Effects of Heavy-Resistance Triceps Surae Muscle

Training on Strength and Muscularity of Men and

Women
LAWRENCE W. WEISS,
FRANK C. CLARK,
and DAVID G. HOWARD

The purpose of this study was to determine selected functional and structural
effects of heavy-resistance training on the triceps surae muscles of men and
women. We pretested 28 men and 28 women for triceps surae muscle isotonic
strength and muscularity after five practice sessions that familiarized them with
the study equipment. Triceps surae muscle isotonic strength was determined
using a 1-repetition maximum seated heel raise. Muscularity involved the meas-
urement of relaxed lower leg circumference and net circumference and ultrason-
ically determined triceps surae muscle thickness. Twenty-eight subjects (14 men,
14 women) were selected randomly after pretesting to participate in 24 sessions
of standardized weight training primarily involving the triceps surae muscles, and
the remaining subjects (14 men, 14 women) served as nontraining controls. After
eight weeks of training, triceps surae muscle isotonic strength had increased
significantly (p < .001) for both men and women in the Treatment Group when
compared with the Control Group. No other dependent variables changed signif-
icantly. We concluded that eight weeks of heavy-resistance training involving the
triceps surae muscles elicits similar significant increases in isotonic muscle
strength in both men and women without concurrent increases in muscularity.
Key Words: Exercise, strengthening; Hypertrophy; Lower extremity, ankle and foot;
Ultrasound; Weight lifting.

Muscle strength enhancement and primarily to be due to men's initially essential to work-induced muscle hyper-
skeletal muscle hypertrophy are two of greater average body mass and lean trophy.12-14 Furthermore, no convincing
the expected outcomes of heavy-resist- body mass.1-3 Relative muscle strength experimental evidence exists of differ-
ance training. The comparative gains in increments after weight training, how- ential hypertrophic responses of men
maximal force-generating capacity ever, may be greater in women than in and women to heavy-resistance training.
(strength) for men and women tend to men.4 These differential responses to In two studies in which the effects of
vary depending on whether strength is heavy-resistance training have been at- heavy-resistance training on men and
expressed on an absolute or relative tributed to social and cultural restric- women were compared directly, the
(percentage change) basis. Absolute tions placed on women in western soci- heavier-weight men obtained greater ab-
gains in muscle strength in response to ety that result in women being much solute increases in body weight, fat-free
standardized heavy-resistance training further from their maximal strength po- weight, and selected limb circumfer-
typically are greater in men than in tential than men.3-5 ences than did the lighter-weight
women.1,2 This phenomenon appears In studies in which women achieved women, although the percentage or rel-
only small increases in muscle size after ative changes on the same variables were
L. Weiss, EdD, FACSM, is Director, Exercise
Science Laboratory, Department of Health, Physi- heavy-resistance training, their low nearly identical for both sexes.5,15
cal Education, and Recreation, Memphis State Uni- blood androgen levels were postulated Weight-training studies in which either
versity, Memphis, TN 38152 (USA). He was Direc- as the primary cause of an apparent lack men or women participated as subjects
tor, Exercise Science Laboratory, School of Health,
Physical Education, Recreation, and Nursing, of muscular hypertrophy.1,5-7 Because have been contradictory about concur-
Georgia Southern College, Statesboro, GA 30460- no difference in the force-generating ca- rent gains in skeletal muscle strength
8073, when this study was conducted.
F. Clark, PhD, is Chairman, Department of Com- pacity of equal cross sections of skeletal and hypertrophy. Several reports have
puter Science, University of Tennessee Center for muscle appears to exist in vivo between indicated that significant strength im-
the Health Sciences, Memphis, TN 38163. men and women,8-11 a lesser amount of provements may occur in the absence
D. Howard, MEd, is Instructor, School of Health,
Physical Education, Recreation, and Nursing, work-induced muscle hypertrophy by of corresponding muscle hypertro-
Georgia Southern College. women seemingly would prevent them phy,16-18 and other studies have re-
This study was supported by the Department of from gaining strength to the same extent ported the two phenomena occurring
Radiologic Services, Bulloch Memorial Hospital,
Statesboro, GA 30458. as men who undergo similar training concurrently.1,3,5,11,19-21
This article was submitted April 17, 1986; was programs. The purpose of our investigation was
with the authors for revision 27 weeks; and was
accepted May 5, 1987. Potential Conflict of Inter- Animal studies, however, have indi- to compare the effects of heavy-resist-
est: 4. cated that androgenic hormones are not ance training in men and women on

208 PHYSICAL THERAPY

 RESEARCH
ucts for any reason in the previous three
months and did not plan to take them
during the course of the study. Each
subject gave written informed consent
according to the guidelines of the uni-
versity's Institutional Review Board be-
fore participating in the investigation.

