To investigate the prophylactic effect of the active isolated stretching technique on exercise-induced muscle damage of wrist flexors.
The mixed model randomised controlled interventional study was ...conducted at the University of Sargodha, Sargodha, Pakistan, from November 2018 to May 2019, and comprised young adults who were untrained, sedentary and healthy who were randomly divided into intervention group A and control group B. Group A participants received self-assisted active isolated stretching before inducing muscle soreness of wrist flexors by eccentric exercises. Group B did not receive any intervention. The outcome measures were pain intensity, muscle soreness, pressure pain threshold, range of motion, and grip strength. Data were collected at baseline, after one hour, and daily from day 1 to 7 after inducing muscle soreness. Data were analysed using SPSS 21.
Of the 60 subjects, there were 30(50%) in each of the two groups. There were 14(23.3%) males and 46(76.7%) females. The overall mean age was 21.47±1.9 years. Group A showed early recovery in pain and muscle soreness compared to group B (p<0.05). Also, a limited deficit in the range of motion, grip strength, and pain pressure threshold was found in group A compared to group B (p<0.05).
Active isolated stretching before strenuous, unaccustomed exercise was found to be useful in ameliorating the symptoms of muscle soreness.
Hamstrings strains are common and debilitating injuries in many sports. Most hamstrings exercises are performed at an inadequately low hip-flexion angle because this angle surpasses 70° at the end of ...the sprinting leg's swing phase, when most injuries occur.
To evaluate the influence of various hip-flexion angles on peak torques of knee flexors in isometric, concentric, and eccentric contractions and on the hamstrings-to-quadriceps ratio.
Descriptive laboratory study.
Research laboratory.
Ten national-level sprinters (5 men, 5 women; age = 21.2 ± 3.6 years, height = 175 ± 6 cm, mass = 63.8 ± 9.9 kg).
For each hip position (0°, 30°, 60°, and 90° of flexion), participants used the right leg to perform (1) 5 seconds of maximal isometric hamstrings contraction at 45° of knee flexion, (2) 5 maximal concentric knee flexion-extensions at 60° per second, (3) 5 maximal eccentric knee flexion-extensions at 60° per second, and (4) 5 maximal eccentric knee flexionextensions at 150° per second.
Hamstrings and quadriceps peak torque, hamstrings-to-quadriceps ratio, lateral and medial hamstrings root mean square.
We found no difference in quadriceps peak torque for any condition across all hip-flexion angles, whereas hamstrings peak torque was lower at 0° of hip flexion than at any other angle (P < .001) and greater at 90° of hip flexion than at 30° and 60° (P < .05), especially in eccentric conditions. As hip flexion increased, the hamstrings-to-quadriceps ratio increased. No difference in lateral or medial hamstrings root mean square was found for any condition across all hip-flexion angles (P > .05).
Hip-flexion angle influenced hamstrings peak torque in all muscular contraction types; as hip flexion increased, hamstrings peak torque increased. Researchers should investigate further whether an eccentric resistance training program at sprint-specific hip-flexion angles (70° to 80°) could help prevent hamstrings injuries in sprinters. Moreover, hamstrings-to-quadriceps ratio assessment should be standardized at 80° of hip flexion.
Eccentric (lengthening) resistance training respectively muscle work requires a lower share of cardiac activity in comparison to concentric (shortening) muscle work. Especially in seniors suffering ...from cardiovascular diseases (still the most common cause of death in industrialized countries) this kind of activity is predisposed due to its possibility of high stimulation of musculoskeletal system only partly (20-25%) stimulating cardiovascular system. Comprehension of positive aspects was addressed for a sample of people doing regular work out while having access to concentric and eccentric training stations. 38 females (57 ± 15.7 years / 163.3 ± 19.4 cm / 63.6 ± 10.4 kg) and 36 males (57.6 ± 16.9 years / 177.4 ± 6.9 cm / 80.6 ± 8.7 kg) visiting at least once a week a fitness mall with access to eccentric and concentric training stations were asked concerning cardiovascular diseases, their corresponding risk factors and their own experience with eccentric muscle training. Differences in the perception of eccentric muscle training compared to concentric training were reported by 18 women and 24 men, however reported Rates of perceived Exertion measured by BORG-Scale (6-20) did not significantly differ. A positive Bias that especially persons with cardiovascular illnesses respectively risk factors preferred this kind of activity was not detectable and knowledge of positive aspects of eccentric training was sparse. General practitioners are encouraged to inform patients of the existence of positive aspects of eccentric muscle training and to motivate patients to absolve their training respectively.
