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Purpose: The optimal approach to hamstring training is heavily debated. Eccentric exercises reduce injury risk; however, it is argued that these exercises transfer poorly to improved hamstring function during sprinting. Some argue that other exercises, such as isometric exercises, result in better transfer to running gait and should be used when training to improve performance and reduce injury risk. Given the performance requirements of the hamstrings during the terminal swing phase, where they are exposed to high strain, exercises should aim to improve the torque production during this phase. This should improve the hamstrings' ability to resist overlengthening consequently, improving performance and limiting strain injury. Most hamstring training studies fail to assess running kinematics postintervention. Of the limited evidence available, only eccentric exercises demonstrate changes in swing-phase kinematics following training. Studies of other exercise modalities investigate effects on markers of performance and injury risk but do not investigate changes in running kinematics. Conclusions: Despite being inconsistent with principles of transfer, current evidence suggests that eccentric exercises result in transfer to swing-phase kinematics. Other exercise modalities may be effective, but the effect of these exercises on running kinematics is unknown. [ABSTRACT FROM AUTHOR]

This study aimed to compare the effects of an accentuated eccentric training programme on physical performance between men and women. Distributed in two groups by gender, 21 male and 21 female athletes performed four sets of seven repetitions of the half-squat exercise twice per week for 6 weeks. Both groups lifted the same absolute load using a rotary inertial device. To accentuate the eccentric action, the eccentric load was twice as heavy as the concentric load. Vertical jump, sprint, and change of direction (COD) performances were measured pre- and post-intervention. To measure strength gains, vertical ground reaction forces were measured for each repetition of the entire training programme. Vertical jump improved post-intervention (MG: 33.88 ± 4.94 to 35.41 ± 4.86; FG: 20.60 ± 4.62 to 22.12 ± 4.32; p < 0.001; η2p = 0.42), while sprint (MG: 3.08 ± 0.11 to 3.07 ± 0.13; FG: 3.66 ± 0.23 to 3.64 ± 0.23) and COD (MG: 7.77 ± 0.42 to 7.61 ± 0.47; FG: 8.44 ± 0.58 to 8.38 ± 0.57) remained unchanged. Concentric and eccentric forces increased for both groups from session 1 to 4 (p < 0.001; η2p >0.39), while only peak eccentric forces increased until session 12 (p = 0.009; η2p = 0.21). In conclusion, even when men are able to produce greater forces with similar loads, accentuated eccentric RT produces similar strength and strength-related adaptations in male and female athletes. [ABSTRACT FROM AUTHOR]

Background and Purpose The characteristics of Proximal Hamstring Tendinopathy (PHT) include deep, localized pain in the region of the ischial tuberosity. Chronic lesions are often found in long-distance runners. Compression of the tendon and shear force at its insertion at the ischial tuberosity during hip flexion/adduction is a key etiologic factor. The aim of this case report is to analyze the effectiveness of an exercise protocol with progression of tendon loading in PHT in an amateur runner, by assessing pain and functional capacity. Case Description The subject was a 30-year-old male runner. After participating in a 10km race, he experienced an insidious onset of deep buttock pain in the right ischial tuberosity. His pain was aggravated by running on sloped roads and prolonged sitting on hard surfaces, particularly while driving. The visual analog scale (VAS) for pain, the Puranen-Orave test (PO), the Bent-Knee stretch test (BK stretch), the supine plank test, the Victorian Institute of Sport Assessment-proximal hamstring tendons (VISA-H) questionnaire, and the sciatic nerve mobility (via the Slump test) were assessed. The intervention involved a 12-week progressive loading exercise program divided into four phases. Outcomes The initial pain was reduced at 6 weeks of intervention and further decreased at 12 weeks (VAS from 7, to 5 and to 1). Function increased at 6 weeks and at 12 weeks (VISA-H from 23, to 53, to 80). Sciatic nerve mobility was normal. Conclusion The progression of training in a subject with PHT tendon injury based on isometric exercise, concentric/eccentric, energy storage, progressively increasing hip flexion was beneficial, increasing function and decreasing pain. Studies with a larger sample size and a more precise methodological design would be necessary to support this type of intervention in clinical practice. Level of Evidence 5 [ABSTRACT FROM AUTHOR]

Exercise interventions are evident in the treatment of mid-portion Achilles tendinopathy (AT). However, there is still a lack of knowledge concerning the effect of different exercise treatments on improving a specific function (e.g., strength) in this population. Thus, this study aimed to systematically review the effect of exercise treatments on different functional outcomes in mid-portion AT. An electronic database of Pubmed, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception to 21 February 2023. Studies that investigated changes in plantar flexor function with exercise treatments were considered in mid-portion AT. Only randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were included. Functional outcomes were classified by kinetic (e.g., strength), kinematic [e.g., ankle range of motion (ROM)], and sensorimotor (e.g., balance index) parameters. The types of exercise treatments were classified into eccentric, concentric, and combined (eccentric plus concentric) training modes. Quality assessment was appraised using the Physiotherapy Evidence Database scale for RCTs, and the Joanna Briggs Institute scale for CCTs. The search yielded 2,260 records, and a total of ten studies were included. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. Eccentric training led to improvements in power outcomes (e.g., height of countermovement jump), and in strength outcomes (e.g., peak torque). Concentric training regimens showed moderate enhanced power outcomes. Moreover, one high-quality study showed an improvement in the balance index by eccentric training, whereas the application of concentric training did not. Combined training modalities did not lead to improvements in strength and power outcomes. Plantarflexion and dorsiflexion ROM measures did not show relevant changes by the exercise treatments. In conclusion, eccentric training is evident in improving strength outcomes in AT patients. Moreover, it shows moderate evidence improvements in power and the sensorimotor parameter "balance index". Concentric training presents moderate evidence in the power outcomes and can therefore be considered as an alternative to improve this function. Kinematic analysis of plantarflexion and dorsiflexion ROM might not be useful in AT people. This study expands the knowledge what types of exercise regimes should be considered to improve the functional outcomes in AT. [ABSTRACT FROM AUTHOR]

