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Eur J Appl Physiol (2004) 92: 399406

DOI 10.1007/s00421-004-1072-y

O R I GI N A L A R T IC L E

Daniel R. Moore Kirsten A. Burgomaster


Lee M. Schoeld Martin J. Gibala Digby G. Sale
Stuart M. Phillips

Neuromuscular adaptations in human muscle following


low intensity resistance training with vascular occlusion

Accepted: 26 January 2004 / Published online: 17 June 2004


 Springer-Verlag 2004

Abstract Low-intensity (50% of a single repetition Keywords Twitch contraction Post-activation


maximum1 RM) resistance training combined with potentiation Motor unit activation
vascular occlusion results in increases in muscle strength
and cross-sectional area [Takarada et al. (2002) Eur J
Appl Physiol 86:308331]. The mechanisms responsible
for this hypertrophy and strength gain remain elusive Introduction
and no study has assessed the contribution of neuro-
muscular adaptations to these strength gains. We It is well established that muscle bres respond to
examined the eect of low-intensity training (8 weeks of overload stresses such as resistance training with both an
unilateral elbow exion at 50% 1 RM) both with (OCC) increase in the cross-sectional area (CSA) of bres
and without vascular occlusion (CON) on neuromus- (hypertrophy) and an increase in force generating
cular changes in the elbow exors of eight previously capacity. During resistance exercise, motor units (MU),
untrained men [19.5 (0.4) years]. Following training, and hence muscle bres, are recruited according to the
maximal voluntary dynamic strength increased size principle (Henneman et al. 1965). This principle
(P<0.05) in OCC (22%) and CON (23%); however, states that MU with smaller cell bodies, which are
isometric maximal voluntary contraction (MVC) associated with type I muscle bres, are activated rst
strength increased in OCC only (8.3%, P<0.05). Motor and at lower exercise intensities. At higher exercise
unit activation, assessed by interpolated twitch, was high intensities, larger MU and their associated type II
(98%) in OCC and CON both pre- and post-training. muscle bres are recruited. For hypertrophy to be
Evoked resting twitch torque decreased 21% in OCC maximized, it is important to activate type II muscle
(P<0.05) but was not altered in CON. Training resulted bres during training since these bres respond to a
in a reduction in the twitch:MVC ratio in OCC only resistive exercise stress with greater hypertrophy than
(29%, P<0.01). Post-activation potentiation (PAP) type I bres (MacDougall et al. 1980; McCall et al.
signicantly increased by 51% in OCC (P<0.05) and 1996). Since motor unit activation (MUA), and there-
was not changed in CON. We conclude that low-- fore bre recruitment, is linearly related to force pro-
intensity resistance training in combination with vas- duction (Sale 2003), many exercise programs aimed at
cular occlusion produces an adequate stimulus for increasing muscle size and strength perform repetitions
increasing muscle strength and causes changes in indices at a target intensity of at least 7095% of an individuals
of neuromuscular function, such as depressed resting one repetition maximum (1 RM).
twitch torque and enhanced PAP. Muscle fatigue also plays a modulatory role in MUA
and bre recruitment. Muscular activity that results in
the onset of muscular fatigue causes a decrease in muscle
force production, which can be compensated for by an
increase in MUA in an eort to maintain force output
D. R. Moore K. A. Burgomaster L. M. Schoeld
M. J. Gibala D. G. Sale S. M. Phillips (&) (Sale 1987). Hence, with fatigue there is an increased
Department of Kinesiology, MUA (Loscher et al. 1996; Suzuki et al. 2002) and,
Exercise and Metabolism Research Group, according to the size principle (Henneman et al. 1965),
McMaster University, 1280 Main St. W., Hamilton, enhanced activation of the higher threshold MUs that
Ontario, L8S 4K1, Canada
E-mail: phillis@mcmaster.ca innervate type II bres.
Tel.: +1-905-5259140 Muscular fatigue may be hastened during low inten-
Fax: +1-905-5234025 sity muscular contractions (i.e., less than 50% of 1 RM)
400

