Non-traditional HIIT-style ROTC training elicits positive bone quality and performance adaptations.

Military personnel experience elevated bone injury incidence, partly due to arduous and repetitive training. Non-traditional High-Intensity Interval Training-style (HIIT) may benefit pre-enlisted Reserve Officer Training Corps (ROTC) cadet's musculoskeletal health and performance prior to military service. This study investigated 16 ROTC (n = 12 males; n = 4 females) and 15 physically active sex-, age-, and body mass-matched Controls' musculoskeletal health and performance from November to April. Total body, lumbar spine, and dual- hip dual-energy X-ray absorptiometry scans and 4%, 38%, 66% tibial peripheral quantitative computed tomography scans, blood draws (serum sclerostin and parathyroid hormone), and maximal muscle strength and aerobic capacity testing were completed. From November to April, ROTC improved bone density (DXA) of the dominant total hip and greater trochanter and non-dominant greater trochanter and 38% and 66% tibial total volumetric and cortical bone density (pQCT) similarly or more than Controls (all p ≤ 0.049). From November to April, ROTC also improved bench and leg press, and peak aerobic capacity (all p ≤ 0.013). From November to January, serum sclerostin increased (p ≤ 0.007) and remained elevated through April, while parathyroid hormone was unchanged. HIIT-style training induced positive musculoskeletal adaptations, suggesting it may be an excellent pre-service training modality for this injury prone group.

Carbohydrate Mouth Rinsing Does Not Alter Central or Peripheral Fatigue After High-Intensity and Low-Intensity Exercise in Men.

ABSTRACT: Black, CD, Haskins, KR, Bemben, MG, and Larson, RD. Carbohydrate mouth rinsing does not alter central or peripheral fatigue after high-intensity and low-intensity exercise in men. J Strength Cond Res 36(1): 142-148, 2022-Carbohydrate (CHO) mouth rinsing improves performance during endurance exercise. However, its ability to attenuate fatigue during strength-based exercise is less certain. This study sought to determine the effects of a CHO mouth rinse on torque production and voluntary activation (VA%) after high-intensity and low-intensity isometric exercise. Twelve male subjects (22.5 ± 2.3 years; 183.5 ± 6.5 cm; 82.2 ± 13.9 kg) completed 4 testing sessions in a double-blind crossover fashion. Knee extension maximal voluntary isometric strength (MVC) was assessed before(Pre), immediately (iPost-Ex), and 5 minutes (5-min Post Ex) after isometric exercise performed at 80% or 20% of MVC. An 8% CHO solution or placebo (PLA) was rinsed for 20 seconds after exercise. VA% was determined by twitch interpolation. A 2 condition (CHO vs. PLA) × 2 contraction intensity (20 vs. 80%) × 3 time (Pre, iPost Ex, and 5-min Post Ex) completely within subject-repeated measured analysis of variance was performed; statistical significance was set at p ≤ 0.05. Greater reductions in MVC were found at iPost-Ex after exercise at 20% compared with 80% of MVC (-25 ± 14% vs. -11 ± 8%; p < 0.001) as well as for VA% (-17 ± 14% vs. -8 ± 14%; p < 0.004). No differences were observed in the CHO vs. PLA condition (p ≥ 0.34). We were successful in eliciting differing levels of central and peripheral fatigue by exercising at a low and high intensity. Despite significantly larger declines in VA% after exercise at 20% of MVC, CHO mouth rinsing had no effects compared with placebo on any measured variable.

Effects of Collagen Peptides on Recovery Following Eccentric Exercise in Resistance-Trained Males-A Pilot Study.

The authors sought to determine whether consuming collagen peptides (CP) enhances musculoskeletal recovery of connective tissues following a damaging exercise bout. Resistance-trained males consumed 15 g/day of CP (n = 7) or placebo (n = 8), and after 7 days, maximal voluntary isometric contraction (MVIC), countermovement jump height, soreness, and collagen turnover were examined. Five sets of 20 drop jumps were performed and outcome measures were collected 24, 48, and 120 hr postexercise. Countermovement jump height was maintained in the CP group at 24 hr (PRE = 39.9 ± 8.8 cm vs. 24 hr = 37.9 ± 8.9 cm, p = .102), whereas the CP group experienced a significant decline at 24 hr (PRE = 40.4 ± 7.9 cm vs. 24 hr = 35.5 ± 6.4 cm, p = .001; d = 0.32). In both groups, muscle soreness was significantly higher than PRE at 24 hr (p = .001) and 48 hr (p = .018) but not at 120 hr (p > .05). MVIC in both legs showed a significant time effect (left: p = .007; right: p = .010) over the 5-day postexercise period. Neither collagen biomarker changed significantly at any time point. CP supplementation attenuated performance decline 24 hr following muscle damage. Acute consumption of CP may provide a performance benefit the day following a bout of damaging exercise in resistance-trained males.

