21% and 5%, respectively, using the 2023 index) and 39% of participants with known prior SARS-CoV-2 infection as having possible LC, which is a new category for the 2024 model. Cluster analysis identified 5 LC subtypes that tracked quality-of-life measures.
CONCLUSIONS AND RELEVANCE: The 2024 LC research index for adults builds on the 2023 index with additional data and symptoms to help researchers classify symptomatic LC and its symptom subtypes. Continued future refinement of the index will be needed as the understanding of LC evolves.

Matched MeSH terms: Fatigue/etiology
Fulltext Cancer-related fatigue treatment: An overview

Mohandas H, Jaganathan SK, Mani MP, Ayyar M, Rohini Thevi GV

J Cancer Res Ther, 2017 12 15;13(6):916-929.
PMID: 29237952 DOI: 10.4103/jcrt.JCRT_50_17

Cancer-related fatigue is a symptom of cancer where most patients or the general practitioners tend to misinterpret due to the insufficient understanding or knowledge of cancer-related fatigue (CRF). This paper will provide a better perspective for the patients and the health professionals on how to manage and handle CRF for both mild and severe fatigue patients. Articles were selected from the searches of PubMed database that had the terms "randomized controlled trials," "cancer," "fatigue," "pharmacologic treatment," and "nonpharmacologic treatment" using both Mesh terms and keywords. The authors have reviewed the current hypothesis and evidence of the detailed etiology of the CRF present in the literature for healthier management, directives, and strategies to improve the treatment of cancer-related fatigue. An algorithm has been blueprinted on screening, and management, of the CRF, and various kinds of effective treatments and assessment tools have been briefly studied and explained. Although many strategies seemed promising, the quality of randomized controlled trials is generally quite low in studies, making it difficult to draw conclusions about the effectiveness of each self-care strategies. Therefore, future studies require better design and reporting of methodological issues to ensure evidence-based self-care recommendations for people receiving cancer treatment.

Matched MeSH terms: Fatigue/chemically induced; Fatigue/pathology; Fatigue/therapy*
Fulltext Integration of Islamic perspectives into medical imaging curriculum: an outcome based education approach

Zainul Ibrahim Zainuddin

International Medical Journal Malaysia, 2018;17(101):23-30.
MyJurnal

This paper presents a conceptual approach to the integration of Islamic perspectives into a Medical Imaging Curriculum to the concept of Outcome-Based Education (OBE). This work is seen within the context of harmonising Islamic principles to a currently accepted concept in education. Although there have been discussions that question the concept of OBE, this paper contends that the integration can benefit from the practicality aspect of OBE. This can reduce the complexities and fatigue in addressing the integration using an educational approach that is different to that being applied to the human sciences. This paper features the main elements in OBE in the form of Islamic programme educational objectives, Islamic programme outcomes, and Islamic domain learning outcomes. The justification to use domain learning outcomes instead of course learning outcome is given. The teaching and learning strategies, as well as the assessment, are examined through a lens that serves to provide a desirable, practical and holistic model of Islamic integration. It is felt that the currently accepted teaching and assessment methodologies can be adapted for the integration exercise. This work also highlights two often overlooked elements of OBE; teacher and student characteristics. The various terminologies that describe the Islamic teacher characteristics and the differences in student learning styles and preferences are presented. Furthermore, suggestions are made to align the assessment of the integration to various taxonomies of learning, with the aim in evaluating the internalisation of the Islamic essences. This work contents that a holistic approach towards integration of Islamic perspectives into Medical Imaging curriculum can be realised.

