Gender differences in strength and muscle fiber characteristics

Patients with operative gluteus medius tears often present with a concomitant history of lumbar pathology

Background

Studies have indicated a correlation between patients presenting with decreased gluteus medius function and a history of lumbar pathology (LP). However, literature investigating the relationship between the prevalence of lumbar pathology in patients with gluteus medius tears is lacking. The purpose of this study is to determine if patients undergoing repair for gluteus medius tears have concomitant lumbar pathology.

Materials and methods

Patients aged 18-80 who underwent endoscopic gluteus medius repair by one fellowship-trained surgeon between May 2016 and May 2020 for peritrochanteric pain/tenderness, abductor weakness, and MRI findings consistent with a gluteus medius tear were identified. Pre-operative and post-operative data were gathered using the Visual Acuity Scale (VAS), and post-operative data was gathered using the Abbreviated International Hip Outcome Tool (iHOT-12) and Hip Outcome Score - Activities of Daily Living (HOS-ADL). Outcomes were compared between patients with and without a history of lumbar pathology.

Results

Of 23 hips, 19 (82.6%) presented with a prior history of lumbar pathology. Twenty (87.0%) patients identified were female. A total of 19 hips were included with completed PROM scores. Patients with lumbar pathology had similar pre and post-operative patient reported outcomes.

Conclusions

This study demonstrates a high incidence of lumbar pathology in patients presenting for operative gluteus medius tears, which may suggest an association between lumbar disease and the development of gluteus medius weakness and tears.

Gender-based analysis of muscle activation while in a sedentary work posture

BACKGROUND

Many people work in a sitting position where they have to use their upper extremities and hands. Muscle activity in sitting position is affected by the chair height of, the height of the worktable, and the distance to the working target.

OBJECTIVE

The purpose of this study is to investigate differences in muscle activity between men and wemen at different chair heghts and working distances.

METHODS

Surface electromyography (EMG) was employed to determine the muscle activity of the upper limbs and the trunk, while an arm-stretching task was performed in a sitting position.

RESULTS

Women's muscle activity was higher than that of men in most muscles as the chair height and working distance changed.

CONCLUSIONS

As the height of the chair or the working distance was changed, muscle activity was greater in women than in men for most of the muscles analyzed. Under the same conditions, women may feel more muscle fatigue than men, so it is necessary to consider gender in the working environment.

Examining Unilateral and Bilateral Exercises through the Load-velocity Relationship

This study aimed to examine the load-velocity (L-V) relationship in the bench-press (BP) and leg-press (LP) exercises performed unilaterally, and compared this unilateral L-V relationship with the bilateral variants. Nineteen men (age=23.5±2.1 years) completed two incremental tests in BP and LP, performed bilaterally and unilaterally, across two sessions with a 48-hour rest period. We found a close relationship between medium propulsive velocity (MPV) and %1RM in unilateral BP (R2  =0.97, SEE=0.06 m·s-1) and LP (R2=0.96, SEE=0.06 m·s-1). No significant differences were observed between the preferred and non-preferred sides in the L-V relationship for either exercise. Additionally, higher velocities were achieved in unilateral exercises compared to bilateral exercises, particularly with light and moderate loads (30-70%1RM) in BP (p<0.05) and with light loads (30-45%1RM) in LP (p<0.05). Close L-V relationships were observed in unilateral exercises, without differences in the L-V relationships between preferred and non-preferred sides despite the interlimb asymmetries in the absolute strength values. Interestingly, lower velocities were observed at light loads (~30-45% 1RM) for bilateral compared to unilateral exercises, which could be explained by different strength deficits for these exercises.

New prediction equations for knee isokinetic strength in young and middle-aged non-athletes

BACKGROUND

This study aimed to develop alternative prediction equations to predict isokinetic muscle strength at 60°/s based on anthropometric characteristics, including body mass, height, age, and sex for young and middle-aged non-athlete populations.

METHODS

Three hundred and thirty-two healthy non-athletic participants (174 females, 158 males) between 20 and 59 years underwent a 60°/s isokinetic knee joint concentric contraction test. Forty people were randomly selected for retesting to assess the reliability of the isokinetic instrument. Multivariate linear regression was used to establish extension peak torque (EPT) and flexion peak torque (FPT) prediction equations. Sixty extra participants were used individually to validate the prediction equations, and Bland Altman plots were constructed to assess the agreement of predicted values with actual measurements.

RESULTS

The result demonstrated that the instrument we used has excellent reliability. The multivariable linear regression model showed that body mass, age, and sex were significant predictors of PT (EPT: Adjusted R2 = 0.804, p < 0.001; FPT: Adjusted R2 = 0.705, p < 0.001). Furthermore, the equations we established had higher prediction accuracy than those of Gross et al. and Harbo et al. CONCLUSION: The equations developed in this study provided relatively low bias, thus providing a more suitable reference value for the knee isokinetic strength of young and middle-aged non-athletes.

Sex differences in wrist strength: a systematic review

Sex differences in strength have been attributed to differences in body anthropometrics and composition; these factors are often ignored when generating workplace guidelines. These differences directly impact the upper extremity, leaving female workers exposed to injury risk. The wide range of tools and techniques for measuring upper extremity strength presents a challenge to ergonomists and work task designers; collating outcomes to provide a clear outlook of differences between males and females is essential and the purpose of this work. Four online databases were searched (PROSPERO ID: CRD42022339023) with a focus on articles assessing sex differences in wrist strength. A total of 2,378 articles were screened for relevancy; 25 full-text articles were included in this systematic review. Articles examined movement pairs (ulnar/radial deviation, pronation/supination, and flexion/extension), as well as contraction types (isometric and isokinetic) to observe sex differences in wrist strength. Across all articles, females produced ∼60-65% of male flexion/extension strength, ∼55-60% pronation/supination strength, and ∼60-70% ulnar/radial deviation strength. Overall, females presented lower strength-producing abilities than males, but when considering strength relative to body mass, male-female differences were less pronounced and occasionally females surpassed male strength metrics; typically, this occurred during flexion/extension, particularly in isokinetic contractions. This review has identified a scarcity of articles examining ulnar/radial deviation, pronation/supination, as well as isokinetic contractions; these are needed to supplement workplace exposure guidelines.

Within- and between-day reliability and repeatability of neuromuscular function assessment in females and males

The study evaluated the reliability and repeatability of the force and surface electromyography activity (EMG) outcomes obtained through voluntary and electrically evoked contractions of knee extensors in females (n = 18) and males (n = 20) and compared these data between sexes. Maximal isometric voluntary contractions (iMVCs) of knee extensors associated with electrical stimulation of the femoral nerve were performed over 4 days (48-h interval), with the first day involving familiarization procedures, the second involving three trials (1-h interval), and the third and fourth involving just one trial. The intraclass correlation coefficient (ICC), coefficient of variation (CV), and repeatability of outcomes from within- and between-day trials were determined for each sex. Females presented lower maximal voluntary force during iMVC (iMVCForce) and associated vastus lateralis EMG activity (root mean square, RMSVL), force evoked by potentiated doublet high-frequency (Db100Force) and single stimuli (Qtw), and M-wave amplitude than males (P ≤ 0.01, partial eta squared ≥0.94). Voluntary activation (VA) and RMSVL/M-wave amplitude did not differ between sexes. iMVCForce, VA, Db100Force, Qtw, and M-wave amplitude were the most reliable outcomes in within-day trials, with similar results between sexes (ICC > 0.62; CV < 6.4%; repeatability: 12.2%-22.6%). When investigating between-day trials, the iMVCForce, VA, Db100Force, and Qtw were the most reliable (ICC > 0.66; CV < 7.5%; repeatability: 13.2%-33.45%) with similar results between sexes. In conclusion, females presented lower iMVCForce and evoked response than males. Although reliability and repeatability statistics vary between trials, data (e.g., from EMG or force signal), and sexes, most of the outcomes obtained through this technique are reliable in females and males.NEW & NOTEWORTHY Although reliability and repeatability of knee extensors vary according to the type of neuromuscular function outcome (e.g., from force or EMG responses), the trial intervals (i.e., hours or days), and the sex of the participant, most force and EMG outcomes obtained through these neuromuscular assessment protocols present ICC > 0.75, very good CV (<10%), and repeatability <25% in within- and between-day trials in both sexes.

The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine

ABSTRACT

Biological sex is a primary determinant of athletic performance because of fundamental sex differences in anatomy and physiology dictated by sex chromosomes and sex hormones. Adult men are typically stronger, more powerful, and faster than women of similar age and training status. Thus, for athletic events and sports relying on endurance, muscle strength, speed, and power, males typically outperform females by 10%-30% depending on the requirements of the event. These sex differences in performance emerge with the onset of puberty and coincide with the increase in endogenous sex steroid hormones, in particular testosterone in males, which increases 30-fold by adulthood, but remains low in females. The primary goal of this consensus statement is to provide the latest scientific knowledge and mechanisms for the sex differences in athletic performance. This review highlights the differences in anatomy and physiology between males and females that are primary determinants of the sex differences in athletic performance and in response to exercise training, and the role of sex steroid hormones (particularly testosterone and estradiol). We also identify historical and nonphysiological factors that influence the sex differences in performance. Finally, we identify gaps in the knowledge of sex differences in athletic performance and the underlying mechanisms, providing substantial opportunities for high-impact studies. A major step toward closing the knowledge gap is to include more and equitable numbers of women to that of men in mechanistic studies that determine any of the sex differences in response to an acute bout of exercise, exercise training, and athletic performance.

