Improvements in shoulder endurance following a baseball-specific strengthening program in high school baseball players

Background:

The posterior shoulder muscles play key roles in maintaining shoulder function in throwing. Arm fatigue has been identified as a risk factor for shoulder and elbow pain in youth baseball pitchers. However, endurance of the posterior shoulder muscles in overhead athletes is not routinely examined or conditioned.

Hypothesis:

Upper extremity muscular endurance can be improved in adolescent baseball players during a 20-week preseason training program. Secondarily, strength will be improved. Finally, these improvements will be associated with maintenance of range of motion.

Study Design:

Cohort study.

Methods:

Fourteen baseball players (age, 16 ± 2 years) attended 3 supervised training sessions per week for 20 weeks. Strengthening of the upper extremity was performed with a specific progression that utilized readily available equipment. Testing was completed at baseline and at 4, 8, and 20 weeks. The posterior shoulder endurance test was performed to assess muscular endurance. Glenohumeral internal and external rotation range of motion and strength were measured.

Results:

Posterior shoulder endurance improved from 30 ± 14 repetitions at baseline to 66 ± 26 at 4 weeks and 88 ± 36 at 20 weeks (P < 0.05). Glenohumeral internal rotation range of motion and the glenohumeral internal/external rotation strength ratio remained similar over the course of the program.

Conclusion:

Implementation of a preseason training program effectively increased shoulder muscular endurance while maintaining strength ratios and range of motion throughout the 20-week program.

Clinical Relevance:

This program improved a key parameter known to be associated with shoulder function and injury risk. This study describes a simple clinical tool to assess muscular endurance of the posterior shoulder.

The effectiveness of a combined exercise intervention on physical fitness factors related to falls in community-dwelling older adults

This study aimed to evaluate the effectiveness of an innovative exercise program on muscle strength, balance, and gait kinematics in elderly community-dwellers. The exercise program included strength and balance training and the 8-form Tai Chi Chuan. The measurements were carried out at baseline and 12 weeks, and consisted of four physical performance tests, joint isokinetic strength tests, and three-dimensional gait analysis. Fifty-six community-dwelling older adults aged 60–80 years old were randomly assigned to an intervention or control group. After 12 weeks, the intervention group showed a 17.6% improvement in the timed up and go test, accompanied by a 54.7% increase in the 30-second chair stand test score. Significant increases in the score of star excursion balance tests, and the strength of the extensor and flexor muscles at knee and ankle joints were also observed. In addition, the intervention group walked at a faster speed with a longer step length, shorter support phase, and a greater sagittal plane range of motion at the hip and ankle joints. No statistical improvements were seen in the control group. This study provided an effective, evidence-based falls prevention program that can be implemented in community settings to improve physical fitness and reduce fall risks among community-dwelling older adults. The star excursion balance test could be a sensitive measure of physical performance for fall risk assessment in older people.

Power training in patients with knee osteoarthritis: a pilot study on feasibility and efficacy

PURPOSE

To explore the feasibility and efficacy of using a power training exercise programme for the quadriceps femoris (QF) in elderly women with knee osteoarthritis (OA).

METHOD

A one-group quasi-experimental design with pre- and post-intervention measurements was conducted on 17 older adult women with knee OA pain. A bilateral QF exercise programme (24 sessions over 8 weeks) consisting of 3 series of 10 repetitions of flexion-extension as fast as possible at 40% of their one-repetition maximum (1RM) was performed in an outpatient physiotherapy clinic. The primary outcome measures were the knee function and associated problems using the Knee injury Osteoarthritis Outcome Score (KOOS) questionnaire and the weekly mean pain score from pain diaries using a visual analogue scale (VAS). QF strength (QFS), power (QFP) and work (QFW) were measured with an isokinetic dynamometer as secondary outcomes.

RESULTS

Significant improvements (p<0.05) were noted on the five categories of the KOOS. Significant decrease (p<0.01) was noted in pain intensity on VAS. QFP and QFW increased significantly on both sides (p<0.05). Exercise compliance was 99.5% for 16 participants.

CONCLUSIONS

A short power-training exercise programme is a feasible training modality for patients with knee OA, and significant functional improvements can be achieved. Further studies must be conducted to better understand the effects of the programme parameters and the generalizability of the findings.

Novel, high-intensity exercise prescription improves muscle mass, mitochondrial function, and physical capacity in individuals with Parkinson's disease

We conducted, in persons with Parkinson's disease (PD), a thorough assessment of neuromotor function and performance in conjunction with phenotypic analyses of skeletal muscle tissue, and further tested the adaptability of PD muscle to high-intensity exercise training. Fifteen participants with PD (Hoehn and Yahr stage 2-3) completed 16 wk of high-intensity exercise training designed to simultaneously challenge strength, power, endurance, balance, and mobility function. Skeletal muscle adaptations (P < 0.05) to exercise training in PD included myofiber hypertrophy (type I: +14%, type II: +36%), shift to less fatigable myofiber type profile, and increased mitochondrial complex activity in both subsarcolemmal and intermyofibrillar fractions (I: +45-56%, IV: +39-54%). These adaptations were accompanied by a host of functional and clinical improvements (P < 0.05): total body strength (+30-56%); leg power (+42%); single leg balance (+34%); sit-to-stand motor unit activation requirement (-30%); 6-min walk (+43 m), Parkinson's Disease Quality of Life Scale (PDQ-39, -7.8pts); Unified Parkinson's Disease Rating Scale (UPDRS) total (-5.7 pts) and motor (-2.7 pts); and fatigue severity (-17%). Additionally, PD subjects in the pretraining state were compared with a group of matched, non-PD controls (CON; did not exercise). A combined assessment of muscle tissue phenotype and neuromuscular function revealed a higher distribution and larger cross-sectional area of type I myofibers and greater type II myofiber size heterogeneity in PD vs. CON (P < 0.05). In conclusion, persons with moderately advanced PD adapt to high-intensity exercise training with favorable changes in skeletal muscle at the cellular and subcellular levels that are associated with improvements in motor function, physical capacity, and fatigue perception.

Resistance training improves body composition and increases matrix metalloproteinase 2 activity in biceps and gastrocnemius muscles of diet-induced obese rats

OBJECTIVE

We investigated the influence of resistance training on body composition and matrix metalloproteinase 2 activity in skeletal muscles of rats fed a high-fat diet.

METHODS

Thirty-two Wistar rats were divided into four experimental groups (n = 8/each) according to diet and exercise status: Control (standard diet), Obese Control (high-fat diet), Resistance Training (standard diet) and Obese Resistance Training (high-fat diet) groups. Animals were fed a high-fat diet for 12 weeks to promote excessive weight gain. Resistance Training groups performed 12 weeks of training periods after this period in a vertical ladder three times/week. Fat percentage, fat-free mass and fat mass were assessed using dual-energy X-ray absorptiometry, and matrix metalloproteinase 2 activity in biceps and gastrocnemius muscles was analyzed using zymography.

RESULTS

Resistance training significantly reduced body and fat masses and fat percentages in both trained groups (p<0.05). The maximal carrying load between trained groups was not different, but relative force was higher in the Resistance Training group (p<0.05). Of note, increased matrix metalloproteinase 2 activity was noted in the tested muscles of both trained groups (p<0.05).

CONCLUSION

In conclusion, altered body composition and muscle matrix metalloproteinase 2 activity promoted by excessive weight gain were positively modified by resistance training.

Heavy Resistance Training and Supplementation With the Alleged Testosterone Booster Nmda has No Effect on Body Composition, Muscle Performance, and Serum Hormones Associated With the Hypothalamo-Pituitary-Gonadal Axis in Resistance-Trained Males

The effects of 28 days of heavy resistance training while ingesting the alleged testosterone-boosting supplement, NMDA, were determined on body composition, muscle strength, serum cortisol, prolactin, and hormones associated with the hypothalamo-pituitary- gonadal (HPG) axis. Twenty resistance-trained males engaged in 28 days of resistance training 4 times/wk while orally ingesting daily either 1.78 g of placebo (PLAC) or NMDA. Data were analyzed with separate 2 x 2 ANOVA (p < 0.05). Criterion measures involved body composition, muscle strength, serum cortisol, prolactin, and gonadal hormone levels [free and total testosterone, luteininzing hormome (LH), gonadotrophin releasing hormone (GnRH), estradiol], and were assessed before (Day 0) and after (Day 29) resistance training and supplementation. No changes were noted for total body water and fat mass in response to resistance training (p > 0.05) or supplementation (p > 0.05). In regard to total body mass and fat-free mass, however, each was significantly increased in both groups in response to resistance training (p < 0.05), but were not affected by supplementation (p > 0.05). In both groups, lower-body muscle strength was significantly increased in response to resistance training (p < 0.05); however, supplementation had no effect (p > 0.05). All serum hormones (total and free testosterone, LH, GnRH, estradiol, cortisol, prolactin) were unaffected by resistance training (p > 0.05) or supplementation (p > 0.05). The gonadal hormones and cortisol and prolactin were unaffected by 28 days of NMDA supplementation and not associated with the observed increases in muscle strength and mass. At the dose provided, NMDA had no effect on HPG axis activity or ergogenic effects in skeletal muscle. Key PointsIn response to 28 days of heavy resistance training and NMDA supplementation, similar increases in muscle mass and strength in both groups occurred; however, the increases were not different between supplement groups.The supplementation of NMDA had no preferential effect on augmenting testosterone or decreasing estrogen, cortisol, and prolactin.While resistance training was effective in increasing muscle mass and strength, it was not preferentially due to NMDA supplementation.At the dose provided, NMDA supplementation for 28 days combined with resistance training does not increases muscle mass and strength due to its ability to elevate endogenous testosterone levels and lower cortisol and prolactin when compared to placebo.

