Author: dhtmlkitchen

The Decision-Making Process

Humans don’t always make decisions by reasoning from evidence to conclusion. More often, they decide based on how something feels, then use logic afterward to justify it. Bias creeps into the decision-making process, and reason arrives later to explain it.

To varying degrees, people prioritize what feels right over what is correct. Reason and evidence are useful only to the extent that they support a desired outcome. This has two implications: first, we must filter extraneous information to stay focused and simplify decisions; second, this necessary process isn’t infallible: we may overlook uncomfortable facts or favor those that support our feelings, distorting our choices.

“Listen, it don’t really matter to me, baby — you believe what you want to believe” — Tom Petty

Reduced Independent Thinking

Reduced independent thinking correlates with reduced openness to evidence. The decision-making process may instead use “common sense” (appeal to popularity), deference to authority or faith (appeal to authority or scripture), external pressure, selfish motives, intuition, personal assumptions, or feelings.

As a result, logic and evidence can be deprioritized as unnecessary overthinking, diminishing input to the decision-making process.

Individual cognition tends to follow habitual patterns that favor either rigorous truth-seeking or comfortable ease, influencing how much reason guides decisions. Thought patterns amplify over time, with conscientious thinkers improving more, and at a faster rate, than those who think poorly. Consistently reflecting on our thought process and rigorously assessing our choices leads to not only better choices, but stronger thinking habits that predict better choices — think of it as QA (Quality Assurance) for your brain and its thoughts.

“If it ain’t broken, you haven’t tested it enough.” — QA mantra

Application in Fitness

In fitness, this shows up when clients resist the discomfort, uncertainty, or delayed reward inherent in effective training. They may make decisions that feel good in the moment but run counter to their stated goals. In such cases, logical coaching alone fails. Emotional connection becomes the critical leverage point for behavioral change — not through indulgence or lowered standards, but by framing discipline as self-respect and effort as agency. Emotional connection doesn’t require compromising standards, nor does it mean being nice or letting excuses slide — it demands firm, compassionate empathy.

Hold Your Standards

The temptation to encourage clients who put forth minimal effort, if indulged, can lead to lowered standards, loss of respect, and complacency — all of which ultimately lead to failure.

Coaching that relies solely on logic may struggle to retain clients, but emotional connection is not a free pass to lower standards or indulge minimal effort. Effective coaching engages clients towards discipline by balancing empathy with accountability to drive retention and results.

Beyond the Grind: A Blueprint for Accelerated Skill Development

What if more isn’t better? What if your efforts are getting in the way of skill mastery? What are you practicing? Does it build mastery, or just wear you down? If practice makes permanent, are you cementing excellence, or engraining flaws?

What’s the cost of more? In this article, we’ll examine what works, what doesn’t, and how to adapt your routine to master your performance.

What Are You Training For? Define Your Purpose

The most important question every athlete must answer is deceptively simple: What exactly are you training for? Your answer reveals whether you’re settling for general fitness or striving for true performance mastery — the latter being the focus of this article.

Getting in Shape vs. Performance Mastery

Getting in shape — improving general health, building strength and endurance, and reaching peak fitness levels — can be accomplished through countless training methods. Almost any program that challenges your body consistently will yield fitness improvements.

Performance mastery demands more. It requires developing specific skills and applying them under pressure. Here, every element serves competitive excellence.

The performance drills are the conditioning. Not separate conditioning disconnected from skill. Training becomes an integrated system where physiological development happens through skill application, not apart from it.

What Defines Perfect Practice?

Perfect practice makes perfect performance. But what exactly constitutes “perfect practice”?

Perfect practice is characterized by three fundamental qualities:

• Direct Transfer — training that closely mimics the exact skills, movements, technique, timing, and conditions needed, wiring the body and brain for performance

  Takeaway: Train what you use in the way you use it, forget the other stuff.

• Context Integration — applying skills and techniques, new and existing, and established patterns in dynamic practice scenarios that mimic the interactive and unpredictable nature of competition, to develop practical adaptable and effective performance

  Takeaway: Apply your skills in progressively challenging performance situations.

• Strategic Recovery — the proactive and intelligent management of physiological resources to optimize adaptation from training, mitigate fatigue, and enhance readiness for subsequent performance

  Takeaway: Treat recovery as training, not an afterthought.

When these elements align, skill development accelerates dramatically. Athletes progress faster initially and ultimately reach higher performance ceilings because they’re building capabilities directly relevant to their competitive demands. Direct Transfer training prioritizes skill development by allocating training time, focus, and recovery resources to relevant practice, improving the rate and quality of skill acquisition.

