High-intensity Strength Training Research Articles

An Exploratory Study on Whether the Interference Effect Occurs When High-Intensity Strength Training Is Performed Prior to High-Intensity Interval Aerobic Training

There is conflicting evidence on whether concurrent aerobic endurance and resistance training (RT) leads to synergistic enhancements in aerobic capacity and muscular strength or causes interference, limiting performance gains. We developed a concurrent training (CT) intervention, including full-body dynamic RT combined with high-intensity interval training (HIIT), on a cycle ergometer to determine whether a brief CT intervention is beneficial to both muscular strength and aerobic capacity. In an exploratory pilot study, participants (n = 10; male = 4) undertook a four-week CT intervention consisting of RT, including six compound movements (bench press, squat, deadlift, Pendley row, squat jumps, and rack pulls), plus cycle HIIT. The pre-/post-intervention improvements were assessed via bench press and leg press 3RM testing, an isometric mid-thigh pull, a countermovement jump, and the change in the relative V˙O2max. We observed significant (p < 0.1) increases in the bench press (6.4%), leg press (6.7%), IMTP (11.1%), and relative V˙O2max (7%) results. Interestingly, the participants with the highest pre-intervention relative V˙O2max demonstrated no performance improvements. These pilot test results suggest that CT is an effective strategy that enables synergistic enhancements that can be observed with very low training volumes. This suggests that CT is an effective strategy for improving muscular strength and aerobic endurance in non-elite physically active individuals.

Blood Flow Restriction Therapy After Anterior Cruciate Ligament Reconstruction

Anterior cruciate ligament reconstruction (ACLR) rehabilitation necessitates restoration of quadriceps strength to minimize reinjury and optimize return to sport (RTS). Patients recovering from ACLR are limited by pain and activity restrictions, resulting in quadriceps muscle atrophy. Blood flow restriction (BFR) therapy involves performing exercises while a specialized blood pressure cuff is applied to the proximal aspect of the operative extremity and inflated to 40% to 90% of the arterial occlusion pressure, as determined using Doppler ultrasonography. BFR is theorized to induce an anaerobic environment and metabolic stress during exercise, promoting muscle hypertrophy and strength gains. Although the physiological mechanism has not been fully elucidated, it is theorized that BFR combined with low-load resistance training could yield muscle adaptations comparable to those of high-load resistance training. For ACLR patients with pain and restrictions precluding high-intensity strength training, incorporation of BFR into postoperative rehabilitation protocols could help mitigate quadriceps weakness and promote RTS. Randomized controlled trials report a prolonged, dose-dependent relation between BFR use and quadriceps and hamstring strength gains, improved bone and muscle mass, and earlier RTS, whereas other studies report no significant difference in quadriceps size, strength, or patient satisfaction compared with controls. Furthermore, although generally considered safe, there are rare reports of associated adverse events such as rhabdomyolysis, and BFR should be avoided in patients with a history of thromboembolic disease or peripheral vasculopathy. The literature examining BFR after ACLR is heterogeneous; lacks standardization; and contains broad variation in reported cuff pressures, as well as timing and duration of BFR use, among protocols. Although the use of BFR after ACLR shows promise, further study is necessary to elucidate the efficacy, safety, and optimal protocols.

Effects of High-intensity Training and Electrical Stimulation on Pain, Disability, Knee Kinematic and Performance in Patellofemoral Pain: A Randomized Controlled Trial

