Age-Related Constraints in the Visuomotor Plasticity of Postural Control as Revealed by a Whole-Body Mirror Learning Task.

Whether visuomotor plasticity of postural control is a trainable feature in older age remains an open question despite the wealth of visually guided exercise games promising to improve balance skill. We asked how aging affects adaptation and learning of a visual feedback (VF) reversal during visually guided weight shifting and whether this skill is modulated by explicit knowledge. Twenty-four older (71.43 ± 2.54 years) and 24 young (24.04 ± 0.93 years) participants were exposed to a 180° VF reversal while tracking a horizontally moving target by voluntarily weight shifting between two force platforms. An explicit strategy was available to half of the participants with detailed instruction to counter the VF rotation. Individual error data were fitted to an exponential function to assess adaptation. Fewer older (12/24) than younger (21/24) participants adapted to the VF reversal, displaying error curves that fitted the exponential function. Older adults who adapted to the VF reversal (responders, n = 12) reached an asymptote in performance in the same weight shifting cycle and displayed a similar mean asymptotic error compared with young participants. Young but not older responders exhibited an aftereffect when the VF reversal was removed. Instruction did not influence spatial error modulations regardless of age. The large individual variations within the older adults' group during early adaptation suggest age-specific limitations in using explicit cognitive strategies when older adults are exposed to an abrupt mirror feedback reversal that requires a change in weight shifting direction during whole-body postural tracking.

Temporal modulation of H-reflex in young and older people: Acute effects during Achilles tendon vibration while standing.

PURPOSE: Examining how timely is sensory input processed and regulated after a perturbation while standing, is a key element to understand postural control, especially in people with balance deficits, such as older adults. In this study, we investigated the age-related temporal modulations in spinal excitability, by measuring the soleus H-reflex within the first 250 ms after switching on (V-ON) and off (V-OFF) a pair of vibrators, placed over the Achilles tendons. METHODS: Twenty young (25.1 ± 5.1 yrs) and 16 older (71.8 ± 6.1 yrs) adults stood blindfolded, while 12-15 s periods of Achilles tendon vibration (ATV) were applied with 20-24 s intervals. Anterior/posterior center of pressure and electromyographic (EMG) responses [soleus (SOL) and tibialis anterior (TA)] were assessed whereas SOL H-reflex normalized to maximum M-wave (H/Mmax) and SOL EMG (H/SOL) were evaluated before ATV (Pre) and at 50, 100, 150, 200 and 250 ms after the V-ON and V-OFF. RESULTS: Only in young adults the TA/SOL EMG ratio decreased 100 (p = 0.032) and 150 ms (p < 0.001) after V-ON and the H/Mmax and H/SOL decreased 150-250 ms after V-ON (p < 0.001). At 50-250 ms after V-OFF, H/Mmax was reduced compared to Pre values (p < 0.001), with no differences between the age groups (p > 0.05). H/SOL was decreased for the young adults (p < 0.001) and remained reduced at least for the first 250 ms after V-OFF. At 150 ms after V-OFF, SOL/Mmax was decreased only for the older adults (p < 0.001), whereas TA/SOL EMG gradually increased for both groups (p < 0.001). CONCLUSION: When ATV is introduced while standing, the spinal excitability of older people is reduced later and to a lesser extent compared to young adults. Their limited capacity to down-regulate the "noisy" sensory input generated by ATV gives further evidence of a possible mechanism for their inefficient postural control.

Electromyographic responses to unexpected Achilles tendon vibration-induced perturbations during standing in young and older people.

This study aimed to investigate age-related differences in electromyographic (EMG) responses to unexpected Achilles tendon vibration (ATV) perturbations while standing blindfold. ATV with variable and random duration (12-15 s) and rest periods (20-24 s) was applied on 18 young and 16 older volunteers. The anterior/posterior center of pressure (CoP) and the soleus (SOL) and tibialis anterior (TA) EMG were analyzed for 1 s before and 8 s after the ATV onset and offset. ATV induced a posterior shift of CoP in both groups, with more pronounced shift in the older group. During ATV onset, the older group demonstrated less SOL and more TA EMG increase compared to the young group. During the first 0.5 s of ATV offset, SOL EMG was decreased in both age groups, while TA showed a burst of EMG activity that was greater in the older group. No difference in the latencies of EMG peaks or valleys was observed between the groups. It is concluded that ATV induces greater posterior CoP shift in older adults, and they adopt a recovery strategy, characterized by a decreased SOL activation and an increased TA activation. These differences are possibly attributed to the increased fear of falling, decreased limits of stability and reduced capacity of older people to reweight their sensory inflow when proprioception is distorted.

