Engagement in muscular strengthening activities is associated with better sleep

Few studies have examined whether engagement in muscular strengthening activities is associated with sleep duration, which was the purpose of this study. Data from the population-based 2005–2006 National Health and Nutrition Examination Survey were used, which included an analytic sample of 4386 adults (20–85 yrs). Sleep duration and engagement in muscle strengthening activities was self-reported. After adjustments (including aerobic-based physical activity), those engaging in muscular strength activities, compared to those not engaging in muscular strengthening activities, had an 19% increased odds of meeting sleep guidelines (7–8 h/night) (Odds Ratio = 1.19, 95% Confidence Interval: 1.01–1.38, P = 0.04). Promotion of muscular strengthening activities by clinicians should occur not only for improvements in other aspects of health (e.g., cardiovascular benefits), but also to help facilitate optimal sleep duration.

Effect of stretching with and without muscle strengthening exercises for the foot and hip in patients with plantar fasciitis: A randomized controlled single-blind clinical trial

OBJECTIVE

To compare the effect of stretching with and without muscle strengthening of the foot alone or foot and hip on pain and function in patients with plantar fasciitis.

DESIGN

Single blind randomized controlled trial.

METHOD

Eighty-three patients with plantar fasciitis were allocated to one of three treatment options for an eight-week period: Foot Exercise Group (FEG - extrinsic and intrinsic foot muscles), Foot and Hip Exercise Group (FHEG - abductor and lateral rotator muscles) and Stretching Alone Exercise Group (SAEG).

MAIN MEASURES

A visual analog scale for pain, the Foot and Ankle Outcome Score and the Star Excursion Balance Test. All evaluations were performed before treatment and after the last treatment session.

RESULTS

Improvements were found in all groups regarding the visual analog scale, the pain, activities of daily living, sports and recreation, quality of life (p < 0.001) and other symptoms (p < 0.01) subscales of the Foot and Ankle Outcome Score as well as posterolateral movement, posteromedial movement and composite score (p < 0.001) on the Star Excursion Balance Test. No time-group interactions were found for any of the variables (p > 0.05).

CONCLUSIONS

All three exercise protocols analyzed led to improvements at eight-week follow-up in pain, function and dynamic lower limb stability in patients with plantar fasciitis.

The Preventive Effects of 8 Weeks of Resistance Training on Glucose Tolerance and Muscle Fiber Type Composition in Zucker Rats

BACKGROUND

We investigated the therapeutic effects of resistance training on Zucker rats before and after the onset of diabetes to understand the importance of the timing of exercise intervention. We assessed whether 8 weeks of resistance training ameliorated impaired glucose tolerance and altered muscle fiber type composition in Zucker rats.

METHODS

Five-week-old male Zucker rats were divided into Zucker lean control (ZLC-Con), non-exercised Zucker diabetic fatty (ZDF-Con), and exercised Zucker diabetic fatty (ZDF-Ex) groups. The ZDF-Ex rats climbed a ladder three times a week for 8 weeks. Intraperitoneal glucose tolerance tests (IPGTT) were performed on the 1st and 8th weeks of training, and grip strength was measured during the last week. We also measured glucose transporter 4 (GLUT4) expression by Western blot and immunofluorescence. Moreover, immunohistochemistry was performed to assess muscle fiber type composition.

RESULTS

Fasting glucose levels and area under the curve responses to IPGTTs gradually increased as diabetes progressed in the ZDF-Con rats but decreased in the ZDF-Ex rats. Grip strength decreased in the ZDF-Con rats. However, resistance training did not improve grip strength in the ZDF-Ex rats. GLUT4 expression in the ZLC-Con and the ZDF-Con rats did not differ, but it increased in the ZDF-Ex rats. The proportions of myosin heavy chain I and II were lower and higher, respectively, in the ZDF-Con rats compared to the ZLC-Con rats. Muscle fiber type composition did not change in the ZDF-Ex rats.

CONCLUSION

Our results suggest that regular resistance training initiated at the onset of diabetes can improve glucose tolerance and GLUT4 expression without changing muscle morphology in Zucker rats.

Can specific loading through exercise impart healing or regeneration of the intervertebral disc?

BACKGROUND CONTEXT

Low back pain (LBP) is highly prevalent and presents an enormous cost both through direct health care and indirectly through significant work and production loss. Low back pain is acknowledged widely to be a multifactorial pathology with a variety of symptoms, dysfunctions, and a number of possible sources of pain. One source that has been suspected and evidenced for some time is the intervertebral disc. Some degree of disc degeneration is a physiologic process associated with aging, however, more severe degeneration and/or structural abnormality may be indicative of a pathologic process or injury and is more commonly present in those suffering from LBP. Much like other tissues (ie, muscle, bone, etc.), it has been suspected that there exists an optimal loading strategy to promote the health of the disc. Exercise is often prescribed for LBP and effectively reduces pain and disability. However, whether specific loading through exercise might plausibly heal or regenerate the intervertebral discs is unknown.

PURPOSE

To examine the effects of loading on regenerative processes in the intervertebral disc and consider the potential for specific exercise to apply loading to the lumbar spine to produce these effects.

STUDY DESIGN

A brief narrative literature review.

METHODS

Studies examining the effects of loading on the intervertebral discs were reviewed to examine the plausibility of using loading through exercise to induce regeneration or healing of the intervertebral disc.

RESULTS

Research from animal model studies suggests the existence of a dose-response relationship between loading and regenerative processes. Although high loading at high volumes and frequencies might accelerate degeneration or produce disc injury, high loading, yet of low volume and at low frequency appears to induce potentially regenerative mechanisms, including improvements in disc proteoglycan content, matrix gene expression, rate of cell apoptosis, and improved fluid flow and solute transport.

CONCLUSIONS

Research suggests a dose-response relationship between loading and disc regenerative processes and that the loading pattern typically used in the lumbar extension resistance exercise interventions (high load, low volume, and low frequency) might impart healing or regeneration of the intervertebral discs. Future research should examine an exercise intervention with in vivo measurement of changes in disc condition. This may provide further evidence for the "black box" of treatment mechanisms associated with exercise interventions.

Partial rotator cuff injury in athletes: bursal or articular?

A painful shoulder is a very common complaint among athletes, especially in the case of those in sports involving throwing. Partial lesions of the rotator cuff may be very painful and cause significant functional limitation to athletes’ sports practice. The incidence of partial lesions of the cuff is variable (13–37%). It is difficult to make the clinical and radiological diagnosis, and this condition should be borne in mind in the cases of all athletes who present symptoms of rotator cuff syndrome, including in patients who are diagnosed only with tendinopathy.

Objective

To evaluate the epidemiological behavior of partial lesions of the rotator cuff in both amateur and professional athletes in different types of sports.

Methods

We evaluated 720 medical files on athletes attended at the shoulder service of the Discipline of Sports Medicine at the Sports Traumatology Center, Federal University of São Paulo. The majority of them were men (65%). Among all the patients, 83 of them were diagnosed with partial lesions of the rotator cuff, by means of ultrasonography or magnetic resonance, or in some cases using both. We applied the binomial test to compare the proportions found.

Result

It was observed that intra-articular lesions predominated (67.6%) and that these occurred more frequently in athletes in sports involving throwing (66%). Bursal lesions occurred in 32.4% of the athletes, predominantly in those who did muscle building (75%).

Conclusion

Intra-articular lesions are more frequent than bursal lesions and they occur predominantly in athletes in sports involving throwing, while bursal lesions were more prevalent in athletes who did muscle building.

Movement velocity as a measure of exercise intensity in three lower limb exercises

The purpose of this study was to investigate the relationship between movement velocity and relative load in three lower limbs exercises commonly used to develop strength: leg press, full squat and half squat. The percentage of one repetition maximum (%1RM) has typically been used as the main parameter to control resistance training; however, more recent research has proposed movement velocity as an alternative. Fifteen participants performed a load progression with a range of loads until they reached their 1RM. Maximum instantaneous velocity (Vmax) and mean propulsive velocity (MPV) of the knee extension phase of each exercise were assessed. For all exercises, a strong relationship between Vmax and the %1RM was found: leg press (r(2)adj = 0.96; 95% CI for slope is [-0.0244, -0.0258], P < 0.0001), full squat (r(2)adj = 0.94; 95% CI for slope is [-0.0144, -0.0139], P < 0.0001) and half squat (r(2)adj = 0.97; 95% CI for slope is [-0.0135, -0.00143], P < 0.0001); for MPV, leg press (r(2)adj = 0.96; 95% CI for slope is [-0.0169, -0.0175], P < 0.0001, full squat (r(2)adj = 0.95; 95% CI for slope is [-0.0136, -0.0128], P < 0.0001) and half squat (r(2)adj = 0.96; 95% CI for slope is [-0.0116, 0.0124], P < 0.0001). The 1RM was attained with a MPV and Vmax of 0.21 ± 0.06 m s(-1) and 0.63 ± 0.15 m s(-1), 0.29 ± 0.05 m s(-1) and 0.89 ± 0.17 m s(-1), 0.33 ± 0.05 m s(-1) and 0.95 ± 0.13 m s(-1) for leg press, full squat and half squat, respectively. Results indicate that it is possible to determine an exercise-specific %1RM by measuring movement velocity for that exercise.

