Feasibility of vertical force-velocity profiles to monitor changes in muscle function following different fatigue protocols.

PURPOSE: This study aimed to explore the feasibility of vertical force-velocity (F-V) profiles to monitor changes in muscle function following different fatigue protocols. The between-day reliability of vertical F-V profiles and the acute effects of two fatigue protocols on the changes of lower limb muscle function were examined. METHODS: Twelve resistance trained males completed a preliminary session to determine their back squat one-repetition maximum (1RM). Afterwards, they randomly performed two experimental sessions that only differed in the fatigue protocol applied: heavy-load traditional (HLT; five repetitions at 80% 1RM) and light-load ballistic (LLB; five repetitions at 30% 1RM) squat protocols. Participants' vertical F-V profiles (maximum theoretical force [F0], maximum theoretical velocity [v0], and maximum power output [Pmax]) were calculated before and immediately after each fatigue protocol. RESULTS: F0, v0, and Pmax showed acceptable to good between-day reliability (coefficient of variation ≤ 4.4%; intraclass correlation coefficient ≥ 0.84). Both fatigue protocols promoted a comparable reduction in Pmax (-10.1% for HLT and -12.2% for LLB). However, the LLB squat protocol reduced more v0 (-9.7%) than F0 (-0.4%), while the HLT squat protocol reduced F0 (-8.4%) more than v0 (-4.1%). CONCLUSIONS: The vertical F-V profile can be used to monitor changes in muscle function given its acceptable between-day reliability and its high sensitivity to detect the acute effect of force-oriented and velocity-oriented fatigue protocols on specific maximal neuromuscular capacities.

Effect on muscle strength after blood flow restriction resistance exercise in early in-patient rehabilitation of post-chronic obstructive pulmonary disease acute exacerbation, a single blinded, randomized controlled study.

BACKGROUND: Early commencement of rehabilitation might counteract the loss of muscle strength due to a chronic obstructive pulmonary disease acute exacerbation (COPDAE). Blood flow restriction resistance exercise (BFR-RE) using a low intensity of training load has demonstrated muscle strength gain in varieties of clinical populations. This trial aimed at studying the efficacy and acceptability of BFR-RE in patients with post-COPDAE which was not reported before. METHOD: A prospective, assessor blinded, randomized controlled study with 2-week in-patient rehabilitation program with BFR-RE was compared to a matched program with resistance exercise without BFR in patients with post-COPDAE. The primary outcome was the change of muscle strength of knee extensor of dominant leg. The secondary outcomes included changes of hand grip strength (HGS), 6-minute walk test (6MWT) distance, short physical performance battery (SPPB) scores, COPD assessment test (CAT) scores; acceptability and feasibility of BFR-RE; and 1-month unplanned re-admission rate. RESULTS: Forty-Five post-COPDAE patients (mean age = 76 ± 10, mean FEV1%=49% ± 24%) were analyzed. After training, BFR-RE group and control group demonstrated a statistically significant median muscle strength gain of 20 (Interquartile range (IQR) 3 to 38) Newton(N) and 12 (IQR -9 to 30) N respectively. BFR-RE group showed a significant change in SPPB scores, but not in 6MWT distance and HGS after training. Between groups did not have statistically significant different in all primary and secondary outcomes, though with similar acceptability. Drop-out rate due to training-related discomfort in BFR-RE group was 3.7%. CONCLUSION: BFR-RE is feasible and acceptable in patients with post-COPDAE. A 2-week inpatient pulmonary rehabilitation with BFR-RE improved muscle strength of knee extensors, but not a greater extent than the same rehabilitation program with resistance exercise without BFR. Further studies could be considered with a longer training duration and progression of resistance load. [ClinicalTrials.gov Identifier: NCT04448236].

The effectiveness and safety of blood flow restriction training for the post-operation treatment of distal radius fracture.

