High-load Resistance Exercise Research Articles

Blood flow restriction Exercise in the perioperative setting to Prevent loss of muscle mass in patients with pancreatic, biliary tract, and liver cancer: study protocol for the PREV-Ex randomized controlled trial

BackgroundPatients diagnosed with pancreatic, biliary tract, and liver cancer often suffer from a progressive loss of muscle mass. Given the considerable functional impairments in these patients, high musculoskeletal weight loads may not be well tolerated by all individuals. The use of blood-flow restricted resistance training (BFR-T) which only requires low training loads may allow for a faster recovery of muscle due to avoidance of high levels of mechanical muscle stress associated with high-load resistance exercise. This study aims to investigate whether BFR-T can prevent or slow down the loss of skeletal muscle mass and enhance the functional capacity and mental health of patients with pancreatic, biliary tract, and liver cancer.MethodsThe PREV-Ex exercise trial is a multicenter two-armed randomized controlled trial. Patients will be randomized to an exercise program consisting of home-based low-load BFR-T during a combined pre- and postoperative period for a total of 6–10 weeks (prehabilitation and rehabilitation), or to a control group. Protein supplementation will be given to both groups to ensure adequate protein intake. The primary outcomes, skeletal muscle thickness and muscle cross-sectional area, will be assessed by ultrasound. Secondary outcomes include the following: (i) muscle catabolism-related and inflammatory bio-markers (molecular characteristics will be assessed from a vastus lateralis biopsy and blood samples will be obtained from a sub-sample of patients); (ii) patient-reported outcome measures (self-reported fatigue, health-related quality of life, and nutritional status will be assessed through validated questionnaires); (iii) physical fitness/performance/activity (validated tests will be used to evaluate physical function, cardiorespiratory fitness and maximal isometric muscle strength. Physical activity and sedentary behavior (assessed using an activity monitor); (iv) clinical outcomes: hospitalization rates and blood status will be recorded from the patients’ medical records; (v) explorative outcomes of patients’ experience of the exercise program which will be evaluated using focus group/individual interviews.DiscussionIt is worthwhile to investigate new strategies that have the potential to counteract the deterioration of skeletal muscle mass, muscle function, strength, and physical function, all of which have debilitating consequences for patients with pancreatic, biliary tract, and liver cancer. The expected findings could improve prognosis, help patients stay independent for longer, and possibly reduce treatment-related costs.Trial registrationClinicalTrials.gov NCT05044065. Registered on September 14, 2021.

Low-Load and High-Load Resistance Exercise Completed to Volitional Fatigue Induce Increases in Postexercise Metabolic Responses With More Prolonged Responses With the Low-Load Protocol.

Grisebach, D, Bornath, DPD, McCarthy, SF, Jarosz, C, and Hazell, TJ. Low-load and high-load resistance exercise completed to volitional fatigue induce increases in post-exercise metabolic responses with more prolonged responses with the low-load protocol. J Strength Cond Res XX(X): 000-000, 2024-Comparisons of high-load with low-load resistance training (RT) exercise have demonstrated no differences in postexercise metabolism when volume is matched. This important limitation of matching or equating volume diminishes benefits of the low-load RT protocol. Therefore, the purpose of this study was to determine the effects of acute low-load high volume and high-load low volume RT protocols completed to volitional fatigue on postexercise metabolism. Eleven recreationally active resistance-trained male subjects (24 ± 2 years; BMI: 25.3 ± 1.5 kg·m-2) completed 3 experimental sessions: (a) no-exercise control (CTRL); (b) RT at 30% 1 repetition maximum (1RM; 30% 1RM); and (c) RT at 90% 1RM (90% 1RM) with oxygen consumption (V̇o2) measurements 2 hours postexercise. The RT sessions consisted of 3 sets of back squats, bench press, straight-leg deadlift, military press, and bent-over rows to volitional fatigue completed sequentially with 90 seconds of rest between sets and exercises. Changes were considered important if p < 0.100 with a ≥medium effect size. V̇o2 1 hour postexercise was elevated following 30% 1RM (25%; p = 0.003, d = 1.40) and 90% 1RM (14%; p = 0.010, d = 1.15) vs. CTRL and remained elevated 2 hours postexercise following 30% 1RM (16%; p = 0.010, d = 1.15) vs. CTRL. Total O2 consumed postexercise increased following 30% 1RM and 90% 1RM (∼17%; p < 0.044, d > 0.91) vs. CTRL. Fat oxidation was elevated 1 hour postexercise following 30% 1RM and 90% 1RM (∼155%; p < 0.001, d > 2.97) and remained elevated 2 hours postexercise following 30% 1RM compared with CTRL and 90% 1RM (∼69%; p < 0.030, d > 1.03). These data demonstrate beneficial changes to postexercise metabolism following high- and low-load RT sessions, with more prolonged effects following the low-load RT protocol completed to volitional fatigue.

