Effects of Low- vs. High-Load Resistance Training on Muscle Strength and Hypertrophy in Well-Trained Men

Hypercaloric 16:8 time-restricted eating during 8 weeks of resistance exercise in well-trained men and women

BACKGROUND

The effectiveness and practicality of time-restricted eating (TRE) when trying to maximize muscle mass and strength is unclear. Thus, we examined the effects of a hypercaloric 16:8 TRE approach during supervised progressive resistance exercise.

METHODS

Seventeen healthy and well-trained men (n = 10) and women (n = 7) were randomly assigned to TRE or control (FED). Both groups consumed a 10% hypercaloric high-protein (2.2 g/kg/d) diet and performed supervised resistance exercise 4× per wk for 8 wk. TRE consumed all calories within an 8 h window starting at least 1 h post-exercise, while FED consumed the same number of calories throughout the day.

RESULTS

Eating windows were significantly different (TRE: 7.9 ± 0.1 h vs. FED: 13.2 ± 0.6 h). Calorie, carbohydrate, fat, and protein intake did not differ statistically between groups. Total exercise volume was significantly lower in TRE than FED (6,960 ± 287 vs. 7,334 ± 289 repetitions), as were subjective daily energy ratings (week 4 = -1.41; p = 0.04, week 8 = -1.04; p = 0.06). Both groups increased maximal upper and lower body strength (1RM) and muscular endurance (ME); however, gains in squat 1RM were 4.0 ± 1.9 kg lower in TRE (p = 0.05). Both groups increased fat-free mass similarly (TRE: 2.67 kg; FED: 1.82 kg, p = 0.04), but FED added 1.4 ± 0.6 kg more fat mass (p = 0.04). Subjective mood and sleep ratings did not change in either group.

CONCLUSIONS

16:8 TRE is viable during periods of muscle size, strength, and endurance development in well-trained young men and women when engaging in progressive resistance exercise and eating in a caloric surplus with adequate protein. However, the differences in total training volume, squat 1RM, fat mass accumulation, and energy are notable and practically relevant. These findings should be considered within the broader context of an individual's goals, lifestyle, preferences, and exercise demands.

Current methods for the exercise dose equalization in resistance training drive to markedly different session-induced efforts

BACKGROUND

Effects comparison of resistance exercises may require equalizing the exercise-induced dose, this is currently done by using methods based on total weight lifted or on sets performed until failure. Dose equalization of resistance training sessions by these methods was analyzed in the present study.

METHODS

Twelve trained participants performed five bench-press sessions with a similar relative endpoint determined by the inability to complete a set of 50% of the maximum repetitions number (MNR). Sessions were performed at 50 or 85% of one-repetition maximum (1-RM) with sets until failure or sets prescribing 50% of MNR. The last session was performed with a reduced recovery pause to match the exercise density (total weight lifted/pause duration) of a previous session.

RESULTS

Sessions resulted in different total weight lifted (3158±1592 kg at 85% of 1-RM vs. 5330±1967 at 50%, P<0.001) and number of sets until failure (5.1±1.9 at 85% of 1-RM vs. 2.9±1.1 at 50%, P<0.001). Matching of sessions' density suppressed the differences in the number of sets performed (P=0.50).

CONCLUSIONS

Protocols' equalization based on the total weight lifted is likely to result in exercise volumes close to maximums when performed with heavy loads, whereas equalization based on sets to failure could induce a sets number close to the maximum when performed with light loads. Current methods for protocols equalization rely on gross values of exercise volume without considering maximums, that can result in markedly unbalanced efforts and biased results. Prescribing each exercise volume according to its maximum might optimize the training protocols' equalization.

Superset Versus Traditional Resistance Training Prescriptions: A Systematic Review and Meta-analysis Exploring Acute and Chronic Effects on Mechanical, Metabolic, and Perceptual Variables

BACKGROUND

Supersets are a time-efficient resistance training (RT) method that involve the sequencing of two exercises with little or no rest between them. However, despite their common implementation during RT, a comprehensive and quantitative review is still lacking.

OBJECTIVES

The primary aim of this systematic review and meta-analysis was to compare the acute and chronic effects of superset and traditional set prescriptions on mechanical, metabolic, and perceptual variables. We also aimed to conduct subgroup analyses to determine the effect of different types of supersets (agonist-antagonist, similar biomechanical, and alternate peripheral supersets).

METHODS

A systematic literature search was conducted in PubMed, Web of Science, Embase, and EBSCO databases from inception to 10 February 2024. Studies written in English and meeting our inclusion criteria were included. Pooled meta-analysis and subgroup meta-analysis were performed using a random-effects model.

RESULTS

Nineteen studies involving 313 participants were included. Although there was considerable variance in certain outcomes, our estimated effects suggested that, compared with traditional set prescription, supersets allow for (1) a similar total number of repetitions [standardized mean differences (SMD) =  - 0.03; p = 0.92] and volume load (SMD = 0.05; p = 0.86) with a shorter session duration and increased training efficiency (SMD = 1.74; p = 0.01); (2) higher blood lactate concentration during (SMD = 0.94; p = 0.03) and after (SMD = 1.13; p < 0.01) RT; (3) higher energy cost during RT (SMD = 1.93; p = 0.04); (4) similar creatine kinase concentration after RT (SMD = 0.22; p = 0.36), surface electromyography (SMD = 0.01; p = 0.98), acute muscle swelling (SMD = - 0.28; p = 0.36) and blood pressure (systolic blood pressure [SMD = 0.08; p = 0.71], diastolic blood pressure [SMD = - 0.05; p = 0.85], and mean arterial pressure [SMD = - 0.03; p = 0.88]); (5) higher rating of perceived exertion (SMD = 0.77; p = 0.02) and similar perceived recovery (SMD = 0.32; p = 0.33); and (6) similar chronic adaptations in maximal strength (SMD = 0.10; p = 0.36), strength endurance (SMD = 0.07; p = 0.81), and muscle hypertrophy (SMD =  - 0.05; p = 0.87). The subgroup analysis revealed that utilizing agonist-antagonist supersets leads to a significant increase in the number of repetitions that are able to be completed compared with traditional sets (SMD = 0.68; p = 0.01). Similar biomechanical supersets led to less volume load (SMD =  - 1.08; p < 0.01) compared with traditional sets.

CONCLUSIONS

Supersets provide a time-efficient alternative to traditional RT, reducing session duration without compromising training volume, muscle activation, perceived recovery, or chronic adaptations in maximal strength, strength endurance, and muscle hypertrophy. Thus, supersets can be effectively implemented by athletes with busy schedules and RT enthusiasts whose main barrier to exercise is time. However, it should be noted that supersets generally induce higher internal loads, more severe muscle damage, and increased perceived exertion, potentially necessitating extended recovery times between sessions. Additionally, superset RT may have a similar potential to traditional RT in eliciting post-exercise hypotension. Regarding different types of supersets, agonist-antagonist supersets are more suitable for maintaining training volume, while similar biomechanical supersets concentrate stimulation on the same muscle group, compromising volume load.

PROTOCOL REGISTRATION

The original protocol for this review was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) in December 2023 (CRD42023491533).

Factors Relating to Sprint Swimming Performance: A Systematic Review

BACKGROUND

Swimming performance depends on a wide variety of factors; however, the interaction between these factors and their importance varies between events. In sprint events, the characterized pacing underlines its specific development, as swimmers must achieve the highest possible speed while sustaining it to the greatest extent possible.

OBJECTIVES

The aim of this review was to identify the key factors underlying sprint swimming performance and to provide in-depth and practical evidence-based information to optimize performance.

METHODS

The review protocol was not registered. PubMed, Web of Science and Scopus databases were searched up to October 31, 2023. Studies involving competitive swimmers and investigating sprint swimming performance were included, while studies conducted with young or masters' swimmers, triathletes or waterpolo players or not investigating sprint swimming performance were excluded. The Downs and Black Quality Assessment Checklist was performed on the included articles to assess the methodological quality.

RESULTS

After applying the PICOS framework, 39 of the 1330 articles initially identified were included according to the PRISMA guidelines. The included records focused mainly on dry-land strength and in-water forces of both upper and lower limbs. A wide range of kinematic variables were also examined, together with the importance of anthropometric and various physiological parameters.

CONCLUSION

This review highlights the importance of developing muscular strength and effectively transferring it to performance in the water. The evidence suggests that muscular development should prioritize enhancing velocity and effective displacement, rather than merely increasing force and performance in loaded tests. However, further research is needed to confirm this. While in-water forces have been well studied, there is a notable lack of analysis regarding drag. The optimal balance between stroke rate and stroke length should be determined individually, with a primary focus on achieving a high stroke length from a high stroke rate. Although anthropometry may play an important role in performance, the interaction of these traits appears to be complex, suggesting that other factors may be more important in determining performance outcomes. From a physiological perspective, the results indicate that the lactate peak and rate of accumulation should be thoroughly developed. Notwithstanding, this review shows the lack of a solid body of knowledge on the importance of anaerobic and especially aerobic factors. Finally, the absence of a list of potential confounders, together with the lack of high-quality studies involving elite swimmers (level 1 and 2), complicates the interpretation of the results.

Effects of low-intensity blood flow restriction training on myocardial injury indices, antioxidant and anti-apoptotic capacity in rats

Objective

This study aims to investigate the effects of low-intensity blood flow restriction training on myocardial tissue in rats. By measuring the levels of myocardial injury biomarkers in serum and the expression of anti-apoptotic and antioxidant proteins in myocardial tissue, the study preliminarily explores the underlying mechanisms.

Methods

Male 3-month-old Sprague-Dawley rats were randomly divided into the following groups: control group (CON), low-intensity training group (LIRT), high-intensity training group (HIRT), and low-intensity blood flow restriction training group (LIBFR), with 6 rats in each group. Body weight, maximum voluntary carrying capacity, myocardial morphology, myocardial injury biomarkers, and the expression levels of Bcl-2, Bax, Nrf2, and Keap1 proteins in myocardial tissue were evaluated.

Results

(1)cTn1 Detection: The HIRT group showed a significant increase in cTn1 levels (P < 0.01), while the LIBFR group had a lower cTn1 level compared to the HIRT group (P < 0.05). (2)Nrf2 and Keap1 Results: Compared to the CON group, the LIBFR group showed an increase in Nrf2 (P < 0.05), and a significant increase in Keap1 (P < 0.01). (3)Bcl-2 and Bax Results: Compared to the CON group, Bcl-2 levels were significantly elevated in the HIRT group (P < 0.01) and increased in the LIBFR group (P < 0.05), while Bax expression was significantly reduced in the LIBFR group (P < 0.05). Regarding the Bcl-2/Bax ratio, the LIRT, HIRT, and LIBFR groups exhibited significantly higher values compared to the CON group (P < 0.01). Furthermore, the HIRT and LIBFR groups showed significantly higher Bcl-2/Bax ratios than the LIRT group (P < 0.01).

