Potential physiological responses contributing to the ergogenic effects of acute ischemic preconditioning during exercise: A narrative review

Ischemic preconditioning (IPC) has been reported to augment exercise performance, but there is considerable heterogeneity in the magnitude and frequency of performance improvements. Despite a burgeoning interest in IPC as an ergogenic aid, much is still unknown about the physiological mechanisms that mediate the observed performance enhancing effects. This narrative review collates those physiological responses to IPC reported in the IPC literature and discusses how these responses may contribute to the ergogenic effects of IPC. Specifically, this review discusses documented central and peripheral cardiovascular responses, as well as selected metabolic, neurological, and perceptual effects of IPC that have been reported in the literature.

Ischaemic preconditioning improves upper-body endurance performance without altering ⩒O2 kinetics

PURPOSE

Whilst pre-exercise ischaemic preconditioning (IPC) can improve lower-body exercise performance, its impact on upper-limb performance has received little attention. This study examines the influence of IPC on upper-body exercise performance and oxygen uptake (⩒O₂) kinetics.

METHODS

Eleven recreationally-active males (24 ± 2 years) completed an arm-crank graded exercise test to exhaustion to determine the power outputs at the ventilatory thresholds (VT1 and VT2) and ⩒O_2peak (40.0 ± 7.4 ml·kg^-1·min^-1). Four main trials were conducted, two following IPC (4 × 5-min, 220 mmHg contralateral upper-limb occlusion), the other two following SHAM (4 × 5-min, 20 mmHg). The first two trials consisted of a 15-minute constant work rate and the last two time-to-exhaustion (TTE) arm-crank tests at the power equivalents of 95% VT1 (LOW) and VT2 (HIGH), respectively. Pulmonary ⩒O₂ kinetics, heart rate, blood-lactate concentration, and rating of perceived exertion were recorded throughout exercise.

RESULTS

TTE during HIGH was longer following IPC than SHAM (459 ± 115 vs 395 ± 102 s, p = 0.004). Mean response time and change in ⩒O₂ between 2-min and end exercise (Δ⩒O₂) were not different between IPC and SHAM for arm-cranking at both LOW (80.3 ± 19.0 vs 90.3 ± 23.5 s [p = 0.06], 457 ± 184 vs 443 ± 245 ml [p = 0.83]) and HIGH (96.6 ± 31.2 vs 92.1 ± 24.4 s [p = 0.65], 617 ± 321 vs 649 ± 230 ml [p = 0.74]). Heart rate, blood-lactate concentration, and rating of perceived exertion did not differ between conditions (all p≥0.05).

CONCLUSION

TTE was longer following IPC during upper-body exercise despite unchanged ⩒O₂ kinetics.

Effects of Different Tissue Flossing Applications on Range of Motion, Maximum Voluntary Contraction, and H-Reflex in Young Martial Arts Fighters

The purpose of this study was to investigate the effects of tissue flossing applied to the ankle joint or to the calf muscles, on ankle joint flexibility, plantarflexor strength and soleus H reflex. Eleven young (16.6 ± 1.2 years) martial arts fighters were exposed to three different intervention protocols in distinct sessions. The interventions consisted of wrapping the ankle (ANKLE) or calf (CALF) with an elastic band for 3 sets of 2 min (2 min rest) to create vascular occlusion. A third intervention without wrapping the elastic band served as a control condition (CON). Active range of motion for ankle (AROM), plantarflexor maximum voluntary contraction (MVC), and soleus H reflex were assessed before (PRE), after (POST), and 10 min after (POST10) the intervention. The H reflex, level of pain (NRS) and wrapping pressure were also assessed during the intervention. Both CALF and ANKLE protocols induced a significant drop in H reflex during the intervention. However, the CALF protocol resulted in a significantly larger H reflex reduction during and after the flossing intervention (medium to large effect size). H reflexes returned to baseline levels 10 min after the intervention in all conditions. AROM and MVC were unaffected by any intervention. The results of this study suggest that tissue flossing can decrease the muscle soleus H reflex particularly when elastic band is wrapped around the calf muscles. However, the observed changes at the spinal level did not translate into higher ankle joint flexibility or plantarflexor strength.

