King Saud University Workshop Outline

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King Saud UniversityWORKSHOPWorkshop Outline1-4pm, 25th September1. Examples of studies – DiscussionHow to design a study thatcan be published inrefereed journalsKen Nosaka2. Exercise to design a study –Presentation and Discussion3. QuestionsProfessor1School of Exercise HealthSciencesEdith Cowan UniversityJoondalup, AUSTRALIA4. Finalising a proposal215th ECSS Congress26/06 (Sat) Physiology 16INTRODUCTION Prevention or attenuation of muscledamage is important (Cheung et al. 2003) Stretching prior to exercise has no orlittle prophylactic effect (Johansson et at. 1999,Effect of Static Stretchingand PNF Training onEccentric ExerciseInduced Muscle DamageRodenburg et al. 1994) Flexible muscle is less susceptible tomuscle damage (McHugh et at. 1999) A few studies examined staticstretching training effect on muscledamage (Eston et at. 2007, LaRoche & Connoly 2006) No study has investigated effect ofPNF training on muscle damageNosaka K1, Chen CH2,3, Chen HL2,Wu CJ2, Tseng KW4, Chen TC23Edith Cowan University (AUSTRALIA)National Chiayi University (TAIWAN)National Taiwan University (TAIWAN)Taipei Physical Education College (TAIWAN)5. Conduct the proposed study(hopefully)4PURPOSEMETHODS - Study Design To investigate whether an 8-weekflexibility training attenuates themagnitude of eccentric exerciseinduced muscle damage3 Groups: Static stretching (n 10),PNF training (n 10), Control (n 10)Hypothesis: less muscle damage To compare between staticstretching and PNF training onthe muscle damage attenuationHypothesis: SS PNF5MVC: ICC 0.96, CV 7.8% OA: ICC 0.88, CV 11.3%ROM: ICC 0.93, CV 6.7% Soreness: ICC 0.99, CV 0.9%61

Flexibility TrainingSubjectsStatic stretching30 untrained young men (students)PNF trainingNo flexibility, resistance, aerobic training (6 months)Age: 20.8 2.3 yHeight: 172.7 6.2 cmBody weight: 66.9 7.0 kgMaximal isokinetic knee flexor concentric strength3 groups: Control, SS, PNF (n 10 / group)7No significant differences in physical characteristicsNo anti-inflammatory drugs, nutritionalsupplementsNo vigorous physical activitiesNormal diet during the experimental period8W-up (5-min jogging @ 6.4 km/h, 1% grade)30-s stretch (30-s rest) x 30 1. 30-s stretch (30-s rest) x 52. (contract:10s – relax:10s –agonist-contract:5s –3 times / week for 8 weeksstretch:10s) x 3A minimum of 24-h interval3. (stretch with kneeextensors/flexorscontraction:10s) x 3Cocentric Strength and ROMEffects of Flexibility TrainingBiodex dynamometer9Velocity: 60 ·s-1ROM: 0-120 Average of 3 trialsOptimum angleLeighton FlexometerBrace and strapsA straight-leg-raise ROM testAverage of 3 trials (60-s rest)10CONPreSSPNFCONROM( )97.6 3.096.1 3.695.5 3.499.0 3.1120.1 123.1 3.7*# 3.5*#MVC-Flx(Nm)70.4 3.972.7 3.270.8 3.771.0 4.079.081.8 3.0*# 3.9*#MVC-Ext(Nm)117.1 6.7124.9 7.8121.9 7.0119.3 6.8128.7 129.3 8.3 6.6*#OA-Flx( )35.6 2.436.5 2.234.1 2.334.5 2.827.923.9 2.6*# 2.7*#Statistical Analyses ROM: 130 - 0 FlexedExtendedAngular velocity: 30 /sPassive recovery: 10 /s1113-s rest between contractions60-s rest between setsPNF* Significantly (P 0.05) different from pre, # significantly (P 0.05) different from CONEccentric Exercise6 sets of 10 maximaleccentric contractionsPostSS 12Changes in muscle strength, optimum angle,ROM, muscle soreness, and plasma CKactivity and myoglobin concentration followingeccentric exerciseTwo-way repeated measures ANOVA tocompare three groups (CON vs SS vs PNF)and between two groups (CON vs SS, CON vsPNF, SS vs PNF)Bonferroni post hoc testPearson correlation coefficient (r)Statistical significance: P 0.05Mean SEM2

Work during Eccentric ExerciseConcentric Strength 10% 12% 18%Greater work for SS and PNF than CON13Similar results for peak torqueFaster recovery for SS and PNF than CON14Plasma CK ActivityRange of MotionFaster recovery for SS and PNF than CONSmaller increases forSS and PNF than CON15Similar results for myoglobin16Flexibility and Muscle DamageMuscle Soreness (VAS)MVC-5dROMPeak CKROMROM / Optimum angle and MVC-5 day, Peak CK activitySmaller increases forSS and PNF than CON17MVC-5dOA18Peak CKOAFlexible subjects are less susceptible to muscle damage3

