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Wang C, Stovitz SD, Kaufman JS, Steele RJ, Shrier I. Principles of musculoskeletal sport injuries for epidemiologists: a review. Inj Epidemiol 2024; 11:21. [PMID: 38802864 PMCID: PMC11131288 DOI: 10.1186/s40621-024-00507-3] [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: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Musculoskeletal injuries are a common occurrence in sport. The goal of sport injury epidemiology is to study these injuries at a population level to inform their prevention and treatment. MAIN BODY This review provides an overview of musculoskeletal sport injuries and the musculoskeletal system from a biological and epidemiologic perspective, including injury mechanism, categorizations and types of sport injuries, healing, and subsequent injuries. It is meant to provide a concise introductory substantive background of musculoskeletal sport injuries for epidemiologists who may not have formal training in the underlying anatomy and pathophysiology. CONCLUSION An understanding of sport injuries is important for researchers in sport injury epidemiology when determining how to best define and assess their research questions and measures.
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Affiliation(s)
- Chinchin Wang
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Steven D Stovitz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, USA
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Russell J Steele
- Department of Mathematics and Statistics, McGill University, Montreal, Canada
| | - Ian Shrier
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, 3755 Côte Ste-Catherine Road, Montreal, QC, H3T 1E2, Canada.
- Department of Family Medicine, McGill University, Montreal, Canada.
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Vetter S, Hepp P, Schleichardt A, Schleifenbaum S, Witt M, Roth C, Köhler HP. Effect of isokinetic eccentric training on the human shoulder strength, flexibility, and muscle architecture in physically active men: A preliminary study. PLoS One 2023; 18:e0293439. [PMID: 38113203 PMCID: PMC10729965 DOI: 10.1371/journal.pone.0293439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/05/2023] [Indexed: 12/21/2023] Open
Abstract
Strengthening the rotator cuff muscles is important for injury prevention and rehabilitation. Since muscle fascicle length improves motor performance and is suggested to reduce the risk of injury for the hamstring, it may be an important variable to promote multidirectional changes in the function and macroscopic structure for the shoulder. Recent literature reviews overwhelmingly suggest that eccentric exercises improve fascicle length and functional measures for the lower limb. However, there is a research gap for the shoulder. Since ultrasound imaging is the most commonly used imaging technique to quantify muscle structure, but has yielded heterogeneous results in different studies, there is another issue and a research gap for the imaging method. Based on the research gaps, the purpose of this study was to evaluate the effects of standardized eccentric strength training on the function and structure of the external rotator cuff muscles using an isokinetic dynamometer and MRI. Therefore, a preliminary pre-post intervention study was conducted and 16 physically active men were recruited in October 2021. For the right shoulder, an eccentric isokinetic training was performed twice a week for almost six weeks. The primary outcome measures (external rotators) were active and passive range of motion, eccentric and concentric torque at 30, 60, and 180°/s isokinetic speed, and fascicle length and fascicle volume for the supraspinatus and infraspinatus muscles. The findings show a training effect for the absolute mean values of eccentric strength (+24%, p = .008). The torque-angle relationship increased, especially in the final phase of range of motion, although a 4% (p = .002) decrease in passive range of motion was found in the stretch test. Positive changes in muscle structure were shown for the supraspinatus muscle fascicle length (+16%, p = .003) and fascicle volume (+19%, p = .002). Based on the study results, we can conclude that eccentric isokinetic training has a significant positive effect on the shoulder. To our knowledge, this is the first eccentric training study using both isokinetic dynamometer and muscle diffusion tensor imaging to access functional and structural changes in the human shoulder rotator cuff muscles. The methods were shown to be applicable for interventional studies. Based on these results, populations such as high-performance handball players with highly trained shoulders should be included in future studies.
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Affiliation(s)
- Sebastian Vetter
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
| | - Pierre Hepp
- Department for Orthopedics, Trauma and Plastic Surgery, Leipzig University, Leipzig, Germany
| | - Axel Schleichardt
- Department of Biomechanics, Institute for Applied Training Science, Leipzig Germany
| | - Stefan Schleifenbaum
- Department for Orthopedics, Trauma and Plastic Surgery, Leipzig University, Leipzig, Germany
| | - Maren Witt
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
| | - Christian Roth
- Department of Pediatric Radiology, Leipzig University, Leipzig, Germany
| | - Hans-Peter Köhler
- Department of Biomechanics in Sports, Leipzig University, Leipzig, Germany
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Vila-Chã C, Bovolini A, Francisco C, Costa-Brito AR, Vaz C, Rua-Alonso M, de Paz JA, Vieira T, Mendonca GV. Acute effects of isotonic eccentric exercise on the neuromuscular function of knee extensors vary according to the motor task: impact on muscle strength profiles, proprioception and balance. Front Sports Act Living 2023; 5:1273152. [PMID: 38022776 PMCID: PMC10655025 DOI: 10.3389/fspor.2023.1273152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Eccentric exercise has often been reported to result in muscle damage, limiting the muscle potential to produce force. However, understanding whether these adverse consequences extend to a broader, functional level is of apparently less concern. In this study, we address this issue by investigating the acute and delayed effects of supramaximal isotonic eccentric exercise on neuromuscular function and motor performance of knee extensors during tasks involving a range of strength profiles, proprioception, and balance. Methods Fifteen healthy volunteers (23.2 ± 2.9 years old) performed a unilateral isotonic eccentric exercise of the knee extensors of their dominant lower limb (4 × 10 reps at 120% of one Repetition Maximum (1RM)). The maximum voluntary isometric contraction (MVC), rate of force development (RFD), force steadiness of the knee extensors, as well as knee joint position sense and mediolateral (MLI) and anteroposterior stability (API) of the dominant lower limb, were measured pre-, immediately, and 24 h after the eccentric exercise. The EMG amplitude of the vastus medialis (VM) and biceps femoris (BF) were concomitantly evaluated. Results MVC decreased by 17.9% immediately after exercise (P < 0.001) and remained reduced by 13.6% 24 h following exercise (P < 0.001). Maximum RFD decreased by 20.4% immediately after exercise (P < 0.001) and remained reduced by 15.5% at 24 h (P < 0.001). During the MVC, EMG amplitude of the VM increased immediately after exercise while decreasing during the RFD task. Both values returned to baseline 24 h after exercise. Compared to baseline, force steadiness during submaximal isometric tasks reduced immediately after exercise, and it was accompanied by an increase in the EMG amplitude of the VM. MLI and knee joint position sense were impaired immediately after isotonic eccentric exercise (P < 0.05). While MLI returned to baseline values 24 h later, the absolute error in the knee repositioning task did not. Discussion Impairments in force production tasks, particularly during fast contractions and in the knee joint position sense, persisted 24 h after maximal isotonic eccentric training, revealing that neuromuscular functional outputs were affected by muscle fatigue and muscle damage. Conversely, force fluctuation and stability during the balance tasks were only affected by muscle fatigue since fully recovered was observed 24 h following isotonic eccentric exercise.
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Affiliation(s)
- Carolina Vila-Chã
- Laboratory for the Assessment of Sports Performance, Physical Exercise and Health (Labmov), Polytechnic of Guarda, Guarda, Portugal
- Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal
| | - Antonio Bovolini
- Laboratory for the Assessment of Sports Performance, Physical Exercise and Health (Labmov), Polytechnic of Guarda, Guarda, Portugal
- Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal
| | - Cristiana Francisco
- Laboratory for the Assessment of Sports Performance, Physical Exercise and Health (Labmov), Polytechnic of Guarda, Guarda, Portugal
| | - Ana R. Costa-Brito
- Laboratory for the Assessment of Sports Performance, Physical Exercise and Health (Labmov), Polytechnic of Guarda, Guarda, Portugal
| | - Cláudia Vaz
- Laboratory for the Assessment of Sports Performance, Physical Exercise and Health (Labmov), Polytechnic of Guarda, Guarda, Portugal
| | - María Rua-Alonso
- Laboratory for the Assessment of Sports Performance, Physical Exercise and Health (Labmov), Polytechnic of Guarda, Guarda, Portugal
- Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal
- Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain
| | | | - Taian Vieira
- Laboratorio di Ingegneria del Sistema Neuromuscolare (LISiN), Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Turin, Italy
- PoliToBIOMed Lab, Politecnico di Torino, Turin, Italy
| | - Goncalo V. Mendonca
- Neuromuscular Research Laboratory, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Interdisciplinary Center for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
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Köhler HP, Witt M. Energy flow in men's javelin throw and its relationship to joint load and performance. PeerJ 2023; 11:e16081. [PMID: 37744222 PMCID: PMC10516106 DOI: 10.7717/peerj.16081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
Background Performance in javelin throwing is dependent on the release speed and therefore the energy transferred to the javelin. Little is known about the flow of mechanical energy in javelin throwing and whether there is a connection to joint loading and throwing performance. The purpose of the study was therefore to investigate (1) the energy flow within the kinetic chain of the throwing arm, (2) how it is related to performance and joint loads and (3) how joint forces and torques are used to transfer, generate and absorb mechanical energy. Methods The kinematics of 10 experienced javelin throwers were recorded using a 12-camera infrared system. 16 markers were placed on the athlete's body, five on the javelin to track the movement of each segment. A segmental power analysis was carried out to calculate energy flow between upper body, upper arm, forearm and hand. Stepwise regression analysis was used to calculate the variable that best predicts release speed and joint loads. Results The results indicate that the higher the peak rate of energy transfer from the thorax to the humerus, the higher the release speed and the joint loads. While there were no differences between the peak rate of energy transfer in the different joints, the energy transferred differed depending on whether joint forces or torques were used. It can be further shown that higher joint torques and thus higher rotational kinetics at the shoulder are linked to higher release speeds. Thus, the movements of the upper body can be of great influence on the result in javelin throwing. Furthermore, the data show that athletes who are able to transfer more energy through the shoulder, rather than generate it, experience a smaller joint loading. An effective technique for improved energy transfer can thus help perform at the same level while lowering joint stress or have higher performance at the same joint loading.
