Feasibility of a physical exercise intervention for patients on a palliative care unit: a critical analysis.

BACKGROUND: Recent exercise intervention studies have shown promising results in improving quality of life (QoL) and physical function (PF) in diverse chronic disease and advanced cancer patients. However, the effects of structured exercise in palliative care patients, having different therapeutic needs, lower life expectancies and PFs remain unknown. This study primarily aimed to assess the feasibility of an exercise intervention with follow-up by analysing recruitment numbers, screening procedures, acceptability, preferences, and safety of the exercise intervention as well as retention in follow-up. Our secondary aims related to changes in QoL and PF. METHODS: This study comprised of a one-arm design without a control group. Over 6 months, every in-hospital palliative care unit (PCU) patient was screened for eligibility. Eligible patients were asked to participate in a 2-week exercise intervention consisting of resistance training and/or endurance training with moderate or high intensity based on personal preferences and a 4-week follow-up. Before and after the exercise intervention, QoL and PF were assessed and a qualitative interview after the intervention addressed expectations and experiences of the exercise intervention. For follow-up, patients were provided with information on independent training and after 1 and 4 weeks a QoL assessment and qualitative interview were conducted. RESULTS: Of 124 patients screened, 10 completed the intervention with an adherence rate of (80 ± 25%), of which 6 patients completed follow-up. Endurance training was the most performed training type and only a few minor adverse events occurred in certain or likely connection to the exercise intervention. While physical QoL and PF measured by arm curl strength and time up and go performance improved, mental QoL and the other PF tests remained unchanged. CONCLUSION: Despite the challenges that were faced in our screening and testing process, that are specific to the palliative patient population with their unique therapeutic requirements and varying mental-/ physical capabilities, we discovered the 2-week exercise intervention to be feasible, safe, and well tolerated by palliative care patients. Moreover, it seems that short-term improvements in QoL and PF are possible. Further full scale studies are required to confirm our findings. TRIAL REGISTRATION: The study was retrospectively registered on 25.01.2022 in the German Clinical Trials Register (DRKS00027861).

The repeated bout effect of traditional resistance training on cycling efficiency and performance.

PURPOSE: This study examined the repeated bout effect of two resistance training bouts on cycling efficiency and performance. METHODS: Ten male resistance-untrained cyclists (age 38 ± 13 years; height 180.4 ± 7.0 cm; weight 80.1 ± 10.1; kg; VO2max 51.0 ± 7.6 ml.kg-1.min-1) undertook two resistance training bouts at six-repetition maximum. Blood creatine kinase (CK), delayed-onset of muscle soreness (DOMS), counter-movement jump (CMJ), squat jump (SJ), submaximal cycling and time-trial performance were examined prior to (Tbase), 24 (T24) and 48 (T48) h post each resistance training bout. RESULTS: There were significantly lower values for DOMS (p = 0.027) after Bout 2 than Bout 1. No differences were found between bouts for CK, CMJ, SJ and submaximal cycling performance. However, jump height (CMJ and SJ) submaximal cycling measures (ventilation and perceived exertion) were impaired at T24 and T48 compared to Tbase (p < 0.05). Net efficiency during submaximal cycling improved at Bout 2 (23.8 ± 1.2) than Bout 1 (24.3 ± 1.0%). There were no changes in cycling time-trial performance, although segmental differences in cadence were observed between bouts and time (i.e. Tbase vs T24 vs T48; p < 0.05). CONCLUSION: Cyclists improved their cycling efficiency from Bout 1 to Bout 2 possibly due to the repeated bout effect. However, cyclists maintained their cycling completion times during exercise-induced muscle damage (EIMD) in both resistance training bouts, possibly by altering their cycling strategies. Thus, cyclists should consider EIMD symptomatology after resistance training bouts, particularly for cycling-specific technical sessions, regardless of the repeated bout effect.

Non-Local Muscle Fatigue Impairs Mean Propulsive Velocity During Strength Loading in Strength-Trained Men.

