Large delayed plasma creatine kinase changes after stepping exercise

The Efficacy of New Zealand Greenshell™ Mussel Powder Supplementation in Supporting Muscle Recovery Following Eccentric Exercise-Induced Muscle Damage in Healthy, Untrained Adult Males

Unaccustomed eccentric exercise results in muscle damage limiting physical performance for several days. This study investigated if Greenshell™ mussel (GSM) powder consumption expedited muscle recovery from eccentric exercise-induced muscle damage (EIMD). Methods: Twenty untrained adult men were recruited into a double-blind, placebo-controlled, cross-over study and were randomly assigned to receive the GSM powder or placebo treatment first. Participants consumed their allocated intervention for four weeks then completed a bench-stepping exercise that induced muscle damage to the eccentrically exercised leg. Muscle function, soreness and biomarkers of muscle damage, oxidative stress and inflammation were measured before exercise, immediately after exercise and 24, 48 and 72 h post exercise. GSM powder promoted muscle function recovery, significantly improving (p < 0.05) isometric and concentric peak torque at 48 h and 72 h post exercise, respectively. Participants on the GSM treatment had faster dissipation of soreness, with significant treatment × time interactions for affective (p = 0.007) and Visual Analogue Scale-assessed pain (p = 0.018). At 72 h, plasma creatine kinase concentrations in the GSM group were lower (p < 0.05) compared with the placebo group. This study provides evidence for GSM powder being effective in supporting muscle recovery from EIMD.

Mechanisms of eccentric contraction-induced muscle damage and nutritional supplementations for mitigating it

Eccentric contraction (ECC) often results in large and long-lasting force deficits accompanied by muscle soreness, primarily due to muscle damage. In this sense, exercises that involve ECC are less desirable. Paradoxically, exercise training that includes a substantial eccentric phase leads to a more powerful activation of the genes responsible for skeletal muscle remodeling (e.g., hypertrophy) than other types of training that emphasize a concentric or isometric phase. Therefore, effective strategies that lessen ECC-induced muscle damage will be of interest and importance to many individuals. The purpose of this brief review is to highlight the published literature on the effects of ECC and/or nutritional supplementations on proteins, lipids, metabolic and ionic changes, and enzyme activities in skeletal muscles subjected to an acute bout of ECC. First, we discuss the potential mechanisms by which ECC causes muscle damage. Previous findings implicate a Ca²⁺ overload-oxidative modification pathway as one possible mechanism contributing to muscle damage. Thereafter, the efficacy of two nutritional supplementations, i.e., L-arginine and antioxidant, is discussed because L-arginine and antioxidant would be expected to ameliorate the adverse effects of Ca²⁺ overload and oxidative modification, respectively. Of these, L-arginine ingestion before ECC seems likely to be the effective strategy for mitigating ECC-related proteolysis. More studies are needed to establish the effectiveness of antioxidant ingestion. The application of effective strategies against muscle damage may contribute to improvements in health and fitness, muscle function, and sports performance.

The influence of external load variables on creatine kinase change during preseason training period

Objective

The aim of the present study was to analyse the relationships between creatine kinase (CK) concentration, an indirect marker of muscle damage, and global positioning system (GPS)-derived metrics of a continuous two-week-long preseason training period in elite football.

Design

Twenty-one elite male professional soccer players were assessed during a 14-day preseason preparatory period. CK concentrations were determined each morning, and a GPS system was used to quantify the external load. A generalized estimating equation (GEE) model was established to determine the extent to which the external load parameter explained post-training CK levels.

Results

The GEE model found that higher numbers of decelerations (χ 2 = 7.83, P = 0.005) were most strongly associated with the post-training CK level. Decelerations and accelerations accounted for 62% and 11% of the post-training CK level, respectively, and considerable interindividual variability existed in the data.

Conclusion

The use of GPS to predict muscle damage could be of use to coaches and practitioners in prescribing recovery practices. Based on GPS data, more individualized strategies could be devised and could potentially result in better subsequent performance.

Preconditioning beef cattle for long-duration transportation stress with rumen-protected methionine supplementation: A nutrigenetics study

In general, beef cattle long-distance transportation from cow-calf operations to feedlots or from feedlots to abattoirs is a common situation in the beef industry. The aim of this study was to determine the effect of rumen-protected methionine (RPM) supplementation on a proposed gene network for muscle fatigue, creatine synthesis (CKM), and reactive oxygen species (ROS) metabolism after a transportation simulation in a test track. Angus × Simmental heifers (n = 18) were stratified by body weight (408 ± 64 kg; BW) and randomly assigned to dietary treatments: 1) control diet (CTRL) or 2) control diet + 8 gr/hd/day of top-dressed rumen-protected methionine (RPM). After an adaptation period to Calan gates, animals received the mentioned dietary treatment consisting of Bermuda hay ad libitum and a soy hulls and corn gluten feed based supplement. After 45 days of supplementation, animals were loaded onto a trailer and transported for 22 hours (long-term transportation). Longissimus muscle biopsies, BW and blood samples were obtained on day 0 (Baseline), 43 (Pre-transport; PRET), and 46 (Post-transport; POST). Heifers' average daily gain did not differ between baseline and PRET. Control heifer's shrink was 10% of BW while RPM heifers shrink was 8%. Serum cortisol decreased, and glucose and creatine kinase levels increased after transportation, but no differences were observed between treatments. Messenger RNA was extracted from skeletal muscle tissue and gene expression analysis was performed by RT-qPCR. Results showed that AHCY and DNMT3A (DNA methylation), SSPN (Sarcoglycan complex), and SOD2 (Oxidative Stress-ROS) were upregulated in CTRL between baseline and PRET and, decreased between pre and POST while they remained constant for RPM. Furthermore, CKM was not affected by treatments. In conclusion, RPM supplementation may affect ROS production and enhance DNA hypermethylation, after a long-term transportation.

Intramuscular mechanisms of overtraining

Strenuous exercise is a potent stimulus to induce beneficial skeletal muscle adaptations, ranging from increased endurance due to mitochondrial biogenesis and angiogenesis, to increased strength from hypertrophy. While exercise is necessary to trigger and stimulate muscle adaptations, the post-exercise recovery period is equally critical in providing sufficient time for metabolic and structural adaptations to occur within skeletal muscle. These cyclical periods between exhausting exercise and recovery form the basis of any effective exercise training prescription to improve muscle endurance and strength. However, imbalance between the fatigue induced from intense training/competitions, and inadequate post-exercise/competition recovery periods can lead to a decline in physical performance. In fact, prolonged periods of this imbalance may eventually lead to extended periods of performance impairment, referred to as the state of overreaching that may progress into overtraining syndrome (OTS). OTS may have devastating implications on an athlete's career and the purpose of this review is to discuss potential underlying mechanisms that may contribute to exercise-induced OTS in skeletal muscle. First, we discuss the conditions that lead to OTS, and their potential contributions to impaired skeletal muscle function. Then we assess the evidence to support or refute the major proposed mechanisms underlying skeletal muscle weakness in OTS: 1) glycogen depletion hypothesis, 2) muscle damage hypothesis, 3) inflammation hypothesis, and 4) the oxidative stress hypothesis. Current data implicates reactive oxygen and nitrogen species (ROS) and inflammatory pathways as the most likely mechanisms contributing to OTS in skeletal muscle. Finally, we allude to potential interventions that can mitigate OTS in skeletal muscle.

