High-intensity Training Research Articles

The effects of two different concurrent training programs on specific performance, physiological and biochemical parameters in soccer players

The study examined the effects of two concurrent training models, one being an eight-week High-Intensity Interval Training (HIIT) and the other, High-Intensity Functional Training (HIFT) both with additional strength training (S), on physiological parameters (blood lactate concentration and heart rate), athlete's performance (maximal strength, explosive power, aerobic endurance, 20 m sprint), and biochemical outputs. The study involved a total of 21 young males playing with amateur soccer licenses for at least 2 years divided into three groups. One group received S + HIIT training, second group received S + HIFT training and the control group continued their soccer-specific training. Both the experimental and the control groups underwent pre- and post-tests and while only the experimental groups underwent an eight-week training program. Pre- and post-tests of the all the participants included measurements of body composition, adaptation studies, trial measurements, biochemical blood, aerobic endurance measurements, sprint tests, and strength measurements. The Mixed Design ANOVA analysis was utilized to examine the performance, physiological, and biochemical data of the participants before and after the experiment. Concurrent training models were effective in increasing athletic performance (VO2max, CMJ, 1RM bench press and Yo-Yo test) and physiological outcomes during recovery (HR, blood lactate, Borg Scale) compared to the control group with traditional training. There was no significant difference between the biochemical changes in the S + HIIT, S + HIFT and control groups during the trial period. In summary, both concurrent training (CT) models had positive effects on sports performance and physiological outcomes, but not on biochemical outcomes.

ANÁLISE DE FATORES DE RISCO ASSOCIADOS A LESÕES EM PRATICANTES DE CROSSFIT: UMA REVISÃO INTEGRATIVA

CrossFit is a high-intensity physical training method that aims to develop skills in ten areas of physical fitness. The practice of this training has been associated with a higher incidence of injuries, especially among men, who tend to seek less guidance from instructors. This study aimed to evaluate the risk factors for injuries in CrossFit practitioners, through a literature review, and to explore physiotherapeutic approaches aimed at enhancing the performance of athletes and students. Data was collected between September and October 2024, using the VHL, PubMed and LILACS databases, from 2016 to 2024. There were 17 articles (3 in BVS, 12 in PubMed and 2 in LILACS), in the end, 7 articles were considered suitable for analysis. The results showed that the common risk factors for injuries in CrossFit practitioners involve muscle overload and joint problems, the results also indicated effective physiotherapeutic approaches to enhance the athletes' performance. In conclusion, the study highlighted the importance of physiotherapeutic approaches to prevent and treat injuries in CrossFit athletes. The correct technical execution of exercises, combined with targeted physiotherapeutic interventions, is essential in reducing risks and improving athletes' performance.

Effect of high-intensity training on physiological parameters among soccer referee: A systematic review

This study explores the psycho-physiological impact of High-Intensity Interval Training (HIIT) on soccer referees, aiming to inform the development of training programmes that integrate educational psychology principles. It investigates how HIIT influences both mental health and physical performance, compared to alternative training methods, such as Small-Sided Games (SSG). A comprehensive review of 60 studies on the effects of HIIT on soccer referees was conducted, with 15 studies selected through rigorous screening. Credible databases were systematically searched, and biases were evaluated using the PICO (Patients, Intervention, Comparison, Outcome) framework to ensure methodological robustness. The study compared the physiological and psychological effects of HIIT and SSG therapies on soccer referees, incorporating funnel plot analysis to assess potential publication bias. The results indicated that SSG sprint training outperforms alternative methods in terms of sprint ability. However, HIIT was found to yield higher mental component summary scores, suggesting potential mental health benefits. The funnel plot revealed potential publication bias, and moderate heterogeneity was observed across studies, raising caution in interpreting the results. Despite these variations, HIIT demonstrated significant improvements in mental health and sprint performance compared to controls. The findings suggest that HIIT can be an effective method for enhancing both the mental and physical fitness of soccer referees. However, the observed heterogeneity and potential biases indicate the need for further research to validate these results and optimise training programmes. Tailored interventions based on these findings could improve officiating efficacy and promote the overall well-being of referees.

Variabilities of salivary human herpesvirus 6, 7, and secretory immunoglobulin A levels from pre- to post-competition periods in baseball players.

