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Clin Physiol Funct Imaging (2009) 29, pp128135 doi: 10.1111/j.1475-097X.2008.00847.x
Summary
Correspondence Metabolic syndrome is associated with reductions in basal limb blood flow.
Michiya Tanimoto, National Institute of Health and Resistance training increasing muscle mass and strength increases basal limb blood
Nutrition, 1-23-1 Toyama, Shinjuku-ku, Tokyo,
flow. Low-intensity resistance exercise with slow movement and tonic force
162-8686, Japan
E-mail: tanimoto@nih.go.jp
generation (LST) has been proposed as one of the effective methods of resistance
training increasing muscle mass and strength. The hypothesis that LST training
Accepted for publication
increases basal femoral blood flow as well as traditional high-intensity resistance
Received 26 March 2008;
accepted 10 November 2008
training at normal speed (HN) was examined. Thirty-six healthy young men
without a history of regular resistance training were randomly assigned to the LST
Key words [5560% one repetition maximum (1RM) load, 3 s lifting and 3 s lowering with
hemodynamics; muscle hypertrophy; resistance no relaxation phase, n = 12], HN (8590% 1RM, 1 s lifting and 1 s lowering
exercise; ultrasonic; vascular resistance with 1 s relaxation, n = 12) or sedentary control (CON, n = 12) groups.
Participants in the training groups underwent two whole-body training sessions
per week for 13 weeks. Basal femoral blood flow increased significantly by +18% in
LST and +35% in HN (both P<005), while there was no such change in CON.
There were no significant differences between these increases induced by LST and
HN, although the increase in LST corresponded to about half that in HN. In
conclusion, not only resistance training in HN but in LST as well, were effective for
increasing basal limb blood flow, and that this effect was evident even in healthy
young men.
Relatively low-intensity (5060% 1RM) resistance training preventive effect, before such investigations are carried out in
with slow movement and tonic force generation (LST) is patients with metabolic syndrome or others and in older people
another method of resistance exercise. Previously, we reported as a curative effect.
that LST training resulted in a significant increase in muscular
size and strength as high-intensity (8090% 1RM) resistance
training with normal speed (HN) in knee extension training Methods
(Tanimoto & Ishii, 2006) and in a whole-body training regimen
Subjects
(Tanimoto et al., 2008), and LST was not associated with either
generation of large force or marked elevation of blood pressure Thirty-six healthy young men without a history of regular
(Tanimoto & Ishii, 2006). Therefore, LST would be one of the exercise training volunteered as subjects in the present study.
useful methods of resistance training for promoting muscular All subjects were non-smokers, normotensive (blood pressure
hypertrophy and strength gain, which is relatively safe for a <140/90 mmHg), non-obese (body mass index <30 kg m)2)
larger population. and free of overt chronic diseases as assessed by medical
With regard to the hypothesis of the effects of LST in history, physical examination and complete blood chemistry
promoting muscle hypertrophy, LST exercise movement was and haematological evaluation. Candidates showing signs of
configured to achieve continuous force generation throughout peripheral artery disease [ankle-brachial index (ABI) <090]
the exercise movement. Continuous force generation at >40% were excluded. The subjects were assigned at random into
maximum voluntary contraction has been shown to suppress three experimental groups (n = 12 for each group: LST, HN,
both blood inflow to and outflow from the muscle due to an CON defined below). Groups were matched for physical
increase in intramuscular pressure (Bonde-Petersen et al., 1975). parameters, such as height, weight and age (Table 1). All
Resistance training regimens with restricted muscular blood subjects were fully informed about the experimental proce-
flow were considered to induce increases in muscular size and dures as well as the purpose of the study, and each subject
strength mediated by the following processes due to oxygen provided written informed consent before participating in the
insufficiency in muscle: (i) stimulated secretion of growth study. The study protocol was approved by the Ethics
hormone by intramuscular accumulation of metabolic Committee for Human Experiments, National Institute of
by-products, such as lactate (Takarada et al., 2000a); (ii) Health and Nutrition.
