Chronic obstructive pulmonary disease (COPD) induces an imbalance in T helper (Th) 17/regulatory T (Treg) cells that contributes to of the dysregulation of inflammation. Exercise training can modulate the immune response in healthy subjects.

We aimed to evaluate the effects of exercise training on Th17/Treg responses and the differentiation of Treg phenotypes in individuals with COPD.

This randomized controlled trial included 50 individuals with severe or very severe COPD who were allocated to the Exercise or Control groups. The Exercise group underwent eight weeks of aerobic and muscle strength training, whereas the Control group received usual care. The primary outcome was the change in the phenotypic characteristics of Tregs and Th17 profile differentiation in systemic inflammation.

Exercise training increased the frequency of total and activated Tregs and decreased the frequency of Th17 cells in between-group comparisons. Additionally, Th17/Treg responses were moderately correlated with improvements in the six-minute walking test, muscle strength of the upper and lower limbs, and daily life physical activity levels.

Exercise training improved functional exercise capacity, muscle strength, and physical fitness, which was associated with a decrease in the Th17 inflammatory response and an increase in Treg cell phenotypes immunosuppressive activity.

Dietary restriction or exercise regimens can promote weight loss or physical fitness among patients with obesity. However, intervention-associated adverse effects may impede patients' motivation to participate in dietary/exercise interventions. We examined the effects of time restricted eating (TRE) with or without resistance training (RT) on body composition, mood profile, and sleep quality in young college adults with overweight or obesity.

Fifty-four young college students with overweight/obesity were randomized into control (CON), TRE, RT, and TRE plus RT (TRE+RT) trials. The TRE trials restricted to an eating window of 10-hour/day for 8-week. The RT trials performed supervised resistance exercise, while the control trial maintained a regular lifestyle. Changes in body composition variables, blood pressure, mood status, and sleep quality were measured before and after the intervention.

TRE intervention alone or in combination with RT significantly (p < 0.01) decreased body weight (>2 kg) and BMI (~1 kg/m2) in adults with overweight/obesity. Both RT alone and combined with TRE substantially decreased fat mass by 1.1 ± 0.5 and 3.2 ± 0.4 kg, respectively. The decreased fat mass was greater in the combination trial than in the RT trial, whereas TRE alone had no effect. In contrast, fat-free mass was significantly (p < 0.01) decreased with TRE (-2.3 ± 06 kg), increased with RT (1.6 ± 0.3 kg), and was stably maintained with combination interventions. The reduced waist and hip circumferences in the TRE (p < 0.01) were similar to those in the TRE+RT trials, however, RT alone had no effect. Time and group interaction showed a large effect size (partial eta squared) for all body composition variables. In addition, RT with or without TRE notably decreased diastolic blood pressure (RT: -5.5 ± 1.9 mmHg, TRE+RT: -4.1 ± 1.5 mmHg, p < 0.05). Mild anxiety levels at baseline in RT (4.8 ± 2.6) and TRE+RT (4.1 ± 3) trials were found to be normal at postintervention in TRE+RT (3.6 ± 1.7) but not in RT (5.6 ± 3.5). No depression or stress was recorded among the participants during the intervention. The reported poor sleep quality among participants at baseline was significantly improved with RT (4.8 ± 2.9; p < 0.05), and tended to improve with TRE+RT interventions (4.5 ± 1.9).

10-hour TRE is beneficial for weight/fat loss without affecting mood status. However, TRE combined with RT might be more effective for weight/fat loss, maintaining muscle mass, and good quality of sleep among young adults with overweight or obesity.

Aerobic and strength exercises are commonly recommended for patients with type-1 diabetes (T1DM) but may not suit everyone. Body-weight functional exercise (BWFE) could offer an alternative for diabetes management. We aimed to compare blood glucose (BG), cardiovascular responses and enjoyment levels following a 30-min session of BWFE versus interval aerobic exercise (IAE) and strength exercise (STE) in patients with T1DM.

Ten T1DM participants (seven female) completed three randomised exercise sessions. BG, heart rate (HR), blood pressure (BP) and double product (DP) were measured before (PRE), immediately after (POST-0) and 20 min post-exercise (POST-20). Maximum and average HR were recorded, and enjoyment levels (EL) were assessed post-exercise. Statistical analysis used generalised estimated equations, with minimal detectable difference for assessing clinical significance.

We observed clinically meaningful reductions in BG after all sessions, but only BWFE showed a statistically significant drop at POST-0 (-2.2 mmol/L) without hypoglycaemia. HR, BP and DP responses were similar across sessions. BWFE showed the highest EL and maximal HR.

BWFE effectively lowered BG safely and provided comparable cardiovascular effects to IAE and STE while being more enjoyable. These findings support incorporating functional exercises into T1DM management to encourage sustained physical activity.

This study retrospectively evaluated data from an athlete management system on the impact of a 6-week, 12-session risk-reduction athletic development training program on maximal isometric strength in post-rehabilitative and healthy men and women. Maximal isometric quadriceps and hamstrings strength were evaluated bilaterally before and after the training program. Out of 55 athletes that had participated in the program, a total of 37 athletes' (13-28 years old) recorded outcomes were utilized in analyses. Thirty-one athletes had undergone rehabilitation (post-rehabilitative athletes) after orthopedic knee surgeries. Six athletes with no previous surgeries performed (healthy athletes) also completed the 6-week program. Repeated measures analyses of variance (leg × time) assessed changes in quadriceps and hamstrings strength at an alpha of p ​≤ ​0.05. There was a main effect for time where the post-rehabilitative athletes' quadriceps and hamstrings strength increased by (mean difference ​± ​standard error) (4.2 ​± ​0.7) kg (p ​< ​0.01) and (4.5 ​± ​0.9) kg (p ​< ​0.01) respectively, with legs (operative [OP]) and non-operative [NOP]) combined. With time points combined, the OP limb was weaker than the NOP limb for quadriceps strength by (2.9 ​± ​0.7) kg (p ​< ​0.01) with no differences in hamstrings strength. For the healthy athletes, there were no changes for quadriceps strength and hamstring strength improved across time by (5.3 ​± ​1.4) kg (p ​= ​0.01) with legs combined. In conclusion, there were improvements in post-rehabilitative and healthy athletes' isometric strength after the training program. However, between-limb strength asymmetries were still apparent in the post-rehabilitation cohort.

Alzheimer's disease (AD) is a neurodegenerative condition that affects memory and cognition, with a higher prevalence in women. Given the lack of effective treatment, physical activity stands out as a complementary approach to prevent or delay disease progression. While numerous studies on humans and animals indicate that aerobic exercise induces brain changes, the impact of resistance exercise (RE) on AD is not fully understood.

This study aimed to investigate the behavioral and molecular changes induced by RE in female transgenic mice with AD at the early and advanced stages of the disease.

Adult (initial phase - 7 to 8 months of age, n = 32) and adult/elderly (advanced phase - 22 to 23 months of age, n = 32) female mice (2xTg-AD) for the APPSWE/PS1dE9 mutation were subjected to a four-week RE protocol. Mobility, anxiety-like behavior, long-term memory (LTM), and depressive-like behavior were assessed. Beta-amyloid (βA) and cytokines were quantified using the ELISA technique.

There was a progressive increase in strength in both trained groups at different ages. RE reversed memory deficits only in adult AD animals and the anxiety-like behavior only in adult/elderly AD animals. RE reversed depressive-like behavior in adult and adult/elderly AD animals. RE reduced βA only in adult AD animals. RE modified the expression of several cytokines in animals in the early and advanced stage of AD.

RE can be a promising strategy to minimize the deleterious effects of AD; however, its effectiveness may be more limited to the early stages of the disease.

