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Mendonca GV, Alves DL, Fitas A, Pezarat-Correia P. Minimum velocity threshold in response to the free-weight back squat: reliability and validity of different submaximal loading schemes. Eur J Appl Physiol 2024:10.1007/s00421-024-05494-3. [PMID: 38730035 DOI: 10.1007/s00421-024-05494-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/20/2024] [Indexed: 05/12/2024]
Abstract
PURPOSE To explore if mean concentric velocity (MCV) of the last repetition before set failure differs between free-weight back squat protocols with greater emphasis on metabolic accumulation vs. mechanical loading. The between-set and between-day reliability of terminal MCV obtained with these different loading schemes was also determined. METHODS Fifteen healthy male participants (18-30 years) were included. They all were required to exhibit a relative strength ≥ 1.5 times their body mass. MCVs were obtained at one-repetition maximum (1RM) and with two submaximal protocols (metabolic emphasis: three sets of 40%1RM with blood-flow restriction vs. mechanical emphasis: three sets 80%1RM without blood-flow restriction). Participants were instructed to reach maximal intended concentric velocity in each repetition up to failure. RESULTS Set failure was achieved at a faster MCV with the metabolic protocol (p < 0.05). The reliability of MCV at failure reached higher values for the metabolic loading scheme. However, while the MCV achieved at failure during the metabolic protocol was systematically higher than the MCV at 1RM (p < 0.05), this was not entirely the case for the mechanical protocol (similar to 1RM MCV during the last sets in both testing days). Finally, the absolute error derived from estimating the MCV at 1RM based on the MCV obtained at set failure with the mechanical protocol was considerably high (≥ 0.05 m/s). CONCLUSION This study indicates that MCV obtained at set failure is dependent on the specificity of the physiological demands of exercise. Thus, MCVs obtained at failure with submaximal loads should not be used to estimate 1RM MCV.
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Affiliation(s)
- Goncalo V Mendonca
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Dafundo, Portugal.
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Dafundo, Portugal.
| | - Diogo L Alves
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Dafundo, Portugal
| | - Afonso Fitas
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Dafundo, Portugal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Dafundo, Portugal
| | - Pedro Pezarat-Correia
- Neuromuscular Research Lab, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Dafundo, Portugal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, 1499-002, Dafundo, Portugal
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Davids CJ, Roberts LA, Bjørnsen T, Peake JM, Coombes JS, Raastad T. Where Does Blood Flow Restriction Fit in the Toolbox of Athletic Development? A Narrative Review of the Proposed Mechanisms and Potential Applications. Sports Med 2023; 53:2077-2093. [PMID: 37578669 PMCID: PMC10587223 DOI: 10.1007/s40279-023-01900-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/15/2023]
Abstract
Blood flow-restricted exercise is currently used as a low-intensity time-efficient approach to reap many of the benefits of typical high-intensity training. Evidence continues to lend support to the notion that even highly trained individuals, such as athletes, still benefit from this mode of training. Both resistance and endurance exercise may be combined with blood flow restriction to provide a spectrum of adaptations in skeletal muscle, spanning from myofibrillar to mitochondrial adjustments. Such diverse adaptations would benefit both muscular strength and endurance qualities concurrently, which are demanded in athletic performance, most notably in team sports. Moreover, recent work indicates that when traditional high-load resistance training is supplemented with low-load, blood flow-restricted exercise, either in the same session or as a separate training block in a periodised programme, a synergistic and complementary effect on training adaptations may occur. Transient reductions in mechanical loading of tissues afforded by low-load, blood flow-restricted exercise may also serve a purpose during de-loading, tapering or rehabilitation of musculoskeletal injury. This narrative review aims to expand on the current scientific and practical understanding of how blood flow restriction methods may be applied by coaches and practitioners to enhance current athletic development models.
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Affiliation(s)
- Charlie J Davids
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia.
| | - Llion A Roberts
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Thomas Bjørnsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Jonathan M Peake
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia
- School of Biomedical Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Truls Raastad
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
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Roberts MD, McCarthy JJ, Hornberger TA, Phillips SM, Mackey AL, Nader GA, Boppart MD, Kavazis AN, Reidy PT, Ogasawara R, Libardi CA, Ugrinowitsch C, Booth FW, Esser KA. Mechanisms of mechanical overload-induced skeletal muscle hypertrophy: current understanding and future directions. Physiol Rev 2023; 103:2679-2757. [PMID: 37382939 PMCID: PMC10625844 DOI: 10.1152/physrev.00039.2022] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
Mechanisms underlying mechanical overload-induced skeletal muscle hypertrophy have been extensively researched since the landmark report by Morpurgo (1897) of "work-induced hypertrophy" in dogs that were treadmill trained. Much of the preclinical rodent and human resistance training research to date supports that involved mechanisms include enhanced mammalian/mechanistic target of rapamycin complex 1 (mTORC1) signaling, an expansion in translational capacity through ribosome biogenesis, increased satellite cell abundance and myonuclear accretion, and postexercise elevations in muscle protein synthesis rates. However, several lines of past and emerging evidence suggest that additional mechanisms that feed into or are independent of these processes are also involved. This review first provides a historical account of how mechanistic research into skeletal muscle hypertrophy has progressed. A comprehensive list of mechanisms associated with skeletal muscle hypertrophy is then outlined, and areas of disagreement involving these mechanisms are presented. Finally, future research directions involving many of the discussed mechanisms are proposed.
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Affiliation(s)
- Michael D Roberts
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - John J McCarthy
- Department of Physiology, College of Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - Troy A Hornberger
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gustavo A Nader
- Department of Kinesiology and Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - Marni D Boppart
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, United States
| | - Andreas N Kavazis
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Paul T Reidy
- Department of Kinesiology, Nutrition and Health, Miami University, Oxford, Ohio, United States
| | - Riki Ogasawara
- Healthy Food Science Research Group, Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Cleiton A Libardi
- MUSCULAB-Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos, São Carlos, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Frank W Booth
- Department of Biomedical Sciences, University of Missouri, Columbia, Missouri, United States
| | - Karyn A Esser
- Department of Physiology and Aging, College of Medicine, University of Florida, Gainesville, Florida, United States
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Reece TM, Godwin JS, Strube MJ, Ciccone AB, Stout KW, Pearson JR, Vopat BG, Gallagher PM, Roberts MD, Herda TJ. Myofiber hypertrophy adaptations following 6 weeks of low-load resistance training with blood flow restriction in untrained males and females. J Appl Physiol (1985) 2023; 134:1240-1255. [PMID: 37022967 PMCID: PMC10190928 DOI: 10.1152/japplphysiol.00704.2022] [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: 11/20/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
The effects of low-load resistance training with blood flow restriction (BFR) on hypertrophy of type I/II myofibers remains unclear, especially in females. The purpose of the present study is to examine changes in type I/II myofiber cross-sectional area (fCSA) and muscle CSA (mCSA) of the vastus lateralis (VL) from before (Pre) to after (Post) 6 wk of high-load resistance training (HL; n = 15, 8 females) and low-load resistance training with BFR (n = 16, 8 females). Mixed-effects models were used to analyze fCSA with group (HL, BFR), sex (M, F), fiber type (I, II), and time (Pre, Post) included as factors. mCSA increased from pre- to posttraining (P < 0.001, d = 0.91) and was greater in males compared with females (P < 0.001, d = 2.26). Type II fCSA increased pre- to post-HL (P < 0.05, d = 0.46) and was greater in males compared with females (P < 0.05, d = 0.78). There were no significant increases in fCSA pre- to post-BFR for either fiber type or sex. Cohen's d, however, revealed moderate effect sizes in type I and II fCSA for males (d = 0.59 and 0.67), although this did not hold true for females (d = 0.29 and 0.34). Conversely, the increase in type II fCSA was greater for females than for males after HL. In conclusion, low-load resistance training with BFR may not promote myofiber hypertrophy to the level of HL resistance training, and similar responses were generally observed for males and females. In contrast, comparable effect sizes for mCSA and 1-repetition maximum (1RM) between groups suggest that BFR could play a role in a resistance training program.NEW & NOTEWORTHY This is the first study, to our knowledge, to examine myofiber hypertrophy from low-load resistance training with blood flow restriction (BFR) in females. Although this type of training did not result in myofiber hypertrophy, there were comparable increases in muscle cross-sectional area compared with high-load resistance training. These findings possibly highlight that males and females respond in a similar manner to high-load resistance training and low-load resistance training with BFR.