Paraspinal muscle function and pain sensitivity following exercise-induced delayed-onset muscle soreness

PURPOSE

The aim of this study was to evaluate the effectiveness of an exercise protocol designed to induce delayed-onset muscle soreness (DOMS) in paraspinal muscles and its effects on low back functional capacities.

METHODS

Twenty-four healthy participants were asked to perform four series of 25 trunk flexion-extension in a prone position (45° inclined Roman chair). The protocol was performed using loads corresponding to participant's trunk weight plus 10% of their trunk extension maximal voluntary contraction. Perceived soreness and pain were assessed using an 11-point numerical analogue scale three times a day during 5 day post-DOMS protocol. Pressure-pain thresholds (PPT) in paraspinal muscles (L2 and L4 bilaterally) and the vastus medialis (control site), and trunk extension maximal voluntary contraction were assessed 24-36 h post-protocol and compared to baseline (t tests).

RESULTS

Muscle soreness (3.8/10) and pain (2.1/10) peak scores were observed 24-36 h post-protocol (mean of 28 h). A significant reduction in trunk extension maximal voluntary contraction was observed post-protocol (p = 0.005). Significant reductions in PPT were observed post-protocol for all trunk extensor sites (ps < 0.01), but not for the control site (p = 0.40).

CONCLUSIONS

The exercise protocol efficiently led to low back muscle DOMS, reduced functional capacities, and increased pain sensitivity locally. Such protocol could be used as an efficient and safe experimental low back pain model.

Effect of downhill walking on next-day muscle damage and glucose metabolism in healthy young subjects

This study aimed to investigate the effect of downhill walking on muscle damage and glucose metabolism in healthy subjects. All ten healthy young men and women (age, 24.0 ± 1.4 years) performed rest, uphill walking, and downhill walking trials. In the exercise trials, uphill (+ 5%) or downhill (- 5%) treadmill walking was performed at 6 km/h for 30 min. On the next day, muscle soreness was significantly higher in the downhill trial than in the uphill trial (P < 0.01). Respiratory metabolic performance did not differ between trials. However, carbohydrate oxidation was negatively correlated with plasma creatine kinase (r = - 0.41) and muscle soreness (r = - 0.47). Fasting blood glucose was significantly lower in the uphill trial than in the rest trial (P < 0.01) but not in the downhill trial. These observations suggest that downhill but not uphill walking causes mild delayed-onset muscle damage, which did not cause marked impairment in glucose metabolism. However, higher muscle damage responders might exhibit lower glucose metabolism.

Metabolic Profiling of Eccentric Exercise-Induced Muscle Damage in Human Urine

Skeletal muscle can be ultrastructurally damaged by eccentric exercise, and the damage causes metabolic disruption in muscle. This study aimed to determine changes in the metabolomic patterns in urine and metabolomic markers in muscle damage after eccentric exercise. Five men and 6 women aged 19~23 years performed 30 min of the bench step exercise at 70 steps per min at a determined step height of 110% of the lower leg length, and stepping frequency at 15 cycles per min. ¹H NMR spectral analysis was performed in urine collected from all participants before and after eccentric exercise-induced muscle damage conventionally determined using a visual analogue scale (VAS) and maximal voluntary contraction (MVC). Urinary metabolic profiles were built by multivariate analysis of principal component analysis (PCA) and orthogonal partial least square-discriminant analysis (OPLS-DA) using SIMCA-P. From the OPLS-DA, men and women were separated 2 hr after the eccentric exercise and the separated patterns were maintained or clarified until 96 hr after the eccentric exercise. Subsequently, urinary metabolic profiles showed distinct trajectory patterns between men and women. Finally, we found increased urinary metabolites (men: alanine, asparagine, citrate, creatine phosphate, ethanol, formate, glucose, glycine, histidine, and lactate; women: adenine) after the eccentric exercise. These results could contribute to understanding metabolic responses following eccentric exercise-induced muscle damage in humans.

Using blood lactate concentration to predict muscle damage and jump performance response to maximal stretch-shortening cycle exercise

BACKGROUND

It is well known that eccentric muscle contractions induce delayed onset muscle soreness (DOMS) and exertional rhabdomyolysis (ERB), both of which are related to high blood levels of muscle damage markers after exercise. Creatine kinase (CK) is, together with some other markers (i.e. myoglobin, α-actin, skeletal troponin), widely used in determination of muscle damage. Moreover, DOMS after eccentric exercise has been shown to be associated with altered blood lactate concentration after subsequent submaximal or maximal cycling exercise. However, it is unknown whether blood lactate can predict muscle damage levels after maximal stretch-shortening cycle (SSC) exercise, as due to the differences in types of contractions between the eccentric and SSC protocol. Additionally, we determined the association between blood lactate concentration and CMJ performance after such a protocol.

METHODS

Forty-three healthy, physically active young men completed a plyometric training session consisting of maximal countermovement jumps (CMJ) to failure. The blood creatine kinase (CK), myoglobin (Mb) and aspartate aminotransferase (AST) samples were taken pre- and 48 hours post-exercise. Blood lactate concentration was determined directly post-exercise.

RESULTS

There was a significant correlation between blood lactate concentration (post) and blood CK (P=0.027), Mb (P=0.007) and AST (P=0.024) (48 hours post), which means that higher blood lactate concentration is associated with higher muscle damage values after exercise. No correlation was found between blood lactate concentration (post) and performance loss which was expressed by the decrease in maximum CMJ height 5 minutes post-exercise.

CONCLUSIONS

Blood lactate concentration could be used as a predictor of muscle damage levels after maximal SSC exercise, which supports the results found in other studies, although after eccentric exercise. However, it cannot predict acute performance loss in jump height.

Acute kidney injury associated with endurance events-is it a cause for concern? A systematic review

INTRODUCTION

A growing body of evidence suggests even small rises in serum creatinine (SCr) are of considerable clinical relevance. Given that participants in endurance events are exposed to potential (repeated) renal insults, a systematic review was undertaken to collate current evidence for acute kidney injury (AKI), complicating such events.

METHODS

A systematic review of studies and case reports meeting inclusion criteria on Medline and EMBASE (inception to October 2015). Included: studies with markers of renal function before and after endurance or ultraendurance events; case reports of severe AKI. Two reviewers assessed risk of bias using the Newcastle-Ottawa scale.

RESULTS

Eleven case report publications (n=27 individuals) of severe AKI, were retrieved, with risk factors including systemic illness or nephrotoxic medications usually identified. From 30 studies of endurance and ultraendurance events, mean rise in SCr was 29 (±12.3) µmol/L after marathon or ultramarathon (17 studies, n=568 participants) events. Where follow-up tests were conducted, SCr returned to baseline within 48 hours. Rises in biomarkers suggest potential parenchymal insult, rather than simply muscle breakdown. However, evidence of long-term deleterious effects is lacking.

