<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">JBiSE</journal-id><journal-title-group><journal-title>Journal of Biomedical Science and Engineering</journal-title></journal-title-group><issn pub-type="epub">1937-6871</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/jbise.2022.153011</article-id><article-id pub-id-type="publisher-id">JBiSE-115940</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Biomedical&amp;Life Sciences</subject></subj-group></article-categories><title-group><article-title>
 
 
  Tremor Associated with Muscle Fatigue Is Temporary and Beneficial: A Case Report
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Hiroyuki</surname><given-names>Tamaki</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Futoshi</surname><given-names>Ogita</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib></contrib-group><aff id="aff1"><addr-line>Department of Sports and Life Science, National Institute of Fitness and Sports, Kanoya, Japan</addr-line></aff><pub-date pub-type="epub"><day>17</day><month>03</month><year>2022</year></pub-date><volume>15</volume><issue>03</issue><fpage>103</fpage><lpage>107</lpage><history><date date-type="received"><day>21,</day>	<month>January</month>	<year>2022</year></date><date date-type="rev-recd"><day>14,</day>	<month>March</month>	<year>2022</year>	</date><date date-type="accepted"><day>17,</day>	<month>March</month>	<year>2022</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  Enhanced physiological tremor (EPT) associated with fatiguing static muscle contractions is generally thought to limit continuous muscle work. However, the EPT dies away, allowing the continuous muscle contraction to be maintained at low-level workload. Here, we report a case study of a 22-year-old male volunteer who performed static plantar flexion at 30% maximal voluntary contraction (MVC) for 66 min with repeated EPT events. Comparative analysis of 1 min pre- and post-EPT phases revealed lower electromyographic (EMG) activity, heart rate, and blood pressure levels during the post-EPT phases, while the popliteal artery blood-flow volume and vascular conductance were raised. EPT may therefore be a mechanism for removing factors that inhibit continuous muscle contraction. This unique case report provides new insight into the functional significance of EPT during prolonged static muscle contractions.
 
</p></abstract><kwd-group><kwd>Enhanced Physiological Tremor</kwd><kwd> Electromyography</kwd><kwd> Blood Flow</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. INTRODUCTION</title><p>Enhanced physiological tremor (EPT) associated with fatiguing static muscle contractions [1 - 4] limits continuous muscle work. However, EPT also dies away, allowing continuous muscle contraction to be maintained at a low-level workload [<xref ref-type="bibr" rid="scirp.115940-ref5">5</xref>] with reduced electromyographic (EMG) activities after EPT events. Reduced EMG activity after EPT events may lead to an increased blood supply resulting from a decline in acting-muscle tissue pressure [6 - 8], which would promote metabolite excretion [9 , 10]. The motor system may therefore use EPT to facilitate the continuation of voluntary muscle activity. Interactions between neuromuscular function and the blood supply to the acting muscle are also important for the continuation of voluntary movement [<xref ref-type="bibr" rid="scirp.115940-ref11">11</xref>]. However, there is little data on the local circulation and neuromuscular activity before and after EPT events during prolonged muscle contractions. We examined the function of EPT by measuring both neuromuscular activity and local circulation during prolonged static muscle contractions.