INTRODUCTION: Distal radius fracture (DRF) is a common injury in the upper extremities. Blood flow restriction (BFR) has been proven to be effective in improving function in low-load training, which is suitable for post-op rehabilitation. We explored the effectiveness and safety of BFR therapy in DRF patients who underwent surgery. MATERIALS AND METHODS: Thirty-five patients were randomly assigned to either the BFR or the regular training (RT; no BFR therapy) groups. All patients completed the same 4-week postoperative rehabilitation program, including anti-inflammatory treatments, strengthening and range of motion (ROM) training. In the BFR group, the pressure was 120 mmHg in strengthening training course. Pain, circumferences of wrists and forearms, ROM, muscle strength, and D-dimer levels were evaluated at weeks 0, 2, and 4. Radius union scoring system (RUSS) was measured at weeks 4 and 12. Finally, wrist functionality (Cooney modification) was evaluated at week 12. RESULTS: The BFR group had significantly decreased pain levels compared with the RT group (p < 0.01, effect size= 2.33, -2.44 at weeks 2 and 4). Swelling was effectively relieved in both groups. The wrist swelling was less in the BFR group (p < 0.01, effect size = -2.17 at week 4). The isometric strength of wrist extension (p < 0.01, effect size = 1.5, 3.02 at weeks 2 and 4), flexion (p < 0.01, effect size = 1.33, 2.53 at weeks 2 and 4), and functionality significantly increased in the BFR group (p < 0.01, effect size = 2.80 at week 12). No risk of VT in the BFR group was found. BFR did not threaten bone healing. CONCLUSIONS: In patients with DRF who underwent corrective surgery, BFR therapy effectively relieved pain and swelling, increased muscle strength and wrist function, and had no additional risks for bone healing and VT.

BFR therapy can significantly reduce pain, strengthen muscles, and improve function.BFR therapy did not significantly improve passive ROM, and further research is needed to determine its ability to reduce swelling.BFR therapy is safe and effective for DRF patients after ORIF, but requires individualized protocols and frequent assessments. Further research is needed for other orthopedic surgeries.

Altitude-induced effects on neuromuscular, metabolic and perceptual responses before, during and after a high-intensity resistance training session.

PURPOSE: We tested if an acute ascending to 2320 m above sea level (asl) affects corticospinal excitability (CSE) and intracortical inhibition (SICI) measured with transcranial magnetic stimulation (TMS) at rest, before, during and after a traditional hypertrophy-oriented resistance training (RT) session. We also explored whether blood lactate concentration (BLa), ratings of perceived exertion (RPE), perceived muscular pain and total training volume differed when the RT session was performed at hypoxia (H) or normoxia (N). METHODS: Twelve resistance-trained men performed eight sets of 10 repetitions at 70% of one repetition maximum of a bar biceps curl at N (SpO2 = 98.0 ± 0.9%) and H (at 2320 asl, SpO2 = 94.0 ± 1.9%) in random order. Before each session, a subjective well-being questionnaire, the resting motor threshold (rMT) and a single pulse recruitment curve were measured. Before, during and after the RT session, BLa, RPE, muscle pain, CSE and SICI were measured. RESULTS: Before the RT session only the rMT differed between H (- 5.3%) and N (ES = 0.38). RPE, muscle pain and BLa increased through the RT session and were greater at H than N (12%, 54% and 15%, respectively) despite a similar training volume (1618 ± 468 kg vs. 1638 ± 509 kg). CSE was reduced during the RT session (~ 27%) but recovered ten minutes after, regardless of the environmental condition. SICI did not change after any RT session. CONCLUSIONS: The data suggest that acute exposure to moderate hypoxia slightly increased the excitability of the most excitable structures of the corticospinal tract but did not influence intracortical or corticospinal responses to a single RT session.

Reporting of Adverse Events in Muscle Strengthening Interventions in Youth: A Systematic Review.

