In order to stimulate further adaptation toward specific training goals, progressive resistance training (RT) protocols are necessary The optimal characteristics of strength-specific programs include the use of concentric (CON), eccentric (ECC), and isometric muscle actions and the performance of bilateral and unilateral single- and multiple-joint exercises In addition, it is recommended that strength programs sequence exercises to optimize the preservation of exercise intensity (large before small muscle group exercises, multiple-joint exercises before single-joint exercises, and higher-intensity before lower-intensity exercises) For novice (untrained individuals with no RT experience or who have not trained for several years) training, it is recommended that loads correspond to a repetition range of an 8-12 repetition maximum (RM) For intermediate (individuals with approximately 6 months of consistent RT experience) to advanced (individuals with years of RT experience) training, it is recommended that individuals use a wider loading range from 1 to 12 RM in a periodized fashion with eventual emphasis on heavy loading (1-6 RM) using 3- to 5-min rest periods between sets performed at a moderate contraction velocity (1-2 s CON; 1-2 s ECC) When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number The recommendation for training frequency is 2-3 d·wk -1 for novice training, 3-4 d·wk -1 for intermediate training, and 4-5 d·wk -1 for advanced training Similar program designs are recommended for hypertrophy training with respect to exercise selection and frequency For loading, it is recommended that loads corresponding to 1-12 RM be used in periodized fashion with emphasis on the 6-12 RM zone using 1- to 2-min rest periods between sets at a moderate velocity Higher volume, multiple-set programs are recommended for maximizing hypertrophy Progression in power training entails two general loading strategies: 1) strength training and 2) use of light loads (0-60% of 1 RM for lower body exercises; 30-60% of 1 RM for upper body exercises) performed at a fast contraction velocity with 3-5 min of rest between sets for multiple sets per exercise (three to five sets) It is also recommended that emphasis be placed on multiple-joint exercises especially those involving the total body For local muscular endurance training, it is recommended that light to moderate loads (40-60% of 1 RM) be performed for high repetitions (>15) using short rest periods (<90 s) In the interpretation of this position stand as with prior ones, recommendations should be applied in context and should be contingent upon an individual's target goals, physical capacity, and training status

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Progression Models in Resistance Training for Healthy Adults

In order to stimulate further adaptation toward a specific training goal(s), progression in the type of resistance training protocol used is necessary. The optimal characteristics of strength-specific programs include the use of both concentric and eccentric muscle actions and the performance of both single- and multiple-joint exercises. It is also recommended that the strength program sequence exercises to optimize the quality of the exercise intensity (large before small muscle group exercises, multiple-joint exercises before single-joint exercises, and higher intensity before lower intensity exercises). For initial resistances, it is recommended that loads corresponding to 8-12 repetition maximum (RM) be used in novice training. For intermediate to advanced training, it is recommended that individuals use a wider loading range, from 1-12 RM in a periodized fashion, with eventual emphasis on heavy loading (1-6 RM) using at least 3-min rest periods between sets performed at a moderate contraction velocity (1-2 s concentric, 1-2 s eccentric). When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number. The recommendation for training frequency is 2-3 d x wk(-1) for novice and intermediate training and 4-5 d x wk(-1) for advanced training. Similar program designs are recommended for hypertrophy training with respect to exercise selection and frequency. For loading, it is recommended that loads corresponding to 1-12 RM be used in periodized fashion, with emphasis on the 6-12 RM zone using 1- to 2-min rest periods between sets at a moderate velocity. Higher volume, multiple-set programs are recommended for maximizing hypertrophy. Progression in power training entails two general loading strategies: 1) strength training, and 2) use of light loads (30-60% of 1 RM) performed at a fast contraction velocity with 2-3 min of rest between sets for multiple sets per exercise. It is also recommended that emphasis be placed on multiple-joint exercises, especially those involving the total body. For local muscular endurance training, it is recommended that light to moderate loads (40-60% of 1 RM) be performed for high repetitions (> 15) using short rest periods (< 90 s). In the interpretation of this position stand, as with prior ones, the recommendations should be viewed in context of the individual's target goals, physical capacity, and training status.

