Subjective Assessment Of Fatigue Research Articles

Sleep, Fatigue, and Recovery Profiles of the Longest Solo Unsupported One-Way Polar Ski Journey Across Antarctica.

Antarctic expeditions are exceptional physiological challenges. Sleep plays a critical role in athletic performance, recovery, and wellness, with sleep disturbances having a negative impact on health and performance. The authors investigated sleep, fatigue, and recovery profiles of the longest solo unsupported one-way polar ski journey across Antarctica. A 33-year-old woman covered 1484.53km from Hercules Inlet to the South Pole, finishing at the Ross Ice Shelf, in 70days and 16hours. Questionnaires on sleep (Pittsburgh Insomnia Rating Scale and Karolinska Sleepiness Scale), fatigue (Subjective Assessment of Fatigue), recovery (Total Quality Recovery), and wellness were completed at different time points (before, during, and after the expedition). Average daily sleep time was between 4 and 5hours, increasing to 7hours for the final part of the expedition. Satisfaction of sleep and lack of energy deteriorated as the expedition progressed, alongside signs of clinical insomnia. Fatigue and muscle soreness increased with increasing milage, with extreme levels and very poor recovery toward the end of the expedition. Despite this, the adventurer continued to perform on extremely high levels. Postexpedition scores returned to baseline, demonstrating the incredible adaptation and ability to recovery. The postexpedition interview showed that prior experience of an Antarctic expedition may have prepared the athlete and made her more resilient for this challenge. The data provide unique insights into Antarctic expeditions and may help us understand the limits of human performance when planning future expeditions of this nature. Female athletes are capable of extreme challenges, breaking established performance boundaries.

Fatigue among Air crews on (Ultra)-Long-Range flights – A comparison of subjective fatigue with objective concentration ability

IntroductionLong duty times are common in the aviation industry, especially with the introduction of ultra long range flights (ULR). This article aims to compare the subjective fatigue assessment and concentration ability of flight crews with objective concentration and alertness tests during (U)LR-flights. MethodThe study examined different (U)LR-flights. Before, during and after the flights subjective fatigue and concentration ability of the flight crew was examined with visual analog scale and objective attention and concentration ability with the FAIR-2 test respectively the 3-min Psychomotor Vigilance Test. For statistical analysis we used a repeated ANOVA with a post-hoc-analysis and a Wilcoxon signed-rank test for connected samples. ResultsIn total 28 crew members were examined. Subjective concentration ability declined and fatigue increased significantly over the course of flights. However, no significant changes were observed in the objective concentration tests performed before and after the flights. ConclusionsThe study found that fatigue significantly increased with flight time, particularly during night hours at the window of circadian low of the crews. However, objective concentration performance showed no significant deterioration over time. The study's results were consistent with previous research, except for the finding that objective concentration was still stable. The study also compared the findings to another profession and found similar results regarding the performance of complex tasks after long working hours while experiencing fatigue. Pratical applicationsThis study helps to understand the effects of ultra long-range flight on fatigue and concentration of the air crew and can help to improve safety issues on such flights.

FADIGA E RECUPERAÇÃO FÍSICA NO BASQUETEBOL EM MEIO A COVID-19

ABSTRACT Introduction: A new research direction to strengthen basketball, improve physical function and enhance the immunity of athletes during the epidemic situation of COVID-19 is requested. Objective: Explore the specific methods of basketball fatigue and physical recovery under the outlook of COVID-19. Methods: 36 college volunteers without significant differences in height, weight, or age were randomly selected for the research. Divided into two groups, the intervention mode of the experimental group was vibration foam roller intervention, while the control group adopted the traditional walking and stretching method. The subjective assessment data of lactic acid change and exercise fatigue were collected and analyzed. Results: One hour after exercise, the rate, and decrease of lactic acid in the experimental group were statistically higher. Before the beginning of the experiment, the subjective assessment of fatigue in the control group was (16.031 ± 2.4438) points, and that in the experimental group was (16.139 ± 2.7043) points. After the end of the ninth week, the subjective assessment of fatigue in the control group was (14.646 ± 2.7453) points, while in the experimental group, it was (11.576 ± 3.2552). Conclusion: The vibrating foam roller massage method can recover athletes from muscle fatigue more efficiently while respecting the limitations imposed by the epidemic situation. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Demystifying the Impact of Age on Safety Performance of Construction Workers: Examining the Mediating Roles of Experience and Fatigue