Dose-and gender-specific effects of resistance training on circulating levels of brain derived neurotrophic factor (BDNF) in community-dwelling older adults

BACKGROUND

BDNF is known to induce neuroplasticity and low circulating levels have been related to neuronal loss in older persons. Physical exercise is thought to trigger BDNF-induced neuroplasticity, but conflicting observations have been reported regarding the effects of resistance training on circulating BDNF in the elderly. These conflicting observations might reflect dose-and gender-specific differences.

METHOD

Fifty-six apparently healthy elderly (68 ± 5 years) participants were randomized to 12 weeks of resistance training (3×/week) at either high-resistance (HIGH, 8 Males, 10 Females, 2 × 10-15 repetitions at 80% 1 RM), low-resistance (LOW, 9 Males, 10 Females, 1 × 80-100 repetitions at 20% 1 RM), or mixed low-resistance (LOW+, 9 Males, 10 Females, 1 × 60 repetitions at 20% 1 RM followed by 1 × 10-20 repetitions at 40% 1 RM). Serum was collected for BDNF assay at baseline and after 12 weeks (24 h-48 h after the last training).

RESULTS

12 weeks of LOW+ exercise significantly increased BDNF levels in male (from 34.9 ± 10.7 ng/mL to 42.9 ± 11.9 ng/mL, time × group interaction p=0.013), but not in female participants. No significant change was observed in HIGH or LOW, neither in male nor female subjects.

CONCLUSION

Our results show that only the mixed-low-resistance training program with a very high number of repetitions at a sufficiently high external resistance was able to increase circulating BDNF in older male participants. Training to volitional fatigue might be necessary to obtain optimal results. Additional studies are needed to unravel the underlying mechanisms, as well as to confirm the observed gender difference.

The relevance of applying exercise training principles when designing therapeutic interventions for patients with inflammatory myopathies: a systematic review

Physical exercise seems to be a safe and effective intervention in patients with inflammatory myopathy (IM). However, the optimal training intervention is not clear. To achieve an optimum training effect, physical exercise training principles must be considered and to replicate research findings, FITT components (frequency, intensity, time, and type) of exercise training should be reported. This review aims to evaluate exercise interventions in studies with IM patients in relation to (1) the application of principles of exercise training, (2) the reporting of FITT components, (3) the adherence of participants to the intervention, and (4) to assess the methodological quality of the included studies. The literature was searched for exercise studies in IM patients. Data were extracted to evaluate the application of the training principles, the reporting of and the adherence to the exercise prescription. The Downs and Black checklist was used to assess methodological quality of the included studies. From the 14 included studies, four focused on resistance, two on endurance, and eight on combined training. In terms of principles of exercise training, 93 % reported specificity, 50 % progression and overload, and 79 % initial values. Reversibility and diminishing returns were never reported. Six articles reported all FITT components in the prescription of the training though no study described adherence to all of these components. Incomplete application of the exercise training principles and insufficient reporting of the exercise intervention prescribed and completed hamper the reproducibility of the intervention and the ability to determine the optimal dose of exercise.

Non-surgical treatment of pain associated with posterior tibial tendon dysfunction: study protocol for a randomised clinical trial

Background

Symptoms associated with pes planovalgus or flatfeet occur frequently, even though some people with a flatfoot deformity remain asymptomatic. Pes planovalgus is proposed to be associated with foot/ankle pain and poor function. Concurrently, the multifactorial weakness of the tibialis posterior muscle and its tendon can lead to a flattening of the longitudinal arch of the foot. Those affected can experience functional impairment and pain. Less severe cases at an early stage are eligible for non-surgical treatment and foot orthoses are considered to be the first line approach. Furthermore, strengthening of arch and ankle stabilising muscles are thought to contribute to active compensation of the deformity leading to stress relief of soft tissue structures. There is only limited evidence concerning the numerous therapy approaches, and so far, no data are available showing functional benefits that accompany these interventions.

Methods

After clinical diagnosis and clarification of inclusion criteria (e.g., age 40–70, current complaint of foot and ankle pain more than three months, posterior tibial tendon dysfunction stage I & II, longitudinal arch flattening verified by radiography), sixty participants with posterior tibial tendon dysfunction associated complaints will be included in the study and will be randomly assigned to one of three different intervention groups: (i) foot orthoses only (FOO), (ii) foot orthoses and eccentric exercise (FOE), or (iii) sham foot orthoses only (FOS). Participants in the FOO and FOE groups will be allocated individualised foot orthoses, the latter combined with eccentric exercise for ankle stabilisation and strengthening of the tibialis posterior muscle. Participants in the FOS group will be allocated sham foot orthoses only. During the intervention period of 12 weeks, all participants will be encouraged to follow an educational program for dosed foot load management (e.g., to stop activity if they experience increasing pain). Functional impairment will be evaluated pre- and post-intervention by the Foot Function Index. Further outcome measures include the Pain Disability Index, Visual Analogue Scale for pain, SF-12, kinematic data from 3D-movement analysis and neuromuscular activity during level and downstairs walking. Measuring outcomes pre- and post-intervention will allow the calculation of intervention effects by 3×3 Analysis of Variance (ANOVA) with repeated measures.

Discussion

The purpose of this randomised trial is to evaluate the therapeutic benefit of three different non-surgical treatment regimens in participants with posterior tibial tendon dysfunction and accompanying pes planovalgus. Furthermore, the analysis of changes in gait mechanics and neuromuscular control will contribute to an enhanced understanding of functional changes and eventually optimise conservative management strategies for these patients.

Trial registration

ClinicalTrials.gov Protocol Registration System: ClinicalTrials.gov ID NCT01839669

Acute response to cluster sets in trained and untrained men

PURPOSE

In traditional sets (TRD) repetitions are performed continuously, whereas cluster sets (CLU) allow a brief rest between groups of repetitions. We investigated the acute mechanical, metabolic, and hormonal response to CLU in men.

METHODS

Twelve resistance-trained (RT) and 11 untrained (UT) men performed TRD (4 × 10 repetitions with 2 min rest) and CLU [4 × (2 × 5) with 1.5 min rest between sets 30 s rest between clusters] at 70 % 1RM back squat in random order. Seven days separated trials. Average power and time under tension (TUT) were calculated. Blood was sampled pre, sets 1, 2, and 3; immediate post-exercise, 5, 15, 30, 60 min post-exercise for blood lactate, total testosterone (TT), free testosterone (FT), growth hormone (GH), and cortisol.

RESULTS

CLU produced greater average power at an increasing number of repetitions over each set with greater total volume load. TUT was shorter for RT and lower for CLU in repetitions 1, 6, 7, 8. Blood lactate was higher Set 2 through 30 min in TRD. RT had higher TT; however, the time course was similar between RT and UT. TT and FT increased immediate post-exercise and remained elevated 30 min in both conditions. GH was significantly greater during TRD with a similar pattern observed in both conditions. Cortisol was significantly lower at 30 min in CLU.

CONCLUSION

CLU allowed greater total volume load, shorter TUT, greater average power, similar anabolic hormonal response, and less metabolic stress. The acute response was similar despite training status.

Core muscle activity in a series of balance exercises with different stability conditions

Literature that provides progression models based on core muscle activity and postural manipulations is scarce. The purpose of this study was to investigate the core muscle activity in a series of balance exercises with different stability levels and additional elastic resistance. A descriptive study of electromyography (EMG) was performed with forty-four healthy subjects that completed 12 exercises in a random order. Exercises were performed unipedally or bipedally with or without elastic tubing as resistance on various unstable (uncontrolled multiaxial and uniaxial movement) and stable surfaces. Surface EMG on the lumbar multífidus spinae (LM), thoracic multífidus spinae (TM), lumbar erector spinae (LE), thoracic erector spinae (TE) and gluteus maximus (GM), on the dominant side of the body were collected to quantify the amount of muscle activity and were expressed as a % of the maximum voluntary isometric contraction (MVIC). Significant differences (p<.001) were found between exercises. The three unipedal standing exercises with additional elastic resistance generated the greatest EMG values, ranging from 19% MVIC to 30% MVIC. Postural manipulations with additional elastic resistance and/or unstable devices increase core muscle activity. An adequate exercise progression based on global core EMG could start with seated positions, progressing to bipedal standing stance (i.e., from either multiaxial or stable surface to uniaxial surface). Following this, unipedal standing positions may be performed (i.e., from either multiaxial or stable surface to uniaxial surface) and finally, elastic resistance must be added in order to increase EMG levels (i.e., from stable surface progressing to any of the used unstable surfaces).

FAST CP: protocol of a randomised controlled trial of the efficacy of a 12-week combined Functional Anaerobic and Strength Training programme on muscle properties and mechanical gait deficiencies in adolescents and young adults with spastic-type cerebral palsy

INTRODUCTION

Individuals with cerebral palsy (CP) have muscles that are smaller, weaker and more resistant to stretch compared to typically developing people. Progressive resistance training leads to increases in muscle size and strength. In CP, the benefits of resistance training alone may not transfer to improve other activities such as walking; however, the transfer of strength improvements to improved mobility may be enhanced by performing training that involves specific functional tasks or motor skills. This study aims to determine the efficacy of combined functional anaerobic and strength training in (1) influencing muscle strength, structure and function and (2) to determine if any changes in muscle strength and structure following training impact on walking ability and gross motor functional capacity and performance in the short (following 3 months of training) and medium terms (a further 3 months post-training).

