Peripheral conduit and resistance artery function are improved following a single, 1-h bout of peristaltic pulse external pneumatic compression

The Effect of Combined Transcranial Direct Current Stimulation and Pneumatic Compression as Part of a Comprehensive Recovery Strategy in Professional Male Top-Level Soccer Players

ABSTRACT

Gonçalves, DS, Moscaleski, LA, da Silva, GM, Morgans, R, Okano, AH, and Moreira, A. The effect of combined transcranial direct current stimulation and pneumatic compression as part of a comprehensive recovery strategy in professional male top-level soccer players. J Strength Cond Res 38(9): 1658-1666, 2024-This retrospective study aimed to examine the effect of transcranial direct current stimulation (tDCS) combined with lower limb pneumatic compression during the postmatch recovery period in top-level professional male soccer players' physiological and perceptual markers of recovery status. During the 2022 season (baseline), pneumatic compression was performed as part of the recovery strategy, applied the day after official match play and psychophysiological measurements (pain, sleep, perceived recovery, and creatine kinase [CK] sampling) were performed on the second day postmatch. During the 2023 season, the tDCS protocol was introduced, with its application being performed simultaneously (in conjunction) with pneumatic compression. Recovery sessions following 10 matches in the 2022 season and following 10 matches in the 2023 season were included in the analyses. Compared with 2022 (baseline; pneumatic compression isolated), the players perceived an increased recovery on the second day postmatch when tDCS was used in conjunction with the pneumatic compression (mean = 12%; p = 0.008) and rated improved sleep quality for the nights after applying tDCS combined with pneumatic compression (mean = 7.5%; p = 0.029). On the second day postmatch, a significant reduction was observed in muscle pain/soreness (mean = 64%; p < 0.0001) and the CK concentration decreased when baseline (pneumatic compression isolated) was compared with tDCS + pneumatic compression (mean = 76%; p = 0.001). In summary, combining pneumatic compression with tDCS may enhance the effects of both interventions, leading to greater overall improvements in recovery. Further research is warranted to confirm these findings and explore the underlying mechanisms in more detail.

Effects of intermittent pneumatic compression on the recovery of cardiovascular parameters after repeated sprint exercise

PURPOSE

Intermittent pneumatic compression (IPC) applies gradual pressure to facilitate lymph and blood flow movement to reduce exercise-induced tissue fluid accumulation and plasma volume loss. This study aimed to evaluate the cardiovascular system response during the recovery with IPC compared with passive recovery (Sham).

METHODS

Sixteen volunteers (7 females and 9 males) executed a cycling-based exhausting sprint interval exercise (8 × 20 s all out), followed by a 30-min IPC or Sham condition. Participants performed two trials in a randomised, counterbalanced, and crossover design. Several cardiovascular parameters (blood pressure, heart function, and peripheral vascular resistance) were recorded at baseline (5'), through the recovery protocol (30'), and afterwards (5').

RESULTS

The use of IPC during the recovery phase led to a faster recovery, stated in relative values to pre-exercise, in mean blood pressure (102.5 ± 19.3% vs. 92.7 ± 12.5%; P < 0.001), and cardiac output (139.8 ± 30.0% vs. 146.2 ± 40.2%; P < 0.05) in comparison to Sham condition. Furthermore, during the IPC-based recovery, there was a slower recovery in cardiac pressure change over time (92.5 ± 25.8% vs. 100.5 ± 48.9%; P < 0.05), and a faster return to pre-exercise values in the peripheral vascular resistance (75.2 ± 25.5% vs. 64.8 ± 17.4%; P < 0.001) compared to Sham.

CONCLUSION

The application of IPC after high-intensity exercise promotes the recovery of the cardiovascular system, reducing cardiovascular strain. Future investigations should consider the effects on the sympathetic-parasympathetic balance, such as heart rate variability, to assess further bonds between the use of IPC and autonomous control.