Background: Eccentric muscle contractions elicit distinct physiological responses, including modulation of the cytokine profile. Although relevant for rehabilitation, the effect of eccentric muscle training on the immune system has never been investigated in multiple sclerosis (MS). Objectives: Examine the immediate cytokine response of interleukin-4 (IL-4), IL-6, IL-10, IL-17a, interferon-gamma, and tumor necrosis factor-alpha after a moderate eccentric training session in individuals with MS. Additionally, further investigate the association between systemic cytokine levels at rest and clinical measures of mobility and lower limb functional strength. Design: Observational study. Methods: The first session included blood sampling for baseline cytokine measures. Subsequently, the participant completed a battery of clinical assessments related to mobility and lower limb strength, that is, the Timed-Up-and-Go Test, Five-Repetition-Sit-to-Stand-Test (5STS), Four-Square-Step-Test, and Two-Minute-Walk-Test. The second session included the eccentric exercise training session, followed by a second blood sampling to assess the acute cytokine response to the eccentric training bout. This session comprised 10 exercises concentrating on the strength of the trunk and lower extremities. Results: Twenty-seven people with MS (pwMS), with a mean age of 40.1 years, participated in the study. No difference was demonstrated in the cytokine concentration values between baseline and immediately after the eccentric training session. The 5STS explained 30.3% of the variance associated with interferon-gamma, 14.8% with IL-4, and 13.8% with IL-10. Conclusion: An eccentric training bout does not impact cytokine concentration in the blood and, consequently, does not boost a pro-inflammatory response, thus, it can be performed on pwMS in a rehabilitation setting. Plain language summary: A strength-lengthening exercise session doesn't affect inflammation markers in people with multiple sclerosis The article explores how a specific type of exercise, called eccentric muscle training, affects people with multiple sclerosis (MS). Eccentric muscle training involves exercises where the muscle lengthens under tension, like when you slowly lower a heavy object. This type of exercise is known for causing unique physical responses, including changes in certain proteins in the blood that help control the immune system and inflammation. The main goal of the study was to see if a session of eccentric muscle training would change the levels of these proteins, called cytokines, in the blood of people with MS immediately after exercise. The cytokines studied included IL-4, IL-6, IL-10, IL-17a, INF-γ, and TNF-α. These proteins are important because they help regulate inflammation and immune responses. The researchers also wanted to know if there was any connection between the levels of these proteins at rest and measures of mobility and leg strength. Twenty-seven people with MS took part in the study. Their average age was 40.1 years. In the first session, blood samples were taken to measure the baseline levels of these proteins, and various tests were conducted to assess mobility and leg strength. In the second session, participants completed an eccentric training session, and another blood sample was taken immediately after to see if there were any immediate changes in the protein levels. The results showed no significant differences in the protein levels before and after the exercise session. This suggests that a single session of eccentric muscle training does not cause an immediate inflammatory response in the blood. Therefore, this type of exercise can be safely included in rehabilitation programs for people with MS without the risk of causing harmful inflammation. Overall, the study supports the safety of eccentric muscle training for people with MS and provides valuable insights into its immediate effects on the immune system. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate changes in physical performance indicators after executing a flywheel or machine-based neuromuscular training program in young female tennis players. Methods: Twenty-four players were divided into a machine-based group (MG), flywheel group (FG), and control group. Countermovement jump (CMJ), sprint time (5, 10, and 15 m), change-of-direction (COD) performance (right and left), medicine-ball throws (overhead, forehand, and backhand), and serve velocity were included as tests at baseline, week 4, and week 8. Results: Both MG and FG largely improved from baseline to weeks 4 and 8 of training in CMJ (11.6, 10.6%; effect size [ES] = 1.24, 1.95). Also, sprint time 5 m and 10 m, COD performance-right, and COD performance-left improved moderately to very largely at week 4 in MG (−5.0% to −6.2%; ES = −1.79 to −4.19) and FG (−2.9% to −5.1%; ES = −1.13 to −1.64), respectively. Regarding medicine-ball throw, only FG improved moderately to very largely from weeks 4 to 8 in overhead (9.3%; ES = 1.46), forehand (8.0%; ES = 1.08), and backhand (6.1%; ES = 1.15). Serve velocity improved moderately from weeks 4 to 8 in MG (5.8%; ES = 0.87). Conclusions: Four weeks of the tested programs seem sufficient to improve physical determinants in young female participants. Greater improvements in CMJ and medicine-ball throw following flywheel neuromuscular training indicate the importance of including exercises that emphasize the stretch-shortening cycle and involve the entire kinetic chain. Performing the same intervention with no load adjustments may stall or even decrease performance in some parameters from weeks 4 to 8. [ABSTRACT FROM AUTHOR]

Rotator cuff injuries are prevalent musculoskeletal injuries that may impair quality of life and function. This narrative review covers current rotator cuff injury rehabilitation breakthroughs and provides insights into evidence-based techniques that improve patient outcomes. Recent advances in evaluation and rehabilitation are the topic of this narrative review. It covers the newest diagnostic techniques and imaging modalities for better diagnosis and patient stratification. It also examines how wearable gadgets and tele rehabilitation might improve recovery. Recent exercise prescription and progression advances include eccentric training, isometric movements, and neuromuscular re-education for rotator cuff repair and function. It emphasises patient-specific rehabilitation procedures and the growing significance of regenerative treatments and biologics in rotator cuff injury treatment. This evaluation also stresses patient education and collaborative decision-making for rehabilitation success. Managing rotator cuff injuries psychologically involves treating pain, fear avoidance, and psychosocial concerns. In conclusion, this narrative review summarises the latest rotator cuff injury rehabilitation techniques and modalities. Rotator cuff injury patients may benefit from these advances in outcomes, recurrence rates, and quality of life. This narrative review helps physicians, researchers, and healthcare workers treating rotator cuff injuries keep current.

Rotator cuff injuries are prevalent musculoskeletal injuries that may impair quality of life and function. This narrative review covers current rotator cuff injury rehabilitation breakthroughs and provides insights into evidence-based techniques that improve patient outcomes. Recent advances in evaluation and rehabilitation are the topic of this narrative review. It covers the newest diagnostic techniques and imaging modalities for better diagnosis and patient stratification. It also examines how wearable gadgets and tele rehabilitation might improve recovery. Recent exercise prescription and progression advances include eccentric training, isometric movements, and neuromuscular re-education for rotator cuff repair and function. It emphasises patient-specific rehabilitation procedures and the growing significance of regenerative treatments and biologics in rotator cuff injury treatment. This evaluation also stresses patient education and collaborative decision-making for rehabilitation success. Managing rotator cuff injuries psychologically involves treating pain, fear avoidance, and psychosocial concerns. In conclusion, this narrative review summarises the latest rotator cuff injury rehabilitation techniques and modalities. Rotator cuff injury patients may benefit from these advances in outcomes, recurrence rates, and quality of life. This narrative review helps physicians, researchers, and healthcare workers treating rotator cuff injuries keep current. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Eccentric resistance training has been shown to elicit beneficial effects on performance and injury prevention in sports because of its specific muscular and neural adaptations. Within the different methods used to generate eccentric overload, flywheel eccentric training has gained interest in recent years because of its advantages over other methods such as its portability, the ample exercise variety it allows and its accommodated resistance. Only a limited number of studies that use flywheel devices provide enough evidence to support the presence of eccentric overload. There is limited guidance on the practical implementation of flywheel eccentric training in the current literature. In this article, we provide literature to support the use of flywheel eccentric training and present practical guidelines to develop exercises that allow eccentric overload. See Supplemental Digital Content 1, http://links.lww.com/SCJ/A380 for a video abstract of this article. [ABSTRACT FROM AUTHOR]

Various methods of eccentric training that aim to increase muscle mass or reduce ground contact time during a landing task have been extensively researched and practically examined. However, multiple methods to implement eccentric training currently exist; they differ in execution and intended training adaptions. There is a clear differentiation between an eccentric muscle action and an eccentric motion whereby a motion alludes to a downward movement of an exercise. The proposed eccentric motions are dissipating eccentrics, deceleration eccentrics, overcoming eccentrics, maximal eccentrics, and rebound eccentrics. These motions formulate into training methods and cues to allow practitioners to clearly differentiate the various eccentric training methods used in research and practice. This review proposes a new conceptual framework that clearly outlines the different forms of eccentric motions that fall into a desired eccentric training method. [ABSTRACT FROM AUTHOR]

Whether eccentric exercise involves active fascicle stretch is unclear due to muscle-tendon unit (MTU) series compliance. Therefore, this study investigated the impact of changing the activation timing and level (i.e., preactivation) of the contraction on muscle fascicle kinematics and kinetics of the human tibialis anterior during dynamometer-controlled maximal voluntary MTU-stretch-hold contractions. B-mode ultrasound and surface electromyography were used to assess muscle fascicle kinematics and muscle activity levels, respectively. Although joint kinematics were similar among MTU-stretch-hold contractions (∼40° rotation amplitude), increasing preactivation increased fascicle shortening and stretch amplitudes (9.9–23.2 mm, P ≤ 0.015). This led to increasing positive and negative fascicle work with increasing preactivation. Despite significantly different fascicle kinematics, similar peak fascicle forces during stretch occurred at similar fascicle lengths and joint angles regardless of preactivation. Similarly, residual force enhancement (rFE) following MTU stretch was not significantly affected (6.5–7.6%, P = 0.559) by preactivation, but rFE was strongly correlated with peak fascicle force during stretch (rrm = 0.62, P = 0.003). These findings highlight that apparent eccentric exercise causes shortening-stretch contractions at the fascicle level rather than isolated eccentric contractions. The constant rFE despite different fascicle kinematics and kinetics suggests that a passive element was engaged at a common muscle length among conditions (e.g., optimal fascicle length). Although it remains unclear whether different fascicle mechanics trigger different adaptations to eccentric exercise, this study emphasizes the need to consider MTU series compliance to better understand the mechanical drivers of adaptation to exercise. NEW & NOTEWORTHY: Apparent eccentric exercises do not result in isolated eccentric contractions, but shortening-stretch contractions at the fascicle level. The amount of fascicle shortening and stretch depends on the preactivation during the exercise and cannot be estimated from the muscle-tendon unit (MTU) or joint kinematics. As different fascicle mechanics might trigger different adaptations to eccentric exercise, muscle-tendon unit series compliance and muscle preactivation need to be considered when eccentric exercise protocols are designed. [ABSTRACT FROM AUTHOR]

