Hemodynamic Response During Different Set Configurations of a Moderate-load Resistance Exercise.

We aimed to determine the cardiovascular responses to two different set configuration resistance-exercise protocols during a knee extension composed of 40 repetitions with a 15RM load and a total resting time of 360 seconds. Twenty-four healthy sport science students randomly performed two sessions: (a) a long set configuration (LSC: 4 sets of 10 repetitions with 2 min rest between sets), and (b) a short set configuration (SSC: 8 sets of 5 repetitions with 51 s rest between sets). Before and during exercise, peak and mean values of heart rate, blood pressure, rate pressure product, and pulse pressure were obtained. Results showed that both protocols increased the overall peak and mean blood pressure values (p<0.001). However, LSC entailed a higher peak blood pressure response at the last set (p=0.041) and an increase throughout the first 30 repetitions (p≤0.007), whereas SSC kept steady after the first 20 repetitions. Additionally, LSC caused higher overall peak and mean heart rate and rate pressure product values (p≤0.003). Summarily, although both protocols raised blood pressure, SSC reduced the extent of the pressure and chronotropic response during resistance exercise.

High-intensity exercise to improve cardiorespiratory fitness in cancer patients and survivors: A systematic review and meta-analysis.

Improving cardiorespiratory fitness (CRFit) in cancer patients is crucial to increase survivorship, promote health, and improve quality of life. High-intensity training (HIT) has the potential to increase CRFit, perhaps better than other exercise modalities, but the extant evidence has yet to be fully explored. This systematic review and meta-analysis aimed to evaluate the effects of HIT on CRFit in cancer patients and survivors and to identify the optimal characteristics of the interventions (eg, cancer type, intervention timing, exercise modality, intervention's duration, and the number of minutes of high-intensity exercise in each session). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A total of 31 articles (2515 participants) were included in the systematic review and 25 in the meta-analyses. CRFit significantly improved with HIT in comparison with a control group (P < .00001, SMD = 0.44 and a 95% confidence interval from 0.25 to 0.64). The results obtained in the sub-analysis were statistically significant except the comparison with the active group CRFit (P = .13). The results showed that higher effects could be achieved in: patients starting to exercise before treatment, interventions longer than eight weeks, programs including exclusively cardiovascular training and with a high-intensity part of session duration of at least 20 minutes.

Load-velocity Profiles Change after Training Programs with Different Set Configurations.

This study explored the changes in load-velocity relationship of bench press and parallel squat exercises following two programs differing in the set configuration. A randomized controlled trial was carried out in a sample of 39 physically active individuals. Participants were assigned to rest redistribution set configuration, traditional set configuration, or control groups. Over 5 weeks, the experimental groups completed 10 sessions with the 10 repetitions maximum load of both exercises. Rest redistribution sets consisted in 16 sets of 2 repetitions with 60 s of rest between sets, and 5 min between exercises, whereas traditional sets entailed 4 sets of 8 repetitions with 5 min of rest between sets and exercises. The load-velocity relationships of both exercises were obtained before and after the training period. For bench press, an increase of the velocity axis intercept, and a decrease of the slope at post-test were observed in both rest redistribution (p<0.001, G=1.264; p<0.001; G=0.997) and traditional set (p=0.01, G=0.654; p=0.001; G=0.593) groups. For squat, the slope decreased (p<0.001; G=0.588) and the velocity axis intercept increased (p<0.001; G=0.727) only in the rest redistribution group. These results show that rest redistribution sets were particularly efficient for inducing changes in the load-velocity relationship.

Set Configuration in Strength Training Programs Modulates the Cross Education Phenomenon.

ABSTRACT: Fariñas, J, Mayo, X, Giraldez-García, MA, Carballeira, E, Fernandez-Del-Olmo, M, Rial-Vazquez, J, Kingsley, JD, and Iglesias-Soler, E. Set configuration in strength training programs modulates the cross education phenomenon. J Strength Cond Res 35(9): 2414-2420, 2021-This study aimed to compare the strength gains in the nontrained arm after 2 independent unilateral training programs differing in the set configuration. Thirty-five subjects were randomly assigned to 3 groups: traditional training (TT; n = 12), cluster training (CT; n = 11), or control (CON; n = 12). The experimental groups performed a 5-week training program of a unilateral biceps curl exercise with the dominant limb using the 10 repetition maximum (10RM) load. Traditional training performed 5 sets of 6 repetitions and 135 seconds of rest between sets. Cluster training completed 30 repetitions with 18.5 seconds of rest between each repetition. Anthropometry (ANT), muscle thickness (MT), 1RM, the number of repetitions with 10RM (n10RM), and isometric maximal voluntary contraction (MVC) were measured before and after the intervention. Regarding the nontrained arm, TT improved 1RM (7.3%, p < 0.001). No changes were observed in CT. Regarding the trained arm, TT improved 1RM (9.1%, p < 0.001), n10RM (p = 0.005), and MVC (p = 0.011), whereas CT only showed a trend for improvement of 1RM (3.4%, p = 0.052). These results suggest that when total volume and repetition-to-rest ratio are equated, a more fatiguing set configuration causes a higher effect on the non-trained limb.