Influence of exercise on the metabolic profile caused by 28 days of bed rest with energy deficit and amino acid supplementation in healthy men

OBJECTIVE

Muscle loss and metabolic changes occur with disuse [i.e. bed rest (BR)]. We hypothesized that BR would lead to a metabolically unhealthy profile defined by: increased circulating tumor necrosis factor (TNF)-α, decreased circulating insulin-like-growth-factor (IGF)-1, decreased HDL-cholesterol, and decreased muscle density (MD; measured by mid-thigh computerized tomography).

METHODS

We investigated the metabolic profile after 28 days of BR with 8 ± 6% energy deficit in male individuals (30-55 years) randomized to resistance exercise with amino acid supplementation (RT, n=24) or amino acid supplementation alone (EAA, n=7). Upper and lower body exercises were performed in the horizontal position. Blood samples were taken at baseline, after 28 days of BR and 14 days of recovery.

RESULTS

We found a shift toward a metabolically unfavourable profile after BR [compared to baseline (BLN)] in both groups as shown by decreased HDL-cholesterol levels (EAA: BLN: 39 ± 4 vs. BR: 32 ± 2 mg/dL, RT: BLN: 39 ± 1 vs. BR: 32 ± 1 mg/dL; p<0.001) and Low MD (EAA: BLN: 27 ± 4 vs. BR: 22 ± 3 cm(2), RT: BLN: 28 ± 2 vs. BR: 23 ± 2 cm(2); p<0.001). A healthier metabolic profile was maintained with exercise, including NormalMD (EAA: BLN: 124 ± 6 vs. BR: 110 ± 5 cm(2), RT: BLN: 132 ± 3 vs. BR: 131 ± 4 cm(2); p<0.001, time-by-group); although, exercise did not completely alleviate the unfavourable metabolic changes seen with BR. Interestingly, both groups had increased plasma IGF-1 levels (EAA: BLN:168 ± 22 vs. BR 213 ± 20 ng/mL, RT: BLN:180 ± 10 vs. BR: 219 ± 13 ng/mL; p<0.001) and neither group showed TNFα changes (p>0.05).

CONCLUSIONS

We conclude that RT can be incorporated to potentially offset the metabolic complications of BR.

Exercise in the management of chronic back pain

BACKGROUND

Chronic back pain is one of the most common and expensive medical conditions facing today's population. Its costs are estimated to be as much as $100 billion in the United States alone. Causation is poorly understood and healthcare providers share little common language concerning this pain. In addition, costly medical diagnostic tests are performed that do little to inform treatment. In the era of evidence-based medicine, back pain healthcare providers must find better ways to communicate with one another.

METHODS

The key to better communication is measurement within the context of an evidence-based, protocol-driven clinical rehabilitation model. Measurement is the key to better communication among providers treating spinal pain. Measurement means acquiring both patient-reported outcomes (PROs) and clinician-based outcomes (CBOs).

RESULTS

Musculoskeletal strengthening of the lumbar and cervical extensors has been shown to significantly reduce pain and provide successful clinical results for patients suffering from chronic back and neck pain. Lumbar strengthening has been successful because it is a safe exercise, it is prescribed based on pretreatment evaluation, and it provides objective measurements.

CONCLUSION

Without measurement, clinical results rely more on opinion than on objectively prescribed courses of treatment. Although indirect measures (PROs) are typically presented in clinical papers and clinical reviews, they are not often used in normal physical therapy practices. Adding direct patient-performance measures (CBOs) creates a much clearer clinical picture. The key to understanding the value of clinical practice and its predictable impact on patient treatment is objective measurement.

Biomechanical study of upper-limb exoskeleton for resistance training with three-dimensional motion analysis system

The world's population is aging rapidly, particularly in developed countries. The trend toward prolonged life expectancy will increase the elderly population and thereby lead to an increase in occurrences of age-related health problems such as chronic disease. Healthcare services and home-based rehabilitation are in high demand, and the demand for professional physical therapy is imposing an increasing burden on the healthcare system. Rehabilitation training devices must keep pace with standards of care, be cost effective, and meet the home-based training requirements of today's rehabilitation trends. This article presents an experimental study of a novel spring-loaded upper-limb exoskeleton meant to enable a patient or nondisabled individual to move a limb at multiple joints in different planes for resistance training in a free and unconstrained environment. To assess the functionality of the design, we have measured its kinematic data while performing designated movements and adopted a motion-capture system to verify the function of our mechanism. The collected data and analysis of the kinematic and dynamic joint torques may not only verify our mechanism but also provide a profound understanding of the design requirements for an appropriate spring-loaded exoskeleton for upper-limb resistance training.

Electromyographic comparison of traditional and suspension push-ups

There is very limited scientific data concerning suspension training. The purpose of this investigation was to compare the electromyographic activity of the pectoralis major, anterior deltoid, and triceps brachii between a suspension push-up and traditional push-up. Twenty-one apparently healthy men (n = 15, age = 25.93 ± 3.67 years) and women (n = 6, age = 23.5 ± 1.97 years) volunteered to participate in this study. All subjects performed four repetitions of a suspension push-up and a traditional push-up where the order of the exercises was randomized. The mean peak and normalized electromyography of the pectoralis major, anterior deltoid, and triceps brachii were compared across the two exercises. Suspension push-ups elicited the following electromyographic values: pectoralis major (3.08 ± 1.13 mV, 69.54 ± 27.6 %MVC), anterior deltoid (5.08 ± 1.55 mV, 81.13 ± 17.77 %MVC), and triceps brachii (5.11 ± 1.97 mV, 105.83 ± 18.54 %MVC). The electromyographic activities during the traditional push-up were as follows: pectoralis major (2.66 ± 1.05 mV, 63.62 ± 16.4 %MVC), anterior deltoid (4.01 ± 1.27 mV, 58.91 ± 20.3 %MVC), and triceps brachii (3.91 ± 1.36 mV, 74.32 ± 16.9 %MVC). The mean peak and normalized electromyographic values were significantly higher for all 3 muscles during the suspension push-up compared to the traditional push-up (p < 0.05). This study suggests that the suspension push-up elicited a greater activation of pectoralis major, anterior deltoid, and triceps brachii when compared to a traditional push-up. Therefore, suspension push-ups may be considered an advanced variation of a traditional push-up when a greater challenge is warranted.

Inter-subject variability of muscle synergies during bench press in power lifters and untrained individuals

The purpose of the study was to elucidate the role of expertise on muscle synergies involved in bench press. Ten expert power lifters (EXP) and nine untrained participants (UNT) completed three sets of eight repetitions at 60% of three repetition maximum in bench press. Muscle synergies were extracted from surface electromyography data of 21 bench press cycles using non-negative matrix factorization algorithm. The synergy activation coefficient represents the relative contribution of the muscle synergy to the overall muscle activity pattern, while the muscle synergy vector represents the relative weighting of each muscle within each synergy. Describing more than 90% of the variability, two muscle synergies reflected the eccentric and concentric phase. The cross-correlations (ρ(max)) for synergy activation coefficient 2 (concentric phase) were 0.83 [0.71;0.88] and 0.59 [0.49;0.77] [Median ρ(max) (25th;75th percentile)] (P = 0.001) in UNT and EXP, respectively. Median correlation coefficient (ρ) for muscle synergy vector 2 was 0.15 [-0.08;0.46] and 0.48 [0.02;0.70] (P = 0.03) in UNT and EXP, respectively. Thus, EXP showed larger inter-subject variability than UNT in the synergy activation coefficient during the concentric phase, while the muscle synergy vectors were less variable in EXP. This points at the importance of a specialized neural strategy in elite bench press performance.

Resistance exercise training for fibromyalgia

BACKGROUND

Fibromyalgia is characterized by chronic widespread pain that leads to reduced physical function. Exercise training is commonly recommended as a treatment for management of symptoms. We examined the literature on resistance training for individuals with fibromyalgia. Resistance training is exercise performed against a progressive resistance with the intention of improving muscle strength, muscle endurance, muscle power, or a combination of these.

OBJECTIVES

To evaluate the benefits and harms of resistance exercise training in adults with fibromyalgia. We compared resistance training versus control and versus other types of exercise training.

SEARCH METHODS

We searched nine electronic databases (The Cochrane Library, MEDLINE, EMBASE, CINAHL, PEDro, Dissertation Abstracts, Current Controlled Trials, World Health Organization (WHO) International Clinical Trials Registry Platform, AMED) and other sources for published full-text articles. The date of the last search was 5 March 2013. Two review authors independently screened 1856 citations, 766 abstracts and 156 full-text articles. We included five studies that met our inclusion criteria.

SELECTION CRITERIA

Selection criteria included: a) randomized clinical trial, b) diagnosis of fibromyalgia based on published criteria, c) adult sample, d) full-text publication, and e) inclusion of between-group data comparing resistance training versus a control or other physical activity intervention.

DATA COLLECTION AND ANALYSIS

Pairs of review authors independently assessed risk of bias and extracted intervention and outcome data. We resolved disagreements between the two review authors and questions regarding interpretation of study methods by discussion within the pairs or when necessary the issue was taken to the full team of 11 members. We extracted 21 outcomes of which seven were designated as major outcomes: multidimensional function, self reported physical function, pain, tenderness, muscle strength, attrition rates, and adverse effects. We evaluated benefits and harms of the interventions using standardized mean differences (SMD) or mean differences (MD) or risk ratios or Peto odds ratios and 95% confidence intervals (CI). Where two or more studies provided data for an outcome, we carried out a meta-analysis.

