Circuit training

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Circuit training is a form of conditioning combining resistance training and high-intensity aerobics. It is designed to be easy to follow and target strength building as well as muscular endurance. An exercise "circuit" is one completion of all prescribed exercises in the program. When one circuit is complete, one begins the first exercise again for another circuit. Traditionally, the time between exercises in circuit training is short, often with rapid movement to the next exercise.
Contents
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1 Example 2 History of circuit training and fundamentals 2.1 Fundamentals 3 Advantages of circuit training 4 Disadvantages of circuit training 5 See also 6 References

[edit]Example
A good circuit training course works the different sections in the body individually. An example of a circuit may be[1]: Upper-body

Squat ups Bench dips Pull ups Medicine ball chest pass Bench lift Inclined press up

Core & trunk

Sit ups (lower abdominals) Stomach crunch (upper abdominals) Back extension chest raise

Lower-body

Squat jumps Compass jumps Astride jumps Step ups Shuttle runs Hopping shuttles Bench squat

Total-body

Burpees Treadmills Squat thrusts Skipping

[edit]History

of circuit training and fundamentals

Circuit training is an evolving training exercise program that was developed by R.E. Morgan and G.T. Anderson in 1953 at the University of Leeds in England.[2]

[edit]Fundamentals
Morgan and Andersons original circuit format included nine to 12 stations. Today, this number varies according to the design of the circuit. The program may be performed with exercise machines, hydraulic equipment, hand-held weights, elastic resistance,calisthenics or any combination. Themed circuits are possible, for example with boxing exercises (boxercise). A 15-second to three-minute aerobics station is placed between each station, allowing this method to improve cardio-respiratory and muscle endurance during the workout. A simpler form the exercise consists of a group running round a gym with a trainer simply calling, for example, "ten push-ups", "ten sit-ups" at intervals.

Studies at Baylor University and The Cooper Institute show that circuit training is the most time efficient way to enhance cardiovascular fitness and muscle endurance. Studies show that circuit training helps women to achieve their goals and maintain them longer than other forms of exercise or diet.[3] And research from Morgan and Anderson showed:

Perhaps a most profound finding of this study, from a health perspective, is that this investigation clearly shows that performance of this circuit of exercises, at this level of intensity elicited oxygen consumption values (39% to 51.5% of VO2max) that meet established guidelines of the American College of Sports Medicine (ACSM) for the recommended intensity (40% to 85% of VO2maxR) of exercise for developing and maintaining cardio-respiratory fitness (Pollock et al., 1998). Thus, this circuit not only provides a suitable muscular fitness stimulus but also helps to meet ACSM cardiovascular guidelines and the newly published Dietary Guidelines for Americans 2005 for physical activity.[2]

[edit]Advantages

of circuit training

An effective means of improving strength endurance (or muscular endurance). May be easily structured to provide a whole body workout. May not require expensive gym equipment. Participants normally work in small groups, allowing beginners to be guided by more

experienced individuals, as well as benefiting from the supervision of the instructor.

Can be adapted for any size workout area. Can be customized for specificity; easy to adapt to your sport. Has the potential to burn more calories than conventional aerobic exercise or strength

training, both during and post-workout (increase in post workout metabolism), thus beneficial for those attempting to lose body fat.

It's the most scientifically proven exercise system. It's time efficient and incorporates strength, flexibility and cardio in the same workout. (The Cooper Institute, Dallas, TX)

[edit]Disadvantages

of circuit training

Whilst being well-suited for developing strength endurance or local muscular endurance, circuit training is less suitable for building muscle bulk and despite some potential strength gains, circuit training is going to provide less results in the way of maximal strength than outright weight training. The duration of some circuit training stations can be in the region of 45 to 60 seconds, and in some cases as long as two minutes. These circuits typically mean that the number of repetitions performed on each station is relatively high, putting each exercise further towards the endurance end of the intensity continuum. Those wishing to optimize increases in strength or muscle bulk (hypertrophy) can reduce the number of repetitions performed and increase the weight to be lifted or increase the intensity, when hydraulics or elastics are used. On the other hand, longer station length is quite appropriate for any cardiovascular (aerobic) stations included in the circuit. Station times can be reduced to 75 or 100 seconds when all of the participants have an adequate level of experience. Reduced station times will encourage the participants to lift heavier weights, which means they can achieve overload with a smaller number of repetitions: typically in the range of 25 to 50 depending on their training goals.[4] However, this provides little time for an instructor to ensure that the activity remains safe and effective by observing technique, posture, and form.

[edit]See

also

An introduction to circuit training

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Circuit training is an effective and quick way to fit your workout into your busy day. Circuit training provides a high intensity cardio workout, along with resistance training. This is designed to target fat loss and lean muscle building. A Circuit is designed with a series of exercises performed in succession of each other. When one Circuit is complete you start the sequence over again with little to no break. To start you want to perform each exercise for 10 reps and 3 times through each Circuit. Remember to perform reps quickly and keep breaks as short as possible. The purpose of Circuit training is to keep moving, which pushes your body aerobically, while still challenging your strength. Circuit training can be an easy way to get a quick, total body workout. Circuits can be performed with little to no gym equipment, or at home. It is also an easy way to train with groups of people. Try this beginner Circuit workout I use for my clients: 1. Push-ups 2. Squats 3. Pull-ups 4. Lunges 5. Dips These are some basic body weight exercises easy for the beginner to perform. Push-up, pull-ups, and dips, can be modified if you can not perform the traditional variation. To modify pull-ups and push-ups, use a smith machine or squat rack with a barbell. A higher bar level will make the exercise easier to perform. Lower the ball as you get stronger. Use the edge of a bench for dips, with your knees bent. Straighten your legs as become stronger.

The Effects of Resistance Exercise on Skeletal Muscle Abnormalities: Comparison of Resistance and Aerobic Exercise
Authors and Disclosures

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Abstract and Introduction Comparison of Resistance and Aerobic Exercise Skeletal Muscle Pathology and HF Physiologic Changes in Muscle Fibers Associated With Physical Inactivity in HF Rationale For Resistance Training in Patients With HF Weight Lifting Exercise Prescription For Patients With HF Recommendation For Future Research Summary
References

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Learn More Comparison of Resistance and Aerobic Exercise

Resistance training, or weight lifting, is classified as an anaerobic activity because it is performed at maximal intensity for short periods (less than 10 seconds) and depends on the availability of muscle-immediate energy sources from adenosine triphosphate (ATP) and creatine phosphate. [11] These activities include weight lifting, circuit weight training, and body building. This kind of exercise is used to build muscle mass and strength and is a common practice among professional athletes. However, most activities of daily living involve lifting, pulling, and climbing motions, which require strength and endurance. Most elderly patients admitted to long-term care facilities, such as nursing homes, are not admitted because they are ill; they are admitted because they lack the strength to perform routine activities of daily living. Therefore, resistance training is an important part of a balanced fitness program. Muscular strength and endurance result from increasing the frequency, duration, and intensity of training. In exercise physiology, this is known as the overload principle. An exercise overload specific to the activity must be applied to enhance physiologic improvement and bring about a training effect. Desired training effects include increases in muscle strength, size, and endurance. [12] Muscle strength is defined as the ability to lift a given load; more precisely, it is the maximum force or tension generated by a muscle or group of muscles and is usually measured by the maximum load that can be lifted in one repetition (1-RM).[5,12] Lifting moderate to heavy weight develops muscle strength. Muscular endurance is the ability to do work over time and is best developed by using lighter weights with greater numbers of repetitions.[13]

In contrast, activities such as running, cycling, and swimming are termed aerobic because they involve the use of large muscles and depend on the body's ability to use oxidative energy systems. Bicycle ergometry and treadmill exercise are the usual aerobic activities prescribed for patients with HF. However, these activities do little to increase muscle strength and endurance. Muscle fiber type recruitment during exercise is another important distinction between the two kinds of exercises. Aerobic exercise recruits slow oxidative (type I) fibers, whereas resistance exercise recruits fast glycolytic (type II) fibers[14] (see the discussion below on muscle fiber types). Increases in strength and power require exercise of short duration and high intensity, such as weight lifting.[12,14] Aerobic training increases maximum oxygen uptake and improves muscle function in patients with HF.[15,16] However, aerobic training is associated with a decrease in muscle mass and thus with a decrease in strength in the untrained areas, such as the arms. [13] This suggests that adaptation is specific to the exercise stress imposed, i.e., specificity of training.[17] Therefore, RE may play an important role in reversing the altered skeletal metabolism seen in patients with HF.

Introduction
Weight training is a form of resistance training, which simply means any kind of exercise in which the Muscles exert force against resistance. Weight training uses weight machines and free weights to apply resistance. Resistance can also be applied with rubber tubes, another person or even water. One of the greatest advantages of weight training is that resistance can be applied in a measured, progressive fashion. After your strength increases enough to lift three blocks of weight, you add another block. The development of all round strength is best achieved via circuit training progressing through strength training. Weight training is the most widely used and popular method of increasing strength. Weight Training Definitions: The term weight training describes a type of exercise that requires the bodys musculature to move (or attempt to move) against an opposing force, usually presented by dome type of equipment. Reasons for Weight training: The main reason exercise scientists now recommend adding resistance training to your exercise program is that, for most of us, nothing in daily life provides adequate stimulation for building and maintaining muscle strength. The benefits of weight training read like an anti-aging potion. Here are some of the reasons you should be sure resistance training is part of your exercise program: 1. Weight training can help to prevent age-associated declines in muscle cell mass and strength Some of the decline in strength that occurs as we age is inevitable. Studies have shown that people lose about 30 percent of their muscle mass between the ages of 20 and 70. That>s the bad news. However, much of the loss of physical function that occurs is due to inactivity and a consequent decline in physical fitness, rather than aging itself. In <<sedentary> muscles, cells shrink and become weaker. The good news is that strength training enables us to maximize the size and strength of the muscle cells we have, no matter how old we are. Even men and women who begin strength training in their 80s and 90s experience significant strength gains, doubling and even tripling their strength after several months of training. 2. Weight training helps maintain the independence of older adults When muscle strength declines to a point where we can no longer take out the trash, carry groceries or take the laundry to the basement, we lose the ability to live independently and must increasingly rely on others for help. Weight training can make an important contribution to the quality of life for older men and women. 3. Weight training can prevent age-associated declines in metabolic rate A decline in muscle mass is one of the main reasons metabolic rate decreases as we age. Metabolic rate is partly a function of how much muscle tissue you have. That>s why bigger people need to eat more. Muscle tissue is metabolically active even when you are not exercising so, even at rest, the more muscle you have, the more calories you burn. Strength training can help slow the age associated decline in metabolic rate by preserving muscle mass.