Persistent physical fatigue (PPhF) accompanying daily intensive training often results in underperformance. While salivary secretory immunoglobulin A (SIgA) has been traditionally used as an immunological marker, salivary human herpesvirus 6 and/or 7 (HHV-6/7) have recently been presented as "microbiological" markers of PPhF. This study aimed to examine the monthly variabilities of salivary HHV-6/7 levels and the difference with SIgA along the training periodization. A total of 27 healthy male university baseball players (N.=17) and non-players (student staff, N.=10) were followed up for 4 months (August, pre-competition period; September and October, competition period; November, post-competition period). The main measures were subjective and objective fatigue parameters (questionnaires and performance tests), and salivary HHV-6/7 and SIgA levels. The fatigue parameters indicated a decrease in athletic performance from August to September due to PPhF during high intensity training in August. Two-way repeated analysis of variance showed that salivary HHV-6 and -7 levels were higher in players compared to non-players (P<0.05). Salivary HHV-6 levels gradually decreased (P<0.05), whereas HHV-7 levels remained unchanged (P>0.05). Salivary SIgA levels were higher in players rather than in non-players (P>0.05), and the levels did not change (P>0.05). Our findings suggest that salivary HHV-6/7 levels, specifically in HHV-6, reflect the degree of PPhF independently of SIgA levels. As saliva can be collected anywhere, periodic monitoring of salivary HHV-6/7 levels may be easily applicable for assessing PPhF beside sports field and allow appropriate conditioning.

The sports performance improving effects of konjac glucomannan with varying molecular weights in overtrained mice

Overtraining affects individuals engaged in high-volume training, potentially hindering athletic performance and revealing shortcomings in suggested solutions. This study evaluated the impact of konjac glucomannan (KGM) with varying molecular weights on the gut microbiome, endurance, and strength in mice subjected to excessive training. The native KGM (1.82 × 107 Da) was enzymatically degraded using endo-1,4-β-mannanase to generate moderate molecular weight KGM (KGM-EM, 1.89 × 105 Da) and low molecular weight KGM (KGM-EL, 1.34 × 104 Da). These fractions were characterized and compared with the native KGM regarding their effects on mice undergoing excessive training. The results demonstrated a positive correlation between KGM's molecular weight and its capacity to mitigate the adverse impacts of excessive training on strength or/and endurance (a significant increase of 55.57 % and 55.70 % by the native KGM compared with the excessive training group). In addition, the native KGM exhibited superior preservation of microbial diversity and composition in fecal samples against excessive training-induced shifts, along with increased production of individual and total short-chain fatty acids in plasma compared with the two degraded products. Overall, these results highlight the potential benefits of high molecular weight KGM for preventing overtraining syndrome and enhancing athletic performance in animal models.

ДИНАМИКА ВАРИАБЕЛЬНОСТИ СЕРДЕЧНОГО РИТМА ПОСЛЕ СИЛОВЫХ ТРЕНИРОВОК С ОГРАНИЧЕНИЕМ КРОВОТОКА У ЛИЦ С МЕТАБОЛИЧЕСКИМ СИНДРОМОМ

We know that autonomic disfunction is due to metabolic pathologies. The same time, physical activity has beneficial effects on metabolic health and heart rate variability (HRV). But there is no consensus about the effect of trainings with weights on HRV in the scientific literature. Purpose: To asses the impact of low-intensity power trainings with blood flow restrictions on HRV of men with metabolic syndrome (MS). Materials and methods: Influence of different weight training modes on 60 men with MS was analyzed. The participants were divided into three groups: low-load resistance training with blood flow restriction (LLBFR; n = 20), high-intensity resistance training without blood flow restriction (HI; n = 20), low-load resistance training without blood flow restriction (LL; n = 20). Trainings were conducted twice a week for 12 weeks. Time and frequency indicators were assessed before and after the investigation. Results: After the investigation, there were an increase in SDNN for the LLBFR group (p = 0.000; Cohen’s d = 0.69), for the HI group (p = 0.000; Cohen’s d = 0.83), for the LL group (p = 0.016; Cohen’s d = 0.22), an increase in RMSSD for the LLBFR group (p = 0.000; Cohen’s d = 0.67), for the HI group (p = 0.000; Cohen’s d = 0.87), for the LL group (p = 0.027; Cohen’s d = 0.26), as well as an increase in pNN50 for the LLBFR group (p = 0.000; Cohen’s d = 0.58), for the HI group (p = 0.000; Cohen’s d = 0.53), for the LL group (p = 0.079; Cohen’s d = 0.14). Statistically significant changes (p ˂ 0.05) were also observed for the frequency parameters of HRV for the LLBFR and HI groups. Conclusions: Resistance training, including in combination with blood flow restriction, has a positive effect on HRV in men with MS.

