Neural Adaptations to Metronome-Paced Strength Training

January 14, 2026 updated by: Egas Moniz - Cooperativa de Ensino Superior, CRL

Neural Adaptations to Metronome-Paced Strength Training: Insights From Neuroscience and Human Movement Variability

The aim of the study is to investigate the effects of incorporating variability within Resistance Training (RT) methods on the neural adaptations along the corticospinal tract and on neuromuscular function. The literature suggests that RTis one of the most common modalities to enhance and restore muscle function and its practice results in adaptation in neural and morphological adaptations. It is also known that conditions such as ageing and injury have a negative impact on neural drive to the muscles with consequences at motor control level that are not addressed by traditional RT. Recent approaches such as metronome paced strength training have been used to cover this motor control dimension through a greater control and consciousness of movement. However, this methodology tends not to incorporate the inherent variability and complex, fractal-like fluctuations that characterize human movement. The investigators propose that incorporating variability through a fractal-like metronome approach will speed up the neural adaptations which will be useful in injury rehab.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Portugal
    • Monte de Caparica
      • Almada, Monte de Caparica, Portugal, 2829-699
        • Recruiting
        • Egas Moniz School of Health & Science
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • aged between 18 and 40 years

Exclusion Criteria:

  • Neurologic conditions;
  • Lower limb disabilities or disease;
  • Not able to provide informed consent;
  • Have an implanted device (e.g. pacemakers) or any metal in the body;
  • Medication advised against the application of Transcranial Magnetic Stimulation;
  • History/family history of seizures, brain lesions or head trauma, neurological or psychiatric diseases, epilepsy, migraine

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Basic Science
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Fractal Paced
Strength training in single leg extension machine, synchronizing each repetition with a fractal-like visual metronome, i.e., a metronome presenting visual external cues with variability within its temporal structure.
Other: Fractal Paced
The intervention consists in a metronome-paced strength training session performed 3 times per week (with 48h of rest between sessions), during 4 weeks. Each session consists in 4 sets of 15 repetitions at 65% of the one-repetition maximal (1RM) in single leg extension machine, synchronizing each repetition with fractal external cues presented by a visual metronome. The rest between sets will be set at 2 minutes of rest between sets.
Experimental: Isochronous Paced
Strength training in single leg extension machine, synchronizing each repetition with a isochronus visual metronome, i.e., a metronome presenting visual external cues withthe same pace in each repetition (without variability)
Other: Isochronous Paced
The intervention consists in a metronome-paced strength training session performed 3 times per week (with 48h of rest between sessions), during 4 weeks. Each session consists in 4 sets of 15 repetitions at 65% of the one-repetition maximal (1RM) single in leg extension machine, synchronizing each repetition with isochronus external cues presented by a visual metronome. The rest between sets will be set at 2 minutes of rest between sets.
Experimental: Self Paced
Strength training in single leg extension machine at participants self pace.
Other: Self Paced
The intervention consists in a metronome-paced strength training session performed 3 times per week (with 48h of rest between sessions), during 4 weeks. Each session consists in 4 sets of 15 repetitions at 65% of the one-repetition maximal (1RM) in single leg extension machine, at their own self pace (with no metronome). The rest between sets will be set at 2 minutes of rest between sets.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Corticospinal Excitability (CSE) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
CSE is a parameter extracted through the application of Transcranial Magnetic Stimulation (TMS). This parameter provides information regarding the level of excitability of the corticospinal tract.
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Short-interval Intracortical Inhibition (SICI) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
SICI is a parameter extracted through the application of Transcranial Magnetic Stimulation (TMS). This parameter provides information regarding the level of inhibition within the motor cortex.
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Corticospinal Silent Period (CSP) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
CSP is a parameter extracted through the application of Transcranial Magnetic Stimulation (TMS). This parameter provides information regarding the level of inhibition along the corticospinal tract.
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Intracortical Facilitation (ICF) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
ICF is a parameter extracted through the application of Transcranial Magnetic Stimulation (TMS). This parameter provides information regarding the level of facilitation within the motor cortex.
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Lumbar Evoked Potentials (LEP) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
LEP is a measure extracted through the aplication of Lumbar stimulation. This measure allow to distinguish the adaptations that occur at spinal level as a result of strength training.
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Maximal Compound Action Potentials (Mmax) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Mmax is a measure assessed through peripheral nerve stimulation and represents the maximal capacity of recruit the motoneurons that innerve a muscle.
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
StartReact Gain changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
StartReact gain is a measure that is calculated following the StartReact protocol. It consists in measuring the participants' reaction times in response to visual stimuli (visual reaction time [VRT]), visual stimuli combined with a quiet sound (visual auditory reaction time [VART]) and visual startling stimuli (visual startling reaction time [VSRT]) and, then, apply the following formula: StartReact gain = ([VRT - VSRT]/[VRT - VART]).
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Single leg extension 1RM changes after 4-weeks intervention (PRE to POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Single leg 1RM is defined as the maximal load that each participant mobilized in a single maximum dynamic knee extension.
PRE (baseline), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Maximal Voluntary Isometric Contraction (MVIC) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
MVIC is defined as the maximal force an individual can produce against an immovable resistance
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Sample Entropy (SampEn) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
SampEn is a non-linear measure of the temporal structure of force output, being an indicator of the regularity of this physiological output. It is obtained from sustained submaximal isometric contractions and it has been proposed as an indirect index of the capacity of the neuromuscular system to adapt the force output to changes in environment, i.e., its adaptability.
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Coefficient ov variation (CV) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
CV is a common linear measure that translates the amount of variability within the signal and is calculated through the standard deviation normalised to the mean of a time series
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Motor Unit Action Potentials (MUAP) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
MUAP is obtained through the decomposition of electromyographic (EMG) signals collected using High-density surface EMG electrodes and is an index of motor unit recruitment.
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
Firing Rate (FR) changes across the 4-weeks intervention (PRE to Week1, Week 2, Week 3, POST and follow-up) both within and between Fractal paced, Isochronus Paced and Self paced groups
Time Frame: PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)
FR is obtained through the decomposition of electromyographic (EMG) signals collected using High-density surface EMG electrodes and is a measure of intramuscular coordination
PRE (baseline), W1 (week 1), W2 (week 2), W3 (week 3), POST (week 4), FUP (follow-up 4 weeks after the end of intervention)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Egas Moniz - Cooperativa de Ensino Superior, CRL

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Fundação para a Ciência e a Tecnologia

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 15, 2024

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 30, 2026

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 29, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 29, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 1, 2024

Study Record Updates

Last Update Posted (Estimated)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
January 16, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 14, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
January 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • METROTRAIN - 1403

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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