</p></sec><sec id="s2"><title>2. METHODS</title><p>We obtained data from a healthy 22-year-old male volunteer. After giving his informed consent, he performed static plantar flexion at 30% maximal voluntary contraction (MVC) with the foot set on a device freely moving in the direction of plantar-dorsi flexion for 66 min (<xref ref-type="fig" rid="fig1">Figure 1</xref>). The protocol was approved by the ethics committee of National Institute of Fitness and Sports. We recorded his ankle joint angle and the surface electromyography (EMG) in his triceps surae (lateral gastrocnemius [LG], medial gastrocnemius [MG], and soleus [Sol]) and tibialis anterior (TA) muscles using a bipolar Ag/AgCl electrode, which wrote to the hard drive of a personal computer via an A/D converter (PowerLab, ADInstruments, Japan) [<xref ref-type="bibr" rid="scirp.115940-ref12">12</xref>]. We also measured his two-dimensional popliteal arterial diameter (AD) and mean blood velocity (MBV) throughout the experiment using an ultrasound Doppler (SSH-140A, Toshiba, Japan) with a linear array transducer (7.5 MHz) [<xref ref-type="bibr" rid="scirp.115940-ref13">13</xref>]. We simultaneously conducted electrocardiography, measured his heart rate (HR) and blood pressure (BP), and continuously monitored his pulse rate (PR) and mean arterial BP with a finger-cuff photoplethysmography device (Finapres, Ohmeda, USA) on his middle finger. We calculated his popliteal artery blood flow (Qpa) as the product of MBV, PR, and arterial cross-sectional area as follows:</p><p>Qpa = MBV ⋅ π ⋅ ( AD / 2 ) 2 ⋅ PR , (1)</p><p>where MBV is mean popliteal artery flow velocity, π is 3.14, AD is arterial diameter, and PR is pulse rate.</p></sec><sec id="s3"><title>3. RESULTS</title><p>We found that EPT events initially occurred at 8.7 min, lasted for approximately 14 s, and diminished, after which the static muscle contractions resumed. The tremor rate ranged between 7 and 10 cycles per second (<xref ref-type="fig" rid="fig2">Figure 2</xref>). The three individual muscles in the triceps surae showed a clear EMG grouping with an active/inactive time ratio of 1.2 during the EPT events (<xref ref-type="fig" rid="fig2">Figure 2</xref>). EMG activity in the TA was unchanged before, during, and after the EPT events. The subject sometimes developed muscle</p><p>pain before an EPT event began. The intervals between EPT events were about three times longer in the first half of the endurance test than the second. Comparative analysis of 1 min pre- and post-EPT phases revealed reduced surface EMG activity (<xref ref-type="fig" rid="fig2">Figure 2</xref>) and reduced HR and BP (<xref ref-type="fig" rid="fig3">Figure 3</xref>) in the post-EPT phase. In contrast, blood-flow volume and vascular conductance increased in the post-EPT phase (<xref ref-type="fig" rid="fig4">Figure 4</xref>).</p></sec><sec id="s4"><title>4. CONCLUSION</title><p>Overall the results showed that the EPT events during prolonged static muscle contractions dead away and then muscle contractions continued. The subject had a tremor rate ranging between 7 - 10 c/s. EMG activity, HR and BP were reduced, while arterial blood flow and vascular conductance increased in the post-EPT phase. EPT events associated with fatiguing static muscle contractions may therefore act as a function of the muscle pump and lead to temporary normalization of homeostasis in muscle tissue. This novel insight into EPT function may provide useful information for the fields of sports medicine and rehabilitation.</p></sec><sec id="s5"><title>CONFLICTS OF INTEREST</title><p>The authors declare no conflicts of interest associated with this manuscript.</p></sec><sec id="s6"><title>REFERENCES</title></sec></body><back><ref-list><title>References</title><ref id="scirp.115940-ref1"><label>1</label><mixed-citation publication-type="other" xlink:type="simple">K&amp;#246;ster, B., Lauk, M., Timmer, J., Winter, T., Guschlbauer, B., Glocker, F.X., Danek, A., Deuschl, G. and Lücking, C.H. (1998) Central Mechanisms in Human Enhanced Physiological Tremor. Neuroscience Letters, 241, 135-138. https://doi.org/10.1016/S0304-3940(98)00015-9</mixed-citation></ref><ref id="scirp.115940-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">Lippold, O. (1981) The Tremor in Fatigue. Human Muscle Fatigue: Physiological Mechanisms, 234-248. https://doi.org/10.1002/9780470715420.ch14</mixed-citation></ref><ref