We compared the effects of varied and constant resistance exercises on muscular adaptations in young women. Seventy young women (21.8 ± 3.4 yrs, 62.0 ± 12.3 kg, 162.3 ± 5.7 cm) were randomly divided into two groups: constant resistance exercises (CON-RE, n = 38) or varied resistance exercises (VAR-RE, n = 32). The resistance training (RT) was performed thrice a week over 10 weeks. CON-RE performed a 45º leg press and stiff-leg deadlift in every training session, while VAR-RE performed 45º leg press and stiff-leg deadlift in the first training session of the week, hack squat and prone leg curl in the second, and Smith machine squat and seated-leg curl in the third. Both groups performed two sets of 10-15 repetitions maximum per resistance exercise. We measured the muscle thickness of the thigh's anterior, lateral, and posterior aspects by ultrasonography at different muscle sites (proximo-distal). Muscular strength was analyzed from the one-repetition maximum (1RM) tests in the 45° leg press and leg extension (non-trained exercise). The muscle thickness increased similarly in both groups for all muscles and sites (CON-RE: +7.8-17.7% vs. VAR-RE: +7.5-19.3%, p > .05). The 1RM increased similarly in both groups (CON-RE: +24.4-32.1% vs. VAR-RE: +29.0-30.1%, p > .05). Both RT routines resulted in virtually similar muscular strength gains and hypertrophy. Therefore, both strategies should be considered for the improvement of strength and muscle growth.

Eliminating risk factors for falls leads to reduction of the incidence of frailty. The recommended training program used only body weight resistance and no equipment to prepare for quick movements in daily living in community-dwelling older adults is unknown. Thus, we compared the effects of weight-bearing resistance training with (WEM) and without explosive motions (WOEM).

Sixty older adults were randomly assigned to WEM and WOEM groups. The WEM group performed the concentric phase during repetitions quickly and the WOEM group performed it at traditional velocity. The designated training programs consisted of 8 events to train the whole body for 50 minutes twice a week for 12 weeks. The changes in the rate of force development of toe grip, single knee extension, and flexion from baseline to 12 weeks were measured. Between-group differences were analyzed for changes in each outcome variable.

Twenty-seven participants in the WEM group (70 [5] y) and 21 participants in the WOEM group (69 [4] y) completed the study. The change in the early rate of force development of toe grip from baseline to 12 weeks was significantly greater in the WEM group (0-30 ms: effect size = 0.53, 95% CI = 6.36-68.10, P = .049; 0-50 ms: effect size = 0.56, CI = 10.05-86.02, P = .046) than in the WOEM group.

Weight-bearing resistance training with explosive motions has the advantage of not being limited to tools and places. Therefore, it is more suitable than traditional repetition velocity training for quick movement by increasing rate of force development in community-dwelling older adults before they become frail.

The addition of blood flow restriction therapy (BFRT) to exercise in patients with olecranon fracture treated surgically has not been described in the literature.

To describe the effects and safety of BFRT exercises in the postoperative rehabilitation of a patient with olecranon fracture.

A 27-year-old male with a surgically treated olecranon fracture completed a 12-week postoperative physical therapy programme. The assessment was performed at the start of rehabilitation, 4 and 12 weeks. The patient had elbow pain, decreased active range of motion (AROM), reduced handgrip strength, and limited physical function. The patient was treated with low-intensity resistance exercises with BFRT. The BFRT was applied with three exercises per stage, at 50% of the limb occlusion pressure and 75 repetitions per exercise. At discharge from physical therapy, improvements were observed in pain intensity (5.9-1.4 cm), AROM of elbow flexion (88°-137°) and extension (-22°--2°), AROM of forearm pronation (18°-68°) and supination (34°-78°), handgrip strength (8 kg-47 kg), physical function (22.9%-89.6%), and disability (72.7%-13.6%). These changes reached the minimal clinically important difference at the time of discharge for all measures, except for extension, pronation, and supination AROM.

The addition of BFRT to exercise was effective in improving pain, elbow, and wrist AROM, handgrip strength, function, and disability in a patient with surgically treated olecranon fracture. Despite the inherent limitations of our design, we believe these preliminary findings are compelling to warrant future investigations.

Quadriceps strength is relevant for recovering functional capacity in total knee arthroplasty (TKA). This requires strength exercises with high loads, which is difficult to perform after TKA. Rehabilitation with blood flow restriction (BFR) produces gains in strength and muscle mass, avoiding the use of heavy loads.

To identify exercise prescription parameters and the effect of BFR training on muscle mass, muscle strength, and functional capacity of patients with TKA.

Following the PRISMA-ScR methodology, a systematic search was carried out in the following databases: Pubmed, Virtual Health Library, Scopus, and Web of Science. The execution of exercises with BFR during TKA prehabilitation and rehabilitation stages were considered. Two authors independently assessed articles for eligibility, and a third author resolved conflicts.

5 articles were selected. During the prehabilitation stage, increases in strength, muscle mass, and functionality occurred. Muscle strength increased in the rehabilitation stage. Studies with a control group did not detect significant differences. Various protocols were applied regarding the prescription, dosage, and implementation of the exercise programs.

Strength, muscle size, and physical function increase in people with TKA during the prehabilitation and rehabilitation stages. The analysis carried out indicates a wide methodological variety, lack of standardization, and gaps in BFR protocol application.

Obesity adversely impacts musculoskeletal health, contributing to functional limitations and an increased risk for falls, fractures and disability. Weight loss can mitigate these effects, but strategies that neglect to incorporate evidence-based dietary and/or exercise approaches can exacerbate musculoskeletal and functional declines. Sustainable weight loss requires a personalised approach that prioritises adequate protein intake and essential nutrients to preserve musculoskeletal health. To enhance adherence and long-term success, dietary strategies should be practical, nutritionally balanced and cost-effective. Similarly, exercise programmes should be individually tailored and progressive, with resistance training central to any program prescribed in the context of weight loss, due to its critical role in maintaining muscle and bone mass and strength. When prescribing weight loss strategies involving lifestyle behaviour changes, clinicians must consider their patient's readiness to change. We have used the transtheoretical model of change framework as an example to identify a patient's level of readiness and provided associated motivational interviewing-based strategies to enhance adherence and engagement. This review outlines evidence-based, practical diet and exercise recommendations and behavioural strategies that can facilitate effective and sustainable weight loss, which is particularly important for at-risk populations such as older adults.

To assess the therapeutic quality of exercise interventions delivered in chronic low back pain (cLBP) trials using the international Consensus on Therapeutic Exercise aNd Training (i-CONTENT) tool and its inter-rater agreement.

We performed a meta-research study, starting from the trials' arms included in the published Cochrane review (2021) 'Exercise therapy for chronic low back pain'. Two pairs of independent reviewers applied the i-CONTENT tool, a standardised tool designed to ensure the quality of exercise therapy intervention, in a random sample of 100 different exercise arms. We assessed the inter-rater agreement of each category calculating the specific agreement. A percentage of 70% was considered satisfactory.

We included 100 arms from 68 randomised controlled trials published between 1991 and 2019. The most assessed exercise types were core strengthening (n=27 arms) and motor control (n=13 arms). Among alternative approaches, yoga (n=11) and Pilates (n=7) were the most representative. Overall, most exercise interventions were rated as having a low risk of ineffectiveness for patient selection (100%), exercise type (92%), outcome type and timing (89%) and qualified supervisor (84%). Conversely, some items showed more uncertainty: the safety of exercise programmes was rated as 'probably low risk' in 58% of cases, exercise dosage in 34% and adherence to exercise in 44%. The items related to exercise dosage (31%) and adherence (29%) had heterogenous judgements, scoring as high risk of ineffectiveness or probably not done. Among all exercise types, Pilates scored best in all domains. A satisfactory specific agreement for 'low risk category' was achieved in all items, except dosage of exercise (60%) and adherence to exercise (54%).

