Thesis (MSc)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: This thesis aims to determine whether supplementation with a grape-seed derived antioxidant, oligomeric proanthocyanidin (PCO) or the glutathione precursor, N-acetylcysteine (NAC) may prove beneficial as treatment for exercise induced muscle damage (EIMD) in athletes. In this double-blind cohort study, 21 healthy, uninjured male rugby-players in mid-season training phase, aged between 18 and 25 years were randomly divided into three treatment groups. Participants received 210 mg PCO, NAC or placebo treatment for 9 consecutive days. The study comprised a 6-day wash-out period (protocol days: -12 to -7), followed by a 6-day supplement loading period (protocol days: -6 to -1) a plyometric exercise intervention (protocol day 0) and continued supplementation for 2 days (protocol days: 1 to 2). The exercise intervention comprised 15 sets of 10 near maximal, vertical plyometric squat jumps. Blood samples and delayed onset of muscle soreness (DOMS) scores were collected on protocol days: -6, 0, 1 and 2. Assessments included serum creatine kinase (CK) activity, oxygen radical absorbance capacity (ORAC), malondialdehyde (MDA) and soluble vascular cell adhesion molecule-1 (sVCAM-1) concentrations over time as well as a differential circulating leukocyte count (neutrophils, lymphocytes, monocytes, eosinophils and basophils). Data analysis of CK activity revealed no significant differences between groups. However, PCO treatment prevented a significant peak in the CK response at 24 h (as seen in the placebo and NAC groups) when compared to baseline, pre and post readings (p<0.05). NAC supplementation significantly improved serum ORAC after the exercise intervention. By 48 h, serum ORAC had improved significantly from readings taken immediately post exercise (p<0.05) only in the NAC group. For all groups, absolute neutrophil counts peaked at 6 h post exercise from baseline or pre readings (p<0.05). In both NAC and placebo treated groups, neutrophil counts had decreased significantly in circulation by 24 h post exercise from the 6 h time-point (p<0.05). However, neutrophil counts only reached significantly lower levels by 48 h post exercise (p<0.05) in the group supplemented with PCO. The monocyte count also peaked significantly at 6 h post exercise when compared with other time-points before and after the exercise intervention (p<0.05) in all treatment groups. Neither antioxidant treatment significantly altered the responses of other leukocyte sub-populations, MDA or sVCAM-1 concentrations where main effects of plyometric exercise was evident. Although not statistically significant, a trend toward diminished sVCAM-1 expression with either antioxidant supplementation was apparent. These findings suggest that PCO supplementation (210mg/d) which includes a 7 day loading period may diminish plyometric EIMD by limiting (but not completely inhibiting) the neutrophil response. Secondary muscle damage may be prevented by partially blunting neutrophil infiltration, rather than only quenching free radicals released during the neutrophil oxidative burst. Furthermore, the finding that NAC supplementation improves serum ORAC only after exercise may provide added benefit when administered in combination with PCO. / AFRIKAANSE OPSOMMING: Hierde tesis is daarop gerig om vas te stel of aanvulling met ‘n druifsaadekstrak (DSE) gederiveerde antioksidant: pro-antosianiedoliese oligomeer (PSO), of die glutathione voorloopermolekule, N-asetielsistien (NAS) voordelig beskou kan word as behandeling vir atlete onderhewig aan spierskade veroorsaak deur oefening. Gedurende hierdie dubbelblinde kohort studie is 21 gesonde, manlike rugbyspelers sonder beserings tussen die ouderdom van 18 en 25 jaar in middel-seison fase ewekansig in drie behandelingsgroepe verdeel. Deelneemers het elk 210 mg PSO, NAS of placebo-aanvulling geneem vir nege agtereenvolgende dae. Die studie het bestaan uit ‘n 6-dag uitwasperiode (protokoldae: -12 tot -7), as ook ‘n 6-dag aanvullings periode (protokoldae: -6 tot -1), gevolg deur ‘n