Progressive Resistance Exercise Training Research Articles

Resistance exercise training to improve post‐operative rehabilitation in knee arthroplasty patients: A narrative review

AbstractKnee osteoarthritis is associated with deficits in muscle strength, muscle mass, and physical functioning. These muscle‐related deficits are acutely exacerbated following total knee arthroplasty (TKA) and persist long after surgery, despite the application of standardized rehabilitation programs that include physical/functional training. Resistance exercise training (RET) has been shown to be a highly effective strategy to improve muscle‐related outcomes in healthy as well as clinical populations. However, the use of RET in traditional rehabilitation programs after TKA is limited. In this narrative review, we provide an updated view on whether adding RET to the standard rehabilitation (SR) in the recovery period (up to 1 year) after TKA leads to greater improvements in muscle‐related outcomes when compared to SR alone. Overall, research findings clearly indicate that both muscle strength and muscle mass can be improved to a greater extent with RET‐based rehabilitation compared to SR. Additionally, measures of physical functioning that rely on quadriceps strength and balance (e.g., stair climbing, chair standing, etc.) also appear to benefit more from a RET‐based program compared to SR, especially in patients with low levels of physical functioning. Importantly though, for RET to be optimally effective, it should be performed at 70%–80% of the one‐repetition maximum, with 3–4 sets per exercise, with a minimum of 3 times per week for 8 weeks. Based upon this narrative review, we recommend that such high‐intensity progressive RET should be incorporated into standard programs during rehabilitation after TKA.

THE EFFECTIVENESS OF PROGRESSIVE RESISTANCE TRAINING IN MANAGING PROGRESSIVE SUPRANUCLEAR PALSY: A CASE STUDY

SETTING The Centre for STRONG Medicine is an outpatient multidisciplinary geriatric service at Concord Hospital, Sydney. An 82-year-old male with a primary diagnosis of Progressive Supranuclear Palsy (PSP) with cardiac and metabolic comorbidities was referred in March 2023. PSP is a rare neurological disorder that affects gait, balance, vision, and cognition. The participant mobilised with a rollator and had previously sustained vertebral and wrist fractures secondary to falls. MANAGEMENT Management was to use progressive resistance training (PRT) to combat mobility decline, prevent falls and provide education to encourage independent exercise. Initial assessment determined current health status using Falls Self Efficacy Scale (FSE-I) and Fried Frailty Phenotype (FFP) questionnaires, and measured function and strength using maximal gait speed, five times sit-to-stand (5xSTS) and one repetition maximum (1RM), respectively. FSE-I determined a high fear of falling and FFP determined frail classification. Outcomes informed the PRT exercise prescription targeting the major muscle groups for 2-3 sets of 7-9 repetitions at 70-85% 1RM progressed gradually and preformed twice weekly in a supervised group. Education regarding breathing, exercise tempo, rest, progression, and risk mitigation were provided. All outcomes were reassessed after 12-weeks of training. RESULTS Attendance was 100% (23 sessions) with improvement in all outcomes. Functional improvements included 0.25metres/second increase in maximal gait speed, 2.5 second reduction in 5xSTS, and safe mobilisation without a rollator. Strength improvements included 101% increase in 1RM leg press, 100% increase in 1RM triceps extension and 72% increase in 1RM seated row. Frailty status improved to pre-frail and fear of falling reduced. Self-reported improvements included increased steadiness and confidence exercising unsupervised. DISCUSSION Although PSP is progressive, PRT resulted in meaningful benefits in strength and function that improved daily task performance and confidence. Further research is needed to investigate the effects of PRT on PSP management in a larger cohort.