by occluding arterial blood ow (Moritani et al. 1992). from the subjects. The study conformed to all standards
Training with reduced muscle blood ow has been for the use of human subjects in research as outlined in
shown to result in an increase in the integrated electro- the Helsinki declaration and was approved by the local
myogram (EMG) of the active muscle, indicating that a Research Ethics Board of McMaster University and
greater number of what would normally be inactive Hamilton Health Sciences.
muscle bres are required to lift relatively light loads
(Moritani et al. 1992; Takarada et al. 2000). Low
intensity occluded resistance training (LIORT) has been General design
shown to be eective at increasing muscle strength and
inducing hypertrophy in trained (Takarada et al. 2002) Subjects trained the elbow exors of both arms three
and untrained (Shinohara et al. 1998; Takarada et al. times per week for a duration of 8 weeks at an intensity
2000) individuals, despite the utilization of relatively low of 50% of their previously determined 1 RM. One arm
(4050% 1 RM) exercise intensities. Enhanced muscle was randomly assigned to perform the training program
strength following LIORT is likely partially mediated by with reduced muscle blood ow (OCC), which was ob-
an increase in muscle CSA (Takarada et al. 2000, 2002). tained through the application of a blood pressure cu
Therefore, it seems that training with a large external around the upper arm, while the other was not occluded
load (i.e., 80% of 1 RM or greater), which can lead to and hence served as a trained, non-occluded control
joint and ligament damage, is not necessary in order to (CON). Isometric strength tests were performed both
obtain signicant muscle strength gains and/or hyper- pre- and post-training and the subjects voluntary dy-
trophy. namic 1 RM was measured bi-weekly to identify chan-
It has already been established that resistance train- ges in muscle strength and to increase the resistive
ing with vascular occlusion can lead to increases in stimulus, if necessary, to maintain 50% of 1 RM. Neu-
strength (Shinohara et al. 1998; Takarada et al. 2000, romuscular adaptations, including MUA and evoked
2002); furthermore, at least part of the increased twitch characteristics, were also assessed pre- and post-
strength can be attributed to muscle hypertrophy training. All subjects received a familiarization session at
(Takarada et al. 2000, 2002). However, increased least 1 week prior to pre-testing in order to become well
strength could also result from neural adaptations, such acquainted with the testing apparatus and protocol.
as increased agonist muscle activation (Sale 2003)
through increased motoneuron ring frequency and/or
motoneuron excitability (Aagaard et al. 2002). Muscular Testing apparatus
adaptations in addition to hypertrophy, such as altered
twitch contractile properties, might also occur. Post- Evoked twitch characteristics, maximal voluntary iso-
activation potentiation (PAP) refers to a phenomenon metric force production (MVC), MUA, and degree of
whereby a conditioning stimulus, such as a 10-s maximal PAP were measured while the subjects sat in an adjust-
voluntary contraction (MVC), increases the muscles able chair with their upper arm resting comfortably in
responsiveness to calcium, which results in a greater the horizontal plane on an aluminum plate of a custom-
twitch torque and shorter twitch duration. PAP has been made apparatus. The subjects forearm was strapped
shown to be greater in type II bres (Hamada et al. with their hand in the supinated position to a second
2000b), is enhanced in endurance athletes (Hamada et al. aluminum plate with Velcro straps. The apparatus
2000a) and unaltered after resistance training (Rice et al. maintained the elbow at an angle of 120, which was
1993). At present, no information exists on how LIORT seen to be the optimum angle for isometric torque gen-
aects neuromuscular adaptations; therefore, the pur- eration in untrained men (Tsunoda et al. 1993). Seat
pose of the present study was to examine the eect of height was adjusted to ensure that the upper arm was at
resistance training with vascular occlusion on neuro- a 90 angle to the chest and the elbow was at the pivot
muscular adaptations, including muscle activation and point of the apparatus. Shoulder movement was limited
twitch contractile properties, as well as post-activation by a second set of Velcro straps to ensure isolation of
potentiation (PAP). torque development by the elbow exors.