Design of the VOILA-intervention study: A 12-week nutrition and resistance exercise intervention in metabolic or mobility compromised Dutch older adults and the response on immune-metabolic, gut and muscle health parameters

BackgroundExercise and nutrition interventions can slow ageing-induced decline in physiology. However, effects are heterogeneous and usually studied separately per outcome domain. In the VOILA study, we simultaneously study various health outcomes relevant for older adults and the inter-individual heterogeneity in response to a lifestyle intervention. MethodsVOILA is a 12-week lifestyle intervention in 3 groups of older adults (≥60 years), with compromised mobility (n=50), compromised metabolic health (n=50), or recovering from total knee replacement (TKR, n=70, of which 20 randomized to standard care only). The intervention includes high-intensity resistance exercise training thrice weekly, nutritional counselling, and nutritional supplements every morning and evening (including 20-25g whey protein and (evening only) 5.5g Biotis™ GOS). We measure immune-metabolic, gut health, muscle mass and physical functioning at baseline and after completion of the intervention/standard care. An additional reference group of healthy older adults (n=50) will undergo baseline measurements only. DiscussionImprovements in various physiological systems are expected, but with differences between groups/individuals. This study will provide insights into how the physiological state of older adults influences the extent of lifestyle-induced health improvements to create better tailored interventions to attenuate biological ageing and improve the health span of subgroups and individuals.

Modulation of physical exercise intensity in motor-cognitive training of adults using the SKILLCOURT technology.

Motor-cognitive training and exergaming often only reach low-to-medium intensities that limits their training efficiency. This study evaluated the physiological profile of different exercises on a novel motor-cognitive training technology designed to cover a broad range of exercise intensities. Twenty-six healthy trained adults (17 males, 23.7 ± 3.8 years) performed five motor-cognitive training tasks on the SKILLCOURT technology. Oxygen consumption (VO2), heart rate (HR), blood [lactate], perceived physical exertion (RPE) responses, and metabolic equivalent (MET) were assessed and compared to an incremental treadmill ramp test determining the maximal oxygen consumption (VO2max) and maximal heart rate (HRmax). Computer-based cognitive training served as control condition. Motor-cognitive exercises reached a higher %VO2max and %HRmax levels when compared to computer-based training (p < 0.001). Average intensity varied significantly between motor-cognitive tasks, with %VO2max ranging from 22% to 81% (p < 0.001), %HRmax from 49% to 89% (p < 0.001), METs from 3.57 to 13.37 (p < 0.001), blood [lactate] from 0.93 to 7.81 mmol·L-1 (p < 0.001), and RPE from 8.5 to 16.4 (p < 0.001). Motor-cognitive training covers a wide range of exercise intensities. This supports individual training subscription and allows high-intensity training to facilitate cardio-vascular adaptations and neural plasticity.

The Effectiveness of Physical Therapy and Rehabilitation Approaches in Low Back Pain on Pain Severity and Disability; A Systematic Review

