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Salem A, Ben Maaoui K, Jahrami H, AlMarzooqi MA, Boukhris O, Messai B, Clark CCT, Glenn JM, Ghazzaoui HA, Bragazzi NL, Ammar A, Trabelsi K, Chtourou H. Attenuating Muscle Damage Biomarkers and Muscle Soreness After an Exercise-Induced Muscle Damage with Branched-Chain Amino Acid (BCAA) Supplementation: A Systematic Review and Meta-analysis with Meta-regression. SPORTS MEDICINE - OPEN 2024; 10:42. [PMID: 38625669 PMCID: PMC11021390 DOI: 10.1186/s40798-024-00686-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 02/16/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Branched-chain amino acid (BCAA) supplementation is one of the most popular strategies used by the general population and athletes to reduce muscle soreness and accelerate the recovery process of muscle damage biomarkers after an intense exercise or training session. OBJECTIVES This systematic review and meta-analysis investigated the effects of BCAA supplementation on muscle damage biomarkers and muscle soreness after exercise-induced muscle damage (EIMD). METHODS The systematic literature search for randomized controlled trials was conducted using seven databases, up to September 13th, 2022. The eligibility criteria for selecting studies were as follows: studies performed on healthy active participants, using BCAA at least once, controlled with a placebo or control group, performing resistance or endurance exercises, and followed up at least once post-EIMD. The methodological quality of the studies was assessed using the "SIGN RCT checklist". Random-effects meta-analyses were processed to compute the standardized mean difference (Hedges' g). Meta-regression analyses were completed with daily and total dosage and supplementation as continuous moderator variables. RESULTS Of the 18 studies included in this meta-analysis, 13 were of high quality and five were of acceptable quality. Our results revealed BCAA supplementation elicits a significant effect on reducing creatine kinase (CK) levels immediately (g = - 0.44; p = 0.006) and 72 h (g = - 0.99; p = 0.002), but not 24 h, 48 h, and 96 h post-EIMD. Additionally, a significant effect on delayed onset of muscle soreness (DOMS) was identified at 24 h (g = - 1.34; p < 0.001), 48 h (g = - 1.75; p < 0.001), 72 h (g = - 1.82; p < 0.001), and 96 h (g = - 0.82; p = 0.008), but not immediately post-EIMD. No significant effect was found on lactate dehydrogenase (LDH) levels at any time point. Meta-regression indicated higher daily and total dosages of BCAA, and longer supplementation periods were related to the largest beneficial effects on CK (total dosage and supplementation period) at 48 h, and on DOMS at 24 h (only daily dosage). CONCLUSION The overall effects of BCAA supplementation could be considered useful for lowering CK and DOMS after EIMD, but not LDH. The longer supplementation period prior to the EIMD could be more effective for CK and DOMS reduction.
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Affiliation(s)
- Atef Salem
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia.
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, 1003, Tunis, Tunisia.