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Affiliation(s)
- Hans-Peter Köhler
- Department of Biomechanics in Sports, Sport Science Faculty, Universität Leipzig, Leipzig, Germany
| | - Maren Witt
- Department of Biomechanics in Sports, Sport Science Faculty, Universität Leipzig, Leipzig, Germany
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Pincheira PA, Mayfield DL, Fox AS, Brown NAT, Carroll TJ, Cresswell AG, Lichtwark GA. Increased muscle force does not induce greater stretch-induced damage to calf muscles during work-matched heel drop exercise. Eur J Appl Physiol 2023; 123:1801-1808. [PMID: 37055644 PMCID: PMC10363059 DOI: 10.1007/s00421-023-05188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 03/22/2023] [Indexed: 04/15/2023]
Abstract
PURPOSE To investigate the effect of muscle force during active stretch on quantitative and qualitative indicators of exercise-induced muscle damage (EIMD) in the medial gastrocnemius (MG) muscle. METHODS Twelve recreationally active volunteers performed two trials of an eccentric heel drop exercise. Participants performed a single bout of low-load (body weight) and high-load (body weight + 30% body weight) exercises on separate legs. The total mechanical work output for each condition was matched between legs. Before, two hours and 48 h after each bout of eccentric exercise, electrically stimulated triceps surae twitch torque, muscle soreness, MG active fascicle length at maximum twitch torque and muscle passive stiffness were collected. Triceps surae electromyographic (EMG) activity, MG fascicle stretch and MG muscle-tendon unit (MTU) length were measured during the eccentric tasks. RESULTS The high-load condition increased triceps surae muscle activity by 6-9%, but reduced MG fascicle stretch (p < 0.001). MTU stretch was similar between conditions. The greater muscle force during stretch did not give rise to additional torque loss (5 vs 6%) or intensify muscle soreness. CONCLUSIONS Adding 30% body weight during eccentric contractions has a modest impact on exercise-induced muscle damage in the medial gastrocnemius muscle. These results suggest that muscle load may not be an important determinant of stretch-induced muscle damage in the human MG muscle. The muscle investigated does exhibit large pennation angles and high series elastic compliance; architectural features that likely buffer muscle fibres against stretch and damage.
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Affiliation(s)
- Patricio A Pincheira
- School of Human Movement and Nutrition Sciences, The University of Queensland, Blair Drive 26B, St Lucia, Brisbane, 4067, Australia.
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
| | - Dean L Mayfield
- Department of Evolution, Ecology, and Organismal Biology, University of California, Riverside, USA
| | - Aaron S Fox
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | | | - Timothy J Carroll
- School of Human Movement and Nutrition Sciences, The University of Queensland, Blair Drive 26B, St Lucia, Brisbane, 4067, Australia
| | - Andrew G Cresswell
- School of Human Movement and Nutrition Sciences, The University of Queensland, Blair Drive 26B, St Lucia, Brisbane, 4067, Australia
| | - Glen A Lichtwark
- School of Human Movement and Nutrition Sciences, The University of Queensland, Blair Drive 26B, St Lucia, Brisbane, 4067, Australia
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Zhang B, Wang K, Zhang E, Shang X. Correlation of Glenohumeral Internal Rotation Deficit With Shoulder Pain in Elite Table Tennis Players. Am J Phys Med Rehabil 2023; 102:687-691. [PMID: 36728366 DOI: 10.1097/phm.0000000000002180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The aims of the study were (1) to investigate glenohumeral internal rotation deficit (a difference in internal rotation of 15.6 degrees or more between dominant and nondominant shoulders) and its correlation with self-reported shoulder pain in table tennis players and (2) to find the optimal cutoff point for the difference in the internal rotation range of motion between dominant and nondominant shoulders of self-reported shoulder pain. DESIGN The internal rotation range of motion of both shoulders of 46 table tennis players was measured in the supine and side-lying positions, and the external rotation range of motion was measured in the supine position. RESULTS Significant differences existed in internal rotation range of motion between the two sides in the supine ( z = 6.53, P < 0.001) and side-lying positions ( z = 5.67, P < 0.001). Self-reported shoulder pain was associated with glenohumeral internal rotation deficit (odds ratio = 6.86, 95% confidence interval = 1.752-26.832, P = 0.006). The cutoff points for the difference in internal rotation range of motion between the sides of self-reported shoulder pain were 17.9 degrees in the supine position and 11.1 degrees in the side-lying position. CONCLUSIONS Table tennis players exhibited glenohumeral internal rotation deficit. There was a correlation between glenohumeral internal rotation deficit and self-reported shoulder pain in the past year; therefore, glenohumeral internal rotation deficit may be a risk factor for shoulder pain in table tennis players.
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Affiliation(s)
- Botao Zhang
- From the Sports Medicine and Physical Therapy School, Beijing Sport University, Beijing, China (BZ, KW, EZ); and National Research Institute of Sports Medicine, Beijing, China (XS)
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Stojanović MDM, Andrić N, Mikić M, Vukosav N, Vukosav B, Zolog-Șchiopea DN, Tăbăcar M, Melinte RM. Effects of Eccentric-Oriented Strength Training on Return to Sport Criteria in Late-Stage Anterior Cruciate Ligament (ACL)-Reconstructed Professional Team Sport Players. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1111. [PMID: 37374316 DOI: 10.3390/medicina59061111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: An effective post-injury training program is essential to regain performance and fulfill criteria for return to sport for team sport athletes following anterior cruciate ligament (ACL) reconstruction. The aim of this study was to compare the effects of 6 weeks of eccentric-oriented strength training vs. traditional strength training during the late-stage ACL-rehab phase on leg strength and vertical and horizontal jumping performance in professional team sport athletes. Materials and Methods: Twenty-two subjects (14 males, 8 females, age 19.9 ± 4.4 years, mass 77.4 ± 15.6 kg, height 182.4 ± 11.7 cm) (mean ± SD) with a unilateral reconstructed ACL (BTB graft) were included in the study. All participants enrolled in the same rehabilitation protocol prior to the training study. Players were randomly assigned to an experimental (ECC: n = 11, age 21.8 ± 4.6 years, mass 82.7 ± 16.6 kg, height 185.4 ± 12.2 cm), and a control group (CON: n = 11, age 19.1 ± 2.1 years, mass 76.6 ± 16.5 kg, height 182.5 ± 10.2 cm). Both groups underwent an equivolumed rehabilitation program, with the only difference being in strength training, which consisted of flywheel training vs. traditional strength training for the experimental and control groups, respectively. Testing was organized before and after the 6-week training programs and included isometric semi-squat tests (ISOSI-injured and ISOSU-uninjured legs), vertical jump tests (CMJ), single-leg vertical jump tests (SLJI-injured and SLJU-uninjured legs), single-leg hop tests (SLHI-injured and SLHU-uninjured legs), and triple hop tests (TLHI-injured and TLHU-uninjured legs). In addition, limb symmetry indexes were calculated for the isometric semi-squat (ISOSLSI) test, the single-leg vertical jump (SLJLSI), and the hop (SLHLSI) tests, as well as the triple-leg hop (THLLSI) test. Results: Main effects of time across training were observed for all dependent variables (posttest > pretest, p < 0.05). Significant group-by-time interactions were found for ISOSU (p < 0.05, ES = 2.51, very large), ISOSI (p < 0.05, ES = 1.78, large), CMJ (p < 0.05, ES = 2.23, very large), SLJI (p < 0.05, ES = 1.48, large), SLHI (p < 0.05, ES = 1.83, large), and TLHI (p < 0.05, ES = 1.83, large). Conclusions: This study suggests that eccentric-oriented strength training in late-stage ACL recovery, undertaken twice or three times weekly for 6 weeks, results in better outcomes than traditional strength training in leg strength, vertical jump ability, and single and triple hop tests with injured legs in professional team sport athletes. It seems that flywheel strength training can be recommended in late-stage ACL recovery for professional team sport athletes in order to regain recommended performance outcome levels faster.
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Affiliation(s)
- Marko D M Stojanović
- Training Expertise Lab, Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Nikola Andrić
- Training Expertise Lab, Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Mladen Mikić
- Training Expertise Lab, Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia
| | - Nikola Vukosav
- Clinic for Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, 21000 Novi Sad, Serbia
| | - Borko Vukosav
- Sports Medicine Department, Medical Clinic "ST Medicina", 21000 Novi Sad, Serbia
| | - Dan-Nicolae Zolog-Șchiopea
- Orthopedic Department, Puls Hospital of Regina Maria Hospital, 540136 Targu Mures, Romania
- Orthopedic Surgery and Traumatology Department, Humanitas Hospital, 400001 Cluj Napoca, Romania
| | - Mircea Tăbăcar
- Orthopedic Department, Puls Hospital of Regina Maria Hospital, 540136 Targu Mures, Romania
| | - Răzvan Marian Melinte
- Orthopedic Department, Puls Hospital of Regina Maria Hospital, 540136 Targu Mures, Romania
- Orthopedic Surgery and Traumatology Department, Humanitas Hospital, 400001 Cluj Napoca, Romania
- Fizionova Reahabilitation, 540136 Targu Mures, Romania
- Orthopedic Surgery and Traumatology Department, Dimitrie Cantemir University, 540136 Targu Mures, Romania
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Šimunič B, Doles M, Kelc R, Švent A. Effectiveness of 448-kHz Capacitive Resistive Monopolar Radiofrequency Therapy After Eccentric Exercise-Induced Muscle Damage to Restore Muscle Strength and Contractile Parameters. J Sport Rehabil 2023:1-8. [PMID: 37192748 DOI: 10.1123/jsr.2022-0162] [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: 04/26/2022] [Revised: 10/17/2022] [Accepted: 03/15/2023] [Indexed: 05/18/2023]
Abstract
CONTEXT Exercise-induced muscle damage (EIMD) is prevalent especially in sports and rehabilitation. It causes loss in skeletal muscle function and soreness. As there are no firm preventive strategies, we aimed to evaluate the preventive efficacy of nonthermal 448-kHz capacitive resistive monopolar radiofrequency (CRMRF) therapy after eccentric bouts of EIMD response in knee flexors. DESIGN Twenty-nine healthy males (age: 25.2 [4.6] y) were randomized in control group (CG; n = 15) and experimental group (EG; n = 14) where EG followed 5 daily 448-kHz CRMRF therapies. All assessments were performed at baseline and post EIMD (EIMD + 1, EIMD + 2, EIMD + 5, and EIMD + 9 d). We measured tensiomyography of biceps femoris and semitendinosus to calculate contraction time, the maximal displacement and the radial velocity of contraction, unilateral isometric knee flexors maximal voluntary contraction torque, and rate of torque development in first 100 milliseconds. RESULTS Maximal voluntary contraction torque and rate of torque development in first 100 milliseconds decreased more in CG than in EG and recovered only in EG. Biceps femoris contraction time increased only in CG (without recovery), whereas in semitendinosus contraction time increased in EG (only at EIMD + 1) and in CG (without recovery). In both muscles, tensiomyographic maximal displacement decreased in EG (in EIMD + 1 and EIMD + 2) and in CG (without recovery). Furthermore, in both muscles, radial velocity of contraction decreased in EG (from EIMD + 1 until EIMD + 5) and in CG (without recovery). CONCLUSION The study shows beneficial effect of CRMRF therapy after inducing EIMD in skeletal muscle strength and contractile parameters in knee flexors.