CONCLUSIONCHEN, C-H., K. NOSAKA, H-L. CHEN, M-J. LIN, K-W.TSENG, and T. C. CHEN. Effects of Flexibility Training onEccentric Exercise–Induced Muscle Damage.Medicine and Science in Sports Exercise. 43(3): 491–500,2011.The 8-week static stretching andPNF training shifted the optimumangle to a longer muscle length,increased the flexibility and strengthof the knee flexors, and similarlyattenuated muscle damage ( 50%)induced by maximal eccentricexercise of the knee flexors192016th ECSS Congress08/07 (Fri) OP-PM42Muscle Damage and RecoveryTwo Maximal Isometric ContractionsAttenuate Magnitude of EccentricExercise-Induced Muscle DamageNosaka K 1, Chen HL 2, Chen TC 21 EdithCowan University (AUSTRALIA)Chiayi University (TAIWAN)2 National21INTRODUCTION The second eccentric exercise boutresults in less muscle damage and fasterrecovery than the initial bout when thesame exercise is repeated (Clarkson et al. 1992) Repeated bout effect: the adaptationwhereby a single bout of eccentricexercise protects against muscle damagefrom subsequent eccentric exercise(McHugh 2003) Low-intensity “non-damaging” eccentricexercise confers protective effect againstmaximal eccentric exercise (Chen et al. 2007;22 Animal studies showed that 75 isometriccontractions conferred protective effectagainst muscle damage induced by 75maximal eccentric contractionsperformed 2 weeks later (Koh & Brooks 2001;Pizza et al., 2002)another type of the repeated bout effect A familiarisation session in whichincludes maximal isometric contractionsappears to attenuate the magnitude ofmuscle damage induced by maximaleccentric contractions performed acouple days later23ArticleLavender & Nosaka 2008, Chen et al. 2011)RATIONALE No previous human studies haveexamined the effect of maximalisometric contractions on eccentricexercise-induced muscle damage It may be that less muscle damagefound in the studies with afamiliarisation session was due toisometric contractions performed inthe session, but this has not beensystematically investigated244

PURPOSESMETHODS: Subjects To investigate whether maximalisometric contractions performed 2days prior to maximal eccentricexercise could attenuate themagnitude of muscle damageNo flexibility, resistance, aerobic training ( 1 year)Age: 22.5 1.7 yHeight: 172.9 5.7 cmBody weight: 71.7 9.0 kg39 untrained young men (students)Maximal isokinetic elbow flexor concentric strengthHypothesis: YesControl, 2-MVC, 10-MVC (n 13 / group) To compare between 2 and 10maximal isometric contractions onmuscle damage induced by 30maximal eccentric contractions25Hypothesis: 2 1026Study Design2-MVC Group 10-MVC GroupSample size estimation based on a pilot studyIsometric Contractions2 or 10 maximalisometric contractions20 flexion3sControl Group210Maximal Isometric Contractions@ 20 Elbow Flexion, 3 s2 days5 sets of 6 Maximal Eccentric Contractions @ 90 /s27Concentric strength (60 /s), Optimum angleRange of motion, Upper arm circumference Pre, PostPlasma CK activity, Myoglobin concentration 1-10 days postMuscle soreness, Echo intensityDependent variables45 s between contractionsNon-dominant armEccentric Exercise5 sets of 6 maximaleccentric contractionsROM: 90-0 90 /s10 s between contractions2 min between sets28Statistical Analyses Two-way repeated measures ANOVA Comparison between 2-MVC and 10MVC groups for the changes independent variables following isometriccontractions Comparison between Control, 2-MVCand 10-MVC groups for the changes independent variables following eccentricexercise Bonferroni post hoc test Statistical significance: P 0.05 Mean SEM29No significant differences in physical characteristicsNo anti-inflammatory drugs, nutritionalsupplementsNo vigorous physical activitiesNormal diet during the experimental periodRESULTS: Isometric Contractions30No significant changes Control5

Work during Eccentric ExerciseConcentric StrengthRecovery2-MVC: 33% 10-MVC: 61% Decrease from 1st set to 5th set25.1 3.1%31Similar results for peak torque32Range of MotionUpper Arm CircumferenceThis image cannot currently be displayed.Increases2-MVC: 44% 10-MVC: 58% Recovery2-MVC: 45% 10-MVC: 61% 3334Muscle Soreness (VAS)Plasma CK ActivityPeak2-MVC: 30% 10-MVC: 55% Peak2-MVC: 61% 10-MVC: 84% 35366