Influence of Body Composition, Load-Velocity Profiles, and Sex-Related Differences on Army Combat Fitness Test Performance

ABSTRACT

Boffey, D, DiPrima, JA, Kendall, KL, Hill, EC, Stout, JR, and Fukuda, DH. Influence of body composition, load-velocity profiles, and sex-related differences on army combat fitness test performance. J Strength Cond Res 37(12): 2467-2476, 2023-The Army Combat Fitness Test (ACFT) became the U.S. Army's mandatory physical fitness test in April of 2022. The purpose of this study was to determine the relationship between ACFT performance and both body composition and velocity profiles and to determine sex differences for these variables. Data were collected at 2 timepoints 4 months apart, from male (n = 55) and female (n = 17) Army Reserve Officers' Training Corps (ROTC) cadets. Body composition was assessed with a bioelectrical impedance spectroscopy device, and cadets completed a hex bar deadlift load-velocity profile (LVP) and ACFT on separate days. Stepwise multiple regressions were used to explain the amount of variance in ACFT total score and individual event performance. Significance for statistical tests was defined as an alpha level of p ≤ 0.05. Muscle mass and body fat percentage accounted for 49% of shared variance of total ACFT score, and deadlift maximal power and maximal velocity accounted for 67% of shared variance of total ACFT score. The 3 repetition maximum deadlift, standing power throw, hand-release push-up, and sprint-drag-carry events favored cadets with more muscle mass, whereas the leg tuck was influenced by the body fat percentage and the 2-mile run was affected by fat mass. Sex had greater predictive capability for the 2-mile run than body composition. Men outperformed women on all individual events, with the greatest differences on standing power throw and sprint-drag-carry. It is recommended that Army ROTC cadets taking the ACFT maximize lower-body power production and increase muscle mass.

Ergonomic risk management process for safety and health at work

Purpose

The paper aims to provide the main principles and practical aspects of the model, to present the process of identifying, determining the level, as well as assessing and managing occupational and ergonomic risks.

Methods

To conduct the research, as well as to identify the influence of various dangerous factors related to the working posture, pace, rhythm of work performance, equipment and individual characteristics of the employee's health condition, methods of complex analysis and synthesis, formal and dialectical logic are used to study the essence of the concept of occupational and ergonomic risks. Additionally, induction and deduction methods are used to examine the cause-and-effect relationships between dangers, dangerous factors, dangerous event, and the severity of consequences to determine the level of occupational and ergonomic risks based on the improved bow-tie model. The proposed approach effectiveness is tested based on the assessment of occupational and ergonomic risks of forest workers (loggers) with the participation of five experts to identify dangerous factors and develop precautionary measures.

Results

An algorithm for managing occupational and ergonomic risks has been developed, consisting of eleven steps, which can be divided into three steps: preparatory, main and documented. It has been determined that occupational and ergonomic risk is the probability of a dangerous event occurring due to employee's physical overload and its impact on the severity of damage to the employee's physical health. The level of occupational and ergonomic risk management is determined taking into account the probability (frequency), intensity and duration of physical overload, as well as the employee's adaptation index to physical overload and his/her health index.

Conclusion

The novelty is the substantiation of the principles of occupational and ergonomic risk management, which are based on the bow-tie model and predict the impact on the probability and severity of consequences of a dangerous event, taking into account dangerous factors. Forms for drawing up occupational and ergonomic risk maps have been developed, in which it is necessary to consider interaction of occupational hazards and occupational-ergonomic risk - physical overload.

Impact of biological sex and sex hormones on molecular signatures of skeletal muscle at rest and in response to distinct exercise training modes

Substantial divergence in cardio-metabolic risk, muscle size, and performance exists between men and women. Considering the pivotal role of skeletal muscle in human physiology, we investigated and found, based on RNA sequencing (RNA-seq), that differences in the muscle transcriptome between men and women are largely related to testosterone and estradiol and much less related to genes located on the Y chromosome. We demonstrate inherent unique, sex-dependent differences in muscle transcriptional responses to aerobic, resistance, and combined exercise training in young and older cohorts. The hormonal changes with age likely explain age-related differential expression of transcripts. Furthermore, in primary human myotubes we demonstrate the profound but distinct effects of testosterone and estradiol on amino acid incorporation to multiple individual proteins with specific functions. These results clearly highlight the potential of designing exercise programs tailored specifically to men and women and have implications for people who change gender by altering their hormone profile.

Age-related sex differences in tongue strength and muscle morphometry in a rat model

OBJECTIVE

To investigate potential effects of sex on voluntary tongue strength, evoked twitch and tetanic tension, speed of contraction, and muscle fiber cross-sectional area in the muscles of the rat tongue. Additionally, we aimed to determine whether estrous cycle stage impacts any of the dependent variables as a pilot investigation into the use of female rats in a model of tongue exercise and aging.

DESIGN

Fischer 344-Brown Norway male and female rats in two age groups (16 middle-aged, 16 young-adult) were trained to use a tongue force operandum. Tongue muscle contraction, myosin heavy chain (MyHC) composition, and cross section area of the genioglossus and styloglossus muscles were examined. Vaginal lavage determined estrous cycle stage of the female rats daily.

RESULTS

The female group had significantly lower evoked twitch and tetanic tension, longer contraction times, and a smaller proportion of MyHC type IIa and MyHC type IIx in the styloglossus muscle. There was no significant sex effect in maximal voluntary tongue force (MVTF) despite a significant weight difference between the male and female groups. There were no significant age or sex effects in the genioglossus. Estrous cycle stage did not have a significant effect on any of the dependent variables.

CONCLUSIONS

Sex and age both have a significant effect on tongue muscle structure and physiology. While the female group showed reduced contraction speed and maximal twitch and tetanic tension relative to the male group, differences in muscle morphology appeared to vary by muscle.

Distal muscle cross-sectional area is correlated with shot put performance

Shot putters throw a heavy shot by "pushing". Pushing involves the coordinated extension of multiple joints and is a common motor task for both upper and lower limbs. In lower limb musculature, proximal-specific development and association with motor performance have been shown in athletes. However, as the upper limb is not mechanically loaded to support the body during daily locomotion, it may develop differently from the lower limb. We investigated the cross-sectional area of the prime movers of the upper limb and upper trunk (pectoralis major, deltoid, triceps brachii, and palmar flexors) in eleven male shot put athletes and fourteen untrained males by obtaining magnetic resonance images and manually tracing the muscles on the images. All target muscles were significantly larger in athletes than non-athletes (p < 0.01), with "huge" effect sizes for the pectoralis major and palmar flexors (d = 2.74, 2.04). All target muscle cross-sectional areas were positively correlated with season best record (r ≥ 0.62, p ≤ 0.04), with a particularly strong correlation for the palmar flexors (r = 0.96). These results suggest that the distal muscles of the upper limb are also expected to develop and are strongly associated with motor performance. This is especially true for the distal upper limb muscles (palmar flexors) in shot putters. These findings provide insight into potential training interventions for athletic performance in forceful upper limb movements.

Evaluation of sex-based differences in resistance exercise training-induced changes in muscle mass, strength, and physical performance in healthy older (≥60 y) adults: A systematic review and meta-analysis

The objective of this systematic review and meta-analysis was to determine if there are sex-based differences in adaptations to resistance exercise training in healthy older adults. Following the screening process, data from 36 studies comparing older males and females (602 males; 703 females; ≥60 years of age) for changes in skeletal muscle size, muscle strength, and/or physical performance following the same resistance exercise training intervention were extracted. Mean study quality was 16/29 (modified Downs and Black checklist), considered moderate quality. Changes in absolute upper-body (Effect Size [ES] = 0.81 [95% CI 0.54, 1.09], P < 0.001), and lower-body (ES = 0.40 [95% CI 0.24, 0.56], P < 0.001) strength were greater in older males than females. Alternatively, changes in relative upper-body (ES = -0.46 [95% CI -0.77, -0.14], P < 0.01), and lower-body (ES = -0.24 [95% CI -0.42, -0.06], P < 0.01) strength were greater in older females than males. Changes in absolute, but not relative, whole-body fat-free mass (ES = 0.18 [95% CI 0.04, 0.33], P < 0.05) were greater in older males than females. There were no sex-based differences for absolute or relative changes in limb muscle size, muscle fiber size, or physical performance.

Water Intake and Handgrip Strength in US Adults: A Cross-Sectional Study Based on NHANES 2011-2014 Data

This study aimed to examine the relationship between daily total intake of water (DTIW) and handgrip strength (HGS) among US adults and to explore the impact of water intake on muscle function and health, providing a reference for public health policies and health education. Using the data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, a cross-sectional survey design was adopted to analyze 5427 adults (48.37% female and 51.63% male) aged 20 years and above. DTIW was assessed using two non-consecutive 24 h dietary recall interviews, and the HGS level was measured using a Takei Dynamometer. Weighted generalized linear regression models and restricted cubic spline plots were used to analyze the linear and nonlinear associations between DTIW and HGS level and to conduct a gender subgroup analysis and an interaction effect test. The results showed that there were significant differences in HGS and other characteristics among different quartile groups of DTIW (p < 0.05). There was a significant nonlinear trend (exhibiting an inverted U-curve) between DTIW and HGS (p for nonlinear = 0.0044), with a cut-off point of 2663 g/day. Gender subgroup analysis showed that the nonlinear trend (exhibiting an inverted U-curve) was significant only in males (p for nonlinear = 0.0016), with a cut-off point of 2595 g/day. None of the stratified variables had an interaction effect on the association between DTIW and HGS (p for interaction > 0.05). In conclusion, this study found a nonlinear association between DTIW and HGS levels, as well as a gender difference. This finding provides new clues and directions for exploring the mechanism of the impact of DTIW on muscle function and health and also provides new evidence and suggestions for adults to adjust their water intake reasonably.

