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Liu H, Jiang L, Wang J. The effects of blood flow restriction training on post activation potentiation and upper limb muscle activation: a meta-analysis. Front Physiol 2024; 15:1395283. [PMID: 39055689 PMCID: PMC11269198 DOI: 10.3389/fphys.2024.1395283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 06/20/2024] [Indexed: 07/27/2024] Open
Abstract
Objective This meta-analysis aims to systematically evaluate the impact of blood flow restriction training (BFRT) on muscle activation and post-activation potentiation (PAP) in the upper limbs, to provide guidance for upper limb protocols aiming to enhance explosive strength and activation. Methods PubMed, CNKI, Web of Science, and EBSCO databases were queried to identify randomized controlled trials (RCTs) investigating the effects of upper limb BFRT on muscle activation and PAP. Inclusion and exclusion criteria were applied using the Cochrane bias risk tool. Literature quality assessment and statistical analysis were conducted using Revman 5.4 and Stata 17.0 software. Sensitivity analysis and funnel plots were utilized to assess result stability and publication bias. Results A total of 31 articles involving 484 participants were included in the analysis. Meta-analysis results showed that upper limb BFRT significantly increased muscle iEMG values [SMD = 0.89, 95%CI (0.21, 1.58), p = 0.01]. BFRT had a significant effect on upper limb explosive force [SMD = 0.73, 95%CI (0.41, 1.04), p < 0.00001]. Subgroup analysis based on literature heterogeneity (I 2 = 92%, 80%) showed that exhaustive BFRT significantly decreased upper limb iEMG [SMD = -0.67, 95%CI (-1.25, -0.09), p = 0.01], with exercise modes including maximum output power of bench press [SMD = 1.87, 95%CI (0.22, 3.53), p < 0.0001], exercise intensity of 40%-70% 1RM [SMD = 1.31, 95%CI (0.61, 2.01), p < 0.0001], and pressure intensity of ≥60% AOP [SMD = 0.83, 95%CI (0.43, 1.23), p < 0.0001] reaching maximum effects and statistical significance. Conclusion Upper limb BFRT can induce muscle activation and PAP. BFRT with 40%-70% 1RM and ≥60% AOP in the upper limbs is more likely to promote PAP. Systematic Review Registration http://inplasy.com, identifier INPLASY202430008.
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Affiliation(s)
- Haiyang Liu
- Department of Physical Education, Ningbo University of Technology, Ningbo, China
| | - Lizhu Jiang
- Ningde Vocational and Technical College, Ningde, China
| | - Jian Wang
- Department of Physical Education, Ningbo University of Technology, Ningbo, China
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Liu Y, Huang C, Xiong Y, Wang X, Shen Z, Zhang M, Gao N, Wang N, Du G, Zhan H. The causal relationship between human brain morphometry and knee osteoarthritis: a two-sample Mendelian randomization study. Front Genet 2024; 15:1420134. [PMID: 39040992 PMCID: PMC11260717 DOI: 10.3389/fgene.2024.1420134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024] Open
Abstract
Background Knee Osteoarthritis (KOA) is a prevalent and debilitating condition affecting millions worldwide, yet its underlying etiology remains poorly understood. Recent advances in neuroimaging and genetic methodologies offer new avenues to explore the potential neuropsychological contributions to KOA. This study aims to investigate the causal relationships between brain-wide morphometric variations and KOA using a genetic epidemiology approach. Method Leveraging data from 36,778 UK Biobank participants for human brain morphometry and 487,411 UK Biobank participants for KOA, this research employed a two-sample Mendelian Randomization (TSMR) approach to explore the causal effects of 83 brain-wide volumes on KOA. The primary method of analysis was the Inverse Variance Weighted (IVW) and Wald Ratio (WR) method, complemented by MR Egger and IVW methods for heterogeneity and pleiotropy assessments. A significance threshold of p < 0.05 was set to determine causality. The analysis results were assessed for heterogeneity using the MR Egger and IVW methods. Brain-wide volumes with Q_pval < 0.05 were considered indicative of heterogeneity. The MR Egger method was employed to evaluate the pleiotropy of the analysis results, with brain-wide volumes having a p-value < 0.05 considered suggestive of pleiotropy. Results Our findings revealed significant causal associations between KOA and eight brain-wide volumes: Left parahippocampal volume, Right posterior cingulate volume, Left transverse temporal volume, Left caudal anterior cingulate volume, Right paracentral volume, Left paracentral volume, Right lateral orbitofrontal volume, and Left superior temporal volume. These associations remained robust after tests for heterogeneity and pleiotropy, underscoring their potential role in the pathogenesis of KOA. Conclusion This study provides novel evidence of the causal relationships between specific brain morphometries and KOA, suggesting that neuroanatomical variations might contribute to the risk and development of KOA. These findings pave the way for further research into the neurobiological mechanisms underlying KOA and may eventually lead to the development of new intervention strategies targeting these neuropsychological pathways.
