Effects of plyometric training on passive stiffness of gastrocnemii muscles and Achilles tendon

Plyometric Training Practices of Brazilian Olympic Sprint and Jump Coaches: Toward a Deeper Understanding of Their Choices and Insights

Plyometric training is extensively used by coaches to enhance neuromuscular performance in a wide variety of sports. Due to the high demands of sprint speed and power output in elite sprinters and jumpers, sprint and jump coaches are likely to have great knowledge on this topic. Undoubtedly, this expertise is even more pronounced for Olympic coaches, who work with some of the fastest and most powerful athletes in the world, and who are required to continually maintain these athletes at optimal performance levels. Describing and discussing the practices commonly adopted by these coaches in detail and extrapolating this experience to other sport coaching contexts and disciplines may be extremely relevant. The current article presents, explores, and illustrates the plyometric training practices of Brazilian Olympic sprint and jump coaches, with a special focus on training programming and exercise selection.

Meta-Analysis of the Effects of Plyometric Training on Lower Limb Explosive Strength in Adolescent Athletes

BACKGROUND

Plyometric training is an effective training method to improve explosive strength. However, the ability to perform plyometric training in the adolescent population is still controversial, with insufficient meta-analyses about plyometric training on lower limb explosive strength in adolescent athletes.

OBJECTIVE

To investigate the influence of plyometric training on the explosive strength of lower limbs in adolescent athletes.

METHODS

We performed a search of six databases (Web of Science, PubMed, Scopus, ProQuest databases, China National Knowledge Infrastructure (CNKI), and Wan-fang database) from the starting year of inclusion in each database to April 4, 2022. The quality of the included literature was assessed using the Cochrane risk assessment tool, and data were analyzed using the Review Manager 5.4 software.

RESULT

Plyometric training had significant effects on the performance of adolescent athletes in countermovement jump (MD = 2.74, 95% CI: 1.62, 3.85, p < 0.01), squat jump (MD = 4.37, 95% CI: 2.85, 5.90, p < 0.01), standing long jump (MD = 6.50, 95% CI: 4.62, 8.38, p < 0.01), 10-m sprint (MD = -0.04, 95% CI: -0.08, -0.00, p = 0.03), and 20-m sprint (MD = -0.12, 95% CI: -0.20, -0.04, p = 0.03); all had positive and statistically significant effects (p < 0.05).

CONCLUSION

Plyometric training can significantly enhance the explosive strength of lower limbs in adolescent athletes.

Effects of Plyometric Training on Physical Performance: An Umbrella Review

BACKGROUND

Plyometric training can be performed through many types of exercises involving the stretch-shortening cycle in lower limbs. In the last decades, a high number of studies have investigated the effects of plyometric training on several outcomes in different populations.

OBJECTIVES

To systematically review, summarize the findings, and access the quality of published meta-analyses investigating the effects of plyometric training on physical performance.

DESIGN

Systematic umbrella review of meta-analyses.

DATA SOURCES

Meta-analyses were identified using a systematic literature search in the databases PubMed/MEDLINE, Scopus, SPORTDiscus, Web of Science, Cochrane Library and Scielo.

ELIGIBILITY CRITERIA FOR SELECTING META-ANALYSES

Meta-analyses that examined the effects of plyometric training on physical fitness in different populations, age groups, and sex.

RESULTS

Twenty-nine meta-analyses with moderate-to-high methodological quality were included in this umbrella review. We identified a relevant weakness in the current literature, in which five meta-analyses included control group comparisons, while 24 included pre-to-post-effect sizes. Trivial-to-large effects were found considering the effects of plyometric training on physical performance for healthy individuals, medium-trivial effects for the sports athletes' groups and medium effects for different sports athletes' groups, age groups, and physical performance.

CONCLUSION

The available evidence indicates that plyometric training improves most related physical fitness parameters and sports performance. However, it is important to outline that most meta-analyses included papers lacking a control condition. As such, the results should be interpreted with caution. PROSPERO number: CRD42020217918.

Effects of Different Long-Term Exercise Modalities on Tissue Stiffness

Stiffness is a fundamental property of living tissues, which may be modified by pathologies or traumatic events but also by nutritional, pharmacological and exercise interventions. This review aimed to understand if specific forms of exercise are able to determine specific forms of tissue stiffness adaptations. A literature search was performed on PubMed, Scopus and Web of Science databases to identify manuscripts addressing adaptations of tissue stiffness as a consequence of long-term exercise. Muscular, connective, peripheral nerve and arterial stiffness were considered for the purpose of this review. Resistance training, aerobic training, plyometric training and stretching were retrieved as exercise modalities responsible for tissue stiffness adaptations. Differences were observed related to each specific modality. When exercise was applied to pathological cohorts (i.e. tendinopathy or hypertension), stiffness changed towards a physiological condition. Exercise interventions are able to determine tissue stiffness adaptations. These should be considered for specific exercise prescriptions. Future studies should concentrate on identifying the effects of exercise on the stiffness of specific tissues in a broader spectrum of pathological populations, in which a tendency for increased stiffness is observed.

Mechanical, Material and Morphological Adaptations of Healthy Lower Limb Tendons to Mechanical Loading: A Systematic Review and Meta-Analysis

BACKGROUND

Exposure to increased mechanical loading during physical training can lead to increased tendon stiffness. However, the loading regimen that maximises tendon adaptation and the extent to which adaptation is driven by changes in tendon material properties or tendon geometry is not fully understood.