Clear definition, identification, and reporting of adverse event (AE) monitoring during training interventions are essential for decision making regarding the safety of training and testing in youths. PURPOSE: To document the extent to which AEs, resulting from intervention studies targeting muscle strengthening training (MST) in youth, are reported by researchers. METHODS: Electronic databases (CINAHL, PubMed, SPORTDiscus, and Web of Science) were searched for English peer-reviewed articles published before April 2018. Inclusion criteria were: (1) average age <16 years, (2) use of MST, (3) statement(s) linked to the presence/absence of AEs, and (4) randomized controlled trials or quasi-experimental designs. Risk of reporting bias for AEs followed recommendations by the Cochrane Collaboration group. RESULTS: One hundred and ninety-one full-text articles were screened. One hundred and thirty met all MST criteria, out of which only 44 (33.8%; n = 1278, age = 12.1 [1.1] y) included a statement as to the presence/absence of adverse events. The 86 other studies (66.2%) included no such statement. Of the reporting 44 studies, 18 (40.1%) indicated one or more adverse events. Of the 93 reported adverse events, 55 (59.1%) were linked to training or testing. CONCLUSIONS: Most MST studies in youth do not report presence/absence of adverse events, and when reported, adverse events are not well defined.

Safety, feasibility, and neuromuscular activity of acute low-load resistance exercise with or without blood flow restriction in patients with severe hemophilia.

OBJECTIVE: To compare the safety, feasibility, and neuromuscular activity of acute low-load resistance exercise with/without blood flow restriction (BFR) in people with severe hemophilia (PwH). METHODS: Eight PwH under prophylaxis (5 with resistance training experience) performed 6 randomly ordered conditions of 3 intensity-matched knee extensions: no external load and no BFR, no external load and light BFR (20% of arterial occlusion pressure [AOP]), no external load and moderate BFR (40% AOP), external low load and no BFR, external low load with light BFR, and external low load with moderate BFR. Rated perceived exertion, pain, exercise tolerability, and adverse effects were assessed. Normalized root-mean-square (nRMS), nRMS spatial distribution, and muscle fiber-conduction velocity (MFCV) were determined using high-density surface electromyography for the vastus medialis and lateralis. RESULTS: Exercises were tolerated, without pain increases or adverse events. Externally resisted conditions with/without BFR provided greater nRMS than nonexternally resisted conditions (p < 0.05). Spatial distribution and MFCV did not vary between conditions. CONCLUSIONS: In these patients, knee extensions with low external resistance and BFR at 20% or 40% AOP appear safe, feasible and do not cause acute/delayed pain. However, BFR during three consecutive repetitions does not increase nRMS nor changes nRMS spatial distribution or MFCV.

Exploring participants' perspectives on adverse events due to resistance training: a qualitative study.

The objective of this study was to explore the experiences and perspectives of individuals with chronic health conditions who had an adverse event (AE) as a result of resistance training (RT). We conducted web conference or telephone-based one-on-one semi-structured interviews with 12 participants with chronic health conditions who had an AE as a result of RT. Interview data were analyzed using the thematic framework method. Six themes were identified: (1) personal experiences with aging influence perceptions of RT; (2) physical and emotional consequences of AEs limit activities and define future RT participation; (3) injury recovery defines the severity of AE; (4) health conditions influence the perceived risks and benefits of participating in RT; (5) RT setting and trained supervision influence exercise behaviors and risk perceptions; and (6) experiencing a previous AE influences future exercise behavior. Despite participant awareness of the value and benefits of RT in both the context of aging and chronic health conditions, there is concern about experiencing exercise-related AEs. The perceived risks of RT influenced the participants' decision to engage or return to RT. Consequently, to promote RT participation, the risks, not just the benefits, should be properly reported in future studies, translated, and disseminated to the public. Novelty: -To increase the quality of published research with respect to AE reporting in RT studies. -Health care providers and people with common health conditions will be able to make evidence-based decisions as to whether the benefits of RT truly outweigh the risks.

Breast cancer-related lymphoedema and resistance exercise: An evidence-based review of guidelines, consensus statements and systematic reviews.

