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The Effects of Intermittent Pneumatic Compression on the Reduction of Exercise-Induced Muscle Damage in Endurance Athletes: A Critically Appraised Topic.
Stedge, HL, Armstrong, K
Journal of sport rehabilitation. 2021;(4):668-671
Abstract
Clinical Scenario: Endurance sports require a great deal of physical training to perform well. Endurance training and racing stress the skeletal muscle, resulting in exercise-induced muscle damage (EIMD). Athletes attempt to aid their recovery in various ways, one of which is through compression. Dynamic compression consists of intermittent pneumatic compression (IPC) devices, such as the NormaTec Recovery System and Recovery Pump. Clinical Question: What are the effects of IPC on the reduction of EIMD in endurance athletes following prolonged exercise? Summary of Key Findings: The current literature was searched to identify the effects of IPC, and 3 studies were selected: 2 randomized controlled trials and 1 randomized cross-over study. Two studies investigated the effect of IPC on delayed onset muscle soreness and plasma creatine kinase in ultramarathoners. The other looked at the impact of IPC on delayed onset muscle soreness in marathoners, ultramarathoners, triathletes, and cyclists. All studies concluded IPC was not an effective means of improving the reduction of EIMD in endurance-trained athletes. Clinical Bottom Line: While IPC may provide short-term relief of delayed onset muscle soreness, this device does not provide continued relief from EIMD. Strength of Recommendation: In accordance with the Strength of Recommendation Taxonomy, the grade of B is recommended based on consistent evidence from 2 high-quality randomized controlled trials and 1 randomized cross-over study.
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Does Low-Level Laser Therapy Decrease Muscle-Damaging Mediators After Performance in Soccer Athletes Versus Sham Laser Treatment? A Critically Appraised Topic.
Bettleyon, J, Kaminski, TW
Journal of sport rehabilitation. 2020;(8):1210-1213
Abstract
Clinical Scenario: Low-level laser therapy (LLLT) is a controversial topic for its use in athletic recovery, mainly due to inconsistency in research regarding the application of LLLT. Articles on LLLT have assessed its effectiveness in untrained humans through pain scales, functional scales, and blood draws, and it has been found capable in nonathletic rehabilitative use. The controversy lies with LLLT in the recovering athlete. Not only do athletes need to perform at high levels, but each sport is unique in the metabolic demands placed on the athletes' bodies. This modality can alter chemical mediators of the inflammatory process, specifically blood lactate (BL) and creatine kinase (CK). During soccer contests, it is a common problem for athletes to have an average CK level of 800 U/L and BL of 8 mmol·L, increasing delayed-onset muscle soreness and fatigue. Micro-CK level elevation is associated with cellular membrane damage, localized hypoxia, and electrolyte imbalances, hindering the recovery process. Clinical Question: Does LLLT decrease muscle-damaging mediators effecting player fatigue and delayed-onset muscle soreness after performance in soccer athletes versus sham treatment? Summary of Key Findings: In 3 studies, preperformance, postperformance, or preperformance and postperformance LLLT was performed and evaluated BL (2 of 3) and CK (2 of 3). In each article, BL and CK showed a significant decrease (P < .05) when performed either preperformance or postperformance versus the control group. The greatest decrease in these mediators was noticed when postperformance laser therapy was performed. Clinical Bottom Line: LLLT at 10, 30, or 50 J performed at a minimum of 2 locations on the rectus femoris, vastus lateralis, and vastus medialis bilaterally for 10 seconds each is significant in decreasing blood serum levels of BL and CK when performed postexercise. Strength of Recommendations: All 3 articles obtained a Physiotherapy Evidence Database score of ≥8/10.
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Recovery responses of testosterone, growth hormone, and IGF-1 after resistance exercise.
Kraemer, WJ, Ratamess, NA, Nindl, BC
Journal of applied physiology (Bethesda, Md. : 1985). 2017;(3):549-558
Abstract
The complexity and redundancy of the endocrine pathways during recovery related to anabolic function in the body belie an oversimplistic approach to its study. The purpose of this review is to examine the role of resistance exercise (RE) on the recovery responses of three major anabolic hormones, testosterone, growth hormone(s), and insulin-like growth factor 1. Each hormone has a complexity related to differential pathways of action as well as interactions with binding proteins and receptor interactions. Testosterone is the primary anabolic hormone, and its concentration changes during the recovery period depending on the upregulation or downregulation of the androgen receptor. Multiple tissues beyond skeletal muscle are targeted under hormonal control and play critical roles in metabolism and physiological function. Growth hormone (GH) demonstrates differential increases in recovery with RE based on the type of GH being assayed and workout being used. IGF-1 shows variable increases in recovery with RE and is intimately linked to a host of binding proteins that are essential to its integrative actions and mediating targeting effects. The RE stress is related to recruitment of muscle tissue with the glandular release of hormones as signals to target tissues to support homeostatic mechanisms for metabolism and tissue repair during the recovery process. Anabolic hormones play a crucial role in the body's response to metabolism, repair, and adaptive capabilities especially in response to anabolic-type RE. Changes of these hormones following RE during recovery in the circulatory biocompartment of blood are reflective of the many mechanisms of action that are in play in the repair and recovery process.