Acute hypoalgesic, neurophysiological and perceptual responses to low-load blood flow restriction exercise and high-load resistance exercise.

This study compared the acute hypoalgesic and neurophysiological responses to low-load resistance exercise with and without blood flow restriction (BFR), and free-flow, high-load exercise. Participants performed four experimental conditions where they completed baseline measures of pain pressure threshold (PPT), maximum voluntary force (MVF) with peripheral nerve stimulation to determine central and peripheral fatigue. Corticospinal excitability (CSE), corticospinal inhibition and short interval intracortical inhibition (SICI) were estimated with transcranial magnetic stimulation. Participants then performed low-load leg press exercise at 30% of one-repetition maximum (LL); low-load leg press with BFR at 40% (BFR40) or 80% (BFR80) of limb occlusion pressure; or high-load leg press of four sets of 10 repetitions at 70% one-repetition maximum (HL). Measurements were repeated at 5, 45min and 24h post-exercise. There were no differences in CSE or SICI between conditions (all P>0.05); however, corticospinal inhibition was reduced to a greater extent (11%-14%) in all low-load conditions compared to HL (P<0.005). PPTs were 12%-16% greater at 5min post-exercise in BFR40, BFR80 and HL compared to LL (P≤0.016). Neuromuscular fatigue displayed no clear difference in the magnitude or time course between conditions (all P>0.05). In summary, low-load BFR resistance exercise does not induce different acute neurophysiological responses to low-load, free-flow exercise but it does promote a greater degree of hypoalgesia and reduces corticospinal inhibition more than high-load exercise, making it a useful rehabilitation tool. The changes in neurophysiology following exercise were not related to changes in PPT.

Effects of low-load blood flow restriction on the venous system in comparison to traditional low-load and high-load exercises.

Purpose: Blood-Flow-Restriction (BFR) training provides the ability to achieve hypertrophy effects even though only light mechanical loads are applied. However, its impact on venous pressures and function are still unknown. Therefore, the present study investigates the influence of BFR-training on intravascular venous pressure and venous function in comparison to control exercises with low or high mechanical loads. Methods: In a randomized cross-over design, ten healthy men (27.6 ± 6.4 years) underwent three trials of unilateral knee-extensor exercise with three different training protocols, low-load- (LL-RT, 30% of the individual 1-repetition-maximum, 1RM), low-load BFR- (LL-BFR-RT, 30% 1RM, 50% limb occlusion pressure, LOP) and high-load resistance exercise (HL-RT, 75% 1RM). Exercise protocols contain about four sets of knee extension exercise (Range-of-Motion: 0-0-95°), separated by 60s of rest. Each set was performed until volitional muscle failure. For analysis of changes in intravascular venous pressures and venous function, a venous catheter was placed at the exercising leg before each trial. Whereas venous pressures were recorded throughout the exercise trials, phlebodynamometric investigations were performed before and after each trial. Furthermore, subjective pain perception during and after exercise was accessed by visual analogue scale. One-way ANOVA was used to assess mean differences between training protocols, while two-way repeated-measures ANOVA (rANOVA; time x condition) was performed to compare changes in measures over time among conditions. Data were given as means ± standard deviation (SD). Results: In comparison to the exercise trials without venous occlusion, total workload was significantly lower in the LL-BFR-RT (LL-RT: 1745 ± 604kg vs LL-BFR-RT: 1274 ± 237kg vs HL-RT: 1847 ± 367kg, p = 0.004) without indicating statistical differences in venous pressures during the exercise sets (interaction: p = 0.140) or pain perception (interaction: p = 0.574). Similarly, phlebodynamometric assessment of venous function (e.g. refill-time of the venous system pre-vs. post exercise trials-LL-RT: 29.7 ± 11.0s vs 25.5 ± 9.6s, LL-BFR-RT: 26.6 ± 13.0s vs 27.3 ± 13.8s, HL-RT: 25.9 ± 10.9s vs 23.1 ± 8.2s) revealed no time (p = 0.156), condition effect (p = 0.802) or their interactions (p = 0.382). Conclusion: The present study is the first one describing the acute effects of LL-BFR-RT to muscle failure on venous pressures and function in comparison to a LL- and HL-RT in the lower limbs. In contrast to the existing literature, LL-BFR-RT does not elevate the venous pressures during exercise higher than a comparative exercise without BFR and does not show any adverse effects on venous function after the exercise.

An Updated Panorama of Blood-Flow-Restriction Methods.

