Resistance Exercise Sessions Comprising Multijoint vs. Single-Joint Exercises Result in Similar Metabolic and Hormonal Responses, But Distinct Levels of Muscle Damage in Trained Men.

ABSTRACT: Barbosa, PH, Bueno de Camargo, JB, Jonas de Oliveira, J, Reis Barbosa, CG, Santos da Silva, A, Dos-Santos, JW, Verlengia, R, Barreira, J, Braz, TV, and Lopes, CR. Resistance exercise sessions comprising multijoint vs. single-joint exercises result in similar metabolic and hormonal responses, but distinct levels of muscle damage in trained men. J Strength Cond Res 38(5): 842-847, 2024-Resistance-type exercise (RE) elicits distinct acute metabolic and hormonal responses, which can be modulated by the manipulation of training variables. The purpose of this study was to compare the metabolic (blood lactate and estimated lactic anaerobic system energy expenditure) and hormonal (growth hormone [GH]) responses to RE sessions composed exclusively of multijoint (MULTI) or single-joint (SINGLE) exercises. Assessments of creatine kinase (CK) levels were also performed. In a crossover design, 10 recreationally resistance-trained men (age: 26.9 ± 3.0 years, total body mass: 83.2 ± 13.8 kg; height: 176 ± 7.0 cm; training experience: 5.5 ± 2.4 years) were randomly submitted to both protocols. Blood collections were made pre, 3 minutes after, and 36 hours after each experimental session. No significant difference between MULTI vs. SINGLE was observed for the rises in blood lactate (p = 0.057) and GH (p = 0.285) levels. For CK, a significant difference between the protocols was noted, in which MULTI resulted in significant rises after 3 minutes (p = 0.017) and 36 hours (p = 0.043) compared with SINGLE. In conclusion, the findings of this study suggest that resistance-trained individuals display similar metabolic and hormonal responses when performing MULTI and SINGLE exercise protocols. Also, RE sessions comprising MULTI exercises induce a higher magnitude of muscle damage, which may require a longer recovery period compared with SINGLE.

Muscle Hypertrophy Responses to Changes in Training Volume: A Retrospective Analysis.

This study assessed associations between changes in the weekly number of sets performed and the percentage change in muscle thickness of the biceps (MTBB) and triceps (MTTB) brachii muscles. Through a retrospective analysis, sixty-eight resistance-trained subjects that participated in previous studies had their previous training volumes analyzed and compared to the volume imposed during each individual study. The relationship between variables was determined through Spearman correlation and a k-cluster analysis was performed to subdivide the participants into three groups and classified as:<0%; 0-50%, and >50% increase in the number of sets for both muscle groups. Moderate and weak correlations were observed between the alterations in training volume and changes in MTBB (rs=0.44, p=0.001) and MTTB (rs=0.35, p=0.002), respectively. A significant difference was noted between<0% to >50% for MTBB and MTTB (p=0.017; p=0.042, respectively), while no significant difference was observed between<0% to 0-50% and 0-50% to >50% (both p >0.05) for both muscle groups. In conclusion, muscle hypertrophy of the upper limbs is only weakly to moderately associated with changes in training volume of trained subjects.

An Examination of Two Resistance Training Frequency Techniques in Morphological and Functional Adaptations of the Patellar Tendon.

The aim of the present study was to investigate the effects of distinct resistance training frequencies with equated-volume conditions in morphological and functional adaptations of the patellar tendon. Twenty-seven recreationally resistance-trained subjects (men [n=17] and women [n=10]) (age: 20.8 ± 1.9 years [range 18 to 25 years]; height: 1.73 ± 9.8 cm; total body mass = 73.2 ± 11.7 kg; previous RT experience = 3.3 ± 1.6 years) volunteered to participate in this study. A total of 16 training sessions were performed during the study period. Each subject's leg was randomly allocated to one of the following training protocols: 2 training sessions/week (2x) or 4 training sessions/week (4x). Measurements of tendon cross sectional area (CSA) and length were performed through ultrasound imaging. One repetition maximum test was performed to assess patellar tendon force (PTF) unilaterally. For CSA (2x: Δ= -1.3%; 4x: Δ= -0.9%), and length (2x: Δ= -0.4%; 4x: Δ= 1.2%), no significant differences were observed within or between conditions (all p > 0.05). For PTF, a significant difference was observed between conditions (mean difference = 0.05 [-125 to 224] p= 0.001). In conclusion, the leg extension exercise performed 2 vs 4x/week induces similar patellar tendon morphological responses. However, the increase in force seems to be enhanced by a lower weekly training frequency associated with a longer intervention period.

