The Effects of Ischemic Preconditioning on Human Exercise Performance: A Counterpoint

Compression Stockings Used During Two Soccer Matches Improve Perceived Muscle Soreness and High-Intensity Performance

ABSTRACT

Gimenes, SV, Marocolo, M, Pavin, LN, Pagoto Spigolon, LM, Neto, OB, Côrrea da Silva, BV, Duffield, R, and Ribeiro da Mota, G. Compression stockings used during two soccer matches improve perceived muscle soreness and high-intensity performance. J Strength Cond Res 35(7): 2010-2017, 2021-Evidence on the use of compression stockings (CS) during soccer matches is limited. Thus, we evaluated the acute effects of CS on match-based physical performance indicators and perceptual responses during 2 consecutive soccer matches with 72-hour recovery. Twenty outfield players were randomly allocated to the CS group (20-30 mm Hg) or control group (non-CS) and performed 2 matches (5 players using CS or regular socks per team/match). Match loads {rating of perceived exertion × minutes; CS ∼830 vs. control 843 (arbitrary units [AU])} and heart rate (HR) responses (both CS and control ∼86% HRpeak) did not differ (p > 0.05) between CS and control groups. Although total distance covered did not differ (p > 0.05) between groups, CS increased distances (effect size [ES] = 0.9-1.32) in higher-speed zones (>19 km·h-1 CS ∼550 m vs. control ∼373 m) alongside an increased number of accelerations (-50.0 to -3.0 m·s-2) than control (CS: 33.7 ± 11.2 vs. control: 23.8 ± 7.9; p = 0.003; ES = 1.04). Perceived recovery did not differ (p > 0.05) between groups for either match but was worse in the second match for both groups. Perceived muscle soreness increased in control after match 2 (from 3.1 ± 1.9 to 6.3 ± 1.6 AU; p < 0.0010) but did not in CS (from 2.8 ± 1.4 to 4.1 ± 1.9 AU; p = 0.6275; ES = 1.24 CS vs. control after match). Accordingly, CS use during 2 soccer matches with 72-hour recovery reduces perceived muscle soreness in the second match and increases higher-speed match running performance.

Methodological Variations Contributing to Heterogenous Ergogenic Responses to Ischemic Preconditioning

Ischemic preconditioning (IPC) has been repeatedly reported to augment maximal exercise performance over a range of exercise durations and modalities. However, an examination of the relevant literature indicates that the reproducibility and robustness of ergogenic responses to this technique are variable, confounding expectations about the magnitude of its effects. Considerable variability among study methodologies may contribute to the equivocal responses to IPC. This review focuses on the wide range of methodologies used in IPC research, and how such variability likely confounds interpretation of the interactions of IPC and exercise. Several avenues are recommended to improve IPC methodological consistency, which should facilitate a future consensus about optimizing the IPC protocol, including due consideration of factors such as: location of the stimulus, the time between treatment and exercise, individualized tourniquet pressures and standardized tourniquet physical characteristics, and the incorporation of proper placebo treatments into future study designs.

Low-Dose Ammonium Preconditioning Enhances Endurance in Submaximal Physical Exercises

Preconditioning is often used in medicine to protect organs from ischemic damage and in athletes to enhance the performances. We tested whether low-dose ammonium preconditioning (AMP) could have a beneficial effect on physical exercises (PE). We used Cardiopulmonary Exercise Testing (CPET) on a treadmill to investigate the effects of low-dose AMP on the physical exercise capacity of professional track and field athletes and tested twenty-five athletes. Because of the individual differences between athletes, we performed a preliminary treadmill test (Pre-test) and, according to the results, the athletes were randomly allocated into the AMP and control (placebo, PL) group based on the similarity of the total distance covered on a treadmill. In the AMP group, the covered distance increased (11.3 ± 3.6%, p < 0.02) compared to Pre-test. Similarly, AMP significantly increased O₂ uptake volume—VO₂ (4.6 ± 2.3%, p < 0.03) and pulmonary CO₂ output—VCO₂ (8.7 ± 2.8%, p < 0.01). Further, the basic blood parameters (pH, pO₂, and lactate) shift was lower despite the greater physical exercise progress in the AMP group compared to Pre-test, whereas in the placebo group there were no differences between Pre-test and Load-test. Importantly, the AMP significantly increased red blood cell count (6.8 ± 2.0%, p < 0.01) and hemoglobin concentration (5.3 ± 1.9%, p < 0.01), which might explain the beneficial effects in physical exercise progress. For the first time, we showed that low-dose AMP had clear beneficial effects on submaximal PE.

The Acute Impact of External Compression on Back Squat Performance in Competitive Athletes

The aim of the present study was to evaluate the effects of external compression with blood flow restriction on power output and bar velocity changes during the back-squat exercise (SQ). The study included 10 judo athletes (age = 28.4 ± 5.8 years; body mass = 81.3 ± 13.1 kg; SQ one-repetition maximum (1-RM) 152 ± 34 kg; training experience 10.7 ± 2.3 years).