Patellofemoral pain (PFP) is a widespread problem in athletes who participate in jumping, cutting, and pivoting sports. Forty-four players participated in this study. They were divided into two groups: exercise plus EMS (G1) and exercise without EMS (G2), both with 12 women and 10 men. The exercise performed was 8 weeks of a high-intensity strength program for 45-60 minutes, plus cooling and a warm-up phase. Visual analogue scale (VAS), disability (Kujala patellofemoral score), knee valgus angle (KVA) and single-leg hop (SLH) were tested before (pre-test) and after training (post-test at 8 weeks) using a within-between group analysis (ANOVA 2×2). At baseline, no differences between groups were found (p > 0.05). After the intervention, both groups improved VAS, KVA, SLH (p < 0.001), and disability (p = 0.042). G1 showed more improvements than G2 for VAS (- 63.4 vs - 51.5 %, p = 0.021, 𝜂p2 = 0.13), disability (+ 32.6 vs + 18.4 %, p = 0.001, 𝜂p2 = 0.52), KVA (+ 4.2 vs + 2.2 %, p = 0.016, 𝜂p2 = 0.214) and SLH (+ 12.3 vs + 6.0 %, p = 0.003, 𝜂p2 = 0.20) respectively. No differences were found between the sexes for each group. Despite both interventions being valid, high-intensity strength training combined with EMS improved pain, disability, knee kinematics, and lower extremity performance more than exercise alone in professional handball athletes with PFP. Keywords: Electrical muscle stimulation, Rehabilitation, Musculoskeletal, Knee, Handball players

Exercise in Chronic Kidney Disease Patients Does Not Significantly Alter Fibrosis in Quadriceps Muscle

Background: Chronic kidney disease (CKD) is commonly associated with decreased physical activity and muscle dysfunction. Muscles in CKD become fibrotic, containing excess extracellular matrix (ECM), particularly collagen. Collagen is cross-linked in the ECM, and increased cross-linking is often associated with fibrosis, stiffness, and reduced ECM remodeling. However, it is not known how exercise in patients with CKD may impact the extent of collagen cross-linking or fibrosis. Additionally, muscle fibrosis may impair muscle adaptations to exercise including, fiber size, fiber type, or vasculature. We predicted that collagen content and cross-linking would decrease, and there would be more Type I fibers and larger fiber size in the patients that were in the exercise group. Methods: Participants were randomized to exercise (n=15) or no exercise (n=5) groups in the Exercise Study Testing Enhanced Energetics of Mitochondria (ESTEEM) clinical trial of non-dialysis patients with CKD. The exercise program consisted of 35 min sessions, 3 times a week for 12 weeks consisting of high-intensity interval training, strength training, and power walking. Vastus lateralis biopsies were obtained before and after the 12 weeks of exercise. A bundle of muscle tissue was powdered and separated into a pepsin soluble and insoluble fraction before applying a hydroxyproline assay for collagen content, with the insoluble fraction representing more cross-linked collagen. For histological analysis 10 μm thick cryosections were stained with Picrosirius Red, or immunofluorescent stains to investigate satellite cells, vasculature, fibro-adipogenic progenitors (FAPs), and muscle fiber types. Picrosirius red sections were imaged under polarized light to look at birefringence as a measure of collagen density. Sections that were stained for fiber type and vasculature were analyzed using semi-automatic muscle analysis using segmentation of histology (SMASH). Results: The overall amount of collagen and collagen cross-linking were not altered in either the exercise or no exercise groups. Picrosirius red stained sections did not reveal a change in ECM area or collagen packing density with exercise. Surprisingly minimum ferret diameter and percentage of type I (slow twitch) fibers decreased in most patients that underwent the exercise program. Type I and type IIa (fast oxidative) fiber size also significantly decreased, while there was no change in type IIx (fast glycolytic) fiber size. Conclusion: This study shows that exercise does not dramatically reduce ECM content or muscle fibrosis in patients with CKD. Surprisingly, the response to exercise was opposite of that anticipated in healthy subject with exercise in CKD producing smaller muscle fibers and a shift away from more oxidative type I fibers. This shows that exercise may have limited capacity to enhance function in CKD muscle, potentially due to irreversible fibrosis. Work supported by mitochondrial bioenergetics in persons with chronic kidney disease (NIH R03DK114502). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Comparative efficacy and acceptability of different exercise patterns for reducing cardiovascular events in pre-diabetes: protocol for a systematic review and network meta-analysis of randomised controlled trials

IntroductionExercise has been used to reverse dysglycaemic states in patients with pre-diabetes. Systematic reviews show that exercise is an effective way to reduce the incidence of diabetes, but there is...