MAIN RESULTS

The literature search yielded 1865 citations with five studies meeting the selection criteria. One of the studies that had three arms contributed data for two comparisons. In the included studies, there were 219 women participants with fibromyalgia, 95 of whom were assigned to resistance training programs. Three randomized trials compared 16 to 21 weeks of moderate- to high-intensity resistance training versus a control group. Two studies compared eight weeks of progressive resistance training (intensity as tolerated) using free weights or body weight resistance exercise versus aerobic training (ie, progressive treadmill walking, indoor and outdoor walking), and one study compared 12 weeks of low-intensity resistance training using hand weights (1 to 3 lbs (0.45 to 1.36 kg)) and elastic tubing versus flexibility exercise (static stretches to major muscle groups).Statistically significant differences (MD; 95% CI) favoring the resistance training interventions over control group(s) were found in multidimensional function (Fibromyalgia Impact Questionnaire (FIQ) total decreased 16.75 units on a 100-point scale; 95% CI -23.31 to -10.19), self reported physical function (-6.29 units on a 100-point scale; 95% CI -10.45 to -2.13), pain (-3.3 cm on a 10-cm scale; 95% CI -6.35 to -0.26), tenderness (-1.84 out of 18 tender points; 95% CI -2.6 to -1.08), and muscle strength (27.32 kg force on bilateral concentric leg extension; 95% CI 18.28 to 36.36).Differences between the resistance training group(s) and the aerobic training groups were not statistically significant for multidimensional function (5.48 on a 100-point scale; 95% CI -0.92 to 11.88), self reported physical function (-1.48 units on a 100-point scale; 95% CI -6.69 to 3.74) or tenderness (SMD -0.13; 95% CI -0.55 to 0.30). There was a statistically significant reduction in pain (0.99 cm on a 10-cm scale; 95% CI 0.31 to 1.67) favoring the aerobic groups.Statistically significant differences were found between a resistance training group and a flexibility group favoring the resistance training group for multidimensional function (-6.49 FIQ units on a 100-point scale; 95% CI -12.57 to -0.41) and pain (-0.88 cm on a 10-cm scale; 95% CI -1.57 to -0.19), but not for tenderness (-0.46 out of 18 tender points; 95% CI -1.56 to 0.64) or strength (4.77 foot pounds torque on concentric knee extension; 95% CI -2.40 to 11.94). This evidence was classified low quality due to the low number of studies and risk of bias assessment. There were no statistically significant differences in attrition rates between the interventions. In general, adverse effects were poorly recorded, but no serious adverse effects were reported. Assessment of risk of bias was hampered by poor written descriptions (eg, allocation concealment, blinding of outcome assessors). The lack of a priori protocols and lack of care provider blinding were also identified as methodologic concerns.

AUTHORS' CONCLUSIONS

The evidence (rated as low quality) suggested that moderate- and moderate- to high-intensity resistance training improves multidimensional function, pain, tenderness, and muscle strength in women with fibromyalgia. The evidence (rated as low quality) also suggested that eight weeks of aerobic exercise was superior to moderate-intensity resistance training for improving pain in women with fibromyalgia. There was low-quality evidence that 12 weeks of low-intensity resistance training was superior to flexibility exercise training in women with fibromyalgia for improvements in pain and multidimensional function. There was low-quality evidence that women with fibromyalgia can safely perform moderate- to high-resistance training.

Safety and feasibility of a home-based six week resistance training program in juvenile idiopathic arthritis

BACKGROUND

Juvenile idiopathic arthritis (JIA), among the most common chronic diseases of childhood, can be associated with attenuated physical activity levels, reduced fitness, decreased functionality and pain. This pilot study aimed to determine the safety, feasibility and effect of a six week resistance training program in children with JIA.

METHODS

Youth (8-18 years) with JIA participated in a home-based resistance training program. Participants reported pain on an electronic diary once a day for one week prior to training, then once a day on non-exercise days and three times a day (before-exercise, after-exercise, and end-of-day) on exercise days for the subsequent six weeks of training. Secondary outcome measures included inflammation (assessed by ultrasound), muscle size (assessed by ultrasound), muscle strength (assessed by dynamometer) and functional ability (assessed by childhood health assessment questionnaire), measured at baseline and post-training. Participants were also instructed to wear an accelerometer one week prior to training to estimate baseline physical activity levels. Statistical analyses included safety (pain changes and any adverse events), feasibility (adherence to program and modifications made to exercises) and effect of program (differences in secondary measures pre and post training). An alpha level of p < 0.05 was accepted as significant.

RESULTS

Seven participants completed an average of 12.7 ± 3.4 (range 8-17) exercise sessions out of a possible 18 (70.6%). No adverse events were reported and pain did not increase over the seven weeks. Secondary measures revealed a significant increase in vastus lateralis thickness from pre to post training (p < 0.05). End-of-day pain intensity was correlated to end-of-day stiffness, fatigue and mood (r = .864, r = .581, r = -.637, respectively, p < 0.001). Pain intensity was also correlated with ratings of perceived exertion of the exercise (r = 0.324, p < 0.01). Only two children met the recommended 60 minutes of moderate to vigorous physical activity per day.

CONCLUSIONS

A six week home-based resistance training program is both safe (absence of pain changes or adverse events over the six weeks) and feasible (comparable adherence rates to other exercise studies involving JIA and individually modifiable) in children with JIA.

The transcriptional coactivator PGC-1α is dispensable for chronic overload-induced skeletal muscle hypertrophy and metabolic remodeling

Skeletal muscle mass loss and dysfunction have been linked to many diseases. Conversely, resistance exercise, mainly by activating mammalian target of rapamycin complex 1 (mTORC1), promotes skeletal muscle hypertrophy and exerts several therapeutic effects. Moreover, mTORC1, along with peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α), regulates skeletal muscle metabolism. However, it is unclear whether PGC-1α is required for skeletal muscle adaptations after overload. Here we show that although chronic overload of skeletal muscle via synergist ablation (SA) strongly induces hypertrophy and a switch toward a slow-contractile phenotype, these effects were independent of PGC-1α. In fact, SA down-regulated PGC-1α expression and led to a repression of energy metabolism. Interestingly, however, PGC-1α deletion preserved peak force after SA. Taken together, our data suggest that PGC-1α is not involved in skeletal muscle remodeling induced by SA.

Orlistat improves endothelial function in obese adolescents: a randomised trial

AIM

To investigate the effect of orlistat on endothelial function in obese adolescents.

METHODS

Single-blind 10-week controlled trial of 67 normolipidaemic obese adolescents randomised into three groups. Group 1 (diet alone), Group 2 (diet and orlistat), Group 3 (diet, orlistat and exercise). Endothelial function measured by flow-mediated dilatation (FMD) of the brachial artery, anthropometric parameters, blood pressure, fasting blood lipids, insulin and glucose levels were recorded at baseline and at 10 weeks.

RESULTS

Sixty four subjects completed the study. Groups were comparable at baseline. FMD increased significantly with orlistat (Groups 2 and 3) but not in Group 1. Orlistat treatment resulted in significantly reduced bodyweight, body mass index (BMI), waist circumference, total and low-density lipoprotein (LDL) cholesterol levels. High-density lipoprotein cholesterol levels were unchanged. Triglyceride and insulin levels were significantly reduced in all three groups. The reduction in cholesterols did not correlate with reductions in weight and BMI. A slight reduction of body fat, both with and without orlistat treatment, correlated with reduction in BMI after adjustment for baseline values. Blood pressure was unaltered by orlistat. Calorie intake was reduced with orlistat, and the decrease noted in % fat and increase in % carbohydrate was significant only in those taking orlistat. The addition of exercise (Group 3 compared with Group 2) altered no parameter.

CONCLUSIONS

Orlistat improves endothelial function and reduces bodyweight, BMI, fasting total and LDL-cholesterol in obese adolescents when combined with dietary control. Improvement in endothelial function if maintained could reflect long-term cardiovascular benefit.

Effects of long-term head-down-tilt bed rest and different training regimes on the coagulation system of healthy men

Immobility plus preexisting chronic disease or acute trauma can activate the coagulation system, thus increasing the risk for thromboembolic events. The effects of long-term bed-rest immobility and microgravity on the coagulation system of healthy persons (e.g., during crewed Mars missions) have not yet been studied. The main objective of the second Berlin BedRest Study (BBR2-2) “Coagulation Part” was to investigate adaptations of the hemostatic system during long-term bed rest (60 days) under simulated microgravity (6° head-down-tilt [6°HDT]) and after mobilization in three different volunteer groups (randomly assigned to CTR= inactive control group; RE= resistive exercise only group; and RVE= resistive exercise with whole-body vibration group). In 24 males (aged 21–45 years), before, during, and after long-term bed rest, key parameters of coagulation were measured from venous blood samples: D-dimer (DD), thrombin–antithrombin III complex (TAT), and prothrombin fragment F1 + 2 (PT-F1 + 2). Additionally, modified rotational thrombelastometry (ROTEM^®) analysis was performed. Times of exploratory analyses were as follows: baseline data collection 2 days before bed rest (BDC-2); eight different days of 6°HDT bed rest (HDT1–HDT60), and two different days after reambulation (R + 3 and R + 6). We found significant changes in DD, TAT, and PT-F1 + 2 over the total time course, but no consistent effect of physical interventions (RE, RVE) on these parameters. Notably, no parameter reached levels indicative of intravascular thrombin formation. All ROTEM® parameters remained within the normal range and no pathological traces were found. Sixty days of 6°HDT bed rest are not associated with pronounced activation of the coagulation system indicative of intravascular thrombus formation in healthy volunteers independent of the training type during the bed rest.

Estimating the energy costs of intermittent exercise

To date, steady state models represent the only acceptable methodology for the estimation of exercise energy costs. Conversely, comparisons made between continuous and intermittent exercise generally reveal major physiological discrepancies, leading to speculation as to why steady state energy expenditure models should be applied to intermittent exercise. Under intermittent conditions, skeletal muscle invokes varying aerobic and anaerobic metabolic responses, each with the potential to make significant contributions to overall energy costs. We hypothesize that if the aerobic-only energetic profile of steady state exercise can be used to estimate the energetics of non-steady state and intermittent exercise, then the converse also must be true. In fact, reasonable estimates of energy costs to work volumes or work rates can be demonstrated under steady state, non-steady state and intermittent conditions; the problem with the latter two is metabolic variability. Using resistance training as a model, estimates of both aerobic and anaerobic energy cost components, as opposed to one or the other, have reduced the overall energetic variability that appears inherent to brief, intense, intermittent exercise models.

