Le travail musculaire excentrique : intérêts dans la prise en charge thérapeutique du sportif

Acute Inflammatory, Cortisol, and Soreness Responses to Supramaximal Accentuated Eccentric Loading

ABSTRACT

Merrigan, JJ and Jones, MT. Acute inflammatory, cortisol, and soreness responses to supramaximal accentuated eccentric loading. J Strength Cond Res 35(2S): S107-S113, 2021-The purpose was to determine differences in time under tension, cortisol, inflammation, and perceived soreness between accentuated eccentric (AEL) and traditional loading (TRA) resistance exercise protocols. Resistance-trained men (n = 21) completed the AEL and TRA protocols in a random order, separated by 48 hours (sets × reps at eccentric/concentric) as follows: AEL65, 3 × 5 at 120/65% 1 repetition maximum (RM); AEL80, 3 × 3 at 120/80% 1RM; TRA65, 3 × 5 at 65/65% 1RM; and TRA80, 3 × 3 at 80/80% 1RM. Four linear position transducers measured eccentric time under tension (ETUT) and total time under tension (TTUT). Ultrasonography measured vastus lateralis muscle thickness and echo intensity at baseline and immediately post-exercise. Salivary cortisol was assessed at baseline, 0-, 15-, 30-, and 60-minute post-exercise. Perceived soreness was assessed at baseline, 24-, and 48-hours post-exercise. During rep 1, AEL65 and AEL80 had longer ETUT and TTUT than TRA65 (p ≤ 0.002) and TRA80 (p ≤ 0.008), respectively. However, AEL65 had shorter ETUT (reps 3-5) and TTUT (reps 3-5) than TRA65 (p ≤ 0.043). Similarly, ETUT (reps 2-3) and TTUT (rep 3) was shorter in AEL80 than TRA80 (p ≤ 0.045). However, there was no protocol effect for ETUT and TTUT (p > 0.05). Muscle thickness changes were trivial after each protocol (AEL80, d = 0.19; TRA80, d = 0.15; AEL65, d = 0.24; TRA65, d = 0.23), but changes in echo intensity were moderate (AEL80, d = 0.61; TRA80, d = 0.61; AEL65, d = 0.61; TRA65, d = 0.76). Salivary cortisol decreased below baseline at 30- and 60-minute post-exercise (p ≤ 0.006). Perceived soreness elevated from baseline to 24 hours for AEL80 (p = 0.006). The inflammatory, cortisol, and soreness responses after AEL were either low or similar to TRA, indicating similar recovery patterns between protocols.

Impact of Rest-Redistribution on Fatigue During Maximal Eccentric Knee Extensions

Redistributing long inter-set rest intervals into shorter but more frequent rest intervals generally maintains concentric performance, possibly due to improved energy store maintenance. However, eccentric actions require less energy than concentric actions, meaning that shorter but more frequent sets may not affect eccentric actions to the same degree as concentric actions. Considering the increased popularity of eccentric exercise, the current study evaluated the effects of redistributing long inter-set rest periods into shorter but more frequent rest periods during eccentric only knee extensions. Eleven resistance-trained men performed 40 isokinetic unilateral knee extensions at 60°·s-1 with 285 s of total rest using traditional sets (TS; 4 sets of 10 with 95 s inter-set rest) and rest-redistribution (RR; 20 sets of 2 with 15 s inter-set rest). Before and during exercise, muscle oxygenation was measured via near-infrared spectroscopy, and rating of perceived exertion (RPE) was recorded after every 10th repetition. There were no differences between protocols for peak torque (RR, 241.58±47.20 N; TS, 231.64±48.87 N; p=0.396) or total work (RR, 215.26±41.47 J; TS, 209.71±36.02 J; p=0.601), but moderate to large effect sizes existed in later repetitions (6,8,10) with greater peak torque during RR (d=0.66-1.19). For the entire session, RR had moderate effects on RPE (RR, 5.73±1.42; TS, 6.09±1.30; p=0.307; d=0.53) and large effects on oxygen saturation (RR, 5857.4±310.0; TS, 6495.8±273.8; p=0.002, d=2.13). Therefore, RR may maintain peak torque or total work during eccentric exercise, improve oxygen utilization at the muscle, and reduce the perceived effort.

Changes in central and peripheral neuromuscular fatigue indices after concentric versus eccentric contractions of the knee extensors

PURPOSE

To better understand neuromuscular characteristics of eccentric exercise-induced muscle damage, this study compared between concentric (CONC) and eccentric (ECC) exercises of knee extensor muscles, and the first (ECC1) and second bouts of the eccentric exercise (ECC2) for central and peripheral parameters associated with neuromuscular fatigue.

METHODS

Twelve young men performed three exercise bouts separated by at least 1 week between CONC and ECC1, and 2 weeks between ECC1 and ECC2. In each exercise, maximal voluntary concentric or eccentric contractions of the knee extensors were performed until a reduction in maximal voluntary isometric contraction (MVC) torque of at least 40% MVC was achieved immediately post-exercise. MVC torque, central (voluntary activation and normalised electromyographic activity), and peripheral neuromuscular indices (evoked torque and M-wave amplitude), and muscle soreness were assessed before (PRE), immediately after (POST), 1 h (1H), and 1-4 days after exercise (D1, D2, D3, and D4).

RESULTS

MVC torque decreased at only POST for CONC (- 52.8%), but remained below the baseline at POST (- 48.6%), 1H (- 34.1%), and D1-D4 (- 34.1 to - 18.2%) after ECC1, and at POST (- 45.2%), 1H (- 24.4%) and D1 (- 13.4%) after ECC2 (p < 0.05). Voluntary activation decreased immediately after ECC1 (- 21.6%) and ECC2 (- 21.1%), but not after CONC. Electrically evoked torques decreased similarly at POST and 1H for the three conditions, but remained below the baseline at D1 only post-ECC1.

CONCLUSION

These results showed that both central and peripheral factors contributed to the MVC decrease after ECC1 and ECC2, but the decrease was mainly due to peripheral factors after CONC.

Isokinetic muscle strengthening after acquired cerebral damage: a literature review

OBJECTIVE

Isokinetic strengthening is a rehabilitation technique rarely used in stroke patients. However, the potential benefits of force and endurance training in this population are strongly suspected.

METHOD

This literature review synthesizes the results of clinical trials on this topic. The research was conducted on PubMed, using "Stroke", "rehabilitation", "isokinetic", "upper limb" and "training" as keywords.

RESULTS

Seventeen studies focusing on the use of isokinetics in assessment or rehabilitation (six studies) following stroke were reviewed. For the lower limb, muscle strength and walking ability improved after isokinetic rehabilitation programs. For the upper limb, the only two studies found in the literature suggest improvement in the strength of the trained muscles, of grip force, of the Fugl-Meyer motor score and of global functional capacities. This review does not reveal any consensus on the protocols to be implemented: type of muscle contraction, velocities….

CONCLUSION

While isokinetic strengthening has not proven its efficiency in rehabilitation of the upper limb following stroke, its interest with regard to rehabilitation of the lower limbs has been recognized. Randomized controlled trials in this field are necessary to confirm its efficiency, especially concerning upper arm rehabilitation.