Exercises delivered for patients with cLBP generally demonstrate favourable therapeutic quality, although some exercise modalities may present poor therapeutic quality related to dosage and adherence. While the i-CONTENT judgements generally showed satisfactory specific agreement between raters, disagreements arose in evaluating some crucial items.

Knee osteoarthritis (OA) is a prevalent joint condition resulting in years lived with disability. A first-line treatment recommended by clinical guidelines is the therapeutic exercise to control pain and improve physical function. One possible approach for exercise supervision is telehealth using video calls, as it can be an effective alternative to in-person physical therapy for treating musculoskeletal conditions, expanding community access to physical rehabilitation. In this scenario, this study aims to investigate whether a muscle-strengthening exercise program for the lower limbs supervised remotely via video calls is as effective as the same exercise applied in person for improving pain, physical function, condition-specific patient-reported outcomes (PROMs), psychological well-being, sleep quality, functional performance, and quadriceps muscle architecture.

A Remote and In-person Supervised Exercise in Patients with Knee Osteoarthritis (RISE-KOA) study is a parallel, two-armed, single-blinded protocol for a non-inferiority randomized controlled trial. Forty-eight participants aged 45 years or more, with a symptomatic and radiographic diagnosis of unilateral or bilateral knee OA (grade II or III according to Kellgren and Lawerence) will be randomly assigned to a remote exercise group supervised by video calls or in-person exercise group supervised at a physiotherapy clinic. Both groups will receive the same muscle-strengthening exercises for the lower extremities for 12 weeks. Follow-ups will be conducted during treatment (6 weeks), after treatment (12 weeks), and 18 weeks after randomization. The primary outcomes will be pain intensity and physical function during (6 weeks) and after treatment (12 weeks). Secondary outcomes will be condition-specific PROMs, psychological well-being, sleep quality, functional performance, and quadriceps muscle architecture.

We hypothesize that muscle strengthening exercise supervised remotely via video calls will not be inferior to in-person exercise at a physiotherapy clinic in terms of primary and secondary outcomes in patients with knee OA.

The study was prospectively registered at ClinicalTrials.gov (NCT06101797). Registered on Oct 26, 2023.

This study analysed perceived exertion (RPE) and blood lactate ([La-]) responses to two resistance training protocols planned with high- (HLI) and low-load intensities combined with blood flow restriction (LLI+BFR). Fourteen trained adults (26.2 ± 2.6 years) performed the HLI and LLI+BFR protocols 48 h apart. The HLI was planned with 70% 1RM (one repetition to maximum), three sets, 12 repetitions, 60 seconds (s) of rest between sets and 120 s between exercises; LLI+BFR was performed at 30% 1RM, for three sets, 15 repetitions, and with 30 s of rest between sets and 180 s between exercises. Blood samples (for [La-] analysis) and RPE (Borg 0-10 scale) were collected in the first minute after each exercise. A two-way ANOVA compared RPE and [La-] responses between exercises in the same protocol, and between protocols comparing the same exercise. RPE increased from the first to the last half (involving upper-limbs and lower-limbs) of exercises in both protocols (p < 0.001). All exercises in HLI elicited higher RPE values than LLI+BFR (p < 0.001). Average RPE scores were higher in HLI than for LLI+BFR (8.1 ± 0.6 > 6.2 ± 1.1, p < 0.001). The [La-] also increased throughout the exercises, with a higher peak response in LLI+BFR than for HLI (9.8 ± 1.6 > 7.2 ± 1.3 mmol × L-1, p < 0.01). Perceptual and metabolic responses during HLI and LLI+BFR training were distinguishable, despite both protocols characterising a high-intensity stimulus.

BackgroundWe aimed to evaluate the effects of 12 weeks of resistance training (RT) on cardiovascular disease (CVD) risk factors in older women with and without history of depression.MethodsWe included 79 older women, 52 without depression and 27 with a history of depression. 79 participants formed the waitlist control group and were instructed to maintain their habitual routine. The participants were reevaluated and attended 12 weeks of RT. The Beck Anxiety Inventory (BAI) and Patient Health Questionnaire-9 (PHQ-9). The serum levels of high-sensitivity C-reactive protein (CRP), glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density cholesterol (LDL-c), and triglycerides (TG) were used as cardiovascular risk factors. The Linear Mixed Model (LMM) was used to compare between groups.ResultsThe average age of the sample was 69.3 ± 5.7 and the body mass index was 28.5 ± 4.5. The 12 weeks of RT resulted in a reduction in BAI (-3.9 [-7.1; -0.6], P < 0.05) and PHQ-9 scores (-1.4 [-3.2; -0.5] P < 0.05) in the Training group with depressive disorders. In the training group with depressive disorders, it was observed an improvement in TG (-17.1 [-43.0; -8.8]), TC (-18.6 [-35.9; -1.3]), LDL-c (-10.3 [-26.8; -6.2]), and CRP (-0.4 [-1.3; -0.5]). Similar results were found for TG, TC, and LDL-c in the Training group without depressive symptoms. No difference between RT groups was observed.ConclusionOur results suggest that RT is effective in improving CVD risk factors, anxiety, and depressive symptoms in older women with history of depression.

The objective of this study was to investigate the equivalence between resistance training protocol with self-selected intensity (RT-SSI) and resistance training protocol with imposed intensity (RT-II) in postmenopausal women.

A randomized study involving 49 women was carried out. Participants were randomly assigned to either RT-II or RT-SSI. The RT-II group performed with a training load initially imposed at 60%, increasing to the 70%-85% range of one maximum repetition (1RM), while the RT-SSI group performed with a training load self-selected by the volunteers for 12 weeks. Muscle strength (1RM), the 6-minute walk test (6MWT), and body composition were assessed before and after the intervention.

Both groups showed significant improvements in strength (P<0.001), muscle mass (P=0.027), and physical performance (P=0.023) after the 12-week intervention. However, there were no significant differences in the effects of the time/group interaction on muscle mass (P=0.750), strength (P=0.651), and physical performance (P=0.724). The equivalence analysis indicated Cohen d values for the effect estimate above the lower limit value for equivalence (d=-0.5). These results suggest that there is no evidence of the inferiority of RT-SSI in relation to RT-II for muscle mass, muscle strength, and physical performance. However, equivalence between interventions was not established, as the upper limits for equivalence were exceeded by the 90% CI.

Our findings indicated that RT-SSI is comparable to RT-II in terms of muscle mass, muscle strength, and physical performance gains in postmenopausal women.

High-intensity resistance training induces structural and functional adaptations in skeletal muscle, yet its impact on cardiac remodeling remains debated. This study aimed to investigate the longitudinal biventricular cardiac response to a 20-week high-intensity resistance training program in previously untrained, healthy males and examine the association between muscle strength gains and cardiac remodeling.

Twenty-seven male volunteers (aged 18-40 years) participated in a high-intensity resistance training program for 20 weeks. Assessments at baseline, 12 weeks, and 20 weeks included resting blood pressure, electrocardiogram (ECG), three-dimensional transthoracic echocardiography (3DTTE), cardiopulmonary exercise testing ([Formula: see text]O2peak), isokinetic dynamometry for muscle strength, and actimetry recordings. Time effects were analyzed using one-way repeated measures ANOVA (P < 0.05).

