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Ramirez V, Ghezelbash F, Shirazi-Adl A, Bazrgari B. Trunk muscle forces and spinal loads during heavy deadlift: Effects of personalization, muscle wrapping, muscle lever arm, and lumbopelvic rhythm. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3680. [PMID: 36606738 DOI: 10.1002/cnm.3680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 11/23/2022] [Accepted: 01/03/2023] [Indexed: 05/12/2023]
Abstract
Heavy deadlift is used as a physical fitness screening tool in the U.S. Army. Despite the relevance of such a screening tool to military tasks performed by Service Members, the biomechanical impact of heavy deadlift and its risk of low-back injury remain unknown. A kinematics-driven musculoskeletal model of spine was implemented to investigate biomechanics of the lower back in a volunteer (23 years old, height of 1.82 m, and body mass of 98.8 kg) during a 68 kg deadlift. In search of protective mechanisms, effects of model personalization and variations in trunk musculature and lumbopelvic rhythm were also investigated. The net moment, compression and shear forces at the L5-S1 reached peaks of 684 Nm, 17.2 and 4.2 kN, respectively. Geometrical personalization and changes in lumbopelvic rhythm had the least effects on predictions while increases in muscle moment arms (40%) had the largest effects that caused, respectively, 32% and 36% decrease in the maximum compressive and shearing forces. Initiating wrapping of back muscles at farther distances from the spine had opposing effects on spinal loads; peak compression at the L5-S1 decreased by 12% whereas shear increased by 19%. Despite mechanisms considered, spinal loads during heavy deadlift exceed the existing evidence concerning the threshold of injury for spinal segments, suggesting the vulnerability to injury. Chronic exposure to such high-spinal loads may lead to (micro) fractures, degeneration, pathoanatomical changes and finally low-back pain.
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Affiliation(s)
- Vanessa Ramirez
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
| | - Farshid Ghezelbash
- Division of Applied Mechanics, Department of Mechanical Engineering, Ecole Polytechnique, Montréal, Québec, Canada
| | - Aboulfazl Shirazi-Adl
- Division of Applied Mechanics, Department of Mechanical Engineering, Ecole Polytechnique, Montréal, Québec, Canada
| | - Babak Bazrgari
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky, USA
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, Kentucky, USA
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Anderson OK, Voskuil CC, Byrd MT, Garver MJ, Rickard AJ, Miller WM, Bergstrom HC, Dinyer McNeely TK. Affective and Perceptual Responses During an 8-Week Resistance Training to Failure Intervention at Low vs. High Loads in Untrained Women. J Strength Cond Res 2023; 37:546-554. [PMID: 35947512 DOI: 10.1519/jsc.0000000000004313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Anderson, AlOK, Voskuil, CC, Byrd, MT, Garver, MJ, Rickard, AJ, Miller, WM, Bergstrom, HC, and Dinyer McNeely, TK. Affective and perceptual responses during an 8-week resistance training to failure intervention at low vs. high loads in untrained women. J Strength Cond Res 37(3): 546-554, 2023-This study examined the effects of resistance training (RT) to failure on the perceptual and affective responses, intent-to-continue RT to failure in a self-initiated session, and affect-intent relationship. Twenty-three untrained women (mean ± SD : age 21.2 ± 2.2 years; height 167 ± 5.7 cm; body mass, 62.3 ± 16.2 kg) completed an 8-week, full-body RT to failure intervention at a low (30% 1RM; n = 11) or high (80% 1RM; n = 12) load. The Borg's rating of perceived exertion (RPE) scale was used to assess the acute (aRPE) and session (sRPE) RPE immediately after repetition failure and each training session, respectively. Immediately, 15-minute, and 60-minute postsession affective responses were assessed using the feeling scale (FS; -5 to +5), and intent to continue to RT was assessed on a scale of 0-100% intention. During week 4 (W4) and week 8 (W8), aRPE (W4: 18 ± 2, W8: 18 ± 2; p ≤ 0.032) and sRPE (W4: 17 ± 2, W8: 18 ± 1; p ≤ 0.018) were greater than that during week 1 (W1; aRPE: 17 ± 2; sRPE: 16 ± 2). The FS responses increased from immediately to 60-minute postsession during W4 ( p ≤ 0.019) and W8 ( p ≤ 0.049). The correlation between affect and intent-to-continue RT increased from W1 ( r = 0.416) to W8 ( r = 0.777). Regardless of load, untrained women reported similar perceptual, affective, and intention responses. These variables should be considered to improve RT program adoption and adherence in women.