pliometriese oefeningsintervensie (protokol dag 0) en verdere aanvulling tot en met 2 dae na die oefening (protokol dae: 1 tot 2). Die oefeningsintervensie het 15 stelle van 10 naastenby maksimale, vertikale pliometriese hurkspronge behels. Bloedmonsters en vertraagde aanvang spierseerheid (VAS) tellings is op protokoldae: -6, 0, 1 en 2 geneem. Analiese het serum kreatien kinase (KK) aktiwiteit, suurstof radikaal absorpsie kapasiteit (SRAK), Malondialdahied (MDA) en oplospare vaskulêresel adhesie molekule-1 (oVAM-1) konsentrasie bepalings asook ‘n differentiële sirkulerende leukosiet seltelling ingesluit. KK aktiewiteit het geen merkwaardige verskil tussen groepe getoon nie. PSO aanvulling het wel gelei tot die voorkoming van ‘n merkwaardige piek in die KK response soos in die placebo en NAC behandelde groepe bevind is by die 24 h tydspunt in vergelyking met basislyn-, voor- en na-oefeningslesings (p<0.05). NAS het ‘n merkwaardige verbetering in serum SRAK getoon, maar eers teen 48 h na oefening. Slegs die NAS behandelde groep het op hierdie tydspunt ‘n betekenisvolle verbetering in SRAK getoon in vergelyking met lesings direk na oefening (p<0.05). Vir alle groepe is ‘n betekenisvolle toename in absolute neutrophiltellings waargeneem 6 h na oefening in vergelyking met basislyn- en vooroefeningslesings (p<0.05). Beide NAS en placebo-behandelde groepe het ‘n betekenisvolle afname in neutrophiltellings teen 24 h na oefening getoon in vergelyking met die 6 h tydspunt (p<0.05) maar met die PSO-behandelde groep word hierde afname eers teen 48 h waargeneem (p<0.05). Monosiettellings het in alle groepe 6 h na oefening ‘n betekinsvolle piek getoon (p<0.05). Waar slegs die hoofeffek van die pliometriese oefening betekenisvol was, het nie een van die twee antioksidant aanvullings ‘n merkwaardige verandering aan die respons van ander leukosiet sub-populasies, MDA of oVAM-1 konsentrasies getoon nie. Al kon statistiese beduidenheid nie bewys word nie, wil dit blyk dat ‘n verminderde oVAM-1 uitdrukking onstaan het in die geval van beide antioksidant-behandelde groepe. Tesame stel hierdie bevindinge voor dat PSO toediening (210mg/d) insluitende ‘n 7-dag aanvullingsperiode die vermoë verleen om die neutrophielrespons gedeeltelik te onderdruk (sonder om dit heeltemal te inhibeer) en sodoende spierskade verminder. Dus word verdere spierskade moontlik verlaag deur die voorkoming van neutrophil weefsel infiltrasie eerder as verwydering van reaktiewe spesies wat vrygestel word tydens oefening. Die bevinding dat NAS aanvulling serum SRAK eers na oefening merkwaardig verbeter, kan as voordelig beskou word, veral wanneer toegedien in samewerking met PSO om verdere spierskade te voorkom en herstelling vinniger te bewerkstellig.

Träningsvärk efter fysisk aktivitet är ett välkänt fenomen. Vad som ligger bakomträningsvärkens effekter såsom smärta och nedsatt rörlighet är mindre välkänt. Träningsvärk, eller ”delayed onset muscle soreness” (DOMS), har i forskningenantagits bero på muskelskada och inflammation i skelettmusklerna efter att ovana ellerexcentriska övningar utförts. Försöken att lindra träningsvärkens effekter har varitmånga, t ex genom antiinflammatoriska läkemedel (NSAID). Syftet med dennasystematiska litteraturstudie var att svara på frågeställningen hur ibuprofen påverkarträningsvärk där hypotesen att ibuprofen skulle ha en dämpande effekt på träningsvärkantogs. Nio artiklar granskades för att besvara hypotesen utan att några slutsatser omibuprofens inverkan på träningsvärk kunde dras då resultaten pekade åt olika håll ochinga tendenser kunde observeras. Den slutsats som kunde dras utifrån litteraturstudienvar att ytterligare forskning på området är behövlig. Om studier inte kan visa att NSAIDdämpar träningsvärk så kan det ifrågasättas om inflammation är orsaken tillträningsvärken. Ytterligare studier på området är viktigt då NSAID är vanligtförekommande som smärtlindrande läkemedel samtidigt som det har biverkningar. Det finns också forskning som tyder på att NSAID kan ha negativ inverkan på de positivaeffekter som är av intresse i träningssammanhang.

