Comparison of Muscle Growth and Dynamic Strength Adaptations Induced by Unilateral and Bilateral Resistance Training: A Systematic Review and Meta-analysis

BACKGROUND

Currently, great debate exists over the proposed superiority of some resistance exercises to induce muscular adaptations. For example, some argue that unilateral exercise (meaning one limb at a time) is superior to bilateral exercises (meaning both limbs). Of note, an evidence-based answer to this question is yet to be determined, particularly regarding muscle hypertrophy.

OBJECTIVE

This systematic review and meta-analysis aimed to compare the effects of unilateral versus bilateral resistance training on muscle hypertrophy and strength gains.

METHODS

A thorough literature search was performed using PubMed, Scopus, and Web of Science databases. The Cochrane Risk of Bias tool 2 (RoBII) tool was used to judge the risk of bias. Meta-analyses were performed using robust variance estimation with small-sample corrections.

RESULTS

After retrieving 703 studies, 9 met the criteria and were included in the meta-analyses. We found no significant differences in muscle hypertrophy between bilateral and unilateral training [effect size (ES): - 0.21, 95% confidence interval (95% CI): - 3.56 to 3.13, P = 0.57]. Bilateral training induced a superior increase in bilateral strength (ES: 0.56, 95% CI: 0.16-0.96, P = 0.01). In contrast, unilateral training elicited a superior increase in unilateral strength (ES: - 0.65, 95% CI: - 0.93 to - 0.37, P = 0.001). Overall, studies presented moderate risk of bias.

CONCLUSION

On the basis of the limited literature on the topic, we found no evidence of differential muscle hypertrophy between the two exercise selections. Strength gains appear to follow the principle of specificity.

Acute hypoalgesic and neurophysiological responses to lower-limb ischaemic preconditioning

The aim of this study was to assess if ischaemic preconditioning (IPC) can reduce pain perception and enhance corticospinal excitability during voluntary contractions. In a randomised, within-subject design, healthy participants took part in three experimental visits after a familiarisation session. Measures of pressure pain threshold (PPT), maximum voluntary isometric force, voluntary activation, resting twitch force, corticospinal excitability and corticospinal inhibition were performed before and ≥10 min after either, unilateral IPC on the right leg (3 × 5 min); a sham protocol (3 × 1 min); or a control (no occlusion). Pain perception was then assessed in response to a hypertonic saline injection into the vastus lateralis muscle. In the right (occluded) leg, PPT was 10% greater after IPC compared to sham (P = 0.004). PPTs were also 9.5% greater in the contralateral leg for IPC compared to sham (P = 0.031). Maximum voluntary force, voluntary activation and resting twitch force were not different between conditions (all P ≥ 0.133). Measures of corticospinal excitability and inhibition also revealed no significant differences between conditions (all P ≥ 0.240). Hypertonic saline evoked pain revealed no difference in reported intensity or duration between conditions (P ≥ 0.082). IPC can reduce pain sensitivity in local and remote areas but does not subsequently impact neurophysiological measures of excitability or inhibition.

Cross-education: motor unit adaptations mediate the strength increase in non-trained muscles following 8 weeks of unilateral resistance training

Introduction

Early increases in muscle strength following unilateral resistance training are typically accompanied by strength gains in the contralateral untrained muscles, a phenomenon known as cross-education. However, the specific motor unit adaptations responsible for this gain transfer remain poorly understood. To address this gap, we recorded myoelectrical activity from the biceps brachii using high-density electromyography.

Methods

Nine participants performed 8-week unilateral resistance training and were compared to nine control individuals who did no intervention. Discharge characteristics of longitudinally tracked motor units were assessed during maximal voluntary contractions and isometric ramp contractions at 35% and 70% of the maximal voluntary force (MVF) at baseline (T0), 4 weeks (T1), and 8 weeks (T2) post-intervention.

Results

MVF increased by 7% in untrained muscles at T1 and 10% at T2 (p < 0.05). These gains were accompanied by significant decreases in motor unit recruitment thresholds (p < 0.01) and higher net discharge rate (i.e., gain in discharge rate from recruitment to peak) following intervention (p < 0.05). Trained muscles presented greater MVF (+11%, T1; +19%, T2) with similar motor unit adaptations, including a lower recruitment threshold (p < 0.01) and a higher net discharge rate (p < 0.01).

Discussion

Our findings indicate that higher strength in untrained muscles is associated with a higher net discharge rate, implying a greater spinal motoneuron output to muscles. The present results underscore the role of motor unit adaptations in the transfer of strength gains to non-trained muscles, offering novel insights into the neural mechanisms underlying cross-education.

Anodal tDCS improves neuromuscular adaptations to short-term resistance training of the knee extensors in healthy individuals

Experimental studies show improvement in physical performance following acute application of transcranial direct current stimulation (tDCS). This study examined the neuromuscular and neural responses to a single training session (Part 1) and following a 3 wk resistance training program (Part 2) performed with the knee extensors, preceded by tDCS over the primary motor cortex. Twenty-four participants (age, 30 ± 7 yr; stature, 172 ± 8 cm; mass, 72 ± 15 kg) were randomly allocated to perform either resistance training with anodal tDCS (a-tDCS) or a placebo tDCS (Sham). Resistance training consisted of 3 × 10 isometric contractions of 3 s at 75% maximal voluntary contraction (MVC). Measures of neuromuscular function (MVC, voluntary activation, and potentiated twitch force), corticospinal excitability, along with short and long cortical inhibition were assessed. Acute tDCS did not affect neuromuscular and neural responses to a single training session (all P ≥ 0.10). Conversely, after the 3 wk training program, MVC increased in both groups (P < 0.01) with a greater increase observed for a-tDCS vs. Sham (∼6%, P = 0.04). Additionally, increased voluntary activation (∼2%, P = 0.04) and corticospinal excitability (∼22%, P = 0.04), accompanied by a shorter silent period (-13%, P = 0.04) were found after a-tDCS vs. Sham. The potentiated twitch force and measures of short and long cortical inhibition did not change after the training program (all P ≥ 0.29). Pretraining administration of tDCS only resulted in greater neuromuscular adaptations following 3 wk of resistance training. These results provide new evidence that tDCS facilitates adaptations to resistance training in healthy individuals.NEW & NOTEWORTHY The initial increase in maximal strength during resistance training is attributed to neural adaptations. Acute administration of transcranial direct current stimulation (tDCS) has been shown to improve motor function and neural adaptations in healthy and clinical populations. This study measured the neuromuscular and neural response to acute (single training session) and short-term (3 wk) resistance training with tDCS. Greater neuromuscular and neural adaptations were only found following 3 wk of resistance training.

