Muscle Damage and Metabolic Responses to Repeated-Sprint Running With and Without Deceleration

Creatine supplementation in the pediatric and adolescent athlete-- A literature review

Background

An increase in intra-muscular creatine through supplementation has been proposed as a strategy for improving muscle performance and recovery, with studies showing some benefit for adult athletes who rely on short, explosive movements. We reviewed and summarized the current literature on creatine supplementation in a pediatric and adolescent population.

Methods

The databases PubMed and EMBASE were queried to identity articles related to the use of creatine supplementation in a healthy pediatric and adolescent population according to the guidelines established by PRISMA. The abstracts of all articles were reviewed to determine relevancy, with those meeting the pre-defined criteria included in the final review.

Results

A combined total of 9393 articles were identified. Following application of filters and review of abstracts, 13 articles were found to meet criteria and were included in the final review. There was a total of 268 subjects across all studies, with mean age ranging from 11.5 to 18.2 years. More than 75% of the studies were randomized-controlled trials, and 85% involved either soccer players or swimmers. The overall quality of the studies was poor, and there were no consistent findings regarding creatine supplementation and improvements in athletic performance. No studies were designed to address the topic of safety.

Conclusions

There is a gap in the study of the safety and efficacy of creatine supplementation in adolescents. Additional studies are needed to evaluate the effects of alterations in muscle composition on the growth, development, and performance of the developing athlete. Orthopedic providers should counsel their pediatric and adolescent patients on the current limitations in trying to assess the true risk and benefit of creatine supplementation for the aspiring athlete.

Level of evidence

Review, III.

Supplementation with Whey Protein, but Not Pea Protein, Reduces Muscle Damage Following Long-Distance Walking in Older Adults

Background: Adequate animal-based protein intake can attenuate exercise induced-muscle damage (EIMD) in young adults. We examined the effects of 13 days plant-based (pea) protein supplementation compared to whey protein and placebo on EIMD in active older adults. Methods: 47 Physically active older adults (60+ years) were randomly allocated to the following groups: (I) whey protein (25 g/day), (II) pea protein (25 g/day) or (III) iso-caloric placebo. Blood concentrations of creatine kinase (CK) and lactate dehydrogenase (LDH), and skeletal muscle mass, muscle strength and muscle soreness were measured prior to and 24 h, 48 h and 72 h after a long-distance walking bout (20−30 km). Results: Participants walked 20−30 km and 2 dropped out, leaving n = 15 per subgroup. The whey group showed a significant attenuation of the increase in EIMD at 24 h post-exercise compared to the pea and placebo group (CK concentration: 175 ± 90 versus 300 ± 309 versus 330 ± 165, p = p < 0.001). No differences in LDH levels, muscle strength, skeletal muscle mass and muscle soreness were observed across groups (all p-values > 0.05). Conclusions: Thirteen days of pea protein supplementation (25 g/day) does not attenuate EIMD in older adults following a single bout of prolonged walking exercise, whereas the whey protein supplementation group showed significantly lower post-exercise CK concentrations.

Physiological and Performance Impacts After Field Supramaximal High-Intensity Interval Training With Different Work-Recovery Duration

High-intensity interval training (HIIT) has numerous external load control variables. The management of these variables makes the physiological responses and performance presented by athletes also modify. The present study aimed to assess the activity of CK and LDH enzymes, performance and metabolic responses caused by two HIIT protocols above the maximum in male recreational runners. Fifteen recreational male runners performed two HIIT protocols in randomized order with multiple conditions: 1) H15 (n = 15), with a HIIT protocol of 15:15 work-recovery duration, and 2) H30 (n = 15) with a HIIT protocol of 30:30 work-recovery duration. Both protocols were performed at similar intensity (130% vV̇O_2max), one set until voluntary exhaustion. Blood samples were collected and used to capture the levels and activities of blood lactate (BLac: mmol⋅L^–1), glucose (GLU: mg⋅dL^–1), creatine kinase (CK: U⋅L^–1), and lactate dehydrogenase (LDH: U⋅L^–1). BLac and GLU were collected at pre, five, and ten minutes after the H15 and H30 protocols were performed. Blood samples were used to measure the activities of CK and LDH enzymes, which were verified 24 h before and 48 h after the protocols. The distance traveled (m), total time (s), and bouts performed (rep) were also registered. Significant differences between conditions H15 and H30 were observed in the bouts performed (p = 0.001; ES = 1.19). Several statistical differences were found over time for BLac [pre vs. post 5 (both conditions: p = 0.001), pre vs. post 10 (both conditions: p = 0.001), and post 5 vs. post 10 (H30: p = 0.004)], CK [pre vs. post 24 (H15: p < 0.001; ES = 0.97 and H30: p = 0.001; ES = 0.74) post 24 vs. post 48 (H30: p = 0.03; ES = 0.56)], and LDH [pre vs. post24 (H15: p = 0.008; ES = 1.07 and H30: p = 0.022; ES = 0.85). No statistical differences between conditions were observed for any blood parameter. Thus, the volunteers exhibited equal performance in both protocols, which resulted in a similar physiological response. Despite this similarity, in comparison to H15, the H30 protocol presented lower CK activity post 48 and lactate levels after 10 min post protocol.