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Photobiomodulation in human muscle tissue: an advantage in sports performance?
Ferraresi, C, Huang, YY, Hamblin, MR
Journal of biophotonics. 2016;(11-12):1273-1299
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Abstract
Photobiomodulation (PBM) describes the use of red or near-infrared (NIR) light to stimulate, heal, and regenerate damaged tissue. Both preconditioning (light delivered to muscles before exercise) and PBM applied after exercise can increase sports performance in athletes. This review covers the effects of PBM on human muscle tissue in clinical trials in volunteers related to sports performance and in athletes. The parameters used were categorized into those with positive effects or no effects on muscle performance and recovery. Randomized controlled trials and case-control studies in both healthy trained and untrained participants, and elite athletes were retrieved from MEDLINE up to 2016. Performance metrics included fatigue, number of repetitions, torque, hypertrophy; measures of muscle damage and recovery such as creatine kinase and delayed onset muscle soreness. Searches retrieved 533 studies, of which 46 were included in the review (n = 1045 participants). Studies used single laser probes, cluster of laser diodes, LED clusters, mixed clusters (lasers and LEDs), and flexible LED arrays. Both red, NIR, and red/NIR mixtures were used. PBM can increase muscle mass gained after training, and decrease inflammation and oxidative stress in muscle biopsies. We raise the question of whether PBM should be permitted in athletic competition by international regulatory authorities.
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Wet, volatile, and dry biomarkers of exercise-induced muscle fatigue.
Finsterer, J, Drory, VE
BMC musculoskeletal disorders. 2016;:40
Abstract
BACKGROUND The physiological background of exercise-induced muscle fatigue(EIMUF) is only poorly understood. Thus, monitoring of EIMUF by a single or multiple biomarkers(BMs) is under debate. After a systematic literature review 91 papers were included. RESULTS EIMUF is mainly due to depletion of substrates, increased oxidative stress, muscle membrane depolarisation following potassium depletion, muscle hyperthermia, muscle damage, impaired oxygen supply to the muscle, activation of an inflammatory response, or impaired calcium-handling. Dehydration, hyperammonemia, mitochondrial biogenesis, and genetic responses are also discussed. Since EIMUF is dependent on age, sex, degree of fatigue, type, intensity, and duration of exercise, energy supply during exercise, climate, training status (physical fitness), and health status, BMs currently available for monitoring EIMUF have limited reliability. Generally, wet, volatile, and dry BMs are differentiated. Among dry BMs of EIMUF the most promising include power output measures, electrophysiological measures, cardiologic measures, and questionnaires. Among wet BMs of EIMUF those most applicable include markers of ATP-metabolism, of oxidative stress, muscle damage, and inflammation. VO2-kinetics are used as a volatile BM. CONCLUSIONS Though the physiology of EIMUF remains to be fully elucidated, some promising BMs have been recently introduced, which together with other BMs, could be useful in monitoring EIMUF. The combination of biomarkers seems to be more efficient than a single biomarker to monitor EIMUF. However, it is essential that efficacy, reliability, and applicability of each BM candidate is validated in appropriate studies.
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The effect of metabolic alkalosis on central and peripheral mechanisms associated with exercise-induced muscle fatigue in humans.
Siegler, JC, Marshall, P
Experimental physiology. 2015;(5):519-30
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Abstract
What is the central question of this study? Does metabolic alkalosis affect central and peripheral mechanisms associated with exercise-induced muscle fatigue in humans? What is the main finding and its importance? Inducing metabolic alkalosis before exercise preserved voluntary activation, but not muscle excitation, after a 2 min maximal voluntary contraction (MVC) followed by ischaemia. An effect of pH was also observed in maximal rates of torque development, where alkalosis mitigated the reduction in maximal rates of torque development after the initial 2 min MVC. For the first time, these results demonstrate a differential effect of pH on voluntary activation as well as maximal rates of torque development after sustained, maximal voluntary knee extension in humans. The increased concentration of protons during fatiguing exercise may contribute to increased activation of group III and IV afferents and subsequently reduced central drive, but this has yet to be confirmed in exercising humans. Here, we determined whether inducing metabolic alkalosis differentially affects descending central drive after fatiguing exercise and whether this effect may, in part, be explained by attenuating group III and IV afferent firing. Eleven men performed a maximal 2 min voluntary knee extension (MVC) followed by a 2 min rest and subsequent 1 min MVC with an occlusive cuff either in placebo [PLA; 0.3 g (kg body weight)(-1) calcium carbonate] or alkalosis conditions [ALK; 0.3 g (kg body weight)(-1) sodium bicarbonate]. Femoral nerve stimulation was applied before exercise, after the 2 min MVC and at 40-60 s intervals throughout the remainder of the protocol to explore central and peripheral mechanisms associated with reductions in maximal force and rate of torque development. Although voluntary activation declined to a similar extent after the 2 min MVC, during the ischaemic period voluntary activation was higher during ALK (PLA, 57 ± 8%; ALK, 76 ± 5%). Maximal voluntary torque declined at similar rates during the task (203 ± 19 N m), but maximal rate of torque development was significantly higher in the ALK conditions after the 2 min MVC (mean difference of 177 ± 60 N m s(-1) ). These results demonstrate the effect of pH on voluntary activation as well as maximal rates of torque development after sustained, maximal voluntary knee extension in humans.