Construction is one of the most hazardous industries with high fatal and nonfatal accidents rates. However, many accidents could be prevented by improving workers’ safety performance. Numerous factors impact their performance, such as safety culture and attitude, distraction, and personal characteristics. Among these factors, age has been widely cited in past research, but there is no unanimity among researchers regarding its impact on workers’ safety performance. Both positive and negative impacts of age on safety performance have been reported in studies, along with several researchers who found no significant difference in safety performance among workers of different ages. To demystify the impact of age on construction workers’ safety performance, this research hypothesizes that the relationship between age and safety performance is mediated by other factors such as experience and fatigue. A survey was conducted among 135 randomly selected participants from 38 construction sites in Iran. The survey consisted of three sections, namely demographic information, subjective fatigue assessment, and safety performance measurement. Statistical analysis revealed that the relationship between age and safety performance is mediated by experience and fatigue, explaining the disparity among past research findings. The findings of this study highlight that age does not have a direct impact, but an indirect impact mediated by multiple factors, on workers’ safety performance. Future research must consider mediating factors when studying the role of age in workers’ safety performance. The results suggest that researchers and practitioners should focus on other factors such as fatigue and safety training, which employers can positively influence.

Slowed reaction times in cognitive fatigue are not attributable to declines in motor preparation.

Cognitive fatigue (CF) can result from sustained mental effort, is characterized by subjective feelings of exhaustion and cognitive performance deficits, and is associated with slowed simple reaction time (RT). This study determined whether declines in motor preparation underlie this RT effect. Motor preparation level was indexed using simple RT and the StartReact effect, wherein a prepared movement is involuntarily triggered at short latency by a startling acoustic stimulus (SAS). It was predicted that if decreased motor preparation underlies CF-associated RT increases, then an attenuated StartReact effect would be observed following cognitive task completion. Subjective fatigue assessment and a simple RT task were performed before and after a cognitively fatiguing task or non-fatiguing control intervention. On 25% of RT trials, a SAS replaced the go-signal to assess the StartReact effect. CF inducement was verified by significant declines in cognitive performance (p = 0.003), along with increases in subjective CF (p < 0.001) and control RT (p = 0.018) following the cognitive fatigue intervention, but not the control intervention. No significant pre-to-post-test changes in SAS RT were observed, indicating that RT increases resulting from CF are not substantially associated with declines in motor preparation, and instead may be attributable to other stages of processing during a simple RT task.

A Transcultural Perspective of Systemic Lupus Erythematosus-Related Fatigue: Systematic Review and Narrative Synthesis.

