Ketone Monoester Followed by Carbohydrate Ingestion after Glycogen-Lowering Exercise Does Not Improve Subsequent Endurance Cycle Time Trial Performance.

Relative to carbohydrate (CHO) alone, exogenous ketones followed by CHO supplementation during recovery from glycogen-lowering exercise have been shown to increase muscle glycogen resynthesis. However, whether this strategy improves subsequent exercise performance is unknown. The objective of this study was to assess the efficacy of ketone monoester (KME) followed by CHO ingestion after glycogen-lowering exercise on subsequent 20 km (TT20km) and 5 km (TT5km) best-effort time trials. Nine recreationally active men (175.6 ± 5.3 cm, 72.9 ± 7.7 kg, 28 ± 5 y, 12.2 ± 3.2% body fat, VO2max = 56.2 ± 5.8 mL· kg BM-1·min-1; mean ± SD) completed a glycogen-lowering exercise session, followed by 4 h of recovery and subsequent TT20km and TT5km. During the first 2 h of recovery, participants ingested either KME (25 g) followed by CHO at a rate of 1.2 g·kg-1·h-1 (KME + CHO) or an iso-energetic placebo (dextrose) followed by CHO (PLAC + CHO). Blood metabolites during recovery and performance during the subsequent two-time trials were measured. In comparison to PLAC + CHO, KME + CHO displayed greater (p < 0.05) blood beta-hydroxybutyrate concentration during the first 2 h, lower (p < 0.05) blood glucose concentrations at 30 and 60 min, as well as greater (p < 0.05) blood insulin concentration 2 h following ingestion. However, no treatment differences (p > 0.05) in power output nor time to complete either time trial were observed vs. PLAC + CHO. These data indicate that the metabolic changes induced by KME + CHO ingestion following glycogen-lowering exercise are insufficient to enhance subsequent endurance time trial performance.

Concurrent Ingestion of Alkaline Water and L-Glutamine Enhanced Salivary α-Amylase Activity and Testosterone Concentration in Boxing Athletes.

Athletes often take sport supplements to reduce fatigue and immune disturbances during or after training. This study evaluated the acute effects of concurrent ingestion of alkaline water and L-glutamine on the salivary immunity and hormone responses of boxers after training. Twelve male boxing athletes were recruited in this study. During regular training, the participants were randomly divided into three groups and asked to consume 400 mL of alkaline water (Group A), 0.15 g/kg body weight of L-glutamine with 400 mL of water (Group G), and 0.15 g/kg of L-glutamine with 400 mL of alkaline water (Group A+G) at the same time each day for three consecutive weeks. Before and immediately after the training, saliva, heart rates, and the rate of perceived exertion were investigated. The activity of α-amylase and concentrations of lactoferrin, immunoglobulin A (IgA), testosterone, and cortisol in saliva were measured. The results showed that the ratio of α-amylase activity/total protein (TP) significantly increased after training in Group A+G but not in Group A or G, whereas the ratios of lactoferrin/TP and IgA/TP were unaffected in all three groups. The concentrations of salivary testosterone after training increased significantly in Group A+G but not in Group A or G, whereas the salivary cortisol concentrations were unaltered in all groups. In conclusion, concurrent ingestion of 400 mL of alkaline water and 0.15 g/kg of L-glutamine before training enhanced the salivary α-amylase activity and testosterone concentration of boxers, which would be beneficial for post-exercise recovery.

Is melatonin as an ergogenic hormone a myth? a systematic review and meta-analysis.

PURPOSE: Melatonin supplementation has been disclosed as an ergogenic substance. However, the effectiveness of melatonin supplementation in healthy subjects has not been systematically investigated. The present study analyzed the effects of melatonin supplementation on physical performance and recovery. In addition, it was investigated whether exercise bout or training alter melatonin secretion in athletes and exercise practitioners. METHODS: This systematic review and meta-analysis were conducted and reported according to the guidelines outlined in the PRISMA statement. Based on the search and inclusion criteria, 21 studies were included in the systematic review, and 19 were included in the meta-analysis. RESULTS: Melatonin supplementation did not affect aerobic performance relative to time trial (-0.04; 95% CI: -0.51 to 0.44) and relative to VO2 (0.00; 95% CI: -0.57 to 0.57). Also, melatonin supplementation did not affect strength performance (0.19; 95% CI: -0.28 to 0.65). Only Glutathione Peroxidase (GPx) secretion increased after melatonin supplementation (1.40; 95% CI: 0.29 to 2.51). Post-exercise melatonin secretion was not changed immediately after an exercise session (0.56; 95% CI: -0.29 to 1.41) and 60 min after exercise (0.56; 95% CI: -0.29 to 1.41). CONCLUSION: The data indicate that melatonin is not an ergogenic hormone. In contrast, melatonin supplementation improves post-exercise recovery, even without altering its secretion.

