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1.  Role of mitochondrial DNA damage and dysfunction in veterans with Gulf War Illness 
PLoS ONE  2017;12(9):e0184832.
Gulf War Illness (GWI) is a chronic multi-symptom illness not currently diagnosed by standard medical or laboratory test that affects 30% of veterans who served during the 1990–1991 Gulf War. The clinical presentation of GWI is comparable to that of patients with certain mitochondrial disorders–i.e., clinically heterogeneous multisystem symptoms. Therefore, we hypothesized that mitochondrial dysfunction may contribute to both the symptoms of GWI as well as its persistence over time. We recruited 21 cases of GWI (CDC and Kansas criteria) and 7 controls to participate in this study. Peripheral blood samples were obtained in all participants and a quantitative polymerase chain reaction (QPCR) based assay was performed to quantify mitochondrial and nuclear DNA lesion frequency and mitochondrial DNA (mtDNA) copy number (mtDNAcn) from peripheral blood mononuclear cells. Samples were also used to analyze nuclear DNA lesion frequency and enzyme activity for mitochondrial complexes I and IV. Both mtDNA lesion frequency (p = 0.015, d = 1.13) and mtDNAcn (p = 0.001; d = 1.69) were elevated in veterans with GWI relative to controls. Nuclear DNA lesion frequency was also elevated in veterans with GWI (p = 0.344; d = 1.41), but did not reach statistical significance. Complex I and IV activity (p > 0.05) were similar between groups and greater mtDNA lesion frequency was associated with reduced complex I (r2 = -0.35, p = 0.007) and IV (r2 = -0.28, p < 0.01) enzyme activity. In conclusion, veterans with GWI exhibit greater mtDNA damage which is consistent with mitochondrial dysfunction.
PMCID: PMC5599026  PMID: 28910366
3.  Force-Velocity, Impulse-Momentum Relationships: Implications for Efficacy of Purposefully Slow Resistance Training 
The purpose of this brief review is to explain the mechanical relationship between impulse and momentum when resistance exercise is performed in a purposefully slow manner (PS). PS is recognized by ~10s concentric and ~4-10s eccentric actions. While several papers have reviewed the effects of PS, none has yet explained such resistance training in the context of the impulse-momentum relationship. A case study of normal versus PS back squats was also performed. An 85kg man performed both normal speed (3 sec eccentric action and maximal acceleration concentric action) and PS back squats over a several loads. Normal speed back squats produced both greater peak and mean propulsive forces than PS action when measured across all loads. However, TUT was greatly increased in the PS condition, with values fourfold greater than maximal acceleration repetitions. The data and explanation herein point to superior forces produced by the neuromuscular system via traditional speed training indicating a superior modality for inducing neuromuscular adaptation.
Key pointsAs velocity approaches zero, propulsive force approaches zero, therefore slow moving objects only require force approximately equal to the weight of the resistance.As mass is constant during resistance training, a greater impulse will result in a greater velocity.The inferior propulsive forces accompanying purposefully slow training suggest other methods of resistance training have a greater potential for adaptation.
PMCID: PMC3761460  PMID: 24149464
Impulse; momentum; purposefully slow; time-under-tension
4.  Effects of Protein Supplementation on Muscular Performance and Resting Hormonal Changes in College Football Players 
The effect of protein supplementation on athletic performance and hormonal changes was examined in 21 experienced collegiate strength/power athletes participating in a 12-week resistance training program. Subjects were randomly assigned to either a protein supplement (PR; n = 11) or a placebo (PL; n = 10) group. During each testing session subjects were assessed for strength (one repetition maximum [1-RM] bench press and squat), power (Wingate anaerobic power test) and body composition. Resting blood samples were analyzed at weeks 0 (PRE), 6 (MID) and 12 (POST) for total testosterone, cortisol, growth hormone, and IGF-1. No difference was seen in energy intake between PR and PL (3034 ± 209 kcal and 3130 ± 266 kcal, respectively), but a significant difference in daily protein intake was seen between PR (2.00 g·kg body mass[BM]-1·d-1) and PL (1.24 g·kgBM-1·d-1). A greater change (p < 0.05) in the ∆ 1-RM squat was seen in PR (23.5 ± 13.6 kg) compared to PL (9.1 ± 11.9 kg). No other significant strength or power differences were seen between the groups. Cortisol concentrations were significantly lower at MID for PL and this difference was significantly different than PR. No significant changes were noted in resting growth hormone or IGF-1 concentrations in either group. Although protein supplementation appeared to augment lower body strength development, similar upper body strength, anaerobic power and lean tissue changes do not provide clear evidence supporting the efficacy of a 12-week protein supplementation period in experienced resistance trained athletes.