Purpose: This study examined the acute influence of a bench press (BP) loading on the explosive squat (SQ) performance and vice versa. Methods: Nineteen strength-trained men completed 2 experimental sessions consisting of either a SQ+BP loading or a BP+SQ loading with 3 × 5 + 3 × 3 repetitions at 80% of the 1-repetition maximum in a randomized order. SQ and BP mean propulsive velocity (MPV) were assessed during both loadings, at baseline (T0) as well as immediately after the first (T1) and second strength loading (T2). Results: Both BP and SQ MPV decreased between T0 and T1 in SQ+BP (-6.13 ± 6.13%, p = .014, g = 0.485 and -9.11 ± 7.23%, p < .001, g = 0.905, respectively) and BP+SQ (-15.15 ± 7.69%, p < .001, g = 1.316 and -7.18 ± 6.16%, p < .001, g = 0.724, respectively). Mean BP MPV was lower in set 2 to set 6 in SQ+BP when compared to BP+SQ (-7.90% - 9.88%, all p < .05, g = 0.523-0.808). Mean SQ MPV was lower in set 1 and set 4 in BP+SQ when compared to SQ+BP (-4.94% - 5.22%, all p < .001, g = 0.329-0.362). Conclusions: These results demonstrate that the presence of non-local muscle fatigue affects the movement velocity. Therefore, if a training program aims to perform strength training exercises with maximal movement velocity, it is essential to carefully evaluate whether upper and lower body exercises should be carried out within close proximity.

The Impact of Exercise-Induced Muscle Damage on Various Cycling Performance Metrics: A Systematic Review and Meta-Analysis.

ABSTRACT: Devantier-Thomas, B, Deakin, GB, Crowther, F, Schumann, M, and Doma, K. The impact of exercise-induced muscle damage on various cycling performance metrics: a systematic review and meta-analysis. J Strength Cond Res 38(1): 196-212, 2024-This systematic review and meta-analysis examined the impact of exercise-induced muscle damage (EIMD) on cycling performance. The primary outcome measure was cycling performance, whereas secondary outcome measures included creatine kinase (CK), delayed-onset muscle soreness (DOMS), and muscular contractions. Data were extracted and quantified through forest plots to report on the standardized mean difference and p values. The meta-analysis showed no significant change in oxygen consumption at 24-48 hours (p > 0.05) after the muscle damage protocol, although ventilation and rating of perceived exertion significantly increased (p < 0.05) during submaximal cycling protocols. Peak power output during both sprint and incremental cycling performance was significantly reduced (p < 0.05), but time-trial and distance-trial performance showed no change (p > 0.05). Measures of CK and DOMS were significantly increased (p < 0.05), whereas muscular force was significantly reduced following the muscle-damaging protocols (p < 0.05), confirming that cycling performance was assessed during periods of EIMD. This systematic review showed that EIMD affected both maximal and submaximal cycling performance. Therefore, coaches should consider the effect of EIMD on cycling performance when implementing unaccustomed exercise into a cycling program. Careful consideration should be taken to ensure that additional training does not impair performance and endurance adaptation.

Evaluation of the Vmaxpro sensor for assessing movement velocity and load-velocity variables: accuracy and implications for practical use.

We investigated the ecological validity of an inertial measurement unit (IMU) (Vmaxpro) to assess the movement velocity (MV) during a 1-repetition maximum (1RM) test and for the prediction of load-velocity (L-V) variables, as well as the ecological intra- day and inter-day reliability during free-weight bench press (BP) and squat (SQ). Furthermore, we provide recommendations for the practical use of the sensor. Twenty-three strength-trained men completed an incremental 1RM test, whereas seventeen men further participated in another 3 sessions consisting of 3 repetitions with 4 different loads (30, 50, 70 and 90% of 1RM) to assess validity and intra- and inter-day reliability, respectively. The MV was assessed using the Vmaxpro and a 3D motion capture system (MoCap). L-V variables and the 1RM were calculated based on submaximal velocities. The Vmaxpro showed high validity during the 1RM test for BP (r = 0.935) and SQ (r = 0.900), but with decreasing validity at lower MVs. The L-V variables and the 1RM demonstrated high validity for BP (r = 0.808-0.942) and SQ (r = 0.615-0.741) with a systematic overestimation. Coefficients of variance for intra- and inter-day reliability ranged from 2.4% to 9.7% and from 3.2% to 8.6% for BP and SQ, respectively. The Vmaxpro appears valid at high and moderately valid at low MVs. Depending on the required degree of accuracy, the sensor may be sufficient for the prediction of L-V variables and the 1RM. Our data indicate the sensor to be suitable for monitoring changes in MVs within and between training sessions.