Após a realização de uma sessão de treinamento (ST) é comum a ocorrência do fenômeno denominado dano muscular induzido pelo exercício (DMIE), que se caracteriza por prejuizos a estrutura da fibra muscular, com ruptura de alguns sarcômeros, desordem miofibrilar e alargamento das linhas Z. Ainda em consequência ao DMIE, surgem alguns sintomas que são utilizados como marcadores indiretos: dor muscular de início tardio (DMIT), redução na produção de força, aumento de enzimas e proteínas na corrente sanguínea e inchaço. O presente estudo examinou os efeitos da suplementação nutricional a fim de minimizar os efeitos deletérios do DMIE em 3 experimentos. No 1° estudo, 36 indivíduos inexperientes em treinamento de força (TF) foram suplementados com: placebo (PLA, n=12, 50mg·kg-1 de carboidrato); leucina (LEU) baixa dose (LBD, n=12, 50mg·kg-1 de LEU + 50mg·kg-1 de carboidrato) e LEU alta dose (LAD, n=12, 250mg·kg-1 de LEU + 50mg·kg-1 de carboidrato) por 6 dias antecedentes a sessão de treinamento (ST), e nos 3 dias seguintes. Foi observada redução significante, p<0.05, na dor muscular de início tardio (DMIT) do peitoral por palpação, e alongamento nos momentos 48h, e 72h após a ST no grupo LBD comparado ao PLA. A redução no teste de 1 repetição máxima (1RM) apresentou significância no grupo PLA em todos momentos após ST. O aumento na atividade da creatina quinase (CK) foi significante no grupo PLA comparado ao LAD em 24h, 48h e 72h após a ST, enquanto o aumento da concentração de mioglobina (Mb) foi significante no grupo PLA comparado ao grupo LBD e LAD em 24h, 48h e 72h após a ST. O 2° estudo contou com a participação de 28 indivíduos com até 6 meses de experiência em TF. Os sujeitos foram suplementados com 3g de &beta;-hidroxi-&beta;-metilbutirato (HM) por 14 dias (H14, n=07); 7 dias (H07, n=07) e placebo por 14 dias (P14) ou 7 dias (P07, n=07) antecedentes a ST, e nos 3 dias seguintes. O aumento da DMIT por palpação e alongamento foi significante no grupo P14 comparado ao H14 em 24h (apenas alongamento), 48h e 72h após ST, ainda no momento 72h o grupo P07 era superior ao H07. A redução no teste de 1RM ocorreu nos 4 grupos imediatamente após, foi mantida em 24h após a ST nos grupos H14, H07 e P07, sem diferenças entre os grupos. O aumento na concentração de Mb foi significante no grupo P14 comparado ao grupo H14. No 3° estudo, 24 indivíduos experientes em TF foram suplementados com 7g de arginina (ARG, n=12) ou placebo (PLA, n=12, 7g carboidrato) 30 minutos pré-ST. O grupo PLA apresentou aumento significante na DMIT por palpação em 24h comparado ao grupo ARG. A redução no teste de 1RM alcançou significância apenas em 24h após a ST no grupo PLA, mas sem diferença entre os grupos. Os resultados do presente estudo permitem concluir que a suplementação nutricional implementada atenuou o comportamento de alguns marcadores indiretos DMIE, com maior efeito para a DMIT e parametros bioquímicos / After performing a training session (TS) is common the occurrence of the phenomenon called muscle damage induced by exercise (DMIE), which is characterized by damage to muscle fiber structure, breaking some sarcomeres, myofibrillar disorder and extension lines Z. As a consequence of DMIE, there are some symptoms that are measured as indirect markers: delayed onset muscle soreness (DOMS), reduction in strength production, increase of enzymes and proteins in the bloodstream, and swelling. The effect of nutritional interventions to minimize deleterious responses associated with exercise-induced muscle damage (EIMD) were investigated in 3 experiments. In study 1, 36 inexperienced subjects in resistance training (RT) were supplemented for 6 days prior to the training session (TS), and in the following 3 days with: placebo (PLA, n=12, 50mg·kg-1 of carbohydrate); leucine (LEU) low dose (LLD, n=12, 250mg·kg-1 LEU + 50mg·kg-1 + carbohydrate) and LEU high dose (LHD, n=12, 