Introduction
Resistance training with blood flow restriction can have the same effects as traditional resistance training. On the other hand, the type of rest between resistance exercises affects muscle adaptation and aerobic muscle fitness. Active rest is likely to increase heart rate, vasodilators such as nitric oxide, and duration of activity in the minimum training time increase the training intensity, which can cause more adaptations [
12]. The current study aimed to determine the effect of six weeks of selected resistance training with active and passive rest, with and without blood flow restriction, on young men’s C Reactive Protein (CRP), Lactate Dehydrogenase (LDH), and muscle endurance.
Materials & Methods
From the available and voluntary samples, 24 healthy young soldiers of the Islamic Republic of Iran Air Force were divided into 3 groups of 8 subjects: traditional resistance training, resistance training with blood flow restriction, and passive rest and resistance training with blood flow restriction and active rest. The occlusion pressure was about 160 to 180 mm Hg for the legs and 140 to 160 mm Hg for the arms, depending on the systolic pressure of each person. Exercise programs were performed for 6 weeks, 3 sessions per week with an intensity of 70-80% One-repetition maximum (1RM) for the traditional resistance group (3 sets of 10), 20-30% 1RM for the passive rest group (30-15-15-15), and 20 -30% 1RM was administered for the active rest group (30-7-15-7-15). Before and after six weeks, physiological and anthropometric characteristics, muscle endurance, and hormonal levels were measured, and ELISA measured blood samples. Data were analyzed using covariance and Bonferroni post hoc tests and paired t-test for comparison within groups.
Results
Results showed that 6 weeks of exercise had a significant effect on Muscle endurance (P=0.001) but on the levels of C-reactive protein (P=0.43) and Lactate dehydrogenase (P=0.44) showed no significant difference. Paired t-test results also showed that at the levels of reactive protein C (Passive rest: P=0.020) and (active rest P=0.017), lactate dehydrogenase (Passive rest: P=0.007) and (Active rest P=0.001). The difference was significant only in the 2 groups with restricted blood flow. Restricted blood flow training with passive and active rest caused a significant reduction (42.30%) in CRP levels and (7.59%) in LDH levels. Also, a significant decrease (38.74%) in CRP and (11.20%) in LDH levels, respectively. But there is no significant difference between pre-test and post-test of CRP and LDH in the traditional resistance training group. There was a significant difference between the pre-test and post-test of all groups in muscle endurance (P=0.001) (
Figure 1,
2) (
Table 1).
Discussion
Clarkson and Thompson reported that regular physical activity reduced levels of muscle damage markers, including LDH [
18]. Probably the reason for the conflict between the previous and present studies is the adaptation due to training. The type and intensity of training, recovery time, age, sex, physical fitness, season, and training with increasing fluctuations affect the concentration of this enzyme [
26].
Studies show that the enzyme LDH has an effective role in causing inflammatory conditions for muscle cells. Some researchers have reported increased levels after physical activity due to damage to muscle fibers [
27]. The 6-weeks training leads to adaptation; this training period will not lead to muscle damage. In addition, CRP is a sensitive inflammatory marker produced by liver cells in response to inflammatory agents and secreted by the liver. Physical activity reduces inflammation by improving endothelial function and has also been shown to reduce CRP production by reducing or inhibiting cytokines [
28].
Previous research has shown a significant reduction in inflammatory factors after long-term exercise [
29]. It has been shown that regular physical activity has the potential to reduce circulating levels of inflammatory markers [
30]. Studies show a positive relationship between CRP and body mass index. The homogeneity of the body mass index of the groups can be considered another reason for the lack of statistically significant differences between the mentioned groups [
40]. On the other hand, training with restricted blood flow enhances angiogenesis, increases the recruitment of type 2 fibers [
44], increases muscle glycogen storage, improves the glycolytic capacity of type 2 fibers [
45], and leads to improved muscle endurance.