Responses of the Serum Lipid Profile to Exercise and Diet Interventions in Nonalcoholic Fatty Liver Disease.

BACKGROUND: This study aimed to assess the response patterns of circulating lipids to exercise and diet interventions in nonalcoholic fatty liver disease (NAFLD). METHODS: The 8.6-month four-arm randomized controlled study comprised 115 NAFLD patients with prediabetes who were assigned to aerobic exercise (AEx; n = 29), low-carbohydrate diet (Diet; n = 28), AEx plus low-carbohydrate diet (AED; n = 29), and nonintervention (NI, n = 29) groups. Hepatic fat content (HFC) was quantified by proton magnetic resonance spectroscopy. Serum lipidomic analytes were measured using liquid chromatography-mass spectrometry. RESULTS: After intervention, the total level of phosphatidylcholine (PC) increased significantly in the AEx group ( P = 0.043), whereas phosphatidylethanolamine (PE) and triacylglycerol decreased significantly in the AED group ( P = 0.046 and P = 0.036, respectively), and phosphatidylserine decreased in the NI group ( P = 0.002). Changes of 21 lipid metabolites were significantly associated with changes of HFC, among which half belonged to PC. Most of the molecules related to insulin sensitivity belonged to sphingomyelin (40 of 79). Controlling for the change of visceral fat, the significant associations between lipid metabolites and HFC remained. In addition, baseline serum lipids could predict the response of HFC to exercise and/or diet interventions (PE15:0/18:0 for AED, area under the curve (AUC) = 0.97; PE22:6(4Z,7Z,10Z,13Z,16Z,19Z)/0:0 for AEx, AUC = 0.90; and PC14:1(9Z)/19:1(9Z) for Diet, AUC = 0.92). CONCLUSIONS: Changes of lipidome after exercise and/or diet interventions were associated with HFC reductions, which are independent of visceral fat reduction, particularly in metabolites belonging to PC. Importantly, baseline PE could predict the HFC response to exercise, and PC predicted the response to diet. These results indicate that a circulating metabolomics panel can be used to facilitate clinical implementation of lifestyle interventions for NAFLD management.

Comparison of the cytokine responses to acute strength exercise between oral contraceptive users and naturally cycling women.

PURPOSE: Cytokines are released as part of an inflammatory reaction in response to strength exercise to initiate muscle repair and morphological adaptations. Whether hormonal fluctuations induced by the menstrual cycle or oral contraceptives affect inflammatory responses to strength exercise remains unknown. Therefore, we aimed to compare the response of cytokines after acute strength exercise in naturally menstruating women and oral contraceptive users. METHODS: Naturally menstruating women (MC, n = 13, 24 ± 4 years, weekly strength training: 4.3 ± 1.7 h) and women using a monophasic combined pill (> 9 months) (OC, n = 8, 22 ± 3 years, weekly strength training: 4.5 ± 1.9 h) were recruited. A one-repetition-maximum (1RM) test and strength exercise in the squat (4 × 10 repetitions, 70%1RM) was performed in the early follicular phase or pill free interval. Concentrations of oestradiol, IL-1ß, IL-1ra, IL-6, IL-8, and IL-10 were assessed before (pre), directly after (post) and 24 h after (post24) strength exercise. RESULTS: IL-1ra increased from pre to post (+ 51.1 ± 59.4%, p = 0.189) and statistically decreased from post to post24 (- 20.5 ± 13.5%, p = 0.011) only in OC. Additionally, IL-1ß statistically decreased from post to post24 (- 39.6 ± 23.0%, p = 0.044) only in OC. There was an interaction effect for IL-1ß (p = 0.038) and concentrations were statistically decreased at post24 in OC compared to MC (p = 0.05). IL-8 increased across both groups from post to post24 (+ 66.6 ± 96.3%, p = 0.004). CONCLUSION: We showed a differential regulation of IL-1ß and IL-1ra between OC users in the pill-free interval and naturally cycling women 24 h after strength exercise, while there was no effect on other cytokines. Whether this is associated with previously shown compromised morphological adaptations remains to be investigated.