Matched MeSH terms: Fatigue
Fulltext Numerical Investigation of 1 × 7 Steel Wire Strand under Fretting Fatigue Condition

Ahmad S, Badshah S, Ul Haq I, Abdullah Malik S, Amjad M, Nasir Tamin M

Materials (Basel), 2019 Oct 23;12(21).
PMID: 31652687 DOI: 10.3390/ma12213463

Wire ropes undergo a fretting fatigue condition when subjected to axial and bending loads. The fretting behavior of wires are classified as line contact and trellis point of contact. The experimental study on the fatigue of wire ropes indicates that most of the failure occurs due to high localized stresses at trellis point of contact. A continuum damage mechanics approach was previously proposed to estimate the fatigue life estimation of wire ropes. The approach majorly depends on the high value of localized stresses as well as the micro-slippage occurs at the contact region. Finite element approach has been used to study radial and axial distribution of stresses and displacement in order to clearly understand the evolution of stresses and existence of relative displacements between neighboring wires under various loading and frictional conditions. The relative movements of contacting wires are more when friction is not considered. In the presence of friction, the relative movement occurs at the boundaries of the contact region. The location of microslip in the presence of friction is backed by the experimental observation stating the crack is initiated at or the outer boundary of the contact spot. The existence of slip is due to different displacement of outer and central wires.

Matched MeSH terms: Fatigue
A case of chronic fatigue syndrome in Malaysia

Zainal NZ

JUMMEC, 2000;5:103-104.

A case of chronic fatigue syndrome (CFS) like illness was identified recently. Diagnosis CFS is commonly used in the western countries but not in Malaysia or other parts of Asia. It is probably because the diagnosis of neurasthenia has gradually disappeared especially in the United States and United Kingdom. Neurasthenia is dropped in the DSM-111 and DSM-1V but is still retained in the 10th International Classification of Disease. This paper is reporting the case and discussing the definition of chronic fatigue syndrome. (JUMMEC 2000; 2:103-104).

Matched MeSH terms: Fatigue
Some medical aspects of human climatology in the equatorial tropics

Ellis FP

Br Med J, 1954;2:549-554.

Matched MeSH terms: Fatigue
Fulltext Muscle Fatigue in the Three Heads of Triceps Brachii During Intensity and Speed Variations of Triceps Push-Down Exercise

Hussain J, Sundaraj K, Subramaniam ID, Lam CK

Front Physiol, 2020;11:112.
PMID: 32153422 DOI: 10.3389/fphys.2020.00112

The objective of this study was to investigate the effects of changes in exercise intensity and speed on the three heads of the triceps brachii (TB) during triceps push-down exercise until task failure. Twenty-five subjects performed triceps push-down exercise at three different intensities (30, 45, and 60% 1RM) and speeds (slow, medium, and fast) until failure, and surface electromyography (sEMG) signals were recorded from the lateral, long and medial heads of the TB. The endurance time (ET), number of repetitions (NR) and rate of fatigue (ROF) were analyzed. Subsequently, the root-mean-square (RMS), mean power frequency (MPF) and median frequency (MDF) under no-fatigue (NF) and fatigue (Fa) conditions were statistically compared. The findings reveal that ROF increases with increase in the intensity and speed, and the opposite were obtained for the ET. The ROF in the three heads were comparable for all intensities and speeds. The ROF showed a significant difference (P < 0.05) among the three intensities and speeds for all heads. The three heads showed significantly different (P < 0.05) MPF and MDF values for all the performed exercises under both conditions, whereas the RMS values were significantly different only under Fa conditions. The current observations suggest that exercise intensity and speed affect the ROF while changes in intensity do not affect the MPF and MDF under Fa conditions. The behavior of the spectral parameters indicate that the three heads do not work in unison under any of the conditions. Changes in the speed of triceps push-down exercise affects the lateral and long heads, but changes in the exercise intensity affected the attributes of all heads to a greater extent.

Matched MeSH terms: Fatigue
Fulltext Does prolonged standing at work among teachers associated with Musculoskeletal Disorders (MSDs)?

Ayuni Nabilah Alias, Karmegam Karuppiah, Vivien How, Velu Perumal

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):281-289.
MyJurnal

In order to accomplish a wide range of duties and responsibilities that may be done under unpleasant working con- ditions, prolonged standing posture is common with school teachers. Nevertheless, standing upright for a long time or otherwise regarded as prolonged standing frequently contributes to body pain and discomfort, muscle fatigue and even health problems such as musculoskeletal disorders (MSDs). The aim of this paper is to review MSDs arising from prolonged standing and spread information on existing ergonomic and non-ergonomic interventions to alleviate prolonged standing discomfort. Systematic review on prolonged standing school teachers with specific keywords were recognized to discover the appropriate studies and information in a systematic search. The informations in this review may be helpful to guide teacher, school management and researchers to implement the suitable interventions in order to minimise the health issue due to MSDs among school teachers.

