Age-Related Differences in Muscle Fatigue Vary by Contraction Type: A Meta-analysis

Abstract
During senescence, despite the loss of strength (force-generating capability) associated with sarcopenia, muscle endurance may improve for isometric contractions. The purpose of this study was to perform a systematic meta-analysis of young versus older adults, considering likely moderators (ie, contraction type, joint, sex, activity level, and task intensity). A 2-stage systematic review identified potential studies from PubMed, CINAHL, PEDro, EBSCOhost: ERIC, EBSCOhost: Sportdiscus, and The Cochrane Library. Studies reporting fatigue tasks (voluntary activation) performed at a relative intensity in both young (18–45 years of age) and old (≥55 years of age) adults who were healthy were considered. Sample size, mean and variance outcome data (ie, fatigue index or endurance time), joint, contraction type, task intensity (percentage of maximum), sex, and activity levels were extracted. Effect sizes were (1) computed for all data points; (2) subgrouped by contraction type, sex, joint or muscle group, intensity, or activity level; and (3) further subgrouped between contraction type and the remaining moderators. Out of 3,457 potential studies, 46 publications (with 78 distinct effect size data points) met all inclusion criteria. A lack of available data limited subgroup analyses (ie, sex, intensity, joint), as did a disproportionate spread of data (most intensities ≥50% of maximum voluntary contraction). Overall, older adults were able to sustain relative-intensity tasks significantly longer or with less force decay than younger adults (effect size=0.49). However, this age-related difference was present only for sustained and intermittent isometric contractions, whereas this age-related advantage was lost for dynamic tasks. When controlling for contraction type, the additional modifiers played minor roles. Identifying muscle endurance capabilities in the older adult may provide an avenue to improve functional capabilities, despite a clearly established decrement in peak torque.