Effect of creati ne l oadi ng on

neuromuscul ar fati gue threshol d

JEFFREY STOUT,
1
JOAN ECKERSON,
1
KYLE EBERSOLE,
2
GERI MOORE,
1
SHARON PERRY,
2
TERRY HOUSH,
2
ANTHONY BULL,
2
JOEL CRAMER,
2
AND ASH BATHEJA
3
1
Exercise Science Department, Creighton University, Omaha 68178;
2
Center for Youth
Fitness and Sports Research, University of Nebraska, Lincoln 68588; and
3
Department
of Physical Therapy, University of Nebraska Medical Center, Omaha, Nebraska 68198
Stout, J effrey, J oan Eckerson, Kyle Ebersole, Geri
Moore, Sharon Perry, Terry Housh, Anthony Bull, J oel
Cramer, and Ash Batheja. Effect of creati ne l oadi ng on
neuromuscul ar fati gue threshol d. J . Appl. Physiol. 88: 109
112, 2000.The purpose of thi s i nvesti gati on was to deter-
mi ne the effect of creati ne (Cr) l oadi ng on the onset of
neuromuscul ar fati gue by moni tori ng el ectromyographi c fa-
ti gue curves from the vastus l ateral i s muscl e usi ng the
physi cal worki ng capaci ty at the fati gue threshol d (PWC
FT
)
test. Usi ng a doubl e-bl i nd random desi gn, 15 women athl etes
[mean age 19.0 2.0 (SD) yr] from the uni versi ty crew team
recei ved a pl acebo (n 8; 20 g gl ucose) or Cr (n 7; 5 g Cr
monohydrate 20 g gl ucose) four ti mes per day for 5
consecuti ve days. Anal ysi s of covari ance was used to anal yze
the data (covari ed for presuppl ementati on PWC
FT
val ues).
The adjusted mean postsuppl ementati on PWC
FT
val ue for the
Cr group (mean 186 W) was si gni cantl y (P 0.05) hi gher
than that of the pl acebo group (mean 155 W). These
ndi ngs suggest that Cr l oadi ng may del ay the onset of
neuromuscul ar fati gue.
ergogeni c ai d; el ectromyography; cycl e ergometry; muscl e
fati gue
A NUMBER OF I NVESTI GATI ONS have used surface el ectro-
myographi c (EMG) procedures to i denti fy the power
output associ ated wi th the onset of neuromuscul ar
fati gue (NMF) duri ng cycl e ergometry (3, 4, 79, 14,
21). NMF i s typi cal l y characteri zed by an i ncrease over
ti me i n the el ectri cal acti vi ty of the worki ng muscl es (2,
4, 14, 15). Mori tani et al . (15) suggested that the
fati gue-i nduced i ncrease i n EMG ampl i tude i s a resul t
of progressi ve recrui tment of addi ti onal motor uni ts
(MU) and/or an i ncrease i n the ri ng frequency of MUs
that have al ready been recrui ted. Theoreti cal l y, work
bouts at power outputs at or bel ow the NMF threshol d
can be mai ntai ned conti nuousl y wi thout EMG evi dence
of fati gue (i .e., no si gni cant i ncrease i n EMG ampl i -
tude over ti me).
DeVri es et al . (3, 4) devel oped an i ncremental cycl e
ergometer test cal l ed the physi cal worki ng capaci ty at
the fati gue threshol d (PWC
FT
), whi ch uti l i zes EMG
fati gue curves to i denti fy the power output that corre-
sponds to the onset of the NMF threshol d. The PWC
FT
represents the hi ghest power output that resul ts i n a
nonsi gni cant (P 0.05) i ncrease i n the el ectri cal
acti vi ty of the thi gh muscl es over ti me. Whereas the
PWC
FT
test has been shown to be rel i abl e (2, 4), val i d
(2), and sensi ti ve to changes i n tness l evel (2), the
physi ol ogi cal mechani sm responsi bl e for the i ncrease
i n EMG ampl i tude over ti me duri ng a fati gui ng task i s
unknown. Two potenti al mechani sms, however, i ncl ude
the accumul ati on of metabol i c by-products (l actate, H

,
P
i
, and ammoni a) and/or the depl eti on of stored energy
substrates [ATP, phosphocreati ne (PCr), and gl ycogen]
(13). Housh et al . (8, 9) have reported that mani pul a-
ti on of bl ood aci d-base bal ance wi th ammoni a chl ori de
and sodi um bi carbonate, as wel l as gl ycogen depl eti on
and supercompensati on, di d not affect the onset of
NMF as measured by the PWC
FT
test. However, McCart-
ney et al . (12) have suggested that al terati ons i n the
bl ood aci d-base state have l i ttl e i nuence on muscl e
pH. I n addi ti on, there i s evi dence to suggest that
skel etal muscl e PCr may serve as a temporal energy
buffer as wel l as a modul ator of gl ycol ysi s and, there-
fore, may i nuence NMF (22). The effect of PCr mani pu-
l ati on on EMG fati gue curves, however, i s unknown.
