Association Between Digitally Provided Education and 90-Day Return to Sexual Activity Following Total Knee Arthroplasty: A Randomized Controlled Trial.

BACKGROUND: Contemporary total knee arthroplasty patients have increased expectations of returning to predisease function, including sexual activity (SA). The purpose of this study was to determine whether patients using a digital care management platform (DCMP) were more likely to have a higher rate and frequency of return to SA. METHODS: We conducted an exploratory analysis of a prospective, multicenter, randomized controlled trial that enrolled patients undergoing total knee arthroplasty. A total of 304 patients were randomized to a DCMP (n = 119) providing preoperative and postoperative education regarding return to SA or standard postoperative care (control group; n = 185). Return to SA, assessed via questionnaire, patient-reported outcome measures, Timed Up and Go test, single leg stance, active range of motion and need for manipulation under anesthesia were assessed at 90 days postoperatively. RESULTS: More patients in the DCMP group returned to SA compared to control at 90 days (58.4 versus 39.6%, P = .018); however, the control group resumed SA sooner (33.1 versus 42.0 days, P = .023). Patients who returned to SA were younger (61.6 versus 65.9 year), more often men (56 versus 35%) (P < .001), higher performing on the Timed Up and Go and single leg stance tests (P < .001), and had greater active range of motion (P = .007). There were no differences in patient-reported outcome measures or need for manipulation under anesthesia between patients that returned to SA and those who did not. CONCLUSIONS: More patients using a DCMP resumed SA at 90 days; however, patients in the control group returned to SA sooner. Those who returned to SA were younger, possessed greater physical function, and were more often men.

Is There a Change in Anxiety and Depression Following Total Knee Arthroplasty?

BACKGROUND: The primary purpose of this study was to investigate whether anxiety and depression change following total knee arthroplasty (TKA). A secondary objective was to explore the association between preoperative variables and changes in anxiety and depression. METHODS: This was a prospective, multicenter, cohort study. Participants (n = 1,852, age 64 ± 8.7 years, a body mass index of 31.3, a modified Comorbidity Index of 1.0 ± 1.3, and 61.7% were women) completed the EuroQol 5-dimension 5-level preoperatively and at 1- and 3-month postoperatively. Fulfillment of physical activity expectations and preparedness to resume activities was assessed at 3 months. The anxiety or depression dimension was analyzed using the Paretian classification profile changes and compared with the sign Fisher's exact test. Logistic regressions were used to analyze the relationship between patient characteristics, preoperative anxiety or depression, activity expectations, preparedness to resume activities, and changes in anxiety/depression. RESULTS: The percentage of patients reporting Level 1 (no anxious or depressed feelings) significantly (P < .0001) increased from preoperative (62.2%) to 3 months (77.1%) postoperative, while levels 2 to 5 (slightly through extremely anxious or depressed) all decreased. The percentage of worsening anxiety and depression was significantly (P < .0001) greater in patients who did not feel they were well prepared to resume activities of daily living (17.7 versus 4.4%) and physical recreation (12.9 versus 3.9%). Preoperative anxiety and depression (odds ratio [OR] 52.27, 95% confidence interval [CI]: 34.98, 80.67), EuroQol 5-dimension 5-level (OR: 2.55, 95% CI: 1.04, 6.34), activity of daily living (OR: 1.57, 95% CI: 1.19, 2.06), and body mass index (OR: 1.05, 95% CI: 1.02, 1.08) were significant (P < .05) predictors of an improving Paretian change profile at 3 months postoperative. CONCLUSIONS: Anxiety and depression decrease following TKA, and these changes appear heavily dependent on a patient's preoperative psychological well-being and postoperative preparedness to resume daily activities. Physicians' awareness of preoperative patient psychological well-being and management of patient preparedness and expectations to resume physical activity may modulate postoperative anxiety and depression.

Impact of Chronic Opioid Use on Postoperative Mobility Recovery and Patient-Reported Outcomes: A Propensity-Matched Study.

