Regulatory Light-Chain Phosphorylation During Weightlifting Training: Association With Postactivation Performance Enhancement.

ABSTRACT: Chiu, LZF, Fry, AC, Galpin, AJ, Salem, GJ, and Cabarkapa, D. Regulatory light-chain phosphorylation during weightlifting training: association with postactivation performance enhancement. J Strength Cond Res 37(10): e563-e568, 2023-Postactivation performance enhancement has been reported for multijoint resistance exercise, with both neural and intrinsic muscle mechanisms suggested as contributing factors. The purpose of this investigation was to examine whether regulatory light-chain (RLC) phosphorylation in a primary mover is associated with enhanced weightlifting performance. Nine male athletes performed 15 sets of 3 repetitions of a multijoint weightlifting activity (clean pull) at 85% 1 repetition maximum. Measures of performance, peak barbell velocity (PV), and average barbell power (AP) were determined by video analysis. Muscle biopsies were taken within 30-60 seconds of completion of the previous lifting set from the vastus lateralis before (PRE), during (MID), and after (POST) a training session. AP was significantly greater for sets 3, 4, and 5 compared with set 1, with large effect sizes (0.8-1.0). Increases in PV did not reach significance; however, the effect size increase for sets 3 and 4 versus set 1 was moderate (0.4). Relative change scores for AP and RLC phosphorylation were positively and negatively correlated at MID (r = 0.60; p = 0.05) and POST (r = -0.74; p = 0.01) exercise, respectively. These data suggest that RLC phosphorylation initially may be associated with postactivation performance enhancement during repeated multijoint exercise.

The Influence of a Bout of Exertion on Novice Barefoot Running Dynamics.

Barefoot, forefoot strike (FFS) running has recently risen in popularity. Relative to shod, rear-foot strike (RFS) running, employing a FFS is associated with heightened triceps surae muscle activation and ankle mechanical demand. Novice to this pattern, it is plausible that habitually shod RFS runners exhibit fatigue to the triceps surae when acutely transitioning to barefoot running, thereby limiting their ability to attenuate impact. Therefore, the purpose was to determine how habitually shod RFS runners respond to an exertion bout of barefoot running, operationally defined as a barefoot run 20% of mean daily running distance. Twenty-one RFS runners performed novice barefoot running, before and after exertion. Ankle peak torque, triceps surae EMG median frequency, foot-strike patterns, joint energy absorption, and loading rates were evaluated. Of the 21 runners, 6 maintained a RFS, 10 adopted a mid-foot strike (MFS), and 5 adopted a FFS during novice barefoot running. In-response to exertion, MFS and FFS runners demonstrated reductions in peak torque, median frequency, and ankle energy absorption, and an increase in loading rate. RFS runners demonstrated reductions in peak torque and loading rate. These results indicate that a short bout of running may elicit fatigue to novice barefoot runners, limiting their ability to attenuate impact. Key pointsIn response to exertion, novice barefoot runners demonstrate fatigue to their soleus.In response to exertion, novice barefoot runners demonstrate a reduction in ankle energy absorptionIn response to exertion, novice barefoot runners demonstrate an increase in loading rate.

The Limiting Joint During a Failed Squat: A Biomechanics Case Series.

This investigation examined the characteristics of a failed back squat. Subjects were instructed to perform 3 repetitions of a barbell squat with a 3 repetition maximum load while instrumented for biomechanical analyses and standing atop force platforms. Inverse dynamics calculations were used to determine the net joint moment (NJM) power, work, and energy of the hip, knee, and ankle. Five subjects failed to complete all 3 repetitions, allowing for comparisons between a successful and the failed repetition. Although the NJM power and work were lower at all 3 joints during the failed attempt, the only statistically significant differences were at the hip. These findings suggest that the energy generated by the hip joint NJM limited performance of the task. However, examination of the NJM energy generation over time on an individual basis uncovered some features that were masked by the aggregated group mean data. For some subjects, the knee NJM limited the movement. Additionally, negligible to modest compensations occurred between the hip and knee NJM: a decreased energy generated by one NJM was often accompanied by an increase in energy generated at the other. A limiting joint, or "weak link," may explain the failure to complete a lift. Interventions should address the limiting joint on an individual-specific basis and incorporate assistive exercises that target these deficiencies.