OBJECTIVE

To determine (1) the effect of mechanical loading on tendon stiffness, modulus and cross-sectional area (CSA); (2) whether adaptations in stiffness are driven primarily by changes in CSA or modulus; (3) the effect of training type and associated loading parameters (relative intensity; localised strain, load duration, load volume and contraction mode) on stiffness, modulus or CSA; and (4) whether the magnitude of adaptation in tendon properties differs between age groups.

METHODS

Five databases (PubMed, Scopus, CINAHL, SPORTDiscus, EMBASE) were searched for studies detailing load-induced adaptations in tendon morphological, material or mechanical properties. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated and data were pooled using a random effects model to estimate variance. Meta regression was used to examine the moderating effects of changes in tendon CSA and modulus on tendon stiffness.

RESULTS

Sixty-one articles met the inclusion criteria. The total number of participants in the included studies was 763. The Achilles tendon (33 studies) and the patella tendon (24 studies) were the most commonly studied regions. Resistance training was the main type of intervention (49 studies). Mechanical loading produced moderate increases in stiffness (standardised mean difference (SMD) 0.74; 95% confidence interval (CI) 0.62-0.86), large increases in modulus (SMD 0.82; 95% CI 0.58-1.07), and small increases in CSA (SMD 0.22; 95% CI 0.12-0.33). Meta-regression revealed that the main moderator of increased stiffness was modulus. Resistance training interventions induced greater increases in modulus than other training types (SMD 0.90; 95% CI 0.65-1.15) and higher strain resistance training protocols induced greater increases in modulus (SMD 0.82; 95% CI 0.44-1.20; p = 0.009) and stiffness (SMD 1.04; 95% CI 0.65-1.43; p = 0.007) than low-strain protocols. The magnitude of stiffness and modulus differences were greater in adult participants.

CONCLUSIONS

Mechanical loading leads to positive adaptation in lower limb tendon stiffness, modulus and CSA. Studies to date indicate that the main mechanism of increased tendon stiffness due to physical training is increased tendon modulus, and that resistance training performed at high compared to low localised tendon strains is associated with the greatest positive tendon adaptation. PROSPERO registration no.: CRD42019141299.

Efectos de los ejercicios pliométricos en pacientes postoperatorio de rotura del tendón calcáneo

De la ruptura del tendón Aquileo se tiene conocimiento desde la antigua Grecia, la cual ha ido en aumento en los últimos años, por ende, se busca implementar mejores herramientas para el tratamiento de la misma, siendo una de ellas los ejercicios pliométricos. Estudios tipo meta-análisis, ensayos controlados aleatorizados y experimentales observaron que la aplicación de ejercicios pliométricos en la mayoría de los participantes mejoraba la calidad del tendón, aumentando elasticidad y disminuyendo su rigidez  (p<0.01) en 14 estudios y en los 3 estudios restantes, no mejoraba la estructura del tendón, sin embargo, mejoraba la sintomatología y funcionalidad del mismo en estudios tardíos (p<0.01). La aplicación de ejercicios pliométricos es una herramienta adicional para tratar a los sujetos sometidos a una operación de ruptura de tendón Aquileo, el cual debe ser aplicado en estadios finales en rehabilitación, mejorando la rigidez del tejido, aumentando la funcionalidad y disminuyendo el dolor crónico.

Effect of Plyometric Jump Training on Skeletal Muscle Hypertrophy in Healthy Individuals: A Systematic Review With Multilevel Meta-Analysis

Objective: To examine the effect of plyometric jump training on skeletal muscle hypertrophy in healthy individuals.

Methods: A systematic literature search was conducted in the databases PubMed, SPORTDiscus, Web of Science, and Cochrane Library up to September 2021.

Results: Fifteen studies met the inclusion criteria. The main overall finding (44 effect sizes across 15 clusters median = 2, range = 1–15 effects per cluster) indicated that plyometric jump training had small to moderate effects [standardised mean difference (SMD) = 0.47 (95% CIs = 0.23–0.71); p < 0.001] on skeletal muscle hypertrophy. Subgroup analyses for training experience revealed trivial to large effects in non-athletes [SMD = 0.55 (95% CIs = 0.18–0.93); p = 0.007] and trivial to moderate effects in athletes [SMD = 0.33 (95% CIs = 0.16–0.51); p = 0.001]. Regarding muscle groups, results showed moderate effects for the knee extensors [SMD = 0.72 (95% CIs = 0.66–0.78), p < 0.001] and equivocal effects for the plantar flexors [SMD = 0.65 (95% CIs = −0.25–1.55); p = 0.143]. As to the assessment methods of skeletal muscle hypertrophy, findings indicated trivial to small effects for prediction equations [SMD = 0.29 (95% CIs = 0.16–0.42); p < 0.001] and moderate-to-large effects for ultrasound imaging [SMD = 0.74 (95% CIs = 0.59–0.89); p < 0.001]. Meta-regression analysis indicated that the weekly session frequency moderates the effect of plyometric jump training on skeletal muscle hypertrophy, with a higher weekly session frequency inducing larger hypertrophic gains [β = 0.3233 (95% CIs = 0.2041–0.4425); p < 0.001]. We found no clear evidence that age, sex, total training period, single session duration, or the number of jumps per week moderate the effect of plyometric jump training on skeletal muscle hypertrophy [β = −0.0133 to 0.0433 (95% CIs = −0.0387 to 0.1215); p = 0.101–0.751].

