-
Sports Medicine (Auckland, N.Z.) Mar 2022Both athletes and recreational exercisers often perform relatively high volumes of aerobic and strength training simultaneously. However, the compatibility of these two... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Both athletes and recreational exercisers often perform relatively high volumes of aerobic and strength training simultaneously. However, the compatibility of these two distinct training modes remains unclear.
OBJECTIVE
This systematic review assessed the compatibility of concurrent aerobic and strength training compared with strength training alone, in terms of adaptations in muscle function (maximal and explosive strength) and muscle mass. Subgroup analyses were conducted to examine the influence of training modality, training type, exercise order, training frequency, age, and training status.
METHODS
A systematic literature search was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched (12 August 2020, updated on 15 March 2021). Eligibility criteria were as follows.
POPULATION
healthy adults of any sex and age; Intervention: supervised concurrent aerobic and strength training for at least 4 weeks; Comparison: identical strength training prescription, with no aerobic training; Outcome: maximal strength, explosive strength, and muscle hypertrophy.
RESULTS
A total of 43 studies were included. The estimated standardised mean differences (SMD) based on the random-effects model were - 0.06 (95% confidence interval [CI] - 0.20 to 0.09; p = 0.446), - 0.28 (95% CI - 0.48 to - 0.08; p = 0.007), and - 0.01 (95% CI - 0.16 to 0.18; p = 0.919) for maximal strength, explosive strength, and muscle hypertrophy, respectively. Attenuation of explosive strength was more pronounced when concurrent training was performed within the same session (p = 0.043) than when sessions were separated by at least 3 h (p > 0.05). No significant effects were found for the other moderators, i.e. type of aerobic training (cycling vs. running), frequency of concurrent training (> 5 vs. < 5 weekly sessions), training status (untrained vs. active), and mean age (< 40 vs. > 40 years).
CONCLUSION
Concurrent aerobic and strength training does not compromise muscle hypertrophy and maximal strength development. However, explosive strength gains may be attenuated, especially when aerobic and strength training are performed in the same session. These results appeared to be independent of the type of aerobic training, frequency of concurrent training, training status, and age.
PROSPERO
CRD42020203777.
Topics: Adaptation, Physiological; Adult; Exercise; Humans; Infant; Infant, Newborn; Muscle Strength; Muscle, Skeletal; Resistance Training
PubMed: 34757594
DOI: 10.1007/s40279-021-01587-7 -
The American Journal of Clinical... Mar 2022Increased protein intake is suggested as a strategy to slow or reverse the loss of muscle mass and strength observed in sarcopenia, but results from studies that... (Meta-Analysis)
Meta-Analysis
Protein interventions augment the effect of resistance exercise on appendicular lean mass and handgrip strength in older adults: a systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Increased protein intake is suggested as a strategy to slow or reverse the loss of muscle mass and strength observed in sarcopenia, but results from studies that directly tested this possibility have been inconsistent.
OBJECTIVES
We assessed the evidence on the effects of whole protein supplementation or higher-protein diets, without the use of amino acids or supplements known to stimulate hypertrophy, alone or in combination with resistance exercise (RE) interventions, on lean body mass (LBM) and strength in older adults.
METHODS
A systematic search was conducted using PubMed, Medline, Web of Science, and Cochrane CENTRAL databases from January 1990 to July 2021. Randomized controlled trials that assessed the effects of protein supplementation and/or higher-protein dietary interventions in older adults (mean age ≥50 y) on total LBM, appendicular lean mass (ALM), and handgrip (HG) and knee extension (KE) strength were included.
