Evaluation of elastic bands for lower extremity resistance training in adults with and without musculo-skeletal pain

The effect of different textured foot orthoses on ankle and knee joint muscles co-contraction in male and female older adults during walking

BACKGROUND

Foot orthoses have been considered to affect static and dynamic functional capacity and could help older adults maintain balance while walking. However, the impact of textured foot orthoses over co-contraction strategies remains uncertain. Therefore, this study aimed to assess the effect of different textured foot orthoses on ankle and knee joint muscle co-contraction in male and female older adults during walking.

RESEARCH QUESTION

How do different textured foot orthoses affect ankle and knee joint muscle co-contraction in older adults during walking?

METHODS

Twenty-eight older adults (14 males and 14 females) participated in this semi-experimental and laboratory study. They walked with customized textured foot orthoses. The muscle activity during walking at five conditions (rigid small textured orthoses, rigid large textured orthoses, soft small textured orthoses, soft large textured orthoses, and without orthoses) was registered, and the directed co-contraction (DCC) and general co-contraction (GCC) were calculated. In the "without orthoses" condition, the participants used shoes only (without insoles).

RESULTS

The results showed that rigid large textured orthoses reduced ankle DCC at the loading phase (p < 0.05). In contrast, rigid, small textured orthoses reduced ankle GCC at the loading phase (p < 0.05). The rigid small textured orthoses reduced knee flexion-extension DCC at loading and mid-stance phases, being greater in females at the push-off phase (p < 0.05), while the soft large textured orthoses reduced the knee mediolateral DCC (p < 0.05). The small textured orthoses produced lower knee GCC at the loading phase but greater in females (p < 0.05). Also, the main differences occurred at the loading and then mid-stance phases.

SIGNIFICANCE

Our results suggest that sex could affect the knee joint GCC when indicating textured orthosis, the indication also depends on which joint is the target. Meanwhile, the rigid small textured orthoses improved the knee GCC during the loading phase. Our results demonstrated that rigid large textured orthoses improved ankle DCC during the loading phase.

Elastic textile-based wearable modulation of musculoskeletal load: A comprehensive review of passive exosuits and resistance clothing

Elastic textiles play a critical role in passive wearable solutions for musculoskeletal load management in both passive exosuits and resistance clothing. These textiles, based on their ability to stretch and retract, can exhibit ambivalence in their load-modulating effects when used in occupational, rehabilitation, exercise, or everyday activity settings. While passive exosuits and resistance garments may appear similar in design, they have opposing goals: to reduce the musculoskeletal load in the case of exosuits and to increase it in the case of resistance clothing. Despite this intrinsic connection, these two approaches have not been extensively linked together. This review aims to fill this gap by examining the common and distinct principles of elastic textiles in passive exosuits and resistance clothing, shedding light on their interactions and the complex dynamics of musculoskeletal load systems. The effectiveness of different designs in passive exosuits that mimic musculoskeletal function and resistance clothing that increase the workload for strength training are critically reviewed. Current challenges in practical implementation and opportunities to improve critical issues, such as preload, thermal comfort, skin friction, and donning and doffing are also highlighted.

Effects of Step Length and Stride Variation During Forward Lunges on Lower-Extremity Muscle Activity

BACKGROUND

The forward lunge is a closed-chain weight-bearing multi-joint exercise simulating the activities of daily living, such as walking or stair climbing, which mainly activates hip, knee, and ankle musculature and is also used by athletes and other individuals to train lower-extremity musculature.

OBJECTIVES

The purpose of this study is to compare lower-extremity muscle recruitment patterns between stride and step length variations in forward lunges.

METHODS

Twenty participants had a mean (±SD) age, mass, and height of 26 ± 6 y, 79 ± 8 kg, and 176 ± 7 cm, respectively, for males, and 27 ± 4 y, 62 ± 6 kg, and 161 ± 7 cm, respectively, for females. All participants used their 12-repetition maximum weight while performing a short step and long step forward lunge with a stride (striding forward and pushing back to the starting position) and without a stride (lunging up and down with feet stationary). During each lunge variation, surface electromyography (EMG) data were collected from the quadriceps, hamstrings, gastrocnemius, hip adductors, gluteus maximus, and gluteus medius muscles, and then normalized as a percent of each muscle's maximum voluntary isometric contraction. A repeated measures two-way analysis of variance was employed (p < 0.01), with step length and stride comprising the two factors.

RESULTS

The following had no significant interactions: (1) quadriceps, hamstrings, gastrocnemius, hip adductor, and gluteus maximus EMG activities were significantly greater in lunges with a long step compared to lunges with a short step; and (2) gluteus maximus and gluteus medius EMG activities were significantly greater in lunges with a stride compared to lunges without a stride. The following had significant interactions: (1) gluteus medius EMG activities were significantly greater in lunges with a long step with and without a stride compared to lunges with a short step with and without a stride; (2) quadriceps EMG activities were generally significantly greater in lunges with long and short steps with a stride compared to lunges with long and short steps without a stride, in lunges with a long step with a stride compared to lunges with a short step with a stride, and in lunges with a short step without a stride compared to lunges with a long step without a stride; (3) hamstring and hip adductor EMG activities were significantly greater in lunges with a long step with a stride compared to lunges with a long step without a stride, and in lunges with a long step with and without a stride compared to lunges with a short step with and without a stride; and (4) gastrocnemius EMG activities were significantly greater in lunges with a long step with and without a stride compared to lunges with a short step with and without a stride.