moderate production of reactive oxygen species promoting
tissue growth (Takarada et al., 2000b); and (iii) additional
Regimens for exercise training
recruitment of fast-twitch fibres under hypoxic conditions
(Shinohara & Moritani, 1992). The subjects in each training group performed whole-body
The present study was performed to investigate whether resistance training regimens consisting of five types of exercise:
resistance training even in LST also increases basal femoral blood vertical squat, chest press, latissimus dorsi pull-down, abdom-
flow as well as in HN, and whether resistance training in LST inal bend and back extension, as described previously (Tanim-
and HN increase basal femoral blood flow even in healthy oto et al., 2008). The subjects performed the following training
young men. regimens.
The present study examined whether LST training can safely LST group: low-intensity (5560% of 1RM) training with
increase basal limb blood flow in healthy young people as a slow movement and tonic force generation [3 s for concentric
LST HN CON
between the head of the humerus and the scapula was positioned experimental period were +68 34% in LST, +91 42% in
at the glenoid fossa. The leg region was defined as the region HN and +13 22% in CON. The absolute changes in LSTM
extending from the inferior border of the ischial tuberosity to the (body mass minus fat and bone mass) in DXA were
distal tip of the toes. The whole body was defined as the region 14 04 kg in LST, 18 04 kg in HN and 06 02 kg in
extending from the shoulders to the distal tip of the toes. A CON. The percent changes in left leg LSTM, defined as leg
reference point that could be visualized clearly on the DXA system muscle mass, were 30 10% in LST, 44 10% in HN and
terminal was selected. 11 08% in CON. On measurement of muscular strength, the
percent changes in total 1RM strength, defined as the sum of
values for all five types of exercise used in the training regimen,
Muscular strength
were +330 88% in LST, +412 78% in HN and
Maximal muscular strength was tested with the five types of +13 24% in CON. For all changes in muscle mass and
exercise used in the training regimen. Values were obtained for strength shown above, increases in the LST and HN groups after
1RM according to the established guidelines (Baechle et al., the experimental period were significantly greater than those in
2000). CON, and there were no significant differences between the
changes in LST and HN. Our previous study provided detailed
data regarding changes in muscle mass and muscular strength
Metabolic risk factors for coronary heart disease
(Tanimoto et al., 2008).
To screen for the presence of coronary heart disease, fasting
plasma concentrations of total cholesterol, HDL cholesterol, LDL
Metabolic risk factors for coronary heart disease
cholesterol, triglycerides and glucose were determined with
enzymatic techniques (Tanaka et al., 2000). There were no significant changes in fasting plasma concentra-
tions of total cholesterol, HDL cholesterol, LDL cholesterol,
triglycerides, fasting glucose or ABI (Table 2). All metabolic risk
Statistical analyses
factors were well within clinically normal levels in all subjects.
All values are expressed as means SE. One-way analysis of Brachial blood pressure, cardiac output and systemic vascular
variance (ANOVA) with Fishers protected least significant resistance (total peripheral resistance: TPR) did not change in
difference (PLSD) was used to determine the significance of any any group (Table 3).
differences among the initial parameters of the three groups.
Two-way ANOVA repeated measures (group period) with
Changes in arterial blood ow
Newman-Keuls method was used to examine differences in
changes in any parameters between groups. For all statistical tests, Figure 1 shows basal femoral (top) and carotid (bottom) blood
P<005 was considered significant. flow and basal femoral blood flow per unit volume of leg
muscle mass (middle) in the three groups before and after the
experimental period. Figure 2 shows femoral and carotid
Results
vascular conductance (upper) and both femoral and carotid
Before the intervention period, there were no significant vascular resistance (lower).