Matched MeSH terms: Muscle Fatigue
Prevalence of fatigue among cancer patients undergoing external radiotherapy

Biswal BM, Kumaraswamy N, Mukhtar F

Southeast Asian J Trop Med Public Health, 2004 Jun;35(2):463-7.
PMID: 15691157

Between July 1999 to November 2000, 115 patients undergoing radiotherapy were evaluated for the development of treatment-related fatigue, using a modified Piper's fatigue scale. The above scale determines 4 dimensions of fatigue ie behavioral severity (6 items), affective meaning (5 items), sensory (5 items), and cognitive mood (6 items). Radiotherapy was delivered to the head and neck, breast, pelvis, and miscellaneous sub-sites. The area of the radiation field ranged from 25 to 480 cm2 (median 156 cm2). Forty-three percent of patients experienced significant fatigue, which altered their work environment. The individual components of fatigue were behavioral severity 25%, affective meaning 21%, sensory 18%, and cognitive mood 16%. Significant radiotherapy-related fatigue was higher in patients treated with advanced-stage disease, large radiotherapy field area, and low pre-radiotherapy hemoglobin level.

Matched MeSH terms: Fatigue/etiology*; Fatigue/epidemiology*; Fatigue/physiopathology
Heightened interoception in adults with fibromyalgia

Todd J, Plans D, Lee MC, Bird JM, Morelli D, Cunningham A, et al.

Biol Psychol, 2024 Feb;186:108761.
PMID: 38309512 DOI: 10.1016/j.biopsycho.2024.108761

Previous research suggests that the processing of internal body sensations (interoception) affects how we experience pain. Some evidence suggests that people with fibromyalgia syndrome (FMS) - a condition characterised by chronic pain and fatigue - may have altered interoceptive processing. However, extant findings are inconclusive, and some tasks previously used to measure interoception are of questionable validity. Here, we used an alternative measure - the Phase Adjustment Task (PAT) - to examine cardiac interoceptive accuracy in adults with FMS. We examined: (i) the tolerability of the PAT in an FMS sample (N = 154); (ii) if there are differences in facets of interoception (PAT performance, PAT-related confidence, and scores on the Private Body Consciousness Scale) between an FMS sample and an age- and gender-matched pain-free sample (N = 94); and (iii) if subgroups of participants with FMS are identifiable according to interoceptive accuracy levels. We found the PAT was tolerable in the FMS sample, with additional task breaks and a recommended hand posture. The FMS sample were more likely to be classified as 'interoceptive' on the PAT, and had significantly higher self-reported interoception compared to the pain-free sample. Within the FMS sample, we identified a subgroup who demonstrated very strong evidence of being interoceptive, and concurrently had lower fibromyalgia symptom impact (although the effect size was small). Conversely, self-reported interoception was positively correlated with FMS symptom severity and impact. Overall, interoception may be an important factor to consider in understanding and managing FMS symptoms. We recommend future longitudinal work to better understand associations between fluctuating FMS symptoms and interoception.

Matched MeSH terms: Fatigue
Fulltext Development of a decision support system for analysis and solutions of prolonged standing in the workplace

Halim I, Arep H, Kamat SR, Abdullah R, Omar AR, Ismail AR

Saf Health Work, 2014 Jun;5(2):97-105.
PMID: 25180141 DOI: 10.1016/j.shaw.2014.04.002

BACKGROUND: Prolonged standing has been hypothesized as a vital contributor to discomfort and muscle fatigue in the workplace. The objective of this study was to develop a decision support system that could provide systematic analysis and solutions to minimize the discomfort and muscle fatigue associated with prolonged standing.
METHODS: The integration of object-oriented programming and a Model Oriented Simultaneous Engineering System were used to design the architecture of the decision support system.
RESULTS: Validation of the decision support system was carried out in two manufacturing companies. The validation process showed that the decision support system produced reliable results.
CONCLUSION: The decision support system is a reliable advisory tool for providing analysis and solutions to problems related to the discomfort and muscle fatigue associated with prolonged standing. Further testing of the decision support system is suggested before it is used commercially.