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Affiliation(s)
- Boštjan Šimunič
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper,Slovenia
| | - Monika Doles
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper,Slovenia
| | - Robi Kelc
- Medical Faculty, Institute for Sports Medicine, University of Maribor, Maribor,Slovenia
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Pimenta R, Antunes H, Lopes T, Veloso A. Do Repeated Sprints Affect the Biceps Femoris Long Head Architecture in Football Players with and without an Injury History?-A Retrospective Study. BIOLOGY 2023; 12:biology12010096. [PMID: 36671788 PMCID: PMC9855802 DOI: 10.3390/biology12010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
The aim of this study was to compare the biceps femoris long head (BFlh) architecture between football players with (twelve) and without (twenty) history of BFlh injury before and after a repeated sprint task. Fascicle length (FL), pennation angle (PA) and muscle thickness (MT) were assessed at rest and in the active condition before and after the repeated sprint protocol. Athletes with previous BFlh injury showed shorter FL at rest (p = 0.014; η2p = 0.196) and active state (p < 0.001; η2p = 0.413), and greater PA at rest (p = 0.002; η2p = 0.307) and active state (p < 0.001; η2p = 0.368) before and after the task. Intra-individual comparisons showed that injured limbs have shorter FL at rest (p = 0.012; η2p = 0.519) and in the active state (p = 0.039; η2p = 0.332), and greater PA in passive (p < 0.001; η2p = 0.732) and active conditions (p = 0.018; η2p = 0.412), when compared with contralateral limbs. Injured players, at rest and in the active condition, display shorter BFlh FL and greater PA than contralateral and healthy controls after repeated sprints. Moreover, the BFlh of injured players presented a different architectural response to the protocol compared with the healthy controls.
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Affiliation(s)
- Ricardo Pimenta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1649-004 Cruz Quebrada-Dafundo, Portugal
- Correspondence: ; Tel.: +35-19-1885-2877
| | - Hugo Antunes
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1649-004 Cruz Quebrada-Dafundo, Portugal
| | - Tomás Lopes
- Department of Biochemistry, King’s College London, London WC2R 2LS, UK
| | - António Veloso
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1649-004 Cruz Quebrada-Dafundo, Portugal
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Lamsfuss J, Bargmann S. Computational modeling of damage in the hierarchical microstructure of skeletal muscles. J Mech Behav Biomed Mater 2022; 134:105386. [DOI: 10.1016/j.jmbbm.2022.105386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 07/09/2022] [Accepted: 07/15/2022] [Indexed: 11/27/2022]
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Itoigawa Y, Koga A, Morikawa D, Kubota A, Uehara H, Maruyama Y, Takazawa Y, Ishijima M. Posterior shoulder stiffness was associated with shoulder pain during throwing in college baseball players: assessment of shear wave elastography. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2022; 33:1237-1244. [PMID: 35583565 DOI: 10.1007/s00590-022-03286-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 05/01/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate shoulder stiffness on the throwing and non-throwing sides in college baseball players using ultrasound shear wave elastography (SWE), and investigate the relationship between stiffness and shoulder pain during throwing. METHODS Forty-nine college baseball players (98 shoulders) were recruited. Shoulder range of motion was evaluated. SWE was used to measure stiffness of the bilateral supraspinatus tendons, infraspinatus tendons, subscapularis tendons, supraspinatus muscles, infraspinatus muscles (ISPM), and posterior capsules. Participants were divided into pain and no pain groups based on the presence or absence of shoulder pain during throwing within 1 month before measurements on the throwing side. Items were compared between the throwing and non-throwing sides, and between the pain and no pain groups. Factors affecting shoulder pain during throwing were also investigated via multiple logistic regression analysis. RESULTS Compared with the non-throwing side, the throwing side had significantly greater external rotation at 90° abduction, significantly lesser internal rotation at 0° abduction and internal rotation at 90° abduction (AbdIR), significantly higher SWE values of the infraspinatus tendon, ISPM, and posterior capsule, and significantly lower SWE values of the subscapularis tendon. Compared with the no pain group, the pain group had a significantly higher SWE value of the ISPM, and significantly lesser AbdIR. Increased ISPM SWE values and decreased AbdIR were significantly correlated with shoulder pain during throwing. CONCLUSIONS The posterior tissue was stiffer than the anterior tissue on the throwing side. Decreased AbdIR and increased ISPM stiffness may be correlated with shoulder pain during throwing.
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Affiliation(s)
- Yoshiaki Itoigawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
| | - Akihisa Koga
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Daichi Morikawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Atsushi Kubota
- Graduate School of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Hirohisa Uehara
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Yuichiro Maruyama
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Yuuji Takazawa
- Graduate School of Health and Sports Science, Juntendo University, Inzai, Japan
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
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12
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Vetter S, Schleichardt A, Köhler HP, Witt M. The Effects of Eccentric Strength Training on Flexibility and Strength in Healthy Samples and Laboratory Settings: A Systematic Review. Front Physiol 2022; 13:873370. [PMID: 35574461 PMCID: PMC9100951 DOI: 10.3389/fphys.2022.873370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
Background: The risk of future injury appears to be influenced by agonist fascicle length (FL), joint range of motion (ROM) and eccentric strength. Biomechanical observations of the torque-angle-relationship further reveal a strong dependence on these factors. In practice, a longer FL improves sprinting performance and lowers injury risk. Classical stretching is a popular and evidenced-based training for enhancing ROM but does not have any effects on FL and injury risk. However, recent studies show that eccentric-only training (ECC) improves both flexibility and strength, and effectively lowers risk of injury. Objectives: To review the evidence on benefits of ECC for flexibility and strength. Methods: COCHRANE, PUBMED, SCOPUS, SPOLIT, and SPONET were searched for laboratory trials that compare ECC to at least one comparison group. Studies were eligible if they examined both strength and flexibility metrics in a healthy sample (<65 years) and met criteria for controlled or randomized clinical trials (CCT, RCT). 18 studies have been included and successfully rated using the PEDro scale. Results: 16 of 18 studies show strong evidence of strength and flexibility enhancements for the lower limb. While improvements between ECC and concentric training (CONC) were similar for eccentric (+19 ± 10% vs. +19 ± 11%) and isometric strength (+16 ± 10% vs. +13 ± 6%), CONC showed larger improvements for concentric strength (+9 ± 6% vs. +16 ± 7%). While for ROM ECC showed improvements (+9 ± 7%), no results could be found for CONC. The overall effectiveness of ECC seems to be higher than of CONC. Conclusion: There is clear evidence that ECC is an effective method for changes in muscle architecture, leading to both flexibility and strength improvements for the lower limb. Due to limited data no shoulder study could be included. Further research is needed for the upper body joints with a focus on functional and structural adaptions. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021283248, identifier CRD42021283248
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Affiliation(s)
- Sebastian Vetter
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
| | - Axel Schleichardt
- Department of Biomechanics, Institute for Applied Training Science, Leipzig, Germany
| | - Hans-Peter Köhler
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
| | - Maren Witt
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
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13
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Montull L, Slapšinskaitė-Dackevičienė A, Kiely J, Hristovski R, Balagué N. Integrative Proposals of Sports Monitoring: Subjective Outperforms Objective Monitoring. SPORTS MEDICINE - OPEN 2022; 8:41. [PMID: 35348932 PMCID: PMC8964908 DOI: 10.1186/s40798-022-00432-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/26/2022] [Indexed: 12/20/2022]
Abstract
Current trends in sports monitoring are characterized by the massive collection of tech-based biomechanical, physiological and performance data, integrated through mathematical algorithms. However, the application of algorithms, predicated on mechanistic assumptions of how athletes operate, cannot capture, assess and adequately promote athletes' health and performance. The objective of this paper is to reorient the current integrative proposals of sports monitoring by re-conceptualizing athletes as complex adaptive systems (CAS). CAS contain higher-order perceptual units that provide continuous and multilevel integrated information about performer-environment interactions. Such integrative properties offer exceptional possibilities of subjective monitoring for outperforming any objective monitoring system. Future research should investigate how to enhance this human potential to contribute further to athletes' health and performance. This line of argument is not intended to advocate for the elimination of objective assessments, but to highlight the integrative possibilities of subjective monitoring.
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Affiliation(s)
- Lluc Montull
- Complex Systems in Sport Research Group, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona, Barcelona, Spain
- University School of Health and Sport, University of Girona, Girona, Spain
| | - Agne Slapšinskaitė-Dackevičienė
- Complex Systems in Sport Research Group, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona, Barcelona, Spain
- Department of Sports Medicine, Faculty of Nursing and Faculty of Public Health, Health Research Institute, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - John Kiely
- Institute of Coaching and Performance, School of Sport and Wellbeing, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Robert Hristovski
- Complex Systems in Sport Research Group, Faculty of Physical Education, Sport and Health, Ss. Cyril and Methodius University in Skopje, Skopje, Macedonia
| | - Natàlia Balagué
- Complex Systems in Sport Research Group, Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona, Barcelona, Spain.
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14
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Arthrogenic Muscle Inhibition: Best Evidence, Mechanisms, and Theory for Treating the Unseen in Clinical Rehabilitation. J Sport Rehabil 2021; 31:717-735. [PMID: 34883466 DOI: 10.1123/jsr.2021-0139] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 08/06/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT Arthrogenic muscle inhibition (AMI) impedes the recovery of muscle function following joint injury, and in a broader sense, acts as a limiting factor in rehabilitation if left untreated. Despite a call to treat the underlying pathophysiology of muscle dysfunction more than three decades ago, the continued widespread observations of post-traumatic muscular impairments are concerning, and suggest that interventions for AMI are not being successfully integrated into clinical practice. OBJECTIVES To highlight the clinical relevance of AMI, provide updated evidence for the use of clinically accessible therapeutic adjuncts to treat AMI, and discuss the known or theoretical mechanisms for these interventions. EVIDENCE ACQUISITION PubMed and Web of Science electronic databases were searched for articles that investigated the effectiveness or efficacy of interventions to treat outcomes relevant to AMI. EVIDENCE SYNTHESIS 122 articles that investigated an intervention used to treat AMI among individuals with pathology or simulated pathology were retrieved from 1986 to 2021. Additional articles among uninjured individuals were considered when discussing mechanisms of effect. CONCLUSION AMI contributes to the characteristic muscular impairments observed in patients recovering from joint injuries. If left unresolved, AMI impedes short-term recovery and threatens patients' long-term joint health and well-being. Growing evidence supports the use of neuromodulatory strategies to facilitate muscle recovery over the course of rehabilitation. Interventions should be individualized to meet the needs of the patient through shared clinician-patient decision-making. At a minimum, we propose to keep the treatment approach simple by attempting to resolve inflammation, pain, and effusion early following injury.