Effects of different intermittent pneumatic compression stimuli on ankle dorsiflexion range of motion

Despite substantial evidence of the effectiveness of intermittent pneumatic compression (IPC) treatments for range of motion (ROM) improvement, little evidence is available regarding how different IPC stimuli affect ankle dorsiflexion (DF) ROM. This study aimed to investigate the effects of different IPC stimuli on the ankle DF ROM. Fourteen, university intermittent team sport male athletes (age: 21 ± 1 year, height: 1.74 ± 0.05 m, body mass: 70.9 ± 7.7 kg, body fat percentage: 14.2 ± 3.6%, body mass index: 23.5 ± 2.5 kg/m²; mean ± standard deviation) completed four experimental trials in a random order: 1) no compression with wearing IPC devices (SHAM), 2) the sequential compression at approximately 80 mmHg (SQUEE80), 3) the uniform compression at approximately 80 mmHg (BOOST80), and 4) the uniform compression at approximately 135 mmHg (BOOST135). For the experimental trials, the participants were initially at rest for 10 min and then assigned to either a 30-min SHAM, SQUEE80, BOOST80, or BOOST135. Participants rested for 20 min after IPC treatment. The Weight-Bearing Lunge Test (WBLT), popliteal artery blood flow, pressure-to-pain threshold (PPT), muscle hardness, heart rate variability, and perceived relaxation were measured before (Pre) and immediately after IPC treatment (Post-0) and 20 min after IPC treatment (Post-20), and the changes in all variables from Pre (Δ) were calculated. ΔWBLT performance, ΔPPT, and Δperceived relaxation in all IPC treatments were significantly higher than those in SHAM at Post-0 and Post-20 (p < 0.05). ΔPopliteal artery blood flow in BOOST80 and BOOST135 was significantly higher than that in SHAM and SQUEE80 at Post-0 (p < 0.05). ΔMuscle hardness and Δheart rate variability did not differ significantly between trials. In conclusion, IPC treatments, irrespective of applied pressure and mode of compression, increased ankle DF ROM. This resulted from decreased pain sensitivity (i.e., increased PPT). In addition, high inflation pressure and frequency did not provide additional benefits in increasing ankle DF ROM.

Effects of an external pneumatic compression device vs static compression garment on peripheral circulation and markers of sports performance and recovery

PURPOSE

To identify the effects of a single 30 min partial lower leg external pneumatic compression (EPC) treatment compared to a static compression (SC) garment or a no treatment control (CTL) on markers of recovery and performance following a muscle damaging protocol.

METHODS

Thirty healthy, active males (23 ± 3 years; 180.2 ± 9.0 cm; 81.6 ± 11.3 kg) performed 100 drop jumps from a 0.6 m box followed by a randomized, single 30 min treatment of either a partial lower leg EPC device worn below the knee and above the ankle (110 mmHg), SC garment (20-30 mmHg) covering the foot and calf just below the knee, or no treatment CTL, and then returned 24 and 48 h later. Participants were assessed for measures of muscle soreness, fatigue, hemodynamics, blood lactate, muscle thickness, circumferences, and performance assessments.

RESULTS

The drop jump protocol significantly increased muscle soreness (p < 0.001), fatigue (p < 0.001), blood flow (p < 0.001), hemoglobin (p < 0.001), and muscle oxygen saturation (SMO₂; p < 0.001). Countermovement jump and squat jump testing completed after treatment with either EPC, SC, or CTL revealed no differences for jump height between any condition. However, EPC treatment maintained consistent braking force and propulsive power measures across all timepoints for countermovement jump testing. EPC and SC treatment also led to better maintenance of squat jump performance for average relative propulsive force and power variables at 24 and 48 h compared to CTL.

CONCLUSIONS

A single 30 min partial leg EPC treatment may lead to more consistent jump performance following a damaging bout of exercise.

Neither Peristaltic Pulse Dynamic Compressions nor Heat Therapy Accelerate Glycogen Resynthesis after Intermittent Running

PURPOSE

To investigate the effects of a single session of either peristaltic pulse dynamic leg compressions (PPDC) or local heat therapy (HT) after prolonged intermittent shuttle running on skeletal muscle glycogen content, muscle function, and the expression of factors involved in skeletal muscle remodeling.

METHODS

Twenty-six trained individuals were randomly allocated to either a PPDC (n = 13) or a HT (n = 13) group. After completing a 90-min session of intermittent shuttle running, participants consumed 0.3 g·kg-1 protein plus 1.0 g·kg-1 carbohydrate and received either PPDC or HT for 60 min in one randomly selected leg, while the opposite leg served as control. Muscle biopsies from both legs were obtained before and after exposure to the treatments. Muscle function and soreness were also evaluated before, immediately after, and 24 h after the exercise bout.

