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Cvečka J, Vajda M, Novotná A, Löfler S, Hamar D, Krčmár M. Benefits of Eccentric Training with Emphasis on Demands of Daily Living Activities and Feasibility in Older Adults: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3172. [PMID: 36833867 PMCID: PMC9958977 DOI: 10.3390/ijerph20043172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/26/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Aging is associated with a decline in physical capabilities and several other health-related conditions. One of the most common age-related processes is sarcopenia. Sarcopenia is usually accompanied with a decline in skeletal muscle mass and physical functioning. A decrease in these markers usually impacts basic daily living activities (DLAs), which become somewhat harder to accomplish for older individuals. Several research studies have examined the demands of DLA in older individuals with results indicating that activities such as walking, sitting, standing, stair climbing, stair descending, and running generate high demands on older adults. The forces that act on individuals are in most cases equal or multiple times higher relative to their body mass. For instance, it was reported that the GRF (ground reaction force) during stair descent ranged from 1.43 to 1.50 of BW (body weight) in an older population. Even higher demands were recorded during other related activities. These demands of DLA raise the question of appropriate rehabilitative or training management procedures. During the past decades, an eccentric form of resistance training gained popularity due to its effectiveness and lower metabolic demands, which seems to be an appropriate method to develop and maintain a basic level of strength capabilities in higher age. Multiple factors of eccentric training have been examined including modality of exercise, intensity, frequency, and safety of the elderly. Several modalities of eccentric exercise have been shown to be effective including traditional methods, as well as machine-based ones, with or without using some equipment. The studies included in this review varied in intensity from low to high; however, the most frequently used intensity was ≥50% of the maximal eccentric strength during two or three eccentric sessions per week. Importantly, the prevalence of injury of older adults appears to have been low to none, highlighting the safety of this approach. In summary, eccentric training prescriptions for older adults should consider the demands of DLA and the characteristics of the elderly for appropriate management of training recommendations.
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Affiliation(s)
- Ján Cvečka
- Hamar Institute for Human Performance, Faculty of Physical Education and Sports, Comenius University in Bratislava, 814 69 Bratislava, Slovakia
| | - Matej Vajda
- Hamar Institute for Human Performance, Faculty of Physical Education and Sports, Comenius University in Bratislava, 814 69 Bratislava, Slovakia
| | - Alexandra Novotná
- Hamar Institute for Human Performance, Faculty of Physical Education and Sports, Comenius University in Bratislava, 814 69 Bratislava, Slovakia
| | - Stefan Löfler
- Ludwig Boltzmann Institute for Rehabilitation Research, 1100 Vienna, Austria
| | - Dušan Hamar
- Hamar Institute for Human Performance, Faculty of Physical Education and Sports, Comenius University in Bratislava, 814 69 Bratislava, Slovakia
| | - Matúš Krčmár
- Department of Physical Education and Sports, Faculty of Education, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia
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2
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Murphy BT, Mackrill JJ, O'Halloran KD. Impact of cancer cachexia on respiratory muscle function and the therapeutic potential of exercise. J Physiol 2022; 600:4979-5004. [PMID: 36251564 PMCID: PMC10091733 DOI: 10.1113/jp283569] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/09/2022] [Indexed: 01/05/2023] Open
Abstract
Cancer cachexia is defined as a multi-factorial syndrome characterised by an ongoing loss of skeletal muscle mass and progressive functional impairment, estimated to affect 50-80% of patients and responsible for 20% of cancer deaths. Elevations in the morbidity and mortality rates of cachectic cancer patients has been linked to respiratory failure due to atrophy and dysfunction of the ventilatory muscles. Despite this, there is a distinct scarcity of research investigating the structural and functional condition of the respiratory musculature in cancer, with the majority of studies exclusively focusing on limb muscle. Treatment strategies are largely ineffective in mitigating the cachectic state. It is now widely accepted that an efficacious intervention will likely combine elements of pharmacology, nutrition and exercise. However, of these approaches, exercise has received comparatively little attention. Therefore, it is unlikely to be implemented optimally, whether in isolation or combination. In consideration of these limitations, the current review describes the mechanistic basis of cancer cachexia and subsequently explores the available respiratory- and exercise-focused literature within this context. The molecular basis of cachexia is thoroughly reviewed. The pivotal role of inflammatory mediators is described. Unravelling the mechanisms of exercise-induced support of muscle via antioxidant and anti-inflammatory effects in addition to promoting efficient energy metabolism via increased mitochondrial biogenesis, mitochondrial function and muscle glucose uptake provide avenues for interventional studies. Currently available pre-clinical mouse models including novel transgenic animals provide a platform for the development of multi-modal therapeutic strategies to protect respiratory muscles in people with cancer.
