Calcium Fluxes in Work-Related Muscle Disorder: Implications from a Rat Model.

INTRODUCTION: Ca2+ regulatory excitation-contraction coupling properties are key topics of interest in the development of work-related muscle myalgia and may constitute an underlying cause of muscle pain and loss of force generating capacity. METHOD: A well-established rat model of high repetition high force (HRHF) work was used to investigate if such exposure leads to an increase in cytosolic Ca2+ concentration ([Ca2+]i) and changes in sarcoplasmic reticulum (SR) vesicle Ca2+ uptake and release rates. RESULT: Six weeks exposure of rats to HRHF increased indicators of fatigue, pain behaviors, and [Ca2+]i, the latter implied by around 50-100% increases in pCam, as well as in the Ca2+ handling proteins RyR1 and Casq1 accompanied by an ∼10% increased SR Ca2+ uptake rate in extensor and flexor muscles compared to those of control rats. This demonstrated a work-related altered myocellular Ca2+ regulation, SR Ca2+ handling, and SR protein expression. DISCUSSION: These disturbances may mirror intracellular changes in early stages of human work-related myalgic muscle. Increased uptake of Ca2+ into the SR may reflect an early adaptation to avoid a sustained detrimental increase in [Ca2+]i similar to the previous findings of deteriorated Ca2+ regulation and impaired function in fatigued human muscle.

Effect of resistance training on headache symptoms in adults: Secondary analysis of a RCT.

BACKGROUND: While strength training for the neck and shoulder muscles may be effective in reducing headache, the optimal combination of exercise frequency and duration is unknown. This study investigates the effect of different time-wise combinations of one weekly hour of strength training for the neck and shoulder muscles on headache frequency, intensity, and use of analgesics. METHODS: A total of 573 office workers were randomly allocated at the cluster-level to five groups; 3 × 20 min a week of minimally supervised (3MS), 1 × 60 (1WS), 3 × 20 (3WS) or 9 × 7 (9WS) min a week of supervised high-intensity strength training for 20 weeks, or to a reference group without training (REF). Headache frequency, intensity, and use of analgesics in relation to headache were determined by questionnaire at baseline and follow-up. RESULTS: The intention-to-treat analysis showed reduced headache frequency and intensity of approximately 50% in all training groups compared with REF at 20-week follow-up (P < 0.001). Use of analgesics was lower in the supervised training groups (1WS, 3WS and 9WS), but not in the group with minimal training supervision (3MS), compared with REF at follow-up. CONCLUSION: One hour of specific strength training - regardless of the distribution during the week - effectively reduced both headache frequency and intensity in office workers. Thus, a large time-wise flexibility exists when implementing specific strength training at the workplace. However, only supervised training led to a reduction in use of analgesics for headache.

Occupational and leisure-time physical activity and workload among construction workers - a randomized control study.

BACKGROUND: There is a lack of quantification of occupational physical activity (OPA) and leisure time physical activity (LTPA) among construction workers. OBJECTIVES: To describe physical activity energy expenditure (PAEE), physical workload, and the effect of a PA-intervention among construction workers. METHODS: Sixty-seven Construction workers self-reported their physical activity (PA), had PA assessed directly (PAEE), and observed OPA using the tool "Posture, Activity, Tools and Handling." The PA-intervention (Intervention; n = 29, Controls; n = 24) included 3x20-min training/week for 12 weeks. RESULTS: Baseline median OPA was 5036 MET-min/week and LTPA 2842 MET-min/week, p < 0.01. OPA directly recorded was (mean ± SE): 56.6 ± 3.2 J/kg/min and LTPA was: 35.7 ± 2.2 J/kg/min (p < 0.001). Manual material handling was performed for ≥ 25% of working time by more than 50% of the participants. Post-intervention, the training group reduced overall PAEE compared to the control group but not specifically during work. CONCLUSIONS: OPA was within the maximum recommended level of 1/3 proposed in consensus guidelines but did not decrease with PA-intervention.

The August Krogh Institute: Capillaries and beyond.

Bengt Saltin knew very well the history and work of the giants whose shoulders he was standing upon, such as August Krogh and Johannes Lindhard. He was basically a physiologist interested in physical activity and exercise, particularly in the cardiovascular and muscular responses. Some of his major original contributions were (a) the human muscle model in terms of the one-legged, knee extensor quantifying work by the high-precision Krogh ergometer and, using this, challenging Krogh's proposed autoregulation of capillary blood flow during exercise; (b) the electrolyte fluxes quantification on an intra- and extra-cellular level in human muscle during exercise to reveal such changes as possible fatigue mechanisms; and (c) the evidence presented that underlined the health-enhancing effect of physical exercise training from bedside to workplace.

