Progressive overload without progressing load? The effects of load or repetition progression on muscular adaptations

Background

Progressive overload is a principle of resistance training exercise program design that typically relies on increasing load to increase neuromuscular demand to facilitate further adaptations. However, little attention has been given to another way of increasing demand-increasing the number of repetitions.

Objective

This study aimed to compare the effects of two resistance training programs: (1) increasing load while keeping repetition range constant vs (2) increasing repetitions while keeping load constant. We aimed to compare the effects of these programs on lower body muscle hypertrophy, muscle strength, and muscle endurance in resistance-trained individuals over an 8-week study period.

Methods

Forty-three participants with at least 1 year of consistent lower body resistance training experience were randomly assigned to one of two experimental, parallel groups: A group that aimed to increase load while keeping repetitions constant (LOAD: n = 22; 13 men, nine women) or a group that aimed to increase repetitions while keeping load constant (REPS: n = 21; 14 men, seven women). Subjects performed four sets of four lower body exercises (back squat, leg extension, straight-leg calf raise, and seated calf raise) twice per week. We assessed one repetition maximum (1RM) in the Smith machine squat, muscular endurance in the leg extension, countermovement jump height, and muscle thickness along the quadriceps and calf muscles. Between-group effects were estimated using analyses of covariance, adjusted for pre-intervention scores and sex.

Results

Rectus femoris growth modestly favored REPS (adjusted effect estimate (CI_90%), sum of sites: 2.8 mm [-0.5, 5.8]). Alternatively, dynamic strength increases slightly favored LOAD (2.0 kg [-2.4, 7.8]), with differences of questionable practical significance. No other notable between-group differences were found across outcomes (muscle thicknesses, <1 mm; endurance, <1%; countermovement jump, 0.1 cm; body fat, <1%; leg segmental lean mass, 0.1 kg), with narrow CIs for most outcomes.

Conclusion

Both progressions of repetitions and load appear to be viable strategies for enhancing muscular adaptations over an 8-week training cycle, which provides trainers and trainees with another promising approach to programming resistance training.

Loaded inter-set stretch may selectively enhance muscular adaptations of the plantar flexors

The purpose of this study was to evaluate differences in changes in muscle strength and muscle thickness (MT) of the plantar flexor muscles between traditional resistance training (RT) involving passive rest and RT combined with inter-set stretch in the calf raise exercise. Employing a within-subject design, 21 young, healthy men performed plantar flexion exercises twice per week in both a traditional RT (TRAD) format and combined with a 20-second inter-set stretch (STRETCH). One leg was randomly assigned to the TRAD condition and the contralateral leg performed the STRETCH condition throughout the 8-week study period. Dependent variables included MT of the lateral gastrocnemius (LG), medial gastrocnemius (MG) and the soleus (SOL), and isometric strength of the plantar flexors. Results indicated a potential beneficial hypertrophic effect of STRETCH compared to TRAD for the SOL [0.7 mm, CI90% = (0, 1.6)], while the LG had more ambiguous effects [0.4 mm (−0.4, 1.3)] and MG effects were equivocal [0 mm (−0.6, 0.7)]. In general, LG demonstrated greater standardized growth [z = 1.1 (1, 1.3)] as compared to MG [z = 0.3 (0.2, 0.5)] and SOL [z = 0.3 (0.2, 0.5)]. Measures of isometric strength showed a modest advantage to STRETCH. In conclusion, loaded inter-set stretch may enhance MT of the soleus but effects on the gastrocnemii appear uncertain or unlikely in untrained men; plantar flexor strength appears to be modestly enhanced by the interventional strategy.

Effects of Lifestyle Factors on Cognition in Minority Population of Older Adults: A Review

The onset of dementia and Alzheimer's disease (AD) is projected to expand over the next several decades in the United States as the population ages. However, the cognitive health burden is not equally distributed among the population, as Hispanics and African Americans are at higher risk of AD when compared with Non-Hispanic Whites. There is some evidence to indicate that cognitive decline may be associated with lifestyle factors and that interventions in these domains may prevent or delay this decline. These lifestyle factors include social engagement, physical activity, both aerobic and strength training, dietary intake, sleep and stress. This review summarizes, in general, what is known about the relationship between risk factors and cognition and, in particular what is known about this relationship in minority populations. The results show that the relationship between these risk factors and cognitive decline is stronger for some of the factors such as physical activity and dietary intake and weaker for the other factors depending on what is measured and in what populations. It does appear, however, that the studies in minority populations is limited and warrants more targeted research and interventions.

