Neuromuscular Adaptations to Same Versus Separate Muscle-Group Concurrent Aerobic and Strength Training in Recreationally Active Males and Females

Combining aerobic and strength training may attenuate neuromuscular adaptations, particularly when both target the same muscle group. This study assessed whether separating the training modalities by muscle groups mitigates this interference. Ninety-six participants (56 males and 40 females) completed a 12-week intervention, divided into three groups: (1) LHLS (lower-body high-intensity interval (HIIT) and strength training), (2) LHUS (lower-body HIIT and upper-body strength training), and (3) LSUS (lower- and upper-body strength training). Maximal (1RM) and explosive strength were assessed using load-velocity profiling, with mean propulsive velocity (MPV) at 30%, 50%, 70%, and 90% of 1RM as a measure of explosive strength. Muscle cross-sectional area (CSA) of the M. vastus lateralis and M. pectoralis major was measured using panoramic ultrasound. Lower-body adaptations were compared between LHLS and LSUS, and upper-body adaptations were compared between LHUS and LSUS. MPV at 70% and 90% of 1RM for the squat (LHLS and LSUS) and bench press (LHUS and LSUS) showed improvements (p < 0.050), with no significant between-group differences. Squat 1RM improved in both LHLS and LSUS, and bench press 1RM increased in both LHUS and LSUS (all p < 0.001). M. vastus lateralis CSA increased in LHLS (p = 0.029) but not in LSUS, whereas M. pectoralis major CSA increased in both LHUS and LSUS (p < 0.001), with no between-group differences. No sex-based differences were observed. Concurrent aerobic and strength training does not impair explosive strength, maximal strength, or muscle hypertrophy, regardless of whether the same or separate muscle groups are targeted.

Integrative effects of resistance training and endurance training on mitochondrial remodeling in skeletal muscle

Resistance training activates mammalian target of rapamycin (mTOR) pathway of hypertrophy for strength gain, while endurance training increases peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) pathway of mitochondrial biogenesis benefiting oxidative phosphorylation. The conventional view suggests that resistance training-induced hypertrophy signaling interferes with endurance training-induced mitochondrial remodeling. However, this idea has been challenged because acute leg press and knee extension in humans enhance both muscle hypertrophy and mitochondrial remodeling signals. Thus, we first examined the muscle mitochondrial remodeling and hypertrophy signals with endurance training and resistance training, respectively. In addition, we discussed the influence of resistance training on muscle mitochondria, demonstrating that the PGC-1α-mediated muscle mitochondrial adaptation and hypertrophy occur simultaneously. The second aim was to discuss the integrative effects of concurrent training, which consists of endurance and resistance training sessions on mitochondrial remodeling. The study found that the resistance training component does not reduce muscle mitochondrial remodeling signals in concurrent training. On the contrary, concurrent training has the potential to amplify skeletal muscle mitochondrial biogenesis compared to a single exercise model. Concurrent training involving differential sequences of resistance and endurance training may result in varied mitochondrial biogenesis signals, which should be linked to the pre-activation of mTOR or PGC-1α signaling. Our review proposed a mechanism for mTOR signaling that promotes PGC-1α signaling through unidentified pathways. This mechanism may be account for the superior muscle mitochondrial remodeling change following the concurrent training. Our review suggested an interaction between resistance training and endurance training in skeletal muscle mitochondrial adaptation.

Efficacy of lower limb strengthening exercises based on different muscle contraction characteristics for knee osteoarthritis: a systematic review and network meta-analysis

Purpose

While strengthening exercises are recommended for knee osteoarthritis (KOA) treatment, the optimal type of muscle contraction remains unclear, with current research showing conflicting results. This network meta-analysis (NMA) aims to evaluate the efficacy of lower limb strengthening exercises based on different muscle contraction characteristics for KOA patients and provide clinical references.

Methods

We conducted the NMA following the PRISMA-NMA. A comprehensive search of five databases (PubMed, Web of Science, CENTRAL, Embase, and SPORTDiscus) up to August 2024 identified randomized controlled trials (RCTs) investigating lower limb strengthening exercises in KOA patients. Control groups included receiving usual care, only providing health education, or no intervention at all. Outcomes analyzed included pain, physical function, quality of life, and muscle strength.

Results

Forty-one studies (2,251 participants) were included. Twenty-eight studies used rigorous randomization; eighteen reported allocation concealment. All had high performance bias risk due to exercise interventions. Regarding efficacy, isokinetic exercise ranked highest in pain relief (SMD = 0.70, 95% CI: 0.50-0.91, SUCRA = 82.6%), function improvement (SMD = 0.75, 95% CI: 0.57-0.92, SUCRA = 96.1%), and enhancement in muscle strength (SMD = 0.56, 95% CI: 0.34-0.78, SUCRA = 90.1%). Isometric exercise ranked highest in improving quality of life (SMD = 0.80, 95% CI: 0.28-1.31, SUCRA = 90.5%). Mixed strengthening exercise ranked lowest across all outcomes. High-frequency interventions (≥5 times/week) showed superior pain relief compared with low-frequency (≤3 times/week) for isotonic, isometric, and isokinetic exercise.

Conclusion

This NMA suggests isokinetic exercise may be most effective for pain, function, and muscle strength in KOA patients, while isometric exercise benefits quality of life most. Mixed strengthening exercise ranked lowest across all outcomes. High-frequency interventions appear more effective than low-frequency ones. These findings support personalized KOA treatment, considering efficacy, accessibility, and patient-specific factors. Study biases, heterogeneity, and other limitations may affect result reliability. Future research should focus on high-quality studies with standardized protocols and analyze dose-response relationships to refine KOA treatment strategies.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024582525, identifier: CRD42024582525.

Effect of Strength and Endurance Training Sequence on Endurance Performance

This review investigates the effect of two different concurrent training sequences on endurance performance. The sequences investigated are Endurance-Resistance (ER) and Resistance-Endurance (RE). A literature search is conducted of the SPORTDiscus and Medline databases. The included studies are randomized control trials, which compare the effect of ER and RE on at least one endurance performance variable. A PEDro scale is used to assess the methodological quality of the articles in this review. Of a total of 152 articles identified during the initial screening, 15 studies meet the inclusion criteria. These studies include 426 participants (298 males and 128 females), with 212 of the participants training with ER and 214 with RE. The results are presented as the percentage change of the mean from pre- to post-test. All the studies show an improvement in endurance from pre to post for both interventions, except for the RE group in one study. This review finds small and non-conclusive sequence effects between ER and RE, suggesting that the sequence of concurrent training is not of great importance in relation to endurance performance.

Perspectives on Concurrent Strength and Endurance Training in Healthy Adult Females: A Systematic Review

BACKGROUND

Both strength and endurance training are included in global exercise recommendations and are the main components of training programs for competitive sports. While an abundance of research has been published regarding concurrent strength and endurance training, only a small portion of this research has been conducted in females or has addressed their unique physiological circumstances (e.g., hormonal profiles related to menstrual cycle phase, menstrual dysfunction, and hormonal contraceptive use), which may influence training responses and adaptations.

OBJECTIVE

The aim was to complete a systematic review of the scientific literature regarding training adaptations following concurrent strength and endurance training in apparently healthy adult females.

METHODS

A systematic electronic search for articles was performed in July 2021 and again in December 2022 using PubMed and Medline. This review followed, where applicable, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the included studies was assessed using a modified Downs and Black checklist. Inclusion criteria were (1) fully published peer-reviewed publications; (2) study published in English; (3) participants were healthy normal weight or overweight females of reproductive age (mean age between > 18 and < 50) or presented as a group (n > 5) in studies including both females and males and where female results were reported separately; (4) participants were randomly assigned to intervention groups, when warranted, and the study included measures of maximal strength and endurance performance; and (5) the duration of the intervention was ≥ 8 weeks to ensure a meaningful training duration.

RESULTS

Fourteen studies met the inclusion criteria (seven combined strength training with running, four with cycling, and three with rowing or cross-country skiing). These studies indicated that concurrent strength and endurance training generally increases parameters associated with strength and endurance performance in female participants, while several other health benefits such as, e.g., improved body composition and blood lipid profile were reported in individual studies. The presence of an "interference effect" in females could not be assessed from the included studies as this was not the focus of any included research and single-mode training groups were not always included alongside concurrent training groups. Importantly, the influence of concurrent training on fast-force production was limited, while the unique circumstances affecting females were not considered/reported in most studies. Overall study quality was low to moderate.

CONCLUSION

Concurrent strength and endurance training appears to be beneficial in increasing strength and endurance capacity in females; however, multiple research paradigms must be explored to better understand the influence of concurrent training modalities in females. Future research should explore the influence of concurrent strength and endurance training on fast-force production, the possible presence of an "interference effect" in athletic populations, and the influence of unique circumstances, such as hormone profile, on training responses and adaptations.