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Affiliation(s)
- Ben T Murphy
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - John J Mackrill
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
| | - Ken D O'Halloran
- Department of Physiology, School of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland
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3
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Peñailillo L, Diaz-Reiher M, Gurovich A, Flores-Opazo M. A Short-Term Eccentric HIIT Induced Greater Reduction in Cardio-Metabolic Risk Markers in Comparison With Concentric HIIT in Sedentary Overweight Men. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2022:1-13. [PMID: 35439422 DOI: 10.1080/02701367.2021.2022087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 12/20/2021] [Indexed: 06/14/2023]
Abstract
Background: Steady-state eccentric exercise training improves cardiometabolic risk (CMR) despite lesser cardiovascular demands compared with load-matched concentric training. Whether a high-intensity interval eccentric training is also effective reducing CMR is unknown. Aim: To compare the effects of a short-term high-intensity interval eccentric training (ECC-HIIT) with high-intensity interval concentric training (CONC-HIIT) on CMR in sedentary overweight men. Methods: Twenty men (age: 27.9 ± 5.3y, body massindex: 29.1 ± 3.1 kg·m-2) were randomly assigned to ECC-HIIT (n = 10) or CONC-HIIT (n = 10) delivered as six sessions, including 4 x 5:2 min work-to-rest ratio, at 80% peak concentric power output. Heart rate (HR), rate of perceived exertion (RPE) and muscle soreness weremonitored during training sessions. Training effects on lipid profile, insulin sensitivity (HOMA-IR), body composition, thigh circumference, isometric knee extensors maximal strength, resting systolic and diastolic blood pressure (SBP and DBP) were determined. Results: Average training HR and RPE were -29%and -50%lower in ECC-HIIT in comparison with CONC-HIIT. Muscle soreness was initially greater after ECC-HIIT compared with CONC-HIIT. Significant changes in total and low-density lipoprotein cholesterol (-7.0 ± 8.7%; p = .02 and -6.3 ± 14.4%; p = .03), SBP (-9.8 ± 7.8%; p = .002), and maximal thigh circumference (+2.5 ± 3.1%; p = .02) were observed following ECC-HIIT. No changes in any CMR marker were observed after CONC-HIIT. Moderate-to-large training effect sizes were obtained in thigh circumference, SBP, total cholesterol and low-density lipoprotein cholesterol in response to ECC-HIIT. Conclusion: A two-week ECC-HIIT was well-tolerated and induced rapid onset improvements in cholesterol and blood pressure compared to conventional CONC-HIIT in sedentary overweight men.
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4
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Čretnik K, Pleša J, Kozinc Ž, Löfler S, Šarabon N. The Effect of Eccentric vs. Traditional Resistance Exercise on Muscle Strength, Body Composition, and Functional Performance in Older Adults: A Systematic Review With Meta-Analysis. Front Sports Act Living 2022; 4:873718. [PMID: 35498525 PMCID: PMC9045400 DOI: 10.3389/fspor.2022.873718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
The effects of eccentric exercise (ECC) in older adults have received limited scientific attention, considering the ample evidence for its effectiveness in general and athletic populations. The purpose of this paper is to review the effects of ECC exercise modalities vs. traditional or concentric (CON) exercise on muscle strength, body composition and functional performance in older adults. Inclusion criteria regarding the age was >55 years. Three major scientific literature databases (PubMed, Scopus and Web of Science) were screened for trials comparing the effect of ECC and CON exercise programs, and 19 papers were included in the meta-analysis. ECC and CON training programs were typically matched by the duration of each session. The difference between ECC and CON was expressed as standardized mean difference (SMD). Regarding isometric knee strength, the pooled effect favored ECC (SMD = 0.50), but was not statistically significant (p = 0.160). ECC exercise elicited greater improvements in timed up and go test (SMD = −0.68; p = 0.004), 2-min sit-stand test (SMD = 0.53; p = 0.030) and 30-s sit-stand test (SMD = 0.81; p = 0.002), but not in 6-min walking test (SMD = 0.01; p = 0.960). The effects on body composition and muscle architecture were unclear (SMD = −1.44 to 1.95; p = 0.060–0.689). In conclusion, our literature review indicates that ECC exercise is superior to, or at least as good as CON exercise for preserving health and overall function in older adults.
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Affiliation(s)
- Klemen Čretnik
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Jernej Pleša
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Koper, Slovenia
| | - Stefan Löfler
- Ludwig Boltzmann Institute for Rehabilitation Research, St. Pölten, Austria
| | - Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Koper, Slovenia
- Human Health Department, InnoRenew CoE, Izola, Slovenia
- Laboratory for Motor Control and Motor Behavior, S2P, Science to Practice, Ltd., Ljubljana, Slovenia
- *Correspondence: Nejc Šarabon
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5
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Kim DY, Oh SL, Lim JY. Applications of Eccentric Exercise to Improve Muscle and Mobility Function in Older Adults. Ann Geriatr Med Res 2022; 26:4-15. [PMID: 35038818 PMCID: PMC8984170 DOI: 10.4235/agmr.21.0138] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/11/2022] [Indexed: 11/01/2022] Open
Abstract
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.
