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Determine whether unilateral low-intensity blood-flow restricted (LIBFR) exercise is as effective as high-intensity (HI) resistance training for improving contralateral muscle strength. Thirty healthy adults (20–30 years) were randomly allocated to the following dynamic plantar-flexion training interventions: HI [75% of one-repetition maximum (1RM), 4 sets, 10 reps] and LIBFR [20% of 1RM, 4 sets, 30 + 15 + 15 + 15 reps]. Evoked V-wave and H-reflex recruitment curves, as well as maximal voluntary contraction (MVC) and panoramic ultrasound assessments of the trained and untrained soleus muscles were obtained pre-training, post-4 weeks of training and post-4 weeks of detraining. Both interventions failed to increase contralateral MVC and muscle cross-sectional area (CSA). Yet, contralateral rate of torque development (RTD) was enhanced by both regimens (12–26%) and this was accompanied by heightened soleus EMG within the first milliseconds of the rising torque-time curve (14–22%; p

Background: An increasing body of evidence indicates that the phase angle (PhA) can be applied as a marker of nutritional status, disease prognosis, and mortality probability. Still, it is not known whether PhA can be used as an indicator of muscular quantity and strength and maximal aerobic capacity in overweight/obese former highly active individuals, an understudied population. This study aimed to analyze the association between PhA with skeletal muscle mass, maximal isometric strength, and maximal aerobic capacity through VO2max, in overweight/obese and inactive former athletes. Methods: Cross-sectional information of 94 (62 males) former adult athletes (age: 43.1 ± 9.4 years old; body mass index: 31.4 ± 4.8 kg/m2) taking part in a weight-loss clinical trial was analyzed. Total fat and fat-free mass were determined by dual-energy X-ray absorptiometry, while skeletal muscle mass was predicted from appendicular lean soft tissue. Values for upper- and lower-body maximal isometric strength were assessed by handgrip and leg press dynamometry. VO2max was determined by indirect calorimetry through a graded exercise test performed on a treadmill. Results: PhA was associated with skeletal muscle mass (r = 0.564, p < 0.001), upper-body strength (r = 0.556, p < 0.001), lower-body strength (r = 0.422, p < 0.001), and VO2max (r = 0.328, p = 0.013). These relationships remained significant for skeletal muscle mass (β = 2.158, p = 0.001), maximal isometric strength (upper-body: β = 2.846, p = 0.012; low-er-body: β = 24.209, p = 0.041) after adjusting for age, sex, and fat mass but not for VO2max (β = −0.163, p = 0.098). Conclusion: Our findings indicated that former athletes with higher values of PhA exhibited greater muscle mass and strength, despite sex, age, and body composition, which suggests that this simple raw BI parameter can be utilized as an indicator of muscle quantity and functionality in overweight/obese former athletes.

Ultrasound imaging allows the evaluation of musculoskeletal morphology and function. Ultrasound elastography can also offer semi-quantitative and/or quantitative assessment of tissue stiffness providing relevant information about adaptations of skeletal muscle mechanical properties. In this study we aimed to explore the feasibility of elastography ultrasound imaging in assessing the effect of strength training on vastus lateralis stiffness. Twenty-eight young male adults were separated in a control (n = 9) and strength-training (n = 20) groups. The strength-training group completed 15 weeks of either concentric (n = 10) or eccentric (n = 10) isokinetic training of the knee extensors. Ultrasound scans of the vastus lateralis for quasi-static elastography were collected. All image acquisitions and measurements were done by the same experienced sonographer. After 15 weeks, knee maximal extension isometric torque increased in the strength-training groups. After strength training, there was a decrease in the amount of red pixels in vastus lateralis region of interest [F(1,18) = 25.490, p &lt, 0.001, &eta, 2 = 0.586], whereas the amount of green and blue pixels increased F(1,18) = 17.179, 0.01, 2 = 0.488, F(1,18) = 6.522, 0.05, 2 = 0.266], suggesting higher vastus lateralis stiffness. We conclude that concentric and eccentric strength training increases skeletal muscle stiffness, which can be evaluated by quasi-static elastography. Ultrasound elastography is suitable for non-invasive evaluation of skeletal muscle functional adaptations, which can be of importance for sports medicine and in designing optimal training and rehabilitation programs.