The association between unilateral heel-rise performance with static and dynamic balance in community dwelling older adults.

As a measure of both strength and muscle endurance of the plantar flexors, the unilateral heel rise (UHR) test has been suggested as a method to evaluate balance capabilities in older adults. Thus, the purpose of this study was to examine the association between UHR performance with biomechanical measures of balance in seniors. Twenty-two older adults completed two testing sessions. The first visit included UHR performance; the second visit included dynamic and static motion analysis. UHR performance was significantly associated with dynamic balance capability as measured by medial-lateral inclination angle during gait. As indicated by an analysis of center of pressure, there were significant associations between UHR performance and measures of static balance. Balance is influenced by plantar flexor performance as measured by the UHR test. We therefore suggest incorporating the UHR test in analyses of balance in seniors.

The physical demands of the tree (vriksasana) and one-leg balance (utthita hasta padangusthasana) poses performed by seniors: a biomechanical examination.

Yoga is considered especially suitable for seniors because poses can be modified to accommodate practitioners' capabilities and limitations. In this study, biomechanical assessments on healthy seniors (n = 20; 70.1 ± 3.8 yr) were used to quantify the physical demands, (net joint moments of force [JMOFs] and muscular activation in the lower extremities) associated with the performance of 3 variations (introductory, intermediate, advanced) of 2 classical Hatha yoga poses - Tree and One-Leg Balance (OLB). ANOVA and Cohen's-d were used to contrast the postural variations statistically. The advanced (single-limb, without additional support) versions were hypothesized to generate the greatest demands, followed by the intermediate (single-limb [Tree] and bilateral-limb [OLB] with support) and introductory (bilateral-limb) versions. Our findings, however, suggest that common, long-held conceptions about pose modifications can be counter-intuitive. There was no difference between the intermediate and advanced Tree variations regarding hip and knee JMOFs in both the sagittal and frontal planes (P = 0.13-0.98). Similarly, OLB introductory and intermediate variations induced sagittal JMOFs that were in the opposite direction of the classic advanced pose version at the hip and knee (P < .001; d = 0.98-2.36). These biomechanical insights provide evidence that may be used by instructors, clinicians and therapists when selecting pose modifications for their yoga participants.

Potentiation of vertical jump performance during a snatch pull exercise session.

Potentiation has been reported in power tasks immediately following a strength stimulus; however, only whole-body performance has been assessed. To determine the acute effects of weightlifting on vertical jump joint kinetics, performance was assessed before, during, and after snatch pull exercise in male athletes. Jumping was assessed using 3D motion analysis and inverse dynamics. Jump height was enhanced at the midpoint (5.77%; p = .001) and end (5.90%; p < .001) of the exercise session, indicating a greater power-generating ability. At the midpoint, knee extensor net joint work was increased (p = .05) and associated with increased jump height (r = .57; p = .02). Following exercise, ankle plantar flexor net joint work was increased (p = .02) and associated with increased jump height (r = .67; p = .006). Snatch pull exercise elicited acute enhancements in vertical jump performance. At the midpoint of the exercise session, greater work at the knee joint contributed to enhanced performance. At the end of the exercise session, greater work at the ankle contributed to enhanced performance. Consequently, potentiation is not elicited uniformly across joints during multijoint exercise.

Sex Difference in Hip Adduction during the Stance Phase of Running: A Swing Phase Problem?

PURPOSE: The purpose of the current study was 1) to evaluate sex differences in peak hip adduction during the late swing and stance phases of running and 2) to determine whether peak hip adduction during late swing is predictive of peak hip adduction during stance. METHODS: A total of 15 female and 16 male heel strike runners ran over ground at a speed of 4 m·s-1. Hip joint kinematics during running were quantified using a 3D motion capture system. Sex differences in peak hip adduction during the late swing and stance phases were compared using independent-samples t-tests. Linear regression analysis was used to determine the relationship between late swing and stance phase hip adduction. RESULTS: Compared with males, females exhibited significantly greater peak hip adduction during both the late swing (8.5° ± 2.6° vs 6.1° ± 2.8°, P = 0.019) and the stance phases of running (13.3° ± 4.2° vs 9.6° ± 3.4°, P = 0.011). Furthermore, late swing peak hip adduction was predictive of subsequent stance phase peak hip adduction (r = 0.63, P < 0.001). CONCLUSION: Sex differences in hip adduction during stance are influenced in part by late swing phase hip adduction. Further studies are needed to identify potential causes of excessive hip adduction during the late swing phase of running.

