Jeremy P. Loenneke’s research while affiliated with University of Mississippi and other places

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Publications (541)


The role of the muscle metaboreflex on cardiovascular responses to submaximal resistance exercise with different pressures and modes of blood flow restriction
  • Article

February 2025

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4 Reads

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William B Hammert

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Jeremy P Loenneke

This study investigated the role of muscle metaboreflex on cardiovascular responses to submaximal resistance exercise using different pressures and modes of blood flow restriction. Fifty-three adults completed six visits. The first visit involved a performance test (2 sets of unilateral knee extension exercise until task failure at 30% 1RM) with continuous blood flow restriction (80% arterial occlusion pressure). In subsequent visits, participants performed 1) a non-exercise control (Control), 70% of the repetitions completed in the performance test with the cuff inflated to 2) continuously 80% arterial occlusion (LL+80%), 3) continuously 40% arterial occlusion (LL+40%), 4) intermittently 80% arterial occlusion during exercise (LL+80%Int), and 5) 0 mmHg (LL), in a randomized order. Three minutes of post-exercise circulatory occlusion was employed to assess the muscle metaboreflex activation. Blood pressure and heart rate were measured at various time points. The pre-post increase in systolic blood pressure was not greater with LL+80%Int (p=0.987) but was greater with LL+80% and LL+40% (LL+80%>LL+40%, p=0.005) than LL by 7 [95%CI: 4, 9] and 4 [95%CI; 2, 6] mmHg, respectively. Heart rate increased only with LL+80% over LL and Control (p<0.001). The changes in systolic blood pressure (p>0.468) and heart rate (p>0.543) did not differ among exercise conditions from immediate post-exercise to the end of the circulatory occlusion. Systolic/diastolic blood pressure returned to a similar level as Control (~120 mmHg, ~70 mmHg, respectively) immediately after the cuff deflation. Continuous blood flow restriction, especially with higher pressure, accentuates muscle metaboreflex activation, resulting in amplified cardiovascular responses to the exercise.


PRISMA flow diagram
Forest plot showing comparative effect of bilateral and unilateral training on muscle hypertrophy. Values represent Cohen’s d (95% confidence interval). Each study is listed on the left side of the plot with squares representing the effect size for each study and 95% confidence interval. The square size varies according to the weights assigned to the different studies. The overall effect is included at the bottom of the plot as a diamond with a width corresponding to the confidence interval for the estimated effect; MT muscle thickness, LTM lean tissue mass
Forest plot showing comparative effect of bilateral and unilateral training on bilateral strength. Values represent Cohen’s d (95% confidence interval). Each study is listed on the left side of the plot with squares representing the effect size for each study and 95% confidence interval. The square size varies according to the weights assigned to the different studies. The overall effect is included at the bottom of the plot as a diamond with a width corresponding to the confidence interval for the estimated effect; 1 RM one-repetition maximum, SQ squat, KE knee extension, LP leg press, KF knee flexion, LPD lat pull down, CP chest press, BC biceps curl, 5 RM 5-repetition maximum
Forest plot showing comparative effect of bilateral and unilateral training on unilateral strength. Values represent Cohen’s d (95% confidence interval). Each study is listed on the left side of the plot with squares representing the effect size for each study and 95% confidence interval. The square size varies according to the weights assigned to the different studies. The overall effect is included at the bottom of the plot as a diamond with a width corresponding to the confidence interval for the estimated effect; 1 RM one-repetition maximum, KE knee extension, LP leg press, R right side, L left side, LPD lat pull down, CP chest press, BC biceps curl, RESS rear elevated split squat, 5 RM 5-repetition maximum
Weighted summary risk of bias plots

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Comparison of Muscle Growth and Dynamic Strength Adaptations Induced by Unilateral and Bilateral Resistance Training: A Systematic Review and Meta-analysis
  • Literature Review
  • Full-text available