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Khouloud Ben Maaoui
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
| | - Haithem Jahrami
- Ministry of Health, Manama, 410, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, 323, Bahrain
| | | | - Omar Boukhris
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia
| | - Balsam Messai
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, 1003, Tunis, Tunisia
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Jordan M Glenn
- Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR, 72701, USA
| | - Hadeel A Ghazzaoui
- Department Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, 11942, Jordan
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, M3J 1P3, Canada
| | - Achraf Ammar
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Khaled Trabelsi
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, 3000, Sfax, Tunisia
| | - Hamdi Chtourou
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, 1003, Tunis, Tunisia
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Fu C, Xia Y, Wang B, Zeng Q, Pan S. MRI T2 mapping and shear wave elastography for identifying main pain generator in delayed-onset muscle soreness: muscle or fascia? Insights Imaging 2024; 15:67. [PMID: 38424366 PMCID: PMC10904698 DOI: 10.1186/s13244-024-01619-6] [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: 05/02/2023] [Accepted: 12/06/2023] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION The main generator of delayed onset muscle soreness (DOMS) is still unknown. This study aimed to clarify the main generator of DOMS. METHODS Twelve participants performed eccentric exercise (EE) on lower legs. MRI and ultrasound were used to assess changes of calf muscle and deep fascia before and after EE. These results were then compared to the muscle pain level. RESULTS Compared to baseline, muscle pain peaked at 24-48 h after EE (downstairs 22.25 ± 6.196, 57.917 ± 9.298, F = 291.168, p < 0.01; resting 5.833 ± 1.899, 5.083 ± 2.429, F = 51.678, p < 0.01). Shear wave speed (SWE) of the deep fascia and T2 values of the gastrocnemius muscle and deep fascia all increased and peaked at 48 h after EE (1.960 ± 0.130, F = 22.293; 50.237 ± 2.963, F = 73.172; 66.328 ± 2.968, F = 231.719, respectively, p < 0.01). These measurements were positively correlated with DOMS (downstairs: r = 0.46, 0.76, 0.87, respectively, p < 0.001; resting: r = 0.42, 0.70, 0.77, respectively, p < 0.001). There was a significant positive correlation between SWE and T2 values of deep fascia (r = 0.54, p < 0.01). CONCLUSION DOMS is a common result of muscle and fascia injuries. Deep fascia edema and stiffness play a crucial role in DOMS, which can be effectively evaluated MR-T2 and SWE. CRITICAL RELEVANCE STATEMENT Delayed-onset muscle soreness is a common result of muscle and deep fascia injuries, in which the edema and stiffness of the deep fascia play a crucial role. Both MRI and shear wave elastography can be effectively used to evaluate soft tissue injuries. KEY POINTS • The deep fascia is the major pain generator of delayed-onset muscle soreness. • There is a significant correlation between fascia injury and delayed-onset muscle soreness. • MRI and shear wave elastography are preferred methods for assessing fascia injuries.
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Affiliation(s)
- Congcong Fu
- Department of Magnetic Resonance Imaging, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
| | - Yu Xia
- Department of Medical Ultrasonic, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
| | - Bingshan Wang
- Department of Magnetic Resonance Imaging, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China
| | - Qiang Zeng
- Department of Magnetic Resonance Imaging, Zhongshan Hospital of Xiamen University, Xiamen, Fujian, China.
| | - Shinong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
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Carrera-Quintanar L, Funes L, Herranz-López M, Vicente-Salar N, Mielgo-Ayuso J, Moya-Ramón M, Pons A, Micol V, Roche E. Acute Antioxidant Response to Two Types of Exercises: 2000 M Run vs. Burpee Test. Antioxidants (Basel) 2024; 13:144. [PMID: 38397742 PMCID: PMC10886302 DOI: 10.3390/antiox13020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/25/2024] Open
Abstract
Physical activity results in oxidative stress, as evidenced by the increased production of reactive oxygen, nitrogen species, and inflammatory mediators. The management of these components is instrumental for antioxidant adaptation to exercise and post-exercise recovery. Therefore, the present report aims to study the antioxidant response to two types of exercise (a 2000 m run and a burpee test) in healthy volunteers after a long period of inactivity (1-2 months). Antioxidant enzyme activities and oxidative stress markers (protein carbonyls and malondialdehyde content) were measured in neutrophils, peripheral blood mononuclear cells, and plasma. These parameters were determined under basal conditions and immediately post-exercise. Compared to those in basal state, neutrophil superoxide dismutase (28.3 vs. 22.9 pkat/109 cells), glutathione peroxidase (147.5 vs. 120.1 nkat/109 cells), and catalase (106.3 vs. 57.9 k/109 cells) were activated significantly (p < 0.05) after the burpee test. Peripheral blood mononuclear cells exhibited only significant (p < 0.05) catalase activation (113.6 vs. 89.4 k/109 cells) after the burpee test. Other enzymes, such as glutathione reductase and myeloperoxidase, tended to increase post-exercise, although the differences from baseline were not significant. Finally, compared to basal conditions, the protein carbonyl (24.5 vs. 14.5 mmol/L) and malondialdehyde (39.6 vs. 18.3 mmol/L) contents increased significantly (p < 0.05) in neutrophils and in plasma (115.1 vs. 97.8 and 130.2 vs. 123.4 μmol/L, respectively) after the burpee test. In conclusion, high-intensity exercise seems to induce immediate oxidative stress in inactive individuals, and the acute antioxidant response was slightly greater after the burpee test than after the 2000 m run. Glutathione-dependent antioxidant systems are activated immediately as protective mechanisms.
