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Background: Low physical activity is a major risk for sarcopenia. Whether training according to physical activity guidelines accompanied with cognitive training is effective on sarcopenia, remains unclear. Aims: We investigated whether the effects of 12-month physical and cognitive training (PTCT) and physical training (PT) on grip and knee extension strength, muscle mass, and walking speed differed between older adults with and without sarcopenia. Methods: Community-dwelling older adults (N = 314, mean age 74.5 ± 3.8 years, 60% women) who did not meet physical activity guidelines were randomized to PTCT and PT groups. PT for both groups included supervised and home-based multicomponent physical training. Cognitive training (CT) included computer-based exercises for executive functioning. Sarcopenia was determined according to the European Working Group on Sarcopenia in Older People 2019 criteria. Generalized estimation equation analysis were conducted. Results: Compared to PT, PTCT had no additive effect on strength, muscle mass, or walking speed in participants with or without sarcopenia. In pooled data (PT + PTCT) change in the grip strength was greater in sarcopenia (n = 49) group compared to non-sarcopenia (n = 264) group (interaction, p =.014). Both groups improved knee extension strength, and walking speed, but no statistically significant difference between the groups were observed. Muscle mass did not change in either group. Conclusion: Physical training according to physical activity recommendations improves muscle strength, walking speed, and maintains muscle mass in sarcopenia. Additional cognitive training had no benefits on these outcomes. Trial registration number: ISRCTN52388040 and date of registration 20/1/2017. [ABSTRACT FROM AUTHOR]

Background: Persistent pain is a complicated phenomenon associated with a wide array of complex pathologies and conditions (e.g., complex regional pain syndrome, non-freezing cold injury), leading to extensive disability and reduced physical function. Conventional resistance training is commonly contraindicated in load compromised and/or persistent pain populations, compromising rehabilitation progression and potentially leading to extensive pharmacological intervention, invasive procedures, and reduced occupational status. The management of persistent pain and utility of adjunct therapies has become a clinical and research priority within numerous healthcare settings, including defence medical services. Main Body: Blood flow restriction (BFR) exercise has demonstrated beneficial morphological and physiological adaptions in load-compromised populations, as well as being able to elicit acute hypoalgesia. The aims of this narrative review are to: (1) explore the use of BFR exercise to elicit hypoalgesia; (2) briefly review the mechanisms of BFR-induced hypoalgesia; (3) discuss potential implications and applications of BFR during the rehabilitation of complex conditions where persistent pain is the primary limiting factor to progress, within defence rehabilitation healthcare settings. The review found BFR application is a feasible intervention across numerous load-compromised clinical populations (e.g., post-surgical, post-traumatic osteoarthritis), and there is mechanistic rationale for use in persistent pain pathologies. Utilisation may also be pleiotropic in nature by ameliorating pathological changes while also modulating pain response. Numerous application methods (e.g., with aerobic exercise, passive application, or resistance training) allow practitioners to cater for specific limitations (e.g., passive, or contralateral application with kinesiophobia) in clinical populations. Additionally, the low-mechanical load nature of BFR exercise may allow for high-frequency use within residential military rehabilitation, providing a platform for conventional resistance training thereafter. Conclusion: Future research needs to examine the differences in pain modulation between persistent pain and pain-free populations with BFR application, supporting the investigation of mechanisms for BFR-induced hypoalgesia, the dose-response relationship between BFR-exercise and pain modulation, and the efficacy and effectiveness of BFR application in complex musculoskeletal and persistent pain populations. Key Points: • Conventional resistance training (e.g., > 70% 1RM) is commonly contraindicated in load compromised and/or persistent pain populations, delaying rehabilitation and reducing military operational readiness. • Blood flow restriction application could alleviate pain following complex injury or persistent pain in military settings, reducing the burden on the individual and UK Defence Medical Services. • The plethora of blood flow restriction applications provide sport and exercise medicine practitioners with many options based on their specific aims and objectives during rehabilitation. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effectiveness of an aquatic progressive resistance exercise (APRE) and PBM (associated or not) on morphology of skeletal muscle and biochemical markers using an experimental model of knee osteoarthritis (OA). Fifty male Wistar rats were randomly distributed into 5 groups: control group (CG); OA control (OAC); OA submitted to APRE (OAE); OA submitted to PBM (OAL); OA submitted to APRE and PBM (OAEL). Trained rats performed a water-jumping program carrying a load equivalent to 50–80% of their body mass strapped to their chest. Laser irradiation (808 nm) was performed on 2 points of the knee joint. Treatments (3 days a week, for 8 weeks) started 4 weeks after the OA induction. The results showed that all OA groups presented a significantly increase in the muscle cross-section area (CSA) and a decrease in muscle fiber density compared to CG. Moreover, both trained groups presented a reduced expression of atrogin and an intense myoD immunoexpression in the laser exercised animals. The results demonstrate that APRE was effective in reducing muscle atrophy markers and its association with PBM could be effective in modulating molecules involved in muscle recovery in knee OA. [ABSTRACT FROM AUTHOR]

Background: With the acceleration of aging, sarcopenia has become a reality of concern today. This study aimed to evaluate the efficacy of various non-pharmacologic interventions and find the optimal interventions for sarcopenia. Methods: PubMed, Medline OVID, EMBASE, Scopus, and Cochrane were searched from 1 January 2000 to 25 October 2023, with language restrictions to English. We analyzed the data through the Bayesian network meta-analysis. Results: Based on the inclusion and exclusion criteria defined by the PICOS principles, we identified 47 eligible clinical trials engaging 4889 individuals (including treatment group = 2835, control group = 2054). The results showed that resistance exercise (low-moderate load) significantly increased muscle mass (skeletal muscle mass and lean body mass) and that exercise plus nutrition improved physical activity indices (handgrip strength, gait speed, TUG test, chair standing). Conclusion: Resistance exercise (low-moderate load), exercise plus nutrition, and nutritional supplementation (fatty acids, etc.) may be protective against sarcopenia. Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display%5frecord.php?RecordID=474799, ID: CRD4202347479. [ABSTRACT FROM AUTHOR]

Aims: Type 2 diabetes mellitus (T2DM) is prevalent worldwide, often manageable through lifestyle changes like physical activity. This meta-analysis aimed to determine the effect of resistance training (RT) on cardiovascular risk factors in adults with T2DM. Methods: Four databases were searched up to March 2024. The mean difference (MD) was calculated by a random effect model with 95% confidence interval (CI). Results: Forty-eight articles were included in the review. There was a significant pooled effect size for the meta-analysis comparing RT vs. control on hemoglobin A1C (MD = -0.49, 95% CI: -0.66, -0.33; P < 0.00001), fasting blood sugar (MD = -11.58, 95% CI: -18.61, -4.55; P = 0.001), insulin (ES = -1.65, 95% CI: -2.87, -0.42; P = 0.008), HOMA-IR (MD = -1.20, 95% CI: -1.85, -0.55; P = 0.0003), triglyceride (MD = -18.14, 95% CI: -30.32, -5.96; P = 0.004), and high-density lipoprotein (MD = 2.71, 95% CI: 0.78, 4.64; P = 0.006). Moreover, RT was effective for reducing body weight (MD = -0.81, 95% CI: -1.50, -0.13; P = 0.02), fat percentage (MD = -0.92, 95% CI: -1.62, -0.22; P = 0.010), and waist circumference (MD = -2.14, 95% CI: -3.00, -1.28; P < 0.00001). Conclusion: RT effectively improves cardiovascular risk factors in T2DM adults, suggesting potential as treatment or prevention. Future studies can consider investigating the optimal RT regimen to achieve effective T2DM management in adults. [ABSTRACT FROM AUTHOR]

Purpose: Resistance exercise can attenuate muscular impairments associated with multiple sclerosis (MS), and blood flow restriction (BFR) may provide a viable alternative to prescribing heavy training loads. The purpose of this investigation was to examine the progression of upper and lower body low-load (30% of one-repetition maximum [1RM]) resistance training (RT) with BFR applied intermittently during the exercise intervals (RT + BFR) versus volume-matched heavy-load (65% of 1RM) RT. Methods: Men and women with MS (n = 16) were randomly assigned to low-load RT + BFR (applied intermittently) or heavy-load RT and completed 12 weeks (2 × /week) of RT that consisted of bilateral chest press, seated row, shoulder press, leg press, leg extension, and leg curl exercises. Exercise load, tonnage, and rating of perceived exertion were assessed at baseline and every 6 weeks. Results: Training load increased to a greater extent and sometimes earlier for RT + BFR (57.7–106.3%) than heavy-load RT (42.3–54.3%) during chest press, seated row, and leg curl exercises, while there were similar increases (63.5–101.1%) for shoulder press, leg extension, and leg press exercises. Exercise tonnage was greater across all exercises for RT + BFR than heavy-load RT, although tonnage only increased during the chest press (70.7–80.0%) and leg extension (89.1%) exercises. Perceptions of exertion (4.8–7.2 au) and compliance (97.9–99.0%) were similar for both interventions. Conclusion: The training-induced increases in load, high compliance, and moderate levels of exertion suggested that RT + BFR and heavy-load RT are viable interventions among people with MS. RT + BFR may be a preferred modality if heavy loads are not well tolerated and/or to promote early-phase training responses. [ABSTRACT FROM AUTHOR]

Purpose: Dysphagia is most prevalent among post stroke aging adults. This systematic review was conducted to collect evidence-based data regarding assessment and therapeutic techniques used to rehabilitate post stroke dysphagia patients. Methods: Four major databases including PubMed, Cochrane Library, Science direct and Google scholar were searched systematically using the defined search strategy to target Randomized Controlled Trials conducted from January 2018 to 2023 using the pre-defined search strategy by three independent reviewers. Results: After following PRISMA guidelines, fifteen articles matched the inclusion criteria. Several evidence based therapies like Neuromuscular Electrical Stimulation Therapy, Effortful Swallowing Training, Tongue Pressure Strength and Accuracy Training, Electrical Stimulation of Hyoid Muscles, Modified Chin Tuck Against Resistance exercise, Oral Neuromuscular Training, and Conventional Speech Therapy with Functional Electrical Stimulation were used frequently for the treatment of old age post stroke dysphagia in different rehabilitation centers. Along with this, a list of different assessment methodologies and tools was made that were used including Functional Oral Intake Scale, Fiber optic Endoscopic Evaluation of Swallowing, Penetration Aspiration Scale, Pooling Scale, Video fluoroscopic Dysphagia Scale, Iowa Oral Performance Instrument, Mann Assessment of Swallowing Ability, and Repetitive Saliva Swallowing Test. Conclusion: Dysphagia is known to be serious complication of stroke. This systematic review shows a significant impact of therapeutic techniques on post stroke dysphagia patients and demonstrates that neuromuscular electrical stimulation therapy is one of the most effective therapeutic techniques used to rehabilitate post stroke dysphagia patients. [ABSTRACT FROM AUTHOR]