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15
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Mechanobiology-based physical therapy and rehabilitation after orthobiologic interventions: a narrative review. INTERNATIONAL ORTHOPAEDICS 2021; 46:179-188. [PMID: 34709429 DOI: 10.1007/s00264-021-05253-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This review aims to summarize the evidence for the role of mechanotherapies and rehabilitation in supporting the synergy between regeneration and repair after an orthobiologic intervention. METHODS A selective literature search was performed using Web of Science, OVID, and PubMed to review research articles that discuss the effects of combining mechanotherapy with various forms of regenerative medicine. RESULTS Various mechanotherapies can encourage the healing process for patients at different stages. Taping, bracing, cold water immersion, and extracorporeal shockwave therapy can be used throughout the duration of acute inflammatory response. The regulation of angiogenesis can be sustained with blood flow restriction and resistance training, whereas heat therapy and tissue loading during exercise are recommended in the remodeling phase. CONCLUSION Combining mechanotherapy with various forms of regenerative medicine has shown promise for improving treatment outcomes. However, further studies that reveal a greater volume of evidence are needed to support clinical decisions.
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16
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Kibler WB, Sciascia A, Pike JSM, Howell M, Wilk KE. Effect of Forearm Position on Glenohumeral External Rotation Measurements in Baseball Players. Sports Health 2021; 14:577-584. [PMID: 34323144 DOI: 10.1177/19417381211032917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Alterations in glenohumeral internal rotation (GIR), glenohumeral external rotation (GER), and the total arc of motion (TAM) have been linked with increased injury risk in the shoulder and elbow. These motions have been routinely measured with the forearm in neutral rotation (GIRN, GERN, TAMN). GER capacity appears to be especially important. The throwing motion, however, requires forearm pronation as GER occurs to achieve optimal cocking (GERP). No previous studies have evaluated GERP to determine GER capacity or pronated TAM (TAMP) values. HYPOTHESIS There would be significant differences between GERN and TAMN and between GERP and TAMP. STUDY DESIGN Cross-sectional. LEVEL OF EVIDENCE Level 3. METHODS Sixty asymptomatic male Minor League Baseball players (32 pitchers, 28 position players) participated in the study and were tested on the first day of spring training. Passive range of motion measurements were recorded using a long-arm bubble goniometer for GIRN, GERN, and GERP on both arms. TAM was calculated separately as the sum of internal and external rotational measurements under neutral and pronated conditions. RESULTS Within pitchers and position players, all measurements were statistically reduced for the throwing arm (P ≤ 0.03) except for GERN of the pitchers. GERP measures were significantly less than GERN for both arms of each group (P < 0.01): pitchers throwing arm +11.8°/nonthrowing arm +4.8°, position players throwing arm = +8.6°/nonthrowing arm +4.0°. CONCLUSION The forearm position of pronation, which appears to be mediated by tightness of the biceps, decreases GER capacity and TAM. GER and TAM should be calculated in neutral and pronated positions, considering that 80% of the players have a demonstrated difference between 8° and 12°. CLINICAL RELEVANCE Measurement of GERP more accurately reflects the GER required in throwing, allows better quantification of the motion capacity necessary to withstand the loads in throwing, and may suggest interventions for at risk athletes.
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Affiliation(s)
- W Ben Kibler
- Shoulder Center of Kentucky, Lexington Clinic, Lexington, Kentucky
| | - Aaron Sciascia
- Department of Exercise and Sport Science, Eastern Kentucky University, Richmond, Kentucky
| | | | - Michael Howell
- Shoulder Center of Kentucky, Lexington Clinic, Lexington, Kentucky
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17
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Van Pelt DW, Lawrence MM, Miller BF, Butterfield TA, Dupont-Versteegden EE. Massage as a Mechanotherapy for Skeletal Muscle. Exerc Sport Sci Rev 2021; 49:107-114. [PMID: 33720912 PMCID: PMC8320327 DOI: 10.1249/jes.0000000000000244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Massage is anecdotally associated with many health benefits, but physiological and clinically relevant mechanisms recently have begun to be investigated in a controlled manner. Herein, we describe research supporting our hypothesis that massage can be used as a mechanotherapy imparting biologically relevant adaptations in skeletal muscle and improving muscle properties.
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Affiliation(s)
- Douglas W Van Pelt
- Department of Physical Therapy and Center for Muscle Biology, University of Kentucky, Lexington, KY
| | - Marcus M Lawrence
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - Benjamin F Miller
- Aging and Metabolism Research Program, Oklahoma Medical Research Foundation, Oklahoma City, OK
| | - Timothy A Butterfield
- Department of Athletic Training and Clinical Nutrition and Center for Muscle Biology, University of Kentucky, Lexington, KY
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18
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Kang L, Liu P, Peng A, Sun B, He Y, Huang Z, Wang M, Hu Y, He B. Application of traditional Chinese therapy in sports medicine. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 3:11-20. [PMID: 35782678 PMCID: PMC9219272 DOI: 10.1016/j.smhs.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/05/2021] [Accepted: 02/05/2021] [Indexed: 01/31/2023] Open
Abstract
Chinese herbs have been used as dietary supplements to improve exercise performance. However, evidence-based studies for the use of Chinese herbs in sports remain scarce. Traditional Chinese therapy (TCT), a form of traditional Chinese non-pharmacological intervention, has remained in use for thousands of years in sports medicine. TCT is beneficial for sports injuries and in enhancing skill development, and is becoming increasingly popular among athletes, fitness enthusiasts, and individuals who regularly exercise. The therapeutic effects of TCT have been demonstrated by clinical and experimental studies, but using these modalities still is associate with potentially adverse effects. Further well-designed studies are necessary to confirm the efficacy of TCT in sports medicine. This review aims to summarize the application of TCT, discuss the issues surrounding TCT clinical research, and provide suggestions for applying traditional Chinese methods in the field of sports medicine.
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Affiliation(s)
- Liang Kang
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, 610041, China
| | - Peijie Liu
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, 610041, China
| | - Aishi Peng
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, 610041, China
| | - Bingxin Sun
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, 610041, China
| | - Yumei He
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, 610041, China
| | - Zenghao Huang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, 610041, China
| | - Minjia Wang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, 610041, China
| | - Yushi Hu
- Sport Hospital Affiliated to Chengdu Sport University, Chengdu, 610041, China
| | - Benxiang He
- Sport Hospital Affiliated to Chengdu Sport University, Chengdu, 610041, China
- Corresponding author. Sport Hospital Affiliated to Chengdu Sports University, 610041, No. 251, Wuhou Temple Street, Wuhou District, Chengdu, China.
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19
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Edouard P, Hollander K, Navarro L, Lacourpaille L, Morales-Artacho AJ, Hanon C, Morin JB, Le Garrec S, Branco P, Junge A, Guilhem G. Lower limb muscle injury location shift from posterior lower leg to hamstring muscles with increasing discipline-related running velocity in international athletics championships. J Sci Med Sport 2021; 24:653-659. [PMID: 33632663 DOI: 10.1016/j.jsams.2021.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/18/2020] [Accepted: 02/07/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To analyse the rates of lower limb muscle injuries in athletics disciplines requiring different running velocities during international athletics championships. DESIGN Prospective total population study. METHODS During 13 international athletics championships (2009-2019) national medical teams and local organizing committee physicians daily reported all newly incurred injuries using the same study design, injury definition and data collection procedures. In-competition lower limb muscle injuries of athletes participating in disciplines involving running (i.e. sprints, hurdles, jumps, combined events, middle distances, long distances, and marathon) were analysed. RESULTS Among the 12,233 registered athletes, 344 in-competition lower limb muscle injuries were reported (36% of all in-competition injuries). The proportion, incidence rates and injury burden of lower limb muscles injuries differed between disciplines for female and male athletes. The most frequently injured muscle group was hamstring in sprints, hurdles, jumps, combined events and male middle distances runners (43-75%), and posterior lower leg in female middle distances, male long distances, and female marathon runners (44-60%). Hamstring muscles injuries led to the highest burden in all disciplines, except for female middle distance and marathon and male long distance runners. Hamstring muscles injury burden was generally higher in disciplines requiring higher running velocities, and posterior lower leg muscle injuries higher in disciplines requiring lower running velocities. CONCLUSIONS The present study shows discipline-specific injury location in competition context. Our findings suggest that the running velocity could be one of the factors that play a role in the occurrence/location of muscle injuries.
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Affiliation(s)
- Pascal Edouard
- Inter-university Laboratory of Human Movement Science (LIBM EA 7424), University of Lyon, University Jean Monnet, France; Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, France; European Athletics Medical and Anti Doping Commission, European Athletics Association (EAA), Switzerland.
| | | | - Laurent Navarro
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U 1059 Sainbiose, Centre CIS, France
| | - Lilian Lacourpaille
- University of Nantes, Movement, Interactions, Performance, MIP, EA 4334, France
| | | | - Christine Hanon
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), France; French Athletics Federation (FFA), France
| | - Jean-Benoît Morin
- Inter-university Laboratory of Human Movement Science (LIBM EA 7424), University of Lyon, University Jean Monnet, France; Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, New Zealand
| | | | - Pedro Branco
- European Athletics Medical and Anti Doping Commission, European Athletics Association (EAA), Switzerland
| | - Astrid Junge
- Medical School Hamburg, Germany; Swiss Concussion Center, Schulthess Clinic Zürich, Switzerland
| | - Gaël Guilhem
- French Institute of Sport (INSEP), Laboratory Sport, Expertise and Performance (EA 7370), France
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20
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Hösl M, Kruse A, Tilp M, Svehlik M, Böhm H, Zehentbauer A, Arampatzis A. Impact of Altered Gastrocnemius Morphometrics and Fascicle Behavior on Walking Patterns in Children With Spastic Cerebral Palsy. Front Physiol 2020; 11:518134. [PMID: 33178029 PMCID: PMC7597072 DOI: 10.3389/fphys.2020.518134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 08/27/2020] [Indexed: 11/13/2022] Open
Abstract
Spastic cerebral palsy (SCP) affects neural control, deteriorates muscle morphometrics, and may progressively impair functional walking ability. Upon passive testing, gastrocnemius medialis (GM) muscle bellies or fascicles are typically shorter, thinner, and less extensible. Relationships between muscle and gait parameters might help to understand gait pathology and pathogenesis of spastic muscles. The current aim was to link resting and dynamic GM morphometrics and contractile fascicle behavior (both excursion and velocity) during walking to determinants of gait. We explored the associations between gait variables and ultrasonography of the GM muscle belly captured during rest and during gait in children with SCP [n = 15, gross motor function classification system (GMFCS) levels I and II, age: 7–16 years] and age-matched healthy peers (n = 17). The SCP children’s plantar flexors were 27% weaker. They walked 12% slower with more knee flexion produced 42% less peak ankle push-off power (all p < 0.05) and 7/15 landed on their forefoot. During the stance phase, fascicles in SCP on average operated on 9% shorter length (normalized to rest length) and displayed less and slower fascicle shortening (37 and 30.6%, respectively) during push-off (all p ≤ 0.024). Correlation analyses in SCP patients revealed that (1) longer-resting fascicles and thicker muscle bellies are positively correlated with walking speed and negatively to knee flexion (r = 0.60–0.69, p < 0.0127) but not to better ankle kinematics; (2) reduced muscle strength was associated with the extent of eccentric fascicle excursion (r = −0.57, p = 0.015); and (3) a shorter operating length of the fascicles was correlated with push-off power (r = −0.58, p = 0.013). Only in controls, a correlation (r = 0.61, p = 0.0054) between slower fascicle shortening velocity and push-off power was found. Our results indicate that a thicker gastrocnemius muscle belly and longer gastrocnemius muscle fascicles may be reasonable morphometric properties that should be targeted in interventions for individuals with SCP, since GM muscle atrophy may be related to decreases in walking speed and undesired knee flexion during gait. Furthermore, children with SCP and weaker gastrocnemius muscle may be more susceptible to chronic eccentric muscle overloading. The relationship between shorter operating length of the fascicles and push-off power may further support the idea of a compensation mechanism for the longer sarcomeres found in children with SCP. Nevertheless, more studies are needed to support our explorative findings.
