Assessing differential responders and mean changes in muscle size, strength, and the crossover effect to 2 distinct resistance training protocols

Responsiveness of functional performance and muscle strength, power, and size to resistance training: A systematic review

There is a recent and growing interest in assessing differential responders to resistance training (RT) for diverse outcomes. Thus, the individual ability to respond to an intervention for a specific measurement, called responsiveness, remains to be better understood. Thus, the current study aimed to summarize the available information about the effects of RT on functional performance and muscle strength, power, and size in healthy adults, through the prevalence rate in different responsiveness classifications models. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered at the International Prospective Register of Systematic Reviews (PROSPERO, CRD42021265378). PubMed/MEDLINE, Scopus, and Embase databases were systematically searched in October 2023. A total of 13 studies were included, totaling 921 subjects. Only two studies presented a low risk of bias. Regarding the effectiveness of RT, the prevalence rate for non-responders ranged from 0% to 44% for muscle strength, from 0% to 84% for muscle size, and from 0% to 42% for functional performance, while for muscle power, the only study found showed a responsiveness rate of 37%. In conclusion, a wide range of differential responders is described for all variables investigated. However, the evidence summarized in this systematic review suggested some caution while interpreting the findings, since the body of evidence found seems to be incipient, and widely heterogeneous in methodological and statistical aspects.

Blood flow restriction augments the cross-education effect of isometric handgrip training

INTRODUCTION

The application of blood flow restriction (BFR) to low-intensity exercise may be able to increase strength not only in the trained limb but also in the homologous untrained limb. Whether this effect is repeatable and how that change compares to that observed with higher intensity exercise is unknown.

PURPOSE

Examine whether low-intensity training with BFR enhances the cross-education of strength compared to exercise without BFR and maximal efforts.

METHODS

A total of 179 participants completed the 6-week study, with 135 individuals performing isometric handgrip training over 18 sessions. Participants were randomly assigned to one of four groups: 1) low-intensity (4 × 2 min of 30% MVC; LI, n = 47), 2) low-intensity with blood flow restriction (LI + 50% arterial occlusion pressure; LI-BFR, n = 41), 3) maximal effort (4 × 5 s of 100% MVC; MAX, n = 47), and 4) non-exercise control (CON, n = 44).

RESULTS

LI-BFR was the only group that observed a cross-education in strength (CON: 0.64 SD 2.9 kg, LI: 0.95 SD 3.6 kg, BFR-LI: 2.7 SD 3.3 kg, MAX: 0.80 SD 3.1 kg). In the trained hand, MAX observed the greatest change in strength (4.8 SD 3.3 kg) followed by LI-BFR (2.8 SD 4.0 kg). LI was not different from CON. Muscle thickness did not change in the untrained arm, but ulna muscle thickness was increased within the trained arm of the LI-BFR group (0.06 SD 0.11 cm).

CONCLUSION

Incorporating BFR into low-intensity isometric training led to a cross-education effect on strength that was greater than all other groups (including high-intensity training).

Assessing the effectiveness of Compare Assistant for improving intra-rater reliability of ultrasound-measured muscle thickness

PURPOSE

Muscle thickness measured via ultrasound is commonly used to assess muscle size. The purpose of this study was to determine if the reliability of this measurement will improve if using the Compare Assistant tool, and whether this depends on technician experience and the muscle being assessed.

METHODS

Individuals came to the laboratory for two visits each separated by 24 h. On day 1, two ultrasound images were taken on the individual's anterior upper arm (elbow flexors) and anterior lower leg (tibialis anterior) by two inexperienced and one experienced ultrasound technician. On day 2, three images were taken: (1) without looking at the previous images taken on day 1; (2) after re-examining the images taken on day 1, and (3) side-by-side with the images taken on day 1 via Compare Assistant. Bayes Factors (BF10) were used to provide evidence for the null (< 0.33) or alternative (> 3) hypotheses.

RESULTS

There was no rater by measurement technique interaction (upper body: BF10 = 0.04, lower body: BF10 = 0.138), nor was there a main effect of measurement technique (upper body: BF10 = 0.052, lower body: BF10 = 0.331), indicating that reliability measures were not improved for either the upper body (CV%, no look: 2.92 vs. Compare Assistant: 2.87) or lower body (CV%, no look: 1.81 vs. Compare Assistant: 1.34) as a result of using Compare Assistant.