Methods Resting twitch

Subjects Resting twitch properties were assessed through percu-


taneous electrical stimulation by lead electrodes prior to
Eight healthy males [age, 19.5 (0.4) years; height, 180.0 strength measurements to ensure results were not con-
(1.0) cm; weight, 84.0 (4.5) kg; means (SE)] with no taminated by PAP. Two lead electrodes (14 cm,
previous weight training experience volunteered for the 24 cm), which were wrapped with gauze and moistened
study. All subjects were informed about the experimental with conducting gel, were placed over the motor point of
procedure to be used as well as the purpose of the study the biceps and on the ventral surface of the forearm just
and all potential risks. Written consent was obtained distal to the elbow, respectively. Stimuli were rectangular
401

voltage pulses of 100 ls duration, produced by a Grass the^interpolated twitch torque and PAP is the rst
S11 stimulator (Grass Instruments, Quincy, Mass., potentiated twitch torque after the MVC). PAP twitch
USA). Signals from the custom design OM2160 torque characteristics were analyzed according to the previously
transducer (Omega Engineering, Stamford, Conn., described technique and MVC values were manually
USA), which was mounted in the shaft of the apparatus analyzed using a cursor-based waveform scrolling tech-
described above, were amplied and ltered at 200 Hz nique.
with a lowpass 2nd order Butterworth lter before being
digitized by ACODAS hardware (Dataq Instruments,
Akron, Ohio, USA). Torque signals were sampled at EMG testing
2 kHz and were stored, analyzed, and digitized by a
Compaq 46 PC computer system and displayed on screen In order to examine the extent of MUA during a
in real time. Maximal twitch contractions were evoked in training session, EMG data were collected in the nal
the resting muscle by progressively increasing the stim- training session for sets 1 and 3 of the second training
ulation intensity until increases failed to increase twitch block (described below). Subjects skin overlying the
torque further. The stimulus intensity that elicited biceps and medial epicondyle was cleaned with dispos-
peak twitch torque was used throughout the duration of able alcohol wipes prior to the application of 1 cm
the tests. Automated twitch analysis was done with diameter disposable Kendall Meditrace 130 electrodes
custom designed software. Twitch properties examined (The Ludlow Company, Chicopee, Mass., USA). Two
were peak torque (PT), torque rise time (RT, time electrodes were placed approximately 1 cm apart over
from 10% to 90% PT), half-relaxation time (HRT), peak the belly of the biceps and one ground electrode was
rate of torque development (RTD), and peak rate of applied to the medial epicondyle of the arm. Raw EMG
torque relaxation (RTR). Peak rates of twitch torque was sampled at 3 kHz using a custom made bioamplier
development and torque relaxation were measured as the with a highpass lter with a cuto frequency of 7 Hz and
greatest change in torque over a 3-ms period on the a lowpass lter with a cuto frequency of 1,000 Hz.
rising and falling phases of the twitch contraction, Data were collected with acquisition software from
respectively. Dataq (Akron, Ohio), digitized, and stored on an IBM
compatible computer. All EMG signals were then full-
wave rectied and integrated over the interval of the
MVC, MUA, and PAP entire concentric contraction phase to determine mean
EMG. Absolute EMG output for the second repetition
MVC, MUA, and PAP were measured through a of set 1 was compared to the nal repetition to examine
modied interpolated twitch protocol. Since the sub- the rise in EMG, and therefore MUA, throughout the
jects resting twitch characteristics were assessed prior to set. The rise in EMG activity throughout set 1 was also
the interpolated twitch protocol, but after having been expressed as the percentage change from repetition 2.
strapped into the testing apparatus (see above), subjects The second and nal repetitions (i.e., concentric phase)
did not warm up the elbow exors before the MVC to were used since they were both preceded by an eccentric
ensure that the resting twitch was not contaminated by contraction and could therefore be easily compared. The
PAP and to maintain the placement of the stimulating rst repetition of both sets 1 and 3 were compared to
electrodes. The protocol began with an electrical stim- examine the level of EMG output required to lift the
ulation at a predetermined voltage (see above) to 50% 1 RM load, which could be used to infer the extent
establish a baseline twitch value. After 5 s, subjects, who of fatigue, and were also expressed as percentage change
performed the protocol on at least one other day to from set 1.
practice the task and become familiar with the testing
equipment, were instructed to perform a single 10-s
isometric MVC accompanied by verbal encouragement. Training protocol
The subjects MVC was dened as the maximal torque
produced at any point throughout the 10-s contraction. Each subject was required to complete an 8-week pro-
Halfway through the MVC, at the 5-s mark, a second gressive resistance training program at an intensity of
stimulus was administered to elicit an interpolated 50% of their previously, and repeatedly, determined
twitch (IT). Five seconds after the cessation of the 10-s 1 RM [described previously by (Burgomaster et al.
MVC, a resting twitch was again evoked to assess the 2003)]. Briey, single arm curls using a weighted cable
extent of PAP. To examine the time course of the PAP, pulley attached to a handle were used to train the elbow
twitches were evoked every 30 s for 3 min following the exors. Training positions were standardized using a
MVC. Thus, the 10-s MVC served a three-fold function. seated preacher bench. Subjects were instructed to
First, it measured the subjects maximal voluntary iso- remain in an upright seated position with their back
metric strength. Second, it acted as a conditioning straight and both feet at on the oor. The seat height
stimulus to elicit PAP. Finally, the 10-s MVC allowed was adjusted so that the upper arm was perpendicular to
determination of the extent of MUA, as dened by the the chest. The upper arm rested comfortably on the
equation: MUA=(1 IT/PAP)100%, (where IT is preacher bench pad and the shoulders remained square
402

