Medicinski Zurnal PDF

VO L U M E 5 3 - S u p p l . 1 t o N o.
3 - J U N E 2 0 1 3
MODERN TRENDS
IN STRENGTH AND CONDITIONING
Guest Editor
CARLO BALDARI
MODERN TRENDS
Guest Editor
CARLO BALDARI
EDIZIONI MINERVA MEDICA

TORINO 2013
THEJOURNAL OF
SPORTS MEDICINE
Vol. 53
AND
PHYSICAL FITNESS
June 2013
Suppl. 1 to No. 3
Contents
MODERN TRENDS
Guest Editor
CARLO BALDARI
olecular and cellular basis of the effects of mechanical load on the musculoskeletal system
M
MIGLIACCIO S., WANNENES F., LENZI A., GUIDETTI L.
ffect of two different strength training volumes on muscle hypertrophy and quality in elderly women
E
R
ADAELLI R., WILHELM E. N., BOTTON C. E., BOTTARO M., CADORE E. L., BROWN L. E., PINTO R. S.
12

18

Influence of exercise order on blood pressure and heart rate variability after a strength training session
Effects of movement speed and intensity on fast excess postexercise oxygen consumption of bench press and half squat
exercises performed to failure

25

30

38

FIGUEIREDO T., MENEZES P., KATTENBRAKER M. S., POLITO M. D., REIS V. M., SIMO R.
SOUSA M. S. C., ARAJO JNIOR A. T., LIMA NETO A. J., VILAA-ALVES J., FERNANDES H. M., REIS V. M.
Effects of different isokinetic knee extension warm-up protocols on muscle performance
ERREIRA-JNIOR J. B., VIEIRA C. A., SOARES S. R. S., MAGALHES I. E. J., ROCHA-JNIOR V. A., VIEIRA A.,
F
BOTTARO M.
Biomechanical determinants of force production in front crawl swimming
IBEIRO J., DE JESUS K., FIGUEIREDO P., TOUSSAINT H., GUIDETTI L., ALVES F., PAULO VILAS-BOAS J.,
R
FERNANDES R. J.
Combined strength and step aerobics training leads to significant gains in maximal strength and body composition in
women

44

51

57

PEREIRA A., COSTA A. M., IZQUIERDO M., SILVA A. J., MARQUES M. C., WILLIAMS J. H. H.
Chronic effect of the combinations of resistance exercises with static stretching exercises on flexibility levels in trained men
BASTOS C. L., VILAA-ALVES J., REIS V. M., TAVARES G. B., GOMES T. M., NOVAES J.
Effects of 24 weeks of strength training or hydrogymnastics on bone mineral density in postmenopausal women
NOVAES G., NOVAES J., VILAA-ALVES J., FERNANDES H. M., FURTADO H., MENDES R., REIS V. M.
Psychological responses to resistance training in middle-aged and older women
FERNANDES H. M., VILAA-ALVES J., NOVAES G. S., FURTADO H., OLIVEIRA D., AIDAR F. J., SAAVEDRA F.
Vol. 53 - Suppl. 1 to No. 3
THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
MODERN TRENDS IN STRENGTH AND CONDITIONING

Guest editor: CARLO BALDARI
J SPORTS MED PHYS FITNESS 2013;53(Suppl. 1 to No. 3):1-5
Molecular and cellular basis

of the effects of mechanical load on the musculoskeletal system
S. MIGLIACCIO 1, F. WANNENES 1, A. LENZI 2, L. GUIDETTI 3
It is well known that mechanical load plays a pivotal role

in the maintenance of muscle and bone tissues homeostasis.
Definitely, absence of gravity, sedentary life or forced bedrest have been shown to negatively impact on musculoskeletal
health, leading to both osteopenia and muscle loss. Furthermore, an increasing number of data links muscle mass and
strength to the maintenance of bone tissue, suggesting that
physical activity might play a pivotal role in the prevention
of bone loss and osteoporosis. Little, however, is known regarding the molecular and cellular mechanisms, which are
involved in the positive effects of mechanical load on both
muscle and bone tissue. Indeed, mechanical load has been always thought to positively affect musculoskeletal system only
due to the proprioceptor mechanisms. However, it has been
recently shown that both muscle and bone can be defined as
endocrine tissues, producing and secreting several growth
factors, myokines and cytokines which could be the major
actors in the maintenance of musculoskeletal system homeostasis induced by mechanical load. This review will describe
the potential cellular and molecular mechanism(s) involved
in the effects induced by mechanical load.
Key words: Musculoskeletal system - Motor activity - Fitness.
hysical activity appears to play a pivotal role in

the maintenance of optimal musculoskeletal system homeostasis. Bone mass and strength appear to
be highly linked with muscle mass showing a strong
association with both bone mineral content and bone
strength.1, 2 Muscle is a primary source of mechanical stimuli for bone and for a long time this has been
thought to be the primary mechanism by which muscle mass could influence and modulate bone remodelling.3 But our understanding of the relationship be-
Corresponding author: S. Migliaccio, MD, PhD, Department of Movement, Human, and Health Sciences, Foro Italico University, largo Lauro
de Bosis 15, 00195 Rome, Italy. E-mail: silvia.migliaccio@uniroma4.it
1Endocrinology
Unit, Department of Movement

Human and Health Sciences
Foro Italico University, Rome, Italy
2Section of Medical Pathophysiology
Endocrinology and Nutrition
Department of Experimental Medicine
Sapienza University, Rome, Italy
3Exercise and Sport Sciences Unit
Department of Movement, Human, and Health Sciences
Foro Italico University, Rome, Italy
tween skeletal muscle and bone tissue has changed

with the recognition that skeletal muscle is a rich
source of secreted factors generally referred to as
myokines that may have important effects on bone
formation and bone resorption.4-6
Myokines is a short-term proposed by Febbraio
and Pedersen in 2005 7 to indicate muscle-derived
cytokines. In general myokines are cytokines, short
peptides and growth factors which are produced and
released by skeletal muscle fibers to exert their effects in other organs of the body, potentially acting
in an autocrine, paracrine, and/or endocrine manner.7
Using a quantitative proteomics platform Henningsen et al.8 have reported that skeletal muscle C2C12
cells are capable of producing several hundred secreted proteins. Thus, skeletal muscle can be considered an endocrine organ producing and releasing
myokines, which work in a hormone-like fashion
and exert specific endocrine effects on other organs
playing important roles in biological homeostasis
such as energy metabolism, angiogenesis and myogenesis and likely bone remodeling as well.
Additionally, several myokines known to play
MIGLIACCIO
Mechanical load on the musculoskeletal system
a role in bone formation (i.e., IGF-1, Osteonectin,

FGFb) are localized on the muscle/bone interface,
which can be defined as a site of fleshy muscle fiber
insertion into periosteum and excludes tendinous
or aponeurotic attachments.6 Thus, it could be hypothesized that large molecules (e.g., myostatin inhibitors, androgen receptor modulators, or vitamin
D receptor agonists) or mechanical load induced by
physical activity, could selectively enhance muscle
mass, by an increased secretion of osteogenic myokines leading to an improvement of bone homeostasis
and bone strength.6
Interestingly a recent study has shown how different exercise intensity can induce and increase in
myokines levels strongly suggesting an involvement
of paracrine and endocrine regulation influenced by
mechanical load.9
IGF-1
Growth hormone (GH) and insulin-like growth
factor 1 (IGF-1) are essential for the development
and growth of the skeleton and maintenance of bone
mass. IGF-1, which mediates most of the effects of
GH on skeletal metabolism, promotes chondrogenesis and increases bone formation by regulating the
functions of differentiated osteoblasts.10 IGF-1 is
also produced by osteoblasts and it prompts in an
autocrine/paracrine fashion the differentiation of osteoblasts, promoting bone formation.11
Interestingly, it has been recently postulated that
IGF-1 can be also considered a myokine since it has
been demonstrated that it is localized on the musclebone interface in vivo, that it is abundant in homogenized muscle tissue and that it is secreted from cultured C2C12 myotubes in vitro.6, 12 GH-dependent
muscle growth, development and hypertrophy leads
to the secretion of IGF-1 by muscle cells.13
Thus, it is possible to hypothesize that muscle
hypertrophy and bone anabolism might be coupled
through an IGF-1- mediated paracrine signalling
mechanism.
Mechanical stimulation of bone cells may induce
IGF-1 secretion by osteoblasts and fibroblasts and it
has been recently shown that muscle-secreted IGF-1
stimulates bone formation by osteoprogenitor cells
in the periosteum that express IGF-1 receptor (IGF1R).6 Additionally, recent data show interacting roles
of IGF-1 signaling and selected integrins in the bone

response to mechanical load, while unloading results
in decreased integrins expression and also resistance
to the anabolic actions of IGF-1 with consequent
bone loss, strongly suggesting a pivotal role of these
factors in the maintenance of skeletal homeostasis
upon mechanical load. Integrins, insulin like growth
factors modulate skeletal health in response to load.14
IL-6
Interleukin 6 (IL-6) belongs to the IL-6 family
of cytokines, which include IL-11, oncostatin M,
leukemia inhibitory factor, ciliary neurotrophic factor, cardiotrophin-1 and cardiotrophin-like cytokine.
The above mentioned cytokines are characterized by
their common use of the IL-6 receptor b, IL-6 receptor b (IL6-Rb), (also known as gp130 or CD130).
The two IL-6 receptors, gp130 and IL-6Ra (also
called gp80 or CD126), belong to the type I cytokine
receptor family, which also includes leptin, growth
hormone, prolactin, erythropoietin, thrombopoietin,
and granulocyte- and granulocyte/macrophage-colony stimulating factors.15
The cytokine IL-6 was the first myokine found to
be secreted into bloodstream in response to muscle
contraction 16 and it has been defined as a myokine
due to the observation that its levels increase in an
exponential fashion proportional to the duration and
intensity of exercise.17 Interestingly, the increase in
IL-6 levels during exercise is not a consequence of
some working muscle damage (as previously commonly thought) but the cytokine is secreted from
muscle cell in a inflammatory TNFa independent
fashion. These findings suggest that muscular IL-6
has a role in metabolism rather than in inflammation.
In fact, IL-6 expression is markedly increased when
intramuscular glycogen levels are low, suggesting
that IL-6 works as an energy sensor.18-20
High levels of IL-6 are tightly associated with
physical inactivity and metabolic syndrome 17 while
basal levels of IL-6 are reduced after endurance training 21 and muscle disuse leads to elevated circulating
IL-6 levels. These observations are very important
to better clarify the endocrine/paracrine relationship
between skeletal muscle and bone tissue. IL-6 acts
as a pro-osteoclastogenic cytokine being involved
directly, and through the stimulation of other factors
June 2013
such as receptor activator of nuclear factor kappa B

ligand (RANKL), in osteoclastogenesis modulation.
In fact IL-6 regulates the proliferation and differentiation of the early osteoclast precursor cells, the
lifespan of the mature osteoclasts and their resorptive activity.22 Recent results strongly suggest that
the healthy muscle could retain IL-6 at low levels
protecting the skeleton from excessive bone resorption, osteopenia and osteoporosis development.
Moreover, it has been shown that chronically increased systemic levels of IL-6 induce significant
bone loss in growing IL-6 transgenic mice.23 In a panel of circulating pro-osteoclastogenic cytokines evaluated in the sera of a Duchenne Muscular Dystrophy
(DMD) animal model (MDX), IL-6 was increased.24
In the same way, DMD patients showed low bone
mineral density (BMD) Z-scores and high boneresorption marker and serum IL-6. Human primary
osteoblasts from healthy donors incubated with sera
from DMD patients showed decreased nodule mineralization and downregulation of many osteogenic
genes, including osterix and osteocalcin. Treatment
with an IL-6-neutralizing antibody, prevented the decrease of osterix and osteoclacin mRNA induced by
the sera of DMD patients, indicating a role of this
cytokine in the bone-induced effects.
Myostatin
Myostatin, a member of the transforming growth
factor-beta (TGF-) superfamily, is a negative regulator of skeletal muscle growth. During embryogenesis myostatin expression is restricted to developing
skeletal muscles, but myostatin is still expressed and
secreted by skeletal muscles during adult life.25 Myostatin circulates in the blood in a latent form bound
to a propeptide, which is then cleaved by BMP1/
tolloid matrix metalloproteinase releasing the active
form. Active myostatin binds to its receptor, the type
IIB activin receptor (ActRIIB) with high affinity and
regulates the expression of its target genes through a
TGF- signaling pathway. Recent studies also show
that myostatin can activate the p38 MAPK, Erk1/2,
and Wnt pathways.26, 27 This finding is particularly
relevant because it is well known that the Wnt signalling pathway plays a pivotal role in the differentiation pattern of osteoblasts.
Recent data obtained in experimental animal mod-
MIGLIACCIO
els have shown that myostatin-deficient mice have

approximately twice the skeletal muscle mass of normal mice, and null mutations in the myostatin gene
significantly increase muscle mass and decrease
subcutaneous fat in a variety of animals, including
humans.28 Likewise it has been demonstrated that
myostatin is highly expressed in the fracture callus
immediately after injury 29 suggesting a direct role
for this factor also in bone development and morphogenesis.
Although the role of myostatin in muscle growth
regulation has been widely investigated, its role in
regulating bone mass architecture and regeneration
is becoming an area of increased interest for the potential use as pharmacological agent.
Interestingly, genetic studies in human populations
have shown that myostatin gene polymorphisms
are associated with alteration in peak bone mineral
density, and transgenic overexpression of myostatin
propeptide, which inhibits myostatin signaling in
vivo, increases BMD in mice.30
The mechanisms by which myostatin regulates
bone formation are not well understood, but several
studies show a direct effect of myostatin on the proliferation and differentiation of mesenchymal stem
cells, and recent data indicate that myostatin and its
receptor are expressed during bone regeneration.30
These findings reveal that molecules targeting myostatin signaling may be novel, effective therapeutic agents to improve muscle strength, increase bone
mass and prevent falls and bone fractures.31
IL-15
Interleukin 15 (IL-15) is a four-a-helix cytokine,
discovered in 1994, which shares many biological
properties with IL-2. IL-15 mRNA is produced by
a wide variety of cells and tissues but the protein is
poorly expressed.32 Two isoforms of IL-15 exist: a
secreted long signaling peptide form and an intracellular short signaling peptide form.33 IL-15 acts
through a widely distributed heterotrimeric receptor
(IL-15R), which consists of a common g-chain, a bchain shared with IL-2 and a exclusive a-chain (Il15Ra). IL-15 requires the presence of IL-15Ra for
efficient biosynthesis and secretion.34, 35
Skeletal muscle tissue produces very high levels
of IL-15 mRNA and expresses IL-15Ra;36 this ob-
MIGLIACCIO
servation suggests that skeletal muscle could be an

important IL-15 producer but the prove that musclederived IL-15 is secreted into the circulation and acts
on other tissues such as adipose or bone tissue has
not been described as yet. Nevertheless the role of
IL-15 as a myokine is very intriguing since it has
been demonstrated an osteoclastogenic role in bone
remodeling. The elevated levels of IL-15 found in
the synovial fluid of patients with rheumatoid arthritis 37 raised the question whether IL-15 could be
involved in bone pathology and also in bone development and physiology. This cytokine stimulates the
formation of osteoclast-like cells in rat bone-marrow
culture in vitro in a direct pattern and not mediated
by combination of M-CSF, IL3 and CSF or TNFa.38
Therefore, it is conceivable that IL-15 might further
stimulates bone destruction by excessive bone resorption by osteoclasts.38, 39
IL-15 stimulates the proliferation of T cells
and their production of osteoclastogenic factors,
including RANKL, IL-17 and INFg, and in IL15Ra-/- mice bone remodeling was decreased and
microstructure was improved in both the cancellous and cortical bone compartments. However,
IL-15Ra-/- mice did not develop osteopetrosis or
osteoclerosis-like bone pattern, indicating that redundant pathways of osteoclast activity modulation in vivo might partially supersede the absence
of IL-15 signaling.40
Conclusions
In conclusion this brief review highlight the importance the cellular factors secreted by the skeletal
muscle in response to load which could play a pivotal role in the maintenance of skeletal health. Further
studies are needed however, to fully characterize the
molecular mechanisms involve in these events.
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16. Pedersen BK, Febbraio MA. Muscle as an endocrine organ: focus
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17. Pedersen BK, Febbraio MA. Muscles, exerciseandobesity: skeletal
muscle as a secretory organ. Nat Rev Endocrinol 2012;8:457-65.
18. Pedersen BK, Steensberg A, Schjerling P. Muscle-derived interleukin-6: possible biological effects. J Physiol 2001;536(Pt 2):32937.
19. Petersen AM, Pedersen BK. The anti-inflammatory effect of exercise. J Appl Physiol 2005;98:1154-62.
20. Pedersen BK, Akerstrom TC, Nielsen AR, Fischer CP. Role of myokines in exercise and metabolism. J Appl Physiol 2007;103:10938.
21. Fischer CP. Interleukin-6 in acute exercise and training: what is the
biological relevance? Exerc Immunol Rev 2006;12:6-33.
22. Pfeilschifter J, Kditz R, Pfohl M, Schatz H. Changes in proinflammatory cytokine activity after menopause. Endocr Rev 2002;23:90119.
23. De Benedetti F, Rucci N, Del Fattore A, Peruzzi B, Paro R, Longo
M et al. Impaired skeletal development in interleukin-6-transgenic
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24. Rufo A, Del Fattore A, Capulli M, Carvello F, De Pasquale L,
Ferrari S et al. Mechanisms
inducing low bone density in Duchenne muscular dystrophy in mice and humans. J Bone Miner Res
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McPherron AC, Lawier AM, Lee S-J. Regulation of skeletal muscle mass in mice by new TGF-beta superfamily member. Nature
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26. Steelman CA, Recknor JC, Nettleton D, Reecy JM. Transcriptional profiling of myostatin-knockout mice implicates Wnt signaling in postnatal skeletal muscle growth and hypertrophy. Faseb J
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27. Joulia-Ekaza D, Cabello G. The myostatin gene: physiology and
pharmacological relevance. Curr Opin. Pharmacol 2007;7:310-5.
28. Kellum E, Starr H, Arounleut P, Immel D, Fulzele S,Wenger K et
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al. Myostatin (GDF-8) Deficiency Increases Fracture Callus Size,

Sox-5 Expression, and Callus Bone Volume. Bone 2009;44:17-23.
29. Cho TJ, Gerstenfeld LC, Einhorn TA. Differential temporal expression of members of the transforming growth factor beta superfamily
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30. Elkasrawy MN, Hamrick MW. Myostatin (GDF-8) as a key factor
linking muscle mass and bone structure. J Musculoskelet Neuronal
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31. Hamrick MW, Samaddar T, Pennington C, McCormick J. Increased
muscle mass with myostatin deficiency improves gains in bone
strength with exercise. J Bone Miner Res 2006;21:477-83.
32. Grabstein KH, Eisenman J, Shanebeck K, Rauch C, Srinivasan S,
Fung V et al. Cloning of a T cell growth factor that interacts with the
beta chain of the interleukin-2 receptor. Science 1994;264:965-8.
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Waldmann TA, Tagaya Y. The multifaceted regulation of interleukin-15 expression and the role of this cytokine in NK cell differentiation and host response to intracellular pathogens. Annu Rev
Immunol 1999;17:19-49.
34. Bergamaschi C, Rosati M, Jalah R, Valentin A, Kulkarni V, Alicea
C et al. Intracellular interaction of interleukin-15 with its receptor
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Mortier E, Woo T, Advincula R, Gozalo S, Ma A. IL-15Ralpha chaperones IL-15 to stable dendritic cell membrane complexes that activate NK cells via trans presentation. J Exp Med 2008;205:1213-25.
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36. Quinn LS. Interleukin-15: a muscle-derived cytokine regulating fatto-lean body composition. J Anim Sci 2008;86(14 Suppl):E75-83.
37. McInnes IB, al-Mughales J, Field M, Leung BP, Huang FP, Dixon
R et al. The role of interleukin-15 in T-cell migration and activation
in rheumatoid arthritis. Nat Med 1996;2:175-82.
38. Ogata Y, Kukita A, Kukita T, Komine M, Miyahara A, Miyazaki S et
al. A novel role of IL-15 in the development of osteoclasts: inability
to replace its activity with IL-2. J Immunol 1999;162:2754-60.
39. Miranda-Cars ME, Benito-Miguel M, Balsa A, Cobo-Ibez T, P
blood T lymphorez de Ayala C, Pascual-Salcedo D et al. Peripheral
cytes from patients with early rheumatoid arthritis express RANKL
and interleukin-15 on the cell surface and promote osteoclastogenesis in autologous monocytes. Arthritis Rheum 2006;54:1151-64.
40. Djaafar S, Pierroz DD, Chicheportiche R, Zheng XX, Ferrari SL,
Ferrari-Lacraz S. Inhibition of T cell-dependent and RANKLdependent osteoclastogenic processes associated with high levels
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Conflicts of interest.The authors certify that there is no conflict of
interest with any financial organization regarding the material discussed
in the manuscript.
Received on June 12, 2013.
Accepted for publication on June 13, 2013.
Effect of two different strength training volumes

on muscle hypertrophy and quality in elderly women
R. RADAELLI 1, E. N. WILHELM 1, C. E. BOTTON 1, M. BOTTARO 2, E. L. CADORE 1, 3, L. E. BROWN 4, R. S. PINTO 1
Aim. The aim of this study was to compare the effects of 13

weeks of low- or high-volume strength training on upper and
lower body muscle thickness and lower body muscle quality
determined by ultrasonography in elderly women.
Methods. Twenty healthy untrained elderly women were randomly assigned into two strength training groups, low-volume (LV; N.=11; 64.63.1 years; 66.45.1 kg; 162.95.8 cm;
24.85.1 kg.m-2) or high-volume (HV; N.=9; 63.92.3 years;
64.17.2 kg; 163.24.9 cm; 24.34.2 kg.m-2). Participants
trained two days per week, with the LV group performing
one-set of each exercise whereas the HV group performed
three-sets of each exercise. The intensity of training was
progressive during the training period and controlled using
number of repetitions maximum (RM).
Results. The knee extensors muscle thickness significantly
increased in both groups after 13 weeks (8.62.9% for LV
and 14.33.9% for HV; P0.001), with no difference between
groups (P>0.05). Both groups showed similar elbow flexors
muscle thickness gains after 13 weeks of training (11.26%
for LV and 12.55.6% for HV). The knee extensors echo intensity significantly decreased for both groups after 13 weeks
(P0.05), with no difference between groups.
Conclusion. These findings suggest that high- and low-volume
strength training are similarly effective in increasing muscle
thickness and improving muscle quality in elderly women after 13 weeks of strength training.
Key words: Aging - Resistance training - Ultrasonography.
ne of the most harmful effects of aging is the

loss of skeletal muscle mass (i.e., sarcopenia).
This process results from a reduction in the number
of muscle fibers and atrophy of the remaining fibers.1,
Corresponding author: R. Radaelli, Physical Education School, Federal University of Rio Grande do Sul, Rua Felizardo n. 760, Bairro
Jardim Botnico, 90690-200, Porto Alegre, Brazil.
E-mail: regis.radaelli@hotmail.com
1Physical Education School

Federal University of Rio Grande do Sul
Porto Alegre, Brazil
2College of Physical Education and Exercise Science
University of Braslia, Braslia, Brazil
3Department of Health Sciences
Public University of Navarre, Navarre, Spain
4Department of Kinesiology
California State University, Fullerton, CA, USA
Along with this change in muscle mass, the aging

process is also associated with changes in muscle
composition,3, 4 resulting in reduced muscle quality
(MQ), especially in elderly women.3 To counteract
this, strength training (ST) is an effective intervention
to reduce losses in skeletal muscle;1 however, the effectiveness of this type of training depends on manipulation of some variables, such as training volume.
ST volume is calculated as the product of the
number of sets performed of each exercise and the
number of repetitions completed per set.5 Previous
studies with young subjects have demonstrated conflicting results regarding the effects of ST volume on
muscle hypertrophy. Some research has found similar muscle hypertrophy using low- and high-volume
ST,6, 7 whereas others found greater gains with highvolume.8, 9
Data on the effects of ST volume on muscle
hypertrophy in elderly people are scarce. To the
best of our knowledge, only one study compared
the effects of low- and high-volume ST on muscle
hypertrophy in an elderly population.10 They observed similar knee extensor muscle hypertrophy in
2
June 2013
Strength training volumes
RADAELLI
elderly women who trained ten weeks using low- or

high-volume. However, they did not investigate the
effects of low- and high-volume training on upperbody muscle mass, and it can be speculated that the
upper and lower-body may respond differently to a
low- or high-volume ST program.8, 9 Furthermore,
their training groups were comprised of young and
elderly women. This may have influenced the results, because gains induced by ST programs can be
affected by age.11, 12
MQ can be assessed by ultrasonography using
echo intensity calculated from a grey scale value.
The increase in echo intensity, which represents
MQ reduction, is believed to be caused by an increase in intramuscular fibrous and adipose tissue deposited within the muscle.13 In fact, it has
been shown that ST may decrease the echo intensity values, which suggests a reduced quantity of
non-contractile tissue within the muscle and an
improved MQ.14 However the effect of different
ST volumes on the MQ of elderly people remains
unknown. The ideal ST volume and its effects on
MQ during different training periods have great
importance for the ST prescription. In untrained
elderly, the stimulus threshold required to elicit neuromuscular adaptations may be lower.10, 15, 16 Thus,
low-volume training, which is associated with greater adherence,16 may be as effective as high-volume
training for improvements in MQ.
Therefore, the aim of the present study was to
compare the effects of low- or high-volume ST on
upper and lower body muscle thickness (MT) and
lower body MQ in elderly women, following 13
weeks of ST.
Materials and methods
Participants
Twenty healthy elderly women that had not participated in a regular strength training program for at
least three months volunteered for this study. They
were randomly divided into two groups, low-volume
(LV; N.=11) or high-volume (HV; N.=9). The physical characteristics of the training groups are showed
in the Table I. All subjects were carefully informed
of the design of the study and gave their written consent to participate. Subjects were free of any cardio-
Table I.Physical characteristics (meanSD) before 13-week

strength training period.
Variable
Low-volume
(N.=11)
High-volume
(N.=9)
Age (y)
Body mass (kg)
Height (cm)
Body fat (%)
BMI (kg.m-2)
Knee extension1-RM
64.63.1
66.45.1
162.95.8
19.83.7
24.85.1
49.516.4
63.92.3
64.17.2
163.24.9
19.17.9
24.34.2
50.816.4
BMI: body mass index (kg/m2); 1-RM: one-repetition maximum.
vascular, metabolic or musculoskeletal limitations

to physical exercise. All the women were postmenopausal and with normal body mass index (BMI). All
procedures of the present study received the approval
of the Institutional Research Ethics Committee and
followed the principles of the Helsinki declaration.
Procedures
Strength training program
A supervised ST program was performed twice
a week for a period of 13 weeks, with at least two
days of rest between training sessions. In each
workout, both groups performed the following exercises: bilateral knee extension, lat pull-down, bilateral leg press, bilateral elbow flexion, bilateral
leg curl, bench press, triceps extension, hip abduction and adduction, and abdominal crunch. During
the training period, the HV group performed three
sets of each exercise with 2-min rest between sets,
whereas the LV group performed one set of each
exercise. The intensity of training (determined by
maximal repetitions RM) was altered similarly
for both groups. The intensity of training utilized
during the training period was choose following
previous studies.9, 17 During the first 6 weeks the
subjects trained at 15-20 RM; during weeks 7-10
they trained at 12-15RM; while in the last three
weeks they trained with an intensity of 10-12 RM.
When participants were able to perform more repetitions than prescribed, the training load for the
next workout was increased by 2.5 to 5 kg. All
training sessions were monitored by at least two
trained investigators and all women completed at
least 95% of the workouts.
RADAELLI
Figure 2.Changes in quadriceps femoris muscle thickness after13 weeks of training. HV: high-volume group; LV: low-volume
group; * Significant increase from pre training values (P0.001).
depressing the dermal surface. All images were digitized and later analyzed in Image-J software (version
1.37, National Institute of Health, USA). All measurements were made by the same investigator. Baseline
test and retest (7 days between test and retest) reliability ICCs of MT measurements were between
0.85 and 0.95.
Muscle quality
Figure 1.Region of interest in the rectus femoris muscle where
the echo intensity was calculated.
Muscle thickness
Real-time B-Mode ultrasonography (PhilipsVMI, Ultra Vision Flip, Brazil) with a 7.5MHz
linear-array probe (38 mm), was used to obtain
MT of the knee extensor muscles. The overall knee
extensors MT (KEMT) was calculated as the sum
of rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM) and vastus intermedius (VI):
MT=RF+VL+VM+VI.17 The MT of the elbow
flexor biceps brachii and brachialis (EFMT) muscles was determined from the sum of their MT
(biceps brachii and brachialis). All sites of MT
measurements have been previously described.18-21
Measurements were performed on the right leg and
arm while the subjects were in a supine position
with limbs extended and relaxed, after resting in
the supine position for 15 min to allow fluid shifts
to occur.22 The probe was coated with a water-soluble
transmission gel to provide acoustic contact without
Knee extensor MQ (KEMQ) was determined from

the echo intensity values calculated by computer
assisted grey-scale analysis using the standard
function of the Image-J software (version 1.37, National institute of health, USA). High values of echo
intensity represents changes associated with increase
of amount noncontractile tissue within of muscle.13
Thus, reducing in amount of noncontractile tissue
within of muscle reducing the echo intensity values
and increase the MQ. To calculate the echo intensity
value, a region of interest in the RF muscle that included as much RF muscle as possible without any
bone or surrounding fascia was selected. The echo intensity value of interest region was calculated and resulted in a number between 0 (black) and 255 (white)
(Figure 1). The mean echo intensity was calculated
using three images.
Statistical analyses
All data are presented as meanSD. Normality
of the distribution and homogeneity for outcome
measures were tested using Shapiro-Wilk and Lev-
June 2013
RADAELLI
Figure 3.Changes in elbow flexors muscle thickness after 13

weeks of training. HV: high-volume group; LV: low-volume
group; * Significant increase from pre training values (P0.001).
Figure 4.Changes in echo intensity after 13 weeks of training.