This study aimed to determine whether men and women display a different magnitude of muscle fatigue in response to high-load (HL) and low-load blood flow-restricted (LLBFR) elbow-flexion exercise. We also explored to which extent both exercise protocols induce similar levels of muscle fatigue (i.e., torque decrement). Sixty-two young participants (31 men and 31 women) performed dynamic elbow flexions at 20 and 75% of one-repetition maximum for LLBFR and HL exercise, respectively. Maximum voluntary isometric contractions were performed before and after exercise to quantify muscle fatigue. Men and women exhibited similar magnitude of relative torque decrement after both exercise protocols (p > 0.05). HL was more fatiguing (∆ torque output: 11.9 and 23 N.m in women and men, respectively) than LLBFR resistance exercise (∆ torque output: 8.3 and 15.4 N.m in women and men, respectively) in both sexes, but this was largely attenuated after controlling for the differences in volume load between protocols (p > 0.05). These data show that torque decrement in response to LLBFR and HL dynamic elbow-flexion exercise does not follow a sexually dimorphic pattern. Our data also indicate that, if performed in a multiple-set fashion and prescribed for a given volume load, elbow-flexion LLBFR exercise induces similar levels of fatigue as HL acute training. Importantly, this occurs similarly in both sexes.

Fatela, P, Reis, JF, Mendonca, GV, Freitas, T, Valamatos, MJ, Avela, J, and Mil-Homens, P. Acute neuromuscular adaptations in response to low-intensity blood flow restricted exercise and high-intensity resistance exercise: are there any differences? J Strength Cond Res 32(4): 902-910, 2018-Numerous studies have reported similar neuromuscular adaptations between low-intensity (LI) blood-flow restricted exercise (BFRE) and high-intensity (HI) resistance training. Unfortunately, none of these experimental designs individualized blood flow restriction (BFR) levels to each participant. Thus, their findings are difficult to interpret. We aimed at comparing the acute effects of LI BFR (80% of absolute vascular occlusion pressure) with LI non-BFR and HI training on muscle torque, activation, and neuromuscular fatigue. Ten men (23.8 ± 5.4 years) exercised at 20 and 75% of 1 repetition maximum with and without BFR (for LI). Blood flow restriction pressure was determined individually using resting blood-flow measurements. Torque was determined during maximal voluntary contractions (MVCs) at pre-exercise and postexercise time points. Surface electromyographic activity (root mean square [RMS] and median frequency [MF]) was recorded for the rectus femoris (RF) and vastus medialis (VM) muscles, before and after each session of training, during isometric contractions at 20% MVC. Torque decreased post-HI and LI BFR (-9.5 and -7.8%, respectively; p < 0.01), but not after LI non-BFR. The MF was reduced following HI training in the VM and the RF muscles (-5.3 and -12.5%, respectively; p ≤ 0.05). Conversely, the impact of LI BFR on reducing MF was limited to the RF muscle (-10.7%, p ≤ 0.05). Finally, when compared to all other conditions, RMS values were consistently higher during submaximal contractions performed after HI training (p ≤ 0.05). Thus, we conclude that, despite enhancing the acute magnitude of muscular activation and fatigue, LI BFR exercise exerts a less profound impact on neuromuscular function than HI resistance training.