Purpose : To report the outcomes of a physiotherapy management approach for de Quervain's disease (DQD), a common hand disorder for which evidence for physiotherapy management is lacking, in 4 ...consecutive patients with DQD. Methods : Participants underwent a median of eight treatment sessions, consisting of mobilizations with movement, eccentric muscle training, and high-voltage electrical stimulation. Outcomes were assessed with an 11-point numeric pain rating scale (NPRS; range 1-10) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH; range 0%-100%). Result s: Median NPRS and DASH scores decreased from a baseline of 5 and 48, respectively, to 2.8 and 19 after treatment; at 6-month follow-up, all participants reported minimal pain and disability, but one participant required a corticosteroid injection shortly after discharge from physiotherapy. Conclusions : Overall outcome was considered successful for three of four patients, comparable to the success rate previously reported for corticosteroid injections. A randomized clinical trial evaluating the efficacy of this intervention seems warranted.
The 2007 review by Visnes and Bahr concluded that athletes with patella tendinopathy should be withdrawn from sport whilst engaging in eccentric exercise (EE) rehabilitation programs. However, ...deprivation of sport is associated with a number of negative psychological and physiological effects. Withdrawal from sport is therefore a decision that warrants due consideration of the risk/benefit ratio. The aim of this study was to determine whether sufficient evidence exists to warrant withdrawal of athletes from sport during an eccentric exercise rehabilitation program. A systematic review of the literature was performed to identify relevant randomised trials. Data was extracted to determine whether athletes were withdrawn from sport, what evidence was presented to support the chosen strategy and whether this affected the clinical outcome. Seven studies were included. None of these reported high quality evidence to support withdrawal. In addition, three studies were identified in which athletes were not withdrawn from sport and still benefited from EE. This review has demonstrated that there is no high quality evidence to support a strategy of withdrawal from sport in the management of patella tendinopathy.
Different series emphasized the necessity of rehabilitation program after infiltration of platelet-rich plasma (PRP) in case of tendinopathy. However, most of them describe only briefly the ...reeducation protocol and these programs vary. Our aim was to extensively describe a specific standardized rehabilitation program.
After a review of literature of post-PRP infiltration protocols, we had developed a standardized rehabilitation protocol. This protocol was evaluated by 30 subjects with chronic jumper's knee who. A standardised progressive sub-maximal eccentric program supervised by a physical therapist for 6 weeks was started 1 week post-infiltration. The patient benefited also from electromyostimulation, isometric strengthening and stretching of the quadriceps, cycloergometer and cryotherapy. After the supervised program, the patient had to make an auto-reeducation added to the reathletisation protocol for 6 more weeks which was followed by maintenance exercises up to 1 year. The assessments were made using a VAS, IKDC and VISA-P scores.
The VAS, IKDC and VISA-P scores decreased very significantly with time. The compliance to auto-reeducation was good.
We proposed a simple and efficient protocol based on sub-maximal eccentric reeducation to add to PRP infiltrations in case of patellar tendinopathy.
Purpose. To evaluate microcirculatory variables in and around the Achilles tendon (AT) in patients undergoing a programme of daily eccentric training for the management of tendinopathy of the main ...body of the AT in non-compliant in contrast to compliant patients.
Methods. A total of 116 patients with tendinopathy of the AT were enrolled for prospective eccentric training. Non-compliant patients were defined following drop-out due to less than 80% participation in the daily eccentric training regimen.