250mg·kg-1 LEU + 50mg·kg-1 + carbohydrate). There was a significant reduction (p <0.05) in delayed onset muscle soreness (DOMS), of the chest by palpation and stretching at 48h, after TS in the LLD group compared to PLA. A significant reduction in the one repetition maximum (1RM) test was observed in the PLA group at all times after TS. The increase in creatine kinase (CK) activity was significant in the PLA group compared to the LHD in 24h, 48h and 72h after TS, while the increase in myoglobin concentration (Mb) was significant in the PLA group compared to the LLD and LHD group in 24h, 48h, and 72h after TS. In study 2, 28 subjects with up to 6 months of RT experience were supplemented with 3g of &beta;-hydroxy-&beta;-methylbutyrate (HM&beta;) for 14 days (H14, n=7); for 7 days (H07, n=7), and placebo for 14 days (P14, n=7) or 7 days (P07, n=7) antecedent to ST, and in the next 3 days. The increase in DOMS by palpation and stretching was significant in the P14 group compared to H14 in 24h (stretching only), 48h and 72h after TS, yet at 72h the P07 group was higher than H07. The reduction in the 1RM test occurred in the 4 groups immediately after and maintained within 24h after TS in groups H14, H07 and P07, and there was no difference between groups. The increase in Mb concentration was significant in the P14 group compared to the H14 group. In study 3, 24 resistance-trained subjects were supplemented with 7g of arginine (ARG, n=12) or placebo (PLA, n=12, 7g of carbohydrate) 30 minutes pre- TS. The PLA group presented a significant increase in DOMS by palpation in 24h compared to the ARG group, and a significant reduction in the 1RM test only in 24h after ST in the PLA group, but without a significant difference between groups. The results of the present study suggest that the responses of indirect markers associated with EIMD were attenuated by nutritional interventions, with greater effect for DOMS and biochemical parameters

Após a realização de uma sessão de treinamento (ST) é comum a ocorrência do fenômeno denominado dano muscular induzido pelo exercício (DMIE), que se caracteriza por prejuizos a estrutura da fibra muscular, com ruptura de alguns sarcômeros, desordem miofibrilar e alargamento das linhas Z. Ainda em consequência ao DMIE, surgem alguns sintomas que são utilizados como marcadores indiretos: dor muscular de início tardio (DMIT), redução na produção de força, aumento de enzimas e proteínas na corrente sanguínea e inchaço. O presente estudo examinou os efeitos da suplementação nutricional a fim de minimizar os efeitos deletérios do DMIE em 3 experimentos. No 1° estudo, 36 indivíduos inexperientes em treinamento de força (TF) foram suplementados com: placebo (PLA, n=12, 50mg·kg-1 de carboidrato); leucina (LEU) baixa dose (LBD, n=12, 50mg·kg-1 de LEU + 50mg·kg-1 de carboidrato) e LEU alta dose (LAD, n=12, 250mg·kg-1 de LEU + 50mg·kg-1 de carboidrato) por 6 dias antecedentes a sessão de treinamento (ST), e nos 3 dias seguintes. Foi observada redução significante, p<0.05, na dor muscular de início tardio (DMIT) do peitoral por palpação, e alongamento nos momentos 48h, e 72h após a ST no grupo LBD comparado ao PLA. A redução no teste de 1 repetição máxima (1RM) apresentou significância no grupo PLA em todos momentos após ST. O aumento na atividade da creatina quinase (CK) foi significante no grupo PLA comparado ao LAD em 24h, 48h e 72h após a ST, enquanto o aumento da concentração de mioglobina (Mb) foi significante no grupo PLA comparado ao grupo LBD e LAD em 24h, 48h e 72h após a ST. O 2° estudo contou com a participação de 28 indivíduos com até 6 meses de experiência em TF. Os sujeitos foram suplementados com 3g de &beta;-hidroxi-&beta;-metilbutirato (HM) por 14 dias (H14, n=07); 7 dias (H07, n=07) e placebo por 14 dias (P14) ou 7 dias (P07, n=07) antecedentes a ST, e nos 3 dias seguintes. O aumento da DMIT por palpação e alongamento