Objectives Biceps femoris long-head architectural assessment using ultrasonography (US) has not been previously described in detail for both acquisition (image capture) and digitization (image measurement) processes, and the effect of the US window width is unknown. This study aimed to describe the reliability and test-retest minimum detectable difference of US-based biceps femoris architectural measurements. Methods Muscle length was determined by marking the muscle-tendon junction distances. Sonograms were acquired with a 6-cm image width and cropped for a 3-cm width in 3 assessments (n = 20 adults). Intra- and inter-rater reliability rates were determined for both image (3- and 6-cm widths) acquisition and digitizing processes separated and together (within session) for the biceps femoris fascicle length, fascicle angle, and muscle thickness measurements using intraclass correlation coefficients (ICCs) and Pearson (r) correlation coefficients. Results Muscle length was measured with high intra-rater (ICC = 0.93; r = 0.92) and inter-rater (ICC = 0.90; r = 0.90) reliability. Intra-rater (coefficient of variation, 0.2%–1.8%) and inter-rater (ICC = 0.79–0.99; r = 0.80–0.99) digitizing reliability rates were high. High intra-rater (ICC = 0.79–0.95; r = 0.79–0.95) and moderate-to-high inter-rater (ICC = 0.51–0.92; r = 0.70–0.93) session reliability rates were found for all architectural parameters for 6- and 3-cm images (intra-rater ICC = 0.77–0.93; r = 0.79–0.93; inter-rater ICC = 0.63–0.98; r = 0.90–0.98). The inter-rater session reliability rates for both image acquisition and digitizing processes were higher for 6-cm images (ICC = 0.65–0.86; r = 0.67–0.87) than 3-cm images (ICC = 0.28–0.93; r = 0.67–0.93). The minimum detectable differences for the 6-cm images were 8.4 mm, 1.5 °, and 1.6 mm for fascicle length, fascicle angle, and muscle thickness, respectively. Conclusions Ultrasonography can be used to reliably assess midmuscle architecture of the biceps femoris muscle when the same rater performs image acquisition and digitization.

Hamstring strain injuries (HSI) are the most common injury in male professional football and are potentially a primary risk factor to re-injury. Although the isokinetic strength ratios have often been used to identify strength imbalances that can augment the risk of injury in football players, the rate of torque development hamstring to quadriceps ratio (RTD H/Q) has rarely been considered in previous reports. Furthermore, little consideration has been given to selective hamstring lengths (30° of knee flexion) and its influence on torque production. The aim of this study was to investigate the RTD H/Q at long hamstring lengths, conventional (concentric/concentric) and functional (eccentric/concentric) H/Q ratios in football players with and without previous HSI. Twenty-four professional male football players (12 and 12 without previous HSI) performed maximal voluntary isometric contractions at long hamstring lengths (knee and hip flexed at 30° and 85°, respectively) and isokinetic concentric and eccentric contractions at 180°.s

We aimed to determine whether blood flow restriction (BFR) alters the characteristics of individual motor units during low-intensity (LI) exercise. Eight men (26.0±3.8 yrs) performed 5 sets of 15 knee extensions at 20% of one-repetition maximum (with and without BFR). Maximal isometric voluntary contractions (MVC) were performed before and after exercise to quantify force decrement. Submaximal isometric voluntary contractions were additionally performed for 18 s, matching trapezoidal target-force trajectories at 40% pre-MVC. EMG activity was recorded from the vastus lateralis muscle. Then, signals were decomposed to extract motor unit recruitment threshold, firing rates and action potential amplitudes (MUAP). Force decrement was only seen after LI BFR exercise (–20.5%; p

The objective of this investigation was to evaluate the accuracy of peak vertical jump power (VJP) to identify children with bone mineral density (BMD) below average, defined as BMD measured by DXA and adjusted for body height at the whole body less head≤- 1.0 standard deviation (SD). The sample included 114 boys and girls aged 8.5±0.4 years old. VJP was estimated from a countermovement jump performed on a contact mat using the measured flight time to calculate the height of rise of the center of gravity. Logistic regression analysis revealed that the odds ratio of having BMD≤1.0 SD decreased 1.2% per watt of power and the probability of BMD below average was 75.6% higher in boys than in girls with the same peak power jump. Receiver operating characteristic analysis showed that the best trade-off between sensitivity and specificity to identify children with BMD- 1.0 SD was 635 watts in boys (sensitivity=63.3%; specificity=69.2%; AUC=0.816, 95% CI: 0.681-0.95; p0.001) and 515 watts in girls (sensitivity=75.0%; specificity=77.0%; AUC=0.849, 95% CI: 0.698-0.999; p=0.002). These cut-off values correspond to a vertical jump of 19.9 cm and 20.5 cm in 8-year-old boys and girls, respectively. The VJP showed a reasonable sensitivity and specificity as well good discriminant ability to identify children with BMD below average.

