PARTIAL RANGE OF MOTION EXERCISE IS EFFECTIVE

FOR FACILITATING MUSCLE HYPERTROPHY AND

FUNCTION THROUGH SUSTAINED INTRAMUSCULAR
HYPOXIA IN YOUNG TRAINED MEN
MASAHIRO GOTO,1,2 CHIKAKO MAEDA,2 TOMOKO HIRAYAMA,2 SHIGERU TERADA,3
SHINSUKE NIRENGI,4 YUKO KUROSAWA,5 AKINORI NAGANO,1 AND TAKAFUMI HAMAOKA5
1
Graduate School of Sport and Health Science, Ritsumeikan University, Kyoto, Japan; 2Department of Physical Therapy, Aino
University, Osaka, Japan; 3Department of Rehabilitation, Kanazawa Red Cross Hospital, Kanazawa, Japan; and 4Division
of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
5
Department of Sports Medicine for Health Promotion, Tokyo Medical University, Tokyo, Japan

ABSTRACT after 8-week exercise training (before 8-week exercise training: r

Goto, M, Chikako, M, Hirayama, T, Terada, S, Nirengi, S, = 0.59, after 8-week exercise training: r = 0.70, p , 0.01).
Kurosawa, Y, Nagano, A, and Hamaoka, T. Partial range of These results suggest that intramuscular hypoxia might facilitate
motion exercise is effective for facilitating muscle hypertrophy muscular hypertrophy with PRE being more effective than FRE.
and function through sustained intramuscular hypoxia in young KEY WORDS resistance exercise, near-infrared spectroscopy,
trained men. J Strength Cond Res 33(5): 1286–1294, 2019— metabolic stress, blood lactate concentration
The acute response to and long-term effects of partial range of
motion exercise (PRE) and full range of motion exercise (FRE)
INTRODUCTION

