Neural Adaptations to Resistive Exercise

Evaluation of a Chair-Mounted Passive Trunk Orthosis: A Pilot Study on Able-Bodied Subjects

Trunk stability is important for adequate arm function due to their kinematic linkage. People with Duchenne muscular dystrophy (DMD) can benefit from trunk-assistive devices for seated daily activities, but existing devices limit trunk movement to forward bending. We developed a new trunk orthosis that has spring and pulley design. This study evaluated orthosis performance with 40 able-bodied subjects under with and without orthosis condition in 20 seated tasks for trunk rotation, forward bending, and side bending movements. Subjects adopted static posture in specific trunk orientation while their muscle activity was recorded. They also rated the subjective scales of perceived exertion and usability. A percent change in muscle activity for each task, due to orthosis use, is reported. Significant muscle activity reductions up to 31% and 65% were observed in lumbar and thoracic erector spinae muscles, respectively. Using three-way ANOVA, we found these reductions to be specific to the task direction and the choice of upper limb that is used to perform the asymmetric tasks. A total of 70% participants reported acceptable usability and ~1-point increase in exertion was found for maximum voluntary reaching with the orthosis. The outcomes of this study are promising, though tested on able-bodied subjects. Hence, orthosis mounted on wheelchairs should be further evaluated on DMD patients.

Arthrogenic Muscle Inhibition: Best Evidence, Mechanisms, and Theory for Treating the Unseen in Clinical Rehabilitation

CONTEXT

Arthrogenic muscle inhibition (AMI) impedes the recovery of muscle function following joint injury, and in a broader sense, acts as a limiting factor in rehabilitation if left untreated. Despite a call to treat the underlying pathophysiology of muscle dysfunction more than three decades ago, the continued widespread observations of post-traumatic muscular impairments are concerning, and suggest that interventions for AMI are not being successfully integrated into clinical practice.

OBJECTIVES

To highlight the clinical relevance of AMI, provide updated evidence for the use of clinically accessible therapeutic adjuncts to treat AMI, and discuss the known or theoretical mechanisms for these interventions.

EVIDENCE ACQUISITION

PubMed and Web of Science electronic databases were searched for articles that investigated the effectiveness or efficacy of interventions to treat outcomes relevant to AMI.

EVIDENCE SYNTHESIS

122 articles that investigated an intervention used to treat AMI among individuals with pathology or simulated pathology were retrieved from 1986 to 2021. Additional articles among uninjured individuals were considered when discussing mechanisms of effect.

CONCLUSION

AMI contributes to the characteristic muscular impairments observed in patients recovering from joint injuries. If left unresolved, AMI impedes short-term recovery and threatens patients' long-term joint health and well-being. Growing evidence supports the use of neuromodulatory strategies to facilitate muscle recovery over the course of rehabilitation. Interventions should be individualized to meet the needs of the patient through shared clinician-patient decision-making. At a minimum, we propose to keep the treatment approach simple by attempting to resolve inflammation, pain, and effusion early following injury.

A Novel Assessment Technique Does Not Produce More Reliable Estimates of Maximal Neuromuscular Strength

Accurate determinations of individuals' one-repetition maximum (1RM) are critical when evaluating the effectiveness of an exercise intervention involving progressive resistance training (RT). Traditional ("bottom-up"; BT) testing methods involve progressions from low to maximal loads and are commonly used in clinical and laboratory environments. Concerns about the reliability of BT testing in certain populations suggest a different technique may be more effective. Purpose: To compare the reliability and effectiveness of traditional 1RM testing to a novel technique (TDT) involving progressive load reductions and a starting intensity equal to 130% of exercisers' estimated 1RM. Method: 70 healthy adults (age = 45.03 ± 25.64 y) with diverse RT experience were randomized into a reliability testing trial (RTT; n = 33) or an optimal method trial (OMT; n = 37). Subjects in the RTT performed either TDT or BT on 3 occasions separated by ≥ 72 hours, while subjects in the OMT performed each method once in random order on separate days. Results: No significant differences in percent coefficient of variation were observed between BT and TDT for either exercise used in the study (pneumatic seated chest press: Hedge's g = 0.25, p = .49; pneumatic recumbent leg press: Hedge's g = 0.12, p = .74). TDT was not found to produce significantly higher 1RM values than BT in any group. Conclusion: TDT does not appear to facilitate more reliable 1RM estimates than BT. Further research is needed to determine the stability of these findings across levels of exercisers' age, sex, and previous RT experience.

Effects of the Proprioceptive Neuromuscular Facilitation Contraction Sequence on Motor Skill Learning-Related Increases in the Maximal Rate of Wrist Flexion Torque Development

Background: The proprioceptive neuromuscular facilitation (PNF) reciprocal contraction pattern has the potential to increase the maximum rate of torque development. However, it is a more complex resistive exercise task and may interfere with improvements in the maximum rate of torque development due to motor skill learning, as observed for unidirectional contractions. The purpose of this study was to examine the cost-benefit of using the PNF exercise technique to increase the maximum rate of torque development.

Methods: Twenty-six participants completed isometric maximal extension-to-flexion (experimental PNF group) or flexion-only (control group) contractions at the wrist. Ten of the assigned contractions were performed on each of three sessions separated by 48-h for skill acquisition. Retention was assessed with 5 contractions performed 2-weeks after acquisition. Torque and surface electromyographic (sEMG) activity were analyzed for evidence of facilitated contractions between groups, as well as alterations in muscle coordination assessed across test sessions. The criterion measures were: mean maximal isometric wrist flexion toque; the maximal rate of torque development (dτ/dt_max); root-mean-square error (RMSE) variability of the rate of torque versus torque phase-plane; the rate of wrist flexion muscle activation (Q₃₀); a coactivation ratio for wrist flexor and extensor sEMG activity; and wrist flexor electromechanical delay (EMD).

Results: There were no significant differences between groups with respect to maximal wrist flexion torque, dτ/dt_max or RMSE variability of torque trajectories. Both groups exhibited a progressive increase in maximal strength (+23.35% p < 0.01, η² = 0.655) and in dτ/dt_max (+19.84% p = 0.08, η² = 0.150) from the start of acquisition to retention. RMSE was lowest after a 2-week rest interval (−18.2% p = 0.04, η² = 0.198). There were no significant differences between groups in the rate of muscle activation or the coactivation ratio. There was a reduction in coactivation that was retained after a 2-week rest interval (−32.60%, p = 0.02, η² = 0.266). Alternatively, EMD was significantly greater in the experimental group (Δ 77.43%, p < 0.01, η² = 0.809) across all sessions. However, both groups had a similar pattern of improvement to the third consecutive day of testing (−16.82%, p = 0.049, η² = 0.189), but returned close to baseline value after the 2-week rest interval.

Discussion: The wrist extension-to-flexion contraction pattern did not result in a greater maximal rate of torque development than simple contractions of the wrist flexors. There was no difference between groups with respect to motor skill learning. The main adaptation in neuromotor control was a decrease in coactivation, not the maximal rate of muscle activation.

Understanding and Synergy: A Single Concept at Different Levels of Analysis?

Biological systems differ from the inanimate world in their behaviors ranging from simple movements to coordinated purposeful actions by large groups of muscles, to perception of the world based on signals of different modalities, to cognitive acts, and to the role of self-imposed constraints such as laws of ethics. Respectively, depending on the behavior of interest, studies of biological objects based on laws of nature (physics) have to deal with different salient sets of variables and parameters. Understanding is a high-level concept, and its analysis has been linked to other high-level concepts such as "mental model" and "meaning". Attempts to analyze understanding based on laws of nature are an example of the top-down approach. Studies of the neural control of movements represent an opposite, bottom-up approach, which starts at the interface with classical physics of the inanimate world and operates with traditional concepts such as forces, coordinates, etc. There are common features shared by the two approaches. In particular, both assume organizations of large groups of elements into task-specific groups, which can be described with only a handful of salient variables. Both assume optimality criteria that allow the emergence of families of solutions to typical tasks. Both assume predictive processes reflected in anticipatory adjustments to actions (motor and non-motor). Both recognize the importance of generating dynamically stable solutions. The recent progress in studies of the neural control of movements has led to a theory of hierarchical control with spatial referent coordinates for the effectors. This theory, in combination with the uncontrolled manifold hypothesis, allows quantifying the stability of actions with respect to salient variables. This approach has been used in the analysis of motor learning, changes in movements with typical and atypical development and with aging, and impaired actions by patients with various neurological disorders. It has been developed to address issues of kinesthetic perception. There seems to be hope that the two counter-directional approaches will meet and result in a single theoretical scheme encompassing biological phenomena from figuring out the best next move in a chess position to activating motor units appropriate for implementing that move on the chessboard.