Why Do Masters Make It Look So Easy?

Watch Steph Curry sink shots without looking at the rim. See Roger Federer return a 140mph serve with precision. Observe Anderson Silva dodge punches by millimeters, seemingly reading his opponent’s mind.

What you’re witnessing is neurological mastery built on multiple foundations with chunking as a foundational role. Chunking is how your brain transforms separate technical elements into unified actions requiring minimal conscious thought.

The underlying mechanism for building this neurological mastery starts with focused, isolated technique drills that train fundamental neural pathways. Tools like bagwork and padwork are crucial here, allowing for the repeated performance of correct form and efficient movement patterns, which programs “chunks” into the nervous system for correct, efficient execution that can be recalled quickly later on. This repeated activation underpins the development of fluid, automatic movements.

The novice boxer laboriously processes each component: plant feet, rotate hips, extend arm, connect with target. The master accesses these as a single chunk—one fluid motion that automatically adjusts to the opponent’s movement. This neurological efficiency frees cognitive resources for higher-level strategy and perception.

Technique drills, practiced with intent, merge these individual components into one fluid motion that can be recalled and executed as a single unit, or chunk. For instance, a novice boxer focuses on the separate steps of a jab: footwork, guard, shoulder rotation, arm extension, fist rotation, and retraction. Through focused drilling, these individual parts become a single “chunk,” allowing a master to execute the jab with speed and fluidity without conscious thought.

As expertise develops, your brain builds upon chunking to create motor schemas, sophisticated performance templates that adapt instantly to changing conditions. These aren’t rigid instructions but adjustable frameworks, like understanding cooking principles rather than following recipes precisely.

Consider the experienced driver on a mountain road: they don’t calculate steering angles and brake pressure — they feel the road and respond intuitively. Elite athletes similarly navigate competitive chaos with control through instantaneous adjustments they’ve built on comprehensive motor schemas, integrating perception, decision-making, and chunked movement patterns.

Isolated drills develop and hone chunks and schemas, but fall apart if not applied in contextual practice. These patterns must be applied under increasingly realistic conditions to develop them for competitive excellence.

Are You Investing or Squandering Your Recovery Resources?

Your body’s recovery is limited. Adaptation from each session draws on these resources.

Recovery is not just passive time between workouts but, an active process deserving strategic allocation:

• Recovery Prioritization — Focus your training on perfecting the skills needed for performance, prioritizing skill development over less relevant activities.
• Interference Management — Minimize training that drains recovery resources.
• Capacity Enhancement — Speed up your recovery. This includes sleep quality, nutrition, hydration, sauna, Zone 2, red light therapy, foam rolling to promote blood flow and remove waste.

Every training decision represents an investment choice — where will you allocate your limited recovery resources for maximum performance return?

The Performance Gap: Why Gym Warriors Fail in the Ring

The gym hero who vanishes under ring lights isn’t bad luck; it’s an explainable neurological failure of transfer. Bridging the gap from masterful technique training to control under chaotic competition demands a deliberate bridge built on four pillars:

   
1. Decision Pressure: While solo drills build foundational skills, they lack the reactive element of a fight. Smart training bridges this gap by progressively layering decision-making into all modalities: from a pad holder who counters, to visualizing defensive needs on the heavy bag, to reacting to subtle cues in shadowboxing, to live partner reaction drills, culminating in live sparring that demands split-second, consequential choices under increasing pressure.

   

2. Perceptual Triggers: Champions see more than movement; they recognize subtle contextual cues – like weight shifts that telegraph attacks before they launch – and react accordingly. Smart training hones this recognition through drills that incorporate authentic visual and kinesthetic information.

   

3. Psychological Resilience: Ring nerves aren’t overcome by willpower alone. Smart training systematically exposes fighters to audience pressure, consequence (even simulated), and strategic uncertainty to build mental fortitude.

   

4. Environmental Realism: The ring or cage, the crowd, and an uncooperative opponent fundamentally change the fight. Preparation must integrate these realities into training scenarios.

Integrate new techniques immediately in low-pressure sparring. Forge resilience through hard sparring under pressure.

Train in a vacuum, and your skills stay there. The gym hero’s downfall isn’t a mystery: skills aren’t magically transported; they’re forged in the fire of fight-like conditions.