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Optimizing intramuscular adaptations to aerobic exercise: effects of carbohydrate restriction and protein supplementation on mitochondrial biogenesis.
Margolis, LM, Pasiakos, SM
Advances in nutrition (Bethesda, Md.). 2013;(6):657-64
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Mitochondrial biogenesis is a critical metabolic adaptation to aerobic exercise training that results in enhanced mitochondrial size, content, number, and activity. Recent evidence has shown that dietary manipulation can further enhance mitochondrial adaptations to aerobic exercise training, which may delay skeletal muscle fatigue and enhance exercise performance. Specifically, studies have demonstrated that combining carbohydrate restriction (endogenous and exogenous) with a single bout of aerobic exercise potentiates the beneficial effects of exercise on markers of mitochondrial biogenesis. Additionally, studies have demonstrated that high-quality protein supplementation enhances anabolic skeletal muscle intracellular signaling and mitochondrial protein synthesis following a single bout of aerobic exercise. Mitochondrial biogenesis is stimulated by complex intracellular signaling pathways that appear to be primarily regulated by 5'AMP-activated protein kinase and p38 mitogen-activated protein kinase mediated through proliferator-activated γ receptor co-activator 1 α activation, resulting in increased mitochondrial DNA expression and enhanced skeletal muscle oxidative capacity. However, the mechanisms by which concomitant carbohydrate restriction and dietary protein supplementation modulates mitochondrial adaptations to aerobic exercise training remains unclear. This review summarizes intracellular regulation of mitochondrial biogenesis and the effects of carbohydrate restriction and protein supplementation on mitochondrial adaptations to aerobic exercise.
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Neuromuscular fatigue in healthy muscle: underlying factors and adaptation mechanisms.
Boyas, S, Guével, A
Annals of physical and rehabilitation medicine. 2011;(2):88-108
Abstract
OBJECTIVES This review aims to define the concept of neuromuscular fatigue and to present the current knowledge of the central and peripheral factors at the origin of this phenomenon. This review also addresses the literature that focuses on the mechanisms responsible for the adaption to neuromuscular fatigue. METHOD One hundred and eighty-two articles indexed in PubMed (1954-2010) have been considered. RESULTS Neuromuscular fatigue has central and peripheral origins. Central fatigue, preponderant during long-duration, low-intensity exercises, may involve a drop in the central command (motor, cortex, motoneurons) elicited by the activity of cerebral neurotransmitters and muscular afferent fibers. Peripheral fatigue, associated with an impairment of the mechanisms from excitation to muscle contraction, may be induced by a perturbation of the calcium ion movements, an accumulation of phosphate, and/or a decrease of the adenosine triphosphate stores. To compensate for the consequent drop in force production, the organism develops several adaptation mechanisms notably implicating motor units. CONCLUSION Fatigue onset is associated with an alteration of the mechanisms involved in force production. Then, the interaction between central and peripheral mechanisms leads to a series of events that ultimately contribute to the observed decrease in force production.
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Muscle fatigue during football match-play.
Reilly, T, Drust, B, Clarke, N
Sports medicine (Auckland, N.Z.). 2008;(5):357-67
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One of the consequences of sustaining exercise for 90 minutes of football match-play is that the capability of muscle to generate force declines. This impairment is reflected in the decline of work-rate towards the late part of the game. Causes of this phenomenon, which is known as fatigue, and some of its consequences are considered in this article. The stores of muscle glycogen may be considerably reduced by the end of the game, especially if there has not been a tapering of the training load. Thermoregulatory strain may also be encountered, resulting in a fall in physical performance, or there may be a reduced central drive from the nervous system. The decline in muscle strength may increase the predisposition to injury in the lower limbs. Central fatigue may also occur with implications for muscle performance. Strategies to offset fatigue include astute use of substitutions, appropriate nutritional preparation and balancing pre-cooling and warm-up procedures. There is also a role for endurance training and for a pacing strategy that optimizes the expenditure of energy during match-play.