Resistance wheel running improves contractile strength, but not metabolic capacity, in a murine model of volumetric muscle loss injury

The primary objective of this study was to determine if low- or high-resistance voluntary wheel running leads to functional improvements in muscle strength (i.e., isometric and isokinetic torque) and metabolic function (i.e., permeabilized fibre bundle mitochondrial respiration) after a volumetric muscle loss (VML) injury. C57BL/6J mice were randomized into one of four experimental groups at age 12 weeks: uninjured control, VML untreated (VML), low-resistance wheel running (VML-LR) and high-resistance wheel running (VML-HR). All mice, excluding the uninjured, were subject to a unilateral VML injury to the plantar flexor muscles and wheel running began 3 days post-VML. At 8 weeks post-VML, peak isometric torque was greater in uninjured compared to all VML-injured groups, but both VML-LR and VML-HR had greater (∼32%) peak isometric torque compared to VML. All VML-injured groups had less isokinetic torque compared to uninjured, and there was no statistical difference among VML, VML-LR and VML-HR. No differences in cumulative running distance were observed between VML-LR and VML-HR groups. Because adaptations in VML-HR peak isometric torque were attributed to greater gastrocnemius muscle mass, atrophy- and hypertrophy-related protein content and post-translational modifications were explored via immunoblot; however, results were inconclusive. Permeabilized fibre bundle mitochondrial oxygen consumption was 22% greater in uninjured compared to VML, but there was no statistical difference among VML, VML-LR and VML-HR. Furthermore, neither wheel running group demonstrated a change in the relative protein content of the mitochondrial biogenesis transcription factor, peroxisome proliferator-activated receptor γ coactivator 1-α (PGC-1α). These results indicate that resistance wheel running alone only has modest benefits in the VML-injured muscle. NEW FINDINGS: What is the central question of the study? Does initiation of a resistance wheel running regimen following volumetric muscle loss (VML) improve the functional capacity of skeletal muscle? What is the main finding and its importance? Resistance wheel running led to greater muscle mass and strength in mice with a VML injury but did not result in a full recovery. Neither low- nor high-resistance wheel running was associated with a change in permeabilized muscle fibre respiration despite runners having greater whole-body treadmill endurance capacity, suggesting resilience to metabolic adaptations in VML-injured muscle. Resistance wheel running may be a suitable adjuvant rehabilitation strategy, but alone does not fully mitigate VML pathology.

The Emerging Role of Hypoxic Training for the Equine Athlete

This paper provides a comprehensive discussion on the physiological impacts of hypoxic training, its benefits to endurance performance, and a rationale for utilizing it to improve performance in the equine athlete. All exercise-induced training adaptations are governed by genetics. Exercise prescriptions can be tailored to elicit the desired physiological adaptations. Although the application of hypoxic stimuli on its own is not ideal to promote favorable molecular responses, exercise training under hypoxic conditions provides an optimal environment for maximizing physiological adaptations to enhance endurance performance. The combination of exercise training and hypoxia increases the activity of the hypoxia-inducible factor (HIF) pathway compared to training under normoxic conditions. Hypoxia-inducible factor-1 alpha (HIF-1α) is known as a master regulator of the expression of genes since over 100 genes are responsive to HIF-1α. For instance, HIF-1-inducible genes include those critical to erythropoiesis, angiogenesis, glucose metabolism, mitochondrial biogenesis, and glucose transport, all of which are intergral in physiological adaptations for endurance performance. Further, hypoxic training could conceivably have a role in equine rehabilitation when high-impact training is contraindicated but a quality training stimulus is desired. This is achievable through purpose-built equine motorized treadmills inside commercial hypoxic chambers.

Effects of Concurrent Resistance and Endurance Training Using Continuous or Intermittent Protocols on Muscle Hypertrophy: Systematic Review With Meta-Analysis

ABSTRACT

Monserdà-Vilaró, A, Balsalobre-Fernández, C, Hoffman, JR, Alix-Fages, C, and Jiménez, SL. Effects of concurrent resistance and endurance training using continuous or intermittent protocols on muscle hypertrophy: Systematic review with meta-analysis. J Strength Cond Res 37(3): 688-709, 2023-The purpose of this systematic review with meta-analysis was to explore the effects of concurrent resistance and endurance training (CT) incorporating continuous or intermittent endurance training (ET) on whole-muscle and type I and II muscle fiber hypertrophy compared with resistance training (RT) alone. Randomized and nonrandomized studies reporting changes in cross-sectional area at muscle fiber and whole-muscle levels after RT compared with CT were included. Searches for such studies were performed in Web of Science, PubMed, Scopus, SPORTDiscus, and CINAHL electronic databases. The data reported in the included studies were pooled in a random-effects meta-analysis of standardized mean differences (SMDs). Twenty-five studies were included. At the whole-muscle level, there were no significant differences for any comparison (SMD < 0.03). By contrast, RT induced greater type I and type II muscle fiber hypertrophy than CT when high-intensity interval training (HIIT) was incorporated alone (SMD > 0.33) or combined with continuous ET (SMD > 0.27), but not compared with CT incorporating only continuous ET (SMD < 0.16). The subgroup analyses of this systematic review and meta-analysis showed that RT induces greater muscle fiber hypertrophy than CT when HIIT is included. However, no CT affected whole-muscle hypertrophy compared with RT.

Potential mechanisms involved in regulating muscle protein turnover after acute exercise: A brief review

It is well established that resistance training increases muscle mass. Indeed, there is evidence to suggest that a single session of resistance training is associated with an increase in muscle protein synthesis in young adults. However, the fundamental mechanisms that are involved in regulating muscle protein turnover rates after an acute bout of physical exercise are unclear. Therefore, this review will briefly focus on summarizing the potential mechanisms behind the growth of skeletal muscle after physical exercise. We also present mechanistic differences that may exist between young and older individuals during muscle protein synthesis and breakdown after physical exercise. Pathways leading to the activation of AKT/mTOR signals after resistance exercise and the activation of AMPK signaling pathway following a HIIT (High intensity interval training) are discussed.

Acute Neuromuscular, Physiological and Performance Responses After Strength Training in Runners: A Systematic Review and Meta-Analysis

Background

Strength training (ST) is commonly used to improve muscle strength, power, and neuromuscular adaptations and is recommended combined with runner training. It is possible that the acute effects of the strength training session lead to deleterious effects in the subsequent running. The aim of this systematic review and meta-analysis was to verify the acute effects of ST session on the neuromuscular, physiological and performance variables of runners.

Methods

Studies evaluating running performance after resistance exercise in runners in the PubMed and Scopus databases were selected. From 6532 initial references, 19 were selected for qualitative analysis and 13 for meta-analysis. The variables of peak torque (P_T), creatine kinase (CK), delayed-onset muscle soreness (DOMS), rating of perceived exertion (RPE), countermovement jump (CMJ), ventilation (VE), oxygen consumption (VO₂), lactate (La) and heart rate (HR) were evaluated.

Results

The methodological quality of the included studies was considered reasonable; the meta-analysis indicated that the variables P_T (p = 0.003), DOMS (p < 0.0001), CK (p < 0.0001), RPE (p < 0.0001) had a deleterious effect for the experimental group; for CMJ, VE, VO₂, La, FC there was no difference. By qualitative synthesis, running performance showed a reduction in speed for the experimental group in two studies and in all that assessed time to exhaustion.

Conclusion

The evidence indicated that acute strength training was associated with a decrease in P_T, increases in DOMS, CK, RPE and had a low impact on the acute responses of CMJ, VE, VO₂, La, HR and submaximal running sessions.

Shared and unique phosphoproteomics responses in skeletal muscle from exercise models and in hyperammonemic myotubes

Skeletal muscle generation of ammonia, an endogenous cytotoxin, is increased during exercise. Perturbations in ammonia metabolism consistently occur in chronic diseases, and may blunt beneficial skeletal muscle molecular responses and protein homeostasis with exercise. Phosphorylation of skeletal muscle proteins mediates cellular signaling responses to hyperammonemia and exercise. Comparative bioinformatics and machine learning-based analyses of published and experimentally derived phosphoproteomics data identified differentially expressed phosphoproteins that were unique and shared between hyperammonemic murine myotubes and skeletal muscle from exercise models. Enriched processes identified in both hyperammonemic myotubes and muscle from exercise models with selected experimental validation included protein kinase A (PKA), calcium signaling, mitogen-activated protein kinase (MAPK) signaling, and protein homeostasis. Our approach of feature extraction from comparative untargeted "omics" data allows for selection of preclinical models that recapitulate specific human exercise responses and potentially optimize functional capacity and skeletal muscle protein homeostasis with exercise in chronic diseases.

A recommended exercise program appropriate for patients with knee osteoarthritis: A systematic review and meta-analysis

Background: Knee osteoarthritis (KOA) is a common degenerative disease. Recommended first-line management includes exercise. However, there is still no standard recommendation for the appropriate exercise program for patients with KOA.

Purpose: This study aims to compare the effects of a land-based exercise program with high vs. uncertain compliance with recommendations among people with KOA in pain, function, and stiffness.

Methods: From January 2000 to January 2022, PubMed, EBSCO, Sport-discuss, Medline, and Web of Science were searched. A comprehensive review of meta-analyses of land-based exercise programs with exercise prescriptions was done in symptomatic individuals with KOA. The Cochrane Collaboration’s standards were followed for study selection, eligibility criteria, data extraction, and statistics, and the Cochrane Collaboration’s tool was used to assess the risk of bias. Review Manager 5 software was used to extract the baseline mean and follow-up values, as well as the accompanying standard deviation, to calculate the standardized mean difference (SMD). In meta-analyses, SMD was calculated for pain outcomes, self-reported physical function, and stiffness. The effects of the outcomes on the subgroups of studies were compared. A fixed- or random-effects model was used in group research studies with comparable outcomes.

Results: There were 15 studies with a total of 1,436 participants. Compliance with the ACSM recommendations was categorized as “high” in five cases and “uncertain” in nine others. The SMD for pain was −0.31 (95% CI −0.47, −0.14) in the subgroup with a high ACSM compliance ratio and −0.55 (95% CI −0.69, −0.41) in the subgroup with uncertain ACSM compliance. For physical function, in the high-compliance group, the SMD was −0.21 (95% CI −0.38, −0.05), while in the uncertain-compliance group, it was −0.61 (95 % CI −0.82, −0.40). The SMD was −0.40 (95 % CI −0.61, −0.19) for stiffness and high compliance with ACSM. The SMD was −0.29 (95% CI −0.66, 0.07) for study interventions with uncertain compliance.