American College of Sports Medicine Position Stand. Progression Models in Resistance Training for Healthy Adults

See related commentary by Kanis, page [1829][1]

Since the publication of the Osteoporosis Canada guidelines in 2002, there has been a paradigm shift in the prevention and treatment of osteoporosis and fractures. [1][2],[2][3] The focus now is on preventing fragility fractures and their negative

/pdf/2010-clinical-practice-guidelines-for-the-diagnosis-and-4ttqfkm9wl.pdf

2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary

Background: Treatment intervention thresholds for prevention of osteoporotic fractures can be derived from reports from the World Health Organization (diagnostic criteria) and National Osteoporosis Foundation (treatment criteria). It is not known how well these thresholds work to identify women who will fracture and are therefore candidates for treatment interventions. We used data from the National Osteoporosis Risk Assessment (NORA) to examine the effect of different treatment thresholds on fracture incidence and numbers of women with fractures within the year following bone mineral density measurement. Methods: The study comprised 149 524 white postmenopausal women aged 50 to 104 years (mean age, 64.5 years). At baseline, bone mineral density was assessed by peripheral bone densitometry at the heel, finger, or forearm. New fractures during the next 12 months were self-reported. Results: New fractures were reported by 2259 women, including 393 hip fractures; only 6.4% had baseline T scores of �2.5 or less (World Health Organization definition for osteoporosis). Although fracture rates were highest in these women, they experienced only 18% of the osteoporotic fractures and 26% of the hip fractures. By National Osteoporosis Foundation treatment guidelines, 22.6% of the women had T scores of 2.0 or less, or �1.5 or less with 1 or more clinical risk factors. Fracture rates were lower, but 45% of osteoporotic fractures and 53% of hip fractures occurred in these women. Conclusions: Using peripheral measurement devices, 82% of postmenopausal women with fractures had T scores better than �2.5. A strategy to reduce overall fracture incidence will likely require lifestyle changes and a targeted effort to identify and develop treatment protocols for women with less severe low bone mass who are nonetheless at increased risk for future fractures.

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Bone mineral density thresholds for pharmacological intervention to prevent fractures

The quest to increase lean body mass is widely pursued by those who lift weights. Research is lacking, however, as to the best approach for maximizing exercise-induced muscle growth. Bodybuilders generally train with moderate loads and fairly short rest intervals that induce high amounts of metabolic stress. Powerlifters, on the other hand, routinely train with high-intensity loads and lengthy rest periods between sets. Although both groups are known to display impressive muscularity, it is not clear which method is superior for hypertrophic gains. It has been shown that many factors mediate the hypertrophic process and that mechanical tension, muscle damage, and metabolic stress all can play a role in exercise-induced muscle growth. Therefore, the purpose of this paper is twofold: (a) to extensively review the literature as to the mechanisms of muscle hypertrophy and their application to exercise training and (b) to draw conclusions from the research as to the optimal protocol for maximizing muscle growth.

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The mechanisms of muscle hypertrophy and their application to resistance training.

This study examined the role of high forces versus metabolic cost in the adaptations following strength training. Ten young, healthy male and female subjects trained one leg using concentric (CL) and the other using eccentric (EL) contractions of the quadriceps muscle for 20 weeks. EL used weights which were 35% higher than those used for CL. Isometric strength, and the length:tension and force:velocity relationship of the muscle were measured before and after training. Muscle cross-sectional area (CSA) was measured near the knee and hip using computed tomography. Increases in isometric strength were greater for CL compared to EL, the difference being significant with the knee at 1.57 rad (90 degrees) [mean (SD), 43.7 (19.6)% vs 22.9 (9.8)%, respectively; P = 0.01]. Increases in isokinetic strength tended to be larger for EL, although the differences were not significant. Significant increases in CSA occurred near the hip for both EL and CL. These results suggest that metabolic cost, and not high forces alone, are involved in the stimuli for muscle hypertrophy and strength gains following high-resistance training.