Fatigue is one of the most common symptoms of systemic lupus erythematosus (SLE) worldwide, yet it remains poorly assessed and managed. The lack of universal definition and standard measurement of fatigue may add to the continued limitations in its understanding across cultures. The psycho-sociocultural underpinnings of fatigue are understudied; therefore, in this paper, we conducted a systematic review to understand a transcultural perspective of SLE-related fatigue. Following PRISMA (Preferred Reporting items for Systematic Reviews and Meta-Analysis) systematic review guidelines, we searched CINAHL Complete, Scopus, and PubMed databases for all published articles covered until the search date. Search was expanded using citation and web search. A 3-step process was used to identify articles meeting the inclusion criteria. The results were analyzed using narrative synthesis. From a total of 370 (n=364, 98.4% scientific databases; n=6, 1.6% web and citation search) articles searched, 18 (4.9%) studies met the inclusion and exclusion criteria and were included in this review. All (18/18, 100%) studies enrolled primarily female participants, and half (9/18, 50%) had cross-sectional designs. Although race was not reported in all studies, most studies had White racial background as the largest proportion of their samples. A majority (7/18, 39%) of the studies were conducted in the United States. Using a narrative synthesis, the prominent themes drawn based on the domains of the culture care theory (CCT) and the sunrise enabler were as follows: SLE-related fatigue (1) as an integral component of the disease process, (2) as a personal challenge, and (3) as a psychosocial dimension. CCT and sunrise enabler by Leininger guided this review. There are still gaps on how other domains of the CCT and sunrise enabler might influence SLE-related fatigue experience, assessment, and evaluation. The findings from this review showed that SLE-related fatigue has disease, personal, and psychosocial components. Thus, a purely subjective assessment of fatigue in SLE and even other conditions may limit a more accurate assessment and management. The inclusion of disease, personal, and psychosocial indicators is warranted and essential. A culturally sensitive and congruent assessment as well as evaluation models and measurement tools should be developed to capture fatigue experiences accurately. In addition, since global migration is inevitable, advancement in symptom management strategies should coincide with the understanding that fatigue has subjective and objective indicators present across cultures.

Клинические проявления постковидного синдрома у мужчин и женщин

Background. Approximately every third patient who passed new coronavirus infection doesn’t feel absolutely healthy even few months ago after disease. Most constantly have noted fatigue (asthenia), sleep disorders, cognitive dysfunction and cardiovascular symptoms. In spite of coexistence different terms which describe persistent post-COVID-19 clinical manifestations, all of them serve the only goal – to demonstrate that the patients need in continuing medical care and rehabilitation after acute period of disease. Aim. Assessment of clinical manifestations of bridge syndrome in men and women. Materials and methods. Clinical manifestations of post-COVID-19 syndrome were assessed in 80 patients (49 women and 31 men) using a clinical interview and voluntary anonymous questionnaire. The mMRC (Modified Medical Research Council) scale was used to assess the severity of dyspnea, the McNair and Kahn questionnaire – for cognitive dysfunction, the FSS (Fatigue Severity Scale) – for the severity of fatigue (asthenia), and the visual analogue scale (VAS) was used for subjective assessment of fatigue. Statistical data processing was performed using the StatPlus 2009 Professional program. Results. Among the most frequently reported complaints of patients in the post-COVID period were fatigue, sleep disturbances, cardiovascular symptoms, pain in muscles and joints. Among women in the post-COVID syndrome, headache was more often recorded, among men – fatigue. The severity of fatigue (asthenia) was also most pronounced among men. A variety of sleep disorders were identified in the vast majority of patients. Daytime sleepiness was recorded more often in men (almost every third man); for women, a characteristic sleep disorder was nightmares, which were not observed in men. Approximately with the same frequency among both sexes, problems with falling asleep and nocturnal awakenings were revealed. Cognitive impairment was observed in approximately one in four patients who had COVID-19, regardless of gender. Statistical relationships between asthenia and cognitive dysfunction were revealed, which are more significant among men. Conclusion. The multiplicity of post-COVID clinical manifestations among men and women raises questions about the heterogeneity and potential summation of the pathogenic mechanisms underlying each symptom. Differences in the clinical symptoms of the post-COVID-19 period among men and women may can be explained by gender-specific immune response and require further study.

Trends Assessing Neuromuscular Fatigue in Team Sports: A Narrative Review.

Neuromuscular fatigue is defined as a reduction induced by exercise in the maximal voluntary force that a muscle or group of muscles can generate. An accumulation of work or an incomplete force restoration can significantly influence the neuromuscular performance in both the short and long terms. Thus, fatigue management is essential for controlling the training adaptations of athletes and reducing their susceptibility to injury and illness. The main individualized monitoring tools used to describe fatigue are questionnaires and subjective assessments of fatigue, biochemical markers, sprint tests, and vertical jump tests. Among the subjective measures, the rating of the perceived exertion has been widely used because of its simplicity and high validity. In terms of the objective measures, one of the more frequently employed tools by practitioners to assess neuromuscular fatigue is the countermovement jump. Because of its high validity and reliability, it is accepted as the reference standard test in sports, in general, and particularly in team sports. Our review aims to clarify how all these indicators, as well as several devices, can help coaches in different sports contexts to monitor neuromuscular fatigue, and how these procedures should be used to obtain data that can be used to make decisions in complex environments.