M
of elbow extensors were compared in young trained men. The
PRE was expected to increase the intramuscular hypoxic envi- uscle response to resistance exercise is affected
ronment, which was theorized to enhance muscular hypertro- by previous exercise training (23). It is specu-
phy. Forty-four resistance-trained men were divided into 2 lated that certain factors inhibit hypertrophic
signaling caused by habitual resistance exer-
training groups, PRE (n = 22) or FRE (n = 22) group, and
cise 1 (13). A previous study detected local increases in
performed the PRE or FRE acute exercise protocol. The PRE
artery diameter and blood flow after 8 weeks of resistance
(elbow range from 458 to 908) and FRE (from 08 to 1208) acute
exercise (22), resulting in blunted hypoxic muscle stimula-
protocols consisted of 3 sets of 8 repetitions, with an 8RM, tion. Wessel et al. (26) reported that the increase in muscle
and an equivalent workload. After the initial testing, the training oxidative capacity produced by resistance training has a neg-
program for each group, comprised 3 training sessions per ative impact on muscle hypertrophy. To obtain effects, such
week for 8 weeks, was started. The acute responses of area as muscle strength enhancement and hypertrophy, in partic-
under the oxygenated hemoglobin (Oxy-Hb) curve, blood lac- ular for resistance-trained individuals, it is important to con-
tate concentration, and root mean square of electromyography sider mechanical and metabolic stress caused by the exercise.
were significantly higher both before and after PRE than FRE Therefore, the effects of a number of different training strat-
training. Long-term effects were produced by both PRE and egies have been examined in trained subjects (9,25).
FRE, with significant (p # 0.05) increases in cross-sectional The partial range of motion exercise (PRE) method is an
exercise method (3,4) that bodybuilders and weightlifters
area (CSA) of triceps brachii and isometric strength. The CSA
often use to increase muscle strength and hypertrophy. As
increased significantly greater after PRE (48.7 6 14.5%) than
PRE uses only the middle range of motion of an exercise,
after FRE (28.2 6 10.9%). Furthermore, during the PRE pro-
PRE will induce greater active and passive muscular tension
gram, a positive correlation was detected between the percent (4) and can be performed with higher loading compared with
increase in CSA and area under the Oxy-Hb curves before and FRE (3). Furthermore, PRE makes it possible to maintain
constant muscular contraction during exercise because of its
Address correspondence to Takafumi Hamaoka, [email protected]. slower movement speed. Constant muscular contraction dur-
33(5)/1286–1294 ing exercise tends to induce intramuscular hypoxia (24). As
Journal of Strength and Conditioning Research higher muscular tension and constant muscular contraction is
Ó 2017 National Strength and Conditioning Association compressing intramuscular capillaries, intramuscular hypoxia
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during PRE is expected. Therefore, PRE might cause greater on muscle strength and CSA. Forty-four trained men with
mechanical and metabolic stress in the muscle than FRE. more than one year of resistance training experience were
McMahon et al. (20) investigated the differences in muscle divided into PRE group (n = 22) or FRE group (n = 22).
size and strength, in recreationally active subjects, after Each group performed lying elbow extension exercise with
a same movement velocity 8-week squatting program with different elbow joint range of motion. To compare the acute
long and short ranges of motion in the rectus femoris mus- metabolic and mechanical responses to the PRE with FRE,
cle. Significant posttraining differences in strength and distal area under the oxygenated hemoglobin (Oxy-Hb) curve,
anatomical cross-sectional area (CSA), with training at a lon- blood lactate concentration, and root mean square (RMS)
ger range of motion, which exhibited greater adaptation than of electromyographic/electromyography (EMG) were eval-
training at a shorter range of motion, are shown. In contrast, uated during and after PRE or FRE. After assessing the acute
there is a study comparing differences in movement kinetics effects, PRE or FRE was performed by each group 3 times
with PRE and FRE in squatting training among recreational a week for 8 weeks. To compare the long-term effects of
weight trainers at 83% of 1RM with nonspecified movement PRE with FRE, CSA and muscular strength were evaluated.
velocity (7). Substantially greater muscle contraction and Furthermore, Pearson’s correlations coefficients were calcu-
power induced during PRE are reported. As mentioned lated to clarify the relationship between the percent increase
above, the biomechanical difference between PRE and in CSA and intramuscular hypoxia during PRE or FRE.
FRE has been studied by some researchers. However, there
Subjects
is little information available regarding the effect of PRE and
Forty-four resistance-trained men (members of a resistance
FRE on muscle energy metabolism. Energy metabolism dur-
weight-training club) were recruited from among students at
ing squatting exercise is possibly different from that of the
Aino University (age range: 20–22 years). The inclusion cri-
lying elbow extension. This is because squatting exercise is
teria for the subjects consisted of at least 1 year of resistance
performed in the basal plane and continuous muscle con-
training experience, participating in a resistance training pro-
traction can be performed even at the final range of motion
gram at least 3 days a week, and performing triceps brachii
where the moment arm reached the longest point (7).
exercises at least once a week. Subjects who reported any
Increased product of the moment arm length and exercise
musculoskeletal injuries of the upper extremities in the year
load during squatting exercise results in greater muscle
before the test were excluded. The subjects were randomly
stretching stimulus applied to the quadriceps femoris, and
assigned to 2 experimental groups, PRE and FRE (Table 1),
muscular hypoxia is promoted as a result. Therefore, the
and were matched for CSA of the right triceps brachii mus-
muscle strength and hypertrophy effects of FRE are greater
cle and maximum voluntary contraction (MVC) of elbow
than PRE. On the other hand, the point of action is coming
extension. All subjects were instructed to refrain from vigor-
out from the basal plane on lying elbow extension, and it
ous physical activity within 24 hours of an initial testing
seems to be difficult to keep constant muscle contraction
session (18). Before participating in the study, the subjects
during FRE (27). The increase in muscle strength and hyper-
were informed about the study procedures and any possible
trophy of PRE and FRE differs according to the exercise
risks both verbally and in writing before signing informed
type.
consent forms. This study was approved by Aino Univer-
The aim of this study was to compare the acute response
sity’s Institutional Review Board, and all subjects signed an
to and long-term effects of 2 different exercise methods, PRE
informed consent before participation.
and FRE, and to determine whether PRE is an effective
exercise method for increasing muscular strength and Procedures
muscle size in people with blunted hypoxic muscle stimu- Partial Range of Motion Exercise and Full Range of Motion
lation resulting from resistance training. We hypothesized Exercise Protocols. For the initial testing session, both PRE
that PRE would induce greater active and passive muscular and FRE groups performed lying elbow extension exercises
tension, and create greater accumulated hypoxic conditions, using a bench and a barbell. All 8RM, PRE, and FRE tests
because of continuous vascular compression, than FRE were performed to compare the acute response to PRE and
would during a single bout of exercise. We also hypothesized FRE on intramuscular oxygenation and muscle activity.
that PRE would be a more effective training method for Five minutes of light stretching was performed as warm-up
increasing muscular strength and size among people with before each testing session. Each subject lay with their back
long-term resistance training who receive lower hypoxic on the bench and both feet on the floor. An electro-
muscle stimulation, with inadequate hypertrophic signaling goniometer (DTS2D goniometer; Noraxon, AZ, USA) was
to the muscle, than untrained individuals. used to measure the range of motion of the elbow joint
during testing. The goniometer was attached to the radial
METHODS side of the right forearm and the lateral side of the upper
Experimental Approach to the Problem right arm. During 1RM and FRE testing, subjects flexed their
A randomized, counterbalanced two-group (PRE and FRE) shoulder joints to 908 with elbow joints in full extension and
pretest and posttest design was used to investigate the effects grasped the barbell. They flexed their elbow from this