Conclusion: The results showed that the land-based training program significantly improved pain, physical function, and stiffness in KOA patients compared to controls. Exercise interventions with high adherence to ACSM recommendations differed significantly only in stiffness measures compared with the uncertain-compliance group.

Clinical Trial Registration:https://www.crd.york.ac.uk/prospero/#recordDetails, identifier PROSPERO (ID CRD42022311660)

The Effects of Concurrent Aerobic and Strength Training on Muscle Fiber Hypertrophy: A Systematic Review and Meta-Analysis

Background

Whole muscle hypertrophy does not appear to be negatively affected by concurrent aerobic and strength training compared to strength training alone. However, there are contradictions in the literature regarding the effects of concurrent training on hypertrophy at the myofiber level.

Objective

The current study aimed to systematically examine the extent to which concurrent aerobic and strength training, compared with strength training alone, influences type I and type II muscle fiber size adaptations. We also conducted subgroup analyses to examine the effects of the type of aerobic training, training modality, exercise order, training frequency, age, and training status.

Design

A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [PROSPERO: CRD42020203777]. The registered protocol was modified to include only muscle fiber hypertrophy as an outcome.

Data Sources

PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched on 12 August, 2020, and updated on 15 March, 2021.

Eligibility Criteria

Population: healthy adults of any sex and age; intervention: supervised, concurrent aerobic and strength training of at least 4 weeks; comparison: identical strength training prescription, with no aerobic training; and outcome: muscle fiber hypertrophy.

Results

A total of 15 studies were included. The estimated standardized mean difference based on the random-effects model was − 0.23 (95% confidence interval [CI] − 0.46 to − 0.00, p = 0.050) for overall muscle fiber hypertrophy. The standardized mean differences were − 0.34 (95% CI − 0.72 to 0.04, p = 0.078) and − 0.13 (95% CI − 0.39 to 0.12, p = 0.315) for type I and type II fiber hypertrophy, respectively. A negative effect of concurrent training was observed for type I fibers when aerobic training was performed by running but not cycling (standardized mean difference − 0.81, 95% CI − 1.26 to − 0.36). None of the other subgroup analyses (i.e., based on concurrent training frequency, training status, training modality, and training order of same-session training) revealed any differences between groups.

Conclusions

In contrast to previous findings on whole muscle hypertrophy, the present results suggest that concurrent aerobic and strength training may have a small negative effect on fiber hypertrophy compared with strength training alone. Preliminary evidence suggests that this interference effect may be more pronounced when aerobic training is performed by running compared with cycling, at least for type I fibers.

Antioxidative properties of phenolic compounds and their effect on oxidative stress induced by severe physical exercise

Extensive research has found strongly increased generation of reactive oxygen species, free radicals, and reactive nitrogen species during acute physical exercise that can lead to oxidative stress (OS) and impair muscle function. Polyphenols (PCs), the most abundant antioxidants in the human diet, are of increasing interest to athletes as antioxidants. Current literature suggests that antioxidants supplementation can effectively modulate these processes. This overview summarizes the actual knowledge of chemical and biomechanical properties of PCs and their impact as supplements on acute exercise-induced OS, inflammation control, and exercise performance. Evidence maintains that PC supplements have high potency to positively impact redox homeostasis and improve skeletal muscle's physiological and physical functions. However, many studies have failed to present improvement in physical performance. Eleven of 15 representative experimental studies reported a reduction of severe exercise-induced OS and inflammation markers or enhancement of total antioxidant capacity; four of eight studies found improvement in exercise performance outcomes. Further studies should be continued to address a safe, optimal PC dosage, supplementation timing during a severe training program in different sports disciplines, and effects on performance response and adaptations of skeletal muscle to exercise.

Effect of intra-session exercise sequence of an 8-week concurrent training program on the components of physical fitness in recreationally trained young adults

This study aimed to determine the effect of the intra-session exercise sequence of a concurrent training programme on the components of health-related physical fitness. Twenty-four healthy young adults were allocated into two different groups differing only in the exercise order to conduct an 8-week intra-session concurrent training programme consisting of three sessions of 60-90 minutes (180-270 min/week), with all-out running sprint intervals, back squat, and bench press endurance and resistance exercises (i.e., ET+RT and RT+ET). The 8-week intra-session concurrent training programme overall improved all the components of physical fitness regardless of the exercise sequence. However, ET + RT and RT + ET groups reported moderate and small improvements for squat jump (ET + RT: 3.82 cm [1.11 to 6.53 cm]; RT + ET: 0.31 cm [-1.72 to 2.33 cm]), countermovement jump (ET + RT: 3.76 cm [1.43 to 6.08 cm]; RT + ET: 2.07 cm [-0.03 to 4.17 cm]) and maximum oxygen uptake (ET + RT: 4.75 ml/kg/min [1.14 to 8.35 ml/kg/min]; RT + ET: 1.66 ml/kg/min [-0.89 to 4.21 ml/kg/min]), respectively. Therefore, greater lower-body power and cardiorespiratory fitness gains might be induced following the ET + RT sequence.

Exercise-Induced Circulating microRNAs: Potential Key Factors in the Control of Breast Cancer

Losses in skeletal muscle mass, strength, and metabolic function are harmful in the pathophysiology of serious diseases, including breast cancer. Physical exercise training is an effective non-pharmacological strategy to improve health and quality of life in patients with breast cancer, mainly through positive effects on skeletal muscle mass, strength, and metabolic function. Emerging evidence has also highlighted the potential of exercise-induced crosstalk between skeletal muscle and cancer cells as one of the mechanisms controlling breast cancer progression. This intercellular communication seems to be mediated by a group of skeletal muscle molecules released in the bloodstream known as myokines. Among the myokines, exercise-induced circulating microRNAs (c-miRNAs) are deemed to mediate the antitumoral effects produced by exercise training through the control of key cellular processes, such as proliferation, metabolism, and signal transduction. However, there are still many open questions regarding the molecular basis of the exercise-induced effects on c-miRNA on human breast cancer cells. Here, we present evidence regarding the effect of exercise training on c-miRNA expression in breast cancer, along with the current gaps in the literature and future perspectives.

The Effects of Concurrent Aerobic and Strength Training on Muscle Fiber Hypertrophy: A Systematic Review and Meta-Analysis

Background

Whole muscle hypertrophy does not appear to be negatively affected by concurrent aerobic and strength training compared to strength training alone. However, there are contradictions in the literature regarding the effects of concurrent training on hypertrophy at the myofiber level.

Objective

The current study aimed to systematically examine the extent to which concurrent aerobic and strength training, compared with strength training alone, influences type I and type II muscle fiber size adaptations. We also conducted subgroup analyses to examine the effects of the type of aerobic training, training modality, exercise order, training frequency, age, and training status.

Design

A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [PROSPERO: CRD42020203777]. The registered protocol was modified to include only muscle fiber hypertrophy as an outcome.

Data Sources

PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched on 12 August, 2020, and updated on 15 March, 2021.

Eligibility Criteria

Population: healthy adults of any sex and age; intervention: supervised, concurrent aerobic and strength training of at least 4 weeks; comparison: identical strength training prescription, with no aerobic training; and outcome: muscle fiber hypertrophy.

Results

A total of 15 studies were included. The estimated standardized mean difference based on the random-effects model was − 0.23 (95% confidence interval [CI] − 0.46 to − 0.00, p = 0.050) for overall muscle fiber hypertrophy. The standardized mean differences were − 0.34 (95% CI − 0.72 to 0.04, p = 0.078) and − 0.13 (95% CI − 0.39 to 0.12, p = 0.315) for type I and type II fiber hypertrophy, respectively. A negative effect of concurrent training was observed for type I fibers when aerobic training was performed by running but not cycling (standardized mean difference − 0.81, 95% CI − 1.26 to − 0.36). None of the other subgroup analyses (i.e., based on concurrent training frequency, training status, training modality, and training order of same-session training) revealed any differences between groups.

Conclusions

In contrast to previous findings on whole muscle hypertrophy, the present results suggest that concurrent aerobic and strength training may have a small negative effect on fiber hypertrophy compared with strength training alone. Preliminary evidence suggests that this interference effect may be more pronounced when aerobic training is performed by running compared with cycling, at least for type I fibers.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01688-x.

Impact of Physical Activity and Exercise on the Epigenome in Skeletal Muscle and Effects on Systemic Metabolism

Exercise and physical activity induces physiological responses in organisms, and adaptations in skeletal muscle, which is beneficial for maintaining health and preventing and/or treating most chronic diseases. These adaptations are mainly instigated by transcriptional responses that ensue in reaction to each individual exercise, either resistance or endurance. Consequently, changes in key metabolic, regulatory, and myogenic genes in skeletal muscle occur as both an early and late response to exercise, and these epigenetic modifications, which are influenced by environmental and genetic factors, trigger those alterations in the transcriptional responses. DNA methylation and histone modifications are the most significant epigenetic changes described in gene transcription, linked to the skeletal muscle transcriptional response to exercise, and mediating the exercise adaptations. Nevertheless, other alterations in the epigenetics markers, such as epitranscriptomics, modifications mediated by miRNAs, and lactylation as a novel epigenetic modification, are emerging as key events for gene transcription. Here, we provide an overview and update of the impact of exercise on epigenetic modifications, including the well-described DNA methylations and histone modifications, and the emerging modifications in the skeletal muscle. In addition, we describe the effects of exercise on epigenetic markers in other metabolic tissues; also, we provide information about how systemic metabolism or its metabolites influence epigenetic modifications in the skeletal muscle.

Compatibility of Concurrent Aerobic and Strength Training for Skeletal Muscle Size and Function: An Updated Systematic Review and Meta-Analysis

BACKGROUND

Both athletes and recreational exercisers often perform relatively high volumes of aerobic and strength training simultaneously. However, the compatibility of these two distinct training modes remains unclear.

