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1.
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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Muscle fibre activation and fatigue with low-load blood flow restricted resistance exercise-An integrative physiology review.
Wernbom, M, Aagaard, P
Acta physiologica (Oxford, England). 2020;(1):e13302
Abstract
Blood flow-restricted resistance exercise (BFRRE) has been shown to induce increases in muscle size and strength, and continues to generate interest from both clinical and basic research points of view. The low loads employed, typically 20%-50% of the one repetition maximum, make BFRRE an attractive training modality for individuals who may not tolerate high musculoskeletal forces (eg, selected clinical patient groups such as frail old adults and patients recovering from sports injury) and/or for highly trained athletes who have reached a plateau in muscle mass and strength. It has been proposed that achieving a high degree of muscle fibre recruitment is important for inducing muscle hypertrophy with BFRRE, and the available evidence suggest that fatiguing low-load exercise during ischemic conditions can recruit both slow (type I) and fast (type II) muscle fibres. Nevertheless, closer scrutiny reveals that type II fibre activation in BFRRE has to date largely been inferred using indirect methods such as electromyography and magnetic resonance spectroscopy, while only rarely addressed using more direct methods such as measurements of glycogen stores and phosphocreatine levels in muscle fibres. Hence, considerable uncertainity exists about the specific pattern of muscle fibre activation during BFRRE. Therefore, the purpose of this narrative review was (1) to summarize the evidence on muscle fibre recruitment during BFRRE as revealed by various methods employed for determining muscle fibre usage during exercise, and (2) to discuss reported findings in light of the specific advantages and limitations associated with these methods.
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3.
Acute and Residual Soccer Match-Related Fatigue: A Systematic Review and Meta-analysis.
Silva, JR, Rumpf, MC, Hertzog, M, Castagna, C, Farooq, A, Girard, O, Hader, K
Sports medicine (Auckland, N.Z.). 2018;(3):539-583
Abstract
BACKGROUND Understanding soccer players' match-related fatigue and recovery profiles likely helps with developing conditioning programs that increase team performance and reduce injuries and illnesses. In order to improve match recovery (the return-to-play process and ergogenic interventions) it is also pivotal to determine if match simulation protocols and actual match-play lead to similar responses. OBJECTIVES (1) To thoroughly describe the development of fatigue during actual soccer match play and its recovery time course in terms of physiological, neuromuscular, technical, biochemical and perceptual responses, and (2) to determine similarities of recovery responses between actual competition (11 vs. 11) and match simulations. METHODS A first screening phase consisted of a systematic search on PubMed (MEDLINE) and SportDiscus databases until March 2016. Inclusion criteria were: longitudinal study with soccer players; match or validated protocol; duration > 45 min; and published in English. RESULTS A total of 77 eligible studies (n = 1105) were used to compute 1196 effect sizes (ES). Half-time assessments revealed small to large alterations in immunological parameters (e.g. leukocytes, ES = 1.9), a moderate decrement in insulin concentration (ES = - 0.9) and a small to moderate impairment in lower-limb muscle function (ES = - 0.5 to - 0.7) and physical performance measures (e.g. linear sprint, ES = - 0.3 to - 1.0). All the systematically analyzed fatigue-related markers were substantially altered at post-match. Hamstrings force production capacity (ES = - 0.7), physical performance (2-4%, ES = 0.3-0.5), creatine kinase (CK, ES = 0.4), well-being (ES = 0.2-0.4) and delayed onset muscle soreness (DOMS, ES = 0.6-1.3) remained substantially impaired at G + 72 h. Compared to simulation protocols, 11 vs. 11 match format (CK, ES = 1.8) induced a greater magnitude of change in muscle damage (i.e. CK, ES = 1.8 vs. 0.7), inflammatory (IL-6, ES = 2.6 vs. 1.1) and immunological markers and DOMS (ES = 1.5 vs. 0.7) than simulation protocols at post-assessments. Neuromuscular performances at post-match did not differ between protocols. CONCLUSION While some parameters are fully recovered (e.g. hormonal and technical), our systematic review shows that a period of 72 h post-match play is not long enough to completely restore homeostatic balance (e.g. muscle damage, physical and well-being status). The extent of the recovery period post-soccer game cannot consist of a 'one size fits all approach'. Additionally, the 'real match' (11 vs. 11 format) likely induces greater magnitudes of perceptual (DOMS) and biochemical alterations (e.g. muscle damage), while neuromuscular alterations were essentially similar. Overall, coaches must adjust the structure and content of the training sessions during the 72-h post-match intervention to effectively manage the training load within this time-frame.
