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Lubiak SM, Lawson JE, Gonzalez Rojas DH, Proppe CE, Rivera PM, Hammer SM, Trevino MA, Dinyer-McNeely TK, Montgomery TR, Olmos AA, Sears KN, Bergstrom HC, Succi PJ, Keller JL, Hill EC. A Moderate Blood Flow Restriction Pressure Does Not Affect Maximal Strength or Neuromuscular Responses. J Strength Cond Res 2024:00124278-990000000-00529. [PMID: 39178106 DOI: 10.1519/jsc.0000000000004907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2024]
Abstract
ABSTRACT Lubiak, SM, Lawson, JE, Gonzalez Rojas, DH, Proppe, CE, Rivera, PM, Hammer, SM, Trevino, MA, Dinyer-McNeely, TK, Montgomery, TR, Olmos, AA, Sears, KN, Bergstrom, HC, Succi, PJ, Keller, JL, and Hill, EC. A moderate blood flow restriction pressure does not affect maximal strength or neuromuscular responses. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this study was to examine the acute effects of blood flow restriction (BFR) applied at 60% of total arterial occlusion pressure (AOP) on maximal strength. Eleven college-aged female subjects completed two testing sessions of maximal unilateral concentric, isometric, and eccentric leg extension muscle actions performed with and without BFR. Separate 3 (mode [isometric, concentric, eccentric]) × 2 (condition [BFR, no BFR]) × 2 (visit [2, 3]) repeated-measures analysis of variances were used to examine mean differences in maximal strength, neuromuscular function, rating of perceived exertion (RPE), and pain. For maximal strength (collapsed across condition and visit), isometric (128.5 ± 22.7 Nm) and eccentric (114.5 ± 35.4 Nm) strength were greater than concentric maximal strength (89.3 ± 22.3 Nm) (p < 0.001-0.041). Muscle excitation relative (%) to isometric non-BFR was greater during the concentric (108.6 ± 31.5%) than during the eccentric (86.7 ± 29.2%) (p = 0.045) assessments but not different than isometric (93.4 ± 17.9%) (p = 0.109) assessments, collapsed across condition and visit. For RPE, there was an interaction such that RPE was greater during non-BFR (4.3 ± 1.7) than during BFR (3.7 ± 1.7) (p = 0.031) during the maximal concentric strength assessments. Furthermore, during maximal strength assessments performed with BFR, isometric RPE (5.8 ± 1.9) was greater than concentric (3.7 ± 1.7) (p = 0.005) and eccentric (4.6 ± 1.9) (p = 0.009) RPE. Finally, pain was greater during the isometric (2.8 ± 2.1 au) than during the concentric (1.8 ± 1.5 au) (p = 0.016), but not eccentric, maximal strength assessments (2.1 ± 1.6 au) (p = 0.126), collapsed across condition and visit. The application of BFR at 60% AOP did not affect concentric, isometric, or eccentric maximal strength or neuromuscular function. Trainers, clinicians, and researchers can prescribe exercise interventions relative to a restricted (when using a moderate AOP) or nonrestricted assessment of maximal strength.