• Combined eccentric training may benefit skeletal muscle function in COPD patients. • Combined eccentric training is safe and well tolerated in patients with COPD. • Eccentric training did not further improve exercise capacity in patients with COPD. To evaluate the adherence to treatment and efficacy of an eccentric-based training (ECC) program on peripheral muscle function and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Prospective, assessor-blinded, randomized controlled trial. The cardiopulmonary rehabilitation unit of a tertiary subacute referral center. Thirty (N=30) stable inpatients (mean age 68±8 years; FEV 1 44±18% of predicted) with COPD were included in the study. Inpatients were randomly assigned to 4 weeks of a combined endurance and resistance ECC (n=15) or conventional training (CON; n=15). Quadriceps peak torque (PT) was the primary outcome measure for muscle function. Rate of force development (RFD), muscle activation and quality (quadriceps PT/leg lean mass), 6-min walk distance (6MWD), 4-meter gait speed (4mGS), 10-meter gait speed, 5-repetition sit-to-stand (5STS), dyspnea rate, and mortality risk were the secondary outcomes. Evaluations were performed at baseline and repeated after 4 weeks and 3 months of follow-up. Quadriceps PT, RFD, and muscle quality improved by 17±23% (P <.001), 19±24%, and 16±20% (both P <.05) within the ECC group. Besides, a significant between-group difference for RFD (56±94 Nm/s, P =.038) was found after training. Both groups showed clinically relevant improvements in 6MWD, 4mGS, dyspnea rate, and mortality risk, with no significant differences between groups. Combined endurance and resistance ECC improved lower limbs muscle function compared with CON in inpatients with COPD. In contrast, ECC did not further improve functional performance, dyspnea, and mortality risk. ECC may be of particular benefit to effect on skeletal muscle function in patients with COPD. [ABSTRACT FROM AUTHOR]

Abstract The objective of this research is to examine the impact of eccentric training on hamstring flexibility and strength in young dancers during the concluding stages of their foundational dance training program. A total of 24 female, second-year dance students from Hebei Normal University were selected as participants. They were divided into three distinct groups: Nordic hamstring exercise and single-leg deadlift group (NHE&SLD), forward bending exercises and standing leg lift group (FBE&SLL), and a control group (CG). The study was designed around a 6-week training regimen. An isokinetic dynamometer was used to measure seated knee flexor–extensor strength, while electronic goniometry was employed to measure hamstring flexibility in the supine position. Paired sample t-tests were conducted within each group, and one-way analysis of covariance (ANCOVA) was utilized for comparisons between groups. In the NHE&SLD group, significant disparities were observed in both concentric (T = − 5.687, P = 0.001) and eccentric (T = − 3.626, P = 0.008) hamstring strength pre and post-intervention. The pre-intervention dominant leg concentric strength test values significantly influenced the post-intervention outcomes (F = 5.313, P = 0.001, η2 = 0.840). Similarly, the pre-intervention dominant leg eccentric strength test values impacted the post-intervention results (F = 4.689, P = 0.043, η2 = 0.190). Following the intervention, the NHE&SLD group displayed marked changes in the active straight leg raising angle on both left (T = − 4.171, P = 0.004) and right (T = − 6.328, P = 0.001) sides. The FBE&SLL group also revealed significant changes in the active straight leg raising angle on both left (T = − 4.506, P = 0.003) and right (T = − 4.633, P = 0.002) sides following the intervention. The pre-intervention left leg concentric strength test value significantly influenced the post-intervention outcomes (F = 25.067, P = 0.001, η2 = 0.556). Likewise, the pre-intervention right leg eccentric strength test value significantly influenced the post-intervention results (F = 85.338, P = 0.01, η2 = 0.810). Eccentric training can better enhance the flexibility and strength of hamstring muscles in dance students. Traditional stretching training significantly improves the flexibility of the hamstring muscles. Eccentric training has more training benefits than traditional stretching training. It is recommended for dance students to use eccentric training when increasing hamstring flexibility and strength.

Purpose: To examine the dose–response of the Nordic hamstring exercise (NHE) on biceps femoris long head (BFlh) architecture and eccentric knee flexor strength. Design: Randomized interventional trial. Methods: Forty recreationally active males completed a 6-week NHE training program consisting of either intermittent low volumes (group 1; n = 10), low volumes (group 2; n = 10), initial high volumes followed by low volumes (group 3; n = 10), or progressively increasing volumes (group 4; n = 10). A 4-week detraining period followed each program. Muscle architecture was assessed weekly during training and after 2 and 4 weeks of detraining. Eccentric knee flexor strength was assessed preintervention and postintervention and after 2 and 4 weeks of detraining. Results: Following 6 weeks of training, BFlh fascicle length (FL) increased in group 3 (mean difference = 0.83 cm, d = 0.45, P =.027, +7%) and group 4 (mean difference = 1.48 cm, d = 0.94, P =.004, +14%). FL returned to baseline following detraining in groups 3 and 4. Strength increased in group 2 (mean difference = 53.6 N, d = 0.55, P =.002, +14%), group 3 (mean difference = 63.4 N, d = 0.72, P =.027, +17%), and group 4 (mean difference = 74.7, d = 0.83, P =.006, +19%) following training. Strength returned to baseline following detraining in groups 2 and 3 but not in group 4. Conclusions: Initial high volumes of the NHE followed by lower volumes, as well as progressively increasing volumes, can elicit increases in BFlh FL and eccentric knee flexor strength. Low volumes of the NHE were insufficient to increase FL, although as few as 48 repetitions in 6 weeks did increase strength. [ABSTRACT FROM AUTHOR]

The objective of this research is to examine the impact of eccentric training on hamstring flexibility and strength in young dancers during the concluding stages of their foundational dance training program. A total of 24 female, second-year dance students from Hebei Normal University were selected as participants. They were divided into three distinct groups: Nordic hamstring exercise and single-leg deadlift group (NHE&SLD), forward bending exercises and standing leg lift group (FBE&SLL), and a control group (CG). The study was designed around a 6-week training regimen. An isokinetic dynamometer was used to measure seated knee flexor–extensor strength, while electronic goniometry was employed to measure hamstring flexibility in the supine position. Paired sample t-tests were conducted within each group, and one-way analysis of covariance (ANCOVA) was utilized for comparisons between groups. In the NHE&SLD group, significant disparities were observed in both concentric (T = − 5.687, P = 0.001) and eccentric (T = − 3.626, P = 0.008) hamstring strength pre and post-intervention. The pre-intervention dominant leg concentric strength test values significantly influenced the post-intervention outcomes (F = 5.313, P = 0.001, η2 = 0.840). Similarly, the pre-intervention dominant leg eccentric strength test values impacted the post-intervention results (F = 4.689, P = 0.043, η2 = 0.190). Following the intervention, the NHE&SLD group displayed marked changes in the active straight leg raising angle on both left (T = − 4.171, P = 0.004) and right (T = − 6.328, P = 0.001) sides. The FBE&SLL group also revealed significant changes in the active straight leg raising angle on both left (T = − 4.506, P = 0.003) and right (T = − 4.633, P = 0.002) sides following the intervention. The pre-intervention left leg concentric strength test value significantly influenced the post-intervention outcomes (F = 25.067, P = 0.001, η2 = 0.556). Likewise, the pre-intervention right leg eccentric strength test value significantly influenced the post-intervention results (F = 85.338, P = 0.01, η2 = 0.810). Eccentric training can better enhance the flexibility and strength of hamstring muscles in dance students. Traditional stretching training significantly improves the flexibility of the hamstring muscles. Eccentric training has more training benefits than traditional stretching training. It is recommended for dance students to use eccentric training when increasing hamstring flexibility and strength. [ABSTRACT FROM AUTHOR]