Endogenous Pain Inhibitory Function: Endurance-Trained Athletes vs Active Controls.

OBJECTIVE: Athletes are at risk for developing chronic pain conditions, but the role of exercise in the modulation of pain in athletes has not been well established. The aim of this study was to investigate conditioned pain modulation (CPM) and exercise-induced hypoalgesia (EIH) responses between 13 endurance-trained athletes and 13 normally active controls. METHODS: In a cross-sectional, nonrandomized study with two independent groups of college-aged males and females, pressure pain thresholds (PPTs) were assessed in the vastus lateralis (VL) and brachioradialis (BR) using a pressure algometer before and after a conditioning stimulus, an isometric hand grip exercise to failure, and a 30-minute run. RESULTS: PPTs increased following the conditioning stimulus, indicating a CPM response, to a similar degree in the BR (19.3% ± 26.5% vs 18.6% ± 16.2%, P = 0.93) and VL (18.9% ± 25.9% vs 28.7% ± 27.4%, P = 0.73) in the athletes and controls. PPTs increased following isometric exercise to a similar extent in athletes and controls in the BR (23.9% ± 22.8% vs 28.2% ± 24.0%, P = 0.75) and VL (15.8% ± 14.8% vs 15.5% ± 11.6%, P = 0.94). Following 30 minutes of running, EIH was similar between athletes and controls in the VL (21.2% ± 17.2% vs 13.8% ± 13.3%, P = 0.23) but was attenuated in the BR of the athletes (6.1% ± 16.9% vs 20.9% ± 20%, P = 0.047). CONCLUSIONS: Athletes and controls exhibited similar endogenous pain inhibitory function both locally and systemically following CPM and isometric, upper body exercise. After the 30-minute run, BR EIH was reduced in the athletes compared with controls, suggesting a reduced systemic response following familiar exercise-perhaps due to the exercise being perceived as less painful and/or effortful.

Estimation of critical end-test torque using neuromuscular electrical stimulation of the quadriceps in humans.

Characterization of critical power/torque (CP/CT) during voluntary exercise requires maximal effort, making difficult for those with neuromuscular impairments. To address this issue we sought to determine if electrically stimulated intermittent isometric exercise resulted in a critical end-test torque (ETT) that behaved similar to voluntary CT. In the first experiment participants (n = 9) completed four bouts of stimulated exercise at a 3:2 duty cycle, at frequencies of 100, 50, 25 Hz, and a low frequency below ETT (Sub-ETT; ≤ 15 Hz). The second experiment (n = 20) consisted of four bouts at a 2:2 duty cycle-two bouts at 100 Hz, one at an intermediate frequency (15-30 Hz), and one at Sub-ETT. The third experiment (n = 12) consisted of two bouts at 50 Hz at a 3:2 duty* cycle with proximal blood flow occlusion during one of the bouts. ETT torque was similar (p ≥ 0.43) within and among stimulation frequencies in experiment 1. No fatigue was observed during the Sub-ETT bouts (p > 0.05). For experiment 2, ETT was similar at 100 Hz and at the intermediate frequency (p ≥ 0.29). Again, Sub-ETT stimulation did not result in fatigue (p > 0.05). Altering oxygen delivery by altering the duty cycle (3:2 vs. 2:2; p = 0.02) and by occlusion (p < 0.001) resulted in lower ETT values. Stimulated exercise resulted in an ETT that was consistent from day-to-day and similar regardless of initial torque, as long as that torque exceeded ETT, and was sensitive to oxygen delivery. As such we propose it represents a parameter similar to voluntary CT.

Carbohydrate Mouth Rinsing Does Not Prevent the Decline in Maximal Strength After Fatiguing Exercise.