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Affiliation(s)
- Matthias Hösl
- Gait and Motion Analysis Laboratory, Schön Klinik Vogtareuth, Vogtareuth, Germany
| | - Annika Kruse
- Department of Biomechanics, Movement and Training Sciences, Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Markus Tilp
- Department of Biomechanics, Movement and Training Sciences, Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Martin Svehlik
- Paediatric Orthopaedics Unit, Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - Harald Böhm
- Gait Laboratory, Orthopedic Children's Hospital Aschau, Aschau im Chiemgau, Germany
| | - Antonia Zehentbauer
- Human Movement Science, Faculty of Sports Science, Ruhr University Bochum, Bochum, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt University of Berlin, Berlin, Germany.,Berlin School of Movement Science, Humboldt University of Berlin, Berlin, Germany
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21
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Pol R, Balagué N, Ric A, Torrents C, Kiely J, Hristovski R. Training or Synergizing? Complex Systems Principles Change the Understanding of Sport Processes. SPORTS MEDICINE - OPEN 2020; 6:28. [PMID: 32661759 PMCID: PMC7359207 DOI: 10.1186/s40798-020-00256-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 06/25/2020] [Indexed: 11/10/2022]
Abstract
There is a need to update scientific assumptions in sport to promote the critical thinking of scientists, coaches, and practitioners and improve their methodological decisions. On the basis of complex systems science and theories of biological evolution, a systematization and update of theoretical and methodological principles to transform the understanding of sports training is provided. The classical focus on learning/acquiring skills and fitness is replaced by the aim of increasing the diversity/unpredictability potential of teams/athletes through the development of synergies. This development is underpinned by the properties of hierarchical organization and circular causality of constraints, that is, the nestedness of constraints acting at different levels and timescales. These properties, that integrate bottom-up and top-down all dimensions and levels of performance (from social to genetic), apply to all types of sport, ages, or levels of expertise and can be transferred to other fields (e.g., education, health, management). The team as the main training unit of intervention, the dynamic concept of task representativeness, and the co-adaptive and synergic role of the agents are some few practical consequences of moving from training to synergizing.
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Affiliation(s)
- Rafel Pol
- Real Federación Española de Fútbol (Spain), Complex Systems in Sport Research Group, Institut Nacional d’Educació Física de Catalunya (INEFC), University of Lleida (UdL), Complex de la Caparrella, s/n, 25192 Lleida, Spain
| | - Natàlia Balagué
- Complex Systems in Sport Research Group, Institut Nacional d’Educació Física de Catalunya (INEFC), University of Barcelona (UB), Av. de l’Estadi, 12-22, 08038 Barcelona, Spain
| | - Angel Ric
- FC Barcelona, Barcelona (Spain), Complex Systems in Sport Research Group, Institut Nacional d’Educació Física de Catalunya (INEFC), University of Lleida (UdL), Complex de la Caparrella, s/n, 25192 Lleida, Spain
| | - Carlota Torrents
- Complex Systems in Sport Research Group, Institut Nacional d’Educació Física de Catalunya (INEFC), University of Lleida (UdL), Complex de la Caparrella, s/n, 25192 Lleida, Spain
| | - John Kiely
- Institute of Coaching and Performance, School of Sport and Wellbeing, University of Central Lancashire, Preston, PR1 2HE UK
| | - Robert Hristovski
- Complex Systems in Sport Research Group, Faculty of Physical Education, Sport and Health, Ss. Cyril and Methodius University, Dimche Mirchev, 1000, Skopje, North Macedonia
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22
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Doguet V, Nosaka K, Guével A, Ishimura K, Guilhem G, Jubeau M. Influence of fascicle strain and corticospinal excitability during eccentric contractions on force loss. Exp Physiol 2019; 104:1532-1543. [PMID: 31374136 DOI: 10.1113/ep087664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/29/2019] [Indexed: 12/13/2022]
Abstract
NEW FINDINGS What is the central question of this study? Do neural and/or mechanical factors determine the extent of muscle damage induced by eccentric contractions? What is the main finding and its importance? The extent of muscle damage induced by eccentric contractions is related to both mechanical strain and corticospinal excitability measured at long muscle lengths during eccentric contractions. ABSTRACT In this study, we investigated whether the mechanical and neural characteristics of maximal voluntary eccentric contractions would determine the extent of change in postexercise maximal voluntary isometric contraction (MVC) torque and muscle soreness. Eleven men performed 10 sets of 15 isokinetic (45 deg s-1 ) maximal voluntary eccentric knee extensions. Knee-extension torque and vastus lateralis fascicle length were assessed at sets 1, 5 and 9. Vastus lateralis motor evoked potential, maximal M wave (MEP/M) and the cortical silent period (CSP) were measured at 75 and 100 deg of knee flexion (0 deg = full extension) during contractions and were normalized to MEP/M (MEP/Mecc/iso ) and CSP (CSPecc/iso ) recorded during isometric MVC at each angle. The MVC torque and muscle soreness of the knee extensors were assessed before, 24, 48 and 96 h after the eccentric contractions. The extent of relative decrease in MVC torque at 24 h postexercise (r2 = 0.38) and peak muscle soreness (r2 = 0.69) were correlated (P < 0.05) with MEP/Mecc/iso measured at 100 deg, but not at 75 deg. The average torque on the descending limb of the torque-angle relationship (r2 = 0.16), fascicle elongation (r2 = 0.18) and CSPecc/iso at both 75 (r2 = 0.00) and 100 deg (r2 = 0.02) were not significantly correlated with the relative decrease in MVC torque. The relative decrease in MVC torque was best predicted by a combination of mean torque on the descending limb, fascicle elongation and MEP/Mecc/iso (R2 = 0.93). It is concluded that the extent of muscle damage based on the reduction in MVC torque is determined by mechanical strain and corticospinal excitability at long muscle lengths during maximal voluntary eccentric contractions.
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Affiliation(s)
- Valentin Doguet
- Nantes Université, Movement-Interactions-Performance, MIP, EA 4334, F-44000, Nantes, France.,Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia
| | - Kazunori Nosaka
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia
| | - Arnaud Guével
- Nantes Université, Movement-Interactions-Performance, MIP, EA 4334, F-44000, Nantes, France
| | - Kazuhiro Ishimura
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia
| | - Gaël Guilhem
- French Institute of Sport (INSEP), Research Department, Laboratory "Sport, Expertise and Performance", EA, 7370, Paris, France
| | - Marc Jubeau
- Nantes Université, Movement-Interactions-Performance, MIP, EA 4334, F-44000, Nantes, France
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23
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Nocella C, Cammisotto V, Pigozzi F, Borrione P, Fossati C, D'Amico A, Cangemi R, Peruzzi M, Gobbi G, Ettorre E, Frati G, Cavarretta E, Carnevale R. Impairment between Oxidant and Antioxidant Systems: Short- and Long-term Implications for Athletes' Health. Nutrients 2019; 11:E1353. [PMID: 31208096 PMCID: PMC6627820 DOI: 10.3390/nu11061353] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 06/06/2019] [Accepted: 06/11/2019] [Indexed: 02/07/2023] Open
Abstract
The role of oxidative stress, an imbalance between reactive oxygen species production (ROS) and antioxidants, has been described in several patho-physiological conditions, including cardiovascular, neurological diseases and cancer, thus impacting on individuals' lifelong health. Diet, environmental pollution, and physical activity can play a significant role in the oxidative balance of an organism. Even if physical training has proved to be able to counteract the negative effects caused by free radicals and to provide many health benefits, it is also known that intensive physical activity induces oxidative stress, inflammation, and free radical-mediated muscle damage. Indeed, variations in type, intensity, and duration of exercise training can activate different patterns of oxidant-antioxidant balance leading to different responses in terms of molecular and cellular damage. The aim of the present review is to discuss (1) the role of oxidative status in athletes in relation to exercise training practice, (2) the implications for muscle damage, (3) the long-term effect for neurodegenerative disease manifestations, (4) the role of antioxidant supplementations in preventing oxidative damages.
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Affiliation(s)
- Cristina Nocella
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, 00161 Rome, Italy.
| | - Vittoria Cammisotto
- Department of General Surgery and Surgical Speciality Paride Stefanini, Sapienza University of Rome, 00161 Rome, Italy.
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy.
| | - Paolo Borrione
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy.
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy.
| | - Alessandra D'Amico
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", 00135 Rome, Italy.
| | - Roberto Cangemi
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, 00161 Rome, Italy.
| | - Mariangela Peruzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
- Mediterranea Cardiocentro, 80122 Napoli, Italy.
| | - Giuliana Gobbi
- Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), Anatomy and Histology Unit, University of Parma, Ospedale Maggiore, 43126 Parma, Italy.
| | - Evaristo Ettorre
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, 00161 Rome, Italy.
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
- IRCCS Neuromed, 86077 Pozzilli IS, Italy.
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
- Mediterranea Cardiocentro, 80122 Napoli, Italy.
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy.
- Mediterranea Cardiocentro, 80122 Napoli, Italy.
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24
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Kellis E. Intra- and Inter-Muscular Variations in Hamstring Architecture and Mechanics and Their Implications for Injury: A Narrative Review. Sports Med 2019; 48:2271-2283. [PMID: 30117053 DOI: 10.1007/s40279-018-0975-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Understanding the architecture, anatomy, and biomechanics of the hamstrings may assist in explaining the mechanisms that affect and improve their function. The aim of this review is to specifically examine intra- and inter-muscular variations in architecture and mechanical properties of the hamstrings. Of the hamstrings, the long head of the biceps femoris shows the shortest and more pennated fibers. The semimembranosus has a similar muscle architecture with a long head of the biceps femoris but it has a different proximal attachment as well as a different moment arm compared with the long head of the biceps femoris. For the same joint motion, the semitendinosus displays less relative strain than the other hamstrings probably owing to a greater length, longer fascicles and, possibly, a longer tendon. Intra-muscular variations in architecture are documented but their implications are currently unclear. Proximally, the long head of the biceps femoris has shorter and more pennated fibers coupled with a narrower aponeurosis than distally, while the semitendinosus is the only muscle that entails a tendinous inscription. In conclusion, some of the identified intra- and inter-muscular variations in architecture may help explain why some muscles sustain injuries more than others. In the same line, exercises designed for the hamstrings may not provide the same stimulus for all components of this muscle group. Future research could examine whether intervention strategies that target specific muscles or specific areas of the hamstrings may offer additional benefits for injury prevention or rehabilitation of their function.
