Effects of Ibuprofen Intake in Muscle Damage, Body Temperature and Muscle Power in Paralympic Powerlifting Athletes

of this study is to evaluate the e ect of ingesting ibuprofen on post-workout recovery of muscle damage, body temperature and muscle power indicators in Paralympic powerlifting athletes. The study was carried out with eight Paralympic powerlifting athletes (aged 27.0 5.3 years and 79.9 25.5 kg of body mass) competing at the national level, with a minimum training experience of 12 months, who all submitted to two experimental conditions: Ibuprofen (2 00 mg) and control. The maximal isometric force of the upper limbs and rate of force development, thermography, and serum biochemical analyzes of creatine kinase, lactate dehydrogenase, aspartate aminotransferase and alanine aminotransferase were measured before, after, 24 h after and 48

national level, with a minimum training experience of 12 months, who all submitted to two experimental conditions: Ibuprofen (2 00 mg) and control. The maximal isometric force of the upper limbs and rate of force development, thermography, and serum biochemical analyzes of creatine kinase, lactate dehydrogenase, aspartate aminotransferase and alanine aminotransferase were measured before, after, 24 h after and 48 h after the intervention. Maximal isometric force only decreased in the placebo condition, which increased back to baseline levels, while no substantial decline in baseline force was seen in the ibuprofen condition, although no e ect for exercise condition was detected. After the exercise, the rate of force development decreased signi cantly for both conditions and did not exceed baseline levels again after 48 h. Muscle temperature decreased signi cantly at 48-h post-exercise in the placebo condition, when compared with the previous day of measurement; and deltoid muscle temperature at 48-h post-exercise was higher with the ibuprofen condition. Although the results indicate some positive e ects of ibuprofen use, they do not enable a clear statement regarding its positive e ects on muscle function and muscle damage. Ibuprofen seems to have caused a delay in the anti-in ammatory response following exercise. Keywords:paralympic powerlifting; ibuprofen; muscle function; muscle damage Int. J. Environ. Res. Public Health2020,17, 5157; doi:10.3390 /ijerph17145157 /journal/ijerph

Int. J. Environ. Res. Public Health2020,17, 5157 2 of 9 1. Introduction Training recovery is important, as it ensures that training and success can continue at high intensities and longer durations to further stimulate the body and trigger adaptations [1]. Athletes practice several days a week in elite sports, and several times a day, and if the recovery is not complete, the workload of the training must be decreased [1,2]. The appearance of in ammation, soreness, and the decrease in athletes´performance are associated with exercise-induced muscle damage. It is due to biochemical stress (oxidative stress) and mechanical stress (contractions) that disrupts the muscle cell membrane and damage the muscle bers' Z bands [3]. This exercise-induced muscle damage has long been quanti ed using skeletal muscle protein and enzyme serum levels (creatine kinase (CK), troponin I, and myoglobin) as markers [3]. To speed up recovery processes and prevent muscle soreness, athletes have used various techniques, such as cryotherapy and non-steroidal anti-in ammatory drugs (NSAIDs) (i.e., ibuprofen), both during competition and training [4,5]. Some of these techniques have been used based on scienti cally hypothesized mechanisms, but the results have been inconsistent. Some have reported that ibuprofen had no major e ects on in ammatory response following resistance exercise [6,7], whereas others [8] supported its bene ts in lowering CK levels and reporting lower muscle soreness after eccentric leg curl exercises, though without bene ts in restoring muscle function. A recent metanalysis supports NSAID use as a means to lower strength loss, soreness, and blood creatine kinase level after an acute muscle injury [9] and ibuprofen has been shown to mitigate fatigue in competitive male runners [10]. Although NSAIDs are often used to alleviate exercise-induced muscle soreness and speed up the recovery process after exercise, there is no support for such an e ect on Paralympic powerlifting athletes to date. A potential bene t could come from ibuprofen use during very intense training short-periods (i.e., a week), where athletes seek to accumulate an unusual amount of work. Therefore, this study aims to analyze the e ect of ibuprofen on post-workout recovery in