According to the results of this study, it seems that a combination of resistance training with restriction of blood flow and Interval training (active rest) can be a good alternative to traditional training and, in some cases, replace resistance training with occlusion and passive rest.
Ethical Considerations
Compliance with ethical guidelines
The Ethics Committee approved all experimental procedures of the Sport Sciences Research Institute of Iran (Code: I.R.SSRC.REC.1398.129) Clinical Trial Code from Iran Clinical Trial Registration Center (ID IRCT20191207045644N1) and were conducted in accordance with the Declaration of Helsinki.
Funding
This article was the result of a research project by Mr. Vahid Fekri Kourabbaslou, which was implemented under the supervision of the Physical Education Department of the Air Force of the Islamic Republic of Iran.
Authors' contributions
The main designer of the project: Vahid Fekri Kourabbaslou; the guide and consultants in designing and modifying the study: Ali Fakourian & Mohsen Heydarian; preparing the study draft and modifying it participated in this study: Seyes Masoud Kashfi.
Conflicts of interest
The authors declared no conflict of interest.
References
- Ernfors P, Kucera J, Lee K, Loring J, Jaenisch R. Studies on the physiological role of brain-derived neurotrophic factor and neurotrophin-3 in knockout mice. Int J Dev Biol. 2003; 39(5):799-807. [PMID]
- Kim M-W, Bang M-S, Han T-R, Ko Y-J, Yoon B-W, Kim J-H, et al. Exercise increased BDNF and trkB in the contralateral hemisphere of the ischemic rat brain. Brain Res. 2005; 1052(1):16-21. [DOI:10.1016/j.brainres.2005.05.070] [PMID]
- McCloskey DP, Adamo DS, Anderson BJ. Exercise increases metabolic capacity in the motor cortex and striatum, but not in the hippocampus. Brain Res. 2001; 891(1):168-75. [DOI:10.1016/S0006-8993(00)03200-5]
- Nawa H, Carnahan J, Gall C. BDNF protein measured by a novel enzyme immunoassay in normal brain and after seizure: Partial disagreement with mRNA levels. Eur J Neurosci. 1995; 7(7):1527-35. [DOI:10.1111/j.1460-9568.1995.tb01148.x] [PMID]
- Drzyzga ŁR, Marcinowska A, Obuchowicz E. Antiapoptotic and neurotrophic effects of antidepressants: A review of clinical and experimental studies. Brain Res Bull. 2009; 79(5):248-57. [DOI:10.1016/j.brainresbull.2009.03.009] [PMID]
- Ivy A, Rodriguez F, Garcia C, Chen M, Russo-Neustadt A. Noradrenergic and serotonergic blockade inhibits BDNF mRNA activation following exercise and antidepressant. Pharmacol Biochem Behav. 2003; 75(1):81-8. [DOI:10.1016/S0091-3057(03)00044-3]
- Silhol M, Arancibia S, Maurice T, Tapia-Arancibia L. Spatial memory training modifies the expression of brain-derived neurotrophic factor tyrosine kinase receptors in young and aged rats. Neuroscience. 2007; 146(3):962-73. [DOI:10.1016/j.neuroscience.2007.02.013] [PMID]
- Hofer M, Pagliusi SR, Hohn A, Leibrock J, Barde Y. Regional distribution of brain-derived neurotrophic factor mRNA in the adult mouse brain. EMBO J. 1990; 9(8):2459-64. [PMID] [PMCID]
- Mowla SJ, Farhadi HF, Pareek S, Atwal JK, Morris SJ, Seidah NG, et al. Biosynthesis and post-translational processing of the precursor to brain-derived neurotrophic factor. J Biol Chem. 2001; 276(16):12660-6. [DOI:10.1074/jbc.M008104200] [PMID]