The objective of this study was to review the efficacy of physical therapy and rehabilitation approaches for low back pain, focusing on pain intensity and disability. A survey of the literature was done in PubMed and Web of Science databases up to January 30, 2024. English studies were required, using keywords: “low back pain,” “pain intensity,” “pain severity,” “disability,” and “physical therapy.” Pain intensity was measured using the Visual Analog Scale and Numeric Rating Scale, including the 11-point Pain Intensity Numerical Rating Scale. Disability was assessed using Activities of Daily Living, Instrumental Activities of Daily Living scales, Roland Morris Disability Questionnaire, and Oswestry Disability Index. Seven studies met the inclusion criteria from 665 initial records. Interventions included osteopathic manipulative treatment, core muscle exercise with interferential current, cognitive functional therapy, dry cupping therapy, high-intensity machine-based core muscle resistance training,heat therapy, transcutaneous electrical nerve stimulation, pelvic traction, Reiki, dynamic muscular stabilization technique, and McGill Big 3. Sample sizes ranged from 30 to 1090 participants. Interferential current combined with core muscle exercises significantly reduced pain intensity compared to each method alone, though not statistically significant (p &gt; 0.05). The high-intensity machine-based core muscle resistance training program group had greater pain relief (P0.05). Dry cupping did not outperform sham cupping. Cognitive functional therapy reduced absenteeism in the first two years but not later. Reiki showed significant improvement in pain and Activities of Daily Living compared to drug therapy, but not to physiotherapy. Physical therapy interventions effectively alleviate symptoms and enhance results for low back pain. However, variability in interventions and outcome measures necessitates cautious interpretation. Further research with standardized protocols is essential to understand the effectiveness and optimal duration of physical therapy for Low Back Pain.

Correlation between Physical Activity and Cardiovascular Endurance of the Employees in Universitas Swadaya Gunung Jati, Cirebon, Indonesia

Background: Cardiovascular endurance refers to a person's ability to perform activities involving the entire body at moderate to high intensity over extended periods. Cardiovascular endurance is influenced by several factors, such as physical activity. Moderate to high-intensity physical activity trains the body to exchange oxygen more efficiently and results in enhancing cardiovascular endurance. Other factors that could contribute in cardiovascular endurance are smoking and Body Mass Index (BMI). Aims: To find the correlation between physical activity, BMI, smoking, and cardiovascular endurance among employees of Universitas Swadaya Gunung Jati, Cirebon, Indonesia. Methods: It was an analytic observational study with a cross-sectional approach that used the GPAQ physical activity questionnaire and cardiovascular endurance data that was obtained through the Harvard Step Test involving 77 educational staff employees at Universitas Swadaya Gunung Jati. The analytical statistics used was Spearman’s correlation test with a significance value of p = &lt;0.05. Results: Most of the Universitas Swadaya Gunung Jati employee’s had moderate level of physical activity (44.2%) and very low cardiovascular endurance (37.7%). The analytical statistic showed a significant correlation between physical activity and cardiovascular endurance with a p-value of 0.034 and a Spearman's r of 0.242. Smoking has significant correlation with cardiovascular endurance with p value of 0.003 and Spearman’s r of 0.338. BMI showed negative and weak correlation with cardiovascular endurance with p value 0.008 and Spearman’s r -0.302. Conclusion: There was a significant correlation between physical activity and cardiovascular endurance among the employees of Universitas Swadaya Gunung Jati, Cirebon, Indonesia. Received: 25 September 2024 | Reviewed: 26 October 2024 | Revised: 17 November 2024 | Accepted: 30 November 2024.

Benefits from Implementing Low- to High-Intensity Inspiratory Muscle Training in Patients Undergoing Cardiac Surgery: A Systematic Review

Cardiac surgery procedures are among the main treatments for people with cardiovascular disease, with physiotherapy playing a vital part. Respiratory complications are common and associated with prolonged Intensive Care Unit (ICU) and hospital stay, as well as increased mortality. Inspiratory muscle training has been found to be beneficial in improving respiratory muscle function in critically ill patients and patients with heart failure. The purpose of this review is to present the results of implementing inspiratory muscle training (IMT) programs in patients before and/or after cardiac surgery. The PubMed, Embase and Science Direct databases were searched from January 2012 to August 2023. In the present review, randomized controlled clinical trials (RCTs), clinical trials and quasi-experimental studies conducted in adult patients pre and/or post cardiac surgery were included. Fifteen studies were considered eligible for inclusion in the review. The results revealed that the IMT programs varied in intensity, repetitions, and duration in all included studies. Most studies implemented the IMT after the surgery. Statistical significance between groups was noted in Maximal Inspiratory Pressure and the 6-Minute Walk Distance Test. Preoperative and postoperative programs could improve inspiratory muscle strength, pulmonary function, and functional capacity as well as decrease the length of hospital stay in patients undergoing cardiac surgery. No clear evidence emerged favoring low or higher IMT intensities. The combination of IMT with other forms of exercise might be beneficial in patients undergoing cardiac surgery. However, further RCTs are required to provide confirming evidence.