Defining ketone supplementation: the evolving evidence for postexercise ketone supplementation to improve recovery and adaptation to exercise.

Over the last decade, there has been a growing interest in the use of ketone supplements to improve athletic performance. These ketone supplements transiently elevate the concentrations of the ketone bodies acetoacetate (AcAc) and d-ß-hydroxybutyrate (ßHB) in the circulation. Early studies showed that ketone bodies can improve energetic efficiency in striated muscle compared with glucose oxidation and induce a glycogen-sparing effect during exercise. As such, most research has focused on the potential of ketone supplementation to improve athletic performance via ingestion of ketones immediately before or during exercise. However, subsequent studies generally observed no performance improvement, and particularly not under conditions that are relevant for most athletes. However, more and more studies are reporting beneficial effects when ketones are ingested after exercise. As such, the real potential of ketone supplementation may rather be in their ability to enhance postexercise recovery and training adaptations. For instance, recent studies observed that postexercise ketone supplementation (PEKS) blunts the development of overtraining symptoms, and improves sleep, muscle anabolic signaling, circulating erythropoietin levels, and skeletal muscle angiogenesis. In this review, we provide an overview of the current state-of-the-art about the impact of PEKS on aspects of exercise recovery and training adaptation, which is not only relevant for athletes but also in multiple clinical conditions. In addition, we highlight the underlying mechanisms by which PEKS may improve exercise recovery and training adaptation. This includes epigenetic effects, signaling via receptors, modulation of neurotransmitters, energy metabolism, and oxidative and anti-inflammatory pathways.

Milk protein ingestion does not enhance recovery from muscle-damaging resistance exercise in untrained males and females: a randomized controlled trial.

Milk-based proteins are a common choice of post-exercise nutrition to enhance exercise recovery and adaptation. Peri-exercise milk protein ingestion may attenuate exercise-induced muscle damage (EIMD), which is a particular risk to untrained individuals. However, most research has been conducted with males, and due to potential sex differences in EIMD, research with both sexes is required. This parallel-group randomized controlled trial examined the impact of milk protein ingestion on recovery from EIMD. Untrained males and females performed a single bout of leg-based resistance exercise and consumed a milk protein (MILK-PRO: n = 4 males, n = 8 females) or isoenergetic control (CON: n = 4 males, n = 8 females) supplement over 4 days post-exercise (17 doses total). Maximum strength was assessed ≥3 wk pre- and 72 and 168 h post-exercise, and measures of leg circumference, range of motion, muscle soreness, pressure-pain threshold (PPT), and serum creatine kinase concentration ([CK]) were conducted pre-, immediately post-, and 24, 48, 72, and 168 h post-exercise. Resistance exercise induced mild muscle damage that was not attenuated with MILK-PRO relative to CON. Peak increases in [CK] and reductions in PPT were greater in males compared with females. Changes in other markers were comparable between sexes. We conclude that moderate resistance exercise in naïve individuals induces muscle damage without compromising muscle strength. We support sex differences in EIMD and emphasize the need for further research with both sexes. Milk protein ingestion was not beneficial for recovery from EIMD, thus alternative management strategies should be investigated. This trial was prospectively registered at ClinicalTrials.gov PRS (protocol ID: 290580A).

Nutritional Compounds to Improve Post-Exercise Recovery.

The metabolic and mechanical stresses associated with muscle-fatiguing exercise result in perturbations to bodily tissues that lead to exercise-induced muscle damage (EIMD), a state of fatigue involving oxidative stress and inflammation that is accompanied by muscle weakness, pain and a reduced ability to perform subsequent training sessions or competitions. This review collates evidence from previous research on a wide range of nutritional compounds that have the potential to speed up post-exercise recovery. We show that of the numerous compounds investigated thus far, only two-tart cherry and omega-3 fatty acids-are supported by substantial research evidence. Further studies are required to clarify the potential effects of other compounds presented here, many of which have been used since ancient times to treat conditions associated with inflammation and disease.

