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Abstract: Nuzzo, JL. Muscle strength preservation during repeated sets of fatiguing resistance exercise: A secondary analysis. J Strength Cond Res 38(6): 1149-1156, 2024-During sustained or repeated maximal voluntary efforts, muscle fatigue (acute strength loss) is not linear. After a large initial decrease, muscle strength plateaus at approximately 40% of baseline. This plateau, which likely reflects muscle strength preservation, has been observed in sustained maximal isometric and repeated maximal isokinetic contractions. Whether this pattern of fatigue occurs with traditional resistance exercise repetitions with free weights and weight stack machines has not been overviewed. Here, the aim was to determine whether the number of repetitions completed across 4 or more consecutive repetitions-to-failure tests exhibits the same nonlinear pattern of muscle fatigue. A secondary analysis was applied to data extracted as part of a recent meta-analysis on repetitions-to-failure tests. Studies were eligible if they reported mean number of repetitions completed in 4-6 consecutive repetitions-to-failure tests at a given relative load. Twenty-nine studies were included. Overall, the results show that the number of repetitions completed in consecutive repetitions-to-failure tests at a given load generally decreases curvilinearly. The numbers of repetitions completed in sets 2, 3, 4, 5, and 6 were equal to approximately 70, 55, 50, 45, and 45% of the number of repetitions completed in set 1, respectively. Longer interset rest intervals typically attenuated repetition loss, but the curvilinear pattern remained. From the results, a chart was created to predict the number of repetitions across 6 sets of resistance exercise taken to failure based on the number of repetitions completed in set 1. The chart is a general guide and educational tool. It should be used cautiously. More data from a variety of exercises, relative loads, and interset rest intervals are needed for more precise estimates of number of repetitions completed during repeated sets of fatiguing resistance exercise., (Copyright © 2024 National Strength and Conditioning Association.)

Purpose: This study aimed to investigate the effect of CBD oil on perceived muscle soreness, inflammation, and strength performance after eccentric exercise (ECC) of the elbow flexors., Methods: Thirteen untrained men (mean ± SD age, 21.85 ± 2.73 yr) performed 6 sets of 10 maximal ECC isokinetic muscle actions of the elbow flexors as part of a double-blind crossover design. Noninvasive (perceived soreness, arm circumference, hanging joint angle (JA), and peak torque (PT)) measures were taken before and after ECC, and 24, 48, and 72 h after ECC. All subjects completed both the supplement (CBD: 150 mg POST, 24 h, 48 h) and placebo (PLC: POST, 24 h, 48 h) condition separated by 2 wk. Four separate two-way repeated-measures ANOVA (condition [CBD vs PLC] × time [PRE vs POST vs 24 h vs 48 h vs 72 h]) were used to analyze perceived soreness, arm circumference, JA, and PT. One-way repeated-measures ANOVA were used to decompose significant interactions and main effects., Results: There was no condition-time interaction or main effect of condition (P > 0.05) for perceived soreness, arm circumference, JA, or PT. There were main effects for time for perceived soreness (P = 0.000, ηp2 = 0.71) and JA (P = 0.006, ηp2 = 0.35)., Conclusions: The current dose of 150 mg CBD oil at POST, 24 h, and 48 h had no effect on noninvasive markers of muscle damage in the upper extremity. At the current dose and schedule, CBD oil may not be beneficial for untrained men as a recovery aid after exercise-induced muscle damage., (Copyright © 2021 by the American College of Sports Medicine.)

Gómez-Carmona, CD, Bastida-Castillo, A, Rojas-Valverde, D, de la Cruz Sánchez, E, García-Rubio, J, Ibáñez, SJ, and Pino-Ortega, J. Lower-limb dynamics of muscle oxygen saturation during the back-squat exercise: effects of training load and effort level. J Strength Cond Res 34(5): 1227-1236, 2020-The aim of this study was to analyze the effect of strength training on lower limb muscle oxygenation. The sample consisted of 12 male subjects (22.4 ± 1.73 years; 1.81 ± 0.08 cm height and 77.76 ± 8.77 kg body mass). Six different strength training stimuli were analyzed, based on the training variables: load (60-75% 1 repetition maximum [1RM]) and level of effort (LE) (E1: 4 × 8 [20RM], E2: 4 × 12 [20RM], E3: 4 × 16 [20RM], E4: 4 × 4 [10RM], E5: 4 × 6 [10RM], and E6: 4 × 8 [10RM]) in the squat exercise up to 90° with a 2-second stop between repetitions to avoid the myotatic reflex. Oxygen saturation at the beginning of the series (SmO2start), oxygen saturation at the end of the series (SmO2stop), percentage of oxygen saturation loss (▽%SmO2), and reoxygenation time (SmO2recT) were assessed using a near-infrared spectroscopy device. In addition, the percentage of mean propulsive velocity loss (%MPVL) was recorded using a linear transducer. The results suggested an influence of LE and training load on muscle oxygenation. A greater LE was directly associated with SmO2recT (r = 0.864), ▽%SmO2 (r = 0.873), and %MPVL (r = 0.883) and inversely with SmO2stop (r = -0.871). When the same LE was used (E1 vs. E4, E2 vs. E5, and E3 vs. E6), it was found that the stimuli with a higher load had a lower SmO2recT, ▽%SmO2, and %MPVL and a higher SmO2stop. Muscle oxygen saturation was found to be minimal (%SmO2 = 0) in stimuli with a LE greater than 60% (E3 and E6). The SmO2 variables studied in the present research could be considered as an easier and more useful method for understanding skeletal muscle fatigue during resistance training.

Context: Resistance training with blood flow restriction (BFR) has increased in clinical rehabilitation due to the substantial benefits observed in augmenting muscle mass and strength using low loads. However, there is a great variability of training pressures for clinical populations as well as methods to estimate it. The aim of this study was to estimate the percentage of maximal BFR that could result by applying different methodologies based on arbitrary or individual occlusion levels using a cuff width between 9 and 13 cm. Design: A secondary analysis was performed on the combined databases of 2 previous larger studies using BFR training. Methods: To estimate these percentages, the occlusion values needed to reach complete BFR (100% limb occlusion pressure [LOP]) were estimated by Doppler ultrasound. Seventy-five participants (age 24.32 [4.86] y; weight: 78.51 [14.74] kg; height: 1.77 [0.09] m) were enrolled in the laboratory study for measuring LOP in the thigh, arm, or calf. Results: When arbitrary values of restriction are applied, a supra-occlusive LOP between 120% and 190% LOP may result. Furthermore, the application of 130% resting brachial systolic blood pressure creates a similar occlusive stimulus as 100% LOP. Conclusions: Methods using 100 mm Hg and the resting brachial systolic blood pressure could represent the safest application prescriptions as they resulted in applied pressures between 60% and 80% LOP. One hundred thirty percent of the resting brachial systolic blood pressure could be used to indirectly estimate 100% LOP at cuff widths between 9 and 13 cm. Finally, methodologies that use standard values of 200 and, 300 mm Hg far exceed LOP and may carry additional risk during BFR exercise. [ABSTRACT FROM AUTHOR]