Matched MeSH terms: Muscle Fatigue
Development of statistical models for predicting muscle and mental activities during repetitive precision tasks

Zadry HR, Dawal SZ, Taha Z

Int J Occup Saf Ergon, 2016 Sep;22(3):374-83.
PMID: 27053140 DOI: 10.1080/10803548.2016.1150094

This study was conducted to develop muscle and mental activities on repetitive precision tasks. A laboratory experiment was used to address the objectives. Surface electromyography was used to measure muscle activities from eight upper limb muscles, while electroencephalography recorded mental activities from six channels. Fourteen university students participated in the study. The results show that muscle and mental activities increase for all tasks, indicating the occurrence of muscle and mental fatigue. A linear relationship between muscle activity, mental activity and time was found while subjects were performing the task. Thus, models were developed using those variables. The models were found valid after validation using other students' and workers' data. Findings from this study can contribute as a reference for future studies investigating muscle and mental activity and can be applied in industry as guidelines to manage muscle and mental fatigue, especially to manage job schedules and rotation.

Matched MeSH terms: Mental Fatigue/physiopathology; Muscle Fatigue/physiology
Fulltext Effects of mental fatigue on technical performance in soccer players: A systematic review with a meta-analysis

Sun H, Soh KG, Mohammadi A, Wang X, Bin Z, Zhao Z

Front Public Health, 2022;10:922630.
PMID: 35937235 DOI: 10.3389/fpubh.2022.922630

BACKGROUND: Mental fatigue largely influences technical performance in soccer, including offensive and defensive skills. However, these effects on technical performance among the soccer players have not yet been aggregated to be assessed systematically.
OBJECTIVE: The purpose of the review was to evaluate the impact of mental fatigue on soccer players' overall technical skills.
METHODS: Drawing on Web of Science, PubMed, Scopus, and EBSCOhost (CENTRAL and SPORTDicus), an in-depth search was conducted. PICOS established the eligibility criteria to select the studies as follows: (i) population-healthy soccer players; (ii) intervention-involving any mental-fatigue-prompted protocol; (iii) comparison-control conditions (active or passive without inducing mental fatigue); (iv) outcomes-technical performance (offensive and defensive skill); and (v) study design-randomized controlled trials.
RESULTS: A total of eight studies were qualified for inclusion in the systematic literature review. Overall, the results indicate that mental fatigue had significant effects on technical skills, including offensive and defensive skills. Specifically, there were significant effects on errors (ES = 0.977; p < 0.001), number of tackles (ES = -0.739; p = 0.005), and the percentage of successful tackles (ES = -0.628; p = 0.022), while there were no significant effects on the number of passes (ES = 0.240; p = 0.328), the percentage of accurate passing (ES = -0.008; p = 0.985), and the number of successful passes (ES = -0.322; p = 0.217).
CONCLUSION: Overall, a significant effect of mental fatigue on the technical performance (e.g., tackles and errors) of soccer players was detected, while no significant effects on passing skills were detected. Future studies may consider investigating technical performance together with other important results (e.g., decision-making skills or internal load).
SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/inplasy-2022-2-0008/, Inplasy protocol 202220008.

Matched MeSH terms: Mental Fatigue
A systematic review of muscle activity assessment of the biceps brachii muscle using mechanomyography

