Blaise Collins, PhD, ACSM-EP-C

After reading this article, the health and fitness professional should be able to

 1) understand the knowledge and skills that certified exercise physiologists possess as a result of their educational background and ACSM Exercise Physiologist (EP) certification;

 2) describe employment opportunities and common tasks for EPs;

 3) identify the various populations that seek guidance from EPs; and

 4) acknowledge the lack of representation of EPs in health care provider… Show more

After reading this article, the health and fitness professional should be able to

 1) understand the knowledge and skills that certified exercise physiologists possess as a result of their educational background and ACSM Exercise Physiologist (EP) certification;

 2) describe employment opportunities and common tasks for EPs;

 3) identify the various populations that seek guidance from EPs; and

 4) acknowledge the lack of representation of EPs in health care provider (HCP) networks. Show less

Purpose
Volumetric muscle loss is a uniquely challenging pathology that results in irrecoverable functional deficits. Furthermore, a breakthrough drug or bioactive factor has yet to be established that adequately improves repair of these severe skeletal muscle injuries. This study sought to assess the ability of an orally administered selective retinoic acid receptor-γ agonist, palovarotene, to improve recovery of neuromuscular strength in a rat model of volumetric muscle… Show more

Purpose
Volumetric muscle loss is a uniquely challenging pathology that results in irrecoverable functional deficits. Furthermore, a breakthrough drug or bioactive factor has yet to be established that adequately improves repair of these severe skeletal muscle injuries. This study sought to assess the ability of an orally administered selective retinoic acid receptor-γ agonist, palovarotene, to improve recovery of neuromuscular strength in a rat model of volumetric muscle loss.

Methods
An irrecoverable, full thickness defect was created in the tibialis anterior muscle of Lewis rats and animals were survived for 4 weeks. Functional recovery of the tibialis anterior muscle was assessed in vivo via neural stimulation and determination of peak isometric torque. Histological staining was performed to qualitatively assess fibrous scarring of the defect site.

Results
Treatment with the selective retinoic acid receptor-γ agonist, palovarotene, resulted in a 38% improvement of peak isometric torque in volumetric muscle loss affected limbs after 4 weeks of healing compared to untreated controls. Additionally, preliminary histological assessment suggests that oral administration of palovarotene reduced fibrous scarring at the defect site.

Conclusions
These results highlight the potential role of selective retinoic acid receptor-γ agonists in the design of regenerative medicine platforms to maximize skeletal muscle healing. Additional studies are needed to further elucidate cellular responses, optimize therapeutic delivery, and characterize synergistic potential with adjunct therapies.

Note: I led study planning, data collection, statistical analysis, and initial draft of the manuscript. Show less

In a double-blind, crossover, randomized and placebo-controlled trial; 28 men and women ingested a placebo (PLA), 3 g of creatine nitrate (CNL), and 6 g of creatine nitrate (CNH) for 6 days. Participants repeated the experiment with the alternate supplements after a 7-day washout. Hemodynamic responses to a postural challenge, fasting blood samples, and bench press, leg press, and cycling time trial performance and recovery were assessed. Data were analyzed by univariate, multivariate, and… Show more