CONCLUSIONS

Raised levels of SCr are reported immediately after endurance events. It is not clear whether this is either clinically significant, or if repeated participation predisposes to long-term sequelae. The aetiology of severe exercise-associated AKI is usually multifactorial, with risk factors generally identified in the rare cases reported. On-site biochemistry, urine analysis and biomarkers of AKI may help identify collapsed runners who are at significant short-term risk and allow suitable follow-up.

The acute benefits and risks of passive stretching to the point of pain

PURPOSE

This study evaluated the acute effects of two different stretch intensities on muscle damage and extensibility.

METHODS

Twenty-two physically active women (age 20 ± 1.0 years) were divided into two matched groups and undertook eight sets of 30-s passive hamstring stretching. One group stretched to the point of discomfort (POD) and the other to the point of pain (POP). Hamstring passive torque, sit and reach (S&R), straight leg raise (SLR), and markers of muscle damage were measured before, immediately after stretching and 24 h later.

RESULTS

S&R acutely increased and was still increased at 24 h with median (interquartile range) of 2.0 cm (0.5-3.75 cm) and 2.0 cm (0.25-3.0 cm) for POP and POD (p < 0.05), respectively, with no difference between groups; similar changes were seen with SLR. Passive stiffness fully recovered by 24 h and there was no torque deficit. A small, but significant increase in muscle tenderness occurred at 24 h in both groups and there was a very small increase in thigh circumference in both groups which persisted at 24 h in POP. Plasma CK activity was not raised at 24 h.

CONCLUSION

Stretching to the point of pain had no acute advantages over stretching to the discomfort point. Both forms of stretching resulted in very mild muscle tenderness but with no evidence of muscle damage. The increased ROM was not associated with changes in passive stiffness of the muscle but most likely resulted from increased tolerance of the discomfort.

Daptomycin Pharmacokinetics and Pharmacodynamics in Septic and Critically Ill Patients

Infections, including sepsis, are associated with high mortality rates in critically ill patients in the intensive care unit (ICU). Appropriate antibiotic selection and adequate dosing are important for improving patient outcomes. Daptomycin is bactericidal in bloodstream infections caused by Staphylococcus aureus and other Gram-positive pathogens cultured in ICU patients. The drug has concentration-dependent activity, and the area under the curve/minimum inhibitory concentration ratio is the pharmacokinetic/pharmacodynamic (PK/PD) index that best correlates with daptomycin activity, whereas toxicity correlates well with daptomycin plasma trough concentrations (or minimum concentration [C min]). Adequate daptomycin exposure can be difficult to achieve in ICU patients; multiple PK alterations can result in highly variable plasma concentrations, which are difficult to predict. For this reason, therapeutic drug monitoring could help clinicians optimize daptomycin dosing, thus improving efficacy while decreasing the likelihood of serious adverse events. This paper reviews the literature on daptomycin in ICU patients with sepsis, focusing on dosing and PK and PD parameters.

Optimum polygenic profile to resist exertional rhabdomyolysis during a marathon

Purpose

Exertional rhabdomyolysis can occur in individuals performing various types of exercise but it is unclear why some individuals develop this condition while others do not. Previous investigations have determined the role of several single nucleotide polymorphisms (SNPs) to explain inter-individual variability of serum creatine kinase (CK) concentrations after exertional muscle damage. However, there has been no research about the interrelationship among these SNPs. The purpose of this investigation was to analyze seven SNPs that are candidates for explaining individual variations of CK response after a marathon competition (ACE = 287bp Ins/Del, ACTN3 = p.R577X, CKMM = NcoI, IGF2 = C13790G, IL6 = 174G>C, MLCK = C37885A, TNFα = 308G>A).

Methods

Using Williams and Folland’s model, we determined the total genotype score from the accumulated combination of these seven SNPs for marathoners with a low CK response (n = 36; serum CK <400 U·L^-1) vs. marathoners with a high CK response (n = 31; serum CK ≥400 U·L^-1).

Results

At the end of the race, low CK responders had lower serum CK (290±65 vs. 733±405 U·L^-1; P<0.01) and myoglobin concentrations (443±328 vs. 1009±971 ng·mL^-1, P<0.01) than high CK responders. Although the groups were similar in age, anthropometric characteristics, running experience and training habits, total genotype score was higher in low CK responders than in high CK responders (5.2±1.4 vs. 4.4±1.7 point, P = 0.02).

Conclusion

Marathoners with a lower CK response after the race had a more favorable polygenic profile than runners with high serum CK concentrations. This might suggest a significant role of genetic polymorphisms in the levels of exertional muscle damage and rhabdomyolysis. Yet other SNPs, in addition to exercise training, might also play a role in the values of CK after damaging exercise.

Insights into the molecular etiology of exercise-induced inflammation: opportunities for optimizing performance

The study of exercise-induced muscle damage (EIMD) is of paramount importance not only because it affects athletic performance but also because it is an excellent model to study the mechanisms governing muscle cachexia under various clinical conditions. Although, a large number of studies have investigated EIMD and its associated inflammatory response, several aspects of skeletal muscles responses remain unclear. In the first section of this article, the mechanisms of EIMD are reviewed in an attempt to follow the events that result in functional and structural alterations of skeletal muscle. In the second section, the inflammatory response associated with EIMD is presented with emphasis in leukocyte accumulation through mechanisms that are largely coordinated by pro- and anti-inflammatory cytokines released either by injured muscle itself or other cells. The practical applications of EIMD and the subsequent inflammatory response are discussed with respect to athletic performance. Specifically, the mechanisms leading to performance deterioration and development of muscle soreness are discussed. Emphasis is given to the factors affecting individual responses to EIMD and the resulting interindividual variability to this phenomenon.

Effect of Muscle-Damaging Eccentric Exercise on Running Kinematics and Economy for Running at Different Intensities

The objective of this study was to explore the changes in running kinematics and economy during running at different intensities 1 and 24 hours after a muscle-damaging bench-stepping exercise. Healthy, physically active adult women were recruited for this study. The subjects' running kinematics, heart rate, gas exchange, minute ventilation, and perceived exertion were continuously recorded during the increasing-intensity running test on a treadmill for different testing conditions: a control condition and 1 and 24 hours after the bench-stepping exercise test. Two muscle damage markers, muscle soreness and blood creatine kinase (CK) activity, were measured before and 24 hours after the stepping exercise. Muscle soreness and blood CK activity were significantly altered (exact p ≤ 0.05, Monte Carlo test) 24 hours after the bench-stepping exercise. The stride length, stride frequency, and support time at different running intensities did not change. Twenty-four hours after the previous step exercise, ankle dorsiflexion in the support phase was significantly higher during severe-intensity running, the range of knee flexion at the stance phase was significantly lower during moderate-intensity running, and knee flexion at the end of the amortization phase was significantly lower during heavy-intensity running compared with the control values (exact p ≤ 0.05, Monte Carlo test). The running economy at moderate and heavy intensities, maximum ventilation, and maximum heart rate did not change. We conclude that, given moderate soreness in the calf muscles 24 hours after eccentric exercise, the running kinematics are slightly but significantly changed without a detectable effect on running economy.