Results. Overall 12-week-compliance was 79% (92 116). The reasons for non-compliance were moving out of town (21%, 5 24), overwhelming pain (25%, 6 24), limited discipline (29%, 7 24), and surgery (17%, 4 24). Capillary blood flow, tendon and paratendon oxygen saturation as well as postcapillary venous filling pressures were not significantly different between compliant and non-compliant patients. Gender, age, BMI, non steroidal anti inflammatory drugs, corticosteroid medication and smoking habits were not significantly different. Only the use of oral contraceptives (non- vs. compliant: 54% vs. 10%, p = 0.0001) and walking swimming (46% vs. 70%, p = 0.041) were significantly different. Pain level was reduced (5.6 ± 1.9 to 2.9 ± 1.2, p < 0.05) following eccentric training.
Conclusions. In patients undergoing eccentric training for tendinopathy of the main body of the AT, there is no difference in microcirculatory variables regardless of compliance with the eccentric exercises programme. With the exception of the more frequent use of oral contraceptive medication and less often walking swimming, no predictive factors could be identified in non-compliant patients.
High-mobility group box 1 (HMGB1) has recently been reported to be involved in proinflammation and tissue repair. Therefore, we hypothesized that HMGB1 is released into the bloodstream after ...eccentric exercises or prolonged endurance activities. Blood samples from 11 participants that performed 100 drop to vertical jumps (DVJ) and from 10 participants that took part in the 1200-km 'Paris-Brest-Paris' bicycle race (PBP) were tested for HMGB1 and creatine kinase (CK) levels. CK increased after both DVJ (pre: 150.6 ± 81.5 U/L; post: 188.8 ± 95.5 U/L 8 h: 790.5 ± 346.4 U/L) and PBP (pre: 81.3 ± 36.4 U/L; post: 725.2 ± 229.5 U/L; 12 h: 535.8 ± 188.6 U/L), indicating membrane damage. However, HMGB1 plasma levels remained below the detection limit (78 pg/mL) of the applied enzyme-linked immunosorbent assay kit for all blood samples analysed. That is, neither high intensity eccentric exercises (DVJ) nor prolonged endurance events (PBP) seemed to affect HMGB1 levels in blood at selected time points.
Background and Objective: Therapeutic eccentric exercise may provide both a structural and functional benefit during tendinopathy rehabilitation. The objective is to find the effect of eccentric ...exercises on improvement of pain and grip strength for subjects with Medial Epicondylitis. Method: Pre to post test experimental study design randomized thirty subjects with medial epicondylitis, 15 each into Group A and Group B. Group B subjects were treated with conventional therapy and Eccentric exercises. Group A subjects were treated with conventional therapy. Results: When means of post intervention were compared using Independent ‘t’ between groups there was no statistically significant difference in improvements obtained in VAS scores and grip strength. There was a statistically significant change in means of VAS score and Grip strength when means were analyzed by using Paired‘t’ test and Wilcoxon signed rank test within the groups with positive percentage of change. Conclusion: It is concluded that four weeks of Eccentric Exercise Programme combined with conventional therapy shown significant effect on improving pain and Grip strength, however the improvement obtained has no difference when compared with control conventional treatment for Subjects with Medial Epicondylitis.
Background: Osteoarthritis is a slowly evolving articular disease, which appears to originate in the cartilage and affects the underlying bone and soft tissues. OA results in pain and functional ...disability. The purpose of this study was to determine the effect of isometric exercises and combined concentric-eccentric exercises in reducing pain and functional disability in patients with osteoarthritis of knee. Methods: Forty individuals who were diagnosed as osteoarthritis by qualified orthopaedics and orthopaedic surgeons were chosen and were randomly divided into 2 groups Group A (N=20) and Group B (N=20). Group A was treated with isometric exercises and Group B was treated with combined concentric-eccentric exercises. The intervention lasted eight weeks and the physical activity was carried out for 3 days a week. Both the groups were assessed for pain and functional disability of knee joint by using WOMAC osteoarthritis index and VAS. Results: Between group analysis of pre and post study data reveals that VAS and WOMAC osteoarthritis index revealed significant findings (P=0.00). Group B performs significantly better on both the scales after the treatment. Conclusion: Both the groups showed significant improvement in decreasing pain and functional disability. But mean scores of Group B showed greater improvement in reducing pain and functional disability as compared to Group A in patients with knee osteoarthritis. Thus the results suggest that a combined concentric-eccentric exercise is more effective than isometric exercises in reducing pain and functional disability in knee osteoarthritis.
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