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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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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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Water-based exercise and low-intensity exercise in combination with blood flow restriction (BFR) are two methods that have independently been shown to improve muscle strength in those of advancing age. The objective of this study was to assess the long-term effect of water-based exercise in combination with BFR on maximum dynamic strength and functional capacity in post-menopausal women. Twenty-eight women underwent an 8-week water-based exercise program. The participants were randomly allocated to one of the three groups: (a) water exercise only, (b) water exercise + BFR, or (c) a non-exercise control group. Functional capacity (chair stand test, timed up and go test, gait speed, and dynamic balance) and strength testing were tested before and after the 8-week aquatic exercise program. The main findings were as follows: (1) water-based exercise in combination with BFR significantly increased the lower limb maximum strength which was not observed with water-based exercise alone and (2) water-based exercise, regardless of the application of BFR, increased functional performance measured by the timed up and go test over a control group. Although we used a healthy population in the current study, these findings may have important implications for those who may be contraindicated to using traditional resistance exercise. Future research should explore this promising modality in these clinical populations.

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This case report assessed quality of life, activities of daily living, motor symptoms, functional ability, neuromuscular parameters and mRNA expression of selected genes related to muscle protein synthesis and degradation in a patient with Multiple System Atrophy (MSA). The patient underwent resistance training with instability devices (i.e., bosu, dyna disk, balance disk, Swiss ball) for six months twice a week. After the six months training, the patient's left and right quadriceps muscle cross-sectional area and leg press one-repetition maximum increased 6.4%, 6.8%, and 40%, respectively; the patient's timed up and go, sit to stand, dynamic balance, and activities of daily living improved 33.3%, 28.6%, 42.3%, and 40.1%, respectively; the patient's severity of motor symptoms and risk of falls decreased 32% and 128.1%, respectively. Most of the subscales of quality of life demonstrated improvements as well, varying from 13.0% to 100.0%. mRNA expression of mechanogrowth factor and mammalian target of rapamycin increased 12.7-fold and 1.5-fold, respectively. This case report describes likely the first nonpharmacological therapeutic tool that might be able to decrease the severity of motor symptoms and risk of falls, and to improve functional ability, neuromuscular parameters, and quality of the life in a patient with MSA. Key pointsSix months of resistance training with instability alleviate the MSA-related effects and improve the quality of life in a patient with MSA.High complexity exercise intervention (i.e., resistance training with instability) may be very beneficial to individuals with impaired motor control and function as MSA patients.Caution should be exercised when interpreting our findings as they cannot be generalized to the entire MSA population and they do not allow establishing causal conclusions on the effects of this mode of exercise on MSA.

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This study investigated the effects of varying strength exercises and loading scheme on muscle cross-sectional area (CSA) and maximum strength after 4 strength training loading schemes: constant intensity and constant exercise (CICE), constant intensity and varied exercise (CIVE), varied intensity and constant exercise (VICE), varied intensity and varied exercise (VIVE). Forty-nine individuals were allocated into 5 groups: CICE, CIVE, VICE, VIVE, and control group (C). Experimental groups underwent twice a week training for 12 weeks. Squat 1 repetition maximum was assessed at baseline and after the training period. Whole quadriceps muscle and its heads CSA were also obtained pretraining and posttraining. The whole quadriceps CSA increased significantly (p ≤ 0.05) in all of the experimental groups from pretest to posttest in both the right and left legs: CICE: 11.6 and 12.0%; CIVE: 11.6 and 12.2%; VICE: 9.5 e 9.3%; and VIVE: 9.9 and 11.6%, respectively. The CIVE and VIVE groups presented hypertrophy in all of the quadriceps muscle heads (p ≤ 0.05), whereas the CICE and VICE groups did not present hypertrophy in the vastus medialis and rectus femoris (RF), and in the RF muscles, respectively (p > 0.05). The CIVE group had greater strength increments than the other training groups (effect size confidence limit of the difference [ESCLdiff] CICE: 1.41-1.56; VICE: 2.13-2.28; VIVE: 0.59-0.75). Our findings suggest: (a) CIVE is more efficient to produce strength gains for physically active individuals; (b) as long as the training intensity reaches an alleged threshold, muscle hypertrophy is similar regardless of the training intensity and exercise variation.

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The present study aimed to determine the concurrent validity of ultrasound (US) measurement of the vastus lateralis muscle (VL) cross-sectional area (CSA) having magnetic resonance imaging (MRI) as the gold standard measurement, in a heterogeneous sample of participants. Thirty-one individuals (52.44 ± 16.37 years; 1.67 ± 0.11 m; 75.25 ± 13.82 kg) volunteered to participate in the study. All the images were performed in the right leg. Image-fitting technique (US) and computerized planimetry technique (US and MRI) were used to determine the VL CSA. The typical error (TE) of measurement was used to determine the concurrent validity of the US measurements. Our results demonstrated good validity of the US compared with the MRI measurements (TE = 0.37 cm; coefficient of variation = 1.75%). The Bland-Altman plot demonstrated bias of 0.07 ± 0.53 cm and limits of agreement of 0.96-1.11 cm. Based on our TE, bias and limits of agreement, we concluded that the US image-fitting technique is valid to assess the VL CSA in a heterogeneous sample of participants. Thereby, US can be used instead of MRI to assess changes in skeletal muscle morphology.

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