Immediate Effect of Compression Contrast Therapy on Quadriceps Femoris Muscles' Regeneration in MMA Fighters

Objectives: This study aimed to evaluate the immediate effect of Game Ready (GR) heat-cold compression contrast therapy (HCCT) on changes in the biomechanical parameters of the quadriceps femoris muscles and tissue perfusion. Methods: Fifteen male MMA fighters were subjected to HCCT on the dominant leg's thigh and control sham therapy on the other. The experimental intervention used a pressure cuff with the following parameters: time-20 min; pressure-25-75 mmHg; and temp.-3-45°C, changing every 2 min. For the control group, the temp. of sham therapy was 15-36 °C, and pressure was 15-25 mmHg, changing every 2 min. Measurements were taken on the head of the rectus femoris muscle (RF) 5 min before therapy, 5 min after, and 1 h after therapy in the same order in all participants: microcirculatory response (PU), muscle tension (MT), stiffness (S), flexibility (E), tissue temperature (°C), and pressure pain threshold (PPT). Results: The analysis revealed significant differences between the HCCT and sham therapy groups and the measurement time (rest vs. post 5 min and post 1 h) for PU, MT, E, and °C (p < 0.00001) (a significant effect of time was found) in response to GR therapy. No significant differences were found for the PPT. Conclusions: The results of this study prove that GR HCCT evokes changes in the biomechanical parameters of the RF muscles and perfusion in professional MMA fighters.

Acute effects of cold, heat and contrast pressure therapy on forearm muscles regeneration in combat sports athletes: a randomized clinical trial

Due to the specific loads that occur in combat sports athletes' forearm muscles, we decided to compare the immediate effect of monotherapy with the use of compressive heat (HT), cold (CT), and alternating therapy (HCT) in terms of eliminating muscle tension, improving muscle elasticity and tissue perfusion and forearm muscle strength. This is a single-blind, randomized, experimental clinical trial. Group allocation was performed using simple 1:1 sequence randomization using the website randomizer.org. The study involved 40 40 combat sports athletes divided into four groups and four therapeutic sessions lasting 20 min. (1) Heat compression therapy session (HT, n = 10) (2) (CT, n = 10), (3) alternating (HCT, n = 10), and sham, control (ShT, n = 10). All participants had measurements of tissue perfusion (PU, [non-reference units]), muscle tension (T-[Hz]), elasticity (E-[arb- relative arbitrary unit]), and maximum isometric force (Fmax [kgf]) of the dominant hand at rest (Rest) after the muscle fatigue protocol (PostFat.5 min), after therapy (PostTh.5 min) and 24 h after therapy (PostTh.24 h). A two-way ANOVA with repeated measures: Group (ColdT, HeatT, ContrstT, ControlT) × Time (Rest, PostFat.5 min, PostTh.5 min, Post.24 h) was used to examine the changes in examined variables. Post-hoc tests with Bonferroni correction and ± 95% confidence intervals (CI) for absolute differences (△) were used to analyze the pairwise comparisons when a significant main effect or interaction was found. The ANOVA for PU, T, E, and Fmax revealed statistically significant interactions of Group by Time factors (p < 0.0001), as well as main effects for the Group factors (p < 0.0001; except for Fmax). In the PostTh.5 min. Period, significantly (p < 0.001) higher PU values were recorded in the HT (19.45 ± 0.91) and HCT (18.71 ± 0.67) groups compared to the ShT (9.79 ± 0.35) group (△ = 9.66 [8.75; 10.57 CI] > MDC(0.73), and △ = 8.92 [8.01; 9.83 CI] > MDC(0.73), respectively). Also, significantly (p < 0.001) lower values were recorded in the CT (3.69 ± 0.93) compared to the ShT (9.79 ± 0.35) group △ = 6.1 [5.19; 7.01 CI] > MDC(0.73). For muscle tone in the PostTh.5 m period significantly (p < 0.001) higher values were observed in the CT (20.08 ± 0.19 Hz) group compared to the HT (18.61 ± 0.21 Hz), HCT (18.95 ± 0.41 Hz) and ShT (19.28 ± 0.33 Hz) groups (respectively: △ = 1.47 [1.11; 1.83 CI] > MDC(0.845); △ = 1.13 [0.77; 1.49 CI] > MDC(0.845), and △ = 0.8 [0.44; 1.16 CI], < MDC(0.845)). The highest elasticity value in the PostTh.5 m period were observed in the CT (1.14 ± 0.07) group, and it was significantly higher than the values observed in the HT (0.97 ± 0.03, △ = 0.18 [0.11; 0.24 CI] > MDC(0.094), p < 0.001), HCT (0.90 ± 0.04, △ = 0.24 [0.17; 0.31 CI] > MDC(0.094), p < 0.001) and ShT (1.05 ± 0.07, △ = 0.094 [0.03; 0.16 CI] = MDC(0.094), p = 0.003) groups. For Fmax, there were no statistically significant differences between groups at any level of measurement. The results of the influence of the forearm of all three therapy forms on the muscles' biomechanical parameters confirmed their effectiveness. However, the effect size of alternating contrast therapy cannot be confirmed, especially in the PostTh24h period. Statistically significant changes were observed in favor of this therapy in PU and E measurements immediately after therapy (PostTh.5 min). Further research on contrast therapy is necessary.