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Affiliation(s)
- Olivia K Anderson
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Caleb C Voskuil
- Department of Kinesiology, Texas Christian University, Fort Worth, Texas
| | - M Travis Byrd
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, Arizona
| | - Matthew J Garver
- School of Nutrition, Kinesiology, and Psychological Science, University of Central Missouri, Warrensburg, Missouri
| | - Alex J Rickard
- School of Nutrition, Kinesiology, and Psychological Science, University of Central Missouri, Warrensburg, Missouri
| | - William M Miller
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University, Mississippi; and
| | - Haley C Bergstrom
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky
| | - Taylor K Dinyer McNeely
- School of Kinesiology, Applied Health and Recreation, Oklahoma State University, Stillwater, Oklahoma
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Jung R, Gehlert S, Geisler S, Isenmann E, Eyre J, Zinner C. Muscle strength gains per week are higher in the lower-body than the upper-body in resistance training experienced healthy young women-A systematic review with meta-analysis. PLoS One 2023; 18:e0284216. [PMID: 37053143 PMCID: PMC10101404 DOI: 10.1371/journal.pone.0284216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Women are underrepresented in resistance exercise-related studies. To date only one meta-analysis provides concrete training recommendations for muscle strength gains through resistance training in eumenorrhoeic women. OBJECTIVE This review aims to identify research gaps to advance future study in this area to expand the knowledge concerning resistance exercise-induced strength gains in women and to provide guidelines on the number of repetitions per set and the training frequency per week to enhance maximal muscle strength. METHODS The electronic databases PubMed and Web of Science were searched using a comprehensive list of relevant terms. After checking for exclusion criteria, 31 studies could be included in the final analysis using data from 621 subjects. From these data sets, the ideal number of repetitions per set and also the training frequency per week were analyzed. RESULTS In the lower body, the largest gains were achieved with 1 to 6 repetitions (17.4% 1RM increase). For lower-body exercises, the highest gains were achieved with 13 to 20 repetitions (8.7% 1RM increase). The lower body should be trained two times a week (8.5% 1RM increase). The upper body should be trained two (5.2% 1RM increase) to three times (4.5% 1RM increase) a week. CONCLUSION Women can increase their 1RM by 7.2% per week in the upper body and by 5.2% per week in the lower-body exercises. The upper body can be trained more than two times per week whereas the lower body should be trained two times. Women with intermediate experiences in RT and advanced performance level show more rapid increases in strength in the lower-body compared to the upper-body while no differences were found between upper and lower limb adaptations in RT-beginner subjects.
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Affiliation(s)
- Roger Jung
- Department of Biosciences of Sport Science, Institute of Sport Science, University of Hildesheim, Hildesheim, Germany
| | - Sebastian Gehlert
- Department of Biosciences of Sport Science, Institute of Sport Science, University of Hildesheim, Hildesheim, Germany
| | - Stephan Geisler
- Fitness and Health, IST University of Applied Sciences, Duesseldorf, Germany
| | - Eduard Isenmann
- Fitness and Health, IST University of Applied Sciences, Duesseldorf, Germany
- Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Julia Eyre
- Fitness and Health, IST University of Applied Sciences, Duesseldorf, Germany
| | - Christoph Zinner
- Department of Sport, University of Applied Sciences for Police and Administration of Hesse, Wiesbaden, Germany
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Coratella G. Appropriate Reporting of Exercise Variables in Resistance Training Protocols: Much more than Load and Number of Repetitions. SPORTS MEDICINE - OPEN 2022; 8:99. [PMID: 35907047 PMCID: PMC9339067 DOI: 10.1186/s40798-022-00492-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022]
Abstract
Manipulating resistance training variables is crucial to plan the induced stimuli correctly. When reporting the exercise variables in resistance training protocols, sports scientists and practitioners often refer to the load lifted and the total number of repetitions. The present conceptual review explores all within-exercise variables that may influence the strength and hypertrophic gains, and the changes in muscle architecture. Together with the (1) load and (2) the number of repetitions, (3) performing repetitions to failure or not to failure, (4) the displacement of the load or the range of movement (full or partial), (5) the portion of the partial movement to identify the muscle length at which the exercise is performed, (6) the total time under tension, the duration of each phase and the position of the two isometric phases, (7) whether the concentric, eccentric or concentric-eccentric phase is performed, (8) the use of internal or external focus and (9) the inter-set rest may all have repercussions on the adaptations induced by each resistance exercise. Manipulating one or more variable allows to increase, equalize or decrease the stimuli related to each exercise. Sports scientists and practitioners are invited to list all aforementioned variables for each exercise when reporting resistance training protocols.
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Affiliation(s)
- Giuseppe Coratella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Giuseppe Colombo 71, 20133, Milan, Italy.