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Affiliation(s)
- Dae Young Kim
- Department of Rehabilitation Medicine, Aging and Mobility Biophysics Laboratory, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, Republic of Korea
| | - Seung Lyul Oh
- Department of Rehabilitation Medicine, Aging and Mobility Biophysics Laboratory, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Institute on Aging, Seoul National University, Seoul, Republic of Korea
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Aging and Mobility Biophysics Laboratory, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Institute on Aging, Seoul National University, Seoul, Republic of Korea
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6
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Lanzi S, Nussbaumer P, Calanca L, Mazzolai L, Malatesta D. Descending stair walking in patients with symptomatic lower extremity peripheral artery disease: A pilot study. Vasc Med 2021; 27:171-173. [PMID: 34865584 PMCID: PMC8996288 DOI: 10.1177/1358863x211058784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Stefano Lanzi
- Heart and Vessel Department, Division of Angiology, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Paula Nussbaumer
- Institute of Sport Sciences, University of Lausanne, Lausanne, Vaud, Switzerland
| | - Luca Calanca
- Heart and Vessel Department, Division of Angiology, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Lucia Mazzolai
- Heart and Vessel Department, Division of Angiology, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Davide Malatesta
- Institute of Sport Sciences, University of Lausanne, Lausanne, Vaud, Switzerland
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7
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Cherouveim ED, Margaritelis NV, Koulouvaris P, Tsolakis C, Malliou VJ, Chatzinikolaou PN, Franchi MV, Porcelli S, Kyparos A, Vrabas IS, Geladas ND, Nikolaidis MG, Paschalis V. Skeletal muscle and cerebral oxygenation levels during and after submaximal concentric and eccentric isokinetic exercise. J Sports Sci 2021; 40:195-202. [PMID: 34602006 DOI: 10.1080/02640414.2021.1983248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The aim was to investigate the potential differences in muscle (vastus lateralis) and cerebral (prefrontal cortex) oxygenation levels as well as in the number of repetitions and total work output between isokinetic eccentric and concentric exercise at a moderate relative intensity until exhaustion. Ten recreationally active young men underwent two isokinetic exercise sessions either concentric or eccentric, one on each randomly selected leg. The protocols were performed at 60°/s and an intensity corresponding to 60% of the maximal voluntary contraction (MVC) of each contraction type. Concentric torque was significantly lower compared to eccentric torque in both peak values and at values corresponding to 60% of MVC [230 ± 18 Nm vs. 276 ± 19 Nm (P = .014) and 137 ± 12 Nm vs. 168 ± 11 Nm, respectively (P = .010)]. The participants performed 40% more contractions during eccentric compared to concentric exercise [122 ± 15 vs. 78 ± 7, respectively]. No differences were found in the levels of oxyhaemoglobin, deoxyhemoglobin, total haemoglobin and tissue saturation index when eccentric and eccentric exercise regimes were compared (all P > .05). Our results demonstrate that eccentric exercise of moderate intensity leads to greater resistance to fatigue and more work output compared to concentric exercise, despite the comparable muscle and cerebral oxygenation levels.
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Affiliation(s)
- Evgenia D Cherouveim
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.,Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikos V Margaritelis
- Dialysis Unit, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece.,Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Panagiotis Koulouvaris
- Sports Excellence, 1 Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Charis Tsolakis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.,Sports Excellence, 1 Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki J Malliou
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis N Chatzinikolaou
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Martino V Franchi
- Institute of Physiology, Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Simone Porcelli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Antonios Kyparos
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis S Vrabas
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikos D Geladas
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Michalis G Nikolaidis
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vassilis Paschalis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
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The Effects of High-Intensity Interval Exercise on Skeletal Muscle and Cerebral Oxygenation during Cycling and Isokinetic Concentric and Eccentric Exercise. J Funct Morphol Kinesiol 2021; 6:jfmk6030062. [PMID: 34287318 PMCID: PMC8293372 DOI: 10.3390/jfmk6030062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/10/2021] [Accepted: 07/14/2021] [Indexed: 11/23/2022] Open
Abstract
The aim of the present study was to study the effects of cycling and pure concentric and pure eccentric high-intensity interval exercise (HIIE) on skeletal muscle (i.e., vastus lateralis) and cerebral oxygenation. Twelve healthy males (n = 12, age 26 ± 1 yr, body mass 78 ± 2 kg, height 176 ± 2 cm, body fat 17 ± 1% of body mass) performed, in a random order, cycling exercise and isokinetic concentric and eccentric exercise. The isokinetic exercises were performed on each randomly selected leg. The muscle and the cerebral oxygenation were assessed by measuring oxyhemoglobin, deoxyhemoglobin, total hemoglobin, and tissue saturation index. During the cycling exercise, participants performed seven sets of seven seconds maximal intensity using a load equal to 7.5% of their body mass while, during isokinetic concentric and eccentric exercise, they were performed seven sets of five maximal muscle contractions. In all conditions, a 15 s rest was adopted between sets. The cycling HIIE caused greater fatigue (i.e., greater decline in fatigue index) compared to pure concentric and pure eccentric isokinetic exercise. Muscle oxygenation was significantly reduced during HIIE in the three exercise modes, with no difference between them. Cerebral oxygenation was affected only marginally during cycling exercise, while no difference was observed between conditions. It is concluded that a greater volume of either concentric or eccentric isokinetic maximal intensity exercise is needed to cause exhaustion which, in turn, may cause greater alterations in skeletal muscle and cerebral oxygenation.
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9
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Drexel H, Mader A, Saely CH, Tautermann G, Dopheide JF, Vonbank A. Downhill hiking improves low-grade inflammation, triglycerides, body weight and glucose tolerance. Sci Rep 2021; 11:14503. [PMID: 34267272 PMCID: PMC8282605 DOI: 10.1038/s41598-021-93879-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 06/21/2021] [Indexed: 11/25/2022] Open
Abstract
Exercise is a well-established tool for cardiovascular risk reduction. Particularly eccentric exercise, which essentially means walking downwards could favour more people becoming physically active. With the present controlled study, we tested the hypothesis that eccentric exercise can improve insulin sensitivity, triglyceride handling, body mass index, glucose tolerance and inflammation. We allocated 127 healthy sedentary individuals to one of two groups: (i) an active group of 102 individuals walking downwards a predefined route three to five times per week over two months, covering a difference in altitude of 540 m; for the upward route a cable car was used, for which adherence was recorded electronically and (ii) a matched control group of 25 individuals who stayed sedentary. Fasting and postprandial metabolic profiles were obtained at baseline and after two months. Compared to baseline, eccentric exercise significantly improved HOMA insulin resistance (1.94 ± 1.65 vs. 1.71 ± 1.36 (µU−1 ml) × ((mmol/l)−122.5); p = 0.038) and resulted in a decrease in fasting glucose (97 ± 15 vs. 94 ± 9 mg dl−1; p = 0.025) and glucose tolerance (238 ± 50 vs. 217 ± 47 mg dl−1 h−1; p < 0.001), whereas these parameters did not change significantly in the control group. Eccentric exercise significantly improved triglyceride tolerance (1923 ± 1295 vs. 1670 ± 1085 mg dl−1 h−1; p = 0.003), whereas triglyceride tolerance remained unchanged in the control group (p = 0.819). Furthermore, body mass index (27.7 ± 4.3 vs. 27.4 ± 4.3 kg m−2; p = 0.003) and C-reactive protein (0.27 ± 0.42 vs. 0.23 ± 0.25 mg dl−1; p = 0.031) were significantly lowered in the eccentric exercise group but not in the control group. Downhill walking, a type of exercise is a promising unusual exercise modality with favorable effects on body mass index, insulin action, on postprandial glucose and triglyceride handling and on C-reactive protein. ClinicalTrials.gov Identifier: NCT00386854.