Therefore, the purpose of the present study was to
determi ne the effect of Cr l oadi ng on the onset of NMF,
as measured by the PWC
FT
test i n women athl etes.
METHODS
Subjects. Fi fteen femal e members of the uni versi ty crew
team [age 19.0 2.0 (SD) yr] vol unteered as subjects for thi s
i nvesti gati on. Al l procedures were approved by the I nsti tu-
ti onal Revi ew Board before the i ni ti ati on of the study, and
each subject was advi sed of any possi bl e ri sks before provi d-
i ng i nformed consent.
Supplementation protocol. None of the subjects had i n-
gested Cr, or any other di etary suppl ements, for a mi ni mum
of 12 wk before the i ni ti ati on of the study. Duri ng the course
of the study, the subjects were asked to mai ntai n thei r
current di etary patterns and abstai n from other nutri ti onal
suppl ements, nonprescri pti on drugs, and caffei ne. After pre-
testi ng, the subjects were randoml y assi gned to one of two
treatment condi ti ons usi ng a doubl e-bl i nd desi gn: 1) 20 g of
avored dextrose powder as a pl acebo (Pl , n 8); or 2) 5.0 g of
Cr monohydrate pl us 20 g of dextrose i n a avored powder
bl end (Cr, n 7) (Creati ne Edge Effervescent, Fortress
Systems, Omaha, NE). The powders, i denti cal i n taste and
appearance, were di ssol ved i n 16 oz of water and i ngested
four ti mes per day for 5 consecuti ve days before posttesti ng.
The costs of publ i cati on of thi s arti cl e were defrayed i n part by the
payment of page charges. The arti cl e must therefore be hereby
marked advertisement i n accordance wi th 18 U.S.C. Secti on 1734
sol el y to i ndi cate thi s fact.
J . Appl. Physiol.
88: 109112, 2000.
8750-7587/00 $5.00 Copyri ght

2000 the Ameri can Physi ol ogi cal Soci ety 109 http://www.jap.org
Electrodeplacement and EMG instrumentation. A bi pol ar
(2.54-cm center-to-center) surface el ectrode (Qui nton Qui ck
prep si l ver-si l ver chl ori de) arrangement was pl aced on the
ri ght thi gh over the l ateral porti on of the vastus l ateral i s
(VL), mi dway between the greater trochanter and the l ateral
condyl e of the femur. The reference el ectrode was pl aced over
the i l i ac crest. I nterel ectrode i mpedance was kept bel ow
2,000 by careful abrasi on of the ski n. The EMG si gnal was
preampl i ed (gai n: 1,000) by usi ng a di fferenti al ampl i er
(EMG 100, Bi opac System, Santa Barbara, CA). The EMG
si gnal was sampl ed at 1,000 poi nts/s and l tered at 10500
Hz. The root mean square EMG ampl i tude val ues were
cal cul ated for the 10-s ti me frame for each sampl e taken
(MP100, Bi opac Systems).
Determination of PWC
FT
. The PWC
FT
val ues were deter-
mi ned from the VL muscl e by usi ng the protocol of deVri es et
al . (3). Fi gure 1 i l l ustrates how the PWC
FT
was determi ned
usi ng the data from subject 7 i n the Cr group (Tabl e 1). The
subjects began pedal i ng (wi th toe cl i ps) at 60 W (70 rpm) on a
cal i brated, el ectroni cal l y braked cycl e ergometer (Corval 400,
Qui nton I nstruments, Seattl e, WA). The power output was
then i ncreased by 30 W every 2 mi n unti l the subject coul d no
l onger mai ntai n 70 rpm. Duri ng each 2-mi n i nterval , si x 10-s
EMG sampl es were recorded from the VL. The PWC
FT
was
determi ned by averagi ng the hi ghest power output that
resul ted i n a nonsi gni cant (P 0.05; si ngl e-tai l ed t-test)
sl ope val ue for the EMG ampl i tude vs. ti me rel ati onshi p, wi th
the l owest power output that resul ted i n a si gni cant (P
0.05) sl ope val ue (Fi g. 1).
Rel i abi l i ty of the PWC
FT
was determi ned by usi ng a
subsampl e of subjects (n 11) measured 7 days apart. The
test-retest i ntracl ass correl ati on coeffi ci ent (R) was 0.94
(SE 6 W), whi ch i s si mi l ar to val ues reported by deVri es et
al . (2, 3) i n ol der (R 0.976) and younger mal e subjects (R
0.947). I n addi ti on, the test-retest mean di fference for the
PWC
FT
val ues 0.5 W was not stati sti cal l y si gni cant (t 0.09;
P 0.05).