Black, CD, Schubert, DJ, Szczyglowski, MK, and Wren, JD. Carbohydrate mouth rinsing does not prevent the decline in maximal strength after fatiguing exercise. J Strength Cond Res 32(9): 2466-2473, 2018-Carbohydrate (CHO) rinsing has been shown to attenuate the decline of maximal voluntary contractions (MVCs) after fatiguing exercise-perhaps through a central mechanism. This study sought to determine the effect of a CHO rinse on MVC, voluntary activation, and contractile properties after fatiguing exercise. Thirteen adults participated in a double-blind, cross-over study. Maximal voluntary contraction of the dominant knee extensors was assessed, and voluntary activation (%VA) was determined using twitch interpolation. Participants then held 50% of MVC until volitional fatigue followed by a 20-second rinse with a solution of 8% maltodextrin (CHO) or placebo (PLA). Maximal voluntary contraction and %VA were reassessed immediately and 5 minutes after exercise. Maximal voluntary contraction did not differ between the CHO and PLA conditions initially (230 ± 90 vs. 232 ± 90 N·m; p = 0.69). Maximal voluntary contraction declined after exercise (p ≤ 0.01), but no differences were found between the CHO and PLA conditions (p ≥ 0.59). %VA did not differ between conditions (91.9 ± 2.9% vs. 91.5 ± 3.8%; p ≥ 0.11) nor did it change after exercise (p = 0.57). Twitch torque, rate of torque development, and rate of torque relaxation were reduced after exercise (p ≤ 0.05) but were unaffected by CHO rinsing (p > 0.05). Unlike a previous study, a CHO rinse did not preserve MVC after fatiguing exercise. This was likely due to a lack of central fatigue induced by the exercise protocol (as %VA was unaffected) as the CHO rinse is thought to work through a central mechanism.

The effects of exercise-induced muscle damage on critical torque.

OBJECTIVE: Exercise-induced muscle damage (EIMD) has been shown to reduce endurance exercise performance. This study examined the effects of EIMD on critical torque (CT) and the sum of the torque integral above CT during (∫ T total) during a 5-min all-out, intermittent isometric knee extension exercise. METHODS: CT was determined in eight participants prior to and 48-h following EIMD. EIMD was induced using electrically stimulated eccentric knee extensions until maximal voluntary strength (MVC) was reduced by 40%. EIMD was assessed by changes in MVC and ratings of muscle soreness using a VAS scale. EMG and near-infrared spectroscopy (NIRS) were collected from the vastus lateralis and vastus medialis, respectively, during the CT test to assess neuromuscular electrical activity and microvascular circulation. RESULTS: MVC decreased 22% (p = 0.006) and soreness increased from 2.1 ± 1.9 to 50.4 ± 31.5 mm (p = 0.002) 48-h following eccentric exercise. CT declined from 61.6 ± 17.8 to 52.0 ± 14.1 Nm (-14%; p = 0.005) post-EIMD. ∫ T total declined 33% (p = 0.0006) post-EIMD. No changes were observed in neuromuscular electrical activity (p = 0.95 for EMG RMS and p = 0.57 for EMG median frequency) or any parameter of microvascular circulation (p = 0.60 for tissue saturation index, p = 0.27 for total hemoglobin and myoglobin, p = 0.51 for oxyhemoglobin, and p = 0.26 for deoxyhemoglobin) between conditions. CONCLUSIONS: Our finding that EIMD-reduced CT may explain the decrements in endurance performance following EIMD observed in the previous studies. The disproportionate reduction in ∫ T total compared to MVC and CT is suggestive of a more rapid depletion of anaerobic energy stores and/or accumulation of metabolic by-products leading to fatigue following EIMD.

Local and Generalized Endogenous Pain Modulation in Healthy Men: Effects of Exercise and Exercise-Induced Muscle Damage.

Isometric exercise has been shown to activate endogenous pain inhibitory pathways in healthy adults, but not in some clinical pain populations. OBJECTIVE: Exercise-induced muscle damage (EIMD) and the associated delayed-onset muscle soreness (DOMS) are a model for studying clinical pain; thus, our purpose was to examine the effects of isometric exercise on pressure pain threshold (PPT) in the presence and absence of DOMS. METHODS: Data were collected on 23 males (22.8 ± 2.5 yrs). PPT was assessed in the right (exercising) and left (resting) quadriceps prior to, every 30 seconds during, and 2 and 15 minutes following an isometric contraction of the right quadriceps at 25% of maximal voluntary contraction (MVC) held until fatigue. Unilateral eccentric exercise was performed to induce DOMS in the exercising leg and testing was repeated 48 hours later. RESULTS: DOMS increased (P < 0.001) and resting PPT decreased (P = 0.03) following EIMD. PPTs were elevated during exercise in the exercising (P ≤ 0.002) and resting (P ≤ 0.002) quadriceps but did not differ between the control and EIMD conditions in either leg (P ≤ 0.61). PPT remained elevated 2 and 15 minutes postexercise (P < 0.05) in the exercised quadriceps in both conditions, but values returned to baseline at 2 (P = 0.91) and 15 minutes (P = 0.28) postisometric exercise in the resting quadriceps. CONCLUSIONS: Unlike clinical pain, DOMS had no effect on the PPT response during exercise in either the exercising or resting quadriceps. The fact that exercise altered PPT in both quadriceps during exercise suggests a generalized pain inhibitory mechanism was activated. However, the restriction of postexercise effects to the exercised limb suggests localized inhibitory mechanism(s) were activated after exercise.