CONCLUSIONS

Lower-extremity muscle activity is generally greater in forward lunges with a long step compared to a short step, and greater in lunges with a stride compared to without a stride. During the externally loaded forward lunge, high to very high muscle activity occurs in the quadriceps, gluteus maximus, and gluteus medius, thus enhancing muscle hypertrophy and strength in these muscles, while moderate muscle activity occurs in the hamstrings, gastrocnemius, and adductor longus.

Effect of thoracolumbosacral braces on running ground reaction force components in male individuals with kyphosis

BACKGROUND & AIMS

Braces are one of the methods for kyphosis treatment, but they can relocate the center of gravity of the trunk, affecting the ground reaction force (GRF) during running. Therefore, this study aimed to investigate the effects of two types of thoracolumbosacral braces on running GRF components in individuals with kyphosis.

MATERIALS & METHODS

Participants were 15 males diagnosed with kyphosis who volunteered in this quasi-experimental study. Each subject performed the barefoot running trials on the force plate with one simple brace, with a sensor brace, and without the brace condition. The ground reaction forces components were calculated in the stance phase. Statistical analysis was done with repeated measures test with a significant level of 0.05.

RESULTS

Peak medial ground reaction force when running with a sensor brace was lower than running with a simple brace (p = 0.017). Free moments were similar during three running conditions (p > 0.05).

CONCLUSION

Lower maximum medial ground reaction force while using a sensor brace may possibly demonstrate the beneficial effects of a sensor brace in individuals with kyphosis.

The interaction effect of different footwear types and static navicular drop or dynamic ankle pronation on the joint stiffness of the lower limb during running

BACKGROUND

Although the effects of footwear type on joint stiffness have previously been investigated, researchers did not consider foot flexibility. Thus, the present investigation aimed to determine the interaction effects of footwear type, static navicular drop and dynamic ankle pronation on dynamic joint stiffness in running.

RESEARCH QUESTION

Does the footwear types in interaction with the foot posture affect the stiffness of the joints of the lower limb?

METHODS

Forty-seven male individuals participated in this study. Firstly, they were divided into the high navicular, low navicular, and normal navicular drop. Secondly, they were divided into the high dynamic ankle pronation, low dynamic ankle pronation, and normal dynamic ankle pronation groups. Participants performed three running trials at 3 ± 0.2 m/s at minimalist footwear, conventional footwear, and barefoot conditions. We collected the ground reaction forces and three-dimensional kinematic data and calculated joint stiffness over the stance phase.

RESULTS

There was no significant main effect of navicular drop or dynamic ankle pronation on dynamic joint stiffness for the ankle, knee, and hip (p > 0.05). However, footwear type significantly affected dynamic joint stiffness. The pairwise comparison revealed that the ankle and hip dynamic joint stiffness magnitudes in the conventional footwear condition were greater than in the barefoot and minimalist footwear conditions (p 0.001). In contrast, the knee dynamic joint stiffness magnitude in the conventional footwear condition was lesser than in barefoot and minimalist footwear conditions (p 0.001).

SIGNIFICANCE

The navicular drop or dynamic ankle pronation did not influence lower limb joint stiffness, and there was no significant interaction between navicular drop or dynamic ankle pronation and footwear on lower limb dynamic joint stiffness. However, conventional footwear increased the ankle and hip dynamic joint stiffness while reducing knee dynamic joint stiffness, leading to changes in transfer energy, which could have implications for relative injury risk.

Effect of six weeks of resistance training on bone preservation in older adults: a randomized control trial

BACKGROUND

It has been established that chronic resistance exercise contributes to positive changes to bone in older adults.

AIMS

This study evaluated the effect of 6 weeks of resistance exercise with either elastic bands or dumbbells vs. a control period on bone morphology of older adults.

METHODS

Fifty-seven adults (mean ± SD; age = 66.5 ± 7.09 yrs; height = 165.2 ± 10.6 cm; body mass = 74.5 ± 14.6 kg) were randomized into three groups (dumbbell, elastic, or control). Participants underwent a total body dual-energy X-ray absorptiometry (DXA) scan for total body and segmental bone mineral content (BMC) and bone mineral density (BMD) before and following 6-week intervention. Age-matched Z-scores for BMD and BMC were recorded. Data were analyzed using two-way repeated measures ANOVAs and 0.05 significance level.

