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American College of Sports Medicine position stand. Progression models in resistance training for healthy adults
... Furthermore, Wanchai et al. [19] and Hasenoehrl et al. [20] concluded that supervised resistance exercise may be safe, feasible, and beneficial for patients with breast cancer-associated edema and those at risk of developing it. The American College of Sports Medicine (ACSM) recommends that exercise prescriptions should adhere to certain principles, specifically the FITT principle, which encompasses exercise frequency, intensity, duration, and type [21]. While a set of resistance exercise training guidelines has been developed for healthy adults, there is no clear standard for the intensity of progressive resistance exercise for patients with breast cancer. ...
... RPE scores of 13-15 points [24] were suitable for intensity. After every 4 weeks of intervention, the weight load was increased by 2-10%1-RM [21], up to a maximum of 70%1-RM Medium/high-load group: The weight load was 50-60%1-RM. Each movement was repeated 8-12 times, each time in 2-3 groups. ...
... Each movement was repeated 8-12 times, each time in 2-3 groups. After every 4 weeks of intervention, the weight load increased by 2-10%1-RM [21], up to a maximum of 80%1-RM Part 3 ...
Purpose
Explore the preventive effects of varying intensity progressive resistance exercise on breast cancer-related lymphedema.
Methods
A total of 114 breast cancer patients who underwent axillary lymph node dissection at Tangshan People’s Hospital from January to April 2024 were included. Participants were randomly assigned to three groups: the control group received conventional care; intervention group 1 received conventional care + low-intensity progressive resistance exercise; and intervention group 2 received routine nursing + moderate and high-intensity progressive resistance exercise. Body composition and grip strength were assessed pre-intervention, post-intervention, and at 3 and 6 months follow-up to compare differences among the groups.
Results
(1) Body composition: At post-intervention, 3 and 6 months follow-up, segmental water differences and extracellular water ratios, along with 1- and 5-kHz SFBIA in both intervention groups, were lower than in the control group. Intervention group 2 had a lower extracellular water ratio than group 1 at post-intervention, and at 3 months follow-up, group 2 showed lower water differences and extracellular water ratios than group 1, with slight variations at 6 months (P < 0.001). (2) Grip strength: At post-intervention, 3 months and 6 months follow-up, grip strength in intervention group 1 and intervention group 2 was higher than that in control group, and the difference was statistically significant (P < 0.001).
Conclusion
Resistance exercise enhances muscle strength and prevents lymphedema, with moderate-high-intensity exercise proving more effective than low intensity. Adverse events were minimal, suggesting that increasing resistance exercise intensity, while considering participants’ conditions, may yield better preventive outcomes.
... Physical exercise is defined as a type of physical activity that is planned, structured, and repetitive, with the goal of improving or maintaining physical fitness levels [4,5]. Therefore, while all physical exercise is a form of physical activity, not all physical activity is considered physical exercise [4,5]. ...
... Physical exercise is defined as a type of physical activity that is planned, structured, and repetitive, with the goal of improving or maintaining physical fitness levels [4,5]. Therefore, while all physical exercise is a form of physical activity, not all physical activity is considered physical exercise [4,5]. Physical inactivity is a significant modifiable health risk behavior and ranks as the fourth leading risk factor for mortality [4,5]. ...
... Therefore, while all physical exercise is a form of physical activity, not all physical activity is considered physical exercise [4,5]. Physical inactivity is a significant modifiable health risk behavior and ranks as the fourth leading risk factor for mortality [4,5]. ...
Objective
To examine the measurement properties of the Regular Physical Exercise Adherence Scale (REPEAS) in Brazilians with chronic pain.
Methods
Cross-sectional and longitudinal design (washout period for reliability). The study was conducted in two Brazilian states, Maranhão and São Paulo, and included Brazilian adults, irregular exercisers, former exercisers or non-exercise practitioners, aged 18 to 59 years and with chronic pain. The instruments used in this study were: the REPEAS, the Numerical Pain Rating Scale (NPRS), the Baecke Habitual Physical Activity Questionnaire (BHPAQ), the Pain Self-Efficacy Questionnaire (PSEQ), and the Roland-Morris Disability Questionnaire for general pain (RMDQ-g). The evaluation focused on structural validity, construct validity, reliability (with standard error of measurement and minimum detectable change), internal consistency, and floor and ceiling effects.
Results
The two-dimensional structure was tested through confirmatory factor analysis, which resulted in adequate fit indeces: chi-square values/degrees of freedom = 1.541, Tucker-Lewis Index = 0.966, comparative fit index = 0.974, root mean square error of approximation = 0.074, and standardized root mean square residual = 0.068. Additionally, satisfactory factor loadings (> 0.40) were obtained. Test-retest reliability and internal consistency were adequate for the environmental factors domain (intraclass correlation coefficient [ICC] = 0.79, Cronbach’s alpha = 0.88) and the personal factors domain (ICC = 0.97, Cronbach’s alpha = 0.93). In hypothesis testing for construct validity, we observed a significant correlation with magnitude below 0.30 of the environmental factors domain of the REPEAS with RMDQ-g, PSEQ and sport domain of the BHPAQ. For the personal factors domain, we observed a significant correlation with a magnitude of 0.30 to 0.50 with RMDQ-g, PSEQ, and sport domain of the BHPAQ, and below 0.30 with leisure domain of the BHPAQ. No floor or ceiling effects were found for the REPEAS domains.
Conclusion
The REPEAS is a valid instrument with a two-dimensional internal structure consisting of 12 items. It has a reliable construct and is suitable for use in the clinical and epidemiological context for adults with chronic pain in Brazil.
... Load adjustments followed a stepwise increase of approximately 5-10% for upper-body exercises and 10-15% for lower-body exercises [39]. Specifically, participants practiced 16 exercises in total, split into two exercise sessions, with 4 multi-joint exercises followed by 4 single-joint exercises per session, in line with ACSM [40] recommendations. To ensure consistency and avoid fatigue during the testing sessions, the rest interval between sets and exercises was set at 3-5 min, with a movement tempo of 3-0-2 s (eccentric-isometric-concentric). ...
... Conversely, lower intensities (e.g., 15RM) generate less AWT, making them more suitable for beginners or individuals recovering from injury. A well-structured, progressive training approach is therefore essential gradually increasing intensity while ensuring optimal biomechanics [40]. Additionally, sex-related physiological differences may influence AWT responses, highlighting the need for individualized training strategies to optimize trunk stability and performance across various loading conditions. ...
Introduction
Resistance exercises are effective for maintaining health and activating stabilizing muscles, as they trigger abdominal wall tension responses. This study compared the effects of multi-joint and single-joint, upper-body and lower-body exercises (Lat pulldown, Rows, Peck deck, Chest press, Biceps curls, Triceps extensions, French-Press, Step up, Hip abduction/adduction, Squat, Leg press, Romanian deadlift, Hamstring curls) performed at maximal and submaximal intensities.
Methods
This cross-sectional study included 12 men and 18 women (age:47.8 ± 5.9 years, height:174.8 ± 10.2 cm, weight: 77.7 ± 15.4 kg, BMI:25.3 ± 3.6), who wore a noninvasive sensor Ohmbelt to measure abdominal wall tension performing exercises at 15 repetition maximum (RM), 10RM, 5RM, and 1RM. Differences across exercises and sex were compared by Friedman test with Durbin-Conover post-hoc, and intensities were analyzed by Wilcoxon test.
Results
The study found significant differences (p < 0.05) in abdominal wall tension changes based on the type of exercise and training intensity. Multi-joint lower-body exercises, such as the Romanian deadlift, dumbbell front squat, and leg press, led to the greatest increases in abdominal tension in both sexes in comparison to single-joint upper-body exercises. Males had higher abdominal wall tension changes than females (p < 0.05) at 1RM, 5RM, and 10RM. However, no significant difference was found at 15RM, indicating that lower intensities produce similar abdominal wall tension changes in both sexes.
Conclusions
This study showed that multi-joint lower-body exercises were found to produce greatest abdominal wall tension increases, especially compared to single-joint upper-body exercises. The abdominal wall tension was higher in males than females due to higher loads, emphasizing the need for exercise-specific approaches.
... This enhances the cycle length, which ultimately contributes to increase maximal velocities and competitive success [3,4,6]. The ability to exert high muscle forces is commonly improved via resistance training, with training intensity typically being quantified in relation to maximal strength [7]. Accordingly, upper-body pulling and pushing exercises, such as the bench press and bench pull, have become fundamental in high-performance training programs, to facilitate the necessary neural and morphological strength adaptations [8]. ...
... Accordingly, upper-body pulling and pushing exercises, such as the bench press and bench pull, have become fundamental in high-performance training programs, to facilitate the necessary neural and morphological strength adaptations [8]. In accordance with the current literature, intensities ranging from 80 to 100% of the dynamic maximal strength are recommended when aiming to improve the maximal strength strength-trained athletes [7,9,10]. To ensure sufficient load and load progression (2-10%) to optimally stimulate muscular adaptions without an increased risk for injury, an accurate assessment of maximal strength is imperative [11,12]. ...
Introduction
In recent years, load-velocity profiles (LVP) have been frequently proposed as a highly reliable and valid alternative to the one-repetition maximum (1RM) for estimating maximal strength and prescribing training loads. However, previous authors commonly report intraclass correlation coefficients (ICC) while neglecting to calculate the measurement error associated with these values. This is important for practitioners, especially in an elite sports setting, to be able to differentiate between small but significant changes in performance and the error rate.
Methods
49 youth elite athletes (17.71±2.07 years) were recruited and performed a 1RM test followed by a load-velocity profiling test using 30%, 50% and 70% of the 1RM in the bench press and bench pull, respectively. Reliability analysis, ICCs and the coefficient of variability, were calculated and supplemented by an agreement analysis including the mean absolute error (MAE) and mean absolute percentage error (MAPE) to provide the resulting measurement error. Furthermore, validity analyses between the measured 1RM and different calculation models to estimate 1RM were performed.
Results
Reliability values were in accordance with current literature (ICC = 0.79–0.99, coefficient of variance [CV] = 1.86–9.32%), however, were accompanied by a random error (mean absolute error [MAE]: 0.05–0.64 m/s, mean absolute percentage error [MAPE]: 2.7–9.5%) arising from test-retest measurement. Strength estimation via the velocity-profile overestimated the bench pull 1RM (limits of agreement [LOA]: -9.73 – -16.72 kg, MAE: 9.80–17.03 kg, MAPE 16.9–29.7%), while the bench press 1RM was underestimated (LOA: 3.34–6.37 kg, MAE: 3.74–7.84 kg, MAPE: 7.5–13.4%); dependent on used calculation model.
Discussion
Considering the observed measurement error associated with LVP-based methods, it can be posited that their utility as a programming strategy is limited. The lack of accuracy required to discriminate between small but significant changes in performance and error, coupled with the potential risks of under- and overestimating 1RM, can result in insufficient stimulus or increased injury risk, respectively. This further diminishes the practicality of these methods, particularly in elite sports settings.
... General recommendations for exercise dosage and progression were followed [37,43], with resistance exercises targeting 40-60% of one repetition maximum, allowing for 8-12 repetitions in 1-3 sets. Resistance equipment, including bands, dumbbells, and machines, was used to tailor and adjust the resistance level for each individual. ...
... Prior studies have shown that patients awaiting THR can tolerate progressive resistance training without adverse effects [33], and that moderate- [55] to high-intensity [56] training is feasible. Although our prehabilitation intervention intended to follow current exercise recommendations for dose and progression [37,43], the physiotherapists delivering the intervention reported through verbal communication that progression was particularly challenging for our study participants as they experienced significant pain during and after exercise. The supervising physiotherapists had to balance intensity with participant willingness to continue exercising throughout the intervention period, sometimes resulting in a lower exercise intensity than prescribed in the study protocol [38]. ...