CONCLUSION

The results of this study suggest that day-to-day reliability of muscle thickness measurement may be limited by random biological variability as opposed to technician error.

Skeletal Muscle Adaptations to High-Load Resistance Training With Pre-Exercise Blood Flow Restriction

ABSTRACT

Hammert, WB, Moreno, EN, Martin, CC, Jessee, MB, and Buckner, SL. Skeletal muscle adaptations to high-load resistance training with pre-exercise blood flow restriction. J Strength Cond Res 37(12): 2381-2388, 2023-This study aimed to determine if blood flow restriction (BFR) could augment adaptations to a high-load training protocol that was inadequate for muscle growth. Forty nontrained individuals had each arm assigned to 1 of 3 elbow flexion protocols: (a) high-load resistance training [TRAD; 4 sets to muscular failure at 70% 1 repetition maximum (1RM)], (b) low repetition high-load resistance training with pre-exercise BFR (PreBFR; 4 sets of 3 repetitions at 70% 1RM + 3 min of pre-exercise BFR), and (c) low repetition high-load resistance training (LRTRAD); 4 sets of 3 repetitions at 70% 1RM). Muscle thickness (MT), 1RM strength, and local muscular endurance (LME) of the elbow flexors were measured before and after 8 weeks. An alpha level of 0.05 was used for all comparisons. For the 50% site, MT increased for TRAD (0.211 cm, 95% confidence interval [95% CI]: 0.143-0.280), PreBFR (0.105 cm, 95% CI: 0.034-0.175), and LRTRAD (0.073 cm, 95% CI: 0.000-0.146). The change for TRAD was greater than PreBFR and LRTRAD. For the 60% site, MT increased for TRAD (0.235 cm, 95% CI: 0.153-0.317), PreBFR (0.097 cm, 95% CI: 0.014-0.180), and LRTRAD (0.082 cm, 95% CI: 0.000-0.164). The change for TRAD was greater than PreBFR and LRTRAD. For the 70% site MT increased for TRAD (0.308 cm, 95% CI: 0.247-0.369), PreBFR (0.103 cm, 95% CI: 0.041-0.166), and LRTRAD (0.070 cm, 95% CI: 0.004-0.137). The change for TRAD was greater than PreBFR and LRTRAD. One repetition maximum and LME significantly increased for each condition, with no differences between conditions. Collapsed across conditions 1RM strength increased 2.094 kg (95% CI: 1.771-2.416) and LME increased 7.0 repetitions (95% CI: 5.7-8.3). In conclusion, the application of BFR to low-repetition, high-load training did not enhance the adaptative response.

The effects of backward vs. forward running training on measures of physical fitness in young female handball players

Introduction

This study examined the effects of an 8-week backward running (BR) vs. forward running (FR) training programmes on measures of physical fitness in young female handball players.

Methods

Twenty-nine players participated in this study. Participants were randomly assigned to a FR training group, BR training group, and a control group.

Results and discussion

Within-group analysis indicated significant, small-to-large improvements in all performance tests (effect size [g] = 0.36 to 1.80), except 5-m forward sprint-time in the BR group and 5- and 10-m forward sprint-time in the FR group. However, the CG significantly decreased forward sprint performance over 10-m and 20-m (g = 0.28 to 0.50) with no changes in the other fitness parameters. No significant differences in the amount of change scores between the BR and FR groups were noted. Both training interventions have led to similar improvements in measures of muscle power, change of direction (CoD) speed, sprint speed either forward or backward, and repeated sprint ability (RSA) in young female handball players, though BR training may have a small advantage over FR training for 10-m forward sprint time and CoD speed, while FR training may provide small improvements over BR training for RSAbest. Practitioners are advised to consider either FR or BR training to improve various measures of physical fitness in young female handball players.

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.

Unilateral high-load resistance training influences strength changes in the contralateral arm undergoing low-load training

OBJECTIVES

Within-subject training models have become common within the exercise literature. However, it is currently unknown if training one arm with a high load would impact muscle size and strength of the opposing arm training with a low load.

DESIGN

Parallel group.

