Is Ischemic Preconditioning Intervention Occlusion-Dependent to Enhance Resistance Exercise Performance?

ABSTRACT: de Souza, HLR, Arriel, RA, Hohl, R, da Mota, GR, and Marocolo, M. Is ischemic preconditioning intervention occlusion-dependent to enhance resistance exercise performance? J Strength Cond Res 35(10): 2706-2712, 2021-Ischemic preconditioning is a rising technique with potential to improve performance. Currently, its effects are still controversial, and a placebo effect seems to have a role. In this sense, this study evaluated the effect of high-pressure (HP) and low-pressure (LP) cuffing on resistance exercise performance during repeated 5-day intervention. Twenty healthy trained men (24.0 ± 4.4 years; 80.1 ± 12.2 kg; and 176.9 ± 6.6 cm) performed a 1 repetition maximum (1RM) test before interventions. Maximal isometric force test, number of repetitions (75% 1RM), total workload (sets × reps × load), fatigue index (FI) ([set 1 - set 3]/set 1 × 100), and perceived scales were assessed during knee extension preceded by HP (3 × 5-minute unilateral leg occlusion at 50 mm Hg above systolic blood pressure), LP (3 × 5-minute unilateral leg occlusion at 20 mm Hg), or control ([CON] 30-minute resting). The main effect of cuff intervention was significant for total workload (F(1,16) = 4.2, p = 0.03) after adjusting for baseline (analysis of covariance). Adjusted means (confidence interval) and effect sizes (ES) indicate that HP (1778 kg [1,613-1944]; ES: 0.29) and LP (1761 kg [1,590-1932]; ES: 0.34) significantly increased total workload compared with CON (1,452 kg [1,262-1,643]; ES: 0.17). Finally, isometric force and FI were similar for all conditions (HP, LP, and CON) with no difference from baseline performance. In conclusion, the short-term (5-day) intervention of HP and LP cuffing increases the total workload. This effect in muscle endurance performance is nondependent of blood flow occlusion, since LP is not able to obstruct arterial blood flow. A likely motivational effect cannot be ruled out.

Effect of blood flow occlusion on neuromuscular fatigue following sustained maximal isometric contraction.

Sustained isometric maximal voluntary contractions (IMVCs) have blood flow occlusive effects on the microvasculature. However, it is unknown if this effect would be magnified with additional blood flow restriction via a cuff and what the influence on fatigue development would be. Twelve healthy male participants performed a 1-min IMVC of the knee extensors with and without additional blood flow occlusion induced by pneumatic cuff in counterbalanced order on separate days. Vastus lateralis muscle deoxygenation was estimated via near-infrared spectroscopy-derived tissue oxygen saturation (SmO2) throughout the fatiguing contraction. Central and peripheral measures of neuromuscular fatigue (NMF) were assessed via surface electromyography (EMG) and force responses to voluntary contractions and peripheral nerve/transcranial magnetic stimulations before, immediately after, and throughout an 8-min recovery period. SmO2, force, and EMG amplitude decreased during the 1-min IMVC, but there were no between-condition differences. Similarly, no significant (p > 0.05) between-condition differences were detected for any dependent variable immediately after the fatiguing contraction. Transcranial magnetic stimulation (TMS)-derived voluntary activation was lower (p < 0.05) in the no-cuff condition during the recovery period. Sustained IMVC results in a similar degree of muscle deoxygenation and NMF as IMVCs with additional occlusion, providing further evidence that a sustained IMVC induces full ischemia. Novelty NMF etiology, muscle oxygenation, and corticospinal factors during an IMVC are similar with or without an occlusion cuff. Contrary to all other measures, TMS-evaluated voluntary activation returned to baseline faster following the occluded condition.

Ischemic preconditioning and exercise performance: shedding light through smallest worthwhile change.

Ischemic preconditioning (IPC) has been suggested as a potential ergogenic aid to improve exercise performance, although controversial findings exist. The controversies may be explained by several factors, including the mode of exercise, the ratio between the magnitude of improvement, or the error of measurement and physiological meaning. However, a relevant aspect has been lacking in the literature: the interpretation of the findings considering statistical tests and adequate effect size (ES) according to the fitness level of individuals. Thus, we performed a systematic review with meta-analysis to update the effects of IPC on exercise performance and physiological responses, using traditional statistics (P values), ES, and smallest worth change (SWC) approach contextualizing the IPC application to applied Sports and Exercise performance. Forty-five studies met the inclusion criteria. Overall, the results show that IPC has a minimal or nonsignificant effect on performance considering the fitness level of the individuals, using statistical approaches (i.e., tests with P value, ES, and SWC). Therefore, IPC procedures should be revised and refined in future studies to evaluate if IPC promotes positive effects on performance in a real-world scenario with more consistent interpretation.