Acute Effects of Foam Rolling on Cycling Performance: A Randomized Cross-Over Study.

Acute foam rolling protocols may increase range of motion without a negative impact on muscle performance. The main purpose of the present study was to investigate the acute effects of foam rolling on cycling performance (mean power and maximal power), affect and perceived exertion. A secondary aim was to assess the effect of foam rolling on post-exercise muscle soreness. In a random order, ten recreationally trained cyclists (age: 26 ± 5 years; height 1.76 ± 0.06 m; total body mass 78.3 ± 19.8 kg; cycling experience: 5.6 ± 5.3 years; 4.1 ± 1.3 cycling sessions per week and 1.4 ± 1.4 strength sessions per week) were submitted to the following experimental conditions (separated by one week) before performing a three-minute, all-out cycling test: foam rolling or control. During foam rolling protocol, participants were instructed to roll back and forth on one leg and to place the opposite leg crossed over, from the proximal to the distal portion of the rectus femoris and vastus lateralis during one set of sixty seconds for each muscle group. Feeling scale (10 min pre and post-test), CR-10 scale of perceived exertion (ten-minute post-test), pressure pain threshold (pre and 24 h post-test) and mean/maximal power were assessed. No significant differences were observed between conditions for mean and maximal power, affect, perceived exertion, and pressure pain threshold (all p > 0.05). In conclusion, a pre-exercise acute session of self-myofascial release does not improve performance and post-exercise muscle soreness of recreationally trained cyclists.

Physiotherapy interventions for the treatment of spasticity in people with spinal cord injury: a systematic review.

STUDY DESIGN: Systematic review. OBJECTIVE: To determine the effectiveness of physiotherapy interventions for the treatment of spasticity in people with spinal cord injuries. SETTING: Not applicable. METHODS: A comprehensive search was undertaken to identify all randomised controlled trials of physiotherapy interventions that included an assessor-reported (objective) or participant-reported (subjective) measure of spasticity. Only trials that provided a physiotherapy intervention on more than one occasion were included. The susceptibility to bias of each trial was rated on the PEDro scale. Data were extracted to derive mean between-group differences (95% CI) for each trial. RESULTS: Twenty-eight trials were identified but only 17 provided useable data. Seven trials compared a physiotherapy intervention to no intervention (or a sham intervention) and 10 trials compared one physiotherapy intervention to another physiotherapy intervention. The median (IQR) PEDro score of the 17 trials was 6/10 (6-8). The most commonly used assessor- and participant-reported measures of spasticity were the Ashworth scale and Spinal Cord Injury Spasticity Evaluation Tool, respectively. Only one trial demonstrated a treatment effect. This trial compared continuous passive motion of the ankle to no treatment on the Ashworth scale. The remaining 16 trials were either inconclusive or indicated that the treatment was ineffective for reducing spasticity. CONCLUSIONS: There is no high-quality evidence to indicate that physiotherapy interventions decrease spasticity but this may reflect a lack of research on the topic. Future trials should focus on participant-reported measures of spasticity that distinguish between the immediate, short-term and long-term effects of any physiotherapy intervention.

Chronic Effects of Heavy Load Activity Performed Before Resistance Training Sessions on the Physical Performance of Youth Soccer Players.