differences in any of the variables among the three groups. In the LST and HN groups, basal femoral blood flow increased
significantly after the experimental period, while there was no
such change in CON. The percent changes in basal femoral
Changes in muscle mass and strength
blood flow were +180 47% in LST and +348 83% in
The percent changes in total MT in ultrasound imaging, defined HN. There were no significant differences between these
as the sum of the values for all six measurement sites, after the changes induced by LST and HN, although the increase in basal
LST HN CON
LST HN CON
Brachial systolic BP, mmHg 1113 16 1114 28 1083 18 1103 13 1084 21 1076 26
Brachial mean BP, mmHg 803 16 800 22 778 09 813 14 778 19 779 20
Brachial diastolic BP, mmHg 607 15 603 24 594 17 618 19 593 17 600 15
Femoral artery lumen diameter, mm 85 02 87 02 84 01 86 02 83 02 85 02
Femoral artery IMT, mm 54 08 56 08 54 07 54 08 52 07 53 05
Femoral artery MBV, cm s)1 139 08 152 07a,b 122 08 157 14a,c 153 15 147 08
Carotid artery lumen diameter, mm 61 01 61 01 62 01 61 01 61 01 62 01
Carotid artery IMT, mm 48 05 49 03 47 04 49 05 47 04 47 05
Carotid artery MBV, cm s)1 310 13 325 10 293 11 321 11 310 12 313 13
Cardiac output, l min)1 37 06 38 06 39 07 41 09 42 08 39 07
systemic vascular resistance, U 224 34 214 44 208 11 210 17 194 14 204 08
femoral blood flow in LST corresponded to about half that in In addition, LST resulted in increases in muscular size and
HN. strength comparable to those associated with HN (Tanimoto
Basal femoral blood flow per unit volume of leg muscle mass et al., 2008). LST met the requirement of the primary purpose of
changed after the experimental period in a manner similar to the resistance training, which is to be effective for gaining muscular
basal femoral blood flow changes described above. The percent size and strength. Meeting this requirement is essential for any
changes in basal femoral blood flow per unit volume of leg study investigating the additional effects of resistance training
muscle mass were +150 48% in LST and +291 82% in methods.
HN. Percent changes in leg muscle mass after the experimental These findings extend our understanding of the relation
period were not related to those in basal leg blood flow in either between resistance training and basal limb blood flow in at
training group (LST and HN; Fig. 3). Furthermore, percent least two additional ways. First, by establishing that traditional
changes in cardiac output after the experimental period were not high-intensity resistance training is effective for increasing
related to those in basal leg blood flow in ether training group basal femoral blood flow (Miyachi et al., 2005; Anton et al.,
(LST and HN; Fig. 4). 2006), the findings presented here indicate that resistance
These changes were associated with a significant increase in training even in LST, which used a relatively low mechanical
femoral vascular conductance and a significant reduction in load, is effective for increasing basal femoral blood flow.
femoral vascular resistance in the LST and HN groups, However, we should emphasize that although not significantly
respectively. The increases in femoral blood flow in the LST different, the change in basal femoral blood flow in LST
and HN group were primarily dependent on an increase in mean corresponded to about half that in HN. Second, by establishing
blood velocity, not on artery lumen diameter (see Table 3). that resistance training increases basal femoral blood flow in
There were no significant changes in any carotid parameter middle-aged men and women whose basal femoral blood flow
(blood flow, vascular conductance or vascular resistance) after decreases with the advancing age (Dinenno et al., 2001a,b;
the experimental period in any of the three groups. Moreau et al., 2003), the findings of the present study
indicated that in both the LST and HN groups, resistance
training increases basal femoral blood flow even in young
Discussion
men. With regard to the intergenerational differences in basal
The present randomized-control intervention study is the first to femoral blood flow changes, changes in basal femoral blood
document the effect of low-intensity (5060% 1RM) resis- flow in young men caused by resistance training in the present
tance training with slow movement and tonic force generation study (15% in LST and 29% in HN) were lower than those in
(LST) on basal femoral blood flow and vascular conductance. middle-aged men and women in the previous study (over
The salient findings of the present study were that basal femoral 50%). This age-related difference would be due to differences
blood flow and vascular conductance significantly increased in the baselines of basal femoral blood flow before the training
even after 13 weeks of LST training, as well as after 13 weeks of intervention period. These findings suggest that LST training
traditional high-intensity (8590% 1RM) resistance training may be one of the effective strategies for increasing basal limb
with normal speed (HN) in young men. perfusion, and that regular resistance training from a
2008 The Authors
Journal compilation 2008 Scandinavian Society of Clinical Physiology and Nuclear Medicine 29, 2, 128135
Slow and tonic resistance training and blood ow, M. Tanimoto et al. 133
(ml. min1)
blood flow
those in whole-leg basal blood flow in the two training groups
400
(LST and HN, r = )005; Fig. 3). Moreover, increases in the
relative blood flow to leg muscle mass in the two training groups
200 were quantitatively the same as increases in whole-leg blood flow
(Fig. 1). These findings suggest that qualitative changes in leg
0 muscles by resistance training (LST and HN) have a more
LST HN CON
immediate and/or potent influence than quantitative changes
Pre Post (gain in muscle mass).