RESULTS
Twenty-eight studies were identified. In pooled analysis, compared with lower protein controls, protein supplementation did not have a significant positive effect on total LBM [weighted mean difference in change (WMD): 0.34; 95% CI: -0.21, 0.89; I2 = 90.01%], ALM (WMD: 0.4; 95% CI: -0.01, 0.81; I2 = 90.38%), HG strength (WMD: 0.69; 95% CI: -0.69, 2.06; I2 = 94.52%), or KE strength (WMD: 1.88; 95% CI: -0.6, 4.35; I2 = 95.35%). However, in interventions that used also RE, statistically significant positive effects of protein were observed for ALM (WMD: 0.54; 95% CI: 0.03, 1.05; I2 = 89.76%) and HG (WMD: 1.71; 95% CI: 0.12, 3.30; I2 = 88.71%). Meta-regression revealed no significant association between age, per-meal protein dose, duration, and baseline protein intake with change in any outcome. Subgroup analysis revealed the statistically significant effects on ALM occurred only in sarcopenic/frail populations (WMD: 0.88; 95% CI: 0.51, 1.25; I2 = 79.0%). Most studies (n = 22) had some risk of bias.
CONCLUSIONS
In older adults performing RE, increased protein intake leads to greater ALM and HG strength compared with lower protein controls. Without RE, protein has no additional benefit on changes in total LBM, ALM, or HG strength.
Topics: Aged; Exercise; Hand Strength; Humans; Randomized Controlled Trials as Topic; Resistance Training; Sarcopenia
PubMed: 34673936
DOI: 10.1093/ajcn/nqab355 -
Healthcare (Basel, Switzerland) Aug 2021Combined training (CT) may combine strength and endurance training within a given time period, but it can also encompass additional protocols consisting of velocity,... (Review)
Review
Combined training (CT) may combine strength and endurance training within a given time period, but it can also encompass additional protocols consisting of velocity, balance, or mobility as part of the same intervention. These combined approaches have become more common in soccer. This systematic review was conducted to (1) characterize the training protocols used in CT studies in soccer, (2) summarize the main physiological and physical effects of CT on soccer players, and (3) provide future directions for research. Methods: A systematic review of Cochrane Library, PubMed, Scopus, SPORTDiscus, and Web of Science databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The PICOS were defined as follows: P (soccer players of any age or sex); I (CT combining strength and endurance or sprinting or balance or mobility training); C (the control group (whenever applicable), with or without comparative interventions in addition to usual soccer training); O (acute and/or chronic responses: biochemical, physiological and physical); S (must have at least two groups, either randomized or non-randomized). The database search initially identified 79 titles. From those, eight articles were deemed eligible for the systematic review. Three studies analyzed acute responses to concurrent training, while the remaining five analyzed adaptations to CT. In those tested for acute responses, physiological (hormonal) and physical (strength and power external load, internal load) parameters were observed. Adaptations were mainly focused on physical parameters (strength and power, sprints, jumps, repeated sprint ability, aerobic, change-of-direction), with relatively little focus on physiological parameters (muscle architecture). Short-term responses to CT can affect hormonal responses of testosterone after resistance training with internal and external load. In turn, these responses' effects on strength and power have produced mixed results, as have adaptations. Specifically, strength and hypertrophy are affected to a lesser extent than speed/power movements. Nevertheless, it is preferable to perform CT before endurance exercises since it is a limiting factor for interference. Volume, intensity, rest between sessions, and athletes' fitness levels and nutrition dictate the degree of interference.
PubMed: 34442212
DOI: 10.3390/healthcare9081075 -
BMJ Open Sport & Exercise Medicine 2021To identify, critique and synthesise the research findings that evaluate the use of resistance training (RT) programmes on return to sport outcome measures for people...
OBJECTIVE
To identify, critique and synthesise the research findings that evaluate the use of resistance training (RT) programmes on return to sport outcome measures for people following ACL repair (ACLR).
DESIGN AND DATA SOURCES
This systematic review included a comprehensive search of electronic databases (EBSCO health databases (CINAHL, MEDLINE, SPORTDiscus), Scopus and Pedro) performed in June 2020 and was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies were appraised using the Downs and Black checklist.
ELIGIBILITY CRITERIA
Randomised and non-randomised controlled trials, longitudinal cohort studies and case series were considered for inclusion where an adequate description of the RT intervention was provided as a part of the study's ACLR rehabilitation protocol. Articles that did not include outcome measures related to return to sport criteria were excluded.
RESULTS
Eleven articles met the inclusion criteria and were subjected to appraisal and data extraction. Study quality ranged from poor to excellent. RT intensity varied considerably among studies (between 5% and >80% of one repetition maximum). Only one identified study specifically investigated the effect of a low-intensity versus high-intensity RT protocol. The majority of studies reported participant outcomes that would not meet commonly used return to sport criteria.