Twenty-two participants completed the study. Resistance training led to significant reductions in arterial systolic and diastolic blood pressure and heart rate. After 20 weeks of training, 3DTTE showed a significant increase in left ventricular (LV) mass (120.1 ± 15.4 g vs. 133.7 ± 16.3 g, p < 0.001), without inducing LV hypertrophy. Balanced increases were observed in LV end-diastolic volume (146.4 ± 18.9 ml vs. 157.9 ± 19.6 ml, p < 0.001) and right ventricular (RV) end-diastolic volume (119 ± 19.4 ml vs. 129.2 ± 21.6 ml, p < 0.001). LV and RV systolic and diastolic function remained unchanged. There were no changes in [Formula: see text]O2peak or daily activity levels. Maximal muscle strength in the quadriceps, hamstrings, triceps, and biceps was significantly correlated with LV and RV end-diastolic volumes and LV mass (p ≤ 0.001).

The resistance training program resulted in significant and rapid muscle strength gains and reduced blood pressure. Cardiac adaptations, including moderate biventricular dilatation, were observed without changes in cardiac function or [Formula: see text]O2peak and were associated with muscle strength gains. Our study highlights that intensive resistance training in novice male resistance trainers induces an adaptive cardiac response, reflecting a physiological adaptation linked to enhanced muscle performance.

ClinicalTrials.gov ID: NCT04187170.

Objectives: This study examined the effects of re-warm-up versus no re-warm-up before squats or bench presses on mechanical, physiological, and psychophysiological responses in recreationally trained men. Methods: Twenty-two participants (22.8 ± 3.3 years) completed four randomized sessions involving different re-warm-up and exercise sequences. Measurements included heart rate, blood lactate, tympanic temperature, and perceived exertion. Key performance metrics, such as mean propulsive velocity, peak velocity, power, velocity loss, and effort index, were analyzed. Results: Findings revealed that re-warming up before squats (W + BP + RW + SQ) significantly enhanced propulsive velocity and power compared to no re-warm-up (W + BP + SQ) (p ≤ 0.05; d = 0.45-0.62). However, re-warming up before the bench press (W + SQ + RW + BP) did not improve mechanical performance compared to the standard sequence (W + SQ + BP) (p > 0.05; d = 0.10-0.38). Notably, velocity loss and effort index were higher in the third bench press set under the W + SQ + BP condition (p ≤ 0.05; d = 0.53-0.60). No significant differences in physiological or psychophysiological responses were found between conditions. Conclusions: Overall, re-warm-up effectively improved squat mechanical performance when performed after the bench press but had a minimal impact on the bench press when performed after squats. These findings suggest that re-warming up before lower-body exercises may enhance mechanical performance, while its benefits may be less pronounced for upper-body exercises.

Resistance exercises are effective for maintaining health and activating stabilizing muscles, as they trigger abdominal wall tension responses. This study compared the effects of multi-joint and single-joint, upper-body and lower-body exercises (Lat pulldown, Rows, Peck deck, Chest press, Biceps curls, Triceps extensions, French-Press, Step up, Hip abduction/adduction, Squat, Leg press, Romanian deadlift, Hamstring curls) performed at maximal and submaximal intensities.

This cross-sectional study included 12 men and 18 women (age:47.8 ± 5.9 years, height:174.8 ± 10.2 cm, weight: 77.7 ± 15.4 kg, BMI:25.3 ± 3.6), who wore a noninvasive sensor Ohmbelt to measure abdominal wall tension performing exercises at 15 repetition maximum (RM), 10RM, 5RM, and 1RM. Differences across exercises and sex were compared by Friedman test with Durbin-Conover post-hoc, and intensities were analyzed by Wilcoxon test.

The study found significant differences (p < 0.05) in abdominal wall tension changes based on the type of exercise and training intensity. Multi-joint lower-body exercises, such as the Romanian deadlift, dumbbell front squat, and leg press, led to the greatest increases in abdominal tension in both sexes in comparison to single-joint upper-body exercises. Males had higher abdominal wall tension changes than females (p < 0.05) at 1RM, 5RM, and 10RM. However, no significant difference was found at 15RM, indicating that lower intensities produce similar abdominal wall tension changes in both sexes.

This study showed that multi-joint lower-body exercises were found to produce greatest abdominal wall tension increases, especially compared to single-joint upper-body exercises. The abdominal wall tension was higher in males than females due to higher loads, emphasizing the need for exercise-specific approaches.

We compared performing preacher and incline biceps curls on changes in elbow flexor muscle size and strength. This was a between-group repeated measure randomized trial. Sixty-three young women performed the preacher biceps curl (n=30) or the incline biceps curl (n=33) for 8 weeks, twice a week. We measured the muscle thickness of elbow flexors at the proximal, middle, and distal sites. We assessed the muscle strength using three repetition maximum tests in the preacher curl and the incline curl. We observed a greater increase in the proximal elbow flexor thickness in the incline biceps curl compared to the preacher biceps curl (mean difference=0.08 cm [95% confidence interval: 0.02, 0.13 cm]). We observed a greater increase in the distal elbow flexor thickness in the preacher biceps curl compared to the incline biceps curl (mean difference=0.10 cm [95%CI: 0.04, 0.15 cm]). The preacher biceps curl showed a greater increase in three repetition maximum tests in the preacher curl (mean difference=1.88 kg [95%CI: 1.14, 2.62 kg]). The incline biceps curl showed a greater increase in three repetition maximum tests in the incline biceps curl (mean difference=0.86 kg [95%CI: 0.10, 1.62 kg]). Our findings suggest regional differences in muscle growth induced by the preacher and incline biceps curls. Strength gains appear to follow the principle of specificity.

In recent years, load-velocity profiles (LVP) have been frequently proposed as a highly reliable and valid alternative to the one-repetition maximum (1RM) for estimating maximal strength and prescribing training loads. However, previous authors commonly report intraclass correlation coefficients (ICC) while neglecting to calculate the measurement error associated with these values. This is important for practitioners, especially in an elite sports setting, to be able to differentiate between small but significant changes in performance and the error rate.

49 youth elite athletes (17.71±2.07 years) were recruited and performed a 1RM test followed by a load-velocity profiling test using 30%, 50% and 70% of the 1RM in the bench press and bench pull, respectively. Reliability analysis, ICCs and the coefficient of variability, were calculated and supplemented by an agreement analysis including the mean absolute error (MAE) and mean absolute percentage error (MAPE) to provide the resulting measurement error. Furthermore, validity analyses between the measured 1RM and different calculation models to estimate 1RM were performed.

Reliability values were in accordance with current literature (ICC = 0.79-0.99, coefficient of variance [CV] = 1.86-9.32%), however, were accompanied by a random error (mean absolute error [MAE]: 0.05-0.64 m/s, mean absolute percentage error [MAPE]: 2.7-9.5%) arising from test-retest measurement. Strength estimation via the velocity-profile overestimated the bench pull 1RM (limits of agreement [LOA]: -9.73 - -16.72 kg, MAE: 9.80-17.03 kg, MAPE 16.9-29.7%), while the bench press 1RM was underestimated (LOA: 3.34-6.37 kg, MAE: 3.74-7.84 kg, MAPE: 7.5-13.4%); dependent on used calculation model.

Considering the observed measurement error associated with LVP-based methods, it can be posited that their utility as a programming strategy is limited. The lack of accuracy required to discriminate between small but significant changes in performance and error, coupled with the potential risks of under- and overestimating 1RM, can result in insufficient stimulus or increased injury risk, respectively. This further diminishes the practicality of these methods, particularly in elite sports settings.