Prediction equations to estimate muscle mass using anthropometric data: a systematic review

CONTEXT

Reduced muscle mass is linked to poor outcomes in both inpatients and outpatients, highlighting the importance of muscle mass assessment in clinical practice. However, laboratory methods to assess muscle mass are not yet feasible for routine use in clinical practice because of limited availability and high costs.

OBJECTIVE

This work aims to review the literature on muscle mass prediction by anthropometric equations in adults or older people.

DATA SOURCES

The following databases were searched for observational studies published until June 2022: MEDLINE, Embase, Scopus, SPORTDiscus, and Web of Science.

DATA EXTRACTION

Of 6437 articles initially identified, 63 met the inclusion criteria for this review. Four independent reviewers, working in pairs, selected and extracted data from those articles.

DATA ANALYSIS

Two studies reported new equations for prediction of skeletal muscle mass: 10 equations for free-fat mass and lean soft tissue, 22 for appendicular lean mass, 7 for upper-body muscle mass, and 7 for lower-body muscle mass. Twenty-one studies validated previously proposed equations. This systematic review shows there are numerous equations in the literature for muscle mass prediction, and most are validated for healthy adults. However, many equations were not always accurate and validated in all groups, especially people with obesity, undernourished people, and older people. Moreover, in some studies, it was unclear if fat-free mass or lean soft tissue had been assessed because of an imprecise description of muscle mass terminology.

CONCLUSION

This systematic review identified several feasible, practical, and low-cost equations for muscle mass prediction, some of which have excellent accuracy in healthy adults, older people, women, and athletes. Malnourished individuals and people with obesity were understudied in the literature, as were older people, for whom there are only equations for appendicular lean mass.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration number CRD42021257200.

Skeletal muscle fibre morphology in childhood-insights into myopenia in pediatric liver disease

TAKE-HOME MESSAGE

Skeletal muscle morphology in healthy children changes with age. Liver disease may preferentially affect type II fibres in adults with end-stage liver disease (ESLD). More research is needed on the effects of ESLD on muscle morphology in children.

A Research Note Investigating the Leg Tuck and Plank With Potential Impacts for Occupational Testing

ABSTRACT

Gonzalez, SM, Withrow, KL, Rubin, DA, Lynn, SK, Dawes, JJ, Orr, RM, and Lockie, RG. A research note investigating the leg tuck and plank with potential impacts for occupational testing. J Strength Cond Res 37(10): 2076-2079, 2023-The U.S. Army recently replaced the leg tuck with the plank in their physical ability testing. There has been limited analysis of whether these 2 tests correlate, have any relationships with body composition and strength, or are sex-neutral. Forty-nine civilian college students (28 males, 21 females) were recruited as surrogates for tactical personnel. The following were measured: height, body mass, body fat percentage (BF%), and muscle mass percentage (MM%) measured through bioelectrical impedance analysis, grip strength, leg tuck, and plank. Independent t -tests were calculated to determine between-sex differences for all variables ( p < 0.05). Partial correlations controlling for sex were used to compute relationships between the leg tuck, plank, and other variables. Stepwise regression controlling for sex derived predictive relationships for the leg tuck and plank. Males were taller, had greater body mass, MM%, and were superior in grip strength and the leg tuck; females had greater BF%. There were no significant between-sex differences for the plank. The leg tuck correlated with BF%, MM%, grip strength, and the plank ( r = ±0.333-0.524). In addition to the leg tuck, the plank correlated with BF% ( r = -0.288). The leg tuck was predicted by sex, grip strength, and the plank (adjusted r2 = 0.662). No variables predicted the plank. As there were no between-sex differences and sex was not a plank predictor, it appears this test minimized sex differences on task performance in civilians. However, the leg tuck and plank likely measure different qualities; further research is needed on job task relationships.

Stability, performance and upper and lower extremities range of motion in elite beach handball athletes: A cross sectional study

Although beach handball is a popular sport worldwide, information about the functional profile in elite athletes are lacking. This study generate a descriptive profile of stability, performance and upper and lower extremities ROM in elite beach handball athletes. Secondary proposals were to compare these outcome measures between sexes and sides, and to report the frequency of athletes "at risk" according to cutoff values for shoulder ROM and dynamic postural stability of the lower extremities. Twenty-eight (n = 16 males, 28.7 ± 5.3 years; n = 12 females, 27.5 ± 5.5 years) elite beach handball athletes were tested. Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), single hop test, modified Star Excursion Balance Test (mSEBT) and passive shoulder, hip and ankle dorsiflexion ROM were assessed. Male athletes presented greater reach distance in the anterior direction [P < .0001; Mean Difference (MD): 36%] and lower reach distance in the posteromedial direction (P < .0001; MD: -29.7%) than female athletes in the mSEBT. Bilateral differences were observed for male athletes during the mSEBT, with the dominant stance limb obtaining a smaller reach distance in the anterior direction (P < .01; MD: -38.3%) and greater reach distance in the posteromedial direction (P < .0001; MD: 30.8%). Male athletes had less upper and lower extremities ROM and reached a smaller normalized single hop distance than female athletes. Most athletes presented mSEBT asymmetries and shoulder ROM deficits which have been shown to increase injury risk. Dynamic postural stability adaptations are present in elite beach handball athletes of both sexes, with more pronounced upper and lower extremity flexibility deficits in male athletes.

The prevalence and clinical course of shoulder injury related to vaccine administration (SIRVA) after COVID-19 vaccines in Dutch hospital workers

INTRODUCTION

Shoulder Injury Related to Vaccine Administration (SIRVA) is a rare disorder characterized by persistent shoulder pain and limited range of motion presenting within 48 h after vaccine administration. With the widespread distribution of the COVID-19 vaccine, the incidence of SIRVA is expected to rise. This sudden rise in vaccine administration presents an ideal opportunity to estimate the prevalence of SIRVA and to better characterize SIRVA.

OBJECTIVE

This study aims to investigate the prevalence of SIRVA following COVID-19 vaccine administration among hospital workers in the Netherlands.

METHODS

A questionnaire was sent to all hospital workers from a single non-academic hospital in the Netherlands. Respondents who had active SIRVA complaints were invited for an outpatient orthopaedic clinic assessment. Data was collected on participant characteristics and physical examination including assessment of active and passive range of motion (ROM). An ultrasound was performed to identify potential abnormalities.

RESULTS

32 out of 981 (3.3%) respondents reported shoulder pain with limited ROM occurring within 48 h after vaccine administration lasting for at least 7 days. Of these 32 respondents with SIRVA, 18 (56.2%) still reported active symptoms at the time of the survey. Clinical examination of 13 (72.2%) respondents with active SIRVA complaints showed limited glenohumeral ROM, limitations in activities of daily living and injection site pain. Twelve out of thirteen (92.3%) respondents with active SIRVA complaints showed abnormalities of the soft-tissue of the shoulder on ultrasound. Physiotherapy was the most common treatment modality for persistent SIRVA complaints (38.9%).

CONCLUSIONS

The prevalence of SIRVA is estimated at 3% in the adult working population. Signs and symptoms of SIRVA are variable in severity, localization and timing. Soft-tissue abnormalities is the most common clinical sign. This study contributes to clinician's knowledge on SIRVA, aiding in early recognition and treatment, which are imperative for prevention of persistent and severe shoulder pathology.

One Velocity Loss Threshold Does Not Fit All: Consideration of Sex, Training Status, History, and Personality Traits When Monitoring and Controlling Fatigue During Resistance Training

PURPOSE

This study aimed to quantify the potential variability in the volume of work completed after reaching different velocity loss (VL) thresholds and determine the effects of sex, training status and history, as well as psychological traits on the reliability and magnitude of the amount of work completed after reaching different VL thresholds using different loads in the back-squat exercise.

METHODS

Forty-six resistance-trained people (15 females and 31 males; 18 to 40 years of age) with a wide range of strength levels, training experience, and different training practices were recruited and performed a one-repetition maximum (1RM) test, and two repetitions to failure (RTF) tests 72 h apart. RTF tests were performed with 70, 80, and 90% of 1RM with 10 min of rest between sets. The Bland-Altman analysis for multiple observations per participant and equivalence tests were used to quantify the variability in the volume of work completed after reaching different VL thresholds, whereas linear and generalised mixed-effects models were used to examine the effects of different moderators on the stability and magnitude of the amount of work completed after reaching different VL thresholds.

RESULTS

The findings of the present study question the utility of using VL thresholds to prescribe resistance training (RT) volume as the agreement in the amount of work completed across two consecutive testing sessions was not acceptable. Regardless of the load used, females completed more repetitions than males across VL thresholds, while males performed repetitions at higher velocities. In addition, individuals with higher levels of emotional stability also tended to perform more repetitions across VL thresholds. Finally, sex, choice of load, strength levels and training practices, as well as emotional stability affected the linearity of the repetition-velocity relationship and when sets terminated.