CONCLUSION
There appears to be considerable variation in the intensity of RT prescribed in research for people following ACLR. Furthermore, in most of the identified studies, RT protocols promoted muscle endurance and hypertrophy without progressing to strength or power-based RT. The findings of this review provide insight into potential factors limiting returning to sport and contributing to reinjury for people following ACLR.
PubMed: 34422294
DOI: 10.1136/bmjsem-2021-001144 -
International Journal of Sports... 2021Blood flow restriction (BFR) training has been reported to have significant benefits on local skeletal muscle including increasing local muscle mass, strength, and...
BACKGROUND
Blood flow restriction (BFR) training has been reported to have significant benefits on local skeletal muscle including increasing local muscle mass, strength, and endurance while exercising with lower resistance. As a result, patients unable to perform traditional resistance training may benefit from this technique. However, it is unclear what effects BFR may have on other body systems, such as the cardiovascular and pulmonary systems. It is important to explore the systemic effects of BFR training to ensure it is safe for use in physical therapy.
PURPOSE
The purpose of this study was to systematically review the systemic effects of blood flow restriction training when combined with exercise intervention.
STUDY DESIGN
Systematic review.
METHODS
Three literature searches were performed: June 2019, September 2019, and January 2020; using MedLine, ScienceDirect, PubMed, Cochrane Reviews and CINAHL Complete. Inclusion criteria included: at least one outcome measure addressing a cardiovascular, endocrinological, systemic or proximal musculoskeletal, or psychosocial outcome, use of clinically available blood flow restriction equipment, use of either resistance or aerobic training in combination with BFR, and use of quantitative measures. Exclusion criteria for articles included only measuring local or distal musculoskeletal changes due to BFR training, examining only passive BFR or ischemic preconditioning, articles not originating from a scholarly peer-reviewed journal, CEBM level of evidence less than two, or PEDro score less than four. Articles included in this review were analyzed with the CEBM levels of evidence hierarchy and PEDro scale.
RESULTS
Thirty-five articles were included in the review. PEDro scores ranged between 4 and 8, and had CEBM levels of evidence of 1 and 2. Common systems studied included cardiovascular, musculoskeletal, endocrine, and psychosocial. This review found positive or neutral effects of blood flow restriction training on cardiovascular, endocrinological, musculoskeletal, and psychosocial outcomes.
CONCLUSIONS
Although BFR prescription parameters and exercise interventions varied, the majority of included articles reported BFR training to produce favorable or non-detrimental effects to the cardiovascular, endocrine, and musculoskeletal systems. This review also found mixed effects on psychosocial outcomes when using BFR. Additionally, this review found no detrimental outcomes directly attributed to blood flow restriction training on the test subjects or outcomes tested. Thus, BFR training may be an effective intervention for patient populations that are unable to perform traditional exercise training with positive effects other than traditional distal muscle hypertrophy and strength and without significant drawbacks to the individual.
LEVEL OF EVIDENCE
1b.
PubMed: 34386277
DOI: 10.26603/001c.25791 -
Frontiers in Nutrition 2021The "leucine trigger" hypothesis was originally conceived to explain the post-prandial regulation of muscle protein synthesis (MPS). This hypothesis implicates the...