Key pointsCollegiate strength/power athletes may not meet daily recommended energy or protein needs.When athletes are provided a protein supplement they appear to meet the recommended daily protein intake for strength/power athletes.Protein supplementation did augment lower body strength development in experienced strength/power athletes.Results of upper body strength, anaerobic power and lean tissue changes did not support the efficacy of a 12-week protein supplementation period in experienced resistance trained athletes.
PMCID: PMC3778704  PMID: 24149229
Sport nutrition; resistance training; endocrine; testosterone
5.  A retrospective cohort study of U.S. service members returning from Afghanistan and Iraq: is physical health worsening over time? 
BMC Public Health  2012;12:1124.
High rates of mental health disorders have been reported in veterans returning from deployment to Afghanistan (Operation Enduring Freedom: OEF) and Iraq (Operation Iraqi Freedom: OIF); however, less is known about physical health functioning and its temporal course post-deployment. Therefore, our goal is to study physical health functioning in OEF/OIF veterans after deployment.
We analyzed self-reported physical health functioning as physical component summary (PCS) scores on the Veterans version of the Short Form 36 health survey in 679 OEF/OIF veterans clinically evaluated at a post-deployment health clinic. Veterans were stratified into four groups based on time post-deployment: (1Yr) 0 – 365 days; (2Yr) 366 – 730 days; (3Yr) 731 – 1095 days; and (4Yr+) > 1095 days. To assess the possibility that our effect was specific to a treatment-seeking sample, we also analyzed PCS scores from a separate military community sample of 768 OEF/OIF veterans evaluated pre-deployment and up to one-year post-deployment.
In veterans evaluated at our clinic, we observed significantly lower PCS scores as time post-deployment increased (p = 0.018) after adjusting for probable post-traumatic stress disorder (PTSD). We similarly observed in our community sample that PCS scores were lower both immediately after and one year after return from deployment (p < 0.001) relative to pre-deployment PCS. Further, PCS scores obtained 1-year post-deployment were significantly lower than scores obtained immediately post-deployment (p = 0.02).
In our clinical sample, the longer the duration between return from deployment and their visit to our clinic, the worse the Veteran’s physical health even after adjusting for PTSD. Additionally, a decline is also present in a military community sample of OEF/OIF veterans. These data suggest that, as time since deployment length increases, physical health may deteriorate for some veterans.
PMCID: PMC3543837  PMID: 23272950
Veterans; Military personnel; Veterans health; Quality of life; Operation enduring freedom; Operation iraqi freedom; Health surveys
6.  Central Adaptations to Repetitive Grasping in Healthy Aging 
Brain topography  2011;24(3-4):292-301.
Augmented cortical activity during repetitive grasping mitigates repetition-related decrease in cortical efficiency in young adults. It is unclear if similar processes occur with healthy aging. We recorded movement-related cortical potentials (MRCP) during 150 repetitive handgrip contractions at 70% of maximal voluntary contraction (MVC) in healthy young (n = 10) and old (n = 10) adults. Repetitions were grouped into two Blocks (Block 1 and 2: repetitions 1–60 and 91–150, respectively) and analyzed separately to assess the effects of aging and block. EMG of the flexor digitorum superficialis and handgrip force were also recorded. No changes in EMG or MVC were observed across blocks for either group. Significant interactions (P < 0.05) were observed for MRCPs recorded from mesial (FCz, Cz, CPz) and motor (C1, C3, Cz) electrode sites, with younger adults demonstrating significant increases in MRCP amplitude. Focal MRCP activity in response to repetitive grasping resulted in minimal changes (i.e. Block 1 versus Block 2) in older adults. Central adaptive processes change across the lifespan, showing increasingly less focal activation in older adults during repetitive grasping. Our findings are consistent with previous paradigms demonstrating more diffuse cortical activation during motor tasks in older adults.
