Eccentric cycling emphasising a low cardiopulmonary demand increases leg strength equivalent to workload matched concentric cycling in middle age sedentary males

The Health and Functional Benefits of Eccentric versus Concentric Exercise Training: A Systematic Review and Meta-Analysis

This review compared the effects of eccentric versus concentric exercise training in healthy people and people with metabolic disease. A systematic search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, CINAHL, SPORTDiscus, Web of Science, SCOPUS and PubMed was conducted in February 2022. Randomised controlled trials conducted on sedentary healthy adults or those with an existing metabolic disease that compared eccentric versus concentric exercise training interventions of four weeks or longer that involved multiple joints and large muscle groups (e.g., walking, whole-body resistance training) were included in the review. The primary outcome was glucose handling, measured as HbA1c, HOMA, fasting glucose or insulin. Measures of cardiovascular health, muscle strength, and functional physical fitness were secondary outcomes. Nineteen trials involving 618 people were included. Results of meta-analyses showed that eccentric exercise had no benefit to glucose handling (HbA1c level; SMD - 0.99; 95% CI, -2.96 to 0.98; n = 74; P = 0.32) but resulted in significant increases in overall muscle strength (SMD 0.70; 95% CI 0.25 to 1.15; n = 224; P = 0.003) and decreases in blood pressure (Systolic Blood Pressure; MD -6.84; 95% CI, -9.84 to -3.84; n = 47, P = 0.00001, and Diastolic Blood Pressure; MD -6.39; 95% CI -9.62 to -3.15; n = 47, P = 0.0001). Eccentric exercise is effective for improving strength and some markers of cardiovascular health compared to traditional exercise modalities. Additional high-quality studies are necessary to validate these results. (PROSPERO registration: CRD42021232167).

Chronic Adaptations to Eccentric Cycling Training: A Systematic Review and Meta-Analysis

This study aimed to investigate the effects of eccentric cycling (ECCCYC) training on performance, physiological, and morphological parameters in comparison to concentric cycling (CONCYC) training. Searches were conducted using PubMed, Embase, and ScienceDirect. Studies comparing the effect of ECCCYC and CONCYC training regimens on performance, physiological, and/or morphological parameters were included. Bayesian multilevel meta-analysis models were used to estimate the population's mean difference between chronic responses from ECCCYC and CONCYC training protocols. Group levels and meta-regression were used to evaluate the specific effects of subjects and study characteristics. Fourteen studies were included in this review. The meta-analyses showed that ECCCYC training was more effective in increasing knee extensor strength, vastus lateralis fiber cross-sectional area, and six-minute walking distance compared to CONCYC. Moreover, ECCCYC was as effective as CONCYC in decreasing body fat percentage. CONCYC was more effective in increasing V˙O2max and peak power output attained during concentric incremental tests. However, group-level analyses revealed that ECCCYC was more effective than CONCYC in improving V˙O2max in patients with cardiopulmonary diseases. ECCCYC is a viable modality for exercise interventions aiming to improve parameters of muscle strength, hypertrophy, functional capacity, aerobic power, and body composition, with more advantages than CONCYC training in improving neuromuscular variables.

A Short-Term Eccentric HIIT Induced Greater Reduction in Cardio-Metabolic Risk Markers in Comparison With Concentric HIIT in Sedentary Overweight Men