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Affiliation(s)
- Heinz Drexel
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria.,Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.,Drexel University College of Medicine, Philadelphia, PA, USA.,Department of Medicine, Academic Teaching Hospital Bregenz, Bregenz, Austria
| | - Arthur Mader
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria. .,Private University of the Principality of Liechtenstein, Triesen, Liechtenstein. .,Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria. .,VIVIT Institute, Academic Teaching Hospital Feldkirch, Carinagasse 47, 6807, Feldkirch, Austria.
| | - Christoph H Saely
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria.,Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.,Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Gerda Tautermann
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria.,Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Jörn F Dopheide
- Division of Angiology, Department of Internal Medicine, Cantonal Hospital Graubuenden, Chur, Switzerland
| | - Alexander Vonbank
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria.,Private University of the Principality of Liechtenstein, Triesen, Liechtenstein.,Department of Medicine I, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
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10
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Regnersgaard S, Knudsen AK, Lindskov FO, Mratinkovic M, Pressel E, Ingersen A, Dela F. Down stair walking: A simple method to increase muscle mass and performance in 65+ year healthy people. Eur J Sport Sci 2021; 22:279-288. [PMID: 33241972 DOI: 10.1080/17461391.2020.1856936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Exercise is important for prevention of sarcopenia in the elderly population. We tested two training modalities, ascending or descending stair walking, representing concentric (CON) and eccentric (ECC) exercise, respectively. We also tested the effects of additional weight during eccentric exercise (ECC+). Thirty-two healthy men and women (70 ± 3 [mean ± SE] yrs.) were randomly assigned to CON, ECC, or ECC+ (carrying +15% of body weight in a vest) in a 3 (n = 32) or 6 (n = 21) week intervention (3 sessions/week). Data was analysed by mixed models approach. Rate of perceived exertion (RPE; Borg scale 6-20; mean values from 3 and 6 weeks) during training did not differ between CON (12.3 ± 0.4), ECC (11.5 ± 0.3), and ECC+ (11.7 ± 0.4). After 6 weeks, leg muscle mass increased more in ECC+ (+0.29 ± 0.09 kg) vs CON (+0.08 ± 0.05 kg) (P<0.05) but not different from ECC (+0.16 ± 0.06 kg). 6-minute walk test (6MWT) increased after 6 weeks more (P<0.05) in ECC+ (+85 ± 23 m) compared with ECC (+37 ± 13 m) and CON (+27 ± 12 m). Intramyocellular glycogen content increased from 359 ± 19 nmol/mg d.w. in CON (to 511 ± 65 and 471 ± 44 after 3 and 6 wks, respectfully (P<0.05)), but not in ECC (to 344 ± 28 after 6 weeks) or in ECC+ (to 389 ± 20 after 6 weeks). Conclusion: carrying extra weight while descending stair walking do not increase RPE, but the ECC+ training resulted in greater muscle responses compared with CON, but glycogen synthesis was stimulated only in CON. Descending stairs is a simple model for prevention and treatment of sarcopenia and the stimulus is enhanced by carrying extra weights.
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Affiliation(s)
- Signe Regnersgaard
- Department of Geriatrics, Bispebjerg University Hospital, Copenhagen, Denmark.,Xlab, Centre for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anna K Knudsen
- Department of Geriatrics, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Filippa O Lindskov
- Department of Geriatrics, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Marija Mratinkovic
- Department of Geriatrics, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Eckart Pressel
- Department of Geriatrics, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Arthur Ingersen
- Department of Geriatrics, Bispebjerg University Hospital, Copenhagen, Denmark.,Xlab, Centre for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Dela
- Department of Geriatrics, Bispebjerg University Hospital, Copenhagen, Denmark.,Xlab, Centre for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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11
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Ellis RE, Dodd KJ, Holland AE, Lim K, Tacey M, Shields N. Effect of eccentric exercise on quality of life and function in people with chronic heart failure: a pilot randomised controlled trial. Disabil Rehabil 2020; 44:2705-2714. [PMID: 33174464 DOI: 10.1080/09638288.2020.1836679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine if eccentric exercise was effective, safe and feasible in increasing function and quality of life in people with heart failure compared to usual care and a waitlist control group. METHODS A prospective, three-armed, parallel-design, assessor-blind, pilot randomised controlled trial with 1:1:1 allocation. Forty-seven participants (16 female; mean age 66 years) with mild to moderate heart failure were randomly allocated to either eccentric exercise, concentric exercise or a waitlist control group. Participants in the exercise groups completed twice-weekly exercise for eight weeks. Primary outcome was walking capacity. Secondary outcomes were quality of life, leg strength and fatigue. Outcomes were assessed at baseline, post intervention and three-month follow-up. Attendance, tolerability and adverse events were used to determine safety and feasibility. RESULTS Intention-to-treat analysis showed no differences between eccentric exercise and either concentric exercise or waitlist for any outcome. Per-protocol analysis found improvements identified by the Minnesota living with heart failure questionnaire were significantly greater post-intervention for eccentric exercise compared to concentric exercise (-17.99 units, 95% confidence interval -35.96 to -0.01). No major adverse events were reported. CONCLUSION In this small trial, eccentric exercise did not demonstrate superior outcomes to concentric exercise or a waitlist control group. CLINICAL TRIAL REGISTRATION The protocol for this trial was registered at clinicaltrials.gov, registration number: NCT02223624, registration date: 22 August 2014.IMPLICATIONS FOR REHABILITATIONRegular physical activity and referral to rehabilitation is recommended for people with chronic heart failure, however exercise can be challenging for this group.Eccentric exercise was safe and tolerable for participants with heart failure.Documentation of exercise progression is important to demonstrate a dose-response relationship.In this study there were no differences between groups who received eccentric exercise, concentric exercise or no exercise.