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Affiliation(s)
- Tanner M Reece
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, United States
| | - Joshua S Godwin
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Michael J Strube
- Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri, United States
| | - Anthony B Ciccone
- Department of Exercise Science and Outdoor Recreation, Utah Valley University, Orem, Utah, United States
| | - Kevan W Stout
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, Kansas, United States
| | - Jeremy R Pearson
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, Kansas, United States
| | - Bryan G Vopat
- University of Kansas School of Medicine-Wichita, Wichita, Kansas, United States
| | - Philip M Gallagher
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, Kansas, United States
| | - Michael D Roberts
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Trent J Herda
- Department of Health, Sport, and Exercise Sciences, University of Kansas, Lawrence, Kansas, United States
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Schoenfeld BJ, Ogborn D, Piñero A, Burke R, Coleman M, Rolnick N. Fiber-Type-Specific Hypertrophy with the Use of Low-Load Blood Flow Restriction Resistance Training: A Systematic Review. J Funct Morphol Kinesiol 2023; 8:jfmk8020051. [PMID: 37218848 DOI: 10.3390/jfmk8020051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/24/2023] Open
Abstract
Emerging evidence indicates that the use of low-load resistance training in combination with blood flow restriction (LL-BFR) can be an effective method to elicit increases in muscle size, with most research showing similar whole muscle development of the extremities compared to high-load (HL) training. It is conceivable that properties unique to LL-BFR such as greater ischemia, reperfusion, and metabolite accumulation may enhance the stress on type I fibers during training compared to the use of LLs without occlusion. Accordingly, the purpose of this paper was to systematically review the relevant literature on the fiber-type-specific response to LL-BFR and provide insights into future directions for research. A total of 11 studies met inclusion criteria. Results of the review suggest that the magnitude of type I fiber hypertrophy is at least as great, and sometimes greater, than type II hypertrophy when performing LL-BFR. This finding is in contrast to HL training, where the magnitude of type II fiber hypertrophy tends to be substantially greater than that of type I myofibers. However, limited data directly compare training with LL-BFR to nonoccluded LL or HL conditions, thus precluding the ability to draw strong inferences as to whether the absolute magnitude of type I hypertrophy is indeed greater in LL-BFR vs. traditional HL training. Moreover, it remains unclear as to whether combining LL-BFR with traditional HL training may enhance whole muscle hypertrophy via greater increases in type I myofiber cross-sectional area.
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Affiliation(s)
- Brad J Schoenfeld
- Department of Exercise Science and Recreation, CUNY Lehman College, Bronx, NY 10468, USA
| | - Dan Ogborn
- Department of Physical Therapy, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Orthopedic Section, Department of Surgery, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Pan Am Clinic Foundation, Winnipeg, MB R3M 3E4, Canada
| | - Alec Piñero
- Department of Exercise Science and Recreation, CUNY Lehman College, Bronx, NY 10468, USA
| | - Ryan Burke
- Department of Exercise Science and Recreation, CUNY Lehman College, Bronx, NY 10468, USA
| | - Max Coleman
- Department of Exercise Science and Recreation, CUNY Lehman College, Bronx, NY 10468, USA
| | - Nicholas Rolnick
- Department of Exercise Science and Recreation, CUNY Lehman College, Bronx, NY 10468, USA
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6
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de Queiros VS, Rolnick N, de Alcântara Varela PW, Cabral BGDAT, Silva Dantas PM. Physiological adaptations and myocellular stress in short-term, high-frequency blood flow restriction training: A scoping review. PLoS One 2022; 17:e0279811. [PMID: 36584157 PMCID: PMC9803189 DOI: 10.1371/journal.pone.0279811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND High frequency (1-2 times per day) low-intensity blood flow restriction (BFR) training has been recommended as a prescription approach for short durations of time to maximize relevant physiological adaptations. However, some studies demonstrate negative physiological changes after short periods of high-frequency BFR training, including prolonged strength decline and muscle fiber atrophy. OBJECTIVES To provide a comprehensive overview of short-term, high-frequency blood flow restriction training, including main adaptations, myocellular stress, limitations in the literature, and future perspectives. METHODS A systematic search of electronic databases (Scopus, PubMed®, and Web of Science) was performed from the earliest record to April 23, 2022. Two independent reviewers selected experimental studies that analyzed physical training protocols (aerobic or resistance) of high weekly frequency (>4 days/week) and short durations (≤3 weeks). RESULTS In total, 22 studies were included in this review. The samples were composed exclusively of young predominantly male individuals. Muscle strength and hypertrophy were the main outcomes analyzed in the studies. In general, studies have demonstrated increases in strength and muscle size after short term (1-3 weeks), high-frequency low-intensity BFR training, non-failure, but not after control conditions (non-BFR; equalized training volume). Under failure conditions, some studies have demonstrated strength decline and muscle fiber atrophy after BFR conditions, accompanying increases in muscle damage markers. Significant limitations exist in the current HF-BFR literature due to large heterogeneities in methodologies. CONCLUSION The synthesis presented indicates that short-term, high-frequency BFR training programs can generate significant neuromuscular adaptations. However, in resistance training to failure, strength declines and muscle fiber atrophy were reported. Currently, there are no studies analyzing low-frequency vs. high-frequency in short-term BFR training. Comparisons between resistance exercises of similar intensities (e.g., combined effort) are lacking, limiting conclusions on whether the effect is a product of proximity to failure or a specific effect of BFR.
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Affiliation(s)
- Victor Sabino de Queiros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Nicholas Rolnick
- The Human Performance Mechanic, CUNY Lehman College, The Bronx, New York, United States of America
| | | | | | - Paulo Moreira Silva Dantas
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
- Graduate Program in Physical Education, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
- * E-mail:
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Going nuclear: Molecular adaptations to exercise mediated by myonuclei. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 5:2-9. [PMID: 36994170 PMCID: PMC10040379 DOI: 10.1016/j.smhs.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/30/2022] [Indexed: 12/13/2022] Open
Abstract
Muscle fibers are multinucleated, and muscle fiber nuclei (myonuclei) are believed to be post-mitotic and are typically situated near the periphery of the myofiber. Due to the unique organization of muscle fibers and their nuclei, the cellular and molecular mechanisms regulating myofiber homeostasis in unstressed and stressed conditions (e.g., exercise) are unique. A key role myonuclei play in regulating muscle during exercise is gene transcription. Only recently have investigators had the capability to identify molecular changes at high resolution exclusively in myonuclei in response to perturbations in vivo. The purpose of this review is to describe how myonuclei modulate their transcriptome, epigenetic status, mobility and shape, and microRNA expression in response to exercise in vivo. Given the relative paucity of high-fidelity information on myonucleus-specific contributions to exercise adaptation, we identify specific gaps in knowledge and provide perspectives on future directions of research.
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8
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Bernard C, Zavoriti A, Pucelle Q, Chazaud B, Gondin J. Role of macrophages during skeletal muscle regeneration and hypertrophy-Implications for immunomodulatory strategies. Physiol Rep 2022; 10:e15480. [PMID: 36200266 PMCID: PMC9535344 DOI: 10.14814/phy2.15480] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023] Open
Abstract
Skeletal muscle is a plastic tissue that regenerates ad integrum after injury and adapts to raise mechanical loading/contractile activity by increasing its mass and/or myofiber size, a phenomenon commonly refers to as skeletal muscle hypertrophy. Both muscle regeneration and hypertrophy rely on the interactions between muscle stem cells and their neighborhood, which include inflammatory cells, and particularly macrophages. This review first summarizes the role of macrophages in muscle regeneration in various animal models of injury and in response to exercise-induced muscle damage in humans. Then, the potential contribution of macrophages to skeletal muscle hypertrophy is discussed on the basis of both animal and human experiments. We also present a brief comparative analysis of the role of macrophages during muscle regeneration versus hypertrophy. Finally, we summarize the current knowledge on the impact of different immunomodulatory strategies, such as heat therapy, cooling, massage, nonsteroidal anti-inflammatory drugs and resolvins, on skeletal muscle regeneration and their potential impact on muscle hypertrophy.