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Dispersion of Knee Helical Axes during Walking after Maximal versus Resistant Strength Training in Healthy Subjects. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12125850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Knee joint stability can be estimated during functional tasks through the analysis of the helical axes (HAs) dispersion. The study aimed at investigating (1) the test–retest reliability of knee HAs dispersion during walking and (2) the effects of maximal versus resistant strength training on knee HAs dispersion during walking. Thirty healthy subjects (age: 22.6 ± 2.1 years) randomized into a maximal training (MT) group and a resistance training (RT) group underwent a 2-week quadricep–hamstring strength training at 90% or 30% of the maximum voluntary contraction, respectively. Participants walked on a treadmill with clusters of retro-reflective markers placed on thighs and shanks to detect knee kinematics with an optoelectronic system. Knee HAs dispersion was assessed using mean distance (MD) and mean angle (MA) at 1 week before training start, before and after the first training session, and before and after the last training session. Moderate to excellent reliability was found for MD and MA on the sagittal plane (ICCs ≥ 0.70). No differences over time were found for MD and MA between MT and RT. HAs dispersion indexes resulted in reliable parameters for the quantification of knee stability on the sagittal plane during walking. Maximal and resistance strength training induced no knee HAs dispersion changes during walking.
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Association of bone-related biomarkers with femoral neck bone strength. BMC Musculoskelet Disord 2022; 23:482. [PMID: 35597928 PMCID: PMC9123746 DOI: 10.1186/s12891-022-05427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Femoral neck fractures are the worst consequence of osteoporosis (OP), and its early prevention and treatment have become a public health problem. This study aims to investigate the relationship of bone-related biomarkers, femoral neck bone mineral density (BMD) and maximum load (Lmax), selecting the indicator which can reflect femoral neck bone loss and reduced bone strength. METHODS A total of 108 patients were recruited from January 2017 to December 2019. Venous blood samples were collected from patients before total hip replacement, and femoral neck samples were collected during the surgery. Femoral neck BMD, femoral neck Lmax, bone-related markers (serum levels of bone turnover markers, protein expression of type I collagen (COL-I) and osteopontin (OPN) in femoral neck) were all measured and analyzed. RESULTS The expression of COL-I in femoral neck were significantly decreased, whereas other markers were all significantly increased with the decreasing of femoral neck BMD and Lmax (P < 0.05). Among them, serum C-terminal telopeptide of type I collagen (CTX) levels and OPN expression of femoral neck were increased in osteopenia. In multiple linear regression analysis, CTX and OPN were both negatively correlated with femoral neck BMD and Lmax, and they were independent factors of femoral neck BMD and Lmax, whereas COL-I was independent factor affecting Lmax (P < 0.05). Besides, CTX was negatively correlated with COL-I (β = -0.275, P = 0.012) and positively correlated with OPN (β = 0.295, P = 0.003). CONCLUSIONS Compared with other indicators, serum CTX was more sensitive to differences in bone mass and bone strength of femoral neck, and could be considered as surrogate marker for OPN and COL-I.Early measurement of CTX could facilitate the diagnosis of osteopenia and provide a theoretical basis for delaying the occurrence of femoral neck OP and fragility fractures.
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Changes in Body Composition and Strength after 12 Weeks of High-Intensity Functional Training with Two Different Loads in Physically Active Men and Women: A Randomized Controlled Study. Sports (Basel) 2022; 10:sports10010007. [PMID: 35050972 PMCID: PMC8822892 DOI: 10.3390/sports10010007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 12/17/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022] Open
Abstract
This study examined the effects of two different resistance loads during high-intensity Functional Training (HIFT) on body composition and maximal strength. Thirty-one healthy young individuals were randomly assigned into three groups: moderate load (ML: 70% 1-RM), low load-(LL: 30% 1-RM), and control (CON). Each experimental group performed HIFT three times per week for 12 weeks with a similar total volume load. Body fat decreased equally in both experimental groups after 6 weeks of training (p < 0.001), but at the end of training it further decreased only in LL compared to ML (−3.19 ± 1.59 vs. −1.64 ± 1.44 kg, p < 0.001), with no change in CON (0.29 ± 1.08 kg, p = 0.998). Lean body mass (LBM) increased after 6 weeks of training (p = 0.019) in ML only, while after 12 weeks a similar increase was observed in LL and ML (1.11 ± 0.65 vs. ML: 1.25 ± 1.59 kg, p = 0.034 and 0.013, respectively), with no change in CON (0.34 ± 0.67 kg, p = 0.991). Maximal strength increased similarly in four out of five exercises for both experimental groups by between 9.5% and 16.9% (p < 0.01) at the end of training, with no change in CON (−0.6 to 4.9%, p > 0.465). In conclusion, twelve weeks of HIFT training with either low or moderate resistance and equal volume load resulted in an equal increase in LBM and maximal strength, but different fat loss.