The adoption of resistance training (RT) programs has been shown to positively influence sports performance-related parameters. However, the chronic effects of maximal strength protocols on the performance of soccer players are not completely investigated. The aim of this study was to evaluate the effects of performing two repetition maximum (2RM) before a resistance training session on the physical performance of youth soccer players. Seventeen players (under-20 category) were allocated in one of the following groups: 2RM + resistance training group (2RM + RT, n = 8) and resistance training group (RTG, n = 9). Both groups performed the same RT protocol during experimental weeks. However, the 2RM + RT performed 1 set of 2RM for 4 exercises, previously to RT protocol. Pre and post intervention period, one repetition maximum of the back squat exercise (1RMSQUAT), sprint time (15m-sprint test), countermovement jump (CMJ), repeated sprint ability (RSABEST and RSAMEAN), and yo-yo intermittent recovery test level-2 (YYIRT2) were assessed. Total load lifted (TLL) during the experimental weeks was also collected. Significant increases in 1RMSQUAT (2RM + RT: +45.1%, d = 4.40; RTG: +32.3%, d = 1.84), 15m sprint (2RM + RT: -9.0%, d = 7.9; RTG: -8.8%%, d = 3.2), CMJ (2RM + RT: +2.3%, d = 0.17; RTG: +0.8%, d = 0.07), RSABEST (2RM + RT: -2.4%, d = 0.6; RTG: -2.3%, d = 1.04), RSAMEAN (2RM + RT: -2.9%, d = 1.33; RTG: -3.4%, d = 1.78), YYIRT2 (2RM + RT: +12.0%, d = 0.82; RTG: +12.1%, d = 0.63) (all p < 0,05) were observed for both groups on pre to post-intervention periods, with no significant difference between groups. Therefore, the 2RM + RT protocol did not promote additional increase on performance of young soccer players.

Reliability of the measures of weight-bearing distribution obtained during quiet stance by digital scales in subjects with and without hemiparesis.

Described as an alternative way of assessing weight-bearing asymmetries, the measures obtained from digital scales have been used as an index to classify weight-bearing distribution. This study aimed to describe the intra-test and the test/retest reliability of measures in subjects with and without hemiparesis during quiet stance. The percentage of body weight borne by one limb was calculated for a sample of subjects with hemiparesis and for a control group that was matched by gender and age. A two-way analysis of variance was used to verify the intra-test reliability. This analysis was calculated using the differences between the averages of the measures obtained during single, double or triple trials. The intra-class correlation coefficient (ICC) was utilized and data plotted using the Bland-Altman method. The intra-test analysis showed significant differences, only observed in the hemiparesis group, between the measures obtained by single and triple trials. Excellent and moderate ICC values (0.69-0.84) between test and retest were observed in the hemiparesis group, while for control groups ICC values (0.41-0.74) were classified as moderate, progressing from almost poor for measures obtained by a single trial to almost excellent for those obtained by triple trials. In conclusion, good reliability ranging from moderate to excellent classifications was found for participants with and without hemiparesis. Moreover, an improvement of the repeatability was observed with fewer trials for participants with hemiparesis, and with more trials for participants without hemiparesis.

Reliability of the Functional Reach Test and the influence of anthropometric characteristics on test results in subjects with hemiparesis.

First designed as an alternative method of assessing balance and susceptibility to falls among elderly, the Functional Reach Test (FR) has also been used among patients with hemiparesis. Then this study aimed to describe the intra- and inter-rater and the test/re-test reliability of the FR measure in subjects with and without hemiparesis while verifying anthropometric influences on the measurements. The FR was administered to a sample of subjects with hemiparesis and to a control group that was matched by gender and age. A two-way analysis of variance was used to verify the intra-rater reliability. It was calculated using the differences between the averages of the measures obtained during single, double or triple trials. The intra-class correlation coefficient (ICC) was utilized and data plotted using the Bland-Altman method. Associations were analyzed using Pearson's correlation coefficient. In general, the intra-rater analysis did not show significant differences between the measures for the single, double or triple trials. Excellent ICC values were observed, and there were no significant associations with anthropometric parameters for the hemiparesis and control subjects. FR showed good reliability for patients with and without hemiparesis and the test measurements were not significantly associated with the anthropometric characteristics of the subjects.

