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Cruz R, Tramontin AF, Oliveira AS, Caputo F, Denadai BS, Greco CC. Ischemic preconditioning increases spinal excitability and voluntary activation during maximal plantar flexion contractions in men. Scand J Med Sci Sports 2024; 34:e14591. [PMID: 38429941 DOI: 10.1111/sms.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/29/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024]
Abstract
The enigmatic benefits of acute limb ischemic preconditioning (IP) in enhancing muscle force and exercise performance have intrigued researchers. This study sought to unravel the underlying mechanisms, focusing on increased neural drive and the role of spinal excitability while excluding peripheral factors. Soleus Hoffmann (H)-reflex /M-wave recruitment curves and unpotentiated supramaximal responses were recorded before and after IP or a low-pressure control intervention. Subsequently, the twitch interpolation technique was applied during maximal voluntary contractions to assess conventional parameters of neural output. Following IP, there was an increase in both maximum normalized force and voluntary activation (VA) for the plantar flexor group, with negligible peripheral alterations. Greater benefits were observed in participants with lower VA levels. Despite greater H-reflex gains, soleus volitional (V)-wave and sEMG amplitudes remained unchanged. In conclusion, IP improves muscle force via enhanced neural drive to the muscles. This effect appears associated, at least in part, to reduced presynaptic inhibition and/or increased motoneuron excitability. Furthermore, the magnitude of the benefit is inversely proportional to the skeletal muscle's functional reserve, making it particularly noticeable in under-recruited muscles. These findings have implications for the strategic application of the IP procedure across diverse populations.
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Affiliation(s)
- Rogério Cruz
- Human Performance Laboratory, São Paulo State University (UNESP), Biosciences Institute, Campus Rio Claro, Brazil
- Human Performance Research Group, Santa Catarina State University, Florianópolis, Brazil
| | | | | | - Fabrizio Caputo
- Human Performance Research Group, Santa Catarina State University, Florianópolis, Brazil
| | - Benedito Sérgio Denadai
- Human Performance Laboratory, São Paulo State University (UNESP), Biosciences Institute, Campus Rio Claro, Brazil
| | - Camila Coelho Greco
- Human Performance Laboratory, São Paulo State University (UNESP), Biosciences Institute, Campus Rio Claro, Brazil
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Salagas A, Tsoukos A, Terzis G, Paschalis V, Katsikas C, Krzysztofik M, Wilk M, Zajac A, Bogdanis GC. Effectiveness of either short-duration ischemic pre-conditioning, single-set high-resistance exercise, or their combination in potentiating bench press exercise performance. Front Physiol 2022; 13:1083299. [PMID: 36589445 PMCID: PMC9797974 DOI: 10.3389/fphys.2022.1083299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022] Open
Abstract
This study compared the effects of short-duration ischemic preconditioning, a single-set high-resistance exercise and their combination on subsequent bench press performance. Twelve men (age: 25.8 ± 6.0 years, bench press 1-RM: 1.21 ± 0.17 kg kg-1 body mass) performed four 12 s sets as fast as possible, with 2 min of recovery between sets, against 60% 1-RM, after: a) 5 min ischemic preconditioning (IPC; at 100% of full arterial occlusion pressure), b) one set of three bench press repetitions at 90% 1-RM (PAPE), c) their combination (PAPE + IPC) or d) control (CTRL). Mean barbell velocity in ischemic preconditioning was higher than CTRL (by 6.6-9.0%, p < 0.05) from set 1 to set 3, and higher than PAPE in set 1 (by 4.4%, p < 0.05). Mean barbell velocity in PAPE was higher than CTRL from set 2 to set 4 (by 6.7-8.9%, p < 0.05), while mean barbell velocity in PAPE + IPC was higher than CTRL only in set 1 (+5.8 ± 10.0%). Peak barbell velocity in ischemic preconditioning and PAPE was higher than CTRL (by 7.8% and 8.5%, respectively; p < 0.05). Total number of repetitions was similarly increased in all experimental conditions compared with CTRL (by 7.0-7.9%, p < 0.05). Rating of perceived exertion was lower in ischemic preconditioning compared with CTRL (p < 0.001) and PAPE (p = 0.045), respectively. These results highlight the effectiveness of short-duration ischemic preconditioning in increasing bench press performance, and suggest that it may be readily used by strength and conditioning coaches during resistance training due to its brevity and lower perceived exertion.