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 Effects of Partial Range of Motion Exercise

TABLE 1. Physical characteristics of subjects.*†

PRE (n = 22) FRE (n = 22)

Before 8-wk ex. After 8-wk ex. Before 8-week ex. After 8-wk ex.

Age (yr) 21.6 6 1.3 — 20.6 6 0.9 —

Height (cm) 170.9 6 3.8 — 169.2 6 4.1 —
Lean body mass (kg) 64.7 6 5.3 65.9 6 4.8 63.3 6 5.7 63.9 6 6.2

*PRE = partial range of motion exercise; FRE = full range of motion exercise.
†Mean 6 SD (n = 22 for both groups) are shown.

starting position to full flexion and then returned to the Ltd., Kanagawa, Japan) was used to measure peripheral muscle
starting position. During PRE testing, the subjects flexed oxygenation and the area under the Oxy-Hb curve in the right
their shoulder joints to 908 with elbow joints flexed by 458 triceps brachii muscle during each exercise. Figure 1 shows
and grasped the barbell. They flexed their elbow from this a typical example of the Oxy-Hb dynamics detected in the
starting position to 908 flexion and then returned to the right triceps brachii muscle during the exercise. The wave-
starting position. This eccentric/concentric contraction length of the emitted light ranged between 750 and 850 nm,
cycle of triceps brachii was performed at a metronome- and the relative concentration of Oxy-Hb in the target tissue
controlled tempo of 1 second per eccentric contraction was quantified according to the Beer-Lambert law (5). The
and 1 second per concentric contraction. The exercise inten- distance between the incident point of the emitted light and
sity was determined at the 8RM for each set, but not by % of the detector was 30 mm. The laser emitter and detector were
1RM, because this method is more commonly used during fixed in place with adhesive tape. The near-infrared spectros-
actual resistance exercises. Both PRE and FRE consist of 8 copy (NIRS) signals were stored in a personal computer.
repetitions per set and 3 sets, with a minute interval between The NIRS signals recorded during exercise do not always
sets. After assessing the acute effects, PRE or FRE using reflect the absolute levels of intramuscular oxygenation.
lying elbow extension exercises was performed by each Therefore, the changes in the oxygenation of working
group 3 times a week for 8 weeks. The intensity was skeletal muscles are expressed relative to the overall changes
increased by 2.5 kg on the first day of every week and in the monitored signal, according to the arterial occlusion
adjusted to the maximum weight which can be performed method (11). In this study, the Oxy-Hb level observed at rest
8 times per set. Table 2 shows the mean exercise intensity was defined as 100%, and the minimum Oxy-Hb plateau
used in the periods of the first week of training, the fourth level induced by arterial occlusion was defined as 0%. A
week of training, and the eighth week of training. Equivalent pressure cuff was placed around the proximal portion of
workloads were used in every period during PRE and FRE. the upper arm and manually inflated to 250 mm Hg until
the minimum plateau level of Oxy-Hb was obtained (2). The
Intramuscular Oxygenation Measurements. A near-infrared area under the Oxy-Hb curve was used to examine the
continuous-wave spectrometer (HB14-2; ASTEM Co., reduction in the intramuscular oxygen level induced during
each exercise, as described by
Manfredini et al. (19). The
mean area under the Oxy-Hb
curve was compared between
TABLE 2. Changes in exercise intensity of 8RM during the 8-wk exercise PRE and FRE and before and
training.*†
after 8-week exercise training.
PRE (n = 22) FRE (n = 22)
Electromyographic Signal Recording
Intensity at first week (kg) 38.6 6 7.9 39.3 6 8.5
Intensity at fourth week (kg) 42.5 6 8.3 41.4 6 7.1 Measurements. The muscle activ-
Intensity at eighth week (kg) 45.2 6 8.7 42.6 6 7.8 ity of the long head of the
triceps brachii was recorded at
*PRE = partial range of motion exercise; FRE = full range of motion exercise. a sample rate of 1,000 Hz using
†Mean 6 SD (n = 22 for both groups) are shown. There was no significant difference
between PRE and FRE in the intensity of 8RM used for lying elbow extension. an EMG system (Myosystem
1200; Noraxon USA Inc., AZ,
USA). Bipolar surface EMG
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Blood Lactate Concentration Measurements. Blood samples