AIMS AND OBJECTIVES: Breast cancer-related lymphoedema (BCRL) is a side effect of cancer treatment and can be alleviated by resistance exercise. This systematic, evidence-based review examined the existing best evidence on resistance exercise for BCRL to accurately describe the current status of the field and offer recommendations for clinicians. METHODS: This review adheres to the PRISMA guidelines. Clinical practice guidelines, consensus documents, systematic reviews and other related evidence-based resources about resistance exercise for BCRL were retrieved through the English databases and guideline websites. The publication data limit was set to December 2020. The following search terms were used: 'breast cancer/breast neoplasm/breast carcinoma/breast tumor/breast malignancy, lymphedema/swelling/edema/lymphoedema, resistance/weight/strength training, best practice/clinical practice/guideline/consensus documents'. The quality of the included studies was evaluated by two authors independently using AGREE II and AMSTAR II tools. Evidence-based recommendations on resistance exercise relevant for BCRL were synthesised and categorised. RESULTS: Twenty two articles (seven guidelines, four consensus documents and eleven systematic reviews) were included. The overall quality of the eleven eligible guidelines and consensus documents was moderate to high according to the AGREE II criteria. The quality of the eleven systematic reviews was critically low to high according to the AMSTAR criteria. Six clinical topics involving 43 recommendations were identified. Recommendations were categorised by safety of resistance training, effectiveness of resistance training, evaluation prior to resistance exercise, resistance exercise prescription, resistance training outcome index and points for attention. CONCLUSIONS: This study summarises 43 recommendations for resistance training for BCRL and provides guidance for clinicians. Based on randomised trials and systematic reviews published in recent years, there is an urgent need to update the guidelines and consensus documents in terms of topics, for example effectiveness of resistance training and resistance training outcome index.

Effect of strength training versus raloxifene on bone weight, blood glucose, lipid and antioxidant profile in ovariectomized rats

We compared the effect of the treatment with strength training (ST) and raloxifene (RALOX) on bone weight, blood glucose, lipid, and antioxidant profile in ovariectomized rats. Twenty-four Wistar rats were distributed into four groups: ovariectomy + VEHICLE (control); ovariectomy + RALOX; ovariectomy + ST; ovariectomy + RALOX + ST. Thirty days after ovariectomy, the animals underwent the treatment with RALOX (750 µcg day-1) and/or ST (three sessions week-1). Thirty days after, all groups were scarified, tibia and femur were weighed, and the blood was collected for analysis of the lipid profile, glucose, and antioxidants catalase (CAT) and glutathione (GSH). The ST group showed greater femur weight (0.82 ± 0.18 g) and RALOX + ST had greater tibia weight (0.61± 0.17 g) than CONTROL with femur weight of 0.65 ± 0.08 g and tibia of 0.49 ± 0.08 g with no differences between treatments (p > 0.05). ST group showed significantly higher catalase (181.7 ± 15.4 µM g-1) compared to the other groups. In contrast, the GSH value was lower in ST group (89.2 ± 8.1 µM g-1) compared to RALOX (175.9 ± 17.1 µM g-1) and RALOX + ST (162.8 ± 12.1 µM g-1), but the values of these two groups did not differ from CONTROL(115.3 ± 21.1 µM g-1). Total cholesterol did not differ between groups (p > 0.05), but exercise alone(54.3 ± 2.5 mg dL-1) or with RALOX (53.0 ± 1.5 mg dL-1) resulted in higher HDL cholesterol than CONTROL (45.5 ± 2.5 mg dL-1). Only RALOX+ST presented lower glucose (140.3 ± 9.7 mg dL-1) values than CONTROL (201.7 ± 30.6 mg dL-1). In conclusion, ST promotes similar benefits on bone and metabolic parameters compared to pharmacological treatment in ovariectomized rats.(AU)

Influence of Alpha-Actinin-3 R577X Polymorphism on Muscle Damage and the Inflammatory Response after an Acute Strength Training Session.