Objective: To investigate the factors that induce strong contractions during repetitive peripheral magnetic stimulation (rPMS) and compare the muscle torque induced by two stimulators (Stim A and Stim B) with different coil properties. Methods: rPMS was applied to the right vastus lateralis of 30 healthy young adults. Stim A contained a 10.1 cm2 rectangular iron core coil, while Stim B contained a 191 cm2 round coil. The knee extensor torque (KET) induced by rPMS at 30 Hz was measured isometrically and divided by the maximum voluntary contraction (MVC) to obtain a relative value of MVC (%MVC). KET at 100% intensity of Stim A (A100%, 1.08 T) was compared to those at 100% or 70% intensity of Stim B (B100%, 1.47 T vs. B70%, 1.07 T). Additionally, we conducted a comprehensive literature search for studies that measured the KET during rPMS. Results: Both the mean values of %MVC using B100% and B70% were significantly greater than that using A100%. Furthermore, the KET induced by Stim B was found to be larger than that described in previous reports, unless booster units were used to directly stimulate the main trunk of the femoral nerve. Conclusion: Stim B induced a stronger muscle contraction force than Stim A did. This may be because the larger the coil area, the wider the area that can be stimulated. Additionally, a circular coil allows for deeper stimulation. [ABSTRACT FROM AUTHOR]

Since the 1970s, researchers have studied a potential difference in muscle fatigue (acute strength loss) between maximal eccentric (ECCmax) and concentric (CONmax) resistance exercise. However, a clear answer to whether such a difference exists has not been established. Therefore, the aim of our paper was to overview methods and results of studies that compared acute changes in muscle strength after bouts of ECCmax and CONmax resistance exercise. We identified 30 relevant studies. Participants were typically healthy men aged 20–40 years. Exercise usually consisted of 40–100 isokinetic ECCmax and CONmax repetitions of the knee extensors or elbow flexors. Both ECCmax and CONmax exercise caused significant strength loss, which plateaued and rarely exceeded 60% of baseline, suggesting strength preservation. In upper‐body muscles, strength loss at the end of ECCmax (31.4 ± 20.4%) and CONmax (33.6 ± 17.5%) exercise was similar, whereas in lower‐body muscles, strength loss was less after ECCmax (13.3 ± 12.2%) than CONmax (39.7 ± 13.3%) exercise. Muscle architecture and daily use of lower‐body muscles likely protects lower‐body muscles from strength loss during ECCmax exercise. We also reviewed seven studies on muscle fatigue during coupled ECCmax‐CONmax exercise and found similar strength loss in the ECC and CON phases. We also found evidence from three studies that more ECC than CON repetitions can be completed at equal relative loads. These results indicate that muscle fatigue may manifest differently between ECCmax and CONmax resistance exercise. An implication of the results is that prescriptions of ECC resistance exercise for lower‐body muscles should account for greater fatigue resilience of these muscles compared to upper‐body muscles. [ABSTRACT FROM AUTHOR]

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Background: Repetitive electrically‐evoked muscle contractions lead to the early onset of muscle fatigue. This study assessed the relationship between muscle mechanomyography (%RMS‐MMG) and tissue oxygen saturation (%TSI) in extensor carpi radialis (ECR) during electrically‐evoked fatiguing exercise in individuals with tetraplegia. Methods: Skin‐surface mechanomyography (MMG) and near‐infrared spectroscopy (NIRS) sensors were placed on the ECR of seven individuals with tetraplegia. All participants performed repetitive electrically‐evoked wrist extension to fatigue while their muscle MMG and NIRS responses were monitored against their power output (PO). Findings: One out of seven participants showed no changes in %TSI throughout the repeated wrist FES‐evoked contraction. The other six participants' %TSI was positively correlated with %PO before fatigue onset. At 50%POpeak, %TSI was negatively correlated (0.489) significantly with declining %PO as the ability of the muscle to take up oxygen became limited. The %RMS‐MMG behaved analogously during pre and post‐fatigue against declining %PO, whereby both displayed positive correlations of 0.443 and 0.214, respectively, (%RMS‐MMG decreased) throughout the exercise session. Regression analysis revealed that %TSI was proportional to pre‐fatigue and inversely proportional to %RMS‐MMG during post‐fatigue. Conclusion: The significant changes in muscle mechanomyography and tissue oxygenation correlations after 50%POpeak implied that the muscle contraction mechanical‐and‐physiological behavior association had been altered following FES‐evoked fatigue. [ABSTRACT FROM AUTHOR]

Purpose: This study examined changes in circulating levels of inflammatory cytokines [IL-6, sIL-6R, TNF-α, and calprotectin], skeletal muscle morphology, and muscle strength following a 50km race in non-elite athletes. Methods: Eleven individuals (8 men; 3 women) underwent pre-race assessments of rectus femoris muscle thickness (resting and contracted) using ultrasound, isometric knee extensor torque, and plasma cytokines. Measures were repeated after 10km of running, the 50km finish (post-race), and again 24-hrs post-race. Results: Compared with baseline values, Δ muscle thickness (resting to contracted) increased significantly 24 hrs post-race (11 ± 11% vs. 22 ± 8%; P = 0.01). Knee extensor torque was significantly reduced immediately post-race (151 ± 46 vs. 134 ± 43 Nm; P = 0.047) but remained similar to post-race values at 24 hrs post-race (P = 0.613). Compared with pre-race levels, IL-6 and calprotectin concentrations increased 302% and 50% after 10km, respectively (P<0.017 for both), peaked post-race (2598% vs. pre-race for IL-6 and 68% vs. pre-race for calprotectin; P = 0.018 for both), and returned to pre-race levels at 24-hrs post-race (P>0.05 for both). Creatine kinase levels rose steadily during and after the race, peaking 24-hrs post-race (184 ± 113 U/L pre-race vs. 1508 ± 1815 U/L 24-hrs post-race; P = 0.005). Conclusion: This is the first report of delayed increases in Δ muscle thickness at 24 hrs post-50km, which are preceded by reductions in knee extensor torque and elevations in plasma IL-6, and calprotectin. Recreational athletes should consider the acute muscle inflammatory response when determining training and recovery strategies for 50km participation. [ABSTRACT FROM AUTHOR]