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Affiliation(s)
- Rachel E Ellis
- Department of Physiotherapy, Northern Health, Epping, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Karen J Dodd
- College of Health and Biomedicine, Victoria University, St Albans, Australia
| | - Anne E Holland
- Department of Physiotherapy, Alfred Health, Melbourne, Australia.,Central Clinical School, Monash University, Melbourne, Australia
| | - Kwang Lim
- Department of Medicine, Melbourne Health, Melbourne, Australia
| | - Mark Tacey
- Department of Research, Northern Health, Epping, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
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12
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Margaritelis NV, Theodorou AA, Chatzinikolaou PN, Kyparos A, Nikolaidis MG, Paschalis V. Eccentric exercise per se does not affect muscle damage biomarkers: early and late phase adaptations. Eur J Appl Physiol 2020; 121:549-559. [PMID: 33156414 DOI: 10.1007/s00421-020-04528-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Acute high-intensity unaccustomed eccentric exercise performed by naive subjects is accompanied by disturbances in muscle damage biomarkers. The aim of the study was to investigate whether a causal relationship indeed exists between eccentric exercise and muscle damage. METHODS Twenty-four men randomly assigned into a concentric only or an eccentric-only training group and performed 10 weeks of isokinetic resistance exercise (one session/week of 75 maximal knee extensors actions). Physiological markers of muscle function and damage (i.e., range of motion, delayed onset muscle soreness, isometric, concentric and eccentric peak torque) were assessed prior to and 1-3 and 5 days post each session. Biochemical markers of muscle damage (creatine kinase) and inflammation (C-reactive protein) were measured prior and 2 days post each session. RESULTS After the first bout, eccentric exercise induced greater muscle damage compared to concentric exercise; however, during the nine following sessions, this effect progressively diminished, while after the 10th week of training, no alterations in muscle damage biomarkers were observed after either exercise protocol. Additionally, strength gains at the end of the training period were comparable between the two groups and were mode-specific. CONCLUSION (1) eccentric exercise per se does not affect muscle damage biomarkers; (2) muscle damage occurs as a result of muscle unaccustomedness to this action type; (3) exercise-induced muscle damage is not a prerequisite for increased muscle strength. Collectively, we believe that muscle unaccustomedness to high-intensity eccentric exercise, and not eccentric exercise per se, is the trigger for muscle damage as indicated by muscle damage biomarkers.
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Affiliation(s)
- Nikos V Margaritelis
- Dialysis Unit, 424 General Military Hospital of Thessaloniki, Thessaloniki, Greece.,Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Anastasios A Theodorou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Panagiotis N Chatzinikolaou
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Antonios Kyparos
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Michalis G Nikolaidis
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Vassilis Paschalis
- Department of Physical Education and Sport Sciences, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Ethnikis Αntistasis 41, 17237, Athens, Greece.
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13
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Sarcopenia: A Contemporary Health Problem among Older Adult Populations. Nutrients 2020; 12:nu12051293. [PMID: 32370051 PMCID: PMC7282252 DOI: 10.3390/nu12051293] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 12/21/2022] Open
Abstract
Sarcopenia, a geriatric disease characterized by a progressive loss of skeletal muscle mass and loss of muscle function, constitutes a rising, often undiagnosed health problem. Its prevalence in the elderly population is largely considered variable, as it ranges from 5% to 50% depending on gender, age, pathological conditions as well as diagnostic criteria. There is no one unified approach of treatment or assessment, which makes sarcopenia even harder to assess. There is a pressing need to provide better diagnosis, diagnostics, prevention, and individualized health care. Physical activity and nutrition are the main studied ways to prevent sarcopenia, and they also offer better outcomes. This review aims to report the prevalence of sarcopenia in older adults, its etiology, prevention, and treatment techniques.
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14
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Association between Reallocation Behaviors and Subjective Health and Stress in South Korean Adults: An Isotemporal Substitution Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072488. [PMID: 32260548 PMCID: PMC7178139 DOI: 10.3390/ijerph17072488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/03/2020] [Indexed: 12/20/2022]
Abstract
This study used an isotemporal substitution (IS) model to determine the potential reallocation effects of sedentary behavior (SB) and physical activity (PA) on subjective health and stress in South Koreans with data from the Sixth Korean National Health and Nutrition Examination Survey 2015. The analysis included 791 participants whose accelerometer-measured PA was available, divided into three age groups (young adults = 151; mid-age adults = 334; older adults = 306). We adopted SB, light PA (LPA), and moderate-to-vigorous PA (MVPA) to determine how time was allocated to each activity level, then examined the effects of reallocation on subjective health and stress across age groups. The analyses were performed in three steps: single-activity, partition, and IS model. An additional ANCOVA was conducted on statistically significant outcomes (i.e., subjective health of young and older adults). We found that among young adults, reallocating 30 min/week of SB to LPA and to MVPA was linked to high levels of subjective health. In older adults, reallocating 30 min/week of SB and LPA to MVPA was associated with high subjective health. However, this relationship was not observed in mid-age adults. None of the age groups showed a relationship between any activity reallocation and stress. Our findings provide the first insight on the development of interventions aimed at promoting active, healthier lifestyles on the basis of behavior reallocation in South Koreans.