METHODS AND ANALYSIS

40 adolescents and young adults with CP will be recruited to undertake a 12-week training programme. The training programme will consist of 3 × 75 min sessions per week, made up of 5 lower limb resistance exercises and 2-3 functional anaerobic exercises per session. The calf muscles will be specifically targeted, as they are the most commonly impacted muscles in CP and are a key muscle group involved in walking. If, as we believe, muscle properties change following combined strength and functional training, there may be long-term benefits of this type of training in slowing the deterioration of muscle function in people with spastic-type CP.

ETHICS AND DISSEMINATION

Ethical approval has been obtained from the ethics committees at The University of Queensland (2014000066) and Children's Health Queensland (HREC/15/QRCH/30). The findings will be disseminated by publications in peer-reviewed journals, conferences and local research organisations' media.

TRIAL REGISTRATION NUMBER

Australian and New Zealand Clinical Trials Registry (ACTRN12614001217695).

Freely chosen stride frequencies during walking and running are not correlated with freely chosen pedalling frequency and are insensitive to strength training

Despite biomechanical differences between walking, running, and cycling, these types of movement are supposedly generated by shared neural networks. According to this hypothesis, we investigated relationships between movement frequencies in these tasks as well as effects of strength training on locomotion behaviour. The movement frequencies during walking, running, and cycling were 58.1±2.6 strides min(-1), 81.3±4.4 strides min(-1), and 77.2±11.5 revolutions min(-1), respectively (n=27). Stride frequencies in walking and running correlated positively (r=0.72, p<0.001) while no significant correlations were found between stride frequencies during walking and running, respectively, and pedalling frequency (r=0.16, p=0.219 and r=0.04, p=0.424). Potential changes in the freely chosen stride frequencies and stride phase characteristics were also investigated during walking and running through 4 weeks of (i) hip extension strength training (n=9), (ii) hip flexion strength training (n=9), and (iii) no intervention (n=9). Results showed that stride characteristics were unaffected by strength training. That is in contrast to previous observations of decreased pedalling frequency following strength training. In total, these results are proposed to indicate that walking and running movements are robustly generated due to an evolutionary consolidation of the interaction between the musculoskeletal system and neural networks. Further, based on the present results, and the fact that cycling is a postnatally developed task that likely results in a different pattern of descending and afferent input to rhythm generating neural networks than walking and running, we propose pedalling to be generated by neural networks mainly consolidated for locomotion.

Theory-based approach for maintaining resistance training in older adults with prediabetes: adherence, barriers, self-regulation strategies, treatment fidelity, costs

Effectively preventing and treating chronic diseases through health behavior changes often require intensive theory- and evidence-based intervention including long-term maintenance components. We assessed the efficacy of theory-based maintenance approaches varying by dose for persistently performing resistance training (RT) with the hypothesis that a higher-dose social cognitive theory (SCT) approach would produce greater RT adherence than lower-dose Standard. The Resist-Diabetes study first established 2×/week resistance training (RT) in a 3-month supervised intervention in older (50-69 years, N = 170), overweight to obese (BMI 25-39.9 kg/m(2)) previously inactive adults who fit prediabetes criteria (fasting glucose concentration = 95-125 mg/dl; oral glucose tolerance test 2-h glucose concentration = 140-199 mg/dl or both). After the supervised phase, participants (N = 159) were then randomly assigned to one of two conditions for transition (3 weeks) and then RT alone in community settings for extended contact, maintenance (6 months), and then no contact (6 months). SCT featured continued tailored, interactive personal, and web-based check-ups focused on RT, self-regulation, and a barrier/strategies approach. Standard involved low-dose, generic personal, and web-based check-ups within the same theoretical approach. SCT and Standard both resulted in similar RT, 2×/week adherence during maintenance (74.4 %) and no-contact phases (53.1 %). Cost analysis indicated the Standard intervention for transition and maintenance was inexpensive ($160). Standard can be translated into practice with the potential for continuous contact and persistence in RT beyond the typical program maintenance phase.

Aerobic and resistance exercise training program intervention for enhancing gait function in elderly and chronically ill Taiwanese patients

OBJECTIVES

This study aimed to develop an effective exercise training program for enhancing the postural stability and gait function of chronically ill patients to avoid falls.

STUDY DESIGN

Pre training-post-training. Analyses were limited to those randomized to the exercise intervention.

METHODS

The participants were chronically ill patients over 45 years old (47-89 years), of whom 25 completed the 12-week training regimen and assessment in the exercise group, whereas 29 completed the assessment in the control group, suffering from cardiovascular disease, diabetes mellitus, or osteoporosis. The average age of the participants was 67.56 ± 10.70 years in the intervention group. All patients in this study signed institutional review board (IRB) agreements before participating (IRB approval no: FEMH-IRB-101029-E, v. 02, date: 20120429).

RESULTS

The results revealed the beneficial effects of regular aerobic and resistance training, which improved in elderly, chronically ill patients. According to our data, most of the gait function measurements exhibited significant differences between the exercise group and control group. The duration of the 'timed up-and-go' test decreased from 7.67 s to 6.76 s (P = 0.00013), and the 'the base of support area' increased from 392.0 cm(2) to 433.2 cm(2) (P = 0.0088). Women attained more significant differences than men in the exercise and control groups (P = 0.0008), and the participants aged 45-65 years had a more satisfactory outcome than those aged > 65 years (P = 0.0109).

CONCLUSION

Regular exercise regimens, such as aerobic, resistance or combination exercise training, enhance the gait function and sense of postural stability in elderly, chronically ill patients. Younger patients attained more positive results than older patients, and women attained more positive results than men. Regular exercise is a means of preventing falls; thus, the government and hospitals should increase promotional measures in aging communities to encourage regular exercise among elderly, chronically ill outpatients.

The effect of a whey protein supplement dose on satiety and food intake in resistance training athletes

OBJECTIVE

Many athletes perform resistance training and consume dietary protein as a strategy to promote anabolic adaptation. Due to its high satiety value, the regular addition of supplemented dietary protein could plausibly displace other key macronutrients such as carbohydrate in an athlete's diet. This effect will be influenced by the form and dose of protein. Therefore, this study assessed the impact of liquid whey protein dose manipulation on subjective sensations of appetite and food intake in a cohort of athletes.

DESIGN

Ten male athletes who performed both resistance and aerobic (endurance) training (21.2 ± 2.3 years; 181.7 ± 5.7 cm and 80.8 ± 6.1 kg) were recruited. In four counter-balanced testing sessions they consumed a manipulated whey protein supplement (20, 40, 60 or 80 g protein) 1 hour after a standardised breakfast. Subsequent energy intake was measured 3 hours after the protein supplement using an ad libitum test meal. Subjective appetite sensations were measured periodically during the test day using visual analogue scales.

RESULTS

All conditions resulted in a significant decrease in ratings of hunger (50-65%; P < 0.05) at the time of supplement consumption. However, there were no significant differences between the conditions at any time point for subjective appetite sensations or for energy consumed in the ad libitum meal: 4382 ± 1004, 4643 ± 982, 4514 ± 1112, 4177 ± 1494 kJ respectively.

CONCLUSION

Increasing whey protein supplement dose above 20 g did not result in a measurable increase in satiety or decrease in food intake. However, the inclusion of additional whey protein supplementation where not otherwise consumed could plausibly reduce dietary intake.

Blood flow restricted exercise for athletes: A review of available evidence

OBJECTIVES

This study aimed to collate current evidence regarding the efficacy of various blood flow restriction (BFR) strategies for well-trained athletes, and to provide insight regarding how such strategies can be used by these populations.

DESIGN

Review article.

METHODS

Studies that had investigated the acute or adaptive responses to BFR interventions in athletic participants were identified from searches in MEDLINE (PubMed), SPORTDiscus (EBSCO) and Google Scholar databases up to April 2015. The reference lists of identified papers were also examined for relevant studies.

RESULTS

Twelve papers were identified from 11 separate investigations that had assessed acute and adaptive responses to BFR in athletic cohorts. Of these, 7 papers observed enhanced hypertrophic and/or strength responses and 2 reported alterations in the acute responses to low-load resistance exercise when combined with BFR. One paper had examined the adaptive responses to moderate-load resistance training with BFR, 1 noted improved training responses to low-work rate BFR cardiovascular exercise, and 1 reported on a case of injury following BFR exercise in an athlete.

CONCLUSIONS

Current evidence suggests that low-load resistance training with BFR can enhance muscle hypertrophy and strength in well-trained athletes, who would not normally benefit from using light loads. For healthy athletes, low-load BFR resistance training performed in conjunction with normal high-load training may provide an additional stimulus for muscular development. As low-load BFR resistance exercise does not appear to cause measureable muscle damage, supplementing normal high-load training using this novel strategy may elicit beneficial muscular responses in healthy athletes.

The use of periodization in exercise prescriptions for inactive adults: A systematic review

BACKGROUND

Periodization of exercise is a method typically used in sports training, but the impact of periodized exercise on health outcomes in untrained adults is unclear.

PURPOSE

This review aims to summarize existing research wherein aerobic or resistance exercise was prescribed to inactive adults using a recognized periodization method.

METHODS

A search of relevant databases, conducted between January and February of 2014, yielded 21 studies published between 2000 and 2013 that assessed the impact of periodized exercise on health outcomes in untrained participants.

RESULTS

Substantial heterogeneity existed between studies, even under the same periodization method. Compared to baseline values or non-training control groups, prescribing periodized resistance or aerobic exercise yielded significant improvements in health outcomes related to traditional and emerging risk factors for cardiovascular disease, low-back and neck/shoulder pain, disease severity, and quality of life, with mixed results for increasing bone mineral density.

