Knee Extension Exercise Research Articles

A comparison of passive heat treatment-induced vascular adaptations relative to exercise training

Epidemiological data indicate that repeated heat stress improves cardiovascular health, making passive heat therapy (PHT) a potential alternative for those unable to exercise. Few studies to date have examined the potential exercise mimetic effects in humans, and it is unclear how adaptations compare in magnitude to exercise training. OBJECTIVE: To examine the effects of 6 weeks of localized, muscle-focused PHT on resistance artery vascular function, exercise hemodynamics, and exercise performance relative to the adaptations observed following high-intensity aerobic exercise training focused on the same muscles. HYPOTHESIS: 6 weeks of PHT, applied through pulsed shortwave diathermy (2 hr, 3 days/week), would increase resistance artery function, improve exercise hemodynamics, and enhance exercise performance more than a sham treatment, but less than single-leg knee extension (KE) exercise training (EX; 40 min, 3 days/week). We also hypothesized that these functional adaptations would be accompanied by increased skeletal muscle capillarity. METHODS: We randomized 34 sedentary but otherwise healthy, young adults (ages 18–36; n = 17 female, 17 male) to receive PHT, EX, or sham heating sessions (SHAM; 2 hr, 3 days/week) over 6 weeks. Vascular function was determined through the blood flow response during both a passive leg movement (PLM) assessment and a knee extension graded exercise test (GXTmax). Muscle biopsies were taken from the vastus lateralis at baseline and after 6 weeks of intervention. RESULTS: Peak muscle treatment temperature was significantly different between all groups with PHT exhibiting a higher peak temperature (~40.80°C) than those in the EX (~37.75°C, P<0.001) and SHAM groups (~36.10°C, P<0.001). Peak blood flow during PLM increased to the same extent (P=0.625) in both the EX (~10.5% increase, P=0.009) and PHT groups (~8.5% increase, P=0.044); but tended to decrease in the SHAM group (P=0.087). KE peak flow increased in EX (~19%, P=0.005), but did not change in PHT (P=0.523) and decreased in SHAM (~7%, P=0.020). Peak vascular conductance during KE significantly increased by ~25% in EX (P=0.030) and PHT (P=0.012). KE peak power increased in EX by ~27% (P=0.001) but did not significantly change in PHT(P=0.175) and SHAM groups (P=0.111). EX, but not PHT or SHAM increased muscle capillary-to-fiber ratio (P = 0.0003), capillary density (P = 0.0428), and the Capillary to Fiber Perimeter Exchange Index (P = 0.0089). CONCLUSIONS: 6 weeks of localized PHT, when applied to young healthy individuals, improved resistance artery function at rest and during exercise to the same extent as exercise training. However, PHT did not lead to increased KE peak flow, microvascular remodeling, or improved exercise performance. Therefore, PHT mimics many, but not all the vascular benefits of exercise training. Further research is necessary to determine the mechanism by which 6 weeks of PHT led to improved vascular function at rest and during exercise. This is the full abstract presented at the American Physiology Summit 2023 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.

Age-associated impairments in exercise tolerance and critical power are related to vascular endothelial dysfunction

Background: Aging results in lower exercise tolerance, manifested as decreased Critical Power (CP). Aging is also associated with reduced physical activity, decreased muscle mass, and impaired vascular endothelial function, all of which may contribute to the age-related decrease in CP. Purpose: The purpose of this study was to determine if the age-related decrease in CP occurs independently of changes in physical activity and muscle mass and if it is related to impaired vascular endothelial function. Methods: 10 Old (63.1 ± 2.5 years, 5 female and 5 male) and 10 Young (24.4 ± 4.0 years, 5 female and 5 male) physically active volunteers enrolled in this study. Physical activity was measured with accelerometry. Leg muscle mass was quantified with dual x-ray absorptiometry (DEXA). CP during single leg knee extension exercise was determined over the course of 4 visits with 3-5 constant-power tests to task failure. On the fifth visit, vascular function of the leg was assessed with the passive leg movement (PLM) hyperemia. Results: Young and Old subjects did not differ in daily step count (Old = 13001.1 ± 2464.0 vs Young = 13527.0 ± 3213.8 steps, P = 0.735) or in leg lean mass (P = 0.901). The Old subjects had a lower mass-specific CP (Old = 3.20 ± 0.94 vs Young = 4.60 ± 0.87 W/kg, P = 0.004). The Old subjects also had significantly lower vascular function assessed by the peak hyperemic response to PLM, even after being normalized for leg-lean mass (Old = 79.4 ± 38.3 vs Young = 128.8 ± 34.9 ml/min/kg, P = 0.010). CP was related to PLM hyperemia (R= 0.63; P = 0.004). Importantly, simultaneously controlling for physical activity (steps per day) and for leg lean mass with partial correlation analysis, actually strengthened the relationship between CP and vascular function assessed by PLM (R = 0.69; P = 0.003). Conclusion: The age-related decline in CP is not merely the consequence of low physical activity or reduced muscle mass. Reductions in the vascular endothelial function within the exercising muscle are strongly related to the observed decline in CP. Future research should determine if interventions known to improve vascular function can ameliorate exercise tolerance in Old adults. BYU College Undergraduate Research Award This is the full abstract presented at the American Physiology Summit 2023 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.