METHODS

The experiment was performed following a randomized crossover design, where each participant performed three different exercise protocols: (1) control, without external compression (CONT); (2) intermittent external compression with pressure of 100% arterial occlusion pressure (AOP) (EC-100); and (3) intermittent external compression with pressure of 150% AOP (EC-150). To assess the differences between conditions, the participants performed 3 sets of 3 repetitions of the SQ at 70% 1-RM. The differences in peak power output (PP), mean power output (MP), peak bar velocity (PV), and mean bar velocity (MV) between the three conditions were examined using repeated measures two-way ANOVA.

RESULTS

The post hoc analysis for the main effect of conditions showed a significant increase in PP (p = 0.03), PV (p = 0.02), MP (p = 0.04), and MV (p = 0.03), for the EC-150, compared to the CONT. Furthermore, a statistically significant increase in PP (p = 0.04), PV (p = 0.03), MP (p = 0.02), and MV (p = 0.01) were observed for the EC-150 compared to EC-100. There were no significant changes in PP, PV, MP, and MV, between EC-100 and CONT conditions.

CONCLUSION

The results indicate that the use of extremely high-pressure external compression (150% AOP) during high-loaded (70% 1-RM) lower limb resistance exercise elicits an acute increase in power output and bar velocity.

Short-Term Blood Flow Restriction Increases Power Output and Bar Velocity During the Bench Press

Wilk, M, Krzysztofik, M, Filip, A, Zajac, A, Bogdanis, GC, and Lockie, RG. Short-term blood flow restriction increases power output and bar velocity during the bench press. J Strength Cond Res XX(X): 000-000, 2020-This study examined the effect of blood flow restriction (BFR) with 2 different types of cuffs on peak power output (PP), mean power output (MP), peak bar velocity (PV), and mean bar velocity (MV) in the bench press exercise (BP). Fourteen healthy strength-trained male athletes (age = 27.6 ± 3.5 years; body mass = 84.1 ± 8.0 kg; height = 175.8 ± 6.7 cm; BP 1 repetition maximum [RM] = 138.6 ± 17.8 kg) performed 3 different testing protocols as follows: without BFR (NO-BFR), BFR with a narrow cuff (BFRNARROW), and BFR with a wide cuff (BFRWIDE) in a randomized crossover design. During all sessions, subjects performed one set of 3 repetitions of the BP exercise using 70% 1RM. Cuff pressure was set to approximately 90% full arterial occlusion pressure of the upper limb at rest. Analyses of variance showed an increase in PP (by 21%, p < 0.01; effect size [ES] = 1.67), MP (by 16%, p < 0.01; ES = 0.93), PV (by 22%, p < 0.01; ES = 1.79), and MV (by 21%, p < 0.01; ES = 1.36) during BFRWIDE compared with NO-BFR and a significant increase in PP (by 15%, p < 0.01; ES = 1.07), MP (by 17%, p < 0.01; ES = 0.78), PV (by 18%, p < 0.01; ES = 1.65), and MV (by 13% p < 0.01; ES = 1.00) during BFRWIDE compared with BFRNARROW. There were no significant differences in any of the variable between NO-BFR and BFRNARROW. The results of the study indicate that short-term BFR training increases power output and bar velocity during the BP exercise. However, only BFRWIDE significantly influenced bar velocity and power output, which indicates that the width of the cuff is a critical factor determining acute exercise adaptation during BFR resistance training.

Effect of remote ischaemic preconditioning on walking in people with multiple sclerosis: double-blind randomised controlled trial

Background

Remote ischaemic preconditioning (RIPC) is the exposure of body parts to brief periods of circulatory occlusion and reperfusion. Recent studies have also shown that RIPC can improve exercise performance in healthy individuals.

Objective

This study aimed to assess the effect of RIPC on walking in people with multiple sclerosis (MS).

Methods

This was a double-blind randomised controlled clinical trial. We used three cycles of RIPC delivered by occluding the upper arm with a blood pressure (BP) cuff inflated to a pressure of 30 mm Hg above the systolic BP. In patients in the sham intervention group, the BP cuff was inflated only to 30 mm Hg below diastolic BP. Outcome measures included the Six-Minute Walk Test (6MWT), gait speed, the Borg rate of perceived exertion (RPE) scale, the tolerability of the RIPC using a Numerical Rating Scale for discomfort from 0 to 10, and adverse events. We identified responders meeting the minimal clinically important difference (MCID) established in the literature in each group.

Results

Seventy-five participants completed the study (RIPC: 38 and Sham: 37). The distance walked during the 6MWT improved by 1.9% in the sham group and 5.7% in the RIPC group (p=0.012). The number of responders meeting MCID criteria in the RIPC group was significantly greater compared with the sham intervention group. No serious adverse events occurred.