Delayed-Onset Muscle Soreness Alters Mechanical Sensitivity, but Not Thermal Sensitivity or Pain Modulatory Function.

Introduction: Many clinical musculoskeletal pain conditions are characterized by chronic inflammation that sensitizes nociceptors. An unresolved issue is whether inflammation affects all nociceptors in a similar manner. Exercise-induced muscle damage (EIMD) has been proposed as a model for simulating clinical inflammatory pain in healthy samples. We sought to test the effect of EIMD on various painful stimuli (pressure and thermal), central pain processing (via the nociceptive flexion reflex) and endogenous pain modulation via conditioned pain modulation and exercise-induced hypoalgesia. Methods: Eighteen participants (9F, age: 24.6 ± 3.3) were recruited for repeated measures testing and each completed pain sensitivity testing prior to and 48 hours after an eccentric exercise protocol. The participants performed a minimum of 6 rounds of 10 eccentric knee extension exercises to induce muscle damage and localized inflammation in the right quadriceps. Force decrements, knee range-of-motion, and delayed onset muscle soreness (DOMS) were used to quantify EIMD. Results: There was a significant main effect of time for pressure pain (%diff; -58.9 ± 23.1; p = 0.02, ηp2 = 0.28) but no significant main effect was observed for limb (%diff; -15.5 ± 23.9; p = 0.53, ηp2 = 0.02). In contrast, there was a significant interaction between time and limb (p < 0.001, ηp2 = 0.47) whereby participants had lower pressure pain sensitivity in the right leg only after the damage protocol (%diff; -105.9 ± 29.2; p = 0.002). Discussion: Individuals with chronic inflammatory pain usually have an increased sensitivity to pressure, thermal, and electrical stimuli, however, our sample, following muscle damage to induce acute inflammation only had sensitivity to mechanical pain. Exercise induced inflammation may reflect a peripheral sensitivity localized to the damaged muscle rather than a global sensitivity like those with chronic pain display.

Ankle dorsiflexion asymmetry and the relationship with walking performance in people with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a neurological disease characterized by demyelination disrupting the central nervous system. Persons with MS may exhibit symptomatic strength asymmetry (SA) that impacts motor gait and ankle mobility. The purpose of the present study was to investigate ankle dorsiflexion SA in people with MS and its relationship to functional performance. RESEARCH QUESTION: Is their a difference in dorsiflexion SA in MS participants compared to healthy individuals and does it impact functional performance? METHODS: 13 MS participants (EDSS 3.5 + 1.8) and 13 age matched NON-MS participants underwent maximal isometric (MVC) dynamometry testing for ankle dorsiflexion in both limbs to determine SA. Participants performed three functional tasks of walking performance. RESULTS: There was a significant intra-limb MVC difference in the MS group, and significantly greater isometric SA (p < 0.007) and isokinetic SA (p < 0.04) in the MS group compared to healthy individuals. The MS group exhibited significant correlations between outcomes of functional walking performance with isokinetic but not isometric SA. There was no significant correlation between disability status and functional task performance. SIGNIFICANCE: Ankle dorsiflexion SA is negatively correlated with functional performance in MS participants. MS disability status was not a predictor of functional task performance, and symptom testing may be appropriate to assess walking ability in persons with MS.

Higher rating of perceived exertion and lower perceived recovery following a graded exercise test during menses compared to non-bleeding days in untrained females.

