Effects of estrogen fluctuation during the menstrual cycle on the response to stretch-shortening exercise in females

Effects of exercise on sex steroid hormones (estrogen, progesterone, testosterone) in eumenorrheic females: A systematic to review and meta-analysis

BACKGROUND

The sex steroid hormones fluctuate during the menstrual cycle, which affects the strength and postural stability of females and leads to injuries and risk of falls. These hormones may be modulated by exercise to impact the overall health of females.

OBJECTIVE

To determine the effects of exercise on sex steroid hormones in eumenorrheic females.

METHODS

This review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines in Lahore, Pakistan. The full-length articles were searched using these databases/search engines (PubMed, Web of Science and Google Scholar, Sci-Hub). Randomized controlled trials along with single group experimental studies were also included. All types of exercises were compared with no exercise in the control group. The Cochrane Risk of Bias assessment tool assessed and screened the articles. The data were then analyzed. The primary outcomes were the levels of estrogen, progesterone and testosterone.

RESULTS

Eleven studies were included (5 randomized controlled trials and 6 quasi-experimental studies). The effects of exercise on free estradiol concentration and serum progesterone level were not significant [p = 0.37 (SMD = 0.33, 95% CI = 0.14 to 0.74, I2 = 0%) and p = 0.84 (S.D= -0.65, C.I= -6.92 to 5.62, I2 = 94%)] respectively, whereas, the effects on testosterone levels were significant [p value < 0.00001 (M.D = 0.89, 95% C.I= -2.16 to 3.95, I2 = 94%)].

CONCLUSION

A blinded randomized controlled trial should be conducted in which a structured approach should be followed by women along with warm-ups, cool down and rest intervals.

TRIAL REGISTRATION NUMBER

The systematic review was registered prospectively on PROSPERO with registration number CRD42023473767.

Monitoring of sprint and change of direction velocity, vertical jump height, and repeated sprint ability in sub-elite female football players throughout their menstrual cycle

AIMS

The aim of this study was to investigate the associations between the early follicular (EF, i.e., menstruation), late follicular (LF), and middle luteal (ML) phases of the menstrual cycle and different factors that may influence football performance.

METHODS

To this end, 11 eumenorrheic sub-elite female football players underwent field tests to assess sprint speed, lower extremity power, repeated sprint ability, velocity on change of direction, and technical skills at each cycle phase.

RESULTS

Performance during the 15-m change of direction ability test, 15-m ball dribbling test, squat jump height, total sprint time [sum of 7 sprints] and decrement score [(mean sprint time/best sprint time × 100) - 100], maximum and mean heart rate, and perceived exertion did not significantly differ among menstrual cycle phases. Conversely, the linear sprint velocity over 10, 20, 30-m distances was decreased in EF vs LF (10-, 20- and 30-m) and in ML vs LF (10- and 20-m) (p < 0.05). The 40-m sprint velocity did not change in the different menstrual cycle phases.

CONCLUSION

Overall, our study suggests that sex hormone fluctuations during the menstrual cycle are not associated with vertical jump, velocity on change of direction, and repeated sprint ability, but may influence linear sprint velocity over short distances (10, 20, and 30 m).

Exercise induced muscle damage and repeated bout effect: an update for last 10 years and future perspectives

Exercise-induced muscle damage (EIMD) and repeated bout effect (RBE) are widely researched across various populations. EIMD is the muscle damage occurring after one bout of unaccustomed exercise while RBE is the attenuation of the same muscle damage in subsequent second bout. RBE seems to have significant implications for exercise prescription. Despite existence of vast literature, there is lack of clarity on the effects of EIMD and RBE in a healthy population. The purpose of this study is to review the literature on EIMD and RBE in healthy participants published during the last 10 years. The search of major databases (including Scopus, Google Scholar and PubMed) was conducted using specific keywords ‘Exercise induced muscle damage’, ‘Repeated bout effect’, ‘Healthy participants’ ‘Pre-conditioning’, ‘Eccentric exercise’. Studies published from 2011 onwards which included EIMD and RBE assessment in healthy participants were included in this review. Database searching revealed a total of 38 studies on EIMD and RBE in healthy participants. Three major themes of papers were identified that focused on EIMD and RBE along with (1) age related differences, (2) sex-based differences, and (3) response in athletes. Findings of this comprehensive review suggests that both EIMD and RBE are age, and sex specific. Delayed onset muscle soreness played a major role in both EIMD and RBE in all the population types. Female participants are less susceptible to EIMD as compared to age-matched male counterparts. Moreover, both EIMD and RBE are more elicited in middle aged and younger adults as compared to children and older adults while the magnitude of RBE turns out to be minimal in trained individuals due to persisting adaptations.