Lateral preference in complex combat situations: Prevalence and relationship with general measures of hand and foot preference

Laterality is considered relevant to performance in combat sports with particular emphasis being placed on fighters' handedness and combat stance. Such approach, however, may fall too short to understand the role of laterality in sports where fighters are allowed to use their hands and feet standing and on the ground. Here, we referred to grappling sports (i) to estimate lateral preferences in selected combat situations and (ii) to test for an association between those preferences and common measures of hand and foot preference. Based on the responses of 135 experienced grapplers who participated in an online questionnaire lateral preference, at the group-level, was revealed in 12 out of 18 combat situations. At an item-level, common measures of lateral preference and grappling-specific lateral preference were related in three out of 36 conditions (footedness only, not handedness). Across items, scores in a grappling-specific laterality index were positively related with foot but not with hand preference scores. Implications for the assessment of lateral preference in combat sports and the use of item-specific terminology in this context are discussed. On a broader scale, we also elaborate on potential consequences of our findings with regard to evolutionary explanations of the maintenance of left-handedness in humans.

Exploratory Systematic Review of Mixed Martial Arts: An Overview of Performance of Importance Factors with over 20,000 Athletes

This review aimed to analyze the findings in the literature related to Mixed Martial Arts (MMA) through an exploratory systematic review and to present the state of the art from a multifactorial perspective. The review was conducted in accordance with the PRISMA statement, with a search performed in the Scopus, PubMed, and Web of Science databases. Participants were competitive athletes (amateurs or professionals) of regional, national, or international levels. Of the 2763 registries identified, 112 studies met the eligibility criteria. The pooled sample size and age were 20,784 participants, with a mean age of 27.7 ± 6 years for male and 28.9 ± 3 years for female, with the vast majority of athletes being male (94.9%). MMA athletes were 17.2% amateurs, 73.8% professionals, and 9% were not reported. The scientific literature related to MMA reported injuries (n = 28), weight loss (n = 21), technical and tactical analysis (n = 23), physical fitness (n = 8), physiological responses and training characteristics (n = 13), psychobiological parameters (n = 12), and interventions applied to MMA athletes (n = 7). Therefore, this exploratory systematic review presents practitioners and researchers with seven broad summaries of each facet of performance of importance in this population of athletes.

Maxillofacial Trauma in the Ultimate Fighting Championship

PURPOSE

The Ultimate Fighting Championship (UFC) is an American mixed martial art (MMA) company. This study aims to characterize patterns and trends of maxillofacial injuries in MMA.

MATERIALS AND METHODS

The study design is a retrospective cohort study. Study sample consisted of fighters that suffered injuries during the matches from January 2015 to December 2019 (N = 259). The Athletic Commissions and corresponding fighting regulatory departments from 16 states and 24 countries were screened for medical reports released by UFC ringside physicians. Predictor variables were sex, weight division, injury location, injury type, and fight outcome (i.e., Technical Knockout/Knockout, Submission, Decision). Primary outcome variables were need for medical suspension and duration of medical suspension, secondary outcome variable was frequency of injury. Chi-square test was used to determine any statistical significance between predictor variables. One-way analysis of variance was used to determine any statistically significant differences between medical suspension times, sex, injury location, type of injury, weight divisions and fight outcome throughout the years. P value less than .05 (95% confidence interval [CI]) was considered statistically significant.

RESULTS

A total of 259 fighters suffered injuries. Of the 319 total injuries, 291 (91.2%) occurred in male fighters, and 28 (8.8%) in females. Middle facial third injuries were the most common for both males and females; lower facial third injuries were proportionally similar. The male weight division with the longest medical suspensions were the light heavyweight (110.68 days) and welterweight (108.25 days) (P < .10166); the female weight division with the longest medical suspension was strawweight (88.92 days) and shortest was bantamweight (81.75 days) (P < .921123).