Dietary nitrate (NO3-) can enhance skeletal muscle contractile function and explosive-type exercise by modulating type II muscle fibers; however, limited attention has been directed at exploring the optimal dosing guidelines and potential performance-enhancing effects of NO3- supplementation during resistance-type exercise. The purpose of our investigation was to examine potential dose-response effects of concentrated NO3--rich beetroot juice on neuromuscular performance during resistance exercise. Eighteen resistance-trained men were assigned in a double-blind, randomized, crossover design, to four conditions to consume beetroot juice containing: negligible NO3- (PL); ~ 6 mmol NO3- (BR-LOW); ~ 12 mmol NO3- (BR-MOD); and ~ 24 mmol NO3- (BR-HIGH). Participants completed 1 set of vertical countermovement jumps (CMJ), 2 sets × 3 repetitions of barbell back squats, and 2 sets × 3 repetitions of barbell bench press 2.5 h post-supplementation. Plasma [NO3-] increased in a dose-dependent manner (P < 0.01). Plasma [nitrite] ([NO2-]) increased in all BR conditions compared to PL (P < 0.05), such that BR-MOD vs. BR-LOW (P < 0.01) and BR-LOW vs. PL (P < 0.01), but BR-HIGH was not different compared to BR-MOD (P > 0.05). Performance was not different between conditions in CMJ, 50% one-repetition maximum (1RM) and 75%1RM back squats, or 50%1RM and 75%1RM bench press (P > 0.05). The change in plasma [NO2-] was significantly correlated with peak power (r = - 0.65, P = 0.003), mean power (r = - 0.52, P = 0.03), and mean velocity (r = - 0.48, P = 0.04) during 50%1RM back squats following BR-LOW vs. PL but not in other conditions (P > 0.05). This study indicates that dietary NO3- does not impact resistance exercise performance at any of the doses assessed in the current study.

To develop the rehabilitation interventions for people with an acute patellar dislocation in the Physiotherapy Rehabilitation Post Patellar Dislocation (PRePPeD) pilot randomized controlled trial (RCT), and to describe how these interventions are delivered.

We developed the interventions drawing on a range of established intervention development approaches and frameworks. We selected intervention components after reviewing the existing evidence, clinical guidelines, UK NHS practice, and relevant scientific theory. We then created early versions of the interventions, and discussed these with clinical experts and patient and public partners. We finalized the interventions considering their feedback, findings from our preliminary study, and what would be acceptable and deliverable in the UK NHS.

Upon randomization, all participants receive a workbook containing advice and initial exercises to implement before their first physiotherapy session. Self-managed rehabilitation then involves a single one-to-one session with a physiotherapist who provides advice, introduces a structured home exercise programme, and uses strategies to support exercise adherence. Participants then continue their recovery independently. Supervised rehabilitation involves four to six one-to-one physiotherapy sessions over a maximum of six months. Physiotherapists also provide advice, prescribe home exercise, and use exercise adherence strategies. Routine follow-up sessions enable physiotherapists to reassess participants and tailor the advice and exercises accordingly.

The interventions were developed and are currently being assessed in the PRePPeD pilot RCT. This will determine whether a full-scale RCT comparing these interventions is feasible. Results are anticipated in Summer 2025.

(1) Background: The range of loads is defined as the difference between the highest and the lowest relative load (i.e., %1RM) used throughout a resistance training program. However, the optimal range of loads has not been studied yet. Thus, the aim of this study was to compare the effects of different ranges of load (from 50 to 85% 1RM (R50-85), from 55 to 75% 1RM (R55-75), and from 60 to 70% 1RM (R60-70) on physical performance using velocity-based resistance training (VBT). (2) Methods: Thirty-eight men (mean ± standard deviation; age: 23.3 ± 3.6 years, body mass: 76.5 ± 8.3 kg, and height: 1.77 ± 0.04 m) were randomly assigned to R50-85, R55-75 and R60-70 groups and followed an 8-week VBT intervention using the full squat (SQ) exercise. All groups trained with similar mean relative intensity (65% 1RM) and total volume (240 repetitions). Pre- and post-training measurements included the following: in the SQ exercise, 1RM load, the average velocity attained for all absolute loads common to pre-tests and post-tests (AV), and the average velocity for those loads that were moved faster (AV > 1) and slower (AV < 1) than 1 m·s-1 at Pre-training tests. Moreover, countermovement jump (CMJ) height and 10 m (T10), 20 m (T20), and 10-20 m (T10-20) running sprint times were measured. (3) Results: Significant group x time interactions were observed in AV (p ≤ 0.01), where R50-85 obtained significantly greater gains than R60-70 (p ≤ 0.05). All groups attained significant increases in 1RM, AV, AV > 1, AV < 1, and CMJ (p ≤ 0.001-0.005). Significant improvements were observed in running sprint for R60-70 in T10-20 and R60-70 in T20 and T10-20 (p ≤ 0.05), but not for R50-85. (4) Conclusions: Different ranges of loads induce distinct strength adaptions. Greater ranges of loads resulted in greater strength gains in the entire load-velocity spectrum. However, in high-velocity actions, such as sprinting, significant enhancements were observed only for smaller ranges of loads. Coaches and strength and conditioning professionals could use a range of loads according to the time-related criterion (i.e., proximity or number of future competitions), enabling better adaptation and increasing physical performance at a specific time.

The aim of the current parallel randomized controlled trial was to compare the effects of ingesting a dietary supplement admixture providing carbohydrates, leucine-fortified whey protein, creatine, β-hydroxy-β-methylbutyrate, and vitamin D3 (Master Recovery 1:1, Crown Sport Nutrition, Spain), versus an isoenergetic carbohydrate-only comparator on body composition, muscle thickness, muscle strength, and performance over a 6-week resistance training program, performed three times per week, in aging, physically active individuals. Twenty participants (10 peri- and post-menopausal females and 10 males) -completed the study after being randomly assigned to one of the following groups: post-workout multi-ingredient (PWS: n = 10, 52.0 ± 5 years, body mass 82.0 ± 18.0 kg) or a comparator (COM: n = 10, 51 ± 3 years, body mass 85.9 ± 17.0 kg). Treatment consisted of ingesting 60.0 g of the assigned supplement immediately after each workout. Compared to baseline, only PWS increased fat-free mass (+1.34 ± 1.2 kg, p = 0.003), reduced fat mass (-1.09 ± 0.7 kg, p < 0.001), waist circumference (-2.5 ± 1.8 cm, p < 0.001), and waist-to-hip ratio (-0.03 ± 0.03 cm, p = 0.007). At post-intervention, waist circumference reduction was different between groups (p = 0.02, d = 1.19). Both treatments similarly improved vastus lateralis and elbow flexor thickness, medicine ball throw, and endurance performance. Although countermovement jump improved for both treatments, the PWS group showed a significantly higher performance increase compared to COM (p < 0.01, d = 1.47). Compared to ingesting carbohydrates only, the use of a targeted multi-ingredient promoted noticeable body composition outcomes and better vertical jump improvements with no further effects on hypertrophy, upper body, and endurance performance. The study was registered as a clinical trial at ClinicalTrials.gov (NCT05769088).

Whether regular intervention via modern communication tools is effective in older patients with type 2 diabetes is unclear. We aimed to determine the effects of tele-guidance for physiotherapy on muscle strength in such patients.

This randomized controlled trial was conducted at seven hospitals across Japan. The study participants were 74 older patients with type 2 diabetes randomly assigned to either the tele-guidance for physiotherapy group, which received weekly telephone interventions, or the non-intervention group. Both groups performed a combined aerobic and resistance exercise program. The intervention period was 6 months, during which the tele-guidance for physiotherapy and non-intervention groups received remote physiotherapy instruction once weekly and at the 3-month mark, respectively.