CONCLUSION

Using the same VL thresholds for all individuals, while assuming generalisability of the stimuli applied, would likely lead to variable acute physiological responses to RT and divergent neuromuscular adaptations over long term. Therefore, VL monitoring practices could be improved by considering sex, training status, history, and psychological traits of individuals due to their effects on the variability in responses to different VL thresholds.

Immediate effects of counterforce brace with and without vibration on pain, muscle strength and range of motion in participants with lateral epicondylitis. A pilot study

Lateral epicondylitis is one of the most common elbow problems. Counterforce braces are commonly used to manage lateral epicondylitis. Recent studies showed that vibration can decrease pain and increase muscle strength by improving motor abilities. The aim of this study was to evaluate the effects of a counterforce brace with and without vibration on pain, muscular strength, wrist and elbow joints range of motion in the participants with lateral epicondylitis. In this repeated measure pre-post clinical trial study, 28 participants with lateral epicondylitis were included. Pain were measured with Visual Analogue Scale (VAS), wrist and elbow flexor/extensor muscles strength with digital dynamometer, wrist and elbow flexion/extension range of motion with goniometer in 3 condition baseline, counterforce brace and counterforce brace with vibration. Pain using counterforce bracing with vibration showed a significant reduction as compared with baseline and counterforce bracing (P < 0.001). Wrist flexor muscles strength (P = 0.005), elbow flexor/extensor muscles strength respectively (P = 0.04, P = 0.02), wrist flexion/extension range of motion (P < 0.001) following the use of counterforce bracing with vibration increased significantly compared with baseline. The results show that the counterforce bracing with and without vibration relieves pain and improves range of motion and muscles strength in lateral epicondylitis participants, but this improvement is more significant with the use of vibration.

Differences and Relationships Between Push-up and Sit-up Variations Among Male Law Enforcement Cadets

ABSTRACT

Lopes dos Santos, M, Thompson, M, Dinyer-McNeely, T, Torrence, T, Lockie, RG, Orr, RM, and Dawes, JJ. Differences and relationships between push-up and sit-up variations among male law enforcement cadets. J Strength Cond Res 37(9): 1865-1869, 2023-The purpose of this study was to explore variation-dependent differences in push-up and sit-up tests, as well as to identify the relationships between push-up and sit-up variations commonly performed among tactical personnel. Data from 41 (age = 21.1 ± 1.8 years, body mass = 89.5 ± 15.5 kg) male police cadets from one US-based training academy who performed the standard push-up (PU Standard ), hand-release push-up (PU Hand-release ), standard sit-up (SU Standard ), and hands behind the head sit-up (SU BehindHead ) were examined. The maximum number of repetitions completed for each exercise was used for analyses with paired-samples t tests used to identify significant differences between outcome measures and effect sizes (ES) to determine change in magnitude. A significant difference, with a large ES, was found in the number of repetitions completed between the push-up variations ( p < 0.001, ES = 0.75) and sit-up variations ( p < 0.001, ES = 1.02). Performance in PU Standard was only able to explain 39% of the variation in PU Hand-release ( r = 0.62, r2 = 0.39, p < 0.001), and performance in the SU Standard was only able to explain 29% of the variation in SU BehindHead ( r = 0.54, r2 = 0.29, p < 0.001). The current study suggests differences in performance capabilities may be dependent on the push-up and sit-up variations chosen for testing. Although it is still unclear whether one variation would be a better predictor of police work performance, agencies must give special attention to the overall construct validity of fitness tests for entry and retention of law enforcement officers.

Effects of Nutrition and Exercise Interventions on Persons with Sarcopenic Obesity: An Umbrella Review of Meta-Analyses of Randomised Controlled Trials

BACKGROUND

Sarcopenic obesity (SO) is an increasing phenomenon and has been linked to several negative health consequences. The aim of this umbrella review is the assessment of effectiveness and certainty of evidence of nutrition and exercise interventions in persons with SO.

METHOD

We searched for meta-analyses of RCTs in PubMed, EMBASE and CENTRAL that had been conducted in the last five years, focusing on studies on the treatment and prevention of SO. The primary endpoints were parameters for SO, such as body fat in %, skeletal muscle mass index (SMMI), gait speed, leg strength and grip strength. The methodological quality was evaluated using AMSTAR and the certainty of evidence was assessed using GRADE.

RESULTS

Four systematic reviews with between 30 to 225 participants were included in the umbrella review. These examined four exercise interventions, two nutrition interventions and four interventions that combined nutrition and exercise. Resistance training was the most frequently studied intervention and was found to improve gait speed by 0.14 m/s to 0.17 m/s and lower leg strength by 9.97 kg. Resistance, aerobic, mixed exercise and hypocaloric diet combined with protein supplementation is not significantly effective on selected outcomes for persons with SO compared to no intervention. The low number of primary studies included in the reviews resulted in moderate to very low certainty of evidence.

CONCLUSION

Despite the lack in certainty of evidence, resistance training may be a suitable intervention for persons with SO, in particular for improving muscle function. Nevertheless, further research is necessary to strengthen the evidence.

Transition from upright to greater forward lean posture predicts faster acceleration during the run-to-sprint transition

BACKGROUND

Forward body lean and greater horizontal ground reaction force have been associated with being able to accelerate during running. However, kinematic features which may predict acceleration during the run-to-sprint transition have not been determined. The purpose of this study was to determine which kinematic changes occur in recreationally active adults and which kinematic features may predict greater acceleration during the run-to-sprint transition.

METHODS

Forty-seven healthy adults completed straight line running along a 30 m track by running in at ∼4 m.s-1. A minimum of 20 trials were completed, with 25 % triggering a light to signal the participant to accelerate as fast as possible. Step characteristics (velocity, length, duration, cadence) and kinematics (neck, trunk, hip, knee and ankle angles and excursions) were determined using a radar gun and inertial measurement units, respectively. ANOVA was used to determine the step-to-step differences and a multiple linear regression was used to determine the relationship between kinematics and acceleration.

RESULTS

There was an initial increase in trunk flexion angle during early acceleration (p < 0.001) with knee joint excursion significantly lower (p < 0.001) during loading and propulsion compared to the run-in steps. Greater acceleration was predicted using a stepwise linear regression by five variables including less neck flexion excursion and trunk flexion angle during swing of the 1st step, greater trunk flexion angle and extension excursion of the neck during propulsion of the 2nd step and greater hip flexion angle at foot strike of the 3rd step (r2 =0.804, p < 0.001).

SIGNIFICANCE

Faster acceleration was observed when participants transitioned from an upright posture to greater forward trunk lean in the early phase of acceleration. Training the run-to-sprint transition, which was shown to have the greatest increase in velocity over the first 5 m, may be encouraged as a sports specific exercise.

Sex-related differences in motor unit behavior are influenced by myosin heavy chain during high- but not moderate-intensity contractions

AIMS

Motor unit recruitment and firing rate patterns of the vastus lateralis (VL) have not been compared between sexes during moderate- and high-intensity contraction intensities. Additionally, the influence of fiber composition on potential sex-related differences remains unquantified.

METHODS

Eleven males and 11 females performed 40% and 70% maximal voluntary contractions (MVCs). Surface electromyographic (EMG) signals recorded from the VL were decomposed. Recruitment thresholds (RTs), MU action potential amplitudes (MUAPAMP ), initial firing rates (IFRs), mean firing rates (MFRs), and normalized EMG amplitude (N-EMGRMS ) at steady torque were analyzed. Y-intercepts and slopes were calculated for MUAPAMP , IFR, and MFR versus RT relationships. Type I myosin heavy chain isoform (MHC) was determined with muscle biopsies.

RESULTS

There were no sex-related differences in MU characteristics at 40% MVC. At 70% MVC, males exhibited greater slopes (p = 0.002) for the MUAPAMP , whereas females displayed greater slopes (p = 0.001-0.007) for the IFR and MFR versus RT relationships. N-EMGRMS at 70% MVC was greater for females (p < 0.001). Type I %MHC was greater for females (p = 0.006), and was correlated (p = 0.018-0.031) with the slopes for the MUAPAMP , IFR, and MFR versus RT relationships at 70% MVC (r = -0.599-0.585).

CONCLUSION

Both sexes exhibited an inverse relationship between MU firing rates and recruitment thresholds. However, the sex-related differences in MU recruitment and firing rate patterns and N-EMGRMS at 70% MVC were likely due to greater type I% MHC and smaller twitch forces of the higher threshold MUs for the females. Evidence is provided that muscle fiber composition may explain divergent MU behavior between sexes.

Feasibility of Conducting Sit-to-Stand Tests Using Video Consultation

Objective

This study is aimed at ascertaining the feasibility of conducting the 1-minute sit-to-stand (1MSTS) and 30-second sit-to-stand (30SSTS) tests for healthy participants via video consultation. A secondary aim was to compare the relationship between the 1MSTS and 30SSTS.

Methods

A total of 63 participants were recruited via the Singapore Institute of Technology emails and social media in 2020 during the peak of COVID-19. Prior to the sit-to-stand testing, all participants completed the consent form and physical activity questionnaires. Anthropometric data such as height and weight were also collected prior to testing. An instructional video detailing the sit-to-stand (STS) movement and the requirements for the environment set-up were sent to the participants via email. All STS tests were conducted virtually via the Zoom application. Healthy participants aged 21 to 55 years old performed a 1MSTS and 30SSTS each in random order.