It is unclear whether human tendon adapts to moderate-intensity, high-volume long-term eccentric exercise, e.g., downhill running (DR) training. This study aimed to investigate the time course of patellar tendon (PT) adaptation to short-term DR training and to determine whether changes in PT properties were related to changes in mechanical stress or loading history. Twelve untrained, young, healthy adults (5 women and 7 men) took part in 4 weeks' DR training, comprising 10 sessions. Running speed was equivalent to 60-65% VÌO2max, and session duration increased gradually (15-30 minutes) throughout training. Isometric knee extensor maximal voluntary torque (MVT), vastus lateralis (VL) muscle physiological cross-sectional area (PCSA) and volume, and PT CSA, stiffness, and Young's modulus were assessed at weeks 0, 2, and 4 using ultrasound and isokinetic dynamometry. Patellar tendon stiffness (+6.4 ± 7.4%), Young's modulus (+6.9 ± 8.8%), isometric MVT (+7.5 ± 12.3%), VL volume (+6.6 ± 3.2%), and PCSA (+3.8 ± 3.3%) increased after 4 weeks' DR (p < 0.05), with no change in PT CSA. Changes in VL PCSA correlated with changes in PT stiffness (r = 0.70; p = 0.02) and Young's modulus (r = 0.63; p = 0.04) from 0 to 4 weeks, whereas changes in MVT did not correlate with changes in PT stiffness and Young's modulus at any time point (p > 0.05). To conclude, 4 weeks' DR training promoted substantial changes in PT stiffness and Young's modulus that are typically observed after high-intensity, low-volume resistance training. These tendon adaptations seemed to be driven primarily by loading history (represented by VL muscle hypertrophy), whereas increased mechanical stress throughout the training period did not seem to contribute to changes in PT stiffness or Young's modulus. [ABSTRACT FROM AUTHOR]

Objective: The study compared the activities of the surface electromyography (sEMG) of trunk and hip muscles during single-leg Romanian deadlift (SLRDL) exercises using a flywheel and dumbbell with different loading positions (ipsilateral and contralateral). Method: Twelve active male subjects with at least 2 years of strength training experience (age: 26.7 ± 3.3 years; weight: 73.9 ± 6.2 kg) participated in this study. sEMG in the percentage of maximum voluntary isometric contraction of four SLRDL exercises (ipsilateral and contralateral loading position for dumbbell and flywheel) in a randomized order for superior gluteus maximus (SGM), inferior gluteus maximus (IGM), gluteus medius (GM), biceps femoris (BF), erector spinae (ES), external oblique (EO), and adductor longus (AL) were measured. One-way repeated measure ANOVA with Bonferroni adjustment (statistical significance at 0.05) and the non-clinical magnitude-based decision with a standardized difference were performed for statistical analysis. Results: The overall results demonstrated a very high level of SGM (105.4%–168.6%) and BF (69.6%–122.4%) muscle activities. A significant moderate increase of sEMG signals in GM, IGM, and ES (dominant side) and a large increase in SGM activity during concentric action when the loading position of flywheel SLRDL was changed from ipsilateral to the contralateral side. No significant difference was observed between flywheel and dumbbell SLRDL exercises. Conclusion: Strength coaches may adopt dumbbell or flywheel SLRDL exercises using the contralateral loading position to simultaneously strengthen the hip extensors and trunk stabilizers effectively. [ABSTRACT FROM AUTHOR]

Exercise has emerged as fundamental therapeutic medicine in the management of cancer. Exercise improves health-related outcomes, including quality of life, neuromuscular strength, physical function, and body composition, and it is associated with a lower risk of disease recurrence and increased survival. Moreover, exercise during or post cancer treatments is safe, can ameliorate treatment-related side effects, and may enhance the effectiveness of chemotherapy and radiation therapy. To date, traditional resistance training (RT) is the most used RT modality in exercise oncology. However, alternative training modes, such as eccentric, cluster set, and blood flow restriction are gaining increased attention. These training modalities have been extensively investigated in both athletic and clinical populations (e.g., age-related frailty, cardiovascular disease, type 2 diabetes), showing considerable benefits in terms of neuromuscular strength, hypertrophy, body composition, and physical function. However, these training modes have only been partially or not at all investigated in cancer populations. Thus, this study outlines the benefits of these alternative RT methods in patients with cancer. Where evidence in cancer populations is sparse, we provide a robust rationale for the possible implementation of certain RT methods that have shown positive results in other clinical populations. Finally, we provide clinical insights for research that may guide future RT investigations in patients with cancer and suggest clear practical applications for targeted cancer populations and related benefits.

Abstract There is a growing body of evidence showing the importance of physical activity against civilization-induced metabolic diseases, including type 2 diabetes (T2DM) and obesity. Eccentric contraction, when skeletal muscles generate force by lengthening, is a unique type of skeletal muscle activity. Eccentric contraction may lead to better power production characteristics of the muscle because eccentric contraction requires less energy and can result in higher tension. Therefore, it is an ideal tool in the rehabilitation program of patients. However, the complex metabolic effect (i.e., fat mass reduction, increased lipid oxidation, improvement in blood lipid profile, and increased insulin sensitivity) of the eccentric contraction alone has scarcely been investigated. This paper aims to review the current literature to provide information on whether eccentric contraction can influence metabolic health and body composition in T2DM or obesity. We also discussed the potential role of myokines in mediating the effects of eccentric exercise. A better understanding of the mechanism of eccentric training and particularly their participation in the regulation of metabolic diseases may widen their possible therapeutic use and, thereby, may support the fight against the leading global risks for mortality in the world.

• Alternative resistance training (RT) methods should be considered in potential exercise prescription for people with cancer and may be of interest for specific cancer populations, stage of disease, or cancer and treatment-related comorbidities. • Robust evidence from research investigating eccentric, cluster sets, and blood flow restriction training in older adults and other clinical populations corroborates its possible use in cancer research. • Alternative RT methods may potentially elicit equal or even greater effects compared to traditional RT on muscle strength, hypertrophy, physical function, and body composition. Exercise has emerged as fundamental therapeutic medicine in the management of cancer. Exercise improves health-related outcomes, including quality of life, neuromuscular strength, physical function, and body composition, and it is associated with a lower risk of disease recurrence and increased survival. Moreover, exercise during or post cancer treatments is safe, can ameliorate treatment-related side effects, and may enhance the effectiveness of chemotherapy and radiation therapy. To date, traditional resistance training (RT) is the most used RT modality in exercise oncology. However, alternative training modes, such as eccentric, cluster set, and blood flow restriction are gaining increased attention. These training modalities have been extensively investigated in both athletic and clinical populations (e.g., age-related frailty, cardiovascular disease, type 2 diabetes), showing considerable benefits in terms of neuromuscular strength, hypertrophy, body composition, and physical function. However, these training modes have only been partially or not at all investigated in cancer populations. Thus, this study outlines the benefits of these alternative RT methods in patients with cancer. Where evidence in cancer populations is sparse, we provide a robust rationale for the possible implementation of certain RT methods that have shown positive results in other clinical populations. Finally, we provide clinical insights for research that may guide future RT investigations in patients with cancer and suggest clear practical applications for targeted cancer populations and related benefits. [Display omitted] [ABSTRACT FROM AUTHOR]

There is considerable debate about the existence of a real eccentric overload in flywheel exercises. This study aimed to analyse the differences in concentric: eccentric mechanical output ratios between different loads and variables in the flywheel squat exercise. Twenty physically active men (22.9 ± 2.2 years, height: 1.8 ± 0.1 m, weight: 79.6 ± 8.2 kg) performed a loading test using five moments of inertia. Angular speed was measured using a rotary encoder, while the vertical force was measured using force plates. For each variable (angular speed, angular acceleration, power, vertical force, and torque), mean and peak values were calculated for concentric and eccentric phases to allow comparisons across the loads. We tested the possible differences in Load x Phase (concentric and eccentric) and Load x Variable. The level of significance was established as p < 0.05. A significant Load x Phase interaction was found in mean angular speed, peak vertical force, peak angular acceleration, peak power and peak torque. Higher eccentric overload values were observed with speed-derived variables (angular speed, angular acceleration and power). In conclusion, speed-derived peak variables and lower loads are more likely to show an eccentric overload and can be used to monitor responses to flywheel training. [ABSTRACT FROM AUTHOR]

