Resistance Training Recommendations Research Articles

Risks and Recommendations for Resistance Training in Youth Athletes: A Narrative Review with Emphasis on Muscular Fitness and Hypertrophic Responses

Risks and Recommendations for Resistance Training in Youth Athletes: A Narrative Review with Emphasis on Muscular Fitness and Hypertrophic Responses

The Power of Resistance Training: Evidence-based Recommendations for Middle-aged and Older Women's Health

Women have a longer life expectancy, but also a poorer quality of life due to the combined effects of aging and menopause. Among the most widely used non-pharmacological therapies that slow down the effects of these phenomena is resistance training. The aims of this narrative review were: 1) to analyze the strength in health parameters of middle-aged and older women; and 2) to provide a series of practical recommendations for resistance training for women. It was found that resistance training has been shown to prevent and/or treat chronic diseases, improve muscle strength, increase bone density, and reduce the risk of falls and fractures in older women. To conduct our search, we utilized various databases, including MedLine (Pubmed) and Cochrane (Wiley), searching for MeSH-compliant keywords such as: (strength training OR resistance training) AND (middle-aged women OR older women). Our search was limited to manuscripts published from April 1, 2013, to April 1, 2023, although some earlier studies were referenced to provide additional context in certain areas of the narrative review. The narrative review highlights that regular resistance training can help older women maintain independence and improve their overall quality of life. Additionally, the narrative review suggests that resistance training may also have beneficial effects on other health outcomes, such as cardiovascular health, function, and musculoskeletal health. Overall, the narrative review provides evidence to support the inclusion of resistance training in the exercise regimen of older women to promote healthy aging. This narrative review aims to provide information on the health benefits of resistance training on middle-aged and older women, and proposes a series of recommendations to promote its safe and effective practice, to help them enjoy healthy aging. Keywords: sarcopenia, functional independence; physical exercise; strength training, quality of life.

Sex differences in the impact of resistance exercise load on muscle damage: A protocol for a randomised parallel group trial

IntroductionResistance training can induce skeletal muscle hypertrophy and strength gains, but is also associated with acute muscle damage, characterised by muscle soreness, impaired muscle function, and structural damage to muscle cell membranes and its components. These consequences can be detrimental to future exercise performance and dampen long-term training adaptations. Previous research has considered resistance exercise intensity as a factor in exercise-induced muscle damage (EIMD), though a clear direction of the findings has not yet been established. Further, female populations are heavily underrepresented in this field of study. Therefore, we here propose a study protocol designed to examine sex differences in the muscle damage response to resistance exercise performed with low or high loads in a population of untrained, young adults.MethodsThis study will employ a randomised parallel group design. Twenty-four males and 24 females will perform an acute leg-based resistance exercise session at either 30% (low-load) or 80% (high-load) of their pre-determined one-repetition maximum (1RM). Maximal leg strength will be determined by a 1RM test 3 wk before and 72 and 168 h after the exercise bout. Additionally, muscle damage will be assessed immediately before the exercise bout and immediately, 24, 48, 72, and 168 h after the exercise bout through measures of muscle soreness, limb circumference, range of motion, and serum concentrations of creatine kinase and interleukin-6. The outcomes of this trial could inform sex-specific resistance training recommendations and help bridge the sex data gap in sport and exercise science research.

Breast cancer-related lymphoedema and resistance exercise: An evidence-based review of guidelines, consensus statements and systematic reviews.

Breast cancer-related lymphoedema (BCRL) is a side effect of cancer treatment and can be alleviated by resistance exercise. This systematic, evidence-based review examined the existing best evidence on resistance exercise for BCRL to accurately describe the current status of the field and offer recommendations for clinicians. This review adheres to the PRISMA guidelines. Clinical practice guidelines, consensus documents, systematic reviews and other related evidence-based resources about resistance exercise for BCRL were retrieved through the English databases and guideline websites. The publication data limit was set to December 2020. The following search terms were used: 'breast cancer/breast neoplasm/breast carcinoma/breast tumor/breast malignancy, lymphedema/swelling/edema/lymphoedema, resistance/weight/strength training, best practice/clinical practice/guideline/consensus documents'. The quality of the included studies was evaluated by two authors independently using AGREE II and AMSTAR II tools. Evidence-based recommendations on resistance exercise relevant for BCRL were synthesised and categorised. Twenty two articles (seven guidelines, four consensus documents and eleven systematic reviews) were included. The overall quality of the eleven eligible guidelines and consensus documents was moderate to high according to the AGREE II criteria. The quality of the eleven systematic reviews was critically low to high according to the AMSTAR criteria. Six clinical topics involving 43 recommendations were identified. Recommendations were categorised by safety of resistance training, effectiveness of resistance training, evaluation prior to resistance exercise, resistance exercise prescription, resistance training outcome index and points for attention. This study summarises 43 recommendations for resistance training for BCRL and provides guidance for clinicians. Based on randomised trials and systematic reviews published in recent years, there is an urgent need to update the guidelines and consensus documents in terms of topics, for example effectiveness of resistance training and resistance training outcome index.