4. Weight training helps to prevent orthopedic problems In our sedentary society, many orthopedic problems are the result of weakness and inflexibility, which are often shrugged off and attributed to the aging process. But many of these aches and pains are not something you have to live with. Neck, back, shoulder, knee and hip pain often respond to physical therapy treatment that includes strengthening and stretching the affected area. Why wait until you get injured to develop optimal strength and flexibility? 5. Weight training strengthens not only muscles Weight training strengthens not only muscles, but other structures as well. These include tendons (which attach muscle to bone), ligaments (which con nect bones at joint areas) and joint capsules. Stronger muscles and joints are less prone to injury. Weight training may also increase bone strength by helping maximize bone mineral deposition in young adults and minimize its loss later in life. 6. Weight training helps you look and feel better Weight training is the most efficient way to improve muscle definition. Many people who work out only two or three sessions per week will start to see improved muscle tone after only eight or 10 weeks Benefits of Strength Training:

Increased muscle fiber size Increased muscle contractile strength Increased bone strength Reduced risk for injury Improved ability to perform work or exercise Improved body composition Increased metabolic rate

. Safety note: People with health concerns or heart disease risk factors should check with their doctors before beginning a new exercise program. How to increase strength A muscle will only strengthen when forced to operate beyond its customary intensity (overload). Overload can be progressed by increasing the: -resistance e.g. adding lOkg to the barbell - Number of repetitions with a particular weight -Number of sets of the exercise - Intensity, i.e., decrease the amount of recovery time Weight Training Terminology:

REPETITION = one complete movement of an exercise. It normally consists of two phases: the concentric muscle action (lifting the resistance) and the eccentric muscle action (lowering of the resistance). SET = a group of repetitions performed continuously without stopping. Sets typically range from 1 to 15 repetitions. REPETITION MAXIMUM (RM) = the maximum number of repetitions per set that can be performed at a given resistance with proper lifting technique POWER = rate of performing work. Power during a repetition is defined as the weight lifted times the vertical distance the weight is lifted divided by the time to complete the repetition. You can increase power by decreasing the time to complete the repetition or by increasing the weight lifted. Breathing: o Exhale concentrically and inhale eccentrically o Breathe in during exertion and breathe out during lowering o Only about 1 or 2 sacs of breath holding STRENGTH = the maximal amount of force a muscle or muscle group can generate in a specified movement pattern at a specified velocity of movement.

Muscle Hypertrophy: Muscle Fiber Hypertrophy Resistance training will increase the muscle size (hypertrophy). Muscle growth depends on the muscle fiber type activated and the pattern of recruitment. Muscle growth is due to one or more of the following adaptations: - increased contractile proteins (actin & myosin)

- increased number of and size of myofibrils per muscle fiber - increased amounts of connective, tendinous & ligamentous tissues - increased enzymes and stored nutrients Muscle Fibers:

Slow-twitch fibers o Fatigue resistant o Dont contract as rapidly and forcefully as fast-twitch fibers o Rely primarily on oxidative energy system Fast-twitch fibers o Contract rapidly and forcefully o Fatigue more quickly than slow-twitch fibers o Rely more on nonoxidative energy system

Types of Strength Training:

Static (isometric) exercise = muscle contraction without a change in the length of the muscle Dynamic (isotonic) exercise = muscle contraction with a change in the length of the muscle o Concentric contraction = muscle applies force as it shortens o Eccentric contraction = muscle applies force as it lengthens

Factors That Affect Strength Training:

GENDER. Although male and female muscle tissue is essentially the same, men typically have more muscle than women because the presence of testosterone positively influences muscle size. AGE. The rate of strength gains appears to be greater during the years of normal growth and development, generally considered to be from ages 10 to 20 years. MUSCLE LENGTH. People with relatively long muscles have a greater potential for developing size and strength than people with relatively short muscles. MUSCLE FIBER TYPE. People with a prevalence of fast-twitch muscle fibers may obtain better results from their strength-training program.

Before and After Exercise: Before you start on your training programme its important to understand, the health and safety procedures involved in weight training. Therefore please take time to read through this section Carefully. That way you can avoid any unnecessary problems or injuries and get the most out of your programme, both in terms of performance and enjoyment. Warm Up: The aim of a warm up is to prepare the athlete both physically and mentally for exercise. When starting exercise, the body begins to release adrenalin, which increases the heart rate and causes dilation of the capillaries in the muscles.

o o o o o

Should gradually increase the heart rate, blood pressure, oxygen consumption, dilation of the blood vessels, elasticity of the active muscles, and the heat produced by the active muscle groups Should consist of graduated aerobic activity and flexibility exercises specific to the biomechanical nature of the primary conditioning activity The intensity of the warm-up should be well below that of the primary conditioning activity a necessity for maximizing safety during strength training workouts. Helps prepare the mind and body for the primary physical activity.

Cool Down: The cool down, like the warm up, is a very important part of each training session and competition. The purpose of the cool down is maintaining light, continuous exercise to allow your body to pump oxygen around the fatigued muscles.

o o o o o

Purpose is to slowly decrease the heart rate and overall metabolism Activity used for cool-down should be low-level aerobic exercise, similar to that of the conditioning exercise Helps prevent the sudden pooling of blood in the veins and ensures adequate circulation to the skeletal muscles, heart, and brain May aid in preventing delayed muscle soreness Reduces any tendency toward post-exercise fainting and dizziness.

Stretching: The stretching that you do in the warm up and cool down has different purposes. In the warm up stretching allows a slight increase in flexibility that will result in improved performance and reduce the likelihood of injury. In the cool down stretching has the purpose of helping the body to remove some of the buildup of lactic acid in the muscles and to improve flexibility. For these reasons the stretching in the warm up and cool down are of different durations. Stretching Guidelines Regular stretching is important in improving flexibility. It takes time to make significant progress with stretching exercises. Start by selecting just a few simple exercises to begin stretching each muscle group. Stretching should be done slowly, with no jerking or bouncing movements never stretch to the point of pain. In the warm up, after reaching a good stretch position, hold it for eight to 15 seconds. In the cool down this can be increased to 45 to 60 seconds The muscle being stretched should be as relaxed as possible. Stretch both sides of the body equally. Stretching exercises are not meant to be competitive. Do not compare progress with others as overstretching can lead to injury. Stretching Exercises: Warm up/pre-exercise stretches should be held for eight to 15 seconds and should be done two to three times. Cool down/postexercise stretches should be held for 45 to 60 seconds and should be done two to three times. In a flexibility session each stretch should be held for 45 to 60 seconds and should be repeated three to five times at least. where stretches can be done on both sides of the body only one side is shown. ensure that you stretch both sides equally. Here are some examples:

Neck extensors - flex the chin to the chest. Scalenes - facing forwards, bring the ear towards Upper Trapezius - turn the head to look over the. the shoulder taking care not to lift the shoulder. Triceps - place your right hand behind your neck. Use shoulder, take care not to turn the body. the left hand to apply pressure to the elbow, drawing the elbow behind the head. Ensure shoulders are relaxed.

Deltoids -reach across the front of the body, using the other arm to draw the arm across. Ensure that the shoulders are kept low. Pectorals/Biceps - stretch both arms behind you, keeping the elbows straight and the thumbs pointing upwards. Ensure that you do not bend forwards.

Wrist flexors - with the elbow straight, use the left hand to apply the stretch by drawing the palm away from the floor, keeping the fingers straight.

Wrist extensors - with the elbow straight, use the left Trunk stretch - standing with feet shoulder width apart, stretch right arm up towards the ceiling and over hand to apply the stretch by bending the wrist, to the left, keeping the body in one plane. bringing the palm towards the floor, keeping the fingers straight.

Abductors - stand astride, with feet parallel, keep the Hip flexors Psoas/Quadriceps - stand astride; stretch forwards, dropping the left knee towards the left leg straight, bend the right knee and stretch until floor, allowing the heel to raise. Keep the body upright. the knee is over the right foot.

Choosing equipment: Weight machines versus free weights, resistance is provided by both types.

Exercise machines: Safer, convenient, and easy to use

Advantages = safe, less balance required, productivity in a short amount of time, less supervision required, and ideal for circuit training Disadvantages = lack of development of balance and coordination and constrained movement patterns.

Free weights: Require more care, balance, and coordination Strength transfers to daily activities

Advantages = balance required which results in better coordination and greater muscle utilization, greater variability, and exercises resemble real-life movements Disadvantages = requires strength to maintain balance and coordination, accidents are more likely to happen, spotters are required, complete workouts may take more time, and inability to train through the entire range of motion Applying the FITT Principle:

Frequency = days per week(American College of Sports Medicine recommends 2-3 days per week allow 1 full day of rest between workouts). Intensity = amount of resistance: Choose resistance based on your current fitness level and goals. To build strength o Lift heavy weights (80% of 1 RM) o Perform a low number of repetitions To build endurance o Lift lighter weights (40-60% of 1 RM) o Perform a high number of repetitions For a general fitness program o Lift moderate weights (70% of 1 RM) o Moderate number of repetitions Time = number of repetitions and sets To build strength and endurance, do enough repetitions to fatigue the muscles The heavier the weight, the fewer the repetitions (1-5) to fatigue = a program to build strength The lighter the weight, the higher the number of repetitions (15-20) to fatigue = a program to build endurance

To build both strength and endurance, try to do 8-12 repetitions of most exercises Type = strength training exercises for all major muscle groups To build strength and endurance, do enough repetitions to fatigue the muscles The heavier the weight, the fewer the repetitions (1-5) to fatigue = a program to build strength The lighter the weight, the higher the number of repetitions (15-20) to fatigue = a program to build endurance To build both strength and endurance, try to do 8-12 repetitions of most exercises

Weight Training Safety: Be Safe. Lifting weights can cause serious injury. You can lift weights more safely by following these basic guidelines. Find an Instructor. Find someone who can help you learn how to do the exercises correctly. Good technique is most important to avoid injury. Set Goals. With your instructor's help, decide on the goals of your weight-training program. These goals will depend on your age, your physical maturity, and the reason you are lifting weights. Wait until youre ready. Wait until your body has matured enough before you try the major lifts Warm Up and Cool Down. Warm up and cool down for each session. Warm up before the weight-lifting session with stretching exercises, DOs

DON'Ts

Do use spotters when you try the major lifts. A spotter is someone who can help you with the weight in case you cannot lift it. Do keep your back straight when lifting. Do use proper lifting technique when moving weights around the room. Do wear shoes with good traction. Do make sure the equipment you use is in good condition. Do follow all of your gym's safety rules.

Don't breathe in and out fast or hold your breath when you lift heavy weights. You may faint and lose control of the weights. Breathe out when you lift or press. Don't continue lifting if you feel pain. Stop the painful exercise for a few days or try it with less weight. Don't exercise any set of muscles more than three times a week. Don't "cheat" on your technique to lift heavy weights. Don't lift heavy weights without spotters. Don't lift more than you know you can lift safely.

Resistance Training: A Review of the Literature

Introduction Each competitive sport has its own unique physical requirements. The term "physical fitness" encompasses such parameters as aerobic power, speed, power, agility, strength, flexibility, anaerobic power, balance, and more. A sport like the marathon obviously requires high levels of aerobic power, but little in the way of power and speed, while an activity like the javelin demands high strength and power and little endurance. Athletes who play most team sports generally need to be prepared in all aspects of fitness--good endurance for the length of the game and possible overtime, but also good speed as games can be decided by sprints. Strength as a fitness factor can be viewed as one of the cornerstones of performance. Strength can be a training focus for performance enhancement or for injury prevention. Each sport will have some specific and unique demands on the various aspects of strength performance; the Olympic lifter performing a clean and jerk, the football lineman blocking, the pole vaulter extending off the pole and over the bar, the soccer

player tackling an opponent, etc. As such, each sport will have training programs designed to prepare specifically for that sport's inherent strength demands. When reviewing research to advise athletes on the "best" way to improve strength, one must first decide on the goals of the program; is the goal to improve strength, mass, or local muscle endurance or is injury prevention the primary reason for this type of training? The purpose of this article is to review the current literature on the various aspects of strength training so that athletes might be achieving the greatest benefits for their personal training goals.