The "leucine trigger" hypothesis was originally conceived to explain the post-prandial regulation of muscle protein synthesis (MPS). This hypothesis implicates the magnitude (amplitude and rate) of post-prandial increase in blood leucine concentrations for regulation of the magnitude of MPS response to an ingested protein source. Recent evidence from experimental studies has challenged this theory, with reports of a disconnect between blood leucine concentration profiles and post-prandial rates of MPS in response to protein ingestion. The primary aim of this systematic review was to qualitatively evaluate the leucine trigger hypothesis to explain the post-prandial regulation of MPS in response to ingested protein at rest and post-exercise in young and older adults. We hypothesized that experimental support for the leucine trigger hypothesis will depend on age, exercise status (rest vs. post-exercise), and type of ingested protein (i.e., isolated proteins vs. protein-rich whole food sources). This qualitative systematic review extracted data from studies that combined measurements of post-prandial blood leucine concentrations and rates of MPS following ingested protein at rest and following exercise in young and older adults. Data relating to blood leucine concentration profiles and post-prandial MPS rates were extracted from all studies, and reported as providing sufficient or insufficient evidence for the leucine trigger hypothesis. Overall, 16 of the 29 eligible studies provided sufficient evidence to support the leucine trigger hypothesis for explaining divergent post-prandial rates of MPS in response to different ingested protein sources. Of these 16 studies, 13 were conducted in older adults (eight of which conducted measurements post-exercise) and 14 studies included the administration of isolated proteins. This systematic review underscores the merits of the leucine trigger hypothesis for the explanation of the regulation of MPS. However, our data indicate that the leucine trigger hypothesis confers most application in regulating the post-prandial response of MPS to ingested proteins in older adults. Consistent with our hypothesis, we provide data to support the idea that the leucine trigger hypothesis is more relevant within the context of ingesting isolated protein sources rather than protein-rich whole foods. Future mechanistic studies are warranted to understand the complex series of modulatory factors beyond blood leucine concentration profiles within a food matrix that regulate post-prandial rates of MPS.
PubMed: 34307436
DOI: 10.3389/fnut.2021.685165 -
Journal of Molecular Medicine (Berlin,... Sep 2021As in other cardiomyopathies, extracellular matrix (ECM) remodeling plays an important role in anthracycline-induced cardiomyopathy. To understand the pattern and timing... (Meta-Analysis)
Meta-Analysis
As in other cardiomyopathies, extracellular matrix (ECM) remodeling plays an important role in anthracycline-induced cardiomyopathy. To understand the pattern and timing of ECM remodeling pathways, we conducted a systematic review in which we describe protein and mRNA markers for ECM remodeling that are differentially expressed in the hearts of animals with anthracycline-induced cardiomyopathy. We included 68 studies in mice, rats, rabbits, and pigs with follow-up of 0.1-8.2 human equivalent years after anthracycline administration. Using meta-analysis, we found 29 proteins and 11 mRNAs that were differentially expressed in anthracycline-induced cardiomyopathy compared to controls. Collagens, matrix metalloproteinases (MMPs), inflammation markers, transforming growth factor ß signaling markers, and markers for cardiac hypertrophy were upregulated, whereas the protein kinase B (AKT) pro-survival pathway was downregulated. Their expression patterns over time from single time point studies were studied with meta-regression using human equivalent years as the time scale. Connective tissue growth factor showed an early peak in expression but remained upregulated at all studied time points. Brain natriuretic peptide (BNP) and MMP9 protein levels increased in studies with longer follow-up. Significant associations were found for higher atrial natriuretic peptide with interstitial fibrosis and for higher BNP and MMP2 protein levels with left ventricular systolic function.
Topics: Animals; Anthracyclines; Apoptosis; Cardiomyopathies; Disease Models, Animal; Extracellular Matrix; Extracellular Matrix Proteins; Fibrosis; Gene Expression Regulation; Myocardium; RNA, Messenger; Signal Transduction; Time Factors; Ventricular Function, Left; Ventricular Remodeling
PubMed: 34052857
DOI: 10.1007/s00109-021-02098-8 -
Gland Surgery Mar 2021Cheek swelling can be attributed to several pathologies, including masseteric hypertrophy, diffuse inflammatory changes and neoplasia. We report an extremely rare case...
Cheek swelling can be attributed to several pathologies, including masseteric hypertrophy, diffuse inflammatory changes and neoplasia. We report an extremely rare case of bilateral cheek swelling as a result of ectopic parotid glands. This case is a young female patient with bilateral ectopic parotid glands superficial to the masseter muscle and the zygomatic arch, demonstrated by the enhanced computed tomography (CT). Medical history, clinical features, videography and management of this case are described. After two years of observation, no significant change in symptoms was observed on this patient. Besides, we conducted a case report and systematic review of cases of ectopic parotid gland. A literature search was performed using PubMed, Web of Science, and Ovid electronic database. A total of 144 papers were retrieved and only one paper was included in the systematic review. In conclusion, bilateral ectopic parotid gland is extremely rare and easily confused with other lumps in the area of head and neck. CT, magnetic resonance imaging (MRI), ultrasound imaging and parotid sialography allow for noninvasive diagnosis of ectopic parotid gland. If the parotid ectopic is highly suspected and the patient does not have obvious symptoms, conservative treatment and long-term observation follow-up are recommended.