There is some evidence that muscular activation during exercise is enhanced by higher levels of blood flow restriction (BFR). However, the impact of different relative levels of BFR on the acute neuromuscular response to resistance exercise is not yet fully understood. We examined the acute effects of low-intensity knee extensions [20 % of 1-repetition maximum (1RM)] with BFR on muscle activation, neuromuscular fatigue and torque in the rectus femoris (RF) and vastus medialis (VM) muscles. Fourteen men (24.8 ± 5.4 years) exercised at 20 % 1RM combined with 40, 60 and 80 % BFR. Restrictive pressures were calculated based on direct blood-flow measurements taken at rest on each participant. Torque was determined during pre- and post-exercise maximal voluntary contractions. Surface electromyographic activity [root mean square (RMS)] was obtained during dynamic and sustained isometric contractions before and after exercise. The median frequency (MF) of the electromyographic power spectrum was computed for isometric contractions. Torque only decreased in the 80 % BFR condition (−5.2 %; p

Borges, A, Teodósio, C, Matos, P, Mil-Homens, P, Pezarat-Correia, P, Fahs, C, and Mendonca, GV. Sexual dimorphism in the estimation of upper-limb blood flow restriction in the seated position. J Strength Cond Res 32(7): 2096-2102, 2018-Arterial occlusion pressure (AOP) is typically used to normalize blood flow restriction (BFR) during low-intensity BFR exercise. Despite strong evidence for sexual dimorphism in muscle blood flow, sex-related differences in AOP estimation remain a controversial topic. We aimed at determining whether the relationship of upper-limb AOP with arm circumference and systolic blood pressure (BP) differs between men and women resting in the seated position. Sixty-two healthy young participants (31 men: 21.7 ± 2.3; 31 women: 22.0 ± 2.0 years) were included in this study. Arm circumference, resting BP, and AOP were taken in the seated position. Multiple linear regression analysis was used to determine whether the relationship of AOP with arm circumference and resting BP differed between sexes. Prediction accuracy was assessed with the mean absolute percent error and Bland-Altman plots. Men had higher systolic BP and larger arm circumference than women (p0.05). Nevertheless, AOP was similar between sexes. Arm circumference, systolic BP, and sex were all significant predictors of AOP (p0.05), explaining 42% of its variance. The absolute percent error was similar in both sexes (men: -0.55 ± 7.12; women: -0.39 ± 6.31%, p0.05). Bland-Altman plots showed that the mean difference between actual and estimated AOP was nearly zero in both groups, with no systematic overestimation or underestimation. In conclusion, arm circumference, systolic BP, and sex are all significant predictors of upper-limb-seated AOP. Their measurement allows for the indirect estimation of BFR pressure within the context of exercise training.

The purpose of this study was to determine the effect of a 15-week partial range of motion (ROM) resistance training program on the vastus lateralis (VL) architecture and mechanical properties, when the time under tension (TUT) was equalized. Nineteen untrained male subjects were randomly assigned to a control (Control; n = 8) or training (TG; n = 11) group. In the TG, the dominant and nondominant legs were randomly selected to be trained with a full ROM (FULL) or a partial ROM (PART) in an isokinetic dynamometer. Training volume was equalized based on the TUT by manipulating sets and repetitions. The VL muscle architecture was assessed by B-mode ultrasonography at rest and during maximal isometric knee extension contractions (MVCs) at ten knee angles. The VL fascicle force and specific tension were calculated from the MVCs with superimposed stimuli, accounting for the moment arm length, muscle architecture, and antagonist coactivation. The FULL training induced changes in fascicle length (FL) (4.9 ± 2.0%, P

BACKGROUND: The isokinetic hamstrings to quadriceps (H:Q) dynamic control ratio (DCR) is frequently used to assess muscle imbalances and to screen for potential risks of knee injuries in sports. OBJECTIVE: To investigate the correlation between knee conventional ratio (CR) and DCR in elite soccer players and check for a possible relationship. A positive correlation would indicate that the CR could predict DCR. METHODS: One hundred and thirteen Brazilian elite soccer players (25.2 ± 5.3 yrs) performed maximal dominant and nondominant knee concentric (CON) and eccentric (ECC) strength tests at 60◦/s on an isokinetic dynamometer in order to calculate CR and DCR. RESULTS:A significant positive correlation between ratios was found for the dominant and non-dominant knees (r = 0.54 and 0.62; p < 0.001 which translated into low R values of 0.29 and 0.39, respectively. CONCLUSION: This suggests that the CR may not replace the DCR and is thus of a limited clinical value in assessing knee muscles imbalance. On the other hand, the paper presents for the first time a robust reference frame for the isokinetic strength and related ratios of the two major knee muscles in soccer players.