Results

All recruited participants completed the STS tests with no reported adverse events. Majority of participants were from the 21- to 25-year-old age groups, and the average number of repetitions performed by this group was 21.9 ± 5.6 for the 30SSTS and 44.7 ± 12.6 for the 1MSTS.

Conclusion

Conducting the STS tests via video consultation was demonstrated to be safe and feasible. The number of repetitions performed in the 1MSTS is correlated to that of the 30SSTS, but 1MSTS has the ability to elicit a greater HR response among younger adults.

Analysis of Ankle Muscle Dynamics during the STS Process Based on Wearable Sensors

Ankle joint moment is an important indicator for evaluating the stability of the human body during the sit-to-stand (STS) movement, so a method to analyze ankle joint moment is needed. In this study, a wearable sensor system that could derive surface-electromyography (sEMG) signals and kinematic signals on the lower limbs was developed for non-invasive estimation of ankle muscle dynamics during the STS movement. Based on the established ankle joint musculoskeletal information and sEMG signals, ankle joint moment during the STS movement was calculated. In addition, based on a four-segment STS dynamic model and kinematic signals, ankle joint moment during the STS movement was calculated using the inverse dynamics method. Ten healthy young people participated in the experiment, who wore a self-developed wearable sensor system and performed STS movements as an experimental task. The results showed that there was a high correlation (all R ≥ 0.88) between the results of the two methods for estimating ankle joint moment. The research in this paper can provide theoretical support for the development of an intelligent bionic joint actuator and clinical rehabilitation evaluation.

Sex differences concerning the effects of ankle muscle fatigue on static postural control and spinal proprioceptive input at the ankle

Aims

The main aim of this study was to determine sex differences in postural control changes with ankle muscle fatigue during a standing forward leaning (FL) task under different vision conditions. The secondary aim was to examine sex differences in the effect of fatigue on soleus (SOL) H-reflex amplitude, a measure of motoneuron excitability with activation of Ia afferents.

Methods

Fifteen healthy young adult males (mean age: 28.0 years) and 16 healthy young adult females (mean age: 26.1 years) were asked to perform four consecutive FL tasks [30 s; two with eyes open (EO) and two with eyes closed (EC)] before, and immediately following a fatiguing exercise consisting of alternating ankle plantarflexion (6 s) and dorsiflexion (2 s) maximal isometric contractions, and at 5 and 10 min of recovery. Center of pressure (COP) sway variables (mean position, standard deviation, ellipse area, average velocity, and frequency), an ankle co-contraction index, and a ratio of SOL H-reflex to the maximum amplitude of the compound muscle action potential (M-max) were obtained during the FL tasks. A rating of perceived fatigue (RPF) was also documented at the different time points.

Results

Time to task failure (reduction of 50% in maximal voluntary isometric contraction torque of ankle plantar flexors) and the increase in RPF value were not significantly different between males and females. Both sex groups showed similar and significant increases (p < 0.05) in mean COP sway velocity with no significant changes in co-contraction indices. No significant effects of fatigue and related interactions were found for SOL H/M-max ratio.

Discussion

The absence of a significant sex difference in postural control change (sway and co-contraction) with fatigue could be explained by similar perceived (RPF) and performance fatigability (exercise duration) between males and females in the present study. Fatigue did not lead to significant changes in SOL spinal motoneuron excitability with activation of Ia afferents.

Sex Differences in Athletic Performance: Perspectives on Transgender Athletes

Sex hormone concentrations, particularly testosterone, are primary determinants of sex-based differences in athletic and sports performance, and this relationship may inform fair competition and participation for athletes. This article describes the sex-based dichotomy in testosterone and the implications for sex-based differences in individual sports performance, including factors that relate to athletic performance for transgender individuals, and areas of future investigation.

A Systematic Review and Meta-Analysis of the Differences in Mean Propulsive Velocity between Men and Women in Different Exercises

The purpose of this paper was to conduct a systematic review and meta-analysis of studies examining the differences in the mean propulsive velocities between men and women in the different exercises studied (squat, bench press, inclined bench press and military press). Quality Assessment and Validity Tool for Correlational Studies was used to assess the methodological quality of the included studies. Six studies of good and excellent methodological quality were included. Our meta-analysis compared men and women at the three most significant loads of the force-velocity profile (30, 70 and 90% of 1RM). A total of six studies were included in the systematic review, with a total sample of 249 participants (136 men and 113 women). The results of the main meta-analysis indicated that the mean propulsive velocity is lower in women than men in 30% of 1RM (ES = 1.30 ± 0.30; CI: 0.99-1.60; p < 0.001) and 70% of 1RM (ES = 0.92 ± 0.29; CI: 0.63, 1.21; p < 0.001). In contrast, for the 90% of the 1RM (ES = 0.27 ± 0.27; CI: 0.00, 0.55), we did not find significant differences (p = 0.05). Our results support the notion that prescription of the training load through the same velocity could cause women to receive different stimuli than men.

Influence of Pennation Angle and Muscle Thickness on Mechanomyographic Amplitude-Torque Relationships and Sex-Related Differences in the Vastus Lateralis

This study examined potential sex-related differences and correlations among the pennation angle (PA), muscle thickness (MT), and mechanomyographic amplitude (MMG_RMS)-torque relationships of the vastus lateralis (VL) in 11 healthy males and 12 healthy females. The PA and MT of the VL were quantified with ultrasound. Participants performed an isometric muscle action of the knee extensors that linearly increased to 70% of maximal strength followed by a 12 s plateau. MMG was recorded from the VL. Linear regression models were fit to the log-transformed MMG_RMS-torque relationships to calculate b terms (slopes) for the linearly increasing segment. MMG_RMS was averaged during the plateau. Males exhibited greater PA (p < 0.001), MT (p = 0.027), b terms (p = 0.005), and MMG_RMS (p = 0.016). The b terms were strongly (p < 0.001, r = 0.772) and moderately correlated (p = 0.004, r = 0.571) with PA and MT, respectively, while MMG_RMS was moderately correlated with PA (p = 0.018, r = 0.500) and MT (p = 0.014, r = 0.515). The greater mechanical behavior of individuals possessing a larger PA and MT of the VL may reflect increased cross-bridge activity within the muscle fibers. Additionally, PA may help explain sex-related differences in MMG_RMS between sexes.

Myofiber hypertrophy adaptations following 6 weeks of low-load resistance training with blood flow restriction in untrained males and females

The effects of low-load resistance training with blood flow restriction (BFR) on hypertrophy of type I/II myofibers remains unclear, especially in females. The purpose of the present study is to examine changes in type I/II myofiber cross-sectional area (fCSA) and muscle CSA (mCSA) of the vastus lateralis (VL) from before (Pre) to after (Post) 6 wk of high-load resistance training (HL; n = 15, 8 females) and low-load resistance training with BFR (n = 16, 8 females). Mixed-effects models were used to analyze fCSA with group (HL, BFR), sex (M, F), fiber type (I, II), and time (Pre, Post) included as factors. mCSA increased from pre- to posttraining (P < 0.001, d = 0.91) and was greater in males compared with females (P < 0.001, d = 2.26). Type II fCSA increased pre- to post-HL (P < 0.05, d = 0.46) and was greater in males compared with females (P < 0.05, d = 0.78). There were no significant increases in fCSA pre- to post-BFR for either fiber type or sex. Cohen's d, however, revealed moderate effect sizes in type I and II fCSA for males (d = 0.59 and 0.67), although this did not hold true for females (d = 0.29 and 0.34). Conversely, the increase in type II fCSA was greater for females than for males after HL. In conclusion, low-load resistance training with BFR may not promote myofiber hypertrophy to the level of HL resistance training, and similar responses were generally observed for males and females. In contrast, comparable effect sizes for mCSA and 1-repetition maximum (1RM) between groups suggest that BFR could play a role in a resistance training program.NEW & NOTEWORTHY This is the first study, to our knowledge, to examine myofiber hypertrophy from low-load resistance training with blood flow restriction (BFR) in females. Although this type of training did not result in myofiber hypertrophy, there were comparable increases in muscle cross-sectional area compared with high-load resistance training. These findings possibly highlight that males and females respond in a similar manner to high-load resistance training and low-load resistance training with BFR.

Association of appendicular extracellular-to-intracellular water ratio with age, muscle strength, and physical activity in 8,018 community-dwelling middle-aged and older adults

BACKGROUND

The appendicular extracellular-to-intracellular water ratio (Ap ECW/ICW) has recently gained attention as a non-invasive measurable marker of muscle quality. However, there is a lack of basic evidence regarding age-related changes, sex differences, contribution to muscle strength independent of skeletal muscle mass (SMM), and potential improvement through physical activity (PA) in Ap ECW/ICW.

METHODS

This cross-sectional study enrolled 8,018 middle-aged and older Japanese individuals (aged 45-75 years). The Ap ECW/ICW and SMM were measured using segmental bioelectrical impedance spectroscopy. Muscle strength was evaluated by measuring the handgrip strength (HGS) with a dynamometer, and the PA level (PAL) was measured with an accelerometer. We performed a linear regression analysis of the associations of the Ap ECW/ICW with age, HGS, and PAL.