Impact of Training Protocols on Lifting Velocity Recovery in Resistance Trained Males and Females

It has been suggested that sex differences exist in recovery following strength training. This study aimed to investigate the differences in recovery kinetics between resistance trained males and females following two different back squat (BSq) protocols. The first protocol (eight females and eight males) consisted of five sets of five repetitions at 80% of their one-repetition maximum (1RM) in the BSq (SMRT), while the second (seven females and eight males) consisted of five sets to muscular failure (MF) with a 4–6RM load (RMRT). The recovery was quantified with the mean concentric velocity (MV) at 80% of the 1RM immediately before and 5 min, 24, 48, and 72 h after the training protocol. Following the SMRT, a significant between-sex difference, favoring the females, was observed at 5 min, 24 h, and 48 h following the SMRT (p < 0.05, Effect Size (ES) = 1.01–2.25). Following the RMRT, only the males experienced a significant drop in performance after 5 min compared to the baseline (p = 0.025, ES = 1.34). However, no sex differences were observed at any timepoint (p > 0.05). These results suggest that males experienced more fatigue than females following a protocol where the volume relative to the 1RM was matched, while no differences in fatigue were evident following a protocol in which multiple sets were performed to MF.

Kinematic and Neuromuscular Measures of Intensity During Drop Jumps in Female Volleyball Players

The aim of this study was to assess drop jump (DJ) performance variables (jump height, contact time, and reactive strength index) concomitant to surface electromyography (sEMG) of lower limb muscles during DJs from different drop heights (intensities). The eccentric and concentric phase sEMG from the gastrocnemius medialis, biceps femoris, and vastus medialis muscles were assessed during all tests, with sEMG activity normalized to maximal voluntary isometric contraction (MVIC). In a cross-sectional, study, 10 amateur female volleyball players (age 22.1 ± 1.8 years; body mass 72.9 ± 15.2 kg; height 1.70 ± 0.08 m) completed DJs from six heights [15–90 cm (DJ15 to DJ90)]. During DJs there was no jump-target box to rebound on to. Results of one-way analysis of variance (ANOVA) showed that the jump height, contact time, and reactive strength index were not significantly (p > 0.05) different between drop heights. Mean biceps femoris eccentric and concentric sEMG ranged from 27 to 50%, although without significant differences between drop heights. Mean gastrocnemius medialis eccentric and concentric sEMG remained relatively constant (∼60–80% MVIC) across DJs heights, although eccentric values reached 90–120% MVIC from DJ75 to DJ90. Mean variations of ∼50–100% MVIC for eccentric and ∼50–70% MVIC for concentric sEMG activations were observed in the vastus medialis across DJs heights. The biceps femoris eccentric/concentric sEMG ratio during DJ45 (i.e., 1.0) was lower (p = 0.03) compared to the ratio observed after DJ90 (i.e., 3.2). The gastrocnemius medialis and vastus medialis eccentric/concentric sEMG ratio were not significantly different between drop heights. In conclusion, jumping performance and most neuromuscular markers were not sensitive to DJ height (intensity) in amateur female volleyball athletes.

Bayesian Estimation of the Variation in Strength and Aerobic Physical Performances in Young Eumenorrheic Female College Students during a Menstrual Cycle

Background: The purpose of the present investigation was to examine changes in strength and aerobic physical performances in young eumenorrheic female college students during the menstruation phase and different testing occasions within a menstrual cycle. Methods: A repeated measure experimental design used to investigate the variation in physical performance from different testing occasions compared to the menstruation phase. Twelve eumenorrhea female college students volunteered to participate in this study. The participants were 19.8 ± 0.8 (±SD) years old, with the body mass of 61.4 ± 11.6 kg, the height of 162.6 ± 5.1 cm, and BMI of 23.2 ± 3.8. All participants reported regular monthly menstrual cycles of 26–33 days, none of whom reported taking oral contraceptives in their entire life. None of the participants was an athlete, and their level of activity was limited to physical education classes and recreational activities. The menstrual cycles during the two cycles before testing had to be between 26 and 35 days to participate in this study. Second, there had to be no current or ongoing neuromuscular diseases or musculoskeletal injuries. Third, no one should be taking any dietary or performance-enhancing supplements that could have affected testing results during this study. The participants tested on one-repetition maximum (1RM) bench press, 1RM leg press, push-up to failure, leg press with 60% of 1RM to failure, and running 1600 m time trial. The participants were tested on four occasions based on the classical model of the menstrual cycle (i.e., 28 days; early follicular phase (menstruation phase) on day 2 (T1), late follicular phase on day 8 (T2), ovulation phase on day 14 (T3), and mid-luteal phase on day 21 (T4)). Data were analyzed using the Bayesian hierarchical model (Bayesian Estimation) with Markov Chain Monte Carlo simulation using the decision-theoretic properties of the high-density interval (HDI) + ROPE decision rule. Results: The Bayesian estimated difference from the four testing occasions neither showed that the most credible parameter values (95% HDI) were sufficiently away from the null value nor showed that the most credible parameter values are close to the null value (Rope odds ratio among all tests were spread in 12.7% < 0 < 87.3% with an effect size ranging between d = −0.01 and 0.44). Hence, no decision can be made as to whether strength and aerobic physical performances change during the menstruation phase compared to the other testing occasions within a menstrual cycle. Conclusions: It was noticed that different studies concluded different results, which make the research in menstrual cycle difficult. However, the results from this study and published studies suggest that future research should investigate and profile motivation and autonomic nervous system activity during the menstruation phase and examine the interaction effect of the three on performance compared to other testing occasions within a menstrual cycle.

The Specificities of Elite Female Athletes: A Multidisciplinary Approach

Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18-40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.