The enhancement of explosive power contributes to the development of anaerobic capacity: A comparison of autoregulatory progressive resistance exercise and velocity-based resistance training

Background/ObjectivesDue to the character of the taekwondo, the adenosine triphosphate–phosphocreatine system provides the energy for each kick, the glycolytic system supports the repeated execution of kicks, and the aerobic system promotes recovery between these movements and the bout. Therefore, taekwondo athletes require high explosive power and anaerobic capacity in order to carry out sustained and powerful attacks. So, the purpose of this study is to compare the effects of APRE and VBRT on lower-limb explosive power and anaerobic capacity in college taekwondo players. MethodsA total of 30 taekwondo players completed an 8-week training intervention with autoregulatory progressive resistance exercise (APRE; n = 15) and velocity-based resistance training (VBRT; n = 15). Testing included the one-repetition maximum squat, countermovement jump (CMJ), taekwondo anaerobic intermittent kick test (TAIKT), and 30-s Wingate anaerobic test (WAnT). Results(1) Intragroup comparisons revealed significant effects for one-repetition maximum squat, peak power of CMJ (CMJPP), relative peak power of CMJ (CMJRPP), and total number of TAIKT (TAIKTTN) in both the APRE and VBRT groups. The VBRT group exhibited small effect sizes for time at peak power of WAnT (WAnTPPT) and moderate effect sizes for peak power of WAnT (WAnTPP), relative peak power of WAnT (WAnTRPP), and fatigue index of TAIKT (TAIKTFI), whereas the APRE group exhibited small effect sizes for TAIKTFI. (2) Intergroup comparisons revealed no significant effects in any of the results. However, VBRT demonstrated a moderate advantage in WAnTPP and WAnTRPP, whereas APRE had a small advantage in CMJPP and CMJRPP. ConclusionsThese findings suggest that APRE improved explosive power (CMJPP and CMJRPP) more, whereas VBRT improved anaerobic power output (WAnTPP and WAnTRPP) more. Both methods were found to have similar effects in improving the anaerobic endurance (WAnTPPT and TAIKTTN) and fatigue index (power drop of WAnT and TAIKTFI).

Effects of the combination of pulsed electromagnetic field with progressive resistance exercise on knee osteoarthritis: A randomized controlled trial.

Knee osteoarthritis (OA) is a common and disabling disease among the elderly population. The optimal conservative treatment for knee OA is not well established. This study aimed to assess the effectiveness of pulsed electromagnetic field (PEMF) combined with progressive resistance exercise (PRE) in improving physical function and pain in patients with knee OA. Thirty-four patients with knee OA (17 in each group) participated in a single-blind randomized control study. Patients were randomly assigned to receive 24 sessions of either combined PEMF and PRE (treatment group) or PRE only (control group). Patients were evaluated at pre-treatment, post-treatment (2 months), and at 3-month and 6-month follow-ups using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Numeric Pain Rating Scale (NPRS); walking speed and 5-times chair stand test. Mixed ANOVA was used for statistical analysis with Bonferroni adjustments. There was no significant group-by-time interaction for any outcome (P> 0.05). However, both groups scored significantly higher on the NPRS and KOOS at post-treatment, 3-, and 6-month follow-up compared to their baseline. Further, both groups completed the 5-times chair stand test and walking speed test with significantly less time at all post-treatment time points than the pre-treatment. None of the study outcomes (NPRS, KOOS, walking speed, and 5 times chair stand) were significantly different between groups at any of the time points. Both treatment options, PRE only versus PRE with PEMF, were equally effective in decreasing pain and improving physical function in patients with knee OA. This would suggest that the optimal parameters for PEMF that may show beneficial effects for knee OA when added to PRE training need to be determined.

Resistance exercise protects mice from protein-induced fat accretion.

Low-protein (LP) diets extend the lifespan of diverse species and are associated with improved metabolic health in both rodents and humans. Paradoxically, many athletes and bodybuilders consume high-protein (HP) diets and protein supplements, yet are both fit and metabolically healthy. Here, we examine this paradox using weight pulling, a validated progressive resistance exercise training regimen, in mice fed either an LP diet or an isocaloric HP diet. We find that despite having lower food consumption than the LP group, HP-fed mice gain significantly more fat mass than LP-fed mice when not exercising, while weight pulling protected HP-fed mice from this excess fat accretion. The HP diet augmented exercise-induced hypertrophy of the forearm flexor complex, and weight pulling ability increased more rapidly in the exercised HP-fed mice. Surprisingly, exercise did not protect from HP-induced changes in glycemic control. Our results confirm that HP diets can augment muscle hypertrophy and accelerate strength gain induced by resistance exercise without negative effects on fat mass, and also demonstrate that LP diets may be advantageous in the sedentary. Our results highlight the need to consider both dietary composition and activity, not simply calories, when taking a precision nutrition approach to health.