Background: Eccentric exercise may be considered as an attractive alternative to conventional exercise in pulmonary rehabilitation (PR) for patients with chronic obstructive pulmonary disease (COPD). However, due to muscle damage associated with eccentric exercise, there has been reluctance in using this exercise form in PR. Objective: The aim of the present study was to investigate the effect of eccentric exercise on markers of muscle damage in patients with COPD. Methods: We analyzed 14 patients with moderate-severe COPD and 14 age-matched healthy controls. Both groups performed submaximal eccentric exercise of the elbow flexors. Muscle soreness (MS), maximum voluntary isometric contraction (MVC) of the elbow flexors, elbow range of motion (ROM), upper arm circumference (CIR), and biochemical markers such as creatine Kinase (CK) and lactate Dehydrogenase (LDH) were measured at pre-exercise, 24 h, 48 h, and 72 h following submaximal eccentric exercise. Results: There was a significant difference in markers of muscle damage, MS (p =.002), MVC (p <.001), ROM (p =.010), CIR (p <.001), and LDH (p =.001). However, no significant differences were observed in the activity of CK (p =.261) between COPD and control group following eccentric exercise which indicates greater degree of muscle damage in COPD as compared with control. Conclusion: Sub-maximal eccentric exercise causes significantly greater muscle damage in elderly COPD patients than healthy controls. Therefore, initial exercise should be progressed with lower intensities to prevent undue muscle damage in these patients. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to evaluate the feasibility of a blood flow restriction (BFR) training regimen in patients with rheumatoid arthritis (RA); and to compare the effects of 4 weeks of BFR training with low-intensity strength training on muscle strength, muscle endurance, and joint pain in patients with RA.Method: In this non-blinded pilot randomized controlled trial, 18 women with RA aged 18-65 years performed low-intensity strength training for the lower limbs three times a week for 4 weeks, and were randomized to train with or without occlusion bands. The primary outcomes were registration of the recruitment process, compliance with training sessions, side effects, perceived pain, and a satisfaction survey. The secondary outcomes were changes in muscle strength, muscle endurance, and joint pain.Results: The findings of this pilot study included a challenging recruitment process, well tolerated training and test protocols, overall good patient satisfaction, no serious side effects, and high compliance. Both groups achieved significant improvements in knee extensor strength from baseline to follow-up, with a change of 11.5 kg [interquartile range (IQR) 9.8;13.0] in the intervention group and 8.4 kg (IQR 5.5;12.4) in the control group, and a significant between-group difference in favour of the intervention group (p = 0.0342).Conclusions: The feasibility results of this study indicated a challenging recruitment process, general satisfaction with the BFR and exercises, good compliance, and only expected non-serious side effects. BFR training may improve knee extensor strength in women with RA, compared low-intensity strength training without BFR. [ABSTRACT FROM AUTHOR]

To study the long-term evolution of patients with lower-limb Complex Regional Pain Syndrome (CRPS), focusing on functional and proprioceptive aspects and quality of life. In 20 patients suffering from chronic distal lower-limb CRPS diagnosed using Budapest criteria, we assessed joint position sense and strength of the knee muscles at the CRPS and unaffected leg, functional exercise capacity, pain, CRPS severity score, quality of life and kinesiophobia. Similar assessments were performed in 20 age-matched controls. The joint position performance (at 45°) was significantly lower for the CRPS leg as compared to controls. The knee extensor strength of the CRPS leg was significantly reduced as compared to the unaffected leg (−27%) and controls (−42%). CRPS patients showed significantly reduced performance at the 6 min-walk test as compared to their age group predicted value and controls. Patients suffering from CRPS for 3.8 years in average still exhibit high pain, severity and kinesiophobia scores. Long-term deficits in strength and proprioceptive impairments are observed at the knee joint of the CRPS leg. This persistent functional disability has significant repercussions on the quality of life. We highlight the importance of including strength and proprioceptive exercises in the therapeutic approaches for CPRS patients. The long-term evolution of patients suffering from lower-limb Complex Regional Pain Syndrome is associated with persistent disability, pain and impacts the quality of life. Strength, proprioceptive, functional and subjective assessments are necessary to better identify deficits. Rehabilitation should focus on the overall deficit of the affected and contralateral limb. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to examine the acute effects of equal volumes of fatiguing high- vs. low-intensity eccentric muscle actions on changes in muscle thickness, echo intensity, muscle blood flow, and adipose thickness. Eighteen men (mean ± SD = 23.2 ± 3.0 years) performed eccentric peak torque (PT) and maximal voluntary isometric contraction (MVIC) trials before (pretest), immediately after (posttest), and 5 minutes after (recovery) performing randomly ordered fatiguing eccentric, isokinetic (180°⋅s-1) muscle actions of the elbow flexors at 40% (72 repetitions) or 80% (36 repetitions) of eccentric PT. Muscle thickness, exercise-induced edema, muscle blood flow, and adipose thickness were also assessed via ultrasound at pretest, posttest, and recovery. There were no intensity-specific effects on the patterns of responses for eccentric PT, MVIC, muscle thickness, echo intensity, muscle blood flow, or adipose thickness. There were, however, effects across time that decreased from pretest to posttest and from pretest to recovery for eccentric PT (21.5 and 13.0%), MVIC (14.6 and 5.8%), and adipose thickness (10.0 and 6.0%), but increased for muscle thickness (7.6 and 5.9%), echo intensity (13.7 and 9.9%), and muscle blood flow (129.6 and 90.1%) (collapsed across 40 and 80%). These findings indicated that when matched for exercise volume, there were no intensity-related effects on the increases in muscle thickness, echo intensity, muscle blood flow, or the decreases in eccentric PT, MVIC, and adipose thickness after fatiguing eccentric muscle actions. Therefore, exercise volume, independent of exercise intensity and number of repetitions, may be a mediating factor of muscle fatigue and performance during eccentric muscle actions. [ABSTRACT FROM AUTHOR]

Redistributing long inter-set rest intervals into shorter but more frequent rest intervals generally maintains concentric performance, possibly due to improved energy store maintenance. However, eccentric actions require less energy than concentric actions, meaning that shorter but more frequent sets may not affect eccentric actions to the same degree as concentric actions. Considering the increased popularity of eccentric exercise, the current study evaluated the effects of redistributing long inter-set rest periods into shorter but more frequent rest periods during eccentric only knee extensions. Eleven resistance-trained men performed 40 isokinetic unilateral knee extensions at 60°·s−1 with 285 s of total rest using traditional sets (TS; 4 sets of 10 with 95 s inter-set rest) and rest-redistribution (RR; 20 sets of 2 with 15 s inter-set rest). Before and during exercise, muscle oxygenation was measured via near-infrared spectroscopy, and rating of perceived exertion (RPE) was recorded after every 10th repetition. There were no differences between protocols for peak torque (RR, 241.58±47.20 N; TS, 231.64±48.87 N; p=0.396) or total work (RR, 215.26±41.47 J; TS, 209.71±36.02 J; p=0.601), but moderate to large effect sizes existed in later repetitions (6,8,10) with greater peak torque during RR (d=0.66-1.19). For the entire session, RR had moderate effects on RPE (RR, 5.73±1.42; TS, 6.09±1.30; p=0.307; d=0.53) and large effects on oxygen saturation (RR, 5857.4±310.0; TS, 6495.8±273.8; p=0.002, d=2.13). Therefore, RR may maintain peak torque or total work during eccentric exercise, improve oxygen utilization at the muscle, and reduce the perceived effort. [ABSTRACT FROM AUTHOR]