Chronic heart failure (CHF) represents one of the most severe and advanced stages of cardiovascular disease. Despite the critical importance of cardiac rehabilitation (CR) in CHF management, while studies have explored the effectiveness of various CR delivery modes and offered valuable context-specific insights, their relative efficacy remains inconsistent across different patient groups, healthcare environments, and intervention approaches. A clearer understanding requires comprehensive comparisons and in-depth analyses to address these variations. Systematic searches were conducted in databases including Pubmed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science, up to August 2024. Two researchers independently screened the literature according to strict inclusion criteria, extracted relevant data, and assessed the quality of included studies using Cochrane Collaboration tools and the Jadad scale. Subsequent pairwise and network meta-analyses were performed using statistical software, including Stata 17.0, to present the results graphically. The network meta-analysis included 9,552 articles, with 33 meeting the inclusion criteria and examining eleven different interventions. All interventions outperformed routine care. Combined CR with aerobic exercise and resistance training (HCR [AE + RE]) significantly improved Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores and 6-min walk test (6MWT) performance, and reduced rehospitalization rates [SUCRA = 96%]. Center-based cardiac rehabilitation (CBCR) with high-intensity interval training (HIIT) was the most effective in enhancing left ventricular ejection fraction (LVEF), while CBCR(AE) demonstrated the greatest improvement in peak oxygen uptake (Peak VO2) [RR = 3.64, 95% CI: 1.66–7.95]. Our analysis identifies HCR (AE + RE) as the most effective intervention for improving quality of life (MLHFQ), exercise capacity (6MWT), and reducing hospital readmissions. CBCR (HIIT) was optimal for enhancing cardiac function through improved LVEF, while CBCR (AE) effectively boosted peak VO2. PROSPERO: CRD42024517039, Review Completed not published. [ABSTRACT FROM AUTHOR]

Introduction: Preparation methods are often used to improve performance (e.g., number of repetitions) within the resistance training session. However, there is still no consensus in the scientific literature on whether there is a superior preparation method for improving performance, particularly in older adults. Methods: We compared the effects of preparation by specific warm-up (SW), static stretching (SS), and control condition (CC) on the total number of repetitions in four exercises: leg extension, triceps pushdown, seated leg curl, and preacher curl. Fifty-seven older women (≥ 60 years) performed the experimental protocols (SW and SS) and the CC in a cross-over and counterbalanced design. Following the preparation protocol, the main exercises were performed in two sets until volitional concentric failure, with a two-minute rest interval between sets and 2–3 min between exercises. The main outcome was the total number of repetitions. Results: The SS improved performance compared to the SW and the CC in the leg extension and seated leg curl resistance exercises. In contrast, the SW impaired performance compared to the SS and CC in the triceps pushdown and preacher curl exercises. Conclusion: Our results suggest that SS may improve performance in lower-limb exercises, while the SW appears to negatively affect performance in upper-limb exercises in resistance-trained older women. [ABSTRACT FROM AUTHOR]

Background: Concurrent training (CT) is a common method used in health-oriented training programs. However, its design needs to be explored in order to inform practitioners about the most effective methods to improve different health-related markers (e.g., maximal fat oxidation [MFO]). Thus, this study aims to determine the order effect of an 8 week CT on the MFO of recreationally trained young adults. Methods: Twenty participants were allocated in two different groups to perform the CT differing only in the exercise sequence. The endurance training (ET) consisted of 4 to 6 repetitions of 30 s all-out running sprints with 4 min of active recovery. The resistance training (RT) consisted of 4 to 6 sets at 60 to 80% of the one-repetition maximum with 5 to 1 repetition in reserve of back squat and bench press exercises. 15 min of rest were established between exercise modes. Previous and after the CT program, participants performed a graded exercise test where MFO was determined. Results: There was a significant time effect on MFO (p = 0.044). A moderate increase was observed in both ET + RT (Mean change: 0.11 [− 0.02 to 0.25] g/min; Effect size: 0.61 [− 0.12 to 1.35]) and RT + ET (Mean change: 0.07 [− 0.01 to 0.16] g/min; Effect size: 0.62 [− 0.12 to 1.36]) groups. No significant interaction was observed (p = 0.658). Conclusions: The 8 week CT program improved the muscle oxidative capacity of recreationally trained young adults regardless of the exercise sequence. [ABSTRACT FROM AUTHOR]

Purpose: This study correlated the heart rate (HR) dynamics and parasympathetic activity at rest, during and after a resistance exercise (RE) session with resting heart rate (RHR) in young men. Methods: The RR-interval series was recorded at rest in the supine (sup) and following the postural change (from supine to orthostatic position) in the orthostatic (ort), as well as during and after 15 min of a RE session in 14 young men. We used RHR value in the supine position and the square root of the mean of the square of successive adjacent R-R intervals difference (rMSSD) as the parasympathetic indexes. The statistical analysis employed Pearson and Spearman correlation tests with a two-tailed p value ≤ 0.05. Results: We observed that HRort, relative variation (∆%) of RHR, and HR and relative (%) heart rate recovery (HRR) at five, ten, and fifteen minutes were correlated with RHR (r = from − 0.80 to 0.89, p ≤ 0.02). At rest, rMSSDsup, rMSSDort, and absolute variation (∆) rMSSD were correlated with RHR (rs = from − 0.53 to − 0.82, p ≤ 0.049); during RE session, we observed a correlation between ∆rMSSD and ∆%rMSSD with RHR (rs = − 0.82 to − 0.68, p ≤ 0.01) and after a RE session, rMSSD5–15 min were correlated with RHR (rs = from − 0.75 to − 0.86, p ≤ 0.01). Conclusion: We concluded that young men with lower RHR showed higher HR dynamics and parasympathetic reactivity at rest, higher parasympathetic withdrawal during the RE session, and higher HRR and parasympathetic reactivation after a RE session. [ABSTRACT FROM AUTHOR]

Purpose: Most studies examining the predictive value of the load–velocity relationship in determining one-repetition maximum (1RM) in the back squat implemented its direct determination to enable testing movement velocity within a predetermined set of relative loads (e.g., 50, 60, 70, 80, and 90% 1RM). We determined whether a different approach of load–velocity profiling affects the accuracy of estimating 1RM. Methods: Predictions based on a practical 2-point approach (no pre-determination of 1RM) were compared to those obtained with the conventional multipoint and 2-point approach (pre-determination of 1RM). 1RM was estimated relying on a reference minimum velocity threshold (MVT) of 0.3 ms−1. Analyses were conducted for separate back-squat variations (n = 13 Smith machine; n = 13 free-weight). Slopes and y-intercepts were compared. The accuracy of 1RM prediction was determined by contrasting actual vs. predicted 1RM values. Results: The individual MVT did not differ from the general 0.3 ms−1 value in either back-squat variation. Slopes and y-intercepts were similar between all determination approaches. For the Smith machine, estimated 1RM did not differ from the actual value with either approach (mean misestimate: −1.83 to 0.02 kg). However, the limits of agreement were wide (~ 12 kg) and the absolute percent error was significantly different from 0 with all approaches (p < 0.05). Conclusion: 1RM can be estimated with similar accuracy with all profiling methods, irrespectively of the back squat variation. However, the free-weight variation displays higher systematic and random errors. It can be concluded that the wide limits of agreement preclude accurate 1RM estimations on an individual basis. [ABSTRACT FROM AUTHOR]

Patients with cardiac disease exhibit exaggerated sympathoexcitation, pressor, and ventilatory responses to muscle metaboreflex activation (MMA). However, the effects of cardiac rehabilitation (CR) and especially resistance training (RT) modalities on MMA are not well known. This study investigated how CR impacts MMA in such patients, specifically examining the effects of two different resistance training (RT) protocols following 12 weeks of CR. In addition to endurance exercises, 32 patients were randomized into either a 3/7 RT modality (comprising 5 sets of 3–7 repetitions) or a control (CTRL) modality (involving 3 sets of 9 repetitions), with distinct inter-set rest intervals (15 s for 3/7 and 60 s for CTRL). MMA, gauged by blood pressure (BP) and ventilatory (Ve) responses during a handgrip exercise at 40% effort and subsequent post-exercise circulatory occlusion, demonstrated CR's significant impact. Systolic BP, initially at + 28 ± 23% pre-CR, improved to + 11 ± 15% post-CR (P =.011 time effect; P =.131 group effect). Diastolic BP showed a similar trend, from + 27 ± 23% to + 13 ± 15% (P =.099 time effect; P =.087 group effect). Ve, initially at + 60 ± 39%, reduced to + 14 ± 19% post-CR (P <.001 time effect; P =.142 group effect). Critical parameters—maximal oxygen consumption, lean mass, hand grip, and quadriceps strength—exhibited parallel increases in both 3/7 and CTRL groups (P <.05 time effect; P >.3 group effect). Ultimately, CR demonstrated comparable improvements in MMA across both RT modalities, indicating its positive influence on cardiovascular responses and physical performance in individuals with cardiac conditions. [ABSTRACT FROM AUTHOR]

Purpose: This study compared the magnitude of excess post-exercise oxygen consumption (EPOC) between kettlebell complexes (KC) and high-intensity functional training (HIFT) and identified predictors of the EPOC response. Methods: Active men (n = 11) and women (n = 10) (age 25 ± 6 yr) initially completed testing of resting energy expenditure and maximal oxygen uptake (VO2max), followed by lower and upper-body muscle endurance testing. On two subsequent days separated by ≥ 48 h, participants completed KC requiring 6 sets of kettlebell exercises (pushups, deadlifts, goblet squats, rows, and swings) with 60 s recovery between sets, and HIFT requiring 6 sets of bodyweight exercises (mountain climbers, jump squats, pushups, and air squats) with 60 s recovery. During exercise, gas exchange data and blood lactate concentration (BLa) were acquired and post-exercise, EPOC was assessed for 60 min. Results: Results showed no difference in EPOC (10.7 ± 4.5 vs. 11.6 ± 2.7 L, p = 0.37), and VO2 and ventilation (VE) were significantly elevated for 30 and 60 min post-exercise in response to KC and HIFT. For KC and HIFT, HRmean and post-exercise BLa (R2 = 0.37) and post-exercise BLa and VE (R2 = 0.52) explained the greatest shared variance of EPOC. Conclusion: KC and HIFT elicit similar EPOC and elevation in VO2 which is sustained for 30–60 min post-exercise, leading to 55 extra calories expended. Results show no association between aerobic fitness and EPOC, although significant associations were revealed for mean HR as well as post-exercise VE and BLa. [ABSTRACT FROM AUTHOR]