Neuronal nitric oxide synthase is dislocated in type I fibers of myalgic muscle but can recover with physical exercise training.

Trapezius myalgia is the most common type of chronic neck pain. While physical exercise reduces pain and improves muscle function, the underlying mechanisms remain unclear. Nitric oxide (NO) signaling is important in modulating cellular function, and a dysfunctional neuronal NO synthase (nNOS) may contribute to an ineffective muscle function. This study investigated nNOS expression and localization in chronically painful muscle. Forty-one women clinically diagnosed with trapezius myalgia (MYA) and 18 healthy controls (CON) were included in the case-control study. Subsequently, MYA were randomly assigned to either 10 weeks of specific strength training (SST, n = 18), general fitness training (GFT, n = 15), or health information (REF, n = 8). Distribution of fiber type, cross-sectional area, and sarcolemmal nNOS expression did not differ between MYA and CON. However, MYA showed increased sarcoplasmic nNOS localization (18.8 ± 12 versus 12.8 ± 8%, P = 0.049) compared with CON. SST resulted in a decrease of sarcoplasm-localized nNOS following training (before 18.1 ± 12 versus after 12.0 ± 12%; P = 0,027). We demonstrate that myalgic muscle displays altered nNOS localization and that 10 weeks of strength training normalize these disruptions, which supports previous findings of impaired muscle oxygenation during work tasks and reduced pain following exercise.

A workplace exercise versus health promotion intervention to prevent and reduce the economic and personal burden of non-specific neck pain in office personnel: protocol of a cluster-randomised controlled trial.

INTRODUCTION: Non-specific neck pain is a major burden to industry, yet the impact of introducing a workplace ergonomics and exercise intervention on work productivity and severity of neck pain in a population of office personnel is unknown. RESEARCH QUESTION: Does a combined workplace-based best practice ergonomic and neck exercise program reduce productivity losses and risk of developing neck pain in asymptomatic workers, or decrease severity of neck pain in symptomatic workers, compared to a best practice ergonomic and general health promotion program? DESIGN: Prospective cluster randomised controlled trial. PARTICIPANTS AND SETTING: Office personnel aged over 18 years, and who work>30 hours/week. INTERVENTION: Individualised best practice ergonomic intervention plus 3×20 minute weekly, progressive neck/shoulder girdle exercise group sessions for 12 weeks. CONTROL: Individualised best practice ergonomic intervention plus 1-hour weekly health information sessions for 12 weeks. MEASUREMENTS: Primary (productivity loss) and secondary (neck pain and disability, muscle performance, and quality of life) outcome measures will be collected using validated scales at baseline, immediate post-intervention and 12 months after commencement. PROCEDURE: 640 volunteering office personnel will be randomly allocated to either an intervention or control arm in work group clusters. ANALYSIS: Analysis will be on an 'intent-to-treat' basis and per protocol. Multilevel, generalised linear models will be used to examine the effect of the intervention on reducing the productivity loss in dollar units (AUD), and severity of neck pain and disability. DISCUSSION: The findings of this study will have a direct impact on policies that underpin the prevention and management of neck pain in office personnel.

Does work-site physical activity improve self-reported psychosocial workplace factors and job satisfaction? A randomized controlled intervention study.

PURPOSE: To investigate whether a work-site strength-training program has a positive effect on self-reported psychosocial workplace factors and job satisfaction. METHODS: We conducted a randomized controlled trial among laboratory technicians implementing neck and shoulder exercises for pain relief, with 199 participants in the training group and 228 in the control group. Influence at work, sense of community, time pressure, and job satisfaction were measured with the Copenhagen Psychosocial Questionnaire at baseline and post-intervention after 20 weeks. RESULTS: There was no statistically significant change in any of the four variables in the training group from baseline to follow-up (all p ≥ 0.39). When we used MANOVA to test for between-group effects over time, we did not find any statistically significant result (all p > 0.14). CONCLUSIONS: This study does not provide evidence for an effect of a work-site strength-training program on self-reported psychosocial workplace factors and job satisfaction.

The health paradox of occupational and leisure-time physical activity.

