Effects of resistance training performed to repetition failure or non-failure on muscular strength and hypertrophy: A systematic review and meta-analysis.

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.

Effects of Resistance Training on Muscle Size and Strength in Very Elderly Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Effects of resistance training on muscle strength and hypertrophy are well established in adults and younger elderly. However, less is currently known about these effects in the very elderly (i.e., 75 years of age and older). OBJECTIVE: To examine the effects of resistance training on muscle size and strength in very elderly individuals. METHODS: Randomized controlled studies that explored the effects of resistance training in very elderly on muscle strength, handgrip strength, whole-muscle hypertrophy, and/or muscle fiber hypertrophy were included in the review. Meta-analyses of effect sizes (ESs) were used to analyze the data. RESULTS: Twenty-two studies were included in the review. The meta-analysis found a significant effect of resistance training on muscle strength in the very elderly [difference in ES = 0.97; 95% confidence interval (CI) 0.50, 1.44; p = 0.001]. In a subgroup analysis that included only the oldest-old participants (80 + years of age), there was a significant effect of resistance training on muscle strength (difference in ES = 1.28; 95% CI 0.28, 2.29; p = 0.020). For handgrip strength, we found no significant difference between resistance training and control groups (difference in ES = 0.26; 95% CI - 0.02, 0.54; p = 0.064). For whole-muscle hypertrophy, there was a significant effect of resistance training in the very elderly (difference in ES = 0 30; 95% CI 0.10, 0.50; p = 0.013). We found no significant difference in muscle fiber hypertrophy between resistance training and control groups (difference in ES = 0.33; 95% CI - 0.67, 1.33; p = 0.266). There were minimal reports of adverse events associated with the training programs in the included studies. CONCLUSIONS: We found that very elderly can increase muscle strength and muscle size by participating in resistance training programs. Resistance training was found to be an effective way to improve muscle strength even among the oldest-old.

What Dose of Caffeine to Use: Acute Effects of 3 Doses of Caffeine on Muscle Endurance and Strength.

PURPOSE: To explore the effects of 3 doses of caffeine on muscle strength and muscle endurance. METHODS: Twenty-eight resistance-trained men completed the testing sessions under 5 conditions: no-placebo control, placebo control, and with caffeine doses of 2, 4, and 6 mg·kg-1. Muscle strength was assessed using the 1-repetition-maximum test; muscle endurance was assessed by having the participants perform a maximal number of repetitions with 60% 1-repetition maximum. RESULTS: In comparison with both control conditions, only a caffeine dose of 2 mg·kg-1 enhanced lower-body strength (d = 0.13-0.15). In comparison with the no-placebo control condition, caffeine doses of 4 and 6 mg·kg-1 enhanced upper-body strength (d = 0.07-0.09) with a significant linear trend for the effectiveness of different doses of caffeine (P = .020). Compared with both control conditions, all 3 caffeine doses enhanced lower-body muscle endurance (d = 0.46-0.68). For upper-body muscle endurance, this study did not find significant effects of caffeine. CONCLUSIONS: This study revealed a linear trend between the dose of caffeine and its effects on upper-body strength. The study found no clear association between the dose of caffeine and the magnitude of its ergogenic effects on lower-body strength and muscle endurance. From a practical standpoint, the magnitude of caffeine's effects on strength is of questionable relevance. A low dose of caffeine (2 mg·kg-1)-for an 80-kg individual, the dose of caffeine in 1-2 cups of coffee-may produce substantial improvements in lower-body muscle endurance with the magnitude of the effect being similar to that attained using higher doses of caffeine.

Caffeine Supplementation for Powerlifting Competitions: An Evidence-Based Approach.