Knee extension force was significantly increased in the tele-guidance for physiotherapy group (from 1.25 ± 0.52 to 1.34 ± 0.54 Nm/kg) but significantly decreased in the non-intervention group (from 1.28 ± 0.46 to 1.22 ± 0.43 Nm/kg). Hemoglobin A1c levels improved significantly in the tele-guidance for physiotherapy and non-intervention groups (from 9.5 ± 2.6 to 7.4 ± 1.6% and from 10.2 ± 2.5 to 7.6 ± 2.0%, respectively). Adherence to the physiotherapy program was significantly higher in the tele-guidance for physiotherapy group than in the non-intervention group (71.8% vs 48.6%).

Weekly tele-guidance for physiotherapy proved effective in improving knee extension force and increasing physiotherapy adherence in older patients with type 2 diabetes. Tele-guidance may be a valuable intervention to improve muscle strength in such patients, offering a cost-effective, accessible solution for healthcare management.

Background: Previous meta-analyses show contrasting findings regarding the effects of blood flow restriction training (BFRT) in different knee conditions. Furthermore, no previous dose-response analysis has been conducted to determine the dose of BFRT required for maximal strength and functionality adaptations. Objective: To analyze the evidence on the effects of BFRT on strength and functionality in patients with knee osteoarthritis or rheumatoid arthritis through a systematic review with dose-response meta-analysis. Methods: Included studies met the following criteria: participants with knee osteoarthritis or rheumatoid arthritis; low-load resistance BFRT as intervention; control group with traditional moderate or high intensity resistance training (MIRT and HIRT); include muscle strength and functionality as primary and secondary outcome measures, respectively; and only randomized controlled trials. A random-effects and a dose-response model estimated strength and functionality using estimates of the total repetitions performed. Results: We included five studies with a sample of 205 participants. No statistically significant differences were found between BFRT and MIRT or HIRT for strength (SMD = -0.06; 95% CI = -0.78-0.67; and p > 0.05) and functionality (SMD = 0.07; 95% CI = -0.23-0.37; and p > 0.05). We found an inverted U-shaped association between the increase in total repetitions and strength gain and between the increase in total repetitions and functional improvement. Conclusions: People with knee osteoarthritis or rheumatoid arthritis can use low-load BFRT for strength and functionality as a similarly effective alternative to MIRT and HIRT. A total of 2000 repetitions per BFRT program are necessary to maximize strength gains in these patients, while functional improvement requires 1800 total repetitions.

As a mind-body exercise, Yijinjing has shown benefits in enhancing the effects of manual therapy for the treatment of pain, disability and soft tissue status associated with non-specific chronic neck pain (NCNP). The efficacy of Yijinjing as an independent exercise regimen for the treatment of NCNP has not been established. This study is designed to assess the efficacy of Yijinjing in patients with NCNP, compared with cervical function training (CFT).

A total of 132 consenting NCNP participants will be randomly assigned in a 1:1 ratio to either the Yijinjing group or the CFT group (three times a week for 8 weeks). Both groups will undergo an 8-week intervention phase. Outcome variables will be assessed at baseline and at 4-week, 8-week and 12-week follow-up. The primary outcome measure is the change in visual analogue scale scores at week 8. Secondary outcomes include neck disability index, cervical range of motion and soft tissue status parameters.

This study has been approved by an independent ethics committee and will be carried out according to the principles of the Declaration of Helsinki, local laws and regulations. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.

ITMCTR2024000323.

Blood flow restriction therapy (BFRT) has gained attention for its capacity to induce substantial muscle hypertrophy and strength gains even when employing relatively minimal loads. Strength training is of significant importance in the rehabilitation of patients experiencing shoulder pain, which may arise from a multitude of sources, including rotator cuff injuries, tendinopathies or postsurgical recovery. However, traditional resistance training can be challenging for these individuals due to the presence of pain and functional limitations. In this regard, BFRT in conjunction with low-load strength training may prove an efficacious alternative. The integration of BFRT into rehabilitation protocols for shoulder pain could provide a viable pathway to improving muscle strength and facilitating recovery while minimising the risk of exacerbating pain or injury. The primary objective of this study is to conduct a systematic review of the effects of training with BFRT of the upper limb on shoulder strength.

A comprehensive database search will be conducted across multiple platforms, including PubMed, Scopus, Ovid, Web of Science, EBSCO, Cochrane Central, PEDro and Google Scholar, using predefined key terms without any language restriction. The particular focus of the study will be clinical trials with a controlled group that assess the impact of BFRT on upper extremity, neck and trunk muscles in both healthy individuals and patients. The primary outcome measure will be shoulder strength and power in different directions. The Cochrane Collaboration's Risk of Bias 2 tool will be employed for the purpose of evaluating the risk of bias inherent to the studies in question. A meta-analysis will be conducted using Stata software. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach will be employed to evaluate the quality of evidence for the primary outcomes.

The previously published papers will be used for all analyses in this study. Results will be disseminated through professional networks, presentations at conferences and publication in a peer-reviewed journal. No ethics approval is required.

CRD42024605189.

Sedentary lifestyles in older individuals are associated with reduced physical function and an increased risk of metabolic diseases such as type 2 diabetes. Physical exercise can enhance muscle mass, insulin sensitivity, and metabolic health. Taekwondo, a martial art that integrates both aerobic and resistance components, may improve strength, balance, and metabolic health in older individuals. This study investigated the effect of long-term Taekwondo training on thigh muscle cross-sectional area, health related physical fitness, and metabolic indicators in sedentary older women.

Seventeen participants (aged 65 years and older, sedentary time 8 h and more per day) were randomly assigned to a Taekwondo group (n = 9) and a control group (n = 8). Outcomes, including thigh muscle cross-sectional area, health-related physical fitness, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), and Glucagon-like peptide-1 (GLP-1) were measured before and after the Taekwondo program. The Taekwondo group underwent 60 min of training, three times per week for 12 weeks. Variable changes over time and between groups were analyzed using two-way repeated measures ANOVA performed for significant interactions.

The Taekwondo group exhibited a significant reduction in body weight, body mass index, body fat, and mean arterial blood pressure (p < 0.05), as well as increased thigh muscle cross-sectional area, lean body mass and lower limb muscle mass (p < 0.05). Improvements in balance and gait speed, stride were observed (p < 0.05), indicating reduced fall risk and enhanced mobility. Laboratory analyses revealed reduced triglyceride and free fatty acids and elevated HDL-cholesterol and GLP-1 levels (p < 0.05). Increased thigh muscle cross-sectional area was inversely correlated with fasting glucose, insulin, and HOMA-IR, suggesting improved insulin sensitivity and glucose regulation.

Long-term Taekwondo training improved thigh muscle cross-sectional area, health-related physical fitness and insulin resistance markers in sedentary older women, providing evidence for its use as an effective intervention to promote metabolic health in this population.

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.

This systematic review and meta-analysis aimed to compare the effects of unilateral versus bilateral resistance training on muscle hypertrophy and strength gains.

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.

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.

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.

This study examined the effects of weightlifting (WTG) and plyometric (PTG) training on ankle mobility, strength, power, and running performance in highly trained adolescent basketball players. Participants (male, n = 23; female, n = 35) were randomly assigned to WTG or PTG, training three times weekly for four weeks. Assessments included ankle dorsiflexion, hip strength (ABD-ADD ratio and asymmetry), handgrip strength, lower limb power (Counter Movement Jump -CMJ- and Broad Jump), and running performance. Both interventions significantly improved ankle dorsiflexion (left: p < .001, d = 1.10; right: p < .001, d = 1.50) and hip strength (left adduction: p = .001, d = 0.93; right abduction: F[1,54] = 6.65, p = .013, d = 0.71). The WTG improved right handgrip strength (m.d. 1.76 kg, p = .028, d = 0.23) and CMJ (m.d. 1.81 cm, p = .004, d = 0.30). Both groups improved Broad Jump performance (WTG: m.d. 0.13 m, p = .002, d = 0.46; PTG: m.d. 0.13 m, p = .007, d = 0.47). The PTG showed significant improvement in the Compass Drill (p = .003, d = 0.42). Both interventions have the potential to enhance physical performance, with no clear superiority for one type of training over the other.

