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As a nitric oxide (NO) enhancer, citrulline malate (CM) has recently been touted as a potential ergogenic aid to both resistance and high-intensity exercise performance, as well as the recovery of muscular performance. The mechanism has been associated with enhanced blood flow to active musculature, however, it might be more far-reaching as either ammonia homeostasis could be improved, or ATP production could be increased via greater availability of malate. Moreover, CM might improve muscle recovery via increased nutrient delivery and/or removal of waste products. To date, a single acute 8 g dose of CM on either resistance exercise performance or cycling has been the most common approach, which has produced equivocal results. This makes the effectiveness of CM to improve exercise performance difficult to determine. Reasons for the disparity in conclusions seem to be due to methodological discrepancies such as the testing protocols and the associated test–retest reliability, dosing strategy (i.e., amount and timing), and the recent discovery of quality control issues with some manufacturers stated (i.e., citrulline:malate ratios). Further exploration of the optimal dose is therefore required including quantification of the bioavailability of NO, citrulline, and malate following ingestion of a range of CM doses. Similarly, further well-controlled studies using highly repeatable exercise protocols with a large aerobic component are required to assess the mechanisms associated with this supplement appropriately. Until such studies are completed, the efficacy of CM supplementation to improve exercise performance remains ambiguous. [ABSTRACT FROM AUTHOR]

Purpose: This study measured the self-reported level of fatigue, pain, and neuromuscular function of the knee extensor muscles over a three-day period that included two consecutive days of full-body resistance exercises. Methods: 10 resistance-trained men performed two consecutive days of full-body resistance exercise. Muscle activation (electromyography and voluntary activation), contractility, and presynaptic inhibition of Ia afferents (homosynaptic and GABA mediated presynaptic inhibition) for the quadriceps were examined from femoral and posterior tibial nerve stimulation. Results: Fatigue and pain were elevated after Day 1, and were not reduced to pre-exercise levels at the start of Day 2 (p < 0.05). Maximal voluntary torque (− 51.4 Nm, 95% CI = 12.4–90.4 Nm, p = 0.005) and rate of torque development (− 469 Nm.s−1, 95% CI = 109–829 Nm.s−1, p = 0.006) were reduced after Day 1, had recovered by Day 2, and did not change after the second training session. The maximal amplitude and rate of rise for the quadriceps twitch were reduced after both training sessions (p < 0.01), with recovery 24 h each session. The maximal amplitude and rate of early muscle activation were reduced after Day 1 (p < 0.01), but no changes were observed for voluntary activation, H-reflex size and shape, or measures of Ia presynaptic inhibition. Conclusion: Resistance exercise in the presence of elevated fatigue and pain from a previous training session does not worsen recovery, or lead to significant alterations in quadriceps neuromuscular function. Reduction in muscle contractility, in the absence of declines in muscle activation, does not lead to decreased voluntary torque. [ABSTRACT FROM AUTHOR]

Purpose: Aerobic (AE) and resistance (RE) exercise elicit unique adaptations in skeletal muscle. The purpose here was to compare the post-exercise response of mTOR signaling and select autophagy markers in skeletal muscle to acute AE and RE. Methods: In a randomized, cross-over design, six untrained men (27 ± 3 years) completed acute AE (40 min cycling, 70% HRmax) and RE (8 sets, 10 repetitions, 65% 1RM). Muscle biopsies were taken at baseline, and at 1 h and 4 h following each exercise. Western blot analyses were performed to examine total and phosphorylated protein levels. Upstream regulator analyses of skeletal muscle transcriptomics were performed to discern the predicted activation states of mTOR and FOXO3. Results: Compared to AE, acute RE resulted in greater phosphorylation (P < 0.05) of mTORSer2448 at 4 h, S6K1Thr389 at 1 h, and 4E- BP1Thr37/46 during the post-exercise period. However, both AE and RE increased mTORSer2448 and S6K1Thr389 phosphorylation at 4 h (P < 0.05). Upstream regulator analyses revealed the activation state of mTOR was increased for both AE (z score, 2.617) and RE (z score, 2.789). No changes in LC3BI protein were observed following AE or RE (P > 0.05), however, LC3BII protein was decreased after both AE and RE at 1 h and 4 h (P < 0.05). p62 protein content was also decreased at 4 h following AE and RE (P < 0.05). Conclusion: Both acute AE and RE stimulate mTOR signaling and similarly impact select markers of autophagy. These findings indicate the early adaptive response of untrained human skeletal muscle to divergent exercise modes is not likely mediated through large differences in mTOR signaling or autophagy. [ABSTRACT FROM AUTHOR]

Purpose: In adults, low-load resistance training with blood flow occlusion (BFO) mimics strength increases that occur from high-load training, without the need to experience high mechanical stress. In view of child–adult differences in exercise responses, this study examined whether BFO during exercise elicits differential changes in maximal voluntary contraction (MVC) and electromyographical (EMG) activity in children and adults. Methods: Sixteen men (24.4 ± 2.5 years) and 14 boys (10.7 ± 2.0 years) performed low-load resistance exercise (25 repetitions at 35% MVC) of the wrist flexors with and without BFO. MVC wrist flexor force and EMG activity of the flexor carpi radialis (FCR) were obtained at the beginning and end of the exercise. Results: Both groups demonstrated a larger decrease in MVC force following BFO (− 18.6 ± 12.5%) than the control (without BFO) condition (− 6.2 ± 15.0%; p < 0.001). Whereas the men's EMG amplitude increased 16.3 ± 20.5% (p = 0.005) during BFO, the boys' EMG amplitude did not change over time or between conditions. In both groups, the mean power frequency (MPF) of the EMG signal decreased more during BFO (− 20.1 ± 9.6%; p < 0.001) than the control condition (− 5.6 ± 9.7%; p = 0.002). Conclusions: Low-load exercise with BFO resulted in similar neuromuscular responses between boys and men, except for an observed increase in the EMG amplitude in men but not boys. While this result might suggest that men relied on a greater activation of higher-threshold motor units during BFO, it does not explain why there were similar decreases in MPF between groups. Therefore, it remains unclear whether the effectiveness of BFO training is similar for children and adults. [ABSTRACT FROM AUTHOR]

The excellent work of Berardi et al. (2021) aroused our interest, which aimed to determine the local and systemic effects of isometric and concentric muscle contractions in conditions of experimental pain and performance fatigue in subjects with and without fibromyalgia (FM). Especially in patients with FM syndrome, chronic patients, who suffer from persistent generalized pain, being associated with psychological distress, catastrophizing of pain, in addition to the reduction in physical function (Chinn et al. [2]). Accessed 25 Mar 2021 3 Dell'osso L. Lifetime post-traumatic stress symptoms are related to the health-related quality of life and severity of pain/fatigue in patients with fibromyalgia. [Extracted from the article]