Statistical analysis. Changes i n body wei ght (BW) as a
resul t of suppl ementati on were anal yzed by usi ng a 2 2
[treatment (Pl , Cr) ti me (pretest, postest)] mi xed factori al
ANOVA. Di fferences i n the mean posttest PWC
FT
val ue were
determi ned by usi ng anal ysi s of covari ance, wi th pretest
PWC
FT
servi ng as the covari ate. Data were consi dered si gni -
cantl y di fferent when the probabi l i ty was P 0.05.
RESULTS
The descri pti ve characteri sti cs of the subjects, as
wel l as the changes i n BW and PWC
FT
for the two
groups, are shown i n Tabl e 1. There were no si gni cant
changes i n BW from pretesti ng to posttesti ng for ei ther
group. However, the adjusted mean posttest PWC
FT
val ue for the Pl group (mean 155 W) was si gni cantl y
l ess than that of the Cr group (mean 186 W).
Fi g. 1. I l l ustrati on of method used for determi ni ng physi cal worki ng
capaci ty at fati gue threshol d (PWC
FT
) for subject 7i n creati ne group.
EMG, el ectromyographi c vol tages; NS, not si gni cant; uVrms, root
mean square EMG ampl i tude.
Tabl e 1. Characteristics of thesubjects (n15)
Subject Age, yr Hei ght, cm BW-Pre, kg BW-Post, kg PWC
FT
-Pre, W PWC
FT
-Post, W
Placebogroup
1 18 163 75.5 75.0 165 135
2 19 165 51.4 51.8 135 135
3 19 167 56.4 56.0 135 135
4 20 167 59.0 59.6 165 165
5 17 170 80.5 81.8 135 165
6 19 164 70.5 69.9 165 165
7 21 160 60.5 59.0 105 105
8 19 163 56.0 56.0 165 165
Mean SD 19.01.2 164.93.1 63.710.4 63.610.6 146.322.3 146.322.3
Creatinegroup
1 17 172 74.3 76.4 165 225
2 21 154 66.7 68.2 165 195
3 20 163 67.3 65.0 195 225
4 22 159 64.0 64.5 165 195
5 18 166 78.9 78.7 225 225
6 18 167 62.7 63.4 165 165
7 20 178 65.5 64.7 105 135
Mean SD 19.41.8 165.68.0 68.55.9 68.76.3 169.336.4 195*34.6
PWC
FT
, physi cal worki ng capaci ty at fati gue threshol d; BW, body wei ght; Pre, before treatment; Post, after treatment. *Mean PWC
FT
-Post
val ues si gni cantl y di fferent from mean PWC
FT
-Pre val ues (P0.05).
110 CREATI NE LOADI NG ON NEUROMUSCULAR FATI GUE
DISCUSSION
Recent i nvesti gati ons (6, 10) usi ng mal e subjects
have shown that Cr l oadi ng (20 g/day) for 5 days
si gni cantl y el evated whol e muscl e Cr stores by an
average of 20%, wi th as much as 20%stored i n the form
of PCr. Vandenberghe et al . (20) demonstrated a 6%
i ncrease i n muscl e PCr concentrati on i n col l ege-age
women (1922 yr ol d) after 4 days of Cr l oadi ng. The
femal e subjects i n the present study (Tabl e 1) were
si mi l ar i n age (1821 yr ol d) and cl osel y fol l owed the Cr
l oadi ng regi men used i n the study by Vandenberghe et
al . (20) (5 g, four ti mes per day for 5 days). Therefore,
al though muscl e PCr l evel s were not di rectl y measured
i n the present study, the resul ts of previ ous i nvesti ga-
ti ons (6, 10, 20) suggest that i t i s l i kel y that the Cr
l oadi ng resul ted i n an i ncrease i n muscl e PCr concentra-
ti on.
Several studi es that have exami ned the ergogeni c
effect of Cr l oadi ng on performance by usi ng supramaxi -
mal workl oads on a cycl e ergometer have reported
si gni cant i ncreases i n total work duri ng both si ngl e
and mul ti pl e bouts of exerci se (1, 11, 17, 22). Recentl y,
Jacobs et al . (11) and Prevost et al . (17) demonstrated
si gni cant i ncreases i n ti me to exhausti on (8.5 and
24%, respecti vel y) duri ng cycl e ergometry at 125 and
150% maxi mal oxygen consumpti on rate after Cr l oad-
i ng i n physi cal l y acti ve men and women. Prevost et al .
hypothesi zed that Cr l oadi ng i ncreased exerci se capac-
i ty and di mi ni shed the exerci se-i nduced ri se i n pl asma
l actate l evel s by del ayi ng anaerobi c gl ycol ysi s. I n con-
trast, Febbrai o et al . (5) demonstrated no si gni cant
di fferences i n ti me to exhausti on and i ntramuscul ar
l actate l evel s duri ng cycl e ergometry at 115120% of
maxi mal oxygen consumpti on rate after Cr l oadi ng i n
untrai ned men.
