Exercise Modalities Research Articles

The Influence of Eccentric Muscle Actions on Concentric Muscle Strength: An Exception to the Principle of Specificity?

The principle of specificity suggests that the largest changes in strength occur when training resembles the specific strength test. A one-repetition maximum (1RM) test, which tests the maximal concentric strength, is commonly used as a surrogate for strength adaptation. When separating muscle actions into concentric or eccentric phases, multiple lines of evidence suggest that eccentric muscle actions possess several distinct physiological properties compared with concentric actions. In accordance, there are instances where the increases in 1RM strength test were similar between eccentric-only and concentric-only resistance training. This is at odds with the principle of specificity which suggests that individuals who trained with concentric actions would be expected to have an advantage in that specific task. Although the mechanistic reasons why eccentric-biased training carries over to maximal concentric strength remains to be elucidated, the lack of discernible differences in strength gains with eccentrically-biased training (e.g., eccentric-only and accentuated eccentric training) may imply that the effects of eccentric loading in training are transferable to concentric strength. Our review revisits the role of eccentric loading in enhancing concentric maximal muscle strength. We also speculate on potential physiological factors (i.e., molecular and neural factors) that may differentiate the effects of eccentric and concentric resistance training on the changes in muscle strength. Currently, the majority of the studies investigating the changes in strength have been conducted using isokinetic eccentric training. This is important as there is a viewpoint that the magnitude of chronic adaptations with different modalities of eccentric exercises (i.e., isotonic, isokinetic, and isoinertial training) may also differ from each other. While it has been suggested that eccentric action has a greater transferable capacity for strength adaptations compared to concentric actions, future investigations are warranted to investigate with different modalities of eccentric exercises. There also remains a host of unanswered questions related to the role of eccentric action for maximal concentric strength. For example, future studies may examine whether the eccentric action would be additive when the training is already maximally loaded during the concentric action for increasing concentric maximal strength. We suggested a few different designs that could be used to answer some of these questions in future studies.

Incorporating Therapeutic Education and Exercise in Migraine Management: A Biobehavioral Approach.

The main objective was to perform a description of the potential biobehavioral factors that influence disability in patients with migraines and develop a multimodal physiotherapy treatment proposal incorporating therapeutic education and exercise prescription, applying a biobehavioral approach. This manuscript highlights the complex interplay between migraines and physical activity, with many migraine sufferers performing reduced physical activity, even during headache-free intervals. The kinesiophobia present in a significant portion of patients with migraine exacerbates functional disability and compromises quality of life. Psychological elements, especially pain catastrophizing, depression, and self-efficacy, further compound migraine-related disability. Addressing these issues requires a multidisciplinary approach that integrates physical activity and behavioral interventions. We propose a therapeutic education model of motor behavior that emphasizes the enhancement of therapeutic exercise outcomes. This model consists of the four following phases: (1) biobehavioral analysis of movement; (2) goal setting; (3) education about exercise benefits; and (4) movement education. A notable feature is the incorporation of motivational interviewing, a communication strategy that amplifies intrinsic motivation for change. Recent clinical guidelines have advocated for specific exercise modalities to ameliorate migraine symptoms. However, we highlight the importance of a tailored exercise prescription to maximize the benefits of exercise and reduce the possible adverse effects. The integration of exercise with other lifestyle recommendations, such as maintaining consistent sleep patterns and employing stress management techniques, is pivotal for improving outcomes in patients with migraine. Although evidence supports the benefits of these interventions in various painful conditions, further research is needed to establish their efficacy specifically for migraine management.

Effects of various exercise types on inflammatory response in individuals with overweight and obesity: a systematic review and network meta-analysis of randomized controlled trials.

