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Background: Effective hypertrophy-oriented resistance training (RT) should comprise a combination of mechanical tension and metabolic stress. Regarding training variables, the most effective values are widely described in the literature. However, there is still a lack of consensus regarding the efficiency of advanced RT techniques and methods in comparison to traditional approaches. Methods: MEDLINE and SPORTDiscus databases were searched from 1996 to September 2019 for all studies investigating the effects of advanced RT techniques and methods on muscle hypertrophy and training variables. Thirty articles met the inclusion criteria and were consequently included for the quality assessment and data extraction. Results: Concerning the time-efficiency of training, the use of agonist-antagonist, upper-lower body supersets, drop and cluster sets, sarcoplasma stimulating training, employment of fast, but controlled duration of eccentric contractions (~2s), and high-load RT supplemented with low-load RT under blood flow restriction may provide an additional stimulus and an advantage to traditional training protocols. With regard to the higher degree of mechanical tension, the use of accentuated eccentric loading in RT should be considered. Implementation of drop sets, sarcoplasma stimulating training, low-load RT in conjunction with low-load RT under blood flow restriction could provide time-efficient solutions to increased metabolic stress. Conclusions: Due to insufficient evidence, it is difficult to provide specific guidelines for volume, intensity of effort, and frequency of previously mentioned RT techniques and methods. However, well-trained athletes may integrate advanced RT techniques and methods into their routines as an additional stimulus to break through plateaus and to prevent training monotony.
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Int. J. Environ. Res. Public Health 2019, 16, 4897; doi:10.3390/ijerph16244897 www.mdpi.com/journal/ijerph
Review
Maximizing Muscle Hypertrophy: A Systematic
Review of Advanced Resistance Training Techniques
and Methods
Michal Krzysztofik *, Michal Wilk, Grzegorz Wojdała and Artur Gołaś
Institute of Sport Sciences, Jerzy Kukuczka Academy of Physical Education in Katowice, ul. Mikolowska 72a,
40-065 Katowice,Poland; m.wilk@awf.katowice.pl (M.W.); wojdala.grzegorz@gmail.com (G.W.);
a.golas@awf.katowice.pl (A.G.)
Corresponding author: m.krzysztofik@awf.katowice.pl
Received: 12 October 2019; Accepted: 03 December 2019; Published: 4 December 2019
Abstract: Background: Effective hypertrophy-oriented resistance training (RT) should comprise a
combination of mechanical tension and metabolic stress. Regarding training variables, the most
effective values are widely described in the literature. However, there is still a lack of consensus
regarding the efficiency of advanced RT techniques and methods in comparison to traditional
approaches. Methods: MEDLINE and SPORTDiscus databases were searched from 1996 to
September 2019 for all studies investigating the effects of advanced RT techniques and methods on
muscle hypertrophy and training variables. Thirty articles met the inclusion criteria and were
consequently included for the quality assessment and data extraction. Results: Concerning the time-
efficiency of training, the use of agonist–antagonist, upper–lower body supersets, drop and cluster
sets, sarcoplasma stimulating training, employment of fast, but controlled duration of eccentric
contractions (~2s), and high-load RT supplemented with low-load RT under blood flow restriction
may provide an additional stimulus and an advantage to traditional training protocols. With regard
to the higher degree of mechanical tension, the use of accentuated eccentric loading in RT should be
considered. Implementation of drop sets, sarcoplasma stimulating training, low-load RT in
conjunction with low-load RT under blood flow restriction could provide time-efficient solutions to
increased metabolic stress. Conclusions: Due to insufficient evidence, it is difficult to provide
specific guidelines for volume, intensity of effort, and frequency of previously mentioned RT
techniques and methods. However, well-trained athletes may integrate advanced RT techniques
and methods into their routines as an additional stimulus to break through plateaus and to prevent
training monotony.
Keywords: muscle growth; drop sets; supersets; accentuated eccentric work; blood flow restriction;
pre-exhaustion; sarcoplasma stimulating training; movement tempo
1. Introduction
Resistance training (RT) is a primary exercise intervention used to develop strength and
stimulate muscle hypertrophy. Increases in muscle mass constitute key components of conditioning
in various sports due to the correlation between muscle cross-sectional area and muscle strength [1,2].
Additionally, an increase in muscle mass is one of the goals of bodybuilding [3], and many
recreationally strength-trained individuals. Furthermore, adequate levels of muscle mass are an
important issue from a health standpoint because its low levels are associated with increased risks of
several diseases such as cardiovascular disease [4] and cardio-metabolic risk in adolescents [5] as well
as type II diabetes in middle aged and older adults [6].
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Muscle hypertrophy occurs when muscle protein synthesis exceeds muscle protein breakdown
and results in positive net protein balance in cumulative periods [7]. This could be achieved with
both RT and protein ingestion, which stimulates muscle protein synthesis and leads to decreases in
muscle protein breakdown [8]. From the nutrition point of view, protein intake alongside RT is a
potent stimulus for muscle protein synthesis. With regard to RT, manipulation of its variables such
as intensity and volume of effort, exercise order, number of performed repetitions and sets, tempo of
movement, and the duration of rest periods between sets and exercises and training status have been
extensively explored and discussed to maximize muscle adaptations [9,10]. Volume and intensity of
effort are basic components with a direct impact on muscular adaptations [11,12]. The American
College of Sports Medicine (ACSM) recommends 13 sets per exercise of 812 repetitions with
7085% of one repetition maximum (1RM) for novice and 36 sets of 112 repetitions with 70100%
1RM for advanced individuals [13]. However, the recent literature shows a much wider range of
training options. Several studies have found that training with low-loads (3060% 1RM) results in
similar hypertrophy to training with moderate and high-loads (>60% 1RM) when volitional fatigue
occurs [11,14–16]. Moreover, reaching volitional fatigue at all times is not necessary to make
significant gains in hypertrophy [17], especially when training with high-loads is considered [18].
Evidence indicates that significant muscle growth occurs when the majority of training sets are
performed with ~3–4 repetitions in reserve (with moderate to high-loads) [19]. Furthermore, it has
been established that the volume of RT, defined as the total number of repetitions (repetitions x sets),
together with loads used for a given exercise, is the key element of adaptation in terms of muscle
hypertrophy; moreover, it has been suggested that higher volumes of effort are warranted for
maximizing muscle growth response in diverse populations [12,20–23]. However, following years of
training, it becomes difficult to induce further muscle hypertrophy [24], therefore individuals seek
advanced resistance training techniques.
The purpose of the present paper was to provide an objective and critical review related to
advanced RT methods and techniques influencing skeletal muscle, which may contribute to
maximizing muscle hypertrophy in both recreational and competitive athletes.
2. Methods
2.1. Literature Search
MEDLINE and SPORTDiscus databases were searched from 1996 to September 2019 for all
studies investigating the effects of advanced resistance training techniques and methods on muscle
hypertrophy and training variables. The search was performed using the following keyword
combinations: (‘strength training’ OR ‘resistance training’ OR ‘hypertrophy training’ OR ‘muscle’)
AND (‘time under tension’ OR ‘movement velocity’ OR ‘eccentric overload’ OR ‘accentuated
eccentric’ OR ‘blood flow restriction’ OR ‘blood flow restricted’ OR occlusion OR ‘cluster set’ OR
‘superset OR ‘agonist-antagonist’ OR ‘pre-exhaustion’ OR ‘drop set’ OR ‘sarcoplasma’ OR ‘advanced
training techniques’ OR ‘cross-sectional area’ OR ‘eccentric duration’). The present review includes
studies that (1) presented original research data on healthy adult participants in an age range of 1944
years old; (2) were published in peer-reviewed journals; and (3) were published in the English
language. No sex restrictions were imposed during the search stage.
2.2. Inclusion and Exclusion Criteria
Research studies investigating the effects of advanced resistance training techniques and
methods on muscle hypertrophy and training variables were the primary focus of the literature
search. Early screening of the articles was based on titles and abstracts. A total of 1088 studies were
initially identified for further scrutiny.
The next step was to select studies with respect to their internal validity: (1) comparison of
different advanced RT techniques and methods with the RT programs performed in traditional
training protocols, (2) muscle hypertrophy and/or muscle strength and/or training volume were
assessed pre- and post-intervention; for muscle hypertrophy both muscle cross-sectional area
Int. J. Environ. Res. Public Health 2019, 16, 4897 3 of 16
changes (magnetic resonance imaging, dual-energy x-ray absorptiometry) and changes in muscle
thickness (ultrasound imaging) were considered, while for muscle strength, tests with a repetition
maximum (RM) component (e.g., % 1RM or 5RM) were considered; for training volume changes in
the number of repetitions, total load and time under tension to muscular failure were considered. The
researchers conducted the literature review independently based on inclusion and exclusion criteria.