Flexible modelling of time-varying exposures and recurrent events to analyse training load effects in team sports injuries

Abstract We present a flexible modelling approach to analyse time-varying exposures and recurrent events in team sports injuries. The approach is based on the piece-wise exponential additive mixed model where the effects of past exposures (i.e. high-intensity training loads) may accumulate over time and present complex forms of association. In order to identify a relevant time window at which past exposures have an impact on the current risk, we propose a penalty approach. We conduct a simulation study to evaluate the performance of the proposed model, under different true weight functions and different levels of heterogeneity between recurrent events. Finally, we illustrate the approach with a case study application involving an elite male football team participating in the Spanish LaLiga competition. The cohort includes time-loss injuries and external training load variables tracked by Global Positioning System devices, during the seasons 2017–2018 and 2018–2019.

Effect of blood flow restriction training on insulin resistance in men with metabolic syndrome: a randomized controlled trial

Introduction. Metabolic syndrome is defined as a pathological condition characterized by abdominal obesity, hypertension, dyslipidemia, and impaired glucose tolerance. Insulin resistance is hypothesized to underlie metabolic syndrome. Modern studies, including Mendelian randomization, have demonstrated that muscle strength and muscle mass may play an important role in the mechanisms of insulin resistance. Aim. To establish the relationship between relative upper limb muscle strength and triglyceride/glucose index, and to evaluate the effects of different resistance exercise regimens on alternative measures of insulin resistance in men with metabolic syndrome. Materials and methods. At the first stage of the study, 216 men aged from 25 to 50 years were examined. The relative muscle strength of the upper limbs in the bench press exercise and the triglyceride/glucose index were assessed. At the second stage, a randomized controlled trial was conducted, for which 60 men who met the criteria for metabolic syndrome. Men with metabolic syndrome were divided into three groups: low-intensity strength training with blood flow restriction (n = 20), high-intensity strength training (n = 20), low-intensity strength training without blood flow restriction (n = 20). Training was carried out 2 times a week for 12 weeks. Before and after the study, the triglycerides/glucose index, the ratio of triglycerides to high-density lipoproteins, and the combination of the triglycerides/glucose index with body mass index were assessed. Results and discussion. It was found that the relative muscle strength of the upper limbs was inversely proportional to the triglycerides/glucose index (r = –0.52; p 0.05) in the examined men. After 12 weeks of resistance training, statistically significant reductions in triglyceride/glucose index, triglyceride/high-density lipoprotein ratio, and triglyceride/glucose index/body mass index combination were found for the low-intensity resistance training with blood flow restriction and high-intensity resistance training groups (both, p 0,01). Changes in body composition, an increase in the proportion of muscle fibers I and IIa and a decrease in the proportion of muscle fibers IIx, an increase in the activity of glucose transporters, and a decrease in systemic inflammation are the main potential mechanisms for the beneficial effects of resistance training, including in combination with blood flow restriction, on insulin resistance in men with metabolic syndrome. Conclusion. There is an inverse relationship between muscle strength and triglycerides/glucose index; resistance training is an effective and safe tool for reducing alternative indicators of insulin resistance and can be included in comprehensive correction programs for men with metabolic syndrome.

Clinical and physiological effects of high-intensity aerobic training on metabolic syndrome: understanding the individual exercise response variability.

We analyzed the interindividual heterogeneity in health responses to a supervised high-intensity interval training (HIIT) program in individuals with metabolic syndrome (MetS). Two-hundred and sixty-four adults with overweight/obesity (56.3±7.3 y, body mass index, 32.3±4.7 kg·m-2), and MetS were randomized to a standard health care non-exercise group (CONT group, N=58) or standard health care plus HIIT (EXER group, N=206). HIIT intervention was performed on a cycloergometer thrice a week (43 min·session-1). The change in MetS components (i.e., MetS z score), cardiorespiratory fitness (VO2PEAK), maximal cycling power (WPEAK), and body weight/composition was assessed in both groups before (0 weeks) and after the intervention (16 weeks). Individual responses in the EXER group were considered attributable to HIIT when the improvements were larger than twice the typical error (>2 TE). TE was calculated using pre- and post-intervention data from the time-matched CONT group. The percent of participants that improved MetS z score beyond 2TE was 51% driven by reductions in blood pressure (45%) and waist circumference (48%). Blood lipids and glucose response were only 21% and 16% (participants improving beyond 2TE). Sixty percent of individuals that improved MetS z score, also improved VO2PEAK (r=-0.013; P=0.86) while 85% of individuals improving MetS z score also improved WPEAK (r=0.151; P=0.03). In summary, health providers can expect that a 16- week HIIT program would indisputably improve MetS in approximately 50% of individuals completing the program. Lastly, WPEAK better predicts which individuals would improve MetS than VO2PEAK when the direct assessment of the five MetS factors is not feasible.