The effect of resistance training programs on lean body mass in postmenopausal and elderly women: a meta-analysis of observational studies

Aging and menopause are associated with morphological and functional changes which may lead to loss of muscle mass and therefore quality of life. Resistance training (RT) is an effective training mode to increase muscle mass. We reviewed the existing literature to identify studies implementing RT protocols and evaluating muscle hypertrophy exclusively in healthy, postmenopausal and elderly women. Participants’ age range was comprised between 50 and 80 years. The primary outcome observed was muscle hypertrophy. Fat mass was also evaluated, if available. PubMed and Web of Science were the screened database, and original articles written in English and published from 2000 up to 2020 were included. 26 articles were considered eligible and included. Quality assessment revealed a “moderate quality” of the included studies, however the majority of studies was able to reach level 4 of evidence and on overall grade of recommendation C. In total, data from 745 female participants subjected to different forms of resistance training were considered. Heterogeneity across studies was present regarding study design, intervention length (mean 16 weeks), training frequency (3 d/w), no. of exercises (n = 7.4) and participants’ age (65.8 ± 4.9 years). Small-to-moderate significant increases (k = 43; SMD = 0.44; 95% CI 0.28; 0.60; p < 0.0001) of lean body mass were observed in post-menopausal and elderly women, regardless of age, intervention period, weekly training frequency and no. of exercises. No effects were noted for fat mass (k = 17; SMD = 0.27; 95% CI − 0.02; 0.55; p = 0.07). Studies need to concentrate on providing information regarding training parameters to more effectively counteract the effects of aging and menopause on skeletal muscle mass.

Anthropometrics and electromyography as predictors for maximal voluntary isometric wrist torque: Considerations for ergonomists

The purpose of this study was to evaluate anthropometry and forearm muscle activity as predictors of maximal isometric wrist torque. Thirteen anthropometric measures, forearm electromyography from flexor carpi radialis (FCR) and extensor carpi radialis (ECR), and maximal isometric wrist flexion/extension torque were obtained from 25 male participants. Pearson correlation coefficients assessed relationships between peak isometric torque and: (1) anthropometrics, (2) FCR and ECR activation, (3) FCR/ECR antagonist/agonist coactivation ratios. Based on significant correlations, linear regression equations were developed (SPSS v.25; p < 0.05). Hand thickness, forearm circumference and ECR activation or hand thickness, elbow circumference, FCR activation and body weight were most highly correlated with extension or flexion torque, respectively. Hand thickness, forearm circumference, and ECR activation (R² = 54.5%; p = 0.001) and hand thickness, elbow circumference, FCR activation (R² = 68.3%; p < 0.001) explained similar variance in torque regressions as did the addition of body weight to extension (R² = 58.0%; p = 0.001) and flexion (R² = 69.9%; p < 0.001) torque regression equations, respectively. Circumference measurements, a pseudo for muscle size, and activation amplitude influenced wrist force output more than limb length or coactivation.

Behavior of motor units during submaximal isometric contractions in chronically strength-trained individuals

Neural and morphological adaptations combine to underpin the enhanced muscle strength following prolonged exposure to strength training, although their relative importance remains unclear. We investigated the contribution of motor unit (MU) behavior and muscle size to submaximal force production in chronically strength-trained athletes (ST) versus untrained controls (UT). Sixteen ST (age: 22.9 ± 3.5 yr; training experience: 5.9 ± 3.5 yr) and 14 UT (age: 20.4 ± 2.3 yr) performed maximal voluntary isometric force (MViF) and ramp contractions (at 15%, 35%, 50%, and 70% MViF) with elbow flexors, whilst high-density surface electromyography (HDsEMG) was recorded from the biceps brachii (BB). Recruitment thresholds (RTs) and discharge rates (DRs) of MUs identified from the submaximal contractions were assessed. The neural drive-to-muscle gain was estimated from the relation between changes in force (ΔFORCE, i.e. muscle output) relative to changes in MU DR (ΔDR, i.e. neural input). BB maximum anatomical cross-sectional area (ACSA_MAX) was also assessed by MRI. MViF (+64.8% vs. UT, P < 0.001) and BB ACSA_MAX (+71.9%, P < 0.001) were higher in ST. Absolute MU RT was higher in ST (+62.6%, P < 0.001), but occurred at similar normalized forces. MU DR did not differ between groups at the same normalized forces. The absolute slope of the ΔFORCE - ΔDR relationship was higher in ST (+66.9%, P = 0.002), whereas it did not differ for normalized values. We observed similar MU behavior between ST athletes and UT controls. The greater absolute force-generating capacity of ST for the same neural input demonstrates that morphological, rather than neural, factors are the predominant mechanism for their enhanced force generation during submaximal efforts.NEW & NOTEWORTHY In this study, we observed that recruitment strategies and discharge characteristics of large populations of motor units identified from biceps brachii of strength-trained athletes were similar to those observed in untrained individuals during submaximal force tasks. We also found that for the same neural input, strength-trained athletes are able to produce greater absolute muscle forces (i.e., neural drive-to-muscle gain). This demonstrates that morphological factors are the predominant mechanism for the enhanced force generation during submaximal efforts.

Evaluation of safety and efficacy of a new device for muscle toning and body shaping

BACKGROUND

The spread of non-invasive procedures for fat deposits removal has increased rapidly in recent years. In the field of esthetic medicine, high-intensity focused electromagnetic field (HIFEM) technology has recently been introduced, as a tool for toning and strengthening muscles, which goes far beyond normal physical exercise.

OBJECTIVE

The purpose of this study is to evaluate the efficacy and safety of a new device for body remodeling.

METHODS

A set of 15 patients (7 males and 8 females, BMI 24.05 ± 2.01 kg m^-2 , age 32-57) participated in this study. Patients were enrolled at Dermatos center, Montesilvano, Abruzzo, Italy. The technology used is FMS (Flat Magnetic Stimulation): 6-8 treatment sessions were performed. The sessions must be repeated twice a week, with a minimum of 2 days between each session. Treatment duration varies from 20 to 45 min, depending on patients.

RESULTS

During 1-month follow-up after the last treatment evaluations, the results showed tonification, the strengthening of muscles, and the reduction of localized adiposity. There is a significant reduction in waist circumference (80.7 ± 4.3 cm vs 77.3 ± 5.6 cm, p < 0.001). All patients showed relatively high satisfaction immediately after the last treatment.

CONCLUSIONS

Our data show that intense muscle activity is generated by FMS treatments, suggesting that this technology could be used as a convenient and effective muscle toning tool.

Effects of Resistance Training Performed with Different Loads in Untrained and Trained Male Adult Individuals on Maximal Strength and Muscle Hypertrophy: A Systematic Review

The load in resistance training is considered to be a critical variable for neuromuscular adaptations. Therefore, it is important to assess the effects of applying different loads on the development of maximal strength and muscular hypertrophy. The aim of this study was to systematically review the literature and compare the effects of resistance training that was performed with low loads versus moderate and high loads in untrained and trained healthy adult males on the development of maximal strength and muscle hypertrophy during randomized experimental designs. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (2021) were followed with the eligibility criteria defined according to participants, interventions, comparators, outcomes, and study design (PICOS): (P) healthy males between 18 and 40 years old, (I) interventions performed with low loads, (C) interventions performed with moderate or high loads, (O) development of maximal strength and muscle hypertrophy, and (S) randomized experimental studies with between- or within-subject parallel designs. The literature search strategy was performed in three electronic databases (Embase, PubMed, and Web of Science) on 22 August 2021. Results: Twenty-three studies with a total of 563 participants (80.6% untrained and 19.4% trained) were selected. The studies included both relative and absolute loads. All studies were classified as being moderate-to-high methodological quality, although only two studies had a score higher than six points. The main findings indicated that the load magnitude that was used during resistance training influenced the dynamic strength and isometric strength gains. In general, comparisons between the groups (i.e., low, moderate, and high loads) showed higher gains in 1RM and maximal voluntary isometric contraction when moderate and high loads were used. In contrast, regarding muscle hypertrophy, most studies showed that when resistance training was performed to muscle failure, the load used had less influence on muscle hypertrophy. The current literature shows that gains in maximal strength are more pronounced with high and moderate loads compared to low loads in healthy adult male populations. However, for muscle hypertrophy, studies indicate that a wide spectrum of loads (i.e., 30 to 90% 1RM) may be used for healthy adult male populations.