Acute fatigue induces paradoxical increases in velocity and power in a sex and myosin isoform dependent manner

OBJECTIVE or our study was to identify effects of acute fatigue on myofibrillar components and their function that persist beyond modifications to intracellular metabolic perturbations. Our HYPOTHESIS was that acute fatigue would induce differential phosphorylation in regulatory proteins in the sarcomere that would reduce tension and increase velocity and power. We used the following METHODS to test that hypothesis. Seven healthy, competitive athletes were recruited to participate (3 male, 4 female), entailing one session of unilateral fatiguing knee extension exercise to the point of task failure. Immediately after, bilateral percutaneous needle muscle biopsy was performed on the vastus lateralis muscle, providing a “fatigued” and “not fatigued” sample. Tissue was separated for phosphoproteomic analysis (western blot and isoelectric separation) and single fiber contractile mechanics (isotonic load clamps; isometric tension, velocity and power). Following mechanical assessment, myosin heavy chain (MHC) isoform was determined for each fiber via SDS-PAGE. Our RESULTS found no effect of fatigue on isometric tension across all fiber types. However, maximum shortening velocity was increased along with contractile power, consistent with our hypotheses. Surprisingly, our results varied by sex and fiber type, such that velocity was increased primarily in MHC IIA/X fibers in males, whereas females demonstrated a blunted response to fatigue. While baseline variation in regulatory protein phosphorylation (Myosin Binding Protein C; MyBP-C) were significantly correlated with power output in contractile power in fast isoforms (MHC IIA, MHC IIA/X) we did not detect significant alterations in phosphorylation of this protein with fatigue. We CONCLUDE that fatigue causes paradoxical increased in velocity and power that are particularly evident in males. While our measurement of MyBP-C phosphorylation did not detect effects of fatigue, other potential sarcomeric proteins may explain this paradoxical response to acute fatigue. Wu Tsai Human Performance Alliance This is the full abstract presented at the American Physiology Summit 2023 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.

Local passive heating administered during recovery impairs subsequent isokinetic knee extension exercise performance

BACKGROUND: Passive heating has attracted attention as a potentially promising recovery modality in sports. However, investigations of passive heating have yielded only inconsistent results for exercise performance. OBJECTIVE: To investigate the acute effects of local passive heating administered between repeated bouts of isokinetic exercise. METHODS: The experiment was a randomized crossover study. There was a total of three visits including a familiarization visit. During the remaining two visits, eleven healthy men performed three bouts of nine sets of isokinetic knee extensions using their dominant single-leg (30 repetitions/set, 180∘/sec). A 15 min recovery, during which a local passive heating pad at control (CON) or heating (HT) was applied to the rectus femoris, was afforded after the 3rd and 6th sets (Recovery 1 and 2). Isokinetic exercise performance, as assessed by peak torque, total work, and average power was analyzed using two-way repeated-measures ANOVA. RESULTS: Following Recovery 1 and 2, isokinetic exercise performance, as assessed by peak torque, total work, and average power was reduced in Set 4 (p< 0.001, p< 0.001, p= 0.080) and Set 7 (p< 0.001, p< 0.001, p= 0.009) in the HT group relative to the CON group. Electromyography analysis revealed that signal amplitude was lower in the HT group in Set 4 (p< 0.001) subsequent to Recovery 1, and that firing frequency was higher in Set 7 (p= 0.002) in the HT group after Recovery 2. Furthermore, EMG time-frequency maps from one representative participant showed that following Recovery 1 and 2 peak energy decreased during the first five repetitions in Set 4 and 7. CONCLUSIONS: Local passive heating administered during recovery decreased subsequent performance of isokinetic knee extensors, muscle activation ability and increased firing frequency maintaining force output. Therefore, local passive heating is not an appropriate acute recovery strategy for isokinetic exercises.

Blood Pressure Responses to Postexercise Circulatory Occlusion Are Attenuated After Exercise-Induced Muscle Weakness.

