Low-intensity eccentric contractions attenuate muscle damage induced by subsequent maximal eccentric exercise of the knee extensors in the elderly

The acute and repeated bout effects of multi-joint eccentric exercise on physical function and balance in older adults

PURPOSE

Eccentric muscle actions generate high levels of force at a low metabolic cost, making them a suitable training modality to combat age-related neuromuscular decline. The temporary muscle soreness associated with high intensity eccentric contractions may explain their limited use in clinical exercise prescription, however any discomfort is often alleviated after the initial bout (repeated bout effect). Therefore, the aims of the present study were to examine the acute and repeated bout effects of eccentric contractions on neuromuscular factors associated with the risk of falling in older adults.

METHODS

Balance, functional ability [timed up-and-go and sit-to-stand], and lower-limb maximal and explosive strength were measured in 13 participants (67.6 ± 4.9 year) pre- and post-eccentric exercise (0, 24, 48, and 72 hr) in Bout 1 and 14 days later in Bout 2. The eccentric exercise intervention was performed on an isokinetic unilateral stepper ergometer at 50% of maximal eccentric strength at 18 step‧min-1 per limb for 7 min (126 steps per limb). Two-way repeated measures ANOVAs were conducted to identify any significant effects (P ≤ 0.05).

RESULTS

Eccentric strength significantly decreased (- 13%) in Bout 1 at 24 hr post-exercise; no significant reduction was observed at any other time-point after Bout 1. No significant reductions occurred in static balance or functional ability at any time-point in either bout.

CONCLUSION

Submaximal multi-joint eccentric exercise results in minimal disruption to neuromuscular function associated with falls in older adults after the initial bout.

The Effects of Pre-conditioning on Exercise-Induced Muscle Damage: A Systematic Review and Meta-analysis

BACKGROUND

Several studies have utilised isometric, eccentric and downhill walking pre-conditioning as a strategy for alleviating the signs and symptoms of exercise-induced muscle damage (EIMD) following a bout of damaging physical activity.

OBJECTIVES

This systematic review and meta-analysis examined the effects of pre-conditioning strategies on indices of muscle damage and physical performance measures following a second bout of strenuous physical activity.

DATA SOURCES

PubMed, CINAHL and Scopus.

ELIGIBILITY CRITERIA

Studies meeting the PICO (population, intervention/exposure, comparison, and outcome) criteria were included in this review: (1) general population or "untrained" participants with no contraindications affecting physical performance; (2) studies with a parallel design to examine the prevention and severity of muscle-damaging contractions; (3) outcome measures were compared using baseline and post-intervention measures; and (4) outcome measures included any markers of indirect muscle damage and muscular contractility measures.

PARTICIPANTS

Individuals with no resistance training experiences in the previous 6 or more months.

INTERVENTIONS

A single bout of pre-conditioning exercises consisting of eccentric or isometric contractions performed a minimum of 24 h prior to a bout of damaging physical activity were compared to control interventions that did not perform pre-conditioning prior to damaging physical activity.

STUDY APPRAISAL

Kmet appraisal system.

SYNTHESIS METHODS

Quantitative analysis was conducted using forest plots to examine standardised mean differences (SMD, i.e. effect size), test statistics for statistical significance (i.e. Z-values) and between-study heterogeneity by inspecting I2.

RESULTS

Following abstract and full-text screening, 23 articles were included in this paper. Based on the meta-analysis, the pre-conditioning group exhibited lower levels of creatine kinase at 24 h (SMD =  - 1.64; Z = 8.39; p = 0.00001), 48 h (SMD =  - 2.65; Z = 7.78; p = 0.00001), 72 h (SMD =  - 2.39; Z = 5.71; p = 0.00001) and 96 h post-exercise (SMD =  - 3.52; Z = 7.39; p = 0.00001) than the control group. Delayed-onset muscle soreness was also lower for the pre-conditioning group at 24 h (SMD =  - 1.89; Z = 6.17; p = 0.00001), 48 h (SMD =  - 2.50; Z = 7.99; p = 0.00001), 72 h (SMD =  - 2.73; Z = 7.86; p = 0.00001) and 96 h post-exercise (SMD =  - 3.30; Z = 8.47; p = 0.00001). Maximal voluntary contraction force was maintained and returned to normal sooner in the pre-conditioning group than in the control group, 24 h (SMD = 1.46; Z = 5.49; p = 0.00001), 48 h (SMD = 1.59; Z = 6.04; p = 0.00001), 72 h (SMD = 2.02; Z = 6.09; p = 0.00001) and 96 h post-exercise (SMD = 2.16; Z = 5.69; p = 0.00001). Range of motion was better maintained by the pre-conditioning group compared with the control group at 24 h (SMD = 1.48; Z = 4.30; p = 0.00001), 48 h (SMD = 2.20; Z = 5.64; p = 0.00001), 72 h (SMD = 2.66; Z = 5.42; p = 0.00001) and 96 h post-exercise (SMD = 2.5; Z = 5.46; p = 0.00001). Based on qualitative analyses, pre-conditioning activities were more effective when performed at 2-4 days before the muscle-damaging protocol compared with immediately prior to the muscle-damaging protocol, or 1-3 weeks prior to the muscle-damaging protocol. Furthermore, pre-conditioning activities performed using eccentric contractions over isometric contractions, with higher volumes, greater intensity and more lengthened muscle contractions provided greater protection from EIMD.

LIMITATIONS

Several outcome measures showed high inter-study heterogeneity. The inability to account for differences in durations between pre-conditioning and the second bout of damaging physical activity was also limiting.

CONCLUSIONS

Pre-conditioning significantly reduced the severity of creatine kinase release, delayed-onset muscle soreness, loss of maximal voluntary contraction force and the range of motion decrease. Pre-conditioning may prevent severe EIMD and accelerate recovery of muscle force generation capacity.