Acute Effects of Two Different Concurrent Training Models on Physiological Parameters, Explosive Strenght and Balance Performance in Soccer Players

In the study, the acute effects of two different concurrent training models including high intensity interval training (HIIT) and high intensity interval functional training (HIFT) plus strength training (S) on physiological indicators (lactate and heart rate) and performance (balance and explosive power) parameters were examined in soccer players. A total of 13 moderately active young soccer players (19.92; ±1.44 years) participated in the study. In the study, body composition measurements, heart rate, lactate, explosive strength measurement and balance testing were measured. Training models (S+HIIT-S+HIFT) were applied sequentially with a crossover design. The training sessions were conducted with a three-day interval. Parameters were analyzed with SPSS24 (SPSS Inc., Chicago, IL, USA). Repeated Measure Analysis of Variance (ANOVA) was used for repeated measures and Bonferroni Correction was used for pairwise comparisons. Significance level was accepted as p

FEASIBILITY OF HIGH-INTENSITY FUNCTIONAL STRENGTH TRAINING AT HOME FOR POSTINJURY OLDER ADULTS

Abstract Older adults who experience a slip, trip, or fall may experience preclinical mobility limitation (PCML), where individuals report modifications but not difficulty in mobility tasks and are at increased risk for future functional decline. Functional decline may be prevented with exercise. The purpose of this pilot trial was to determine the feasibility (adherence, recruitment, retention, safety) and preliminary outcomes (physical functioning, cognitive functioning, enjoyment) of home-based 12-week high-intensity functional strength training (HIFST) for community-dwelling older adults (≥ 55 years) with PCML who have had an injury from a slip, trip, or fall in the previous year. The trial is currently underway (target completion spring 2023). Participants are stratified by sex and randomized (1:1) to HIFST or a stretching program, both delivered by a physiotherapist via videoconferencing. Feasibility will be assessed based on predetermined criteria and reported using descriptive statistics. Preliminary effects will be reported as between group differences. To date, 20 participants (11 HIFST, 9 stretch) have enrolled (target n=24). Six participants have completed the HIFST intervention, and 2 have withdrawn before completion (reasons: mental health crisis and acute knee pain episode) with a total adherence rate of 85.8% of sessions completed (97.7% for the 6 participants who did not withdraw) which exceeds our threshold for feasibility (≥ 70%). No serious intervention-related adverse events have been reported. The results of this pilot will provide essential information for future research regarding the process, resources, and potential effects of home-based HIFST in a PCML post-injury older adult population.

ACCEPTABILITY OF HIGH-INTENSITY FUNCTIONAL STRENGTH TRAINING AT HOME FOR POSTINJURY OLDER ADULTS

Abstract Regular exercise plays a vital role in optimizing aging and preventing functional decline. Despite the recognized benefit of exercise, adherence is challenging, and acceptability of exercise interventions is crucial. Acceptability is influenced by various factors, including content, context, and delivery. The purpose of this qualitative descriptive study is to determine the acceptability to older adult participants of a home-based high-intensity functional strength training (HIFST) intervention delivered by a physiotherapist via videoconferencing. HIFST involves the use of periods of ‘hard’ effort using everyday strength-building movements alternating with ‘easy’ recovery periods. This study accompanies an ongoing pilot randomized controlled trial investigating the feasibility of HIFST (completion: spring 2023). We are conducting semi-structured interviews and a short anonymous survey with participants who have completed HIFST. Data collected is being analyzed using qualitative content analysis. To date, results from 8 participants (2 men, 6 women, 55-81 years) demonstrate a positive overall impression of HIFST with all participants noting enjoyment, a good experience, and/or meeting their expectations. Participants reported certain aspects less/more enjoyable than others (e.g., specific exercises). No technical difficulties have been noted and many participants appreciated the convenience of an online format. Prior knowledge of interval-based exercise was minimal for most participants and the majority commented on a preference for shorter intervals with shorter rest periods. Further data collection and analysis will provide a contextualized understanding of the HIFST intervention and important considerations for exercise prescription in an aging population.