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) possess analgesic and anti-inflammatory properties by inhibiting cyclooxygenase (COX) enzymes. Conflicting evidence exists on whether NSAIDs influence signaling related to muscle adaptations and exercise with some research finding a reduction in muscle protein synthesis signaling via the AKT-mTOR pathway, changes in satellite cell signaling, reductions in muscle protein degradation, and reductions in cell proliferation. In this study, we determined if a single maximal dose of flurbiprofen (FLU), celecoxib (CEL), ibuprofen (IBU), or a placebo (PLA) affects the short-term muscle signaling responses to plyometric exercise. Methods: This was a block randomized, double-masked, crossover design, where 12 participants performed four plyometric exercise bouts consisting of 10 sets of 10 plyometric jumps at 40% 1RM. Two hours before exercise, participants consumed a single dose of celecoxib (CEL 200 mg), IBU (800 mg), FLU (100 mg) or PLA with food. Muscle biopsy samples were collected before and 3-h after exercise from the vastus lateralis. Data were analyzed using a repeated measures (RM) ANOVA, ANOVA, or a Friedman test. Significance was considered at p < 0.05. Results: We found no treatment effects on the mRNA expression of PTSG1, PTSG2, MYC, TBP, RPLOP, MYOD1, Pax7, MYOG, Atrogin-1, or MURF1 (all, p > 0.05). We also found no treatment effects on AKT-mTOR signaling or MAPK signaling measured through the phosphorylation status of mTORS2441, mTORS2448, RPS6 235/236, RPS 240/244, 4EBP1, ERK1/2, p38 T180/182 normalized to their respective total abundance (all, p > 0.05). However, we did find a significant difference between MNK1 T197/202 in PLA compared to FLU (p <.05). Conclusion: A single, maximal dose of IBU, CEL, or FLU taken prior to exercise did not affect the signaling of muscle protein synthesis, protein degradation, or ribosome biogenesis three hours after a plyometric training bout. [ABSTRACT FROM AUTHOR]

Background: Resistance training (RT) has been identified as an important lifestyle activity for health. While systematic reviews have examined behavior change techniques (BCTs) used in interventions and potential correlates of RT behavior, the connection between BCTs and changes in putative mediators and RT participation have yet to be linked. The purpose of this review was to examine RT intervention effects, as coded by BCT clusters, on behavior change via capability, opportunity, and motivation as putative mediators of that change. Method: Literature searches were concluded in January of 2023, using three databases. Eligible studies included a comparison group, assessed RT as an outcome, included BCTs, assessed potential mediators, and were in English. The initial search yielded 1050 hits, which was reduced to 5 to independent RT interventions. Screening of previous reviews yielded three additional papers for a total of 8 papers. Each paper was assessed for the associations between intervention effects (as BCT clusters) on mechanisms of action (a path), effects of mechanisms of action on behavior (b path), and indirect (ab path) and direct (c path) effects of BCT clusters. Results: There was support that interventions had significant effects on capability and opportunity with inconclusive effects on motivation (a path). Both capabilities and motivation had associations with RT behavior (b path). The examined studies showed that changes in capabilities have the strongest support as a mediator with some support for motivation as a mediator (ab path). Studies that used more BCT clusters seemed to have a more positive effect on behavior, yet there were no trends to suggest any one crucial BCT cluster (c path). Conclusion: Current evidence suggests that capabilities and motivation are important to target in RT interventions. Future interventions would be well suited to utilize behavior change techniques that address these mediators. [ABSTRACT FROM AUTHOR]

Purpose: A network meta-analysis was utilized to compare the rehabilitative effectiveness of different exercise interventions on motor function in cerebral palsy(CP) patients. Methods: Computer searches were conducted across 9 databases, including PubMed, Cochrane Library, Scopus, Web of Science, Embase, and others, to identify randomized controlled trials focusing on different exercise interventions aimed at enhancing motor function in CP patients. The search spanned from the inception of the databases to January 31, 2024. Results: 20 articles, encompassing 570 patients and evaluating three types of exercise interventions, were included in the analysis. Results showed that aerobic training, resistance training, and mixed training exhibited superior outcomes compared to the control group, as evidenced by improvements in Gross Motor Function Measure scores, muscle strength, gait speed, and 10-Meter Walk Test scores (P < 0.05). Furthermore, the network meta-analysis revealed that resistance training ranked highest in enhancing gross motor function and gait speed among CP patients, while mixed training was deemed most effective in improving muscle strength and 10-Meter Walk Test scores. Conclusion: Exercise interventions have been shown to significantly improve motor function in CP patients. Among these, resistance training and mixed training stand out for their effectiveness in enhancing walking capabilities. Resistance training is specifically aimed at improving gross motor function, while mixed training focuses on increasing muscle strength. [ABSTRACT FROM AUTHOR]

Resistance training (RT) triggers diverse morphological and physiological adaptations that are broadly considered beneficial for performance enhancement as well as injury risk reduction. Some athletes and coaches therefore engage in, or prescribe, substantial amounts of RT under the assumption that continued increments in maximal strength capacity and/or muscle mass will lead to improved sports performance. In contrast, others employ minimal or no RT under the assumption that RT may impair endurance or sprint performances. However, the morphological and physiological adaptations by which RT might impair physical performance, the likelihood of these being evoked, and the training program specifications that might promote such impairments, remain largely undefined. Here, we discuss how selected adaptations to RT may enhance or impair speed and endurance performances while also addressing the RT program variables under which these adaptations are likely to occur. Specifically, we argue that while some myofibrillar (muscle) hypertrophy can be beneficial for increasing maximum strength, substantial hypertrophy can lead to macro- and microscopic adaptations such as increases in body (or limb) mass and internal moment arms that might, under some conditions, impair both sprint and endurance performances. Further, we discuss how changes in muscle architecture, fiber typology, microscopic muscle structure, and intra- and intermuscular coordination with RT may maximize speed at the expense of endurance, or maximize strength at the expense of speed. The beneficial effect of RT for sprint and endurance sports can be further improved by considering the adaptive trade-offs and practical implications discussed in this review. [ABSTRACT FROM AUTHOR]

The upper trapezius muscle is often excessively excited during resistance training exercises, increasing the shoulder's liability to musculoskeletal disorders of individuals participating in overhead sports or throwing activities. Different approaches have been proposed for reducing the potentially harmful loading of the upper trapezius. None, however, has been devised to deal directly with the main culprit: the muscle excitation. This non-randomized comparative study explores the feasibility of biofeedback based on surface electromyograms (EMGs) in suppressing undue excitation of the upper trapezius during a seated row exercise. Eight male volunteers were instructed to perform the wide-grip seated row exercise without and with the EMG biofeedback of the upper trapezius. Surface EMGs from the three portions of the trapezius and the serratus anterior were sampled with pairs of surface electrodes. A triaxial accelerometer was positioned on the weight stack for the identification of the exercise phase and repetition. This study showed that during the "with biofeedback" condition, the participants were able to activate the upper trapezius and serratus anterior to a lower degree (~ 10%) compared to the "without biofeedback" condition. Future studies should explore if this can lead to greater gains in muscle performance and/or reduce the risk of shoulder injury. [ABSTRACT FROM AUTHOR]

Purpose: Resistance exercise training (RET) effectively increases skeletal muscle mass and strength in healthy postmenopausal women. However, its effects on these parameters in postmenopausal breast cancer survivors are controversial or limited. Therefore, the aim of this study was to compare the effects of a 12-week progressive whole-body RET program on skeletal muscle mass, strength, and physical performance in healthy postmenopausal women versus postmenopausal women who survived breast cancer. Methods: Thirteen healthy postmenopausal women (HEA, 54 ± 3 years, BMI 26.6 ± 2.7 kg·m2, n = 13) and eleven postmenopausal breast cancer survivors (BCS, 52 ± 5 years, BMI 26.8 ± 2.1 kg·m2, n = 11) participated in the study. Before and after the RET program, evaluations were performed on quadriceps muscle thickness, one-repetition maximum strength (1RM) for various exercises, grip strength, and physical performance. Results: Both groups showed significant improvements in quadriceps muscle thickness (time effect, P < 0.001); 1RM strength for leg extension, leg press, chest press, horizontal row, and elbow extension (time effect, all P < 0.001); as well as handgrip strength (time effect, P = 0.035) and physical performance (time effect, all P < 0.001) after the 12-week RET program. There were no significant differences between the groups in response to RET for any of the outcomes measured. Conclusion: Twelve weeks of RET significantly increases skeletal muscle mass, strength, and physical performance in postmenopausal women. No differences were observed between healthy postmenopausal women and postmenopausal breast cancer survivors. These findings point out that this study’s RET promotes skeletal muscle mass, strength, and performance gains regardless of breast cancer. Pre-Print Platform Research Square:; Clinical trial registration: NCT05690295. [ABSTRACT FROM AUTHOR]

Resistance exercise provides significant benefits to skeletal muscle, including hypertrophy and metabolic enhancements, supporting overall health and disease management. However, skeletal muscle responsiveness to resistance exercise is significantly reduced in conditions such as aging and diabetes. Recent reports suggest that glycation stress contributes to muscle atrophy and impaired exercise-induced muscle adaptation; however, its role in the muscle response to resistance exercise remains unclear. Therefore, in this study, we investigated whether methylglyoxal (MGO), a key factor in glycation stress, affects the acute responsiveness of skeletal muscles to resistance exercise, focusing on protein synthesis and the key signaling molecules. This study included 12 8-week-old male Sprague–Dawley rats divided into two groups: one received 0.5% MGO-supplemented drinking water (MGO group) and the other received regular water (control group). After 10 weeks, the left tibialis anterior muscle of each rat was subjected to electrical stimulation (ES) to mimic resistance exercise, with the right muscle serving as a non-stimulated control. Muscle protein-synthesis rates were evaluated with SUnSET, and phosphorylation levels of key signaling molecules (p70S6K and S6rp) were quantified using western blotting. In the control group, stimulated muscles exhibited significantly increased muscle protein synthesis and phosphorylation levels of p70S6K and S6rp. In the MGO group, these increases were attenuated, indicating that MGO treatment suppresses the adaptive response to resistance exercise. MGO diminishes the skeletal muscle's adaptive response to ES-simulated resistance exercise, affecting both muscle protein synthesis and key signaling molecules. The potential influence of glycation stress on the effectiveness of resistance exercise or ES emphasizes the need for individualized interventions in conditions of elevated glycation stress, such as diabetes and aging. [ABSTRACT FROM AUTHOR]