Resistance exercise induces region-specific adaptations in anterior pituitary gland structure and function in rats

The anterior pituitary gland (AP) increases growth hormone (GH) secretion in response to resistance exercise (RE), but the nature of AP adaptations to RE is unknown. To that end, we examined the effects of RE on regional AP somatotroph GH release, structure, and relative quantity. Thirty-six Sprague-Dawley rats were assigned to one of four groups: 1) no training or acute exercise (NT-NEX); 2) no training with acute exercise (NT-EX); 3) resistance training without acute exercise (RT-NEX); 4) resistance training with acute exercise (RT-EX). RE incorporated 10, 1 m-weighted ladder climbs at an 85° angle. RT groups trained 3 days/wk for 7 wk, progressively. After death, trunk blood was collected, and each AP was divided into quadrants (ventral-dorsal and left-right). We measured: 1) trunk plasma GH; 2) somatotroph GH release; 3) somatotroph size; 4) somatotroph secretory content; and 5) percent of AP cells identified as somatotrophs. Trunk GH differed by group (NT-NEX, 8.9 ± 2.4 μg/l; RT-NEX, 9.2 ± 3.5 μg/l; NT-EX, 15.6 ± 3.4 μg/l; RT-EX, 23.4 ± 4.6 μg/l). RT-EX demonstrated greater somatotroph GH release than all other groups, predominantly in ventral regions (P < 0.05-0.10). Ventral somatotrophs were larger in NT-EX and RT-NEX compared with RT-EX (P < 0.05-0.10). RT-NEX exhibited significantly greater secretory granule content than all other groups but in the ventral-right region only (P < 0.05-0.10). Our findings indicate reproducible patterns of spatially distinct, functionally different somatotroph subpopulations in the rat pituitary gland. RE training appears to induce dynamic adaptations in somatotroph structure and function.

Sixteen weeks of resistance training can decrease the risk of metabolic syndrome in healthy postmenopausal women

BACKGROUND

The postmenopausal phase has been considered an aggravating factor for developing metabolic syndrome. Notwithstanding, no studies have as yet investigated the effects of resistance training on metabolic syndrome in postmenopausal women. Thus, the purpose of this study was to verify whether resistance training could reduce the risk of metabolic syndrome in postmenopausal women.

METHODS

Twenty postmenopausal women were randomly assigned to a resistance training protocol (n = 10, 53.40 ± 3.95 years, 64.58 ± 9.22 kg) or a control group (n = 10, 53.0 ± 5.7 years, 64.03 ± 5.03 kg). In the resistance training protocol, ten exercises were performed, with 3 × 8-10 maximal repetitions three times per week, and the load was increased every week. Two-way analysis of variance was used to evaluate specific metabolic syndrome Z-score, high density lipoprotein cholesterol, fasting blood glucose, triglycerides, waist circumference, blood pressure, strength, and body composition. The level of statistical significance was set at P < 0.05.

RESULTS

The main results demonstrated a significant decrease of metabolic syndrome Z-score when the postmenopausal women performed resistance training (P = 0.0162). Moreover, we observed decreases in fasting blood glucose for the resistance training group (P = 0.001), and also significant improvements in lean body mass (P = 0.042, 2.46%), reduction of body fat percentage (P = 0.001, -6.75%) and noticeable increases in muscle strength after resistance training to leg press (P = 0.004, 41.29%) and bench press (P = 0.0001, 27.23%).

CONCLUSION

It was concluded that resistance training performed three times a week may reduce the metabolic syndrome Z-score with concomitant decreases in fasting blood glucose, improvements in body composition, and muscle strength in postmenopausal women.

Effects of ovariectomy and resistance training on oxidative stress markers in the rat liver

OBJECTIVE

The objective of this study was to assess the effects of resistance training on oxidative stress markers in the livers of ovariectomized rats.

METHOD

Adult Sprague-Dawley rats were divided into the following four groups (n = 8 per group): sham-operated sedentary, ovariectomized sedentary, sham-operated resistance training, and ovariectomized resistance training. During the resistance training period, the animals climbed a 1.1-m vertical ladder with weights attached to their tails; the sessions were conducted 3 times per week, with 4-9 climbs and 8-12 dynamic movements per climb. The oxidative stress was assessed by measuring the levels of reduced glutathione and oxidized glutathione, the enzymatic activity of catalase and superoxide dismutase, lipid peroxidation, vitamin E concentrations, and the gene expression of glutathione peroxidase.

RESULTS

The results showed significant reductions in the reduced glutathione/oxidized glutathione ratio (4.11±0.65 nmol/g tec), vitamin E concentration (55.36±11.11 nmol/g), and gene expression of glutathione peroxidase (0.49±0.16 arbitrary units) in the livers of ovariectomized rats compared with the livers of unovariectomized animals (5.71±0.71 nmol/g tec, 100.14±10.99 nmol/g, and 1.09±0.54 arbitrary units, respectively). Moreover, resistance training for 10 weeks was not able to reduce the oxidative stress in the livers of ovariectomized rats and induced negative changes in the hepatic anti-oxidative/oxidative balance.

CONCLUSION

Our findings indicate that the resistance training program used in this study was not able to attenuate the hepatic oxidative damage caused by ovariectomy and increased the hepatic oxidative stress.

Untrained young men have dysfunctional HDL compared with strength-trained men irrespective of body weight status

We examined the impact of strength fitness and body weight on the redox properties of high-density lipoprotein (HDL) and associations with indices of vascular and metabolic health. Ninety young men were categorized into three groups: 1) overweight untrained (OU; n = 30; BMI 30.7 ± 2.1 kg/m(2)); 2) overweight trained [OT; n = 30; BMI 29.0 ± 1.9; ≥4 d/wk resistance training (RT)]; and 3) lean trained (LT; n = 30; BMI 23.7 ± 1.4; ≥4 d/wk RT). Using a novel assay on the basis of the HDL-mediated rate of oxidation of dihydrorhodamine (DOR), we determined the functional (redox) properties of HDL and examined correlations between DOR and indices of vascular and metabolic health in the cohort. DOR was significantly lower in both trained groups compared with the untrained group (LT, 1.04 ± 0.49; OT, 1.39 ± 0.57; OU, 1.80 ± 0.74; LT vs. OU P < 0.00001; OT vs. OU P = 0.02), however, DOR in the OT group was not significantly different from that of the LT group. DOR was negatively associated with HDL-cholesterol (R = -0.64), relative strength (R = -0.42), sex hormone-binding globulin (R = -0.42), and testosterone (R = -0.35) (all P ≤ 0.001); whereas DOR was positively associated with triglycerides (R = 0.39, P = 0.002), oxidized low-density lipoprotein (R = 0.32), body mass index (R = 0.43), total mass (R = 0.35), total fat mass (R = 0.42), waist circumference (R = 0.45), and trunk fat mass (R = 0.42) (all P ≤ 0.001). Chronic RT is associated with improved HDL redox activity. This may contribute to the beneficial effects of RT on reducing cardiovascular disease risk, irrespective of body weight status.

Identification of anaerobic threshold by analysis of heart rate variability during discontinuous dynamic and resistance exercise protocols in healthy older men

The purposes of this study were to determine anaerobic threshold (AT) during discontinuous dynamic and resistive exercise protocols by analysing of heart rate variability (HRV) and blood lactate (BL) in healthy elderly subjects and compare the cardiovascular, metabolic and autonomic variables obtained from these two forms of exercise. Fourteen elderly (70 ± 4 years) apparently healthy males underwent the following tests: (i) incremental ramp test on cycle ergometer, (ii) one repetition maximum (1RM) leg press at 45°, (iii) a discontinuous exercise test on a cycle ergometer (DET-C) protocol and (iv) a resistance exercise leg press (DET-L) protocol. Heart rate, blood pressure and BL were obtained during each increment of exercise intensity. No significant differences (P>0·05) were found between methods of AT determination (BL and HRV) nor the relative intensity corresponding to AT (30% of maximum intensity) between the types of exercise (DET-C and DET-L). Furthermore, no significant differences (P>0·05) were found between the DET-C and DET-L in relation to HRV, however, the DET-L provided higher values of systolic blood pressure and BL (P<0·05) from the intensity corresponding to AT. We conclude that HRV was effective in determination of AT, and the parasympathetic modulation responses obtained during dynamic and resistive exercise protocols were similar when compared at the same relative intensity. However, DET-L resulted in higher values of blood pressure and BL at workloads beyond AT.

Non-uniform muscle oxygenation despite uniform neuromuscular activity within the vastus lateralis during fatiguing heavy resistance exercise

Previous studies have reported for the vastus lateralis (VL) that the extent of muscle hypertrophy in response to resistance training is greater in the distal than in the middle region, despite uniform muscle fibre composition within VL along its length. In the present study, to investigate mechanism(s) for such non-uniform muscle hypertrophy, we simultaneously measured neuromuscular activity and muscle oxygenation state at the middle and distal regions of VL during fatiguing heavy resistance exercise. Twelve males performed unilateral knee extension exercise which consisted of 4 sets of 8 repetitions at intensity of 80% of the individual one repetition maximum. During the resistance exercise, neuromuscular activities and muscle oxygenation status at the middle and distal regions (50% and 70% of the thigh length, respectively) of VL were measured by using electromyography and near-infrared spectroscopy, respectively. Neuromuscular activities were similar between the distal and middle regions of VL, whereas muscle tissue oxygenation saturation was significantly lower at the distal than at the middle region of VL. These results suggest a possibility that the regional difference in muscle oxygenation but not in neuromuscular activity during fatiguing heavy resistance exercise is responsible for the regional difference in hypertrophy within a muscle.