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Affiliation(s)
- Clara Bernard
- Institut NeuroMyoGène, Unité Physiopathologie et Génétique du Neurone et du MuscleUniversité Claude Bernard Lyon 1, CNRS UMR 5261, INSERM U1315, Université LyonLyonFrance
| | - Aliki Zavoriti
- Institut NeuroMyoGène, Unité Physiopathologie et Génétique du Neurone et du MuscleUniversité Claude Bernard Lyon 1, CNRS UMR 5261, INSERM U1315, Université LyonLyonFrance
| | - Quentin Pucelle
- Université de Versailles Saint‐Quentin‐En‐YvelinesVersaillesFrance
| | - Bénédicte Chazaud
- Institut NeuroMyoGène, Unité Physiopathologie et Génétique du Neurone et du MuscleUniversité Claude Bernard Lyon 1, CNRS UMR 5261, INSERM U1315, Université LyonLyonFrance
| | - Julien Gondin
- Institut NeuroMyoGène, Unité Physiopathologie et Génétique du Neurone et du MuscleUniversité Claude Bernard Lyon 1, CNRS UMR 5261, INSERM U1315, Université LyonLyonFrance
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LIM CHANGHYUN, NUNES EVERSONA, CURRIER BRADS, MCLEOD JONATHANC, THOMAS AARONCQ, PHILLIPS STUARTM. An Evidence-Based Narrative Review of Mechanisms of Resistance Exercise-Induced Human Skeletal Muscle Hypertrophy. Med Sci Sports Exerc 2022; 54:1546-1559. [PMID: 35389932 PMCID: PMC9390238 DOI: 10.1249/mss.0000000000002929] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Skeletal muscle plays a critical role in physical function and metabolic health. Muscle is a highly adaptable tissue that responds to resistance exercise (RE; loading) by hypertrophying, or during muscle disuse, RE mitigates muscle loss. Resistance exercise training (RET)-induced skeletal muscle hypertrophy is a product of external (e.g., RE programming, diet, some supplements) and internal variables (e.g., mechanotransduction, ribosomes, gene expression, satellite cells activity). RE is undeniably the most potent nonpharmacological external variable to stimulate the activation/suppression of internal variables linked to muscular hypertrophy or countering disuse-induced muscle loss. Here, we posit that despite considerable research on the impact of external variables on RET and hypertrophy, internal variables (i.e., inherent skeletal muscle biology) are dominant in regulating the extent of hypertrophy in response to external stimuli. Thus, identifying the key internal skeletal muscle-derived variables that mediate the translation of external RE variables will be pivotal to determining the most effective strategies for skeletal muscle hypertrophy in healthy persons. Such work will aid in enhancing function in clinical populations, slowing functional decline, and promoting physical mobility. We provide up-to-date, evidence-based perspectives of the mechanisms regulating RET-induced skeletal muscle hypertrophy.
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Affiliation(s)
- CHANGHYUN LIM
- Department of Kinesiology, McMaster University, Hamilton, Ontario, CANADA
| | - EVERSON A. NUNES
- Department of Kinesiology, McMaster University, Hamilton, Ontario, CANADA
- Department of Physiological Science, Federal University of Santa Catarina, Florianópolis, Santa-Catarina, BRAZIL
| | - BRAD S. CURRIER
- Department of Kinesiology, McMaster University, Hamilton, Ontario, CANADA
| | - JONATHAN C. MCLEOD
- Department of Kinesiology, McMaster University, Hamilton, Ontario, CANADA
| | - AARON C. Q. THOMAS
- Department of Kinesiology, McMaster University, Hamilton, Ontario, CANADA
| | - STUART M. PHILLIPS
- Department of Kinesiology, McMaster University, Hamilton, Ontario, CANADA
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10
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Martin PM, Bart RM, Ashley RL, Velasco T, Wise SR. An Overview of Blood Flow Restriction Physiology and Clinical Considerations. Curr Sports Med Rep 2022; 21:123-128. [PMID: 35394953 DOI: 10.1249/jsr.0000000000000948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT The utilization of blood flow restriction has garnished considerable attention due to its widespread application and benefits that include strength enhancement, muscle hypertrophy, and increased level of function for specific populations. Blood flow restriction induces a hypoxic environment within a muscle group, initiating a metabolic cascade that stimulates muscle protein synthesis, altered gene regulation of muscle satellite cells, and increased muscle fiber recruitment, ultimately resulting in improved strength and endurance. When using blood flow restriction, consideration of the individual patient, occlusion pressure, cuff width, and cuff size are paramount. Blood flow restriction has been proven to be a consistently safe and effective tool for augmenting rehabilitative regimens for the upper and lower extremity.
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Affiliation(s)
- Peter Mitchell Martin
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | - Ryan M Bart
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | - Robert L Ashley
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | | | - Sean R Wise
- National Capital Consortium Military Sports Medicine Fellowship, Fort Belvoir Community Hospital, Fort Belvoir, VA
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11
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Bemben DA, Sherk VD, Buchanan SR, Kim S, Sherk K, Bemben MG. Acute and Chronic Bone Marker and Endocrine Responses to Resistance Exercise With and Without Blood Flow Restriction in Young Men. Front Physiol 2022; 13:837631. [PMID: 35370772 PMCID: PMC8969015 DOI: 10.3389/fphys.2022.837631] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/22/2022] [Indexed: 12/28/2022] Open
Abstract
In this study, we compared acute and chronic bone marker and hormone responses to 6 weeks of low intensity (20% 1RM) blood flow restriction (BFR20) resistance training to high intensity (70% 1RM) traditional resistance training (TR70) and moderate intensity (45% 1RM) traditional resistance training (TR45) in young men (18–35 years). Participants were randomized to one of the training groups or to a control group (CON). The following training programs were performed 3 days per week for 6 weeks for knee extension and knee flexion exercises: BFR20, 20%1RM, 4 sets (30, 15, 15, 15 reps) wearing blood flow restriction cuffs around the proximal thighs; TR70, 70% 1RM 3 sets 10 reps; and TR45, 45% 1RM 3 sets 15 reps. Muscle strength and thigh cross-sectional area were assessed at baseline, between week 3 and 6 of training. Acute bone marker (Bone ALP, CTX-I) and hormone (testosterone, IGF-1, IGFBP-3, cortisol) responses were assessed at weeks 1 and 6, with blood collection done in the morning after an overnight fast. The main findings were that the acute bone formation marker (Bone ALP) showed significant changes for TR70 and BFR20 but there was no difference between weeks 1 and 6. TR70 had acute increases in testosterone, IGF-1, and IGFBP-3 (weeks 1 and 6). BFR20 had significant acute increases in testosterone (weeks 1 and 6) and in IGF-1 at week 6, while TR45 had significant acute increases in testosterone (week 1), IGF-1 (week 6), and IGFBP-3 (week 6). Strength and muscle size gains were similar for the training groups. In conclusion, low intensity BFR resistance training was effective for stimulating acute bone formation marker and hormone responses, although TR70 showed the more consistent hormone responses than the other training groups.
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Affiliation(s)
- Debra A. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
- *Correspondence: Debra A. Bemben,
| | - Vanessa D. Sherk
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Samuel R. Buchanan
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - SoJung Kim
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ, United States
| | - Kyle Sherk
- Hanger Clinic, Denver, CO, United States
| | - Michael G. Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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12
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Hughes L, Hackney KJ, Patterson SD. Optimization of Exercise Countermeasures to Spaceflight Using Blood Flow Restriction. Aerosp Med Hum Perform 2022; 93:32-45. [PMID: 35063054 DOI: 10.3357/amhp.5855.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION: During spaceflight missions, astronauts work in an extreme environment with several hazards to physical health and performance. Exposure to microgravity results in remarkable deconditioning of several physiological systems, leading to impaired physical condition and human performance, posing a major risk to overall mission success and crew safety. Physical exercise is the cornerstone of strategies to mitigate physical deconditioning during spaceflight. Decades of research have enabled development of more optimal exercise strategies and equipment onboard the International Space Station. However, the effects of microgravity cannot be completely ameliorated with current exercise countermeasures. Moreover, future spaceflight missions deeper into space require a new generation of spacecraft, which will place yet more constraints on the use of exercise by limiting the amount, size, and weight of exercise equipment and the time available for exercise. Space agencies are exploring ways to optimize exercise countermeasures for spaceflight, specifically exercise strategies that are more efficient, require less equipment, and are less time-consuming. Blood flow restriction exercise is a low intensity exercise strategy that requires minimal equipment and can elicit positive training benefits across multiple physiological systems. This method of exercise training has potential as a strategy to optimize exercise countermeasures during spaceflight and reconditioning in terrestrial and partial gravity environments. The possible applications of blood flow restriction exercise during spaceflight are discussed herein.Hughes L, Hackney KJ, Patterson SD. Optimization of exercise countermeasures to spaceflight using blood flow restriction. Aerosp Med Hum Perform. 2021; 93(1):32-45.