A short set configuration attenuates the cardiac parasympathetic withdrawal after a whole-body resistance training session.

PURPOSE: We aimed to analyse the acute effects of set configuration on cardiac parasympathetic modulation and blood pressure (BP) after a whole-body resistance training (RT) session. METHODS: Thirty-two participants (23 men and 9 women) performed one control (CON) and two RT sessions differing in the set configuration but with the same intensity (15RM load), volume (200 repetitions) and total resting time (360 s between sets for each exercise and 3 min between exercises): a long set configuration (LSC: 4 sets of 10 repetitions with 2 resting minutes) and a short set configuration session (SSC, 8 sets of 5 repetitions with 51 resting seconds). Heart rate variability, baroreflex sensitivity, the low frequency of systolic blood pressure oscillations (LFSBP), BP and lactatemia were evaluated before and after the sessions and mechanical performance was evaluated during exercise. RESULTS: LSC induced greater reductions on cardiac parasympathetic modulation versus SSC after the session and the CON (p < 0.001 to p = 0.024). However, no LFSBP and BP significant changes were observed. Furthermore, LSC caused a higher lactate production (p < 0.001) and velocity loss (p ≤ 0.001) in comparison with SSC. CONCLUSION: These findings suggest that SSC attenuates the reduction of cardiac parasympathetic modulation after a whole-body RT, improving the mechanical performance and decreasing the glycolytic involvement, without alterations regarding vascular tone and BP.

Reliability of force-velocity parameters obtained from linear and curvilinear regressions for the bench press and squat exercises.

This study aimed to compare the goodness of fit and the reliability of different regression models for fitting the force-velocity relationship (FV) of bench press (BP) and squat (SQ). Additionally, the reliability of the position on FV of the velocity (V1RM) and the force performed with the 1RM (F1RM) was explored. Nine rugby players and 12 judokas participated in this study. The FV of BP and SQ were obtained twice by a protocol performed until the 1RM. Individual FV were fitted by linear (LM), quadratic polynomial (PM), and exponential models (EM). Adjusted coefficients of determination of LM and PM (medians higher than 0.919) were higher than for EM. The reliability was higher for LM in comparison with PM. The reliability of V1RM was not acceptable (CV% = 19 and 18% for BP and SQ). High reliability was observed for F1RM (CV% = 3 and 2% for BP and SQ) and for the ratio between F1RM and the force-axis intercept of FV (CV% = 2 and 4% for BP and SQ). The reliability of the relative values of F1RM around 92 and 87% of F0 for BP and SQ suggests the use of these values for monitoring resistance training programmes.

Perceived Exertion Is Affected by the Submaximal Set Configuration Used in Resistance Exercise.

Mayo, X, Iglesias-Soler, E, and Kingsley, JD. Perceived exertion is affected by the submaximal set configuration used in resistance exercise. J Strength Cond Res 33(2): 426-432, 2019-Previously, perceived exertion in submaximal resistance exercise protocols was reported to be affected by the intensity of load followed by work-to-rest ratio. Nevertheless, the effect of set configuration, which entails the metabolic, hormonal, and neuromuscular implication of the session, is currently unknown, despite the fact that perceived exertion discriminates these differences. We aimed to analyze the effect of 3 submaximal set configurations on perceived exertion and their relationship with velocity as a mechanical measure of fatigue. Seventeen healthy subjects (23 ± 2 years) performed with the 10-repetition maximum load on the leg press (211 ± 45 kg) a total of 40 repetitions with 720 seconds of rest in 3 randomized experimental sessions with the same work-to-rest ratio. The sessions consisted of an interrepetition rest design performing individual repetitions, a cluster design performing groups of 4 repetitions, and a traditional design performing groups of 8 repetitions. At the end of the session, the nonparametric analysis of variance-type test revealed differences between protocols (p < 0.001), with lower values of perceived exertion in the interrepetition rest design in comparison with the cluster design (p = 0.003) and traditional design (p < 0.001). In addition, Spearman's rank correlations (p < 0.001) were observed for the interrepetition rest design (rho = -0.72) and traditional design (rho = -0.8) between perceived exertion and velocity. Our findings suggest that the submaximal set configuration is a determinant of perceived exertion by itself, and that perceived exertion represents similar mechanisms as velocity, such as fatigue and certain characteristics of the session and the individual.

