Original Research

Repeated Plyometric Exercise Attenuates Blood Glucose in Healthy

Adults

SALDIAM R. BARILLAS‡, CASEY M. WATKINS†, MEGAN A. WONG†, IAN J.

DOBBS†, DAVID C. ARCHER‡, CAMERON N. MUNGER‡, ANDREW J.
GALPIN‡, JARED W. COBURN‡, and LEE E. BROWN‡

Human Performance Laboratory, Department of Kinesiology, California State

University, Fullerton, Fullerton, CA, USA

†Denotes graduate student author, ‡Denotes professional author

ABSTRACT
International Journal of Exercise Science 10(7): 1076-1084, 2017. Plyometric exercise
is popular in commercial exercise programs aiming to maximize energy expenditure for weight
loss. However, the effect of plyometric exercise on blood glucose is unknown. The purpose of this
study was to investigate the effect of relatively high intensity plyometric exercise on blood
glucose. Thirteen subjects (6 females age= 21.8 ± 1.0 yrs.; height= 163.7 ± 7.8 cm; mass= 60.8 ± 6.7
kg and 7 males age= 22.0 ± 2.6 yrs.; height= 182.3 ± 3.6 cm; mass= 87.4 ± 12.5 kg) volunteered to
participate. Subjects completed two random conditions on two separate days, consisting of either
five sets of 10 maximal effort countermovement squat jumps (SJ) with 50 seconds’ rest between
sets or quiet sitting (SIT) for the time equated to the SJ duration (~4min). Immediately after each
condition, subjects drank 75g of anhydrous glucose (CHO) in 100ml of water. Blood glucose
measurements were taken via finger prick pre and immediately post SJ or SIT, and 5, 15, 30, and
60 min post. A 2x6 (condition x time) ANOVA revealed a significant interaction where SJ blood
glucose was lower at 15 (114.0 ± 14.6 mg/dl) and 30 (142.1 ± 22.5 mg/dl) min compared to SIT
(15min 130.8 ± 14.0 mg/dl and 30min 159.3 ± 21.0 mg/dl). The current plyometric protocol
attenuated CHO-induced blood glucose at 15 and 30 min. This may be due to increased
physiological stress applied to the muscles, thus increasing muscular glucose uptake.

KEY WORDS: Glycemic control, jump, diabetes, interval training

INTRODUCTION

The prevalence of diabetes in the United States in 2012 was 14.3%, which has increased from
10% in 1999 (8). Impaired glucose metabolism is the underlying mechanism in diabetes (25).
Carbohydrates are substrate macronutrients that release energy for cellular demands.
Carbohydrates broken down in the gut lead to elevated blood glucose concentrations. The
body stores the excess blood glucose in adipose, muscle, or liver tissue (21). Fasting blood
glucose at or below 99 mg/dl indicates normal glucose metabolism (2, 4, 21, 25, 34) while a
 Int J Exerc Sci 10(7): 1076-1084, 2017

value above 100 mg/dl is considered pre-diabetic or diabetic (2, 4, 21, 25, 34). Exercise is on the
forefront of treatment options for glucose metabolic diseases due to its low price and
effectiveness. Exercise prescription with high intensity, short duration and/or Type II muscle
fiber recruitment increases glycogenolysis (21). This causes an elevation in glycogen synthase,
which increases blood glucose uptake and replenishes glycogen concentrations in the resting
muscle (21).

Aerobic exercise commonly involves low intensity, long duration bouts. Walking is a modality
of aerobic exercise that decreases blood glucose in Type 2 diabetic individuals, with an
additive effect if they walk at a higher intensity (13). Running type interventions based on
heart rate and or oxygen consumption have shown both positive (7, 36) and no relationships
(6, 9, 10) in controlling blood glucose. However, exercise adherence is a limiting factor in these
interventions designed to regulate blood glucose (6, 7, 9-11, 13, 17, 23, 24, 28, 33, 36).