Skeletal Muscle Adaptations and Performance Outcomes Following a Step and Exponential Taper in Strength Athletes

Before major athletic events, a taper is often prescribed to facilitate recovery and enhance performance. However, it is unknown which taper model is most effective for peaking maximal strength and positively augmenting skeletal muscle. Thus, the purpose of this study was to compare performance outcomes and skeletal muscle adaptations following a step vs. an exponential taper in strength athletes. Sixteen powerlifters (24.0 ± 4.0 years, 174.4 ± 8.2 cm, 89.8 ± 21.4 kg) participated in a 6-week training program aimed at peaking maximal strength on back squat [initial 1-repetition-maximum (1RM): 174.7 ± 33.4 kg], bench press (118.5 ± 29.9 kg), and deadlift (189.9 ± 41.2 kg). Powerlifters were matched based on relative maximal strength, and randomly assigned to either (a) 1-week overreach and 1-week step taper or (b) 1-week overreach and 3-week exponential taper. Athletes were tested pre- and post-training on measures of body composition, jumping performance, isometric squat, and 1RM. Whole muscle size was assessed at the proximal, middle, and distal vastus lateralis using ultrasonography and microbiopsies at the middle vastus lateralis site. Muscle samples (n = 15) were analyzed for fiber size, fiber type [myosin-heavy chain (MHC)-I, -IIA, -IIX, hybrid-I/IIA] using whole muscle immunohistochemistry and single fiber dot blots, gene expression, and microRNA abundance. There were significant main time effects for 1RM squat (p < 0.001), bench press (p < 0.001), and deadlift, (p = 0.024), powerlifting total (p < 0.001), Wilks Score (p < 0.001), squat jump peak-power scaled to body mass (p = 0.001), body mass (p = 0.005), fat mass (p = 0.002), and fat mass index (p = 0.002). There were significant main time effects for medial whole muscle cross-sectional area (mCSA) (p = 0.006) and averaged sites (p < 0.001). There was also a significant interaction for MHC-IIA fiber cross-sectional area (fCSA) (p = 0.014) with post hoc comparisons revealing increases following the step-taper only (p = 0.002). There were significant main time effects for single-fiber MHC-I% (p = 0.015) and MHC-IIA% (p = 0.033), as well as for MyoD (p = 0.002), MyoG (p = 0.037), and miR-499a (p = 0.033). Overall, increases in whole mCSA, fCSA, MHC-IIA fCSA, and MHC transitions appeared to favor the step taper group. An overreach followed by a step taper appears to produce a myocellular environment that enhances skeletal muscle adaptations, whereas an exponential taper may favor neuromuscular performance.

Auto-regulatory progressive training compared to linear programming on muscular strength, endurance, and body composition in recreationally active males

We compared eight weeks of auto-regulatory progressive resistance exercise (APRE) to linear programming resistance exercise (LPRE) on changes in muscular strength and endurance, anaerobic power, and body composition in recreationally active males. Twenty-four recreationally active males (age: 24 ± 3 y; body mass: 78.3 ± 10.3 kg) were randomly assigned to one of two groups: APRE (n = 12) and LPRE (n = 12). Both groups performed supervised training 3x/week for eight weeks Upper and lower body muscular strength and endurance, anaerobic power, and body composition were assessed at baseline, week 4, and 48 h after the final training session. Repeated measures ANOVA and hedge's g effect sizes (ES) were used to interpret the data. After training, there was a significant increase in absolute leg press (APRE: ES = 2.23; LPRE: ES = 1.35) and chest press strength (APRE: ES = 2.19; LPRE: ES = 0.98), upper (APRE: ES = 2.50; LPRE: ES = 1.074), and lower body peak power (APRE: ES = 0.78; LPRE: ES = 0.39), and upper (APRE: ES = 2.50; LPRE: ES = 1.60) and lower mean power (APRE: ES = 0.99; LPRE: ES = 0.54) over time in both groups compared to baseline. Following APRE, absolute leg press strength was significantly greater compared to LPRE (p = 0.04; ES = 2.41, ES = 1.36), while absolute chest press strength gains were similar between groups (p = 0.08; ES = 2.21, ES =  0.98). Skeletal muscle mass significantly increased similarly in both groups over time (APRE: ES = 0.46; LPRE: ES = 0.21), while there was no change over time or between groups for body fat %. APRE and LPRE were both effective at improving anaerobic power and skeletal muscle mass; however, APRE was more effective at improving lower body muscular strength in recreationally active males.

Periodization and Block Periodization in Sports: Emphasis on Strength-Power Training-A Provocative and Challenging Narrative

ABSTRACT

Stone, MH, Hornsby, WG, Haff, GG, Fry, AC, Suarez, DG, Liu, J, Gonzalez-Rave, JM, and Pierce, KC. Periodization and block periodization in sports: emphasis on strength-power training-a provocative and challenging narrative. J Strength Cond Res 35(8): 2351-2371, 2021-Periodization can be defined as a logical sequential, phasic method of manipulating fitness and recovery phases to increase the potential for achieving specific performance goals while minimizing the potential for nonfunctional over-reaching, overtraining, and injury. Periodization deals with the micromanagement of timelines and fitness phases and is cyclic in nature. On the other hand, programming deals with the micromanagement of the training process and deals with exercise selection, volume, intensity, etc. Evidence indicates that a periodized training process coupled with appropriate programming can produce superior athletic enhancement compared with nonperiodized process. There are 2 models of periodization, traditional and block. Traditional can take different forms (i.e., reverse). Block periodization has 2 subtypes, single goal or factor (individual sports) and multiple goals or factors (team sports). Both models have strengths and weaknesses but can be "tailored" through creative programming to produce excellent results for specific sports.

Effects of Power and Ballistic Training on Table Tennis Players' Electromyography Changes

The aim of the present study was to analyze the effects of ballistic and power training on table tennis players' electromyography (EMG) changes. Thirty male table tennis players, who were able to perform top spin strikes properly, were randomly assigned to three groups: power training (PT; n = 10); ballistic training (BT; n = 10); and no training (CON = control group; n = 10). PT and BT were performed 3 times weekly for 8 weeks. Before and after training programs, a one-repetition maximum test (1RM) and the EMG activity of all the subjects' upper/lower body muscles while performing top spin strokes were analyzed. After training, significant interactions (group × time) were observed in increasing 1RM strength in upper/lower muscles (p < 0.05). However, neither training type had any significant effect on muscle EMG activity. These findings suggest that there should not necessarily be any significant change in the EMG signal after BT and PT despite the increase in muscle strength.

Scaling of Joint Motion and Muscle Activation for 3-Dimensional Control of Reach Extent

This study investigated the scaling of upper arm kinematics, joint motion, and muscle activation for three-dimensional (3D) reaches to targets of increasing distance. Fifteen participants completed 108 total reaches to targets placed 7, 14, and 21 cm across midline. Peak velocity, acceleration, and time to peak velocity scaled to both target and movement distance. Shoulder and elbow excursion scaled to target distance and were highly coordinated. Anterior deltoid activation scaled to both target and movement distance in the early and late phases of reach control. Biceps and triceps activation scaled to movement distance primarily in the late phase. Scaling of these outcome variables provides a model for understanding the control of reach distance in a 3D environment.

A New Muscle Activation Dynamics Model, That Simulates the Calcium Kinetics and Incorporates the Role of Store-Operated Calcium Entry Channels, to Enhance the EMG-Driven Hill-type Models

Hill-type models are frequently used in biomechanical simulations. They are attractive for their low computational cost and close relation to commonly measured musculotendon parameters. Still, more attention is needed to improve the activation dynamics of the model specifically because of the nonlinearity observed in the EMG-Force relation. Moreover, one of the important and practical questions regarding the assessment of the model's performance is how adequately can the model simulate any fundamental type of human movement without modifying model parameters for different tasks? This paper tries to answer this question by proposing a simple physiologically based activation dynamics model. The model describes the ?kinetics of the calcium dynamics while activating and deactivating the muscle contraction process. Hence, it allowed simulating the recently discovered role of store-operated calcium entry (SOCE) channels as immediate counter-flux to calcium loss across the tubular system during excitation-contraction coupling. By comparing the ability to fit experimental data without readjusting the parameters, the proposed model has proven to have more steady performance than phenomenologically based models through different submaximal isometric contraction levels. This model indicates that more physiological insights is key for improving Hill-type model performance.

Resistance Exercise, Aging, Disuse, and Muscle Protein Metabolism

Skeletal muscle is the organ of locomotion, its optimal function is critical for athletic performance, and is also important for health due to its contribution to resting metabolic rate and as a site for glucose uptake and storage. Numerous endogenous and exogenous factors influence muscle mass. Much of what is currently known regarding muscle protein turnover is owed to the development and use of stable isotope tracers. Skeletal muscle mass is determined by the meal- and contraction-induced alterations of muscle protein synthesis and muscle protein breakdown. Increased loading as resistance training is the most potent nonpharmacological strategy by which skeletal muscle mass can be increased. Conversely, aging (sarcopenia) and muscle disuse lead to the development of anabolic resistance and contribute to the loss of skeletal muscle mass. Nascent omics-based technologies have significantly improved our understanding surrounding the regulation of skeletal muscle mass at the gene, transcript, and protein levels. Despite significant advances surrounding the mechanistic intricacies that underpin changes in skeletal muscle mass, these processes are complex, and more work is certainly needed. In this article, we provide an overview of the importance of skeletal muscle, describe the influence that resistance training, aging, and disuse exert on muscle protein turnover and the molecular regulatory processes that contribute to changes in muscle protein abundance. © 2021 American Physiological Society. Compr Physiol 11:2249-2278, 2021.