Methods Adaptations to Resistance Training Local Muscle Endurance Hypertrophy Table 1 Table 2

Methods
Data Sources: Relevant studies were identified by OVID, Cumulative Index to Nursing and Allied Health Literature (CINAHL), National Library of Medicine, PubMed, MEDLINE, SPORTDiscus, Arizona Health Information Network (AZHIN), Cochrane Central Register of Controlled Trials Register, and hand searches of relevant conference proceedings. The search terms were muscle , strength , resistance training , weighttraining , circuit training , periodization , adaptation . Inclusion criteria : Randomized control trials were preferred and non-randomized cohort studies (of human subjects only) were included if published in a peer-reviewed journal. Study design included a method to measure changes in muscular strength (e.g., 1-Repetition Maximum, whole muscle cross sectional area, peak torque, maximum voluntary isometric contraction, muscle biopsy). Articles must have rated greater than (or equal to) a 4 on the PEDro rating scale (11 points possible). Twenty-one articles met the inclusion criteria and were used in this review. Appraisal of evidence . The body of evidence was evaluated according to recommendations from the Agency for Healthcare Research & Quality (REF) (U.S. Department of Health and Human Services). The evidence was thus appraised for its quality, quantity, and consistency. To determine quality of individual studies, the PEDro (Physiotherapy Evidence Database) rating scale was used. The PEDro scale is based on the Delphi list developed by Verhagen et al. Consensus of the two examiners arrived at the final evidence rating for each study according to the 11-point possible scale. Collectively this body of appraised evidence was used to summarize the original question and provide recommendations based on the widelyaccepted Strength of Recommendation Taxonomy (SORT) model described by Ebell et al (2004). Summary of evidence : The search criteria identified a total of 480 papers for review, of which 21 met the inclusion and exclusion criteria for this evidence-based review. The preponderance of the evidence supports the use of resistance training to enhance muscular strength in a variety of healthy populations with differing exercise-experience levels. Evaluating an Individual Article or Body of Evidence We used modified SORT criteria to rate each individual article as a level of evidence using the following criteria: Level 1

Level 2

Randomized control trial (PEDro #2) Groups must be similar at baseline (PEDro #4) Allocation of groups was concealed OR there was blinding of assessors who measured a key

outcome (PEDro #3 or #7) Between group statistical comparison must be performed (PEDro #10) Measures of point variability for one outcome (PEDro #11)

Randomized control trial (PEDro #2) Groups must be similar at baseline (PEDro #4) Between group statistical comparison must be performed (PEDro #10)


Level 3

Measures of point variability for one outcome (PEDro #11)

Case Studies, consensus guidelines, usual practice, opinion

As is the case in most exercise studies of this type, all the reviewed studies provide level 2 evidence. After reviewing each individual article, a grade was assigned to the body of evidence based on available articles. We assigned a grade of A (consistent and good-quality patient-oriented evidence), B (inconsistent or limited-quality patient-oriented evidence), or C (consensus, usual practice, disease-oriented evidence, case studies) to the following statement: stretching influences performance. All papers reviewed here were graded a "B". < TOP >

Adaptations to Resistance Training

Article selection purposely was rigorous in an attempt to minimize confounding factors that can be evident from less well-controlled studies. We found 21 papers that satisfied the severe restrictions of this review. The studies could be categorized according to responses to training for strength, hypertrophy, and local muscle endurance. Studies are presented chronologically within each section. Many of the studies presented data in graphic form meaning effect sizes could not be determined. Rhea (2004) has proposed modifications for interpreting effect sizes in strength training studies ( Table 1 ). When effect sizes are presented, refer to this table to help in interpreting the magnitude of the effect. Operational definitions of training protocols are presented in Table 2 . Methodology in resistance training studies manipulates a wide variety of training variables. Strength For many fitness professionals, potentially large markets are the middle aged and older adults wishing to lengthen their active years with systematic training. Hakkinen et al (2000) investigated the train-ability of older adults. While there is ample early data that shows older adults are responsive to training, the nature of the response to resistance training is an important concept when designing training programs and following the progress of people in training. This project recruited 42 men and women who were blocked according to age and gender. Thus, four groups were established: men with an average age of 42 (M40, n=10)), men with an average age of 71 (M70, n=11), women with an average age of 39 (W40, n=10), and women with an average age of 67 (W70, n=10). These subjects were considered healthy and active with no resistance training background. The training program was six months in length. Each subject was tested for isometric knee extension torque and 1-RM knee extension, each with EMG of the vastus medialis, lateralis, and biceps femoris. Testing was performed pre training and every two months of the study. Muscle biopsies of the vastus laterals were taken before and after training. The training program was a basic linear periodized program. For the first 2 months, the intensity progressed from 50-70% of 1RM. The intensity then progressed from 70-80% of 1RM over the next 2 months. The final two months were 3-6 repetitions of 70-80% of 1RM with 4-6 sets of 50-60% 1-RM. Training incorporated both heavy and explosive resistance training. All sessions were supervised. Body mass and composition was unchanged throughout the study. Isometric peak torque was, as expected, greatest for the younger subjects. Each group improved torque output over the course of the study to similar degrees: M40=+28%, W40=+27%, M70=+27%, W70=+26%. Leg extension 1-RM also was improved: M40=+27%, W40=+35%, M70=+21%, W70=+31%. EMG assessment of (isometric and concentric ) extensor muscle activation was significantly greater for the vastus muscles for all age groups and unchanged in the biceps femoris for all 4 groups. Force-time curves (a statement on the rate of force production) again was increased in all four groups: M40=+21%, W40=+32%, M70=+21%, W70=+22%. Muscle fiber distribution was unchanged during the study. As expected, the males had larger mean fiber area of both major fiber types than women. Training, however, increased type I fiber area in the W70 group and type II overall, specifically the type IIb fibers, in both groups of women with no traininginduced changes in fiber area in the men. The best correlation with torque output was with the percentage of type II fibers. < TOP > These data demonstrate the impressive gains possible in novice, middle aged, and older lifters. Both isometric and dynamic force production as well as rate of force production. This combination of heavy resistance and explosive training was particularly effective at increasing the size of the type II fibers in women. If much of the age-associated decline in force production is related to a loss of muscle mass, a

training program like this demonstrates the body's ability to adapt by increasing type II fiber area (in women) and the ability of the nervous system to activate muscles (in all ages and genders). Thus, a 2 day per week training program consisting of heavy resistance and explosive lifting techniques is an effective prescription for maintaining muscle mass or increasing factors of muscle mass. These types of adaptations often are cited as reasons why trained older individuals have fewer falls and are more stable in various activities of daily living in their age group. Both the neural and muscle adaptations, especially in the type II fibers, are important contributors Kraemer and colleagues conducted a very practical application of strength training for sports performance (AJSM, 2000). While there are a number of projects conducted using athletes, one factor that does not get studied routinely is the effect of the training program on specific aspects of the performance of skill in that sport. In this project, 24 female collegiate tennis players were matched on ability and randomly assigned to a control group (n=8), a low volume (n=8), or a high volume (n=8) resistance training program. The control group followed their normal program of tennis training while the low volume group did one set of a circuit of resistance training machines, 8-10RM of each exercise. The high volume group followed a periodized program (4-6RM, 8-10RM, or 12-15RM depending on the training day). Resistance training was conducted 2-3 days per week for 9 months. Each subject was tested at 0, 4, 6, and 9 months of training. Body composition (skin-folds), anaerobic power output (counter movement jump, Wingate test), and 1RM for the machine leg press, free weight shoulder press, and bench press were all determined. The maximal serve velocity was also determined as a measure of tennis skill performance. As expected, there were no differences in overall body mass between the three groups nor was there any change in body mass over the course of the study within each group. The periodized group did, however, show significant increases in lean body mass and decreases in fat mass over the nine months while the other two groups showed no changes over time. Peak power on the Wingate test and vertical jump height continually increased in the periodized group over the course of the study. The other two groups showed no such improvements. Dynamic muscular strength also followed a similar pattern over the course of the study. All three tests of strength were increased in the periodized group throughout the nine months of the project. The low volume group showed increases in all three lifts from pre-training to the four-month test date and these results were maintained for the remainder of the study at a level below that of the periodized group. There were no changes over time in the control group. Finally, tennis serve velocity increased in the periodized group at four and nine months with no changes in serve velocity seen in the low volume or control groups. Unfortunately, the data were presented as bar graphs, so it was impossible to determine effect sizes for this study. There were two important findings from this study. First, strength training led to improvements in specific skill performance. This is important in that many think that supplemental strength training is for injury prevention and improvement in overall physical fitness, but probably would have little effect on actual skill performance. The data from this project clearly demonstrate that a periodized program could improve serve velocity, but that a lower volume training program had no effect on skill performance. This leads to the second important finding. There appears to be a threshold of training volume for resistance training to affect performance and continued development of strength. Simply performing resistance training is not enough to see any supplemental or skill-specific performance. To achieve the improvements in body composition, physical performance, and skill performance, the program needs to be of sufficient volume. While this project demonstrates this concept, the actual threshold remains elusive. For some, training is a solitary endeavor. A training program is considered and carried out alone. Maybe the athlete trains with friends, but the details and practice of training are unique to each participant. While safety issues suggest that resistance training, especially free weight training, be performed with a partner, the primary purpose of the partner is safety. The fitness industry has seen a rapid expansion of professionals with special interest and expertise in resistance training. When their responsibility is to ensure that each client realize their personal fitness goals, these professionals often will directly supervise each training session, offering guidance and support. Mazzetti et al (2000) explored the effect of direct supervision by randomly assigning moderately experienced male lifters to follow a prescribed resistance training program to either a group who was directly supervised (n=10) or a group who were unsupervised when training (n=8). All had 1-2 years of experience and were equally matched on demographics and prestudy performance, although the supervised group had greater bench press 1-RM upon entering the study. Strength performance was determined with 1-RM for the squat, bench press, jump squat power output, and endurance of the bench press (number of reps at 80% of 1-RM). Body mass and composition were also measured. Data was collected at outset and after 12 weeks of training. The subjects followed a periodized plan. The program began with a general preparatory phase (weeks 1-2, 3 sets, 12-RM, 3