to the cable pulley. Subjects contracted their elbow for dependent samples. For all analyses, when signicant
exors and moved the weight in the sagittal plane in an interactions were found, the Tukey post hoc test was
eort to maximally isolate the elbow exor muscle group used to test dierences among mean values. Signicance
and limit extraneous movements. The training weight of was accepted at P 0.05. All data are presented as
each arm was selected as 50% 1 RM, measured by a means (SE).
three-trial average on the same apparatus, and was ad-
justed according to bi-weekly maximal strength assess-
ments. Subjects served as their own controls as their Results
arms were randomly assigned to either the OCC or CON
condition. Blood ow occlusion was applied with a Training session
pneumatic blood pressure cu (width, 7 cm; length,
53 cm) that was placed on the upper arm just proximal During the rst training session, 10.0 (0), 5.8 (0.4), and
to the belly of the biceps. The cu was inated to 3.0 (0.6) repetitions were performed in sets 1, 2 and 3,
100 mmHg and was maintained at this pressure respectively. During the last training session, 10 (0), 7.5
throughout the duration of the training block, as dened (0.9), and 5.9 (1.6) repetitions in training block 1 and 9.4
by the training protocol (details given in Table 1). A cu (0.5), 5.5 (0.8), and 3.6 (1.0) repetitions in training block
pressure of 100 mmHg was selected for the occlusive 2 were performed in sets 1, 2, and 3, respectively.
stimulus as this pressure has been suggested to restrict
venous blood ow and cause pooling of blood in
capacitance vessels distal to the cu, ultimately Strength
restricting arterial blood ow (Takarada et al. 2000).
Each training block consisted of a dened number of The MVC was similar between conditions at baseline
sets separated by a 1-min rest period, and a 5-min rest [OCC, 61.6 (5.2) Nm; CON, 64.3 (4.5) Nm] and sig-
period was allowed between training blocks, in which nicantly increased by 10% in the OCC condition only
the cu was removed in OCC. The number of repetitions (interaction, P<0.05; Fig. 1). Maximal voluntary dy-
for the non-occluded arm was matched to that of the namic 1 RM was not dierent between limbs at baseline
occluded arm to ensure the same relative amount of [OCC, 42.4 (1.9) kg; CON, 43.2 (2.0) kg] and increased
work was performed by each arm. Each repetition by 22 and 23% for the OCC and CON conditions,
consisted of a concentric (muscle shortening) contrac- respectively (main eect for time, P<0.05), with no
tion (elbow joint angle that progressed from 180 to 45, dierences between conditions (Fig. 2).
where 180 is full extension) and an eccentric (muscle
lengthening) contraction (return to starting position).
Subjects were encouraged to maintain a repetition ca- Motor unit activation
dence of a 2-s concentric phase and a 2-s eccentric phase
according to a metronome. Verbal encouragement was MUA during the MVC was high in both arms pre-
provided to ensure maximum eort. training [OCC= 97.6 (1.0)%; CON= 98.0 (0.4)%] and
was not altered following training.