Recovery from Resistance Exercise in Older Adults: A Systematic Scoping Review

BACKGROUND

Resistance exercise is recommended for maintaining muscle mass and strength in older adults. However, little is known about exercise-induced muscle damage and recovery from resistance exercise in older adults. This may have implications for exercise prescription. This scoping review aimed to identify and provide a broad overview of the available literature, examine how this research has been conducted, and identify current knowledge gaps relating to exercise-induced muscle damage and recovery from resistance exercise in older adults.

METHODS

Studies were included if they included older adults aged 65 years and over, and reported any markers of exercise-induced muscle damage after performing a bout of resistance exercise. The following electronic databases were searched using a combination of MeSH terms and free text: MEDLINE, Scopus, Embase, SPORTDiscus and Web of Science. Additionally, reference lists of identified articles were screened for eligible studies. Data were extracted from eligible studies using a standardised form. Studies were collated and are reported by emergent theme or outcomes.

RESULTS

A total of 10,976 possible articles were identified and 27 original research articles were included. Findings are reported by theme; sex differences in recovery from resistance exercise, symptoms of exercise-induced muscle damage, and biological markers of muscle damage.

CONCLUSIONS

Despite the volume of available data, there is considerable variability in study protocols and inconsistency in findings reported. Across all measures of exercise-induced muscle damage, data in women are lacking when compared to males, and rectifying this discrepancy should be a focus of future studies. Current available data make it challenging to provide clear recommendations to those prescribing resistance exercise for older people.

Pedal cadence does not affect muscle damage to eccentric cycling performed at similar mechanical work

Purpose: This study aimed to investigate muscle damage when performing equal mechanical work of fast and slow pedaling speed by eccentric muscle actions (ECCs) cycling.

Methods: Nineteen young men [mean ± standard deviation (SD) age: 21.0 ± 2.2 years; height: 172.7 ± 5.9 cm; and body mass: 70.2 ± 10.5 kg] performed maximal effort of ECCs cycling exercise with fast speed (Fast) and slow speed trials (Slow). First, subjects performed the Fast for 5 min by one leg. Second, Slow performed until the total mechanical work was equal to that generated during Fast other one leg. Changes in maximal voluntary isometric contraction (MVC) torque of knee extension, isokinetic pedaling peak torque (IPT), range of motion (ROM), muscle soreness, thigh circumference, muscle echo intensity, and muscle stiffness were assessed before exercise, and immediately after exercise, and 1 and 4 days after exercise.

Results: Exercise time was observed in the Slow (1422.0 ± 330.0 s) longer than Fast (300.0 ± 0.0 s). However, a significant difference was not observed in total work (Fast:214.8 ± 42.4 J/kg, Slow: 214.3 ± 42.2 J/kg). A significant interaction effect was not observed in peak values of MVC torque (Fast:1.7 ± 0.4 Nm/kg, Slow: 1.8 ± 0.5 Nm/kg), IPT, muscle soreness (Fast:4.3 ± 1.6 cm, Slow: 4.7 ± 2.9 cm). In addition, ROM, circumference, muscle thickness, muscle echo intensity, and muscle stiffness also showed no significant interaction.

Conclusion: The magnitude of muscle damage is similar for ECCs cycling with equal work regardless of velocity.

Applications of Eccentric Exercise to Improve Muscle and Mobility Function in Older Adults

Muscle aging ultimately leads to the deterioration of human physiological functioning, including declining muscle strength, loss of muscle mass, and decreased quality of life in advanced age. Eccentric exercise is a key intervention that has the potential to ameliorate this problem. Recent studies have focused on evidence-based exercise interventions to prevent declines in muscle strength and physical function in older adults. This paper reviewed relevant literature on the use of eccentric exercise to improve muscle and mobility function in older adults. We explained not only the changes in mobility that occur with aging but also the rationale for and positive effects of eccentric intervention in older adults. We also explored several proposed mechanisms for the intramuscular changes caused by eccentric muscle contraction and considered the safety and side effects accompanying eccentric training. We concluded by suggesting that eccentric exercise is an exercise modality that can potentially improve muscle strength and enhance mobility in older adults.

Striking muscle adaptations induced by volume-dependent repeated bouts of low-intensity eccentric exercise of the elbow flexors

We investigated the effects of repeating 30 low-intensity eccentric contractions with a dumbbell corresponding to 10% maximal isometric strength (10%EC) on muscle strength and hypertrophy, and muscle damage after 30 maximal eccentric contractions (MaxEC) of the elbow flexors. Young men were placed into 1 of 3 experimental groups that performed 10%EC either once, twice a week for 4 (8 bouts) or 8 weeks (16 bouts) before MaxEC, or a control group that performed 2 bouts of MaxEC separated by 2 weeks (n = 13/group). Repeating 16 bouts of 10%EC increased (P < 0.05) maximal voluntary contraction strength (30 ± 21%) and muscle thickness (4.2 ± 2.3%) greater than 8 bouts (16 ± 4%, 1.9 ± 1.3%). Changes in the muscle damage markers after MaxEC were smaller (P < 0.05) for the experimental groups than the control group, and the magnitude of muscle damage protection was greater (P < 0.05) after 16 bouts (65 ± 30%) than 8 bouts (55 ± 33%), followed by 1 bout (34 ± 27%). The protection by 16 bouts was similar (P = 0.81) to that shown by the second MaxEC of the control group. These results showed that 10%EC produced potent muscle adaptation effects accumulatively and conferred muscle damage protection, but 1 bout of 10%EC was still effective for conferring approximately 20% of the protection of that by 16 bouts. Novelty: Repeating low-intensity eccentric exercise induces large increases in muscle strength and hypertrophy. Low-intensity eccentric exercise protects muscle damage induced by maximal eccentric contractions, and the protection is reinforced by repeating it. These are especially beneficial for individuals who are frail and cannot tolerate high-intensity resistance training.