Effect of citrulline malate supplementation on muscle function and bioenergetics during short-term repeated bouts of fatiguing exercise.

Citrulline malate (CM) has been shown to improve muscle performance in healthy participants during a single exercise session. Yet, within the framework of exercises repeated at close time interval, the consequences of CM ingestion on mechanical performance are controversial and the bioenergetics side remains undocumented. The aim of this double-blind placebo-controlled study was to evaluate in vivo the effect of short-term (7 doses in 48 h) oral administration of CM upon gastrocnemius muscle function and bioenergetics using non-invasive multimodal NMR techniques in healthy rats. The experimental protocol consisted of two 6-min bouts of fatiguing exercise spaced by an 8-min recovery period. CM treatment did not affect the basal bioenergetics status and increased the half-fatigue time during the first exercise bout. With exercise repetition, it prevented PCr cost alteration and decreased both the glycolytic ATP production and the contractile ATP cost in working muscle, but these changes were not associated to any improvement in mechanical performance. In addition, CM did not influence the replenishment of high-energy phosphorylated compounds during the post-exercise recovery periods. Therefore, short-term CM administration enhances muscle bioenergetics throughout fatiguing bouts of exercise repeated at close time interval but this enhancement does not benefit to mechanical performance.

The Influence of Phototherapy on Recovery From Exercise-Induced Muscle Damage.

Background: Intense physical activity can result in exercise-induced muscle damage, delayed-onset muscle soreness, and decrements in performance. Phototherapy (PhT), sometimes referred to as photobiomodulation or low-level laser therapy, may enhance recovery from vigorous exercise. Purpose: The purpose of this study was to assess the influence of phototherapy on functional movements (vertical jump, agility), and perceptions of muscle soreness following exercise-induced muscle damage caused by high volume sprinting and decelerations. Methods: In a between-group design, 33 participants performed 40x15m sprints, a protocol intended to cause muscle damage. Immediately following sprinting and in the four days following, vertical jump and agility were assessed, as well as calf, hamstring, quadriceps, and overall perceptions of soreness. Sixteen subjects (age 20.6±1.6 yrs; BMI 25.8±4.6 kg.m-2) received PhT prior to testing each day, while 17 (age 20.8±1.3 yrs; BMI 26.2±4.5 kg.m-2) received sham PhT and served as a control (CON). Measurements were recorded during five days of recovery from the repeated sprint protocol, then compared to those recorded during three baseline days of familiarization. Area under the curve was calculated by summing all five scores, and comparing those values by condition via a two-tailed unpaired t-test for normally distributed data, and a two-tailed Mann-Whitney U test for nonparametric data (alpha level = 0.05). Results: Calf soreness was lower in PhT compared to CON (p = 0.02), but no other significant differences were observed between groups for vertical jump, agility, quadriceps, hamstring, and overall soreness (p > 0.05). Discussion: Phototherapy may attenuate soreness in some muscle groups following exercise-induced muscle damage, but may not enhance recovery after explosive, short-duration activities. Conclusion: Phototherapy may not be a useful recovery tool for those participating in explosive, short-duration activities. Level of evidence: 2c.

Cultural differences in hydration practices among physically active individuals: a narrative review.

It is well-established that appropriate hydration practices are essential in promoting health and optimizing performance and recovery. However, evidence-based hydration guidelines may not be adopted due to cultural differences across countries, such as religious beliefs, traditions, preferences, and beverage availability. Examples of hydration practices influenced by culture include beer consumption after sports in Western countries, consumption of sugarcane juice in India and Ramadan fasting among Muslims. For most cultural hydration practices, there is limited scientific evidence on their effects on rehydration, exercise performance, and recovery. Despite possible benefits of various hydration practices on exercise performance and recovery, they are inconsistent with current evidence-based hydration recommendations. More research on the impacts of cultural hydration differences on physiology, performance, and recovery is warranted to allow evidence-based guidelines and advisories. Abbreviations: ABV: alcohol by volume, ACSM: American College of Sports Medicine, NATA: National Athletic Trainers' Association, ROS: reactive oxygen species, TCM: Traditional Chinese Medicine.