CONCLUSIONS

Upper and midface trauma was predominant with fractures concentrated in the light heavyweight and welterweight divisions. Medical suspensions duration were longer in the light heavyweight and welterweight divisions.

The physical demands of mixed martial arts: A narrative review using the ARMSS model to provide a hierarchy of evidence

The physical demands of mixed martial arts (MMA) training and competition is not yet well quantified. The Applied Research Model for the Sport Sciences (ARMSS) provides a framework through which to conduct sport science, determining pertinent questions to test research findings in real-world settings. The aim of this review was to evaluate MMA research within the context of ARMSS to critically analyse our understanding of the physical requirements of MMA training and competition. Research databases were searched, with 70 peer-reviewed articles being discussed in relation to the specific stage of the ARMSS in which their results best fit. MMA research was found to be mostly foundational and descriptive in nature and has generally not developed along systematic lines. The internal and external loads and responses to training and competition have not been adequately identified. Therefore, it is not currently possible to state which variables are key predictors of success, or how coaches can optimally manipulate these variables. We propose that MMA research be refocused to be conducted within ARMSS. Specifically, stage 2 studies describing the physical, physiological and technical demands of MMA training and competition, and stage 3 studies determining the physiological predictors of performance should be initially prioritised.

Acute fatigue affects reaction times and reaction consistency in Mixed Martial Arts fighters

Mixed Martial Arts (MMA) is a multielement combat sport where fighters need to quickly react to an opponent’s movements under fatigued conditions. Research indicates that fast reaction time is important in many sports, but the effect of fatigue has shown negative, null, or even positive influences on reaction time. However, few studies have been conducted in a controlled setting, especially using MMA figthers, whose matches are frequently resolved in a split-second. Therefore, this study investigated whether acute neuromuscular fatigue affects reaction and movement times, and their consistency in MMA fighters (N = 45). Before and after an upper-body Wingate test, a simple visual reaction time task was completed. Results showed a significant negative effect of fatigue on the reaction times and their consistency, with longer reactions (1.5% change) and lower consistency (14.7% change) after the Wingate test. Further, greater amounts of fatigue during the Wingate test seemed to negatively affect the consistency of post-Wingate movement time. Due to cumulative fatigue and the dynamic nature of MMA, our data indicate that not only the decrements in aerobic and anaerobic power likely affect a fighter’s performance, but their reaction time and motor time may also be compromised during a fight.

Neuromuscular Fatigue Induced by a Mixed Martial Art Training Protocol

Giboin, L-S and Gruber, M. Neuromuscular fatigue induced by a mixed martial art training protocol. J Strength Cond Res XX(X): 000-000, 2019-Mixed martial arts (MMA) is a full-contact sport whose popularity and professionalism are rapidly growing. However, the specific physiological demands of this sport have been only scarcely studied so far, and especially the amount or type of neuromuscular fatigue induced by an MMA bout remains completely unknown. We estimated neuromuscular fatigue of knee extensors muscles during and after an MMA training protocol designed to simulate the physiological demands of MMA competition in competitive practitioners (n = 9) with isometric maximal voluntary force (MVF), potentiated muscle twitch at rest (Ptw), and voluntary activation (VA). Bayesian linear mixed models showed that the training protocol induced a reduction of MVF, Ptw, and VA. Although the largest reduction across time of VA was smaller than the largest reduction of Ptw, an effect of VA, but not of Ptw, was found on MVF variation. The training protocol induced neuromuscular fatigue, with a larger peripheral (Ptw) than central component (VA). However, despite the large decrease in Ptw, force production capacity was related only to VA, indicating that central control might play an important role in the compensation of the peripheral fatigue components estimated with Ptw. This central compensation can most probably prevent a too large loss of muscle force during the training protocol.

Dynamics of cognitive performance at rest and after exhaustive exercise in top-three world-ranked mixed martial arts athletes: a series of case studies

Cognitive performance plays a key role in sports performance, especially in combat sports such as mixed martial arts (MMA). Studies with active and sedentary individuals showed either no change or decreased cognitive performance during or immediately after exercise. However, it is possible that elite MMA athletes would present preserved/improved cognitive performance after exhaustive exercise. In this series of cases studies, we tested this hypothesis by submitting three elite MMA athletes from the Bellator MMA® and UFC® to a cognitive assessment before, immediately after and 15 min after exhaustive exercise. A modified computerized version of the Stroop Test was used to test cognitive inhibition performance, from which reaction time (RT) and accuracy were obtained. The athletes performed an incremental exercise on a cycle simulator until volitional exhaustion. Immediately after exercise RT improved consistently in all three athletes (-6.5%; -8.0%; -15.0%), while accuracy presented a small increase (2.6%), decreases (-3.8%) or no change. Fifteen minutes after exercise, RT remained improved in two athletes (-9.1% and -15.5) or slightly increased (0.4%), while accuracy presented small increase in all athletes (0.5%; 1.3%; 2.1%) compared to pre-exercise. This result indicates that elite MMA athletes may present improved cognitive performance immediately after exhaustive exercise, which suggests that cognitive-motor training for MMA should be considered when planning a training program.

