A single set of exhaustive exercise before

resistance training improves muscular

performance in young men

Andreo Fernando Aguiar, Cosme

Franklim Buzzachera, Rafael Mendes
Pereira, Vanda Cristina Sanches, Renata
Borges Januário, et al.
European Journal of Applied
Physiology

ISSN 1439-6319
Volume 115
Number 7

Eur J Appl Physiol (2015) 115:1589-1599

DOI 10.1007/s00421-015-3150-8

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 Author's personal copy
Eur J Appl Physiol (2015) 115:1589–1599
DOI 10.1007/s00421-015-3150-8

ORIGINAL ARTICLE

A single set of exhaustive exercise before resistance training

improves muscular performance in young men
Andreo Fernando Aguiar · Cosme Franklim Buzzachera · Rafael Mendes Pereira ·
Vanda Cristina Sanches · Renata Borges Januário · Rubens Alexandre da Silva ·
Lucas Maciel Rabelo · André Wilson de Oliveira Gil 

Received: 21 August 2014 / Accepted: 20 February 2015 / Published online: 10 March 2015
© Springer-Verlag Berlin Heidelberg 2015

Abstract  Conclusion  These results suggest that the inclusion of a

Purpose  The purpose of this study was to examine the single set of exhaustive exercise at 20 % of 1RM before
effects of an additional set of exhaustive exercise before traditional hypertrophic training can be a suitable strategy
traditional hypertrophic training on quadriceps muscle per- for inducing additional beneficial effects on quadriceps
formance in young men. strength, hypertrophy, and endurance in young men.
Methods  Subjects performed maximal dynamic strength
(1RM), local muscular endurance (LME), and magnetic Keywords  Resistance training · Quadriceps · 1RM ·
resonance imaging (MRI) tests before and after an 8-week Endurance · Cross-sectional area · Muscular strength
hypertrophic training program using a knee extensor
machine. After baseline testing, the subjects were divided Abbreviations
into 3 groups: untrained control, traditional training (TR), 1RM One repetition maximum
and prior exhaustive training (PE). Both the TR and PE CSA Cross-sectional area
groups trained using the same training protocol (2 days LME Local muscular endurance
week−1; 3 sets of 8–12 repetitions at 75 % of 1RM); the MRI Magnetic resonance imaging
only difference was that the PE group performed an addi- CV Coefficient of variation
tional set of exhaustive exercise at 20 % of 1RM before RT Resistance training
each training session. EMG Electromyography
Results  After 8 weeks, the PE group experienced a greater VL Vastus lateralis
(P < 0.05) increase in 1RM, cross-sectional area, and LME SENIAM Surface EMG for Non-Invasive Assessment of
than the TR group. Additionally, no changes (P > 0.05) in Muscles
daily dietary intake were observed between groups. RMS Root mean square
BMI Body mass index

Communicated by William J. Kraemer.

A. F. Aguiar (*) · C. F. Buzzachera · R. M. Pereira ·
V. C. Sanches · R. B. Januário · R. A. da Silva · L. M. Rabelo ·
A. W. de Oliveira Gil  muscle fiber/cell size (Russell et al. 2000) due to an
Center of Research in Health Sciences, North University
of Paraná (UNOPAR), Avenue Paris, 675, Jardim Piza, Londrina,
PR CEP 86041‑120, Brazil
e-mail: afaguiarunesp@gmail.com
R. B. Januário 
Department of Physical Education, Centre for Physical Education
and Sports, Londrina State University (UEL), Londrina, PR,
Brazil
Introduction
Skeletal muscle hypertrophy is characterized by increased
increase in the number of myofibrils, which are added
in parallel (Paul and Rosenthal 2002). Given that a posi-
tive correlation exists between muscle cross-sectional
area (CSA) and muscular strength (Maughan et al. 1983),
hypertrophy is particularly important to athletes who are
involved in strength and power sports (e.g., football line-
men, rugby players, and powerlifters) and bodybuilding,