Effect of brief daily resistance training on rapid force development in painful neck and shoulder muscles: randomized controlled trial

Objective: To determine the effect of small daily amounts of progressive resistance training on rapid force development of painful neck/shoulder muscles.

Methods: 198 generally healthy adults with frequent neck/shoulder muscle pain (mean: age 43·1 years, computer use 93% of work time, 88% women, duration of pain 186 day during the previous year) were randomly allocated to 2- or 12 min of daily progressive resistance training with elastic tubing or to a control group receiving weekly information on general health. A blinded assessor took measures at baseline and at 10-week follow-up; participants performed maximal voluntary contractions at a static 90-degree shoulder joint angle. Rapid force development was determined as the rate of torque development and maximal muscle strength was determined as the peak torque.

Results: Compared with the control group, rate of torque development increased 31·0 Nm s⁻¹ [95% confidence interval: (1·33–11·80)] in the 2-min group and 33·2 Nm s⁻¹ (1·66–12·33) in the 12-min group from baseline to 10-week follow-up, corresponding to an increase of 16·0% and 18·2% for the two groups, respectively. The increase was significantly different compared to controls (P<0·05) for both training groups. Maximal muscle strength increased only ∼5–6% [mean and 95% confidence interval for 2- and 12-min groups to control, respectively: 2·5 Nm (0·05–0·73) and 2·2 Nm (0·01–0·70)]. No significant differences between the 2- and 12-min groups were evident. A weak but significant relationship existed between changes in rapid force development and pain (r = 0·27, P<0·01), but not between changes in maximal muscle strength and pain.

Conclusion: Small daily amounts of progressive resistance training in adults with frequent neck/shoulder pain increases rapid force development and, to a less extent, maximal force capacity.

Cancer cachexia prevention via physical exercise: molecular mechanisms

Cancer cachexia is a debilitating consequence of disease progression, characterised by the significant weight loss through the catabolism of both skeletal muscle and adipose tissue, leading to a reduced mobility and muscle function, fatigue, impaired quality of life and ultimately death occurring with 25-30 % total body weight loss. Degradation of proteins and decreased protein synthesis contributes to catabolism of skeletal muscle, while the loss of adipose tissue results mainly from enhanced lipolysis. These mechanisms appear to be at least, in part, mediated by systemic inflammation. Exercise, by virtue of its anti-inflammatory effect, is shown to be effective at counteracting the muscle catabolism by increasing protein synthesis and reducing protein degradation, thus successfully improving muscle strength, physical function and quality of life in patients with non-cancer-related cachexia. Therefore, by implementing appropriate exercise interventions upon diagnosis and at various stages of treatment, it may be possible to reverse protein degradation, while increasing protein synthesis and lean body mass, thus counteracting the wasting seen in cachexia.

Inflammation marker, damage marker and anabolic hormone responses to resistance training with vascular restriction in older males

The goal of this study was to examine anabolic hormone, muscle damage marker and inflammation marker responses to two types of resistance training protocols in older men. Thirty-six healthy older males (mean age = 56.6 ± 0.6 years) completed 6 weeks of high-intensity resistance training (HI-RT), low-intensity resistance training with vascular restriction (LI-BFR) or no exercise control group (CON) three times per week. Three upper body exercises were performed by both exercise groups at the same intensity (at 80% 1-RM), but lower body exercises were performed by the HI-RT group at 80% 1-RM and by the LI-BFR group at 20% 1-RM with vascular restriction. Resting serum creatine kinase (CK), interleukin 6 (IL-6), insulin-like growth factor-I (IGF-I), IGF binding protein 3 (IGFBP-3) and testosterone (T) were measured before and after training. No significant group differences in resting CK, IL-6, IGF-I, IGFBP-3 and T were detected following training (P>0.05). In addition, there were no significant changes in muscle cross-sectional area (CSA), but a trend for significant decreases in the percent changes in thigh subcutaneous fat (P = 0.051). Although training-induced anabolic hormone response did not reach statistical significance, our findings on CK and IL-6 indicated that the LI-BFR training protocol was safe and well tolerated for older men to perform to improve muscular strength.

A community-wide campaign to promote physical activity in middle-aged and elderly people: a cluster randomized controlled trial

BACKGROUND

We aimed to evaluate the effectiveness of a community-wide campaign (CWC) for promoting physical activity in middle-aged and elderly people.

METHODS

A cluster randomized controlled trial (RCT) with a community as the unit of randomization was performed using a population-based random-sampled evaluation by self-administered questionnaires in the city of Unnan, Shimane Prefecture, Japan. The evaluation sample included 6000 residents aged 40 to 79 years. We randomly allocated nine communities to the intervention group and three to the control group. The intervention was a CWC from 2009 to 2010 to promote physical activity, and it comprised information, education, and support delivery. The primary outcome was a change in engaging in regular aerobic, flexibility, and/or muscle-strengthening activities evaluated at the individual level.

RESULTS

In total, 4414 residents aged 40-79 years responded to a self-administered questionnaire (73.6% response rate). Awareness of the CWC was 79% in the intervention group. Awareness and knowledge were significantly different between the intervention and control groups, although there were no significant differences in belief and intention. The 1-year CWC did not significantly promote the recommended level of physical activity (adjusted odds ratio: 0.97; 95% confidence interval: 0.84-1.14).

CONCLUSIONS

This cluster RCT showed that the CWC did not promote physical activity in 1 year. Significant differences were observed in awareness and knowledge between intervention and control groups as short-term impacts of the campaign.

TRIAL REGISTRATION

UMIN-CTR UMIN000002683.

Women with metabolic syndrome present different autonomic modulation and blood pressure response to an acute resistance exercise session compared with women without metabolic syndrome

Metabolic syndrome (MetS) is a cluster of risk factors in individuals with high risk of diabetes and heart disease. Resistance training (RT) has been proposed to be a safe, effective and worthwhile method for the prevention and treatment of metabolic and cardiovascular diseases. However, no study has analysed the acute response of blood pressure (BP) and autonomic control of heart rate (HR) after a RT session in female patients with MetS. The aim of the present study was to analyse the response of laboratory assessed and ambulatory BP and cardiac autonomic modulation after a RT session in women with MetS. Nine women without MetS (35.0 ± 6.7 years) and 10 women with MetS (34.1 ± 9.4 years) completed one experimental exercise session and a control session. Laboratory BP, heart rate variability (HRV) and ambulatory BP of each subject were measured at rest, over 60 min, and for 24 h after the end of the sessions, respectively. There was a significant reduction in systolic blood pressure (SBP), night time diastolic blood pressure (DBP) and mean blood pressure (MBP) only for women with MetS, for all periods after the RT session when compared with the control session (P<0.05). Significantly lower laboratory values of SBP and DBP (10, 30 and 40 min postexercise) and MBP (10, 40 and 50 min postexercise) were observed in women with MetS (P<0.05). Patients with MetS exhibited significant lower basal HRV and a lower autonomic responsiveness during the 60 min of acute recovery. These results confirmed that an acute session of resistance exercise induced a lower BP during day time and sleeping hours in women with MetS that may offer a cardio-protective effect. Women with MetS exhibited an impaired autonomic modulation at rest and a lower acute autonomic responsiveness to a RT session. The dissociation between BP and HRV responses suggests that other factors than autonomic control could be involved in the hypotensive effect of a RT session in MetS patients.

Physical activity in obesity and metabolic syndrome

Biological aging is typically associated with a progressive increase in body fat mass and a loss of lean body mass. Owing to the metabolic consequences of reduced muscle mass, it is understood that normal aging and/or decreased physical activity may lead to a higher prevalence of metabolic disorders. Lifestyle modification, specifically changes in diet, physical activity, and exercise, is considered the cornerstone of obesity management. However, for most overweight people it is difficult to lose weight permanently through diet or exercise. Thus, prevention of weight gain is thought to be more effective than weight loss in reducing obesity rates. A key question is whether physical activity can extenuate age-related weight gain and promote metabolic health in adults. Current guidelines suggest that adults should accumulate about 60 minutes of moderate-intensity physical activity daily to prevent unhealthy weight gain. Because evidence suggests that resistance training may promote a negative energy balance and may change body fat distribution, it is possible that an increase in muscle mass after resistance training may be a key mediator leading to better metabolic control.

Effect of resistance training on plasma nitric oxide and asymmetric dimethylarginine concentrations in type I diabetic rats

BACKGROUND

Asymmetric dimethylarginine (ADMA) has a predominant role in progression of some cardiovascular diseases, including diabetes. It interferes with L-arginine in production of nitric oxide (NO) by inhibition of NO synthase. The purpose of this study was to evaluate the effect of resistance training on plasma NO and ADMA concentrations in type 1 diabetic male rats.

METHODS

Thirty-six male wistar rats were randomly divided into four groups: (1) control; (2) diabetic; (3) diabetic trained, and (4) control trained (n = 9 each). In the trained groups, the animals undertook one training session per day, 3 days/week, for 4 weeks. At the end of experiment, blood samples were taken and the concentrations of plasma glucose, insulin, lipid profile, NO and ADMA concentrations were determined.

RESULTS

plasma ADMA concentration showed a significant increase in diabetic rats compare to control group (0.73 ± 0.07 vs. 0.62 ± 0.04 μmol/l; P < 0.05). The plasma ADMA level in the trained diabetic and control were lower than the sedentary groups, although it was not statistically significant. Plasma NO concentration in diabetic group was lower than control (P < 0.05). Resistance training significantly increased plasma NO concentration in diabetic animals (P < 0.05).

CONCLUSION

Elevated ADMA level in diabetic animals can normalize during resistance exercise. Reduced ADMA level and increased NO level following resistance training might improve cardiovascular risk in diabetic subjects.