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Affiliation(s)
- Sean M Lubiak
- School of Kinesiology & Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, Orlando, Florida
| | - John E Lawson
- School of Kinesiology & Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, Orlando, Florida
| | - David H Gonzalez Rojas
- School of Kinesiology & Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, Orlando, Florida
| | - Christopher E Proppe
- School of Kinesiology & Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, Orlando, Florida
| | - Paola M Rivera
- School of Kinesiology & Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, Orlando, Florida
| | - Shane M Hammer
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Michael A Trevino
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Taylor K Dinyer-McNeely
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Tony R Montgomery
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Alex A Olmos
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Kylie N Sears
- Applied Neuromuscular Physiology Laboratory, Department of Kinesiology, Applied Health, and Recreation, Oklahoma State University, Stillwater, Oklahoma
| | - Haley C Bergstrom
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky
| | - Pasquale J Succi
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, Kentucky
| | - Joshua L Keller
- Department of Health, Kinesiology, and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, Alabama
- College of Medicine, Department of Physiology and Cell Biology, University of South Alabama, Mobile, Alabama
| | - Ethan C Hill
- School of Kinesiology & Rehabilitation Sciences, Division of Kinesiology, University of Central Florida, Orlando, Florida
- Florida Space Institute, Partnership I, Research Parkway University of Central Florida, Orlando, Florida; and
- College of Medicine, University of Central Florida, Orlando, Florida
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Vehrs PR, Richards S, Blazzard C, Hart H, Kasper N, Lacey R, Lopez D, Baker L. Use of a handheld Doppler to measure brachial and femoral artery occlusion pressure. Front Physiol 2023; 14:1239582. [PMID: 37664423 PMCID: PMC10470651 DOI: 10.3389/fphys.2023.1239582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Objective: Measurement of arterial occlusion pressure (AOP) is essential to the safe and effective use of blood flow restriction during exercise. Use of a Doppler ultrasound (US) is the "gold standard" method to measure AOP. Validation of a handheld Doppler (HHDOP) device to measure AOP could make the measurement of AOP more accessible to practitioners in the field. The purpose of this study was to determine the accuracy of AOP measurements of the brachial and femoral arteries using an HHDOP. Methods: We simultaneously measured AOP using a "gold standard" US and a HHDOP in the dominant and non-dominant arms (15 males; 15 females) and legs (15 males; 15 females). Results: There were no differences in limb circumference or limb volume in the dominant and non-dominant arms and legs between males and females or between the dominant and non-dominant arms and legs of males and females. The differences between US and HHDOP measures of AOP in the dominant and non-dominant arms and legs were either not significant or small (<10 mmHg) and of little practical importance. There were no sex differences in AOP measurements of the femoral artery (p > 0.60). Bland-Altman analysis yielded an average bias (-0.65 mmHg; -2.93 mmHg) and reasonable limits of agreement (±5.56 mmHg; ±5.58 mmHg) between US and HHDOP measures of brachial and femoral artery AOP, respectively. Conclusion: HHDOP yielded acceptable measures of AOP of the brachial and femoral arteries and can be used to measure AOP by practitioners for the safe and effective use of blood flow restriction. Due to the potential differences in AOP between dominant and non-dominant limbs, AOP should be measured in each limb.
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Affiliation(s)
- Pat R. Vehrs
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Shay Richards
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Chase Blazzard
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Hannah Hart
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Nicole Kasper
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Ryan Lacey
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Daniela Lopez
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Luke Baker
- Department of Statistics, Ohio State University, Columbus, OH, United States
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CHEN TREVORC, WU SHANGHEN, CHEN HSINLIAN, TSENG WEICHIN, TSENG KUOWEI, KANG HSINGYU, NOSAKA KAZUNORI. Effects of Unilateral Eccentric versus Concentric Training of Nonimmobilized Arm during Immobilization. Med Sci Sports Exerc 2023; 55:1195-1207. [PMID: 36849120 PMCID: PMC10241444 DOI: 10.1249/mss.0000000000003140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
INTRODUCTION The present study tested the hypothesis that eccentric training (ET) of nonimmobilized arm would attenuate negative effects of immobilization and provide greater protective effects against muscle damage induced by eccentric exercise after immobilization, when compared with concentric training (CT). METHODS Sedentary young men were placed to ET, CT, or control group ( n = 12 per group), and their nondominant arms were immobilized for 3 wk. During the immobilization period, the ET and CT groups performed five sets of six dumbbell curl eccentric-only and concentric-only contractions, respectively, at 20%-80% of maximal voluntary isometric contraction (MVCiso) strength over six sessions. MVCiso torque, root-mean square (RMS) of electromyographic activity during MVCiso, and bicep brachii muscle cross-sectional area (CSA) were measured before and after immobilization for both arms. All participants performed 30 eccentric contractions of the elbow flexors (30EC) by the immobilized arm after the cast was removed. Several indirect muscle damage markers were measured before, immediately after, and for 5 d after 30EC. RESULTS ET increased MVCiso (17% ± 7%), RMS (24% ± 8%), and CSA (9% ± 2%) greater ( P < 0.05) than CT (6% ± 4%, 9% ± 4%, 3% ± 2%) for the trained arm. The control group showed decreases in MVCiso (-17% ± 2%), RMS (-26% ± 6%), and CSA (-12% ± 3%) for the immobilized arm, but these changes were attenuated greater ( P < 0.05) by ET (3% ± 3%, -0.1% ± 2%, 0.1% ± 0.3%) than CT (-4% ± 2%, -4% ± 2%, -1.3% ± 0.4%). Changes in all muscle damage markers after 30EC were smaller ( P < 0.05) for the ET and CT than the control group, and ET than the CT group (e.g., peak plasma creatine kinase activity: ET, 860 ± 688 IU·L -1 ; CT, 2390 ± 1104 IU·L -1 ; control, 7819 ± 4011 IU·L -1 ). CONCLUSIONS These results showed that ET of the nonimmobilized arm was effective for eliminating the negative effects of immobilization and attenuating eccentric exercise-induced muscle damage after immobilization.