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where competitors are judged on both the quantity and
quality of their muscle development (Schoenfeld 2010).
Increased muscle mass is also vital for maintaining or
developing physical fitness and functional capacity in rec-
reational lifters (Schoenfeld 2010) and older adults (Hunter
et al. 2004). Therefore, maximizing muscle hypertrophy
has significant practical and clinical implications for a vari-
ety of populations associated to sports and health.
While mechanical stress is unquestionably a primary
stimulus for muscle hypertrophy, there is a compelling evi-
dence that metabolic stress also may contribute to muscle
growth (Schoenfeld 2013). Previous Kaatsu training studies
(training with blood flow restriction) have shown that even
low-intensity exercises (<40 % 1RM) can stimulate myofi-
brillar protein synthesis (MPS) (Fry et al. 2010) and pro-
duce marked muscle hypertrophy and strength gains (Abe
et al. 2006; Loenneke et al. 2012; Takarada et al. 2000b,
2002), similar to those observed at 80 % of 1RM (Abe et al.
2006). One possible explanation for this effect is that the
venous occlusion induces increased local fatigue (Phillips
2009) and metabolite accumulation (Loenneke et al. 2010)
that forces recruitment of the type II fibers (Suga et al.
2009, 2010; Takarada et al. 2000a, b), which are highly
hypertrophic (Campos et al. 2002). This enhanced recruit-
ment of type II fibers has been proposed as the primary
mechanism by which such exercise elicits hypertrophic
adaptations (Loenneke et al. 2012; Meyer 2006). In this
sense, several mechanisms have been proposed to explain
how metabolic stress increases the type II fiber recruitment:
(1) the accumulation of intracellular H+, which inhibits
muscle contractility and thereby promotes the recruitment
of additional type II fibers (Debold 2012; Miller et al. 1996;
Takarada et al. 2000b); (2) local hypoxia, which induces the
activation of type II fibers in an attempt to maintain high
levels of force production (Moritani et al. 1992; Sundberg
1994); and (3) intracellular free radical generation, which
elicits increased type II fiber recruitment by hastening the
onset of fatigue (Debold 2012). Thus, muscle hypertrophy
occurs independent of the exercise intensity, as long as type
II fibers are activated (Phillips 2009).
Moreover, the recruitment of type II fibers triggers the
activation of anabolic signaling proteins [primarily, ribo-
somal protein S6 and extracellular signal-regulated kinase
(S6K1)] involved in the regulation of MPS (Koopman et al.
2006). The response of S6K1 is notable because the phos-
phorylation of this protein has been shown to be predictive
of muscle hypertrophy (West et al. 2009) and its response
is approximately 3- to 4-fold higher in type II fibers com-
pared to type I fibers (Doessing et al. 2010). Thus, these
data suggest that regardless of training intensity, type II
fiber recruitment is a prerequisite condition to maximize
the increased muscle hypertrophy and strength during a
resistance training (RT) program. However, to date, most
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Eur J Appl Physiol (2015) 115:1589–1599
RT studies have shown that training volume appears be
more important than intensity (load) to promoting increased
muscle mass (Burd et al. 2010a, b; Krieger 2010; Mitch-
ell et al. 2012; Rhea et al. 2002, 2003; Wolfe et al. 2004),
ignoring the fact that stimulating the recruitment of type
II fibers can be a beneficial strategy for further increasing
muscle strength and hypertrophy during a high-intensity
RT program. Thus, there is still much to learn about how to
stimulate the maximal recruitment of type II fibers during a
RT program and, thus, develop novel training protocols to
maximize strength and hypertrophy gains.
Therefore, we speculate that if a greater number of type
II fibers are recruited when the point of muscular fatigue
is reached (Schoenfeld 2013; Willardson 2007), and the
metabolic stress (e.g., greater training volume) can enhance
type II fiber recruitment (Suga et al. 2009, 2010; Takarada
et al. 2000a, b), then stimulating muscle failure (principally
of type I fibers) and metabolic accumulation before tradi-
tional RT would promote a greater global recruitment of
type II fibers and thus further stimulate muscle strength and
hypertrophy. Thus, the purpose of this study was to inves-
tigate the effects of an additional set of exhaustive exercise
at 20 % of 1RM (to induce the fatigue of type I fibers and
metabolite accumulation) before high-intensity RT on mus-
cle strength and hypertrophy in young men.
Methods
Experimental approach
A prospective, 3 group, matched, double-blind, randomized
controlled study with repeated measures was performed
to examine the effects of an additional set of exhaustive
exercise (for more details see description in the “Resist-
ance training protocol” section) immediately before high-
intensity RT (American College of Sports Medicine 2009)
on the maximal dynamic strength (1RM), CSA, and endur-
ance of the quadriceps muscle in young men (Fig. 1). For
this purpose, all subjects performed 1RM, local muscu-
lar endurance (LME), and magnetic resonance imaging
(MRI) tests on 2 separate occasions [before (M1) and after
(M2) an 8-week RT program] after a 3-week familiariza-
tion period (3 non-consecutive days per week, for a total
of 9 sessions) with the physical tests to minimize potential
learning effects (Fig. 1). The 1RM and LME tests were per-
formed using a bilateral knee extensor machine. After base-
line testing (M1), the subjects were matched according to
1RM values and then randomly assigned in a double-blind
fashion to 1 of 3 groups: untrained control (CO, N  = 9),
traditional training (TR, N = 9), and prior exhaustive train-
ing (PE, N  = 9). Two days after the 8-week experimental
period, the subjects completed the same battery of tests
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Eur J Appl Physiol (2015) 115:1589–1599 1591