The objective of this study was to verify the influence of the ACTN3 R577X polymorphism on muscle damage and the inflammatory response after an acute strength training (ST) session. Twenty-seven healthy male individuals (age: 25 ± 4.3 years) participated in the study, including 18 RR/RX and 9 XX individuals. The participants were divided into two groups (RR/RX and XX groups) and subjected to an acute ST session, which consisted of a series of leg press, leg extension machine, and seated leg curl machine. The volunteers were instructed to perform the greatest volume of work until concentric muscle failure. Each volunteer's performance was analyzed as the load and total volume of training, and the blood concentrations of C-C motif chemokine ligand 2 (CCL2), interleukin-8 (IL-8), creatine kinase (CK), lactate dehydrogenase (LDH), myoglobin, testosterone, and cortisol were measured before the ST session and 30 min and 24 h postsession. The ACTN3 R577X polymorphism effect was observed, with increased concentrations of CCL2 (p < 0.01), IL-8 (p < 0.01), and LDH (p < 0.001) in XX individuals. There was an increase in the concentration of CK in the RR/RX group compared to XX at 24 h after training (p > 0.01). The testosterone/cortisol ratio increased more markedly in the XX group (p < 0.001). Regarding performance, the RR/RX group presented higher load and total volume values in the training exercises when compared to the XX group (p < 0.05). However, the XX group presented higher values of delayed onset muscle soreness (DOMS) than the RR/RX group (p < 0.05). The influence of ACTN3 R577X polymorphism on muscle damage and the inflammatory response was observed after an acute ST session, indicating that the RR/RX genotype shows more muscle damage and a catabolic profile due to a better performance in this activity, while the XX genotype shows more DOMS.

Feasibility of High-Intensity Resistance Training Sessions in Cancer Survivors.

ABSTRACT: Schlüter, K, Schneider, J, Rosenberger, F, and Wiskemann, J. Feasibility of high-intensity resistance training sessions in cancer survivors. J Strength Cond Res 36(9): 2643-2652, 2022-Moderate-intensity resistance training (MIRT) is regarded as safe in cancer survivors (CS), but for high-intensity resistance training (HIRT), evidence is lacking. Hence, in the current exploratory analyses, single sessions of HIRT are compared with MIRT regarding safety and feasibility. Twenty-three of 24 included CS (14 breast and 10 prostate CS, 61.6 ± 9.5 years, body mass index 27.0 ± 4.3 kg·m -2 , 6-52 weeks after end of primary therapy) started a 12-week resistance training (RT) with a daily undulating periodization model including HIRT (90% of 1 repetition maximum [1RM]) and MIRT (67% 1RM) sessions. Parameters of safety (adverse events [AEs] and training-related pain), feasibility (physical and mental exhaustion, sensation of effort, enjoyment, and dropout rate), and adherence were assessed. An alpha level of 0.05 was applied for analyses. Nineteen of 23 training starters (83%) completed all sessions. Fourteen minor AEs occurred. A significantly higher increase for physical exhaustion appeared in HIRT ( p < 0.001). For 18% (HIRT) and 19% (MIRT) of the sessions, training-related pain was reported with no significant difference between intensities. In total, 34% of HIRT and 35% of MIRT sessions were perceived as overstraining or partly overstraining with no significant difference between intensities, but enjoyment (median and quartiles on a 1-7 scale) was high for both (HIRT = 5 [5;6] and MIRT = 5 [4,6]). Our analysis indicates that HIRT sessions do not differ from MIRT sessions concerning safety or feasibility, but training-related pain should be monitored. RT protocols incorporating high-intensity training loads can be applied safely in breast and prostate CS.

Towards an improved understanding of proximity-to-failure in resistance training and its influence on skeletal muscle hypertrophy, neuromuscular fatigue, muscle damage, and perceived discomfort: A scoping review.