Injury risk-factor differences between two golf swing styles: a biomechanical analysis of the lumbar spine, hip and knee.

The golf swing has been associated with mechanical injury risk factors at many joints. One swing, the Minimalist Golf Swing, was hypothesised to reduce lumbar spine, lead hip, and lead knee ranges of motion and peak net joint moments, while affecting swing performance, compared to golfers' existing swings. Existing and MGS swings of 15 golfers with handicaps ranging from +2 to -20 were compared. During MGS downswing, golfers had 18.3% less lumbar spine transverse plane ROM, 40.7 and 41.8% less lead hip sagittal and frontal plane ROM, and 39.2% less lead knee sagittal plane ROM. MGS reduced lead hip extensor, abductor, and internal rotator moments by 17.8, 19.7 and 43%, while lead knee extensor, abductor, adductor and external rotator moments were reduced by 24.1, 26.6, 37 and 68.8% respectively. With MGS, club approach was 2° shallower, path 4° more in-to-out and speed 2 m/s slower. MGS reduced certain joint ROM and moments that are linked to injury risk factors, while influencing club impact factors with varying effect. Most golf injuries are from overuse, so reduced loads per cycle with MGS may extend the healthy life of joints, and permit golfers to play injury-free for more years.

Knee extensor dynamics in the volleyball approach jump: the influence of patellar tendinopathy.

STUDY DESIGN: Controlled laboratory study using a cross-sectional design. OBJECTIVES: To evaluate knee joint dynamics in elite volleyball players with and without a history of patellar tendinopathy, focusing on mechanical energy absorption and generation. We hypothesized that tendinopathy would be associated withreduced net joint work and net joint power. BACKGROUND: Patellar tendinopathy is a common, debilitating injury affecting competitive volleyball players. METHODS: Thirteen elite male players with and without a history of patellar tendinopathy (mean ± SD age, 27 ± 7 years) performed maximum-effort volleyball approach jumps. Sagittal plane knee joint kinematics, kinetics, and energetics were quantified in the lead limb, using data obtained from a force platform and an 8-camera motion analysis system. Vertical ground reaction forces and pelvis vertical velocity at takeoff were examined. Independent sample t tests were used to evaluate group differences (α = .05). RESULTS: The tendinopathy group, compared to controls, demonstrated significant reductions (approximately 30%) in net joint work and net joint power during the eccentric phase of the jump, with no differences in the concentric phase. Positive to-negative net joint work and net joint power ratios were significantly higher in the tendinopathy group, which had a net joint work ratio of 1.00 (95% CI: 0.77, 1.24) versus 0.76 (95% CI: 0.64, 0.88) for controls, and a net joint power ratio of 1.62 (95% CI: 1.15, 2.10) versus 1.00 (95% CI: 0.80, 1.21) for controls. There were no significant differences in net joint moment, angular velocity, or range of motion. Peak vertical ground reaction forces were lower for the tendinopathy group, while average vertical ground reaction forces and pelvis vertical velocity were similar. CONCLUSION: Patellar tendinopathy is associated with differences in sagittal plane mechanical energy absorption at the knee during maximum-effort volleyball approach jumps. Net joint work and net joint power may help define underlying mechanisms, adaptive effects, or rehabilitative strategies for individuals with patellar tendinopathy.

Time series analysis: evaluating performance trends within resistance exercise sessions.