Exercise blood pressure (BP) responses are thought to be determined by relative exercise intensity (percent maximal voluntary contraction (MVC) strength). However, cross-sectional studies report that during a static contraction, higher absolute force is associated with greater BP responses to relative intensity exercise and subsequent muscle metaboreflex activation with postexercise circulatory occlusion (PECO). We hypothesized that a bout of unaccustomed eccentric exercise would reduce knee extensor MVC and subsequently attenuate BP responses to PECO. Continuous BP, heart rate, muscle oxygenation, and knee extensor electromyography were recorded in 21 young healthy individuals (female, n = 10) during 2 min of 20% MVC static knee extension exercise and 2 min of PECO, performed before and 24 h after 300 maximal knee extensor eccentric contractions to cause exercise-induced muscle weakness. As a control, 14 participants repeated the eccentric exercise 4 wks later to test whether BP responses were altered when exercise-induced muscle weakness was attenuated via the protective effects of the repeated bout effect. Eccentric exercise reduced MVC in all participants (144 ± 43 vs 110 ± 34 N·m, P < 0.0001). BP responses to matched relative intensity static exercise (lower absolute force) were unchanged after eccentric exercise ( P > 0.99) but were attenuated during PECO (systolic BP: 18 ± 10 vs 12 ± 9 mm Hg, P = 0.02). Exercise-induced muscle weakness modulated the deoxygenated hemoglobin response to static exercise (64% ± 22% vs 46% ± 22%, P = 0.04). When repeated after 4 wks, exercise-induced weakness after eccentric exercise was attenuated (-21.6% ± 14.3% vs -9.3 ± 9.7, P = 0.0002) and BP responses to PECO were not different from control values (all, P > 0.96). BP responses to muscle metaboreflex activation, but not exercise, are attenuated by exercise-induced muscle weakness, indicating a contribution of absolute exercise intensity on muscle metaboreflex activation.

Influence of unilateral and bilateral knee extension fatigue protocols on inter-limb asymmetries assessed through countermovement jumps

ABSTRACT This study explores the sensitivity of jump type (unilateral and bilateral) and output variable (mean force, propulsive impulse, and jump height) to detect the changes in inter-limb asymmetries induced by unilateral and bilateral fatigue protocols. Thirty-eight individuals performed two testing sessions that consisted of (I) nine “pre-fatigued” countermovement jumps (CMJs; three bilateral and six unilateral [three with each leg]), (II) fatigue protocol and (III) nine “post-fatigued” CMJs. The testing sessions only differed in the fatigue protocol (five sets to failure against the 15-repetition maximum load using either the unilateral or bilateral knee extension exercise). The magnitude of all CMJ-derived variables (mean force, impulse, and jump height) decreased following both unilateral (p ≤ 0.002) and bilateral fatigue protocols (p ≤ 0.018). However, only unilateral protocol accentuated inter-limb asymmetries, which was detected for all variables during the unilateral CMJ (from −4.33% to −2.04%; all p < 0.05) but not during the bilateral CMJ (from −0.64% to 0.54%; all p > 0.05). The changes in inter-limb asymmetries following the unilateral and bilateral fatigue protocols were not significantly correlated between the unilateral and bilateral CMJs (r s ≤ 0.172). The unilateral CMJ should be recommended for the testing purposes over the bilateral CMJ due to its greater sensitivity to detect the selective effects of fatigue.

The Influence of Hip and Knee Joint Angles on Quadriceps Muscle-Tendon Unit Properties during Maximal Voluntary Isometric Contraction.

Determining how the quadriceps femoris musculotendinous unit functions, according to hip and knee joint angles, may help with clinical decisions when prescribing knee extension exercises. We aimed to determine the effect of hip and knee joint angles on structure and neuromuscular functioning of all constituents of the quadriceps femoris and patellar tendon properties. Twenty young males were evaluated in four positions: seated and supine in both 20° and 60° of knee flexion (SIT20, SIT60, SUP20, and SUP60). Peak knee extension torque was determined during maximal voluntary isometric contraction (MVIC). Ultrasound imaging was used at rest and during MVIC to characterize quadriceps femoris muscle and tendon aponeurosis complex stiffness. We found that peak torque and neuromuscular efficiency were higher for SUP60 and SIT60 compared to SUP20 and SIT20 position. We found higher fascicle length and lower pennation angle in positions with the knee flexed at 60°. The tendon aponeurosis complex stiffness, tendon force, stiffness, stress, and Young's modulus seemed greater in more elongated positions (60°) than in shortened positions (20°). In conclusion, clinicians should consider positioning at 60° of knee flexion rather than 20°, regardless if seated or supine, during rehabilitation to load the musculotendinous unit enough to stimulate a cellular response.