days/week, 1-2min recovery between sets), a hypertrophy phase (weeks 3-6, 3 sets, 8-10 RM, 4 d/wk, 4590s recovery), a strength phase (weeks 7-10, 3-4 sets, 6-8 RM, 3 d/wk, 1-2 min recovery) and a peaking phase (weeks 11-12, 2-3 sets, 3-6 RM, 3 d/wk, 1-2.5 min recovery). Training logs were kept to determine training loads. The supervised group had a greater training load for the squat (beginning at the 7 th week) and for the bench (beginning with the 3 rd week). Both groups improved their squat and bench press performance. For the squat, the relative improvement was 33% and 25% for the supervised and unsupervised groups, respectively. For the bench press, the relative improvement was 22% and 15% for the supervised and unsupervised groups, respectively. Jump squat power output and bench press endurance both improved, but there were no group differences. The data were presented in bar graphs so an effect size could not be determined. Body mass and fat free mass increased in only the supervised group (fat free mass: supervised ES= 0.54, unsupervised ES= 0.16). The impact of a personal trainer is obvious. The subjects advanced their training load at a faster rate and subsequent performance benefited. As local endurance responds to duration of training vs. intensity, and both groups followed a similar program, the lack of a group difference is not surprising. While not directly studied, it appears that the presence of the personal trainer fostered competitiveness and enhanced motivation, especially after the opening weeks of familiarization to the program. The trainer appeared to be beneficial in advancing the program by encouraging the subjects to tolerate greater training loads and the subsequent improvement in strength performance. This project offers objective evidence that optimal strength performance adaptations to a periodized program will be best when the athlete received personal supervision in research or in practice. Many prescriptions for exercise stress the importance of resistance training to maintain muscle mass through the lifespan. While there are reports that show maintenance of muscle mass while aging, there is little data about the response of muscle in older individuals subjected to a high intensity training program. Izquierdo et al (2001) recruited middle age (average age=46y, n=11) and older (average 64y, n=11) men from a private recreational and physical fitness club to participate in a 16-week high intensity resistance training program. After passing a full medical clearance, the subjects underwent a series of strength, power, muscle mass, and hormonal assessments. A 1-RM was determined for a half squat and bench press. Testing at varying percentages of 1-RM for each lift produced a power-load curve. Muscle cross sectional area of the quadriceps was determined by ultrasonography; a reliable method with a low coefficient of variation. Cortisone, total and free testosterone were determined pre, mid and post study. The lifts used in training included leg extensions, arm extension and other multi-joint upper body, and core exercises all performed on machines. The training program was basically in 8-week segments. The first 8weeks of training were 50-70% of 1RM (10-15 repetitions per set) for 3-4 sets of each exercise. During the next 8 weeks, the loads were progressively increased every four weeks. The training was considered to be a combination of heavy-resistance and "explosive" training. Routine daily and recreational activities were continued throughout the study. Muscle cross sectional area, strength and power all improved in both groups. Quadriceps cross sectional area increased by a little over 10% in both groups (middle age: ES=0.8; older: ES=0.4). Overall mass and lean mass were unchanged, but there was a small decrease in body fat percentage (middle ES=2.0; older ES=0.4). There was a similar relative improvement in half squat 1-RM (middle age: 113 to 163kg, +45%, ES=1.9; older: 100 to 136kg, +41%, ES=1.5). Knee extension 1-RM also improved by similar percentages (middle age: 75 to 95kg, +29%, ES=2.0; older: 59 to 73kg, +25%, ES=1.3). The degree of improvement was greatest over the last 8 weeks of the study. Knee extension isometric force improvements were similar. Bench press 1-RM followed a similar pattern (middle age: 58 to 80kg, +36%, ES=1.4; older: 47 to 64kg, +36%, ES=1.7). The power-load curves for leg extension and bench press were all improved. The only blood parameter to change over the course of the study was a reduction in cortisol at week 16 in the older subjects. < TOP > Despite the small subject number and resultant questions about statistical power, the authors were confident in saying that middle aged and older men following this high resistance program, performed only twice per week, were able to demonstrate significant force and power improvements. While the relative improvements were similar for the two age groups, as expected, the absolute loads were greatest for the younger subjects. The greatest degree of improvement occurred in the second 8-week period, especially in the middle aged group, when the intensity of training was periodically increased. The older subjects failed to improve to the same degree when the loads were increased suggesting the program they were following might have been near their physiological limits. These improvements in strength performance of the legs

were associated with a significant improvement in quadriceps cross-sectional area. The subjects in this study all had serum values within the normal ranges. In past studies, subjects whose serum results improved were hypogonadal when they began training. Based on these results, a high intensity resistance program would allow men of this age to maintain their activities of daily living that require strength and power output instead of continuing to lose muscle mass and function. Clinicians have been applying exercise as a treatment mode in various disease states for symptomatic or clinical benefits. For example, fibromyalgia's symptoms predominantly are localized to soft tissue, particularly skeletal muscle. In some patients, muscular strength is hindered while in others, there is no effect on strength reported. Hakkinen et al (2002) conducted a training study on women with fibromyalgia to see if resistance training would be beneficial for this clinical population. They also looked at hormonal modulators of muscle mass and strength to look for potential interactions of training, hormones, and fibromyalgia. They randomized 21 pre-menopausal women with clinically diagnosed fibromyalgia into a training (n=11) or a control (n=10) group. Twelve healthy controls were also recruited. After a 4 week control period, 21 weeks of training followed. Strength was measured as the isometric force of the knee extensors and flexors. EMG was collected at the same time as the force measurements. Cross sectional area of the thigh muscles was obtained using MRI. The hormonal panel included testosterone, growth hormone, IGF-1, and DHEA sulfate. Patient reported muscle pain was obtained 1 week prior to each test period. The 2 day per week training program was directed at the thigh muscles, but other exercises for the trunk and upper extremity were performed. Intensity increased (and repetitions decreased) in 7 week blocks. Acute hormone responses to heavy labor were determined after a heavy session of 5 sets of 10RM. Maximum knee extension and flexion force increased 18% and 13% respectively in the patients in the training group and 22% and 26% in the control group. There were no changes in the untrained patient group. EMG showed increased neural activation in the training groups. Both training groups increased the cross sectional area of the quadriceps, 7% for the patient group and 9% for the controls. There were no changes in the hormonal panel at basal testing, but growth hormone did show a post exercise increase in the training groups. It was interesting that patients with a disease that affects skeletal muscle increased their thigh muscle strength, neural activation, and cross sectional area. Their responses to training were similar to age matched controls. The hormonal panel was consistent with controls. Thus, there appeared to be a value to using resistance training in women with fibromyalgia in helping them manage their disease. The dizzying array of training variables and potential interaction of these variables suggests that a person attempting to train without the guidance of a trained fitness professional may well design a program that will not be appropriate for their fitness goals. After decisions are made about sets, reps, and loads, the program needs to be planned according to progression, which means there must be considerations about the various ways to periodize the program. Throughout this review are papers that compare a periodized vs. some more traditional program with results favorable for a periodized program. But there are a number of types of periodization and few papers that directly compare these methods. Rhea et al (2002) compared a linear vs. a daily undulating program. The challenge of these types of comparative studies is how to control for other training variables. In this study, training volume and intensity were held constant. Traditional periodization varies volume and intensity during macro, meso, and micro cycles over numerous weeks. The undulating cycle varies these factors daily or weekly. This study was a head-to-head comparison of linear vs. daily undulating periodization cycles. Twenty college age males were recruited from weight training classes. Each had been in a strength training program for the prior two years following essentially a linear program. Body composition was determined using the Bod Pod. The program was 12 weeks in length and testing for 1-RM bench and leg press was conducted at 0, 6, and 12 weeks. The subjects were randomly assigned to a group with 10 men in each group. The program was 3 days per week and took about 40 minutes to complete. The program focused on the bench and leg presses, but also included crunches, biceps curls, and lat pull downs. No other strength training was permitted. The linear group did 3 sets of 8-RM for weeks 1-4, 3 sets of 6-RM for weeks 5-8, and 3 sets of 4-RM of each lift. The daily undulating group did 3 sets of 8-RM on Monday, 3 sets of 6-RM on Wednesday, and 3 sets of 4-RM on Friday. One week of active rest occurred between weeks 5 and 6. There were significant increases across time on absolute force output for the leg press for each group, but no changes in bench press performance. Relative increases were greatest for 0 to 6 weeks and from 0 to

12 weeks for both groups for each lift. Bench and leg press performance increased by 14% and 25% respectively for the linear group. Bench and leg press performance increased by 29% and 56% respectively for the undulating group. These increases for the undulating group were significantly greater than the increases for the linear group. There were no changes in body composition. The undulating program provided the necessary stress and variation to yield greater responses than did the linear program. The subjects in this study had resistance training experience and whether similar results would be seen with novice, elite, or elderly subjects would only be speculative. The small sample size and narrow subject selection of this study make generalizations difficult. Another concern is the potential for overreaching and overtraining. Some subjects in the undulating group complained of fatigue and muscle soreness late in the study suggesting that close monitoring of people training using this undulating method may be warranted. If the program is planned to achieve a peak performance at the end of this cycle, fatigue and soreness could well diminish power output and performance. However, these data support the use of an undulating periodized program over a traditional linear program to improve strength performance and avoid a plateau reported in long term use of linear programs. An added benefit to following this type of program is the increase in strength in the absence of changes in body mass that might be beneficial for athletes in weight restrictive sports like wrestling, boxing, competitive weight lifting, or the so-called aesthetic sports of gymnastics, diving, or dance. The authors cautioned against the uncontrolled use of an undulating program because of the risk of overtraining. So far, the optimal during of an undulating cycle has not been established so close monitoring is needed. With symptoms being reported late in a 12 week cycle, extending a cycle beyond this duration might not be advised. The debate surrounding one vs. multiple sets is based on conflicting work where some show that multiple sets are superior and others show that the gains from a single set are the same--meaning a program can be carried out in less time. In their review of the published literature, Rhea et al (2002) point out 3 specific limitations. First, in many cases, pretest measures were not conducted which limits the ability to discuss the relative improvements in performance. Second, the rest interval between sets was not controlled being unstated in some studies and up to 30 minutes in other studies. Finally, the training intensity was uncontrolled. With some many potential factors potentially offering alternative explanations about the results, a conclusion about single vs. multiple sets remains elusive. This project was a designed test: 1 vs. 3 set training over a 12 week program. Eighteen men from a college weight training class were recruited and randomly assigned to either 1 or 3 sets of training. All subjects had at least 2 years of recreational lifting experience; however, two subjects were taking creatine and were excluded. A 1-RM was determined for both the bench and leg press and body composition was determined using a Bod Pod. Testing was conducted pre training, at 6 and 12 weeks of training. Each group trained 3 days per week using a daily undulating cycle where the intensity was 8-10RM, 6-8RM, and 4-6RM for the first, second, and third training day of the week. One week of active rest was scheduled between weeks 5 and 6. The 3 set group was allowed 1-2 minutes rest between sets. The 1 set group also performed exercises unrelated to the bench and leg press to equate the total training time for the 2 groups. The overall increase in 1-RM for the leg press was 26% and 56% in the 1 and 3 set groups, respectively. For the bench press, the overall improvements were 20% and 33%, respectively. For the 1 set group, the bulk of the improvements occurred in the first 6 weeks. The effect sizes for the 3 set group (1 set group as the controls) were 2.3 for the bench press and 6.5 for the leg press. Such large effect sizes for the 3 set group confirm just how much better 3 sets are than 1 for improving bench and leg press strength. While 1 set is effective at improving strength, multiple sets caused even greater gains in strength. Selection of the number of sets needs to be considered based on the goals of the training program. The goals of some may not be for maximal strength gains and could use a single set program while those whose desire is maximal strength gains would be advised to use multiple sets. Circuit weight training is a time-efficient method that has become quite popular with people looking to vary their workout routine. One selling point is based on reports that circuit weight training also improves cardiovascular fitness. Because of this bonus, circuit weight training has become a staple of cardiac rehabilitation programs to improve strength, local muscle endurance, and whole body endurance in a time efficient setting. While there are numerous studies on the adaptations to more traditional resistance training regimens, Harbor and colleagues (2003) wanted to verify the nature of the training response to a circuit weight training program, a topic that had not been seriously pursued in the literature. This was a small study with of only 12 sedentary men performing circuit weight training for 10 weeks. Subjects were randomly assigned, according to a 2:1 procedure to either a training (n=8) or a control (n=4) group. Body composition (by underwater weighing), a series of 1-RM values for all 10 exercises used in

