Muscle Endurance, Neuromuscular Fatigability and Cognitive Control During Prolonged Dual-Task in People With Chronic Obstructive Pulmonary Disease: A Case-Control Study

Abstract Recent studies suggest that, compared to healthy individuals, people with chronic obstructive pulmonary disease (pwCOPD) present a reduced capacity to perform cognitive-motor dual-task (CMDT). However, these studies were focused on short-duration CMDT offering limited insight to prolonged CMDT inducing fatigue, which can be encountered in daily life. The present study aimed to explore the effect of adding a cognitive task during repeated muscle contractions on muscle endurance, neuromuscular fatigability and cognitive control in pwCOPD compared to healthy participants Thirteen pwCOPD and thirteen age- and sex-matched healthy participants performed submaximal isometric contractions of the knee extensors until exhaustion in two experimental sessions: (1) without cognitive task and (2) with a concurrent working memory task (i.e., 1-back task). Neuromuscular fatigability (as well as central and peripheral components measured by peripheral magnetic stimulation), cognitive performance and perceived muscle fatigue were assessed throughout the fatiguing tasks. Independently to the experimental condition, pwCOPD exhibited lower muscle endurance compared to healthy participants (p=0.039), mainly explained by earlier peripheral fatigue and faster attainment of higher perceived muscle fatigue (p<0.05). However, neither effect of cognitive task (p=0.223) nor interaction effect (group × condition; p=0.136) was revealed for muscle endurance. Interestingly, cognitive control was significantly reduced only in pwCOPD at the end of CMDT (p<0.015), suggesting greater difficulty for patients with dual-tasking under fatigue. These findings provide novel insights into how and why fatigue develops in COPD in dual-task context, offering a rationale for including such tasks in rehabilitation programs.