Low-intensity elbow flexion eccentric contractions attenuate maximal eccentric exercise-induced muscle damage of the contralateral arm

Skeletal Muscle Heat Shock Protein Content and the Repeated Bout Effect

The "Repeated Bout Effect" (RBE) occurs when a skeletal muscle is preconditioned with a few lengthening contractions (LC) prior to exposing the muscle to a greater number of LC. The preconditioning (PC) results in significantly less damage and preservation of force. Since it takes only a few LC to increase muscle heat shock protein (HSP) content, it was of interest to examine the relationship between HSPs and the RBE. To do this, one tibialis anterior (TA) muscle from Sprague-Dawley rats (n = 5/group) was preconditioned with either 0, 5, or 15 lengthening contractions (LC) and exposed to a treatment of 60 LC 48 h later. Preconditioning TA muscles with 15 LC, but not 5 LC, significantly elevated muscle αB-crystallin (p < 0.05), HSP25 (p < 0.05), and HSP72 content (p < 0.001). These preconditioned TA muscles also showed a significantly (p < 0.05) reduced loss of active torque throughout the subsequent 60 LC. While there was a trend for all preconditioned muscles to maintain higher peak torque levels throughout the 60 LC, no significant differences were detected between the groups. Morphologically, preconditioned muscles appeared to show less discernible muscle fiber damage. In conclusion, an elevated skeletal muscle HSP content from preconditioning may contribute to the RBE.

Exercise-Dependent Modulation of Immunological Response Pathways in Endurance Athletes With and Without Atrial Fibrillation

BACKGROUND

Atrial fibrillation (AF) is a common arrhythmia characterized by uncoordinated atrial electrical activity. Lone AF occurs in the absence of traditional risk factors and is frequently observed in male endurance athletes, who face a 2- to 5-fold higher risk of AF compared with healthy, moderately active males. Our understanding of how endurance exercise contributes to the pathophysiology of lone AF remains limited. This study aimed to characterize the circulating protein fluctuations during high-intensity exercise as well as explore potential biomarkers of exercise-associated AF.

METHODS AND RESULTS

A prospective cohort of 12 male endurance cyclists between the ages of 40 and 65 years, 6 of whom had a history of exercise-associated AF, were recruited to participate using a convenience sampling method. The circulating proteome was subsequently analyzed using multiplex immunoassays and aptamer-based proteomics before, during, and after an acute high-intensity endurance exercise bout to assess temporality and identify potential markers of AF. The endurance exercise bout resulted in significant alterations to proteins involved in immune modulation (eg, growth/differentiation factor 15), skeletal muscle metabolism (eg, α-actinin-2), cell death (eg, histones), and inflammation (eg, interleukin-6). Subjects with AF differed from those without, displaying modulation of proteins previously known to have associations with incident AF (eg, C-reactive protein, insulin-like growth factor-1, and angiopoietin-2), and also with proteins having no previous association (eg, tapasin-related protein and α2-Heremans-Schmid glycoprotein).

CONCLUSIONS

These findings provide insights into the proteomic response to acute intense exercise, provide mechanistic insights into the pathophysiology behind AF in athletes, and identify targets for future study and validation.

Contralateral protective effect against repeated bout of damaging exercise: A meta-analysis

The purpose was to summarize the studies examining the contralateral protective effect on the maximal strength in the subsequent bout of muscle-damaging exercise. The literature search was conducted through CINAHL plus, SportDiscus, and PubMed. Hedge's g effect size (ES) and 95% confidence intervals (CIs) were computed using a random effects model. From 14 papers and 25 ESs, the mean ES for contralateral repeated bout effect (CL-RBE) on 1-, 2-, and 3-day post maximal strength were -0.61 (95% CI = -0.80, -0.41), -0.50 (95% CI = -0.67, -0.33), and -0.74 (95% CI = -1.01, -0.48), respectively. For moderator analyses, the mean ESs were not influenced by type (isometric vs. isokinetic) of strength, but CL-RBE on maximal strength was influenced by duration (≤6 weeks) between bouts. Therefore, the meta-analysis demonstrated that an initial bout of exercise induces the protective effect on contralateral limb muscles regardless of the different type of strength, but can be affected by different duration (≤6 weeks) between exercise bouts.