Posture dependent ankle and foot muscle responses evoked by Achilles' tendon vibration.

To investigate the link between the triceps surae and the intrinsic muscles of the foot, often underestimated in posture maintenance, we asked how Achilles' tendon vibration modulates the EMG activity of the soleus and flexor digitorum brevis (FDB) muscles during different postural tasks: sitting, standing and forward leaning. Young healthy participants (n = 19, age = 24 ± 7.4 years) stood for 60 s in three visually controlled postures, while vibration (1.5-1.8 mm, 80 Hz) was bilaterally applied over the Achilles' tendon during the middle 20 s. Center of Pressure (CoP) and EMG activity of the soleus and FDB muscle were summarized in 5 s epochs and compared across time (before, during and after vibration) and postural tasks. Achilles' tendon vibration shifted the CoP position forward in sitting and backward in standing and leaning and increased the root mean square of the CoP velocity to a greater extent in standing and leaning compared to sitting. Soleus and FDB EMG amplitude also increased in response to vibration. These responses were posture dependent, being greater in standing (soleus: 57 %, FDB: 67 % relative to pre-vibration) compared to sitting (soleus: 36 %, FDB: 27 % relative to pre-vibration) and leaning (soleus: 26 %, FDB: 8% relative to pre-vibration). After vibration offset, both soleus and FDB showed sustained activation across all three postures. Results highlight the presence of Ia afferent projections from the soleus to the α motor neurons of the FDB muscle triggered by Achilles' tendon vibration. This link is posture dependent serving a functional role in standing and forward leaning in the presence of externally applied perturbations.

Standing on unstable surface challenges postural control of tracking tasks and modulates neuromuscular adjustments specific to task complexity.

Understanding the modulations of motor control in the presence of perturbations in task conditions of varying complexity is a key element towards the design of effective perturbation-based balance exercise programs. In this study we investigated the effect of mechanical perturbations, induced by an unstable surface, on muscle activation and visuo-postural coupling, when actively tracking target motion cues of different complexity. Four postural tasks following a visual oscillating target of varying target complexity (periodic-sinusoidal vs. chaotic-Lorenz) and surface (stable-floor vs. unstable-foam) were performed. The electromyographic activity of the main plantarflexor and dorsiflexor muscles was captured. The coupling between sway and target was assessed through spectral analysis and the system's local dynamic stability through the short-term maximum Lyapunov exponent. We found that external perturbations increased local instability and deteriorated visuo-motor coupling. Visuo-motor deterioration was greater for the chaotic target, implying that the effect of the induced perturbations depends on target complexity. There was a modulation of the neuromotor system towards amplification of muscle activity and coactivation to compensate surface-related perturbations and to ensure robust motor control. Our findings provide evidence that, in the presence of perturbations, target complexity induces specific modulations in the neuromotor system while controlling balance and posture.

Predictive and Reactive Locomotor Adaptability in Healthy Elderly: A Systematic Review and Meta-Analysis.

BACKGROUND: Locomotor adaptability is based on the implementation of error-feedback information from previous perturbations to predictively adapt to expected perturbations (feedforward) and to facilitate reactive responses in recurring unexpected perturbations ('savings'). The effect of aging on predictive and reactive adaptability is yet unclear. However, such understanding is fundamental for the design and application of effective interventions targeting fall prevention. METHODS: We systematically searched the Web of Science, MEDLINE, Embase and Science Direct databases as well as the reference lists of the eligible articles. A study was included if it addressed an investigation of the locomotor adaptability in response to repeated mechanical movement perturbations of healthy older adults (≥60 years). The weighted average effect size (WAES) of the general adaptability (adaptive motor responses to repeated perturbations) as well as predictive (after-effects) and reactive adaptation (feedback responses to a recurring unexpected perturbation) was calculated and tested for an overall effect. A subgroup analysis was performed regarding the factor age group [i.e., young (≤35 years) vs. older adults]. Furthermore, the methodological study quality was assessed. RESULTS: The review process yielded 18 studies [1009 participants, 613 older adults (70 ± 4 years)], which used various kinds of locomotor tasks and perturbations. The WAES for the general locomotor adaptability was 1.21 [95% confidence interval (CI) 0.68-1.74, n = 11] for the older and 1.39 (95% CI 0.90-1.89, n = 10) for the young adults with a significant (p < 0.05) overall effect for both age groups and no significant subgroup differences. Similar results were found for the predictive (older: WAES 1.10, 95% CI 0.37-1.83, n = 8; young: WAES 1.54, 95% CI 0.11-2.97, n = 7) and reactive (older: WAES 1.09, 95% CI 0.22-1.96, n = 5; young: WAES 1.35, 95% CI 0.60-2.09, n = 5) adaptation featuring significant (p < 0.05) overall effects without subgroup differences. The average score of the methodological quality was 67 ± 8 %. CONCLUSIONS: The present meta-analysis provides elaborate statistical evidence that locomotor adaptability in general and predictive and reactive adaptation in particular remain highly effective in the elderly, showing only minor, not statistically significant age-related deficits. Consequently, interventions which use adaptation and learning paradigms including the application of the mechanisms responsible for an effective predictive and reactive dynamic stability control may progressively improve older adults' recovery performance and, thus, reduce their risk of falling.