Fig. 1  Experimental design

(M2) to examine possible and group-by-time interactions Table 1  Baseline characteristics

(Fig. 1). CO (N = 9) TR (N = 9) PE (N = 9)

Subjects Age (years) 20.0 ± 1.8 20.9 ± 2.0 21.0 ± 1.9

Body mass (kg) 75.0 ± 8.8 73.7 ± 9.4 69.8 ± 11.2
Apparently healthy 18- to 25-year-old men voluntarily Height (cm) 176.4 ± 8.1 173.8 ± 6.9 174.4 ± 2.2
participated in this study with written informed consent. BMI (kg m2) 24.1 ± 2.0 24.4 ± 2.5 22.9 ± 3.6
To qualify as participants, the following criteria for the 1RM (kg) 106.4 ± 2.6 107.4 ± 3.9 106.6 ± 4.5
subjects were required: (1) not be vegetarian, (2) have not Values are mean ± SD. There were no differences between the groups
ingested any ergogenic supplement or anabolic steroids for BMI Body mass index, 1RM one repetition maximum
the 6 months prior to the start of study, (3) have not ingested
any medication that could affect muscle growth or the abil-
ity to train intensely during the study, (4) not be involved
in the practice of systematized physical activity more than
2 days per week, for the 6 months prior to the start of study,
(5) have a detailed description of their lifestyle and daily
food intake, and (6) have medical approval for the practice
of physical exercise. Twenty-seven men [mean (SD) age
20.6 (1.9) years, height 174.8 (6.0) cm, and body mass 72.7
(9.7) kg] who met these criteria volunteered to participate
in the study. The physical characteristics of the CO, TR,
and PE groups at baseline are presented in Table 1. All sub-
jects were informed of the procedures, risks, and benefits of
the investigation and signed an informed consent document
approved by the Institutional Review Board of the North
University of Paraná (protocol no: 14773113.5.0000.0108).
All procedures were performed according to the principles
outlined in the 1964 Declaration of Helsinki.

Resistance training protocol
Both the TR and PE groups trained under the same training
regime (2 days week−1; 3 sets of 8–12 repetitions at 75 %
of 1RM, with 1 min rest between sets) during an 8-week RT
program designed to promote muscle hypertrophy (Ameri-
can College of Sports Medicine 2009). The only difference
in the training protocol was that the PE group performed
an additional set of exhaustive exercise immediately (30 s)
before each training session (Fig. 2). The exercise used for
training was a bilateral knee extension in a seated position
using a commercial knee extensor machine (Bad Boy Gym
Fig. 2  Training session design. The numbers in the boxes indicate
the exercise intensity (% of 1RM)
equipment, São Paulo, Brazil), with a range of motion of
90°–30° of knee flexion (0° = full knee extension), and the
velocity/cadence of muscle action was 30 repetitions per
minute (1 s concentric: 1 s eccentric), which was controlled
with a metronome. Each training session began with a spe-
cific warm-up exercise (1 set of 12 repetitions with a self-
selected load) for the quadriceps muscle. For the additional
set of exhaustive exercise, the subjects were instructed to