Increased adiposity is associated with altered skeletal muscle energetics.

The objective of this pilot study was to characterize relationships between skeletal muscle energy metabolism and body composition in healthy adults with varied amounts and distribution of adipose tissue. In vivo muscle energetics were quantified using dynamic 31P magnetic resonance spectroscopy with knee extension exercise standardized to subject lean body mass. Spearman's correlation analysis examined relationships between muscle metabolism indices and measures of adiposity including body mass index (BMI), total body fat, and quadriceps intermuscular adipose tissue (IMAT). Post hoc partial correlations were examined controlling for additional body composition measures. Kruskal-Wallis tests with Dunn-Sidak post hoc comparisons evaluated group differences in energy metabolism based on body composition profiles (i.e., lean, normal-weight obese, and overweight-obese) and IMAT tertiles. BMI negatively correlated with end-exercise muscle pH after correcting for IMAT and total body fat (r = -0.46, P = 0.034). Total adiposity negatively correlated with maximum oxidative capacity after correcting for IMAT (r = -0.54, P = 0.013). IMAT positively correlated with muscle proton buffering capacity after correcting for total body fat (r = 0.53, P = 0.023). Body composition groups showed differences in end-exercise fall in [PCr] with normalized workload (P = 0.036; post hoc: overweight-obese < lean, P = 0.029) and maximum oxidative capacity (P = 0.021; post hoc: normal-weight obese < lean, P = 0.016). IMAT tertiles showed differences in end-exercise fall in [PCr] with normalized workload (P = 0.035; post hoc: 3rd < 1st, P = 0.047). Taken together, these results support increased adiposity is associated with reduced muscle energetic efficiency with more reliance on glycolysis, and when accompanied with reduced lean mass, is associated with reduced maximum oxidative capacity.NEW & NOTEWORTHY Skeletal muscle energy production is influenced by both lean body mass and adipose tissue but the effect of their distribution on energy metabolism is unclear. This study examined variations in quadriceps muscle energy metabolism in healthy adults with varied relative amounts of lean and adipose tissue. Results suggest increased adiposity is associated with reduced muscle energetic efficiency with more reliance on glycolysis, and when accompanied with reduced lean mass, is associated with reduced maximum oxidative capacity.

Normalization of the electromyography amplitude during a multiple-set resistance training protocol: Reliability and differences between approaches.

The first aim was to investigate the impact of different electromyography (EMG) parameters as a reference to normalize the EMG amplitude of the superficial quadriceps femoris muscles across different sets of a knee extension exercise. The second aim is to examine the reliability between days of the EMG parameters used as a reference. Eleven young males attended the laboratory on 4 different days and performed one repetition maximum test, maximumvoluntary isometric contractions, and a resistance training protocol until failure. Surface EMG was placed over the rectus femoris, vastus lateralis, and vastus medialis muscles. Seven EMG parameters were calculated from the tasks and used to normalize EMG amplitude measured during the resistance training protocol. A repeated-measures two-way ANOVA was used (normalized EMG amplitude×set) to compare normalized EMG across sets, while an intraclass correlation coefficient, coefficient of variation, and Bland-Altman plots were used to calculate the intra-day reliability of the EMG parameters. The present investigation showed that normalized EMG amplitude of the superficial muscles of the quadriceps measured during a knee extension exercise is influenced by the EMG parameter and depends on the muscle. While rectus femoris and vastus lateralis normalized EMG amplitude presented one parameter among seven showing similar value to the other parameters, VM showed two. Lastly, all EMG parameters for all muscles presented an overall excellent reliability and agreement between days.

Effect of Increased Pressure Pain Threshold on Resistance Exercise Performance With Blood Flow Restriction.