In total, 30 studies met the inclusion criteria for the review (Figure 1).
Figure 1. The different phases of the search and study selection.
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2.3. Results
Table 1. Experimental details of the studies included in the review.
Reference Sample
Training
Method /
Technique
Training
Duration
Exercise
Prescription Conditions
Were
Repetitions
Performed to
Volitional
Fatigue?
Measurement
Variables Conclusions
Wilk et al.
2018 [25]
42 trained
males Tempo ECC Acute Bench Press 2/0/2/0 vs. 5/0/3/0
vs. 6/0/4/0 Yes TVOL
Regular movement tempo resulted
in highest REP to failure but with
the lowest total TUT.
Hatfield et al.
2006 [26]
9 trained
males Tempo ECC Acute Back Squat and
Shoulder Press
10/0/10/0 vs.
volitional
movement tempo
Yes TVOL
Volitional movement tempo
resulted in higher REP to failure.
Sakamoto and
Sinclair 2006
[27]
13 males Tempo ECC Acute Bench Press slow vs, medium
vs. fast vs. ballistic Yes TVOL
Fast movement velocity resulted in
the highest REP to failure.
Burd et al.
2012 [28] 8 males Tempo ECC Acute Knee Extension 6/0/6/0 vs. 1/0/1/0 Yes TVOL Slow movement tempo resulted in
higher TUT.
Shibata et al.
2018 [29]
24 male
soccer
players
Tempo ECC 6 weeks Parallel Back
Squat 4/0/2/0 vs. 2/0/2/0 Yes HT, STH
Both protocols lead to significant
increase in muscle HT, but longer
ECC duration was less effective in
STH improvement.
English et al.
2014 [30] 40 males AEL 8 weeks Leg Press and Calf
Press
0, 33, 66, 100, or
138% of 1RM No HT, STH
AEL lead to the highest increases
in muscle HT and STH.
Brandenburg
and Docherty
2002 [31]
18 males AEL 9 weeks
Preacher Curls,
Supine Elbow
Extensions
75% vs. 120% 1RM Yes HT, STH
AEL lead to higher increase in STH
for supine elbow extension, with
no significant changes in muscle
HT in both groups.
Walker et al.
2016 [32]
28 trained
males AEL 10 weeks
Leg Press and
Unilateral Knee
Extension
6RM Leg Press,
10RM Unilateral
Knee extensions
vs. 140% 1RM
Yes HT, TVOL
AEL lead to higher increase in
work capacity (REP to failure), but
not muscle HT.
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Friedmann-
Bette et al.
2010 [33]
25 trained
males AEL 6 weeks
Unilateral Knee
Extensions
8RM vs. 1.9-fold
higher for ECC Yes HT, STH
Both protocols lead to significant
increase in muscle HT and STH.
Loenneke et
al. 2012 [34]
20 (10 males
and 10
females)
trained
BFR Acute
Bilateral Knee
Extension
30% 1RM BFR vs.
30% 1RM without
BFR
Yes TVOL BFR reduced REP to failure.
Kubo et al.
2006 [35] 9 males BFR 12 weeks Unilateral Knee
Extensions
20% 1RM BFR vs.
80% 1RM without
BFR
No HT
Both protocols lead to significant
increase in muscle HT.
Lowery et al.
2014 [36] 20 males BFR 4 weeks Biceps Curls
30% 1RM BFR vs.
60% 1RM without
BFR
No HT
Both protocols lead to significant
increase in muscle HT.
Farup et al.
2015 [37] 10 males BFR 6 weeks Dumbbell Curls
40% 1RM BFR vs.
40% 1RM without
BFR
Yes HT, TVOL
Both protocols lead to significant
increase in muscle HT, with
reduced REP to failure in BFR.
Ellefsen et al.
2015 [38]
9 untrained
females BFR 12 weeks
Unilateral Knee
Extensions
30% 1RM BFR vs.
610RM without
BFR
Yes HT
Both protocols lead to significant
increase in muscle HT.
Laurentino et
al. 2012 [39] 29 males BFR 8 weeks Bilateral Knee
Extension
20% 1RM without
BFR vs. 20%1RM
BFR vs. 80%1RM
without BFR
No HT, STH
BFR lead to increase in muscle HT
and STH with the same degree as
high-intensity RT.
Lixandrao et
al. 2015 [40] 26 males BFR 12 weeks Bilateral Knee
Extension
20 or 40% 1RM +
BFR (40 or
80%AOP) vs. 80%
1RM without BFR
No HT, STH
When BFR protocols are
performed at very low intensities
higher AOP is required. BFR
protocols significantly improved
muscle HT and STH, but with less
effect in STH.
Yamanaka et
al. 2012 [41] 32 athletes BFR 4 weeks Bench Press and
Back Squat
20% 1RM BFR vs.
20% 1RM No HT, STH
BFR significantly improved muscle
HT and STH.
Cook et al.
2018 [42] 18 males BFR 6 weeks Leg Press and
Knee Extension
70% 1RM vs. 20%
1RM BFR
Yes (only last
set) HT, STH
Both protocols significantly
improved muscle HT and STH, but
BFR was less effective.
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Yasuda et al.
2011 [43] 30 males BFR 6 weeks Bench Press 75% 1RM vs. 30%
1RM BFR No HT, STH
Both protocols significantly
improved muscle HT and STH, but
BFR was less effective.
Oliver et al.
2015 [44]
23 (12
trained and
11
untrained)
males
CS Acute Back Squat
4 sets of 10 REP vs.
4 sets of 2 CS of 5
REP at 70% 1RM
No TVOL
CS allowed to lift a greater TVOL
load with reduced TUT.
Iglesias-Soler
et al. 2014 [45] 9 athletes CS Acute Parallel Back
Squat
3 sets to muscular
failure of TS or CS Yes TVOL CS lead to higher REP to failure.
Tufano et al.
2017 [46]
12 trained
males CS Acute Back Squat
3 sets of 12 REP vs.
3 sets of 3 CS of 4
REP vs. 3 sets of 6
CS of 2 REP at 60%
1RM
No TVOL
CS protocols lead for greater
external loads and higher TUT.
Wallace et al.
2019 [47]
11 trained
males
SS / Pre-
Exhaustion Acute
Bench Press,
Incline Bench
Press, Triceps
Pushdowns,
TS vs. SS
(agonists) vs. pre-
exhaustion (single-
joint + multi-joint
exercise) vs. pre-
exhaustion (multi-
joint + single-joint)
Yes TVOL
SS (agonists) decreased TVOL
load.
Robbins et al.
2010 [48]
16 trained
males
SS / Pre-
Exhaustion Acute Bench Press,
Bench Pull SS vs. TS Yes TVOL SS (agonist-antagonist) increased
total TVOL load.
Weakley et al.
2017 [49]
14 trained
males
SS / Pre-
Exhaustion Acute
Back Squat, Bench
Press, Romanian
Deadlift,
Dumbbell
Shoulder Press,
Bent Over Row,
Upright Row
TS vs. SS vs. tri-
sets No TVOL
SS (upper-lower body, agonist-
antagonist) and tri-sets protocols
were more efficient (kilograms
lifted per minute) than TS.
Soares et al.
2016 [50]
14 trained
males
SS / Pre-
Exhaustion Acute
Bench Press and
Triceps
Pushdowns
pre-exhaustion vs.
TS Yes TVOL
Total TVOL load lifted is reduced
when multi-joint exercise is
performed after single-joint.
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Fink et al. 2018
[51] 16 males DS / SST 6 weeks Triceps
Pushdowns
3 sets of TS vs.
single DS Yes HT
Single set of DS lead to higher
muscle HT.
Angleri et al.
2017 [52] 32 males DS / SST 12 weeks Leg Press and
Knee Extension
DS vs. TS vs.
crescent pyramid Yes HT, STH
All protocols significantly
improved muscle HT and ST.
de Almeida et
al. 2019 [53]
12 trained
males DS / SST Acute
Biceps Curls and
Triceps Pulley
Extensions
TS vs. SST Yes HT, TVOL
SST lead to greater acute muscle
HT, with reduced training time,
even with a lower total TVOL load.
Ozaki et al.