The underrepresentation of the female population in exercise sciences could be attributed, at least in part, to difficulty in appropriately accounting for the effects of the menstrual cycle (MC). Previous studies examining the effects of the MC on aerobic performance and subjective measures of aerobic performance show conflicting results. Purpose: The study examined how the MC affects the objective and subjective measures of aerobic performance within untrained female participants and in comparison with untrained male participants assessed at similar time intervals. Methods: Twenty-one participants (12 females and 9 males) completed a graded exercise test (GXT) on a cycle ergometer. The female participants were tested during their early follicular (EF; menses), ovulatory (O), and mid-luteal (ML) phases of the MC. The male participants were included as the control group and were randomly assigned to a menstrual cycle phase for each visit. During GXT, maximal oxygen consumption (VO2max), respiratory exchange ratio (RER), maximal heart rate (HRmax), peak blood lactate, and rating of perceived exertion (RPE) were determined. Twenty-four hours post-exercise, the perceived recovery status (PRS) was assessed. The MC phase was estimated using basal body temperature (BBT) in the female participants. Results: The male participants obtained a higher peak power and VO2max compared to the female participants (p < 0.05). All objective measures of aerobic performance did not significantly differ across the MC phases or time points that were tested. In the untrained female participants, an effect of the MC phase on RPE was found, with RPE being higher at EF (8.92 ± 0.79) compared to O (7.67 ± 1.23; p < 0.05) and ML (7.75 ± 1.06; p < 0.05). In addition, an effect of the MC phase on PRS was found, with perceived recovery being lower at EF (6.83 ± 0.94) compared to O (8.83 ± 1.12) and ML (8.67 ± 0.65; all p < 0.005) for the untrained female participants. No significant differences in RPE and PRS were found between tests in the untrained male participants. The female participants had lower perceived recovery following EF (6.83 ± 0.94) compared with the male participants (9.00 ± 1.00; p < 0.001). Conclusion: The untrained female participants perceived greater exertion during GXT and impaired recovery following GXT in EF compared to O and ML. These results may be attributed to either a drop in female sex hormone concentrations or discomfort associated with menses. The male participants did not exhibit any changes over time. Future studies using subjective parameters such as perceived exertion to track the internal load of training in the naturally menstruating female population should consider menses.

Phase I study of heat-deployed liposomal doxorubicin during radiofrequency ablation for hepatic malignancies.

PURPOSE: A phase I dose escalation study was performed with systemically delivered lyso-thermosensitive liposomal doxorubicin (LTLD). The primary objectives were to determine the safe maximum tolerated dose (MTD), pharmacokinetic properties, and dose-limiting toxicity (DLT) of LTLD during this combination therapy. MATERIALS AND METHODS: Subjects eligible for percutaneous or surgical radiofrequency (RF) ablation with primary (n = 9) or metastatic (n = 15) tumors of the liver, with four or fewer lesions as large as 7 cm in diameter, were included. RF ablation was initiated 15 minutes after starting a 30-minute intravenous LTLD infusion. Dose levels between 20 mg/m(2) and 60 mg/m(2) were evaluated. Magnetic resonance imaging, positron emission tomography, and computed tomography were performed at predetermined intervals before and after treatment until evidence of recurrence was seen, administration of additional antitumor treatment was performed, or a total of 3 years had elapsed. RESULTS: DLT criteria were met at 60 mg/m(2), and the MTD was defined as 50 mg/m(2). RF ablation was performed during the peak of the plasma concentration-time curve in an effort to yield maximal drug deposition. LTLD produced reversible, dose-dependent neutropenia and leukopenia. CONCLUSIONS: LTLD can be safely administered systemically at the MTD (50 mg/m(2)) in combination with RF ablation, with limited and manageable toxicity. Further evaluation of this agent combined with RF ablation is warranted to determine its role in the management of liver tumors.

Prior eccentric exercise reduces v[combining dot above]o2peak and ventilatory threshold but does not alter movement economy during cycling exercise.