A comparison of techniques to determine active motor threshold for transcranial magnetic stimulation research

The determination of active motor threshold (AMT) is a critical step in transcranial magnetic stimulation (TMS) research. As AMT is frequently determined using an absolute electromyographic (EMG) threshold (e.g., 200 µV peak-to-peak amplitude), wide variation in EMG recordings across participants has given reason to consider relative thresholds (e.g., = 2 × background sEMG) for AMT determination. However, these approaches have not been systemically compared. Our purpose was to compare AMT estimations derived from absolute and relative criteria commonly used in the quadriceps, and assess the test-retest reliability of each approach. We used a repeated measures design to assess AMT estimations in the vastus lateralis (VL) from eighteen young adults (9 males and 9 females; mean ± SD age = 23 ± 2 years) across two laboratory visits. AMT was determined for each criterion, at each lab visit. A paired samples t-test was used to compare mean differences in AMT estimations during the second laboratory visit. Paired samples t-tests and intraclass correlation coefficients (ICC2,1) were calculated to assess test-retest reliability of each criterion. Differences between the criteria were small and not statistically significant (p = 0.309). The absolute criterion demonstrated moderate to excellent reliability (ICC2,1 = 0.866 [0.648-0.950]), but higher AMTs were observed in the second visit (p = 0.043). The relative criteria demonstrated good-to-excellent test-retest reliability (ICC2,1 = 0.894 [0.746-0.959]) and AMTs were not different between visits (p = 0.420). TMS researchers aiming to track corticospinal characteristics across visits should consider implementing relative criterion approaches during their AMT determination protocol.

Changes in motor unit behaviour across repeated bouts of eccentric exercise

Unaccustomed eccentric exercise (EE) is protective against muscle damage following a subsequent bout of similar exercise. One hypothesis suggests the existence of an alteration in motor unit (MU) behaviour during the second bout, which might contribute to the adaptive response. Accordingly, the present study investigated MU changes during repeated bouts of EE. During two bouts of exercise where maximal lengthening dorsiflexion (10 repetitions × 10 sets) was performed 3 weeks apart, maximal voluntary isometric torque (MVIC) and MU behaviour (quantified using high-density electromyography; HDsEMG) were measured at baseline, during (after set 5), and post-EE. The HDsEMG signals were decomposed into individual MU discharge timings, and a subset were tracked across each time point. MVIC was reduced similarly in both bouts post-EE (Δ27 vs. 23%, P = 0.144), with a comparable amount of total work performed (∼1,300 J; P = 0.905). In total, 1,754 MUs were identified and the decline in MVIC was accompanied by a stepwise increase in discharge rate (∼13%; P < 0.001). A decrease in relative recruitment was found immediately after EE in Bout 1 versus baseline (∼16%; P < 0.01), along with reductions in derecruitment thresholds immediately after EE in Bout 2. The coefficient of variation of inter-spike intervals was lower in Bout 2 (∼15%; P < 0.001). Our data provide new information regarding a change in MU behaviour during the performance of a repeated bout of EE. Importantly, such changes in MU behaviour might contribute, at least in part, to the repeated bout phenomenon.

Exercise training effect on skeletal muscle motor drive in older adults: A systematic review with meta-analysis of randomized controlled trials

The meta-analysis aimed to determine whether exercise training can positively change indices of motor drive, i.e., the input from the central nervous system to the muscle, and how training characteristics, motor drive assessment, assessed muscle, and testing specificity could modulate the changes in motor drive in older adults. A random-effect meta-analysis model using standardized mean differences (Hedges' g) determined treatment effects. Moderators (e.g., training type and intensity) and meta-regressors (e.g., number of sessions) were performed using mixed- and fixed-effect models. A significant Q-test, followed by pairwise post hoc comparisons, determined differences between levels of the categorical moderators. Methodological quality was assessed using the Cochrane risk of bias tool. Ten randomized controlled trials, 290 older adults, met the inclusion criteria. Only strength and power exercise training were retrieved from the search and included in the analysis. Strength (g = 0.60, 95 % CI 0.24 to 0.96) and power training (g = 0.51, 95 % CI 0.02 to 1.00) increased motor drive compared with a control condition. High (g = 0.66; 95 % CI 0.34 to 0.97) and low-high (g = 1.23; 95 % CI 0.19 to 2.27) combinations of training intensities increased motor drive compared to the control condition. The multi-joint training and testing exercise structure (g = 1.23; 95 % CI 0.79 to 1.67) was more effective in increasing motor drive (Qdf=2 = 14.15; p = 0.001) than the multi-single joint structure (g = 0.46; 95 % CI 0.06 to 0.85). Therefore, strength and power training with high volume and intensity associated with multi-joint training and testing combination of exercises seem to improve skeletal muscle motor drive in older adults effectively.

Effect of resistance training on quadriceps femoris muscle thickness obtained by ultrasound: A systematic review with meta-analysis

OBJECTIVE

The present study aimed to determine the magnitude and intervention time of resistance training required to generate adaptations in the muscle thickness of the quadriceps muscle obtained by ultrasound in healthy adults.

METHOD

A systematic review with meta-analysis was conducted on studies recovered from Pubmed, Web of Science, and Scopus databases up to March 2022. The study selection process was carried out by two independent researchers, with the presence of a third researcher in case of disagreements. The methodological quality of the studies was determined with the TESTEX scale, and the risk of bias analysis was determined using Cochrane's RoB 2.0 tool. The meta-analysis used the inverse of the variance with a fixed model, and the effect size was reported by the standardized mean difference (SMD) with a confidence interval of 95%.