2018 [54]
9 untrained
males DS / SST 8 weeks Dumbbell Curls
3 sets of 80%1RM
vs. 3 sets of
30%1RM vs. 1 set
of 80%1RM and
then four DS at
65%, 50%, 40%
and 30%1RM
Yes HT, STH,
TVOL
A single high-load set with
additional four DS increased
muscle HT and STH as well as
work capacity (REP to failure),
with an reduced training time.
ECC: eccentric; TVOL: training volume; HT: hypertrophy; STH: strength; REP: repetitions; TUT: time under tension; AEL: accentuated eccentric loading; 1RM: one-
repetition maximum; ECC: eccentric; BFR: blood flow restriction; RT: resistance training; AOP: arterial occlusion pressure; CS: cluster set; TS: traditional set; SS: superset;
DS: drop sets; SST: sarcoplasma stimulating training.
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3. Discussion
3.1. Training Considerations
Three major factors are emphasized in the conventional hypertrophy model: mechanical tension,
metabolic stress, and muscle damage [55]. These factors can occur by optimal manipulation of RT
variables and through a wide range of RT techniques. Progressive mechanical tension overload is
considered one of the major factors of muscle growth and changes in muscle architecture, which are
attained by increasing RT intensity of effort. RT with high-loads (>85% 1RM), and a low number of
repetitions (15) as well as long rest intervals (~35 min) is largely oriented toward a greater
magnitude of mechanical tension, which primarily develops strength, while muscle hypertrophy is
compromised [13]. RT with a lower number of repetitions, yet with high-loads emphasizes
mechanical tension and results in high levels of neural recruitment (fast-twitch muscle fibers).
Another critical variable influencing hypertrophy with an evidenced dose-response relationship is
RT volume [11,56]. Higher RT volume (2830 sets/muscle/week) is associated with greater increases
in hypertrophy compared to lower volume (610 sets/muscle/week) in both untrained and trained
populations [12,20]. Implementation of training with moderate number of repetitions (~612),
multiple sets (36), moderate loads (6080% 1RM), and short rest intervals (60 s) between sets elicits
greater metabolic stress (in contrast with high-loads), which appears to be a potent stimulus for
inducing muscle hypertrophy [57]. However, as long as RT is performed to volitional fatigue, training
load might not affect exercise-induced muscle growth. Findings by Schoenfeld et al. [11] indicate that
both low-load RT (60% 1RM) performed to volitional fatigue and moderate-load RT (>60% 1RM)
elicit significant increases in muscle hypertrophy among well-trained young men. However, the
participants following the low-load RT protocol performed approximately three times the total
training volume compared to the high-load group (sets × repetitions). Similar findings were also
demonstrated in a study by Ikezoe et al. [58], which highlighted the importance of performing
exercise to volitional fatigue when low-loads were used to maximize muscle hypertrophy outcomes.
These authors compared increments in muscle thickness (rectus femoris) after eight weeks of training
with low-load, higher volume (30% 1RM, 12 sets x 8 repetitions) to training with high-load, lower
volume (80% 1RM, 3 sets x 8 repetitions) leg extensions in young men. Considering that the training
volume in the high-load group was significantly lower than that in the low-load, the degree of muscle
thickness attained after intervention was almost twice as high in the high-load group [58]. However,
it should be noted that if RT is not conducted to volitional fatigue, reaching the minimum RT intensity
threshold (>60%1RM) is necessary to maximize muscle hypertrophy [59].
Furthermore, implementation of advanced RT techniques could provide an additional stimulus
to break through plateaus for trained subjects [24] and prevent excessive monotony in training. The
most recent RT techniques and methods frequently used by practitioners and coaches include
accentuated eccentric loading, prolonged eccentric tempo, cluster sets, high-load RT combined with
low-load RT under blood flow restriction, supersets, drop sets, pre-exhaustion, and sarcoplasma
stimulating training.
3.2. Tempo Eccentric Technique
One of the advanced RT techniques is based on a prolonged duration of the eccentric phase of
the movement. The duration of each repetition can be identified by movement tempo, which is
determined by four digits (e.g., 2/0/1/0) corresponding to the duration (in seconds) of particular
phases of movement (eccentric, transition, concentric, transition) [30]. Changes in the movement
tempo during RT impacts the maximal number of repetitions performed in a set, the maximal time
under tension, and the final exercise volume [25–27]. Several studies have indicated that the use of a
faster movement tempo (e.g., 2/0/2/0) results in a significant increase in the maximal number of
performed repetitions when compared to the slower tempo (e.g., 6/0/2/0) [25–27]. In contrast, a slower
tempo of movement, especially during the eccentric phase (e.g., 6/0/2/0), decreases the number of
performed repetitions, but extends the time under tension, which may contribute to greater muscle
Int. J. Environ. Res. Public Health 2019, 16, 4897 9 of 16
hypertrophy [28]. On the other hand, a meta-analysis of Schoenfeld et al. [60] indicates that similar
hypertrophic responses occur when the duration of repetitions ranges from 0.5 to 8 s, although it
must be noted that they [60] did not control the duration of particular phases of movement (eccentric
vs. concentric), thus making it difficult to draw definite conclusions. Furthermore, a study by Shibata
et al. [29] showed that the dominant leg thigh cross-sectional area increased in a similar manner
following both the slow (4 s) and the fast (2 s) eccentric phase during the back squat exercise
performed to volitional fatigue in a group of male soccer players. In light of the greater force capacity
of eccentric actions, and the fact that the energy requirements are typically 4-fold smaller than during
the concentric contraction of the same load [61], it would seem logical that lower metabolic stress
may occur, which could limit the responses to this training technique.
However, studies indicate a wide range of manipulation of the duration of the eccentric phase
of movement can be employed if the primary goal of training is to maximize muscle hypertrophy
[29,60]. Although, it is not currently clear whether slow tempo provides a superior stimulus for
muscle hypertrophy, from a practical point of view, employing a fast but controlled duration of the
eccentric phase (~2s) may allow for a high time-efficiency of training and prevent the excessive time
of training sessions.
3.3. Accentuated Eccentric Loading Method
Another useful method that can be used during RT, based on eccentric contractions includes
accentuated eccentric loading (AEL). This training strategy is based on the muscles’ ability to generate
greater force during maximal eccentric (~2060%) versus other types of contraction. The use of weight
releasers allow for overloading the muscles during the eccentric phase of movement due to its specific
construction. The weight can be unloaded in the transition from the eccentric to the concentric phase
of movement. The use of high-loads during the eccentric phase of movement is associated with
significant exercise induced muscle damage and mechanical tension, which have been associated
with a hypertrophic response [55]. Furthermore, some studies have shown that performing eccentric-
only contractions led to higher gains in muscle mass when compared to concentric-only actions
[30,62]. Nonetheless, recent literature has indicated that when the volume of training was matched,
both AEL and high-load RT led to similar hypertrophic responses in groups of strength-trained
athletes [31,32,63]. Furthermore, RT protocols that did not promote significant muscle damage still
induced similar muscle hypertrophy in comparison with those protocols that promoted initial muscle
damage [7]. However, differences appear in muscle architecture adaptations. Training with the
concentric-only phase led to muscle growth mainly by the addition of sarcomeres in parallel
(increased pennation angle with little change in fascicle length), while training with eccentric-only
contractions led by the addition of sarcomeres in series (increased fascicle length and a small increase
in the pennation angle) [64].
Furthermore, due to the greater mechanical tension, it could provide an additional hypertrophic
stimulus [31,33,65]. Although it must be noted that the main disadvantage of this technique is the
necessity of weight releasers or the presence of experienced spotters during training. Moreover AEL,
requires the eccentric load to reload after every repetition, thus is possible that the inter-repetition
rest may excessively extend the time of particular repetitions and the whole training session.
3.4. Low-Load Resistance Training Under Blood Flow Restriction
Another RT method that allows for the avoidance of high mechanical stress associated with
high-load RT and the high training volumes required when exercising with low-loads to volitional
fatigue is to combine RT under blood flow restriction (BFR) [34,66,67]. The BFR method involves the
application of a restrictive device (a tourniquet, an inflatable cuff, or elastic wraps) on the proximal
part of the limb to reduce the arterial blood flow and to occlude the venous return [67]. Such an
intervention results in an accumulation of metabolic products distal to the restriction and when
coupled with RT, drastically increases metabolic stress. However, with regard to low-load RT under
BFR, a significant increase in the muscle cross-sectional area was observed even without reaching
volitional fatigue in particular sets [35]. Furthermore, several studies have suggested that increases
Int. J. Environ. Res. Public Health 2019, 16, 4897 10 of 16
in muscle mass following low-load RT under BFR (2030% 1RM) do not exceed those observed after
the use of high-load RT (80% 1RM) without BFR [36–38]. The effectiveness of using BFR concerns
various populations such as non-athletes [39,40], moderately experienced participants (>1 year) [36],
and elite athletes [41,42]. High-load RT with additional low-load sets under BFR may elicit beneficial
muscular responses in healthy athletes [68].