Insidious Safety Threat of Fatigue: Investigating Construction Workers’ Risk of Accident Due to Fatigue

The construction industry is among the most hazardous occupations. Workers are expected to fulfill physically and mentally demanding tasks in construction environments while they are exposed to numerous safety hazards. The dynamic and demanding nature of construction activities makes workers vulnerable to experience levels of fatigue on a daily basis. Fatigue is ubiquitous among construction workers and has been frequently cited as an underlying cause of the accidents. Despite the high rates of accidents in construction, research has shown that most of them can be prevented if workers identify hazards and perceive the associated safety risks. However, the impact of fatigue on the two leading safety indicators (i.e., hazard recognition and safety risk perception) has not been empirically studied before in the construction industry context. Therefore, this study aims to fill this gap by investigating the impact of fatigue on construction workers’ hazard recognition and safety risk perception. To achieve the research goals, 135 construction workers were recruited to participate in the study. A validated safety instrument and three subjective fatigue assessment scales were used to measure safety performance and fatigue levels of the participants, respectively. The analysis of the data showed statistically significant correlation (p-value<0.001) between fatigue and hazard recognition (rp=−0.58) and fatigue and safety risk perception (rp=−0.51). Linear regressions associated 37% of the variability in hazard recognition and 28% of safety risk perception with elements of fatigue. The findings revealed that among all aspects of fatigue, intershift recovery and acute fatigue have the most profound impacts on the safety performance of workers. A novel model was developed and tested to explain how construction workers’ safety performance (i.e., hazard recognition and safety risk perception) are impacted by elements of fatigue. This study offers practical recommendations for construction professionals and practitioners to control and mitigate the undesirable influences of fatigue on workers. These recommendations are presented as the hierarchy of fatigue interventions in the order of most effective to the least effective including (1) Elimination, (2) Substitution, (3) Engineering Solutions, (4) Administrative Interventions, and (5) Personal Assistive Equipment (PAE).

Evaluation of a Fatigue Detector Using Eye Closure-Associated Indicators Acquired from Truck Drivers in a Simulator Study.

This paper presents a camera-based prototype sensor for detecting fatigue and drowsiness in drivers, which are common causes of road accidents. The evaluation of the detector operation involved eight professional truck drivers, who drove the truck simulator twice—i.e., when they were rested and drowsy. The Fatigue Symptoms Scales (FSS) questionnaire was used to assess subjectively perceived levels of fatigue, whereas the percentage of eye closure time (PERCLOS), eye closure duration (ECD), and frequency of eye closure (FEC) were selected as eye closure-associated fatigue indicators, determined from the images of drivers’ faces captured by the sensor. Three alternative models for subjective fatigue were used to analyse the relationship between the raw score of the FSS questionnaire, and the eye closure-associated indicators were estimated. The results revealed that, in relation to the subjective assessment of fatigue, PERCLOS is a significant predictor of the changes observed in individual subjects during the performance of tasks, while ECD reflects the individual differences in subjective fatigue occurred both between drivers and in individual drivers between the ‘rested’ and ‘drowsy’ experimental conditions well. No relationship between the FEC index and the FSS state scale was found.