Statistics
Twitch characteristics
MVC, MUA and resting twitch data were analyzed with
a two (within) factor ANOVA (training condition, OCC Resting twitch PT was similar between arms at baseline
vs CON; time,pre- vs post-training). Post-MVC (PAP) and decreased 21% in the OCC arm only following
data were analyzed with a three (within) factor ANOVA
[training condition, time, and timing (time post-MVC)].
The absolute EMG data recorded during the nal
training session were analyzed with a two (within) factor
ANOVA (training condition, repetitions). Data for rel-
ative increase in EMG were analyzed with a paired t-test

Table 1 Training program. Training expressed as number of sets


target number of repetitions per set. F Set to failure

Week Block 1 Rest interval Block 2

1 210, 1F N/A N/A


2 210, 1F 5 min 110 Fig. 1 Maximal voluntary isometric torque (mvc) of the elbow
3 210, 1F 5 min 210 exors in the occluded (OCC) and non-occluded (CON) conditions,
48 210, 1F 5 min 210, 1F both pre- and post-training. Values are means (SE). *P<0.05,
dierent from pre-training and CON
403

Fig. 2 Percentage increase from pre-training in isotonic (1 RM)


strength for both OCC and CON. *P<0.05, dierent from pre-
training;  P<0.05, dierent from pre-training and week 2; 
P<0.05, dierent from pre-training and weeks 2 and 4. There was
no dierence between groups

training (interaction, P<0.05; Table 2; Fig. 3a).


Twitch:MVC ratio was similar between limbs at baseline
[OCC=0.17 (0.02); CON=0.16 (0.03)] and decreased
29% in the OCC condition only (interaction, P<0.01;
Fig. 4). Training did not signicantly (P>0.05) alter Fig. 3 A Peak resting (Rest) and post-activation potentiation
RT, HRT, RTD, or RTR in either the OCC or CON (PAP) absolute twitch torque in OCC and CON conditions, both
arms (Table 2). pre- and post-training. *P<0.05, dierent from pre-training and
CON. B Percentage change in twitch torque, versus baseline, of the
rst PAP twitch. *P<0.05, dierent from pre-training and CON
Post-activation potentiation
(P>0.05) dierences in absolute EMG activity between
When compared to the baseline twitch, the degree of the OCC and CON conditions (Table 4); however OCC
PAP evident in the twitch torque was similar at baseline experienced a signicantly (P<0.05) greater relative
between arms and was increased by 52% following increase from set 1 to set 3 in the EMG of the rst
training only in the OCC condition (interaction, repetition (Fig. 5).
P<0.05; Table 3; Fig. 3b), however, the absolute PAP
twitch torque was similar between the conditions both
pre- and post-training (Fig. 3a). Training did not sig- Discussion
nicantly (P>0.05) alter RT, HRT, RTD, or RTR in
the rst PAP twitch (Table 3) or in any of the later PAP The present study demonstrated that training at an
twitches (data not shown) in either the OCC or CON intensity of 50% 1 RM is eective at increasing volun-
conditions. tary dynamic elbow exor strength independent of the
application of a blood ow occlusion stimulus. Our
results are similar to that of Shinohara and colleagues
EMG activity (1998) who demonstrated that 4 weeks of isometric
training at 40% MVC with tourniquet ischemia signi-
In training block 2 of the nal training session, there was cantly improved isometric strength, while training at the
a main eect for time (P<0.05) but no signicant same intensity without occlusion yielded strength
increases that approached statistical signicance
(P=0.056). Movement pattern specicity (i.e., similarity
Table 2 Involuntary resting twitch characteristics in OCC and
CON conditions

