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Stroke Increases Neuromuscular Fatigability in Females but not Males during Isometric Exercise
Zhilun Zhou1,2, Brian D Schmit3, Matthew J Durand4,5,6
1Department of Physical Therapy, Marquette University, Milwaukee, WI.
Medicine and Science in Sports and Exercise
|December 5, 2025
Summary
Stroke impacts female fatigability more than male fatigability during leg exercises. This sex-specific difference in neuromuscular fatigability may stem from central versus peripheral mechanisms.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Exercise Physiology
Background:
- Females exhibit poorer motor function outcomes post-stroke compared to males.
- The influence of stroke on neuromuscular fatigability between sexes remains unclear.
Purpose of the Study:
- To investigate sex-specific differences in stroke's impact on neuromuscular fatigability.
- To compare fatigability and neuromuscular responses between male and female stroke survivors and controls.
Main Methods:
- Forty-one chronic stroke survivors and 23 neurotypical controls performed sustained isometric knee extension.
- Fatigability was measured by task duration; muscle contractile properties (Q tw) and neuromuscular activation (EMG) were assessed.
- Two-way ANOVAs analyzed group and sex effects; Pearson correlations explored associations between fatigability and neuromuscular measures.
Main Results:
- Female stroke survivors showed significantly reduced task duration compared to neurotypical females, unlike males.
- Stroke survivors exhibited reduced Q tw and EMG changes compared to controls.
- Females showed smaller changes in Q tw and EMG compared to males during exercise.
Conclusions:
- Stroke exacerbates fatigability in females but not males during submaximal isometric knee extension.
- Sex-specific effects of stroke on fatigability suggest differing central and peripheral mechanisms.
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