BACKGROUND: Opioid use prior to total joint arthroplasty may be associated with poorer postoperative outcomes. However, few studies have reported the impact on postoperative recovery of mobility. We hypothesized that chronic opioid users would demonstrate impaired objective and subjective mobility recovery compared to nonusers. METHODS: A secondary data analysis of a multicenter, prospective observational cohort study in which patients used a smartphone-based care management platform with a smartwatch for self-directed rehabilitation following hip or knee arthroplasty was performed. Patients were matched 2:1 based on age, body mass index, sex, procedure, Charnley class, ambulatory status, orthopedic procedure history, and anxiety. Postoperative mobility outcomes were measured by patient-reported ability to walk unassisted at 90 days, step counts, and responses to the 5-level EuroQol-5 dimension 5-level, compared by Chi-square and student's t-tests. Unmatched cohorts were also compared to investigate the impact of matching. RESULTS: A total of 153 preoperative chronic opioid users were matched to 306 opioid-naïve patients. Age (61.9 ± 10.5 versus 62.1 ± 10.3, P = .90) and sex (53.6 versus 53.3% women, P = .95) were similar between groups. The proportion of people who reported walking unassisted for 90 days did not vary in the matched cohort (87.8 versus 90.7%, P = .26). Step counts were similar preoperatively and 1-month postoperatively but were lower in opioid users at 3 and 6 months postoperatively (4,823 versus 5,848, P = .03). More opioid users reported moderate to extreme problems with ambulation preoperatively on the 5-level EuroQol-5 dimension 5-level (80.6 versus 69.0%, P = .02), and at 6 months (19.2 versus 9.3%, P = .01). CONCLUSIONS: Subjective and objective measures of postoperative mobility were significantly reduced in patients who chronically used opioid medications preoperatively. Even after considering baseline factors that may affect ambulation, objective mobility metrics following arthroplasty were negatively impacted by preoperative chronic opioid use.

Patient satisfaction and patient-reported outcomes do not vary by BMI class in total hip arthroplasty.

PURPOSE: Obesity has been identified as a risk factor for postoperative complications in patients undergoing total hip arthroplasty (THA). This study aimed to investigate patient-reported outcomes, pain, and satisfaction as a function of body mass index (BMI) class in patients undergoing THA. METHODS: 1736 patients within a prospective observational study were categorized into BMI classes. Pre- and postoperative Hip disability and Osteoarthritis Outcome Score for Joint Replacement (HOOS JR), satisfaction, and pain scores were compared by BMI class using one-way ANOVA. RESULTS: Healthy weight patients reported the highest preoperative HOOS JR (56.66 ± 13.35) compared to 45.51 ± 14.45 in Class III subjects. Healthy weight and Class III patients reported the lowest (5.65 ± 2.01) and highest (7.06 ± 1.98, p < 0.0001) preoperative pain, respectively. Changes in HOOS JR scores from baseline suggest larger improvements with increasing BMI class, where Class III patients reported an increase of 33.7 ± 15.6 points at 90 days compared to 26.1 ± 17.1 in healthy weight individuals (p = 0.002). Fewer healthy weight patients achieved the minimal clinically important difference (87.4%) for HOOS JR compared to Class II (96.5%) and III (94.7%) obesity groups at 90 days postoperatively. Changes in satisfaction and pain scores were largest in the Class III patients. Overall, no functional outcomes varied by BMI class postoperatively. CONCLUSION: Patients of higher BMI class reported greater improvements following THA. While risk/benefit shared decision-making remains a personalized requirement of THA, this study highlights that utilization of BMI cutoff may not be warranted based on pain and functional improvement.

Early- to Mid-Term Review of a Prospective, Multi-Center, International, Outcomes Study of an Anatomically Designed Implant with Posterior-Stabilized Bearing in Total Knee Arthroplasty.

Background and Objectives: National joint registries report higher total knee arthroplasty (TKA) revision rates in posterior-stabilized (PS) systems compared to non-posterior-stabilized designs. The purpose of this study was to investigate the implant survivorship and clinical outcomes of an anatomic implant with a PS bearing. Materials and Methods: An early- to mid-term follow-up of a prospective, multi-center, non-controlled outcomes study of patients who received primary TKA between November 2014 and June 2017 was performed. A total of 800 cases using PS bearings that were implanted in 664 patients were monitored post-operatively for their implant survivorship and adverse events for up to five years. The Knee Society Knee and Function scores, patient satisfaction, the five-dimensional European Quality of Life questionnaire, and range of motion (ROM) were evaluated pre-operatively and post-operatively at six weeks, six months, one year, two years, three years, and five years. Results: The mean follow-up period was 3.7 ± 1.3 years, and the three-year implant survival rate was 99.3% (95% CI: 98.4%, 99.7%) with five revisions during the five-year follow-up. Patient satisfaction was 96.1% at six weeks and increased to 99.3% at one year. All patient-reported outcome measures significantly (p < 0.0001) increased up to the one-year follow-up and then remained stable up to the five-year follow-up. Conclusions: This study supports the excellent survivorship and patient-reported outcomes of the Persona® Knee system using cemented, fixed bearing, posterior-stabilized components with minimal complications at early- to mid-term follow-up in an international Asian population. Ongoing observations are being performed to investigate the mid- to long-term survivorship and clinical outcomes associated with this knee system.

Acute Capsaicin Supplementation Improved Resistance Exercise Performance Performed After a High-Intensity Intermittent Running in Resistance-Trained Men.