RESULTS

The Ap ECW/ICW increased by 0.019 for men and 0.014 for women per 5-year increase in age (p < 0.001), and the age-related increase was greater in men than in women (p for interaction <0.001). The Ap ECW/ICW was more strongly associated with the HGS than with the SMM in both men and women (p < 0.001). PAL showed a significant inverse association with the Ap ECW/ICW in both men and women (p < 0.001).

CONCLUSIONS

Ap ECW/ICW is higher with age, and it varies by sex. The Ap ECW/ICW may reflect muscle strength more than the SMM, suggesting that the Ap ECW/ICW may be improved by PA. The findings from this study may provide a framework for further Ap ECW/ICW research.

Time Decay in the Performance Benefits From Repeated-Sprint Training in Hypoxia in World-Class Short-Track Speed Skaters

PURPOSE

In short-track speed skating, athletes need to possess specific physiological capabilities to perform explosive starts and to finish races with faster lap times than their opponents. Repeated-sprint training in hypoxia (RSH) can enhance repeated-sprint ability and high-intensity performance. This study aimed to evaluate the relationship between on- and off-ice performance indicators for training and testing purposes and how these are optimized with RSH in world-class short-track speed skaters including world and Olympic champions.

METHODS

RSH training was administered for 3 consecutive weeks, 3 times per week, at 3500 m of simulated altitude. Testing sessions (on-ice: 3-lap, 27-lap; off-ice: cycling incremental test, 7-s and 30-s Wingate) were performed immediately before and 2 and 4 weeks after RSH to determine the time course of decay.

RESULTS

On-ice top speed showed a small and possibly beneficial change of ∼0.9% for the women and large and almost certain ∼0.7% improvement for the men 2 weeks post-RSH. Cycling peak power showed a moderate and probable ∼5.4% improvement for the men 2 weeks after RSH. These adaptations reverted to baseline 4 weeks post-RSH. Wingate average power showed a small and possibly beneficial gain (∼3.4%) in performance 4 weeks post-RSH.

CONCLUSION

Although scientific controls could not be added due to the extremely high caliber of these athletes and low sample size of the national team, this study suggests that cycling RSH can be added immediately after on-ice training and can transfer into meaningful improvements on the ice in both male and female skaters.

Short-term exposure to air pollution and outpatient visits for conjunctivitis: a time-series analysis in Urumqi, China

Conjunctivitis is an inflammatory disease of the conjunctival tissue caused by a variety of causes; despite the conjunctiva being directly exposed to the external atmospheric environment, the important role of air pollution is not fully evaluated, especially in areas with poor air quality undergoing rapid economic and industrial development. Information on 59,731 outpatient conjunctivitis visits from 1 January 2013 to 31 December 2020 was obtained from the Ophthalmology Department of the First Affiliated Hospital of Xinjiang Medical University (Urumqi, Xinjiang, China), and data on six air pollutants including particulate matter with a median aerometric diameter of less than 10 and 2.5 mm (PM₁₀ and PM_2.5, respectively), carbon monoxide (CO), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and ozone (O₃) from eleven standard urban background fixed air quality monitors were also recorded. A time-series analysis design and a quasi-Poisson generalized linear regression model combined with a distributed lagged nonlinear model (DLNM) were used to fit the effect of exposure to air pollutants on the risk of conjunctivitis outpatient visits. Further subgroup analyses were conducted for gender, age, and season, as well as the type of conjunctivitis. Single and multi-pollutant models showed that exposure to PM_2.5, PM₁₀, NO₂, CO, and O₃ was associated with increased risk of outpatient conjunctivitis visits on the lag 0 day and various other lag days. Variations in the effect estimates on direction and magnitude were found in different subgroup analyses. We conducted the first time-series analysis with the longest duration as well as the largest sample size in Northwest China, which provides evidence that outpatient conjunctivitis visits is significantly associated with air pollution in Urumqi, China. Meanwhile, our results demonstrate the effectiveness of SO₂ reduction in reducing the risk of outpatient conjunctivitis visits in the Urumqi region and reaffirm the need to implement special air pollution control measures.

The sex effects on changes in jump performance following an isometric back squat conditioning activity in trained adults

There are limited data concerning the disparity between males and females in post-activation performance enhancement (PAPE) based on isometry. Therefore, this study aimed to establish if sex differences exist in the PAPE effect on jump height. The study included 30 males and 15 females aged between 19 and 25, with relative strength in the back squat of at least 110% of body weight and a minimum of 3 years of resistance training experience. A baseline countermovement jump (CMJ) was performed, and the PAPE protocol, which involved three 4-s sets of isometric full-back squats with a 1-min rest interval, was introduced. Five CMJs were performed over the following 9 minutes in 2 minutes rest intervals. Changes (Δ) towards the baseline and each jump height results were calculated and analyzed in the absolute (cm) and relative (%) approach. The repeated measures ANOVA with sex as between-groups effect and time of the changes as within-group effect were conducted. Results showed statistically significant interaction (sex×time) in absolute changes (Δ cm) (F = 2.50, η2 = 0.05, p = 0.0447), which indicated that the sex effect has changed over time. Post-hoc test showed that during the first 3 minutes, men and women benefited equally, but in the fifth and seventh minutes, the observed changes were greater in men, thus close to significance (p = 0.0797, p = 0.0786), and in the last minute, the difference was statistically significant (p = 0.0309). Also, a statistically significant interaction effect was observed for relative changes (Δ %) (F = 4.22, η2 = 0.09, p = 0.0027). At the beginning (the first and third minutes), changes in females were greater than in males, but the differences were insignificant. However, after 5 minutes, the decrease in females was observed with statistically significant differences in the last minute compared to males (p = 0.0391). Chi-Squared analysis indicated that the time to peak performance was insignificant (χ 2 = 7.45, p = 0.1140) in both sexes. The introduced PAPE protocol based on isometry improved jump height in both sexes, with performance enhancement recorded in the third-minute post-activation. However, performance decreased in females over the next 6 minutes, while it was maintained in the male group. Despite the generally positive short-term effects of the protocol on females, the usefulness of the protocol is limited.

Short-Term effects of ambient ozone on the risk of conjunctivitis outpatient visits: a time-series analysis in Pudong New Area, Shanghai

To date, the relationship between conjunctivitis and air pollutants has been widely concerned, but the conclusions are not very unified. This study aims to explore the short-term effects of ambient ozone (O₃) on the conjunctivitis outpatient visits in Pudong New Area, Shanghai. A quasi-Poisson model combined with the distributed lag nonlinear model (DLNM) was performed to study the short-term effects of O₃ on the risk of outpatient visits for conjunctivitis, after controlling the effects of temperature, relative humidity and wind speed. Taking the median concentration of O₃ as a reference, the moderate high O₃ (75th percentile) showed the largest effect estimates for single and cumulative lag effects at lag 4 (RR 1.013, 95% confidence interval [CI] 1.006-1.019) and lag 0-10 (RR 1.075, 95%CI 1.025-1.128), respectively. Our study suggested that the moderate high O₃ increased the chances of conjunctivitis outpatient visits and had an evident lag effect.

Aerobically trained older adults show impaired resting, but preserved exercise-induced circulating progenitor cell count, which was not improved by sprint interval training

Older adults exhibit a reduced number and function of CD34 + circulating progenitor cells (CPC), a known risk factor for cardiovascular disease. Exercise promotes the mobilisation of CPCs from bone marrow, so whether ageing per se or physical inactivity in older age reduces CPCs is unknown. Thus, this study examined the effect of age on resting and exercise-induced changes in CPCs in aerobically trained adults and the effect of 8 weeks of sprint interval training (SIT) on resting and exercise-induced CPCs in older adults. Twelve young (22-34 years) and nine older (63-70 years) adults participated in the study. Blood was sampled pre and immediately post a graded exercise test to exhaustion in both groups. Older participants repeated the process after 8 weeks of SIT (3 × 20 s 'all-out' sprints, 2 × a week). Total CPCs (CD34⁺) and endothelial progenitor cells (EPCs: CD34⁺KDR⁺) were determined by flow cytometry. Older adults exhibited lower basal total CD34⁺ CPCs (828 ± 314 vs. 1186 ± 272 cells·mL^-1, p = 0.0149) and CD34⁺KDR⁺ EPCs (177 ± 128 vs. 335 ± 92 cells·mL^-1, p = 0.007) than younger adults. The maximal exercise test increased CPCs in young (CD34⁺: p = 0.004; CD34⁺KDR⁺: p = 0.017) and older adults (CD34⁺: p < 0.001; CD34⁺KDR⁺: p = 0.008), without difference between groups (p = 0.211). SIT did not alter resting or exercise-induced changes in CPCs in the older cohort (p > 0.232). This study suggests age per se does not impair exercise-induced CPC counts, but does lower resting CPC counts.

Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)

Background

The Composite Dietary Antioxidant Index (CDAI), a composite score of multiple dietary antioxidants (including vitamin A, C, and E, selenium, zinc, and carotenoids), represents an individual's comprehensive dietary antioxidant intake profile. CDAI was developed based on its combined effect on pro-inflammatory markers Tumor Necrosis Factor-α (TNF-α) and anti-inflammatory effects of Interleukin-1β (IL-1β), which are associated with many health outcomes, including depression, all-cause mortality, colorectal cancer, etc. Handgrip strength is used as a simple measure of muscle strength, not only is it highly correlated with overall muscle strength, but also serves as a diagnostic tool for many adverse health outcomes, including sarcopenia and frailty syndromes.