Development and Interplay of Metabolic and Mechanical Performance Determinants Over an Annual Training Period in Adolescent National-Level Squad Swimmers.

PURPOSE: The study examined the longitudinal interplay of anthropometric, metabolic, and neuromuscular development related to performance in adolescent national-level swimmers over 12 months. METHODS: Seven male and 12 female swimmers (14.8 [1.3] y, FINA [International Swimming Federation] points 716 [51]) were tested before (T0) and after the preparation period (T1), at the season's peak (T2), and before the next season (T3). Anthropometric (eg, fat percentage) and neuromuscular parameters (squat and bench-press load-velocity profile) were assessed on dry land. Metabolic (cost of swimming [C], maximal oxygen uptake [V˙O2peak], and peak blood lactate [bLapeak]) and performance (sprinting speed [vsprint] and lactate thresholds [LT1 and 2]) factors were determined using a 500-m submaximal, 200-m all-out, 20-second sprint, and incremental test (+0.03 m·s-1, 3 min), respectively, in front-crawl swimming. RESULTS: vsprint (+0.6%) and LT1 and 2 (+1.9-2.4%) increased trivially and slightly, respectively, from T0 to T2 following small to moderate strength increases (≥+10.2%) from T0 to T1 and V˙O2peak (+6.0%) from T1 to T2. Bench-press maximal strength and peak power correlated with vsprint from T0 to T2 (r ≥ .54, P < .05) and LT2 at T1 (r ≥ .47, P < .05). Changes in fat percentage and V˙O2peak (T2-T1 and T3-T2, r ≤ -.67, P < .01) and C and LT2 (T2-T0, r = -.52, P = .047) were also correlated. CONCLUSIONS: Increases in strength and V˙O2peak from preparation to the competition period resulted in improved sprint and endurance performance. Across the season, upper-body strength was associated with vsprint and LT2, although their changes were unrelated.

Contribution of different strength determinants on distinct phases of Olympic rowing performance in adolescent athletes.

Aerobic metabolism dominates Olympic rowing, but research on the relative contribution of strength and power demands is limited. This study aimed to identify the contribution of different strength determinants for distinct phases of rowing ergometer performance. The cross-sectional analysis comprised of 14 rowing athletes (4 female, 10 male, age: 18.8 ± 3.0y, 16.9 ± 2.2y). Measurements included anthropometrics, maximal strength of leg press, trunk extension and flexion, mid-thigh pull (MTP) and handgrip strength, VO2max, and a 2000 m time trial, where peak forces at the start, middle and end phase were assessed. Additionally, rate of force development (RFD) was assessed during the isometric leg press and MTP with intervals of 150, 350 ms and 150, 300 ms, respectively. Stepwise regression models for ergometer performance showed that the start phase was mainly explained by maximal trunk extension and RFD 300 ms of MTP (R2 = 0.91, p < 0.001) and the middle section by VO2max, maximal leg press strength and sitting height (R2 = 0.84, p < 0.001). For the end phase, a best fit was observed for trunk flexion, RFD 350 ms of leg press, body height and sex (R2 = 0.97 p < 0.001), whereas absolute VO2max, trunk flexion and sex explained variance over the entire 2000 m time trial (R2 = 0.98, p < 0.001). It appears that for the high acceleration in the start phase, force transmission through maximum strength for trunk extension is essential, while fast power production along the kinetic chain is also relevant. Additionally, the results support that maximal force complements the reliance on VO2max. Further intervention studies are needed to refine training recommendations.