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perform as many repetitions as possible at 20 % of 1RM
until failure. We used a light load of 20 % of 1RM dur-
ing the prior exhaustive exercise because previous studies
reported that training to failure at a relatively low inten-
sity (up to 30 % of 1RM) primarily recruits slow-twitch
motor units (American College of Sports Medicine 2009;
Sale 1987). The prior exhaustive exercise was designed to
induce the fatigue/exhaustion of the type I fibers before the
high-intensity RT training. Qualified personnel supervised
each participant individually during every workout. Each
subject received a training logbook, in which the research-
ers recorded the weekly training load (weight). The train-
ing load was adjusted every 15 days according to a 1RM
test. At the end of each session, the muscles exercised were
stretched for approximately 5 min. The sessions were per-
formed between 7 and 9 pm.
Training volume
The training volume (kg × sets × repetitions) was progres-
sive throughout the training program, and each participant
was able to complete 12 repetitions required in each of 3
sets of resistance exercise. The total work volume in each
training bout was determined according to the following
equations:
1. Training volume for PE group = [additional set
(load × reps)] + [traditional training (load × reps)].
2. Training volume for TR group = [traditional training
(load × reps)].
Nutrient intake
Under the supervision of nutritionists, the subjects com-
pleted 3-day dietary intake records (including 1 weekend
day) before and after the 8-week RT program; standard por-
tions were used to assess the amount of food and drink con-
sumed. The total energy intake and macronutrient amounts
were calculated using software for nutritional assessment
(Avanutri, version 3.1.4, Rio de Janeiro-RJ, Brazil). Partici-
pants were instructed to maintain their habitual daily diet.
Water intake was ad libitum.
Familiarization protocol
All subjects (including the controls) completed a 3-week
orientation program (3 non-consecutive days per week, for
a total of 9 sessions) before M1 for familiarization with the
equipment and exercise to minimize any potential learning
effects and establish the reliability of the testing protocols
(Gotshalk et al. 2002). The sessions consisted of repeated
performance of knee extension exercise (3 sets of 8–12 rep-
etitions) (days 1, 2, and 3), and tests of 1RM (days 4, 5,
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and 6) and muscular endurance (1 set at 60 % of 1RM until
failure) (days 7, 8, and 9). Maximal effort in each test was
requested during the last 5 sessions to reduce any learning
effects and to make the data consistent. The intraclass cor-
relation coefficients were ≥0.97 for each test, indicating
the elimination of the learning curve for the subjects (Krae-
mer et al. 2006). All familiarization sessions and physical
tests were performed at the same location, between 7 and
9 pm.
Maximal dynamic strength
Maximal dynamic strength was assessed using a 1RM
standard testing protocol as previously documented by
Baechle and Earle (2008). The 1RM test was preceded by
a set of warm-up exercise (5–10 repetitions) at approxi-
mately 50 % of the load to be used in the first attempt of
the 1RM test. After 2 min of rest, the 1RM attempts were
performed with a progressively increasing load for each
attempt and were separated by 3- to 5-min rest intervals.
The subjects were permitted 2–3 attempts to determine the
1RM value. 1RM was defined as the greatest load lifted
through a full range of motion before 2 failed attempts at
a given load. Verbal encouragement was provided during
all 1RM attempts. The exercise execution technique was
standardized and continuously monitored in an attempt
to assure the quality of the data. Reproducibility of the
strength measures was determined on 8 subjects, 2 weeks
apart. The coefficient of variation (CV) was 3.1 % for 1RM
measures.
MRI
The CSA of the quadriceps muscle of the dominant side
was measured before (M1) and after (M2) the 8-week train-
ing period via MRI using a 1.5 T Signa Horizon LX-GE
scanner (GE Medical System, Milwaukee, WI, USA).
MRI was used because it provides the most accurate in
vivo measurement of a muscle’s cross section (Mitsiopou-
los et al. 1998) and is radiation free. The subjects had not
been engaged in any testing or training 2 days prior to the
MRI scanning. The subjects were placed within the station-
ary, external field in the supine position with the mid-point
of the thigh (half-way between trochanter major and epi-
condylus lateralis of the femur) as the point of reference
(Esmarck et al. 2001). To determine the CSA, 6 transaxial
images were obtained at mid-thigh with a flip angle of 90°
with the following parameters: repetition time = 600 ms
and echo time = 13 ms. Each data set was obtained with
a field of view = 18 mm consisting of a 384/224 pixel
matrix. The slice thickness was 60 mm and the interslice
gap was 10 mm. The transaxial images were transferred
to a computer-aided workstation and analyzed using the
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Eur J Appl Physiol (2015) 115:1589–1599 1593
software Axiovision v3.0 software (Carl Zeiss, Jena, Ger-
many). The area was then calculated by a pixel counting
routine and by a scale conversion algorithm. All 4 heads
of the quadriceps femoris muscle were outlined manually
3 times by same rater blinded in respect to treatments and
time point, and the CSA was determined as the average of
the 3 measures (Esmarck et al. 2001). To establish intra-
rater reliability of CSA measurement, the same rater per-
formed three CSA measurements, repeated on the same
subject on 3 different days. The error in this technique was
estimated to be 0.6 %, while the coefficient of variation
[(CV) = SD X̄
× 100] between three CSA measurements
was 0.2 %. Previous analysis revealed an intra-rater reli-
ability level greater than 0.96.
Muscular endurance tests and electromyographic (EMG)
signal recordings
A LME test was performed before (M1) and after (M2)
the 8-week experimental period. Briefly, the subjects were
instructed to perform as many repetitions as possible at
60 % of 1RM until failure (Campos et al. 2002). We used a
load at 60 % 1RM to have a more global response (recruit-
ment of the type I and II fibers) of LME. During the test,
surface EMG signals were recorded from the vastus later-
alis (VL) muscle using a pre-amplified (gain: 1000) active
surface electrode (Model DE-2.3; Delsys, Inc., Wellesley,
MA) at a sampling rate of 2000 Hz and EMGworks 4.0.5
analyses software (Delsys System, Boston, MA). The
subject’s skin was prepared by removing the superficial
dead skin and was sterilized with an alcohol swab. The
electrode was placed on a location near the center of the
belly of the muscle according to the recommendations of
SENIAM (Surface EMG for Non-Invasive Assessment
of Muscles), and the reference electrode was fixed at the
right styloid process. The EMG signals were filtered with
a band-pass digital filter between 20 and 500 Hz using
Matlab 11.0 routines (Mathworks®, South Natick, MA,
USA). From the EMG signals corresponding to the second
and before last contractions of the endurance test (e.g., to
avoid the acceleration and the deceleration portions of the
concentric leg contractions during the extension phase of
movement), a moving RMS method was executed on suc-
cessive 250-ms (512 points) time-series windows (50 %
overlapped) to obtain the RMS average values during the
entire leg flexion–extension fatigue exercise. The RMS val-
ues were then normalized by the maximal number of rep-
etitions (NmáxRep) performed during the endurance test,
according to the following equation: %RMS = [(RMS/
NmáxRep) × 100 %]. The %RMS values were used as the
pre- and post-training muscular work index. Specifically,
a lower %RMS value during the endurance test at 60 %
of 1RM indicated greater muscle efficiency (lower fiber
recruitment was required to support the functional demand
of the endurance exercise until failure). Reproducibility of
the LME measures was determined on 10 subjects, 1 week
apart. The CV was 3.3 % for LME.
Statistical analysis
Data are expressed as the mean ± SD. To ensure data relia-
bility, the statistical procedures were performed after a pre-
liminary study of the variables to determine the normality
and equality of the variance between groups; the statistical
power was 80 % for the assessed comparisons. On the basis
of a statistical power of 0.80, a moderately large effect size
(0.35), and an overall level of significance of 0.05, 9 sub-
jects were required in each group. A one-way ANOVA was
used to determine differences in the baseline measurements
between the groups for the body mass, age, height, BMI,
and 1RM variables. A 3 (group: CO vs. TR vs. PE) × 5
(time: basal, 2, 4, 6, and 8 weeks) ANOVA with repeated
measures was used to evaluate the data across time and
between groups for the training load. A 3 (group: CO vs.
TR vs. PE) × 2 (time: pre- and post-test) ANOVA with
repeated measures was used to evaluate the data across time
and between groups for the 1RM, CSA, LME, and nutri-
ent intake (dependent variables). All analyses were done on
the raw data. When significant differences were confirmed
with ANOVA, multiple comparisons testing was performed
using Bonferroni post hoc analysis to identify these differ-
ences. The level of significance was set at P ≤ 0.05. Statis-
tical analyses were performed using Statistica 7.0 software
(StatSoft, Tulsa, OK).
Results
Participant characteristics
All participants (CO, N = 9; TR, N = 9; PE, N = 9) who
began the 8-week RT program completed the study. The
baseline characteristics of the subjects are presented in
Table 1. All groups had similar (P > 0.05) baseline physical
characteristics. In addition, no significant (P > 0.05) dif-
ferences in the daily dietary intakes were observed among
the groups before and after the 8-week intervention period
(Table 2).
Maximal dynamic strength
The 1RM for each group is presented in Fig. 3. Both the
TR and PE groups demonstrated a significant (P < 0.05)
improvement in the 1RM strength from pre- to post-test.
A significant group-by-time interaction indicated a greater
increase (P < 0.05) in 1RM strength in the PE group (∆ %:
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Table 2  Dietary analyses