Background
Prehabilitation involving a planned exercise program before surgery is proposed to improve rehabilitation and postoperative outcomes. However, the current evidence on the efficacy of prehabilitation for patients awaiting total hip replacement is conflicting. The aim of this study was to evaluate efficacy of preoperative exercises and education (AktivA®) for adults 70 years or older awaiting total hip replacement.
Methods
In a two-armed randomized controlled trial we recruited 98 participants aged 70 years or older with a Harris Hip Score less than 60 awaiting elective primary total hip replacement. Participants were recruited at three hospitals in Norway between 2019 and 2022. Participants were randomly assigned to prehabilitation or usual care. The prehabilitation group received a tailored exercise program for 6–12 weeks in addition to patient education. Gait speed, the primary outcome, was measured by the 40 m Fast-Paced Walk Test. Secondary outcomes included performance-based tests (Chair Stand Test, Timed Up & Go Test, 6-Minute Walk Test, Stair Climb Test) and patient-reported outcomes (Hip Disability and Osteoarthritis Outcome Score (HOOS) and EQ-5D). Outcomes were assessed at baseline, post intervention, and further 6 weeks, 3-, 6-, and 12 months post-surgery.
Results
For the primary outcome gait speed at the primary endpoint (3 months post-surgery), no significant between-group differences were observed. However, post-intervention (before surgery), we found a significant improvement in favor of prehabilitation for both gait speed (0.15 m/s, 95% CI 0.02–0.28) and the HOOS quality of life subscale (11.93, 95% CI 3.38–20.48). No other significant differences were found at any post-surgery follow-up for these outcomes. For other secondary outcomes, there were no between-group differences at any point of assessment. Both groups showed improvement across all outcomes 3–12 months after surgery.
Conclusions
The AktivA®program, used as a prehabilitation intervention during a period of 6–12 weeks before total hip replacement did not improve gait speed or any other post-operative outcomes compared to usual care. Both groups demonstrated significant improvement in gait speed and performed well relative to Western reference values 12 months post-surgery. Thus, replacing painful hip joints through total joint replacement seems to outweigh the efficacy of prehabilitation.
Trial registration
ClinicalTrials.gov Identifier: NCT03602105—initial release: 06/06/2018.
... Resistance exercise training has been widely recommended for individuals of all ages and fitness levels (American College of Sports, 2009). It offers numerous benefits, including increased muscle strength and mass, improved bone density, enhanced metabolic rate, improved joint function, and reduced risks of chronic diseases such as type 2 diabetes and cardiovascular disease (American College of Sports, 2009). ...
... Resistance exercise training has been widely recommended for individuals of all ages and fitness levels (American College of Sports, 2009). It offers numerous benefits, including increased muscle strength and mass, improved bone density, enhanced metabolic rate, improved joint function, and reduced risks of chronic diseases such as type 2 diabetes and cardiovascular disease (American College of Sports, 2009). A recent systematic review and meta-analysis of the effect of resistance exercise training suggested that the training volume and training intensity are key factors for improving muscle strength and mass, and power output (Vieira et al., 2021). ...
This study investigated whether home‐based bathing intervention (HBBI) improve muscle strength gain and protect cardiovascular function by short‐term resistance training (RT). Thirty‐one healthy young men measured the maximum voluntary isometric contraction (MVC) of knee extensor, electrically evoked knee extension torque, and mean arterial pressure (MAP). Then, participants were divided into three groups with matching MVC: shower without bathing (control, n = 10), thermoneutral bathing (36°C‐bathing, n = 10), and hot bathing (40°C‐bathing, n = 11), and conducted 2 weeks of HBBI. Following familiarization for HBBI, participants completed 2 weeks of HBBI and acute RT (five sessions of three sets of 10 isometric knee extension at 60% MVC). Baseline neuromuscular and cardiovascular function was assessed again following completion of the 2 weeks of intervention. MVC was non‐significantly increased after the RT period in 40°C‐bathing with large effect size (partial η² = 0.450). The electrically evoked knee extension torque (10/100‐Hz ratio) was significantly increased after the RT period in control (p = 0.020). MAP did not alter due to bathing intervention and RT (all p > 0.05). HBBI improved muscle strength without RT‐induced alteration of peripheral muscle condition. Shower without bathing reduced muscle strength gain but increased peripheral muscle condition. Short‐term RT does not adversely affect the cardiovascular function, regardless of HBBI.
... In this model, general principles for exercise order would be to perform large multi-joint, compound movements before small/single-joint exercises (e.g., Push up before triceps pulldown, squats before leg extensions, etc.). Additionally, training muscular power requires an individual to complete movements at higher velocities (56,83). Consequently, when incorporating strength, power and hypertrophy in the same training session, it is recommended to complete power exercises first, such that fatigue from prior exercises don't negatively impact the ability to train appropriately for power development (41,42). ...
... A review of the strengths, limitations, and applications of each of these concepts is beyond the scope of this review. In this light, readers are directed to other excellent reviews/positions stands on RE program design (41,83). Further, there are very few trials specifically comparing different progression models of RE in older adults, clinical populations, or individuals with cancer. ...
Resistance exercise (RE) has been demonstrated to result in a myriad of benefits for individuals treated for cancer, including improvements in muscle mass, strength, physical function, and quality of life. Though this has resulted in the development of recommendations for RE in cancer management from various international governing bodies, there is also increasing recognition of the need to improve the design of RE interventions in oncology. The design and execution of RE trials are notoriously complex, attempting to account for numerous cancer/treatment related symptoms/side effects. Further, the design of exercise trials in oncology also present numerous logistical challenges, particularly those that are scaled for effectiveness, where multi-site trials with numerous exercise facilities are almost a necessity. As such, this review paper highlights these considerations, and takes evidence from relevant areas (RE trials/recommendations in oncology, older adults, and other clinical populations), and provide a practical framework for consideration in the design and delivery of RE trials. Ultimately, the purpose of this framework is to provide suggestions for researchers on how to design/conduct RE trials for individuals with cancer, rather than synthesizing evidence for guidelines/recommendations on the optimal RE dose/program.
... Based on these studies in healthy subjects [59,60], a dose-response relationship could have been expected, although exercise responses may differ between healthy adults and adults with severe osteoarthritis recovering from surgery. The American College of Sports Medicine does state that individuals respond differently to resistance training based on training status, past experience and joint health [61] and that a variety of exercise intensities may be effective in the elderly population especially when they start exercising [61]. Much like the effect size of spontaneous recovery may blur or exclude an exercise dose-response relationship after THA, the effect size of starting resistance exercise (going from nothing to something) may also blur or exclude an exercise dose-response relationship in previously untrained adults. ...
... Based on these studies in healthy subjects [59,60], a dose-response relationship could have been expected, although exercise responses may differ between healthy adults and adults with severe osteoarthritis recovering from surgery. The American College of Sports Medicine does state that individuals respond differently to resistance training based on training status, past experience and joint health [61] and that a variety of exercise intensities may be effective in the elderly population especially when they start exercising [61]. Much like the effect size of spontaneous recovery may blur or exclude an exercise dose-response relationship after THA, the effect size of starting resistance exercise (going from nothing to something) may also blur or exclude an exercise dose-response relationship in previously untrained adults. ...
Background
Postoperative rehabilitation exercise is commonly prescribed after total hip arthroplasty (THA), but its efficacy compared to no or minimal rehabilitation exercise has been questioned. Preliminary efficacy would be indicated if a dose-response relationship exists between performed exercise dose and degree of postoperative recovery. The objective was to evaluate the preliminary efficacy of home-based rehabilitation using elastic band exercise on performance-based function after THA, based on the association between performed exercise dose and change in performance-based function (gait speed) from 3 (start of intervention) to 10 weeks (end of intervention) after surgery.
Methods
A prospective cohort study was conducted. Following primary THA, patients were prescribed home-based rehabilitation exercise using elastic bands. Performed exercise dose (repetitions/week) was objectively measured using attached sensor technology. Primary outcome was change in gait speed (40 m fast-paced walk test). Secondary outcomes included patient-reported hip disability. In the primary analysis, a linear regression model was used.
Results
Ninety-four patients (39 women) with a median age of 66.5 years performed a median of 339 exercise repetitions/week (1st-3rd quartile: 209–549). Across outcomes, participants significantly improved from 3 to 10-week follow-up. The association between performed exercise dose and change in mean gait speed was 0.01 m/s [95% CI: -0.01; 0.02] per 100 repetitions.
Conclusions
We found no indication of preliminary efficacy of home-based rehabilitation exercise using elastic bands, as no significant and clinically relevant associations between performed exercise dose and changes in outcomes were present. Trials comparing postoperative rehabilitation exercise with no exercise early after THA are warranted.
Trial registration
Pre-registered: ClinicalTrials.gov (Identifier: NCT03109821, 12/04/2017).
... The training parameters used by the study participants are depicted in Table 1. Table 1 Recommendations established by the American College of Sports Medicine (2009) and Kraemer & Ratamess (2004) for improving muscular endurance, compared [1], [8] The outcomes are juxtaposed with the recommendations outlined by the American College of Sports Medicine (2009) and Kraemer and Ratamess (2004) for muscular endurance training across the analyzed parameters [1], [8]. ...
... The training parameters used by the study participants are depicted in Table 1. Table 1 Recommendations established by the American College of Sports Medicine (2009) and Kraemer & Ratamess (2004) for improving muscular endurance, compared [1], [8] The outcomes are juxtaposed with the recommendations outlined by the American College of Sports Medicine (2009) and Kraemer and Ratamess (2004) for muscular endurance training across the analyzed parameters [1], [8]. ...
This study investigated the effectiveness of training methodologies for improving muscular endurance in young adult males and whether these practices align with scientific recommendations. A cross-sectional descriptive comparative study was conducted with 115 male participants aged 18 to 26. Data on various training parameters were collected using a self-administered questionnaire. The results indicated that participants exhibited discrepancies in their training practices compared to established scientific recommendations. An important percentage of study participants did not exercise according to the recommended guidelines regarding exercise sequencing, intensity, repetitions, rest periods, and training supervision. Participants who followed the recommendations regarding intensity, sets, repetitions, weekly training frequency, and supervision achieved higher objective accomplishment scores. Thus, there are notable discrepancies between everyday gym practices and scientific recommendations for improving muscular endurance in young adult men. Adherence to current recommendations and professional supervision are essential for maximizing training effectiveness, preventing injuries, and facilitating future adaptations.
... It is known that resistance training has positive effects on body composition, performance, functionality, and quality of life (Bull et al., 2020). Progressive resistance training programs with different intensities are recommended for healthy adults (Lloyd et al., 2014;Medicine, 2009). The American College of Sports Medicine (ACSM) recommends high-intensity resistance training (HIRT) at 60-70% of 1Repeat Maximum (RM) to develop muscle strength and 70-85% of 1RM to achieve muscle hypertrophy (Medicine, 2009). ...
... Progressive resistance training programs with different intensities are recommended for healthy adults (Lloyd et al., 2014;Medicine, 2009). The American College of Sports Medicine (ACSM) recommends high-intensity resistance training (HIRT) at 60-70% of 1Repeat Maximum (RM) to develop muscle strength and 70-85% of 1RM to achieve muscle hypertrophy (Medicine, 2009). ...
... However, high load strength training (HLRT) effectively enables both strength and hypertrophic muscle adaptations [12]. Therefore, the American College of Sports Medicine (ASCM) guidelines recommend training intensities of at least 70% of 1 Repetition Maximum (RM) when wanting to induce strength increments [13]. ...