This study highlights the importance of the neuromuscular system for rowing performance, which has to be considered in addition to the well-known factors VO₂max, anthropometry and sex.For overall 2000 m rowing performance, maximal leg strength appears to complement the reliance on VO₂max for maintenance of force production.For efficient force transmission in the start phase, maximal strength of trunk extension and a fast power production along the kinetic chain of legs, trunk and arms are essential, while towards the end of the race isometric trunk flexion and rate of force development of leg press appear to be important.

Exercise precision medicine for type 2 diabetes: Targeted benefit or risk?

Concurrent exercise and metformin administration may reduce the acute and chronic effects of exercise on glucose metabolism in the patients with type 2 diabetes (T2D). However, several studies suggest that combing metformin and exercise treatment may have neither additive effect nor even cause adverse effects in T2D patients. This case report aimed to highlight the challenges associated with prescribing exercise to type 2 diabetes patients undergoing metformin treatment. A 67-years old woman was followed-up for five months, including assessment of the acute and chronic glucose and lactate metabolism induced by concomitant exercise and metformin. The findings were four-fold: 1) During a high-intensity interval training bout, blood glucose systematically decreased, while blood lactate concentrations fluctuated randomly; 2) Basal blood lactate levels were well above 2 mmol/L on days with medication only; 3) Combined exercise and metformin administration induced additive effects on the normalization of glucose and 4) high levels of physical activity had a positive impact on the continuous glucose fluctuations, while decreased levels of physical activity induced a large fluctuation of glucose due to home confinement of an infectious disease caused by the SARS-CoV-2 virus. Our findings showed that when combined with exercise and metformin treatment for T2D patients, exercise may contribute to improving glycemic control while metformin may elevate lactate levels in the long term. The observed results underline the need to prescribe exercise and monitor lactate levels for reducing possible risks associated with metformin treatment and reinforce the importance of tailoring exercise therapy.

Acute Effects of Combined Lower-Body High-Intensity Interval Training and Upper-Body Strength Exercise on Explosive Strength Performance in Naturally Menstruating Women.

PURPOSE: We aimed at investigating the acute effects of lower-body high-intensity interval training (HIIT) on upper- and lower-body explosive strength assessed by mean propulsive velocity (MPV) in naturally menstruating women. In addition, we assessed the combination of lower-body HIIT and squat, as well as lower-body HIIT and bench press, on bench press and squat MPV. METHODS: Thirteen women (age: 23 [2] y, menstrual cycle length: 28.4 [2.0] d) completed 2 training modalities on separate days (separated by 30 [4.2] d) consisting of HIIT followed by lower-body (HIIT + LBS) or upper-body (HIIT + UBS) strength loading. Squat and bench press MPV were assessed before HIIT (T0), after HIIT (T1), after the strength loading (T2), and 24 hours postloading (T3). RESULTS: Mixed factorial analysis of variance indicated a significant effect for time in bench press and squat (P < .001) but not for interaction. Pairwise comparison showed that bench press MPV remained unchanged (P = 1.000) at T1 but was reduced at T2 compared with T0 (HIIT + LBS: -8.2% [3.9%], HIIT + UBS: -13.8% [12.1%], P < .001) and T1 (HIIT + LBS: -7.1% [3.2%], HIIT + UBS: -12.7% [8.7%], P < .001). Squat MPV decreased at T1 (HIIT + LBS: -6.0% [8.8%], HIIT + UBS: -4.8% [5.4%], P = .009) and was found to be decreased at T2 compared with T0 in both conditions (HIIT + LBS: -6.9% [3.3%], HIIT + UBS: -7.4% [6.1%], P < .001) but not compared with T1 (P = 1.000). Bench press and squat MPV returned to baseline at T3 compared with T0 (P > .050). CONCLUSION: Lower- but not upper-body explosive strength was reduced by HIIT. HIIT combined with upper- or lower-body strength loading resulted in a reduction of squat and bench press explosive strength.

Validity and Test-Retest Reliability of the Vmaxpro Sensor for Evaluation of Movement Velocity in the Deep Squat.

