Ischemic Preconditioning and Acute Recovery of Performance in Rugby Union Players

The effects of different ischemic conditioning on strength training recovery

The aim was to explore the impact of ischemic conditioning (IC) before or after strength training (ST) on recovery and to compare IC with traditional recovery methods (static stretching and foam rolling). Thirtyseven healthy males were divided into four groups: CON (no intervention), TRA (stretching and foam rolling after ST), IPC (IC before ST), and PEIC (IC after ST). The ST protocol consisted of five sessions, spaced every two days. Muscle soreness, thigh circumference (TC), countermovement jumps (CMJ), knee isokinetic muscle strength (peak torque [PT], relative peak torque [RPT]), and lactate dehydrogenase (LDH), creatine kinase (CK), malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant capacity (T-AOC), C-reactive protein (CRP) and interleukin-6 (IL-6) were measured at baseline, 24 h after the first intervention (1st-24 h), and 24 h and 48 h after the fifth intervention (5th-24 h, 5th-48 h). No significant differences were found in CMJ in PEIC at all timepoints (P > 0.05), while IPC had lower CMJ at 1st-24 h than baseline (P < 0.05). Right quadriceps RPT and PT in TRA were unchanged at all timepoints (P > 0.05), whereas IPC and PEIC had lower values at 1st-24 h than baseline (P < 0.05). No significant differences were found in LDH and IL-6 in IPC and PEIC at all timepoints (P > 0.05), but TRA showed significant differences in LDH at 1st-24 h and in IL-6 at 1st-24 h and 5th-24 h than baseline (P < 0.05). Results indicated acute PEIC better maintained CMJ than IPC. Acute TRA promoted faster recovery of lower extremity strength than IC, while IC led to a faster recovery of muscle damage and inflammation than TRA.

The effect of a 2-week ischaemic preconditioning intervention on anaerobic performance in male academy football players: a randomized, single-blinded, SHAM-Controlled study

Ischaemic preconditioning (IPC), brief periods of ischaemia immediately followed by reperfusion applied to a vascular bed, has emerged as a method to improve exercise performance. There is, however, a lack of research exploring repeated episodes of IPC on anaerobic performance. The aim of this study was to determine if a 2-week repeated IPC intervention could enhance anaerobic performance in male academy football players. Eight male academy football players completed two, 2-week intervention trials: six IPC episodes (4 × 5 min at 220 mmHg per episode), and six SHAM episodes (4 × 5 min at 20 mmHg per episode). Prior to and following each intervention trial, the participants completed assessments of anaerobic performance (Running Anaerobic Sprint Test [RAST]), and superficial femoral artery endothelial function (flow-mediated dilation [FMD]). IPC significantly enhanced peak and mean power output by 12% (p = 0.026) and 11% (p = 0.019) and significantly improved superficial femoral artery FMD (p = 0.049). The increase in endothelial function suggests that this may be a mechanism contributing to this enhancement of anaerobic performance. The present study supports the use of repeated IPC prior to matches and training sessions to enhance anaerobic performance.

Blood flow restriction as a post-exercise recovery strategy: A systematic review of the current status of the literature

The aim of this study was to systematically review the current literature on blood flow restriction (BFR) as a post-exercise recovery strategy. Experimental studies investigating the effect of BFR on recovery after exercise were included. Only studies meeting the following inclusion criteria were selected: (a) studies investigating about BFR as a post-exercise recovery strategy in athletes and healthy individuals; (b) the full text being available in English; (c) experimental research study design. Studies that exclusively analyzed BFR as a recovery strategy during the exercise (e.g., recovery strategy between bouts of exercise) were excluded. A literature review was conducted on the PubMed, Cochrane, and Web of Science electronic databases up until May 7th, 2023. The main findings were that (i) 9 studies investigated passive BFR as a post-exercise recovery strategy, which shows a significant lack of research in both team and individual sports (especially in female populations), and only 2 studies used active BFR protocols; (ii) although a high quality range of studies was observed, there were methodological limitations such as BFR interventions that were usually conducted after fatiguing protocols or fitness tests, which may not represent the real exercise (e.g., a sprint session of 6 sets of 50 m may induce muscle damage but it does not represent the demands of a team sport like rugby or soccer); (iii) there is a lack of consistency in BFR protocols (e.g., number of cycles or duration of the occlusion-reperfusion periods) for recovery; (iv) some studies showed beneficial effects while others found no positive or detrimental effects of BFR as a post-exercise recovery strategy in comparison with the control/SHAM group. In conclusion, only 11 studies investigated BFR as a post-exercise recovery strategy and there is not any significant amount of evidence in team or individual sports (especially in female populations). BFR could be a potential post-exercise recovery strategy, but practitioners should use caution when applying this method of recovery for their athletes and clients. In addition, it would be of interest for high performance-related practitioners to have a better understanding of the benefits of BFR interventions combined with either active or passive forms of exercise as a post-exercise recovery strategy.