Conclusion: Plyometric jump training can induce skeletal muscle hypertrophy, regardless of age and sex. There is evidence for relatively larger effects in non-athletes compared with athletes. Further, the weekly session frequency seems to moderate the effect of plyometric jump training on skeletal muscle hypertrophy, whereby more frequent weekly plyometric jump training sessions elicit larger hypertrophic adaptations.

Sex-related differences and effects of short and long trail running races on resting muscle-tendon mechanical properties

The purpose of the study was to assess sex-related differences in resting mechanical properties and adaptations of skeletal muscles and tendons in response to trail running races of different distances using multi-site shear wave elastography assessments of the lower limb, force capacity and blood analyses. Sex differences in resting mechanical properties of knee extensor and plantar flexor muscles and tendons were characterized by shear wave velocity measurements in healthy males (N=42) and females (N=25) trained in long distance running. Effects of running distance on muscle and tendon properties were assessed in short (<60km, N=23) vs. long (>100km, N=26) distance races. Changes in isometric maximal voluntary contraction torque, serum C-reactive protein and creatine kinase activity were also quantified after running races. Higher shear wave velocity of relaxed triceps surae muscle was detected in females as compared to males before running races (+4.8%, p=0.006), but the significant increases in triceps surae muscle group (+7.0%, p=0.001) and patellar tendon shear wave velocity (+15.4%, p=0.001) after short-distance races were independent of sex. A significant decrease in triceps surae muscle shear wave velocity was found after long-distance races in the whole experimental population (-3.1%, p=0.049). Post-races increase in C-reactive protein and creatine kinase activity were significantly correlated to the relative decreases in triceps surae and quadriceps femoris skeletal muscle shear wave velocity (ρ=-0.56, p=0.001 and ρ=-0.51, p=0.001, respectively). Resting mechanical properties of muscles and tendons are affected by sex, and that adaptations to trail races are related to running distance. Exercise-induced changes in resting skeletal muscle mechanical properties are associated with enhanced indirect markers of inflammation and muscle damage.

Effects of Plyometric Training on Lower Body Muscle Architecture, Tendon Structure, Stiffness and Physical Performance: A Systematic Review and Meta-analysis

BACKGROUND

Plyometric training (PT) has been widely studied in sport science. However, there is no review that determines the impact of PT on the structural variables and mechanical properties of the lower limbs and physical performance.

OBJECTIVE

The aim of this systematic review and meta-analysis was to determine the effects of PT on lower body muscle architecture, tendon structure, stiffness and physical performance.

METHODS

Five electronic databases were analysed. The inclusion criteria were: (1) Availability in English; (2) Experimental studies that included a PT of at least eight sessions; and (3) Healthy adults subjects. Four meta-analyses were performed using Review Manager software: (1) muscle architecture; (2) tendon structure; (3) muscle and tendon stiffness; (4) physical performance.

RESULTS

From 1008 search records, 32 studies were eligible for meta-analysis. Muscle architecture meta-analysis found a moderate effect of PT on muscle thickness (Standard Mean Difference (SMD): 0.59; [95% Confidence Interval (CI) 0.47, 0.71]) and fascicle length (SMD: 0.51; [95% CI 0.26, 0.76]), and a small effect of PT on pennation angle (SMD: 0.29; [95% CI 0.02, 0.57]). The meta-analysis found a moderate effect of PT on tendon stiffness (SMD: 0.55; [95% CI 0.28, 0.82]). The lower body physical performance meta-analysis found a moderate effect of PT on jumping (SMD: 0.61; [95% CI 0.47, 0.74]) and strength (SMD: 0.57; [95% CI 0.42, 0.73]).

CONCLUSION

PT increased the thickness, pennation angle and fascicle length of the evaluated muscles. In addition, plyometrics is an effective tool for increasing tendon stiffness and improving jump and strength performance of the lower body.

Preseason weight-bearing ankle dorsiflexion in male professional football players with and without a history of severe ankle injury: A novel analysis in an English Premier League club

OBJECTIVES

Ankle injuries are common in professional football and have profound player/team/club consequences. The weight-bearing lunge-test (WBLT) assesses ankle dorsiflexion range-of-motion in football primary/secondary injury prevention and performance contexts. Data for uninjured and previously ankle-injured players in the English Premier League (EPL) is not available. This study analysed WBLT measurements (cm) within and between uninjured and previously severe ankle-injured players (injured-stiff group, injured-lax group) in one EPL club.

DESIGN

Cross-sectional.

SETTING

Preseason.

PARTICIPANTS

Forty-nine players (age 22.9 ± 4.6 yr; height 181.6 ± 5.2 cm; mass 77.7 ± 7.6 kg).

MAIN OUTCOME MEASURES

Prevalence (%) of previous unilateral severe ankle injury (USAI). Side-to-side (right/left, dominant/nondominant, injured/uninjured) WBLT comparisons at group-level (t-test [within-group]; Welch's ANOVA [between-group]; effect sizes [within-/between-group]) and individual-level (limb symmetry index [%]; absolute-asymmetry [%]).

RESULTS

Prevalence of USAI was 38.7%. There were no statistically-significant side-to-side differences for within-/between-group comparisons. Effect sizes: just-below-large (injured-stiff) and extremely-large (injured-lax) for within-group injured-side/uninjured-side comparisons; just-below-medium (injured-lax) to just-above-medium (injured-stiff) for injured-side comparisons to uninjured players. Absolute-asymmetries: uninjured players, 15.4±13.2%; injured-stiff, 21.8±33.6%; injured-lax 20.4±13.6%.

CONCLUSIONS

Over one-third of players had previous USAI. Effect sizes indicate substantial within-group side-to-side differences and less substantial between-group differences. Across groups, some players had absolute-asymmetries that may elicit concern in ankle primary/secondary injury prevention and performance contexts.