The Effects of Whole-Body Photobiomodulation Light-Bed Therapy on Creatine Kinase and Salivary Interleukin-6 in a Sample of Trained Males: A Randomized, Crossover Study

Photobiomodulation therapy (PBMT) can be applied to the whole body as compared to the application of using single hand-held devices that isolate a smaller muscle area. The purpose of this study was to examine the effects of an acute dose of whole-body PBMT pre- and post-high-intensity resistance training on creatine kinase (CK) and salivary interleukin-6 (IL-6) in a sample of trained males. Twelve males (31 ± 8.3 years, 177.2 ± 5.4 cm, and 86.0 ± 7.5 kg) were part of a randomized, counterbalanced, cross-over design, whereby each participant performed a high-intensity resistance training session that consisted of the bench press, chin-up, and repeated sprints on two separate occasions. Each participant was assigned to either the PBMT or control condition on two separate weeks, with a 10-days washout period between the weeks. Creatine kinase was measured at baseline, 24, 48, and 72 h post-exercise. Salivary IL-6 was measured at baseline, 60, 90, and 120 min. A paired t-test showed no significant difference (p = 0.669) in the area under the curve (AUC) for CK during the PBMT (191.7 ± 48.3) and control conditions (200.2 ± 68.0). A Wilcoxon signed-rank test also showed no significant median difference (p = 0.155) in the AUC for salivary IL-6 during the PBMT (Mdn = 347.7) and control conditions (Mdn = 305.8). An additional Wilcoxon signed-rank test for CK percentage change from 24 to 72 h showed the PBMT condition (Mdn = −45%) to have a −18% median difference as compared to the control condition (Mdn = −41%). As such, whole-body PBMT does not significantly reduce the activity of salivary IL-6 or CK concentration during the 24 to 72-h recovery post-high-intensity resistance training.

High-Intensity Functional Training Improves Cardiorespiratory Fitness and Neuromuscular Performance Without Inflammation or Muscle Damage

Posnakidis, G, Aphamis, G, Giannaki, CD, Mougios, V, Aristotelous, P, Samoutis, G, and Bogdanis, GC. High-intensity functional training improves cardiorespiratory fitness and neuromuscular performance without inflammation or muscle damage. J Strength Cond Res XX(X): 000-000, 2020-We examined the effects of high-intensity functional training (HIFT) on cardiorespiratory and neuromuscular performance, as well as on inflammatory and muscle damage markers. Thirteen physically active healthy volunteers (aged 28.3 ± 3.8 years, 5 men and 8 women) underwent 8 weeks of a group HIFT program performed 3 times per week. Each session consisted of 4 rounds of a 9-exercise circuit (30-second exercise and 15-second recovery). During the first and last weeks of training, venous blood was sampled daily to monitor changes in serum C-reactive protein (CRP) and creatine kinase (CK). After 8 weeks of HIFT, body fat decreased by 0.64 ± 1.01 kg (p = 0.041), maximal oxygen uptake improved by 1.9 ± 2.2 ml·kg·min (p = 0.009), countermovement jump by 2.6 ± 1.5 cm (p = 0.001), bench press 1-repetition maximum (1RM) by 4.5 ± 3.8 kg (p = 0.001), maximum number of bench press repetitions at 65% 1RM by 4 ± 5 repetitions (p = 0.03), and abdominal muscle endurance by 6 ± 4 repetitions (p < 0.001). In both week 1 and week 8 of training, CK increased mildly in the morning after the first session of the week (main effect for day, p = 0.008), whereas no significant changes were observed in CRP (p = 0.31). During week 8, CK on all days was ∼32% lower compared with week 1 (160 vs. 235 U·L; main effect of week 1 vs. week 8, p = 0.027), whereas CRP remained unchanged (p = 0.225). This HIFT program was effective in improving cardiorespiratory and neuromuscular physical fitness without causing significant inflammation or muscle damage in physically active subjects.