Recent technical advances allow coaches, sport scientists, and researchers to take frequent performance measurements, both within a training session and across a period of training. These performance measurements should demonstrate a systematic pattern, based on physiologic responses and adaptations; however, variability in performance, resulting from both physiologic and psychological factors, may hamper interpretation of these measures. This report describes the moving-average method used in time series analysis to reduce variability and elucidate systematic patterns during high-power resistance exercise. Men (n = 10) power athletes performed 3 high-power resistance exercise sessions (75% 1 repetition maximum [RM]/5 repetitions x 12 sets; 85% 1RM/3 x 15; 95% 1RM/1 x 20). Average barbell power was recorded during the exercise sessions using three-dimensional motion analysis. High-power resistance exercise resulted in increases in performance early in the exercise sessions (p < 0.05) and decreases in performance after the mid-point in the exercise session (p < 0.05). Deviations in performance responses were observed, which obscured the systematic pattern. A 3-point moving average reduced the effects of the deviations, allowing a systematic pattern, consistent with known acute physiologic responses, to be identified. Acutely, exercise elicits changes in performance that should follow a systematic pattern. Determining the systematic pattern associated with various exercise and loading parameters can be utilized to optimize such parameters to maximize the training stimulus while minimizing fatigue. The use of time series analysis, specifically the moving average technique, reduces within-session variability allowing the systematic pattern to be determined.

The relationships between the unified Parkinson's disease rating scale and lower extremity functional performance in persons with early-stage Parkinson's disease.

BACKGROUND: The Unified Parkinson's Disease Rating Scale (UPDRS) is the "gold standard" assessment tool for characterizing impairments in persons with Parkinson's disease (PD); however, this scale's ability to predict functional capabilities across different functional tasks has not been adequately assessed in persons with early-stage PD. METHODS: Thirty persons with PD within 3 years of diagnosis and without motor fluctuation performed self-selected walking, fast walking, and sit-to-stand and stair-climbing tasks. Pearson's correlation coefficients were used to calculate correlations with a standard UPDRS examination (P<.05). Simple linear regression models were used to fit each functional performance outcome measure with the UPDRS total predictor scores. RESULTS: The correlations between the UPDRS motor (section III), UPDRS total scores, and all timed functional performance measures were fair to good (range, 0.45-0.57). Conversely, only greater self-selected time to walk 50 ft correlated with a higher UPDRS activities of daily living (II) score (r=.386; P<.05). CONCLUSIONS: The UPDRS motor (III) and total scores may be good predictors of overall lower extremity function in persons with early-stage PD. Understanding the relationships between UPDRS scores and functional capabilities may allow clinicians to better quantify early physical functioning, longitudinally assess disease progression, and assess the efficacy of interventions.

Standing task difficulty related increase in agonist-agonist and agonist-antagonist common inputs are driven by corticospinal and subcortical inputs respectively.

In standing, coordinated activation of lower extremity muscles can be simplified by common neural inputs to muscles comprising a functional synergy. We examined the effect of task difficulty on common inputs to agonist-agonist (AG-AG) pairs supporting direction specific reciprocal muscle control and agonist-antagonist (AG-ANT) pairs supporting stiffness control. Since excessive stiffness is energetically costly and limits the flexibility of responses to perturbations, compared to AG-ANT, we expected greater AG-AG common inputs and a larger increase with increasing task difficulty. We used coherence analysis to examine common inputs in three frequency ranges which reflect subcortical/spinal (0-5 and 6-15 Hz) and corticospinal inputs (6-15 and 16-40 Hz). Coherence was indeed higher in AG-AG compared to AG-ANT muscles in all three frequency bands, indicating a predilection for functional synergies supporting reciprocal rather than stiffness control. Coherence increased with increasing task difficulty, only in AG-ANT muscles in the low frequency band (0-5 Hz), reflecting subcortical inputs and only in AG-AG group in the high frequency band (16-40 Hz), reflecting corticospinal inputs. Therefore, common neural inputs to both AG-AG and AG-ANT muscles increase with difficulty but are likely driven by different sources of input to spinal alpha motor neurons.

The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson's disease.

