***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim was to investigate the effects of low-load resistant training combined with vascular occlusion or normobaric hypoxic exposure , on  neuromuscular function . In a r and omised controlled trial , well-trained athletes took part in a 5-week training of knee flexor/extensor muscles in which low-load resistant exercise ( 20 % of one repetition maximum , 1-RM ) was combined with either ( 1 ) an occlusion pressure of approximately 230 mmHg ( KT , n = 10 ) , ( 2 ) hypoxic air to generate an arterial blood oxygen saturation of ~80 % ( HT , n = 10 ) , or ( 3 ) with no additional stimulus ( CT , n = 10 ) . Before and after training , participants completed the following tests : 3-s maximal voluntary contraction ( MVC3 ) , 30-s MVC , and an endurance test ( maximal number of repetitions at 20 % 1-RM , Reps20 ) . Electromyographic activity ( root mean square , RMS ) was measured during tests and the cross-sectional area ( CSA ) of the quadriceps and hamstrings was measured pre- and post-training . Relative to CT , KT , and HT showed likely increases in MVC3 ( 11.0 ± 11.9 and 15.0 ± 13.1 % , mean ± 90 % confidence interval ) , MVC30 ( 10.2 ± 9.0 and 18.3 ± 17.4 % ) , and Reps20 ( 28.9 ± 23.7 and 23.3 ± 24.0 % ) . Compared to the CT group , CSA increased in the KT ( 7.6 ± 5.8 ) and HT groups ( 5.3 ± 3.0 ) . KT had a large effect on RMS during MVC3 , compared to CT ( effect size 0.8 ) and HT ( effect size 0.8 ) . We suspect hypoxic conditions created within the muscles during vascular occlusion and hypoxic training may play a key role in these performance enhancements Previous studies have shown that low-intensity resistance training with restricted muscular venous blood flow ( Kaatsu ) causes muscle hypertrophy and strength gain . To investigate the effects of daily physical activity combined with Kaatsu , we examined the acute and chronic effects of walk training with and without Kaatsu on MRI-measured muscle size and maximum dynamic ( one repetition maximum ) and isometric strength , along with blood hormonal parameters . Nine men performed Kaatsu-walk training , and nine men performed walk training alone ( control-walk ) . Training was conducted two times a day , 6 days/wk , for 3 wk using five sets of 2-min bouts ( treadmill speed at 50 m/min ) , with a 1-min rest between bouts .  Mean oxygen uptake during Kaatsu-walk and control-walk exercise was 19.5 ( SD 3.6 ) and 17.2 % ( SD 3.1 ) of treadmill-determined maximum oxygen uptake , respectively . Serum growth hormone was elevated ( P < 0.01 ) after acute Kaatsu-walk exercise but not in control-walk exercise .  MRI-measured thigh muscle cross-sectional area and muscle volume increased by 4 - 7 % , and one repetition maximum and maximum isometric strength increased by 8 - 10 % in the Kaatsu-walk group . There was no change in muscle size and dynamic and isometric strength in the control-walk group . Indicators of muscle damage ( creatine kinase and myoglobin ) and resting anabolic hormones did not change in both groups . The results suggest that the combination of leg muscle blood flow restriction with slow-walk training induces muscle hypertrophy and strength gain , despite the minimal level of exercise intensity . Kaatsu-walk training may be a potentially useful method for promoting muscle hypertrophy , covering a wide range of the population , including the frail and elderly Abstract Herda , AA , Herda , TJ , Costa , PB , Ryan , ED , Stout , JR , and Cramer , JT . Muscle performance , size , and safety responses after eight weeks of resistance training and protein supplementation : A r and omized , double-blinded , placebo-controlled clinical trial . J Strength Cond Res 27(11 ) : 3091–3100 , 2013—The purpose of this study was to examine the effects of 2 different types of protein supplementation on thigh muscle cross-sectional area ( CSA ) , blood markers , muscular strength , endurance , and body composition after 8 weeks of low- or moderate-volume resistance training in healthy , recreationally trained , college-aged men . One hundred and six men were r and omized into 5 groups : low-volume resistance training with bioenhanced whey protein ( BWPLV ; n = 22 ) , moderate-volume resistance training with BWP ( BWPMV ; n = 20 ) , moderate-volume resistance training with st and ard whey protein ( SWPMV ; n = 22 ) , moderate-volume resistance training with a placebo ( PLA ; n = 21 ) , or moderate-volume resistance training with no supplementation ( CON ; n = 21 ) . Except for CON , all groups consumed 1 shake before and after each exercise session and one each on the nontraining day . The BWPLV , BWPMV , and SWPMV groups received approximately 20 g of whey protein per shake , whereas the BWP groups received 5 g of additional polyethylene glycosylated ( PEG ) leucine . Resistance training sessions were performed 3 times per week for 8 weeks . There were no interactions ( p > 0.05 ) for muscle strength and endurance variables , body composition , muscle CSA , and safety blood markers , but the main effects for training were observed ( p ⩽ 0.05 ) . However , the Albumin : Globulin ratio for SWPMV was lower ( p = 0.037 ) than BWPLV and BWPMV . Relative