RESULTS

BMCarm improved for the dumbbell group (p = 0.016) after the training, with no change in BMD for any group (p > 0.05). Additionally, significant (time x treatment group) interaction (p = 0.024) of age-matched Z-scores indicated an improvement in only the dumbbell group after 6 weeks (p = 0.015), with no change in the elastic group despite them having greater Z-scores than the control group.

DISCUSSION

This study is the first to demonstrate acute normative adaptations as dumbbell-based programs may promote positive maintenance of bone metrics over 6 weeks, despite the lack of significant change in absolute BMC or BMD.

CONCLUSION

Adults did not lose relative bone mass with acute exercise using dumbbells as the external load applied and this may lead to positive changes following chronic training. There was no bone-related impact from elastic bands, suggesting a weighted load or force produced relative to gravity is beneficial.

Rehabilitation Strategies for the Neurologic Horse

Rehabilitation of the neurologic horse represents a unique challenge for the equine practitioner. Improving postural stability and balance control through improving the strength of the spinal stabilizer muscle multifidus remains one of the most promising rehabilitative targets. This muscle can be targeted through the use of physiotherapeutic exercises, various forms of perturbation, and even whole-body vibration. Neuroanatomic localization and diagnosis specificity enable the practitioner to determine suitability for such rehabilitative tasks, and with the advent of evolving strategies and commercially available equipment, the bandwidth for professionally guided programs is continuously being developed and is expected to improve traditional outcomes.

Long-term training on sand changes lower limb muscle activities during running in runners with over-pronated feet

BACKGROUND

Running on sand could be a promising exercise intervention for the treatment of over-pronated feet. However, there is a lack of knowledge about the effects of running on sand on muscle activities. Therefore, this study aims to evaluate the long-term effects of running on sand on the activities of selected lower limb muscles in individuals with OPF compared with healthy controls.

METHODS

Sixty recreational adult male runners with over-pronated feet (foot posture index > 10) were divided into two equal groups (intervention and control). Participants ran barefoot at a pre-defined speed (⁓3.3 m/s) over level stable ground both before and after long-term training on the sand. Muscle activities were recorded using a surface bipolar electromyography system.

RESULTS

For the intervention group, we found a reduced foot posture index (p < 0.001; d = 2.00) and significant group-by-time interactions for gluteus medius activity during the mid-stance phase (p < 0.028; d = 0.59). Significantly higher gluteus medius activity (p = 0.028, d = 0.569) was found during the post-test. We also observed significant group-by-time interactions for medial gastrocnemius activity during the push-off phase (p < 0.041; d = 0.54). Significantly larger medial gastrocnemius activity (p = 0.041; d = 0.636) was found during the post-test compared to the pre-test.

CONCLUSIONS

Long-term running on sand resulted in reduced pronation, increased medial gastrocnemius activity, and improved frontal plane pelvic stability due to higher gluteus medius activity.

TRIAL REGISTRATION

IRCT20191211045704N1. Registered 25 February 2020. Retrospectively registered.

Quantifying Muscle Forces and Joint Loading During Hip Exercises Performed With and Without an Elastic Resistance Band

An increase in hip joint contact forces (HJCFs) is one of the main contributing mechanical causes of hip joint pathologies, such as hip osteoarthritis, and its progression. The strengthening of the surrounding muscles of the joint is a way to increase joint stability, which results in the reduction of HJCF. Most of the exercise recommendations are based on expert opinions instead of evidence-based facts. This study aimed to quantify muscle forces and joint loading during rehabilitative exercises using an elastic resistance band (ERB). Hip exercise movements of 16 healthy volunteers were recorded using a three-dimensional motion capture system and two force plates. All exercises were performed without and with an ERB and two execution velocities. Hip joint kinematics, kinetics, muscle forces, and HJCF were calculated based on the musculoskeletal simulations in OpenSim. Time-normalized waveforms of the different exercise modalities were compared with each other and with reference values found during walking. The results showed that training with an ERB increases both target muscle forces and HJCF. Furthermore, the ERB reduced the hip joint range of motion during the exercises. The type of ERB used (soft vs. stiff ERB) and the execution velocity of the exercise had a minor impact on the peak muscle forces and HJCF. The velocity of exercise execution, however, had an influence on the total required muscle force. Performing hip exercises without an ERB resulted in similar or lower peak HJCF and lower muscle forces than those found during walking. Adding an ERB during hip exercises increased the peak muscle and HJCF but the values remained below those found during walking. Our workflow and findings can be used in conjunction with future studies to support exercise design.