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Theisen BJ, Larson PD, Chambers CC. Optimizing Rehabilitation and Return to Sport in Athletes With Anterior Knee Pain Using a Biomechanical Perspective. Arthrosc Sports Med Rehabil 2022; 4:e199-e207. [PMID: 35141552 PMCID: PMC8811520 DOI: 10.1016/j.asmr.2021.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/18/2021] [Indexed: 11/28/2022] Open
Abstract
Anterior knee pain represents one of the most common athletic knee conditions and arguably also one of the most complex. The patellofemoral joint is at the center of several forces, and alterations in any of these force vectors due to muscular imbalance, soft-tissue tightness or laxity, and altered functional movement patterns can all combine to create a painful anterior knee. While typically anterior knee pain is not a surgical entity, the orthopaedic surgeon with an understanding of these biomechanical intricacies is best positioned to provide comprehensive evidence-based care for the patient with anterior knee pain. Level of Evidence V, expert opinion.
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Ramirez VJ, Bazrgari B, Gao F, Samaan M. Low Back Biomechanics during Repetitive Deadlifts: A Narrative Review. IISE Trans Occup Ergon Hum Factors 2022. [PMID: 34875981 DOI: 10.1080/24725838.2021.2015642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OCCUPATIONAL APPLICATIONSHeavy deadlifting is used as a screening tool or training protocol for recruitment and retention in physically-demanding occupations, especially in the military. Spinal loads experienced during heavy deadlifts, particularly shearing forces, are well above recommended thresholds for lumbar spine injury in occupational settings. Although members of the noted occupation likely have stronger musculoskeletal systems compared to the general population, experiencing shearing forces that are 2 to 4 times larger than the threshold of injury, particularly under repetitive deadlift, may transform a screening tool or training protocol to an occupationally-harmful physical activity.
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Affiliation(s)
| | - Babak Bazrgari
- Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - Fan Gao
- Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - Michael Samaan
- Biomedical Engineering, University of Kentucky, Lexington, KY, USA
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Vann CG, Sexton CL, Osburn SC, Smith MA, Haun CT, Rumbley MN, Mumford PW, Montgomery NT, Ruple BA, McKendry J, Mcleod J, Bashir A, Beyers RJ, Brook MS, Smith K, Atherton PJ, Beck DT, McDonald JR, Young KC, Phillips SM, Roberts MD. Effects of High-Volume Versus High-Load Resistance Training on Skeletal Muscle Growth and Molecular Adaptations. Front Physiol 2022; 13:857555. [PMID: 35360253 PMCID: PMC8962955 DOI: 10.3389/fphys.2022.857555] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
We evaluated the effects of higher-load (HL) versus (lower-load) higher-volume (HV) resistance training on skeletal muscle hypertrophy, strength, and muscle-level molecular adaptations. Trained men (n = 15, age: 23 ± 3 years; training experience: 7 ± 3 years) performed unilateral lower-body training for 6 weeks (3× weekly), where single legs were randomly assigned to HV and HL paradigms. Vastus lateralis (VL) biopsies were obtained prior to study initiation (PRE) as well as 3 days (POST) and 10 days following the last training bout (POSTPR). Body composition and strength tests were performed at each testing session, and biochemical assays were performed on muscle tissue after study completion. Two-way within-subject repeated measures ANOVAs were performed on most dependent variables, and tracer data were compared using dependent samples t-tests. A significant interaction existed for VL muscle cross-sectional area (assessed via magnetic resonance imaging; interaction p = 0.046), where HV increased this metric from PRE to POST (+3.2%, p = 0.018) whereas HL training did not (-0.1%, p = 0.475). Additionally, HL increased leg extensor strength more so than HV training (interaction p = 0.032; HV < HL at POST and POSTPR, p < 0.025 for each). Six-week integrated non-myofibrillar protein synthesis (iNon-MyoPS) rates were also higher in the HV versus HL condition, while no difference between conditions existed for iMyoPS rates. No interactions existed for other strength, VL morphology variables, or the relative abundances of major muscle proteins. Compared to HL training, 6 weeks of HV training in previously trained men optimizes VL hypertrophy in lieu of enhanced iNon-MyoPS rates, and this warrants future research.