While proximity-to-failure is considered an important resistance training (RT) prescription variable, its influence on physiological adaptations and short-term responses to RT is uncertain. Given the ambiguity in the literature, a scoping review was undertaken to summarise evidence for the influence of proximity-to-failure on muscle hypertrophy, neuromuscular fatigue, muscle damage and perceived discomfort. Literature searching was performed according to PRISMA-ScR guidelines and identified three themes of studies comparing either: i) RT performed to momentary muscular failure versus non-failure, ii) RT performed to set failure (defined as anything other than momentary muscular failure) versus non-failure, and iii) RT performed to different velocity loss thresholds. The findings highlight that no consensus definition for "failure" exists in the literature, and the proximity-to-failure achieved in "non-failure" conditions is often ambiguous and variable across studies. This poses challenges when deriving practical recommendations for manipulating proximity-to-failure in RT to achieve desired outcomes. Based on the limited available evidence, RT to set failure is likely not superior to non-failure RT for inducing muscle hypertrophy, but may exacerbate neuromuscular fatigue, muscle damage, and post-set perceived discomfort versus non-failure RT. Together, these factors may impair post-exercise recovery and subsequent performance, and may also negatively influence long-term adherence to RT.KEY POINTS This scoping review identified three broad themes of studies investigating proximity-to-failure in RT, based on the specific definition of set failure used (and therefore the research question being examined), to improve the validity of study comparisons and interpretations.There is no consensus definition for set failure in RT, and the proximity-to-failure achieved during non-failure RT is often unclear and varies both within and between studies, which together poses challenges when interpreting study findings and deriving practical recommendations regarding the influence of RT proximity-to-failure on muscle hypertrophy and other short-term responses.Based on the limited available evidence, performing RT to set failure is likely not superior to non-failure RT to maximise muscle hypertrophy, but the optimal proximity to failure in RT for muscle hypertrophy is unclear and may be moderated by other RT variables (e.g., load, volume-load). Also, RT performed to set failure likely induces greater neuromuscular fatigue, muscle damage, and perceived discomfort than non-failure RT, which may negatively influence RT performance, post-RT recovery, and long-term adherence.

Volume Load Rather Than Resting Interval Influences Muscle Hypertrophy During High-Intensity Resistance Training.

ABSTRACT: Longo, AR, Silva-Batista, C, Pedroso, K, de Salles Painelli, V, Lasevicius, T, Schoenfeld, BJ, Aihara, AY, de Almeida Peres, B, Tricoli, V, and Teixeira, EL. Volume load rather than resting interval influences muscle hypertrophy during high-intensity resistance training. J Strength Cond Res 36(6): 1554-1559, 2022-Interset rest interval has been proposed as an important variable for inducing muscle mass and strength increases during resistance training. However, its influence remains unclear, especially when protocols with differing intervals have equalized volume. We aimed to compare the effects of long (LI) vs. short rest interval (SI) on muscle strength (one repetition maximum [1RM]) and quadriceps cross-sectional area (QCSA), with or without equalized volume load (VL). Twenty-eight subjects trained twice a week for 10 weeks. Each subject's leg was allocated to 1 of 4 unilateral knee extension protocols: LI, SI, SI with VL -matched by LI (VLI-SI), and LI with VL-matched by SI (VSI-LI). A 3-minute rest interval was afforded in LI and VSI-LI protocols, while SI and VLI-SI employed a 1-minute interval. All subjects trained with a load corresponding to 80% 1RM. One repetition maximum and QCSA were measured before and after training. All protocols significantly increased 1RM values in post-training (p < 0.0001; LI: 27.6%, effect size [ES] = 0.90; VLI-SI: 31.1%, ES = 1.00; SI: 26.5%, ES = 1.11; and VSI-LI: 31.2%, ES = 1.28), with no significant differences between protocols. Quadriceps cross-sectional area increased significantly for all protocols in post-training (p < 0.0001). However, absolute changes in QCSA were significantly greater in LI and VLI-SI (13.1%, ES: 0.66 and 12.9%, ES: 0.63) than SI and VSI-LI (6.8%, ES: 0.38 and 6.6%, ES: 0.37) (both comparisons, p < 0.05). These data suggest that maintenance of high loads is more important for strength increases, while a greater VL plays a primary role for hypertrophy, regardless of interset rest interval.

Low-Load Resistance Training to Volitional Failure Induces Muscle Hypertrophy Similar to Volume-Matched, Velocity Fatigue.