... Muscle fibers are recruited according to the 'size principle', in which the smaller motor units associated with type I muscle fibers are activated initially at lower intensities, whereas the larger motor units related to type II muscle fibers are recruited at higher exercise intensities. Since the level of MPS is determined by the amount of muscle fibers activated, it is generally accepted that higher intensities (>70% of 1 Repetition Maximum (1RM)) are required to induce positive muscle adaptations in terms of hypertrophy and strength, as HLRT recruits both type I and type II muscle fibers (whereas LLRT mostly recruits type I fibers) [13]. Interestingly, previous research using integrated electromyography (iEMG) has demonstrated that during BFRT, recruitment of type II muscle fibers happens even at low intensities (~20% 1RM), due to the low oxygen levels and metabolite accumulation induced by vascular occlusion, which causes the type I fibers to fatigue more rapidly [26,[29][30][31]. ...
Knee osteoarthritis is a prevalent joint disease affecting millions of individuals globally. While total knee arthroplasty is an effective treatment for advanced stages of KOA, it may not be suitable for earlier stages or younger patients. Supervised exercise therapy has proven to be the first line treatment of preference in tackling pain and disability caused by KOA. However, the high intensities required to induce positive muscle adaptations are not indicated in this population as this is often accompanied by pain, discomfort, and frustration; leaving low load resistance training as the only feasible method of treatment. Recently, the use of blood flow restriction training began to emerge as a substitute for high load resistance training. With BFRT, a cuff is applied around the proximal aspect of the affected limb, causing partial arterial and full venous occlusion, thereby inducing localized hypoxia and accumulation of metabolites, mimicking the effects of high load resistance training, albeit with low loads. Consequently, BFRT might offer a suitable and more effective alternative for KOA patients who are not (yet) eligible for TKA, compared to the traditional exercise therapy. This review aims to summarize the current evidence as regards the application of Blood Flow Restriction in exercise therapy of knee osteoarthritis patients, with particular consideration of the underlying mechanisms and its safety, as well as general guidelines for practical implementation into clinical practice. In doing so, this narrative review aims to create a framework allowing the translation from theory to practice.
... Exercise intensity was adjusted using the modified Borg Rate of Perceived Exertion (RPE) scale. The resistance element utilised a daily undulated periodisation approach, focusing on hypertrophy work and was progressed using the "2 for 2" rule [42]. In the case of pin-loaded machines, the pin was moved to the next available weight. ...
Purpose
Most exercise interventions for men with prostate cancer utilise resistance and aerobic exercise, though the optimal combination of each for cardiometabolic health and quality of life outcomes is unclear. This study aimed to determine the feasibility of an aerobic-emphasised (AE) versus a resistance-emphasised (RE) exercise intervention in men with prostate cancer undergoing androgen deprivation therapy (ADT) and radiation therapy (RT).
Methods
A 6-month two-armed randomised feasibility study was undertaken. Prostate cancer patients (n = 24) undergoing ADT and RT were randomised to either an AE (n = 12) or RE (n = 12) supervised programme. The primary outcome was feasibility, assessed via recruitment, retention, adherence and safety.
Results
Twenty-four men were randomised, the recruitment rate was 19%. For AE and RE respectively, retention was 75% and 83%, adherence to the exercise prescription was 80% and 76%, attendance was 91% and 92%, with attendance during RT at 96% and 95%. No serious adverse events were recorded. Preliminary evidence favoured the AE intervention (p < 0.05) for certain quality of life domains and haematology markers and the RE intervention (p = 0.05) for BESS balance scores. Pre- to post-intervention improvements (p < 0.05) were observed in multiple functional fitness outcomes.
Conclusion
An exercise trial that carefully varies both resistance and aerobic elements is feasible for men with prostate cancer undergoing active treatment. Strategies would have to be implemented to increase recruitment for a larger trial.
Trial registration
The trial has been registered on ClinicalTrials.gov as of the 14th of December 2021 (NCT05156424).
... Maximal strength was measured as one repetition maximum (1RM, which is the maximal weight an individual can lift once in one exercise) in a horizontal dynamic leg press (Technogym, Italy) following a protocol of the American College of Sports Medicine [46]. The 1RM was assessed after two warm-up sets with 5-8 repetitions each (one set at 40-60% and one set at 60-80% of estimated 1RM). ...
Background
Although evidence for exercise-induced changes in neurocognitive biomarkers is emerging, research examining acute responses to different exercise regimes across sex and age is lacking. This study investigated serum concentrations of three neurocognitive biomarkers (i.e., Klotho, brain-derived neurotrophic factor (BDNF), and glycosylphosphatidylinositol-specific phospholipase D1 (GPLD1)) after acute strength and aerobic exercise, along with skeletal muscle gene expression.
Methods
In a within-subjects crossover design, blood samples of 19 young women, 20 young men, and 14 elderly men were taken before, immediately, 3 h and 24 h after one bout of strength training (ST) and high-intensity interval training (HIIT). Muscle biopsies were taken from a subgroup (n = 22) before, 3 h and 24 h after ST and HIIT for gene expression analyses. Time changes and baseline levels, including the influence of sex and age, were analyzed using a multilevel model and Welch’s analysis of variance, respectively. Biomarker levels were adjusted for exercise-induced plasma volume changes.
Results
Serum concentration of all biomarkers increased after ST and HIIT but were not affected by sex or age. While serum Klotho and BDNF levels peaked immediately after exercise in all groups, serum GPLD1 levels were highest at 3 h (young groups only). Age was a determining factor for baseline measures; young men had higher and lower resting serum Klotho and BDNF concentration, respectively, than elderly men. Muscle gene expression of Klotho increased after both exercise modes, and BDNF and GPLD1 expression was reduced within 24 h.
Conclusions
Circulating levels of biomarkers linked to brain health can acutely be increased by one bout of ST or HIIT. This increase might be related to altered gene expression of these proteins in skeletal muscle. Ultimately, this could have beneficial implications for the management of mental and neurocognitive impairments.
... Our team previously validated a 20-week high-intensity resistance training program that demonstrated its feasibility and effectiveness in significantly increasing maximal muscle strength in the upper and lower body according to existing results in resistance training [20][21][22], as measured by the dynamometry method, among previously untrained healthy male volunteers [23]. The present study aimed to describe the longitudinal biventricular cardiac response to this 20-week high-intensity resistance training program in participants without preexisting cardiac remodeling using 3D echocardiography, and to assess the association between muscle strength gains and both left and right ventricular exercise-induced adaptations. ...
Background
High-intensity resistance training induces structural and functional adaptations in skeletal muscle, yet its impact on cardiac remodeling remains debated. This study aimed to investigate the longitudinal biventricular cardiac response to a 20-week high-intensity resistance training program in previously untrained, healthy males and examine the association between muscle strength gains and cardiac remodeling.
Methods
Twenty-seven male volunteers (aged 18–40 years) participated in a high-intensity resistance training program for 20 weeks. Assessments at baseline, 12 weeks, and 20 weeks included resting blood pressure, electrocardiogram (ECG), three-dimensional transthoracic echocardiography (3DTTE), cardiopulmonary exercise testing (O2peak), isokinetic dynamometry for muscle strength, and actimetry recordings. Time effects were analyzed using one-way repeated measures ANOVA (P < 0.05).
Results
Twenty-two participants completed the study. Resistance training led to significant reductions in arterial systolic and diastolic blood pressure and heart rate. After 20 weeks of training, 3DTTE showed a significant increase in left ventricular (LV) mass (120.1 ± 15.4 g vs. 133.7 ± 16.3 g, p < 0.001), without inducing LV hypertrophy. Balanced increases were observed in LV end-diastolic volume (146.4 ± 18.9 ml vs. 157.9 ± 19.6 ml, p < 0.001) and right ventricular (RV) end-diastolic volume (119 ± 19.4 ml vs. 129.2 ± 21.6 ml, p < 0.001). LV and RV systolic and diastolic function remained unchanged. There were no changes in O2peak or daily activity levels. Maximal muscle strength in the quadriceps, hamstrings, triceps, and biceps was significantly correlated with LV and RV end-diastolic volumes and LV mass (p ≤ 0.001).
Conclusion
The resistance training program resulted in significant and rapid muscle strength gains and reduced blood pressure. Cardiac adaptations, including moderate biventricular dilatation, were observed without changes in cardiac function or O2peak and were associated with muscle strength gains. Our study highlights that intensive resistance training in novice male resistance trainers induces an adaptive cardiac response, reflecting a physiological adaptation linked to enhanced muscle performance.
Trial registration
ClinicalTrials.gov ID: NCT04187170.
... Although there were no significant changes in skeletal muscle mass, the significant improvement in KEF suggests that low-intensity resistance training (30-40% of 1RM) can enhance muscle function without increasing muscle mass. High-intensity resistance training (>60% of 1RM) is required to increase muscle mass 29,30 , which was beyond the scope of this study. However, the resistance exercise load setting in this study was 30-40% of 1RM. ...
Aims/Introduction
Whether regular intervention via modern communication tools is effective in older patients with type 2 diabetes is unclear. We aimed to determine the effects of tele‐guidance for physiotherapy on muscle strength in such patients.
Materials and Methods
This randomized controlled trial was conducted at seven hospitals across Japan. The study participants were 74 older patients with type 2 diabetes randomly assigned to either the tele‐guidance for physiotherapy group, which received weekly telephone interventions, or the non‐intervention group. Both groups performed a combined aerobic and resistance exercise program. The intervention period was 6 months, during which the tele‐guidance for physiotherapy and non‐intervention groups received remote physiotherapy instruction once weekly and at the 3‐month mark, respectively.
Results
Knee extension force was significantly increased in the tele‐guidance for physiotherapy group (from 1.25 ± 0.52 to 1.34 ± 0.54 Nm/kg) but significantly decreased in the non‐intervention group (from 1.28 ± 0.46 to 1.22 ± 0.43 Nm/kg). Hemoglobin A1c levels improved significantly in the tele‐guidance for physiotherapy and non‐intervention groups (from 9.5 ± 2.6 to 7.4 ± 1.6% and from 10.2 ± 2.5 to 7.6 ± 2.0%, respectively). Adherence to the physiotherapy program was significantly higher in the tele‐guidance for physiotherapy group than in the non‐intervention group (71.8% vs 48.6%).
Conclusions
Weekly tele‐guidance for physiotherapy proved effective in improving knee extension force and increasing physiotherapy adherence in older patients with type 2 diabetes. Tele‐guidance may be a valuable intervention to improve muscle strength in such patients, offering a cost‐effective, accessible solution for healthcare management.
... Current research on PFP rehabilitation often follows the exercise dosage described by the American College of Sports Medicine. 35 The most intense exercise programs for PFP include ten repetitions per exercise session conducted two to four times per week for a total of six weeks 6 for reducing pain and improving muscle function properties. However, kinesiophobia typically requires more than three to eight weeks of rehabilitation intervention. ...
