Central and Peripheral Fatigue During Resistance Exercise - A Critical Review

Effect of Lactobacillus plantarum TWK10 on Exercise Physiological Adaptation, Performance, and Body Composition in Healthy Humans

Probiotics have been rapidly developed for health promotion, but clinical validation of the effects on exercise physiology has been limited. In a previous study, Lactobacillus plantarum TWK10 (TWK10), isolated from Taiwanese pickled cabbage as a probiotic, was demonstrated to improve exercise performance in an animal model. Thus, in the current study, we attempted to further validate the physiological function and benefits through clinical trials for the purpose of translational research. The study was designed as a double-blind placebo-controlled experiment. A total of 54 healthy participants (27 men and 27 women) aged 20–30 years without professional athletic training were enrolled and randomly allocated to the placebo, low (3 × 10¹⁰ colony forming units (CFU)), and high dose (9 × 10¹⁰ CFU) TWK10 administration groups (n = 18 per group, with equal sexes). The functional and physiological assessments were conducted by exhaustive treadmill exercise measurements (85% VO_2max), and related biochemical indices were measured before and after six weeks of administration. Fatigue-associated indices, including lactic acid, blood ammonia, blood glucose, and creatinine kinase, were continuously monitored during 30 min of exercise and a 90 min rest period using fixed intensity exercise challenges (60% VO_2max) to understand the physiological adaptation. The systemic inflammation and body compositions were also acquired and analyzed during the experimental process. The results showed that TWK10 significantly elevated the exercise performance in a dose-dependent manner and improved the fatigue-associated features correlated with better physiological adaptation. The change in body composition shifted in the healthy direction for TWK10 administration groups, especially for the high TWK10 dose group, which showed that body fat significantly decreased and muscle mass significantly increased. Taken together, our results suggest that TWK10 has the potential to be an ergogenic aid to improve aerobic endurance performance via physiological adaptation effects.

Decrease in Attentional Performance After Repeated Bouts of High Intensity Exercise in Association-Football Referees and Assistant Referees

Referees and assistant referees are submitted to high physical stress during matches. Pressure to make decisions in front of large crowds is another potential stressor. These two stressors can impair attention executive control, depending on physical fitness and individual vulnerability or resilience to situational pressure. Error percentage for referees and assistants may reach around 14% during a soccer match. Although previous studies have suggested that soccer referees and assistants should take cognitive assessments, they are only required by Fédération Internationale de Football Association (FIFA) to demonstrate knowledge of the rules and pass annually in a fitness test (FIFA-Test). This study aimed to assess attention performance in referees and assistants before and after the mandatory FIFA-Test. It is hypothesized that the high physical demands associated with the pressure to pass the FIFA-Test would interfere with attention performance. The sample included 33 referees and 20 assistants. The Continuous Visual Attention Test (CVAT) consisted of a 15-min Go/No-go task. Performance in the CVAT is based on four variables: omission and commission errors, reaction time, and variability of reaction time (VRT). Failure in the CVAT was defined by a performance below the 5th percentile of the age- and sex-matched normative data in at least one variable of the CVAT. Before the FIFA-Test all participants performed the CVAT. The second CVAT began 3-7 min directly following completion of the FIFA-test. Considering only the officials who passed both the FIFA-Test and the first CVAT (19 referees and 15 assistants), 44% (9 referees and 6 assistants) exhibited a performance decline in the second CVAT. A significant increase in VRT was found after the high intensity exercise. As increase in VRT is thought to reflect executive dysfunctions and lapses of attention, we concluded that physical fitness alone may not be enough to help officials cope with the physical and contextual stresses associated with the FIFA-Test. These data suggest that over 35% of soccer referees and their assistants who were considered physically able to referee matches may not be mentally prepared for the attentional demands of refereeing soccer matches.

Wearable sensors for monitoring the internal and external workload of the athlete

The convergence of semiconductor technology, physiology, and predictive health analytics from wearable devices has advanced its clinical and translational utility for sports. The detection and subsequent application of metrics pertinent to and indicative of the physical performance, physiological status, biochemical composition, and mental alertness of the athlete has been shown to reduce the risk of injuries and improve performance and has enabled the development of athlete-centered protocols and treatment plans by team physicians and trainers. Our discussions in this review include commercially available devices, as well as those described in scientific literature to provide an understanding of wearable sensors for sports medicine. The primary objective of this paper is to provide a comprehensive review of the applications of wearable technology for assessing the biomechanical and physiological parameters of the athlete. A secondary objective of this paper is to identify collaborative research opportunities among academic research groups, sports medicine health clinics, and sports team performance programs to further the utility of this technology to assist in the return-to-play for athletes across various sporting domains. A companion paper discusses the use of wearables to monitor the biochemical profile and mental acuity of the athlete.