Conclusion

Low-intensity blood flow restriction training can effectively reduce cTn1 in rat serum, decrease cardiomyocyte apoptosis, and improve antioxidant capacity, which has a certain protective effect on the myocardium.

Improving the Use of Lifting Velocity to Predict Repetitions to Failure: A Systematic Review

BACKGROUND

A recent advancement in velocity-based training involves estimating the maximum number of repetitions to failure (RTF) by analyzing the fastest velocity recorded within a set. A systematic review examining the fundamental characteristics of the RTF-velocity relationship is still lacking.

PURPOSE

This study aimed to (1) determine the basic properties of the RTF-velocity relationships (goodness of fit, reliability, and accuracy) and (2) offer guidance on implementing various methodological factors that can impact the RTF accuracy prediction.

METHODS

Data were sourced from 3 databases: PubMed, SPORTDiscus, and Scopus. Studies were qualified for inclusion if they involved at least 2 sets performed to failure with different loads, utilized multijoint weight-lifting exercises, and monitored the RTF and fastest velocity for each set.

RESULTS

Six studies demonstrated (1) robust goodness of fit, (2) acceptable to high between-sessions reliability for the velocities associated to each RTF (1-15 RTF), and (3) acceptable RTF prediction accuracy during fatigue-free sessions (long interset rest), but, when fatigued (ie, short interset rest) the accuracy was compromised except for athletes with high training experience (eg, >2 y training-to-failure experience).

CONCLUSIONS

The relationship properties remain unaffected regardless of the exercise (upper- vs lower-body), equipment (Smith- vs free-weight), velocity variable (mean and peak velocity), and resting time (from 5 to 10 min). However, the modeling procedure used (multiple- vs 2-point) did alter the accuracy. The individualized RTF-velocity relationships can be constructed through a linear regression model, but the failure experience seems to be a critical factor to increase its accuracy.

Repetition-dependent acutecardiopulmonary responses during intensity-matched squats in males

The 'strength-endurance continuum' is a key concept in strength training (ST). Although cardiopulmonary responses have seldom been reported in conjunction with ST, this repeated-measurement study examined acute blood pressure and haemodynamic responses continuously depending on the number of repetitions but without changing the intensity. Fifteen healthy male participants (21.6 (2.0) years; mean (SD)) performed an incremental exercise test and a 3-repetition maximum test (3-RM) on a Smith machine. They were then randomly assigned to three ST sessions involving 10, 20 and 30 repetitions at 50% of their 3-RM. Blood pressure (vascular unloading technique) and cardiopulmonary responses (spirometry and impedance cardiography) were continuously monitored. Heart rate (121 (10) vs. 139 (22) vs. 153 (13) bpm, P = 0.001, respectively), cardiac output (10.4 (1.9) vs. 13.6 (3.8) vs. 14.6 (3.1) L/min, P = 0.001, respectively) and diastolic blood pressure (113 (8) vs. 116 (21) vs. 135 (22) mmHg, P = 0.001, respectively) increased in the training sessions with higher repetitions. Stroke volume, systolic blood pressure and end-diastolic volume indicated no change in peak values between training sessions. Total peripheral resistance (13.6 (2.8) vs. 11.3 (3.6) vs. 11.2 (3.1) mmHg min/L, P = 0.002, respectively) was significantly lower with 20 and 30 repetitions, while oxygen uptake (V ̇ O 2 ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}}}$ : 15.5 (1.9) vs. 20.5 (4.1) vs. 20.6 (4.4) mL/min/kg, P = 0.001, respectively) was significantly higher. ST of moderate intensity with an exhausting number (>20) of repetitions induces strong haemodynamic responses, especially high cardiac afterload and a compensatory heart rate acceleration, which may also create a strong stimulus for cardiopulmonary adaptation.

Quantification of training-induced alterations in body composition via automated machine learning analysis of MRI images in the thigh region: A pilot study in young females

The maintenance of an appropriate ratio of body fat to muscle mass is essential for the preservation of health and performance, as excessive body fat is associated with an increased risk of various diseases. Accurate body composition assessment requires precise segmentation of structures. In this study we developed a novel automatic machine learning approach for volumetric segmentation and quantitative assessment of MRI volumes and investigated the efficacy of using a machine learning algorithm to assess muscle, subcutaneous adipose tissue (SAT), and bone volume of the thigh before and after a strength training. Eighteen healthy, young, female volunteers were randomly allocated to two groups: intervention group (IG) and control group (CG). The IG group followed an 8-week strength endurance training plan that was conducted two times per week. Before and after the training, the subjects of both groups underwent MRI scanning. The evaluation of the image data was performed by a machine learning system which is based on a 3D U-Net-based Convolutional Neural Network. The volumes of muscle, bone, and SAT were each examined using a 2 (GROUP [IG vs. CG]) × 2 (TIME [pre-intervention vs. post-intervention]) analysis of variance (ANOVA) with repeated measures for the factor TIME. The results of the ANOVA demonstrate significant TIME × GROUP interaction effects for the muscle volume (F1,16 = 12.80, p = 0.003, ηP 2 = 0.44) with an increase of 2.93% in the IG group and no change in the CG (-0.62%, p = 0.893). There were no significant changes in bone or SAT volume between the groups. This study supports the use of artificial intelligence systems to analyze MRI images as a reliable tool for monitoring training responses on body composition.

The efficacy of high load-volume exercise versus low load-volume exercise for rotator cuff tendinopathy: A pilot and feasibility trial

BACKGROUND

The most effective exercise variables for rotator cuff tendinopathy are unknown.

OBJECTIVE

Determine feasibility of a fully powered trial comparing high load-volume versus low load-volume exercise for adults with rotator cuff tendinopathy.

DESIGN

Two arm, multi-centre pilot and feasibility randomised controlled trial.

METHODS

Participants aged over 18 were recruited via social media and randomised into 12 weeks of either high load-volume exercise (i.e. with dumbbell resistance) or low load-volume exercise (i.e. without added resistance). Feasibility outcomes were rates of recruitment, retention, questionnaire completion, adverse events and adherence to prescribed exercise.

RESULTS

Fifteen participants were randomised to high load-volume and 16 to low load-volume (18/31 were female). Retention rate was 84% at 6 weeks, and 81% at 12 and 26 weeks. Five participants withdrew and one participant was lost to follow up. Questionnaire completion rate was 78%. Adherence to the prescribed exercise sets was 77%. Recruitment, conversion and retention rates were above the pre-defined success criterion. There were no serious adverse events.

CONCLUSION

A fully powered multi-centre randomised trial is feasible with minor amendments addressing exercise adherence and questionnaire response rate. Future trials should utilise outcomes that consider participants baseline physical activity levels and adequately measure pain disparate from performance.

Muscle Strength and Size Relationships with Unilateral Progressive Resistance Training

Purpose

This study defines correlative and causal relationships between muscle strength and size before and after unilateral resistance training (RT) in a large cohort of healthy adults, focusing on sex differences within these relationships.

Methods

Results from 1233 participants (504 males and 729 females) in a retrospective analysis were included. Maximal voluntary isometric contraction strength (MVC), one-repetition maximum strength (1RM), biceps cross-sectional area (CSA) and elbow flexor volume (VOL) measures of the non-dominant and dominant arm were evaluated from baseline and after 12-wk RT twice per week. Correlations of MVC and VOL and 1RM and VOL were calculated in the whole cohort and within each sex independently. Causal analysis modeling was used to infer mechanistic relationships among variables.

Results

Absolute muscle strength and size related to one another both at baseline and following training, however correlation strength in each sex were weak. After RT, MVC relative change and VOL relative change correlations were correlated for the whole cohort (r=0.16; p<0.001) and females (r=0.18; p<0.001), but not in males (r=0.11; p=0.07). No significant correlations for relative change in 1RM and VOL were observed for the whole cohort or within sex. Causal discovery determined that change in VOL caused significant change in 1RM (but not MVC) and age was identified as a potential cause.

Conclusions

Sex differences occur in muscle size and strength relationship adaptations following resistance training, most notably the absence of significant relationships between relative size and strength changes in men. Simpson's paradox bias, where assessing the combined data of males and females (also affecting overall sample size) affects identifies patterns differently than assessing relationships within each sex, may partially explain our findings.

Eight-week lat pull-down resistance training with joint instability leads to superior pull-up endurance performance and reduced antagonist coactivation in recreationally active male college students

This study aimed to investigate the effects of an 8-week lat pull-down resistance training program with joint instability on pull-up performance in male college students. Thirty-four healthy recreationally active male college students were randomly assigned to either the joint instability resistance training (IRT) or traditional resistance training (TRT) group. Participants of the TRT and IRT groups performed lat pull-down training on stable and joint instability conditions for 8 weeks, respectively. Pull-up endurance (number of repetitions), anthropometry, lat pull-down maximal voluntary isometric contraction (MVIC) peak force, and movement stability of performing unstable lat pull-down were tested before and after the 8-week training. Surface electromyography of biceps brachii (BB), triceps brachii (TB), brachioradialis (BR), anterior deltoid (AD), middle deltoid (MD), posterior deltoid (PD), pectoralis major (PM), and latissimus dorsi (LD) muscles were recorded during the pull-up endurance test. The level of significance is set at p ≤ 0.05. The results demonstrated that the pull-up endurance and lat pull-down MVIC peak force of both IRT and TRT groups were significantly enhanced after 8-week training compared to the pre-training test. Notably, the number of pull-up repetitions of the IRT group was 45.5% higher than the TRT group. These findings suggest that lat pull-down training performed with joint instability may lead to greater improvements in pull-up endurance compared to the stable condition, possibly attributed to enhanced muscle contraction efficiency as indicated by decreased antagonist coactivation activity.

The Effects of CrossFit® Practice on Physical Fitness and Overall Quality of Life

We have examined the impact of CrossFit® workout sessions on physical fitness, comparing the obtained outcomes with the recommendations of the American College of Sports Medicine. In addition, we provide suggestions to improve training monitoring, as well as practical applications for researchers, coaches and practitioners. CrossFit® imposes high cardiorespiratory and metabolic demands, promoting improvements in circulatory capacity, oxidative metabolism and muscular endurance. Sustained elevations in heart rate contribute to cardiovascular conditioning, while a post-exercise hypotensive effect may help to reduce cardiovascular risks. Structured CrossFit® programs have led to improvements in maximal strength and muscular endurance, with substantial increases in squat performance observed in both untrained and recreationally active individuals. In addition, CrossFit® improves mental health through its motivating community. However, the high metabolic demands, increased creatine kinase levels and reduced performance in the countermovement jump reveal that muscle damage and neuromuscular fatigue can persist for up to 48 h. Balancing these intense sessions with adequate recovery is crucial, as improper management may lead to overtraining and compromise fitness gains. Future research should explore long-term cardiovascular adaptations, differences in gains and recovery between males and females and the application of real-time biomarker and artificial intelligence technologies to improve the training efficiency and safety. Machine learning algorithms could further personalize feedback, adapting to each individual's biomechanics and physiological responses over time.