Ischemic Preconditioning Maintains Performance on Two 5-km Time Trials in Hypoxia.

PURPOSE: The ergogenic effect of ischemic preconditioning (IPC) on endurance exercise performed in hypoxia remains debated and has never been investigated with successive exercise bouts. Therefore, we evaluated if IPC would provide immediate or delayed effects during two 5-km cycling time trials (TT) separated by ~1 h in hypoxia. METHODS: In a counterbalanced randomized crossover design, 13 healthy males (27.5 ± 3.6 yr) performed two maximal cycling 5-km TT separated by ~1 h of recovery (TT1 25 min and TT2 2 h post-IPC/SHAM), preceded by IPC (3 × 5 min occlusion 220 mm Hg/reperfusion 0 mm Hg, bilaterally on thighs) or SHAM (20 mm Hg) at normobaric hypoxia (fraction of inspired oxygen [FiO2] of 16%). Performance and physiological (i.e., oxyhemoglobin saturation, heart rate, blood lactate, and vastus lateralis oxygenation) parameters were recorded. RESULTS: Time to complete (P = 0.011) 5-km TT and mean power output (P = 0.005) from TT1 to TT2 were worse in SHAM, but not in IPC (P = 0.381/P = 0.360, respectively). There were no differences in time, power output, or physiological variables during the two TT between IPC and SHAM. All muscle oxygenation indices differed (P < 0.001) during the IPC/SHAM with a greater deoxygenation in IPC. During the TT, there was a greater concentration of total hemoglobin in IPC than SHAM (P = 0.047) and greater total hemoglobin in TT1 than TT2. Further, the concentration of oxyhemoglobin was lower during TT2 than TT1 (P = 0.005). CONCLUSION: In moderate hypoxia, IPC allowed maintaining a higher blood volume during a subsequent maximal exercise, mitigating the performance decrement between two consecutive cycling TT.

The Demands of Amputee Soccer Impair Muscular Endurance and Power Indices But Not Match Physical Performance.

We investigated the match demands (distances covered and acute physiological responses) of amputee soccer and its impact on muscular endurance and power. Measures such as heart rate, blood lactate concentration, subjective rating of perceived exertion, and time-motion characteristics were recorded in 16 Brazilian amputee soccer players during matches. Before and after matches, players completed a battery of tests: push-ups, countermovement vertical jump performance, and medicine ball throwing. Small differences were found between the first and second half for the distance covered in total and across various speed categories. Heart rate responses, blood lactate concentrations, and peak speed did not differ between halves, and all neuromuscular performance measures decreased after the match particularly after push-ups, although the rating of perceived exertion increased markedly compared with prematches. Although match physical performances were consistent across halves, the overall demands impaired test performance, especially for upper limb and closed kinetic chain exercise.

The quantification of game-induced muscle fatigue in amputee soccer players.

BACKGROUND: This study quantified the degree of game-induced muscular fatigue in amputee soccer players. METHODS: Thirty-three male amputee soccer players performed muscular tests (Push Up Test [PUT], Countermovement Jump Test [CMJ] and medicine-ball throw [MBT]) before and after a competitive match. Five players served as a control group. The rating of perceived exertion was recorded after each battery. RESULTS: Control group demonstrated no differences between the two testing batteries (P>0.05, effect size [ES]: 0.1-0.4). However, match group illustrated markedly lower performances for PUT (-17%, P<0.01, ES: 0.9) with less pronounced declines in MBT (-8%, P<0.01, ES: 0.7) and CMJ (-5%, P<0.01, ES: 0.3) compared to pre-match values. The rating of perceived exertion were higher after the match compared to baseline values (+60%, P<0.01, ES: 2.4). CONCLUSIONS: The data demonstrate that the fatigue experienced after amputee soccer matches causes impairments in muscular performance and this could be different to able-bodied players.

Optimal load for the peak power and maximal strength of the upper body in Brazilian Jiu-Jitsu athletes.