Muscle Fatigue Analysis During Welding Tasks Using sEMG and Recurrence Quantification Analysis

The main goal of this study was to detect muscle fatigue and to identify muscles vulnerable to musculoskeletal disorders by evaluating muscle activation of subjects during welding tasks. In this study, six subjects performed two different welding tasks for a total of three hours. Surface electromyography (sEMG) was used to record the muscle activation of sixteen different muscles. Recurrence Quantification Analysis (RQA) was then used to analyze the EMG data. In addition, a subjective fatigue assessment was conducted to draw comparisons with the RQA results. According to the RQA results, twelve of the tested muscles experienced fatigue by showing significant difference in RQA values (p-value &amp;lt; 0.05) between the first and last 10 minutes of the experiment. Moreover, time-to-fatigue results obtained from RQA and subjective analysis were closely correlated for seven muscle groups. This study showed that RQA can be used in ergonomic studies for evaluating muscle activation during construction tasks.

Influence mechanism of running sportswear fatigue based on BP neural network

The fatigue of running sportswear is reflected in the fatigue caused by the tightness of the tights on the skin surface of the limbs, trunk, and other parts during long-term running sports. However, the current research on the fatigue of running sportswear is not deep enough. Therefore, the purpose of this study is to study the mechanism of the fatigue of running sportswear based on BP neural network. This article first takes sportswear as the starting point and uses the surface myoelectricity index as a physiological quantity as a means to combine clothing with sports medicine and sports physiology, breaking the traditional shackles of subjective assessment of fatigue, and giving play to the advantages of interdisciplinary to expand the new direction of the apparel industry and, secondly, use muscle fatigue evaluation method to analyze the muscles of the lower leg under the pressure of sportswear to analyze the strength of the EMG signal and the number of participating sports units and the frequency of discharge synchronization. Experimental data shows that the AUC is 0.756 when wearing sports tights, the sensitivity and specificity are 72% and 19%, and the accuracy is 65%. The experimental results show that clothing pressure affects the fatigue of running sportswear based on BP neural network.

A strength-oriented exercise session required more recovery time than a power-oriented exercise session with equal work.

The present randomized cross-over controlled study aimed to compare the rate of recovery from a strength-oriented exercise session vs. a power-oriented session with equal work. Sixteen strength-trained individuals conducted one strength-oriented session (five repetitions maximum (RM)) and one power-oriented session (50% of 5RM) in randomized order. Squat jump (SJ), countermovement jump (CMJ), 20-m sprint, and squat and bench press peak power and estimated 1RMs were combined with measures of rate of perceived exertion (RPE) and perceived recovery status (PRS), before, immediately after and 24 and 48 h after exercise. Both sessions induced trivial to moderate performance decrements in all variables. Small reductions in CMJ height were observed immediately after both the strength-oriented session (7 ± 6%) and power-oriented session (5 ± 5%). Between 24 and 48 h after both sessions CMJ and SJ heights and 20 m sprint were back to baseline. However, in contrast to the power-oriented session, recovery was not complete 48 h after the strength-oriented session, as indicated by greater impairments in CMJ eccentric and concentric peak forces, SJ rate of force development (RFD) and squat peak power. In agreement with the objective performance measurements, RPE and PRS ratings demonstrated that the strength-oriented session was experienced more strenuous than the power-oriented session. However, these subjective measurements agreed poorly with performance measurements at the individual level. In conclusion, we observed a larger degree of neuromuscular impairment and longer recovery times after a strength-oriented session than after a power-oriented session with equal total work, measured by both objective and subjective assessments. Nonetheless, most differences were small or trivial after either session. It appears necessary to combine several tests and within-test analyses (e.g., CMJ height, power and force) to reveal such differences. Objective and subjective assessments of fatigue and recovery cannot be used interchangeably; rather they should be combined to give a meaningful status for an individual in the days after a resistance exercise session.

Muscle fatigue and performance analysis during fundamental laparoscopic surgery tasks

The goal of this study is to detect muscle fatigue and time-to-fatigue in vulnerable muscle groups, before determining whether the former has any effect on surgical performance. In the experiment, surface electromyography (sEMG) was deployed to record the muscle activations of 12 subjects while performing fundamentals of laparoscopic surgery (FLS) tasks for a total of three hours. In all, 16 muscle groups were tested. The resultant data were then reconstructed using recurrence quantification analysis (RQA). In addition, a subjective fatigue assessment was conducted to draw comparisons with the RQA results. The subjects' performance was also investigated via a FLS task performance analysis, the results demonstrating that RQA can detect muscle fatigue in 12 muscle groups as well as their time-to-fatigue. The results also indicated that RQA and subjective fatigue assessment are very closely correlated (p-value < 0.05). However, the performance analysis results showed that the subjects' performance improved over time.