Low-Intensity Resistance Exercise in Cardiac Rehabilitation: A Narrative Review of Mechanistic Evidence and Clinical Implications

Cardiac rehabilitation, a multi-component intervention designed to mitigate the impact of cardiovascular disease, often underutilises low-intensity resistance exercise despite its potential benefits. This narrative review critically examines the mechanistic and clinical evidence supporting the incorporation of low-intensity resistance exercise into cardiac rehabilitation programmes. Research indicates that low-intensity resistance exercise induces hypertrophic adaptations by maximising muscle fibre activation through the size principle, effectively recruiting larger motor units as it approaches maximal effort. This activation promotes adaptation in both type I and II muscle fibres, resulting in comparable increases in myofibrillar protein synthesis and phosphorylation of key signalling proteins when compared to high-intensity resistance exercise. Low-intensity resistance exercise provides equivalent improvements in muscular strength and hypertrophy compared to high-intensity protocols while addressing barriers to participation, such as concerns about safety and logistical challenges. By facilitating engagement through a more accessible exercise modality, low-intensity resistance exercise might improve adherence rates and patient outcomes in cardiac rehabilitation. Additionally, the ability of low-intensity resistance exercise to address sarcopenia and frailty syndrome, significant determinants of cardiovascular disease progression, can enhance the recovery and overall quality of life for patients. This review establishes evidence-based recommendations for the inclusion of low-intensity resistance exercise in cardiac rehabilitation, offering a promising pathway to enhance the effectiveness of these programmes.

Quadriceps electromyography during flywheel-based inertial training (FIT) and dynamic constant external resistance (DCER) squats at similar tempo

Flywheel-based iso-inertial training (FIT) has been purported to provide enhanced adaptations to muscle overload compared to dynamic constant external resistance (DCER), but previous studies have not controlled for exercise intensity. We compared quadriceps electromyography (EMG) amplitude between FIT- and DCER-squats with similar tempo. Eleven (5 M and 6F) resistance-trained participants completed sets of five maximal velocity FIT (0.025 kg∙m2) and DCER (55 ± 15 %1RM) squats. Sagittal plane knee joint angles and surface EMG activity of the vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) were measured. Repetition time and peak knee angles were similar between FIT and DCER squats. Mean knee angular velocity during the concentric (122.2 ± 23.6 vs. 108.9 ± 22.9, p = 0.022, Cohen's D: 0.820), but not eccentric, phase was significantly greater during FIT. Peak VM (210.4 ± 49.3 vs. 177.5 ± 56.3 %MVIC, p = 0.001; Cohen's D: 1.416), but not VL or RF, EMG amplitude was significantly greater in FIT compared to DCER. Mean EMG amplitude was significantly (p < 0.001) greater during the concentric than the eccentric phase for the VL and VM but not RF. Mean EMG amplitude was not significantly different between modes during either the concentric or eccentric phase. Quadriceps EMG amplitude is largely similar between FIT and DCER squats when matched for movement velocity.

Relationship between histological findings of vastus lateralis muscle and function after total hip arthroplasty in patients with hip fracture: a prospective cohort study

BACKGROUND AND PURPOSE

 We aimed to examine the histological characteristics of vastus lateralis muscles in patients undergoing total hip arthroplasty (THA) following femoral neck fractures and to explore the correlation between muscle fiber types and postoperative functional recovery.

METHODS

 34 patients undergoing THA for femoral neck fractures were included. A biopsy of the vastus lateralis muscle was performed during surgery, followed by immunohistochemical staining. Subsequently, image analysis was conducted to measure the average area of muscle fiber types and the number of type I and II muscle fibers, and the ratio of the area and the number of type II muscle fibers. Functional recovery was assessed 2 weeks post-surgery using the Short Physical Performance Battery (SPPB).

RESULTS

A significant positive correlation was observed between type II muscle fibers and SPPB scores. The ratio of type II muscle fiber area and number strongly correlated with the SPPB scores, indicating a robust static association. The average area of type II fibers showed a strong correlation (r = 0.63, P < 0.001), as did the number of type II fibers (r = 0.53, P = 0.001). Moreover, the ratio of type II muscle fiber area and number significantly correlated with SPPB scores (area: r = 0.77, P < 0.001; number: r = 0.51, P = 0.002), indicating that larger and more numerous type II fibers are associated with better physical performance.

CONCLUSION

The reduction of type II muscle fibers was strongly correlated with a low SPPB postoperative functional recovery in patients who underwent THA following femoral neck fractures.

Electromyographic activity of the ankle and foot during functional exercises and traditional exercises

INTRODUCTION

Traditional exercises using an elastic band are often standard in clinical practice to gain muscle strength. Additionally, functional exercises are considered more representative of functional tasks or sport. However, it is unclear whether functional exercises are comparable to traditional exercises in activating the ankle joint and foot.

OBJECTIVE

The purpose of this study was to analyze the effects of functional exercise and traditional exercise on the muscle activity of the ankle joint and foot.

METHODS

Thirty women participated in this study. Using surface electromyographic, muscle activation of the Tibialis Anterior (TA), Peroneus Longus (FL), Peroneus Short (FC), Gastrocnemius Medialis (GM) and Flexor Digitorum Shortus (FCD) was measured in nine exercises (dorsiflexion with an elastic band, plantar flexion with an elastic band, inversion with an elastic band, eversion with an elastic band, towel curl, standing plantar flexion, squats with an elastic band on the foot, diagonal propulsion and propulsion with peroneal stimulation). The muscle activation was normalized by the activation in maximum voluntary isometric contraction.

RESULTS

Functional exercises showed larger mean EMG amplitudes than the traditional exercises for all muscle groups (p > 0.05).

CONCLUSION

Functional exercises provoked more activation compared with the traditional exercises. Functional exercises can be indicated to improve muscle function and functional task performance in populations that suffer dysfunction in ankle joint and foot.

High-load and low-volume warm-up increases performance in a resistance training session

INTRODUCTION

A warm-up is recommended prior to performing a resistance training workout. Understanding the dose-response effect of warm-up load intensities can contribute to subsequent workout performance. The aim of this study was to compare different warm-up load intensities on subsequent resistance training volume in a workout.

METHODS

Fifteen men who had at least six months of resistance training experience were evaluated. Three resistance training sessions were performed with warm-up load intensities of 40%, 60%, and 80% of the ten-repetition maximum was applied for 15, 10 and 5 repetitions, respectively. Each session consisted of the bench press, inclined leg press, and wide grip lat pulldown exercises performed for three sets to failure with 2 min rest between sets and exercises.

RESULTS

The 80% warm-up resulted in significantly greater total training volume (TTV) when compared to the 60% (p = 0.010) and 40% (p = 0.038) conditions. In addition, volume load and repetition performance were greater in the 80% condition versus the 60% condition for the bench press (p = 0.037 and p = 0.015, respectively). For the inclined leg press, the difference was close to significance with a probability value of p = 0.055 when comparing the 80% versus 40% protocols.

CONCLUSION

Before starting a resistance training session, it is recommended that a warm-up for each exercise be performed at 80% of the initial workout load.

Light weights are as effective as heavy weights for muscle activation in the Hammerobics exercise

PURPOSE

We previously reported that a Hammerobics exercise using weights can enhance trunk and lower extremity muscles, some studies suggested that training effects could also be expected without heavy weights. If the muscle activity induced by Hammerobics swinging with a 'light plastic ball' equals or surpasses that of the isometric static squat and synchronized squat with a heavy ball, this training approach could alleviate joint strain, fostering an exercise regimen universally accessible across generations, benefit for workouts sports and rehabilitation.

METHODS

Fifteen healthy men participated in this study. By using surface electromyography, muscle activities for the abductor hallucis, tibialis anterior, tibialis posterior, peroneus longus, rectus femoris, biceps femoris long head, semitendinosus, gluteus maximus, multifidus, and internal oblique muscles were measured during a light Hammerobics synchronized squat (HSS-light), Hammerobics synchronized squat, and conventional isometric squat, and statistically compared.

RESULTS

The front-to-back tibialis anterior activity of HSS-light was significantly higher than that of conventional isometric squat. The activities of all other muscles, except for the multifidus, were not significantly different between these exercises in the front-to-back and back-to-front phases. Compared to the Hammerobics synchronized squat, the light Hammerobics synchronized squat showed no differences in front-to-back tibialis anterior, rectus femoris, biceps femoris long head, and internal oblique activities and back-to-front abductor hallucis, tibialis anterior, rectus femoris, and internal oblique activities.

CONCLUSION

The HSS-light could stimulate muscles to the same level as the conventional isometric squat without weight bearing. While the HSS-light was less effective than the Hammerobics synchronized squat, there was no significant difference in internal oblique, rectus femoris, and tibialis anterior activities between these exercises. Hence, the HSS-light is an exercise method that can be viable approach to promoting accessible workouts sports and rehabilitation.

Progression of total training volume in resistance training studies and its application to skeletal muscle growth

Progressive overload describes the gradual increase of stress placed on the body during exercise training, and is often quantified (i.e. in resistance training studies) through increases in total training volume (i.e. sets × repetitions × load) from the first to final week of the exercise training intervention. Within the literature, it has become increasingly common for authors to discuss skeletal muscle growth adaptations in the context of increases in total training volume (i.e. the magnitude progression in total training volume). The present manuscript discusses a physiological rationale for progressive overload and then explains why, in our opinion, quantifying the progression of total training volume within research investigations tells very little about muscle growth adaptations to resistance training. Our opinion is based on the following research findings: (1) a noncausal connection between increases in total training volume (i.e. progressively overloading the resistance exercise stimulus) and increases in skeletal muscle size; (2) similar changes in total training volume may not always produce similar increases in muscle size; and (3) the ability to exercise more and consequently amass larger increases in total training volume may not inherently produce more skeletal muscle growth. The methodology of quantifying changes in total training volume may therefore provide a means through which researchers can mathematically determine the total amount of external 'work' performed within a resistance training study. It may not, however, always explain muscle growth adaptations.