Both Unopposed and Opposed Judo Tasks are Suitable for Analyzing Changes in Lateral Preference.

Judo coaches aim to develop left-handed techniques in right-handed judoka due to a potential frequency-dependent strategic advantage during competition. Thus, easily completed tasks are needed to track the progression of the lateral preference index (percentage as right-handed actions). Thirty naïve volunteers performed two tasks, an unopposed repetition-based dynamic task (yakusoku geiko) and an opposed-bouts task (randori), before and after eight-week training protocols differing in the executing side. Training protocols consisted of a control group (without any instruction regarding the practice side), a bilateral group (practicing with both dominant and nondominant sides), and a nondominant group (practicing exclusively on the nondominant side). ANOVA-type tests were used for analyzing the suitability of the unopposed repetition-based dynamic task for detecting changes in the lateral preference index and for analyzing the concordance between tasks. Additionally, concordance was tested with Spearman's rank correlations and Bland-Altman plots. Lower lateral preference indices (i.e., reductions of executions as right-hander) were observed after training in the nondominant group and in comparison with the control group and bilateral group on the posttest (p < 0.05). ANOVA-test for concordance analysis revealed no differences between tasks (p > 0.05) with significant correlations (p < .05) and low bias during the pretest (ρ = 0.563; bias: 4.29, 95% LoA: -36.32-27.74%) and the posttest (ρ = 0.718, bias: 0.69, 95% LoA: -39.37-40.77%). In conclusion, an unopposed repetition-based dynamic task detected reductions in lateral preference index after an eight-week nondominant training period. These results agreed with those observed with the opposed-bouts task. This indicates the eligibility of yakusoku geiko for coaching delivery due to general suitability of the unopposed repetition-based dynamic task to track the maintenance or progression of left-handedness in judo trainees.

Effects of bilateral and non-dominant practices on the lateral preference in judo matches.

This study analysed the effects of bilateral and non-dominant practice on novice practitioners' lateral preference for judo skills in a combat context (i.e., randori). Thirty sports sciences students (22 men and 8 women; mean age 19 ± 1 years) with right hand, foot, and counterclockwise rotation preferences were divided into 3 groups: bilateral (BG; n = 8), non-dominant (NDG; n = 11), and control (CG; n = 11). Participants received 8 weeks of training at a rate of 3 days per week. The NDG was trained to perform judo skills exclusive with their non-dominant side, while the BG performed every task symmetrically. Before and after training, participants were recorded during two 3-min randoris to obtain the percentage of their engagement in dominant side actions. Pretest percentages were 73.1 ± 19.9%, 77.8 ± 18.8%, and 68.9 ± 27.2% for BG, NDG, and CG, respectively. Post-test values were 75.0 ± 15.6%, 23.3 ± 27.9%, and 72.2.9 ± 20.4%, respectively. Significant differences were observed between NDG and each of the other groups after the training. Changes from pretest were only significant for NDG (P = 0.003). These results suggest that lateral preference among novice judo practitioners during randori can be modulated by the type of practice.

High-Intensity Interval Cycling Exercise on Wave Reflection and Pulse Wave Velocity.