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Affiliation(s)
- Yongming Liu
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Chao Huang
- Yunyang County People’s Hospital Rehabilitation Medicine Department, Chongqing, China
| | - Yizhe Xiong
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiang Wang
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Zhibi Shen
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Mingcai Zhang
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Ningyang Gao
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Nan Wang
- Department of Traditional Chinese Medicine, Shanghai Yangzhi Rehabilitation Hospital (Yangzhi Affiliated Rehabilitation Hospital), School of Medicine, Tongji University, Shanghai, China
| | - Guoqing Du
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Hongsheng Zhan
- Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Traumatology and Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
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Zhang WY, Zhuang SC, Chen YM, Wang HN. Validity and reliability of a wearable blood flow restriction training device for arterial occlusion pressure assessment. Front Physiol 2024; 15:1404247. [PMID: 38911327 PMCID: PMC11191424 DOI: 10.3389/fphys.2024.1404247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/20/2024] [Indexed: 06/25/2024] Open
Abstract
Purpose The blood flow restriction (BFR) training is an effective approach to promoting muscle strength, muscle hypertrophy, and regulating the peripheral vascular system. It is recommended to use to the percentage of individual arterial occlusion pressure (AOP) to ensure safety and effectiveness. The gold standard method for assessing arterial occlusive disease is typically measured using Doppler ultrasound. However, its high cost and limited accessibility restrict its use in clinical and practical applications. A novel wearable BFR training device (Airbands) with automatic AOP assessment provides an alternative solution. This study aims to examine the reliability and validity of the wearable BFR training device. Methods Ninety-two participants (46 female and 46 male) were recruited for this study. Participants were positioned in the supine position with the wearable BFR training device placed on the proximal portion of the right thigh. AOP was measured automatically by the software program and manually by gradually increasing the pressure until the pulse was no longer detected by color Doppler ultrasound, respectively. Validity, inter-rater reliability, and test-retest reliability were assessed by intraclass correlation coefficients (ICC) and Bland-Altman analysis. Results The wearable BFR training device demonstrated good validity (ICC = 0.85, mean difference = 4.1 ± 13.8 mmHg [95% CI: -23.0 to 31.2]), excellent inter-rater reliability (ICC = 0.97, mean difference = -1.4 ± 6.7 mmHg [95% CI: -14.4 to 11.7]), and excellent test-retest reliability (ICC = 0.94, mean difference = 0.6 ± 8.6 mmHg [95% CI: -16.3 to 17.5]) for the assessment of AOP. These results were robust in both male and female subgroups. Conclusion The wearable BFR training device can be used as a valid and reliable tool to assess the AOP of the lower limb in the supine position during BFR training.
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Affiliation(s)
- Wei-Yang Zhang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
- Sports Medicine Key Laboratory of Sichuan Province, Chengdu, Sichuan, China
| | - Shu-Can Zhuang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
| | - Yuan-Ming Chen
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, Sichuan, China
| | - Hao-Nan Wang
- Sports Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Hong QM, Wang HN, Liu XH, Zhou WQ, Luo XB. Intermittent blood flow restriction with low-load resistance training for older adults with knee osteoarthritis: a randomized, controlled, non-inferiority trial protocol. Trials 2024; 25:352. [PMID: 38822360 PMCID: PMC11140873 DOI: 10.1186/s13063-024-08203-9] [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: 11/02/2023] [Accepted: 05/28/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a chronic musculoskeletal disorder characterized by pain and functional impairment. Blood flow restriction (BFR) with low-load resistance training (LLRT) demonstrates a similar improvement in clinical outcomes to high-load resistance training (HLRT) in treating KOA. It has not been established whether intermittent blood flow restriction (iBFR) with LLRT can lead to clinical outcomes that are comparable to those produced by continuous blood flow restriction (cBFR) with LLRT and HLRT. The aim of the proposed study is to evaluate the efficacy of iBFR with LLRT on pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), muscle strength, muscle mass, physical function, perceptions of discomfort and effort, and adherence in KOA patients. METHODS This is a three-arm, non-inferiority, randomized controlled trial utilizing blinded assessors. Two hundred thirteen participants will be randomly allocated to one of the following three groups: iBFR group-receiving 4 months of LLRT with iBFR, twice weekly (n = 71); cBFR group-receiving 4 months of LLRT with cBFR, twice weekly (n = 71); or HLRT group-receiving 4 months of HLRT without BFR, twice weekly (n = 71). The primary outcome is pain. The secondary outcomes include the WOMAC, muscle strength, muscle mass, physical function, perceptions of discomfort and effort, and adherence. Pain and WOMAC will be measured at the baseline and 4 and 12 months after randomizations. Muscle strength, muscle mass, and physical function will be measured at the baseline and 4 months after randomizations. The perceptions of discomfort and effort will be measured during the first and final sessions. DISCUSSION BFR with LLRT has a similar improvement in clinical outcomes as HLRT. However, cBFR may cause elevated ratings of perceived exertion and local discomfort, compromising patient tolerability and treatment adherence. If iBFR with LLRT could produce improvement in clinical outcomes analogous to those of HLRT and iBFR with LLRT, it could be considered an alternative approach for treating patients with KOA. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2300072820. Registered on June 26, 2023.