To explore effective exercise types for reducing chronic inflammation in individuals with overweight and obesity (IOO) while accounting for confounders. A systematic search for RCTs in English between January 2000 and August 2023 was conducted to evaluating exercise effects on inflammatory biomarkers in IOO. A network meta-analysis conducted. A total of 123 RCTs were analyzed. Different exercise type yielded distinct effects on various inflammatory biomarkers. Specifically, aerobic exercise combined with resistance training (COM) and aerobic exercise (AE) were the most effective for improving leptin levels. AE exhibited the greatest effectiveness in reducing CRP and increasing adiponectin. High-intensity interval training (HIIT) was identified as the most effective exercise modality for ameliorating IL-6, TNF-α, and IL-10. Resistance training (RT) had the least effect compared to other exercise types. Meta regression and subgroup analyses revealed that high-intensity AE demonstrated a greater effect size compared to moderate-intensity AE. The impact of AE on IL-10 was positively associated with both the training period and the age of participants. Positive correlations were observed between reductions in body fat and the effect sizes of CRP, TNF-α, and IL-10. Gender influenced AE effects on IL-6 and TNF-α, with females responding better. This study highlights the potential of exercise in alleviating the inflammatory status in IOO, with different exercise types showing various effects on specific inflammatory biomarkers. The intensity and duration of exercise had a dose-response relationship with intervention effectiveness. Changes in body composition correlated with the effectiveness of the intervention. COM, AE, and HIIT are recommended exercise approaches.

Advanced resistance exercise combined with aerobic rehabilitation training on cardiopulmonary function

Chronic diseases are the number one killer in the world today, and the most common cause of chronic diseases is lack of exercise. Research on the application of artificial intelligence technology in the medical field can shorten the distance between clinical best practice and practical application, and promote the standardized management of clinicians according to specifications. In this paper, three different exercise methods, continuous aerobic, anaerobic, and control, were used to conduct a 12-week study. This paper discussed the effects of three different forms of exercise on the body shape, body composition, and metabolism of patients with chronic diseases, and discussed the intervention effects of the same exercise mode in different periods (0–6 weeks, 6–12 weeks), to provide a theoretical basis for more effective and targeted choice of exercise intervention programs. Through training load, training frequency, training sequence, training interval, and other factors, a training plan can be designed. To avoid mistakes, experts often try to do some items that are prone to mistakes, especially lung function measurement. The scores of self-care, extraction, standing, occupation/housework, social activities, and total scores were significantly lower than those before intervention (P < 0.01). Advanced resistance kinetic energy can significantly improve the exercise and cardiopulmonary function of patients with various types of chronic diseases. Advanced resistance kinetic energy can significantly promote the strength and explosive force of the shoulder, waist, and back muscles in chronic patients, and can significantly promote the muscle adaptability of the shoulder, waist, and back muscles in chronic patients.

Comparisons of Intradialytic Exercise Versus Home-Based Exercise in Hemodialysis Patients: A Narrative Review.

With the increasing prevalence of end-stage kidney disease, the number of patients requiring hemodialysis (HD) continues to rise. While life-sustaining, HD is often associated with adverse effects such as muscle loss, physical deconditioning, fatigue, and compromised health-related quality of life (HRQoL). Recent research suggests that intradialytic exercise (IDE) and home-based exercise (HBE) may mitigate these adverse effects and improve patient outcomes. However, the existing literature mainly focuses on the outcomes of both exercises, whereas the comparison of types is often omitted. Hence, this review consolidates findings from studies investigating the effectiveness, implementation, safety, feasibility, and adherence of different types of IDE and HBE in HD patients. Overall, the current literature bolsters the significance of IDE and HBE for improving health in HD patients. IDE and HBE enhance physical function, cardiopulmonary capacity, HRQoL, and cognitive well-being. Some research proposed an indirect link between IDE and survival rates. Despite these benefits, challenges remain in implementing these exercise modalities, including patient adherence and the feasibility of routine exercise during HD sessions. Integrating these exercises into routine care allows healthcare providers to enhance outcomes for HD patients. Further research is suggested to optimize exercise protocols and explore long-term effects and cost-effectiveness.

Quantitative analysis of effectiveness and associated factors of exercise on symptoms in osteoarthritis: a pharmacodynamic model-based meta-analysis

ObjectiveThis study aims to evaluate the time point and magnitude of peak effectiveness of exercise and the effects of various exercise modalities for osteoarthritis (OA) symptoms and to identify factors...

A review of exercise interventions for reducing anxiety symptoms: Insights and implications.