Superiority of High-Load vs. Low-Load Resistance Training in Military Cadets

ABSTRACT

Øfsteng, SF, Hammarström, D, Knox, S, Jøsok, Ø, Helkala, K, Koll, L, Hanestadhaugen, M, Raastad, T, Rønnestad, BR, and Ellefsen, S. Superiority of high-load vs. low-load resistance training in military cadets. J Strength Cond Res 38(9): 1584-1595, 2024-Muscle strength and power are important determinants of soldiers' performance in modern warfare. Here, we compare the efficacy of 22 weeks of whole-body resistance training with high load (HL, 10 repetitions maximum/RM) and low load (LL, 30RM) for developing maximal muscle strength and power, performance, and muscle mass in moderately trained cadets (20 ± 1 year, f; n = 5, m; n = 22). Outcome measures were assessed at baseline and at week 22, in addition to a mid-intervention assessment at week 10. Twenty-two weeks of HL led to greater increases in muscle strength (upper limb, Δ 10%, 95% CI [2.8, 17.1], p = 0.01; lower limb, Δ 9.9%, CI [1.1, 18.6], p = 0.029), jump height (Δ 5.5%, CI [1.4, 9.6], p = 0.011), and upper limb lean mass (Δ 5.2%, CI [1, 9.4], p = 0.018) compared with LL. HL and LL led to similar changes in agility, muscle endurance performance, lower limb muscle mass, and cross-sectional area in m. vastus lateralis. For all variables, training-associated changes occurred primarily during the initial 10 weeks of the intervention, including the differential responses to HL and LL. In conclusion, although 22 weeks of HL led to greater increases in lower and upper limb muscle strength, power, and upper limb lean mass than LL, the 2 load conditions led to similar improvements in agility performance and lower limb muscle mass. Our results thus indicate that both loading regimes elicit multifaceted physiological improvements important for military readiness.

Innovations in the Assessment of Skeletal Muscle Health: A Glimpse into the Future

Skeletal muscle is the largest organ system in the human body and plays critical roles in athletic performance, mobility, and disease pathogenesis. Despite growing recognition of its importance by major health organizations, significant knowledge gaps remain regarding skeletal muscle health and its crosstalk with nearly every physiological system. Relevant public health challenges like pain, injury, obesity, and sarcopenia underscore the need to accurately assess skeletal muscle health and function. Feasible, non-invasive techniques that reliably evaluate metrics including muscle pain, dynamic structure, contractility, circulatory function, body composition, and emerging biomarkers are imperative to unraveling the complexities of skeletal muscle. Our concise review highlights innovative or overlooked approaches for comprehensively assessing skeletal muscle in vivo. We summarize recent advances in leveraging dynamic ultrasound imaging, muscle echogenicity, tensiomyography, blood flow restriction protocols, molecular techniques, body composition, and pain assessments to gain novel insight into muscle physiology from cellular to whole-body perspectives. Continued development of precise, non-invasive tools to investigate skeletal muscle are critical in informing impactful discoveries in exercise and rehabilitation science.

Postural Control and Neuromuscular Activation in 11-13-Year-Old Athletic Boy Swimmers

OBJECTIVE

This study compared postural control and neuromuscular activation in athletic swimmers (A-S) and non-athletic swimmers (N-A-S) in older children.

METHODS

Ten A-S and ten N-A-S underwent assessments of center of pressure (CoP) parameters under static and dynamic surfaces in two directions (dynamic mediolateral (DML) and dynamic anteroposterior (DAP)) in eyes-open (EO) and eyes-closed (EC) conditions, and electromyography (EMG) parameters under DAP and DML directions in EO and EC conditions.

RESULTS

Results showed that A-S demonstrated significantly superior postural control (p < 0.05), with smaller CoP area and lower CoP mean velocity compared with N-A-S, particularly in static with EC, DAP with EO and EC, and DML with EO conditions. A-S exhibited significantly larger neuromuscular activation amplitudes (p < 0.05), especially in the AP direction.

CONCLUSIONS

These findings suggested that athletic swimming training may enhance postural control and neuromuscular activation in 11-13-year-old children, emphasizing the potential benefits of incorporating swimming exercises in these children.

Differences in knee flexor and extensor force and kinematic variables in rural versus urban area female students in Romania

The study aimed to identify and explain the typical differences in low-intensity high-volume resistance training (LIHV-RT) performances for major muscle groups between rural versus urban young female students to establish the relevant set of quantitative and qualitative resistance training parameters. The study sample included 46 recreational active female students at the Transilvania University of Brașov, (mean ± SD age, 20 ± 1 year; body mass, 60 ± 3 kg; height, 160 ± 4 cm) grouped urban vs. rural. The study used modified resistance exercise machines for the hamstring- and quadricep-group muscles, equipped with a dynamometer and sensors for identifying developed forces and accelerations. A number of 368 tests were performed, representing two attempts for each subject, for knee flexion and knee extension exercises, with two different loads. For the performance analysis some variables were considered: the maximum number of repetition until failure, maximum force developed, maximum acceleration, the duration of the set and the mean time per repetition. The maximum number of repetition to failure shows a significant higher value for rural than urban in case of knee flexion (d = 0.98 [0.32, 1.54] for load 1(L1) and d = 0.65 [0.03, 1.21] for load 2(L2)) and in case of knee extension (d = 1.89 [1.11, 2.48] for L1 and d = 1.67 [0.92, 2.25] for L2). The total duration of the sets shows a significant higher value for rural than urban in case of knee flexion (d = 0.84 [0.19, 1.39] for L2) and in case of knee extension (d = 1.46 [0.74, 2.03] for L1 and d = 1.56 [0.98, 2.14] for L2). Additionally we found differences in the quality of the relevant repetitions execution and in the impulse developed during the LIHV- MNRF sets. The study's main finding was that there are differences in LIHV-RT performances knee flexion and knee extension antagonistic exercises, between rural and urban female students. We concluded that the obtained results allow teachers to understand the optimal design of RT programs for the different groups of participants, in order to adapt their teaching techniques so that their final objectives are achieved, insisting on particular aspects of the theoretical or practical contents.

Changes in muscular strength following nine weeks of high- or low-load resistance training

BACKGROUND

Traditional resistance training schemes often utilize higher loads for strength gains and lower loads for muscular endurance or hypertrophy. This study aimed to investigate muscular strength adaptations after nine weeks of high- or low-load resistance training.

METHODS

Seventeen recreationally-trained male lifters were recruited for this study (age 20.4±2.7 years) and split into high-load (85% 1-RM; N.=8) or low-load (30% 1-RM; N.=9), completing three whole-body training sessions per week for nine weeks. Each session included three working sets of repetitions to failure. At baseline and every three weeks after, knee extension/flexion were tested using an isokinetic dynamometer. Participants completed three 5-s MVIC and isokinetic muscle actions at 60°/s and 120°/s, with the highest torque value used in analysis. Predicted 1-RM testing was at baseline and end of training program. ANCOVAs were conducted to analyze changes in strength, with significance set at P<0.05.

RESULTS

This study demonstrated similar MVIC and peak torque values for both isokinetic speeds, although there were nonsignificant decreases largely driven by the 30% group. The high-load group showed greater increases in 1-RM following the training program.

CONCLUSIONS

This study suggests training with lighter loads may be detrimental for long term isokinetic strength, whereas heavier loads could result in maintenance and greater increases in 1-RM despite performing repetitions to failure.

Effects of Chronic Static Stretching on Maximal Strength and Muscle Hypertrophy: A Systematic Review and Meta-Analysis with Meta-Regression

BACKGROUND

Increases in maximal strength and muscle volume represent central aims of training interventions. Recent research suggested that the chronic application of stretch may be effective in inducing hypertrophy. The present systematic review therefore aimed to syntheisize the evidence on changes of strength and muscle volume following chronic static stretching.

METHODS

Three data bases were sceened to conduct a systematic review with meta-analysis. Studies using randomized, controlled trials with longitudinal (≥ 2 weeks) design, investigating strength and muscle volume following static stretching in humans, were included. Study quality was rated by two examiners using the PEDro scale.

RESULTS

A total of 42 studies with 1318 cumulative participants were identified. Meta-analyses using robust variance estimation showed small stretch-mediated maximal strength increases (d = 0.30 p < 0.001) with stretching duration and intervention time as significant moderators. Including all studies, stretching induced small magnitude, but significant hypertrophy effects (d = 0.20). Longer stretching durations and intervention periods as well as higher training frequencies revealed small (d = 0.26-0.28), but significant effects (p < 0.001-0.005), while lower dosage did not reach the level of significance (p = 0.13-0.39).

CONCLUSIONS

While of minor effectiveness, chronic static stretching represents a possible alternative to resistance training when aiming to improve strength and increase muscle size. As a dose-response relationship may exist, higher stretch durations and frequencies as well as long program durations should be further elaborated.

Ladder-based resistance training with the progression of training load altered the tibial nerve ultrastructure and muscle fiber area without altering the morphology of the postsynaptic compartment

Scientific evidence regarding the effect of different ladder-based resistance training (LRT) protocols on the morphology of the neuromuscular system is scarce. Therefore, the present study aimed to compare the morphological response induced by different LRT protocols in the ultrastructure of the tibial nerve and morphology of the motor endplate and muscle fibers of the soleus and plantaris muscles of young adult Wistar rats. Rats were divided into groups: sedentary control (control, n = 9), a predetermined number of climbs and progressive submaximal intensity (fixed, n = 9), high-intensity and high-volume pyramidal system with a predetermined number of climbs (Pyramid, n = 9) and lrt with a high-intensity pyramidal system to exhaustion (failure, n = 9). myelinated fibers and myelin sheath thickness were statistically larger in pyramid, fixed, and failure. myelinated axons were statistically larger in pyramid than in control. schwann cell nuclei were statistically larger in pyramid, fixed, and failure. microtubules and neurofilaments were greater in pyramid than in control. morphological analysis of the postsynaptic component of the plantar and soleus muscles did not indicate any significant difference. for plantaris, the type i myofibers were statistically larger in the pyramid and fixed compared to control. the pyramid, fixed, and failure groups for type ii myofibers had larger csa than control. for soleus, the type i myofibers were statistically larger in the pyramid than in control. pyramid and fixed had larger csa for type ii myofibers than control and failure. the pyramid and fixed groups showed greater mass progression delta than the failure. We concluded that the LRT protocols with greater volume and progression of accumulated mass elicit more significant changes in the ultrastructure of the tibial nerve and muscle hypertrophy without endplate changes.

Can resistance training improve throwing performance in handball players? A Systematic review and meta-analysis

BACKGROUND

Throwing is one of the most important movement in handball. Throwing performance is crucial for success in handball.