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Affiliation(s)
- TREVOR C. CHEN
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei City, TAIWAN
| | - SHANG-HEN WU
- Department of Physical Education, Health and Recreation, National Chiayi University, Chiayi County, TAIWAN
| | - HSIN-LIAN CHEN
- Department of Physical Education, Health and Recreation, National Chiayi University, Chiayi County, TAIWAN
| | - WEI-CHIN TSENG
- Department of Physical Education, University of Taipei, Taipei City, TAIWAN
| | - KUO-WEI TSENG
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, TAIWAN
| | - HSING-YU KANG
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei City, TAIWAN
| | - KAZUNORI NOSAKA
- Centre for Human Performance, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, AUSTRALIA
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Quantifying the Generality of Strength Adaptation: A Meta-Analysis. Sports Med 2023; 53:637-648. [PMID: 36396899 DOI: 10.1007/s40279-022-01790-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Isotonic exercise is the most common mode of strength training. Isotonic strength is often measured in the movement that was exercised, but isometric and isokinetic movements are also commonly used to quantify changes in muscular strength. Previous research suggests that increasing strength in one movement may not lead to an increase in strength in a different movement. Quantifying the increase in strength in a movement not trained may be important for understanding strength training adaptations and making recommendations for resistance exercise and rehabilitation programs. OBJECTIVE To quantify changes in non-specific strength relative to a control. DESIGN A systematic review and random effects meta-analysis was conducted investigating the effects of isotonic strength training on isotonic and isokinetic/isometric strength. SEARCH AND INCLUSION This systematic review was conducted in Google scholar, PubMed, Academic Search Premier, and MENDELEY. To be included in this review paper the article needed to meet the following criteria: (1) report sufficient data for our variables of interest (i.e., changes in isotonic strength and changes in isokinetic or isometric strength); (2) include a time-matched non-exercise control; (3) be written in English; (4) include healthy human participants over the age of 18 years; (5) the participants had to train and test isotonically; (6) the participants had to be tested isokinetically or isometrically on a device different from that they trained on; (7) the non-specific strength task had to test a muscle involved in the training (i.e., could not have trained chest press and test handgrip strength); and (8) the control group and the experimental group had to perform the same number of strength tests. RESULTS We completed two separate searches. In the original search a total of 880 papers were screened and nine papers met the inclusion criteria. In the secondary search a total of 2594 papers were screened and three additional papers were added (total of 12 studies). The overall effect of resistance training on changes in strength within a movement that was not directly trained was 0.8 (Cohen's d) with a standard error of 0.286. This overall effect was significant (t = 2.821, p = 0.01) and the 95% confidence interval (CI) is 0.22-1.4. The overall effect of resistance training on strength changes within a movement that was directly trained was 1.84 (Cohen's d) with a standard error of 0.296. This overall effect was significant (t = 6.221, p < 0.001) and the 95% CI is 1.23-2.4. CONCLUSION The results of our meta-analysis suggest that strength increases in both the specific and non-specific strength tests. However, the smaller effect size associated with non-specific strength suggests that it will be difficult for a single study to meaningfully investigate the transfer of strength training adaptions.