training, muscle biopsies, and hormonal values (lactate, testosterone, cortisol) were determined before and after the training program. The training program was periodized over the 3 days a week, 10-week program. The duration of each set was to be 20-30 seconds in length with a 10-30 second rest period between each set. All major muscle groups (no core or trunk stabilizers) were activated during the training program that was conducted on Nautilus and Hammer Strength devices. This program led to no statistical changes in body composition with the effect size of any changes being small according to the authors (0.22 to 0.38). Nine of the 10 exercises were significantly improved by circuit weight training with effect sizes ranging from 0.6 (chest press) to 2.24 (leg press). No significant improvement was seen for the leg curl exercise. While changes in fiber type percentages were not expected nor found, the cross sectional area of the type IIa fibers and the myosin heavy chain expression for IIa fibers both increased. Testosterone and cortisol were unchanged by this protocol. < TOP > This study did not have a group undergoing traditional resistance training so the results were compared with historical data in the literature. The improvement in strength, such as the 15% increase in leg press 1RM and 37% increase in the chest press were stated to be consistent with the literature. The authors felt that these increases in the absence of an increase in fat free mass (+3%, ES=0.22) support the role of neural factors in strength performance. The adaptations to the type IIa fibers, the more oxidative of the type II fibers, emphasizes that this protocol had an effect on the subset of fibers. Equipment issues prevented determination of VO2max, but (unpublished) treadmill time to exhaustion was unchanged by the training. This study had a number of limitations. For example, the small sample size reduces the statistical power of the project. While the absolute changes in body composition were consistent with significant changes in the literature, no body composition results achieved statistical significance in this project. The small numbers also impact effect sizes. Not doing a test of muscle endurance was probably an oversight. The study had no traditional training group forcing comparison with the literature. This study has generalizability issues. The subjects were sedentary with no training experience of any kind for at least 12 months prior to the project. While this group would be applicable for other sedentary groups, many studies use subjects with some measure of recent weight training experience. Thus, comparing the results to the literature requires finding other studies with sedentary subjects. Few studies in this review used purely sedentary subjects. Despite these limitations, circuit weight training was effective at improving muscle strength in untrained individuals. In a follow-up to their earlier training study on female tennis players, Kraemer and coworkers (2003) varied the training protocol. The earlier study (Kraemer, 2000) compared a single set training protocol with a linear periodized program. In this project, a non-periodized program (constant resistance and volume) was compared with a non-linear periodization program. A total of 30 female collegiate competitive tennis players were randomly assigned to one of three groups: control (n=8), periodized (n=9), and constant (n=10). As before, a wide range of performance measures were assessed at 4, 6, and 9 months of training: body composition; anaerobic power; aerobic capacity; sprint speed and agility; handgrip strength; 1-RM for the leg bench, and shoulder press; ball velocity for the serve, forehand, and backhand; and a panel of hormonal variables. All women in the resistance training groups trained 3 days per week. Those in the constant group performed 2 sets of all 11-12 exercises and 3 sets of 4-5 of the exercises (depending on the day), 8-10RM for the duration of the study. Those in the periodized group did the same except they performed 4-6 RM on Monday, 8-10 RM on Wednesday, and 12-15 RM on Friday. The control players performed routine tennis training. While there were no significant differences in body composition at any time point between the three groups, both resistance training groups increased fat free mass and reduced body fat percentage during the study. Anaerobic power (Wingate test) was best in the periodized group at 4 and 6 months, but by 9 months, the two training groups were similar. VO2max decreased over time in the training groups. Sprinting speed (10 and 20m) and agility were unchanged with time or between groups. Both groups improved their vertical jump performance, but by 9 months the periodized group showed a greater relative improvement in jump height over the constant group (50% vs. 37% respectively). Grip strength for both hands increased with training without any group effect. The 1-RM for the leg press increased more rapidly in the periodized group, but by 9 months both groups were similarly increased (19% vs 17% for the periodized and constant groups respectively). The same pattern was evident for the bench press, but the relative improvements favored the periodized group over the constant group (23% vs. 17%, respectively). There were nearly identical improvements in shoulder press 1-RM, again with the periodized group gaining

strength earlier in the program. Both groups improved ball velocities; however, the periodized group had greater relative increase in service (29% vs. 16%), forehand (22% vs 17%), and backhand (36% vs. 14%) ball velocities. This project showed that a daily, periodized resistance training program was superior to a constant training program. The improvement in the three measures of ball velocity seemed to be a result of improved strength. While both methods improved strength, the addition of training variation resulted in greater improvements. In the long run, the relative improvements were similar; the periodized program produced more rapid initial gains, a factor to be considered when designing supplemental strength training programs. Based on these results, this type of training program was not specific enough to impact speed and agility. Anaerobic power increased rapidly in the early portions of the program, but failed to continue to improve demonstrating the difficulty in continuing to improve anaerobic power over a long competitive season. Thus, a season of competitive tennis training probably should focus on maintaining, rather than improving, anaerobic power. The lack of significant responses of the hormonal panel indicates that tennis training is not sufficiently demanding to require adaptations. The definitive differences in training programs affect both the rate and magnitude of improvement in various performance measures. These differences are important when planning supplementary training programs for competitive sports. Another application of the linear vs. undulating periodized programs investigated whether similar results would be found for local muscle endurance. Another project by Rhea and colleagues (2003) compared linear and daily undulating programs while adding a third group that followed a reverse linear program where volume is gradually increased and intensity decreased over the course of the study. The purpose was to compare the effect of these three types of training programs on local muscle endurance. Many endurance runners are adding supplement resistance training to their training program for a number of reasons including improving local muscle endurance. Improving local muscle endurance increases running economy and endurance performance. This comparatively large project studied 60 men and women who were recruited from university weight training classes, all of whom had at least 12 months, but no more than 5 years, of weight training experience upon enrollment. Over the course of the 15-week training program, the subjects had to only do the prescribed exercises for their lower extremities. After random assignment to groups (10 men and 10 women to each group), local muscle endurance was assessed as the number of leg extension repetitions at 50% of their own body weight. Testing was done at the beginning, the 7 th and 15 th week of training. A 1RM for leg extension was also determined pre and post training. The training programs were equated for volume and intensity. The training program was held twice per week and focused on leg extension. The linear group (operationally defined as the control group) followed a periodized program where the performed 3 sets of 25 repetitions for weeks 1-5, 2 sets for 20 repetitions for weeks 6-10, and 3 sets of 15 RM for weeks 11-15. The reverse linear group did just the opposite. The undulating group followed the linear pattern over a 3-day cycle and repeated throughout. As planned, there was no difference in the total volume of work performed over the 15 weeks. Local muscular endurance increased in all groups by 56%, 73%, and 54% in the linear, reverse, and undulating groups, respectively. There were no between group differences despite the relatively large improvement by the reverse group. The effect size for endurance of the reserve group (compared to the linear group) was 0.27 and for the undulating group was -0.02 (statistically significant, although trivial effect sizes). Strength as 1-RM improved by 9% (from 79 to 85kg), 6% (73 to 77kg), and 10% (74 to 81kg) for the linear, reverse, and undulating groups, respectively. Again, there were no between group differences, born out by the trivial effect sizes (ES reverse training=-0.31; undulating training=0.04; again statistically significant). Leg circumference was reduced by 1-1.5%. All three programs were effective at improving local muscle endurance. The magnitude of the effect size for the reverse program, while significantly better than the undulating effect size, should still be considered trivial. When comparing results between the linear vs. the reverse training programs, the gradual increases in repetitions in the reverse program was more effective at improving endurance. Some might question the use of body mass for determining endurance resistance, placing larger subjects at a disadvantage. Results for men and women were pooled leading to rather large variances. Also, the wide range (1-5yrs) of prior lifting experience could also have contributed to the wide variations. The authors did not measure muscle or fiber area and could only speculate about why there was a small reduction in leg circumference. Because both the linear and undulating groups improved strength and the reverse had the greatest effect on endurance, recommendations on the type of program should be based on the goals of the training program. Based on these results, when endurance athletes are attempting to improve local muscle

endurance to achieve the expected improvements in running economy and performance, a reverse protocol is probably the best option. < TOP >

Local Muscle Endurance

Local muscle endurance is generally assessed according to the number of lifts successfully performed at some submaximal resistance--typically a multi-joint lift (e.g., squat, bench press, leg press) against a resistance ranging from 60-80% of 1RM. Most studies focus on a variety of aspects of resistance training with local muscle endurance as one aspect of many. As frequently noted, the number of training variables for resistance training (e.g., sets, reps, intensity, rest period, types of lifts, progression, experience of the subjects) means that studies can be quite different while still addressing the same topic. A large number of studies were reviewed, but only a few met all the inclusion criteria of this review. Hass (2000) concentrated on the effect of training volume on strength, endurance, and body composition in recreational lifters. With most studies showing the importance of intensity on lifting performance, the authors felt that while both groups would improve on the various performance factors, increasing the number of sets would not lead to even more improvements. This study selected subjects from a commercial fitness center ranging in age from 20 to 50 years of age. All the subjects had a lifting history (6 years) typically training three days per week. A total of 42 subjects were randomized to either 1 or 3 sets for each exercise of a nine machine circuit. Each set was 8-12 repetitions, each lift was a 2 second concentric and a 4 second eccentric phase. The load was increased 5-10% once 12 repetitions were performed for any lift. The subjects in the 3 set group were allowed 3-5 minutes between circuits. The full training program was 13 weeks in length. The training program used the MedX system (MedX Corp., Ocala, FL) Muscle strength was determined with a 1-RM for leg extension, leg curl, chest press, overhead press, and biceps curl. Tests were conducted pre-training, mid-study, and post-training. After a warm-up, each subject loaded the machine to the prestudy training load. Resistance was progressively loaded until the 1-RM was achieved. Two sessions, separated by 48 hours, were required to determine 1-RM for all the maneuvers. Bilateral, isometric testing of knee flexion and extension at 6 different angles of knee flexion was also determined. Local endurance was determined for the chest press and leg extension. After a warm-up, the subjects performed the lift as many times as possible at 75% of their pre-training 1-RM. Anthropometrics (skinfolds, diameters, and circumferences) were used to determine body composition. A total of 49 initially enrolled, but 42 completed the study (30 females). Failure to adhere to the protocol or injury necessitated exclusion from the project. As expected, chest press and leg extension 1-RM increased significantly (results were reported in bar graphs, thus effect sizes could not be determined) for both groups. In most cases, the increase in strength was between 5 and 10% from pre-training to mid-study to the post training tests. There were no differences in between groups on any of the lifts. Isometric strength improved, but not at every angle. Again, there were no group differences. Muscle endurance for both lifts increased for each lift. For the one-set group, endurance for the chest press and leg extension increased by 48% and 49%. For the three-set group, endurance increased by 58% and 67%, respectively. While both groups improved their local muscle endurance, there were no differences between groups for either lift. Both groups increased their lean body mass, but again, there were not differences between the training groups. Of all the data collected and the various ways to represent the results, the only variable where the three-set group was significantly better than the one-set group was for leg curl strength as kg/kg lean mass (effect size = 1.0). Kraemer conducted another multi-center trial; this time adding a military site (Kraemer, 2001). This broad study looked at performance responses to a wide variety of training protocols, some of which were not resistance based programs. They applied different periodized programs to a sample of military women for six months to see just how strength, power, endurance, and military occupational tasks were affected. In addition, the results were compared with active, but not resistance trained men to learn more about gender differences.