Fatigue at Work: Scale Validation with Airline Pilots

In the organizational context, the study of occupational stress encompasses constructs of fatigue at work. Within the air transportation sector, fatigue at work is a potential issue influencing both safety and occupational stress. The objective of the present study was to perform a convergent-discriminant validity analysis of the Feeling of Fatigue scale in the area of Administration. Data from an observational cross-sectional study involving a sample of 1,066 airline pilots were analyzed using quantitative modeling. Confirmatory factor analysis with the structural equations model was performed to determine the validity of a Portuguese version of the Feeling of Fatigue scale in the organizational context of civil aviation. This study fills a gap in the literature on occupational stress in Administration, highlighting the relevance of research on fatigue at work. The results confirmed the validity of a Portuguese version of a mature scale for subjective assessment of fatigue in Administration, thereby contributing to fatigue management in organizational settings.

Research on the influence factors of the carrying system

Objective: To investigate surface electromyography signal (sEMG) of the major back muscle group and subjective fatigue assessment under different experimental combinations during walk with weight on both shoulders, as well as the functional status and fatigue property of human muscles. Methods: From October to December, 2017, 10 college students were recruited to participate in shoulder weight-bearing work and walk under the combinations of different shoulder strap widths, weights, and hardness of waist cushion. The subjects were required to complete 12 sets of experiments, with each set lasting for 15 minutes, and the rest time between work was 30 minutes. The sEMG signals of the upper trapezius and the erector spinae were measured during the experiment, and subjective fatigue assessment was performed during rest. The time domain evaluation index (average amplitude, aEMG) , the frequency domain evaluation index (median frequency, MF) , and the data of subjective assessment were processed and analyzed. Results: Weight and shoulder strap width had a significantly effect on fatigue (P<0.01) , and the change in the hardness of waist cushion had no significant effect on fatigue (P>0.05) . There was an interaction effect between weight and shoulder strap width (P<0.01) , and there was no interaction effect between weight, shoulder strap width, and hardness of waist cushion (P>0.05) . For the backpack carrying system, the combination of 10% weight and 50 mm shoulder strap width was the best one for relieving fatigue. The subjective test also showed that subjective feelings of muscle fatigue were associated with the weight and width, which was consistent with sEMG results. Conclusion: The results of this experiment show that the combination of 10% weight and 50 mm shoulder strap width can help to relieve muscle fatigue during walk with weight on both shoulders, and weight-bearing walking is more likely to cause the fatigue of the erector spinae.

Effects of Cognitive Loading on the Development of Muscle Fatigue

The aim of the present work was to study the effects of cognitive loading requiring activation of the attention systems on the development of muscle fatigue. The dynamics of measures of arm muscle fatigue were evaluated in two sessions, separated by 5 min, consisting of 250 maximum-strength dynamometer compressions in response to acoustic target signals in three tasks with different levels of cognitive loading. The first experiment used only the target signals; in experiment two, the subjects had to discriminate the target signal from an equal number (250) of nontarget signals, which required voluntary attention. In experiment three, the proportions of target stimuli were 17 and 83%, respectively, i.e., the target stimulus was random (deviant), activating not only voluntary attention, but also involuntary attention. Measurements of grip strength, maximum voluntary contraction strength, and subjective assessments of fatigue before and after the motor tasks showed that experiments involving voluntary and involuntary attention to sound stimuli produced a smaller rate of development of muscle fatigue. Activation of involuntary attention, accompanied by the appearance of mismatch negativity on the EEG, enhanced the effect of voluntary attention.