Protective effect by low-intensity downhill running training against muscle damage and oxidative stress after high-intensity downhill running in rats

This study examined the effects of low-intensity eccentric exercise training performed before high-intensity eccentric exercise on muscle damage markers, oxidative stress and antioxidant defense. Twenty-two rats were divided into 3 groups; control (CON; n = 6), high-intensity eccentric exercise (HE; n = 8) and low-intensity eccentric exercise training plus high-intensity eccentric exercise (LET + HE; n = 8). Rats in the HE group performed HE at once. Rats in the LET + HE group performed LET and then HE protocol was applied. Blood and vastus intermedius muscle samples were taken 24 hours after the last exercise session for analyses of muscle damage, oxidative stress, and antioxidant defense markers. Muscle damage markers were higher in the HE group than the CON (137%-488%) and the LET + HE groups (82%-110%) (P < 0.05). Oxidative stress marker was higher in the HE group than the CON (65%) and the LET + HE (50%) groups (P < 0.05). Antioxidant defense markers were higher in the LTE + HE group than the HE group (39%-51%) (P < 0.05). In conclusion, low-intensity eccentric exercise training performed before high-intensity eccentric exercise conferred a protective effect against muscle damage by reducing oxidative stress and increasing antioxidant defense.

Effect of repeated eccentric exercise on muscle damage markers and motor unit control strategies in arm and hand muscle

To examine the contralateral repeated bout effect (CL-RBE) on muscle damage markers and motor unit (MU) control strategies, seventeen healthy adults performed two bouts of 60 eccentric contractions with elbow flexor (EF group; n ​= ​9) or index finger abductor (IA group; n ​= ​8) muscles, separated by 1 week. All participants randomly performed eccentric exercise on either the right or left arm or hand muscles, and muscle damage markers and submaximal trapezoid contraction tests were conducted pre, post, 1- and 2-day post eccentric protocol. One week after the first bout, the same exercise protocol and measurements were performed on the contralateral muscles. Surface electromyographic (EMG) signals were collected from biceps brachii (BB) or first dorsal interosseous (FDI) during maximal and submaximal tests. The linear regression analyses were used to examine MU recruitment threshold versus mean firing rate and recruitment threshold versus derecruitment threshold relationships. EMG amplitude from BB (bout 1 vs. bout 2 ​= ​65.71% ​± ​22.92% vs. 43.05% ​± ​18.97%, p ​= ​0.015, d ​= ​1.077) and the y-intercept (group merged) from the MU recruitment threshold versus derecruitment threshold relationship (bout 1 vs. bout 2 ​= ​−7.10 ​± ​14.20 vs. 0.73 ​± ​16.24, p ​= ​0.029, d ​= ​0.513) at 50% MVIC were significantly different between two bouts. However, other muscle damage markers did not show any CL-RBE in both muscle groups. Therefore, despite changes in muscle excitation and MU firing behavior, our results do not support the existence of CL-RBE on BB and FDI muscles.

Striking muscle adaptations induced by volume-dependent repeated bouts of low-intensity eccentric exercise of the elbow flexors

We investigated the effects of repeating 30 low-intensity eccentric contractions with a dumbbell corresponding to 10% maximal isometric strength (10%EC) on muscle strength and hypertrophy, and muscle damage after 30 maximal eccentric contractions (MaxEC) of the elbow flexors. Young men were placed into 1 of 3 experimental groups that performed 10%EC either once, twice a week for 4 (8 bouts) or 8 weeks (16 bouts) before MaxEC, or a control group that performed 2 bouts of MaxEC separated by 2 weeks (n = 13/group). Repeating 16 bouts of 10%EC increased (P < 0.05) maximal voluntary contraction strength (30 ± 21%) and muscle thickness (4.2 ± 2.3%) greater than 8 bouts (16 ± 4%, 1.9 ± 1.3%). Changes in the muscle damage markers after MaxEC were smaller (P < 0.05) for the experimental groups than the control group, and the magnitude of muscle damage protection was greater (P < 0.05) after 16 bouts (65 ± 30%) than 8 bouts (55 ± 33%), followed by 1 bout (34 ± 27%). The protection by 16 bouts was similar (P = 0.81) to that shown by the second MaxEC of the control group. These results showed that 10%EC produced potent muscle adaptation effects accumulatively and conferred muscle damage protection, but 1 bout of 10%EC was still effective for conferring approximately 20% of the protection of that by 16 bouts. Novelty: Repeating low-intensity eccentric exercise induces large increases in muscle strength and hypertrophy. Low-intensity eccentric exercise protects muscle damage induced by maximal eccentric contractions, and the protection is reinforced by repeating it. These are especially beneficial for individuals who are frail and cannot tolerate high-intensity resistance training.