Is Ischemic Preconditioning Intervention Occlusion-Dependent to Enhance Resistance Exercise Performance?

ABSTRACT

de Souza, HLR, Arriel, RA, Hohl, R, da Mota, GR, and Marocolo, M. Is ischemic preconditioning intervention occlusion-dependent to enhance resistance exercise performance? J Strength Cond Res 35(10): 2706-2712, 2021-Ischemic preconditioning is a rising technique with potential to improve performance. Currently, its effects are still controversial, and a placebo effect seems to have a role. In this sense, this study evaluated the effect of high-pressure (HP) and low-pressure (LP) cuffing on resistance exercise performance during repeated 5-day intervention. Twenty healthy trained men (24.0 ± 4.4 years; 80.1 ± 12.2 kg; and 176.9 ± 6.6 cm) performed a 1 repetition maximum (1RM) test before interventions. Maximal isometric force test, number of repetitions (75% 1RM), total workload (sets × reps × load), fatigue index (FI) ([set 1 - set 3]/set 1 × 100), and perceived scales were assessed during knee extension preceded by HP (3 × 5-minute unilateral leg occlusion at 50 mm Hg above systolic blood pressure), LP (3 × 5-minute unilateral leg occlusion at 20 mm Hg), or control ([CON] 30-minute resting). The main effect of cuff intervention was significant for total workload (F(1,16) = 4.2, p = 0.03) after adjusting for baseline (analysis of covariance). Adjusted means (confidence interval) and effect sizes (ES) indicate that HP (1778 kg [1,613-1944]; ES: 0.29) and LP (1761 kg [1,590-1932]; ES: 0.34) significantly increased total workload compared with CON (1,452 kg [1,262-1,643]; ES: 0.17). Finally, isometric force and FI were similar for all conditions (HP, LP, and CON) with no difference from baseline performance. In conclusion, the short-term (5-day) intervention of HP and LP cuffing increases the total workload. This effect in muscle endurance performance is nondependent of blood flow occlusion, since LP is not able to obstruct arterial blood flow. A likely motivational effect cannot be ruled out.

Neuromuscular Adjustments Following Sprint Training with Ischemic Preconditioning in Endurance Athletes: Preliminary Data

This preliminary study examined the effect of chronic ischemic preconditioning (IPC) on neuromuscular responses to high-intensity exercise. In a parallel-group design, twelve endurance-trained males (VO₂max 60.0 ± 9.1 mL·kg⁻¹·min⁻¹) performed a 30-s Wingate test before, during, and after 4 weeks of sprint-interval training. Training consisted of bi-weekly sessions of 4 to 7 supra-maximal all-out 30-s cycling bouts with 4.5 min of recovery, preceded by either IPC (3 × 5-min of compression at 220 mmHg/5-min reperfusion, IPC, n = 6) or placebo compressions (20 mmHg, PLA, n = 6). Mechanical indices and the root mean square and mean power frequency of the electromyographic signal from three lower-limb muscles were continuously measured during the Wingate tests. Data were averaged over six 5-s intervals and analyzed with Cohen’s effect sizes. Changes in peak power output were not different between groups. However, from mid- to post-training, IPC improved power output more than PLA in the 20 to 25-s interval (7.6 ± 10.0%, ES 0.51) and the 25 to 30-s interval (8.8 ± 11.2%, ES 0.58), as well as the fatigue index (10.0 ± 2.3%, ES 0.46). Concomitantly to this performance difference, IPC attenuated the decline in frequency spectrum throughout the Wingate (mean difference: 14.8%, ES range: 0.88–1.80). There was no difference in root mean square amplitude between groups. These preliminary results suggest that using IPC before sprint training may enhance performance during a 30-s Wingate test, and such gains occurred in the last 2 weeks of the intervention. This improvement may be due, in part, to neuromuscular adjustments induced by the chronic use of IPC.