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González-Bartholin R, Mackay K, Valladares D, Zbinden-Foncea H, Nosaka K, Peñailillo L. Changes in oxidative stress, inflammation and muscle damage markers following eccentric versus concentric cycling in older adults. Eur J Appl Physiol 2019; 119:2301-2312. [DOI: 10.1007/s00421-019-04213-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/14/2019] [Indexed: 01/15/2023]
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16
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Comparison between eccentric and concentric resistance exercise training without equipment for changes in muscle strength and functional fitness of older adults. Eur J Appl Physiol 2019; 119:1581-1590. [PMID: 31055678 DOI: 10.1007/s00421-019-04147-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 04/20/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE The present study tested the hypothesis that resistance exercise training focusing on eccentric muscle contractions would improve muscle strength and functional physical fitness more than concentric contraction-focused resistance training in older adults. METHODS Healthy older adults (65-84 years) were placed into eccentric (ECC; n = 9) or concentric training group (CON; n = 8). They performed 4-6 basic manual resistance exercises focusing on either eccentric or concentric muscle contractions once at a community centre and at least twice at home a week for 8 weeks. Muscle thickness of the quadriceps femoris (MT), knee extensor maximal voluntary isometric contraction strength (MVC), 30-second chair stand (CS), 3-metre timed up and go (TUG), 2-minute step (2MS), sit and reach (SR), and static balance with eyes open and closed (Bal-EC) were assessed before and 7 days after the last community centre session. RESULTS Changes in MT (ECC: 21.6 ± 9.2% vs CON: 6.7 ± 7.1%), MVC (38.3 ± 22.6% vs 8.2 ± 8.4%), CS (51.0 ± 21.7% vs 34.6 ± 28.3%), TUG (16.7 ± 9.9% vs 6.3 ± 7.7%), 2MS (9.9 ± 6.0% vs 6.0 ± 7.3%) and Bal-EC (35.1 ± 6.7% vs 8.8 ± 16.2%) from baseline were greater (P < 0.05) for the ECC than the CON group. CONCLUSION These results show that the eccentric manual resistance exercise training was more effective for improving lower limb strength, mobility, and postural stability of older adults when compared with the concentric training. This suggests the significance of emphasising eccentric muscle contractions in movements to maintain and improve physical function.
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Julian V, Thivel D, Costes F, Touron J, Boirie Y, Pereira B, Perrault H, Duclos M, Richard R. Eccentric Training Improves Body Composition by Inducing Mechanical and Metabolic Adaptations: A Promising Approach for Overweight and Obese Individuals. Front Physiol 2018; 9:1013. [PMID: 30131705 PMCID: PMC6090036 DOI: 10.3389/fphys.2018.01013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 07/09/2018] [Indexed: 12/04/2022] Open
Abstract
Skeletal muscle generates force by either shortening (concentrically) or lengthening (eccentrically). Eccentric (ECC) exercise is characterized by a lower metabolic demand and requires less muscle activity than concentric (CON) exercise at the same level of exerted force. However, the specific effect of ECC training vs. CON training on lean and fat mass remains underexplored. The first aim of this paper was to review the available evidence regarding the effects of ECC training on whole body and segmental lean and fat mass and, when possible, compare these with the effects of CON training. The second aim was to provide some insights into the main mechanical, physiological, and metabolic adaptations of ECC training that contribute to its effects on body composition. The third aim was to determine the beneficial effects of ECC exercise on health-related parameters in overweight and obese patients. ECC training is an effective modality to improve lean mass, but when matched for load or work, the difference between ECC and CON trainings seems unclear. A few studies reported that ECC training is also efficient at reducing fat mass. By increasing post-exercise resting energy expenditure, modifying metabolic substrate, and improving both blood lipid profile and insulin resistance, ECC training is a potential exercise modality for individuals with chronic conditions such as those who are overweight and obese. Further investigations using standardized experimental conditions, examining not only segmental but also whole body composition, are required to compare ECC and CON trainings.