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Affiliation(s)
- Christopher G. Vann
- School of Kinesiology, Auburn University, Auburn, AL, United States
- Duke Molecular Physiology Institute, Duke University School of Medicine, Duke University, Durham, NC, United States
| | - Casey L. Sexton
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Shelby C. Osburn
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Morgan A. Smith
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | | | | | - Petey W. Mumford
- Department of Kinesiology, Lindenwood University, St. Charles, MO, United States
| | | | - Bradley A. Ruple
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - James McKendry
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Jonathan Mcleod
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Adil Bashir
- MRI Research Center, Auburn University, Auburn, AL, United States
| | - Ronald J. Beyers
- MRI Research Center, Auburn University, Auburn, AL, United States
| | - Matthew S. Brook
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic, and Molecular Physiology, University of Nottingham, Nottingham, United Kingdom
| | - Kenneth Smith
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic, and Molecular Physiology, University of Nottingham, Nottingham, United Kingdom
| | - Philip J. Atherton
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic, and Molecular Physiology, University of Nottingham, Nottingham, United Kingdom
| | - Darren T. Beck
- School of Kinesiology, Auburn University, Auburn, AL, United States
- Edward Via College of Osteopathic Medicine – Auburn Campus, Auburn, AL, United States
| | | | - Kaelin C. Young
- School of Kinesiology, Auburn University, Auburn, AL, United States
- Edward Via College of Osteopathic Medicine – Auburn Campus, Auburn, AL, United States
| | | | - Michael D. Roberts
- School of Kinesiology, Auburn University, Auburn, AL, United States
- Edward Via College of Osteopathic Medicine – Auburn Campus, Auburn, AL, United States
- *Correspondence: Michael D. Roberts,
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Bielitzki R, Behrendt T, Behrens M, Schega L. Time to Save Time: Beneficial Effects of Blood Flow Restriction Training and the Need to Quantify the Time Potentially Saved by Its Application During Musculoskeletal Rehabilitation. Phys Ther 2021; 101:6315163. [PMID: 34228788 DOI: 10.1093/ptj/pzab172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/14/2021] [Accepted: 06/06/2021] [Indexed: 11/14/2022]
Abstract
The main goal of musculoskeletal rehabilitation is to achieve the pre-injury and/or pre-surgery physical function level with a low risk of re-injury. Blood flow restriction (BFR) training is a promising alternative to conventional therapy approaches during musculoskeletal rehabilitation because various studies support its beneficial effects on muscle mass, strength, aerobic capacity, and pain perception. In this perspective article, we used an evidence-based progressive model of a rehabilitative program that integrated BFR in 4 rehabilitation phases: (1) passive BFR, (2) BFR combined with aerobic training, (3) BFR combined with low-load resistance training, and (4) BFR combined with low-load resistance training and traditional high-load resistance training. Considering the current research, we propose that a BFR-assisted rehabilitation has the potential to shorten the time course of therapy to reach the stage where the patient is able to tolerate resistance training with high loads. The information and arguments presented are intended to stimulate future research, which compares the time to achieve rehabilitative milestones and their physiological bases in each stage of the musculoskeletal rehabilitation process. This requires the quantification of BFR training-induced adaptations (eg, muscle mass, strength, capillary-to-muscle-area ratio, hypoalgesia, molecular changes) and the associated changes in performance with a high measurement frequency (≤1 week) to test our hypothesis. This information will help to quantify the time saved by BFR-assisted musculoskeletal rehabilitation. This is of particular importance for patients, because the potentially accelerated recovery of physical functioning would allow them to return to their work and/or social life earlier. Furthermore, other stakeholders in the health care system (eg, physicians, nurses, physical therapists, insurance companies) might benefit from that with regard to work and financial burden.
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Affiliation(s)
- Robert Bielitzki
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Tom Behrendt
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany.,Department of Orthopedics, University Medicine Rostock, Rostock, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Coelho-Júnior HJ, Uchida MC, Picca A, Bernabei R, Landi F, Calvani R, Cesari M, Marzetti E. Evidence-based recommendations for resistance and power training to prevent frailty in community-dwellers. Aging Clin Exp Res 2021; 33:2069-2086. [PMID: 33587271 DOI: 10.1007/s40520-021-01802-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/21/2021] [Indexed: 02/07/2023]
Abstract
Frailty is a reversible state of reduced resilience to stressful events resulting from a multisystem impairment of the human body. As frailty progresses, people become more vulnerable to numerous adverse events, including falls and fractures, cognitive decline, disability, hospitalization, nursing home placement, and death. As such, substantial health care costs are associated with frailty. These features have led to the recognition of frailty as a public health problem. The identification of strategies for the management of frailty has, therefore, become a topic of extensive instigation. In this context, resistance (RT) and power training (PT) have received considerable attention, and experts in the field have recently suggested that both training modalities may improve frailty-related parameters. However, most studies have only included robust people and investigated frailty as a secondary outcome, so that current literature only allows RT and PT preventive programs against frailty to be designed. Here, we provide evidence-based critical recommendations for the prescription of RT and PT programs against incident frailty in community-dwellers.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, 13083-970, Brazil.