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13
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Blood Flow Restriction Therapy and Its Use for Rehabilitation and Return to Sport: Physiology, Application, and Guidelines for Implementation. Arthrosc Sports Med Rehabil 2022; 4:e71-e76. [PMID: 35141538 PMCID: PMC8811521 DOI: 10.1016/j.asmr.2021.09.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/22/2021] [Indexed: 12/26/2022] Open
Abstract
Blood flow restriction (BFR) is an expanding rehabilitation modality that uses a tourniquet to reduce arterial inflow and occlude venous outflow in the setting of resistance training or exercise. Initially, this technique was seen as a way to stimulate muscular development, but improved understanding of its physiologic benefits and mechanism of action has allowed for innovative clinical applications. BFR represents a way to decrease stress placed on the joints without compromising improvements in strength, whereas for postoperative, injured, or load-compromised individuals BFR represents a way to accelerate recovery and prevent atrophy. There is also growing evidence to suggest that it augments cardiovascular fitness and attenuates pain. The purpose of this review is to highlight the physiology and evidence behind the various applications of BFR, with a focus on postoperative rehabilitation. While much remains to be learned, it is clear that blood flow restriction therapy stimulates muscle hypertrophy via a synergistic response to metabolic stress and mechanical tension, with supplemental benefits on cardiovascular fitness and pain. New forms of BFR and expanding applications in postoperative patients and athletes hold promise for expedited recovery. Continued adherence to rehabilitation guidelines and exploration of BFRs physiology and various applications will help optimize its effect and prescription. Level of Evidence V, expert opinion.
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14
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Freitas EDS, Karabulut M, Bemben MG. The Evolution of Blood Flow Restricted Exercise. Front Physiol 2021; 12:747759. [PMID: 34925056 PMCID: PMC8674694 DOI: 10.3389/fphys.2021.747759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/10/2021] [Indexed: 11/25/2022] Open
Abstract
The use of blood flow restricted (BFR) exercise has become an accepted alternative approach to improve skeletal muscle mass and function and improve cardiovascular function in individuals that are not able to or do not wish to use traditional exercise protocols that rely on heavy loads and high training volumes. BFR exercise involves the reduction of blood flow to working skeletal muscle by applying a flexible cuff to the most proximal portions of a person’s arms or legs that results in decreased arterial flow to the exercising muscle and occluded venous return back to the central circulation. Safety concerns, especially related to the cardiovascular system, have not been consistently reported with a few exceptions; however, most researchers agree that BFR exercise can be a relatively safe technique for most people that are free from serious cardiovascular disease, as well as those with coronary artery disease, and also for people suffering from chronic conditions, such as multiple sclerosis, Parkinson’s, and osteoarthritis. Potential mechanisms to explain the benefits of BFR exercise are still mostly speculative and may require more invasive studies or the use of animal models to fully explore mechanisms of adaptation. The setting of absolute resistive pressures has evolved, from being based on an individual’s systolic blood pressure to a relative measure that is based on various percentages of the pressures needed to totally occlude blood flow in the exercising limb. However, since several other issues remain unresolved, such as the actual external loads used in combination with BFR, the type of cuff used to induce the blood flow restriction, and whether the restriction is continuous or intermittent, this paper will attempt to address these additional concerns.
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Affiliation(s)
- Eduardo D S Freitas
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
| | - Murat Karabulut
- Department of Health and Human Performance, University of Texas Rio Grande Valley, Brownsville, TX, United States
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, United States
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15
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Reply. Clin J Sport Med 2021; 31:e513. [PMID: 32932365 DOI: 10.1097/jsm.0000000000000854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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16
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Travis SK, Zwetsloot KA, Mujika I, Stone MH, Bazyler CD. Skeletal Muscle Adaptations and Performance Outcomes Following a Step and Exponential Taper in Strength Athletes. Front Physiol 2021; 12:735932. [PMID: 34777004 PMCID: PMC8582352 DOI: 10.3389/fphys.2021.735932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Before major athletic events, a taper is often prescribed to facilitate recovery and enhance performance. However, it is unknown which taper model is most effective for peaking maximal strength and positively augmenting skeletal muscle. Thus, the purpose of this study was to compare performance outcomes and skeletal muscle adaptations following a step vs. an exponential taper in strength athletes. Sixteen powerlifters (24.0 ± 4.0 years, 174.4 ± 8.2 cm, 89.8 ± 21.4 kg) participated in a 6-week training program aimed at peaking maximal strength on back squat [initial 1-repetition-maximum (1RM): 174.7 ± 33.4 kg], bench press (118.5 ± 29.9 kg), and deadlift (189.9 ± 41.2 kg). Powerlifters were matched based on relative maximal strength, and randomly assigned to either (a) 1-week overreach and 1-week step taper or (b) 1-week overreach and 3-week exponential taper. Athletes were tested pre- and post-training on measures of body composition, jumping performance, isometric squat, and 1RM. Whole muscle size was assessed at the proximal, middle, and distal vastus lateralis using ultrasonography and microbiopsies at the middle vastus lateralis site. Muscle samples (n = 15) were analyzed for fiber size, fiber type [myosin-heavy chain (MHC)-I, -IIA, -IIX, hybrid-I/IIA] using whole muscle immunohistochemistry and single fiber dot blots, gene expression, and microRNA abundance. There were significant main time effects for 1RM squat (p < 0.001), bench press (p < 0.001), and deadlift, (p = 0.024), powerlifting total (p < 0.001), Wilks Score (p < 0.001), squat jump peak-power scaled to body mass (p = 0.001), body mass (p = 0.005), fat mass (p = 0.002), and fat mass index (p = 0.002). There were significant main time effects for medial whole muscle cross-sectional area (mCSA) (p = 0.006) and averaged sites (p < 0.001). There was also a significant interaction for MHC-IIA fiber cross-sectional area (fCSA) (p = 0.014) with post hoc comparisons revealing increases following the step-taper only (p = 0.002). There were significant main time effects for single-fiber MHC-I% (p = 0.015) and MHC-IIA% (p = 0.033), as well as for MyoD (p = 0.002), MyoG (p = 0.037), and miR-499a (p = 0.033). Overall, increases in whole mCSA, fCSA, MHC-IIA fCSA, and MHC transitions appeared to favor the step taper group. An overreach followed by a step taper appears to produce a myocellular environment that enhances skeletal muscle adaptations, whereas an exponential taper may favor neuromuscular performance.
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Affiliation(s)
- S. Kyle Travis
- Exercise and Sport Sciences Laboratory, Department of Sport, Exercise, Recreation, and Kinesiology, East Tennessee State University, Johnson City, TN, United States
- Department of Rehabilitative Sciences, East Tennessee State University, Johnson City, TN, United States
- Integrative Muscle Physiology Laboratory, Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
| | - Kevin A. Zwetsloot
- Integrative Muscle Physiology Laboratory, Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
- Department of Biology, Appalachian State University, Boone, NC, United States
| | - Iñigo Mujika
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Spain
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Michael H. Stone
- Exercise and Sport Sciences Laboratory, Department of Sport, Exercise, Recreation, and Kinesiology, East Tennessee State University, Johnson City, TN, United States
| | - Caleb D. Bazyler
- Exercise and Sport Sciences Laboratory, Department of Sport, Exercise, Recreation, and Kinesiology, East Tennessee State University, Johnson City, TN, United States
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17
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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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18
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Proppe CE, Rivera PM, Hill EC, Housh TJ, Keller JL, Smith CM, Anders JPV, Schmidt RJ, Johnson GO, Cramer JT. The effects of blood flow restriction resistance training on indices of delayed onset muscle soreness and peak power. ISOKINET EXERC SCI 2021. [DOI: 10.3233/ies-210158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Low-load resistance training with blood flow restriction (LL + BFR) attenuated delayed onset muscle soreness (DOMS) under some conditions. OBJECTIVE: The purpose of this study examined the effects of reciprocal concentric-only elbow flexion-extension muscle actions at 30% of peak torque on indices of DOMS. METHODS: Thirty untrained women (mean ± SD; 22 ± 2.4 years) were randomly assigned to 6 training days of LL + BFR (n= 10), low-load non-BFR (LL) (n= 10), or control (n= 10). Participants completed 4 sets (1 × 30, 3 × 15) of submaximal (30% of peak torque), unilateral, isokinetic (120∘s-1) muscle actions. Indices of DOMS including peak power, resting elbow joint angle (ROM), perceived muscle soreness (VAS), and pain pressure threshold (PPT) were assessed. RESULTS: There were no changes in peak power, ROM, or VAS. There was a significant interaction for PPT. Follow-up analyses indicated PPT increased for the LL + BFR condition (Day 5 > Day 2), but did not decrease below baseline. The results of the present study indicated LL + BFR and LL did not induce DOMS for the elbow extensors in previously untrained women. CONCLUSION: These findings suggested LL + BFR and LL concentric-only resistance training could be an effective training modality to elicit muscular adaptation without inducing DOMS.