Kataoka, R, Song, JS, Bell, ZW, Wong, V, Spitz, RW, Yamada, Y, and Loenneke, JP. Effect of increased pressure pain threshold on resistance exercise performance with blood flow restriction. J Strength Cond Res 37(6): 1204-1210, 2023-This study aimed to examine whether increasing pressure pain threshold (PPT) through isometric handgrip exercise (HG) affects the number of repetitions completed and discomfort with knee extension exercise (KE) with blood flow restriction (BFR), and examine whether performing additional exercise leads to a further increase in PPT. Forty-one participants completed 2 trials: rest followed by low-load KE with BFR at 80% of resting arterial occlusion pressure (Rest + KE BFR) and low-intensity (30% of maximal strength) HG exercise followed by KE with BFR (HG + KE BFR). Pressure pain threshold was measured before and after exercise at the forearm and tibialis anterior. Results are presented as median difference (95% credible interval). Pressure pain threshold increased at the forearm (Bayes factor [BF 10 ]: 5.2 × 10 7 ) and tibialis anterior (BF 10 : 1.5 × 10 6 ) after HG exercise. However, this did not lead to greater repetitions being completed with BFR exercise (0.2 [-0.1, 0.6] repetitions, BF 10 : 0.07). Pressure pain threshold after BFR exercise was not augmented over that observed with HG exercise (0.02 [-0.15, 0.2] kg·cm -2 , BF 10 : 0.175) at the forearm. More data are needed in the lower body to determine which model best fits the data (BF 10 : 0.84). Discomfort with BFR exercise was not different between conditions (1.0 [-2.3, 4.4] arbitrary units, BF 10 : 0.10). The pain-reducing effect of prior exercise did not change the repetitions completed with BFR exercise, suggesting that the change in PPT may not have been great enough to alter performance. Performing additional exercise did not elicit further increases in PPT nor was perceived discomfort to BFR exercise altered by changes in PPT.

Different time course recovery of muscle edema within the quadriceps femoris and functional performance after single- vs multi-joint exercises.

This study aimed to verify the time course recovery of muscle edema within the quadriceps femoris and functional performance after lower-body single- and multi-joint exercises. For this within-participant unilateral and contralateral experimental design, fourteen untrained young males performed a unilateral knee extension exercise (KE), and a unilateral leg press (LP) exercise in a counterbalanced order. At pre-, post-, 24 h, 48 h, 72 h, and 96 h after exercise, the peak torque (PT), unilateral countermovement jump (uCMJ) performance, and rectus femoris (RF) and vastus lateralis (VL) muscle thicknesses were recorded in both legs. The PT decreased immediately after (p = 0.01) both exercises (KE and LP) and was fully recovered 24 h after KE (p = 0.38) and 48 h after LP (p = 0.68). Jump height and power, in the uCMJ, followed the same PT recovery pattern after both exercises. However, vertical stiffness (Kvert) was not affected at any time point after both protocols. The RF thickness increased after both exercises (p = 0.01) and was fully restored 48 h after KE (p = 0.86) and 96 h after LP (p = 1.00). The VL thickness increased after both exercises (p = 0.01) and was fully restored 24 h after LP (p = 1.00) and 48 h after KE (p = 1.00). The LP exercise, compared to KE, induced more prolonged impairment of functional performance and delayed recovery of RF muscle edema. However, the VL edema-induced muscle swelling recovery was delayed after the KE exercise. The different recovery kinetics between functional performance and muscle damage should be taken into consideration depending on the objectives of the next training sessions.

Effects of Press Needle Intervention on Knee Flexion and Extension Movements: A Randomized Trial

Objective: Knee flexion exercise is a type of exercise therapy for improving knee-joint muscle strength. Among the knee extensors, the vastus medialis muscle is less active and prone to disuse atrophy. The effects of press needle acupuncture include vasodilation, which may affect blood flow in the vastus medialis. This study examined the effects of exercise stimulation + press needle stimulation on muscle blood flow. Materials and Methods: Conducted in Teikyo Heisei University, Tokyo, Japan, this randomized controlled trial involved 30 healthy adults in 3 groups (10 who did not receive stimulation, 10 who received exercise stimulation only, and 10 who received press needle stimulation + exercise stimulation). The stimulations were applied once per week, for 3 weeks. After resting for 10 minutes, the nonstimulated group rested for 2 additional minutes, and the other 2 groups performed knee flexion and extension exercises considered to be “very very hard on the Borg rating.” After this activity, the 2 stimulation groups rested for 10 minutes. Press needle stimulation was applied on the vastus medialis muscles of both thighs in the combination stimulation group. Results: The combination group had a smaller decrease in muscle tissue oxygen saturation and an increase in total hemoglobin, compared to the exercise only stimulation group. Conclusions: Press needle stimulation during exercise may dilate muscle blood vessels. Future studies should examine the effectiveness of this stimulation for age-specific and knee diseases.