A Narrative Review of Cancer-Related Fatigue (CRF) and Its Possible Pathogenesis

Many cancer patients suffer from severe fatigue when treated with chemotherapy or radiotherapy; however, the etiology and pathogenesis of this kind of fatigue remains unknown. Fatigue is associated with cancer itself, as well as adjuvant therapies and can persist for a long time. Cancer patients present a high degree of fatigue, which dramatically affects the quality of their everyday life. There are various clinical research studies and reviews that aimed to explore the mechanisms of cancer-related fatigue (CRF). However, there are certain limitations in these studies: For example, some studies have only blood biochemical texts without histopathological examination, and there has been insufficient systemic evaluation of the dynamic changes in relevant indexes. Thus, we present this narrative review to summarize previous studies on CRF and explore promising research directions. Plenty of evidence suggests a possible association between CRF and physiological dysfunction, including skeletal muscular and mitochondrial dysfunction, peripheral immune activation and inflammation dysfunction, as well as central nervous system (CNS) disorder. Mitochondrial DNA (mtDNA), mitochondrial structure, oxidative pressure, and some active factors such as ATP play significant roles that lead to the induction of CRF. Meanwhile, several pro-inflammatory and anti-inflammatory cytokines in the peripheral system, even in the CNS, significantly contribute to the occurrence of CRF. Moreover, CNS function disorders, such as neuropeptide, neurotransmitter, and hypothalamic-pituitary-adrenal (HPA) axis dysfunction, tend to amplify the sense of fatigue in cancer patients through various signaling pathways. There have been few accurate animal models established to further explore the molecular mechanisms of CRF due to different types of cancer, adjuvant therapy schedules, living environments, and physical status. It is imperative to develop appropriate animal models that can mimic human CRF and to explore additional mechanisms using histopathological and biochemical methods. Therefore, the main purpose of this review is to analyze the possible pathogenesis of CRF and recommend future research that will clarify CRF pathogenesis and facilitate the formulation of new treatment options.

Shorter But More Frequent Rest Periods: No Effect on Velocity and Power Compared to Traditional Sets Not Performed to Failure

Performing traditional sets to failure is fatiguing, but redistributing total rest time to create short frequent sets lessens the fatigue. Since performing traditional sets to failure is not always warranted, we compared the effects of not-to-failure traditional sets and rest redistribution during free-weight back squats in twenty-six strength-trained men (28 ± 5.44 y; 84.6 ± 10.5 kg, 1RM-to-body-mass ratio of 1.82 ± 0.33). They performed three sets of ten repetitions with 4 min inter-set rest (TS) and five sets of six repetitions with 2 min inter-set rest (RR6) at 70% of one repetition maximum. Mean velocity (p > 0.05; d = 0.10 (-0.35, 0.56)) and mean power (p > 0.05; d = 0.19 (-0.27, 0.64)) were not different between protocols, but the rating of perceived exertion (RPE) was less during RR6 (p < 0.05; d = 0.93 (0.44, 1.40)). Also, mean velocity and power output decreased (RR6: 14.10% and 10.95%; TS: 17.10% and 15.85%, respectively) from the first repetition to the last, but the percentage decrease was similar (velocity: p > 0.05; d = 0.16 (0.30, 0.62); power: p > 0.05; d = 0.22 (-0.24, 0.68)). These data suggest that traditional sets and rest redistribution maintain velocity and power output to a similar degree when traditional sets are not performed to failure. However, rest redistribution might be advantageous as RR6 displayed a lower RPE.