were collected at rest, immediately after, and 5 minutes after
the exercise. Approximately 5 mL of blood was taken from
the fingertip with a needle and immediately analyzed for
blood lactate concentration using a lactate analyzer (Lactate
Pro; Kyoto Primary Science Inc., Kyoto, Japan). The mean
blood lactate concentration immediately after the exercise
was compared between PRE and FRE and between before
and after 8-week exercise training (24).

Cross-Sectional Area of Triceps Brachii Measurements. The

muscle thickness (MT) of triceps brachii and the circum-
ference of the upper arm at the 60% proximal between
acromion and olecranon of the right upper arm were
measured using an ultrasound imaging unit (Noblus;
Hitachi Medical Inc., Tokyo, Japan) and a tape measure
at rest. The CSA was calculated as the product of MT and
circumference (1). A trained technician performed all the
tests. Water-soluble transmission gel was applied to the
Figure 1. Typical examples showing changes in intramuscular oxidative measurement site, and a 2.5-MHz ultrasound probe was
metabolism in the right triceps brachii muscle before and during PRE (A) placed perpendicular to the tissue interface without
and FRE (B). The resting and minimum levels of Oxy-Hb were defined as
100% (baseline) and 0%, respectively, according to the arterial
depressing the skin. The images were saved to a hard
occlusion method. PRE = partial range of motion exercise; FRE = full drive. Muscle thickness dimensions were obtained by
range of motion exercise; Oxy-Hb = oxygenated hemoglobin. measuring the distance from the subcutaneous adipose
tissue-muscle interface to the muscle-bone interface. The
mean CSA of triceps brachii was compared between PRE
and FRE and before and after 8-week exercise training.
electrodes (model: M-150Ag/AgCl; Nihon Kohden Inc.,
Furthermore, the relationship between the percent
Tokyo, Japan) were used to measure EMG signals from
increase in CSA and area under the Oxy-Hb curve during
the long head of the triceps brachii during exercise. Based on
PRE and FRE before and after 8-week exercise training
the surface electromyography for the noninvasive assess-
was calculated.
ment of muscles (SENIAM) recommendations (12), pairs of
EMG electrodes were placed along the muscle midline. The
bipolar surface EMG electrodes were placed in line with the Measurements of Muscle Strength. The maximum isometric
muscle fibers. The center-to-center distance between each contraction torque (MVC) and isokinetic torque-angular
pair of electrodes was 2.5 cm. Before the placement, each velocity relationship of elbow extensor muscles were mea-
subject’s skin was shaved, wiped using skin preparation gel sured using an isokinetic dynamometer (Cybex 770-NORM;
(Nihon Kohden Inc.), and cleaned with alcohol wipes. A Cybex International, MA). To familiarize with the test
reference electrode was placed over the acromioclavicular procedure, the subjects performed 10 trials each for iso-
joint. All of the recorded interelectrode resistance values metric at an elbow joint angle of 908, and the isokinetic
were below 10 kV. Myoelectric signals were relayed from torque at preset angular velocities of 1208 and 2008 per sec-
the bipolar electrodes to a TeleMyo device (TeleMyo 2400T; ond 5 times a week before the muscle strength measure-
Noraxon USA Inc.). The raw EMG signals were rectified, ments were taken. They laid down on a bed while
band-pass filtered, and integrated using commercially avail- grasping the lever with their right hand. The pivot point of
able software (MyoResearch XP; Noraxon USA Inc.). The the lever was accurately aligned with the rotational axis of
EMG amplitude was measured from EMG signals: (a) dur- the elbow joint. The isometric torque was measured at an
ing MVC measurements, RMS of EMG was calculated elbow joint angle of 908, and the isokinetic torque was mea-
based on a 500-millisecond time window centered on the sured at preset angular velocities of 1208 and 2008 per sec-
highest force value, (2) during the PRE and FRE, RMS of ond. The range of angular movement of the elbow joint was
EMG was calculated for each repetition based on a 500- limited between 08and 908 (16). Three trials were made for
millisecond time window centered on the highest value. isometric torque and each isokinetic angular velocity condi-
All RMS of EMG measurements were normalized to pre- tion, and the highest torque obtained was used for further
exercise MVC. The mean RMS of EMG was compared analysis. The mean muscle strength was compared between
between PRE and FRE and between before and after PRE and FRE and between before and after 8-week exercise
8-week exercise training (10). training.