The comparison of cold-water immersion and cold air therapy on maximal cycling performance and recovery markers following strength exercises

This study examined the effects of cold-water immersion (CWI) and cold air therapy (CAT) on maximal cycling performance (i.e. anaerobic power) and markers of muscle damage following a strength training session. Twenty endurance-trained but strength-untrained male (n = 10) and female (n = 10) participants were randomised into either: CWI (15 min in 14 °C water to iliac crest) or CAT (15 min in 14 °C air) immediately following strength training (i.e. 3 sets of leg press, leg extensions and leg curls at 6 repetition maximum, respectively). Creatine kinase, muscle soreness and fatigue, isometric knee extensor and flexor torque and cycling anaerobic power were measured prior to, immediately after and at 24 (T24), 48 (T48) and 72 (T72) h post-strength exercises. No significant differences were found between treatments for any of the measured variables (p > 0.05). However, trends suggested recovery was greater in CWI than CAT for cycling anaerobic power at T24 (10% ± 2%, ES = 0.90), T48 (8% ± 2%, ES = 0.64) and T72 (8% ± 7%, ES = 0.76). The findings suggest the combination of hydrostatic pressure and cold temperature may be favourable for recovery from strength training rather than cold temperature alone.

Muscle Damage following Maximal Eccentric Knee Extensions in Males and Females

Aim

To investigate whether there is a sex difference in exercise induced muscle damage.

Materials and Method

Vastus Lateralis and patella tendon properties were measured in males and females using ultrasonography. During maximal voluntary eccentric knee extensions (12 reps x 6 sets), Vastus Lateralis fascicle lengthening and maximal voluntary eccentric knee extensions torque were recorded every 10° of knee joint angle (20–90°). Isometric torque, Creatine Kinase and muscle soreness were measured pre, post, 48, 96 and 168 hours post damage as markers of exercise induced muscle damage.

Results

Patella tendon stiffness and Vastus Lateralis fascicle lengthening were significantly higher in males compared to females (p<0.05). There was no sex difference in isometric torque loss and muscle soreness post exercise induced muscle damage (p>0.05). Creatine Kinase levels post exercise induced muscle damage were higher in males compared to females (p<0.05), and remained higher when maximal voluntary eccentric knee extension torque, relative to estimated quadriceps anatomical cross sectional area, was taken as a covariate (p<0.05).

Conclusion

Based on isometric torque loss, there is no sex difference in exercise induced muscle damage. The higher Creatine Kinase in males could not be explained by differences in maximal voluntary eccentric knee extension torque, Vastus Lateralis fascicle lengthening and patella tendon stiffness. Further research is required to understand the significant sex differences in Creatine Kinase levels following exercise induced muscle damage.

Time-course of recovery of peak oxygen uptake after exercise-induced muscle damage

V̇O2 peak has been shown to be reduced 48 h following exercise-induced muscle damage (EIMD), but it is unclear how long this reduction may persist. In this study eight endurance trained participants (21.5 ± 1.1 years old) performed a maximal exercise tests over 10-days followings EIMD. Cardiorespiratory variables were collected via open-circuit spirometry and soreness, maximal strength (MVC), motor-unit recruitment, and contractile properties were assessed prior to each test. MVC was reduced for up to 4-days (p ≤ 0.05) and soreness was evident for 10-days in the quadriceps (p < 0.05). V̇O2peak was reduced 7.4% 2-days post EIMD (55.5 ± 6.0 vs. 51.3 ± 5.8; p = 0.006) and remained reduced in 6 of 8 participants at 10-days post (p = 0.005). No relationship was found between changes in MVC, soreness, motor-unit recruitment, and contractile properties and changes in V̇O2peak (p > 0.05). EIMD resulted in small, but prolonged reductions in V̇O2peak. Our findings suggest mechanisms aside from force loss and soreness are primarily responsible for the reductions in V̇O2peak after EIMD.

The relationship of creatine kinase variability with body composition and muscle damage markers following eccentric muscle contractions

[Purpose]

The purpose of the study was to investigate the relationship between CK variability and body composition and muscle damage markers following eccentric exercise.

[Methods]

Total 119 healthy male subjects were recruited to perform 50 eccentric contractions consisted of 2 sets of 25 contractions. Then, blood creatine kinase (CK) activity was analyzed to divide into three groups based on their CK activity levels. Maximum isometric strength (MIS), muscle soreness (SOR) and body composition data were obtained before and after exercise.

[Results]

The results showed that high CK responders had a significant decrease in MIS (p<0.001) and greater SOR (p<0.01) following eccentric exercise compared to low CK responders. Percent body fat was also higher in high responders compared to low responders (p=0.014). Peak CK activity was significantly correlated with MIS and SOR but no correlation with % body fat, muscle mass, and body mass index.

[Conclusion]

CK variability following eccentric exercise is closely related to MIS and SOR and % body fat may be a potent factor for CK variability.

Blood flow after exercise-induced muscle damage

CONTEXT

The most common modality used to address acute inflammation is cryotherapy. Whereas pain decreases with cryotherapy, evidence that changes occur in perfusion of skeletal muscle is limited. We do not know whether ice attenuates the increases in perfusion associated with acute inflammation.

OBJECTIVE

To examine the effects of repeated applications of ice bags on perfusion of the gastrocnemius muscle after an eccentric exercise protocol.

DESIGN

Controlled laboratory study.

SETTING

Laboratory.

PATIENTS OR OTHER PARTICIPANTS

Eighteen healthy participants (3 men, 15 women; age = 22.2 ± 2.2 years, height = 166.0 ± 11.9 cm, mass = 69.4 ± 25.0 kg).

INTERVENTION(S)

To induce eccentric muscle damage, participants performed 100 unilateral heel-lowering exercises off a step to the beat of a metronome. A randomized intervention (cryotherapy, sham, control) was applied to the exercised lower extremity immediately after the protocol and again at 10, 24, and 34 hours after the protocol.

MAIN OUTCOME MEASURE(S)

Baseline perfusion measurements (blood volume, blood flow, and blood flow velocity) were taken using contrast-enhanced ultrasound of the exercised leg. Perfusion was reassessed after the first intervention and 48 hours after the protocol as percentage change scores. Pain was measured with a visual analog scale at baseline and at 10, 24, 34, and 48 hours after the protocol. Separate repeated-measures analyses of variance were used to assess each dependent variable.

RESULTS

We found no interactions among interventions for microvascular perfusion. Blood volume and blood flow, however, increased in all conditions at 48 hours after exercise (P < .001), and blood flow velocity decreased postintervention from baseline (P = .041). We found a time-by-intervention interaction for pain (P = .009). Visual analog scale scores were lower for the cryotherapy group than for the control group at 34 and 48 hours after exercise.

CONCLUSIONS

Whereas eccentric muscle damage resulted in increased blood flow, ice did not decrease muscle perfusion 48 hours after exercise. Therefore, ice does not seem to decrease muscle perfusion when blood flow is elevated, as it would be during inflammation.