Exercise with blood-flow restriction (BFR) is being increasingly used by practitioners working with athletic and clinical populations alike. Most early research combined BFR with low-load resistance training andconsistently reported increased muscle size and strength without requiring the heavier loads that are traditionally used for unrestricted resistance training. However, this field has evolved with several different active and passive BFR methods emerging in recent research. This commentary aims to synthesize the evolving BFR methods for cohorts ranging from healthy athletes to clinical or load-compromised populations. In addition, real-world considerations for practitioners are highlighted, along with areas requiring further research. The BFR literature now incorporates several active and passive methods, reflecting a growing implementation of BFR in sport and allied health fields. In addition to low-load resistance training, BFR is being combined with high-load resistance exercise, aerobic and anaerobic energy systems training of varying intensities, and sport-specific activities. BFR is also being applied passively in the absence of physical activity during periods of muscle disuse or rehabilitation or prior to exercise as a preconditioning or performance-enhancement technique. These various methods have been reported to improve muscular development; cardiorespiratory fitness; functional capacities; tendon, bone, andvascular adaptations; and physical and sport-specific performance and to reduce pain sensations. However, in emerging BFR fields, many unanswered questions remain to refine best practice.

Acute effect of low-load resistance exercise with blood flow restriction on oxidative stress biomarkers: A systematic review and meta-analysis.

The purpose of this review was to analyze the acute effects of low-load resistance exercise with blood flow restriction (LLE-BFR) on oxidative stress markers in healthy individuals in comparison with LLE or high-load resistance exercise (HLRE) without BFR. A systematic review was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. These searches were performed in CENTRAL, SPORTDiscus, EMBASE, PubMed, CINAHL and Virtual Health Library- VHL, which includes Lilacs, Medline and SciELO. The risk of bias and quality of evidence were assessed through the PEDro scale and GRADE system, respectively. Thirteen randomized clinical trials were included in this review (total n = 158 subjects). Results showed lower post-exercise damage to lipids (SMD = -0.95 CI 95%: -1.49 to -0. 40, I2 = 0%, p = 0.0007), proteins (SMD = -1.39 CI 95%: -2.11 to -0.68, I2 = 51%, p = 0.0001) and redox imbalance (SMD = -0.96 CI 95%: -1.65 to -0.28, I2 = 0%, p = 0.006) in favor of LLRE-BFR compared to HLRE. HLRE presents higher post-exercise superoxide dismutase activity but in the other biomarkers and time points, no significant differences between conditions were observed. For LLRE-BFR and LLRE, we found no difference between the comparisons performed at any time point. Based on the available evidence from randomized trials, providing very low or low certainty of evidence, this review demonstrates that LLRE-BFR promotes less oxidative stress when compared to HLRE but no difference in levels of oxidative damage biomarkers and endogenous antioxidants between LLRE. Register number: PROSPERO number: CRD42020183204.

Exercised-Induced Hypoalgesia following An Elbow Flexion Low-Load Resistance Exercise with Blood Flow Restriction: A Sham-Controlled Randomized Trial in Healthy Adults.

We aimed to evaluate the hypoalgesic effect of an elbow flexion low-load resistance exercise with blood flow restriction (LLRE-BFR) when compared to high-load resistance exercise (HLRE) with sham-BFR in healthy individuals. Forty healthy young adults (17 women), with a mean age ± SD: 26.6 ± 6.8 years, and mean body mass index ± SD: 23.6 ± 2.7 were randomly assigned to either an LLRE-BFR (30% 1 repetition maximum, RM) or an HLRE with sham-BFR group (70% of 1 RM). Blood pressure and pressure pain thresholds (PPTs) were measured pre- and post-exercise intervention. The rating of perceived exertion (RPE) was recorded after each set. There were non-significant between-group changes in PPT at the dominant biceps (-0.61, 95%CI: -1.92 to 0.68) with statistically significant reductions between pre- and post-exercise in LLRE-BFR (effect size, d = 0.88) and HLRE-BFR (effect size, d = 0.52). No within- or between-group differences were recorded in PPT at non-exercising sites of measurement. No mediating effects of changes in blood pressure or RPE on the changes in pressure pain threshold were observed. LLRE-BFR produced a similar hypoalgesic effect locally compared to HLRE and can be used as an alternative intervention to decrease pain sensitivity when HLRE is contraindicated or should be avoided.

Resistance Exercise-Induced Increases in Muscle Myostatin mRNA and Protein Expression Are Subsequently Decreased in Circulation in the Presence of Increased Levels of the Extracellular Matrix Stabilizing Protein Decorin.