Background: Steady-state eccentric exercise training improves cardiometabolic risk (CMR) despite lesser cardiovascular demands compared with load-matched concentric training. Whether a high-intensity interval eccentric training is also effective reducing CMR is unknown. Aim: To compare the effects of a short-term high-intensity interval eccentric training (ECC-HIIT) with high-intensity interval concentric training (CONC-HIIT) on CMR in sedentary overweight men. Methods: Twenty men (age: 27.9 ± 5.3y, body massindex: 29.1 ± 3.1 kg·m-2) were randomly assigned to ECC-HIIT (n = 10) or CONC-HIIT (n = 10) delivered as six sessions, including 4 x 5:2 min work-to-rest ratio, at 80% peak concentric power output. Heart rate (HR), rate of perceived exertion (RPE) and muscle soreness weremonitored during training sessions. Training effects on lipid profile, insulin sensitivity (HOMA-IR), body composition, thigh circumference, isometric knee extensors maximal strength, resting systolic and diastolic blood pressure (SBP and DBP) were determined. Results: Average training HR and RPE were -29%and -50%lower in ECC-HIIT in comparison with CONC-HIIT. Muscle soreness was initially greater after ECC-HIIT compared with CONC-HIIT. Significant changes in total and low-density lipoprotein cholesterol (-7.0 ± 8.7%; p = .02 and -6.3 ± 14.4%; p = .03), SBP (-9.8 ± 7.8%; p = .002), and maximal thigh circumference (+2.5 ± 3.1%; p = .02) were observed following ECC-HIIT. No changes in any CMR marker were observed after CONC-HIIT. Moderate-to-large training effect sizes were obtained in thigh circumference, SBP, total cholesterol and low-density lipoprotein cholesterol in response to ECC-HIIT. Conclusion: A two-week ECC-HIIT was well-tolerated and induced rapid onset improvements in cholesterol and blood pressure compared to conventional CONC-HIIT in sedentary overweight men.

The Effect of Eccentric vs. Traditional Resistance Exercise on Muscle Strength, Body Composition, and Functional Performance in Older Adults: A Systematic Review With Meta-Analysis

The effects of eccentric exercise (ECC) in older adults have received limited scientific attention, considering the ample evidence for its effectiveness in general and athletic populations. The purpose of this paper is to review the effects of ECC exercise modalities vs. traditional or concentric (CON) exercise on muscle strength, body composition and functional performance in older adults. Inclusion criteria regarding the age was >55 years. Three major scientific literature databases (PubMed, Scopus and Web of Science) were screened for trials comparing the effect of ECC and CON exercise programs, and 19 papers were included in the meta-analysis. ECC and CON training programs were typically matched by the duration of each session. The difference between ECC and CON was expressed as standardized mean difference (SMD). Regarding isometric knee strength, the pooled effect favored ECC (SMD = 0.50), but was not statistically significant (p = 0.160). ECC exercise elicited greater improvements in timed up and go test (SMD = −0.68; p = 0.004), 2-min sit-stand test (SMD = 0.53; p = 0.030) and 30-s sit-stand test (SMD = 0.81; p = 0.002), but not in 6-min walking test (SMD = 0.01; p = 0.960). The effects on body composition and muscle architecture were unclear (SMD = −1.44 to 1.95; p = 0.060–0.689). In conclusion, our literature review indicates that ECC exercise is superior to, or at least as good as CON exercise for preserving health and overall function in older adults.

A Semi-recumbent Eccentric Cycle Ergometer Instrumented to Isolate Lower Limb Muscle Contractions to the Appropriate Phase of the Pedal Cycle

Eccentric (ECC) cycling is used in rehabilitation and sports conditioning settings. We present the construction and mode of operation of a custom-built semi-recumbent ECC cycle designed to limit the production of lower limb muscle activity to the phase of the pedal cycle known to produce ECC contractions. A commercially available semi-recumbent frame and seat (Monarch, 837E Semi-recumbent Bike, Sweden) were used to assemble the ergometer. An electrical drive train system was constructed using individual direct drive servo motors. To avoid active muscle activation occurring during the non-ECC pedaling phase of cycling, a “trip” mechanism was integrated into the drivetrain system using a servo-driven regenerative braking mechanism based on the monitoring of the voltage produced over and above a predetermined threshold produced by the motors. The servo drive internal (DC bus) voltage is recorded and internally monitored during opposing (OPP) and non-opposing (N-OPP) phases of the pedal cycle. To demonstrate that the cycle functions as desired and stops or “trips” when it is supposed to, we present average (of 5 trials) muscle activation patterns of the principal lower limb muscles for regular ECC pedal cycles in comparison with one pedal cycle during which the muscles activated outside the desired phase of the cycle for a sample participant. This semi-recumbent ECC cycle ergometer has the capacity to limit the occurrence of muscle contraction only to the ECC phase of cycling. It can be used to target that mode of muscle contraction more precisely in rehabilitation or training studies.