Declines in muscle contractility and activation during isometric contractions of the knee extensors vary with contraction intensity and exercise volume

NEW FINDINGS

What is the central question of this study? Is there a critical threshold beyond which the loss of muscle contractility is regulated by the level of muscle activation during single-limb exercise of differing intensities and volumes? What is the main finding and its importance? Plateaus in the decline in muscle contractility during single-limb knee extension depended on both exercise volume and contraction intensity.  A plateau was only evident with an increase in exercise volume.  Muscle activation increased and did not decline despite substantial reductions in contractility. The findings indicate that the decrease in muscle contractility exhibited by resistance-trained men during the performance of submaximal isometric contractions with the knee extensors was not regulated by the level of muscle activation.

ABSTRACT

Our study examined the influence of contraction intensity and exercise volume on changes in muscle contractility and activation of the knee extensor muscles. Maximal voluntary torque (MVT) and rate of change in torque, surface electromyograms, voluntary activation, V-waves and quadriceps resting twitch measures were assessed in 10 resistance-trained men during two experimental sessions. Each session began with an initial baseline series of contractions at a fixed intensity of 40% or 80% MVT. The 40%-only session continued with five contractions to task failure at 40% MVT. The 80% session continued with five contractions to failure each at 80%, 60% and 40% MVT. Greater reductions in MVT were observed during the baseline contractions of the 40%-only session compared with the 80% session at each matched-volume time point (P < 0.05), with similar changes in twitch values (P < 0.001). MVT and twitch values plateaued at each intensity during the 80% session and were significantly different across intensities: 80% > 60% > 40% (P < 0.001). There were no differences for measures during the five contractions at 40% MVT performed on the different days, despite a greater volume of exercise performed prior to the 40% MVT during the 80% session. At each contraction intensity, a plateau in contractility loss was observed as more contractions were performed. We found that initial increases in muscle activation were maintained in the presence of increases in exercise volume and, in contrast to the critical-threshold hypothesis, did not decline in parallel with reductions in muscle contractility.

Effect of 10 consecutive days of remote ischemic preconditioning on local neuromuscular performance

BACKGROUND

Most studies focus on the effects of a single remote ischemic preconditioning (RIPC) session on performance. However, the training-like effect of repeat RIPC sessions performed on consecutive days could potentially be even more beneficial to neuromuscular performance than a single RIPC session. Therefore, aim of the study was to assess the impact of 10 days of RIPC on local neuromuscular performance.

METHODS

Thirty-seven male participants performed 10 days of either RIPC or sham-controlled condition. Before and after procedure, the maximal voluntary contraction and muscle fatigue were assessed by dynamometry and surface electromyography (EMG) of the isometric extension of the knee joint. The following neuromuscular outcomes were investigated: peak torque (PKTQ); rate of force development (RTD); time to failure; and the slope of median frequency of power spectrum (MDF) and EMG amplitude.

RESULTS

After RIPC, while there was no change in PKTQ and time to failure, the late RTD and MDF slope were significantly affected. The RTD at 0-100 and 0-200 ms showed 24 and 16% increase, respectively, while the MDF slope showed 24% decrease in rectus femoris.

CONCLUSIONS

10 days of RIPC induced neuromuscular performance changes in the quadriceps muscle. Even though there were no changes in task to failure performance, RIPC showed EMG changes limited to rectus femoris and increased late RTD in MVC task.