Effects of the Menstrual Cycle on Jumping, Sprinting and Force-Velocity Profiling in Resistance-Trained Women: A Preliminary Study

The aim of this study was to examine the effects of the menstrual cycle on vertical jumping, sprint performance and force-velocity profiling in resistance-trained women. A group of resistance-trained eumenorrheic women (n = 9) were tested in three phases over the menstrual cycle: bleeding phase, follicular phase, and luteal phase (i.e., days 1-3, 7-10, and 19-21 of the cycle, respectively). Each testing phase consisted of a battery of jumping tests (i.e., squat jump [SJ], countermovement jump [CMJ], drop jump from a 30 cm box [DJ30], and the reactive strength index) and 30 m sprint running test. Two different applications for smartphone (My Jump 2 and My Sprint) were used to record the jumping and sprinting trials, respectively, at high speed (240 fps). The repeated measures ANOVA reported no significant differences (p ≥ 0.05, ES < 0.25) in CMJ, DJ30, reactive strength index and sprint times between the different phases of the menstrual cycle. A greater SJ height performance was observed during the follicular phase compared to the bleeding phase (p = 0.033, ES = -0.22). No differences (p ≥ 0.05, ES < 0.45) were found in the CMJ and sprint force-velocity profile over the different phases of the menstrual cycle. Vertical jump, sprint performance and the force-velocity profiling remain constant in trained women, regardless of the phase of the menstrual cycle.

Electromyographic Assessment of the Lower Leg Muscles during Concentric and Eccentric Phases of Standing Heel Raise

Only a small number of muscle activation patterns from lower limbs have been reported and simultaneous muscle activation from several lower limb muscles have not yet been investigated. The purpose of this study was to examine any gender differences in surface electromyography (EMG) activity from six recorded lower limb muscles of the dominant limb at baseline (i.e., with the foot placed flat on the floor and in the neutral position), and during concentric and eccentric phases when performing a heel raise task. In total, 10 females and 10 males performed a standing heel raise task comprising of three continuous phases: baseline, unloading (concentric muscle action), and loading (eccentric muscle action) phases. Muscle activation from six muscles (gastrocnemius medialis, gastrocnemius lateralis, soleus, tibialis anterior, peroneus longus, and peroneus brevis) were measured using the Myon 320 EMG System. Root mean squared values of each muscle were calculated for each phase. Descriptive and inferential statistics were incorporated into the study. Statistically significant p values were set at 0.05. The results showed no significant differences between baseline, concentric, and eccentric phases with respect to each of the muscles investigated. Except for the gastrocnemius medialis at baseline and concentric phases, no significant differences were observed between genders or contractions. The data suggests that gender does not significantly influence the eccentric phase during the standing heel raise task.

The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis

Background

Concentrations of endogenous sex hormones fluctuate across the menstrual cycle (MC), which could have implications for exercise performance in women. At present, data are conflicting, with no consensus on whether exercise performance is affected by MC phase.

Objective

To determine the effects of the MC on exercise performance and provide evidence-based, practical, performance recommendations to eumenorrheic women.

Methods

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four databases were searched for published experimental studies that investigated the effects of the MC on exercise performance, which included at least one outcome measure taken in two or more defined MC phases. All data were meta-analysed using multilevel models grounded in Bayesian principles. The initial meta-analysis pooled pairwise effect sizes comparing exercise performance during the early follicular phase with all other phases (late follicular, ovulation, early luteal, mid-luteal and late luteal) amalgamated. A more comprehensive analysis was then conducted, comparing exercise performance between all phases with direct and indirect pairwise effect sizes through a network meta-analysis. Results from the network meta-analysis were summarised by calculating the Surface Under the Cumulative Ranking curve (SUCRA). Study quality was assessed using a modified Downs and Black checklist and a strategy based on the recommendations of the Grading of Recommendations Assessment Development and Evaluation (GRADE) working group.

Results

Of the 78 included studies, data from 51 studies were eligible for inclusion in the initial pairwise meta-analysis. The three-level hierarchical model indicated a trivial effect for both endurance- and strength-based outcomes, with reduced exercise performance observed in the early follicular phase of the MC, based on the median pooled effect size (ES_0.5 = − 0.06 [95% credible interval (CrI): − 0.16 to 0.04]). Seventy-three studies had enough data to be included in the network meta-analysis. The largest effect was identified between the early follicular and the late follicular phases of the MC (ES_0.5 = − 0.14 [95% CrI: − 0.26 to − 0.03]). The lowest SUCRA value, which represents the likelihood that exercise performance is poor, or among the poorest, relative to other MC phases, was obtained for the early follicular phase (30%), with values for all other phases ranging between 53 and 55%. The quality of evidence for this review was classified as “low” (42%).

Conclusion

The results from this systematic review and meta-analysis indicate that exercise performance might be trivially reduced during the early follicular phase of the MC, compared to all other phases. Due to the trivial effect size, the large between-study variation and the number of poor-quality studies included in this review, general guidelines on exercise performance across the MC cannot be formed; rather, it is recommended that a personalised approach should be taken based on each individual's response to exercise performance across the MC.

Electronic supplementary material

The online version of this article (10.1007/s40279-020-01319-3) contains supplementary material, which is available to authorized users.