The most frequently and evidence-based repetition and set scheme involves 30 repetitions in the
first set followed by three sets of 15 repetitions with 30 s rests in between with 2040% 1RM and
pressure, which contribute to 4080% of arterial occlusion pressure [69]. However, it must be noted
that BFR induced muscle growth is limited to the limb muscles [43].
3.5. Cluster Sets Technique
Another RT technique that partly allows for the balance of both mechanical tension and
metabolic stress consists of cluster sets. In a traditional scheme of sets, repetitions, a chosen group of
exercises are performed consecutively, with a long inter-set rest interval, are then followed by another
set of repetitions. On the contrary, cluster sets include short, inter-set rest intervals (2060s) with a
lower number of repetitions [70]. Previous research has mostly investigated the effects of cluster sets
on force production, power output, and movement velocity, while findings related to muscle
hypertrophy are limited [44]. Nevertheless, implementation of inter-set rest intervals allows for a
greater RT volume to be achieved for a particular external load when compared with a traditional
scheme of sets [44,45] in trained and untrained men, possibly providing an additional stimulus for
muscle hypertrophy. However, it should be noted that cluster sets induce less metabolic stress, but
greater emphasis is placed on mechanical stress due to the use of higher training intensities of effort
in comparison with traditional sets [44–46,71]. Thus, the implementation of cluster sets with short
inter-set rest intervals could be a useful strategy to carry out high-volume sessions of high-loads,
while keeping a high time-efficiency of training (training volume/time). Furthermore, cluster sets
may serve as an alternative to traditional sets for promoting muscle hypertrophy over time during
parallel periodization models [46], and prevent monotony in training. Moreover, future studies
should investigate the direct effects of cluster sets on exercise-induced muscle growth.
3.6. Supersets and Pre-exhaustion Technique
Supersets and pre-exhaustion during RT can be defined as a pair of different exercise sets
performed without rest. Supersets most commonly consist of two exercises for the same muscle group
[47], agonist-antagonist muscles [48,72] or alternating upper and lower body muscle groups [49]
consecutively followed by a recovery period; pre-exhaustion involves performing a single-joint
before a multi-joint exercise for the same muscle group (e.g., dumbbell fly before the bench press). In
a study by Wallace et al. [47], supersets (flat bench press followed by the incline bench press) resulted
in a significantly lower volume of training than a traditional exercise order in strength-trained males.
However, with regard to agonist–antagonist supersets, investigation by Robbins et al. [48] (bench
pull paired with the bench press) indicated a significantly higher training volume when compared to
a traditional exercise order. Furthermore, this type of superset as well as upper–lower body supersets
were found to be more time-efficient than traditional exercise order sessions [48,49].
The pre-exhaustion technique is commonly used by bodybuilders seeking to enhance the muscle
growth of target muscles. The rationale for this technique is that performing a single-joint exercise
first fatigues the agonist in isolation, thereby placing greater stress on the agonist and increasing its
activation during multi-joint exercise and potentiating its hypertrophy [73]. Another variation is the
reverse pre-exhaustion (e.g., triceps pushdown before the bench press), and the justification for this
approach is that the fatigued synergist contributes less to the subsequent multi-joint exercise, thereby
placing greater stress on the agonist group [74]. However, a study by Golas et al. [75] partially
disagreed with this statement as the results indicated that a pre-exhaustion exercise (incline dumbbell
fly) did not affect the pectoralis major activity during the flat bench press exercise at 95% 1RM.
Despite that, pre-exhaustion of the synergist muscles (triceps brachii and anterior deltoid before the
bench press) led to their higher activation during the multi-joint movement (bench press) as
Int. J. Environ. Res. Public Health 2019, 16, 4897 11 of 16
compared to the baseline [75]. Furthermore, results of a study by Soares et al. [50] suggested that pre-
exhaustion (triceps pushdown followed by the bench press) decreased the maximal number of
repetitions performed during a set to volitional fatigue.
In conclusion, practitioners aiming to maximize training volume and intensity of effort may be
well advised to consider the use of supersets (agonist–antagonist and upper–lower body) in their RT
programs. The use of these exercise orders may be more time-efficient than the traditional approach,
and especially useful when time limitations exist in the planning of training sessions.
3.7. Drop Sets and Sarcoplasma Stimulating Training Technique
Drop sets involve performing a set to volitional fatigue with a given load and then immediately
reducing the load (e.g., ~20%) and continuing the exercise until subsequent volitional fatigue [76].
Briefly, the rationale for this technique is high metabolic stress induced due to a high number of
repetitions performed with short rest intervals. Accordingly, a study by Fink et al. [51] showed
significantly higher muscle thickness after drop sets in comparison with RT following a traditional
sets scheme, which can be considered as a potential marker for metabolic stress [57]. Furthermore,
results of the study by Fink et al. [51] showed significant increases in the triceps cross-sectional area
after six weeks of drop sets training when compared to traditional sets. Nevertheless, it must be noted
that participants taking part in this research were recreational trained persons with little experience
in RT (did not regularly train for more than one year). On the other hand, Angleri et al. [52]
demonstrated that drop sets did not promote greater lower body muscle growth when compared
with traditional sets in well-trained males when training volume was equalized.
Similarly to drop sets, sarcoplasm stimulating training (SST) consists of sets of exercises
performed at 70–80% 1RM to volitional fatigue and then repeating this protocol twice more with 20
s rest intervals in between. The next step is to reduce the external load by 20% and perform an
additional set with a 4/0/1/0 tempo; following a 20 s rest interval, 20% of the external load is reduced
again, and a set with 4/0/1/0 tempo is completed to volitional fatigue. In the last set, the load is further
decreased by 20% and after its completion, following a 20 s rest interval, a static hold is performed
(e.g., at 90° of elbow flexion) to volitional fatigue [53]. Another SST variation refers to the performance
of eight sets of exercises at 7080% 1RM to volitional fatigue with programmed rest intervals between
subsequent sets (45, 30, 15, 5, 5, 15, 30, and 45 s) without reducing the load [53]. Similarly, to drop
sets, the main aim of SST is to induce high metabolic stress [53]. Recently, de Almeida et al. [53]
demonstrated that SST resulted in greater acute biceps brachii and triceps brachii muscle thickness
when compared to a traditional set scheme in trained subjects, even when total training volume was
higher in a traditional set scheme RT.
Evidence suggests the beneficial effects of both drop sets and SST in acute increases in triceps
brachii muscle thickness [53] in both amateur and well-trained subjects, even with lower training
volume versus a traditional set scheme RT. However, studies that have investigated the chronic
effects of drop sets did not show a superior hypertrophy response when compared with traditional
sets [52,54]. Moreover, the chronic effects of SST on muscle growth have not been examined yet.
3.8. Limitations
The present review has several limitations that should be addressed. The majority of included
studies did not control nutritional intake, which can affect the magnitude of muscle adaptations.
Another limitation relates to studies that examined the influence of advanced methods and
techniques on training variables, but did not analyze hypertrophic responses and/or strength
improvements, which would be the basis for explaining their efficiency. In addition, only one study
[44] directly compared the responses between trained and untrained participants.
4. Conclusions
Considering the aforementioned studies, effective hypertrophy-oriented training should
comprise a combination of mechanical tension and metabolic stress. In summary, foundations for
Int. J. Environ. Res. Public Health 2019, 16, 4897 12 of 16
individuals seeking to maximize muscle growth should be hypertrophy-oriented RT consisting of
multiple sets (36) of six to 12 repetitions with short rest intervals (60 s) and moderate intensity of
effort (6080% 1RM) with subsequent increases in training volume (12–28 sets/muscle/week) [20].