RESULTS

The changes in glycogen content were similar (P > 0.05) between the thigh exposed to PPDC and the control thigh ~90 min (Control: 14.9 ± 34.3 vs PPDC: 29.6 ± 34 mmol·kg-1 wet wt) and ~210 min (Control: 45.8 ± 40.7 vs PPDC: 52 ± 25.3 mmol·kg-1 wet wt) after the treatment. There were also no differences in the change in glycogen content between thighs ~90 min (Control: 35.9 ± 26.1 vs HT: 38.7 ± 21.3 mmol·kg-1 wet wt) and ~210 min (Control: 61.4 ± 50.6 vs HT: 63.4 ± 17.5 mmol·kg-1 wet wt) after local HT. The changes in peak torque and fatigue resistance of the knee extensors, muscle soreness, and the mRNA expression and protein abundance of select factors were also similar (P > 0.05) in both thighs, irrespective of the treatment.

CONCLUSIONS

A single 1-h session of either PPDC or local HT does not accelerate glycogen resynthesis and the recovery of muscle function after prolonged intermittent shuttle running.

The long-term arterial assist intermittent pneumatic compression generating venous flow obstruction is responsible for improvement of arterial flow in ischemic legs

Background

There is a large group of patients with ischemia of lower limbs not suitable for surgical reconstruction of arteries treated with the help of external assist by intermittent pneumatic compression devices (IPC). Until recently the generally accepted notion was that by compressing tissues below the knee, veins become emptied, venous pressure drops to zero and the increased arterial-venous pressure gradient enables greater arterial flow. We used a pump that, in contradiction to the “empty veins” devices, limited the limb venous outflow by venous obstructions and in a long period therapy expanded the perfusion vessels and brought about persistent reactive hyperemia.

Aim

To check the toe and calf arterial inflow measured by venous stasis plethysmography and capillary flow velocity during arterial assist IPC in a long-term therapy of ischemic legs.

Material and methods

Eighteen patients (12M, 6F) age 62 to 75 with leg peripheral arterial disease (PAD, Fontaine stage II) were studied. Pneumatic device with two 10cm wide cuffs (foot, calf) (Bio Compression Systems, Moonachie, NJ, USA) inflated to 120 mmHg for 5–6 sec to obstruct the venous flow, deflation time 16 sec, applied for 45–60 min daily for a period of 2 years.

Results

At pump inflation increase in toe arterial pressure, volume, capillary blood flow velocity and one-minute arterial inflow test was observed. Increased toe volume appeared concomitantly with the inflated chamber venous obstruction. Resting pressure in the great saphenous vein increased. The two years therapy showed persistence of the resting limb increased toe capillary flow. Intermittent claudication distance increased by 20–120%. After two years arterial assist TBI increased from 0.2 to 0.6 (range 0.3 to 0.8) (p<0.05 vs pre-therapy). The toe arterial inflow dominated over that in calf skin and muscles, nevertheless, there was prolongation of the claudication distance presumably due to dilatation of exchange vessels also in muscles.

Conclusions

Our arterial assist IPC brought about increase in the toe capillary flow, long lasting dilatation of toe capillaries and extension of painless walking distance. The crucial factor of rhythmic repeated venous outflow obstructions should be taken into account in designing effective assist devices.

Effects of Intermittent Pneumatic Compression on Leg Vascular Function in People with Spinal Cord Injury: A Pilot Study

Objective: The purpose of this pilot study was to determine whether 60 mins of intermittent pneumatic compression therapy (IPC) could acutely increase leg blood flow-induced shear stress and enhance vascular endothelial function in persons with spinal cord injury (SCI). Design: Pretest with multiple posttests, within subject randomized control design. Setting: University of Southern Mississippi, Spinal Cord Injury Research Program within the School of Kinesiology, recruiting from the local community in Hattiesburg, Jackson, and Gulfport, MS. Participants: Eight adults with SCI (injury level: T3 and below; ASIA class A-C; age: 41±17 yrs). Interventions: A 60-min IPC session was performed in one leg (experimental leg; EXP), with the other leg serving as a control (CON). Outcomes Measures: Posterior-tibial artery shear rate (Doppler-ultrasound) was examined at rest, and at 15 and 45 mins during IPC. Endothelial function was assessed using the flow-mediated dilation (FMD) technique, before and after IPC. Results: Resting FMD (mm) was similar between legs at rest. A two-way repeated measures ANOVA (leg x time) revealed that during IPC, peak shear rate increased in the EXP leg (215±137 to 285±164 s^-1 at 15 mins; +39±29%, P = 0.03), with no change occurring in the CON. In addition, FMD significantly increased in the EXP leg (Pre IPC: 0.36±0.14 vs. Post IPC: 0.47±0.17 mm; P = 0.011, d = 0.66), with no change occurring in the CON leg. Conclusion: These preliminary findings suggests that IPC therapy may acutely increase leg shear stress within 15 mins, with a resultant moderate-large improvement in vascular endothelial function after 60 mins in people with SCI.