Resistance Training Recommendations to Maximize Muscle Hypertrophy in an Athletic Population: Position Stand of the IUSCA

Hypertrophy can be operationally defined as an increase in the axial cross-sectional area of a muscle fiber or whole muscle, and is due to increases in the size of pre-existing muscle fibers. Hypertrophy is a desired outcome in many sports. For some athletes, muscular bulk and, conceivably, the accompanying increase in strength/power, are desirable attributes for optimal performance. Moreover, bodybuilders and other physique athletes are judged in part on their muscular size, with placings predicated on the overall magnitude of lean mass. In some cases, even relatively small improvements in hypertrophy might be the difference between winning and losing in competition for these athletes. This position stand of leading experts in the field synthesizes the current body of research to provide guidelines for maximizing skeletal muscle hypertrophy in an athletic population. The recommendations represent a consensus of a consortium of experts in the field, based on the best available current evidence. Specific sections of the paper are devoted to elucidating the constructs of hypertrophy, reconciliation of acute vs long-term evidence, and the relationship between strength and hypertrophy to provide context to our recommendations.

Resistance Training Recommendations for Children and Adolescents With Cystic Fibrosis-Related Diabetes.

Cystic fibrosis (CF) is the most prevalent hereditary life-threatening disease in the Caucasian population. With the improvement in clinical care, individuals with CF are living longer, and CF-related diabetes (CFRD) has emerged as a major complication. The diagnosis of CFRD is associated with shortening survival, increasing morbidity, worsening physical capacity, and body composition. Engagement in exercise training has become a prominent nonpharmacologic intervention that aims to improve fitness and clinical outcomes in individuals with CF and CFRD. This column will specifically focus on the potential benefits of resistance training and provide recommendations for children and adolescents with CF and CFRD.

Loading Recommendations for Muscle Strength, Hypertrophy, and Local Endurance: A Re-Examination of the Repetition Continuum.

Loading recommendations for resistance training are typically prescribed along what has come to be known as the “repetition continuum”, which proposes that the number of repetitions performed at a given magnitude of load will result in specific adaptations. Specifically, the theory postulates that heavy load training optimizes increases maximal strength, moderate load training optimizes increases muscle hypertrophy, and low-load training optimizes increases local muscular endurance. However, despite the widespread acceptance of this theory, current research fails to support some of its underlying presumptions. Based on the emerging evidence, we propose a new paradigm whereby muscular adaptations can be obtained, and in some cases optimized, across a wide spectrum of loading zones. The nuances and implications of this paradigm are discussed herein.

Resistance Training for Older Adults: Position Statement From the National Strength and Conditioning Association.

Fragala, MS, Cadore, EL, Dorgo, S, Izquierdo, M, Kraemer, WJ, Peterson, MD, and Ryan, ED. Resistance training for older adults: position statement from the national strength and conditioning association. J Strength Cond Res 33(8): 2019-2052, 2019-Aging, even in the absence of chronic disease, is associated with a variety of biological changes that can contribute to decreases in skeletal muscle mass, strength, and function. Such losses decrease physiologic resilience and increase vulnerability to catastrophic events. As such, strategies for both prevention and treatment are necessary for the health and well-being of older adults. The purpose of this Position Statement is to provide an overview of the current and relevant literature and provide evidence-based recommendations for resistance training for older adults. As presented in this Position Statement, current research has demonstrated that countering muscle disuse through resistance training is a powerful intervention to combat the loss of muscle strength and muscle mass, physiological vulnerability, and their debilitating consequences on physical functioning, mobility, independence, chronic disease management, psychological well-being, quality of life, and healthy life expectancy. This Position Statement provides evidence to support recommendations for successful resistance training in older adults related to 4 parts: (a) program design variables, (b) physiological adaptations, (c) functional benefits, and (d) considerations for frailty, sarcopenia, and other chronic conditions. The goal of this Position Statement is to a) help foster a more unified and holistic approach to resistance training for older adults, b) promote the health and functional benefits of resistance training for older adults, and c) prevent or minimize fears and other barriers to implementation of resistance training programs for older adults.