Indirect Markers of Muscle Damage Throughout the Menstrual Cycle

Context: The indirect markers of muscle damage have been previously studied in females. However, inconclusive results have been found, possibly explained by the heterogeneity regarding monitoring and verification of menstrual-cycle phase. Purpose: To determine whether the fluctuations in sex hormones during the menstrual cycle influence muscle damage. Methods: A total of 19 well-trained eumenorrheic women (age 28.6 [5.9] y; height 163.4 [6.1] cm; weight 59.6 [5.8] kg body mass) performed an eccentric-based resistance protocol consisting of 10 × 10 back squats at 60% of their 1-repetition maximum on the early follicular phase (EFP), late follicular phase, and midluteal phase of the menstrual cycle. Range of motion, muscle soreness, countermovement jump, and limb circumferences were evaluated prior to 24 and 48 hours postexercise. Perceived exertion was evaluated after each set. Results: Differences in sex hormones indicated that tests were adequately performed in the different menstrual-cycle phases. Prior to exercise, muscle soreness was higher in the EFP (4.7 [7.7]) than in the late follicular phase (1.1 [3.2]; P = .045). No other variables showed significant differences between phases. Time-point differences (baseline, 24, and 48 h) were observed in knee range of motion (P = .02), muscle soreness, countermovement jump, and between sets for perceived exertion (P < .001). Conclusion: Although the protocol elicited muscle damage, hormonal fluctuations over the menstrual cycle did not seem to affect indirect markers of muscle damage, except for perceived muscle soreness. Muscle soreness was perceived to be more severe before exercise performed in EFP, when estrogen concentrations are relatively low. This may impair women’s predisposition to perform strenuous exercise during EFP.

Exercise-Induced Muscle Damage During the Menstrual Cycle: A Systematic Review and Meta-Analysis

ABSTRACT

Romero-Parra, N, Cupeiro, R, Alfaro-Magallanes, VM, Rael, B, Rubio-Arias, JA, Peinado, AB, and Benito, PJ, IronFEMME Study Group. Exercise-induced muscle damage during the menstrual cycle: A systematic review and meta-analysis. J Strength Cond Res 35(2): 549-561, 2021-A strenuous bout of exercise could trigger damage of muscle tissue, and it is not clear how sex hormone fluctuations occurring during the menstrual cycle (MC) affect this response. The aims of this study were to systematically search and assess studies that have evaluated exercise-induced muscle damage (EIMD) in eumenorrheic women over the MC and to perform a meta-analysis to quantify which MC phases display the muscle damage response. The guidelines of the Preferred Reported Items for Systematic Reviews and Meta-Analysis were followed. A total of 19 articles were analyzed in the quantitative synthesis. Included studies examined EIMD in at least one phase of the following MC phases: early follicular phase (EFP), late follicular phase (LFP), or midluteal phase (MLP). The meta-analysis demonstrated differences between MC phases for delayed onset muscle soreness (DOMS) and strength loss (p < 0.05), whereas no differences were observed between MC phases for creatine kinase. The maximum mean differences between pre-excercise and post-exercise for DOMS were EFP: 6.57 (4.42, 8.71), LFP: 5.37 (2.10, 8.63), and MLP: 3.08 (2.22, 3.95), whereas for strength loss were EFP: -3.46 (-4.95, -1.98), LFP: -1.63 (-2.36, -0.89), and MLP: -0.72 (-1.07, -0.36) (p < 0.001). In conclusion, this meta-analysis suggests that hormone fluctuations throughout the MC affect EIMD in terms of DOMS and strength loss. Lower training loads or longer recovery periods could be considered in the EFP, when sex hormone concentrations are lower and women may be more vulnerable to muscle damage, whereas strength conditioning loads could be enhanced in the MLP.

Methodological Approach of the Iron and Muscular Damage: Female Metabolism and Menstrual Cycle during Exercise Project (IronFEMME Study)

Abstract

Background: The increase in exercise levels in the last few years among professional and recreational female athletes has led to an increased scientific interest about sports health and performance in the female athlete population. The purpose of the IronFEMME Study described in this protocol article is to determine the influence of different hormonal profiles on iron metabolism in response to endurance exercise, and the main markers of muscle damage in response to resistance exercise; both in eumenorrheic, oral contraceptive (OC) users and postmenopausal well-trained women. Methods: This project is an observational controlled randomized counterbalanced study. One hundered and four (104) active and healthy women were selected to participate in the IronFEMME Study, 57 of which were eumenorrheic, 31 OC users and 16 postmenopausal. The project consisted of two sections carried out at the same time: iron metabolism (study I) and muscle damage (study II). For the study I, the exercise protocol consisted of an interval running test (eight bouts of 3 min at 85% of the maximal aerobic speed), whereas the study II protocol was an eccentric-based resistance exercise protocol (10 sets of 10 repetitions of plate-loaded barbell parallel back squats at 60% of their one repetition maximum (1RM) with 2 min of recovery between sets). In both studies, eumenorrheic participants were evaluated at three specific moments of the menstrual cycle: early-follicular phase, late-follicular phase and mid-luteal phase; OC users performed the trial at two moments: withdrawal phase and active pill phase. Lastly, postmenopausal women were only tested once, since their hormonal status does not fluctuate. The three-step method was used to verify the menstrual cycle phase: calendar counting, blood test confirmation, and urine-based ovulation kits. Blood samples were obtained to measure sex hormones, iron metabolism parameters, and muscle damage related markers. Discussion: IronFEMME Study has been designed to increase the knowledge regarding the influence of sex hormones on some aspects of the exercise-related female physiology. Iron metabolism and exercise-induced muscle damage will be studied considering the different reproductive status present throughout well-trained females’ lifespan.

