Time-course of changes in performance, biomechanical, physiological and perceptual responses following resistance training sessions.

This study determined the time-course of recovery after resistance training (RT) sessions and the association between changes in performance with changes in biomechanical, physiological and perceptual parameters. After a 4-week familiarization period, 14 resistance-trained males performed 3 experimental conditions, each one including 2 sessions with a recovery interval of 24, 48 h or 72 h, in a randomized order. RT sessions consisted of 5 sets of 8-10RM on squat and leg press exercises. The resistance was equal for the 2 sessions of each condition and repetitions were performed until concentric failure. Volume load (VL) and first set volume load (FSVL) were compared between sessions. Tests before each session included countermovement jump (CMJ), maximal voluntary isometric contraction (MVIC), creatine kinase (CK) and delayed onset muscle soreness (DOMS). (2 × 3) ANOVA with effect sizes (ES) assessed the time-course of recovery and Kendall test the correlation between variables (α = 0.05). Significant interaction was observed for all variables, except for CK, where a condition main effect occurred. Comparisons between post and pre-intervals showed VL (p = 0.011;ES = -0.90) decreased for 24 h condition, while FSVL remained decreased for 48 h (p = 0.031;ES = -0.63) and DOMS increased (p = 0.001;ES = 3.52). CMJ (p = 0.025;ES = 0.25) and MVIC (p = 0.031;ES = 0.14) performance increased at 72 h. FSVL (r = 0.424), CMJ (r = 0.439), MVIC (r = 0.389) and DOMS (r = -0.327) were significantly correlated with VL (p < 0.05). Time-course of VL showed the necessity of at least 48 h for the reestablishment of performance, though better perceptual responses were evident at 72h. Thus, both recovery intervals may be beneficial after lower-limbs RT until concentric failure, though chronic effects still need to be investigated.

Power loss is attenuated following a second bout of high-intensity eccentric contractions due to the repeated bout effect's protection of rate of torque and velocity development.

High-intensity unaccustomed eccentric contractions result in weakness and power loss because of fatigue and muscle damage. Through the repeated bout effect (RBE), adaptations occur, then damage and weakness are attenuated following a subsequent bout. However, it is unclear whether the RBE protects peak power output. We investigated the influence of the RBE on power production and estimated fatigue- and damage-induced neuromuscular impairments following repeated high-intensity eccentric contractions. Twelve healthy adult males performed 5 sets of 30 maximal eccentric elbow flexions and repeated an identical bout 4 weeks later. Recovery was tracked over 7 days following both bouts. Reduced maximum voluntary isometric contraction torque, and increased serum creatine kinase and self-reported soreness indirectly inferred muscle damage. Peak isotonic power, time-dependent measures - rate of velocity development (RVD) and rate of torque development (RTD) - and several electrophysiological indices of neuromuscular function were assessed. The RBE protected peak power, with a protective index of 66% 24 h after the second eccentric exercise bout. The protection of power also related to preserved RVD (R2 = 0.61, P < 0.01) and RTD (R2 = 0.39, P < 0.01). Furthermore, the RBE's protection against muscle damage permitted the estimation of fatigue-associated neuromuscular performance decrements following eccentric exercise. Novelty: The repeated bout effect protects peak isotonic power. Protection of peak power relates to preserved rates of torque and velocity development, but more so rate of velocity development. The repeated bout effect has little influence on indices of neuromuscular fatigue.

Inhibition of Peripheral ERK Signaling Ameliorates Persistent Muscle Pain Around Trigger Points in Rats.

The purpose of this study was to investigate whether the ERK signaling pathway was involved in ameliorating chronic myofascial hyperalgesia from contused gastrocnemius muscle in rats. We established an animal model associated with myofascial pain syndrome and described the mechanism of muscle pain in an animal model. Changes in the mechanical pain threshold were observed 0.5, 1, 2, 3, 4, 5, 8, 12, 18, and 24 h after ERK inhibitor injection around myofascial trigger points (MTrPs) of the gastrocnemius muscle in rats. Morphological changes in gastrocnemius muscle cells were observed by hematoxylin and eosin (H&E) staining. ERK signaling pathway activation was detected through immunohistochemistry and Western blotting. The main morphological characteristics of injured muscle fibers around MTrPs include gathered circular or elliptical shapes of different sizes in the cross-section and continuous inflated and tapering fibers in the longitudinal section. After intramuscular injection of U0126 (ERK inhibitor), the mechanical pain threshold significantly increased. The reduction in mechanical hyperalgesia was accompanied by reduced ERK protein phosphorylation, myosin light chain kinase (MLCK) protein, p-MLC protein expression, and the cross-sectional area of skeletal muscle cells around MTrPs. An ERK inhibitor contributed to the attenuation of mechanical hyperalgesia in the rat myofascial pain model, and the increase in pain threshold may be related to MLCK downregulation and other related contraction-associated proteins by ERK.