Assessment of Fatigue in Multiple Sclerosis

AbstractOne of the most frequent symptoms in multiple sclerosis (MS) is fatigue. It has a major impact on quality of life as well as on professional activity. Even nowadays it is still unclear what constitutes an adequate assessment of the perceived fatigue.The following overview will discuss different possibilities to assess fatigue with the help of questionnaires, clinical interviews or the objective measurement of cognitive performance. Furthermore, a structured guideline for the assessment of fatigue will be proposed. Clinical criteria for MS related fatigue include the main symptoms, their everyday relevance, the possible causal relation with the cause of disease (the underlying MS), as well as an exclusion of other possible somatic or psychological reasons. It is recommended to use the “Würzburger Erschöpfungs-Inventar bei Multipler Sklerose (WEIMUS)” (English: Würzburg Fatigue Inventory for Multiple Sclerosis) and especially the “Fatigue Scale for Motor and Cognitive Functions” (FSMC), as these questionnaires distinguish between motor and cognitive fatigue and due to the larger number of research studies using the FSMC. Moreover, the presence of depression, quality of sleep and daytime sleepiness should be assessed. In addition, general cognitive performance as well as performance during monotonous stimulation (vigilance) should be assessed. This may be relevant for the evaluation of a patient’s capacity to work, and for determining prognosis, as there are indications for a relation to relapse frequency, a change from a clinically isolated syndrome (CIS) to an MS diagnosis with an increase of brain atrophy.All in all, it can be said, that despite the growing convergence of diagnostic criteria, the available studies of the objective as well as the subjective assessment of fatigue are still not sufficient and further research is needed.

Could Objective Tests Be Used to Measure Fatigue in Patients With Advanced Cancer?

ContextAssessment of cancer-related fatigue is currently based on patient-reported outcomes. We asked whether objective assessments, such as muscle strength and nutritional markers, can be used as surrogate measures of cancer-related fatigue. ObjectiveWe examined the association among three fatigue scales, muscle strength, and nutritional markers in patients with advanced cancer. MethodsIn this prospective study, we enrolled hospitalized cancer patients who had been seen in palliative care consultation at MD Anderson Cancer Center. We assessed fatigue using three fatigue scales—the Brief Fatigue Inventory (BFI), the Edmonton Symptom Assessment System (ESAS), and the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30)—and determined their association with objective assessments, including handgrip strength, maximal inspiratory pressure, lean body mass, phase angle, and albumin. Spearman's correlation test was used to assess associations. ResultsAmong 222 patients, the mean age was 55 years; 59% were women. The median overall survival was 106 days. The total BFI score had weak association with handgrip strength (ρ = −0.18, P = 0.007) and no association with the remaining objective measures. ESAS fatigue and EORTC fatigue showed similar findings. Total BFI had moderate-to-strong association with ESAS (ρ = 0.54, P < 0.0001) and EORTC (ρ = 0.60, P < 0.0001) fatigue. ConclusionOur study showed that subjective assessment of fatigue based on patient-reported outcomes correlates only weakly with muscle strength and nutritional markers; thus, patient-reported outcomes remain the gold standard for fatigue assessment.

Muscle fatigue and performance analysis during fundamental laparoscopic surgery tasks

The goal of this study is to detect muscle fatigue and time-to-fatigue in vulnerable muscle groups, before determining whether the former has any effect on surgical performance. In the experiment, surface electromyography (sEMG) was deployed to record the muscle activations of 12 subjects while performing fundamentals of laparoscopic surgery (FLS) tasks for a total of three hours. In all, 16 muscle groups were tested. The resultant data were then reconstructed using recurrence quantification analysis (RQA). In addition, a subjective fatigue assessment was conducted to draw comparisons with the RQA results. The subjects' performance was also investigated via a FLS task performance analysis, the results demonstrating that RQA can detect muscle fatigue in 12 muscle groups as well as their time-to-fatigue. The results also indicated that RQA and subjective fatigue assessment are very closely correlated (p-value < 0.05). However, the performance analysis results showed that the subjects' performance improved over time.