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Ischemic Preconditioning Blunts Muscle Damage Responses Induced by Eccentric Exercise.

Franz, Alexander; Behringer, Michael; Harmsen, Jan-Frieder; Mayer, Constantin; Krauspe, Rüdiger; Zilkens, Christoph; Schumann, Moritz
Medicine & Science in Sports & Exercise: Post Acceptance: August 22, 2017
doi: 10.1249/MSS.0000000000001406
Original Investigation: PDF Only

Purpose: Ischemic preconditioning (IPC) is known to reduce muscle damage induced by ischemia and reperfusion-injury (I/R-Injury) during surgery. Due to similarities between the pathophysiological formation of I/R-injury and eccentric exercise-induced muscle damage (EIMD), as characterized by an intracellular accumulation of Ca2+, an increased production of reactive oxygen species and increased pro-inflammatory signaling, the purpose of the present study was to investigate whether IPC performed prior to eccentric exercise may also protect against EIMD.

Methods: Nineteen healthy men were matched to an eccentric only (ECC) (n=9) or eccentric proceeded by IPC group (IPC+ECC) (n=10). The exercise protocol consisted of bilateral biceps curls (3x10 repetitions at 80% of the concentric 1RM). In IPC+ECC, IPC was applied bilaterally at the upper arms by a tourniquet (200 mmHg) immediately prior to the exercise (3x5 minutes of occlusion, separated by 5 minutes of reperfusion). Creatine Kinase (CK), arm circumference, subjective pain (VAS score) and radial displacement (Tensiomyography, Dm) were assessed before IPC, pre-exercise, post-exercise, 20 minutes-, 2 hours-, 24 hours-, 48 hours- and 72 hours post-exercise.

Results: CK differed from baseline only in ECC at 48h (p<0.001) and 72h (p<0.001) post-exercise. After 24h, 48h and 72h, CK was increased in ECC compared to IPC+ECC (between groups: 24h: p=0.004, 48h: p<0.001, 72h: p<0.001). VAS was significantly higher in ECC at 24-72 h post-exercise, when compared to IPC+ECC (between groups: all p<0.001). Dm was decreased on all post-exercise days in ECC (all p<0.001) but remained statistically unchanged in IPC+ECC (between-groups p<0.01).

Conclusions: These findings indicate that IPC performed prior to a bout of eccentric exercise of the elbow flexors blunts EIMD and exercise-induced pain, while maintaining the contractile properties of the muscle.

(C) 2017 American College of Sports Medicine