CONCLUSIONS

Although it is premature to conclude that periodized exercise is superior to non-periodized exercise for improving health outcomes, periodization appears to be a feasible means of prescribing exercise to inactive adults within an intervention setting. Further research is necessary to understand the effectiveness of periodizing aerobic exercise, the psychological effects of periodization, and the feasibility of implementing flexible non-linear methods.

Associations between lower extremity muscle mass and metabolic parameters related to obesity in Japanese obese patients with type 2 diabetes

Background. Age-related loss of muscle mass (sarcopenia) increases the incidence of obesity in the elderly by reducing physical activity. This sarcopenic obesity may become self-perpetuating, increasing the risks for metabolic syndrome, disability, and mortality. We investigated the associations of two sarcopenic indices, the ratio of lower extremity muscle mass to body weight (L/W ratio) and the ratio of lower extremity muscle mass to upper extremity muscle mass (L/U ratio), with metabolic parameters related to obesity in patients with type 2 diabetes and obesity.

Methods. Of 148 inpatients with type 2 diabetes treated between October 2013 and April 2014, we recruited 26 with obesity but no physical disability. Daily physical activity was measured by a triaxial accelerometer during a period of hospitalization, and which was also evaluated by our previously reported non-exercise activity thermogenesis questionnaire. We measured body composition by bioelectrical impedance and investigated the correlations of L/W and L/U ratios with body weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), visceral fat area, subcutaneous fat area, serum lipid profile, and daily physical activity.

Results. The L/W ratio was significantly and negatively correlated with BMI, WC, WHR, body fat mass, body fat percentage, subcutaneous fat area, and serum free fatty acid concentration, was positively correlated with daily physical activity: the locomotive non-exercise activity thermogenesis score, but was not correlated with visceral fat area. The L/U ratio was significantly and positively correlated with serum high-density lipoprotein cholesterol.

Conclusions. High L/W and L/U ratios, indicative of relatively preserved lower extremity muscle mass, were predictive of improved metabolic parameters related to obesity. Preserved muscle fitness in obesity, especially of the lower extremities, may prevent sarcopenic obesity and lower associated risks for metabolic syndrome and early mortality.

Strength training and risk of type 2 diabetes in a Japanese working population: A cohort study

AIMS/INTRODUCTION

Muscle strength training has been suggested to improve glucose metabolism; however, epidemiological evidence regarding strength training's effects on diabetes risk is scarce. We prospectively examined the association between strength training and the risk of type 2 diabetes in Japanese men and women.

MATERIALS AND METHODS

The sample included health checkups on 26,630 Japanese male and female workers aged 30-64 years without diabetes at baseline. Weekly time spent on strength training was elicited using a self-reported questionnaire. Type 2 diabetes was diagnosed based on hemoglobin A1c, fasting glucose, random plasma glucose and self-report in an annual health checkup. Hazard ratio (HR) and its 95% confidence interval (CI) for incident diabetes was estimated using a Cox proportional hazards model.

RESULTS

During a mean follow up of 5.2 years with 139,748 person-years, 1,770 individuals developed diabetes. Age- and sex-adjusted HR for diabetes was 0.58 (95% CI 0.42-0.79) in those who engaged in strength training compared with those who engaged in no strength training. After further adjusting for potential confounders, the corresponding HR was 0.66 (95% CI 0.48-0.90). Additional adjustment for body mass index did not materially change the result; the HR was 0.70 (95% CI 0.51-0.96). The association was more pronounced in individuals aged 50 years or older than those aged <50 years, although the difference in the association by age was not significant.

CONCLUSIONS

These results suggest that engagement in strength training could help to reduce the risk of type 2 diabetes in a Japanese working population.

Three and six grams supplementation of d-aspartic acid in resistance trained men

Background

Although abundant research has investigated the hormonal effects of d-aspartic acid in rat models, to date there is limited research on humans. Previous research has demonstrated increased total testosterone levels in sedentary men and no significant changes in hormonal levels in resistance trained men. It was hypothesised that a higher dosage may be required for experienced lifters, thus this study investigated the effects of two different dosages of d-aspartic acid on basal hormonal levels in resistance trained men and explored responsiveness to d-aspartic acid based on initial testosterone levels.

Methods

Twenty-four males, with a minimum of two years’ experience in resistance training, (age, 24.5 ± 3.2 y; training experience, 3.4 ± 1.4 y; height, 178.5 ± 6.5 cm; weight, 84.7 ± 7.2 kg; bench press 1-RM, 105.3 ± 15.2 kg) were randomised into one of three groups: 6 g.d⁻¹ plain flour (D0); 3 g.d⁻¹ of d-aspartic acid (D3); and 6 g.d⁻¹ of d-aspartic acid (D6). Participants performed a two-week washout period, training four days per week. This continued through the experimental period (14 days), with participants consuming the supplement in the morning. Serum was analysed for levels of testosterone, estradiol, sex hormone binding globulin, albumin and free testosterone was determined by calculation.

Results

D-aspartic acid supplementation revealed no main effect for group in: estradiol; sex-hormone-binding-globulin; and albumin. Total testosterone was significantly reduced in D6 (P = 0.03). Analysis of free testosterone showed that D6 was significantly reduced as compared to D0 (P = 0.005), but not significantly different to D3. Analysis did not reveal any significant differences between D3 and D0. No significant correlation between initial total testosterone levels and responsiveness to d-aspartic acid was observed (r = 0.10, P = 0.70).

Conclusions

The present study demonstrated that a daily dose of six grams of d-aspartic acid decreased levels of total testosterone and free testosterone (D6), without any concurrent change in other hormones measured. Three grams of d-aspartic acid had no significant effect on either testosterone markers. It is currently unknown what effect this reduction in testosterone will have on strength and hypertrophy gains.

Core strength training for patients with chronic low back pain

[Purpose] Through core strength training, patients with chronic low back pain can strengthen their deep trunk muscles. However, independent training remains challenging, despite the existence of numerous core strength training strategies. Currently, no standardized system has been established analyzing and comparing the results of core strength training and typical resistance training. Therefore, we conducted a systematic review of the results of previous studies to explore the effectiveness of various core strength training strategies for patients with chronic low back pain. [Methods] We searched for relevant studies using electronic databases. Subsequently, we evaluated their quality by analyzing the reported data. [Results] We compared four methods of evaluating core strength training: trunk balance, stabilization, segmental stabilization, and motor control exercises. According to the results of various scales and evaluation instruments, core strength training is more effective than typical resistance training for alleviating chronic low back pain. [Conclusion] All of the core strength training strategies examined in this study assist in the alleviation of chronic low back pain; however, we recommend focusing on training the deep trunk muscles to alleviate chronic low back pain.

Should We Recommend Exercise after the Fontan Procedure?

BACKGROUND

The Fontan procedure, the last of a series of operations performed in patients with congenital heart defects, offers improved exercise capacity compared to baseline function but is still reduced compared to healthy peers. Exercise training may improve exercise tolerance but there is no consensus on the safety of this practice or the optimal training regimen. We performed a systematic literature review on the effects of exercise training in patients with a Fontan circulation.

METHODS

Medline and Embase databases were systematically searched for articles regarding Fontan Procedure and cardiac rehabilitation.

RESULTS

A total of 23 articles met all inclusion criteria; in total, 201 Fontan subjects were included. Characteristics of the exercise training programs varied significantly. There were no adverse effects related to training programs reported in the literature. Most studies reported benefit across various exercise parameters related to exercise tolerance.

CONCLUSIONS

Exercise training is safe and beneficial in patients with a Fontan circulation. Exercise training should become a standard of care within this population. Physiological adaptation following exercise training needs to be investigated more extensively.

Is repetition failure critical for the development of muscle hypertrophy and strength?

This investigation sought to determine the effect of resistance training to failure on functional, structural and neural elbow flexor muscle adaptation. Twenty-eight males completed a 4-week familiarization period and were then counterbalanced on the basis of responsiveness across; non-failure rapid shortening (RS; rapid concentric, 2 s eccentric), non-failure stretch-shortening (SSC; rapid concentric, rapid eccentric), and failure control (C, 2 s concentric, 2 s eccentric), for a 12-week unilateral elbow flexor resistance training regimen, 3 × week using 85% of one repetition maximum (1RM). 1RM, maximal voluntary contraction (MVC), muscle cross-sectional area (CSA), and muscle activation (EMG(RMS)) of the agonist, antagonist, and stabilizer muscles were assessed before and after the 12-week training period. The average number of repetitions per set was significantly lower in RS 4.2 [confidence interval (CI): 4.2, 4.3] and SSC 4.2 (CI: 4.2, 4.3) compared with C 6.1 (CI: 5.8, 6.4). A significant increase in 1RM (30.5%), MVC (13.3%), CSA (11.4%), and agonist EMG(RMS) (22.1%) was observed; however, no between-group differences were detected. In contrast, antagonist EMG(RMS) increased significantly in SSC (40.5%) and C (23.3%), but decreased in RS (13.5%). Similar adaptations across the three resistance training regimen suggest repetition failure is not critical to elicit significant neural and structural changes to skeletal muscle.

