Does Aerobic Training Promote the Same Skeletal Muscle Hypertrophy as Resistance Training? A Systematic Review and Meta-Analysis

Abstract

Background

Currently, there are inconsistencies in the body of evidence for the effects of resistance and aerobic training on skeletal muscle hypertrophy.

Objective

We aimed to systematically review and meta-analyze current evidence on the differences in hypertrophic adaptation to aerobic and resistance training, and to discuss potential reasons for the disparities noted in the literature.

Methods

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed for this review. The Downs and Black checklist was used for the assessment of methodological quality of the included studies. A random-effects meta-analysis was employed. In total, three analyses were performed: (1) for whole-muscle knee extensor data; (2) for type I fiber cross-sectional area; and (3) for type II fiber cross-sectional area.

Results

The final number of included studies in the present review is 21. All studies were of good or moderate methodological quality. The meta-analysis for whole-muscle hypertrophy resulted in a significant pooled difference (p < 0.001) in responses between the aerobic training and resistance training interventions. The pooled Hedge's g, favoring resistance over aerobic training, was 0.66 (95% confidence interval 0.41–90; I² = 0%). The meta-analysis for type I fiber cross-sectional area data resulted in a significant pooled difference (p < 0.001) between the aerobic training and resistance training groups. The pooled Hedge's g, favoring resistance training over aerobic training, was 0.99 (95% confidence interval 0.44–1.54; I² = 24%). The meta-analysis of type II fiber cross-sectional area data resulted in a significant pooled difference (p < 0.001) between the aerobic training and resistance training groups. The pooled Hedge's g, favoring resistance training over aerobic training, was 1.44 (95% confidence interval 0.93–1.95; I² = 8%).

Conclusions

The results of this systematic review and meta-analysis suggest that single-mode aerobic training does not promote the same skeletal muscle hypertrophy as resistance training. This finding was consistent with measurements of muscle hypertrophy both at the whole-muscle and myofiber levels. While these results are specific to the knee extensor musculature, it can be hypothesized that similar results would be seen for other muscle groups as well.

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Effects of Jumping Exercise on Muscular Power in Older Adults: A Meta-Analysis

Abstract

Background

Jump training (JT) can be used to enhance the ability of skeletal muscle to exert maximal force in as short a time as possible. Despite its usefulness as a method of performance enhancement in athletes, only a small number of studies have investigated its effects on muscle power in older adults.

Objectives

The aims of this meta-analysis were to measure the effect of JT on muscular power in older adults (≥ 50 years), and to establish appropriate programming guidelines for this population.

Data Sources

The data sources utilised were Google Scholar, PubMed, and Microsoft Academic.

Study Eligibility Criteria

Studies were eligible for inclusion if they comprised JT interventions in healthy adults (≥ 50 years) who were free of any medical condition that could impair movement.

Study Appraisal and Synthesis Methods

The inverse variance random-effects model for meta-analyses was used because it allocates a proportionate weight to trials based on the size of their individual standard errors and facilitates analysis while accounting for heterogeneity across studies. Effect sizes (ESs), calculated from a measure of muscular power, were represented by the standardised mean difference and were presented alongside 95% confidence intervals (CIs).

Results

Thirteen training groups across nine studies were included in this meta-analysis. The magnitude of the main effect was 'moderate' (0.66, 95% CI 0.33, 0.98). ESs were larger in non-obese participants (body mass index [BMI] < 30 vs. ≥ 30 kg/m²; 1.03 [95% CI 0.34, 1.73] vs. 0.53 [95% CI − 0.03, 1.09]). Among the studies included in this review, just one reported an acute injury, which did not result in the participant ceasing their involvement. JT was more effective in programmes with more than one exercise (range 1–4 exercises; ES = 0.74 [95% CI − 0.49, 1.96] vs. 0.53 [95% CI 0.29, 0.78]), more than two sets per exercise (range 1–4 sets; ES = 0.91 [95% CI 0.04, 1.77] vs. 0.68 [95% CI 0.15, 1.21]), more than three jumps per set (range 1–14 jumps; ES = 1.02 [95% CI 0.16, 1.87] vs. 0.53 [95% CI − 0.03, 1.09]) and more than 25 jumps per session (range 6–200 jumps; ES = 0.88 [95% CI 0.05, 1.70] vs. 0.49 [95% CI 0.14, 0.83]).

Conclusions

JT is safe and effective in older adults. Practitioners should construct varied JT programmes that include more than one exercise and comprise more than two sets per exercise, more than three jumps per set, and 60 s of recovery between sets. An upper limit of three sets per exercise and ten jumps per set is recommended. Up to three training sessions per week can be performed.