Corticomotor excitability of gluteus maximus and hip extensor strength: The influence of sex

PURPOSE

To compare hip extensor strength and corticomotor excitability (CME) of gluteus maximus (GM) between males and females. A secondary purpose was to determine if CME of GM is predictive of hip extensor strength.

METHOD

Thirty-two healthy individuals participated (15 males and 17 females). CME of GM was assessed using the input-output curve (IOC) procedure acquired from transcranial magnetic stimulation (average slope). Hip extensor strength was measured by a dynamometer during a maximal voluntary isometric contraction. Independent t-tests were used to compare CME of GM and peak hip extensor torque between males and females. Linear regression analysis was used to determine whether peak hip extensor torque was predicted by CME of GM.

RESULT

Compared to males, females demonstrate lower peak hip extensor torque (4.42 ± 1.11 vs. 6.15 ± 1.72 Nm/kg/m2, p < 0.01) and lower CME of GM (1.36 ± 1.07 vs. 2.67 ± 1.30, p < 0.01). CME of GM was a significant predictor of peak hip extensor torque for males and females combined (r² = 0.36, p < 0.001).

CONCLUSION

Our findings support the premise that corticomotor excitability plays a role in the ability of a muscle to generate torque.

Resistance Exercise After Laparoscopic Surgery Enhances Improvement in Exercise Tolerance in Geriatric Patients With Gastrointestinal Cancer

INTRODUCTION

 Early mobilization after cancer surgery is generally recommended. However, the effects of postoperative resistance exercise during a hospital stay have been rarely investigated. This study aimed to clarify the effects of resistance exercise after laparoscopic surgery on exercise tolerance and skeletal muscle mass in geriatric patients with gastrointestinal cancer.

METHODS

This single-center retrospective observational study included patients with gastrointestinal cancer who admitted for laparoscopic surgery. Exercise tolerance and skeletal muscle mass were assessed using a six-minute walking test (6MWT) and skeletal muscle index (SMI) at admission and discharge, respectively. Intergroup comparisons of absolute changes in 6MWT and SMI were analyzed by the unpaired t-test or Mann-Whitney U test according to whether resistance exercise was performed or not. Multivariable linear regression analyses were used to analyze the association of resistance exercise with changes in 6MWT and SMI. The analyses were adjusted for age, sex, cancer stage, postoperative complication, and preoperative exercise tolerance and skeletal muscle mass.

RESULTS

Altogether, 66 patients (mean age 69.9 years; 60.6% men) were recruited. Of them, 72.7% performed the resistance exercise and started at a median of 4.5 postoperative days. There were no significant intergroup differences in absolute changes in the 6MWT and the SMI (p = 0.153, p = 0.476, respectively). Multivariable linear regression analysis showed that resistance exercise was independently and positively associated with the 6MWT at discharge (β = 1.70, 95% confidence interval, 1.88 to 71.09) and did not significantly contribute to the SMI at discharge (95% confidence interval, -0.21 to 0.27).

CONCLUSION

Resistance exercise may enhance the improvement in postoperative exercise tolerance in geriatric patients with gastrointestinal cancer who underwent laparoscopic surgery.

Effects of Cross-Education After 6 Weeks of Eccentric Single-Leg Decline Squats Performed With Different Execution Times: A Randomized Controlled Trial

BACKGROUND

Cross-education of strength refers to the strength gain that is transferred to the contralateral limb after a unilateral training program.

HYPOTHESIS

Unilateral eccentric training using different muscle contraction times would improve the structural and functional properties of the untrained contralateral limb.

STUDY DESIGN

Randomized controlled trial.

LEVEL OF EVIDENCE

Level 2.

METHODS

Thirty-six participants were randomized into a control group, experimental group 1 (EG6s; eccentric contraction runtime = 6 seconds) and experimental group 2 (EG3s; eccentric contraction runtime = 3 seconds). The thickness and elastographic index of the patellar tendon (PT), lean mass and fat percentage of the thigh, contractile properties of the vastus lateralis (VL), as well as isometric, concentric, and eccentric knee extensor peak torques, and eccentric single-leg decline squat (SLDS_e) 1 repetition maximum (1-RM) were measured after 6 weeks of SLDS_e training (3 times per week, 80% of 1-RM) and after 6 weeks of detraining in the untrained contralateral limb.

RESULTS

After training, there was an increase in lean thigh mass of the untrained limb in both groups: EG6s (0.17 ± 0.29 kg;P = 0.03; effect size [ES] = 0.15) and EG3s (0.15 ± 0.23 kg; P = 0.04; ES = 0.19). Likewise, both EG6s (62.30 ± 19.09 kg; P < 0.001; ES = 4.23) and EG3s (68.09 ± 27.49 kg; P < 0.001; ES = 3.40) increased their 1-RM, isometric (EG6s: 48.64 ± 44.82 N·m, P < 0.001, ES = 0.63; EG3s: 34.81 ± 47.30 N·m, P = 0.004, ES = 0.38), concentric at 60 deg/s and 180 deg/s and eccentric at 60 deg/s and 180 deg/s knee extensor peak torques (P < 0.05) in the untrained limb. However, no differences were found in the contractile properties of the VL or in the thickness of the PT after eccentric training in either of the 2 experimental groups.

CONCLUSION

Regardless of the runtime of the contraction, 6 weeks of SLSD_e was effective for inducing structural and strength adaptations in the contralateral untrained limb. However, most of these adaptations were lost after 6 weeks of detraining.

CLINICAL RELEVANCE

Our study suggests that cross-education training can be of great importance for clinical application and musculoskeletal and neuromuscular rehabilitative processes after unilateral injury.

Exercise training improves postural steadiness in cancer survivors undergoing chemotherapy

BACKGROUND

Cancer and cancer treatments negatively affect somatosensory, vestibular, and visual inputs that regulate postural stability and balance, increasing the risk of falling. Exercise training has been shown to mitigate other negative side effects of cancer treatments, such as reducing peripheral neuropathy.

RESEARCH QUESTION

How does 12 weeks of supervised exercise training influence postural stability in cancer survivors who receive chemotherapy?

METHODS

Postural stability of cancer survivors (n = 25; mass = 79.0 ± 22.6 kg; height = 1.66 ± 0.08 m; age = 61 ± 10 years) receiving chemotherapy was assessed prior to and following a 12-week individualized exercise training program by quantifying changes in center of pressure data. A series of 2-factor (pre/post x condition) analysis of variance with repeated measures were used to identify differences between conditions and pre- and post- training program on time and frequency domain measures.

RESULTS

Mediolateral root mean square excursion (p = 0.040; es = 0.20) and resultant mean frequency (p = 0.044; es = 0.29) of the center of pressure trajectory were found to be significantly different between pre- and post-training program. Further, participants dealt better with perturbations after completing the training program by reducing mediolateral root mean square excursion and 95 % confidence ellipse when visual stimulus was removed.

SIGNIFICANCE

Supervised exercise training in cancer patients undergoing chemotherapy improves postural stability in the mediolateral direction. Given that mediolateral movement of the center of pressure has previously been associated with fallers in other populations, exercise training during cancer treatments may be beneficial.

Traditional Lègong Dance Training Is Superior to Moderate Aerobic Training on Physical Fitness Improvement Among Young Girls

BACKGROUND

Légong dance is a famous Balinese dance with a dynamic movement. It potentially becomes an exercise of choice to improve young girls' physical fitness. This study aimed to evaluate légong dance training's effect on physical fitness compared with aerobic training.

METHODS

Forty young girls were randomly assigned to the aerobic training (AG) and lègong dance (DG) group and trained with jogging and lègong dancing at moderate-intensity aerobic training. Each was carried out for 30 minutes, 3 times a week, for 6 weeks.

RESULT

Aerobic capacity (estimated maximal oxygen consumption) improved significantly in AG and DG, with a mean difference and Cohen d effect size of 0.36 mL/kg/min and 0.68. The back- and leg-muscle strength increased significantly in DG and AG, with a mean difference of 5.55 kg and 6.67 kg, and an effect size of 0.69 and 0.77. Balance improved significantly in DG and AG, with a mean difference of 21.26 seconds and an effect size of 1.05. All significant values are reported at P < .05. There were no significant improvements in arm muscle strength, body fat percentage, and flexibility in either group (P > .05).