Effect of Blood Flow-Restricted Strength Training on Body Composition: a Randomized Controlled Study of Patients with Metabolic Syndrome

INTRODUCTION. Low-intensity resistance training with blood flow restriction is an effective strategy for increasing muscle mass and strength, as well as reducing excess subcutaneous and visceral fat deposition. In recent years, this method has been used in various populations. The purpose of this study was to evaluate the effect of low-intensity resistance training with blood flow restriction on anthropometric parameters and body composition in men with metabolic syndrome.
 AIM. To evaluate the effect of low-intensity strength training with blood flow restriction on anthropometric indices and body composition in men with metabolic syndrome.
 MATERIALS AND METHODS. The study involved 60 untrained men (mean age 38.7 ± 5.6 years) who meet the criteria for metabolic syndrome due to health reasons. Participants were divided into three groups according to resistance training regimens: low-intensity resistance with blood flow restriction; high-intensity training; low-intensity training without blood flow restriction. Before and after 12 weeks of training, the groups were assessed for body mass index, fat mass, visceral fat area, musculoskeletal mass, waist circumference.
 RESULTS. There was a statistically significant decrease in fat mass, visceral fat area, waist circumference and an increase in musculoskeletal mass (p 0.05) in the groups of low-intensity strength training with blood flow restriction and high-intensity strength training. In the parameters of men belonging to the group of low-intensity strength training without blood flow restriction, no statistically significant changes were found (p 0.05).
 CONCLUSION. In summary, the study found that low-intensity resistance training with blood flow restriction effectively altered the body composition of men with metabolic syndrome.

Abstract 12093: Bi-Ventricular Cardiac Adaptations to 20 Weeks of High-Intensity Resistance Training in Healthy Untrained Men: A 3D Echocardiography Longitudinal Study

Introduction: The historical description of cardiac remodelling between strength and endurance athletes, made by Morganroth in the 1970s, has been challenged with the advancements in our understanding of the protective effect of Valsalva manoeuvres and the emergence of sophisticated imaging techniques for cardiac function assessment. Objective: We aimed to analyze the kinetics of muscular and cardiac responses to 20 weeks of high-intensity resistance training in healthy untrained volunteers. Methods: A total of 27 young and healthy men with an average age of 22.8±3.2 years participated in a 20-week strength training program. The training program intensity was guided by 1-Repetition Maximum (RM) testing. Before and after 12 and 20 weeks of training, participants were assessed using body composition analysis, electrocardiogram, 3D transthoracic echocardiography, cardiopulmonary exercise testing ( V O 2peak ), and muscle isokinetic dynamometry. Anova was utilized to analyse time effect. Results: Among the initial cohort, 22 subjects completed the study protocol. Arterial blood pressure significantly decreased at both time points. Isokinetic evaluation confirmed increases in maximal strength for quadriceps (Δ 0-20wk =+46.8Nm, P<0.001), hamstrings (Δ 0-20wk =+25.3Nm, P=0.025), triceps (Δ 0-20wk =+11.6Nm, P=0.005), and biceps (Δ 0-20wk =+9.2Nm, P=0.023). Regarding cardiac analysis, after 20 weeks of training 3D left ventricular (LV) mass increased (120.1±15.4 to 133.7±16.3 g, P=0.018), with an augmentation in both septal wall (6.1±1.1 to 7.2±1.4 mm, P=0.027) and posterior wall thickness (5.5±1.3 to 7.1±1.3 mm, P<0.001). 3D LV end-diastolic volume increased by 7.28% without reaching a significant difference. Right ventricular (RV) wall thickness also increased (3.33±0.73 to 3.89±0.8 mm, P=0.04), with a slight non-significant augmentation of 3D RV end-diastolic volume by 7.89%. No significant changes were found in LV and RV systolic or diastolic function. Conclusions: This study demonstrated that our 20-week high-intensity strength training program resulted in a rapid and significant increase in muscular strength. The cardiac response to strength training showed a moderate biventricular response like that of endurance athlete

Response to physical activity of females with multiple sclerosis throughout the menstrual cycle: a protocol for a randomised crossover trial (EMMA Project)

The relationship between multiple sclerosis (MS) and females is a crucial aspect in the development of the disease, with the ovarian hormonal cycle being a sensitive stage, especially in females...