The Effect of Nitrate-Rich Beetroot Juice on Markers of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Human Intervention Trials.

This systematic review and meta-analysis of randomized controlled trials examined whether dietary nitrate supplementation attenuates exercise-induced muscle damage (EIMD) and is reported according to the PRISMA guidelines. Medline and SPORTDiscus databases were searched from inception to June 2020. Inclusion criteria were studies in adult humans consuming inorganic nitrate before and after exercise and that measured markers implicated in the etiology of EIMD (muscle function, muscle soreness, inflammation, myocellular protein efflux, oxidative stress, range of motion) <168 h post. The Cochrane Collaboration risk of bias two tool was used to critically appraise the studies; forest plots were generated with random-effects models and standardized mean differences (SMD). Nine studies were included in the systematic review and six in the meta-analysis. All studies were rated to have some concerns for risk of bias. All trials in the meta-analysis provided nitrate as beetroot juice, which accelerated isometric strength recovery 72 h post-exercise (SMD: 0.54, p = 0.01) and countermovement jump performance 24-72 h post-exercise (SMD range: 0.75-1.32, p < 0.03). Pressure pain threshold was greater with beetroot juice 48 (SMD: 0.58, p = 0.03) and 72 h post-exercise (SMD: 0.61, p = 0.02). Beetroot juice had no effect on markers of oxidative stress and creatine kinase (p > 0.05), but c-reactive protein was higher vs. placebo at 48 h post-exercise (SMD: 0.55, p = 0.03). These findings suggest that nitrate-rich beetroot juice may attenuate some markers of EIMD, but more large-scale controlled trials in elite athletes are needed.

Dance therapy as an alternative for cardiac rehabilitation in women population: autonomic and hemodynamic acute responses - a crossover clinical trial protocol

Abstract Aim: The objective of this study is to 1. Investigate in women with cardiac risk factors the acute responses of cardiac autonomic modulation and hemodynamic parameters during and after a dance-based cardiac rehabilitation session and II. Compare these responses with a conventional exercise-based cardiac rehabilitation session. Methods: This will be a crossover-clinical trial that will enroll women with at least one cardiac risk factor. The interventions consist of one dance-based (DB) and one traditional exercise-based (EB) session of cardiac rehabilitation, both composed of initial rest, warm-up, moderate-intensity physical exercise, fast recovery evaluation in orthostatic position, and slow recovery evaluation. The main outcomes are 1. Autonomic modulation, evaluated through heart rate variability linear and non-linear methods, and II. Hemodynamic parameters (heart rate, blood pressure, peripheral oxygen saturation, and respiratory rate). All measures will be evaluated in specific moments during the initial rest, physical exercise, and recovery. Conclusion: The results will allow the safe inclusion of dance-based sessions in cardiac rehabilitation programs opening an important field of research to investigate the long-term effects on physical fitness and cardiac risk factors, as well as adherence and motivation to attend cardiac rehabilitation in the women population.

The Effect of Creatine Supplementation on Markers of Exercise-Induced Muscle Damage: A Systematic Review and Meta-Analysis of Human Intervention Trials.

This systematic review and meta-analysis examined the effects of creatine supplementation on recovery from exercise-induced muscle damage, and is reported according to the PRISMA guidelines. MEDLINE and SPORTDiscus were searched for articles from inception until April 2020. Inclusion criteria were adult participants (≥18 years); creatine provided before and/or after exercise versus a noncreatine comparator; measurement of muscle function recovery, muscle soreness, inflammation, myocellular protein efflux, oxidative stress; range of motion; randomized controlled trials in humans. Thirteen studies (totaling 278 participants; 235 males and 43 females; age range 20-60 years) were deemed eligible for analysis. Data extraction was performed independently by both authors. The Cochrane Collaboration Risk of Bias Tool was used to critically appraise the studies; forest plots were generated with random-effects model and standardized mean differences. Creatine supplementation did not alter muscle strength, muscle soreness, range of motion, or inflammation at each of the five follow-up times after exercise (<30 min, 24, 48, 72, and 96 hr; p > .05). Creatine attenuated creatine kinase activity at 48-hr postexercise (standardized mean difference: -1.06; 95% confidence interval [-1.97, -0.14]; p = .02) but at no other time points. High (I2; >75%) and significant (Chi2; p < .01) heterogeneity was identified for all outcome measures at various follow-up times. In conclusion, creatine supplementation does not accelerate recovery following exercise-induced muscle damage; however, well-controlled studies with higher sample sizes are warranted to verify these conclusions. Systematic review registration (PROSPERO CRD42020178735).

