Objectives: Men who receive androgen deprivation therapy (ADT) for prostate cancer (PCa) are at risk of several adverse effects that can be detrimental to both their physical and mental health. Common adverse effects include weight gain, muscle wasting, cardiovascular morbidity, fatigue and impaired quality of life (QOL). This study tested whether a combined aerobic and resistance exercise program can alleviate some of these symptoms in men receiving ADT. Design: Men with PCa, aged 50-80 years, receiving ADT were recruited to participate in this prospective randomized controlled trial. Subjects were assigned to a usual care group (UCG) or an exercise intervention group (EIG). The EIG completed a 16 week combined aerobic and resistance exercise program. Outcomes measures were assessed at baseline, 16 weeks, and 24 weeks and included: cardio-respiratory fitness; muscle strength and endurance; body composition; and reports of QOL, fatigue, mood, partner relations, and exercise behaviour. Results: Fifteen men were recruited to this study, but two participants in the EIG did not finish the study leaving the EIG with an n = 6 and the UCG with an n = 7. The exercise program did not lead to changes in weight, BMI or body fat. There was a small, close to significant, increase in muscle mass in the EIG over the intervention period (p = 0.052). This is encouraging as it demonstrates that exercise can counteract the catabolic effects of ADT. Interestingly, cardio-respiratory fitness improved over the course of the study for both groups. Muscular fitness, however, improved only for the EIG. There was a significant difference in chest press strength (p = 0.041) and leg press strength was bordering significance (p = 0.058). Unexpectedly, QOL declined for both groups during the intervention (p = 0.029). Participants in both groups also reported increased levels of fatigue from baseline to 24 weeks, although these changes were not significant (p = 0.586). Mood worsened over the study period for both groups from baseline to 16 weeks, but this increase in anxiety and depression was reduced at the follow-up period. These changes, too, were not significant (p = 0.364). Reports of partner relationships trended towards lower scores from baseline to 16 weeks. The men’s report in both groups and the women’s report in the EIG improved at the 24 week mark, but women in the UCG experienced further decline. Surprisingly, participants in both groups reported increases in exercise behaviour from baseline to 24 weeks. This could account for the lack of difference found in many of the measures. The power of this study was 0.22. Conclusion: Although this was a small study, it showed that a combined aerobic and resistance exercise program can have some positive benefits for men with PCa who are receiving ADT. Larger trials are needed to further examine the role of exercise in ameliorating the side effects of ADT, particularly in the areas of mood and partner relationships.

Resistance exercise using weights typically offers constant external load during coupled shortening (concentric) and lengthening (eccentric) muscle actions in sets of consecutive repetitions until failure. However, the constant external load and the inherent capability of skeletal muscle to produce greater force in the eccentric compared with the concentric action, would infer that most actions are executed with incomplete motor unit involvement. In contrast, use of the inertia of flywheels to generate resistance allows for maximal voluntary force to be produced throughout the concentric action, and for brief episodes of greater eccentric than concentric loading, i.e. “eccentric overload”. Thus, it was hypothesized that acute flywheel resistance exercise would induce greater motor unit and muscle use, and subsequent fatigue, compared with traditional weight stack/free weight resistance exercise. Furthermore, it was hypothesized that flywheel training would induce more robust neuromuscular adaptations compared with training using weights. A total of 43 trained and untrained men were investigated in these studies. Knee extensor muscle activation, fatigue response and muscle use were assessed during exercises by recording electromyographic signals and by means of functional magnetic resonance imaging, respectively. Flywheel resistance exercise provoked maximal or near maximal muscle activation from the first repetition, induced robust fatigue, and prompted more substantial motor unit and muscle use than weight stack/free weight resistance exercise in both novice and resistance trained men. Both prior to and following five weeks of unilateral knee extension training, the eccentric muscle activation was greater with flywheel than weight stack training. Furthermore, weight stack training generated greater increases of dynamic strength and neural adaptations, while flywheel training generated more prominent hypertrophy of individual quadriceps muscles and greater improvement of maximal isometric strength. Hence, due to the preferential metabolic cost of the concentric rather than eccentric actions, the maximal activation through the entire range of the concentric action within each repetition of a set during flywheel resistance exercise probably evoked the marked fatigue, and prompted more substantial muscle use than resistance exercise using weights. Furthermore, while any cause‐effect relationship remains to be determined, results of the pesent study suggest that brief episodes of “eccentric overload” amplify muscular adaptations following concentriceccentric resistance training.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniv. / Härtill 5 uppsatser.