GÓmez-Carmona, CD, Bastida-Castillo, A, Rojas-Valverde, D, de la Cruz Sánchez, E, Garcia-Rubio, J, Ibáñez, SJ, and Pino-Ortega, J. Lower-limb dynamics of muscle oxygen saturation during the back-squat exercise: effects of training load and effort level. J Strength Cond Res 34(5): 1227-1236, 2020 The aim of this study was to analyze the effect of strength training on lower limb muscle oxygenation. The sample consisted of 12 male subjects (22.4 ± 1.73 years; 1.81 ± 0.08 cm height and 77.76 ± 8.77 kg body mass). Six different strength training stimuli were analyzed, based on the training variables: load (60-75% 1 repetition maximum [1RM]) and level of effort (LE) (E1: 4 × 8 [20RM], E2: 4 × 12 [20RM], E3: 4 × 16 [20RM], E4: 4 × 4 [10RM], E5: 4 × 6 [10RM], and E6: 4 × 8 [10RM]) in the squat exercise up to 90° with a 2-second stop between repetitions to avoid the myotatic reflex. Oxygen saturation at the beginning of the series (SmO2start), oxygen saturation at the end of the series (SmO2stop), percentage of oxygen saturation loss (▿ %SmO2), and reoxygenation time (SmO2recT) were assessed using a near-infrared spectroscopy device. In addition, the percentage of mean propulsive velocity loss (%MPVL) was recorded using a linear transducer. The results suggested an influence of LE and training load on muscle oxygenation. A greater LE was directly associated with SmO2recT (r =0.864), ▿ %SmO2 (r=0.873), and %MPVL (r=0.883) and inversely with SmO2stop (r =−0.871). When the same LE was used (E1 vs. E4, E2 vs. E5, and E3 vs. E6), it was found that the stimuli with a higher load had a lower SmO2recT, ▿ %SmO2, and %MPVL and a higher SmO2stop. Muscle oxygen saturation was found to be minimal (%SmO2 =0) in stimuli with a LE greater than 60% (E3 and E6). The SmO2 variables studied in the present research could be considered as an easier and more useful method for understanding skeletal muscle fatigue during resistance training [ABSTRACT FROM AUTHOR]

Blood flow restriction (BFR) combined with resistance training (RT-BFR) shows significant benefits in terms of muscle strength and hypertrophy. Such effects have been observed in clinical populations, in groups of physically active people, and among competitive athletes. These effects are comparable or, in some cases, even more efficient compared to conventional resistance training (CRT). RT-BFR stimulates muscle hypertrophy and improves muscle strength even at low external loads. Since no extensive scientific research has been done in relation to groups of athletes, the aim of the present study was to identify technical, physiological and methodological aspects related to the use of RTBFR in competitive athletes from various sport disciplines. RT-BFR in groups of athletes has an effect not only on the improvement of muscle strength or muscle hypertrophy, but also on specific motor abilities related to a particular sport discipline. The literature review reveals that most experts do not recommend the use RT-BFR as the only training method, but rather as a complementary method to CRT. It is likely that optimal muscle adaptive changes can be induced by a combination of CRT and RT-BFR. Some research has confirmed benefits of using CRT followed by RT-BFR during a training session. The use of BFR in training also requires adequate progression or modifications in the duration of occlusion in a training session, the ratio of exercises performed with BFR to conventional exercises, the value of pressure or the cuff width. [ABSTRACT FROM AUTHOR]

Introduction: Impaired skeletal muscle oxygenation potentially contributes to reduced exercise capacity in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients during early recovery and may explain altered hemoglobin responses to exercise following allo-HSCT. We investigated whether skeletal muscle oxygenation parameters and hemoglobin parameters in the tibialis anterior decreased following allo-HSCT, and whether these results were associated with declines in exercise capacity.Methods: We used near-infrared spectroscopy during and following a repeated isometric contraction task at 50% of maximal voluntary contraction in 18 patients before and after allo-HSCT.Results: The rate of decrease in the muscle oxy-hemoglobin saturation (SmO2; an index of skeletal muscle oxygenation) was significantly lower after allo-HSCT (P < 0.01). In contrast, total hemoglobin (an index of hemoglobin) was not different after allo-HSCT. Furthermore, SmO2 during and following exercise was associated with exercise capacity (r = 0.648; P = 0.004 vs. r = 0.632; P = 0.005).Conclusion: The results of this study reveal that although the peripheral hemoglobin response was not altered by allo-HSCT, skeletal muscle oxygenation was decreased following allo-HSCT. Furthermore, the decrease in skeletal muscle oxygenation was associated with a reduction in exercise capacity. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare core muscle activation during a prone bridge (plank) until failure and 6-RM back squats. Twelve resistance-trained males (age 23.5 ± 2.6 years, body mass 87.8 ± 21.3 kg, body height 1.81 ± 0.08 m) participated in this study. Total exercise time and EMG activity of the rectus abdominis, external abdominal oblique and erector spinae were measured during 6-RM back squats and a prone bridge with a weight of 20% of participants’ body mass on their lower back. The main findings showed non-significant differences between the exercises in the rectus abdominis or external oblique, but greater erector spinae activation in squatting. Furthermore, in contrast to the prone bridge, the erector spinae and rectus abdominis demonstrated increasing muscle activation throughout the repetitions while squatting, whereas the prone bride demonstrated increasing external oblique activation between the beginning and the middle of the set. It was concluded that since squatting resulted in greater erector spine activation, but similar rectus abdominis and oblique external activation as the prone bridge, high-intensity squats rather than isometric low intensity core exercises for athletes would be recommended. [ABSTRACT FROM AUTHOR]

The study aimed to compare the chronic eccentric-overload training effects of unilateral (lateral lunge) vs bilateral (half-squat) using an inertial device, on hypertrophy and physical performance. Twenty-seven young team sports male players performed a 4 sets of 7 repetitions of inertial eccentric overload training, biweekly for 6 weeks, distributed in unilateral lunge group (UG: age: 22.8 ± 2.9 years; body mass: 75.3 ± 8.8 kg; height: 177.3 ± 3.7 cm) and bilateral squat group (BG: age: 22.6 ± 2.7 years; body mass: 79.5 ± 12.8 kg; height: 164.2 ± 7 cm). Lower limb muscle volume, counter movement jump (CMJ), power with both (POWER), dominant (POWERd) and no-dominant leg (POWERnd), change of direction turn of 90° with dominant (COD90d) and no-dominant leg (COD90nd) and 180° (COD180d and COD180nd), and 10m sprint time (T-10m) were measured pre and post-intervention. The UG obtained an increase of adductor major (+11.1%) and vastus medialis (+12.6%) higher than BG. The BG obtained an increase of vastus lateralis (+9.9%) and lateral gastrocnemius (+9.1%) higher than UG. Both groups improved CMJ, POWER, POWERd, POWERnd, COD90 and DEC-COD90, without changes in T-10m. The UG decrease DEC-COD90nd (-21.1%) and BG increase POWER (+38.6%) substantially more than the other group. Six-weeks of unilateral / bilateral EO training induce substantial improvements in lower limbs muscle volume and functional performance, although unilateral training seems to be more effective in improving COD90 performance. [ABSTRACT FROM AUTHOR]