Resistance exercise protects mice from protein-induced fat accretion

Low-protein (LP) diets extend the lifespan of diverse species and are associated with improved metabolic health in both rodents and humans. Paradoxically, many athletes and bodybuilders consume high-protein (HP) diets and protein supplements, yet are both fit and metabolically healthy. Here, we examine this paradox using weight pulling, a validated progressive resistance exercise training regimen, in mice fed either an LP diet or an isocaloric HP diet. We find that despite having lower food consumption than the LP group, HP-fed mice gain significantly more fat mass than LP-fed mice when not exercising, while weight pulling protected HP-fed mice from this excess fat accretion. The HP diet augmented exercise-induced hypertrophy of the forearm flexor complex, and weight pulling ability increased more rapidly in the exercised HP-fed mice. Surprisingly, exercise did not protect from HP-induced changes in glycemic control. Our results confirm that HP diets can augment muscle hypertrophy and accelerate strength gain induced by resistance exercise without negative effects on fat mass, and also demonstrate that LP diets may be advantageous in the sedentary. Our results highlight the need to consider both dietary composition and activity, not simply calories, when taking a precision nutrition approach to health.

Preventing lower limb lymphedema after pelvic lymphadenectomy with progressive resistance exercise training: A randomized controlled trial

ObjectiveThis study aimed to assess the efficacy of a self-designed progressive resistance exercise training program for preventing the development of lower limb lymphedema. MethodsAn open-label randomized controlled trial was conducted in patients who underwent radical surgery for cervical cancer treatment in our department between October 7, 2019, and October 7, 2021. The participants were randomly assigned to one of three groups: progressive resistance exercise training, graduated compression stocking, and control group. ResultsA total of 267 patients were enrolled (89 in each group). The incidence of lower limb lymphedema was 9.0% (n = 8) in the progressive resistance exercise training group, 28.1% (n = 25) in the graduated compression stocking group, and 42.7% (n = 38) in the control group. Over the 2-year follow-up period, the risk of lower limb lymphedema was significantly lower in the progressive resistance exercise training group than in the control group, with a hazard ratio (HR) (95% confidence interval [CI]) of 0.156 (0.073–0.335). The study was underpowered to demonstrate a statistically significant reduction in risk in the graduated compression stocking group, with an HR (95% CI) of 0.624 (0.376–1.033). ConclusionsProgressive resistance exercise training is an effective strategy for preventing lower limb lymphedema after pelvic lymphadenectomy for cervical cancer. It imposes no additional economic burden and can be performed conveniently without the need for dedicated exercise facilities. This makes it particularly accessible to patients in developing countries, allowing them to exercise at their convenience. Trial registrationChiCTR1800014905.

Novel Approach to Intradialytic Progressive Resistance Exercise Training

Physical activity levels are typically undesirably low in chronic kidney disease patients, especially in those undergoing haemodialysis, and particularly on dialysis days. Intradialytic exercise programmes could be a solution to this issue and have been reported to be safe and relatively easily implemented in dialysis clinics. Nevertheless, such implementation has been failing in part due to barriers such as the lack of funding, qualified personnel, equipment, and patient motivation. Intradialytic aerobic exercise has been the most used type of intervention in dialysis clinics. However, resistance exercise may be superior in eliciting potential benefits on indicators of muscle strength and mass. Yet, few intradialytic exercise programmes have focused on this type of intervention, and the ones which have report inconsistent benefits, diverging on prescribed exercise intensity, absent or subjective load progression, equipment availability, or exercise supervision. Commonly, intradialytic resistance exercise interventions use free weights, ankle cuffs, or elastic bands which hinder load progression and exercise intensity monitoring. Here, we introduce a recently developed intradialytic resistance exercise device and propose an accompanying innovative resistance exercise training protocol which aims to improve the quality of resistance exercise interventions within dialysis treatment sessions.