Influence of bench angle on upper extremity muscular activation during bench press exercise

This study compared the muscular activation of the pectoralis major, anterior deltoid and triceps brachii during a free-weight barbell bench press performed at 0°, 30°, 45° and -15° bench angles. Fourteen healthy resistance trained males (age 21.4 ± 0.4 years) participated in this study. One set of six repetitions for each bench press conditions at 65% one repetition maximum were performed. Surface electromyography (sEMG) was utilised to examine the muscular activation of the selected muscles during the eccentric and concentric phases. In addition, each phase was subdivided into 25% contraction durations, resulting in four separate time points for comparison between bench conditions. The sEMG of upper pectoralis displayed no difference during any of the bench conditions when examining the complete concentric contraction, however differences during 26-50% contraction duration were found for both the 30° [122.5 ± 10.1% maximal voluntary isometric contraction (MVIC)] and 45° (124 ± 9.1% MVIC) bench condition, resulting in greater sEMG compared to horizontal (98.2 ± 5.4% MVIC) and -15 (96.1 ± 5.5% MVIC). The sEMG of lower pectoralis was greater during -15° (100.4 ± 5.7% MVIC), 30° (86.6 ± 4.8% MVIC) and horizontal (100.1 ± 5.2% MVIC) bench conditions compared to the 45° (71.9 ± 4.5% MVIC) for the whole concentric contraction. The results of this study support the use of a horizontal bench to achieve muscular activation of both the upper and lower heads of the pectoralis. However, a bench incline angle of 30° or 45° resulted in greater muscular activation during certain time points, suggesting that it is important to consider how muscular activation is affected at various time points when selecting bench press exercises.

The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients - A randomized controlled trial

BACKGROUND & AIM

Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient. The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than standard care. Secondary outcomes were changes in muscle strength, functional ability and body weight.

METHODS

29 acutely admitted old (>65 years) patients were randomly assigned to the intervention (n = 14) or to standard care (n = 15). The Intervention Group received 1.7 g protein/kg/day during admission and a daily protein supplement (18.8 g protein) and resistance training 3 times per week the 12 weeks following discharge. Muscle mass was assessed by Dual-energy X-ray Absorptiometry. Muscle strength was assessed by Hand Grip Strength and Chair Stand Test. Functional ability was assessed by the de Morton Mobility Index, the Functional Recovery Score and the New Mobility Score. Changes in outcomes from time of admission to three-months after discharge were analysed by linear regression analysis.

RESULTS

The intention-to-treat analysis showed no significant effect of the intervention on lean mass (unadjusted: β-coefficient = -1.28 P = 0.32, adjusted for gender: β-coefficient = -0.02 P = 0.99, adjusted for baseline lean mass: β-coefficient = -0.31 P = 0.80). The de Morton Mobility Index significantly increased in the Control Group (β-coefficient = -11.43 CI: 0.72-22.13, P = 0.04). No other differences were found.

CONCLUSION

No significant effect on muscle mass was observed in this group of acutely ill old medical patients. High compliance was achieved with the dietary intervention, but resistance training was challenging. Clinical trials identifier NCT02077491.

[Physical exercise in the frail elderly: an update]

Frailty is a state of vulnerability that involves an increased risk of adverse events and disability in older adults. It is a condition with a complex etiology and pathophysiology. Skeletal muscle power decreases earlier than muscle strength with advancing age and is more strongly associated with functional capacity than muscle strength in frail elderly populations. Multicomponent exercise programs, and especially resistance exercise that includes muscle power training, are currently the most relevant interventions to slow down disability and other adverse outcomes, even in the oldest-old. Moreover, these programs are valuable interventions in other frailty domains, such as falls and cognitive decline. Physical exercise, in the frail elderly, should be prescribed with a progressive individualized plan and just like other medical treatments.

The effects of exercise training programs on plasma concentrations of proenkephalin Peptide F and catecholamines

To determine if exercise training alters the pattern and magnitude of plasma concentrations of proenkephalin Peptide F and epinephrine, plasma proenkephalin [107-140] Peptide F(ir) and catecholamines were examined pre-training (T-1), and after 4- (T-2), 8- (T-3), and 12-weeks (T-4) of training. 26 healthy men were matched and randomly assigned to one of three groups: heavy resistance strength training (Strength, n=9), high intensity endurance training (Endurance, n=8), or both training modalities combined (Combined, n=9). Blood was collected using a syringe with a cannula inserted into a superficial arm vein with samples collected at rest, after each 7 min stage and 5 and 15 min into recovery. With training, all groups observed shifted plasma Peptide F responses to graded exercise, where significant increases were observed at lower exercise intensities. Increases in plasma epinephrine with exercise were observed in all groups. The Combined group saw increases at 25% at T-3 and for 50% at T-2, T-3, and T-4 which was higher than T-1. The Endurance group demonstrated increases for 50% at T-1, T-2, T-3 but not at T-4. The plasma epinephrine response to graded exercise was reduced in the Strength group. Increases in plasma norepinephrine above rest were observed starting at 50% . The Strength group demonstrated a significant reduction in norepinephrine observed at 100% at T-3 and T-4. Peptide F and catecholamines responses to graded exercise can be altered by different types of physical exercise training. Simultaneous high intensity training may produce adrenal medulla exhaustion when compared to single mode training.

Improved knee extensor strength with resistance training associates with muscle specific miRNAs in older adults

Regular exercise, particularly resistance training (RT), is the only therapy known to consistently improve muscle strength and quality (force per unit of mass) in older persons, but there is considerable variability in responsiveness to training. Identifying sensitive diagnostic biomarkers of responsiveness to RT may inform the design of a more efficient exercise regimen to improve muscle strength in older adults. MicroRNAs (miRNAs) are small non-coding RNAs that regulate gene expression. We quantified six muscle specific miRNAs (miR-1, -133a, -133b, -206, -208b and -499) in both muscle tissue and blood plasma, and their relationship with knee extensor strength in seven older (age=70.5 ± 2.5 years) adults before and after 5 months of RT. MiRNAs differentially responded to RT; muscle miR-133b decreased, while all plasma miRNAs tended to increase. Percent changes in knee extensor strength with RT showed strong positive correlations with percent changes in muscle miR-133a, -133b, and -206 and with percent changes in plasma and plasma/muscle miR-499 ratio. Baseline level of plasma or plasma/muscle miR-499 ratio further predicts muscle response to RT, while changes in muscle miR-133a, -133b, and -206 may correlate with muscle TNNT1 gene alternative splicing in response to RT. Our results indicate that RT alters muscle specific miRNAs in muscle and plasma, and that these changes account for some of the variation in strength responses to RT in older adults.

Exercise and sex steroid hormones in skeletal muscle

Sex steroid hormones are secreted mainly by the ovary and testis and regulate diverse physiological processes in target tissues. Recent studies have shown that sex steroidogenesis-related mRNA and protein expressions, such as for 17β-hydroxysteroid dehydrogenase (HSD), 3β-HSD, 5α-reductase and aromatase cytochrome P-450 (P450arom) enzymes, are detected in the skeletal muscle, while testosterone, estradiol, and 5α-dihydrotestosterone (DHT) were locally synthesized in skeletal muscle from dehydroepiandrosterone (DHEA). Moreover, in animal and human studies, the sex steroidogenesis enzymes and sex steroid hormone levels in skeletal muscle are upregulated by acute and chronic exercise stimulation. The enhanced muscle sex steroidgenesis is associated with glycemic control via upregulation of muscle glucose transporter-4 (GLUT-4) signaling in obese and diabetic rats and with muscle mass and strength in older men. Thus, an exercise-induced increase of sex steroid hormone in muscle may positively impact age-related concerns such as life-related diseases and sarcopenia.

Effects of core strength training using stable versus unstable surfaces on physical fitness in adolescents: a randomized controlled trial

Background

It has been demonstrated that core strength training is an effective means to enhance trunk muscle strength (TMS) and proxies of physical fitness in youth. Of note, cross-sectional studies revealed that the inclusion of unstable elements in core strengthening exercises produced increases in trunk muscle activity and thus provide potential extra training stimuli for performance enhancement. Thus, utilizing unstable surfaces during core strength training may even produce larger performance gains. However, the effects of core strength training using unstable surfaces are unresolved in youth. This randomized controlled study specifically investigated the effects of core strength training performed on stable surfaces (CSTS) compared to unstable surfaces (CSTU) on physical fitness in school-aged children.

Methods

Twenty-seven (14 girls, 13 boys) healthy subjects (mean age: 14 ± 1 years, age range: 13–15 years) were randomly assigned to a CSTS (n = 13) or a CSTU (n = 14) group. Both training programs lasted 6 weeks (2 sessions/week) and included frontal, dorsal, and lateral core exercises. During CSTU, these exercises were conducted on unstable surfaces (e.g., TOGU© DYNAIR CUSSIONS, THERA-BAND© STABILITY TRAINER).

Results

Significant main effects of Time (pre vs. post) were observed for the TMS tests (8-22%, f = 0.47-0.76), the jumping sideways test (4-5%, f = 1.07), and the Y balance test (2-3%, f = 0.46-0.49). Trends towards significance were found for the standing long jump test (1-3%, f = 0.39) and the stand-and-reach test (0-2%, f = 0.39). We could not detect any significant main effects of Group. Significant Time x Group interactions were detected for the stand-and-reach test in favour of the CSTU group (2%, f = 0.54).

Conclusions

Core strength training resulted in significant increases in proxies of physical fitness in adolescents. However, CSTU as compared to CSTS had only limited additional effects (i.e., stand-and-reach test). Consequently, if the goal of training is to enhance physical fitness, then CSTU has limited advantages over CSTS.