BACKGROUND: Occupational and leisure-time physical activity are considered to provide similar health benefits. The authors tested this hypothesis. METHODS: A representative sample of Danish employees (n=7144, 52% females) reported levels of occupational and leisure-time physical activity in 2005. Long-term sickness absence (LTSA) spells of ≥3 consecutive weeks were retrieved from a social-transfer payment register from 2005 to 2007. RESULTS: 341 men and 620 females experienced a spell of LTSA during the period. Cox analyses adjusted for age, gender, smoking, alcohol, body mass index, chronic disease, social support from immediate superior, emotional demands, social class and occupational or leisure-time physical activity showed a decreased risk for LTSA among workers with moderate (HR 0.85, CI 0.72 to 1.01) and high (HR 0.77, CI 0.62 to 0.95) leisure-time physical activity in reference to those with low leisure-time physical activity. In contrast, an increased risk for LTSA was shown among workers with moderate (HR 1.59, CI 1.35 to 1.88) and high (HR 1.84, CI 1.55 to 2.18) occupational physical activity referencing those with low occupational physical activity. CONCLUSION: The hypothesis was rejected. In a dose-response manner, occupational physical activity increased the risk for LTSA, while leisure-time physical activity decreased the risk for LTSA. The findings indicate opposing effects of occupational and leisure-time physical activity on global health.

Work related perceived stress and muscle activity during standardized computer work among female computer users.

The current study investigated the associations between work-related perceived stress and surface electromyographic (sEMG) parameters (muscle activity and muscle rest) during standardized simulated computer work (typing, editing, precision, and Stroop tasks). It was part of the European case-control study, NEW (Neuromuscular assessment in the Elderly Worker). The present cross-sectional study was based on a questionnaire survey and sEMG measurements among Danish and Swedish female computer users aged 45 or older (n=49). The results show associations between work-related perceived stress and trapezius muscle activity and rest during standardized simulated computer work, and provide partial empirical support for the hypothesized pathway of stress induced muscle activity in the association between an adverse psychosocial work environment and musculoskeletal symptoms in the neck and shoulder.

Selective activation of neuromuscular compartments within the human trapezius muscle.

Task-dependent differences in relative activity between "functional" subdivisions within human muscles are well documented. Contrary, independent voluntary control of anatomical subdivisions, termed neuromuscular compartments is not observed in human muscles. Therefore, the main aim of this study was to investigate whether subdivisions within the human trapezius can be independently activated by voluntary command using biofeedback guidance. Bipolar electromyographical electrodes were situated on four subdivisions of the trapezius muscle. The threshold for "active" and "rest" for each subdivision was set to >12% and <1.5% of the maximal electromyographical amplitude recorded during a maximal voluntary contraction. After 1h with biofeedback from each of the four trapezius subdivisions, 11 of 15 subjects learned selective activation of at least one of the four anatomical subdivisions of the trapezius muscle. All subjects managed to voluntarily activate the lower subdivisions independently from the upper subdivisions. Half of the subjects succeeded to voluntarily activate both upper subdivisions independently from the two lower subdivisions. These findings show that anatomical subdivisions of the human trapezius muscle can be independently activated by voluntary command, indicating neuromuscular compartmentalization of the trapezius muscle. The independent activation of the upper and lower subdivisions of the trapezius is in accordance with the selective innervation by the fine cranial and main branch of the accessory nerve to the upper and lower subdivisions. These findings provide new insight into motor control characteristics, learning possibilities, and function of the clinically relevant human trapezius muscle.

Responses of algesic and metabolic substances to 8 h of repetitive manual work in myalgic human trapezius muscle.

The trapezius muscle often develops pain as the result of repetitive and stressful work tasks although it is unclear to what extent this pain is due to alterations in muscle concentrations of algesic/nociceptive substances. Twenty women with chronic neck- and shoulder pain (TM) whose work required highly repetitive work tasks and 20 pain-free female colleagues (CON) were studied during and after a full 8-hour workday. We collected microdialysates from their dominant/most painful trapezius muscle; concentrations of serotonin, glutamate, lactate, pyruvate, potassium, bradykinin, and cytokines and blood flow were determined. In addition, we measured surface electromyogram, task exposure level, pain intensity, perceived mental stress, and urine-cortisol. In connection to the clinical neck and shoulder examination, we determined pressure pain thresholds (PPTs) over the trapezius and tibialis muscles. TM had higher concentrations of glutamate (71+/-42 vs. 36+/-15 micromol l(-1)) and pyruvate (187+/-89 vs. 125+/-63 micromol l(-1)) than CON. Interstitial serotonin was higher in TM (before work: 10.6+/-10.8 vs. 2.2+/-1.2 nM; after work: 9.2+/-8.3 vs. 1.5+/-2.9 nM). The trapezius blood flow during the working day was higher in TM than in CON. TM had lower PPT and higher pain intensity throughout the working day. No differences in EMG, task exposure level, mental stress, or urine-cortisol in the groups were found. These findings support the idea that peripheral nociceptive processes are activated in occupationally active subjects, who are diagnosed with trapezius myalgia. In contrast, no sign of low blood flow or increased stress or muscle activity markers were found in TM.