The women were assigned to one of six training protocols: total strength/power, total strength/hypertrophy, upper body strength/power, upper body strength/hypertrophy, field exercises, or aerobic training. The resistance programs were periodized as a 24-week macrocyle and two 12-week mesocycles separated with a 3-week period of active rest. The aerobic group training was also periodized on a similar schedule. Field training included plyometrics, calisthenics, and partner-resisted activities. As before, subjects were tested pre training, mid study (3 months) and post training (6 months). Tests included anthropometrics, 1-RM for squat, bench press, high pull and box lift, power tests (squat jump, bench press throw), squat endurance, repetitive box lift, 2-mile loaded run, and the US Army physical fitness tests. All resistance data was collected using the Plyometric Power System. Eleven to 18 women were assigned to the training groups. A total of 100 men were tested for gender comparisons. When viewing the pre- vs. post-training results, lean mass increased in only the total strength/power (ES=.42) and field training groups (ES=.27). This study had numerous outcomes, but for the purposes of this section, only the local muscle endurance results will be reported. These include the squat endurance and repetitive box lift, and the 2-mile loaded run. At the 6-month test period, the total strength/hypertrophy group outperformed the field and aerobic training groups on the squat endurance (number of proper repetitions of 45.4kg). After training, there were no differences between the total strength/power or the total strength/hypertrophy when compared with the men. For the repetitive box lifts (move as many 20.45kg boxes from the floor to a platform 1.32m from the floor), all resistance groups outperformed the field and aerobic groups. After training, there were no gender differences between the resistance trained women and the men. The field and aerobic trained women performed best on the 2-mile loaded run. Effect sizes were not reported. Data was reported in bar graphs, so an accurate effect size could not be determined. Overall, the 6-month resistance training programs were effective at improving local muscle endurance as well as reducing the differences between men and women, including performances on military tasks. The authors demonstrated the vital role of resistance training in enhancing physical performance. In a multi-center project from Colorado to Indiana to Pennsylvania to Finland, Kraemer's group compared low volume vs. high volume resistance training in women (Marx, 2001). While the design of previous paper (Haas, 2000) was simple: 1 set vs. 3 sets, this paper added a periodization schedule to the high volume group. < TOP > A total of 34 active, untrained women met the inclusion criteria and were randomly assigned to a single set circuit group, a high volume periodized group or a control group. The randomization procedure equated the subjects on age, height, mass, and body composition. Muscle strength for the bench and leg press was assessed as 1-RM on a Universal TM weight machines. Endurance of the same lifts was determined as the number of successful repetitions at 80% of their 1-RM. A one-minute sit-up test was also conducted. Other tests included the Wingate anaerobic power test, a standing vertical jump, and a 40-yard dash. Tests were conducted pre training, then after 3 and 6 months of training. The single set training program subjects trained on 3 non-consecutive days, 8-12 repetitions (to momentary failure). Resistance was increased once the subject could perform 12 repetitions without assistance. Two separate circuits were devised to relieve boredom and staleness. Both circuits used 10 different exercises for the arms, shoulders, trunk, thighs, and legs. The high volume group followed 2 circuits over their 4-day week. One circuit was performed on Monday and Thursday (7 exercises, 2-4 sets each) while the other was performed on Tuesday and Friday (12 exercises, 2-4 sets each). On Monday and Thursday, the intensity varied from high (3-5RM), moderate (810RM), or light (12-15RM). Resistance was moderate on Tuesday and Friday. Loads were increased once the subject could perform the desired number or repetitions without assistance. How much the loads were increased was not stated for either group. The control group did no resistance training. With makeup days allowed on weekends, all training subjects completed 100% of the training session for the full 24 weeks. Both groups maintained overall mass, but each lost fat with the low volume subjects decreasing from 15.5% to 23%, while the high volume subjects decreased from 16.5 to 19.8% (low volume ES=.69, high

volume ES=1.4). This means both groups gained muscle mass (low volume ES=.2, high volume ES=.62) by the end of the study. Strength, as 1-RM, increased for both lifts in both groups. Bench press 1-RM for the low volume subjects increased from 22.1kg to 24.8kg while the high volume group increased from 21.8kg to 32kg. Leg press strength increased from 95.6 kg to 106.3 kg and from 95.5kg to 126kg for the low and high volume groups, respectively. The effect size of the increase in bench and leg press strength was 1.7 and 1.4, respectively for the low volume group. Yet, the effect sizes for the bench and leg press in the high volume group was markedly larger as 6.4 and 4.7, respectively. The improvements in local muscle endurance followed a similar course; a good response in the low volume group, but a more substantial response in the high volume group. The effect size for bench press endurance in the low volume subjects was 1.25 (from 9.6 to 10.6 reps) and for the leg press the effect size was 1.6 (from 11.2 to 13.3 reps). Both results are excellent. But the high volume group showed some very impressive effect sizes. For the bench press, the effect size was 4.6 (from 9.5 to 11.8 reps) and for the leg press the effect size was 4.3 (from 11.3 to 18.6 reps), among the highest reported for resistance training studies. Similar relationships were seen for the Wingate peak power (low ES=.54, high ES=2.68), sit-ups (low ES=1.4, high ES=6.5), vertical jump (low ES=2.05, high ES=5.2), and 40-yard sprint (low ES=.16, high ES=2.1). The data was pretty conclusive that a high volume resistance training program led to greater responses in previously untrained women that is similar to results in men. While the volume was substantially greater in the high volume group, there was also an intensity factor with the periodized approach. The authors were firm in their conclusion that "the variation of volume and intensityis vital for improvement in muscular performance" While this section's emphasis is local muscle endurance, such a program had far reaching effects on a variety of high power output activities. Anyone with any experience with resistance training knows that different adaptations are possible depending on how the training variables are manipulated. Prior work has shown that the number of repetitions allowed by the level of resistance will dictate the nature of the adaptive response. Campos and colleagues (2002) compared low, intermediate, and high repetition resistance training to see where along this "repetition maximum continuum" specific adaptations occurred. The study included 32 young men who were randomly assigned to one of four groups for this 8-week training study. The low repetition training group (n=9) trained at 3-5RM with 3 minutes rest between sets, the intermediate training group (n=11) trained at 9-11RM with 2 minutes of rest, the high repetition training group (n=7) trained at 20-28 RM with 1 minute rest between sets, and a control group (n=5). The frequency of training was 2 days per week for the first 4 weeks and 3 days per week for the last 4 weeks. Total training volume was equal. The point of focus was the vastus lateralis muscle. Body composition was estimated by skinfolds. Aerobic capacity was determined on a cycle ergometer. Strength (1-RM) was measured for the leg press, squat, and leg extension) and endurance was determined as the number of repetitions at 60% RM. Muscle biopsies were taken to measure muscle fiber composition, cross sectional area, capillary density, and selected biochemical assays. These tests were performed before and after training. After training, only the high repetition group improved aerobic power output (watts) and time to exhaustion. There were no changes in whole body oxygen consumption. The total volume of work was similar between all three groups, as planned. All three groups improved their 1-RM measures. The low repetition group had the greatest gain in the leg press and squat exercises. Conversely, the high repetition group showed the greatest gain in local muscle endurance in all three exercises. The intermediate group also showed a significant increase, but not to the same magnitude as the high repetition group. Muscle fiber composition was unchanged throughout (although some trends were evident specific to the type of training performed), but the low repetition group showed significant increases in types I and IIb areas while the intermediate group increased all three major fiber populations. There were no significant changes in cross sectional area in any of the fiber types for the high repetition group. The capillary density for all three major fiber types increased in all 3 groups, but the only statistically significant increase was in the number of capillaries per type IIa fiber in the intermediate repetition group. While there were some trends toward fiber composition alterations, the more distinctive changes were specific to the training impulse; the high repetition group improved in local endurance while the low repetition improved their 1-RM. In the short term, low and intermediate repetition training induced somewhat similar responses. Adaptations were specific to the intensity and the number of repetitions.

Another variable in designing strength training programs is the rest interval between exercises and sets. In many programs, as the resistance increases, so does the rest interval to allow for recovery of short-term energy sources (ATP and phosphocreatine) and eliminate fatigue inducing waste products (e.g., hydrogen ions). An appropriately applied rest interval will then restore force production. While longer rest intervals may well reduce the total number of repetitions and impact the total training volume, applying the shortest rest that allows for rectifying energy and fatigue issues should allow the athlete to sustain repetitions and keep intensity high for best gains in strength. Willardson and Burkett (2006) studied three different rest intervals on multiple sets of either heavy or light bench press loads. This was not a training study. Sixteen recreationally trained lifters (mass=92kg, bench 1-RM=119.9kg) who practiced bodybuilding training volunteered to participate in the 4-week study. During week 1, a 1-RM for the bench press was determined. Over the next 3 weeks, each subject was tested twice per week (72hr between session). Tests on the first day used a load corresponding to 80% of 1-RM and the second day, the tests used a load of 50% of 1-RM. On each day, 5 sets were performed to voluntary exhaustion. A different rest interval (1, 2, or 3 minutes) was used each week (counterbalanced design). For the five sets at the 50% load, the average number of reps at 1, 2, and 3 minutes were 59, 75, and 88 respectively. For the five sets at the 80% load, the average number of reps was 18, 23, and 27. The differences between each recovery interval were significant for each load. Focusing on the individual sets showed that the greatest decline in reps occurred from the first to the third set, after which the number of reps performed plateaued (e.g., 2 min rest, 80% 1-RM reps per set = 9.1, 5.2, 3.4, 2.8, 2.6; 1 min rest, 50% 1-RM = 29.9, 10, 7.1, 6.1, 6.1). Regardless of the recovery time, the ability to perform the task was consistent in that there was a rapid decline in number of reps to failure over the first 3 sets before plateauing. When the rest interval increased, the level of the plateau also increased. The plateau began at about set 3, so for the 50% of 1-RM load, the number of reps to fatigue were 7.1, 11.2, and 14.1 for 1, 2, and 3 minutes of rest, respectively. This project might be considered as applicable to an undulating cycle of training, so that on a day when the goal is strength development, the rest interval should be 3 minutes to avoid the significant declines in repetitions. In addition, if the sets are restricted to a specified number and not done to failure, 1 or 2 minutes of rest should be realistic because of the reduced metabolic demand. If with 3 minutes of recovery, repetitions cannot be maintained, the authors suggested reducing the resistance. At the outset of a new program, the authors suggested a 3 minute recovery period that gradually is reduced to 1 minute as conditioning improves, based on the ability to sustain the number of repetitions with consecutive sets. < TOP >