The role of metabolites in strength training. I. A comparison of eccentric and concentric contractions

The aim of this study was to compare the effects of intense endurance vs strengthening exercise on bone mass and serum testosterone levels in male athletes. Bone mineral density (BMD) of the total body and spine and serum testosterone levels were measured in male rowers (n = 12), triathletes (n = 8) and sedentary controls (n = 13). The total body scan also gave values for percentage body fat and regional bone densities. Calcium intake and physical activity levels were measured by questionnaire. The rowers had significantly higher BMD in the spine and total body than the triathletes (P < 0.01 and P < 0.05 respectively) and sedentary controls (P < 0.01 and P < 0.05). There were no differences between the triathletes and controls. Serum testosterone levels were significantly lower in the triathletes than in the controls (P < 0.05); there was no significant difference between the rowers and controls. All groups fell within the normal range for testosterone. In a step-wise multiple regression, including age, body mass, height, calcium intake and activity, no single factor had a significant effect on spine BMD. Body mass had a significant effect on total body BMD and could account for the differences between the groups. A significant positive correlation was found between calcium intake and total body BMD. The heavy weight training typical of rowing training seemed to result in significant bone accretion. The low testosterone levels in the triathletes may have negated any positive effect of the increased exercise on BMD.

Spine and total body bone mineral density and serum testosterone levels in male athletes.

Changes in strength, speed and size of the quadriceps muscle have been investigated in elderly men and women after 6 months of isometric strength training. We have also indirectly investigated the role of metabolites as a stimulus for muscle hypertrophy by studying two training protocols. One thigh was trained using short, intermittent contractions (IC), while the other trained using long, continuous contractions (CC). This meant that there should be a greater metabolite change in the muscle performing CC, as the blood flow is occluded for longer. Nine subjects [eight women, mean (SE) age, 71.8 (2.9) years] were measured for contractile properties and strength before and after training, and compared to nine age-matched controls [71.5 (2.1) years]. The training group increased quadriceps strength by 48.7 (9.1)% (P < 0.005) and 53.1 (11.3)% (P < 0.005) following the IC and CC protocols, respectively. There was no change in muscle strength in the controls. Both muscles showed significant slowing after training as measured by the relaxation times and the force-frequency ratio. There were non-significant decreases in muscle fatigability after training. The control group also showed some significant decreases in fatigability and muscle speed. The training group showed significant increases in muscle (and bone) cross-sectional area of 4.0 (1.7)% and 4.9 (1.3)% following the CC and IC protocols, respectively. These increases were significantly different from the decrease observed in the control group. These findings suggest that people over the age of 55 still have the capacity to increase muscle strength and size, and that the training causes slowing of the muscle. Muscle hypertrophy does not seem to be strongly influenced by metabolite changes in this age group, as there were no differences in measurements observed between protocols.

Effects of isometric strength training on quadriceps muscle properties in over 55 year olds.

Using the KinCom 500H isokinetic dynamometer the first part of this study measured the characteristics of the force velocity relationship curve for the human knee extensors between −1.57 (eccentric) and 3.67 (concentric) rads · s−1 (−90 and 210° s1) for both legs in 4 subjects. A significant increase in force generation was seen in eccentric activity at 0.52 rads · s−1 (30° s−1) but not at 1.57 rads · s−1 (90° s−1) compared to maximum voluntary isometric force (P < 0.005). This increase was, however, lower than would be expected from the classical force-velocity relationship. The second part of the study examined whether restricting the range of movement was able to further increase the eccentric forces. In a further 6 subjects, the eccentric contractions were repeated during either an 80° (15–95° flexion) and a 50° (45–95° flexion) range of movement. Significant increases in force were seen over the shorter range of movement at 0.52 rads · s−1 (30° s−1) (P = 0.006) and 1.57 rads · s−1 (90° s−1) (P < 0.001).

O M Rutherford

Papers

The role of metabolites in strength training. I. A comparison of eccentric and concentric contractions

Spine and total body bone mineral density and serum testosterone levels in male athletes.

Effects of isometric strength training on quadriceps muscle properties in over 55 year olds.

Reduction in range of movement can increase maximum voluntary eccentric forces for the human knee extensor muscles