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Affiliation(s)
| | | | - Ethan C. Hill
- University of Central Florida, Orlando, FL, USA
- Florida Space Institute, Orlando, FL, USA
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19
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Wilburn DT, Machek SB, Zechmann B, Willoughby DS. Comparison of skeletal muscle ultrastructural changes between normal and blood flow-restricted resistance exercise: A case report. Exp Physiol 2021; 106:2177-2184. [PMID: 34438467 DOI: 10.1113/ep089858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/16/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the main observation in this case? The main observation of this case report is that blood flow-restricted exercise can cause myofibrils to have an aberrant wave-like appearance that is accompanied by irregular pockets of sarcoplasm in the intermyofibrillar space, while traditional forms of damage to the Z-discs and contractile elements are not as apparent. What insights does it reveal? Our findings indicate that blood flow restriction-mediated fluid pooling might cause alterations in skeletal muscle ultrastructure after exercise that might be directly related to myofibre swelling. ABSTRACT The acute effects of blood flow-restricted (BFR) exercise training on skeletal muscle ultrastructure are poorly understood owing to inconsistent findings and the use of largely imprecise systemic markers for indications of muscle damage. The purpose of this study was to compare myofibrillar ultrastructure before and 30 min after normal and BFR resistance exercise using transmission electron microscopy in a single individual to evaluate the feasibility of this more nuanced approach. One apparently healthy male with 13 years of resistance exercise completed six sets of both BFR [30% of one-repetition maximum (1-RM)] and normal non-occluded (70% of 1-RM) unilateral angled leg press on the contralateral leg, as a control, after assessment of 1-RM 72 h before. Vastus lateralis muscle biopsies were collected before and 30 min after each exercise session. The lengths and widths of 250 sarcomeres and the sarcoplasmic area were assessed via 20 individual transmission electron photomicrographs. Analysis revealed that BFR training (1.769 ± 0.12 μm) increased sarcomere length when compared with normal exercise (1.64 ± 0.17 μm; P < 0.001), without differences in sarcomere width between conditions (BFR, 0.90 ± 0.26 μm; normal, 0.93 ± 0.27 μm; P = 0.172). Furthermore, there were no significant interaction (P = 0.168) or condition effects between BFR (25.98 ± 4.17%) and normal (27.3 ± 6.49%) resistance exercise for sarcoplasmic area (P = 0.229). Exercise also increased sarcoplasmic area within the myofibril (pre-exercise, 24.42 ± 5.13%; postexercise, 28.95 ± 5.92%) for both conditions (P = 0.001). This case study demonstrates a unique BFR training-induced alteration in myofibril ultrastructure that appeared wave like and was accompanied by intracellular abnormalities that appeared to be fluid pockets of sarcoplasm disrupting the surrounding myofibrils.
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Affiliation(s)
- Dylan T Wilburn
- Exercise & Biochemical Nutrition Laboratory, Department of Health, Human Performance & Recreation, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Steven B Machek
- Exercise & Biochemical Nutrition Laboratory, Department of Health, Human Performance & Recreation, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, USA
| | - Bernd Zechmann
- Center for Microscopy and Imaging, Baylor University, Waco, Texas, USA
| | - Darryn S Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, Texas, USA
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20
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Davids CJ, Raastad T, James LP, Gajanand T, Smith E, Connick M, McGorm H, Keating S, Coombes JS, Peake JM, Roberts LA. Similar Morphological and Functional Training Adaptations Occur Between Continuous and Intermittent Blood Flow Restriction. J Strength Cond Res 2021; 35:1784-1793. [PMID: 34027913 DOI: 10.1519/jsc.0000000000004034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Davids, CJ, Raastad, T, James, L, Gajanand, T, Smith, E, Connick, M, McGorm, H, Keating, S, Coombes, JS, Peake, JM, and Roberts, LA. Similar morphological and functional training adaptations occur between continuous and intermittent blood flow restriction. J Strength Cond Res 35(7): 1784-1793, 2021-The aim of the study was to compare skeletal muscle morphological and functional outcomes after low-load resistance training using 2 differing blood flow restriction (BFR) protocols. Recreationally active men and women (n = 42 [f = 21], 24.4 ± 4.4 years) completed 21 sessions over 7 weeks of load-matched and volume-matched low-load resistance training (30% 1 repetition maximum [1RM]) with either (a) no BFR (CON), (b) continuous BFR (BFR-C, 60% arterial occlusion pressure [AOP]), or (c) intermittent BFR (BFR-I, 60% AOP). Muscle mass was assessed using peripheral quantitative computed tomography before and after training. Muscular strength, endurance, and power were determined before and after training by assessing isokinetic dynamometry, 1RM, and jump performance. Ratings of pain and effort were taken in the first and final training session. An alpha level of p < 0.05 was used to determine significance. There were no between-group differences for any of the morphological or functional variables. The muscle cross sectional area (CSA) increased pre-post training (p = 0.009; CON: 1.6%, BFR-C: 1.1%, BFR-I: 2.2%). Maximal isometric strength increased pre-post training (p < 0.001; CON: 9.6%, BFR-C: 14.3%, BFR-I: 19.3%). Total work performed during an isokinetic endurance task increased pre-post training (p < 0.001, CON: 3.6%, BFR-C: 9.6%, BFR-I: 11.3%). Perceptions of pain (p = 0.026) and effort (p = 0.033) during exercise were higher with BFR-C; however, these reduced with training (p = 0.005-0.034). Overall, these data suggest that when 30% 1RM loads are used with a frequency of 3 times per week, the addition of BFR does not confer superior morphological or functional adaptations in recreationally active individuals. Furthermore, the additional metabolic stress that is proposed to occur with a continuous BFR protocol does not seem to translate into proportionally greater training adaptations. The current findings promote the use of both intermittent BFR and low-load resistance training without BFR as suitable alternative training methods to continuous BFR. These approaches may be practically applicable for those less tolerable to pain and discomfort associated with ischemia during exercise.
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Affiliation(s)
- Charlie J Davids
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lachlan P James
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Trishan Gajanand
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Emily Smith
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Mark Connick
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Hamish McGorm
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia
| | - Shelley Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Jonathan M Peake
- Queensland Academy of Sport, Nathan, Australia.,School of Biomedical Sciences and Institute of Health and Biomedical Sciences, Queensland University of Technology, Brisbane, Australia; and
| | - Llion A Roberts
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia.,School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
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21
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Bjørnsen T, Wernbom M, Paulsen G, Berntsen S, Brankovic R, Stålesen H, Sundnes J, Raastad T. Frequent blood flow restricted training not to failure and to failure induces similar gains in myonuclei and muscle mass. Scand J Med Sci Sports 2021; 31:1420-1439. [PMID: 33735465 DOI: 10.1111/sms.13952] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 02/15/2021] [Accepted: 03/04/2021] [Indexed: 12/19/2022]
Abstract
The purpose of the present study was to compare the effects of short-term high-frequency failure vs non-failure blood flow-restricted resistance exercise (BFRRE) on changes in satellite cells (SCs), myonuclei, muscle size, and strength. Seventeen untrained men performed four sets of BFRRE to failure (Failure) with one leg and not to failure (Non-failure; 30-15-15-15 repetitions) with the other leg using knee-extensions at 20% of one repetition maximum (1RM). Fourteen sessions were distributed over two 5-day blocks, separated by a 10-day rest period. Muscle samples obtained before, at mid-training, and 10-day post-intervention (Post10) were analyzed for muscle fiber area (MFA), myonuclei, and SC. Muscle size and echo intensity of m.rectus femoris (RF) and m.vastus lateralis (VL) were measured by ultrasonography, and knee extension strength with 1RM and maximal isometric contraction (MVC) up until Post24. Both protocols increased myonuclear numbers in type-1 (12%-17%) and type-2 fibers (20%-23%), and SC in type-1 (92%-134%) and type-2 fibers (23%-48%) at Post10 (p < 0.05). RF and VL size increased by 5%-10% in both legs at Post10 to Post24, whereas the MFA of type-1 fibers in Failure was decreased at Post10 (-10 ± 16%; p = 0.02). Echo intensity increased by ~20% in both legs during Block1 (p < 0.001) and was ~8 to 11% below baseline at Post24 (p = 0.001-0.002). MVC and 1RM decreased by 5%-10% after Block1, but increased in both legs by 6%-11% at Post24 (p < 0.05). In conclusion, both short-term high-frequency failure and non-failure BFRRE induced increases in SCs, in myonuclei content, muscle size, and strength, concomitant with decreased echo intensity. Intriguingly, the responses were delayed and peaked 10-24 days after the training intervention. Our findings may shed light on the mechanisms involved in resistance exercise-induced overreaching and supercompensation.