RESULTS

Ten studies were included in a meta-analysis. The overall analysis of the studies demonstrated an SMD = 0.35 [95% CI: 0.13-0.56] (P = 0.002), with a low heterogeneity of I2 = 0% (P = 0.52). No publication bias was detected using a funnel plot followed by Egger's test (P = 0.06). The degree of certainty of the meta-analysis was high using the GRADE tool.

CONCLUSION

We found that resistance training can generate significant average increases of 16.6% in muscle thickness obtained by ultrasound in the quadriceps femoris muscles of healthy adults. However, the subgroup analysis showed that significant effect sizes were only observed after eight weeks of training.

Cortical and spinal responses to short-term strength training and detraining in young and older adults in rectus femoris muscle

INTRODUCTION

Strength training mitigates the age-related decline in strength and muscle activation but limited evidence exists on specific motor pathway adaptations.

METHODS

Eleven young (22-34 years) and ten older (66-80 years) adults underwent five testing sessions where lumbar-evoked potentials (LEPs) and motor-evoked potentials (MEPs) were measured during 20 and 60% of maximum voluntary contraction (MVC). Ten stimulations, randomly delivered, targeted 25% of maximum compound action potential for LEPs and 120, 140, and 160% of active motor threshold (aMT) for MEPs. The 7-week whole-body resistance training intervention included five exercises, e.g., knee extension (5 sets) and leg press (3 sets), performed twice weekly and was followed by 4 weeks of detraining.

RESULTS

Young had higher MVC (~ 63 N·m, p = 0.006), 1-RM (~ 50 kg, p = 0.002), and lower aMT (~ 9%, p = 0.030) than older adults at baseline. Young increased 1-RM (+ 18 kg, p < 0.001), skeletal muscle mass (SMM) (+ 0.9 kg, p = 0.009), and LEP amplitude (+ 0.174, p < 0.001) during 20% MVC. Older adults increased MVC (+ 13 N·m, p = 0.014), however, they experienced decreased LEP amplitude (- 0.241, p < 0.001) during 20% MVC and MEP amplitude reductions at 120% (- 0.157, p = 0.034), 140% (- 0.196, p = 0.026), and 160% (- 0.210, p = 0.006) aMT during 60% MVC trials. After detraining, young and older adults decreased 1-RM, while young adults decreased SMM.

CONCLUSION

Higher aMT and MEP amplitude in older adults were concomitant with lower baseline strength. Training increased strength in both groups, but divergent modifications in cortico-spinal activity occurred. Results suggest that the primary locus of adaptation occurs at the spinal level.

Reliability of transcranial magnetic stimulation-evoked responses on knee extensor muscles during cycling

Transcranial magnetic stimulation (TMS) measures the excitability and inhibition of corticomotor networks. Despite its task-specificity, few studies have used TMS during dynamic movements and the reliability of TMS paired pulses has not been assessed during cycling. This study aimed to evaluate the reliability of motor evoked potentials (MEP) and short- and long-interval intracortical inhibition (SICI and LICI) on vastus lateralis and rectus femoris muscle activity during a fatiguing single-leg cycling task. Nine healthy adults (2 female) performed two identical sessions of counterweighted single-leg cycling at 60% peak power output until failure. Five single pulses and ten paired pulses were delivered to the motor cortex, and two maximal femoral nerve stimulations (Mmax) were administered during two baseline cycling bouts (unfatigued) and every 5 min throughout cycling (fatigued). When comparing both baseline bouts within the same session, MEP·Mmax-1 and LICI (both ICC: >0.9) were rated excellent while SICI was rated good (ICC: 0.7-0.9). At baseline, between sessions, in the vastus lateralis, Mmax (ICC: >0.9) and MEP·Mmax-1 (ICC: 0.7) demonstrated good reliability; LICI was moderate (ICC: 0.5), and SICI was poor (ICC: 0.3). Across the fatiguing task, Mmax demonstrated excellent reliability (ICC > 0.8), MEP·Mmax-1 ranged good to excellent (ICC: 0.7-0.9), LICI was moderate to excellent (ICC: 0.5-0.9), and SICI remained poorly reliable (ICC: 0.3-0.6). These results corroborate the cruciality of retaining mode-specific testing measurements and suggest that during cycling, Mmax, MEP·Mmax-1, and LICI measures are reliable whereas SICI, although less reliable across days, can be reliable within the same session.

Acute hypoalgesic, neurophysiological and perceptual responses to low-load blood flow restriction exercise and high-load resistance exercise

This study compared the acute hypoalgesic and neurophysiological responses to low-load resistance exercise with and without blood flow restriction (BFR), and free-flow, high-load exercise. Participants performed four experimental conditions where they completed baseline measures of pain pressure threshold (PPT), maximum voluntary force (MVF) with peripheral nerve stimulation to determine central and peripheral fatigue. Corticospinal excitability (CSE), corticospinal inhibition and short interval intracortical inhibition (SICI) were estimated with transcranial magnetic stimulation. Participants then performed low-load leg press exercise at 30% of one-repetition maximum (LL); low-load leg press with BFR at 40% (BFR40) or 80% (BFR80) of limb occlusion pressure; or high-load leg press of four sets of 10 repetitions at 70% one-repetition maximum (HL). Measurements were repeated at 5, 45 min and 24 h post-exercise. There were no differences in CSE or SICI between conditions (all P > 0.05); however, corticospinal inhibition was reduced to a greater extent (11%-14%) in all low-load conditions compared to HL (P < 0.005). PPTs were 12%-16% greater at 5 min post-exercise in BFR40, BFR80 and HL compared to LL (P ≤ 0.016). Neuromuscular fatigue displayed no clear difference in the magnitude or time course between conditions (all P > 0.05). In summary, low-load BFR resistance exercise does not induce different acute neurophysiological responses to low-load, free-flow exercise but it does promote a greater degree of hypoalgesia and reduces corticospinal inhibition more than high-load exercise, making it a useful rehabilitation tool. The changes in neurophysiology following exercise were not related to changes in PPT.