METHODS

116 participants were randomized to one of three groups that completed 6-weeks (18 sessions) of elbow flexion exercise. Group 1 trained their dominant arm only, beginning with a one-repetition maximum test (≤5 attempts), followed by four sets of exercise using a weight equivalent to 8-12 repetition maximum. Group 2 completed the same training as Group 1 in their dominant arm, while the non-dominant arm completed four sets of low-load exercise (30-40 repetition maximum). Group 3 trained their non-dominant arm only, performing the same low-load exercise as Group 2. Participants were compared for changes in muscle thickness and elbow flexion one-repetition maximum.

RESULTS

The greatest changes in non-dominant strength were present in Groups 1 (Δ 1.5 kg; untrained arm) and 2 (Δ1.1 kg; low-load arm with high load on opposite arm), compared to Group 3 (Δ 0.3 kg; low-load only). Only the arms being directly trained observed changes in muscle thickness (≈Δ 0.25 cm depending on site).

CONCLUSIONS

Within-subject training models are potentially problematic when investigating changes in strength (though not muscle growth). This is based on the finding that the untrained limb of Group 1 saw similar changes in strength as the non-dominant limb of Group 2 which were both greater than the low-load training limb of Group 3.

Effects of Unilateral Eccentric versus Concentric Training of Nonimmobilized Arm during Immobilization

INTRODUCTION

The present study tested the hypothesis that eccentric training (ET) of nonimmobilized arm would attenuate negative effects of immobilization and provide greater protective effects against muscle damage induced by eccentric exercise after immobilization, when compared with concentric training (CT).

METHODS

Sedentary young men were placed to ET, CT, or control group ( n = 12 per group), and their nondominant arms were immobilized for 3 wk. During the immobilization period, the ET and CT groups performed five sets of six dumbbell curl eccentric-only and concentric-only contractions, respectively, at 20%-80% of maximal voluntary isometric contraction (MVCiso) strength over six sessions. MVCiso torque, root-mean square (RMS) of electromyographic activity during MVCiso, and bicep brachii muscle cross-sectional area (CSA) were measured before and after immobilization for both arms. All participants performed 30 eccentric contractions of the elbow flexors (30EC) by the immobilized arm after the cast was removed. Several indirect muscle damage markers were measured before, immediately after, and for 5 d after 30EC.

RESULTS

ET increased MVCiso (17% ± 7%), RMS (24% ± 8%), and CSA (9% ± 2%) greater ( P < 0.05) than CT (6% ± 4%, 9% ± 4%, 3% ± 2%) for the trained arm. The control group showed decreases in MVCiso (-17% ± 2%), RMS (-26% ± 6%), and CSA (-12% ± 3%) for the immobilized arm, but these changes were attenuated greater ( P < 0.05) by ET (3% ± 3%, -0.1% ± 2%, 0.1% ± 0.3%) than CT (-4% ± 2%, -4% ± 2%, -1.3% ± 0.4%). Changes in all muscle damage markers after 30EC were smaller ( P < 0.05) for the ET and CT than the control group, and ET than the CT group (e.g., peak plasma creatine kinase activity: ET, 860 ± 688 IU·L -1 ; CT, 2390 ± 1104 IU·L -1 ; control, 7819 ± 4011 IU·L -1 ).

CONCLUSIONS

These results showed that ET of the nonimmobilized arm was effective for eliminating the negative effects of immobilization and attenuating eccentric exercise-induced muscle damage after immobilization.

The Prevalence of Responders and Non-Responders for Body Composition, Resting Blood Pressure, Musculoskeletal, and Cardiorespiratory Fitness after Ten Weeks of School-Based High-Intensity Interval Training in Adolescents