process after exercise, there is no support for such an e ect on Paralympic powerlifting athletes to date. A potential bene t could come from ibuprofen use during very intense training short-periods (i.e., a week), where athletes seek to accumulate an unusual amount of work. Therefore, this study aims to analyze the e ect of ibuprofen on post-workout recovery in Paralympic powerlifting athletes. Speci cally, this study investigates the potential e ect of ibuprofen ingestion to reduce muscle damage, body temperature, and preserve muscle power. It is hypothesized that the ibuprofen would enhance recovery from powerlifting, as well as reduce muscle damage, body temperature, and preserve muscle power. 2. Materials and Methods 2.1. Participants The present study consisted of a randomized cross-over clinical trial. Eight Paralympic powerlifting athletes volunteered for the study (age=27.0 5.3 years, body mass=79.9 25.3 kg, training experience =3.5 0.2 years, 1RM bench press=133.1 31.4 kg, 1RM/body mass=1.7 0.3). The athletes ful lled all prerequisites of the Brazilian Paralympic Committee [11], and were classi ed as national elite athletes. Two athletes had a spinal cord injury below the eighth thoracic vertebra, one had sequelae due to poliomyelitis, one had cerebral palsy, two had a malformation of the lower limbs, and two were amputated. Athletes were not included in the study if they (1) reported the consumption of banned substances, (2) had been previously diagnosed with cardiac or metabolic disease, or (3) were involved in any process to induce rapid weight loss at the time of recruitment. The athletes participated voluntarily and signed an informed consent form in accordance with Resolution 466/2012 of the National Commission for Research Ethics (CONEP) of the National Health Council, and the ethical principles of the latest version of the Declaration of Helsinki 2013 (and the World Medical Association). This study was approved by the Research Ethics Committee of the Federal University of Sergipe, CAAE: 79909917.0.0000.55.46. 2.2. Experimental Design All athletes underwent a 1 repetition maximal (1RM) bench press test twice, with a 48 h rest between tests. After a standardized warm-up, each subject started the attempts with a weight that he

2013 (and the World Medical Association). This study was approved by the Research Ethics Committee of the Federal University of Sergipe, CAAE: 79909917.0.0000.55.46. 2.2. Experimental Design All athletes underwent a 1 repetition maximal (1RM) bench press test twice, with a 48 h rest between tests. After a standardized warm-up, each subject started the attempts with a weight that he

Int. J. Environ. Res. Public Health2020,17, 5157 3 of 9 believed could be lifted only once using maximum e ort. Increases in weight were added until the maximum load that could be lifted once was reached. If the athlete failed to perform a single repetition, 2.5% of the load used in the test were subtracted [12]. The subjects rested for 3–5 min between attempts. The largest record between the two sessions was taken as the individual´s 1RM. Coe cient of variation between the two measures was ICC>93%. On the subsequent two weeks, participants underwent a training session with bench press exercises with one week in between. All participants randomly trained using the two di erent recovery methods: ingesting placebo (PLA) or ibuprofen (IBU). All assessments were carried out 30 min before the training started, immediately at the end, 24 h and 48 h after the training (Table). Assessments included: (i) Measurement of muscle function; (ii) thermography; and (iii) blood collections. Table 1.Experimental design. Week Day Day Day Week 1 Day 1 1RM test Day 2 1RM re-test Week 2 (experiment) Day 3 Pre-exercise data TrainingInt. J. Environ. Res. Public Health 2020, 17, x 3 of 10 believed could be lifted only once using maximum effort. Increases in weight were added until the maximum load that could be lifted once was reached. If the athlete failed to perform a single repetition, 2.5% of the load used in the test were subtracted [12]. The subjects rested for 3–5 min between attempts. The largest record between the two sessions was taken as the individual´s 1RM. Coefficient of variation between the two measures was ICC > 93%. On the subsequent two weeks, participants underwent a training session with bench press exercises with one week in between. All participants randomly trained using the two different recovery methods: ingesting placebo (PLA) or ibuprofen (IBU). All assessments were carried out 30 min before the training started, immediately at the end, 24 h and 48 h after the training (Table 1). Assessments included: (i) Measurement of muscle function; (ii) thermography; and (iii) blood collections. The intervention protocol consisted

in between. All participants randomly trained using the two different recovery methods: ingesting placebo (PLA) or ibuprofen (IBU). All assessments were carried out 30 min before the training started, immediately at the end, 24 h and 48 h after the training (Table 1). Assessments included: (i) Measurement of muscle function; (ii) thermography; and (iii) blood collections. The intervention protocol consisted of warm-up for upper limbs, using three exercises (abduction of the shoulders with dumbbells, elbow extension in the pulley and rotation of the shoulders with dumbbells) with three sets of 10 to 20 repetitions [13]. Soon after, a specific warm-up was performed on the bench press with a 30% load of 1RM, 10 slow repetitions (3:1 s, eccentric: concentric) and 10 fast repetitions (1:1 s, eccentric: concentric). This was followed with five sets of bench press of five maximum repetitions (5 sets—85 at 90% RM), using a fixed load. The complete session lasted for 1 h 30 min. During the test, athletes received verbal encouragement to achieve maximum performance [13]. To perform the bench press, an official straight bench (Eleiko, Chicago, IL, USA), approved by the International Paralympic Committee [11] was used. Ingestion of IBU (ibuprofen) or PLA (placebo) occurred 15 min before and 5 h post-training, according to De Souza et al. [10]. Participants received two capsules of IBU (each capsule containing 400 mg) and were instructed to ingest one capsule before training and one capsule post-training. In the control condition, two flour capsules were delivered. Both IBU and PLA were packaged in identical capsules. The experiment was double-blind, and the order of distribution of the capsules was determined at random. Table 1. Experimental design. Week Day Day Day Week 1 Day 1 1RM test Day 2 1RM re-test Week 2 (experiment) Day 3 Pre-exercise data Training Day 3 Post-exercise data Day 4 and Follow-up 24 and 48 h Week 3 (experiment) Day 6 Pre-exercise data Training Day 7 Post-exercise data Day 8 and 9 Follow-up 24 and 48 h 2.3. Measurements The evaluations of maximal isometric force and rate of force development (RFD) were determined by a Muscle