Alterations in Body Composition, Resting Metabolic Rate, Muscular Strength, and Eating Behavior in Response to Natural Bodybuilding Competition Preparation: A Case Study

Schoenfeld, BJ, Alto, A, Grgic, J, Tinsley, G, Haun, CT, Campbell, BI, Escalante, G, Sonmez, GT, Cote, G, Francis, A, and Trexler, ET. Alterations in body composition, resting metabolic rate, muscular strength, and eating behavior in response to natural bodybuilding competition preparation: A case study. J Strength Cond Res 34(11): 3124-3138, 2020-We carried out a prospective case study in a high-level amateur natural male bodybuilder throughout preparation for 4 competitions and during the ensuing postcontest recovery period. Laboratory testing was conducted monthly over a 1-year period, which included the following assessments: B-mode ultrasound evaluation of muscle thickness (MT), multifrequency bioelectrical impedance analysis, blood pressure and heart rate assessment, resting metabolic rate via indirect calorimetry, skinfold testing, vertical jump height, isometric lower-body strength testing, and a 3-factor eating questionnaire. Blood work (including testosterone, thyroid hormone, sex hormone binding globulin, glomerular filtration rate, blood urea nitrogen, aspartate aminotransferase, alanine aminotransferase, white blood count, albumin to globulin ratio, and lipoprotein A) was obtained separately from an outside laboratory at 4 time points. We also assessed the effectiveness of a carbohydrate (carb) deplete and carb load peaking strategy employed immediately before competition. The subject employed a high-volume, high-frequency, whole-body training program throughout the study period. Average daily nutritional intakes ranged from 1,953 to 3,415 kcal: 104-386 g carb; 253-263 g protein, and; 57-95 g lipid. Body fat was reduced to very low levels (∼5%) immediately before competition, but this corresponded with a loss of lean mass. Alterations in metabolism, hormonal status, explosive strength, and psychological aspects of eating were observed during precontest preparation; however, all of these variables recovered quickly postcompetition. The implementation of a carb depleteand carb load peaking strategy acutely increased MT and thus may be a viable precontest approach to maximize muscular aesthetics.

Do the anatomical and physiological properties of a muscle determine its adaptive response to different loading protocols?

It has been proposed that superior muscle hypertrophy may be obtained by training muscles predominant in type I fibers with lighter loads and those predominant in type II fibers with heavier loads.

PURPOSE

To evaluate longitudinal changes in muscle strength and hypertrophy of the soleus (a predominantly slow-twitch muscle) and gastrocnemius (muscle with a similar composition of slow and fast-twitch fibers) when subjected to light (20-30 repetition maximum) and heavy (6-10 repetition maximum) load plantarflexion exercise.

METHODS

The study employed a within-subject design whereby 26 untrained young men had their lower limbs randomized to perform plantarflexion with a low-load (LIGHT) and a high-load (HEAVY) for 8 weeks. Muscle thickness was estimated via B-mode ultrasound and maximal strength was determined by isometric dynamometry.

RESULTS

Results showed that changes in muscle thickness were similar for the soleus and the gastrocnemius regardless of the magnitude of load used in training. Furthermore, each of the calf muscles demonstrated robust hypertrophy, with the lateral gastrocnemius showing greater gains compared to the medial gastrocnemius and soleus. Both HEAVY and LIGHT training programs elicited similar hypertrophic increases in the triceps surae. Finally, isometric strength increases were similar between loading conditions.

CONCLUSIONS

The triceps surae muscles respond robustly to regimented exercise and measures of muscle hypertrophy and isometric strength appear independent of muscle fiber type composition. Moreover, the study provides further evidence that low-load training is a viable strategy to increase hypertrophy in different human muscles, with hypertrophic increases similar to that observed using heavy loads.