Fast-Velocity Eccentric Cycling Exercise Causes Greater Muscle Damage Than Slow Eccentric Cycling

This study aims to investigate muscle damage occurring in the early and recovery phases after fast-velocity and slow-velocity eccentric cycling. Eleven untrained men (age, 20.0 ± 1.7 years; height, 171.3 ± 6.8 cm; weight, 61.8 ± 7.7 kg; and %body fat, 13.2 ± 2.9%) performed slow-velocity maximal isokinetic eccentric cycling (slow-velocity; 30°/s) with one leg and fast-velocity (fast-velocity; 210°/s) isokinetic eccentric cycling with the other leg. Changes in maximal voluntary isokinetic concentric contraction (MVCC) torque at velocities of 30 and 210°/s, range of motion (ROM), and muscle soreness were assessed by pressure using a digital muscle stiffness instrument; thigh circumference, muscle echo intensity, and muscle stiffness were assessed before exercise, and immediately after exercise, 1 day, and 4 days after exercise. Comparing with the results obtained for slow-velocity cycling (post: 215.9 ± 32.3 Nm, day 1: 192.9 ± 47.4 Nm, day 4: 184.3 ± 47.2 Nm) and before exercise, MVCC after fast-velocity cycling significantly decreased at immediately (160.4 ± 43.5 Nm), 1 day (143.6 ± 54.1 Nm), and 4 days (150.1 ± 44.5 Nm) after exercise (p < 0.05). Significant increase in muscle soreness for vastus lateralis was observed after fast-velocity cycling (41.2 ± 16.9 mm) compared with slow-velocity cycling (23.7 ± 12.2 mm) 4 days after exercise (p < 0.05). However, no significant difference in muscle soreness was observed for rectus femoris and vastus medialis at any time points after exercise. In addition, no significant differences were observed in the ROM, thigh circumference, muscle echo intensity, and muscle stiffness. In conclusion, fast-velocity eccentric cycling causes a decrease in muscle strength and an increase in soreness as compared to slow-velocity eccentric cycling.

The effectiveness of low intensity exercise and blood flow restriction without exercise on exercise induced muscle damage: A systematic review

OBJECTIVE

To investigate the evidence and provide clinical recommendations for low intensity exercises(LIE) and blood flow restriction(BFR) without exercise on reducing the effects of exercise induced muscle damage(EIMD).

METHOD

PubMed, Embase, Web of science, and PEDro(Physiotherapy Evidence Database) were searched up to December 2019 for studies that included LIE or BFR without exercise and their effect on EIMD.

RESULTS

Out of 3192 studies, 23 were included with 17 on LIE and 6 on BFR without exercise. 11 studies demonstrated positive effects for LIE on EIMD, with two level 2 and nine level 3 studies. Two level 2 and two level 3 studies found benefits for BFR without exercise on reducing the negative effects of EIMD, while two level 2 studies found did not find benefits for BFR without exercise.

CONCLUSION

Moderate to low levels of evidence supported LIE, particularly in the form of protective low load eccentric exercise, in reducing the negative effects of EIMD. Conflicting moderate to low levels of evidence was found regarding BFR without exercise. There does seem to be potential benefit for BFR without exercise in untrained individuals. Clinicians can provide clinical recommendations as LIE and BFR without exercise reducing EIMD.

Echo Intensity Reliability From Two Ultrasound Systems

Objective:

Echo intensity measurements are highly influenced by ultrasound system and parameters used for measurement, making comparisons of results obtained from different ultrasound machines difficult. Therefore, it is necessary to understand how reliability changes when using different ultrasound systems and parameters.

Materials and Methods:

ALOKA SSD4000 and GE LOGIQ P6 systems were used to compare rectus femoris echo intensity in 16 healthy young subjects (eight women) using different depths (D), gains (G), and frequencies (F). The following settings were adopted: ALOKA1 (D6/G30/F7.5), ALOKA2 (D6/G45/F7.5), ALOKA3 (D6/G30/F10), LOGIQ1 (D6/G50/F15), LOGIQ2 (D6/G0/F15), LOGIQ3 (D6/G0/F10), and LOGIQ4 (D6/G30/F10). Intraclass correlation coefficient, standard error of the measure, minimum difference, and Bland-Altman tests were performed to calculate reliability and agreement between systems’ settings.

Results:

ALOKA1 × LOGIQ1, ALOKA1 × LOGIQ4, and ALOKA3 × LOGIQ1 showed moderate to high ICCs and agreement on the Bland-Altman test.

Conclusion:

Echo intensity varies between systems and parameters, but reliability can be increased by adjusting the ultrasound settings.

The Impact of Protein Supplementation on Exercise-Induced Muscle Damage, Soreness and Fatigue Following Prolonged Walking Exercise in Vital Older Adults: A Randomized Double-Blind Placebo-Controlled Trial

Background: It is unknown whether protein supplementation can enhance recovery of exercise-induced muscle damage in older adults who have a disturbed muscle protein synthetic response. We assessed whether protein supplementation could attenuate exercise-induced muscle damage and soreness after prolonged moderate-intensity walking exercise in older adults. Methods: In a double-blind, placebo-controlled intervention study, 104 subjects (81% male, ≥65 years) used either a protein (n = 50) or placebo supplement (n = 54) during breakfast and directly after exercise. Within a walking event, study subjects walked 30/40/50 km per day on three consecutive days. Muscle soreness and fatigue were determined with a numeric rating scale, and creatine kinase (CK) concentrations and serum inflammation markers were obtained. Results: Habitual protein intake was comparable between the protein (0.92 ± 0.27 g/kg/d) and placebo group (0.97 ± 0.23 g/kg/d, p = 0.31). At baseline, comparable CK concentrations were found between the protein and the placebo group (110 (IQR: 84–160 U/L) and 115 (IQR: 91–186 U/L), respectively, p = 0.84). Prolonged walking (protein: 32 ± 9 km/d, placebo: 33 ± 6 km/d) resulted in a cumulative increase of CK in both the protein (∆283 (IQR: 182–662 U/L)) and placebo group (∆456 (IQR: 209–885 U/L)) after three days. CK elevations were not significantly different between groups (p = 0.43). Similarly, no differences in inflammation markers, muscle soreness and fatigue were found between groups. Conclusions: Protein supplementation does not attenuate exercise-induced muscle damage, muscle soreness or fatigue in older adults performing prolonged moderate-intensity walking exercise.