January 2025

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1,104 Reads

Sports Medicine

Background Currently, great debate exists over the proposed superiority of some resistance exercises to induce muscular adaptations. For example, some argue that unilateral exercise (meaning one limb at a time) is superior to bilateral exercises (meaning both limbs). Of note, an evidence-based answer to this question is yet to be determined, particularly regarding muscle hypertrophy. Objective This systematic review and meta-analysis aimed to compare the effects of unilateral versus bilateral resistance training on muscle hypertrophy and strength gains. Methods A thorough literature search was performed using PubMed, Scopus, and Web of Science databases. The Cochrane Risk of Bias tool 2 (RoBII) tool was used to judge the risk of bias. Meta-analyses were performed using robust variance estimation with small-sample corrections. Results After retrieving 703 studies, 9 met the criteria and were included in the meta-analyses. We found no significant differences in muscle hypertrophy between bilateral and unilateral training [effect size (ES): − 0.21, 95% confidence interval (95% CI): − 3.56 to 3.13, P = 0.57]. Bilateral training induced a superior increase in bilateral strength (ES: 0.56, 95% CI: 0.16–0.96, P = 0.01). In contrast, unilateral training elicited a superior increase in unilateral strength (ES: − 0.65, 95% CI: − 0.93 to − 0.37, P = 0.001). Overall, studies presented moderate risk of bias. Conclusion On the basis of the limited literature on the topic, we found no evidence of differential muscle hypertrophy between the two exercise selections. Strength gains appear to follow the principle of specificity.

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Investigating the Influence of Limb Blood Flow on Contraction-Induced Muscle Growth and the Impact of that Growth on Changes in Maximal Strength

November 2024

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27 Reads

Medicine and Science in Sports and Exercise

Changes in skeletal muscle size may be affected by resting blood flow (e.g., nutrient delivery) and this change in size is a hypothesized mechanism for changes in strength. Purpose To determine: 1) whether the relationship between isometric training and muscle growth depends on baseline blood flow or is mediated by a change in blood flow and 2) whether muscle growth mediates changes in maximal isometric strength. Methods 179 participants were randomized into: low-intensity isometric handgrip exercise (LI), low-intensity isometric handgrip exercise with blood flow restriction (LI-BFR), maximal handgrip exercise (MAX), and a non-exercise control (CONTROL). Muscle thickness, strength, and resting limb blood flow were measured before and after the six-week intervention. Results Baseline blood flow did not moderate training effects on muscle thickness changes (MTHchg) ( p = 0.666), and moderated mediation tests were non-significant. Although the LI-BFR group showed a significant effect on MTHchg ( p = 0.018), MTHchg was not significantly related to handgrip strength change (HGchg) ( p = 0.281), suggesting no mediation of the training-to-strength effect by MTHchg. Both the LI-BFR ( p = 0.004) and MAX ( p < 0.001) groups exhibited positive direct effects on HGchg compared to CONTROL. Furthermore, there were no differences between training groups and CONTROL on blood flow change (BFchg), BFchg and MTHchg were not significantly related, and neither BFchg nor MTHchg predicted HGchg, providing no evidence for mediated pathways. Conclusions Muscle growth may not have occurred to an extent that would require vascular adaptation. Training maximally induced the greatest strength adaptations but was seemingly not driven by muscle growth.


The adjusted (covaried for baseline) change scores for one repetition maximum (1RM) strength for the non‐dominant (A) and dominant (B) arms. The mean change in strength is represented by the middle bar, and the upper and lower bars represent the 95% credible intervals. The hypotheses at the top of each figure represent the hypothesis with the greatest posterior probability. D + ND, Training on both dominant and non‐dominant arm; D‐Only, Training on dominant arm only; ND‐Only, Training on non‐dominant arm only; Control, Time‐matched non‐exercise control.
The adjusted (covaried for baseline) changes for muscle thickness. Changes at the 60% site in the non‐dominant (A) and dominant (B) arm. Changes at the 70% site in the non‐dominant (C) and dominant (D) arm. The mean changes in muscle thickness are represented by the middle bar, and the upper and lower bars represent the 95% credible intervals. The hypotheses at the top of each figure represent the hypothesis with the greatest posterior probability. D + ND, Training on both dominant and non‐dominant arm; D‐Only, Training on dominant arm only; ND‐Only, Training on non‐dominant arm only; Control, Time‐matched non‐exercise control.
Does Unilateral High‐Load Resistance Training Influence Strength Change in the Contralateral Arm Also Undergoing High‐Load Training?