PMCID: PMC3171517  PMID: 21519868
Movement-related cortical potential; Bereitschaftspotential; Central adaptation; Repetitive voluntary contraction; Aging
7.  Resistance training induces supraspinal adaptations: evidence from movement-related cortical potentials 
Early effects of a resistance training program include neural adaptations at multiple levels of the neuraxis, but direct evidence of central changes is lacking. Plasticity exhibited by multiple supraspinal centers following training may alter slow negative electroencephalographic activity, referred to as movement-related cortical potentials (MRCP). The purpose of this study was to determine whether MRCPs are altered in response to resistance training. Eleven healthy participants (24.6 ± 3.5 years) performed 3 weeks of explosive unilateral leg extensor resistance training. MRCP were assessed during 60 self-paced leg extensions against a constant nominal load before and after training. Resistance training was effective (P < 0.001) in increasing leg extensor peak force (+22%), rate of force production (+32%) as well as muscle activity (iEMG; +47%, P < 0.05). These changes were accompanied by several MRCP effects. Following training, MRCP amplitude was attenuated at several scalp sites overlying motor-related cortical areas (P < 0.05), and the onset of MRCP at the vertex was 28% (561 ms) earlier. In conclusion, the 3-week training protocol in the present study elicited significant strength gains which were accompanied by neural adaptations at the level of the cortex. We interpret our findings of attenuated cortical demand for submaximal voluntary movement as evidence for enhanced neural economy as a result of resistance training.
PMCID: PMC2892548  PMID: 20306270
Movement-related cortical potential; Bereitschaftspotential; Resistance training; Neural adaptation
8.  Repeated bout effect is absent in resistance trained men 
A prior bout of exercise is well known to confer protection from subsequent eccentric bouts (i.e. repeated bout effect; RBE), which may be fostered through neural adaptations, specifically a shift in the frequency content of the surface electromyogram (EMG). It is currently not clear whether chronically resistance trained men are capable of a RBE driven by neural adaptations. Eleven resistance trained men (23.5 ± 3.4 yrs) performed 100 eccentric actions of the barbell bench press exercise, followed by an equivalent bout 14 days later. Indirect markers of muscle damage (i.e. force production, soreness) along with surface EMG were measured before and through 48 h of recovery. Median frequency and maximal isometric force demonstrated time main effects (p > 0.05), but no RBE. A prior bout of eccentric exercise does not confer a RBE for indirect markers of muscle injury or elicit changes in the frequency content of the EMG signal in resistance trained men.
PMCID: PMC2783719  PMID: 19059793
Repeated bout effect; Muscle damage; EMG; Eccentric exercise; Bench press
9.  Reference Equation for the Six-Minute Walk in Individuals with Parkinson Disease 
Normal values as well as determining factors for the six-minute walk test are available in healthy adults, but less is known about individuals with Parkinson disease (PD). The purpose of this study was to create a PD-specific reference equation and identify unique factors associated with six-minute walk distance (6MWD). Eighty individuals (66.3 ± 9.8 yrs) with mild to moderate PD underwent a neurologic examination (UPDRS) and completed a small battery of tests to assess their balance confidence, fall risk, mobility, and balance. 6MWD was 394.1 ± 98.4 m (95% confidence interval: 370.0 – 418.1). Stepwise multiple regression analysis demonstrated the timed up-and-go test (TUG), one-leg stance test (OLS), and gender to be significant independent contributors to 6MWD and accounted for 56.6% of the variance. The resulting PD-specific regression equation is as follows: 6MWDpred = 543.06 + (− 10.83*TUG) + (2.04*OLS) + (−44.44*Gender). (For gender: 0 = female, 1 = male). Future interpretation of 6MWD in individuals with PD may be enhanced if expressed as a percentage of the predicted value utilizing this reference equation.