The Beneficial Effects of Lactobacillus plantarum PS128 on High-Intensity, Exercise-Induced Oxidative Stress, Inflammation, and Performance in Triathletes

A triathlon, which consists of swimming, bicycling, and running, is a high-intensity and long-term form of exercise that can cause injuries such as muscular damage, inflammation, oxidative stress, and energy imbalance. Probiotics are thought to play an important role in disease incidence, health promotion, and nutrient metabolism, but only a few studies have focused on physiological adaptations to exercise in sports science. Previous studies indicated that Lactobacillus supplementation could improve oxidative stress and inflammatory responses. We investigate the effects of Lactobacillus plantarum PS128 supplementation on triathletes for possible physiological adaptation. The triathletes were assigned to one of two groups with different exercise intensity stimulations with different time-points to investigate the effects of body compositions, inflammation, oxidative stress, performance, fatigue, and injury-related biochemical indices. L. plantarum PS128 supplementation, combined with training, can significantly alleviate oxidative stress (such as creatine kinase, Thioredoxin, and Myeloperoxidase indices) after a triathlon (p < 0.05). This effect is possibly regulated by a 6–13% decrease of indicated pro-inflammation (TNF-α, IL-6, and IL-8) cytokines (p < 0.05) and 55% increase of anti-inflammation (IL-10) cytokines (p < 0.05) after intensive exercise stimulation. In addition, L. plantarum PS128 can also substantially increase 24–69% of plasma-branched amino acids (p < 0.05) and elevate exercise performance, as compared to the placebo group (p < 0.05). In conclusion, L. plantarum PS128 may be a potential ergogenic aid for better training management, physiological adaptations to exercise, and health promotion.

Reduced Volume 'Daily Max' Training Compared to Higher Volume Periodized Training in Powerlifters Preparing for Competition-A Pilot Study

The present study looked to examine reduced volume ‘daily max’ (near max loads) training compared to higher volume periodized training in powerlifters preparing for competition. Ten competitive powerlifters were split into 2 groups (MAX group and PER group) and participated in a 10-week training intervention either following a “daily max” training protocol or a traditional periodized training protocol while preparing for competition. All participants underwent 1RM testing for squat (SQ), bench press (BP) and deadlift (DL) prior to the 10-week intervention. The MAX group performed single sets of single repetitions using a load equating to an RPE rating of 9–9.5 while the PER group performed higher volume periodized training with loads ranging from 70%1RM up to 93%1RM as well as a taper at the final weeks of the training intervention. Both groups were tested after the 10-week training intervention at the Greek IPF-affiliate National Championships. In the PER group, powerlifting (PL) total increased for P1 and P3 by 2% and 6.5% respectively while P2 experienced no change. In the MAX group PL total increased for P1 and P2 by 4.8% and 4.2% respectively while it decreased by 0.5%, 3.4% and 5% for P3, P4 and P5 respectively. In the MAX group peri PL total increased for P1–4 by 3.6%, 4.2%, 4.5% and 1.8% respectively while it decreased by 1.2% for P5. The results of this pilot study show that single-set, single-rep, RPE based ‘daily max’ training may be a favorable strategy for some beginner-intermediate powerlifters preparing for competition while it may lead to performance decreases for others. Further, it suggests that performance may be comparable to traditional periodized training during shorter training cycles, though future work with larger samples is needed to further test this. Practically ‘daily max’ training may be useful for PL athletes looking to maintain strength during periods with limited training time available.

Drive in Sports: How Mental Fatigue Affects Endurance Performance

Performance in endurance sports relies on athletes' drive, which is the sum of all factors pushing athletes to exert effort during exercise. Mental fatigue can influence endurance performance by decreasing athletes' drive to exercise. From a psychological point of view, mental fatigue has two separate components: it can affect drive by increasing the perceived effort necessary for a given task ("I cannot do this, I am too exhausted"), or by decreasing the perceived value of the reward that can be obtained ("I do not want to do this, it is not worth it"). Neurophysiological theories confirm this dual nature of mental fatigue. It is suggested that mental fatigue can activate the inhibition centers of the brain, increasing perceived effort for a given task, hence decreasing drive and willingness to act. On the other hand, it may also deactivate facilitative brain centers (normally responsible for motivated behavior and increased drive toward a reward), also resulting in decreased drive. In this Perspective we will adopt a multidimensional approach, describing how mental fatigue interacts with drive and performance in endurance exercise. We aim to show how mental fatigue affects endurance performance via two main mechanisms: perceived effort and reward. We will study the interaction between mental fatigue and other factors impacting on drive, such as perceived exertion and motivation, and examine how these factors combined result in athletes' exercise behavior (such as pacing) and performance. This will provide researchers, coaches, and athletes with useful tools in order to understand, influence and enhance athletes' drive in exercise, which is of high relevance in elite endurance sports, where mental fatigue, motivation, and stakes all are of the highest level.