Background: Low-load resistance training (< 50% of one-repetition maximum [1RM]) associated with blood-flow restriction (BFR-RT) has been thought to promote increases in muscle strength and mass. However, it remains unclear if the magnitude of these adaptations is similar to conventional high-load resistance training (> 65% 1RM; HL-RT). Objective: To compare the effects of HL- versus BFR-RT on muscle adaptations using a systematic review and meta-analysis procedure. Methods: Studies were identified via electronic databases based on the following inclusion criteria: (a) pre- and post-training assessment of muscular strength; (b) pre- and post-training assessment of muscle hypertrophy; (c) comparison of HL-RT vs. BFR-RT; (d) score ≥ 4 on PEDro scale; (e) means and standard deviations (or standard errors) are reported from absolute values or allow estimation from graphs. If this last criterion was not met, data were directly requested from the authors. Results: The main results showed higher increases in muscle strength for HL- as compared with BFR-RT, even when considering test specificity, absolute occlusion pressure, cuff width, and occlusion pressure prescription. Regarding the hypertrophic response, results revealed similar effects between HL- and BFR-RT, regardless of the absolute occlusion pressure, cuff width, and occlusion pressure prescription. Conclusions: Based on the present data, maximum muscle strength may be optimized by specific training methods (i.e., HL-RT) while both HL- and BFR-RT seem equally effective in increasing muscle mass. Importantly, BFR-RT is a valid and effective approach for increasing muscle strength in a wide spectrum of ages and physical capacity, although it may seem particularly of interest for those individuals with physical limitations to engage in HL-RT. [ABSTRACT FROM AUTHOR]

BACKGROUND: After ankle sprains, therapists may use proprioceptive training programs to manage residual symptoms and reduce the risk for recurrent injuries. However, evidence on program effectiveness is limited. OBJECTIVE: To investigate effectiveness of balance and proprioceptive neuromuscular facilitation (PNF) programs in individuals with sprain. METHODS: Participants were recruited from a rehabilitation center and were randomly allocated to a balance or PNF group. Both groups received 10 training sessions, within a six-week period. Ankle position sense, isokinetic strength and EMG activity were assessed by a blinded investigator at baseline, at the end of training and eight weeks after training. Recurrent injuries were recorded 12 months after training. RESULTS: Twenty participants provided follow-up data. Eight weeks after training, significant (p < 0.017) gains were found in most strength measures for both groups, apart from dorsiflexion strength (p > 0.05). For the balance group, there were no recurrent injuries and for the PNF group the recurrent injury rate was 20%. Eight weeks after training, the balance group significantly (p < 0.017) improved plantar flexion position sense and EMG activity of peroneus longus muscle and the PNF group significantly (p < 0.017) improved EMG activity of tibialis anterior muscle. CONCLUSIONS: For individuals with sprain, balance and PNF programs are recommended for ankle strengthening. They may also be effective in reducing the risk for recurrent injuries. [ABSTRACT FROM AUTHOR]

Several studies have confirmed the efficacy of flywheel paradigm training for improving or benefiting muscle volume and force. A meta-analysis of 13 studies with a total of 18 effect sizes was performed to analyse the role of various factors on the effectiveness of flywheel paradigm training. The following inclusion criteria were employed for the analysis: (a) randomized studies; (b) high validity and reliability instruments; (c) published in a high quality peer-reviewed journal; (d) healthy participants; (e) studies where the eccentric programme were described; and (f) studies where increases in muscle volume and force were measured before and after training. Increases in muscle volume and force were noted through the use of flywheel systems during short periods of training. The increase in muscle mass appears was not influenced by the existence of eccentric overload during the exercise. The increase in force was significantly higher with the existence of eccentric overload during the exercise. The responses identified in this analysis are essential and should be considered by strength and conditioning professionals regarding the most appropriate dose response trends for flywheel paradigm systems to optimize the increase in muscle volume and force. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetic patients and non-diabetic patients were referred for evaluation for chronic exertional compartment syndrome (CECS) based on clinical examination and complaints of activity-related leg pain in the region of the tibialis anterior muscle. Previous studies using near-infrared spectroscopy (NIRS) showed greater deoxygenation during exercise for CECS patients versus healthy controls; however, this comparison has not been done for diabetic CECS patients. Methods: We used NIRS to test for differences in oxygenation kinetics for Type 1 diabetic patients diagnosed with (CECS-diabetics, n = 9) versus diabetic patients without (CON-diabetics, n = 10) leg anterior chronic exertional compartment syndrome. Comparisons were also made between non-diabetic CECS patients (n = 11) and healthy controls (CON, n = 10). The experimental protocol consisted of thigh arterial cuff occlusion (AO, 1-minute duration), and treadmill running to reproduce symptoms. NIRS variables generated were resting StO2%, and oxygen recovery following AO. Also, during and following treadmill running the magnitude of deoxygenation and oxygen recovery, respectively, were determined. Results: There was no difference in resting StO2% between CECS-diabetics (78.2±12.6%) vs. CON-diabetics (69.1±20.8%), or between CECS (69.3±16.2) vs. CON (75.9±11.2%). However, oxygen recovery following AO was significantly slower for CECS (1.8±0.8%/sec) vs. CON (3.8±1.7%/sec) (P = 0.002); these data were not different between the diabetic groups. StO2% during exercise was lower (greater deoxygenation) for CECS-diabetics (6.3±8.6%) vs. CON-diabetics (40.4±22.0%), and for CECS (11.3±16.8%) vs. CON (34.1±21.2%) (P<0.05 for both). The rate of oxygen recovery post exercise was faster for CECS-diabetics (3.5±2.6%/sec) vs. CON-diabetics (1.4±0.8%/sec) (P = 0.04), and there was a tendency of difference for CECS (3.1±1.4%/sec) vs. CON (1.9±1.3%/sec) (P = 0.05). Conclusion: The greater deoxygenation during treadmill running for the CECS-diabetics group (vs. CON-diabetics) is in line with previous studies (and with the present study) that compared non-diabetic CECS patients with healthy controls. Our findings could suggest that NIRS may be useful as a diagnostic tool for assessing Type 1 diabetic patients suspected of CECS. [ABSTRACT FROM AUTHOR]

The present study aimed to analyze and compare the effects of four different interval-training protocols on aerobic fitness and muscle strength. Thirty-seven subjects (23.8 ± 4 years; 171.7 ± 9.5 cm; 70 ± 11 kg) were assigned to one of four groups: low-intensity interval training with ( BFR, n = 10) or without ( LOW, n = 7) blood flow restriction, high-intensity interval training ( HIT, n = 10), and combined HIT and BFR ( BFR + HIT, n = 10, every session performed 50% as BFR and 50% as HIT). Before and after 4 weeks training (3 days a week), the maximal oxygen uptake ( VO2max), maximal power output ( Pmax), onset blood lactate accumulation ( OBLA), and muscle strength were measured for all subjects. All training groups were able to improve OBLA ( BFR, 16%; HIT, 25%; HIT + BFR, 22%; LOW, 6%), with no difference between groups. However, VO2max and Pmax improved only for BFR (6%, 12%), HIT (9%, 15%) and HIT + BFR (6%, 11%), with no difference between groups. Muscle strength gains were only observed after BFR training (11%). This study demonstrates the advantage of short-term low-intensity interval BFR training as the single mode of training able to simultaneously improve aerobic fitness and muscular strength. [ABSTRACT FROM AUTHOR]