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Vann CG, Sexton CL, Osburn SC, Smith MA, Haun CT, Rumbley MN, Mumford PW, Montgomery NT, Ruple BA, McKendry J, Mcleod J, Bashir A, Beyers RJ, Brook MS, Smith K, Atherton PJ, Beck DT, McDonald JR, Young KC, Phillips SM, Roberts MD. Effects of High-Volume Versus High-Load Resistance Training on Skeletal Muscle Growth and Molecular Adaptations. Front Physiol 2022; 13:857555. [PMID: 35360253 PMCID: PMC8962955 DOI: 10.3389/fphys.2022.857555] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
We evaluated the effects of higher-load (HL) versus (lower-load) higher-volume (HV) resistance training on skeletal muscle hypertrophy, strength, and muscle-level molecular adaptations. Trained men (n = 15, age: 23 ± 3 years; training experience: 7 ± 3 years) performed unilateral lower-body training for 6 weeks (3× weekly), where single legs were randomly assigned to HV and HL paradigms. Vastus lateralis (VL) biopsies were obtained prior to study initiation (PRE) as well as 3 days (POST) and 10 days following the last training bout (POSTPR). Body composition and strength tests were performed at each testing session, and biochemical assays were performed on muscle tissue after study completion. Two-way within-subject repeated measures ANOVAs were performed on most dependent variables, and tracer data were compared using dependent samples t-tests. A significant interaction existed for VL muscle cross-sectional area (assessed via magnetic resonance imaging; interaction p = 0.046), where HV increased this metric from PRE to POST (+3.2%, p = 0.018) whereas HL training did not (-0.1%, p = 0.475). Additionally, HL increased leg extensor strength more so than HV training (interaction p = 0.032; HV < HL at POST and POSTPR, p < 0.025 for each). Six-week integrated non-myofibrillar protein synthesis (iNon-MyoPS) rates were also higher in the HV versus HL condition, while no difference between conditions existed for iMyoPS rates. No interactions existed for other strength, VL morphology variables, or the relative abundances of major muscle proteins. Compared to HL training, 6 weeks of HV training in previously trained men optimizes VL hypertrophy in lieu of enhanced iNon-MyoPS rates, and this warrants future research.
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Affiliation(s)
- Christopher G. Vann
- School of Kinesiology, Auburn University, Auburn, AL, United States
- Duke Molecular Physiology Institute, Duke University School of Medicine, Duke University, Durham, NC, United States
| | - Casey L. Sexton
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Shelby C. Osburn
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - Morgan A. Smith
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | | | | | - Petey W. Mumford
- Department of Kinesiology, Lindenwood University, St. Charles, MO, United States
| | | | - Bradley A. Ruple
- School of Kinesiology, Auburn University, Auburn, AL, United States
| | - James McKendry
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Jonathan Mcleod
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Adil Bashir
- MRI Research Center, Auburn University, Auburn, AL, United States
| | - Ronald J. Beyers
- MRI Research Center, Auburn University, Auburn, AL, United States
| | - Matthew S. Brook
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic, and Molecular Physiology, University of Nottingham, Nottingham, United Kingdom
| | - Kenneth Smith
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic, and Molecular Physiology, University of Nottingham, Nottingham, United Kingdom
| | - Philip J. Atherton
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic, and Molecular Physiology, University of Nottingham, Nottingham, United Kingdom
| | - Darren T. Beck
- School of Kinesiology, Auburn University, Auburn, AL, United States
- Edward Via College of Osteopathic Medicine – Auburn Campus, Auburn, AL, United States
| | | | - Kaelin C. Young
- School of Kinesiology, Auburn University, Auburn, AL, United States
- Edward Via College of Osteopathic Medicine – Auburn Campus, Auburn, AL, United States
| | | | - Michael D. Roberts
- School of Kinesiology, Auburn University, Auburn, AL, United States
- Edward Via College of Osteopathic Medicine – Auburn Campus, Auburn, AL, United States
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Bielitzki R, Behrendt T, Behrens M, Schega L. Time to Save Time: Beneficial Effects of Blood Flow Restriction Training and the Need to Quantify the Time Potentially Saved by Its Application During Musculoskeletal Rehabilitation. Phys Ther 2021; 101:6315163. [PMID: 34228788 DOI: 10.1093/ptj/pzab172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/14/2021] [Accepted: 06/06/2021] [Indexed: 11/14/2022]
Abstract
The main goal of musculoskeletal rehabilitation is to achieve the pre-injury and/or pre-surgery physical function level with a low risk of re-injury. Blood flow restriction (BFR) training is a promising alternative to conventional therapy approaches during musculoskeletal rehabilitation because various studies support its beneficial effects on muscle mass, strength, aerobic capacity, and pain perception. In this perspective article, we used an evidence-based progressive model of a rehabilitative program that integrated BFR in 4 rehabilitation phases: (1) passive BFR, (2) BFR combined with aerobic training, (3) BFR combined with low-load resistance training, and (4) BFR combined with low-load resistance training and traditional high-load resistance training. Considering the current research, we propose that a BFR-assisted rehabilitation has the potential to shorten the time course of therapy to reach the stage where the patient is able to tolerate resistance training with high loads. The information and arguments presented are intended to stimulate future research, which compares the time to achieve rehabilitative milestones and their physiological bases in each stage of the musculoskeletal rehabilitation process. This requires the quantification of BFR training-induced adaptations (eg, muscle mass, strength, capillary-to-muscle-area ratio, hypoalgesia, molecular changes) and the associated changes in performance with a high measurement frequency (≤1 week) to test our hypothesis. This information will help to quantify the time saved by BFR-assisted musculoskeletal rehabilitation. This is of particular importance for patients, because the potentially accelerated recovery of physical functioning would allow them to return to their work and/or social life earlier. Furthermore, other stakeholders in the health care system (eg, physicians, nurses, physical therapists, insurance companies) might benefit from that with regard to work and financial burden.