Talib I, Sundaraj K, Lam CK, Sundaraj S

J Musculoskelet Neuronal Interact, 2018 12 01;18(4):446-462.
PMID: 30511949

This systematic review aims to categorically analyses the literature on the assessment of biceps brachii (BB) muscle activity through mechanomyography (MMG). The application of our search criteria to five different databases identified 319 studies. A critical review of the 48 finally selected records, revealed the diversity of protocols and parameters that are employed in MMG-based assessments of BB muscle activity. The observations were categorized into the following: muscle torque, fatigue, strength and physiology. The available information on the muscle contraction protocol, sensor(s), MMG signal parameters and obtained results were then tabulated based on these categories for further analysis. The review affirms that - 1) MMG is suitable for skeletal muscle activity assessment and can be employed potentially for further investigation of the BB muscle activity and condition (e.g., force, torque, fatigue, and contractile properties), 2) a majority of the records focused on static contractions of the BB, and the analysis of dynamic muscle contractions using MMG is thus a research gap, and 3) very few studies have focused on the analysis of BB muscle activity under externally stimulated contractions. Taken together, the findings of this review on BB activity assessment using MMG affirm the potential of MMG as an alternative tool.

Matched MeSH terms: Muscle Fatigue/physiology*
Analysis of fatigue in the three heads of the triceps brachii during isometric contractions at various effort levels

Hussain J, Sundaraj K, Subramaniam ID, Lam CK

J Musculoskelet Neuronal Interact, 2019 09 01;19(3):276-285.
PMID: 31475934

OBJECTIVE: The objective of this study was to investigate fatigue in the three heads of the triceps brachii (TB) muscle using surface electromyography (sEMG) obtained at 30%, 45% and 60% of maximal voluntary contraction (MVC).
METHODS: Twenty-five subjects performed isometric elbow extension until failure, and the rate of fatigue (ROF), time to fatigue (TTF) and normalized TTF (NTTF) were statistically analysed. Subsequently, the behaviour of root-mean-square (RMS), mean-power frequency (MPF) and median-power frequency (MDF) under pre-, onset- and post-fatigue conditions were compared.
RESULTS: The findings indicated that, among the heads, ROF was statistically significant at 30% and 45% MVC (P<0.05) but TTF and NTTF at all intensities was statistically insignificant (P>0.05). For every head, only TTF was statistically significant (P<0.05) at different intensities. MPF and MDF under pre-, onset- and post-fatigue conditions were statistically significant (P<0.05) among the heads at all intensities, whereas RMS showed no such behaviour.
CONCLUSION: The investigated parameters reveal that the three heads of TB act independently before fatigue onset and appear to work in union after fatigue. Synergist head pairs exhibit similar spectral and temporal behaviour in contrast to the non-synergist TB head pair. We find spectral parameters to be more specific predictors of fatigue.

Matched MeSH terms: Muscle Fatigue/physiology*
Fulltext Exploratory study of brain waves and corresponding brain regions of fatigue on-call doctors using quantitative electroencephalogram

Xavier G, Su Ting A, Fauzan N

J Occup Health, 2020 Jan;62(1):e12121.
PMID: 32515890 DOI: 10.1002/1348-9585.12121

OBJECTIVES: It is common to find doctors working long and odd hours and many at times without rest and sleep. Despite the evidence of adverse risk, jeopardizing patient safety under the hands of fatigue doctors under such working hours has not changed in many places. It has argued that with such training and subsequent experience, such issues with patient safety reduce. Fatigue too is argued as subjective, as those who can withstand the stress still perform. Nevertheless, undeniably working under fatigue is not safe for both the patient and the doctor. This study is a novel attempt to explore and objectify the state of fatigue using quantitative EEG among post-call doctors.
METHOD: Seven volunteer post-call doctors were recruited to go through an EEG recording before and after their on-call rotation while at rest and subsequently while carrying out Stroop Test, putting their cognitive function at work.
RESULTS: The doctors have worked up to 33 hours in a row and have had sleep of an average of 1.5 hours. It is found that during task there is a statistically significant increase in theta (frontal and occipital regions) and beta (occipital region) band power while at task post-call. Alpha band power is increased in the frontal and reduced in other regions. Correlation with Stroop Test results indicated that those who have higher alpha, beta, and lower relative theta powers at the frontal region at post-call rest have higher percentage of correct congruent trials.
CONCLUSION: The results objectively imply that these fatigue doctors are under more strain while carrying out a task and corresponds to the implicated regions of brain stimulated by the task accordingly.