Purpose

The association between CDAI and Handgrip strength (HGS) is currently unclear. This study investigated the association between CDAI (including its components) and HGS in 6,019 American adults.

Method

The research data were selected from the 2011-2014 National Health and Nutrition Survey (NHANES), and a total of 6,019 American adults were screened and included. A weighted generalized linear regression model was used to evaluate CDAI (including its components) and HGS.

Results

(1) CDAI was significantly positively correlated with HGS (β = 0.009, 0.005∼0.013, P < 0.001), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.084, 0.042∼0.126, P = 0.002) and significant in trend test (P for trend < 0.0100). Gender subgroup analysis showed that male CDAI was significantly positively correlated with HGS (β = 0.015, 0.007∼0.023, P = 0.002), and the trend test showed that compared with the lowest quartile of CDAI, the highest quartile of CDAI was positively correlated with HGS (β = 0.131, 0.049∼0.213, P = 0.006) and the trend test was significant (P for trend < 0.0100). There was no correlation between female CDAI and HGS, and the trend test was not statistically significant (P > 0.05). (2) The intake of dietary vitamin E, Zinc and Selenium showed a significant positive correlation with HGS (β = 0.004, 0.002∼0.007, P = 0.006; β = 0.007, 0.004∼0.009, P < 0.001; β = 0.001, 0.001∼0.001, P < 0.001), vitamin A, vitamin C and carotenoid were significantly associated with HGS in the Crude Model, but this significant association disappeared in the complete model with the increase of control variables. Gender subgroup analysis showed that in model 3, male dietary intake levels of vitamin E, Zinc, and Selenium were significantly positively correlated with HGS (β = 0.005, 0.002∼0.009, P = 0.011; β = 0.007, 0.004∼0.011, P = 0.001; β = 0.001, 0.001∼0.001, P = 0.004), the rest of the indicators had no significant correlation with HGS. Among the female subjects, dietary zinc intake was significantly positively correlated with HGS (β = 0.005, 0.001∼0.008, P = 0.008), and there was no significant correlation between other indicators and HGS (P > 0.05).

Conclusion

There was an association between the CDAI and HGS, but there was a gender difference, and there was an association between the CDAI and HGS in male, but the association was not significant in female. Intake of the dietary antioxidants vitamin E, selenium, and zinc was associated with HGS in male, but only zinc was associated with HGS among dietary antioxidants in female.

Prevalence of sarcopenia in older women and level of agreement between the diagnostic instruments proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2)

BACKGROUND

The European Working Group on Sarcopenia in Older People 2 (EWGSOP2) proposed the use of different diagnostic tools to assess sarcopenia. This study aimed to determine prevalence rates of sarcopenia according to the diagnostic instruments proposed by EWGSOP2 and to assess their level of agreement in older Brazilian women.

METHODS

A cross-sectional study with 161 community-dwelling older Brazilian women. Probable sarcopenia was assessed through Handgrip Strength (HGS) and the 5-times sit-to-stand test (5XSST). In addition to reduced strength, Appendicular Skeletal Muscle Mass (ASM) (obtained by Dual-energy X-ray absorptiometry) and ASM/height² were considered for diagnosis confirmation. Sarcopenia severity was determined by reduced muscle strength and mass and poor functional performance assessed by Gait Speed (GS), Short Physical Performance Battery (SPPB), and Timed Up and Go test (TUG). McNemar's test and Cochran's Q-test were used to compare sarcopenia prevalence. Cohen's Kappa and Fleiss's Kappa tests were used to assess the level of agreement.

RESULTS

The prevalence of probable sarcopenia was significantly different (p < 0.05) when using HGS (12.8%) and 5XSST (40.6%). Regarding confirmed sarcopenia, the prevalence was lower when using ASM/height² than with ASM. Regarding severity, the use of SPPB resulted in a higher prevalence in relation to GS and TUG.

CONCLUSION

There were differences in the prevalence rates of sarcopenia and low agreement between the diagnostic instruments proposed by the EWGSOP2. The findings suggest that these issues must be considered in the discussion on the concept and assessment of sarcopenia, which could ultimately help to better identify patients with this disease in different populations.

Influence of muscle volume on jumping performance in healthy male and female youth and young adults

BACKGROUND

Sex differences that appear throughout puberty have a substantial impact on the training process. It remains unclear what effect these sex differences should have on how training programs are planned and performed and what objectives should be established for boys and girls of different ages. This study aimed to investigate the relationship between vertical jump performance and muscle volume based on age and sex.

METHODS

One hundred eighty healthy males (n = 90) and females (n = 90) performed three different types of vertical jumps (VJ): squat jump (SJ), counter movement jump (CMJ), and counter movement jump with arms (CMJ with arms). We used the anthropometric method to measure muscle volume.

RESULTS

Muscle volume differed across age groups. There were significant effects of age, sex, and their interaction on the SJ, CMJ, and CMJ with arms heights. From the age of 14-15, males exhibited better performances than females, and large effect sizes became apparent in the SJ (d = 1.09, P = 0.04), CMJ (d = 2.18; P = 0.001) and CMJ with arms (d = 1.94; P = 0.004). For the 20-22-year-old age group, there was a significant difference in VJ performance between males and females. Extremely large effect sizes became apparent in the SJ (d = 4.44; P = 0.001), CMJ (d = 4.12; P = 0.001) and CMJ with arms (d = 5.16; P = 0.001). When performances were normalized to the lower limb length, these differences persisted. After normalization to muscle volume, males exhibited better performance when compared to females. This difference persisted only for the 20-22-year-old group on the SJ (p = 0.005), CMJ (p = 0.022) and CMJ with arms (p = 0.016). Among male participants, muscle volume was significantly correlated with SJ (r = 0.70; p < 0.01), CMJ (r = 0.70; p < 0.01) and CMJ with arms (r = 0.55; p < 0.01).

CONCLUSIONS

The results indicate that muscle volume may be one of the major determining factors in sex differences in vertical jumping performance.

Validity of using perceived exertion to assess muscle fatigue during back squat exercise

The rating of perceived exertion (RPE) scale has been found to reflect physiological responses, and this study aimed to assess the validity of using the Borg CR-10 scale and velocity loss to evaluate muscle fatigue quantified by surface electromyography during back squat (BS) exercise. A total of 15 collegiate male athletes underwent three non-explosive BS tasks comprising low, medium, and high volumes at 65% of their one-repetition maximum. RPEs, spectral fatigue index (SFI), and velocity loss during BS exercise were assessed throughout the trials. Significant differences in overall RPE (p < 0.001) and average SFI (p < 0.05) were observed between the conditions, whereas no significant difference was observed in average velocity loss. Significant increases in RPE and SFI (p < 0.001) were observed within the exercise process, whereas a significant increase in velocity loss was not observed. Correlation analyses indicated a significant correlation between RPE and SFI obtained during exercise (r = 0.573, p < 0.001). However, no significant correlation was observed between velocity loss and SFI. These results demonstrated that RPE could be used as a muscle fatigue predictor in BS exercise, but that velocity loss may not reflect muscle fatigue correctly when participants cannot and/or are not required to perform BS explosively. Furthermore, practitioners should not use velocity loss as a muscle fatigue indicator in some resistance exercise situations, such as rehabilitation, beginner, and hypertrophy programs.

Association of Strength Performance in Bench Press and Squat with Anthropometric Variables between Resistance-Trained Males and Females

Individual differences in the appropriate percentage of 1-RM for a given repetition range could be a result of variation in anthropometrics and/or sex. Strength endurance is the term used to describe the ability to perform a number of repetitions prior to failure (AMRAP) in sub-maximal lifts and is important in determining the appropriate load for the targeted repetition range. Earlier research investigating the association of AMRAP performance and anthropometric variables was often performed in a sample of pooled sexes or one sex only or by utilizing tests with low ecological validity. As such, this randomized cross-over study investigates the association of anthropometrics with different measures of strength (maximal and relative strength and AMRAP) in the squat and bench press for resistance-trained males (n = 19, 24.3 ± 3.5 years, 182 ± 7.3 cm, 87.1 ± 13.3 kg) and females (n = 17, 22.1 ± 3 years, 166.1 ± 3.7 cm, 65.5 ± 5.6 kg) and whether the association differs between the sexes. Participants were tested for 1-RM strength and AMRAP performance, with 60% of 1-RM in the squat and bench press. Correlational analysis revealed that for all participants, lean mass and body height were associated with 1-RM strength in the squat and bench press (0.66, p ≤ 0.01), while body height was inversely associated with AMRAP performance (r ≤ -0.36, p ≤ 0.02). Females had lower maximal and relative strength with a greater AMRAP performance. In the AMRAP squat, thigh length was inversely associated with performance in males, while fat percentage was inversely associated with performance in females. It was concluded that associations between strength performance and anthropometric variables differed for males and females in fat percentage, lean mass, and thigh length.

The impact of acute skeletal muscle loss after gastrointestinal cancer surgery on physical function

INTRODUCTION

Significant skeletal muscle loss occurs commonly after cancer surgery; however, the impact of postoperative acute skeletal muscle loss on physical function remains poorly understood.

OBJECTIVE

To determine the impact of surgery-associated acute skeletal muscle wasting on physical function in the early postoperative period in patients with gastrointestinal cancer.

DESIGN

A single-center retrospective observational study.

SETTING

General hospital.

PATIENTS

Hospitalized patients with gastrointestinal cancer who were admitted for surgery.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

The main outcome was the partial correlation between postoperative changes in skeletal muscle index (SMI) and physical function such as handgrip strength, gait speed, and 6-minute walk test.

