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Ischemic preconditioning (IPC), which involves episodes of blood flow restriction followed by reperfusion, has uncertain effects on athletes. Additionally, employing sports-specific tests that are highly familiar to athletes can enhance methodological rigor in determining IPC's effects on taekwondo performance. This study aimed to investigate IPC's influence on taekwondo athletes' performance through two studies. To induce occlusion in both studies, the cuff was inflated to an individualized occlusion pressure established for each athlete's lower limb, with four cycles of occlusion lasting five minutes each, alternated with five-minute reperfusion intervals. Both traditional frequentist statistics and Bayesian analysis were employed. In the first study, eleven high-level athletes were subjected to either IPC or a placebo (SHAM) procedure on both legs, followed by performing countermovement jumps (CMJs) and a specific taekwondo endurance test. However, no significant differences were observed in taekwondo endurance performance or CMJ between the IPC and SHAM conditions. The second study involved fourteen elite athletes who underwent the same IPC or SHAM conditions, performing CMJ and three bouts of the Multiple Frequency Speed of Kick test (FSKTmult) in three blocks, each separated by approximately thirty minutes. Again, the results indicated no significant differences in FSKTmult measures or CMJ performance between the two conditions. In conclusion, IPC did not significantly affect neuromuscular (in both studies), endurance (in the first study), or anaerobic (in the second study) performance in these taekwondo athletes.

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The aim of this review was to verify the effects of aerobic exercise combined with blood flow restriction on older adult functionality. Systematic searches were performed in PubMed, Web of Science, and Embase between July and December 2023. Randomized studies with participants aged ≥ 60 years who were evaluated before and after the experimental protocols were included. We registered this systematic review at the International Prospective Register (PROSPERO CRD42022347205). The search strategy identified 2698 studies, four of which were included in the review, with 80 participants. The results suggested that aerobic exercise combined with blood flow restriction increased performance on specific functional tests. However, these results should be interpreted with caution due to the low-to-moderate study quality, as well as the low number of participants and studies. In conclusion, aerobic exercise and blood flow restriction may increase functional capacity in older adults. Further studies are needed to confirm such findings. (AU)

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BACKGROUND: Older adults, as the population considered at increased risk for severe COVID-19, were the most impacted by social isolation. Thus, this study aimed to assess the salivary immune/inflammatory response of older adults before and during the COVID-19 pandemic. METHODS: A cohort of 11 older adults (mean age 66.8 ± 6.1) was followed at three different time points: before (S1) and after 6 (S2) and 20 months (S3) of the beginning of the COVID-19 pandemic in Brazil. Unstimulated saliva samples were obtained to assess the levels of antibodies (secretory IgA, IgG and IgM) by ELISA and cytokines (IL-2, IL-5, IL-6, IL-8 and IL-10, TSLP, IFN-γ, TNF-α) by multiplex analysis. Significant differences were evaluated using the Kruskal-Wallis test with Dunn's post-test. RESULTS: None volunteer presented periodontal disease or caries. All volunteers received at least two doses of the COVID-19 vaccines after S2 and before S3. A tendency to increase salivary levels of SIgA and IgM at S2 and of IgG at S3 were observed compared to the values found at S1 and S2. Significantly decreased levels of IL-2 and IL-5 were found at S2 and S3 (p < 0.001) time points. Lower levels of IFN-γ were found at S2 as compared to the values observed at S1 (p < 0.01). A significant decrease in the IFN-γ/IL-10 ratio was found at S2 (p < 0.01). When assessing the Th1/Th2 ratios, a significant decrease was found in the IFN-γ/TSLP ratio at S2 (p < 0.001) and S3 (p < 0.001) when compared to the values at S1. In addition, a significant increase was observed in the TNF-α/IL-5 ratio at S2 (p < 0.001) and S3 (p < 0.001) in comparison to the values at S1. In a similar way, an increase in the TNF-α/IL-6 ratio (Fig. 5E) was observed at S3 (p < 0.001) when compared to the values at S1. CONCLUSIONS: Overall, this study provides valuable insights into the impact of COVID-19-induced social isolation on immune/inflammatory responses in the upper airway mucosa, particularly those present in oral cavity, of older adults. It demonstrates that a controlled shift in Th1 and Th2 immune responses, both during infection and post-vaccination, can create favorable conditions to combat viral infections without exacerbating the immune response or worsening the pathology.

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A decrease in brain volume (ie, brain atrophy) is a marker of cognitive health in older adults. Insufficient weekly accumulation of moderate and vigorous physical activity (MVPA) has been associated with lower brain volume. As this association has been established for a small number of brain areas and structures and atrophy rates seem to be nonuniform between them, more comprehensive analyses are warranted. We compared the volume of 71 brain areas and structures in 45 older adults who met and did not meet objectively measured MVPA recommendations. In addition, we used multiple regression models to determine whether cardiorespiratory fitness (VO2PEAK), MVPA, and health-related risk factors could affect the atrophy of brain areas and structures. An accelerometer (GT9-X ActiGraph) was worn for 7 days. Participants were then classified into 2 groups: <150 minutes MVPA (<150'MVPA; n = 20) and ≥150 minutes MVPA (≥150'MVPA; n = 25) per week. Older adults who accumulated ≥150'MVPA per week had significantly higher absolute and relative (% of intracranial volume) volumes of 39 and 9 brain areas and structures, respectively, than those who accumulated <150'MVPA per week. Higher VO2PEAK seems to be a key predictor of the atrophy of brain areas and structures. In conclusion, meeting weekly physical activity recommendations seems to have a widespread effect on preserving the volume of more than 30 brain areas and structures in older adults. VO2PEAK seems to be the most frequent and important predictor of brain volume preservation.