Neuromuscular interactions around the knee in children, adults and elderly.

Although injury and neuromuscular activation patterns may be common for all individuals, there are certain factors which differentiate neuromuscular activity responses between children, adults and elderly. The purpose of this study is to review recent evidence on age differences in neural activation and muscle balances around the knee when performing single joint movements. Particularly, current evidence indicates that there are some interesting similarities in the neuromuscular mechanisms by which children or the elderly differ compared with adults. Both children and elderly display a lower absolute muscle strength capacity than adults which cannot fully be explained by differences in muscle mass. Quadriceps activation failure is a common symptom of all knee injuries, irrespective of age but it is likely that its effect is more evident in children or adults. While one might expect that antagonist co-activation would differ between age categories, it appears that this is not the case. Although hamstring: quadriceps ratio levels are altered after knee injury, it is not clear whether this is an age specific response. Finally, evidence suggests that both children and the elderly display less stiffness of the quadriceps muscle-tendon unit than adults which affects their knee joint function.

Lower safety factor for old adults during walking at preferred velocity.

Older adults are more prone to falls during walking than young adults, although they walk more slowly and demonstrate higher stability state. This paradox of higher stability state but less safe locomotion let us hypothesize that older people may move closer to their dynamic stability limits. In order to investigate this hypothesis, the present study examined the safety factor of dynamic stability in old and young individuals when walking at their preferred velocity. Twelve older and 12 young male participants walked at their (a) walk-to-run transition velocity (WRV, i.e., maximum capacity) and (b) preferred walking velocity (PWV, i.e., actual applied load). Whole body kinematic data and ground reaction forces were captured. Dynamic stability was assessed using the "margin of stability (MoS)" as a criterion for the stability state of the body (extrapolated center of mass concept). The safety factor was calculated as the ratio between MoS at WRV and MoS at PWV. We found that, although older participants walked slower and provided a higher stability state compared to young ones, they showed a significantly reduced safety factor during preferred walking. This confirmed our hypothesis. Old adults do not walk slowly enough in relation to their maximum walking velocity, resulting to a lower safety factor during normal locomotion. Apparently, the age-related muscle degeneration affects WRV more than PWV. The resulting lower safety factor for the older participants may partly explain the increased risk of falls in their daily life, in spite of slower locomotion.

Stair descending exercise increases muscle strength in elderly males with chronic heart failure.

BACKGROUND: Previous studies from our group have shown that "pure" eccentric exercise performed on an isokinetic dynamometer can induce health-promoting effects that may improve quality of life. In order to investigate whether the benefits of "pure" eccentric exercise can be transferred to daily activities, a new and friendlier way to perform eccentric exercise had to be invented. To this end, we have proceeded to the design and construction of an automatic escalator, offering both stair descending (eccentric-biased) and stair ascending (concentric-biased) exercise. FINDINGS: Twelve elderly males (60-70 yr) with chronic heart failure participated in the present study. Participants carried out six weeks of stair descending or ascending training on the novel SmartEscalator device. Muscle damage and performance indices were evaluated before and at day 2 post exercise at the first and sixth week of training. Both training regimes increased, albeit not significantly in some cases, eccentric, concentric and isometric torque. After six weeks of stair descending exercise, eccentric, concentric and isometric peak torque increased 12.3%, 7.7% and 8.8%, respectively, whereas after stair ascending exercise eccentric, concentric and isometric peak torque increased 7.1%, 9.6% and 5.9%, respectively. CONCLUSIONS: Stair descending exercise appears to be a pleasant and mild activity that can be easily followed by the elderly. Compared to the more demanding stair ascending exercise, changes in muscle strength are similar or even greater. Elderly or people with impaired endurance wishing to increase their muscle strength may be benefited by participating in activities with strong eccentric component, such as stair descending.