Eye blink frequency during different computer tasks quantified by electrooculography.

The purpose of the study was to evaluate electrooculography (EOG) as an automatic method to measure the human eye blink frequency (BF) during passive and interactive computer tasks performed at two screen heights. Ten healthy subjects (5 males and 5 females) participated in the study in a 23 degrees C temperature and 30-35% relative humidity controlled simulated office environment. Each test subject completed a 2 x 10 min active task of computer work and a 3 x 10 min passive task of watching a film on a video display unit (VDU). Both tasks included two viewing angles: standard (the monitors' upper edge was in the same height as the subjects' eyes) and low (lowered by 25 degrees). EOG signals were recorded with two Ag/AgCl surface electrodes positioned above and below the right eye, and a reference electrode was placed behind the ear. The experiments were video filmed, and eye blinks were counted manually from the video recordings and compared to the EOG measurements. The method showed a high validity to detect blinks during computer work: 95.4% of the blinks were retrieved by the EOG method and very few artefacts from eye movements were erroneously classified as eye blinks (2.4%). By use of the EOG method, the computer task was found to significantly decrease the BF by 69% compared to the passive task (P < 0.001), and a small decrease (12-14%) was found by lowering the viewing angle by 25 degrees.

Trapezius muscle rest time during standardised computer work--a comparison of female computer users with and without self-reported neck/shoulder complaints.

Work related musculoskeletal disorders (WMSDs) in the shoulder/neck area are a common and increasing problem among European computer workers, especially women. Long-term low-level workloads with low degree of muscle rest are a potential risk factor for developing WMSDs. The purpose of the present study of female computer users (age 45-65 years) in Denmark and Sweden was to investigate if subjects with self-reported neck/shoulder complaints (cases, N=35) show less trapezius muscle relative rest time (RRT) than controls (N=44) when performing standardised short-term computer work tasks in controlled laboratory conditions. Surface electromyography (EMG) signals were recorded bilaterally from the upper trapezius muscles during a type, edit, precision and colour word stress task. Besides RRT, 10th percentile RMS values were calculated. On the average, 15 of the cases and 18 of the controls showed analysable EMG files per task. For the colour word stress task, the results showed lower RRT values and higher 10th percentile RMS amplitude levels among cases compared to controls. No such signs could be found for the other tasks performed. The present results indicate an increased motor response to a psychological stressor among subjects with self-reported neck/shoulder complaints.

Relationship between efficiency and pedal rate in cycling: significance of internal power and muscle fiber type composition.

Cycling was performed to test the following two hypotheses: (1) muscular efficiency is unrelated to pedal rate (61, 88, and 115 r.p.m.) for a group of subjects with a wide range of slow twitch (ST) fibers in spite of decreasing whole-body efficiency and (2) muscular efficiency correlates positively with % ST muscle fibers, and this correlation is more pronounced at low pedal rates than at high pedal rates. Whole-body gross efficiency decreased from 20-22% at 61 r.p.m. to 15-18% at 115 r.p.m. Mean muscular efficiency for all subjects (n=16) was approximately 26%, with delta efficiency being constant and muscular efficiency (taking internal power into account) slightly increasing with pedal rate. Muscular efficiency correlated positively (R(2)=0.25) with % ST fibers (21-97% ST in m. vastus lateralis) at 115 r.p.m. while not at 61 and 88 r.p.m. In conclusion, the decrease in whole-body gross efficiency with increasing pedal rate was not explained by a decrease in muscular efficiency, and supported increase in internal power to account for the increase in metabolic power with increasing pedal rate. Furthermore, differences between individuals in muscle fiber type composition affected muscular efficiency, which correlated positively with % ST muscle fibers during fast pedalling.

Surface mechanomyogram amplitude is not attenuated by intramuscular pressure.