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Affiliation(s)
- Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, 62110, Greece.
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25
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Lichtwark GA, Farris DJ, Chen X, Hodges PW, Delp SL. Microendoscopy reveals positive correlation in multiscale length changes and variable sarcomere lengths across different regions of human muscle. J Appl Physiol (1985) 2018; 125:1812-1820. [DOI: 10.1152/japplphysiol.00480.2018] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Sarcomere length is a key physiological parameter that affects muscle force output; however, our understanding of the scaling of human muscle from sarcomere to whole muscle is based primarily on cadaveric data. The aims of this study were to explore the in vivo relationship between passive fascicle length and passive sarcomere length at different muscle-tendon unit lengths and determine whether sarcomere and fascicle length relationships are the same in different regions of muscle. A microendoscopy needle probe capable of in vivo sarcomere imaging was inserted into a proximal location of the human tibialis anterior muscle at three different ankle positions [5° dorsiflexion, 5° plantar flexion (PF), and 15° PF] and one distal location at a constant ankle position (5° PF distal). Ultrasound imaging of tibialis anterior fascicles, centered on the location of the needle probe, was performed for each condition to estimate fascicle length. Sarcomere length and fascicle length increased with increasing muscle-tendon unit length, although the correlation between sarcomere length change and muscle fascicle length change was only moderate ( r2 = 0.45). Passive sarcomere length was longer at the distal imaging site than the proximal site ( P = 0.01). When sarcomere number was estimated from sarcomere length and fascicle length, there were fewer sarcomeres in the fibers of distal location than the proximal location ( P = 0.01). These data demonstrate that fascicle length changes are representative of sarcomere length changes, although significant variability in sarcomere length exists within a muscle and sarcomere number per fiber is region-dependent. NEW & NOTEWORTHY Sarcomere and fascicle lengths were measured in vivo from human muscle to examine the relationship between the different scales of organization. Changes in fascicle length were moderately related to sarcomere length changes; however, sarcomere length and number per fiber varied from proximal to distal regions of the muscle. Differences in average sarcomere operating lengths across the muscle suggest potentially different stresses or strains experienced within different regions of muscle.
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Affiliation(s)
- Glen A. Lichtwark
- School of Human Movement and Nutrition Sciences, Centre for Sensorimotor Performance, The University of Queensland, Brisbane, Queensland, Australia
| | - Dominic J. Farris
- School of Human Movement and Nutrition Sciences, Centre for Sensorimotor Performance, The University of Queensland, Brisbane, Queensland, Australia
- Sport and Health Sciences, College of Life and Environmental Sciences, The University of Exeter, Exeter, United Kingdom
| | - Xuefeng Chen
- Department of Bioengineering, Stanford University, Stanford, California
| | - Paul W. Hodges
- School of Health and Rehabilitation Sciences, Centre for Clinical Research Excellence in Spinal Pain, Injury, and Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Scott L. Delp
- Department of Bioengineering, Stanford University, Stanford, California
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26
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Menezes MA, Pereira TAB, Tavares LM, Leite BTQ, Neto AGR, Chaves LMS, Lima LV, Da Silva-Grigolleto ME, DeSantana JM. Immediate effects of transcutaneous electrical nerve stimulation (TENS) administered during resistance exercise on pain intensity and physical performance of healthy subjects: a randomized clinical trial. Eur J Appl Physiol 2018; 118:1941-1958. [PMID: 29978261 DOI: 10.1007/s00421-018-3919-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Exercise-induced muscle pain is a self-limiting condition which impacts physical activity habits. Transcutaneous electrical nerve stimulation (TENS) promotes pain reduction and functional improvement in different pain conditions. We propose that applying TENS during exercise might reduce pain and improve physical performance. Thus, we aimed to investigate immediate effects of TENS applied during resistance exercise. METHODS Healthy subjects of both sexes, irregularly active or sedentary were assigned into two groups: active (n = 24) or placebo (n = 22) TENS. The study was conducted over five moments: on day 0, subjects were recruited, on day 1 subjects performed the one-repetition maximum test (1RM); 72 h later, on day 2, 1RM was retested; 48 h later, on day 3, TENS was applied during a functional-resisted exercise protocol for upper limbs (bench press and rowing), with an intensity of 80% of 1RM; and 24 h after, on day 4, subjects were reevaluated. Assessment included pain intensity at rest and with movement, pressure pain thresholds, and muscle fatigue. RESULTS TENS did not reduce pain intensity when compared to placebo (p > 0.05). TENS reduce PPT in the latissmus dorsi: p = 0.02 and anterior tibialis: p = 0.04 in immediate reassessment. Immediate effects of TENS were significant for fatigue perception at rest (p = 0.01) and number of maximum repetitions during exercise sets, starting from the 5th set of rowing exercise (p = 0.002). CONCLUSION Our results show that TENS did not reduce pain perception in healthy individuals, but its use induced increased muscle action, contributing to a greater fatigue perception.
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Affiliation(s)
- Mayara A Menezes
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Thaís A B Pereira
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Leonardo M Tavares
- Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Belissa T Q Leite
- Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Antônio G R Neto
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Leury M S Chaves
- Department of Physical Education, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Lucas V Lima
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Marzo E Da Silva-Grigolleto
- Graduate Program in Physiological Sciences, Federal University of Sergipe, Aracaju, SE, Brazil.,Department of Physical Education, Federal University of Sergipe, Aracaju, SE, Brazil
| | - Josimari M DeSantana
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, SE, Brazil. .,Graduate Program in Physiological Sciences, Federal University of Sergipe, Aracaju, SE, Brazil. .,Department of Physical Therapy, Federal University of Sergipe, Aracaju, SE, Brazil. .,Department of Physical Therapy, Federal University of Sergipe, Av. Marechal Rondon, s/n, São Cristóvão, SE, 49100-000, Brazil.
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27
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Pol R, Hristovski R, Medina D, Balague N. From microscopic to macroscopic sports injuries. Applying the complex dynamic systems approach to sports medicine: a narrative review. Br J Sports Med 2018; 53:1214-1220. [PMID: 29674346 DOI: 10.1136/bjsports-2016-097395] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2018] [Indexed: 11/04/2022]
Abstract
A better understanding of how sports injuries occur in order to improve their prevention is needed for medical, economic, scientific and sports success reasons. This narrative review aims to explain the mechanisms that underlie the occurrence of sports injuries, and an innovative approach for their prevention on the basis of complex dynamic systems approach. First, we explain the multilevel organisation of living systems and how function of the musculoskeletal system may be impaired. Second, we use both, a constraints approach and a connectivity hypothesis to explain why and how the susceptibility to sports injuries may suddenly increase. Constraints acting at multiple levels and timescales replace the static and linear concept of risk factors, and the connectivity hypothesis brings an understanding of how the accumulation of microinjuries creates a macroscopic non-linear effect, that is, how a common motor action may trigger a severe injury. Finally, a recap of practical examples and challenges for the future illustrates how the complex dynamic systems standpoint, changing the way of thinking about sports injuries, offers innovative ideas for improving sports injury prevention.
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Affiliation(s)
- Rafel Pol
- Futbol Club Barcelona. Complex Systems in Sport Research Group, INEFC, Universitat de Lleida (UdL), Barcelona, Spain
| | - Robert Hristovski
- Complex Systems in Sport Research Group, Faculty of Physical Education, Sport and Health, Saints Cyril and Methodius University, Skopje, Macedonia (the former Yugoslav Republic of Macedonia)
| | - Daniel Medina
- Futbol Club Barcelona. Complex Systems in Sport Research Group, Barcelona, Spain
| | - Natalia Balague
- Complex Systems in Sport Research Group, INEFC, Universitat de Barcelona (UB), Barcelona, Spain
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28
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Baker BA. Efficacy of Age-Specific High-Intensity Stretch-Shortening Contractions in Reversing Dynapenia, Sarcopenia, and Loss of Skeletal Muscle Quality. J Funct Morphol Kinesiol 2018; 3:36. [PMID: 31149646 PMCID: PMC6537613 DOI: 10.3390/jfmk3020036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
During the aging process, skeletal muscle performance and physiology undergoes alterations leading to decrements in functional capacity, health-span, and independence. Background: The utility and implementation of age-specific exercise is a paramount research agenda focusing on ameliorating the loss of both skeletal muscle performance and physiology; yet, to date, no consensus exists as to the most appropriate mechanical loading protocol design or overall exercise prescription that best meets this need. Thus, the purpose of this review is to highlight the most optimal type of exercise presently available and provide the most current, evidence-based findings for its efficacy. The hypothesis that high-intensity, stretch-shortening contractions (SSCs)-a form of "resistance-type exercise" training-present as the preferred exercise mode for serving as an intervention-based modality to attenuate dynapenia, sarcopenia, and decreased muscle quality with aging, even restoring the overall youthful phenotype, will be demonstrated. Conclusions: Appreciating the fundamental evidence supporting the use of high-intensity SSCs in positively impacting aging skeletal muscle's responsivity and their use as a specific and sensitive countermeasure is crucial. Moreover, from an applied perspective, SSCs may improve skeletal muscle quality and rejuvenate health-span and, ultimately, lead to augmented functional capacity, independence, and quality of life concomitant with decreased morbidity.
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Affiliation(s)
- Brent A Baker
- Health Effects Laboratory Division, Toxicology and Molecular Biology Branch, Systems Mechanophysiology and Aging Research Team, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
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29
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Damas F, Libardi CA, Ugrinowitsch C. The development of skeletal muscle hypertrophy through resistance training: the role of muscle damage and muscle protein synthesis. Eur J Appl Physiol 2017; 118:485-500. [PMID: 29282529 DOI: 10.1007/s00421-017-3792-9] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/16/2017] [Indexed: 11/25/2022]
Abstract
Resistance training (RT)-induced skeletal muscle hypertrophy is a highly intricate process. Despite substantial advances, we are far from understanding exactly how muscle hypertrophy develops during RT. The aim of the present review is to discuss new insights related to the role of skeletal muscle damage and muscle protein synthesis (MPS) in mediating RT-induced hypertrophy. Specifically, the thesis that in the early phase of RT (≤ 4 previous RT sessions) increases in muscle cross-sectional area are mostly attributable to muscle damage-induced muscle swelling; then (after ~ 10 sessions), a modest magnitude of muscle hypertrophy ensues; but only during a latter phase of RT (after ~ 18 sessions) is true muscle hypertrophy observed. We argue that the initial increases in MPS post-RT are likely directed to muscle repair and remodelling due to damage, and do not correlate with eventual muscle hypertrophy induced by several RT weeks. Increases in MPS post-RT session only contribute to muscle hypertrophy after a progressive attenuation of muscle damage, and even more significantly when damage is minimal. Furthermore, RT protocols that do not promote significant muscle damage still induce similar muscle hypertrophy and strength gains compared to conditions that do promote initial muscle damage. Thus, we conclude that muscle damage is not the process that mediates or potentiates RT-induced muscle hypertrophy.