PubMed: 33842261
DOI: 10.21037/gs-20-751 -
Journal of Sport and Health Science Mar 2022One of the most life-threatening comorbidities in elderly cancer patients is cancer cachexia, which is characterized by the ongoing loss of skeletal muscular strength... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
One of the most life-threatening comorbidities in elderly cancer patients is cancer cachexia, which is characterized by the ongoing loss of skeletal muscular strength and mass and is also associated with aging. There is a lack of recommendations for optimal resistance training (RT) for those patients. The purpose of this study was to systematically review and quantify the effects of RT on muscular strength and hypertrophy in elderly cancer patients.
METHODS
Five electronic databases were searched (until January 2020) for studies that met the following criteria: (i) cancer patients aged ≥60 years; (ii) structured and supervised RT intervention for ≥6 weeks; and (iii) measured muscular strength and/or hypertrophy.
RESULTS
Thirteen studies (717 participants, average age = 66 years) met the inclusion criteria. RT significantly increased muscular strength (mean effect size = 0.87, 95% confidence interval (95%CI): 0.43-1.32, p < 0.001) and did not significantly induce muscle hypertrophy (mean effect size = 0.09, 95%CI: -0.14 to 0.31, p = 0.45). In subgroup analyses for muscle strength, higher weekly frequency was significantly associated with larger effect size. Egger's test showed no significant publication bias for the 2 outcomes.
CONCLUSION
The results suggest that RT improves muscular strength but does not significantly induce muscle hypertrophy in elderly cancer patients.
Topics: Aged; Humans; Hypertrophy; Middle Aged; Muscle Strength; Muscle, Skeletal; Neoplasms; Resistance Training
PubMed: 33592324
DOI: 10.1016/j.jshs.2021.02.002 -
Journal of Sport and Health Science Mar 2022We aimed to perform a systematic review and meta-analysis of the effects of training to muscle failure or non-failure on muscular strength and hypertrophy. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
We aimed to perform a systematic review and meta-analysis of the effects of training to muscle failure or non-failure on muscular strength and hypertrophy.
METHODS
Meta-analyses of effect sizes (ESs) explored the effects of training to failure vs. non-failure on strength and hypertrophy. Subgroup meta-analyses explored potential moderating effects of variables such as training status (trained vs. untrained), training volume (volume equated vs. volume non-equated), body region (upper vs. lower), exercise selection (multi- vs. single-joint exercises (only for strength)), and study design (independent vs. dependent groups).
RESULTS
Fifteen studies were included in the review. All studies included young adults as participants. Meta-analysis indicated no significant difference between the training conditions for muscular strength (ES = -0.09, 95% confidence interval (95%CI): -0.22 to 0.05) and for hypertrophy (ES = 0.22, 95%CI: -0.11 to 0.55). Subgroup analyses that stratified the studies according to body region, exercise selection, or study design showed no significant differences between training conditions. In studies that did not equate training volume between the groups, the analysis showed significant favoring of non-failure training on strength gains (ES = -0.32, 95%CI: -0.57 to -0.07). In the subgroup analysis for resistance-trained individuals, the analysis showed a significant effect of training to failure for muscle hypertrophy (ES = 0.15, 95%CI: 0.03-0.26).
CONCLUSION
Training to muscle failure does not seem to be required for gains in strength and muscle size. However, training in this manner does not seem to have detrimental effects on these adaptations, either. More studies should be conducted among older adults and highly trained individuals to improve the generalizability of these findings.
Topics: Adaptation, Physiological; Aged; Humans; Hypertrophy; Muscle Strength; Muscle, Skeletal; Resistance Training; Young Adult
PubMed: 33497853
DOI: 10.1016/j.jshs.2021.01.007