Effect of preconditioning exercise on biceps brachii myotendinous junction displacement during elbow flexor eccentric exercise

The present study tested the hypothesis that 30 low-intensity (10%) eccentric contractions (10%EC) or two maximal voluntary isometric contractions at a long muscle length (2MVIC) that were performed at two days before maximal eccentric exercise of the elbow flexors consisting of five sets of six maximal eccentric contractions (MaxEC) would reduce increases in biceps brachii distal myotendinous junction displacement (MTJd) over the eccentric contractions during MaxEC. Sedentary young men were randomly placed (n = 12/group) to a control group that performed two bouts of MaxEC (CONT-1st, CONT-2nd) separated by two weeks, or one of two preconditioning groups that performed 10%EC or 2MVIC at 20° elbow flexion at two days prior to MaxEC. All exercises were performed by the non-dominant arm. MTJd of each contraction was assessed by B-mode ultrasound, and its changes over sets were compared among the groups. The average MTJd from the start to the end of six eccentric contractions in the first set was similar among the groups (6.4 ± 0.7 mm). The MTJd increased from the first to fifth set, but the increase was smaller (P < .05) for the 10%EC (13 ± 6%) and 2MVIC (16 ± 9%) groups, and CONT-2nd (3 ± 6%) when compared with CONT-1st (60 ± 12%). Both 10%EC and 2MVIC groups showed smaller (P < .05) changes in all muscle damage markers after MaxEC similarly when compared with CONT-1st, but the changes were greater than those after CONT-2nd. These results supported the hypothesis that protective effect was associated with less MTJd changes, suggesting that this is associated with the mechanisms underpinning the preconditioning effect on muscle damage.

The effectiveness of low intensity exercise and blood flow restriction without exercise on exercise induced muscle damage: A systematic review

OBJECTIVE

To investigate the evidence and provide clinical recommendations for low intensity exercises(LIE) and blood flow restriction(BFR) without exercise on reducing the effects of exercise induced muscle damage(EIMD).

METHOD

PubMed, Embase, Web of science, and PEDro(Physiotherapy Evidence Database) were searched up to December 2019 for studies that included LIE or BFR without exercise and their effect on EIMD.

RESULTS

Out of 3192 studies, 23 were included with 17 on LIE and 6 on BFR without exercise. 11 studies demonstrated positive effects for LIE on EIMD, with two level 2 and nine level 3 studies. Two level 2 and two level 3 studies found benefits for BFR without exercise on reducing the negative effects of EIMD, while two level 2 studies found did not find benefits for BFR without exercise.

CONCLUSION

Moderate to low levels of evidence supported LIE, particularly in the form of protective low load eccentric exercise, in reducing the negative effects of EIMD. Conflicting moderate to low levels of evidence was found regarding BFR without exercise. There does seem to be potential benefit for BFR without exercise in untrained individuals. Clinicians can provide clinical recommendations as LIE and BFR without exercise reducing EIMD.

Contralateral Effects by Unilateral Eccentric versus Concentric Resistance Training

PURPOSE

Unilateral resistance training increases muscle strength of the contralateral homologous muscle by the cross-education effect. Muscle damage induced by second eccentric exercise bout is attenuated, even when it is performed by the contralateral limb. The present study compared the effects of unilateral eccentric training (ET) and concentric training (CT) of the elbow flexors (EF) on maximal voluntary isometric contraction (MVC) strength and muscle damage of the contralateral untrained EF.

METHODS

Young men were placed into ET, CT, ipsilateral repeated bout (IL-RB), and contralateral repeated bout (CL-RB) groups (n = 12 per group). The ET and CT groups performed unilateral EF training consisting of five sets of six eccentric and concentric contractions, respectively, once a week for 5 wk by increasing the intensity from 10% to 100% of MVC, followed by 30 maximal eccentric contractions (30MaxEC) of the opposite EF 1 wk later. The IL-RB group performed two bouts of 30MaxEC separated by 2 wk using the nondominant arm, and CL-RB group performed two bouts of 30MaxEC with a different arm for each bout in 1-wk apart.

RESULTS

The MVC increased (P < 0.05) greater for the trained (19% ± 8%) and untrained (11% ± 5%) arms in ET when compared with those in CT (10% ± 6%, 5% ± 2%). The magnitude of changes in muscle damage markers was reduced by 71% ± 19% after the second than the first bout for IL-RB group, and by 48% ± 21% for CL-RB group. Eccentric training and CT attenuated the magnitude by 58% ± 25% and 13% ± 13%, respectively, and the protective effect of ET was greater (P < 0.05) than CL-RB, but smaller (P < 0.05) than IL-RB.

CONCLUSIONS

These results showed that cross-education effect was stronger for ET than CT, and progressive ET produced greater contralateral muscle damage protective effect than a single eccentric exercise bout.