- Rehabilitation Unit, Lar Mãe Mariana Nursing Home, Poá, Brazil.
| | - Marco Carlos Uchida
- Applied Kinesiology Laboratory-LCA, School of Physical Education, University of Campinas, Campinas, 13083-970, Brazil
| | - Anna Picca
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | - Roberto Bernabei
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | | | - Riccardo Calvani
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, Università di Milano, 20122, Milan, Italy
- Geriatric Unit, IRCCS Istutiti Clinici Scientifici Maugeri, 20138, Milan, Italy
| | - Emanuele Marzetti
- Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
- Department of Geriatrics and Internal Medicine, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore. L.Go F, Vito 1, 00168, Rome, Italy.
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13
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LOPEZ PEDRO, RADAELLI RÉGIS, TAAFFE DENNISR, NEWTON ROBERTU, GALVÃO DANIELA, TRAJANO GABRIELS, TEODORO JULIANAL, KRAEMER WILLIAMJ, HÄKKINEN KEIJO, PINTO RONEIS. Resistance Training Load Effects on Muscle Hypertrophy and Strength Gain: Systematic Review and Network Meta-analysis. Med Sci Sports Exerc 2021; 53:1206-1216. [PMID: 33433148 PMCID: PMC8126497 DOI: 10.1249/mss.0000000000002585] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to analyze the effect of resistance training (RT) performed until volitional failure with low, moderate, and high loads on muscle hypertrophy and muscle strength in healthy adults and to assess the possible participant-, design-, and training-related covariates that may affect the adaptations. METHODS Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science databases were searched. Including only studies that performed sets to volitional failure, the effects of low- (>15 repetitions maximum (RM)), moderate- (9-15 RM), and high-load (≤8 RM) RTs were examined in healthy adults. Network meta-analysis was undertaken to calculate the standardized mean difference (SMD) between RT loads in overall and subgroup analyses involving studies deemed of high quality. Associations between participant-, design-, and training-related covariates with SMD were assessed by univariate and multivariate network meta-regression analyses. RESULTS Twenty-eight studies involving 747 healthy adults were included. Although no differences in muscle hypertrophy between RT loads were found in overall (P = 0.113-0.469) or subgroup analysis (P = 0.871-0.995), greater effects were observed in untrained participants (P = 0.033) and participants with some training background who undertook more RT sessions (P = 0.031-0.045). Muscle strength improvement was superior for both high-load and moderate-load compared with low-load RT in overall and subgroup analysis (SMD, 0.60-0.63 and 0.34-0.35, respectively; P < 0.001-0.003), with a nonsignificant but superior effect for high compared with moderate load (SMD, 0.26-0.28, P = 0.068). CONCLUSIONS Although muscle hypertrophy improvements seem to be load independent, increases in muscle strength are superior in high-load RT programs. Untrained participants exhibit greater muscle hypertrophy, whereas undertaking more RT sessions provides superior gains in those with previous training experience.
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Affiliation(s)
- PEDRO LOPEZ
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
| | - RÉGIS RADAELLI
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BRAZIL
| | - DENNIS R. TAAFFE
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
| | - ROBERT U. NEWTON
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA,School of Human Movement and Nutrition Sciences, University of Queensland, Queensland, AUSTRALIA
| | - DANIEL A. GALVÃO
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
| | - GABRIEL S. TRAJANO
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, AUSTRALIA
| | - JULIANA L. TEODORO
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BRAZIL
| | | | - KEIJO HÄKKINEN
- Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - RONEI S. PINTO
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BRAZIL
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14
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Schoenfeld BJ, Grgic J, Van Every DW, Plotkin DL. Loading Recommendations for Muscle Strength, Hypertrophy, and Local Endurance: A Re-Examination of the Repetition Continuum. Sports (Basel) 2021; 9:sports9020032. [PMID: 33671664 PMCID: PMC7927075 DOI: 10.3390/sports9020032] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 12/16/2022] Open
Abstract
Loading recommendations for resistance training are typically prescribed along what has come to be known as the “repetition continuum”, which proposes that the number of repetitions performed at a given magnitude of load will result in specific adaptations. Specifically, the theory postulates that heavy load training optimizes increases maximal strength, moderate load training optimizes increases muscle hypertrophy, and low-load training optimizes increases local muscular endurance. However, despite the widespread acceptance of this theory, current research fails to support some of its underlying presumptions. Based on the emerging evidence, we propose a new paradigm whereby muscular adaptations can be obtained, and in some cases optimized, across a wide spectrum of loading zones. The nuances and implications of this paradigm are discussed herein.
