Tendinopatija Ahilove tetive sindrom je prenaprezanja sustava za kretanje koji se očituje
bolnošću i oteklinom u Ahilovoj tetivi i/ili oko nje te dovodi do smanjenja ili nemogućnosti
obavljanja ...željenih radnih i/ili sportskih aktivnosti. U posljednjih je tridesetak godina učestalost
pojavljivanja tendinopatije Ahilove tetive u porastu zbog sve češćeg sudjelovanja ljudi u
sportskim aktivnostima, no valja naglasiti da se u trećini slučajeva javlja u ljudi koji se ne bave
nikakvom fizičkom aktivnošću. Istraživanja su pokazala da u podlozi ovog stanja leži degenerativni,
a ne upalni proces. Predisponirajući čimbenici nastanka tendinopatije Ahilove tetive
mogu biti ili direktno vezani uz osobu (tzv. unutarnji) i tada je najčešće riječ o nepovoljnim
anatomskim značajkama donjeg ekstremiteta, ili indirektno vezani uz osobu (tzv. vanjski)
među kojima su najčešće pogreške u treningu i nošenje neprimjerene obuće. Za postavljanje
dijagnoze od najveće su važnosti temeljita anamneza i klinički pregled. Od slikovnih se metoda
savjetuje načiniti ultrazvuk, dok se magnetska rezonancija savjetuje samo u slučaju neuspjelog
inicijalnog liječenja. Cilj ovog rada jest uputiti na suvremene smjernice neoperacijskog i kirurškog
liječenja neinsercijske tendinopatije Ahilove tetive. Neoperacijsko liječenje uvijek valja
započeti ekscentričnim vježbama, a ako se nakon dvanaestotjednog programa ne postigne zadovoljavajući
rezultat, tada se savjetuje primijeniti neku drugu metodu neoperacijskog liječenja.
Kirurško je liječenje potrebno u 25 do 45,5 % bolesnika koji nakon provedenog neoperacijskog
liječenja nisu zadovoljni ishodom. Danas raste popularnost minimalno invazivnih
kirurških postupaka koji omogućuju bržu rehabilitaciju, manji morbiditet i brži povratak svakodnevnim
aktivnostima u odnosu na standardni kirurški postupak.
There is a decrease in quadriceps muscle strength in subjects with patellofemoral pain syndrome. Various types of strengthening exercises of the quadriceps are done as part of its management, but the ...effect of isotonic eccentric quadriceps muscle exercises on patellofemoral pain syndrome has not been studied. Hence the aim of this exploratory pilot study was to evaluate the effect of eccentric quadriceps training in patients with patellofemoral pain.
Twenty patients (12 female and 8 male, mean ages, 27.50 +/- 6.6 years) with patellofemoral pain syndrome were treated. The eccentric training of the quadriceps was given using a Baltimore Therapeutic Equipment (BTE) Primus machine. The main outcome measures used were percentage time on target as shown by the BTE primus machine, SF-36 Health questionnaire and patellofemoral pain severity scale. Statistical analysis was performed using SPSS 13.
All the outcome measures showed significant improvements (P<0.05). Percentage time on target improved with a mean difference of 23.6, the SF-36 questionnaire showed an improvement in physical component score, mental component score and bodily pain with a mean difference of 10.9, 2.6 and 29.2 respectively and pain score when taken using patellofemoral severity scale also improved with a mean difference of 3.4.
Isotonic eccentric training of quadriceps muscles was found to be effective in reducing pain and improving the functional status of patients with patellofemoral pain syndrome and can be suggested as part of the treatment.
Abstract Eccentric contractions of jaw-closing muscles are difficult to perform. This may explain why fatigue-inducing experiments performed so far suggest the jaw-closing muscles to be fatigue ...resistant. Aim of this study was to construct an apparatus that can impose intense eccentric contractions to the jaw-closing muscles, and to test the hypothesis that eccentric contractions can provoke symptoms of delayed-onset muscle soreness (DOMS) in these muscles. The provocation apparatus consists of two tungsten arms connected by a hinge axis on one end. Participants bite with their anterior teeth on biting plates located on the other end. Each time the experimenter gradually releases the compression force of the apparatus’ rubber tubings, the mouth is forced open and the jaw-closing muscles perform an eccentric contraction. Six male participants performed eccentric contractions of their jaw-closing muscles in six sets of exercises, each lasting 5 min, and with 1 min of rest in between. Each set consisted of 60 open-close movements. Before and after the exercises, and after 24 h, 48 h, and 1 week, feelings of fatigue and pain, the maximum mouth opening without pain, muscles’ tenderness to palpation and the maximum voluntary bite force were recorded. After 24 h and 48 h, the levels of fatigue and pain were elevated, the maximum mouth opening without pain was smaller, and five of the participants reported tenderness to palpation. The maximum voluntary bite force was also smaller after 24 h. These findings indicate that this novel apparatus is successful in inducing DOMS in the jaw-closing muscles.
Rehabilitation protocols involving eccentric resistance exercise performed with loading more than 100% concentric 1-repetition maximum are effective in increasing muscle function in both healthy and ...injured populations. The mode of eccentric exercise (isokinetic versus isotonic) may be an important factor in limiting symptoms of delayed-onset muscle soreness and in improving muscle function after training.