Early Signs of Inflammation With Mild Oxidative Stress in Mixed Martial Arts Athletes After Simulated Combat

Gomes-Santos, JAF, Lambertucci, RH, Vardaris, CV, Passos, MEP, Silva-Junior, EP, Hatanaka, E, Gorjão, R, McAnulty, SR, Souza-Junior, TP, and Barros, MP. Early signs of inflammation with mild oxidative stress in Mixed Martial Arts athletes after simulated combat. J Strength Cond Res XX(X): 000-000, 2019-Combat sports involve a combination of strenuous physical activity, usually at the anaerobic threshold, followed by intermittent low-intensity recovery periods for energy re-establishment. Oxidative stress and inflammation are inevitable exercise-related processes that could drastically affect athletic performance and practitioners' health, unless efficiently controlled during and after physical activities. This study aims to measure oxidative stress and inflammation biomarkers in the plasma of 12 top ranked professional Mixed Martial Arts (MMAs) athletes before and after simulated combats under official rules (pre-post study). Our results show that the athletes exhibited mild oxidative imbalances in plasma, evidenced by significant (p < 0.01) higher contents of both reduced (+7.3%) and oxidized glutathione (+28%), uric acid (+21%), and "free" iron (+21%) after combat, whereas variation tendencies (0.05 < p < 0.01) were observed in the antioxidant capacity in plasma (-40%), and SOD (-27%) or GPX (+20%) antioxidant activities in erythrocytes. However, a clear pro-inflammatory state was detected by increases in circulating cytokines IL-6 (+6,020%), IL-1β (+4,357%), and tumor necrosis factor alpha (+63%), and by an abrupt drop of the anti-inflammatory cytokine IL-10 (-98%). A significant correlation was observed between pre-post variations of IL-6 and GSH/GSSG ratio in plasma (p < 0.0001), which reinforces the integration between oxidative stress and inflammation during MMA combats. Considering metabolic and mechanical stresses (imposed by combat techniques, e.g., punches and joint locks), this study indicates pre-existing inflammation, although minor oxidative stress, in MMA professionals after combat.

Predictors of Fighting Ability Inferences Based on Faces

Facial perception plays a key role in various social interactions, including formidability assessments. People make relatively accurate inferences about men's physical strength, aggressiveness, and success in physical confrontations based on facial cues. The physical factors related to the perception of fighting ability and their relative contribution have not been investigated yet, since most existing studies employed only a limited number of threat potential measures or proxies. In the present study, we collected data from Czech Mixed Martial Arts (MMA) fighters regarding their fighting success and physical performance in order to test physical predictors of perceived fighting ability made on the basis of high-fidelity facial photographs. We have also explored the relationship between perceived and actual fighting ability. We created standardized 360° photographs of 44 MMA fighters which were assessed on their perceived fighting ability by 94 raters (46 males). Further, we obtained data regarding their physical characteristics (e.g., age, height, body composition) and performance (MMA score, isometric strength, anaerobic performance, lung capacity). In contrast to previous studies, we did not find any significant links between the actual and the perceived fighting ability. The results of a multiple regression analysis have, however, shown that heavier fighters and those with higher anaerobic performance were judged as more successful. Our results suggest that certain physical performance-related characteristics are mirrored in individuals' faces but assessments of fighting success based on facial cues are not congruent with actual fighting performance.

Towards a Determination of the Physiological Characteristics Distinguishing Successful Mixed Martial Arts Athletes: A Systematic Review of Combat Sport Literature

BACKGROUND

Mixed martial arts (MMA) is a combat sport underpinned by techniques from other combat disciplines, in addition to strategies unique to the sport itself. These sports can be divided into two distinct categories (grappling or striking) based on differing technical demands. Uniquely, MMA combines both methods of combat and therefore appears to be physiologically complex requiring a spectrum of mechanical and metabolic qualities to drive performance. However, little is known about the physiological characteristics that distinguish higher- from lower-level MMA athletes. Such information provides guidance for training interventions, performance testing and talent identification. Furthermore, while MMA incorporates techniques from both grappling and striking sports, it is unknown precisely how these disciplines differ physiologically. Understanding the relationship between higher-level competitors in grappling and striking combat sports can provide further insight into the development of the optimal performance profile of a higher-level MMA athlete.