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Fatigue and Recovery in Rugby: A Review.
Tavares, F, Smith, TB, Driller, M
Sports medicine (Auckland, N.Z.). 2017;(8):1515-1530
Abstract
The physical demands and combative nature of rugby lead to notable levels of muscle damage. In professional rugby, athletes only have a limited timeframe to recover following training sessions and competition. Through the implementation of recovery strategies, sport scientists, practitioners and coaches have sought to reduce the effect of fatigue and allow athletes to recover faster. Although some studies demonstrate that recovery strategies are extensively used by rugby athletes, the research remains equivocal concerning the efficacy of recovery strategies in rugby. Moreover, given the role of inflammation arising from muscle damage in the mediation of protein synthesis mechanisms, some considerations have been raised on the long-term effect of using certain recovery modalities that diminish inflammation. While some studies aimed to understand the effects of recovery modalities during the acute recovery phase (<48 h post-match), others investigated the effect of recovery modalities during a more prolonged timeframe (i.e. during a training week). Regarding the acute effectiveness of different recovery modalities, cold water immersion and contrast baths seem to provide a beneficial effect on creatine kinase clearance, neuromuscular performance and delayed onset of muscle soreness. There is support in the literature concerning the effect of compression garments on enhancing recovery from delayed onset of muscle soreness; however, conflicting findings were observed for the restoration of neuromuscular function with the use of this strategy. Using a short-duration active recovery protocol seems to yield little benefit to recovery from rugby training or competition. Given that cold modalities may potentially affect muscle size adaptations from training, their inclusion should be treated with caution and perhaps restricted to certain periods where athlete readiness is more important than increases in muscle size.
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5.
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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Effects of beta-alanine supplementation on performance and muscle fatigue in athletes and non-athletes of different sports: a systematic review.
Berti Zanella, P, Donner Alves, F, Guerini de Souza, C
The Journal of sports medicine and physical fitness. 2017;(9):1132-1141
Abstract
INTRODUCTION Beta-alanine (BA) is a non-essential amino acid that can be synthesized in the liver and obtained from diet, particularly from white and red meat. Increased availability of BA via dietary supplement, may improve performance of athletes. The aim of this study was to conduct a review of the use of BA supplementation as an ergogenic aid to improve performance and fatigue resistance in athletes and non-athletes. EVIDENCE ACQUISITION In this systematic review, a search in PubMed and Bireme databases was performed for the terms "beta-alanine," "beta-alanine and exercise," "carnosine" or "carnosine and exercise" in the titles or abstracts. We included randomized, clinical trials published between 2005 and 2015. EVIDENCE SYNTHESIS Twenty-three studies were selected. Most of them included physically active individuals. The mean intervention period was 5.2±1.8 weeks, and mean BA dose was 4.8±1.3 g/day. The main outcome measures were blood lactate, pH, perceived exertion, power and physical working capacity at fatigue threshold. After BA supplementation, no statistically significant difference was observed in total work, exercise performance time, oxygen consumption and time to exhaustion. CONCLUSIONS BA supplementation seems to improve perceived exertion and biochemical parameters related to muscle fatigue and less evidence was found for improvement in performance.
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Fatigue associated with prolonged graded running.