- Patapoutian A, Reichardt LF. Trk receptors: Mediators of neurotrophin action. Curr Opin Neurobiol. 2001; 11(3):272-80. [DOI:10.1016/S0959-4388(00)00208-7]
- Barde Y-A, Edgar D, Thoenen H. Purification of a new neurotrophic factor from mammalian brain. EMBO J. 1982; 1(5):549-53. [PMCID]
- Maisonpierre PC, Belluscio L, Squinto S, Ip NY, Furth ME, Lindsay RM, et al. Neurotrophin-3: A neurotrophic factor related to NGF and BDNF. Science. 1990; 247(4949 Pt 1):1446-52. [DOI:10.1126/science.247.4949.1446] [PMID]
- Sell H, Eckel J. Chemotactic cytokines, obesity and type 2 diabetes: In vivo and in vitro evidence for a possible causal correlation? Proc Nutr Soc. 2009; 68(4):378-84. [DOI:10.1017/S0029665109990218] [PMID]
- Rawson ES, Freedson PS, Osganian SK, Matthews CE, Reed G, Ockene IS. Body mass index, but not physical activity, is associated with C-reactive protein. Med Sci Sports Exerc. 2003; 35(7):1160-6. [DOI:10.1249/01.MSS.0000074565.79230.AB] [PMID]
- Hölscher C. Nitric oxide, the enigmatic neuronal messenger: Its role in synaptic plasticity. Trends Neurosci. 1997; 20(7):298-303. [DOI:10.1016/S0166-2236(97)01065-5]
- Smith LL. Cytokine hypothesis of overtraining: A physiological adaptation to excessive stress? Med Sci Sports Exerc. 2000; 32(2):317-31. [DOI:10.1097/00005768-200002000-00011] [PMID]
- Pedersen BK, Ostrowski K, Rohde T, Bruunsgaard H. The cytokine response to strenuous exercise. Can J Physiol Pharmacol. 1998; 76(5):505-11. [DOI:10.1139/y98-055] [PMID]
- Clarkson PM, Thompson HS. Antioxidants: What role do they play in physical activity and health? Am J Clin Nutr. 2000; 72(S 2):637S-46. [DOI:10.1093/ajcn/72.2.637S] [PMID]
- Jafari A, Zarghami Khameneh A. [Effect of single bout resistance exhaustive exercise following different doses of acute caffeine ingestin on indices-induced muscular in male olleyball (Persian)]. Metab Exerc. 2014; 3(2):141-53. https://jme.guilan.ac.ir/article_694.html?lang=en
- Sharifian Z. [Comparison of the effect of a resistance training session with and without vascular occlusion on muscle injury indices in young girls (Persian)] [MSc. Thesis]. Mashhad: University of Sabzevar; 2014. https://ganj.irandoc.ac.ir/#/articles/d125d717793c3de06050b768aeabab21
- Neto GR, Novaes JS, Salerno VP, Gonçalves MM, Batista GR, Cirilo-Sousa MS. Does a resistance exercise session with continuous or intermittent blood flow restriction promote muscle damage and increase oxidative stress? J Sports Sci. 2018; 36(1):104-10. [DOI:10.1080/02640414.2017.1283430] [PMID]
- Fattah A, Salem H. Effect of occlusion swimming training on physiological biomarkers and swimming performance. World J Sport Sci. 2011; 4(1):70-5. https://sponet.fi/Record/4022416
- Mohebi H, Rahmaniniya F, Arabmomeni A, Reyasi A, Marandi M. [The effects of intermittent training and age on blood lactate (La) Level and lactate dehydrogenase enzyme (LDH) activity in male wistar rats (Persian)]. Pars J Jahrom Univ of Med Sci. 2014; 12(4):23-30 [DOI:10.29252/jmj.12.4.4]
- Gaeeni A, Vatani D, Ashrafi J, Mogharnesi M. [Effect of Short-term and long-term exercise three types of speeed, endurance and a combination of lactate dehydrogenase, creatine kinase and plasma malondialdehyde in rats (Persian)]. J Sport Biosci. 2010; 3(8):5-20. https://jsb.ut.ac.ir/article_23856.html