ABSTRACT: Terada, K, Kikuchi, N, Burt, D, Voisin, S, and Nakazato, K. Full title: Low-load resistance training to volitional failure induces muscle hypertrophy similar to volume-matched, velocity fatigue. J Strength Cond Res 36(6): 1576-1581, 2022-We investigated how resistance training (RT) to failure at low load affects acute responses and chronic muscle adaptations compared with low-load RT to velocity fatigue at equal work volume. Twenty-seven subjects performed 8 weeks of bench press twice weekly. Subjects were randomly assigned to one of 3 groups: low-load volitional failure (LVoF, n = 9), low-load velocity fatigue (LVeF, n = 8), and high-load (HL, n = 10). Resistance training comprised 3 sets to failure at 40% one repetition maximum (1RM) in the LVoF group, 3 sets to velocity fatigue (20% lifting velocity loss) at 40% 1RM in the LVeF group, and 3 sets of 8 repetitions at 80% 1RM in the HL group. We measured muscle strength, hypertrophy, endurance, and power at baseline and after the RT program. We also measured muscle swelling and blood lactate after each RT bout to investigate the acute response. There were no differences in total work volume between the LVoF and LVeF groups. Responses to RT were similar between LVoF and LVeF, whether looking at acute muscle swelling, increase in blood lactate, chronic hypertrophy, and strength gain. However, LVoF and LVeF RT triggered different responses to muscle function in comparison with HL training: LVoF and LVeF showed enhanced acute responses and greater chronic endurance gains, but lower chronic strength gains than HL. In conclusion, low-load RT to volitional failure induces muscle hypertrophy similar to volume-matched velocity fatigue.

Researchers' perspectives on adverse event reporting in resistance training trials: a qualitative study.

The objectives of our study were to understand researchers' current practices and perspectives on adverse event (AE) reporting in clinical trials of resistance training (RT) and to identify barriers and facilitators of AE reporting. We conducted web conference or telephone-based one-on-one semistructured interviews with 14 researchers who have published RT studies. We audio-recorded and transcribed the interviews and analyzed the data using the thematic framework method. Four themes were identified: (1) researchers lack guidance and/or motivation for rigorous AE reporting; (2) researchers who undertake AE reporting educate and value participants, use trained personnel, and implement standardized guidelines; (3) suboptimal implementation of existing AE reporting standards and the perception that available guidelines do not apply to exercise trials; and (4) acceptability and feasibility of an exercise-specific guide for AE reporting depend on its content and format. In conclusion, AE reporting methods in the field of exercise science do not align with best practice. Strategies to reduce inconsistent and suboptimal AE reporting in RT trials are urgently needed and could be based on the barriers and facilitators identified in this study.

Relationship between protein intake and resistance training-induced muscle hypertrophy in middle-aged women: A pilot study.

OBJECTIVE: The aim of this study was to observe the relationship of protein intake at each meal and daily total with change in lean tissue mass with progressive resistance exercise training (RET) in healthy middle-aged women. METHODS: Twenty-two healthy Japanese women were recruited from Shiga Prefecture, Japan, and a supervised whole body RET program was conducted twice a week for 16 wk. The dietary intake was assessed using 3-d dietary records. Dual-energy x-ray absorptiometry was used to measure the whole body lean soft tissue mass (WLTM). Multiple regression analysis was performed to examine the relationship between the protein intake and RET-induced changes in the WLTM after adjusting for age, sleep quality, physical activity, and energy intake. RESULTS: The 16-wk RET program caused a significant gain in the WLTM (1.46 ± 0.45%, P = 0.004). Multiple regression analysis showed that the baseline protein intake at breakfast was negatively associated with the percent change in the WLTM (ß = -1.598; P = 0.022). Additionally, the percent change (ß = 0.624; P = 0.018) in protein intake at breakfast was positively associated with the percent change in WLTM. CONCLUSION: Increasing protein intake at breakfast may contribute to RET-induced muscle hypertrophy in middle-aged women, especially among those who habitually consume low-protein levels at breakfast. However, future studies with larger sample sizes are required to confirm the importance of protein intake at breakfast.