Many observations have demonstrated great heterogeneity in the magnitude of the response to the physical exercise stimulus. Only a few studies have investigated the effects of high-intensity interval training (HIIT) on the prevalence of non-responders (NRs) in adolescents while considering health-related fitness measurements and other co-variables. Therefore, the aim of the current work was twofold: (1) to assess the effects of ten weeks of school-based HIIT on the prevalence of responders (Rs) and NRs for body composition, resting blood pressure (BP), cardiorespiratory and musculoskeletal fitness, and (2) to assess the relationship of this prevalence with sex, body mass category, and biological maturation status, while estimating the likelihood of a response. Adolescents aged 16 years (n = 73) were included in the study. Waist-to-hip ratio, body fat percentage (BFP), skeletal muscle mass (SMM), BP, cardiorespiratory fitness (CRF), and musculoskeletal fitness were the primary outcomes. Co-variables included sex, body mass index (BMI), and maturity offset. The percentages of the Rs and NRs were analyzed based on changes (Δ) between post-intervention and pre-intervention values. The typical error (TE) method was used to identify Rs and NRs. Results showed a variation in the relative size of changes (% of changes) depending on the variable and sex. The greatest changes were observed in females' abdomen muscle strength (Δ% = 23.89%), and the difference from that of males (Δ% = 5.98%) was statistically significant (p < 0.001) with very large effect size of (Cohen's d = 0.941). Similar significant differences in relative changes were observed in body composition, but in the reverse direction. Males gained more from HIIT in the decrease in the body fat percentage (Δ% = -8.24%) and increase in skeletal muscle mass (Δ% = 3.38%) comparing to females (Δ% = 0.46, p = 0.040 and Δ% = 1.06%, p = 0.007, respectively). Effect size for body fat was small (Cohen's d = 0.469), and for skeletal muscle mass it was moderate (Cohen's d = -0.659). The results also showed positive significant differences in the prevalence of Rs compared to NRs in BFP, SMM, systolic BP (SBP), diastolic BP (DBP), CRF, and abdominal muscular strength (ABS) (p = 0.047, p = 0.047, p < 0.001, p = 0.003, p = 0.014, and p = 0.014, respectively). The effect was greatest and largest for SBP (Cohen's ω = 0.67). Sex was related to the prevalence of Rs for ABS and close to significance for SMM. More males than females benefited from HIIT in SMM (p = 0.058), but more females than males had ABS benefits (p = 0.050). Males were more likely (2.5-fold) to be Rs than females in SMM. BMI was not related to the prevalence of Rs and NRs. Biological maturation was related to the prevalence of Rs and NRs in SMM (p = 0.036) and SBP (p = 0.016). In SBP, 100% of the early matured derived benefit from HIIT, but the effect size was small (Cramer's V = 0.27). Those who maturated later were more likely (almost 70%) to be Rs. Thus, the HIIT program introduced to a typical physical education (PE) lesson can be considered partially effective. Therefore, there is a need to continue the search for an optimal and effective program for all health-related parameters. The close relationship between analyzed values and sex and biological maturation, but not BMI, indicates that the intervention programs should be tailored specifically for males and females.

Quantifying the Generality of Strength Adaptation: A Meta-Analysis

BACKGROUND

Isotonic exercise is the most common mode of strength training. Isotonic strength is often measured in the movement that was exercised, but isometric and isokinetic movements are also commonly used to quantify changes in muscular strength. Previous research suggests that increasing strength in one movement may not lead to an increase in strength in a different movement. Quantifying the increase in strength in a movement not trained may be important for understanding strength training adaptations and making recommendations for resistance exercise and rehabilitation programs.

OBJECTIVE

To quantify changes in non-specific strength relative to a control.

DESIGN

A systematic review and random effects meta-analysis was conducted investigating the effects of isotonic strength training on isotonic and isokinetic/isometric strength.

SEARCH AND INCLUSION

This systematic review was conducted in Google scholar, PubMed, Academic Search Premier, and MENDELEY. To be included in this review paper the article needed to meet the following criteria: (1) report sufficient data for our variables of interest (i.e., changes in isotonic strength and changes in isokinetic or isometric strength); (2) include a time-matched non-exercise control; (3) be written in English; (4) include healthy human participants over the age of 18 years; (5) the participants had to train and test isotonically; (6) the participants had to be tested isokinetically or isometrically on a device different from that they trained on; (7) the non-specific strength task had to test a muscle involved in the training (i.e., could not have trained chest press and test handgrip strength); and (8) the control group and the experimental group had to perform the same number of strength tests.

RESULTS

We completed two separate searches. In the original search a total of 880 papers were screened and nine papers met the inclusion criteria. In the secondary search a total of 2594 papers were screened and three additional papers were added (total of 12 studies). The overall effect of resistance training on changes in strength within a movement that was not directly trained was 0.8 (Cohen's d) with a standard error of 0.286. This overall effect was significant (t = 2.821, p = 0.01) and the 95% confidence interval (CI) is 0.22-1.4. The overall effect of resistance training on strength changes within a movement that was directly trained was 1.84 (Cohen's d) with a standard error of 0.296. This overall effect was significant (t = 6.221, p < 0.001) and the 95% CI is 1.23-2.4.