Resistance exercise (RE) activates cell signaling pathways associated with myostatin. Decorin is located in the extracellular matrix (ECM) and can block the inhibitory effect of myostatin. This study sought to determine the impact of low-load (LL) and high-load (HL) RE on myostatin mRNA and protein expression along with changes in muscle decorin and circulating follistatin. Ten resistance-trained men performed a LL (50% 1RM) and HL (80% 1RM) RE session using the angled leg press and leg extension with load and volume equated. Venous blood samples and muscle biopsies were obtained prior to and at 3h and 24h following each RE session. Muscle myostatin mRNA expression was increased at 24h post-exercise (p = 0.032) in LL and at 3h (p = 0.044) and 24h (p = 0.003) post-exercise in HL. Muscle decorin was increased at 24h post-exercise (p < 0.001) in LL and HL; however, muscle myostatin was increased at 24h post-exercise (p < 0.001) only in HL. For muscle Smad 2/3, no significant differences were observed (p > 0.05). Serum follistatin was increased and myostatin decreased at 24h post-exercise (p < 0.001) in LL and HL. Muscle myostatin gene and protein expression increased in response to HL RE. However, serum myostatin was decreased in the presence of increases in decorin in muscle and follistatin in circulation. Therefore, our data suggest a possible mechanism may exist where decorin within the ECM is able to bind to, and decrease, myostatin that might otherwise enter the circulation for activin IIB (ACTIIB) receptor binding and subsequent canonical signaling through Smad 2/3.

Acute Effect of Resistance Training With Blood Flow Restriction on Perceptual Responses: A Systematic Review and Meta-Analysis.

Several studies have compared perceptual responses between resistance exercise with blood flow restriction and traditional resistance exercise (non-BFR). However, the results were contradictory. To analyze the effect of RE+BFR versus non-BFR resistance exercise [low-load resistance exercise (LL-RE) or high-load resistance exercise (HL-RE)] on perceptual responses. CINAHL, Cochrane Library, PubMed®, Scopus, SPORTDiscus, and Web of Science were searched through August 28, 2021, and again on August 25, 2022. Studies comparing the effect of RE+BFR versus non-BFR resistance exercise on rate of perceived exertion (RPE) and muscle pain/discomfort were considered. Meta-analyses were conducted using the random effects model. Systematic review and meta-analysis. Level 2. All data were reviewed and extracted independently by 2 reviewers. Disagreements were resolved by a third reviewer. Thirty studies were included in this review. In a fixed repetition scheme, the RPE [standardized mean difference (SMD) = 1.04; P < 0.01] and discomfort (SMD = 1.10; P < 0.01) were higher in RE+BFR than in non-BFR LL-RE, but similar in sets to voluntary failure. There were no significant differences in RPE in the comparisons between RE+BFR and non-BFR HL-RE; after sensitivity analyses, it was found that the RPE was higher in non-BFR HL-RE in a fixed repetition scheme. In sets to voluntary failure, discomfort was higher in RE+BFR versus non-BFR HL-RE (SMD = 0.95; P < 0. 01); however, in a fixed scheme, the results were similar. In sets to voluntary failure, RPE is similar between RE+BFR and non-BFR exercise. In fixed repetition schemes, RE+BFR seems to promote higher RPE than non-BFR LL-RE and less than HL-RE. In sets to failure, discomfort appears to be similar between LL-RE with and without BFR; however, RE+BFR appears to promote greater discomfort than HL-RE. In fixed repetition schemes, the discomfort appears to be no different between RE+BFR and HL-RE, but is lower in non-BFR LL-RE.

Acute effects of low load resistance training with blood flow restriction on serum growth hormone, insulin-like growth factor-1, and testosterone in patients with mild to moderate unilateral knee osteoarthritis

ObjectiveTo investigate the acute effects of blood flow restriction (BFR) with single-leg low load resistance exercise and high load resistance exercise on serum insulin-like growth factor-1 (IGF-1), growth hormone (GH), and testosterone in patients with unilateral knee osteoarthritis (OA). MethodsThis study recruited 18 postmenopausal female patients with mild to moderate unilateral knee OA, which was then followed by randomly conducting three resistance exercise protocols by drawing lots: 1. A 30% 1-repetition maximum (1-RM) resistance exercise with BFR of 70% arterial occlusive pressure (AOP) (BFR group); 2. A 70% 1-RM resistance exercise without BFR (RES group); 3. A 30% 1-RM resistance exercise without BFR (CON group). Blood lactate (BLA) and muscle growth related hormone levels were tested at 4-time points: before exercise, immediately after exercise, 15 min after exercise, and 30 min after exercise. ResultsThere was no statistical difference between the indexes in each group before exercise, but the different exercise had different effects on each index and also an interactive effect (P < 0.05). The increase of rating of perceived exertion in the BFR and RES groups, which were of similar magnitude, was greater compared to the levels in the CON group (P < 0.05). Post-exercise BLA levels were lower in the CON group in comparison to the BFR and RES groups (P < 0.05). Rather than the RES group, GH levels of the BFR group were also significantly higher than the CON group (P < 0.05) at 15 min post-exercise. At post- and 15 min after exercise, the CON group recorded significantly lower IGF-1 levels compared to the BFR and RES groups (P < 0.05). At post- and 15 min after exercise, the CON group (P < 0.05) reflected the lowest testosterone levels, followed by the RES group (P < 0.05), and the highest in the BFR group (P < 0.05). ConclusionsMyogenesis-related hormones in women with unilateral knee OA could be increased by high load resistance exercise and low load resistance exercise with BFR on unaffected limb.