Resistance training is variable, utilizing moderate to high intensities and low to high volumes.
It has been shown to be effective at decreasing blood glucose immediately post exercise (24),
and after 12 (23, 33), and 16 weeks (28), but has also been shown to have no effect (30).
Physiological blood glucose adaptations to resistance training have been shown to be similar
to aerobic training (3, 12, 15, 22, 27, 29, 37), while reducing total workout time. A dilemma with
resistance training for affecting blood glucose is that there is no standardized protocol to
follow relative to intensity and duration, thus the mixed results. High intensity, interval
training structured in a short duration model have been shown to decrease blood glucose (3,
12, 15, 22, 27, 29, 37). Jump plyometrics are a form of short duration, high intensity exercise
that normally involve low repetitions, thereby reducing fatigue and maximizing the storage
and release of kinetic energy (32). Furthermore, plyometric exercise training duration has been
shown to be significantly less than resistance or aerobic exercise training (20). One limiting
factor for current short duration, high intensity protocols is the necessary use of technical
equipment (e.g. cycle ergometer), which are not practical for the lay person due to their
expense.

Current literature has focused on performance adaptations to plyometric exercise (16, 17, 19)
with clear implications for strength and conditioning. Physiological adaptations such as,
increased bone mineral density (14, 18, 26), muscle strength (16, 31), neuromuscular function
(1, 5), and cardiorespiratory function (38) have been reported with plyometric exercise. In this
manner, plyometrics fit the short duration, high intensity profile and should elicit similar
responses in acute blood glucose, but have not been investigated.

Current effective protocols at increasing blood glucose regulation are limited by time,
equipment, and expense making them impractical to prescribe on a scale that matches the
prevalence of glucose metabolic diseases. Plyometric exercise is a more practical form of short
duration, high intensity exercise. Therefore, the purpose of this study was to investigate the
acute effect of plyometric exercise on blood glucose.

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METHODS

Participants
Assuming an effect size f of 0.25, a power of 80%, and a correlation of r=0.80 between repeated
measures, a power analysis estimated a sample size of 12 subjects. Thirteen recreationally
resistance trained participants, (age range 19-29; 6 females age=21.8 ± 1.0 yrs.; height=163.7 ±
7.8 cm; mass=60.8 ± 6.7 kg and 7 males age=22.0 ± 2.6 yrs.; height=182.3 ± 3.6 cm; mass=87.4 ±
12.5 kg) with no lower body injuries within the last year were recruited from within a
University Kinesiology program. Inclusion criteria were to be currently engaged in habitual
plyometric exercise (≥1 plyometric exercise per week for the past 6 months) and resistance
training (>3 resistance training days per week for the past 6 months). Additional inclusion
criteria was the ability to achieve 80% of age predicted max heart rate (APMHR) following the
plyometric exercise. Participants read and signed a University IRB approved informed consent
form before testing began.

Protocol
Familiarization: Height and mass were recorded using a scale (ES200L; Ohaus Corporation
Pinebrook, NJ, USA) and stadiometer (752KL, Seca; Ontario, CA) on day one. They then
performed a dynamic warm-up consisting of walking knee hugs, reverse lunges, single leg
hamstring bows, and side lunges twice for 10 meters. Participants were then familiarized with
the squat jump protocol by standing inside a four-square foot box with their feet slightly wider
than hip width. They extended their arms over head with a slight bend in the elbows followed
by squatting down and swinging their arms to perform a counter movement maximal effort
jump. Participants performed three jumps with maximal effort for familiarization. They were
instructed and encouraged to perform these maximal effort counter movements jumps 10
times. Participants were also familiarized with a finger prick blood draw. They returned for
days two and three after an eight-hour fast. Additionally, they were asked to refrain from
resistance training or alcohol consumption for 48 and 24 hours, respectively.