Heart failure is considered as a systemic disease as beside the heart, skeletal muscle is affected. In this retrospective case-control study 64 men and 15 women with heart failure as well as an individually pairwise matched sample by sex, age and body mass index of healthy individuals from the COmPLETE cohort study performed an exhaustive cardiopulmonary exercise test, strength tests and anthropometric measurements. V̇O 2 peak was 28.6% lower in male and 24.6% lower in female patients with heart failure as compared to healthy controls. Strength parameters are significantly higher for counter movement jump in male subjects. In females, significant differences were detected for mid-thigh pull in healthy versus patients with heart failure. Skeletal muscle mass of patients was in male as well as female 3.7% lower than in controls. Furthermore, the function of skeletal muscle seems impaired as the ability to accelerate is significantly lower in affected male with a heart pathology. It seems that severe affections (approx. 25 to 30%) on cardiocirculatory level are associated with moderate to low affections on functional and structural capacity on skeletal muscle level. Further, as in the male cohort with a heart pathology acceleration meaning 'fast' contracting is impaired, it is suggested, that the central limitations respectively the low perfusion of skeletal muscle over years yield to adaptions on muscle cell level ingoing with a decreased ability of fast contracting. It is therefore suggested, that the central circulatory limitations in patients with heart failure, respectively the low perfusion of skeletal muscle over years, promote maladaptation's in the periphery. • We show for a strictly matched cohort with Heart Failure from the COmPLETE cohort versus healthy controls that severe affections on cardiocirculatory level are associated with moderate affections on skeletal muscle level. • As the differences on skeletal muscle are smaller than on cardiac level, a preserved function is implied potentially ingoing with better tissue trainability. • In consequence, for patients unable to perform aerobic exercise, skeletal muscle should be directly addressed. [ABSTRACT FROM AUTHOR]

There is a growing body of evidence showing the importance of physical activity against civilization-induced metabolic diseases, including type 2 diabetes (T2DM) and obesity. Eccentric contraction, when skeletal muscles generate force by lengthening, is a unique type of skeletal muscle activity. Eccentric contraction may lead to better power production characteristics of the muscle because eccentric contraction requires less energy and can result in higher tension. Therefore, it is an ideal tool in the rehabilitation program of patients. However, the complex metabolic effect (i.e., fat mass reduction, increased lipid oxidation, improvement in blood lipid profile, and increased insulin sensitivity) of the eccentric contraction alone has scarcely been investigated. This paper aims to review the current literature to provide information on whether eccentric contraction can influence metabolic health and body composition in T2DM or obesity. We also discussed the potential role of myokines in mediating the effects of eccentric exercise. A better understanding of the mechanism of eccentric training and particularly their participation in the regulation of metabolic diseases may widen their possible therapeutic use and, thereby, may support the fight against the leading global risks for mortality in the world. [ABSTRACT FROM AUTHOR]

There is considerable debate about the existence of a real eccentric overload in flywheel exercises. This study aimed to analyse the differences in concentric: eccentric mechanical output ratios between different loads and variables in the flywheel squat exercise. Twenty physically active men (22.9±2.2 years, height: 1.8±0.1 m, weight: 79.6±8.2 kg) performed a loading test using five moments of inertia. Angular speed was measured using a rotary encoder, while the vertical force was measured using force plates. For each variable (angular speed, angular acceleration, power, vertical force, and torque), mean and peak values were calculated for concentric and eccentric phases to allow comparisons across the loads. We tested the possible differences in Load×Phase (concentric and eccentric) and Load×Variable. The level of significance was established as p < 0.05. A significant Load×Phase interaction was found in mean angular speed, peak vertical force, peak angular acceleration, peak power and peak torque. Higher eccentric overload values were observed with speed-derived variables (angular speed, angular acceleration and power). In conclusion, speed-derived peak variables and lower loads are more likely to show an eccentric overload and can be used to monitor responses to flywheel training.

Purpose: To examine the differences between performing Nordic hamstring exercises once or twice a week on hamstring eccentric strength and other muscle-strain risk factors in high-level football players. Methods: In this randomized trial, 32 football players (18–23 y old) completed an 8-week Nordic hamstring exercise training program in 1 of 2 experimental groups: group 1 (once a week; n = 15) and group 2 (twice a week; n = 17). Knee-flexor/extensor peak torques and biceps femoris long-head muscle architecture were assessed through isokinetic dynamometry and ultrasonography, respectively, before and after the training programs. Analysis of covariance, effect sizes (ESs), and t tests for percentage change were used to assess the effect of the 2 interventions on the outcome measures. Results: Group 2 demonstrated higher hamstring concentric peak torque than group 1 posttraining (155–164 vs 149–158 N·m; P =.043; ES = 0.27), although there was also a statistical trend for higher hamstring eccentric peak torque (212–234 vs 198–221 N·m; P =.098; ES = 0.37), hamstring-to-quadriceps conventional ratio (0.56–0.59 vs 0.54–0.57; P =.089; ES = 0.31), and hamstring-to-quadriceps functional ratio (0.76–0.84 vs 0.71–0.79; P =.076; ES = 0.50). No between-groups differences were found for muscle thickness (P =.864; ES = 0.12), pennation angle (P =.289; ES = 0.18), fascicle length (P =.406; ES = 0.03), and quadriceps concentric peak torque (P =.340; ES = 0.02). Conclusion: Only the Nordic hamstring exercise training program performed twice a week strengthened the hamstrings of high-level football players, while similar changes in muscle architecture occurred with both once- and twice-weekly sessions. [ABSTRACT FROM AUTHOR]

Objective: The study compared the activities of the surface electromyography (sEMG) of trunk and hip muscles during single-leg Romanian deadlift (SLRDL) exercises using a flywheel and dumbbell with different loading positions (ipsilateral and contralateral).Method: Twelve active male subjects with at least 2 years of strength training experience (age: 26.7 ± 3.3 years; weight: 73.9 ± 6.2 kg) participated in this study. sEMG in the percentage of maximum voluntary isometric contraction of four SLRDL exercises (ipsilateral and contralateral loading position for dumbbell and flywheel) in a randomized order for superior gluteus maximus (SGM), inferior gluteus maximus (IGM), gluteus medius (GM), biceps femoris (BF), erector spinae (ES), external oblique (EO), and adductor longus (AL) were measured. One-way repeated measure ANOVA with Bonferroni adjustment (statistical significance at 0.05) and the non-clinical magnitude-based decision with a standardized difference were performed for statistical analysis.Results: The overall results demonstrated a very high level of SGM (105.4%–168.6%) and BF (69.6%–122.4%) muscle activities. A significant moderate increase of sEMG signals in GM, IGM, and ES (dominant side) and a large increase in SGM activity during concentric action when the loading position of flywheel SLRDL was changed from ipsilateral to the contralateral side. No significant difference was observed between flywheel and dumbbell SLRDL exercises.Conclusion: Strength coaches may adopt dumbbell or flywheel SLRDL exercises using the contralateral loading position to simultaneously strengthen the hip extensors and trunk stabilizers effectively.

Groin injuries are common in sports, almost 68% adductor strain among them, which generally more prone in football, soccer, hockey, and other games. The available literature well describes the rehabilitation phase of adductor strain but an application of dry needling on adductor injuries are not yet established. Two national-level younger football players were clinically diagnosed with the adductor strain. They had severe pain on medial aspect of the thigh, aggravated with kicking and functional activity (VAS- 8/10, LEFS 58/80, 69/80). The therapist assessed the patients and designed their rehabilitation protocol as per their findings of the examination. The lower extremity functional scale (LEFS), global rating scale, and VAS were used as outcome variables. The total intervention was given for 10–12 weeks, follow up had been taken for 4 months. The application of dry needling reduced the pain, improved and relieved the symptoms. The eccentric strengthening of the adductors and core stability improved the strength as well as functional activity of the lower limb. The case study is not generalized the effect of treatment. Thus, a randomized control trial is suggested for further study. [ABSTRACT FROM AUTHOR]

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Strength training has been a common intervention used to improve neuromuscular activity within the synergic and/or agonist-antagonist muscles. This study aimed to evaluate simultaneous electrical activity of quadriceps and hamstring muscles after strength eccentric training versus concentric training.Methods: This experimental study has a between-group comparison design with a population of 26 males divided into two groups, namely the eccentric training group and the concentric training group. Maximal knee extension force and bipolar surface electromyography (EMG) signals from quadriceps and hamstring muscles were simultaneously recorded pre- and post-concentric and eccentric strength training. After EMG pre-processing for noise reduction, EMG signals were evaluated in two groups by time and frequency analysis. Nine EMG features (six time features and three frequency features) were analyzed in two groups pre- and post-training by statistical analysis.Results: The results showed that the maximal voluntary isometric contraction (MIVC) of quadriceps muscles was significantly increased in both groups from pre- to post-training (p 0.05).Conclusion: Based on the current results, great changes in time and frequency features of quadriceps and hamstring EMGs were achieved using eccentric training. Thus, eccentric strength training could be more effective in triggering neuromuscular activity within the agonist and antagonist muscles simultaneously.