ABSTRACT: Feuerbacher, JF, Jacobs, MW, Dragutinovic, B, Goldmann, J-P, Cheng, S, and Schumann, M. Validity and test-retest reliability of the Vmaxpro sensor for evaluation of movement velocity in the deep squat. J Strength Cond Res 37(1): 35-40, 2023-We aimed at assessing the validity and test-retest reliability of the inertial measurement unit-based Vmaxpro sensor compared with a Vicon 3D motion capture system and the T-Force sensor during an incremental 1-repetition maximum (1RM) test and at submaximal loads. Nineteen subjects reported to the laboratory for the 1RM test sessions, whereas 15 subjects carried out another 3 sessions consisting of 3 repetitions with 4 different intensities (30, 50, 70, and 90% of 1RM) to determine the intra- and interday reliability. The Vmaxpro sensor showed high validity (Vicon: R2 = 0.935; T-Force: R2 = 0.968) but an overestimation of the mean velocities (MVs) of 0.06 ± 0.08 m·s-1 and 0.06 ± 0.06 m·s-1 compared with Vicon and T-Force, respectively. Regression analysis indicated a systematic bias that is increasing with higher MVs. The intraclass correlation coefficients (ICCs) for Vmaxpro were moderate to high for intraday (ICC: 0.662-0.938; p ≤ 0.05) and for interday (ICC: 0.568-0.837; p ≤ 0.05) reliability, respectively. The Vmaxpro is a valid and reliable measurement device that can be used to monitor movement velocities within a training session. However, practitioners should be cautious when assessing movement velocities on separate days because of the moderate interday reliability.

Validity of three smartwatches in estimating energy expenditure during outdoor walking and running.

Commercially wrist-worn devices often present inaccurate estimations of energy expenditure (EE), with large between-device differences. We aimed to assess the validity of the Apple Watch Series 6 (AW), Garmin FENIX 6 (GF) and Huawei Watch GT 2e (HW) in estimating EE during outdoor walking and running. Twenty young normal-weight Chinese adults concurrently wore three index devices randomly positioned at both wrists during walking at 6 km/h and running at 10 km/h for 2 km on a 400- meter track. As a criterion, EE was assessed by indirect calorimetry (COSMED K5). For walking, EE from AW and GF was significantly higher than that obtained by the K5 (p < 0.001 and 0.002, respectively), but not for HW (p = 0.491). The mean absolute percentage error (MAPE) was 19.8% for AW, 32.0% for GF, and 9.9% for HW, respectively. The limits of agreement (LoA) were 44.1, 150.1 and 48.6 kcal for AW, GF, and HW respectively. The intraclass correlation coefficient (ICC) was 0.821, 0.216 and 0.760 for AW, GF, and HW, respectively. For running, EE from AW and GF were significantly higher than the K5 (p < 0.001 and 0.001, respectively), but not for HW (p = 0.946). The MAPE was 24.4%, 21.8% and 11.9% for AW, GF and HW, respectively. LoA were 62.8, 89.4 and 65.6 kcal for AW, GF and HW, respectively. The ICC was 0.741, 0.594, and 0.698 for AW, GF and HW, respectively. The results indicate that the tested smartwatches show a moderate validity in EE estimations for outdoor walking and running.

Acute Effects of High-Intensity Interval Running on Lower-Body and Upper-Body Explosive Strength and Throwing Velocity in Handball Players.