Exercise-induced muscle damage (EIMD) has been shown to reduce force production and result in delayed-onset soreness and pain in the damaged muscle(s). Cycling in the presence of EIMD reduces peak power output and time-trial performance. However, its effect on peak aerobic capacity has not been widely studied. The purpose of this study was to examine the impact of EIMD targeted specifically to the quadriceps muscle group on peak oxygen consumption (V[Combining Dot Above]O2peak) during cycling. Ten participants (4 men, 6 women) completed a V[Combining Dot Above]O2peak test on a cycle ergometer before and 48 hours after performing 24 eccentric contractions with their right and left quadriceps with a weight equal to 120% of 1-repetition maximal concentric strength (1RM). The EIMD was assessed using 1RM, and muscle soreness was assessed using a 100-mm visual analog scale. The presence of EIMD was confirmed by a 9% reduction in 1RM (p = 0.0001) and increased ratings of soreness from 2.4 ± 2.1 to 24.6 ± 10.8 mm (p = 0.001). The V[Combining Dot Above]O2peak was reduced from 46.2 ± 9.7 to 41.8 ± 10.7 ml·kg·min (10%; p = 0.01) with participants terminating exercise at lower heart rates 191 ± 9 vs. 186 ± 10 b·min (p = 0.02) and power output 248 ± 79 vs. 238 ± 81 W (p = 0.02) after EIMD. Additionally, ventilatory threshold decreased from 34.2 ± 7.8 to 30.5 ± 8.5 ml·kg·min (11%; p = 0.031). Despite the reduction in V[Combining Dot Above]O2peak, cycling economy (p = 0.17) did not differ pre-EIMD and post-EIMD. These findings indicate that EIMD reduced peak aerobic exercise capacity to an extent that could result in meaningful reductions in exercise performance. The reduction is likely attributable to a combination of reduced strength, earlier accumulation of lactic acid, and heightened muscle pain during exercise.

Body composition does not influence conditioned pain modulation and exercise-induced hyperalgesia in healthy males and females.

BACKGROUND: Obese individuals report a higher susceptibility to chronic pain. Females are more likely to have chronic pain and excess adipose tissue. Chronic pain is associated with dysfunctional pain-modulatory mechanisms. Body composition differences may be associated with pain modulation differences in males and females. The purpose of this study was to investigate body composition (lean vs fat mass) differences and pain-modulatory functioning in healthy males and females. METHODS: Pressure pain thresholds (PPT) of 96 participants (47 M; 49F) were assessed in both arms and legs before and after a double-footed ice bath (2°C) for 1 min and an isometric knee extension, time to failure task. The difference between post- and pre-measures was defined as conditioned pain-modulatory (CPM) response (ice bath) and exercise-induced hypoalgesia (EIH) response. Whole-body and site-specific fat and lean tissue were assessed via the DXA scan. RESULTS: Sex differences were found in whole-body lean mass (61.5 ± 6.7 kg vs 41.2 ± 5.4 kg; p < 0.001) but not fat mass amount (17.2 ± 10.5 kg vs 21.0 ± 9.7 kg; p = 0.068). No effect of sex was found between limb CPM (p = 0.237) and limb EIH (p = 0.512). When controlling for lean mass, there was no significant effect of sex on CPM (p = 0.732) or EIH (p = 0.474) response. Similar findings were found for fat mass. CONCLUSION: The lack of difference suggests that males and females have similar modulatory functioning. It appears that in healthy adults free from chronic pain, neither fat mass nor lean mass has an influence on endogenous pain-modulatory function. SIGNIFICANCE: Men and women exhibited similar CPM and EIH despite marked differences in body composition. Our findings suggest whole-body and limb-specific lean tissue mass and fat mass do not influence CPM and EIH in adults without chronic pain.

Bone, Biomarker, Body Composition, and Performance Responses to 8 Weeks of Reserve Officers' Training Corps Training.

CONTEXT: Military personnel engage in vigorous exercise, often resulting in higher bone mineral density; however, leg bone injuries occur frequently in this population. Predictors of change in tibial bone quality and strength need to be characterized in this high-risk population. OBJECTIVES: To examine the effects of an 8-week military training intervention on total body and site-specific bone density and tibial bone quality, serum biomarkers (parathyroid hormone and sclerostin), body composition, and physical performance and to investigate which outcome variables (biomarkers, body composition, and physical performance) predict estimated tibial bone strength in college-aged Reserve Officers' Training Corps (ROTC) participants. DESIGN: Prospective cohort study. SETTING: University of Oklahoma. PATIENTS OR OTHER PARTICIPANTS: The ROTC participants (14 males, 4 females) were matched for sex, age, and mass to physically active control participants (14 males, 4 females). The ROTC participants engaged in an 8-week training intervention, while the physically active control group made no changes to their exercise routines. MAIN OUTCOME MEASURE(S): Preintervention general health questionnaires were completed. Pre-, mid-, and postintervention bone scans (dual-energy x-ray absorptiometry and peripheral quantitative computed tomography); serum blood draws (parathyroid hormone and sclerostin); and physical performance measures (muscle strength and aerobic capacity) were obtained. RESULTS: The ROTC participants exhibited increased hip bone density mineral and content (both P values ≤ .02) after the 8-week intervention. Sclerostin, but not parathyroid hormone, was a positive correlate and predictor in all ROTC models for estimated bone strength at the fracture-prone 38% tibial site (ie, 38% of the tibial length proximal to the distal end of the tibia). Both groups displayed decreased total body and regional fat mass, and ROTC participants' aerobic capacity increased (all P values ≤ .05). CONCLUSIONS: All bone, body composition, and performance measures either improved or were maintained in response to ROTC training. Sclerostin should be further investigated as a potential early indicator of changes in estimated tibial bone strength in military cohorts.