Fewer studi es have been conducted to determi ne the
effects of Cr l oadi ng on submaxi mal exerci se perfor-
mance (16, 18). Nel son et al . (16) recentl y reported that
Cr l oadi ng i n mal e and femal e athl etes (age range
2127 yr) resul ted i n a 12% i ncrease i n the venti l atory
threshol d as wel l as a decrease i n bl ood l actate and
ammoni a concentrati ons duri ng i ncremental cycl e er-
gometry. I n contrast, Stroud et al . (18) reported that Cr
l oadi ng had no effect on respi ratory gas exchange or
bl ood l actate accumul ati on duri ng i ncremental tread-
mi l l exerci se i n physi cal l y acti ve men. Di screpanci es i n
the l i terature regardi ng the effects of Cr l oadi ng on
performance may be attri buted to the hi ghl y vari abl e
i nteri ndi vi dual response i n muscl e Cr retenti on as a
resul t of Cr l oadi ng (1, 6). Recentl y, Casey et al . (1)
demonstrated a posi ti ve rel ati onshi p (r 0.71, P
0.05) between anaerobi c exerci se performance duri ng
cycl e ergometry and the magni tude of muscl e Cr reten-
ti on from Cr l oadi ng, and they concl uded that the
i mprovement i n anaerobi c performance was cri ti cal l y
dependent on the magni tude of muscl e Cr retenti on
fol l owi ng l oadi ng.
McCl aren et al . (13) have suggested that a decrease
i n muscl e pH, as a resul t of the accumul ati on of H

or
i ntra- and extracel l ul ar ammoni a, may be responsi bl e
for fati gue-i nduced i ncreases i n MU recrui tment and
the correspondi ng i ncrease i n EMG ampl i tude. I n
agreement, Tayl or et al . (19) al so found that, for
i ncr emental cycl e er gometr y, the accumul ati on of
pl asma l actate and ammoni a was associ ated wi th an
i ncrease i n EMG ampl i tude measured from the rectus
femori s muscl e. Therefore, there i s evi dence to suggest
that a rel i ance on anaerobi c gl ycol ysi s l eads to an
i ncrease i n EMG ampl i tude from the worki ng muscl es
as a resul t of changes i n muscl e and bl ood l actate l evel s
and the correspondi ng decrease i n pH.
I n the present study, Cr l oadi ng resul ted i n a del ay i n
the onset of NMF (as measured by the PWC
FT
test),
whi ch may have been due to the effect of el evated
muscl e PCr on the transi ti on from aerobi c to anaerobi c
metabol i sm. Prevost et al . (17) and Vol ek and Kraemer
(22) have hypothesi zed that i ncreasi ng muscl e PCr
content by Cr l oadi ng may decrease the rel i ance on
anaerobi c gl ycol ysi s, reduce i ntramuscul ar l actate accu-
mul ati on, and, therefore, del ay the onset of fati gue.
Thus the resul ts of the present study suggest that
duri ng i ncremental cycl e ergometry Cr l oadi ng may
del ay the onset of NMF and the fati gue-i nduced i n-
crease i n EMG at submaxi mal power outputs by reduc-
i ng the rel i ance on anaerobi c gl ycol ysi s and attenuat-
i ng the accumul ati on of l actate and ammoni a i n the
worki ng muscl es and bl ood.
I n summary, Cr l oadi ng resul ted i n a si gni cantl y
hi gher PWC
FT
val ue (186 W) compared wi th a Pl
(155 W), i ndi cati ng that Cr l oadi ng may del ay the onset
of NMF duri ng i ncremental cycl e ergometry i n femal e
athl etes. The del ay i n NMF may have been due to
augmented PCr l evel s i n the muscl e, whi ch may have
resul ted i n a greater capaci ty to del ay anaerobi c gl ycol y-
si s (16, 17, 22). Future studi es that woul d di rectl y
measure muscl e PCr, l actate, and ammoni um l evel s are
warranted to val i date these resul ts.
We thank Fortress I nternati onal (Omaha, NE) for fundi ng thi s
study.
Address for repri nt requests and other correspondence: J. R. Stout,
Crei ghton Uni v., Exerci se Sci ence Dept., 2500 Cal i forni a Pl ., Omaha,
NE 68178 (E-mai l : jrstout@crei ghton.edu).
Recei ved 14 May 1999; accepted i n nal form 31 August 1999.
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112 CREATI NE LOADI NG ON NEUROMUSCULAR FATI GUE