Strength-trained adults demonstrate greater corticoreticular activation versus untrained controls

The rapid increase in strength following strength-training involves neural adaptations, however, their specific localisation remains elusive. Prior focus on corticospinal responses prompts this study to explore the understudied cortical/subcortical adaptations, particularly cortico-reticulospinal tract responses, comparing healthy strength-trained adults to untrained peers. Fifteen chronically strength-trained individuals (≥2 years of training, mean age: 24 ± 7 years) were compared with 11 age-matched untrained participants (mean age: 26 ± 8 years). Assessments included maximal voluntary force (MVF), corticospinal excitability using transcranial magnetic stimulation (TMS), spinal excitability (cervicomedullary stimulation), voluntary activation (VA) and reticulospinal tract (RST) excitability, utilizing StartReact responses and ipsilateral motor-evoked potentials (iMEPs) for the flexor carpi radialis muscle. Trained participants had higher normalized MVF (6.4 ± 1.1 N/kg) than the untrained participants (4.8 ± 1.3 N/kg) (p = .003). Intracortical facilitation was higher in the strength-trained group (156 ± 49%) (p = .02), along with greater VA (98 ± 3.2%) (p = .002). The strength-trained group displayed reduced short-interval-intracortical inhibition (88 ± 8.0%) compared with the untrained group (69 ± 17.5%) (p < .001). Strength-trained individuals exhibited a greater normalized rate of force development (38.8 ± 10.1 N·s-1/kg) (p < .009), greater reticulospinal gain (2.5 ± 1.4) (p = .02) and higher ipsilateral-to-contralateral MEP ratios compared with the untrained group (p = .03). Strength-trained individuals displayed greater excitability within the intrinsic connections of the primary motor cortex and the RST. These results suggest greater synaptic input from the descending cortico-reticulospinal tract to α-motoneurons in strength-trained individuals, thereby contributing to the observed increase in VA and MVF.

Corticospinal and spinal responses following a single session of lower limb motor skill and resistance training

Prior studies suggest resistance exercise as a potential form of motor learning due to task-specific corticospinal responses observed in single sessions of motor skill and resistance training. While existing literature primarily focuses on upper limb muscles, revealing a task-dependent nature in eliciting corticospinal responses, our aim was to investigate such responses after a single session of lower limb motor skill and resistance training. Twelve participants engaged in a visuomotor force tracking task, self-paced knee extensions, and a control task. Corticospinal, spinal, and neuromuscular responses were measured using transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS). Assessments occurred at baseline, immediately post, and at 30-min intervals over two hours. Force steadiness significantly improved in the visuomotor task (P < 0.001). Significant fixed-effects emerged between conditions for corticospinal excitability, corticospinal inhibition, and spinal excitability (all P < 0.001). Lower limb motor skill training resulted in a greater corticospinal excitability compared to resistance training (mean difference [MD] = 35%, P < 0.001) and control (MD; 37%, P < 0.001). Motor skill training resulted in a lower corticospinal inhibition compared to control (MD; - 10%, P < 0.001) and resistance training (MD; - 9%, P < 0.001). Spinal excitability was lower following motor skill training compared to control (MD; - 28%, P < 0.001). No significant fixed effect of Time or Time*Condition interactions were observed. Our findings highlight task-dependent corticospinal responses in lower limb motor skill training, offering insights for neurorehabilitation program design.

Determining intracortical, corticospinal and alpha motoneurone excitability in athletes with patellar tendinopathy compared to asymptomatic controls

BACKGROUND

Lower capacity to generate knee extension maximal voluntary force (MVF) has been observed in individuals affected with patellar tendinopathy (PT) compared to asymptomatic controls. This MVF deficit is hypothesized to emanate from alterations in corticospinal excitability (CSE). The modulation of CSE is intricately linked to the excitability levels at multiple sites, encompassing neurones within the corticospinal tract (CST), intracortical neurones within the primary motor cortex (M1), and the alpha motoneurone. The aim of this investigation was to examine the excitability of intracortical neurones, CST neurones, and the alpha motoneurone, and compare these between volleyball and basketball athletes with PT and matched asymptomatic controls.

METHOD

Nineteen athletes with PT and 18 asymptomatic controls participated in this cross-sectional study. Transcranial magnetic stimulation was utilized to assess CST excitability, corticospinal inhibition (silent period, and short-interval cortical inhibition). Peripheral nerve stimulation was used to evaluate lumbar spine and alpha motoneurone excitability, including the evocation of lumbar-evoked potentials and maximal compound muscle action potential (MMAX ), and CSE with central activation ratio (CAR). Knee extension MVF was also assessed.

RESULTS

Athletes with PT exhibited longer silent period duration and greater electrical stimulator output for MMAX , as well as lower MVF, compared to asymptomatic controls (p < 0.05).

CONCLUSION

These findings indicate volleyball and basketball athletes with PT exhibit reduced excitability of the alpha motoneurone or the neuromuscular junction, which may be linked to lower MVF. Subtle alterations at specific sites may represent compensatory changes to excitability aiming to maintain efferent drive to the knee extensors.

Acute Effects of Strength and Skill Training on the Cortical and Spinal Circuits of Contralateral Limb

Unilateral strength and skill training increase strength and performance in the contralateral untrained limb, a phenomenon known as cross-education. Recent evidence suggests that similar neural mechanisms might be responsible for the increase in strength and skill observed in the untrained hand after unimanual training. The aims of this study were to: investigate whether a single session of unimanual strength and skill (force-tracking) training increased strength and skill in the opposite hand; measure ipsilateral (untrained) brain (via transcranial magnetic stimulation, TMS) and spinal (via the monosynaptic reflex) changes in excitability occurring after training; measure ipsilateral (untrained) pathway-specific changes in neural excitability (via TMS-conditioning of the monosynaptic reflex) occurring after training. Participants (N = 13) completed a session of unimanual strength (ballistic isometric wrist flexions) and skill (force-tracking wrist flexions) training on two separate days. Strength increased after training in the untrained hand (p = 0.025) but not in the trained hand (p = 0.611). Force-tracking performance increased in both the trained (p = 0.007) and untrained (p = 0.010) hand. Corticospinal excitability increased after force-tracking and strength training (p = 0.027), while spinal excitability was not affected (p = 0.214). TMS-conditioned monosynaptic reflex increased after force-tracking (p = 0.001) but not strength training (p = 0.689), suggesting a possible role of polysynaptic pathways in the increase of cortical excitability observed after training. The results suggest that cross-education of strength and skill at the acute stage is supported by increased excitability of the untrained motor cortex.New & Noteworthy: A single session of isometric wrist flexion strength and skill straining increased strength and skill in the untrained limb. The excitability of the untrained motor cortex increased after strength and skill training. TMS-conditioned H-reflexes increased after skill but not strength training in the untrained hand, indicating that polysynaptic pathways in the increase of cortical excitability observed after skill training.