Kingsley, JD, Tai, YL, Vaughan, J, and Mayo, X. High-intensity interval cycling exercise on wave reflection and pulse wave velocity. J Strength Cond Res 31(5): 1313-1320, 2017-The purpose of this study was to assess the effects of high-intensity exercise on wave reflection and aortic stiffness. Nine young, healthy men (mean ± SD: age: 22 ± 2 years) participated in the study. The high-intensity interval cycling exercise consisted of 3 sets of Wingate Anaerobic Tests (WATs) with 7.5% of bodyweight as resistance and 2 minutes of rest between each set. Measurements were taken at rest and 1 minute after completion of the WATs. Brachial and aortic blood pressures, as well as wave reflection characteristics, were measured through pulse wave analysis. Aortic stiffness was assessed through carotid-femoral pulse wave velocity (cfPWV). A repeated-measures analysis of variance was used to investigate the effects of the WATs on blood pressure and vascular function across time. There was no change in brachial or aortic systolic pressure from rest to recovery. There was a significant (p ≤ 0.05) decrease in brachial diastolic pressure (rest: 73 ± 6 mm Hg; recovery: 67 ± 9 mm Hg) and aortic diastolic pressure (rest: 75 ± 6 mm Hg; recovery: 70 ± 9 mm Hg) from rest to recovery. In addition, there was no significant change in the augmentation index (rest: 111.4 ± 6.5%; recovery: 109.8 ± 5.8%, p = 0.65) from rest to recovery. However, there was a significant (p ≤ 0.05) increase in the augmentation index normalized at 75 b·min (rest: 3.29 ± 9.82; recovery 21.21 ± 10.87) during recovery compared with rest. There was no change in cfPWV (rest: 5.3 ± 0.8 m·s; recovery: 5.7 ± 0.5m·s; p = 0.09) in response to the WAT. These data demonstrate that high-intensity interval cycling exercise with short rest periods has a nonsignificant effect on vascular function.

Changes in the Force-Velocity Mechanical Profile After Short Resistance Training Programs Differing in Set Configurations.

The main aim of this study was to analyze the effect of resistance training programs differing in set configuration on mechanical force-velocity profiles. Thirteen participants performed 10 unilateral knee extension training sessions over 5 weeks. Each limb was randomized to one of the following set configurations: traditional (4 sets of 8 repetitions at maximum intended velocity, 10RM load, 3-min pause between sets) or interrepetition rest (32 maximum intended velocity repetitions, 10RM load, 17.4 s of rest between each repetition). Velocity of each repetition was recorded throughout the program. Before and after training, individual linear force velocities were calculated, and the following parameters were obtained: force and velocity axis intercept, slope, and estimated maximum power. Mean velocity was higher throughout the program for interrepetition rest configuration (0.54 ± 0.01 vs. 0.48 ± 0.01 m∙s-1 for interrepetition rest, and traditional configuration respectively; main effect of set configuration: P < .001). There was a significant increase in force and velocity intercepts, but a steeper negative slope after both training protocols (main effect of time: P < .001 for every variable). Differences in resistance training velocity did not affect the adaptations. Our results suggest that, in a short-term program, maximum intended rather than actual velocity is a key factor to modulate strength adaptations.

Inter-repetition rest training and traditional set configuration produce similar strength gains without cortical adaptations.

This study compared the functional and neural effects of two strength training programmes differing in set configuration. Thirteen participants performed 10 sessions, over a period of 5 weeks, of unilateral leg extensions with different set configurations but with identical work-to-rest ratios for each limb: a traditional configuration (4 sets of 8 repetitions, 10RM load, 3-min pause between sets) and an inter-repetition rest configuration (32 repetitions, 10RM load, 17.4 s of rest between each repetition). Mean propulsive velocity of the traditional sessions was lower than for inter-repetition rest sessions (0.48 ± 0.06 vs. 0.54 ± 0.06 m · s(-1); P < 0.001), while perceived exertion was higher (8.3 ± 0.9 and 6.56 ± 1.6 for traditional training and IRT; P = 0.002). One repetition maximum (RM), work with 10RM load, maximum mean propulsive power, maximum voluntary contraction and time to failure with 50% of maximum isometric force improved similarly in both legs (time effect, P < 0.001; effect size range, 0.451-1.190). Time and set configuration did not show significant main effects or interactions for cortical adaptations (motor-evoked potentials, short-interval intracortical inhibition, intracortical facilitation). There were no significant correlations between changes in cortical and peripheral neural adaptations and strength improvement. In conclusion, inter-repetition rest configuration was as effective as traditional training in improving muscle performance.

Arterial Stiffness and Autonomic Modulation After Free-Weight Resistance Exercises in Resistance Trained Individuals.