LDH isoenzyme 5 is an index of early onset muscle soreness during prolonged running.

BACKGROUND: Muscle soreness is also induced during prolonged running such as a full marathon, and muscle soreness and increased damage markers are detected immediately after such a running. We named this muscle soreness, early onset muscle soreness (EOMS). Additionally, lactate dehydrogenase (LDH) level which has some isoenzyme is increased immediately after prolonged exercise. However, it is unclear that EOMS is related to muscle damage markers on prolonged running. This study aimed to determine at which point EOMS, and muscle damage markers are related to EOMS during prolonged running. METHODS: We studied 11 male subjects who habitually perform aerobic exercise. They ran 30 km at 90% of ventilatory threshold intensity. Every 10 km, we estimated perceived muscle soreness, and sampled blood to measure muscle and liver damage, inflammation, and oxidative stress (d-ROM and BAP) markers. RESULTS: Muscle soreness score lower limbs were significantly appeared at 20 km compared to that at 0 km. Serum lactate dehydrogenase (LDH) level increased at 30 km compared to that at 0 km. LDH isoenzymes 3, 4, and 5, and neutrophils significantly increased at 30 km compared to those at 0 km. Serum LDH isoenzyme 5 and change in aspartate aminotransferase significantly increased at 20 km. In addition, there was a significant correlation between the thigh NRS and amount of serum LDH isoenzyme 5 from 0 km to 20 km. d-ROM and BAP increased at 10 km compared to those at 0 km. CONCLUSIONS: EOMS started to occur at 20 km during a 30 km running task. Our data suggest that LDH isoenzyme 5 is a marker of occurrence in EOMS during prolonged running.

The effects of training status and exercise intensity on exercise-induced muscle damage.

BACKGROUND: Individuals participating in exercise beyond their level of fitness may be at higher risk for exercise-induced muscle damage, however the impact of training status on muscle damage development is not well understood. The purpose of this study was to measure skeletal muscle damage and soreness after five days of high and low intensity exercise in previously trained and untrained individuals. METHODS: Eighteen males and females (9 trained and 9 untrained) completed five consecutive days of high intensity (HI) exercise and five consecutive days of low intensity (LI) exercise. Blood was drawn at the initial visit and after completion of each exercise intensity period. RESULTS: CK was elevated post exercise for both groups during both intensities, but was greater in trained vs. untrained (HI: 203.6 vs. 143.4 IU/L and LI: 156.4 vs. 109.3 IU/L; P<0.01). Myoglobin was significantly higher after exercise for both groups (P<0.01) and was higher following high vs. low intensity in trained (P<0.01), but not untrained (P=0.052). Untrained experienced soreness following one day of high intensity exercise vs. after 3 days in trained participants (P=0.04, P=0.02). CONCLUSIONS: The current study suggests that high intensity exercise results in greater muscle damage in both trained and untrained individuals vs. low intensity exercise. However untrained participants experience more pain and with earlier onset and should therefore take caution when beginning exercise programs that require consecutive sessions of high intensity exercise.

Enhanced External Counterpulsation and Recovery From a Plyometric Exercise Bout.

OBJECTIVE: To analyze the effectiveness of enhanced external counterpulsation (EECP) on recovery from exercise-induced muscle damage (EIMD). DESIGN: This study followed a crossover, placebo-controlled, counterbalanced design. PARTICIPANTS: Ten healthy active subjects (7 male; 27 ± 4 years). INTERVENTIONS: Participants performed a plyometric exercise bout (10 sets of 10 jumps interspersed with 1-minute rests) and were then assigned to recover for 30 minutes with either EECP (cuff pressure = 80 mm Hg) or a Sham intervention (0 mm Hg) immediately after exercise and at 24 hours after exercise. Two weeks later, they repeated the protocol with the other recovery intervention. MAIN OUTCOME MEASURES: Muscle soreness, creatine kinase (CK) activity, jump performance, and tensiomyographic variables were measured before exercise, and 24 and 48 hours after exercise. RESULTS: The mean jump height of the plyometric bout did not differ between EECP and Sham (P > 0.05). Exercise resulted in increased muscle soreness (P < 0.001) and CK levels (P < 0.001), as well as in impaired jump performance (P < 0.05). No changes were observed in tensiomyographic variables. No significant differences were found between interventions for any of the study outcomes. CONCLUSIONS: No benefits on recovery from EIMD after a plyometric exercise bout were observed with EECP.