S100B as a marker for brain damage and blood-brain barrier disruption following exercise

BACKGROUND

S100B level in the blood has been used as a marker for brain damage and blood-brain barrier (BBB) disruption. Elevations of S100B levels after exercise have been observed, suggesting that the BBB may be compromised during exercise. However, an increase in S100B levels may be confounded by other variables.

OBJECTIVES

The primary objective of this review was to compile findings on the relationship between S100B and exercise in order to determine if this protein is a valid marker for BBB disruptions during exercise. The secondary objective was to consolidate known factors causing S100B increases that may give rise to inaccurate interpretations of S100B levels.

DATA SOURCES AND STUDY SELECTION

PubMed, Web of Science and ScienceDirect were searched for relevant studies up to January 2013, in which S100B measurements were taken after a bout of exercise. Animal studies were excluded. Variables of interest such as the type of activity, exercise intensities, duration, detection methods, presence and extent of head trauma were examined and compiled.

RESULTS

This review included 23 studies; 15 (65 %) reported S100B increases after exercise, and among these, ten reported S100B increases regardless of intervention, while five reported increases in only some trials but not others. Eight (35 %) studies reported no increases in S100B levels across all trials. Most baseline S100B levels fall below 0.16 μg/L, with an increase in S100B levels of less than 0.07 μg/L following exercise. Factors that are likely to affect S100B levels include exercise intensity, and duration, presence and extent of head trauma. Several other probable factors influencing S100B elevations are muscle breakdown, level of training and oxidative stress, but current findings are still weak and inconclusive.

CONCLUSIONS

Elevated S100B levels have been recorded following exercise and are mostly attributed to either an increase in BBB permeability or trauma to the head. However, even in the absence of head trauma, it appears that the BBB may be compromised following exercise, with the severity dependent on exercise intensity.

Vibration Therapy in Management of Delayed Onset Muscle Soreness (DOMS)

Both athletic and nonathletic population when subjected to any unaccustomed or unfamiliar exercise will experience pain 24-72 hours postexercise. This exercise especially eccentric in nature caused primarily by muscle damage is known as delayed-onset muscle soreness (DOMS). This damage is characterized by muscular pain, decreased muscle force production, reduce range of motion and discomfort experienced. DOMS is due to microscopic muscle fiber tears. The presence of DOMS increases risk of injury. A reduced range of motion may lead to the incapability to efficiently absorb the shock that affect physical activity. Alterations to mechanical motion may increase strain placed on soft tissue structures. Reduced force output may signal compensatory recruitment of muscles, thus leading to unaccustomed stress on musculature. Differences in strength ratios may also cause excessive strain on unaccustomed musculature. A range of interventions aimed at decreasing symptoms of DOMS have been proposed. Although voluminous research has been done in this regard, there is little consensus among the practitioners regarding the most effective way of treating DOMS. Mechanical oscillatory motion provided by vibration therapy. Vibration could represent an effective exercise intervention for enhancing neuromuscular performance in athletes. Vibration has shown effectiveness in flexibility and explosive power. Vibration can apply either local area or whole body vibration. Vibration therapy improves muscular strength, power development, kinesthetic awareness, decreased muscle sore, increased range of motion, and increased blood flow under the skin. VT was effective for reduction of DOMS and regaining full ROM. Application of whole body vibration therapy in postexercise demonstrates less pressure pain threshold, muscle soreness along with less reduction maximal isometric and isokinetic voluntary strength and lower creatine kinase levels in the blood.

Metabolic and muscle damage profiles of concentric versus repeated eccentric cycling

PURPOSE

Eccentric cycling is an exercise modality that could elicit multiple health benefits with low metabolic cost, but unaccustomed performance results in significant muscle damage. It is not known whether muscle damage is attenuated when eccentric cycling is repeated; thus, this study compared metabolic and muscle damage responses to concentric (CONC) and two consecutive eccentric (ECC1 and ECC2) cycling bouts.

METHODS

Ten men (28 ± 8 yr) performed each cycling bout for 30 min at 60% of the maximal concentric power output at 60 rpm, with 2 wk between bouts. HR, oxygen consumption (V˙O2), blood lactate (BLa), RPE, and muscle activity (EMG) data were collected during cycling. Maximal voluntary isometric knee extensor (MVC) strength, squat (SJ), countermovement jump (CMJ) height, muscle soreness indicators, and plasma creatine kinase (CK) activity were measured before, immediately after, and 1-4 d after exercise.

RESULTS

Average HR, V˙O2, BLa, and RPE were lower (P < 0.05) during ECC1 than CONC, and EMG amplitude was also lower during ECC1 than CONC. Decreases in MVC, CMJ, and SJ and the increase in muscle soreness were greater (P x0003C; 0.05) after ECC1 than CONC. Increases in creatine kinase were minimal after all bouts. When comparing ECC1 and ECC2, HR and BLa were lower (P < 0.05) during ECC2 than ECC1, and decreases in MVC, CMJ, and SJ and the increase in muscle soreness were greater (P < 0.05) after ECC1 than ECC2. After ECC2, MVC, CMJ, and SJ did not change and no muscle soreness was developed.

CONCLUSIONS

Eccentric cycling was less metabolically demanding than concentric cycling, and HR and BLa were further reduced during ECC2. Muscle damage is minimal after ECC2 and should not influence the choice to undertake eccentric cycling training.

Role of oxidative stress in impaired insulin signaling associated with exercise-induced muscle damage

Skeletal muscle is a major tissue that utilizes blood glucose. A single bout of exercise improves glucose uptake in skeletal muscle through insulin-dependent and insulin-independent signal transduction mechanisms. However, glucose utilization is decreased in muscle damage induced by acute, unaccustomed, or eccentric exercise. The decrease in glucose utilization is caused by decreased insulin-stimulated glucose uptake in damaged muscles with inhibition of the membrane translocation of glucose transporter 4 through phosphatidyl 3-kinase/Akt signaling. In addition to inflammatory cytokines, reactive oxygen species including 4-hydroxy-2-nonenal and peroxynitrate can induce degradation or inactivation of signaling proteins through posttranslational modification, thereby resulting in a disturbance in insulin signal transduction. In contrast, treatment with factors that attenuate oxidative stress in damaged muscle suppresses the impairment of insulin sensitivity. Muscle-damaging exercise may thus lead to decreased endurance capacity and muscle fatigue in exercise, and it may decrease the efficiency of exercise therapy for metabolic improvement.

Microvascular perfusion increases after eccentric exercise of the gastrocnemius

OBJECTIVES

The purpose of this study was to assess microvascular perfusion immediately after eccentric exercise using contrast-enhanced sonography.

METHODS

An intravenous catheter was placed in the antecubital vein of the arm contralateral to the leg being tested for the delivery of microbubbles to 18 healthy volunteers (mean age ± SD, 22.2 ± 2.2 years; height, 166.0 ± 11.9 cm; weight, 69.4 ± 25.0 kg). Eccentric exercises were performed unilaterally in a randomized leg. Calf-lowering repetitions off a raised step were performed to the beat of a metronome over 3 seconds in the sequence of 50 repetitions, 5 minutes of rest, and 50 repetitions. Microvascular perfusion (blood volume, blood flow, and blood flow velocity) was measured before and immediately after exercise using replenishment kinetics.