Moreover, trained athletes may consider integrating advanced resistance training techniques and
methods to provide an additional stimulus to break through plateaus, prevent monotony, and reduce
the time of training sessions. Evidence suggests some beneficial effects for selected RT techniques
especially in the case of training volume, time-efficiency, and intensity of effort. Furthermore, even
though most of these techniques and methods did not show a superior hypertrophy response
compared to the traditional approach, it may serve as an alternative to prevent monotony or it could
improve readiness to training sessions. To maintain high time-efficiency of training and when time
limitations exist, the use of agonist–antagonist, upper–lower body supersets, drop sets, SST, and
cluster sets may provide an advantage to the traditional approach. Furthermore, the employment of
fast but controlled tempo (~2 s) and supplementation of high-load RT with low-load RT under BFR
may allow for high time-efficiency of training and prevent excessively long training sessions. With
regard to the higher degree of mechanical tension, the use of AEL in RT should be considered,
therefore, in cases where time is limited, cluster sets might be a better choice. The implementation of
drop sets, SST, and low-load RT under BFR could provide time-efficient techniques to increase
metabolic stress. In summary, currently there is not sufficient evidence to provide specific guidelines
for volume, intensity of effort, and frequency of the previously mentioned resistance training
techniques.
Furthermore, persistence in training and diet is essential. Recently, research has shown that
muscle hypertrophy that occurs at initial stages of RT (~4 sessions) is mostly attributable to muscle
damage induced cell swelling with the majority of strength gains resulting from neural adaptations
(812 sessions). Within the latter phase of RT (610 weeks), muscle growth begins to become the
dominant factor [7].
Authors’ Contributions: Study concept and design: M.K. and G.W.; Acquisition of data: M.K. and G.W.;
Analysis and interpretation of data: M.K. and G.W.; Writing—original draft: M.K.; Writing—review and editing:
A.G. and M.W.; Supervision: A.G. and M.W.
Funding: This research received no external funding.
Acknowledgements: The study was supported and funded by the statutory research project of the Jerzy
Kukuczka Academy of Physical Education in Katowice, Poland.
Conflict of Interest: The authors declare that the research was conducted in the absence of any commercial or
financial relationships that could be construed as a potential conflict of interest.
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... However, performing a reduced duration (faster tempo) enables performance of more repetitions [80]. The theory behind this is that, although participants complete repetitions in a faster time, they complete more volume, increasing TUT [62,74,80,81]. These findings have been confirmed in the acute studies by Wilk et al. [52] and Sampson et al. [48] (Table 3) and in the chronic study by Kojić et al. [62] (Table 5) and are further supported by Pryoh et al. [46], who indicated a higher total number of repetitions during a 1 s eccentric tempo but did not show TUT results. ...
... This was further supported by Schoenfeld et al. [88], who found no distinct difference between 0.8 and 8 s of total repetition duration with respect to muscle hypertrophy and stated that eccentric durations should range from 2 to 4 s. Krzysztofik et al. [81] noted that more research is needed [88] but that eccentric phase durations of < 2 s show promise for increasing muscle mass. ...
... Reviews vary on the temporal definition of fast and slow tempos, with some suggesting that 1 s eccentric and 1 s concentric are fast [14,97,98]. However, the review by Krzysztofik et al. [81] defined fast as < 2 s for the eccentric phase, whereas Wilk et al. [80] determined a temporal range of 2-4.9 s as fast for a whole repetition and explained that durations < 2 s could be termed 'explosive' or as 'moving as fast as possible' (Table 8). These disparities within the literature confuse how movements should be defined and performed to attain desired results. ...
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Eccentric training as a method to enhance athletic performance is a topic of increasing interest to both practitioners and researchers. However, data regarding the effects of performing the eccentric actions of an exercise at increased velocities are limited. This narrative review aimed to provide greater clarity for eccentric methods and classification with regard to temporal phases of exercises. Between March and April 2021, we used key terms to search the PubMed, SPORTDiscus, and Google Scholar databases within the years 1950–2021. Search terms included ‘fast eccentric’, ‘fast velocity eccentric’, ‘dynamic eccentric’, ‘accentuated eccentric loading’, and ‘isokinetic eccentric’, analysing both the acute and the chronic effects of accelerated eccentric training in human participants. Review of the 26 studies that met the inclusion criteria identified that completing eccentric tempos of < 2 s increased subsequent concentric one repetition maximum performance, velocity, and power compared with > 4 s tempos. Tempos of > 4 s duration increased time under tension (TUT), whereas reduced tempos allowed for greater volume to be completed. Greater TUT led to larger accumulation of blood lactate, growth hormone, and testosterone when volume was matched to that of the reduced tempos. Overall, evidence supports eccentric actions of < 2 s duration to improve subsequent concentric performance. There is no clear difference between using eccentric tempos of 2–6 s if the aim is to increase hypertrophic response and strength. Future research should analyse the performance of eccentric actions at greater velocities or reduced time durations to determine more factors such as strength response. Tempo studies should aim to complete the same TUT for protocols to determine measures for hypertrophic response.
... Metabolic stress also increases the production of anabolic myokines such as interleukin-15 by releasing IGF-1 and decreasing muscle catabolic factors. In this regard, some techniques can be used to increase muscle lactate and blood urea levels and exercise with limited blood flow (Katsu) to increase muscle metabolic stress (45). ...
... In contrast, short rest intervals (30 seconds) resulted in tremendous metabolic stress compared to longer rest intervals (90 seconds) and were associated with higher levels of blood lactate, growth hormone, epinephrine, and norepinephrine (28). Other factors affecting the amount of metabolic stress in PA are genetic status, age, and gender (45,49). Briefly, it is better to use light intensity training exercises based on VO 2Peak in clinical conditions (Figure 1). ...
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Background: Complementary methods such as physical activity (PA) and fasting are particularly important for cancer patients. The present study reviewed the effects of regular PA and fasting on cancer patients and attempted to explain the relevant mechanisms. Methods: Several electronic databases such as PubMed, Elsevier, and Google Scholar were searched for keywords. After reviewing, 412 articles were identified until February 1, 2021. The inclusion criteria included meta-analysis, clinical intervention studies that considered different effects of fasting and various types of exercise on health indicators. After carefully reviewing and eliminating duplicates, 68 articles were identified based on the PICO format (participants, intervention, comparison, and results). Results: The short-term fasting (STF) before chemotherapy (48-72 hours) or rehabilitation exercise could be modulating fasting blood sugar, growth factors, oxidative stress (OS), and inflammatory pathways. In addition, physiological metabolic stress induced by STF or rehabilitation exercise could regulate sex hormone-binding globulin, fat oxidation, leptin secretion, hyperinsulinemia, maintaining mass muscle, and bone density, boosting the immune system, and improving the therapeutic index of cancer. Conclusion: Metabolic stress in cancer cells leads to the intake of high doses of chemotherapy. The rehabilitation exercise prevents the complications of the disease and improves the patient’s quality of life. Thus, these interventions can be used to improve the cancer-based therapeutic index on individual differences.
... Metabolic stress also increases the production of anabolic myokines such as interleukin-15 by releasing IGF-1 and decreasing muscle catabolic factors. In this regard, some techniques can be used to increase muscle lactate and blood urea levels and exercise with limited blood flow (Katsu) to increase muscle metabolic stress (45). ...
... In contrast, short rest intervals (30 seconds) resulted in tremendous metabolic stress compared to longer rest intervals (90 seconds) and were associated with higher levels of blood lactate, growth hormone, epinephrine, and norepinephrine (28). Other factors affecting the amount of metabolic stress in PA are genetic status, age, and gender (45,49). Briefly, it is better to use light intensity training exercises based on VO 2Peak in clinical conditions (Figure 1). ...
Article
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Background: Complementary methods such as physical activity (PA) and fasting are particularly important for cancer patients. The present study reviewed the effects of regular PA and fasting on cancer patients and attempted to explain the relevant mechanisms. Methods: Several electronic databases such as PubMed, Elsevier, and Google Scholar were searched for keywords. After reviewing, 412 articles were identified until February 1, 2021. The inclusion criteria included meta-analysis, clinical intervention studies that considered different effects of fasting and various types of exercise on health indicators. After carefully reviewing and eliminating duplicates, 68 articles were identified based on the PICO format (participants, intervention, comparison, and results). Results: The short-term fasting (STF) before chemotherapy (48-72 hours) or rehabilitation exercise could be modulating fasting blood sugar, growth factors, oxidative stress (OS), and inflammatory pathways. In addition, physiological metabolic stress induced by STF or rehabilitation exercise could regulate sex hormone-binding globulin, fat oxidation, leptin secretion, hyperinsulinemia, maintaining mass muscle, and bone density, boosting the immune system, and improving the therapeutic index of cancer. Conclusion: Metabolic stress in cancer cells leads to the intake of high doses of chemotherapy. The rehabilitation exercise prevents the complications of the disease and improves the patient’s quality of life. Thus, these interventions can be used to improve the cancer-based therapeutic index on individual differences.