The effects of a maximal power training cycle on the strength, maximum power, vertical jump height and acceleration of high-level 400-meter hurdlers

The aim of this study was to determine the effects of a power training cycle on maximum strength, maximum power, vertical jump height and acceleration in seven high-level 400-meter hurdlers subjected to a specific training program twice a week for 10 weeks. Each training session consisted of five sets of eight jump-squats with the load at which each athlete produced his maximum power. The repetition maximum in the half squat position (RM), maximum power in the jump-squat (W), a squat jump (SJ), countermovement jump (CSJ), and a 30-meter sprint from a standing position were measured before and after the training program using an accelerometer, an infra-red platform and photo-cells. The results indicated the following statistically significant improvements: a 7.9% increase in RM (Z=-2.03, p=0.021, δc=0.39), a 2.3% improvement in SJ (Z=-1.69, p=0.045, δc=0.29), a 1.43% decrease in the 30-meter sprint (Z=-1.70, p=0.044, δc=0.12), and, where maximum power was produced, a change in the RM percentage from 56 to 62% (Z=-1.75, p=0.039, δc=0.54). As such, it can be concluded that strength training with a maximum power load is an effective means of increasing strength and acceleration in high-level hurdlers.

Using bench press load to predict upper body exercise loads in physically active individuals

This study investigated whether loads for assistance exercises of the upper body can be predicted from the loads of the bench press exercise. Twenty-nine physically active collegiate students (age: 22.6 ± 2.5; weight training experience: 2.9 ± 2.1 years; estimated 1RM bench press: 54.31 ± 14.60 kg; 1RM: body weight ratio: 0.80 ± 0.22; BMI: 22.7 ± 2.1 kg·m(-2)) were recruited. The 6RM loads for bench press, barbell bicep curl, overhead dumbbell triceps extension, hammer curl and dumbbell shoulder press were measured. Test-retest reliability for the 5 exercises as determined by Pearson product moment correlation coefficient was very high to nearly perfect (0.82-0.98, p < 0.01). The bench press load was significantly correlated with the loads of the 4 assistance exercises (r ranged from 0.80 to 0.93, p < 0.01). Linear regression revealed that the bench press load was a significant (R(2) range from 0.64 to 0.86, p < 0.01) predictor for the loads of the 4 assistance exercises. The following 6RM prediction equations were determined: (a) Hammer curl = Bench press load (0.28) + 6.30 kg, (b) Barbell biceps curl = Bench press load (0.33) + 6.20 kg, (c) Overhead triceps extension = Bench press load (0.33) - 0.60 kg, and (d) Dumbbell shoulder press = Bench press load (0.42) + 5.84 kg. The difference between the actual load and the predicted load using the four equations ranged between 6.52% and 8.54%, such difference was not significant. Fitness professionals can use the 6RM bench press load as a time effective and accurate method to predict training loads for upper body assistance exercises. Key pointsThe bench press load was significantly correlated with the loads of the 4 assistance exercises.No significant differences were found between the actual load and the predicted load in the four equations.6RM bench press load can be a time effective and accurate method to predict training loads for upper body assistance exercises.

Effects of eight weeks of resistance training on the risk factors of metabolic syndrome in overweight /obese women - "A Pilot Study"

BACKGROUND

The purpose of the present study was to examine the effects of eight weeks of resistance training (RT) on anthropometric, cardiovascular and biochemical risk factors of metabolic syndrome (MetS), and neuromuscular variables on overweight/obese women.

METHODS

Fourteen middle-aged (33.9 ± 8.6 years) overweight/obese women (body mass index - BMI 29.6 ± 4.1 kg/m2) underwent 24 sessions (3 times/week) of a whole body RT program with 3 sets of 8-12 repetitions maximum (RM). The following variables were evaluated: maximum strength on chest press and frontal lat pull-down; isometric hand-grip strength; biceps brachii (BB) and rectus femoris (RF) muscle thickness, body mass; BMI; body adiposity index (BAI); waist, hip and neck circumferences; visceral fat volume; blood glucose; glycated hemoglobin (HbA1c); insulin; HDL-C and triglycerides.

RESULTS

There was an increase of chest press (from 52.9 ± 9.7 to 59.8 ± 7.7 kg; P = 0.02) and front lat pull-down (from 51.5 ± 7.5 to 57.6 ± 9.2 kg; P = 0.01) muscle strength, isometric handgrip (P = 0.02) and RF muscle thickness (from 42.2 ± 8.5 to 45.1 ± 7.3 mm; P = 0.02) after the 8 week RT program. There were no statistically significant alterations on plasma glucose, HbA1c, insulin, triglycerides, HDL-C, anthropometric indexes and BB muscle thickness (p > 0.05).

CONCLUSIONS

A RT program without caloric restriction promotes an increase on muscle thickness and strength, with no effects on risk factors of MetS in overweight/obese women.

Does frequency of resistance training affect tibial cortical bone density in older women? A randomized controlled trial

SUMMARY

This randomized controlled trial evaluated the effect of resistance training frequency (0, 1, and 2 times/week) on cortical volumetric bone mineral density (vBMD) at the tibia in older women. There was no mean difference in change in tibial cortical vBMD in older women who engaged in resistance training (RT) one or two times/week compared with the control group over 12 months after adjusting for baseline values.

INTRODUCTION

National guidelines recommend RT two to three times/week to optimize bone health. Our objective was to determine the effect of a 12-month intervention of three different RT frequencies on tibial volumetric cortical density (CovBMD) in healthy older women.

METHODS

We randomized participants to the following groups: (1) 2×/week balance and tone group (i.e., no resistance beyond body weight, BT), (2) 1×/week RT (RT1), and (3) 2×/week RT (RT2). Treatment allocation was concealed, and measurement team and the bone data analyst were blinded to group allocation. We used peripheral quantitative computed tomography to acquire one 2.3-mm scan at the 50 % tibia, and the primary outcome was CovBMD. Data were collected at baseline, 6 and 12 months, and we used linear mixed modeling to assess the effect at 12 months.

RESULTS

We assessed 147 participants; 100 women provided data at all three points. Baseline unadjusted mean (SD) tibial CovBMD (in milligrams per cubic centimeter) at the 50 % site was 1,077.4 (43.0) (BT), 1,087.8 (42.0) (RT1), and 1,058.7 (60.4) (RT2). At 12 months, there were no statistically significant differences (-0.45 to -0.17 %) between BT and RT groups for mean difference in change in tibial CovBMD for exercise interventions (BT, RT1, RT2) after adjusting for baseline tibial CovBMD.

CONCLUSION

We note no mean difference in change in tibial CovBMD in older women who engaged in RT one or two times/week compared with the control group over 12 months. It is unknown if RT of 3× or 4×/week would be enough to promote a statistically significant difference in change of bone density.

The effects of multidisciplinary rehabilitation in patients with early-to-middle-stage Huntington's disease: a pilot study

BACKGROUND AND PURPOSE

Despite advances in the understanding of Huntington's disease (HD), treatment remains symptomatic. Multidisciplinary rehabilitation, however, appears to impact disease progression. Here we show the feasibility, safety and efficacy of a 9-month multidisciplinary rehabilitation programme in a small cohort of patients with early-to-middle-stage HD.

METHODS

Twenty patients with HD were assigned to two groups, equally matched for cognitive and motor scores. One group received the intervention, whilst the other served as control. The Unified-Huntington's-Disease-Rating-Scale-Total-Motor-Score was the primary outcome measure. Neurocognitive/psychological tests, body composition, postural stability, strength and quality of life assessments were secondary outcome measures.

RESULTS

The intervention reduced motor and postural stability deterioration, with minor improvements in depression, cognition and quality of life. Significant gains were observed for fat-free mass and strength.

CONCLUSION

This pilot study suggests that a prolonged multidisciplinary rehabilitation programme in early-to-middle-stage HD is feasible, well-tolerated and associated with therapeutic benefit. Further explorative, larger studies are warranted.

Acute effects of three different circuit weight training protocols on blood lactate, heart rate, and rating of perceived exertion in recreationally active women

Interval and circuit weight training are popular training methods for maximizing time-efficiency, and are purported to deliver greater physiological benefits faster than traditional training methods. Adding interval training into a circuit weight-training workout may further enhance the benefits of circuit weight training by placing increased demands upon the cardiovascular system. Our purpose was to compare acute effects of three circuit weight training protocols 1) traditional circuit weight training, 2) aerobic circuit weight training, and 3) combined circuit weight-interval training on blood lactate (BLA), heart rate (HR), and ratings of perceived exertion (RPE). Eleven recreationally active women completed 7 exercise sessions. Session 1 included measurements of height, weight, estimated VO2max, and 13 repetition maximum (RM) testing of the weight exercises. Sessions 2-4 were held on non-consecutive days for familiarization with traditional circuit weight training (TRAD), aerobic circuit weight training (ACWT), and combined circuit weight-interval training (CWIT) protocols. In sessions 5-7, TRAD, ACWT, and CWIT were performed in a randomized order ≥ 72 hr apart for measures of BLA, HR, and RPE at pre-exercise and following each of three mini-circuit weight training stations. Repeated-measures ANOVAs yielded significant interactions (p < 0.05) in BLA, HR, and RPE. Combined circuit weight-interval training (CWIT) produced higher BLA (7.31 ± 0.37 vs. TRAD: 3.99 ± 0.26, ACWT: 4.54 ± 0.31 mmol.L(-1)), HR (83.51 ± 1.18 vs. TRAD: 70.42 ± 1.67, ACWT: 74.13 ± 1.43 beats.min(-1)) and RPE (8.14 ± 0.41 vs. TRAD: 5.06 ± 0.43, ACWT: 6.15 ± 0.42) at all measures. Aerobic circuit weight training (ACWT) elicited greater RPE than traditional circuit weight training (TRAD) at all measures. Including combined circuit weight-interval training (CWIT) workouts into exercise programming may enhance fitness benefits and maximize time-efficiency more so than traditional circuit training methods.