Plyometric or Control Intervention: Days 2 and 3 were randomized where participants

performed either squat jumps (SJ) or quiet sitting (SIT). Whichever one they did not do on day
two was completed on day three. Participants could work quietly for the hour of blood glucose
measurements post SJ or SIT.

Participants arrived on both day two and three and sat for 10 min. They then performed the
same warm up as day one. After the warm up they either performed SJ or SIT conditions. For
SJ they were instructed to stand inside a four-square foot box and perform five sets of 10
maximal effort counter movement jumps with 50 seconds of standing rest. For SIT they sat for
a time that was equated to the SJ condition which was predetermined by the time of the 10-
maximal effort counter movement jumps on day one multiplied by four with 200 seconds
added (~4min).

Measuring Blood Glucose: Blood glucose was measured using a glucose meter (Accu-Chek
Performa, Indianapolis, IN). Participant’s blood was drawn with a lancing device (Accu-Chek

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Softclix Plus, Indianapolis, IN) on the fourth and fifth phalange tip. Fasting blood glucose was
measured after the initial 10 min of quiet sitting (pre) and immediately post the SJ or SIT
conditions. They ingested a 75g load of anhydrous glucose (CHO) dissolved in 100 ml of water
within two min of finishing SJ or SIT. Dosage amount is consistent with previous research (36,
37). Blood glucose was then measured at 5, 15, 30, and 60 min post the drink.

Statistical Analysis
Data were analyzed using a 2x6 (condition x time) analysis of variance (ANOVA). Main effects
were followed up with pairwise comparisons. An alpha level of 0.05 was used to determine
statistical significance, and SPSS version 23.0 software (SPSS, Inc., Chicago, IL, USA) was used
for all analyses.

RESULTS

For blood glucose, there was a significant two-way interaction. This was followed up with two
1X6 ANOVAs for time, one for each condition.

Pairwise comparisons revealed that SJ and SIT at 5, 15, 30 and 60 min post were significantly
greater than baseline (table 1). Also, SJ blood glucose was lower at 15 and 30 min post
compared to SIT (table 1).

Table 1. Blood glucose (mean ± SD mg/dl) between time and squat jump (SJ) and sitting (SIT) conditions.
SJ SIT
Baseline 93.8 ± 8.8 94.9 ± 8.7
Immediately Post 98.2 ± 8.1 97.0 ± 7.8
5m Post 106.1 ± 9.5* 106.1 ± 12.8*
15m Post 114.0 ± 14.6*† 130.8 ± 14.0*
30m Post 142.1 ± 22.5*† 159.3 ± 21.0*
60m Post 146.5 ± 34.1* 144.6 ± 19.1*
* = Significantly greater than baseline (p<0.05). † = Significantly less than SIT value (p<0.05)

DISCUSSION

The purpose of this study was to investigate the effect of plyometric exercise on blood glucose.
Our results demonstrated there was a significant decrease in glucose at 15m and 30m
following SJ exercise when compared to sitting rest. Therefore, it appears that an exercise
protocol of five sets of 10 maximal effort counter movement jumps places enough
physiological stress on recreationally resistance trained males and females to elicit an
attenuated blood glucose response post CHO ingestion. A possible factor for this response
could be a cardiovascular intensity of 80% APMHR providing adequate physiological stress to
the muscles, thus increasing muscular glucose uptake.

Mul et al. conducted a review of current literature surrounding the role of exercise in glucose
uptake (21). Skeletal muscle has energy substrates that originate from either glucose or
triglyceride like compounds. Glycogenolysis, breakdown of glycogen, is increased by either
increasing duration, intensity of the exercise, or utilizing Type II muscle fibers, followed by an

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increase in glycogen synthase. However, the transportation process is the rate-limiting step for
glucose utilization; hence, exercise promotes glucose uptake into the liver, skeletal muscle, and
adipose tissue. Therefore, increasing intensity of the exercise may elicit better glucose
regulation.

