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Nuzzo JL, Pinto MD, Nosaka K. Overview of muscle fatigue differences between maximal eccentric and concentric resistance exercise. Scand J Med Sci Sports 2023; 33:1901-1915. [PMID: 37269142 DOI: 10.1111/sms.14419] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/04/2023]
Abstract
Since the 1970s, researchers have studied a potential difference in muscle fatigue (acute strength loss) between maximal eccentric (ECCmax ) and concentric (CONmax ) resistance exercise. However, a clear answer to whether such a difference exists has not been established. Therefore, the aim of our paper was to overview methods and results of studies that compared acute changes in muscle strength after bouts of ECCmax and CONmax resistance exercise. We identified 30 relevant studies. Participants were typically healthy men aged 20-40 years. Exercise usually consisted of 40-100 isokinetic ECCmax and CONmax repetitions of the knee extensors or elbow flexors. Both ECCmax and CONmax exercise caused significant strength loss, which plateaued and rarely exceeded 60% of baseline, suggesting strength preservation. In upper-body muscles, strength loss at the end of ECCmax (31.4 ± 20.4%) and CONmax (33.6 ± 17.5%) exercise was similar, whereas in lower-body muscles, strength loss was less after ECCmax (13.3 ± 12.2%) than CONmax (39.7 ± 13.3%) exercise. Muscle architecture and daily use of lower-body muscles likely protects lower-body muscles from strength loss during ECCmax exercise. We also reviewed seven studies on muscle fatigue during coupled ECCmax -CONmax exercise and found similar strength loss in the ECC and CON phases. We also found evidence from three studies that more ECC than CON repetitions can be completed at equal relative loads. These results indicate that muscle fatigue may manifest differently between ECCmax and CONmax resistance exercise. An implication of the results is that prescriptions of ECC resistance exercise for lower-body muscles should account for greater fatigue resilience of these muscles compared to upper-body muscles.
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Affiliation(s)
- James L Nuzzo
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Matheus D Pinto
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Kazunori Nosaka
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Boyd L, Deakin GB, Devantier-Thomas B, Singh U, Doma K. The Effects of Pre-conditioning on Exercise-Induced Muscle Damage: A Systematic Review and Meta-analysis. Sports Med 2023; 53:1537-1557. [PMID: 37160563 PMCID: PMC10356650 DOI: 10.1007/s40279-023-01839-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Several studies have utilised isometric, eccentric and downhill walking pre-conditioning as a strategy for alleviating the signs and symptoms of exercise-induced muscle damage (EIMD) following a bout of damaging physical activity. OBJECTIVES This systematic review and meta-analysis examined the effects of pre-conditioning strategies on indices of muscle damage and physical performance measures following a second bout of strenuous physical activity. DATA SOURCES PubMed, CINAHL and Scopus. ELIGIBILITY CRITERIA Studies meeting the PICO (population, intervention/exposure, comparison, and outcome) criteria were included in this review: (1) general population or "untrained" participants with no contraindications affecting physical performance; (2) studies with a parallel design to examine the prevention and severity of muscle-damaging contractions; (3) outcome measures were compared using baseline and post-intervention measures; and (4) outcome measures included any markers of indirect muscle damage and muscular contractility measures. PARTICIPANTS Individuals with no resistance training experiences in the previous 6 or more months. INTERVENTIONS A single bout of pre-conditioning exercises