Detraining Effects on Musculoskeletal Parameters in Early Postmenopausal Osteopenic Women: 3-Month Follow-Up of the Randomized Controlled ACTLIFE Study.

Periods of absence from supervised group exercise while maintaining physical activity might be a frequent pattern in adults' exercise habits. The aim of the present study was to determine detraining effects on musculoskeletal outcomes after a 3-month detraining period in early post-menopausal, osteopenic women. Due to the COVID-19 pandemic, we terminated the 18-month randomized controlled ACTLIFE exercise intervention immediately after the 13-month follow-up assessment. This put an abrupt stop to the high-intensity aerobic and resistance group exercise sessions undertaken three times per week by the exercise group (EG: n = 27) and the gentle exercise program performed once per week for the attention control group (CG: n = 27); but both groups were permitted to conduct individual outdoor activity for the 3-month lock-down period. Study endpoints were lean body mass (LBM), bone mineral density (BMD) at the lumbar spine (LS), maximum hip-/leg extension strength and power. Detraining-induced reductions of LBM, hip/leg strength and power (but not BMD-LS) were significantly greater (p < 0.001 to p = 0.044) compared with the CG. Significant exercise effects, i.e. differences between EG and CG, present after 13 months of exercise, were lost after 3 months of detraining for LBM (p = 0.157) and BMD-LS (p = 0.065), but not for strength (p < 0.001) and power (p < 0.001). Of note, self-reported individual outdoor activities and exercise increased by about 40% in both groups during the lock-down period. Three months' absence from a supervised group exercise protocol resulted in considerable detraining effects for musculoskeletal parameters. Thus, exercise programs for adults should be continuous rather than intermittent.Trial registration number: ClinicalTrials.gov: NCT04420806, 06.05.2020.

Impact of 3 months of detraining after high intensity exercise on menopause-related symptoms in early postmenopausal women - results of the randomized controlled actlife project.

Regular exercise might reduce postmenopausal symptoms, however even short-moderate periods of absence from exercise training might significantly reduce these positive effects. The aim of the study was thus to determine detraining effects on postmenopausal symptoms after a 3-month detraining period in early post-menopausal women. After 13 months, the exercise group (EG: n = 27; 54.6 ± 2.0; 23.6 ± 3.3 kg/m2) had to abruptly stop their supervised, facility-based, high intensity aerobic and resistance group exercise conducted three times per week due to the COVID-19 pandemic and the corresponding lockdown of all training facilities in Germany. In parallel, the control group (CG: n = 27; 55.6 ± 1.6 years, 25.2 ± 5.2 kg/m2) had to terminate their low-intensity exercise program performed once per week. Study endpoint as determined after 3 months of detraining was menopausal symptoms as determined by the Menopausal Rating Scale II (MRS II). The intention to treat principle with multiple imputation was applied. After 13 months of intense multicomponent exercise and significant exercise-induced effects on menopausal symptoms, a further 3 months of detraining resulted in non-significant deteriorations (p = .106) in the exercise group, while non-significant improvements were observed in the control group (p = .180). Corresponding group differences were significant (p = .036) after detraining. Of importance, self-reported individual outdoor activities increased by about 40% in both groups during the three-month lock-down period. Three months of absence from a supervised high-intensity group exercise protocol resulted in detraining effects on postmenopausal symptoms even when outdoor physical activity was increased significantly. Trial registration number: ClinicalTrials.gov: NCT03959995.

Changes in Menopausal Risk Factors in Early Postmenopausal Osteopenic Women After 13 Months of High-Intensity Exercise: The Randomized Controlled ACTLIFE-RCT.