59 The effectiveness of a progressive resistance exercise class for Sarcopenic hospitalised older adults

Abstract Background Sarcopenia is common in the older inpatient population with an estimated prevalence of 22.6%. A Progressive Resistance Training (PRT) program addressing sarcopenia is recommended to counteract its adverse effects of increased falls and mortality. The delivery of exercise in the acute setting can pose a challenge for health care professionals. Therefore, this study aimed to examine the effectiveness of a PRT exercise class for older adults in an acute setting. Methods This was an observational study using a convenience sample of older adults undergoing physiotherapy within the hospital. All participants deemed medically suitable were referred by their primary physiotherapist. Participants underwent PRT including upper and lower body exercises, twice a week. These patients also undertook regular physiotherapy outside of the class. The primary outcome measures were the five times Sit-to-Stand (5STS) and bilateral hand-grip recorded by their primary physiotherapist pre-class attendance and on their last class. Results A total of 10 participants engaged in the PRT class. 70% were male and 30% were female with and average age of 77.5 years. The average number of classes attended was 3.1. Participants demonstrated an improvement in sarcopenic measure of 5STS, median change of 7.9 seconds (interquartile range [IQR] 4.88–11.75 seconds), and grip strength, median improvement in left 0.96 kgs (IQR -3.85-5.18) and right 0.1kgs (IQR -1.55-1.68). Conclusion This PRT exercise class demonstrated an improvement in sarcopenic measures in hospitalised older adults. These results are not exclusively due to PRT class attendance however this programme is an example of an effective way to address the negative effects of sarcopenia and the identified research gap in providing exercise in the acute setting. Further research is required to examine the effect of combining nutritional education with PRT training as an intervention for older adults with sarcopenia.

Comparing autoregulatory progressive resistance exercise and velocity-based resistance training on jump performance in college badminton athletes.

Jumping ability has been identified as a key factor that influences the performance of badminton athletes. Autoregulatory progressive resistance exercise (APRE) and velocity-based resistance training (VBRT) are commonly used approaches to enhance muscle strength and have been shown to accurately monitor the development of explosive power to improve jumping ability. This study aims to investigate the effects of APRE and VBRT on badminton athletes' jumping ability and to provide practical insights into improving their jumping performance during competitions. Upon completing familiarization and pretesting, 18 badminton athletes were included and completed the training intervention (age, 21.4 ± 1.4 years; stature, 170.1 ± 7.3 cm; body mass, 65.9 ± 12 kg); they were randomly divided into the APRE group (n = 9) and VBRT group (n = 9). Jumping performance was assessed during the countermovement jump (CMJ), squat jump (SJ), and drop jump (DJ) via SmartJump, with CMJ 's and SJ's jump height, eccentric utilization ratio (EUR), and reactive strength index (RSI). All participants then completed a 4-week in-season resistance training intervention. (1) The results of the within-group indicated that only the CMJ (pre: 41.56 ± 7.84 vs post: 43.57 ± 7.85, p < 0.05) of the APRE group had significant differences, whereas the SJ, EUR, and RSI were not significantly different (p > 0.05). (2) The results of the intergroups revealed that all indicators had no significant differences (p > 0.05), but APRE had a moderate effect size on the improvement of the CMJ (η2 = 0.244) and EUR (η2 = 0.068) when compared with VBRT. The results showed that, compared to VBRT, APRE can effectively improve the performance of the reactive athletes' lower limb explosive power in the CMJ in a shorter period of time. The findings indicate that APRE may be useful for coaches seeking to improve the CMJ performance of athletes in the short term.

The effect of fish oil supplementation on resistance training-induced adaptations.