consisting of eccentric or isometric contractions performed a minimum of 24 h prior to a bout of damaging physical activity were compared to control interventions that did not perform pre-conditioning prior to damaging physical activity. STUDY APPRAISAL Kmet appraisal system. SYNTHESIS METHODS Quantitative analysis was conducted using forest plots to examine standardised mean differences (SMD, i.e. effect size), test statistics for statistical significance (i.e. Z-values) and between-study heterogeneity by inspecting I2. RESULTS Following abstract and full-text screening, 23 articles were included in this paper. Based on the meta-analysis, the pre-conditioning group exhibited lower levels of creatine kinase at 24 h (SMD = - 1.64; Z = 8.39; p = 0.00001), 48 h (SMD = - 2.65; Z = 7.78; p = 0.00001), 72 h (SMD = - 2.39; Z = 5.71; p = 0.00001) and 96 h post-exercise (SMD = - 3.52; Z = 7.39; p = 0.00001) than the control group. Delayed-onset muscle soreness was also lower for the pre-conditioning group at 24 h (SMD = - 1.89; Z = 6.17; p = 0.00001), 48 h (SMD = - 2.50; Z = 7.99; p = 0.00001), 72 h (SMD = - 2.73; Z = 7.86; p = 0.00001) and 96 h post-exercise (SMD = - 3.30; Z = 8.47; p = 0.00001). Maximal voluntary contraction force was maintained and returned to normal sooner in the pre-conditioning group than in the control group, 24 h (SMD = 1.46; Z = 5.49; p = 0.00001), 48 h (SMD = 1.59; Z = 6.04; p = 0.00001), 72 h (SMD = 2.02; Z = 6.09; p = 0.00001) and 96 h post-exercise (SMD = 2.16; Z = 5.69; p = 0.00001). Range of motion was better maintained by the pre-conditioning group compared with the control group at 24 h (SMD = 1.48; Z = 4.30; p = 0.00001), 48 h (SMD = 2.20; Z = 5.64; p = 0.00001), 72 h (SMD = 2.66; Z = 5.42; p = 0.00001) and 96 h post-exercise (SMD = 2.5; Z = 5.46; p = 0.00001). Based on qualitative analyses, pre-conditioning activities were more effective when performed at 2-4 days before the muscle-damaging protocol compared with immediately prior to the muscle-damaging protocol, or 1-3 weeks prior to the muscle-damaging protocol. Furthermore, pre-conditioning activities performed using eccentric contractions over isometric contractions, with higher volumes, greater intensity and more lengthened muscle contractions provided greater protection from EIMD. LIMITATIONS Several outcome measures showed high inter-study heterogeneity. The inability to account for differences in durations between pre-conditioning and the second bout of damaging physical activity was also limiting. CONCLUSIONS Pre-conditioning significantly reduced the severity of creatine kinase release, delayed-onset muscle soreness, loss of maximal voluntary contraction force and the range of motion decrease. Pre-conditioning may prevent severe EIMD and accelerate recovery of muscle force generation capacity.
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Affiliation(s)
- Lachlan Boyd
- College of Healthcare Sciences, Sports and Exercise Science, James Cook University, 1 James Cook Drive, Rehabilitation Sciences Building, Douglas, Townsville, QLD, 481, Australia
| | - Glen B Deakin
- College of Healthcare Sciences, Sports and Exercise Science, James Cook University, 1 James Cook Drive, Rehabilitation Sciences Building, Douglas, Townsville, QLD, 481, Australia
| | - Baily Devantier-Thomas
- College of Healthcare Sciences, Sports and Exercise Science, James Cook University, 1 James Cook Drive, Rehabilitation Sciences Building, Douglas, Townsville, QLD, 481, Australia
| | - Utkarsh Singh
- College of Healthcare Sciences, Sports and Exercise Science, James Cook University, 1 James Cook Drive, Rehabilitation Sciences Building, Douglas, Townsville, QLD, 481, Australia
| | - Kenji Doma
- College of Healthcare Sciences, Sports and Exercise Science, James Cook University, 1 James Cook Drive, Rehabilitation Sciences Building, Douglas, Townsville, QLD, 481, Australia.