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 Effects of Partial Range of Motion Exercise

Statistical Analyses
All data are expressed as mean 6 SD. All statistical analyses
were performed using SPSS for Windows version 21.0 (SPSS
Statistics 21.0; IBM, Tokyo, Japan).
A 2-way (training protocol [PRE: n = 22 vs. FRE: n = 22]
3 intervention of 8-week exercise training program [pre-
training vs. posttraining]) mixed-measures analysis of vari-
ance, with the Greenhouse-Geisser correction and
Bonferroni pairwise comparisons, was used to analyze the
differences in mean area under the Oxy-Hb curve, blood
lactate concentration, RMS of EMG, CSA of triceps brachii,
muscle strength, and exercise intensity of 8RM. Pearson’s
correlation coefficients were calculated for the relationships
between percent increase in CSA of triceps brachii and pre-
training and posttraining area under the Oxy-Hb curve dur- Figure 3. Mean values of %MVC-root mean square (RMS) of EMG
ing PRE and FRE. An alpha level of 0.05 was used to before and after 8-week PRE and FRE programs. Mean 6 SD (n = 22 for
determine statistical significance. Sample size was estimated both groups) are shown. No interaction between type of exercise and 8-
week exercise training. As a main effect, FRE values , PRE values (p #
using G*power. Effects sizes were calculated using mean and 0.05) and before 8-week exercise training values , after 8-week exercise
SDs according to the methods of Cohen (6). We used training values (p # 0.05). MVC = maximum voluntary contraction;
an effect size of 0.40. Using a power of 0.93 and alpha error EMG = electromyography; PRE = partial range of motion exercise;
FRE = full range of motion exercise.
of 0.05, a sample size of 22 participants per group was
suggested.

RESULTS after 8-week exercise training (p # 0.05). The percent

decrease in area under the Oxy-Hb curve was 221.7 6
Intramuscular Oxygenation Measurements
12.7% for PRE and 29.6 6 12.5% for FRE (Figure 2). The
Figure 1 shows typical examples of changes in relative oxy-
area under the Oxy-Hb curve during PRE was significantly
genation levels in the right triceps brachii muscle before and
lower after 8-week exercise training than before 8-week exer-
during PRE and FRE. In both types of exercise, Oxy-Hb
cise training (p # 0.05).
levels decreased immediately as the exercise repetitions
started, and then recovered quickly, followed by hypercom- Electromyographic Signal Recording Measurements
pensation after the completion of the exercise repetitions. Figure 3 shows the %MVC-RMS of EMG recorded in the
The mean area under the Oxy-Hb curve was significantly triceps brachii during exercise. Both before and after 8-week
higher during PRE than during FRE for both before and exercise training, %MVC-RMS of EMG was significantly
higher during PRE than during FRE (p # 0.05). The %