Reliability of Human Achilles Tendon Stiffness Measures Using Freehand 3-D Ultrasound

Achilles tendon (AT) stiffness is an important property of both human locomotor performance and injury mechanics. Freehand 3-D ultrasound (3-DUS) is a promising method for measuring stiffness of the Achilles tendon, particularly the free AT (2-6 cm proximal to calcaneus), which is commonly injured. The aim of this study was to investigate the test-retest reliability of freehand 3-DUS in measuring free AT stiffness in humans. The free Achilles tendon length of healthy participants (n = 10) was scanned on the same day on two consecutive occasions (1 h apart) during rest and isometric plantar flexion contractions at 20%, 40% and 60% of maximum force. The slope of the force-elongation curve over these force levels represented individual stiffness (N/mm). Relative reliability was assessed using the intra-class correlation coefficient (ICC), and absolute reliability was estimated with the standard error of measurement (SEM) and smallest detectable change. Systematic bias in stiffness measures was explored by comparing test and retest distributions and Bland-Altman plots. The test-retest reliability of free AT stiffness measured using freehand 3-DUS was excellent [ICC = 0.994, 95% confidence interval [CI]: 0.978-0.999)]. The mean stiffness values at test (361.83 N/mm [170.77]) and retest (364.98 N/mm [168.57]) did not significantly differ (p = 0.72), and the smallest detectable change was 52.14 N/mm. The Bland-Altman plot indicated the absence of systematic bias (95% CI: -22.18 to 15.88). Freehand 3-DUS provides reliable and precise measures of tendon stiffness and can be used to detect small changes in free AT stiffness in response to load or tendon pathology.

The influence of lower limb plyometric and resistance training on the stiffness of Achilles and patellar tendons in recreational athletes

Study aim: This study aimed to investigate the influence of combined plyometric and resistance training of lower limbs when administered for a shorter duration of six weeks on the stiffness of Achilles and patellar tendons as well as the jump height.

Materials and methods: Twenty recreational athletes were administered six weeks of a single session of lower limb resistance training and one session of plyometric training every week for a total duration of six weeks. Tendon stiffness was measured using MyotonPro, and vertical jump height was derived from the force plate at baseline and six weeks after the intervention.

Results: There was a statistically significant difference (p < 0.01) between the baseline and post-training measures of patellar and Achilles tendons stiffness as well as the squat jump (SJ) and countermovement jump (CMJ) height.

Conclusion: Both resistance and plyometric training may be incorporated into the training session as combined training showed significant improvements in jump height and tendon stiffness after six weeks of combined RT and PT.

The Time-Course of Changes in Muscle Mass, Architecture and Power During 6 Weeks of Plyometric Training

Purpose

To investigate the time-course of changes in knee-extensors muscle mass, architecture and function in response to plyometric training (PLT) performed on a novel training device, the Tramp-Trainer. This machine consists in a trampoline connected to an inclined sledge which allows the performance of repeated jumps while the subject is sitting on a chair.

Methods

Eight healthy males (173.6 ± 4.7 cm, 69.7 ± 13.5 kg, 25.3 ± 4.6 years) underwent 6 weeks of bilateral PLT on the tramp-trainer machine. Training was performed three times per week (between 120 and 150 bounces per session). Knee-extensor maximum voluntary torque (MVT) and power, quadriceps femoris (QF) volume (VOL), cross-sectional area from the 20% to the 60% of femur length and CSA_mean, together with vastus lateralis (VL) architecture (fascicle length, Lf, and pennation angle, PA) were assessed after 2, 4, and 6 weeks of PLT.

Results

All results are presented as changes versus baseline values. MVT increased by 17.8% (week 2, p < 0.001) and 22.2% (week 4, p < 0.01), respectively, and declined to 13.3% (p < 0.05) at week 6 of PLT. Power increased by 18.2% (week 4, p < 0.05) and 19.7% (week 6, p < 0.05). QF VOL increased by 4.7% (week 4, p < 0.05) and 5.8% (week 6, p < 0.01); VL VOL increased by 5.2%, (p < 0.05), 8.2%, (p < 0.01), and 9.6% (p < 0.05) at weeks 2, 4, and 6, respectively. An increase in Lf was detected already at wk 2 (2.2%, p < 0.05), with further increase at 4 and 6 weeks of PLT (4 and 4.4%, respectively, p < 0.01). PA increased by 5.8% (p < 0.05) at week 6. Significant positive correlations were found between CSA_mean and Power (R² = 0.46, p < 0.001) and between QF VOL and Power (R² = 0.44, p < 0.024).

Conclusions

PLT induced rapid increases in muscle volume, fascicle length, pennation angle, torque and power in healthy younger adults. Notably, changes in VL VOL and Lf were detectable already after 2 weeks, followed by increases in knee extensors VOL and power from week 4 of PLT. Since the increase in CSA_mean and QF VOL cannot fully explain the increment in muscle power, it is likely that other factors (such as adaptations in neural drive or tendon mechanical properties) may have contributed to such fucntional changes.