... This is confirmed by (Krzysztofik, Wilk, Wojdała, & Gołaś) in that training programs include selection of exercises, sets, repetitions, intensity, duration of repetitions and appropriate rest. As for the more advanced programs, they provide details and may include advanced techniques that develop the training process [2]. The basis of training is to search for the problem and attempt to overcome the obstacles that we may encounter during training. ...
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The Study Aims at-Preparing exercises in variable ratios for periods of work and rest (1:1) and (1:2) and its reflection on the development of some physical variables for players practicing handball at the ages of 40-50 years.-Recognizing the reflection of exercises in variable ratios for periods of work and rest in the development of some physical variables for handball players aged 40-50 years.
... On the other hand, exercise with occlusion tends to promote gains in strength and muscle hypertrophy (34), and this type of training can induce muscle damage (44). In this sense, three factors tend to promote more muscle hypertrophy, mechanical tension, metabolic stress and muscle damage (19), where training with increased tension time tends to promote a increased muscle thickness (17). Thus, the present study hypothesized that thermography may be a form of control aimed at hypertrophy in different training methods. ...
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This study aimed to evaluate the local temperature, lactate, and blood glucose in three strength training methods. The study included 12 male subjects; (22.15 ± 5.77 years, 76.85 ± 9.15 kg, 1.72 ± 0.09 m), with minimum of 12 months of strength training experience, and all participated in the three training methods: the occlusion training (Kaatsu); the tension training (Tension); and the traditional training (Traditional). The Kaatsu training consisted in 3 sets of 10RM with occlusion device in both arms inflated to a 130% occlusion pressure. In addition, the tension method was performed with 30% of 1RM and the traditional training, consisted in 10 repetitions with 80% RM. Regarding the temperature variation, differences were observed between the Kaatsu and Traditional methods in relation to Tension (p = .049, η 2 p = 0.187). While for blood glucose (p = .351, η 2 p = 0.075) and lactate (p = .722, η 2 p = 0.022) there were no differences between the methods. Regarding the temperature (°C) measured by thermography and asymmetry, the right side showed a decrease in the post-test, in relation to the pre-test, in all methods (p < .05, η 2 p > 0.150). The left (p = .035, η 2 p = 0.301) and right (p = .012, η 2 p = 0.324) sides showed a decrease in temperature, in the post-test in relation to the pre-test, in the Kaatsu and traditional method. In asymmetry, the three methods showed an increase in the post-test in relation to the pre-test (p = .042, η 2 p = 0.158). In conclusion, tension method seems to stimulate greater heat production than the other methods. This information can help coaches to choose among these training methods according to the desired physiological response.
... Of 26 sports reviewed, Oja et al. [31] found strengthening benefits only for running, tennis and football., This is an unsurprising outcome given that to produce high forces, and to generate the necessary amount of mechanical tension for adaptation in most commonly used resistance exercises, muscle fibers must shorten slowly against a relatively heavy resistive load [40,41]. ...
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The current UK physical activity guidelines recommend that adults aged 19 to 65 years perform activity to strengthen muscle and bone a minimum of twice weekly. The number of adults meeting strengthening activity guidelines is lower than for aerobic activity, but estimates vary between studies partly due to differences in how muscle-strengthening activity is defined. We aimed to provide estimates for strengthening activity prevalence in English adults based on a nationally representative sample of n = 253,423 18-65-year-olds. We attempted to quantify the variation in estimates attributable to differences in the way strengthening activity is defined. Finally, we aim to provide a brief descriptive epidemiology of the factors associated with strengthening activity. Adults met guidelines for aerobic activity if they reported the activity equivalent to >150 min/week moderate-intensity exercise. Respondents met strengthening guidelines if they reported at least two bouts per week of strengthening activity. We defined strengthening activity, first, according to criteria used in the Health Survey for England (HSE). Second, we counted bouts of strengthening activities for which we could find evidence of health-related benefits (Evidence). Third, we included bouts of strengthening activity as defined in current UK physical activity guidelines (Guideline). Two-thirds (67%) of adults met guidelines for aerobic activity (69% of men, 65% of women). Less than one-third (29% of men and 24% of women) met guidelines for the HSE definition of strengthening activity. Under the Evidence definition, 16% of men and 9% of women met strengthening guidelines. Using the most-stringent definition (Guideline) just 7.3% of men and 4.1% of women achieved the recommendations for strengthening activity. We found females and older adults (50–65 years) were less likely to meet guidelines for aerobic, strengthening, and combined aerobic plus strengthening activity. The prevalence of meeting activity guidelines was lower in adults from more deprived areas (compared with the least deprived); Adults with lower academic qualifications (Level 1) were less likely to meet activity guidelines than those educated to Level 4 (Degree Level) or higher. Having a limiting disability was associated with a lower prevalence of meeting activity guidelines. Associations between socio-demographic measures and the prevalence of adults meeting activity guidelines were stronger for strengthening activity than for aerobic 51(or combined aerobic plus strengthening) activity Compared with aerobic activity, fewer adults engage in strengthening activity regardless of how it is defined. The range in estimates for how many adults meet strengthening activity guidelines can be explained by variations in the definition of ‘strengthening’ that are used and the specific sports or activities identified as strengthening exercise. When strengthening activity is included, the proportion of English adults meeting current physical activity guidelines could be as high as 1 in 3 but possibly as low as just 1 in 20. A harmonized definition of strengthening activity, that is aligned with physical activity guidelines, is required to provide realistic and comparable prevalence estimates.
... Although the most recognized procedure to improve FFM is to perform resistance training [259,260], there is some literature demonstrating that low-intensity exercise (e.g., a 45 min walk on a treadmill at 40% VO2 peak) protects lean mass and prevents muscle protein breakdown [261]. In calorie-restrained postmenopausal women, lean mass is equally preserved with both low-intensity (45-50% of heart rate reserve (HRR)) and vigorous-intensity (70-75% of HRR) exercise for a matched total energy expenditure of 700 kcal/wk [262] and similar weight loss. ...
Article
Recent literature shows that exercise is not simply a way to generate a calorie deficit as an add-on to restrictive diets but exerts powerful additional biological effects via its impact on mitochondrial function, the release of chemical messengers induced by muscular activity, and its ability to reverse epigenetic alterations. This review aims to summarize the current literature dealing with the hypothesis that some of these effects of exercise unexplained by an energy deficit are related to the balance of substrates used as fuel by the exercising muscle. This balance of substrates can be measured with reliable techniques, which provide information about metabolic disturbances associated with sedentarity and obesity, as well as adaptations of fuel metabolism in trained individuals. The exercise intensity that elicits maximal oxidation of lipids, termed LIPOXmax, FATOXmax, or FATmax, provides a marker of the mitochondrial ability to oxidize fatty acids and predicts how much fat will be oxidized over 45–60 min of low- to moderate-intensity training performed at the corresponding intensity. LIPOXmax is a reproducible parameter that can be modified by many physiological and lifestyle influences (exercise, diet, gender, age, hormones such as catecholamines, and the growth hormone-Insulin-like growth factor I axis). Individuals told to select an exercise intensity to maintain for 45 min or more spontaneously select a level close to this intensity. There is increasing evidence that training targeted at this level is efficient for reducing fat mass, sparing muscle mass, increasing the ability to oxidize lipids during exercise, lowering blood pressure and low-grade inflammation, improving insulin secretion and insulin sensitivity, reducing blood glucose and HbA1c in type 2 diabetes, and decreasing the circulating cholesterol level. Training protocols based on this concept are easy to implement and accept in very sedentary patients and have shown an unexpected efficacy over the long term. They also represent a useful add-on to bariatric surgery in order to maintain and improve its weight-lowering effect. Additional studies are required to confirm and more precisely analyze the determinants of LIPOXmax and the long-term effects of training at this level on body composition, metabolism, and health.