ABSTRACT: de Freitas, MC, Cholewa, JM, Panissa, VLG, Toloi, GG, Netto, HC, Zanini de Freitas, C, Freire, RV, Lira, FS, and Rossi, FE. Acute capsaicin supplementation improved resistance exercise performance performed after a high-intensity intermittent running in resistance-trained men. J Strength Cond Res 36(1): 130-134, 2022-We sought to investigate the acute effects of capsaicin supplementation on the rate of perceived exertion (RPE) and heart rate during high-intensity intermittent exercise (HIIE) and resistance exercise performance executed after HIIE in resistance-trained men. Eleven resistance-trained men completed 2 randomized, double-blind trials: capsaicin condition or a placebo condition. The concurrent exercise session was composed of a 5-km intermittent run (1:1 effort and passive recovery ratio) and subsequent resistance exercise (4 × 70% of 1RM until muscle failure in the half-squat exercise). Heart rate was recorded during HIIE and after the protocol RPE (0-10 scale) was accessed. The resistance exercise performance was analyzed by the maximum number of repetitions performed for each set and the total volume (repetitions × weight lifted). During HIIE, the RPE (capsaicin = 7 ± 1 vs. placebo = 8 ± 1 points, t = -3.674, p = 0.005) and mean heart rate (capsaicin = 153 ± 13 vs. placebo = 158 ± 12 bpm, t = -2.292, p = 0.048) were significantly lower in the capsaicin compared with placebo condition. For subsequent resistance exercise, there was a significant decrease in volume across time (F = 19.889, p < 0.001, η2= 0.69) with maximal number of repetitions performed in capsaicin than placebo condition (2,077.6 ± 465.2 kg vs. 1,838.9 ± 624.1 kg, p = 0.028, d = 0.43), but the condition vs. set was not significant (F = 0.582, p = 0.632, η2= 0.06). Acute capsaicin supplementation induced a lower mean heart rate and RPE during HIIE and improved subsequent resistance exercise performance in resistance-trained men.

Postactivation Potentiation Improves Acute Resistance Exercise Performance and Muscular Force in Trained Men.

ABSTRACT: Conrado de Freitas, M, Rossi, FE, Colognesi, LA, de Oliveira, JVNS, Zanchi, NE, Lira, FS, Cholewa, JM, and Gobbo, LA. Postactivation potentiation improves acute resistance exercise performance and muscular force in trained men. J Strength Cond Res 35(5): 1357-1363, 2021-The purpose of this study was to investigate the effects of heavy back squat (90% one repetition maximum [1RM]) postactivation potentiation (PAP) on acute resistance exercise performance and force production in recreationally trained men, and to verify the relationship between maximal strength and the PAP response. Ten resistance-trained men randomly completed 4 experimental trials: (a) back squats without PAP (No-PAP), (b) back squats with PAP, (c) maximum voluntary isometric contraction (MVIC) of the quadriceps without PAP, and (d) MVIC with PAP. Back squats were performed with 4 sets at 70% of 1 RM with 2 minutes of rest interval. The number of squats repetitions performed was recorded for each set, and a total number of repetitions were calculated to analyze performance. Maximum voluntary isometric contraction was measured using electronic dynamometer, and the peak force and mean force were recorded. Blood lactate concentration was analyzed presquat and postsquat exercise. Repetitions performed in the first set was significantly (p < 0.001) greater in the PAP condition (22.00 ± 5.14) compared with No-PAP (15.50 ± 5.10), which resulted in significantly (p = 0.001) more total repetitions performed in the PAP (56.20 ± 17.3) condition compared with No-PAP (48.80 ± 14.5). Maximum voluntary isometric contraction peak was higher in PAP than in No-PAP (PAP = 765.7 ± 147.8 vs. No-PAP = 696.8 ± 131.5 N, p = 0.006). No significant correlations were observed between back squat 1RM relative to body mass and the PAP response in squat and MVIC. There were no significant differences in lactate concentration between conditions. In conclusion, PAP resulting from a heavy load prior back squat exercise improved total volume during resistance exercise. In addition, PAP was effective to increase force production during MVIC, but there was no relationship between relative 1RM values and the PAP response in trained men.

Appetite Is Suppressed After Full-Body Resistance Exercise Compared With Split-Body Resistance Exercise: The Potential Influence of Lactate and Autonomic Modulation.