November 2024

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170 Reads

Scandinavian Journal of Medicine and Science in Sports

Training one limb with a high‐load has been shown to augment strength changes in the opposite limb training with a low‐load (via cross‐education of strength), indicating that within‐subject models can be problematic when investigating strength changes. This study examined if the cross‐education of strength from unilateral high‐load training could augment the strength changes in the opposite arm undergoing the same unilateral high‐load training. 160 participants were randomized to one of four groups: (1) training on the dominant arm followed by the non‐dominant arm (D + ND), (2) training on the dominant arm only (D‐Only), (3) training on the non‐dominant arm only (ND‐Only), and (4) a non‐exercise control. All exercise groups performed 18 sessions of unilateral high‐load elbow flexion exercise over 6 weeks. Participants were compared for changes in 1RM strength and muscle thickness. Changes in strength of the non‐dominant arm were greater in D + ND (2.7 kg) and ND‐Only (2.6 kg) compared to D‐Only (1.5 kg) and control (−0.2 kg), while the changes were greater in D‐Only compared to control. The same finding was observed in the dominant arm. Only the arms being directly trained observed increases in muscle thickness. Unilateral high‐load resistance training increased strength in the opposite untrained arm, without changes in muscle thickness. This cross‐education of strength did not augment the strength changes in the contralateral arm undergoing the same unilateral high‐load training. However, it does not necessarily indicate that within‐subject models are methodologically sound to investigate strength change if both limbs are trained with a high‐load.


Methodological Considerations When Studying Resistance-Trained Populations: Ideas for Using Control Groups

November 2024

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135 Reads

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1 Citation

The Journal of Strength and Conditioning Research

The applicability of training effects from experimental research depends on the ability to quantify the degree of measurement error accurately over time, which can be accounted for by including a time-matched nonexercise control group. Yet, control groups are rarely included in studies on resistance-trained individuals. Many authors instead report short term relative or absolute measures of reliability for the interpretation of statistical tests and the size or meaning of effects observed and assume that good short-term reliability justifies the lack of a control group. In this article, we offer some potential alternatives for employing control groups in research studies on resistance-trained individuals. We wish to suggest researchers consider using a “time-matched training group” (i.e., resistance-trained individuals who keep an exercise log, continue their normal training, and perform the pre- and posttest measures spanning the same duration as that of the exercise group or groups) and/or a time-matched nonexercise control group (i.e., non resistance-trained individuals who perform only the pre- and posttest measures spanning the same duration as that of the exercise training group or groups). If it is not feasible (e.g., researchers do not wish to randomly assign individuals to a time-matched training group or include a time-matched nonexercise control group) to employ such designs, or relevant, then an alternative approach might be to include a run-in (i.e., control) period that spans the same duration as the exercise training intervention. Our hope is that this article can help strengthen future research designs conducted on resistance-trained individuals.



Comparison of Sport Type on the Handgrip Strength Change in Young Athletes

November 2024

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1 Read

American Journal of Human Biology

Objective Whether or not an athlete plays with sports equipment in their hands may influence handgrip strength (HGS) changes during development, but longitudinal studies have not confirmed this. This study compared one‐year HGS changes between two sports types (soccer vs. kendo) in children and adolescent athletes. Methods One hundred sixty‐eight young athletes (86 kendo boys and 82 soccer boys) had two HGS measurements separated by 1 year. A 2 (sports) by 2 (timepoints 1 and 2) repeated measures ANOVA was used to determine whether HGS changed differently between sports. Results There was no evidence for a sport × time interaction in HGS ( p = 0.14); however, the mean difference and 95% CI were in the direction of favoring a greater change in kendo athletes [difference of 0.6 (95% CI: −0.2, 1.5) kg]. There was a main effect of time and sport. Kendo athletes had a 4.6 (95% CI: 1.8, 7.5) kg greater HGS than soccer athletes. There was no evidence that the change in HGS between sports depended on the initial age of the athlete ( p = 0.205). Conclusion Using sports equipment during play may positively affect HGS.