Figure 4. Mean values of blood lactate concentrations immediately after

Figure 2. Mean values of area under the Oxy-Hb curve during PRE and PRE and FRE before and after 8-week exercise training. Mean 6 SD (n =
FRE before and after 8-week exercise training. Mean 6 SD (n = 22 for 22 for both groups) are shown. No interaction between type of exercise
both groups) are shown. p # 0.05, significant differences between PRE and 8-week exercise training. As a main effect, FRE values , PRE values
and FRE values (*) and between before and after 8-week exercise (p # 0.05) and before 8-week exercise training values , after 8-week
training values (✣). Oxy-Hb = oxygenated hemoglobin; PRE = partial exercise training values (p # 0.05). PRE = partial range of motion
range of motion exercise; FRE = full range of motion exercise. exercise; FRE = full range of motion exercise.

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Both PRE and FRE produced significant increases in the

blood lactate concentration after exercise compared with
the resting concentration. No significant differences were
observed between the immediately after-exercise value and
the 5-minute after-exercise value. Figure 4 shows the blood
lactate concentration immediately after PRE and FRE before
and after 8-week exercise training. Both before and after
8-week exercise training, the mean blood lactate concentra-
tion after PRE was significantly higher than after FRE (p #
0.05). There was no significant difference between before and
after exercise training. Mean blood concentration before
8-week exercise training was significantly higher than the
value after 8-week exercise training (p # 0.05). There was
no interaction between type of exercise and training period.
Changes in Muscle Cross-Sectional Area
Figure 5. Cross-sectional area (CSA) of right triceps brachii muscle Figure 5 shows CSA before and after the 8-week PRE and
before and after 8-week PRE and FRE programs. Mean 6 SD (n = 22 for FRE training programs. Both PRE and FRE significantly
both groups) are shown. p # 0.05, significant differences between PRE
and FRE values after 8-week exercise training (*) and both PRE and FRE
increased the CSA of triceps brachii compared with before
values between before and after 8-week exercise training (✣). PRE = the 8-week exercise training programs (p # 0.05). The per-
partial range of motion exercise; FRE = full range of motion exercise. cent increase in the CSA of triceps brachii was 48.7 6 14.5%
after the 8-week PRE program and 28.2 6 10.9% after the 8-
week FRE program. The CSA after 8-week exercise training
MVC-RMS of EMG after 8-week exercise training was sig- was significantly larger after the 8-week PRE program than
nificantly higher than the value after 8-week exercise training the 8-week FRE program (p # 0.05). Furthermore, in the
(p # 0.05). There was no interaction between type of exer- PRE program, there were significant correlations between
cise and training period. the percent increase in CSA and before (r = 0.59, p ,
0.01) and after 8-week exercise training (r = 0.70, p ,
Blood Lactate Concentration Measurements
0.01) area under the Oxy-Hb curves. However, in the FRE
Blood lactate concentration was measured at rest (before
program, there were no significant correlations between the
8-week exercise training: PRE 1.6 6 0.2 mM, FRE 1.5 6
percent increase in CSA and either before ([r = 0.33, p =
0.2 mM, after 8-week exercise: PRE 1.4 6 0.2 mM, FRE
0.13] or after [r = 0.18, p = 0.41] 8-week exercise training
1.5 6 0.2 mM), immediately after exercise (before 8-week
area under the Oxy-Hb curve (Figure 6).
exercise training: PRE 9.9 6 2.1 mM, FRE 7.3 6 1.0 mM,
after 8-week exercise: PRE 8.9 6 1.4 mM, FRE 7.0 6 1.08 Changes in Muscular Strength
mM), and 5 minutes after exercise (before 8-week exercise The force-velocity relations obtained before and after the 8-
training: PRE 9.8 6 1.9 mM, FRE 7.1 6 1.0 mM, after week exercise training programs are shown in Table 3. Both
8-week exercise: PRE 9.0 6 1.5 mM, FRE 7.2 6 1.1 mM). PRE and FRE 8-week exercise training programs produced

Figure 6. The relationship between area under the Oxy-Hb curve and percent increase in cross-sectional area (CSA) of triceps brachii muscle before (left) and
after (right) 8-week PRE and FRE programs. Oxy-Hb = oxygenated hemoglobin; PRE = partial range of motion exercise; FRE = full range of motion exercise.

