title: A Systematic Review of the Role of Vitamin D on Neuromuscular Remodelling Following Exercise and Injury.
abstract: Vitamin D is important for skeletal muscle health and deficiency is associated with clinical neuromuscular symptoms of poor strength and gait. Supplementation can independently increase muscle strength in chronically deficient populations. However, the regulatory role of vitamin D on neuromuscular remodelling and adaptation subsequent to exercise conditioning or injury has not been systematically reviewed.
  
  
  OBJECTIVE
  to systematically review the available evidence of the role of vitamin D on neuromuscular remodelling following exercise conditioning, exercise- or experimentally induced injury. We searched Medline (OVID platform), PubMed, Embase and Web of Science for randomised controlled trials (RCTs) including measures of neuromuscular function, injury and/or inflammation; a physiologically stressful intervention involving exercise conditioning, exercise- or experimentally induced injury and; vitamin D supplementation. Nine RCTs met the inclusion criteria. Significant heterogeneity of methodological approaches and outcomes meant that meta-analysis of data was limited. Qualitative findings indicated that vitamin D may be an effective accelerant of neuromuscular remodelling in animal models (24-140 % improved recovery vs. control); the effects in humans are inconclusive and likely influenced by baseline vitamin D and supplementation strategy. Results of the meta-analyses indicated no effect of vitamin D supplementation on muscle strength adaptation following resistance training [standardised mean difference (SMD): 0.74, P = 0.42] or muscle damage (SMD: -0.03, P = 0.92), although inflammatory markers were elevated in the latter (SMD: 0.56, P = 0.04). Data from animal models offer promising and plausible mechanisms for vitamin D as an agent for neuromuscular adaptation. Further high-quality research is needed to offer clearer insight into the influential role of vitamin D in human populations.
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK. minshullc@hotmail.com.|School of Clinical Sciences, University of Edinburgh, Little France Crescent, Edinburgh, EH16 4SB, UK. minshullc@hotmail.com.
authors.forename: Claire
authors.initials: C
authors.lastname: Minshull
authors.affiliation: School of Clinical Sciences, University of Edinburgh, Little France Crescent, Edinburgh, EH16 4SB, UK.|Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK.
authors.forename: Leela C
authors.initials: LC
authors.lastname: Biant
authors.affiliation: School of Clinical Sciences, University of Edinburgh, Little France Crescent, Edinburgh, EH16 4SB, UK.|Institute of Genetics and Molecular Medicine, Western General Hospital, University of Edinburgh, Edinburgh, EH4 2XU, UK.
authors.forename: Stuart H
authors.initials: SH
authors.lastname: Ralston
authors.affiliation: School of Health Sciences, Queen Margaret University, Edinburgh, EH21 6UU, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Gleeson
mesh_terms: D000222:Adaptation, Physiological / Q000187:drug effects; D000818:Animals; D019587:Dietary Supplements; D015444:Exercise / Q000502:physiology*; D006801:Humans; D053580:Muscle Strength / Q000187:drug effects*; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000293:injuries*; D014807:Vitamin D / Q000494:pharmacology*
chemical_list: D014807:Vitamin D
keywords: Injury; Muscle damage; Neuromuscular adaptation; Neuromuscular function; Vitamin D