OBJECTIVE

This article aims to analyse the scientific literature on MMA and the primary combat sports underpinning it to determine the physiological adaptations that distinguish superior competitors, with a view to defining the optimal physiological profile for higher-level MMA performance. Furthermore, this article will explore the differences in these capabilities between grappling- and striking-based combat sports in the context of MMA.

METHODS

A literature search was undertaken via PubMed, Web of Science, SportDiscus and Google Scholar. The following sports were included for systematic review based on their relevance to MMA: mixed martial arts, boxing, Brazilian jiu-jitsu, judo, karate, kickboxing, Muay Thai and wrestling. The inclusion criteria allowed studies that compared athletes of differing competition levels in the same sport using a physiological performance measure. Only male, adult (aged 17-40 years), able-bodied competitors were included. The search history spanned from the earliest record until September 2015.

RESULTS

Of the eight combat sports searched for, five were represented across 23 studies. Sixteen investigations described maximal strength or neuromuscular power variables, while 19 articles reported anaerobic or aerobic measures. The results indicate that a number of strength, neuromuscular power and anaerobic variables distinguished higher- from lower-level combat sport athletes. However, these differences were less clear when groups were stratified within, rather than between competition grades. Greater aerobic power was generally not present amongst superior combat sport competitors.

CONCLUSION

There appear to be differing physiological profiles between more successful grappling and striking combat sport athletes. This is represented by high-force demands of grappling sports causing an upwards shift of the entire force-velocity relationship driven by an increase in maximal strength. In comparison, smaller increases in maximal force production with more notable enhancements in lighter load, higher velocity actions may better identify superior performance in striking sports. Anaerobic capabilities largely distinguished higher- from lower-level combat sport athletes. In particular, longer-term anaerobic efforts seem to define successful grappling-based athletes, while superior competitors in striking sports tend to show dominance in shorter-term measures when compared with their lower-level counterparts. Given the demand for both forms of combat in MMA, a spectrum of physiological markers may characterize higher-level competitors. Furthermore, the performance profile of successful MMA athletes may differ based on combat sport history or competition strategy.

Comparisons: Technical-Tactical and Time-Motion Analysis of Mixed Martial Arts by Outcomes

Miarka, B, Vecchio, FBD, Camey, S, and Amtmann, JA. Comparisons: technical-tactical and time-motion analysis of mixed martial arts by outcomes. J Strength Cond Res 30(7): 1975-1984, 2016-The aim of this study was to compare time-motion and technical-tactical analysis between paired outcomes and rounds of mixed martial arts (MMA) matches. The sample consisted of 645 rounds of MMA competition paired by outcomes (first round, winners n = 215 and losers n = 215; second round, winners n = 215 and losers n = 215; third round, winners n = 215 and losers n = 215). The time-motion variables were categorized into low-intensity or high-intensity, stand-up or groundwork situations. Stand-up techniques were analyzed by observing total strikes to the head and body, and takedowns. The actions on the ground were analyzed by observing submission activity, including successful choking and joint locking actions, and also positional improvements, including advances to the mount, half guard, and side and back positions. Chi-squared and Wilcoxon tests were conducted with a significance level of p ≤ 0.05. Results showed that winners had higher values for total strikes and submissions in all rounds, and also positional improvements, over losers. The standing combat with low-intensity comparisons presented differences between the rounds first, with a median of 2:33.5 (P25-P75%: 1:20-3:56) minute, second, with 2:37 (1:24-3:59) minute, and third, with 2:07 (1:06-3:39.2) minute. These data suggest a focus on the intermittent demand presented in combat phases with a special attention to the strike and ground technical-tactical skills; strength and conditioning coaches could emphasize the effort pause ratios for both standing and ground combat that mimic the requirements of MMA, especially during the third round.

Mental toughness of mixed martial arts athletes at different levels of competition

This study investigated whether mental toughness distinguishes mixed martial arts (MMA) athletes competing at different levels. It was theorized that higher mental toughness would separate those competing at the professional level compared to lower levels. Male MMA competitors (N = 136, M age = 27.1 yr., SD = 4.8) were categorized as amateur, semi-professional, or professional and assessed by questionnaire using the Psychological Performance Inventory-A and the Sports Mental Toughness Questionnaire. There were statistically significant differences between the three groups on mental toughness. The professional group had higher scores compared to semi-professional and amateur groups with regard to confidence, positive cognition, and determination. The findings supported previous work that athletes performing at higher levels have superior mental toughness.