Generalized anxiety disorder (GAD) is a prevalent mental health condition affecting a significant proportion of the adult population. Despite the availability of pharmacological treatments, their long-term efficacy and potential side effects necessitate exploring alternative interventions. Aerobic exercise has emerged as a promising non-pharmacological approach for managing anxiety symptoms in individuals with GAD. This narrative review examines the efficacy of aerobic exercise interventions in alleviating symptoms of anxiety disorders, drawing on a comprehensive analysis of relevant literature. The review synthesizes findings from studies investigating various forms of aerobic exercise, including high-intensity interval training, resistance training, Pilates, and walking. The results indicate that aerobic exercise interventions demonstrate efficacy in reducing anxiety symptoms and improving overall well-being across diverse populations, including primary care patients, individuals with coronary heart disease, and older adults with cancer undergoing chemotherapy. The review discusses the neurobiological and psychological mechanisms underlying the anxiolytic effects of aerobic exercise. It highlights the implications of these findings for clinical practice, public health initiatives, and future research directions. Despite the promising evidence, limitations in study methodologies and heterogeneity across interventions warrant a cautious interpretation of the results. Further research is needed to elucidate optimal exercise modalities, dosages, and long-term effects on anxiety outcomes.

Effects and mechanisms of supramaximal high-intensity interval training on extrapulmonary manifestations in people with and without chronic obstructive pulmonary disease (COPD-HIIT): study protocol for a multi-centre, randomized controlled trial

BackgroundBeyond being a pulmonary disease, chronic obstructive pulmonary disease (COPD) presents with extrapulmonary manifestations including reduced cognitive, cardiovascular, and muscle function. While exercise training is the cornerstone in the non-pharmacological treatment of COPD, there is a need for new exercise training methods due to suboptimal adaptations when following traditional exercise guidelines, often applying moderate-intensity continuous training (MICT). In people with COPD, short-duration high-intensity interval training (HIIT) holds the potential to induce a more optimal stimulus for training adaptations while circumventing the ventilatory burden often associated with MICT in people with COPD. We aim to determine the effects of supramaximal HIIT and MICT on extrapulmonary manifestations in people with COPD compared to matched healthy controls.MethodsCOPD-HIIT is a prospective, multi-centre, randomized, controlled trial with blinded assessors and data analysts, employing a parallel-group designed trial. In phase 1, we will investigate the effects and mechanisms of a 12-week intervention of supramaximal HIIT compared to MICT in people with COPD (n = 92) and matched healthy controls (n = 70). Participants will perform watt-based cycling two to three times weekly. In phase 2, we will determine how exercise training and inflammation impact the trajectories of neurodegeneration, in people with COPD, over 24 months. In addition to the 92 participants with COPD performing HIIT or MICT, a usual care group (n = 46) is included in phase 2. In both phases, the primary outcomes are a change from baseline in cognitive function, cardiorespiratory fitness, and muscle power. Key secondary outcomes include change from baseline exercise tolerance, brain structure, and function measured by MRI, neuroinflammation measured by PET/CT, systemic inflammation, and intramuscular adaptations. Feasibility of the interventions will be comprehensively investigated.DiscussionThe COPD-HIIT trial will determine the effects of supramaximal HIIT compared to MICT in people with COPD and healthy controls. We will provide evidence for a novel exercise modality that might overcome the barriers associated with MICT in people with COPD. We will also shed light on the impact of exercise at different intensities to reduce neurodegeneration. The goal of the COPD-HIIT trial is to improve the treatment of extrapulmonary manifestations of the disease.Trial registrationClinicaltrials.gov: NCT06068322. Prospectively registered on 2023-09-28.

Impact of Six Months of Three Different Modalities of Exercise on Stress in Post-Treatment Breast Cancer Survivors

Abstract: Background/Objectives: Extensive evidence suggests that exercise is physically and mentally beneficial for cancer survivors. This study reports on changes in self-reported stress, physiological biomarkers for stress (salivary cortisol), and HR-QOL constructs for fifty breast cancer survivors participating in one of three different exercise programs over 6 months. Methods: Fifty post-treatment breast cancer survivors were randomized to either therapeutic yoga-based exercise (YE), comprehensive exercise (CE) (aerobic, resistance, flexibility), or choosing (C) their own exercise activities. Participants completed the Perceived Stress Scale (PSS), Medical Outcomes Short-Form 36® (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Five samples of salivary cortisol were collected on two consecutive days. The 10 samples were used to calculate the diurnal rhythm slope. Outcome measures were repeated after six months. Results: All groups improved in HR-QOL measures of PSS; PSQI sleep quality components of latency and daytime functioning; and five of the ten SF-36 scales (Mental Component Scale, Social Functioning subscale, Mental Health subscale, Physical Component Scale, Physical Functioning subscale). Although the CE group observed the most favorable change in cortisol (−0.183), where cortisol slope changes approached significance (p = 0.057), but no significant decrease in cortisol between groups were noted. Conclusion: Our results suggest that it is the engagement of, rather than the specific type of exercise, which is associated with improved HR-QOL. However, longer-term studies with better adherence monitoring and larger sample sizes are needed to better determine clinical impact.