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Affiliation(s)
- Felipe Damas
- School of Physical Education and Sport, University of São Paulo, Av. Prof. Mello Moraes, 65, São Paulo, SP, 05508-030, Brazil. .,Laboratory of Neuromuscular Adaptations to Resistance Training-MUSCULAB, Department of Physical Education, Federal University of São Carlos, Rod. Washington Luiz, km 235-SP310, São Carlos, SP, 13565-905, Brazil.
| | - Cleiton A Libardi
- Laboratory of Neuromuscular Adaptations to Resistance Training-MUSCULAB, Department of Physical Education, Federal University of São Carlos, Rod. Washington Luiz, km 235-SP310, São Carlos, SP, 13565-905, Brazil
| | - Carlos Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, Av. Prof. Mello Moraes, 65, São Paulo, SP, 05508-030, Brazil
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30
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Hicks KM, Onambele-Pearson GL, Winwood K, Morse CI. Muscle-Tendon Unit Properties during Eccentric Exercise Correlate with the Creatine Kinase Response. Front Physiol 2017; 8:657. [PMID: 28974931 PMCID: PMC5610718 DOI: 10.3389/fphys.2017.00657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 08/17/2017] [Indexed: 11/13/2022] Open
Abstract
Aim: The aim of this paper was to determine whether; (1) patella tendon stiffness, (2) the magnitude of vastus lateralis fascicle lengthening, and (3) eccentric torque correlate with markers of exercise induced muscle damage. Method: Combining dynamometry and ultrasonography, patella tendon properties and vastus lateralis architectural properties were measured pre and during the first of six sets of 12 maximal voluntary eccentric knee extensions. Maximal isometric torque loss and creatine kinase activity were measured pre-damage (-48 h), 48, 96, and 168 h post-damage as markers of exercise-induced muscle damage. Results: A significant increase in creatine kinase (883 ± 667 UL) and a significant reduction in maximal isometric torque loss (21%) was reported post-eccentric contractions. Change in creatine kinase from pre to peak significantly correlated with the relative change in vastus lateralis fascicle length during eccentric contractions (r = 0.53, p = 0.02) and with eccentric torque (r = 0.50, p = 0.02). Additionally, creatine kinase tended to correlate with estimated patella tendon lengthening during eccentric contractions (p < 0.10). However, creatine kinase did not correlate with resting measures of patella tendon properties or vastus lateralis properties. Similarly, torque loss did not correlate with any patella tendon or vastus lateralis properties at rest or during eccentric contractions. Conclusion: The current study demonstrates that the extent of fascicle strain during eccentric contractions correlates with the magnitude of the creatine kinase response. Although at rest, there is no relationship between patella tendon properties and markers of muscle damage; during eccentric contractions however, the patella tendon may play a role in the creatine kinase response following EIMD.
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Affiliation(s)
- Kirsty M Hicks
- Department of Sport, Exercise & Rehabilitation, Northumbria UniversityNewcastle Upon Tyne, United Kingdom.,Department of Exercise and Sport Science, Health Exercise and Active Living Research Centre, Manchester Metropolitan UniversityCrewe, United Kingdom
| | - Gladys L Onambele-Pearson
- Department of Exercise and Sport Science, Health Exercise and Active Living Research Centre, Manchester Metropolitan UniversityCrewe, United Kingdom
| | - Keith Winwood
- Department of Exercise and Sport Science, Health Exercise and Active Living Research Centre, Manchester Metropolitan UniversityCrewe, United Kingdom.,School of Healthcare Science, Manchester Metropolitan UniversityManchester, United Kingdom
| | - Christopher I Morse
- Department of Exercise and Sport Science, Health Exercise and Active Living Research Centre, Manchester Metropolitan UniversityCrewe, United Kingdom
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Abstract
Context: Neuromuscular alterations are a major causal factor of primary and secondary injuries. Though injury prevention programs have experienced some success, rates of injuries have not declined, and after injury, individuals often return to activity with functionality below clinical recommendations. Considering alternative therapies to the conventional concentric exercise approach, such as one that can target neuromuscular injury risk and postinjury alterations, may provide for more effective injury prevention and rehabilitation protocols. Evidence Acquisition: Peer-reviewed sources available on the Web of Science and MEDLINE databases from 2000 through 2016 were gathered using searches associated with the keywords eccentric exercise, injury prevention, and neuromuscular control. Hypothesis: Eccentric exercise will reduce injury risk by targeting specific neural and morphologic alterations that precipitate neuromuscular dysfunction. Study Design: Clinical review. Level of Evidence: Level 4. Results: Neuromuscular control is influenced by alterations in muscle morphology and neural activity. Eccentric exercise beneficially modifies several underlying factors of muscle morphology (fiber typing, cross-sectional area, working range, and pennation angle), and emerging evidence indicates that eccentric exercise is also beneficial to peripheral and central neural activity (alpha motorneuron recruitment/firing, sarcolemma activity, corticospinal excitability, and brain activation). Conclusion: There is mounting evidence that eccentric exercise is not only a therapeutic intervention influencing muscle morphology but also targets unique alterations in neuromuscular control, influencing injury risk.
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Affiliation(s)
- Lindsey K Lepley
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Adam S Lepley
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - James A Onate
- School of Health and Rehabilitative Sciences, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Dustin R Grooms
- Ohio Musculoskeletal & Neurological Institute, Ohio University, Athens, Ohio.,Division of Athletic Training, School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, Ohio
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32
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Effectiveness of a Home-Based Eccentric-Exercise Program on the Torque-Angle Relationship of the Shoulder External Rotators: A Pilot Study. J Sport Rehabil 2017; 26:141-150. [PMID: 28414265 DOI: 10.1123/jsr.2017-0020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT The role of the rotator cuff is to provide dynamic stability to the glenohumeral joint. Human and animal studies have identified sarcomerogenesis as an outcome of eccentric training indicated by more torque generation with the muscle in a lengthened position. OBJECTIVE The authors hypothesized that a home-based eccentric-exercise program could increase the shoulder external rotators' eccentric strength at terminal internal rotation (IR). DESIGN Prospective case series. SETTING Clinical laboratory and home exercising. PARTICIPANTS 10 healthy subjects (age 30 ± 10 y). INTERVENTION All participants performed 2 eccentric exercises targeting the posterior shoulder for 6 wk using a home-based intervention program using side-lying external rotation (ER) and horizontal abduction. MAIN OUTCOME MEASURES Dynamic eccentric shoulder strength measured at 60°/s through a 100° arc divided into 4 equal 25° arcs (ER 50-25°, ER 25-0°, IR 0-25°, IR 25-50°) to measure angular impulse to represent the work performed. In addition, isometric shoulder ER was measured at 5 points throughout the arc of motion (45° IR, 30° IR, 15° IR, 0°, and 15° ER). Comparison of isometric and dynamic strength from pre- to posttesting was evaluated with a repeated-measure ANOVA using time and arc or positions as within factors. RESULTS The isometric force measures revealed no significant differences between the 5 positions (P = .56). Analysis of the dynamic eccentric data revealed a significant difference between arcs (P = .02). The percentage-change score of the arc of IR 25-50° was found to be significantly greater than that of the arc of IR 0-25° (P = .007). CONCLUSION After eccentric training the only arc of motion that had a positive improvement in the capacity to absorb eccentric loads was the arc of motion that represented eccentric contractions at the longest muscle length.
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33
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Abstract
Clinical Scenario: Even though chronological aging is an inevitable phenomenological consequence occurring in every living organism, it is biological aging that may be the most significant factor challenging our quality of life. Development of functional limitations, resulting from improper maintenance and restoration of various organ systems, ultimately leads to reduced health and independence. Skeletal muscle is an organ system that, when challenged, is often injured in response to varying stimuli. Overt muscle-strain injury can be traumatic, clinically diagnosable, properly managed, and a remarkably common event, yet our contemporary understanding of how age and environmental stressors affect the initial and subsequent induction of injury and how the biological processes resulting from this event are modifiable and, eventually, lead to functional restoration and healing of skeletal muscle and adjacent tissues is presently unclear. Even though the secondary injury response to and recovery from "contraction-induced" skeletal-muscle injury are impaired with aging, there is no scientific consensus as to the exact mechanism responsible for this event. Given the multitude of investigative approaches, particular consideration given to the appropriateness of the muscle-injury model, or research paradigm, is critical so that outcomes may be physiologically relevant and translational. In this case, methods implementing stretch-shortening contractions, the most common form of muscle movements used by all mammals during physical movement, work, and activity, are highlighted. CLINICAL RELEVANCE Understanding the fundamental evidence regarding how aging influences the responsivity of skeletal muscle to strain injury is vital for informing how clinicians approach and implement preventive strategies, as well as therapeutic interventions. From a practical perspective, maintaining or improving the overall health and tissue quality of skeletal muscle as one ages will positively affect skeletal muscle's safety threshold and responsivity, which may reduce incidence of injury, improve recovery time, and lessen overall fiscal burdens.
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Wilk KE, Williams RA, Dugas JR, Cain EL, Andrews JR. Current Concepts in the Assessment and Rehabilitation of the Thrower’s Shoulder. OPER TECHN SPORT MED 2016. [DOI: 10.1053/j.otsm.2016.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Hösl M, Böhm H, Arampatzis A, Keymer A, Döderlein L. Contractile behavior of the medial gastrocnemius in children with bilateral spastic cerebral palsy during forward, uphill and backward-downhill gait. Clin Biomech (Bristol, Avon) 2016; 36:32-9. [PMID: 27208665 DOI: 10.1016/j.clinbiomech.2016.05.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/11/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND Plantarflexor tightness due to muscle degenerations has been frequently documented in children with spastic cerebral palsy but the contractile behavior of muscles during ambulation is largely unclear. Especially the adaptability of gastrocnemius muscle contraction on sloped surface could be relevant during therapy. METHODS Medial gastrocnemius contractions were measured during flat-forward, uphill (+12% incline) and backward-downhill (-12% decline) treadmill gait in 15 children with bilateral cerebral palsy, walking in crouch, and 17 typically developing controls (age: 7-16years) by means of ultrasound and motion analysis. Tracked fascicle and calculated series elastic element length during gait were normalized on seated rest length. Additionally electromyography of the medial gastrocnemius, soleus and tibialis anterior was collected. FINDINGS During forward gait spastic gastrocnemii reached 10% shorter relative fascicle length, 5% shorter series elastic element length and showed 37% less concentric fascicle excursion than controls. No difference in eccentric fascicle excursion existed. Uphill gait increased concentric fascicle excursion in children with cerebral palsy and controls (by 23% and 41%) and tibialis anterior activity during swing (by 33% and 48%). Backward downhill gait more than doubled (+112%) eccentric fascicle excursion in cerebral palsy patients. INTERPRETATION Apart from having innately shorter fascicles at rest, flat-forward walking showed that spastic gastrocnemius fascicles work at shorter relative length than those of controls. Uphill gait may be useful to concentrically train push-off skills and foot lift. During backward-downhill gait the gastrocnemius functions as a brake and displays more eccentric excursion which could potentially stimulate sarcomere-genesis in series with repeated training.