Ischemic Preconditioning and Muscle Force Capabilities

ABSTRACT

Valenzuela, PL, Martín-Candilejo, R, Sánchez-Martínez, G, Bouzas Marins, JC, de la Villa, P, and Sillero-Quintana, M. Ischemic preconditioning and muscle force capabilities. J Strength Cond Res 35(8): 2187-2192, 2021-This study analyzed the effects of ischemic preconditioning (IPC) on muscle force capabilities. Sixteen male subjects participated in this randomized, crossover, sham-controlled study. They were assigned to either IPC (3 × 5 minutes at 220 mm Hg in both arms with 5-minute rests) or a sham intervention (SHAM) (occlusion pressure set at 10 mm Hg). Forty minutes later, their force capabilities on the bench press exercise were assessed (load-velocity relationship with light, moderate, and heavy loads [30, 50, and 70% body mass, respectively]; 1 repetition maximum [1RM]; and number of repetitions to failure in 3 sets with 60% RM). The skin temperature (Tsk) of the pectoral and biceps muscles was analyzed as a secondary endpoint by means of infrared thermography. A significant decrease in the Tsk of the pectoral and biceps muscles was observed after the intervention (p < 0.01) and before the warm-up (p < 0.05) in IPC, but not in SHAM. However, exercise resulted in a similar Tsk increase in the pectoral muscles in both conditions (p > 0.05). No significant differences (p > 0.05 for all) were observed between conditions in the mean velocity attained with light (1.11 ± 0.11 and 1.09 ± 0.14 m·s-1, respectively), moderate (0.83 ± 0.14 and 0.83 ± 0.16 m·s-1), nor heavy loads (0.56 ± 0.17 and 0.54 ± 0.16 m·s-1), in 1RM (75.0 ± 18.9 and 73.1 ± 15.0 kg for IPC and SHAM, respectively; p = 0.181), nor in the number of repetitions performed (52 ± 13 and 54 ± 16 repetitions, p = 0.492). In summary, IPC decreased Tsk locally (biceps) and remotely (pectoral). However, it did not alter muscle force capabilities nor the Tsk response to exercise.

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.

Ischemic Preconditioning Blunts Loss of Knee Extensor Torque Complexity with Fatigue

INTRODUCTION

Neuromuscular fatigue reduces the temporal structure, or complexity, of muscle torque output, purportedly through an effect on motor unit behavior. Ischemic preconditioning (IPC), an emerging ergogenic aid, has been demonstrated to have a potent effect on muscular output and endurance. We therefore tested the hypothesis that IPC would attenuate the fatigue-induced loss of muscle torque complexity.

METHODS

Ten healthy participants (6 males/4 females) performed intermittent isometric knee extension contractions (6 s contraction, 4 s rest) to task failure at 40% maximal voluntary contraction. Contractions were preceded by either IPC (three bouts of 5 min proximal thigh occlusion at 225 mm Hg, interspersed with 5 min rest) or SHAM (as IPC, but occlusion at only 20 mm Hg) treatments. Torque and EMG signals were sampled continuously. Complexity and fractal scaling were quantified using approximate entropy (ApEn) and the detrended fluctuation analysis (DFA) α scaling exponent. Muscle oxygen consumption (mV˙O2) was determined using near-infrared spectroscopy.

RESULTS

IPC increased time to task failure by 43% ± 13% (mean ± SEM, P = 0.047). Complexity decreased in both trials (decreased ApEn, increased DFA α; both P < 0.001), although the rate of decrease was significantly lower after IPC (ApEn, -0.2 ± 0.1 vs -0.4 ± 0.1, P = 0.013; DFA α, 0.2 ± 0.1 vs 0.3 ± 0.1, P = 0.037). Similarly, the rates of increase in EMG amplitude (P = 0.022) and mV˙O2 (P = 0.043) were significantly slower after IPC.

CONCLUSION

These results suggest that the ergogenic effect of IPC observed here is of neural origin and accounts for the slowing of the rates of change in torque complexity, EMG amplitude, and mV˙O2 as fatigue develops.

Sex differences in fatigability after ischemic preconditioning of non-exercising limbs

Background

Ischemic preconditioning (IPC) is suggested to decrease fatigability in some individuals but not others. Sex differences in response to IPC may account for this variability and few studies systematically investigated the effects of IPC in men and women. The goal of this study was to determine if time to task failure, perception of pain, and neuromuscular mechanisms of fatigability were altered by IPC in men and women.

Methods

Ten women (29 ± 5 years old) and 10 men (28 ± 6 years old) performed isometric contractions with the plantar flexor muscles of the dominant leg at 20% of maximal voluntary contraction until task failure. We used a repeated measures design where each individual performed 3 randomized and counterbalanced test sessions: (A) IPC session, cuff inflation and deflation (5 min each repeated 3 times) performed before the exercise by inflating cuffs to the non-dominant leg and arm; (B) sham session, cuffs were inflated for a short period (1 min); and (C) control session, no cuffs were involved.