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Background: The prominent insertion/deletion polymorphism in the gene for the major modulator of tissue perfusion, angiotensin-converting enzyme (ACE-I/D) is associated with variability in adjustments in cardiac and skeletal muscle performance with standard forms of endurance and strength type training. Here, we tested whether the ACE-I/D genotype would be associated with variability in the effects of interval-type training on peak and aerobic performance of peripheral muscle and cardio-vasculature and post-exercise recovery. Methods: Nine healthy subjects (39.0 ± 14.7 years of age; 64.6 ± 16.1 kg, 173.6 ± 9.9) completed eight weeks of interval training on a soft robotic device based on repeated sets of a pedaling exercise at a matched intensity relative to their peak aerobic power output. Prior to and post-training, peak anaerobic and aerobic power output was assessed, mechanical work and metabolic stress (oxygen saturation and hemoglobin concentrations of Musculus vastus lateralis (VAS) and Musculus gastrocnemius (GAS), blood lactate and factors setting cardiac output such as heart rate, systolic and diastolic blood pressure were monitored during ramp-incremental exercise and interval exercise with the calculation of areas under the curve (AUC), which were put in relation to the produced muscle work. Genotyping was performed based on I- and D-allele-specific polymerase chain reactions on genomic DNA from mucosal swaps. The significance of interaction effects between training and ACE I-allele on absolute and work-related values was assessed with repeated measures ANOVA. Results: Subjects delivered 87% more muscle work/power, 106% more cardiac output, and muscles experienced ~72% more of a deficit in oxygen saturation and a ~35% higher passage of total hemoglobin during single interval exercise after the eight weeks of training. Interval training affected aspects of skeletal muscle metabolism and performance, whose variability was associated with the ACE I-allele. This concerned the economically favorable alterations in the work-related AUC for the deficit of SmO2 in the VAS and GAS muscles during the ramp exercise for the I-allele carriers and opposing deteriorations in non-carriers. Conversely, oxygen saturation in the VAS and GAS at rest and during interval exercise was selectively improved after training for the non-carriers of the I-allele when the AUC of tHb per work during interval exercise deteriorated in the carriers. Training also improved aerobic peak power output by 4% in the carriers but not the non-carriers (p = 0.772) of the ACE I-allele while reducing negative peak power (−27.0%) to a lesser extent in the ACE I-allele carriers than the non-carriers. Variability in cardiac parameters (i.e., the AUC of heart rate and glucose during ramp exercise, was similar to the time to recovery of maximal tHb in both muscles after cessation of ramp exercise, only associated with the ACE I-allele but not training per se. Diastolic blood pressure and cardiac output during recovery from exhaustive ramp exercise demonstrated a trend for training-associated differences in association with the ACE I-allele. Discussion: The exercise-type dependent manifestation of antidromic adjustments in leg muscle perfusion and associated local aerobic metabolism between carriers and non-carriers of the ACE I-allele with the interval-training highlight that non-carriers of the I-allele do not present an essential handicap to improve perfusion-related aerobic muscle metabolism but that the manifestation of responsiveness depends on the produced work. Conclusions: The deployed interval-type of exercise produced ACE I-allele-related differences in the alterations of negative anaerobic performance and perfusion-related aerobic muscle metabolism, which manifestation is exercise specific. The training-invariant ACE I-allele-associated differences in heart rate and blood glucose concentration emphasize that the repeated impact of the interval stimulus, despite a near doubling of the initial metabolic load, was insufficient to overturn ACE-related genetic influences on cardiovascular function. [ABSTRACT FROM AUTHOR]

Exercise interventions are evident in the treatment of mid-portion Achilles tendinopathy (AT). However, there is still a lack of knowledge concerning the effect of different exercise treatments on improving a specific function (e.g., strength) in this population. Thus, this study aimed to systematically review the effect of exercise treatments on different functional outcomes in mid-portion AT. An electronic database of Pubmed, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception to 21 February 2023. Studies that investigated changes in plantar flexor function with exercise treatments were considered in mid-portion AT. Only randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were included. Functional outcomes were classified by kinetic (e.g., strength), kinematic [e.g., ankle range of motion (ROM)], and sensorimotor (e.g., balance index) parameters. The types of exercise treatments were classified into eccentric, concentric, and combined (eccentric plus concentric) training modes. Quality assessment was appraised using the Physiotherapy Evidence Database scale for RCTs, and the Joanna Briggs Institute scale for CCTs. The search yielded 2,260 records, and a total of ten studies were included. Due to the heterogeneity of the included studies, a qualitative synthesis was performed. Eccentric training led to improvements in power outcomes (e.g., height of countermovement jump), and in strength outcomes (e.g., peak torque). Concentric training regimens showed moderate enhanced power outcomes. Moreover, one high-quality study showed an improvement in the balance index by eccentric training, whereas the application of concentric training did not. Combined training modalities did not lead to improvements in strength and power outcomes. Plantarflexion and dorsiflexion ROM measures did not show relevant changes by the exercise treatments. In conclusion, eccentric training is evident in improving strength outcomes in AT patients. Moreover, it shows moderate evidence improvements in power and the sensorimotor parameter “balance index”. Concentric training presents moderate evidence in the power outcomes and can therefore be considered as an alternative to improve this function. Kinematic analysis of plantarflexion and dorsiflexion ROM might not be useful in AT people. This study expands the knowledge what types of exercise regimes should be considered to improve the functional outcomes in AT.

The present study aimed to investigate the effect of different volumes of fast eccentric-based training on body composition and lipidemic–glycemic profiles in females, as well as to explore the relationship between the change in glycemic–lipidemic profiles and the change in muscle fibre composition. Twenty-nine young females were assigned into three groups and performed 10 weeks (2 training sessions per week) of either 3 (LV), 6 (MV) or 9 (HV) sets/session of four fast velocity eccentric-only half-squats against 70% of concentric 1RM, followed by 3 maximum countermovement jumps (CMJ) after each set. Body composition, vastus lateralis fibre-type composition, and resting blood lipidemic and glycemic indices were evaluated 1 week before and after the training intervention. Significant changes in body composition, fasting glucose, HOMA-IR and blood lipids were found after training with MV and HV (p < 0.05; η2: 0.135–0.390). Significant correlations were found between muscle fibres' percentage cross-sectional areas (%CSA) and resting glycemic–lipid values (r:−0.543to 0.730, p < 0.05). Training-induced changes of glycemic-lipid profiles were highly correlated to those of type IIa and IIx %CSAs (r: −0.895 to 0.898, p < 0.05). Partial Correlations revealed a significant impact of the imposed training volumes on these correlations. These results suggest that six but mostly nine sets per training session of the imposed training stimuli are needed for beneficial changes in resting glycemic–lipidemic profiles, changes which are related to the training-induced changes in muscle fibre composition. However, these relationships are dictated by the imposed training volumes. Highlights Power training induces beneficial changes in body composition, glycemic and lipidemic profiles. Greater training volumes are needed for the healthier changes in glycemic–lipidemic profiles. Higher Type I, IIA and lower IIX percentage cross-sectional areas are linked with healthier body composition and glycemic-lipidemic profiles. Individuals experiencing the greatest increase in Type IIa and decrease in Type IIX muscle fibres cross-sectional areas after power training are those with the greatest beneficial changes in body composition, glycemic and lipidemic profiles. [ABSTRACT FROM AUTHOR]

Copyright of Actividad Fisica & Deporte is the property of Universidad de Ciencias Aplicadas & Ambientales and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Iliopsoas tendinopathy is a chronic degenerative condition that occurs due to repeated flexion of the hip joint and restricts the patient's physical activities. Case presentation: A 20-year-old female squash player presented with right iliopsoas tendinopathy. Her problem started with a sharp ache in her upper thigh, while running and exercising. To help her return to sports, she received high-intensity laser therapy (HILT), and eccentric-biased training. The Visual Analogue Scale, Global Rating of Change Scale and Manual Muscle Testing scores all improved after the interventions shown at follow-up. Conclusions: Eccentric-biased exercise, in conjunction with HILT was effective in the rehabilitation of this patient with iliopsoas tendinopathy. [ABSTRACT FROM AUTHOR]