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Affiliation(s)
- Valérie Julian
- Service de Médecine du Sport et Explorations Fonctionnelles, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Laboratoire AME2P, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Frédéric Costes
- Service de Médecine du Sport et Explorations Fonctionnelles, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Julianne Touron
- INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Yves Boirie
- Service de Nutrition Clinique, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Bruno Pereira
- Service de Biostatistique, CHU Clermont-Ferrand, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Hélène Perrault
- Faculté des Sciences de la Santé, Université d'Ottawa, Ottawa, ON, Canada
| | - Martine Duclos
- Service de Médecine du Sport et Explorations Fonctionnelles, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Ruddy Richard
- Service de Médecine du Sport et Explorations Fonctionnelles, CHU Clermont-Ferrand, INRA, CRNH, Université Clermont Auvergne, Clermont-Ferrand, France
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18
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Nishikawa KC, Lindstedt SL, LaStayo PC. Basic science and clinical use of eccentric contractions: History and uncertainties. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:265-274. [PMID: 30356648 PMCID: PMC6189250 DOI: 10.1016/j.jshs.2018.06.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 12/30/2017] [Accepted: 01/09/2018] [Indexed: 05/18/2023]
Abstract
The peculiar attributes of muscles that are stretched when active have been noted for nearly a century. Understandably, the focus of muscle physiology has been primarily on shortening and isometric contractions, as eloquently revealed by A.V. Hill and subsequently by his students. When the sliding filament theory was introduced by A.F. Huxley and H.E. Huxley, it was a relatively simple task to link Hill's mechanical observations to the actions of the cross bridges during these shortening and isometric contractions. In contrast, lengthening or eccentric contractions have remained somewhat enigmatic. Dismissed as necessarily causing muscle damage, eccentric contractions have been much more difficult to fit into the cross-bridge theory. The relatively recent discovery of the giant elastic sarcomeric filament titin has thrust a previously missing element into any discussion of muscle function, in particular during active stretch. Indeed, the unexpected contribution of giant elastic proteins to muscle contractile function is highlighted by recent discoveries that twitchin-actin interactions are responsible for the "catch" property of invertebrate muscle. In this review, we examine several current theories that have been proposed to account for the properties of muscle during eccentric contraction. We ask how well each of these explains existing data and how an elastic filament can be incorporated into the sliding filament model. Finally, we review the increasing body of evidence for the benefits of including eccentric contractions into a program of muscle rehabilitation and strengthening.
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Affiliation(s)
- Kiisa C. Nishikawa
- Center for Bioengineering Innovation and Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Stan L. Lindstedt
- Center for Bioengineering Innovation and Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
- Corresponding author
| | - Paul C. LaStayo
- Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT 86011, USA
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19
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Chen TC, Hsieh CC, Tseng KW, Ho CC, Nosaka K. Effects of Descending Stair Walking on Health and Fitness of Elderly Obese Women. Med Sci Sports Exerc 2018; 49:1614-1622. [PMID: 28291022 DOI: 10.1249/mss.0000000000001267] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
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.
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Affiliation(s)
- Trevor C Chen
- 1Department of Physical Education, National Taiwan Normal University, Taipei City, TAIWAN; 2Department of Exercise and Health Sciences, University of Taipei, Taipei City, TAIWAN; and 3Centre for Exercise and Sports Science Research, School of Medical and Health Sciences Edith Cowan University, Western Australia, AUSTRALIA
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20
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Gielen S. Exercise training in heart failure: which training modality works best? J Appl Physiol (1985) 2017; 123:442-443. [PMID: 28596272 DOI: 10.1152/japplphysiol.00444.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 05/17/2017] [Indexed: 01/14/2023] Open
Affiliation(s)
- Stephan Gielen
- Klinikum Lippe, Klinik für Innere Medizin/Kardiologie, Angiologie und Internistische Intensivmedizin, Detmold, Germany; and Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Halle/Saale, Germany
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21
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CHASLAND LAURENC, GREEN DANIELJ, MAIORANA ANDREWJ, NOSAKA KAZUNORI, HAYNES ANDREW, DEMBO LAWRENCEG, NAYLOR LOUISEH. Eccentric Cycling. Med Sci Sports Exerc 2017; 49:646-651. [DOI: 10.1249/mss.0000000000001151] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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22
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Effects of an Eight-Week Stepladder Exercise Protocol on Lower Limb Muscular Strength of Apparently Healthy Young Adults. HUMAN MOVEMENT 2017. [DOI: 10.1515/humo-2017-0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AbstractPurpose. Backward descent of stairs is associated with improved muscle strength and reduced joint stress, but the effect of backward ascent of stairs on lower limb muscle strength has not been reported. This study compared the effects of forward and backward stair climbing on lower limb muscle strength in apparently healthy young adults. Methods. The total of 31 young volunteers were allocated to either forward or backward stair climbing group (n = 16 and 15, respectively). Dynamic quadriceps and hamstring muscle strength was assessed in addition to thigh girth at baseline and at weeks 4 and 8 with the use of the repetitive maximum method and tape measure, respectively. Results. Between baseline and week 8, muscular strength in both groups (quadriceps: 14.4 ± 3.6 to 16.4 ± 3.4 kg; 14.0 ± 2.9 to 15.3 ± 2.7 kg; hamstring: 12.2 ± 3.2 to 13.4 ± 3.2; 11.7 ± 2.5 to 12.9 ± 2.7 kg) increased significantly (p < 0.05) while the increase in thigh girth was not significant (p > 0.05). The groups were comparable in all three measures post intervention. Conclusions. Forward and backward stair climbing protocols are effective for improving the dynamic strength of the hamstring and quadriceps muscles of apparently healthy young adults. Thus, either protocol could be used for the improvement of lower limbs dynamic muscle strength.
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Karagiannis C, Savva C, Mamais I, Efstathiou M, Monticone M, Xanthos T. Eccentric exercise in ischemic cardiac patients and functional capacity: A systematic review and meta-analysis of randomized controlled trials. Ann Phys Rehabil Med 2016; 60:58-64. [PMID: 27988306 DOI: 10.1016/j.rehab.2016.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/30/2016] [Accepted: 10/31/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND Eccentric (ECC) exercise is an "economical" type of exercise with low energy requirements and does not cause early fatigue. Therefore, it is used for cardiac patients, who have low physical activity and exercise intolerance, as an easier kind of training. OBJECTIVE This systematic review aimed to investigate the efficacy of ECC exercise for functional capacity (FC) in patients with ischemic heart disease. DESIGN Systematic review. METHODS MEDLINE via PubMed and EBSCO databases were searched for articles of randomized controlled trials of adults with ischemic heart disease who underwent ECC training as compared with other forms of exercise (concentric exercise) or no exercise and assessed FC. The methodologic quality of studies was assessed by the PEDro scale. A meta-analysis was performed with sufficient homogeneity between at least 2 studies in the pre-defined comparisons. RESULTS Four studies, investigating a total of 99 subjects, met the inclusion criteria. The results of the studies did not clearly indicate whether ECC exercise could improve FC better than traditional forms of exercise. However, the small number of studies and their methodologic weaknesses do not allow for drawing firm conclusions. CONCLUSIONS We found contradictory results about the effectiveness of ECC as compared with concentric exercise in terms of FC in ischemic cardiac patients. Further investigation with well-designed randomized trials is needed to determine the effectiveness of this kind of exercise for FC in such patients.