<p>Sarcopenia is the age-associated loss of muscle mass and strength. Studies have shown that combining resistance training with high protein intake increases muscle mass and strength in older adults. Women are at higher risk than men of sarcopenia. Thus, it is essential to find interventions to lessen women’s risk of losing muscle mass with aging. However, limited studies combine a specific higher-protein diet and a resistance training program in older women to determine skeletal muscle responses. This study aimed to assess the impact of a 12-week resistance training program with a high protein lean beef diet on skeletal muscle mass, strength, and quality in older women compared to a normal protein diet or a high protein diet composed of a lesser amount of beef. </p> <p>The study included three diets; a USDA recommended protein diet (0.8 g/kg/day), a high protein lean beef diet (1.4 g/kg/day), and a high protein diet composed of lesser beef (1.4 g/kg/day). Sixteen subjects were included in the study. The resistance training program consisted of leg extension, leg press, leg curl, chest press, and seated row. Muscle strength was determined by one-repetition maximum assessment at weeks one, six, and twelve. In addition, subjects underwent an MRI pre- and post-intervention to assess quadriceps volume and intermuscular adipose tissue (IMAT). Muscle quality was defined as the leg extension one-repetition maximum over the quadriceps volume. </p> <p>Muscle strength, muscle quality, and quadriceps volume increased with training in all three diet groups (P<0.05, main effect of time). No difference in muscle strength, quality, or quadriceps volume was found between the diet groups. IMAT decreased in all diet groups (P<0.05, main effect of time), but no differences were seen between the diet groups. These findings suggest that the 12-weeks of resistance training increased skeletal muscle strength, quality, and mass, independent of the normal protein or high protein diet and the source of protein in the diet.</p>

No description available.

The effects of low carbohydrate (CHO), high fat (LCHF) diets on adaptations to high-intensity exercise have recently gained interest. Consuming a LCHF may potentially decrease the ability to use CHO during exercise and impair high-intensity exercise adaptations. Therefore, the purpose of this investigation was to examine the importance of CHO timing while consuming a LCHF diet and completing a high-intensity exercise program. Eighteen resistance trained males were randomized into two treatment groups. Both groups completed 6 weeks of a high-intensity exercise training program with the first 2 weeks serving as familiarization to resistance training (RT) 3 days per week and completing one high-intensity interval training (HIIT) session. During the final 4 weeks, participants trained 5 days per weeks, three days of RT and two days of HIIT (repeated 30 s all out sprints). All participants consumed a LCHF diet (~25%, ~25%, and ~50% of daily kilocalorie intake coming from CHO, protein, and fat). The supplemented (SUPP) group (n=9) consumed 30 g of CHO during exercise and 40 g of CHO immediately after each exercise session. The remainder of the SUPP groups daily CHO intake came outside of training. The non-supplemented (NONSUPP) group (n=9) consumed an artificially flavored placebo during exercise. The NONSUPP group had the same daily CHO intake as the SUPP group, with the only difference being CHO timing. Dependent variables measured pre-and post-training included back squat and bench press one-repetition maximums, peak oxygen consumption (V̇O2 peak), power output (Wingate test), body composition, fasted glucose, insulin, and testosterone, and gastrointestinal distress (GID) during exercise. Both groups significantly improved back squat and bench press strength, biceps thickness, absolute and relative V̇O2 peak, and power output. Respiratory exchange ratio was significantly lower and time to exhaustion significantly increased during the post V̇O2 peak test. However, there were no changes in resting glucose, insulin, and testosterone or body fat. RT and HIIT caused significant increases in GID, independent of beverage content, with no differences between training. Our results suggest that CHO timing has no impact on adaptations to exercise training, but favorable training adaptations can be made while consuming a LCHF diet.

No description available.

This study determined the effect of milk or carbohydrate-electrolyte supplementation immediately after resistance exercise on muscle protein breakdown before and after a 10-week resistance training program. Nineteen untrained males, 18-25 years of age, consumed either a carbohydrate-electrolyte (CHO) or milk (MILK) beverage immediately after a strenuous leg resistance exercise bout, both before and after training. Muscle protein breakdown, as estimated by 3-methylhistidine-to-creatinine ratio, was significantly reduced after resistance exercise for both groups, as the ratio was decreased by 19.9% from baseline on the day of resistance exercise. A trend was present for a training effect for 3-methylhistidine-to-creatinine ratio (p<0.07), as the reduction from before to after resistance exercise was greater after training. There was no difference in muscle protein breakdown between the groups. One hour after exercise, serum concentrations of amino acids were significantly elevated for MILK and significantly reduced for CHO. Serum glucose was significantly higher for both groups 30 minutes post-exercise than baseline, and serum insulin was greater than baseline 30 minutes and 1 hour after exercise. Serum insulin was significantly greater for CHO than MILK 1 hour after resistance exercise. No effect of training was observed for the response of serum amino acids, glucose, or insulin to resistance exercise with beverage ingestion. In conclusion, although the type of beverage ingested post-exercise affected serum insulin and amino acid concentrations, it did not influence the reduction in muscle protein breakdown observed after resistance exercise. A trend was present for a greater reduction in protein breakdown after training. / Master of Science