OBJECTIVES: To obtain preliminary data on the effects of high-intensity exercise on functional performance in people with Parkinson's disease (PD) relative to exercise at low and no intensity and to determine whether improved performance is accompanied by alterations in corticomotor excitability as measured through transcranial magnetic stimulation (TMS). DESIGN: Cohort (prospective), randomized controlled trial. SETTING: University-based clinical and research facilities. PARTICIPANTS: Thirty people with PD, within 3 years of diagnosis with Hoehn and Yahr stage 1 or 2. INTERVENTIONS: Subjects were randomized to high-intensity exercise using body weight-supported treadmill training, low-intensity exercise, or a zero-intensity education group. Subjects in the 2 exercise groups completed 24 exercise sessions over 8 weeks. Subjects in the zero-intensity group completed 6 education classes over 8 weeks. MAIN OUTCOME MEASURES: Unified Parkinson's Disease Rating Scales (UPDRS), biomechanic analysis of self-selected and fast walking and sit-to-stand tasks; corticomotor excitability was assessed with cortical silent period (CSP) durations in response to single-pulse TMS. RESULTS: A small improvement in total and motor UPDRS was observed in all groups. High-intensity group subjects showed postexercise increases in gait speed, step and stride length, and hip and ankle joint excursion during self-selected and fast gait and improved weight distribution during sit-to-stand tasks. Improvements in gait and sit-to-stand measures were not consistently observed in low- and zero-intensity groups. The high-intensity group showed lengthening in CSP. CONCLUSIONS: The findings suggest the dose-dependent benefits of exercise and that high-intensity exercise can normalize corticomotor excitability in early PD.

The influence of deformation on barbell mechanics during the clean pull.

For simplicity of biomechanical analyses, the weightlifting barbell is typically modelled as a rigid, nondeformable object. Most coaches and weightlifters, however, are aware of the elastic nature of the barbell, and its influence on the successful completion of lifting attempts. Variables such as velocity, work performed, and power output are indicators of the quality of performance during the snatch, clean, and related weightlifting pulling movements. The aim of this study was to establish whether differences exist in determining these biomechanical parameters when the centre of the barbell is analysed compared with each end of the barbell. Nine men performed three maximal-effort repetitions in the clean pull exercise at 85% of their self-reported single repetition maximum (1-RM) clean (90-155 kg) using a barbell instrumented for mechanical analysis. Results indicated that peak barbell speed was 5-30% (P < 0.05) lower for the centre of the barbell than the ends. Although differences (P < 0.05) in kinetic and potential energy were found between the centre and ends of the bar, differences between total work performed were small (< 6%; P < 0.05) and no differences were observed for average power (P > 0.05). Although approximately the same work and power occur for the centre and ends of the barbell, they manifest as different kinematics as a result of the elastic nature of the equipment. The elastic characteristics should be considered when selecting instrumentation and variables for research involving barbells. Coaches should be aware of the elasticity of barbells, including selecting appropriate viewing angles as well as understanding how deformation may affect the ends of the barbell relative to the centre.

Lower-limb dynamics and clinical outcomes for habitually shod runners who transition to barefoot running.

OBJECTIVES: Recent investigations have revealed lower vertical loading rates and knee energy absorption amongst experienced barefoot runners relative to those who rear-foot strike (RFS). Although this has led to an adoption of barefoot running amongst many recreational shoe runners, recent investigations indicate that the experienced barefoot pattern is not immediately realized. Therefore, the purpose this investigation was to quantify changes in lower-extremity dynamics and clinical outcomes measures for habitually shod runners who perform a transition to barefoot running. DESIGN & PARTICIPANTS: We examined lower-extremity dynamics and clinical outcomes for 26 RFS shod runners who performed an 8-10 week transition to barefoot running. SETTING: Runners were evaluated at the University of Southern California's Musculoskeletal Biomechanics Research Laboratory. MAIN OUTCOME MEASURES: Foot-strike patterns, vertical load rates, and joint energetics were evaluated before and after the transition using inverse dynamics. Clinical assessments were conducted throughout the transition by two licensed clinicians. RESULTS: Eighteen of the 26 runners successfully completed the transition: 7 maintained a RFS, 8 adopted a mid-foot strike (MFS), and 3 adopted a forefoot strike (FFS) during novice barefoot running. Following the transition, novice MFS/FFS runners often demonstrated reversions in strike-patterns and associated reductions in ankle energetics. We report no change in loading rates and knee energy absorption across transition time points. Importantly, there were no adverse events other than transient pain and soreness. CONCLUSIONS: These findings indicate that runners do not innately adopt the biomechanical characteristics thought to lower injury risk in-response to an uninstructed barefoot running transition.