Resistance exercise training (RET) is a common and well-established method to induce hypertrophy and improvement in strength. Interestingly, fish oil supplementation (FOS) may augment RET-induced adaptations. However, few studies have been conducted on young, healthy adults. A randomized, placebo-controlled design was used to determine the effect of FOS, a concentrated source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), compared to placebo (PL) on RET-induced adaptations following a 10-week RET program (3days·week-1). Body composition was measured by dual-energy x-ray absorptiometry (LBM, fat mass [FM], percent body fat [%BF]) and strength was measured by 1-repetition maximum barbell back squat (1RMSQT) and bench press (1RMBP) at PRE (week 0) and POST (10weeks). Supplement compliance was assessed via self-report and bottle collection every two weeks and via fatty acid dried blood spot collection at PRE and POST. An a priori α-level of 0.05 was used to determine statistical significance and Cohen's d was used to quantify effect sizes (ES). Twenty-one of 28 male and female participants (FOS, n =10 [4 withdrawals]; PL, n =11 [3 withdrawals]) completed the 10-week progressive RET program and PRE/POST measurements. After 10-weeks, blood EPA+DHA substantially increased in the FOS group (+109.7%, p<.001) and did not change in the PL group (+1.3%, p =.938). Similar between-group changes in LBM (FOS: +3.4%, PL: +2.4%, p =.457), FM (FOS: -5.2%, PL: 0.0%, p =.092), and %BF (FOS: -5.9%, PL: -2.5%, p =.136) were observed, although, the between-group ES was considered large for FM (d =0.84). Absolute and relative (kg·kg [body mass]-1) 1RMBP was significantly higher in the FOS group compared to PL (FOS: +17.7% vs. PL: +9.7%, p =.047; FOS: +17.6% vs. PL: +7.3%, p =.011; respectively), whereas absolute 1RMSQT was similar between conditions (FOS: +28.8% vs. PL: +20.5%, p =.191). Relative 1RMSQT was higher in the FOS group (FOS: +29.3% vs. PL: +17.9%, p =.045). When combined with RET, FOS improves absolute and relative 1RM upper-body and relative 1RM lower-body strength to a greater extent than that observed in the PL group of young, recreationally trained adults.

The Effect of Progressive Resistance Exercise Training on Cardiovascular Risk Factors in People with Intellectual Disabilities: A Study Protocol.

Progressive resistance exercise training (PRET) reduces cardiovascular risk factors (CVRF) in the general population. It is unknown if PRET also reduces these risk factors in adults with intellectual disabilities (ID). The aim is to present the protocol of an intervention study that investigates the effect of PRET on CVRF in adults with ID. We will use a repeated time series design with one study group. Adults with mild-to-moderate ID and at least two CVRF are eligible (Netherlands Trial Register, NL8382). During a 12-week baseline period, measurements take place at a 6-week interval. After this, the PRET programme starts for 24 weeks, after which all measurements will be repeated. We will use hierarchical regression models, adjusted for sport activity and medication use, to estimate the effect of PRET. After the intervention, the participants will be followed-up for 12 weeks. We will evaluate factors for successful implementation of exercise in daily life. Primary outcomes are: hypertension, obesity, hypercholesterolemia, diabetes, metabolic syndrome. Secondary outcomes are: physical fitness, sarcopenia, physical activity, activities of daily living, falls, challenging behaviour. If our results show that the PRET programme is effective, it may be a promising non-pharmacological intervention to reduce CVRF in adults with ID.