We aimed to determine how a bout of resistance or aerobic exercise impacts physiological responses and performance during firefighting occupational tasks. Thirty-two non-firefighters completed two baseline assessments and three trials: resistance exercise (RE), aerobic exercise (AE), or a rested control (CON). Trials were followed by an occupational task assessment (OTA; four rounds of 10 deadlifts (38.6–61.4 kg) and 0.24-km 40lb-sandbag carry) in an environmental chamber (35 °C/50% humidity) while wearing standard municipal firefighter gear. Time to complete by condition was not statistically different (CON: 18.9 ± 4.4, AE: 20.0 ± 3.6, RE: 20.2 ± 5.0 min; p = 0.16). During the OTA average heart rate (CON: 149 ± 16, AE: 166 ± 12, RE: 160 ± 13 bpm; p < 0.01), estimated core temperature (CON: 37.6 ± 0.4, AE: 38.7 ± 0.3, RE: 38.4 ± 0.5 °C; p < 0.01), and skin temperature (CON: 36.3 ± 0.5, AE: 37.5 ± 0.6, RE: 36.9 ± 0.9 °C; p < 0.01) were elevated following AE and RE compared to CON, and higher following AE compared to RE. Our findings suggest job performance may not be impacted, although physiological stress during the tasks may be elevated, following on-shift exercise, and more prominently following aerobic exercise. [ABSTRACT FROM AUTHOR]

To analyse the effectiveness of resistance training on secondary sarcopenia, we conducted a meta-analysis to elucidate the effects of resistance training (RT) on muscle strength (handgrip strength [HGS]), muscle mass (Skeletal muscle mass index [SMI]), and physical function (Gait speed [GS]) in patients with secondary sarcopenia. All studies published between 2015 and January 2024 on the effects of resistance training on patients with secondary sarcopenia were retrieved from 6 electronic databases: PubMed, Web of Science Core Collection, Embase, the Cochrane Library, the China National Knowledge Infrastructure (CNKI) Core journals and the Wanfang Database. Two researchers independently extracted and evaluated studies that met the inclusion and exclusion criteria. Finally, 12 randomized controlled trials were included. Pooled analyses of baseline data and results were performed using Review Manager 5.3 with standardized mean variance (SMD) and random effects model. The study included 12 randomized controlled trials involving 639 patients (mean age 57.28 ± 2.66 to 79.6 ± 5.4 years). There are five types of complications among the patients: obesity, type 2 diabetes, Alzheimer's disease, hemodiaysis, and pancreatic cancer. Compared with the control group, RT effectively improved HGS [SMD = 2.47, 95% CI (1.50, 3.43), p < 0.01, I2 = 94%]; SMI [SMD = 0.94, 95% CI (0.52, 1.36), p < 0.01, I2 = 56%]; and GS [SMD = 2.18, 95% CI (-0.01, 4.37), p ≥ 0.05, I2 = 97%]. Further subgroup analysis of the results showed that the intervention effect on grip strength was greater for non-elastic band resistance [SMD = 2.40, 95% CI (1.05, 3.75), p < 0.01, I2 = 94%] than for elastic band resistance (EBRT) [SMD = 1.22, 95% CI (-0.14, 2.58), p < 0.01, I2 = 95%]. The intervention effect of RT on grip strength is more significant in patients with T2D [SMD = 0.59, 95%CI (0.26–0.93, p < 0.01, I2 = 27%] and obesity [SMD = 0.74, 95%CI (0.32–1.15, p < 0.01, I2 = 0%]. For patients with secondary sarcopenia, Resistance training (RT) can effectively enhance muscle strength and muscle mass; however, it does not significantly improve physical function. Different RT intervention methods have different effects on patients, such as elastic band training and non-elastic band training (bounce ball RT; equipment RT, etc.). Different types of complications may influence the effectiveness of RT intervention. [ABSTRACT FROM AUTHOR]

Complement-dependent cytotoxicity (CDC) is a primary mechanism-of-action of monoclonal antibody (mAb) immunotherapies used to treat haematological cancers, including rituximab and daratumumab. However, mAb efficacy may be limited by reduced bioavailability of complement C1q – which activates the complement classical pathway following interactions with mAb-opsonised target cells. C1q is secreted by phagocytes upon recruitment to sites of muscle damage to facilitate muscular repair, hence we hypothesised that muscle damaging exercise may increase C1q 'spill-over' into blood. Additionally, other complement proteins (e.g., C1s) have been reported to increase following ultra-endurance and resistance exercise. Taken together, we hypothesised that muscle damaging exercise could be harnessed to enhance mAb-mediated CDC. In this study, n = 8 healthy males (28 ± 5-years) completed two 45-minute treadmill running protocols: (1) a flat running protocol at a speed 15% above anaerobic threshold, and (2) a downhill running protocol (− 10% slope) at the same speed. Blood samples were collected before, immediately after, and 1-hour, 24-hours, 2-days, and 4-days after exercise. Isolated serum was assessed for C1q by ELISA, and used to measure mAb (rituximab, daratumumab) mediated CDC against two haematological cancer cell lines (Raji, RPMI-8226) in vitro. Isolated plasma was assessed for markers of inflammation (C-reactive protein [CRP]), and muscle damage (creatine kinase [CK]) by turbidimetry. C1q and CDC activity were not different between running protocols and did not change over time (p > 0.05). Significantly greater perceived muscle soreness (p < 0.001) and fluctuations observed from baseline to 24-hours post-exercise in the downhill running trial in CK (+ 171%) and CRP (+ 66%) suggests some degree of muscle damage was present. It is possible that any increase in C1q post-exercise may have been masked by the increase and subsequent interaction with CRP, which utilises C1q to facilitate muscular repair. This is the first study to investigate whether exercise can increase circulating C1q and improve mAb-mediated CDC and our findings show that downhill running exercise does not increase circulating C1q nor improve CDC in vitro. [ABSTRACT FROM AUTHOR]

Background: Climbing places high loads through the hands and fingers, and climbers may benefit from specific finger strength training (hangboarding) protocols. The purpose of this study was to evaluate the effect of a 10-minute low intensity hangboard finger strengthening protocol ("Abrahangs"), compared with the generally accepted Max Hangs protocol for training maximal grip strength. Methods: We retrospectively evaluated the change in grip strength and Strength: Weight following Max Hangs, Abrahangs, or the two protocols performed concurrently in rock climbers who used the Crimpd app to log their training. Users who had completed two finger strength tests within a 4–16-week period were included. Climbers were grouped by the number of training sessions into: "Climbing Only", "Abrahangs Only", "Max Hangs Only" and "Both" Max Hangs and Abrahangs. Results: Frequent low intensity finger loading was as effective at improving grip strength in climbers as training with maximal loads. Additionally, combining low intensity and maximal load training resulted in additive strength gains. Conclusions: These results suggest that low-intensity long duration holds provide a promising training paradigm for training finger strength that is gentle enough to incorporate into existing training programs. Key Points: • A 10-minute low-intensity long duration hold protocol can improve finger strength in rock climbers. • The increase in strength with low-intensity long duration holds is equivalent to that of maximal hang training. • The two types of training have an additive effect on grip strength. • This is the first retrospective study to examine the effects of different training programs in a large population of climbers. [ABSTRACT FROM AUTHOR]

Background: Resting heart rate (HR) and HR variability (HRV) are widely used parameters to assess cardiac autonomic nervous system function noninvasively. While resting assessments can be performed during sleep or after awakening, it would be relevant to know how interchangeable the results of these measurements are. This study aimed at examining the alignment between nocturnal and morning assessments during regular endurance training and in response to intensive training. A total of 24 recreational runners performed a 3-week baseline period (BL) and a 2-week overload (OL) period (Lucia's training impulse + 80%). Their running performance was assessed with a 3000-m running test after the BL and OL. The participants recorded daily their nocturnal HR and HRV (the natural logarithm of the root mean square of successive differences; LnRMSSD) with a photoplethysmography-based wrist device and performed an orthostatic test (2-min supine, 2-min standing) every morning with a chest-strap HR sensor. The HR and LnRMSSD segments that were analyzed from the nocturnal recordings included start value (SleepStart), end value (SleepEnd), first 4-h segment 30 min after detected sleep onset (Sleep4h), and full sleep time (SleepFull). The morning segments consisted of the last-minute average in both body positions. All segments were compared at BL and in response to the 3000-m test and OL. Results: All nocturnal HR and LnRMSSD segments correlated with supine and standing segments at BL (r = 0.42 to 0.91, p < 0.05). After the 3000-m test, the HR increased and LnRMSSD decreased only in the SleepStart, Sleep4h, and SleepFull segments (p < 0.05). In response to the OL, the standing HR decreased (p < 0.01), while the LnRMSSD increased (p < 0.05) in all segments except for SleepStart. The Pearson correlations between relative changes in nocturnal and morning segments were − 0.11 to 0.72 (3000-m) and − 0.25 to 0.79 (OL). The OL response in Sleep4h HR and LnRMSSD correlated with the relative change in 3000-m time (r = 0.63, p = 0.001 and r=-0.50, p = 0.013, respectively). Conclusions: Nocturnal and morning HR and LnRMSSD correlated moderately or highly in the majority of cases during the BL, but their responses to intensive training were not similarly aligned, especially in LnRMSSD. The nocturnal segments seemed to be sensitive to physical loading, and their responses were associated with the performance-related training responses. Key Points: • Moderate-to-high correlations were found between nocturnal and morning assessments of HR and HRV during regular endurance training in recreational runners. • In their responses to maximum exercise, nocturnal and morning HR and HRV were not necessarily aligned, as nocturnal segments seemed more responsive to such a stimulus. • While lower HR and higher HRV were associated with better endurance performance in all recording segments, changes in these parameters after the overload period correlated only in nocturnal segments. [ABSTRACT FROM AUTHOR]