PMCID: PMC2867249  PMID: 20437318
Exercise test; functional capacity; Parkinson disease; walking
10.  Effects of Moderate-Volume, High-Load Lower-Body Resistance Training on Strength and Function in Persons with Parkinson's Disease: A Pilot Study 
Parkinson's Disease  2010;2010:824734.
Background. Resistance training research has demonstrated positive effects for persons with Parkinson's disease (PD), but the number of acute training variables that can be manipulated makes it difficult to determine the optimal resistance training program. Objective. The purpose of this investigation was to examine the effects of an 8-week resistance training intervention on strength and function in persons with PD. Methods. Eighteen men and women were randomized to training or standard care for the 8-week intervention. The training group performed 3 sets of 5–8 repetitions of the leg press, leg curl, and calf press twice weekly. Tests included leg press strength relative to body mass, timed up-and-go, six-minute walk, and Activities-specific Balance Confidence questionnaire. Results. There was a significant group-by-time effect for maximum leg press strength relative to body mass, with the training group significantly increasing their maximum relative strength (P < .05). No other significant interactions were noted (P > .05). Conclusions. Moderate volume, high-load weight training is effective for increasing lower-body strength in persons with PD.
PMCID: PMC2957327  PMID: 20976096
11.  Podokinetic after-rotation in a simulated reduced gravity environment 
Somatosensory & motor research  2008;25(3):188-193.
Stepping in place on a rotating platform for a period of 15 minutes induces an adaptive response, podokinetic after-rotation (PKAR), which causes a blindfolded individual to inadvertently rotate when attempting to step in place on the floor. The purpose of this investigation was to determine whether lower extremity load receptors were involved in this adaptation. As load receptor input is critical for locomotion, we hypothesized that manipulating load via body weight support (BWS) would influence PKAR. Eleven healthy female volunteers performed 15 minutes of stepping in place on a rotating treadmill (stimulation), followed by 10 minutes of stepping in place (response) without vision on a stationary surface. Response and stimulation periods were with 50% body weight support (BWS) and without body weight support (NoBWS) in all four possible combinations (BWS-BWS, NoBWS-NoBWS, BWS-NoBWS, and NoBWS-BWS). Conditions were randomly assigned to all subjects and performed on four separate occasions at least 48 hr apart. During the 10-min PKAR response period, trunk angular velocity was calculated and plotted versus time, and exponential models were applied to the data to obtain curve-fit parameters for each condition. Despite the manipulations of BWS, no significant differences were found for any parameter value (p = 0.13–0.98). BWS applied during stimulation only, response only, or during both stimulation and response does not appear to influence PKAR. This suggests that load receptors may not play a critical role in mediating adaptive changes in locomotor trajectory control in response to walking on a rotating surface.
PMCID: PMC2672566  PMID: 18821283
Podokinetic after-rotation; load receptor; body weight support
12.  Prior exercise and antioxidant supplementation: effect on oxidative stress and muscle injury 
Both acute bouts of prior exercise (preconditioning) and antioxidant nutrients have been used in an attempt to attenuate muscle injury or oxidative stress in response to resistance exercise. However, most studies have focused on untrained participants rather than on athletes. The purpose of this work was to determine the independent and combined effects of antioxidant supplementation (vitamin C + mixed tocopherols/tocotrienols) and prior eccentric exercise in attenuating markers of skeletal muscle injury and oxidative stress in resistance trained men.
Thirty-six men were randomly assigned to: no prior exercise + placebo; no prior exercise + antioxidant; prior exercise + placebo; prior exercise + antioxidant. Markers of muscle/cell injury (muscle performance, muscle soreness, C-reactive protein, and creatine kinase activity), as well as oxidative stress (blood protein carbonyls and peroxides), were measured before and through 48 hours of exercise recovery.