We determined the optimal load for the peak power output (PPO) during the bench press throw (BPT) in Brazilian Jiu-Jitsu (BJJ) athletes and compared the PPO and maximal strength between advanced (AD) and nonadvanced (NA) athletes. Twenty-eight BJJ athletes (24.8 ± 5.7 years) performed the BPT at loads of 30, 40, 50, and 60% of their 1 repetition maximum (RM) in a randomized order (5-minute rest between BPTs). The PPO was determined by measuring the barbell displacement by an accelerometer (Myotest). The absolute (F = 7.25; p < 0.001; effect size [ES] = 0.21) and relative intensities were different (F = 7.11; p < 0.001; ES = 0.21) between the AD and NA. There was also a group and intensity interaction effect (F = 2.79; p = 0.046; ES = 0.10), but the differences were centered around the AD group, which achieved higher values using 40% (p = 0.001) and 50% of the 1RM (p < 0.001) than the PPO with 60% of 1RM. The AD athletes presented with higher 1RM than NA (p ≤ 0.05; ES = 1.0), but there was no difference (p > 0.05) in the PPO (30-60% 1RM). A polynomial adjustment indicated that the optimal load was ∼42% of 1RM for all groups and subgroups (R from 0.82 to 0.99). Our results suggest that there can be (1RM) differences between AD and NA BJJ athletes; however, there is no difference in the muscle power between the AD and NA groups. Additionally, ∼42% of 1RM seems to be the optimal load for developing maximal power using the BPT for the BJJ athletes.

Physical activity helps to control music performance anxiety.

We evaluated if regular physical activity could influence musical performance anxiety (MPA) in college music students. Levels of MPA, as measured with the Kenny MPA Inventory, and a survey about the physical activity habits were obtained from 87 students of music. The results showed that physically active musicians had lower MPA scores (p<0.05) than non-active ones, independent of gender. We conclude that there is an association between physical activity and minor MPA, and studies with a longitudinal design should be done to explore this important issue.

Muscle damage of resistance-trained men after two bouts of eccentric bench press exercise.

The present study tested the hypothesis that resistance-trained individuals would also show less muscle damage in the second than in the first eccentric exercise bout (i.e., repeated bout effect) as shown in untrained individuals. This study investigated changes in indirect markers of muscle damage after 2 bouts of free weight eccentric exercise performed by 8 resistance-trained men. The participants (24.4 ± 1.2 years) performed 4 sets of 8 eccentric actions (3 seconds for each repetition) at 70% of eccentric 1 repetition maximum (1RM) load in a bench press exercise with 2 minutes of rest between sets, and repeated the same exercise 2 weeks later. Bench press 1RM, delayed onset muscle soreness (DOMS) assessed by a 6-point Likert scale, serum creatine kinase (CK) activity, and plasma prostaglandin E2 concentration (PGE2) were measured before and 24, 48, 72, and 96 hours after the exercise, and the changes were compared between bouts. The changes in the variables were smaller (p ≤ 0.05) after the second than the first bout indicated by a smaller decline in 1RM strength (first bout: -10.2 ± 1.0% vs. second bout: -5.7 ± 1.5%), peak DOMS (3.8 ± 0.4 vs. 1.7 ± 0.5), peak CK (637.3 ± 133.3 vs. 305.4 ± 63.6 IU·L), and peak PGE2 (761.2 ± 171.0 vs. 307.2 ± 48.3 pg·mL). These results show a typical repeated bout effect. Thus, it is concluded that the repeated bout effect occurs in resistance-trained individuals.

Muscle mass gain after resistance training is inversely correlated with trunk adiposity gain in postmenopausal women.

The aim of this study was to evaluate alterations in trunk adiposity (TA) over 9 months of resistance training (RT) and associate these changes with the hypertrophy of muscle mass (MM) in postmenopausal women (PW). The investigation used a sample that consisted of 22 PW (44-69 years old). The group was subjected to RT (60-80% of 1 repetition maximum) for the total body 3 d · wk(-1). Body composition (dual-energy x-ray absorptiometry) and plasma levels of insulin-like growth factor-1 (IGF-1), follicle-stimulating hormone, E2 (Immulite system), and interleukin-6 (IL-6; enzyme-linked immunosorbent assay) were assessed at the beginning and end of the experiment. After RT, only women who acquired up to 5% TA gained MM, whereas women who acquired >5% TA exhibited increased IL-6 and no MM gain (p < 0.05). The ΔMM was negatively associated with time of menopause (r = -0.45, p < 0.05) and positively associated with baseline IGF-1 (r = 0.47, p < 0.05). Only ΔLE (leg extension) was negatively associated with baseline IL-6 (p < 0.05). Trunk adiposity growth (ΔTF, kilograms) was positively correlated with changes in IL-6 (r = 0.68, p < 0.05). The MM gain was negatively correlated with ΔTF (r = -0.63, p < 0.05) and changes in IL-6 (r = -0.73, p < 0.05). After adjusting all of the confounding variables, only baseline IGF-1 (positively) and changes in IL-6 (negatively) influenced MM, and only the increase in TA influenced IL-6. Our study suggests that increased levels of TA during RT increase IL-6 concentrations, which is a significant negative predictor of MM gain in PW.