What is the optimal time-response window for the use of photobiomodulation therapy combined with static magnetic field (PBMT-sMF) for the improvement of exercise performance and recovery, and for how long the effects last? A randomized, triple-blinded, placebo-controlled trial.

BACKGROUND: The optimal time-response window for photobiomodulation therapy (PBMT) using low-level laser therapy (LLLT) and/or light emitting diodes therapy (LEDT) combined with static magnetic fields (sMF) before physical activity still was not fully investigated. The aim of the present study was to investigate the better of four time-response windows for PBMT combined with sMF (PBMT-sMF) use before exercise in humans. METHODS: A prospectively registered, randomized, triple-blinded (volunteers, therapists and assessors) placebo-controlled trial was carried out. Sixty healthy untrained male subjects were randomly allocated to six experimental groups (n = 10 per group): PBMT-sMF 5 mins, PBMT-sMF 3 h, PBMT-sMF 6 h, PBMT-sMF 1-day, placebo, and control. The control group performed all procedures, however did not receive any kind of intervention. PBMT-sMF active or PBMT-sMF placebo was applied precisely in different time points after baseline MVC test to ensure that both MVC tests and eccentric exercise protocol would occur at the same hour of the day in all groups. Then, after five minutes, 3 h, 6 h or 1-day (24 h) of PBMT-sMF treatment (active or placebo) the eccentric exercise protocol was performed. The primary outcome was peak torque obtained from maximum voluntary contraction (MVC). The secondary outcomes were creatine kinase (CK), and delayed onset muscle soreness (DOMS). The primary and secondary outcomes were measured at baseline, immediately after, 1 h, 24 h and 48 h after the eccentric exercise protocol. RESULTS: Sixty patients were randomized and analyzed to each sequence. The outcomes in absolute values show that all active PBMT-sMF groups increased (p < 0.05) MVC from immediately after to 1 h after eccentric exercise, and decreased (p < 0.05) CK activity at all time points. However, PBMT-sMF 5 mins, 3 h and 6 h groups showed better results in MVC and CK analysis from 24 h to 48 h, and also to DOMS (p < 0.05) at all time points. Participants did not report any adverse events. CONCLUSIONS: PBMT-sMF can be used from 5 min to 6 h before exercise, and the effects can last up to 54 h after treatment. However, the effects start to decrease when a 1-day (24 h) time-response window is used. TRIAL REGISTRATION: NCT03420391. Registered 05 February 2018.

Perceptions and use of recovery strategies: Do swimmers and coaches believe they are effective?

This study aimed to investigate swimmer's use and coach prescription of recovery strategies during training and competition while examining perceived challenges, barriers, and beliefs in the importance of their effectiveness. A mixed-methods sequential explanatory design was implemented. Thirty-seven male and 45 female sub-elite to elite swimmers (age 18 ± 3 y), and 4 male and 6 female coaches (age 40 ± 9 y) completed an online, 78-item recovery strategy survey. Swimmers and coaches responded to questions regarding when, why, and how they used recovery strategies, perceived challenges and barriers to strategy inclusion during training and competition. Data were coded and analysed thematically. Fisher's Exact Test was conducted on 5-point Likert scale responses. Most recovery strategies were used and prescribed more during competition. Swimmers reported active recovery as the most effective recovery strategy (44%), whereas coaches rated sleep or napping (40%). Swimmers and coaches perceived most recovery strategies to be more effective and important during competition than in training. Swimmers used, and coaches prescribed, recovery strategies more during the competition, highlighting the discrepancies in use between training and competition. Targeted education programmes should enhance athletes and coach's recovery knowledge and practical application of strategies, while accounting for individual sport and life demands.

Anserine Reverses Exercise-Induced Oxidative Stress and Preserves Cellular Homeostasis in Healthy Men.