The menopausal transition is a critical period in women's lives. Exercise might be the most promising non-pharmaceutic intervention to address the large variety of risk factors related to the pronounced estradiol decline during peri- and early-postmenopause. The aim of this study was to determine the effect of an 18-month multipurpose exercise program on risk factors and symptoms related to the menopausal transition. Fifty-four women 1-5 years postmenopause with osteopenia or osteoporosis were randomly assigned 1) to a high impact weight-bearing/high-intensity/velocity resistance training group (EG: n=27) exercising three times a week or 2) to an attendance control group (CG: n=27) that performed low-intensity exercise once a week. Both groups were supplemented with cholecalciferol and calcium. The primary study endpoint was bone mineral density (BMD) at lumbar spine (LS) and total hip, secondary outcomes were lean body mass (LBM), total and abdominal body percentage, metabolic syndrome Z-Score (MetS-Z), menopausal symptoms and muscle strength and power. Due to COVID-19, the study was stopped after 13 months. We observed significant effects for BMD-LS (EG: 0.002±.018 versus CG: -.009±0.018 mg/cm2, p=0.027) but not for BMD total hip (EG: -0.01±.016 versus CG: -.009±0.020 mg/cm2, p=0.129). LBM improved significantly in the EG and decreased in the CG (0.39±1.08 vs -0.37±1.34 kg, p=0.026). Total and abdominal body fat improved significantly in the EG and was maintained in the CG (-1.44±1.49 vs -0.02±1.55 kg, p=0.002 and -1.50±2.33 vs 0.08±2.07 kg, p=0.011). Significant effects in favor of the EG were also determined for menopausal symptoms (p=0.029), hip/leg extension strength (p<0.001) and power (p<0.001). However, changes of the MetS-Z did not differ significantly (p=0.149) between EG and CG. In summary, with minor exceptions, we demonstrated the effectiveness of a multipurpose exercise protocol dedicated to early-postmenopausal women on various risk factors and complaints related to the menopausal transition.

Effects of Compression Tights on Recovery Parameters after Exercise Induced Muscle Damage: A Randomized Controlled Crossover Study.

INTRODUCTION: Recent meta-analyses on compression garments have reported faster recovery of muscle function particularly after intense eccentric power or resistance exercise. However, due to the complex interaction between cohorts included, exercises involved and compression applied, recovery length and modalities, and outcome parameters selected, only limited practical recommendations can be drawn from these studies. Thus, our aim was to determine the effect of compression tights on recovery from high mechanical and metabolic stress monitored over a longer recovery period. MATERIAL AND METHODS: Using a crossover design, 19 resistance-trained 4th/5th Division German handball players (31.3±7.7 years; 24.1±3.8 kg/m2) were randomly assigned at the start of the project to the compression tight (recovery-pro-tights, cep, Bayreuth, Germany) or the control group. Immediately after a combined lower extremity resistance training and electromyostimulation, participants had to wear compression tights. Compression was applied initially for 24 h and then 12 h intermitted by 12 h of nonuse for a total of 96 h. Primary study endpoint was maximum isokinetic hip/leg-extensor strength (MIES) as determined by a leg-press. Secondary endpoint was lower extremity power as assessed by a counter movement jump. Follow-up assessments were conducted 24, 48, 72, and 96 h postexercise. Outcomes were analyzed using a linear mixed effect model with spherical symmetric within-condition correlation. RESULTS: All 19 participants underwent their allocated treatment and passed through the project strictly according to the study protocol. MIES demonstrated significantly (p=0.003) lower overall reductions (155 N) after wearing compression tights. In parallel, lower extremity power significantly (p<0.001) varies between both conditions with lower reductions in favor of the compression condition. Of importance, full recovery for lower extremity muscle strength or power was still not reached 96 h postexercise. CONCLUSION: Based on our results we recommend athletes wear compression tights for faster recovery, particularly after intense exercise with a pronounced eccentric aspect.

Stimulus Level during Endurance Training: Effects on Lactate Kinetics in Untrained Men.

BACKGROUND/OBJECTIVE: Not only but particularly due to their time efficiency, High-Intensity Interval Training (HIIT) is becoming increasingly popular in fitness-oriented endurance sports. The purpose of this study was to determine the effect of a HIIT running program versus a Moderate Intensity Continuous Exercise (MICE) training running program (16 weeks each) on lactate kinetics in untrained males. METHODS: 65 healthy but untrained males (30-50 years, BMI: 27.2 ± 3.7kg/m2) were randomly assigned to either an HIIT (n=33) or a waiting-control/MICE group (n=32). HIIT consisted of intervals and intense continuous running bouts at or above the individual anaerobic threshold (IANS, 95-110% of IANS-HR), while MICE focused on continuous running at 70-82.5% IANS-HR. Both programs were adjusted for "total workload". Study endpoints were time to IANS and time from IANS till "time to exhaustion" (TTE) as assessed by stepwise treadmill test. RESULTS: In both exercise groups time to reach IANS (MICE: 320 ± 160 s versus HIIT: 198 ± 118 s) increased significantly (p<.001), with the groups differing significantly (p<.001). Time from IANS until TTE was prolonged significantly among the HIIT group (27 ± 66s, p=.030), while among the MICE group a significant reduction of time from IANS until TTE (59 ± 109s; p=.017) was determined. Between-group difference is significant (p=.003) for this parameter. In both groups TTE increased significantly (HIIT: 27.2 ± 17.7% versus MICE: 29.0 ± 19.4%, both p<.001) at a similar level (p=.279). CONCLUSION: HIIT and MICE protocols, when adjusted for total workload, similarly increased running performance in untrained male subjects; however, the underlying mechanisms differ fundamentally. Due to its effects on aerobic and anaerobic performance improvement, HIIT can be recommended for untrained individuals as a time-efficient alternative or complementary training method to MICE. However, our protocol did not confirm the general superiority of HIIT versus MICE on the key endurance parameter "time to exhaustion" that has been reported by other comparative exercise studies.