Pathophysiology of exercise-induced muscle damage and its structural, functional, metabolic, and clinical consequences

Extreme or unaccustomed eccentric exercise can cause exercise-induced muscle damage, characterized by structural changes involving sarcomere, cytoskeletal, and membrane damage, with an increased permeability of sarcolemma for proteins. From a functional point of view, disrupted force transmission, altered calcium homeostasis, disruption of excitation-contraction coupling, as well as metabolic changes bring about loss of strength. Importantly, the trauma also invokes an inflammatory response and clinically presents itself by swelling, decreased range of motion, increased passive tension, soreness, and a transient decrease in insulin sensitivity. While being damaging and influencing heavily the ability to perform repeated bouts of exercise, changes produced by exercise-induced muscle damage seem to play a crucial role in myofibrillar adaptation. Additionally, eccentric exercise yields greater hypertrophy than isometric or concentric contractions and requires less in terms of metabolic energy and cardiovascular stress, making it especially suitable for the elderly and people with chronic diseases. This review focuses on our current knowledge of the mechanisms underlying exercise-induced muscle damage, their dependence on genetic background, as well as their consequences at the structural, functional, metabolic, and clinical level. A comprehensive understanding of these is a prerequisite for proper inclusion of eccentric training in health promotion, rehabilitation, and performance enhancement.

Comparison among three different intensities of eccentric contractions of the elbow flexors resulting in the same strength loss at one day post-exercise for changes in indirect muscle damage markers

PURPOSE

The present study compared three different intensity elbow flexor eccentric exercises resulting in the same magnitude of maximal voluntary isomeric contraction torque (MVC) decrease at 1 day post-exercise for changes in several indirect markers of muscle damage and proprioception.

METHODS

Sedentary young men performed eccentric contractions of the elbow flexors using a dumbbell corresponding to either 10%, 50% or 100% of MVC to induce ~ 20% decrease in MVC at 1 day post-exercise (n = 12/group). MVC, range of motion (ROM), upper arm circumference (CIR), muscle soreness, plasma creatine kinase (CK) activity, and proprioception measures (force match, joint position sense) were taken before to 5 days after exercise, and the changes were compared among the groups.

RESULTS

MVC and ROM recovered faster (P < 0.05) in the order of 10% (e.g., 3 days post-exercise: - 3 ± 4%, 0 ± 1%), 50% (- 12 ± 3%, - 3 ± 2%) and 100% group (- 16 ± 4%, - 5 ± 1%). Peak CIR, muscle soreness and CK activity were smaller for 10% (Δ3 ± 1 mm, 26 ± 10 mm, 1049 ± 316 IU/L) than 50% (Δ6 ± 2 mm, 36 ± 14 mm, 1473 ± 429 IU/L) and 100% groups (Δ8 ± 2 mm, 47 ± 15 mm, 2104 ± 929 IU/L). The proprioception measures recovered faster (P < 0.05) for 10% followed by 50% then 100% group. The recovery rate of MVC from immediately to 1 day post-exercise was correlated (P < 0.05) with the changes in the muscle damage and proprioception markers.

CONCLUSION

These results suggest that the MVC at 1 day post-exercise does not necessarily predict the changes in muscle damage markers in the following days, but the MVC recovery rate in the first 24 h reflects the magnitude of muscle damage better.

Damage protective effects conferred by low-intensity eccentric contractions on arm, leg and trunk muscles

PURPOSE

Low-intensity eccentric contractions with a load corresponding to 10% of maximal voluntary isometric contraction strength (10% EC) attenuate muscle damage in a subsequent bout of higher-intensity eccentric contractions performed within 2 weeks for the elbow flexors, knee flexors and knee extensors. However, it is not known whether this strategy could be applied to other muscles. This study investigated whether 10% EC would confer damage protective effect on high-intensity eccentric contractions (80% EC) for nine different muscle groups.

METHODS

Untrained young men were placed to an experimental or a control group (n = 12/group). Experimental group performed 50 eccentric contractions with a load corresponding to 10% EC at 2 days prior to 50 eccentric contractions with 80% EC for the elbow flexors and extensors, pectoralis, knee flexors and extensors, plantar flexors, latissimus, abdominis and erector spinae. Control group performed 80% EC without 10% EC. Changes in maximal voluntary isometric contraction strength (MVC) and muscle soreness, plasma creatine kinase (CK) activity and myoglobin concentration after 80% EC were compared between groups by a mixed-factor ANOVA.

RESULTS

MVC recovered faster (e.g., 6-31% greater MVC at 5 days post-exercise), and peak muscle soreness was 36-54% lower for Experimental than Control group for the nine muscles (P < 0.05). Increases in plasma CK activity and myoglobin concentration were smaller for Experimental (e.g., peak CK: 2763 ± 3459 IU/L) than Control group (120,360 ± 50,158 IU/L).

CONCLUSIONS

These results showed that 10% EC was effective for attenuating the magnitude of muscle damage after 80% EC for all muscles, although the magnitude of the protective effect differed among the muscles.