A single set of exhaustive exercise before resistance training improves muscular performance in young men

The neurological effects of acute physical exhaustion on inhibitory function

OBJECTIVE

We aimed to investigate the neural mechanisms underlying the inhibitory function performance of maritime Search and Rescue (SAR) personnel in states of physical exhaustion.

BACKGROUND

SAR missions pose serious challenges to the cognitive function of SAR personnel, especially in extreme environments and physical exhaustion. It is important to understand SAR personnel's cognitive performance and neural activity under exhaustion to improve the efficiency of task execution and ensure work safety.

METHOD

Twenty-six maritime SAR personnel were recruited to simulate boat operations until they reached a self-imposed state of exhaustion. The exhaustion state was monitored by maximum heart rate and subjective fatigue scale. Two event-related potentials, N200 and P300, were measured during a Go-Nogo task before and after a session of acute exhaustive tasks.

RESULTS

After exhaustion, a marked reduction in accuracy, a notable increase in N200 amplitude, and a substantial decline in P300 amplitude under the Nogo condition were observed compared to the baseline phase. Pre- and post-exhaustion comparisons using standardized low-resolution brain electromagnetic tomography revealed reduced activations in the right middle temporal gyrus's N200 component after exhaustion in SAR personnel during the Nogo condition.

CONCLUSION

The results suggest that acute physical exhaustion significantly impacts the inhibition ability of SAR personnel, prolonging the conflict monitoring phase and weakening the response inhibition phase. These findings provide valuable insights into how physical exhaustion affects cognitive functions critical to the safety and effectiveness of SAR operations, and can inform strategies to improve training and equipment to enhance performance under extreme conditions.

Effects of neuromuscular control and strengthening exercises on MRI-measured thigh tissue composition and muscle properties in people with knee osteoarthritis - an exploratory secondary analysis from a randomized controlled trial

OBJECTIVE

To investigate the effects of adding strength training to neuromuscular control exercises on thigh tissue composition and muscle properties in people with radiographic-symptomatic knee osteoarthritis (KOA).

METHODS

In this exploratory secondary analysis of a randomized controlled trial, using a complete-case approach, participants performed 12 weeks of twice-weekly neuromuscular control exercise and patient education (NEMEX, n = 34) or NEMEX plus quadriceps strength training (NEMEX+ST, n = 29). Outcomes were MRI-measured inter- and intramuscular adipose tissue (InterMAT, IntraMAT), quadriceps muscle cross-sectional area (CSA), knee-extensor strength, specific strength (strength/lean CSA) and 30 s chair-stands. Between-group effects were compared using a mixed model analysis of variance.

RESULTS

At 12 weeks, responses to NEMEX+ST overlapped with NEMEX for all outcomes. Both groups reduced InterMAT (NEMEX+ST=25 %, NEMEX=21 %); between-group difference: 0.8cm2 (95 % CI: -0.1, 1.7). NEMEX+ST decreased IntraMAT (2 %) and NEMEX increased IntraMAT (4 %); between-group difference 0.1 %-points (-0.3, 0.5). Both groups increased quadriceps CSA and lean CSA (CSA minus IntraMAT), improved knee-extensor strength and specific strength, and improved chair-stand performance with a trend towards greater effects in NEMEX+ST.

CONCLUSION

Adding strength training to 12 weeks of neuromuscular control exercises provided largely similar effects to neuromuscular control exercises alone in decreasing InterMAT and IntraMAT, in improving knee-extensor strength, CSA and in improving performance-based function in KOA persons, with a trend towards greater effects with additional strength training. Notably, both groups substantially reduced InterMAT and improved specific strength (an index of muscle quality). Our hypothesis-generating work warrants exploration of the roles played by InterMAT and IntraMAT in exercise effects in KOA.

Maximal Number of Repetitions at Percentages of the One Repetition Maximum: A Meta-Regression and Moderator Analysis of Sex, Age, Training Status, and Exercise