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Affiliation(s)
- Brad J. Schoenfeld
- Department of Health Sciences, CUNY Lehman College, Bronx, NY 10468, USA; (D.W.V.E.); (D.L.P.)
- Correspondence:
| | - Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia;
| | - Derrick W. Van Every
- Department of Health Sciences, CUNY Lehman College, Bronx, NY 10468, USA; (D.W.V.E.); (D.L.P.)
| | - Daniel L. Plotkin
- Department of Health Sciences, CUNY Lehman College, Bronx, NY 10468, USA; (D.W.V.E.); (D.L.P.)
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15
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Bergstrom HC, Dinyer TK, Succi PJ, Voskuil CC, Housh TJ. Applications of the Critical Power Model to Dynamic Constant External Resistance Exercise: A Brief Review of the Critical Load Test. Sports (Basel) 2021; 9:sports9020015. [PMID: 33494200 PMCID: PMC7909812 DOI: 10.3390/sports9020015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 11/16/2022] Open
Abstract
The study and application of the critical power (CP) concept has spanned many decades. The CP test provides estimates of two distinct parameters, CP and W', that describe aerobic and anaerobic metabolic capacities, respectively. Various mathematical models have been used to estimate the CP and W' parameters across exercise modalities. Recently, the CP model has been applied to dynamic constant external resistance (DCER) exercises. The same hyperbolic relationship that has been established across various continuous, whole-body, dynamic movements has also been demonstrated for upper-, lower-, and whole-body DCER exercises. The asymptote of the load versus repetition relationship is defined as the critical load (CL) and the curvature constant is L'. The CL and L' can be estimated from the same linear and non-linear mathematical models used to derive the CP. The aims of this review are to (1) provide an overview of the CP concept across continuous, dynamic exercise modalities; (2) describe the recent applications of the model to DCER exercise; (3) demonstrate how the mathematical modeling of DCER exercise can be applied to further our understanding of fatigue and individual performance capabilities; and (4) make initial recommendations regarding the methodology for estimating the parameters of the CL test.
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Affiliation(s)
- Haley C. Bergstrom
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA; (T.K.D.); (P.J.S.); (C.C.V.)
- Correspondence:
| | - Taylor K. Dinyer
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA; (T.K.D.); (P.J.S.); (C.C.V.)
| | - Pasquale J. Succi
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA; (T.K.D.); (P.J.S.); (C.C.V.)
| | - Caleb C. Voskuil
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA; (T.K.D.); (P.J.S.); (C.C.V.)
| | - Terry J. Housh
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE 68583, USA;
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16
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Costa BDDV, Kassiano W, Nunes JP, Kunevaliki G, Castro-E-Souza P, Rodacki A, Cyrino LT, Cyrino ES, Fortes LDS. Does Performing Different Resistance Exercises for the Same Muscle Group Induce Non-homogeneous Hypertrophy? Int J Sports Med 2021; 42:803-811. [PMID: 33440446 DOI: 10.1055/a-1308-3674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study aimed to compare the effect of performing the same or different exercises for a muscle group on resistance training (RT) sessions on muscle hypertrophy at different sites along muscle length. Twenty-two detrained men (23.3±4.1 years) were randomly allocated to the following groups: a group that performed the same exercises in all training sessions (N-VAR=11) or one that varied the exercises for the same muscle groups (VAR=11). All were submitted to 3 weekly sessions for nine weeks. Muscle thickness was assessed at the proximal, middle, and distal sites of the lateral and anterior thigh, elbow flexors, and extensors by B-mode ultrasound. The VAR group significantly increased all the sites analyzed (P<0.05). Furthermore, the proximal site of the lateral thigh showed a larger relative increase when compared to the middle site (P<0.05). In contrast, the N-VAR group were not revealed significant improvements only for the middle site of the lateral thigh and the proximal site of the elbow flexors (P>0.05). Our results suggest that to perform different resistance exercises can induce hypertrophy of all sites assessed in detrained young men.
