Mental fatigue is a psychobiological state caused by prolonged periods of demanding cognitive activity. Although the impact of mental fatigue on cognitive and skilled performance is well known, its effect on physical performance has not been thoroughly investigated. In this randomized crossover study, 16 subjects cycled to exhaustion at 80% of their peak power output after 90 min of a demanding cognitive task (mental fatigue) or 90 min of watching emotionally neutral documentaries (control). After experimental treatment, a mood questionnaire revealed a state of mental fatigue (P = 0.005) that significantly reduced time to exhaustion (640 +/- 316 s) compared with the control condition (754 +/- 339 s) (P = 0.003). This negative effect was not mediated by cardiorespiratory and musculoenergetic factors as physiological responses to intense exercise remained largely unaffected. Self-reported success and intrinsic motivation related to the physical task were also unaffected by prior cognitive activity. However, mentally fatigued subjects rated perception of effort during exercise to be significantly higher compared with the control condition (P = 0.007). As ratings of perceived exertion increased similarly over time in both conditions (P < 0.001), mentally fatigued subjects reached their maximal level of perceived exertion and disengaged from the physical task earlier than in the control condition. In conclusion, our study provides experimental evidence that mental fatigue limits exercise tolerance in humans through higher perception of effort rather than cardiorespiratory and musculoenergetic mechanisms. Future research in this area should investigate the common neurocognitive resources shared by physical and mental activity.

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Top walking speed (TWS) was used to compare UKA with TKA. Two groups of 23 patients, well matched for age, gender, height and weight and radiological severity were recruited based on high functional scores, more than twelve months post UKA or TKA. These were compared with 14 preop patients and 14 normal controls. Their gait was measured at increasing speeds on a treadmill instrumented with force plates. Both arthroplasty groups were significantly faster than the preop OA group. TKA patients walked substantially faster than any previously reported series of knee arthroplasties. UKA patients walked 10% faster than TKA, although not as fast as the normal controls. Stride length was 5% greater and stance time 7% shorter following UKA — both much closer to normal than TKA. Unlike TKA, UKA enables a near normal gait one year after surgery.

Purposes Post arthroplasty gait analysis has up till now been performed on subjects walking slowly on flat ground rather than challenging them at faster speeds or walking uphill. We therefore asked: (1) Is there a measurable difference in the performance of hip resurfacing arthroplasty (HRA) and total hip arthroplasty (THA) limbs at patients' self-determined fastest walking speeds and steepest inclines? and (2) Is there a relationship between the observed differences between the gait of HRA and THA implanted limbs and patient walking speeds and inclines. Methods In an ethically approved study we recruited patients with bilateral hip arthroplasties: one HRA and one THA. Nine subjects were assessed using an instrumented treadmill at a range of speeds and inclines by a blinded observer. The ground reaction forces of subjects were recorded and an age, sex and BMI matched control group was used for comparison. Results Increasing walking speed correlated strongly with between leg differences in weight acceptance (r =0.9, p = 0.000) and push-off force (r =0.79, p = 0.002). HRA implanted limbs accepted significantly more weight at top walking speeds (1208 N ± 320 versus 1279 N ± 370, p = 0.026) and pushed off with greater force when walking uphill (818 N±163 versus 855±166, p=0.012). HRA limbs more closely approximated to the gait of the normal control group. Conclusions Arthroplasty implants do have an impact on the gait characteristics of patients. Differences in gait are more likely to be evident when assessment is made at fast speeds and walking uphill. This study suggests that HRA may enable a more normal gait.