The study tested whether anserine (beta-alanyl-3-methyl-l-histidine), the active ingredient of chicken essence affects exercise-induced oxidative stress, cell integrity, and haematology biomarkers. In a randomized placebo-controlled repeated-measures design, ten healthy men ingested anserine in either a low dose (ANS-LD) 15 mg.kg-1.bw-1, high dose (ANS-HD) 30 mg.kg-1.bw-1, or placebo (PLA), following an exercise challenge (time to exhaustion), on three separate occasions. Anserine supplementation increased superoxide dismutase (SOD) by 50% (p < 0.001, effect size d = 0.8 for both ANS-LD and ANS-HD), and preserved catalase (CAT) activity suggesting an improved antioxidant activity. However, both ANS-LD and ANS-HD elevated glutathione disulfide (GSSG), (both p < 0.001, main treatment effect), and consequently lowered the glutathione to glutathione disulfide (GSH/GSSG) ratio compared with PLA (p < 0.01, main treatment effect), without significant effects on thiobarbituric acid active reactive substances (TBARS). Exercise-induced cell damage biomarkers of glutamic-oxaloacetic transaminase (GOT) and myoglobin were unaffected by anserine. There were slight but significant elevations in glutamate pyruvate transaminase (GPT) and creatine kinase isoenzyme (CKMB), especially in ANS-HD (p < 0.05) compared with ANS-LD or PLA. Haematological biomarkers were largely unaffected by anserine, its dose, and without interaction with post exercise time-course. However, compared with ANS-LD and PLA, ANS-HD increased the mean cell volume (MCV), and decreased the mean corpuscular haemoglobin concentration (MCHC) (p < 0.001). Anserine preserves cellular homoeostasis through enhanced antioxidant activity and protects cell integrity in healthy men, which is important for chronic disease prevention. However, anserine temporal elevated exercise-induced cell-damage, together with enhanced antioxidant activity and haematological responses suggest an augmented exercise-induced adaptative response and recovery.

Males and females exhibit similar muscle glycogen recovery with varied recovery food sources.

PURPOSE: Research has elucidated the impact of post-exercise carbohydrate nutrition and environmental conditions on muscle glycogen re-synthesis. However, research has minimally considered the implications of glycogen recovery in females and has mostly focused on commercial sport nutrition products. The purpose of this study was to determine the effects of varied mixed macronutrient feedings on glycogen recovery and subsequent exercise performance in both sexes. METHODS: Males (n = 8) and females (n = 8) participated in a crossover study. Subjects completed a 90-min cycling glycogen depletion trial, then rested for 4 h. Two carbohydrate feedings (1.6 g kg-1) of either sport supplements or potato-based products were delivered at 0 and 2 h post-exercise. Muscle biopsies (glycogen) and blood samples (glucose, insulin) were collected during the recovery. Afterwards, subjects completed a 20 km cycling time trial. RESULTS: There was no difference between sexes or trials for glycogen recovery rates (male: 7.9 ± 2.7, female: 8.2 ± 2.7, potato-based: 8.0 ± 2.5, sport supplement: 8.1 ± 3.1 mM kg wet wt-1 h-1, p > 0.05). Time trial performance was not different between diets (38.3 ± 4.4 and 37.8 ± 3.9 min for potato and sport supplement, respectively, p > 0.05). CONCLUSIONS: These results indicate that food items, such as potato-based products, can be as effective as commercially marketed sports supplements when developing glycogen recovery oriented menus and that absolute carbohydrate dose feedings (g kg-1) can be effectively applied to both males and females.

A Novel Blue-Red Photobiomodulation Therapy Patch Effects on a Repetitive Elbow-Flexion Fatigue Task.