The maximal number of repetitions that can be completed at various percentages of the one repetition maximum (1RM) [REPS ~ %1RM relationship] is foundational knowledge in resistance exercise programming. The current REPS ~ %1RM relationship is based on few studies and has not incorporated uncertainty into estimations or accounted for between-individuals variation. Therefore, we conducted a meta-regression to estimate the mean and between-individuals standard deviation of the number of repetitions that can be completed at various percentages of 1RM. We also explored if the REPS ~ %1RM relationship is moderated by sex, age, training status, and/or exercise. A total of 952 repetitions-to-failure tests, completed by 7289 individuals in 452 groups from 269 studies, were identified. Study groups were predominantly male (66%), healthy (97%), < 59 years of age (92%), and resistance trained (60%). The bench press (42%) and leg press (14%) were the most commonly studied exercises. The REPS ~ %1RM relationship for mean repetitions and standard deviation of repetitions were best described using natural cubic splines and a linear model, respectively, with mean and standard deviation for repetitions decreasing with increasing %1RM. More repetitions were evident in the leg press than bench press across the loading spectrum, thus separate REPS ~ %1RM tables were developed for these two exercises. Analysis of moderators suggested little influences of sex, age, or training status on the REPS ~ %1RM relationship, thus the general main model REPS ~ %1RM table can be applied to all individuals and to all exercises other than the bench press and leg press. More data are needed to develop REPS ~ %1RM tables for other exercises.

Strength training in addition to neuromuscular exercise and education in individuals with knee osteoarthritis-the effects on pain and sensitization

BACKGROUND

There is a lack of evidence of the relative effects of different exercise modes on pain sensitization and pain intensity in individuals with knee osteoarthritis (KOA).

METHODS

Ninety individuals with radiographic and symptomatic KOA, ineligible for knee replacement surgery, were randomized to 12 weeks of twice-weekly strength training in addition to neuromuscular exercise and education (ST+NEMEX-EDU) or neuromuscular exercise and education alone (NEMEX-EDU). Outcomes were bilateral, lower-leg, cuff pressure pain- and tolerance thresholds (PPT, PTT), temporal summation (TS), conditioned pain modulation (CPM), self-reported knee pain intensity and number of painful body sites.

RESULTS

After 12 weeks of exercise, we found significant differences in increases in PPT (-5.01 kPa (-8.29 to -1.73, p = .0028)) and PTT (-8.02 kPa (-12.22 to -3.82, p = .0002)) in the KOA leg in favour of ST+NEMEX-EDU. We found no difference in effects between groups on TS, CPM or number of painful body sites. In contrast, there were significantly greater pain-relieving effects on VAS mean knee pain during the last week (-8.4 mm (-16.2 to -0.5, p = .0364) and during function (-16.0 mm (-24.8 to -7.3, p = .0004)) in favour of NEMEX-EDU after 12 weeks of exercise.

CONCLUSION

Additional strength training reduced pain sensitization compared to neuromuscular exercise and education alone, but also attenuated the reduction in pain intensity compared to neuromuscular exercise and education alone. The study provides the first dose- and type-specific insight into the effects of a sustained exercise period on pain sensitization in KOA. Future studies are needed to elucidate the role of different exercise modes.

SIGNIFICANCE

This study is an important step towards better understanding the effects of exercise in pain management of chronic musculoskeletal conditions. We found that strength training in addition to neuromuscular exercise and education compared with neuromuscular exercise and education only had a differential impact on pain sensitization and pain intensity, but also that regardless of the exercise mode, the positive effects on pain sensitization and pain intensity were comparable to the effects of other therapeutic interventions for individuals with knee osteoarthritis.

The Effectiveness of Two Methods of Prescribing Load on Maximal Strength Development: A Systematic Review

Background

Optimal prescription of resistance exercise load (kg) is essential for the development of maximal strength. Two methods are commonly used in practice with no clear consensus on the most effective approach for the improvement of maximal strength.

Objective

The primary aim of this review was to compare the effectiveness of percentage 1RM (% 1RM) and repetition maximum targets (RM) as load prescription methods for the development of maximal strength.

Methods

Electronic database searches of MEDLINE, SPORTDiscus, Scopus, and CINAHL Complete were conducted in accordance with PRISMA guidelines. Studies were eligible for inclusion if a direct measure of maximal strength was used, a non-training control group was a comparator, the training intervention was > 4 weeks in duration and was replicable, and participants were defined as healthy and between the ages of 18–40. Methodological quality of the studies was evaluated using a modified Downs and Black checklist. Percentage change (%) and 95% confidence intervals (CI) for all strength-based training groups were calculated. Statistical significance (p < 0.05) was reported from each study.

Results

Twenty-two studies comprising a total of 761 participants (585 males and 176 females) were found to meet the inclusion criteria. 12 studies were returned for % 1RM, with 10 for RM. All studies showed statistically significant improvements in maximal strength in the training groups (31.3 ± 21.9%; 95% CI 33.1–29.5%). The mean quality rating for all studies was 17.7 ± 2.3. Four studies achieved a good methodological rating, with the remainder classified as moderate.