Exercise induced changes in echo intensity within the muscle: a brief review

Echo intensity is the mean pixel intensity of a specific region of interest from an ultrasound image. This variable has been increasingly used in the literature as a physiological marker. Although there has been an increased interest in reporting changes in echo intensity in response to exercise, little consensus exists as to what a change in echo intensity represents physiologically. The purpose of this paper is to review some of the earliest, as well as the most up to date literature regarding the changes in echo intensity in response to exercise. Echo intensity has been used to measure muscle quality, muscle damage, acute swelling, and intramuscular glycogen. The changes in echo intensity, however, are not consistent throughout the literature and often times lead to conclusions that seem contrary to the physiologic effects of exercise. For example, echo intensity increases in conjunction with increases in strength, contrary to what would be expected if echo intensity was a marker of muscle quality/muscle damage. It is conceivable that a change in echo intensity represents a range of physiologic effects at different time points. We recommend that these effects should be determined experimentally in order to rule out what echo intensity might and might not represent. Until this is done, caution should be employed when interpreting changes in echo intensity with acute and chronic exercise.

Photobiomodulation Therapy Does Not Attenuate Fatigue and Muscle Damage in Judo Athletes: A Randomized, Triple-Blind, Placebo-Controlled Trial

Fatigue and muscle damage negatively affect performance in lower limb exercises involving the stretch-shortening cycle in judo athletes during competition and training sessions. Photobiomodulation therapy has emerged as an effective non-invasive strategy to attenuate fatigue and muscle damage when applied before different types of exercises. Our objective was to investigate the effects of photobiomodulation therapy on fatigue and muscle damage in judo athletes. Sixteen judo athletes participated in the study (23.1 ± 3.8 years, 77.9 ± 14.9 kg, 173.1 ± 8.9 cm, 17.5 ± 7.3 body fat%, 12.9 ± 5.0 years of practice). Each participant received, in a randomized manner, photobiomodulation in one limb and placebo in the contralateral limb on the same day. Thereafter, subjects performed a stretch-shortening cycle protocol to induce muscle fatigue and damage. Countermovement jump (impulse, peak power, peak velocity, and peak force), echo intensity (rectus femoris and vastus lateralis), and muscle soreness were assessed at different time points before, during, immediately post, and 24 and 48 h after the protocol. Muscle fatigue was detected due to reductions in countermovement jump impulse (14.7 ± 9.8 and 15.9 ± 15.5%), peak power (12.9 ± 8.5 and 11.9 ± 6.9%), peak velocity (8.6 ± 8.1 and 6.5 ± 6.0%), and peak force (7.0 ± 5.3 and 8.0 ± 6.1%) after the protocol (p < 0.001), for placebo and photobiomodulation therapy, respectively. Muscle damage was detected due to reductions in countermovement jump impulse (−6.1 ± 19.2% and −4.5 ± 9.2%, p < 0.05), increases in echo intensity (rectus femoris, 21.0 ± 11.9 and 20.8 ± 9.0%; and vastus lateralis, 22.4 ± 23.2%; and 16.7 ± 23.8%; p < 0.001), and quadriceps muscle soreness (3.6 ± 1.6 and 3.5 ± 1.7 a.u; p < 0.011), 48 h after the protocol, for placebo and photobiomodulation therapy, respectively. No differences were observed between photobiomodulation therapy and placebo at any time points for any variables (p > 0.05), indicating no positive effect favoring photobiomodulation therapy. In conclusion, our findings suggest no effect of photobiomodulation therapy applied before exercise to reduce lower limb muscle fatigue and damage during and following a stretch-shortening cycle protocol in judo athletes.

Eccentric Muscle Contractions: Risks and Benefits

Eccentric contractions, characterized by the lengthening of the muscle-tendon complex, present several unique features compared with other types of contractions, which may lead to unique adaptations. Due to its specific physiological and mechanical properties, there is an increasing interest in employing eccentric muscle work for rehabilitation and clinical purposes. However, unaccustomed eccentric exercise is known to cause muscle damage and delayed pain, commonly defined as “Delayed-Onset Muscular Soreness” (DOMS). To date, the most useful preventive strategy to avoid these adverse effects consists of repeating sessions involving submaximal eccentric contractions whose intensity is progressively increased over the training. Despite an increased number of investigations focusing on the eccentric contraction, a significant gap still remains in our understanding of the cellular and molecular mechanisms underlying the initial damage response and subsequent adaptations to eccentric exercise. Yet, unraveling the molecular basis of exercise-related muscle damage and soreness might help uncover the mechanistic basis of pathological conditions as myalgia or neuromuscular diseases. In addition, a better insight into the mechanisms governing eccentric training adaptations should provide invaluable information for designing therapeutic interventions and identifying potential therapeutic targets.

Damage protective effects conferred by low-intensity eccentric contractions on arm, leg and trunk muscles

PURPOSE

Low-intensity eccentric contractions with a load corresponding to 10% of maximal voluntary isometric contraction strength (10% EC) attenuate muscle damage in a subsequent bout of higher-intensity eccentric contractions performed within 2 weeks for the elbow flexors, knee flexors and knee extensors. However, it is not known whether this strategy could be applied to other muscles. This study investigated whether 10% EC would confer damage protective effect on high-intensity eccentric contractions (80% EC) for nine different muscle groups.