OBJECTIVE

Τo investigate the level of evidence for the effect of resistance training (RT) on throwing performance in handball players.

METHODS

Systematic searches of Pubmed, Medline complete, Cinahl, Sport Discus and Scopus were undertaken for peer reviewed articles published between 18 March 1995 to 18 March 2023. Randomized, controlled, clinical studies, written in English, aiming to investigate the effect at least one modality of RT on throwing performance (velocity or/and accuracy) in handball players were considered for inclusion in the study. The eligible studies were assessed for methodological quality using the Physical Therapy Evidence Database (PEDRO) scale. The Best Evidence Synthesis (BES) approach was used for synthesizing and reporting the results. Furthermore, the random-effects model was used for the meta-analysis and the Q-statistic was used to test the null hypothesis that all studies in the analysis share a common effect size.

RESULTS

One hundred ninety-eight studies were identified, of which 30 were included. A total of 727 handball players (males = 388, females = 292) were included. 28 of the 30 studies were rated as high methodological quality studies (PEDRO score > 70%) while the rest of the studies were rated as moderate methodological quality studies (PEDRO score ≤ 60%). The mean effect size for the effectiveness of resistance training (RT) in improving jumping throw, running throw, and standing throw velocity were 1.128 (95% CI 0.457 - 1.798), 1.756 (95% CI 1.111 - 2.400), and 1.098 (95% CI 0.689 - 1.507) correspondingly. Traditional weight training using barbells in mostly compound lifts yielded the most significant and robust results. Other RT modalities such as elastic bands, medicine balls, core training and ballistic training showed no significant results or positive effects due to the limited number of the studies.

CONCLUSION

Strong evidence exists only for the effectiveness of RT using barbells in increasing throwing velocity. In contrast, the remaining RT modalities, while yielding positive results, have limited support due to limited number of studies and the high heterogeneity between studies. Furthermore, there is insufficient evidence to support various forms of RT in increasing throw distance. Finally, medicine ball training and elastic band training demonstrated no benefits in improving throwing accuracy.

TRIAL REGISTRATION

PROSPERO ID: CRD42023393574.

Resistance Training to Muscle Failure with Variable Load Intensities: Implications for Post-Exercise Blood Pressure and Heart Rate Variability in Trained Men

Background: The modulation of cardiac sympathovagal balance alters following acute resistance training (RT) sessions. Nevertheless, the precise influence of RT at varying load intensities on this physiological response remains to be fully elucidated. Therefore, the aim of this study was to compare the time course of recovery following low- (40%), moderate- (60%), and high- (80%) load-intensity RT protocols performed up to muscle repetition failure in resistance-trained men. Method: Sixteen young, resistance-trained men (mean age: 21.6 ± 2.5 years, mean height: 175.7 ± 8.9 cm, mean weight: 77.1 ± 11.3 kg) participated in a randomized crossover experimental design involving three sessions, each taken to the point of muscle failure. These sessions were characterized by different load intensities: low (40% of 1-repetition maximum, 1RM), moderate (60% of 1RM), and high (80% of 1RM). The exercise regimen comprised four exercises-back squat (BS), bench press (BnP), barbell row (BR), and shoulder press (SP)-with each exercise consisting of three sets. Throughout each session, heart rate variability (HRV) and blood pressure (BP) parameters were assessed both pre-exercise and during a 40 min post-exercise period, segmented into 10 min intervals for stabilization. Statistical analysis involved the use of a repeated measures ANOVA. Results: It was observed that the 40% and 60% RT sessions resulted in a significantly higher root mean square of successive R-R intervals (RMSSD) value compared to the 80% RT session in the post-exercise recovery process in 30 min (respectively, p = 0.025; p = 0.028) and 40 min (respectively, p = 0.031; p = 0.046), while the 40% and 60% RT sessions produced similar responses. The 40% RT session was significantly higher in the high frequency (HF) value post-exercise in 40 min compared to the 80% RT session (p = 0.045). Conclusions: Our findings suggest that engaging in resistance training (RT) sessions to muscle failure at an intensity of 80% induces acute increases in sympathetic activity, potentially leading to elevated cardiovascular stress. For individuals with normal blood pressure, it is advisable to opt for lighter loads and higher repetition volumes when prescribing RT, as heavier-load RT may carry an increased risk of cardiac-related factors.

Understanding the variation in exercise responses to guide personalized physical activity prescriptions

Understanding the factors that contribute to exercise response variation is the first step in achieving the goal of developing personalized exercise prescriptions. This review discusses the key molecular and other mechanistic factors, both extrinsic and intrinsic, that influence exercise responses and health outcomes. Extrinsic characteristics include the timing and dose of exercise, circadian rhythms, sleep habits, dietary interactions, and medication use, whereas intrinsic factors such as sex, age, hormonal status, race/ethnicity, and genetics are also integral. The molecular transducers of exercise (i.e., genomic/epigenomic, proteomic/post-translational, transcriptomic, metabolic/metabolomic, and lipidomic elements) are considered with respect to variability in physiological and health outcomes. Finally, this review highlights the current challenges that impede our ability to develop effective personalized exercise prescriptions. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) aims to fill significant gaps in the understanding of exercise response variability, yet further investigations are needed to address additional health outcomes across all populations.

Proteomic Profiling of Muscular Adaptations to Short-Term Concentric Versus Eccentric Exercise Training in Humans

The molecular mechanisms underlying muscular adaptations to concentric (CON) and eccentric (ECC) exercise training have been extensively explored. However, most previous studies have focused on specifically selected proteins, thus, unable to provide a comprehensive protein profile and potentially missing the crucial mechanisms underlying muscular adaptation to exercise training. We herein aimed to investigate proteomic profiles of human skeletal muscle in response to short-term resistance training. Twenty young males were randomly and evenly assigned to two groups to complete a 4-week either ECC or CON training program. Measurements of body composition and physiological function of the quadriceps femoris were conducted both before and after the training. Muscle biopsies from the vastus lateralis of randomly selected participants (five in ECC and four in CON) of both before and after the training were analyzed using the liquid-chromatography tandem mass spectrometry in combination with bioinformatics analysis. Neither group presented a significant difference in body composition or leg muscle mass; however, muscle peak torque, total work, and maximal voluntary contraction were significantly increased after the training in both groups. Proteomics analysis revealed 122 differentially abundant proteins (DAPs; p value < 0.05 & fold change >1.5 or <0.67) in ECC, of which the increased DAPs were mainly related to skeletal muscle contraction and cytoskeleton and enriched specifically in the pentose phosphate pathway, extracellular matrix-receptor interaction, and PI3K-Akt signaling pathway, whereas the decreased DAPs were associated with the mitochondrial respiratory chain. One hundred one DAPs were identified in CON, of which the increased DAPs were primarily involved in translation/protein synthesis and the mitochondria respiratory, whereas the decreased DAPs were related to metabolic processes, cytoskeleton, and de-ubiquitination. In conclusion, the 4-week CON and ECC training resulted in distinctly different proteomic profiles, especially in proteins related to muscular structure and metabolism.

Effects of blood flow restriction therapy in patients with knee osteoarthritis: protocol for an overview of systematic reviews

Background

Osteoarthritis (OA) is the most common and prevalent musculoskeletal disease associated with population aging, negatively impacting function and quality of life. A consequence of knee OA is quadriceps muscle weakness. Musculoskeletal rehabilitation using low load exercises, associated with Blood Flow Restriction (BFR) may be a useful alternative to high load exercises when those cannot be tolerated. Several systematic reviews have reported inconclusive results due to discrepancies in study findings, heterogeneity of results, evaluated time points, and research questions explored.

Objective

To perform an overview of systematic reviews with meta-analyses, synthesizing the most recent evidence on the effects of muscle strength training with BFR for knee OA.

Methodology

Systematic reviews that include primary controlled and randomized clinical trials will be considered for inclusion. Articles will be considered only if they present a clear and reproducible methodological structure, and when they clearly demonstrate that a critical analysis of the evidence was carried out using instrumented analysis. Narrative reviews, other types of review, overviews of systematic reviews, and diagnostic, prognostic and economic evaluation studies will be excluded. Studies must include adults aged 40 years and older with a diagnosis of knee OA. Two authors will perform an electronic search with guidance from an experienced librarian. The following databases will be searched: PubMed via MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), PEDro, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Web of Science, and the gray literature. The search strategy used in the databases will follow the acronym PICOS (population, intervention, comparison, outcome, and study design). Screening (i.e., titles and abstracts) of studies identified by the search strategy will be selected using Rayyan (http://rayyan.qcri.org). The quality assessment will be performed using the "Assessment of Multiple Systematic Reviews" (AMSTAR-2) tool.

Systematic Review Registration

PROSPERO, CRD42022367209.

Improving Cardiorespiratory and Muscular Function of Korean Firefighters: A Kinect-Based Mixed Reality Device Exercise Intervention Randomized Control Trial

OBJECTIVE

This study addresses declining physical fitness among Korean firefighters due to a low exercise participation rate caused by the absence of exercise instructors. The research explores Virtual Mate (VM), a Kinect-based mixed reality device, as a potential solution, but its capacity to replace training instructors in enhancing physical fitness remains uncertain.

METHODS

Twenty Korean male firefighters were divided into two groups: the exercise group received an 8-week intervention using VM, while the control group maintained regular physical activity. Cardiopulmonary function and muscle function were measured.

RESULTS

After 8 weeks, the exercise group demonstrated a significant improvement in VO 2peak . Furthermore, there were notable enhancements in the strength and endurance of most knee, shoulder, and trunk flexors and extensors.

CONCLUSIONS

Integrating VM into an exercise program can effectively improve cardiorespiratory and muscular function in Korean firefighters.

Comparison of kinematics and electromyography in the last repetition during different maximum repetition sets in the barbell back squat

Background

The barbell squat is an exercise used to strengthen the lower limbs, with implications for both performance in sports and improving movement during everyday tasks. Although the exercise is being trained across a variety of repetition ranges, the technical requirements may vary, affecting appropriate repetition range for specific training goals.

Methods

A randomised within-subject design was used to compare kinematics and surface electromyography (EMG) in the lower extremities during different concentric phases (pre-, sticking- and post-sticking region) of the last repetition when performing squats at different repetition maximums (RMs). Thirteen strength-trained men (age: 23.6 ± 1.9 years; height: 181.1 ± 6.5 cm; body mass: 82.2 kg, 1RM: 122.8 ± 16.2, relative strength: 1.5 ± 0.2 x body mass in external load) performed a 1, 3, 6, and 10RM squat, in a randomised order.