Tecnologia baropodométrica utilizada para analisar tipos de suporte de peso durante postura ortostática hemiparética / Baropodometric technology used to analyze types of weight-bearing during hemiparetic upright position

INTRODUCTION: Although baropodometric analysis has been published since the 1990s, only now it is found a considerable number of studies showing different uses in the rehabilitation. OBJECTIVE: To amplify the use of this technology, this research aimed to analyze baropodometric records during upright position of subjects with hemiparesis, describing a way to define weight-bearing profiles in this population. METHOD: 20 healthy subjects were matched by gender and age with 12 subjects with chronic spastic hemiparesis. This control group was formed to establish the limits of symmetry during weight-bearing distribution in the hemiparesis group. Next, hemiparesis group was submitted to procedures to measure baropodometric records used to provide variables related to the weight-bearing distribution, the arch index and the displacements in the center of pressure (CoP). Data were used to compare differences among kinds of weight-bearing distribution (symmetric, asymmetric toward non-paretic or paretic foot) and coordination system for CoP displacements. RESULTS: Hemiparesis group was compounded by eight symmetrics, eight asymmetrics toward non-paretic foot and four asymmetric toward paretic foot. Significant differences in the weight-bearing distributions between non-predominantly and predominantly used foot did not promote differences in the other baropodometric records (peak and mean of pressure, and support area). Mainly in the asymmetry toward non-paretic foot it was observed significant modifications of the baropodometric records. CONCLUSION: Baropodometric technology can be used to analyze weight-bearing distribution during upright position of subjects with hemiparesis, detecting different kinds of weight-bearing profiles useful to therapeutic programs and researches involving subjects with this disability.

INTRODUÇÃO: Embora análises baropodométricas sejam encontradas desde a década de 1990, somente agora é observado número considerável de estudos mostrando usos na reabilitação. OBJETIVOS: Para ampliar o uso dessa tecnologia, objetivou-se analisar registros baropodométricos durante a posição ortostática de sujeitos com hemiparesia, descrevendo o suporte de peso nessa população. MÉTODOS: 20 sujeitos saudáveis foram pareados por gênero e idade com 12 sujeitos com hemiparesia espástica crônica. Controles foram formados para estabelecer limites de simetria na distribuição do suporte de peso no grupo hemiparesia. Em seguida, o grupo hemiparesia foi submetido a procedimentos usados para fornecer variáveis como: distribuição no suporte de peso, índice de arqueamento e deslocamentos no centro de pressão (CoP). Os dados diferenciaram tipos de distribuição do suporte de peso (simétrico, assimétrico em direção ao pé não parético ou parético) e estabeleceram sistemas de coordenadas para deslocamentos do CoP. RESULTADOS: O grupo hemiparesia apresentou oito simétricos, oito assimétricos em direção ao pé não parético e quatro em direção ao pé parético. Distribuição assimétrica do suporte entre os pés não predominantemente ou predominantemente usados não promoveram diferenças em registros baropodométricos (pico e média de pressão e área de suporte). Principalmente para a assimetria em direção ao pé não parético, observou-se modificações significativas nos registros baropodométricos. CONCLUSÃO: Tecnologia baropodométrica pode ser usada para analisar a distribuição no suporte de peso durante a posição ortostática de sujeitos com hemiparesia, detectando diferentes tipos de suporte de peso, úteis para serem usados em programas terapêuticos e em pesquisas envolvendo sujeitos com essa incapacidade.

Comparação entre medidas de descarga, simetria e transferência de peso em indivíduos com e sem hemiparesia / Comparison between bearing, symmetry, and transfer weight measurements in subjects with or without hemiparesis

Avaliação da Simetria e Transferência de Peso (ASTP) foi indicada para se fazer associação entre simetria e atividades funcionais nas hemiparesias, apontando simétricos como mais capacitados. Contudo, tais relações não são claras e divergem com evidências que sugerem assimetrias como estratégias funcionais. Assim, objetivou-se verificar se as medidas subjetivamente determinadas pela ASTP concordam com medidas calculas pela descarga de peso entre os pés. Realizou-se estudo observacional do tipo transversal para amostra de sujeitos com hemiparesia (n=20) pareados por idade e gênero a controles (n=20). Os participantes submeteram-se a procedimentos para obtenção de escore determinado pela ASTP e para cálculo da razão de simetria (RS) na descarga de peso entre os pés obtido por meio de duas balanças digitais. Os resultados obtidos pela ASTP identificaram apenas um sujeito com hemiparesia apresentando simetria, dentre os quatro sujeitos identificados pela RS como simétricos. Ainda, a ASTP não diferenciou assimetrias com sobrecarga para o lado afetado e apresentou correlação significativa somente quando os escores foram analisados com os valores de RS<1(sobrecarga para o lado não afetado). Conclui-se que a ASTP não foi concordante em identificar sujeitos hemiparéticos com descarga de peso compatível com simetria. Ainda, não identificou sobrecargas para o lado afetado que poderia conduzir a análises equivocadas da associação entre simetria e desempenho funcional.