METHODS

Untrained young men were placed to an experimental or a control group (n = 12/group). Experimental group performed 50 eccentric contractions with a load corresponding to 10% EC at 2 days prior to 50 eccentric contractions with 80% EC for the elbow flexors and extensors, pectoralis, knee flexors and extensors, plantar flexors, latissimus, abdominis and erector spinae. Control group performed 80% EC without 10% EC. Changes in maximal voluntary isometric contraction strength (MVC) and muscle soreness, plasma creatine kinase (CK) activity and myoglobin concentration after 80% EC were compared between groups by a mixed-factor ANOVA.

RESULTS

MVC recovered faster (e.g., 6-31% greater MVC at 5 days post-exercise), and peak muscle soreness was 36-54% lower for Experimental than Control group for the nine muscles (P < 0.05). Increases in plasma CK activity and myoglobin concentration were smaller for Experimental (e.g., peak CK: 2763 ± 3459 IU/L) than Control group (120,360 ± 50,158 IU/L).

CONCLUSIONS

These results showed that 10% EC was effective for attenuating the magnitude of muscle damage after 80% EC for all muscles, although the magnitude of the protective effect differed among the muscles.

Differential Effects of Different Warm-up Protocols on Repeated Sprints-Induced Muscle Damage

Chen, CH, Ye, X, Wang, YT, Chen, YS, and Tseng, WC. Differential effects of different warm-up protocols on repeated sprints-induced muscle damage. J Strength Cond Res 32(11): 3276-3284, 2018-The purpose of this investigation was to examine whether adding a set of hamstring resistance exercise or dynamic stretching to a regular running-based warm-up before a bout of repeated sprints provides protective effects against the sprinting-induced muscle damage. Twelve elite tennis players participated in this study. After the familiarization, subjects completed 3 separate randomly sequenced experimental visits, during which 3 different warm-up interventions were performed before the muscle-damaging protocol (12 sets of 30-m maximal repeated sprints): 5 minutes of running (control); control with single leg slide curl (SLC); and control with active hamstring stretching (AHS). Before, immediately (POST0), 1 day (POST1), and 2 days after (POST2) the sprints, hip flexion passive range of motion, hamstring muscle thickness and pennation angle, muscle stiffness, and knee flexion concentric peak torque were measured. Repeated sprints have induced muscle damage in all 3 visits. For AHS, the muscle thickness and stiffness values at POST2 were significantly lower than those of other 2 protocols. In addition, the decrements of concentric strength at POST0, POST1, and POST2 for AHS were also significantly less than those of control and SLC. Therefore, adding a set of dynamic hamstrings stretching to a regular warm-up protocol before repeated sprints has protective effect on the sprinting-induced muscle damage. Athletes whose competitions are densely scheduled (e.g., tennis player in a tournament) may take advantage of this strategy to facilitate muscle recovery from the potential muscle damage, thus, to get maximal recovery for the subsequent competitions.

Effects of preconditioning hamstring resistance exercises on repeated sprinting-induced muscle damage in female soccer players

To examine whether adding preconditioning hamstring resistance exercises to a regular warm-up prior to a repeated sprinting exercise provides protection against the sprinting-induced muscle damage. Ten female soccer players (mean ± SD age: 21.3 ± 4.5yrs; height: 171.34 ± 8.29 cm; weight: 68.53 ± 11.27 kg) participated in this study. After the familiarization visit, the subjects completed three separate randomly sequenced experimental visits, during which three different warm-up interventions were performed before the muscle-damaging protocol (12 sets of 30-m maximal repeated sprints): 1. Regular running and static stretching (Control); 2. Control with hyperextensions (HE); 3. Control with single leg Romanian deadlift (SLRD). Before (Pre), immediately (Post0), 24 hours (24hr), and 48 hours after (48hr) the sprints, hamstring muscle thickness, muscle stiffness, knee flexion eccentric peak torque, knee extension concentric peak torque, and functional hamstring to quadriceps ratios were measured. Repeated sprints have induced muscle damage (e.g., an average of 42% knee flexion eccentric strength reduction) in all three conditions. After the SLRD, hamstring muscle thickness decreased from 24hr to 48hr (p < 0.001). Additionally, muscle stiffness and eccentric strength for the SLRD showed no difference from baseline at 24hr and 48hr, respectively. When compared with the SLRD at 48hr, the muscle stiffness and the eccentric strength were greater and lower, respectively, in other protocols. The SLRD protocol had protective effect on sprinting-induced muscle damage markers than other protocols. Athletes whose competitions/training are densely scheduled may take advantage of this strategy to facilitate muscle recovery.

Effects of Descending Stair Walking on Health and Fitness of Elderly Obese Women

PURPOSE

Eccentric exercise training produces positive fitness and health outcomes, but whether this is also the case for descending stair walking (DSW) is unknown. This study investigated the hypothesis that DSW would improve insulin sensitivity, lipid profiles and physical fitness better than ascending stair walking (ASW).

METHODS

Elderly (≥60 yr) obese women were placed to either DSW or ASW group (n = 15 per group). An elevator was used to eliminate ascending stairs for DSW, and descending stairs for ASW. Descending stair walking and ASW were performed twice a week for 12 wk by increasing the repetitions gradually. Overnight fasting blood samples were taken 3 d before the first training session and 4 d after the last training session, and analyzed for insulin sensitivity and lipid profile markers. Resting HR, systolic blood pressure, and diastolic blood pressure, bone mineral density, knee extensor maximal voluntary isometric contraction strength and several functional physical fitness measures were taken before and after the intervention.