Accelerating Recovery from Exercise-Induced Muscle Injuries in Triathletes: Considerations for Olympic Distance Races

The triathlon is one of the fastest developing sports in the world due to expanding participation and media attention. The fundamental change in Olympic triathlon races from a single to a multistart event is highly demanding in terms of recovery from and prevention of exercise-induced muscle injures. In elite and competitive sports, ultrastructural muscle injuries, including delayed onset muscle soreness (DOMS), are responsible for impaired muscle performance capacities. Prevention and treatment of these conditions have become key in regaining muscular performance levels and to guarantee performance and economy of motion in swimming, cycling and running. The aim of this review is to provide an overview of the current findings on the pathophysiology, as well as treatment and prevention of, these conditions in compliance with clinical implications for elite triathletes. In the context of DOMS, the majority of recovery interventions have focused on different protocols of compression, cold or heat therapy, active regeneration, nutritional interventions, or sleep. The authors agree that there is a compelling need for further studies, including high-quality randomized trials, to completely evaluate the effectiveness of existing therapeutic approaches, particularly in triathletes. The given recommendations must be updated and adjusted, as further evidence emerges.

Unilateral application of an external pneumatic compression therapy improves skin blood flow and vascular reactivity bilaterally

Background

We sought to determine the effects of unilateral lower-limb external pneumatic compression (EPC) on bilateral lower-limb vascular reactivity and skin blood flow.

Methods

Thirty-two participants completed this two-aim study. In AIM1 (n = 18, age: 25.5 ± 4.7 years; BMI: 25.6 ± 3.5 kg/m²), bilateral femoral artery blood flow and reactivity (flow mediated dilation [FMD]) measurements were performed via ultrasonography at baseline (PRE) and immediately following 30-min of unilateral EPC treatment (POST). AIM2 (n = 14, age: 25.9 ± 4.5; BMI: 27.2 ± 2.7 kg/m²) involved 30-min unilateral EPC (n = 7) or sham (n = 7) treatment with thermographic bilateral lower-limb mean skin temperature (MST) measurements at baseline, 15-min of treatment (T15) and 0, 30 and 60-min (R0, R30, R60) following treatment.

Results

Comparative data herein are presented as mean ± 95% confidence interval. AIM1: No significant effects on total reactive hyperemia blood flow were observed for the treated (i.e., compressed) or untreated (i.e., non-compressed) leg. A significant effect of time, but no time*leg interaction, was observed for relative FMD indicating higher reactivity bilaterally with unilateral EPC treatment (FMD: +0.41 ± 0.09% across both legs; p < 0.05). AIM2: Unilateral EPC treatment was associated with significant increases in whole-leg MST from baseline during (T15: +0.63 ± 0.56 °C in the visible untreated/contralateral leg, p < 0.025) and immediately following treatment (i.e., R0) in both treated (+1.53 ± 0.59 °C) and untreated (+0.60 ± 0.45 °C) legs (p < 0.0125). Across both legs, MST remained elevated with EPC at 30-min post-treatment (+0.60 ± 0.45 °C; p < 0.0167) but not at 60-min post (+0.27 ± 0.46 °C; p = 0.165). Sham treatment was associated with a significant increase in the treated leg immediately post-treatment (+1.12 ± 0.31 °C; p < 0.0167), but not in the untreated leg (−0.27 ± 0.12 °C). MST in neither the treated or untreated leg were increased relative to baseline at R30 or R60 (p > 0.05). Finally, during treatment and at all post-treatment time points (i.e., R0, R30 and R60), independent of treatment group (EPC vs. sham), there was a significant effect of region. The maximum increase in MST was observed at the R0 time point and was significantly (p < 0.05) larger in the thigh region (+1.02 ± 0.31 °C) than the lower-leg (+0.47 ± 0.29 °C) region. However, similar rates of MST decline from R0 in the thigh and lower leg regions were observed at the R30 and R60 time points.