Results

The main findings were that barbell-, ankle-, knee- and hip kinematics were similar across different repetition ranges, except for a smaller trunk lean at 1RM in the pre-sticking region compared to other repetitions and in the sticking region compared to 10RM (p ≤ 0.04). Furthermore, 1RM revealed significantly higher EMG amplitude in the vastus lateralis, gastrocnemius and soleus in the sticking and post-sticking regions when compared to 10RM. It was concluded that 10RM may locally fatigue the vastus lateralis and plantar flexors, explaining the lower EMG amplitude. The observed differences indicate that requirements vary for completing the final repetition of the 10RM compared to the 1RM, an important aspect to consider in training to enhance 1RM strength.

The Connection Between Resistance Training, Climbing Performance, and Injury Prevention

BACKGROUND

Climbing is an intricate sport composed of various disciplines, holds, styles, distances between holds, and levels of difficulty. In highly skilled climbers the potential for further strength-specific adaptations to increase performance may be marginal in elite climbers. With an eye on the upcoming 2024 Paris Olympics, more climbers are trying to maximize performance and improve training strategies. The relationships between muscular strength and climbing performance, as well as the role of strength in injury prevention, remain to be fully elucidated. This narrative review seeks to discuss the current literature regarding the effect of resistance training in improving maximal strength, muscle hypertrophy, muscular power, and local muscular endurance on climbing performance, and as a strategy to prevent injuries.

MAIN BODY

Since sport climbing requires exerting forces against gravity to maintain grip and move the body along the route, it is generally accepted that a climber`s absolute and relative muscular strength are important for climbing performance. Performance characteristics of forearm flexor muscles (hang-time on ledge, force output, rate of force development, and oxidative capacity) discriminate between climbing performance level, climbing styles, and between climbers and non-climbers. Strength of the hand and wrist flexors, shoulders and upper limbs has gained much attention in the scientific literature, and it has been suggested that both general and specific strength training should be part of a climber`s training program. Furthermore, the ability to generate sub-maximal force in different work-rest ratios has proved useful, in examining finger flexor endurance capacity while trying to mimic real-world climbing demands. Importantly, fingers and shoulders are the most frequent injury locations in climbing. Due to the high mechanical stress and load on the finger flexors, fingerboard and campus board training should be limited in lower-graded climbers. Coaches should address, acknowledge, and screen for amenorrhea and disordered eating in climbers.

CONCLUSION

Structured low-volume high-resistance training, twice per week hanging from small ledges or a fingerboard, is a feasible approach for climbers. The current injury prevention training aims to increase the level of performance through building tolerance to performance-relevant load exposure and promoting this approach in the climbing field.

Effects of blood flow restriction training on sports performance in athletes: a systematic review with meta-analysis

INTRODUCTION

Blood flow restriction training (BFRT) is an effective training method to improve sports performance in healthy athletes. Nevertheless, a systematic review with meta-analysis regarding how BFRT affects sports performance in athletes is still lacking. Consequently, the study attempted to expand and consolidate the prior studies regarding the effect of BFRT on technical and physical performance in athletes.

EVIDENCE ACQUISITION

This study was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyzes) statement guidelines for a systematic review of the academic databases Scopus, Web of Science, PubMed, EBSCOhost (SportDiscus), and Google Scholar. The PEDro scale was used to assess the methodological quality of the included publications, which ranged from moderate to high quality. The systematic review protocol was registered on inplasy.com (INPLASY202380049).

EVIDENCE SYNTHESIS

Out of 249 studies identified, 93 articles were evaluated as eligible, and after the screening, 18 studies were finally included in this systematic review. Meta-analysis results showed a significant enhancement on vertical jump height in the BFRT group compared to the control group (SMD=1.39, 95% CI=0.30-2.49, P=0.01). BFRT was able to significantly increase maximal oxygen uptake (SMD=1.65, 95% CI=0.56-2.74, P<0.01). While no significant improvement in sprint time was observed (SMD= -0.18, 95% CI=-1.18-0.82, P=0.115).

CONCLUSIONS

The finding suggests that BFRT is beneficial to athletes as this training method can be effective in enhancing physical and technical performance in athletes. Nevertheless, further analysis needs to be conducted to fully determine the effectiveness of the moderators of the intervention on sports performance.

Fascia Tissue Manipulations in Chronic Low Back Pain: A Pragmatic Comparative Randomized Clinical Trial of the 4xT Method® and Exercise Therapy

BACKGROUND

The 4xT method is a protocolized practice in treating musculoskeletal disorders. The 4xT method consists of four components: Test (functional diagnostic test), Trigger (fascia tissue manipulations), Tape (elastic taping), and Train (exercise). There is a lack of clinical studies evaluating the treatment effects of the use of the 4xT method.

METHODS

A randomized controlled trial was conducted to compare the effectiveness of the 4xT method and exercise therapy-only in patients with chronic nonspecific low back pain. Based on a priori sample size calculation, fifty-one individuals with chronic nonspecific low back pain were randomly assigned to either the 4xT or exercise group. Both groups underwent a six-week rehabilitation program with two treatments per week. The primary outcomes were trunk flexion and extension mobility, trunk flexion, and extension mobility-dependent pain, and quality of life evaluated during a 6-week therapy period and after a 6-week therapy-off period.

RESULTS

Interaction effects were noted in all outcomes. The 4xT group showed significant improvements over time for trunk flexion and extension mobility, trunk flexion and extension mobility-dependent pain, and quality of life (p < 0.05), with no significant relapse post-therapy (except for extension mobility). The exercise group exhibited significant within-time changes in the quality of life, as measured with the VAS (p < 0.05), but not for EQ-5D-3L.

CONCLUSIONS

The results of this study demonstrate that the 4xT method stands out as a promising and impactful treatment option for chronic nonspecific low back pain individuals, as it demonstrated significant reductions in mobility-dependent pain, increased trunk mobility, and improved quality of life compared to exercise-only treatments.

Effects of Low-Load, High-Repetition Resistance Training on Maximum Muscle Strength and Muscle Damage in Elite Weightlifters: A Preliminary Study

This study aimed to assess the impact of different resistance training (RT) loads and repetition on muscle damage, intramuscular anabolic signaling, and maximal muscle strength (MMS) in weightlifters. Eighteen male weightlifters were randomly assigned to 8 weeks of supervised RT regimes: high-load, low-repetition (HL), low-load, high-repetition (LH), and combination of HL and LH (COMBI). All groups exhibited a significant increase in skeletal muscle mass (SMM) and growth hormone levels, which ultimately contributed to improvement in MMS as indicated by 1-repetition maximum in the back squat and back muscle strength. Notably, while there were no significant changes in the mTOR protein, the phosphorylation of phosphorylation of p70 ribosomal protein S6 kinase 1 (p70S6K1), eukaryotic initiation factor 4E-binding protein 1 (4E-BP1), and eukaryotic elongation factor 2 (eEF2), which are involved in muscle cell growth, was significantly affected by the different training regimens. More importantly, LH-RT led to a significant reduction in muscle damage markers, creatine kinase (CK) and lactate dehydrogenase (LDH), suggesting reduced recovery time and fatigue. Our results demonstrated that the LH-RT paradigm could be a viable alternative for weightlifters to enhance MMS and muscle hypertrophy similar to HL-RT, while reducing RT-induced muscle damage, ultimately contributing to the enhancement of exercise performance.

The effect of fish oil supplementation on resistance training-induced adaptations

BACKGROUND

Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may augment RET-induced adaptations. However, few studies have been conducted on young, healthy adults.

METHODS

A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3 days·week^-1). Body composition was measured by dual-energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum barbell back squat (1RM_SQT) and bench press (1RM_BP) at PRE (week 0) and POST (10 weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An a priori α-level of 0.05 was used to determine statistical significance and Cohen's d was used to quantify effect sizes (ES).

RESULTS

Twenty-one of 28 male and female participants (FOS, n = 10 [4 withdrawals]; PL, n = 11 [3 withdrawals]) completed the 10-week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, p< .001) and did not change in the PL group (+1.3%, p = .938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, p = .457), FM (FOS: -5.2%, PL: 0.0%, p = .092), and %BF (FOS: -5.9%, PL: -2.5%, p = .136) were observed, although, the between-group ES was considered large for FM (d = 0.84). Absolute and relative (kg·kg [body mass]^-1) 1RM_BP was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, p = .047; FOS: +17.6% vs. PL: +7.3%, p = .011; respectively), whereas absolute 1RM_SQT was similar between conditions (FOS: +28.8% vs. PL: +20.5%, p = .191). Relative 1RM_SQT was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, p = .045).

CONCLUSIONS

When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults.

Physiology of Stretch-Mediated Hypertrophy and Strength Increases: A Narrative Review

Increasing muscle strength and cross-sectional area is of crucial importance to improve or maintain physical function in musculoskeletal rehabilitation and sports performance. Decreases in muscular performance are experienced in phases of reduced physical activity or immobilization. These decrements highlight the need for alternative, easily accessible training regimens for a sedentary population to improve rehabilitation and injury prevention routines. Commonly, muscle hypertrophy and strength increases are associated with resistance training, typically performed in a training facility. Mechanical tension, which is usually induced with resistance machines and devices, is known to be an important factor that stimulates the underlying signaling pathways to enhance protein synthesis. Findings from animal studies suggest an alternative means to induce mechanical tension to enhance protein synthesis, and therefore muscle hypertrophy by inducing high-volume stretching. Thus, this narrative review discusses mechanical tension-induced physiological adaptations and their impact on muscle hypertrophy and strength gains. Furthermore, research addressing stretch-induced hypertrophy is critically analyzed. Derived from animal research, the stretching literature exploring the impact of static stretching on morphological and functional adaptations was reviewed and critically discussed. No studies have investigated the underlying physiological mechanisms in humans yet, and thus the underlying mechanisms remain speculative and must be discussed in the light of animal research. However, studies that reported functional and morphological increases in humans commonly used stretching durations of > 30 min per session of the plantar flexors, indicating the importance of high stretching volume, if the aim is to increase muscle mass and maximum strength. Therefore, the practical applicability seems limited to settings without access to resistance training (e.g., in an immobilized state at the start of rehabilitation), as resistance training seems to be more time efficient. Nevertheless, further research is needed to generate evidence in different human populations (athletes, sedentary individuals, and rehabilitation patients) and to quantify stretching intensity.

Effects of blood-flow restricted exercise versus conventional resistance training in musculoskeletal disorders-a systematic review and meta-analysis

OBJECTIVE

To compare the effect of low-load blood flow restricted resistance training (BFR-RT) versus high-load resistance training (HL-RT) on muscle strength, muscle mass, physical function, patient-reported outcomes, and adherence to training in clinical musculoskeletal populations.