HV: high-volume group; LV: low-volume group; *Significant decrease from pre training values (P0.05).
enes test, respectively. As data showed normal distribution and homogeneity (P>0.05), the effects of
training volume was assessed by a two-way mixed
model (group x time) Analysis of Variance (ANOVA). When a significant F value was identified, a
Bonferroni post hoc test was used to identify pairwise differences between means. The significance
level was set at P0.05.
Muscle quality
Results
There were no significant differences between

groups at baseline. In both groups, echo intensity significantly decreased after 13 weeks of training, from
141.317 to 123.312.7 (by -12.99.9%) (P0.05)
in LV group and from 141.320.4 to 110.416.3
(by -20.97.7%) (P0.05) in HV group (F(1)=67.77;
P0.05; 2=0.89), with no significant difference between groups (F(1)=0.18; P>0.05; 2= 0.02;), and
no significant time-group interactions (F(1)=0.74;
P>0.05; 2=0.08) (Figure 4).
Muscle hypertrophy
Before training, there were no significant differences between groups in KEMT or EFMT (P>0.05).
The KEMT increased significantly in both groups
after 13 weeks of training, from 64.614.8 mm
to 69.915.2 mm (by 8.62.9%) (P0.001) in LV
group and from 59.89.5 mm to 68.310.6 mm (by
14.33.9%) (P0.001) in HV group (F(1)=288.68;
P0.001; 2=0.97), however there were no group
effect (F(1)=0.18; P>0.05; 2=0.02) and no significant time-group interaction (F(1)=13.27; P>0.05;
2=0.62) at any time point (Figure 2). Regarding
EFMT, significant increases were also observed for
both groups after 13 weeks of ST, from 25.55
mm to 27.94 mm (by 11.26%) (P0.001) in
LV group and from 22.74.1 mm to 25.54.7 mm
(12.55.6%) (P0.001) in HV group (F(1)=88.50;
P0.001; 2=0.91), with no difference between
groups (F(1)=4.54; P>0.05; 2=0.36) and no significant
time-group interaction at any time point (F(1)=0.26;
P>0.05; 2=0.03) (Figure 3).
Discussion
The primary findings of the present study were that
LV and HV groups demonstrated similar increases
in KEMT, EFMT and MQ after 13 weeks of training.
These results suggest that only one set per exercise
(i.e., low volume) is as effective as three sets per exercise (i.e., high volume) in promoting hypertrophy
and enhancing MQ in untrained elderly women during early training phases.
Regarding knee extensor muscle hypertrophy, our
results corroborate the study of Cannon and Marino,10 who observed similar muscle hypertrophy
in subjects who trained with low- or high-volume
during ten weeks of ST. Nevertheless, subjects in
their study were young and elderly women, and this
makes comparison difficult with our present results.
Muscle hypertrophy is strongly associated with
muscle damage, endocrinal responses and metabolic
stimulus.23 For example, muscle damage induced by
RADAELLI
ST is associated with the activation of satellite cells,

inammatory agents and upregulation of IGF-1,24
which are anabolic mechanisms important for hypertrophic response. Therefore, it could be speculated
that multiple sets using the same intensity of training
than single set would induce more structural damage
and, consequently, increased responses. However,
our results showed that HV and LV groups demonstrated a similar increase in KEMT after 13 weeks of
training. Thus, it might be suggested that low- and
high-volume strength training, scheduled with equal
intensity of training in each exercise, for elderly
women may promote similar responses in mechanisms associated with muscle hypertrophy during
the first 13 weeks of ST.
To the best of the authors knowledge, no studies
have assessed the effects of low- or high-volume ST
on hypertrophy of upper-body muscles in the elderly.
Similar to the present study, previous investigations
using young subjects have shown similar upper-limb
hypertrophy induced by ST. Bottaro et al.,6 found
that MT of the biceps brachii equally increased significantly for subjects who trained with low- or highvolume (7.2% and 5.9%, respectively) following
ten weeks of training, Likewise, Ronnestad et al.,8
observed similar increases in cross sectional area
of the trapezius muscle after 12 weeks of training
in subjects who trained with low- or high-volume
(13.92.5% and 9.71.4%, respectively). In another study,9 it was also observed similar increases in
cross sectional area of the trapezius between groups
that used low- or high-volume training. As observed
in these studies, we showed that low-volume ST is effective for elderly women to achieve significant muscle
hypertrophy in upper-body muscles. In general, the arm
muscles are less trained than the leg muscles,8 and,
consequently, the threshold to induce muscle hypertrophy in the former may be lower. From a practical
standpoint, a low volume of ST (i.e., one set per exercise) was sufficient stimulus to promote hypertrophy in both upper and lower-body muscles, at least
for 13 weeks of training.
MQ in our study significantly improved for both LV
and HV groups after 13 weeks of training, with no difference between groups. A previous study also observed
a decrease in echo intensity of the vastus lateralis after
a ST program.14 However, the present study is the first
to compare the effects of different volumes of ST on
MQ assessed by echo intensity. Our results are impor-
10
tant because it shows that elderly women can significantly improve their MQ using a low-volume of ST. The
mechanisms associated with MQ improvement are still
unclear but it has been suggested that the echo intensity assessed by gray scale values is associated with the
amount of intramuscular brous and adipose tissue,13
thus the improvement in MQ could be associated with a
reduction in the amount of non-contractile tissue within
the muscle. In fact, echo intensity has been negatively
associated with strength performance in elderly populations.25 Thus, our results suggest that both low and high
volume ST induces similar improvements in MQ.
Limitations of the study
It is important to note some limitations in the
present study. The small sample size of the training
groups limits the extrapolation of the findings to all
elderly women. Additionally, in the present study
the training intensity was determined by RM and
ST programs that use other way to control training
intensity, like percentage of the RM, may observe
different results.
Conclusions
In summary, the results of the present study showed

that low- and high-volume ST was equally effective to
promote muscle hypertrophy in lower- and upper-body
muscles, as well as improving MQ in the lower-body
of elderly women. These findings have important implications for the prescription of ST programs, since elderly women may benefit from ST using a low-volume
program for a period of three months. However, future
studies utilizing longer periods of training are necessary to investigate whether additional sets may promote
greater lower- and upper-body muscle gains.
References
1. Aagaard P, Suetta C, Caserotti P, Magnusson SP, Kjaer M. Role
of the nervous system in sarcopenia and muscle atrophy with aging: strength training as a countermeasure. Scand J Med Sci Sports
2010;20:49-64.
2. Doherty TJ. Invited review: Aging and sarcopenia. J Appl Physiol
2003;95:1717-27.
3. Goodpaster BH, Carlson CL, Visser M, Kelley DE, Scherzinger A,
Harris TB et al. Attenuation of skeletal muscle and strength in the
elderly: The Health ABC Study. J Appl Physiol 2001;90:2157-65.
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4. Visser M, Kritchevsky SB, Goodpaster BH, Newman AB, Nevitt

M, Stamm E et al. Leg muscle mass and composition in relation
to lower extremity performance in men and women aged 70 to 79:
the health, aging and body composition study. J Am Geriatr Soc
2002;50:897-904.
5. Hass CJ, Garzarella L, de Hoyos D, Pollock ML. Single versus multiple sets in long-term recreational weightlifters. Med Sci Sports
Exerc 2000;32:235-42.
6. Bottaro M, Veloso J, Wagner D, Gentil P. Resistance training for
strength and muscle thickness:Effect of number of sets and muscle
group trained. Sci Sports 2011;26:259-64.
7. Starkey DB, Pollock ML, Ishida Y, Welsch MA, Brechue WF,
Graves JE et al. Effect of resistance training volume on strength and
muscle thickness. Med Sci Sports Exerc 1996;28:1311-20.
8. Ronnestad BR, Egeland W, Kvamme NH, Refsnes PE, Kadi F,
Raastad T. Dissimilar effects of one- and three-set strength training on strength and muscle mass gains in upper and lower body in
untrained subjects. J Strength Cond Res 2007;21:157-63.
9. Hanssen KE, Kvamme NH, Nilsen TS, Ronnestad B, Ambjornsen
IK, Norheim F et al. The effect of strength training volume on satellite cells, myogenic regulatory factors, and growth factors. Scand J
Med Sci Sports 2012 [Epub ahead of print].
10. Cannon J, Marino FE. Early-phase neuromuscular adaptations to
high- and low-volume resistance training in untrained young and
older women. J Sports Sci 2010;28:1505-14.
11. Ivey FM, Tracy BL, Lemmer JT, NessAiver M, Metter EJ, Fozard
JL et al. Effects of strength training and detraining on muscle quality: age and gender comparisons. J Gerontol A Biol Sci Med Sci
2000;55:B152-7.
12. Lemmer JT, Hurlbut DE, Martel GF, Tracy BL, Ivey FM, Metter EJ
et al. Age and gender responses to strength training and detraining.
Med Sci Sports Exerc 2000;32:1505-12.
13. Pillen S, Tak RO, Zwarts MJ, Lammens MM, Verrijp KN, Arts IM
et al. Skeletal muscle ultrasound: correlation between fibrous tissue
and echo intensity. Ultrasound Med Biol 2009;35:443-6.
14. Sipila S, Suominen H. Quantitative ultrasonography of muscle: detection of adaptations to training in elderly women. Arch Phys Med
Rehabil 1996;77:1173-8.
15. Galvao DA, Taaffe DR. Resistance exercise dosage in older adults:
single- versus multiset effects on physical performance and body
composition. J Am Geriatr Soc 2005;53:2090-7.
16. Rhea MR, Alvar BA, Burkett LN, Ball SD. A meta-analysis to de-
termine the dose response for strength development. Med Sci Sports
Exerc 2003;35:456-64.
17. Cadore EL, Izquierdo M, Alberton CL, Pinto RS, Conceicao M,
Cunha G et al. Strength prior to endurance intra-session exercise
sequence optimizes neuromuscular and cardiovascular gains in elderly men. Exp Gerontol 2012;47:164-9.
18. Chilibeck PD, Stride D, Farthing JP, Burke DG. Effect of creatine
ingestion after exercise on muscle thickness in males and females.
19. Korhonen MT, Mero AA, Alen M, Sipila S, Hakkinen K, Liikavainio T et al. Biomechanical and skeletal muscle determinants of maximum running speed with aging. Med Sci Sports Exerc 2009;41:84456.
20. Miyatani M, Kanehisa H, Fukunaga T. Validity of bioelectrical impedance and ultrasonographic methods for estimating the muscle
volume of the upper arm. Eur J Appl Physiol 2000;82:391-6.
21. Kumagai K, Abe T, Brechue WF, Ryushi T, Takano S, Mizuno M.
Sprint performance is related to muscle fascicle length in male 100m sprinters. J Appl Physiol 2000;88:811-6.
22. Berg HE, Tedner B, Tesch PA. Changes in lower limb muscle crosssectional area and tissue fluid volume after transition from standing
to supine. Acta Physiol Scand 1993;148:379-85.
23. Schoenfeld BJ. The mechanisms of muscle hypertrophy and their
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24. Schoenfeld BJ. Does exercise-induced muscle damage play a role
in skeletal muscle hypertrophy? J Strength Cond Res 2012;26:144153.
25. Visser M, Goodpaster BH, Kritchevsky SB, Newman AB, Nevitt M,
Rubin SM, et al. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci 2005;60:32433.
Acknowledgements.The authors would like to thank CNPq
and CAPES.
Conflicts of interest.The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Received on March 10, 2013.
11

Influence of exercise order on blood pressure and heart

rate variability after a strength training session
T. FIGUEIREDO 1, 2, P. MENEZES 1, M. S. KATTENBRAKER 3, M. D. POLITO 4, V. M. REIS 2, R. SIMO 1, 2
Aim. The purpose of this study was to compare the effects

of two different strength training (ST) exercise sequences on
blood pressure (BP) and heart rate variability (HRV) after a
ST session.
Methods. Ten male subjects participated in the study. After
determining the one repetition maximum load (1RM) for the
bench press (BP), lat pull down (LPD), shoulder press (SP),
triceps extension (TE), biceps curl (BC), leg extension (LE),
leg curl (LC) and leg press (LP), participants performed two
different exercise sequences. During sequence 1 (SEQ1) sub
jects performed 3 sets of 12 repetitions at 80% 1RM, with
3 minutes rest between sets and exercises with the following
order: BP, LPD, SP, TE, BC, LE, LC, and LP. After 72 hours,
subjects performed the SEQ2 with the same volume of exer
cise, but the order of exercises was reversed. BP and HRV
were measured before and after the training sessions.
Results.
The systolic blood pressure and mean arterial pres
sure were significantly higher for SEQ2 when compared to
SEQ1. HRV showed significant differences between exercises
orders, as SEQ1 presented higher values of low frequency
normalized units band, lower values of high frequency nor
malized units band and lower values of the standard devia
tion of differences between adjacent normal R-R intervals
when compared to SEQ2.
Conclusion.
The order of ST exercises has a significant im
pact on the cardiac autonomic nervous system and on postexercise blood pressure response. ST beginning with lower
body exercises and progressing toward upper body exercises
are more likely to produce a lower cardiovascular stress.
Key words: Resistance training - Hypotension - Autonomic
nervous system.
trength training (ST) is an important part of a

well-rounded physical exercise program and
Corresponding author: T. Figueiredo, Department of Sport Science,

Exercise and Health Univesidade de Trs-os-Montes e Alto Douro,
5000-801, Vila Real, Portugal. E-mail: tc-figueiredo@uol.com.br
12
1Rio de Janeiro Federal University

School of Physical Education and Sports
Rio de Janeiro, Brazil
2Department of Sport Science
Exercise and Health
Trs-os-Montes e Alto Douro University
Vila Real, Portugal
3Eastern Illinois University
Kinesiology & Sports Studies Department
Charleston, IL, USA
4Department of Physical Education
State University of Londrina
Center of Physical Education and Sport
Londrina, Brazil
there is evidence that a single strength training session (STS) promotes acute modifications in blood
pressure (BP) and heart rate variability (HRV) of
normotensive and hypertensive individuals.1, 2
Blood pressure response after ST is an important
topic of study, because post exercise hypotension,
i.e., a BP reduction to levels below those observed at
rest or prior to exercise, has a significant role in the
management of BP.1 Several studies have examined
blood pressure behavior from ST performed with
different volumes and intensities.2-5 However, the influences of these ST-related variables on BP after a
STS are scarcely known.2
To the best of our knowledge, only three studies
have investigated the physiological pathways of BP
control derived from a STS,2, 6, 7 while other studies
have focused on the manipulation of methodological
variables of ST such as training intensity, rest interval or concurrent training.5, 8, 9 Until now, one study
June 2013
INFLUENCE OF EXERCISE ORDER ON BLOOD PRESSURE AND HEART RATE VARIABILITY
has investigated the acute response of BP and HRV

associated with a STS and its relationship with ST
intensity.2 In light of this observation, it is necessary
to better understand the mechanisms of BP control
from this type of exercise performed with different
exercise orders since exercise order can influence
repetition performance and different physiological
mechanisms during ST.10, 11 Furthermore, current
literature does not provide significant information
about the physiological pathways of STS and the impact on BP and HRV.
Since previous studies analyzing the effect of exercise order on BP and HRV after a STS are scarce,
the purpose of this study was to compare the effect
of two different exercise orders in a STS on the BP
and HRV.
Participants
Ten normotensive men with previous experience
in ST participated in this study (age: 26.64.5 years;
height: 173.88.1 cm; body mass: 77.68.3 kg;
BMI: 25.42.4 kg/m2; resting systolic blood pressure (SBP): 126.58 mmHg; resting diastolic blood
pressure (DBP): 74.74 mmHg). According to the
criteria established by the Seventh Joint National
Committee 12 the following criteria were adopted
for subject recruitment: (a) nonsmokers; (b) absence
of any kind of metabolic disease; (c) no articular or
bone injury; and (d) absence of any medication. Participants were informed about the study procedures,
possible risks and benefits, and signed an informed
consent form. This study was approved by the Ethics
Committee of the Rio de Janeiro Federal University.
Participants were instructed to maintain their usual
activities and eating habits throughout the study period.
Procedures
One repetition maximum (1RM) testing
During the first laboratory visit, the participants
height and body mass were measured by means of
an analogical scale (Filizola, Brazil) and a stadiometer followed by 1RM testing. The 1RM testing be-
FIGUEIREDO
gan with a warm-up at 50% of the predicted 1RM.

After five minutes rest, each subject was encouraged
to perform one repetition with a heavier load. If the
attempt was successful, the load was increased and
the attempt repeated. After 72h a second visit occurred and the 1RM test was repeated, with the
highest successful lift being recorded as the 1RM.13
The exercises performed were the bench press (BP),
front lat pull down (LPD), shoulder press (SP), triceps extension (TE), biceps curl (BC), leg extension
(LE), leg curls (LC) and leg press (LP). The 1RM
assessments were divided over a four day period.
On the first and third day BP, LE, BC and LC were
tested and retested, on second and fourth days LPD,
LP, SP and TE were performed. To minimize the error during 1RM tests, standardized strategies were
adopted.13
Exercise sessions
Seventy two hours after the last 1RM assessment,
participants performed one of the two exercise sequences in a counterbalanced crossover design. The
second session was performed 72 hours after the first
session. The exercise order for SEQ1 was BP, LPD,
SP, TE, BC, LE, LC and LP. The exercise order for
SEQ2 was reversed. The warm-up consisted of 10
repetitions of the first exercise at 40% of 1RM. A
3-minute rest interval was allowed after the warm-up
before participants performed the assigned exercise
sequence. Both exercise sequences consisted of 3
sets of each exercise (80% of 1RM) with 3-minute
rest intervals between sets and exercises. During the
exercise sessions, subjects were verbally encouraged
to perform 10 to 12 repetitions in all sets. During all
training sessions participants were asked to avoid the
Valsalva maneuver.
Measures of heart rate and heart rate variability
A heart rate monitor (Polar RS800sd, Finland)
was continuously used for 30 minutes before and for
60 minutes after the sessions for monitoring HR and
HRV. Data were recorded on the equipment and then
immediately downloaded to the computer to be analyzed by the Polar Precision Performance Software
(Release 3.00, Kempele, Finland). The HRV parameters were analyzed according to the components of
13
FIGUEIREDO
low frequency in normalized units (LF-nu), high frequency in normalized units (HF-nu) and the standard
deviation of differences between adjacent normal
R-R intervals (RMSSD) after Fourier transformation
and noise filtering through the program Kubios HRV
Analysis Software version 2.0 (Kuopio, Finland).
Data were collected at rest and after the ST sessions.
Subjects remained at rest in a supine position in a
quiet room with temperature maintained between 20
C and 22 C.
Arterial blood pressure assessment
Systolic blood pressure (SBP), diastolic blood
pressure (DBP) and mean arterial pressure (MAP)
were measured using an automatic oscillometric device (PM50 NIBP/Spo2, CONTEC, EUA). The resting BP value was averaged over three consecutive
measurements with an interval of 5 minutes after the
individual remained in a supine position for 10 min.
Afterwards, BP was assessed every 10 minutes over
a 60 minute period. Measurements were performed
in the left arm, following the recommendations of
the American Heart Association.14
Statistical analysis
Data for all variables were analyzed using the
Shapiro-Wilk normality test and the Bartlett criterion for homocedasticity. An intraclass coefficients
correlation (ICC) was used to test the reliability of
1RM tests. A paired Student t-tests were applied to
compare the following parameters: 1RM test and
retest and total number of repetitions performed
in SEQ1 and SEQ2. The resting values of SBP,
DBP, MAP, HR, RMSSD, LF-nu and HF-nu were
analyzed separately using one-way ANOVA. Subsequently, a two-way repeated measures ANOVA
was used to compare the resting values and postexercise measures within and between sessions. In
all cases, the post-hoc Bonferroni was used. Additionally, effect sizes (ESs; the difference between
pretest and posttest scores divided by the pretest
SD) were calculated for the SBP, DBP, MAP and
RMSSD for both exercise orders. The scale proposed by Rhea 15 was used to determine the magnitude of the ES. Alpha was set at P<0.05 and all
analyzes were performed with the Prisma (v. 5.0,
Graphpad).
14
Figure 1.
Systolic blood pressure response to two strength training exercises sessions (mean+SD).
Results
All tested variables followed a normal distribution (P>0.05). The data of 1RM test were analyzed
using intraclass correlation coefficients (BP r=0.95,
LPD r=0.96, SP r=0.90, TE r=0.98, BC r=0.97, LE
r=0.98, LC r=0.97 and LP r=0.96) and showed high
reliability.
Average values at rest and during 60 minutes
post-exercise for the SBP at different exercise orders are showed in Figure 1. No significant differences were found between rest values (P>0.05).
There were significant differences between the two
exercise sequences from 20 to 60 minutes in SBP
(P<0.05). For the DBP, there were no differences
in the measures between rest and after exercise and
between the two exercise sequences (P>0.05). Postexercise MAP was significantly different between
SEQ1 and SEQ2 at 20 minutes (874 vs. 944
mmHg; P<0.05) and 30 minutes (877 vs. 946
mmHg; P<0.05).
Table I shows the systolic, diastolic, mean arterial
pressure and RRmed ES after STS with different exercise orders. SBP and DBP effect sizes presented
different classifications on all time values, with the
exception of DBP at 10 minutes which showed small
modifications on blood pressure control in SEQ1.
Additionally, lower SBP and DBP ES were consistently observed for the SEQ1 condition at all time
points.
Compared to the pre intervention, RMSSD value
was reduced throughout the one hour period after
both ST sequences, with significant differences be-
June 2013
FIGUEIREDO
Table I.Effect Size: SBP, DBP, MAP and RRmed after both sequences of strength training.
SBP
SEQ1
SEQ2
DBP
SEQ1
SEQ2
MAP
SEQ1
SEQ2
RMSSD
SEQ1
SEQ2
Magnitude
Classification
Magnitude
Classification
Magnitude
Classification
Magnitude
Classification
Magnitude
Classification
Magnitude
Classification
Magnitude
Classification
Magnitude
Classification
10 min
20 min
30 min
40 min
50 min
60 min
1.10
Mod.
2.08
Large
0.51
Sm.
0.12
Sm.
1.38
Mod.
1.30
Mod.
4.97
Large
1.27
Mod.
0.60
Sm.
2.04
Large
0.94
Mod.
0.39
Sm.
1.06
Mod.
0.62
Mod.
7.39
Large
1.72
Large
0.37
Sm.
1.50
Large
1.30
Mod.
0.35
Sm.
1.03
Mod.
0.86
Mod.
6.96
Large
1.50
Mod.
0.40
Sm.
0.90
Mod.
1.34
Mod.
0.33
Sm.
1.21
Mod.
0,85
Mod.
6.47
Large
1.12
Mod.
1.10
Mod.
1.30
Large
1.95
Large
0.59
Mod.
1.00
Mod.
1.41
Mod.
5.14
Large
1.25
Mod.
1.13
Mod.
1.80
Large
1.58
Large
0.91
Mod.
0.60
Mod.
1.25
Mod.
4.50
Large
1.20
Mod.
Legend: Sm. Small; Mod. Moderate; SBP. Systolic blood pressure; DBP. Diastolic blood pressure; MAP. Mean arterial pressure; RMSSD. Standard
deviation of differences between adjacent normal R-R intervals.
37.98.7), 50 minutes (22.24.5 vs. 34.710.0), and