Intensity of exercise can be graded as low, moderate, or high and can be defined by heart rate,
maximal effort, or % V02max (3, 7). Dube et al, had participants cycle at 75% peak HR and
found blood glucose uptake was increased greater when higher kilocalories were expended
(7). Little et al. utilized 90% and 65% peak HR and found blood glucose was better regulated
post exercise with higher intensity (15). Babraj compared a maximal effort Wingate protocol to
continuous self-paced cycling and found a chronic adaptation of increased blood glucose
regulation with the Wingate protocol (3). Intensity can also be graded by percentage of peak
energy expenditure (pEE). Karlsoft et al. measured intensities of interval walking above and
below 75% pEE, and continuous constant walking at 55% pEE (13). Steps per day did not differ
between conditions. However, a decrease in body mass adiposity and lower blood glucose
with an increase in VO2max were only shown in interval walking. The present study varied
intensity by heart rate with the same number of jumps and rest per participant. The inclusion
of 80% APMHR fits within prior investigations that used 70-90% of peak HR (7, 13, 15).
Similarly, the present study showed lower blood glucose following SJ at 15 and 30 min,
possibly due to the relatively high intensity of the protocol. Glycogen utilization is dependent
on exercise intensity and duration (21). Therefore, the current study exhibits exponential
glycogen utilization with increased exercise intensity (35).

Exercise choice can be categorized by oxygen consumption, anaerobic, aerobic, force

production, continuous or plyometric. Ortega et al. demonstrated increased acute blood
glucose uptake at 30m, 24h, and 48h post-exercise with sprint and aerobic exercise compared
to no exercise, and greater positive effects at 30 min’ post with sprint training compared to
aerobic training (22). Little et al. reported similar findings with blood glucose uptake being
greater with sprint training compared to aerobic training (15). Andersen et al. utilized an
exercise choice of soccer skills to elicit an increase in blood glucose uptake (2). The present
study demonstrated lower blood glucose in the SJ condition at 15m and 30m. Plyometric
exercise is dependent on reducing the amount of time spent on the ground and maximizing
the time spent in the air, thus utilizing high force production and velocity to overcome
gravitational forces. This force-velocity couple requires usage of Type II muscle fibers at high
intensities that stimulates blood glucose uptake into the working muscles (21).

Exercise volume can be varied by duration, sets or repetitions. Little et al. varied volume by
having subjects perform either 10 sets of one-min cycle sprints or 30 min of continuous cycling
(15). Ortega et al. used either four sets of 30 second maximal effort cycle sprints, or 60, or 30
min of continuous cycling and found that the lower volume protocols increased blood glucose
regulation greater than the higher volume protocols (22). The present study lasted less than
five min overall, while work bouts were one min. The average duration of one set for the
current plyometric protocol was 11 seconds whereas prior research has utilized no less than 30
seconds. However, there was a decrease in blood glucose with the current exercise

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prescription. Plyometric exercise sets rarely last more than four – six repetitions in order to
reduce fatigue and maximize storing and releasing of kinetic energy (1). The low volume
prescription used in the present study may have been mediated by the high intensity.
Increasing volume and intensity stimulates muscle glycogen depletion and decreases blood
glucose. However, in a practical sense, volume directly relates to duration as greater volume
takes a longer time to complete. In contrast, with increased intensity a low duration can be
maintained, yet still stimulate blood glucose uptake.

Fitness level refers to an individual’s physiological capabilities in relation to exercise. Young

healthy sedentary or recreationally active men have shown an increase in blood glucose
regulation when performing six sets of 30 second maximal effort sprints (3). However, when
comparing trained, low BMI, and untrained, high BMI, participants with the same exercise
protocol, lean participants had significantly less blood glucose uptake following exercise when
compared to untrained participants (9). The current study demonstrated a decrease in blood
glucose following SJ among recreationally resistance trained adults. Our population was
healthy and able to achieve elevated heart rates with our protocol, eliciting enough
physiological stress to stimulate change in blood glucose regulation. Trained populations may
not show an effect with this protocol due to cardiovascular efficiency providing energy for
maximal effort jumps with sub maximal heart rates, thus muscle glycogen would not deplete
enough to increase blood glucose uptake.