OBJECTIVE

This systematic review assessed the compatibility of concurrent aerobic and strength training compared with strength training alone, in terms of adaptations in muscle function (maximal and explosive strength) and muscle mass. Subgroup analyses were conducted to examine the influence of training modality, training type, exercise order, training frequency, age, and training status.

METHODS

A systematic literature search was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched (12 August 2020, updated on 15 March 2021). Eligibility criteria were as follows.

POPULATION

healthy adults of any sex and age; Intervention: supervised concurrent aerobic and strength training for at least 4 weeks; Comparison: identical strength training prescription, with no aerobic training; Outcome: maximal strength, explosive strength, and muscle hypertrophy.

RESULTS

A total of 43 studies were included. The estimated standardised mean differences (SMD) based on the random-effects model were - 0.06 (95% confidence interval [CI] - 0.20 to 0.09; p = 0.446), - 0.28 (95% CI - 0.48 to - 0.08; p = 0.007), and - 0.01 (95% CI - 0.16 to 0.18; p = 0.919) for maximal strength, explosive strength, and muscle hypertrophy, respectively. Attenuation of explosive strength was more pronounced when concurrent training was performed within the same session (p = 0.043) than when sessions were separated by at least 3 h (p > 0.05). No significant effects were found for the other moderators, i.e. type of aerobic training (cycling vs. running), frequency of concurrent training (> 5 vs. < 5 weekly sessions), training status (untrained vs. active), and mean age (< 40 vs. > 40 years).

CONCLUSION

Concurrent aerobic and strength training does not compromise muscle hypertrophy and maximal strength development. However, explosive strength gains may be attenuated, especially when aerobic and strength training are performed in the same session. These results appeared to be independent of the type of aerobic training, frequency of concurrent training, training status, and age.

PROSPERO

CRD42020203777.

Maximal muscular power: lessons from sprint cycling

Maximal muscular power production is of fundamental importance to human functional capacity and feats of performance. Here, we present a synthesis of literature pertaining to physiological systems that limit maximal muscular power during cyclic actions characteristic of locomotor behaviours, and how they adapt to training. Maximal, cyclic muscular power is known to be the main determinant of sprint cycling performance, and therefore we present this synthesis in the context of sprint cycling. Cyclical power is interactively constrained by force-velocity properties (i.e. maximum force and maximum shortening velocity), activation-relaxation kinetics and muscle coordination across the continuum of cycle frequencies, with the relative influence of each factor being frequency dependent. Muscle cross-sectional area and fibre composition appear to be the most prominent properties influencing maximal muscular power and the power-frequency relationship. Due to the role of muscle fibre composition in determining maximum shortening velocity and activation-relaxation kinetics, it remains unclear how improvable these properties are with training. Increases in maximal muscular power may therefore arise primarily from improvements in maximum force production and neuromuscular coordination via appropriate training. Because maximal efforts may need to be sustained for ~15-60 s within sprint cycling competition, the ability to attenuate fatigue-related power loss is also critical to performance. Within this context, the fatigued state is characterised by impairments in force-velocity properties and activation-relaxation kinetics. A suppression and leftward shift of the power-frequency relationship is subsequently observed. It is not clear if rates of power loss can be improved with training, even in the presence adaptations associated with fatigue-resistance. Increasing maximum power may be most efficacious for improving sustained power during brief maximal efforts, although the inclusion of sprint interval training likely remains beneficial. Therefore, evidence from sprint cycling indicates that brief maximal muscular power production under cyclical conditions can be readily improved via appropriate training, with direct implications for sprint cycling as well as other athletic and health-related pursuits.

Creatine Supplementation, Physical Exercise and Oxidative Stress Markers: A Review of the Mechanisms and Effectiveness

Oxidative stress is the result of an imbalance between the generation of reactive oxygen species (ROS) and their elimination by antioxidant mechanisms. ROS degrade biogenic substances such as deoxyribonucleic acid, lipids, and proteins, which in turn may lead to oxidative tissue damage. One of the physiological conditions currently associated with enhanced oxidative stress is exercise. Although a period of intense training may cause oxidative damage to muscle fibers, regular exercise helps increase the cells' ability to reduce the ROS over-accumulation. Regular moderate-intensity exercise has been shown to increase antioxidant defense. Endogenous antioxidants cannot completely prevent oxidative damage under the physiological and pathological conditions (intense exercise and exercise at altitude). These conditions may disturb the endogenous antioxidant balance and increase oxidative stress. In this case, the use of antioxidant supplements such as creatine can have positive effects on the antioxidant system. Creatine is made up of two essential amino acids, arginine and methionine, and one non-essential amino acid, glycine. The exact action mechanism of creatine as an antioxidant is not known. However, it has been shown to increase the activity of antioxidant enzymes and the capability to eliminate ROS and reactive nitrogen species (RNS). It seems that the antioxidant effects of creatine may be due to various mechanisms such as its indirect (i.e., increased or normalized cell energy status) and direct (i.e., maintaining mitochondrial integrity) mechanisms. Creatine supplement consumption may have a synergistic effect with training, but the intensity and duration of training can play an important role in the antioxidant activity. In this study, the researchers attempted to review the literature on the effects of creatine supplementation and physical exercise on oxidative stress.

Hormonal Contraceptive Use Does Not Affect Strength, Endurance, or Body Composition Adaptations to Combined Strength and Endurance Training in Women

ABSTRACT

Myllyaho, MM, Ihalainen, JK, Hackney, AC, Valtonen, M, Nummela, A, Vaara, E, Häkkinen, K, Kyröläinen, H, and Taipale, RS. Hormonal contraceptive use does not affect strength, endurance, or body composition adaptations to combined strength and endurance training in women. J Strength Cond Res 35(2): 449-457, 2021-This study examined the effects of a 10-week period of high-intensity combined strength and endurance training on strength, endurance, body composition, and serum hormone concentrations in physically active women using hormonal contraceptives (HCs, n = 9) compared with those who had never used hormonal contraceptives (NHCs, n = 9). Training consisted of 2 strength training sessions and 2 high-intensity running interval sessions per week. Maximal bilateral isometric leg press (Isom), maximal bilateral dynamic leg press (one repetition maximum [1RM]), countermovement jump (CMJ), a 3,000-m running test (3,000 m), body composition, and serum hormone levels were measured before and after training between days 1-5 of each subject's menstrual cycle. Both groups increased 1RM and CMJ: HC = 13.2% (p < 0.001) and 9.6% (p < 0.05), and NHC = 8.3% (p < 0.01) and 8.5% (p < 0.001). Hormonal contraceptive improved 3,000 m by 3.5% (p < 0.05) and NHC by 1% (n.s.). Never used hormonal contraceptive increased lean mass by 2.1% (p < 0.001), whereas body fat percentage decreased from 23.9 ± 6.7 to 22.4 ± 6.0 (-6.0%, p < 0.05). No significant changes were observed in body composition in HC. No significant between-group differences were observed in any of the performance variables. Luteinizing hormone concentrations decreased significantly (p < 0.05) over 10 weeks in NHC, whereas other hormone levels remained statistically unaltered in both groups. It seems that the present training is equally appropriate for improving strength, endurance, and body composition in women using HC as those not using HC without disrupting hypothalamic-pituitary-gonadal axis function.

The neuromuscular, physiological, endocrine and perceptual responses to different training session orders in international female netball players

AbstractThe 20 h responses of International female netball players to training days requiring two sessions (netball and strength, separated by two hours) ordered alternatively were examined. Eleven players completed strength followed by netball training two hours later (STR-NET), with the order reversed (NET-STR) on a separate day. Well-being, neuromuscular performance (jump height [JH], peak power output [PPO], peak velocity [PV]) and endocrine function (testosterone, cortisol concentrations) were measured before sessions one (PreS1) and two (PreS2), immediately after sessions one (IPS1) and two (IPS2), and 20 h post session one (20P). Session and differential ratings of perceived exertion (upper-body, cognitive/technical [RPE-T], lower-body, breathlessness) were collected, and accelerometry and heart rate measured netball load. Identification of clear between-order differences was based on the nonoverlap of the 95% confidence interval (95%CI) for mean differences relative to baseline. Compared to PreS1, greater increases in JH (percentage difference between trials; 95%CI: 9%; 4-14%), PPO (5%; 2-8%), PV (3%; 1-5%) and cortisol concentration (45%; 1-88%), and a greater decrease for testosterone/cortisol ratio (-35%; -72 to -2%) occurred at PreS2 in NET-STR. At 20P, greater decreases in JH (10%; 5-15%), PPO (4%; 1-8%) and PV (4%; 2-6%) were observed following STR-NET. No differences existed for well-being, whilst RPE-T was greater (15 AU; 3-26 AU) for strength training during NET-STR. Session order influenced neuromuscular and endocrine responses in International female netball players, highlighting session ordering as a key consideration when planning training.

Responses to oral glucose challenge differ by physical activity volume and intensity: A pilot study

BACKGROUND

One-hour postprandial hyperglycemia is associated with increased risk of type 2 diabetes and cardiovascular disease. Physical activity (PA) has short-term beneficial effects on post-meal glucose response. This study compared the oral glucose tolerance test results of 3 groups of people with habitually different levels of PA.

METHODS

Thirty-one adults without diabetes (age 25.9 ± 6.6 years; body mass index 23.8 ± 3.8 kg/m²; mean ± SD) were recruited and divided into 3 groups based on self-reported PA volume and intensity: low activity < 30 min/day of moderate-intensity activity (n = 11), moderately active ≥ 30 min/day of moderate-intensity PA (n = 10), and very active ≥ 60 min/day of PA at high intensity (n = 10). Participants completed an oral glucose tolerance test (50 g glucose) with capillary blood samples obtained at baseline, 15 min, 30 min, 45 min, 60 min, 90 min, and 120 min post-ingestion.