60 minutes (20.05.6 vs. 33.47.9) (P<0.05).
Discussion
Figure 2.Power LF standardized at rest, immediately after

strength training and for one hour divided in ten minutes periods. *Significant difference between sequences at that time point
(P<0.05). Significant difference for intragroup rest (P<0.05).
tween sequences (P<0.05). However, a major magnitude of ES was found for the SEQ1 (4.97) when
compared with the SEQ2 (1.29) (Table I).
LFun band during 50 minutes after ST demonstrated a significant increase when compared to
SEQ1 rest values, and when SEQ1 was compared
with SEQ2 (P<0.05) as illustrated in Figure 2.
HF band showed significant differences between SEQ1 and SEQ2 at 30 minutes (23.47.0 vs.
The major findings of this study include the following: (a) exercise order influenced HRV and cardiac autonomic control after ST, demonstrating an
increased sympathetic tone and a reduced parasympathetic tone after the session, particularly when
SEQ1 was performed; (b) exercise order influenced
SBP after ST but did not elicit a significant post-exercise hypotensive response in normotensive, physically active men; and (c) blood pressure response was
higher in SEQ2 which incorporated lower body exercises at the beginning of the session and progressed
toward upper body exercises. In the present study the
subjects performed two different STS containing the
same exercises and the same total work volume. Our
results showed that SEQ1 promoted major alterations in cardiac autonomic control when compared
with SEQ2. A major increase in sympathetic tonus
and a reduction in parasympathetic tonus observed
in SEQ1 can be probably attributed to a concentric
failure that occurs in upper body exercises at the beginning of the sequence.2 On the other hand, a possible muscular fatigue at the beginning of the sequence
15
FIGUEIREDO
may reduce plasma volume and, in consequence, the

cardiac output and systolic volume which promotes a
major cardiovascular imbalance after the session.2, 16
Additionally, concentric failure increases the recruitment of additional motor units requiring a progressive activation of the sympathetic nervous system to
maintain training intensity.17 Finally, a greater activation of metaboreceptors, mechanoreceptors and
arterial baroreflex may occur due to a reduction in
blood flow promoted by a plasma volume decrease
to the active muscles and an increase in peripheral
vascular resistance induced by a mechanical occlusion of blood flow promoted by muscular contraction.2
The results of this study are in agreement with two
previous studies. Both studies demonstrated greater
sympathetic activation after ST suggesting that ST
elicits important changes in the cardiac autonomic
control after the session and these responses may
be related to training intensity and total volume.2, 18
Resk et al.2 investigated the effect of two different
intensities (40% and 80% of 1RM) on HRV and did
not found significant differences between intensities on cardiac autonomic control after a STS. On
the other hand, Lima et al.18 found significant differences between different intensities after ST and
concluded that major alterations occur after high intensity STS when compared with moderate or low
intensity training. The differences in the total training volume potentially influence the magnitude and
duration of increased sympathetic activity after ST.
However, studies analyzing the cardiovascular response after STS performed with different volumes
are not reported, as this is the first study to examine
the influence of exercise order on cardiovascular responses after STS.
Recently, Lima et al.18 demonstrated that cardiac
sympathetic activation remains higher than resting
values after upper body STS. Their results partially
corroborate the current studys results. For example,
in SEQ1 there was a similar increase in sympathetic
activation; however, the reduction of parasympathetic activity observed by the HF band and RMSSD
index in SEQ1 when compared with SEQ2 has an
important practical application. For instance, an increase in the sympathetic activation combined with
a reduction of parasympathetic activity increases the
risk of cardiovascular events in both healthy individuals and patients with cardiovascular disease.19
16
In relation to SBP, DBP and MBP the present

study demonstrated that exercise order influences
both the magnitude and duration of BP response.
Effect size data demonstrates a smaller magnitude
and duration of SBP increase in SEQ1 when compared with SEQ2. On the other hand, SEQ1 ES data
presented a longer duration of hypotensive response
in DBP for SEQ1 compared with SEQ2. The results
also show a small increase or a reduction in SBP and
DBP when SEQ1 was performed. Previous studies
examined different aspects of post exercise hypotension and some demonstrated that ST is capable of
reducing SBP, DBP and MBP.2, 5 As observed in this
study, the SBP response after strength training, specifically in SEQ1, demonstrated a small reduction in
normotensive male subjects, although other studies
demonstrated a hypotensive response after single
bouts of training.5 A possible explanation for the excessive BP response in SEQ1 attributable to the cardiac stress may be the high intensity of training at the
beginning of the session which can result in plasma
reduction and an increased cardiac contractile effort
to maintain cardiac output.2 On the other hand, the
influence of the parasympathetic nervous system in
SEQ2 does not allow for the complete restoration of
BP to resting values.
Although this study did not demonstrate a significant PEH in DBP after a STS, other have found differences in isolated sessions, which may be partially
explained by the methodological dissimilarity that
may have influenced the results. For example, major
and longer hypotensive responses to ST were found
in individuals that had previous experience in ST with
sessions that were performed at moderate to high intensity (i.e., 6RM, 12RM, 70% of 10RM and 80% of
1RM).3, 5 Ruiz et al.20 analyzed physically active men
and adopted distinct protocols in exercise sessions;
strength training was performed with slightly higher
intensities, and the subjects performed 12 maximum
repetitions. In this study, subjects had more frequent,
intense sessions that may have contributed to the onset of PEH. Therefore, the authors of this study have
concluded that high intensity training (80% of 1RM)
combined with longer rest interval between sets and
exercises (3 minutes) does not contribute to PEH in
trained subjects.
Beyond the findings presented here, it is important to consider some limitations of this study. The
blood pressure assessments were done in a supine
June 2013
position, which does not contribute to a reduction in

SBP.21 On the other hand, HRV can be affected during a prolonged seated position which can lead to a
reduction in venous return and increased baroreflex
activity.22 Due to a lack of studies reporting the influence of exercise order on HRV after a STS, and how
to perform the two measurements together, a supine
position was adopted. Additionally, because this
study investigated normotensive young subjects, the
results presented here are may not be generalizable
to other populations. Further research is needed to
examine the PEH response related to the manipulation of ST methodological variables.
Conclusions
The findings of this study demonstrated different
HRV behavior in trained normotensive men after
high-intensity strength training performed with two
different exercise orders. Therefore, one may conclude that strength training composed of upper and
lower body exercises beginning with lower body exercises and progressing toward upper body exercises
are more likely to produce a lower cardiac stress
when compared to the reverse order. Therefore, professionals should prescribe lower body exercises
first if the goal is to reduce cardiac stress. Since the
results of this study are likely to only be applied to
trained normotensive male individuals, further research testing other populations is warranted.
References
1. American College of Sports Medicine. Position Stand: Exercise and
hypertension. Med Sci Sports Exerc 2004;36:533-53.
2. Rezk CC, Marrache RC, Tinucci T, Mion D Jr, Forjaz CL. Postresistance exercise hypotension, hemodynamics, and heart rate
variability: influence of exercise intensity. Eur J Appl Physiol
2006;98:105-12.
3. Polito MD, Farinatti PTV. The effects of muscle mass and number
of sets during resistance exercise on postexercise hypotension. J
Strength Cond Res 2009;23:2351-7.
4. Queiroz ACC, Gagliardi JFL, Forjaz CLM, Rezk CC. Clinic and
ambulatory blood pressure responses after resistance exercise. J
5. Simo R, Fleck SJ, Polito M, Monteiro W, Farinatti PTV. Effects of
resistance training intensity, volume, and session format on the post
exercise hypotensive response. J Strength Cond Res 2005;19:853-8.
6. Niemel TH, Kiviniemi AM, Hautala AJ, Salmi JA, Linnamo V,
Tulppo MP. Recovery pattern of baroreflex sensitivity after exercise.
FIGUEIREDO
Med Sci Sports Exerc 2008;40:864-70.7. Polito MD, Nbrega ACL,

Farinatti P. Blood pressure and forearm blood flow after multiple
sets of a resistive exercise for the lower limbs. Blood Press Monit
2011;16:180-5.
8. De Salles BF, Maior AS, Polito M, Novaes J, Alexander J, Rhea M
et al. Influence of rest interval lengths on hypotensive response after
strenght training sessions performed by older man. J Strenght Cond
Res 2010;24:3049-54.
9. Teixeira L, Ritti-Dias RM, Tinucci T, Mion Jnior D, Forjaz CL.
Post-concurrent exercise hemodynamics and cardiac autonomic
modulation. Eur J Appl Physiol 2011;111:2069-78.
10. Figueiredo T, Rhea MR, Bunker D, Dias I, De Salles BF, Fleck S et
al.
The influence of exercise order on local muscular endurance during resistance training in women. Hum Movement 2011;12:237-41.
11. Simo R, De Salles BF, Figueiredo T, Dias I, Willardson JM.
Exercise order in resistance training. Sports Med 2012;42:1-15.
12. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA,
Izzo JL J et al. The Seventh Report of the Joint National Committee
on Prevention, Detection, Evaluation, and Treatment of High Blood
Pressure: the JNC 7 report. JAMA 2003;289:2560-72.
13. Simo R, Spineti J, Salles BF, et al. Comparison between nonlinear
and linear periodized resistance training: Hypertrophic and strenght
effects. J Strength Cond Res 2012;26:1389-95.
14. Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN
et al.
Recommendations of blood pressure measurement in humans and experimental animals. Part 1: Blood pressure measurement in humans. A statement for professionals from the subcommittee of professional and public education of the American Heart
Association Council on high blood pressure research. Circulation
2005;111:697-716.
15. Rhea MR. Determining the magnitude of treatment effects in
strength training research through the use of the effect size. J
16. Forjaz CL, Cardoso CG, Rezk CC, Santaella DF, Tinucci T. Postexercise hypotension and hemodynamics: the role of exercise intensity. J Sports Med Phys Fitness 2004;44:54-62.
17. Secher NH. Heart rate at the onset of static exercise in man with partial neuromuscular blockade. J Physiol London 1985;368:481-90.
18. Lima AH, Forjaz CL, Silva GQ, Meneses AL, Silva AJ, Ritti-Dias
RM.
Acute effect of resistance exercise intensity in cardiac autonomic modulation after exercise. Arq Bras Cardiol 2011;96:498503.
19. Task Force of the European Society of Cardiology, the North American Society of Pacing Electrophysiology. Heart rate variability:
standards of measurement, physiological interpretation and clinical
use. Circulation 1996;93:1043-65.
20. Ruiz RJ, Simo R, Saccomani MG, Casonatto J, Alexander JL,
Rhea M et al. Isolated and combined effects of aerobic and strength
exercise on post-exercise blood pressure and cardiac vagal reactivation in normotensive men. J Strength Cond Res 2011;25:640-45.
21. Farinatti PTV, Nakamura FY, Polito MD.
Influence of recovery posture on blood pressure and heart rate after resistance exercises in
normotensive subjects. J Strength Cond Res 2009;23:2487-92.
22. Gotshall RW, Aten LA, Yumikura S. Difference in the cardiovascular response to prolonged sitting in men and women. Can J Appl
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Funding.Nothing to declare.
in the manuscript.
17

Effects of movement speed and intensity

on fast excess postexercise oxygen consumption
of bench press and half squat exercises performed to failure
M. S. C. SOUSA
1, 2 ,
A. T. ARAJO JNIOR
Aim. The aim of this study was to investigate the effects of

movement speed and intensity in the fast excess post-exercise
oxygen consumption (EPOC) in bench press (BP) and half
squat (SQ) exercises.
Methods. This was a cross-sectional study with 12 healthy
subjects (34.509.11 years, 80.5812.07 kg, 176.467.41 cm),
recreational bodybuilders involved in systematic training
three times a week for at least six month. Each subject randomly performed eight exhaustive bouts (four BP and four
SQ) combining two movement speeds (40 and 52 beats/min)
and two intensities (60% and 80% 1-RM). Recovery between
bouts was 48-h. 1-RM was assessed twice before the experiment with two 8-RM test separated by 72-h. Expired gases
were continuously measured during exercise and in the first
8-min post-exercise with a Cosmed K4 portable device.
Results. For the bench press, the repeated measures revealed
a significant effect of movement speed and time, with the lower movement speed (40 beats/min) resulting in higher VO2
mean values. For the SQ exercise, significant differences were
found for the main effect of time, but not for intensity, neither for movement speed. In addition, the fast EPOC after
BP was also greater when the slow movement speed was applied, while no significant effect of the movement speed was
observed in the SQ exercise.
Conclusion. It was concluded that, at least for BP exercise, a
slow movement speed seems to be the best way to promote an
increase in energy expenditure during the postexercise period.
Key words: Resistance training - Muscle fatigue - Oxygen consumption - Respiratory transport.
he effectiveness and the usefulness of resistance

exercise on the development of strength, muscle
hypertrophy, power and muscle endurance has long
been recognized. After the 1990 position stand of the
Corresponding author: M. do Socorro Cirilo Sousa, Center for Health
Sciences, Federal University of Paraiba (UFPB), Departament of Physical Education, Campus I - Cidade Universitria, CEP: 58038-000 Joo
Pessoa PB, Brazil. E-mail: helpcirilo@yahoo.com.br
18
1, 3 ,
A. J. LIMA NETO 1, J. VILAA-ALVES

H. M. FERNANDES 2, 4, V. M. REIS
2, 4
2, 4
1Center for Health Sciences

Federal University of Paraiba (UFPB)
Joo Pessoa, PB, Brazil
2University of Trs-os-Montes and Alto Douro (UTAD)
Vila Real, Portugal
3Federal Institute of Science and
Technology Education (IFPB)
Campina Grande, PB, Brazil
4Research Centre in Sport
Health and Human Development (CIDESD)
Vila Real, Portugal
American College of Sports Medicine, many individuals have decided to incorporate resistance exercises in their physical activity programs designed to
address health promotion.1 Aerobic and resistance
exercises are believed to increase energy expenditure
during the postexercise period. However, when it
comes to resistance exercise there is still controversy
on whether the best combinations to elevate the excess postexercise oxygen consumption (EPOC) and
thereby increase energy expenditure during the recovery phase.
It is understood that variables such as intensity,
rest interval, movement speed, number of sets,
among others, are preponderant on energy expenditure after an exercise session.2, 3 Among these, load
intensity 4 and movement speed 5, 6 may be cited
as some of the most important. The numerous possibilities of combination of these variables may favor a rather large variability in energy expenditure
of a session of strength exercise.7 Previous studies,
June 2013
Effects of movement speed and intensity on fast excess postexercise oxygen consumption
with strength exercise, have addressed the influence

of exercise order on the number of repetitions performed and perceived exertion.8, 9 Others have discussed the various modes and methods of resistance
training and their effectiveness and usefulness in
achieving the desired goals,10 or have explored
how to use the available scientific knowledge to
develop personalized training programs,11 namely
by assessing the influence of the intervals between
sets.12, 13 Moreover, different combinations of these
variables can influence both the magnitude and duration of the fast, slow and ultra-slow components
of EPOC.14 For Gaesser and Brooks,3 the metabolic
basis of the EPOC can be assessed by analyzing
its influential factors, namely the levels of catecholamines, thyroxine, glucocorticoids, fatty acid metabolism and body temperature.
For that reason, in our opinion, it is necessary
to develop more research on the influence of the
exercise prescription variables in resistance training and provide some insights that may help to
improve the related knowledge. The bioenergetics
of resistance exercise is little known, especially
when concerning the quantification of the energy
cost in specific exercises.15 Furthermore, the majority of the studies present severe limitations,
such as. Therefore, understanding the best way to
promote an increase in energy expenditure during
the postexercise in strength exercises, in different
conditions (intensity and velocity) is of great interest and warrants further investigation. Our findings and recommendations are presented based
on the need to inform exercise physiologists and
related scientist and practitioners of the caution
needed when making decisions in how to improve
the EPOC.
Knowledge on the specific energy cost of different combinations of exercise intensity and speed
of movement, are necessary to design resistance
training programs addressing the fat mass loss.
Thus, the aim of this study was to investigate the
effect of movement speed and intensity in the fast
EPOC in bench press (BP) and half squat (SQ) exercises performed to failure. Therefore, it has been
hypothesized that the EPOC, in strength training
exercises, is higher when using high loads with
lower velocity and the recruitment of large muscle
groups.
SOUSA

Participants
Twelve males volunteered for the experiment
(34.509.11 years of age, 80.5812.07 kg of body
mass, and 176.467.41 cm of height). Participants
were experienced in strength training for at least six
months and trained at least three times a week. Before
data collection, volunteers responded to the PAR-Q
questionnaire and signed an informed consent form.
All procedures were approved by the institutional
ethics committee of the Research Centre in Sport,
Health and Human Development (CIDESD) of the
Department of Sport Science, Exercise and Health
the University of Trs-os-Montes and Alto Douro
(UTAD). The following exclusion criteria were adopted: a) use of drugs that could affect the cardiorespiratory responses; b) bone, joint or muscle diagnosed problems that could limit the execution of
the resistance training; c) systemic hypertension
(140/90 mmHg or use of antihypertensive medication); and d) any type of metabolic disease.
Procedure
One repetition maximum testing and resting
metabolism assessment
Prior to pre-testing, all participants underwent
a familiarization period for three days during one
week, in which the subjects performed the same exercises as used in the 1-RM tests, with the aim of
standardizing the technique of each exercise. The
sessions included three sets of 10 repetitions, using
a light weight. After the familiarization period, all
participants performed the one repetition maximum
(1-RM) tests and retests, on two non-consecutive
days, in order to determine test-retest reliability. The
1-RM tests were then performed on the same day for
a barbell bench press and half squat (Rotech, Gois,
Brazil), with a 10 minute rest interval between exercises, using a randomized and counterbalanced
order. The 1-RM loads were determined in fewer
than five attempts with a rest interval of five minutes
between attempts. The heaviest resistance achieved
on either of the test days was considered the 1-RM
value for each exercise. No exercise besides the other tests performed, as described in the timeline, was
19
SOUSA
Figure 1.Experimental design of the study.
allowed in the period between 1-RM test sessions, in

order not to interfere with the test-retest reliability
results. To minimize error during the 1-RM tests, the
following strategies were adopted:16 (a) standardized
instructions concerning the testing procedure were
given to the participants before the test; (b) participants received standardized instructions on specific
exercise technique; and (c) verbal encouragement
was provided during the testing procedure.
Before the first familiarization session,
after a minimum of 12h fasting, resting metabolic rate (RMR)
was measured by indirect calorimetry using COSMED K4b2. The measurement was performed in
an isolated room, with the door closed and the lights
dimmed. RMR was then measured for 30 minutes.
RMR was determined from steady-state VO2 values
during the last 25 minutes of measurement.
Exercise protocols
Each subject randomly performed eight exhaustive bouts (four BP and four SQ) combining two
movement speeds (40 and 50 beats/min) and two intensities (60% and 80% 1-RM) (Figure 1). Recovery
between bouts was 48-h. 1-RM was assessed twice
before the experiment with two 8-RM test separated
20
by 72-h.17 Movement speeds during exercise were

determined using a metronome. Expired gases were
continuously measured during exercise and during
the first 8-min postexercise with a Cosmed K4 portable device (K4 b2, Cosmed USA Inc., Chicago, IL,
USA). Data was collected breath by breath and then
averaged in 20 second intervals. The purpose of time
averaging is to decrease the physiological variability in the data in gas exchange indirect calorimetry.18
Available data demonstrates that the reproducibility
of Vo2max is not affected by the length of the O2
time-average interval.19 Calibration procedures for
the K4 were performed before each session according to the manufacturer instructions.
Immediately after exercise, subjects sat quietly for 10 min and data
was recorded during the first 8-min. The fast EPOC
was calculated as the amount of VO2 above resting
level accumulated over the 8-min period.
Data are presented as meanstandard deviation
(SD). Normality and sphericity assumptions were
checked respectively with the Shapiro-Wilk and the
Mauchly tests. A 2 (intensity) X 2 (movement speed)
X 8 (minutes after exercise) within-subjects analysis
June 2013
SOUSA
Figure 2.VO2 off-kinetics in the bench press. bpm = beats per

minute, 1-RM = one repetition maximum.
Figure 3.VO2 off-kinetics in the half squat.bpm: beats per

minute; 1-RM: one epetition maximum
of variance (ANOVA) was independently conducted

for each exercise (BP and SQ). When a significant
main effect was found, post-hoc tests (Bonferroni
test with adjustment for multiple comparisons) were
used to identify pairwise differences. Partial etasquared values (p) were reported as measures of
effect size, with values higher than 0.01, 0.06 and
0.14 representing small, medium, and large effects,
respectively. 20 Statistical power for the adopted alpha level ranged from 0.99 to 1.00. The level of significance in this study was set at P<0.05.
not for intensity, F(1,11)=1.37, P=0.266, p=0.11. Significant effects were also found for the interaction
between intensity and time, F(7,77)=10.61, P<0.001,
p=0.49, and movement speed and time, F(7,77)=7.62,
P<0.001, p=0.41, with higher intensity (80%) and
lower movement speed (40 beats/min) resulting in
higher VO2 responses. However, the interaction between intensity and movement speed, F(1,11)=0.62,
P=0.450, p=0.05, and the interaction between intensity, movement speed and time, F(7,77)=0.71, P=0.667,
p=0.06, were nonsignificant. Pairwise comparisons
revealed that the 40 beats/min movement speed resulted in higher post-exercise oxygen consumption
mean values (7.210.20) when compared with the
52 beats/min movement speed (6.660.19, P<0.001).
Post-hoc tests only revealed significant decrements in
VO2 from the first to the third minute after exercise
(P<0.001) (Figure 2).
For the half squat exercise, the Shapiro-Wilk test
indicated that the data was normally distributed
(P>0.05), whereas Mauchlys Test of Sphericity indicated that the assumption of sphericity had been
violated for the main effect of time, (27)=75.52,
P<0.001, and for the interaction effect between intensity and time, (27)=55.53, P=0.002, and, therefore, Greenhouse-Geisser corrections were used
(epsilons=0.266 and 0.307, respectively). The repeated measures ANOVA revealed significant differ-
Results
The post exercise VO2 values for each exercise
condition are shown in Figure 2 (bench press) and 3
(half squat) during the 8 minutes post-exercise.
For the bench press exercise, the Shapiro-Wilk
test indicated that the data was normally distributed
(P>0.05), whereas Mauchlys Test of Sphericity indicated that the assumption of sphericity had been violated for the main effect of time, (27)=75.46, P<0.001,
and, therefore, a Greenhouse-Geisser correction was
used (epsilon=0.217). The repeated measures ANOVA
revealed significant differences for the main effects of
movement speed, F(1,11)=28.10, P<0.001, p=0.72,
and time, F(1.52,16.72)=140.44, P<0.001, p=0.93, but
21
SOUSA
Table I.Descriptive statistics for the EPOC accumulated by exercise condition.
Bench press
Half squat
40 bpm 60% 1-RM

MSD
40 bpm 80% 1-RM

MSD
52 bpm 60% 1-RM

MSD
52.288.98
68.5311.60
56.115.23
69.035.73
48.497.94
66.4211.26
ences for the main effect of time, F(1.87,20.51)=766.86,

P<0.001, p=0.99, but not for intensity, F(1,11)=0.69,
P=0.423, p=0.06, neither for movement speed,
F(1,11)=0.03, P=0.878, p=0.00. Significant effects were also found for the interaction between
intensity, movement speed and time, F(7,77)=4.55,
P<0.001, p=0.29. However, the interaction between intensity and movement speed, F(1,11)=4.54,
P=0.056, p=0.29, between intensity and time,
F(2.15,23.64)=2.08, P=0.144, p=0.16, and between
movement speed and time, F(7,77)=0.91, P=0.500,
p=0.08, were nonsignificant. Post-hoc tests revealed significant decrements in VO2 from the first
to the fourth minute after exercise (P<0.001).
The results for the fast EPOC on the first 8 minutes post-exercise for each exercise condition are
presented in Table I.
For both exercises, the Shapiro-Wilk test and
Mauchlys Test of Sphericity supported the normality and the sphericity assumptions (P>0.05). For
the bench press, the within-subjects ANOVA revealed a significant effect for the exercise condition,
F(3,33)=3.41, P=0.029, p=0.72. Significant post-hoc
differences were found between exercise conditions performed at the same intensity but at different
movement speeds. More specifically, pairwise comparisons indicated that bench press exercises performed at a slower velocity resulted in significantly
greater magnitudes of EPOC (P<0.05). Regarding
the half squat, no significant effect was found for the
exercise condition (F(3,33)=0.88, P=0.459, p=0.08).
Discussion
The aim of this study was to investigate the effect
of movement speed and intensity in the fast EPOC
in bench press and half squat exercises performed to
failure. The main findings of the present study for the
bench press, were a significant effect of movement
speed and time, with the lower movement speed (40
beats/min) resulting in higher VO2 mean values. For
22
52 bpm 80% 1-RM

MSD
51.096.49
70.847.24
the SQ exercise, significant differences were found

for the main effect of time, but not for intensity, neither for movement speed. In addition, the fast EPOC
after BP was also greater when the slow movement
speed was applied, while no significant effect of the
movement speed was observed in the SQ exercise.
The investigation of the effects of resistance exercise on EPOC is not new. Factors such as increased
body temperature, maintenance of hyperkinetic circulation or high ventilation have been identified as related to a higher VO2 in the first hour subsequent to
a resistance training session. 21 Indeed, studies using
resistance exercise have demonstrated its effect on the
magnitude of energy expenditure during the recovery period with results ranging from 6 to 114 kcal,
60 min to 15h after exercise.8, 12, 22 Although a higher
emphasis has been placed on the slow component of
the EPOC, where the metabolism of fatty acids may
be increased for several days,3, 23 the present study
aimed to solely evaluate the fast component of the
EPOC. For the fast component, replenishment of energy phosphates and oxyhemoglobin, the restoration
of muscle phosphate supplies and power required for
the conversion of lactate into glycogen could explain
up to half of the variation in EPOC. 7 In the present
study we did not aim to assess the magnitude of the
increased post-exercise energy expenditure but rather
compare variations of two typical resistance exercises
regarding its intensity and movement speed. If differences were to exist, then these should be mirrored
in the first minutes post-exercise. In fact, the present
study showed the rapid decline of VO2 after BP and
SQ exercises performed to failure, as post-exercise
VO2 returned close to resting values after 3-min and
after 4-min, respectively in BP and in SQ exercises.
Thornton and Potteiger,4 in a study with 14 men,
compared high-intensity (2 sets of 8 repetitions at
85% of 8-RM) with low intensity (2 sets of circuit,
with 15 repetitions at 45% of 8-RM) resistance exercise bouts, with 60 seconds of rest between sets.
They found that exercise performed with greater intensity produced a higher EPOC for all post-exercise
June 2013
periods that were studied (20, 60 and 120 minutes).