Trial registration

ClinicalTrials.gov Identifier: NCT02290457 Registered 13 November 2014.

Intralimb joint coordination of the lower extremities in resistance training exercises

To facilitate the greatest transfer of improvements to athletic performance or daily activity, the resistance training exercises employed by athletic or recreationally trained individuals must be selected considering biomechanical similarity to meet the specific demands of their sport or activity. The purpose of this study was to compare intralimb joint coordination in eight experienced lifters performing three conventional strength-training exercises: the forward lunge, the dead lift, and the forward step-up. Lower-extremity angular displacement curves, maximum joint excursions, and mean absolute relative phases were determined. Results revealed general in-phase, interjoint relationships while comparing exercises. Forward lunge interjoint relationships were more out-of-phase when compared with the other two exercises. It is suggested that in-phase coordination was the predominant pattern employed while performing the closed kinetic chain exercises normally used in strength training, in particular for knee-hip relationship. Nevertheless the forward component of movement can change the coordination strategy when performing lunges.

Training in the functional movement circle to promote strength and mobility-related activities in older adults: a randomized controlled trial

Movements of everyday life (e.g., climbing stairs, rising from a chair, walking) are essential for older adults to stay functional and independent. Due to the aging process, muscle mass decreases and balance abilities are reduced. One major criticism of former interventions is that implemented resistance and balance exercises were not associated with movements needed in older adults' everyday life. The Functional Movement Circle for older adults (FuMoC) includes the combination of three aspects: resistance, balance, and movements of everyday life. The aim of this study was to compare the effects of training in the FuMoC with those of other training programs. A randomized controlled trial (RCT) with three intervention groups (IG1: FuMoC; IG2: resistance and balance training; IG3: coordination training) with a training period of 6 months and one inactive control group (CG) was conducted. At baseline (T1), after three (T2) and six (T3) months, parameters of strength (isometric strength measurement and One-Repetition Maximum test in leg and chest press) and mobility-related activities (gait analysis, Multisurface Obstacle Test for Older Adults (MSOT), Chair Rise Test (CRT), Timed Up & Go Test (TUG), Maximum Step Length Test (MSLT)) were assessed as primary outcomes. Data of 78 (43 males, 35 females) older adults were analyzed (mean age: 68.4 years). Significant (p < 0.05) interactions between time and group were observed in most of the primary outcomes. IG1 showed the highest improvement rates in MSOT (+16 %), CRT (+28 %), TUG (+14 %), and MSLT (+15 %); demonstrating advantages of training in the FuMoC compared to other training programs.

The effect of two different hand exercises on grip strength, forearm circumference, and vascular maturation in patients who underwent arteriovenous fistula surgery

Objective

To compare the effect of two different hand exercises on hand strength and vascular maturation in patients who underwent arteriovenous fistula surgery.

Methods

We recruited 18 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, 10 subjects performed hand-squeezing exercise with GD Grip, and other 8 subjects used Soft Ball. The subjects continued the exercises for 4 weeks. The hand grip strength, pinch strength (tip, palmar and lateral pinch), and forearm circumference of the subjects were assessed before and after the hand-squeezing exercise. The cephalic vein size, blood flow velocity and volume were also measured by ultrasonography in the operated limb.

Results

All of the 3 types of pinch strengths, grip strength, and forearm circumference were significantly increased in the group using GD Grip. Cephalic vein size and blood flow volume were also significantly increased. However, blood flow velocity showed no difference after the exercise. The group using Soft Ball showed a significant increase in the tip and lateral pinch strength and forearm circumference. The cephalic vein size and blood flow volume were also significantly increased. On comparing the effect of the two different hand exercises, hand-squeezing exercise with GD Grip had a significantly better effect on the tip and palmar pinch strength than hand-squeezing exercise with Soft Ball. The effect on cephalic vein size was not significantly different between the two groups.

Conclusion

The results showed that hand squeezing exercise with GD Grip was more effective in increasing the tip and palmar pinch strength compared to hand squeezing exercise with soft ball.

Ursolic Acid-induced elevation of serum irisin augments muscle strength during resistance training in men

Ursolic acid (UA), a type of pentacyclic triterpenoid carboxylic acid purified from natural plants, can promote skeletal muscle development. We measured the effect of resistance training (RT) with/without UA on skeletal muscle development and related factors in men. Sixteen healthy male participants (age, 29.37±5.14 years; body mass index=27.13±2.16 kg/m²) were randomly assigned to RT (n=7) or RT with UA (RT+UA, n=9) groups. Both groups completed 8 weeks of intervention consisting of 5 sets of 26 exercises, with 10~15 repetitions at 60~80% of 1 repetition maximum and a 60~90-s rest interval between sets, performed 6 times/week. UA or placebo was orally ingested as 1 capsule 3 times/day for 8 weeks. The following factors were measured pre-and post-intervention: body composition, insulin, insulin-like growth factor-1 (IGF-1), irisin, and skeletal muscle strength. Body fat percentage was significantly decreased (p<0.001) in the RT+UA group, despite body weight, body mass index, lean body mass, glucose, and insulin levels remaining unchanged. IGF-1 and irisin were significantly increased compared with baseline levels in the RT+UA group (p<0.05). Maximal right and left extension (p<0.01), right flexion (p<0.05), and left flexion (p<0.001) were significantly increased compared with baseline levels in the RT+UA group. These findings suggest that UA-induced elevation of serum irisin may be useful as an agent for the enhancement of skeletal muscle strength during RT.

High-speed circuit training vs hypertrophy training to improve physical function in sarcopenic obese adults: a randomized controlled trial

BACKGROUND

Progressive loss of muscle and strength with age is often coincident with increases in adiposity, leading to a condition called sarcopenic obesity. Studies have shown sarcopenic obese adults to be at higher risk for declines in physical function. Despite this rising public health concern, no intervention studies currently exist in this population.

METHODS

A total of 21 sarcopenic obese adults, 60 years or older, were randomized into two groups, strength/hypertrophy (SH, n=9) and high-speed circuit (HSC, n=8) and were trained for 15 weeks. The primary outcome was the SPPB modified as a measure of physical function, assessed by assessors blinded to randomization. Secondary outcomes were lower body and upper body power and strength, instrumental activities of daily living (IADL), ratings of perceived exertion (RPE), body fat % (BF%), skeletal muscle index (SMI), and grip strength (GRP).

RESULTS

For the SPPB results favored HSC over SH (1.1, 95% CI (-.1 to 2.4), p=.08) and showed a moderate effect size (Hedge g=0.6, 95% CI (-0.4, 1.6)). For secondary outcomes, lower body power (mean difference=158 W, 95% CI (2, 315); p=.01) and RPE (mean difference=-1.5, 95% CI (-2.9, -0.12); p=.04) also favored HSC. IADL, SMI, BF%, upper and lower body strength and upper body power, showed no statistically significant differences between groups.

CONCLUSIONS

Considering the moderate effect size, the large treatment effect shown by the upper limit of the 95% CI, the low perceived exertion, and no adverse effects, HSC training should be further investigated with a larger sample size in sarcopenic obese adults.

Musculoskeletal management of a patient with a history of chronic ankle sprains: identifying rupture of peroneal brevis and peroneal longus with diagnostic ultrasonography

OBJECTIVE

The purpose of this case report is to describe the use of mobilization and eccentric exercise training for a patient with ankle pain and a history of chronic ankle sprains and discuss the course of diagnostic decision making when the patient did not respond to care.

CLINICAL FEATURES

A 48-year-old police officer who had sustained multiple ankle sprains throughout his life presented with pain and restriction in his ability to walk, run, and work. The Global Rating of Change Scale score was - 6, the Numeric Pain Rating Scale score was 7/10, and the Lower Extremity Functional Scale score was - 33. Palpation of the peroneus longus and brevis muscles and inversion with overpressure reproduced the chief concern (Numeric Pain Rating Scale 7/10). The patient was initially diagnosed with chronic peroneal tendinopathy.

INTERVENTION AND OUTCOME

Treatment included lateral translation mobilization of the talocrural joint combined with eccentric exercise using an elastic band for the peroneal muscles. The patient reported improvement in pain and function during the course of intervention but not as rapidly as expected. Therefore, follow-up ultrasonographic imaging and radiography were performed. These studies revealed partial rupture of the peroneal brevis muscle and total rupture of the peroneal longus muscle.

CONCLUSION

A patient with long-term concerns of the foot complex with a diagnosis of peroneal tendinopathy showed slight improvement with eccentric exercises combined with manual therapy of the talocrural joint. After a course of treatment but minimal response, a diagnosis of tendon rupture was confirmed with diagnostic ultrasonography. Clinicians should be aware that when injuries do not improve with care, tendon rupture should be considered.