Lean Mass is Associated with, but Does Not Mediate Sex Differences in Pressure Pain Sensitivity in Healthy Adults.

Background: Sex differences exist in pain sensitivity, however, the underlying mechanism(s) that explain these differences are not fully understood. Pain sensitivity has been shown to be influenced by body mass index, but limited data exist on the role of body composition on pain sensitivity. The purpose was to examine the influence of body composition on pain sensitivity in males and females. Methods: This cross-sectional study design used pressure pain thresholds (PPT) of 87 participants (45 female) who were assessed in the vastus lateralis (leg PPT) and brachioradialis (arm PPT) using a pressure algometer. Fat and lean tissue were assessed via dual-energy X-ray absorptiometry (DXA). A two group by two limb, repeated measured ANOVA was used to assess differences between limbs and sex. Spearman correlations and hierarchical regression analyses were employed to determine the association between body composition and PPT. Results: Males had higher PPTs then females (P<0.05) and had higher DXA assessed lean and lower levels fat mass (P<0.05). Total body and limb specific lean mass was associated with PPTs (r≥0.34; P<0.05). Hierarchical regression analysis revealed lean mass was a significant predictor of 8% of the variance in arm PPT (P<0.006) and 18% of the variance in leg PPT (P<0.001). However, lean mass was not found to statistically mediate the observed sex differences in PPT. Conclusion: This finding suggests lean mass may play a previously unknown role in sex differences in pressure pain sensitivity. Future studies are needed to confirm this finding and a larger sample size is likely required to have sufficient power to perform the mediation analysis.

Social Distancing, Psychological Mood and Physical Activity Behavior During COVID-19 in the United States.

Social distancing, during previous epidemics, has been shown to lead to poor mental health outcomes and reduced physical activity. The purpose of the present study was to examine the relationships between self-reported psychological state and physical activity behaviors of individuals under social distancing policies during the COVID-19 pandemic. 199 individuals (29.85 ± 10.22 yrs) in the United States who had been in social distancing for 2-4 weeks participated in this study. Participants answered a questionnaire regarding feelings of loneliness, depression, anxiety, mood state, and physical activity. 66.8% of participants had depressive symptoms and 72.8% had symptoms of anxiety. Loneliness was correlated with depression (r = 0.66), trait anxiety (r = 0.36), fatigue (r = 0.38), confusion (r = 0.39), and total mood disturbance (TMD; r = 0.62). Participation in total physical activity was negatively associated with depressive symptoms (r = -0.16) and TMD (r = -0.16). State anxiety was positively associated with participation in total physical activity (r = 0.22). In addition, a binomial logistic regression was performed to predict participation in sufficient physical activity. The model explained 45% of the variance in physical activity participation and correctly categorized 77% of cases. Individuals with higher vigor scores had an increased likelihood of participating in sufficient physical activity. Loneliness was associated with negative psychological mood state. Individuals with higher feelings of loneliness, depressive symptoms, trait anxiety, and negative mood state were observed to spend less time engaged in physical activity. Higher state anxiety was positively associated with engagement in physical activity.

Symptomatic but not Asymptomatic COVID-19 Impairs Conditioned Pain Modulation in Young Adults.

Pain is a common symptom reported in COVID-19 patients. Impaired endogenous pain-modulatory mechanisms such as conditioned pain modulation (CPM), and exercise-induced hypoalgesia (EIH) have been found in chronic pain conditions but is often overlooked in acute conditions that evoke painful symptoms, such as COVID-19. The purpose was to compare pressure-pain sensitivity, CPM, and EIH function among individuals who previously had COVID-19, both symptomatically and asymptomatically, and a healthy control group. Pressure pain thresholds of 59 participants were assessed in the forearm and leg using a pressure algometer before and after 1) submersion of their dominant foot in cold water (2°C) for 1min; and 2) isometric knee extension performed to task-failure at 25% of their maximal contraction. The CPM response was attenuated in individuals who were infected with symptomatic COVID-19 (N = 26) compared to asymptomatic COVID-19 (N = 13) in arm (-1.0% ± 20.3 vs 33.3% ± 26.2; P < .001) and leg (12.8% ± 22.0 vs 33.8% ± 28.2; P = .014) and compared to controls (N = 20) in arm only (-1.0% ± 26.2 vs 23.4% ± 28.2; P = .004). The EIH response was not different between groups. CPM was impaired in individuals who had symptomatic COVID-19, which may have long-term implications on pain modulation. PERSPECTIVE: This study reveals that CPM was impaired in individuals who had symptomatic COVID-19 during the first wave of COVID-19, pre vaccine. These findings present a preliminary motive to study the long-term implications of COVID-19 and its effects on pain modulation.