Acute circulatory and femoral hemodynamic responses induced by standing core exercise at different rotational cadence: a crossover study

BackgroundCore exercise is often adopted as an adjunct in maintaining musculoskeletal health in rehabilitation; we previously showed that standing core rotational exercise improves femoral blood flow after training. This study aimed to investigate the effects of different rotational cadences on circulatory and hemodynamic responses after acute standing core exercise.MethodsSixteen healthy male adults (22 ± 1 yrs) were randomly assigned to participate in two 30-min standing core exercises of fast (75 rpm, FC) and slow cadence (20 rpm, SC) sessions after completing an acute bout of seated knee extension exercise session (KE) (80% of 1 repetition maximum × 12 repetitions × 3 sets). Impedance cardiography-derived circulatory responses and femoral hemodynamics by ultrasound imaging were measured pre- and 30, and 60 min post-exercise.ResultsKE acutely increased post-exercise cardiac output at 30 min (p = 0.008) and heart rate at 30 min (p = 0.04) and 60 min (p = 0.01), yet brachial blood pressure did not change. Systemic vascular resistance was significantly lower after FC and KE at 30 min (p = 0.008) and 60 (p = 0.04) min, respectively, compared with the baseline. In addition, KE acutely decreased post-exercise arterial stiffness (p = 0.05) at 30 min, increased femoral conductance (p = 0.03, p < 0.001), and blood flow (p = 0.009, p < 0.001) at 30 and 60 min. No significant changes were observed in absolute femoral blood flow after FC and SC, except that FC significantly increased relative femoral blood flow (p = 0.007) and conductance (p = 0.005). Post-exercise femoral diameter significantly increased in KE at 30 (p = 0.03) and 60 min (p = 0.01), but not in core exercise.ConclusionOur results suggest that standing core exercise elicits circulatory and hemodynamic changes only when the rotational cadence is set at a faster cadence, which provides preliminary scientific evidence for its use in exercise programs.

Low-Load Resistance Exercise with Blood Flow Restriction Increases Hypoxia-Induced Angiogenic Genes Expression.

The aim of the study was to determine whether low-load exercise (LL) with blood flow restriction (LL-BFR) would induce similar changes in expression of genes involved in hypoxia and angiogenesis compared to LL and high-load exercise (HL). Twenty-four males (age: 21.3 ± 1.9 years, body height: 1.74 ± 0.8 m, body mass: 73 ± 1.8 kg) were allocated into three groups: low-load exercise (LL), low-load exercise with blood-flow restriction (LL-BFR), and high-load exercise (HL). For the LL-BFR group a pneumatic cuff was inflated at 80% of the arterial occlusion pressure. All participants performed bilateral knee extension exercise, twice a week, for 8 weeks. LL and LL-BFR groups performed 3-4 sets of 15 reps at 20% 1RM, whilst the HL group performed 3-4 sets of 8-10 reps at 80% 1RM with a 60-s rest interval between sets. The hypoxia-inducible factor-1 alpha (HIF-1α) and beta (HIF-1β), vascular endothelial growth factor (VEGF), neuronal (nNOS), and inducible nitric oxide synthase (iNOS) genes expression were assessed before and after training. HIF-1α and HIF-1β mRNA levels significantly increased in the LL-BFR group and exceeded those elicited by HL and LL groups (p < .0001). VEGF gene expression was increased in both LL-BFR and HL groups, however, LL-BFR elicited a greater increase than LL (p < .0001). nNOS and iNOS genes expression significantly increased in all groups with greatest increases being observed in the LL-BFR group (p < .0001). The findings suggest that LL-BFR induces greater increases in genes expression related to hypoxia and angiogenesis than traditional resistance training.

The acute effects of knee extension exercises with different contraction durations on the subsequent maximal knee extension torque among athletes with different strength levels.

Individuals with high fatigue resistance against a high-intensity conditioning activity (CA) may be able to avoid experiencing significant fatigue and enhance their voluntary performance. We examined whether the optimal contraction duration of dynamic knee extension exercises to maximize subsequent voluntary performance varies depending on the strength level of an individual. The study participants were 22 male American college football players. Initially, all participants performed a 10-s maximal isometric knee extension exercise and were classified as stronger individuals (n = 8) and weaker individuals (n = 8) based on their relative muscle strength. Each group then performed three types of dynamic CA with different contraction durations (6 s [6-CA], 12 s [12-CA], and 18 s [18-CA]) in random order. To observe the time-course changes in post-activation potentiation and performance enhancement, the twitch torques induced by electrical stimulation and isokinetic knee extension torques at 180°/s were recorded before and after each CA. The twitch torque increased at 10 s (29.5% ± 9.3%) and 1 min (18.5% ± 6.8%) after 6-CA for the stronger individuals (p < 0.05). However, no post-activation potentiation was induced in the weaker individuals in either protocol. Voluntary performance increased at 4 (7.0% ± 4.5%) and 7 (8.2% ± 4.3%) min after 18-CA for stronger individuals (p < 0.05). However, there was no post-activation performance enhancement in either protocol for weaker individuals. Thus, CA with a relatively long contraction duration was optimal to maximize the subsequent voluntary performance for stronger individuals. It remains unknown whether CAs performed with relatively short or long contraction durations were optimal for weaker individuals.