CONCLUSION 37 CHEN, H-L., NOSAKA, K., PEARCE AJ., CHEN, TC.Two maximal isometric contractions attenuate the magnitudeof eccentric exercise-induced muscle damage.Applied Physiology, Nutrition, and Metabolism.37(4): 680-689, 2012.-035)The magnitude of muscle damageinduced by maximal eccentriccontractions of the elbow flexors wasattenuated by both 2 and 10 maximalisometric contractions performed 2 daysprior to the eccentric exerciseArticleThe magnitude of protective effect wasgreater for 10 than 2 maximal isometriccontractions, but the difference wassmallEvery muscle contraction counts!17th ECSS Congress06/07 (Fri) OP-PM37Muscle Physiology38INTRODUCTION Protective Effect Conferred byMaximal Isometric Contractions ata Long Muscle LengthNosaka K 1, Chen TC 2McHugh 2003) Lin M-J 3, Chen C-H 4, Chen HL 21 Edith39Cowan University (AUSTRALIA)2 NCYU, 3 CCU, 4 NTU(TAIWAN)Magnitude of muscle damage is smallerand recovery is faster after the secondthan initial eccentric exercise bout:Repeated bout effect (Clarkson et al. 1992,Submaximal eccentric exercise including“low-intensity” (non-damaging) eccentricexercise confers protective effect againstmaximal eccentric exercise (Chen et al.2007; Lavender & Nosaka 2008, Chen et al. 2011)40ECSS 2011: Protective Effect by Max Isometric ContractionsPURPOSETo investigate the protective effect by 2maximal voluntary isometric contractionsat 20º elbow flexion (2MVCs) on changesin indirect muscle damage markersfollowing maximal eccentric contractions(MaxECC) that were performedimmediately after, or 2, 4 or 7 days laterHypotheses: 1) immediately before: no effect;2) 4 days: residual effect; 3) 7 days: no effect41Chen et al . Appl Physiol Nutr Metab. 2012427

Study Design2 Maximal Isometric Contractions@ 20 Elbow Flexion, 3 s15 min0 day 2 days 4 days 7 daysIsometric ContractionsUntrained young men(n 13/group)21.8 2.3 y173.6 5.6 cm69.2 11.1 kg2 maximal isometriccontractions: 3 s45 s between contractions20 flexionNon-dominant armControlEccentric Exercise5 sets of 6 Maximal Eccentric Contractions @ 90 /s43Concentric strength (60 /s), Optimum angleRange of motion, Upper arm circumference Pre, PostPlasma CK activity, Myoglobin concentration 1-10 days postMuscle soreness, Echo intensityDependent variables5 sets of 6 maximaleccentric contractions10 s betweencontractions2 min between setsROM: 90-0 , 90 /s44RESULTS: Changes after 2MVCsStatistical μg/L)VAS(mm) Two-way repeated measures ANOVA Comparison between Control, 0d,2d, 4d, and 7d groups for thechanges in dependent variablesfollowing eccentric exercise Bonferroni post hoc test Statistical significance: P 0.05 Mean SEM4546Work during Eccentric Exercisepre32.7 0.877.2 1.6142.4 0.9274.7 3.7116.8 4.624.3 0.80.0 0.0post31.7 0.776.7 1.6142.8 1.0274.9 3.6---d132.1 0.877.2 1.6143.0 1.0274.8 3.6117.9 5.125.4 1.20.3 0.1d232.9 0.777.3 1.5142.7 1.0274.9 3.6118.9 5.524.7 0.80.1 0.1No significant changesConcentric Strength2d4d0d, 7d47Similar results for peak torque488

Range of MotionUpper Arm Circumference0d, 7d2d4d4d2d0d, 7d4950Muscle Soreness (VAS)Plasma CK Activity0d, 7d0d, 7d4d4d2d2d51Similar results for plasma Mb concentration52Echo IntensityCONCLUSION The magnitude of muscle damageinduced by maximal eccentriccontractions of the elbow flexors wasattenuated by 2MVCs performed 2 or 4days, but not immediately or 7 days priorto the eccentric exercise The protective effect is short-lived, and itrequires at least one day for the effect tobe produced0d, 7d4d2d53549

PRACTICAL IMPLICATIONS Applied Physiology, Nutrition and MetabolismRejectedMVC measures at a long musclelength (e.g., familiarisation session)should be scheduled more than aweek before MaxECCA few MVCs can be used as a “preconditioning” exercise to attenuatepotential muscle damageEvery muscle contraction counts anda few MVCs is better than nothing55RevisedSubmitted toEuropean Journal of Applied PhysiologyArticle56Design a “Publishable” Study Find a good topic Know the background of the study(what is the originality of the study?) Set a clear research question andhypothesis Assume “comments” from reviewerswhen designing a study (e.g. sample size,reliability, validity, statistical analysis)61Key Factors Clear research questionLogical hypothesisOriginalityRationale SignificanceReasonable approach to the questionReliable methodsAppropriate analysis and interpretation62Exercise 1Exercise 2What do you want to study? List three “questions” that you wantto know from “research”Explain how important and excitingyour research question is–Why is it important?–How is it exciting?– 1– 2– 3575810

Exercise 3Exercise 4If you have an unlimited funding, howwill you design a study to answerthe research question? Aim(s)Explain the following in ONE sentence Background Aim(s) Methods Methodology Timeline5960Brain Storming Diabetes Physical fitness tests for children Effects of pray on healthThank youvery muchQuestions?Comments? Influence of fasting on performance60Ken Nosakak.nosaka@ecu.edu.au11

13-s rest between contractions 60-s rest between sets 11 Statistical Analyses Changes in muscle strength, optimum angle, ROM, muscle soreness, and plasma CK activity and myoglobin concentration following eccentric exercise Two-way repeated measures ANOVA to compare three groups (CON vs SS vs PNF) andbetween two groups (CON vs SS, CON vs

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