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Ema R. Unique neuromuscular activation of the rectus femoris during concentric and eccentric cycling. J Electromyogr Kinesiol 2022; 63:102638. [DOI: 10.1016/j.jelekin.2022.102638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 11/16/2022] Open
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Muanjai P, Mickevicius M, Snieckus A, Jones DA, Zachovajevas P, Satkunskiene D, Venckunas T, Kamandulis S. Response of Knee Extensor Muscle-Tendon Unit Stiffness to Unaccustomed and Repeated High-Volume Eccentric Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094510. [PMID: 33922796 PMCID: PMC8122999 DOI: 10.3390/ijerph18094510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/16/2021] [Accepted: 04/22/2021] [Indexed: 12/20/2022]
Abstract
The purposes of this study were to investigate the muscle-tendon unit stiffness response and to compare the stiffness with those of other indirect markers induced by two bouts of unaccustomed eccentric exercise. Eleven untrained men performed two bouts of 200 maximal eccentric contractions of the right quadriceps 4 weeks apart. Changes in stiffness, pain evoked by stretching and pressure, plasma creatine kinase (CK) activity, and muscle thickness were followed for 7 days after each bout. Stiffness and pain peaked immediately and 1 day after the first exercise bout, whereas CK and thickness were highest 4 and 7 days after the first exercise bout, respectively (p < 0.05 for all). Muscular pain, thickness, and stiffness responses were lower by 53.3%, 99%, and 11.6%, respectively, after the repeated bout compared to after the first bout (p < 0.05 for all), while CK activity response did not differ significantly between bouts. High responders for an increase in muscle-tendon unit stiffness showed a repeated-bout effect for stiffness, pain, and CK activity (by 29%, 65%, and 98%, p < 0.05 for all), but the repeated-bout effect was not that clear in low responders. These findings suggest that a repeated eccentric exercise bout effect on stiffness in quadriceps is mostly not associated with muscle pain and CK activity, but there are large individual differences.
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Affiliation(s)
- Pornpimol Muanjai
- Department of Physical Therapy, Allied Health Sciences Faculty, Burapha University, Chonburi 20131, Thailand
- Exercise and Nutrition Innovation and Sciences Research Unit, Burapha University, Chonburi 20131, Thailand
- Correspondence:
| | - Mantas Mickevicius
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (M.M.); (A.S.); (D.A.J.); (D.S.); (T.V.); (S.K.)
| | - Audrius Snieckus
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (M.M.); (A.S.); (D.A.J.); (D.S.); (T.V.); (S.K.)
| | - David A. Jones
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (M.M.); (A.S.); (D.A.J.); (D.S.); (T.V.); (S.K.)
- School of Healthcare Sciences, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Pavelas Zachovajevas
- Department of Applied Biology and Rehabilitation, Lithuanian Sports University, 44221 Kaunas, Lithuania;
| | - Danguole Satkunskiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (M.M.); (A.S.); (D.A.J.); (D.S.); (T.V.); (S.K.)
| | - Tomas Venckunas
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (M.M.); (A.S.); (D.A.J.); (D.S.); (T.V.); (S.K.)
| | - Sigitas Kamandulis
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (M.M.); (A.S.); (D.A.J.); (D.S.); (T.V.); (S.K.)
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Chen TC, Tseng WC, Chen HL, Tseng KW, Chou TY, Huang YC, Nosaka K. Striking muscle adaptations induced by volume-dependent repeated bouts of low-intensity eccentric exercise of the elbow flexors. Appl Physiol Nutr Metab 2021; 46:897-905. [PMID: 33577401 DOI: 10.1139/apnm-2020-1016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We investigated the effects of repeating 30 low-intensity eccentric contractions with a dumbbell corresponding to 10% maximal isometric strength (10%EC) on muscle strength and hypertrophy, and muscle damage after 30 maximal eccentric contractions (MaxEC) of the elbow flexors. Young men were placed into 1 of 3 experimental groups that performed 10%EC either once, twice a week for 4 (8 bouts) or 8 weeks (16 bouts) before MaxEC, or a control group that performed 2 bouts of MaxEC separated by 2 weeks (n = 13/group). Repeating 16 bouts of 10%EC increased (P < 0.05) maximal voluntary contraction strength (30 ± 21%) and muscle thickness (4.2 ± 2.3%) greater than 8 bouts (16 ± 4%, 1.9 ± 1.3%). Changes in the muscle damage markers after MaxEC were smaller (P < 0.05) for the experimental groups than the control group, and the magnitude of muscle damage protection was greater (P < 0.05) after 16 bouts (65 ± 30%) than 8 bouts (55 ± 33%), followed by 1 bout (34 ± 27%). The protection by 16 bouts was similar (P = 0.81) to that shown by the second MaxEC of the control group. These results showed that 10%EC produced potent muscle adaptation effects accumulatively and conferred muscle damage protection, but 1 bout of 10%EC was still effective for conferring approximately 20% of the protection of that by 16 bouts. Novelty: Repeating low-intensity eccentric exercise induces large increases in muscle strength and hypertrophy. Low-intensity eccentric exercise protects muscle damage induced by maximal eccentric contractions, and the protection is reinforced by repeating it. These are especially beneficial for individuals who are frail and cannot tolerate high-intensity resistance training.