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Individuals following bariatric surgery are considered at high risk for the development of sarcopenic obesity (excess fat mass, low muscle mass and low physical function), and exercise may play an important role in its prevention and treatment. We systematically reviewed 5 scientific databases (Embase, Medline, Scopus, SPORTDiscus, and Web of Science) and 2 grey literature databases (ProQuest and Google Scholar) for clinical trials that evaluated the effect of exercise on muscle strength in adults following bariatric surgery and conducted a separate meta-analysis for studies that used different muscle strength tests. Random-effect models, restricted maximum likelihood method and Hedges' g were used. The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020152142). Fifteen studies were included (638 patients), none had a low risk of bias, and all were included in at least 1 of the 5 meta-analyses (repetition maximum [lower and upper limbs], sit-to-stand, dynamometer, and handgrip tests). Exercise interventions improved both upper (effect size, 0.71; 95% CI, 0.41-1.01; I2 = 0%) and lower (effect size, 1.37; 95% CI, 0.84-1.91; I2 = 46.14) limb muscle strength, as measured by repetition maximum tests. Results were similar for the sit-to-stand (effect size, 0.60; 95% CI, 0.20-1.01; I2 = 68.89%) and dynamometer (effect size, 0.46; 95% CI, 0.06-0.87; I2 = 31.03%), but not for the handgrip test (effect size, 0.11; 95% CI, -0.42-0.63; I2 = 73.27%). However, the certainty level of the meta-analyses was very low. Exercise with a resistance training component performed post bariatric surgery may improve muscle strength, which is related to sarcopenic obesity, functional capacity, and mortality risk, therefore should be included in the follow-up.
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Pre-exhaustion (PE) is a popular resistance training strategy that involves performing a single-joint exercise followed by a multi-joint exercise with minimal recovery between the transition. This approach is widely used by bodybuilding athletes and resistance training (RT) enthusiasts with the aim of enhancing muscle strength and hypertrophy. The present paper aimed to provide a narrative review as to the effects of the PE method on different acute and chronic outcomes, and discuss relevant practical applications. When considering the body of literature as a whole, we conclude that current evidence does not support a benefit to the PE method compared to traditional RT models regarding chronic improvements in strength, hypertrophy and body composition. However, the heterogeneous study designs confound the ability to draw strong conclusions on the topic. Further investigations are warranted with strict control of study variables to better elucidate what, if any, benefits may be obtained by the PE method.
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Bodybuilding involves an intricate combination of training and dieting focused around periodic mesocycles to tailor time towards preparation and competition. In contrast to other muscle sports (such as weightlifting and powerlifting), bodybuilding competitors are judged on appearance (muscle size, definition and posing) as opposed to physical performance. Professional competitors achieve this by altering training variables (such as intensity and volume) as well as dietary and supplementation strategies throughout the 'season'. These mesocycles follow protocols based on a scientific literature, with the intention to achieve better results and preserve the health of each competitor. In order to achieve the long term improvements to health and skill-related components of fitness, a programme and strategy must be implemented that incorporates components of both dietary restriction as well as systematic variations to training and exercise selection. Because of the nature of body aesthetics and muscularity in bodybuilding, off-season training follows hypertrophic goals to increase muscular size. Increased caloric intake as well as increased training volume and intensity are the most common adaptations to a hypertrophic mesocycle. A positive energetic caloric balance (~10-20%) and high protein consumption provide necessary nutrients for muscle protein synthesis and energy storage and usage. During any cycle, weight gain and loss should not surpass 5% bodyweight per week to reduce the health concerns associated with rapid weight fluctuations. Current literature suggests that macronutrient intakes of protein 1.6-2.2 g•kg-1 •d-1 (25-30% TDC), carbohydrates 5-6 g•kg-1 •d-1 (50-60% TDC) and fat 1-1.5 g•kg-1 •d-1 (20-25% TDC) are suggested as optimal for professional bodybuilders to meet the physiological needs of an off-season mesocycle focusing on lean muscle gain. Bodybuilding • Nutrition • Hypertrophy • Performance • Physique
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Background: Trained subjects have difficulty in achieving continued results following years of training, and the manipulation of training variables through advanced resistance training (RT) methods is widely recommended to break through plateaus. Objective: The purpose of the present study was to compare the acute effects of traditional RT (TRT) versus two types of sarcoplasma stimulating training (SST) methods on total training volume (TTV), lactate, and muscle thickness (MT). Methods: Twelve trained males (20.75 ± 2.3 years; 1.76 ± 0.14 meters; body mass = 79.41 ± 4.6 kg; RT experience = 4.1 ± 1.8 years) completed three RT protocols in a randomly sequenced order: TRT, SST contraction type (SST-CT), or SST rest interval variable (SST-RIV) with 7 days between trials in arm curl (elbow flexors) and triceps pulley extension (elbow extensors) performed on the same day. Results: The SST groups displayed greater acute biceps and triceps brachii (TB) MT versus the TRT session, with no difference in lactate levels between them. The SST-CT resulted in greater biceps and TB MT versus the SST-RIV session. The TTV was greater for the TRT session versus the SST sessions, except in the case of the elbow flexors (no difference was observed between TRT and SST-CT), and higher for the SST-CT versus the SST-RIV. Conclusion: Trained subjects may benefit from using the SST method as this method may offer a superior MT stimulus and reduced training time, even with a lower TTV.
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The current manuscript sets out a position stand for blood flow restriction exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this position stand is to set out a current research informed guide to blood flow restriction training to practitioners. This covers the use of blood flow restriction to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in blood flow restriction training research with expertise in exercise science, strength and conditioning and sports medicine.
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This study investigated the effects of advanced training techniques (ATT) on muscular responses and if performing a second training session would negatively affect the training stimulus. Eleven strength-trained males performed a traditional strength training session (TST) and four different ATT: pre-exhaustion A (PE-A), pre-exhaustion B (PE-B), forced repetitions (FR), and super-set (SS). On day 1, SS produced lower volume load than TST, FR, and PE-B (16.0%, p=0.03; 14.9, p= 0.03 and 18.2%, p=0.01, respectively). On day 2, SS produced lower volumes than all the other ATT (9.73-18.5%, p=0.03). Additionally, subjects demonstrated lower perceived exertion on day 1 compared to day 2 (6.5 ± 0.4 AU vs. 8.7 ± 0.3 AU, p = 0.0001). For blood lactate concentration [La-] on days 1 and 2, [La-] after the tenth set was the highest compared to all other time points (baseline: 1.7 ± 0.2, fifth-set: 8.7 ± 1.0, tenth-set 9.7 ± 0.9, post-5 min: 8.7 ± 0.7 mmol·L 1 , p=0.0001). Acute muscle swelling was greater immediately and 30-min post compared to baseline (p=0.0001). On day 2, electromyography (EMG) amplitude on the clavicular head of the pectoralis major was lower for SS than TST, PEA , and PE-B (11.7%, p=0.01; 14.4%, p=0.009; 20.9%, p = 0.0003, respectively). Detrimental effects to the training stimulus were not observed when ATT (besides SS) are repeated. Strength trained individuals can sustain performance, compared to TST, when they are using ATT in an acute fashion. Although ATT have traditionally been used as a means to optimize metabolic stress, volume load, and neuromuscular responses, our data did not project differences in these variables compared to TST. However, it is important to note that different ATT might produce slight changes in volume load, muscle excitation, and fluid accumulation in strength-trained individuals from session to session.
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Blood flow restriction (BFR) combined with resistance training (RT-BFR) shows significant benefits in terms of muscle strength and hypertrophy. Such effects have been observed in clinical populations, in groups of physically active people, and among competitive athletes. These effects are comparable or, in some cases, even more efficient compared to conventional resistance training (CRT). RT-BFR stimulates muscle hypertrophy and improves muscle strength even at low external loads. Since no extensive scientific research has been done in relation to groups of athletes, the aim of the present study was to identify technical, physiological and methodological aspects related to the use of RT-BFR in competitive athletes from various sport disciplines. RT-BFR in groups of athletes has an effect not only on the improvement of muscle strength or muscle hypertrophy, but also on specific motor abilities related to a particular sport discipline. The literature review reveals that most experts do not recommend the use RT-BFR as the only training method, but rather as a complementary method to CRT. It is likely that optimal muscle adaptive changes can be induced by a combination of CRT and RT-BFR. Some research has confirmed benefits of using CRT followed by RT-BFR during a training session. The use of BFR in training also requires adequate progression or modifications in the duration of occlusion in a training session, the ratio of exercises performed with BFR to conventional exercises, the value of pressure or the cuff width.
