Research articles

By Mr. Gustavo Barquilha , Mr. Marco C Uchida , Mr. Vinícius C Santos , Mr. Nivaldo R Moura , Dr. Rafael H Lambertucci , Dr. Elaine Hatanaka , Dr. Maria F Cury-Boaventura , Dr. Tania C Pithon-Curi , Dr. Renata Gorjão , Dr. Sandro M Hirabara
Corresponding Author Dr. Sandro M Hirabara
ICAFE, Cruzeiro do Sul University, Rua Galvão Bueno, 868 - Brazil 01506-000
Submitting Author Dr. Sandro M Hirabara
Other Authors Mr. Gustavo Barquilha
ICAFE, Cruzeiro do Sul University, - Brazil

Mr. Marco C Uchida
Physical Education, UniFIEO, - Brazil

Mr. Vinícius C Santos
ICB, University of São Paulo, - Brazil

Mr. Nivaldo R Moura
ICAFE, Cruzeiro do Sul University, - Brazil

Dr. Rafael H Lambertucci
ICAFE, Cruzeiro do Sul University, - Brazil

Dr. Elaine Hatanaka
ICAFE, Cruzeiro do Sul University, - Brazil

Dr. Maria F Cury-Boaventura
ICAFE, Cruzeiro do Sul University, - Brazil

Dr. Tania C Pithon-Curi
ICAFE, Cruzeiro do Sul University, - Brazil

Dr. Renata Gorjão
ICAFE, Cruzeiro do Sul University, - Brazil


One Repetition Maximum Test, Muscle Damage, Inflammation, Creatine Kinase, C-Reactive Protein,

Barquilha G, Uchida MC, Santos VC, Moura NR, Lambertucci RH, Hatanaka E, et al. Characterization of the Effects of One Maximal Repetition Test on Muscle Injury and Inflammation Markers. WebmedCentral PHYSIOLOGY 2011;2(3):WMC001717
doi: 10.9754/journal.wmc.2011.001717
Submitted on: 09 Mar 2011 07:04:41 PM GMT
Published on: 10 Mar 2011 09:56:03 PM GMT


We assessed the influence of the one repetition maximum (1RM) bench press exercise on the temporal profile of markers of muscular injury (creatine kinase - CK - activity) and inflammation (interleukin-2 - IL-2, IL-1β, tumoral necrose factor-a - TNF-α, IL-6, and C-reactive protein - CRP). Participants were 11 healthy subjects both genders (eight men and three women), active, involved in strength training, for recreational purposes for more than six months. Characteristics of the volunteers were: age (21.5 ± 6.5 years), weight (70.1 ± 21.1 kg), height (172.8 ± 52.1 cm), and fat mass (14.5 ± 5.7 %). Sample blood was colleted before the 1 RM test and at 1 h, 24 h, 48 h, and 6 days after the test. Statistical analysis was performed using ANOVA with repeated measurements and Bonferroni post-test. There was a significant increase in the CK activity after 6 days of the test when compared to pre-test time, whereas CRP activity increased 24 and 48 hours when compared to pre-test period. There was not significant difference in the plasma cytokine levels. Although 1 RM test did not alter the levels of inflammatory cytokines, it can be observed through this work that this test can induce muscle damage, which would be a negative factor for athletes, since the muscle injury and inflammation are associated with decreased performance, especially strength and muscle power.