Exercising with virtual reality is potentially better for the working memory and positive mood than cycling alone

Background and aimsAlthough virtual reality (VR) exercise has attracted attention as a factor in exercise habituation due to its mood-enhancing effects, its impact on brain function remains unclear. This study aimed to explore how VR exercise affects working memory, a key executive function, and its underlying neural mechanisms. MethodsThe study involved 23 healthy university students who engaged in exercise in a VR environment. Outcomes included cardiorespiratory and psychological assessments, as well as functional magnetic resonance imaging (fMRI). ResultsOur findings indicate that a 10-min VR exercise session improved mood (arousal and vitality level) and working memory task performance (3-back task) more effectively than exercise or rest alone. Furthermore, the results confirmed that increased vitality from both exercise and VR exercise interventions was associated with improved 3-back task performance. However, specific brain regions contributing to this enhancement remain unidentified. ConclusionThese results highlight VR exercise as an optimal exercise program for enhancing working memory function by increasing vitality levels. These insights underscore the potential of VR as a novel exercise modality, with benefits extending beyond exercise adherence to potentially prevent dementia and depression.

Macrophages on the run: Exercise balances macrophage polarization for improved health

ObjectiveExercise plays a crucial role in maintaining and improving human health. However, the precise molecular mechanisms that govern the body’s response to exercise or/compared to periods of inactivity remain elusive. Current evidence appears to suggest that exercise exerts a seemingly dual influence on macrophage polarization states, inducing both pro-immune response M1 activation and cell-repair-focused M2 activation. To reconcile this apparent paradox, we leveraged a comprehensive meta-analysis of 75 diverse exercise and immobilization published datasets (7000+ samples), encompassing various exercise modalities, sampling techniques, and species. Methods75 exercise and immobilization expression datasets were identified and processed for analysis. The data was analyzed using boolean relationships which uses binary gene expression relationships in order to increase the signal to noise achieved from the data, allowing for the use of comparison across such a diverse set of datasets. We utilized a boolean relationship-aided macrophage gene model [1], to model the macrophage polarization state in pre and post exercise samples in both immediate exercise and long term training. ResultsOur modeling uncovered a key temporal dynamic: exercise triggers an immediate M1 surge, while long term training transitions to sustained M2 activation. These patterns were consistent across different species (human vs mouse), sampling methods (blood vs muscle biopsy), and exercise type (resistance vs endurance), and routinely showed statistically significant results. Immobilization was shown to have the opposite effect of exercise by triggering an immediate M2 activation. Individual characteristics like gender, exercise intensity and age were found to impact the degree of polarization without changing the overall patterns. To model macrophages within the specific context of muscle tissue, we identified a focused gene set signature of muscle resident macrophage polarization, allowing for the precise measurement of macrophage activity in response to exercise within the muscle. ConclusionsThese consistent patterns across all 75 examined studies suggest that the long term health benefits of exercise stem from its ability to orchestrate a balanced and temporally-regulated interplay between pro-immune response (M1) and reparative macrophage activity (M2). Similarly, it suggests that an imbalance between pro-immune and cell repair responses could facilitate disease development. Our findings shed light on the intricate molecular choreography behind exercise-induced health benefits with a particular insight on its effect on the macrophages within the muscle.

The Effects Of Different Exercise Modes On Obesity-related Muscle Atrophy In Mice

The Effects Of Different Exercise Modes On Obesity-related Muscle Atrophy In Mice

The Evolvement of Session Design From Junior Age to Senior Peak Performance in World-Class Cross-Country Skiers.