Exercise Leg Blood Flow Is Preserved in Long-term Breast Cancer Survivors Previously Treated With Anthracycline Chemotherapy.

The objective of this investigation was to compare the acute hemodynamic responses during single-leg knee extension (SLKE) exercise between female breast cancer (BC) survivors previously treated with anthracycline chemotherapy and age- and sex-matched control (CON) subjects. Fourteen BC survivors (age: 61 ± 7 yr; time post-anthracycline therapy: 12 ± 6 yr) and nine CON subjects (age: 59 ± 7 yr) performed SLKE exercise at 25%, 50%, and 75% of peak power output during which heart rate, blood pressure (BP), leg blood flow (Doppler ultrasonography), and vascular conductance (leg blood flow/mean BP) were measured. Quadriceps mass was estimated from thigh volume and skinfold measures. Breast cancer survivors had lower quadriceps mass compared with CON subjects (1803 ± 607 vs 2601 ± 1102 g, P = .04). No difference was found between groups for maximal SLKE power output (28 ± 11 vs 34 ± 17 W, P = .35), heart rate (109 ± 14 vs 103 ± 13 bpm, P = .36), or mean arterial BP (122 ± 18 vs 119 ± 26 mm Hg, P = .33). Rest and submaximal exercise mean arterial BP, leg blood flow (indexed to quadriceps muscle mass), and leg vascular conductance were not significantly different between BC survivors and CON subjects. Leg blood flow during submaximal SLKE exercise is preserved in long-term BC survivors previously treated with anthracycline chemotherapy.

Effect of iron deficiency on skeletal muscle metabolism in heart failure with preserved ejection fraction

Abstract Background Iron deficiency (ID) is suggested to be one of the key comorbidities contributing to heart failure with preserved ejection fraction (HFpEF) and concomitant exercise intolerance, possibly by inducing systemic inflammation and microvascular dysfunction (MVD). ID is associated with poorer prognosis in HFpEF, but its exact impact on exercise capacity in HFpEF patients remains to be further investigated. Purpose To evaluate the effect of ID on exercise capacity in HFpEF patients by assessing skeletal muscle metabolism. Additionally, to assess the association between ID and MVD in HFpEF patients. Methods This prospective study included patients diagnosed with HFpEF according to the ESC Heart Failure 2016 guidelines between January 2018 and May 2021. Patients were excluded if they were of childbearing potential, had any iron supplementation 6 months or chemotherapy 1 year prior to inclusion, were known with significant peripheral artery disease, or had any contraindication for phosphorus-magnetic resonance spectroscopy (31P-MRS). Iron status was defined as absolute ID (serum ferritin &amp;lt;100μg/L), relative ID (serum ferritin 100–299μg/L and transferrin saturation &amp;lt;20%), and no ID. Skeletal muscle oxidative capacity of the upper leg was evaluated by determining phosphocreatine (PCr) recovery kinetics with 31P-MRS in the vastus lateralis muscle after isometric knee extension exercise. Microvascular function was assessed as heat-induced skin hyperemia using laser-Doppler flowmetry. Clinical data up to 6 months prior to or after inclusion was used. Results Twenty-four HFpEF patients without ID and 18 with ID were included, including 14 patients with absolute ID. Clinical characteristics of patients without ID and with ID were comparable: median age 74 [69–79] vs. 77 [69–81] years, 13 (54%) vs. 14 (78%) were females, and 20 (83%) vs. 16 (89%) had a history of hypertension (Table 1). Both groups showed similar halftime of PCr recovery after exercise (29.2 [22.8–33.2] vs. 27.0 [21.1–31.4] seconds, p=0.416), and similar skin hyperaemic flow increase (1142 [576–2247] vs. 1023 [574–1511] %, p=0.554). These measures of skeletal muscle metabolism and microvascular function were not correlated. In a subset of patients (11 without ID and 13 with ID), elevated high-sensitive C-reactive protein (hsCRP) was correlated with PCr recovery halftime in those with ID (R2 0.565, p=0.003). This correlation was not found in patients without ID (R2 0.119, p=0.300) in the original data (Figure 1), but was found after removal of a prominent outlier (R2 0.654, p=0.005). Conclusion HFpEF patients without ID showed comparable skeletal muscle oxidative capacity and microvascular skin hyperaemia compared to HFpEF patients with ID. Post-hoc analysis suggests that inflammation affects skeletal muscle metabolism in HFpEF patients, possibly regardless of ID. Future studies on the effects of ID and inflammation on cellular metabolism could suggest therapeutic targets in HFpEF. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): This study was funded by Vifor Pharma. The funder had no influence on the study results.