Background: Assuming that the mechanisms inducing adaptation in healthy tendons yield similar responses in tendinopathic tendons, we hypothesized that a high-loading exercise protocol that increases tendon stiffness and cross-sectional area in male healthy Achilles tendons may also induce comparable beneficial adaptations in male tendinopathic Achilles tendons in addition to improving pain and function. Objectives: We investigated the effectiveness of high-loading exercise in Achilles tendinopathy in terms of inducing mechanical (tendon stiffness, maximum strain), material (Young's modulus), morphological (tendon cross-sectional area (CSA)), maximum voluntary isometric plantar flexor strength (MVC) as well as clinical adaptations (Victorian Institute of Sports Assessment—Achilles (VISA-A) score and pain (numerical rating scale (NRS))) as the primary outcomes. As secondary outcomes, drop (DJ) and counter-movement jump (CMJ) height and intratendinous vascularity were assessed. Methods: We conducted a controlled clinical trial with a 3-month intervention phase. Eligibility criteria were assessed by researchers and medical doctors. Inclusion criteria were male sex, aged between 20 and 55 years, chronic Achilles tendinopathy confirmed by a medical doctor via ultrasound-assisted assessment, and a severity level of less than 80 points on the VISA-A score. Thirty-nine patients were assigned by sequential allocation to one of three parallel arms: a high-loading intervention (training at ~ 90% of the MVC) (n = 15), eccentric exercise (according to the Alfredson protocol) as the standard therapy (n = 15) and passive therapy (n = 14). Parameters were assessed pre- and-post-intervention. Data analysis was blinded. Results: Primary outcomes: Plantar flexor MVC, tendon stiffness, mean CSA and maximum tendon strain improved only in the high-loading intervention group by 7.2 ± 9.9% (p = 0.045), 20.1 ± 20.5% (p = 0.049), 8.98 ± 5.8% (p < 0.001) and −12.4 ± 10.3% (p = 0.001), respectively. Stiffness decreased in the passive therapy group (−7.7 ± 21.2%; p = 0.042). There was no change in Young's modulus in either group (p > 0.05). The VISA-A score increased in all groups on average by 19.8 ± 15.3 points (p < 0.001), while pain (NRS) dropped by −0.55 ± 0.9 points (p < 0.001). Secondary outcomes: CMJ height decreased for all groups (−0.63 ± 4.07 cm; p = 0.005). There was no change in DJ height and vascularity (p > 0.05) in either group. Conclusion: Despite an overall clinical improvement, it was exclusively the high-loading intervention that induced significant mechanical and morphological adaptations of the plantar flexor muscle–tendon unit. This might contribute to protecting the tendon from strain-induced injury. Thus, we recommend the high-loading intervention as an effective (alternative) therapeutic protocol in Achilles tendinopathy rehabilitation management in males. Clinical Trials Registration Number: NCT02732782. [ABSTRACT FROM AUTHOR]

Abstract Background Over the last years there have been a wide body of research exploring the best strategies to promote acute enhancements in players’ performance. Despite that, most studies have been focused on adult and elite players, and different results may be identified when considering players from lower levels of performance and belonging to youth categories. In addition, most studies conducted in this domain focused in repetitive movement patterns, and while adding variability has been considered as a useful approach to enhance players’ performance at short and long-term perspectives, less is known regarding it applicability to acute enhance players physical performance. Therefore, this study aimed to compare the acute enhancement effects of performing the half-squat in a flywheel ergometer between a more-repetitive approach (low noise) and a more variable approach (differential learning, high noise) in youth soccer players. Methods A total of sixteen players (age = 16.2 ± 0.6 years) was exposed to four conditions in a randomized order: (1) repetitive intervention for 30 s; (2) repetitive intervention for 10-min; (3) differential learning intervention for 30 s; (4) differential learning intervention for 10-min. Each condition consisted in 3 sets of 6 repetitions of eccentric half squats performed in a flywheel ergometer. Countermovement jump, 10 m and 30 m linear sprint, and change-of-direction ability were measured every session at baseline (pre-test) and after each protocol (post-test). Results No potentiation effect was observed overall with any of the interventions. In addition, no differences between protocols were found for sprinting. However, the repetitive intervention impaired jumping performance for both 30 s (small effects, p ≤ .05) and 10-min intervals (small effects, p ≤ .05), as well as in the change-of-direction task for 30 s (p ≤ .05). Conclusions These results may be due to the players’ low experience in eccentric flywheel training. Despite these findings, individual potentiation responses emerged from both protocols when considering the individual responses, reinforcing the need to establish more personalized approaches.

Abián-Vicén, J, Martínez, F, Jiménez, F, and Abián, P. Effects of eccentric single-leg decline squat training performed with different execution times on maximal strength and muscle contraction properties of the knee extensor muscles. J Strength Cond Res 36(11): 3040–3047, 2022—The eccentric phase of the single-leg decline squat (SLDSe) has been described as a method to maximally load the knee extensor and has been used as an easy and effective rehabilitation exercise for patellar tendinopathy. The purpose of this study was to examine the impact of 6-week SLDSe training with 2 technical execution times on changes related to strength and muscle contractile properties. Thirty-six healthy volunteers were randomly divided into 3 groups: a control group (CG, n = 13, no training), a slow training group (n = 11, SLDSe in 6 seconds), and a fast training group (n = 12, SLDSe in 3 seconds). Subjects completed a 6-week SLDSe training program (80% of eccentric one repetation maximum [1RM]) 3 days a week. Pre, post, and 6-week follow-up of maximal dynamic and isometric strength and muscle contractile properties were assessed. After 6 weeks, training maximal loads showed a significant increase (p < 0.05) in 1RM of the SLDSe (∼92–95%), the concentric peak torque at 180°·s−1 (∼38%) and 60°·s−1 (∼25%), and the extension isometric peak torque (∼12%), with no differences between both experimental groups. Moreover, a decrease (p < 0.05) was found in the contraction time of the vastus medialis (VM) and the response time of the 3 analyzed quadriceps muscles. After the 6-week detraining period, there was a decrease in strength in all tests and in both experimental groups (1RM = 28–37%, isometric and isokinetic tests = 7–17%) and all contractile properties returned to baseline, except for the response time of the vastus lateralis in the fast training group and the contraction time of the VM in the STG. In conclusion, the SLDSe training protocol produced significant increases in muscle strength, showing important neuromuscular changes regardless of the technical execution time. It was also found that the training reduced the response and contraction time of the knee extensor musculature. [ABSTRACT FROM AUTHOR]

Background: Hamstrings extensibility is affected as a result of lack of physical activity causing a limitation of extension motion of the knee joint, increases posterior pelvic tilting and reducing lumbar lordosis that can result in nonspecific low back pain. Aim: To compare the effects of muscle energy technique versus eccentric training on hamstrings extensibility among adolescent girls. Methods: Based on Inclusion and Exclusion criteria, 60 adolescent girls of age group 15-24 years were assessed & selected using Active Knee Extension Test for a lag in extension of around 20 degrees during performance of the test. The subjects were divided into three groups of 20 each. Group A (Control Group) was given Conventional treatment as Hot Pack as warm up over the Hamstrings muscle for both the lower limbs & Static Stretching. Thereafter, Group B (Experimental Group 1) was given Muscle Energy Technique & Conventional treatment and Group C (Experimental Group 2) was given Eccentric Training & Conventional treatment for total 6 sessions as 3 sessions a week for 2 weeks respectively. Results: Data was meaningfully assorted through calculation of Mean and Standard Deviation. Thereafter, T test was applied for comparison between the MET group and Eccentric Training group and Control Group. The level of significance was fixed at p<0.05. There was significant difference within and between the MET group and Eccentric Training group for both the limbs. Conclusion: The study concluded that MET was better than Eccentric Training in improving Hamstrings extensibility among Adolescent Girls. [ABSTRACT FROM AUTHOR]

Successful performances in rugby league require the ability to engage in repeated contact efforts with minimal recovery while maintaining a high running intensity. The capacity to express high levels of time-limited force appears to underlie many important physical attributes required to meet the repeated-effort demands of rugby league play. If appropriately periodised and integrated into the training plan, resistance exercise that sufficiently loads the eccentric phase of movement may provide a beneficial stimulus to improve players’ force-generating capacity. Comprehensive reviews relating to the adaptive effects of eccentric training and the methods most commonly prescribed in practical environments are available and may provide context for applying these strategies. However, no literature to date has specifically discussed the planning and programming of eccentric resistance exercise to enhance force production characteristics in elite athletes. Therefore, this narrative review focuses on the periodisation of eccentrically-integrated resistance training during a 17-week National Rugby League pre-season phase. To help guide programming during the pre-season period, the 17-week timeline is divided into several phases (i.e., general preparation, special preparation, active rest, and pre-competition). Within the periodised model, eccentric exercise parameters (i.e., volume, load [% 1RM]) are manipulated to progressively increase the rate of muscle lengthening velocity over the pre-season phase and sequentially elicit changes in muscle-tendon properties and neural function that culminate in improving muscular strength expression.