CO (N = 9) TR (N = 9) PE (N = 9)

Carbohydrate (%)
 Pre 65.5 ± 2.2 64.8 ± 4.6 64.6 ± 3.1
 Post 65.9 ± 0.8 64.2 ± 5.3 63.0 ± 5.3
Protein (%)
 Pre 17.4 ± 1.4 17.9 ± 1.8 19.1 ± 2.3
 Post 17.6 ± 1.8 19.8 ± 5.6 21.5 ± 5.3
Fat (%)
 Pre 17.1 ± 2.7 16.6 ± 3.8 16.3 ± 2.1
 Post 16.5 ± 2.1 16.0 ± 2.3 15.5 ± 1.9

There were no differences between the groups

Fig. 4  Training load progression throughout the 8-week training
program in the control (CO, N = 9), traditional training (TR, N = 9),
and prior exhaustive training (PE, N = 9) groups. The values are the
mean ± SD. *Significant difference among groups (P < 0.05). #Sig-
nificant difference compared with baseline for TR and PE groups
(P < 0.05)

Fig. 3  Delta change in one repetition maximum (1RM) knee exten-

sion exercise after training program in the control (CO, N = 9), tradi-
tional training (TR, N = 9), and prior exhaustive training (PE, N = 9)
groups. The values are the mean ± SD. *P < 0.05 compared with the
CO group. #P < 0.05 compared with the TR group

+44.2  ± 6.5) than in the TR group (∆ %: +26.6  ± 7.2).