Conclusions

Both % 1RM and RM are effective tools for improving maximal strength. % 1RM appears to be a better prescriptive method than RM potentially due to a more sophisticated management of residual fatigue. However, large heterogeneity was present within this data. Lower body and multi-joint exercises appear to be more appropriate for developing maximal strength. Greater consensus is required in defining optimal training prescriptions, physiological adaptations, and training status.

Electronic supplementary material

The online version of this article (10.1007/s40279-019-01241-3) contains supplementary material, which is available to authorized users.

Are We Exploring the Potential Role of Specialized Techniques in Muscle Hypertrophy?

Specialized resistance training techniques (e.g., drop-set, rest-pause) are commonly used by well-trained subjects for maximizing muscle hypertrophy. Most of these techniques were designed to allow a greater training volume (i.e., total repetitions×load), due to the supposition that it elicits greater muscle mass gains. However, many studies that compared the traditional resistance training configuration with specialized techniques seek to equalize the volume between groups, making it difficult to determine the inherent hypertrophic potential of these advanced strategies, as well as, this equalization restricts part of the practical extrapolation on these findings. In this scenario, the objectives of this manuscript were 1) to present the nuance of the evidence that deals with the effectiveness of these specialized resistance training techniques and - primarily - to 2) propose possible ways to explore the hypertrophic potential of such strategies with greater ecological validity without losing the methodological rigor of controlling possible intervening variables; and thus, contributing to increasing the applicability of the findings and improving the effectiveness of hypertrophy-oriented resistance training programs.

Low-dose strength training in addition to neuromuscular exercise and education in patients with knee osteoarthritis in secondary care - a randomized controlled trial

OBJECTIVES

To investigate the effects of lower limb strength training in addition to neuromuscular exercise and education (ST + NEMEX-EDU) compared to neuromuscular exercise and education alone (NEMEX-EDU) on self-reported physical function in patients with knee osteoarthritis (KOA).

DESIGN

Patient-blinded, parallel-group randomized controlled trial (RCT).

METHODS

The trial included 90 patients in secondary care with radiographic and symptomatic KOA, ineligible for knee replacement. Both groups exercised twice weekly for 12 weeks. Additional strength training consisted of a single, fatiguing knee extension set (30-60RM) before four sets of leg-press (8-12RM). Primary outcome was the between-group difference on the subscale activities of daily living from the Knee Injury and Osteoarthritis Outcome Score (KOOS_ADL) at 12 weeks. Secondary outcomes included KOOS symptoms, pain, function in sport and recreation, and quality of life, 40 m walk, stair climb, leg extension power, EuroQol-5D-5L, pain medication usage, and adverse events.

RESULTS

There was no statistically significant between-group difference in KOOS_ADL at 12-weeks; adjusted mean difference -1.15 (-6.78 to 4.48). Except for the stair climb test, which demonstrated an adjusted mean difference of 1.15 (0.09-2.21) in favor of ST + NEMEX-EDU, all other outcomes showed no statistically significant between-group differences. Neither group improved leg extension power.

CONCLUSION

The addition of lower-limb strength training, using a low-dose approach, to neuromuscular exercise and education carried no additional benefits on self-reported physical function or on most secondary outcomes. Both groups displayed similar improvements at 12-week follow-up. Hence, the current low-dose strength training approach provided no additional clinical value in this group of KOA patients. Trial identifier (ClinicalTrials.gov): NCT03215602.

Effects of Pre-exhaustion Versus Traditional Resistance Training on Training Volume, Maximal Strength, and Quadriceps Hypertrophy

BACKGROUND

The pre-exhaustion (PreEx) method is used as a resistance training (RT) method to increase muscle mass, yet the chronic effects of this method are poorly understood.

OBJECTIVE

Although readily prescribed as a RT method for promotion of muscle hypertrophy, few researches give light to gains made after chronic PreEx RT. Therefore, we compared the effects of traditional versus PreEx RT programs on muscle strength, body composition, and muscular hypertrophy in adult males.

METHODS

Untrained subjects (age: 31.37 ± 6.83 years; height: 175.29 ± 5.52 cm; body mass: 82.04 ± 13.61 kg; 1RM leg press: 339.86 ± 61.17 kg; 1RM leg extension: 121.71 ± 11.93 kg) were submitted to 9 weeks of RT with weekly sessions. Traditional (TRT) group (n = 12) performed three sets at 45° of leg press exercise at 75% of 1RM, PreEx group (n = 12) completed a set to failure on a leg extension machine prior to the leg press, and the control (CON) group (n = 7) did not train. Maximum strength, muscle thickness, and body composition were analyzed.

