Reliability of transcranial magnetic stimulation-evoked responses on knee extensor muscles during cycling

Transcranial magnetic stimulation (TMS) measures the excitability and inhibition of corticomotor networks. Despite its task-specificity, few studies have used TMS during dynamic movements and the reliability of TMS paired pulses has not been assessed during cycling. This study aimed to evaluate the reliability of motor evoked potentials (MEP) and short- and long-interval intracortical inhibition (SICI and LICI) on vastus lateralis and rectus femoris muscle activity during a fatiguing single-leg cycling task. Nine healthy adults (2 female) performed two identical sessions of counterweighted single-leg cycling at 60% peak power output until failure. Five single pulses and ten paired pulses were delivered to the motor cortex, and two maximal femoral nerve stimulations (M_max) were administered during two baseline cycling bouts (unfatigued) and every 5 min throughout cycling (fatigued). When comparing both baseline bouts within the same session, MEP·M_max⁻¹ and LICI (both ICC: >0.9) were rated excellent while SICI was rated good (ICC: 0.7–0.9). At baseline, between sessions, in the vastus lateralis, M_max (ICC: >0.9) and MEP·M_max⁻¹ (ICC: 0.7) demonstrated good reliability; LICI was moderate (ICC: 0.5), and SICI was poor (ICC: 0.3). Across the fatiguing task, M_max demonstrated excellent reliability (ICC > 0.8), MEP·M_max⁻¹ ranged good to excellent (ICC: 0.7–0.9), LICI was moderate to excellent (ICC: 0.5–0.9), and SICI remained poorly reliable (ICC: 0.3–0.6). These results corroborate the cruciality of retaining mode-specific testing measurements and suggest that during cycling, M_max, MEP·M_max⁻¹, and LICI measures are reliable whereas SICI, although less reliable across days, can be reliable within the same session.