RESULTS

There were no significant differences between groups for age or body fat percentage or glycated hemoglobin (p > 0.05). The groups were significantly different in terms of baseline glucose level (p = 0.003) and, marginally, for gender (p = 0.053) and BMI (p = 0.050). There was a statistically significant effect of PA on the 1-h postprandial glucose results (p = 0.029), with differences between very active and low activity groups (p = 0.008) but not between the moderately active and low activity groups (p = 0.360), even when baseline glucose level and gender differences were accounted for. For incremental area under the curve there was no significant effect of activity group once gender and body fat percentage had been accounted for (p = 0.401). Those in the low activity group took 15 min longer to reach peak glucose level than those in the very active group (p = 0.012).

CONCLUSION

The results suggest that high levels of PA have a beneficial effect on postprandial blood glucose profiles when compared to low and moderate levels of activity.

Effect of aging and obesity on GLUT12 expression in small intestine, adipose tissue, muscle, and kidney and its regulation by docosahexaenoic acid and exercise in mice

Obesity is characterized by excessive fat accumulation and inflammation. Aging has also been characterized as an inflammatory condition, frequently accompanied by accumulation of visceral fat. Beneficial effects of exercise and n-3 long-chain polyunsaturated fatty acids in metabolic disorders have been described. Glucose transporter 12 (GLUT12) is one of the less investigated members of the GLUT family. Glucose, insulin, and tumor necrosis factor alpha (TNF-α) induce GLUT12 translocation to the membrane in muscle, adipose tissue, and intestine. We aimed to investigate GLUT12 expression in obesity and aging, and under diet supplementation with docosahexaenoic acid (DHA) alone or in combination with physical exercise in mice. Aging increased GLUT12 expression in intestine, kidney, and adipose tissue, whereas obesity reduced it. No changes on the transporter occurred in skeletal muscle. In obese 18-month-old mice, DHA further decreased GLUT12 in the 4 organs. Aerobic exercise alone did not modify GLUT12, but the changes triggered by exercise were able to prevent the DHA-diminishing effect, and almost restored GLUT12 basal levels. In conclusion, the downregulation of metabolism in aging would be a stimulus to upregulate GLUT12 expression. Contrary, obesity, an excessive energy condition, would induce GLUT12 downregulation. The combination of exercise and DHA would contribute to restore basal function of GLUT12. Novelty In small intestine, kidney and adipose tissue aging increases GLUT12 protein expression whereas obesity reduces it. Dietary DHA decreases GLUT12 in small intestine, kidney, adipose tissue and skeletal muscle. Exercise alone does not modify GLUT12 expression, nevertheless exercise prevents the DHA-diminishing effect on GLUT12.

Physical Activity-Dependent Regulation of Parathyroid Hormone and Calcium-Phosphorous Metabolism

Exercise perturbs homeostasis, alters the levels of circulating mediators and hormones, and increases the demand by skeletal muscles and other vital organs for energy substrates. Exercise also affects bone and mineral metabolism, particularly calcium and phosphate, both of which are essential for muscle contraction, neuromuscular signaling, biosynthesis of adenosine triphosphate (ATP), and other energy substrates. Parathyroid hormone (PTH) is involved in the regulation of calcium and phosphate homeostasis. Understanding the effects of exercise on PTH secretion is fundamental for appreciating how the body adapts to exercise. Altered PTH metabolism underlies hyperparathyroidism and hypoparathyroidism, the complications of which affect the organs involved in calcium and phosphorous metabolism (bone and kidney) and other body systems as well. Exercise affects PTH expression and secretion by altering the circulating levels of calcium and phosphate. In turn, PTH responds directly to exercise and exercise-induced myokines. Here, we review the main concepts of the regulation of PTH expression and secretion under physiological conditions, in acute and chronic exercise, and in relation to PTH-related disorders.

The relationship between training load and fitness indices over a pre-season in professional soccer players

BACKGROUND

An association between training load and changes in aerobic fitness has been established but the effect of training load on changes in strength/power remains controversial.

METHODS

Internal (Banister's TRIMP) and external (total distance, high-speed running and sprint distance) training load was collected from sixteen professional soccer players during and aerobic fitness and strength/power variables were measured before and after a 9-week pre-season.

RESULTS

Banister's TRIMP had a moderate correlation with changes in maximal oxygen uptake (r=0.46, 90% CI: 0.04; 0.74). Total distance had a large and a moderate correlation with changes in velocity at 2M (r=0.60, 90% CI: 0.23; 0.82) and changes in velocity at 4M (r=0.42, 90% CI: -0.01; 0.72). High-speed running had moderate correlations with changes in maximal oxygen uptake (r=0.45, 90% CI: 0.03; 0.74), velocity at 2M (r=0.45, 90% CI: 0.03; 0.74) and velocity at 4M (r=0.39, 90% CI: -0.00; 0.70). Sprint distance had a large and a moderate correlation with changes in maximal oxygen uptake (r=0.58, 90% CI: 0.20; 0.81) and velocity at 4M (r=0.46, 90% CI: 0.00; 0.74 respectively). High versus low total distance was associated with lower changes in squat jump and countermovement jump (ES=-0.90, 90% CI: -1.57; -0.24 and ES=-1.06, 90% CI: -1.89; -0.24) respectively. High versus low high-speed running was associated with higher changes in maximal oxygen uptake (ES=0.36, 90% CI: 0.02; 0.70) but lower changes in squat jump (ES=-0.58, 90% CI: -1.32; 0.15).

CONCLUSIONS

External rather internal training load had more pronounced correlations with changes in aerobic fitness. Higher compared with lower volumes of total distance and high-speed running were associated with lower gains in strength/power indices. Establishing a "dose-response" association between external/internal training load and endurance as well as strength adaptations, may maximize endurance gains with the least possible interference on strength/power gains, thus better informing soccer training practice.

The Relative Handgrip Strength and Risk of Cardiometabolic Disorders: A Prospective Study

Background

This study aims to investigate the association between handgrip strength (HGS) and cardiometabolic disorders (CMD), including hypertension, diabetes, and dyslipidemia, in a prospective study.

Methods

The association between HGS and CMD was examined using the data from 5,271 Chinese adult participants ≥45 years old enrolled in the CHARLS (Chinese Health and Retirement Prospective Cohort Study) during 2011-2015. Relative HGS, calculated as maximal absolute HGS from both hands divided by body mass index, was used in the primary analysis and divided into three groups according to the tertiles (T1, T2, and T3).

Results

The participants with higher relative HGS had a lower risk of hypertension, diabetes, and dyslipidemia than those with lower HGS, although did not reach statistical significance for diabetes and hypertension in males. Participants with higher HGS had significantly lower risk of hypertension [T3 vs. T1: OR = 0.69, 95% CI = 0.51-0.91, P = 0.010] and dyslipidemia (OR = 0.65, 95% CI = 0.51-0.83, P < 0.001) in males. For females, participants with higher HGS had significantly lower risks of dyslipidemia (OR = 0.67, 95% CI = 0.54-0.83, P < 0.001).

Conclusion

A consistent association was observed between higher relative HGS and lower risk of CMD. Further research is required to evaluate whether relative HGS can be a convincing predictor for the occurrence of CMD and as a target for intervention in the high-risk population.

Order of same-day concurrent training influences some indices of power development, but not strength, lean mass, or aerobic fitness in healthy, moderately-active men after 9 weeks of training

Background

The importance of concurrent exercise order for improving endurance and resistance adaptations remains unclear, particularly when sessions are performed a few hours apart. We investigated the effects of concurrent training (in alternate orders, separated by ~3 hours) on endurance and resistance training adaptations, compared to resistance-only training.

Materials and methods

Twenty-nine healthy, moderately-active men (mean ± SD; age 24.5 ± 4.7 y; body mass 74.9 ± 10.8 kg; height 179.7 ± 6.5 cm) performed either resistance-only training (RT, n = 9), or same-day concurrent training whereby high-intensity interval training was performed either 3 hours before (HIIT+RT, n = 10) or after resistance training (RT+HIIT, n = 10), for 3 d^.wk^-1 over 9 weeks. Training-induced changes in leg press 1-repetition maximal (1-RM) strength, countermovement jump (CMJ) performance, body composition, peak oxygen uptake (V˙O2peak), aerobic power (W˙peak), and lactate threshold (W˙LT) were assessed before, and after both 5 and 9 weeks of training.

Results

After 9 weeks, all training groups increased leg press 1-RM (~24–28%) and total lean mass (~3-4%), with no clear differences between groups. Both concurrent groups elicited similar small-to-moderate improvements in all markers of aerobic fitness (V˙O2peak ~8–9%; W˙LT ~16-20%; W˙peak ~14-15%). RT improved CMJ displacement (mean ± SD, 5.3 ± 6.3%), velocity (2.2 ± 2.7%), force (absolute: 10.1 ± 10.1%), and power (absolute: 9.8 ± 7.6%; relative: 6.0 ± 6.6%). HIIT+RT elicited comparable improvements in CMJ velocity only (2.2 ± 2.7%). Compared to RT, RT+HIIT attenuated CMJ displacement (mean difference ± 90%CI, -5.1 ± 4.3%), force (absolute: -8.2 ± 7.1%) and power (absolute: -6.0 ± 4.7%). Only RT+HIIT reduced absolute fat mass (mean ± SD, -11.0 ± 11.7%).

Conclusions

In moderately-active males, concurrent training, regardless of the exercise order, presents a viable strategy to improve lower-body maximal strength and total lean mass comparably to resistance-only training, whilst also improving indices of aerobic fitness. However, improvements in CMJ displacement, force, and power were attenuated when RT was performed before HIIT, and as such, exercise order may be an important consideration when designing training programs in which the goal is to improve lower-body power.