The Path to Mastery: Building Your Blueprint

Here’s how to build an elite combat sports program built on smarter, biologically aligned principles:

1. Technical Excellence Through Contextual Integration

Neural Pathway Activation & Skill Encoding

Focused, isolated technique drills train fundamental neural pathways. Bagwork and padwork allow for the repeated performance of correct form and efficient movement patterns, building conditioning by training technique under fatigue.

Technical development accelerates when initially isolated skills are rapidly integrated into performance contexts. Rather than endlessly drilling techniques in isolation, successful athletes quickly apply new skills in increasingly realistic scenarios.

For example, a basketball player might practice a new shooting technique for 10 minutes, then immediately incorporate it into decision-based drills and small-sided games. This progression creates not just technical proficiency but the ability to execute under the perceptual and decision-making demands of competition.

2. The Conditioning Is the Training

The most effective training approaches recognize that technical practice inherently develops the specific conditioning needed for performance. Boxing combinations naturally train the energy systems required for boxing. Tennis movement patterns directly develop the specific endurance needed for match play.

This integration creates remarkable efficiency:

• Simultaneous skill and conditioning.
• Learning to maintain technique under fatigue — crucial for competition.
• Higher engagement leading to greater training intensity.
• More efficient use of time, focus, and recovery resources in relevant practice.

By structuring technical practice to progressively challenge relevant physiological systems, athletes develop conditioning that directly supports performance excellence.

3. Strategic Complementary Development

While sport-specific training forms the foundation of mastery development, certain complementary approaches may enhance performance, if applied strategically.

• Foundation Strength — Targeted resistance training that develops the fundamental force-producing capabilities underlying sport-specific movements.

  An athletics lab study on well-trained MMA athletes showed improvements in strength, power, and aerobic fitness with competition-oriented high-intensity, low-volume strength training (Kostikiadis et al., 2018). However, the study’s outcomes don’t show direct transfer to MMA performance. Because such training heavily taxes the CNS, it requires careful consideration in the scope of athletics programs.

• Movement Efficiency — Mobility and coordination work that enhances the biomechanical foundations of performance.
• Recovery Enhancement — Practices like Zone 2 cardiovascular training, breath work, and sleep optimization that expand recovery capacity

The key distinction: movement efficiency and recovery enhancement primarily support sport-specific development, strength training requires careful management, as it uses limited recovery resources.

4. Individualized Progression Management

The path to mastery isn’t linear — it requires systematic progression based on individual adaptation responses. Successful athletes continuously assess both performance transfer and recovery status, adjusting training loads and emphases accordingly.

This process demands honest evaluation of two critical questions:

• Is my training directly transferring to performance improvement?
• Am I managing recovery resources effectively?

When these questions guide training decisions, both immediate progress and long-term development accelerate.

Why Generalized Training Misses the Mark

You’ve probably seen athletes running through ladders and cones, drills that look fast and agile. These SAQ drills improve fundamental speed, agility, and quickness, especially in developing athletes. However, they don’t develop sport-specific skills, which are best developed and applied as integral components of performance, not isolated drills with low transfer.

Instead, speed, agility, and quickness should be practiced as drills with direct transfer. This involves repeatedly practicing correct performance with integrated footwork to develop sport-specific speed and agility, and using partner-based reaction drills to develop the quickness of relevant skills.

Furthermore, SAQ drills consume finite recovery resources that are better allocated to practicing sport-specific training, which yields greater transfer to performance.

Illustrating the Principles: Integrated Training in Action

Hypothetical Scenario: Elite Combat Sports Program

Imagine a professional MMA team that restructures its training entirely around sport-specific skill development, thoughtfully considering biological rhythms and recovery.

Instead of separate “conditioning”, physiological challenges are integrated directly into technical and tactical training, with the daily schedule potentially looking like this:

• Mid-Morning: High-focus, high-intensity training for skill acquisition and motor learning, taking advantage of peak cognitive function.
• Nap (Post-Training): A 20–30 minute nap to enhance consolidation, memory, and recovery.
• Evening: A second session focused on physical output, more practice, or additional skills, allowing you to capitalize on physical readiness and motor skill reinforcement.

Evening training can be effective for performance. By this time, muscle temperature and neuromuscular performance are likely to be closer to their daily peak. The key thing is that, if the athlete isn’t overly fatigued from the first session and has benefited from the post-training nap, they can maintain good focus and motivation for the evening session. Furthermore, sleep after evening training will help consolidate the motor skills practiced earlier in the day and provide crucial recovery for both the brain and muscles.