CONCLUSION

Lègong dance training results in significant physical fitness improvement and better results than aerobic training.

Effects of TheraBand and Theratube Eccentric Exercises on Quadriceps Muscle Strength and Muscle Mass in Young Adults

Purpose

This study was aimed at comparing the effects of TheraBand and theratube eccentric exercises on quadriceps muscle strength in young adults.

Methods

Thirty young adults (19 females, 11 males) participated in this pretest-posttest experimental study. Participants were randomly assigned to one of the two groups: TheraBand and theratube groups. They received the training intervention 3 times a week for 4 weeks (12 sessions) with progression after 2 weeks. Maximum eccentric quadriceps strength was assessed using the Biodex isokinetic dynamometer system. Additionally, quadriceps muscle mass was measured using a tape.

Results

Both groups showed a significant improvement in the peak torque of the eccentric isokinetic quadriceps' strength after weeks 2 and 4. Strength change in the quadriceps was nonsignificant in the theratube group compared to the TheraBand group after 4 weeks of training (p < 0.05). There was no increase in muscle mass during the 4 weeks of training in any group (p > 0.05).

Conclusion

Both the TheraBand and theratube are equally effective in the strengthening of the quadriceps muscle in young adults. Therefore, either the TheraBand or theratube may be used according to the availability and feasibility of the subjects for training intervention.

A Narrative Review of Handgrip Strength and Cognitive Functioning: Bringing a New Characteristic to Muscle Memory

BACKGROUND

Measures of handgrip strength have not only emerged as a clinically viable screening tool for determining risk for morbidity, functional disability, and early mortality, but also for helping to identify cognitive deficits. However, the phenomena that links low handgrip strength with cognitive decline remains unclear. The role of the muscular and neural systems, and their adaptations to muscle strengthening activities over the life course, may provide important information for how age-related changes to muscle mass, strength, and neural capacity influence cognition. Moreover, disentangling how handgrip strength and cognitive function are associated may help to inform healthcare providers working with aging adults and guide targeted interventions aiming to preserve muscle and cognitive functioning.

OBJECTIVE

To 1) highlight and summarize evidence examining the associations of handgrip strength and cognitive functioning, and 2) provide directions for future research in this area.

METHODS

Articles from the PubMed database were searched from November 2018-May 2019. The search term algorithm, inclusion and exclusion criteria were pre-specified by investigators.

RESULTS

Several cross-sectional and longitudinal studies have revealed that measures of handgrip strength were associated with cognitive declines regardless of age demographics and the presence of comorbidities.

CONCLUSION

Handgrip strength can be used in clinical and epidemiological settings for helping to determine the onset and progression of cognitive impairment. Future research should continue to examine how handgrip strength and cognitive function are linked.

Exercise Training and Neuromuscular Parameters in Patients With Type 1 Diabetes: Systematic Review and Meta-Analysis

BACKGROUND

The present study aimed to systematically review the literature on the effects of physical training on neuromuscular parameters in patients with type 1 diabetes mellitus (T1DM).

METHODS

The PubMed, Scopus, EMBASE, and COCHRANE databases were accessed in September 2020. Clinical trials that evaluated the effects of physical training on neuromuscular parameters (maximum strength, resistance strength, muscle power, muscle quality, and muscle thickness) of patients with T1DM compared with a control group were considered eligible. The results were presented as the standardized mean difference with 95% confidence intervals. Effect size (ES) calculations were performed using the fixed effect method, with α = .05.

RESULTS

Combined training increased the maximum strength levels in individuals with T1DM to a lesser extent than in healthy individuals (ES: 0.363; P = .038). Strength training increased the maximum strength (ES: 1.067; P < .001), as well as combined training (ES: 0.943; P < .001); both compared with aerobic training in patients with T1DM. Strength training increased the maximum strength in a similar magnitude to combined training in patients with T1DM (ES: -0.114; P = .624).

CONCLUSION

Both combined training and strength training represent effective strategies for improving the maximum strength in individuals with T1DM.

Blood Flow Restriction Does Not Promote Additional Effects on Muscle Adaptations When Combined With High-Load Resistance Training Regardless of Blood Flow Restriction Protocol

ABSTRACT

Teixeira, EL, Ugrinowitsch, C, de Salles Painelli, V, Silva-Batista, C, Aihara, AY, Cardoso, FN, Roschel, H, and Tricoli, V. Blood flow restriction does not promote additional effects on muscle adaptations when combined with high-load resistance training regardless of blood flow restriction protocol. J Strength Cond Res 35(5): 1194-1200, 2021-The aim of this study was to investigate, during high-load resistance training (HL-RT), the effect of blood flow restriction (BFR) applied during rest intervals (BFR-I) and muscle contractions (BFR-C) compared with HL-RT alone (no BFR), on maximum voluntary isometric contraction (MVIC), maximum dynamic strength (one repetition maximum [1RM]), quadriceps cross-sectional area (QCSA), blood lactate concentration ([La]), and root mean square of the surface electromyography (RMS-EMG) responses. Forty-nine healthy and untrained men (25 ± 6.2 years, 178.1 ± 5.3 cm and 78.8 ± 11.6 kg) trained twice per week, for 8 weeks. One leg of each subject performed HL-RT without BFR (HL-RT), whereas the contralateral leg was randomly allocated to 1 of 2 unilateral knee extension protocols: BFR-I or BFR-C (for all protocols, 3 × 8 repetitions, 70% 1RM). Maximum voluntary isometric contraction, 1RM, QCSA, and acute changes in [La] and RMS-EMG were assessed before and after training. The measurement of [La] and RMS-EMG was performed during the control sessions with the same relative load obtained after the 1RM test, before and after training. Similar increases in MVIC, 1RM, and QCSA were demonstrated among all conditions, with no significant difference between them. [La] increased for all protocols in pre-training and post-training, but it was higher for BFR-I compared with the remaining protocols. Increases in RMS-EMG occurred for all protocols in pre-training and post-training, with no significant difference between them. In conclusion, despite of a greater metabolic stress, BFR inclusion to HL-RT during rest intervals or muscle contraction did not promote any additive effect on muscle strength and hypertrophy.

Is the Focal Muscle Vibration an Effective Motor Conditioning Intervention? A Systematic Review

Mechanical vibration, applied to single or few muscles, can be a selective stimulus for muscle spindles, able to modify neuromuscular management, inducing short and long-term effects, are now mainly employed in clinic studies. Several studies reported as treatments with focal vibratory (FVT) can influence neuromuscular parameters also in healthy people. However, the application modalities and the consequent effects are remarkably fragmented. This paper aims to review these studies and to characterize the FVT effectiveness on long-term conditional capacities in relation to FVT characteristics. A systematic search of studies published from 1985 to 2020 in English on healthcare databases was performed. Articles had to meet the following criteria: (1) treatment based on a locally applied vibration on muscle belly or tendon; (2) healthy adults involved; (3) outcomes time analysis enduring for more than 24 h. Twelve studies were found, all of them presented an excellent quality score of ≥75%. All selected papers reported positive changes, comparable with traditional long-lasting training effects. Muscle force and power were the most investigated parameters. The after-effects persisted for up to several months. Among the different FV administration modalities, the most effective seems to show a stimulus frequency of ≈100 Hz, repeated more times within three-five days on a voluntary contracted muscle.

The Maximal Lactate Steady State Workload Determines Individual Swimming Performance

The lactate threshold (LT) and the strongly related maximal lactate steady state workload (MLSS_W) are critical for physical endurance capacity and therefore of major interest in numerous sports. However, their relevance to individual swimming performance is not well understood. We used a custom-made visual light pacer for real-time speed modulation during front crawl to determine the LT and MLSS_W in a single-exercise test. When approaching the LT, we found that minute variations in swimming speed had considerable effects on blood lactate concentration ([La^-]). The LT was characterized by a sudden increase in [La^-], while the MLSS_W occurred after a subsequent workload reduction, as indicated by a rapid cessation of blood lactate accumulation. Determination of the MLSS_W by this so-called "individual lactate threshold" (ILT)-test was highly reproducible and valid in a constant speed test. Mean swimming speed in 800 and 1,500 m competition (S-Comp) was 3.4% above MLSS_W level and S-Comp, and the difference between S-Comp and the MLSS_W (Δ S-Comp/MLSS_W) were higher for long-distance swimmers (800-1,500 m) than for short- and middle-distance swimmers (50-400 m). Moreover, Δ S-Comp/MLSS_W varied significantly between subjects and had a strong influence on overall swimming performance. Our results demonstrate that the MLSS_W determines individual swimming performance, reflects endurance capacity in the sub- to supra-threshold range, and is therefore appropriate to adjust training intensity in moderate to severe domains of exercise.