Testing
Pretests and posttests were adminis-
tered for the following dependent vari-
ables: 1) isotonic plantar flexion
strength, 2) lower leg circumference and
net circumference, and 3) ultrasonically
assessed skeletal muscle thickness. Be-
fore pretesting, all subjects participated
in five pretraining sessions to practice a
standardized weight-lifting technique.
We conducted the pretraining sessions
to familiarize all subjects thoroughly
with the strength-testing apparatus so
that valid data could be obtained.
Each pretraining session began with
six minutes of static calf stretching that
involved placing the plantar surface of
the metatarsals of one foot on the outer
edge of a 7-in* step and concurrently
dropping the heel to the maximal dor-
siflexion position for about 45 seconds.
Each leg was stretched four times, twice
with the knee extended and twice with
the knee slightly flexed. The stretching
activities were followed by four to six
sets of seated heel raises in which the
knees were placed at 90 degrees of flex-
ion, the lumbar spine was extended, and
both hands were pronated on top of
apparatus pads located on the distal as-
pect of the quadriceps femoris muscle
(Fig. 1). Trial and error was used during
pretraining to identify a level of resist-
ance that would enable the subject to
perform four to six repetitions maxi-
Fig. 1. Subject demonstrating strength testing and use of training apparatus for the triceps mum (RM). We used multiple repeti-
surae muscles. A fixed-angle goniometer was used to determine whether plantar flexion
occurred through at least 45 degrees during testing. tions during pretraining to lessen the
potential for injury because of the sub-
selected functional and structural char- Two men in the Treatment Group with- jects' lack of familiarization with the
acteristics of the triceps surae muscles. drew for personal reasons before the equipment. Repetitions were of such a
We expected the training program to study was completed. For a minimum low number, however, that we felt we
elicit significant increases in muscle of three months before the initiation of could reasonably estimate each subject's
strength and size in both men and the study, subjects were not engaged 1-RM level of resistance. Subjects who
women. actively in any type of physical training made more weight selection "errors"
involving the legs. They also reported during pretraining were required to
METHOD on a questionnaire that they were free complete more sets of heel raises than
of any musculoskeletal disease and had those who were more adept in selecting
Subjects a weight to lift that enabled them to
not used any exogenous substances that
We selected 56 volunteers, 18 to 26 might produce anabolic effects. In an achieve the 4- to 6-RM range.
years of age ( = 20.8, s = 1.8) to effort to eliminate the negative impact During a sixth session, subjects' plan-
participate in this investigation. Four- of exogenous estrogen intake on protein tar flexion strength (1 RM) was deter-
teen men and 14 women were chosen retention,7,22 women participated as mined. The heel lift was considered suc-
randomly to participate in the training subjects only if they reported on a ques-
program, and the remaining 14 men and tionnaire that they had not taken or
14 women served as sedentary controls. been given estrogen-containing prod- * 1 in = 2.54 cm.