RESULTS

Blood volume and flow both significantly increased after exercise (P < .001). Baseline measurements were 5.88 ± 1.33 dB and 2.34 ± 0.41 dB/s and increased to 12.20 ± 3.31 dB and 4.52 ± 1.05 dB/s, respectively. There was a significant decrease in blood flow velocity (P = .035) after exercise (0.38 ± 0.03 s(-1)) from baseline (0.41 ± 0.06 s(-1)).

CONCLUSIONS

Circulatory responses were altered after eccentric exercise, which may be due to the metabolic demand placed on the body. On the basis of this finding, eccentric exercise may be used as a model to assess the effect modalities have on the circulatory system after an elevated state of microvascular perfusion is reached.

Genetic polymorphisms associated with exertional rhabdomyolysis

Exertional rhabdomyolysis (ER) occurs in young, otherwise healthy, individuals principally during strenuous exercise, athletic, and military training. Although many risk factors have been offered, it is unclear why some individuals develop ER when participating in comparable levels of physical exertion under identical environmental conditions and others do not. This study investigated possible genetic polymorphisms that might help explain ER. DNA samples derived from a laboratory-based study of persons who had never experienced an episode of ER (controls) and clinical ER cases referred for testing over the past several years were analyzed for single nucleotide polymorphisms (SNPs) in candidate genes. These included angiotensin I converting enzyme (ACE), α-actinin-3 (ACTN3), creatine kinase muscle isoform (CKMM), heat shock protein A1B (HSPA1B), interleukin 6 (IL6), myosin light chain kinase (MYLK), adenosine monophosphate deaminase 1 (AMPD1), and sickle cell trait (HbS). Population included 134 controls and 47 ER cases. The majority of ER cases were men (n = 42/47, 89.4 %); the five women with ER were Caucasian. Eighteen African Americans (56.3 %) were ER cases. Three SNPs were associated with ER: CKMM Ncol, ACTN3 R577X, and MYLK C37885A. ER cases were 3.1 times more likely to have the GG genotype of CKMM (odds ratio/OR = 3.1, confidence interval/CI 1.33-7.10), 3.0 times for the XX genotype of ACTN3 SNP (OR = 2.97, CI 1.30-3.37), and 5.7 times for an A allele of MYLK (OR = 21.35, CI 2.60-12.30). All persons with HbS were also ER cases. Three distinct polymorphisms were associated with ER. Further work will be required to replicate these findings and determine the mechanism(s) whereby these variants might confer susceptibility.

In vivo passive mechanical properties of skeletal muscle improve with massage-like loading following eccentric exercise

A quasi-linear viscoelasticity (QLV) model was used to study passive time-dependent responses of skeletal muscle to repeated massage-like compressive loading (MLL) following damaging eccentric exercise. Six skeletally mature rabbits were surgically instrumented with bilateral peroneal nerve cuffs for stimulation of the hindlimb tibialis anterior (TA) muscles. Following the eccentric exercise, rabbits were randomly assigned to a four-day MLL protocol mimicking deep effleurage (0.5 Hz, 10 N for 15 min or for 30 min). The contralateral hindlimb served as the exercised, no-MLL control for both MLL conditions. Viscoelastic properties of the muscle pre-exercise, post-exercise on Day 1, and pre- and post-MLL Day 1 through Day 4 were determined with ramp-and-hold tests. The instantaneous elastic response (AG(0)) increased following exercise (p<0.05) and decreased due to both the 15 min and 30 min four-day MLL protocols (p<0.05). Post-four days of MLL the normalized AG(0) decreased from post-exercise (Day 1, 248.5%) to the post-MLL (Day 4, 98.5%) (p<0.05), compared to the no-MLL group (Day 4, 222.0%) (p<0.05). Exercise and four-day MLL showed no acute or cumulative effects on the fast and slow relaxation coefficients (p>0.05). This is the first experimental evidence of the effect of both acute (daily) and cumulative changes in viscoelastic properties of intensely exercised muscle due to ex vivo MLL. It provides a starting point for correlating passive muscle properties with mechanical effects of manual therapies, and may shed light on design and optimization of massage protocols.

Cytokine and satellite cell responses to muscle damage: interpretation and possible confounding factors in human studies

It is plausible that multiple muscle biopsies following a muscle damaging intervention can exacerbate the inflammatory and subsequent satellite cell responses. To elucidate confounding effects of muscle biopsy procedure on satellite cell number, indirect markers of damage and the inflammatory response following acute downhill running (DHR) were investigated. 10 healthy male participant were divided into a non-exercising control (n = 4) and DHR (12 × 5min bouts, 10 % decline at 85 % VO(2)max) (n = 6) group. Blood samples were taken pre, post and every 24 h for 9 days. Serum was analysed for creatine kinase (CK), myoglobin (Mb), lactate dehydrogenase (LDH), TNF-α, IL-6 and IL-10. Muscle biopsies taken on days 1 and 2 post intervention from opposing legs were analysed for Pax7(+) satellite cells. In the DHR group, Mb (536 ± 277 ng mL(-1)), IL-6 (12.6 ± 4.7 pg mL(-1)) and IL-10 (27.3 ± 11.5 pg mL(-1)) peaked immediately post DHR, while CK (2651 ± 1911 U L(-1)), LDH (202 ± 47 U L(-1)) and TNF-α (25.1 ± 8.7 pg mL(-1)) peaked on day 1. A 30 % increase in Pax7(+) satellite cells on day 1 in the DHR group was no longer apparent on day 2. H&E staining show evidence of phagocytosis in the DHR group. No significant changes over time were observed in the control group for any of the variables measured. Events observed in the DHR group were as a result of the intervention protocol and subsequent muscle damage. The relationship between SC proliferation and pro-inflammatory cytokine release appears to be complex since the IL-6/IL-10 response time differs significantly from the TNF-α response.

Movement demands in Australian rules football as indicators of muscle damage

The purpose of this study was to determine if there is an association between variables that describe movements in an Australian Rules football (ARF) game with muscle damage. Fourteen elite junior ARF players were monitored with a global positioning system (GPS) during a match, and muscle damage was estimated by determining creatine kinase (CK) 24 hours postmatch. The players were median split based on CK levels, into a high and low CK group, and the groups were compared with independent t-tests. The primary finding was that the group that experienced greater muscle damage (high CK group) generally covered significantly (p < 0.05) greater distances. This was the case for running speeds between 4 and 7 m·s(-1) and, with the exception of high acceleration, all intensities of acceleration and deceleration. The high, as compared with the low, CK group also produced a significantly greater (42%) "player load." All of these significant differences were accompanied by large effect sizes. Group-specific Pearson (r) correlations between CK level and GPS variables suggest that a certain volume of movement is required before the elicitation of a positive relationship beyond trivial or small. Correlations between CK and running speeds >4 m·s(-1) and moderate-high acceleration and deceleration were negative in the low CK (lesser volumes) group. With the exception of low-intensity acceleration/deceleration, the same relationships were positive and generally of a moderate-to-large magnitude in the high CK (greater volumes) group. It may be that a certain volume of movement is required for that movement to be strongly associated with CK levels. It was concluded that selected GPS variables obtained from ARF games can be used as indicators of muscle damage, and this information may be used to individualize recovery strategies after games.