Effects of a 20-Week High-Intensity Strength Training Program on Muscle Strength Gain and Cardiac Adaptation in Untrained Men: Preliminary Results of a Prospective Longitudinal Study.

As strength sports gain popularity, there is a growing need to explore the impact of sustained strength training on cardiac biventricular structure and function, an area that has received less attention compared to the well-established physiological cardiac adaptation to endurance training. This study aims to implement a 20-week high-intensity strength training program to enhance maximal muscle strength and evaluate its impact on cardiac biventricular adaptation in healthy, untrained men. A total of 27 healthy and untrained young men (mean age 22.8, SD 3.2 years) participated in a strength training program designed to increase muscle strength. The training program involved concentric, eccentric, and isometric exercise phases, conducted over a consecutive 20-week time frame with a frequency of 3 weekly training sessions. Participants were evaluated before and after 12 and 20 weeks of training through body composition analysis (bioelectrical impedance), a 12-lead resting electrocardiogram, 3D transthoracic echocardiography, cardiopulmonary exercise testing, and muscle isokinetic dynamometry. The progression of strength training loads was guided by 1-repetition maximum (RM) testing during the training program. Of the initial cohort, 22 participants completed the study protocol. No injuries were reported. The BMI (mean 69.8, SD 10.8 kg/m² vs mean 72, SD 11 kg/m²; P=.72) and the fat mass (mean 15.3%, SD 7.5% vs mean 16.5%, SD 7%; P=.87) remained unchanged after training. The strength training program led to significant gains in 1-RM exercise testing as early as 4 weeks into training for leg extension (mean 69.6, SD 17.7 kg vs mean 96.5, SD 31 kg; P<.001), leg curl (mean 43.2, SD 9.7 kg vs mean 52.8, SD 13.4 kg; P<.001), inclined press (mean 174.1, SD 41.1 kg vs mean 229.2, SD 50.4 kg; P<.001), butterfly (mean 26.3, SD 6.2 kg vs mean 32.5, SD 6.6 kg; P<.001), and curl biceps on desk (mean 22.9, SD 5.2 kg vs mean 29.6, SD 5.2 kg; P<.001). After 20 weeks, the 1-RM leg curl, bench press, pullover, butterfly, leg extension, curl biceps on desk, and inclined press showed significant mean percentage gains of +40%, +41.1%, +50.3%, +63.5%, +80.1%, +105%, and +106%, respectively (P<.001). Additionally, the isokinetic evaluation confirmed increases in maximal strength for the biceps (+9.2 Nm), triceps (+11.6 Nm), quadriceps (+46.8 Nm), and hamstrings (+25.3 Nm). In this paper, only the training and muscular aspects are presented; the cardiac analysis will be addressed separately. This study demonstrated that a short-term high-intensity strength training program was successful in achieving significant gains in muscle strength among previously untrained young men. We intend to use this protocol to gain a better understanding of the impact of high-intensity strength training on cardiac physiological remodeling, thereby providing new insights into the cardiac global response in strength athletes. ClinicalTrials.gov NCT04187170; https://clinicaltrials.gov/study/NCT04187170.

Acute upper and lower limb hemodynamic responses during single sessions of low- versus high-intensity inspiratory muscle strength training.