Objectives: To evaluate and compare the effects of mindful movement therapy and general exercise therapy on pain intensity, leg muscle fitness, and psychological features in university athletes with chronic patellofemoral pain Study design: Randomized controlled trial, a pilot study Setting: Sport laboratory room, Department of Health and Sport Science, Mahasarakham University Subjects: Thirteen athletes with chronic patellofemoral pain Methods: The participants were males and females aged 19 to 25 years old who had had anterior knee pain for over three months. The self-report questionnaire and clinical tests diagnosed patellofemoral pain. The thirteen people were divided into two groups by block randomized allocation: the mindful movement group (n=7) and the general exercise therapy group (n=6). They were assessed for pain intensity, leg muscle fitness, and psychological features before and after the eight-week study. Both groups visited the physiotherapist to train three times a week for eight weeks. Results: After the 8-week intervention, both groups showed significant improvement in pain intensity, pain catastrophizing scale, fear-avoidance beliefs questionnaire, and strength, endurance, and power tests of the legs over baseline (p < 0.05), but the acceptance scores of the mindful movement group (p = 0.286) and all levels of mindfulness of the general exercise therapy group showed no statistically significant difference (p = 0.904). The differences in average outcomes between the two groups at baseline were not statistically significant with the exception of leg power (p = 0.008). Moreover, there was no significant difference in the change in all outcomes between the two groups after the 8-week intervention (p > 0.05). Conclusions: Both interventions can reduce pain intensity and improve physical and psychological features, even though the athletes had continued to perform other physical activities in daily life while participating in the program. Future studies with Original Article a larger sample size and a determination of retention time are needed.
... • Movement competency usually acknowledged as a baseline marker of implementation and progression of RT programmes in general (240), and in JT programmes in particular (50,241,242). However, JT studies in soccer players frequently fail to report on participants' movement competency during JT exercises and progressive overload. ...
Purpose
To conduct a systematic scoping review assessing the effects of jump training in soccer players physical fitness.
Methods
Included studies incorporated: (i) soccer players; (ii) jump-training interventions; and (iii) outcomes related to physical fitness (e.g. endurance). Selection was not based on comparator groups and/or study designs. PubMed, Web of Science, and Scopus databases were searched for documents. One author led the process, and a second author independently verified the process. The type of outcome measure determined studies aggrupation [e.g. vertical jump (e.g. height; contact time)], with a narrative synthesis accompanied by data summaries (e.g. percentage).
Results
Included studies involved males (adults k = 25; youths k = 52) and females (adults k = 8; youths k = 3). Nonrandomised interventions (single-arm and multi-arm) comprised ~40% of the studies, with durations between 3–96 weeks, and improvements in 1 outcome, including body composition, stiffness, electromyographic activity, potential injury risk factors, kicking velocity, repeated sprint ability, linear sprinting, endurance, balance, maximal strength, and jump performance. However, only 10-13 participants were involved in jump training groups. Further, false significant results and publication bias in favour of studies with significant findings are potentially common issues in the available literature.
Conclusions
Jump training may improve physical fitness in soccer players. However, methodological issues (e.g. non-randomisedcontrolled studies) and evidence gaps (e.g. fewer female studies) were noted. More and better-designed jump training studies on soccer participants are advised before robust recommendations regarding optimal jump training regimens can be made.
... The study's third finding was to reveal the subjective and objective loading characteristics of the three sports. According to the American College of Sports Medicine (ACSM), monitoring the exercise process through ITL can more accurately quantify and assess the training effect 52 . Additionally, a positive exercise experience contributes to the development of interest, while a negative experience is not conducive to habit formation 53 . ...
Chronic sedentary behavior can have a negative impact on the executive function (EF) of young people. While physical activity (PA) has been shown to improve this phenomenon, the effects of different types of PA on EF vary. In this study, we compared the effects of moderate-intensity continuous training (MICT) (60–70% HRmax, 30 min), body weight training (BWT) (2 sets tabata, 20 min), and mind-body exercise (MBE) (2 sets Yang style shadowboxing, 20 min) on EF in 59 sedentary youth (n = 59, age = 20.36 ± 1.78, BMI = 24.91 ± 1.82, P>0.05) to identify the optimal dose of PA for improving EF. Metrics related to the EF task paradigm included stop signal, electroencephalogram (EEG), event-related potential (ERP), P300, N200, error-related negativity (ERN), and error positivity (Pe). error positivity (Pe), and β-wave in frontal lobe; training monitoring, including heart rate (HR), rating of perceived exertion (RPE), feeling scale (FS), and dual-mode model (DMM); load assessment, including Edward’s TRIMP (TRIMP) and session-RPE (s-RPE). The study results indicate that BWT significantly improved accuracy in terms of EF (F = 16.84, P = 0.0381) and was comparable to MICT in terms of shortening reaction time (F = 58.03, P = 0.0217; F = 75.49, P = 0.0178). Regarding ERP, BWT reduced the amplitude values of N200 compared to ERN (F = 44.35, P = 0.0351; F = 48.68, P = 0.0317), increased P300 compared to Pe (F = 97.72, P<0.01; F = 29.56, P = 0.0189), and shortened P300 latency (F = 1.84, P = 0.0406). In contrast, MICT was only effective for P300 with Pe (F = 66.59, P = 0.0194; F = 21.04, P = 0.0342) and shortened N200 latency (F = 27.29, P = 0.0411). The increase in total amplitude and β-oscillation in terms of EEG was proportional to the exercise intensity, with the difference between MICT and BWT being present at 5–20 Hz, and MBE at 10–15 Hz. Regarding training load, the order of HR, RPE, TRIMP, and s-RPE was BWT > MICT > MBE (F = 202.69; F = 114.69; F = 114.69; P = 0.0342). The latency of N200 was also shortened (F = 27.29, P = 0.0411). The results showed that PA improves EF in sedentary youth, although BWT works best, it leads to a decrease in motor perception. Initially, MICT was scheduled alongside MBE and later replaced with BWT. This may help establish an exercise habit while improving EF.
... These strength sessions should target all major muscle groups, involving 8-10 exercises and 2-4 sets of 8-12 repetitions per exercise [54,[64][65][66]. With the recommended 1-2 min of rest between sets, each session will take approximately 40-60 min [66,67], bringing the total weekly minimum to approximately 230-270 min when combined with the aerobic component. However, reducing strength training to a minimum should not be the goal, as higher volumes of resistance exercise are associated with improved glycemic control in T2D [21]. ...
Chronic medical conditions caused by the inadequate adaptation of the body to modern lifestyles, such as physical inactivity and unhealthy diets, are on the rise. This study assessed whether a comprehensive lifestyle intervention, including high volumes of supervised exercise, could improve health outcomes. Eight volunteers with lifestyle‐related diseases received a 6‐month lifestyle intervention consisting of 8000–10 000 steps/day, 6 moderate‐intensity endurance and 3 resistance training sessions per week, a 5‐week long hike, and dietary advice. This was followed by 7 months of limited remote supervision, ending 13 months from baseline. The participants (3 females, 5 males; mean age 42.9 years) had conditions including type 2 diabetes (T2D), depression/stress, and metabolic syndrome (MS). After 6 months, body weight decreased significantly by 23 kg (95% CI; −33.7 to −12.2), with a minor non‐significant decrease in lean body mass of 1.96 kg (95% CI; −4.34 to 0.27). Maximal oxygen consumption (VO2max) increased by 18.5 mL/O2/kg/min. (95% CI; 13.8–23.1) and systolic and diastolic blood pressures decreased by 33 (95% CI; −39 to −26) and 18 mmHg (95% CI; −23 to −14), respectively. Three of the 4 participants with T2D had normalized glycated hemoglobin (HbA1c) levels, and all showed improved 2‐h oral glucose tolerance (OGTT) without pharmacological treatment. Participants with T2D continued to lower HbA1c during the 7‐month follow‐up period. This 6‐month lifestyle intervention restored metabolic health and improved cardiovascular health in 8 participants with lifestyle‐related diseases while reducing the need for pharmacological treatments. These findings suggest that comprehensive lifestyle changes can reverse several medical conditions caused by evolutionary mismatch.
... Эффективность тепловидения наглядно показывает его применение для оценки силовой тренировки [48]. Полезность силовых упражнений под контролем тепловидения, а именно снижение спортивного травматизма, показана как у детей, так и у взрослых, у элитных спортсменов и у непрофессионалов [49]. ...
The narrative review is dedicated to justifying the feasibility of using infrared thermal imaging in children’s sports. It examines the possibilities of thermal imaging in sports physiology and medicine, the concept of a ‘Athlete’s Thermal Passport,’ and various applications of the method during training and competitive periods, as well as its effectiveness in preventing sports injuries. The practical value of thermal imaging is demonstrated within a comprehensive approach for monitoring health, assessing performance, and identifying potential issues throughout a child’s sporting career.
... By significantly increasing the metabolic stimulus, BFR allows for much lower mechanical loads compared with the 70% of one repetition maximum (1RM) recommended by the American College of Sports Medicine for strength increments. 18 Consequently, BFR might offer a suitable and more effective strength training method for patients with KOA whose degenerated joints do not tolerate high-intensity exercises well. Therefore, this randomised controlled trial (RCT) aimed to assess the functional results (both short-term and sustained) of BFR in a large sample of KOA. ...
Objectives
Knee osteoarthritis (KOA) is a leading cause of global disability with conventional exercise yielding only modest improvements. Here we aimed to investigate the benefits of integrating blood flow restriction (BFR) into traditional exercise programmes to enhance treatment outcomes.
Methods
The Vascular Occlusion for optimizing the Functional Improvement in patients with Knee Osteoarthritis randomised controlled trial enrolled 120 patients with KOA at Ghent University Hospital, randomly assigning them to either a traditional exercise programme or a BFR-enhanced programme over 24 sessions in 12 weeks. Assessments were conducted at baseline, 6 weeks, 12 weeks and 3 months postintervention using linear mixed models with Dunn-Sidak corrections for multiple comparisons. Primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire at 3 months follow-up with knee strength, Pain Catastrophizing Scale questionnaire and functional tests as secondary outcomes. Analysis followed an intention-to-treat approach ( NCT04996680 ).
Results
The BFR group showed greater improvements in KOOS pain subscale (effect size (ES)=0.58; p=0.0009), quadriceps strength (ES=0.81; p<0.0001) and functional tests compared with the control group at 12 weeks. At 3 months follow-up, the BFR group continued to exhibit superior improvements in KOOS pain (ES=0.55; p=0.0008), symptoms (ES=0.59; p=0.0004) and quality of life (QoL) (ES=0.66; p=0.0001) with sustained benefits in secondary outcomes. Drop-out rates were similar in both groups.
Conclusion
Incorporating BFR into traditional exercise programmes significantly enhances short-term and long-term outcomes for patients with KOA demonstrating persistent improvements in pain, symptoms, QoL and functional measures compared with conventional exercise alone. These findings suggest that BFR can provide the metabolic stimulus needed to achieve muscle strength and functional gains with lower mechanical loads. Reduced pain and increased strength support a more active lifestyle, potentially maintaining muscle mass, functionality and QoL even beyond the supervised intervention period.
Trial registration number
NCT04996680 .
... Two exercise modalities (HIIT and RT) were employed in this study. Meanwhile, the training protocols were designed according to the guidelines provided by the American College of Sports Medicine (ACSM) [23,24] and all training sessions were conducted under supervision. ...
To explore the genetic architecture underlying exercise-induced fat mass change, we performed a genome-wide association study with a Chinese cohort consisting of 442 physically inactive healthy adults in response to a 12-week exercise training (High-intensity Interval Training or Resistance Training). The inter-individual response showed an exercise-induced fat mass change and ten novel lead SNPs were associated with the response on the level of P<1×10−5. Four of them (rs7187742, rs1467243, rs28629770 and rs10848501) showed a consistent effect direction in the European ancestry. The Polygenic Predictor Score (PPS) derived from ten lead SNPs, sex, baseline body mass and exercise protocols explained 40.3% of the variance in fat mass response, meanwhile importantly the PPS had the greatest contribution. Of note, the subjects whose PPS was lower than −9.301 had the highest response in exercise-induced fat loss. Finally, we highlight a series of pathways and biological processes regarding the fat mass response to exercise, e.g. apelin signaling pathway, insulin secretion pathway and fat cell differentiation biological process.