The increase in EPOC in high-intensity exercise was
probably caused by an increased metabolic response
during exercise, which requires increased energy
turnover. The results of the present study do not confirm this assumption, since no significant main effect
of exercise intensity on the fast EPOC was observed.
A recently study made by Thornton et al.,24 with
overweight females, corroborate with your findings. There results suggest that resistance training
using low (45% of 8RM) or high intensity (85% of
the 8RM) with an equated work volume (3 sets of
15 and 8 repetitions, low and high intensity, respectively) produce a similar EPOC. On the other hand,
exercises with large muscle groups tend to increase
the total energy cost 25 and, consequently, a higher
EPOC.26 In the present study, the results confirm that
the exercise that involved larger muscle groups (SQ)
required a greater energy turnover post-exercise and
amounted a larger EPOC during the 8-min period of
the end of the exercise.
We analyze the effect of different movement
speeds in the two exercises that were investigated.
We could not find in the literature a similar protocol.
However, Hunter et al.5 compared the effect of the
traditional versus super slow resistance training in
the energy expenditure during and 15 minutes post
exercise session. They observed higher energy expenditure during and after session in the traditional
resistance training. But, is important refer, that the
velocity of the movement used in the traditional resistance training was 0.9 seconds on the concentric
phase of the movement and 0.8 seconds on the eccentric phase. This movement velocity was lower
than the two velocities used in the present study.
The research herein sought a sample of male practitioners familiarized with strength training, as a
means to minimize possible errors due to typical
research bias. This procedure matches what is typical in the literature. It has been shown that repetitions performed at high velocities with moderate to
high loads more suitable than low velocities for increases in muscle strength.5 Also, high-speed muscle
contractions, which involve greater threshold motor
units, could induce a more expensive energy cost.
27 However, our results suggest that, at least for the
BP exercise, a high movement speed may low the
post-exercise energy expenditure, whereas no differences were detected in the SQ exercise.
SOUSA
A possible limitation of this study is associated

with energy expenditure pre-exercise, which was not
measured; thus, it is not possible to determine if the
resting metabolism before the sessions was similar
or not. Moreover and since the present study only
addressed two exercises/intensities/velocities, future
research is needed to fully elucidate the relationships
between variations in exercise intensity, movement
velocities and their effect on energy expenditure in
both women and men, trained or untrained.
Conclusions
Post-exercise VO2 declined fast from the first minute to the second minute and attained almost 100%
of the decline (near resting VO2 values) at the 4th
minute of recovery for both BP and SQ exercises.
The movement speed did not affect the fast EPOC
in SQ but it did in BP (where the lower movement
speed induced a higher EPOC). It was concluded
that, at least for BP exercise, in a reduced movement
speed (40 bpm) leads to inducing the muscles a larger time under tension, which seems to be the best
way to promote an increase in energy expenditure
during the fast post-exercise period seems to be the
best way to promote an increase in energy expenditure during the fast postexercise period.
Knowledge of the energy cost, influenced by intensity variables in resistance exercise prescription
should of great interest to those who exercise, at
least partly for weight control, considering the fast
excess postexercise oxygen consumption in a rest
interval between series during a resistance exercise
bout. Thus, in a weight loss program, the specific
types of resistance exercises (e.g., bench press) with
slow movement speed should be included with aerobic exercise to promote fat loss or body composition
improvement. These findings have useful implications for recreational exercisers and personal fitness
trainers that aim to optimize the excess post-exercise
oxygen consumption.
References
1. ACSM. American College of Sports Medicine Position Stand. The
recommended quantity and quality of exercise for developing and
maintaining cardiorespiratory and muscular fitness, and flexibility
in healthy adults. Med Sci Sports Exerc 1998;30:975-91.
2. Castinheiras Neto AG, Silva NL, Farinatti PTV. Influncia das vari-
23
SOUSA
veis do treinamento contra-resistncia sobre o consumo de oxignio em excesso aps o exerccio: uma reviso sistemtica. Rev Bras
Med Esporte 2009;15:70-8.
3. Gaesser GA, Brooks GA. Metabolic bases of excess post-exercise
oxygen consumption: a review. Med Sci Sports Exerc 1984;16:29-43.
4. Thornton MK, Potteiger JA. Effects of resistance exercise bouts of
different intensities but equal work on EPOC. Med Sci Sports Exerc
2002;34:715-22.
5. Hunter GR, Seelhorst D, Snyder S. Comparison of metabolic and
heart rate responses to super slow vs. traditional resistance training.
J Strength Cond Res 2003;17:76-81.
6. Cormie P, McGuigan MR, Newton RU. Developing maximal neuromuscular power: part 2 - training considerations for improving
maximal power production. Sports Med 2011;41:125-46.
7. Bangsbo J. Quantification of anaerobic energy production during
intense exercise. Med Sci Sports Exerc 1998;30:47-52.
8. Monteiro W, Simo R, Farinatti P. Manipulao na ordem dos
exerccios e sua influncia sobre nmero de repeties e percepo
subjetiva de esforo em mulheres treinadas. Rev Bras Med Esporte
2005;11:146-50.
9. Simao R, Farinatti PT, Polito MD, Maior AS, Fleck SJ. Influence
of exercise order on the number of repetitions performed and perceived exertion during resistance exercises. J Strength Cond Res
2005;19:152-6.
10. Stone MH, Wilson GD. Resistive training and selected effects. Med
Clin North Am 1985;69(1):109-22.
11. Fleck SJ, Kraemer WJ. Designing resistance training programs.
Champaign, Il: Human Kinetics; 2004.
12. Richmond SR, Godard MP. The effects of varied rest periods between sets to failure using the bench press in recreationally trained
men. J Strength Cond Res 2004;18:846-9.
13. Willardson JM, Burkett LN. The effect of rest interval length on the
sustainability of squat and bench press repetitions. J Strength Cond
Res 2006;20:400-3.
14. Matsuura C, Meirelles CM, Gomes PSC. Gasto energtico e consu
mo de oxignio ps-exerccio contra-resistncia. Revista Nutrio
2006;19:729-40.
15. Scott CB. Contribution of blood lactate to the energy expenditure of
weight training. J Strenght Cond Res 2006;20:404-11.
16. Simao R, Spineti J, de Salles BF, Matta T, Fernandes L, Fleck SJ
et al.
Comparison between nonlinear and linear periodized resistance training: hypertrophic and strength effects. J Strength Cond
Res 2012;26:1389-95.
17. Brzycki H. Strength testing: predicting a one-rep max from reps-tofatigue. JOHPERD 1993;64:2.
24
18. Robergs RA, Dwyer D, Astorino T. Recommendations for improved

data processing from expired gas analysis indirect calorimetry.
Sports Med 2010;40:95-111.
19. Midgley AW, McNaughton LR, Carroll S. Effect of the Vo2 timeaveraging interval on the reproducibility of Vo2max in healthy athletic subjects. Clin Physiol Funct Imaging 2007;27:122-5
20. Cohen J. Statistical Power Analysis for the Behavioral Sciences.
Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
21. Borsheim E, Bahr R. Effect of exercise intensity, duration and mode
on post-exercise oxygen consumption. Sports Med 2003;33:103760.
22. Sforzo GA, Touey PR. Manipulating exercise order affects muscular performance during a resistance exercise training session. J
23. Dolezal BA, Potteiger JA, Jacobsen DJ, Benedict SH. Muscle damage and resting metabolic rate after acute resistance exercise with an
eccentric overload. Med Sci Sports Exerc 2000;32:1202-7.
24. Thornton MK, Rossi SJ, McMillan JL. Comparison of two different resistance training intensities on excess post-exercise oxygen
consumption in African American women who are overweight. J
25. Robergs RA, Gordon T, Reynolds J, Walker TB. Energy expenditure during bench press and squat exercises. J Strength Cond Res
2007;21:123-30.
26. Burns SF, Oo HH, Tran AT. Effect of sprint interval exercise on postexercise metabolism and blood pressure in adolescents. Int J Sport
Nutr Exerc Metab 2012;22:47-54.
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versus slow contractions and exercise intensity on energy expenditure. Med Sci Sports Exerc 2007;39:1291-301.
Funding.This research was funded by Center for Research in
Sport, Health and Human Development (CIDESD) of the Department of Sport Science, Exercise and Health the University of Trsos-Montes and Alto Douro (UTAD).
Conflicts of interest.The authors certify that there is no conflict of interest with any financial organization regarding
the material discussed in the manuscript.
Acknowledgements.We thank the interagency Federal University of Paraba - Brazil and University Trs-os-Montes and Alto
Douro - Portugal for the permission to conduct this research.
June 2013

Effects of different isokinetic knee extension

warm-up protocols on muscle performance
J. B. FERREIRA-JNIOR
1, 2 ,
C. A. VIEIRA 1, 3, S. R. S. SOARES 1, I. E. J. MAGALHES 1,

V. A. ROCHA-JNIOR 1, A. VIEIRA 1, M. BOTTARO 1
Aim. The optimal warm-up protocol for isokinetic strength

performance assessment remains unclear. Therefore, the
purpose of this study was to analyze the effects of different
warm-up routines on strength production in young adults.
Methods. Fifteen healthy young men (24.83.5 years) were exposed to five different isokinetic warm-up protocols. Isokinetic
strength was assessed after each protocol at 60.s-1. The warmup protocols were: (1) submaximal, 10 submaximal consecutive
repetitions (50% of maximum effort) at 60.s-1; (2) intermittent,
one set of 10 maximal intermittent contractions (30 s between
contractions) at 60.s-1; (3) 180, 10 maximal consecutive repetitions at 180.s-1; (4) 300, 10 maximal consecutive repetitions at
300.s-1 and (5) control session (no warm-up).
Results. Peak torque was greater (P<0.05) after the intermittent (295.353.2 N.m) when compared to 300 (267.547.3
N.m) and 180 (275.248.6 N.m) warm-up protocols. Also,
peak torque was higher (P<0.05) in the control (285.448.7
N.m) protocol when compared to 300. Load range was greater
(P<0.05) in both no warm-up (121.53.5 ms) and intermittent
(121.62.4 ms) protocols when compared to 300 (118.46.7
ms) and submaximum (117.75.5 ms) warm-up protocols.
Power did not differ among protocols (P=0.31).
Conclusion. Warm-up is not necessary before isokinetic tests,
however, for those subjects that believe in physiological benefits of warm-up, the intermittent protocol could be an interesting strategy. In addition, subjects should avoid warm-up
using velocities higher than the testing velocity.
Key words: Muscle strength dynamometer - Torque - Quadrceps muscle.
he assessment of human performance is important for functional capacity assessment and appropriate exercise prescription for athletes and reha-
Corresponding author: J. Batista Ferreira Jnior, Federal Institute of

Triangulo Mineiro, Road MG 188, km 167, Fazendinha, 38600-000 Paracatu, Minas Gerais, Brazil. E-mail: joaojunior@iftm.edu.br
1College of Physical Education

University of Braslia, Braslia, Brazil
2Federal Institute of Tringulo Mineiro
Minas Gerais, Brazil
3College of Physical Education
Federal University of Gois, Goinia, Brazil
bilitation.1 Muscular strength is a valuable attribute

to perform many day-to-day activities, as well as important on sports performance. Thus, there is a need
for a reliable and accurate assessment of muscular
performance parameters to determine an individuals
capabilities and potential limitations.2 The device universally accepted as gold standard for force measurement is the isokinetic dynamometer.3 However,
many internal and external factors in the isokinetic
testing procedures can have an undesirable effect on
the test results.4 One factor would be the warm-up
performed before an isokinetic test or training.
Bishop 5 and Sweet 6 believe that warm-up provide
a physical and psychic readiness state before exercise. According to Bishop,5 warm-up has been proposed to affect performance through various mechanisms such as decrease in the viscous resistance of
muscles, increase in oxygen delivery to the muscle,
as well as anaerobic metabolism, and nerve conduction rate. Also, recent study reported that warm-up
before exercise can cause postactivation potentiation. The post activation potentiation is the transient
increase in muscle contractile performance following previous conditioning contractile activity.7
Many authors recommend to warm-up before an
25
FERREIRA-JNIOR
Isokinetic knee extension warm-up protocols
isokinetic exercise or test to achieve maximal performance.1, 8 However, studies utilizing isokinetic
strength testing or training have been using different
warm-up protocols. Further examination of isokinetic testing protocols revealed that the warm-up velocities used in the literature range from 30 to 300.s-1,2,
9-16 and in many cases investigators fail to report the
warm-up protocol.17, 18 Thus, there is no consensus
about the appropriate warm-up protocol that should
be performed before an isokinetic test or training. As
a result, the purpose of this study was to analyze the
effects of different isokinetic warm-up protocols on
muscle performance in young adults.
Procedures
Participants
Fifteen healthy young men (24.83.5 years,
83.711.4 kg, 178.89 cm) volunteered to participate
in this study. All the subjects were included if they exercised (aerobic and/or anaerobic) at least three days
per week for 30 min session (5.53.4 practice years).
They were free from any lower-limb musculoskeletal
injuries and neuromuscular disorders. The investigation was approved by an institutional review board for
use of human subjects, followed the principles of the
Helsinki declaration and all the participants signed an
informed consent form before participation.
Experimental design
One week before the beginning of the studies, subjects visited the laboratory for a familiarization session with the experimental procedures. To test the
effects of specific warm-up on muscle performance,
subjects carried out an isokinetic knee extension
strength test after each warm-up protocols on five
separate days with seven days apart. The isokinetic
strength test consisted two sets of four repetitions at
60.s-1 with 60 s of rest interval. The warm-up situations for knee extensors were: 1) submaximal, 10
submaximal consecutive repetitions (50% of maximum effort) at 60.s-1; 2) intermittent, one set of 10
maximal intermittent contractions (30 s between contractions) at 60.s-1; 3) 180, 10 maximal consecutive
repetitions at 180.s-1; 4) 300, 10 maximal consecutive repetitions at 300.s-1; and 5) control session (no
26
warm-up), sat quietly. The different warm-up protocols were randomly assigned for each of the five test
sessions in a counterbalanced fashion.
The submaximum warm-up, warm-up at 180.s-1
and warm-up at 300.s-1 were chosen because they
have been frequently used during warm-up routines
before isokinetic performance studies.2, 9-14 The intermittent warm-up was chosen since recent research
has shown that intermittent contraction could be an
effective way to produce greater peak torque.15 To
avoid circadian influences, the subjects performed
all situations at the same time of day. The participants were instructed to avoid strenuous physical activity for lower limbs and caffeine consumption 48
and 24 h prior to the experiment, respectively.
Isokinetic peak torque, as well as power output

were measured by the Biodex System 3 Isokinetic
Dynamometer (Biodex Medical, Inc., Shirley, NY,
USA). The participants were positioned comfortably
on the dynamometer seat with safety belts fastened
on the trunk, pelvis and thigh to minimize extra body
movements which could affect the peak torque and
power output values. The lateral epicondyle of the
femur was used as a marker to align the knee rotation
axis and the instrument rotation axis, allowing free
and comfortable knee flexion and extension from 80
flexion to full extension. With the participants positioned on the seat, the following measures were recorded: seat height, backrest inclination, dynamometer height and lever arm length. These measures
were recorded on familiarization session to standardize the test position of each participant individually.
Gravity correction was obtained by measuring the
torque exerted by the lever arm and the participants
leg at full extension and relaxed. The values of the
isokinetic variables were automatically adjusted for
gravity with the software Biodex Advantage (Biodex
Medical, Inc., Shirley, NY, USA). All these procedures were in accordance to Bottaro et al.19
The calibration of the Biodex dynamometer was
carried out according to the specifications contained
in the instruction manual. For the test, the participants were asked to cross the arms across the chest.
Moreover, they received verbal encouragement
throughout the testing session. The test procedure
was carried out by the same examiner for all partici-
June 2013
FERREIRA-JNIOR
Table I.Isokinetic variables evaluated during knee extension isokinetic test after the following warm-up protocols: submaximum,
intermittent, at 180.s-1, at 300.s-1 and no warm-up.
Peak torque (N.m)

Power (W)
Load range (ms)
No warm-up
Submaximum
285.448.7*
195.432.7
121.53.5
281.944.8
190.641.6
117.75.5
Intermittent
295.353.2* #
198.235.9
121.62.4
180.s-1
300.s-1
275.248.6
190.833
119.83.8
267.547.3
183.828.1
118.46.7
(*) P< 0.05, higher than 300.s-1. (#) P< 0.05, higher than 180.s-1. () P< 0.05, higher than submaximum and 300.s-1.
pants. The load range, defined as the range of motion

in which the subject sustained a preselected isokinetic velocity,20 started when the volunteers obtained at
least 95% of preset speed (60.s-1) and finished when
values below this levels were reached.4
Statistical analyses
Data are presented as mean+standard deviation.
The Komolgorov-Smirnov test was used to check data
for normal distribution. Considering that data presented normal distribution, a one-way repeated measure
ANOVA was used to verify differences in peak torque,
power output and load range. In the case of significant
differences, a Student Newman Keuls post-hoc test
was applied. The significance level was set at 5%.
Results
The results on peak torque, power output and load
range after the warm-up protocols are reported in Table I. Peak torque was higher after the control and
intermittent protocols when compared to 300 protocol (F=5.15, P=0.001, power=0.905 and p2=0.27).
Also, peak torque after the intermittent protocol was
significantly greater than 180 protocol.
There was no difference among protocols on power
output (F=1.21, P=0.31, power=0.091 and p2=0.08).
On the other hand, load range was greater after the
control and intermittent protocols when compared to
300 and submaximum protocols (F=2.85, P=0.034,
power=0.51 and p2=0.19).
Discussion
The aim of this study was to analyze the different warm-up protocols before an isokinetic test on
muscle performance. One of the main findings of the

present study was that the warm-ups protocols were
not more efficient than no warm-up control protocol.
Altamirano et al.21 examined concentric and isometric muscle performance during knee extension after
two warm-up situations: 1) 10 min of stationary cycling at 70% of predicted maximum heart rate; and
2) no warm-up. The results indicated that an active
warm-up did not affect peak torque, rate of torque
development, or measures of muscle activation (amplitude and frequency of electromyographic signal
and mechanomyographic frequency).
In a point/counterpoint, Sweet and Hagerman 6
mentioned that performing 1 or 2 sets of light intensity
work prior to each set of exercise is supposed to help
prepare a muscle for higher intensity exercise by increasing local blood flow to the muscle and loosening
the connective tissues to prevent strains. As a counterpoint, they argued that anytime a muscle is used, the
cardiovascular system responds within a few seconds
to increase blood flow to working muscles in order
to provide necessary oxygen. Moreover, the source
of ATP could be depleted to some extent with warmup sets, which would reduce the muscles fully rested
capability. This hypothesis may help explain why the
warm-ups protocols have not been more efficient than
no warm-up control protocol in the present study.
Another interesting finding of the present study
was that control and intermittent protocols showed
higher peak torque when compared to higher velocities warm-ups protocols (180 and 300). In accordance to Bishop,22 it appears that task-specific warmup may provide ergogenic benefits in addition to
those provided by a general, active warm-up. Both
180 and 300 warm-ups were the only warm-up protocols non specific to the isokinetic test performed
in the present study. Besides, Bishop 22 suggest that
low intensity warm-up can worsen short-term (<10
s) and intermediate performance (>10 s, but <5 min).
27
FERREIRA-JNIOR
Thus, the non specificity and also lower intensity of

180 and 300 warm-up protocols seem to be responsible for the impaired peak torque when compared
to control and intermittent protocols. The lower load
range in the 300 warm-up protocol reported in this
study contributes to this assumption.
Bishop 5 also suggested that high intensity warmup, especially if it includes maximum voluntary
contraction, may enhance muscle performance by
postactivation potentiation. Thereby, postactivation
potentiation may have been occurred during the
intermittent protocol.15 Batista et al.15 tested if an
intermittent muscle contraction protocol produces
a cumulative effect of postactivation potentiation
between consecutive contractions. Ten subjects underwent 5 randomized experimental sessions, during
which they performed a set of 10 unilateral knee extensions, one every 30 s, at 60.s-1 in an isokinetic
dynamometer. The peak torque was evaluated over
the 10 unilateral knee extensions as well as at the
randomized intervals of 4, 6, 8, 10, and 12 min post
intermittent muscle contractions by 3 knee extensions at 60.s-1. Peak torque was potentiated 1.30.79
N.m per unilateral knee extensions. Additionally the
potentiation effect persisted for 12 min after the last
contraction, indicating that intermittent conditioning activities seem to be an effective way to produce
postactivation potentiation.
It has also been hypothesized that warm up may
have a number of psychological effects, for example,
increased preparedness.5, 6 Sweet and Hagerman 6
reported that specific warm-up focuses the individuals attention on what exactly they need to do, thus
providing the proper mental state for the exercise.
In this way, the warm-up may allow the individual
time to practice proper form and technique for each
exercise. Thereby, for those that believe in the psychology effects of warm-up, the intermittent protocol could be an interesting strategy. A major limitation of the study was that the mechanisms of muscle
activation during warm-up were not measured. Also,
different warm-up modes such as running, cycling
or stretching were not assessed in the present study.
Conclusions
In conclusion, warm-up could not be necessary before isokinetic test or training. On the
28
other hand, for individuals or athletes habituated

to warm-up before resistance exercise, the intermittent protocol could be an interesting strategy.
However, those individuals should avoid warm-up
using velocities higher than the velocity used for
testing or training. Further studies on this topic are
necessary in order to provide grounds for a more
precise conclusion and understanding of the effect
of intensity, velocity, duration, and recovery duration during warm-up before an isokinetic muscle
performance.
References
1. Brown LE, Weir JP. ASEP Procedures recommendation I: accurate assessment of muscular strength and power. J Exerc Physiol
2001;4:1-21.
2. Bottaro M, Russo A, de Oliveira RJ. The effects of rest interval on
quadriceps torque during an isokinetic testing protocol in elderly. J
Sports Sci Med 2005;4:285-90.
3. De Ste Croix M, Deighan M, Armstrong N. Assessment and interpretation of isokinetic muscle strength during growth and maturation. Sports Med 2003;33:727-43.
4. Schwartz FP, Bottaro M, Celes RS, Brown LE, Nascimento FAD.
The influence of velocity overshoot movement artifact on isokinetic
knee extension tests. J Sports Sci Med 2010;9:140-6.
5. Bishop D. Warm up I: potential mechanisms and the effects of passive
warm up on exercise performance. Sports Med 2003;33:439-54.
6. Sweet SH, Hagerman, P. Warm-up or no warm-up. Strength Cond J
2001;23:36-36.
7. DeRenne C. Effects of postactivation potentiation warm-up in male
and female sport performances: a brief review. Strength Cond J
2010;32:58-64.
8. Osternig LR. Isokinetic dynamometry: implications for muscle testing and rehabilitation. Exerc Sport Sci Rev 1986;14:45-80.
9. Stock MS, Beck TW, DeFreitas JM. The effects of diverting activities on recovery from fatiguing concentric isokinetic muscle actions. J Strength Cond Res 2011;25:1911-7.
10. Signorile JF, Carmel MP, Lai SH, Roos BA. Early plateaus of power
and torque gains during high- and low-speed resistance training of
older women. J Appl Physiol 2005;98:1213-20.
11. Katsiaras A, Newman AB, Kriska A, Brach J, Krishnaswami S,
Feingold E, et al. Skeletal muscle fatigue, strength, and quality
in the elderly: the Health ABC Study. J Appl Physiol 2005;99:
210-6.
12. Howatson G, Glaister M, Brouner J, van Someren KA. The reliability of electromechanical delay and torque during isometric and concentric isokinetic contractions. J Electromyogr Kines 2009;19:9759.
13. de Souza TPJr, Fleck SJ, Simao R, Dubas JP, Pereira B, Pacheco
EMD et al. Comparison between constant and decreasing rest intervals: influence on maximal strength and hypertrophy. J Strength
Cond Res 2010;24:1843-50.
14. Cramer JT, Housh TJ, Weir JP, Johnson GO, Ebersole KT, Perry SR
et al. Power output, mechanomyographic, and electromyographic
responses to maximal, concentric, isokinetic muscle actions in men
and women. J Strength Cond Res 2002;16:399-408.
15. Batista MAB, Ugrinowitsch C, Roschel H, Lotufo R, Ricard
MD, Tricoli VAA. Intermittent exercise as a conditioning activity to induce postactievation potentiation. J Strength Cond Res
2007;21:837-40.
June 2013
16. Arroyo-Morales M, Fernandez-Lao C, Ariza-Garcia A, Toro-Velasco C, Winters M, Diaz-Rodriguez L et al. Psychophysiological

effects of preperformance massage before isokinetic exercise. J
17. Pincivero DM, Lephart SM, Karunakara RG. Effects of rest interval
on isokinetic strength and functional performance after short term
high intensity training. Br J Sports Med 1997;31:229-34.
18. Deli CK, Paschalis V, Theodorou AA, Nikolaidis MG, Jamurtas
AZ, Koutedakis Y. Isokinetic knee joint evaluation in track and field
events. J Strength Cond Res 2011;25:2528-36.
19. Bottaro M, Ernesto C, Celes R, Farinatti PTV, Brown LE, Oliveira
RJ. Effects of age and rest interval on strength recovery. Int J Sports
Med 2010;31:22-5.
20. Brown LE, Whitehurst M, Findley BW, Gilbert R, Buchalter DN.
Isokinetic load range during shoulder rotation exercises in elite
male junior tennis players. J Strength Cond Res 1995;9:160-4.
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21. Altamirano KM, Coburn JW, Brown LE, Judelson DA. Effects of
warm-up on peak torque, rate of torque development, and electromyographic and mechanomyographic signals. J Strength Cond Res
2012;26:1296-301.
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Acknowledgements.The authors would like to thank the Conselho Nacional de Desenvolvimento Cientifico e Tecnolgico in
Brazil.
29