Human muscle proteome modifications after acute or repeated eccentric exercises

INTRODUCTION

Delayed-onset muscle soreness (DOMS), a condition triggered by eccentric exercise, affects muscle cells at a biochemical level in a poorly understood fashion. The objective of the present study was to examine human muscle proteome modifications induced by strenuous eccentric exercises after a specific training aimed to prevent DOMS.

METHODS

Biopsy samples of the rectus femoris were obtained from healthy human volunteers in three successive conditions: 1) at rest, 2) 24 h after an injuring exercise protocol consisting of three series of 30 maximal contractions of the quadriceps on an isokinetic dynamometer, and 3) 24 h after a similar exercise bout preceded either by five eccentric training sessions or by no training.

RESULTS

Muscle damage was assessed before and 1 d after each maximal eccentric test by comparing three indirect markers: plasma activity of creatine kinase, muscle stiffness, and subjective pain intensity. Compared with the first eccentric test, those markers were reduced after the second test and further reduced if this second test followed the eccentric training, thus confirming the protective effect of such training. Muscle protein extracts were subjected to a two-dimensional difference gel electrophoresis proteomic analysis coupled with matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry protein identification. Surprisingly, we observed that myosin heavy chains decreased after the first eccentric test and were reduced further with other contractile proteins after the second test. Furthermore, the expression of several glycolytic enzymes decreased only after the second test, which was preceded by a specific training.

CONCLUSIONS

These findings suggest that the eccentric training resulted in a switch to oxidative metabolism, which may be associated with protection from DOMS.

No effect of carbohydrate-protein on cycling performance and indices of recovery

PURPOSE

The aim of this study was to determine whether adding protein to a CHO beverage would improve late-exercise cycle time-trial performance over CHO alone. Furthermore, we examined the effects of coingesting protein with CHO during exercise on postexercise markers of sarcolemmal disruption and the recovery of muscle function.

METHODS

In a double-blind, crossover design, 12 trained male cyclists performed 120 min of steady-state (SS) cycling at approximately 55% VO2max followed by a time trial lasting approximately 1 h. At 15-min intervals during SS exercise, participants consumed either a CHO or a CHO + protein (CHO + Pro) beverage (providing 65 g x h(-1) CHO or 65 g x h(-1) CHO plus 19 g x h(-1) protein). Twenty-four hours after the onset of the SS cycle, participants completed a maximum isometric strength test. At rest and 24 h postexercise, a visual analog scale was used to determine lower-limb muscle soreness, and blood samples were obtained for plasma creatine kinase concentration. Dietary control was implemented 24 h before and during the time course of each trial.

RESULTS

Average power output sustained during time trial was similar for CHO and CHO + Pro, with no effect of treatment on the time to complete the time trial (60:13 +/- 1:33 and 60:51 +/- 2:40 (min:s) for CHO and CHO + Pro, respectively). Postexercise isometric strength significantly declined for CHO (15% +/- 3%) and CHO + Pro (11% +/- 3%) compared with baseline (486 +/- 28 N). Plasma creatine kinase concentrations, and visual analog scale soreness significantly increased at 24 h postexercise, with no difference between treatments.

CONCLUSIONS

The present findings suggest that CHO + Pro coingestion during exercise does not improve late-exercise time-trial performance, ameliorate markers of sarcolemmal disruption, or enhance the recovery of muscle function at 24 h postexercise over CHO alone.

Stretch-induced membrane damage in muscle: comparison of wild-type and mdx mice

One component of stretch-induced muscle damage is an increase in the permeability of the cell membrane. As a result soluble myoplasmic proteins leak out of the muscle into the plasma, extracellular proteins can enter the muscle, and extracellular ions, including calcium, are driven down their electrochemical gradient into the myoplasm. In Duchenne muscular dystrophy, caused by the absence of the cytoskeletal protein dystrophin, stretch-induced membrane damage is much more severe. The most popular theory to explain the occurrence of stretch-induced membrane damage is that stretched-contractions cause transient mechanically-induced defects in the membrane (tears or rips). Dystrophin, which is part of a mechanical link between the contractile machinery and the extracellular matrix, is thought to contribute to membrane strength so that in its absence mechanically-induced defects are worse. In our view the evidence that stretch-induced muscle damage causes increased membrane permeability is overwhelming but the evidence that the increased permeability is caused by mechanically-induced defects is weak. Instead we review the substantial evidence that the membrane permeability is a secondary consequence of the mechanical events in which elevated intracellular calcium and reactive oxygen species are important intermediaries.

Force per active area and muscle injury during electrically stimulated contractions

Multiple mechanical factors have been implicated in the initiation of exercise-induced muscle injury. Although high absolute force levels are associated with greater injury, the importance of high force per active area independent of absolute force remains to be determined, especially in humans.

PURPOSE

This study sought to examine the role of specific force in muscle injury when peak eccentric force and total eccentric force were matched between two exercise bouts.

METHODS

Ten subjects (six men, four women) performed 80 electrically stimulated (EMS) eccentric contractions of the right and left quadriceps femoris (QF) through a 90 degree arc at approximately 45 degrees x s(-1). Specific force was manipulated by applying 25-Hz EMS to one thigh and 100-Hz EMS to the contralateral thigh, whereas force production was matched by lowering the EMS amplitude during the 100-Hz bout. T2 magnetic resonance images of the QF were collected before and 3 d after the eccentric exercise bouts. Injury was assessed via changes in isometric force and ratings of soreness in the QF over the course of 28 d after exercise and by determining changes in T2 relaxation time and muscle volume 3 d after exercise.

RESULTS

The 100-Hz EMS induced a greater force loss (P < 0. 05), soreness (P < 0.05), change in muscle volume (P = 0.03), and volume of muscle demonstrating an increase in T2 (P = 0.005) compared with 25-Hz EMS.

CONCLUSIONS

Our findings suggest that in humans, high specific force potentially plays an important role in the initiation of exercise-induced muscle injury.

Muscle injury after repeated bouts of voluntary and electrically stimulated exercise

Repeated bouts of eccentric exercise reduce the amount of exercise-induced muscle injury.

PURPOSE

This study sought to evaluate the importance of neural adaptations by comparing the repeated bout effect on muscle injury caused by voluntary and electrically stimulated eccentric exercise.

METHODS

Sixteen subjects (nine men, seven women) were assigned into two groups; electrical stimulation (STIM) and voluntary (VOL). Each group performed 2 identical bouts of 80 eccentric contractions of the quadriceps femoris (QF) through a 90 degree arc at approximately 45 degrees x s(-1), separated by 7 wk. T2-weighted magnetic resonance images of the QF were obtained before and 3 d after each exercise bout. Injury was assessed by determining changes in T2 relaxation time and muscle volume 3 d after exercise, and changes in isometric force and ratings of soreness for 28 d after exercise.