CONCLUSION

The results of our meta-analysis suggest that strength increases in both the specific and non-specific strength tests. However, the smaller effect size associated with non-specific strength suggests that it will be difficult for a single study to meaningfully investigate the transfer of strength training adaptions.

Sex segregation in strength sports: Do equal-sized muscles express the same levels of strength between sexes?

OBJECTIVES

Concerns have been raised against the current two-sex binary category in sports competitions. The thesis states that if males and females were separated based on muscle size, it would negate the strength advantage between the sexes. We tested the possible sex differences in various strength outcomes when pair-matched for muscle thickness.

METHODS

A total of 16 different data sets (n = 963) were assessed to pair-match females with males who had a muscle thickness value within 2%. We further compared the competition performances of the smallest male weight class within the International Powerlifting Federation (IPF) to different weight classes in females.

RESULTS

Overall, 76%-88% of the strength assessments were greater in males than females with pair-matched muscle thickness, regardless of contraction types (i.e., isotonic, isometric, isokinetic). Additionally, males in the lightest weight division in the IPF largely outperformed females in heavier weight divisions.

CONCLUSIONS

Our results would suggest that segregation based on muscle mass or surrogates of muscle mass (e.g., lean body mass) might not be an appropriate classification to create fair competition within strength sports. This is not to refute the concept of the desegregation of the two-sex binary category but to present data that raises important concerns about the potential sex-based differences in strength performance.

Does performing resistance exercise to failure homogenize the training stimulus by accounting for differences in local muscular endurance?

The prescription of resistance exercise often involves administering a set number of repetitions to be completed at a given relative load. While this accounts for individual differences in strength, it neglects to account for differences in local muscle endurance and may result in varied responses across individuals. One way of potentially creating a more homogenous stimulus across individuals involves performing resistance exercise to volitional failure, but this has not been tested and was the purpose of the present study. Individuals completed 2 testing sessions to compare repetitions, ratings of perceived exertion (RPE), muscle swelling and fatigue responses to arbitrary repetition (SET) vs. failure (FAIL) protocols using either 60% or 30% one-repetition maximum. Statistical analyses assessed differences in the variability between protocols. Forty-six individuals (25 females and 21 males) completed the study. There was more variability in the number of repetitions completed during FAIL when compared to SET protocols. Performing the 60% 1RM condition to failure appeared to reduce the variability in muscle swelling (average variance: 60%-SET = .034, 60%-FAIL = .023) and RPE (average variance: 60%-SET = 4.0, 60%-FAIL = 2.5), but did not alter the variability in muscle fatigue. No differences in variability were present between the SET-30% and FAIL-30% protocols for any of the dependent variables. Performing resistance exercise to failure may result in a more homogenous stimulus across individuals, particularly when using moderate to high exercise loads. The prescription of resistance exercise should account for individual differences in local muscle endurance to ensure a similarly effective stimulus across individuals.Highlights There is a large variance in the number of repetitions individuals can complete even when exercising with the same relative load.Ratings of perceived exertion and muscle swelling responses become more homogenous when exercising to volitional failure as compared to using performing a set number of repetitions, particularly when moderate to higher loads are used.The prescription of exercise should take into consideration the individual's local muscle endurance as opposed to choosing an arbitrary number of repetitions to be completed at a given relative load.

Daily protein-polyphenol ingestion increases daily myofibrillar protein synthesis rates and promotes early muscle functional gains during resistance training