Cold-Water Immersion Does Not Accelerate Performance Recovery After 10-km Street Run: Randomized Controlled Clinical Trial.

The use of strategies to assure better post-effort recovery is frequent in sports settings. There are several interventions available for exercise induced muscle damage recovery, but cold-water immersion (CWI) stands out among them. The effects of CWI are unclear in the literature and, although the number of street runners has been growing, there is a gap in the scientific evidence regarding the use of CWI to recover runners' performance after a 10-km street run. Purpose: The goal of our study was to analyze the effects of CWI on the recovery of muscle damage markers after a 10-km street run. Method: We randomly assigned thirty male recreational street runners, immediately after a 10-km street run, into three recovery groups: control (rest for 10 minutes), immersion (10 min immersed in water without ice at room temperature) and CWI (10 min immersed in water with ice at 10ºC). We assessed pain, triple hop distance, extensor peak torque and blood creatine kinase levels pre- and post-run, post-intervention and 24 hours after the run. Results: The 10-km run was enough to decrease triple hop distance and extensor peak torque, and increase levels of creatine kinase (p < 0.05); however, we found no time/group interactions in any of the assessed variables after we applied the appropriate interventions (p > 0.05). Conclusion: 10-min CWI at 10°C was no more effective than water immersion and rest in recovering muscle damage markers after 10-km runs.

Does vibration benefit delayed-onset muscle soreness?: a meta-analysis and systematic review.

OBJECTIVE: Delayed-onset muscle soreness (DOMS) is a symptom of exercise-induced muscle injury that is commonly encountered in athletes and fitness enthusiasts. Vibration is being increasingly used to prevent or treat DOMS. We therefore carried out a meta-analysis to evaluate the effectiveness of vibration in patients with DOMS. METHOD: We searched nine databases for randomized controlled trials of vibration in DOMS, from the earliest date available to 30 May 2018. Visual analogue scale (VAS) and creatine kinase (CK) levels were set as outcome measures. RESULTS: The review included 10 identified studies with 258 participants. The meta-analysis indicated that vibration significantly improved the VAS at 24, 48, and 72 hours after exercise, and significantly improved CK levels at 24 and 48 hours, but not at 72 hours. CONCLUSION: Vibration is a beneficial and useful form of physiotherapy for alleviating DOMS. However, further studies are needed to clarify the role and mechanism of vibration in DOMS.

A Nutraceutical Composition Decreases CPK Levels in Saos-2 Cells and in Patients with Elevated Serum Levels of This Enzyme.

OBJECTIVES: This study aimed to investigate the effects of a nutraceutical composition on the expression of some genes involved in muscle cells and functioning in osteoblast cells. The effects of nutraceutical composition have been compared to the effects of atorvastatin, which induces muscle pain and elevated creatine phosphokinase (CPK) serum level when administered to patients. In particular, we analyzed the MyoD-1 gene, which is responsible for modulation of the CPK gene, which is a marker of muscle pain and damage. METHODS: The effects of nutraceutical composition on Saos-2 cells were compared with the effects of atorvastatin. The mRNAs were extracted and the expression levels of mitochondrial and cytoplasmic CPK genes and MyoD-1 were analyzed by real-time polymerase chain reaction (RT-PCR). Moreover, the effects on lactate dehydrogenase (LDH) activity and adenosine triphosphate (ATP) synthesis were measured in the osteoblast cell line. Furthermore, 11 patients with muscle pain or elevated CPK serum levels received a supplementation of the nutraceutical composition to test whether CPK levels could be downregulated. RESULTS: The analysis in Saos-2 cells showed that the nutraceutical composition upregulates the gene expression of MyoD-1 and downregulates the expression of the cytoplasmic isoform of CPK gene expression (p ≤ 0.05); moreover, it slightly increases ATP amount and decreases LDH activity. Conversely, atorvastatin represses the expression of MyoD-1 gene without significant changing into the expression levels of both cytoplasmic and mitochondrial CPK genes. Moreover, atorvastatin does not increase the ATP amount or increase LDH activity. Remarkable, the nutraceutical composition is able to decrease CPK levels in serum of patients and in some cases improve myalgia symptoms. CONCLUSION: The nutraceutical composition decreases CPK levels both in vitro and in vivo, suggesting that it might be useful to management of nonneurological myalgia symptoms.

A Randomized Controlled Trial of Massage and Pneumatic Compression for Ultramarathon Recovery.