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Affiliation(s)
- Andreas Salagas
- School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Tsoukos
- School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Terzis
- School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassilis Paschalis
- School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Katsikas
- School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Michal Krzysztofik
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Michal Wilk
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Adam Zajac
- Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Gregory C. Bogdanis
- School of Physical Education and Sports Science, National and Kapodistrian University of Athens, Athens, Greece,*Correspondence: Gregory C. Bogdanis,
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Han Z, Zhao W, Lee H, Wills M, Tong Y, Cheng Z, Dai Q, Li X, Wang Q, Geng X, Ji X, Ding Y. Remote Ischemic Conditioning With Exercise (RICE)-Rehabilitative Strategy in Patients With Acute Ischemic Stroke: Rationale, Design, and Protocol for a Randomized Controlled Study. Front Neurol 2021; 12:654669. [PMID: 34012417 PMCID: PMC8126608 DOI: 10.3389/fneur.2021.654669] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 03/15/2021] [Indexed: 01/01/2023] Open
Abstract
Objective: Exercise rehabilitation is an effective therapy in reducing the disability rate after stroke and should be carried out as early as possible. However, very early rehabilitation exercise exacerbates brain injury and is difficult to conduct in stroke patients due to their weakened and potentially disabled state. It is valuable to explore additional early rehabilitation strategies. Remote Ischemic Conditioning (RIC) is a novel therapy designed to protect vital organs from severe lethal ischemic injury by transient sublethal blood flow to non-vital organs, including the distal limbs, in order to induce endogenous protection. RIC has previously been conducted post-stroke for neuroprotection. However, whether combined early RIC and exercise (RICE) therapy enhances stroke rehabilitation remains to be determined. Methods: This is a single-center, double-blinded, randomized controlled trial that will enroll acute ischemic stroke patients within 24 h of symptom onset or symptom exacerbation. All enrolled patients will be randomly assigned to either the RICE group (exercise with RIC) or the control group (exercise with sham RIC) at a ratio of 1:1, with 20 patients in each group. Both groups will receive RIC or sham RIC within 24 h after stroke onset or symptom exacerbation, once a day, for 14 days. All patients will begin exercise training on the fourth day, twice a day, for 11 days. Their neurological function [Modified Rankin Scale (mRS) score, National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index, and walking ability], infarct volume (nuclear magnetic resonance, MRI), and adverse events will be evaluated at different time points in their post-stroke care. Results: The primary outcome is safety, measured by the incidence of any serious RICE-related adverse events and decreased adverse events during hospitalization. The secondary outcome is a favorable prognosis within 90 days (mRS score < 2), determined by improvements in the mRS score, NIHSS score, Barthel Index, walking ability after 90 days, and infarct volume after 12 ± 2 days. Conclusion: This study is a prospective randomized controlled trial to determine the rehabilitative effect of early RIC followed by exercise on patients with acute ischemic stroke. Trial Registration:www.chictr.org.cn, identifier: ChiCTR2000041042
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Affiliation(s)
- Zhenzhen Han
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Wenbo Zhao
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hangil Lee
- School of Medicine, Wayne State University, Detroit, MI, United States
| | - Melissa Wills
- School of Medicine, Wayne State University, Detroit, MI, United States
| | - Yanna Tong
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Zhe Cheng
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Qingqing Dai
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaohua Li
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Qingzhu Wang
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xunming Ji
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuchuan Ding
- School of Medicine, Wayne State University, Detroit, MI, United States
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Lima-Soares F, Pessoa KA, Torres Cabido CE, Lauver J, Cholewa J, Rossi F, Zanchi NE. Determining the Arterial Occlusion Pressure for Blood Flow Restriction: Pulse Oximeter as a New Method Compared With a Handheld Doppler. J Strength Cond Res 2020; 36:1120-1124. [PMID: 32379239 DOI: 10.1519/jsc.0000000000003628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Lima-Soares, F, Pessoa, KA, Torres Cabido, CE, Lauver, J, Cholewa, J, Rossi, FE, and Zanchi, NE. Determining the arterial occlusion pressure for blood flow restriction: pulse oximeter as a new method compared with a handheld Doppler. J Strength Cond Res XX(X): 000-000, 2020-In laboratorial and clinical settings, the use of Doppler ultrasound equipment has been considered the gold standard method to determine arterial occlusion pressure (AOP). However, the use of Doppler equipment is inherently limited to the technical expertise needed to perform AOP measurements. To overcome the technical difficulties of the use of Doppler equipment use in the determination of AOP, a simpler and less subjective methodology would be helpful for blood flow restriction (BFR) practitioners. In this regard, portable pulse oximetry has been largely used in clinical practice for measuring systolic pressures, as well as loss or recovery of pulse, with results similar to those observed with the use of Doppler equipment. For such purposes, the AOP from young male and female subjects was evaluated after different body positions (standing, seated, and supine positions). Loss of capillary blood flow or AOP was readily determined by simple visual inspection for the pulse oximeter and loss of sound for the Doppler equipment. The results presented herein strongly suggest the use of the portable pulse oximetry equipment as reliable, when compared with the handheld Doppler (seated K = 0.962, standing K = 0.845, and supine K = 0.963 and seated rs = 0.980, standing rs = 0.958, and supine rs = 0.955). Because AOP measurement by pulse oximetry is relatively easier to perform and financially more accessible than handheld Doppler equipment, BFR practitioners may benefit from this new methodology to measure AOP, thus determining individualized restriction pressures.
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Affiliation(s)
- Fernanda Lima-Soares
- Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, Brazil.,Department of Physical Education, Federal University of Maranhão (UFMA), Laboratory of Cellular and Molecular Biology of Skeletal Muscle (LABCEMME), São Luís, Brazil
| | - Kassiana A Pessoa
- Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, Brazil.,Department of Physical Education, Federal University of Maranhão (UFMA), Laboratory of Cellular and Molecular Biology of Skeletal Muscle (LABCEMME), São Luís, Brazil
| | - Christian E Torres Cabido
- Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, Brazil.,Department of Physical Education, Federal University of Maranhão (UFMA), Physical Exercise, Health and Human Performance Research Group, Federal University of Maranhão (UFMA), São Luís, Brazil
| | - Jakob Lauver
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina, United States
| | - Jason Cholewa
- Department of Kinesiology, Coastal Carolina University, Conway, South Carolina, United States
| | - Fabrício Rossi
- Immunometabolism of Skeletal Muscle and Exercise Research Group, Department of Physical Education, Federal University of Piauí (UFPI), Teresina-PI, Brazil
| | - Nelo E Zanchi
- Department of Physical Education, Federal University of Maranhão (UFMA), São Luís, Brazil.,Department of Physical Education, Federal University of Maranhão (UFMA), Laboratory of Cellular and Molecular Biology of Skeletal Muscle (LABCEMME), São Luís, Brazil
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