In this paper, we review the effects of caffeine on muscle strength and provide suggestions for caffeine supplementation in powerlifting competitions. The currently available studies indicate that caffeine ingestion may enhance strength in two powerlifting competition events, the squat and the bench press. For the deadlift, the same might be expected even though studies directly using this event are lacking. Optimal doses of caffeine are likely in the range from 2 to 6 mg·kg-1, and are highly individual. When using caffeine-containing capsules, 60 minutes pre-exercise seems to be a good timing of caffeine consumption. For other sources such as caffeinated chewing gum, a shorter period (5 to 10 min) from consumption to the start of the exercise seems to be effective. For shorter duration powerlifting competitions (e.g., 2 hours), one pre-competition dose of caffeine could be sufficient for acute performance-enhancing effects that might be maintained across all three events. For longer duration competitions (with longer rest periods between one repetition maximum attempts), there might be a benefit to repeated dosing with caffeine; for example, ingesting smaller doses of caffeine before each attempt or event. During training, powerlifters may consider ingesting caffeine only before the training sessions with the highest intensity. This approach might eliminate the attenuation of caffeine's effects associated with chronic caffeine ingestion and would help in maximizing performance benefits from acute caffeine ingestion at the competition. Nonetheless, withdrawal from caffeine (e.g., no caffeine intake seven days before competition) does not seem necessary and may have some indirect negative effects.

The Effects of 3 Different Doses of Caffeine on Jumping and Throwing Performance: A Randomized, Double-Blind, Crossover Study.

PURPOSE: To examine the acute effects of 3 doses of caffeine on upper- and lower-body ballistic exercise performance and to explore if habitual caffeine intake affects the acute effects of caffeine ingestion on ballistic exercise performance. METHODS: Twenty recreationally active male participants completed medicine-ball-throw and vertical-jump tests under 4 experimental conditions (placebo and 2, 4, and 6 mg·kg-1 of caffeine). RESULTS: One-way repeated-measures analysis of variance (ANOVA) with subsequent post hoc analyses indicated that performance in the medicine-ball-throw test improved, compared with placebo, only with a 6 mg·kg-1 dose of caffeine (P = .032). Effect size, calculated as the mean difference between the 2 measurements divided by the pooled SD, amounted to 0.29 (+3.7%). For the vertical-jump test, all 3 caffeine doses were effective (compared with placebo) for acute increases in performance (P values .022-.044, effect sizes 0.35-0.42, percentage changes +3.7% to +4.1%). A 2-way repeated-measures ANOVA indicated that there was no significant group × condition interaction effect, suggesting comparable responses between low (≤100 mg·d-1) and moderate to high (>100 mg·d-1) caffeine users to the experimental conditions. CONCLUSION: Caffeine doses of 2, 4, and 6 mg·kg-1 seem to be effective for acute enhancements in lower-body ballistic exercise performance in recreationally trained male individuals. For the upper-body ballistic exercise performance, only a caffeine dose of 6 mg·kg-1 seems to be effective. The acute effects of caffeine ingestion do not seem to be affected by habitual caffeine intake; however, this requires further exploration.

Does Aerobic Training Promote the Same Skeletal Muscle Hypertrophy as Resistance Training? A Systematic Review and Meta-Analysis.

BACKGROUND: Currently, there are inconsistencies in the body of evidence for the effects of resistance and aerobic training on skeletal muscle hypertrophy. OBJECTIVE: We aimed to systematically review and meta-analyze current evidence on the differences in hypertrophic adaptation to aerobic and resistance training, and to discuss potential reasons for the disparities noted in the literature. METHODS: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed for this review. The Downs and Black checklist was used for the assessment of methodological quality of the included studies. A random-effects meta-analysis was employed. In total, three analyses were performed: (1) for whole-muscle knee extensor data; (2) for type I fiber cross-sectional area; and (3) for type II fiber cross-sectional area. RESULTS: The final number of included studies in the present review is 21. All studies were of good or moderate methodological quality. The meta-analysis for whole-muscle hypertrophy resulted in a significant pooled difference (p < 0.001) in responses between the aerobic training and resistance training interventions. The pooled Hedge's g, favoring resistance over aerobic training, was 0.66 (95% confidence interval 0.41-90; I2 = 0%). The meta-analysis for type I fiber cross-sectional area data resulted in a significant pooled difference (p < 0.001) between the aerobic training and resistance training groups. The pooled Hedge's g, favoring resistance training over aerobic training, was 0.99 (95% confidence interval 0.44-1.54; I2 = 24%). The meta-analysis of type II fiber cross-sectional area data resulted in a significant pooled difference (p < 0.001) between the aerobic training and resistance training groups. The pooled Hedge's g, favoring resistance training over aerobic training, was 1.44 (95% confidence interval 0.93-1.95; I2 = 8%). CONCLUSIONS: The results of this systematic review and meta-analysis suggest that single-mode aerobic training does not promote the same skeletal muscle hypertrophy as resistance training. This finding was consistent with measurements of muscle hypertrophy both at the whole-muscle and myofiber levels. While these results are specific to the knee extensor musculature, it can be hypothesized that similar results would be seen for other muscle groups as well.