Blood flow restriction (BFR) training (also known as Kaatsu training) is an increasingly common practice employed during resistance exercise by athletes attempting to enhance skeletal muscle mass and strength. During BFR training, blood flow to the exercising muscle is mechanically restricted by placing flexible pressurizing cuffs around the active limb proximal to the working muscle. This maneuver results in the accumulation of metabolites (e.g., protons and lactic acid) in the muscle interstitium that increase muscle force and promote muscle growth. Therefore, the premise of BFR training is to simulate and receive the benefits of high-intensity resistance exercise while merely performing low-intensity resistance exercise. This technique has also been purported to provide health benefits to the elderly, individuals recovering from joint injuries, and patients undergoing cardiac rehabilitation. Since the seminal work of Alam and Smirk in the 1930s, it has been well established that reductions in blood flow to exercising muscle engage the exercise pressor reflex (EPR), a reflex that significantly contributes to the autonomic cardiovascular response to exercise. However, the EPR and its likely contribution to the BFR-mediated cardiovascular response to exercise is glaringly missing from the scientific literature. Inasmuch as the EPR has been shown to generate exaggerated increases in sympathetic nerve activity in disease states such as hypertension (HTN), heart failure (HF), and peripheral artery disease (PAD), concerns are raised that BFR training can be used safely for the rehabilitation of patients with cardiovascular disease, as has been suggested. Abnormal BFR-induced and EPR-mediated cardiovascular complications generated during exercise could precipitate adverse cardiovascular or cerebrovascular events (e.g., cardiac arrhythmia, myocardial infarction, stroke and sudden cardiac death). Moreover, although altered EPR function in HTN, HF, and PAD underlies our concern for the widespread implementation of BFR, use of this training mechanism may also have negative consequences in the absence of disease. That is, even normal, healthy individuals performing resistance training exercise with BFR are potentially at increased risk for deleterious cardiovascular events. This review provides a brief yet detailed overview of the mechanisms underlying the autonomic cardiovascular response to exercise with BFR. A more complete understanding of the consequences of BFR training is needed before this technique is passively explored by the layman athlete or prescribed by a health care professional. [ABSTRACT FROM AUTHOR]

The article focuses on a study which is aimed at comparative analysis of the effects of low-resistance training coupled with blood flow restriction (LRT-BFR) and high-intensity resistance training (HRT) on the quadriceps muscle strength and mass when performed in healthy elderly age group. Various tests were performed including one repetition maximum test in which leg press strength was assessed, determination of cross-sectional area of quadriceps and determination of blood flow restriction.

Purpose: Eccentric muscle actions are important to the development of muscle mass and strength and may affect bone mineral density (BMD). This study's purpose was to determine the relative effectiveness of five different eccentric:concentric load ratios to increase musculoskeletal parameters during early adaptations to resistance training. Methods: Forty male subjects performed a supine leg press and calf press training program 3 days week for 8 weeks. Subjects were matched for pre-training leg press 1-repetition maximum strength (1-RM) and randomly assigned to one of five training groups. Concentric training load (% 1-RM) was constant across groups, but within groups, eccentric load was 0, 33, 66, 100, or 138 % of concentric load. Muscle mass (dual energy X-ray absorptiometry; DXA), strength (1-RM), and BMD (DXA) were measured pre- and post-training. Markers of bone metabolism were assessed pre-, mid- and post-training. Results: The increase in leg press 1-RM in the 138 % group (20 ± 4 %) was significantly greater ( P < 0.05) than the 0 % (8 ± 3 %), 33 % (8 ± 5 %) and 66 % (8 ± 4 %) groups, but not the 100 % group (13 ± 6 %; P = 0.15). All groups, except the 0 % group, increased calf press 1-RM ( P < 0.05). Leg lean mass and greater trochanter BMD were increased only in the 138 % group ( P < 0.05). Conclusions: Early-phase adaptations to eccentric overload training include increases in muscle mass and site-specific increases in BMD and muscle strength which are not present or are less with traditional and eccentric underload training. Eccentric overload provides a robust musculoskeletal stimulus that may benefit bedridden patients, individuals recovering from injury or illness, and astronauts during spaceflight. [ABSTRACT FROM AUTHOR]

It is generally believed that optimal hypertrophic and strength gains are induced through moderate- or high-intensity resistance training, equivalent to at least 60 % of an individual's 1-repetition maximum (1RM). However, recent evidence suggests that similar adaptations are facilitated when low-intensity resistance exercise (~20-50 % 1RM) is combined with blood flow restriction (BFR) to the working muscles. Although the mechanisms underpinning these responses are not yet firmly established, it appears that localized hypoxia created by BFR may provide an anabolic stimulus by enhancing the metabolic and endocrine response, and increase cellular swelling and signalling function following resistance exercise. Moreover, BFR has also been demonstrated to increase type II muscle fibre recruitment during exercise. However, inappropriate implementation of BFR can result in detrimental effects, including petechial haemorrhage and dizziness. Furthermore, as BFR is limited to the limbs, the muscles of the trunk are unable to be trained under localized hypoxia. More recently, the use of systemic hypoxia via hypoxic chambers and devices has been investigated as a novel way to stimulate similar physiological responses to resistance training as BFR techniques. While little evidence is available, reports indicate that beneficial adaptations, similar to those induced by BFR, are possible using these methods. The use of systemic hypoxia allows large groups to train concurrently within a hypoxic chamber using multi-joint exercises. However, further scientific research is required to fully understand the mechanisms that cause augmented muscular changes during resistance exercise with a localized or systemic hypoxic stimulus. [ABSTRACT FROM AUTHOR]

To evaluate the effects of cooling between exercise sessions on intramuscular water movement and muscle performance, the lower extremities of nine untrained men were assigned to either a cooling protocol (20-min water immersion, 15 ° C) or a noncooling protocol. Each subject performed two exercise sessions involving maximal concentric knee extension and flexion (three repetitions, 60°/s; followed by 50 repetitions, 180°/s). The peak torque at 60°/s and total work, mean power, and decrease rate of torque value at 180°/s were evaluated. Axial magnetic resonance diffusion-weighted images of the mid-thigh were obtained before and after each exercise session. Apparent diffusion coefficient ( ADC) values for the quadriceps and hamstrings were calculated for evaluating intramuscular water movement. Both groups exhibited significantly increased ADC values for the quadriceps and hamstrings after each exercise session. These ADC values returned to the pre-exercise level after water immersion. No significant difference was observed in muscle performance from first exercise session to the next in either group, except for increased total work and mean power in knee flexion in the cooled group. Cooling intervention between exercise sessions decreased exercise-induced elevation of intramuscular water movement and had some beneficial effects on muscle endurance of knee flexors, but not knee extensors. [ABSTRACT FROM AUTHOR]