Adult Gross Motor Learning and Sleep: Is There a Mutual Benefit?

Posttraining consolidation, also known as offline learning, refers to neuroplastic processes and systemic reorganization by which newly acquired skills are converted from an initially transient state into a more permanent state. An extensive amount of research on cognitive and fine motor tasks has shown that sleep is able to enhance these processes, resulting in more stable declarative and procedural memory traces. On the other hand, limited evidence exists concerning the relationship between sleep and learning of gross motor skills. We are particularly interested in this relationship with the learning of gross motor skills in adulthood, such as in the case of sports, performing arts, devised experimental tasks, and rehabilitation practice. Thus, the present review focuses on sleep and gross motor learning (GML) in adults. The literature on the impact of sleep on GML, the consequences of sleep deprivation, and the influence of GML on sleep architecture were evaluated for this review. While sleep has proven to be beneficial for most gross motor tasks, sleep deprivation in turn has not always resulted in performance decay. Furthermore, correlations between motor performance and sleep parameters have been found. These results are of potential importance for integrating sleep in physiotherapeutic interventions, especially for patients with impaired gross motor functions.

Responsiveness of the Countermovement Jump and Handgrip Strength to an Incremental Running Test in Endurance Athletes: Influence of Sex

The present study analyzed the acute effects of an incremental running test on countermovement jump (CMJ) and handgrip strength performance in endurance athletes, considering the effect of post-exercise recovery time and sex. Thirty-three recreationally trained long-distance runners, 20 men and 13 women, participated voluntarily in this study. The participants performed the Léger test, moreover, the CMJ and handgrip strength tests were carried out before and after the running test and during different stages of recovery (at the 1st min of recovery (posttest1), 5th min of recovery (posttest2), and 10th min of recovery (posttest3)). Two-way analysis of variance revealed a significant improvement in the CMJ (pre-posttest1, p = 0.001) and handgrip strength (pre-posttest2, p = 0.017) during recovery time. The Pearson’s Chi-2 test showed no significant relationship (p ≥ 0.05) between sex and post-activation potentiation (PAP). A linear regression analysis pointed to heart rate recovery as a predictive factor of CMJ improvement (PAP). In conclusion, despite significant fatigue reached during the Léger test, the long-distance runners did not experience an impaired CMJ and handgrip strength performance, either men or women, achieving an improvement (PAP) in posttest conditions. The results obtained showed no significant relationship between sex and PAP. Moreover, significant effect of recovery after running at high intensity on CMJ performance and handgrip strength was found. Finally, the data suggest that PAP condition can be predicted by heart rate recovery in endurance runners.

The effect of CYP1A2 genotype on the ergogenic properties of caffeine during resistance exercise: a randomized, double-blind, placebo-controlled, crossover study

AIM

The purpose of this study was to examine the effect of CYP1A2 -163C>A polymorphism on the ergogenic effects of caffeine supplementation during a resistance exercise (RE) session.

METHODS

In a randomized, double-blind, placebo (PL)-controlled, crossover study, 30 resistance-trained men took part in two RE sessions (three sets to failure at 85% of one repetition maximum, 2-min rest between sets), including bench press (BP), leg press (LP), seated cable row, and shoulder press (SP) following caffeine (CAF) (6 mg kg^-1) or PL (6 mg kg^-1 of maltodextrin) ingestion 1 h prior to the trial. The number of repetitions was recorded after each set, along with calculation of total number of repetitions for each exercise. Genomic DNA was isolated from the whole blood samples for analyzing the CYP1A2 -163C>A polymorphism through amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Subjects were classified as either AA (n = 14) or AC/CC genotypes (n = 16).

RESULTS

The two-way ANOVA with repeated measures revealed differences between AAs and AC/CCs under CAF conditions for repetitions performed in sets 1, 2, and 3 of BP (F_{(1, 28)} = 14.84, P = 0.001, ƞ² = 0.34), LP (F_{(1, 28)} = 8.92, P = 0.006, ƞ² = 0.24), SR (F_{(1, 28)} = 17.38, P = 0.0001, ƞ² = 0.38), and SP (F_{(1, 28)} = 3.76, P = 0.063, ƞ² = 0.11). CAF also increased the total number of repetitions performed for all three sets in AAs versus AC/CCs for BP (F_{(1, 28)} = 8.72, P = 0.006, ƞ² = 0.23), LP (F_{(1, 28)} = 4.67, P = 0.03, ƞ² = 0.14), SR (F_{(1, 28)} = 5.54, P = 0.02, ƞ² = 0.16), and SP (F_{(1, 28)} = 3.89, P = 0.058, ƞ² = 0.12) in athletes who were homozygous carriers of the A allele, compared to the C allele carriers. Therefore, AA homozygotes were able to carry out a greater total volume of RE work under CAF but not PL conditions, compared to the C allele carriers.