Kingsley, JD, Mayo, X, Tai, YL, and Fennell, C. Arterial stiffness and autonomic modulation after free-weight resistance exercises in resistance trained individuals. J Strength Cond Res 30(12): 3373-3380, 2016-We investigated the effects of an acute bout of free-weight, whole-body resistance exercise consisting of the squat, bench press, and deadlift on arterial stiffness and cardiac autonomic modulation in 16 (aged 23 ± 3 years; mean ± SD) resistance-trained individuals. Arterial stiffness, autonomic modulation, and baroreflex sensitivity (BRS) were assessed at rest and after 3 sets of 10 repetitions at 75% 1-repetition maximum on each exercise with 2 minutes of rest between sets and exercises. Arterial stiffness was analyzed using carotid-femoral pulse wave velocity (cf-PWV). Linear heart rate variability (log transformed [ln] absolute and normalized units [nu] of low-frequency [LF] and high-frequency [HF] power) and nonlinear heart rate complexity (Sample Entropy [SampEn], Lempel-Ziv Entropy [LZEn]) were measured to determine autonomic modulation. BRS was measured by the sequence method. A 2 × 2 repeated measures analysis of variance (ANOVA) was used to analyze time (rest, recovery) across condition (acute resistance exercise, control). There were significant increases in cf-PWV (p = 0.05), heart rate (p = 0.0001), normalized LF (LFnu; p = 0.001), and the LF/HF ratio (p = 0.0001). Interactions were also noted for ln HF (p = 0.006), HFnu (p = 0.0001), SampEn (p = 0.001), LZEn (p = 0.005), and BRS (p = 0.0001) such that they significantly decreased during recovery from the resistance exercise compared with rest and the control. There was no effect on ln total power, or ln LF. These data suggest that a bout of resistance exercise using free-weights increases arterial stiffness and reduces vagal activity and BRS in comparison with a control session. Vagal tone may not be fully recovered up to 30 minutes after a resistance exercise bout.

Exercise Type Affects Cardiac Vagal Autonomic Recovery After a Resistance Training Session.

Mayo, X, Iglesias-Soler, E, Fariñas-Rodríguez, J, Fernández-del-Olmo, M, and Kingsley, JD. Exercise type affects cardiac vagal autonomic recovery after a resistance training session. J Strength Cond Res 30(9): 2565-2573, 2016-Resistance training sessions involving different exercises and set configurations may affect the acute cardiovascular recovery pattern. We explored the interaction between exercise type and set configuration on the postexercise cardiovagal withdrawal measured by heart rate variability and their hypotensive effect. Thirteen healthy participants (10 repetitions maximum [RM] bench press: 56 ± 10 kg; parallel squat: 91 ± 13 kg) performed 6 sessions corresponding to 2 exercises (Bench press vs. Parallel squat), 2 set configurations (Failure session vs. Interrepetition rest session), and a Control session of each exercise. Load (10RM), volume (5 sets), and rest (720 seconds) were equated between exercises and set configurations. Parallel squat produced higher reductions in cardiovagal recovery vs. Bench press (p = 0.001). These differences were dependent on the set configuration, with lower values in Parallel squat vs. Bench press for Interrepetition rest session (1.816 ± 0.711 vs. 2.399 ± 0.739 Ln HF/IRR × 10, p = 0.002), but not for Failure session (1.647 ± 0.904 vs. 1.808 ± 0.703 Ln HF/IRR × 10, p > 0.05). Set configuration affected the cardiovagal recovery, with lower values in Failure session in comparison with Interrepetition rest (p = 0.027) and Control session (p = 0.022). Postexercise hypotension was not dependent on the exercise type (p > 0.05) but was dependent on the set configuration, with lower values of systolic (p = 0.004) and diastolic (p = 0.011) blood pressure after the Failure session but not after an Interrepetition rest session in comparison with the Control session (p > 0.05). These results suggest that the exercise type and an Interrepetition rest design could blunt the decrease of cardiac vagal activity after exercise while exercising to muscular failure may contribute to the onset of postexercise hypotension.

Effects of set configuration of resistance exercise on perceived exertion.

Set configuration refers to the repetitions performed with regard to the maximum possible number of repetitions, a factor affecting RPE that has not been previously studied. This study analyzed the effect of set configuration and muscle mass on RPE. Eight students (M age = 23.7 yr. ± 1.7) completed four sessions corresponding to types of exercise with different amount of muscle mass (bench press and parallel squat) and two set configurations: a session with five sets of repetitions to failure and a cluster session. The cluster session involved the same intensity, volume, and rest than the failure session, guaranteeing the same work-to-rest ratio. RPE was higher in Failure vs Cluster sessions and higher in parallel squat vs bench press. This suggests that set configuration influences RPE. Similarly, RPE can be affected by the muscle mass of the exercise performed.