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 Effects of Partial Range of Motion Exercise

TABLE 3. Effects of exercise on force-velocity reactions.*

Isokinetic torque at 1208 Isokinetic torque at 2008

Isometric torque (Nm) per second (Nm) per second (Nm)

Before 8-wk ex. After 8-wk ex. Before 8-wk ex. After 8-wk ex. Before 8-wk ex. After 8-wk ex.

PRE 59.8 6 9.5 83.6 6 10.2†z 49.2 6 8.7 63.8 6 11.4† 45.6 6 10.5 50.1 6 10.3
FRE 61.3 6 11.4 76.2 6 12.6† 49.6 6 9.7 64.7 6 12.3† 46.7 6 12.1 51.9 6 13.5

*PRE = partial range of motion exercise; FRE = full range of motion exercise.
†Mean 6 SD (n = 22 for both groups) are shown. p # 0.05, before 8-wk exercise training vs. after 8-wk exercise training.
zp # 0.05, PRE vs. FRE.

significant increases in the isometric strength and isokinetic Because the maximal elbow extension isometric torque per
strength at 1208 per second compared with before the train- unit CSA of triceps brachii did not change significantly after
ing programs, but there was no significant change in isoki- PRE and FRE, muscle hypertrophy may be the primary
netic strength at 2008 per second. After the 8-week exercise factor influencing increases in isometric strength after the
training programs, isometric strength was significantly 8-week exercise training programs. Furthermore, data
greater in PRE subjects than in FRE subjects. There was showed that intramuscular hypoxia might be the primary
no significant difference in the isokinetic strength at 1208 factor influencing greater muscle hypertrophy because there
per second and at 2008 per second between PRE and were higher correlations between the percent increase in
FRE. The maximal elbow extension isometric torque per CSA and area under the Oxy-Hb curves after 8-week exer-
unit CSA of triceps brachii did not change significantly after cise training. A previous study reports that continuous resis-
the 8-week PRE and FRE training programs: from 0.4 6 0.1 tance training results in blunted hypoxic stimulation because
to 0.5 6 0.1 in PRE subjects and from 0.5 6 0.1 to 0.5 6 0.1 of local increasing in artery diameter and blood flow (22).
in FRE subjects. Our study showed the same results as previous studies. As
shown in Figure 3, the area under the Oxy-Hb curve during
DISCUSSION both PRE and FRE decreased after the 8-week exercise
In this study, after a comparison of acute effects, changes in training period. Even after the 8-week exercise training, the
muscle strength and size were compared between 2 groups, area under the Oxy-Hb curve during PRE was higher than
PRE and FRE, after completing two 8-week resistance that during FRE. The correlation coefficient between area
exercise training programs. The acute effects on area under under the Oxy-Hb curve and percent increase in CSA of
the Oxy-Hb curve, blood lactate concentration, and RMS of triceps brachii muscle after 8-week exercise suggested that
EMG recorded in the triceps brachii were higher during and PRE was more likely to induce intramuscular hypoxia than
after PRE than during and after FRE. The PRE was FRE and was an effective exercise protocol for muscle
characterized physiologically by higher area under the hypertrophy (Figure 6). An effect of mechanical stress, other
Oxy-Hb curve, greater motor unit activation, and higher than hypoxia, as a trigger of muscle hypertrophy might be
blood lactate concentration (Figures 2–4). During PRE, the considered as an explanation for the lack of a relationship
restriction of muscular blood flow, because of higher mus- between the percent increase in CSA in the FRE program
cular tension and constant muscle contraction, might be one and the area under the Oxy-Hb curve (9). Numerous studies
reason for the higher area under the Oxy-Hb curve. Higher have described the effects of a single bout of resistance exer-
muscular tension and constant muscle contraction led to cise under acute hypoxia on muscle strength and hypertro-
mechanical capillary compression, resulting in restricted phy in humans. For example, it is reported that performing
blood flow to muscles and the induction of acute intramus- resistance training under intracellular or environmental hyp-
cular hypoxia, and enhanced a glycolytic pathway under oxia elicited intramuscular conditions prone to enhancing
hypoxic conditions. This suggested that PRE induced higher protein synthesis (24), the levels of growth hormone, epi-
intramuscular hypoxia than FRE. nephrine, and lactate (17), and mammalian targets of rapa-
Long-term effects produced after both 8-week PRE and mycin (mTOR) signaling (8). In addition, a study using rats