Research to Back It Up:

• Napping and consolidation: Studies show that sleep immediately following training is critical for motor learning. (Reference: Walker, M., et al. (2005) – “Sleep-dependent motor skill learning.”)
• Cognitive sharpness and executive function: Cognitive performance, including decision-making and focus, is generally better mid-morning. (Reference: Schmidt & Lee, Motor Learning and Performance (textbook).)

Practical Application:

Training Window: By training in the mid-morning and following it with a nap, you maximize cognitive resources for motor learning, and then later reinforce motor skills with another round of training.

Recovery and Consolidation: The nap and sleep after the second session allow your body and brain to consolidate what’s been learned, promoting both physical recovery and motor skill retention.

The results of such a biologically aligned and integrated approach: Athletes maintain higher technical quality under fatigue, recover better between sessions, and maintain performance longer in competition. Consequently, competitive success improves compared to traditional approaches.

Real-World Application: The Power of Purposeful Training

Case Study: Youth Tennis Development

A tennis academy abandoned traditional agility ladder and cone drills in favor of movement patterns directly connected to game situations. Rather than practicing footwork in isolation, players developed movement skills through progressively challenging game-based scenarios.

After implementing this approach, players showed significantly faster decision-making, more efficient court movement, and greater resilience in competitive pressure situations. Tournament results reflected these improvements, with players demonstrating particular advantages in extended matches where technical consistency under fatigue became crucial.

Creating Your Mastery Blueprint: An Action Plan

How can you apply these principles to accelerate your development?

1. Clarify your purpose — Define whether you’re training for general fitness or specific performance mastery
2. Examine every training element through the lens of transfer — Ask “How directly does this translate to my competitive performance?”
3. Replace isolated drills with contextual alternatives — Integrate technical elements into realistic performance scenarios
4. Structure practice to simultaneously develop skills and specific conditioning — Design technical sessions that progressively challenge relevant energy systems
5. Prioritize recovery enhancement — Implement practices that expand recovery capacity rather than further depleting it
6. Continuously assess both performance transfer and recovery status — Make data-informed adjustments to optimize development

Neurological Foundations of Athletic Mastery

Athletic excellence is built through specific neurophysiogical adaptations. Understanding these mechanisms reveals why certain training approaches accelerate skill development while others waste precious recovery resources.

Motor Pattern Consolidation

Your brain doesn’t store individual movements — it builds integrated neural networks that link perception, decision, and action. This consolidation process follows distinct phases:

• Cognitive Phase: Conscious attention to movement mechanics requires significant mental bandwidth, limiting performance under pressure
• Associative Phase: Movements become more fluid as neural pathways strengthen, though execution still requires some conscious oversight
• Autonomous Phase: Movements become largely subconscious, freeing mental resources for strategic decisions

This progression explains why isolated drills, far above SAQ drills, still fail in competition — they remain trapped in early development phases without advancing to autonomous execution under realistic conditions.

Contextual Encoding

Your brain encodes skills differently based on the learning environment. Skills acquired in simplified settings lack critical contextual triggers needed during performance. Three key mechanisms explain this:

• State-Dependent Learning: Neural pathways formed under specific conditions activate most efficiently under similar conditions
• Perceptual-Motor Coupling: Your brain creates direct links between environmental cues and appropriate responses
• Attentional Framework Development: Training in realistic contexts builds the ability to focus on relevant cues while filtering distractions

Athletes who train primarily through decontextualized drills develop skills that require conscious translation to performance settings — a process that breaks down under competitive pressure.

Skill Transfer Mechanics

Not all practice transfers equally to performance. Transfer effectiveness depends on three neurological factors:

• Movement Pattern Specificity: Similar neural activation sequences between practice and performance
• Decision-Making Integration: Practice that includes the decision constraints present in competition
• Performance Context Replication: Training environments that mirror competitive demands

This explains why athletes can excel in training yet struggle in competition — different neural pathways are being activated in each environment.

Blueprint for Brain-Optimized Training

To accelerate skill development based on these neurological principles:

1. Minimize Isolated Technique Time: Move quickly from technical instruction to contextual application
2. Implement Decision-Rich Practice: Even basic drills should incorporate relevant decisions
3. Create Progressive Pressure Environments: Systematically introduce competitive elements that trigger performance-specific neural adaptation
4. Train Perception: Explicitly develop recognition of critical environmental cues
5. Practice State Regulation: Train under varying emotional conditions to develop adaptable performance states

Training as your brain encodes and accesses athletic skills transforms every practice minute into direct performance enhancement rather than abstract physical development.

The mastery question “What are you training for?” extends to the neurological level — are you training neural pathways that will activate under competitive conditions, or merely developing capabilities that remain inaccessible when they matter most?