The Effect of Strength Training on Vastus Lateralis' Stiffness: An Ultrasound Quasi-Static Elastography Study

Ultrasound imaging allows the evaluation of musculoskeletal morphology and function. Ultrasound elastography can also offer semi-quantitative and/or quantitative assessment of tissue stiffness providing relevant information about adaptations of skeletal muscle mechanical properties. In this study we aimed to explore the feasibility of elastography ultrasound imaging in assessing the effect of strength training on vastus lateralis stiffness. Twenty-eight young male adults were separated in a control (n = 9) and strength-training (n = 20) groups. The strength-training group completed 15 weeks of either concentric (n = 10) or eccentric (n = 10) isokinetic training of the knee extensors. Ultrasound scans of the vastus lateralis for quasi-static elastography were collected. All image acquisitions and measurements were done by the same experienced sonographer. After 15 weeks, knee maximal extension isometric torque increased in the strength-training groups. After strength training, there was a decrease in the amount of red pixels in vastus lateralis region of interest [F_(1,18) = 25.490; p < 0.001; η² = 0.586], whereas the amount of green and blue pixels increased F_(1,18) = 17.179; p < 0.01; η² = 0.488; F_(1,18) = 6.522; p < 0.05; η² = 0.266], suggesting higher vastus lateralis stiffness. We conclude that concentric and eccentric strength training increases skeletal muscle stiffness, which can be evaluated by quasi-static elastography. Ultrasound elastography is suitable for non-invasive evaluation of skeletal muscle functional adaptations, which can be of importance for sports medicine and in designing optimal training and rehabilitation programs.

Effect of 4-week cyclic stretching program on muscle properties and physical performance in healthy adult men

BACKGROUND

The short-term effect of cyclic stretching (CS) has been found to decrease muscle hardness and improve physical performance. However, the long-term effect of CS program was unclear. This study investigated the long-term effect of CS program on muscle properties and physical performance.

METHODS

Eighteen healthy men participated in this study. The participants were assigned randomly to either the CS or control group (9 participants in each group) to conduct 2 min CS of the plantar flexor muscles 5 times a week for 4 weeks. Before and after intervention, the gastrocnemius medialis muscle hardness, muscle-tendon joint (MTJ) angle, and MTJ displacement (ΔMTJ) were measured as indices of muscle properties. In addition, the maximum range of motion of ankle dorsiflexion (ROM max), normalized maximum peak torque of plantar flexor (NPT), vertical jump height, and dynamic postural stability, dynamic postural stability index (DPSI) were measured as indices of physical performance.

RESULTS

The CS program was found to significantly decrease muscle hardness and increase vertical jump height and ROM max, but not to change the MTJ angle, ΔMTJ, NPT, and DPSI.

CONCLUSIONS

The results of our study suggested that long-term CS program was effective in decreasing muscle hardness and increasing vertical jump height.

Objective assessment of stiffness in the gastrocnemius muscle in patients with symptomatic Achilles tendons

OBJECTIVES

To establish quantitative values of stiffness for the gastrocnemius muscle in patients diagnosed with Achilles tendinopathy.

DESIGN

Case-control study with a single (cross sectional) time point of patients diagnosed with unilateral Achilles tendinopathy and an asymptomatic group.

METHODS

Sample of 50 participants: 25 participants with symptomatic unilateral Achilles tendinopathy (symptomatic group) with the asymptomatic side of this group used as a control (control group 1). A third group of 25 participants with asymptomatic Achilles tendons (control group 2). Mechanical stiffness parameters, including natural oscillation frequency (F), dynamic stiffness (S), mechanical stress relaxation time (R), logarithmic decrement (D) and creep (C), were assessed using the MyotonPRO. Measurements at the medial and lateral gastrocnemii were taken as non-weight bearing (NWB) and weight bearing (WB).

RESULTS

Significant (p<0.05) differences were observed between the mean symptomatic group and control groups 1 and 2 in the WB and NWB conditions for natural oscillation frequency (F), dynamic stiffness (S), and creep (C). There was a significant reduction in S WB and conversely a significant increase in S of the symptomatic group NWB. Creep (C) and mechanical stress relaxation time (R) were significantly (p<0.05) less in the symptomatic group NWB. Significant differences were observed between the NWB and WB data sets for logarithmic decrement (D). NWB D demonstrated significantly (p<0.05) higher scores than the WB condition.

CONCLUSION

This study demonstrated that there was a significant reduction in stiffness of the gastrocnemius muscle in participants with Achilles tendinopathy compared with the two control groups. The WB MyotonPRO measures for the symptomatic groups of F and S were significantly lower, indicating a decrease in the tonal properties (F) and dynamic stiffness (S) of the muscle. The application of MyotonPRO technology to measure changes in stiffness in the gastrocnemius muscle may be useful to measure as part of a rehabilitation programme where specific attention could be placed to increase the tonal properties of the muscle. Further studies are required to develop a robust clinical application of this technology, particularly with regard to Achilles tendinopathy.

Difference of neuromuscular responses by additional loads during plyometric jump

Plyometric training is a training method to increase the motor output, stretch-shortening cycle which could be associated with power output. To increase the neuromuscular output, various training variables have been incorporated in training programs. Weight vest is one of the variables to develop it. However, how much load can effectively develop the neural response is still not clearly understood. The aim of this study was to identify the effects of additional external loads on neuromuscular response of lower body during plyometric jump. Total 19 men performed jump tests with weight vest (two jumps in each additional load; 0%, 10%, 15% and 20% of bodyweight [BW]). During the tests, neuromuscular responses of lower extremity were measured. In vertical jump, 0%BW group was higher than the other heavier loads. In rate of force development (RFD), 10%BW was higher than 15%BW and 20%BW. In 0-30 msec of interval RFD, the heavier load groups were greater than 0%BW and in 0-50 msec, 15%BW and 20%BW were higher than 0%BW. In neuromuscular efficiency (NME), 15%BW and 20%BW were greater than 0%BW in ankle joint. This research indicated that plyometric jump with additional load causes greater RFD and NME of lower extremity compared with jump training without additional load. During weight vest plyometric jump, 10%-20% of BW load is advantageous to NME of lower body and 10% of BW load is effective to develop RFD of lower extremity.