Efficacy of home-based kinesthesia, balance & agility exercise training among persons with symptomatic knee osteoarthritis

The purpose of this study was to determine the efficacy of a home-based kinesthesia, balance and agility (KBA) exercise program to improve symptoms among persons age ≥ 50 years with knee osteoarthritis (OA). Forty-four persons were randomly assigned to 8-weeks, 3 times per week KBA, resistance training (RT), KBA + RT, or Control. KBA utilized walking agility exercises and single-leg static and dynamic balancing. RT used elastic resistance bands for open chain lower extremity exercises. KBA + RT performed selected exercises from each technique. Control applied inert lotion daily. Outcomes included the OA specific WOMAC Index of Pain, Stiffness, and Physical Function (PF), community activity level, exercise self-efficacy, self-report knee stability, and 15m get up & go walk (GUG). Thirty-three participants [70.7 (SD 8.5) years] completed the trial. Analysis of variance comparing baseline, mid-point, and follow-up measures revealed significant (p < 0.05) improvements in WOMAC scores among KBA, RT, KBA + RT, and Control, with no differences between groups. However, Control WOMAC improvements peaked at mid-point, whereas improvement in the exercise conditions continued at 8-weeks. There were no significant changes in community activity level. Only Control improved exercise self-efficacy. Knee stability was improved in RT and Control. GUG improved in RT and KBA+RT. These results indicate that KBA, RT, or a combination of the two administered as home exercise programs are effective in improving symptoms and quality of life among persons with knee OA. Control results indicate a strong placebo effect in the short term. A combination of KBA and RT should be considered as part of the rehabilitation program, but KBA or RT alone may be appropriate for some patients. Studies with more statistical power are needed to confirm or refute these results. Patient presentation, preferences, costs, and convenience should be considered when choosing an exercise rehabilitation approach for persons with knee OA.

Effects of weight training on cognitive functions in elderly with Alzheimer's disease

Deterioration in cognitive functions is characteristic in Alzheimer's disease (AD) and may be associated with decline in daily living activities with consequent reduced quality of life.

The effects of an aerobic and resistance exercise training program on cognition following stroke

BACKGROUND

Cognitive benefits obtained from exercise in healthy populations support the idea that aerobic and resistance training (AT+RT) would confer benefit for poststroke recovery. However, there is little evidence regarding the effectiveness of such programs.

OBJECTIVE

To evaluate the effects of a 6-month exercise program of AT+RT on cognition in consecutively enrolled patients with motor impairments ≥10 weeks poststroke.

METHODS

Outcomes were measured before and after 6 months of AT+RT on 41 patients. Cognition was measured by the Montreal Cognitive Assessment (MoCA). Secondary measures included evaluation of gas exchange anaerobic threshold (ATge), body composition by dual energy X-ray absorptiometry, and depressive symptoms by questionnaire.

RESULTS

There were significant improvements in overall MoCA scores (22.5 ± 4.5 to 24.0 ± 3.9, P < .001) as well as in the subdomains of attention/concentration (4.7 ± 1.7 to 5.2 ± 1.3, P = .03) and visuospatial/executive function (3.4 ± 1.1 to 3.9 ± 1.1, P = .002). There was a significant reduction in the proportion of patients meeting the threshold criteria for mild cognitive impairment (MCI) at baseline compared with posttraining (65.9% vs 36.6%, P < .001). In a linear regression model, there was a positive association between change in cognitive function and change in fat-free mass of the nonaffected limbs (β = .002; P = .005) and change in attention/concentration and change in ATge (β = .383; P ≤ .001), independent of age, sex, time from stroke, and change in fat mass and depression score.

CONCLUSION

A combined training model (AT+RT) resulted in improvements in cognitive function and a reduction in the proportion of patients meeting the threshold criteria for MCI. Change in cognition was positively associated with change in fat-free mass and ATge.

Efficacy of phosphatidic acid ingestion on lean body mass, muscle thickness and strength gains in resistance-trained men

BACKGROUND

Phosphatidic acid (PA) has been reported to activate the mammalian target of rapamycin (mTOR) signaling pathway and is thought to enhance the anabolic effects of resistance training. The purpose of this pilot study was to examine if oral phosphatidic acid administration can enhance strength, muscle thickness and lean tissue accruement during an 8-week resistance training program.

METHODS

Sixteen resistance-trained men were randomly assigned to a group that either consumed 750 mg of PA (n = 7, 23.1 ± 4.4 y; 176.7 ± 6.7 cm; 86.5 ± 21.2 kg) or a placebo (PL, n = 9, 22.5 ± 2.0 y; 179.8 ± 5.4 cm; 89.4 ± 13.6 kg) group. During each testing session subjects were assessed for strength (one repetition maximum [1-RM] bench press and squat) and body composition. Muscle thickness and pennation angle were also measured in the vastus lateralis of the subject's dominant leg.

RESULTS

Subjects ingesting PA demonstrated a 12.7% increase in squat strength and a 2.6% increase in LBM, while subjects consuming PL showed a 9.3% improvement in squat strength and a 0.1% change in LBM. Although parametric analysis was unable to demonstrate significant differences, magnitude based inferences indicated that the Δ change in 1-RM squat showed a likely benefit from PA on increasing lower body strength and a very likely benefit for increasing lean body mass (LBM).

CONCLUSIONS

Results of this study suggest that a combination of a daily 750 mg PA ingestion, combined with a 4-day per week resistance training program for 8-weeks appears to have a likely benefit on strength improvement, and a very likely benefit on lean tissue accruement in young, resistance trained individuals.

Dietary protein to maximize resistance training: a review and examination of protein spread and change theories

An appreciable volume of human clinical data supports increased dietary protein for greater gains from resistance training, but not all findings are in agreement. We recently proposed "protein spread theory" and "protein change theory" in an effort to explain discrepancies in the response to increased dietary protein in weight management interventions. The present review aimed to extend "protein spread theory" and "protein change theory" to studies examining the effects of protein on resistance training induced muscle and strength gains. Protein spread theory proposed that there must have been a sufficient spread or % difference in g/kg/day protein intake between groups during a protein intervention to see muscle and strength differences. Protein change theory postulated that for the higher protein group, there must be a sufficient change from baseline g/kg/day protein intake to during study g/kg/day protein intake to see muscle and strength benefits. Seventeen studies met inclusion criteria. In studies where a higher protein intervention was deemed successful there was, on average, a 66.1% g/kg/day between group intake spread versus a 10.2% g/kg/day spread in studies where a higher protein diet was no more effective than control. The average change in habitual protein intake in studies showing higher protein to be more effective than control was +59.5% compared to +6.5% when additional protein was no more effective than control. The magnitudes of difference between the mean spreads and changes of the present review are similar to our previous review on these theories in a weight management context. Providing sufficient deviation from habitual intake appears to be an important factor in determining the success of additional protein in enhancing muscle and strength gains from resistance training. An increase in dietary protein favorably effects muscle and strength during resistance training.

Reproducibility of an aerobic endurance test for nonexpert swimmers

Background:

This study aimed to verify the reproduction of an aerobic test to determine nonexpert swimmers’ resistance.

Methods:

The sample consisted of 24 male swimmers (age: 22.79 ± 3.90 years; weight: 74.72 ± 11.44 kg; height: 172.58 ± 4.99 cm; and fat percentage: 15.19% ± 3.21%), who swim for 1 hour three times a week. A new instrument was used in this study (a Progressive Swim Test): the swimmer wore an underwater MP3 player and increased their swimming speed on hearing a beep after every 25 meters. Each swimmer’s heart rate was recorded before the test (BHR) and again after the test (AHR). The rate of perceived exertion (RPE) and the number of laps performed (NLP) were also recorded. The sample size was estimated using G*Power software (v 3.0.10; Franz Faul, Kiel University, Kiel, Germany). The descriptive values were expressed as mean and standard deviation. After confirming the normality of the data using both the Shapiro–Wilk and Levene tests, a paired t-test was performed to compare the data. The Pearson’s linear correlation (r) and intraclass coefficient correlation (ICC) tests were used to determine relative reproducibility. The standard error of measurement (SEM) and the coefficient of variation (CV) were used to determine absolute reproducibility. The limits of agreement and the bias of the absolute and relative values between days were determined by Bland–Altman plots. All values had a significance level of P < 0.05.

Results:

There were significant differences in AHR (P = 0.03) and NLP (P = 0.01) between the 2 days of testing. The obtained values were r > 0.50 and ICC > 0.66. The SEM had a variation of ±2% and the CV was <10%. Most cases were within the upper and lower limits of Bland–Altman plots, suggesting correlation of the results. The applicability of NLP showed greater robustness (r and ICC > 0.90; SEM < 1%; CV < 3%), indicating that the other variables can be used to predict incremental changes in the physiological condition of swimmers.

Conclusion:

The Progressive Swim Test for nonexpert swimmers produces comparable results for noncompetitive swimmers with a favorable degree of reproducibility, thus presenting possible applications for researching the physiological performance of nonexpert swimmers.