No Time to Lift? Designing Time-Efficient Training Programs for Strength and Hypertrophy: A Narrative Review

Abstract

Lack of time is among the more commonly reported barriers for abstention from exercise programs. The aim of this review was to determine how strength training can be most effectively carried out in a time-efficient manner by critically evaluating research on acute training variables, advanced training techniques, and the need for warm-up and stretching. When programming strength training for optimum time-efficiency we recommend prioritizing bilateral, multi-joint exercises that include full dynamic movements (i.e. both eccentric and concentric muscle actions), and to perform a minimum of one leg pressing exercise (e.g. squats), one upper-body pulling exercise (e.g. pull-up) and one upper-body pushing exercise (e.g. bench press). Exercises can be performed with machines and/or free weights based on training goals, availability, and personal preferences. Weekly training volume is more important than training frequency and we recommend performing a minimum of 4 weekly sets per muscle group using a 6–15 RM loading range (15–40 repetitions can be used if training is performed to volitional failure). Advanced training techniques, such as supersets, drop sets and rest-pause training roughly halves training time compared to traditional training, while maintaining training volume. However, these methods are probably better at inducing hypertrophy than muscular strength, and more research is needed on longitudinal training effects. Finally, we advise restricting the warm-up to exercise-specific warm-ups, and only prioritize stretching if the goal of training is to increase flexibility. This review shows how acute training variables can be manipulated, and how specific training techniques can be used to optimize the training response: time ratio in regard to improvements in strength and hypertrophy.

Graphic Abstract

Concentric and Eccentric Force Changes with Elastic Band and Isotonic Heavy Resistance Training: A Randomized Controlled Trial

BACKGROUND

Inclusion of resistance training as part of a general fitness program to improve health, and lower risk of disease and injury is well established. Two common options to improve strength are elastic bands and weights. Comparison between elastic bands (as the sole resistance) to isotonic strengthening for concentric and eccentric strength outcomes following the use of low repetitions/heavy resistance has not been reported.

HYPOTHESIS/PURPOSE

The purpose was to examine the effects of a four-week isotonic low repetitions/heavy resistance strengthening program compared to a low repetitions/heavy resistance elastic band strengthening program on shoulder external rotation, hip abduction, and elbow flexion concentric and eccentric isokinetic force production in college aged untrained females.

STUDY DESIGN

Randomized Trial.

METHODS

Twenty healthy females performed pre-and-post isokinetic (60 degrees/second) concentric/eccentric testing of the elbow flexors, shoulder external rotators, and hip abductors. Participants were randomly assigned to a four-week independent low repetitions/heavy resistance strengthening program performed with either elastic bands or isotonic exercises.

RESULTS

A significant (p < 0.05) effect of time was found for eccentric elbow flexor and concentric and eccentric hip abduction force production in the elastic band group with post-test values greater than pre-test values. A significant (p < 0.05) effect of time was found for elbow flexor concentric and eccentric force production in the isotonic group with post-test values greater then pre-test values. No significant (p>0.05) effect of time was found for shoulder external rotator concentric and eccentric forces for both groups, the isotonic group's hip abduction concentric and eccentric force production and elastic band group's elbow flexion concentric force production. No significant effect of intervention (p >0.05) on concentric or eccentric elbow flexors, shoulder external rotators, or hip abductors force production was found, with pre-test and post-test values being similar between groups.

CONCLUSION

Health care practitioners and coaches can consider the prescription of a heavy resistance training program with elastic bands or isotonic exercises for an independent exercise program and expect similar concentric and eccentric muscle force changes.

LEVEL OF EVIDENCE

Level 2b.

Effects of TheraBand and Theratube Eccentric Exercises on Quadriceps Muscle Strength and Muscle Mass in Young Adults

Purpose

This study was aimed at comparing the effects of TheraBand and theratube eccentric exercises on quadriceps muscle strength in young adults.

Methods

Thirty young adults (19 females, 11 males) participated in this pretest-posttest experimental study. Participants were randomly assigned to one of the two groups: TheraBand and theratube groups. They received the training intervention 3 times a week for 4 weeks (12 sessions) with progression after 2 weeks. Maximum eccentric quadriceps strength was assessed using the Biodex isokinetic dynamometer system. Additionally, quadriceps muscle mass was measured using a tape.

Results

Both groups showed a significant improvement in the peak torque of the eccentric isokinetic quadriceps' strength after weeks 2 and 4. Strength change in the quadriceps was nonsignificant in the theratube group compared to the TheraBand group after 4 weeks of training (p < 0.05). There was no increase in muscle mass during the 4 weeks of training in any group (p > 0.05).

Conclusion

Both the TheraBand and theratube are equally effective in the strengthening of the quadriceps muscle in young adults. Therefore, either the TheraBand or theratube may be used according to the availability and feasibility of the subjects for training intervention.

Effects of Chair-Based, Low-Load Elastic Band Resistance Training on Functional Fitness and Metabolic Biomarkers in Older Women