Test-retest reliability of cortico-spinal measurements in the rectus femoris at different contraction levels

Single-pulse Transcranial Magnetic Stimulation (TMS) and, very recently, lumbar stimulation (LS) have been used to measure cortico-spinal excitability from various interventions using maximal or submaximal contractions in the lower limbs. However, reliability studies have overlooked a wide range of contraction intensities for MEPs, and no reliability data is available for LEPs. This study investigated the reliability of motor evoked potentials and lumbar evoked potentials at different stimulation intensities and contraction levels in m.rectus femoris. Twenty-two participants performed non-fatiguing isometric knee extensions at 20 and 60% of maximum voluntary contraction (MVC). LS induced a lumbar-evoked potential (LEP) of 25 and 50% resting maximal compound action potential (M-max). TMS stimulator output was adjusted to 120, 140, and 160% of active motor threshold (aMT). In each contraction, a single MEP or LEP was delivered. Ten contractions were performed at each stimulator intensity and contraction level in random order. Moderate-to-good reliability was found when LEP was normalized to M-max/Root Mean Square in all conditions (ICC:0.74-0.85). Excellent reliability was found when MEP was normalized to Mmax for all conditions (ICC > 0.90) at 60% of MVC. Good reliability was found for the rest of the TMS conditions. Moderate-to-good reliability was found for silent period (SP) elicited by LS (ICC: 0.71-0.83). Good-to-excellent reliability was found for SP elicited by TMS (ICC > 0.82). MEPs and LEPs elicited in m.rectus femoris appear to be reliable to assess changes at different segments of the cortico-spinal tract during different contraction levels and stimulator output intensities. Furthermore, the TMS- and LS- elicited SP was a reliable tool considered to reflect inhibitory processes at spinal and cortical levels.

Enhanced skeletal muscle contractile function and corticospinal excitability precede strength and architectural adaptations during lower-limb resistance training

PURPOSE

Evolving investigative techniques are providing greater understanding about the early neuromuscular responses to resistance training among novice exercisers. The aim of this study was to investigate the time-course of changes in muscle contractile mechanics, architecture, neuromuscular, and strength adaptation during the first 6-weeks of lower-limb resistance training.

METHODS

Forty participants: 22 intervention (10 males/12 females; 173.48 ± 5.20 cm; 74.01 ± 13.13 kg) completed 6-week resistance training, and 18 control (10 males/8 females; 175.52 ± 7.64 cm; 70.92 ± 12.73 kg) performed no resistance training and maintained their habitual activity. Radial muscle displacement (Dm) assessed via tensiomyography, knee extension maximal voluntary contraction (MVC), voluntary activation (VA), corticospinal excitability and inhibition via transcranial magnetic stimulation, motor unit (MU) firing rate, and muscle thickness and pennation angle via ultrasonography were assessed before and after 2, 4, and 6-weeks of dynamic lower-limb resistance training or control.

RESULTS

After 2-weeks training, Dm reduced by 19-25% in the intervention group; this was before any changes in neural or morphological measures. After 4-weeks training, MVC increased by 15% along with corticospinal excitability by 16%; however, there was no change in VA, corticospinal inhibition, or MU firing rate. After 6-weeks training there was further MVC increase by 6% along with muscle thickness by 13-16% and pennation angle by 13-14%.

CONCLUSION

Enhanced contractile properties and corticospinal excitability occurred before any muscle architecture, neural, and strength adaptation. Later increases in muscular strength can be accounted for by architectural adaptation.

Identifying the role of the reticulospinal tract for strength and motor recovery: A scoping review of nonhuman and human studies

In addition to the established postural control role of the reticulospinal tract (RST), there has been an increasing interest on its involvement in strength, motor recovery, and other gross motor functions. However, there are no reviews that have systematically assessed the overall motor function of the RST. Therefore, we aimed to determine the role of the RST underpinning motor function and recovery. We performed a literature search using Ovid Medline, Embase, CINAHL Plus, and Scopus to retrieve papers using key words for RST, strength, and motor recovery. Human and animal studies which assessed the role of RST were included. Studies were screened and 32 eligible studies were included for the final analysis. Of these, 21 of them were human studies while the remaining were on monkeys and rats. Seven experimental animal studies and four human studies provided evidence for the involvement of the RST in motor recovery, while two experimental animal studies and eight human studies provided evidence for strength gain. The RST influenced gross motor function in two experimental animal studies and five human studies. Overall, the RST has an important role for motor recovery, gross motor function and at least in part, underpins strength gain. The role of RST for strength gain in healthy people and its involvement in spasticity in a clinical population has been limitedly described. Further studies are required to ascertain the role of the RST's role in enhancing strength and its contribution to the development of spasticity.

Does the reticulospinal tract mediate adaptation to resistance training in humans?

Resistance training increases volitional force-producing capacity, and it is widely accepted that such an increase is partly underpinned by adaptations in the central nervous system, particularly in the early phases of training. Despite this, the neural substrate(s) responsible for mediating adaptation remains largely unknown. Most studies have focused on the corticospinal tract, the main descending pathway controlling movement in humans, with equivocal findings. It is possible that neural adaptation to resistance training is mediated by other structures; one such candidate is the reticulospinal tract. The aim of this narrative mini-review is to articulate the potential of the reticulospinal tract to underpin adaptations in muscle strength. Specifically, we 1) discuss why the structure and function of the reticulospinal tract implicate it as a potential site for adaptation; 2) review the animal and human literature that supports the idea of the reticulospinal tract as an important neural substrate underpinning adaptation to resistance training; and 3) examine the potential methodological options to assess the reticulospinal tract in humans.