Giandolini, M, Vernillo, G, Samozino, P, Horvais, N, Edwards, WB, Morin, JB, Millet, GY
European journal of applied physiology. 2016;(10):1859-73
Abstract
Scientific experiments on running mainly consider level running. However, the magnitude and etiology of fatigue depend on the exercise under consideration, particularly the predominant type of contraction, which differs between level, uphill, and downhill running. The purpose of this review is to comprehensively summarize the neurophysiological and biomechanical changes due to fatigue in graded running. When comparing prolonged hilly running (i.e., a combination of uphill and downhill running) to level running, it is found that (1) the general shape of the neuromuscular fatigue-exercise duration curve as well as the etiology of fatigue in knee extensor and plantar flexor muscles are similar and (2) the biomechanical consequences are also relatively comparable, suggesting that duration rather than elevation changes affects neuromuscular function and running patterns. However, 'pure' uphill or downhill running has several fatigue-related intrinsic features compared with the level running. Downhill running induces severe lower limb tissue damage, indirectly evidenced by massive increases in plasma creatine kinase/myoglobin concentration or inflammatory markers. In addition, low-frequency fatigue (i.e., excitation-contraction coupling failure) is systematically observed after downhill running, although it has also been found in high-intensity uphill running for different reasons. Indeed, low-frequency fatigue in downhill running is attributed to mechanical stress at the interface sarcoplasmic reticulum/T-tubule, while the inorganic phosphate accumulation probably plays a central role in intense uphill running. Other fatigue-related specificities of graded running such as strategies to minimize the deleterious effects of downhill running on muscle function, the difference of energy cost versus heat storage or muscle activity changes in downhill, level, and uphill running are also discussed.
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A narrative review of exercise-associated muscle cramps: Factors that contribute to neuromuscular fatigue and management implications.
Nelson, NL, Churilla, JR
Muscle & nerve. 2016;(2):177-85
Abstract
Although exercise-associated muscle cramps (EAMC) are highly prevalent among athletic populations, the etiology and most effective management strategies are still unclear. The aims of this narrative review are 3-fold: (1) briefly summarize the evidence regarding EAMC etiology; (2) describe the risk factors and possible physiological mechanisms associated with neuromuscular fatigue and EAMC; and (3) report the current evidence regarding prevention of, and treatment for, EAMC. Based on the findings of several large prospective and experimental investigations, the available evidence indicates that EAMC is multifactorial in nature and stems from an imbalance between excitatory drive from muscle spindles and inhibitory drive from Golgi tendon organs to the alpha motor neurons rather than dehydration or electrolyte deficits. This imbalance is believed to stem from neuromuscular overload and fatigue. In concert with these findings, the most successful treatment for an acute bout of EAMC is stretching, whereas auspicious methods of prevention include efforts that delay exercise-induced fatigue. Muscle Nerve 54: 177-185, 2016.
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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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Muscle Fatigue from the Perspective of a Single Crossbridge.
Debold, EP, Fitts, RH, Sundberg, CW, Nosek, TM
Medicine and science in sports and exercise. 2016;(11):2270-2280
Abstract
The repeated intense stimulation of skeletal muscle rapidly decreases its force- and motion-generating capacity. This type of fatigue can be temporally correlated with the accumulation of metabolic by-products, including phosphate (Pi) and protons (H). Experiments on skinned single muscle fibers demonstrate that elevated concentrations of these ions can reduce maximal isometric force, unloaded shortening velocity, and peak power, providing strong evidence for a causative role in the fatigue process. This seems to be due, in part, to their direct effect on muscle's molecular motor, myosin, because in assays using isolated proteins, these ions directly inhibit myosin's ability to move actin. Indeed, recent work using a single molecule laser trap assay has revealed the specific steps in the crossbridge cycle affected by these ions. In addition to their direct effects, these ions also indirectly affect myosin by decreasing the sensitivity of the myofilaments to calcium, primarily by altering the ability of the muscle regulatory proteins, troponin and tropomyosin, to govern myosin binding to actin. This effect seems to be partially due to fatigue-dependent alterations in the structure and function of specific subunits of troponin. Parallel efforts to understand the molecular basis of muscle contraction are providing new technological approaches that will allow us to gain unprecedented molecular detail of the fatigue process. This will be crucial to fully understand this ubiquitous phenomenon and develop appropriately targeted therapies to attenuate the debilitating effects of fatigue in clinical populations.