ABSTRACT: Conrado de Freitas, M, Ricci-Vitor, AL, de Oliveira, JVNS, Quizzini, GH, Vanderlei, LCM, Silva, BSA, Zanchi, NE, Cholewa, JM, Lira, FS, and Rossi, FE. Appetite is suppressed after full-body resistance exercise compared with split-body resistance exercise: the potential influence of lactate and autonomic modulation. J Strength Cond Res 35(9): 2532-2540, 2021-The purposes of this study were to investigate the effects of full- vs. split-body resistance training on appetite and leptin response and to verify the potential involvement of lactate and autonomic modulation during this response in trained men. Twelve recreationally resistance-trained men (age = 26.1 ± 5.5 years) performed 3 randomized trials in 3 conditions: upper body (UB), lower body (LB), and full body (FB). The subjective rating of hunger was obtained through a visual analog scale. Leptin and lactate concentration were evaluated at rest, immediately after exercise, and during recovery. Heart rate variability in the time and frequency domains was recorded at baseline and during recovery (until 60 minutes after exercise) to assess autonomic modulation. The FB condition induced lower subjective hunger ratings than the UB at Post-1 hour (p < 0.05) and a significant difference in the area under the curve between conditions (p = 0.028) with lower hunger sensation for FB in relation to UB (p = 0.041). The FB presented greater lactate concentration and induced slower heart rate variability recovery in relation to UB and LB conditions (p < 0.05), and heart rate variability remained lower until 60 minutes after exercise compared with rest only in the FB condition. There was a significant negative correlation between subjective hunger ratings and lactate concentration only for the FB condition (r = -0.72, p = 0.028). Full-body resistance exercise induced lower subjective hunger ratings after exercise in relation to UB resistance exercise. The FB also induced higher lactate production and slower recovery of autonomic modulation compared with the UB and LB conditions. Future research is necessary to investigate a mechanistic relationship between lactate concentrations and hunger suppression after resistance exercise.

Comparison Between Full-Body vs. Split-Body Resistance Exercise on the Brain-Derived Neurotrophic Factor and Immunometabolic Response.

Lira, FS, Conrado de Freitas, M, Gerosa-Neto, J, Cholewa, JM, and Rossi, FE. Comparison between full-body vs. split-body resistance exercise on the brain-derived neurotrophic factor immunometabolic response. J Strength Cond Res 34(11): 3094-3102, 2020-Intense aerobic exercise seems to increase serum concentrations of brain-derived neurotrophic factor (BDNF) in conjunction with increasing lactate; however, less is known about the BDNF response to differing resistance exercise protocols. We hypothesized that full-body (FB) resistance exercise will elicit a greater increase in serum BDNF and lactate compared with split-body resistance exercise. Twelve recreationally resistance-trained men (age = 25.3 ± 5.9 years) performed 3 randomized trials of 18 sets of exercise: upper-body (UB), lower-body (LB), and FB conditions. Serum BDNF levels were assessed at rest, immediately Post-exercise, Post-1 hour, and Post-2 hours during recovery. Lactate concentration was evaluated at rest, after 9 sets, Post-exercise, Post-5, Post-10, and Post-30 minutes during recovery. In addition, interleukin (IL-6 and IL-10) and the IL-6/IL-10 ratio were calculated. Lactate concentration and total volume were greater in the FB condition compared with LB and UB (p < 0.05). For BDNF, effect sizes were largest in the LB (1.4), followed by the FB (0.75), and moderate to UB (0.33), although no significant differences were observed between conditions. There was a statistically significant relationship between lactate and BDNF only for LB condition (rho = 0.72; p = 0.013). There were a greater IL-10 Post-1 hour for FB condition compared with UB and LB (p < 0.001), and lower IL-6/IL-10 ratio in FB compared with UB (p < 0.001). Lower body induced a great BDNF response, and FB resistance exercise elicited a greater increase of serum cytokines than UB in trained men. We speculate that the volume of work performed by larger muscles has a larger influence on BDNF than overall volume.

A Single Dose of Oral ATP Supplementation Improves Performance and Physiological Response During Lower Body Resistance Exercise in Recreational Resistance-Trained Males.

Freitas, MC, Cholewa, JM, Gerosa-Neto, J, Gonçalves, DC, Caperuto, EC, Lira, FS, and Rossi, FE. A single dose of oral ATP supplementation improves performance and physiological response during lower body resistance exercise in recreational resistance-trained males. J Strength Cond Res 33(12): 3345-3352, 2019-The aim of this study was to investigate the acute effect of adenosine-5'-triphosphate (ATP) supplementation on performance and physiological responses during resistance exercise in recreationally resistance-trained males. Eleven men (age = 27.5 ± 5.5 years, mass = 83.4 ± 9.8 kg, height = 182 ± 0.04 cm) completed 2 randomized, double-blind trials: ATP supplement condition (ATP = 400 mg) or a placebo condition. Thirty minutes after supplement consumption, subjects performed 4 sets of half-squats until momentary muscular failure at 80% of the 1 repetition maximum with 2 minutes of recovery between sets. The total number of repetitions, blood pressure, heart rate, blood lactate, and oxygen consumption were evaluated. The total weight lifted were higher for the ATP condition compared with placebo (Placebo = 3,995.7 ± 1,137.8, ATP = 4,967.4 ± 1,497.9 kg; p = 0.005). Heart rate was higher at set-4 for ATP compared with placebo (p < 0.001) and oxygen consumption during exercise was greater for ATP (p = 0.021). There were no differences between conditions for lactate and blood pressure. In summary, a single oral dose of ATP supplementation improved lower-body resistance training performance and energy expenditure in recreational resistance-trained males.