Week 2 (experiment) Day 3 Pre-exercise data Training Day 3 Post-exercise data Day 4 and Follow-up 24 and 48 h Week 3 (experiment) Day 6 Pre-exercise data Training Day 7 Post-exercise data Day 8 and 9 Follow-up 24 and 48 h 2.3. Measurements The evaluations of maximal isometric force and rate of force development (RFD) were determined by a Muscle Lab load cell (Model PFMA 3010 and Muscle Lab System; Ergotest, Langesund, Norway), attached to the bench by Spider HMS carabiners (Simond, Chamonix, France) and a steel chain with breaking loads of 21 kg and 2300 kg, respectively. The perpendicular distance between the load cell and the center of the joint was determined to calculate the joint torque [14]. Each subject performed three repetitions of 5 s of maximal effort with 10min of rest between repetitions to measure maximal isometric force [15]. A steel chain was used to fix the load cell to the bench. The perpendicular distance between the load cell and the center of the joint was adjusted so that there was approximately 90º of elbow angle, and 15 cm from the bar to the external bone. The RFD was determined using the force to time ratio until reaching the maximal force (RFD = ΔStrength/ΔTime) [14,16]. This distance was determined by measuring the range of motion with a goniometer (FL6010, Sanny, São Paulo, Brazil). Day 3 Post-exercise data Day 4 and Follow-up 24 and 48 h Week 3 (experiment) Day 6 Pre-exercise data TrainingInt. J. Environ. Res. Public Health 2020, 17, x 3 of 10 believed could be lifted only once using maximum effort. Increases in weight were added until the maximum load that could be lifted once was reached. If the athlete failed to perform a single repetition, 2.5% of the load used in the test were subtracted [12]. The subjects rested for 3–5 min between attempts. The largest record between the two sessions was taken as the individual´s 1RM. Coefficient of variation between the two measures was ICC > 93%. On the subsequent two weeks, participants underwent a training session with bench press exercises with one

repetition, 2.5% of the load used in the test were subtracted [12]. The subjects rested for 3–5 min between attempts. The largest record between the two sessions was taken as the individual´s 1RM. Coefficient of variation between the two measures was ICC > 93%. On the subsequent two weeks, participants underwent a training session with bench press exercises with one week in between. All participants randomly trained using the two different recovery methods: ingesting placebo (PLA) or ibuprofen (IBU). All assessments were carried out 30 min before the training started, immediately at the end, 24 h and 48 h after the training (Table 1). Assessments included: (i) Measurement of muscle function; (ii) thermography; and (iii) blood collections. The intervention protocol consisted of warm-up for upper limbs, using three exercises (abduction of the shoulders with dumbbells, elbow extension in the pulley and rotation of the shoulders with dumbbells) with three sets of 10 to 20 repetitions [13]. Soon after, a specific warm-up was performed on the bench press with a 30% load of 1RM, 10 slow repetitions (3:1 s, eccentric: concentric) and 10 fast repetitions (1:1 s, eccentric: concentric). This was followed with five sets of bench press of five maximum repetitions (5 sets—85 at 90% RM), using a fixed load. The complete session lasted for 1 h 30 min. During the test, athletes received verbal encouragement to achieve maximum performance [13]. To perform the bench press, an official straight bench (Eleiko, Chicago, IL, USA), approved by the International Paralympic Committee [11] was used. Ingestion of IBU (ibuprofen) or PLA (placebo) occurred 15 min before and 5 h post-training, according to De Souza et al. [10]. Participants received two capsules of IBU (each capsule containing 400 mg) and were instructed to ingest one capsule before training and one capsule post-training. In the control condition, two flour capsules were delivered. Both IBU and PLA were packaged in identical capsules. The experiment was double-blind, and the order of distribution of the capsules was determined at random. Table 1. Experimental design. Week Day Day Day Week 1 Day 1 1RM test Day 2 1RM