Transcranial Direct Current Stimulation (tDCS) Improves Back-Squat Performance in Intermediate Resistance-Training Men

Purpose: The purpose of this study was to evaluate the effects of anodal tDCS applied over the dorsolateral prefrontal cortex (DLPFC) on muscle endurance in the back-squat exercise. Methods: Eleven healthy males, intermediate in resistance training (RT), aged between 18 and 31 years (25.5 ± 4.4 years) were recruited. In the initial visits (1st and 2nd visits), participants performed a 1RM test to determine the load in the back-squat exercise. Following the two initials visits, participants attended the lab for the two experimental conditions (anodal tDCS and sham), which were completed a week apart, with sessions randomly counterbalanced. The stimulation was applied over the DLPFC for 20 minutes using a 2 mA current intensity. Immediately after the experimental conditions, participants completed three sets of maximum repetitions (80% of 1RM), with a 1-minute recovery interval between each set in the back-squat exercise. Muscle endurance was determined by the total number of repetitions and the number of repetitions in each set. Results: The total number of repetitions was higher in the anodal tDCS condition compared to sham condition (p ≤ .0001). Moreover, the number of repetitions performed in the first set was higher for anodal tDCS condition than in the sham condition (p ≤ .01). Conclusion: This study found improvement in back-squat exercise performance after the application of anodal tDCS. The effects of anodal tDCS applied over DLPFC may be a promising ergogenic resource on muscle endurance in the back-squat exercise.

Use-dependent corticospinal excitability is associated with resilience and physical performance during simulated military operational stress

Simulated military operational stress (SMOS) provides a useful model to better understand resilience in humans as the stress associated with caloric restriction, sleep deficits, and fatiguing exertion degrades physical and cognitive performance. Habitual physical activity may confer resilience against these stressors by promoting favorable use-dependent neuroplasticity, but it is unclear how physical activity, resilience, and corticospinal excitability (CSE) relate during SMOS. To examine associations between corticospinal excitability, physical activity, and physical performance during SMOS. Fifty-three service members (age: 26 ± 5 yr, 13 women) completed a 5-day and -night intervention composed of familiarization, baseline, SMOS (2 nights/days), and recovery days. During SMOS, participants performed rigorous physical and cognitive activities while receiving half of normal sleep (two 2-h blocks) and caloric requirements. Lower and upper limb CSE were determined with transcranial magnetic stimulation (TMS) stimulus-response curves. Self-reported resilience, physical activity, military-specific physical performance (TMT), and endocrine factors were compared in individuals with high (HIGH) and low CSE based on a median split of lower limb CSE at baseline. HIGH had greater physical activity and better TMT performance throughout SMOS. Both groups maintained physical performance despite substantial psychophysiological stress. Physical activity, resilience, and TMT performance were directly associated with lower limb CSE. Individual differences in physical activity coincide with lower (but not upper) limb CSE. Such use-dependent corticospinal excitability directly relates to resilience and physical performance during SMOS. Future studies may use noninvasive neuromodulation to clarify the interplay among CSE, physical activity, and resilience and improve physical and cognitive performance.NEW & NOTEWORTHY We demonstrate that individual differences in physical activity levels coincide with lower limb corticospinal excitability. Such use-dependent corticospinal excitability directly relates to resilience and physical performance during a 5-day simulation of military operational stress with caloric restriction, sleep restriction and disruption, and heavy physical and cognitive exertion.

Corticospinal and intracortical excitability is modulated in the knee extensors after acute strength training

The corticospinal responses to high-intensity and low-intensity strength-training of the upper limb are modulated in an intensity-dependent manner. Whether an intensity-dependent threshold occurs following acute strength training of the knee extensors (KE) remains unclear. We assessed the corticospinal responses following high-intensity (85% of maximal strength) or low-intensity (30% of maximal strength) KE strength-training with measures taken during an isometric KE task at baseline, post-5, 30 and 60-min. Twenty-eight volunteers (23 ± 3 years) were randomized to high-intensity (n = 11), low-intensity (n = 10) or to a control group (n = 7). Corticospinal responses were evoked with transcranial magnetic stimulation at intracortical and corticospinal levels. High- or low-intensity KE strength-training had no effect on maximum voluntary contraction force post-exercise (P > 0.05). High-intensity training increased corticospinal excitability (range 130-180%) from 5 to 60 min post-exercise compared to low-intensity training (17-30% increase). Large effect sizes (ES) showed that short-interval cortical inhibition (SICI) was reduced only for the high-intensity training group from 5-60 min post-exercise (24-44% decrease) compared to low-intensity (ES ranges 1-1.3). These findings show a training-intensity threshold is required to adjust CSE and SICI following strength training in the lower limb.

Response of the Cerebral Cortex to Resistance and Non-resistance Exercise Under Different Trajectories: A Functional Near-Infrared Spectroscopy Study

Background: At present, the effects of upper limb movement are generally evaluated from the level of motor performance. The purpose of this study is to evaluate the response of the cerebral cortex to different upper limb movement patterns from the perspective of neurophysiology.

Method: Thirty healthy adults (12 females, 18 males, mean age 23.9 ± 0.9 years) took resistance and non-resistance exercises under four trajectories (T1: left and right straight-line movement; T2: front and back straight-line movement; T3: clockwise and anticlockwise drawing circle movement; and T4: clockwise and anticlockwise character ⁕ movement). Each movement included a set of periodic motions composed of a 30-s task and a 30-s rest. Functional near-infrared spectroscopy (fNIRS) was used to measure cerebral blood flow dynamics. Primary somatosensory cortex (S1), supplementary motor area (SMA), pre-motor area (PMA), primary motor cortex (M1), and dorsolateral prefrontal cortex (DLPFC) were chosen as regions of interests (ROIs). Activation maps and symmetric heat maps were applied to assess the response of the cerebral cortex to different motion patterns.

Result: The activation of the brain cortex was significantly increased during resistance movement for each participant. Specifically, S1, SMA, PMA, and M1 had higher participation during both non-resistance movement and resistance movement. Compared to non-resistance movement, the resistance movement caused an obvious response in the cerebral cortex. The task state and the resting state were distinguished more obviously in the resistance movement. Four trajectories can be distinguished under non-resistance movement.

Conclusion: This study confirmed that the response of the cerebral motor cortex to different motion patterns was different from that of the neurophysiological level. It may provide a reference for the evaluation of resistance training effects in the future.