Impact of resistance training and chicken intake on vascular and muscle health in elderly women.

Resistance training is a well-known exercise therapy for preventing and improving lacks of muscle mass, strength, and quality with advances in age; however, its effects on arterial stiffness are not beneficial. Additionally, a higher intake of protein, which is an effective nutrient for muscle health, results in lower arterial stiffness. Whether the combination of moderate to high-intensity resistance training and high-protein intake would improve muscle mass, strength, and quality and cancel the resistance training-induced increase in arterial stiffness in elderly women remains unclear. Ninety-three elderly women (67.2±5.3years) were randomly divided into four groups; sedentary control (CON), higher dietary animal protein intake (HP), resistance training (RT), and combination of RT and HP (RT+HP) groups. Participants in the RT and RT+HP groups completed 12weeks of resistance training (exercise intensity at 70% of one-repetition maximum (1-RM), three sets with 10 repetitions of leg extension and curls, 3days/week). In addition to the daily diet, the HP and RT+HP groups consumed steamed chicken breast as a high-protein diet. Percent changes in thickness (indices of muscle mass) and echo intensity (index of muscle quality) in the quadriceps muscle, 1-RM of leg extension and curls (index of muscle strength), and circulating C1q levels (a potential biomarker of muscle fibrosis) in the RT and RT+HP groups significantly improved after both RT and RT+HP interventions (P<0.05). Percent changes in carotid-femoral pulse wave velocity (cfPWV) and carotid β-stiffness (indices of arterial stiffness), and circulating angiotensin II (a vasoconstrictor peptide hormone) levels via each intervention were significantly higher in the RT group (4.9±12.7%, 13.8±13.5%, 94.9±132.7%, respectively), as compared with the CON group (-2.5±5.9%, 0.2±8.1%, 21.2±79.3%, respectively) (P<0.05). Of note, no significant differences in the cfPWV, carotid β-stiffness, and circulating angiotensin II levels between the RT+HP (-2.4±9.3%, 2.4±10.3%, -5.7±29.6%, respectively) and CON groups were observed. Furthermore, significant positive relationships between the percent changes in circulating angiotensin II levels, and cfPWV (r=0.438, P<0.01) and carotid β-stiffness (r=0.328, P<0.01) were observed. The combination of moderate to high-intensity resistance training and regular intake of steamed chicken breast as a high-protein food could increase muscle mass, strength, and quality and could cancel resistance training-induced increases in arterial stiffness in elderly women.

Regular high-intensity ergocycle training effective in reduction in BMI, percentage of body fat, HbA1c, and improving muscle mass in in patients with type 2 diabetes

This study aims to examine the effects of high-intensity ergocycle training on four key parameters crucial for managing type 2 diabetes (T2D): Body Mass Index (BMI), body fat percentage, Hemoglobin A1C (HbA1c), and muscle mass. A total of 24 male patients with T2D, aged 41-65, participated in the study and underwent a high-intensity ergocycle training intervention, conducted three times per week for eight weeks. Parameters such as HbA1c, BMI, PBF, and SM were observed before and after the intervention. Data analysis techniques included paired sample t-tests and independent sample t-tests with a significance level of 5%. The results indicated a significant reduction in HbA1c, BMI, and PBF, as well as a significant increase in SM before and after the high-intensity ergocycle training intervention (p ≤ 0.05). Additionally, we observed a reduction in ∆-HbA1c, ∆-BMI, ∆-PBF, and an increase in ∆-SM between groups (p ≤ 0.05). These findings demonstrate that regular high-intensity ergocycle training is significantly effective in reducing BMI, body fat percentage, and HbA1c levels while increasing muscle mass in patients with T2D. This result provides solid evidence that high-intensity ergocycle training can be used as a modality to improve insulin resistance in patients with T2D.