Effect of Ischemic Preconditioning on Acute Recovery in Elite Judo Athletes: A Randomized, Single-Blind, Crossover Trial

PURPOSE

The ischemic preconditioning (IPC) method has been shown to aid the recovery processes; however, no studies have been done to assess its acute recovery use in judo. This study aimed to examine IPC of lower limbs effects on recovery after a judo-specific performance in highly trained male judokas and its applicability during a competition day.

METHODS

A single-blind, placebo-randomized crossover study was carried out on a sample of 13 elite male judo athletes. They undertook measurements of body composition, judo-specific task (Special Judo Fitness Test), jump performance, handgrip strength, lactate, blood pressure, perceived exertion, and delayed-onset muscle soreness. IPC was applied on the legs and inflated 50 mm Hg above the systolic blood pressure for 5 minutes and repeated 3 times for each leg, with 5 minutes of reperfusion. Two-way analysis of variance with repeated measurements was used to determine changes between interventions and measurement times. Paired-sample t test and 1-way repeated-measures analysis of variance was used to determine the difference among measurement times. Statistical significance was set at P < .05.

RESULTS

The IPC intervention resulted in (1) decreased heart rate at 30 and 60 minutes during recovery (P = .002; P = .001), (2) better countermovement jump performance at 60 minutes (P = .05), (3) lower perceived-muscle-soreness scores (P = .006), and (4) maintained handgrip strength compared with placebo.

CONCLUSIONS

The present study revealed that IPC applied to judo athletes following judo-specific exercise resulted in better cardiovascular and neuromuscular recovery and could be a useful tool to enhance recovery during judo competition breaks between preliminaries and final block.

Methodological Variations Contributing to Heterogenous Ergogenic Responses to Ischemic Preconditioning

Ischemic preconditioning (IPC) has been repeatedly reported to augment maximal exercise performance over a range of exercise durations and modalities. However, an examination of the relevant literature indicates that the reproducibility and robustness of ergogenic responses to this technique are variable, confounding expectations about the magnitude of its effects. Considerable variability among study methodologies may contribute to the equivocal responses to IPC. This review focuses on the wide range of methodologies used in IPC research, and how such variability likely confounds interpretation of the interactions of IPC and exercise. Several avenues are recommended to improve IPC methodological consistency, which should facilitate a future consensus about optimizing the IPC protocol, including due consideration of factors such as: location of the stimulus, the time between treatment and exercise, individualized tourniquet pressures and standardized tourniquet physical characteristics, and the incorporation of proper placebo treatments into future study designs.