No group by time interactions were noted for any variable (P > 0.05). Time main effects were noted for creatine kinase activity, muscle soreness, maximal isometric force and peak velocity (P < 0.0001). Protein carbonyls and peroxides were relatively unaffected by exercise.
There appears to be no independent or combined effect of a prior bout of eccentric exercise or antioxidant supplementation as used here on markers of muscle injury in resistance trained men. Moreover, eccentric exercise as used in the present study results in minimal blood oxidative stress in resistance trained men. Hence, antioxidant supplementation for the purpose of minimizing blood oxidative stress in relation to eccentric exercise appears unnecessary in this population.
PMCID: PMC2131751  PMID: 17915021
13.  Effect of Protein Intake on Strength, Body Composition and Endocrine Changes in Strength/Power Athletes 
Comparison of protein intakes on strength, body composition and hormonal changes were examined in 23 experienced collegiate strength/power athletes participating in a 12-week resistance training program. Subjects were stratified into three groups depending upon their daily consumption of protein; below recommended levels (BL; 1.0 – 1.4 g·kg-1·day-1; n = 8), recommended levels (RL; 1.6 – 1.8 g·kg-1·day-1; n = 7) and above recommended levels (AL; > 2.0 g·kg-1·day-1; n = 8). Subjects were assessed for strength [one-repetition maximum (1-RM) bench press and squat] and body composition. Resting blood samples were analyzed for total testosterone, cortisol, growth hormone, and insulin-like growth factor. No differences were seen in energy intake (3,171 ± 577 kcal) between the groups, and the energy intake for all groups were also below the recommended levels for strength/power athletes. No significant changes were seen in body mass, lean body mass or fat mass in any group. Significant improvements in 1-RM bench press and 1-RM squat were seen in all three groups, however no differences between the groups were observed. Subjects in AL experienced a 22% and 42% greater change in Δ 1-RM squat and Δ 1-RM bench press than subjects in RL, however these differences were not significant. No significant changes were seen in any of the resting hormonal concentrations. The results of this study do not provide support for protein intakes greater than recommended levels in collegiate strength/power athletes for body composition improvements, or alterations in resting hormonal concentrations.
PMCID: PMC2129168  PMID: 18500968
sport nutrition; resistance training; hormones; testosterone; cortisol
14.  Protein – Which is Best? 
Protein intake that exceeds the recommended daily allowance is widely accepted for both endurance and power athletes. However, considering the variety of proteins that are available much less is known concerning the benefits of consuming one protein versus another. The purpose of this paper is to identify and analyze key factors in order to make responsible recommendations to both the general and athletic populations. Evaluation of a protein is fundamental in determining its appropriateness in the human diet. Proteins that are of inferior content and digestibility are important to recognize and restrict or limit in the diet. Similarly, such knowledge will provide an ability to identify proteins that provide the greatest benefit and should be consumed. The various techniques utilized to rate protein will be discussed. Traditionally, sources of dietary protein are seen as either being of animal or vegetable origin. Animal sources provide a complete source of protein (i.e. containing all essential amino acids), whereas vegetable sources generally lack one or more of the essential amino acids. Animal sources of dietary protein, despite providing a complete protein and numerous vitamins and minerals, have some health professionals concerned about the amount of saturated fat common in these foods compared to vegetable sources. The advent of processing techniques has shifted some of this attention and ignited the sports supplement marketplace with derivative products such as whey, casein and soy. Individually, these products vary in quality and applicability to certain populations. The benefits that these particular proteins possess are discussed. In addition, the impact that elevated protein consumption has on health and safety issues (i.e. bone health, renal function) are also reviewed.
Key PointsHigher protein needs are seen in athletic populations.Animal proteins is an important source of protein, however potential health concerns do exist from a diet of protein consumed from primarily animal sources.With a proper combination of sources, vegetable proteins may provide similar benefits as protein from animal sources.Casein protein supplementation may provide the greatest benefit for increases in protein synthesis for a prolonged duration.
PMCID: PMC3905294  PMID: 24482589
Sport supplementation; ergogenic aid; animal protein; vegetable protein

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