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Acknowledgment to reviewers

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Surgical technique and chylothorax following coronary artery bypass grafting

Achilleas Lazopoulos, Dimitrios Paliouras, Nikolaos Barbetakis

Annals of Cardiac Anaesthesia 2018 21(4):468-468



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Predictors of acute kidney injury in patients undergoing adult cardiac surgery

Sreja Gangadharan, KR Sundaram, Senthilvelan Vasudevan, B Ananthakrishnan, Rakhi Balachandran, Abraham Cherian, Praveen Kerala Varma, Luis Bakero Gracia, K Murukan, Ashish Madaiker, Rajesh Jose, Rakesh Seetharaman, Kirun Gopal, Sujatha Menon, M Thushara, Reshmi Liza Jose, G Deepak, Sudheer Babu Vanga, Aveek Jayant

Annals of Cardiac Anaesthesia 2018 21(4):448-454

Background: Acute kidney injury (AKI) after cardiac surgery (CS) is not uncommon and has serious effects on mortality and morbidity. A majority of patients suffer mild forms of AKI. There is a paucity of Indian data regarding this important complication after CS. Aims and Objectives: The primary objective was to study the incidence of AKI associated with CS in an Indian study population. Secondary objectives were to describe the risk factors associated with AKI-CS in our population and to generate outcome data in patients who suffer this complication. Methods: Serial patients (n = 400) presenting for adult CS (emergency/elective) at a tertiary referral care hospital in South India from August 2016 to November 2017 were included as the study individuals. The incidence of AKI-CS AKI network (AKIN criteria), risk factors associated with this condition and the outcomes following AKI-CS are described. Results: Out of 400, 37 (9.25%) patients developed AKI after CS. AKI associated with CS was associated with a mortality of 13.5% (no AKI group mortality 2.8%, P = 0.001 [P < 0.05]). When AKI was severe enough to need renal replacement therapy, the mortality increased to 75%. Patients with AKI had a mean hospital stay 16.92 ± 12.75 days which was comparatively longer than patients without AKI (14 ± 7.98 days). Recent acute coronary syndrome, postoperative atrial fibrillation, and systemic hypertension significantly predicted the onset of AKI-CS in our population. Conclusions: The overall incidence of AKI-CS was 9.25%. The incidence of AKI-CS requiring dialysis (Stage 3 AKIN) AKI-CS was lower (2%). However, mortality risks were disproportionately high in patients with AKIN Stage 3 AKI-CS (75%). There is a need for quality improvement in the care of patients with AKI-CS in its most severe forms since mortality risks posed by the development of Stage 3 AKIN AKI is higher than reported in other index populations from high resource settings.

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Facilitating noncardiac surgery for the patient with left ventricular assist device: A guide for the anesthesiologist

Kai-Yin Hwang, Nian-Chih Hwang

Annals of Cardiac Anaesthesia 2018 21(4):351-362

The introduction of left ventricular assist device (LVAD) has improved survival rates for patients with end-stage heart failure. Two categories of VADs exist: one generates pulsatile flow and the other produces nonpulsatile continuous flow. Survival is better for patients with continuous-flow LVADs. With improved survival, more of such patients now present for noncardiac surgery (NCS). This review, written for the general anesthesiologists, addresses the perioperative considerations when the patient undergoes NCS. For best outcomes, a multidisciplinary approach is essential in perioperative management of the patient.

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Preoperative predictors of poor laryngoscope views in pediatric population undergoing cardiac catheterization

Madan Mohan Maddali, Haifa Mohammed Ali Al-Zaabi, Is'haq Said Salim Al-Aamri, Nishant Ram Arora, Sathiya Murthi Panchatcharam

Annals of Cardiac Anaesthesia 2018 21(4):376-381

Background: The primary objective of this study was to identify pre-anesthetic airway assessment parameters that would predict Cormack and Lehane grade III and IV laryngoscopy views in pediatric patients undergoing cardiac catheterization procedures. The secondary end points were to identify factors that would contribute to difficult laryngoscope views in this subset of patients. Settings and Design: Prospective observational study performed at a single tertiary cardiac care center. Materials and Methods: 199 children below 5 years of age undergoing elective cardiac catheterization were included. Pre-anesthetic airway assessment was done by modified Mallampati grading, lower lip to chin distance [LCD], tragus to mouth angle [TMA], thyromental distance [TMD], neck circumference [NC], and the ratio of height to thyromental distance [RHTMD]. Demographic data including American Society of Anesthesiologists physical status [ASA PS] were recorded for each child. Receiver Operating Characteristic curves were plotted and Areas Under the Curve were measured to identify the best cut off values for each of the airway evaluation method that would predict poor laryngoscopy views as well as assess their accuracy in doing so. Results: LCD, TMD and low body mass index were found to have good sensitivity, specificity and accuracy in predicting Grade III and IV laryngoscope views. ASA PS grade III and above patients had a significantly higher incidence of poor laryngoscope visualization. Conclusions: LCD, TMA, TMD, NC, RHTMD and BMI could all be used combinedly as screening tools during pre-anesthetic airway evaluation for predicting difficult laryngoscope views in children. Among these, LCD, TMD along with low body mass index might have better accuracy.

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