- Porsesh M, Habibi A, Ahmadi Barati S, Fatemi S. [Compare the effect of six weeks of resistance training with and without vascular occlusion on serum levels of CRP nd LDH in active girls (Persian)]. J Shahid Sadoughi Univ Med Sci. 2016; 24(9):706-15. https://jssu.ssu.ac.ir/browse.php?a_code=A-10-2876-1&sid=1&slc_lang=fa
- Williams C, Kronfeld D, Hess T, Saker K, Waldron J, Crandell K, et al. Antioxidant supplementation and subsequent oxidative stress of horses during an 80-km endurance race. J Anim Sci. 2004; 82(2):588-94. [DOI:10.2527/2004.822588x] [PMID]
- Choung B, Byun S, Suh J, Kim TY. Extracellular superoxide dismutase tissue distribution and the patterns of superoxide dismutase mRNA expression following ultraviolet irradiation on mouse skin. Exp Dermatol. 2004; 13(11):691-9. [DOI:10.1111/j.0906-6705.2004.00209.x] [PMID]
- Akbarnehad A, Souri R, Bigdeli MD, Sayyah M. [The comparison of the effects of intermittent and continuous exercises on general inflammatory markers (Crp and Fibrinogen Serums) of young obese women (Persian)]. J Sport Biosci. 2013; 5(4):21-33. [DOI:10.22059/JSB.2013.35668]
- Zoladz J, Pilc A, Majerczak J, Grandys M, Zapart-Bukowska J, Duda K. Endurance training increases plasma brain-derived neurotrophic factor concentration in young healthy men. J Physiol Pharmacol. 2008; 59(S 7):119-32. [PMID]
- Deminice R, Sicchieri T, Mialich MS, Milani F, Ovidio PP, Jordao AA. Oxidative stress biomarker responses to an acute session of hypertrophy-resistance traditional interval training and circuit training. J Strength Cond Res. 2011; 25(3):798-804. [DOI:10.1519/JSC.0b013e3181c7bac6] [PMID]
- Marcell TJ, McAuley KA, Traustadóttir T, Reaven PD. Exercise training is not associated with improved levels of C-reactive protein or adiponectin. Metabolism. 2005; 54(4):533-41. [DOI:10.1016/j.metabol.2004.11.008] [PMID]
- Campisi J, Fleshner M. Role of extracellular HSP72 in acute stress-induced potentiation of innate immunity in active rats. J Appl Physiol. 2003; 94(1):43-52. [DOI:10.1152/japplphysiol.00681.2002] [PMID]
- Daryanoosh F, Mehraban D. [Evaluating inflammatory index changes and muscle injuries in male mice after 8 weeks of aerobic exercise and omega-3 consumption (Persian)]. J Sport Biosc. 2012; 4(10):77-94. [DOI:10.22059/JSB.2012.21999]
- Safarzade A, Talebi Gorkani E. [The effect of progressive training on serum levels of inflamatory markers and vaspin in male rats (Persian)]. Koomesh. 2012; 14(1):97-103. http://koomeshjournal.semums.ac.ir/article-1-1629-fa.html
- Tartibian B, Akbari H, Ameri H. [The effect of a 6-Week camp Preparation on complement System(C3,C4) in young Professional Karate Ka (Persian)]. Harakat. 2009; (39):161-74. https://www.sid.ir/en/Journal/ViewPaper.aspx?ID=133693
- Ramezanpour MR, Hejazi SM, Hosseinnezhad M. [The Comparison of HS-CRP, TG, LDL-c and HDL-c in Active and Non Active Middle-aged Women (Persian)]. Med J Mashhad Univ Med Sci. 2013; 56(2):93-8. http://mjms.mums.ac.ir/article_848.html
- Clark B, Manini T, Hoffman R, Williams P, Guiler M, Knutson M, et al. Relative safety of 4 weeks of blood flow-restricted resistance exercise in young, healthy adults. Scand J Med Sci Sports. 2011; 21(5):653-62. [DOI:10.1111/j.1600-0838.2010.01100.x] [PMID] [PMCID]