Hypertrophy
For many, a desired outcome of resistance training is growth of muscle tissue. This hypertrophy and resulting strength enhancement accompanies long-term resistance training. Many realize that the initial rapid increase in strength when a novice begins a resistance training program is due in large part to neural adaptations increasing muscle fiber recruitment. Hypertrophy, according to genetic considerations, follows. The following papers, reported chronologically, met the inclusion criteria about the nature of the hypertrophic response to resistance training. One of the long-standing questions of the latter 10-20 years of the 20 th century surrounded the question of hypertrophy (increasing fiber size) or hyperplasia (increasing fiber number). Some early work in animals suggested a major role of hyperplasia leading to some investigations on humans using the muscle biopsy technique (for fiber area) and imaging (for muscle area). Dividing muscle area by fiber area was a gross method of estimating fiber number. McCall (1996) attempted to determine the interaction of hypertrophy and hyperplasia on recreationally trained male lifters. Fifteen of 28 applicants were selected, but only 12 completed the study. Training was conducted 3 days per week emphasizing all major muscle groups, but 4 exercises involved elbow flexion--the muscles of interest. The resistance was 10RM and once a subject could execute the lifts 10-12 times without assistance, 5% was added. Strength (as 1-RM) was determined every 3 weeks during the 12-week study. Diet was evaluated to ensure similar protein intake throughout the study (1.5g/kg mass). Areas of the arm were determined pre and post training using MRI while needle biopsies of the biceps were used for cellular dimensions. The 12-week program showed no changes in mass or sum of skinfold thicknesses. Protein intake remained constant at 15.5-17.5% of total calorie intake, with only one subject needing to increase protein calories. Forearm flexion strength was determined using a preacher curl exercise and 1-RM showed consistent increases every three weeks. Each test period was significantly greater than pre-training only.

The observed increases were not different from one session to the next. The data were presented in bar graphs so effect sizes could not be accurately determined. Overall arm cross sectional area was significantly increased by 14% (ES=.90). Individually, the biceps brachii increased by 12% (ES=.55), the brachialis by 7.5% (p=n.s., ES=.51), and the triceps by 25% (ES=.95). Both type I (+10%) and type II (+17%) fiber types significantly increased in area. A final result was capillary density. Capillaries per fiber increased for both type I fibers (+13%, ES=.98) and for type II fibers (22.6%, ES=1.51). The number of fibers counted per biopsy sample was small, around 120-130 fibers. Despite the small numbers in this study, there were some interesting findings. The observed change in muscle size was due mostly to hypertrophy. With both fiber types increasing in area, the greatest improvement was in the type II fibers. Overall, there was no evidence of hyperplasia, although there was the rare subject who did show some evidence of hyperplasia. One of the problems in hyperplasia studies in humans is the small number of fibers counted. Stable estimates of fiber number require many more cells. Also of interest was the increase in capillaries per fiber in rough proportion to fiber area. There is some agreement that adaptations to resistance training programs can be influenced by the experience of the subjects. The prior study was conducted on college age males with recreational lifting experience. Chilibeck (1998) studied 29 young women with "minimal strength training experience." Their goal was to determine how much hypertrophy contributes to the increase in strength. Their project was unique in that it compared simple (one joint) vs. complex (multi-joint) movements. The training program was twice a week for 20 weeks. The simple exercise was the forearm curl while the complex lifts were the bench and leg presses. Other upper and lower extremity exercises were included. The intensity of the upper body exercises was 6-10RM and 10-12RM for the lower body exercises. An additional factor in the project was a "whole" (all exercises performed on two days per week) or a "split" (half on MondayWednesday and other half on Tuesday-Thursday) routine. A 1-RM for the bench press, leg press, and the forearm curl was used to verify change in strength. Muscle mass was imaged using DEXA. Data was collected pre training, mid (10 weeks), and post training (20 weeks). The training group consisted of 19 women with the remaining 10 serving as controls. The training group was further divided for comparison of whole vs. split training routines that was reported in another outlet (Calder, 1994). All assignments were random. Forearm curl, bench, and leg press strength were significantly increased at each testing period. For example, curl strength increased by 50% from pre to mid training and 15% from mid to post training. Bench press strength increased by 22% and 8%, respectively. Leg press strength increased by 13% and 7.5%, respectively. The improvement in muscle mass of the arms were significant only from pre to mid training (7.5%) while increases on trunk (2.7%) and leg mass (2%) occurred only from mid to post training. The data were presented as bar graphs so effect sizes could not be determined. The increase in muscle mass "correlated poorly" with the change in strength. The project has limited generalizability as the subject sample was female with limited resistance training experience and the results might have differed in male subjects, for subjects with more extensive resistance training experience, or a different training prescription. Regardless, the rapid hypertrophy of the more simple exercises vs. the later hypertrophy of the more complex exercises suggests there was some prolonged neural adaptation for the complex exercises. The simpler, single joint exercise showed the more rapid adaptation while the greatest adaptation in the complex exercises happened later. With his prior study showing the role of hypertrophy in the adaptive response, the next paper from McCall and colleagues (1999) analyzed blood drawn from the subjects in their 1996 study to learn more about the role of anabolic hormones in the hypertrophic response to a resistance training program specifically designed to induce hypertrophy. This small study of recreational resistance trained college men followed the same protocol of their 1996 project outlined above, only in this project blood samples were drawn to analyze for growth hormone, insulin-like growth factor (IGF-1), testosterone, cortisol, and sex hormone binding globulin (SHBG). Resting values were determined pre and post training. Responses to exercise were obtained before, during, and after the 10 th and 20 th exercise session. The strength and cross sectional adaptations are discussed in the 1996 paper (above). In this paper, an untrained control group of eight was added. There were no changes, other than a decrease in cortisol, in resting hormone concentrations before or after training or between groups. Hormonal concentrations of IGF-1, testosterone, and SHBG (after correction for exercise-induced decreases in plasma volume), were unaffected by exercise while growth hormone was increased in response to exercise. Cortisol was elevated post exercise. There were no differences in the pattern of response between the 10 th and 20 th week.

There were few correlations between the panel of hormones and the resulting muscle and fiber hypertrophy reported in their 1996 paper. The only correlation was between exercise-induced growth hormone concentrations and increases in muscle fiber area. The authors postulated that the development of muscle hypertrophy from resistance training could be influenced by the repeated exercise-induced elevations of growth hormone. Most of the papers reported here are longer term studies. Blazevich and colleagues (2003) conducted a short-term project of only five weeks. They pointed out that most of the earlier work show improvements, but the length of the studies are such that even mid-study measurements would likely miss changes that might occur during a short term training period. A unique feature of this project was the attempt to determine muscle fascicle angle, a factor in force output. They started with 30 competitive athletes, but injuries forced seven to drop out leaving 23 (8 women) who completed the study. All subjects competed in team sports and had performed resistance training for at least 3 months prior to enrolling in the study. Before the project began, they trained in their sport twice per week, played one match per week, and did two resistance training sessions per week. During the study, they performed a 4-week "standardization" period of resistance (2d/wk) and sprint/jump training (2d/wk). After this phase, the subjects were randomly assigned to a squat, a hack squat or a sprint/jump training group where each performed exercises specific to their assignment. The subjects in the two resistance training groups trained twice a week with a heavy (3 sets, 6RM) and a light (squat jumps, isometric contractions at 30-50% max). The sprint/jump group trained with multiple 20m and 30m sprints along with one and two-legged counter movement jumps. Sprint speed (10m and 20m), one and two-legged counter movement jumps, 1-RM squat and hack squat, force during loaded (30% and 60% of isometric maximum) jump squats, and isokinetic knee extension were tested before and after the training period. Fascicle angle and length within the vastus lateralis and rectus femoris was determined by ultrasound. While there were significant increases in performance on selected variables (10m, 1 and 2 legged isometric hack squat, force during loaded jump squats), there were no group differences suggesting all groups responded to a similar magnitude. Isokinetic torque was unchanged with training. There was a reduction in fascicle angle in the distal vastus lateralis in the sprint/jump training group alone. Fascicle angle increased in the proximal vastus lateralis in the squat and hack squat group, but decreased in the sprint/jump group. Fascicle angle also increased in the distal rectus femoris group in only the hack squat training group. Increases in fascicle length were more commonly seen in response to sprint/jump training. Muscle thickness was increased with training, but there were no group differences. The authors felt it was significant that they found changes in muscle fascicle architecture in such a brief training study and that the changes were specific to the type of training. Sprint/jump training (i.e., high velocity training) led to decreases in fascicle angle and increases in fascicle length while resistance training increased the fascicle angle without changing fascicle length. By individual muscle, the monoarticular vastus lateralis displayed greater changes in architecture than the biarticular rectus femoris. Based on the fundamental differences in the training programs, it appeared that the force-velocity nature of the individual training exercises had a specific effect on muscle fascicle architecture. Despite the changes in architecture, there was little effect on performance between the groups. < TOP > In the early to middle 1980's came reports that concurrent strength and endurance training interfered with the adaptations of each other. Subsequent studies either confirmed or failed to find this same interference effect. With some sports and occupations requiring both strength and endurance, Hakkinen (2003) looked at combined strength and endurance training vs. strength training during a long term study. This is another paper with WJ Kraemer as an integral part of the research team. The study began with 32 healthy men from Finland (age=37.5y) enrolling, but five had to withdraw. A total of 16 men were in the strength training only group and 11 in the combined group. The study was 21 weeks long with testing, pre training, and then every 7 weeks. Strength was determined isometrically and concentrically for the hip, knee, and ankle extensors and knee flexors. A 1-RM was obtained for each movement. MRI was used to determine muscle cross sectional area of the right quadriceps. A cycle ergometer was used to measure aerobic power as well as aerobic and anaerobic thresholds. Numerous other mechanical measures were obtained (e.g., EMG, rate of force development, and more), but will not be reported here.