... According to the American College of Sports Medicine (2009), functional exercise is work against resistance, with the force generated exerting direct benefits for both the performance of activities of daily living and movements related to the practice of sports. The relevance of functional exercise is in the broad application possibilities and the transference of the effects to daily activities [17][18][19]. ...
Background/objective
Fibromyalgia is a non-inflammatory syndrome characterized by generalized muscle pain, with other symptoms. Numerous forms of physical training for this population have been studied through high-quality randomized clinical trials involving strength, flexibility, aerobic conditioning and multicomponent exercise interventions. This research evaluated the effectiveness of a functional exercise program at reducing pain, improving functional capacity, increasing muscle strength as well as improving flexibility, balance and quality of life in individuals with fibromyalgia.
Methods
Eighty-two women with fibromyalgia were randomized into two groups. The functional exercise group performed functional exercises in 45-minute sessions twice per week for 14 weeks. The stretching exercise group performed flexibility exercises with the same duration and frequency. Outcome measures were: visual analog scale for widespread pain; Fibromyalgia Impact Questionnaire for health-related quality of life; Timed Up and Go test for functional performance; one-repetition maximum for muscle strength, Sit and Reach test on Wells bench for flexibility; Berg Balance Scale for balance; SF-36 for general quality of life.
Results
After the intervention, the functional exercise group had a statistically significant reduction in pain (interaction p = 0.002), and improvement in health-related quality of life measured by the Fibromyalgia Impact Questionnaire (interaction p < 0.001) and in general health state domain of SF-36 (interaction p = 0.043) compared to the stretching exercise group. No significant differences between groups were found regarding improvements in functional capacity, muscle strength, flexibility or balance.
Conclusion
Functional exercise training was effective at reducing pain and improving quality of life in patients with fibromyalgia compared to stretching exercises.
Trial registration
ClinicalTrials.gov Identifier: NCT03682588 First prospectively registered in March 2018.
... Strength training is one of the most effective ways to combat muscle weakness, as it can signi cantly improve the strength of thigh muscles such as the quadriceps and promote the recovery of knee joint function 26 . The American College of Sports Medicine (ACSM) recommends that resistance training to enhance muscle strength should involve a resistance load of at least 60%-70% of the single-repetition maximum load (1-repetition maximum, 1RM) 27 . To increase muscle volume, a positive load of 70%-85% of the 1RM is suggested. ...
The purpose of this study was to investigate the effects of combining BFRT with EMS on muscle functions and sports performance in football players with knee osteoarthritis (KOA). This parallel randomized controlled trial was conducted on 64 football players diagnosed with KOA at Chengdu Sport University. Participants were enrolled based on predefined eligibility criteria and randomly allocated to four groups: the control group (CTR, n = 16), BFRT-alone group (BFRT, n = 16), EMS-alone group (EMS, n = 16), and BFRT combined with EMS group (CMB, n = 16). Data were gathered via the 10-meter sprint, 20-meter sprint, countermovement jump (CMJ), and Illinois agility test (IAT) to assess sports performance. Additionally, peak torque (PT) was used to measure muscle strength, the root mean square (RMS) was used to assess muscle activation, and the cross-sectional area (CSA) was used to evaluate muscle volume. The data were statistically analyzed via SPSS software, and a p-value < 0.05 was considered significant. Following the 8-week intervention, the CMB group exhibited greater improvement in the 10-m sprint compared to the CTR group and demonstrated significant enhancements in the 20-m sprint, CMJ, and IAT, outperforming the other three groups ( p < 0.05). To PT, the CMB groups demonstrated significant superiority over the other three groups, while the BFRT group exhibited greater improvement in PT than the EMS group ( p < 0.05). Concerning RMS, the EMS and CMB groups showed significant improvements compared with the CTR and BFRT groups, whereas the improvement in the BFRT group was significantly greater than that in the CTR group ( p < 0.05). For CSA, the BFRT and CMB groups presented notable advancements compared with the CTR and EMS groups ( p < 0.05). In summary, the results suggest that BFRT combined with EMS can increase muscle strength in male football players with KOA through improving muscle volume and neuromuscular recruitment under low-intensity resistance training, thereby increasing explosive power and agility.
... Resistance training (RT) is a popular physical activity recommended for the enhancement or maintenance of musculoskeletal health [9]. It is typically performed with free weights, resistance machines and isokinetic equipment. ...
The present chapter delves into the topic of muscle hypertrophy in detail, focusing on defining what muscle hypertrophy is, the types of hypertrophy, the mechanisms, and the relationship with resistance training, as well as the variables affecting hypertrophy such as nutrition, rest, exercise selection, training volume, and training frequency, among others. The importance of mechanical tension, metabolic stress, and muscle damage as triggers for muscle hypertrophy is emphasized. Various types of muscle hypertrophy are explored, including connective tissue hypertrophy and sarcoplasmic and myofibrillar hypertrophy. The text also delves into how hypertrophy mechanisms relate to resistance training, highlighting the significance of mechanical tension and metabolic stress as stimuli for muscle hypertrophy. In a practical point of view, the text also discusses factors like nutrition and recovery, highlighting the importance of maintaining a positive energy balance and adequate protein intake to promote muscle growth optimally. Training variables such as exercise selection, exercise order, intensity, volume, frequency, and tempo of execution are discussed in detail, outlining their impact on muscle hypertrophy. The text provides a comprehensive overview of muscle hypertrophy, analyzing various factors that influence the ability to increase muscle mass. It offers detailed information on the biological mechanisms, types of hypertrophy, training strategies, and nutritional and recovery considerations necessary to achieve optimal results in terms of muscle hypertrophy.
... In each exercise, they performed 3 sets of repetitions until moderate fatigue (i.e., a reduction of movement velocity) with 90 s interval between the sets and the exercises. The intensity was set at 50% of 1 repetition maximal (1RM) measured before the beginning of the study, and workload was increased by 5-10% when the patient was able to perform more than 15 repetitions without moderate fatigue in two consecutive sets [38]. Each training session lasted around 30 to 40 minutes. ...
Ambulatory blood pressure (ABP) monitoring is a widespread recommendation for the diagnosis and management of hypertension. Dynamic resistance training (DRT) and isometric handgrip training (IHT) have been recommended for hypertension treatment, but their effects on ABP have been poorly studied. Additionally, combined dynamic and isometric handgrip resistance training (CRT) could produce an additive effect that has yet to be tested. Thus, this randomized controlled trial was designed to evaluate the effects of DRT, IHT and CRT on mean ABP and ABP variability. Fifty-nine treated men with hypertension were randomly allocated to 1 of four groups: DRT (8 dynamic resistance exercises, 50% of 1RM, 3 sets until moderate fatigue), IHT (4 sets of 2 min of isometric handgrip at 30% of MVC), CRT (DRT + IHT) and control (CON – 30 min of stretching). Interventions occurred 3 times/week for 10 weeks, and ABP was assessed before and after the interventions. ANOVAs and ANCOVAs adjusted for pre-intervention values were employed for analysis. Mean 24-h, awake and asleep BPs did not change in either group throughout the study (all, P > 0.05). Nocturnal BP fall as well as the standard deviation, coefficient of variation and the average real variability of ABP also did not change significantly in either group (all, P < 0.05). Changes in all these parameters adjusted to the pre-intervention values were also similar among the four groups (all, p > 0.05). In treated men with hypertension, 10 weeks of DRT, IHT or CRT does not decrease ABP levels nor change ABP variability.
... In the present study, we evaluated all these cardiovascular parameters in two distinct muscle groups in young adults, filling part of the gap of the effects of resistance exercise. The intensity of EFlex and KExt exercises was 50% of 1RM, considered effective for beginner training [37]. During the execution of the exercises, care was taken that the exercises were performed without the presence of the Valsalva maneuver [33]. ...
Background
Different types of exercise, performed acutely or chronically, have different repercussions on central hemodynamics, arterial stiffness, and cardiac function. In this study, we aim to compare the effects of acute elbow flexion (EFlex) and knee extension (KExt) exercises on vascular and hemodynamic parameters and arterial stiffness indices in healthy young adults.
Methods
Young adults (20 to 39 years) underwent randomized muscle strength tests to obtain 1 repetition maximum (1RM) for elbow flexion (EFlex) and knee extension (KExt). After a minimum interval of 48 h, cardiovascular parameters were assessed using Mobil-O-Graph® (Mobil-O-Graph, IEM, Germany) at three-time points: at baseline (before exercise), immediately after elbow flexion or knee extension exercises with a load corresponding to 50% of 1RM (T0) and after 15 min of rest (T15).
Results
Immediately after exercise (T0), peripheral systolic blood pressure, peripheral pulse pressure, central systolic blood pressure, and central pulse pressure were significantly higher in KExt than EFlex (Δ 3.13; Δ 3.06; Δ 5.65; Δ 5.61 mmHg, respectively). Systolic volume, cardiac output, and cardiac index were significantly higher immediately after KExt when compared with EFlex (Δ 4.2 ml; Δ 0.27 ml/min and 0.14 l/min*1/m², respectively). The reflection coefficient and the pulse wave velocity were also significantly higher at T0 in KExt compared to EFlex ( Δ 8.59 and Δ 0.12 m/sec, respectively).
Conclusion
Our results show differential contribution of muscle mass in vascular and hemodynamic parameters evaluated immediately after EFlex and KExt. In addition, our study showed for the first time that the reflection coefficient, an index that evaluates the magnitude of the reflected waves from the periphery, was only affected by KExt.
... The whole body RTI included six seated machine resistancetraining exercises and two body-weight exercises, performed with 8-12 repetitions in 2 sets [15]. The same physiotherapist constructed and supervised the RTI, throughout the study period [16]. Intervention compliance was defined as an average attendance to ≥ 2 weekly sessions, controlled by gym electronic card system logs. ...
Background
Most women experience vasomotor symptoms (VMS) during the menopausal transition. A 15-week resistance training intervention (RTI) significantly reduced moderate-to-severe VMS (MS-VMS) and improved health-related quality of life (HRQoL) and cardiovascular risk markers in postmenopausal women. Whether a short RTI could have long-term effects is unknown. We aimed to investigate whether there were intervention-dependent effects two years after a 15-week RTI on MS-VMS frequency, HRQoL, and cardiovascular risk markers in postmenopausal women.
Methods
This observational prospective cohort study is a follow-up to a randomized controlled trial (RCT) on a 15-week RTI in postmenopausal women (n = 57). The control group had unchanged low physical activity during these first 15 weeks. At the follow-up contact two years post-intervention, 35 women agreed to participate in an additional physical visit at the clinic with clinical testing, blood sampling, and magnetic resonance imaging, identical to the protocol at the baseline visit at the start of the RCT.
Results
Although all women showed reduced MS-VMS and increased moderate-to-vigorous physical activity (MVPA) over the 2-year follow-up compared to baseline, the groups from the original RCT (intervention group; IG, control group; CG) changed differently over time (p < 0.001 and p = 0.006, respectively) regarding MS-VMS. The IG maintained a significantly lower MS-VMS frequency than the CG at the 6-month follow-up. At the 2-year follow-up, there was no significant difference between the original RCT groups. No significant changes over time or differences between groups were found in HRQoL or cardiovascular risk markers. However, significant interactions between original RCT groups and time were found for visceral adipose tissue (p = 0.041), ferritin (p = 0.045), and testosterone (p = 0.010).