The Influence of Eccentric Muscle Actions on Concentric Muscle Strength: An Exception to the Principle of Specificity?

October 2024

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447 Reads

International Journal of Strength and Conditioning

The principle of specificity suggests that the largest changes in strength occur when training resembles the specific strength test. A one-repetition maximum (1RM) test, which tests the maximal concentric strength, is commonly used as a surrogate for strength adaptation. When separating muscle actions into concentric or eccentric phases, multiple lines of evidence suggest that eccentric muscle actions possess several distinct physiological properties compared with concentric actions. In accordance, there are instances where the increases in 1RM strength test were similar between eccentric-only and concentric-only resistance training. This is at odds with the principle of specificity which suggests that individuals who trained with concentric actions would be expected to have an advantage in that specific task. Although the mechanistic reasons why eccentric-biased training carries over to maximal concentric strength remains to be elucidated, the lack of discernible differences in strength gains with eccentrically-biased training (e.g., eccentric-only and accentuated eccentric training) may imply that the effects of eccentric loading in training are transferable to concentric strength. Our review revisits the role of eccentric loading in enhancing concentric maximal muscle strength. We also speculate on potential physiological factors (i.e., molecular and neural factors) that may differentiate the effects of eccentric and concentric resistance training on the changes in muscle strength. Currently, the majority of the studies investigating the changes in strength have been conducted using isokinetic eccentric training. This is important as there is a viewpoint that the magnitude of chronic adaptations with different modalities of eccentric exercises (i.e., isotonic, isokinetic, and isoinertial training) may also differ from each other. While it has been suggested that eccentric action has a greater transferable capacity for strength adaptations compared to concentric actions, future investigations are warranted to investigate with different modalities of eccentric exercises. There also remains a host of unanswered questions related to the role of eccentric action for maximal concentric strength. For example, future studies may examine whether the eccentric action would be additive when the training is already maximally loaded during the concentric action for increasing concentric maximal strength. We suggested a few different designs that could be used to answer some of these questions in future studies.



Citations (47)


... Thirdly, while body mass was regularly monitored, and most participants were in an energy surplus during the intervention, nutrition was not systematically tracked, which may have introduced variability in training responses. Furthermore, although we utilized a within-subject design, no control group was included which limits the ability to quantify the degree of measurement error accurately over time [46]. Finally, ultrasound measurements were taken at only two sites on the lateral deltoid, whereas regional differences in muscle thickness increases may have occurred at other sites. ...

Reference:

Dumbbell versus cable lateral raises for lateral deltoid hypertrophy: an experimental study
Methodological Considerations When Studying Resistance-Trained Populations: Ideas for Using Control Groups
  • Citing Article
  • November 2024

The Journal of Strength and Conditioning Research

... As highlighted by a previous study, individuals can be trained to sense the target BFR pressure through repeated inflations and deflations at 40% arterial occlusion pressure, resulting in improved accuracy in estimating the target pressure [20]. The high-intensity sets were performed first, followed by the low-intensity sets. ...

Individuals Can be Taught to Sense the Degree of Vascular Occlusion: Implications for Practical Blood Flow Restriction
  • Citing Article
  • August 2024

The Journal of Strength and Conditioning Research

... A typical instance of such early neural changes is cross-education, also known as cross-transfer or interlimb transfer (Manca et al., 2018), in which unilateral resistance training induces gain transfers to the contralateral untrained limb (Moritani and deVries, 1979;Manca et al., 2021;Kay et al., 2024). These gains seem specific to strength and skill transfer, as muscle endurance does not seem to transfer to the untrained side (Song et al., 2024). ...

Cross-Education of Muscular Endurance: A Scoping Review

Sports Medicine

... CE effects after unilateral motor training for strength tasks are typically $50% relative to the motor performance gain in the trained limb (Carroll et al., 2006). The direction and magnitude of transfer may depend on specific aspects of the training paradigm including which limb is trained [dominant or non-dominant (Farthing, 2009)] although recent reviews have found little support for asymmetrical transfer of strength (Wong et al., 2024). Teixeira (2000) observed when an anticipation factor is introduced through visual feedback, the direction of transfer (between dominant and non-dominant limb and vice versa) is symmetrical. ...