To compare functional and symptomatic responses after an eccentric-only (ECC) isotonic exercise protocol and after a combined concentric-eccentric (CON-ECC) isokinetic exercise protocol matched for total exercise volume.
Observational study.
Controlled research laboratory.
Twenty-four healthy, untrained, college-aged men (n = 12) and women (n = 12).
Participants were randomly assigned to the ECC isotonic or CON-ECC isokinetic exercise group and performed a single bout of resistance exercise involving the elbow flexors.
Measurements of elbow flexion and extension, isometric strength, and muscle point tenderness were obtained before exercise (baseline) and during follow-up sessions (days 2, 4, 7, and 14). Separate 1-way analyses of variance and repeated-measures analyses of variance were used to determine outcome differences. Tukey post hoc testing was performed when indicated.
At baseline, no differences were present between groups for any measure. The ECC isotonic exercise protocol resulted in a 30% to 36% deficit in muscle strength, a 5% to 7% reduction in elbow flexion, and a 6% to 8% reduction in elbow extension at follow-up days 2 and 4 (P < .01). The CON-ECC isokinetic exercise protocol did not alter muscle strength or range of motion at any time when compared with baseline. Muscle point tenderness increased from baseline on days 2 and 4 in both groups (P < .05) but was not different between groups throughout the recovery period.
Our results indicated more pronounced functional deficits occurred after a single bout of ECC isotonic exercise than with a CON-ECC isokinetic exercise protocol matched for training volume.
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.
Eleven healthy volunteers took part in three sessions where computer work was performed for 10 min in each session. The recordings were made on two consecutive days. After the first session, the ...subjects underwent a series of high intensity eccentric exercises of shoulder elevation to induce muscle soreness. The second session was performed immediately after the exercises and third session 24 hours after the exercise. Surface electromyography (EMG) of descending and ascending trapezius, deltoideus anterior and serratus anterior was recorded. Exposure variation analysis (EVA) centroid and marginal distribution was computed. Principle component analysis (PCA) was performed on both cases. Describing more than 80% of variance, first eight components for EVA marginal distributions and first four ones for EVA centroid were picked to be investigated. The sole EVA amplitude levels played a practically significant role to describe the variation in EVA marginal distribution. However, a significant pattern of load redistribution to superficial muscles was not found. This may suggest investigating the role of deep muscles in redistribution of load during computer work in response to high level eccentric contractions.
Aim: To verify whether "Eccentric muscle training of quadriceps
femoris muscle in athletes will be effective in minimizing the
incidence and severity of delayed onset muscle soreness (DOMS)". Long
...distance runners suffer with delayed onset muscle soreness. Many
interventions have been tried and reported. Methods : Forty long
distance male runners between 18-25 years of age were included in this
study. They were equally categorized in two groups. Control group
consisted of the subjects who were given only stretching exercises. The
experimental group was given eccentric repetitive low intensity
eccentric muscle training of quadriceps femoris muscle along with
stretching exercises. Visual Analog Scale (VAS) pain scale and
Functional Independence Measure Score (FIMS) were used as prognostic
tools. The data collected was analyzed with the help of unpaired "t"
test and chi square test. Results : Experimental group showed
improvement in pain scale compared to control group (t value= 2.02 at
p< 0.05). FIMS showed significant improvement in experimental group
(t value= 2.02 at p< 0.05). Conclusion: Eccentric training of
quadriceps femoris muscle can be incorporated into warm up program for
the long distance runners to reduce delayed onset muscle soreness.
Tendinopathy is a disorder increasing in prevalence and its treatment involves a huge effort from patient and therapist.
Despite the extent of the disorder-targeted therapies has been limited due to ...lack of knowledge of the underlying pathophysiology.
Repetitive loading and intrinsic risk factors, such as genetic variants of matrix proteins, neuronal dysregulation, and metabolic disorders contribute to the development of tendinopathy.
Tendinosis is a fibrotic, failed healing response associated with pathological vessel and sensory nerve ingrowth. Aberrant sensory nerve sprouting may partly cause nociception and partly, by release of neuronal mediators contribute to causing the fibrosis.
Eccentric exercise should be the basis of treatment, and can be combined with other modalities of treatment with less scientific evidence. Novel targeted therapies are emerging, for example, mini-operative procedures, but multicenter trials are needed to prove their clinical effectiveness.
U današnje vrijeme rabe se različiti načini liječenja
skakačkog koljena, od kojih sve više na popularnosti
dobivaju metode neoperacijskog liječenja. Ekscentrične
vježbe su jedna od najčešće ...korištenih metoda
neoperacijskog liječenja skakačkog koljena, a zasnivaju
se na polaganom izvođenju kontrakcije mišića pri čemu
se, za razliku od koncentričnih vježbi, mišićna vlakna
produžuju, a ne skraćuju. Istraživanja provedena tijekom
proteklog desetljeća, u kojima se uspoređuju rezultati
dobiveni ekscentričnim načinom vježbanja s rezultatima
drugih metoda liječenja uglavnom govore u prilog
provođenju liječenja ekscentričnim vježbama. Cilj ovog
rada je uputiti na provođenje ekscentričnih vježbi kao
jedne od mogućnosti neoperacijskog liječenja skakačkog
koljena te prikazati naš program provođenja tih vježbi
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