Volume 68 / Number 2, February 1988 209

cessful only if it was executed through a
C R O S S SECTION OF LOWER LEG
minimum of 45 degrees of plantar flex­
ion as determined by a small, fixed- (anterior)
angle goniometer. Subjects continued to
increase the weight lifted until they no
longer could move through 45 degrees Skin surface
of plantar flexion. Unlimited rest inter­
vals were allowed between maximal
attempts. Tibia
We took circumference and net cir­
cumference measurements at the largest
girth of the subject's relaxed right calf. Fibula
Both circumference measurements were Net c i r c u m f e r e n c e line
determined using a controlled-tension Subcutaneous fat layer
Lufkin† tape. The distance of the meas­ Skeletal muscle
urement site above the inferior border
of the lateral malleolus was noted for
subsequent calf measurements. Net cir­
cumference was calculated by subtract­
ing the approximate thickness of the Medial skinfold site
subcutaneous fat layer, as determined Lateral skinfold site
by Harpenden skinfold calipers.* Skin­
fold measurements were taken at sepa­
rate premarked sites posterior to both (posterior)
the medial and lateral heads of the gas­
Fig. 2. Schematic cross section of right lower leg depicting the two skinfold sites used to
trocnemius muscle parallel to the lon­ calculate net circumference. Net circumference is a measure of muscle and bone, excluding
gitudinal axis of the leg. The median of the subcutaneous fat layer.
three measurements taken at each site
was accepted as representative of the
thickness of the subcutaneous fat layer. head of the gastrocnemius muscle. Ex­ seated heel raises. The muscle-stretching
cept when resolution was inadequate, a activities were the same as those de­
Net circumference was calculated using
7.5-MHz transducer was used; other­ scribed for pretraining. Training con­
modifications of techniques previously
wise, a 5.0-MHz transducer was substi­ sisted of four sets of seated heel raises at
described17,23,24 in which the cross sec­
tuted. Muscle thickness values were not 9 to 13 RM with a two- to three-minute
tion of an extremity is considered cir­
corrected for the calibration velocity rest interval between sets. When the sub­
cular (Fig. 2). Modifications consisted
(1,540 m/sec) of the instrument. Be­ ject exceeded the 13-RM limit, the re­
of using two skinfold sites instead of four
cause the velocity of sound in skeletal sistance was increased for subsequent
and calculating net circumference in­
muscle is 1,570 m/sec, we expected the sets. Competitive body builders fre­
stead of net cross-sectional area of the B-mode scanner to underestimate mus­
limb. The net circumference ( C ) of the quently complete multiple sets ranging
cle thickness consistently by 2%. from 8 to 15 RM to maximize muscular
calf was calculated as To facilitate data collection and en­ hypertrophy. Because we were inter­
C' = π [(C/π) - (skinfold average/2)] sure that subjects would be tested at the ested in the development of muscular
same time relative to the completion of strength and hypertrophy, we chose a
where π is 3.1416, C is the circumfer­ their triceps surae muscle development range of repetitions that we thought
ence, and skinfold average is the average program, start-up training days were would result in the optimal attainment
of the medial and lateral skinfolds. staggered. Posttesting for the dependent of both goals.
Ultrasonically determined measure­ variables associated with muscularity
ments of skeletal muscle thickness were was carried out two days posttraining Data Analysis
made with a 32-shade, B-mode ultra­ with strength assessed on the third post-
sound scanner (Datason DB§) as pre­ training day. Descriptive values for all dependent
viously described for procedures variables were calculated separately for
developed in our laboratory.25 In that Training Program men and women in each group. The
investigation, we reported reliability difference between pretest and posttest
coefficients of .98 and .99 for repeated After pretraining and pretesting, the data represents the cumulative change
measurements on men and women, re­ Control Group continued its typical subjects experienced during the study.
spectively. A transverse survey scan was nontraining routine for eight weeks. The change data for each dependent
made at the largest circumference of the During that time interval, the Treat­ variable were compared separately for
calf, after which measurements were ob­ ment Group participated in 24 sessions men and women in both the Treatment
tained posterior to the tibia at the medial of heavy-resistance bilateral triceps and Control Groups using one-way
surae muscle training at a standardized analyses of variance.
† Country Technology Inc, PO Box 87, Gays
time of day on Mondays, Wednesdays,
Mills, WI 54631. and Fridays. Training was preceded by RESULTS
‡ Quinton Instrument Co, 2121 Terry Ave, Se­ warm-up activities consisting of six min­
attle, WA 98121.
§ General Electric Co, Medical Systems Group, utes of gastrocnemius and soleus muscle For the men in the Treatment Group,
Ultrasound Div, Rancho Cordova, CA 95670. stretching and a submaximal set of 10 plantar flexion strength increased