The 1RM strength of the CO group remained unchanged
(P > 0.05) from pre- to post-test (∆ %: 0.4 ± 0.5). Addi-
tionally, the training load (kg) was significantly (P < 0.05)
greater in PE group compared to TR group at 2 (+3.9), 4
(+4.2), 6 (+5.6), and 8 (+7.4) weeks (Fig. 4). Training
volumes during the intervention period were 15.6 % (pre)
and 23.3 % (post) greater (P < 0.05) in the PE group (pre:
3452.2  ± 147.9 kg, and post: 4769.1 ± 181.2 kg) com-
pared with the TR group (pre: 2899.1 ± 104.0 kg, and post:
3672.0 ± 147.2 kg).
Fig. 5  MRI axial images of the right thigh from a subject from the
Quadriceps CSA control (CO, N  = 9), traditional training (TR, N  = 9), and prior
exhaustive training (PE, N = 9) groups pre-training (a, c, and e) and
A representative MRI axial image from each group is post-training (b, d, and f). RF rectus femoris, VM vastus medialis, VL
vastus lateralis, VI vastus intermedius. Note the greater increase in
shown in Fig. 5, and the corresponding data are presented the quadriceps cross section (as indicated by the VL thickness dashed
in Fig. 6. Both the TR and PE groups demonstrated a sig- line) from pre- to post-test in the PE group compared with the TR
nificant (P < 0.05) increase in the total quadriceps CSA group