To compare designs of training sessions applied by world-class cross-countryskiers during their most successful junior and senior season. Retrospective analysis of self-reported training characteristics (ie,training form, intensity, and exercise mode) among 8 male and 7 female world-class cross-country skiers was conducted. Total number of sessions (441 [71] vs 519 [34], P < .001, large effect) and mean duration (1.5 [0.1]h vs 1.7 [0.1]h, P < .001, moderate effect) increased from junior to senior age. More double-session days were performed at senior age (124 [50] vs 197 [29]d, P < .001, large). The number (310 [64] vs 393 [64], P < .001, large effect) and duration (1.3 [0.1]h vs 1.5 [0.1]h, P < .001, moderate effect) of low-intensity training sessions increased from junior to senior age. Regarding intensive training, most emphasis was put on high-intensity training sessions lasting 20 to 39minutes with <5-minute intervals at junior age, while 40 to 59minutes ofmoderate-intensity training with 5- to 9-minute intervals was predominant at senior age. More MIXED (combined moderate- and high-intensity) sessions (9 [7] vs 14 [7], P = .023, moderate effect) and longer races (0.5 [0.1]h vs 0.6 [0.1]h, P = 0.29, moderate effect) compensated for fewer high-intensity training sessions at senior age (36 [17] vs 25 [10], P = .027, moderate effect). Duration of strength-training sessions increased significantly (0.6 [0.1] vs 0.8 [0.2]h, P = 0.30, moderate effect), while other training forms remained unchanged. World-class cross-country skiers increased their training volume from junior to senior age primarily by more and longer low-intensity training sessions and more often training twice per day. Concurrently, the most frequent intensive sessions were modified from high- to moderate-intensity training, lasted longer, and contained longer intervals.

The Effect Of Two Acute Exercise Modalities On Physiology And Cognition During Firefighter Occupational Tasks

The Effect Of Two Acute Exercise Modalities On Physiology And Cognition During Firefighter Occupational Tasks

Changes In Peak Torque Following Different Exercise Modalities To Fatigue

Changes In Peak Torque Following Different Exercise Modalities To Fatigue

Physiotherapy Management of Frozen Shoulder Dextra with InfraRed (IR), Transcutaneous Electrical Nerve Stimulation (TENS) and Active Exercise Modalities

Frozen shoulder, commonly called adhesive capsulitis, is a painful condition in the shoulder and results in a limited range of motion of the joint (LGS). Frozen shoulder is a condition where shoulder movement becomes limited. Frozen shoulder has varying degrees of severity, ranging from mild to severe pain, and the degree of limitation to movement of the glenohumeral joint. To reduce pain and limited joint movement, which will later increase the ability for functional activities, the role and modalities of physiotherapy can be used in the form of InfraRed, Transcutaneous Electrical Nerve Stimulation, and Active Exercise. This scientific paper is a case study that raises patient cases and collects data through physiotherapy. InfraRed, Transcutaneous Electrical Nerve Stimulation, and Active Exercise are the modalities provided. After receiving physiotherapy treatment 3 times, the results of the shoulder already appear symmetrical; there is an increase in the Joint Scope of Motion (LGS) of the shoulder dextra, a decrease in pain in the shoulder dextra, the loss of spasm of the anterior and medial deltoid muscles, and the ability of the patient's functional activities using the Shoulder Pain and Disability Index (SPADI). Conclusion: Physiotherapy treatment of Frozen Shoulder Dextra using InfraRed, Transcutaneous Electrical Nerve Stimulation, and Active Exercise modalities has been proven to eliminate spasms, increase joint range of motion (LGS), reduce pain, increase muscle strength and increase functional activity capabilities using Shoulder Pain and Disability Index (SPADI).

Relationships between morphological factors and heat extraction from the upper arm using liquid cooling garment

Astronauts wear liquid perfused garments inside their outer spacesuits for regulating body temperature. The present study explored relationships between local heat production from the upper arm and body morphology while wearing liquid perfused sleeve. Heat extraction from the upper arm of 19 subjects (8 males and 11 females) during three different exercise modes (running at 6–8 km∙h−1, cycling at 40–55 W, and arm ergometer at 10–20 W) and rest has been investigated. The total body fat (27.5 ± 7.2%), body mass index (24.4 ± 2.7 kg·m−2), arm surface area (589 ± 90 cm2), and arm volume (1300 ± 300 mL) were considered as covariates. Subjects wore a liquid perfused sleeve over the upper arm (left) with the water inlet temperature of 24.0 ± 0.3 °C and the heat extraction was calculated using the water flow rate and temperature differences. Heat extraction from the upper arm showed no significant differences among the three exercises. During cycling, there was a negative relationship between heat extraction and total body fat (r = − 0.527, P < 0.05). Heat extraction was more related to the arm volume (P < 0.05) than the surface area of the upper arm, which was significant only for the male group in the cycling mode. For the female group, heat extraction was related to upper arm temperature in the cycling and arm exercise modes (for both exercises P < 0.05). These results can be applied to improve liquid cooling garments for astronauts, considering their body morphology and sex.