Biomechanical determinants
of force production in front crawl swimming
J. RIBEIRO 1, K. DE JESUS 1, P. FIGUEIREDO
Aim. Swimming propulsive force is a main performance

determinant that has been related to some biomechanical
parameters. Nevertheless, as the link among those parameters and force production remains unclear, it was aimed to
examine the relationships between the stroking parameters,
intracycle velocity variations, arm coordination, propelling
efficiency and force production in front crawl swimming.
Methods. Ten trained swimmers performed two repetitions
of an intermittent graded velocity protocol using arms-only
front crawl technique (one on the system to measure active
drag force, which gives us the mean propulsive force, and
other in free-swimming conditions), consisting in 10 bouts
of 25 m from slow to maximal velocity. The tests were videotaped in the sagittal plane (2D kinematical analysis) and
video images were digitized enabling the stroking parameters
(velocity, stroke frequency and stroke length), intracycle velocity variations, index of coordination and propelling efficiency assessment.
Results. Force presented a direct relationship with velocity,
stroke frequency and index of coordination (r=0.86, 0.82,
0.61, respectively, P<0.05) and an inverse relationship with
stroke length, intracyclic velocity variations and propelling
efficiency (r=-0.66, -0.57, 0.60, respectively, P<0.05). The relationships between force and velocity, and between force
and intracyclic velocity variations, were best expressed by
a power regression model (F=18.01v2.5 and F =3.00IVV-1.50,
respectively). A quadratic regression was the most appropriated model for expressing the relationships between force
and stroke frequency (F=-57.10SF2+220.98SF-105.04), index
of coordination (F=45.45IdC2+2.10IdC+0.05) and propelling
efficiency (F=328.62F2-1350.212F+1536.46).
Conclusion. High stroke frequency, optimal coordination and
low intracyclic velocity variations seem to be required to produce high force values in front crawl swimming. By knowing
Corresponding author: R. J. Fernandes, Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University
of Porto, Rua Plcido Costa 91, 4200 Porto, Portugal.
E-mail: ricfer@fade.up.pt
30
1, 2 , H. TOUSSAINT 3 , L. GUIDETTI 4 , F. ALVES 5

J. PAULO VILAS-BOAS 1, 6, R. J. FERNANDES 1, 6
1Centre of Research, Education

Innovation and Intervention in Sport, Faculty of Sport
University of Porto, Porto, Portugal
2Higher Education Institute of Maia, Maia, Portugal
3Amsterdam University of Applied Sciences
School of Sports and Nutrition, Amsterdam, Netherlands.
4Health Sciences Department
University of Rome Foro Italico, Rome, Italy
5Faculty of Human Movement
Technical University of Lisbon, Lisbon, Portugal
6Porto Biomechanics Laboratory
University of Porto, Porto, Portugal
how to manipulate those variables, both in training and competition conditions, swimmers would be able to increase their
force production.
Key words: Biomechanics - Swimming - Stroke.
wimming velocity depends on the generation of

propulsive force necessary to match the hydrodynamic drag produced by the moving body. So, the
capability to produce high propulsive force, while
reducing the opposite drag, is decisive to achieve
a certain velocity.1, 2 Since velocity is a product of
stroke frequency (SF) and stroke length (SL), and
its increase (or decrease) is determined by SF and
SL combinations,3, 4 the relationship between these
parameters is one of the major points of interest in
swimming training and research.1, 5 Nevertheless, the
complex relationships between those stroke characteristics have been often reported as the swimmers
ability to swim with high efficiency, emphasizing the
swimming technique rather than the propulsive force
June 2013
Biomechanical determinants of force production
RIBEIRO
Figure 1.System to measure active drag (MAD-sytem, A) and respective force transducer (B).
production. In fact, the relationship between stroking parameters and the effective ability to produce
muscular force (to execute the stroke cycles) lacks
experimental evidence.
The action of the arms, legs and trunk varies, during a stroke cycle, resulting in an intermittent application of force and, therefore, in intracycle velocity
variations 6 (IVV) that are responsible for average
velocity degradation.7 The IVV have also been reported as a relevant swimming performance determinant since, for a finite energy supply, the best
solution to optimize performance is to reduce its
magnitude and increase the capacity to produce propulsive force.4, 7 Increases in IVV imply greater mechanical work demand and, theoretically, changes of
10% in the swimming velocity within a stroke cycle
results in an additional work of about 3%.8 Therefore, IVV should give an indication of swimming efficiency and swimmers technical level.9
Complementarily, it is known that IVV are influenced by inter-arm coordination 10, 11 (traditionally
assessed by the index of coordination IdC that
quantifies the lag time between the propulsive action
of the two arms). It was observed previously that
when during increasing swim paces a change from
catch-up to superposition has been adopted by elite
swimmers to maintain continuity between the propulsive phases,9 meaning that using a best coordination solution, swimmers should be able to reduce
IVV and optimize propulsion.4, 7
Nonetheless, the propulsion continuity in swimming could not be automatically related to greater
propulsion generation, since it depends on the correct orientation and velocity of the body segments.
Thus, the capability to generate effective propulsion
reflects the swimmers propelling
efficiency,
and despite it
has been considered as a swimming performance determinant, and discriminative of technical
level,12 its relationship with force production has not
yet been clarified. The purpose of this study was to
examine the relationships between stroking parameters, IVV, arm coordination, propelling efficiency
and force production in front crawl swimming.
Participants
Ten trained male swimmers volunteered to participate in the present study. Their main physical characteristics, training background and performance are
as follows: 18.962.56 years, height: 1.800.65 m,
body mass: 72.464.33 kg, years of training background: 13.573.08, percentage of the 100 m world
record: 89.5715.91%). Participants were previously familiarized with the test procedures and the
equipment used in the experiment. All participants
provided informed written consent before data collection, which was approved by the local ethics com-
31
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mittee. All experiments were conducted according to

the Declaration of Helsinki.
Experimental procedure
The test session took place in a 25 m indoor pool,
1.90 m deep, with a water temperature of 27.5 C. A
warm-up of low to moderate swimming intensity was
conducted, both in free swimming and on a system
to measure active drag force (MAD-system).12 Briefly, each subject performed two sets of an intermittent graded velocity protocol consisting in 10 bouts
of 25 m front crawl using only the arms (with the
legs elevated and constrained by a pull buoy), with 3
min rest in-between, from slow to maximal velocity:
one set was conducted on the MAD-system and the
other in free-swimming conditions, with a 24 h interval. Each bout was self-paced to avoid the velocity
variations that can arise when the swimmer follows
a target.9 The swimmers were randomly assigned to
start testing by performing on the MAD-system or
swimming freely. Each subject swam alone, avoiding pacing or drafting effects.
MAD-system
The MAD-system required the swimmer to directly push-off fixed pads attached to a 23 m rod,
which was fixed 0.8 m below water surface, and
had a standard distance of 1.35 m between each pad
(Figure 1A). The rod was instrumented with a force
transducer allowing measurement of push-off force
from each pad (Figure 1B).
The force signals were acquired by an A/D converter (BIOPAC Systems, Inc., Goleta, CA, USA)
at a sample rate of 500 Hz and filtered with a low
pass digital filter with a cut-off frequency of 10 Hz.
Assuming a constant swimming velocity, the mean
force equals the mean drag force and, hence, the 10
velocity/force ratio data were least square fitted according to Equation 1:
D = A . vn (1)
where D is active drag force, A and n are parameters of the power function and v is the swimming
velocity. For each subject A and n were estimated
using equation (1) (Matlab version R2012a, Mathworks, Inc., Natick, MA, USA) with a LevenbergMarquardt algorithm.2, 13
32
Biomechanical parameters
Swimmers were videotaped in the sagittal plane
(for 2D kinematical analysis) using a underwater
camera (Sony DCR-HC42E, 1/250 digital shutter, Nagoya, Japan) kept at 0.30 m depth (Sony
SPK-HCB waterproof box, Tokyo, Japan) and at
6.78 m from the plane of movement, as previously
described.14 Subjects were monitored when passing through a specific pre-calibrated space using
two-dimensional rigid calibration structure (6.30
m2) with six control points. The video images were
digitized using Ariel Performance Analysis System
(Ariel Dynamics, San Diego, USA) at a frequency
of 50 Hz, considering five anatomical reference
points: humeral heads, ulnohumeral joints, radiocarpal joints, 3rd dactylions and trochanter major. A
2D reconstruction was accomplished using Direct
Linear Transformation algorithm and a low pass
digital filter of 5Hz.
SF was assessed by the inverse of the time needed
to complete one stroke cycle and SL by the horizontal displacement of the left hip. The mean velocity
was computed by dividing the swimmers average
hip horizontal displacement by the time required to
complete one stroke cycle. The IVV was calculated
through the coefficient of variation of the velocity to
time mean values (Equation 2):7
CV = SD . mean-1 (2)
where CV is the coefficient of variation and SD the
standard deviation of velocity values.
Arm coordination was quantified using the IdC,
measuring the time duration between the final of
the propulsive action of one arm and the beginning of the propulsion of the other, and expressed
as percentage of the overall duration of the stroke
cycle.15 The propulsive phase was considered to
begin with the start of the backward movement
of the hand until the moment where it exits from
the water (pull and push phases), and the non-propulsive phase initiates with the hand water release
and ends at the beginning of the propulsive phase
(recovery, entry and catch phases). For the front
crawl technique, three coordination modes were
proposed:15 1) catch-up, when a lag time occurred
between the propulsive phases of the two arms (index of coordination <0%); 2) opposition, when the
propulsive phase of one arm started when the other
arm ended its propulsive phase (index of coordina-
June 2013
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Figure 2.Comparison between free swimming (black) and MAD-system (gray) conditions for the normalized velocity (A) and the
normalized stroke frequency (SF, B) at each velocity. * Significant difference between the two conditions, P<0.05
Table I.Results of the Pearsons correlation.
Force
Velocity
SR
SL
IVV
IdC
Velocity
SR
SL
IVV
IdC
0.86
0.82
0.84
-0.66
-0.57
-0.84
-0.57
-0.62
-0.57
-0.50
-0.61
-0.56
-0.71
-0.69
-0.48
-0.60
-0.48
-0.77
-0.86
0.46
-0.74
SR: stroke frequency; SL: stroke length; IVV: intracyclic velocity variations; IdC: index of coordination; F: propelling efficiency.
tion=0%); and 3) superposition, when the propulsive phases of the two arms are overlapped (index
of coordination >0%).
The propelling efficiency (F) of the arm stroke
was estimated by assessing the underwater phase
only, according to Equation 3:16
F = (v / 2 . . SF . L) (2 / ) (3)
being v the mean velocity of the swimmer, SF the
stroke frequency (in Hz) and L the average shoulder
to hand distance
(
assessed trigonometrically by measuring the upper limb length and the average elbow
angle during the insweep of the arm pull). The equation was not adapted for the contribution of the legs
(as originally proposed) as swimmers performed
with arms only.
The normality of distribution was checked using
the Shapiro-Wilk test. Descriptive statistics (mean,
range and standard deviation) from all measured

variables were calculated. A two-way ANOVA was
used to compare the normalized velocity and SF in
free swimming and MAD-system conditions. The effect of bouts of 25 m on the different variables was
analysed through the one-way ANOVA repeated
measures. The relationships among variables were
assessed by Pearsons correlation test and regression
analysis (using second degree polynomial, linear,
exponential, power or logarithm regression models).
For the exponential and power regressions the coordination data were normalized between 0 and 1, as
follows (Equation 4):
1 [(30 - IdC) / 60] (4)
Then, the model was created by averaging the individual coefficients and the regression model was
selected in function of the error of each individual
and the average equation. These statistical analyses
were performed using IBM SPSS Statistics and the
level of significance was set at 5%.
33
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Table II.Regressions models.

Regression
Power
Quadratic
Quadratic
Power
Quadratic
Quadratic
Equation
Mean error
F=18.01v2.5
F=-57.10SF2+220.98SF-105.04
F=338.62SL2-250.55SL+51.18
F=3.00IVV-1.50
F=45.45IdC2+2.10IdC+0.05
F=328.62F 2-1350.212F+1536.46
0.09
0.23
0.32
0.34
0.21
0.20
Results
A non-significant difference (3.420.93%) was
observed for normalized velocity between free and
MAD-system conditions, while a statistical difference of 19.575.78% (F8.162 = 380.76, P<0.05) was
noted between normalized SF (Figure 2).
For the 10 bouts of free swimming, the ANOVA indicated an increase of velocity (F9.81=80.56, P<0.05),
SF (F9.81=30.20, P<0.05), IdC (F9.81=9.64, P<0.05)
and force (F9.81=50.27, P<0.05), and decrease of SL
(F9.81=17.55, P<0.05), IVV (F9.81=4.14, P< 0.05) and
F (F9.81=11.94, P<0.05).
The results of the Pearsons correlation, among all
variables, are presented in Table I.
As the swimmers increased force production, the
velocity (r=0.86, P<0.05), SF (r=0.82, P<0.05) and
IdC (R=0.61, P<0.05) increased, and SL (r=-0.66,
P<0.05), IVV (r=-0.57, P<0.05) and F (r=-0.60,
P<0.05) decreased.
From the five tested regressions models, two were
found as the most appropriated, both for individual
(Table II) and polled analysis (Figure 3).
The relationship between force and velocity and
IVV showed that a power regression was the most
appropriate fit and, on the other hand, a quadratic regression was found as the best model between force
and SF, SL, IdC and F.
Discussion
Force production in front crawl swimming has
been considered as a main performance determinant,
but its relationship with the most relevant biomechanical parameters lacks experimental evidence.
The aim of the present study was to examine the relationships between force and stroking parameters
(velocity, SF and SL), IVV, IdC and F, in front crawl
34
SD error
0.03
0.19
0.23
0.26
0.19
0.17
Min<Error<Max
Min<R2<Max
Mean R2
0.01<Error<1.04
0.01<Error<1.87
0.02<Error<1.98
0.09<Error<2.11
0.05<Error<1.78
0.03<Error<1.55
0.98<R2<1
0.99
0.94
0.87
0.63
0.71
0.81
0.83<R2<0.97
0.78<R2<0.92
0.43<R2<0.90
0.45<R2<0.95
0.68<R2<0.96
swimming. The main findings of the present study

were that high force production requires increases in
SF and, consequently, in velocity. Coordination adaptations permitted high force outputs due to continuity of propulsive phases and, concomitantly, IVV
decreases, avoiding velocity degradation. The linkage between force and SF, SL, IdC and F showed a
quadratic dependence and a power regression model
was found between force and velocity and IVV.
In the present study, the assessed mean values of
propulsive forces were assumed to be equal to the
mean drag forces obtained from measurements on
MAD-system,17 once, for a constant velocity the
mean propulsive force should be equal to the mean
drag force acting on the swimmers body.2, 13 In addition, the maximal force production in free swimming
would be similar to the recorded force production
when swimming on the MAD-system, a fact that was
confirmed by the normalized velocity. Nevertheless,
the normalized SF changed between the two conditions, being higher on the MAD-system due to the
fixed SL, as previously described.9
Concerning the stroking parameters, the correlation between force and velocity was positive and a
quadratic dependence was observed. These data are
in agreement with the literature,2, 13, 18 evidencing the
importance of swimming velocity on force production, particularly with increasing velocity. Moreover, force produced by the swimmers showed to be
positively influenced by SF increases, confirming
previous investigations 18, 19 and consequently, lower
SL1. The quadratic linkage between force and these
variables could be explained by the fact that, at early
protocol stages (lower values of velocity), force production might mostly be due to the fast increase in
SF, and consequent decrease in SL. After that, the
increase in force production might be more dependent on combination of a slightly additional increase
of SF and a vaguely maintenance of SL, similar to
June 2013
RIBEIRO
Figure 3.Relationship between force and velocity (A), stroke frequency (B) stroke length (C), intracyclic velocity variations (D),
index of coordination (E) and propelling efficiency (F) average for the ten swimmers.
35
RIBEIRO
the reported relation of these parameters with swimming velocity.1

The inverse relationship of force and IVV highlighted the importance of propulsive continuity
to achieve higher values of force production,4 and
their non-linear relationship could be explained by
the fact that the neuromuscular activation of several
muscles in a multi-segment and multi-joint movement follows the curvilinear force-velocity relationship pattern for a single joint system.20 Such increase
of propulsive continuity was concomitant with the
rise of IdC values, presenting a quadratic relationship with force,21 corroborating that to produce higher force values swimmers modify their arm stroke.
This changes in arm coordination reflect changes on
reduction of relative duration of the non-propulsive
phases that, consequently, lead to changes on SR and
SL.15, 22, 23 This coordination, and consequent stroking parameters adaptations, might be interpreted has
a response of the swimmer to produce force, demonstrating that its production is directly dependent on
motor control and optimal coordination pattern, as a
response to the imposed constraints (e.g., hydrodinamic drag).21
The IdC changes enabled continuity between the
propulsive phases, but this did not necessarily mean
higher propulsion generation values since swimmers
could slipped through the water. This fact could be
explained by the observed inverse relationship, and
negative quadratic dependence of force on F. A
greater propelling efficiency is traditionally associated with a better capacity to produce force,1, 24 but,
since a high SF is required to generate force and F
was inversely related to SF, consequently a reduction
of the propulsion effectiveness has occurred.
Conclusions
Optimization of force production required increases in SF and, consequently, in swimming velocity. Optimal coordination adaptations, enabling continuity of propulsive phases and IVV decreases were
essential to produce higher values of force. However,
these adaptations did not necessarily guarantee propulsion efficiency as observed by SL and F decrease.
Hence, the manipulation of the biomechanical variables might be one of the factors through which
swimming force could be altered, emphasising the
36
need of its evaluation, identification and intervention

as a common practice both in swimming training and
competition.
References
1. Barbosa T, Bragada J, Reis V, Marinho D, Carvalho C, Silva AJ.
Energetics and biomechanics as determining factors of swimming performance: Updating the state of the art. J Sci Med Sport
2010;13:262-9.
2.
Toussaint HM, de Groot G, Savelberg HHCM, Vervoorn K, Hollander AP, Van Ingen Schenau GJ. Active drag related to velocity in
male and female swimmers. J Biomechanics 1988;21:435-8.
3. Craig AB, Pendergast DR. Relationships of stroke rate, distance per
stroke, and velocity in competitive swimming. Med Sci Sports Exerc 1979;11:278-83.
4. Figueiredo P, Pendergast DR, Vilas-Boas JP, Fernandes RJ.
Interplay of biomechanical, energetic, coordinative, and muscular factors in a 200 m front crawl swim. BioMed Res Int 2013;2013:1-12.
5. Fernandes RJ, Fernandes RJ, Billat VL, Cruz AC, Colaco PJ, Cardoso CS et al.
Does net energy cost of swimming affect time to exhaustion at the individuals maximal oxygen consumption velocity?
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6. DAcquisto L, Costill D. Relationship between intracyclic linear
body velocity fluctuations, power and sprint breaststroke performance. J Swimming Res 1998;13:8-14.
7. Figueiredo P, Kjendlie PL, Vilas-Boas JP, Fernandes RJ. Intracycle
velocity variation of the body centre of mass in front crawl. Int J
Sports Med 2012;33:285-90.
8. Nigg BM. Selected methodology in biomechanics with respect to
swimming. In: Hollander AP, Huijing PA, Groot Gd, editors. Biomechanics and Medicine in Swimming. Champaign, IL: Human
Kinetics Publishers; 1983. p. 72-80.
9. Seifert L, Toussaint HM, Alberty M, Schnitzler C, Chollet D. Arm
coordination, power, and swim efficiency in national and regional
front crawl swimmers. Hum Mov Sci 2010;29:426-39.
10.
Alberty M, Sidney M, Huot-Marchand F, Hespel JM, Pelayo P. Intracyclic velocity variations and arm coordination during exhaustive
exercise in front crawl stroke. Int J Sports Med 2005;26:471-5.
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Schnitzler C, Seifert L, Ernwein V, Chollet D. Arm coordination adaptations assessment in swimming. Int J Sports Med 2008;29:4806.
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Toussaint HM, Knops W, de Groot G, Hollander AP. The mechanical efficiency of front crawl swimming. Med Sci Sport Exerc
1990;22:402-8.
13. Toussaint HM, Roos PE, Kolmogorov S. The determination of drag
in front crawl swimming. J Biomech 2004;37:1655-63.
14.
Fernandes R, Ribeiro J, Figueiredo P, Seifert L, Vilas-Boas J. Kinematics of the hip and body center of mass in front crawl. J Hum Kin
2012;33:15-23.
15. Chollet D, Chalies S, Chatard JC. A new index of coordination for
the crawl: Description and usefulness. Int J Sports Med 2000;2:549.
16. Zamparo P, Pendergast DR, Mollendorf J, Termin A, Minetti AE.
An energy balance of front crawl. Eur J Appl Physiol 2005;94:13444.
17. Berger MAM, Hollander AP, De Groot G. Determining propulsive
force in front crawl swimming: A comparison of two methods. J
Sports Sci 1999;17:97-105.
18. Martin RB, Yeater RA, White MK. A simple analytical model for
the crawl stroke. J Biomech 1981;14:539-48.
19.
Cabri JMH, Annemans L, Clarys JP, Bollens E, Publie J. The relation of stroke frequency, force, and EMG in front crawl tethered
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swimming. Swimming science: In: Ungerechts BE, Wilkie K, Reischle K, editors. Swimming science V. Champaign, IL: Human Kinetics Publishers; 1988. p. 183-9.
20. Minetti AE. The three modes of terrestrial locomotion. In: Nigg B,
MacIntosh B, Mester J, editors. Biomechanics and biology of movement. Champaign, IL: Human Kinetics; 2000. p. 67-78.
21. Seifert L, Chollet D. Modelling spatial-temporal and coordinative
parameters in swimming. J Sci Med Sport 2009;12:495-9.
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Seifert L, Chollet D, Rouard A. Swimming constraints and arm coordination. Hum Mov Sci 2007;26:68-86.
23. Figueiredo P, Morais P, Vilas-Boas JP, Fernandes RJ. Changes in
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Toussaint HM, Carol A, Kranenborg H, Truijens MJ. Effect of fatigue on stroking characteristics in an arms-only 100-m front-crawl
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Funding.This investigation was supported by grants of
Portuguese Science and Technology Foundation (PTDC/DES/
101224/2008) (SFRH/BD/81337/2011).
37

Combined strength and step aerobics training leads

to significant gains in maximal strength
and body composition in women
A. PEREIRA 1, 2, A. M. COSTA 2, 3, 4, M. IZQUIERDO 5, A. J. SILVA 1, 2, M. C. MARQUES 2, 3, J. H. H.WILLIAMS 6
Aim. Examine the effects of 8 weeks of strength training program alone or combined exercise (step aerobics exercise and
strength training) on Body Mass Index (BMI), waist circumference (WC), and maximal strength (1RM) in lower- and
upper-body extremities.
Methods. Thirty-six women were randomized into three
groups: strength training (S, N.=13; age: 61.09.3 years,
BMI: 27.34.7 kg/m2), combined step aerobics training and
strength training (SE, N.=11; age: 58.38.1 years, BMI:
27.83.7 kg/m2), or control (C, N.=12; age: 59.07.2 years,
BMI: 29.54.8 kg/m2) groups. Subjects from both experimental groups performed 3 training sessions per week for 45-60
minutes per session. The S was submitted to a high-speed
training that consisted of 40% to 75% of 1RM (3 sets 412
reps). The SE group combined aerobic exercise using step
platform plus strength training.
Results. Both training groups significantly improved leg
press (S, 80.7% and SE, 42.4%, P<0.001 respectively) and
leg extension strength (S, 71% and SE, 35.7%, P=0.000
respectively). However, only the S group showed a significant increase in seated bench press maximal strength (S,
+116.7%, SE, +13.6%, P=0.266 and P=0.000 respectively).
Over the 8-week training period, the SE group showed
significant changes in BMI and in waist circumference
(-5.3%, P=0.016 and -3.0%, -2.5 cm, P=0.005, respectively). No signicant differences were found in the S or
C groups.
Conclusion. Decreases in body fat and waist circumference
were more evident following combined training. In contrast,
higher strength gains particularly for the upper body occurred following 8 weeks of strength training alone compared
to combined training.
Key words: Aged - Female - Training - Body Mass Index Waist circumference.
Corresponding author: A. Pereira, Department of Sport Sciences, University of Trs-os-Montes e Alto Douro, Vila Real, Portugal.
E-mail: anapereira@utad.pt
38
1Department of Sport Sciences