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Affiliation(s)
- Trevor C Chen
- Department of Physical Education, National Taiwan Normal University, Taipei City, Taiwan
| | - Wei-Chin Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, Taiwan
| | - Hsin-Lian Chen
- Department of Physical Education, Health and Recreation, National Chiayi University, Chaiyi County, Taiwan
| | - Kuo-Wei Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, Taiwan
| | - Tai-Ying Chou
- Department of Athletic Performance, National Taiwan Normal University, Taipei City, Taiwan
| | - Yuh-Chuan Huang
- Physical Education Office, Ming Chuan University, Taipei City, Taiwan
| | - Kazunori Nosaka
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Western Australia, Australia
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Ho CC, Nosaka K, Tseng KW, Tseng WC, Lau WY, Bogdanis GC, Chen TC. Effect of preconditioning exercise on biceps brachii myotendinous junction displacement during elbow flexor eccentric exercise. Scand J Med Sci Sports 2020; 31:813-825. [PMID: 33349963 DOI: 10.1111/sms.13911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/29/2022]
Abstract
The present study tested the hypothesis that 30 low-intensity (10%) eccentric contractions (10%EC) or two maximal voluntary isometric contractions at a long muscle length (2MVIC) that were performed at two days before maximal eccentric exercise of the elbow flexors consisting of five sets of six maximal eccentric contractions (MaxEC) would reduce increases in biceps brachii distal myotendinous junction displacement (MTJd) over the eccentric contractions during MaxEC. Sedentary young men were randomly placed (n = 12/group) to a control group that performed two bouts of MaxEC (CONT-1st, CONT-2nd) separated by two weeks, or one of two preconditioning groups that performed 10%EC or 2MVIC at 20° elbow flexion at two days prior to MaxEC. All exercises were performed by the non-dominant arm. MTJd of each contraction was assessed by B-mode ultrasound, and its changes over sets were compared among the groups. The average MTJd from the start to the end of six eccentric contractions in the first set was similar among the groups (6.4 ± 0.7 mm). The MTJd increased from the first to fifth set, but the increase was smaller (P < .05) for the 10%EC (13 ± 6%) and 2MVIC (16 ± 9%) groups, and CONT-2nd (3 ± 6%) when compared with CONT-1st (60 ± 12%). Both 10%EC and 2MVIC groups showed smaller (P < .05) changes in all muscle damage markers after MaxEC similarly when compared with CONT-1st, but the changes were greater than those after CONT-2nd. These results supported the hypothesis that protective effect was associated with less MTJd changes, suggesting that this is associated with the mechanisms underpinning the preconditioning effect on muscle damage.
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Affiliation(s)
- Chih-Chiao Ho
- Department of Physical Education, National Taiwan Normal University, Taipei City, Taiwan
| | - Kazunori Nosaka
- School of Medical and Health Sciences, Centre for Exercise and Sports Science Research, Edith Cowan University, Joondalup, WA, Australia
| | - Kou-Wei Tseng
- Department of Exercise and Health Science, University of Taipei, Taipei City, Taiwan
| | - Wei-Chin Tseng
- Department of Exercise and Health Science, University of Taipei, Taipei City, Taiwan
| | - Wing-Yin Lau
- School of Medical and Health Sciences, Centre for Exercise and Sports Science Research, Edith Cowan University, Joondalup, WA, Australia
| | - Gregory C Bogdanis
- School of P.E. & Sport Science, National & Kapodistrian University of Athens, Athens, Greece
| | - Trevor C Chen
- Department of Physical Education, National Taiwan Normal University, Taipei City, Taiwan
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Ma F, Li Y, Yang J, Li X, Zeng N, Martin RL. The effectiveness of low intensity exercise and blood flow restriction without exercise on exercise induced muscle damage: A systematic review. Phys Ther Sport 2020; 46:77-88. [PMID: 32882622 DOI: 10.1016/j.ptsp.2020.08.011] [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] [Received: 04/22/2020] [Revised: 08/15/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the evidence and provide clinical recommendations for low intensity exercises(LIE) and blood flow restriction(BFR) without exercise on reducing the effects of exercise induced muscle damage(EIMD). METHOD PubMed, Embase, Web of science, and PEDro(Physiotherapy Evidence Database) were searched up to December 2019 for studies that included LIE or BFR without exercise and their effect on EIMD. RESULTS Out of 3192 studies, 23 were included with 17 on LIE and 6 on BFR without exercise. 11 studies demonstrated positive effects for LIE on EIMD, with two level 2 and nine level 3 studies. Two level 2 and two level 3 studies found benefits for BFR without exercise on reducing the negative effects of EIMD, while two level 2 studies found did not find benefits for BFR without exercise. CONCLUSION Moderate to low levels of evidence supported LIE, particularly in the form of protective low load eccentric exercise, in reducing the negative effects of EIMD. Conflicting moderate to low levels of evidence was found regarding BFR without exercise. There does seem to be potential benefit for BFR without exercise in untrained individuals. Clinicians can provide clinical recommendations as LIE and BFR without exercise reducing EIMD.