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Affiliation(s)
- Lucrecia Carrera-Quintanar
- Doctorate in Translational Nutrition Sciences (DCNT) University Center of Health Sciences (CUCS), University of Guadalajara (UDG), Guadalajara 44340, Mexico
| | - Lorena Funes
- Institute of Research, Development and Innovation in Healthcare Biotechnology of Elche (IDiBE), Miguel Hernández University (UMH), 03202 Elche, Spain
| | - María Herranz-López
- Institute of Research, Development and Innovation in Healthcare Biotechnology of Elche (IDiBE), Miguel Hernández University (UMH), 03202 Elche, Spain
| | - Néstor Vicente-Salar
- Department of Applied Biology-Nutrition, Institute of Bioengineering, Miguel Hernández University (UMH), 03202 Elche, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
| | - Manuel Moya-Ramón
- Department of Sport Sciences, Sports Research Center, Miguel Hernández University (UMH), 03202 Elche, Spain
| | - Antoni Pons
- Research Group on Community Nutrition and Oxidative Stress, University of Balearic Islands, 07122 Palma de Mallorca, Spain
- CIBER Physiopathology of Obesity and Nutrition/Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Vicente Micol
- Institute of Research, Development and Innovation in Healthcare Biotechnology of Elche (IDiBE), Miguel Hernández University (UMH), 03202 Elche, Spain
- CIBER Physiopathology of Obesity and Nutrition/Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Enrique Roche
- Department of Applied Biology-Nutrition, Institute of Bioengineering, Miguel Hernández University (UMH), 03202 Elche, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
- CIBER Physiopathology of Obesity and Nutrition/Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
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Caballero-García A, Noriega-González DC, Roche E, Drobnic F, Córdova A. Effects of L-Carnitine Intake on Exercise-Induced Muscle Damage and Oxidative Stress: A Narrative Scoping Review. Nutrients 2023; 15:nu15112587. [PMID: 37299549 DOI: 10.3390/nu15112587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/16/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Exercise-induced muscle damage results in decreased physical performance that is accompanied by an inflammatory response in muscle tissue. The inflammation process occurs with the infiltration of phagocytes (neutrophils and macrophages) that play a key role in the repair and regeneration of muscle tissue. In this context, high intensity or long-lasting exercise results in the breakdown of cell structures. The removal of cellular debris is performed by infiltrated phagocytes, but with the release of free radicals as collateral products. L-carnitine is a key metabolite in cellular energy metabolism, but at the same time, it exerts antioxidant actions in the neuromuscular system. L-carnitine eliminates reactive oxygen and nitrogen species that, in excess, alter DNA, lipids and proteins, disturbing cell function. Supplementation using L-carnitine results in an increase in serum L-carnitine levels that correlates positively with the decrease in cell alterations induced by oxidative stress situations, such as hypoxia. The present narrative scoping review focuses on the critical evaluation of the efficacy of L-carnitine supplementation on exercise-induced muscle damage, particularly in postexercise inflammatory and oxidative damage. Although both concepts appear associated, only in two studies were evaluated together. In addition, other studies explored the effect of L-carnitine in perception of fatigue and delayed onset of muscle soreness. In view of the studies analyzed and considering the role of L-carnitine in muscle bioenergetics and its antioxidant potential, this supplement could help in postexercise recovery. However, further studies are needed to conclusively clarify the mechanisms underlying these protective effects.