Adaptations in the passive mechanical properties of skeletal muscle to altered patterns of use

The aim of this mini-review is to describe the present state of knowledge regarding the effects of chronic changes in the patterns of muscle use (defined as changes lasting >1 wk), including muscle stretching, strengthening, and others, on the passive mechanical properties of healthy human skeletal muscles. Various forms of muscle stretch training and some forms of strength training (especially eccentric training) are known to strongly impact the maximum elongation capacity of muscles in vivo (i.e., maximum joint range of motion), largely by increasing our ability to tolerate higher stretch loads. However, only small effects are observed in the passive stiffness of the muscle-tendon unit (MTU) or the muscle itself, although a reduction in muscle stiffness has been observed in the plantar flexors after both stretching and eccentric exercise interventions. No changes have yet been observed in viscoelastic properties such as the MTU stress-relaxation response, although a minimum of evidence indicates that hysteresis during passive stretch-relaxation cycles may be reduced by muscle stretching training. Importantly, data exist for relatively few muscle groups, and little is known about the effects of age and sex on the adaptive process of passive mechanical properties. Despite the significant research effort afforded to understanding the effects of altered physical activity patterns on the maximum range of motion at some joints, further information is needed before it will be possible to develop targeted physical activity interventions with the aim of evoking specific changes in passive mechanical properties in individuals or in specific muscles and muscle groups.

Automatic Myotendinous Junction Tracking in Ultrasound Images with Phase-Based Segmentation

Displacement of the myotendinous junction (MTJ) obtained by ultrasound imaging is crucial to quantify the interactive length changes of muscles and tendons for understanding the mechanics and pathological conditions of the muscle-tendon unit during motion. However, the lack of a reliable automatic measurement method restricts its application in human motion analysis. This paper presents an automated measurement of MTJ displacement using prior knowledge on tendinous tissues and MTJ, precluding the influence of nontendinous components on the estimation of MTJ displacement. It is based on the perception of tendinous features from musculoskeletal ultrasound images using Radon transform and thresholding methods, with information about the symmetric measures obtained from phase congruency. The displacement of MTJ is achieved by tracking manually marked points on tendinous tissues with the Lucas-Kanade optical flow algorithm applied over the segmented MTJ region. The performance of this method was evaluated on ultrasound images of the gastrocnemius obtained from 10 healthy subjects (26.0 ± 2.9 years of age). Waveform similarity between the manual and automatic measurements was assessed by calculating the overall similarity with the coefficient of multiple correlation (CMC). In vivo experiments demonstrated that MTJ tracking with the proposed method (CMC = 0.97 ± 0.02) was more consistent with the manual measurements than existing optical flow tracking methods (CMC = 0.79 ± 0.11). This study demonstrated that the proposed method was robust to the interference of nontendinous components, resulting in a more reliable measurement of MTJ displacement, which may facilitate further research and applications related to the architectural change of muscles and tendons.

Effects of Karate Fights on Achilles Tendon Stiffness Measured by Myotonometry

The aim of the study was to investigate the influence of karate fights on Achilles tendon stiffness in karate competitors. Eleven male karate fighters participated in the present study. A handheld MyotonPRO device (MyotonPRO, Myoton Ltd, Estonia) was applied to measure Achilles tendon stiffness in karate fighters. The Achilles tendon was tested 5 cm above the tuber calcanei. Stiffness measurements were performed before and after eight sparring fights. Each fight lasted 2 min and was separated by a 2 min rest period. Achilles tendon stiffness for the dominant leg increased significantly from before fights (751.57 ± 123.493 N/m) to immediately after fights (809.43 ± 160.425 N/m) (p = 0.012). Presented results should be used by strength and conditioning coaches in training programs as a way to decrease the risk of injury.

Short-term Resistance and Plyometric Training Improves Eccentric Phase Kinetics in Jumping

The purpose of this investigation was to examine the effect of an abbreviated resistance and plyometric training program on force- and power-time curve variables during jumping. Nineteen male subjects were assigned to either a training (n = 9) or control group (n = 10). Training consisted of performing 3 sets of 3 repetition squats (90% of 1 repetition maximum [RM]) and 5 sets of 6 repetition drop jumps from 40 cm twice per week for 4 weeks. A 1RM in the squat and countermovement (CMJ) and static jump (SJ) performance was assessed before and after training. Several variables were analyzed for individual subject force- and power-time curves for the jumps. Average force- and power-time curves for all subjects combined were also analyzed. Absolute and relative squat strength significantly increased in training group (p ≤ 0.05). Calculation of variables from individual subject force-time curves during the CMJ indicated a significant decrease in eccentric time, minimum force, and eccentric impulse and significant increase in eccentric rate of force development in training group. Analysis of individual power-time curves in the CMJ also revealed a significant decrease in minimum power and eccentric work and a significant increase in eccentric rate of power development. No significant changes occurred in the variables measured for the SJ. The results of this study indicate that short-term strength and plyometric training may preferentially influence eccentric performance variables during jumping in comparison with longer term training enhancements to the concentric phase performance.