210 PHYSICAL THERAPY

 RESEARCH

TABLE 1
Adaptations of the Triceps Surae Muscle Group of Men and Women to Heavy-Resistance Training
Triceps Surae
Plantar Flexion Calf Calf Net
Muscle
Strength Circumference Circumference
Thickness
(kg) (cm) (cm) (cm)
s s s s
Treatment Group pretest for men 98.5 16.5 37.80 2.10 34.53 2.06 5.32 .50
Treatment Group posttest for
men 113.5 13.3 37.57 1.98 34.12 2.09 5.44 .44
Change (%) 13.2 -0.6 -1.2 2.2
Control Group pretest for men 91.9 18.6 37.91 2.58 34.28 2.90 5.33 .57
Control Group posttest for men 91.9 19.8 37.69 2.43 34.26 2.25 5.25 .60
Change (%) 0.0 -0.6 -0.1 -1.5
Treatment Group pretest for
women 81.0 23.8 35.33 3.95 29.96 4.28 4.74 .76
Treatment Group posttest for
women 93.4 22.8 35.32 3.91 29.24 4.06 4.87 .71
Change (%) 13.3 0.0 -2.4 2.7
Control Group pretest for women 74.4 8.1 35.61 3.27 29.59 1.39 4.98 .63
Control Group posttest for
women 74.4 8.1 35.39 3.60 29.77 1.94 4.90 .59
Change (%) 0.0 -0.6 0.6 -1.6

TABLE 2
Comparison of Treatment and Control Groups for Changes in Strength and Muscularity After Heavy-Resistance Triceps
Surae Muscle Training
Plantar Flexion Calf Calf Net Triceps Surae
Strength Circumference Circumference Muscle Thickness
(kg) (cm) (cm) (cm)

s s s s
Treatment Group for men
(n = 12) 15.0 13.4 -0.23 .45 -0.41 .34 0.12 .38
Control Group for men
(n = 14) 0.0 5.0 -0.22 .36 -0.03 .85 -0.08 .18
F 15.17a 0.01 2.11 3.21
Treatment Group for women
(n = 14) 12.3 10.2 -0.01 .39 -0.51 .74 0.13 .30
Control Group for women
(n = 14) 0.0 6.2 -0.22 .44 0.19 1.12 -0.01 .27
F 15.01 a 1.87 3.72 1.63
a
p < .001.

TABLE 3 study was determined by subtracting the

Analysis of Variance for Treatment Group Versus Control Group on Change in Pretest pretest values from the posttest values.
and Posttest Scores of Isotonic Plantar Flexion Strength The only significant difference between
Source df SS MS F P the Treatment and Control Groups was
in plantar flexion strength; both men
Men
Total 25 18074.04 and women in the Treatment Group
Treatment 1 7001.12 7001.12 15.18 .0007 had significant increases in plantar flex-
Error 24 11072.92 461.37 ion strength (p < .001) compared with
Women subjects in the Control Group. No sig-
Total 27 14092.86 nificant differences (p > .05) were found
Treatment 1 5157.14 5157.14 15.01 .0007 between the Treatment and Control
Error 26 8935.71 343.68 Groups for any of the selected measures
of lower leg muscularity (Tabs. 2, 3).
13.2%; calf circumference and net cir- net circumference decreased 2.4%, and
cumference decreased 0.6% and 1.2%, triceps surae muscle thickness increased
respectively; and triceps surae muscle 2.7%. Descriptive data for our measures DISCUSSION
thickness increased 2.2%. For the of strength and muscularity are pre- This investigation was designed to
women in the Treatment Group, plan- sented separately for men and women compare the effects of a standardized
tar flexion strength increased 13.3%, in Table 1. The change in each depen- heavy-resistance triceps surae muscle
calf circumference did not change, calf dent variable over the course of the training program on the development of