The strength aspect of the training focused on the quadriceps. Training was conducted twice a week. Additional upper body and trunk work was also performed. The training protocol was based in 7 week segments. During the first 7 weeks, the subjects performed 3-4 sets of 10-15 repetitions at 50-70% of 1RM of each exercise. The loads were increased by about 10% for the next 7 weeks with a slight reduction in the repetitions. For the final weeks, the loads were again increased with corresponding decreases on repetitions. A three-week taper began at week 18. Endurance training was also conducted twice a week. During the first 7 weeks, the subjects performed cycle ergometer exercise for 30 minutes just under their aerobic threshold intensity. During the next 7 weeks, on the first endurance day of the week, they cycled for 45 minutes at progressively increased intensities (15 minutes below aerobic threshold, 10 minutes between the aerobic and anaerobic thresholds, 5 minutes above the anaerobic threshold, 15 minutes below the aerobic threshold). The second endurance day they cycled for 60 minutes below the aerobic threshold. The goal of the final 7 weeks was to increase cycling speed through a series of high intensity intervals one day a week and to increase endurance with 60-90 minutes at the aerobic threshold on the other day. Bilateral, concentric leg extension1-RM increased in parallel in the two groups, each by 21-22%. Uni and bilateral isometric leg extension force showed similar increases. The increase in quadriceps cross sectional area averaged 6% and 9% in the strength and strength/endurance groups, respectively. At the fiber level, the cross sectional area of the type I, type IIa, and type IIb increased by 47%, 26%, and 37%, respectively for the strength trained group and by 13%, 23%, and 31%, respectively for the strength/endurance trained group. Of the mechanical data, only maximum rate of force development and corresponding EMG in the strength/endurance group were below that of the strength group and these could affect explosive strength. Endurance, as VO2max, increased by 18.5% in the strength/endurance group, maximal power output increased by 17% as well as the work loads for the aerobic (+16%) and the anaerobic (+14%) thresholds. The authors felt that their data did not support the concept that concurrent endurance training "interfered" with strength enhancement or hypertrophy. Both strength and endurance increased by nearly similar magnitudes. However, the authors point out that there may be a potential for interference should the intensity of training be greater than that used in this project. In this case, rapid strength gains might occur early in the training program, but then show only limited improvements later a program. They also questioned a potential for interference in explosive power output based on some of their neural activation data. One finding that did have very practical significance was that endurance could improve training only twice per week. Because of the numerous training variables in resistance training, it is difficult to design a single study that will allow direct comparison of all the possible variables; it would just be too big a training study. What Kraemer et al (2004) tried to do was compare a program focusing on hypertrophy vs. a program focusing on strength/power with a further factor of transfer (upper body only vs. whole body training). They chose to study previously untrained women for 6 months. Prior work on this population had shown training plateaus at around 12-15 weeks of training and the authors were curious if their periodized program might continue to stress the women sufficiently to continued improvements. A total of 85 women completed this 6-month training program. These untrained, but active college women, were randomly assigned to one of four groups or to a control group. One factor was training emphasis (power or hypertrophy) and the other was training location (upper body only, total body) giving four groups: total body power (TP, n=18), total body hypertrophy (TH, n=21), upper body power (UP, n=21), and upper body hypertrophy (UH, n=19). The control group had six subjects. Body composition was estimated using skinfolds; muscle and limb cross sectional areas (mid thigh, mid upper arm) was determined using MRI images. Squat and bench press 1-RM were determined. Power was measured with the jump squat and the ballistic bench press. The training programs were all linear periodized in design; the details and lifts used are beyond the scope of this paper. All tests were conducted pretraining, then after 12 and 24 weeks of training. All groups increased fat free mass, except the upper body power group, after 24 weeks of training. There were some group differences in percent body fat, but no significant changes over time within any group. Cross sectional areas of the arm increased in all groups (TP=6.6%, TH=15%, UP=11.7%, UH=13.4%). Overall, there was an 11% increase in area from pre to mid training and an increase of ~6% from mid training to post training. For the thigh, only the total body training groups increased their cross sectional area from pre to mid training (TP=4.8%, TH=2.7%) and from mid training to post training (TP=4.8%, TH=4.2%). The cross sectional area of all arm muscles for all training groups was increased over time. The

cross sectional area of each of the anterior thigh muscles was increased in the both total body training groups, but only the short head of the biceps femoris. Curiously, the vastus intermedius was increased in both upper body training groups. Squat 1-RM was increased in both total body groups at both test periods while all training groups increased 1-RM bench press performance at all test periods. Jump squat power output at 30% and 60% of 1-RM increased in the TP and TH. Power output during the ballistic bench press was increased significantly from pre to post training in all four training groups. The data for performance were presented in bar graphs making accurate effect size impossible to determine. This project adds further support for the specificity of training concept in that the upper body training groups had little transfer to the untrained lower body while the total body groups showed improvements for both the upper and lower body measurements. On the strength vs. power question, the authors showed that both were about equally effective at improving strength, power, and cross sectional areas of the muscle groups trained. Of particular interest was the continued improvement in performance by these women throughout the duration of the study demonstrating that women following a well-designed and executed program can continue to show improvements and not reach the early plateau of earlier research. < TOP >

References: Strength: (1) Hakkinen K, Pakarinen A, Hannonen P, et al. Effects of strength training on muscle strength, cross sectional area, maximal electromyographic activity, and serum hormones in premenopausal women with fobromyalgia. J Rheumatol 2002;29:1287-1295. (2) Harber MP, Fry AC, Rubin MR, et al. Skeletal muscle and hormonal adaptations to circuit weight training in untrained men. Scand J Med Sci Sports 2004;14:176-185. (3) Izquierdo M, Hakkinen K, Ibanez J, et al. Effects of strength training on muscle power and serum hormones in middle aged and older men. J Appl Physiol 2001;90:1497-1507. (4) Kraemer WJ, Hakkinen K, Triplett-McBride NT, et al. Physiological changes with periodized resistance training in women tennis players. Med Sci Sports Exerc 2003;35:157-168. (5) Kraemer WJ, Ratamess N, Fry AC, et al. Influence of resistance training volume and periodization on physiological and performance adaptations in collegiate women tennis players. Am J Sports Med2000;28:626-633. (6) Mazetti SA, Kraemer WJ, Volek SJ, et al. The influence of direct supervision of resistance training on strength performance. Med Sci Sport Exerc 2000;32:1175-1184. (7) Rhea MR, Alvar BA, Ball SC, Burkett LN. Three sets of weight training superior to 1 set with equal intensity for eliciting strength. J Stren Cond Res 2002;16:525-529. (8) Rhea MR, Ball SC, Phillips WT, Burkett LN. A comparison of linear and daily undulating periodized programs with equated volume and intensity for strength. J Stren Cond Res 2002;16:250-255. (9) Rhea MR, Phillips WT, Burkett LN, et al. A comparison of linear and daily undulating periodized programs with equated volume and intensity for local muscle endurance. J Stren Cond Res 2003;17:82-87. Endurance: (10) Campos ER, Luecke TJ, Wendeln HK, et al. Muscular adaptations in response to three different resistance training regimens: specificity of repetition maximum training zones. Europ J Appl Physiol2002;88:50-60. (11) Hass CJ, Garzarella L, De Hoyos D, Pollack ML. Single versus multiple sets in long-term recreational weightlifters. Med Sci Sports Exerc 2000;32:235-242. (12) Kraemer WJ, Mazzetti SA, Nindl BC, et al. Effect of resistance training on women's strength/power and occupational performances. Med Sci Sports Exerc 2001;33:1011-1025. (13) Marx JO, Ratamess NA, Nicdl BC, et al. Low volume circuit versus high volume periodized resistance training in women. Med Sci Sports Exerc 2001;33:635-643.

(14) Willardson JM, Burkett LN. The effect of rest interval length on bench press performance with heavy vs. light loads. J Stren Cond Res 2006;20:296-399. Hypertrophy: (15) Blazevich AJ, Gill ND, Bronks R, Newton RU. Training specific muscle architecture adaptation after 5weeks training in athletes. Med Sci Sports Exerc 2003;35:2013-2022. (16) Chilibeck PD, Calder AW, Sale DG, Webber CE. A comparison of strength and muscle mass increases during resistance training in young women. Europ J Appl Physiol 1998;77:170-175. (17) Hakkinen K, Alan M, Kraemer WJ, et al. Neuromuscular adaptations during concurrent strength and endurance training versus strength training. Europ J Appl Physiol 2003;89:42-52. (18) Kraemer WJ, Nindl BC, Ratamess NA, et al. Changes in muscle hypertrophy in women with periodized resistance training. Med Sci Sports Exerc 2004;36:697-708. (19) McCall GE, Byrnes WC, Dickinson A, et al. Muscle fiber hypertrophy, hyperplasia, and capillary density in college men after resistance training. J Appl Physiol 1996;81:2004-2012. (20) McCall GE, Byrnes WC, Fleck SJ, et al. Acute and chronic hormonal responses to resistance training designed to promote muscle hypertrophy. Can J Appl Physiol 1999;24:96-107. Recent reviews: (21) Bird SP, Tarpenning KM, Marino FE. Designing resistance training programmes to enhance muscular fitness: a review of acute programme variables. Sports Med 2005;35:841-851. (22) Cohen J. Statistical Power Analysis for the Behavioral Sciences (2 nd ed). Hillsdale, NJ: L. Erlbaum Associates, 1988. (23) Crewther B. Cronin J, Keogh J. Possible stimuli for strength and power adaptation: acute mechanical responses. Sports Med 2005;35:967-989. (24) Ebell MH, Siwek J, Weiss BD, et al. Strength of recommendation taxonomy (SORT): a patientcentered approach to grading evidence in the medical literature. Am Fam Physician Feb 2004 1;69(3):54856. (25) Fry AC. The role of resistance exercise intensity on muscle fibre adaptations. Sports Med 2004;34:663-679. (26) Kraemer WJ, Ratamess NA. Fundamentals of resistance training: progression and exercise prescription. Med Sci Sports Exerc 2004;36:674-688. (27) Peterson MD, Rhea MR, Alvar BA. Maximizing strength development in athletes: a meta-analysis to determine the does-response relationship. J Stren Cond Res 2004;18:388-382. (28) Rhea MR, Alvar BA, Burkett LN, Ball SD. A meta-analysis to determine the dose response for strength development. Med Sci Sports Exerc 2003;35:456-464. (29) Rhea MR. Determining the magnitude of treatment effects in strength training research through the use of the effect size. J Stren Cond Res 2004;18:918-920. < TOP > Table 1 - Revised 1 magnitude of effect size for strength training research 2
Magnitude Trivial <0.50 Small <0.40 Moderate 0.41-0.70 Large >0.70
1 2

Cohen

Untrained*

Recreationally trained* <0.35

Highly trained* <0.25

0.50 - 1.25

0.35 - 0.80

0.25 - 0.50

1.25 - 1.90

0.80 - 1.50

0.50 - 1.0

>2.0

>1.50

>1.0

This table is a revision of the original description of Cohen, 1988 Table modified from Rhea, 2004

*Untrained: no consistent training for 1 year; recreationally trained: consistent training for 1-5 years; highly trained: consistent training for >5 years Table 2 - Definitions of training protocols
Name Single set A single set of each exercise, usually performed until failure Multiple set Multiple sets of each exercise (usually 3+ sets), usually performed to failure Linear progression Typically, a constant number or sets and reps to failure. Once the maximum number of reps for all sets is achieved, the resistance is increased according to a predefined progression Linear periodization A traditional periodization program of progressive phases organized over weeks: e.g., preparation (3 sets, 12RM), hypertrophy (3 sets, 8-10RM), strength (3-4 sets, 6-8RM), peaking (2-3 sets, 3-6RM) Daily undulated periodization Method

The volume and intensity of training changes each training day of the week: e.g., Monday 3 sets 8RM, Wednesday 3 sets 6RM, Friday 3 sets 4RM

Circuit weight training Series of resistance training exercises performed according to a set duration (20-30s) and minimal rest (10-30s), at moderate intensity (4060% 1-RM) Strength/power training Lifting weights in a ballistic manner with a high velocity of movement, typical of power lifting protocols Strength/hypertrophy training

Lifting weights in a controlled manner at a slower velocity, typical of body building protocols

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