Increasing mediolateral standing sway is associated with increasing corticospinal excitability, and decreasing M1 inhibition and facilitation.

In standing, corticospinal excitability increases and primary motor cortex (M1) inhibition decreases in response to anterior posterior or direction unspecific manipulations that increase task difficulty. However, mediolateral (ML) sway control requires greater active neural involvement. Therefore, the primary purpose of this study was to determine the pattern of change in neural excitability when ML postural task difficulty is manipulated and to test whether the neural excitability is proportional to ML sway magnitude across conditions. Tibialis anterior corticospinal excitability was quantified using motor evoked potential (MEP) and postural sway was indexed using ML center of pressure (COP) velocity. Additionally, we examined inhibition and facilitation processes in the primary motor cortex using the paired pulse short interval intracortical inhibition (SICI) and intracortical facilitation (ICF) techniques respectively. Measurements were repeated in four conditions with quiet stance as a control. Differences between conditions were tested using one-way repeated measures ANOVAs, on log transformed data. Associations were quantified using Spearman's Rank Correlation Coefficient. There was a significant main effect of condition on all the neural excitability measures with MEP (p<0.001) being highest in the most difficult condition, and SICI (p=0.01), ICF (p<0.001) being lowest in the most difficult condition. Increasing ML COP velocity was significantly associated with increasing MEP amplitude (r=0.68, p<0.001), but decreasing SICI (r=0.24, p=0.03) and ICF (r=-0.54, p<0.001). Our results show that both corticospinal and M1 excitability in standing are scaled in proportion to ML task difficulty.

In Standing, Corticospinal Excitability Is Proportional to COP Velocity Whereas M1 Excitability Is Participant-Specific.

Reductions in the base of support (BOS) make standing difficult and require adjustments in the neural control of sway. In healthy young adults, we determined the effects of reductions in mediolateral (ML) BOS on peroneus longus (PL) motor evoked potential (MEP), intracortical facilitation (ICF), short interval intracortical inhibition (SICI) and long interval intracortical inhibition (LICI) using transcranial magnetic stimulation (TMS). We also examined whether participant-specific neural excitability influences the responses to increasing standing difficulty. Repeated measures ANOVA revealed that with increasing standing difficulty MEP size increased, SICI decreased (both p < 0.05) and ICF trended to decrease (p = 0.07). LICI decreased only in a sub-set of participants, demonstrating atypical facilitation. Spearman's Rank Correlation showed a relationship of ρ = 0.50 (p = 0.001) between MEP size and ML center of pressure (COP) velocity. Measures of M1 excitability did not correlate with COP velocity. LICI and ICF measured in the control task correlated with changes in LICI and ICF, i.e., the magnitude of response to increasing standing difficulty. Therefore, corticospinal excitability as measured by MEP size contributes to ML sway control while cortical facilitation and inhibition are likely involved in other aspects of sway control while standing. Additionally, neural excitability in standing is determined by an interaction between task difficulty and participant-specific neural excitability.

Bilateral differences in the net joint torques during the squat exercise.

Bilateral movements are common in human movement, both as exercises and as daily activities. Because the movement patterns are similar, it is often assumed that there are no bilateral differences (BDs; differences between the left and right sides) in the joint torques that are producing these movements. The aim of this investigation was to test the assumption that the joint torques are equal between the left and right lower extremities by quantifying BDs during the barbell squat. Eighteen recreationally trained men (n = 9) and women (n = 9) completed 3 sets of 3 repetitions of the squat exercise, under 4 loading conditions: 25, 50, 75, and 100% of their 3 repetition maximum, while instrumented for biomechanical analysis. The average net joint moment (ANJM) and maximum flexion angle (MFA) for the hip, knee, and ankle as well as the average vertical ground reaction force (AVGRF) and the average distance from the ankle joint center to the center of pressure (ADCOP) were calculated. Group mean and individual data were analyzed (alpha = 0.05). At each joint, there was a significant main effect for side and load, no main effect for gender, with few significant interactions. The hip ANJM was 12.4% larger on the left side, the knee ANJM was 13.2% larger on the right side, and the ankle ANJM was 16.8% larger on the left side. Differences in MFAs between sides were less than 2 degrees for all 3 joints (all p > 0.20 except for the knee at 75% [p = 0.024] and 100% [p = 0.025]), but the AVGRF and the ADCOP were 6% and 11% larger on the left side. Few subjects exhibited the pattern identified with the group mean data, and no subject exhibited nonsignificant BDs for all 3 joints. These findings suggest that joint torques should not be assumed to be equal during the squat and that few individual subjects follow the pattern exhibited by group mean data.