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Affiliation(s)
- Fenghao Ma
- Yangzhi Rehabilitation Hospital, Sunshine Rehabilitation Center, Tongji University School of Medicine, Shanghai, 201619, China; Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.
| | - Yingqi Li
- Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.
| | - Jinchao Yang
- Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.
| | - Xidian Li
- Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.
| | - Na Zeng
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital Research Institution (OHRI), Ottawa, Ontario, Canada.
| | - RobRoy L Martin
- Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA.
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Tseng WC, Nosaka K, Tseng KW, Chou TY, Chen TC. Contralateral Effects by Unilateral Eccentric versus Concentric Resistance Training. Med Sci Sports Exerc 2020; 52:474-483. [PMID: 31524834 DOI: 10.1249/mss.0000000000002155] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Unilateral resistance training increases muscle strength of the contralateral homologous muscle by the cross-education effect. Muscle damage induced by second eccentric exercise bout is attenuated, even when it is performed by the contralateral limb. The present study compared the effects of unilateral eccentric training (ET) and concentric training (CT) of the elbow flexors (EF) on maximal voluntary isometric contraction (MVC) strength and muscle damage of the contralateral untrained EF. METHODS Young men were placed into ET, CT, ipsilateral repeated bout (IL-RB), and contralateral repeated bout (CL-RB) groups (n = 12 per group). The ET and CT groups performed unilateral EF training consisting of five sets of six eccentric and concentric contractions, respectively, once a week for 5 wk by increasing the intensity from 10% to 100% of MVC, followed by 30 maximal eccentric contractions (30MaxEC) of the opposite EF 1 wk later. The IL-RB group performed two bouts of 30MaxEC separated by 2 wk using the nondominant arm, and CL-RB group performed two bouts of 30MaxEC with a different arm for each bout in 1-wk apart. RESULTS The MVC increased (P < 0.05) greater for the trained (19% ± 8%) and untrained (11% ± 5%) arms in ET when compared with those in CT (10% ± 6%, 5% ± 2%). The magnitude of changes in muscle damage markers was reduced by 71% ± 19% after the second than the first bout for IL-RB group, and by 48% ± 21% for CL-RB group. Eccentric training and CT attenuated the magnitude by 58% ± 25% and 13% ± 13%, respectively, and the protective effect of ET was greater (P < 0.05) than CL-RB, but smaller (P < 0.05) than IL-RB. CONCLUSIONS These results showed that cross-education effect was stronger for ET than CT, and progressive ET produced greater contralateral muscle damage protective effect than a single eccentric exercise bout.
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Affiliation(s)
- Wei-Chin Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, TAIWAN
| | - Kazunori Nosaka
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Western Australia, AUSTRALIA
| | - Kuo-Wei Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, TAIWAN
| | - Tai-Ying Chou
- Department of Athletic Performance, National Taiwan Normal University, Taipei City, TAIWAN
| | - Trevor C Chen
- Department of Physical Education, National Taiwan Normal University, Taipei City, TAIWAN
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Barrie B. Concurrent Resistance Training Enhances Performance in Competitive Distance Runners: A Review and Programming Implementation. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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