Blood-Flow-Restriction-Training-Induced Hormonal Response is not Associated with Gains in Muscle Size and Strength.

The aim of this study was to determine whether increases in post-exercise endocrine response to low-load resistance exercise with blood flow restriction and high-load resistance exercise would have association with increases in muscle size and strength after an 8-week training period. Twenty-nine untrained men were randomly allocated into three groups: low-load resistance exercise with (LL-BFR) or without blood flow restriction (LL), and high-load resistance exercise (HL). Participants from LL-BFR and LL groups performed leg extension exercise at 20% of one repetition maximum (1RM), four sets of 15 repetitions and the HL group performed four sets of eight repetitions at 80% 1RM. Before the first training session, growth hormone (GH), insulin-like growth factor 1 (IGF-1), testosterone, cortisol, and lactate concentration were measured at rest and 15 min after the exercise. Quadriceps CSA and 1RM knee extension were assessed at baseline and after an 8-week training period. GH increased 15 min after exercise in the LL-BFR (p = 0.032) and HL (p < 0.001) groups, with GH concentration in the HL group being higher than in the LL group (p = 0.010). There was a time effect for a decrease in testosterone (p = 0.042) and an increase in cortisol (p = 0.005), while IGF-1 remained unchanged (p = 0.346). Both muscle size and strength were increased after training in LL-BFR and HL groups, however, these changes were not associated with the acute post-exercise hormone levels (p > 0.05). Our data suggest that other mechanisms than the acute post-exercise increase in systemic hormones induced by LL-BFR and HL produce changes in muscle size and strength.

Acute hemodynamic responses from low-load resistance exercise with blood flow restriction in young and older individuals: A systematic review and meta-analysis of cross-over trials.

To summarize the existing evidence on the acute response of low-load (LL) resistance exercise (RE) with blood flow restriction (BFR) on hemodynamic parameters. MEDLINE (via PubMed), EMBASE (via Scopus), SPORTDiscus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Scienceand MedRxiv databases were searched from inception to February 2022. Cross-over trials investigating the acute effect of LLRE + BFR versus passive (no exercise) and active control methods (LLRE or HLRE) on heart rate (HR), systolic (SBP), diastolic (DBP)and mean (MBP) blood pressure responses. The quality of the studies was assessed using the PEDro scale, risk of bias using the RoB 2.0 tool for cross-over trialsand certainty of the evidence using the GRADE method. A total of 15 randomized cross-over studies with 466 participants were eligible for analyses. Our data showed that LLRE + BFR increases all hemodynamic parameters compared to passive control, but not compared to conventional resistance exercise. Subgroup analysis did not demonstrate any differences between LLRE + BFR and low- (LL) or high-load (HL) resistance exercise protocols. Studies including younger volunteers presented higher chronotropic responses (HR) than those with older volunteers. Despite causing notable hemodynamic responses compared to no exercise, the short-term LLresistance exercise with BFR modulates all hemodynamic parameters HR, SBP, DBPand MBP, similarly to a conventional resistance exercise protocol, whether at low or high-intensity. The chronotropic response is slightly higher in younger healthy individuals despite the similarity regarding pressure parameters.

How does multi-set high-load resistance exercise impact neuromuscular function in normoxia and hypoxia?