Variance in fitness of the participants, exercise choice, volume or intensity may have played a
role in the results of the present study. Future studies may want to investigate various exercise
prescriptions that reach 80% APMHR with untrained and diabetic populations to further
investigate the effect of plyometric exercise on blood glucose. Reaching 80% APMHR might be
the desired physiological stress level to stimulate a change in blood glucose.

The present study demonstrated that an exercise protocol of five sets of 10 maximal effort
counter movement placed enough physiological stress on recreationally resistance trained
males and females to elicit an attenuated blood glucose response post CHO ingestion.
However, this type of exercise may require skill and could possibly be unsafe for special
populations, such as Type II diabetics, the elderly, low bone mineral density, etc. Future
research should examine exercise selection with similar movement patterns, such as medicine
ball slams, squats, kettle bell swings, etc. to elicit similar effects.

REFERENCES

1. Ache-Dias J, Dellagrana RA, Teixeira AS, Dal Pupo J, Moro AR. Effect of jumping interval training on
neuromuscular and physiological parameters: a randomized controlled study. Appl Physiol Nutr Metab 41(1):20-
5, 2016.

2. Andersen TR, Schmidt JF, Thomassen M, Hornstrup T, Frandsen U, Randers MB, Hansen PR, Krustrup P,
Bangsbo J. A preliminary study: effects of football training on glucose control, body composition, and
performance in men with type 2 diabetes. Scand J Med Sci Sports 24 Suppl 1:43-56, 2014.

International Journal of Exercise Science http://www.intjexersci.com

1081
 Int J Exerc Sci 10(7): 1076-1084, 2017

3. Babraj JA, Vollaard NB, Keast C, Guppy FM, Cottrell G, Timmons JA. Extremely short duration high intensity
interval training substantially improves insulin action in young healthy males. BMC Endocr Disord 9:3, 2009.

4. Boule NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in
type 2 diabetes mellitus: A meta-analysis of controlled cinical trials. JAMA 286:1218-27, 2001.

5. Cadore EL, Pinheiro E, Izquierdo M, Correa CS, Radaelli R, Martins JB, Lhullier FLR, Laitano O, Cardoso M,
Pinto RS. Neuromuscular, hormonal, and metabolic responses to different plyometric training volumes in rugby
players. J Strength Cond Res 27(11):3001-10, 2013.

6. Ciolac EG, Bocchi EA, Bortolotto LA, Carvalho VO, Greve JM, Guimaraes GV. Effects of high-intensity aerobic
interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young
normotensive women at high familial risk for hypertension. Hypertens Res 33(8):836-43, 2010.

7. Dube JJ, Allison KF, Rousson V, Goodpaster BH, Amati F. Exercise dose and insulin sensitivity: relevance for
diabetes prevention. Med Sci Sports Exerc 44(5):793-9, 2012.

8. Dwyer-Lindgren L, Mackenbach JP, Van Lenthe FJ, Flaxman AD, Mokdad AH. Diagnosed and undiagnosed
diabetes prevalence by county in the U.S., 1999-2012. Diabetes Care 39:1556-62, 2016.

9. Glynn EL, Piner LW, Huffman KM, Slentz CA, Elliot-Penry L, AbouAssi H, White PJ, Bain JR, Muehlbauer MJ,
Ilkayeva OR, Stevens RD, Porter Starr KN, Bales CW, Volpi E, Brosnan MJ, Trimmer JK, Rolph TP, Newgard CB,
Kraus WE. Impact of combined resistance and aerobic exercise training on branched-chain amino acid turnover,
glycine metabolism and insulin sensitivity in overweight humans. Diabetologia 58(10):2324-35, 2015.