Strength training can improve myriad health parameters in elderly cohorts. Although potentially more appropriate for the elderly, low-load resistance training protocols have been less investigated. We aimed to examine the effects of 12 weeks of chair-based, low-load resistance training with elastic band (EBT) on functional fitness and metabolic biomarkers in older women. One hundred sixty-eight women were allocated randomly to an elastic band resistance training (EBT, n = 86, 75.7 ± 8.9 years, 71.3 ± 12.2 kg) or a control group (CON, n = 82, 74.5 ± 8.2years, 70.6 ± 12.0 kg). RT protocol consisted of periodized chair-based, low-load whole-body resistance exercises (2 sets, 12-15 repetitions, 40-60% of one repetition maximum-1RM) using an elastic band, twice weekly for 12 weeks. The resistance training program was generally designed to maintain internal load over time, provided with increasing intensity using various elastic bands (Thera-Band). Functional fitness (30-s Chair Stand,30-s Arm Curl, 2-min Step Test, Chair Sit-and-Reach, Back Scratch, 8-Foot Up-and-Go, Handgrip Strength) and metabolic markers (Fasting blood glucose, triglycerides, total cholesterol, high (HDL) and low (LDL) density lipoprotein) were measured before and after the training period. To detect pre/post intervention changes and between group- differences 2x2 repeated measures ANOVA was applied. Significant improvements over time for all fitness variables for EBT comparing to CON were obtained (F = 12.78, p < 0.05 for 30-s Chair Stand; F = 14.04, p < 0.05 for 30-s Arm Curl; F = 5.18, p < 0.05 for 2-min Step Test; F = 10.90, p < 0.05 for Chair Sit-and-Reach; F = 16.57, p < 0.05 for Back Scratch; F = 11.79, p < 0.05 for 8-foot Up-and-Go; and F = 29.25, p < 0.05 for Handgrip Strength). In addition, significant improvements over time for all but one (triglycerides) biomarkers for EBT comparing to CON were obtained (F = 7.30, p < 0.05 for blood sugar levels; F = 13.36, p < 0.05 for total cholesterol; F = 8.61, p < 0.05 for HDL; and F = 11.53, p < 0.05 for LDL). Furthermore, the participants' adherence to training sessions of over 90% was reported. In conclusion, 12 weeks of EBT is safe and beneficial for improving health-related fitness and metabolic biomarkers in older women and seems to be viable model to ensure a high training adherence rate.

Short-term resistance training in older adults improves muscle quality: A randomized control trial

The purpose of this study was to evaluate whether dumbbell resistance training (DBRT) and elastic band resistance training (EBRT) are equally beneficial in the older adult. Sixty-five healthy participants (mean±SD; age=66.5±7.09 years; height=165.2±10.6 cm; body mass=74.5±14.6 kg) volunteered for this study. Participants underwent a total body dual-energy x-ray absorptiometry (DXA) scan for segmental and total body muscle and fat estimation. Functional tests included the short physical performance battery, timed up-and-go, and heel-to-toe walk. Strength was measured on dominant handgrip strength, maximal bench press, and leg press. Participants were block randomized into one of three groups: elastic band resistance training (EBRT), dumbbell resistance training (DBRT), or control (CON). EBRT and DBRT were asked to visit the laboratory twice weekly over 6-weeks while CON maintained their daily routine. Data were analyzed using a two-way repeated measures ANOVA and an alpha set at 0.05. Results indicated there was a two-way interaction for bench press, leg press, upper- and lower-body muscle quality and total arm lean mass (p<0.05). Specifically, the EBRT and DBRT improved from pre to post for total arm lean mass (p<0.021, p<0.004, respectively). Additionally, for bench press and leg press, all groups improved pre to post training (p<0.05) with DBRT superior to CON. These data suggest that EBRT provides an effective, portable, and cost-effective means to enhance lower-body function and muscle quality in an aging population, yet DBRT may be more impactful for total-body improvements.

Effects of a Sport-Specific Upper-Body Resistance-Band Training Program on Overhead Throwing Velocity and Glenohumeral Joint Range of Motion

Oranchuk, DJ, Ecsedy, EN, and Robinson, TL. Effects of a sport-specific upper-body resistance-band training program on overhead throwing velocity and glenohumeral joint range of motion. J Strength Cond Res XX(X): 000-000, 2020-Practitioners seek optimal, yet practical means to enhance performance while aiming to minimize injury risk. Resistance bands offer portability and safety and enable similar movements to competition. However, the effect of movement-specific resistance-band training on throwing performance and markers of injury risk has yet to be elucidated. Therefore, the purpose of this study was to compare the effects of a resistance training program using resistance bands with sport-specific (SS), or general-training (GT) exercises. Twenty-eight collegiate female softball players were randomly allocated to an SS (n = 15) or GT (n = 13) 8-week resistance-band program. Dependent variables included peak and mean throwing velocity, 1 repetition maximum (1RM) cable Chop-test, and glenohumeral internal and external rotation range of motion (ROM). No significant (p ≤ 0.338) differences were found between groups at baseline. Improvements in peak (p = 0.006, 4.9%, effect size [ES] = 0.61) and mean (p = 0.004, 3.1%, ES = 0.49) throwing velocity were seen after SS training, while the 1RM Chop-test increased in both SS (p < 0.001, 23.5%, ES = 1.06) and GT (p = 0.049, 26.1%, ES = 0.57) groups. However, no between-group differences (p ≥ 0.109, ES ≤ 0.17) were present in any variable. Neither the Chop-test nor shoulder internal or external ROM had more than moderate correlations with throwing velocity (r ≤ 0.30, p ≥ 0.119). Therefore, practitioners should not depend solely on SS resistance-band training when aiming to improve throwing velocity or measures of shoulder rotational health. However, resistance bands appear to be a practical alternative when traditional means of resistance training are not available. In addition, strength and conditioning coaches should not use the Chop-test or shoulder ROM to predict throwing performance.

Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia

BACKGROUND

Ankles and knees are commonly affected in people with hemophilia and thus are targets for prevention or rehabilitation. However, to our knowledge, no studies have evaluated muscle activity and safety during exercises targeting the lower limbs in people with hemophilia; this lack of information hinders clinical decision-making.

OBJECTIVE

The aim of this study was to compare the tolerability of, safety of, and muscle activity levels obtained with external resistance (elastic or machine)-based and non-external resistance-based lower limb exercises in people with hemophilia.

DESIGN

This was a cross-sectional study.

METHODS

Eleven people who had severe hemophilia and were undergoing prophylactic treatment participated. In a single experimental session, participants performed knee extension and ankle plantar flexion during 3 exercise conditions in random order: elastic band-based resistance (elastic resistance), machine-based resistance (machine resistance), and no external resistance. Exercise intensities for the 2 external resistance-based conditions were matched for perceived exertion. Muscle activity was determined using surface electromyography (EMG) for the rectus femoris, biceps femoris, gastrocnemius lateralis, and tibialis anterior muscles. Participants were asked to rate exercise tolerability according to a scale ranging from "very well tolerated" to "not tolerated" and to report possible adverse effects 24 and 48 hours after the session.

RESULTS

No adverse effects were reported, and exercise tolerability was generally high. In the knee extension exercise, the rectus femoris normalized EMG values during the elastic resistance and machine resistance conditions were similar; 29% to 30% higher activity was obtained during these conditions than during the non-external resistance condition. In the ankle plantar flexion exercise, the gastrocnemius lateralis normalized EMG value was 34% higher during the machine resistance condition than without external resistance, and the normalized EMG values during the elastic resistance and other conditions were similar.

LIMITATIONS

The small sample size and single training session were the primary limitations of this study.

CONCLUSIONS

Exercises performed both with elastic bands and with machines at moderate intensity are safe, feasible, and efficient in people with severe hemophilia, providing comparable activity levels in the agonist muscles.

Effects of Corrective Training on Drop Landing Ground Reaction Force Characteristics and Lower Limb Kinematics in Older Adults With Genu Valgus: A Randomized Controlled Trial

The aim of this study was to identify the effects of a corrective exercise program on landing ground reaction force characteristics and lower limb kinematics in older adults with genu valgus. A total of 26 older male adults with genu valgus were randomized into two groups. An experimental group conducted a 14-week corrective exercise program, whereas a control group did not perform any exercise. The experimental group displayed lower peak vertical, peak anterior and posterior, and peak medial ground reaction force components during the posttest compared with the pretest. The vertical loading rate, impulses, and free moment amplitudes were not statistically different between groups. In the experimental group, the peak knee abduction during the posttest was significantly smaller and the peak hip flexion angle was significantly greater than during the pretest. The authors suggest that this corrective exercise program may be a suitable intervention to improve landing ground reaction forces and lower limb kinematics in older male adults with genu valgus.

Muscle Activity in Upper-Body Single-Joint Resistance Exercises with Elastic Resistance Bands vs. Free Weights

Elastic resistance bands require little space, are light and portable, but their efficacy has not yet been established for several resistance exercises. The main objective of this study was to compare the muscle activation levels induced by elastic resistance bands versus conventional resistance training equipment (dumbbells) in the upper-body resistance exercises flyes and reverse flyes. The level of muscle activation was measured with surface electromyography in 29 men and women in a cross-over design where resistance loadings with elastic resistance bands and dumbbells were matched using 10-repetition maximum loadings. Elastic resistance bands induced slightly lower muscle activity in the muscles most people aim to activate during flyes and reverse flies, namely pectoralis major and deltoideus posterior, respectively. However, elastic resistance bands increased the muscle activation level substantially in perceived ancillary muscles, that is deltoideus anterior in flyes, and deltoideus medius and trapezius descendens in reverse flyes, possibly due to elastic bands being a more unstable resistance modality. Overall, the results show that elastic resistance bands can be considered a feasible alternative to dumbbells in flyes and reverse flyes.

Exercise intervention for unilateral amputees with low back pain: study protocol for a randomised, controlled trial

Background

Atraumatic lower limb amputation is a life-changing event for approximately 185,000 persons in the United States each year. A unilateral amputation is associated with rapid changes to the musculoskeletal system including leg and back muscle atrophy, strength loss, gait asymmetries, differential mechanical joint loading and leg length discrepancies. Even with high-quality medical care and prostheses, amputees still develop secondary musculoskeletal conditions such as chronic low back pain (LBP). Resistance training interventions that focus on core stabilization, lumbar strength and dynamic stability during loading have strong potential to reduce LBP and address amputation-related changes to the musculoskeletal system. Home-based resistance exercise programs may be attractive to patients to minimize travel and financial burdens.