Acute interval waking with blood flow restriction could not increase ERK, p38 and decrease myostatin

BACKGROUND

There is mounting evidence that moderate to high intensity exercise training has a key role in skeletal muscle adaption. Blood flow restriction (BFR) low intensity exercise training associated with unique effect on muscle hypertrophy. The purpose of the study was to investigate of effect of acute interval walking with blood flow restriction on phosphorylation of 4EBP1, P38, ERK and myostatin (MSTN) of skeletal muscle in inactive men.

METHODS

Five healthy inactive men were participated in 2 sessions with 14 days interspersed. Session one was including BFR by 5 intervals 3-min walking at 55%Maximum heart rate (MHR) and 1 min at rest. Session two was including 5 intervals 3-min walking at 55% MHRand 1 min at rest without BFR. All samples were collected at 30 min and 3 h after exercise test. Concentration of P38, ERK and MSTN skeletal muscle were evaluated by Western blotting. Dependent t-test and Independent t-test was used to analyze the data after subtracting the post-test score from the pre-test. However, there was a significant difference between the pre and post-test for 4EBP1 (P=0.001) and ERK (P=0.049) in the blood flow restriction group.

RESULTS

There was no significant difference between pre and post-test of P38 (P=0/452). Significant difference was observed for ERK (P=0.012) in acute interval walking (P=0.049). There was no significant difference between pre and post-test of 4EBP1 (P=0.064) and P38 (P=0/122). No significant difference was found between two group for concentration of 4EBP1 (P=0.068), P38 (P-0.091) and ERK (P=0.827), (P≥0.05).

CONCLUSIONS

This study has shown that acute interval walking with blood flow restriction does not activate MAPK pathway signaling in inactive men.

Myokines: The endocrine coupling of skeletal muscle and bone

Bone and skeletal muscle are integrated organs and their coupling has been considered mainly a mechanical one in which bone serves as attachment site to muscle while muscle applies load to bone and regulates bone metabolism. However, skeletal muscle can affect bone homeostasis also in a non-mechanical fashion, i.e., through its endocrine activity. Being recognized as an endocrine organ itself, skeletal muscle secretes a panel of cytokines and proteins named myokines, synthesized and secreted by myocytes in response to muscle contraction. Myokines exert an autocrine function in regulating muscle metabolism as well as a paracrine/endocrine regulatory function on distant organs and tissues, such as bone, adipose tissue, brain and liver. Physical activity is the primary physiological stimulus for bone anabolism (and/or catabolism) through the production and secretion of myokines, such as IL-6, irisin, IGF-1, FGF2, beside the direct effect of loading. Importantly, exercise-induced myokine can exert an anti-inflammatory action that is able to counteract not only acute inflammation due to an infection, but also a condition of chronic low-grade inflammation raised as consequence of physical inactivity, aging or metabolic disorders (i.e., obesity, type 2 diabetes mellitus). In this review article, we will discuss the effects that some of the most studied exercise-induced myokines exert on bone formation and bone resorption, as well as a brief overview of the anti-inflammatory effects of myokines during the onset pathological conditions characterized by the development a systemic low-grade inflammation, such as sarcopenia, obesity and aging.

Racing weight and resistance training: perceptions and practices in trained male cyclists

Objectives: This study sought to investigate the perceptions and practices of achieving 'race weight' in a population of trained male cyclists. A secondary focus was to investigate the use of gym-based strength training, a possible attenuator of the side effects associated with weight reduction.Methods: A total of n = 97 well-trained cyclists ranging from local club level to international standard completed an online survey capturing data on the aforementioned topics.Results: Forty-nine percent of respondents indicated they were unsatisfied with their current bodyweight, with a similar percentage across club, national and international level riders. Riders who identified as climbers had lower reported bodyweight; however, all categories of riders expressed a desire to reduce bodyweight by a similar percentage (1.9%, ± 3.4%; 90% CL). Seventy-seven percent of respondents indicated that they had recently tried or were currently trying to reduce bodyweight, most commonly by reducing food intake and avoiding sugary foods. Nine percent indicated they were using either supplements or medications to lower bodyweight, and 27% reported having sought advice from a health professional. A higher proportion of international riders engaged in strength training (85%), compared to national (50%) and club (55%) riders (p< 0.05). The most cited reasons for not strength training were time constraints and believing it was not beneficial to their cycling performance.Conclusion: These data suggest that trained male cyclists are a highly weight-conscious population who engage in a variety of practices to reduce weight. Practitioners should be aware of these tendencies, as they may carry significant health implications if poorly implemented.

Low intensity rowing with blood flow restriction over 5 weeks increases V̇O2max in elite rowers: A randomized controlled trial

OBJECTIVES

The present randomized controlled intervention study examined the effects of practical blood flow restriction (pBFR) on maximal oxygen uptake (V̇O₂max) during low intensity rowing.

DESIGN

Thirty-one elite rowers were either assigned to the intervention (INT) or control (CON) group, using the minimization method (Strata: Gender, Age, Height, V̇O₂max).

METHOD

While INT (n=16; 4 female, 12 male, 21.9±3.2 years, 180.4±8.7cm, 73.6±10.9kg, V̇O₂max: 63.0±7.9ml/min/kg) used pBFR during boat- and indoor-rowing training, CON (n=15, 4 female, 11 male, 21.7±3.7 years, 180.7±8.1cm, 72.5±12.1kg, V̇O₂max: 63.2±8.5ml/min/kg) completed the identical training without pBFR. pBFR of the lower limb was applied via customized elastic wraps. Training took place three times a week over 5 weeks (accumulated net pBFR: 60min/week; occlusion per session: 2-times 10min/session) and was used exclusively at low intensities (<2mmol/L). A spiroergometric ramp test (V̇O₂max; 30-40W/min increase) on rowing-ergometer and one-repetition maximum test of the squat exercise (SQ1RM) was employed to assess endurance and strength capacity.

RESULTS

Significant group×time interactions (η_p²=0.26) in favor of INT were found for V̇O₂max (+9.1±6.2%, Effect Size=1.3) compared to CON (+2.5±6.1%, ES=0.3). SQ1RM (η_p²=0.01) was not affected by the pBFR intervention.

CONCLUSIONS

This study revealed that 15 sessions of pBFR application with a cumulative total pBFR load of 5h over a 5 weeks macrocycle remarkably increased V̇O₂max. Thus, pBFR might serve as a promising means to improve aerobic capacity in highly trained elite rowers.

Adaptations to Concurrent Training in Combination with High Protein Availability: A Comparative Trial in Healthy, Recreationally Active Men

Background

We implemented a high-protein diet (2 g·kg⁻¹·d⁻¹) throughout 12 weeks of concurrent exercise training to determine whether interferences to adaptation in muscle hypertrophy, strength and power could be attenuated compared to resistance training alone.

Methods

Thirty-two recreationally active males (age: 25 ± 5 years, body mass index: 24 ± 3 kg·m⁻²; mean ± SD) performed 12 weeks of either isolated resistance (RES; n = 10) or endurance (END; n = 10) training (three sessions·w⁻¹), or concurrent resistance and endurance (CET; n = 12) training (six sessions·w⁻¹). Maximal strength (1RM), body composition and power were assessed pre- and post-intervention.

Results

Leg press 1RM increased ~ 24 ± 13% and ~ 33 ± 16% in CET and RES from PRE-to-POST (P < 0.001), with no difference between groups. Total lean mass increased ~ 4% in both CET and RES from PRE-to-POST (P < 0.001). Ultrasound estimated vastus lateralis volume increased ~ 15% in CET and ~ 11% in RES from PRE-to-POST (P < 0.001), with no difference between groups. Wingate peak power relative to body mass displayed a trend (P = 0.053) to be greater in RES (12.5 ± 1.6 W·kg BM⁻¹) than both CET (10.8 ± 1.7 W·kg BM⁻¹) and END (10.9 ± 1.8 W·kg BM⁻¹) at POST. Absolute VO_2peak increased 6.9% in CET and 12% in END from PRE-to-POST (P < 0.05), with no difference between groups.

Conclusion

Despite high protein availability, select measures of anaerobic power-based adaptations, but not muscle strength or hypertrophy, appear susceptible to ‘interference effects’ with CET and should be closely monitored throughout training macro-cycles.

Trials Registry: This trial was registered with the Australian-New Zealand Clinical Trials Registry (ACTRN12617001229369).

Electronic supplementary material

The online version of this article (10.1007/s40279-018-0999-9) contains supplementary material, which is available to authorized users.

Blood flow restricted resistance exercise and reductions in oxygen tension attenuate mitochondrial H2 O2 emission rates in human skeletal muscle

KEY POINTS

Blood flow restricted resistance exercise (BFR-RE) is capable of inducing comparable adaptations to traditional resistance exercise (RE), despite a lower total exercise volume. It has been suggested that an increase in reactive oxygen species (ROS) production may be involved in this response; however, oxygen partial pressure ( P O 2 ) is reduced during BFR-RE, and the influence of P O 2 on mitochondrial redox balance remains poorly understood. In human skeletal muscle tissue, we demonstrate that both maximal and submaximal mitochondrial ROS emission rates are acutely decreased 2 h following BFR-RE, but not RE, occurring along with a reduction in tissue oxygenation during BFR-RE. We further suggest that P O 2 is involved in this response because an in vitro analysis revealed that reducing P O 2 dramatically decreased mitochondrial ROS emissions and electron leak to ROS. Altogether, these data indicate that mitochondrial ROS emission rates are attenuated following BFR-RE, and such a response is likely influenced by reductions in P O 2 .