Effectiveness of low-load resistance training with blood flow restriction vs. conventional high-intensity resistance training in older people diagnosed with sarcopenia: a randomized controlled trial

Low-load resistance training with blood flow restriction (LRT-BFR) has shown potential to improve muscle strength and mass in different populations; however, there remains limited evidence in sarcopenic people diagnosed with sarcopenia criteria. This study systematically compared the effectiveness of LRT-BFR and conventional high-intensity resistance training (CRT) on clinical muscle outcomes (muscle mass, strength and performance), cardiovascular disease (CVD) risk factors and sarcopenia-related biomarkers of older people with sarcopenia. Twenty-one older individuals (aged 65 years and older) diagnosed with sarcopenia were randomly assigned to the LRT-BFR (20%–30% one-repetition maximum (1RM), n = 10) or CRT (60%–70% 1RM, n = 11) group. Both groups underwent a supervised exercise program three times a week for 12 weeks. The primary outcome was knee extensor strength (KES), and the secondary outcomes included body composition (body mass, body mass index and body fat percentage), muscle mass [appendicular skeletal muscle mass index (ASMI)], handgrip strength, physical performance [short physical performance battery (SPPB) and 6-m walk], CVD risk factors [hemodynamic parameters (systolic and diastolic blood pressure and heart rate (SBP, DBP and HR)) and lipid parameters (total cholesterol, triglyceride (TG), high-density lipoprotein (HDL) and low-density lipoprotein)], sarcopenia-related blood biomarkers [inflammatory biomarkers, hormones (growth hormone (GH) and insulin-like growth factor 1) and growth factors (myostatin and follistatin)] and quality of life [Short Form 36 Health Survey (SF-36)]. Both interventions remarkably improved the body composition, KES, 6-m walk, SBP, HDL, TG, GH, FST and SF-36 scores. CRT significantly improved the ASMI (p < 0.05) and SPPB (p < 0.05). A significant improvement in HR was observed only after LRT-BFR. No significant between-group differences were found before and after the interventions. This study suggested that LRT-BFR and CRT are beneficial to the clinical muscle outcomes, CVD risk factors and certain sarcopenia-related biomarkers of older people with sarcopenia. By comparison, CRT seems more effective in improving muscle mass, while LRT-BFR may be more beneficial for improving cardiovascular health in this population. Therefore, LRT-BFR is a potential alternative to CRT for aging sarcopenia.

Six weeks of polarized functional interval training with large training load reductions does not affect performance gains compared to traditional workouts.

High-intensity functional interval training (HIFT) is predominantly composed of high exercise training intensities (HiT) and loads. Both have been linked to a higher risk of overtraining and injuries in inexperienced populations. A polarized training approach is characterized by high amounts of low-intensity training (LiT) and only approximately 5%-20% HiT. Compared to HIT-based training, this approach can result in temporary training load and intensity reductions without diminishing training gains. Thus, we aimed to examine the effects of traditional (TRAD) HIFT vs. polarized (POL) HIFT on relevant performance parameters. Thirty athletes (15 females, age: 26.6 ± 5.0 years, height: 1.76 ± 0.13 m, body mass: 79.6 ± 12.4 kg, prior experience: 2.3 ± 2.0 years, training volume: 6.1 ± 2.4 h/wk) were randomly assigned to 6 weeks of either POL (78% LiT, 22% threshold intensity training (ThT) to HiT) or TRAD (26% LiT, 74% ThT to HiT). HIFT performance testing focused on maximal strength (squat: SQ1RM, deadlift: DL1RM, overhead press: OHP1RM, high pull: HP1RM), endurance (peak oxygen uptake: V̇O2peak, lactate threshold: LT, peak power output (PPO), and benchmark HIFT workout (Jackie: 1000 m rowing, 50 thrusters, and 30 pull-ups for time). POL (785 ± 71 au) completed significantly (p ≤ 0.001; SMD = 4.55) lower training load (eTRIMP) than TRAD (1,273 ± 126 au). rANCOVA revealed no statistical relevant group×time interaction effects (0.094 ≤ p ≤ 0.986; 0.00 ≤ ηp 2 ≤ 0.09) for SQ1RM, DL1RM, OHP1RM, high pull, V̇O2peak, LT, PPO, and Jackie performance. Both groups revealed trivial to moderate but significant (rANCOVA time effects: p ≤ 0.02; 0.01 ≤ ηp 2 ≤ 0.11; 0.00 ≤ SMD ≤ 0.65) performance gains regarding DL1RM, OHP1RM, HP1RM, and Jackie. Despite a notably lower total training load, conditioning gains were not affected by a polarized functional interval training regimen.