Eccentric (ECC) exercise is classically used to improve muscle strength and power in healthy subjects and athletes. Due to its specific physiological and mechanical properties, there is an increasing interest in employing ECC muscle work for rehabilitation and clinical purposes. Nowadays, ECC muscle actions can be generated using various exercise modalities that target small or large muscle masses with minimal or no muscle damage or pain. The most interesting feature of ECC muscle actions is to combine high muscle force with a low energy cost (typically 4- to 5-times lower than concentric muscle work) when measured during leg cycle ergometry at a similar mechanical power output. Therefore, if caution is taken to minimize the occurrence of muscle damage, ECC muscle exercise can be proposed not only to athletes and healthy subjects, but also to individuals with moderately to severely limited exercise capacity, with the ultimate goal being to improve their functional capacity and quality of life. The first part of this review article describes the available exercise modalities to generate ECC muscle work, including strength and conditioning exercises using the body's weight and/or additional external loads, classical isotonic or isokinetic exercises and, in addition, the oldest and newest specifically designed ECC ergometers. The second part highlights the physiological and mechanical properties of ECC muscle actions, such as the well-known higher muscle force-generating capacity and also the often overlooked specific cardiovascular and metabolic responses. This point is particularly emphasized by comparing ECC and concentric muscle work performed at similar mechanical (i.e., cycling mechanical power) or metabolic power (i.e., oxygen uptake, $$ \dot{V}{\text{O}}_{2} $$). In particular, at a similar mechanical power, ECC muscle work induces lower metabolic and cardiovascular responses than concentric muscle work. However, when both exercise modes are performed at a similar level of $$ \dot{V}{\text{O}}_{2} $$, a greater cardiovascular stress is observed during ECC muscle work. This observation underlines the need of cautious interpretation of the heart rate values for training load management because the same training heart rate actually elicits a lower $$ \dot{V}{\text{O}}_{2} $$ in ECC muscle work than in concentric muscle work. The last part of this article reviews the documented applications of ECC exercise training and, when possible, presents information on single-joint movement training and cycling or running training programs, respectively. The available knowledge is then summarized according to the specific training objectives including performance improvement for healthy subjects and athletes, and prevention of and/or rehabilitation after injury. The final part of the article also details the current knowledge on the effects of ECC exercise training in elderly populations and in patients with chronic cardiac, respiratory, metabolic or neurological disease, as well as cancer. In conclusion, ECC exercise is a promising training modality with many different domains of application. However, more research work is needed to better understand how the neuromuscular system adapts to ECC exercise training in order to optimize and better individualize future ECC training strategies. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the impact three weeks of eccentric training combined with overspeed exercises had on power and running speed performance gains in trained athletes. Researchers evaluated 20 team sports athletes. They found that the training and exercises led to enhanced power and running speed performance gains in the athletes.

Objective: to evaluate knee joint position sense (JPS) and muscle strength following an accelerated rehabilitation protocol after ACL reconstruction and compare it with the contralateral non-injured leg and with an age-matched non-injured control group. Design: Seven subjects (age: 26.6±4.8 years) submitted to ACL reconstruction (ACL group) using a patellar tendon auto-graft (bone-tendon-bone) and nine healthy subjects (age: 26.8±3.8 years) participated in this cross-sectional study. JPS was evaluated using a technique of open-kinetic chain and active knee positioning. Knee extensors and flexors muscle strength was evaluated in an isokinetic dynamometer at 180°/s (3.14 rad.s-1) and 60°/s (1.05 rad.s-1). Results: The ACL group showed better knee JPS in the uninjured knee than in the reconstructed knee in absolute (2.17°±2.69° vs. 5.98°±2.64°, p<0.05), relative (2.17°±2.69° vs. 5.98°±2.64°, p<0.05), and variable angular errors (2.38±1.15° vs. 2.011.64, p<0.05). The reconstructed knee also exhibited inferior JPS compared to both limbs of the control group. No significant differences in quadriceps and hamstrings muscle strength were observed. Significant contralateral differences between ACL and control group were found for knee extensors at 60°/s (33.6±18.0% vs. 5.9±7.1%, p<0.05) and 80°/s (20.2±13.5% vs. 5.8±3.9%, p<0.05), and knee flexors at 60°/s (16.2±6.4% vs. 8.5±5.0%, p<0.05). Conclusion: Our findings indicate that JPS and muscle function are still impaired after an accelerated rehabilitation protocol for ACL reconstruction surgery, suggesting that these individuals are still predisposed to further muscle or proprioceptive related knee injury. [ABSTRACT FROM AUTHOR]

The focal point of previous literature was establishing the efficacy of blood flow restriction training with respect to muscular strength, muscular hypertrophy, and muscular endurance. After mounting evidence supporting the efficacy of low‐intensity blood flow restriction training, research has shifted to the overall safety of this training modality. The aim of this review was to summarize the research on the overall safety of blood flow restriction training, focusing on the cardiovascular system (central and peripheral), muscle damage, oxidative stress, and nerve conduction velocity responses compared with those observed with regular exercise. Although still sparse, the blood flow restriction training research thus far is promising with respect to safety outcomes. Individuals respond similarly to blood flow restriction training and to regular exercise; however, longer term studies are required to better understand the chronic effects of low‐intensity blood flow restriction training and possible safety issues. [ABSTRACT FROM AUTHOR]

In the quest to maximize average propulsive stroke impulses over 2000-m racing, testing and training of various strength parameters have been incorporated into the physical conditioning plans of rowers. Thus, the purpose of this review was 2-fold: to identify strength tests that were reliable and valid correlates (predictors) of rowing performance; and, to establish the benefits gained when strength training was integrated into the physical preparation plans of rowers. The reliability of maximal strength and power tests involving leg extension (e.g. leg pressing) and arm pulling (e.g. prone bench pull) was high (intra-class correlations 0.82-0.99), revealing that elite rowers were significantly stronger than their less competitive peers. The greater strength of elite rowers was in part attributed to the correlation between strength and greater lean body mass (r = 0.57-0.63). Dynamic lower body strength tests that determined the maximal external load for a one-repetition maximum (1RM) leg press (kg), isokinetic leg extension peak force (N) or leg press peak power (W) proved to be moderately to strongly associated with 2000-m er-gometer times (r = -0.54 to -0.68; p < 0.05). Repetition tests that assess muscular or strength endurance by quantifying the number of repetitions accrued at a fixed percentage of the strength maximum (e.g. 50-70% 1 RM leg press) or set absolute load (e.g. 40 kg prone bench pulls) were less reliable and more time consuming when compared with briefer maximal strength tests. Only leg press repetition tests were correlated with 2000-m ergometer times (e.g. r = -0.67; p < 0.05). However, these tests differentiate training experience and muscle morphology, in that those individuals with greater training experience and/or proportions of slow twitch fibres performed more repetitions. Muscle balance ratios derived from strength data (e.g. hamstring-quadriceps ratio <45% or knee extensor-elbow flexor ratio around 4.210.22 to 1) appeared useful in the pathological assessment of low back pain or rib injury history associated with rowing. While strength partially explained variances in 2000-m ergometer performance, concurrent endurance training may be counterproductive to strength development over the shorter term (i.e. <12 weeks). Therefore, prioritization of strength training within the sequence of training units should be considered, particularly over the non-competition phase (e.g. 2-6 sets x 4-12 repetitions, three sessions a week). Maximal strength was sustained when infrequent (e.g. one or two sessions a week) but intense (e.g. 73-79% of maximum) strength training units were scheduled; however, it was unclear whether training adaptations should emphasize maximal strength, endurance or power in order to enhance performance during the competition phase. Additionally, specific on-water strength training practices such as towing ropes had not been reported. Further research should examine the on-water benefits associated with various strength training protocols, in the context of the training phase, weight division, experience and level of rower, if limitations to the reliability and precision of performance data (e.g. 2000-m time or rank) can be controlled. In conclusion, while positive ergometer time-trial benefits of clinical and practical significance were reported with strength training, a lack of statistical significance was noted, primarily due to an absence of quality long-term controlled experimental research designs. [ABSTRACT FROM AUTHOR]