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Affiliation(s)
| | - Witalo Kassiano
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, Brazil
| | - João Pedro Nunes
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, Brazil
| | - Gabriel Kunevaliki
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, Brazil
| | - Pâmela Castro-E-Souza
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, Brazil
| | - Andre Rodacki
- Department of Physical Education, Federal University of Paraná, Curitiba, Brazil
| | - Letícia Trindade Cyrino
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, Brazil
| | - Edilson S Cyrino
- Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, Brazil
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Interlimb Neuromuscular Responses During Fatiguing, Bilateral, Leg Extension Exercise at a Moderate Versus High Load. Motor Control 2020; 25:59-74. [PMID: 33059330 DOI: 10.1123/mc.2020-0050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/24/2020] [Accepted: 08/29/2020] [Indexed: 11/18/2022]
Abstract
This study determined the load- and limb-dependent neuromuscular responses to fatiguing, bilateral, leg extension exercise performed at a moderate (50% one-repetition maximum [1RM]) and high load (80% 1RM). Twelve subjects completed 1RM testing for the bilateral leg extension, followed by repetitions to failure at 50% and 80% 1RM, on separate days. During all visits, the electromyographic (EMG) and mechanomyographic (MMG), amplitude (AMP) and mean power frequency (MPF) signals were recorded from the vastus lateralis of both limbs. There were no limb-dependent responses for any of the neuromuscular signals and no load-dependent responses for EMG AMP, MMG AMP, or MMG MPF (p = .301-.757), but there were main effects for time that indicated increases in EMG and MMG AMP and decreases in MMG MPF. There was a load-dependent decrease in EMG MPF over time (p = .032) that suggested variability in the mechanism responsible for metabolite accumulation at moderate versus high loads. These findings suggested that common drive from the central nervous system was used to modulate force during bilateral leg extension performed at moderate and high loads.
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Spitz RW, Bell ZW, Wong V, Yamada Y, Song JS, Buckner SL, Abe T, Loenneke JP. Strength testing or strength training: considerations for future research. Physiol Meas 2020; 41:09TR01. [PMID: 33017302 DOI: 10.1088/1361-6579/abb1fa] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Maximal strength testing is often performed to assess the efficacy of training programs or as a way to prescribe exercise load. Generally, it is believed that high load exercise is superior to low load exercise at increasing absolute strength, however this is not always the case (i.e. strength increases similarly between groups). We hypothesized that some of the discrepancy in the literature may be related to performing the strength test itself. To investigate this further we reviewed the literature looking for studies comparing high load and low load exercise. The included studies were separated into 'no extra practice' and 'practice'. No extra practice means the strength test was only performed at pre and post whereas practice refers to additional strength tests performed throughout the training intervention. Our results indicated that the differences between high load and low load exercise can be reduced when the group training with a low load is allowed additional exposure to the maximal strength test. This suggests that repeated exposure to strength tests may augment low load training adaptations and influence the outcomes. We discuss potential moderators of this relationship (e.g. how low is the low load, complexity of the skill) and offer considerations for future research. Based on this it would be recommended that when investigating the effects of low load training strength tests should be limited to pre and post intervention or if a control group is utilized then the control group should receive the same number of exposures to the strength test.
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Affiliation(s)
- Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS 38677, United States of America
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Endurance Training vs. Circuit Resistance Training: Effects on Lipid Profile and Anthropometric/Body Composition Status in Healthy Young Adult Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041222. [PMID: 32074953 PMCID: PMC7068336 DOI: 10.3390/ijerph17041222] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 12/20/2022]
Abstract
Background: Endurance training (ET) and resistance training (RT) are known to be effective in improving anthropometric/body composition and lipid panel indicators, but there is an evident lack of studies on differential effects of these two forms of physical exercise (PE). This study aimed to evaluate the differential effects of 8-week ET and RT among young adult women. Methods: Participants were women (n = 57; age: 23 ± 3 years; initial body height: 165 ± 6 cm; body mass: 66.79 ± 7.23 kg; BMI: 24.37 ± 2.57 kg/m2) divided into the ET group (n = 20), RT group (n = 19), and non-exercising control group (n = 18). All participants were tested for cardiovascular risk factors (CRF), including total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, glucose, and anthropometric/body composition (body mass, body mass index, skinfold measures, body fat %) at the beginning and at the end of the study. Over the 8 weeks, the ET group trained three times/week on a treadmill while the RT group participated in equal number of circuit weight training sessions. Both types of training were planned according to participants’ pre-study fitness status. Results: A two-factor analysis of variance for repeated measurements (“group” × “measurement”) revealed significant main effects for “measurement” in CRF. The “group × measurement” interaction was significant for CRF. The post-hoc analysis indicated significant improvements in CRF for RT and ET. No significant differential effects between RT and ET were evidenced. Conclusions: The results of this study evidence improvements of CRF in young adult women as a result of 8-week ET and RT. The lack of differential training-effects may be attributed to the fact that all participants underwent pre-study screening of their fitness status, which resulted in application of accurate training loads.
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