The Path Forward: Excellence Through Purposeful Specificity

The science is clear: training that incorporates contextual elements and proper motor learning principles produces superior results at all levels of athletic ability. The path to mastery requires training with precise purpose — where every element directly contributes to performance excellence.

This doesn’t invalidate all general physical development, particularly for beginners or in rehabilitation contexts. However, as performance goals become more defined, training must become increasingly specific to those demands.

By understanding the science of motor learning, training transfer, and recovery management, athletes can create development pathways that maximize both the rate and extent of performance improvement.

The question isn’t whether you can afford to train with greater specificity — it’s whether your ambitions for mastery allow you to train any other way.

References

• Coutts, A.J., et al. (2007). “Monitoring for overreaching in rugby league players.” European Journal of Applied Physiology, 99(3), 313-324.
• Deci, E.L., & Ryan, R.M. (2000). “The ‘what’ and ‘why’ of goal pursuits: Human needs and the self-determination of behavior.” Psychological Inquiry, 11, 227-268.
• El-Ashker, S. (2018). “Cardio-Respiratory Endurance Responses Following a Simulated 3 × 3 Minutes Amateur Boxing Contest in Elite Level Boxers.”
• El-Ashker, S. (2018). “The impact of a boxing training program on physical fitness and technical performance effectiveness.”
• Fathloun, M., et al. (2011). “Effect of specific versus non-specific training on agility performances.” Science & Sports, 26(2), 75-79.
• Gandevia, S.C. (2001). “Spinal and supraspinal factors in human muscle fatigue.” Physiological Reviews, 81(4), 1725-1789.
• Graybiel, A.M. (1998). “The basal ganglia and chunking of action repertoires.” Neurobiology of Learning and Memory, 70(1-2), 119-136.
• Knudson, D. (2005). “Evidence-based practice in kinesiology: The theory to practice gap revisited.” Physical Educator, 62(4), 212-221.
• Kostikiadis, S., et al. (2018). “The Effect of Short-Term Sport-Specific Strength and Conditioning Training on Physical Fitness of Well-Trained Mixed Martial Arts Athletes.” Journal of Sports Science & Medicine, 17(3), 348-358.
• Nader, G.A. (2006). “Concurrent strength and endurance training: From molecules
• Sheppard, J.M., & Young, W.B. (2006). “Agility literature review: Classifications, training and testing.” Journal of Sports Sciences, 24(9), 919-932.
• Smith, A.D. (2003). “Peer relationships in physical activity contexts: A road less traveled in youth sport and exercise psychology research.” Psychology of Sport and Exercise, 4(1), 25-39.
• Wolpert, D.M., et al. (2011). “Principles of sensorimotor learning.” Nature Reviews Neuroscience, 12(12), 739-751.
• Wymbs, N.F., et al. (2012). “Neural evidence that sequence-specific training enhances learning in developmental dyslexia.” Proceedings of the National Academy of Sciences, 109(40), 16731-16736.

We prioritize safety in our workouts, and when it comes to exercises like the seated cable row, that can translate to strict form with limited range of motion. But have you stopped to consider the trade-offs? If these “safe” variations hinder natural movement and don’t improve our ability to function in daily life or sports, do they actually deliver on their promise of preventing injury? And if not, why are we doing them?

Most trainers teach this exercise with rigid posture, fundamentally limiting its functional effectiveness. Instead of instructing clients to remain frozen in place for “safety”, we should encourage more natural biomechanical movement. In practice, coaching this a lot harder than it seems! This article breaks down how it’s done.

Scapular Mechanics: The Key to Effective Movement

The slight forward hinge allows the scapula to protract, creating a more significant stretch on the retractors. This approach:

• Reduces arm dominance
• Strengthens middle trapezius
• Improves rhomboid engagement
• Counteracts rounded shoulder posture

The increased forward reach due to the slight forward hinge allows the scapula to protract, leading to a more significant stretch on the retractors, reducing dominance of the arms, and sets up a more powerful retraction, strengthening the middle trapezius. This strengthens the rhomboids for better posture in sports and daily activities, counteracting the common tendency towards rounded shoulders, as upper cross syndrome.

Planks: Assessing core strength can be challenging, especially when loose clothing or higher body fat levels obscure visual cues. Starting with planks helps them engage their core, while we assess and correct their posture.

Deadlifts: Deadlifts warm up the entire back and posterior chain, training the mechanical hinging of the hip while maintaining a neutral spine, and promoting full back engagement.