RESULTS

A total of 69 patients (41 male and 28 female) with a mean age of 70.5 years were included. SMI was significantly correlated with physical function, such as handgrip strength (r = 0.757, p < .001), maximum gait speed (r = 0.318, p = .008), and 6-minute walk test (r = 0.365, p = .002) before surgery. In contrast, partial correlation analysis between the absolute changes in SMI and physical function after controlling for SMI and each physical function before surgery showed no significant correlation. Multivariable linear regression analyses also showed that postoperative change in SMI was not significantly associated with the postoperative change in physical function but it was associated with the length of stay after surgery, SMI at admission, and absolute change in body fat percentage.

CONCLUSIONS

The absolute change in SMI during the early postoperative period was not linearly correlated with the degree of decline in physical function. Further studies are necessary to investigate the effects of the respective changes in skeletal muscle mass and physical function on clinical outcomes.

Narrative Review of Sex Differences in Muscle Strength, Endurance, Activation, Size, Fiber Type, and Strength Training Participation Rates, Preferences, Motivations, Injuries, and Neuromuscular Adaptations

ABSTRACT

Nuzzo, JL. Narrative review of sex differences in muscle strength, endurance, activation, size, fiber type, and strength training participation rates, preferences, motivations, injuries, and neuromuscular adaptations. J Strength Cond Res 37(2): 494-536, 2023-Biological sex and its relation with exercise participation and sports performance continue to be discussed. Here, the purpose was to inform such discussions by summarizing the literature on sex differences in numerous strength training-related variables and outcomes-muscle strength and endurance, muscle mass and size, muscle fiber type, muscle twitch forces, and voluntary activation; strength training participation rates, motivations, preferences, and practices; and injuries and changes in muscle size and strength with strength training. Male subjects become notably stronger than female subjects around age 15 years. In adults, sex differences in strength are more pronounced in upper-body than lower-body muscles and in concentric than eccentric contractions. Greater male than female strength is not because of higher voluntary activation but to greater muscle mass and type II fiber areas. Men participate in strength training more frequently than women. Men are motivated more by challenge, competition, social recognition, and a desire to increase muscle size and strength. Men also have greater preference for competitive, high-intensity, and upper-body exercise. Women are motivated more by improved attractiveness, muscle "toning," and body mass management. Women have greater preference for supervised and lower-body exercise. Intrasexual competition, mate selection, and the drive for muscularity are likely fundamental causes of exercise behaviors in men and women. Men and women increase muscle size and strength after weeks of strength training, but women experience greater relative strength improvements depending on age and muscle group. Men exhibit higher strength training injury rates. No sex difference exists in strength loss and muscle soreness after muscle-damaging exercise.

The effect of pinch span on pinch force sense in healthy participants

The purpose of the current investigation was to evaluate the effect of pinch span on the perception of pinch force in typical participants. The healthy participants (10 males and 10 females) conducted an ipsilateral force reproduction test with three distinct pinch spans (2, 4, and 6 cm) at three distinct forces of 10%, 30%, and 50% maximum voluntary isometric contraction. The findings revealed a significantly greater consistency (lower variable error (VE)) of 4 cm compared with 2 and 6 cm pinch spans. Our study also showed that the participants might use a larger force (more overestimated) output for larger pinch spans (4 and 6 cm) than small pinch spans (2 cm). These results may offer significant insights into the higher rates of musculoskeletal disorders among females, enabling researchers and clinicians to design novel interventions and tools to improve pinch force perception and reduce hand injury rates in males and females.

Is absolute or relative knee flexor strength related to patient-reported outcomes in patients treated with ACL reconstruction with a hamstring tendon autograft? An analysis of eccentric Nordic hamstring strength and seated concentric isokinetic strength

BACKGROUND

There is a need for better understanding of how knee flexor strength influence patient-reported outcomes (PROs) after anterior cruciate ligament (ACL) reconstruction. Our aim was to investigate the relationship between the eccentric NordBord test and the seated concentric Biodex test with PROs, during the first year of rehabilitation after ACL reconstruction with hamstring tendon (HT) autograft.

METHODS

Patients with an index ACL reconstruction with an HT autograft participating in a rehabilitation registry were screened for inclusion. Outcomes of interest were the correlation between absolute (N/kg or Nm/kg) and relative (limb symmetry index) knee flexor strength measured in the NordBord and Biodex with the results of PROs. The significance level was set at p < 0.05 and Pearson's correlation coefficient was used.

RESULTS

137 patients were included (47% women) with a mean age of 24.8 ± 8.4 years. There were non-significant and weak correlations between relative strength for all PROs. Significant and weak correlations between absolute strength in the Biodex with the Knee Self-Efficacy Scale₁₈ (K-SES₁₈) present at 4 and 8 months, and for the ACL-Return to Sport after Injury scale (ACL-RSI) at 12 months was observed, accounting for 8.4-15.7% of the variance. Significant and weak correlations between absolute strength in the Nordbord with the Knee injury and Osteoarthritis Outcome Scale subscale Sports and Recreation at 4 months, the K-SES₁₈ present and the ACL-RSI at 8 months were observed, accounting for 9.4-14.4% of the variance.

CONCLUSION

Absolute knee flexor strength relative to bodyweight for both the Biodex and NordBord test appeared to have a stronger relationship with perceived knee function than relative knee flexor strength, although the observed correlations were weak.

Sex segregation in strength sports: Do equal-sized muscles express the same levels of strength between sexes?

OBJECTIVES

Concerns have been raised against the current two-sex binary category in sports competitions. The thesis states that if males and females were separated based on muscle size, it would negate the strength advantage between the sexes. We tested the possible sex differences in various strength outcomes when pair-matched for muscle thickness.

METHODS

A total of 16 different data sets (n = 963) were assessed to pair-match females with males who had a muscle thickness value within 2%. We further compared the competition performances of the smallest male weight class within the International Powerlifting Federation (IPF) to different weight classes in females.

RESULTS

Overall, 76%-88% of the strength assessments were greater in males than females with pair-matched muscle thickness, regardless of contraction types (i.e., isotonic, isometric, isokinetic). Additionally, males in the lightest weight division in the IPF largely outperformed females in heavier weight divisions.

CONCLUSIONS

Our results would suggest that segregation based on muscle mass or surrogates of muscle mass (e.g., lean body mass) might not be an appropriate classification to create fair competition within strength sports. This is not to refute the concept of the desegregation of the two-sex binary category but to present data that raises important concerns about the potential sex-based differences in strength performance.

Contribution of skeletal muscle to cancer immunotherapy: A focus on muscle function, inflammation, and microbiota

Sarcopenia, characterized by degenerative and systemic loss of skeletal muscle mass and function, is a multifactorial syndrome commonly observed in individuals with cancer. Additionally, it represents a poor nutritional status and indicates possible presence of cancer cachexia. Recently, with the extensive application of cancer immunotherapy, the effects of sarcopenia/cachexia on cancer immunotherapy, have gained attention. The aim of this review was to summarize the influence of low muscle mass (sarcopenia/cachexia) on the response and immune-related adverse events to immunotherapy from the latest literature. It was revealed that low muscle mass (sarcopenia/cachexia) has detrimental effects on cancer immunotherapy in most cases, although there were results that were not consistent with this finding. This review also discussed potential causes of the paradox, such as different measure methods, research types, muscle indicators, time point, and cancer type. Mechanically, chronic inflammation, immune cells, and microbiota may be critically involved in regulating the efficacy of immunotherapy under the condition of low muscle mass (sarcopenia/cachexia). Thus, nutritional interventions will likely be promising ways for individuals with cancer to increase the efficacy of immunotherapy in the future, for low muscle mass (sarcopenia/cachexia) is an important prognostic factor for cancer immunotherapy.

Muscle strength gains per week are higher in the lower-body than the upper-body in resistance training experienced healthy young women-A systematic review with meta-analysis

BACKGROUND

Women are underrepresented in resistance exercise-related studies. To date only one meta-analysis provides concrete training recommendations for muscle strength gains through resistance training in eumenorrhoeic women.

OBJECTIVE

This review aims to identify research gaps to advance future study in this area to expand the knowledge concerning resistance exercise-induced strength gains in women and to provide guidelines on the number of repetitions per set and the training frequency per week to enhance maximal muscle strength.

METHODS

The electronic databases PubMed and Web of Science were searched using a comprehensive list of relevant terms. After checking for exclusion criteria, 31 studies could be included in the final analysis using data from 621 subjects. From these data sets, the ideal number of repetitions per set and also the training frequency per week were analyzed.

RESULTS

In the lower body, the largest gains were achieved with 1 to 6 repetitions (17.4% 1RM increase). For lower-body exercises, the highest gains were achieved with 13 to 20 repetitions (8.7% 1RM increase). The lower body should be trained two times a week (8.5% 1RM increase). The upper body should be trained two (5.2% 1RM increase) to three times (4.5% 1RM increase) a week.

CONCLUSION

Women can increase their 1RM by 7.2% per week in the upper body and by 5.2% per week in the lower-body exercises. The upper body can be trained more than two times per week whereas the lower body should be trained two times. Women with intermediate experiences in RT and advanced performance level show more rapid increases in strength in the lower-body compared to the upper-body while no differences were found between upper and lower limb adaptations in RT-beginner subjects.