The effect of different resistance training protocols equalized by time under tension on the force-position relationship after 10 weeks of training period

This study investigated the impact of performing two equalized resistance training (RT) protocols for 10 weeks that differ only by repetition duration and number in the force-position and EMG-position relationship. Participants performed an equalized (36 s of time under tension; 3-4 sets; 3 min between sets; 50-55% of one-repetition maximum; 3× week) RT intervention on the bench press and the only different change between protocols was repetition number (RN; 12 vs.6) or duration (RD; 3 s vs. 6 s). Two experimental groups (RN₁₂RD₃, n = 12; and RN₆RD₆, n = 12) performed the RT, while one group was the control (Control, n = 11). Maximal isometric contractions at 10%, 50% and 90% of total bench press range of motion were performed pre- and post-RT, while electromyography was recorded. It demonstrated an increase in isometric force (+14% to 24%, P < 0.001) shifting up the force-position relationship of the training groups after RT, although no difference was between training groups compared to the Control. Neuromuscular activation from pectoralis major presented an increase after training for both RT groups (+44%; P < 0.001) compared to the Control. However, although not significantly different, triceps brachii also presented an increase depending on the protocol (+25%). In conclusion, 10 weeks of an equalized RT with longer RN and shorter RD (or opposite) similarly increases the ability to produce maximal isometric force during the bench exercise across different angles, while neuromuscular activation of the pectoralis major partially explained the shift-up of the force-position relationship after training.

Do exercise-induced increases in muscle size contribute to strength in resistance-trained individuals?

AIM

Previous work in non-resistance-trained individuals has found that an increase in muscle size has no additive effect on changes in strength. However, it is thought that muscle growth is of increased importance for resistance-trained individuals.

PURPOSE

Experiment 1: To examine changes in muscle thickness (MT) and one repetition maximum (1RM) strength following 8 weeks of bi-weekly 1RM practice or traditional training. Experiment 2: To determine whether increasing muscle size increases strength potential when followed by 4 weeks of 1RM training.

METHODS

Participants performed biceps curls for 8 weeks (Experiment 1). One arm performed 4 sets of as many repetitions as possible with approximately 70% of 1RM (TRAD), and the other arm performed a single 1RM. For experiment 2, both arms trained for muscle size and strength.

RESULTS

Experiment 1 (n = 25): for MT, the posterior probabilities favoured the hypothesis that MT changed more in the TRAD condition [mean difference: 50% site 0.15 (-0.09, 0.21) cm; 60% site 0.14 (0.06, 0.23) cm; 70% site 0.17 (0.10, 0.23) cm]. For 1RM strength, each condition changed equivalently. Experiment 2 (n = 18): for MT, the posterior probabilities favoured the hypothesis that MT changed similarly between conditions following a 4-week strength phase. For changes in 1RM strength, the evidence favoured neither hypothesis (i.e. null vs. alternative). Of note, the mean difference between conditions was small [0.72 (4.3) kg].

CONCLUSIONS

1RM training produces similar increases in strength as traditional training. Experiment 2 suggests that increases in muscle mass may not increase the 'potential' for strength gain.

Post-operative Rehabilitation for Scapular Muscle Reattachment: A Case Report

BACKGROUND AND PURPOSE

Scapular muscle detachment is a rare orthopedic problem that has been described in the literature in patients following traumatic events involving traction, direct trauma, or a motor vehicle accident. The purpose of this case report is to describe the post-operative rehabilitation following scapular muscle reattachment surgery. Unique to this case report is the patient's perspective, an orthopedic physical therapist with 25 years of experience.

CASE DESCRIPTION

A 47-year-old female physical therapist experienced a traction injury to bilateral upper extremities during a medical procedure resulting in bilateral rhomboid, and bilateral lower trapezius muscles were detached from the medial scapular border. Reconstruction of the left scapulothoracic musculature occurred five and one-half years post-injury with the right repaired one year later. This case report describes the rehabilitation program that took one-year to recover for each arm with a period of protected motion for 16-weeks and gradual return to function as a manual physical therapist over a period of one-year.

OUTCOMES

The American Shoulder and Elbow Surgeons (ASES) Standardized Assessment Form and pain-free range of motion was used pre- and postoperatively. Left and right shoulder pre-operative ASES scores were 68 and 72, respectively. At the one-year post-operative the left shoulder was rated at 82 and the right shoulder was 90. Pain-free range of motion was achieved in both arms by one year. Functional limitations requiring strength overhead were the slowest to return and were not completely back at one year following either surgery.

DISCUSSION

Rehabilitation protocols for scapular muscle reattachment surgery are not commonly available to allow physical therapists to guide their patients and structure a rehabilitation program. This case report provides a sample pre-operative set of educational guidelines and a post-operative protocol for use after scapular reattachment surgery. This case report is unique because it offers a patient perspective who is a physical therapist and underwent this surgery twice. Therefore, providing insight on how to prepare for such a unique operation. The slow recovery is due to three issues 1) the prolonged time from injury to diagnosis created significant muscle wasting and muscular imbalance of surrounding tissues, 2) once this tissue was repaired it requires months of protection to recover, 3) the involved scapulothoracic muscle have to regain adequate strength as the foundation for upper extremity functions.

LEVEL OF EVIDENCE

Level 5.

Muscle Activation Sequence in Flywheel Squats

Background: Muscle coordination is important for rational and effective planning of therapeutic and exercise interventions using equipment that mimics functional movements. Our study was the first to assess muscle coordination during flywheel (FW) squats. Methods: Time-of-peak electromyographic activation order was assessed separately for 8, 4, and 3 leg muscles under four FW loads. A sequential rank agreement permutations tests (SRA) were conducted to assess activation order and Kendall’s tau was used to assess the concordance of activation order across subjects, loads and expected order of activation. Results: SRA revealed a latent muscle activation order at loads 0.05, 0.075, and 0.1, but not at 0.025 kg·m². Kendall’s tau showed moderate-to-strong concordance between the expected (proximal-to-distal) and the observed muscle activation order only at a load 0.025 kg·m², regardless of the number of muscles analyzed. Muscle activation order was highly concordant between loads 0.05, 0.075, and 0.1 kg·m². Conclusions: The results show a specific role of each muscle during the FW squat that is load-dependent. While the lowest load follows the proximal-to-distal principle of muscle activation, higher loads lead to a reorganization of the underlying muscle coordination mechanisms. They require a specific and stable muscle coordination pattern that is not proximal-to-distal.

Fish Protein Ingestion Induces Neural, but Not Muscular Adaptations, Following Resistance Training in Young Adults

Purpose: Nutritional supplementation in conjunction with exercise is of interest for the prevention or improvement of declines in motor performances in older adults. An understanding of the effects on both young and older adults contributes to its effective application. We investigated the effect of fish protein ingestion with resistance training on neural and muscular adaptations in young adults using interventions and assessments that have already been tested in older adults.

Methods: Eighteen young adults underwent 8 weeks of isometric knee extension training. During the intervention, nine participants ingested 5 g of fish protein (n = 9, Alaska pollack protein, APP), and the other nine participants ingested casein as a control (n = 9, CAS) in addition to daily meals. Before, during, and after the intervention, the isometric knee extension force, lower extremity muscle mass, and motor unit firing pattern of knee extensor muscles were measured.

Results: Maximum voluntary contraction (MVC) was significantly increased in both APP and CAS groups from 0 weeks to 4, 6, and 8 weeks of intervention (p < 0.001), but there were no significant differences between the groups (p = 0.546–0.931). Muscle mass was not significantly changed during the intervention in either group (p = 0.250–0.698). Significant changes in motor unit firing rates (p = 0.02 and 0.029 for motor units recruited at 20–40% of MVC and at 40–60%) were observed following the intervention in the APP but not CAS (p = 0.120–0.751) group.

Conclusions: These results suggest that dietary fish protein ingestion changes motor unit adaptations following resistance training in young adults.

Neuromuscular Adaptations and Enhancement of Physical Performance in Female Basketball Players After 8 Weeks of Plyometric Training

The aim of this study was to examine the effects of an 8-week in-season plyometric training (PT) program on the physical performance and neuromuscular adaptations of female basketball players. Twenty-seven elite female basketball players (aged 21.0 ± 2.6 years) were assigned between an experimental group (n = 15) who substituted a part of their usual training with biweekly PT, and a control group (n = 12) who maintained their standard basketball training. Analyses of variance and co-variance assessed changes in 10, 20, and 30 m sprint times, ability to change direction (T-test) and jumping ability [squat jump (SJ) and countermovement jump (CMJ)] with electromyographic assessment of the vastus lateralis, vastus medialis, and rectus femoris muscles during jumping and meassurement of the isokinetic strength of the knee muscles. After 8 weeks of the plyometric program the experimental group enhanced change of direction performance (Δ = −3.90%, d = 0.67) and showed a greater thigh cross sectional area (Δ = 9.89%, d = 0.95) relative to controls. Neural adaptations included significant improvements of EMG parameters for the vastus medialis muscle during Squat Jumping (Δ = 109.3%, d = 0.59). However, trends to improvements of sprinting times and jumping performances did not reach statistical significance. In addition, there were no gains in the peak torque and the average power of the quadriceps and hamstring muscles at either slow or moderate test speeds. We conclude that 8-weeks of PT (72–126 jumps) was insufficient to improve many of the variables associated with basketball performance in our subject-group. Further studies of female basketball players, extending the program period and increasing the intensity and speed of jumps are recommended in the search for more significant results.

