Aerobic Training With Blood Flow Restriction on Muscle Hypertrophy and Strength: Systematic Review and Meta-analysis.

ABSTRACT: de Lemos Muller, CH, Farinha, JB, Leal-Menezes, R, and Ramis, TR. Aerobic training with blood flow restriction on muscle hypertrophy and strength: systematic review and meta-analysis. J Strength Cond Res 38(7): 1341-1349, 2024-Integrating strength and endurance training in a single exercise session, even on separate days, can be physically demanding and time-consuming. Therefore, there is a growing interest in identifying efficient training methods that can concurrently enhance cardiovascular and neuromuscular performance through a singular training modality. This study conducted a systematic review and meta-analysis to explore the effects of aerobic training with blood flow restriction (AT + BFR) on muscle hypertrophy and strength gains in healthy individuals. Our study was registered at PROSPERO and used multiple databases (PubMed, Embase, Scopus, and Web of Science), seeking clinical trials that examined AT + BFR influence on muscle hypertrophy and strength gains in individuals aged 18-60 years and comparing with aerobic training without BFR. The risk of bias and method quality were assessed using the ROB2.0 tool and PEDro scale, respectively, and the quality of evidence was evaluated with the GRADE method. A random-effects model was used for meta-analysis, and standardized mean difference (SMD) was calculated for each outcome. Of 4,462 records, 29 full texts were assessed for eligibility, with 7 articles meeting the inclusion criteria. The results indicated that AT + BFR was more beneficial for inducing muscle hypertrophy than aerobic training without BFR (SMD [95% CI] = 0.86 [0.37-1.35]; I2 = 42%). Furthermore, AT + BFR was associated with greater improvements in muscle strength (SMD [95% CI] = 0.41 [0.10-0.72]; I2 = 0%). Despite the generally high risk of bias for both outcomes, these encouraging findings underscore the clinical significance of AT + BFR as a compelling tool for enhancing neuromuscular parameters.

Diclofenac attenuates inflammation through TLR4 pathway and improves exercise performance after exhaustive swimming.

BACKGROUND: The use of NSAIDs has become a common practice to counteract the pro-inflammatory acute effects of exercise, in order to improve sports performance. The liver, due to its central role in energy metabolism, may be involved primarily in the process of ROS generation and consequently inflammation after exhaustive exercise. OBJECTIVE: To analyze the influence of diclofenac on the liver TLR4 pathway and time to exhaustion in rats submitted to repeated exhaustive swimming. METHODS: An exhaustive test was performed in order to mimic athletes' routine, and inflammatory status and oxidative stress markers were evaluated in the liver. Animals were divided into sedentary and exhaustion groups, with this last performing three exhaustive swimming bouts. At the same time, diclofenac or saline was pre-administered once a day for nine days. RESULTS: Data showed significantly increased COX-2, TLR4, and MyD88 protein content in the liver after exhaustive swimming bouts. The levels of pro-inflammatory cytokines also increased after exhaustive exercise, while these effects were attenuated in the group treated with diclofenac plus exhaustive swimming bouts. The anti-inflammatory modulation provoked by diclofenac treatment was associated with an increased time to exhaustion in the exercise bouts. The exhaustive exercise increased TBARS formation, but diclofenac treatment blunted this elevation, while GSH/GSSG ratios in both exhaustion-saline and exhaustion-diclofenac-treated groups were lower than in the sedentary-saline group. CONCLUSIONS: Our findings suggest that diclofenac may improve exercise performance and represent an effective tool to ameliorate the pro-inflammatory status in liver when associated with exhaustive exercise, and the liver may be a possible therapeutic target.

Superior Effects of High-Intensity Interval vs. Moderate-Intensity Continuous Training on Endothelial Function and Cardiorespiratory Fitness in Patients With Type 1 Diabetes: A Randomized Controlled Trial.