Purpose: Eccentric quasi-isometric (EQI) resistance training is emerging as a promising option in sports medicine and rehabilitation. Despite prior research on EQI contractions in quadriceps and biceps brachii, their use in hamstring injury contexts is underexplored. Therefore, our study examines and contrasts the biomechanics and fatigue effects of EQI training on knee extensors and flexors. Methods: Following familiarization, 16 healthy, active participants (9 men, 7 women; 23.5 ± 2.6 years, 72.1 ± 12.8 kg, 173.4 ± 10.7 cm) performed, in random order, four EQI contractions for knee extensions and flexions, respectively. EQI contractions were isotonically loaded to 70% of concentric (60°·s−1) maximal voluntary contraction. Rest between repetitions was set at three minutes, while four minutes separated each muscle group. Peak torque, mean torque, and optimal angle were evaluated pre- and post-bouts. Inter-repetition contraction time and angular velocity were also assessed. Results: Average torque was 160.9 ± 44.2 and 71.5 ± 23.2 Nm for the extensors and flexors. Peak and mean torque significantly decreased for both extensors (p < 0.001, d = 0.70–0.71) and flexors (p ≤ 0.022, d = 0.36) after EQI contractions, respectively. However, the optimal angle increased for extensors (p < 0.001, d = 1.00) but not flexors (p = 0.811, d = 0.06). During EQI contractions, knee flexors exhibited greater intra-repetition velocity than extensors (p = 0.002; η2 = 0.50). Decreases in inter-repetition time and range of motion were more consistent for the extensors. Conclusions: Distinct responses exist when comparing EQI contractions of the knee extensors and flexors, particularly their effect on peak torque angles. These findings suggest knee flexors may require lower relative intensities to align more closely with extensor EQI contractions. [ABSTRACT FROM AUTHOR]

Pulmonary arterial hypertension (PAH) is a disease that affects millions of people worldwide. Besides the effects on the lungs and heart, PAH can affect other organs, including the liver, kidneys, brain, glands, and testis. This study aimed to evaluate the impact of PAH and physical resistance training (RT), a complementary treatment for hypertension, on epididymis morphology and function and sperm parameters. Wistar rats were divided into four experimental groups (n = 8/ group): sedentary control, sedentary PAH, RT control, and RT + PAH. PAH was induced using monocrotaline injections on Day 1 and 7 of the experiment. Sixteen rats from RT groups underwent RT training for 30 days, while rats from sedentary groups did not exercise. The epididymis was processed and analyzed using microscopic, biochemical, and functional approaches. Sperm were harvested from the cauda epididymis and evaluated for morphology and motility. Our results showed that PAH compromised the epididymis antioxidant defense system and reduced NO levels, leading to an imbalance in the organ's mineral content. These alterations affected the epididymis morphology and reduced the sperm transit time in the proximal epididymis, resulting in an increase in abnormal sperm morphology in the cauda region. Unfortunately, RT was not a good therapy against the PAH effect on the epididymis. PAH negatively affected epididymis functions with consequences to male gametes. Dysfunctions in the post-testicular environment may lead to male infertility due to the disturbance of spermatozoa fecundity. [ABSTRACT FROM AUTHOR]

Purpose: The effects of aerobic exercise interventions for reducing fatigue after cancer treatment are well-established, and the effect of resistance training remains uncertain. Therefore, this systematic review and meta-analysis aim to analyze the effect of resistance training and combined resistance and endurance training on cancer-related fatigue (CRF) in breast cancer patients. Methods : A systematic search for randomized controlled trials (RCTs) was conducted on the PubMed, SPORTDiscus, Embase, and Cochrane databases, focusing on the effect of supervised resistance training and combined supervised resistance and endurance training on CRF. Random-effect models were employed for calculating the standardized mean difference (SMD). Risk of bias was assessed with risk of bias 2 (RoB2), and certainty of evidence was judged according to the GRADE approach. Results : A total of 9 RCTs with 1512 participants were included, and data from 866 participants in 8 RCTs were used for the meta-analysis. The risk of bias was deemed low in seven studies, while one study exhibited attrition bias, and one showed possible selection bias. Resistance training probably reduce the total fatigue (SMD= −0.30, 95% CI −0.52, −0.08, p=0.008), with individual studies showing small effects on physical and emotional CRF. A combined resistance and endurance training reduce total fatigue (SMD= −0.34, 95% CI −0.51, −0.17, p= 0.0001), with individual studies indicating moderate effects on physical fatigue, in daily life fatigue, and small effects on emotional and cognitive CRF. Conclusion: Both supervised resistance training and combined resistance and endurance training have a small effect on total CRF. There is a trend towards an influence of intensity, with higher intensity potentially resulting in lower total CRF. [ABSTRACT FROM AUTHOR]

Aging has made stroke a top killer and disabler, with post-stroke sarcopenia worsening disability and quality of life. While resistance training benefits the elderly, its impact on stroke patients is understudied. This study evaluates the potential of a 4-week unilateral resistance training (URT) program to prevent sarcopenia in stroke patients. It assesses the impact of URT on hand grip strength (HG), muscle thickness (MT), upper limb functionality, and the psychological status of the patients. The study aims to quantitatively analyze these indicators to inform evidence-based post-stroke rehabilitation practices. This study employed a randomized controlled trial (RCT) involving 77 eligible stroke survivors, equally allocated into a control group (n = 39) and an intervention group (n = 38). The control group received standard rehabilitation, while the intervention group additionally underwent a 4-week URT program. The primary outcomes were unaffected side HG and MT, measuring muscle mass and function. Secondary outcomes included the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) for upper limb functionality and the Hamilton Depression Rating Scale (HAMD) for psychological well-being changes. Statistical analysis showed significant differences (p < 0. 05) in all measured parameters between the intervention and control groups after the 4-week period. Intra-group comparisons also indicated substantial improvements (p < 0. 05). Unilateral resistance training significantly mitigates muscle atrophy in stroke patients, preventing sarcopenia and enhancing upper limb function. It also ameliorates depressive symptoms, improving rehabilitation outcomes and overall quality of life. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the effects of free swimming (FS), aquatic resistance training (ART), and their combination (FS&ART) on the body composition, blood pressure, and physical fitness of older adults. The study employed a randomized controlled design, comparing three experimental groups with a control group. Eighty volunteers aged between sixty and seventy years (age: 66.2 ± 2.3 years; body mass index: 25.8 ± 4.3 kg/m²) participated in the 16-week intervention, consisting of two weekly sessions. Assessments were conducted at baseline and post-intervention, including anthropometric measurements, blood pressure readings, and the Senior Fitness Test. Significant differences were found between groups in post-intervention considering the chair stand test (p = 0.017; ES = 0.125), arm curl test (p = 0.029; ES = 0.111), 8-foot up and go test (p = 0.042; ES = 0.102), and walk test − 6 min (p = 0.005; ES = 0.156). Specifically, both ART (+ 20.1%; p < 0.05) and FS&ART (+ 19.5%; p < 0.05) showed significantly greater improvements in the chair stand test compared to the control group. Similarly, ART (+ 23.1%; p < 0.05) and FS&ART (+ 18.7%; p < 0.05) performed better than the control group. FS&ART also exhibited a significant improvement over the control group in the 8-foot up-and-go test (+ 14.6%; p < 0.05). In the 6-minute walk test, FS (+ 19.4%; p < 0.05) and FS&ART (+ 15.9%; p < 0.05) both significantly outperformed the control group. This study found that FS improves cardiovascular endurance, while ART enhances muscular strength and endurance in older adults, with combined benefits for agility, suggesting integration of combined modalities into community wellness initiatives for enhanced physical fitness and health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Physical inactivity and sedentary behavior both increase the risk of chronic disease and mortality. Regular participation in physical activity and reducing sedentary behavior play important roles in maintaining physical health and disease prevention. Objective: The purpose of this study was to investigate the effect of programed walking exercise using a wearable hip exoskeleton, Bot Fit on muscle strength, muscle effort, and the kinematics of the pelvis in younger adults. Methods: We designed three parallel experimental conditions and randomly assigned participants to one of three groups: those assigned to exercise using an interval program of Bot Fit (interval group), those who used a power program of Bot Fit (power group), and a control group who exercised without Bot Fit. A total of 45 young adults participated in 18 exercise-intervention sessions over six weeks, and all participants were assessed at two time points: before and after the 18 exercise sessions. Each assessment evaluated muscle strength, muscle effort, and the kinematics of the pelvis during walking. In addition, the number of steps, distance, energy expenditure, and heart rate for 30 min during the exercise sessions were recorded. Results: A significant increase in the maximum voluntary contraction (MVC) of the left biceps femoris (BF) was evident in the interval group, while significant changes in the MVC of the bilateral BF were seen in the power group after Bot Fit exercise. A significant decrease of muscle effort in the right BF in the interval group and right lumbar erector spinae and bilateral BF in the power group were also observed. In addition, the symmetry index of pelvic tilt significantly improved in the interval group, and greater exercise volume and intensity in both the interval and power groups compared with the control group were confirmed as measured by the number of steps, distance, energy expenditure, and heart rate. Conclusions: The results of this study confirmed the beneficial effect of programed walking exercise using the Bot Fit on muscle strength of trunk and lower extremities, muscle effort, and pelvic movement symmetry in younger adults. Personalized exercise programs can be provided for younger adults using various resistance or assistance modes of robotic device with the Bot Fit. Trial Registration: ClinicalTrials.gov, NCT05862077. Registered 22 March 2022, https://register.clinicaltrials.gov/. Key Points: • Bot Fit exercise offers several key advantages over exercise without a Bot Fit in terms of muscle strength, muscle effort, and pelvic symmetry during walking in younger adults. • Greater exercise volume and intensity in interval and power groups who exercised with Bot Fit were confirmed through number of steps, distance, energy expenditure, and heart rate compared to control group who exercised without Bot Fit. [ABSTRACT FROM AUTHOR]