Plasticity of the human tendon to short- and long-term mechanical loading.

This review examines the effects of short- and long-term static and cyclic mechanical loading on the mechanical properties of tendons. Tendons do not alter their mechanical properties after static and cycling loading that occurs during fatiguing contractions. Adaptations can occur after the application of long-term loading, but the strain magnitude must exceed a given threshold.

Effects of submaximal and maximal long-lasting contractions on the compliance of vastus lateralis tendon and aponeurosis in vivo.

The present study investigated the effects of submaximal sustained and maximal repetitive contractions on the compliance of human vastus lateralis (VL) tendon and aponeurosis in vivo using two different fatiguing protocols. Twelve male subjects performed three maximum voluntary isometric contractions (MVC) of the knee extensors before and after two fatiguing protocols on a dynamometer. The first fatiguing protocol consisted of a long-lasting sustained isometric knee extension contraction at 25% MVC until failure (inability to hold the defined load). The second fatiguing protocol included long-lasting isokinetic (90 degrees/s) knee extension contractions, where maximum moment was exerted and failure was proclaimed when this value fell below 70% of unfatigued maximum isokinetic moment. Ultrasonography was used to determine the elongation and strain of the VL tendon and aponeurosis. Muscle fatigue was indicated by a significant decrease in maximum resultant knee extension moment (p<0.05) observed during the MVCs after both long-lasting contractions. No significant (p>0.05) differences in elongation and strain of the VL tendon and aponeurosis were found, when compared every 300 N (tendon force) before and after the fatiguing protocols. The present data indicate, that the VL tendon and aponeurosis in vivo do not suffer from changes in the compliance neither after long-lasting static mechanical loading (strain approximately 3.2%) nor after long-lasting cyclic mechanical loading (strain 6.2-5.5%).

Deficits in the way to achieve balance related to mechanisms of dynamic stability control in the elderly.

The purpose of this study was to examine the postural corrections related to components of dynamic stability aimed to increase our understanding of successful postural control among the elderly population. This was done by comparing balance behaviour of older adults who were able to recover stability (stable) and others who failed to regain stability (unstable) with a single step after a forward fall. Thirty-eight old male adults (64+/-3yr, 176+/-6cm, 78.5+/-7.8kg) had to recover balance after a sudden induced forward fall. All participants performed maximal isometric ankle plantarflexion and knee extension contractions on a dynamometer. The elongation of the gastrocnemius medialis and the vastus lateralis tendon and aponeuroses during isometric contraction was examined by ultrasonography. There were no differences in leg-extensor muscle strength or tendon stiffness between the two groups showing that the muscle tendon capacities may not be the reason for the observed differences in dynamic stability control. The unstable participants created a higher horizontal ground reaction push-off force of the support limb in the second part ( approximately 260ms after release) of the phase until touchdown leading to an unstable body position at touchdown. The results indicate deficits in the way to achieve balance related to mechanisms responsible for dynamic stability control within the elderly population.

Effect of voluntary activation on age-related muscle fatigue resistance.

Ageing is associated with a higher fatigue resistance during submaximal or maximal fatiguing contractions. The present study aimed to investigate the contribution of the central and peripheral fatigue to the age-related differences in fatigue development of the plantar flexor muscles. Therefore, the voluntary activation, rest twitch moment and voluntary plantar flexor moment were examined before during as well as 2, 5 and 10min after a fatiguing task. This consisted of intermittent isometric submaximal plantar flexor contractions at equal intensity for both young and old adults (considering the age-related differences in muscle inhibition). Consequently, possible differences between young and old adults in voluntary activation during the maximal contraction utilised for determining the intensity of the fatiguing task, which can influence fatigue development, have been taken into account. The plantar flexors moment was calculated using inverse dynamics and the voluntary activation was measured using the twitch interpolation technique. Changes in voluntary activation and rest twitch moment during the fatiguing task were used to assess central and peripheral fatigue, respectively. In both young and old adults, peripheral ( approximately 20%) as well as central fatigue ( approximately 9%) contributed to the time to task failure. Old adults demonstrated greater time to task failure than young ones, but similar voluntary activation behaviour during the fatiguing task. We concluded that, the age-related enhancement in fatigue resistance is not attributable to voluntary activation but is linked to mechanisms located within the working muscle.