This study compared acute changes in measures of arterial stiffness (AS) between two resistance training (RT) protocols that were load, volume and rest matched, but differed in intensity of effort. Eleven healthy adults (36.4 ± 6.8 years) performed a RT protocol with high intensity of effort (HE) and a RT protocol with low intensity of effort (LE). The HE protocol consisted of 3 sets of 12 repetitions, while the LE comprised of 6 sets of 6 repetitions. Loading intensity, volume load, and total rest duration were equivalent between the RT sessions. Pulse wave velocity, augmentation index values collected at baseline, immediately post and 15 min post-exercise. HE elicited significantly greater increases in carotid-femoral pulse wave velocity (6.4 ± 0.3 to 7.3 ± 0.5 m/s) when compared to LE (6.6 ± 0.3 to 6.7 ± 0.3 m/s) (p < 0.05). Both HE and LE induced significant increases in augmentation index (13 ± 5.6 to 28.1 ± 9.3%) post exercise (all p < 0.05). These findings demonstrate that RT with a lower intensity of effort attenuate increases in measures of arterial stiffness compared to a RT scheme at higher intensity of effort when volume load and total rest are equalized.

In people with chronic non-specific low back pain, what is the effect of high-intensity Pilates exercise compared with low-intensity Pilates exercise on pain, disability, patient-specific function, kinesiophobia and isometric hip strength?

Randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis.

One hundred and sixty-eight people with chronic non-specific low back pain and aged between 18 and 60 years.

Participants were allocated to undertake 1-hour sessions of clinical Pilates at either high-intensity or low-intensity, twice per week for 6 weeks.

The primary outcomes were the numerical pain scale and the Roland Morris Disability Questionnaire at the end of the 6-week intervention period. The secondary outcomes were the Patient-Specific Functional Scale, the Tampa Scale for Kinesiophobia and isometric hip strength at 6 weeks. Pain and disability were also re-measured 6 and 12 months after the intervention.

The two Pilates regimens had negligible differences in effects on all outcomes at the end of the intervention period. At 6 and 12 months, the between-group differences in pain intensity were still negligible but the confidence intervals around those estimates spanned from around no effect to a worthwhile benefit (≥ 1.4) from low-intensity Pilates compared with high-intensity Pilates: 6-month MD 0.6 (95% CI -0.2 to 1.4) and 12-month MD 0.8 (95% CI 0.0 to 1.6). The effect on disability remained negligible at 6 and 12 months. Adverse events were less common in the low-intensity group: absolute risk reduction 0.20 (95% CI 0.10 to 0.31).

High-intensity and low-intensity Pilates had very similar effects on pain, disability and other outcomes in people with chronic non-specific low back pain. Physiotherapists should endorse low-intensity Pilates exercises for managing chronic non-specific low back pain because the effects on most outcomes are very similar to high-intensity Pilates exercise but there are fewer side effects.

RBR-2d2vb9.

It is still unclear whether traditional resistance training (TRT) provides the best or optimal stimulation for increasing maximum strength compared to cluster training (CT).

This study assessed the long-term impact of cluster training on the augmentation of maximum strength in young adults through the implementation of meta-analysis and further investigation of the factors associated with training duration.

Literature was searched in Web of Science, Pub Med, EBSCOhost, SPORTDiscus, and Google Scholar. After screening, 21 articles and 49 reports were included. Revman 5.4 was used for literature quality evaluation, heterogeneity testing, and data consolidation. Stata 15.1 was used for drawing forest plots, subgroup analysis, taking sensitivity analysis and meta-regression to explore the sources of heterogeneity, creating a funnel plot to evaluate publication bias, quantifying publication bias, and trimming and filling. The original protocol was prospectively registered at the PROSPERO (CRD42024547097).

The random effects meta-analysis results showed significant heterogeneity (I2 = 70.7%), SMD = 0.10, 95% confidence interval (CI) [-0.14, 0.33], indicating no difference between CT and TRT in general. However, considering training duration, CT was more effective in 4-8 weeks (SMD = 0.24, 95%CI [0.06, 0.42]), while TRT was better in 9-12 weeks (SMD = -1.54, 95%CI [-3.03, -0.05]). Sub-group analysis found that CT had a better effect on people aged 23 and above (SMD = 0.38, 95% CI [0.11, 0.65]), and there was no significant difference in sex and participant type.

Cluster training (CT) mitigates exercise-induced fatigue more effectively than traditional resistance training (TRT) and enables more efficient maximum strength growth within the initial 8 weeks, however, the converse holds after 9 weeks. For preparation periods of 8 weeks or less, such as a microcycle or a specific stage in block periodization, trainers are advised to adopt CT for enhancing or maintaining maximum strength. This suggests that trainers, when undertaking maximum strength training, whether short-term or long-term, can not only consider CT but also precisely schedule the time-course of resistance training modalities within continuous periodization. Specifically, they can switch to TRT after 8-weeks of CT to achieve more favorable training outcomes.

PROSPERO.

Rehabilitative exercises require precise movement coordination and target accuracy for optimal effectiveness. This paper explores the impact of tongue strength exercises (TSE) performance accuracy on exercise outcomes, adherence, and participant confidence and motivation. An 8-week randomized clinical trial included 84 typically aging participants divided into four groups defined by access to biofeedback (present/absent) and TSE intensity dosing (maximal/submaximal) during a home exercise program (HEP). Retention, training, and HEP accuracy were tracked at biweekly visits and during HEP for participants with access to a biofeedback device. Associations with tongue strength outcomes, participant factors, biofeedback, and intensity dosing were analyzed. Exercise accuracy measures did not contribute to tongue strength outcomes at the end of 8 weeks. Increased training accuracy (less practice required to achieve competency) was associated with higher participant confidence and better adherence to the HEP. The presence of biofeedback was associated with reduced adherence but better retention accuracy, while maximal intensity was associated with improvements in all accuracy measures compared to submaximal intensity exercise. These findings in typically aging participants suggest the need for tailored approaches in swallowing-related exercise programs, given the effects of biofeedback and exercise intensity on motor learning and exercise retention. Accuracy performance and its effect on clinical outcomes warrants study in clinical populations with dysphagia and with various rehabilitative approaches.Trial Registration Clincialtrials.gov: NCT04809558.

Evidence supporting the prescription of effortful swallowing (ES) as a rehabilitation exercise remains lacking. This study aimed to evaluate the effect of rest interval length between sets on oral swallowing pressure during ES exercises in healthy adults. This study was a randomized trial of participants using a crossover design. Forty-three healthy adults (25.0 ± 3.7 years; 32 women and 11 men) without swallowing difficulties were recruited and participated in all four conditions (rest intervals between sets: 0-, 1-, 3-, and 5-min intervals) in a random order. The exercise constituted five sets, each comprising 10 ES repetitions. ES was performed with saliva swallows. The rest interval between each repetition was fixed at 10 s, and the oral swallowing pressure during ES was measured using a tongue pressure measuring device. Oral swallowing pressures were significantly lower in the fifth set than in the first set at the 0-min rest condition. In the comparison by condition, oral swallowing pressures were significantly higher in the 5-min than in the 0-min rest conditions in the fourth set and in the 3- and 5-min rest conditions than in the 0-min rest condition in the fifth set. A rest interval of appropriate length between sets during ES exercises may consistently maintain the targeted high swallowing pressures during the exercises. Further studies using more diverse equipment and targeting older patients and those with dysphagia are required to determine the effect of the rest interval length between sets on the degree of exercise intensity to improve the swallowing-related muscle strength.