Clinical sensitivity and specificity of multiple T2-hyperintensities on brain magnetic resonance imaging in diagnosis of neurofibromatosis type 1 in children: diagnostic accuracy study.

AIM: To determine the prevalence, number, and location of multiple (≥2) T2-hyperintensities on brain magnetic resonance imaging (MRI) in children with neurofibromatosis type 1 (NF1) and their correlation with age, and to establish their sensitivity, specificity, and accuracy for the diagnosis of NF1 in children, especially in the early age (2-7 years). METHODS: We performed a cross-sectional study of 162 patients with NF1 from Croatian Neurofibromatosis Association Database and 163 control children between the ages of 2 and 18 years who underwent brain MRI between 1989 and 2009. RESULTS: Multiple T2-hyperintensities were present in 74% of NF1 patients and 1.8% of controls. They were mainly located in the basal ganglia, brainstem, and cerebellum and were significantly decreased in prevalence and number in the older age. T2-hyperintensities had excellent diagnostic accuracy with the area under the receiver operating characteristic (ROC) curve of 0.849 and 95% confidence interval (CI) of 0.805-0.886. The diagnostic sensitivity, specificity, and accuracy rate of T2-hyperintensities for NF1 were highest in the youngest age (2-7 years): 81% (95% CI 71%-89.1%), 99% (95% CI 92.3%-100%), and 85.8 (95% CI 83.3-93.8), respectively. CONCLUSION: This study strongly suggests the inclusion of T2-hyperintensities on brain MRI on the list of diagnostic criteria for NF1, especially in children of early age, when the clinical penetration of the NF1 gene has not yet been completely finished.

[Neurofibromatosis type 2 (central neurofibromatosis or bilateral acoustic neuromas, vestibular schwannomas): from phenotype to gene]. / Neurofibromatoza tip 2 (centralna neurofibromatoza ili bilateralni akusticki neuromi, vestibularni svanomi): od fenotipa do gena.

Neurofibromatosis type 2 (NF2) is an autosomal dominant disease that predisposes to bilateral vestibular schwannomas (neurinomas), other central and peripheral nervous system tumours (multiple meningeomas and neurofibromas) and ocular abnormalities (cataract). The NF2 tumour suppresor gene is localised on chromosome 22q12 and encodes protein called schwannomin or merlin which is related to a family of cytoskeleton-to-membrane proteins linkers ERM (ezrin-radixin-moesin proteins). About 50% of all cases are new germline mutations, although about 20% of apparently sporadic cases represent somatic mosaicism. The majority of observed germline NF2 mutations are point mutations which result in schwannomin with an altered or absent C-terminal domain. NF2 has a variable clinical presentation, with two basic types: severe type having early onset and progressive growth of tumors and the milder type having later onset and less aggressive course. The genotype-phenotype correlations indicate a greater variability of clinical disease expression. In this paper we discuss the epidemiology, genetic and clinical characteristics, diagnostic criteria, investigations, screening for risk persons and recommendations for care and therapy of patients with NF2.