Trial registration

The study was registered at Clinicaltrials.gov NCT04458662 on 2 July 2020.

Menstrual Cycle Effects on Exercise-Induced Fatigability

Estrogen and progesterone have distinct concentrations across the menstrual cycle, each one promoting several physiological alterations other than preparing the uterus for pregnancy. Whether these physiological alterations can influence motor output during a fatiguing contraction is the goal of this review, with an emphasis on the obtained effect sizes. Studies on this topic frequently attempt to report if there is a statistically significant difference in fatigability between the follicular and luteal phases of the menstrual cycle. Although the significant difference (the P-value) can inform the probability of the event, it does not indicate the magnitude of it. We also investigated whether the type of task performed (e.g., isometric vs. dynamic) can further influence the magnitude by which exercise-induced fatigue changes with fluctuations in the concentration of ovarian hormones. We retrieved experimental studies in eumenorrheic women published between 1975 and 2019. The initial search yielded 921 studies, and after manual refinement, 46 experimental studies that reported metrics of motor output in both the follicular and luteal phases of the menstrual cycle were included. From these retrieved studies, 15 showed a statistical difference between the luteal and follicular phases (seven showing less fatigability during the luteal phase and eight during the follicular phase). The effect size was not consistent across studies and with a large range (-6.77; 1.61, favoring the luteal and follicular phase, respectively). The inconsistencies across studies may be a consequence of the differences in the limb used during the fatiguing contraction (upper vs. lower extremity), the type of contraction (isometric vs. dynamic), the muscle mass engaged (single limb vs. full body), and the techniques used to define the menstrual cycle phase (e.g., serum concentration vs. reported day of menses). Further studies are required to determine the effects of a regular menstrual cycle phase on the exercise-induced fatigability.

Physical, Biochemical, and Neuromuscular Responses to Repeated Sprint Exercise in Eumenorrheic Female Handball Players: Effect of Menstrual Cycle Phases

Graja, A, Kacem, M, Hammouda, O, Borji, R, Bouzid, MA, Souissi, N, and Rebai, H. Physical, biochemical, and neuromuscular responses to repeated sprint exercise in eumenorrheic female handball players: effect of menstrual cycle phases. J Strength Cond Res XX(X): 000-000, 2020-Very few studies have been interested in the relationship between ovarian hormones and physiological function in female athletes. The aim of this study was to assess the effect of menstrual phases (MP) on physical, neuromuscular, and biochemical responses after repeated sprint exercise (RSE) in female handball players. Ten eumenorrheic athletes (22.5 ± 1.5 years, 1.70 ± 0.04 m) participated in 3 study visits (follicular phase [FP], luteal phase [LP], and premenstrual phase [PMP]). During each MP, they performed 20 × 5-second cycle sprints interspersed with 25 seconds of rest. Maximal voluntary contraction (MVC) tests of the knee extensor muscles at 90° of knee flexion were performed before and after RSE. Peak force and electromyography (EMG) signals were measured during the MVC tests. Blood samples were collected before and 3 minutes after each session. The percentage of decrement in peak power output over the 20 × 5-second cycle test (i.e., fatigue index) calculated between sprints 1 and 20 decreased significantly during PMP (-43.3% ± 5.7%) but not in LP (-39.2% ± 7.7%) compared with FP (-32.44% ± 6.3%) (p < 0.05). Moreover, no significant difference was found between MP in all frequency components of EMG before RSE (p > 0.05). Maximal voluntary contraction, neuromuscular efficiency, and median frequency values of vastus lateralis and rectus femoris were significantly decreased in PMP compared with FP and LP (p < 0.05). Creatine kinase (CK) levels were significantly higher in PMP compared with FP and LP after RSE (p < 0.05). These findings suggest that RSE induces more peripheral fatigue associated with muscle damage in PMP. This might be attributable to hormonal variation across MP. Therefore, FP seems to be the right time for intense training to improve strength performance.

Influence of the Menstrual Cycle on Blood Markers of Muscle Damage and Inflammation Following Eccentric Exercise

The aim of this study was to evaluate whether the menstrual cycle and its underlying hormonal fluctuations affect muscle damage and inflammation in well-trained females following an eccentric exercise. Nineteen eumenorrheic women performed an eccentric squat-based exercise in the early follicular phase, late follicular phase and mid-luteal phase of their menstrual cycle. Sex hormones and blood markers of muscle damage and inflammation –creatine kinase, myoglobin, lactate dehydrogenase, interleukin-6, tumoral necrosis factor-α, and C reactive protein– were analyzed in each phase. No effect of menstrual cycle phase was observed (p > 0.05), while an interaction for interleukin-6 was shown (p = 0.047). Accordingly, a moderate effect size [0.68 (0.53)–0.84 (0.74)], indicated that interleukin-6 values 2 h post-trial (2.07 ± 1.26 pg/mL) were likely to be higher than baseline (1.59 ± 0.33 pg/mL), 24 h (1.50 ± 0.01 pg/mL) and 48 h (1.54 ± 0.13 pg/mL) in the mid-luteal phase. Blood markers of muscle damage and inflammation were not affected by the menstrual cycle in well-trained women. The eccentric exercise barely triggered muscle damage and hence, no inflammation was observed, possibly due to participants training status. The mid-luteal phase was the only phase reflecting a possible inflammatory response in terms of interleukin-6, although further factors than sex hormones seem to be responsible for this finding.