Volume 68 / Number 2, February 1988 211

strength and muscularity in young men plantar flexion strength in the absence Clinical Implications
and women. It is widely accepted that of corresponding macroscopic increases
men and women respond similarly to in triceps surae muscularity in un- The results of this study support the
heavy-resistance training on a relative trained, but healthy, men and women. hypothesis that men and women would
basis in the development of muscle Because the soleus muscle comprises make similar percentage increases in
strength, but when expressed in absolute only a portion of the triceps surae mus- muscle strength after standardized
terms, men have the capacity to gain cle thickness and lower leg circumfer- heavy-resistance training of the triceps
substantially more strength and muscle ence, whether exclusive soleus muscle surae muscles. Significant muscle
mass.1-4,6 Clear documentation of differ- changes were obscured in this study by strength increments also can be realized
ences in muscular adaptations to heavy- inadequately sensitive measurement after eight weeks of training without
resistance training by men and women, protocols is unclear. concurrent muscular hypertrophy in
however, is unavailable. Two studies Conflicting evidence has been re- both men and women. When short-term
have been reported that compared the ported concerning the relative adapta- training programs are devised for the
chronic adaptations of men and women tions of slow-twitch oxidative muscle development of the posterior lower leg,
to progressive, heavy-resistance train- fibers, the predominant fiber in the so- therefore, sex need not be a considera-
ing.5,15 The men in both investigations leus muscle,26-28 compared with either tion. Furthermore, when dealing with
initially had greater body weight, fat- the fast-twitch oxidative muscle fibers healthy but untrained adults, it is unrea-
free body weight, limb circumference or the fast-twitch glycolytic muscle fi- sonable to expect a significant increase
measurements, and muscle strength bers after heavy-resistance training. Al- in triceps surae muscle size after eight
than the women. After training, abso- though several reports indicate that se- weeks of heavy-resistance seated heel-
lute increases in these variables likewise lective hypertrophy of the fast-twitch raise training similar to that in this
were greater comparatively in the men muscle fibers is not a consequence of study.
than in the women. In contrast, no sex weight training,29-32 other reports have
differences were observed for percentage indicated that the fast-twitch muscle fi- CONCLUSIONS
changes on the same variables, indicat- bers more readily increase in cross-sec-
ing that relative changes were similar in tional area after heavy-resistance train- Eight weeks of heavy-resistance train-
both men and women. ing.33-36 Consequently, the primary use ing involving the triceps surae muscles
We used a seated heel raise in this of a more heterogeneous muscle for elicited significant increases in isotonic
study to conduct heavy-resistance train- training, such as the gastrocnemius strength in both men and women with-
ing. This particular exercise primarily muscle, might reveal different adaptive out concurrent increases in muscularity.
involves the use of the uniarticular so- responses and possibly an alternative When expressed on the basis of percent-
leus muscle, because the flexed knee perspective on the existence of any sex age increase, the average change in
position substantially reduces any con- differences in training effects after strength after a standardized program of
tribution the biarticular gastrocnemius heavy-resistance exercise. The protocols triceps surae muscle weight training was
muscle otherwise might make to plantar used in this study to assess calf muscu- relatively equal in men and women.
flexion. Any training effect in the triceps larity, furthermore, are either indirect in
surae muscles, therefore, probably nature (circumference and net circum- Acknowledgment. We thank Cerillo
would occur primarily in the soleus ference) or lack thorough verification of Aseron, MD, and Linda Tinker, De-
muscle. validity (ultrasonically assessed muscle partment of Radiologic Services,
Eight weeks of heavy-resistance train- thickness).25 Conclusions based on the Bulloch Memorial Hospital, for their
ing (as in this study) most likely will results of this study, therefore, should be cooperation and assistance in the collec-
elicit significant increases in isotonic interpreted cautiously. tion of ultrasonic data.

REFERENCES

1. Brown C, Wilmore J: The effects of maximal 9. Ikai M, Fukunaga T: A study on training effect 14. lanuzzo C, Chen V: Metabolic character of
resistance training on the strength and body on strength per unit cross-sectional area of hypertrophied rat muscle. J Appl Physiol: Res-
composition of women athletes. Med Sci muscle by means of ultrasonic measurement. pirat Environ Exercise Physiol 46:738-742,
Sports 5:174-177, 1974 Internationale Zeitschrift fuer Angewandte 1979
2. O'Shea J, Wegner J: Power weight training Physiologie Einschliesslich Arbeitsphysiologie 15. Knapik J, Wright J, Kowal D, et al: The influence
and the female athlete. The Physician and 28:173-180,1970 of US Army basic entry training on the muscular
Sportsmedicine 9(6): 109-120,1981 10. Shantz P, Randall-Fox E, Hutchison W, et al: strength of men and women. Aviat Space En-
3. Hosier W, Morrow J: Arm and leg strength Muscle fiber type, distribution, muscle cross- viron Med 51:1086-1090,1980
compared between young women and men sectional area and maximal voluntary strength 16. Capen E, Bright J, Line P: The effects of weight
after allowing for differences in body size and in humans. Acta Physiol Scand 117:219-226, training on strength, power, muscular endur-
composition. Ergonomics 25:309-313,1982 1983 ance and anthropometric measurements on a
4. Berger R: Applied Exercise Physiology. Phila- select group of college women. Journal of the
11. Young A, Stokes M, Walker I, et al: The rela-
delphia, PA, Lea & Febiger, 1982 Association for Physical and Mental Rehabili-
tionship between quadriceps size and strength
5. Wilmore J: Alterations in strength, body com- tation 15:169-173,1961
in normal young adults. Ann Rheum Dis
position and anthropometric measurements 17. Moritani T, deVries H: Potential for gross mus-
40:619, 1983
consequent to a 10-week weight training pro- cle hypertrophy in older men. J Gerontol
gram. Med Sci Sports 6:133-138,1974 12. Goldberg A, Etlinger J, Goldspink D, et al: 35:672-682, 1980
6. Lamb D: Androgens and exercise. Med Sei Mechanism of work-induced hypertrophy of 18. Wells J, Jokr E, Bohanen J: The effect of
Sports 7:1-5, 1975 skeletal muscle. Med Sci Sports 7:248-261, intensive training upon body composition of
7. Minguell J, Sierralta W: Molecular mechanisms 1975 adolescent girls. Journal of the Association for
of action of the male sex hormones. J Endo- 13. Goldberg A: Relationship between hormones Physical and Mental Rehabilitation 17:68-72,
crinol 65:287-315,1975 and muscular work in determining muscle size. 1973
8. Davies C, White M, Young K: Muscle function In Alpert N (ed): Cardiac Hypertrophy. New 19. Krotkiewski M, Aniansson A, Grimby G, et al:
in children. Eur J Appl Physiol 52:111-114, York, NY, Academic Press Inc, 1971, pp The effect of unilateral isokinetic strength train-
1983 39-53 ing on local adipose and muscle tissue mor-