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Affiliation(s)
- Robert Bielitzki
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Tom Behrendt
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany.,Department of Orthopedics, University Medicine Rostock, Rostock, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Davids CJ, Næss TC, Moen M, Cumming KT, Horwath O, Psilander N, Ekblom B, Coombes JS, Peake JM, Raastad T, Roberts LA. Acute cellular and molecular responses and chronic adaptations to low-load blood flow restriction and high-load resistance exercise in trained individuals. J Appl Physiol (1985) 2021; 131:1731-1749. [PMID: 34554017 DOI: 10.1152/japplphysiol.00464.2021] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Blood flow restriction (BFR) with low-load resistance exercise (RE) is often used as a surrogate to traditional high-load RE to stimulate muscular adaptations, such as hypertrophy and strength. However, it is not clear whether such adaptations are achieved through similar cellular and molecular processes. We compared changes in muscle function, morphology and signaling pathways between these differing training protocols. Twenty-one males and females (mean ± SD: 24.3 ± 3.1 years) experienced with resistance training (4.9 ± 2.6 years) performed nine weeks of resistance training (three times per week) with either high-loads (75-80% 1RM; HL-RT), or low-loads with BFR (30-40% 1RM; LL-BFR). Before and after the training intervention, resting muscle biopsies were collected, and quadricep cross-sectional area (CSA), muscular strength and power were measured. Approximately 5 days following the intervention, the same individuals performed an additional 'acute' exercise session under the same conditions, and serial muscle biopsies were collected to assess hypertrophic- and ribosomal-based signaling stimuli. Quadricep CSA increased with both LL-BFR (7.4±4.3%) and HL-RT (4.6±2.9%), with no significant differences between training groups (p=0.37). Muscular strength also increased in both training groups, but with superior gains in squat 1RM occurring with HL-RT (p<0.01). Acute phosphorylation of several key proteins involved in hypertrophy signaling pathways, and expression of ribosomal RNA transcription factors occurred to a similar degree with LL-BFR and HL-RT (all p>0.05 for between-group comparisons). Together, these findings validate low-load resistance training with continuous BFR as an effective alternative to traditional high-load resistance training for increasing muscle hypertrophy in trained individuals.