Conclusions
A 15-week resistance training intervention reduced MS-VMS frequency up to six months post-intervention compared to a CG, but the effect was not maintained after two years. The RTI did neither contribute to preserved improvements of cardiovascular risk markers nor improved HRQoL after two years compared to a CG.
Trial registration
Clinical trials.gov registered ID: NCT01987778, trial registration date 2013–11-19.
... Highvelocity resistance exercises (exercises involving concentric muscle contractions with the intention of moving as-fast-as-possible) may result in greater improvements in LEP and should be considered when designing exercise programs as part of the first-line treatment for hip OA. When designing exercise programs where muscle power is one of the goals, one could consider the general recommendations by the American College of Sports Medicine of exercises with heavy loads (85-100% of 1 RM) to increase the force component of the power equation, and light to moderate loads (0-60% of 1 RM) to improve the velocity component [36]. However, both exercise programs investigated in this cohort, PRT and NEMEX, seem sufficient for attaining small-to-moderate increases in muscle power and equally effective for improving physical function. ...
Objective
To investigate associations between changes in leg extensor muscle power of the affected limb (ΔLEP) and changes in physical function after 12 weeks of progressive resistance training (PRT) or neuromuscular exercise (NEMEX) in patients with hip osteoarthritis.
Design
Secondary analyses of a randomized controlled trial. From 160 participants enrolled in the clinical trial and cluster randomized to PRT (n = 82) or NEMEX (n = 78), a total of 147 (92%) had complete follow-up data and were included in the analyses. Simple linear and multivariate linear regression models estimated the crude and adjusted associations between ΔLEP normalized to body weight (watt/kg) and changes in performance-based and patient-reported measures of physical function.
Results
Adjusted estimates [95% confidence intervals] showed associations between ΔLEP (watt/kg) and changes in 30-s chair stand test (β: 2.34 [1.33; 3.35], R²: 0.13), 9-step timed stair climb test (β: −1.47 [-2.09; −0.85], R²: 0.38), 40-m fast paced walking test (β: −2.20 [-3.30; −1.11], R²: 0.09), Activities of Daily Life function (β: 8.63 [3.16; 14.10], R²: 0.23) and Sport and Recreation function (β: 10.57 [2.32; 18.82], R²: 0.21) subscales from the Hip disability and Osteoarthritis Outcomes Score. Group allocation to PRT did not lead to greater regression coefficients than in NEMEX.
Conclusions
Changes in leg extensor muscle power after supervised exercise are consistently associated with changes in physical function across performance-based and patient-reported measures in patients with hip osteoarthritis. These associations seem to be independent of allocation to PRT or NEMEX.
... The load was increased daily by 10% of the initial MIP, independent of the daily MIP measurement, if the previous session was completed. According to the American Sport College Medicine [26], for local muscular endurance training, it is recommended that light to moderate loads (40-60% of 1 maximal resistance) be performed for high repetitions (> 15) using short rest periods (< 90 s). To our point of view, this regimen of training performed by Cader et al. correspond to a low intensity program for endurance training. ...
Background
Inspiratory muscle training (IMT) is well-established as a safe option for combating inspiratory muscles weakness in the intensive care setting. It could improve inspiratory muscle strength and decrease weaning duration but a lack of knowledge on the optimal training regimen raise to inconsistent results. We made the hypothesis that an innovative mixed intensity program for both endurance and strength improvement could be more effective. We conducted a multicentre randomised controlled parallel trial comparing the impacts of three IMT protocols (low, high, and mixed intensity) on inspiratory muscle strength and endurance among difficult-to-wean patients.
Methods
Ninety-two patients were randomly assigned to three groups with different training programs, where each performed an IMT program twice daily, 7 days per week, from inclusion until successful extubation or 30 days. The primary outcome was maximal inspiratory pressure (MIP) increase. Secondary outcomes included peak pressure (Ppk) increase as an endurance marker, mechanical ventilation (MV) duration, ICU length of stay, weaning success defined by a 2-day ventilator-free after extubation, reintubation rate and safety.
Results
MIP increases were 10.8 ± 11.9 cmH 2 O, 4.5 ± 14.8 cmH 2 O, and 6.7 ± 14.5 cmH 2 O for the mixed intensity (MI), low intensity (LI), and high intensity (HI) groups, respectively. There was a non-statistically difference between the MI and LI groups (mean adjusted difference: 6.59, 97.5% CI [− 14.36; 1.18], p = 0.056); there was no difference between the MI and HI groups (mean adjusted difference: − 3.52, 97.5% CI [− 11.57; 4.53], p = 0.321). No significant differences in Ppk increase were observed among the three groups. Weaning success rate observed in MI, HI and LI group were 83.7% [95% CI 69.3; 93.2], 82.6% [95% CI 61.2; 95.0] and 73.9% [95% CI 51.6; 89.8], respectively. MV duration, ICU length of stay and reintubation rate had similar values. Over 629 IMT sessions, six adverse events including four spontaneously reversible bradycardia in LI group were possibly related to the study.
Conclusions
Among difficult-to-wean patients receiving invasive MV, no statistically difference was observed in strength and endurance progression across three different IMT programs. IMT appears to be feasible in usual cares, but some serious adverse events such as bradycardia could motivate further research on the specific impact on cardiac system.
Trial registration Clinicaltrials.gov identifier: NCT02855619. Registered 28 September 2014
... There may be truth to both perspectives. Surprisingly, when a sedentary person performs an exercise training program the vast majority of studies indicate that regular physical activity, in the absence of dietary intervention, is not effective at promoting clinically significant weight loss in the majority of people [20,22,23,246]. ...
Purpose of Review
Considering the high prevalence of obesity and related metabolic impairments in the population, the unique role nutrition has in weight loss, reversing metabolic disorders, and maintaining health cannot be overstated. Normal weight and well-being are compatible with varying dietary patterns, but for the last half century there has been a strong emphasis on low-fat, low-saturated fat, high-carbohydrate based approaches. Whereas low-fat dietary patterns can be effective for a subset of individuals, we now have a population where the vast majority of adults have excess adiposity and some degree of metabolic impairment. We are also entering a new era with greater access to bariatric surgery and approval of anti-obesity medications (glucagon-like peptide-1 analogues) that produce substantial weight loss for many people, but there are concerns about disproportionate loss of lean mass and nutritional deficiencies.
Recent Findings
No matter the approach used to achieve major weight loss, careful attention to nutritional considerations is necessary. Here, we examine the recent findings regarding the importance of adequate protein to maintain lean mass, the rationale and evidence supporting low-carbohydrate and ketogenic dietary patterns, and the potential benefits of including exercise training in the context of major weight loss.
Summary
While losing and sustaining weight loss has proven challenging, we are optimistic that application of emerging nutrition science, particularly personalized well-formulated low-carbohydrate dietary patterns that contain adequate protein (1.2 to 2.0 g per kilogram reference weight) and achieve the beneficial metabolic state of euketonemia (circulating ketones 0.5 to 5 mM), is a promising path for many individuals with excess adiposity.
Graphical Abstract
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... BFRT is the partial restriction of arterial flow by applying pneumatic cuffs to the proximal portion of the extremity and complete restriction of venous outflow [1,2]. According to the original perspective, exercise training with a load exceeding 70 % of 1RM (repetition-maximum) can induce muscle hypertrophy [3]. Previous studies have demonstrated significant gains in muscle strength and hypertrophy even with resistance training at 30 % of 1RM when combined with blood flow restriction (BFR) [4,5]. ...
Objective: This systematic review aims to investigate the effect of blood flow restriction training (BFRT) on upper extremity muscle strength in pathological conditions of the upper extremity musculoskeletal system or in healthy individuals.
Materials and Methods: This study was conducted in accordance with the PRISMA guideline statement. The randomized
controlled studies which published from January 2000 to May
2022 were searched in the PubMed, Web of Science, MEDLINE,
Scopus, and Cochrane Library databases. Inclusion criteria were
healthy clinical population or musculoskeletal pathology related to the upper extremity, participants aged 18 and above,
application of blood flow restriction to the arm, a randomized
controlled study design, and publication in English. Additionally, the presentation of upper extremity muscle strength as an
outcome measurement was required. The quality of the studies was evaluated using The Physiotherapy Evidence Database
(PEDro) scale. Articles that were non-randomized, inaccessible
in full text, and scored 4 or below on the PEDro scale were excluded.
Results: Five studies were included with 219 participants. The
included studies had PEDro scores ranging from 5 to 8, with an
average score of 6.4. This review demonstrated a positive or
neutral effect of BFRT on grip strength and shoulder strength.
Conclusion: Although some studies have reported positive effects of BFRT on upper extremity muscle strength, there is no
conclusive evidence regarding the protocol to be used for increasing upper extremity muscle strength
... Guidelines for physical exercise suggest that, to enhance muscular fitness in the older people, RE with light to moderate intensity (up to 50% of 1 maximal repetition), and three sets of 8-12 repetitions performed two to three times a week can already elicit muscular and molecular effects/adaptations. Furthermore, it has been suggested that performing more sets (4 sets) per muscle group is more efficient for gaining strength (64,65). ...
Alzheimer’s disease (AD) is among common cause of dementia. Complementary therapies, such as resistance exercise (RE), have been proposed as an alternative for the treatment of AD. We performed a systematic review and meta-analysis to investigate the effects of RE on the cognitive function of AD animal models and their physiological mechanisms.
This review was submitted to PROSPERO (CRD42019131266) and was done according to PRISMA checklist. Four databases were used in the search: MEDLINE/PUBMED, SCOPUS, Web of Science and Google Scholar. We used SYRCLE and CAMAREDES to assess the risk of bias and methodological quality. We calculated the standardized mean difference using 95% confidence intervals and considered the random effects model and p < 0.05 to determine significance.
A total of 1,807 studies were founded, and after the selection process, only 11 studies were included in this review and 8 studies were included for meta-analysis. Four studies applied RE before AD induction, 7 studies applied RE after AD induction or in the AD condition. All studies included 550 adult and older animals weighing 25–280g. Our analysis revealed that RE had a positive effect on memory in AD animal models but did not show a significant impact on anxiety.
RE performed four or six weeks, more than three days a week, had a significant protective effect on memory. The included studies had a high risk of bias and moderate methodological quality. Therefore, RE can be a potential strategy for preventing cognitive decline in animal models.
Fatigue is an inevitable part of resistance training, making its monitoring crucial to prevent performance decline. This study evaluated the validity of ratings of perceived exertion (RPE) as a measure of fatigue during power bench press (BP) exercises. Fourteen sub-elite male athletes completed three BP tasks with varying volumes (low, medium, high) at 65% of their one-repetition maximum. RPE, spectral fatigue index (SFI), and velocity loss were measured across all conditions. Significant effects were observed for overall RPE, average velocity loss, and average SFI (all p < 0.001). As tasks progressed, RPE and SFI increased significantly (p < 0.001), while velocity loss was not significant in the low-volume condition. Significant correlations were found between RPE and SFI (r = 0.547, p < 0.001), velocity loss and SFI (r = 0.603, p < 0.001), and RPE and velocity loss (r = 0.667, p < 0.001). The findings suggest that both RPE and velocity loss are valid measures of fatigue in power BP exercises. However, RPE is a more practical option due to its simplicity and accessibility. Furthermore, RPE can act as a substitute for velocity when measurement tools are unavailable. It should be noted that velocity alone may not fully capture fatigue in low-repetition power training.
Background
Persistent pain is a complicated phenomenon associated with a wide array of complex pathologies and conditions (e.g., complex regional pain syndrome, non-freezing cold injury), leading to extensive disability and reduced physical function. Conventional resistance training is commonly contraindicated in load compromised and/or persistent pain populations, compromising rehabilitation progression and potentially leading to extensive pharmacological intervention, invasive procedures, and reduced occupational status. The management of persistent pain and utility of adjunct therapies has become a clinical and research priority within numerous healthcare settings, including defence medical services.