Results

Compared with control, IPC increased time to task failure in men (mean difference, 5 min; confidence interval (CI) of mean difference, 2.2; 7.8 min; P = 0.01) but not women (mean difference, − 0.6 min; CI of mean difference, − 3.5; 2.4 min; P = 0.51). In men, but not women, the IPC-induced increase in time to task failure was associated with lower response to pressure pain (r = − 0.79). IPC further exposed sex differences in arterial pressure during fatiguing contractions (session × sex: P < 0.05). Voluntary activation, estimated with the twitch interpolation technique, and presynaptic inhibition of leg Ia afferents were not altered after IPC for men and women. The tested variables were not altered with sham.

Conclusions

The ergogenic effect of IPC on time to task failure was observed only in men and it was associated with reductions in the perception of pain. This pilot data suggest the previously reported inter-individual variability in exercise-induced fatigability after IPC could be a consequence of the sex and individual response to pain.

Cardiac autonomic recovery following traditional and augmented remote ischemic preconditioning

PURPOSE

While the possible ergogenic benefits of remote ischemic preconditioning (RIPC) make it an attractive training modality, the mechanisms of action remain unclear. Alterations in neural tone have been demonstrated in conjunction with circulatory occlusion, yet investigation of the autonomic nervous system following RIPC treatment has received little attention. We sought to characterize alterations in autonomic balance to both RIPC and augmented RIPC (RIPC_aug) performed while cycling, using acute and sustained autonomic indices.

METHODS

Thirteen participants (8M:5F) recorded baseline waking heart rate variability (HRV) for 5 days prior to treatment. Participants then completed control exercise (CON), RIPC, and RIPC_aug interventions in a randomized cross-over design. Cardiovascular measurements were recorded immediately before and after each intervention at rest, and during an orthostatic challenge. Waking HRV was repeated the morning after each intervention.

RESULTS

RIPC resulted in acutely reduced resting heart rates (HR) (∆ - 4 ± 6 bpm, P = 0.02) and suppressed HR 30 s following the orthostatic challenge compared to CON (64 ± 10 vs 74 ± 9 bpm, P = 0.003). RIPC_aug yielded elevated HRs compared to CON and RIPC prior to (P = 0.003) and during the orthostatic challenge (P = 0.002). RIPC_aug reduced LnSDNN (Baseline 4.39 ± 0.27; CON 4.44 ± 0.39; RIPC 4.41 ± 0.34; RIPC_aug 4.22 ± 0.29, P = 0.02) and LnHfa power (Baseline 7.82 ± 0.54; CON 7.73 ± 1.11; RIPC 7.89 ± 0.78; RIPC_aug 7.23 ± 0.87, P = 0.04) the morning after treatment compared to all other conditions.

CONCLUSIONS

Our data suggest that RIPC may influence HR acutely, possibly through a reduction in cardiac sympathetic activity, and that RIPC_aug reduces HRV through cardiac vagal withdrawal or increased cardiac sympathetic modulation, with alterations persisting until the following morning. These findings imply a dose-response relationship with potential for optimization of performance.

Ischemic Preconditioning Did Not Affect Central and Peripheral Factors of Performance Fatigability After Submaximal Isometric Exercise