Scapular pushups & Pull-ups: These exercises should not be done to failure, but should be to “wake up” the shoulder external rotators, to stimulate neuromuscular engagement.

Detailed Seated Cable Row Execution

Steps to perfect the movement:

Use the neutral close-grip handle to target the lats maximally.

1. Sit tall, chest up, feet planted
2. Tuck chin slightly
3. Engage core and natural lower back curve
4. Push hips back slightly (like a deadlift)
5. Feel the stretch in the lats
6. Pull your elbows back toward your lower ribs, keeping them close to your sides.
7. As you pull, bring your torso upright, lift your chest, retract shoulder blades, and keep shoulders down—core tight, no leaning back
8. Finish with the handle between your navel and solar plexus
9. Squeeze back muscles hard and hold briefly for a peak contraction
10. Keeping chest high, chin neutral, core engaged, control the return

Safety

Rounding places stress on the lumbar discs, risking serious injury. To avoid this, the client must not only have the right cues, but a strong core and good hip and hamstring mobility, as weakness and tightness can contribute to poor form. Follow the ordered approach outlined above, beginning with exercises that engage the core and train hip hinge and mobility, and use scapular protraction and retraction to wake those muscles up.

This approach maximizes the seated cable row’s benefits by improving neuromuscular engagement, muscle recruitment, range of motion, and functional movement patterns, in contrast to overly-cautious “safe” variations that limit natural movement and fluidity and don’t translate well to activities of daily life or athletics.

Hypothesis

High-intensity exercise (HIT) combined with creatine monohydrate supplementation (CM) confers greater neurocognitive benefits than either alone.

Rationale

Combining HIT with CM may enhance creatine’s transport to the brain, leading to greater cognitive, antioxidant, and neuroprotective effects. This is due to creatine’s ability to cross the blood-brain barrier (BBB), potentially increased by exercise-induced blood flow, vasodilation within the brain, and hormonal responses that further stimulate brain creatine uptake. Querido

This mechanistic basis may provide a theoretical framework for enhancing the benefits of other nutraceuticals.

Exercise Brain Benefits

Exercise boosts cerebral blood flow through vasodilation, increased circulatory volume, and enhanced neurovascular coupling, directing blood flow to the brain regions actively engaged in the exercise. High-intensity exercise improves cognitive function and brain health by increasing cerebral blood flow, BDNF, IGF-1, and osteocalcin. S.E. Browne

Creatine Brain Benefits

Creatine supplementation has been shown to improve cognitive function and provide neuroprotection in persons with neurocognitive impairment. J.F. Sandkühler

Creatine supplementation increases brain creatine levels. During stress or trauma, such as intense exercise, creatine supplementation improves oxidative DNA injury and normalizes brain and body creatine levels. S. Forbes

A 2023 review study published in Sports Medicine found long-term high-dosage creatine supplementation increases brain creatine stores, improves cognition and memory, especially in older adults or during times of metabolic stress (e.g. sleep deprivation), improves aspects of recovery from traumatic brain injury in children, and has the potential to reduce symptoms of depression and anxiety. D. Candow

Creatine has shown neuroprotection in PD patients with cognitive decline via creatine transporter uptake. In a rodent model, high-dosage creatine was shown to exert anti-inflammatory, antioxidative, and anti-aggregant effects on α-synucleinopathy. Y. Leem H. Chang

A long-term, multicenter, double-blind, parallel-group, placebo-controlled, 1:1 randomized efficacy trial for 10g of creatine in PD patients showed benefit to the Unified Parkinson’s Disease Rating Scale (UPDRS) both at 1 year and at 18 months, but eventually terminated early with no determined harm or benefit. K. Kieburtz

To address the nutritional requirements for the demands of the HIT group, each participant will also consume a post-workout protein shake.

Exercise and Cerebral Blood Flow

Aerobic exercise can increase cerebral blood flow and potentially enhance BBB permeability, at least temporarily. For the given volumetric load and intensity of the HIT exercise protocol, cardiovascular output will be high, around 75% HRmax (possibly higher for untrained PD patients, depending on individual motor efficiency). The cardiovascular intensity alone should be sufficient to significantly increase cerebral blood flow and promote physiological adaptations.

High-intensity strength training (HIT) increases IGF-1 levels more significantly compared to cardiovascular training. IGF-1 enhances creatine uptake in muscles, and creatine supplementation further increases IGF-1 mRNA expression in human skeletal muscle, providing a synergistic benefit that supports improved muscle performance and recovery, indirectly benefiting cognitive function through reduced fatigue and better overall physical health.