Conclusion

Single cycle of RIPC resulted in immediate improvement in walking distances during 6MWT in people with MS.

Trial registration numbers

NCT03153553

Ischemic preconditioning and exercise performance: shedding light through smallest worthwhile change

Ischemic preconditioning (IPC) has been suggested as a potential ergogenic aid to improve exercise performance, although controversial findings exist. The controversies may be explained by several factors, including the mode of exercise, the ratio between the magnitude of improvement, or the error of measurement and physiological meaning. However, a relevant aspect has been lacking in the literature: the interpretation of the findings considering statistical tests and adequate effect size (ES) according to the fitness level of individuals. Thus, we performed a systematic review with meta-analysis to update the effects of IPC on exercise performance and physiological responses, using traditional statistics (P values), ES, and smallest worth change (SWC) approach contextualizing the IPC application to applied Sports and Exercise performance. Forty-five studies met the inclusion criteria. Overall, the results show that IPC has a minimal or nonsignificant effect on performance considering the fitness level of the individuals, using statistical approaches (i.e., tests with P value, ES, and SWC). Therefore, IPC procedures should be revised and refined in future studies to evaluate if IPC promotes positive effects on performance in a real-world scenario with more consistent interpretation.

Wearing Colored Glasses can Influence Exercise Performance and Testosterone concentration?

Perception of red color is associated with higher testosterone concentration and better human performance. Thus, we evaluated the acute effects of wearing colored-lens glasses on the YoYo intermittent endurance exercise test 2 (YoYoIE2) performance indicators and testosterone concentration. Ten soccer players performed three YoYoIE2 (counterbalanced crossover) wearing colorless (control), blue- or red-lensed glasses (2-4 days of rest in between). YoYoIE2 performance did not differ among the trials ( p >0.05), but blood testosterone increased post-exercise in red compared to red baseline (red=14%, effect size=0.75). Analysis showed faster heart rate recovery ( p <0.05) at 1 min post-test for blue compared to red lenses. Rating of perceived exertion and blood lactate concentration did not differ ( p >0.05) among the trials. Wearing red-colored lenses during high-intensity intermittent exercise increased testosterone concentration, but do not influence performance.

Acute ischemic preconditioning does not influence high-intensity intermittent exercise performance

This study evaluated the acute effect of ischemic preconditioning (IPC) on a high-intensity intermittent exercise performance and physiological indicators in amateur soccer players. Thirteen players (21.5 ± 2 yrs) attended three trials separated by 3–5 days in a counterbalanced randomized cross-over design: IPC (4 × 5-min occlusion 220 mmHg/reperfusion 0 mmHg) in each thigh; SHAM (similar to the IPC protocol but “occlusion” at 20 mmHg) and control (seated during the same time of IPC). After 6-min of each trial (IPC, SHAM or control), the players performed the YoYo Intermittent Endurance Test level 2 (YoYoIE2). The distance covered in the YoYoIE2 (IPC 867 ± 205 m; SHAM 873 ± 212 m; control 921 ± 206 m) was not different among trials (p = 0.10), furthermore, lactate concentration and rate of perceived exertion did not differ (P > 0.05) among protocols. There were also no significant differences in either mean heart rate (HR) or peak HR (p > 0.05) for both IPC and SHAM compared to control. Therefore, we conclude that acute IPC does not influence high-intensity intermittent exercise performance in amateur soccer players and that rate of perceived exertion, heart rate and lactate do not differ between the intervention IPC, SHAM and control.

Ischemic Preconditioning and Acute Recovery of Performance in Rugby Union Players

Ischemic preconditioning has been used as a training and/or pre-competition strategy; however its use for post-exercise recovery is still unclear. This study aimed to evaluate the impact of ischemic preconditioning on performance and recovery ratings following a simulated match in sub-elite rugby players. Following baseline measures, male players (n=8) performed a 40 min, rugby-specific exercise protocol followed by an intervention: 21 min of ischemic preconditioning (3×5 min occlusion at 220 mmHg with 2 min reperfusion at 0 mmHg) or passive rest (control) on 2 separate days. An agility T-test, a single vertical countermovement jump and 30 s of continuous vertical jumps were performed at baseline (–24 h), immediately after exercise, and immediately after the intervention. The rugby-specific exercise protocol induced similar mean heart rates (158.3±18.0 vs. 158.7±16.0 bpm) and perceived exertion levels (8.2±0.9 vs. 8.0±1.0) for both trials with all recovery performance measures and rating of recovery (13.9±1.4 vs. 13.6±1.6) similar between ischemic preconditioning and control trials (best p=0.385). We conclude that the use of ischemic preconditioning does not improve recovery acutely (~1 h) including specific variables related to rugby performance in amateur rugby union players.