Machines and free weight exercises: a systematic review and meta-analysis comparing changes in muscle size, strength, and power

INTRODUCTION

To compare changes in muscle size, strength, and power between free-weight and machine-based exercises.

EVIDENCE ACQUISITION

The online databases of Pubmed, Scopus, and Web of Science were each searched using the following terms: ""free weights" OR barbells OR dumbbells AND machines" up until September 15, 2020. A three-level random effects meta-analytic model was used to compute effect sizes.

EVIDENCE SYNTHESIS

When strength was tested using a free-weight exercise, individuals training with free-weights gained more strength than those training with machines [ES: 0.655; (95% CI: 0.269, 1.041)]. When strength was tested a machine-based exercise incorporated as part of the machine-based training program, individuals training with machines gained more strength than those training with free-weights [ES: -0.784 (95% CI: -1.223, -0.344)]. When strength was tested using a neutral device, machines and free-weight exercises resulted in similar strength gains [ES: 0.128 (95% CI: -0303, 0.559)]. There were no differences in the change in power [ES: -0.049 (95% CI: -0.557, 0.460)] or muscle hypertrophy [ES: -0.01 (95% CI: -0.525, 0.545)] between exercise modes.

CONCLUSIONS

Individuals looking to increase strength and power should take into account the specificity of exercise, and how their strength and power will be tested and applied. Individuals looking to increase general strength and muscle mass to maintain health may choose whichever activity they prefer and are more likely to adhere to.

Neural adaptations to long-term resistance training: evidence for the confounding effect of muscle size on the interpretation of surface electromyography

This study compared elbow flexor (EF; experiment 1) and knee extensor (KE; experiment 2) maximal compound action potential (M_max) amplitude between long-term resistance trained (LTRT; n = 15 and n = 14, 6 ± 3 and 4 ± 1 yr of training) and untrained (UT; n = 14 and n = 49) men, and examined the effect of normalizing electromyography (EMG) during maximal voluntary torque (MVT) production to M_max amplitude on differences between LTRT and UT. EMG was recorded from multiple sites and muscles of EF and KE, M_max was evoked with percutaneous nerve stimulation, and muscle size was assessed with ultrasonography (thickness, EF) and magnetic resonance imaging (cross-sectional area, KE). Muscle-electrode distance (MED) was measured to account for the effect of adipose tissue on EMG and M_max. LTRT displayed greater MVT (+66%-71%, P < 0.001), muscle size (+54%-56%, P < 0.001), and M_max amplitudes (+29%-60%, P ≤ 0.010) even when corrected for MED (P ≤ 0.045). M_max was associated with the size of both muscle groups (r ≥ 0.466, P ≤ 0.011). Compared with UT, LTRT had higher absolute voluntary EMG amplitude for the KE (P < 0.001), but not the EF (P = 0.195), and these differences/similarities were maintained after correction for MED; however, M_max normalization resulted in no differences between LTRT and UT for any muscle and/or muscle group (P ≥ 0.652). The positive association between M_max and muscle size, and no differences when accounting for peripheral electrophysiological properties (EMG/M_max), indicates the greater absolute voluntary EMG amplitude of LTRT might be confounded by muscle morphology, rather than providing a discrete measure of central neural activity. This study therefore suggests limited agonist neural adaptation after LTRT.NEW & NOTEWORTHY In a large sample of long-term resistance-trained individuals, we showed greater maximal M-wave amplitude of the elbow flexors and knee extensors compared with untrained individuals, which appears to be at least partially mediated by differences in muscle size. The lack of group differences in voluntary EMG amplitude when normalized to maximal M-wave suggests that differences in muscle morphology might impair interpretation of voluntary EMG as an index of central neural activity.

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.

Reliability of corticospinal excitability estimates for the vastus lateralis: Practical considerations for lower limb TMS task selection

Transcranial magnetic stimulation (TMS) is increasingly used to examine lower extremity corticospinal excitability (CSE) in clinical and sports research. Because CSE is task-specific, there is growing emphasis on the use of ecological tasks. Nevertheless, the comparative reliability of CSE measurements during established (e.g. knee extensions; KE) and more recent ecological (e.g. squats; SQT) lower extremity tasks has received less attention. The aim of this study was to compare the test-retest reliability of CSE, force, and muscle activity (EMG) during isometric SQT and KE. 19 right-footed men (age: 25 ± 5 yrs) with similar fitness and body composition performed SQT (N = 7) or KE (N = 12) on two consecutive days. Force and EMG were recorded during maximum voluntary isometric contractions (MVC). Corticospinal excitability was determined in the dominant leg during light (15% MVC) contractions based on motor evoked potential (MEP) stimulus-response-curves (SRC). Test-retest reliability, absolute agreement, and consistency were determined for force, EMG, and SRC MEP maximum (MEPMAX) and rising phase midpoint (V50). As a secondary analysis, all outcomes were compared between groups with mixed-methods ANCOVAs (Task × Time, covariate: body-fat-percentage). Compared with SQT, KE displayed better test-retest reliability and agreement for MEPMAX whereas V50, force, and EMG were similarly reliable. Force (p = 0.01) and MEPMAX (p = 0.02) were also greater during KE despite a similar V50 (p = 0.11). Differences in test-retest reliability, absolute agreement, and between-group comparisons highlight the need to carefully select lower limb TMS assessment tasks and encourage future efforts to balance ecological validity with statistical sensitivity.