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Affiliation(s)
- Thomas Bjørnsen
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.,Norwegian Olympic Federation, Oslo, Norway
| | - Mathias Wernbom
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Göteborg, Sweden.,Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Gøran Paulsen
- Norwegian Olympic Federation, Oslo, Norway.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Sveinung Berntsen
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Robert Brankovic
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Håkon Stålesen
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Joakim Sundnes
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Truls Raastad
- Center for Health and Performance, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Göteborg, Sweden
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22
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Bjørnsen T, Wernbom M, Paulsen G, Markworth JF, Berntsen S, D'Souza RF, Cameron-Smith D, Raastad T. High-frequency blood flow-restricted resistance exercise results in acute and prolonged cellular stress more pronounced in type I than in type II fibers. J Appl Physiol (1985) 2021; 131:643-660. [PMID: 33955259 DOI: 10.1152/japplphysiol.00115.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Myocellular stress with high-frequency blood flow-restricted resistance exercise (BFRRE) was investigated by measures of heat shock protein (HSP) responses, glycogen content, and inflammatory markers. Thirteen participants [age: 24 ± 2 yr (means ± SD), 9 males] completed two 5-day blocks of seven BFRRE sessions, separated by 10 days. Four sets of unilateral knee extensions to failure at 20% of one-repetition maximum (1RM) were performed. Muscle samples obtained before, 1 h after the first session in the first and second block (acute 1 and acute 2), after three sessions (day 4), during the "rest week," and at 3 (post 3) and 10 days postintervention (post 10) were analyzed for HSP70, αB-crystallin, glycogen [periodic acid-Schiff (PAS) staining], mRNAs, miRNAs, and CD68+ (macrophages) and CD66b+ (neutrophils) cell numbers. αB-crystallin translocated from the cytosolic to the cytoskeletal fraction after acute 1 and acute 2 (P < 0.05) and immunostaining revealed larger responses in type I than in type II fibers (acute 1, 225 ± 184% vs. 92 ± 81%, respectively, P = 0.001). HSP70 was increased in the cytoskeletal fraction at day 4 and post 3, and immunostaining intensities were more elevated in type I than in type II fibers at day 4 (206 ± 84% vs. 72 ± 112%, respectively, P <0.001), during the rest week (98 ± 66% vs. 42 ± 79%, P < 0.001), and at post 3 (115 ± 82% vs. 28 ± 78%, P = 0.003). Glycogen content was reduced in both fiber types, but most pronounced in type I, which did not recover until the rest week (-15% to 29%, P ≤ 0.001). Intramuscular macrophage numbers were increased by ∼65% postintervention, but no changes were observed in muscle neutrophils. We conclude that high-frequency BFRRE with sets performed till failure stresses both fiber types, with type I fibers being most affected.NEW & NOTEWORTHY BFRRE has been reported to preferentially stress type I muscle fibers, as evidenced by HSP responses. We extend these findings by showing that the HSP responses occur in both fiber types but more so in type I fibers and that they can still be induced after a short-term training period. Furthermore, the reductions in glycogen content of type I fibers after strenuous frequent BFRRE in unaccustomed subjects can be prolonged (≥5 days), probably due to microdamage.
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Affiliation(s)
- Thomas Bjørnsen
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.,Norwegian Olympic Federation, Oslo, Norway
| | - Mathias Wernbom
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.,The Rydberg Laboratory for Applied Sciences, Halmstad University, Halmstad, Sweden.,Department of Food and Nutrition, and Sport Science, Center for Health and Performance, University of Gothenburg, Göteborg, Sweden
| | - Gøran Paulsen
- Norwegian Olympic Federation, Oslo, Norway.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Sveinung Berntsen
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Randall F D'Souza
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Discipline of Nutrition, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - David Cameron-Smith
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore.,Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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23
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Wernbom M, Paulsen G, Bjørnsen T, Cumming K, Raastad T. Risk of Muscle Damage With Blood Flow-Restricted Exercise Should Not Be Overlooked. Clin J Sport Med 2021; 31:223-224. [PMID: 33882543 DOI: 10.1097/jsm.0000000000000755] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/19/2019] [Indexed: 02/02/2023]
Affiliation(s)
- Mathias Wernbom
- Department of Food and Nutrition, and Sport Science, Center for Health and Performance, University of Gothenburg, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gøran Paulsen
- Norwegian Olympic and Paralympic Committee and Confederation of Sport, Oslo, Norway
| | - Thomas Bjørnsen
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway; and
| | - Kristoffer Cumming
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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24
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Haddock B, Hansen SK, Lindberg U, Nielsen JL, Frandsen U, Aagaard P, Larsson HBW, Suetta C. Exercise-induced fluid shifts are distinct to exercise mode and intensity: a comparison of blood flow-restricted and free-flow resistance exercise. J Appl Physiol (1985) 2021; 130:1822-1835. [PMID: 33914664 DOI: 10.1152/japplphysiol.01012.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
MRI can provide fundamental tools in decoding physiological stressors stimulated by training paradigms. Acute physiological changes induced by three diverse exercise protocols known to elicit similar levels of muscle hypertrophy were evaluated using muscle functional magnetic resonance imaging (mfMRI). The study was a cross-over study with participants (n = 10) performing three acute unilateral knee extensor exercise protocols to failure and a work matched control exercise protocol. Participants were scanned after each exercise protocol; 70% 1 repetition maximum (RM) (FF70); 20% 1RM (FF20); 20% 1RM with blood flow restriction (BFR20); free-flow (FF) control work matched to BFR20 (FF20WM). Post exercise mfMRI scans were used to obtain interleaved measures of muscle R2 (indicator of edema), R2' (indicator of deoxyhemoglobin), muscle cross sectional area (CSA) blood flow, and diffusion. Both BFR20 and FF20 exercise resulted in a larger acute decrease in R2, decrease in R2', and expansion of the extracellular compartment with slower rates of recovery. BFR20 caused greater acute increases in muscle CSA than FF20WM and FF70. Only BFR20 caused acute increases in intracellular volume. Postexercise muscle blood flow was higher after FF70 and FF20 exercise than BFR20. Acute changes in mean diffusivity were similar across all exercise protocols. This study was able to differentiate the acute physiological responses between anabolic exercise protocols. Low-load exercise protocols, known to have relatively higher energy contributions from glycolysis at task failure, elicited a higher mfMRI response. Noninvasive mfMRI represents a promising tool for decoding mechanisms of anabolic adaptation in muscle.NEW & NOTEWORTHY Using muscle functional MRI (mfMRI), this study was able to differentiate the acute physiological responses following three established hypertrophic resistance exercise strategies. Low-load exercise protocols performed to failure, with or without blood flow restriction, resulted in larger changes in R2 (i.e. greater T2-shifts) with a slow rate of return to baseline indicative of myocellular fluid shifts. These data were cross evaluated with interleaved measures of macrovascular blood flow, water diffusion, muscle cross sectional area (i.e. acute macroscopic muscle swelling), and intracellular water fraction measured using MRI.