RESULTS

Average HR during DSW (88.6 ± 7.8 bpm) was lower (P < 0.05) than that of ASW (113.7 ± 10.9 bpm). Resting HR (-10%) and systolic blood pressure (-9%) decreased greater after DSW than ASW (-4% for both), and bone mineral density increased (6%) only for DSW (P < 0.05). Decreases in serum triacylglycerols, total and low-density lipoprotein cholesterols, glucose, insulin, homeostasis model assessment and whole blood glycosylated hemoglobin, and increases in high-density lipoprotein cholesterols were greater (P < 0.05) after DSW than ASW. Maximal voluntary isometric contraction strength increased greater for DSW (34%) than ASW (15%), and many of functional physical fitness measures showed greater (P < 0.05) improvement for DSW than ASW.

CONCLUSIONS

These results supported the hypothesis and suggest that DSW is an effective exercise intervention for elderly obese women to improve their health and fitness.

Superior Effects of Eccentric to Concentric Knee Extensor Resistance Training on Physical Fitness, Insulin Sensitivity and Lipid Profiles of Elderly Men

It has been reported that eccentric training of knee extensors is effective for improving blood insulin sensitivity and lipid profiles to a greater extent than concentric training in young women. However, it is not known whether this is also the case for elderly individuals. Thus, the present study tested the hypothesis that eccentric training of the knee extensors would improve physical function and health parameters (e.g., blood lipid profiles) of older adults better than concentric training. Healthy elderly men (60–76 years) were assigned to either eccentric training or concentric training group (n = 13/group), and performed 30–60 eccentric or concentric contractions of knee extensors once a week. The intensity was progressively increased over 12 weeks from 10 to 100% of maximal concentric strength for eccentric training and from 50 to 100% for concentric training. Outcome measures were taken before and 4 days after the training period. The results showed that no sings of muscle damage were observed after any sessions. Functional physical fitness (e.g., 30-s chair stand) and maximal concentric contraction strength of the knee extensors increased greater (P ≤ 0.05) after eccentric training than concentric training. Homeostasis model assessment, oral glucose tolerance test and whole blood glycosylated hemoglobin showed improvement of insulin sensitivity only after eccentric training (P ≤ 0.05). Greater (P ≤ 0.05) decreases in fasting triacylglycerols, total, and low-density lipoprotein cholesterols were evident after eccentric training than concentric training, and high-density lipoprotein cholesterols increased only after eccentric training. These results support the hypothesis and suggest that it is better to focus on eccentric contractions in exercise medicine.

Prevention of downhill walking-induced muscle damage by non-damaging downhill walking

PURPOSE

Mountain trekking involves level, uphill, and downhill walking (DW). Prolonged DW induces damage to leg muscles, reducing force generating ability and muscle coordination. These increase risks for more serious injuries and accidents in mountain trekking, thus a strategy to minimize muscle damage is warranted. It has been shown that low-intensity eccentric contractions confer protective effect on muscle damage induced by high-intensity eccentric contractions. This study tested the hypothesis that 5-min non-damaging DW would attenuate muscle damage induced by 40-min DW, but 5-min level walking (LW) would not.

METHODS

Untrained young men were allocated (n = 12/group) to either a control or one of the two preconditioning groups (PRE-DW or PRE-LW). The PRE-DW and PRE-LW groups performed 5-min DW (-28%) and 5-min LW, respectively, at 5 km/h with a load of 10% body mass, 1 week before 40-min DW (-28%, 5 km/h, 10% load). The control group performed 40-min DW only. Maximal knee extension strength, plasma creatine kinase (CK) activity, and muscle soreness (0-100 mm visual analogue scale) were measured before and 24 h after 5-min DW and 5-min LW, and before and 24, 48, and 72 h after 40-min DW.

RESULTS

No significant changes in any variables were evident after 5-min DW and 5-min LW. After 40-min DW, the control and PRE-LW groups showed significant (P<0.05) changes in the variables without significant differences between groups (control vs. PRE-LW; peak strength reduction: -19.2 ± 6.9% vs. -18.7 ± 11.0%, peak CK: 635.5 ± 306.0 vs. 639.6 ± 405.4 U/L, peak soreness: 81.4 ± 14.8 vs. 72.0 ± 29.2 mm). These changes were significantly (P<0.05) attenuated (47-64%) for the PRE-DW group (-9.9 ± 9.6%, 339.3 ± 148.4 U/L, 27.8 ± 16.8 mm).

CONCLUSIONS

The results supported the hypothesis and suggest that performing small volume of downhill walking is crucial in preparation for trekking.

Effects of low-level laser therapy applied before or after plyometric exercise on muscle damage markers: randomized, double-blind, placebo-controlled trial

Promising effects of phototherapy on markers of exercise-induced muscle damage has been already demonstrated in constant load or isokinetic protocols. However, its effects on more functional situations, such as plyometric exercises, and when is the best moment to apply this treatment (pre- or post-exercise) remain unclear. Therefore, the purpose of this study was to investigate the effect of low-level laser therapy (LLLT) before or after plyometric exercise on quadriceps muscle damage markers. A randomized, double-blinded, placebo-controlled trial was conducted with 24 healthy men, 12 at pre-exercise treatment group and 12 at post-exercise treatment group. Placebo and LLLT (810 nm, 200 mW per diode, 6 J per diode, 240 J per leg) were randomly applied on right/left knee extensor muscles of each volunteer before/after a plyometric exercise protocol. Muscular echo intensity (ultrasonography images), soreness (visual analogue scale - VAS), and strength impairment (maximal voluntary contraction - MVC) were assessed at baseline, 24, 48, and 72 h post-exercise. Legs treated with LLLT before or after exercise presented significantly smaller increments of echo intensity (values up to 1 %) compared to placebo treatments (increased up to ∼7 %). No significant treatment effect was found for VAS and MVC, although a trend toward better results on LLLT legs have been found for VAS (mean values up to 30 % lesser than placebo leg). In conclusion, LLLT applied before or after plyometric exercise reduces the muscle echo intensity response and possibly attenuates the muscle soreness. However, these positive results were not observed on strength impairment.