To Flex or Rest: Does Adding No-Load Isometric Actions to the Inter-Set Rest Period in Resistance Training Enhance Muscular Adaptations? A Randomized-Controlled Trial

We aimed to investigate the effects of resistance training (RT) combined with no-load isometric actions (iso-holds) during the inter-set recovery period versus RT that involves passive inter-set rest on muscular strength, muscular hypertrophy, and muscular endurance in resistance-trained men. Twenty-seven resistance-trained male volunteers were randomly assigned to either a traditional group (TRAD) that performed a hypertrophy-oriented RT routine with the rest intervals spent passively (n = 13) or to a group that supplemented traditional RT with iso-holds (ISO) for the working muscle group between each set (n = 14). Training for both routines consisted of three weekly sessions performed for 8 weeks. Three sets of 8–12 repetitions were performed per exercise. A 2-min rest interval was afforded between sets; the ISO group performed iso-holds for the first 30 s of each rest interval and then recovered for the final 90 s. Maximal strength was assessed using the one repetition maximum (1RM) tests in the leg press and bench press. Upper-body muscle endurance was assessed by performing the bench press to failure at 50% of 1RM. Muscle thickness (MT) of the elbow flexors, elbow extensors, mid-thigh, and lateral thigh was assessed using B-mode ultrasound. Results indicated a favorable effect of ISO on MT in the mid-thigh. Alternatively, there was a possible detrimental effect for ISO on leg press strength. No other notable differences were seen between conditions. In conclusion, the use of inter-set iso-holds may be a time-efficient strategy to enhance development of the quadriceps femoris; conversely, it may be detrimental to maximizing lower body strength.

Resistance Training Volume Enhances Muscle Hypertrophy but Not Strength in Trained Men

Purpose

The purpose of this study was to evaluate muscular adaptations between low-, moderate-, and high-volume resistance training protocols in resistance-trained men.

Methods

Thirty-four healthy resistance-trained men were randomly assigned to one of three experimental groups: a low-volume group performing one set per exercise per training session (n = 11), a moderate-volume group performing three sets per exercise per training session (n = 12), or a high-volume group performing five sets per exercise per training session (n = 11). Training for all routines consisted of three weekly sessions performed on nonconsecutive days for 8 wk. Muscular strength was evaluated with one repetition maximum (RM) testing for the squat and bench press. Upper-body muscle endurance was evaluated using 50% of subjects bench press 1RM performed to momentary failure. Muscle hypertrophy was evaluated using B-mode ultrasonography for the elbow flexors, elbow extensors, mid-thigh, and lateral thigh.

Results

Results showed significant preintervention to postintervention increases in strength and endurance in all groups, with no significant between-group differences. Alternatively, while all groups increased muscle size in most of the measured sites from preintervention to postintervention, significant increases favoring the higher-volume conditions were seen for the elbow flexors, mid-thigh, and lateral thigh.

Conclusions

Marked increases in strength and endurance can be attained by resistance-trained individuals with just three 13-min weekly sessions over an 8-wk period, and these gains are similar to that achieved with a substantially greater time commitment. Alternatively, muscle hypertrophy follows a dose–response relationship, with increasingly greater gains achieved with higher training volumes.

Initial results of a new access device for hemodialysis technical note

BACKGROUND

A new subcutaneous device (DIALOCKtrade mark) provides vascular access to patients who currently require hemodialysis (HD). The device consists of a port-like valve, implanted subcutaneously below the clavicle, which provides a linear flow passage to two catheters placed in the right atrium via the internal or external jugular vein. The valve is accessed percutaneously with needle-cannulas that functionally convert the device to twin catheters for connecting the patient to the HD lines.

METHODS

The device was implanted in 10 outpatients under local anesthesia. Patients used the device during dialysis 3 times/week, and data were collected on blood flow, pressures, adverse events and patient and nurse satisfaction.