Effects of long-term Tai Chi vs. aerobic exercise on antioxidant activity and cognitive function in individuals with Parkinson’s disease

An imbalance between the generation of reactive oxygen species and the body’s antioxidant defense mechanisms is closely related to the development and progression of Parkinson’s disease (PD). Considering that physical exercise is a potential therapeutic intervention for modulating oxidative stress markers and cognitive function in PD, the primary purpose of this study was to compare the effects of different long-term exercise modalities on antioxidants and cognitive performance in patients with PD. In addition, the secondary purpose was to explore whether changes in the levels of these biochemical markers are associated with alterations in cognitive performance pre- and post-intervention. In all, 61 participants were randomly divided into the aerobic exercise (AE, n=20), Tai Chi exercise (TCE, n=21), or control (n=20) group. Blood samples were collected before and after a 12-week intervention period for the analysis of antioxidant markers [leukocyte 8-hydroxydeoxyguanosine (8-OHdG), catalase (CAT), glutathione (GSH), glutathione peroxidase (GSH-Px), oxidized glutathione (GSSG), superoxide dismutase (SOD), and uric acid (UA)]. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE). Although no significant changes were observed in the activity of 8-OhdG, GSH-Px, GSSG, GSH:GSSG ratio, SOD, and cognitive performance in the AE and TCE groups, the 12-week AE intervention led to a significant increase in CAT and GSH levels, along with a significantly decrease in UA levels among individuals with PD. Conversely, the TCE intervention resulted in a significant increase in GSH levels. However, SOD activity and MMSE scores were significantly decreased after 12 weeks in the control group. The correlations between changes in MMSE scores and changes in the levels of GSH and UA prior to and after the intervention reached significance in the AE group. Thus, long-term AE and TCE might serve as effective strategies for reducing oxidative damage and preserving cognitive function in PD, with AE exhibiting greater benefits compared with TCE. These findings hold potential clinical relevance as complementary measures to standard medical treatments and alternative therapies, such as antioxidant supplements and dietary adjustments, particularly for individuals in the early stages of PD.

“When hearing hoof beats from behind, expect horses, not zebras” – What flexibility research should adopt from scientific philosophy. A critical perspective on available evidence