CONCLUSION

In conclusion, acute ingestion of CAF significantly enhanced RE performance in resistance-trained men who were homozygous for the A allele, but not for C allele carriers. Further studies are needed to replicate the potential role of the CYP1A2 -163C>A polymorphism on the ergogenic effects of CAF in other modes of exercise and in other populations.

Effects of a 60 Minute on Ice Game Simulation on the Balance Error Scoring System

Mild traumatic brain injuries (mTBIs) are common in contact sports. There is an association between mTBIs and altered motor function. BioSway technology measures individuals' balance using the Balance Error Scoring System (BESS). Prior to incorporating BESS testing in concussion protocol, other variables that influence the BESS test require review. The objective of this study is to determine if game fatigue in hockey players also influences the BESS score. 23 male (21.08 ± 1.09) National Collegiate Athletic Association (NCAA) athletes were tested using the BioSway™ (Biodex, USA). The BESS test measures the Sway Index (SI) -a calculation of deviation from the center of mass. Balance errors were counted according to BESS standard testing protocol. Baseline and post BESS scores were completed at rest and following exertion in a standard non-contact practice setting. Heart rate and rate of perceived exertion (RPE) were recorded to document fatigue during a 60 minute non contact game simulation. Statistical analysis was performed using SPSS v.25. A paired sample t-test comparing sway index in the single, double, and tandem pre and post stances demonstrated no significance (p=.567, .666, .098) respectively. A paired sample t-test demonstrated a significant increase in balance errors in the single leg stance following 60 minutes on ice (p=.006). While mTBIs influence balance, this study demonstrates that game-like exertion also influences single leg stance balance as measured by the BioSway technology and BESS testing protocol. Athlete fatigue should be considered a confounding variable in measure of balance as an indicator of mTBI.

Influence of platinum harmonized textile on neuromuscular, systemic and subjective recovery

The clothing manufacturer Venex Life-Science tracks the strategy to enhance recovery process through implementing platinum harmonized technology (PHT) into their Venex^® Regeneration Wear. The proposed mechanisms of the regeneration wear are an increase of parasympathetic activity and an increase of the temperature due far-infrared radiation. The purpose of this study was to investigate potential effects of Venex regeneration wear on the recovery of neuromuscular, systemic and subjective parameters following exercise. In a randomized, single-blinded cross-over design, 13 strength-trained male participants performed two exercise sessions in one day. After the first exercise session and for 3 nights following the exercise day participants wore the Venex regeneration wear or a placebo product. Measures of isometric maximum voluntary contraction (MVC), voluntary activation (VA) and potentiated twitch torque (PTT) of the knee extensors, as well as maximum jump height during the Counter-Movement and Drop Jump, creatinkinase (CK) and subjective parameters (perceived pain, recovery condition and sleep quality) were obtained before and after each exercise session and 24, 48, and 72 hours after the first exercise session. MVC, PTT, CK and jump parameters changed over time during the exercise day as well as on the following days, however, there were no significant differences between treatments. Subjective parameters showed strong effect sizes (i. e. Cohen’s d > 0.6) in favor for Venex but no significant differences between treatments. Based on these findings, it is concluded that wearing a platinum harmonized textile following exercise did not improve neuromuscular and systemic recovery in a trained male population to a statistical noticeable extent. However, the findings for the subjective parameters suggest some potential for enhanced recovery that requires further research.