The muscle metabolic rate and capillary density may be
004 qualitative factors contributing to increased basal femoral blood
Basal femoral blood flow/
Pre Post
025 Pre Post
025
02
02
vascular resistance
(mmHg.ml1.min)
vascular resistance
*
(mmHg.ml1.min)
*
015
Carotid
Femoral
015
01 01
005 005
0 0
LST HN CON LST HN CON
Pre Post
Figure 2 Femoral and carotid vascular resis-
Pre Post tance and conductance before and after the
8 8 intervention period. Means SE (n = 12 for
* * each group) in femoral and carotid vascular
vascular conductance
vascular conductance
(ml.min1.mmHg1)
6 6
vascular resistance (lower) in the three exper-
Femoral
50 r = 0.19, NS
Basal femoral blood flow changes
50
r = 005, NS
40 40
30 30
%
20
%
20
10 10
0 0
20 10 0 10 20 30 40 20 10 0 10 20 30 40
10 10
Left leg muscle mass changes
Cardiac output changes
%
%
Figure 3 Relations between leg muscle mass changes and basal
Figure 4 Relations between cardiac output changes and basal femoral
femoral blood flow changes in the two trained groups (n = 24). Left leg
blood flow changes in trained group subjects (n = 24). Change in cardio
LSTM (lean soft tissue mass) is defined as left leg muscle mass. Change in
output was not related to that in basal femoral blood flow (r = 019).
leg muscle mass was not related to that in femoral leg blood flow
(r = )005).
Conclusion
pressure (Tanimoto & Ishii, 2006), and so it would be a safe and
useful method of exercise for increasing peripheral blood flow. The results of the present study indicated that resistance training,
The reduction in leg blood flow may limit peripheral glucose even in LST, increased basal femoral blood flow and vascular
uptake and contribute to glucose intolerance and hyperinsulin- conductance as in HN, and that regular resistance training from a
emia (Lind & Lithell, 1993). In addition, it may also impair the young age may contribute to preservation of basal limb blood
clearance of atherogenic lipids and contribute to chronic flow. LST promotes muscular hypertrophy and strength gain
dyslipidaemia (Baron et al., 1990). Regular resistance training comparable to those in HN without high mechanical load. LST is
in the LST group may contribute to a lower incidence of proposed as a safe and useful exercise method not only for
cardiovascular disease through its influence on basal femoral muscular hypertrophy and strength gain, but also for increasing
blood flow. peripheral blood flow and vascular conductance as an additional
2008 The Authors
Journal compilation 2008 Scandinavian Society of Clinical Physiology and Nuclear Medicine 29, 2, 128135
Slow and tonic resistance training and blood ow, M. Tanimoto et al. 135
effect. This study investigated preventive effects for healthy Leithe ME, Margorien RD, Hermiller JB, Unverferth DV, Leier CV.
people, not curative effects for patients with metabolic syndrome Relationship between central hemodynamics and regional blood flow
or other diseases. Expanding this study to cover investigation in in normal subjects and in patients with congestive heart failure.
Circulation (1984); 69: 5764.
patient groups is an issue for future consideration.
Lind L, Lithell H. Decreased peripheral blood flow in the pathogenesis of
the metabolic syndrome comprising hypertension, hyperlipidemia,
and hyperinsulinemia. Am Heart J (1993); 125: 14941497.
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