University of Trs-os-Montes and Alto Douro
Vila Real, Portugal
2Research Centre in Sports
Health and Human Development
Vila Real, Portugal
3Department of Sport Sciences
University of Beira Interior, Covilh, Portugal
4CICS-UBI, Health Sciences Research Center, Portugal
5Department of Health Sciences
Public University of Navarre, Navarre, Spain
6Chester Centre for Stress Research
University of Chester, UK
ge-related changes in body composition have

been previously reported in older populations
(i.e., increase in fat mass and decrease in muscle
mass).1-3 Impairment refers to the physiological
mechanisms that include alterations in individual
muscle fiber contractile properties and modifications
in neuromuscular function.2 Losses can lead to increase the risk of physical function and deterioration
of strength performance especially in older women 4
as well as to an increase in metabolic disorders and
mortality. Recently, muscular adaptation to resistant
training as shown to be useful in strength gains with
substantial improvements in dynamic exercises in
upper and lower limbs (44.1-61.8%) over 12 weeks
of training period in older people.5
Abdominal obesity is also a key feature in cardiovascular risk assessment, a growing epidemic that
affects more than 300 million people worldwide,6
particularly in women after menopause.7 In previous
studies, waist circumference has been proposed as
June 2013
COMBINED STRENGTH AND STEP AEROBICS TRAINING
the best simple anthropometric index of abdominal

visceral adipose tissue accumulation in the elderly,
being also related to heart and vascular risk.8-10
Aerobic training is one of the most popular exercises,11-13 but in women to our knowledge, no studies have observed the effect of step aerobics training combined with strength exercise on muscular
performance and body composition. It is known
that combined training may lead to lower strength
or muscle power gains,14, 15 as well as lower magnitude of endurance 15, 16 compared with pure strength
training programs or endurance alone. Nevertheless,
the variability between exercise programs characteristics may partly explain some mixed findings.17
There are studies about different types of training in older women, but to date, we are unaware of
any research investigating the whole-body combined
training-induced pattern of strength response between
the lower and, especially, the upper extremity muscles
in previously untrained women. The aim of this

innovative study was to examine the effects of 8-week
of combined three-weekly step aerobics exercise and
resistance training on maximal strength of the lowerand upper-body extremities and waist circumference
(WC), compared with three-weekly strength training
program alone and a control group. It was hypothesized that specific combined training in women would
lead to similar gains in maximal strength of the lowerextremity muscles, but better improvements in body
composition, compared with strength training alone.
Participants
Thirty-six women volunteered (60.08.5 years old)
to participate in this study. All participants fulfilled
the inclusion criteria: living independently in the
community, being without contraindications to cardiorespiratory fitness assessment and not having history
of regular exercise. Before inclusion in the study, all
candidates were thoroughly screened by a physician.
Each woman also answered a face-to-face questionnaire addressing medical history and medication use.
Participants were then randomized into two training groups and one control group: strength training
(S, N.=13; age: 61.09.3 years, BMI: 27.34.7 kg/
m2), combined endurance and strength training (SE,
PEREIRA
N.=11; age: 58.38.1 years, BMI: 27.83.7 kg/m2),

or control (C, N.=12; age: 59.07.2 years, BMI:
29.54.8 kg/m2) groups (Table I). Subjects were informed about any potential risks and/or discomforts
associated with participation in the study and were
required to complete informed consent form before
being included in the study. All physical or psychological diseases that may have precluded ability to
perform the requested training exercises and testing were considered exclusion criteria. The experimental procedures were approved by the University
of Trs-os-Montes and Alto Douro, Department of
Sport Sciences, following the Helsinki declaration.
Procedure
To test the stability and reliability of all variables,
individuals were evaluated at same time and location
and supervised by the same researchers at pre- and
post-interventions. Subjects were evaluated twice
before the start of training (two weeks before and at
baseline), and this served as a control period. Tests
were applied to both groups at two intervals: before
the experimental period (T1) and after the 8-week
experimental period (T2).
Anthropometric assessment
The anthropometric assessment was carried out in
a separate room by a single trained examiner. A detailed description of the testing procedures has been
given elsewhere.4 The waist circumference (WC)
was measured with a flexible and inelastic measuring tape (Hoechstmass-Rollfix, Germany) with a
precision of 0.1 centimeters, taking the necessary
care not to compress tissues. The WC was measured
at the midpoint between the iliac crest and the last rib
18 and was carried out at the end-expiratory position.
The intra-class correlation coefcient (ICC) for BMI
and WC was 0.91and 0.93, respectively.
Strength Test
A detailed description of the testing procedures
has been given elsewhere.4, 17 In brief, lower- and
upper-body maximal strength was assessed using
one-repetition concentric maximum (1RM) actions
in a leg press (1RMLP), leg extension (1RMLE) and
in a bench-press (1RMBP) position, respectively.
39
PEREIRA
Table I.Physical characteristics of the control (C), strength (S) and combined endurance and strength (SE) training groups at baseline and after 8 weeks of training.
Variable
Group
Age (years)
C (n=12)
S (n =13)
SE (n =11)
C
S
SE
C
S
SE
C
S
SE
C
S
SE
Body Mass (kg)
Total Standing Height (m)
BMI (kg.m-2)
WC (cm)
T1
T2
(T1-T2)
59.07.2
61.09.3
58.38.1
72.712.9
66.812.0
65.87.8
1.560.08
1.560.06
1.570.04
29.54.8
27.34.7
27.83.7
86.15.9
83.99.9
83.05.08
59.17.2
61.19.3
58.48.1
72.813.3
67.211.3
65.87.9
1.560.07
1.56.07
1.570.03
29.65.0
27.44.4
26.33.6
87.67.0b
84.110.1c
80.55.6
0.877
0.979
0.879
0.667
0.413
0.336
0.989
0.786
0.765
0.696
0.836
0.016
0.106
0.733
0.005
P (T1-T2)- P value between 2nd and 1st moment; BMI = body mass index.a weight-to-height ratio.calculated by dividing ones weight in kilograms by the
square of ones height in meters; C Control Group. S resistance training group. SE - combined endurance and strength training; Signicant changes
(P0.05) between the groups; a P<0.05.C significantly different from S; b P<0.05.C significantly different from SE; c P<0.05. S significantly different
from SE.
Specic warm-up was allowed consisting of 1 set of

5 repetitions at 4060% of the perceived maximum.
Separate attempts were performed to determine the
one repetition maximum until the subject was unable
to extend the leg and arm muscles to the required position. The intra-class correlation coefcient (ICC)
for 1RMLP, 1RMLE and 1RMBP was 0.94, 0.95 and
0.93, respectively.
High-speed strength training
The subjects included in the S group were asked to
report to the training facility three times per week for
8 weeks, on nonconsecutive days. Each training session included 2 exercises for the leg extensor muscles
(leg extension and leg press) and 1 exercise for the
arm extensor muscles (the bench press) and finished
with abdominal crunches and trunk extensors. An interval period of at least 2 min was permitted between
sets and between exercises. During the first 2 week
of the training period, the subjects trained with loads
of 4050% of the individual 1RM, 10-12 repetitions
per set, and 3-4 sets of each exercise, and progressively increase to 75% of 1RM, 3 sets by 46 reps.
40
Subjects were performing all exercises at high velocity, with instructions to do them as fast as you can.
Combined strength and step aerobics training
The training protocol for the step aerobics group
(SE) consisted of 3 sessions per week, 45 to 60 minutes per session for 8 weeks with the same certified
instructor. The aerobic component within the training program included 30 minutes of cardiovascular
exercises using a step platform. Each session included 10 minutes of warm-up and 20 minutes of
step aerobics training. In the first 2 weeks of exercise, participants were initiated to the basic movements and choreography with continuous movement
of legs and alternating movement of the arms (bicep
curls and lateral raises at shoulder level and above the
head) simultaneously with the selected steps. Exercise included movements of conventional basic step;
V; A; L; turn step (right and left lead); alternating knee-lift, leg up and down; alternating kicks
and lateral lunge. The aerobic session started with
a work heart rate (HR) of 40-50% HR (1-3th week),
increasing progressively to 50-70% HR (4-6th week),
June 2013
PEREIRA
Table II.Mean standard deviation of upper and lower limbs

strength at all three assessment moments.
Group
1 RMBP (kg)
1 RMLE (kg)
1RMLP (kg)
C (n=12)
S (n =13)
SE (n =11)
C
S
SE
C
S
SE
T1
T2
(T1-T2)
12.13.5
12.64.8
12.52.6
21.78.1
20.78.1
22.16.1
22.98.2
23.87.4
24.35.4
11.63.2a
27.38.3c
14.25.1*
21.65.7a. b
35.34.3c
30.06.7*
23.37.1 a. b
43.06.3c
34.64.1*
0.339
<0.001
0.266
0.989
<0.001
<0.001
0.674
<0.001
<0.001
P (T1-T2)- p value between 2nd and 1st moment; WC Waist Circumference; C Control Group. S resistance training group. SE - combined endurance and strength training; *Signicant changes (P<0.05) between the
groups; a P<0.05.C significantly different from S; b P<0.05.C significantly
different from SE; c P<0.05. S significantly different from SE.
and then to 70-85% HR (7-8th week). The perceived

exertion was 11 to 13 (6 to 20 point, Borg scale).
Heart rate reserve was determined by the Karvonen
formula.19 HR monitoring equipment (Accurex plus,
Polar Electro Oy, Finland) was used to monitor and
keep records during exercise. Music was selected
to increase work heart rate and the cadence of the
sessions was between 120 and 128 foot-strikes per
minute. Then, subjects performed the same resistance exercise prescription applied to the S group.
Each training session was closely supervised and
monitored by two researchers, specialized in physiology and in aerobic-dance instruction to direct and
assist each subject towards achieving the appropriate
work rates and loads.
The Kolmogorov-Smirnov test was used to evaluate the normality of the distribution of the variables.
The intra-individual reproducibility of the measurements was assessed by the intraclass correlation
coeficient (ICC). Descriptive statistics (meanSD)
were calculated for all variables. To assess any differences among the three groups initial anthropometry or performance variables a one-way analysis
of variance (ANOVA) was used. When significant
differences were found, Tukeys post-hoc test was
used to identify which groups differed among them.
For the variables that did not pass the normality test,
Kruskall-Wallis test and Dunns post-hoc test were
used. Two-way ANOVA with repeated measures
(groups x moments) was used to assess the training
related effects. To establish statistical significance,
a P0.05 criterion was used. All data were analyzed
using SPSS 17.0.
Results
At baseline evaluation, no significant differences
(P>0.05) were observed between the exercise and
control groups in any of the studied variables. From
pre- to post-training period, the S group signicantly
increased (P<0.001) their dynamic strength performance in 1RMBP (116.7%), 1RMLE (71.0%) and
1RMLP (80.7%), whereas the SE group also significant
increased maximal strength performance but only in
lower limbs (1RMLE: 35.7% and 1RMLP: 42.4%,
P<0.001 respectively and 1RMBP: 13.6%, P=0.266).
No signicant changes were observed for the C group
(Table II). No signicant changes (P>0.05) in height
or body mass were observed (Table I) between the
rst (T1) and the second evaluation (T2) in all the
groups. However, BMI showed a significant decrease between T1 and T2 only in SE group (-5.6%,
P=0.016). Likewise, signicant decreases (P<0.05)
were observed only in the SE group for WC by -3%
(-2.5 cm, P=0.005) (S: +0.2% and C: +1.7%, P=0.106
and P=0.733, respectively) (Table II).
Discussion
The primary findings of the present study demonstrated that 8 weeks of strength training alone is an
effective way to enhance maximal dynamic strength
with only two exercises of resistance training for upper and lower extremities per session. Additionally,
combined step aerobics exercise and strength training was not effective in increase maximal strength in
upper limbs but induced significant improvements in
the body composition, mirrored here by the reduction in waist circumference.
Significant improvements in maximal dynamic
strength in upper body extremity performed by bench
press exercise were only observed in the S group.
This suggests a positive effect of strength training on
41
PEREIRA
upper-extremity in women. Our ndings agree with

previous studies that used bench press exercise.20, 21
Therefore, both S and SE training groups
significantly improved lower-extremity strength (1RMLP: 42.480.7% and 1RMLE:
35.7-71%). Our results
are comparable with recent studies on previously untrained
women after 8-24 weeks of strength training.22-24
As results achieved were greater in magnitude
in bench press exercise it may indicate differential
changes in activity patterns between upper and lower muscles and perhaps lesser strength in the arms
compared to the legs.25, 26 Moreover, the alternating
movement of the arms during step workout could
also cause greater weariness at the end of the aerobic
training session, and, consequently, induce declines
in muscle performance and self-motivation to perform the rest of the strength exercises. Thus, as the
present study demonstrated, strength training alone
is more favorable to increase muscular performance
in upper extremity in women.27, 28
Relatively to body composition, there were significant changes in BMI and in waist circumference
only in SE group. This can be partially explained
by the efficacy of the combined training. Since step
aerobic exercise does not appear to signicantly prevent the age-related decrease in muscle mass and
strength in the older population,29 the decreased that
we observed may be explained by the loss of some
fat mass. Previous studies on age-dependent height
have suggested that an incorrect overestimation of
adiposity may induce a false BMI by more than 2.5
kg/m2 in women across aging,30 being a weak predictive indicator of obesity particularly in populations
of short stature as the Portuguese.31 Nevertheless,
as the accumulation of intra-abdominal fat seems to
persist even without significant body mass changes,32
weight losses may be necessary, especially when the
optimization of the musculoskeletal function in aging is essential.3 Results of the present study indicate
that baseline WC values are above the threshold value for the European women (80 cm), which suggests
an increased risk of cardiovascular disease.33, 34 The
present study has shown that combined training may
potentially countering the age-related increase in abdominal fat (-2.5 cm) in older women and emphasizes the importance of concomitant training-induced
changes in body composition in the prevention and
treatment of metabolic risk factors. Ours results also
contribute to a novel finding in the prescription of
42
exercise especially to older obese individuals aerobic workout using step platforms may have a better
effect in mobilization of the major muscles groups in
upper limbs, leading to better physical condition and
also providing greater effects in weight loss.
Some studies related to the effects of step aerobics
training on body mass and body fat percentage have
failed to find any significant changes,13, 35 although,
as our study verified, strength training after step
aerobics session may be essential to improve body
composition. Thereafter, strength stimulus in combined training may help explain the additional beneficial outcome of muscular improvement in lower
and upper extremities.36, 37
The first limitation constraint of the present study
was that the fat and lean mass was not measured because BMI and waist circumference cannot predict
total body composition. Also Karvonen formula was
used to evaluate heart rate for older adults but this
have some constraints in this population, in future
studies different protocols should be used. A second
limitation is that the level of functional capacity and
balance of the participants were not measured. With
this mind, further research with step aerobics training or multicomponent training should be developed
in order to determine if this type of exercise could be
applicable to older persons with balance problems or
low functional fitness.
Conclusions
As a means of evaluating the specicity of each
type of training proposed here, it seems that combined training can be a useful working tool for health
and sports professionals, contributing to a better way
of prolonging functional independence and quality
of life in older adults.
Practical applications
Step aerobics training can be considered an effective exercise modality to prevent the loss of muscular performance and its associated consequences.
Understanding the nature of combined or multicomponent training may help choreographers and professionals in sport science to develop exercise combinations that are more useful and helpful to increase
strength in older people and to prevent the age-related changes in body composition.
June 2013
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Acknowledgements.The research of John Williams and Ana Pereira
has been supported by a University of Chester International Research
Excellence Award, funded under the Santander Universities scheme.
43

Chronic effect of the combinations

of resistance exercises
with static stretching exercises
on flexibility levels in trained men
C. L. BASTOS 2, J. VILAA-ALVES 1, 2, V. M. REIS 1, 2, G. B. TAVARES 3, T. M. GOMES 3, J. NOVAES 3
Aim. Aim of the study was to investigate the effects of eight

weeks of strength training, conducted with and without static
stretching exercises (before and between sets of resistance ex
ercises) on the flexibility in trained men.
Methods. Thirty subjects were randomly divided in three
experimental groups: static stretching before resistance ex
ercises (SSBRE); static stretching between sets of resistance
exercises (SSBSRE); and strength training without static
stretching (ST).
Results. A 3 (groups) X 2 (time) ANCOVA was performed
and did
not show any significant
difference for the compari

sons between the groups. For the analysis within groups, the
results showed significant changes, between measurements
times on the range of motion only on the horizontal adduction
of the shoulder (20.12%, 12.46% and -8.56%, SSBRE, SSB
SRE and ST, respectively), horizontal flexion with the knee
joint flexed (8.04%, 2,39% and 6.35%, SSBRE, SSBSRE
and ST, respectively) and medial rotation of the hip (0.48%,
28.30% and 8.79%, SSBRE, SSBSRE and ST, respectively).
No significant interactions were observed between measure
ments times and groups.
Conclusion. Based on the present results, the flexibility of
trained men increases on some shoulder movements with
the used of SSBRE and SSBSRE and increases on some hip
joint movements independently of the experimental protocols
used.
Key words: Resistance training - Muscle stretching exercises Range of motion.
uscle strength and flexibility are fundamental

for a good physical and skeletal muscle function, contributing for the preservation of healthy
muscles and joints, and a better quality of life.1
Corresponding author: J. Vilaa Alves, Sports Department, University
of Trs-os-Montes e Alto Douro, Parque Desportivo da UTAD, Apartado
1013, 5001-801 Vila Real, Portugal. E-mail: josevilaca@utad.pt
44
1Research Centre in Sport, Health

and Human Development (CIDESD), Vila Real, Portugal
2University of Trs-os-Montes
and Alto Douro (UTAD), Vila Real, Portugal
3School of Physical Education and Sports
Rio de Janeiro Federal University, Rio de Janeiro, Brazil
Therefore, both motor capacities should necessarily

be included within any supervised training program.1
Performing stretching exercises alone seems to
provoke significant chronic effects on strength performance.2, 3 Kokkonen et al.3 observed increases
up to 31% on the performance of the 1RM tests,
after performing static stretching for eight weeks.
On the other hand, Rees et al.2 using proprioceptive
neuromuscular facilitation (PNF) stretching technique, observed increases on the maximal isometric
strength (26%) and on the rate of force development
(25%) for the plantar flexors muscles. Conversely,
LaRoche et al.4 using static and dynamic stretching exercises, observed minimal increases on the
peak torque of the extensor muscles of the hip, but
not significantly different from those of the control
group who had not perform any exercise for four
weeks.
Studies with elderly of both genders have shown
that the execution of isolated strength training (ST)
causes significant increases on the flexibility of several joints. Barbosa et al.5 observed increases of
nearly 13% in sedentary elderly when performing
the sit and reach test after 10 weeks of ST. Similar
results have been found by Fatouros et al.6 who observed significant increases on the flexibility, rang-
June 2013
Effect of resistance exercises with static stretching exercises on flexibility
ing from 3% to 28%, in sedentary elderly men after

16 weeks of ST performed with different intensities.
However, the results of the studies, which used
participants from different age groups, tended to be
inconsistent. Monteiro et al.7 investigated the effects
of resistance exercises (RE) on the flexibility in sedentary middle-aged women (35 to 39 years-old).
The movements of the shoulder horizontal adduction, the flexion and extension of the trunk and the
hip presented significant increases (37.3%, 146.2%,
135.6% and 15.4%, respectively) after 10 weeks of
ST. Santos et al.8 observed that two orders of RE
execution, the alternated segment and the agonistantagonist orders, tended to promote identical increases (P<0.05) on the articular range of motion
in sedentary women. While analysing the effects
of RE, performed either alone or combined with
stretching exercises, Simo et al.9 observed significant increases on all flexibility assessment comparisons, and concluded that the execution of RE alone
caused significant increases on the flexibility. However, Nbrega et al.10 have not observed significant
differences in sedentary young peoples joint range
of motion after 12 weeks of RE executed in an isolated manner. However, significant increases were
observed in the flexibility specific training group
(+33%; P<0.001) and in the flexibility and ST combined training group (+18%; P<0.001).
Ress et al.2 suggested that an increase on strength
after the chronic execution of stretching exercises
can occur through increases in the myotendinous
unity, as a result of high mechanical stresses on the
tendons and muscles. This mechanical stress contributes to changes in the collagens structure and
promotes the hypertrophic process. However, the
mechanisms responsible for the increase on flexibility as a consequence of chronic ST are not clarified in
the literature. The possibility that has been proposed
for such adaptation is based on the increase in the
tendon and ligaments tension in addition to the muscular strength increases and the muscle contractility
that enable a wider joint range of motion.11
Even though some evidence has provided support
for the chronic influence of ST on different joints
flexibility, the chronic effect of the combinations in
different moments of RE with static stretching exercises (SSE) in the same sessions, in trained adults,
has not yet been investigated.
Therefore, the aim of the present study was to in-
BASTOS
Table I.Participants characteristics.

Group
SBST
SDST
ST
Variable
Age (years)
Body mass (kg)
Height (m)
BMI (kg/m2)
Age (years)
Body mass (kg)
Height (m)
BMI (kg/m2)
Age (years)
Body mass (kg)
Height (m)
BMI (kg/m2)
MeanSD
29.803.55
78.977.19
1.770.05
25.233.22
28.002.87
72.3910.23
1.700.06
24.862.60
29.902.88
85.058.75
1.740.06
28.062.04
P (SW)
0.121
0.641
0.949
0.788
0.134
0.883
0.385
0.341
0.824
0.198
0.800
0.053
SD: standard deviation; BMI: Body Mass Index; P value (SW) ShapiroWilk normality test; SSBST: static stretching before resistance exercises; SSBSRE: static stretching between sets of resistance exercises; ST:
strength training without static stretching.
vestigate the effects of eight weeks of ST performed

in an isolated manner and combined with SSE (before and between sets of RE) on the flexibility of
trained men.
Participants
Thirty male and physically active adults volunteered to participate in this study. The characteristics
of the subjects are displayed in Table I. The inclusion
criteria of this study were: A) to be physically active
with at least one year of experience on the strength
and flexibility exercises suggested on the study, with
a frequency of four times a week; B) to not have any
functional limitation that could influence the ST or
the flexibility or the 8RM tests performance; and C)
to not have/report any medical condition that could
influence the tests results. The Ethical Committee
of Research of the Clinical Hospital Gaspar Viana,
Belm do Par/Brasil approved this study with the
process number 133/2010.
Experimental design
The present study was a longitudinal, randomized
experiment with three groups that aimed to deter-
45
BASTOS
Figure 1.Stretching positions adopted for the upper and lower limbs: A) for the horizontal shoulder and elbow extensors; B) for the
horizontal shoulder and elbow flexors; C) for the knee extensors; D) for the knee flexors and the hips extensors.
mine the effects of different ST programs on joint

range of motion, in trained men. The intervention
period of the study lasted for eight weeks, involving
the execution of ST sessions in an isolated manner
or combined with SSE. Before starting the training sessions, the recruited subjects (N.=30) were
randomly divided in the following experimental
groups: SSE before the RE (SSBRE; N.=10), who
performed the static stretching protocol (SSP) for
each primary motor muscle of the RE sequence in
the beginning of each ST session; SSE between
each set of RE (SSBSRE; N.=10), who performed
the SSP before each exercise of the ST sequence;
Strength Training (ST; N.=10): execution of the resistance exercises sequence without performing any
type of SSE.
The initial strength and flexibility levels were
measured 48 and 72 hours (test and retest) before
the beginning of the training period. After the eight
training weeks, the same tests were repeated in order
to verify the effects of each experimental condition
on the dependent variables.
Strength training program
The subjects performed ST for eight weeks, with a
weekly frequency of three sessions, with a 48-hours
interval between them, for a total of 24 sessions.
The subjects performed vertical chest press (VCP);
wide gripe front lat pull-down (WGFLP); seated
leg extension (SLE); seated leg curl (SLC); barbell
curl biceps (BCB); triceps pushdown on the pulley
46
(TPP); abdominal crunch (AC); and lumbar extensions (LE). Selected exercises were chosen in order
to create a proper balance on the muscular development. Thus, agonist and antagonist training methods were used. In each RE, four sets of 8 to 10 maximal repetitions were performed with 90-second
rest interval between sets. Abdominal crunch and
lumbar extensions were performed for 15 and 20
repetitions per set, respectively. The training loads
were adjusted to 8RM and gradually increased every time the subjects were able to perform 10RM
in every set of each exercise. These changes were
done until the minor limit of repetitions (8RM) was
achieved.
Static stretching protocol
The stretching exercises were executed accordingly with the RE performed, using the static method. It was used one set for each SSE before RE
by the SSBRE group and between each set by the
SSBRE. The SSE was performed while maintaining the position to a mild discomfort for 30 seconds.12-14 Static stretching was performed for the
horizontal shoulder flexors and extensors, the knee
flexors and extensors, the elbow, and the hip extensors (Figure 1).
Flexibility measures
The flexibility measurements were done using a
goniometry technique (angular tests), in accordance
June 2013
BASTOS
Table II.Articular range of motion values on all the experimental situations.