DATA SOURCES

Web of Science, Cochrane Central, Medline, Embase, SportDiscus was searched on the 30th May 2022.

REVIEW METHODS

This study was conducted as a systematic review and meta-analysis. Randomized Controlled Trials (RCTs) were included if they (i) included patients, (ii) comprised of a BFR-RT intervention protocol and a group who performed HL-RT (≥ 70%1RM) for at least eight exercise sessions, and (iii) involved at least 1 exercise that targeted the lower limbs. The Cochrane Risk of Bias tool was used to evaluate the risk of bias. The meta-analyses were performed using a random effects model with an adjustment to the confidence interval.

RESULTS

Seven RCTs comprising 303 participants (BFR-RT: n = 151; HL-RT: n = 152) were identified. HL-RT and BFR-RT showed similar gains in dynamic (1-10RM) knee extensor strength and leg press strength, quadriceps cross sectional area, sit-to-stand performance, and patient reported pain and function. There was a moderate effect favoring BFR-RT for increasing maximal isometric knee extensor strength. The grading of certainty in evidence was low-to-very low for all outcome variables.

CONCLUSION

This systematic review and meta-analysis extends our current knowledge about BFR-RT and HL-RT as equally effective exercise methods for inducing gains in maximal muscle strength in healthy populations, by now also comprising patients suffering from various clinical musculoskeletal conditions. The certainty in the estimates was low-to-very low, prompting the inclusion of future higher-quality trials.

TRIAL REGISTRATION

PROSPERO ID (CRD42022337173). Registered June 18th 2022.

Effects of manual resistance versus weight resistance training on body composition and strength in young adults after a 14-week intervention

Manual Resistance Training (MRT) is an alternative training modality where the external resistance is provided by a spotter.

PURPOSE

The purpose of this study was to observe changes in body composition and muscular fitness after a 14-week MRT intervention compared to changes elicited by a Weight Resistance Training (WRT) intervention.

METHODS

Eighty-four young adults were randomly assigned to either the MRT (n = 53, height 170.1 ± 8.1 cm, body mass 73.9 ± 16.0 kg, and body fat 24.6 ± 8.7%) or WRT (n = 31, mean ± SD: height 169.6 ± 10.1 cm, body mass 75.0 ± 17.4 kg, and body fat 24.7 ± 8.5%) group. Body composition was assessed by Dual-energy X-ray Absorptiometry (DEXA), muscular strength and muscular endurance were tested before and after the intervention.

RESULTS

Findings indicated that trunk, arm, leg, and total lean mass increased in both groups after the intervention (p < 0.05). Moreover, total fat mass significantly decreased compared to baseline in both groups (p < 0.05). However, no statistically significant changes were observed in Bone Mineral Density and Bone Mineral Content in response to the intervention. Both MRT and WRT programs were successful at significantly increasing muscular strength and endurance (p < 0.05).

CONCLUSION

The changes in body composition after a 14-week MRT program were similar to those of the WRT intervention. Hence, an MRT program may be effectively used to increase lean mass and decrease fat mass.

Lifting velocity predicts the maximum number of repetitions to failure with comparable accuracy during the Smith machine and free-weight prone bench pull exercises

This study compared the accuracy of the fastest mean velocity from set (MVfastest) to predict the maximum number of repetitions to failure (RTF) between 2 variants of prone bench pull (PBP) exercise (Smith machine and free-weight) and 3 methods (generalized, individualized multiple-point, and individualized 2-point). Twenty-three resistance-trained males randomly performed 2 sessions during Smith machine PBP and 2 sessions during free-weight PBP in different weeks. The first weekly session determined the RTF-MVfastest relationships and subjects completed single sets of repetitions to failure against 60-70-80-90%1RM. The second weekly session explored the accuracy of RTFs prediction under fatigue conditions and subjects completed 2 sets of 65%1RM and 2 sets of 85%1RM with 2 min of rest. The MVfastest associated with RTFs from 1 to 15 were greater for Smith machine compared to free-weight PBP (F ≥ 42.9; P < 0.001) and for multiple-point compared to 2-point method (F ≥ 4.6; P ≤ 0.043). The errors when predicting RTFs did not differ between methods and PBP variants, whereas all RTF-MVfastest relationships overestimated the RTF under fatigue conditions. These results suggest that RTF-MVfastest relationships present similar accuracy during Smith machine and free-weight PBP exercises and it should be constructed under similar training conditions.

Evaluating the Asymmetry of Muscle Activation and Strength in Paralympic Powerlifting Athletes

BACKGROUND

Strength training is a complex task, as it requires a combination of many variables. In paralympic powerlifting (PP) asymmetries for the evaluation of activation, and static force indicators have been increasingly studied.

OBJECTIVE

To investigate the asymmetries in the strength and muscle activation indicators, before and after a training session of PP athletes.

METHODOLOGY

Twelve elite athletes from the PP participated in the study, and asymmetry was evaluated through surface electromyography (sEMG) and static strength indicators. Evaluations were made before and after a protocol of five series of five repetitions (5 × 5), with 80% of 1-Maximum Repetition (1RM).

RESULTS

In the pectoral muscles, there were differences in the non-dominant limbs between the before and after in the sEMG. There were differences in the pectoralis muscle in the non-dominant limb between moments before (110.75 ± 59.52%) and after (130.53 ± 98.48%, p < 0.001), and there was no difference in triceps activation. In the Maximum Isometric Strength (MIF), there was a difference in the non-dominant limb between before (710.36 ± 129.36) and after (620.27 ± 69.73; p < 0.030). There was a difference before in the dominant (626.89 ± 120.16; 95% CI 550.55-703.24) and non-dominant (710.36 ± 129.36; p = 0.011) limbs. There was no difference in time to MIF.

CONCLUSION

PP athletes showed small levels of asymmetry before and after training, and adaptation to training tends to promote fewer asymmetries.

The Effects of Resistance Training on Muscular Fitness, Muscle Morphology, and Body Composition in Elite Female Athletes: A Systematic Review

BACKGROUND

Well programmed strength and conditioning training is an indispensable part of the long-term training process for athletes in individual and team sports to improve performance and prevent injuries. Yet, there is a limited number of studies available that examine the effects of resistance training (RT) on muscular fitness and physiological adaptations in elite female athletes.

OBJECTIVES

This systematic review aimed to summarize recent evidence on the long-term effects of RT or combinations of RT with other strength-dominated exercise types on muscular fitness, muscle morphology, and body composition in female elite athletes.

MATERIALS AND METHODS

A systematic literature search was conducted in nine electronic databases (Academic Search Elite, CINAHL, ERIC, Open Access Theses and Dissertations, Open Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, and SPORTDiscus) from inception until March 2022. Key search terms from the MeSH database such as RT and strength training were included and combined using the operators "AND," "OR," and "NOT". The search syntax initially identified 181 records. After screening for titles, abstracts, and full texts, 33 studies remained that examined the long-term effects of RT or combinations of RT with other strength-dominated exercise types on muscular fitness, muscle morphology, and body composition in female elite athletes.

RESULTS

Twenty-four studies used single-mode RT or plyometric training and nine studies investigated the effects of combined training programs such as resistance with plyometric or agility training, resistance and speed training, and resistance and power training. The training duration lasted at least 4 weeks, but most studies used ~ 12 weeks. Studies were generally classified as 'high-quality' with a mean PEDro score of 6.8 (median 7). Irrespective of the type or combination of RT with other strength-dominated exercise regimens (type of exercise, exercise duration, or intensity), 24 out of 33 studies reported increases in muscle power (e.g., maximal and mean power; effect size [ES]: 0.23 < Cohen's d < 1.83, small to large), strength (e.g., one-repetition-maximum [1RM]; ES: 0.15 < d < 6.80, small to very large), speed (e.g., sprint times; ES: 0.01 < d < 1.26, small to large), and jump performance (e.g., countermovement/squat jump; ES: 0.02 < d < 1.04, small to large). The nine studies that examined the effects of combined training showed significant increases on maximal strength (ES: 0.08 < d < 2.41, small to very large), muscle power (ES: 0.08 < d < 2.41, small to very large), jump and sprint performance (ES: 0.08 < d < 2.41, small to very large). Four out of six studies observed no changes in body mass or percentage of body fat after resistance or plyometric training or combined training (ES: 0.026 < d < 0.492, small to medium). Five out of six studies observed significant changes in muscle morphology (e.g., muscle thickness, muscle fiber cross-sectional area; ES: 0.23 < d < 3.21, small to very large). However, one study did not find any changes in muscle morphology (i.e., muscle thickness, pennation angle; ES: 0.1 < d < 0.19, small).

CONCLUSION

Findings from this systematic review suggest that RT or combined RT with other strength-dominated exercise types leads to significant increases in measures of muscle power, strength, speed, and jump performance in elite female athletes. However, the optimal dosage of programming parameters such as training intensity and duration necessary to induce large effects in measures of muscular fitness and their physiological adaptations remain to be resolved in female elite athletes.

The Effect of Feedback on Resistance Training Performance and Adaptations: A Systematic Review and Meta-analysis

BACKGROUND

Augmented feedback is often used during resistance training to enhance acute physical performance and has shown promise as a method of improving chronic physical adaptation. However, there are inconsistencies in the scientific literature regarding the magnitude of the acute and chronic responses to feedback and the optimal method with which it is provided.

OBJECTIVE

This systematic review and meta-analysis aimed to (1) establish the evidence for the effects of feedback on acute resistance training performance and chronic training adaptations; (2) quantify the effects of feedback on acute kinematic outcomes and changes in physical adaptations; and (3) assess the effects of moderating factors on the influence of feedback during resistance training.

METHODS

Twenty studies were included in this systematic review and meta-analysis. This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases were searched, and studies were included if they were peer-reviewed investigations, written in English, and involved the provision of feedback during or following dynamic resistance exercise. Furthermore, studies must have evaluated either acute training performance or chronic physical adaptations. Risk of bias was assessed using a modified Downs and Black assessment tool. Multilevel meta-analyses were performed to quantify the effects of feedback on acute and chronic training outcomes.

RESULTS

Feedback enhanced acute kinetic and kinematic outputs, muscular endurance, motivation, competitiveness, and perceived effort, while greater improvements in speed, strength, jump performance, and technical competency were reported when feedback was provided chronically. Furthermore, greater frequencies of feedback (e.g., following every repetition) were found to be most beneficial for enhancing acute performance. Results demonstrated that feedback improves acute barbell velocities by approximately 8.4% (g = 0.63, 95% confidence interval [CI] 0.36-0.90). Moderator analysis revealed that both verbal (g = 0.47, 95% CI 0.22-0.71) and visual feedback (g = 1.11, 95% CI 0.61-1.61) were superior to no feedback, but visual feedback was superior to verbal feedback. For chronic outcomes, jump performance might have been positively influenced (g = 0.39, 95% CI - 0.20 to 0.99) and short sprint performance was likely enhanced (g = 0.47, 95% CI 0.10-0.84) to a greater extent when feedback is provided throughout a training cycle.