Inspiratory muscle strength training (IMST) has shown potential to improve both respiratory and cardiovascular function in health and disease. Less is known about acute hemodynamic responses to a single IMST session, therefore we assessed upper and lower limb blood flow via Doppler ultrasound in the brachial and popliteal arteries, respectively. Mean, anterograde, and retrograde blood flow (BF) and shear rate (SR) were assessed relative to baseline during low-intensity (15% maximal inspiratory pressure - PImax) and high-intensity (75% PImax) IMST. During low-intensity IMST, popliteal BF and SR were reduced by ∼10%, and brachial BF and SR were reduced by ∼40%. During high-intensity IMST, popliteal BF and SR were reduced by ∼20%, and brachial BF and SR were reduced by ∼35%. BF and SR responses were not statistically different between low-intensity and high-intensity training for either blood vessel (P > 0.05). In addition, anterograde BF and SR were significantly decreased in the brachial artery for both low-intensity and high-intensity training (P < 0.05), but not the popliteal artery (P > 0.05). Finally, during IMST retrograde BF and SR were significantly increased in both the upper and lower limbs during low-intensity and high-intensity training (P < 0.05). These data provide novel insight into the acute BF and SR responses to a single bout of IMST and may enhance our understanding of the mechanism(s) by which IMST imparts its beneficial chronic effects on cardiovascular function.NEW & NOTEWORTHY Herein, we demonstrate for the first time that upper and lower limb blood flow and shear rate patterns are altered during a single bout of IMST, at low- and high-intensity training. Specifically, anterograde blood flow and shear rate are significantly reduced in the brachial artery, whereas retrograde blood flow is significantly elevated in both the brachial and popliteal arteries. These findings provide insight into the vascular impact of IMST, which may inform future mechanistic studies.

Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty

BackgroundTo investigate the effect of preoperative high-intensity strength training combined with balance training on the knee function of end-stage knee osteoarthritis (KOA) patients after total knee arthroplasty (TKA).MethodsA prospective study was conducted on end-stage KOA patients awaiting TKA. The patients were divided into an experimental group and a control group according to whether they received a preoperative training intervention. The differences in knee flexor–extensor strength, knee range of motion (ROM), timed up and go (TUG) test result, stair ascend/descend test result, Knee Society score (KSS) and Berg balance scale (BBS) score were assessed in both groups at baseline (T1), before operation (T2), 3 months after operation (T3), and 1 year after operation (T4).ResultsAfter high-intensity strength training and balance training, the knee flexor–extensor strength, TUG test result, stair ascend/descend test result, and KSS were all significantly improved at T2 in the experimental group over the control group. At T3, the knee ROM, knee flexor–extensor strength, TUG test result, BBS score, and KSS clinical and functional scores were all significantly superior in the experimental group. The experimental group enjoyed a superiority in KSS clinical and functional scores until T4. Group × time and between-group interactions were found in all assessment indicators in both groups (p < 0.01).ConclusionPreoperative high-intensity strength training combined with balance training can enhance the knee flexor–extensor strength and balance of patients with end-stage KOA in the short term and help improve early outcomes after KOA.Trial registration ChiCTR2000032857, 2020-05-13.

The impact of high intensity interval training in a diverse group of cancer survivors: CAPABLE, a pilot study

PurposeGiven the well-documented benefits of regular exercise to cancer survivors, current American Cancer Society guidelines recommend that patients engage in a minimum of 150 min per week of moderate-to-vigorous physical activity with a minimum of two days of strength training. However, few survivors meet this goal, particularly among minorities. MethodsThe CAPABLE study is a single-arm, pilot exercise intervention that introduced 48 cancer survivors to a high intensity interval and strength training program three days a week for 12 weeks. We evaluated the impact of this unique training method on bodyweight, % body fat, serum markers correlated with an adverse cardiometabolic profile and health-related quality of life (HRQoL). Measures were summarized at baseline and program exit. Paired t-tests were used to assess change in each of these measures over time. ResultsWe observed losses in weight, body mass index, and % body fat, and glycosylated hemoglobin (HbA1c) levels over 12-weeks. There were also clinically meaningful improvements in reported overall HRQoL (FACTG total change +9.5 (95% CI, 4.6, 14.4)) and in each one of the individual domains (physical, social, emotional, and functional well-being). ConclusionsWe observed meaningful improvements in body composition, HbA1c and quality of life over 12 weeks among cancer survivors participating in a high-intensity interval training program. Future work will include a control arm for comparison and address barriers to participation and adherence which will be important in using this intervention and others like it to improve outcomes and reduce cancer health disparities.