Before the prescription of resistance exercise, it is common to use some tests in order to evaluate muscle strength and track, as for example the one repetition maximum test (1 RM test). This test, by raising the maximum weight possible in a single complete movement, aims to stimulate the dynamic maximum strength by the practitioner (Ware et al. 1995). The 1 RM test has several advantages, such as low cost, easy implementation, specificity, and ability to adapt to reality of various sports (Barnard et al. 1999). However, physiological changes induced by the 1 RM test have been poorly studied. Here, we evaluated the effects of 1 RM on muscle injury and inflammatory markers in healthy subjects.
Resistance exercise has been shown to be an important intervention for promoting and maintaining health and quality of life. However, the physiological changes promoted by resistance exercise are under investigation yet. It is noteworthy to date that no studies are found about the muscle damage and inflammation caused by the 1RM test in healthy subjects.
Analysis of markers of muscular injury and inflammation is frequently used to investigate whether there is muscle damage induced by exercise (Glesson 2002; Margonis et al. 2007; Uchida et al. 2009). The activity of the creatine kinase (CK) in blood has been used as a main surrogate marker of muscle damage, resulting from eccentric exercise (Stupka et al. 2000; Totsuka et al. 2002; Evans et al. 2002; Nosaka et al. 2002a; Nosaka et al. 2002b; Tartibian et al. 2009). The increase CK activity in plasma indicates that there was a release of the enzyme due to a rupture of the muscle cell membrane (muscle damage), considering that CK does not have the ability to cross the membrane when the sarcoplasm is intact (Brown et al. 1997; Brancaccio et al. 2007). Increased plasma activity of this enzyme is influenced by both the volume and intensity of exercise (Tiidus and Ianuzzo 1983; Uchida et al. 2009).
Tissue damage leads to activation of the immune defense cells, the leukocytes, in order to remove unwanted elements arising from such injury (Pyne 1994). When activated, the leukocytes can stimulate the release of proinflammatory cytokines such as tumor necrosis factor-α (TNF-α) and interleukins (IL), IL-8 and IL-6. These factors stimulate the release of anti-inflammatory cytokines as IL-1ra and may also stimulate the acute phase proteins, such as C-reactive protein (CRP) (Nieman et al. 2005; Smith 2000b; Robson 2003; Steensberg et al. 2003).
Abrupt increases in markers of muscle damage and inflammation resulting from intense muscle effort can affect the immune system and metabolism, impairing the performance of athletes (Nieman 2007; Steensberg et al. 2003). The 1 RM test is greatly and frequently used for measuring muscle strength, but its effects on muscle damage and inflammatory process is not known yet. Thus, the purpose of this study was to assess the influence of the 1RM bench press exercise on the temporal profile of markers of muscular injury and inflammation in healthy subjects.


Participants of the study were 11 healthy subjects both genders (eight men and three women), active, involved in strength training, for recreational purposes for more than six months. Characteristics of the volunteers were: age (21.5 ± 6.5 years), weight (70.1 ± 21.1 kg), height (172.8 ± 52.1 cm), and fat mass (14.5 ± 5.7 %). The subjects voluntarily signed a consent form. This study was approved by the ethics committee and research of the Cruzeiro do Sul University (protocol No. 039/2009).
Exercise protocol (1 RM test)
For the determination of 1 RM in a bench press exercise, participants were instructed to grip the bar at a comfortable position, which was typically 10 to 20 cm wider than shoulder width (Kim et al. 2002). Subjects performed a warm-up consisting in 3 sets: 1st set: 8–10 repetitions using a light weight (~ 50% of 1 RM); 2nd set: 3–5 repetitions using a moderate weight (~ 70% 1 of RM); 3rd set: 1–3 repetitions using a heavy weight (~ 80% of 1RM). After the warm-up, each participant was submitted to the 1 RM test by increasing the resistance on subsequent attempts until he or she was unable to finalize a full correct movement. Approximately 5 sets of one repetition were accomplished and each attempt was separated by 3 min of rest (Shimano et al. 2006). The 1 RM tests were accomplished by two trained spotters.
Determination of the CK, plasma interleukin concentrations and serum CRP
CK activity and CRP were determined by a highly sensitive immunoturbidimetric method (Bioclin Diagnostics, São Paulo, Brazil), according to the manufacturer’s instructions. Plasma concentrations of IL-6, IL-8, TNF-α, and IL-1ra were determined based on the enzyme-linked immunosorbent assay (ELISA), using a Duoset Kit (Quantikine, R&D Systems, Minneapolis, MM, USA), following the manufacturer’s instructions.
Statistical analysis
Analysis of variance (ANOVA) with repeated mesuarements, followed by the Tukey post-test, was performed to verify the statistical differences. Criterion for statistical significance was set at p