Study Design Randomized controlled trial. Background Postexercise recovery techniques are widely used, but little research has examined their effectiveness. Objectives To examine the effectiveness of massage and pneumatic compression on recovery from a 161-km ultramarathon. Methods Participants in the 2015 161-km Western States Endurance Run were randomized to a 20-minute postrace intervention of massage, intermittent sequential pneumatic compression, or supine rest. Each subject completed two 400-m runs at maximum speed before the race and on days 3 and 5 after the race, and also provided muscle pain and soreness ratings and overall muscular fatigue scores before and for 7 days after the race. Results Among the 72 runners who finished the race and completed the study, comparison among intervention groups revealed no significant group or interaction effect on 400-m run time, but there was a significant (P<.0001) time effect. Immediately posttreatment, massage resulted in lower muscle pain and soreness ratings compared with the supine-rest control condition (P<.0001), while both massage (P<.0001) and pneumatic compression (P<.01) resulted in lower overall muscular fatigue scores compared with the control group. There were no significant differences between groups in any outcome 1 to 7 days after the race. Conclusion Single 20-minute sessions of postrace massage and intermittent sequential pneumatic compression provide some immediate subjective benefit. There is no evidence, however, that such treatments provide extended subjective or functional benefits of clinical importance. The trial was registered at www.clinicaltrials.gov (NCT02530190). Level of Evidence Therapy, level 1b. J Orthop Sports Phys Ther 2016;46(5):320-326. Epub 23 Mar 2016. doi:10.2519/jospt.2016.6455.

Are compression garments effective for the recovery of exercise-induced muscle damage? A systematic review with meta-analysis.

PURPOSE: The aim was to identify benefits of compression garments used for recovery of exercised-induced muscle damage. METHODS: Computer-based literature research was performed in September 2015 using four online databases: Medline (PubMed), Cochrane, WOS (Web Of Science) and Scopus. The analysis of risk of bias was completed in accordance with the Cochrane Collaboration Guidelines. Mean differences and 95% confidence intervals were calculated with Hedges' g for continuous outcomes. A random effect meta-analysis model was used. Systematic differences (heterogeneity) were assessed with I(2) statistic. RESULTS: Most results obtained had high heterogeneity, thus their interpretation should be careful. Our findings showed that creatine kinase (standard mean difference=-0.02, 9 studies) was unaffected when using compression garments for recovery purposes. In contrast, blood lactate concentration was increased (standard mean difference=0.98, 5 studies). Applying compression reduced lactate dehydrogenase (standard mean difference=-0.52, 2 studies), muscle swelling (standard mean difference=-0.73, 5 studies) and perceptual measurements (standard mean difference=-0.43, 15 studies). Analyses of power (standard mean difference=1.63, 5 studies) and strength (standard mean difference=1.18, 8 studies) indicate faster recovery of muscle function after exercise. CONCLUSIONS: These results suggest that the application of compression clothing may aid in the recovery of exercise induced muscle damage, although the findings need corroboration.

Macro-creatine kinase: a neglected cause of elevated creatine kinase.

Macro-creatine kinase (macro-CK) is a neglected cause of raised CK. Over a 10-year period, we observed five cases. Three patients had macro-CK type 1. One patient with fibromyalgia underwent several explorations to find a muscular pathology; another, who had elevated CK-MB (muscle-brain fraction) activity, was referred to a cardiologist, and statin therapy was erroneously discontinued in two patients. Two patients had macro-CK type 2: a man with a neuroendocrine carcinoma and a woman with rheumatoid arthritis. Diagnosis of type 1 obviates the need to carry out pointless and expensive investigations seeking a neuromuscular or cardiac pathology, and also, the unwarranted discontinuation of statin therapy. Type 2 must prompt investigations for a neoplasm.

Evaluation of serum leaking enzymes and investigation into new biomarkers for exercise-induced muscle damage.