Methods/design

This study will be a single-assessor-blinded, pre-post-test randomised controlled trial involving 40 men and women aged 18–60 years with traumatic, unilateral transtibial amputation. Participants will be randomised to a home-based, resistance exercise group (HBRX) or a wait-list control group (CON). The HBRX will consist of 12 weeks of elastic resistance band and bodyweight training to improve core and lumbopelvic strength. Participants will be monitored via Skype or Facetime on a weekly basis. The primary outcome will be pain severity (11-point Numerical Pain Rating Scale; NRS_pain). Secondary outcomes will include pain impact on quality of life (Medical Outcomes Short Form 36, Oswestry Disability Index and Roland Morris Disability Questionnaire), kinematics and kinetics of walking gait on an instrumented treadmill, muscle morphology (muscle thickness of multifidus, transversus abdominis, internal oblique), maximal muscle strength of key lumbar and core muscles, and daily step count.

Discussion

The study findings will determine whether a HBRX program can decrease pain severity and positively impact several physiological and mechanical factors that contribute to back pain in unilateral transtibial amputees with chronic LBP. We will determine the relative contribution of the exercise-induced changes in these factors on pain responsiveness in this population.

Trial registration

ClinicalTrials.gov, ID: NCT03300375. Registered on 2 October 2017.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-017-2362-0) contains supplementary material, which is available to authorized users.

Multiple-joint exercises using elastic resistance bands vs. conventional resistance-training equipment: A cross-over study

Previous studies indicate that elastic resistance bands (ERB) can be a viable option to conventional resistance-training equipment (CRE) during single-joint resistance exercises, but their efficacy has not been established for several commonly used multiple-joint resistance exercises. Thus, we compared muscular activation levels in four popular multiple-joint exercises performed with ERB (TheraBand^®) vs. CRE (Olympic barbell or cable pulley machines). In a cross-over design, men and women (n = 29) performed squats, stiff-legged deadlifts, unilateral rows and lateral pulldown using both modalities. Multilevel mixed-effects linear regression analyses of main and interaction effects, and subsequent post hoc analyses were used to assess differences between the two resistance-training modalities. CRE induced higher levels of muscle activation in the prime movers during all exercises (p < .001 for all comparisons), compared to muscle activation levels induced by ERB. The magnitude of the differences was marginal in lateral pulldown and unilateral rows and for the erector spinae during stiff-legged deadlifts. In squats the quadriceps femoris activations were substantially lower for ERB. The differences between ERB and CRE were mostly observed during the parts of the contractions where the bands were relatively slack, whilst the differences were largely eliminated when the bands became elongated in the end ranges of the movements. We conclude that ERB can be a feasible training modality for lateral pulldowns, unilateral rows and to some extent stiff-legged deadlifts, but not for the squat exercise.

Muscle activation comparisons between elastic and isoinertial resistance: A meta-analysis

BACKGROUND

Elastic resistance has been commonly used in the therapeutic and fitness setting; however, the ability of elastic resistance to overload and activate muscles has been questioned because of linear increase in elastic resistance as the device is elongated. The purpose of this meta-analysis was to examine the available literature on muscle activation associated with isoinertial and elastic resistance exercises, and to provide a quantitative summary comparing the two resistance training modes.

METHODS

In a random-effects model, the Hedge's g effect size was used to calculate the biased corrected standardized mean difference between the elastic and isoinertial resistance activation of prime movers (agonist), antagonists, assistant movers and stabilizer muscles.

FINDINGS

There was a lack of significant difference with the prime movers (effect size=-0.037, confidence interval: -0.202 to 0.128, p=0.660), antagonists (effect size=0.089, confidence interval: -0.112 to 0.290, p=0.385), synergists (effect size=-0.133, confidence interval: -0.342 to 0.076, p=0.213) and stabilizer (effect size=0.142, confidence interval: -0.006 to 0.289, p=0.060) muscle electromyography activity recorded during similar exercises using elastic and isoinertial resistance.

INTERPRETATION

Elastic resistance provides similar prime mover, antagonist, assistant movers and stabilizer muscle activation as isoinertial resistance; contradicting the traditional criticism that the elastic band would not elicit comparable levels of muscle activation as isoinertial resistance exercise. Since development of muscle strength is closely related to the duration of muscle tension, relatively equal muscle adaptations could be expected following the two modes of training provided that equal external resistance is employed between the two exercises.

LEVEL OF EVIDENCE

2a.

Associations between biopsychosocial factors and chronic upper limb pain among slaughterhouse workers: cross sectional study

Background

Knowledge of factors associated with chronic pain is necessary for preventive strategies. The present study investigates biopsychosocial differences, with specific focus on rate of force development (RFD) and work ability, between workers with and without chronic upper limb pain.