Anthropometrical Determinants of Deadlift Variant Performance.

The barbell deadlift is a popular exercise and one of the three lifts in competitive powerlifting. While muscle activation has been tested between the sumo (SDL) and conventional deadlift (CDL), the relationships between anthropometrics and deadlift performance in the two styles is not yet known. The purpose of this study was to investigate the relationships between anthropometrics and SDL versus CDL performance (SDL:CDL strength ratio). Forty-seven (n = 28 male, n = 19 female) deadlift naïve subjects participated in this study. Anthropometric measurements were arm and hand length, wrist and ankle girth, seated height, thigh length, and lower leg length. Deadlift instructions for the two styles were provided on day 1 and 2. On day 3 and 4, deadlift 1RM was tested for the SDL or CDL in random order, and then deadlift repetitions to volitional fatigue with 60% of 1RM were measured. No significant differences between CDL 1RM and SDL 1RM were found. The only significant correlation found between the anthropometric predictors and the SDL:CDL strength ratio was an inverse relationship with the sitting height to total height ratio (r = 0.297, p = 0.043). Total repetitions to volitional fatigue was higher in females compared to males for both lifts (p = 0.041). Our findings suggest that the sumo deadlift may be slightly mechanically advantageous for deadlift naïve individuals with longer torsos, while the conventional deadlift may be better suited for those with shorter torsos.

The Effects of Moderate- Versus High-Load Resistance Training on Muscle Growth, Body Composition, and Performance in Collegiate Women.

Cholewa, JM, Rossi, FE, MacDonald, C, Hewins, A, Gallo, S, Micenski, A, Norton, L, and Campbell, BI. The effects of moderate- versus high-load resistance training on muscle growth, body composition, and performance in collegiate women. J Strength Cond Res 32(6): 1511-1524, 2018-Twenty young women (20.3 + 1.5 years, 164 + 6 cm, 68.7 + 13.8 kg) without prior structured resistance training experience were recruited for this study. Body composition (BodPod), compartmental water (Bioelectrical Impedance), 7-site skinfold, and arm and thigh cross-sectional area (CSA) were assessed before and after 8-week training. Performance testing consisted of vertical jump, 3-kg chest pass initial velocity, squat 1RM, and overhead press 1RM. After 2 weeks of familiarization training, subjects were matched for body composition and relative squat strength and randomly assigned to either a high-load (HL: n = 10; 4 sets of 5-7 repetitions) or moderate-load (ML: n = 10; 2 sets of 10-14 repetitions) group that completed 6-7 exercises per day performed to momentary muscular failure. Training was divided into 2 lower and one upper body training sessions per week performed on nonconsecutive days for 8 weeks. There were no statistically significant main effects for group or group × time interactions for any variable assessed. Both HL and ML resulted in similar significant increases in lean body mass (1.5 ± 0.83 kg), lean dry mass (1.32 ± 0.62 kg), thigh CSA (6.6 ± 5.6 cm), vertical jump (2.9 ± 3.2 cm), chest pass velocity (0.334 ± 1.67 m·s), back squat one repetition maximum (1RM) (22.5 ± 8.1 kg), and overhead press (3.0 ± 0.8 kg). High-load group and ML group also both resulted in significant decreases in percent body fat (1.3 ± 1.3%), total body water (0.73 ± 0.70 L), and intracellular water (0.43 ± 0.38 L). The results of this study indicate that both moderate-load and high-load training are effective at improving muscle growth, body composition, strength and power in untrained young women.

Acute Capsaicin Supplementation Improves 1,500-m Running Time-Trial Performance and Rate of Perceived Exertion in Physically Active Adults.

de Freitas, MC, Cholewa, JM, Gobbo, LA, de Oliveira, JVNS, Lira, FS, and Rossi, FE. Acute capsaicin supplementation improves 1,500-m running time-trial performance and rate of perceived exertion in physically active adults. J Strength Cond Res 32(2): 572-577, 2018-The purpose of this study was to investigate the acute effect of capsaicin supplementation on performance, rate of perceived exertion (RPE), and blood lactate concentrations during short-duration running in physically active adults. Ten physically active men (age = 23.5 ± 1.9 years, mass = 78.3 ± 12.4 kg, and height = 177.9 ± 5.9 cm) completed 2 randomized, double-blind trials: Capsaicin condition (12 mg) or a placebo condition. Forty-five minutes after supplement consumption, the participants performed a 1,500-m running time trial. Time (in seconds) was recorded. Blood lactate concentration was analyzed at rest, immediately after exercise, after 5, 10, and 30 minutes during recovery and the RPE was collected after exercise. The time was significantly (t = 3.316, p = 0.009) lower in the capsaicin (371.6 ± 40.8 seconds) compared with placebo (376.7 ± 39 seconds). Rate of perceived exertion was significantly (t = 2.753, p = 0.022) less in the capsaicin (18.0 ± 1.9) compared with the placebo (18.8 ± 1.3). Lactate increased across time for both conditions without significant differences between (p > 0.05). In summary, acute capsaicin supplementation improves middle distance running (1,500 m) performance and reduced RPE in physically active adults.