This investigation determined whether existing muscle damage markers and organ damage markers respond to an acute eccentric exercise protocol and are associated with affected muscle symptoms. Nine healthy-young men completed one-leg calf-raise exercise with their right leg on a force plate. They performed 10 sets of 40 repetitions of exercise at 0.5 Hz with a load corresponding to half of their body weight, with 3 min rest between sets. The tenderness of medial gastrocnemius, lateral gastrocnemius and soleus, and the ankle active range of motion (ROM) were assessed before, immediately after, 24 h and 48 h, 72 h, 96 h and 168 h after exercise. Blood and urine were collected pre-exercise and 2 h, 4 h, 24 h, 48 h, 72 h and 96 h post-exercise. Serum was analyzed for creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and aldolase (ALD) activities. We also determined heart-type fatty acid-binding protein (H-FABP), intestinal-type fatty acid-binding protein (I-FABP) and liver-type fatty acid-binding protein (L-FABP), neutrophil gelatinase-associated lipocalin (NGAL), interleukin (IL)-17A, IL-23, nerve growth factor (NGF), soluble-Endothelial (sE)-selectin, s-Leukocyte (L)-selectin, s-Platelets (P)-selectin, and 8-isoprostane in plasma and urine. The tenderness of proximal and middle gastrocnemius increased significantly 72 h (p < 0.05, p < 0.01) after exercise. Ankle active ROM in dorsal flexion decreased significantly 48 h (p < 0.05) and 72 h (p < 0.01) after exercise. CK and ALD activities significantly increased at 72 h (p < 0.05) and remained elevated at 96 h (p < 0.01) postexercise compared to pre-exercise values. Also, ALD which showed relatively lower interindividual variability was significantly correlated with tenderness of middle gastrocnemius at 72 h. LDH activity significantly increased 96 h postexercise (p < 0.01), whereas the increase in AST and ALT activities 96 h post-exercise was not significantly different from pre-exercise values. There were no significant changes in FABPs, NGAL, IL-17A, IL-23, NGF, selectins and 8-isoprostanes in plasma and urine. In conclusion, calf-raise exercise induced severe local muscle damage symptoms which were accompanied by increases in both serum CK and ALD activities, but we could not detect any changes in examined markers of organ damage, inflammation and oxidative stress. Further research is needed to determine other more sensitive biomarkers and the underlying mechanisms of exercise-induced muscle damage.

Compound heterozygous mutations in glycyl-tRNA synthetase are a proposed cause of systemic mitochondrial disease.

BACKGROUND: Glycyl-tRNA synthetase (GARS) is an aminoacyl-tRNA synthetase (ARS) that links the amino acid glycine to its corresponding tRNA prior to protein translation and is one of three bifunctional ARS that are active within both the cytoplasm and mitochondria. Dominant mutations in GARS cause rare forms of Charcot-Marie-Tooth disease and distal spinal muscular atrophy. CASE PRESENTATION: We report a 12-year old girl who presented with clinical and biochemical features of a systemic mitochondrial disease including exercise-induced myalgia, non-compaction cardiomyopathy, persistent elevation of blood lactate and alanine and MRI evidence of mild periventricular leukomalacia. Using exome sequencing she was found to harbor compound heterozygous mutations within the glycyl-tRNA synthetase (GARS) gene; c.1904C > T; p.Ser635Leu and c.1787G > A; p.Arg596Gln. Each mutation occurred at a highly conserved site within the anticodon binding domain. CONCLUSION: Our findings suggest that recessive mutations in GARS may cause systemic mitochondrial disease. This phenotype is distinct from patients with previously reported dominant mutations in this gene, thereby expanding the spectrum of disease associated with GARS dysregulation.

Muscle atrophy, pain, and damage in bed rest reduced by resistive (vibration) exercise.

UNLABELLED: The purpose of this study was to investigate the effectiveness of a short-duration (5-6 min, 3 d·wk) resistive exercise program with (RVE) or without (RE) whole-body vibration in reducing muscle atrophy in the lower limb during prolonged inactivity when compared with that in an inactive control group. METHODS: As part of the second Berlin BedRest Study, 24 male subjects underwent 60 d of head-down tilt bed rest. Using magnetic resonance imaging, muscle volumes of the individual muscles of the lower limb were calculated before and at various intervals during and after bed rest. Pain levels and markers of muscle damage were also evaluated during and after bed rest. Adjustment of P values to guard against false positives was performed via the false discovery rate method. RESULTS: On the "intent-to-treat" analysis, RE reduced atrophy of the medial and lateral gastrocnemius, soleus, vasti, tibialis posterior, flexor hallucis longus, and flexor digitorum longus (P ≤ 0.045 vs control group) and RVE reduced atrophy of the medial and lateral gastrocnemius and tibialis posterior (P ≤ 0.044). Pain intensity reports after bed rest were lower in RE at the foot (P ≤ 0.033) and whole lower limb (P = 0.01) and in RVE at the thigh (P ≤ 0.041), lower leg (P ≤ 0.01), and whole lower limb (P ≤ 0.036). Increases in sarcomere-specific creatine kinase after bed rest were less in RE (P = 0.020) and RVE (P = 0.020). No differences between RE and RVE were observed. CONCLUSIONS: In conclusion, a short-duration RVE or RE can be effective in reducing the effect of prolonged bed rest on lower extremity muscle volume loss during bed rest and muscle damage and pain after bed rest.