The pectoralis minor muscle and shoulder movement-related impairments and pain: Rationale, assessment and management

The adaptive shortening or tightness of the pectoralis minor muscle (PMm) is one of the potential biomechanical mechanisms associated with altered scapular alignment at rest and scapular motion during arm elevation (scapular dyskinesis) in patients with shoulder complaints. This masterclass briefly reviews the role of the PMm in shoulder movement-related impairments and provides a critical overview of the assessment of PMm tightness and the conventional approaches to increase its resting length and extensibility. A rehabilitation approach focused on PMm stretching and simultaneous optimization of the kinematic chain of arm elevation is also discussed, hoping to improve the management of shoulder movement-related impairments and pain.

Comparing passive angle-torque curves recorded simultaneously with a load cell versus an isokinetic dynamometer during dorsiflexion stretch tolerance assessments

The purpose of the present study was to compare the passive angle-torque curves and the passive stiffness (PS, N m °(-)(1)) values recorded simultaneously from a load cell versus an isokinetic dynamometer during dorsiflexion stretch tolerance assessments in vivo. Nine healthy men (mean ± SD age = 21.4 ± 1.6 years) completed stretch tolerance assessments on a custom-built apparatus where passive torque was measured simultaneously from an isokinetic dynamometer and a load cell. Passive torque values that corresponded with the last 10° of dorsiflexion, verified by surface electromyographic amplitude, were analyzed for each device (θ1, θ2, θ3, …, θ10). Passive torque values measured with the load cell were greater (p ≤ 0.05) than the dynamometer torque values for θ4 through θ10. There were more statistical differentiations among joint angles for passive torque measured by the load cell, and the load cell measured a greater (p ≤ 0.01) increase in passive torque and PS than the isokinetic dynamometer. These findings suggested that when examining the angle-torque curves from passive dorsiflexion stretch tolerance tests, a load cell placed under the distal end of the foot may be more sensitive than the torque recorded from an isokinetic dynamometer.

Mechanical and neural changes in plantar-flexor muscles after spinal cord injury in humans

STUDY DESIGN

Cross-sectional study.

OBJECTIVES

To determine the effect of injury duration on plantar-flexor elastic properties in individuals with chronic spinal cord injury (SCI) and spasticity.

SETTING

National Rehabilitation Center for Persons with Disabilities, Japan.

METHODS

A total of 16 chronic SCI patients (age, 33±9.3 years; injury localization, C6-T12; injury duration, 11-371 months) participated. Spasticity of the ankle plantar-flexors was assessed using the Modified Ashworth Scale (MAS). The calf circumference and muscle thickness of the medial gastrocnemius (MG), lateral gastrocnemius and soleus were assessed using tape measure and ultrasonography. In addition, the ankle was rotated from 10° plantar-flexion to 20° dorsiflexion at 5 deg s(-1) with a dynamometer, and the ankle angle and torque were recorded. After normalizing the data (the initial points of angle and torque were set to zero), we calculated the peak torque and energy. Furthermore, angle-torque data (before and after normalization) were fitted with a second- and fourth-order polynomial, and exponential (Sten-Knudsen) models, and stiffness indices (SISOP, SIFOP, SISK) and AngleSLACK (the angle at which plantar-flexor passive torque equals zero) were calculated. The stretch reflex gain and offset were determined from 0-10° dorsiflexion at 50, 90, 120 and 150 deg s(-1). After logarithmic transformation, Pearson's correlation coefficients were calculated.

RESULTS

MAS, calf circumference, MG thickness, peak torque and SIFOP significantly decreased with injury duration (r log-log=-0.63, -0.69, -0.63, -0.53 and -0.55, respectively, P<0.05). The peak torque and SIFOP maintained significant relationships even after excluding impacts from muscle morphology.

CONCLUSION

Plantar-flexor elasticity in chronic SCI patients decreased with increased injury duration.

Human Achilles tendon plasticity in response to cyclic strain: effect of rate and duration

High strain magnitude and low strain frequency are important stimuli for tendon adaptation. Increasing the rate and duration of the applied strain may enhance the adaptive responses. Therefore, our purpose was to investigate the effect of strain rate and duration on Achilles tendon adaptation. The study included two experimental groups (N=14 and N=12) and a control group (N=13). The participants of the experimental groups exercised according to a reference protocol (14 weeks, four times a week), featuring a high strain magnitude (~6.5%) and a low strain frequency (0.17 Hz, 3 s loading/3 s relaxation) on one leg and with either a higher strain rate (one-legged jumps) or a longer strain duration (12 s loading) on the other leg. The strain magnitude and loading volume were similar in all protocols. Before and after the interventions, the tendon stiffness, Young's modulus and cross-sectional area were examined using magnetic resonance imaging, ultrasound and dynamometry. The reference and long strain duration protocols induced significantly increased (P<0.05) tendon stiffness (57% and 25%), cross-sectional area (4.2% and 5.3%) and Young's modulus (51% and 17%). The increases in tendon stiffness and Young's modulus were higher in the reference protocol. Although region-specific tendon hypertrophy was also detected after the high strain rate training, there was only a tendency of increased stiffness (P=0.08) and cross-sectional area (P=0.09). The control group did not show any changes (P=0.86). The results provide evidence that a high strain magnitude, an appropriate strain duration and repetitive loading are essential components for an efficient adaptive stimulus for tendons.

Immediate effect of exercise on achilles tendon properties: systematic review

INTRODUCTION

Understanding the mechanical and morphological adaptation of the Achilles tendon (AT) in response to acute exercise could have important implications for athletic performance, injury prevention, and rehabilitation. The purpose of this study was to conduct a systematic review and critical evaluation of the literature to determine the immediate effect of a single bout of exercise on the mechanical and morphological properties of the AT in vivo.