Striving for Global Consensus: A Systematic Review of Social Return on Investment Applied to Physical Activity and Sport.

BACKGROUND: Physical activity and sport (PAS) have been related to health and social benefits, but their monetary value remains unclear. This systematic review on the social return on investment of PAS aimed to find what are the social outcomes measured in previous PAS literature and how are these measured and valued. METHODS: A systematic search was conducted on WoS, PubMed, and EconLit. Articles in English, measuring the social value of any type of PAS in monetary terms and utilizing a social return on investment framework, were included. Risk of bias was evaluated using the Drummond checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. RESULTS: Fifty-five documents (2010-2022), from all continents except America, were included; only 8 were published in peer-reviewed journals, whereas 47 were reports. Most studies evaluated the benefits of specific programs, and 6 measured the engagement in PAS at the population level based on national or community surveys. The social outcomes identified were health (94.5%), crime (50.9%), education (83.6%), subjective well-being (89.1%), social capital (60%), and other (3.6%-23.6%). The valuation methods included willingness to pay, well-being valuation, the cost of an activity that could result in the same outcome, and cost databases associating outcomes with a monetary value. CONCLUSIONS: This study updates a previous review and widens the scope by answering the question of how social outcomes are measured and valued in previous PAS literature. Given the heterogeneity found in the application of the method, this review will inform a Delphi study to reach a Global Consensus Statement on the measurement of social value and PAS.

An online home-based exercise program improves autonomic dysfunction in breast cancer survivors.

Introduction: Exercise interventions for breast cancer survivors have proved their potential to improve clinical, physical, and psychosocial outcomes. However, limited studies have explored exercise effects on autonomic dysfunction and the measurement of exercise tolerance and progression through daily heart rate variability (HRV). Purpose: To analyze the effects of a 16-wk exercise intervention on the autonomic modulation of breast cancer survivors, as well as to examine the evolution of daily measured HRV and its interaction with exercise sessions in this population. Methods: A total of 29 patients who had undergone chemotherapy and radiotherapy were randomly assigned to the exercise group or to the control group. The exercise intervention was delivered remotely through online meetings and consisted of supervised training resistance and cardiovascular exercise 3 times per week. During the intervention all patients measured their HRV daily obtaining the napierian logarithm of the root mean square of successive differences between normal heartbeats (lnrMSSD) and the napierian logarithm of the standard deviation of the interbeat interval of normal sinus beats (lnSDNN) values at four moments: day 0 (the morning of the training sessions), 24, 48, and 72 h after exercise. Results: The results revealed a significant interaction between group and months during the intervention period for lnrMSSD and lnSDNN (p < 0.001). Additionally, there were significant differences in lnSDNN recovery time between months (p < 0.05), while differences in lnrMSSD become apparent only 24 h after exercise (p = 0.019). The control group experienced a significant decrease in both variables monthly (p < 0.05) while exercise group experienced a significant increment (p < 0.05). Conclusion: HRV is daily affected by exercise training sessions in cancer patients. Although results strongly support the role of exercise as a post-chemotherapy and radiotherapy rehabilitation strategy for breast cancer survivors to improve autonomic imbalance, further research is necessary to validate these initial findings.

No impact of combining multi-ingredient supplementation with exercise on body composition and physical performance, in healthy middle-aged and older adults: A systematic review and meta-analysis.

BACKGROUND: Protein-based multi-ingredient (MTN) supplements have been suggested as a safe and effective way of enhancing exercise outcomes. However, their effectiveness remains controversial when compared to isocaloric and single-nutrient supplements. This review aims to systematically summarise the current knowledge of multi-ingredient supplementation to optimise body composition and physical performance in middle-aged and older adults. MATERIAL AND METHODS: A systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search of the literature was conducted using PubMed, EBSCOhost, Google Scholar, Web of Science, and SPORTDiscus from June to October 2021. Every publication identified from the outset to October 2021 was considered. The main inclusion criteria comprised randomized controlled trial (RCT) studies conducted in adults (≥45 years old), following resistance- or endurance-based training programmes for a period of 6 weeks or longer, combined with MTN supplementation and a calorie equivalent comparator (COMP) supplement (e.g., carbohydrates). Continuous data on body composition [fat-free mass (FFM) or lean body mass], strength, and functional capacity as markers of physical performance were pooled using a random-effects model. RESULTS: Initially, 3329 publications were identified. Data from nine RCTs were ultimately included, involving 476 participants. The overall quality of the included studies was high, demonstrating a low risk of bias. Compared to COMP, no significant further benefits of ingesting MTN were identified for FFM (kg) (g = 0.044, 95 % CI -0.14 to 0.22), upper-body strength (kg) (g = 0.046, 95 % CI -0.24 to 0.33), lower-body strength, leg press exercise (kg) (g = 0.025, 95 % CI -0.26 to 0.31), leg extension exercise (kg) (g = 0.106, 95 % CI -0.15 to 0.36) and functional capacity (time in seconds) (g = 0.079, 95 % CI -0.12 to 0.27). CONCLUSIONS: No additional benefits of ingesting MTN vs. COMP to maximise exercise-induced outcomes on body composition and physical performance in healthy physically active middle-aged and older adults have been identified.