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Affiliation(s)
- Charlie J Davids
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia
| | - Tore C Næss
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
| | - Maria Moen
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
| | | | - Oscar Horwath
- Åstrand Laboratory, Department of Physiology, Nutrition and Biomechanics, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Niklas Psilander
- Åstrand Laboratory, Department of Physiology, Nutrition and Biomechanics, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Björn Ekblom
- Åstrand Laboratory, Department of Physiology, Nutrition and Biomechanics, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Jonathan M Peake
- Queensland Academy of Sport, Nathan, Australia.,Queensland University of Technology, School of Biomedical Science, Brisbane, Australia
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
| | - Llion Arwyn Roberts
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia.,Griffith Sports Science, School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
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LOPEZ PEDRO, RADAELLI RÉGIS, TAAFFE DENNISR, NEWTON ROBERTU, GALVÃO DANIELA, TRAJANO GABRIELS, TEODORO JULIANAL, KRAEMER WILLIAMJ, HÄKKINEN KEIJO, PINTO RONEIS. Resistance Training Load Effects on Muscle Hypertrophy and Strength Gain: Systematic Review and Network Meta-analysis. Med Sci Sports Exerc 2021; 53:1206-1216. [PMID: 33433148 PMCID: PMC8126497 DOI: 10.1249/mss.0000000000002585] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE This study aimed to analyze the effect of resistance training (RT) performed until volitional failure with low, moderate, and high loads on muscle hypertrophy and muscle strength in healthy adults and to assess the possible participant-, design-, and training-related covariates that may affect the adaptations. METHODS Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, MEDLINE, CINAHL, EMBASE, SPORTDiscus, and Web of Science databases were searched. Including only studies that performed sets to volitional failure, the effects of low- (>15 repetitions maximum (RM)), moderate- (9-15 RM), and high-load (≤8 RM) RTs were examined in healthy adults. Network meta-analysis was undertaken to calculate the standardized mean difference (SMD) between RT loads in overall and subgroup analyses involving studies deemed of high quality. Associations between participant-, design-, and training-related covariates with SMD were assessed by univariate and multivariate network meta-regression analyses. RESULTS Twenty-eight studies involving 747 healthy adults were included. Although no differences in muscle hypertrophy between RT loads were found in overall (P = 0.113-0.469) or subgroup analysis (P = 0.871-0.995), greater effects were observed in untrained participants (P = 0.033) and participants with some training background who undertook more RT sessions (P = 0.031-0.045). Muscle strength improvement was superior for both high-load and moderate-load compared with low-load RT in overall and subgroup analysis (SMD, 0.60-0.63 and 0.34-0.35, respectively; P < 0.001-0.003), with a nonsignificant but superior effect for high compared with moderate load (SMD, 0.26-0.28, P = 0.068). CONCLUSIONS Although muscle hypertrophy improvements seem to be load independent, increases in muscle strength are superior in high-load RT programs. Untrained participants exhibit greater muscle hypertrophy, whereas undertaking more RT sessions provides superior gains in those with previous training experience.
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Affiliation(s)
- PEDRO LOPEZ
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
| | - RÉGIS RADAELLI
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BRAZIL
| | - DENNIS R. TAAFFE
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
| | - ROBERT U. NEWTON
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
- School of Human Movement and Nutrition Sciences, University of Queensland, Queensland, AUSTRALIA
| | - DANIEL A. GALVÃO
- Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, AUSTRALIA
| | - GABRIEL S. TRAJANO
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, AUSTRALIA
| | - JULIANA L. TEODORO
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BRAZIL
| | | | - KEIJO HÄKKINEN
- Neuromuscular Research Center, Biology of Physical Activity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FINLAND
| | - RONEI S. PINTO
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, BRAZIL
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9
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A Retrospective Analysis to Determine Whether Training-Induced Changes in Muscle Thickness Mediate Changes in Muscle Strength. Sports Med 2021; 51:1999-2010. [PMID: 33881748 DOI: 10.1007/s40279-021-01470-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To investigate the role of muscle thickness changes on changes in strength following 6 weeks of unaccustomed resistance training, via retrospective analysis. METHODS 151 participants completed 6 weeks of no intervention (CONTROL), one-repetition maximum training (1RM-TRAIN), or traditional resistance training (TRAD-TRAIN). Groups were assigned by covariate adaptive randomization. 1RM-TRAIN and TRAD-TRAIN performed elbow flexion exercise on the dominant arm 3 times/week. One-repetition maximum strength and muscle thickness (B-mode ultrasound at 50, 60, and 70% of the anterior upper arm) were assessed pre- and post-training. Direct and indirect effects on strength via each training modality were quantified relative to CONTROL using indicator-coded, change-score mediation analyses for each muscle thickness site. Values are presented as regression coefficients (95% CI). RESULTS The effect of 1RM-TRAIN on muscle thickness was greater than CONTROL for 60% [0.09 (0.01, 0.17) cm] and 70% [0.09 (0.01,0.18) cm] models. All muscle thickness changes for TRAD-TRAIN were greater than CONTROL: 50% [0.24 (0.16, 0.33) cm], 60% [0.25 (0.17, 0.33) cm], 70% [0.23 (0.14, 0.32) cm]. All direct effects on strength were greater for 1RM-TRAIN versus CONTROL: 50% [1.90 (1.21, 2.58) kg], 60% [1.89 (1.19, 2.58) kg], 70% [1.81 (1.12, 2.51) kg]; and TRAD-TRAIN versus CONTROL: 50% [2.04 (1.29, 2.80) kg], 60% [1.98 (1.22, 2.75) kg], 70% [1.79 (1.05, 2.53) kg]. Compared to CONTROL, there was no indication of an effect of 1RM-TRAIN on strength through muscle thickness (i.e., indirect effect) for 50% [- 0.03 (- 0.17, 0.10)], 60% [- 0.01 (- 0.17, 0.17)], or 70% [0.07 (- 0.09, 0.28)] sites, nor of TRAD-TRAIN for 50% [- 0.11 (- 0.48,0.29)], 60% [- 0.04 (- 0.42, 0.40)], and 70% sites [0.17 (- 0.23,0.58)]. CONCLUSION Training-induced changes in muscle thickness do not appear to appreciably mediate training-induced changes in the strength of untrained individuals during the first 6 weeks of training.
