Franz Alexander, Behringer Michael, Harmsen Jan-Frieder, Mayer Constantin, Krauspe Rüdiger, Zilkens Christoph, Schumann Moritz
1Department of Orthopedics, University Hospital Duesseldorf, Duesseldorf, GERMANY; 2Faculty of Sport Sciences, Goethe University Frankfurt, Frankfurt, GERMANY; and 3Department of Molecular and Cellular Sport Medicine, German Sport University, Cologne, GERMANY.
Med Sci Sports Exerc. 2018 Jan;50(1):109-115. doi: 10.1249/MSS.0000000000001406.
Ischemic preconditioning (IPC) is known to reduce muscle damage induced by ischemia and reperfusion injury during surgery. Because of similarities between the pathophysiological formation of ischemia and reperfusion injury and eccentric exercise-induced muscle damage (EIMD), as characterized by an intracellular accumulation of Ca, an increased production of reactive oxygen species, and increased proinflammatory signaling, the purpose of the present study was to investigate whether IPC performed before eccentric exercise may also protect against EIMD.
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 (3 × 10 repetitions at 80% of the concentric one-repetition maximum). In IPC + ECC, IPC was applied bilaterally at the upper arms by a tourniquet (200 mm Hg) immediately before the exercise (3 × 5 min of occlusion, separated by 5 min of reperfusion). Creatine kinase (CK), arm circumference, subjective pain (visual analog scale score), and radial displacement (tensiomyography, maximal radial displacement) were assessed before IPC, preexercise, postexercise, and 20 min, 2 h, 24 h, 48 h, and 72 h postexercise.
CK differed from baseline only in ECC at 48 h (P < 0.001) and 72 h (P < 0.001) postexercise. After 24, 48, and 72 h, CK was increased in ECC compared with IPC + ECC (between groups: 24 h, P = 0.004; 48 h, P < 0.001; 72 h, P < 0.001). The visual analog scale score was significantly higher in ECC at 24-72 h postexercise when compared with IPC + ECC (between groups: all P values < 0.001). The maximal radial displacement was decreased on all postexercise days in ECC (all P values < 0.001) but remained statistically unchanged in IPC + ECC (between groups: P < 0.01).
These findings indicate that IPC performed before a bout of eccentric exercise of the elbow flexors blunts EIMD and exercise-induced pain while maintaining the contractile properties of the muscle.
已知缺血预处理（IPC）可减少手术期间缺血和再灌注损伤所诱导的肌肉损伤。由于缺血和再灌注损伤的病理生理形成与离心运动诱导的肌肉损伤（EIMD）存在相似性，其特征为细胞内钙蓄积、活性氧生成增加以及促炎信号增强，本研究旨在探究在离心运动前进行IPC是否也能预防EIMD。
19名健康男性被分为单纯离心运动组（ECC；n = 9）或IPC后进行离心运动组（IPC + ECC；n = 10）。运动方案包括双侧二头肌弯举（以向心一次重复最大值的80%进行3组，每组10次重复）。在IPC + ECC组中，在运动前（3次5分钟的阻断，间隔5分钟再灌注）立即通过上臂止血带（200毫米汞柱）对双侧施加IPC。在IPC前、运动前、运动后以及运动后20分钟、2小时、24小时、48小时和72小时评估肌酸激酶（CK）、上臂围、主观疼痛（视觉模拟评分）和桡骨位移（张力肌电图，最大桡骨位移）。
CK仅在运动后48小时（P < 0.001）和72小时（P < 0.001）的ECC组与基线存在差异。在24、48和72小时后，与IPC + ECC组相比，ECC组的CK升高（组间比较：24小时，P = 0.004；48小时，P < 0.001；72小时，P < 0.001）。与IPC + ECC组相比，运动后24 - 72小时ECC组的视觉模拟评分显著更高（组间比较：所有P值< 0.001）。ECC组在运动后的所有天数最大桡骨位移均降低（所有P值< 0.001），而IPC + ECC组保持统计学上的不变（组间比较：P < 0.01）。
这些发现表明，在肘部屈肌进行一轮离心运动前进行IPC可减轻EIMD和运动诱导的疼痛，同时维持肌肉的收缩特性。