ABSTRACT This study examined whether hypoxia during multi-set, high-load resistance exercise alters neuromuscular responses. Using a single-blinded (participants), randomised crossover design, eight resistance-trained males completed five sets of five repetitions of bench press at 80% of one repetition maximum in moderate normobaric hypoxia (inspiratory oxygen fraction = 0.145) and normoxia. Maximal isometric bench press trials were performed following the warm-up, after 10 min of altitude priming and 5 min post-session (outside, inside and outside the chamber, respectively). Force during pre-/post-session maximal voluntary isometric contractions and bar velocity during exercise sets were measured along with surface electromyographic (EMG) activity of the pectoralis major, anterior deltoid and lateral and medial triceps muscles. Two-way repeated measures ANOVA (condition×time) were used. A significant time effect (p = 0.048) was found for mean bar velocity, independent of condition (p = 0.423). During sets of the bench press exercise, surface EMG amplitude of all studied muscles remained unchanged (p > 0.187). During maximal isometric trials, there were no main effects of condition (p > 0.666) or time (p > 0.119), nor were there any significant condition×time interactions for peak or mean forces and surface EMG amplitudes (p > 0.297). Lower end-exercise blood oxygen saturation (90.9 ± 1.8 vs. 98.6 ± 0.6%; p < 0.001) and higher blood lactate concentration (5.8 ± 1.4 vs. 4.4 ± 1.6 mmol/L; p = 0.007) values occurred in hypoxia. Acute delivery of systemic normobaric hypoxia during multi-set, high-load resistance exercise increased metabolic stress. However, only subtle neuromuscular function adjustments occurred with and without hypoxic exposure either during maximal isometric bench press trials before versus after the session or during actual exercise sets. Highlights Performing multi-set, high-load bench press resistance exercise in hypoxia accentuates metabolic stress, as evidenced by lower arterial oxygen saturation and higher blood lactate concentration, compared to normoxia. Acute hypoxic exposure doesn’t alter neuromuscular responses during the execution of the sets since mean bar velocity dropped similarly in both conditions from set 2 to set 5 with no difference in peak velocity and surface EMG amplitude of the prime movers during the bench press. Only subtle adjustments in peak or mean force and accompanying surface EMG activity occur with and without hypoxic exposure during maximal isometric bench press trials after a 10-min hypoxic priming period and 5 min after the session in reference to post-warm-up.

운동경험이 없는 남성의 저항성 운동강도 차이가 근 손상 지표, 근력 및 근 비대 효과에 미치는 영향

This study was conducted to identify the intensity of resistance exercise that can improve muscle strength and hypertrophy while preventing muscle damage in untrained men in their 20s. Thirty men were divided into control group(n=10), low-load resistance exercise group(n=10), and high-load resistance exercise group(n=10). Resistance exercise of LLRG was performed with 40% 1RM, 3 sets, and repetitions per set until spontaneous muscle failure occurred. Resistance exercise of HLRG was performed with 80% 1RM, 3 sets, and repetitions per set until spontaneous muscle failure occurred. Resistance exercise was performed 3 times a week for a total of 12 weeks. After the end of the experiment, repeated measures ANOVA was performed to analyze the changes in the muscle damage indicator, muscle strength, and muscle hypertrophy. The results were as follows. Results of muscle damage indicator showed no significant difference in LLRG, but LDH, CK, Myoglobin, and AST significantly increased in HLRG after 12 weeks. And the result of muscle strength, both LLRG and HLRG were significantly increased, but HLRG was increased more than LLRG. In addition, the results of muscle mass were significantly increased to a similar level for both LLRG and HLRG. Summarizing the above results, it is judged that resistance exercise of 40% 1RM level of exercise intensity during the initial exercise plan for subjects without exercise experience can prevent muscle damage and increase muscle hypertrophy.

Supplementation of Specific Collagen Peptides Following High-Load Resistance Exercise Upregulates Gene Expression in Pathways Involved in Skeletal Muscle Signal Transduction.

Previous evidence suggests that resistance training in combination with specific collagen peptides (CP) improves adaptive responses of the muscular apparatus. Although beneficial effects have been repeatedly demonstrated, the underlying mechanisms are not well understood. Therefore, the primary objective of the present randomized trial was to elucidate differences in gene expression pathways related to skeletal muscle signal transduction following acute high-load resistance exercise with and without CP intake. Recreationally active male participants were equally randomized to high-load leg extension exercise in combination with 15 g CP or placebo (PLA) supplementation. Muscle biopsies from the vastus lateralis muscle were obtained at baseline as well as 1, 4 and 24 h post exercise to investigate gene expression using next generation sequencing analysis. Several important anabolic pathways including PI3K-Akt and MAPK pathways were significantly upregulated at 1 and 4 h post-exercise. Significant between-group differences for both pathways were identified at the 4 h time point demonstrating a more pronounced effect after CP intake. Gene expression related to the mTOR pathway demonstrated a higher visual increase in the CP group compared to PLA by trend, but failed to achieve statistically significant group differences. The current findings revealed a significantly higher upregulation of key anabolic pathways (PI3K-Akt, MAPK) in human skeletal muscle 4 h following an acute resistance training combined with intake of 15 g of specific collagen peptides compared to placebo. Further investigations should examine potential relationships between upregulated gene expression and changes in myofibrillar protein synthesis as well as potential long-term effects on anabolic pathways on the protein level.