Matched MeSH terms: Fatigue/physiopathology*
Fulltext Clinical Characteristics and Diagnostic Challenges of COVID-19: An Update From the Global Perspective

Israfil SMH, Sarker MMR, Rashid PT, Talukder AA, Kawsar KA, Khan F, et al.

Front Public Health, 2020;8:567395.
PMID: 33505949 DOI: 10.3389/fpubh.2020.567395

Clinical characteristics are essential for the correct diagnosis of diseases. The current review aimed to summarize the global clinical characteristics of the COVID-19 patients systematically and identify their diagnostic challenges to help the medical practitioners properly diagnose and for better management of COVID-19 patients. We conducted a systematic search in PubMed, Web of Science, Scopus, Science Direct, and Google Scholar databases for original articles containing clinical information of COVID-19 published up to 7th May 2020. Two researchers independently searched the databases to extract eligible articles. A total of 34 studies from 8 different countries with 10889 case-patients were included for clinical characteristics. The most common clinical symptoms were cough 59.6, fever 46.9, fatigue 27.8, and dyspnea 20.23%. The prominent laboratory findings were lymphocytopenia 55.9, elevated levels of CRP 61.9, aspartate aminotransferase 53.3, LDH 40.8, ESR 72.99, serum ferritin 63, IL-6 52, and prothrombin time 35.47%, and decreased levels of platelets 17.26, eosinophils 59.0, hemoglobin 29, and albumin 38.4%. CT scan of the chest showed an abnormality in 93.50% cases with bilateral lungs 71.1%, ground-glass opacity 48%, lesion in lungs 78.3%, and enlargement of lymph node 50.7%. Common comorbidities were hypertension, diabetes, obesity, and cardiovascular diseases. The estimated median incubation period was 5.36 days, and the overall case fatality rate was 16.9% (Global case fatality outside China was 22.24%: USA 21.24%, Italy 25.61%, and others 0%; whereas the case fatality inside the Hubei Province of China was found to be 11.71%). Global features on the clinical characteristics of COVID-19 obtained from laboratory tests and CT scan results will provide useful information to the physicians to diagnose the disease and for better management of the patients as well as to address the diagnostic challenges to control the infection.

Matched MeSH terms: Fatigue/etiology*
Fulltext Assessment of muscle activity using electrical stimulation and mechanomyography: a systematic review

Uwamahoro R, Sundaraj K, Subramaniam ID

Biomed Eng Online, 2021 Jan 03;20(1):1.
PMID: 33390158 DOI: 10.1186/s12938-020-00840-w

This research has proved that mechanomyographic (MMG) signals can be used for evaluating muscle performance. Stimulation of the lost physiological functions of a muscle using an electrical signal has been determined crucial in clinical and experimental settings in which voluntary contraction fails in stimulating specific muscles. Previous studies have already indicated that characterizing contractile properties of muscles using MMG through neuromuscular electrical stimulation (NMES) showed excellent reliability. Thus, this review highlights the use of MMG signals on evaluating skeletal muscles under electrical stimulation. In total, 336 original articles were identified from the Scopus and SpringerLink electronic databases using search keywords for studies published between 2000 and 2020, and their eligibility for inclusion in this review has been screened using various inclusion criteria. After screening, 62 studies remained for analysis, with two additional articles from the bibliography, were categorized into the following: (1) fatigue, (2) torque, (3) force, (4) stiffness, (5) electrode development, (6) reliability of MMG and NMES approaches, and (7) validation of these techniques in clinical monitoring. This review has found that MMG through NMES provides feature factors for muscle activity assessment, highlighting standardized electromyostimulation and MMG parameters from different experimental protocols. Despite the evidence of mathematical computations in quantifying MMG along with NMES, the requirement of the processing speed, and fluctuation of MMG signals influence the technique to be prone to errors. Interestingly, although this review does not focus on machine learning, there are only few studies that have adopted it as an alternative to statistical analysis in the assessment of muscle fatigue, torque, and force. The results confirm the need for further investigation on the use of sophisticated computations of features of MMG signals from electrically stimulated muscles in muscle function assessment and assistive technology such as prosthetics control.

Matched MeSH terms: Muscle Fatigue/physiology

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