Effects of multi-ingredient supplementation on resistance training in young males

Muscle strength and fatigue resistance increases with resistance training. Resistance training adaptations can be enhanced with single-ingredient or dual-ingredient supplementation but less is known about resistance training adaptations by multi-ingredient supplementation. We examined the effects of a commercial multi-ingredient supplement on resistance training adaptations for training-specific and non-training-specific tasks in young males. Male participants (n = 16, age 21±2 years, body mass 74.5±5.9 kg, body height 177±5 cm) had at least 1 year experience with resistance training exercises. Training (7 muscle groups, 4 sessions/week, weekly adjustments) consisted of two 6 weeks blocks with 4 weeks between blocks. During training, participants consumed placebo (i.e. maltodextrin, n = 7) or the sports nutritional supplement Cyclone (Maximuscle Ltd, UK, n = 9) (main ingredients creatine monohydrate, whey protein, glutamine and HMB) twice daily with one intake <15 min following a training session. Unpaired Student’s t-test was used for placebo and Cyclone group comparison of percentage changes with p < 0.05. Effect sizes (Cohen’s d) were calculated for the Cyclone group. Cyclone did not enhance maximal voluntary isometric force (MVIF) (p = 0.56), time to fatigue at 70% MVIF (p = 0.41) and peak concentric strength (60°·s⁻¹) (p = 0.66) of m.quadriceps femoris (i.e. the non-specific training tasks). For the specific-training tasks, Cyclone did not enhance one-repetition maximum (1-RM) of lateral pull (p = 0.48) but there was a trend and large effect size for 1-RM of bench press (p = 0.07, d = 0.98) and 45° leg press (p = 0.07, d = 1.41). Cyclone resulted in an increase in number of repetitions for 80% pre-training 1-RM for lateral pull (p = 0.02, d = 1.30), bench press (p = 0.03, d = 1.20) with a trend for 45° leg press (p = 0.08, d = 0.96). Cyclone during resistance training enhanced the performance of 1-RM and number of repetitions at 80% of pre-training 1RM of some training-specific tasks, all with large effect sizes. Our observations suggest that Cyclone during resistance training substantially improves the ability to perform training-related tasks.

Different types of resistance training in type 2 diabetes mellitus: effects on glycaemic control, muscle mass and strength

BACKGROUND

Resistance training has become a mainstay of exercise training in type 2 diabetes mellitus (T2DM). However, it remains controversial whether hypertrophy resistance training (HRT) is superior to endurance resistance training (ERT) with regard to its effects on glycaemic control, muscle mass and strength.

METHODS

Thirty-two patients with T2DM (13 men and 19 women; 64.8 ± 7.8 years) were randomly assigned to either eight weeks of HRT (n = 16; 2 sets, 10-12 repetitions, 70% of the one-repetition maximum (1-RM)) or ERT (n = 16; 2 sets, 25-30 repetitions, 40% 1-RM). In addition, all patients participated in aerobic exercise training (AET; 1 hour/day on 2 non-consecutive days/week; cycle ergometer; 70% of heart rate reserve).

RESULTS

After eight weeks of intervention, there were time but not group effects for reduced glucose and fructosamine levels, weight, BMI, waist circumference, subcutaneous abdominal fat, resting heart rate, systolic and diastolic blood pressure; muscle mass of the arms and physical exercise capacity increased significantly. Significant time and group effects were documented for maximum strength of the chest, with a greater increase for HRT than ERT (p = 0.01).

CONCLUSIONS

Specific maximal resistance training of the chest muscles led to superior gain in strength as compared to endurance resistance training. This, however, did not translate into superior values of glycaemic control, weight, waist circumference, muscle mass and physical work capacity, which all improved significantly by a similar magnitude in both groups. Since overall effects of both protocols were comparable, both may be offered to patients according to their personal preference.

Whole Body Vibration Training is Osteogenic at the Spine in College-Age Men and Women

Osteoporosis is a chronic skeletal disease characterized by low bone mass which is currently challenging the American health care system. Maximizing peak bone mass early in life is a cost-effective method for preventing osteoporosis. Whole body vibration (WBV) is a novel exercise method with the potential to increase bone mass, therefore optimizing peak bone and decreasing the risk for osteoporotic fracture. The aim of this investigation was to evaluate changes in bone mineral density at the hip, spine, and whole body in college-age men and women who underwent a WBV training protocol. Active men (n=6) and women (n=4), ages 18-22 participated in the WBV training; while an additional 14 volunteers (1 male, 13 female) served as controls. All participants completed baseline and follow-up questionnaires to assess health history, physical activity, dietary intake, and menstrual history. The WBV training program, using a Vibraflex 550, incorporated squats, stiff-leg dead lifts, stationary lunges, push-up holds, bent-over rows, and jumps performed on the platform, and occurred 3 times a week, for 12 weeks. Dual energy x-ray absorptiometry (Hologic Explorer, Waltham, MA, USA) was used to assess bone mineral density (BMD, g/cm(2)). A two-tailed, t-test identified significantly different changes in BMD between the WBV and control groups at the lateral spine (average change of 0.022 vs. -0.015 g/cm(2)). The WBV group experienced a 2.7% and 1.0% increase in BMD in the lateral spine and posterior-anterior spine while the control group decreased 1.9% and 0.9%, respectively. Results indicate that 12 weeks of WBV training was osteogenic at the spine in college-age men and women.

The interactions between hemostasis and resistance training: a review

Physical inactivity is considered a risk factor for cardiovascular disease and is strongly associated with changes in arterial structure. Regular physical activity and exercise contributes to the prevention of coronary artery disease. Therefore, cardiovascular and resistance training improve hemostatic parameters and promote a less thrombotic blood profile. This review highlights the studies, mechanisms, and outcomes relating to the effectiveness of resistance training on the process of hemostasis. The Pubmed, Scopus, Medline, Scielo, Lilacs, Ibecs, and Cochrane databases were used to locate the original articles. Seventeen studies were found during the research process. Of these, ten articles were excluded. Those protocols using a high volume of training for young adults showed a greater fibrinolytic response, and training protocols with intensities above 80% of 1 maximum repetition showed an increased platelet activity. In subjects with coronary artery disease, just one session of resistance training resulted in improvement in the fibrinolytic system (tissue plasminogen activator) without raising potential thrombotic markers.

Exercise order affects the total training volume and the ratings of perceived exertion in response to a super-set resistance training session

The super-set is a widely used resistance training method consisting of exercises for agonist and antagonist muscles with limited or no rest interval between them – for example, bench press followed by bent-over rows. In this sense, the aim of the present study was to compare the effects of different super-set exercise sequences on the total training volume. A secondary aim was to evaluate the ratings of perceived exertion and fatigue index in response to different exercise order. On separate testing days, twelve resistance-trained men, aged 23.0 ± 4.3 years, height 174.8 ± 6.75 cm, body mass 77.8 ± 13.27 kg, body fat 12.0% ± 4.7%, were submitted to a super-set method by using two different exercise orders: quadriceps (leg extension) + hamstrings (leg curl) (QH) or hamstrings (leg curl) + quadriceps (leg extension) (HQ). Sessions consisted of three sets with a ten-repetition maximum load with 90 seconds rest between sets. Results revealed that the total training volume was higher for the HQ exercise order (P = 0.02) with lower perceived exertion than the inverse order (P = 0.04). These results suggest that HQ exercise order involving lower limbs may benefit practitioners interested in reaching a higher total training volume with lower ratings of perceived exertion compared with the leg extension plus leg curl order.

Changes in physical fitness, bone mineral density and body composition during inpatient treatment of underweight and normal weight females with longstanding eating disorders

The purpose of this study was to examine changes in aerobic fitness, muscular strength, bone mineral density (BMD) and body composition during inpatient treatment of underweight and normal weight patients with longstanding eating disorders (ED). Twenty-nine underweight (BMI < 18.5, n = 7) and normal weight (BMI ≥ 18.5, n = 22) inpatients (mean (SD) age: 31.0 (9.0) years, ED duration: 14.9 (8.8) years, duration of treatment: 16.6 (5.5) weeks) completed this prospective naturalistic study. The treatment consisted of nutritional counseling, and 2 × 60 min weekly moderate intensive physical activity in addition to psychotherapy and milieu therapy. Underweight patients aimed to increase body weight with 0.5 kg/week until the weight gain goal was reached. Aerobic fitness, muscular strength, BMD and body composition were measured at admission and discharge. Results showed an increase in mean muscular strength, total body mass, fat mass, and body fat percentage, but not aerobic capacity, among both underweight and normal weight patients. Lumbar spine BMD increased among the underweight patients, no changes were observed in BMD among the normal weight patients. Three out of seven underweight patients were still underweight at discharge, and only three out of nine patients with excessive body fat (i.e., >33%) managed to reduce body fat to normal values during treatment. These results calls for a more individualized treatment approach to achieve a more optimal body composition among both underweight and normal to overweight patients with longstanding ED.

Effects of Carbohydrate-Protein Ingestion Post-Resistance Training in Male Rugby Players

Evidence suggests that carbohydrate-protein (CHO-PRO) drinks post-exercise are an advantageous nutritional recovery intervention. Resistance trained (n = 14, mean ± SD; age 19 ± 1 yr, mass 95 ± 9 kg, % fat 17 ± 4 % and BMI 28.5 ± 1.8 kg.m^-2) male rugby players participated in a study investigating effects of carbohydrate (CHO) and CHO-PRO drinks on subsequent resistance exercise performance. Following an initial resistance training (RT) protocol consisting of 8 circuits of 5 discrete exercises at 10 repetition maximum (RM), participants received 10 mL.kg^-1 BM of randomised sports drink (LCHO, HCHO and CHO-PRO) on completion of the RT protocol and at 120 min into a 240 min recovery period. Post-recovery, participants completed a test to failure (TTF) protocol performing as many circuits of the same exercises at 10-RM to failure. Individual exercise cumulative load (∑W) lifted and total work capacity (TWC) for each trial was recorded. Both ∑W and TWC were normalised for body mass (kg.kg^-1 BM). Data were analysed using repeated measures ANOVA with post-hoc Student-Neuman-Keuls pair-wise comparisons (P<0.05). Despite large intra-subject variability between trials, TWC normalised for body mass was significantly greater following CHO-PRO compared with HCHO and LCHO (188 ± 26 vs. 157 ± 21 and 150 ± 16 kg.kg^-1 BM, respectively; P<0.05). The ∑W lifted after ingestion of HCHO and LCHO were not significantly different despite differing CHO and caloric content. The CHO-PRO induced enhancement of recovery was possibly due to higher rates of glycogen restoration after the initial glycogen depleting RT protocol.