Parametera OCC CON

Pre Post Pre Post

PT (Nm) 10.1 (2.1) 8.0 (1.3)* 9.8 (1.8) 9.8 (1.5)


RT (ms) 36.6 (2.4) 32.6 (6.9) 34.8 (5.7) 35.6 (6.4)
HRT (ms) 73.9 (8.9) 75.0 (23.2) 83.1 (19.8) 74.6 (24.0)
RTD (Nms1) 287.4 (16.6) 236.3 (17.8) 290.8 (17.6) 273.5 (9.6)
RTR (Nms1) 116.2 (19.6) 104.6 (17.3) 101.6 (8.3) 132.6 (21.5)

*Signicantly dierent from pre-training and CON (P<0.05)


a
OCC With vascular occlusion, CON without vascular occlusion, Fig. 4 Twitch:maximum voluntary contraction (MVC) ratio in
PT peak torque,RT rise time, HRT half-relaxation time, RTD peak OCC and CON conditions, both pre- and post-training. *P<0.05,
rate of torque development, RTR peak rate of torque relaxation dierent from pre-training and CON
404

Table 3 Involuntary PAP twitch characteristics in OCC and CON


conditions immediately following a 10-s MVC

Parameter OCC CON

Pre Post Pre Post

PT (Nm) 16.3 (0.7) 15.7 (0.7) 16.6 (0.7) 16.8 (0.9)