This study aimed to compare the effect of high-intensity interval training (HIIT) with moderate-intensity continuous training (MCT) on endothelial function, oxidative stress and clinical fitness in patients with type 1 diabetes. Thirty-six type 1 diabetic patients (mean age 23.5 ± 6 years) were randomized into 3 groups: HIIT, MCT, and a non-exercising group (CON). Exercise was performed in a stationary cycle ergometers during 40 min, 3 times/week, for 8 weeks at 50-85% maximal heart rate (HRmax) in HIIT and 50% HRmax in MCT. Endothelial function was measured by flow-mediated dilation (FMD) [endothelium-dependent vasodilation (EDVD)], and smooth-muscle function by nitroglycerin-mediated dilation [endothelium-independent vasodilation (EIVD)]. Peak oxygen consumption (VO2peak) and oxidative stress markers were determined before and after training. Endothelial dysfunction was defined as an increase < 8% in vascular diameter after cuff release. The trial is registered at ClinicalTrials.gov, identifier: NCT03451201. Twenty-seven patients completed the 8-week protocol, 9 in each group (3 random dropouts per group). Mean baseline EDVD was similar in all groups. After training, mean absolute EDVD response improved from baseline in HIIT: + 5.5 ± 5.4%, (P = 0.0059), but remained unchanged in MCT: 0.2 ± 4.1% (P = 0.8593) and in CON: -2.6 ± 6.4% (P = 0.2635). EDVD increase was greater in HIIT vs. MCT (P = 0.0074) and CON (P = 0.0042) (ANOVA with Bonferroni). Baseline VO2peak was similar in all groups (P = 0.96). VO2peak increased 17.6% from baseline after HIIT (P = 0.0001), but only 3% after MCT (P = 0.055); no change was detected in CON (P = 0.63). EIVD was unchanged in all groups (P = 0.18). Glycemic control was similar in all groups. In patients with type 1 diabetes without microvascular complications, 8-week HIIT produced greater improvement in endothelial function and physical fitness than MCT at a similar glycemic control.

Effects of Two Combined Exercise Designs Associated With High-Fat Meal Consumption on Postprandial Lipemia, Insulinemia, and Oxidative Stress.

Farinha, JB, Macedo, CEO, Rodrigues-Krause, J, Krüger, RL, Boeno, FP, Macedo, RCO, Queiroz, JN, Teixeira, BC, and Reischak-Oliveira, A. Effects of two combined exercise designs associated with high-fat meal consumption on postprandial lipemia, insulinemia, and oxidative stress. J Strength Cond Res 32(5): 1422-1430, 2018-Impaired postprandial lipemia (PPL) response after the consumption of a high-fat meal (HFM) is linked to diabetes, oxidative stress, and cardiovascular events. The aim of this study was to investigate lipid and glucose metabolism and oxidative stress responses of 2 different combined exercise designs associated with HFM consumption. Eleven healthy and physically active men (27.36 ± 5.04 years) participated in this study. After the pretrial visits, participants were randomly assigned to perform 2-day trials in 3 different conditions (interspaced by at least 1 week): resting (REST), circuit combined exercise (CIRC), or traditional combined exercise (COMB), on the evening of day 1. On the morning of day 2, an HFM was provided and blood samples were obtained before and after 1, 3, and 5 hours of HFM consumption. No differences were found with respect to glucose, thiobarbituric acid-reactive substances, or total thiol levels in between time points or conditions. One-way analysis of variance demonstrated a difference between REST and CIRC (p = 0.029; reduction of 35.29%) and between REST and COMB (p = 0.041; reduction of 33.41%) conditions with incremental area under the curve (iAUC) for triacylglycerol levels. A difference between REST and CIRC (p = 0.03; reduction of 34.22%) conditions in terms of iAUC for insulin was also found. Both CIRC and COMB exercise designs can reduce PPL associated with HFM consumption. Moreover, CIRC reduces the iAUC for insulin, suggesting additional benefits for prescribing this type of exercise.