Assessment of symmetry and weight-transfer (ASWT) was indicated to relate symmetry and functional activity in the hemiparesis, pointing as the most qualified symmetrical. However, such relationships are not clear and disagree with evidences suggesting asymmetries as strategies for functional strategies. Then, it was proposed to verify the measurements subjectively determined by ASWT agree with measurements calculated by weight-bearing distribution for each foot. It was applied observational study with transversal design for sample of subjects with hemiparesis (n=20) matched by age and gender with controls (n=20). Participants were included in procedures toobtain scores by ASWT and to calculate symmetry ratio (SR) in the weight-bearing between feet by digital scales. The results obtained by ASWT indicated only one subject with hemiparesis presenting symmetry among four subjects identified as symmetric by SR. Besides, the ASWT did not differ overweight toward the affected side and presented significant correlation only when the scores were analyzed with values of SR<1(overweight toward the non-affected side). It was concluded that the ASWT was not agreementto identify weight-bearing distribution compatible with symmetry. Moreover, it did not identify overweight toward the affected side that could to drive to mistaken analysis of the relationship between symmetries and functional performance.

Is it correct to always consider weight-bearing asymmetrically distributed in individuals with hemiparesis?

Injuries may cause unilateral deterioration of brain areas related to postural control resulting in lateralized motor disability with abnormal asymmetry in weight-bearing distribution. Although overloading toward the nonaffected limb has been described as the preferred posture among individuals with hemiparesis, characterization of the weight-bearing asymmetry is poorly and indirectly described. Therefore, this study aimed to describe weight-bearing distribution during upright stance, establishing criteria to consider asymmetry in hemiparesis when analyzed within the limits defined by controls matched by age and gender. Forty subjects with (n = 20) or without hemiparesis (n = 20) were included in procedures to record weight-bearing values between hemibodies, and these values were used to calculate a symmetry ratio. Control presented 95% confidence interval (CI) of the mean for symmetry ratio ranging from 0.888 to 1.072, defining limits to symmetry. Four subjects with hemiparesis (20%) had symmetry ratios inside limits defined by controls (i.e., weight-bearing symmetrically distributed), and 11 (55%) subjects without hemiparesis showed symmetry ratios outside the limits, suggesting asymmetrical weight-bearing distribution. It was concluded that asymmetry, when present in a control group, was more frequently overloading nonpredominantly used hemibody (nondominant side), differing from a hemiparesis group commonly forced to assume the nonaffected side as the predominantly used hemibody and where the overload was observed.

A Brazilian experience to describe functioning and disability profiles provided by combined use of ICD and ICF in chronic stroke patients at home-care.

PURPOSE: To present experience of combined use of the International Classifications to determine functioning and disability profiles of chronic stroke patients at home-care. METHODS: It was a design observational study with 13 subjects sampled from 39 patients with stroke pre-selected from 115 patients attended by a public home-care service. Their socio-demographic and others independent variables were assessed and frequencies of codified events from International Classification of Diseases (ICD) and International Classification of Functioning, Disability and Health (ICF) were recorded. RESULTS: Endocrine, nutritional and metabolic diseases; diseases of the nervous and circulatory system; diseases of skin and subcutaneous tissue and diseases of the musculoskeletal system and connective tissue were recorded by ICD being complemented by ICF mainly describing impairments in neuromusculoskeletal and movement-related function and structure; limitations in activities and participation for domestic life and barriers for natural environment and human-made changes to environment. Moreover, it was observed functioning profile describing sensory function and structures related to movements preserved; good interpersonal interactions and facilities provided by services and policies. CONCLUSION: Preserved functions and structures related to movement and advantages in interpersonal interactions, public services and healthy policies could be used to guide therapy and to prevent rehospitalisation commonly observed in chronic stroke survivals.