Illustration 1 shows the activity of CK and the concentration of CRP in plasma (Illustration 1A and 1B, respectively). The 1 RM test increased the CK activity
after 24 h, remaining elevated up to 6 days after the test (p less than 0.05) in a time-dependent manner (Ilustration 1A). CRP concentration was elevated 24 h after the 1
RM test (p less than 0.001), remained elevated up to 48 h (p less than 0.001) and returned to the basal value at 6 days after the test (Illustration 1B). No changes in the pro-inflammatory cytokines IL-6, TNF-a, IL-8 and IL-1Ra induced by 1 RM test were found (Illustration 2)


Although a growing number of studies focusing the changes in markers of inflammation and injury during and after resistance exercise, nothing is known about the physiological aspect of the test after completion of a 1 RM test, one exercise of high intensity and low volume. In this study, we found a linear increase in activity of CK at the times 24 h, 48 h, and 6 days after the 1 RM test. Studies have shown that CK may remain increased up to 7 days after the execution of an effort (Brancaccio et al. 2007; Bruunsgaard et al. 1997).
Uchida et al. (2009) conducted a study which aimed to investigate muscle damage in different intensities in bench press exercise. The intensities were 50%, 75%, 90% and 110% of 1 RM. The activity of CK enzyme increased significantly in all groups after bout, with no significant difference among groups, probably because the total volumes were similar among them. Already Paschalis and colleagues (Paschalis et al. 2005) compared two different protocols of resistance exercise, with a moderate and one with high intensity, finding a significant increase of CK in both protocols. But, it is noteworthy that the highest value of CK activity presented in this study was found in the group who performed intense exercise, showing that the intensity of exercise is the major factor in modulating the response of CK activity.
Were also evaluated some markers of muscle inflammation. These markers were cytokines (IL-8, IL1R-a, TNF-α and IL-6), which did not show significant changes with the test of 1RM. Our results corroborate the findings of Uchida et al. (2009) and Hirose et al. (2004), who also found no significant changes of the cytokines analyzed with a protocol of strength training. The Ushida’study (2009) evaluated the cytokines IL-6 and IL-1β, in addition to TNF-α. No significant change was found in none of these cytokines in any of intensities studied (50, 75, 90 and 110% of 1 RM). Hirose et al. (2004) investigated the effect of a protocol of eccentric exercise (6 sets of 5 repetitions in exercise of elbow flexors) in several cytokines, among them the IL-1ra, IL-6, IL-8 and TNF- α. These cytokines, in corroborating with our results, were not significantly modified by the eccentric exercise. Changes in plasma cytokines have been found in exercises cyclic bulk (Toft et al. 2000; Nieman 2001). Thus, one possible reason for the lack of alteration of cytokines in our study is the small volume used by the 1 RM test. In addition, an important factor that should be taken into account is the difficulty in detecting cytokines in plasma, due to the short time that they are stable (Petersen and Pedersen 2005).
In the present study, we found an increase in acute phase protein CRP, which peaked at 48 hours after te 1 RM test. CRP has proinflammatory characteristics (activation of the complement system and opsonization of bacteria) and anti-inflammatory (to prevent the adhesion of neutrophils to endothelial cells, inhibit the generation of superoxide by neutrophils and stimulating the synthesis of the receptor antagonist IL-1) (du Closs 2000; Epstein 1999, Semple et al. 2004). Taylor et al. (1987) found an increase of 300%, 24 hours after performing a triathlon race. Semple and colleagues (2004) also found a significant increase of this protein after an ultramarathon. It is well known that the cytokines IL-6 and TNF-α stimulate the production of acute-phase proteins, such as CRP (Semple et al. 2004; Du Closs 2000). In our study we found a significant increase in CRP, but was not detected increased IL-6 and TNF-α, possibly because the CRP is more stable in plasma than cytokines, which are more difficult to detect (Pedersen 2005).
In conclusion, the 1 RM test (a session of high intensity, but low volume) was enough to increase CK activity and CRP concentration in the plasma. These results suggest that indeed there were muscle damage and inflammatory response (increased CRP) after the 1 RM test. Concentration of pro-inflammatory cytokines, however, was not modified by the test.