The contribution of low-frequency fatigue to the loss of quadriceps contractile function following repeated drop jumps

NEW FINDINGS

What is the central question of this study? Why do some subjects recover slowly following a bout of eccentric exercise and why is recovery faster following a repeated bout? What is the main finding and its importance? The results are consistent with two major causes of the reduction of quadriceps torque, the onset of low-frequency fatigue which recovered relatively fast and a second, delayed form of damage. Differences in the delayed damage process largely accounted for the differences in the rate of torque recovery between subjects after a first bout and it was suppression of the delayed damage which accounted for the faster recovery following a repeated bout of eccentric exercise.

ABSTRACT

The purpose of this study was to determine the extent to which low-frequency fatigue (LFF) accounts for the loss of quadriceps strength and time course of recovery following a series of drop jumps (DJs). Seventeen female subjects (20.8 ± 1.4 years) undertook 100 DJs, which were repeated 4 weeks later. Maximum isometric torque (MIT) and the ratio of torque generated by 20 and 100 Hz electrical stimulation (20/100), as a measure of LFF, were measured over 7 days following each series of DJs. After the first series the 20/100 ratio fell to a greater extent than MIT (to 35 ± 8.7% and 69 ± 11%, respectively) but recovered over 2-3 days, while MIT showed little recovery over this time. Changes of the 20/100 ratio were similar between subjects with fast or slow MIT recovery. Following the second series of DJs, changes in the 20/100 ratio were similar to those of the first bout and there were no differences between fast and slow recovering subjects. MIT, however, recovered more rapidly than after the first bout; the faster recovery was confined to the subjects who recovered slowly following the first bout. The results are consistent with two major causes of the reduction of quadriceps torque, the onset of low-frequency fatigue which recovered relatively fast and a second, delayed, form of damage. The latter largely accounted for the differences in MIT recovery between subjects after the first bout, while suppression of the delayed damage accounted for the faster recovery following the repeated bout.

Eccentric and concentric blood flow restriction resistance training on indices of delayed onset muscle soreness in untrained women

PURPOSE

Unaccustomed exercise can result in delayed onset muscle soreness (DOMS), particularly as a result of the eccentric phase of the muscle contraction. Resistance training combined with venous blood flow restriction (vBFR) may attenuate DOMS, but the available information in this regard is conflicting. Therefore, the purpose of this study was to examine the effects of low-load eccentric vBFR (Ecc-vBFR) and concentric vBFR (Con-vBFR) resistance training on indices of DOMS.

METHODS

Twenty-five previously untrained women completed seven days of either Ecc-vBFR (n = 12) or Con-vBFR (n = 13) forearm flexion resistance training at a velocity of 120° s^-1 on an isokinetic dynamometer. The Ecc-vBFR group used a training load that corresponded to 30% of eccentric peak torque and the Con-vBFR group used a training load that corresponded to 30% of concentric peak torque.

RESULTS

There were no differences between Ecc-vBFR and Con-vBFR at any of the seven training sessions on any of the indices of DOMS. There were no decreases in the maximal voluntary isometric contraction torque which increased at days 6 and 7. Similarly, there were no changes in perceived muscle soreness, pain pressure threshold, elbow joint angle, or edema (as assessed by echo intensity via ultrasound) across the seven training sessions.

CONCLUSIONS

The Ecc-vBFR and Con-vBFR low-load training protocols were not associated with DOMS and there were no differences between protocols when performed using the same relative training intensity. These findings suggested that both unaccustomed eccentric and concentric low-load training did not result in DOMS when combined with vBFR.

Effects of Maturation on Physical Fitness Adaptations to Plyometric Jump Training in Youth Females

Romero, C, Ramirez-Campillo, R, Alvarez, C, Moran, J, Slimani, M, Gonzalez, J, and Banzer, WE. Effects of maturation on physical fitness adaptations to plyometric jump training in youth females. J Strength Cond Res XX(X): 000-000, 2019-The aim of this study was to compare the effects of maturation on physical fitness adaptations to plyometric jump training (PJT) in youth females. Jumping, sprinting, change of direction speed, endurance, and maximal strength were measured pre-post 6 weeks of PJT in 7th- and 10th-grade subjects. In the seventh grade, subjects formed a PJT group (Plyo-7, n = 10; age, 12.7 ± 0.6 years; breast maturation stages IV [n = 2], III [n = 7], and II [n = 1]) and an active control group (Con-7, n = 9; age, 12.8 ± 0.6 years; breast maturation stages IV [n = 2], III [n = 6], and II [n = 1]). In the 10th grade, subjects conformed a PJT group (Plyo-10, n = 9; age, 16.3 ± 0.5 years; breast maturation stages V [n = 5] and IV [n = 4]) and an active control group (Con-10, n = 9; age, 16.2 ± 0.5 years; breast maturation stages V [n = 5] and IV [n = 4]). Magnitude-based inferences were used for data analysis, with effect sizes (ESs) interpreted as <0.2 = trivial; 0.2-0.6 = small; 0.6-1.2 = moderate; 1.2-2.0 = large; and 2.0-4.0 = very large. The Plyo-7 and Plyo-10 showed meaningful improvements in all physical fitness measures (ES = 0.21-2.22), while Con-7 and Con-10 showed only trivial changes. The Plyo-7 and Plyo-10 showed meaningful (ES = 0.16-2.22) greater improvements in all physical fitness measures when compared with their control counterparts. The Plyo-10 showed meaningful greater improvements in 20-m sprint, 2-km running time trial, maximal strength, squat jump, and drop jump from 20 cm (ES = 0.21-0.42) when compared with Plyo-7. In conclusion, PJT is effective in improving physical fitness in younger and older female youths. However, greater adaptations were observed in more mature subjects.