Ultrasound (US) has an important role in musculoskeletal (MSK) evaluation, allowing the study of muscle morphology and function. Muscle thickness (MT) and muscle echo-intensity (EI) are two important parameters that may quantify muscle structural adaptations to a variety of stimuli. The aim was to explore the potential of quantitative US imaging for assessing the adaptations and responses of the muscle tissue to increased contractile activity using B-mode US. This study was centred on the quadriceps femoris muscle contractile activity on MT and EI.Twenty-eight young male adults participated in the study, divided in a control group and two training groups performing concentric or eccentric strength training, respectively. The effect of a 15-week strength program was studied on MT and EI in several regions of the heads of the quadriceps femoris using B-mode US. All images acquisitions and measurements were done by the same experience sonographer.Strength training resulted in an increase of MT at all muscles and sites (p 0.05), except the VM. Strength training failed in changing EI in most of the quadriceps femoris, except in the VI and some regions of the VL. No statistically significant differences were observed in our quantitative US parameters between concentric and eccentric training (p 0.05).These results emphasise the value of MT as a quantifiable muscle US method for evaluating muscle adaptation to exercise training. However, the inconsistency of the EI values indicates that more studies are needed to develop it as an accurate diagnostic tool.

Information regarding the effects of stretching intensity on the joint torque-angle response is scarce. The present study examined the effects of three static stretching protocols with different intensities and durations on the passive knee extension torque-angle response of seventeen male participants (age ± SD: 23.9 ± 3.6 years, height: 177.0 ± 7.2 cm, BMI: 22.47 ± 1.95 kg · m(2)). The stretching intensity was determined according to the maximal tolerable torque of the first repetition: fifty per cent (P50), seventy-five per cent (P75) and the maximum intensity without pain (P100). Five repetitions were performed for each protocol. The stretch duration of each repetition was 90, 135 and 180 s for P100, P75 and P50, respectively. The rest period between repetitions was 30 s. Passive torque at a given angle, angle, stress relaxation, area under the curve, surface electromyography activity and visual analogue scale score were compared. The significant (P < 0.05) results found were as follows: (i) the P50 and P75 did not increase the angle and passive peak torque outcomes, despite more time under stretch; (ii) only the P100 increased the angle and passive peak torque outcomes; (iii) the perception of stretching intensity mainly changed depending on knee angle changes, and not passive torque; (iv) the P50 induced a higher passive torque decrease; (v) when protocols were compared for the same time under stretch, the torque decrease was similar; (vi) the change in torque-angle curve shape was different depending on the stretching protocol. In conclusion, higher stretch duration seems to be a crucial factor for passive torque decrease and higher stretch intensity for maximum angle increase.

Previous studies have reported no changes on muscle architecture (MA) after static stretching interventions; however, authors have argued that stretching duration and intensity may not have been sufficient. A high-intensity stretching intervention targeting the knee flexors with an 8-week duration was conducted to observe the effects on biceps femoris long head (BF) architecture. Participants (n = 5) performed an average of 3.1 assisted-stretching sessions per week, whereas a control group (n = 5) did not perform stretching. The knee extension passive maximal range of motion (ROM), and BF fascicle length (FL), fascicle angle, and muscle thickness were assessed before and after the intervention. A significant increase was observed for FL (+12.3 mm, p = 0.04) and maximal ROM (+14.2°, p = 0.04) for the stretching group after the intervention. No significant changes were observed for the control group in any parameter. An 8-week high-intensity stretching program was observed to efficiently increase the BF FL, as well as the knee extension maximal ROM. Stretching intensity and duration may play an important role on MA adaptation.