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Affiliation(s)
- Bryan Haddock
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sofie K Hansen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulrich Lindberg
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jakob Lindberg Nielsen
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ulrik Frandsen
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Per Aagaard
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Henrik B W Larsson
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Suetta
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark.,Geriatric Research Unit, Department of Medicine Herlev and Gentofte Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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25
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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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26
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Burr JF, Hughes L, Warmington S, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J, Patterson SD. Response: Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2020; 11:574633. [PMID: 33192577 PMCID: PMC7662128 DOI: 10.3389/fphys.2020.574633] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 10/05/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jamie F Burr
- Human Performance and Health Research Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Science University of Guelph, Guelph, ON, Canada
| | - Luke Hughes
- School of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom
| | - Stuart Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Brendan R Scott
- Murdoch Applied Sports Science Laboratory, Murdoch University, Murdoch, WA, Australia
| | - Johnny Owens
- Owens Recovery Science, San Antonio, TX, United States
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, University of Mississippi, Oxford, MS, United States
| | - Jakob L Nielsen
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Gilberto Laurentino
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | | | | | - Jeremy Loenneke
- Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, University of Mississippi, Oxford, MS, United States
| | - Stephen D Patterson
- School of Sport, Health and Applied Science, St Mary's University, Twickenham, United Kingdom
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27
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Emphasizing Task-Specific Hypertrophy to Enhance Sequential Strength and Power Performance. J Funct Morphol Kinesiol 2020; 5:jfmk5040076. [PMID: 33467291 PMCID: PMC7739346 DOI: 10.3390/jfmk5040076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/04/2020] [Accepted: 10/21/2020] [Indexed: 12/15/2022] Open
Abstract
While strength is indeed a skill, most discussions have primarily considered structural adaptations rather than ultrastructural augmentation to improve performance. Altering the structural component of the muscle is often the aim of hypertrophic training, yet not all hypertrophy is equal; such alterations are dependent upon how the muscle adapts to the training stimuli and overall training stress. When comparing bodybuilders to strength and power athletes such as powerlifters, weightlifters, and throwers, while muscle size may be similar, the ability to produce force and power is often inequivalent. Thus, performance differences go beyond structural changes and may be due to the muscle's ultrastructural constituents and training induced adaptations. Relative to potentiating strength and power performances, eliciting specific ultrastructural changes should be a variable of interest during hypertrophic training phases. By focusing on task-specific hypertrophy, it may be possible to achieve an optimal amount of hypertrophy while deemphasizing metabolic and aerobic components that are often associated with high-volume training. Therefore, the purpose of this article is to briefly address different types of hypertrophy and provide directions for practitioners who are aiming to achieve optimal rather than maximal hypertrophy, as it relates to altering ultrastructural muscular components, to potentiate strength and power performance.
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28
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Buckner SL, Jessee MB, Mouser JG, Dankel SJ, Mattocks KT, Bell ZW, Abe T, Loenneke JP. The Basics of Training for Muscle Size and Strength: A Brief Review on the Theory. Med Sci Sports Exerc 2020; 52:645-653. [PMID: 31652235 DOI: 10.1249/mss.0000000000002171] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The periodization of resistance exercise is often touted as the most effective strategy for optimizing muscle size and strength adaptations. This narrative persists despite a lack of experimental evidence to demonstrate its superiority. In addition, the general adaptation syndrome, which provides the theoretical framework underlying periodization, does not appear to provide a strong physiological rationale that periodization is necessary. Hans Selye conducted a series of rodent studies which used toxic stressors to facilitate the development of the general adaptation syndrome. To our knowledge, normal exercise in humans has never been shown to produce a general adaptation syndrome. We question whether there is any physiological rationale that a periodized training approach would facilitate greater adaptations compared with nonperiodized approaches employing progressive overload. The purpose of this article is to briefly review currently debated topics within strength and conditioning and provide some practical insight regarding the implications these reevaluations of the literature may have for resistance exercise and periodization. In addition, we provide some suggestions for the continued advancement within the field of strength and conditioning.
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Affiliation(s)
- Samuel L Buckner
- USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL
| | - Matthew B Jessee
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University, MS
| | - J Grant Mouser
- Department of Kinesiology and Health Promotion, Troy University, Troy, AL
| | - Scott J Dankel
- Department of Health and Exercise Science, Exercise Physiology Laboratory, Rowan University, Glassboro, NJ
| | | | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS
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29
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Rolnick N, Schoenfeld BJ. Blood Flow Restriction Training and the Physique Athlete: A Practical Research-Based Guide to Maximizing Muscle Size. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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30
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Pignanelli C, Burr JF. Greater discomfort with blood flow restriction training compared to standard low‐load resistance exercise when both are performed to task failure. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Christopher Pignanelli
- Department of Human Health and Nutritional Sciences University of Guelph Guelph ON Canada
| | - Jamie F. Burr
- Department of Human Health and Nutritional Sciences University of Guelph Guelph ON Canada
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31
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Vissing K, Groennebaek T, Wernbom M, Aagaard P, Raastad T. Myocellular Adaptations to Low-Load Blood Flow Restricted Resistance Training. Exerc Sport Sci Rev 2020; 48:180-187. [DOI: 10.1249/jes.0000000000000231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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32
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Hansen SK, Ratzer J, Nielsen JL, Suetta C, Karlsen A, Kvorning T, Frandsen U, Aagaard P. Effects of alternating blood flow restricted training and heavy-load resistance training on myofiber morphology and mechanical muscle function. J Appl Physiol (1985) 2020; 128:1523-1532. [PMID: 32324471 DOI: 10.1152/japplphysiol.00015.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
To investigate if short-term block-structured training consisting of alternating weeks of blood flow restricted low-load resistance training (BFR-RT) and conventional free-flow heavy-load resistance training (HL-RT) leads to superior gains in mechanical muscle function, myofiber size, and satellite cell (SC) content and myonuclear number compared with HL-RT alone. Eighteen active young participants (women/men: 5/13, 23 ± 1.2 yr) were randomized to 6 wk (22 sessions) of lower limb HL-RT [70-90% one repetition maximum (1-RM)] (HRT, n = 9) or block-structured training alternating weekly between BFR-RT (20% 1-RM) and HL-RT (BFR-HRT, n = 9). Maximal isometric knee extensor strength (MVC) and muscle biopsies (VL) were obtained pre- and posttraining to examine changes in muscle strength, myofiber cross-sectional area (CSA), myonuclear (MN) number, and SC content. MVC increased in both training groups (BFR-HRT: +12%, HRT: +7%; P < 0.05). Type II myofiber CSA increased similarly (+16%) in BFR-HRT and HRT (P < 0.05), while gains in type I CSA were observed following HRT only (+12%, P < 0.05). In addition, myonuclear number remained unchanged, whereas SC content increased in type II myofibers following HRT (+59%, P < 0.05). Short-term alternating BFR-RT and HL-RT did not produce superior gains in muscle strength or myofiber size compared with HL-RT alone. Noticeably, however, conventional HL-RT could be periodically replaced by low-load BFR-RT without compromising training-induced gains in maximal muscle strength and type II myofiber size, respectively.NEW & NOTEWORTHY The present data demonstrate that periodically substituting heavy-load resistance training (HL-RT) with low-load blood flow restricted resistance training (BFR-RT) leads to similar gains in type II myofiber CSA and muscle strength as achieved by HL-RT alone. Furthermore, we have for the first time evaluated myonuclear content and myonuclear domain size before and after training intervention across separate fiber size clusters and found no within-cluster changes for these parameters with training.
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Affiliation(s)
- S K Hansen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Geriatric Research Unit, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | - J Ratzer
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - J L Nielsen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - C Suetta
- Geriatric Research Unit, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark.,Geriatric Research Unit, Herlev-Gentofte University Hospital, Copenhagen, Denmark
| | - A Karlsen
- Institute of Sports Medicine Copenhagen, Denmark.,Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark.,Center of Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Kvorning
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Team Danmark (The Danish Elite Sport Institution), Brøndby, Denmark
| | - U Frandsen
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - P Aagaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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33
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Wernbom M, Schoenfeld BJ, Paulsen G, Bjørnsen T, Cumming KT, Aagaard P, Clark BC, Raastad T. Commentary: Can Blood Flow Restricted Exercise Cause Muscle Damage? Commentary on Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2020; 11:243. [PMID: 32265737 PMCID: PMC7098946 DOI: 10.3389/fphys.2020.00243] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 03/02/2020] [Indexed: 01/02/2023] Open
Affiliation(s)
- Mathias Wernbom
- Center for Health and Performance, Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Brad J. Schoenfeld
- Department of Health Sciences, CUNY Lehman College, Bronx, NY, United States
| | - Gøran Paulsen
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Thomas Bjørnsen
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Kristoffer T. Cumming
- Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Notodden, Norway
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Brian C. Clark
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, United States
- Department of Biomedical Sciences, Ohio University, Athens, OH, United States
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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34
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Wernbom M, Aagaard P. Muscle fibre activation and fatigue with low-load blood flow restricted resistance exercise-An integrative physiology review. Acta Physiol (Oxf) 2020; 228:e13302. [PMID: 31108025 DOI: 10.1111/apha.13302] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/12/2019] [Accepted: 05/17/2019] [Indexed: 12/13/2022]
Abstract
Blood flow-restricted resistance exercise (BFRRE) has been shown to induce increases in muscle size and strength, and continues to generate interest from both clinical and basic research points of view. The low loads employed, typically 20%-50% of the one repetition maximum, make BFRRE an attractive training modality for individuals who may not tolerate high musculoskeletal forces (eg, selected clinical patient groups such as frail old adults and patients recovering from sports injury) and/or for highly trained athletes who have reached a plateau in muscle mass and strength. It has been proposed that achieving a high degree of muscle fibre recruitment is important for inducing muscle hypertrophy with BFRRE, and the available evidence suggest that fatiguing low-load exercise during ischemic conditions can recruit both slow (type I) and fast (type II) muscle fibres. Nevertheless, closer scrutiny reveals that type II fibre activation in BFRRE has to date largely been inferred using indirect methods such as electromyography and magnetic resonance spectroscopy, while only rarely addressed using more direct methods such as measurements of glycogen stores and phosphocreatine levels in muscle fibres. Hence, considerable uncertainity exists about the specific pattern of muscle fibre activation during BFRRE. Therefore, the purpose of this narrative review was (1) to summarize the evidence on muscle fibre recruitment during BFRRE as revealed by various methods employed for determining muscle fibre usage during exercise, and (2) to discuss reported findings in light of the specific advantages and limitations associated with these methods.