The role of the neural stimulus in regulating skeletal muscle hypertrophy.

Resistance training is frequently performed with the goal of stimulating muscle hypertrophy. Due to the key roles motor unit recruitment and mechanical tension play to induce muscle growth, when programming, the manipulation of the training variables is oriented to provoke the correct stimulus. Although it is known that the nervous system is responsible for the control of motor units and active muscle force, muscle hypertrophy researchers and trainers tend to only focus on the adaptations of the musculotendinous unit and not in the nervous system behaviour. To better guide resistance exercise prescription for muscle hypertrophy and aiming to delve into the mechanisms that maximize this goal, this review provides evidence-based considerations for possible effects of neural behaviour on muscle growth when programming resistance training, and future neurophysiological measurement that should be tested when training to increase muscle mass. Combined information from the neural and muscular structures will allow to understand the exact adaptations of the muscle in response to a given input (neural drive to the muscle). Changes at different levels of the nervous system will affect the control of motor units and mechanical forces during resistance training, thus impacting the potential hypertrophic adaptations. Additionally, this article addresses how neural adaptations and fatigue accumulation that occur when resistance training may influence the hypertrophic response and propose neurophysiological assessments that may improve our understanding of resistance training variables that impact on muscular adaptations.

Blood-flow restricted exercise following ankle fractures - A feasibility study.

BACKGROUND: The objective was to investigate the feasibility of blood flow restricted exercise (BFRE) as a rehabilitation modality in patients with a unilateral ankle fracture. METHODS: Feasibility study with a prospective cohort design. Inclusion criteria were above 18 years of age and unilateral ankle fractures. EXCLUSION CRITERIA: history of cardiac or embolic diseases, cancer, diabetes, hypertension and family history of cardio or vascular diseases. The predefined feasibility outcome was based on three criteria regarding patients experience with participating in the BFRE protocol and the absence of any serious adverse events. RESULTS: Eight patients were included. Median age was 33 years (range: 23-60). All eight patients reported maximum satisfaction on the two questions regarding patient's perception of the overall experience with BFRE training and the feasibility to introduce BFRE as an intervention. CONCLUSION: Early use of BFRE in patients with unilateral ankle fractures seems feasible in patients without comorbidity.

Urinary Incontinence in Competitive Women Weightlifters.

ABSTRACT: Wikander, L, Kirshbaum, MN, Waheed, N, and Gahreman, DE. Urinary incontinence in competitive women weightlifters. J Strength Cond Res 36(11): 3130-3135, 2022-Urinary incontinence has the potential to diminish athletic performance and discourage women from participating in sport and exercise. This study determined the prevalence and possible risk factors for urinary incontinence in competitive women weightlifters. This research was a cross-sectional, survey-based study completed by 191 competitive women weightlifters. The frequency and severity of urinary incontinence was determined using the Incontinence Severity Index. Urinary incontinence was defined as an Incontinence Severity Index score >0. The survey questions focused on risk factors, the context and triggers for urinary incontinence, and self-care strategies. Approximately, 31.9% of subjects experienced urinary incontinence within 3 months of completing the survey. Incontinence Severity Index scores were significantly correlated with parity ( r = 0.283, p = 0.01) and age ( r = 0.216, p = 0.01). There was no significant correlation between the Incontinence Severity Index score and the number of years participating in any form of resistance training ( r = -0.010, p = 0.886) or weightlifting ( r = -0.045, p = 0.534), body mass index ( r = 0.058, p = 0.422), or competition total ( r = -0.114, p = 0.115). The squat was the most likely exercise to provoke urinary incontinence. Although the number of repetitions, weight lifted, body position, and ground impact may increase the likelihood of urinary incontinence occurring during a lift, it is difficult to determine which factor has the greatest influence. Some self-care strategies used by competitive women weightlifters who experience urinary incontinence, such as training while dehydrated, have the potential to diminish athletic performance.