Factors underpinning the time-course of resistance-type exercise training (RET) adaptations are not fully understood. This study hypothesized that consuming a twice-daily protein-polyphenol beverage (PPB; n = 15; age, 24 ± 1 yr; BMI, 22.3 ± 0.7 kg·m^-2) previously shown to accelerate recovery from muscle damage and increase daily myofibrillar protein synthesis (MyoPS) rates would accelerate early (10 sessions) improvements in muscle function and potentiate quadriceps volume and muscle fiber cross-sectional area (fCSA) following 30 unilateral RET sessions in healthy, recreationally active, adults. Versus isocaloric placebo (PLA; n = 14; age, 25 ± 2 yr; BMI, 23.9 ± 1.0 kg·m^-2), PPB increased 48 h MyoPS rates after the first RET session measured using deuterated water (2.01 ± 0.15 vs. 1.51 ± 0.16%·day^-1, respectively; P < 0.05). In addition, PPB increased isokinetic muscle function over 10 sessions of training relative to the untrained control leg (%U) from 99.9 ± 1.8 pretraining to 107.2 ± 2.4%U at session 10 (vs. 102.6 ± 3.9 to 100.8 ± 2.4%U at session 10 in PLA; interaction P < 0.05). Pre to posttraining, PPB increased type II fCSA (PLA: 120.8 ± 8.2 to 109.5 ± 8.6%U; PPB: 92.8 ± 6.2 to 108.4 ± 9.7%U; interaction P < 0.05), but the gain in quadriceps muscle volume was similar between groups. Similarly, PPB did not further increase peak isometric torque, muscle function, or MyoPS measured posttraining. This suggests that although PPB increases MyoPS and early adaptation, it may not influence longer term adaptations to unilateral RET.NEW & NOTEWORTHY Using a unilateral model of resistance training, we show for the first time that a protein-polyphenol beverage increases initial rates of myofibrillar protein synthesis and promotes early functional improvements. Following a prolonged period of training, this strategy also increases type II fiber hypertrophy and causes large individual variation in gains in quadricep muscle cross-sectional area.

The Effects of Resistance Training on Architecture and Volume of the Upper Extremity Muscles: A Systematic Review of Randomised Controlled Trials and Meta-Analyses

To systematically review the effects of exercise on fascicle geometry and muscle size parameters of the upper extremity muscles, the CENTRAL, CINAHL, PubMed and OpenGrey databases were searched on 31 July 2021. Finally, 17 randomised controlled trials (RCTs) were included in this systematic review. High-intensity bench press training (g = 1.03) and 12 RM bench press exercises (g = 1.21) showed a large effect size on increasing pectoralis major muscle size. In the elbow extensors, large effects were reported for an increase in muscle size with isometric maximal voluntary co-contraction training (g = 1.97), lying triceps extension exercise (g = 1.25), and nonlinear periodised resistance training (g = 2.07). In addition, further large effects were achieved in the elbow flexors via traditional elbow flexion exercises (g = 0.93), concentric low-load forearm flexion-extension training (g = 0.94, g = 1), isometric maximal voluntary co-contraction training (g = 1.01), concentric low-load forearm flexion-extension training with blood flow restriction (g = 1.02, g = 1.07), and nonlinear periodised resistance training (g = 1.13, g = 1.34). Regarding the forearm muscles, isometric ulnar deviation training showed a large effect (g = 2.22) on increasing the flexor carpi ulnaris and radialis muscle size. Results show that these training modalities are suitable for gaining hypertrophy in the relevant muscles with at least four weeks of training duration. Future RCTs should investigate the effects of exercise modalities on the triceps brachii fascicle geometry, the infraspinatus muscle thickness (MT) and the subscapular MT due to their associations with sports performance.

The Minimum Effective Training Dose Required for 1RM Strength in Powerlifters

The aim of this multi-experiment paper was to explore the concept of the minimum effective training dose (METD) required to increase 1-repetition-maximum (1RM) strength in powerlifting (PL) athletes. The METD refers to the least amount of training required to elicit meaningful increases in 1RM strength. A series of five studies utilising mixed methods, were conducted using PL athletes & coaches of all levels in an attempt to better understand the METD for 1RM strength. The studies of this multi-experiment paper are: an interview study with elite PL athletes and highly experienced PL coaches (n = 28), an interview and survey study with PL coaches and PL athletes of all levels (n = 137), two training intervention studies with intermediate-advanced PL athletes (n = 25) and a survey study with competitive PL athletes of different levels (n = 57). PL athletes looking to train with a METD approach can do so by performing ~3-6 working sets of 1-5 repetitions each week, with these sets spread across 1-3 sessions per week per powerlift, using loads above 80% 1RM at a Rate of Perceived Exertion (RPE) of 7.5-9.5 for 6-12 weeks and expect to gain strength. PL athletes who wish to further minimize their time spent training can perform autoregulated single repetition sets at an RPE of 9-9.5 though they should expect that strength gains will be less likely to be meaningful. However, the addition of 2-3 back-off sets at ~80% of the single repetitions load, may produce greater gains over 6 weeks while following a 2-3-1 squat-bench press-deadlift weekly training frequency. When utilizing accessory exercises in the context of METD, PL athletes typically utilize 1-3 accessory exercises per powerlift, at an RPE in the range of 7-9 and utilize a repetition range of ~6-10 repetitions.