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Affiliation(s)
- Mathias Wernbom
- Center for Health and Performance, Department of Food and Nutrition and Sport Science University of Gothenburg Gothenburg Sweden
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Per Aagaard
- Department of Sports Sciences and Clinical Biomechanics, SDU Muscle Research Cluster (SMRC) University of Southern Denmark Odense M Denmark
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35
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D'Souza RF, Zeng N, Markworth JF, Figueiredo VC, Hedges CP, Petersen AC, Della Gatta PA, Cameron-Smith D, Mitchell CJ. Whey Protein Supplementation Post Resistance Exercise in Elderly Men Induces Changes in Muscle miRNA's Compared to Resistance Exercise Alone. Front Nutr 2019; 6:91. [PMID: 31249834 PMCID: PMC6582369 DOI: 10.3389/fnut.2019.00091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 05/24/2019] [Indexed: 12/17/2022] Open
Abstract
Progressive muscle loss with aging results in decreased physical function, frailty, and impaired metabolic health. Deficits in anabolic signaling contribute to an impaired ability for aged skeletal muscle to adapt in response to exercise and protein feeding. One potential contributing mechanism could be exerted by dysregulation of microRNAs (miRNAs). Therefore, the aim of this study was to determine if graded protein doses consumed after resistance exercise altered muscle miRNA expression in elderly men. Twenty-three senior men (67.9 ± 0.9 years) performed a bout of resistance exercise and were randomized to consume either a placebo, 20 or 40 g of whey protein (n = 8, n = 7, and n = 8, respectively). Vastus lateralis biopsies were collected before, 2 and 4 h after exercise. Expression of 19 miRNAs, previously identified to influence muscle phenotype, were measured via RT-PCR. Of these, miR-16-5p was altered with exercise in all groups (p = 0.032). Expression of miR-15a and-499a increased only in the placebo group 4 h after exercise and miR-451a expression increased following exercise only in the 40 g whey supplementation group. Changes in p-P70S6KThr389 and p-AktSer473 following exercise were correlated with alterations in miR-208a and-499a and-206 expression, irrespective of protein dose, suggesting a possible role for miRNA in the regulation of acute phosphorylation events during early hours of exercise recovery.
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Affiliation(s)
- Randall F D'Souza
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Discipline of Nutrition, The University of Auckland, Auckland, New Zealand
| | - Nina Zeng
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - James F Markworth
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, United States
| | - Vandre C Figueiredo
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,College of Health Sciences, University of Kentucky, Lexington, KY, United States
| | - Christopher P Hedges
- Applied Surgery and Metabolism Laboratory, School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Aaron C Petersen
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia
| | - Paul A Della Gatta
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - David Cameron-Smith
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,Food and Bio-based Products, AgResearch Grasslands, Palmerston North, New Zealand.,The Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Cameron J Mitchell
- Liggins Institute, The University of Auckland, Auckland, New Zealand.,School of Kinesiology, University of British Colombia, Vancouver, BC, Canada
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36
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Sieljacks P, Wang J, Groennebaek T, Rindom E, Jakobsgaard JE, Herskind J, Gravholt A, Møller AB, Musci RV, de Paoli FV, Hamilton KL, Miller BF, Vissing K. Six Weeks of Low-Load Blood Flow Restricted and High-Load Resistance Exercise Training Produce Similar Increases in Cumulative Myofibrillar Protein Synthesis and Ribosomal Biogenesis in Healthy Males. Front Physiol 2019; 10:649. [PMID: 31191347 PMCID: PMC6548815 DOI: 10.3389/fphys.2019.00649] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 05/08/2019] [Indexed: 12/25/2022] Open
Abstract
Purpose: High-load resistance exercise contributes to maintenance of muscle mass, muscle protein quality, and contractile function by stimulation of muscle protein synthesis (MPS), hypertrophy, and strength gains. However, high loading may not be feasible in several clinical populations. Low-load blood flow restricted resistance exercise (BFRRE) may provide an alternative approach. However, the long-term protein synthetic response to BFRRE is unknown and the myocellular adaptations to prolonged BFRRE are not well described. Methods: To investigate this, 34 healthy young subjects were randomized to 6 weeks of low-load BFRRE, HLRE, or non-exercise control (CON). Deuterium oxide (D2O) was orally administered throughout the intervention period. Muscle biopsies from m. vastus lateralis were collected before and after the 6-week intervention period to assess long-term myofibrillar MPS and RNA synthesis as well as muscle fiber-type-specific cross-sectional area (CSA), satellite cell content, and myonuclei content. Muscle biopsies were also collected in the immediate hours following single-bout exercise to assess signaling for muscle protein degradation. Isometric and dynamic quadriceps muscle strength was evaluated before and after the intervention. Results: Myofibrillar MPS was higher in BFRRE (1.34%/day, p < 0.01) and HLRE (1.12%/day, p < 0.05) compared to CON (0.96%/day) with no significant differences between exercise groups. Muscle RNA synthesis was higher in BFRRE (0.65%/day, p < 0.001) and HLRE (0.55%/day, p < 0.01) compared to CON (0.38%/day) and both training groups increased RNA content, indicating ribosomal biogenesis in response to exercise. BFRRE and HLRE both activated muscle degradation signaling. Muscle strength increased 6-10% in BFRRE (p < 0.05) and 13-23% in HLRE (p < 0.01). Dynamic muscle strength increased to a greater extent in HLRE (p < 0.05). No changes in type I and type II muscle fiber-type-specific CSA, satellite cell content, or myonuclei content were observed. Conclusions: These results demonstrate that BFRRE increases long-term muscle protein turnover, ribosomal biogenesis, and muscle strength to a similar degree as HLRE. These findings emphasize the potential application of low-load BFRRE to stimulate muscle protein turnover and increase muscle function in clinical populations where high loading is untenable.
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Affiliation(s)
- Peter Sieljacks
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jakob Wang
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Thomas Groennebaek
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Emil Rindom
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | - Jon Herskind
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anders Gravholt
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Andreas B. Møller
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Robert V. Musci
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | | | - Karyn L. Hamilton
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, United States
| | - Benjamin F. Miller
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States
| | - Kristian Vissing
- Section for Sports Science, Department of Public Health, Aarhus University, Aarhus, Denmark
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37
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Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol 2019; 10:533. [PMID: 31156448 PMCID: PMC6530612 DOI: 10.3389/fphys.2019.00533] [Citation(s) in RCA: 303] [Impact Index Per Article: 60.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/15/2019] [Indexed: 12/14/2022] Open
Abstract
The current manuscript sets out a position stand for blood flow restriction (BFR) exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to BFR training to practitioners. This covers the use of BFR to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in BFR training research with expertise in exercise science, strength and conditioning and sports medicine.
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Affiliation(s)
- Stephen D. Patterson
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Luke Hughes
- Faculty of Sport, Health and Applied Sciences, St Marys University, London, United Kingdom
| | - Stuart Warmington
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Jamie Burr
- Department of Human Health and Nutritional Science, University of Guelph, Guelph, ON, Canada
| | - Brendan R. Scott
- Murdoch Applied Sports Science Laboratory, Discipline of Exercise Science, Murdoch University, Perth, WA, Australia
| | - Johnny Owens
- Owens Recovery Science, San Antonio, TX, United States
| | - Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
| | - Jakob L. Nielsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Cleiton Augusto Libardi
- MUSCULAB – Laboratory of Neuromuscular Adaptations to Resistance Training, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Gilberto Laurentino
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Gabriel Rodrigues Neto
- Coordination of Physical Education/Professional Master’s in Family Health, Nursing and Medical Schools, Nova Esperança (FAMENE/FACENE), João Pessoa, Brazil
| | | | - Juan Martin-Hernandez
- I+HeALTH Research Group, Department of Health Sciences, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain
| | - Jeremy Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, University of Mississippi, Oxford, MS, United States
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