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We examined hypertrophic outcomes of weekly graded whey protein dosing (GWP) vs. whey protein (WP) or maltodextrin (MALTO) dosed once daily during 6 weeks of high-volume resistance training (RT). College-aged resistance-trained males (training age = 5 ± 3 years; mean ± SD) performed 6 weeks of RT wherein frequency was 3 d/week and each session involved 2 upper- and 2 lower-body exercises (10 repetitions/set). Volume increased from 10 sets/exercise (week 1) to 32 sets/exercise (week 6), which is the highest volume investigated in this timeframe. Participants were assigned to WP (25 g/d; n = 10), MALTO (30 g/d; n = 10), or GWP (25–150 g/d from weeks 1–6; n = 11), and supplementation occurred throughout training. Dual-energy x-ray absorptiometry (DXA), vastus lateralis (VL), and biceps brachii ultrasounds for muscle thicknesses, and bioelectrical impedance spectroscopy (BIS) were performed prior to training (PRE) and after weeks 3 (MID) and 6 (POST). VL biopsies were also collected for immunohistochemical staining. The GWP group experienced the greatest PRE to POST reduction in DXA fat mass (FM) (−1.00 kg, p < 0.05), and a robust increase in DXA fat- and bone-free mass [termed lean body mass (LBM) throughout] (+2.93 kg, p < 0.05). However, the MALTO group also experienced a PRE to POST increase in DXA LBM (+2.35 kg, p < 0.05), and the GWP and MALTO groups experienced similar PRE to POST increases in type II muscle fiber cross-sectional area (~+300 μm2). When examining the effects of training on LBM increases (ΔLBM) in all participants combined, PRE to MID (+1.34 kg, p < 0.001) and MID to POST (+0.85 kg, p < 0.001) increases were observed. However, when adjusting ΔLBM for extracellular water (ECW) changes, intending to remove the confounder of edema, a significant increase was observed from PRE to MID (+1.18 kg, p < 0.001) but not MID to POST (+0.25 kg; p = 0.131). Based upon DXA data, GWP supplementation may be a viable strategy to improve body composition during high-volume RT. However, large LBM increases observed in the MALTO group preclude us from suggesting that GWP supplementation is clearly superior in facilitating skeletal muscle hypertrophy. With regard to the implemented RT program, ECW-corrected ΔLBM gains were largely dampened, but still positive, in resistance-trained participants when RT exceeded ~20 sets/exercise/wk.
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Purpose: The purpose of this study was to evaluate muscular adaptations between low-, moderate-, and high-volume resistance training (RT) protocols in resistance-trained men. Methods: Thirty-four healthy resistance-trained men were randomly assigned to 1 of 3 experimental groups: a low-volume group (1SET) performing 1 set per exercise per training session (n = 11); a moderate-volume group (3SET) performing 3 sets per exercise per training session (n = 12); or a high-volume group (5SET) performing 5 sets per exercise per training session (n = 11). Training for all routines consisted of three weekly sessions performed on non-consecutive days for 8 weeks. Muscular strength was evaluated with 1 repetition maximum (RM) testing for the squat and bench press. Upper-body muscle endurance was evaluated using 50% of subjects bench press 1RM performed to momentary failure. Muscle hypertrophy was evaluated using B-mode ultrasonography for the elbow flexors, elbow extensors, mid-thigh and lateral thigh. Results: Results showed significant pre-to-post intervention increases in strength and endurance in all groups, with no significant between-group differences. Alternatively, while all groups increased muscle size in most of the measured sites from pre-to-post intervention, significant increases favoring the higher volume conditions were seen for the elbow flexors, mid-thigh, and lateral thigh. Conclusion: Marked increases in strength and endurance can be attained by resistance-trained individuals with just three, 13-minute weekly sessions over an 8-week period, and these gains are similar to that achieved with a substantially greater time commitment. Alternatively, muscle hypertrophy follows a dose-response relationship, with increasingly greater gains achieved with higher training volumes.
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Background: The current recommendations for resistance training (RT) frequency range from 2 to 5 days per week (days week- 1) depending on the subjects' training status. However, the relationship between RT frequency and muscular strength remains controversial with reported variances existing across different population groups. We conducted a meta-analysis that (1) quantified the effects of low (LF; 1 day week- 1), medium (MF; 2 days week- 1), or high (HF; ≥ 3 days week- 1) RT frequency on muscular strength per exercise; (2) examined the effects of different RT frequency on one repetition maximum (1RM) strength gain profiles (multi-joint exercises and single joint exercises); (3) examined the effects of different RT frequency on 1RM strength gain when RT volume is equated; and (4) examined the effects of different RT frequency on 1RM strength gains on upper and lower body. Methods: Computerised searches were performed using the terms 'strength training frequency', 'resistance training frequency', 'training frequency', and 'weekly training frequency'. After review, 12 studies were deemed suitable according to pre-set eligibility criteria. Primary data were pooled using a random-effects model. Outcomes analysed for main effects were pre- to post strength change with volume-equated studies that combined multi-joint and isolation exercise; isolation-only exercise and untrained subjects only. Heterogeneity between studies was assessed using I2 and Cochran's Q statistics with funnel plots used to assess publication bias and sensitivity analyses calculated for subgroups. Results: Pre- versus post-training strength analysis comprised of 74 treatment groups from 12 studies. For combined multi-joint and isolation exercises, there was a trend towards higher RT frequency compared with lower frequency [mean effect size (ES) 0.09 (95% CI - 0.06-0.24)] however not significant (p = 0.25). Volume-equated pre- to post-intervention strength gain was similar when LF was compared to HF [mean ES 0.03 (95% CI - 0.20-0.27); p = 0.78]. Upper body pre- to post-intervention strength gain was greater when HF was compared with LF [mean ES 0.48 (95% CI 0.20-0.76)] with significant differences between frequencies (p < 0.01). Upper body pre- to post-intervention strength gain was similar when MF was compared with LF (ES 0.12; 95% CI - 0.22-0.47); p = 0.48]. There was no significant difference in lower body mean ES between HF and LF [mean ES 0.21(95% CI - 0.55-0.13); p = 0.22]. There was a trend towards a difference in mean ES between MF and HF [mean ES 0.41(95% CI - 0.26-1.09); however, the effect was not significant (p = 0.23). Conclusions: The existing data does not provide a strong correlation between increased weekly training frequency (HF) and maximal strength gain in upper and lower body resistance exercises for a mixed population group. When RT is volume-equated for combined multi-joint and isolation exercises, there is no significant effect of RT frequency on muscular strength gain. More investigations are required to explore the effects of varying weekly training frequencies adequately.
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The pre-exhaustion (PE) system in resistance training is largely used by athletes and practitioners with the goal of enhancing muscular adaptations. PE consists of performing a single-joint exercise prior to a multiple-joint exercise in an effort to increase the overload (muscle activation and/or training volume) in a given muscle. Different PE approaches have been investigated in research; this review discusses the relevant literature regarding the efficacy of PE for potentiating overload and muscle hypertrophy. In general, PE does not alter the neuromuscular activity of the target muscle in multi-joint exercise, but it does allow for a greater training volume.
Article
Shibata, K, Takizawa, K, Nosaka, K, and Mizuno, M. Effects of prolonging eccentric phase duration in parallel back-squat training to momentary failure on muscle cross sectional area, squat one repetition maximum, and performance tests in university soccer players. J Strength Cond Res XX(X): 000-000, 2018-This study aimed to compare 2 squat training programs repeated until momentary failure with different eccentric phase duration (2 seconds vs. 4 seconds) on the changes in muscle cross-sectional area, squat 1 repetition maximum (1RM), squat jump (SJ), and countermovement jump (CMJ) height, agility (T-test), and Yo-Yo intermittent recovery test (YY-IR2). Male university soccer players (19.9 ± 0.9 years, 172.2 ± 3.8 cm, 66.1 ± 6.6 kg) were randomly assigned to one of the 2 groups; CON for 2 seconds and ECC for 4 seconds (C2/E4, n = 11) or CON for 2 seconds and ECC for 2 seconds (C2/E2, n = 11). They performed parallel back-squat exercises twice a week for 6 weeks using 75% 1RM weight to momentary failure in each set for 3 sets with each protocol. Outcome measurements were taken before (Pre) and after 3 (Mid; 1RM, SJ, and CMJ only), and at 6 weeks (Post). One repetition maximum increased more (p < 0.05) for C2/E2 (Pre: 95.9 ± 12.2 kg, Mid: 108.2 ± 15.4 kg, Post: 113.6 ± 14.8 kg) than C2/E4 (95.5 ± 12.9 kg, 102.7 ± 15.6 kg, 105.5 ± 14.9 kg, respectively). Cross-sectional area (50% of the thigh length: 3.5 ± 2.8%), SJ (6.7 ± 8.9%) and CMJ height (6.3 ± 8.6%) increased similarly between C2/E2 and C2/E4, but no significant changes in T-test or YY-IR2 were evident in either group. These results suggest that increasing the ECC phase duration during squat exercises does not produce greater training effects when compared with a shorter ECC phase-duration program with momentary failure.