BACKGROUND: Photobiomodulation (laser/light) therapy has reduced skeletal muscle fatigue and improved performance in previous research. OBJECTIVE: To determine if the application of a novel blue (450 nm) and red (645 nm) light-emitting diode photobiomodulation therapy patch improves muscle function and decreases perceived exertion after an elbow-flexion fatigue protocol. PARTICIPANTS: Thirty-four strength-trained individuals (male = 32 and female = 2, age = 22.5 [2.7] y). METHODS: Participants were randomly assigned to an active or placebo treatment. On  visit 1, participants' 1-repetition maximal biceps curl was determined, and an orientation session of the fatigue task occurred to ensure no learning effects. Fifty percent of the participants' 1-repetition maximum was used during the fatigue protocol. On visit 2, participants performed biceps curl repetitions at a speed of 25 repetitions per minute until they could not physically move the weight past 90° of elbow flexion or stay with the set pace. After the fatigue protocol, a 30-minute blue/red light (wavelength = 450 and 645 nm, peak irradiance = 9 mW/cm2, duty cycle = pulsed 33%, and fluence = 5.4 J/cm2) or sham treatment was administered based on the randomized group assignment. Immediately following, the participants repeated the fatigue protocol. The number of complete repetitions was counted, and the participants rated their perceived level of exertion on the Borg scale immediately after each fatigue bout. RESULTS: Overall, fatigue occurred between the 2 exercise bouts (pretreatment = 44.1 [12.3] and posttreatment = 37.4 [9.6] repetitions, P = .02). However, less fatigue was noted in the number of participants of the active treatment group than the sham treatment group. During the posttreatment fatigue task, 29.4% of participants in the active treatment group improved compared to 0% in the sham treatment (P = .045). CONCLUSION: Nearly 30% of participants had an increase benefit during a repeated-bout fatigue task due to the blue/red light-emitting diode photobiomodulation light patch.

Traditional Chinese acupressure massage ameliorates systemic inflammatory responses and joint mobility limitation after acute repeated jumping exercise.

CONTEXT: Alternative medical and training approaches to accelerate recovery among athletes are growing in popularity. The potential benefits of acupressure massage on attenuating muscle soreness and promoting post-exercise recovery capacity are still unclear. OBJECTIVE: This study compares the effects of traditional Chinese acupressure massage (TCAM) and active recovery, on subject recovery capacity after acute repeated jumping exercise. DESIGN: Twenty healthy male athletes were randomly assigned to traditional Chinese acupressure massage (TCAM; N = 10) or active recovery (AR; performing low-intensity exercise during post-exercise recovery; N = 10) groups. TCAM and AR intervention were applied after repeated jumping exercise. Pain scale, knee active/passive range of motion (AROM/PROM), jumping performance, quadriceps maximum voluntary contraction force, creatine kinase, and leukocyte subpopulations were measured at baseline, after and 48 h after exercise. RESULTS: No significant interaction effects were observed between the jumping performance, quadriceps maximum voluntary contraction (MVC) force, power-to-weight ratio for the two groups before the exercise, after the exercise, and 48 h post exercise. However, the knee flexion AROM/PROM was greater in the TCAM group than that for the AR group (p = 0.005). There were no differences in the VAS, MVC, and jumping performance between treatments. The white blood cell (p = 0.024), and monocytes (p = 0.023) responses were lower in the TCAM group. CONCLUSIONS: We demonstrated that TCAM generates beneficial effects on attenuating joint mobility limitations and lowering systemic inflammatory responses after acute exercise in athletes. These findings suggest that TCAM may be a practical alternative approach for athletes participating in consecutive competitions containing eccentric elements.

Protein intake and amino acid supplementation regulate exercise recovery and performance through the modulation of mTOR, AMPK, FGF21, and immunity.

Exercise is considered to be the best approach to improve quality of life, and together with a healthy and adequate dietary pattern, exercise represents the best strategy to reduce the risk of chronic metabolic and inflammatory diseases, such as those related to obesity. The regularity and intensity of exercise is modulated at the molecular level in the skeletal muscle by two protein kinases, the mechanistic target of rapamycin (mTOR) and AMP-activated protein kinase (AMPK), which act as sensors of external stimuli, showing the energy status of muscular fibers. The mTOR pathway is activated by insulin and amino acid availability, and its metabolic actions culminate in increased protein synthesis and reduced autophagy, leading to an increase in muscle mass. In contrast, AMPK activation induces a transcriptional program aimed to increase the mitochondrial content in skeletal muscle, transforming fast-twitch glycolytic fibers to slow-twitch oxidative fibers and increasing resistance to fatigue. In addition, inadequate exercise training induces imbalance in the immune response, generating excessive inflammation and/or immunosuppression. The purpose of this review is to summarize recent studies that provide insight into dietary protein interventions and/or amino acid supplementation that may improve outcomes after exercise by modulating 1) mTOR and AMPK activation during early exercise recovery, leading to increased muscle protein synthesis or increased oxidative capacity; 2) undesirable inflammatory responses; and 3) fibroblast growth factor 21 (FGF21) levels that may have relevant implications in skeletal muscle metabolism, particularly during the exercise recovery and performance of obese subjects.