The present study was designed to provide further insight into the mechanistic basis for the improved exercise tolerance following ischemic preconditioning (IPC) by investigating key-determinants of performance and perceived fatigability. Using a randomized, counterbalanced, single-blind, sham-controlled, crossover design, 16 males performed an isometric time-to-exhaustion test with the knee extensors at 20% maximal voluntary torque (MVT) after an IPC and a sham treatment (SHAM). Those who improved their time-to-exhaustion following IPC performed a time-matched IPC trial corresponding to the exercise duration of SHAM (IPC_tm). Neuromuscular function was assessed before and after exercise termination during each condition (IPC, IPC_tm, and SHAM) to analyze the impact of IPC on performance fatigability and its central and peripheral determinants. Muscle oxygenation (SmO₂), muscle activity, and perceptual responses (effort and muscle pain) were recorded during exercise. Performance fatigability as well as its central and peripheral determinants were quantified as percentage pre-post changes in MVT (ΔMVT) as well as voluntary activation (ΔVA) and quadriceps twitch torque evoked by paired electrical stimuli at 100 and 10 Hz (ΔPS100 and ΔPS10⋅PS100^-1 ratio), respectively. Time-to-exhaustion, performance fatigability, its determinants, muscle activity, SmO₂, and perceptual responses during exercise were not different between IPC and SHAM. However, six participants improved their performance by >10% following IPC (299 ± 71 s) compared to SHAM (253 ± 66 s, d = 3.23). The time-matched comparisons (IPC_tm vs. SHAM) indicated that performance fatigability, its determinants, and SmO₂ were not affected, while effort perception seemed to be lower (η_p ² = 0.495) in those who improved their time-to-exhaustion. The longer time-to-exhaustion following IPC seemed to be associated with a lower effort perception (η_p ² = 0.380) and larger impairments in neuromuscular function, i.e., larger ΔMVT, ΔVA, and ΔPS10⋅PS100^-1 ratio (d = 0.71, 1.0, 0.92, respectively). IPC did neither affect exercise tolerance, performance fatigability, as well as its central and peripheral determinants, nor muscle activity, SmO₂, and perceptual responses during submaximal isometric exercise. However, IPC seemed to have an ergogenic effect in a few subjects, which might have resulted from a lower effort perception during exercise. These findings support the assumption that there are 'responders' and 'non-responders' to IPC.

Modulation of spinal cord excitability following remote limb ischemic preconditioning in healthy young men

Remote limb ischemic preconditioning (RIPC) has shown to improve dynamic postural control in humans. However, studies on the underlying adaptations of spinal cord networks have never been performed. The present work addresses this issue by investigating parameters from the soleus H-reflex recruitment curve (RC), presynaptic mechanisms of reflex modulation (presynaptic inhibition-PSI, and post activation depression-PAD), and the excursion of the center of pressure (CP) recorded during 1 min in upright stance over a compliant surface. A sham ischemic protocol (partial obstruction of blood flow) was applied to the contralateral thigh along four consecutive days. The same procedure was repeated with full obstruction (RIPC) three days after ending the sham protocol. Data were collected before and after both sham and RIPC protocols. The follow-up data were collected five days after the last ischemic intervention. Significant reduction was detected for both the fast oscillations of the CP (higher frequency components) and the parameter estimated from the RC corresponding to the high amplitude H-reflexes (p < 0.05). Even though the magnitude of effects was similar, it was washed out within three days after sham, but persisted for at least five days after RIPC. No significant differences were found for PSI and PAD levels across conditions. These findings indicate that RIPC leads to enduring changes in spinal cord excitability for the latest reflexively recruited motoneurons, along with improvement in balance control. However, these adaptations were not mediated by the presynaptic mechanisms currently assessed.

Changes in the quadriceps spinal reflex pathway after repeated sprint cycling are not influenced by ischemic preconditioning

PURPOSE

We examined the effect of ischemic preconditioning (IPC) on changes in muscle force, activation, and the spinal reflex pathway during and after repeated sprint cycling.

METHODS

Eight recreationally active men (high-intensity cardiorespiratory training > 3 times per week, > 6 months) completed two exercise sessions (5 sets of 5 cycling sprints, 150% max W), preceded by either IPC (3 × 5 min leg occlusions at 220 mmHg) or SHAM (3 × 5 min at 20 mmHg). Knee extensor maximal force and rate of force were measured before (PRE), immediately post (POST), 1H, and 24H after cycling. Twitch interpolation and resting potentiated twitches were applied to estimate voluntary activation and muscle contractility, respectively. Quadriceps H-reflex recruitment curves were collected at all time-points using 10 Hz doublet stimulation to allow estimation of H-reflex post-activation depression. Surface electromyograms and tissue oxygenation (via near-infrared spectroscopy) were continuously recorded during cycling.

RESULTS

IPC did not affect any measure of neuromuscular function or performance during cycling. Maximal force and muscle contractility were significantly lower at POST and 1H compared to PRE and 24H by up to 50% (p < 0.01). Maximal force was lower than PRE at 24H by 8.7% (p = 0.028). Voluntary activation and rate of force were unchanged. A rightwards shift was observed for the H-reflex recruitment curve POST, and post-activation depression was higher than all other time-points at 24H (p < 0.05). Muscle activation and oxygenation decreased during cycling.