Acute Capsaicin Supplementation Improves Resistance Training Performance in Trained Men.

Conrado de Freitas, M, Cholewa, JM, Freire, RV, Carmo, BA, Bottan, J, Bratfich, M, Della Bandeira, MP, Gonçalves, DC, Caperuto, EC, Lira, FS, and Rossi, FE. Acute capsaicin supplementation improves resistance training performance in trained men. J Strength Cond Res 32(8): 2227-2232, 2018-The purpose of this study was to investigate the acute effect of capsaicin supplementation on performance, rate of perceived exertion (RPE), and blood lactate concentrations during resistance exercise in healthy trained young men. Ten resistance-trained men (age = 22.7 ± 4.0 years, mass = 82.3 ± 9.6 kg, and height = 175 ± 0.1 cm) completed 2 randomized, double-blind trials: capsaicin condition (12 mg) or a placebo condition. Forty-five minutes after supplement consumption, subjects performed 4 sets until movement failure in the squat exercise at 70% of 1 repetition maximum with 90 seconds of rest interval between sets. The total mass lifted (total repetitions × mass lifted) was calculated. The RPE was recorded after the last set. Blood lactate was analyzed after each set of exercise, immediately postexercise, and after 3, 5, and at 30 minutes during recovery. The number of repetitions in each set decreased significantly after all sets compared with set-1 and after set-3 and set-4 in relation to set-2 (p < 0.001); however, total mass lifted was higher in capsaicin compared with placebo (3,919.4 ± 1,227.4 kg vs. 3,179.6 ± 942.4 kg, p = 0.002). Blood lactate increased significantly after each set (p < 0.001); however, there were no differences between conditions. Rate of perceived exertion was significantly less for the capsaicin condition than placebo (17.2 ± 1.0 vs. 18.3 ± 1.7, p = 0.048). In summary, acute capsaicin supplementation improves lower-body resistance training performance in trained young men.

Dietary proteins and amino acids in the control of the muscle mass during immobilization and aging: role of the MPS response.

Dietary proteins/essential amino acids (EAAs) are nutrients with anabolic properties that may increase muscle mass or attenuate muscle loss during immobilization and aging via the stimulation of muscle protein synthesis (MPS). An EAA's anabolic threshold, capable to maximize the stimulation of MPS has been hypothesized, but during certain conditions associated with muscle loss, this anabolic threshold seems to increase which reduces the efficacy of dietary EAAs to stimulate MPS. Preliminary studies have demonstrated that acute ingestion of dietary proteins/EAA (with a sufficient amount of leucine) was capable to restore the postprandial MPS during bed rest, immobilization or aging; however, whether these improvements translate into chronic increases (or attenuates loss) of muscle mass is equivocal. For example, although free leucine supplementation acutely increases MPS and muscle mass in some chronic studies, other studies have reported no increases in muscle mass following chronic leucine supplementation. In contrast, chronically increasing leucine intake via the consumption of an overall increase in dietary protein appears to be the most effective dietary intervention toward increasing or attenuating lean mass during aging; however, more research investigating the optimal dose and timing of protein ingestion is necessary. Several studies have demonstrated that decreases in postprandial MPS as a result of increased circulating oxidative and inflammatory are more responsible than muscle protein breakdown for the decreases in muscle mass during disuse and health aging. Therefore, nutritional interventions that reduce oxidation or inflammation in conjunction with higher protein intakes that overcome the anabolic resistance may enhance the MPS response to feeding and either increase muscle mass or attenuate loss. In preliminary studies, antioxidant vitamins and amino acids with antioxidant or anti-inflammatory properties show potential to restore the anabolic response associated with protein ingestion. More research, however, is required to investigate if these nutrients translate to increases in MPS and, ultimately, increased lean mass in aging humans. The purpose of the present review is to discuss the role of protein/EAA intake to enhance postprandial MPS during conditions associated with muscle loss, and bring new perspectives and challenges associated nutritional interventions aimed to optimize the anabolic effects of dietary protein/EAAs ingestion.