Acute Effects of Different Intensities during Bench Press Exercise on the Mechanical Properties of Triceps Brachii Long Head

This study aimed to analyze acute changes in the muscle mechanical properties of the triceps brachii long head after bench press exercise performed at different external loads and with different intensities of effort along with power performance. Ten resistance-trained males (age: 27.7 ± 3.7 yr, body mass: 90.1 ± 17.1 kg, height: 184 ± 4 cm; experience in resistance training: 5.8 ± 2.6 yr, relative one-repetition maximum (1RM) in the bench press: 1.23 ± 0.22 kg/body mass) performed two different testing conditions in a randomized order. During the experimental session, participants performed four successive sets of two repetitions of the bench press exercise at: 50, 70, and 90% 1RM, respectively, followed by a set at 70% 1RM performed until failure, with a 4 min rest interval between each set. Immediately before and after each set, muscle mechanical properties of the dominant limb triceps brachii long head were assessed via a Myoton device. To determine fatigue, peak and average barbell velocity were measured at 70% 1RM and at 70% 1RM until failure (only first and second repetition). In the control condition, only muscle mechanical properties at the same time points after the warm-up were assessed. The intraclass correlation coefficients indicated “poor” to “excellent” reliability for decrement, relaxation time, and creep. Therefore, these variables were excluded from further analysis. Three-way ANOVAs (2 groups × 2 times × 4 loads) indicated a statistically significant group × time interaction for muscle tone (p = 0.008). Post hoc tests revealed a statistically significant increase in muscle tone after 70% 1RM (p = 0.034; ES = 0.32) and 90% 1RM (p = 0.011; ES = 0.56). No significant changes were found for stiffness. The t-tests indicated a significant decrease in peak (p = 0.001; ES = 1.02) and average barbell velocity (p = 0.008; ES = 0.8) during the first two repetitions of a set at 70% 1RM until failure in comparison to the set at 70% 1RM. The results indicate that low-volume, high-load resistance exercise immediately increases muscle tone but not stiffness. Despite no significant changes in the mechanical properties of the muscle being registered simultaneously with a decrease in barbell velocity, there was a trend of increased muscle tone. Therefore, further studies with larger samples are required to verify whether muscle tone could be a sensitive marker to detect acute muscle fatigue.

The Role of Plasma Extracellular Vesicles in Remote Ischemic Conditioning and Exercise-Induced Ischemic Tolerance.

Ischemic conditioning and exercise have been suggested for protecting against brain ischemia-reperfusion injury. However, the endogenous protective mechanisms stimulated by these interventions remain unclear. Here, in a comprehensive translational study, we investigated the protective role of extracellular vesicles (EVs) released after remote ischemic conditioning (RIC), blood flow restricted resistance exercise (BFRRE), or high-load resistance exercise (HLRE). Blood samples were collected from human participants before and at serial time points after intervention. RIC and BFRRE plasma EVs released early after stimulation improved viability of endothelial cells subjected to oxygen-glucose deprivation. Furthermore, post-RIC EVs accumulated in the ischemic area of a stroke mouse model, and a mean decrease in infarct volume was observed for post-RIC EVs, although not reaching statistical significance. Thus, circulating EVs induced by RIC and BFRRE can mediate protection, but the in vivo and translational effects of conditioned EVs require further experimental verification.

Low-Load Blood Flow Restriction and High-Load Resistance Training Induce Comparable Changes in Patellar Tendon Properties.

Low-load resistance training with blood flow restriction (LL-BFR) has emerged as a viable alternative to conventional high-load (HL) resistance training regimens. Despite increasing evidence confirming comparable muscle adaptations between LL-BFR and HL resistance exercise, only very little is known about tendinous mechanical and morphological adaptations after LL-BFR. Therefore, the aim of the present study was to examine the effects of 14 wk of LL-BFR and HL training on patellar tendon adaptations. Twenty-nine recreationally active male participants were randomly allocated into the following two groups: LL-BFR resistance training (20%-35% one-repetition maximum (1RM)) or HL resistance training (70%-85% 1RM). Both groups trained three times per week for 14 wk. One week before and after the intervention, patellar tendon mechanical and morphological properties were assessed via ultrasound and magnetic resonance imaging. In addition, changes in muscle cross-sectional area were quantified by magnetic resonance imaging and muscle strength via dynamic 1RM measurements. The findings demonstrated that both LL-BFR and HL training resulted in comparable changes in patellar tendon stiffness (LL-BFR: +25.2%, P = 0.003; HL: +22.5%, P = 0.024) without significant differences between groups. Similar increases in tendon cross-sectional area were observed in HL and LL-BFR. Muscle mass and strength also significantly increased in both groups but were not statistically different between HL (+38%) and LL-BFR (+34%), except for knee extension 1RM where higher changes were seen in LL-BFR. The present results support the notion that both HL and LL-BFR cause substantial changes in patellar tendon properties, and the magnitude of changes is not significantly different between conditions. Further studies that examine the physiological mechanisms underlying the altered tendon properties after LL-BFR training are needed.