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Affiliation(s)
- Qiao-Mei Hong
- Department of Sport Medicine, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan Province, China
| | - Hao-Nan Wang
- Sports Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
- Department of Orthopedics and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.
| | - Xi-Hui Liu
- Department of Sport Medicine, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan Province, China
| | - Wen-Qi Zhou
- Department of Sport Medicine, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan Province, China
| | - Xiao-Bing Luo
- Department of Sport Medicine, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan Province, China
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Wen Z, Zhu J, Wu X, Zheng B, Zhao L, Luo X, Wu Z. Effect of Low-Load Blood Flow Restriction Training on Patients With Functional Ankle Instability: A Randomized Controlled Trial. J Sport Rehabil 2023; 32:863-872. [PMID: 37558223 DOI: 10.1123/jsr.2022-0462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 08/11/2023]
Abstract
CONTEXT Decreased muscle strength and balance in patients with functional ankle instability (FAI) can be effectively improved by ankle strength training. Low-load blood flow restriction (LL-BFR) training increases muscle size and strength, but there is limited evidence from studies on muscle strength and balance in FAI patients. OBJECTIVE To study the effects of LL-BFR training versus high-load training (HLT) on muscle strength and balance in FAI patients. DESIGN Randomized controlled trial. PARTICIPANTS Forty-six young adults with a history of FAI. INTERVENTIONS Participants in the LL-BFR and HLT groups performed 4 sets (30 × 15 × 15 × 15) of ankle training at 20% to 40% of the one-repetition maximum and 70% to 85% one-repetition maximum, respectively, twice a week for 6 weeks. MAIN OUTCOME MEASURE(S) Plantar flexion, dorsiflexion, inversion, and eversion muscle strength, and the Y-balance test scores were assessed at baseline and after 3 and 6 weeks; the thickness of the tibialis anterior, triceps surae, and peroneus longus muscles were assessed at baseline and after 6 weeks. RESULTS Inversion, eversion, dorsiflexion, and plantar flexion muscle strength; tibialis anterior, triceps surae, and peroneus longus thickness; and Y-balance test scores were significantly increased in the LL-BFR group after 3 and 6 weeks compared with baseline (P < .05), with no significant difference between the LL-BFR and HLT groups after 6 weeks (P > .05). However, at the end of 3 weeks, eversion muscle strength and Y-balance test scores were significantly higher in the LL-BFR group than in the HLT group (P < .05). CONCLUSIONS Over 6 weeks, LL-BFR training was as effective as HLT in improving ankle muscle strength, muscle thickness, and balance in FAI patients, but LL-BFR training improved the ankle eversion muscle strength and dynamic balance more than HLT did in the early stages of the intervention. This finding will provide a new intervention strategy for the clinical rehabilitation of FAI patients.