212 PHYSICAL THERAPY

 RESEARCH
phology, thickness, and enzymes. Eur J Appl skeletal muscle thickness in the calf area. Phys ities and fiber characteristics in human skeletal
Physiol 40:271-281, 1979 Ther 65:477-481, 1985 muscle. Acta Physiol Scand 96:392-398,1976
20. Mayhew H, Gross P: Body composition 26. Ariano M, Armstrong R, Edgerton V: Hind limb 32. Young A, Stokes M, Round J, et al: The effect
changes in young women with high resistance muscle fiber populations of five mammals. J of high-resistance training on the strength and
weight training. Research Quarterly 45:433- Histochem Cytochem 21:51-55,1973 cross-sectional area of the human quadriceps.
440,1974 27. Burke R, Levine D, Salcman M, et al: Motor Eur J Clin Invest 13:411-417,1983
21. Moritani T, deVries H: Neural factors versus units in cat soleus muscle: Physiological, his- 33. Costill D, Coyle E, Fink W, et al: Adaptations
hypertrophy in the time course of muscle tochemical, and morphological characteristics. in skeletal muscle following strength training. J
strength gain. Am J Phys Med 58:115-130, J Physiol (Lond) 238:503-514,1974 Appl Physiol: Respirat Environ Exercise Physiol
1979 28. Johnson M, Polgar J, Weightman D, et al: Data 46:96-99, 1979
22. Burke C, Anderson D: Sex-hormone-binding on the distribution of fiber types in thirty-six
globulin is an estrogen amplifier. Nature human muscles: An autopsy study. J Neurol 34. Gordon E: Anatomical and biochemical adap-
240:38-40,1972 Sci 18:111-129,1973 tations of muscle to different exercises. JAMA
23. Jones P, Pearson J: Anthropometric determi- 201:129-132,1967
29. Dons B, Bollerup K, Bonde-Peterson F, et al:
nation of leg fat and muscle plus bone volumes The effect of weight-lifting exercise related to 35. Houston M, Froese E, Valeriote St P, et al:
in young male and female adults. J Physiol muscle fiber composition and muscle cross- Muscle performance, morphology and meta-
(Lond) 204:63-66, 1969 sectional area in humans. Eur J Appl Physiol bolic capacity during strength training and de-
24. Kirwan J, Byron M, Winfield J, et al: Circumfer- 40:95-106,1979 training: A one-leg model. Eur J Appl Physiol
ential measurements in the assessment of 30. Tesch P, Larsson L: Muscle hypertrophy in 51:25-35,1983
synovitis of the knee. Rheumatol Rehabil 18: body builders. Eur J Appl Physiol 49:301-306, 36. MacDougall J, Elder G, Sale D, et al: Effects of
78-84,1979 1982 strength training and immobilization on human
25. Weiss LW, Clark FC: Ultrasonic protocols for 31. Thorstensson A, Hulten B, von Dobeln W, et muscle fibers. Eur J Appl Physiol 43:25-34,
separately measuring subcutaneous fat and al: Effect of strength training on enzyme activ- 1980

Volume 68 / Number 2, February 1988 213