Concentric versus eccentric cycling at equal power output or effort perception: Neuromuscular alterations and muscle pain

This study aimed to compare neuromuscular alterations and perceptions of effort and muscle pain induced by concentric and eccentric cycling performed at the same power output or effort perception. Fifteen participants completed three 30-min sessions: one in concentric at 60% peak power output (CON) and two in eccentric, at the same power output (ECC_POWER ) or same perceived effort (ECC_EFFORT ). Muscle pain, perception of effort, oxygen uptake as well as rectus femoris and vastus lateralis electromyographic activities were collected when pedaling. The knee extensors maximal voluntary contraction (MVC) torque, the torque evoked by double stimulations at 100 Hz and 10 Hz (Dt100; Dt10), and the voluntary activation level (VAL) were evaluated before and after exercise. Power output was higher in ECC_EFFORT than CON (89.1 ± 23.3% peak power). Muscle pain and effort perception were greater in CON than ECC_POWER (p < 0.03) while muscle pain was similar in CON and ECC_EFFORT (p > 0.43). MVC torque, Dt100, and VAL dropped in all conditions (p < 0.04). MVC torque (p < 0.001) and the Dt10/ Dt100 ratio declined further in ECC_EFFORT (p < 0.001). Eccentric cycling perceived as difficult as concentric cycling caused similar muscle pain but more MVC torque decrease. A given power output induced lower perceptions of pain and effort in eccentric than in concentric yet similar MVC torque decline. While neural impairments were similar in all conditions, eccentric cycling seemed to alter excitation-contraction coupling. Clinicians should thus be cautious when setting eccentric cycling intensity based on effort perception.

Elevated body temperature contributes to the increased heart rate response during eccentric compared to concentric cycling when matched for oxygen consumption

A cardiovascular requirement to facilitate thermal homeostasis may partly contribute to the elevated heart rate during eccentric cycling. This study compared the body temperature response to a bout of eccentric (ECC) and concentric (CON) cycling to account for the difference in heart rate. Eight (N = 8) aerobically trained males (age 35 y [SD 8], peak oxygen consumption 3.82 L.min^-1 [SD 0.79]) completed an ECC cycling trial (60% PPO) followed by an oxygen consumption/duration matched CON trial (30   ∘ C , 35% RH) on a separate day. Trial termination was determined as an elevation in aural temperature, a surrogate of deep body temperature, by +0.5   ∘ C during ECC. Mean skin (8-sites) and body temperature (weighting of 80:20 for auditory canal and mean skin temperature) were calculated. Matching the oxygen consumption between the trials increased external work during ECC cycling (CON: 71 [SD 14] ECC: 194 [SD 38] W, p < 0.05) and elevated aural temperature (+0.5   ∘ C ) by 20 min 32 s [SD 9 min 19 s] in that trial. The peak rate of rise in aural temperature was significantly greater in ECC (CON: 0.012 [SD 0.007] ECC: 0.031 [SD 0.002] ^oC.s^-1, p < 0.05). Aural, mean skin and body temperature were significantly higher during the ECC trial (p < 0.05) and this was accompanied by elevated mean heart rate (CON: 103 [SD 14] ECC: 118 [SD 12] b.min^-1, p < 0.05) and thermal discomfort (p < 0.05). Moderate load eccentric cycling imposes an elevated thermal strain when compared to concentric cycling. This requirement for dissipating heat, in part, explains the elevated heart rate during eccentric cycling.

Aerobic Metabolic Adaptations in Endurance Eccentric Exercise and Training: From Whole Body to Mitochondria