Matching Clinical Profiles with Interventions to Optimize Daily Stepping in People with Stroke.

Individualizing interventions is imperative to optimize physical activity in people with chronic stroke. This secondary analysis grouped individuals with chronic stroke into clinical profiles based on baseline characteristics and examined if these clinical profiles preferentially benefitted from a specific rehabilitation intervention to improve daily step-activity. Participants had non-cerebellar strokes ≥6 months prior to enrollment, were 21-85 years old, had walking speeds of 0.3-1.0 m/s, and took <8,000 steps-per-day. Participants were randomized to 1 of 3 interventions: high-intensity treadmill training (FAST), a step-activity behavioral intervention (SAM), or a combined intervention (FAST+SAM). The primary outcome was the interaction of latent class (clinical profile) and intervention group (FAST, SAM, FAST+SAM) on a change in steps-per-day. Key clinical characteristics to identify the latent classes included walking speed, walking endurance, balance self-efficacy, cognition, and area deprivation. Of the 190 participants with complete pre- and post-intervention data (mean [SD] age, 64 [12] years; 93 females [48.9%]), 3 distinct profiles of people with chronic stroke were identified. Within our sample, class 1 had the lowest walking capacity (speed and endurance), lowest balance self-efficacy, and highest area deprivation, and had the greatest change in step-activity when enrolled in the SAM (mean[95%CI], 1624 [426 - 2821]) or FAST+SAM (1150 [723 - 1577]) intervention. Class 2 had walking capacity, baseline steps-per-day, and self-efficacy values between Class 1 and 3, and had the greatest change in step-activity when enrolled in the SAM (2002 [1193-2811]) intervention. Class 3 had the highest walking capacity, highest self-efficacy, and lowest area deprivation and the greatest change in step-activity when enrolled in the FAST+SAM (1532 [915-2150]) intervention. People with chronic stroke require different interventions to optimize a change in step-activity. Clinicians can use clinically relevant measures to personalize intervention selection to augment step-activity in people with chronic stroke. NCT02835313; https://clinicaltrials.gov/ct2/show/NCT02835313.

Utility of fat-free adipose tissue correction formula for tracking body composition changes with dual-energy X-ray absorptiometry.

Fat loss is often the target of weight loss interventions; however, preservation of lean soft tissue (LST) may be more important for health and weight maintenance. Though some LST loss may be inevitable when tracking body composition changes using dual-energy X-ray absorptiometry (DXA), correcting for the fat-free component of adipose tissue (FFAT) in DXA-derived LST (DXALST) has been proposed. This analysis sought to evaluate differences between DXALST and FFAT-corrected LST (FFATLST) amongst varied populations and interventions to understand application of the correction formula on LST outcomes. 226 subjects were analyzed across five prior studies. Three studies evaluated combined nutrition and exercise (high-intensity interval training [HIIT] or high-intensity resistance training [HIRT]) interventions, including HIIT + HIRT with pre- and post-nutrient timing (HIITRT), HIIT + essential amino acids (HIITAA), and HIRT + protein (HIRTPRO). Remaining studies evaluated HIIT (HIITOW) and protein following bariatric surgery (BARPRO). Pre and post total body DXA scans were used to measure DXALST, body mass, and fat mass (FM). The correction formula was applied to calculate FFATLST. Paired sample t-tests were used to evaluate differences between DXALST and FFATLST change scores (Δ) across all subjects, within each study and intervention. Significant differences between ΔDXALST and ΔFFATLST were observed for BARPRO (mean difference [MD; ΔDXALST-ΔFFATLST] ± standard error [SE]: -3.5 ± 1.2 kg, p < 0.001), as well as HIRTPRO (-0.1 ± 0.2 kg, p = 0.004). When evaluating LST, the FFAT correction may be specifically applicable to cases of significant weight loss (>10% of original weight) or body recomposition (≥2% FM loss and ≥2% LST gain).