The 1RM test is widely used by athletes of various sports. It can be observed through this work that this test of high intensity and low volume can lead to induction of muscle damage, which would be a negative factor for the athletes, since the muscle injury and inflammation are associated with decreased performance, especially strength and muscle power. Therefore, special care must be taken in introducing the 1RM test in sports periodization.


1 RM, one repetition maximum; IL, interleucin; TNF, tumoral necrosis factor; CK, creatine kinase; CRP, C-reactive protein


This study was supported by grants from FAPESP, CNPq, and CAPES.


1. Barnard KL, Adams KJ, Swank AM, Mann E, Denny DM (1999) Injuries and muscle soreness during the one repetition maximum assessment in a cardiac rehabilitation population. Journal of Cardiopulmonary Rehabilitation 19:52-58.
2. Brancaccio P, Maffulli N, Limongelli FM (2007) Creatine kinase monitoring in sport medicine.  British Medical Bulletin 81:209-230.
3. Brown SJ, Child SH, Donnelly AE (1997) Exercise-induced skeletal muscle damage and aaptations following repeated bouts of eccentric muscle contractions. Journal of Sports Sciences 15:215-222.
4. Bruunsgaard H, Galbo H, Halkjaer-Kristensen J, Johansen TL, MacLean DA, Pedersen BK (1997) Exercise-induced increase in serum interleukin-6 in humans is related to muscle damage. Journal of Physiology 15:833–841.
5. Clarkson PM, Hubal MJ (2002) Exercise-induce Muscle Damage in Humans. American Journal of Physiology Rehabilitation 81:52-69.
6. Du Clos TW (2000) Function of C-reactive protein. Annals of Medicine  32:274-278.
7. Evans RK, Knight KL, Draper DO, Parcell, AC (2002) Effects of warm-up before eccentric exercise on indirect markers of muscle damage. Medicine and Science & Sports and Exercise 34:1892–1899.
8. Epstein FH (1999) Acute phase proteins and other systemic responses to inflammation. The New England Journal of Medicine 340:448-454.
9. Fallon KE (2001) The acute phase response and exercise: The ultra-marathon as prototype exercise. Clinical Journal of  Sports Medicine 11:38-43.
10. Gleeson M (2002) Biochemical and immunological markers of overtraining. Journal of Sports Science and Medicine 1:31-41
11. Hirose L, Nosaka K, Newton M, Laveder A, Kano M, Peake J, Suzuki K (2004) Changes in inflammatory mediators following eccentric exercise of the elbow flexors. Exercise Immunology Reviews 10:75-1090.
12. Kim PS, Mayhew JL, Peterson DF (2002). A modified YMCA bench press test as a predictor of 1 repetition maximum bench press strength. Journal of Strength and Conditioning Research 16:440–445.
13. Lake MJ, Lafortune MA (1998) Mechanical inputs related to perception of lower extremity impact loading severity. Medicine and Science & Sports and Exercise 30:136-143
14. Margonis K, Fatouros IG, Jamurtas AZ, Nikolaidis MG, Douroudos I, Chatzinikolaou A, Mitrakou A, Mastorakos G, Papassotiriou I, Taxildaris K, Kouretas D (2007) Oxidative stress biomarkers responses to physical overtraining: Implications for diagnosis. Free Radical Biology and Medicine 43:901-910.
15. Nieman DC, Davis JM, Henson DA, Gross SJ, Dumke CL, Utter AC, Vinci DM, Carson JA, Brown A, McAnulty LS, Triplett NT (2005) Muscle cytokine mRNA changes after 2.5 h of cycling: influence of carbohydrate. Medicine and Science & Sports and Exercise 37:1283-1290.
16. Nieman DC (2007) Marathon training and immune function. Sports Medicine 37:412-415.
17. Nieman DC, Dru A, Henson LL, Smith AC, Utter DM, Vinci J, Mark D, David E, Shute M (2001) Cytokine changes after a marathon race. Journal of Applied Physiology  91:109–114.
18. Nosaka K, Newton M, Sacco P (2002a). Delayed-onset muscle soreness does not reflect the magnitude of eccentric exercise-induced muscle damage. Scandinavian Journal of Medicine and Science in Sports 12:337–346.