A characteristic feature of eccentric as compared with concentric exercise is the ability to generate greater mechanical loads for lower cardiopulmonary demands. Current evidence concurs to show that eccentric training translates into considerable gains in muscle mass and strength. Less is known, however, regarding its impact on oxygen transport and on factors to be considered for optimizing its prescription and monitoring. This article reviews the existing evidence for endurance eccentric exercise effects on the components of the oxygen transport system from systemic to mitochondria in both humans and animals. In the studies reviewed, specially designed cycle-ergometers or downhill treadmill running were used to generate eccentric contractions. Observations to date indicate that overall, the aerobic demand associated with the eccentric training load was too low to significantly increase peak maximal oxygen consumption. By extension, it can be inferred that the very high eccentric power output that would have been required to solicit a metabolic demand sufficient to enhance peak aerobic power could not be tolerated or sustained by participants. The impact of endurance eccentric training on peripheral flow distribution remains largely undocumented. Given the high damage susceptibility of eccentric exercise, the extent to which skeletal muscle oxygen utilization adaptations would be seen depends on the balance of adverse and positive signals on mitochondrial integrity. The article examines the protection provided by repeated bouts of acute eccentric exercise and reports on the impact of eccentric cycling and downhill running training programs on markers of mitochondrial function and of mitochondrial biogenesis using mostly from animal studies. The summary of findings does not reveal an impact of training on skeletal muscle mitochondrial respiration nor on selected mitochondrial messenger RNA transcripts. The implications of observations to date are discussed within future perspectives for advancing research on endurance eccentric exercise physiological impacts and using a combined eccentric and concentric exercise approach to optimize functional capacity.

Moving forward with backward pedaling: a review on eccentric cycling

PURPOSE

There is a profound gap in the understanding of the eccentric cycling intensity continuum, which prevents accurate exercise prescription based on desired physiological responses. This may underestimate the applicability of eccentric cycling for different training purposes. Thus, we aimed to summarize recent research findings and screen for possible new approaches in the prescription and investigation of eccentric cycling.

METHOD

A search for the most relevant and state-of-the-art literature on eccentric cycling was conducted on the PubMed database. Literature from reference lists was also included when relevant.

RESULTS

Transversal studies present comparisons between physiological responses to eccentric and concentric cycling, performed at the same absolute power output or metabolic load. Longitudinal studies evaluate responses to eccentric cycling training by comparing them with concentric cycling and resistance training outcomes. Only one study investigated maximal eccentric cycling capacity and there are no investigations on physiological thresholds and/or exercise intensity domains during eccentric cycling. No study investigated different protocols of eccentric cycling training and the chronic effects of different load configurations.

CONCLUSION

Describing physiological responses to eccentric cycling based on its maximal exercise capacity may be a better way to understand it. The available evidence indicates that clinical populations may benefit from improvements in aerobic power/capacity, exercise tolerance, strength and muscle mass, while healthy and trained individuals may require different eccentric cycling training approaches to benefit from similar improvements. There is limited evidence regarding the mechanisms of acute physiological and chronic adaptive responses to eccentric cycling.

Leg Muscle Activity and Perception of Effort before and after Four Short Sessions of Submaximal Eccentric Cycling

Background: This study tested muscle activity (EMG) and perception of effort in eccentric (ECC) and concentric (CON) cycling before and after four sessions of both. Methods: Twelve volunteers naïve to ECC cycling attended the laboratory six times. On day 1, they performed a CON cycling peak power output (PPO) test. They then carried-out four sessions comprising two sets of 1 to 1.5-min cycling bouts at 5 intensities (30, 45, 60, 75, and 90% PPO) in ECC and CON cycling. On day 2 and day 6 (two weeks apart), EMG root mean square of the vastus lateralis (VL), rectus femoris (RF), biceps femoris (BF), and soleus (SOL) muscles, was averaged from 15 to 30 s within each 1-min bout and perception of effort was asked after 45 s. Results: Before the four cycling sessions, while VL EMG was lower in ECC than CON cycling, most variables were not different. Afterwards, ECC cycling exhibited lower RF EMG at 75 and 90% PPO (all p < 0.02), lower VL and BF EMG at all exercise intensities (all p < 0.02), and inferior SOL EMG (all p < 0.04) except at 45% PPO (p = 0.07). Perception of effort was lower in ECC cycling at all exercise intensities (all p < 0.03) but 60% PPO (p = 0.11). Conclusions: After four short sessions of ECC cycling, the activity of four leg muscles and perception of effort became lower in ECC than in CON cycling at most of five power outputs, while they were similar before.

Corrigendum: Neuromuscular and Perceptual Responses to Sub-Maximal Eccentric Cycling

[This corrects the article on p. 354 in vol. 10, PMID: 30984032.].