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Eur J Appl Physiol (2015) 115:1589–1599 1595
Fig. 6  Quadriceps muscle cross-sectional area (CSA) of the 4 heads
of the quadriceps [vastus lateralis (VL), vastus medialis (VM), vas-
tus intermedius (VI), and rectus femoris (RF)] pre- and post-training
in the control (CO, N  = 9), traditional training (TR, N  = 9), and
prior exhaustive training (PE, N  = 9) groups. The values are the
mean ± SD. *P < 0.05 compared with all corresponding pre-training
values. #P < 0.05 compared with the corresponding TR and CO post-
training values
from pre- to post-test (∆ %, TR: +11.8 vs. PE: +20.8,
P < 0.05). A significant group-by-time interaction indicated
a greater increase (P < 0.05) in total CSA (4 heads of the
quadriceps) in the PE group (∆ %, VL: +16.7 %; VM:
+16.9 %; VI: +13.4 %; and RF: +28.4 %) than in the TR
group (∆ %, VL: +10.2 %; VM: +9.3 %; VI: +8.0 %; and
RF: +18.4 %). The total quadriceps CSA of the CO group
remained unchanged (P > 0.05) from pre- to post-test.
Muscle endurance and efficiency
A significant group-by-time interaction (P < 0.05) was
observed for LME (number of total repetitions) and mus-
cle work index (%RMS) (Fig. 7a, b). The PE group had a
significantly greater number of total repetitions (∆ %, TR:
+20.2 % vs. PE: +36.9 %, P < 0.05) and lower %RMS
values (∆ %, TR: −30.8 % vs. PE: −50.5 %, P < 0.05) at
post-test than the TR group. The number of repetitions and
%RMS in the CO group remained unchanged (P > 0.05)
from pre- to post-test.
Discussion
This study was mainly designed to determine whether the
inclusion of a single set of exhaustive exercise at 20 %
of 1RM immediately before traditional RT would pro-
vide additional beneficial effects on the maximal dynamic
strength (1RM knee extension), CSA, endurance, and
muscle efficiency of the quadriceps muscle in young men.
We hypothesized that muscle failure (principally of type
Fig. 7  Maximal number of repetitions (a) and muscular work index
(%RMS) (b) for the knee extension exercise at 60 % of 1RM pre-
training (white bar) and post-training (black bar) in the control (CO,
N = 9), traditional training (TR, N = 9), and prior exhaustive training
(PE, N = 9) groups. %RMS = [(RMS/NmáxRep) × 100 %]. The val-
ues are the mean ± SD. *P < 0.05 compared with all corresponding
pre-training values. #P < 0.05 compared with the corresponding TR
and CO post-training values
I fibers) and metabolic accumulation induced by prior
exhaustive exercise would promote a greater global recruit-
ment of type II fibers during traditional training sets and,
thus, further stimulate muscle performance and adapta-
tions. Our results confirm this hypothesis by showing for
the first time that 1RM knee extension, CSA, endurance,
and muscle efficiency were significantly enhanced by the
inclusion of a single set of exhaustive exercise at 20 % of
1RM immediately before traditional resistance training.
The traditional hypertrophic training protocol used in
this investigation was originally designed in accordance
with the ACSM Position Stand guidelines on progression
models in RT for healthy adults (American College of
Sports Medicine 2009). However, we included a single set
of exhaustive exercise before traditional resistance training
(PE group) because we are particularly interested in induc-
ing muscle failure (principally of type I fibers) and metabo-
lite accumulation before traditional resistance training. Our
study is limited because we cannot confirm the fatigue/
exhaustion of type I fibers (e.g., depletion of the ATP-PC
system); however, evidence from previous studies confirms
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1596
that training to failure at a relatively low intensity (up to
30 % of 1RM) primarily recruits slow-twitch motor units
(Abe et al. 2006; Mitsiopoulos et al. 1998). Therefore, the
additional set of exhaustive exercise indeed induced fatigue
in the type I fibers before the traditional training. To our
knowledge, this study is the first to use a training strategy
to stimulate the recruitment of the type II fibers during sets
of traditional resistance training.
The traditional RT protocol (3 sets of 8–12 repetitions
at 75 % of 1RM) used in the TR group resulted in a sig-
nificant increase (∆ %) of 11.8 and 26.6 % in the quadri-
ceps muscle CSA and 1RM, respectively. This result is per-
haps not surprising considering previously published data
on RT (4–12 week) using multiple sets (Holm et al. 2008;
Ronnestad et al. 2007; Seynnes and de Boer 2007; Soon-
este et al. 2013) in which showed increases of ~8–13 %
and ~16–36 % in muscle CSA (Holm et al. 2008; Hubal
et al. 2005; McCall et al. 1996; Ronnestad et al. 2007;
Sooneste et al. 2013) and 1RM (Campos et al. 2002; Holm
et al. 2008; Sooneste et al. 2013), respectively. However, a
novel finding in the current study was the marked increase
of 20.5 and 44.2 % in CSA and 1RM, respectively, in the
PE group. This result supports the hypothesis proposed in
this study that inclusion of an additional set of exhaustive
exercise at 20 % of 1RM before traditional RT promotes
additional effects on muscle strength and hypertrophy
in young men. We believe that this beneficial effect from
the additional set was primarily due to the greater train-
ing volume for two possible reasons. First, the PE group
performed approximately 45–55 repetitions during the
additional set of prior exhaustive exercise at 20 % of 1RM.
This number is twofold greater than is generally performed
during the traditional training sets (8–12 repetitions) for
inducing hypertrophy (American College of Sports Medi-
cine 2009). Considering that an additional set at 20 % of
1RM until failure recruited primarily type I fibers (Ameri-
can College of Sports Medicine 2009; Sale 1987) and that
a greater number of type II fibers are recruited when the
point of muscular fatigue is reached (Schoenfeld 2013;
Willardson 2007), it is likely that the elevated fatigue of
type I fibers during the additional set resulted in a greater
subsequent recruitment of type II fibers and consequent
hypertrophy. Indeed, previous studies have shown that the
global increase in muscle strength and mass in response to
progressive RT results from a greater hypertrophic effect
on type II fibers (26–57 %) than on type I fibers (12.5–
15 %) (Campos et al. 2002; Kosek et al. 2006; Shepstone
et al. 2005; Tesch 1987). Furthermore, type II muscle fibers
appear to be more sensitive to GH stimulation (Aroniadou-
Anderjaska et al. 1996) and S6K1 activity (involved in the
regulation of MPS) (Tannerstedt et al. 2009), indicating
that the increased recruitment of type II fibers could favor