FRE programs were significant increases in muscle size reports that chronic venous blood flow restriction for 14
(Figure 5) and muscular strength without isokinetic strength days promoted leg muscle hypertrophy because of increas-
at 2008 per second (Table 3). There were greater increases in ing levels of heat-shock protein 72 and decreasing levels of
isometric strength and muscle size after PRE than after FRE. myostatin protein (15). Taken together, these observations
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demonstrate that performing PRE, under intramuscular hyp- sufficiently obtained during FRE. This was confirmed by
oxia, significantly enhances hypertrophic signaling and mus- the result that %MVC-RMS of EMG during FRE was lower
cular size compared with FRE. than PRE. On the other hand, as the PRE of this study used
The maintenance of constant muscular tension during exercise only the middle range of motion, higher %MVC-RMS of
may result in hypoxic conditions, as reflected by an increasing EMG was obtained during PRE than during FRE. Further-
area under the Oxy-Hb curve, and of energetic stress to the more, as the motion speed of PRE was slower with an angu-
muscle, as reflected by the level of blood lactate concentration. lar velocity 458 than FRE, sustained muscle contraction
Tanimoto et al. (24) compared a low-intensity (50% of 1RM) might be obtained during PRE. This higher muscular tension
exercise with slow-speed knee extensions, 3 seconds for each and sustained muscle contraction throughout the exercise
concentric and eccentric contraction (low-intensity with slow- caused intramuscular hypoxia on triceps brachii muscle. As
speed [LS]), with a high-intensity (80% of 1RM) exercise with a result, the effects of isometric muscle contraction power
normal speed knee extensions, 1 second for each concentric and and muscle hypertrophy on triceps brachii muscle were
eccentric contraction (high-intensity with normal speed [HN]). higher in PRE than FRE.
Acute effects of knee extension torque, muscular activity on It was confirmed that PRE is a more effective exercise
EMG, intramuscular oxygenation, and blood lactate concentra- method to increase isometric muscle strength and hypertro-
tion are measured. They report that constant muscular tension phy of the triceps brachii muscle on lying elbow extension. In
was maintained during LS, but is difficult to maintain during HN. addition, it was suggested that a muscle strength increase in
Therefore, intramuscular hypoxia is induced more during LS speed corresponding to the exercise speed used for training
than during HN. In this current study, it was assumed that can be expected as a training effect. Furthermore, this study
PRE used only the middle range of motion, which activates revealed that the degree of intramuscular hypoxia during
active and passive muscular tension, and therefore, muscular exercise is related to muscle hypertrophy.
contraction could be maintained during PRE exercises despite
being performed at almost the same intensity as HN (21). PRACTICAL APPLICATIONS
After 8-week PRE and FRE exercise training programs, An 8RM load exercise at the middle range of motion was
isometric strength and isokinetic strength at 1208 per second performed in PRE, and it resulted in acute physiological
increased significantly, but isokinetic strength at 2008 per effects similar to isometric contraction, such as intramuscular
second did not (Table 3). The reason for the lack of signif- hypoxia and higher blood lactate concentration. Furthermore,
icant increase in isokinetic strength at 2008 per second can PRE produced greater increases than FRE in triceps brachii
be explained by the results of a previous study that shows CSA after the 8-week exercise training programs. Therefore,
muscular strength gains are specific to the movement speed PRE might be a valid training protocol, especially, for well-
used in the training regimens (14). The movement speeds trained individuals with blunted hypoxic muscle stimulation
were almost 458 per second in PRE and 1208 per second in because of long-term resistance training. As it is assumed that
FRE, and these speeds were too slow to increase isokinetic weight-bearing and nonweight-bearing muscles react differ-
strength at 2008 per second. The significant difference in ently to a particular exercise (27), the results of this study
isometric strength, between PRE and FRE posttraining, might be limited to upper extremity muscles.
could be explained by the differences in CSA. In regard to
the isokinetic strength at 1208 per second, PRE was superior
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