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Affiliation(s)
- C Karagiannis
- European University of Cyprus, School of Sciences, Department of Health Sciences, Nicosia, Cyprus.
| | - C Savva
- European University of Cyprus, School of Sciences, Department of Health Sciences, Nicosia, Cyprus
| | - I Mamais
- European University of Cyprus, School of Sciences, Department of Health Sciences, Nicosia, Cyprus
| | - M Efstathiou
- University of Nicosia, Department of Life and Health Sciences, Nicosia, Cyprus
| | - M Monticone
- University of Cagliari, Department of Public Health, Clinical and Molecular Medicine, Cagliari, Italy
| | - T Xanthos
- European University of Cyprus, School of Medicine, Nicosia, Cyprus
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Hoppeler H. Moderate Load Eccentric Exercise; A Distinct Novel Training Modality. Front Physiol 2016; 7:483. [PMID: 27899894 PMCID: PMC5110564 DOI: 10.3389/fphys.2016.00483] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/07/2016] [Indexed: 12/25/2022] Open
Abstract
Over the last 20 years a number of studies have been published using progressive eccentric exercise protocols on motorized ergometers or similar devices that allow for controlled application of eccentric loads. Exercise protocols ramp eccentric loads over an initial 3 weeks period in order to prevent muscle damage and delayed onset muscle soreness. Final training loads reach 400-500 W in rehabilitative settings and over 1200 W in elite athletes. Training is typically carried out three times per week for durations of 20-30 min. This type of training has been characterizes as moderate load eccentric exercise. It has also been denoted RENEW (Resistance Exercise via Negative Eccentric Work by LaStayo et al., 2014). It is distinct from plyometric exercises (i.e., drop jumps) that impose muscle loads of several thousand Watts on muscles and tendons. It is also distinct from eccentric overload training whereby loads in a conventional strength training setting are increased in the eccentric phase of the movement to match concentric loads. Moderate load eccentric exercise (or RENEW) has been shown to be similarly effective as conventional strength training in increasing muscle strength and muscle volume. However, as carried out at higher angular velocities of joint movement, it reduces joint loads. A hallmark of moderate load eccentric exercise is the fact that the energy requirements are typically 4-fold smaller than in concentric exercise of the same load. This makes moderate load eccentric exercise training the tool of choice in medical conditions with limitations in muscle energy supply. The use and effectiveness of moderate load eccentric exercise has been demonstrated mostly in small scale studies for cardiorespiratory conditions, sarcopenia of old age, cancer, diabetes type 2, and neurological conditions. It has also been used effectively in the prevention and rehabilitation of injuries of the locomotor system in particular the rehabilitation after anterior cruciate ligament surgery.
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Affiliation(s)
- Hans Hoppeler
- Department of Anatomy, University of BernBern, Switzerland
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25
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Abstract
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.
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26
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Ellis R, Shields N, Lim K, Dodd KJ. Eccentric exercise in adults with cardiorespiratory disease: a systematic review. Clin Rehabil 2015; 29:1178-97. [DOI: 10.1177/0269215515574783] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 01/28/2015] [Indexed: 11/16/2022]
Abstract
Objective: To determine if eccentric exercise is effective, tolerable and safe for adults with chronic cardiorespiratory disease. Data sources: We searched electronic databases from inception until January 2015 (Medline, CINAHL, Embase, SportDiscus, PEDro, Cochrane Central and AMED) supplemented by citation tracking and reference list scanning. Review methods: Included articles had to report effects of eccentric exercise, alone or as a primary component of intervention, of any intensity and duration, on adults with chronic cardiorespiratory disease. Trials needed to be reported as full text in a peer-reviewed journal and include control data (randomised, quasi-randomised and single group cross-over design trials). Any outcomes or comparison interventions were accepted. Methodological rigor was assessed using the PEDro scale. Results: Of 22 potentially relevant articles, 10 met inclusion criteria. They reported results from seven trials with a total of 112 participants across the diseases. PEDro scores were low (median 3). Eccentric exercise increased strength and mobility to comparable levels as concentric exercise, however, it did so with lower oxygen consumption (effect size as large as d = –3.07 (–4.12, –1.80)), and four-fold power output (effect size d = –3.60 (–5.03, –1.66)). There were no adverse events reported for eccentric exercise. Pain was avoided with familiarisation sessions and individual exercise prescription. Conclusion: Eccentric exercise is beneficial and at least comparable with traditional exercise in improving walking and strength for people with chronic cardiorespiratory disease. It was well tolerated and we identified no safety concerns for the use of this intervention for this population.
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Affiliation(s)
- Rachel Ellis
- Physiotherapy, Northern Health, Epping, Australia
| | - Nora Shields
- Department of Physiotherapy, La Trobe University, Melbourne, Australia
- Allied Health, Northern Health, Epping, Australia
| | - Kwang Lim
- Medicine, Northern Health, Epping, Australia
| | - Karen J Dodd
- Department of Physiotherapy, La Trobe University, Melbourne, Australia
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