Influence of Osteopathic Medical Students' Personal Health on Attitudes Toward Counseling Obese Pediatric Patients.

Research has shown that physicians with positive health and lifestyle behaviors have more positive attitudes toward effective counseling, but little is known about how personal health behaviors of medical students influence their attitudes regarding pediatric obesity counseling before entering practice. To determine whether the personal health status and habits of osteopathic medical students influence their attitudes toward counseling obese pediatric patients regarding lifestyle behaviors. A cross-sectional survey was distributed electronically to first- through fourth-year osteopathic medical students. The survey assessed students' personal lifestyle habits and their top anticipated barriers to providing pediatric weight counseling. A total of 200 participants completed the survey. National physical activity recommendations were met by 81 participants (40.5%). These 81 participants had significantly more positive attitudes toward pediatric physical activity counseling than participants who did not meet the recommendations (H=-35.06, P=.001) or those who only met resistance training recommendations (H=40.63, P=.021). Participants with obesity had significantly lower pediatric weight management counseling scores than overweight participants (H=40.77, P=.028). Thirty-one participants (15.5%) consumed a healthy amount of both vegetables and fruit. These 31 participants had significantly higher dietary mean item counseling scores than those who did not (H=-30.40, P=.048). Participants identified the barriers "Time" (137 [68.5%]) and "Difficult for patients to change behavior" (99 [49.5%]) most frequently. Clinical participants identified "Poor or lacking reimbursement" (21 [28.0%]) more frequently than preclinical participants (12 [9.6]). Medical students who exhibited healthier lifestyle habits were more likely to positively view pediatric obesity management counseling.

Institutional Guidelines for Resistance Exercise Training in Cardiovascular Disease: A Systematic Review

Institutional position stands are useful for practitioners when designing exercise routines for specific populations. Resistance training has been included in programs for patients with cardiovascular disease. The objective of this systematic review was to analyze institutional guidelines providing recommendations for resistance training applied to cardiovascular disease. PubMed, Web of Science, and Scopus databases were searched from inception until 30 April, 2018. Of 994 articles initially found, 13 position stands were retained. Consensual indications occurred only for number of sets (one to three sets) and training frequency (two to three sessions/week). Recommendations concerning other major training variables were discordant regarding workload (none or loads ranging from < 30% up to 80% 1 repetition maximum) and exercise order (none or vaguely indicating alternation of muscle groups or circuit format), or insufficient regarding intervals between sets and exercises or number and type of exercises. Overall, guidelines lack recommendations of specific procedures for each type of disease at different severity levels, cardiovascular risk during exercise, or criteria for training progression. Recommendations provided by institutional guidelines appear to be insufficient to support adequate resistance training prescription in the context of cardiovascular disease.

Evaluating the clinical implementation of structured exercise: A randomized controlled trial among non-insulin dependent type II diabetics