Minimal important change (MIC) is the smallest change that can be considered important. In hip osteoarthritis (OA) several measurement instruments are recommended but lack MIC estimates.

The objective was to estimate the MIC after supervised group-based exercise for the following measurement instruments; Hip Disability and Osteoarthritis Outcome Score (HOOS), European Quality of Life 5 Dimensions (EQ-5D-5L), 30-s Chair Stand Test, 40-m Fast-paced Walk Test, 9-step Stair Climb Test, Nottingham Leg Extension Power Rig, and unilateral One-Repetition-Maximum Leg Press.

Secondary analysis from a randomized trial of 160 participants with hip OA randomized to two different exercise interventions.

Participants were assessed using the instruments at baseline and after 12 weeks of exercise. At follow-up the participants also rated their perceived change using a Global Rating of Change Score (GRCS). A correlation of >0.3 between the measurement instruments and the GRCS was a prerequisite for estimating the MIC using the predictive modeling approach.

Only two measurement instruments had acceptable correlations and were included in the MIC analysis. The MIC for the five HOOS subscales ranged from 6 to 10 points (scale range: 0-100). The MIC for the EQ-5D-5L index (scale range: -0.757 to 1) and EQ-VAS (scale range: 0-100) were 0.054 (0.03; 0.08) and 4.83 (1.37; 8.48), respectively.

The reported MIC values indicate the minimal improvement that the average patient with hip OA would consider important after 12 weeks of exercise and will help clinicians and researchers interpret the clinical importance of the results of exercise interventions.

Older adults typically exhibit reductions in skeletal muscle maximal strength and the ability to produce force rapidly. These reductions are often augmented by concomitant acute and chronic diseases, resulting in attenuated physical performance and higher propensity of falls and injuries. With the proportion of older adults in the population increasing, there is an alarming need for cost-effective strategies to improve physical performance and combat a multitude of age-related diseases. Surprisingly, despite convincing evidence emerging over three decades that strength training can substantially improve maximal strength (1RM), rate of force development (RFD) and power, contributing to improved health, physical performance and fall prevention, it appears that it has not fully arrived at the older adults' doorsteps. The aim of the current narrative review is to accentuate the convincing benefits of strength training in healthy and diseased older adults. As intensity appears to play a key role for improvements in 1RM, RFD and power, this review will emphasize training performed with heavy (80%-84% of 1RM) and very heavy loads (≥ 85% of 1RM), where the latter is often referred to as maximal strength training (MST). MST uses loads of ~90% of 1RM, which can only be performed a maximum of 3-5 times, 3-5 sets and maximal intentional concentric velocity. Strength training performed with loads in the heavy to very heavy domain of the spectrum may, because of the large increases in muscle strength, focuses on neural adaptations and relatively low risk, provides additional benefits for older adults and contrasts current guidelines which recommend low-to-moderate intensity (60%-70% of 1RM) and slow-moderate concentric velocity. This review also provides information on practical application of MST aimed at practitioners who are involved with preventive and/or rehabilitative health care for older adults.

Mind-body exercise (MBE) has shown promise in mitigating the effects of sarcopenia and frailty in older adults. Nevertheless, its effectiveness in enhancing muscle function and physical performance in this population has not been well established. This study aimed to investigate the effects of MBE on older adults with sarcopenia and frailty, to offer evidence-based exercise recommendations.

A comprehensive search for randomized controlled trials (RCTs) was conducted through multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, China National Knowledge Infrastructure (CNKI), WanFang, and Chinese Scientific Journals Full-Text Database (VIP), supplemented by manual reference searches from inception until February 2024. The eligible RCTs compared MBE with passive or active exercise controls, focusing on muscle function and physical performance in older adults aged 60 years or above. Subgroup analyses were conducted to evaluate the types, duration, and frequency of MBE.

Nine eligible RCTs with 1838 participants were included in this study. MBE demonstrated significant improvements compared with passive control, particularly in grip strength (WMD [weighted mean difference] = 0.99; 95% CI [95% confidence interval] = 0.06, 1.92; I2 = 3%, p = 0.04), Timed Up and Go Test (TUGT) (WMD = -4.04; 95% CI = -5.54, -2.53; I2 = 12%, p < 0.01), and Berg Balance Scale (BBS) scores (WMD = 3.63; 95% CI = 0.38, 6.87; I2 = 0%, p = 0.03). Even when compared to active exercise training, improvements were still observed in TUGT and BBS (p < 0.001), with a trend toward improved grip strength (WMD = -2.20; 95% CI = -4.35, -0.04; p = 0.05). No positive effect on muscle mass was observed. Subgroup analysis indicated that MBE performed more than 5 times a week for a short or medium duration (4-24 weeks) could improve grip strength (p < 0.05). Moderate-frequency intervention over a short period in this population yielded greater improvements in gait speed and Chair Rise Test completion time (p < 0.05).

MBE can enhance muscle function and physical performance to some extent in older adults with sarcopenia and frailty, whether they are compared with passive or active exercise training. However, positive effects on muscle mass have not been observed. Future studies are warranted to compare it with well-designed active exercise training programs that match the exercise volume, to draw more definitive conclusions to support the notion that MBE yields comparable effects.

Urinary stress incontinence has a high prevalence in women, with many associated risk factors, such as high impact and intensity sports due to increased intra-abdominal pressure causing stretching and weakening of the pelvic floor muscles. No previous study has investigated the effects of undulatory resistance training (URT), deemed as high impact sports's modality, on urinary bladder (UB) and tissue remodeling. Healing of tissue depends on the equilibrium of metalloproteinases (MMPs) and their inhibitors (TIMPS). We aimed to investigate the histomorphological effects of URT on UB wall. Twelve female Wistar rats were randomly divided in two groups: sedentary (SED, n = 5) and URT (n = 7). URT was performed with a ladder climbing equipment after the maximum loaded carrying test (MLCT) was carried out. The training sessions were organized in three blocks increasing the MLCT's weight each block. New MLCT were set at the end of each block. The day after the last training, the rat was euthanized and the UB was harvested and stored in formalin for later histological analysis stained with hematoxylin-eosin (HE), Masson's trichrome (MT), picrosirius-hematoxylin (PH) and resorcin-fuchsin (RF), and immunohistochemistry for metalloproteinase-1 (MMP1) and tissue inhibitor of metalloproteinase (TIMP1). UB slices of URT rats stained with HE showed changes in all UB layers, with increased thickeness of the urothelium. MT staining allowed to observe an increased collagen concentration on the lamina propria layer (LP) of URT rats. PH staining demonstrated a higher luminous intensity for collagen type I and III in lamina propria and smooth muscle layers of the UB wall in the URT group than in SED. RF staining demonstrated an increase of elastic fiber concentration on the LP and smooth muscle layer of the bladder wall in the URT group. Immunohistochemistry of UB slices showed that MMP1 and TIMP1 were immunolabeled on the LP the UB wall in URT rats, with TIMP1 showing a lighter labeling than MMP1. Therefore, the findings suggest that URT induces remodeling of the urinary bladder wall characterized by imbalance between MMP1 and TIMP1 and evoking an alteration in the connective tissue from loose to dense.