Effects of resistance training on muscle strength, endurance, and motor unit according to ciliary neurotrophic factor polymorphism in male college students

Changes in muscle mass and strength across the adult age span are variable and related to the ciliary neurotrophic factor (CNTF) genotype. In particular, a single CNTF haplotype (1357 G→A) is important for neuronal and muscular developments and may be associated with muscle strength response to resistance training. We examined whether CNTF genotype differentially influences the effect of resistance training on neuromuscular improvement in male college students. Resistance training of the upper extremities comprised 3 sets at 75%-85% intensity per 1 repetition maximum, 3 times a week, for a total of 8 weeks. We measured isokinetic muscle function of the elbow joint with regard to strength (60°/s) and endurance (180°/s) by using an isokinetic dynamometer. The biceps brachii (BB) and brachioradialis muscles were studied using surface electromyography with spike-triggered averaging to assess surface-detected motor unit potential (SMUP) area. After resistance training, the SMUP of the BB increased significantly at 60°/s (p < 0.05), but no difference in the CNTF genotype was observed. The SMUP of the BB at 180°/s increased significantly in the GG/AA genotype group compared with that in the GA genotype group (p < 0.05). The average power of the elbow flexor at 180°/s increased significantly after resistance training (p < 0.05), but again, no difference in the CNTF genotype was observed. Thus, improvements in muscle strength and endurance may have resulted directly from resistance training rather than from genetic factors related to nerves in muscle tissue. Key PointsResistance training improves muscle strength and endurance in young men.This improvement in muscular strength and endurance is irrespective of CNTF genotypes.

Evaluation of Resettin® on serum hormone levels in sedentary males

Background

Comparisons of hormones such as dihydrotestosterone (DHT), estradiol (E2), and testosterone indicate their impact on metabolism and body composition. While less is known regarding DHT and E2, testosterone is an androgenic metabolic hormone capable of positively regulating a variety of anabolic and androgenic processes in the body. Accordingly, it has been postulated that the age-related reduction in serum testosterone levels leads to reductions in lean muscle mass, bone mineral density, and other physical conditions that impair physical performance and decrease quality of life. Preliminary studies suggest that key ingredients found in Resettin®/MyTosterone™, a natural supplement containing the carotenoid astaxanthin from Haematococcus pluvialis and Saw Palmetto berry lipid extract from Serenoa repens, could positively impact testosterone levels. To investigate the clinical efficacy of Resettin®, the serum profiles of testosterone, E2 and DHT in healthy sedentary males before and after Resettin® treatment were evaluated in a randomized, placebo controlled clinical trial.

Method

Twenty healthy, sedentary men between the ages of 21 and 70 were randomized into either an 800 mg/day or 1200 mg/day Resettin®/MyTosterone™ treatment group or lecithin, which was used as the placebo. After a 14-day treatment period, there was a 14-day washout period. After the wash-out period, participants were crossed over within their respective group to either Resettin®/MyTosterone™ or the lecithin placebo for 14 days.

Results

After 14 days, participants receiving 800 mg per day of Resettin® had significantly reduced baseline-subtracted serum DHT levels in comparison to the placebo control group. While after 14 days, participants receiving 1200 mg per day of Resettin® had significantly reduced baseline-subtracted serum DHT and E2 levels in comparison to the placebo control group. Moreover, participants receiving 1200 mg per day of Resettin® experienced a 38% increase in serum testosterone levels in comparison to the placebo control group, but the effect did not reach statistical significance.

Conclusion

Although additional studies will be required to evaluate how Resettin® may promote proper testosterone regulation, these findings indicate that Resettin® can favorably influence serum hormone profiles in men.

Relationships among muscle dysmorphia characteristics, body image quality of life, and coping in males

OBJECTIVES

The purpose of this study was to examine relationships among bodybuilding dependence, muscle satisfaction, body image-related quality of life and body image-related coping strategies, and test the hypothesis that muscle dysmorphia characteristics may predict quality of life via coping strategies.

DESIGN

Participants (294 males, Mage=20.5 years, SD=3.1) participated in a cross-sectional survey.

METHODS

Participants completed questionnaires assessing muscle satisfaction, bodybuilding dependence, body image-related quality of life and body image-related coping.

RESULTS

Quality of life was correlated positively with muscle satisfaction and bodybuilding dependence but negatively with body image coping (P<0.05). Body image coping was correlated positively with bodybuilding dependence and negatively with muscle satisfaction (P<0.05). Mediation analysis found that bodybuilding dependence and muscle satisfaction predicted quality of life both directly and indirectly via body image coping strategies (as evidenced by the bias corrected and accelerated bootstrapped confidence intervals).

CONCLUSIONS

These results provide preliminary evidence regarding the ways that muscularity concerns might influence body image-related quality of life.

Dietary intake modification in response to a participation in a resistance training program for sedentary older adults with prediabetes: findings from the Resist Diabetes study

Engagement in one type of health behavior change may exert a "spillover" effect resulting in other behavior changes. Few studies have examined dietary intake following prolonged training, and none have evaluated spontaneous dietary changes beyond alterations in energy or macronutrient intake following initiation of strength/resistance training (RT). The purpose of this observational investigation was to determine if spontaneous dietary intake modifications occur in response to initiation of an RT program, among older adults. Previously sedentary adults with prediabetes (n=134, age=59±1 years) were enrolled in a supervised 12-week RT program. Participants were not given dietary advice or encouraged to change eating behaviors. Three non-consecutive 24-hour dietary recalls were collected at baseline and after 12 weeks of RT. Reductions in intake of energy (1914±40 kcal vs. 1834±427 kcal, p=0.010), carbohydrate (211.6±4.9 g vs. 201.7±5.2 g, p=0.015), total sugar (87.4±2.7 g vs. 81.5±3.1 g, p=0.030), glycemic load (113.4±3.0 vs. 108.1±3.2, p=0.031), fruits and vegetables (4.6±0.2 servings vs. 4.1±0.2 servings, p=0.018), and sweets and desserts (1.1±0.07 servings vs. 0.89±0.07 servings, p=0.023) were detected over time. No changes in other dietary intake variables were observed. Mode of exercise and disease state may be important factors in determining whether dietary modifications occur with exercise initiation, among previously sedentary adults. Successful initiation of RT may represent an opportunity for health care professionals to promote beneficial changes in dietary habits, among older adults with prediabetes.

The PULSE (Prevention Using LifeStyle Education) trial protocol: a randomised controlled trial of a Type 2 Diabetes Prevention programme for men. Contemp Clin Trials. 2014;39:132-144. [PMID: 25092484 DOI: 10.1016/j.cct.2014.07.008]

BACKGROUND

Intensive lifestyle interventions have been successful in reducing type 2 diabetes incidence. Whether intensive programmes requiring face-to-face contact, trained staff and access to facilities are feasible, on a larger scale, has been debated.

OBJECTIVES

The aim of this study is to determine the feasibility and efficacy of a lifestyle intervention for type 2 diabetes prevention in men using an assessor-blinded, parallel-group, randomised controlled trial. The 'Type 2 Diabetes PULSE (Prevention Using LifeStyle Education) Programme for Men' is a 6-month, self-administered, gender-tailored lifestyle intervention, with a multicomponent approach (weight loss, dietary modification, aerobic exercise and resistance training). Eligible men were aged 18-65 years, overweight/obese (BMI 25-40 kg·m(-2)) and at high-risk for type 2 diabetes (score ≥ 12, Australian diabetes risk tool). Men with diagnosed prediabetes were eligible, but those with type 1 and 2 diabetes were ineligible. Randomisation was stratified by age (<50 or ≥ 50 years) and BMI category (kg·m(-2): 25-29.9; 30-34.9; 35-40) to the intervention or wait-list control group. Data are collected at study entry (baseline), 3 and 6 months. The primary outcome is weight change at 6 months. Secondary outcomes include: fasting plasma glucose, HbA1C, waist circumference, body composition, blood pressure, diet quality, aerobic fitness, muscular fitness and physical activity. Generalised linear mixed models (intention-to-treat) will assess outcomes for treatment (intervention vs. control), time (baseline, 3 and 6-months) and the treatment-by-time interaction.

CONCLUSION

The results will determine the efficacy of a type 2 diabetes prevention programme for men with potential for wide reach and dissemination.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ACTRN12612000721808).

Muscle power training in the institutionalized frail: a new approach to counteracting functional declines and very late-life disability

Skeletal muscle power decreases earlier than muscle strength with advancing age and is more strongly associated with functional test performance than muscle strength in elderly populations. In addition, some studies have shown that resistance training designed to improve muscle power output (high speed of movement) enhances several functional outcomes in the healthy elderly. Therefore, muscle power has emerged as a factor that is also potentially associated with functional limitations in frail elderly adults. The purpose of this review was to provide recent evidence regarding the association between skeletal muscle power and functional capacity in physically frail individuals. Scielo, Science Citation Index, MEDLINE, Scopus, Sport Discus and ScienceDirect databases were searched from 1990 to 2014. Recently, it has been shown that functional capacity among frail elderly adults could be improved by performing resistance training at a high speed of movement with a loading stimulus that optimizes muscle power output. Routine multicomponent interventions that include muscle power training should be prescribed to institutionalized oldest old because such interventions improve the overall physical status of frail elderly individuals and prevent disability and other adverse outcomes. This result is especially important in frail subjects, who urgently need to improve their functional capacities to prevent adverse outcomes such as falls, hospitalizations, disability, or even death.