Background: Sprinting is important for both individual and team sports, and enhancing performance is often done through resisted, assisted, or combined sprint training. However, the effectiveness of these methods compared to traditional sprint training remains inconclusive. The objective of this review with meta-analysis was to review the current literature on intervention studies analyzing the effects of resisted, assisted, and combined (resisted–assisted) training on sprint kinematics and performance in terms of acceleration and maximum velocity. Methods: A literature search was conducted using SPORTDiscus up to and including April 19, 2023. The following eligibility criteria were applied: (1) a longitudinal study over a minimum of four weeks; (2) studies using resistance (sleds, parachutes, uphill slope, towing devices) or assistance (towing devices, downhill slope), or a combination of both; (3) a main intervention focused on resisted or assisted training, or a combination of both; (4) measurement of maximum velocity, acceleration measured in (s) with a minimum distance of 10-m, or kinematic changes such as step frequency, ground contact time, flight time, and step length; and (5) peer-reviewed studies. Results: Twenty-one studies were included in this review with meta-analysis. Kinematic changes, changes in acceleration, and changes in maximum velocity were analyzed. Only resisted sprint training was associated with a significant improvement in 10-m acceleration compared to normal (i.e. without assistance or resistance) sprinting (Z = 2.01, P = 0.04). With resisted, assisted and combined sprint training no significant changes in kinematics, 20-m times or maximum velocity were found when compared to normal sprint training. However, in the within group, effect sizes resisted sprint training had a moderate effect on 10-m times. A moderate effect on ground contact time, step frequency, 10-and 20-meter time after assisted sprint training was found, while combined sprint training had a moderate effect on maximum velocity. Conclusion: Resisted sprint training seems to be effective for improving acceleration ability, with significant decreases in the 10-m times. There were no other significant findings, suggesting that normal sprinting yields the same change in 20-m times, kinematics and maximum velocity as resisted, assisted and combined sprint training. However, moderate effect sizes using these different training methods were found, which may suggest that the different training forms could be useful for improving different parts of the sprint and changing the kinematics. Combination (uphill–downhill) sprint training seems to be effective at improving maximum velocity, while assisted sprint training was the most effective training to increase step frequency, which can affect sprint performance positively. However, more studies, especially in assisted sprints, need to be conducted to determine the full effect of these training forms. Key Points: • Resisted sprint training is effective for improving acceleration ability; however, combination (uphill–downhill) sprint training is more effective at improving maximum velocity. • The overall group analysis shows that all of the training forms decrease the flight time. • Assisted sprint training is the most effective training to increase step frequency, which can affect sprint performance positively. [ABSTRACT FROM AUTHOR]

Background: In general, it has been suggested that females are more fatigue-resistant than males, with the magnitude of difference being most pronounced during low-intensity sustained contractions. However, the mechanisms for the apparent sex difference have not yet been fully elucidated in the literature. This study aimed to examine sex-related differences in fatigability and patterns of neuromuscular responses for surface electromyographic (sEMG) and mechanomyographic (sMMG) amplitude and frequency (MPF) characteristics during a sustained submaximal bilateral, isometric leg extension muscle action. Methods: A sample of 20 young recreationally active males and females with previous resistance training experience performed a sustained, submaximal, bilateral isometric leg extension until task failure. Time-to-task failure was compared using a nonparametric bootstrap of the 95% confidence interval for the mean difference between males and females. Additionally, patterns of response for sEMG and sMMG amplitude and MPF of the dominant limb were examined using linear mixed effect models. Results: There were no differences in time-to-task failure between males and females. Additionally, neuromuscular responses revealed similar patterns of responses between males and females. Interestingly, sEMG amplitude and sMMG amplitude and MPF all revealed non-linear responses, while sEMG MPF demonstrated linear responses. Conclusion: These data revealed that time-to-task failure was not different between males and females during sustained submaximal bilateral, isometric leg extension. Interestingly, the parallel, non-linear, increases in sEMG and sMMG amplitude may indicate fatigue induced increases in motor unit recruitment, while the parallel decreases in sMMG MPF may be explained by the intrinsic properties of later recruited motor units, which may have inherently lower firing rates than those recruited earlier. [ABSTRACT FROM AUTHOR]

Resistance training activates mammalian target of rapamycin (mTOR) pathway of hypertrophy for strength gain, while endurance training increases peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) pathway of mitochondrial biogenesis benefiting oxidative phosphorylation. The conventional view suggests that resistance training-induced hypertrophy signaling interferes with endurance training-induced mitochondrial remodeling. However, this idea has been challenged because acute leg press and knee extension in humans enhance both muscle hypertrophy and mitochondrial remodeling signals. Thus, we first examined the muscle mitochondrial remodeling and hypertrophy signals with endurance training and resistance training, respectively. In addition, we discussed the influence of resistance training on muscle mitochondria, demonstrating that the PGC-1α-mediated muscle mitochondrial adaptation and hypertrophy occur simultaneously. The second aim was to discuss the integrative effects of concurrent training, which consists of endurance and resistance training sessions on mitochondrial remodeling. The study found that the resistance training component does not reduce muscle mitochondrial remodeling signals in concurrent training. On the contrary, concurrent training has the potential to amplify skeletal muscle mitochondrial biogenesis compared to a single exercise model. Concurrent training involving differential sequences of resistance and endurance training may result in varied mitochondrial biogenesis signals, which should be linked to the pre-activation of mTOR or PGC-1α signaling. Our review proposed a mechanism for mTOR signaling that promotes PGC-1α signaling through unidentified pathways. This mechanism may be account for the superior muscle mitochondrial remodeling change following the concurrent training. Our review suggested an interaction between resistance training and endurance training in skeletal muscle mitochondrial adaptation. [ABSTRACT FROM AUTHOR]

Purpose: Autophagy and heat shock protein (HSP) response are proteostatic systems involved in the acute and adaptive responses to exercise. These systems may upregulate sequentially following cellular stress including acute exercise, however, currently few data exist in humans. This study investigated the autophagic and HSP responses to acute intense lower body resistance exercise in peripheral blood mononuclear cells (PBMCs) with and without branched-chain amino acids (BCAA) supplementation. Methods: Twenty resistance-trained males (22.3 ± 1.5 yr; 175.4 ±.7 cm; 86.4 ± 15.6 kg) performed a bout of intense lower body resistance exercise and markers of autophagy and HSP70 were measured immediately post- (IPE) and 2, 4, 24, 48, and 72 h post-exercise. Prior to resistance exercise, 10 subjects were randomly assigned to BCAA supplementation of 0.22 g/kg/d for 5 days pre-exercise and up to 72 h following exercise while the other 10 subjects consumed a placebo (PLCB). Results: There were no difference in autophagy markers or HSP70 expression between BCAA and PLCB groups. LC3II protein expression was significantly lower 2 and 4 h post-exercise compared to pre-exercise. LC3II: I ratio was not different at any time point compared to pre-exercise. Protein expression of p62 was lower IPE, 2, and 4 h post-exercise and elevated 24 h post-exercise. HSP70 expression was elevated 48 and 72 h post-exercise. Conclusions: Autophagy and HSP70 are upregulated in PBMCs following intense resistance exercise with autophagy increasing initially post-exercise and HSP response in the latter period. Moreover, BCAA supplementation did not affect this response. [ABSTRACT FROM AUTHOR]

Purpose: To explore if mean concentric velocity (MCV) of the last repetition before set failure differs between free-weight back squat protocols with greater emphasis on metabolic accumulation vs. mechanical loading. The between-set and between-day reliability of terminal MCV obtained with these different loading schemes was also determined. Methods: Fifteen healthy male participants (18–30 years) were included. They all were required to exhibit a relative strength ≥ 1.5 times their body mass. MCVs were obtained at one-repetition maximum (1RM) and with two submaximal protocols (metabolic emphasis: three sets of 40%1RM with blood-flow restriction vs. mechanical emphasis: three sets 80%1RM without blood-flow restriction). Participants were instructed to reach maximal intended concentric velocity in each repetition up to failure. Results: Set failure was achieved at a faster MCV with the metabolic protocol (p < 0.05). The reliability of MCV at failure reached higher values for the metabolic loading scheme. However, while the MCV achieved at failure during the metabolic protocol was systematically higher than the MCV at 1RM (p < 0.05), this was not entirely the case for the mechanical protocol (similar to 1RM MCV during the last sets in both testing days). Finally, the absolute error derived from estimating the MCV at 1RM based on the MCV obtained at set failure with the mechanical protocol was considerably high (≥ 0.05 m/s). Conclusion: This study indicates that MCV obtained at set failure is dependent on the specificity of the physiological demands of exercise. Thus, MCVs obtained at failure with submaximal loads should not be used to estimate 1RM MCV. [ABSTRACT FROM AUTHOR]

Several observational and experimental studies in humans have suggested that high protein intake (PI) causes intraglomerular hypertension leading to hyperfiltration. This phenomenon results in progressive loss of renal function with long-term exposure to high-protein diets (HPDs), even in healthy people. The recommended daily allowance for PI is 0.83 g/kg per day, which meets the protein requirement for approximately 98% of the population. A HPD is defined as a protein consumption > 1.5 g/kg per day. Athletes and bodybuilders are encouraged to follow HPDs to optimize muscle protein balance, increase lean body mass, and enhance performance. A series of studies in resistance-trained athletes looking at HPD has been published concluding that there are no harmful effects of HPD on renal health. However, the aim of these studies was to evaluate body composition changes and they were not designed to assess safety or kidney outcomes. Here we review the effects of HPD on kidney health in athletes and healthy individuals with normal kidney function. [ABSTRACT FROM AUTHOR]

Background: Persistently elevated glycosylated hemoglobin (HbA1c) is associated with a higher risk of long-term vascular complications. Objective: We evaluated the effect of different exercise modalities and doses on HbA1c levels in patients with type 2 diabetes. Methods: A systematic search for randomized controlled trials involving exercise interventions in patients with type 2 diabetes was conducted across seven electronic databases, encompassing data from their inception up to October 2023. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose–response meta-analyses using the random-effects model were conducted to analyze the effect of exercise on HbA1c levels. Results: A total of 85 randomized controlled trials with 5535 participants were included. The network meta-analysis showed that high-intensity interval training (HIIT) has the highest ranked (MD = − 0.78% [− 8.50 mmol/mol]; 95% CrI: − 1.04, − 0.51), followed by combined aerobic and resistance exercise (CE) (MD = − 0.54% [− 5.90 mmol/mol]; 95% CrI: − 0.69, − 0.40), yoga (MD = − 0.45% [− 4.92 mmol/mol]; 95% CrI: − 0.77, − 0.13), and continuous aerobic exercise (CAE) (MD = − 0.42% [− 4.58 mmol/mol]; 95% CrI: − 0.54, − 0.30). In addition, a significant improvement in HbA1c levels can be observed when the total exercise dose reaches 840 metabolic equivalent of tasks-min/week. Conclusions: There was low-quality evidence that HIIT, CE, yoga, and CAE may be effective treatment modalities for improving HbA1c in patients with type 2 diabetes, and there was no significant difference in efficacy. Moreover, a non-linear dose–response relationship was found for total exercise and HbA1c levels. Future research should further investigate the specific effects of different exercise doses on HbA1c levels in patients with type 2 diabetes and provide a more personalized exercise prescription. [ABSTRACT FROM AUTHOR]