CONCLUSIONS

Feedback during resistance training can lead to enhanced acute performance within a training session and greater chronic adaptations. Studies included in our analysis demonstrated a positive influence of feedback, with all outcomes showing superior results than when no feedback is provided. For practitioners, it is recommended that high-frequency, visual feedback is consistently provided to individuals when they complete resistance training, and this may be particularly useful during periods of low motivation or when greater competitiveness is beneficial. Alternatively, researchers must be aware of the ergogenic effects of feedback on acute and chronic responses and ensure that feedback is standardised when investigating resistance training.

Operational Modal Analysis of Near-Infrared Spectroscopy Measure of 2-Month Exercise Intervention Effects in Sedentary Older Adults with Diabetes and Cognitive Impairment

The Global Burden of Disease Study (GBD 2019 Diseases and Injuries Collaborators) found that diabetes significantly increases the overall burden of disease, leading to a 24.4% increase in disability-adjusted life years. Persistently high glucose levels in diabetes can cause structural and functional changes in proteins throughout the body, and the accumulation of protein aggregates in the brain that can be associated with the progression of Alzheimer's Disease (AD). To address this burden in type 2 diabetes mellitus (T2DM), a combined aerobic and resistance exercise program was developed based on the recommendations of the American College of Sports Medicine. The prospectively registered clinical trials (NCT04626453, NCT04812288) involved two groups: an Intervention group of older sedentary adults with T2DM and a Control group of healthy older adults who could be either active or sedentary. The completion rate for the 2-month exercise program was high, with participants completing on an average of 89.14% of the exercise sessions. This indicated that the program was practical, feasible, and well tolerated, even during the COVID-19 pandemic. It was also safe, requiring minimal equipment and no supervision. Our paper presents portable near-infrared spectroscopy (NIRS) based measures that showed muscle oxygen saturation (SmO2), i.e., the balance between oxygen delivery and oxygen consumption in muscle, drop during bilateral heel rise task (BHR) and the 6 min walk task (6MWT) significantly (p < 0.05) changed at the post-intervention follow-up from the pre-intervention baseline in the T2DM Intervention group participants. Moreover, post-intervention changes from pre-intervention baseline for the prefrontal activation (both oxyhemoglobin and deoxyhemoglobin) showed statistically significant (p < 0.05, q < 0.05) effect at the right superior frontal gyrus, dorsolateral, during the Mini-Cog task. Here, operational modal analysis provided further insights into the 2-month exercise intervention effects on the very-low-frequency oscillations (<0.05 Hz) during the Mini-Cog task that improved post-intervention in the sedentary T2DM Intervention group from their pre-intervention baseline when compared to active healthy Control group. Then, the 6MWT distance significantly (p < 0.01) improved in the T2DM Intervention group at post-intervention follow-up from pre-intervention baseline that showed improved aerobic capacity and endurance. Our portable NIRS based measures have practical implications at the point of care for the therapists as they can monitor muscle and brain oxygenation changes during physical and cognitive tests to prescribe personalized physical exercise doses without triggering individual stress response, thereby, enhancing vascular health in T2DM.

Comparison of traditional vs. lighter load strength training on fat-free mass, strength, power and affective responses in middle and older-aged adults: A pilot randomized trial

OBJECTIVES

Strength training is widely recommended to improve strength, muscle mass and power. However, the feasibility and potential efficacy of strength training using lighter loads near failure on these outcomes in middle and older-aged adults remains unclear.

METHODS

23 community-living adults were randomized into two groups: Traditional strength training (ST) (8-12 repetitions) or a lighter load, higher repetitions (LLHR) (20-24 repetitions) group. Participants performed a full-body workout (twice a week) with 8 exercises at a perceived exertion of 7-8 (0-10 scale) for 10 weeks. Post-testing was performed by an assessor blinded to group assignments. An analysis of covariance (ANCOVA) was used to examine between group differences using baseline values as a covariate.

RESULTS

The study involved individuals with a mean age of 59 years, of which 61 % were women. The LLHR group demonstrated a high attendance rate of 92 % (9.5 %) and reported leg press exercise RPE of 7.1 (0.53), along with a session feeling scale of 2.0 (1.7). There was a trivial difference in fat free mass (FFM) favoring LLHR vs ST [0.27 kg 95 % CI (-0.87, 1.42)]. The ST group exhibited superior increases in leg press 1 repetition maximum (1RM) strength [-14 kg (-23, -5)], while the LLHR group showed greater strength endurance increases (65 % 1RM) [8 repetitions (2, 14)]. Leg press power [41 W (-42, 124)] and exercise efficacy [-3.8 (-21.2, 13.5)] demonstrated trivial between-group differences.

CONCLUSION

A pragmatic, full-body strength training program with lighter loads taken close to failure appears to be a viable option for promoting muscular adaptations in middle- and older-aged adults. These results are exploratory and require a larger trial for confirmation.

Physiological Responses and Adaptations to Lower Load Resistance Training: Implications for Health and Performance

Resistance training is a method of enhancing strength, gait speed, mobility, and health. However, the external load required to induce these benefits is a contentious issue. A growing body of evidence suggests that when lower load resistance training [i.e., loads < 50% of one-repetition maximum (1RM)] is completed within close proximity to concentric failure, it can serve as an effective alternative to traditional higher load (i.e., loads > 70% of 1RM) training and in many cases can promote similar or even superior physiological adaptations. Such findings are important given that confidence with external loads and access to training facilities and equipment are commonly cited barriers to regular resistance training. Here, we review some of the mechanisms and physiological changes in response to lower load resistance training. We also consider the evidence for applying lower loads for those at risk of cardiovascular and metabolic diseases and those with reduced mobility. Finally, we provide practical recommendations, specifically that to maximize the benefits of lower load resistance training, high levels of effort and training in close proximity to concentric failure are required. Additionally, using lower loads 2-3 times per week with 3-4 sets per exercise, and loads no lower than 30% of 1RM can enhance muscle hypertrophy and strength adaptations. Consequently, implementing lower load resistance training can be a beneficial and viable resistance training method for a wide range of fitness- and health-related goals.

Myofiber hypertrophy adaptations following 6 weeks of low-load resistance training with blood flow restriction in untrained males and females

The effects of low-load resistance training with blood flow restriction (BFR) on hypertrophy of type I/II myofibers remains unclear, especially in females. The purpose of the present study is to examine changes in type I/II myofiber cross-sectional area (fCSA) and muscle CSA (mCSA) of the vastus lateralis (VL) from before (Pre) to after (Post) 6 wk of high-load resistance training (HL; n = 15, 8 females) and low-load resistance training with BFR (n = 16, 8 females). Mixed-effects models were used to analyze fCSA with group (HL, BFR), sex (M, F), fiber type (I, II), and time (Pre, Post) included as factors. mCSA increased from pre- to posttraining (P < 0.001, d = 0.91) and was greater in males compared with females (P < 0.001, d = 2.26). Type II fCSA increased pre- to post-HL (P < 0.05, d = 0.46) and was greater in males compared with females (P < 0.05, d = 0.78). There were no significant increases in fCSA pre- to post-BFR for either fiber type or sex. Cohen's d, however, revealed moderate effect sizes in type I and II fCSA for males (d = 0.59 and 0.67), although this did not hold true for females (d = 0.29 and 0.34). Conversely, the increase in type II fCSA was greater for females than for males after HL. In conclusion, low-load resistance training with BFR may not promote myofiber hypertrophy to the level of HL resistance training, and similar responses were generally observed for males and females. In contrast, comparable effect sizes for mCSA and 1-repetition maximum (1RM) between groups suggest that BFR could play a role in a resistance training program.NEW & NOTEWORTHY This is the first study, to our knowledge, to examine myofiber hypertrophy from low-load resistance training with blood flow restriction (BFR) in females. Although this type of training did not result in myofiber hypertrophy, there were comparable increases in muscle cross-sectional area compared with high-load resistance training. These findings possibly highlight that males and females respond in a similar manner to high-load resistance training and low-load resistance training with BFR.

Intensity-dependent cardiopulmonary response during and after strength training

Whereas cardiopulmonary responses are well understood in endurance training, they are rarely described in strength training. This cross-over study examined acute cardiopulmonary responses in strength training. Fourteen healthy male strength training-experienced participants (age 24.5 ± 2.9 years; BMI 24.1 ± 2.0 kg/m²) were randomly assigned into three strength training sessions (three sets of ten repetitions) with different intensities (50%, 62,5%, and 75% of the 3-Repetition Maximum) of squats in a smith machine. Cardiopulmonary (impedance cardiography, ergo-spirometry) responses were continuously monitored. During exercise period, heart rate (HR 143 ± 16 vs. 132 ± 15 vs. 129 ± 18 bpm, respectively; p < 0.01; η²_p 0.54) and cardiac output (CO: 16.7 ± 3.7 vs. 14.3 ± 2.5 vs. 13.6 ± 2.4 l/min, respectively; p < 0.01; η²_p 0.56) were higher at 75% of 3-RM compared to those at the other intensities. We noted similar stroke volume (SV: p = 0.08; η²_p 0.18) and end-diastolic volume (EDV: p = 0.49). Ventilation (V_E) was higher at 75% compared to 62.5% and 50% (44.0 ± 8.0 vs. 39.6 ± 10.4 vs. 37.6 ± 7.7 l/min, respectively; p < 0.01; η²_p 0.56). Respiration rate (RR; p = .16; η²_p 0.13), tidal volume (VT: p = 0.41; η²_p 0.07) and oxygen uptake (VO₂: p = 0.11; η²_p 0.16) did not differ between intensities. High systolic and diastolic blood pressure were evident (62.5% 3-RM 197 ± 22.4/108.8 ± 13.4 mmHG). During the post-exercise period (60 s), SV, CO, V_E, VO_2, and VCO₂ were higher (p < 0.01) than during the exercise period, and the pulmonary parameters differed markedly between intensities (V_E p < 0.01; RR p < 0.01; VT p = 0.02; VO₂ p < 0.01; VCO₂ p < 0.01). Despite the differences in strength training intensity, the cardiopulmonary response reveals significant differences predominantly during the post-exercise period. Intensity-induced breath holding induces high blood pressure peaks and cardiopulmonary recovery effects after exercise.