Dynamic stability control in forward falls: postural corrections after muscle fatigue in young and older adults.

Many studies report that muscle strength loss may alter the human system's capacity to generate rapid force for balance corrections after perturbations, leading to deficient recovery behaviours. Yet little is known regarding the effect of modifications in the neuromuscular system induced by fatigue on dynamic stability control during postural perturbations. This study investigates the effect of muscle strength decline induced by fatiguing contractions on the dynamic stability control of young and older adults during forward falls. Eleven young and eleven older male adults had to regain balance after sudden falls before and after submaximal fatiguing knee extension-flexion contractions. Young subjects had a higher margin of stability than older ones before and after the fatiguing task. This reflects their enhanced ability in using mechanisms for maintaining dynamic stability (i.e. a greater base of support). The margin of stability, the boundary of the base of support and the position of the extrapolated centre of mass, remained unaffected by the reduction in muscle strength induced by the fatiguing contractions, indicating an appropriate adjustment of the motor commands to compensate the deficit in muscle strength. Both young and older adults were able to counteract the decreased horizontal ground reaction forces after the fatiguing task by flexing their knee to a greater extent, leading to similar decreases in the horizontal velocity of centre of mass as in the pre fatigue condition. The results demonstrate the ability of the central nervous system to rapidly modify the execution of postural corrections including mechanisms for maintaining dynamic stability.

Age-related effect of static and cyclic loadings on the strain-force curve of the vastus lateralis tendon and aponeurosis.

The objective of the present study was to investigate the age-related effects of submaximal static and cyclic loading on the mechanical properties of the vastus lateralis (VL) tendon and aponeurosis in vivo. Fourteen old and 12 young male subjects performed maximal voluntary isometric knee extensions (MVC) on a dynamometer before and after (a) a sustained isometric contraction at 25% MVC and (b) isokinetic contractions at 50% isokinetic MVC, both until task failure. The elongation of the VL tendon and aponeurosis was examined using ultrasonography. To calculate the resultant knee joint moment, the kinematics of the leg were recorded with eight cameras (120 Hz). The old adults displayed significantly lower maximal moments but higher strain values at any given tendon force from 400 N and up in all tested conditions. Neither of the loading protocols influenced the strain-force relationship of the VL tendon and aponeurosis in either the old or young adults. Consequently, the capacity of the tendon and aponeurosis to resist force remained unaffected in both groups. It can be concluded that in vivo tendons are capable of resisting long-lasting static (~4.6 min) or cyclic (~18.5 min) mechanical loading at the attained strain levels (4-5%) without significantly altering their mechanical properties regardless of age. This implies that as the muscle becomes unable to generate the required force due to fatigue, the loading of the tendon is terminated prior to provoking any significant changes in tendon mechanical properties.

Age-related deficit in dynamic stability control after forward falls is affected by muscle strength and tendon stiffness.

The purpose of the work was to determine whether the age-related muscle weakness diminishes older adults' ability to use mechanisms responsible for maintaining dynamic stability after forward falls. Nine older and nine younger adults participated in this study. To analyse the capacities of the leg-extensor muscle-tendon units, all subjects performed isometric maximal voluntary plantarflexion and knee extension contractions on a dynamometer. The elongation of the gastrocnemius medialis and the vastus lateralis tendon and aponeuroses during isometric contraction was examined by ultrasonography. Recovery behaviour was determined after a sudden fall from two forward-inclined lean angles. Compared to older adults, younger adults had higher muscle strength and tendon stiffness. Younger adults created a higher margin of stability compared to older, independent of perturbation intensity. The main mechanism improving the margin of dynamic stability was the increase of the base of support. The results, further, demonstrated that the locomotion strategy employed before touchdown affects the stability of the stance phase and that muscle strength and tendon stiffness contributed significantly to stability control. We concluded that, to reduce the risk of falls, older individuals may benefit from muscle-tendon unit strengthening programs as well as from interventions exercising the mechanisms responsible for dynamic stability.

Mechanical and morphological properties of the triceps surae muscle-tendon unit in old and young adults and their interaction with a submaximal fatiguing contraction.