A pilot randomised controlled trial of a periodised resistance training and protein supplementation intervention in prostate cancer survivors on androgen deprivation therapy.

INTRODUCTION: Prostate cancer survivors (PCS) receiving androgen deprivation therapy (ADT) experience deleterious side effects such as unfavourable changes in cardiometabolic factors that lead to sarcopenic obesity and metabolic syndrome (MetS). While loss of lean body mass (LBM) compromises muscular strength and quality of life, MetS increases the risk of cardiovascular disease and may influence cancer recurrence. Exercise can improve LBM and strength, and may serve as an alternative to the pharmacological management of MetS in PCS on ADT. Prior exercise interventions in PCS on ADT have been effective at enhancing strength, but only marginally effective at enhancing body composition and ameliorating cardiometabolic risk factors. This pilot trial aims to improve on existing interventions by employing periodised resistance training (RT) to counter sarcopenic obesity in PCS on ADT. Secondary aims compare intervention effects on cardiometabolic, physical function, quality of life and molecular skeletal muscle changes. An exploratory aim examines if protein supplementation (PS) in combination with RT elicits greater changes in these outcomes. METHODS AND ANALYSIS: A 2×2 experimental design is used in 32 PCS on ADT across a 12-week intervention period. Participants are randomised to resistance training and protein supplementation (RTPS), RT, PS or control. RT and RTPS groups perform supervised RT three times per week for 12 weeks, while PS and RTPS groups receive 50 g whey protein per day. This pilot intervention applies a multilayered approach to ameliorate detrimental cardiometabolic effects of ADT while investigating molecular mechanisms underlying skeletal muscle changes in PCS. ETHICS AND DISSEMINATION: This trial was approved by the University of Southern California Institutional Review Board (HS-13-00315). Results from this trial will be communicated in peer-reviewed publications and scientific presentations. TRIAL REGISTRATION NUMBER: NCT01909440; Pre-results.

Effects of resistance training on insulin sensitivity in overweight Latino adolescent males.

PURPOSE: Insulin resistance is thought to be a core defect in the pathophysiology of obesity-related comorbidities in children, such as type 2 diabetes. Exercise training is known to improve insulin resistance and reduce the risk of type 2 diabetes in adults. However, very little is known regarding the effects of exercise on insulin resistance in youth. Therefore, we examined the effects of a 16-wk resistance training exercise intervention on insulin sensitivity in youth at high risk for developing type 2 diabetes. METHODS: Twenty-two overweight Latino adolescent males were randomly assigned to either a twice-per-week resistance training group (RT=11) or a nonexercising control group (C=11) for 16 wk. Strength was assessed by one-repetition maximum, body composition was quantified by dual-energy x-ray absorptiometry, and insulin sensitivity was determined by the frequently sampled intravenous glucose tolerance test with minimal modeling. RESULTS: Significant increases in upper- and lower-body strength were observed in the RT compared with the C group. The RT group significantly increased insulin sensitivity compared with the C group (P<0.05), and this increase remained significant after adjustment for changes in total fat mass and total lean tissue mass (P<0.05). Compared with baseline values, insulin sensitivity increased 45.1+/-7.3% in the RT group versus -0.9+/-12.9% in controls (P<0.01). CONCLUSION: A twice-per-week 16-wk resistance training program can significantly increase insulin sensitivity in overweight Latino adolescent males independent of changes in body composition.