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The aim of the study was to determine whether low-load exercise (LL) with blood flow restriction (LL-BFR) would induce similar changes in expression of genes involved in hypoxia and angiogenesis compared to LL and high-load exercise (HL). Twenty-four males (age: 21.3 ± 1.9 years, body height: 1.74 ± 0.8 m, body mass: 73 ± 1.8 kg) were allocated into three groups: low-load exercise (LL), low-load exercise with blood-flow restriction (LL-BFR), and high-load exercise (HL). For the LL-BFR group a pneumatic cuff was inflated at 80% of the arterial occlusion pressure. All participants performed bilateral knee extension exercise, twice a week, for 8 weeks. LL and LL-BFR groups performed 3-4 sets of 15 reps at 20% 1RM, whilst the HL group performed 3-4 sets of 8-10 reps at 80% 1RM with a 60-s rest interval between sets. The hypoxia-inducible factor-1 alpha (HIF-1α) and beta (HIF-1ß), vascular endothelial growth factor (VEGF), neuronal (nNOS), and inducible nitric oxide synthase (iNOS) genes expression were assessed before and after training. HIF-1α and HIF-1ß mRNA levels significantly increased in the LL-BFR group and exceeded those elicited by HL and LL groups (p < .0001). VEGF gene expression was increased in both LL-BFR and HL groups, however, LL-BFR elicited a greater increase than LL (p < .0001). nNOS and iNOS genes expression significantly increased in all groups with greatest increases being observed in the LL-BFR group (p < .0001). The findings suggest that LL-BFR induces greater increases in genes expression related to hypoxia and angiogenesis than traditional resistance training.

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Physical distancing was used to prevent transmission of COVID-19, however there are concerns that this may promote harmful impacts on health, such as reduced levels of physical practice and changes in food intake and gut microbiota composition. This study evaluated the impacts of 6 months physical distancing on Brazilian older women upon body mass index (BMI), strength, physical activity level (IPAQ), eating habits, neurological markers (brain-derived neurotrophic factor-BDNF and cortisol), cytokines (IL-2, IL-5, IL-6, IL-10, interferon-IFN-γ, tumor necrosis factor-TNF-α), aging-associated markers (vascular endothelial growth factor-VEGF, insulin-like growth factor-IGF-1, klotho and thymic stromal lymphopoietin-TSLP), besides specific groups of fecal microbiota. Fifteen women, over 60 years old, residents of São Paulo state (Brazil), were evaluated in March and in September 2020. The older adult women, with a mean age 66 ± 6.2 years presented significantly increased BMI and high effect size for non-protective foods consumption, reduced light physical activity and strength 6 months following the physical distancing. Furthermore, the serum concentration of IFN-γ, IGF-1, and IFN-γ/IL-5 were significantly higher, while lower concentration of IL-2 and IL-5 were observed 6 months after the physical distancing. Significant increase was noted only to Blautia spp. abundance after 6 months of physical distancing. Several correlations were observed at both before and after physical distancing, however, interestingly, many of them were lost or inverted 6 months following, while new ones emerged. Taken together, these results showed that lifestyle changes and stress conditions addressed by physical distancing from the COVID-19 pandemic impacted the health of older women included in the present study. Therefore, future follow-up studies are essential to propose interventions in order to restore the health conditions observed before the pandemic period, and thus to maintain the quality of life of older adults in different socioeconomic contexts.

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The aim of this study was to determine whether increases in post-exercise endocrine response to low-load resistance exercise with blood flow restriction and high-load resistance exercise would have association with increases in muscle size and strength after an 8-week training period. Twenty-nine untrained men were randomly allocated into three groups: low-load resistance exercise with (LL-BFR) or without blood flow restriction (LL), and high-load resistance exercise (HL). Participants from LL-BFR and LL groups performed leg extension exercise at 20% of one repetition maximum (1RM), four sets of 15 repetitions and the HL group performed four sets of eight repetitions at 80% 1RM. Before the first training session, growth hormone (GH), insulin-like growth factor 1 (IGF-1), testosterone, cortisol, and lactate concentration were measured at rest and 15 min after the exercise. Quadriceps CSA and 1RM knee extension were assessed at baseline and after an 8-week training period. GH increased 15 min after exercise in the LL-BFR (p = 0.032) and HL (p < 0.001) groups, with GH concentration in the HL group being higher than in the LL group (p = 0.010). There was a time effect for a decrease in testosterone (p = 0.042) and an increase in cortisol (p = 0.005), while IGF-1 remained unchanged (p = 0.346). Both muscle size and strength were increased after training in LL-BFR and HL groups, however, these changes were not associated with the acute post-exercise hormone levels (p > 0.05). Our data suggest that other mechanisms than the acute post-exercise increase in systemic hormones induced by LL-BFR and HL produce changes in muscle size and strength.