The electromyogram (EMG) and intramuscular pressure (IMP) increase linearly with force during voluntary static contractions, while the surface mechanomyogram (MMG) increases linearly only up to approximately 70% of the maximal voluntary contraction (MVC) and then levels off. The aim of this study was to investigate the possible influence of IMP on the non-linear MMG increase with force and hence on the signal generation process. Seven subjects performed static contractions of the elbow flexors during: (1) ramp contractions from 0 to 60% of the MVC, and (2) steps at 10, 20 and 40% of the MVC. An external pressure of 0 and 50 mmHg for the ramps or 0, 20, 40, 60, 80 and 100 mmHg for the steps was applied by means of a sphygmomanometer cuff in separate trials. The EMG and the MMG were detected in the biceps brachii by means of a pair of surface electrodes and an accelerometer. The IMP was measured using a Millar tipped pressure transducer, and the data was presented as the mean and standard deviation in each case. The IMP was strongly and linearly related to the external pressure and contraction force both during ramps and steps. The EMG(rms) and MMG(rms) were never reduced as a consequence of the IMP increments. In contrast, a steeper MMG(rms) versus %MVC relationship during ramps at 50 mmHg cuff pressure, and an influence of the cuff pressure at 40% of MVC on MMG(rms) were evident. We conclude that IMP per se does not attenuate the MMG generation process during voluntary contraction, suggesting that the previously described MMG(rms) decrease at near maximal static efforts must be attributed to other determinants, such as a fusion-like situation due to the high motor unit firing rate.

Clinical signs and physical function in neck and upper extremities among elderly female computer users: the NEW study.

The aim of the study was to present the prevalence of clinical signs and symptoms among female computer users above 45 years, both in a group with self-reported neck/shoulder trouble (NS cases) and in a group without such trouble (NS controls). The hypothesis was that computer users with self-reported neck/shoulder trouble have more clinical findings than those not reporting trouble, and that a corresponding pattern holds true for physical function. In total 42 and 61 questionnaire-defined NS cases and NS controls participated and went through a clinical examination of the neck and upper extremities and five physical function tests: maximal voluntary contraction (MVC) of shoulder elevation, abduction, and handgrip, as well as endurance at 30% MVC shoulder elevation and a physical performance test. Based on clinical signs and symptoms, trapezius myalgia (38%), tension neck syndrome (17%) and cervicalgia (17%) were the most frequent diagnoses among NS cases, and were significantly more frequent among NS cases than NS controls. A total of 60% of the subjects with reported trouble had one or several of the diagnoses located in the neck/shoulder. Physical function of the shoulder was lower in subjects with self-reported trouble as well as in the subgroup of NS cases with clinical diagnoses. In conclusion, the present clinical diagnoses and physical function tests differed between NS cases and NS controls, and are therefore recommended to be included as quantitative objective measures in assessing musculoskeletal health. Physical function tests should be further developed in order to be able to detect pre-stages of work-related disorders for preventive strategies.

Neuromuscular assessment in elderly workers with and without work related shoulder/neck trouble: the NEW-study design and physiological findings.

Musculoskeletal disorders in the neck and shoulder area are a major occupational concern in the European countries especially among elderly females. The aim was to assess these disorders based on quantitative EMG indicators and functional tests. 252 female computer users (45-68 years) were recruited from four European countries in two contrast groups: (1) 88 neck/shoulder (NS) cases reporting trouble in the neck and/or shoulder region for more than 30 days during the last year, and (2) 164 NS-controls reporting such trouble for no more than 7 days. Questionnaires, functional/clinical tests, and physiological recordings were performed in workplace related field studies. The results showed no differences in anthropometrics but NS-cases reported more strained head positions and more eye problems than controls. The psychosocial working factors were similar, although, NS-controls had slightly better scores on working conditions, general health, and vitality compared to cases. The NS-cases had lower maximal voluntary contraction (MVC) during shoulder elevation (mean (SD) 310 (122) N) compared to the controls (364 (122) N). During 30% MVC electromyography (EMGrms) in the trapezius muscle was lower in NS-cases (194 (105) muV) than in controls (256 (169) muV), while no differences were found regarding endurance time. Estimated conduction velocity was not different between NS-cases and -controls. Four functional computer tests were performed equally well by NS-cases and -controls, and the corresponding EMG variables also did not differ. A major finding in this large-scale epidemiological study is the significantly lower MVC in NS-cases compared with NS-controls together with lower EMGrms value at 30% MVC, while computer tasks were performed at similar relative muscle activation. The study was unable to reveal quantitative EMG indicators and functional tests that could objectively assess disorders in NS-cases.