ABSTRACT

Low-load blood flow restricted resistance exercise (BFR-RE) training has been proposed to induce comparable adaptations to traditional resistance exercise (RE) training, however, the acute signalling events remain unknown. Although a suggested mechanism of BFR-RE is an increase in reactive oxygen species (ROS) production, oxygen partial pressure ( P O 2 ) is reduced during BFR-RE, and the influence of O₂ tension on mitochondrial redox balance remains ambiguous. We therefore aimed to determine whether skeletal muscle mitochondrial bioenergetics were altered following an acute bout of BFR-RE or RE, and to further examine the role of P O 2 in this response. Accordingly, muscle biopsies were obtained from 10 males at rest and 2 h after performing three sets of single-leg squats (RE or BFR-RE) to failure at 30% one-repetition maximum. We determined that mitochondrial respiratory capacity and ADP sensitivity were not altered in response to RE or BFR-RE. Although maximal (succinate) and submaximal (non-saturating ADP) mitochondrial ROS emission rates were unchanged following RE, BFR-RE attenuated these responses by ∼30% compared to pre-exercise, occurring along with a reduction in skeletal muscle tissue oxygenation during BFR-RE (P < 0.01 vs. RE). In a separate cohort of participants, evaluation of mitochondrial bioenergetics in vitro revealed that mild O₂ restriction (50 µm) dramatically attenuated maximal (∼4-fold) and submaximal (∼50-fold) mitochondrial ROS emission rates and the fraction of electron leak to ROS compared to room air (200 µm). Combined, these data demonstrate that mitochondrial ROS emissions are attenuated following BFR-RE, a response which may be mediated by a reduction in skeletal muscle P O 2 .

Supervised Physical Training Enhances Muscle Strength but Not Muscle Mass in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis

Introduction: Androgen deprivation therapy (ADT) is considered the basic treatment for advanced prostate cancer, but it is highly associated with detrimental changes in muscle mass and muscle strength. The aim of this meta-analysis was to investigate the effects of supervised physical training on lean mass and muscle strength in prostate cancer patients undergoing ADT.

Methods: A systematic literature search was performed using MEDLINE, Embase, and ScienceDirect until October 2018. Only studies that examined both muscle mass and strength in prostate cancer patients undergoing ADT were included. Outcomes of interest were changes in lean body mass (surrogate for muscle mass) as well as upper and lower body muscle strength. The meta-analysis was performed with fixed-effects models to calculate mean differences between intervention and no-training control groups.

Results: We identified 8,521 publications through the search of the following key words: prostate cancer, prostate tumor, prostate carcinoma, prostate neoplasm, exercise, and training. Out of these studies, seven randomized controlled trials met the inclusion criteria and where included in the analysis. No significant mean differences for changes in lean mass were observed between the intervention and control groups (0.49 kg, 95% CI: −0.76, 1.74; P = 0.44). In contrast, the mean difference for muscle strength was significant both in chest (3.15 kg, 95% CI: 2.46, 3.83; P < 0.001) and in leg press (27.46 kg, 95% CI: 15.05, 39.87; p < 0.001).

Conclusion: This meta-analysis provides evidence that low- to moderate-intensity resistance and aerobic training is effective for increasing muscle strength but may not be sufficient to affect muscle mass in prostate cancer patients undergoing ADT. The underlying mechanisms for this maladaptation may in part be explained by an insufficient stimulus induced by the training regimens as well as a delayed initiation of training in relation to the start of ADT. When interpreting the present findings, one should bear in mind that the overall number of studies included in this review was rather low, emphasizing the need for further studies in this field.

Effect of a four-week ketogenic diet on exercise metabolism in CrossFit-trained athletes

BACKGROUND

The ketogenic diet is becoming a popular nutritional model among athletes. However, the relationship between its use and metabolism during exercise seems to have not been fully investigated.

METHODS

The aim of the study was to assess the effects of a four-week ketogenic diet (KD) on fat and carbohydrate (CHO) utilization during an incremental cycling test (ICT) in CrossFit-trained female (n = 11) and male (n = 11) athletes. During the ICT (while consuming the customary diet and after the KD), oxygen uptake and carbon dioxide exhalation were registered, and CHO and fat utilization as well as energy expenditure were calculated.

RESULTS

In males, the KD led to an increase in fat utilization (g·min- 1·kgFFM- 1 and % oxidation). It was particularly noticeable at exercise intensities up to 80% of VO2max. An increase in the area under the curve (AUC) was seen in males but not in females at up to ≤65% VO2max of fat utilization.

CONCLUSIONS

Male CrossFit-trained athletes seem to be more prone to shifts in macronutrient utilization (in favor of fat utilization) during submaximal intensity exercise under a ketogenic diet than are female athletes.

TRIAL REGISTRATION

Clinical Trials Gov, NCT03665948 . Registered 11 September 2018 (retrospectively registered).

RESISTANCE EXERCISE PROTOCOL DOES NOT CAUSE ACUTE GENOTOXIC EFFECTS IN TRAINED INDIVIDUALS

ABSTRACT Introduction: Resistance exercise, particularly strength training, has been progressively gaining more and more followers worldwide. Despite a considerable increase in the amount of research and literature available on this topic, resistance training is undergoing important developments. Anaerobic metabolism, which characterizes resistance training, enhances the ischemic process and blood reperfusion, thereby generating reactive oxygen species (ROS). The imbalance between the production of free radicals and antioxidant defenses may induce oxidative stress with subsequent protein oxidation, lipid peroxidation, DNA damage in several cells, and other effects. This process may be intensified at rest because the O2 deficit is counteracted by a process known as excess post-exercise oxygen consumption. Objective: To analyze the effects of ROS in strength training on the DNA of human lymphocyte, biomarkers of lipid damage (TBARS) and metabolism (triglycerides, protein, glycose, albumin and urea). Methods: Comet assay involving a count of 100 cells, which were divided into five classes of damage (no damage = 0, maximum damage = 4), thereby constituting an indication of DNA damage, and the micronucleus test, where the cell samples were centrifuged at 1000-1500 RPM for ten minutes at room temperature for the micronuclei analysis. Results: An elevation in triglyceride concentrations was observed 5h post-exercise (p=0.018), probably due to nutrition. There were no significant differences in the other biochemical parameters. In terms of the DNA damage measured by the Comet assay and micronucleus test, no statistical differences were observed until 5h post-exercise. Conclusion: The proposed training session did not cause oxidative or genotoxic damage in trained individuals under the proposed conditions. Level of Evidence II; Prognostic studies-Investigation of the effect of patient characteristics on the disease outcome.

Association of skeletal muscle and serum metabolites with maximum power output gains in response to continuous endurance or high-intensity interval training programs: The TIMES study - A randomized controlled trial

BACKGROUND

Recent studies have begun to identify the molecular determinants of inter-individual variability of cardiorespiratory fitness (CRF) in response to exercise training programs. However, we still have an incomplete picture of the molecular mechanisms underlying trainability in response to exercise training.

OBJECTIVE

We investigated baseline serum and skeletal muscle metabolomics profile and its associations with maximal power output (MPO) gains in response to 8-week of continuous endurance training (ET) and high-intensity interval training (HIIT) programs matched for total units of exercise performed (the TIMES study).

METHODS

Eighty healthy sedentary young adult males were randomized to one of three groups and 70 were defined as completers (> 90% of sessions): ET (n = 30), HIIT (n = 30) and control (CO, n = 10). For the CO, participants were asked to not exercise for 8 weeks. Serum and skeletal muscle samples were analyzed by 1H-NMR spectroscopy. The targeted screens yielded 43 serum and 70 muscle reproducible metabolites (intraclass > 0.75; coefficient of variation < 25%). Associations of baseline metabolites with MPO trainability were explored within each training program via three analytical strategies: (1) correlations with gains in MPO; (2) differences between high and low responders to ET and HIIT; and (3) metabolites contributions to the most significant pathways related to gains in MPO. The significance level was set at P < 0.01 or false discovery rate of 0.1.

RESULTS

The exercise programs generated similar gains in MPO (ET = 21.4 ± 8.0%; HIIT = 24.3 ± 8.5%). MPO associated baseline metabolites supported by all three levels of evidence were: serum glycerol, muscle alanine, proline, threonine, creatinine, AMP and pyruvate for ET, and serum lysine, phenylalanine, creatine, and muscle glycolate for HIIT. The most common pathways suggested by the metabolite profiles were aminoacyl-tRNA biosynthesis, and carbohydrate and amino acid metabolism.

CONCLUSION

We suggest that MPO gains in both programs are potentially associated with metabolites indicative of baseline amino acid and translation processes with additional evidence for carbohydrate metabolism in ET.

Physical Activity and Bone Health: What Is the Role of Immune System? A Narrative Review of the Third Way

Bone tissue can be seen as a physiological hub of several stimuli of different origin (e.g., dietary, endocrine, nervous, immune, skeletal muscle traction, biomechanical load). Their integration, at the bone level, results in: (i) changes in mineral and protein composition and microarchitecture and, consequently, in shape and strength; (ii) modulation of calcium and phosphorous release into the bloodstream, (iii) expression and release of hormones and mediators able to communicate the current bone status to the rest of the body. Different stimuli are able to act on either one or, as usual, more levels. Physical activity is the key stimulus for bone metabolism acting in two ways: through the biomechanical load which resolves into a direct stimulation of the segment(s) involved and through an indirect load mediated by muscle traction onto the bone, which is the main physiological stimulus for bone formation, and the endocrine stimulation which causes homeostatic adaptation. The third way, in which physical activity is able to modify bone functions, passes through the immune system. It is known that immune function is modulated by physical activity; however, two recent insights have shed new light on this modulation. The first relies on the discovery of inflammasomes, receptors/sensors of the innate immunity that regulate caspase-1 activation and are, hence, the tissue triggers of inflammation in response to infections and/or stressors. The second relies on the ability of certain tissues, and particularly skeletal muscle and adipose tissue, to synthesize and secrete mediators (namely, myokines and adipokines) able to affect, profoundly, the immune function. Physical activity is known to act on both these mechanisms and, hence, its effects on bone are also mediated by the immune system activation. Indeed, that immune system and bone are tightly connected and inflammation is pivotal in determining the bone metabolic status is well-known. The aim of this narrative review is to give a complete view of the exercise-dependent immune system-mediated effects on bone metabolism and function.