VP.89 Skeletal muscle after a single bout of eccentric exercise in myotonic dystrophy type 1: a complete proteomic analysis

Myotonic dystrophy type 1 (DM1) is a multisystemic progressive genetic disease that causes muscle weakness and wasting. Strength training has been shown to be safe and can induce maximal strength gains. However, the underlying molecular mechanisms of these maximal strength gains remain unclear. The aim of this study is to determine how a single bout of eccentric exercise modulates protein expression in DM1 individuals compared to controls. Eight men with DM1 and five healthy controls completed the study. On day zero, a biopsy of the vastus lateralis was taken. On day eight, participants completed a standardized eccentric knee extension exercise protocol of the biopsied leg on an isokinetic device. 24 hours later, on day nine, a second biopsy was taken in the same muscle. Proteomics were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS): all samples were pooled to create an ion library which was used to assess muscle protein expression in individual samples. A total of 894 proteins were identified. Protein expression and its modulation by exercise were heterogenous in DM1 individuals. The expression of 111 proteins was significantly modulated by exercise for the control subjects while 50 were significantly modulated in DM1 subjects. Of these proteins, 9 had increased their expression in both groups. This includes 4 structural proteins (FLNC, NEXN, XIRP1 and NRAP), 2 translation factors (EF2 and IF5), a ubiquitin and skeletal muscle differentiation modulator (KLHL40), a chaperone protein (HS90B) and a neutrophil serine protease inhibitor (ILEU). In both groups, a mitochondrial protein (NDUB8) had decreased its expression. Further analyses are being conducted to assess how DM1 individuals responded differently to exercise compared to healthy controls. In conclusion, despite the genetic default, DM1 muscle has some similar responses to exercise compared to healthy controls although it remains heterogenous among DM1 individuals.

Acute changes in motor unit discharge property after concentric versus eccentric contraction exercise in knee extensor

This study aimed to investigate the motor unit firing property immediately after concentric or eccentric contraction exercise. Eighteen healthy men performed repetitive maximal isokinetic knee extension exercises with only concentric or eccentric contraction until they exerted less than 80% of the baseline strength. Before and after the fatiguing exercise, high-density surface electromyography of the vastus lateralis was recorded during submaximal ramp-up isometric contraction and individual motor units were identified. Only motor units that could be tracked before and after exercise were analyzed. Muscle cross-sectional area of the vastus lateralis was measured using ultrasound, and electrically evoked torque was recorded before and after the exercise. Sixty-five and fifty-three motor units were analyzed before and after the concentric and eccentric contractions, respectively. The results showed that motor units with moderate to high recruitment thresholds significantly decreased recruitment thresholds under both conditions, and the motor unit discharge rates significantly increased after concentric contraction compared to eccentric contraction. A greater muscle cross-sectional area was observed with concentric contraction. The evoked torque was significantly decreased under both conditions, but no difference between the conditions. These results suggest that fatiguing exercise with concentric contraction contributes to greater neural input to muscles and metabolic responses than eccentric contraction.

The Hypoalgesic Effect of Low-Load Exercise to Failure Is Not Augmented by Blood Flow Restriction

ABSTRACTPurpose: To 1) examine whether blood flow restriction would provide an additional exercise-induced hypoalgesic response at an upper and lower limb when it is incorporated with low-load resistance exercise until failure, and 2) examine if increases in blood pressure and discomfort, with blood flow restricted exercise, would mediate the exercise-induced hypoalgesia over exercise without blood flow restriction. Methods: Forty healthy young participants completed two trials: four sets of unilateral knee extension exercise to failure at 30% of one-repetition maximum, with and without blood flow restriction. Pressure pain thresholds were assessed before (twice) and 5-min post exercise at an upper and lower limb. Blood pressure and discomfort ratings were recorded to examine mediating effects on exercise-induced hypoalgesia with blood flow restricted exercise. Results: Pressure pain threshold increased following both exercise conditions compared to a control, without any differences between exercise conditions at the upper (exercise conditions vs. control: ~0.37 kg/cm2) and lower (exercise conditions vs. control: ~0.60 kg/cm2) limb. The total number of repetitions was lower for exercise with blood flow restriction compared to exercise alone [median difference (95% credible interval) of −27.0 (−29.8, −24.4) repetitions]. There were no mediating effects of changes in blood pressure, nor changes in discomfort, for the changes in pressure pain threshold at either the upper or lower limb. Conclusion: The addition of blood flow restriction to low-load exercise induces a similar hypoalgesic response to that of non-blood flow restricted exercise, with a fewer number of repetitions.