Intramuscular pressure and tissue oxygenation during low-force static contraction do not underlie muscle fatigue.

AIM: To test the hypothesis that time-wise increase in intramuscular pressure (IMP) and subsequent decrease in muscle tissue oxygenation (TO(2)) results in muscle fatigue development during a non-exhaustive, low-force contraction evidenced by changes in electromyogram (EMG) and particular mechanomyogram (MMG). METHODS: Seven subjects performed static elbow flexion at 10% maximal voluntary contraction (MVC) for 10 min (10% MVC(10 min)). Surface EMG, MMG, IMP and TO(2) measured by near-infrared spectroscopy was recorded from m. biceps brachii during 10% MVC(10 min) and during 5% MVC test contractions of 1 min duration performed before 10% MVC(10 min), 10 and 30 min post-exercise. EMG and MMG were analysed for root mean square (rms) and mean power frequency (mpf). RESULTS: During 10% MVC(10 min) MMGrms increased from initial level of 0.04 +/- 0.01 to 0.11 +/- 0.07 m s(-2) in the last minute and MMGmpf and EMGmpf decreased from 34.9 +/- 8.2 to 21.3 +/- 3.8 Hz and from 71.7 +/- 10.9 to 61.7 +/- 10.0 Hz respectively. Similar changes were present in 5% MVC test contractions 30 min post-exercise. Initially, TO(2) decreased by 6.9 +/- 6.5% of resting level but returned to rest within 1 min. IMP remained constant during the contraction after an initial fourfold increase from resting level of 12.2 +/- 10.4 mmHg. CONCLUSIONS: IMP was anticipated to increase with time of contraction due to e.g. increased muscle water content; but this was not confirmed. Consequently, muscle blood flow was unlikely to be impeded with contraction time, which may account for the maintenance of TO(2). Thus, decreased TO(2) did not underlie either acute or long-term muscle fatigue development evidenced by changes in EMG and particular MMG variables.

Interstitial muscle lactate, pyruvate and potassium dynamics in the trapezius muscle during repetitive low-force arm movements, measured with microdialysis.

AIM: Local muscle metabolic responses to repetitive low-force contractions and to intense static contractions were studied by microdialysis in humans. METHODS: Microdialysate and electromyography (EMG) were sampled from the trapezius muscle, mixed venous blood samples were taken and perceived exertion was rated (0-9) before and during 20 min of standardized repetitive arm movement (REP), 60 min recovery (R1), and 10 min 90 degrees sustained arm position (SUS) at 20% maximum voluntary contraction, followed by 60 min recovery (R2) in six healthy male participants (28-33 years). RESULTS: Average muscle activity was 8 +/- 2% of EMGmax-RMS (mean +/-SEM) during REP and 22 +/- 5% of EMGmax-RMS during SUS. Perceived exertion increased from 0 to 3.2 +/- 0.5 during REP and from 0 to 8.5 +/- 0.3 during SUS. During REP interstitial muscle lactate increased from 2.1 +/- 0.2 to 2.9 +/- 0.2 mmol L(-1) (P < 0.001) and returned to the baseline level during R1, while dialysate [K+] increased from 3.8 +/- 0.2 to 4.7 +/- 0.2 mmol L(-1) (P < 0.002) and returned to 3.8 +/- 0.2 mmol L(-1) during R1. In contrast, plasma lactate and [K+] remained unchanged. During SUS interstitial muscle lactate increased from 2.3 +/- 0.2 to 3.3 +/- 0.3 mmol L(-1) (P < 0.003), increased further to 6.5 +/- 1.3 mmol L(-1) post-exercise (P < 0.001) and returned to baseline levels during R2. Dialysate [K+] increased from 3.9 +/- 0.2 to 4.6 +/- 0.2 mmol L(-1) (P < 0.05) and returned to baseline level during R2. Plasma lactate increased significantly during SUS whereas plasma [K+] was unchanged. During REP and SUS interstitial pyruvate was unchanged but increased in the post-exercise period proportional to the exercise intensity. CONCLUSIONS: The microdialysis technique was effective in revealing muscle metabolic events that were not found systemically. Furthermore, the trapezius muscle showed an anaerobic metabolism during low-force contraction, which could indicate inhomogeneous muscle activation.