The purposes of this study were to examine (a) whether the morphological properties of the muscle gastrocnemius medialis (GM) contribute to the known enhanced muscle fatigue resistance during submaximal sustained isometric plantar flexion contraction of old compared to young adults and (b) whether a submaximal fatiguing contraction differently affects the mechanical properties of the GM tendon and aponeurosis of old and young adults. Fourteen old and 12 young male subjects performed maximal voluntary isometric plantar flexions (MVC) on a dynamometer before and after a submaximal fatiguing task (40% MVC). Moments and EMG signals from the gastrocnemius medialis and lateralis, soleus and tibialis anterior muscles were measured. The elongation of the GM tendon and aponeurosis and the morphological properties of its contractile element were examined by means of ultrasonography. The old adults showed lower maximal ankle joint moment, stiffness and fascicle length in both tested conditions. The submaximal fatiguing contraction did not affect the force-strain relationship of the GM tendon and aponeurosis of either young or old adults. The time to task failure was longer for the old adults and was strongly correlated with the fascicle length (r(2)=0.50, P<0.001). This provides evidence on that the lower ratio of the active muscle volume to muscle force for the old adults might be an additional mechanism contributing to the known age related increase in muscle fatigue resistance.

Changes in fascicle length from rest to maximal voluntary contraction affect the assessment of voluntary activation.

The purpose of this study was to investigate the effect of the differences between the actual fascicle length during a voluntary contraction and the fascicle length at rest of the triceps surae muscle on the determination of the voluntary activation (VA) by using the interpolated twitch technique. Twelve participants performed isometric voluntary maximal (MVC) and submaximal (20%, 40%, 60% and 80% MVC) contractions at two different ankle angles (75 degrees and 90 degrees ) under application of the interpolated twitch technique. Two ultrasound probes were used to determine the fascicle length of soleus, gastrocnemius medialis and gastrocnemius lateralis muscles. Further, the MVCs and the twitches were repeated for six more ankle angles (85 degrees , 95 degrees , 100 degrees , 105 degrees , 110 degrees and 115 degrees ). The VA of the triceps surae muscle were calculated (a) using the rest twitch force (RTF) measured during the same trial as the interpolated twitch force (ITF; traditional method) and (b) using the RTF at an ankle angle where the fascicle length showed similar values between ITF and RTF (fascicle length consideration method). The continuous changes in fascicle length from rest to MVC affect the accuracy of the assessment of the VA. The traditional method overestimates the assessment of the VA on average 4% to 12%, especially at 90 degrees ankle angle (i.e. short muscle length). The reason for this influence is the unequal force-length potential of the muscle at twitch application by the measure of ITF and RTF. These findings provide evidence that the fascicle length consideration method permits a more precise prediction (an improvement of 4-12%) of the voluntary contraction compared to the traditional method.

Effect of muscle fatigue on the compliance of the gastrocnemius medialis tendon and aponeurosis.

The aim of the present study was to examine whether or not the compliance of the gastrocnemius medialis (GM) tendon and aponeurosis is influenced by submaximal fatiguing efforts. Fourteen elderly male subjects performed isometric maximal voluntary plantarflexion contractions (MVC) on a dynamometer before and after two fatiguing protocols. The protocols consisted of: (1) submaximal concentric isokinetic contractions (70% isokinetic MVC) at 60 degrees /s and (2) a sustained isometric contraction (40% isometric MVC) until failure to hold the defined moment. Ultrasonography was used to determine the elongation and strain of the GM tendon and aponeurosis. To account for the axis misalignment between ankle and dynamometer, the kinematics of the leg were captured at 120 Hz. The maximum moment decreased from 85.9+/-17.9 Nm prior fatigue to 79.2+/-19 Nm after isokinetic fatigue and to 69.9+/-16.4 Nm after isometric fatigue. The maximal strain of the GM tendon and aponeurosis before fatigue, after isokinetic and after isometric fatigue were 4.9+/-1.1%, 4.4+/-1.1% and 4.3+/-1.1% respectively. Neither the strain nor the elongation showed significant differences before and after each fatiguing task at any 100 N step of the calculated tendon force. This implies that the compliance was not altered after either the isokinetic or the isometric fatiguing task. Therefore it was concluded that the strains during the performed submaximal fatiguing tasks, were too small to provoke any structural changes in tendon and aponeurosis.