Evidence-based recommendations for natural bodybuilding contest preparation: nutrition and supplementation

The popularity of natural bodybuilding is increasing; however, evidence-based recommendations for it are lacking. This paper reviewed the scientific literature relevant to competition preparation on nutrition and supplementation, resulting in the following recommendations. Caloric intake should be set at a level that results in bodyweight losses of approximately 0.5 to 1%/wk to maximize muscle retention. Within this caloric intake, most but not all bodybuilders will respond best to consuming 2.3-3.1 g/kg of lean body mass per day of protein, 15-30% of calories from fat, and the reminder of calories from carbohydrate. Eating three to six meals per day with a meal containing 0.4-0.5 g/kg bodyweight of protein prior and subsequent to resistance training likely maximizes any theoretical benefits of nutrient timing and frequency. However, alterations in nutrient timing and frequency appear to have little effect on fat loss or lean mass retention. Among popular supplements, creatine monohydrate, caffeine and beta-alanine appear to have beneficial effects relevant to contest preparation, however others do not or warrant further study. The practice of dehydration and electrolyte manipulation in the final days and hours prior to competition can be dangerous, and may not improve appearance. Increasing carbohydrate intake at the end of preparation has a theoretical rationale to improve appearance, however it is understudied. Thus, if carbohydrate loading is pursued it should be practiced prior to competition and its benefit assessed individually. Finally, competitors should be aware of the increased risk of developing eating and body image disorders in aesthetic sport and therefore should have access to the appropriate mental health professionals.

Clinical application of a robotic ankle training program for cerebral palsy compared to the research laboratory application: does it translate to practice?

OBJECTIVE

To determine the clinical efficacy of an ankle robotic rehabilitation protocol for patients with cerebral palsy.

DESIGN

The clinic cohort was identified from a retrospective chart review in a before-after intervention trial design and compared with a previously published prospective research cohort.

SETTING

Rehabilitation hospital.

PARTICIPANTS

Children (N=28; mean age, 8.2±3.62 y) with Gross Motor Function Classification System levels I, II, or III who were referred for ankle stretching and strengthening used a robotic ankle device in a clinic setting. Clinic results were compared with a previously published cohort of participants (N=12; mean age, 7.8±2.91 y) seen in a research laboratory-based intervention protocol.

INTERVENTIONS

Patients in the clinic cohort were seen 2 times per week for 75-minute sessions for a total of 6 weeks. The first 30 minutes of the session were spent using the robotic ankle device for ankle stretching and strengthening, and the remaining 45 minutes were spent on functional movement activities. There was no control group.

MAIN OUTCOME MEASURES

We compared pre- and postintervention measures of plantarflexor and dorsiflexor range of motion, strength, spasticity, mobility (Timed Up and Go test, 6-minute walk test, 10-m walk test), balance (Pediatric Balance Scale), Selective Control Assessment of the Lower Extremity (SCALE), and gross motor function measure (GMFM).

RESULTS

Significant improvements were found for the clinic cohort in all main outcome measures except for the GMFM. These improvements were equivalent to those reported in the research cohort, except for larger SCALE test changes in the research cohort.

CONCLUSIONS

These findings suggest that translation of repetitive, goal-directed biofeedback training into the clinic setting is both feasible and beneficial for patients with cerebral palsy.

Low intensity resistance training improves systolic function and cardiovascular autonomic control in diabetic rats

AIMS

We evaluated the effects of low intensity resistance training (RT) on left ventricular (LV) function, baroreflex sensitivity (BRS), and cardiovascular autonomic control of streptozotocin-induced diabetic rats.

METHODS

Male Wistar rats were divided into (n=8 each group): sedentary control (SC), trained control (TC), sedentary diabetic (SD), and trained diabetic (TD). Trained groups underwent low intensity RT (40%-50% 1 repetition maximum) for 10 weeks. Echocardiographic evaluation, arterial pressure (AP), heart rate (HR), BRS, and autonomic measurements were performed.

RESULTS

Diabetes induced an increase in glycemia and a reduction in body weight in diabetics when compared with control animals. Diabetic rats displayed cardiac dysfunction, reduced systolic AP and HR, impaired BRS and autonomic derangement when compared to control rats. RT improved ejection fraction (SD: 68%±1.3% vs. TD: 75%±3.0%) and velocity of circumferential fiber shortening (SD: 0.32±0.02 vs. TD: 0.40±0.01 circ/seg.10(-4)). Trained diabetic rats presented increased AP (+10.2%), HR (+10.4%), and BRS after RT protocol.

CONCLUSIONS

Low intensity RT induced an increase in systolic function in diabetic rats. This may be due to positive LV remodeling and BRS improvement, which may have played an important role in the attenuation of hemodynamic impairment and cardiac autonomic neuropathy in streptozotocin-diabetic rats.

Synergistic effects of resistance training and protein intake: practical aspects

Resistance training is a potent stimulus to increase skeletal muscle mass. The muscle protein accretion process depends on a robust synergistic action between protein intake and overload. The intake of protein after resistance training increases plasma amino acids, which results in the activation of signaling molecules leading to increased muscle protein synthesis (MPS) and muscle hypertrophy. Although both essential and non-essential amino acids are necessary for hypertrophy, the intake of free L-leucine or high-leucine whole proteins has been specifically shown to increase the initiation of translation that is essential for elevated MPS. The literature supports the use of protein intake following resistance-training sessions to enhance MPS; however, less understood are the effects of different protein sources and timing protocols on MPS. The sum of the adaptions from each individual training session is essential to muscle hypertrophy, and thus highlights the importance of an optimal supplementation protocol. The aim of this review is to present recent findings reported in the literature and to discuss the practical application of these results. In that light, new speculations and questions will arise that may direct future investigations. The information and recommendations generated in this review should be of benefit to clinical dietitians as well as those engaged in sports.

Effects of 8 weeks resistance training on plasma vaspin and lipid profile levels in adult men with type 2 diabetes

BACKGROUND

Vaspin is associated with decreased blood glucose concentration. In this study, we aimed to investigate the effects of resistance exercise training on plasma vaspin and lipid profile levels in patients with type 2 diabetes.

METHODS

Thirty men were divided into 2 groups: control (n=15), and resistance exercise (n=15). The resistance group performed a resistance exercise consisting of 3 circuits of 8-15 repetitions of the 8 exercises. Lipid profiles and vaspin levels were measured at baseline and at the end of study. This study was registered in the Iranian Registry of Clinical Trial (www.irct.ir) with registration number ID: IRCT2013060911772N1.

RESULTS

Intergroup study showed that after an 8-week of resistance training, resistance group had reductions in vaspin (330.50±82.51 ng/ml vs 251.62±107.28 ng/ml, p=0.03), and TC levels (185.21±47.51 mg/dL vs 171.10±37.91 mg/dL p= 0.02); but, had increase in HDL-C levels (38.20±20.65 mg/dL vs 43.80±7.87 mg/dL p=0.01), whereas, vaspin levels significantly increased in control groups (344±78.64 ng/ml vs 436 ± 70.47 ng/ml, p= 0.03). On the other hand, significant difference was seen in plasma vaspin levels between two groups.

CONCLUSION

Our findings suggest that resistance training significantly decreased the level of vaspin without affecting the lipid profile level.

The Effect of 10 Weeks Resistance Training on Cholesterol and Blood Triglyceride Levels of Patients with Fatty Liver Disease

The present study aims to consider the effect of 10 weeks resistance trainings on cholesterol and blood triglyceride (TG) levels of patients with having fatty liver, aged 50 to 60 in National Iranian South Oil Company (NISOC). This research is practical and its plan has been done experimentally with pretest and post-test on experimental and control groups. In this study, 20 samples from 100 patients who referred to sonography clinic in NISOC with distinction of fatty liver were selected randomly and divided into two groups of control (n = 10) and experimental (n = 10). Cholesterol and blood trigly-ceride were measured as pretest. Test of normality for TG was (p = 0/200) by Kolmogorov-Smirnov and (p = 0/070) for cholesterol by Shapiro-Wilk test. After 10 weeks resistance trainings, the analysis and resolution of data were done by computer and SPSS (16) software as well as the descriptive and statistical methods (t-test). Comparison between these two groups showed that 8 weeks resistance trainings with a ≤ 0.05 causes significant decrease in the amount of TG but did not any significant effect on cholesterol of fatty liver patients. How to cite this article: Valizadeh R, Askarabadi SH, Karampour S, Tehrani MA. The Effect of 10 Weeks Resistance Training on Cholesterol and Blood Triglyceride Levels of Patients with Fatty Liver Disease. Euroasian J Hepato-Gastroenterol 2014;4(1):64-65.

Effects of resistance exercise order on the number of repetitions performed to failure and perceived exertion in untrained young males

Exercise order is an essential variable of resistance training (RT) programs which is usually related to repetition performance. The purpose of this study was to investigate the acute effect of different resistance exercise order on the number of repetitions performed to failure and related ratings of perceived exertion (RPE). Thirteen male adolescents (age: 14.46 ± 1.39 years, body height: 165.31 ± 12.75 cm, body mass: 58.73 ± 12.27 kg, estimated body fat: 21.32 ± 2.84%), without previous experience in RT, performed four resistance exercises: incline leg press (ILP), dumbbell lunge (DL), bench press (BP) and lying barbell triceps extension (TE) in two sequences - Sequence A (SEQA): ILP, DL, BP and TE; sequence B (SEQB): ILP, BP, DL and TE. The exercise sequences were performed in a randomized crossover design with a rest interval of 72h between sessions. Within-subjects analysis showed significant differences in the number of repetitions performed to failure in both sequences, but not in the RPE. Post-hoc tests revealed significant decrements in the number of repetitions from the first to the remaining exercises in both sequences. However, pairwise comparisons did not indicate significant differences between the same exercises performed in different sequences. In conclusion, the results of the current study in adolescents suggest that the main exercises should be performed at the beginning of the RT session.