Tongue Strength Training Increases Daytime Upper Airway Stability in Rats

PURPOSE

Tongue strength training (TST) has been shown to decrease the apnea-hypopnea index in some patients with obstructive sleep apnea (OSA). However, whether TST modulates the central regulation of genioglossus and influences the stability of the upper airway remains unknown. The purpose of this study was to dynamically assess the effect of TST on the upper airway.

METHODS

Sixteen adult male Sprague-Dawley rats were studied to explore the mechanism of TST improving the upper airway function. The rats were randomly assigned to the normal control (NC) and TST groups. The TST group underwent 8-week progressive resistance tongue exercise training. Transcranial magnetic stimulation (TMS) responses and EMG activities were consistently recorded for 2 h on days 0, 14, 28, and 56 of the experiments in both groups. Theoretical critical pressure (Pcrit) value was measured on days 0, 14, 28, and 56.

RESULTS

The TST group showed shorter TMS latency and higher genioglossus EMG activity, which lasted from 5 min to 80 min after training on day 56 of training, than the NC group. The TST group showed significantly lower theoretical Pcrit values on days 28 and 56 of training than the NC group (-4.07±0.92 vs -3.12±0.77 cmH₂O, P< 0.05, -4.66±0.74 vs -3.07±0.38 cmH₂O, P< 0.01).

CONCLUSION

This study revealed that an 8-week TST could gradually and transiently increase corticomotor excitability of genioglossus, elevate the genioglossus EMG activity, and ultimately enhance the stability of the upper airway during daytime. Moreover, improved neuromuscular excitability occurred prior to the enhanced upper airway stability. These findings provide a theoretical foundation for TST as a promising treatment for OSA patients.

Functional relevance of resistance training-induced neuroplasticity in health and disease

Repetitive, monotonic, and effortful voluntary muscle contractions performed for just a few weeks, i.e., resistance training, can substantially increase maximal voluntary force in the practiced task and can also increase gross motor performance. The increase in motor performance is often accompanied by neuroplastic adaptations in the central nervous system. While historical data assigned functional relevance to such adaptations induced by resistance training, this claim has not yet been systematically and critically examined in the context of motor performance across the lifespan in health and disease. A review of muscle activation, brain and peripheral nerve stimulation, and imaging data revealed that increases in motor performance and neuroplasticity tend to be uncoupled, making a mechanistic link between neuroplasticity and motor performance inconclusive. We recommend new approaches, including causal mediation analytical and hypothesis-driven models to substantiate the functional relevance of resistance training-induced neuroplasticity in the improvements of gross motor function across the lifespan in health and disease.

Acute Effects of Elastic Bands as Resistance or Assistance on EMG, Kinetics, and Kinematics During Deadlift in Resistance-Trained Men

The aim of the study was to compare neuromuscular activation, kinetics and kinematics in three variations of the deadlift: (1) free weights, (2) free weights with elastic bands as resistance (bands anchored to the ground) and (3) free weights with elastic bands as assistance (bands attached above the bar). Sixteen resistance-trained men performed one repetition of the three variations as fast as possible using a 2-repetition maximum load in randomized and counterbalanced order. Muscle activation (gluteus maximus, semitendinosus, biceps femoris, erector spinae, vastus lateralis, and vastus medialis), kinematics (average-, peak-, and time to peak velocity), and kinetics (average-, peak,-and time to peak force) were measured during the ascending movement. Resisted and assisted deadlifts led to higher average and peak force outputs (p < 0.001–0.037, ES = 0.29–0.58), and time to peak velocity was shorter when compared to the free weights deadlift (p = 0.005–0.010, ES = 0.83–1.01). However, peak force was achieved faster when using free weights (p < 0.001, ES = 1.58–2.10) and assisted deadlifts had a lower peak velocity compared to resisted and free weights deadlift (p = 0.004–0.046, ES = 0.43–0.60). There were no significant differences in muscle activation between the different conditions (p = 0.082–1.000). In conclusion, the assisted and resisted deadlift produced higher force when compared to free weights. However, free weight and resisted deadlift seem more favorable for the barbell velocity. These findings are of importance for athletes and coaches which should select exercise depending on the goal of the session.

The Influence of Movement Tempo on Acute Neuromuscular, Hormonal, and Mechanical Responses to Resistance Exercise-A Mini Review

Wilk, M, Tufano, JJ, and Zajac, A. The influence of movement tempo on acute neuromuscular, hormonal, and mechanical responses to resistance exercise-a mini review. J Strength Cond Res 34(8): 2369-2383, 2020-Resistance training studies mainly analyze variables such as the type and order of exercise, intensity, number of sets, number of repetitions, and duration and frequency of rest periods. However, one variable that is often overlooked in resistance training research, as well as in practice, is premeditated movement tempo, which can influence a myriad of mechanical and physiological factors associated with training and adaptation. Specifically, this article provides an overview of the available scientific literature and describes how slower tempos negatively affect the 1-repetition maximum, the possible load to be used, and the number of repetitions performed with a given load, while also increasing the total time under tension, which can mediate acute cardiovascular and hormonal responses. As a result, coaches should consider testing maximal strength and the maximal number of repetitions that can be performed with each movement tempo that is to be used during training. Otherwise, programming resistance training using various movement tempos is more of a trial-and-error approach, rather than being evidence or practice based. Furthermore, practical applications are provided to show how movement tempo can be adjusted for a variety of case study-type scenarios.

Intrinsic foot muscle strengthening exercises with electromyographic biofeedback achieve increased toe flexor strength in older adults: A pilot randomized controlled trial

BACKGROUND

Toe flexor strength is important for preventing older adults from falling. Although intrinsic foot muscles are the main determinants of toe flexor strength, exercises for strengthening these muscles are difficult for older adults. This study therefore aimed to determine whether the use of electromyographic biofeedback helps older adults to perform intrinsic foot muscle strengthening exercises.

METHODS

This randomized controlled trial had two parallel arms. Participants were randomly allocated to the control group or the electromyographic biofeedback group. Control participants performed two progressive intrinsic foot muscle strengthening exercises twice a week for 6 weeks. Participants in the other group performed these exercises assisted by electromyographic biofeedback. Primary outcome measures were changes in toe flexor strength and the timed up-and-go and functional reach tests (the latter two being balance tests).

FINDINGS

Altogether, 23 older adults were randomized to the control group (n = 12) or the electromyographic biofeedback group (n = 11). After the 6-week intervention, toe flexor strength on the dominant side increased in both groups (P < 0.017). However, toe flexor strength on the nondominant side increased only in the electromyographic biofeedback group (P < 0.017), with a large effect size of 1.5. There were no changes in the two balance tests. Three of the control group and two of the electromyographic biofeedback group were lost to follow- up.

INTERPRETATION

Our results indicate that, the use of electromyographic biofeedback can enhance the effect of intrinsic foot muscle strengthening exercises on the nondominant side in older adults.

CLINICAL TRIAL REGISTRATION NUMBER

UMIN000036521.

Poor Dietary Protein Intake in Elderly Population with Sarcopenia and Osteosarcopenia: A Nationwide Population-Based Study

BACKGROUND

Our purpose in this study was to evaluate any deficiency of protein intake for different types of sarcopenia, including osteosarcopenia and sarcopenic obesity and to establish a cut-off value for the relationship between malnutrition, sarcopenia, and osteosarcopenia.

METHODS

The cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. A total of 4,020 participants (men, 1,698 and women, 2,322) were analyzed in the present study. Sarcopenia is defined according to the criteria for the Asia Working Group for Sarcopenia. To evaluate the adequacy of protein intake, the value obtained by dividing the amount of protein consumed through food by the daily recommended protein amount (50 g/day) of Korean males was defined as the nutrient intake ratio.

RESULTS

Total protein (P&lt;0.001 in men, P&lt;0.001 in women) and low dietary intake protein (P&lt;0.001 in men, P=0.046 in women) were significantly lower in the sarcopenia group than in the normal group, and were significantly lower in the osteosarcopenia group than in the normal group for both men and women. The cut-off value of the adjusted weight of protein intake for sarcopenia was 0.58 g/kg/day in men and 0.98 g/kg/day in women. The cut-off value for adjusted weight of protein intake for osteo-sarcopenia was 0.8 g/kg/day in men and 0.5 g/kg/day in women.