BackgroundThe American Diabetes Association (ADA) currently recommends 150 min of moderate-intensity aerobic exercise per week and resistance exercise at least twice per week in individuals with type 2 diabetes (T2DM) to improve overall health [1]. However, approximately 38% of patients with T2DM do not exercise at recommended levels and 31% do not exercise at all [2]. The efficacy of structured exercise interventions has been proven effective in reducing glycosylated hemoglobin A1c (HbA1c) levels in patients, but practical approaches are needed to translate these findings into the clinical setting [3–7]. ObjectiveThe Initiate and Maintain Physical Activity in Clinics (IMPACT) Study aims to compare structured group exercise within the clinic to usual care in T2DM patients. The main purpose of the study is to determine the optimal and feasible level and weekly frequency of structured contact in a clinical setting needed to initiate and maintain physical activity recommendations long-term. Study designIMPACT is a longitudinal, randomized-controlled study designed to track study participants over 30 months. Once study participants have met eligibility and enrollment criteria, they are randomized and enrolled into one of three arms: 1× per week exercise, 3× per week exercise, or the usual care control group. After randomization, participants begin Phase 1: Initiate lasting 6 months. Over the course of Phase 1, participants in the exercise groups will attend instructor led group training at a Stanford approved physical fitness facility. At the end of 6 months, participants enter Phase 2: Maintain lasting 24 months. Over the course of Phase 2, participants in all three arms will attend periodic follow-up visits for clinical measurements and survey administration for their final two years of participation. These findings will enable the clinical implementation of a structured exercise regimen designed to specifically address the aerobic and resistance training recommendations for patients with T2DM.

Exercise-Induced Hypoalgesia Is Not Influenced by Physical Activity Type and Amount.

This studied examined the EIH response to pressure stimuli among college-age women of differing activity levels. Fifty women were tested. Pressure pain threshold (PPT) values were assessed before and immediately after isometric handgrip exercise to exhaustion in the right and left forearms. Participant's PA levels were assessed by wearing an accelerometer for seven consecutive days during waking hours, excluding water activities. Participants were classified into four PA groups: met the American College of Sports Medicine aerobic recommendations (AERO), met aerobic and resistance training recommendations (AERO + RT), insufficiently aerobically active but resistance trained (RT), and insufficiently active (IA) based on their measured and self-reported PA level and type. AERO and AERO + RT had greater vigorous (P < 0.001) and total PA (P < 0.001) compared with RT and IA. EIH was observed for PPT in both right and left arms (P < 0.001), with PPT increasing 7.7% (529 ± 236 vs 569 ± 235 kPa) and 7.0% (529 ± 299 vs 571 ± 250 kPa) in the right and left forearms, respectively. EIH did not differ among activity groups (P = 0.82). PPT values were found to be inversely related to vigorous-intensity PA (r = -0.29). PA levels and types had no effect on endogenous pain inhibition after exercise in college-age women.

Resistance Training for Shoulder Complex Stabilization

The purpose of this review is to provide resistance training recommendations to improve shoulder joint stabilization based on shoulder mechanics and mechanisms of injury. The shoulder encounters external axial loading and internal forces from the shoulder musculature that can lead to injury with shoulder stabilization weakness. Training the musculature to stabilize the shoulder increases the likelihood of achieving muscle balance and reducing the risk of injury. The selected exercises and exercise prescriptions are recommended to create this balance to prevent shoulder impingement and injury caused by common axial loading.

Recommendations for resistance training in patients with fibromyalgia

It may seem counter-intuitive to purposely stress muscle in patients who have muscle pain. However, a growing body of evidence challenges the assumption that resistance (strength) training worsens muscle pain in people with fibromyalgia (FM). In fact, the latest evidence indicates that when resistance training is tailored to individual needs, people with FM can obtain worthwhile improvements in FM severity. Clinicians need a deeper understanding of how resistance training helps people with FM, so as to prescribe more specific, personalized resistance training to their patients.

Changes of Body Composition, Muscular Strength and Physical Performance Due to Resistance Training in Older Persons with Sarcopenic Obesity.

At present, it is unclear whether older, obese persons with or without sarcopenia respond differently to training. Furthermore, there are no differentiated recommendations for resistance training for this special target group. The objectives are to investigate the changes in the physical parameters of older, obese men caused by training and to reappraise the modalities of resistance training for older persons. Pre-test-post-test design. The participants were 33 physically inactive and obese older men (≥ 65 years, BMI ≥30 kg/m2), with-out severe diseases. Subjects were divided into two groups: NSAR (no or presarcopenia, n= 15) or SAR (sarcopenia, n= 18). The intervention consisted of progressive resistance training, twice a week for 16 weeks with finally 80-85% of maximum strength and three sets with 8-12 repetitions. The training contained six exercises for the major muscle groups. Sarcopenia was assessed using the Short Physical Performance Battery (SPPB), hand-grip strength, skeletal muscle mass index (SMI), and gait speed over a 6-meter walkway. Furthermore, the maximum dynamic strength (1 RM) was assessed. At baseline, the NSAR group had significantly better values in SMI, SPPB score, hand-grip strength, and 1 RM. After training, the results in both groups displayed an increase in 1 RM at the lower limbs (NSAR 18%, SAR 38%) and the upper limbs (NSAR 12%, SAR 14%). Also, the SPPB score (NSAR 11%, SAR 15%) and the 6-m-gait speed (NSAR 5%, SAR 10%) increased. The SAR group was able to increase their right hand-grip strength by 12%, whereas the NSAR group maintained their initial high strength values. SMI did not change in both groups. Both groups show improvements after resistance training with slightly more benefits for men with sarcopenia. Results of this study can be used to define specific training regimens for N(SAR) subjects.