IMPLEMENTING A PROGRESSIVE RESISTANCE TRAINING PROGRAM IN YOUTH JUNIOR OLYMPIC WOMEN’S GYMNASTICS

Competitive gymnasts in the Women’s Junior Olympic (JO) program are highly conditioned, typically training 8-20 hours per week. Training often consists of high-repetition body-weight activities with little variability. This method of training lacks progressive resistance exercise (PRE) training, a cornerstone for muscular adaptation. To investigate the benefits of 10 weeks of PRE training, 1 day/week, on muscular strength and power in women’s JO child and adolescent gymnasts. 50 females aged 7-17 years (mean 10.2±2.7 years), competing on JO levels 3-10 participated. Gymnasts in JO Levels 3 and 4 were divided into either the Control Group or the PRE group. The Control Group continued the standard non-PRE conditioning. The PRE Group underwent the prescribed PRE training. Level 5-10 gymnasts also underwent PRE training and were separately analyzed in a quasi-experimental repeated measures design. 15 exercises were completed. Tests for lower- and upper-body power included vertical leap and a modified Wingate arm-ergometer anaerobic test (Arm-WAnT). Compared to the Control Group, the PRE Group had a greater improvement in vertical power (p=0.003), and Arm-WAnT peak power and mean power (p=0.044 and 0.023), but no difference in Arm-WAnT fatigue index. Gymnasts in Levels 5 to 10 similarly improved vertical power (2224±756W to 2473±688W, p&lt;0.001), Arm-WAnT peak power (80.9±30.1W to 93.2±40.6W, p&lt;0.001), and mean power (62.8±23.2 to 70.1±27.3, p&lt;0.001), with no change in Arm-WAnT fatigue index. 10 weeks of PRE will improve upper- and lower-body power in child and adolescent female JO gymnasts.

MO600: Effects of Intradialytic Progressive Resistance and Aerobic Exercise Training on Physical Function

Abstract BACKGROUND AND AIMS Haemodialysis (HD) patients frequently experience reduced physical function, which is exacerbated throughout dialysis vintage, therefore compromising their quality of life. Despite recent studies highlighting improvements in physical function regardless of exercise modality, well-designed randomized controlled trials with progressive resistance exercise training protocols are scarce. Thus, this study investigated the effects of 12 weeks of intradialytic progressive resistance exercise (RE) and aerobic exercise (AE) training on physical function in HD patients. METHOD Fifty-six adult HD patients from three NephroCare Portugal SA clinics were included in this study. Following a 6-week run-in control period, participants were randomly allocated into either a supervised intradialytic AE [(n = 29, male: 66%, age: 66 ± 16 years)] or RE [(n = 27, male: 67%, age: 63 ± 14 years)] training protocol, 3 sessions per week for 12 weeks. Intradialytic RE training consisted of 2 sets of 12 repetitions of 8 different exercises for upper and lower body using free-weight dumbbells and a newly designed weight machine, while intradialytic AE training was performed on a cycle ergometer at 50–70 rpm for 30 min at a rating of perceived exertion (RPE) 12–14 (Borg scale). Physical function was assessed by completing the Sit to Stand 60 (STS-60) test, the Short Physical Performance Battery (SPPB), the Incremental Shuttle Walk Test (ISWT), the Timed Up and Go (TUG) test and isometric handgrip strength (HGS) on three occasions: before and after the 6-week run-in control, and after the 12-week exercise periods. The 6-week control period data were analyzed by paired sample t-tests or Wilcoxon rank test as this is prior to randomization. Training effects were examined using an ANOVA with mixed design (within- and between-subjects) for data with normal distribution or if data still with non-normal distribution after log transformation, Wilcoxon rank test (within subjects) and Mann–Whitney test (between subjects) were used with a significance value of P &amp;lt; 0.05. RESULTS There was no change in any variable when comparing before and after the 6-week control period (P &amp;gt; 0.05). AE and RE training significantly increased the number of repetitions performed on the STS-60 test compared to before the 12-week intervention, but had no effect on the SPPB scores. Additionally, despite no changes in the distance covered in ISWT in the AE group, AE training reduced the TUG time and an increase in HGS was observed. On the other hand, patients that performed RE training increased their walking distance in ISWT. However, no change in HGS was observed. Yet, and despite not impactful, a 0.1 s significant increase in the median time performed on the TUG test was also observed. Nevertheless, no changes between groups were observed after the 12-week exercise intervention (Table 1). CONCLUSION We conclude that 12 weeks of AE training seem to improve HGS, STS-60 and TUG test performance in HD patients, whereas progressive RE training only had an effect on the STS-60 and ISWT performance in these patients. This may suggest that HD patients can benefit from different exercise interventions which can improve their overall physical function. FUNDING Portuguese Foundation of Science and Technology (SFRH/BD/138 940/2018 and UID/04 045/2020). ACKNOWLEDGEMENTS We would like to acknowledge the support of NephroCare Portugal, the University of Maia staff, MSc students and all study participants for their collaboration.