In a double-blind, crossover, randomized and placebo-controlled trial; 28 men and women ingested a placebo (PLA), 3 g of creatine nitrate (CNL), and 6 g of creatine nitrate (CNH) for 6 days. Participants repeated the experiment with the alternate supplements after a 7-day washout. Hemodynamic responses to a postural challenge, fasting blood samples, and bench press, leg press, and cycling time trial performance and recovery were assessed. Data were analyzed by univariate, multivariate, and repeated measures general linear models (GLM). No significant differences were found among treatments for hemodynamic responses, clinical blood markers or self-reported side effects. After 5 days of supplementation, one repetition maximum (1RM) bench press improved significantly for CNH (mean change, 95% CI; 6.1 [3.5, 8.7] kg) but not PLA (0.7 [-1.6, 3.0] kg or CNL (2.0 [-0.9, 4.9] kg, CNH, p = 0.01). CNH participants also tended to experience an attenuated loss in 1RM strength during the recovery performance tests following supplementation on day 5 (PLA: -9.3 [-13.5, -5.0], CNL: -9.3 [-13.5, -5.1], CNH: -3.9 [-6.6, -1.2] kg, p = 0.07). After 5 days, pre-supplementation 1RM leg press values increased significantly, only with CNH (24.7 [8.8, 40.6] kg, but not PLA (13.9 [-15.7, 43.5] or CNL (14.6 [-0.5, 29.7]). Further, post-supplementation 1RM leg press recovery did not decrease significantly for CNH (-13.3 [-31.9, 5.3], but did for PLA (-30.5 [-53.4, -7.7] and CNL (-29.0 [-49.5, -8.4]). CNL treatment promoted an increase in bench press repetitions at 70% of 1RM during recovery on day 5 (PLA: 0.4 [-0.8, 1.6], CNL: 0.9 [0.35, 1.5], CNH: 0.5 [-0.2, 0.3], p = 0.56), greater leg press endurance prior to supplementation on day 5 (PLA: -0.2 [-1.6, 1.2], CNL: 0.9 [0.2, 1.6], CNH: 0.2 [-0.5, 0.9], p = 0.25) and greater leg press endurance during recovery on day 5 (PLA: -0.03 [-1.2, 1.1], CNL: 1.1 [0.3, 1.9], CNH: 0.4 [-0.4, 1.2], p = 0.23). -truncated Show less

We examined the effects of ingesting two preworkout supplements (PWSs) on selective attention and response inhibition, perceived exercise readiness (herein, readiness), and exercise performance-related parameters. Resistance-trained participants (N = 19) were randomized to a double-blind, crossover (7-day washout) placebo (PLA)-controlled study supplementing with (1) PLA; (2) PWS [beta-alanine (3.2 g), arginine alpha ketoglutarate (2.0 g), creatine nitrate (2.0 g), ascorbic acid (500 mg)… Show more

We examined the effects of ingesting two preworkout supplements (PWSs) on selective attention and response inhibition, perceived exercise readiness (herein, readiness), and exercise performance-related parameters. Resistance-trained participants (N = 19) were randomized to a double-blind, crossover (7-day washout) placebo (PLA)-controlled study supplementing with (1) PLA; (2) PWS [beta-alanine (3.2 g), arginine alpha ketoglutarate (2.0 g), creatine nitrate (2.0 g), ascorbic acid (500 mg), N-acetyl tyrosine (300 mg), caffeine (300 mg), tetramethyluric acid (10 mg), Mucuna pruriens extract standardized for 15% l-Dopa (1.0 g), theacrine (10 mg), pyridoxal 5-phosphate (1.48 mg), folic acid (0.50 mg), and methylcobalamin (1.8 mg)]; and (3) PWS150 at ∼150% the PWS dose. Primary outcomes were Stroop test responses for congruent, incongruent, and interference tasks. Secondary outcomes were readiness and exercise performance (bench and leg press/Wingate). Data were analyzed by general linear models and presented as mean (standard deviation) or mean change [95% confidence interval, CI].Significant improvements in Stroop word testing were observed for PWS (6.57, 95% CI [1.36–11.8]) and PWS150 (11.5, 95% CI [6.26–16.6]), but not PLA (1.31, 95% CI [−3.89 to 6.52]). Significant changes in Stroop color testing were observed for PWS150 (8.1, 95% CI [4.52–11.6]) and PLA (4.47, 95% CI [0.89–8.05]), but not PWS (2.31, 95% CI [−1.26 to 5.89]). Similar results were observed for word–color. When all domains were summed, PWS150 (27.42 counts, 95% CI [16.08–38.76]) and PWS (12.26 counts, 95% CI [0.92–23.60]) showed significant improvements, but not PLA (11.26 counts, 95% CI [−0.077 to 22.60]). No significant changes in readiness, exercise performance, or adverse changes were otherwise observed.Consistent improvements in selective attention and response inhibition were observed with PWS150, but not readiness or exercise performance. Show less