RESULTS

The device was used for HD almost immediately (median 3 days after implantation) and functioned successfully for more than nine months (mean +/- SD 7.3 +/- 1.5) in all but one patient who died of unrelated causes after one month; there were >800 dialysis sessions total. Blood flows over 300 ml/min were consistently achieved (average 326 +/- 40) with venous and arterial pressures of 200 +/- 44 and -246 +/- 29 mm Hg, respectively. After 66 patient-months, condition of the needle puncture sites remained satisfactory. Five systemic infections occurred in four patients, producing 2.3 bacteremic episodes per 1000 patient-days. All resolved without the need for device removal. There were no infections at the puncture sites. Two patients required fibrin sheath stripping of their catheters, one whose heparin lock was not changed for 23 days (for reasons unrelated to the device). Patient and nurse acceptance was excellent.

CONCLUSION

The device represents a positive improvement in the area of HD access.

New access device for hemodialysis

A new subcutaneous device (Dialock; Biolink Corp., Middleboro, MA) provides vascular access to patients who currently require hemodialysis (HD). The device consists of a port-like valve, implanted subcutaneously below the clavicle, which provides a linear flow passage to two catheters placed in the right atrium via the jugular vein. The valve is accessed percutaneously with needle-cannulas that functionally convert the device to twin catheters for connecting the patient to the HD lines. Interdialytic patency is maintained using a standard heparin lock. The device has been implanted in 10 outpatients under local anesthesia, with almost immediate use for HD (median, 3 days) and has functioned successfully for more than 6 months (mean +/- SD, 4.0 +/- 1.7; > 400 dialysis sessions). Blood flows over 300 ml/min were consistently achieved (average, 320 +/- 50) with venous and arterial pressures of 197 +/- 42 mmHg and -241 +/- 31 mmHg, respectively. After 40 patient-months, condition of the needle puncture sites remains satisfactory. Four systemic infections have occurred in three patients; all have resolved without the need for device removal. There have been no infections at the puncture sites. One patient whose heparin lock was not changed for 23 days (for reasons unrelated to the device) required fibrin sheath stripping of his catheters. Patient and nurse acceptance has been excellent. The device may offer substantial improvement over conventional devices for HD access.

The use of heated citric acid for dialyzer reprocessing

Dialyzer reprocessing with heated water (100 to 105 degrees C) for 20 h can be used safely in lieu of chemical methods for disinfection. All infective agents including spores are destroyed and depyrogenation may occur. However, these temperatures may result in structural damage to the dialyzer, limiting reuse. Dialyzer reprocessing by using 1.5% citric acid heated to 95 degrees C for 20 h is an alternative method that produces equivalent microbiologic effects. Citric acid is well known as a disinfecting agent used for dialysis equipment. Because there is little structural damage to dialyzer components at 95 degrees C, reuse statistics are improved (mean reuse increased to 12.8). Both small and large molecule clearances and the sieving coefficient for protein are insignificantly altered by the process. Whereas the procedure is relatively simple, quality-assurance indicators are essential. The method has appeal because it avoids the use of chemical germicides. However, at present it has only been tested thoroughly in polysulfone dialyzers with heat-resistant polycarbonate casings and polyurethane resin. The clinical experience is favorable.

Intradialytic parenteral nutrition: a practical approach

Intradialytic parenteral nutrition (IDPN) therapy is becoming more prevalent in the malnourished patient undergoing maintenance hemodialysis. This is of particular concern to the nephrology nurse in that additional time is required to administer the solution, monitor the patient, and document the process. The IDPN monitoring flowsheet described in this article was developed to promote continuity of care from treatment to treatment, especially during initiation of IDPN, and to assist the nephrology nurse in administering and monitoring the therapy.

On the Extrusion in Superplastic Conditions

In this paper the range within which the slab method is accurate enough to calculate the extrusion pressure in superplastic condition has been determined. A realistic velocity field, supported by experimental evidence, has been adopted. A strain rate field has been evaluated and an appropriate constitutive equation has been introduced. The slab method and the upper bound approach, here developed, have then been used to study the superplastic extrusion through a conical die. A comparison of the two solutions thus obtained has been carried out. It has been found that in any case the curves obtained using the slab method run higher than those obtained using the upper-bound approach. The analysis developed may be used to determine the range within the slab method is accurate enough for engineering purposes.