Chronic Eccentric Exercise and the Older Adult

Eccentric exercise has gained increasing attention as a suitable and promising intervention to delay or mitigate the known physical and physiological declines associated with aging. Determining the relative efficacy of eccentric exercise when compared with the more conventionally prescribed traditional resistance exercise will support evidence-based prescribing for the aging population. Thus, original research studies incorporating chronic eccentric exercise interventions in the older adult population were included in this review. The effects of a range of eccentric exercise modalities on muscular strength, functional capacity, body composition, muscle architecture, markers of muscle damage, the immune system, cardiovascular system, endocrine system, and rating of perceived exertion were all reviewed as outcomes of particular interest in the older adult. Muscular strength was found to increase most consistently compared with results from traditional resistance exercise. Functional capacity and body composition showed significant improvements with eccentric endurance protocols, especially in older, frail or sedentary cohorts. Muscle damage was avoided with the gradual progression of novel eccentric exercise, while muscle damage from intense acute bouts was significantly attenuated with repeated sessions. Eccentric exercise causes little cardiovascular stress; thus, it may not generate the overload required to elicit cardiovascular adaptations. An anabolic state may be achievable following eccentric exercise, while improvements to insulin sensitivity have not been found. Finally, rating of perceived exertion during eccentric exercise was often significantly lower than during traditional resistance exercise. Overall, evidence supports the prescription of eccentric exercise for the majority of outcomes of interest in the diverse cohorts of the older adult population.

Delayed onset muscle soreness: Involvement of neurotrophic factors

Delayed-onset muscle soreness (DOMS) is quite a common consequence of unaccustomed strenuous exercise, especially exercise containing eccentric contraction (lengthening contraction, LC). Its typical sign is mechanical hyperalgesia (tenderness and movement related pain). Its cause has been commonly believed to be micro-damage of the muscle and subsequent inflammation. Here we present a brief historical overview of the damage-inflammation theory followed by a discussion of our new findings. Different from previous observations, we have observed mechanical hyperalgesia in rats 1-3 days after LC without any apparent microscopic damage of the muscle or signs of inflammation. With our model we have found that two pathways are involved in inducing mechanical hyperalgesia after LC: activation of the B2 bradykinin receptor-nerve growth factor (NGF) pathway and activation of the COX-2-glial cell line-derived neurotrophic factor (GDNF) pathway. These neurotrophic factors were produced by muscle fibers and/or satellite cells. This means that muscle fiber damage is not essential, although it is sufficient, for induction of DOMS, instead, NGF and GDNF produced by muscle fibers/satellite cells play crucial roles in DOMS.

Low-intensity eccentric contractions of the knee extensors and flexors protect against muscle damage

This study investigated the magnitude and duration of the protective effect of low-intensity eccentric contractions (LowEC) against damage induced by maximal eccentric contractions (MaxEC) of the knee flexors (KF) and extensors (KE). Young men were assigned to 8 experimental groups and 2 control groups (n = 13/group); the experimental groups performed LowEC of KF or KE 2 days (2d), 1 week (1wk), 2 weeks (2wk), or 3 weeks (3wk) before MaxEC, while the control groups performed MaxEC of KF or KE without LowEC. The 2d, 1wk, 2wk, and 3wk groups performed 30 LowEC of KF or 60 LowEC of KE with a load of 10% of maximal voluntary isometric contraction strength on a resistance-training machine, and all groups performed 30 MaxEC of KF or 60 MaxEC of KE on an isokinetic dynamometer. Several muscle damage markers were measured from before to 2 days after exercise (LowEC) or from before to 5 days after exercise (MaxEC). No significant changes in any variables were evident after LowEC. The changes in all variables after MaxEC were smaller (P < 0.05) for the 2d and 1wk groups (e.g., peak creatine kinase activity: 1002 ± 501 IU/L; peak muscle soreness: 13 ± 5 mm) than for the control group (peak creatine kinase activity: 3005 ± 983 IU/L; peak muscle soreness 28 ± 6 mm) for both KE and KF. There were no significant differences between the 2d and 1wk groups or among the 2wk, 3wk, and control groups. These results show that LowEC provided 30%–66% protection against damage induced by MaxEC of KF and KE, and the protective effect lasted 1 week.

Effect of preconditioning by light load eccentric exercise versus heat on markers of muscle damage in collegiate males

BACKGROUND

Delayed onset muscle soreness (DOMS) occurs following unaccustomed or intense bouts of exercise. Previous research has demonstrated that that preconditioning with low load exercise or heat relieves muscle soreness. However, actively warming up the muscles with exercise may be an effective alternative.

OBJECTIVES

This study compared preconditioning effect of light load eccentric exercise and heat using microwave diathermy on markers of muscle damage in collegiate males.

PATIENTS AND METHODS

Thirty six sedentary collegiate males were randomly assigned into two experimental groups: 10% Eccentric exercise group (10% ECC group) and Microwave diathermy group (MWD group). Both the groups performed 30 repetitions of maximal eccentric exercise (Max-ECC) of the elbow flexors. The 10% ECC group performed light load eccentric exercise (10% ECC), five sets, six repetitions using a dumbbell set at 10% of maximal voluntary isometric contraction strength (MVC), 2 days prior to Max-ECC. The MWD group received heat using microwave diathermy (150 watts, 20 minutes) one day prior to Max-ECC. Changes in MVC, range of motion (ROM), upper arm circumference, soreness, were assessed before and 24-72 hours after whereas serum creatine kinase activity and lactate dehydrogenase (LDH) activity up to 48 hours following the Max-ECC were compared between groups by a mixed model ANOVA.

RESULTS

No significant difference (P > 0.05) were found between the groups for changes in all variables post Max-ECC, except for LDH activity showing significant interaction effect (P = 0.04).