Due to its high energy requirements, brain cells are susceptible to Reactive Oxygen and Nitrogen Species (RONS), mitochondrial damage, and energy depletion. Strength training produces less RONS due to its reliance on the TCA cycle, resulting in lower ratio of oxidative stress than the amount of cardio required to achieve same cerebral blood flow and hormonal benefits.

Creatine Supplementation Studies

Research indicates that creatine supplementation can improve cognitive function and has neuroprotective effects. However, the dosage and duration required for optimal cognitive benefits are still under investigation.

Combined Effects

Many studies have examined the combined effects of exercise and creatine on muscle performance and recovery, but research on cognitive outcomes is less extensive. The hypothesis that HIT could enhance cerebral creatine uptake is supported by the rationale of increased blood flow and transporter activity.

Enhanced Recovery

Intense exercise and cognitive activity depletes brain phosphocreatine (Pcr) levels. Creatine supplementation can mitigate this depletion and improve recovery from high-intensity exercise, as well as cognitive function. C. Rae, A.C. Passaquin

Decreased Oxidative Stress

CM supplementation decreases oxidative stress by reducing the immediate demand on oxidative phosphorylation (OXPHOS) and its production of RONS, and by directly scavenging free radicals. H. Arazi

Double Crossover Design Overview

Participants: Individuals with early Parkinson’s disease (PD) and mild MDS-UPDRS impairment, randomly selected into groups:

Sequence 1

1. HIT + CM
2. HIT + Placebo
3. CM Only
4. Placebo

Sequence 2

1. HIT + Placebo
2. CM Only
3. Placebo only
4. HIT + CM

Sequence 3

1. CM Only
2. Placebo
3. HIT + CM
4. HIT + Placebo

Sequence 4

1. Placebo
2. HIT + CM
3. HIT + Placebo
4. CM Only

Each participant gets all interventions to control for individual differences, reduce the number of participants needed, and ensure every participant receives an active intervention. Each intervention phase is followed by a 4 week washout period and testing, to monitor possible carryover effects.

Duration: 16 weeks is adequate for observing potential cognitive and neuroprotective effects. Exercise Protocol: High-Intensity Training (HIT): Exercises: Olympic lifts and plyometrics. Frequency & Duration: 70 minutes (including warm-up and cool down), six times per week, supervised to ensure safety, form, and protocol adherence.

For transparency, participants must be fully informed about the potential benefits and risks associated with both the active treatment and the possibility of receiving placebo.

CM Supplementation

Dosage: 10 g of CM daily, split into two 5 g doses (pre- and post-workout), during warm-up and cool-down for HIT group.

Approach for Intensity

Initial Assessment

Assess participants’ current fitness levels, physical condition, and any potential limitations. Develop individualized exercise plans based on the baseline fitness evaluation. Strength Assessment: Calculate 10 RM for deadlift, squat, overhead press, bench press, barbell row, and box jump (height in cm).

For box jump assessment tests, calculate vertical jump, then move to a lower height and gradually increase within a safety threshold to the trainee’s comfort level.

For some bodyweight exercises, it is not possible to directly calculate the 10 RM as for weighted exercises. Instead, use the following formula:

max_reps * intensity * target_reps/10

For example, if the client can do 8 pushups and the desired intensity is 80% of 10 RM for 6 reps, do 8 × 0.8 × 6/10 ≈ 4 pushups. Adjust the number of reps as appropriate to roughly match the desired intensity level.

Progressive Intensity

Begin with 50-60% of maximal 10 repetition effort (10 rm), and increase the intensity 5% every 2-4 weeks, with rest between sets below 60s. Target Intensity Range: Aim to reach and maintain an intensity level of 70-85% of maximal effort for most of the intervention period. This range is typically sufficient to increase blood flow and confer cognitive benefits without excessive risk.

Sessions

• Day 1: HIT + Zone 2 Cardio
• Day 2: Zone 3 Cardio (40 min ergometer)
• Day 3: HIT + Active Recovery
• Day 4: Zone 3 Cardio
• Day 5: HIT + Zone 2 Cardio
• Day 6: Zone 3 Cardio
• Day 7: HIT + Active Recovery

Zone 3 is 30 min of ergometer at 70% HRMax, at the trainee’s convenience.

Zone 2 is 40 min of walking, monitored with a fitness tracker, at the trainee’s convenience.

Active recovery is 10 minutes of walking, monitored with a fitness tracker, followed by a gentle 30 minute group session consisting of a series of instructor-led mobility movements.