IPT (%) 67.2 (13.7) 101.3 (15.7)* 72.9 (11.8) 74.5 (11.2)
RT (ms) 36.6 (0.7) 33.1 (2.4) 36.8 (0.9) 39.3 (1.6)
HRT (ms) 55.9 (6.1) 52.6 (6.8) 58.0 (6.2) 60.2 (4.0)
RTD (Nms1) 472.5 (26.9) 454.5 (40.8) 467.6 (23.7) 438.4 (6.1)
RTR (Nms1) 264.4 (57.7) 261.8 (44.9) 255.0 (30.4) 244.8 (25.9) Fig. 5 Percentage increase in EMG during block 2 of the nal
training session of the rst repetition of set 3, compared to the rst
*Signicantly dierent from pre-training and CON (P<0.05) repetition of set 1 (set 1 set 3) and the 10th repetition of set 1
a
PAPPost-activation potentiation, MVC maximal voluntary con- compared to the 2nd repetition of set 1 (rep 2 rep 10) of the elbow
traction, IPT increase in peak torque from rest exors. EMG data were collected during the rst training block of
the last training session. *P<0.05, dierent from CON
between training and testing modes) can have a large
inuence on an individuals ability to produce force More importantly, our 8.3% increase in isometric
(Thorstensson et al. 1976). It has been suggested that strength was similar to the previously reported 13%
resistance training may alter force production through increase in isometric strength, despite our training
task-specic MU activation within a muscle and among duration being half of that used by Takarada et al.
synergistic muscles, eectively improving muscle coor- (2000). Therefore, our results demonstrate that training
dination to facilitate strength gains (Sale 1987, 2003). with a relatively light load with vascular occlusion can
Similarly, resistance training and the practice it aords signicantly increase muscle strength in a novel (i.e.,
may reduce the amount of antagonist co-contraction, unpracticed) force generating maneuver.
allowing a greater net force production in the practiced In the present study, the MUA of the elbow exors
maneuver (Sale 2003). Therefore the increase in volun- (measured during the isometric MVC) was high (98%)
tary dynamic strength in both OCC and CON in the in both the OCC and CON groups prior to the onset of
present study may have primarily been the result of training, which has been shown previously (Allen et al.
neuromuscular adaptations such as enhanced task-spe- 1995), and was not altered following training. Strength
cic MU activation and/or improved muscle coordina- gains independent of increases in MUA suggests mus-
tion. cular adaptations, such as bre hypertrophy, may have
LIORT was eective at increasing strength in an been responsible for the moderate strength gains seen in
unpracticed situation, as evidenced by the signicant the present study. However, if muscle hypertrophy was
increase in isometric MVC strength in the OCC condi- responsible for the observed increase in isometric
tion only. Our results are in agreement with the work of strength, it is unclear why dynamic maximal strength
Takarada and colleagues (Takarada et al. 2000) who was not similarly aected. It should also be noted that
demonstrated that dynamic resistance training at 50% the interpolated twitch technique is unable to detect
1 RM with an occlusion pressure of 110 mmHg resulted more specic neuromuscular changes, such as a decrease
in an 18.4% increase, when collapsed across all tested in antagonist co-activation or an increase in muscle
isokinetic contraction velocities, in voluntary elbow coordination, which have also been suggested to
exor strength, which was signicantly greater than inuence strength gains (Carolan and Cafarelli 1992;
training at the same intensity in the absence of the Rutherford and Jones 1986).
occlusive stimulus (1.0%). Moreover, the strength in- The presence of the blood pressure cu in the OCC
crease as a result of low-intensity occlusion training was condition would likely accelerate the onset of fatigue
comparable to the increase seen while training without and reduce muscle force production, necessitating an
occlusion at 80% of 1 RM (22.6%) (Takarada et al. increase in bre recruitment in order to move the 50%
2000), an intensity of contraction more commonly used 1 RM load (Sale 1987). While absolute EMG activity
to stimulate hypertrophy and maximize strength gains. during the nal training session increased in both the
OCC and CON conditions, it was slightly exaggerated in
Table 4 EMG activity in OCC and CON conditions during train-
ing block 2 of the nal training session OCC, as demonstrated through a trend for a greater rise
during the rst training set (P=0.076). This suggests
OCC CON that the OCC condition required a greater amount of
Set 1 Set 3 Set 1 Set 3
muscle activity than CON to lift the 50% 1 RM load. In
addition, while the absolute EMG for the rst repetition
Repetition 1 50122 785222 59827 66533 of sets 1 and 3 showed a trend towards being greater in
EMG (mV) OCC (P=0.085), the relative increase in the EMG
Repetition 2 Repetition 10 Repetition 2 Repetition 10 during the rst repetition was signicantly greater in
Set 1 686.552.7 961.068.3 751.150.4 878.4214.0
EMG (mV)
OCC compared to CON. Greater EMG activity during
the rst repetition of the OCC condition would suggest
405