RESULTS

PreEx group increased in maximal strength on leg press (16 ± 8%) and leg extension (17 ± 11%), while the TRT group improved by 15 ± 9 and 11 ± 4%, respectively. The thickness of the quadriceps muscles increased for both intervention groups. Specifically, the post-training thickness of the vastus lateralis was significantly higher for PreEx (55%) compared to the CON group. The TRT group presented a greater loss of total and thigh fat mass when compared with the PreEx method. These results were found in the presence of a lower training load for the PreEx group.

CONCLUSION

The PreEx training can decrease the total training volume while maintaining results in strength and hypertrophy when comparing to TRT. However, TRT may be optimal if the goal is to decrease fat mass.

Effect of individualized resistance training prescription with heart rate variability on individual muscle hypertrophy and strength responses

The aim of the present study was to investigate if resistance training (RT), performed with individualized recovery between sessions (RT-IND), promotes greater gains in strength and muscle mass and reduces the variability on adaptations compared to RT with fixed recovery intervals (RT-FIX). Twenty young men (age 21.9 ± 3.3 years) were randomized in the RT-IND and RT-FIX groups. Five days before the beginning of the training, measurements of the root mean square of successive R-R intervals differences (RMSSD) values of each individual were performed to establish the baseline values. Before each RT session, the RMSSD values determined whether the participants from RT-IND protocol were recovered from the previous session. Participants performed the RT session only if RMSSD values had returned to the baseline, otherwise they had to wait for an additional 24 h. RT-FIX performed an RT session every 48 h. Muscle strength was measured by one-maximal repetition (1-RM) test and muscle cross-section area (CSA) of the vastus laterals by ultrasonography were assessed pre- and post-training. 1-RM values increased significantly from pre to post-training for both groups (RT-IND: 30% and RT-FIX: 42%, main time effect, P < 0001), with no significant difference between groups. Muscle CSA increased significantly from pre to post-training (RT-IND: 15.7% and RT-FIX: 15.8%, main time effect, P < 0001), with no significant difference between groups. In conclusion, RT-IND did not increase the gains in muscle strength and mass neither reduce the variability in muscle adaptations when compared to the RT-FIX.

Volume for Muscle Hypertrophy and Health Outcomes: The Most Effective Variable in Resistance Training

Resistance training is the most effective method to increase muscle mass. It has also been shown to promote many health benefits. Although it is deemed safe and of clinical relevance for treating and preventing a vast number of diseases, a time-efficient and minimal dose of exercise has been the focus of a great number of research studies. Similarly, an inverted U-shaped relationship between training dose/volume and physiological response has been hypothesized to exist. However, the majority of available evidence supports a clear dose-response relationship between resistance training volume and physiological responses, such as muscle hypertrophy and health outcomes. Additionally, there is a paucity of data to support the inverted U-shaped response. Although it may indeed exist, it appears to be much more plastic than previously thought. The overarching principle argued herein is that volume is the most easily modifiable variable that has the most evidenced-based response with important repercussions, be these muscle hypertrophy or health-related outcomes.

l-Arginine supplementation does not improve muscle function during recovery from resistance exercise

The purpose of this study was to investigate the effects of l-arginine supplementation on muscle recovery after a single session of high-intensity resistance exercise (RE). Twenty healthy young adult participants (22.8 ± 3.4 years old) were assigned to 1 of 2 groups (N = 10 per group): a placebo-supplement group or an l-arginine-supplement group. The groups completed a session of high-intensity RE (0 h) and 3 subsequent fatigue test sessions (at 24, 48, and 72 h postexercise) to assess the time course of muscle recovery. During the test sessions, we assessed the following dependent variables: number of maximum repetitions, electromyographic signal (i.e., root mean square (RMS) and median frequency (MF) slope), muscle soreness, perceived exertion, blood levels of creatine kinase (CK) and lactate, and testosterone:cortisol ratio. Number of maximum repetitions increased at 48 and 72 h postexercise in both groups (time, P < 0.05). CK levels and muscle soreness increased at 24 h postexercise and then progressively returned to baseline at 72 h post exercise in both groups (time, P < 0.05). Lactate levels increased immediately postexercise but were reduced at 24 h postexercise in both groups (time, P < 0.05). Testosterone:cortisol ratio, RMS, and MF slope remained unchanged during the recovery period in both groups (time, P > 0.05). No significant (P > 0.05) group × time interaction was found for all dependent variables during the recovery period. In conclusion, our data indicate that l-arginine supplementation does not improve muscle recovery following a high-intensity RE session in young adults.