Objective Little is known about the influence of different training types on relative fat mobilization with exercise. The purpose of this study was to analyze the changes induced by aerobic training (AT), resistance (RT) or a combination of both (AT+RT) on total fat mass (TFM) and regional fat mass (RFM). Further, the relative contribution of different regions, upper limbs (UL), lower limbs (LL), and trunk (Tr), were compared. Design and Methods Forty-five overweight and premenopausal women were randomized in either AT, RT or AT+RT. All training groups exercised for the same duration (60 min), 3 times per week for 5 months. Body composition was estimated using dual energy X-ray absorptiometry. Results TFM decreased significantly in all groups (−4.6 ± 1.9 kg; −3.8 ± 2.6 kg, and −4.7 ± 3.0 kg in AT, RT, and AT+RT groups respectively; P < 0.001). The relative contribution of FM into each segment changed significantly: TrFM represented 46.6% ± 5.8% of TFM at baseline and reduced to 43.1% ± 5.5% (P < 0.001); LLFM was 39.7% ± 5.8% vs. 41.6% ± 5.7% (P < 0.01); ULFM was 11.3% ± 1.3% vs. 12.2% ± 1.4% (P < 0.01). Conclusion Training type did not influence changes of TFM and RFM. Fat mobilization came predominantly from Tr in all training protocols. These findings suggest that overweight and obese women can reduce TFM and RFM, independently of training type.

Purpose People vary in flexibility regarding maximum joint angle, resistance to stretch and mechanical responses during stretching exercises. Body composition (BC) has been been mentioned as one of the factors for flexibility differences. The aim of this study was to determine how body composition and anthropometric measures of the lower limb is associated with passive knee extension (PKE) torque-angle (T-A) response. Methods Twenty-five male subjects with poor flexibility performed a maximal PKE repetition (velocity of 2°/s; 90 seconds in the static phase). Knee passive T-A, vastus medialis and semitendinosous electromyographic activity were recorded during the protocol. Viscoelastic stress relaxation (VSR) amplitude, knee passive stiffness (KPS), lower limb body composition assessed by dual energy x-ray absorptiometry, and anthropometry measures were determined. Results Thigh skeletal muscle and bone mass, as well as thigh perimeter, showed a moderated correlation with passive torque (r = 0.45; r = 0.6; r = 0.59, respectively), joint angle (r = 0.46; r = 0.5; r = 0.5), and VSR (r = 0.46; r = 0.49; r = 0.5). Thigh skeletal muscle was also correlated with KPS (r = 0.42). All these correlations were statistically significant (p

In the context of physical education curricula, markers of physical fitness (e.g., aerobic capacity, muscu- lar strength, flexibility, and body mass index or body fat) are usually evaluated in reference to health standards. Despite their possible mediating role in the relationship between weight-bearing or muscle forces and features of bone tissue, these attributes of fitness may not be the most relevant to predict skeletal health. It is therefore important to analyze the relative contribution of these factors to the variability in bone tissue of different parts of the skeleton, and to analyze it by gender, as sensitivity to mechanical loading can diverge for boys and girls. We compared the effects of habitual physical activity (PA) and lean mass, as surrogates of weight-bearing and muscle forces, and of physical fitness (aerobic and muscle capacity of lower and upper limbs) on bone mineral content (BMC) and size of total body, lumbar spine, femoral neck, and 1/3 radius in 53 girls and 64 boys from 7.9 to 9.7 years of age. After controlling for bone age, body mass, body height, and calcium intake, lean mass was the most important predictor of bone size and/or mineral in both genders (p \ 0.05), while habitual weight-bearing PA positively influenced BMC in boys (p \ 0.05). The effect of muscle in bone was not determined by PA and fitness score did not explain bone variability. Femoral neck was the bone site more closely associated with mechanical loading factors; boys with a PA ( 608 counts/min/day (*105 min/day of moderate and vigorous intensity) showed 13-20% more BMC than those with less physical activity, and girls with a lean mass (19 kg showed 12-19% more BMC than those with less lean mass. These findings suggest that lean mass was the most important predictor of bone size and/or mineralization in both genders, while habitual weight- bearing PA appears to positively impact on bone mineral in prepubertal boys and that both lean mass and PA need to be considered in physical education curricula and other health-enhancing programs.