that the blood pressure cu interfered with the clearance to perform a given task, conserving the energy of the
of potentially fatiguing metabolites (eg., H+ ions) from inactive bres and reducing situations in which full
the active muscle during the rest interval, necessitating a MUA would be required. Furthermore, if the MUA for
greater bre recruitment to lift the 50% 1 RM load. a specic task is reduced, this would mean a greater
Alternatively, accelerated muscle fatigue in the OCC proportion of active bres will be the energy ecient
condition may have increased the degree of MU syn- type I bres (in accordance with the size principle of
chronization leading to an increase in the overall EMG MU recruitment), which will have a further energy
interference amplitude (Yao et al. 2000). Once inte- conserving eect.
grated, this enhanced EMG interference amplitude LIORT can be a valuable alternative to enhancing
could then lead to a net increase in the EMG signal muscle strength in the absence of a large external load.
independent of any appreciable rise in MUA. However, Populations such as the elderly or post-surgery rehabil-
Suzuki and colleagues (2002) reported that the increase itation patients, who may have compromised strength
in surface EMG during sustained voluntary submaximal and/or joint stability, would benet from a low intensity
contractions corresponds to an increase in the number of resistance training program. Exercise programs that
active MUs. Furthermore, a sustained contraction at utilize a relatively light training load (i.e., equal to or less
50% of maximal force is associated with an increased than 50% of maximal strength) in combination with
EMG activity and a decreased interpolated twitch tor- vascular occlusion would reduce joint articular and lig-
que (Loscher et al. 1996), indicating that an increase in ament stress forces, which could reduce the incidence of
MUA and a decrease in the number of inactive bres has injury, while still provide an adequate stimulus to induce
occurred. Therefore, the present results of greater EMG increases in muscle strength and muscle hypertrophy
during training with blood ow occlusion would suggest (Shinohara et al. 1998; Takarada et al. 2000, 2002).
that a greater proportion of muscle bres (likely type II While LIORT may not be suitable for all elderly indi-
bres), were active in the OCC than the CON condition. viduals, owing to the potential vascular problems that
In the present study, resting isometric twitch torque can be associated with this population, it has previously
decreased in the OCC arm but was unaltered in the been shown to be eective in increasing muscle strength
CON arm following training. Previously, resistance and size in aged women (Takarada et al. 2000) and could
training has resulted in an increased (Rich and Cafarelli be considered a viable intervention in the future.
2000), decreased (Sale et al. 1982), or unaltered (Alway In summary, resistance training at an intensity of
et al. 1989; Kitai and Sale 1989; Rice et al. 1993) resting 50% 1 RM resulted in signicant increases in dynamic
twitch torque. Decreased resting twitch tension has voluntary strength, which may have primarily occurred
previously been suggested to reect an increased exten- through neuromuscular adaptations such as improved
sibility of the muscle-tendon complex (Sale et al. 1982); muscle coordination. In contrast, only training with
however this cannot explain the results of the present vascular occlusion at 50% 1 RM elicited signicant
investigation since participants trained both arms at the gains in isometric strength without any alterations in
same relative intensity. While a depressed twitch torque maximal MUA. Training with vascular occlusion sig-
in OCC may be a reection of low-frequency fatigue in nicantly depressed resting twitch torque, the negative
response to the training regimen, our data does not al- eects of which are abolished following a stimulus that
low us to investigate this possibility fully. Since we are induces PAP. Therefore, we conclude that low-intensity
the rst to examine the eects of LIORT on resting resistance training in combination with vascular occlu-
twitch properties, our nding of a depressed resting sion produces an adequate stimulus for increasing
twitch torque may be unique to the occlusive stimulus. muscle strength independent of a large external load,
Therefore, further studies are needed to determine the and causes changes in indices of neuromuscular func-
underlying mechanism for the decrease in twitch tension tion, such as a depressed resting twitch torque and en-
following LIORT seen in the present investigation. hanced PAP.
In examining the extent of PAP following training, it
was seen that the OCC condition demonstrated a sig- Acknowledgements This study was supported by the Natural Sci-
nicantly greater PAP whereas the CON arm did not. ence and Engineering Research Council (NSERC) of Canada
both SMP and MJG. Daniel Moore is the recipient of an NSERC
This increased PAP was the result of a lower resting PGS-A scholarship. Thanks to the subjects for their time and ef-
twitch torque in the OCC arm that was restored to the fort. Thanks as well to Mr. John Moroz for his expert technical
pre-training PAP torque. It appears that a brief condi- assistance. SMP is the recipient of a Premiers Research Excellence
tioning stimulus, in this case a 10-s MVC, produces an Award and a CIHR New Investigator Award and acknowledges
these sources of funding in the completion of this work.
adequate level of PAP to counteract whatever is
responsible for the depressed resting twitch in the OCC
arm. A greater relative increase in PAP following
LIORT would be considered a positive outcome, since References
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