- Laswati H, Sugiarto D, Poerwandari D, Pangkahila JA, Kimura H. Low-intensity exercise with blood flow restriction increases muscle strength without altering hsCRP and fibrinogen levels in healthy subjects. Chin J Physiol. 2018; 61(3):188-95. [DOI:10.4077/CJP.2018.BAG567] [PMID]
- Madarame H, Kurano M, Fukumura K, Fukuda T, Nakajima T. Haemostatic and inflammatory responses to blood flow-restricted exercise in patients with ischaemic heart disease: A pilot study. Clin Physiol Funct Imaging. 2013; 33(1):11-7. [DOI:10.1111/j.1475-097X.2012.01158.x] [PMID]
- Arazi H, Ebrahimi M, Hoseini K. [The effect of anabolic steroids on Bodybuilders blood CRP (Persian)]. J Payavard Salamet. 1389; 4(3):43-9. https://payavard.tums.ac.ir/article-1-93-en.html
- Hoseini Kakhak A, Sharifi A. [Comprasion of the effect of traditional resistance training with resistance training with vascular occlusion on muscular function and cardiovascular endurance in young female (Persian)]. J Sport Biosci. 2012; 4(10):95-114.[DOI:10.22059/JSB.2012.22000]
- Mostafalou A, Hosseini SA, Haghighi AH. [The effect of resistance training with emphasis on eccentric phase with and without blood flow restriction and traditional resistance training on blood cortisol, endurance performance and anaerobic power in male soccer players (Persian)]. Metab Exerc. 2018; 8(8):61-77. https://jme.guilan.ac.ir/?_action=article&kw=18338&_kw=Resistance+training+Eccentric&lang=en
- Cook SB, Brown KA, DeRuisseau K, Kanaley JA, Ploutz-Snyder LL. Skeletal muscle adaptations following blood flow-restricted training during 30 days of muscular unloading. J Appl Physiol. 2010; 109(2):341-9. [DOI:10.1152/japplphysiol.01288.2009] [PMID]
- Wernbom M, Augustsson J, Raastad T. Ischemic strength training: A low-load alternative to heavy resistance exercise? Scand J Med Sci Sports. 2008; 18(4):401-16. [DOI:10.1111/j.1600-0838.2008.00788.x] [PMID]
- Takarada Y, Sato Y, Ishii N. Effects of resistance exercise combined with vascular occlusion on muscle function in athletes. Eur J Appl Physiol. 2002; 86(4):308-14. [DOI:10.1007/s00421-001-0561-5] [PMID]
- Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes. 2010; 2011:868305. [DOI:10.1155/2011/868305] [PMID] [PMCID]
- Zabihi D. [The effect of 12 sessions of Cycling with blood flow restriction on active men performance (Persian)][MSc. thesis]. Tehran: University of Kharazmi; 2013.
- Saadi M. [Coprasion the effect of 6 weeks of Interval running on treadmill with and without blood flow restriction on aerobic, anaerobic and explosive power of active male Student of Chamran University (Persian)][MSc. thesis]. Ahvaz: Shahid Chamran University; 2015.
- Brito AF, Alves NF, Araújo AS, Gonçalves MC, Silva AS. Active intervals between sets of resistance exercises potentiate the magnitude of postexercise hypotension in elderly hypertensive women. J Strength Cond Res. 2011; 25(11):3129-36. [DOI:10.1519/JSC.0b013e318212dd25] [PMID]
- Keyhanian A, Ebrahim K, Raajabi H, Marandi S. [Compaison the effect of resistance exercise with active and passive rest on aerobic and anaerobic fitness in soccer players (Persian)]. J Sport Med Technol. 2015; 13(9):47-62. [DOI:10.18869/acadpub.jsmt.13.9.47]