CONCLUSIONS

Preconditioning with light load eccentric exercise and heat using microwave diathermy treatment did not differ in their effects on muscle damage markers after Max-ECC. However, with time their effects on LDH activity were found to be different.

Effect of a prior bout of preconditioning exercise on muscle damage from downhill walking

This study investigated whether reduced-duration downhill walking (DW) would confer a protective effect against muscle damage induced by a subsequent bout of longer duration DW performed 1 week or 4 weeks later. Healthy young adults were allocated to a control or one of the preconditioning exercise (PRE-1wk or PRE-4wk) groups (10 men and 4 women per group). PRE-1wk and PRE-4wk groups performed 20-min DW (-28% slope, 5 km/h, 10% body mass added to a backpack) 1 week and 4 weeks before 40-min DW, respectively, and the control group performed 40-min DW only. Maximal voluntary contraction (MVC) knee extension torque, plasma creatine kinase (CK) activity, and muscle soreness (100-mm visual analog scale) were measured before, immediately after, and 24, 48, and 72 h after DW, and the changes in these variables were compared among groups. The control group showed symptoms of muscle damage (e.g., prolonged decrease in MVC: -14% ± 10% at 48 h post-DW) after 40-min DW. Changes in all variables after 40-min DW of PRE-1wk and PRE-4wk groups were 54%-61% smaller (P < 0.05) than the control group, without significant differences between PRE-1wk and PRE-4wk groups for MVC and plasma CK activity. Importantly, changes after the preconditioning exercise (20-min DW) were 67%-69% smaller (P < 0.05) than those after the 40-min DW of the control group. These findings suggest that 20-min DW resulting in minor muscle damage conferred a protective effect against subsequent 40-min DW, and its effect could last for more than 4 weeks.

Muscle damage after low-intensity eccentric contractions with blood flow restriction

Discrepancies exist whether blood flow restriction (BFR) exacerbates exercise-induced muscle damage (EIMD). This study compared low-intensity eccentric contractions of the elbow flexors with and without BFR for changes in indirect markers of muscle damage. Nine untrained young men (18-26 y) performed low-intensity (30% 1RM) eccentric contractions (2-s) of the elbow flexors with one arm assigned to BFR and the other arm without BFR. EIMD markers of maximum voluntary isometric contraction (MVC) torque, range of motion (ROM), upper arm circumference, muscle thickness and muscle soreness were measured before, immediately after, 1, 2, 3, and 4 days after exercise. Electromyography (EMG) amplitude of the biceps brachii and brachioradialis were recorded during exercise. EMG amplitude was not significantly different between arms and did not significantly change from set 1 to set 4 for the biceps brachii but increased for the brachioradialis (p ≤ 0.05, 12.0% to 14.5%) when the conditions were combined. No significant differences in the changes in any variables were found between arms. MVC torque decreased 7% immediately post-exercise (p ≤ 0.05), but no significant changes in ROM, circumference, muscle thickness and muscle soreness were found. These results show that BFR does not affect EIMD by low-intensity eccentric contractions.

Muscle echo intensity: reliability and conditioning factors

OBJECTIVE

To assess the issue of muscle echo intensity reliability and to investigate the relationship between muscle echo intensity and size, shape and location of the region of interest (ROI) used for echo intensity quantification.

METHODS

Ultrasonographic scans of the following five muscles were acquired in twenty healthy subjects: biceps brachii, rectus femoris, vastus lateralis, tibialis anterior and medial gastrocnemius. Muscle echo intensity was quantified in each scan.

RESULTS

We found that the agreement between the different sized ROIs considered in each scan ranged from moderate (ICC: 0.54) to high (ICC: 0.86) and that the echo intensity consistency between equal sized ROIs of the three scans ranged from low (ICC: 0.42) to very high (0.91). The echo intensity of tibialis anterior and rectus femoris was different between different sized, shaped and located ROIs. The echo intensity of biceps brachii and tibialis anterior was higher than that of all other muscles, and females had higher echo intensity than males. Moreover, the muscle echo intensity was positively correlated with the subcutaneous layer thickness in three of five muscles.

CONCLUSION

The echo intensity reliability was function of the ROI size. Muscle and gender variability in echo intensity was likely due to differences in fibrous and adipose tissue content and distribution. Possible explanations for the observed correlations between muscle echo intensity and subcutaneous layer thickness include the dependence of both variables on total body adiposity or the direct dependence of the extent of intramuscular fat on the amount of subcutaneous fat.

Rate of force development as a measure of muscle damage

This study tested the hypothesis that rate of force development (RFD) would be a more sensitive indirect marker of muscle damage than maximum voluntary isometric contraction (MVC) peak torque. Ten men performed one concentric cycling and two eccentric cycling (ECC1, ECC2) bouts for 30 min at 60% of maximal concentric power output with 2 weeks between bouts. MVC peak torque, RFD, and vastus lateralis electromyogram amplitude and mean frequency were measured during a knee extensor MVC before, immediately after and 1-2 days after each bout. The magnitude of decrease in MVC peak torque after exercise was greater (P < 0.05) for ECC1 (11-25%) than concentric cycling (2-12%) and ECC2 (0-16%). Peak RFD and RFD from 0-30 ms, 0-50 ms, 0-100 ms, to 0-200 ms decreased (P < 0.05) immediately after all cycling bouts without significant differences between bouts, but RFD at 100-200 ms interval (RFD(100-200)) decreased (P < 0.05) at all time points after ECC1 (24-32%) and immediately after ECC2 (23%), but did not change after CONC. The magnitude of decrease in RFD(100-200) was 7-19% greater than that of MVC peak torque after ECC1 (P < 0.05). It is concluded that RFD(100-200) is a more specific and sensitive indirect marker of eccentric exercise-induced muscle damage than MVC peak torque.