Muscle damage responses to resistance exercise performed with high-load versus low-load associated with partial blood flow restriction in young women

The aim of this study was to compare if an acute exercise session of high-load resistance training (HL-RT, e.g. 70% of 1 repetition-maximum, 1 RM) induces a higher magnitude of muscle damage compared with a RT protocol with low-loads (e.g. 20% 1 RM) associated with partial blood flow restriction (LL-BFR), and investigate the recovery in the days after the protocols. We used an unilateral crossover research design in which 10 young women (22(2) y; 162(5) cm; 66(11) kg) performed HL-RT and LL-BFR in a randomized, counterbalanced manner with a minimum interval of 2 weeks between protocols. Indirect muscle damage markers were evaluated before and once a day for 4 days into recovery. Main results showed decreases of 8-12% at 24-48 h in maximal voluntary isometric and concentric contraction torques (P < 0.03), and changes in muscle architecture markers (P < 0.03) for HL-RT and LL-BFR, with no differences between protocols (P > 0.05). Moreover, delayed onset muscle soreness increased only after LL-BFR (P < 0.001). We conclude that an acute bout of low volume HL-RT or LL-BFR to failure resulted in edema-induced muscle swelling, but do not induce major or long-lasting decrements in muscle function and the level of soreness promoted from LL-BFR was mild.

A systematic review on the effects of resistance and plyometric training on physical fitness in youth- What do comparative studies tell us?

INTRODUCTION

To date, several meta-analyses clearly demonstrated that resistance and plyometric training are effective to improve physical fitness in children and adolescents. However, a methodological limitation of meta-analyses is that they synthesize results from different studies and hence ignore important differences across studies (i.e., mixing apples and oranges). Therefore, we aimed at examining comparative intervention studies that assessed the effects of age, sex, maturation, and resistance or plyometric training descriptors (e.g., training intensity, volume etc.) on measures of physical fitness while holding other variables constant.

METHODS

To identify relevant studies, we systematically searched multiple electronic databases (e.g., PubMed) from inception to March 2018. We included resistance and plyometric training studies in healthy young athletes and non-athletes aged 6 to 18 years that investigated the effects of moderator variables (e.g., age, maturity, sex, etc.) on components of physical fitness (i.e., muscle strength and power).

RESULTS

Our systematic literature search revealed a total of 75 eligible resistance and plyometric training studies, including 5,138 participants. Mean duration of resistance and plyometric training programs amounted to 8.9 ± 3.6 weeks and 7.1±1.4 weeks, respectively. Our findings showed that maturation affects plyometric and resistance training outcomes differently, with the former eliciting greater adaptations pre-peak height velocity (PHV) and the latter around- and post-PHV. Sex has no major impact on resistance training related outcomes (e.g., maximal strength, 10 repetition maximum). In terms of plyometric training, around-PHV boys appear to respond with larger performance improvements (e.g., jump height, jump distance) compared with girls. Different types of resistance training (e.g., body weight, free weights) are effective in improving measures of muscle strength (e.g., maximum voluntary contraction) in untrained children and adolescents. Effects of plyometric training in untrained youth primarily follow the principle of training specificity. Despite the fact that only 6 out of 75 comparative studies investigated resistance or plyometric training in trained individuals, positive effects were reported in all 6 studies (e.g., maximum strength and vertical jump height, respectively).

CONCLUSIONS

The present review article identified research gaps (e.g., training descriptors, modern alternative training modalities) that should be addressed in future comparative studies.