Similar Recovery of Maximal Cycling Performance after Ischemic Preconditioning, Neuromuscular Electrical Stimulation or Active Recovery in Endurance Athletes

This study investigated the efficacy of ischemic preconditioning (IPC) on the recovery of maximal aerobic performance and physiological responses compared with commonly used techniques. Nine endurance athletes performed two 5-km cycling time trials (TT) interspersed by 45 minutes of recovery that included either IPC, active recovery (AR) or neuromuscular electrical stimulation (NMES) in a randomized crossover design. Performance, blood markers, arterial O₂ saturation (S_pO₂), heart rate (HR), near-infrared spectroscopy-derived muscle oxygenation parameters and perceptual measures were recorded throughout TTs and recovery. Differences were analyzed using repeated-measures ANOVAs and Cohen's effect size (ES). The decrement in chronometric performance from TT1 to TT2 was similar between recovery modalities (IPC: -6.1 sec, AR: -7.9 sec, NMES: -5.4 sec, p = 0.84, ES 0.05). The modalities induced similar increases in blood volume before the start of TT2 (IPC: 13.3%, AR: 14.6%, NMES: 15.0%, p = 0.79, ES 0.06) and similar changes in lactate concentration and pH. There were negligible differences between conditions in bicarbonate concentration, base excess of blood and total concentration of carbon dioxide, and no difference in S_pO₂, HR and muscle O₂ extraction during exercise (all p > 0.05). We interpreted these findings to suggest that IPC is as effective as AR and NMES to enhance muscle blood volume, metabolic by-products clearance and maximal endurance performance. IPC could therefore complement the athlete's toolbox to promote recovery.

Time Course of Recovery for Performance Attributes and Circulating Markers of Muscle Damage Following a Rugby Union Match in Amateur Athletes

BACKGROUND

We sought to determine the time course of changes in neuromuscular performance and muscle damage following a single rugby union match.

METHODS

Fourteen male amateur rugby players (28.9 ± 3.5 yrs; 1.7 ± 5.1 m; 86.1 ± 11.1 kg) participated. Plasma activity of creatine kinase ([CK]) and lactate dehydrogenase (LDH), L-run test (change of direction) and 30-m sprint (T30; speed) with 10-m lap time (T10; acceleration) were assessed on six occasions: one week before the match (PRE) and immediately, 24, 48, 72, and 96 h post-match.

RESULTS

Relative to PRE, LDH was elevated immediately post-match (+33.6% ± 13.6%; p < 0.001) and [CK] was elevated immediately (+64.1% ± 38.8%, p = 0.001) and 24 h post-match (+352% ± 317%; p = 0.024). L-run test time increased 16.0 ± 8.7% relative to PRE at 24 h post (p < 0.001) and remained elevated through 96 h post-match (p < 0.05). T10 and T30 times increased relative to PRE immediately post-match (+12.0% ± 10.4%, p = 0.008; and +6.1% ± 4.9%; p = 0.006, respectively), though T30 times were similar to baseline by 48 h post-match whereas T10 times remained elevated through 72 h post-match.

CONCLUSIONS

A single, competitive rugby union match induces significant muscle damage and performance decrements with distinct time courses of recovery in amateur athletes. Notably, change of direction attributes (i.e., L-run) appear to have the longest time course to full recovery.

An overview of ischemic preconditioning in exercise performance: A systematic review

Ischemic preconditioning (IPC) is an attractive method for athletes owing to its potential to enhance exercise performance. However, the effectiveness of the IPC intervention in the field of sports science remains mitigated. The number of cycles of ischemia and reperfusion, as well as the duration of the cycle, varies from one study to another. Thus, the aim of this systematic review was to provide a comprehensive review examining the IPC literature in sports science. A systematic literature search was performed in PubMed (MEDLINE) (from 1946 to May 2018), Web of Science (sport sciences) (from 1945 to May 2018), and EMBASE (from 1974 to May 2018). We included all studies investigating the effects of IPC on exercise performance in human subjects. To assess scientific evidence for each study, this review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The electronic database search generated 441 potential articles that were screened for eligibility. A total of 52 studies were identified as eligible and valid for this systematic review. The studies included were of high quality, with 48 of the 52 studies having a randomized, controlled trial design. Most studied showed that IPC intervention can be beneficial to exercise performance. However, IPC intervention seems to be more beneficial to healthy subjects who wish to enhance their performance in aerobic exercises than athletes. Thus, this systematic review highlights that a better knowledge of the mechanisms generated by the IPC intervention would make it possible to optimize the protocols according to the characteristics of the subjects with the aim of suggesting to the subjects the best possible experience of IPC intervention.