ABSTRACT: Seipp, D, Feuerbacher, JF, Jacobs, MW, Dragutinovic, B, and Schumann, M. Acute effects of high-intensity interval running on lower-body and upper-body explosive strength and throwing velocity in handball players. J Strength Cond Res 36(11): 3167-3172, 2022-The purpose of this study was to determine the acute effects of handball-specific high-intensity interval training (HIIT) on explosive strength and throwing velocity, after varying periods of recovery. Fourteen highly trained male handball players (age: 25.4 (26.2 ± 4.2) performed HIIT consisting of repeated 15-second shuttle runs at 90% of final running speed (V IFT ) to exhaustion . Upper-body and lower-body explosive strength and throwing velocities were measured before and immediately after HIIT, as well as after 6 hours. These tests included 3 repetitions of both bench press and squat exercise at 60% of the 1 repetition maximum (1RM) as well as 3 repetitions of the set shot without run up and jump shot, respectively. Explosive squat performance was significantly reduced at post (-5.48%, p = 0.026) but not at 6 h (-0.24%, p = 1.000). Explosive bench press performance remained statistically unaltered at post (0.32%, p = 1.000) and at 6 hour (1.96%, p = 1.000). This was also observed in the subsequent throws both immediately after (-0.60%, p = 1.000) (-0.31%, p = 1.000) and at 6 h (-1.58%, p = 1.000) (1.51%, p = 0.647). Our data show a reduction in explosive strength of the lower but not upper extremities when preceded by running HIIT. Since throwing velocity was not affected by intense lower-body exercise, combining lower-body HIIT and throwing practice may be of no concern in highly trained handball players.

Autologous Blood Doping Induced Changes in Red Blood Cell Rheologic Parameters, RBC Age Distribution, and Performance.

Autologous blood doping (ABD) refers to the transfusion of one's own blood after it has been stored. Although its application is prohibited in sports, it is assumed that ABD is applied by a variety of athletes because of its benefits on exercise performance and the fact that it is not detectable so far. Therefore, this study aims at identifying changes in hematological and hemorheological parameters during the whole course of ABD procedure and to relate those changes to exercise performance. Eight healthy men conducted a 31-week ABD protocol including two blood donations and the transfusion of their own stored RBC volume corresponding to 7.7% of total blood volume. Longitudinal blood and rheological parameter measurements and analyses of RBC membrane proteins and electrolyte levels were performed. Thereby, responses of RBC sub-populations-young to old RBC-were detected. Finally, exercise tests were carried out before and after transfusion. Results indicate a higher percentage of young RBC, altered RBC deformability and electrolyte concentration due to ABD. In contrast, RBC membrane proteins remained unaffected. Running economy improved after blood transfusion. Thus, close analysis of RBC variables related to ABD detection seems feasible but should be verified in further more-detailed studies.

Acute Effects of Concurrent High-Intensity Interval Cycling and Bench-Press Loading on Upper- and Lower-Body Explosive Strength Performance.

PURPOSE: This study examined the acute effects of lower-body high-intensity interval loading (HIIT) on explosive upper- and lower-body strength, as well as the combined effect of HIIT and bench-press loading versus HIIT and squat loading on the explosive upper- and lower-body strength. METHODS: Fifteen physically active men completed 2 sessions consisting of HIIT (4 × 4 min cycling at 80% of peak power output) immediately followed by lower- (HIIT + LBS) or upper-body (HIIT + UBS) strength loading (3 × 5 + 3 × 3 repetitions at 80% 1-repetition maximum [ie, 6 sets in total]) in a randomized order. Squat and bench-press mean propulsive velocity (MPV) was assessed before HIIT (T0), immediately after HIIT (T1), immediately after the strength loading (T2), and 24 hours after the experimental session (T3). RESULTS: Squat MPV decreased to a similar magnitude at T1 in HIIT + LBS (-5.3% [7.6%], P = .117, g = .597) and HIIT + UBS (-5.7% [6.9%], P = .016, g = .484), while bench press remained unchanged (-1.4% [4.7%], P = 1.000, g = .152, and -1.0% [7.0%], P = 1.000, g = .113, respectively). Both squat and bench-press MPV were statistically reduced at T2 compared to T0 (HIIT + LBS: -7.5% [7.8%], P = .016, g = .847, and -6.8% [4.6%], P < .001, g = .724; HIIT + UBS: -3.9% [3.8%], P = .007, g = .359, and -15.5% [6.7%], P < .001, d = 1.879). Bench-press MPV at T2 was significantly lower in HIIT + UBS when compared to HIIT + LBS (P = .002, d = 1.219). CONCLUSION: These findings indicate lower- but not upper-body explosive strength to be acutely reduced by preceding lower-body HIIT. However, lower-body HIIT combined with either upper- or lower-body strength loading resulted in a similar acute reduction of both squat and bench-press explosive strength.