Discussion

Unilateral EPC may be an effective intervention for increasing skin blood flow and/or peripheral conduit vascular reactivity in the contralateral limb. While EPC was effective in increasing whole-leg MST bilaterally, there appeared to be a more robust response in the thigh compared to the lower-leg. Thus, proximity along the leg may be an important consideration in prospective treatment strategies.

Impact of external pneumatic compression target inflation pressure on transcriptome-wide RNA expression in skeletal muscle

Next‐generation RNA sequencing was employed to determine the acute and subchronic impact of peristaltic pulse external pneumatic compression (PEPC) of different target inflation pressures on global gene expression in human vastus lateralis skeletal muscle biopsy samples. Eighteen (N = 18) male participants were randomly assigned to one of the three groups: (1) sham (n = 6), 2) EPC at 30–40 mmHg (LP‐EPC; n = 6), and 3) EPC at 70–80 mmHg (MP‐EPC; n = 6). One hour treatment with sham/EPC occurred for seven consecutive days. Vastus lateralis skeletal muscle biopsies were performed at baseline (before first treatment; PRE), 1 h following the first treatment (POST1), and 24 h following the last (7th) treatment (POST2). Changes from PRE in gene expression were analyzed via paired comparisons within each group. Genes were filtered to include only those that had an RPKM ≥ 1.0, a fold‐change of ≥1.5 and a paired t‐test value of <0.01. For the sham condition, two genes at POST1 and one gene at POST2 were significantly altered. For the LP‐EPC condition, nine genes were up‐regulated and 0 genes were down‐regulated at POST1 while 39 genes were up‐regulated and one gene down‐regulated at POST2. For the MP‐EPC condition, two genes were significantly up‐regulated and 21 genes were down‐regulated at POST1 and 0 genes were altered at POST2. Both LP‐EPC and MP‐EPC acutely alter skeletal muscle gene expression, though only LP‐EPC appeared to affect gene expression with subchronic application. Moreover, the transcriptome response to EPC demonstrated marked heterogeneity (i.e., genes and directionality) with different target inflation pressures.

Concomitant external pneumatic compression treatment with consecutive days of high intensity interval training reduces markers of proteolysis

PURPOSE

To compare the effects of external pneumatic compression (EPC) and sham when used concurrently with high intensity interval training (HIIT) on performance-related outcomes and recovery-related molecular measures.

METHODS

Eighteen recreationally endurance-trained male participants (age: 21.6 ± 2.4 years, BMI: 25.7 ± 0.5 kg/m², VO_2peak: 51.3 ± 0.9 mL/kg/min) were randomized to balanced sham and EPC treatment groups. Three consecutive days of HIIT followed by EPC/sham treatment (Days 2-4) and 3 consecutive days of recovery (Days 5-7) with EPC/sham only on Days 5-6 were employed. Venipuncture, flexibility and pressure-to-pain threshold (PPT) measurements were made throughout. Vastus lateralis muscle was biopsied at PRE (i.e., Day 1), 1-h post-EPC/sham treatment on Day 2 (POST1), and 24-h post-EPC/sham treatment on Day 7 (POST2). 6-km run time trial performance was tested at PRE and POST2.

RESULTS

No group × time interaction was observed for flexibility, PPT, or serum measures of creatine kinase (CK), hsCRP, and 8-isoprostane. However, there was a main effect of time for serum CK (p = 0.005). Change from PRE in 6-km run times at POST2 were not significantly different between groups. Significant between-groups differences existed for change from PRE in atrogin-1 mRNA (p = 0.018) at the POST1 time point (EPC: - 19.7 ± 8.1%, sham: + 7.7 ± 5.9%) and atrogin-1 protein concentration (p = 0.013) at the POST2 time point (EPC: - 31.8 ± 7.5%, sham: + 96.0 ± 34.7%). In addition, change from PRE in poly-Ub proteins was significantly different between groups at both the POST1 (EPC: - 26.0 ± 10.3%, sham: + 34.8 ± 28.5%; p = 0.046) and POST2 (EPC: - 33.7 ± 17.2%, sham: + 21.4 ± 14.9%; p = 0.037) time points.