10. Hittel DS, Axelson M, Sarna N, Shearer J, Huffman KM, Kraus WE. Myostatin decreases with aerobic exercise
and associates with insulin resistance. Med Sci Sports Exerc 42(11):2023-9, 2010.

11. Ishiguro H, Kodama S, Horikawa C, Fujihara K, Hirose AS, Hirasawa R, Yachi Y, Ohara N, Shimano H,
Hanyu O, Sone H. In search of the ideal resistance training program to improve glycemic control and its
indication for patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Sports Med 46(1):67-
77, 2016.

12. Jelleyman C, Yates T, O'Donovan G, Gray LJ, King JA, Khunti K, Davies MJ. The effects of high-intensity
interval training on glucose regulation and insulin resistance: a meta-analysis. Obes Rev 16(11):942-61, 2015.

13. Karstoft K, Winding K, Knudsen SH, Nielsen JS, Thomsen C, Pedersen BK, Solomon TP. The effects of free-
living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic
patients: a randomized, controlled trial. Diabetes Care 36(2):228-36, 2013.

14. Kato T, Terashima T, Yamashita T, Hatanaka Y, Honda A, Umemura Y. Effect of low-repetition jump training
on bone mineral density in Young Women. J Appl Physiol 100:839-43, 2005.

15. Little JP, Jung ME, Wright AE, Wright W, Manders RJ. Effects of high-intensity interval exercise versus
continuous moderate-intensity exercise on postprandial glycemic control assessed by continuous glucose
monitoring in obese adults. Appl Physiol Nutr Metab 39(7):835-41, 2014.

16. Macaluso F, Isaacs AW, Myburgh KH. Preferential type II muscle fiber damage from plyometric exercise. J
Athl Train 47(4):414-20, 2012.

17. MacDonald CJ, Lamont HS, Garner JC. A comparison of the effects of 6 weeks of traditional resistance
training, plyometric training, and complex training on measures of strength and anthropometrics. J Strength
Cond Res 26(2):422-31, 2012.

International Journal of Exercise Science http://www.intjexersci.com

1082
 Int J Exerc Sci 10(7): 1076-1084, 2017

18. Maggio AB, Rizzoli RR, Marchand LM, Ferrari S, Beghetti M, Farpour-Lambert NJ. Physical activity increases
bone mineral density in children with type 1 diabetes. Med Sci Sports Exerc 44(7):1206-11, 2012.

19. Michailidis Y, Fatouros IG, Primpa E, Michailidis C, Avloniti A, Chatzinikolaou A, Barbero-Alvarez JC,
Tsoukas D, Douroudos II, Draganidis D, Leontsini D, Margonis K, Berberidou F, Kambas A. Plyometrics'
trainability in preadolescent soccer atheletes. J Strength Cond Res 27(1):38-49, 2013.

20. Moreno SD, Brown, L. E., Coburn, J. W., Judelson, D. A. Effect of cluster sets on plyometric jump power. J
Strength Cond Res 28(9):2424-8, 2014.

21. Mul JD, Stanford KI, Hirshman MF, Goodyear LJ. Exercise and regulation of carbohydrate metabolism. Prog
Mol Biol Transl Sci 135:17-37, 2015.

22. Ortega JF, Fernandez-Elias VE, Hamouti N, Pallares JG, Mora-Rodriguez R. Higher insulin-sensitizing
response after sprint interval compared to continuous exercise. Int J Sports Med 36(3):209-14, 2015.

23. Park BS, Khamoui AV, Brown LE, Kim DY, Han KA, Min KW, An GH. Effects of elastic band resistance
training on glucose control, body composition, and physical function in women with short- vs. long-duration
type 2 diabetes. J Strength Cond Res 2015.