Primum non nocere: A commentary on avoidable injuries and safe resistance training techniques

Objectives: Recently attention has been brought to potentially unsafe training methods within the practice of resistance training. Thus purpose of this commentary is to highlight the importance of the moral injunction Primum non nocere, and of weighing risks to rewards of training methods, for those providing resistance training recommendations and practitioners of it as a training approach. Design & Methods: Narrative review Results: It appears that many popular resistance training methods that make use of either explosive movements or unstable platforms with heavy external loading may present an increased risk of injury. In addition they may not offer any greater improvements to measures of health and fitness above safer alternatives that utilise more controlled repetition durations and avoid use of unstable platforms. Indeed, as resistance type and load may not be as important for determining strength or hypertrophic adaptations as previously thought, nor does there appear to be much supporting evidence for the transfer of balance skills developed using unstable platforms to other movement skills, the necessity of such unsafe practices appears further questionable. Conclusions: It is recommended that persons wishing to engage in resistance training for the purposes of health and fitness whilst reducing risk of injury should utilise a controlled repetition duration that maintains muscular tension and avoid use of unstable platforms. Indeed, practices involving use of lower external loads, or even the absence of external loads such as bodyweight training or isometric co-contraction, may also be effective and may pose an even lower risk of injury.

Treinamento resistido para crianças e adolescentes

Em uma sociedade onde a aparência corporal é muito valorizada, as academias de musculação são procuradas de forma cada vez mais precoce pelos jovens. O objetivo deste estudo foi fazer uma análise retrospectiva sobre a evolução das recomendações do treinamento resistido para crianças e adolescentes. A busca bibliográfica foi realizada nas bases de dados PubMed, Web of Science e Scielo. As estratégias de busca incluíram a combinação dos seguintes descritores: “resistance training”, “strength training”, “weight-training” “adolescents”, “children” e “youth”. A busca bibliográfica resultou em 349 artigos. A leitura e análise dos resumos pelos autores resultou na seleção de 25 artigos, respeitando os critérios de inclusão adotados. Os resultados indicam que as primeiras publicações sobre o tema ocorreram em 1990 e, a partir de então, observou-se uma evolução substancial tanto no número de publicações quanto nas abordagens do treinamento resistido para crianças e adolescentes. A análise dos artigos mostra que atualmente é possível encontrar informações qualificadas cujos indicativos suportam a prática do treinamento resistido por parte de crianças e adolescentes de forma segura e eficaz. Pode-se concluir que não restam dúvidas sobre os benefícios do treinamento resistido para a saúde dos jovens, respeitadas as recomendações vigentes as quais são pontuadas ao longo desta revisão. Convém destacar que permanecem latentes questões associadas às respostas crônicas do treinamento resistido nesta faixa etária, assim como dúvidas em relação à prescrição para as diferentes idades, ergonomia dos equipamentos e ambientes.