Impact of beta‐Hydroxy‐beta‐methylbutyrate plus Vitamin D3 Supplementation on Skeletal Muscle Size, Function and Quality in Sedentary and Resistance Exercise Trained Women

The age‐related loss of skeletal muscle mass, quality, and strength can lead to the loss of independence later in life. Beta‐hydroxy‐beta‐methylbutyrate (HMB), a leucine metabolite, can increase skeletal muscle size and function. However, emerging evidence suggests HMB may be less effective at improving muscle function in people with insufficient Vitamin D3 levels (25‐hydroxy‐Vitamin D (25‐OH‐D) &lt;30 ng/mL,) common in middle‐aged and older adults. Therefore, our current study tested the hypothesis that combining HMB (Calcium salt) with Vitamin D3 (HMB+D) would increase skeletal muscle size, quality and function in middle aged women (53±1 yrs, 26±1 kg/m2, n=43) randomized to sedentary control (SED) or progressive resistance exercise training (RT). In a placebo‐controlled, double‐blinded fashion, women were further randomized to placebo or HMB+D (3g of HMB + 2000IU of Vitamin D3). Study enrollment and recruitment occurred before and after COVID‐19 stay at home measures. In both RT and SED, HMB+D raised circulating levels of 25‐OH‐D after 8 (33±2 ng/mL) and 12 (35±2 ng/mL) weeks to reach sufficient Vitamin D3 levels. In SED, HMB+D prevented the loss of lean arm mass observed in the placebo group (0.07±0.06 vs ‐0.19±0.06 kg; P&lt;0.05). HMB+D also increased thigh skeletal muscle (26±13 vs ‐5±8 cm3; P&lt;0.05) and decreased intermuscular adipose tissue (IMAT) volume (‐20±11 vs 5±6 cm3; P&lt;0.05) compared to placebo. However, 12‐weeks of HMB+D did not change skeletal muscle function. In the RT, 12‐weeks of HMB+D decreased IMAT compared to placebo (‐22±13 vs 6±4 cm3; P&lt;0.05) but did not influence the increase in skeletal muscle mass or function. These data show that 12‐weeks of HMB+D supplementation consistently decreased thigh IMAT volume in both SED and RT. HMB+D in sedentary middle‐aged women was beneficial for skeletal muscle size but did not lead to improved muscle function or quality. Further, HMB+D did not influence the hypertrophic or functional improvements after resistance exercise training in middle‐aged women. HMB+D may be able to help combat the age‐related loss of skeletal muscle mass in sedentary women. These results lend support to conducting a larger study for a longer duration to validate these findings as well as explore additional populations who may also benefit from HMB+D.

Decongestive progressive resistance exercise with an adjustable compression wrap for breast cancer-related lymphoedema (DREAM): protocol for a randomised controlled trial

IntroductionBreast cancer-related lymphoedema (BCRL) is a chronic swelling in the arm on the side of the breast cancer surgery, affecting one in five women. Recent studies in BCRL have demonstrated...

Relationship between protein intake and resistance training–induced muscle hypertrophy in middle-aged women: A pilot study

ObjectiveThe aim of this study was to observe the relationship of protein intake at each meal and daily total with change in lean tissue mass with progressive resistance exercise training (RET) in healthy middle-aged women. MethodsTwenty-two healthy Japanese women were recruited from Shiga Prefecture, Japan, and a supervised whole body RET program was conducted twice a week for 16 wk. The dietary intake was assessed using 3-d dietary records. Dual-energy x-ray absorptiometry was used to measure the whole body lean soft tissue mass (WLTM). Multiple regression analysis was performed to examine the relationship between the protein intake and RET-induced changes in the WLTM after adjusting for age, sleep quality, physical activity, and energy intake. ResultsThe 16-wk RET program caused a significant gain in the WLTM (1.46 ± 0.45%, P = 0.004). Multiple regression analysis showed that the baseline protein intake at breakfast was negatively associated with the percent change in the WLTM (β = –1.598; P = 0.022). Additionally, the percent change (β = 0.624; P = 0.018) in protein intake at breakfast was positively associated with the percent change in WLTM. ConclusionIncreasing protein intake at breakfast may contribute to RET-induced muscle hypertrophy in middle-aged women, especially among those who habitually consume low-protein levels at breakfast. However, future studies with larger sample sizes are required to confirm the importance of protein intake at breakfast.