Hemodynamic response and pulse wave analysis after upper- and lower-body resistance exercise with and without blood flow restriction

ABSTRACT Resistance exercise (RE) has been shown to elevate hemodynamics and pulse wave reflection. However, the effects of acute RE with blood flow restriction (BFR) on hemodynamics and pulse wave reflection are unclear. The purpose of this study was to evaluate the differences between upper- and lower-body RE with and without BFR on hemodynamics and pulse wave reflection. Twenty-three young resistance-trained individuals volunteered for the study. Hemodynamics and pulse wave reflection were assessed at rest, 10, 25, 40, and 55 min after either upper- or lower-body with or without BFR. The upper-body RE (URE) consisted of the latissimus dorsi pulldown and chest press; the lower-body RE (LRE) consisted of knee extension and knee flexion. The BFR condition consisted of four sets of 30, 15, 15, and 15 repetitions at 30% 1-repetition maximum (1RM) while the without BFR condition consisted of four sets of 8 repetitions at 70% 1RM. Heart rate, rate pressure product, and subendocardial viability ratio significantly (p < 0.05) increased after all exercises. Brachial and aortic systolic blood pressure (BP) significantly (p < 0.05) elevated after LRE while brachial and aortic diastolic BP significantly (p < 0.05) reduced after URE. Augmentation pressure, augmentation index (AIx), AIx normalized at 75 bpm, and wasted left ventricular pressure energy significantly (p < 0.05) increased after URE while transit time of reflected wave significantly (p < 0.05) decreased after LRE. URE places greater stress on pulse wave reflection while LRE results in greater responses in BP. Regardless of URE or LRE, the cardiovascular responses between BFR and without BFR are similar. HIGHLIGHTS High-load resistance exercise and low-load resistance exercise with blood flow restriction may produce similar cardiovascular responses. Upper-body resistance exercise generates greater changes on pulse wave reflections while lower-body resistance exercise induces greater elevations in systolic blood pressure.

Acute cellular and molecular responses and chronic adaptations to low-load blood flow restriction and high-load resistance exercise in trained individuals.

Blood flow restriction (BFR) with low-load resistance exercise (RE) is often used as a surrogate to traditional high-load RE to stimulate muscular adaptations, such as hypertrophy and strength. However, it is not clear whether such adaptations are achieved through similar cellular and molecular processes. We compared changes in muscle function, morphology, and signaling pathways between these differing training protocols. Twenty-one males and females (means ± SD: 24.3 ± 3.1 yr) experienced with resistance training (4.9 ± 2.6 yr) performed 9 wk of resistance training (three times per week) with either high-loads (75%-80% 1RM; HL-RT), or low-loads with BFR (30%-40% 1RM; LL-BFR). Before and after the training intervention, resting muscle biopsies were collected, and quadricep cross-sectional area (CSA), muscular strength, and power were measured. Approximately 5 days following the intervention, the same individuals performed an additional "acute" exercise session under the same conditions, and serial muscle biopsies were collected to assess hypertrophic- and ribosomal-based signaling stimuli. Quadricep CSA increased with both LL-BFR (7.4 ± 4.3%) and HL-RT (4.6 ± 2.9%), with no significant differences between training groups (P = 0.37). Muscular strength also increased in both training groups, but with superior gains in squat 1RM occurring with HL-RT (P < 0.01). Acute phosphorylation of several key proteins involved in hypertrophy signaling pathways, and expression of ribosomal RNA transcription factors occurred to a similar degree with LL-BFR and HL-RT (all P > 0.05 for between-group comparisons). Together, these findings validate low-load resistance training with continuous BFR as an effective alternative to traditional high-load resistance training for increasing muscle hypertrophy in trained individuals.NEW & NOTEWORTHY Low-load resistance exercise with blood flow restriction (LL-BFR) is an effective method for stimulating muscular adaptations, but phenotypical and mechanistic comparisons with traditional high-load training (HL-RT) in trained populations are scarce. The findings indicate that hypertrophy, but not strength, is comparable between LL-BFR and HL-RT, and the acute cellular and molecular processes for hypertrophy were similar, but not identical, between protocols. Thus, LL-BFR is an effective alternative to HL-RT for obtaining hypertrophy in trained populations.