A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training.

It is well known that physical activity and exercise is associated with a lower risk of a range of morbidities and all-cause mortality. Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort. Why this may be the case is perhaps explained by the accumulating evidence linking physical fitness and performance outcomes (e.g. cardiorespiratory fitness, strength, and muscle mass) also to morbidity and mortality risk. Current guidelines about the performance of moderate/vigorous physical activity using aerobic exercise modes focuses upon the accumulation of a minimum volume of physical activity and/or exercise, and have thus far produced disappointing outcomes. As such there has been increased interest in the use of higher effort physical activity and exercise as being potentially more efficacious. Though there is currently debate as to the effectiveness of public health prescription based around higher effort physical activity and exercise, most discussion around this has focused upon modes considered to be traditionally 'aerobic' (e.g. running, cycling, rowing, swimming etc.). A mode customarily performed to a relatively high intensity of effort that we believe has been overlooked is resistance training. Current guidelines do include recommendations to engage in 'muscle strengthening activities' though there has been very little emphasis upon these modes in either research or public health effort. As such the purpose of this debate article is to discuss the emerging higher effort paradigm in physical activity and exercise for public health and to make a case for why there should be a greater emphasis placed upon resistance training as a mode in this paradigm shift.

Lighter-Load Exercise Produces Greater Acute- and Prolonged-Fatigue in Exercised and Non-Exercised Limbs.

Purpose: The present study compared the fatigue and perceptual responses to volume-load matched heavier- and lighter- load resistance exercise to momentary failure in both a local/exercised, and non-local/non-exercised limb. Methods: Eleven resistance-trained men undertook unilateral maximal voluntary contraction (MVC) testing for knee extension prior to and immediately, 24 hr- and 48 hr- post heavier (80% MVC) and lighter  (40% MVC) load dynamic unilateral knee extension exercise. Only the dominant leg of each participant was exercised to momentary failure using heavier and lighter loads, and perceptions of discomfort were measured immediately upon exercise cessation. Results: Point estimates and confidence intervals suggested that immediately post-exercise there was greater fatigue in both the exercised and non-exercised legs for the lighter- load condition. At 24 hr the exercised leg under the heavier-load condition had recovered to pre-exercise strength; however, the exercised leg under lighter- load condition had still not fully recovered by 48 hr. For the non-exercised leg, only the lighter-load condition induced fatigue; however, recovery had occurred by 48 hr. Median discomfort ratings were statistically significantly different (Z = -2.232, p = .026) between lighter and heavier loads (10 [IQR = 0] and 8 [IQR = 3], respectively). Conclusions: This study suggests that lighter-load resistance exercise induces greater fatigue in both the exercised- and non-exercised limbs, compared to heavier-load resistance exercise. These findings may have implications for exercise frequency as it may be possible to engage in heavier-load resistance exercise more frequently than a volume-load matched protocol using lighter loads.Abbreviations CI: Confidence intervals: ES: Effect size: MVC: Maximum voluntary contraction; Nm:Newton meters; RM: Repetition maximum; SD: Standard deviation; SI: Strength index.