foi significante no grupo P14 comparado ao H14 em 24h (apenas alongamento), 48h e 72h após ST, ainda no momento 72h o grupo P07 era superior ao H07. A redução no teste de 1RM ocorreu nos 4 grupos imediatamente após, foi mantida em 24h após a ST nos grupos H14, H07 e P07, sem diferenças entre os grupos. O aumento na concentração de Mb foi significante no grupo P14 comparado ao grupo H14. No 3° estudo, 24 indivíduos experientes em TF foram suplementados com 7g de arginina (ARG, n=12) ou placebo (PLA, n=12, 7g carboidrato) 30 minutos pré-ST. O grupo PLA apresentou aumento significante na DMIT por palpação em 24h comparado ao grupo ARG. A redução no teste de 1RM alcançou significância apenas em 24h após a ST no grupo PLA, mas sem diferença entre os grupos. Os resultados do presente estudo permitem concluir que a suplementação nutricional implementada atenuou o comportamento de alguns marcadores indiretos DMIE, com maior efeito para a DMIT e parametros bioquímicos / After performing a training session (TS) is common the occurrence of the phenomenon called muscle damage induced by exercise (DMIE), which is characterized by damage to muscle fiber structure, breaking some sarcomeres, myofibrillar disorder and extension lines Z. As a consequence of DMIE, there are some symptoms that are measured as indirect markers: delayed onset muscle soreness (DOMS), reduction in strength production, increase of enzymes and proteins in the bloodstream, and swelling. The effect of nutritional interventions to minimize deleterious responses associated with exercise-induced muscle damage (EIMD) were investigated in 3 experiments. In study 1, 36 inexperienced subjects in resistance training (RT) were supplemented for 6 days prior to the training session (TS), and in the following 3 days with: placebo (PLA, n=12, 50mg·kg-1 of carbohydrate); leucine (LEU) low dose (LLD, n=12, 250mg·kg-1 LEU + 50mg·kg-1 + carbohydrate) and LEU high dose (LHD, n=12, 250mg·kg-1 LEU + 50mg·kg-1 + carbohydrate). There was a significant reduction (p <0.05) in delayed onset muscle soreness (DOMS), of the chest by palpation and stretching at 48h, after TS in the LLD group compared to PLA. A significant reduction in the one repetition maximum (1RM) test was observed in the PLA group at all times after TS. The increase in creatine kinase (CK) activity was significant in the PLA group compared to the LHD in 24h, 48h and 72h after TS, while the increase in myoglobin concentration (Mb) was significant in the PLA group compared to the LLD and LHD group in 24h, 48h, and 72h after TS. In study 2, 28 subjects with up to 6 months of RT experience were supplemented with 3g of &beta;-hydroxy-&beta;-methylbutyrate (HM&beta;) for 14 days (H14, n=7); for 7 days (H07, n=7), and placebo for 14 days (P14, n=7) or 7 days (P07, n=7) antecedent to ST, and in the next 3 days. The increase in DOMS by palpation and stretching was significant in the P14 group compared to H14 in 24h (stretching only), 48h and 72h after TS, yet at 72h the P07 group was higher than H07. The reduction in the 1RM test occurred in the 4 groups immediately after and maintained within 24h after TS in groups H14, H07 and P07, and there was no difference between groups. The increase in Mb concentration was significant in the P14 group compared to the H14 group. In study 3, 24 resistance-trained subjects were supplemented with 7g of arginine (ARG, n=12) or placebo (PLA, n=12, 7g of carbohydrate) 30 minutes pre- TS. The PLA group presented a significant increase in DOMS by palpation in 24h compared to the ARG group, and a significant reduction in the 1RM test only in 24h after ST in the PLA group, but without a significant difference between groups. The results of the present study suggest that the responses of indirect markers associated with EIMD were attenuated by nutritional interventions, with greater effect for DOMS and biochemical parameters