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Affiliation(s)
- Ziliang Wen
- Southwest University School of Physical Education, Beibei, CQ,China
- Sport Rehabilitation Research Institute of Southwest University, Beibei, CQ,China
- High School Affiliated to Southwest University, Beibei, CQ,China
| | - Jiang Zhu
- Sport Rehabilitation Research Institute of Southwest University, Beibei, CQ,China
- Southwest University Hospital, Beibei, CQ,China
| | - Xuelian Wu
- Sport Rehabilitation Research Institute of Southwest University, Beibei, CQ,China
- Southwest University Hospital, Beibei, CQ,China
| | - Bing Zheng
- Sport Rehabilitation Research Institute of Southwest University, Beibei, CQ,China
- Southwest University Hospital, Beibei, CQ,China
| | - Li Zhao
- Sport Rehabilitation Research Institute of Southwest University, Beibei, CQ,China
- Southwest University Hospital, Beibei, CQ,China
| | - Xin Luo
- Southwest University School of Physical Education, Beibei, CQ,China
- Sport Rehabilitation Research Institute of Southwest University, Beibei, CQ,China
| | - Zonghui Wu
- Southwest University School of Physical Education, Beibei, CQ,China
- Sport Rehabilitation Research Institute of Southwest University, Beibei, CQ,China
- Southwest University Hospital, Beibei, CQ,China
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Kong W, Wang H, Cheng L, Ni G. Comparing the effect of intermittent blood flow restriction training and high-load resistance training in patients with patellofemoral pain: study protocol for a randomised trial. BMJ Open 2023; 13:e073188. [PMID: 37865415 PMCID: PMC10603463 DOI: 10.1136/bmjopen-2023-073188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 10/02/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Patellofemoral pain (PFP) syndrome is a common knee joint functional disorder. Blood flow restriction (BFR) training has shown promise in improving PFP; however, the effectiveness of intermittent BFR (iBFR) training remains uncertain. This study aims to compare the rehabilitative effects of iBFR combined with low-load resistance training and high-load resistance training in PFP patients and to assess the effectiveness of iBFR combined with low-load resistance training for improving PFP. METHODS AND ANALYSIS This randomised, patient-assessor blinded, controlled trial will include 42 eligible PFP patients randomly allocated to an intervention group (iBFR combined with low-load resistance training) or a control group (high-load resistance training) in a 1:1 ratio. Participants will receive interventions three times per week for 8 weeks and will be followed up for 24 weeks. The primary outcome measure is pain, and the secondary outcomes include self-reported function, quality of life, muscle strength and muscle thickness. Assessments will be conducted at baseline, 8 weeks and 24 weeks during follow-up. Intention-to-treat analysis will be performed.Collectively, we expect that the findings of this randomised clinical trial will contribute to understanding the potential benefits of iBFR training and provide insightful guidance for developing more effective treatment strategies for patients with PFP. ETHICS AND DISSEMINATION This study was approved by the Sports Science Experiment Ethics Committee of Beijing Sport University (2022274H). Written informed consent will be obtained from all participants. Trial results will be disseminated through peer-reviewed publications. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR2300068281).
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Affiliation(s)
- Weiya Kong
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Haonan Wang
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Lin Cheng
- Department of Rehabilitation, Tongzhou District Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Guoxin Ni
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China
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Yeh WL, Hsu YJ, Ho CS, Ho HH, Kuo YW, Tsai SY, Huang CC, Lee MC. Lactobacillus plantarum PL-02 Supplementation Combined With Resistance Training Improved Muscle Mass, Force, and Exercise Performance in Mice. Front Nutr 2022; 9:896503. [PMID: 35571912 PMCID: PMC9094439 DOI: 10.3389/fnut.2022.896503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/07/2022] [Indexed: 12/23/2022] Open
Abstract
Increasing numbers of researchers are investigating the benefits of probiotics in enhancing exercise performance and verifying the role of the gut–muscle axis. In our previous study, Lactobacillus plantarum PL-02 improved exercise performance and muscle mass. Therefore, the purpose of this study was to investigate whether supplementation with PL-02 combined with resistance training has a synergistic effect on exercise performance and muscle mass. All the animals were assigned into four groups (n = 8/group): a sedentary control with normal distilled water group (vehicle, n = 8); PL-02 supplementation group (PL-02, 2.05 × 109 CFU, n = 8); resistance training group (RT, n = 8); PL-02 supplementation combined with resistance training group (PL-02 + RT, 2.05 × 109 CFU, n = 8). Supplementation with PL-02 for four consecutive weeks combined with resistance exercise training significantly improved the grip strength and the maximum number of crawls; increased the time of exhaustive exercise; significantly reduced the time required for a single climb; and reduced the lactate, blood ammonia, creatine kinase, and blood urea nitrogen produced after exercise (p < 0.05). In addition, it produced substantial benefits for increasing muscle mass without causing any physical damage. In summary, our findings confirmed that PL-02 or RT supplementation alone is effective in improving muscle mass and exercise performance and in reducing exercise fatigue, but the combination of the two can achieve increased benefits.
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Affiliation(s)
- Wen-Ling Yeh
- Department of Orthopedic Surgery, Lotung Poh-Ai Hospital, Luodong, Taiwan.,Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Ju Hsu
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Chin-Shen Ho
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Hsieh-Hsun Ho
- Department of Research and Design, Bioflag Biotech Co., Ltd., Tainan, Taiwan
| | - Yi-Wei Kuo
- Department of Research and Design, Bioflag Biotech Co., Ltd., Tainan, Taiwan
| | - Shin-Yu Tsai
- Department of Research and Design, Bioflag Biotech Co., Ltd., Tainan, Taiwan
| | - Chi-Chang Huang
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Mon-Chien Lee
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
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