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Schoenfeld BJ, Grgic J, Van Every DW, Plotkin DL. Loading Recommendations for Muscle Strength, Hypertrophy, and Local Endurance: A Re-Examination of the Repetition Continuum. Sports (Basel) 2021; 9:sports9020032. [PMID: 33671664 PMCID: PMC7927075 DOI: 10.3390/sports9020032] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 12/16/2022] Open
Abstract
Loading recommendations for resistance training are typically prescribed along what has come to be known as the “repetition continuum”, which proposes that the number of repetitions performed at a given magnitude of load will result in specific adaptations. Specifically, the theory postulates that heavy load training optimizes increases maximal strength, moderate load training optimizes increases muscle hypertrophy, and low-load training optimizes increases local muscular endurance. However, despite the widespread acceptance of this theory, current research fails to support some of its underlying presumptions. Based on the emerging evidence, we propose a new paradigm whereby muscular adaptations can be obtained, and in some cases optimized, across a wide spectrum of loading zones. The nuances and implications of this paradigm are discussed herein.
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Affiliation(s)
- Brad J. Schoenfeld
- Department of Health Sciences, CUNY Lehman College, Bronx, NY 10468, USA; (D.W.V.E.); (D.L.P.)
- Correspondence:
| | - Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne, VIC 8001, Australia;
| | - Derrick W. Van Every
- Department of Health Sciences, CUNY Lehman College, Bronx, NY 10468, USA; (D.W.V.E.); (D.L.P.)
| | - Daniel L. Plotkin
- Department of Health Sciences, CUNY Lehman College, Bronx, NY 10468, USA; (D.W.V.E.); (D.L.P.)
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11
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Saatmann N, Zaharia OP, Loenneke JP, Roden M, Pesta DH. Effects of Blood Flow Restriction Exercise and Possible Applications in Type 2 Diabetes. Trends Endocrinol Metab 2021; 32:106-117. [PMID: 33358931 DOI: 10.1016/j.tem.2020.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/15/2020] [Accepted: 11/24/2020] [Indexed: 12/18/2022]
Abstract
Blood flow restriction resistance training (BFRT) employs partial vascular occlusion of exercising muscles via inflation cuffs. Compared with high-load resistance training, mechanical load is markedly reduced with BFRT, but induces similar gains in muscle mass and strength. BFRT is thus an effective training strategy for people with physical limitations. Recent research indicates that BFRT has beneficial effects on glucose and mitochondrial metabolism. BFRT may therefore qualify as a valuable exercise alternative for individuals with type 2 diabetes (T2D), a disorder characterized by impaired glucose metabolism, musculoskeletal decline, and exacerbated progression of sarcopenia. This review covers the effects of BFRT in healthy populations and in persons with impaired physical fitness, the mechanisms of action of this novel training modality, and possible applications for individuals with T2D.
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Affiliation(s)
- Nina Saatmann
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Michael Roden
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany; Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
| | - Dominik H Pesta
- Institute for Clinical Diabetology, Leibniz Center for Diabetes Research at Heinrich-Heine University Düsseldorf, German Diabetes Center, Düsseldorf, Germany; German Center for Diabetes Research (DZD eV), Partner Düsseldorf, Germany; Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany; Centre for Endocrinology, Diabetes and Preventive Medicine (CEDP), University Hospital Cologne, Cologne, Germany.
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