JRM (0)
SE
SABD
HABS
HADS
LRS
MRS
EF
HFKF
HFKE
HE
HABD
LRH
MRH
KF
SSBRE
SSBSRE
ST
Pre
Post
Pre
Post
Pre
Post
61.2016.94
174.0017.91
32.3012.35
100.2017.80
75.2021.10
59.1014.36
130.509.40
109.508.72
81.0016.32
23.9011.64
42.5013.09
34.808.78
41.408.51
126.705.83
69.9013.00
187.306.57
38.8015.77
118.609.22
93.405.17
64.8013.54
136.107.62
118.307.44
82.5012.45
26.905,88
49.0011.62
37.908.94
41.609.43
130.107.69
59.8013.05
170.909.47
34.508.02
99.2019.61
80.507.28
62.6014.97
130.2013.01
113.2011.41
83.2012.51
24.408.46
37.707.21
30.207.54
31.106.03
121.309.57
68.7010.95
181.505.50
38.808.36
116.6016.22
94.3014.55
63.109.97
133.206.48
115.9010.56
85.309.45
27.006.13
45.108.39
33.504.12
40.204.78
122.908.34
56.6021.56
165.5024.86
39.7010.95
99.9020.87
60.7028.39
58.7030.49
122.809.52
107.106.45
75.8012.84
21.908.95
48.2011.33
32.907.59
33.006.41
120.6012.42
61.0017.53
180.907.03
36.3011.25
117.7014.75
79.0026.23
54.8022.89
128.0011.99
113.909.27
78.1016.28
32.0017.46
47.208.09
34.504.86
35.905.72
126.609.64
M MxG G
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
N
- P<0.01; - P<0.05; N: without significance differences; M: effect moment; MxG: interaction moment group; G: differences between groups; JRM:
joint range of motion; SSBRE: static stretching before resistance exercises group; SSBSRE: static stretching between sets of resistance exercises group;
ST: performing resistance exercises without stretching exercises; SE: shoulder extension; SABD: shoulder abduction; HAS: horizontal adduction of the
shoulder; LRS: lateral rotation of the shoulder; MRS: middle rotation of the shoulder; EF: elbow flexion; HFKF: hip flexion with knee flexed; HFKE:
hip flexion with the knee on extension; HE: hip extension; HABD: hip abduction; LRH: lateral rotation of the hip; MRH: medial rotation of the hip; KF:
knee flexion.
with the Norkin and White 15 protocol, assessing a

maximum amplitude of eight articular movements:
1) shoulder joint flexion; 2) shoulder joint extension;
3) shoulder joint horizontal abduction; 4) shoulder
joint horizontal adduction; 5) trunk flexion; 5) trunk
extension; 6) hips joint flexion; and 7) knee joint extension. With the exception of the trunk movements,
all measures were collected in the right side. An experienced specialist measured the joint range motion
with a 360 goniometer (Lafayette Goniometer Set,
Sammons Preston Rolyan 7514, USA).
The data was processed by the SPSS 19.0 for Mac
and presented as mean and standard deviation. Shapiro-Wilk, Levene and Mauchlys tests were used in
order to check, respectively, the normality, homogeneity and sphericity of the samples data variances.
The intraclass correlation coefficient (ICC) was used
to measure the repeatability on the strength tests
(8RM) and the flexibility (goniometry). A 3 (groups)
X 2 (time) repeated measures ANCOVA was performed with body mass and height as covariates. The
significance level was established in 5%.
Results
All the flexibility and strength measures collected
at the pre-test showed an excellent repeatability, with
the ICC values varying between 0.90 and 0.98, respectively.
The analysis of variance did not show significant differences between groups. With respect to
the within-groups analysis, results showed significant changes (P<0.05) in HABS (F=802.596;
P=0.026; p2=0.183), HFKF (F=1478.968; P<0.001;
p2=0.512) and MRH (F=297.253; P=0.041;
p2=0.157) articular movements when compared
with the before and after measurements times (Table
II). In all these joints the range of motion increased
between the pre and post-tests, with exception on
HABS, for the ST group, who decrease 8.56%. It
was not observed any significant interaction between
measurements times and groups.
Discussion
The aim of this study was to examine the effects of
eight weeks of ST performed in an isolated manner
47
BASTOS
or combined with static stretching exercises (before

and between the RE sets) on the flexibility levels in
trained men. Based on the obtained data, we could
observe that only one movement for the shoulder
joint (HABS) was positively affected by SSBRE
and SSBSRE interventions and negatively by ST.
Also, only two movements of the hip joint (HFKF
and MRH) were positively affected by all the training protocols. The present results confirm previous
studies,5-7, 15 that showed that performing isolated ST
could also promote significant increases on the joint
range of motion performance.
Nevertheless, the present data does not confirm
what has been previously reported by Nbrega et
al.,10 who have investigated the effect of 12 weeks of
isolated ST, flexibility training, and the combination
of both, on the joint range of motion in untrained
subjects. These authors concluded that isolated ST
didnt promoted increases on any joint range of motion. According to them, in order to increase the joint
range of motion, specific stretching exercises are
needed. Nevertheless, the present study demonstrated that isolated ST promoted significant increases
on the joint range of motion for the HFKF (6.35%)
and for MRH (8.79%). The different stretching tests
used on the studies may partly explain the different results obtained. More specifically, Nbrega et
al.10 measured the flexibility by using the Flexitest,
which is an extremely subjective test where a slight
interpretation change could lead to different results
on the evaluation within and between subjects. On
the present study, flexibility was measured through
angular goniometry tests, in accordance with the
Norkin and White 15 protocol, on which all the
movements were executed on maximum range of
motion. Also, on the present study, the participants
were trained men and in Nbrega et al.,10 study they
were sedentary of both sexes. These differences may
influence the different results observed between the
present and Nbrega et al.10 study.
Barbosa et al.5 observed significant increases in
the sit-and-reach performance on elderly patients,
attending a cardiac rehabilitation program, after ten
weeks of ST. The average increase was 4 cm (1.6
inch) when the before and after measurements times
were compared. On the present study, however without significance difference, an increase of 46.12%
on the HE movement was observed. The no significance differences observed on this movement, on
48
the present study, may be caused by the differences

between groups on the baseline values of body mass
and height.
Monteiro et al.7 investigated the effects of 10
weeks of ST performed on a circuit method in middle-aged sedentary women and observed significant
increases on the flexibility for the trunk, hips, and
shoulder joints. Increases of 37.3% for the HADS
and 23.6% for the HE were found. On the present
study increases of 17.82% for the HADS and 46.12%
for the HE were observed but without statistical significance. These differences may be explained by the
different ST methods applied and the differences in
baselines values mentioned before. While Monteiro
et al.7 used a circuit training method, the present
study used a multi sets of RE with agonist/antagonist
order method for each joint. Furthermore, the different levels of trainability of the participants may have
also influenced the outcome results.
This investigation results are in accordance with
the ones found by Fatouros et al.16 on which eight
subjects performed 16 weeks of ST. As in the present
study, these authors verified significant increases
(P<0.05) for the hip flexion movement. Nonetheless,
it is important to underline that, on that particular
study,16 the duration of the ST was two times longer,
which may suggest that the increases on the flexibility levels observed in a larger number of movements
by Fatouros et al.,16 may be due to the higher intervention period and, therefore, the bigger stretching
volume.
Santos et al.8 were the first to analyse if moderately intense ST improved sedentary womens flexibility. The participants were divided in 3 groups: the
agonist/antagonist group (AA), the alternating segment group (AS) and the control group (CG). Both
groups (AA and AS) considerably increased their
strength and flexibility during the intervention, when
compared with the CG (P<0.05). The AS group increased their strength and flexibility more than the
AA group (P<0.05), in all the measures. In brief, this
study showed that sedentary young womens flexibility could be improved after 8 weeks of resisted
exercise.
After 16 weeks of training, Simo et al.9 analysed
the flexibility and strength gains in 80 sedentary
women randomly divided in four groups: strength
(N.=20), strength and flexibility (N.=20), flexibility
(N.=20) and control group (N.=20). Flexibility was
June 2013
assessed using the sit-and-reach test and strength

was measured using the 10RM tests for the leg press
and horizontal chest press exercises. Results showed
that all experimental groups demonstrated significant improvements when compared to the baseline
and the control group, although no difference was
found between these three groups. In short terms, the
authors demonstrated that the RE contributes to the
improvement and maintenance of flexibility without
including any type of stretching, but RE and stretching can be prescribed together in order to obtain better results.
The intensity of the ST is a determining factor for
the flexibility increases on different joints, as a result
of this exercise. Fatouros et al.6 aimed to investigate
the effect of manipulating the resistance exercise intensity in 58 elderly divided in three groups: low
(40% of the 1RM), moderate (60% of the 1RM) and
high intensity (80% of the 1RM). The intervention
time was 24 weeks. Based on the obtained results,
percentage increases in the different joints flexibility depended on the exercise intensity. The low intensity group had a lower range of increase on flexibility (3-12%), when compared with the moderate
and high intensity groups (6 to 22% and 8 to 28%,
respectively). The authors observed significant increases in the movement range on the sit-and-reach
test, and on the goniometry for the elbow flexion,
the knee flexion, the shoulder flexion, the shoulder
extension, the hip flexion and extension. No significant change was shown for the hip adduction, the
hip abduction, or the shoulder adduction. Both the
present study and Fatouros et al.s 6 study showed
that ST could increase the range of motion during
the hip flexion.
The physiological mechanisms that can be responsible for the increase on flexibility as a result of ST
are not well understood, but several hypothesis have
been suggested: 1) ST increases the tensive strength
of the tendons and ligaments, increasing their mass
and contractility, allowing for a higher movement
range;11 2) ST may increase the collagens turnover
tax in different structures of the musculoskeletal system. Since the synthesis and degradation tax of the
collagen fibers can be changed by physical activity,
as a consequence of the increase of the mechanical stress applied along the longitudinal axis of the
fibers, it is observed a decrease on the formation of
cross-bridges, as it is evidenced on animals mod-
BASTOS
els. The decrease on the quantity of cross-bridges,

especially on the tendon, allows a better deformation of this structure (extensibility), reducing this
way the chances of rupture, in addition to easing the
transmission of the force generated by the muscles
to the bones, which would lead to an increase in the
movement range.17 Moreover, a better force transmission, linked with specific ST adaptations, such as
the increase of the capacity of generating muscular
strength by the trained muscles and the reduction on
the movement antagonistic muscles co-activation,
can cause an increase on the movement range when
this is performed actively.
The principal limitations of this study were the
number of the participants, the differences at baseline on the body mass and height and the duration of
the interventions programs. We propose the application of the same study design in more participants
and longer intervention periods with homogeneous
anthropometric characteristics.
Conclusions
In summary, the execution of all the experimental
protocols caused significant increases on few joints
movements flexibility in trained men, with the exception of HABS movement, in the ST group, that
showed a significant decrease. The comparisons between the groups showed no significant differences
between the executions of ST in an isolated manner
or combined with SSE.
References
1. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ,
Lee IM et al. Quantity and quality of exercise for developing and
maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med Sci Sports Exerc 2011;43:1334-59.
2. Rees SS, Murphy AJ, Watsford ML, McLachlan KA, Coutts AJ.
Effects of proprioceptive neuromuscular facilitation stretching on
stiffness and force-producing characteristics of the ankle in active
women. J Strength Cond Res 2007;21:572-5.
3. Kokkonen J, Nelson AG, Tarawhiti T, Buckingham P, Winchester
JB.
Early phase resistance training strength gains in novice lifters are enhanced by doing static stretching. J Strength Cond Res
2010;24:502-4.
4. LaRoche D, Lussier M, Roy S. Chronic stretching and voluntary
muscle force. J Strength Cond Res 2008;22:589-7.
5. Barbosa A, Santarm J, Filho W, Marucci M. Effects of resistance
training on the sit-and-reach test in elderly women. J Strength Cond
Res 2002;16:14-8.
49
BASTOS
6. Fatouros I, Kambas A, Katrabasas I, Leontsini D, Chatzinikolaou A,

Jamurtas A. Resistance training and detraining effects on flexibility
performance in the elderly are intensity-dependent. J Strength Cond
Res 2006;20:634-8.
7. Monteiro W, Simo R, Polito M, Santana C, Chaves R, Bezerra E
et al. Influence of strength training on adults womens flexibility. J
8. Santos E, Rhea MR, Simo R, Dias I, de Salles BF, Novaes J et al.
Influence of moderately intense strength training on flexibility in
sedentary young women. J Strength Cond Res 2010;24:3144-5.
9. Simo, R, Lemos A, Salles B, Leite T, Oliveira , Rhea M et al. The
influence of strength, flexibility, and simultaneous training on flexibility and strength gains. J Strength Cond Res 2011;25:1333-5.
10. Nbrega ACL, Paula KC, Carvalho AC.
Interaction between resistance training and flexibility training in healthy young adults. J
11. Spirduso W. Physical dimensions of aging. Champaign, IL: Human
Kinetics; 1995.
12. Kraemer WJ, Adams K, Cafarelli E, Dudley GA, Dooly C, Feigenbaum MS et al. Progression models in resistance training for
healthy adults. Med Sci Sports Exerc 2002;34:364-80.
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13. American College of Sports Medicine. Progression models in resistance training for healthy adults. Med Sci Sports Exerc 2009;41:687708.
14. Winchester J, Nelson A, Kokkonen J. A single 30-s stretch is sufficient to inhibit maximal voluntary strength. Res Q Exerc Sport
2009;80:257-4.
15. Norkin CC, White DJ, Settineri LIC.
Medida do movimento articular: manual de goniometria. Porto Alegre: Artes Mdicas;1997.
16. Fatouros I, Taxildaris K, Tokmakidis S, Kalapotharakos V, Aggelousis N, Athanasopoulos S et al. The effects of strength training,
cardiovascular training and their combination on flexibility of inactive older adults. Int J Sports Med 2002;23:112-7.
17. Kovanen V, Suominen H, Heikkinen E. Mechanical properties of
fast and slow skeletal muscle with special reference to collagen and
endurance training. J Biomech 1984;17:725-35.
in the manuscript.
June 2013

Effects of 24 weeks of strength training or hydrogymnastics

on bone mineral density in postmenopausal women
G. NOVAES 1, J. NOVAES 2, J. VILAA-ALVES 1, 3, H. M. FERNANDES 1, 3
H. FURTADO 4, 5, R. MENDES 1, 3, V. M. REIS 1, 3
Aim. The aim of this study was to investigate and compare the
effects of 24 weeks of strength training or hydrogymnastics
on bone mineral density in postmenopausal women.
Methods.
Thirty one elderly women (66.96.1 years old) vol
unteered to participate in 24 weeks of supervised exercise,
performed on three non-consecutive days a week. Partici
pants were allocated into two groups according to their pref
erences: strength training (ST, N.=14) and hydrogymnastics
(HG, N.=17). The bone mineral densities (BMD) at the femo
ral neck (FN) and lumbar spine (L1 to L4) were assessed at
baseline and after 24 weeks of exercise.
Results. BMD levels at the femoral neck and lumbar spine
significantly increased in the ST group (4.25% and 5.59%,
respectively; P=0.001) and maintained (0.02% and 0.37%,
respectively; P>0.05) in the HG group, with no differences
between groups after 24 weeks of exercise (P>0.05).
Conclusion. These findings indicate that 24 weeks of strength
training are effective in moderately increasing BMD at the
femoral neck and lumbar spine in postmenopausal women,
while the same period of hydrogymnastics tended to maintain
these BMD-related levels. However, 24 weeks of exercise in
tervention were not sufficient to identify differences between
exercise groups.
Key words: Exercise - Bone density - Women - Osteoporosis,
postmenopausal.
he reduction of the bone mineral density (BMD)

associated with a menopausal condition (i.e., osteopenia) has been recognized as an important public
health issue that affects an increasingly number of
aged women, since it can act as a precursor condition of osteoporosis. Although a reduction of bone
mass is observable from the middle adulthood in
Corresponding author: J. Vilaa Alves, Sports Department, University
of Trs-os-Montes e Alto Douro, Parque Desportivo da UTAD, Apartado
1013, 5001-801 Vila Real, Portugal. E-mail: josevilaca@utad.pt

Health and Human Development, Vila Real, Portugal
2School of Physical Education and Sports
Rio de Janeiro Federal University, Rio de Janeiro, Brazil
3University of Trs-os-Montes
and Alto Douro (UTAD), Vila Real, Portugal
4Castelo Branco University, Rio de Janeiro, Brasil
5Secretaria Municipal de Envelhecimento Saudvel
e Qualidade de Vida
Prefeitura da Cidade do Rio de Janeiro, Brasil
some areas with a larger amount of trabecular bone,

a drastic decline in BMD and a deteriorated bone micro-architecture occurs mainly in women aged over
55 years and/or entering the menopause.1 The osteoporosis condition associated with a physical
functional decline is a risk factor of age-related fractures

caused by falls, which are consequently linked to
loss of autonomy, lower quality of life and elevated
morbidity and mortality rates.2
Available evidence has suggested that physical
activity is a nonpharmacological intervention that
plays a crucial role in the prevention of osteoporosis,3-5 which may be explained by the fact that the extra tendons tension on the bone structure appears to
be an important stimulus to osteogenesis,6, 7 and an
important determinant of BMD maintenance or increase.1, 8-10 Those suggestions have been confirmed
by longitudinal intervention studies that found positive exercise-related effects on BMD among men
and women, especially when accompanied by exercise-induced changes in fitness.11, 12
However, the type/mode and length of the exercise
intervention needed to promote an adequate tension
51
NOVAES
EFFECTS OF 24 WEEKS OF STRENGTH TRAINING OR HYDROGYMNASTICS
Table I.MeanSD of bone mineral density (BMD) levels in the Strength Training and Hydrogymnastics groups at baseline and after
24 weeks of exercise.
Strength Training
Femoral neck (g/cm2)

Lumbar spine (g/cm2)
Baseline
After 24 weeks
Baseline
After 24 weeks
0.8800.12
0.8360.11
0.9170.13
0.8830.10
0.8980.09
0.8950.11
0.8980.08
0.8980.11
in the bone structure still remains undetermined.1, 6

More precisely, the controversy may be associated
with the type and level of tension promoted by the
different physical activities. 13 For example, exercise
effects can be caused by gravitational and reaction
forces such as on walking, running and dancing or
by muscular contractions such as swimming. Moreover, different types/modes of exercise may include
weight-bearing (e.g., aerobics, strength training and
individual/team sports) or non/minimal weight-bearing activities (e.g., swimming, hydrogymnastics and
cycling). Regarding the length of the exercise intervention, some studies have suggested that physiologically signicant improvements in BMD are only observable after a prolonged intervention period (i.e.,
one year).1 However, more recently, Marques et al.14
demonstrated that 8 months of ST were sufficient to
increase the BMD at the trochanter and total hip of
older women, and also suggested that this mode of
exercise was more effective than aerobic exercise
for inducing favourable changes in BMD. Given the
above evidence and taking into consideration that the
bone remodelling process/cycle takes approximately 4 to 6 months to complete in the adult skeleton,1
it is of great interest to investigate if lower length
exercise interventions based on different mechanical loadings provide sufficient stimulus to increase
BMD in postmenopausal women.
Therefore, the main purpose of the present study
was to investigate and compare the effects of 24
weeks of ST or hydrogymnastics on bone mineral
density in postmenopausal women.
Participants
Thirty-one, Caucasian, postmenopausal elderly
women, with 66.96.1 years old, 73.7010.38 kg
52
Hydrogymnastic
of body mass and 155.1010.05 cm height were

assigned into two groups, according to their preferences and willingness to participate in a long-term
intervention: strength training (ST, N.=14) and hydrogymnastics (HG, N.=17). All participants fulfilled
the following inclusion criteria: living independently
in the community, aged 55 or above, postmenopausal status, being without contraindications to physical
activity and not reporting history of regular structured exercise. By the end of study, all participants
attained more than 85% of the exercise sessions. The
procedures were designed according to the Helsinki
Declaration and were approved by the Institutional
Research Ethics Committee (Table I).
Procedure
Prior to the baseline measurements, all participants were informed of the aims of the study/intervention and provided a signed informed consent. A
PAR-Q questionnaire and a medical and exercise
history questionnaires were also administered and
completed at this moment. Anthropometric measures were recorded in light clothing through the use
of a portable stadiometer (Sanny, model ES2030,
Brazil) with a precision of 0.1 cm and a portable
scale (Tanita, model BF-562, Japan) with a precision of 0.1 kg. The resting heart rate of women in
the HG group was measured by palpating the radial
pulse for 60 seconds, after being quietly sat during
five minutes. On the other hand, the one repetition
maximum (1-RM) tests of exercises using additional
weights were performed based on the Knutzen et
al.15 recommendations. Participants completed two
weeks of familiarization with the equipment, prior to
the strength testing, and were advised regarding the
execution of proper technique.
Participants of both groups were instructed not to
change their nutrition and social practices during the
24 weeks of intervention.
June 2013
Bone mineral density assessment

Bone densitometry was conducted using a Discovery Wi (Hologic Inc., Bedford, MA, USA) dual-energy X-ray absorptiometer, and measurements were
taken at the left femoral neck and the first four lumbar vertebrae (L1-L4) of the spine (anteroposterior
plane). BMD results were calculated by dividing the
bone mineral content by the bone area, and expressed
in g/cm2. DXA calibration was executed according
to the manufacturers specifications. All scans were
performed by the same certified technician for each
participant at baseline and after 24 weeks.
Exercise programs
Both exercise prescription and programming were
planned in order to promote the functional fitness
and designed according to recent guidelines for the
geriatric population.16, 17 Exercise classes were conducted three times per week on alternate days, with
each session lasting for about 45 minutes, including
warm-up and cool down. Exercise programs were
conducted by certified and experienced fitness instructors.
Each session of the ST group began with a 5-10
minute cardiovascular warm-up, followed by resistance training exercises and ending with a 5-10
minute stretch/cool down. During the first 12 weeks,
women performed the following exercises: squats
with dumbbells, rowing with dumbbells, leg curl,
vertical chest press, leg standing calf raise with
dumbbell, dumbbells shoulder press, biceps curl
with dumbbells, seated dumbbell triceps extension,
abdominal crunch and lumbar extensions. During
the first two weeks of the ST, a higher emphasis
was placed on the proper and safe execution of each
exercise. During the training period, women were
required to perform three sets of the first eight exercises previously mentioned: 10 repetitions with a
load of 70% of 1-RM (1st day), 8 repetitions with a
load of 80% of 1-RM (2nd day) and 12 repetitions
with a load of 60% of 1-RM (3rd day). With respect
to the abdominal and lumbar extensions exercises,
women performed three sets of 20 repetitions. There
were 1 minute rest periods between all exercises and
3 minutes rest periods between sets. The weight load
was increased by 5% every 3 weeks. During the second phase of the intervention (13-24th weeks), the
ST program included exercises that replicated pos-
NOVAES
sible/typical daily activities and needs. During this

period, women performed the following exercises:
wall squat, chair squat, wall push-ups, raising a 1 kg
weight from the ground and placing it on 1.6 meter
high shelf, stair climbing and descending, a simulated car entry and exit, carrying grocery-like bags with
a total of 3 kg for a distance of 5 meters, abdominal
crunch and lumbar extensions. Women performed
three sets of 30 seconds for each one of the first
seven exercises. For the abdominal and lumbar extensions exercises, women were required to perform
three sets of 30 repetitions each. The rest periods and
weight load increase (in exercises using additional
weights) adopted in the first phase were maintained
during the second phase of the intervention.
Regarding the HG, each session included 10 min
of stretching and warm-up, 30 min of shallow water
endurance-type exercises and 5 min of cool-down/
relaxation, at a public indoor swimming pool with a
water depth of 1.20-1.40 m and a water temperature
of 30.5 C. The training zone was individually determined using the heart rate reserve as determined by
the Karvonen formula.18 On each session, 4 women
were randomly selected to wear heart rate monitoring equipment (Polar, model FT1, Finland) and
were instructed to attain 70 to 80% of their work
heart rate. The pace of the exercises was determined
by appropriate synchronous music selected by the
certified fitness instructor. During the first 12 weeks,
the cardio workout consisted of consecutive bouts of
a combination of movements, such as forward, backward and side walking, kicking, knee up, twisting,
shoulders adduction/abduction, elbow flexion, and
squats. During the second phase of the intervention
(week 13 to week 24), the main component of the
classes also included the use of aqua gloves and
flotation devices, and the practice of waterpower workouts in chest-deep water.

The data was processed by the SPSS 21.0 for Mac
and presented as meanSD. Two
way (groups x moments) repeated measures ANOVA was performed

to investigate the exercise related effects. Partial etasquared values (p) were reported as measures of
effect size according to the following rule of thumb:
small (>0.01), medium (>0.06) and large (>0.14).19
Shapiro-Wilk, Levene and Mauchlys tests were
53
NOVAES
used in order to check, respectively, the normality,

homogeneity and sphericity of the samples data variances when performing the ANOVA, and none of
the assumptions was violated. Percent changes (%)
from baseline to week 24 were calculated through
the differences in the scores. Follow-up paired t tests
were conducted to compare pre and posttest difference scores for each group separately. The
significance level was established at 5%.

Results
At baseline, there were no between-group significant differences in BMD at the femoral neck
(P=0.624) and lumbar spine (P=0.140).
For the BMD at the femoral neck, the repeated
measures ANOVA revealed a significant effect for
the interaction between groups and time (F=5.52;
P=0.026; p=0.16) and the main effect of time
(F=5.63; P=0.025; p=0.16), but not for the main
effect of groups (F=0.00; P=0.998; p=0.00). Follow-up paired t tests revealed that the BMD levels
at the femoral neck significantly increased (4.25%;
P=0.001) in the ST group and maintained (0.02%;
P=0.989) in the HG group.
Regarding the BMD at the lumbar spine, the repeated measures ANOVA revealed a significant
effect for the groups-time interaction (F=11.31;
P=0.002; p=0.28) and the main effect of time
(F=15.00; P=0.001; p=0.34), but not for the main
effect of groups (F=0.97; P=0.333; p=0.03). Follow-up paired t tests revealed that the BMD levels
at the lumbar spine significantly increased (5.59%;
P=0.001) in the ST group and maintained (0.37%;
P=0.678) in the HG group.
Discussion
The data of the present study showed that ST
was an effective exercise intervention in improving
the BMD in 24 weeks in postmenopausal elderly
women. These findings support those referenced by
Bemben and Fetters, 1 suggesting that ST contributes to the overload of clinically important body
sites (spine, hip, wrist) while also giving the extra
skeletal benets of improving muscular strength and
balance, which are associated with a reduced risk for
54
falls. Walls et al. 20 indicated on their meta-analysis