Effects of whole-body electromyostimulation on chronic nonspecific low back pain in adults: a randomized controlled study.

PURPOSE: Low back pain (LBP) is one of the most frequent chronic conditions worldwide. Data from a recent meta-analysis indicated that whole-body electromyostimulation (WB-EMS), a time-effective, joint-friendly, and highly individualized training technology, demonstrated promising effects on LBP; however, methodologic limitations prevent definitive evidence for this result. Thus, the aim of this study was to conduct a randomized controlled WB-EMS trial to determine the corresponding effect on chronic, nonspecific LBP in people with chronic LBP. PATIENTS AND METHODS: Thirty LBP patients, 40-70 years old, were randomly assigned into two groups (WB-EMS: 15; control [CG]: 15). While the nonactive CG maintained their lifestyle, the WB-EMS group completed a 12-week WB-EMS protocol (1×20 min/week) with slight movements, specifically dedicated to LBP. Pain intensity and frequency were determined by a 4-week pain diary before and during the last 4 weeks of intervention. Primary study endpoint was average pain intensity at the lumbar spine. RESULTS: At baseline, no group differences apart from nonregular exercise were observed. Mean intensity of LBP decreased significantly in the WB-EMS group (P=0.002) and remained unchanged in the CG (P=0.730), with a significant difference between both groups (P=0.027). Maximum isometric trunk extensors improved significantly in the WB-EMS group (P=0.005), while no significant difference was seen in the CG (P=0.683). In contrast to the significant difference between WB-EMS group and CG for the latter parameter (P=0.038), no intergroup difference was determined for maximum isometric trunk flexors (P=0.091). The WB-EMS group showed a significant increase of this parameter (P=0.003), while no significant change was determined in the CG (P=0.563). CONCLUSION: WB-EMS is a time-effective training method for reducing chronic nonspecific LBP and increasing maximum trunk strength in people with such complaints. After this promising comparison with a nonactive CG, research needs to be extended to include comparisons with active groups (WB-Vibration, conventional back strengthening).

Protein Supplementation to Augment the Effects of High Intensity Resistance Training in Untrained Middle-Aged Males: The Randomized Controlled PUSH Trial.

High intensity (resistance exercise) training (HIT) defined as a "single set resistance exercise to muscular failure" is an efficient exercise method that allows people with low time budgets to realize an adequate training stimulus. Although there is an ongoing discussion, recent meta-analysis suggests the significant superiority of multiple set (MST) methods for body composition and strength parameters. The aim of this study is to determine whether additional protein supplementation may increase the effect of a HIT-protocol on body composition and strength to an equal MST-level. One hundred and twenty untrained males 30-50 years old were randomly allocated to three groups: (a) HIT, (b) HIT and protein supplementation (HIT&P), and (c) waiting-control (CG) and (after cross-over) high volume/high-intensity-training (HVHIT). HIT was defined as "single set to failure protocol" while HVHIT consistently applied two equal sets. Protein supplementation provided an overall intake of 1.5-1.7 g/kg/d/body mass. Primary study endpoint was lean body mass (LBM). LBM significantly improved in all exercise groups (p ≤ 0.043); however only HIT&P and HVHIT differ significantly from control (p ≤ 0.002). HIT diverges significantly from HIT&P (p = 0.017) and nonsignificantly from HVHIT (p = 0.059), while no differences were observed for HIT&P versus HVHIT (p = 0.691). In conclusion, moderate to high protein supplementation significantly increases the effects of a HIT-protocol on LBM in middle-aged untrained males.