CONCLUSIONS

IPC has a nominal effect on mechanisms associated with neuromuscular function during and after exercise in healthy populations.

Effect of ischemic preconditioning and changing inspired O2 fractions on neuromuscular function during intense exercise

The aim of the present study was to determine whether ischemic preconditioning (IPC)-mediated effects on neuromuscular function are dependent on tissue oxygenation. Eleven resistance-trained males completed four exercise trials (6 sets of 11 repetitions of maximal effort dynamic single-leg extensions) in either normoxic [fraction of inspired oxygen ([Formula: see text]): 21%) or hypoxic [Formula: see text]: 14%] conditions, preceded by treatments of either IPC (3 × 5 min bilateral leg occlusions at 220 mmHg) or sham (3 × 5 min at 20 mmHg). Femoral nerve stimulation was utilized to assess voluntary activation and potentiated twitch characteristics during maximal voluntary contractions (MVCs). Tissue oxygenation (via near-infrared spectroscopy) and surface electromyography activity were measured throughout the exercise task. MVC and twitch torque declined 62 and 54%, respectively (MVC: 96 ± 24 N·m, Cohen’s d = 2.9, P < 0.001; twitch torque: 37 ± 11 N·m, d = 1.6, P < 0.001), between pretrial measurements and the sixth set without reductions in voluntary activation ( P > 0.21); there were no differences between conditions. Tissue oxygenation was reduced in both hypoxic conditions compared with normoxia ( P < 0.001), with an even further reduction of 3% evident in the hypoxic IPC compared with the sham trial (mean decrease 1.8 ± 0.7%, d = 1.0, P < 0.05). IPC did not affect any measure of neuromuscular function regardless of tissue oxygenation. A reduction in [Formula: see text] did invoke a humoral response and improved muscle O2 extraction during exercise, however, it did not manifest into any performance benefit.

NEW & NOTEWORTHY Ischemic preconditioning did not affect any facet of neuromuscular function regardless of the degree of tissue oxygenation. Reducing the fraction of inspired oxygen induced localized tissue deoxygenation, subsequently invoking a humoral response, which improved muscle oxygen extraction during exercise. This physiological response, however, did not manifest into any performance benefits.

The effect of IPC on central and peripheral fatiguing mechanisms in humans following maximal single limb isokinetic exercise

Ischemic preconditioning (IPC) has been suggested to preserve neural drive during fatiguing dynamic exercise, however, it remains unclear as to whether this may be the consequence of IPC-enhanced muscle oxygenation. We hypothesized that the IPC-enhanced muscle oxygenation during a dynamic exercise task would subsequently attenuate exercise-induced reductions in voluntary activation. Ten resistance trained males completed three 3 min maximal all-out tests (AOTs) via 135 isokinetic leg extensions preceded by treatments of IPC (3 × 5 min bilateral leg occlusions at 220 mmHg), SHAM (3 × 5 min at 20 mmHg) or CON (30 min passive rest). Femoral nerve stimulation was utilized to assess voluntary activation and potentiated twitch torque during maximal voluntary contractions (MVCs) performed at baseline (BL), prior to the AOT (Pre), and then 10 sec post (Post). Tissue oxygenation (via near-infrared spectroscopy) and sEMG activity was measured throughout the AOT. MVC and twitch torque levels declined (MVC: -87 ± 23 Nm, 95% CI = -67 to -107 Nm; P < 0.001, twitch: -30 ± 13 Nm; 95% CI = -25 to -35 Nm; P < 0.001) between Pre and Post without reductions in voluntary activation (P = 0.72); there were no differences between conditions (MVC: P = 0.75, twitch: P = 0.55). There were no differences in tissue saturation index (P = 0.27), deoxyhemoglobin concentrations (P = 0.86) or sEMG activity (P = 0.92) throughout the AOT. These findings demonstrate that IPC does not preserve neural drive during an all-out 3 min isokinetic leg extension task.