id="scirp.115940-ref3"><label>3</label><mixed-citation publication-type="other" xlink:type="simple">Lippold, O.C.J., Redfearn, J.W.T. and Vu&amp;#269;o, J. (1957) The Rhythmical Activity of Groups of Motor Units in the Voluntary Contraction of Muscle. Journal of Physiology, 137, 473-487. https://doi.org/10.1113/jphysiol.1957.sp005828</mixed-citation></ref><ref id="scirp.115940-ref4"><label>4</label><mixed-citation publication-type="other" xlink:type="simple">McAuley, J.H. (2000) Physiological and Pathological Tremors and Rhythmic Central Motor Control. Brain, 123, 1545-1567. https://doi.org/10.1093/brain/123.8.1545</mixed-citation></ref><ref id="scirp.115940-ref5"><label>5</label><mixed-citation publication-type="other" xlink:type="simple">Lippold, O.C.J. (1970) Oscillation in the Stretch Reflex Arc and the Origin of the Rhythmical, 8-12 c/s Component of Physiological Tremor. Journal of Physiology, 206, 359-382. https://doi.org/10.1113/jphysiol.1970.sp009018</mixed-citation></ref><ref id="scirp.115940-ref6"><label>6</label><mixed-citation publication-type="other" xlink:type="simple">Sadamoto, T., Bonde-Petersen, F. and Suzuki, Y. (1983) Skeletal Muscle Tension, Flow, Pressure, and EMG during Sustained Isometric Contractions in Humans. European Journal of Applied Physiology and Occupational Physiology, 51, 395-408. https://doi.org/10.1007/BF00429076</mixed-citation></ref><ref id="scirp.115940-ref7"><label>7</label><mixed-citation publication-type="other" xlink:type="simple">Wall&amp;#248;e, L. and Wesche, J. (1988) Time Course and Magnitude of Blood Flow Changes in the Human Quadriceps Muscles during and Following Rhythmic Exercise. Journal of Physiology, 405, 257-273. https://doi.org/10.1113/jphysiol.1988.sp017332</mixed-citation></ref><ref id="scirp.115940-ref8"><label>8</label><mixed-citation publication-type="other" xlink:type="simple">Wesche, J. (1986) The Time Course and Magnitude of Blood Flow Changes in the Human Quadriceps Muscles Following Isometric Contraction. Journal of Physiology, 377, 445-462. https://doi.org/10.1113/jphysiol.1986.sp016197</mixed-citation></ref><ref id="scirp.115940-ref9"><label>9</label><mixed-citation publication-type="other" xlink:type="simple">Kahn, J.F. and Monod, H. (1989) Fatigue Induced by Static Work. Ergonomics, 32, 839-846. https://doi.org/10.1080/00140138908966846</mixed-citation></ref><ref id="scirp.115940-ref10"><label>10</label><mixed-citation publication-type="other" xlink:type="simple">Pollak, K.A., Swenson, J.D., Vanhaitsma, T.A., Hughen, R.W., Jo, D., Light, K.C., Schweinhardt, P., Amann, M. and Light, A.R. (2014) Exogenously Applied Muscle Metabolites Synergistically Evoke Sensations of Muscle Fatigue and Pain in Human Subjects. Experimental Physiology, 99, 368-380. https://doi.org/10.1113/expphysiol.2013.075812</mixed-citation></ref><ref id="scirp.115940-ref11"><label>11</label><mixed-citation publication-type="other" xlink:type="simple">Sj&amp;#248;gaard, G., Savard, G. and Juel, C. (1988) Muscle Blood Flow during Isometric Activity and Its Relation to Muscle Fatigue. European Journal of Applied Physiology and Occupational Physiology, 57, 327-335. https://doi.org/10.1007/BF00635992</mixed-citation></ref><ref id="scirp.115940-ref12"><label>12</label><mixed-citation publication-type="other" xlink:type="simple">Tamaki, H., Kirimoto, H., Yotani, K. and Takekura, H. (2011) Frequent Alternate Muscle Activity of Plantar Flexor Synergists and Muscle Endurance during Low-Level Static Contractions as a Function of Ankle Position. Journal of Physiological Sciences, 61, 411-419. https://doi.org/10.1007/s12576-011-0157-8</mixed-citation></ref><ref id="scirp.115940-ref13"><label>13</label><mixed-citation publication-type="other" xlink:type="simple">Nishiwaki, M., Kawakami, R., Saito, K., Tamaki, H., Takekura, H. and Ogita, F. (2011) Vascular Adaptations to Hypobaric Hypoxic Training in Postmenopausal Women. Journal of Physiological Sciences, 61, 83-91. https://doi.org/10.1007/s12576-010-0126-7</mixed-citation></ref></ref-list></back></article>