RESULTS

The initial bout of exercise caused significant changes in T2 relaxation time, isometric force, and ratings of soreness in both STIM and VOL groups (P < 0.05). After the repeated bout, significantly smaller changes were noted in soreness ratings (P < 0.05), mean change in T2 (P<0.05), and percentage of the QF demonstrating an increase in T2 (P < 0.05) compared with the initial bout in both exercise groups.

CONCLUSIONS

A repeated-bout effect was observed after electrically stimulated exercise, and the magnitude of the effect was similar to that observed with voluntary exercise. This suggests that the primary mechanism for the reduction in muscle injury after repeated exercise bouts is not related to changes in muscle recruitment and is potentially related to structural changes within the muscles.

Heat shock protein translocation and expression response is attenuated in response to repeated eccentric exercise

AIM

This study hypothesized that heat shock protein (HSP) translocation and upregulation is more probable to occur after eccentric exercise than after concentric exercise or repeated eccentric exercise.

METHODS

Fourteen young, healthy, untrained male subjects completed two bench-stepping exercise bouts with 8 weeks between bouts, and were compared with a control group (n = 6). Muscle biopsies collected from m. vastus lateralis of both legs prior to and at 3 h, 24 h and 7 days after exercise were quantified for mRNA levels and/or for HSP27, alphabeta-crystallin and inducible HSP70 content in cytosolic and cytoskeletal protein fractions.

RESULTS

The first bout of exercise reduced muscle strength and increased muscle soreness predominantly in the eccentric leg (P < 0.05). These responses were attenuated after the repeated eccentric exercise bout (P < 0.05), suggesting a repeated bout adaptation. Increases in inducible HSP70 and HSP27 protein content in cytoskeletal fractions were observed exclusively after eccentric exercise (P < 0.05). For HSP27, an approx. 10-fold upregulation after first-bout eccentric exercise was attenuated to a an approximately fourfold upregulation after the repeated eccentric exercise bout. mRNA levels for HSP70, HSP27 and alphabeta-crystallin were upregulated within approximately two to fourfold ranges at time points 3 and 24 h post-exercise (P < 0.05). This upregulation was induced exclusively by eccentric exercise but with a tendency to attenuated expression 3 h after the repeated eccentric exercise bout.

CONCLUSION

Our results show that HSP translocation and expression responses are induced by muscle damaging exercise, and suggest that such HSP responses are closely related to the extent of muscle damage.

Effects of step exercise on muscle damage and muscle Ca2+ content in men and women

Eccentric exercise often produces severe muscle damage, whereas concentric exercise of a similar load elicits a minor degree of muscle damage. The cellular events initiating muscle damage are thought to include an increase in cytosolic Ca. It was hypothesized that eccentric muscle activity in humans would lead to a larger degree of cell damage and increased intracellular Ca accumulation in skeletal muscle than concentric activity would. Furthermore, possible differences between men and women in muscle damage were investigated following step exercise. Thirty-three healthy subjects (18 men and 15 women) participated in a 30-minute step exercise protocol involving concentric contractions with 1 leg and eccentric contractions with the other leg. Muscle Ca content, maximal voluntary contraction (MVC), and muscle enzymes in the plasma were measured. In a subgroup of the subjects, T2 relaxation time was measured by magnetic resonance imaging. No significant changes were found in muscle Ca content in vastus lateralis biopsy specimens in women or in men. Following step exercise, MVC decreased in both legs of both genders. The women had a significantly larger strength decrease in the eccentric leg than the men had on postexercise day 2 (p < 0.01). Plasma creatine kinase increased following step exercise, with a sevenfold higher response in women than in men on day 3 (p < 0.001). The women, but not the men, had an increase in T2 relaxation time in the eccentrically working adductor magnus muscle, peaking on day 3 (75%) (p < 0.001). In conclusion, step exercise does not lead to Ca accumulation in the vastus lateralis but does induce muscle damage preferentially in the eccentrically working muscles, considerably more in women than in men. This indicates that gender-specific step training programs may be warranted to avoid excessive muscle damage.

Metabolic and anti-inflammatory benefits of eccentric endurance exercise - a pilot study

BACKGROUND

Eccentric endurance exercise (e.g. hiking downwards) is less strenuous than concentric exercise (e.g. hiking upwards) but its potential to reduce cardiovascular risk is unknown.

MATERIALS AND METHODS

We randomly allocated 45 healthy sedentary individuals (16 men and 29 women, mean age 48 years) to one of two groups, one beginning with two months of hiking upwards, the other with two months of hiking downwards the same route, with a crossover for a further two months. For the opposite way, a cable car was used where compliance was recorded electronically. The difference in altitude was 540 metres; the distance was covered three to five times a week. Fasting and postprandial metabolic profiles were obtained at baseline and after the two month periods of eccentric and concentric exercise, respectively.

RESULTS

Forty-two of the 45 participants completed the study; the compliance rate was therefore 93%. Compared with baseline, eccentric exercise lowered total cholesterol (by 4.1%; P = 0.026), low-density lipoprotein (LDL) cholesterol (by 8.4%, P = 0.001), Apolipoprotein B/Apolipoprotein A1 ratio (by 10.9%, P < 0.001), homeostasis model assessment of insulin resistance scores (by 26.2%, P = 0.017) and C-reactive protein (by 30.0%; P = 0.007); the magnitude of these changes was comparable to that of concentric exercise. Eccentric exercise improved glucose tolerance (by 6.2%, P = 0.023), whereas concentric exercise improved triglyceride tolerance (by 14.9%, P = 0.022).

CONCLUSIONS

Eccentric endurance exercise is a promising new exercise modality with favourable metabolic and anti-inflammatory effects and is well applicable to sedentary individuals.

Effects of concentric and repeated eccentric exercise on muscle damage and calpain-calpastatin gene expression in human skeletal muscle

The purpose of this study was to compare the responsiveness of changes in Ca(2+)-content and calpain-calpastatin gene expression to concentric and eccentric single-bout and repeated exercise. An exercise group (n = 14) performed two bouts of bench-stepping exercise with 8 weeks between exercise bouts, and was compared to a control-group (n = 6). Muscle strength and soreness and plasma creatine kinase and myoglobin were measured before and during 7 days following exercise bouts. Muscle biopsies were collected from m. vastus lateralis of both legs prior to and at 3, 24 h and 7 days after exercise and quantified for muscle Ca(2+)-content and mRNA levels for calpain isoforms and calpastatin. Exercise reduced muscle strength and increased muscle soreness predominantly in the eccentric leg (P < 0.05). These responses as well as plasma levels of creatine kinase and myoglobin were all attenuated after the repeated eccentric exercise bout (P < 0.05). Total muscle Ca(2+)-content did not differ between interventions. mRNA levels for calpain 2 and calpastatin were upregulated exclusively by eccentric exercise 24 h post-exercise (P < 0.05), with no alteration in expression between bouts. Calpain 1 and calpain 3 mRNA did not change at any specific time point post-exercise for either intervention. Our mRNA results suggest a regulation on the calpain-calpastatin expression response to muscle damaging eccentric exercise, but not concentric exercise. Although a repeated bout effect was demonstrated in terms of muscle function, no immediate support was provided to suggest that regulation of expression of specific system components is involved in the repeated bout adaptation.