In a double-blind, randomized and crossover manner, 25 resistance-trained participants ingested a placebo (PLA) beverage containing 12 g of dextrose and a beverage (RTD) containing caffeine (200 mg), β-alanine (2.1 g), arginine nitrate (1.3 g), niacin (65 mg), folic acid (325 mcg), and Vitamin B12 (45 mcg) for 7-days, separated by a 7-10-day. On day 1 and 6, participants donated a fasting blood sample and completed a side-effects questionnaire (SEQ), hemodynamic challenge test, 1-RM and… Show more

In a double-blind, randomized and crossover manner, 25 resistance-trained participants ingested a placebo (PLA) beverage containing 12 g of dextrose and a beverage (RTD) containing caffeine (200 mg), β-alanine (2.1 g), arginine nitrate (1.3 g), niacin (65 mg), folic acid (325 mcg), and Vitamin B12 (45 mcg) for 7-days, separated by a 7-10-day. On day 1 and 6, participants donated a fasting blood sample and completed a side-effects questionnaire (SEQ), hemodynamic challenge test, 1-RM and muscular endurance tests (3 × 10 repetitions at 70% of 1-RM with the last set to failure on the bench press (BP) and leg press (LP)) followed by ingesting the assigned beverage. After 15 min, participants repeated the hemodynamic test, 1-RM tests, and performed a repetition to fatigue (RtF) test at 70% of 1-RM, followed by completing the SEQ. On day 2 and 7, participants donated a fasting blood sample, completed the SEQ, ingested the assigned beverage, rested 30 min, and performed a 4 km cycling time-trial (TT). Data were analyzed by univariate, multivariate, and repeated measures general linear models (GLM), adjusted for gender and relative caffeine intake. Data are presented as mean change (95% CI). An overall multivariate time × treatment interaction was observed on strength performance variables (p = 0.01). Acute RTD ingestion better maintained LP 1-RM (PLA: -0.285 (-0.49, -0.08); RTD: 0.23 (-0.50, 0.18) kg/kgFFM, p = 0.30); increased LP RtF (PLA: -2.60 (-6.8, 1.6); RTD: 4.00 (-0.2, 8.2) repetitions, p = 0.031); increased BP lifting volume (PLA: 0.001 (-0.13, 0.16); RTD: 0.03 (0.02, 0.04) kg/kgFFM, p = 0.007); and, increased total lifting volume (PLA: -13.12 (-36.9, 10.5); RTD: 21.06 (-2.7, 44.8) kg/kgFFM, p = 0.046). -truncated Show less

The evaluation of concussed athletes, including testing to determine if and when they may return to play, has become an important task of athletic trainers and team physicians. Currently, concussion protocols are in place, which depend largely upon assessments based upon neurocognitive testing (NCT). The authors have evaluated the use of a biomarker of brain trauma, marinobufagenin (MBG), and compared its application in concussed athletes with the performance of NTC. We found a disparity… Show more

The evaluation of concussed athletes, including testing to determine if and when they may return to play, has become an important task of athletic trainers and team physicians. Currently, concussion protocols are in place, which depend largely upon assessments based upon neurocognitive testing (NCT). The authors have evaluated the use of a biomarker of brain trauma, marinobufagenin (MBG), and compared its application in concussed athletes with the performance of NTC. We found a disparity between these two testing procedures. In this communication, the findings of these comparative data are presented. We noted that athletes whose NCT evaluations had returned to baseline and who were allowed to again participate in play then showed a recurrence of elevated urinary MBG excretion. These observations raise concern as to the processes currently in effect with regard to the decision as to returning athletes to the full activity. They suggest a need for further evaluation. Show less

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