the hypertrophy response. Thus, it seems logical that the
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Eur J Appl Physiol (2015) 115:1589–1599
greater recruitment of type II fibers in the PE group should
result in greater increases in 1RM (+17.6 %) and total
CSA (+8.5 %) compared with those in the traditional train-
ing group (TR group).
Second, the greater metabolite accumulation induced
by the additional set until exhaustion in the PE group may
have increased the recruitment of type II fibers and fur-
ther stimulated hypertrophy during the training bout. This
hypothesis is consistent with previous Kaatsu training stud-
ies (training with blood flow restriction) that showed an
increased recruitment of type II fibers (Suga et al. 2009,
2010; Takarada et al. 2000a, b) and consequent amplifica-
tion of the hypertrophy response (Takarada et al. 2002),
even under light load conditions (Fry et al. 2010). This
enhanced type II fiber recruitment has been proposed as
the primary mechanism by which such exercise elicits
hypertrophic adaptations (Loenneke et al. 2011; Meyer
2006). One possible explanation for this effect is that the
venous occlusion induces increased metabolite accumula-
tion (Loenneke et al. 2010) that forces recruitment of the
type II fibers (Suga et al. 2009, 2010; Takarada et al. 2000a,
b), which are highly hypertrophic (Campos et al. 2002).
The effects of metabolic stress are also supported by pre-
vious findings of RT studies, which showed similar MPS
responses independent of exercise intensity (Mitchell et al.
2012) and greater hypertrophy (Krieger 2010; Wolfe et al.
2004) and strength (Rhea et al. 2002, 2003; Wolfe et al.
2004) responses in higher volume protocols compared to
single-set protocols. Thus, the greater metabolite accu-
mulation in the PE group induced by greater training vol-
ume from the additional set could further stimulate type II
fiber recruitment and maximize the hypertrophy response
during the training bouts. From a practical perspective,
our findings challenge the recommendation that mechani-
cal load (training intensity) provides a superior anabolic
stimulus for hypertrophy (American College of Sports
Medicine 2009) and suggest that metabolic stress should
be an important variable to consider when RT programs for
strength and hypertrophy are designed.
It is important to note that the increase in training vol-
ume from the additional set is effective only when the train-
ing intensity (workload) is sufficient to promote an adap-
tive stimulus of strength and hypertrophy. Campos et al.
(2002) have reported that an 8-week traditional training
program involving 2 sets of 20–28 repetitions (high-vol-
ume, low-intensity) did not result in muscle fiber hyper-
trophy. In contrast, a low-volume, moderate-intensity pro-
tocol (3 sets of 9–11 repetitions) promoted a significant
increase in the CSA of the 3 major muscle fiber types (I,
IIa, and IIx) (Campos et al. 2002). Additionally, previous
studies showed that gains in muscle strength are inhibited
when muscular endurance training is performed concur-
rently (Bell et al. 1991; Hickson 1980; Sale et al. 1990),
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Eur J Appl Physiol (2015) 115:1589–1599 1597
suggesting that an increase in training volume can decrease
the training intensity and, thus, suppress the training effects
on muscle strength. In our study, the subjects who per-
formed prior exhaustive exercise at 20 % of 1RM to failure
(PE group) were able to complete the total number of rep-
etitions (range of 8–12 repetitions) required for each of the
3 sets of traditional hypertrophic training, that is, the prior
exhaustive exercise did not affect the intensity of the subse-
quent training sets. The maintenance of exercise intensity
even with the volume increase from an additional set could
explain the benefits of the protocol presented in this study.
Thus, the combination of prior exhaustive exercise (empha-
sizing increased total work) and traditional RT (emphasiz-
ing mechanical loading) used in our study appears to be
the most effective combination for promoting an additional
increase in muscle strength and hypertrophy. The train-
ing protocol presented here highlights that the variation in
training volume and its interaction with intensity are key
factors for maximizing strength and hypertrophy.
Additionally, the PE group experienced greater increases
in LME and work efficiency compared with the TR group
from pre- to post-training. These results are perhaps not
surprising considering the previously published data on RT
in humans (Campos et al. 2002; Goto et al. 2004; Huczel
and Clarke 1992). The results of these studies show that
high-volume, low-intensity protocols result in a greater
increase in muscular endurance than low-volume, high-
intensity protocols. Thus, the greater increase in train-
ing volume in the PE group compared with the TR group
could, at least partially, explain the additional increase in
LME after the 8-week RT program. It is important to note
that a considerable increase in training volume (e.g., mul-
tiple sets with 15–20 repetitions or more) generally sup-
presses the training effects on strength and hypertrophy
(Campos et al. 2002) due to the reduction in training inten-
sity. However, in our study, the greater training volume in
the PE group further promoted LME without affecting the
additional gains in 1RM and hypertrophy. As a result, the
combination of these effects promoted greater muscular
work efficiency (as indicated by the lowest muscular work
index) during the LME test in the PE group compared with
the group TR. This result indicates that this novel training
protocol can also improve muscle fiber recruitment during
repeated, maximal contraction activities.
In conclusion, our results show that the inclusion of a
single set of exhaustive exercise at 20 % of 1RM immedi-
ately before traditional RT promotes additional beneficial
effects on quadriceps maximal strength, hypertrophy, and
endurance in young subjects. To define the usefulness of
this protocol in other populations (e.g., women and older
subjects) and muscle groups (e.g., muscles of the upper
body extremities), future studies should be performed
to clarify the physiological (e.g., potential for inducing
overtraining) and metabolic (e.g., GH, testosterone, lac-
tate, and cortisol levels) responses to prolonged train-
ing (>8 week) and to determine how including this set
with other types of exercise affects a periodized training
program.
Conflict of interest  No conflicts of interest, financial, or otherwise,
are declared by the author(s).
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