Methods

Eighty-two male slaughterhouse workers, 49 with chronic upper limb pain and 33 pain-free controls participated in the study. Maximal muscle strength, RFD, and muscle activity was determined from fast and forceful maximal voluntary contractions for the shoulder and hand. Participants filled out a questionnaire on work ability (work ability index), work disability (Work module of DASH questionnaire), fear avoidance, and self-rated health. Additionally, pressure pain threshold (PPT) was measured in muscles of the arm, shoulder and lower leg.

Results

Muscle strength and RFD (determined within time intervals of 30, 50, 100, and 200 ms relative to onset of contraction) was 28 % and 58–78 % lower, respectively, in workers with chronic pain compared with pain-free controls, and paralleled by reduced muscle activity (all p < 0.001). Workers with chronic pain had lower PPT of the arm, shoulder and lower leg (p < 0.01), and reported impaired work ability index score and general health along with higher work disability and fear avoidance compared with controls (all p < 0.0001). No differences were observed between the groups in regard to age, BMI, physical activity level, job position and duration of slaughterhouse work (all p > 0.4).

Conclusions

Chronic upper limb pain was paralleled by reduced neuromuscular function of the shoulder and hand along with impaired work ability, work disability and general health. Future studies on chronic pain management at the workplace should carefully consider the biopsychosocial nature of pain when designing and implementing preventive strategies.

Electromyographic Comparison of Elastic Resistance and Machine Exercises for High-Intensity Strength Training in Patients With Chronic Stroke

OBJECTIVE

To investigate whether elastic resistance training can induce comparable levels of muscle activity as conventional machine training in patients with chronic stroke.

DESIGN

Comparative study.

SETTING

Outpatient rehabilitation facility.

PARTICIPANTS

Stroke patients (N=18) with hemiparesis (mean age, 57 ± 8y).

INTERVENTIONS

Patients performed 3 consecutive repetitions at 10 repetition maximum of unilateral knee extension and flexion using elastic resistance and conventional machine training.

MAIN OUTCOME MEASURES

Surface electromyography was measured in vastus lateralis, vastus medialis, biceps femoris, and semitendinosus and was normalized to maximal electromyography (% of max) of the nonparetic leg.

RESULTS

In the paretic leg, agonist muscle activity ranged from 18% to 24% normalized electromyography (% of max) (nEMG) during knee flexion and from 32% to 40% nEMG during knee extension. For knee extension, vastus lateralis nEMG was higher during machine exercise than during elastic resistance exercise (40% [95% confidence interval {CI}, 33-47] vs 32% [95% CI, 25-39]; P=.003). In the nonparetic leg, agonist muscle activity ranged from 54% to 61% during knee flexion and from 52% to 68% during knee extension. For knee flexion semitendinosus nEMG was higher (61% [95% CI, 50-71] vs 54% [95% CI, 44-64]; P=.016) and for knee extension vastus medialis nEMG was higher (68% [95% CI, 60-76] vs 56% [95% CI, 48-64]; P<.001) during machine exercise than during elastic resistance exercise. By contrast, antagonist coactivation was significantly higher during knee flexion when performed using elastic resistance compared with the machine. Lastly, there were no differences in perceived exertion between exercise modalities.

CONCLUSIONS

Machine training appears to induce slightly higher levels of muscle activity in some of the investigated muscles compared to elastic resistance during lower limb strength training in patients with chronic stroke. The higher level of coactivation during knee flexion when performed using elastic resistance suggests that elastic resistance exercises are more difficult to perform. This is likely due to a higher level of movement instability.

Core Muscle Activity, Exercise Preference, and Perceived Exertion during Core Exercise with Elastic Resistance versus Machine

Objectives. To investigate core muscle activity, exercise preferences, and perceived exertion during two selected core exercises performed with elastic resistance versus a conventional training machine. Methods. 17 untrained men aged 26-67 years participated in surface electromyography (EMG) measurements of five core muscles during torso-twists performed from left to right with elastic resistance and in the machine, respectively. The order of the exercises was randomized and each exercise consisted of 3 repetitions performed at a 10 RM load. EMG amplitude was normalized (nEMG) to maximum voluntary isometric contraction (MVC). Results. A higher right erector spinae activity in the elastic exercise compared with the machine exercise (50% [95% CI 36-64] versus 32% [95% CI 18-46] nEMG) was found. By contrast, the machine exercise, compared with the elastic exercise, showed higher left external oblique activity (77% [95% CI 64-90] versus 54% [95% CI 40-67] nEMG). For the rectus abdominis, right external oblique, and left erector spinae muscles there were no significant differences. Furthermore, 76% preferred the torso-twist with elastic resistance over the machine exercise. Perceived exertion (Borg CR10) was not significantly different between machine (5.8 [95% CI 4.88-6.72]) and elastic exercise (5.7 [95% CI 4.81-6.59]). Conclusion. Torso-twists using elastic resistance showed higher activity of the erector spinae, whereas torso-twist in the machine resulted in higher activity of the external oblique. For the remaining core muscles the two training modalities induced similar muscular activation. In spite of similar perceived exertion the majority of the participants preferred the exercise using elastic resistance.