Effectiveness of long-term physical rehabilitation to improve balance and locomotion in older people with Parkinson's disease

Walking and balance alterations are critical to address in older adults living with Parkinson's Disease (PD). These alterations negatively impact activities of daily life, decrease the quality of life and increase the risk of falls. Objective: Analyse the effectiveness of different long-term exercise interventions to improve walking and balance parameters in people aged over 60 years with PD. Methods: Experimental studies from the last 10 years collected from 5 databases (PEDro, PubMed, WOS and EBSCO) were analysed. PEDro scale was used to analyse the quality of the studies, and the result shown in the studies was contrasted with the minimal detectable change (MDC). Results: From 413 studies, a total of 7 RCTs and 2 pilot studies were included in the analysis. The range of age was 65.8 ± 10.7 and 73.59 ± 7.93 years. The duration of the disease was 5 to 15 years. The methodological quality ranged from "good" to "excellent". Conclusions: More significant clinical effect in PD population was obtained after interventions that included: high-intensity strength training, progressive increase of resistance, aerobic exercise, and walking and balance training.

Effects of Combined Training Programs in Individuals with Fibromyalgia: A Systematic Review.

Fibromyalgia is a rheumatic disease characterised by chronic widespread muscular pain and its treatment is carried out by pharmacological interventions. Physical exercise and a healthy lifestyle act as an important mechanism in reducing the symptoms of the disease. The aims of this study were to analyse and systematise the characteristics of combined training programs (i.e., type and duration of interventions, weekly frequency, duration and structure of training sessions and prescribed intensities) and to analyse their effects on people diagnosed with fibromyalgia. A systematic literature search was performed using the PRISMA method and then randomised controlled trial articles that met the eligibility criteria were selected. The Physiotherapy Evidence Database scale was used to assess the quality and risk of the studies. A total of 230 articles were selected, and in the end, 13 articles met the defined criteria. The results showed different exercise interventions such as: combined training, high-intensity interval training, Tai Chi, aerobic exercise, body balance and strength training. In general, the different interventions were beneficial for decreasing physical symptoms and improving physical fitness and functional capacity. In conclusion, a minimum duration of 14 weeks is recommended for better benefits. Moreover, combined training programs were the most effective for this population, in order to reduce the symptoms of the disease with a duration between 60 and 90 min, three times a week with a light to moderate intensity.

The effect of blood flow restriction training combined with electrical muscle stimulation on neuromuscular adaptation: a randomized controlled trial.

Objective: Low-intensity resistance training (≤25% 1RM) combined with blood flow restriction training (BFRT) is beneficial to increasing muscle mass and muscle strength, but it cannot produce increased muscle activation and neuromuscular adaptation, as traditional high-intensity strength training does. The purpose of this study is to investigate the effects of independently applying BFRT and electrical muscle stimulation (EMS), as well as combining the two methods, on muscle function. Methods: Forty healthy participants with irregular exercise experiences were randomly assigned to four groups: BFRT-alone group (BFRT, n = 10), EMS-alone group (EMS, n = 10), BFRT combined with EMS group (CMB, n = 10), and the control group (CTR, n = 10). All participants received low-intensity squat training at a load of 25% 1RM 5 times/week for 6weeks. Cross-sectional area (CSA) and electromyographic root mean square (RMS) in the rectus femoris, as well as peak torque (PT) of the knee extensor, were measured before and following a 6-week intervention. Results: Following the 6-week intervention, the increases in muscle activation in the CMB group were statistically higher than those in the BFRT group (p < 0.001), but not different from those in the EMS group (p = 0.986). Conclusion: These data suggest that the combination of BFRT and EMS for low-intensity squat training improved the muscle strength of the lower limbs by promoting muscle hypertrophy and improving muscle activation, likely because such a combination compensates for the limitations and deficiencies of the two intervention methods when applied alone.