The aim of this systematic review was to determine if eccentric exercise is superior to concentric exercise in stimulating gains in muscle strength and mass. Meta-analyses were performed for comparisons between eccentric and concentric training as means to improve muscle strength and mass. In order to determine the importance of different parameters of training, subgroup analyses of intensity of exercise, velocity of movement and mode of contraction were also performed. Twenty randomised controlled trials studies met the inclusion criteria. Meta-analyses showed that when eccentric exercise was performed at higher intensities compared with concentric training, total strength and eccentric strength increased more significantly. However, compared with concentric training, strength gains after eccentric training appeared more specific in terms of velocity and mode of contraction. Eccentric training performed at high intensities was shown to be more effective in promoting increases in muscle mass measured as muscle girth. In addition, eccentric training also showed a trend towards increased muscle cross-sectional area measured with magnetic resonance imaging or computerised tomography. Subgroup analyses suggest that the superiority of eccentric training to increase muscle strength and mass appears to be related to the higher loads developed during eccentric contractions. The specialised neural pattern of eccentric actions possibly explains the high specificity of strength gains after eccentric training. Further research is required to investigate the underlying mechanisms of this specificity and its functional significance in terms of transferability of strength gains to more complex human movements. [ABSTRACT FROM AUTHOR]

Strength training with low loads in combination with vascular occlusion has been proposed as an alternative to heavy resistance exercise in the rehabilitation setting, especially when high forces acting upon the musculo-skeletal system are contraindicated. Several studies on low-to-moderate intensity resistance exercise combined with cuff occlusion have demonstrated increases in muscle strength and size that are comparable to those typically seen after conventional high-load strength training. However, the physiological mechanisms by which occlusion training induces increased muscle mass and strength are currently unclear, although several candidate stimuli have been proposed. Also, the long-term safety, practicality, and efficacy of this training method are still controversial. Furthermore, recent studies have demonstrated that in some instances, tourniquet cuffs may not be necessary for relative ischemia and significant training effects to occur with resistance exercise at low-to-moderate loads. The aims of the present review are to summarize current opinion and knowledge regarding the physiology of ischemic strength training and to discuss some of the training and health aspects of this type of exercise. In addition, suggestions for further research are given. [ABSTRACT FROM AUTHOR]

To test the hypothesis that sex influences forearm blood flow (FBF) during exercise, 15 women and 16 men of similar age [women 24.3 ± 4.0 (SD) vs. men 24.9 ± 4.5 yr] but different forearm muscle strength (women 290.7 ± 44.4 vs. men 509.6 ± 97.8 N; P < 0.05) performed dynamic handgrip exercise as the same absolute workload was increased in a ramp function (0.25 W/min). Task failure was defined as the inability to maintain contraction rate. Blood pressure and FBF were measured on separate arms during exercise by auscultation and Doppler ultrasound, respectively. Muscle strength was positively correlated with endurance time (r = 0.72, P < 0.01) such that women had a shorter time to task failure than men (450.5 ± 113.0 vs. 831.3 ± 272.9 s; P < 0.05). However, the percentage of maximal handgrip strength achieved at task failure was similar between sexes (14% maximum voluntary contraction). FBF was similar between women and men throughout exercise and at task failure (women 13.6 ± 5.3 vs. men 14.5 ± 4.9 ml·min-1 1·100 ml-1). Mean arterial pressure was lower in women at rest and during exercise; thus calculated forearm vascular conductance (FVC) was higher in women during exercise but similar between sexes at task failure (women 0.13 ± 0.05 vs. men 0.11 ± 0.04 ml·min-1 ·100 ml-1 ·mmHg-1). In conclusion, the similar FBF during exercise was achieved by a higher FVC in the presence of a lower MAP in women than men. Still, FBF remained coupled to work rate (and presumably metabolic demand) during exercise irrespective of sex. [ABSTRACT FROM AUTHOR]

The purpose of this study was to monitor neuromuscular changes in quadriceps femoris muscle at 1 and 3 months after anterior cruciate ligament reconstruction (ACLR). Changes in isometric muscle strength (MVC), voluntary activation and surface electromyogram (EMG) parameters were examined in relation to knee stability, pain and swelling in 31 patients (25 M, 6 F) mean (SD) 30(8) years. Physically inactive (RC) and sports participants (SC) acted as controls. Median frequency (Hz) and amplitude (mV) of rectus femoris using Fast Fourier Transform (FFT) 211 was calculated during 5-s isometric contractions at 100, 75, 50 and 25% of MVC. One month after surgery, a significant correlation ( P < 0.01) was found between activation (%) and MVC of injured knee extensors. By 3 months, most patients were pain free and had achieved full activation but still had muscle weakness. At 1 and 3 months post-surgery and for all levels of MVC contraction, the median frequencies of the injured limbs were significantly lower ( P < 0.05) compared to the SC group as were those of the RC group. There was a significant lowering of the median frequencies of the uninjured limbs compared to the SC group at 75 and 100% of MVC. The EMG amplitude of the uninjured and injured limbs mirrored those of the SC and RC groups, respectively. These results support the view that muscle activation patterns were altered following ACL injury and surgical repair and may contribute to subsequent changes in muscle fibre properties during detraining and subsequent retraining. [ABSTRACT FROM AUTHOR]

Blood flow‐restricted resistance exercise (BFRRE) has been shown to induce increases in muscle size and strength, and continues to generate interest from both clinical and basic research points of view. The low loads employed, typically 20%‐50% of the one repetition maximum, make BFRRE an attractive training modality for individuals who may not tolerate high musculoskeletal forces (eg, selected clinical patient groups such as frail old adults and patients recovering from sports injury) and/or for highly trained athletes who have reached a plateau in muscle mass and strength. It has been proposed that achieving a high degree of muscle fibre recruitment is important for inducing muscle hypertrophy with BFRRE, and the available evidence suggest that fatiguing low‐load exercise during ischemic conditions can recruit both slow (type I) and fast (type II) muscle fibres. Nevertheless, closer scrutiny reveals that type II fibre activation in BFRRE has to date largely been inferred using indirect methods such as electromyography and magnetic resonance spectroscopy, while only rarely addressed using more direct methods such as measurements of glycogen stores and phosphocreatine levels in muscle fibres. Hence, considerable uncertainity exists about the specific pattern of muscle fibre activation during BFRRE. Therefore, the purpose of this narrative review was (1) to summarize the evidence on muscle fibre recruitment during BFRRE as revealed by various methods employed for determining muscle fibre usage during exercise, and (2) to discuss reported findings in light of the specific advantages and limitations associated with these methods. [ABSTRACT FROM AUTHOR]