Main Body
Blood flow restriction (BFR) exercise has demonstrated beneficial morphological and physiological adaptions in load-compromised populations, as well as being able to elicit acute hypoalgesia. The aims of this narrative review are to: (1) explore the use of BFR exercise to elicit hypoalgesia; (2) briefly review the mechanisms of BFR-induced hypoalgesia; (3) discuss potential implications and applications of BFR during the rehabilitation of complex conditions where persistent pain is the primary limiting factor to progress, within defence rehabilitation healthcare settings. The review found BFR application is a feasible intervention across numerous load-compromised clinical populations (e.g., post-surgical, post-traumatic osteoarthritis), and there is mechanistic rationale for use in persistent pain pathologies. Utilisation may also be pleiotropic in nature by ameliorating pathological changes while also modulating pain response. Numerous application methods (e.g., with aerobic exercise, passive application, or resistance training) allow practitioners to cater for specific limitations (e.g., passive, or contralateral application with kinesiophobia) in clinical populations. Additionally, the low-mechanical load nature of BFR exercise may allow for high-frequency use within residential military rehabilitation, providing a platform for conventional resistance training thereafter.
Conclusion
Future research needs to examine the differences in pain modulation between persistent pain and pain-free populations with BFR application, supporting the investigation of mechanisms for BFR-induced hypoalgesia, the dose-response relationship between BFR-exercise and pain modulation, and the efficacy and effectiveness of BFR application in complex musculoskeletal and persistent pain populations.
This study investigated the effect of bodyweight squat (BWS) with blood flow restriction (BFR) exercise on sprint and jump performance in collegiate male soccer players. Twenty-four male collegiate soccer players (age: 19.3±1.0 years; height: 178.8±5.8 cm; body mass: 73.5±10.7 kg) were randomly divided equally into BFR or control groups. The BFR group performed BWS with BFR, while the Control group performed BWS without BFR 3x/week for eight weeks on nonconsecutive days. Both groups performed BWS for 30-15-15-15 repetitions with 30-second rest between sets (with continuous BFR pressure between sets). Limb occlusion pressure (LOP) was measured in a supine position after 10 min of passive rest by the automated device. Progressive overload was achieved by increasing LOP % weekly. The pressure was set at 60% LOP for the first four weeks and then was increased to 70% LOP for weeks 5 and 6 and then to 80% LOP for weeks 7 and 8. Countermovement jump (CMJ) and 30m sprint performance were assessed before and after the exercise program. No statistically significant differences between groups were identified. Both groups significantly increased sprint and CMJ performance (p<0.05). BFR and control groups increased jumping performance by 7% (ES: 0.55) and 2% (ES: 0.13), respectively. As for sprint performance, BFR and control groups increased by 5% (ES: 1.53) and 3.5% (ES: 1.14), respectively. In conclusion, the BFR group showed a larger effect size for sprint performance, suggesting that BFR may have a moderate to large effect on performance.
Background:
Pelvic floor muscle training (PFMT) is a recommended treatment for female stress, urgency, and mixed urinary incontinence. Training varies in exercise type (pelvic floor muscles contracting with and without other muscles), dose, and delivery (e.g. amount and type of supervision).
Objectives:
To assess the effects of alternative approaches (exercise type, dose, and delivery) to pelvic floor muscle training (PFMT) in the management of urinary incontinence (stress, urgency, and mixed) in women.
Search methods:
We searched the Cochrane Incontinence Specialised Register (searched 27 September 2023; which contains CENTRAL, MEDLINE, ClinicalTrials.gov, and World Health Organization ICTRP), handsearched journals and conference proceedings, and reviewed reference lists of relevant articles.
Selection criteria:
Randomised, quasi-randomised, or cluster-randomised trials in female stress, urge, or mixed urinary incontinence where one trial arm included PFMT and another was an alternative approach to PFMT type, dose, or intervention delivery. We excluded studies with participants with neurological conditions or pregnant or recently postpartum.
Data collection and analysis:
Two review authors independently assessed trials for eligibility and methodological quality using the Cochrane RoB 1 tool. We extracted and cross-checked data and resolved disagreements by discussion. Data processing was as described in the Cochrane Handbook for Systematic Reviews of Interventions (Version 6). Synthesis was completed in intervention subgroups.
Main results:
This is a review update. The analysis included 63 trials with 4920 women; the previous version included 21 trials with 1490 women. Samples sizes ranged from 11 to 362. Overall, study participants were mid-age (45 to 65 years) parous women with stress or stress-predominant mixed urinary incontinence (46 trials), who had no prior incontinence treatment or pelvic surgery, or appreciable pelvic floor dysfunction. Trials were conducted in countries around the world, mostly in middle- or high-income settings (53 trials). All trials had one or more arms using 'direct' PFMT, defined as repeated, isolated, voluntary pelvic floor muscle contractions. Trials were categorised as comparisons of exercise type (27 trials, 3 subgroups), dose (11 trials, 5 subgroups, 1 with no data), and delivery (25 trials, 5 subgroups). Incontinence quality of life data are reported here as the primary outcome. Adverse event data were summarised narratively. Comparison 1: exercise type Co-ordinated training (body movements with concurrent pelvic floor muscle contraction) versus direct PFMT Co-ordinated training may slightly improve quality of life (standardised mean difference (SMD) -0.22, 95% confidence interval (CI) -0.44 to -0.01; I2 = 81%; 8 trials, 356 women; low-certainty evidence). Indirect training (exercises that are not contractions of the pelvic floor muscles) versus direct PFMT Direct PFMT may moderately improve quality of life (SMD 0.70, 95% CI 0.38 to 1.02; I2 = 78%; 4 trials, 170 women; low-certainty evidence). Indirect training combined with direct PFMT versus direct PFMT Combining indirect training with direct PFMT may make little to no difference in quality of life (SMD -0.08, 95% CI -0.26 to 0.10; I2 = 33; 7 trials, 482 women; low-certainty evidence). Comparison 2: exercise dose PFMT with resistance device versus PFMT without resistance device PFMT without a resistance device may slightly improve incontinence quality of life, but the evidence is very uncertain (SMD 0.22, 95% CI -0.04 to 0.48; I2 = 32%; 3 trials, 227 women; very low-certainty evidence). Maximal pelvic floor muscle contractions versus submaximal pelvic floor muscle contractions No data reported. PFMT more days per week versus PFMT fewer days per week PFMT more days per week may greatly improve incontinence quality of life (SMD -1.60, 95% CI -2.15 to -1.05; 1 trial, 68 women; low-certainty evidence). PFMT in upright body positions versus PFMT when lying down No data reported. Comparison 3: exercise intervention delivery PFMT supervised in clinic versus PFMT at home Clinic supervision may slightly improve incontinence quality of life, but the evidence is very uncertain (SMD -0.30, 95% CI -0.65 to 0.05; I2 = 89%; 3 trials, 137 women; very low-certainty evidence). More clinician contact for PFMT supervision versus less clinician contact No usable data reported. Individual supervision of PFMT versus group supervision Individually supervised PFMT probably results in little to no difference in quality of life (SMD -0.18, 95% CI -0.35 to -0.01; I2 = 0%; 5 trials, 544 women; moderate-certainty evidence). PFMT supervised in clinic versus supervision using e-health (mobile app communication with clinicians) Clinic supervision may make little to no difference in incontinence quality of life, but the evidence is very uncertain (SMD -0.11, 95% CI -0.41 to 0.19; 1 trial, 173 women; very low-certainty evidence). PFMT instruction delivered via e-health versus written instruction E-health delivery may slightly improve quality of life (SMD -0.21, 95% CI -0.43 to 0.01; I2 = 25%; 3 studies, 318 women; low-certainty evidence). Adverse events Nine trials collected adverse event data; 66/1083 (6%) women had an adverse event. Almost all events were associated with use of an intravaginal or intrarectal training device. The adverse events were vaginal discharge, spotting, or discomfort. Limitations in the evidence Four main factors influenced our certainty in the evidence: 44 trials were at unclear or high risk of selection bias; data were sparse in some subgroups with few trials, trials that did not measure outcomes of interest, or did not report usable data; results were inconsistent; and many trials were small (imprecise).
Authors' conclusions:
Although there is low- to moderate-certainty evidence that some approaches to PFMT are better than others, for some there was little or no difference. The 7th International Consultation on Incontinence recommends PFMT as first-line therapy for women with urinary incontinence. Direct PFMT (sets of repeated, isolated, voluntary pelvic floor muscle contractions) may result in a small improvement in incontinence quality of life compared to indirect training. In terms of improved quality of life, PFMT can be supervised individually or in a group because it probably makes little to no difference in achieving this outcome. Many comparisons had low- or very low-certainty evidence, often because there was only one trial or several small trials with methodological limitations. More, better designed and reported trials, directly comparing PFMT approaches are needed, especially trials investigating exercise dose.
Uma modalidade que vem sendo muito prescrita é o treinamento de força (TF), que consiste em realizar contrações musculares, gerando tensão muscular. Os indivíduos que buscam por este treinamento procuram alcançar alguns objetivos, e para que isto ocorra as variáveis do treinamento devem ser seguidas corretamente. Isto posto, algumas variáveis do treinamento como a intensidade e o volume são imprescindíveis para obter os ganhos desejados, devendo seguir as suas recomendações durante a realização dos exercícios. Sendo assim, devido à carência de estudos sobre a correta utilização da sobrecarga no treinamento de força, o presente estudo tem como objetivo avaliar as cargas e repetições utilizadas no treinamento de força de acordo com sexo, idade, índice de massa corporal (IMC) e tempo de experiência dos praticantes. Procedimentos metodológicos: A amostra deste estudo foi determinada por conveniência não aleatória e composta por 77 praticantes de treinamento de força de ambos os sexos com experiência em treinamento de força (28 ±7,26 anos; massa corporal de 73,09±13,3 Kg; estatura de 1,72±0,09 m; Índice de Massa Corporal de 24,43±2,98 Kg\m², sendo o estudo aprovado pelo Comitê em Ética da instituição proponente. A coleta de dados ocorreu em duas etapas, na qual a primeira foi de recrutamento, registro das cargas e repetições utilizadas habitualmente (RHab) em seus treinamentos nos exercícios Puxada Frontal, Leg Press 45º e Tríceps Polia, e ainda, da execução de uma série com repetições até a falha concêntrica, com a carga utilizada habitualmente em seu treinamento em cada um dos exercícios. Na segunda etapa, foi realizado o teste de uma repetição máxima (1RM) estimado nos mesmos exercícios, sendo estes dados utilizados para relativizar a carga habitual em %. Após a coleta, as variáveis foram analisadas e são apresentados por meio de estatística descritiva e a comparação realizada por meio do teste t para amostras pareadas e de uma amostra (p>0,05). Os resultados do presente estudo indicam a utilização de intensidades de 1RM relativamente baixas-moderadas, ficando entre 14,30 a 85,90% 1RM, sendo que as médias diferiram entre os três exercícios, havendo uma menor intensidade utilizada no Leg Press 45º (54,09±11,21%), moderada no Tríceps Polia (57,72±10,01%) e superior na Puxada Frontal (61,03±8,76%), onde indivíduos do sexo masculino utilizaram maiores cargas. As médias nas repetições habituais foram semelhantes entre os exercícios, no Leg Press 45º (11,23±1,52), Tríceps Polia (11,19±1,26) e Puxada Frontal (11,12±1,42), e nas repetições máximas Leg Press 45º (21,40±5,15), Tríceps Polia (28,92±25,61) e Puxada Frontal (21,34±8,12). Nas comparações entre os subgrupos, apenas as mulheres apresentaram maiores repetições habituais e máximas, quando comparadas com os homens. Desta forma, conclui-se que foram utilizadas cargas abaixo do recomendado e o número de repetições estão subestimados. Sendo assim, vale ressaltar a importância do controle dos treinamentos por um profissional de Educação Física capacitado para uma melhor supervisão e periodização do TF, o que poderá gerar melhores resultados.