19. Nosaka K, Newton M, Sacco, P. (2002b). Muscle damage and soreness after endurance exercise of the elbow flexors. Medicine and Science in Sports and Exercise 34:920–927.
20. Paschalis V, Koutedakis Y, Jamurtas AZ, Mougios V, Baltzopoulos V (2005) Equal volumes of high and low intensity of eccentric exercise in relation to muscle damage and performance. Journal of Strength and Conditioning Research 19:184–188.
21. Petersen AM, Pedersen BK (2005) The anti-inflammatory effect of exercise. Journal of Applied Physiology 98:1154–1162
22. Pyne DB (1994) Regulation of neutropil function during exercise. Sports Medicine 17:245-258.
23. Robson PJ (2003) Elucidating the unexplained underperformance syndrome in endurance athletes: the interleukin-6 hypothesis. Sports Medicine 33:771-778.
24. Semple SJ, Smith LL, McKune AJ, Neveling N, Wadee A (2004) alterations in acute-phase reactants (CRP, rheumatoid factor, complement, factor B, and immune complexes) following an ultramarathon. South African Journal of Sports Medicine 20:17-21.
25. Shimano T, Kraemer WJ, Spiering BA, Volek JS, Hatfield DL, Silvestre R, Vingren JL, Fragala MS, Maresh CM, Fleck SJ, Newton RU, Spreuwenberg LP, Hakkinen K (2006). Relationship between the number of repetitions and selected percentages of one repetition maximum in free weight exercises in trained and untrained men. Journal of Strength and Conditioning Research 20:819–823.
26. Smith LL, Anwar A, Fragen M, Rananto C, Holbert D (2000a) Cytokines and cell adhesion molecules associated with high-intensity eccentric exercise. European Journal of Applied Physiology  82:61-67.
27. Smith LL (2000b) Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress? Medicine and Science & Sports and Exercise 32:317-331.
28. Steensberg A, Fischer CP, Keller C, Møller K, Pedersen BK (2003) IL-6 enhances plasma IL-1ra, IL-10, and cortisol in humans. American Journal Physiology Endocrinology Metabolism 285:433-437.
29. Stupka N, Lowther S, Chorneyko K, Bourgeois JM, Hogben C, Tarnopolsky MA (2000) Gender differences in muscle inflammation after eccentric exercise. Journal of Applied Physiology 89:2325-2332.
30. Taylor C, Rogers G, Goodman C, Baynes RD, Bothwell TH, Bezwoda WR, Kramer F, hattingh J (1987) Hematologic, iron-lelated, and acute-phase protein responses to sustained strenuous exercise. Journal of Applied Physiology 62:464-469.
31. Tartibian B, Azadpoor N, Abbasi, A (2009) Effects of two different type of treadmill running on human blood leukocyte populations and inflammatory indices in young untrained men. Journal of Sports Medicine and Physical Fitness 49:214-223.
32. Tiidus PM, Ianuzzo CD (1983) Effects of intensity and duration of muscular exercise on delayed soreness and serum enzyme activities. Medicine and Science & Sports and Exercise 15:461-5.
33. Totsuka M, Nakaji S, Suzuki K (2002) Break point of serum creatine kinase release after endurance exercise. Journal of Applied Physiology 93:1280-1286.
34. Toft AD, Thorn M, Ostrowski K, Asp K, Møller K, Iversen S et al. N-3 polyunsaturated fatty acids do not affect cytokine response to strenuous exercise. Journal of Applied Physiology  89:2401–2406.
35. Uchida MC, Nosaka K, Ugrinowitsch C, Yamashita A, Martins JE, Moriscot AS, Aoki MS (2009) Effect of bench press exercise intensity on muscle soreness and inflammatory mediators. Journal of Sports Sciences 27:499-507.
36. Ware JS, Clemens CT, Mayhew JL, Johnston TJ (1995) Muscular endurance repetitions to predict bench press and squat strength in college football players. Journal of Strength and Conditioning Research 9:99-103.

Source(s) of Funding

This work was supported by CNPq, FAPESP and CAPES.

Competing Interests

This study has no competing interests.


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