METHODS

Five electronic research databases were systematically searched for intervention-based studies reporting mechanical and morphological properties of the AT after a single bout of exercise.

RESULTS

Searches revealed 3292 possible articles; 21 met the inclusion criteria. There is evidence that maximal isometric contractions and prolonged static stretching (>5 min) of the triceps surae complex cause an immediate decrease in AT stiffness, whereas prolonged running and hopping have minimal effect. Limited but consistent evidence exists, indicating that AT hysteresis is reduced after prolonged static stretching. Consistent evidence supports a reduction in free AT diameter (anterior-posterior) after dynamic ankle exercise, and this change appears most pronounced in the healthy tendon and after eccentric exercise.

CONCLUSIONS

The mechanical and morphological properties of the AT in vivo are affected by acute exercise in a mode- and dose-dependent manner. Transient changes in AT stiffness, hysteresis, and diameter after unaccustomed exercise modes and doses may expose the tendon to increased risk of strain injury and impact on the mechanical function of the triceps surae muscle-tendon unit.

Changes in contractile and elastic properties of the triceps surae muscle induced by neuromuscular electrical stimulation training

PURPOSE

Neuromuscular electrical stimulation (NMES) training is known to induce improvement in force production capacities and fibre-type transition. The aim of this study was to determine whether NMES training also leads to changes in the mechanical properties of the human triceps surae (TS) muscle.

METHODS

Fifteen young male subjects performed a training protocol (4 weeks, 18 sessions, 4-5 sessions per week) based on a high-frequency isometric NMES programme of TS muscle. Quick-release test was used to evaluate Musculo-Tendinous (MT) stiffness index (SIMT) as the slope of the linear MT stiffness-torque relationships under submaximal contraction. Sinusoidal perturbations allowed the assessment of musculo-articular stiffness index (SIMA) as well as the calculation of the maximal angular velocity ([Formula: see text]) of TS muscle using an adaptation of Hill's equation.

RESULTS

After NMES training, Maximal Voluntary Contraction under isometric conditions and [Formula: see text] increased significantly by 17.5 and 20.6 %, respectively, while SIMT and SIMA decreased significantly (-12.7 and -9.3 %, respectively).

CONCLUSIONS

These changes in contractile and elastic properties may lead to functional changes of particular interest in sport-related activities as well as in the elderly.

Effects of eccentric training on mechanical properties of the plantar flexor muscle-tendon complex

Eccentric training is a mechanical loading classically used in clinical environment to rehabilitate patients with tendinopathies. In this context, eccentric training is supposed to alter tendon mechanical properties but interaction with the other components of the muscle-tendon complex remains unclear. The aim of this study was to determine the specific effects of 14 wk of eccentric training on muscle and tendon mechanical properties assessed in active and passive conditions in vivo. Twenty-four subjects were randomly divided into a trained group (n = 11) and a control group (n = 13). Stiffness of the active and passive parts of the series elastic component of plantar flexors were determined using a fast stretch during submaximal isometric contraction, Achilles tendon stiffness and dissipative properties were assessed during isometric plantar flexion, and passive stiffness of gastrocnemii muscles and Achilles tendon were determined using ultrasonography while ankle joint was passively moved. A significant decrease in the active part of the series elastic component stiffness was found (P < 0.05). In contrast, a significant increase in Achilles tendon stiffness determined under passive conditions was observed (P < 0.05). No significant change in triceps surae muscles and Achilles tendon geometrical parameters was shown (P > 0.05). Specific changes in muscle and tendon involved in plantar flexion are mainly due to changes in intrinsic mechanical properties of muscle and tendon tissues. Specific assessment of both Achilles tendon and plantar flexor muscles allowed a better understanding of the functional behavior of the muscle-tendon complex and its adaptation to eccentric training.

Influence of overweight on the active and the passive fraction of the plantar flexors series elastic component in prepubertal children

The influence of overweight, as a precursor to obesity, was analyzed on the elastic properties of the triceps surae. Based on body mass index (BMI), children (9 years ± 4 mo) were classified as control (CON; n = 23; BMI -1SD>Z score<1SD) or overweight (OW; n = 21, BMI 1SD>Z score<3SD) with regard to reference data from the World Health Organization. Musculotendinous (MT) stiffness of the series elastic component (SEC) was determined using quick-release tests to obtain 1) the MT stiffness index from the slope of either linear stiffness-torque (SI(MT-Torque)) or stiffness-EMG (SI(MT-EMG)) relationships and 2) passive stiffness from the intercept point with the ordinate. Finally, the SEC active (α(0)) and passive fractions (C(passive)) were separated as described by Morgan (Am J Physiol, 1977), using alpha-torque (α(0-Torque,) C(passive-Torque)) or alpha-EMG (α(0-EMG,) C(passive-EMG)) relationships. No significant differences in SI(MT-Torque) or α(0-Torque) were observed between OW and CON. SI(MT-EMG) or α(0-EMG) values were significantly different between OW and CON, which indicate an increase in MT stiffness. In all cases, passive stiffness (K(p), C(passive-torque), C(passive-EMG)) was significantly greater in OW but independent of the activation capacities. These results indicate that a weight-related additional loading of the MT structures in OW children caused the MT system to response accordingly to the functional demand, i.e., higher stiffness of the MT structures due to a concomitant increase in the stiffness of the SEC passive and active fraction. This study also reveals that possible differences in the activation capacities influence the determination of MT stiffness of the SEC active fraction.