study that ST programs tend to prevent or reverse
bone mass loss by almost 1% per year in the lumbar spine and femoral neck, when compared with the
control groups, which is of great significance from
a clinical point of view, since the risk ratio for hip
fracture increases with a reduction of one standard
deviation in BMD in elderly women. 21
The significant changes in BMD in the ST group
may be related to the extra tension of the tendons on
the bones structures that promote the osteogenesis.1,
8, 10 On the other hand, in the aquatic environment,
the effect of thrust on an immersed body tends to reduce this extra tension who is an important stimulus
to osteogenesis. 6,7 Another aspect to be considered
is that the eccentric muscle contractions are lowered or even null in water environment. The lack of
these types of muscle actions causes less tension of
the tendons on the bone, when compared with the
same movement performed in land. 22 In addition,
Marques et al., 23 refereed on their meta-analysis
study that low-impact physical activities seem to be
ineffective in increasing BMD even when performed
in land. Consequently, it has been suggested that intense/high impact exercise programs are needed to
increase bone mineral density in postmenopausal
women, preferably weighed against other popular
and applicable exercise programs such as aerobic
classes, Tai Chi, and walking, which appear to be
easier to adhere to, but are less effective on the osteoporosis prevention in this geriatric population. 24
On the other hand, Rotstein et al., 25 observed significant differences in the BMD at the lumbar spine
of postmenopausal women who performed hydrogymnastics for 7 months, with a weekly frequency
of three times, but not in the femoral neck. The depth
of the pool may be one of the factors that could help
explain these results. On the present study and in
Rotstein et al.,25 a 1.40m of depth was used. This
depth allows a fewer interference of thrust on the
upper limbs, which have muscles with insertions
in the lumbar spine and consequently a higher tension on these structures. This fact may be the one of
the possible reasons why in the HG group, on the
present study, the BMD in the lumbar spine did not
change.
Kemper et al., 6 did not observed significant differences in the BMD at the femoral neck and lumbar spine, after 24 weeks, either in the group that
June 2013
performed ST or in the group that performed swimming. The results observed by Kemper et al, 6 are
not in accordance with the present study on the ST.
This fact may be related with the methodology of
the ST. In the Kemper et al. 6 study, the load was
increased every four weeks in all exercises, while in
the present study, there was an increment of 5% of
the initial 1RM load, every three weeks. However, in
the study performed by Korpelainen et al., 26 no significant difference was observed in the BMD of the
femur bone, between and within exercise and control
groups, after 30 weeks of exercise intervention, even
in the exercise group which performed high intensity exercises. The possible reason may be related
with the fact that these exercise sessions were performed at home without specialist supervision. This
fact probably promoted a low control of the load and
intensities of the exercises and sessions. The load is
an important factor to promote tension on the tendon
muscle structure. The use of a load of about 80% of
1RM or more with a partial range of motion appears
to be beneficial on the promotion of the osteogenesis.27, 28
On the other hand, on the period comprised between 12 to 24 weeks of ST, on the present study, it
was used a combination of traditional ST exercises
with activities that simulated daily life functions.
These exercises involved muscle groups that were
part of the femoral neck and lumbar spine structures
and were performed with fast movements for 30
seconds. Stengel et al. 29 used ST exercises that also
involved fast movements and also observed positive
effects on the BMD in postmenopausal women. The
use of this methodology may promote a higher tension of the tendons in bones structures, and thereby
promote the osteogenesis. Therefore, the length of
24 weeks of the ST program alongside an average
load of about 80% of the 1RM, or more, with a partial range of motion, using concentric and eccentric
muscle actions performed with fast movements,
seems to provide an effective methodology for promoting BMD levels at some body sites.
Some limitations of the present study should be
acknowledged. Firstly, it was not possible to recruit
an adequate control group to be followed with no
alteration in exercise practices. Secondly, and although women were instructed to maintain their nutrition routines, no assessment of dietary supplement
intakes was performed throughout the study.
NOVAES
Conclusions
In conclusion, the present findings indicate that
24 weeks of strength training are effective in moderately increasing BMD at the femoral neck and lumbar spine in postmenopausal women, while the same
period of hydrogymnastics tended to maintain these
BMD-related levels. However, 24 weeks of exercise
intervention were not sufficient to identify differences between exercise groups.
References
1. Bemben A, Fetters L. The independent and additive effects of exercise training and estrogen on bone metabolism. J Strength Cond Res
2000;14:114-6.
2. Madureira M, Bonf E, Takayama L, Pereira R. A 12-month randomized controlled trial of balance training in elderly women with osteoporosis: improvement of quality of life. Maturitas 2010;66:2065.
3. Hasselstrm H, Karlsson M, Hansen E, Grnfeldt V, Froberg K,
Andersen B. Peripheral bone mineral density and different intensities of physical activity in children 6-8 years old: the Copenhagen
School Child Intervention study. Calcif Tissue Int 2007;80:31-7.
4. Miyabara Y, Onoe Y, Harada A, Kuroda T, Sasaki S, Ohta H. Effect
of physical activity and nutrition on bone mineral density in young
Japanese women. J Bone Miner Metab 2007;25:414-5.
5. Nilsson M, Ohlsson C, Eriksson L, Frndin K, Karlsson M, Ljunggren O. Competitive physical activity early in life is associated
with bone mineral density in elderly Swedish men. Osteoporos Int
2008;19:1557-9.
6. Kemper C, Oliveira D, Bottaro M, Moreno R, Bezerra A, Guido
M. Effects of swimming and resistance training on bone mineral
density of older women. Rev Bras Med Esporte 2009;15:10-3.
7. Tenrio S, Alves B, Bezerra L, Souza L, Catanho A, Tashiro T. Effect of physical training on the bone tissue and the calcium serum
concentration in ovariectomized mice. Acta Cir Bras 2005;20:280-3.
8. Kemmler W, Engelke K, Von Stengel S, Weineck J, Lauber D, Kalender A. Long-term four-year exercise has a positive effect on menopausal risk factors: the Erlangen Fitness Osteoporosis Prevention
Study. J Strength Cond Res 2007;21:232-7.
9. Mansfield M. Designing exercise programs to lower fracture risk in
mature women. Strength Cond J 2006;28:24-5.
10. Suominen H. Muscle training for bone strength. Aging Clin Exp
Res 2006;18:85-8.
11. Judge O, Kleppinger A, Kenny A, Smith A, Biskup B, Marcella G.
Home-based resistance training improves femoral bone mineral density in women on hormone therapy. Osteoporos Int 2005;16:109612.
12. Stewart J, Bacher C, Hees S, Tayback M, Ouyang P, Jan de Beur S.
Exercise effects on bone mineral density relationships to changes in
fitness and fatness. Am J Prev Med 2005;28:453-7.
13.
Kelley GA, Kelley KS, Tran ZV. Resistance training and bone mineral density in women: a meta-analysis of controlled trials. Am J
Phys Med Rehabil 2001;80:65-77.
14. Marques A, Wanderley F, Machado L, Sousa F, Viana L, MoreiraGonalves D. Effects of resistance and aerobic exercise on physical
function, bone mineral density, OPG and RANKL in older women.
Exp Gerontol 2011;46:524-8.
15. Knutzen M, Brilla R, Caine D. Validity of 1RM prediction equation
for older adults. J Strength Cond Res 1999;13:242-6.
55
NOVAES
16. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King
AC et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the
American Heart Association. Med Sci Sports Exerc 2007;39:143545.
17. Rahl L. Physical activity and health guidelines: recommendations
for various ages, fitness levels, and conditions from 57 authoritative
sources. Champaign, IL: Human Kinetics; 2010.
18. Karvonen MJ, Kentala E, Mustala O. The effects of training on heart
rate: a longitudinal study. Ann Med Exp Biol Fenn 1957;35:307-15.
19. Cohen J. Statistical power analysis for the behavioral sciences. 2nd
edition. Hillsdale: L. Erlbaum Associates; 1988.
20. Wolff I, Van Croonenborg J, Kemper H, Kostense P, Twisk J. The
effect of exercise training programs on bone mass: A meta-analysis
of published controlled trials in pre and postmenopausal women.
Osteoporos Int 1999;9:1-11.
21. Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P
et al. Predictive value of BMD for hip and other fractures. J Bone
Miner Res 2005;20:1185-11.
22. Hawkins A, Schroeder T, Wiswell A, Jaque V, Marcell J, Costa K.
Eccentric muscle action increases site-specific osteogenic response.
23. Marques E, Mota J, Carvalho J. Exercise effects on bone mineral
density in older adults: a meta-analysis of randomized controlled
trials. Age 2012;34:1493-12.
24. Schmitt N, Schmitt J, Doren M. The role of physical activity in the
prevention of osteoporosis in postmenopausal women: An update.
Maturitas 2009;63:34-4.
56
25. Rotstein A, Harush M, Vaisman N. The effect of a water exercise

program on bone density of postmenopausal women. J Sports Med
Phys Fitness 2008;48:352-7.
26. Korpelainen R, Keinamen-Kiukaanniemi S, Heikkinen J, Vaananen
K, Korpelainen J. Effect of impact exercise on bone mineral density
in elderly women with low BMD: a population-based randomized
controlled 30-month intervention. Osteoporos Int 2006;17:109-11
27. Ebben P, Fauth L, Kaufmann E, Petushek J. Magnitude and rate of
mechanical loading of a variety of exercise modes. J Strength Cond
Res 2010;24:213-4.
28. Ebben P, Garceau R, Wurm J, Suchomel J, Duran K, Petushek J.
The optimal back squat load for potential osteogenesis. J Strength
Cond Res 2012;26:1232-5.
29. Stengel V, Kemmler W, Pintag R, Beeskow C, Weineck J, Lauber D.
Power training is more effective than strength training for maintaining bone mineral density in postmenopausal women. J Appl Physiol
2005;99181-7.
in the manuscript.
Acknowledgements.The authors would like to thank Esposende
2000, E.M., for providing the logistical support necessary to conduct
the present research.
June 2013

Psychological responses to resistance training

in middle-aged and older women
H. M. FERNANDES 1, 2, J. VILAA-ALVES 1, 2, G. S. NOVAES 1, 2
H. FURTADO 3, 4, D. OLIVEIRA 1, 2, F. J. AIDAR 1, 2, F. SAAVEDRA 1, 2
Aim. The aim of the present study was to investigate the effects of resistance training on selected psychological variables
(perception of health status, body satisfaction, life satisfaction and depression) in elderly women.
Methods. A total of 14 women, aged 55 years and above
(M=63.36, SD=4.47), volunteered to participate in a 24 weeks
supervised exercise intervention, three times a week on alternate days. During the first 12 weeks, women performed sets
of calisthenics and weight-lifting exercises with dumbbells.
During the second phase of the intervention (13-24th weeks),
the strength training program also included sets of possible/
typical daily living activities/tasks and needs (e.g., raising and
placing weights on high shelves, stair climbing and descending,
simulated car entry and exit, and carrying grocery-like bags).
Measures were assessed at baseline, after 12 and 24 weeks.
Results.
Within-subjects analysis indicated no significant differences between baseline and week 12 scores. Between week
12 and week 24, significant differences were found in the perceived health status (P=0.046) and depression scores (P=0.041),
but not in body satisfaction and satisfaction with life.
Conclusion. These results indicate that resistance training
promotes significant improvements in the perceived health
status and reductions in depressive symptoms, and suggest
that resistance exercises based upon the middle-aged and
older womens daily living tasks/demands and needs may be
a more efficacious and beneficial type of exercise for their
well-being.
Key words: Resistance training - Mental health - Women - Activities of daily living - Longitudinal studies.
he beneficial effects of regular physical activity

(e.g., unstructured daily activities such as walk-
Corresponding author: H. M. Fernandes, Research Centre in Sport,

Health and Human Development, University of Trs-os-Montes and
Alto Douro, Parque Desportivo da UTAD, Apartado 1013, 5001-801
Vila Real, Portugal. E-mail: hmfernandes@gmail.com

Health and Human Development (CIDESD)
Vila Real, Portugal
2University of Trs-os-Montes and Alto Douro (UTAD)
Vila Real, Portugal
3Castelo Branco University, Rio de Janeiro, Brasil
4Secretaria Municipal de Envelhecimento
Saudvel e Qualidade de Vida
Prefeitura da Cidade do Rio de Janeiro, Brasil
ing, jogging, and cycling) and exercise participation

on the physical, social and mental health of elderly
individuals are well documented.1-5 Although much
of this evidence has been based on aerobic-based activities or exercise programs, the recent guidelines
for older adults recommended by the American College of Sports Medicine (ACSM) and the American
Heart Association (AHA) have placed additional
emphasis on muscle-strengthening activities, with
the aim of promoting and maintaining health and
physical independence.6
However, despite this evidence and recommendations, epidemiological research indicates that a considerable number of elderly individuals is not regularly involved in physical activity or fails to achieve
the international recommendations.6-9 From a public
health perspective, this is problematic since a large
percentage of this population has at least one chronic disease and represents the highest proportion of
health care use.10 Moreover, loss of independence
and reduced well-being related to impaired functioning are one of the most distressing factors associated
with the aging process.11
Nevertheless, the available descriptive evidence
57
FERNANDES
PSYCHOLOGICAL RESPONSES TO RESISTANCE TRAINING IN MIDDLE-AGED AND OLDER WOMEN
suggests that, besides walking and jogging, weightlifting or strength training are among the most preferred and practiced exercises by middle-aged and
older adults,12 although the prevalence rate for resistive exercise is lower than average young adult participation levels.2, 5 Albeit available data on gender
specific participation is scarce, one may assume a
lower proportion of female participants.7
Within the physical activity and well-being literature in older adults, a great extent of available
studies has reported results without separating men
and women.3 At the same time, of the 36 intervention studies these authors reviewed, only seven were
performed with women only. Research shows that
women have higher life expectancies, higher rates of
morbidity, and report more mental health problems
(e.g., depression), lower levels of perceived health
status and life satisfaction, which in turn may lead
to higher and more costly medical care services.13-15
Given this evidence, more research is warranted to
investigate the psychological responses of this geriatric population to a supervised progressive strength
training program. In order to provide further insight
into the plausible effects of resistance training in
middle-aged and older women, different conditions/
means of resistance were prescribed and incorporated into the two phases of the long-term intervention (1-12th weeks and 13-24th weeks). Usually,
most of the strength training programs for women
suggest the use of free weights such as dumbbells
and ankle cuff weights or elastic bands and body
weight as the means of resistance.2 Given the specific nature of adaptation to exercise and the need for
maintaining muscle mass and muscular strength in
this period of life, one may advocate for an exercise
prescription that also includes possible/typical daily
living activities/demands and needs (e.g., raising and
placing weights on high shelves, stair climbing and
descending, simulated car entry and exit, and carrying grocery-like bags), which represent increasingly
difficult daily motor tasks during the aging process.
Therefore, the present study aimed to investigate
the effects of resistance training on selected psychological variables (perception of health status, body
satisfaction, life satisfaction and depression) in elderly women. More specifically, changes in the outcome measures were analyzed after the first (1-12th
weeks) and the second phase (13-24th weeks) of the
exercise intervention.
58

Participants
Initially, a total of fifteen middle-aged and older
women volunteered to participate in the present
longitudinal intervention study. However, since one
participant moved away to a different country, only
fourteen women (N.=14) completed all of the assessments and were then analyzed. Participants ranged
in age from 55 to 69 years (M=63.36, SD=4.47).
At baseline, 78.6% of the women were married or
de facto and 21.4% were widowed or divorced. The
womens mean height and body mass values were
1.550.06 m and 67.917.94 kg, respectively, and
the body mass index (BMI) was 28.242.76 kg/m.
Women were eligible to participate in the study, providing they met the following inclusion criteria: age
55 or above, postmenopausal status, absence of diagnosed neurodegenerative or neuromuscular disorders,
nonexistence of medical contraindications to physical activity, and not having participated in any structured exercise program in the two-year period previous the present study. Participants were recruited in
a northern coastline region of Portugal, and invited
to participate in the exercise program through local
community advertising, namely in newspapers and in
socio-cultural organizations for seniors. No sample
size was determined at the beginning of the study.
Instruments
Self-reported health status was assessed using a
single item question that asked women to rate their
health status using a 10-point scale ranging from 1
(very poor) to 10 (excellent). Body satisfaction was
evaluated by one question (How satisfied are you
with your body/appearance?) using a 10-point response scale (1: very dissatisfied to 10: very satisfied). Satisfaction with life was measured using the
self-report measure developed by Diener et al.,16 that
contains 5 items responded on a 7-point scale ranging from 1 (strongly disagree) to 7 (strongly agree).
The range of possible scale scores is from 7 to 35. In
the present study, Cronbach alpha values varied between 0.79 and 0.84. To assess scores of depression
symptoms, the Beck Depression Inventory (BDI),
originally developed by Beck et al.,17 was used. The
BDI consists of 21 symptoms rated on a 4-point se-
June 2013
verity scale (0 to 3), with possible total scale scores

ranging from 0 to 63. Women were instructed to respond according to how they felt over the last week.
In this study the BDI was treated as a unidimensional
scale and internal consistency values ranged from
0.77 to 0.82.
Procedures
The study protocol was previously approved by
the institutional ethics committee and the principles
of the Helsinki Declaration were followed throughout the study.
Prior to the baseline measurements, all women
were informed of the studys objectives and signed
an informed consent. The PAR-Q questionnaire and
a medical and exercise history questionnaires were
also completed in this phase in order to identify
possible exclusion criteria. Furthermore, individual
characteristics (age, marital status, height, and body
mass) were also assessed pre-intervention. Anthropometric measures were recorded in light clothing using a portable stadiometer (Sanny, model
ES2030, Brazil) with a precision of 0.1 cm and a
portable scale (Tanita, model BF-562, Japan) with
a precision of 0.1 kg. Body mass index (BMI) was
then calculated using the Quetelet formula. The procedures to determine the one repetition maximum (1RM) were performed according to the recommendations of Knutzen et al.18 Prior to the strength testing,
participants completed two weeks of familiarization
(4-6 sessions) with the equipment and exercises to be
used in the first phase of the intervention, and were
advised regarding the execution of proper technique.
Each woman completed the medical and exercise
history questionnaires and the outcome measures in
a quiet room at baseline, after 12 weeks and after
24 weeks. All participants were asked to not change
significantly their nutrition and social practices during the duration of the study. The resistance training
program was guided by a certified and trained fitness
instructor with experience with elderly individuals.
The exercise program was essentially designed to
enhance the functional fitness of the participants and
was based on recent recommendations for this population.6, 12 Gym classes were conducted three times
a week on alternate days, with each session lasting
about 45 minutes including a 5-10 minute cardiovascular warm-up and a 5 minute cool down.
FERNANDES
During the first 12 weeks, women performed

the following ten exercises: squats with dumbbells, rowing with dumbbells, leg curl, vertical
chest press, leg standing calf raise with dumbbell,
dumbbells shoulder press, biceps curl with dumbbells, seated dumbbell triceps extension, abdominal
crunch and lumbar extensions. A higher emphasis
was placed on the proper and safe execution of each
exercise during the initial phase of the strength
training (about two weeks). For the first eight exercises, women were required to perform three sets
of repetitions as follows: 10 repetitions with a load
of 70% of 1-RM (1st day), 8 repetitions with a load
of 80% of 1-RM (2nd day) and 12 repetitions with
a load of 60% of 1-RM (3rd day). For the abdominal and lumbar extensions exercises, women were
required to perform three sets of 20 repetitions. Interval periods of at least 1 and 3 minutes were assured between exercises and sets, respectively. The
weight load was increased by 5% every 3 weeks.
During the second phase of the intervention (1324th weeks), the resistance training program was
designed towards possible/typical daily living activities and needs. During this period, women performed the following exercises: wall squat, chair
squat, wall push-ups, raising a 1 kg weight from
the ground and placing it on 1.6 meter high shelves,
stair climbing and descending, a simulated car entry
and exit, carrying grocery-like bags with a total of
3 kg for a distance of 5 meters, abdominal crunch
and lumbar extensions. For the first seven exercises,
women were required to perform three sets of 30
seconds for each exercise. For the abdominal and
lumbar extensions exercises, women were required
to perform three sets of 30 repetitions each. The
previous interval periods and weight load increase
were maintained during this phase. Participants
overall adherence rate was higher than 85%.
Descriptive statistics of data were presented as
mean (M) and standard deviation (SD). Percent
changes (%) from baseline to week 12 and from
week 12 to week 24 were calculated from the differences in the scores. Skewness and kurtosis coefficients were computed for univariate normality
analyses purposes, and all values were within 2.
The internal consistency of the measured scales
59
FERNANDES
Table I.Descriptive results (MSD) of the outcome measures at baseline, after 12 weeks and after 24 weeks of resistance training.
Perception of health status

Body satisfaction
Satisfaction with life
Depression
Baseline
After 12 weeks
After 24 weeks
6.431.78
8.001.92
28.217.59
21.717.31
7.071.69
7.931.00
29.364.33
21.505.63
8.141.46
8.501.40
30.504.83
17.643.18
was estimated using the Cronbachs alpha. Withinsubjects ANOVAs were performed to investigate
exercise-related changes in the outcome measures
over time. Post-hoc tests with Bonferroni adjustment for multiple comparisons were used to identify
pairwise differences. Partial eta-squared values (p)
were reported as measures of effect size, with values
higher than 0.01, 0.06 and 0.14 representing small,
medium, and large effects, respectively.19 The level
of significance in this study was set at P<0.05. All
statistical analyses were conducted by using SPSS
(version 16.0, SPSS Inc., Chicago, USA).
Results
The descriptive results of the outcome measures at
the three assessment moments are shown in Table I.
Mauchlys test of sphericity indicated that the assumption of sphericity was not violated for these data
(P>0.05). The repeated measures ANOVA revealed
a large significant effect of time on perception of
health status (F(2,26)=4.73, P=0.018, p=0.27) and on
depression scores (F(2,26)=4.90, P=0.016, p=0.27),
but not on body satisfaction (F(2,26)=1.04,P=0.368,
p=0.07) and satisfaction with life (F(2,26)=1.16,
P=0.331, p=0.08). Pairwise comparisons indicated
no significant differences between baseline and week
12s scores. Between week 13 and week 24, results
indicated significant improvements in the perceived
health status (+15.13%, P=0.046) and reductions in
the depression scores (17.95%, P=0.041).
Discussion
The aim of the present study was to investigate the
effects of resistance training on selected psychological variables (perception of health status, body satisfaction, life satisfaction and depression) in elderly
60
women. The main findings of the present study were

that: i) 24 weeks of supervised resistance training promoted beneficial changes in health perception and depressive symptoms scores and ii) significant changes
in these outcome measures were only found in the
second phase (13-24th weeks) of the intervention.
Although accumulated research has demonstrated
a link between physical activity and diverse psychological benefits, available evidence on the specific
effects of nonaerobic modes of exercise, especially
among older people, is limited and has provided
mixed findings. While some meta-analytic findings
have supported the superiority of aerobic exercise,20
others have provided a larger effect size for anaerobic/resistance training 1 or similar positive effects.3,
21, 22 In addition, one other meta-analysis showed no
significant effect of resistance training on mood improvement.23 With respect to the present study, the
obtained results provide evidence to support the effectiveness of 24-weeks of supervised resistance
training on decreasing depressive symptoms and
promoting a better perceived health status in middleaged and older women, which is of great significance
given that, in past generations, it was not normative
for this population to participate in moderate to vigorous structured exercise.24, 25 These findings corroborate and extend previous studies that reported
favorable effects of this mode of exercise in reducing depressive symptoms in older adults with 26 or
without clinical disorders.1, 3, 21 Moreover, the results
of the present study also showed a simultaneous
significant improvement in the womens perceived
health status, which agrees with the fact that these
two constructs, depression and self-rated health, are
highly related.27
Previous research has suggested that positive
psychological responses to exercise might be mediated by changes in improved daily functioning
and related satisfaction with physical function.28, 29
This aspect is of particular relevance among the
June 2013
elderly since age-related loss of functional capacity, autonomy and independence are usually associated with a poorer mental health status.2, 11, 30
As a result, at least two factors may help explain
the observed beneficial effects of resistance training among this geriatric population. First, musclestrengthening activities might provide the necessary
stimulus to improve daily functioning 1, 6 and, consequently, promote an overall well-being improvement.3 Secondly, perceived improvements in the
functional capacity have been proven to provide a
mastery experience among this population, enhancing their physical self-efficacy, which in turn leads
to improved mood.3, 29, 31 This argument receives
additional support from the fact that significant improvements were only found in the second phase of
the intervention, which emphasized possible/typical daily living activities/tasks that are increasingly
more difficult to perform during the aging process. Furthermore, this evidence suggests the need
to include an informational component in similar
programs for middle-aged and older adults that provides detailed testing, comprehensible explanations
and feedback on physical function improvement.28
On the other hand, the absence of resistance training effects on body satisfaction and life satisfaction
scores may be explained by the relatively high values obtained at the baseline assessment, which may
have resulted in a ceiling effect and, therefore, reduced the sensitivity of these general, non-domain
specific, measures to identify significant changes
during the intervention.3
However, when interpreting the findings of the
current study, some limitations should be considered. Firstly, the reduced size of the sample obtained may have lead to an underestimation of the
intervention effects. Secondly, the sequence of the
intervention phases may have affected the changes
in the outcome measures. Therefore, future research
should investigate if an exercise order/intervention
phase effect mediates the psychological responses
to resistance training among middle-aged and older
women. Thirdly, in order to overcome the absence
of an adequate control group and the quasi-experimental design of the present study, future research is
needed to evaluate the effectiveness of this exercise
mode in older adults using randomized controlled
trial designs and controlling for other possible influential factors (e.g., living alone).
FERNANDES
Conclusions
In summary, our results indicate that 24 weeks of
resistance training promotes significant improvements in the perceived health status and reductions
in depressive symptoms in middle-aged and older
women. Moreover, the findings of the present study
suggest that resistance exercises based upon this populations daily living tasks/demands and needs may
be a more efficacious and beneficial type of exercise
for their well-being. Therefore, it is recommended
that future research and intervention efforts should
give emphasis to the weight training based on daily
motor tasks and needs, which has demonstrated to
improve mental health and appears to be (more) appreciated by middle-aged and elderly women. Based
on the evidence of the present study, one also suggests that this means of resistance exercise may contribute to a more practical dissemination and acceptability of this training modality among the female
geriatric population.
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2. Singh MA. Exercise comes of age: rationale and recommendations
for a geriatric exercise prescription. J Gerontol A Biol Sci Med Sci
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3. Netz Y, Wu MJ, Becker BJ, Tenenbaum G. Physical activity and
psychological well-being in advanced age: a meta-analysis of intervention studies. Psychol Aging 2005;20:272-84.
4. Williams MA, Haskell WL, Ades PA, Amsterdam EA, Bittner V,
Franklin BA et al. Resistance
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Council on Nutrition, Physical Activity, and Metabolism. Circulation 2007;116:572-84.
5. Peterson MD, Rhea MR, Sen A, Gordon PM. Resistance exercise
for muscular strength in older adults: a meta-analysis. Ageing Res
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6. Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King
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Funding.None.
in the manuscript.
Acknowledgements.The authors would like to thank Esposende
2000, E.M., for the support and facilities that made this research possible.
June 2013
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VO L U M E 5 3 - S u p p l . 1 t o N o.

EDIZIONI MINERVA MEDICA

Effects of different isokinetic knee extension warm-up protocols on muscle performance

Biomechanical determinants of force production in front crawl swimming

Psychological responses to resistance training in middle-aged and older women

Vol. 53 - Suppl. 1 to No. 3

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

MODERN TRENDS IN STRENGTH AND CONDITIONING

Molecular and cellular basis

It is well known that mechanical load plays a pivotal role

hysical activity appears to play a pivotal role in

Vol. 53 - Suppl. 1 to No. 3

Unit, Department of Movement

tween skeletal muscle and bone tissue has changed

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Mechanical load on the musculoskeletal system

a role in bone formation (i.e., IGF-1, Osteonectin,

of IGF-1 signaling and selected integrins in the bone

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Mechanical load on the musculoskeletal system

such as receptor activator of nuclear factor kappa B

Vol. 53 - Suppl. 1 to No. 3

els have shown that myostatin-deficient mice have

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Mechanical load on the musculoskeletal system

servation suggests that skeletal muscle could be an

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Mechanical load on the musculoskeletal system

al. Myostatin (GDF-8) Deficiency Increases Fracture Callus Size,

Vol. 53 - Suppl. 1 to No. 3

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

J SPORTS MED PHYS FITNESS 2013;53(Suppl. 1 to No. 3):6-11

Effect of two different strength training volumes

Aim. The aim of this study was to compare the effects of 13

ne of the most harmful effects of aging is the

1Physical Education School

Along with this change in muscle mass, the aging

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Strength training volumes

elderly women who trained ten weeks using low- or

Vol. 53 - Suppl. 1 to No. 3

Table I.Physical characteristics (meanSD) before 13-week

BMI: body mass index (kg/m2); 1-RM: one-repetition maximum.

vascular, metabolic or musculoskeletal limitations

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Strength training volumes

Knee extensor MQ (KEMQ) was determined from

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Strength training volumes

Figure 3.Changes in elbow flexors muscle thickness after 13

Figure 4.Changes in echo intensity after 13 weeks of training.

There were no significant differences between

Vol. 53 - Suppl. 1 to No. 3

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Strength training volumes

ST is associated with the activation of satellite cells,

In summary, the results of the present study showed

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Strength training volumes

4. Visser M, Kritchevsky SB, Goodpaster BH, Newman AB, Nevitt

Vol. 53 - Suppl. 1 to No. 3

THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS

Influence of exercise order on blood pressure and heart

Effects of different isokinetic knee extension warm-up protocols on muscle performance

Biomechanical determinants of force production in front crawl swimming

Psychological responses to resistance training in middle-aged and older women