High-intensity exercise prescription guided by heart rate variability in breast cancer patients: a study protocol for a randomized controlled trial.

BACKGROUND: Breast cancer is a chronic disease with a large growth in its treatments, prognosis, improvements, side effects and rehabilitation therapies research. These advances have also highlighted the need to use physical exercise as a countermeasure to reduce the cardiotoxicity of pharmacological treatments, increase patients' strength and quality of life and improve body composition, physical condition and mental health. However, new investigations show the need for a closed exercise individualisation to produce higher physiological, physical and psychological benefits in remote exercise programs. To this end, the present study will use, in a novel way in this population, heart rate variability (HRV) as a measure for prescribing high-intensity training. Thus, the primary objective of this randomised clinical trial is to analyse the effects of a high-intensity exercise program daily guided by HRV, a preplanned moderate to high-intensity exercise intervention and a usual care group, in breast cancer patients after chemotherapy and radiotherapy treatments. METHODS: For this purpose, a 16-week intervention will be carried out with 90 breast cancer patients distributed in 3 groups (a control group, a moderate to high-intensity preplanned exercise group and a high-intensity exercise group guided by HRV). Both physical exercise interventions will be developed remotely and supervised including strength and cardiovascular exercises. Physiological variables, such as cardiotoxicity, biomarkers, lipid profile, glucose, heart rate and blood pressure; physical measures like cardiorespiratory capacity, strength, flexibility, agility, balance and body composition; and psychosocial variables, as health-related quality of life, fatigue, functionality, self-esteem, movement fear, physical exercise level, anxiety and depression will be measure before, after the intervention and 3 and 6 months follow up. DISCUSSION: Personalized high-intensity exercise could be a promising exercise intervention in contrast to moderate-intensity or usual care in breast cancer patients to reach higher clinical, physical and mental effects. In addition, the novelty of controlling HRV measures daily may reflect exercise effects and patients' adaptation in the preplanned exercise group and a new opportunity to adjust intensity. Moreover, findings may support the effectiveness and security of physical exercise remotely supervised, although with high-intensity exercise, to reach cardiotoxicity improvements and increase physical and psychosocial variables after breast cancer treatments. Trial registration ClinicalTrials.gov nº NCT05040867 ( https://clinicaltrials.gov/ct2/show/record/NCT05040867 ).

Physical Inactivity Levels of European Adolescents in 2002, 2005, 2013, and 2017.

Sport and Physical Activity (PA) Special Eurobarometer surveys may inform of the physical inactivity (PIA) levels in the European Union (EU). This study aimed to analyse the PIA levels of EU adolescents (15-17 years) in four time points, according to gender. The data were from 2002, 2005, 20013, and 2017 Special Eurobarometers. Adolescents were categorised as "Inactive" when performing less than 60 min/day of moderate to vigorous PA on average. A χ2 test was used to compare the levels of PIA between survey years. PIA levels between gender were analysed using a Z-score test for two population proportions. PIA levels ranged from 67.2% for boys (59.4% to 71.5%;) to 76.8% for girls (76.0% to 83.4) across the time points. Adjusted standardised residuals revealed a decrease in the observed levels versus the expected for 2005 (whole sample: -4.2; boys: -3.3) and an increase for 2013 (whole sample: +2.9; boys: +2.5). Boys presented lower PIA levels than girls in all years (p ≤ 0.003), but descriptively, the difference progressively decreased (from 18.4% to 11.8%). No significant reductions in PIA levels were observed between 2002 and 2017, and girls reported consistently higher levels of PIA than boys.