Differences in brain structure and theta burst stimulation-induced plasticity implicate the corticomotor system in loss of function after musculoskeletal injury

Traumatic musculoskeletal injury (MSI) may involve changes in corticomotor structure and function, but direct evidence is needed. To determine the corticomotor basis of MSI, we examined interactions among skeletomotor function, corticospinal excitability, corticomotor structure (cortical thickness and white matter microstructure), and intermittent theta burst stimulation (iTBS)-induced plasticity. Nine women with unilateral anterior cruciate ligament rupture (ACL) 3.2 ± 1.1 yr prior to the study and 11 matched controls (CON) completed an MRI session followed by an offline plasticity-probing protocol using a randomized, sham-controlled, double-blind, cross-over study design. iTBS was applied to the injured (ACL) or nondominant (CON) motor cortex leg representation (M1_LEG) with plasticity assessed based on changes in skeletomotor function and corticospinal excitability compared with sham iTBS. The results showed persistent loss of function in the injured quadriceps, compensatory adaptations in the uninjured quadriceps and both hamstrings, and injury-specific increases in corticospinal excitability. Injury was associated with lateralized reductions in paracentral lobule thickness, greater centrality of nonleg corticomotor regions, and increased primary somatosensory cortex leg area inefficiency and eccentricity. Individual responses to iTBS were consistent with the principles of homeostatic metaplasticity; corresponded to injury-related differences in skeletomotor function, corticospinal excitability, and corticomotor structure; and suggested that corticomotor adaptations involve both hemispheres. Moreover, iTBS normalized skeletomotor function and corticospinal excitability in ACL. The results of this investigation directly confirm corticomotor involvement in chronic loss of function after traumatic MSI, emphasize the sensitivity of the corticomotor system to skeletomotor events and behaviors, and raise the possibility that brain-targeted therapies could improve recovery.NEW & NOTEWORTHY Traumatic musculoskeletal injuries may involve adaptive changes in the brain that contribute to loss of function. Our combination of neuroimaging and theta burst transcranial magnetic stimulation (iTBS) revealed distinct patterns of iTBS-induced plasticity that normalized differences in muscle and brain function evident years after unilateral knee ligament rupture. Individual responses to iTBS corresponded to injury-specific differences in brain structure and physiological activity, depended on skeletomotor deficit severity, and suggested that corticomotor adaptations involve both hemispheres.

The knowns and unknowns of neural adaptations to resistance training

The initial increases in force production with resistance training are thought to be primarily underpinned by neural adaptations. This notion is firmly supported by evidence displaying motor unit adaptations following resistance training; however, the precise locus of neural adaptation remains elusive. The purpose of this review is to clarify and critically discuss the literature concerning the site(s) of putative neural adaptations to short-term resistance training. The proliferation of studies employing non-invasive stimulation techniques to investigate evoked responses have yielded variable results, but generally support the notion that resistance training alters intracortical inhibition. Nevertheless, methodological inconsistencies and the limitations of techniques, e.g. limited relation to behavioural outcomes and the inability to measure volitional muscle activity, preclude firm conclusions. Much of the literature has focused on the corticospinal tract; however, preliminary research in non-human primates suggests reticulospinal tract is a potential substrate for neural adaptations to resistance training, though human data is lacking due to methodological constraints. Recent advances in technology have provided substantial evidence of adaptations within a large motor unit population following resistance training. However, their activity represents the transformation of afferent and efferent inputs, making it challenging to establish the source of adaptation. Whilst much has been learned about the nature of neural adaptations to resistance training, the puzzle remains to be solved. Additional analyses of motoneuron firing during different training regimes or coupling with other methodologies (e.g., electroencephalography) may facilitate the estimation of the site(s) of neural adaptations to resistance training in the future.

Training load but not fatigue affects cross-education of maximal voluntary force

The purpose of this study was to determine the effects of training load (25% vs. 75% of one repetition maximum [1RM]) and fatigue (failure vs. non-failure) during four weeks of unilateral knee extension resistance training (RT) on maximal voluntary force in the trained and the untrained knee extensors. Healthy young adults (n = 42) were randomly assigned to control (CON, n = 9, 24 ± 4.3 years), low-load RT to failure (LLF, n = 11, 21 ± 1.3 years, three sets to failure at 25% of 1RM), high-load RT to failure (HLF, n = 11, 21 ± 1.4 years, three sets to failure at 75% of 1RM), and high-load RT without failure (HLNF, n = 11, 22 ± 1.5 years, six sets of five repetitions at 75% of 1RM) groups. Before and after the four weeks of training, 1RM, maximal voluntary isometric force, and corticospinal excitability (CSE) were measured. 1RM in the trained (20%, d = 0.70, 15%, d = 0.61) and the untrained knee extensors (5%, d = 0.27, 6%, d = 0.26) increased only in the HLF and HLNF groups, respectively. MVIC force increased only in the trained leg of the HLF (5%, d = 0.35) and HLNF groups (12%, d = 0.67). CSE decreased in the VL of both legs in the HLNF group (-19%, d = 0.44) and no changes occurred in the RF. In conclusion, high- but not low-load RT improves maximal voluntary force in the trained and the untrained knee extensors and fatigue did not further enhance these adaptations. Voluntary force improvements were unrelated to CSE changes in both legs.

Flywheel squats versus free weight high load squats for improving high velocity movements in football. A randomized controlled trial

Background

High load (HL: > 85% of one repetition maximum (1RM)) squats with maximal intended velocity contractions (MIVC) combined with football sessions can be considered a relevant and time-efficient practice for maintaining and improving high velocity movements in football. Flywheel (FW) resistance exercise (RE) have recently emerged with promising results on physical parameters associated with football performance.

Methods

In this randomized controlled trial over 6 weeks, 38 recreationally active male football players randomly performed RE with MIVCs two times per week as either 1) FW squats (n = 13) or 2) barbell free weight (BFW) HL squats (n = 13), where a third group served as controls (n = 12). All three groups conducted 2–3 football sessions and one friendly match a week during the intervention period. Pre- to post changes in 10-m sprint, countermovement jump (CMJ) and 1RM partial squat were assessed with univariate analyses of variance.

Results

The FW and BFW group equally improved their 10-m sprint time (2 and 2%, respectively, within group: both p < 0.001) and jump height (9 and 8%, respectively, within group: both p < 0.001), which was superior to the control group’s change (between groups: both p < 0.001). The BFW group experienced a larger increase (46%) in maximal squat strength than the FW group (17%, between groups: p < 0.001), which both were higher than the control group’s change (both p < 0.001).

Conclusion

Squats carried out with FWs or BFWs where both are performed with MIVCs and combined with football sessions, were equally effective in improving sprint time and jump height in football players. The BFW group experienced a more than two-fold larger increase in maximal partial squat strength than the FW group in maximal partial squat strength. This presents FW RE as an alternative to BFW HL RE for improving high velocity movements in football.

Trial registration

ClinicalTrials.gov Identifier: NCT04113031 (retrospectively registered, date: 02.10.2019).