Background
The optimal prescription and precise recommendations of resistance training volume for older adults is unclear in the current literature. In addition, the interactions between resistance training volume and program duration as well as physical health status remain to be determined when assessing physical function, muscle size and hypertrophy and muscle strength adaptations in older adults.
Objectives
This study aimed to determine which resistance training volume is the most effective in improving physical function, lean body mass, lower-limb muscle hypertrophy and strength in older adults. Additionally, we examined whether effects were moderated by intervention duration (i.e. short term, < 20 weeks; medium-to-long term, ≥ 20 weeks) and physical health status (i.e. physically healthy, physically impaired, mixed physically healthy and physically impaired; PROSPERO identifier: CRD42023413209).
Methods
CINAHL, Embase, LILACS, PubMed, Scielo, SPORTDiscus and Web of Science databases were searched up to April 2023. Eligible randomised trials examined the effects of supervised resistance training in older adults (i.e. ≥ 60 years). Resistance training programs were categorised as low (LVRT), moderate (MVRT) and high volume (HVRT) on the basis of terciles of prescribed weekly resistance training volume (i.e. product of frequency, number of exercises and number of sets) for full- and lower-body training. The primary outcomes for this review were physical function measured by fast walking speed, timed up and go and 6-min walking tests; lean body mass and lower-body muscle hypertrophy; and lower-body muscle strength measured by knee extension and leg press one-repetition maximum (1-RM), isometric muscle strength and isokinetic torque. A random-effects network meta-analysis was undertaken to examine the effects of different resistance training volumes on the outcomes of interest.
Results
We included a total of 161 articles describing 151 trials (n = 6306). LVRT was the most effective for improving timed up and go [− 1.20 standardised mean difference (SMD), 95% confidence interval (95% CI): − 1.57 to − 0.82], 6-min walk test (1.03 SMD, 95% CI: 0.33–1.73), lean body mass (0.25 SMD, 95% CI: 0.10–0.40) and muscle hypertrophy (0.40 SMD, 95% CI: 0.25–0.54). Both MVRT and HVRT were the most effective for improving lower-limb strength, while only HVRT was effective in increasing fast walking speed (0.40 SMD, 95% CI: − 0.57 to 0.14). Regarding the moderators, our results were independent of program duration and mainly observed for healthy older adults, while evidence was limited for those who were physically impaired.
Conclusions
A low resistance training volume can substantially improve healthy older adults’ physical function and benefits lean mass and muscle size independently of program duration, while a higher volume seems to be necessary for achieving greater improvements in muscle strength. A low volume of resistance training should be recommended in future exercise guidelines, particularly for physically healthy older adults targeting healthy ageing.
Despite the remarkable and progressive advances made in the prevention and management of cardiovascular diseases, the recurrence of cardiovascular events remains unacceptably elevated with a notable size of the residual risk. Indeed, in patients who suffered from myocardial infarction or who underwent percutaneous or surgical myocardial revascularization, life-style changes and optimized pharmacological therapy with antiplatelet drugs, lipid lowering agents, beta-blockers, renin angiotensin system inhibitors and antidiabetic drugs, when appropriate, are systematically prescribed but they might be insufficient to protect from further events. In such a context, an increasing body of evidence supports the benefits of cardiac rehabilitation (CR) in the setting of secondary cardiovascular prevention, consisting in the reduction of myocardial oxygen demands, in the inhibition of atherosclerotic plaque progression and in an improvement of exercise performance, quality of life and survival. However, prescription and implementation of CR programs is still not sufficiently considered.
The aim of this position paper of the Italian Society of Cardiovascular Prevention (SIPREC) and of the Italian Heart Failure Association (ITAHFA) is to examine the reasons of the insufficient use of this strategy in clinical practice and to propose some feasible solutions to overcome this clinical gap.
Background
The decline of physical function during chemotherapy predicts poor quality of life and premature death. It is unknown if resistance training prevents physical function decline during chemotherapy in colon cancer survivors.
Methods
This multicenter trial randomly assigned 181 colon cancer survivors receiving postoperative chemotherapy to home-based resistance training or usual care control. Physical function outcomes included the short physical performance battery, isometric handgrip strength, and the physical function subscale of the Medical Outcomes Short-Form 36-item questionnaire. Mixed models for repeated measures quantified estimated treatment differences.
Results
At baseline, participants had a mean (SD) age of 55.2 (12.8) years; 67 (37%) were 60 years or older, and 29 (16%) had a composite short physical performance battery score of no more than 9. Compared with usual care control, resistance training did not improve the composite short physical performance battery score (estimated treatment difference = −0.01, 95% confidence interval [CI] = −0.32 to 0.31; P = .98) or the short physical performance battery scores for balance (estimated treatment difference = 0.01, 95% CI = −0.10 to 0.11; P = .93), gait speed (estimated treatment difference = 0.08, 95% CI = −0.06 to 0.22; P = .28), and sit-to-stand (estimated treatment difference = −0.08, 95% CI = −0.29 to 0.13; P = .46). Compared with usual care control, resistance training did not improve isometric handgrip strength (estimated treatment difference = 1.50 kg, 95% CI = −1.06 to 4.05; P = .25) or self-reported physical function (estimated treatment difference = −3.55, 95% CI = −10.03 to 2.94); P = .28). The baseline short physical performance battery balance score (r = 0.21, 95% CI = 0.07 to 0.35) and handgrip strength (r = 0.23, 95% CI = 0.09 to 0.36) correlated with chemotherapy relative dose intensity.
Conclusion
Among colon cancer survivors with relatively high physical functioning, random assignment to home-based resistance training did not prevent physical function decline during chemotherapy.
Clinical Trial Registration
NCT03291951.
This study investigated the effect of a resistance training (RT) period at terrestrial (HH) and normobaric hypoxia (NH) on both muscle hypertrophy and maximal strength development with respect to the same training in normoxia (N). Thirty-three strength-trained males were assigned to N (FiO2 = 20.9%), HH (2,320 m asl) or NH (FiO2 = 15.9%). The participants completed an 8-week RT program (3 sessions/week) of a full body routine. Muscle thickness of the lower limb and 1RM in back squat were assessed before and after the training program. Blood markers of stress, inflammation (IL-6) and muscle growth (% active mTOR, myostatin and miRNA-206) were measured before and after the first and last session of the program. Findings revealed all groups improved 1RM, though this was most enhanced by RT in NH (p = 0.026). According to the moderate to large excess of the exercise-induced stress response (lactate and Ca²⁺) in HH and N, results only displayed increases in muscle thickness in these two conditions over NH (ES > 1.22). Compared with the rest of the environmental conditions, small to large increments in % active mTOR were only found in HH, and IL-6, myostatin and miR-206 in NH throughout the training period. In conclusion, the results do not support the expected additional benefit of RT under hypoxia compared to N on muscle growth, although it seems to favour gains in strength. The greater muscle growth achieved in HH over NH confirms the impact of the type of hypoxia on the outcomes.
Background
Accounting for more than 60% of cancer survivors, older (≥65 years) cancer survivors have a 2- to 5-fold risk of physical function impairment, compared to cancer-free peers. One strategy to improve physical function is dietary and resistance training interventions, which improve muscle strength and mass by stimulating muscle protein synthesis. The E-PROOF (E-intervention for Protein Intake and Resistance Training to Optimize Function) study will examine the feasibility, acceptability, and preliminary efficacy of a 12-week randomized controlled trial of an online, tailored nutritional and resistance training education and counseling intervention to improve physical function and associated health outcomes (muscle strength, health-related quality of life (HRQoL), self-efficacy, and weight management).
Methods
In this study, 70 older cancer survivors will be randomized to one of two groups: experimental (receiving remote behavioral counseling and evidence-based education and resources), and control (general survivorship education). We will examine the intervention effects on physical function, muscle strength, HRQoL, self-efficacy, weight, and waist circumference during a 12-week period between the experimental and control groups. Three months following the end of the intervention, we will conduct a follow-up assessment to measure physical function, muscle strength, and HRQoL.
Significance and impact
This study is the first synchronous, online protein-focused diet and resistance training intervention among older cancer survivors. This novel study advances science by promoting independent health behaviors among older cancer survivors to improve health outcomes, and provide foundational knowledge to further address this growing problem on a wider scale through online platforms.
O objetivo deste estudo foi analisar o efeito do exercício resistido calistênico com e sem restrição de fluxo sanguíneo (RFS) na pressão arterial sistólica (PAS), pressão arterial diastólica (PAD), pressão arterial média (PAM), frequência cardíaca (FC), duplo produto (DP), percepção subjetiva de esforço (PSE), percepção subjetiva de dor (PSD) e o número de repetições (NR). Participaram do estudo 10 homens recreacionalmente treinados (24,9±7,1 anos), onde foram realizados dois protocolos experimentais de maneira randomizada e com um intervalo de sete dias para a execução do outro protocolo: a) realização de uma série até a falha concêntrica com RFS à 80% do ponto de oclusão, b) realização de uma série até a falha concêntrica sem RFS. Todas as variáveis foram verificadas antes da execução de cada protocolo, imediatamente após sua execução e 15 minutos após cada protocolo realizado, com exceção da PSE, PSD e NR, que foram verificadas apenas imediatamente após cada protocolo. Quando comparados os respectivos momentos de repouso, imediatamente após a série e 15 minutos após a conclusão de cada protocolo, foi observado que não houveram diferenças significativas entre eles referente à PAS, PAD, PAM, FC, DP, PSE e a PSD (p>0,05), contudo para o NR foi visto uma diminuição significativa para o protocolo associado à RFS (p=0,045). Conclui-se que a RFS parece causar efeitos hemodinâmicos e perceptivos de esforço e dor similares ao treinamento calistênico tradicional, diferindo apenas para a contagem de repetições mostrando um desempenho superior para o grupo sem RFS.
We compared the effects of different calf training weekly sets on muscle size changes. Sixty-one untrained young women performed a calf training program for 6 weeks, 3 d·wk–1, with differences in the resistance training volume. The participants were randomly assigned to 1 of the 3 groups: 6-SET, 9-SET, and 12-SET calf training weekly sets. The calf raise exercise was performed in sets of 15–20 repetitions maximum. The muscle thickness measurements of medial gastrocnemius (MG), lateral gastrocnemius (LG), and soleus (SOL) were taken via B-mode ultrasound. We used the sum of the three-muscle thickness as a proxy for the triceps surae (TSSUM). The 12-SET group elicited greater increases than 6-SET in LG (6-SET = +8.1% vs. 12-SET = +14.3%; P = 0.017), SOL (6-SET = +6.7% vs. 12-SET = +12.7%; P = 0.024), and TSSUM (6-SET = +6.9% vs. 12-SET = +12.0%; P = 0.005), but there was no significant difference in MG changes (6-SET = +6.6% vs. 12-SET = +9.9%; P = 0.067). There were no significant differences when comparing 9-SET vs. 6-SET and 12-SET (P ≥ 0.099). Although all groups experienced calf muscle hypertrophy, our results suggest that the higher dose range may optimize triceps surae muscle size gains.
ResearchGate has not been able to resolve any references for this publication.