Impact of Short and Moderate Rest Intervals on the Acute Immunometabolic Response to Exhaustive Strength Exercise: Part I.

The purpose of this study was to verify the influence of the short and moderate intervals of recovery in response to an acute bout of exhaustive strength exercise on performance, inflammatory, and metabolic responses in healthy adults. Eight healthy subjects (age = 24.6 ± 4.1 years) performed 2 randomized sequences: short = 70% of 1 repetition maximum (1RM) with 30 seconds of rest between sets; moderate = 70% of 1RM with 90 seconds of rest between sets. All sequences of exercises were performed over 4 sets until movement failure in the squat and bench press exercises, respectively. The total number of repetitions performed was recorded for each set of each exercise for all sequences. The percentages of fat mass and fat-free mass were estimated by dual-energy x-ray absorptiometry. Glucose, tumor necrosis factor-α, interleukin (IL)-6, IL-10, and nonester fatty acid were assessed, at baseline, immediately after exercise, after 15 and 30 minutes. When compared with the maximum number of repetitions and the total weight lifted, there was a statistically significant decrease after both intervals. The only statistically significant decreases over time occurred at the post-15 minutes assessment of the IL-6 and glucose when a moderate interval of recovery was performed. When comparing the alterations between the pools (the mean of the cluster of all periods in each variable), there was a statistically significant increase on the IL-6 and IL-10 when a moderate interval of recovery was performed again, however, not considering a statistical difference on the IL-10. Thus, we concluded that different interval of recovery in response to exhaustive strength exercise decreases performance but in only moderate intervals, it is associated with inflammatory and metabolic response.

Impact of Short and Moderate Rest Intervals on the Acute Immunometabolic Response to Exhaustive Strength Exercise: Part II.

The purpose of this study was to investigate the influence of short and moderate recovery intervals during heavy strength exercise on performance, inflammatory, and metabolic responses in recreational weightlifters. Eight healthy subjects (age = 24.6 ± 4.1 years) performed 2 randomized sequences with different rest intervals: short = 90% of 1RM and 30 seconds rest allowed between sets; moderate = 90% of 1RM and 90 seconds rest allowed between sets. All sequences of exercises were performed over 4 sets until movement failure in the squat and bench press exercises, respectively. Glucose, TNF-α, IL-6, IL-10, IL-10/TNF-α ratio, and nonester fatty acid concentrations were assessed at the baseline, immediately postexercise, post-15 and post-30 minutes. We observed a statistically significant decrease after 30 seconds on maximum number of repetitions (p = 0.003) and total weight lifted (p = 0.006) after the bench press, and there was a marginal decrease in the squat (p = 0.055). The glucose concentrations showed a significant increase post-15 minutes in the 30-second condition (pre-exercise = 86.1 ± 9.1, immediately = 85.3 ± 8.2, post-15 = 97.0 ± 9.0, post-30 = 87.1 ± 5.3 mg/dl; p = 0.015); on the other hand, IL-10 increased post-30 minutes in the 90-second condition (pre-exercise = 18.2 ± 12.7, immediately = 16.4 ± 10.7, post-15 = 16.8 ± 12.2, post-30 = 35.0 ± 13.1 pg/ml; p < 0.001). In addition, the 90-second condition showed anti-inflammatory effects (as indicated by IL-10/TNF-α ratio: pre-exercise = 1.08 ± 1.32, immediately = 1.23 ± 1.20, post-15 = 1.15 ± 1.14, post-30 = 2.48 ± 2.07; p = 0.020) compared with the 30-second condition (pre-exercise = 1.30 ± 2.04, immediately = 0.99 ± 1.27, post-15 = 1.23 ± 1.82, post-30 = 1.28 ± 1.28; p = 0.635). Thus, we concluded that a moderate interval of recovery (90 seconds) during heavy strength exercise allowed higher workload, IL-10 levels, and IL-10/TNF-α ratio in recreational weightlifters.

Immunometabolic Responses to Concurrent Training: The Effects of Exercise Order in Recreational Weightlifters.