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PURPOSE: This study aimed at assessing the effect of chemotherapy on dietary intake and nutritional status of patients with colorectal cancer undergoing chemotherapy. METHODS: Observational, cross-sectional study conducted with 35 patients of both sexes, aged 50 years or older. Dietary intake was assessed four times: before (T0), twice during (T1 and T2), and after (TF) chemotherapy. Data on energy, macronutrients, and micronutrients were used for assessing dietary intake. Nutritional status was assessed on the first day and at the end of the chemotherapy cycle. The data were treated statistically using a 5% significance level. RESULTS: The intake of energy, carbohydrates, lipids, selenium, and iron was lower after chemotherapy infusion (p < 0.05). Energy consumption decreased when comparing T0 (1419.8 ± 527.1 kcal) with T1 (1181.9 ± 423.2 kcal). Regarding macronutrients, carbohydrates and lipids showed a drop (p < 0.05), but there were no differences in protein intake, and it was observed that the consumption of food sources such as dairy was prioritized. In the analysis of vitamins and minerals, vitamins dropped but without a significant difference. There were significant differences between T1 and TF for iron (9.7 mg ± 4.5 mg and 12.0 ± 4.0 mg) and selenium (77.4 ± 29.7 µg and 93.6 ± 37.8 µg). There was no change in body composition and nutritional status between chemotherapy cycles. CONCLUSION: The treatment reduced patients' food consumption after the chemotherapy session and impacted dietary intake, which demonstrates the importance of nutritional counseling and intervention, especially on energy consumption.

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Laurentino, GC, Loenneke, JP, Mouser, JG, Buckner, SL, Counts, BR, Dankel, SJ, Jessee, MB, Mattocks, KT, Iared, W, Tavares, LD, Teixeira, EL, and Tricoli, V. Validity of the handheld Doppler to determine lower-limb blood flow restriction pressure for exercise protocols. J Strength Cond Res 34(9): 2693-2696, 2020-Handheld (HH) Doppler is frequently used for determining the arterial occlusion pressure during blood flow restriction exercises; however, it is unknown whether the blood flow is occluded when the auscultatory signal is no longer present. The purpose of this study was to assess the validity between the HH Doppler and the Doppler ultrasound (US) measurements for determining the arterial occlusion pressure in healthy men. Thirty-five participants underwent 2 arterial occlusion pressure measurements. In the first measure, a pressure cuff (17.5 cm wide) was placed at the most proximal region of the thigh and the pulse of posterior tibial artery was detected using an HH Doppler probe. The cuff was inflated until the auscultatory pulse was no longer detected. After 10 minutes of rest, the procedure was repeated with the Doppler US probe placed on the superficial femoral artery. The cuff was inflated up to the point at which the femoral arterial blood flow was interrupted. The point at which the auscultatory pulse and blood flow were no longer detected was deemed the arterial occlusion pressure. There were no significant differences in arterial occlusion pressure level between the HH Doppler and the Doppler US (133 [±18] vs. 135 [±17] mm Hg, p = 0.168). There was a significant correlation (r = 0.938, p = 0.168), reasonable agreement, and a total error of the estimate of 6.0 mm Hg between measurements. Arterial occlusion pressure level determined by the HH Doppler and the Doppler US was similar, providing evidence that the HH Doppler is a valid and practical method.

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The purpose of the present study was to compare changes in muscle strength and hypertrophy between volume-equated resistance training (RT) performed 2 versus 3 times per week in trained men. Thirty-six resistance-trained men were randomly assigned to one of the two experimental groups: a split-body training routine (SPLIT) with muscle groups trained twice per week (n = 18) over four weekly sessions, or a total-body routine (TOTAL), with muscle groups being trained three times per week (n = 18) over three weekly sessions. The training intervention lasted 10 weeks. Testing was carried out pre- and post-study to assess maximal muscular strength in the back squat and bench press, and hypertrophic adaptations were assessed by measuring muscle thickness of the elbow flexors, elbow extensors, and quadriceps femoris. Twenty-eight subjects completed the study. Significant pre-to-post intervention increases in upper and lower-body muscular strength occurred in both groups with no significant between-group differences. Furthermore, significant pre-to-post intervention increases in muscle size of the elbow extensors and quadriceps femoris occurred in both groups with no significant between-group differences. No significant pre-to-post changes were observed for the muscle size of elbow flexors both in the SPLIT or TOTAL group. In conclusion, a training frequency of 2 versus 3 days per week produces similar increases in muscular adaptations in trained men over a 10-week training period. Nonetheless, effect size differences favored SPLIT for all hypertrophy measures, indicating a potential benefit for training two versus three days a week when the goal is to maximize gains in muscle mass.