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Affiliation(s)
- Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain
| | - David C Noriega-González
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Enrique Roche
- Department of Applied Biology-Nutrition, Institute of Bioengineering, University Miguel Hernández, 03202 Elche, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Franchek Drobnic
- Medical Services Wolverhampton Wanderers FC, Wolverhampton WV3 9BF, UK
| | - Alfredo Córdova
- Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain
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Noriega-González D, Caballero-García A, Roche E, Álvarez-Mon M, Córdova A. Inflammatory Process on Knee Osteoarthritis in Cyclists. J Clin Med 2023; 12:jcm12113703. [PMID: 37297897 DOI: 10.3390/jcm12113703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
Osteoarthritis is a disorder affecting the joints and is characterized by cellular stress and degradation of the extracellular matrix cartilage. It begins with the presence of micro- and macro-lesions that fail to repair properly, which can be initiated by multiple factors: genetic, developmental, metabolic, and traumatic. In the case of the knee, osteoarthritis affects the tissues of the diarthrodial joint, manifested by morphological, biochemical, and biomechanical modifications of the cells and the extracellular matrix. All this leads to remodeling, fissuring, ulceration, and loss of articular cartilage, as well as sclerosis of the subchondral bone with the production of osteophytes and subchondral cysts. The symptomatology appears at different time points and is accompanied by pain, deformation, disability, and varying degrees of local inflammation. Repetitive concentric movements, such as while cycling, can produce the microtrauma that leads to osteoarthritis. Aggravation of the gradual lesion in the cartilage matrix can evolve to an irreversible injury. The objective of the present review is to explain the evolution of knee osteoarthritis in cyclists, to show the scarce research performed in this particular field and extract recommendations to propose future therapeutic strategies.
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Affiliation(s)
- David Noriega-González
- Department of Surgery, Ophthalmology, Otorhinolaryngology and Physiotherapy, Faculty of Medicine, HVUV, 47003 Valladolid, Spain
| | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Los Pajaritos, 42004 Soria, Spain
| | - Enrique Roche
- Department of Applied Biology-Nutrition and Institute of Bioengineering, Miguel Hernández University (UMH), 03202 Elche, Spain
- Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain
- CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Internal Medicine, University of Alcalá de Henares, 28801 Alcalá de Henares, Spain
| | - Alfredo Córdova
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR Physical Exercise and Aging, University of Valladolid, Campus Duques de Soria, 42004 Soria, Spain
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Drobnic F, Lizarraga MA, Caballero-García A, Cordova A. Coenzyme Q 10 Supplementation and Its Impact on Exercise and Sport Performance in Humans: A Recovery or a Performance-Enhancing Molecule? Nutrients 2022; 14:1811. [PMID: 35565783 PMCID: PMC9104583 DOI: 10.3390/nu14091811] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 02/06/2023] Open
Abstract
Evidence exists to suggest that ROS induce muscular injury with a subsequent decrease in physical performance. Supplementation with certain antioxidants is important for physically active individuals to hasten recovery from fatigue and to prevent exercise damage. The use of nutritional supplements associated with exercise, with the aim of improving health, optimizing training or improving sports performance, is a scientific concern that not only drives many research projects but also generates great expectations in the field of their application in pathology. Since its discovery in the 1970s, coenzyme Q10 (CoQ10) has been one of the most controversial molecules. The interest in determining its true value as a bioenergetic supplement in muscle contraction, antioxidant or in the inflammatory process as a muscle protector in relation to exercise has been studied at different population levels of age, level of physical fitness or sporting aptitude, using different methodologies of effort and with the contribution of data corresponding to very diverse variables. Overall, in the papers reviewed, although the data are inconclusive, they suggest that CoQ10 supplementation may be an interesting molecule in health or disease in individuals without a pathological deficiency and when used for optimising exercise performance. Considering the results observed in the literature, and as a conclusion of this systematic review, we could say that it is an interesting molecule in sports performance. However, clear approaches should be considered when conducting future research.
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Affiliation(s)
| | | | - Alberto Caballero-García
- Department of Anatomy and Radiology, Faculty of Health Sciences, GIR: “Physical Exercise and Aging”, Campus Universitario “Los Pajaritos”, University of Valladolid, 42004 Soria, Spain;
| | - Alfredo Cordova
- Department of Biochemistry, Molecular Biology and Physiology, Faculty of Health Sciences, GIR: “Physical Exercise and Aging”, Campus Universitario “Los Pajaritos”, University of Valladolid, 42004 Soria, Spain;
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