Circulating microRNA responses to acute whole-body vibration and resistance exercise in postmenopausal women.

Evaluating alterations in circulating microRNA (c-miRNA) expression may provide deeper insight into the role of exercise in the attenuation of the negative effects of aging on musculoskeletal health. Currently, there are sparse data on c-miRNA responses to acute exercise in postmenopausal women. The purpose of this study was to characterize the effects of acute bouts of resistance exercise and whole-body vibration on expression of selected c-miRNAs in postmenopausal women aged 65-76 years (n=10). We also examined relationships between c-miRNAs and muscle strength and bone characteristics. This randomized crossover design study compared c-miRNA responses to a bout of resistance exercise (RE) (3 sets 10 reps 70% 1 repetition maximum (1RM), 5 exercises) and a bout of whole-body vibration (WBV) (5 sets 1 min bouts 20Hz 3.38mm peak to peak displacement, Vibraflex vibration platform). DXA was used to measure body composition and areal bone mineral density (aBMD) of the total body, AP lumbar spine, and dual proximal femur. pQCT was used to measure tibia bone characteristics (4%, 38%, 66% sites). Blood samples were collected before exercise (Pre), immediately-post (IP), 60 minutes post (60P), 24 hours (24H), and 48 hours (48H) after exercise to measure serum miR-21-5p, -23a-3p, -133a-3p, -148a-3p (qPCR) and TRAP5b (ELISA). There was a significant modality × time interaction for c-miR-21-5p expression (p=0.019), which decreased from 60P to 24H after WBV only. TRAP5b serum concentrations significantly increased IP then decreased below Pre at 24H for both WBV and RE (p<0.01). Absolute changes in TRAP5b were negatively correlated with c-miR-21-5p fold changes (r= -0.642 to -0.724, p<0.05) for both exercise modalities. There were significant negative correlations between baseline c-miRNAs and bone status variables (r= -0.639 to -0.877, p<0.05). Our findings suggest that whole-body vibration is a sufficient mechanical stimulus for altering c-miR-21-5p expression, whereas a high intensity resistance exercise protocol did not elicit any c-miRNA responses in postmenopausal women. Increases in the bone resorption marker, TRAP5b, were associated with greater downregulation of c-miR-21-5p expression.

Short-Term Analysis (8 Weeks) of Social Distancing and Isolation on Mental Health and Physical Activity Behavior During COVID-19.

Due to the COVID-19 pandemic, cities and states adopted social distancing, social isolation, or quarantine measurements to slow the transmission of the disease. Negative mental health outcomes including depression and anxiety have been associated with social distancing or social isolation. The purpose of the present study was to examine changes in psychological health and physical activity over an 8 week period under social distancing policies during the COVID-19 pandemic. Methods: Ninety (73.3% female; age 32.04 ± 11.33) individuals participated in this study. Qualifying participants answered questions using an online survey regarding their loneliness, depressive symptoms, anxiety symptoms, mood state, and physical activity over four time points each lasting two weeks. Results: Symptoms of depression and state anxiety were increased in the population when compared to nationwide statistics from before the COVID-19 pandemic. Time point 2, ~1 month into social isolation, showed the most significant effects on mental health. During this time point, 100% of the participants showed symptoms of depression. There were no significant changes in physical activity over the 8 weeks. Loneliness, depressive symptoms, fatigue, and mood state were negatively associated with participation in physical activity. Vigor and state anxiety were associated with participation in physical activity. Conclusion: Social isolation and social distancing practices have had a negative effect on depression, anxiety, and mood over time. It appeared that depressive symptoms and total mood disturbance was elevated during time point two. Depressive symptoms were much higher than average compared to previous epidemiological data. Physical activity amount did not change over time but was associated with poor mental health.