Myositis is associated with reduced quality of life, which is accompanied by significant impairments in muscle endurance and strength, altogether representing cardinal traits in patients with myositis. This randomised controlled trial aimed to investigate the effect of high-intensity resistance training on quality of life in patients with myositis. Thirty-two patients with established, stable myositis were randomised to 16 weeks of high-intensity resistance training (intervention group) or 16 weeks of usual care (control group). Primary outcome was quality of life assessed as the change in the physical component summary score (PCS) of the Short Form-36 health questionnaire from baseline to post-intervention. Secondary outcomes included functional capacity measures, such as functional index 3, and International Myositis Assessment and Clinical Studies Group (IMACS) disease activity and damage core set measures, including manual muscle testing 8 (MMT8). The primary outcome PCS showed an improvement in favour of high-intensity resistance training with a between-group difference of 5.33 (95% CI 0.61; 10.05) (p = 0.03). Additionally, functional index 3 showed a between-group difference indicating greater gains with high-intensity resistance training 11.49 (95% CI 3.37; 19.60) (p = 0.04), along with a between-group improvement in MMT8 1.30 (95% CI 0.09; 2.51) (p = 0.04). High-intensity resistance training for 16 weeks effectively improved quality of life in patients with myositis. Clinical measures of muscle endurance and muscle strength were also found to improve with high-intensity resistance training, while patients stayed in disease remission. Consequently, progressively adjusted high-intensity resistance training is feasible and causes no aggravation of the disease, while benefitting patients with myositis. Clinical trial registration: Clinicaltrials.gov ID: NCT04486261—https://clinicaltrials.gov/study/NCT04486261. [ABSTRACT FROM AUTHOR]

Background: The complex-contrast training (CCT) method utilizes two exercises with different loads and movement velocities in a set-by-set fashion to induce multiple neuromuscular adaptations. The speculated primary mechanism involves the post-activation potentiation or post-activation performance enhancement (PAPE) of the muscles used during the heavy load (low velocity) exercise, thereby improving the performance of lower load (high velocity) exercise. However, no previous study has attempted to systematically synthesize the available evidence on CCT (e.g., if post-activation potentiation or PAPE was measured during the training sessions during the intervention period). This study aimed to synthesize the available evidence on CCT using a systematic scoping review approach. More specifically, we identified gaps in the literature using an evidence gap map (EGM), and provided future directions for research. Methods: Three electronic databases (PubMed, Scopus, and Web of Science) were searched up to 20th February 2024. Data were extracted under a PICO framework: (a) Participants-related data (e.g., age, sex, type of sport); (b) Intervention-related data (e.g., duration of training); (c) Comparators (when available); and (d) Outcomes (e.g., measures of physical fitness). Interactive EGMs were created using the EPPI mapper software. Results: From the 5,695 records screened, 68 studies were eligible for inclusion, involving 1,821 participants (only 145 females from 5 studies). All CCT interventions lasted ≤ 16 weeks. More than half of the studies assessed countermovement jump, sprint, and maximal strength performances. No studies were identified which examined upper-body CCT exercises alone, and no study assessed PAPE during the CCT sessions. Overall, the available evidence was rated with a low level of confidence. Conclusions: In conclusion, whether CCT produces a PAPE that translates into longitudinal performance gains remains unclear. Moreover, the available evidence on the effects of CCT on various outcomes provides low confidence regarding the most effective way to implement this training method, particularly among females, and beyond long-term interventions. Key Points: The current evidence of complex-contrast training (CCT) for various outcome variables (e.g., sprinting, jumping) includes a limited number of participants (N < 800). Longitudinal studies beyond sixteen weeks of duration were unavailable, and only a small number of studies (n = 5/68) were available on female participants. Previous studies have considered the post-activation performance enhancement (PAPE) phenomenon during CCT sessions as one of the main mechanisms responsible for improving physical fitness attributes (e.g., sprinting, jumping). However, no longitudinal study has assessed PAPE responses during CCT sessions. Hence, the role of PAPE in physical fitness improvement after CCT has yet to be clarified. [ABSTRACT FROM AUTHOR]

Background: As a novel and time-efficient exercise form, high-intensity interval training (HIIT) has shown great potential in improving health-related physical fitness among diverse populations. However, empirical evidence on its efficacy among the elderly has not been well summarized. This systematic review and meta-analysis aimed to determine the effect of HIIT interventions on the parameters related to physical fitness and health of older adults, including resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), cardiorespiratory fitness (CRF), body mass index (BMI), body fat percent (BF%), waist circumference (WC), muscular endurance (ME), muscular strength (MS), muscular power (MP), balance and flexibility, compared to non-exercise and other-exercise (e.g., moderate-intensity continuous training, resistance training) conditions. Methods: Literature published from January 2000 to May 2023 was collected through extensive searches across eight databases and relevant review papers. Randomized controlled trials (RCTs) featuring a minimum 2-week exercise intervention for older adults (≥ 60 years) were included. The pooled effect size of Hedges'g was estimated using random-effects models in R. Meta-regression was performed for both categorical (health status, duration of training programme, and frequency) and continuous moderators (mean age, male rate, and attrition rate). Results: Forty-four eligible RCTs with 1863 participants (52.1% female; 60.5–81.2 years) were included in the quantitative analysis. Compared to non-exercise condition, HIIT significantly improved resting HR (g = -0.36, 95%CI = [-0.67, -0.05], P = 0.032), SBP (g = -0.29, 95%CI = [-0.54, -0.03], P = 0.008), CRF (g = 0.77, 95%CI = [0.51, 1.04], P < 0.001), BF% (g = -0.26, 95%CI = [-0.41, -0.11], P = 0.006), MS (g = 0.47, 95%CI = [0.23, 0.71], P = 0.004), ME (g = 0.65, 95%CI = [0.10, 1.19], P = 0.036), and balance (e.g., timed-up-and-go) (g = -0.79, 95%CI = [-1.19, -0.40], P = 0.035). Compared to other-exercise condition, HIIT significantly improved resting HR (g = -0.11, 95%CI = [-0.21, -0.01], P = 0.029), SBP (g = -0.14, 95%CI = [-0.28, -0.01], P = 0.038), and CRF (g = 0.23, 95%CI = [0.07, 0.38], P = 0.008). No significant difference was found between HIIT and non-exercise condition for DBP, BMI and WC, as well as between HIIT and other-exercise condition for DBP, BMI, BF%, WC, ME, and balance (all P > 0.05). Meta-regression indicated that mean age moderated the HIIT effect on resting HR (b = -0.02, P = 0.014; HIIT vs. other-exercise condition) and SBP (b = 0.03, P = 0.048; HIIT vs. non-exercise), and attrition rate moderated the effect on CRF (b = 0.03, P = 0.007; HIIT vs. non-exercise). Conclusion: This study supports the efficacy of HIIT in improving resting HR, SBP, CRF, BF%, MS, ME and balance among older adults. More empirical evidence is needed to determine the efficacy of HIIT for MP and flexibility in this population. Trial Registration: PROSPERO CRD42022316246. Key Points: • HIIT is an effective approach for improving older adults' resting heart rate (HR), systolic blood pressure (SBP), cardiorespiratory fitness (CRF), body fat percent (BF%), muscular strength (MS), and balance, compared with non-exercise condition. • HIIT outperformed the other exercise interventions in improving older adults' resting HR, SBP, CRF, and muscular endurance (ME). • Mean age and attrition rate were identified as potential moderators for the HIIT effects on resting HR, SBP and CRF. [ABSTRACT FROM AUTHOR]

We investigated the effectiveness of a resistance training (RT) protocol with lower volume and lower load in the body recomposition of postmenopausal women, and to determine whether changes in body recomposition induced by RT would be associated with changes in physical performance, independently of confounding factors. Participants were randomly assigned to one of three groups: I) Single set-high load (SSHL, n = 14, 1 set of 8 to 12 maximum repetitions), II) Single set-low load (SSLL, n = 15, 1 set of 25 to 30 maximum repetitions), and III) Multiple sets-high load (MSHL, n = 14, 3–6 sets of 8 to 12 maximum repetitions). The study extended over a duration of 27 weeks, encompassing 24 weeks of RT. We assessed body composition using dual-energy X-ray absorptiometry, physical performance using the Timed Up and Go and sit and stand tests, and muscle strength using the one-repetition maximum (1RM) test. We quantified body recomposition using a composite z score calculated as follows: (appendicular lean mass % delta z score) + (− 1 × fat mass delta % z score) / 2. Results showed significant improvements in physical performance (P < 0.001), significant reductions in visceral adipose tissue, total fat mass, and % fat (P = 0.003, P = 0.042, and P < 0.001, respectively), and increases in muscle mass and strength (P < 0.001), regardless of group assignment. Notably, the higher load groups (SSHL and MSHL) had significantly greater body recomposition compared to the lower load group (SSLL), particularly after adjusting for age, physical activity, and sitting time (P = 0.028). Therefore, the higher load of RT is a critical factor in the body recomposition of postmenopausal women. Furthermore, the positive effects of body recomposition induced by RT extend to physical performance and muscle strength. [ABSTRACT FROM AUTHOR]