Obesity prevalence, physical activity, and dietary practices among adults in Saudi Arabia.

The current study evaluated obesity prevalence, physical activity, and dietary practices among Saudi adults in the Makkah region of the Kingdom of Saudi Arabia (KSA). The current survey was accomplished between November 2021 and March 2022. A validated questionnaire, Arab Teens Lifestyle Study (ATLS), was used to evaluate all participants' physical activities, sedentary behaviors, and nutritional habits in addition to demographic data. A total of 2,115 people [1,238 (58.5%) women and 877 (41.5%) men] participated in this survey. Being overweight was prevalent in 32.8% of the population (41% of men and 28.9% of women), obesity was prevalent in 23% of the population (males 23.1% and females 24.2%). Obese people consumed more soft drinks, and overweight people did not consume enough vegetables (fresh/cooked). Obese people consumed fast food (e.g., burgers, sausage, pizza, or Arabic shawarma) over three times each week. The mean (SD) number of days of practice walking was 2.51 (2.05) vs. 1.3 (1.87) (p < 0.001) for lean and obese individuals, respectively. In addition, individuals with normal BMI had more days of jogging, moderate and high-intensity exercise, dancing, and strength training than those with obesity. The odds of being obese increased with age (OR: 1.07; p < 0.001), in males (OR: 2.16; p < 0.001), in participants earning <5,000 SR/month (1.3 thousand $) and 10-15 thousand SR/month (1.34-2.66 thousand $) (OR: 2.36; P = 0.01). Obesity was inversely associated with moderate-intensity exercise (OR: 0.802; p = 0.009), and regular walking (OR: 0.685; CI: 0.624-0.752; p < 0.001). Overweight and obesity were prevalent in 32.8% and 23% of the population, respectively. Sociodemographic factors associated with obesity. Focused intervention strategies are needed to overcome the obesity issue.

The Predictive Ability of Total Genotype Score and Serum Metabolite Markers in Power-Based Sports Performance Following Different Strength Training Intensities — A Pilot Study

Muscular power is one of the factors that contribute to an athlete’s performance. This study aimed to explore the predictive ability of total genotype score (TGS) and serum metabolite markers in power-based sports performance following different strength training (ST) intensities. We recruited 15 novice male field hockey players (age = 16.27 ± .12 years old, body mass index = 22.57 ± 2.21 kg/m2) and allocated them to; high-intensity strength training (HIST, n=5), moderate intensity strength (MIST, n=5), and control group (C, n=5). Both training groups completed an eight-week ST intervention. Pre- and post-training muscular power (vertical jump) was measured. The participants were genotyped for; ACE (rs1799752), ACTN3 (rs1815739), ADRB3 (rs4994), AGT (rs699), BDKRB2 (rs1799722), PPARA (rs4253778), PPARGC1A (rs8192678), TRHR (rs7832552), and VEGF (rs1870377). TGS was calculated to annotate for strength-power (STP) and endurance (END) qualities. Subsequently, serum metabolomics analysis was conducted using Liquid chromatography-mass spectrometry Quadrupole-Time-of-Flight (LC-MS QTOF) to profile differentially expressed metabolite changes induced by training. Multiple regression analysis was conducted to explore the ability of TGS and differentially expressed metabolite markers to predict muscular power changes following the intervention. Multiple Regression revealed that only TGS STP might be a significant predictor of muscular power changes following MIST (adjusted R2=.906, p&lt;.05). Additionally, ST also resulted in significant muscular power improvement (p&lt;.05) and perturbation of the sphingolipid metabolism pathway (p&lt;.05). Therefore, selected gene variants may influence muscular power. Therefore, STP TGS might be able to predict muscular power changes following MIST.