Exercise and Disease Management

The second edition of Exercise and Disease Management is a great resource for students, new graduates, and experienced clinicians whose practice encompasses a diverse patient population. Written as a teaching and managing resource that emphasizes exercise prescription for physicians and other medical professionals, this volume features a question-and-answer section at the end of each chapter designed to help patients understand their disease, a ready-to-use exercise prescription resource page at the end of each chapter, and an accompanying CD with patient workbooks designed to facilitate self-management. Overall, this is a well-organized and detailed overview and a useful reference for those seeking to augment their clinical knowledge and gain a better understanding of various chronic conditions and special populations. Chapters 1–9 deal with chronic conditions, while chapters 10–14 provide exercise guidelines for special populations. The chapters follow an organized framework: a brief background, medical management, specific considerations for exercise, and exercise prescription. The format of the exercise prescription is similar to the FITT principle, addressing frequency, intensity, time, and type of exercise appropriate for each patient population. The authors consistently provide examples of modalities for aerobic activity, but their recommendations for resistance training require clinicians to apply their own knowledge of exercise. The book is therefore better suited to clinicians looking for a guiding framework within which they can effectively apply current clinical expertise than for those looking to expand their exercise reserve. The book's clinical utility is enhanced by the continuum of clinical integration, from the pathophysiology of the disease to exercise guidelines and recommended reading. Each chapter concludes with a section on common questions, written from a patient's perspective, that guides the reader to consider strategies for communicating the medical content to the patient population. The accompanying CD contains 11 condition-specific patient workbooks, corresponding to the first 11 chapters of the book. Each workbook contains the same preface, an alternative medicine summary, and a self-care overview. Sections tailored specifically to the condition address guidelines for aerobic and resistance training. These workbooks are heavily influenced by a physician perspective and do not expand on the benefits of physical therapy specifically, beyond mentioning the physical therapist as a medical professional who may be involved in the patient's care. Because they are modifiable, however, relevant sections can be adapted and presented through a physical therapy lens, or revised as a resource for physical therapists to use with their clients as a self-management tool. While it remains a comprehensive reference, Exercise and Disease Management is directed to a physician audience, which explains its assumption that “very few physicians and healthcare professionals ask their patients about exercise; fewer of them know how exercise modifies health and disease and how to prescribe exercise” (p. xix). Furthermore, because the content is American, statistics surrounding prevalence rates, economic costs, and mortality rates cannot be generalized beyond the population of the United States. Overall, Exercise and Disease Management will be valuable to both new graduates and experienced clinicians as a comprehensive reference resource for multiple chronic conditions and special populations commonly seen in physical therapy. Therapists who use this resource will supplement the material presented with their knowledge of exercise programmes and principles to design optimal exercise programmes for a variety of patient populations.

Exploring opportunities for colorectal cancer screening and prevention in the context of diabetes self-management: an analysis of the 2010 National Health Interview Survey

Because diabetes is associated with increased colorectal cancer (CRC) risk, it is important that people with diabetes receive CRC screenings according to guidelines. In addition, many diabetes self-care recommendations are associated with a reduced risk of CRC. This study aims to identify potential opportunities for enhancing CRC prevention within the context of diabetes management. Using data from 1,730 adults with diabetes aged 50-75years who responded to the 2010 National Health Interview Survey, we calculated population estimates of behaviors consistent with US Preventive Services Task Force guidelines for CRC screening and American Diabetes Association recommendations for diabetes care. We examined bivariate associations between CRC screening and selected diabetes self-care behaviors associated with CRC risk. Results were stratified by demographic characteristics. Thirty-nine percent of adults with diagnosed diabetes were not up-to-date with CRC screenings. Sixteen percent smoked and 2% exceeded alcohol intake recommendations. Among those capable of exercise, 69 and 90% did not meet aerobic exercise and resistance training recommendations, respectively. CRC screening was generally not associated with diabetes self-care behaviors. Among some demographic groups, CRC screening was associated with adequate aerobic activity, not smoking, and being overweight or obese. Many adults with diabetes do not follow guidelines for CRC screening or recommendations for diabetes care that may also reduce CRC risk. Thus, opportunities may exist to jointly promote CRC screening and prevention and diabetes self-management among adults with diabetes.

RESISTANCE TRAINING FOR HYPERTENSION

In Brief LEARNING OBJECTIVES • Provide a brief overview of hypertension, the epidemiology of hypertension, associated health risks, and basic pharmacology for hypertension. • Discuss the research examining the effects resistance training has on blood pressure. • Provide resistance training recommendations for people with hypertension. Hypertension is a chronic medical condition that affects millions of Americans, and increases the risk for stroke and other cardiovascular diseases. Resistance training should be included in a comprehensive exercise program designed to help prevent or manage chronic disease in hypertensive individuals. This article will cover the epidemiology of hypertension, discuss the research on acute and chronic blood pressure responses to resistance training and provide evidence-based guidelines for designing resistance training programs for persons with hypertension.