Individual Participant Data Meta-Analysis Provides No Evidence of Intervention Response Variation in Individuals Supplementing With Beta-Alanine

Currently, little is known about the extent of interindividual variability in response to beta-alanine (BA) supplementation, nor what proportion of said variability can be attributed to external factors or to the intervention itself (intervention response). To investigate this, individual participant data on the effect of BA supplementation on a high-intensity cycling capacity test (CCT110%) were meta-analyzed. Changes in time to exhaustion (TTE) and muscle carnosine were the primary and secondary outcomes. Multilevel distributional Bayesian models were used to estimate the mean and SD of BA and placebo group change scores. The relative sizes of group SDs were used to infer whether observed variation in change scores were due to intervention or non-intervention-related effects. Six eligible studies were identified, and individual data were obtained from four of these. Analyses showed a group effect of BA supplementation on TTE (7.7, 95% credible interval [CrI] [1.3, 14.3] s) and muscle carnosine (18.1, 95% CrI [14.5, 21.9] mmol/kg DM). A large intervention response variation was identified for muscle carnosine (σIR = 5.8, 95% CrI [4.2, 7.4] mmol/kg DM) while equivalent change score SDs were shown for TTE in both the placebo (16.1, 95% CrI [13.0, 21.3] s) and BA (15.9, 95% CrI [13.0, 20.0] s) conditions, with the probability that SD was greater in placebo being 0.64. In conclusion, the similarity in observed change score SDs between groups for TTE indicates the source of variation is common to both groups, and therefore unrelated to the supplement itself, likely originating instead from external factors such as nutritional intake, sleep patterns, or training status.

A Retrospective Analysis to Determine Whether Training-Induced Changes in Muscle Thickness Mediate Changes in Muscle Strength

OBJECTIVE

To investigate the role of muscle thickness changes on changes in strength following 6 weeks of unaccustomed resistance training, via retrospective analysis.

METHODS

151 participants completed 6 weeks of no intervention (CONTROL), one-repetition maximum training (1RM-TRAIN), or traditional resistance training (TRAD-TRAIN). Groups were assigned by covariate adaptive randomization. 1RM-TRAIN and TRAD-TRAIN performed elbow flexion exercise on the dominant arm 3 times/week. One-repetition maximum strength and muscle thickness (B-mode ultrasound at 50, 60, and 70% of the anterior upper arm) were assessed pre- and post-training. Direct and indirect effects on strength via each training modality were quantified relative to CONTROL using indicator-coded, change-score mediation analyses for each muscle thickness site. Values are presented as regression coefficients (95% CI).

RESULTS

The effect of 1RM-TRAIN on muscle thickness was greater than CONTROL for 60% [0.09 (0.01, 0.17) cm] and 70% [0.09 (0.01,0.18) cm] models. All muscle thickness changes for TRAD-TRAIN were greater than CONTROL: 50% [0.24 (0.16, 0.33) cm], 60% [0.25 (0.17, 0.33) cm], 70% [0.23 (0.14, 0.32) cm]. All direct effects on strength were greater for 1RM-TRAIN versus CONTROL: 50% [1.90 (1.21, 2.58) kg], 60% [1.89 (1.19, 2.58) kg], 70% [1.81 (1.12, 2.51) kg]; and TRAD-TRAIN versus CONTROL: 50% [2.04 (1.29, 2.80) kg], 60% [1.98 (1.22, 2.75) kg], 70% [1.79 (1.05, 2.53) kg]. Compared to CONTROL, there was no indication of an effect of 1RM-TRAIN on strength through muscle thickness (i.e., indirect effect) for 50% [- 0.03 (- 0.17, 0.10)], 60% [- 0.01 (- 0.17, 0.17)], or 70% [0.07 (- 0.09, 0.28)] sites, nor of TRAD-TRAIN for 50% [- 0.11 (- 0.48,0.29)], 60% [- 0.04 (- 0.42, 0.40)], and 70% sites [0.17 (- 0.23,0.58)].