Influence of Maturation Status on Eccentric Exercise-Induced Muscle Damage and the Repeated Bout Effect in Females

This study compared changes in indirect muscle damage markers, proprioception and arterial stiffness after elbow flexor eccentric exercise between pre-pubescent (9-10 y), pubescent (14-15 y), and post-pubescent (20-24 y) healthy, untrained females (n = 13/group). The maturation of the participants was confirmed by the hand bone age. All participants performed two bouts of 30 sub-maximal eccentric contractions (EC1, EC2) using a dumbbell set at 60% of pre-exercise maximal voluntary isometric elbow flexion strength at 90°. Changes in maximal voluntary concentric contraction (MVC) torque, muscle soreness (SOR), plasma creatine kinase activity, proprioception (position sense, joint reaction angle) and arterial stiffness (carotid-femoral pulse-wave velocity: cfPWV) before to 5 days after EC1 and EC2 were compared among groups by a mixed-design two-way ANOVA. Pre-exercise MVC torque and cfPWV were smaller (P < 0.05) for the pre-pubescent (MVC: 10.0 ± 0.9 Nm, cfPWV: 903 ± 60 cm/s) and the pubescent (14.3 ± 1.1 Nm, 967 ± 61 cm/s) than the post-pubescent (19.1 ± 1.4 Nm, 1,103 ± 73 cm/s). Changes in all variables after EC1 were smaller (P < 0.05) for the pre-pubescent (e.g., MVC at 1 d post-exercise: -10 ± 6%, peak SOR: 5 ± 2 mm) than the pubescent (-15 ± 9%, 12 ± 6 mm) and the post-pubescent (-25 ± 7%, 19 ± 13 mm). After EC2, changes in all variables were smaller (P < 0.05) than those after EC1 for all groups (e.g., MVC at 1 d post-exercise, pre-pubescent: -4 ± 6%, pubescent: -9 ± 4%, post-pubescent: -14 ± 5%; peak SOR: 3 ± 2, 7 ± 3, 11 ± 6 mm), but the magnitude of the repeated bout effect was not different (P > 0.05) among the groups. These results show that the extents of muscle damage, and proprioception and arterial stiffness changes after eccentric exercise are greater at later stages of maturation, but the repeated bout effect is not affected by maturation.

Influence of ovarian hormones on strength loss in healthy and dystrophic female mice

PURPOSE

The primary objective of this study was to determine whether strength loss and recovery after eccentric contractions are impaired in healthy and dystrophic female mice with low levels of ovarian hormones.

METHODS

Female C57BL/6 (wild-type) or mdx mice were randomly assigned to ovarian-intact (Sham) and ovariectomized (Ovx) groups. Anterior crural muscles were tested for susceptibility to injury from 150 or 50 eccentric contractions in wild-type and mdx mice, respectively. An additional experiment challenged mdx mice with a 2-wk treadmill running protocol followed by an eccentric contraction injury to posterior crural muscles. Functional recovery from injury was evaluated in wild-type mice by measuring isometric torque 3, 7, 14, or 21 d after injury.

RESULTS

Ovarian hormone deficiency in wild-type mice did not affect susceptibility to injury because the ∼50% isometric torque loss after eccentric contractions did not differ between Sham and Ovx mice (P = 0.121). Similarly, in mdx mice, hormone deficiency did not affect the percent of preinjury isometric torque lost by anterior crural muscles after eccentric contractions (P = 0.952), but the percent of preinjury torque in posterior crural muscles was lower in Ovx than in Sham mice (P = 0.014). Recovery from injury in wild-type mice was affected by hormone deficiency. Sham mice recovered preinjury isometric strength by 14 d (96% ± 2%), whereas Ovx mice maintained deficits at 14 and 21 d after injury (80% ± 3% and 84% ± 2%, P < 0.001).

CONCLUSIONS

Ovarian hormone status did not affect the vulnerability of skeletal muscle to strength loss after eccentric contractions. However, ovarian hormone deficiency did impair the recovery of muscle strength in female mice.

Dietary intervention restored menses in female athletes with exercise-associated menstrual dysfunction with limited impact on bone and muscle health

Exercise-related menstrual dysfunction (ExMD) is associated with low energy availability (EA), decreased bone mineral density (BMD), and increased risk of musculoskeletal injury. We investigated whether a 6-month carbohydrate-protein (CHO-PRO) supplement (360 kcal/day, 54 g CHO/day, 20 g PRO/day) intervention would improve energy status and musculoskeletal health and restore menses in female athletes (n = 8) with ExMD. At pre/post-intervention, reproductive and thyroid hormones, bone health (BMD, bone mineral content, bone markers), muscle strength/power and protein metabolism markers, profile of mood state (POMS), and energy intake (EI)/energy expenditure (7 day food/activity records) were measured. Eumenorrheic athlete controls with normal menses (Eumen); n = 10) were measured at baseline. Multiple linear regressions were used to evaluate differences between groups and pre/post-intervention blocking on participants. Improvements in EI (+382 kcal/day; p = 0.12), EA (+417 kcal/day; p = 0.17) and energy balance (EB; +466 kcal/day; p = 0.14) were observed with the intervention but were not statistically significant. ExMD resumed menses (2.6 ± 2.2-months to first menses; 3.5 ± 1.9 cycles); one remaining anovulatory with menses. Female athletes with ExMD for >8 months took longer to resume menses/ovulation and had lower BMD (low spine (ExMD = 3; Eumen = 1); low hip (ExMD = 2)) than those with ExMD for <8 months; for 2 ExMD the intervention improved spinal BMD. POMS fatigue scores were 15% lower in ExMD vs. Eumen (p = 0.17); POMS depression scores improved by 8% in ExMD (p = 0.12). EI, EA, and EB were similar between groups, but the intervention (+360 kcal/day) improved energy status enough to reverse ExMD despite no statistically significant changes in EI. Similar baseline EA and EB between groups suggests that some ExMD athletes are more sensitive to EA and EB fluctuations.