Turning Up the Heat: An Evaluation of the Evidence for Heating to Promote Exercise Recovery, Muscle Rehabilitation and Adaptation

Historically, heat has been used in various clinical and sports rehabilitation settings to treat soft tissue injuries. More recently, interest has emerged in using heat to pre-condition muscle against injury. The aim of this narrative review was to collate information on different types of heat therapy, explain the physiological rationale for heat therapy, and to summarise and evaluate the effects of heat therapy before, during and after muscle injury, immobilisation and strength training. Studies on skeletal muscle cells demonstrate that heat attenuates cellular damage and protein degradation (following in vitro challenges/insults to the cells). Heat also increases the expression of heat shock proteins (HSPs) and upregulates the expression of genes involved in muscle growth and differentiation. In rats, applying heat before and after muscle injury or immobilisation typically reduces cellular damage and muscle atrophy, and promotes more rapid muscle growth/regeneration. In humans, some research has demonstrated benefits of microwave diathermy (and, to a lesser extent, hot water immersion) before exercise for restricting muscle soreness and restoring muscle function after exercise. By contrast, the benefits of applying heat to muscle after exercise are more variable. Animal studies reveal that applying heat during limb immobilisation attenuates muscle atrophy and oxidative stress. Heating muscle may also enhance the benefits of strength training for improving muscle mass in humans. Further research is needed to identify the most effective forms of heat therapy and to investigate the benefits of heat therapy for restricting muscle wasting in the elderly and those individuals recovering from serious injury or illness.

The Impact of Resistance Training on Swimming Performance: A Systematic Review

BACKGROUND

The majority of propulsive forces in swimming are produced from the upper body, with strong correlations between upper body strength and sprint performance. There are significant gaps in the literature relating to the impact of resistance training on swimming performance, specifically the transfer to swimming performance.

OBJECTIVE

The aims of this systematic literature review are to (1) explore the transfer of resistance-training modalities to swimming performance, and (2) examine the effects of resistance training on technical aspects of swimming.

METHODS

Four online databases were searched with the following inclusion criteria: (1) journal articles with outcome measures related to swimming performance, and (2) competitive swimmers participating in a structured resistance-training programme. Exclusion criteria were (1) participants with a mean age <16 years; (2) untrained, novice, masters and paraplegic swimmers; (3) triathletes and waterpolo players; (4) swimmers with injuries or illness; and (5) studies of starts and turns specifically. Data were extracted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the Physiotherapy Evidence Database (PEDro) scale was applied.

RESULTS

For optimal transfer, specific, low-volume, high-velocity/force resistance-training programmes are optimal. Stroke length is best achieved through resistance training with low repetitions at a high velocity/force. Resisted swims are the most appropriate training modality for improving stroke rate.

CONCLUSION

Future research is needed with respect to the effects of long-term resistance-training interventions on both technical parameters of swimming and overall swimming performance. The results of such work will be highly informative for the scientific community, coaches and athletes.

Interpreting Adaptation to Concurrent Compared with Single-Mode Exercise Training: Some Methodological Considerations

Incorporating both endurance and resistance training into an exercise regime is termed concurrent training. While there is evidence that concurrent training can attenuate resistance training-induced improvements in maximal strength and muscle hypertrophy, research findings are often equivocal, with some suggesting short-term concurrent training may instead further enhance muscle hypertrophy versus resistance training alone. These observations have questioned the validity of the purported 'interference effect' on muscle hypertrophy with concurrent versus single-mode resistance training. This article aims to highlight some methodological considerations when interpreting the concurrent training literature, and, in particular, the degree of changes in strength and muscle hypertrophy observed with concurrent versus single-mode resistance training. Individual training status clearly influences the relative magnitude and specificity of both training adaptation and post-exercise molecular responses in skeletal muscle. The training status of participants is therefore likely a key modulator of the degree of adaptation and interference seen with concurrent training interventions. The divergent magnitudes of strength gain versus muscle hypertrophy induced by resistance training also suggests most concurrent training studies are likely to observe more substantial changes in (and in turn, any potential interference to) strength compared with muscle hypertrophy. Both the specificity and sensitivity of measures used to assess training-induced changes in strength and muscle hypertrophy also likely influence the interpretation of concurrent training outcomes. Finally, the relative importance of any modulation of hypertrophic versus strength adaptation with concurrent training should be considered in context with the relevance of training-induced changes in these variables for enhancing athletic performance and/or functional capacity. Taken together, these observations suggest that aside from various training-related factors, additional non-training-related variables, including participant training status and the measures used to assess changes in strength and muscle hypertrophy, are important considerations when interpreting the outcomes of concurrent training interventions.

A Brief Review on Concurrent Training: From Laboratory to the Field

The majority of sports rely on concurrent training (CT; e.g., the simultaneous training of strength and endurance). However, a phenomenon called “Concurrent training effect” (CTE), which is a compromise in adaptation resulting from concurrent training, appears to be mostly affected by the interference of the molecular pathways of the underlying adaptations from each type of training segments. Until now, it seems that the volume, intensity, type, frequency of endurance training, as well as the training history and background strongly affect the CTE. High volume, moderate, continuous and frequent endurance training, are thought to negatively affect the resistance training-induced adaptations, probably by inhibition of the Protein kinase B—mammalian target of rapamycin pathway activation, of the adenosine monophosphate-activated protein kinase (AMPK). In contrast, it seems that short bouts of high-intensity interval training (HIIT) or sprint interval training (SIT) minimize the negative effects of concurrent training. This is particularly the case when HIIT and SIT incorporated in cycling have even lower or even no negative effects, while they provide at least the same metabolic adaptations, probably through the peroxisome proliferator-activated receptor-γ coactivator (PGC-1a) pathway. However, significant questions about the molecular events underlying the CTE remain unanswered.

Prevalence of Non-responders for Blood Pressure and Cardiometabolic Risk Factors Among Prehypertensive Women After Long-Term High-Intensity Interval Training

Background: Exercise is known to improve cardiometabolic outcomes; however, results are typically reported as mean values, and there is wide interindividual variability in terms of response that has not been explored in populations at risk for hypertension. Our aim was to investigate both the effects on and the prevalence of non-responders (NRs) for decreasing blood pressure (BP) and other risk factors among prehypertensive women after long-term high-intensity interval training (HIIT). A secondary aim was to report potential variables that can predict decreases in BP after HIIT. Methods: Sedentary overweight/obese women (age 35.9 ± 5.4 year; body mass index [BMI] 30.9 ± 6.2 kg/m2) were assigned to a prehypertensive (PreHTN; N = 44) or normotensive (NT; N = 40) group according to their ambulatory BP at baseline. Subjects underwent a thrice-weekly 16-week HIIT program (7-10 × 1 min exercise with 2 min of rest). Training-induced changes in body composition and cardiovascular, metabolic, strength, and endurance performance markers were measured, and the prevalence of NRs was reported as a percentage. All outcomes were analyzed by multivariable regression. Results: Statistically significant (P < 0.05) decreases in systolic BP (SBP) were detected in the PreHTN group (Δ -8 mmHg) compared with baseline, whereas the NT group (Δ + 3 mmHg) showed a non-significant increase in SBP. Diastolic BP (DBP) was significantly decreased in the PreHTN group (Δ -5.8 mmHg) and non-significantly decreased (Δ -2 mmHg) in the NT group. Also, there were significant differences (P < 0.0001) in the prevalence of NRs based on SBP between the PreHTN and NT groups (11.4 vs. 68.8%), but similar prevalence of NRs based on DBP. SBP alone was a powerful predictive factor for a beneficial SBP reduction, explaining 51.2% of the results, which was similar to other more complex models tested. Conclusion: The prevalence of NRs based on SBP and DBP was different between prehypertensive and normotensive subjects after 16 weeks of HIIT. Other comorbidities such as body composition and metabolic outcomes showed almost similar modifications between prehypertensive and normotensive subjects, being the most basic predictive factor for BP reduction baseline SBP, which we refer to as 'BP health status' (51.2%). This improvement in BP was accompanied by other known improvements of HIIT on body composition, metabolic and endurance performance in both study cohorts. Trial Registration: ClinicalTrials.gov ID: NCT03000140 (Register 20 December, 2016).

How to Construct, Conduct and Analyze an Exercise Training Study?

Randomized controlled trials (RCTs) can be regarded as gold standard in investigating dose-response and causal relationships in exercise science. Recommendations for exercise training routines and efficacy analyses of certain training regimen require valid data derived from robust RCTs. Moreover, meta-analyses rely on RCTs and both RCTs and meta-analyses are considered the highest level of scientific evidence. Beyond general study design a variety of methodological aspects and notable pitfalls has to be considered. Therefore, exercise training studies should be carefully constructed focusing on the consistency of the whole design "package" from an explicit hypothesis or research question over study design and methodology to data analysis and interpretation. The present scoping review covers all main aspects of planning, conducting, and analyzing exercise based RCTs. We aim to focus on relevant aspects regarding study design, statistical power, training planning and documentation as well as traditional and recent statistical approaches. We intend to provide a comprehensive hands-on paper for conceptualizing future exercise training studies and hope to stimulate and encourage researchers to conduct sound and valid RCTs in the field of exercise training.