CONCLUSION

Training-induced changes in muscle thickness do not appear to appreciably mediate training-induced changes in the strength of untrained individuals during the first 6 weeks of training.

The effects of exergames on muscle strength: A systematic review and meta-analysis

This systematic review and meta-analysis examined studies on the chronic effects of exergames on muscle strength in humans. PubMed, Scopus, CENTRAL, Web of Science, SciELO, Biblioteca Virtual em Saúde, and Google Scholar were searched, and manual searches of the reference lists of included studies and hand-searches on Physiotherapy Evidence Database and ResearchGate were conducted from inception to August 10, 2020. Randomized and non-randomized exergame intervention studies with or without a non-exercise group and/or a "usual care intervention group" (any other intervention that did not incorporate exergames), which evaluated muscle strength through direct measurements, were included. Forty-seven and 25 studies were included in the qualitative review and meta-analysis, respectively. The between-groups meta-analyses showed no significant differences between exergames and non-exercise control groups for handgrip strength in heathy/unhealthy middle-aged/older adults or knee extension maximum voluntary isometric contraction (MVIC) in healthy older adults. However, exergames provided a greater increase in handgrip strength, knee flexion MVIC, and elbow extension MVIC, but not knee extension MVIC or elbow flexion MVIC, in individuals with different health statuses when compared to usual care interventions. Also, there was a greater increase in handgrip strength in children with hemiplegic cerebral palsy favouring usual care plus exergames compared to usual care interventions. These results suggest that exergames may improve upper and lower limb muscle strength in individuals with different heath statuses compared to usual care interventions, but not muscle strength in middle age/older adults after accounting for random error. Also, exergames appear to be a useful tool for improving handgrip strength in children with hemiplegic cerebral palsy when added to usual care. However, as the exergame interventions were applied in different populations and there currently are many different approaches to perform exergames, future randomized controlled trials with high methodological quality and large sample sizes are needed to provide more compelling evidence in favour of a specific exergame protocol, or to elucidate exergame protocol design principles that appear to strongly influence outcomes.

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

AIM

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Strength testing or strength training: considerations for future research

Maximal strength testing is often performed to assess the efficacy of training programs or as a way to prescribe exercise load. Generally, it is believed that high load exercise is superior to low load exercise at increasing absolute strength, however this is not always the case (i.e. strength increases similarly between groups). We hypothesized that some of the discrepancy in the literature may be related to performing the strength test itself. To investigate this further we reviewed the literature looking for studies comparing high load and low load exercise. The included studies were separated into 'no extra practice' and 'practice'. No extra practice means the strength test was only performed at pre and post whereas practice refers to additional strength tests performed throughout the training intervention. Our results indicated that the differences between high load and low load exercise can be reduced when the group training with a low load is allowed additional exposure to the maximal strength test. This suggests that repeated exposure to strength tests may augment low load training adaptations and influence the outcomes. We discuss potential moderators of this relationship (e.g. how low is the low load, complexity of the skill) and offer considerations for future research. Based on this it would be recommended that when investigating the effects of low load training strength tests should be limited to pre and post intervention or if a control group is utilized then the control group should receive the same number of exposures to the strength test.

Effects of mirror feedback during balanced exercise performance in the old people with mild cognitive impairment

Unbalanced movements between the bilateral sides may lead to dyskinesia and reduced motor function. The upper limbs are the most complex joints with different rate of usage between the limbs. The dominant side is repeatedly used more than the contralateral side for better dexterity and musculoskeletal utility. Such imbalance between the two bilateral sides may lead to further difference in movement ability. This study aimed to observe the feasibility of the mirror feedback method in the upper limb movements in the old people with mild cognitive impairment. Twenty-seven-old people with history of stroke were selected. Motion sensors were used to assess the location and motion of two limbs in synchronized lateral raise that include the abduction and adduction motions during the mirror feedback and no feedback trials. The results of the mirror feedback showed comparatively similar motions between the left and right upper limbs. The results of the study may indicate possible recommendation of mirror feedback method for synchronizing exercise motion of the upper limbs for the old people with mild cognitive impairment.