The American College of Sports Medicine classifies flexibility as one out of 5 important health-related parameters that should be addressed in preventive and therapeutic training programs (Garber et al., 2011). Due to its importance in health and athletic performance development, there is an increasing number of studies to figure out flexibility training interventions as well as underlying mechanisms. While several exercise modalities are available, stretching and foam rolling (FR) are the most common training routines to improve range of motion (ROM). Interestingly, acute and chronic effects are mainly attributed to very similar mechanisms, more specifically, improved stretch tolerance and/or structural adaptations such as stiffness reductions in the muscle, the tendon, or the muscle-tendon complex (Takeuchi et al., 2023). Since stretching and FR seem to induce similar effect sizes in acute flexibility, authors suggested the replacement of static stretching to FR in movement preparation routines to avoid the stretch-induced force deficit, thus, impairments of subsequent strength related performance. Similarly, when discussing chronic flexibility routine effects, literature suggests task specificity. Therefore, increased ROM was attributed to specific stretch/foam rolling induced stiffness and passive peak torque changes. Unfortunately, statements developed from used research designs are incomprehensive. When referring to acute stretching of foam rolling effects that can be extracted from numerous systematic reviews, conclusions were drawn from comparisons to passive controls. This, however, does exclusively allow statements that stretching/FR was effective compared to doing nothing, however, does not exclude general warm-up effects, induced by muscle activity. Referring to William of Ockham (1287 – 1347), one popular philosopher from the United Kingdom, the most obvious explanatory approach would be the most likely one. In medicine diagnostics, this statement is metaphorically described as “when hearing hoof beats from behind, expect horses, not zebras”. Therefore, since both routines enhance temperature, the most likely explanation suggest acute ROM increases could rely on general warm-up effects instead of task-specific adaptations. Similarly, for chronic effects, literature suggests that ROM can be increased by several alternative interventions, e.g. full ROM resistance training, indicating shared mechanisms. Both interventions share underlying physiological mechanisms, such as inducing mechanical tension in high muscle lengths. Consequently, we extensively discussed available evidence in our published research. Key findings will be presented to challenge current paradigms (Warneke et al., 2024). References Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I.-M., Nieman, D. C., &amp; Swain, D. P. (2011). Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults. Medicine &amp; Science in Sports &amp; Exercise, 43(7), 1334–1359. https://doi.org/10.1249/MSS.0b013e318213fefb Takeuchi, K., Nakamura, M., Fukaya, T., Konrad, A., &amp; Mizuno, T. (2023). Acute and long-term effects of static stretching on muscle-tendon unit stiffness: A systematic review and meta-analysis. Journal of Sports Science and Medicine, 22, 465–475. https://doi.org/10.52082/jssm.2023.465 Warneke, K., Behm, D. G., Alizadeh, S., Hillebrecht, M., Konrad, A., &amp; Wirth, K. (2024). Discussing conflicting explanatory approaches in flexibility training under consideration of physiology - A narrative review. Sports Medicine, 54, 1785-1799. https://doi.org/10.1007/s40279-024-02043-y

Reverse periodization in ultratrail: The road to the 2023 World Mountain and Trail Running Championships of an elite female ultrarunner

Introduction and Purpose Traditionally, linear periodization has been widely applied to endurance training programs, whereas reverse periodization has been often used for shorter endurance events (Clemente-Suárez et al., 2015; Clemente-Suárez et al., 2018; Clemente-Suárez &amp; Ramos-Campo, 2019) and fitness (Prestes et al., 2009). The aim of this study was to describe the training characteristics of a Spanish high-level female ultrarunner in her preparation to the 2023 World Mountain and Trail Running Championships using a reverse linear periodization model. Methods Day-by-day data training of 1 study subject for 29 weeks (from November 2022 to June 2023) was retrospectively analyzed. Training form (endurance, strength or complementary sessions), intensity (low-, moderate-, and high-intensity training), intensity distribution, exercise endurance mode (cycling, elliptical, running or trail running) and specific exercise mode goal session (running uphill, running flat, running downhill, hiking or mixed) were considered. Specific sessions, key competitions, tapering, hypoxia period and periodization were also analyzed. Results An average training of 8 hr and 53 min per week, covering 87.2 km and 3,755 m of altitude gain, was completed. The hardest week consisted of 14 hr and 58 min, 145 km, and 7,552 m of altitude gain. Distribution percentage of the training form of total training time was ~60% of running, ~17% cross training (mainly road cycling) and ~11% of strength training. Intensity distribution varied considering specificity and characteristics of the main races, progressing from more polarized to pyramidal pattern distribution. Moreover, running volume increased during the preparation period and more specific sessions and with mixed specific exercise modes was realized close to the main races, with the longest trail run of 4 hr 18 min of duration. Training in hypoxia was also completed, and tapering started 12 days before the world championship. In addition to the World Championship, National Championship races were held during the preparation period, where a 4th and a 3rd place in the Marathon (February 2023) and Ultratrail (April 2023) National Championships, respectively, was achieved. Discussion Reverse periodization has been successfully implemented in an elite female ultrarunner, finishing 11th in the 2023 World Mountain and Trail Running Championships. Reverse periodization was planned and completed, mainly considering volume and tendency of distribution, going from a polarized pattern to a pyramidal one. Moreover, overall planning and key sessions progressed in specificity, developing more rolling-hill trail runs, longer trail runs, longer longest trail run of the week, and more specific exercise modes (i.e. more hiking and mixed sessions vs flats runs) along the macrocycle. Conclusion Training specificity in trail running, considering race intensity, exercise mode and race characteristics (i.e., elevation gain and distance) progressed during the macrocycle. Reverse periodization can be successfully implemented in ultratrail running by focusing on specific training and race demands, especially close to the main races.