protein intake ( PROREL ) indicated a significant interaction ( p < 0.001 ) with no differences across groups at pre ; however , BWPLV , BWPMV , and SWPMV had a greater intake than did PLA or CON at post ( p < 0.001 ) . This study indicated that 8 weeks of resistance training improved muscle performance and size similarly among groups regardless of supplementation PURPOSE To examine the effects of moderate-load exercise with and without blood-flow restriction ( BFR ) on strength , power , and repeated-sprint ability , along with acute and chronic salivary hormonal parameters . METHODS Twenty male semiprofessional rugby union athletes were r and omized to a lower-body BFR intervention ( an occlusion cuff inflated to 180 mmHg worn intermittently on the proximal thighs ) or a control intervention that trained without occlusion in a crossover design . Experimental sessions were performed 3 times a week for 3 wk with 5 sets of 5 repetitions of bench press , leg squat , and pull-ups performed at 70 % of 1-repetition maximum . RESULTS Greater improvements were observed ( occlusion training vs control ) in bench press ( 5.4 ± 2.6 vs 3.3 ± 1.4 kg ) , squat ( 7.8 ± 2.1 vs 4.3 ± 1.4 kg ) , maximum sprint time ( -0.03 ± 0.03 vs -0.01 ± 0.02 s ) , and leg power ( 168 ± 105 vs 68 ± 50 W ) . Greater exercise-induced salivary testosterone ( ES 0.84 - 0.61 ) and cortisol responses ( ES 0.65 - 0.20 ) were observed after the occlusion intervention sessions compared with the nonoccluded controls ; however , the acute cortisol increases were attenuated across the training block . CONCLUSIONS Occlusion training can potentially improve the rate of strength-training gains and fatigue resistance in trained athletes , possibly allowing greater gains from lower loading that could be of benefit during high training loads , in competitive seasons , or in a rehabilitative setting . The clear improvement in bench-press strength result ing from lower-body occlusion suggests a systemic effect of BFR training Purpose This study investigates the impact of two different intensities and different volumes of low-load resistance training ( LLRT ) with and without blood flow restriction on the adaptation of muscle strength and size . Methods The sample was divided into five groups : one set of 20 % of one repetition maximum ( 1RM ) , three sets of 20 % of 1RM , one set of 50 % of 1RM , three sets of 50 % of 1RM , or control . LLRT was performed with ( OC ) or without ( NOC ) vascular occlusion , which was selected r and omly for each subject . The maximal muscle strength ( leg extension ; 1RM ) and the cross-sectional area ( quadriceps ; CSA ) were assessed at baseline and after 8 weeks of LLRT . Results 1RM performance was increased in both groups after 8 weeks of training : OC ( 1 × 50 % = 20.6 % ; 3 × 50 % = 20.9 % ; 1 × 20 % = 26.6 % ; 3 × 20 % = 21.6 % ) and NOC ( 1 × 50 % = 18.6 % ; 3 × 50 % = 26.8 % ; 1 × 20 % = 18.5 % ; 3 × 20 % = 21.6 % ; 3 × 20 % = 24.7 % ) compared with the control group ( −1.7 % ) . Additionally , the CSA was increased in both groups : OC ( 1 × 50 % = 2.4 % ; 3 × 50 % = 3.8 % ; 1 × 20 % = 4.6 % ; 3 × 20 % = 4.8 % ) and NOC ( 1 × 50 % = 2.4 % ; 3 × 50 % = 1.5 % ; 1 × 20 % = 4.3 % ; 3 × 20 % = 3.8 % ) compared with the control group ( −0.7 % ) . There were no significant differences between the OC and NOC groups . Conclusion We conclude that 8 weeks of LLRT until failure in novice young lifters , regardless of occlusion , load or volume , produces similar magnitudes of muscular hypertrophy and strength OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity Elastic b and ( EB ) training is a common form of resistance training used by the elderly , individuals with joint problems or those recovering from injury .  EB training performed at low intensities by these population s may have little effect on muscle hypertrophy . However , when combined with blood flow restriction ( BFR ) , low‐intensity EB resistance training may result in muscle hypertrophy Purpose Slow-walk training combined with restricted leg muscular blood flow ( KAATSU ) produces muscle hypertrophy and strength gains in young men , which may lead to increased aerobic capacity and functional fitness . The purpose of this study was to investigate the effects of walk training combined with KAATSU on muscle size , strength , and functional ability , as well as aerobic capacity , in older participants . Methods A total of 19 active men and women , aged 60 to 78 years , were r and omized into either a KAATSU-walk training group ( n = 11 , K-walk ) or a nonexercising control group ( n = 8 , control ) . The K-walk group performed 20-minute treadmill walking ( 67 m/min ) , 5 days/wk for 6 weeks . Results Isometric ( 11 % ) and isokinetic ( 7%-16 % ) knee extension and flexion torques 
    Output:
    
Current evidence suggests that the addition of BFR to dynamic exercise training is effective for augmenting changes in both muscle strength and size .
This effect was consistent for both resistance training and aerobically-based exercise , although the effect sizes varied .
The magnitude of observed changes are noteworthy , particularly considering the relatively short duration of the average intervention