This study examined the effects of carbohydrate supplementation on resistance exercise performance, cortisol levels, and creatine kinase levels in trained males undergoing energy restriction. Sixteen experimental subjects were randomly assigned to a carbohydrate (C, n=8) or placebo group (P, n=8). The remaining six subjects served as controls (N). Performance tests were done before (Trials 1 and 2) and after (Trial 3) energy restriction. Experimental subjects consumed a low calorie formula diet for three days (18 kcal-1 kg-1 d-1). They had blood drawn before and after T2 and T3. For T3, they consumed either a carbohydrate (1g kg-1) or a placebo beverage 30 minutes before exercise. There was a significant increase in resting cortisol levels following energy restriction. CK levels were significantly elevated after exercise, suggestion muscle damage. Carbohydrate supplementation had no effect on blood glucose, cortisol, creatine kinase, or RPE. The number of repetitions performed during the final set of bench press showed significant interaction between groups and time. P and N increased the number of repetitions performed from T2 to T3 (15.0 + 1.4 to 17.3 + 0.8 for P, 15.0 + 2.7 to 16.7 + 2.3 for N). C decreased the number of repetitions performed 17.6 + 0.7 to 17.3 + 1.0). The number of repetitions performed during the final set of leg extensions showed no interaction between groups and time (p=0.801). This study did not support a benefit of consuming carbohydrate prior to resistance exercise for dieting athletes but illustrates that energy restriction increases a catabolic hormone. / Master of Science

Bakgrund: Generaliserat ångestsyndrom (GAD) är en vanlig diagnos med negativa konsekvenser såväl på individ- som samhällsnivå. För att som fysioterapeuter kunna fånga upp den här typen av patienter och då ha god kunskap om olika träningsformer som tillförlitlig behandling ansågs det fördelaktigt att undersöka det vetenskapliga underlaget för styrketräning som behandlingsmetod. Syfte: Syftet med denna litteraturstudie var att undersöka det vetenskapliga underlaget för effekten av styrketräning, i jämförelse med annan eller ingen intervention, som behandlingsmetod för att minska oros- och ångestsymtom hos vuxna mellan 18-64 år med GAD. Metod: En litteraturstudie av randomiserade kontrollerade studier där populationen var vuxna mellan 18-64 år med GAD. Sökningar genomfördes i databaserna PubMed, Cochrane, PEDro och Psycinfo. Fyra studier inkluderades och granskades sedan med PEDro. Den sammanvägda tillförlitligheten av resultatet av tre studier bedömdes med hjälp av GRADEstud. Resultat: Det vetenskapliga underlaget för styrketräning som behandling för personer med GAD är för begränsat för att kunna dra några starka slutsatser. Alla inkluderade studier visade dock på reducering av oros- och ångestsymtom, som båda är kännetecknande symtom för GAD. Konklusion: Det sammanvägda resultatet indikerar på att styrketräning skulle kunna vara en alternativ behandlingsmetod för denna patientgrupp. Mer forskning behövs dock för att kunna utvärdera effekten av styrketräning som behandling för personer med GAD. / Background: Generalized anxiety disorder (GAD) is a common diagnosis with negative consequences both on an individual and societal level. In order for physiotherapists to be able to catch these patients and then have good knowledge of different forms of exercise as reliable treatment, it was considered beneficial to investigate the scientific basis for resistance exercise training as a treatment method. Objective: The aim of this literature review was to investigate the scientific basis for the effect of resistance exercise training, in comparison with other or no intervention, as a treatment method to reduce worry and anxiety symptoms in adults aged 18-64 with GAD. Method: A literature review of randomized controlled trials where the population was adults between 18-64 years old with GAD. Searches were conducted in the databases PubMed, Cochrane, PEDro and Psycinfo. Four studies were included and reviewed with PEDro. The combined reliability of the results of three studies was assessed using GRADEstud. Results: The scientific basis for resistance exercise training as a treatment for people with GAD is too limited to be able to draw any strong conclusions. However, all included studies showed a reduction in worry and anxiety symptoms, both of which are characteristic symptoms of GAD. Conclusion: The combined results indicate that strength training could be an alternative treatment method for this patient group. However, more research is needed to be able to evaluate the effect of strength training as a treatment for people with GAD.