CONCLUSIONS

A comprehensive dietary assessment to detect nutritional deficits that predispose one to or aggravate muscle atrophy is important for establishing a treatment plan for patients with malnutrition.

Acute Hamstring Muscle Tears in Climbers-Current Rehabilitation Concepts

Acute hamstring injuries are often caused by the heel hook technique. This technique is unique to climbing and causes injury to muscular and inert tissues of the posterior thigh. The heel hook is used by climbers during strenuous ascent on overhanging walls and when crossing difficult terrain. The technique reduces the amount of upper body strength required during strenuous climbing because the climber's center of mass is retained within the base of support. The heel hook is stressful collectively for the hamstring muscle group and musculotendinous junction. Depending on injury severity, both conservative and surgical methods exist for the management of hamstring injuries. Contemporary approaches to rehabilitation primarily advocate the use of eccentric muscle strengthening strategies because of high rates of elongation stress associated with sprinting and team sports. However, there is reason to doubt whether this alone is sufficient to rehabilitate the climbing athlete in light of the high degree of concentric muscle strength required in the heel hook maneuver. This review examines the contemporary rehabilitation and strength and conditioning literature in relation to the management of acute hamstring musculotendinous injuries for the climbing athlete. The review provides a comprehensive approach for the rehabilitation and athletic preparation of the climbing athlete from the initial injury to full return to sports participation.

The effect of electrical muscle stimulation on quadriceps muscle strength and activation patterns in healthy young adults

AbstractThe aim of the present study was to clarify the effect of electrical muscle stimulation (EMS) on the spatial distribution pattern of electromyographic activity in healthy young adults using multi-channel surface electromyography (SEMG). A total of 32 men (age = 21-26 years) were randomly assigned to the intervention group (n = 18) and control group (n = 14). Participants in the intervention group performed EMS to stimulate the bilateral lower limb muscle for four weeks (20 min/3 days/week). The control group received no EMS intervention. To understand the effects of EMS, the following measurements were made at baseline and four weeks: knee extension torque, muscle mass, and spatial distribution of neuromuscular activation during a target torques [10%, 30%, 50%, and 70% of the maximal voluntary contraction (MVC)] using multi-channel SEMG. The knee extension torque was significantly increased in intervention group compared with control group (p < 0.0001). However, the muscle mass did not show a significant difference between pre and post intervention in each group. The muscle activation patterns of 50% and 70% MVC task showed significant enhancement between baseline and four weeks in the intervention group. Furthermore, a moderate correlation between Δ knee extension torque and Δ spatial distribution pattern of electromyographic activity of 50% and 70% MVC in the intervention group was observed. These results suggested EMS intervention induced different distribution of muscle activity at high-intensity muscle contraction compared with low-intensity muscle contraction.

Effect of a 6-week strength-training program on neuromuscular efficiency in type 2 diabetes mellitus patients

Background

The neuromuscular system generates human movement. The functional capacity of the neuromuscular system in patients with type 2 diabetes mellitus (T2DM) is decreased and this affects the generation of muscle force. Exercise is recommended as an effective treatment in such cases. Short-duration strength training causes neural adaptations in healthy participants, but the effects of strength training on T2DM are unclear. The present study aimed to evaluate the effect of strength training on neuromuscular efficiency of lower limb muscles in T2DM.

Methods

Surface electromyograms (SEMG) of the knee flexors and extensors were recorded during isometric contractions. The ratio of peak torque to SEMG amplitude was calculated as neuromuscular efficiency. Measurements were taken before the intervention after 6 weeks of non-training, and after 6 weeks of strength training.

Results

SEMG amplitudes did not differ among the subsequent measurement sessions. Flexor and extensor peak torque increased after the strength-training program. The neuromuscular efficiency of all muscles increased after the 6 weeks of strength training.

Conclusion

A 6-week strength-training program increased the neuromuscular efficiency and peak torque in patients with T2DM; however, the electrical properties of the muscles did not change. These results may be related to increased neural adaptations and motor learning in the early stages of strength training.

Varying the Order of Combinations of Single- and Multi-Joint Exercises Differentially Affects Resistance Training Adaptations

Brandão, L, de Salles Painelli, V, Lasevicius, T, Silva-Batista, C, Brendon, H, Schoenfeld, BJ, Aihara, AY, Cardoso, FN, de Almeida Peres, B, and Teixeira, EL. Varying the order of combinations of single- and multi-joint exercises differentially affects resistance training adaptations. J Strength Cond Res 34(5): 1254-1263, 2020-Our study aimed to compare the effects of multi-joint (MJ) and single-joint (SJ) exercises, either isolated or in combination, and in different orders, on cross-sectional area (CSA) of the pectoralis major (PM) and different heads of the triceps brachii (TB), as well as on the one-repetition maximum (1-RM) in the bench press and lying barbell triceps press. Forty-three young men were randomly assigned to one of 4 possible RT protocols: barbell bench press plus lying barbell triceps press (MJ + SJ, n = 12); lying barbell triceps press plus barbell bench press (SJ + MJ, n = 10); barbell bench press (MJ, n = 10); or lying barbell triceps press (SJ, n = 11). Results showed significant within-group increases in 1-RM bench press for MJ, MJ + SJ, and SJ + MJ but not for SJ. Conversely, significantly greater within-group increases in elbow extension 1-RM were noted for SJ, MJ + SJ, and SJ + MJ but not for MJ. Significantly greater increases in PM CSA were observed for MJ, MJ + SJ, and SJ + MJ compared with SJ. Significant increases in TB CSA were noted for SJ, MJ + SJ, and SJ + MJ, but not for MJ, without observed between-group differences. Individual analysis of TB heads showed significantly greater CSA increases in the lateral head for MJ, MJ + SJ, and SJ + MJ compared with SJ. Alternatively, significantly greater increases in the long head were observed for SJ, MJ + SJ, and SJ + MJ compared with MJ. CSA increases for the medial head were statistically similar between conditions. Our findings indicate that muscular adaptations are differentially affected by performance of MJ and SJ exercises.

pH-Gated Succinate Secretion Regulates Muscle Remodeling in Response to Exercise

In response to skeletal muscle contraction during exercise, paracrine factors coordinate tissue remodeling, which underlies this healthy adaptation. Here we describe a pH-sensing metabolite signal that initiates muscle remodeling upon exercise. In mice and humans, exercising skeletal muscle releases the mitochondrial metabolite succinate into the local interstitium and circulation. Selective secretion of succinate is facilitated by its transient protonation, which occurs upon muscle cell acidification. In the protonated monocarboxylic form, succinate is rendered a transport substrate for monocarboxylate transporter 1, which facilitates pH-gated release. Upon secretion, succinate signals via its cognate receptor SUCNR1 in non-myofibrillar cells in muscle tissue to control muscle-remodeling transcriptional programs. This succinate-SUCNR1 signaling is required for paracrine regulation of muscle innervation, muscle matrix remodeling, and muscle strength in response to exercise training. In sum, we define a bioenergetic sensor in muscle that utilizes intracellular pH and succinate to coordinate tissue adaptation to exercise.

Optimised force-velocity training during pre-season enhances physical performance in professional rugby league players

The effectiveness of 8-week force-velocity optimised training was assessed in highly trained professional rugby league athletes. Players (age 24 ± 3 years; body mass 94.9 ± 21.6 kg; height 181.3 ± 6.0 cm) were strength-matched and assigned to a force-velocity optimised group (OP; n = 15) or a general strength-power group (GP; n = 14). Tests included 10-m, 20-m sprints, 3 repetition-maximum squat and squat jumps over five load conditions to ascertain vertical force-velocity relationship. ANCOVA revealed there was a group effect for force-velocity deficit (P < 0.001), with the OP two-fold greater than the GP group (OP pre: 51.13 ± 31.42%, post: 62.26 ± 31.45%, GP pre: 33.00 ± 19.60%, post: 31.14 ± 31.45%, P < 0.001). There were further group effects for 3RM squat (OP pre: 151.17 ± 22.95 kg, post: 162.17 ± 24.16 kg, GP pre: 156.43 ± 25.07 kg, post: 163.39 ± 25.39 kg, P < 0.001), peak power (OP pre: 3195 ± 949 W, post: 3552 ± 1033 W, GP pre: 3468 ± 911 W, post: 3591 ± 936 W, P < 0.001), and SJ (OP pre: 39.79 ± 7.80 cm, post: 42.69 ± 7.83 cm, GP pre: 40.44 ± 6.23 cm, post: 41.14 ± 5.66 cm, P < 0.001). Prescribing F-V deficit training is superior for improving physical performance within highly trained RL players.