Low appendicular muscle mass is correlated with femoral neck bone mineral density loss in postmenopausal women.

BACKGROUND: After menopause, rapid bone mass loss occurs in response to hypoestrogenism. Several studies suggest that muscle mass and bone mineral density (BMD) are positively associated in postmenopausal women. Therefore, it may be assumed that postmenopausal low appendicular muscle mass (aMM) can increase BMD loss in a short period of time. OBJECTIVE: The purpose of this study was to assess relationship of aMM with femoral neck BMD in postmenopausal women. METHODS: Prospective, controlled clinical Trial including 64 women aged 45-70 years, who had not had their last menstruation for at least one year. Subjects were divided into two groups: low aMM (n = 32), and normal aMM (n-32). Femoral neck BMD and muscle mass were measured by DXA at baseline and after twelve months. Pairwise and independent t tests were used for data analysis. RESULTS: Baseline weight, BMI and muscle mass (total and appendicular) significantly differ between groups (p < 0.05). After twelve months, femoral neck BMD was significantly lower in the group with low aMM, whereas no significant difference was observed in the group with normal aMM (p < 0.05). CONCLUSION: In postmenopausal women, low appendicular muscle mass is associated negatively with femoral neck BMD in a short period of time.

Time course of strength and power recovery after resistance training with different movement velocities.

The purpose of this study was to evaluate the time course of strength and power recovery after a single bout of strength training designed with fast and slow contraction velocities. Nineteen male subjects were randomly divided into 2 groups: the slow-velocity contraction (SV) group and the fast velocity contraction (FV) group. Resistance training protocols consisted of 5 sets of 12 repetition maximum (5 × 12RM) with 50 seconds of rest between sets and 2 minutes between exercises. Contraction velocity was controlled by the execution time for each repetition (SV-6 seconds to complete concentric and eccentric phases and for FV-1.5 seconds). Leg Press 45° 1RM (LP 1RM), horizontal countermovement jump (HCMJ), and right thigh circumference (TC) were accessed in 6 distinct moments: base (1 week before exercise), 0 (immediately after exercises), 24, 48, 72, and 96 hours after exercise protocol. The SV and FV presented significant LP 1RM decrements at 0, and these were still evident 24-48 hours postexercise. The magnitude of decline was significantly (p < 0.05) higher for FV. The SV and FV presented significant HCMJ decrements at 0, but only for FV were these still evident 24-72 hours postexercise. The SV and FV presented significant TC increments at 0, and these were still evident 24-48 hours postexercise for SV but for FV it continued up to 96 hours. The magnitude of increase was significantly (p < 0.05) higher for FV. In conclusion, the fast contraction velocity protocol resulted in greater decreases in LP 1RM and HCMJ performance, when compared with slow velocity. The results lead us to interpret that this variable may exert direct influence on acute muscle strength and power generation capacity.

[Leptin, ghrelin, and physical exercise]. / Leptina, ghrelina e exercício físico: Leptin, ghrelin, and physical exercise.

Obesity is a major public health problem in the Western world resulting in serious social, physical and psychological damages. The genesis of obesity is complex involving a variety of factors such as genetic, psychological, metabolic and environmental factors. Progress in endocrinology and metabolism show that adipocyte is considered now as an endocrine tissue producing several substance including adiponectin, tumor necrosis factor-alpha, interleukin-6 and leptin. Specifically, leptin is the main peptide produced by the adipocyte and its serum concentration represents an important peripheral signal in the regulation of food intake and energy expenditure in mammals. In addition to leptin, a new peptide was discovered recently named ghrelin. Ghrelin, a peptide hormone identified in the stomach, is directly involved with the regulation of energy balance and obesity. Physical exercise has been used as a non-pharmacological tool in management of body weight and the effect of physical activity on weight control is an important issue for clinical studies in endocrinology field. Thus, this review will attempt to update the knowledge of leptin and ghrelin on the body weight regulation and the effect of exercise training on these peptide concentrations. It can be concluded that the relationship between physical exercise and the plasma concentration of these peptides is not clear. The reasons for that could be related to the differences in duration, intensity and frequency of the training program employed in each study. Indeed, most of the studies have not analyzed the intensity of training program by either plasma lactate concentration or maximum oxygen consumption. On the other hand, genetic basis could also explain the discrepancies found in some studies, since it has been shown that polymorphism for a variety of genes might be an important factor to determine the differences of cellular response to physical training.