CONCLUSIONS

EPC when used concurrently with HIIT and in subsequent recovery days reduces skeletal muscle markers of proteolysis.

Does external pneumatic compression treatment between bouts of overreaching resistance training sessions exert differential effects on molecular signaling and performance-related variables compared to passive recovery? An exploratory study

Purpose

We sought to compare the effects of external pneumatic compression (EPC) and sham when used concurrently with resistance training on performance-related outcomes and molecular measures related to recovery.

Methods

Twenty (N = 20) resistance-trained male participants (aged 21.6±2.4 years) were randomized to balanced sham or EPC intervention groups. The protocol consisted of 3 consecutive days of heavy, voluminous back squat exercise followed by EPC/sham treatment (Days2-4) and 3 consecutive days of recovery (Days5-7) with EPC/sham only on Days5-6. On Day1 (PRE), and Days3-7, venipuncture, flexibility and pressure-to-pain threshold (PPT) measures were performed. Vastsus lateralis muscle tissue was biopsied at PRE, 1-h post-EPC/sham treatment on Day2 (POST1) and 24-h post-EPC/sham treatment on Day7 (POST2). Isokinetic peak torque was assessed at PRE and POST2.

Results

Peak isokinetic strength did not change from PRE to POST2 in either group. The PPT was significantly lower on Days3-6 with sham, indicating greater muscle soreness, though this was largely abolished in the EPC group. A significant decrease in flexibility with sham was observed on Day3 (+16.2±4.6% knee joint angle; P<0.01) whereas there was no change with EPC (+2.8±3.8%; P>0.01). Vastus lateralis poly-ubiquitinated proteins significantly increased at the POST2 time point relative to PRE with sham (+66.6±24.6%; P<0.025) and were significantly greater (P<0.025) than those observed with EPC at the same time point (-18.6±8.5%). 4-hydroxynonenal values were significantly lower at POST2 relative to PRE with EPC (-16.2±5.6%; P<0.025) and were significantly lower (P<0.025) than those observed with sham at the same time point (+11.8±5.9%).

Conclusion

EPC mitigated a reduction in flexibility and PPT that occurred with sham. Moreover, EPC reduced select skeletal muscle oxidative stress and proteolysis markers during recovery from heavy resistance exercise.

A single 60-min bout of peristaltic pulse external pneumatic compression transiently upregulates phosphorylated ribosomal protein s6

We investigated whether a single 60-min bout of whole leg, peristaltic pulse external pneumatic compression (EPC) altered select growth factor-related mRNAs and/or various phospho(p)-proteins related to cell growth, proliferation, inflammation and apoptosis signalling (e.g. Akt-mTOR, Jak-Stat). Ten participants (8 males, 2 females; aged 22·2 ± 0·4 years) reported to the laboratory 4 h post-prandial, and vastus lateralis muscle biopsies were obtained prior to (PRE), 1 h and 4 h post-EPC treatment. mRNA expression was analysed using real-time RT-PCR and phosphophorylated and cleaved proteins were analysed using an antibody array. No changes in selected growth factor-related mRNAs were observed following EPC. All p-proteins significantly altered by EPC decreased, except for p-rps6 (Ser235/236) which increased 31% 1 h post-EPC compared to PRE levels (P = 0·016). Notable decreases also included p-BAD (Ser112; -28%, P = 0·004) at 4 h post-EPC compared to PRE levels. In summary, an acute bout of EPC transiently upregulates p-rps6 as well as affecting other markers in the Akt-mTOR signalling cascade. Future research should characterize whether chronic EPC application promotes alterations in lower-limb musculature and/or enhances exercise-induced training adaptations.

Preconditioning with peristaltic external pneumatic compression does not acutely improve repeated Wingate performance nor does it alter blood lactate concentrations during passive recovery compared with sham

Application of dynamic external pneumatic compression (EPC) during recovery from athletic activities has demonstrated favorable effects on flexibility, soreness, swelling, and blood lactate (BLa) concentrations. However, the effects of "preconditioning" with a peristaltic pulse EPC device on subsequent performance and BLa concentrations have not been characterized. Herein, we demonstrate that pretreatment for 30 min with EPC has no effect on subsequent supramaximal exercise performance or BLa concentrations during passive recovery.