The Acute Physiological Responses of Eccentric Cycling During the Recovery Periods of a High Intensity Concentric Cycling Interval Session

Eccentric and concentric exercise is associated with disparate acute and chronic responses. We uniquely interspersed workload equivalent eccentric cycling during each recovery period of a high intensity interval training (HIIT) cycling trial to determine acute cardiopulmonary, thermal and psycho-physiological responses. Twelve males [age 28 years (SD 6), peak oxygen consumption 48 mL ⋅ kg^–1 ⋅ min^–1 (SD 6)] completed two high intensity interval cycling trials [4 × 5 min, 60% peak power output (PPO)] separated by 7–10 days. The CON_R trial required participants to cycle concentrically during each recovery period (5 min, 30% PPO). The ECC_R trial modified the recovery to be eccentric cycling (5 min, 60% PPO). High intensity workload (CON_R: 187 ± 17; ECC_R: 187 ± 21 W), oxygen consumption (CON_R: 2.55 ± 0.17; ECC_R: 2.68 ± 0.20 L ⋅ min^–1), heart rate (CON_R: 165 ± 7; ECC_R: 171 ± 10 beats ⋅ min^–1) and RPE legs (CON_R: 15 ± 3; ECC_R: 15 ± 3) were equivalent between trials. Eccentric cycling recovery significantly increased external workload (CON_R: 93 ± 18; ECC_R: 196 ± 24 W, P < 0.01) yet lowered oxygen consumption (CON_R: 1.51 ± 0.18; ECC_R: 1.20 ± 0.20 L ⋅ min^–1, P < 0.05) while heart rate (CON_R: 132 ± 13; ECC_R: 137 ± 12 beats ⋅ min^–1) and RPE of the legs (CON_R: 11 ± 7; ECC_R: 12 ± 7) remained equivalent. There was no significant difference in the aural temperature between the trials (ECC_R: 37.3 ± 0.1°C; CON_R: 37.4 ± 0.1°C, P > 0.05), yet during recovery periods mean skin temperature was significantly elevated in the ECC_R (ECC_R: 33.9 ± 0.2°C; CON_R: 33.3 ± 0.2°C, P < 0.05). Participants preferred ECC_R (10/12) and rated the ECC_R as more achievable (82.8 ± 11.4 mm) than CON_R (79.4 ± 15.9 mm, P < 0.01). In conclusion, eccentric cycling during the recovery period of a HIIT training session, offers a novel approach to concurrent training methodology. The unique cardiopulmonary and skeletal muscle responses facilitate the achievement of both training stimuli within a single exercise bout.

Neuromuscular and Perceptual Responses to Sub-Maximal Eccentric Cycling

Objective

Eccentric (ECC) cycle-ergometers have recently become commercially-available, offering a novel method for rehabilitation training. Many studies have reported that ECC cycling enables the development of higher levels of muscular force at lower cardiorespiratory and metabolic loads, leading to greater force enhancements after a training period. However, fewer studies have focused on the specific perceptual and neuromuscular changes. As the two latter aspects are of major interest in clinical settings, this review aimed to present an overview of the current literature centered on the neuromuscular and perceptual responses to submaximal ECC cycling in comparison to concentric (CON) cycling.

Design

Narrative review of the literature.

Results

At a given mechanical workload, muscle activation is lower in ECC than in CON while the characteristics of the musculo-articular system (i.e., muscle-tendon unit, fascicle, and tendinous tissue length) are quite similar. At a given heart rate or oxygen consumption, ECC cycling training results in greater muscular hypertrophy and strength gains than CON cycling. On the contrary, CON cycling training seems to enhance more markers of muscle aerobic metabolism than ECC cycling performed at the same heart rate intensity. Data concerning perceptual responses, and neuromuscular mechanisms leading to a lower muscle activation (i.e., neural commands from cortex to muscular system) at a given mechanical workload are scarce.

Conclusion

Even though ECC cycling appears to be a very useful tool for rehabilitation purposes the perceptual and neural commands from cortex to muscular system during exercise need to be further studied.