24. Praet SF, Manders RJ, Lieverse AG, Kuipers H, Stehouwer CD, Keizer HA, van Loon LJ. Influence of acute
exercise on hyperglycemia in insulin-treated type 2 diabetes. Med Sci Sports Exerc 38(12):2037-44, 2006.

25. Qiu S, Cai X, Schumann U, Velders M, Sun Z, Steinacker JM. Impact of walking on glycemic control and other
cardiovascular risk factors in type 2 diabetes: a meta-analysis. PLoS One 9(10):e109767, 2014.

26. Reiger J, Yingling VR. The effects of short-term jump training on bone metabolism in females using oral
contraceptives. J Sports Sci 34(3):259-66, 2016.

27. Richards JC, Johnson TK, Kuzma JN, Lonac MC, Schweder MM, Voyles WF, Bell C. Short-term sprint interval
training increases insulin sensitivity in healthy adults but does not affect the thermogenic response to beta-
adrenergic stimulation. J Physiol 588(Pt 15):2961-72, 2010.

28. Shaibi GQ, Cruz ML, Ball GDC, Weigensberg MJ, Salem GJ, Crespo NC, Goran MI. Effects of resistance
training on insulin sensitivity in overweight Latino adolescent males. Med Sci Sports Exerc 38(7):1208-15, 2006.

29. Skelly LE, Andrews PC, Gillen JB, Martin BJ, Percival ME, Gibala MJ. High-intensity interval exercise induces
24-h energy expenditure similar to traditional endurance exercise despite reduced time commitment. Appl
Physiol Nutr Metab 39(7):845-8, 2014.

30. Stensvold D, Tjonna AE, Skaug EA, Aspenes S, Stolen T, Wisloff U, Slordahl SA. Strength training versus
aerobic interval training to modify risk factors of metabolic syndrome. J Appl Physiol (1985) 108(4):804-10, 2010.

31. Tofas T, Jamurtas AZ, Fatouros I, Nikolaidis MG, Koutedakis Y, Sinouris EA, Papageorgakopoulou N,
Theocharis DA. Plyometric exercise increases serum indices of muscle damage and collagen breakdown. J
Strength Cond Res 22(2):490-6, 2008.

32. Turner AN, Jeffreys I. The stretch-shortening cycle: Proposed mechanisms and methods for enhancement.
Strength Cond J 32(4)2012.

33. Van Der Heijden GJ, Wang ZJ, Chu Z, Toffolo G, Manesso E, Sauer PJ, Sunehag AL. Strength exercise
improves muscle mass and hepatic insulin sensitivity in obese youth. Med Sci Sports Exerc 42(11):1973-80, 2010.

International Journal of Exercise Science http://www.intjexersci.com

1083
 Int J Exerc Sci 10(7): 1076-1084, 2017

34. Van Dijk JW, Manders RJ, Canfora EE, Mechelen WV, Hartgens F, Stehouwer CD, Van Loon LJ. Exercise and
24-h glycemic control: equal effects for all type 2 diabetes patients? Med Sci Sports Exerc 45(4):628-35, 2013.

35. van Loon LJ, Greenhaff PL, Constantin-Teodosiu D, Saris WHM, Wagenmakers AJM. The effects of increasing
exerise intensity on muscle fuel utilisation in humans. J Physiol 536(1):295-304, 2001.

36. Venables MC, Jeukendrup AE. Endurance training and obesity: effect on substrate metabolism and insulin
sensitivity. Med Sci Sports Exerc 40(3):495-502, 2008.

37. Whyte LJ, Ferguson C, Wilson J, Scott RA, Gill JM. Effects of single bout of very high-intensity exercise on
metabolic health biomarkers in overweight/obese sedentary men. Metabolism 62(2):212-9, 2013.

38. Williams BM, Kraemer RR. Comparison of cardiorespiratory and metabolic responses in kettlebell high-
intensity interval training versus sprint interval cycling. J Strength Cond Res 29(12):3317-25, 2015.

International Journal of Exercise Science http://www.intjexersci.com

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