Moderate Intensity Exercise (Zone 3) improves increasing cerebral blood flow and cardiovascular health at a reduced injury risk.

Low Intensity Cardio (Zone 2) improves aerobic endurance and promote recovery, ensuring sustained exercise adherence and minimizing injury risk.

Active Recovery promotes recovery, reduces soreness, and promotes relaxation, contributing to program sustainability.

Incorporating moderate or low intensity exercise and active recovery into a high-intensity training (HIT) routine for individuals, especially those with early Parkinson’s disease (PD), can help mitigate the risk of burnout, overtraining, and CNS overstimulation while still promoting various physiological and cognitive benefits. Here’s a proposed routine that balances HIT with cardio and recovery:

Each 70 minute HIT session begins with a 20 minute warm up, followed by 30 minutes of work, and ends with a 20 minute cool down. Warm Up: 15 minutes of working exercises performed at 40–50% of 10 RM for 10 sets of 3-5 and 10 minutes of mobility and light stretching to avoid injury and improve recovery (hang stretch, scapular pushup, cat/cow, walking, box squat, half kneel hip flexor stretch, etc.). Cool down: 10 minutes of low intensity cardiovascular exercise (fast walking) and 10 minutes of stretching.

HIT Progressive Intensity Exercise Protocol

4 times per week, 30 minutes of working sets, 60 – 75s rest between sets for a total of 15 sets.

Weeks 1-4:

Moderate intensity (50-60% of 10 RM) Volume: 15 sets of 10 repetitions

Weeks 5-8

Increase to moderate-high intensity (65-75% of 10 RM) Volume: 15 sets of 8-10 repetitions

Weeks 9-12

Further increase to high intensity (80-90% of 10 RM) Volume: 15 sets of 6-8 repetitions

Weeks 13-16

High-intensity (95-105% of 10 RM) Volume: 15 sets of 3-5 repetitions

Safety and Monitoring

All sessions are supervised by trained professionals to monitor form, intensity, and safety. Feedback and Adjustments: Regularly check in with participants to assess their comfort, fatigue levels, and any adverse effects. Adjust the intensity as needed based on individual responses.

Assessment

Cognitive Performance Tests

Backward digit span for working memory and MDS-UPDRS

MRI

To measure creatine levels in the brain and assess neuroprotective effects.

Blood Biomarkers

IGF-1, BDNF, osteocalcin, and oxidative stress markers.

References

• Regulation of cerebral blood flow during exercise, Jordan S Querido, A William Sheel.
• Chapter 9 – Effects of acute high-intensity exercise on cognitive performance in trained individuals: A systematic review, Sarah E. Browne, et al.
• Oral creatine monohydrate supplementation improves brain performance: a double-blind, placebo-controlled, cross-over trial, Caroline Rae, et al

  Creatine supplementation had a significant positive effect on both working memory (backward digit span) and intelligence (Raven’s Advanced Progressive Matrices), both tasks that require speed of processing.

• Creatine supplementation reduces skeletal muscle degeneration and enhances mitochondrial function in mdx mice, Anne-Catherine Passaquin , et al.

  This study found creatine supplementation in mice improves muscle health and may provide a scientific basis for its use as adjuvant therapy in Duchenne muscular dystrophy.

• Creatine supplementation with exercise reduces α-synuclein oligomerization and necroptosis in Parkinson’s disease mouse model, Yea-Hyun Leem, et al.

  These authors found that creatine supplementation with exercise has anti-inflammatory, antioxidative, and anti-α-synucleinopathy effects, thereby reducing necroptotic cell death in a PD mouse model.

• “Heads Up” for Creatine Supplementation and its Potential Applications for Brain Health and Function”, Darren G. Candow, et al.
• Creatine Supplementation, Physical Exercise and Oxidative Stress Markers, Hamid Arazi, et al.

  This review study concluded creatine’s antioxidant mechanisms include reduced ROS and RNS, and that creatine can maintain mitochondrial integrity, increase creatine phosphate (CP) resources, act as a cellular energy buffer, and protect two important cellular targets, mtDNA and RNA, from oxidative damage.

• Effects of Creatine Supplementation on Brain Function and Health, Scott C. Forbes, et al.
• The effects of creatine supplementation on cognitive performance—a randomised controlled study, Julia Fabienne Sandkühler, et al.
• Creatine supplementation affords cytoprotection in oxidatively injured cultured mammalian cells via direct antioxidant activity, Piero Sestili, et al.
• The effect of creatine supplementation upon inflammatory and muscle soreness markers after a 30km race, Santos, et al.