Citrulline Malate Does Not Improve Muscle Recovery after Resistance Exercise in Untrained Young Adult Men

The effects of citrulline malate (CM) on muscle recovery from resistance exercise remains unknown. We aimed to determine if citrulline malate supplementation improves muscle recovery after a single session of high-intensity resistance exercise (RE) in untrained young adult men. Nine young adult men (24.0 ± 3.3 years) participated in a double-blind crossover study in which they received 6 g of CM and placebo (PL) on two occasions, separated by a seven-day washout period. Each occasion consisted of a single session of high-intensity RE (0 h) and three subsequent fatigue tests sessions (at 24, 48, and 72 h) to assess the time course of muscle recovery. During the tests sessions, we assessed the following variables: number of maximum repetitions, electromyographic signal (i.e., root mean square (RMS) and median frequency (MF)), muscle soreness and perceived exertion, as well as blood levels of creatine kinase (CK), lactate, insulin, and testosterone:cortisol ratio. CK levels increased at 24 h post-exercise and remained elevate at 48 and 72 h, with no difference between CM and PL conditions. Muscle soreness increased at 24 h post-exercise, which progressively returned to baseline at 72 h in both conditions. Lactate levels increased immediately post-exercise and remained elevated at 24, 48, and 72 h in both conditions. No significant treatment × time interaction was found for all dependents variables (maximum repetitions, perceived exertion, CK, lactate, RMS, MF, and testosterone:cortisol ratio) during the recovery period. In conclusion, our data indicate that CM supplementation (single 6 g dose pre-workout) does not improve the muscle recovery process following a high-intensity RE session in untrained young adult men.

A comparison of volume-equated knee extensions to failure, or not to failure, upon rating of perceived exertion and strength adaptations

The present study aimed to compare the effects of repetition duration-, volume-, and load-matched resistance training to muscular failure (MMF) or not to muscular failure (NMF) on maximal voluntary isometric knee extensor strength. This design also allowed testing of the efficacy of “5×5” training. Nine recreationally active males (age, 21.4 ± 1.2 years; height, 1.79 ± 0.07 m; weight, 78.4 ± 7.1 kg) performed unilateral resistance training at 80% of maximal torque at 2×/week for 6 weeks. Using their nondominant leg, participants performed 5 sets of 5 repetitions (NMF). Using their dominant leg, participants performed 25 repetitions in as few sets as possible (MMF). All repetitions were performed at a pace of 2 s concentric, 1 s isometric pause, and 2 s eccentric with a 2-min rest interval between sets. Analyses identified significant pre- to post-intervention strength increases for both MMF and NMF, with effect sizes (ESs) of 2.01 and 1.65, respectively, with no significant differences between conditions (p > 0.05). Peak and mean ratings of perceived exertion (RPEs) were significantly higher for MMF compared with NMF conditions (p < 0.0001), and a tendency for significantly higher RPE values reported for later sets for the NMF condition. Total training time per session was significantly longer for NMF compared with MMF (p < 0.001). The present study suggests that in untrained participants, resistance training NMF produces equivocally the same strength increases as training to MMF when volume-matched. However, resistance training to MMF appears to be a more time-efficient protocol and may produce greater strength gains as indicated by a larger ES.

Determination of a strength index for upper body local endurance strength in sedentary individuals: a cross sectional analysis

A range of balance between flexor and extensor muscles is fundamental in order to prevent pathologies caused by bad postures or to ensure health of the joint as a measure of prevention of overtraining in specific muscle groups. Therefore, the aim of this study is to examine the ratio between "pulling" and "pushing" strength in sedentary individuals. 212 healthy participants, of both genders (139 male and 73 female; age 32 ± 13.3 years, weight 70.2 ± 14.1 kg, height 173 ± 9 cm) were retained for investigation. Strength was assessed through a new methodology: Pulling through a lat-pulldown test while pushing strength through a chest-press test. Both tests were performed to exhaustion with an overload of 30 % of each participants bodyweight. Such method aims to prevent excessive overloads in sedentary individuals. Pearson's correlations and a t test to assess differences were analyzed. Subsequently, the ratio for both genders of pulling and pushing local endurance strength was assessed by means. A mean number of 57 repetitions was shown with the lat-pulldown while 34 repetition with the chest press. A correlation of 0.42 has been found between the number of repetitions of the two tests. A significant difference (p < 0.001) was found between such performances. No correlation was found between the strength measures and the anthropometric parameters of the participants. The lat machine to chest press ratio was 1.36:1 for male while 2.69:1 for female. The results indicate that sedentary participants have higher pulling rather than pushing local endurance strength. Such ratio should be considered as a normative value when starting to perform exercise protocols. Resistance training should be performed in order to improve strength measures of the weaker muscles and reduce such ratio.