Objective: To establish the effect of high-intensity and progressive volume resistance training (HIRT), on general health, functional, mental status, and quality of life (QOL) indicators in people with spinal cord injury (SCI). Methods: The sample consisted of five people with SCI of both sexes, aged 46.2 ± 13.9 years, submitted to 12 weeks of HIRT, twice a week. We analyzed before and after the 12 weeks of intervention: body composition, muscle strength, functional status, perception of mental status, and QOL, using the following tests: dual-energy X-ray densitometry, 1RM, isometry of biceps, elbow flexion, Wingate, zigzag, medicine ball pitch, Beck inventory (anxiety, depression, and mental disorder) and SF-36. Results: The results pointed to an increase in the training load, the total bone mineral content (p = 0.043), the muscle power at 80% of 1RM (p = 0.043), the functional state (anaerobic power [MD = 6.81%; p = 0.043] and explosive strength [mean difference (MD) = 30.57%; p = 0.043] of the shoulder girdle muscles), the mental state (MD = 71.46%; p = 0.006) and finally, improvement in QOL, especially in the functional (MD = 60.87%; p = 0.006) and social aspects (MD = 44.44%; p = 0.006). Conclusions: HIRT can improve or maintain body composition, developing muscle power, anaerobic power, and explosive strength of the upper limbs that will impact functional capacity, promoting greater autonomy, with consequent reflex in improving mental state and of the QOL of the person with SCI. [ABSTRACT FROM AUTHOR]

Resistance training (RT) programs for older adults typically involve manipulating variables such as load, volume of sets, frequency, and exercise selection. Overall, these variables may affect motivation, enjoyment, and adherence in older adults. Therefore, understanding the affective responses of older adults to these RT variables is crucial to designing effective and sustainable exercise programs. We aimed to investigate systematically the affective responses across different RT variables in older adults. We searched observational and experimental studies on MEDLINE (via PubMed), EMBASE, SPORTSDiscus, Web of Science, SCOPUS, and LILACS. Eligibility criteria were: (a) older adults (≥ 60 years); (b) experimental or observational study design (e.g., cross-sectional study, prospective cohort, etc.); (c) studies that investigated RT as exercise mode; and (d) studies that explored the affective responses (i.e., feeling, enjoyment) of older adults to RT variables (e.g., load, cadence, exercise order). Our main findings revealed that the load variable has received more attention in research. There was a trend among older adults favoring low-load RT protocols over high-load ones. In addition, most of studies showed that these preferences were associated with more positive affective responses, suggesting that individualized exercise programs aligned with older adults' preferences may enhance the effectiveness of RT regimens. In conclusion, our study emphasizes the importance of considering the load variable in resistance training for older adults. We found a preference for low-load protocols, linked to more positive emotional responses. Exercise programs to individual preferences may enhance the effectiveness of resistance training regimens in this demographic. [ABSTRACT FROM AUTHOR]

Purpose: Resistance training (RT) induces muscle growth at varying rates across RT phases, and evidence suggests that the muscle-molecular responses to training bouts become refined or attenuated in the trained state. This study examined how proteolysis-related biomarkers and extracellular matrix (ECM) remodeling factors respond to a bout of RT in the untrained (UT) and trained (T) state. Methods: Participants (19 women and 19 men) underwent 10 weeks of RT. Biopsies of vastus lateralis were collected before and after (24 h) the first (UT) and last (T) sessions. Vastus lateralis cross-sectional area (CSA) was assessed before and after the experimental period. Results: There were increases in muscle and type II fiber CSAs. In both the UT and T states, calpain activity was upregulated and calpain-1/-2 protein expression was downregulated from Pre to 24 h. Calpain-2 was higher in the T state. Proteasome activity and 20S proteasome protein expression were upregulated from Pre to 24 h in both the UT and T. However, proteasome activity levels were lower in the T state. The expression of poly-ubiquitinated proteins was unchanged. MMP activity was downregulated, and MMP-9 protein expression was elevated from Pre to 24 h in UT and T. Although MMP-14 protein expression was acutely unchanged, this marker was lower in T state. TIMP-1 protein levels were reduced Pre to 24 h in UT and T, while TIMP-2 protein levels were unchanged. Conclusion: Our results are the first to show that RT does not attenuate the acute-induced response of proteolysis and ECM remodeling-related biomarkers. [ABSTRACT FROM AUTHOR]

Background: Walking/run promotes greater post-exercise hypotension (PEH) than resistance exercise (RE) which can be associated nitric oxide production. Then, we investigated if adding walking between RE increases PEH. Methods: Thirteen hypertensive women (48 ± 1.9 years; 26.8 ± 0.3 kg/m2) performed five experimental sessions: 1—traditional RE with passive interval (PIBS); 2—RE with active interval between sets (AIBS); 3—RE with active interval between exercises (AIEX); 4—aerobic exercise (AE); 5—no exercise. Blood pressure was measured before and immediately after exercise and every 10 min of a 60-min post-exercise recovery period. Plasma nitrite (NO) and malondialdehyde (MDA) were also measured. Results: AIBS, AIEX, and AE sessions promoted systolic PEH (12 ± 1.53; 16 ± 2.13; 18 ± 1.34 mmHg, respectively) and diastolic PEH (8 ± 1.38; 8 ± 0.79; 8 ± 0.58 mmHg). In AIBS, AIEX and AE sessions, significant PEH was noted at 10 or 20 min; in PIBS, PEH was significant only at 40 min. In the PIBS session, NO did not change, but presented higher values after AIBS, AIEX and AE sessions. MDA showed no changes between sessions. Conclusions: Passive or active intervals in resistance exercise promote PEH in hypertensive women. Active intervals shorten the PEH onset time as additional benefit. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the effect of aging and resistance training with a moderate load on the size and mechanical properties of the patellar (PT) and Achilles tendon (AT) and their associated aponeuroses; medial gastrocnemius (MG) and vastus lateralis (VL). Young (Y55; 24.8 ± 3.8 yrs, n = 11) and old men (O55; 70.0 ± 4.6 yrs, n = 13) were assigned to undergo a training program (12 weeks; 3 times/week) of moderate slow resistance training [55% of one repetition maximum (RM)] of the triceps surae and quadriceps muscles. Tendon dimensions were assessed using 1.5 T magnetic resonance imaging before and after 12 weeks. AT and PT cross sectional area (CSA) were determined every 10% of tendon length. Mechanical properties of the free AT, MG aponeurosis, PT, and VL aponeurosis were assessed using ultrasonography (deformation) and tendon force measurements. CSA of the AT but not PT was greater in O55 compared with Y55. At baseline, mechanical properties were generally lower in O55 than Y55 for AT, MG aponeurosis and VL aponeurosis (Young's modulus) but not for PT. CSA of the AT and PT increased equally in both groups following training. Further, for a given force, stiffness and Young's modulus also increased equally for VL aponeurosis and AT, for boths groups. The present study highlights that except for the PT, older men have lower tendon (AT, MG aponeurosis, and VL aponeurosis) mechanical properties than young men and 12-weeks of moderate slow resistance training appears sufficient to improve tendon size and mechanical adaptations in both young and older men. New and Noteworthy: These novel findings suggest that short-term moderate slow resistance training induces equal improvements in tendon size and mechanics regardless of age. [ABSTRACT FROM AUTHOR]

Background: The proximity to failure in which sets are terminated has gained attention in the scientific literature as a potentially key resistance training variable. Multiple meta-analyses have directly (i.e., failure versus not to failure) or indirectly (e.g., velocity loss, alternative set structures) evaluated the effect of proximity to failure on strength and muscle hypertrophy outcomes categorically; however, the dose–response effects of proximity to failure have not been analyzed collectively in a continuous manner. Objective: To meta-analyze the aforementioned areas of relevant research, proximity to failure was quantified as the number of repetitions in reserve (RIR). Importantly, the RIR associated with each effect in the analysis was estimated on the basis of the available descriptions of the training interventions in each study. Data were extracted and a series of exploratory multilevel meta-regressions were performed for outcomes related to both strength and muscle hypertrophy. A range of sensitivity analyses were also performed. All models were adjusted for the effects of load, method of volume equating, duration of intervention, and training status. Results: The best fit models for both strength and muscle hypertrophy outcomes demonstrated modest quality of overall fit. In all of the best-fit models for strength, the confidence intervals of the marginal slopes for estimated RIR contained a null point estimate, indicating a negligible relationship with strength gains. However, in all of the best-fit models for muscle hypertrophy, the marginal slopes for estimated RIR were negative and their confidence intervals did not contain a null point estimate, indicating that changes in muscle size increased as sets were terminated closer to failure. Conclusions: The dose–response relationship between proximity to failure and strength gain appears to differ from the relationship with muscle hypertrophy, with only the latter being meaningfully influenced by RIR. Strength gains were similar across a wide range of RIR, while muscle hypertrophy improves as sets are terminated closer to failure. Considering the RIR estimation procedures used, however, the exact relationship between RIR and muscle hypertrophy and strength remains unclear. Researchers and practitioners should be aware that optimal proximity to failure may differ between strength and muscle hypertrophy outcomes, but caution is warranted when interpreting the present analysis due to its exploratory nature. Future studies deliberately designed to explore the continuous nature of the dose–response effects of proximity to failure in large samples should be considered. [ABSTRACT FROM AUTHOR]

Background: Exercise is an important component of rehabilitation care for people with coronary heart disease (CHD). Objectives: The aim of this study was to critically analyze and summarize the existing evidence from published systematic reviews (SRs) and meta-analyses of randomized controlled trials (RCTs) that have evaluated the effects of different types of exercise interventions on cardiorespiratory fitness, as measured by peak oxygen consumption in people with CHD. Methods: Electronic databases (Cochrane Library, Medline/PubMed, EMBASE, and PEDro) were searched for SRs of exercise interventions of people with CHD. Two reviewers assessed the quality of SRs using the AMSTAR-2 tool and evaluated the strength of evidence quality with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system for relevant outcome measures. Mean difference (MD) and 95% confidence intervals (CIs) were calculated. Results: Thirty-one SRs (with 125 RCTs) met the study criteria, including 33,608 patients. Compared with usual care, continuous aerobic exercise produced an improvement in peak oxygen consumption, MD of 3.8 mL kg−1 min−1 (95% CI: 3.204.4, I2 = 67%); high-intensity interval training, MD 6.1 mL kg−1 min−1 (95% CI: 0.4–11.8, I2 = 97%); resistance training, MD of 2.1 mL kg−1 min−1 (95% CI: 0.98–3.2, I2 = 60%); combined aerobic and resistance training, MD of 3.0 mL kg−1 min−1 (95% CI: 2.5–3.4, I2 = 0%); and water-based exercise, MD of 4.4 mL kg−1 min−1 (95% CI, 2.1–6.7; I2 = 2%). Conclusion: Exercise interventions improve peak oxygen consumption in people with CHD. However, there was moderate to very-low certainty for the evidence found. [ABSTRACT FROM AUTHOR]