Heavy vs Light Load Single-Joint Exercise Performance with Different Rest Intervals

The aim of the study was to compare the effect of three distinct rest period lengths between sets of upper body single-joint exercise with different load zones and volume designed for either endurance or hypertrophy (50% or 80% of 1-RM). Sixteen trained men (20.75 ± 2.54 years; 76.35 ± 5.03 kg; 176.75 ± 3.33 cm, 24.53 ± 1.47 kg/m2) performed a test and retest of 1-RM on non-consecutive days. Forty-eight hours after load testing, the participants were randomly assigned to six sessions consisting of four sets of the triceps pull-down, combining different intensities with distinct rest periods between sets. The shorter 1 minute rest promoted a significant reduction in the total repetition number compared to 3 minute rest for both workloads. There was a difference between 3 and 5 minute conditions for the 50% of 1-RM that did not occur for the 80% of 1-RM condition. Both intensities presented significant interaction values for the rest conditions vs. each set (50% p = 0.0001; 80% p = 0.0001). Additionally, significant values were found for the main effect of the performance of subsequent sets (50% p = 0.003; 80% p = 0.001) and rest conditions (50% p = 0.0001; 80% p = 0.0001). In conclusion, for heavier loads (80%) to fatigue, longer rest of 3 to 5 minutes seems to allow for better recovery between sets and thus, promotes a greater volume. However, when training with lighter loads (50%), the magnitude of the rest seems to directly affect the performance of subsequent sets, and also presents a correlation with total volume achieved for the upper body single-joint exercise scheme.

The effect of mineral-based alkaline water on hydration status and the metabolic response to short-term anaerobic exercise

Previously it was demonstrated that mineralization and alkalization properties of mineral water are important factors influencing acid-base balance and hydration in athletes. The purpose of this study was to investigate the effects of drinking different types of water on urine pH, specific urine gravity, and post-exercise lactate utilization in response to strenuous exercise. Thirty-six male soccer players were divided into three intervention groups, consuming around 4.0 l/day of different types of water for 7 days: HM (n=12; highly mineralized water), LM (n=12; low mineralized water), and CON (n=12; table water). The athletes performed an exercise protocol on two occasions (before and after intervention). The exercise protocol consisted of 5 bouts of intensive 60-s (120% VO_2max) cycling separated by 60 s of passive rest. Body composition, urinalysis and lactate concentration were evaluated – before (t0), immediately after (t1), 5’ (t2), and 30’ (t3) after exercise. Total body water and its active transport (TBW – total body water / ICW – intracellular water / ECW – extracellular water) showed no significant differences in all groups, at both occasions. In the post-hydration state we found a significant decrease of specific urine gravity in HM (1021±4.2 vs 1015±3.8 g/L) and LM (1022±3.1 vs 1008±4.2 g/L). We also found a significant increase of pH and lactate utilization rate in LM. In conclusion, the athletes hydrated with alkaline, low mineralized water demonstrated favourable changes in hydration status in response to high-intensity interval exercise with a significant decrease of specific urine gravity, increased urine pH and more efficient utilization of lactate after supramaximal exercise.

The Role of Adrenomedullin in Cardiovascular Response to Exercise - A Review

Adrenomedullin (ADM), the product of the vascular endothelial and smooth muscle cells, and cardiomyocytes, is considered to be a local factor controlling vascular tone, cardiac contractility and renal sodium excretion. The aim of this article was to review the existing data on the effect of different types of exercise on plasma ADM concentration in healthy men. The results of studies on the effect of dynamic exercise on the plasma ADM are contradictory. Some authors reported an increase in plasma ADM, while others showed a slight decrease or did not observe any changes. The inverse relationship between plasma ADM and mean blood pressure observed during maximal exercise support the concept that ADM might blunt the exercise-induced systemic blood pressure increase. Positive relationships between increases in plasma ADM and those in noradrenaline, atrial natriuretic peptide (ANP) or interleukin-6 observed during prolonged exercise suggest that the sympathetic nervous system and cytokine induction may be involved in ADM release. Increased secretion of ADM and ANP during this type of exercise may be a compensatory mechanism attenuating elevation of blood pressure and preventing deterioration of cardiac function. Studies performed during static exercise have showed an increase in plasma ADM only in older healthy men. Positive correlations between increases in plasma ADM and those in noradrenaline and endothelin-1 may indicate the interaction of these hormones in shaping the cardiovascular response to static exercise. Inverse relationships between exercise-induced changes in plasma ADM and those in cardiovascular indices may be at least partly associated with inotropic action of ADM on the heart. Interactions of ADM with vasoactive peptides, catecholamines and hemodynamic factors demonstrate the potential involvement of this peptide in the regulation of blood pressure and myocardial contractility during exercise.