The objective of this study was to analyze the effects of two 8-week neuromuscular training (NMT) interventions on selected physical indicators in young tennis players. Twenty-four junior male tennis players were assigned to a machine-based (MG) (n = 8), flywheel (FG) (n = 8) or a control training group (CG) (n = 8). Tests at baseline, week 4and 8 included: countermovement jump (CMJ); speed (S; 5, 10, 15 m); agility (right [AR] and left [AL]); serve velocity (SV) and medicine ball throws (MBT; overhead [O], forehand [FH], backhand [BH]). MG and FG attained large positive effects at week 4 in CMJ, S 10 m; AR, AL and MBT FH only in FG. Regarding inter- to post-test, MG achieved large positive effects in MBT O, FH and both groups in BH. Large negative effects appeared for FG in S 5 and 10 m and AR and AL. Both NMT interventions led to positive effects from baseline to week 4 measures in CMJ, S 5 m, 10 m and agility and at week 8 in MBT. Conducting the same NMT for a longer period of time did not lead to the same improvements and other negative effects in FG appeared. Results indicate that performing these interventions with little exercise variability or load management, especially after technical-tactical sessions, could interpose further beneficial outcomes and initial gains could be impaired. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze the effects of two 8-week neuromuscular training (NMT) interventions on selected physical indicators in young tennis players. Twenty-four junior male tennis players were assigned to a machine-based (MG) (n = 8), flywheel (FG) (n = 8) or a control training group (CG) (n = 8). Tests at baseline, week 4 and 8 included: countermovement jump (CMJ); speed (S; 5, 10, 15 m); agility (right [AR] and left [AL]); serve velocity (SV) and medicine ball throws (MBT; overhead [O], forehand [FH], backhand [BH]). MG and FG attained large positive effects at week 4 in CMJ, S 10 m; AR, AL and MBT FH only in FG. Regarding inter- to post-test, MG achieved large positive effects in MBT O, FH and both groups in BH. Large negative effects appeared for FG in S 5 and 10 m and AR and AL. Both NMT interventions led to positive effects from baseline to week 4 measures in CMJ, S 5 m, 10 m and agility and at week 8 in MBT. Conducting the same NMT for a longer period of time did not lead to the same improvements and other negative effects in FG appeared. Results indicate that performing these interventions with little exercise variability or load management, especially after technical-tactical sessions, could interpose further beneficial outcomes and initial gains could be impaired.

Increased serial sarcomere number (SSN) has been observed in rats following downhill running training due to the emphasis on active lengthening contractions; however, little is known about the influence on dynamic contractile function. Therefore, we employed 4 weeks of weighted downhill running training in rats, then assessed soleus SSN and work loop performance. We hypothesised trained rats would produce greater net work output during work loops due to a greater SSN. Thirty-one Sprague-Dawley rats were assigned to a training or sedentary control group. Weight was added during downhill running via a custom-made vest, progressing from 5–15% body mass. Following sacrifice, the soleus was dissected, and a force-length relationship was constructed. Work loops (cyclic muscle length changes) were then performed about optimal muscle length (LO) at 1.5–3-Hz cycle frequencies and 1–7-mm length changes. Muscles were then fixed in formalin at LO. Fascicle lengths and sarcomere lengths were measured to calculate SSN. Intramuscular collagen content and crosslinking were quantified via a hydroxyproline content and pepsin-solubility assay. Trained rats had longer fascicle lengths (+13%), greater SSN (+8%), and a less steep passive force-length curve than controls (P0.05). Net work output was greater (+78–209%) in trained than control rats for the 1.5-Hz work loops at 1 and 3-mm length changes (P

Introduction Full-thickness rotator cuff tear is present in almost 50% of patients over age 65 years, and its degree is known to be a good predictor of the severity of muscle-wasting (MW) sarcopaenia, also known as fatty degeneration (FD). A FD CT grade > 2° is recognized as a borderline of its reversibility. A disuse model of supraspinatus FD (grade 2) in rabbits provides clinically relevant data. Therefore, the present study evaluates the correlation between eccentric mechanotransduction, neuromuscular transmission (NT), and reversibility of muscle fatty infiltration (MFI) in rabbit supraspinatus FD > 2°. Material and methods The supraspinatus tendon was detached from the greater tubercle, infraspinatus, and subscapularis in 16 rabbits. The tendon was reinserted after 12 weeks, and the animals were euthanized 24 weeks after reconstruction. MFI was measured in the middle part of the supraspinatus. Single-fibre EMG (SFEMG) examination of the supraspinatus NT was performed on 4 animals. Results The power of analysis was 99%. Significant differences in MFI volume were found between the operated (4.6 ±1.1%) and the opposite control sides (2.91 ±0.61%) (p 0.05); however, 6.5% of the examined muscle fibres exhibited NT disorders combined with blockade of conduction in 2.5% of muscle fibres. Conclusions Critical MFI in a disuse model of rabbit supraspinatus FD, CT grade > 2°, is substantially reversible by eccentric training despite subclinical impairment of neuromuscular transmission. In addition, 0.63% reversal of MFI is correlated with 1% hypertrophy of type I and II muscle fibre diameter.

Simple Summary: Muscle health should be prioritized in individuals with conditions who may be at risk of obesity accompanied by sarcopenia. In this context, muscle quality is a novel index of functional capacity that is increasingly relied upon as a critical biomarker of muscle health in low-functioning aging. However, there is scarce evidence regarding which muscle phenotype elicits a more robust effect on important molecules responsible for muscle regeneration and energy homeostasis. Hence, in this study, we evaluated the time-course responses on interleukin-6 and creatine kinase levels following acute eccentric resistance exercise in sedentary obese elderly women with muscle quality differences. This issue is valuable because eccentric exercise may be a particularly promising approach for older adults to efficiently improve muscle mass, strength, and functional performance. We observed that obese older women with high baseline muscle quality display significant increases of interleukin-6 and creatine kinase following an acute eccentric exercise intervention. Such individuals are commonly termed "high-responders". In contrast, the participants with low muscle quality showed exceptionally small responses ("low responders") for these molecules compared to individuals with high baseline muscle quality. Muscle phenotype can potentially contribute to individual variation in exercise responses. This phenomenon of responsiveness may clarify important training adaptations. This study aimed to evaluate the time course and responsiveness of plasma interleukin-6 (IL-6) and creatine kinase (CK) levels following acute eccentric resistance exercise in sedentary obese older women with a different muscle quality index (MQI). Eighty-eight participants (69.4 ± 6.06 years) completed an acute eccentric resistance exercise (7 sets of 10 repetitions at 110% of 10-repetition maximum with 3 min rest interval). Participants were divided into two groups: high or low MQI according to 50th percentile cut-off. The responsiveness was based on minimal clinical important difference. There were no differences between groups and time on IL-6 and CK levels (p > 0.05). However, the high MQI group displayed a lower proportion of low responders (1 for laboratory and 2 for field-based vs. 5 and 4) and a higher proportion of high responders for IL-6 (7 for laboratory and 6 for field-based vs. 4 and 5) compared to low MQI group. In addition, the high MQI group showed a higher proportion of high responders for CK (11 for laboratory and 9 for field-based vs. 6 and 6) compared to low MQI. A prior MQI screening can provide feedback to understand the magnitude response. Individual responsiveness should be taken into consideration for maximizing eccentric exercise prescription. [ABSTRACT FROM AUTHOR]