Inoue, DS, Panissa, VLG, Monteiro, PA, Gerosa-Neto, J, Rossi, FE, Antunes, BMM, Franchini, E, Cholewa, JM, Gobbo, LA, and Lira, FS. Immunometabolic responses to concurrent training: the effects of exercise order in recreational weightlifters. J Strength Cond Res 30(7): 1960-1967, 2016-The relationship between immunometabolic response and performance is not well understood. This study evaluated the influence of concurrent strength and high-intensity aerobic sequence of exercise order between sessions on strength performance, metabolic, and inflammatory response. Eleven recreational weightlifters underwent the following 2 randomized sessions: (a) strength-aerobic exercise order (SA) and (b) aerobic-strength exercise order (AS). Blood samples were collected before (Pre) and immediately after the first exercise (Post-1) and the second exercise (Post-2) of each session. The SA condition presented a higher number of repetitions (SA: 54 ± 15 vs. AS: 43 ± 12) and total volume (SA: 7,265 ± 2,323 vs. AS: 5,794 ± 1846 kg) than the AS condition (both p = 0.001). Glucose was higher in Pre when compared with post-1 in both orders (p ≤ 0.05); changes in lactate were time-dependent in the different orders (p ≤ 0.05); however, AS post-2 lactate was lower when compared with SA post-2 (p ≤ 0.05). Interleukin-6 levels showed time-dependent changes for both exercise orders (p ≤ 0.05). Tumor necrosis factor alpha (TNF-α) level was increased only in AS post-1 (AS: pre = 21.91 ± 35.47, post-1 = 26.99 ± 47.69 pg·ml vs. SA: pre = 25.74 ± 43.64, post-1 = 29.74 ± 46.05 pg·ml, p ≤ 0.05). These results suggest that concurrent training order exhibits different immunometabolic responses and, at least in part, can be associated with the acute decline in strength performance induced by concurrent exercise. Our results point to a possible role of TNF-α (post-1 AS condition) as a trigger to restore the energy demand by providing substrates to help maintain contractile activity in skeletal muscle.

Effects of betaine on performance and body composition: a review of recent findings and potential mechanisms.

Betaine is a methyl derivative of glycine first isolated from sugar beets. Betaine consumed from food sources and through dietary supplements presents similar bioavailability and is metabolized to di-methylglycine and sarcosine in the liver. The ergogenic and clinical effects of betaine have been investigated with doses ranging from 500 to 9,000 mg/day. Some studies using animal models and human subjects suggest that betaine supplementation could promote adiposity reductions and/or lean mass gains. Moreover, previous investigations report positive effects of betaine on sports performance in both endurance- and resistance-type exercise, despite some conflicting results. The mechanisms underlying these effects are poorly understood, but could involve the stimulation of lipolysis and inhibition of lipogenesis via gene expression and subsequent activity of lipolytic-/lipogenic-related proteins, stimulation of autocrine/endocrine IGF-1 release and insulin receptor signaling pathways, stimulation of growth hormone secretion, increased creatine synthesis, increases in protein synthesis via intracellular hyper-hydration, as well as exerting psychological effects such as attenuating sensations of fatigue. However, the exact mechanisms behind betaine action and the long-term effects of supplementation on humans remain to be elucidated. This review aims to describe evidence for the use of betaine as an ergogenic and esthetic aid, and discuss the potential mechanisms underlying these effects.

Ten weeks of Capsicum annuum L. extract supplementation did not change adipose tissue-derived hormones, appetite, body composition, and muscle strength when combined with resistance training in healthy untrained men: A clinical trial study.

Capsiate (CAP) is a nonpungent capsaicin analog (Capsicum annuum L. extract) that has been studied as a potential antiobesity agent. However, the interaction between chronic CAP supplementation and resistance training is not clear. The purpose of this study was to examine the changes in adipose tissue-derived hormones, body composition, appetite, and muscle strength after 10 weeks of resistance training, combined with chronic CAP supplementation in healthy untrained men. We hypothesized that CAP could induce higher benefits when combined with resistance training after 10 weeks of intervention compared to resistance training alone. Twenty-four young men (age, 22.0 ± 2.9) were randomized to either capsiate supplementation (CAP = 12 mg/day) or placebo (PL), and both groups were assigned to resistance training. Body composition, leptin and adiponectin concentrations, subjective ratings of appetite, energy intake, and exercise performance were assessed at before and after 10 weeks of progressive resistance training. There was a significant increase in body mass (P < .001), fat-free mass (CAP: 58.0 ± 7.1 vs. post, 59.7 ± 7.1 kg; PL: pre, 58.4 ± 7.3 vs. post, 59.8 ± 7.1 kg; P < .001), resting metabolic rate (CAP: pre, 1782.9 ± 160.6 vs. post, 1796.3 ± 162.0 kcal; PL: pre, 1733.0 ± 148.9 vs. post, 1750.5 ± 149.8 kcal; P < .001), maximal strength at 45 leg press (P < .001) and bench press (P < .001) in both groups, but no significant (P > .05) supplementation by training period interaction nor fat mass was observed. For subjective ratings of appetite, energy intake, leptin, and adiponectin, no significant effect of supplementation by training period interaction was observed (P > .05). In conclusion, 10 weeks of resistance training increased total body weight, muscle mass, and maximum strength in healthy untrained men; however, CAP supplementation (12 mg, 7 days per week) failed to change adipose tissue-derived hormones, appetite, body composition and muscle strength in this population. Registered under Brazilian Registry of Clinical Trials (RBR-8cz9kfq).