ingest one capsule before training and one capsule post-training. In the control condition, two flour capsules were delivered. Both IBU and PLA were packaged in identical capsules. The experiment was double-blind, and the order of distribution of the capsules was determined at random. Table 1. Experimental design. Week Day Day Day Week 1 Day 1 1RM test Day 2 1RM re-test Week 2 (experiment) Day 3 Pre-exercise data Training Day 3 Post-exercise data Day 4 and Follow-up 24 and 48 h Week 3 (experiment) Day 6 Pre-exercise data Training Day 7 Post-exercise data Day 8 and 9 Follow-up 24 and 48 h 2.3. Measurements The evaluations of maximal isometric force and rate of force development (RFD) were determined by a Muscle Lab load cell (Model PFMA 3010 and Muscle Lab System; Ergotest, Langesund, Norway), attached to the bench by Spider HMS carabiners (Simond, Chamonix, France) and a steel chain with breaking loads of 21 kg and 2300 kg, respectively. The perpendicular distance between the load cell and the center of the joint was determined to calculate the joint torque [14]. Each subject performed three repetitions of 5 s of maximal effort with 10min of rest between repetitions to measure maximal isometric force [15]. A steel chain was used to fix the load cell to the bench. The perpendicular distance between the load cell and the center of the joint was adjusted so that there was approximately 90º of elbow angle, and 15 cm from the bar to the external bone. The RFD was determined using the force to time ratio until reaching the maximal force (RFD = ΔStrength/ΔTime) [14,16]. This distance was determined by measuring the range of motion with a goniometer (FL6010, Sanny, São Paulo, Brazil). Day 7 Post-exercise data Day 8 and 9 Follow-up 24 and 48 h The intervention protocol consisted of warm-up for upper limbs, using three exercises (abduction of the shoulders with dumbbells, elbow extension in the pulley and rotation of the shoulders with dumbbells) with three sets of 10 to 20 repetitions [13]. Soon after, a speci c warm-up was performed on the bench

data Day 8 and 9 Follow-up 24 and 48 h The intervention protocol consisted of warm-up for upper limbs, using three exercises (abduction of the shoulders with dumbbells, elbow extension in the pulley and rotation of the shoulders with dumbbells) with three sets of 10 to 20 repetitions [13]. Soon after, a speci c warm-up was performed on the bench press with a 30% load of 1RM, 10 slow repetitions (3:1 s, eccentric: concentric) and 10 fast repetitions (1:1 s, eccentric: concentric). This was followed with ve sets of bench press of ve maximum repetitions (5 sets—85 at 90% RM), using a xed load. The complete session lasted for 1 h 30 min. During the test, athletes received verbal encouragement to achieve maximum performance [13]. To perform the bench press, an o cial straight bench (Eleiko, Chicago, IL, USA), approved by the International Paralympic Committee [11] was used. Ingestion of IBU (ibuprofen) or PLA (placebo) occurred 15 min before and 5 h post-training, according to De Souza et al. [10]. Participants received two capsules of IBU (each capsule containing 400 mg) and were instructed to ingest one capsule before training and one capsule post-training. In the control condition, two our capsules were delivered. Both IBU and PLA were packaged in identical capsules. The experiment was double-blind, and the order of distribution of the capsules was determined at random. 2.3. Measurements The evaluations of maximal isometric force and rate of force development (RFD) were determined by a Muscle Lab load cell (Model PFMA 3010 and Muscle Lab System; Ergotest, Langesund, Norway), attached to the bench by Spider HMS carabiners (Simond, Chamonix, France) and a steel chain with breaking loads of 21 kg and 2300 kg, respectively. The perpendicular distance between the load cell and the center of the joint was determined to calculate the joint torque [14]. Each subject performed three repetitions of 5 s of maximal e ort with 10min of rest between repetitions to measure maximal isometric force [15]. A steel chain was used to x the load cell to the bench. The perpendicular distance between the load cell

load cell and the center of the joint was determined to calculate the joint torque [14]. Each subject performed three repetitions of 5 s of maximal e ort with 10min of rest between repetitions to measure maximal isometric force [15]. A steel chain was used to x the load cell to the bench. The perpendicular distance between the load cell and the center of the joint was adjusted so that there was approximately 90 of elbow angle, and 15 cm from the bar to the external bone. The RFD was determined using the force to time ratio until reaching the maximal force (RFD=DStrength/DTime) [14,16]. This distance was determined by measuring the range of motion with a goniometer (FL6010, Sanny, S¢o Paulo, Brazil).

This study investigates ibuprofen's effects on recovery in Paralympic powerlifting athletes.