The Effects of Concurrent Aerobic and Strength Training on Muscle Fiber Hypertrophy: A Systematic Review and Meta-Analysis.

BACKGROUND: Whole muscle hypertrophy does not appear to be negatively affected by concurrent aerobic and strength training compared to strength training alone. However, there are contradictions in the literature regarding the effects of concurrent training on hypertrophy at the myofiber level. OBJECTIVE: The current study aimed to systematically examine the extent to which concurrent aerobic and strength training, compared with strength training alone, influences type I and type II muscle fiber size adaptations. We also conducted subgroup analyses to examine the effects of the type of aerobic training, training modality, exercise order, training frequency, age, and training status. DESIGN: A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) [PROSPERO: CRD42020203777]. The registered protocol was modified to include only muscle fiber hypertrophy as an outcome. DATA SOURCES: PubMed/MEDLINE, ISI Web of Science, Embase, CINAHL, SPORTDiscus, and Scopus were systematically searched on 12 August, 2020, and updated on 15 March, 2021. ELIGIBILITY CRITERIA: Population: healthy adults of any sex and age; intervention: supervised, concurrent aerobic and strength training of at least 4 weeks; comparison: identical strength training prescription, with no aerobic training; and outcome: muscle fiber hypertrophy. RESULTS: A total of 15 studies were included. The estimated standardized mean difference based on the random-effects model was - 0.23 (95% confidence interval [CI] - 0.46 to - 0.00, p = 0.050) for overall muscle fiber hypertrophy. The standardized mean differences were - 0.34 (95% CI - 0.72 to 0.04, p = 0.078) and - 0.13 (95% CI - 0.39 to 0.12, p = 0.315) for type I and type II fiber hypertrophy, respectively. A negative effect of concurrent training was observed for type I fibers when aerobic training was performed by running but not cycling (standardized mean difference - 0.81, 95% CI - 1.26 to - 0.36). None of the other subgroup analyses (i.e., based on concurrent training frequency, training status, training modality, and training order of same-session training) revealed any differences between groups. CONCLUSIONS: In contrast to previous findings on whole muscle hypertrophy, the present results suggest that concurrent aerobic and strength training may have a small negative effect on fiber hypertrophy compared with strength training alone. Preliminary evidence suggests that this interference effect may be more pronounced when aerobic training is performed by running compared with cycling, at least for type I fibers.

Recommendations for Determining the Validity of Consumer Wearables and Smartphones for the Estimation of Energy Expenditure: Expert Statement and Checklist of the INTERLIVE Network.

BACKGROUND: Consumer wearables and smartphone devices commonly offer an estimate of energy expenditure (EE) to assist in the objective monitoring of physical activity to the general population. Alongside consumers, healthcare professionals and researchers are seeking to utilise these devices for the monitoring of training and improving human health. However, the methods of validation and reporting of EE estimation in these devices lacks rigour, negatively impacting on the ability to make comparisons between devices and provide transparent accuracy. OBJECTIVES: The Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The network was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables and smartphones in the estimation of EE. METHODS: The recommendations were developed through (1) a systematic literature review; (2) an unstructured review of the wider literature discussing the potential factors that may introduce bias during validation studies; and (3) evidence-informed expert opinions from members of the INTERLIVE network. RESULTS: The systematic literature review process identified 1645 potential articles, of which 62 were deemed eligible for the final dataset. Based on these studies and the wider literature search, a validation framework is proposed encompassing six key domains for validation: the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. CONCLUSIONS: The INTERLIVE network recommends that the proposed protocol, and checklists provided, are used to standardise the testing and reporting of the validation of any consumer wearable or smartphone device to estimate EE. This in turn will maximise the potential utility of these technologies for clinicians, researchers, consumers, and manufacturers/developers, while ensuring transparency, comparability, and replicability in validation. TRIAL REGISTRATION: PROSPERO ID: CRD42021223508.