Is there evidence for the asymmetrical transfer of strength to an untrained limb?

European Journal of Applied Physiology

... It has recently been demonstrated that a single bout of blood flow restricted (BFR) resistance exercise can promote exercise-induced hypoalgesia, as reflected by an increase in pressure pain threshold (PPT) to a greater extent than free-flow, low-load exercise (Hughes and Patterson 2020;Hammert et al. 2024;Norbury et al. 2024). Furthermore, BFR exercise has been shown to be more effective than low-load, free-flow exercise for reducing pain in individuals with knee osteoarthritis (Korakakis et al. 2018b) as well as being more effective than traditional high-load exercise in those recovering from anterior cruciate ligament reconstruction . ...

Blood flow restriction augments exercise-induced pressure pain thresholds over repetition and effort matched conditions
  • Citing Article
  • February 2024

... Initially, work by Pereira et al. (2020) found that IPC in the contralateral arm and leg reduced the intensity of pain during a sustained pressure stimulus on the finger when compared to sham and control conditions, and this reduction in pain was related to an improvement in exercise performance. However, recent work (Kataoka et al. 2022) has demonstrated increases in PPTs after IPC, but this did not translate to improved maximal isokinetic elbow flexion performance. Conversely, Angius et al. (2022) found that IPC did not significantly increase PPTs or decrease pain during a fixed intensity knee-extensor exercise task compared to a sham, but IPC did reduce the pain intensity experienced during post-exercise circulatory occlusion. ...

The Impact of Different Ischemic Preconditioning Pressures on Pain Sensitivity and Resistance Exercise Performance
  • Citing Article
  • January 2024

The Journal of Strength and Conditioning Research

... This phenomenon suggests that this effect occurs due to neural adaptations and possibly hormonal responses that benefit both limbs despite training only one. It underscores the interconnectedness and shared neural pathways between the limbs during resistance training (Wong et al., 2024). ...

Blood flow restriction augments the cross-education effect of isometric handgrip training

European Journal of Applied Physiology

... However, handgrip strength, determined in early adulthood, may change only with age-related decline or when injury/disease occurs. 8,9 Thus, the handgrip strength acquired during the developmental period until adulthood is thought to be of great importance. Recent studies revealed that the type of sport played, i.e., whether or not an athlete played with sports equipment in their hands (i.e., "upper + lower body" sports or "lower body" sports), might influence the development of handgrip strength during the period of growth. ...

Different Resistance Exercise Interventions for Handgrip Strength in Apparently Healthy Adults: A Systematic Review

International Journal of Clinical Medicine

... De la misma forma el Taekwondo la biomecánica muscular se basa en movimientos explosivos del tren superior por lo que la fuerza manual suele ser alta (Chaabène et al. 2012). Las diferencias en la fuerza prensil entre diferentes disciplinas deportivas fueron señaladas por Abe et al. (2024). Siendo las diferencias en los programas de entrenamiento clave para el aumento de la fuerza en los diferentes deportes. ...

Handgrip strength of young athletes differs based on the type of sport played and age
  • Citing Article
  • November 2023

American Journal of Human Biology

... Well-structured and closely supervised exercise training programs are designed to combat muscle atrophy, stimulate muscle growth, and preserve muscle function as individuals age [148,149]. Resistance exercise benefits muscle health through various physiological mechanisms and signaling pathways, including vasodilation, antithrombotic effects, reduced oxidative stress, anti-inflammatory responses, activation of mechanistic target of rapamycin complex-1 (mTORC1), enhanced mitochondrial biogenesis, increased Insulin-like Growth Factor 1 (IGF-1), stimulation of peroxisomes, and improved insulin sensitivity [150,151]. These molecular adaptations show that skeletal muscle is highly responsive and adaptable to activity. ...

The Plateau in Muscle Growth with Resistance Training: An Exploration of Possible Mechanisms

Sports Medicine