A muscle cell-macrophage axis involving matrix metalloproteinase 14 facilitates extracellular matrix remodeling with mechanical loading.

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. For successful adaptation to mechanical loading, remodeling processes must occur. In a large cohort of older adults, transcriptomics revealed that genes involved in ECM remodeling, including matrix metalloproteinase 14 (MMP14), were the most upregulated following 14 weeks of progressive resistance exercise training (PRT). Using single‐cell RNA‐seq, we identified macrophages as a source of Mmp14 in muscle following a hypertrophic exercise stimulus in mice. In vitro contractile activity in myotubes revealed that the gene encoding cytokine leukemia inhibitory factor (LIF) is robustly upregulated and can stimulate Mmp14 expression in macrophages. Functional experiments confirmed that modulation of this muscle cell‐macrophage axis facilitated Type I collagen turnover. Finally, changes in LIF expression were significantly correlated with MMP14 expression in humans following 14 weeks of PRT. Our experiments reveal a mechanism whereby muscle fibers influence macrophage behavior to promote ECM remodeling in response to mechanical loading.

Perceptions and Experiences of a Progressive Resistance Exercise Program in People with Chronic Kidney Disease

Muscle wasting is highly prevalent in chronic conditions, such as chronic kidney disease (CKD), and can result in decreased physical functioning and strength, and impaired ability to perform daily tasks, thus impacting quality of life. Exercise, particularly resistance training, promotes a multitude of benefits, including prevention and management of muscle dysfunction; however, engagement in resistance training is poor. The aim of this study was to understand the views of people with CKD who participated in a research study evaluating a progressive resistance exercise program. Semi-structured interviews were conducted with 11 people with CKD Stage 3 and 4. Five themes were identified: experiences of muscle weakness; preconceptions of resistance exercise; experiences of participating in a resistance exercise program; perceived impact of the resistance exercise program; and maintenance of resistance exercise. Parti - cipants believed the resistance exercise program could improve their functional performance and quality of life. They disclosed factors that can enable or deter both uptake and maintenance in training, which can be considered when developing resistance-based exercise programs. Findings highlight the need for patient education and counselling about the importance and implementation of appropriate and progressive resistance exercise training.

Progressive resistance exercise training to prevent lower-limb lymphedema after cervical cancer surgery: A feasibility study

ObjectiveRadical hysterectomy with pelvic lymphadenectomy is the standard surgical treatment for early stage cervical cancer. One of the most common complications after this surgery is lower extremity lymphedema (LLL). Program of progressive resistance exercise training (PRET) is a possible way to prevent LLL for cervical cancer patients postoperatively. Before we start a randomized controlled trial to evaluate the preventive effect of PRET, we conducted this pilot study to assess the feasibility of PRET after cervical cancer surgery. MethodsThe primary purpose of the pilot study was the feasibility of PRET, as well as the satisfaction and adherence to the PRET assessed by a questionnaire. We conducted a single-arm prospective study involving cervical cancer patients who underwent radical hysterectomy with pelvic lymphadenectomy. Participants exercised twice a day for 24 weeks (two weeks of supervised in hospital and then 22 weeks of home-based training) after surgical treatment. All patients were followed up for 12 months. Information that included the limb volume, BMI, perceived difficulty level and adherence rate was collected. ResultsFrom February to April 2019, a total of 24 patients participated in the study. None of them dropped out. The adherence rate was more than 75% in majority of the patients, the perceived difficulty level of the PRET was high (for the first phase, the fourth phase and the fifth phase, more than half of the participants felt the intensity of the exercise appropriate), and no serious adverse events in the study were observed. ConclusionsExercise training was safe and feasible. The preliminary results offered us the possibility to further test the preventive effect of PRET in a full-scale randomized controlled trial.