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Affiliation(s)
- Matthias Hösl
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauer Str. 18, 83229 Aschau im Chiemgau, Germany; Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstraße 13, Haus 11, 10115 Berlin, Germany.
| | - Harald Böhm
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauer Str. 18, 83229 Aschau im Chiemgau, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstraße 13, Haus 11, 10115 Berlin, Germany
| | - Antonia Keymer
- Department of Biomechanics in Sports, Technische Universität München, Uptown München-Campus D, Georg-Brauchle-Ring 60/62, 80992 München, Germany
| | - Leonhard Döderlein
- Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauer Str. 18, 83229 Aschau im Chiemgau, Germany
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Baumert P, Lake MJ, Stewart CE, Drust B, Erskine RM. Genetic variation and exercise-induced muscle damage: implications for athletic performance, injury and ageing. Eur J Appl Physiol 2016; 116:1595-625. [PMID: 27294501 PMCID: PMC4983298 DOI: 10.1007/s00421-016-3411-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/03/2016] [Indexed: 02/06/2023]
Abstract
Prolonged unaccustomed exercise involving muscle lengthening (eccentric) actions can result in ultrastructural muscle disruption, impaired excitation-contraction coupling, inflammation and muscle protein degradation. This process is associated with delayed onset muscle soreness and is referred to as exercise-induced muscle damage. Although a certain amount of muscle damage may be necessary for adaptation to occur, excessive damage or inadequate recovery from exercise-induced muscle damage can increase injury risk, particularly in older individuals, who experience more damage and require longer to recover from muscle damaging exercise than younger adults. Furthermore, it is apparent that inter-individual variation exists in the response to exercise-induced muscle damage, and there is evidence that genetic variability may play a key role. Although this area of research is in its infancy, certain gene variations, or polymorphisms have been associated with exercise-induced muscle damage (i.e. individuals with certain genotypes experience greater muscle damage, and require longer recovery, following strenuous exercise). These polymorphisms include ACTN3 (R577X, rs1815739), TNF (-308 G>A, rs1800629), IL6 (-174 G>C, rs1800795), and IGF2 (ApaI, 17200 G>A, rs680). Knowing how someone is likely to respond to a particular type of exercise could help coaches/practitioners individualise the exercise training of their athletes/patients, thus maximising recovery and adaptation, while reducing overload-associated injury risk. The purpose of this review is to provide a critical analysis of the literature concerning gene polymorphisms associated with exercise-induced muscle damage, both in young and older individuals, and to highlight the potential mechanisms underpinning these associations, thus providing a better understanding of exercise-induced muscle damage.
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Affiliation(s)
- Philipp Baumert
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Mark J Lake
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Claire E Stewart
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Barry Drust
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Robert M Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK.
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Guilhem G, Doguet V, Hauraix H, Lacourpaille L, Jubeau M, Nordez A, Dorel S. Muscle force loss and soreness subsequent to maximal eccentric contractions depend on the amount of fascicle strain in vivo. Acta Physiol (Oxf) 2016; 217:152-63. [PMID: 26786411 DOI: 10.1111/apha.12654] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 01/06/2016] [Accepted: 01/09/2016] [Indexed: 11/30/2022]
Abstract
AIM Defining the origins of muscle injury has important rehabilitation and exercise applications. However, current knowledge of muscle damage mechanics in human remains unclear in vivo. This study aimed to determine the relationships between muscle-tendon unit mechanics during maximal eccentric contractions and the extent of subsequent functional impairments induced by muscle damage. METHODS The length of the muscle-tendon unit, fascicles and tendinous tissues was continuously measured on the gastrocnemius medialis using ultrasonography, in time with torque, during 10 sets of 30 maximal eccentric contractions of plantar flexors at 45°s(-1) , in seventeen participants. RESULTS Muscle-tendon unit, fascicles and tendinous tissues were stretched up to 4.44 ± 0.33 cm, 2.31 ± 0.64 cm and 1.92 ± 0.61 cm respectively. Fascicle stretch length, lengthening amplitude and negative fascicle work beyond slack length were significantly correlated with the force decrease 48 h post-exercise (r = 0.51, 0.47 and 0.68, respectively; P < 0.05). CONCLUSIONS This study demonstrates that the strain applied to human muscle fibres during eccentric contractions strongly influences the magnitude of muscle damage in vivo. Achilles tendon compliance decreases the amount of strain, while architectural gear ratio may moderately contribute to attenuating muscle fascicle lengthening and hence muscle damage. Further studies are necessary to explore the impact of various types of task to fully understand the contribution of muscle-tendon interactions during active lengthening to muscle damage.
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Affiliation(s)
- G. Guilhem
- Laboratory Sport, Expertise and Performance (EA 7370); Research Department; French National Institute of Sport (INSEP); Paris France
| | - V. Doguet
- Laboratory ‘Movement, Interactions, Performance’ (EA 4334); Faculty of Sport Sciences; University of Nantes; Nantes France
| | - H. Hauraix
- Laboratory ‘Movement, Interactions, Performance’ (EA 4334); Faculty of Sport Sciences; University of Nantes; Nantes France
| | - L. Lacourpaille
- Laboratory Sport, Expertise and Performance (EA 7370); Research Department; French National Institute of Sport (INSEP); Paris France
- Laboratory ‘Movement, Interactions, Performance’ (EA 4334); Faculty of Sport Sciences; University of Nantes; Nantes France
| | - M. Jubeau
- Laboratory ‘Movement, Interactions, Performance’ (EA 4334); Faculty of Sport Sciences; University of Nantes; Nantes France
| | - A. Nordez
- Laboratory ‘Movement, Interactions, Performance’ (EA 4334); Faculty of Sport Sciences; University of Nantes; Nantes France
| | - S. Dorel
- Laboratory ‘Movement, Interactions, Performance’ (EA 4334); Faculty of Sport Sciences; University of Nantes; Nantes France
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Rehabilitation of the Overhead Throwing Athlete: There Is More to It Than Just External Rotation/Internal Rotation Strengthening. PM R 2016; 8:S78-90. [DOI: 10.1016/j.pmrj.2015.12.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/10/2015] [Accepted: 12/12/2015] [Indexed: 11/21/2022]
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Maeo S, Yamamoto M, Kanehisa H. Downhill walking training with and without exercise-induced muscle damage similarly increase knee extensor strength. J Sports Sci 2016; 34:2018-26. [PMID: 26920254 DOI: 10.1080/02640414.2016.1149607] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study examined whether avoiding or experiencing exercise-induced muscle damage (EIMD) influences strength gain after downhill walking training. Healthy young males performed treadmill downhill walking (gradient: -28%, velocity: 5 km · h(-1) and load: 10% of body mass) 1 session per week for four weeks using either a ramp-up protocol (n = 16), where exercise duration was gradually increased from 10 to 30, 50 and 70 min over four sessions, or a constant protocol (n = 14), where exercise duration was 40 min for all four sessions. Indirect markers of EIMD were measured throughout the training period. Maximal knee extension torque in eccentric (-1.05 rad·s(-1)), isometric and concentric (1.05 rad·s(-1)) conditions were measured at pre- and post-training. The ramp-up group showed no indications of EIMD throughout the training period (e.g., plasma creatine kinase (CK) activity: always <185 U · L(-1)) while EIMD was evident after the first session in the constant group (CK: peak 485 U · L(-1)). Both groups significantly increased maximal knee extension torque in all conditions with greater gains in eccentric (ramp-up: +19%, constant: +21%) than isometric (+16%, +15%) and concentric (+12%, +10%) strength without any significant group-difference. The current results suggest that EIMD can be avoided by the ramp-up protocol and is not a major determinant of training-induced strength gain.
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Affiliation(s)
- Sumiaki Maeo
- a Faculty of Sport Sciences , Waseda University , Mikajima , Tokorozawa , Japan.,b Japan Society for the Promotion of Science , Tokyo , Japan
| | - Masayoshi Yamamoto
- c Department of Sports and Life Science , National Institute of Fitness and Sports in Kanoya , Shiromizu , Kanoya , Japan
| | - Hiroaki Kanehisa
- c Department of Sports and Life Science , National Institute of Fitness and Sports in Kanoya , Shiromizu , Kanoya , Japan
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Sudo M, Ando S, Poole DC, Kano Y. Blood flow restriction prevents muscle damage but not protein synthesis signaling following eccentric contractions. Physiol Rep 2015; 3:3/7/e12449. [PMID: 26149281 PMCID: PMC4552529 DOI: 10.14814/phy2.12449] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
There is a growing body of evidence to suggest that resistance training exercise combined with blood flow restriction (BFR) increases muscle size and strength in humans. Eccentric contraction (ECC) frequently induces severe muscle damage. However, it is not known whether and to what extent muscle damage occurs following ECC + BFR due to the difficulty of conducting definitive invasive studies. The purpose of this study was to examine muscle fiber damage following ECC + BFR at the cellular level. High-intensity ECC was purposefully selected to maximize the opportunity for muscle damage and hypertrophic signaling in our novel in vivo animal model. Male Wistar rats were assigned randomly to the following groups: ECC and ECC + BFR at varying levels of occlusion pressure (140, 160, and 200 Torr). In all conditions, electrical stimulation was applied to the dorsiflexor muscles simultaneously with electromotor-induced plantar flexion. We observed severe histochemical muscle fiber damage (area of damaged fibers/total fiber area analyzed) following ECC (26.4 ± 4.0%). Surprisingly, however, muscle damage was negligible following ECC + BFR140 (2.6 ± 1.2%), ECC+BFR160 (3.0 ± 0.5%), and ECC + BFR200 (0.2 ± 0.1%). Ribosomal S6 kinase 1 (S6K1) phosphorylation, a downstream target of rapamycin (mTOR)-phosphorylation kinase, increased following ECC + BFR200 as well as ECC. In contrast, S6K1 phosphorylation was not altered by BFR alone. The present findings suggest that ECC combined with BFR, even at high exercise intensities, may enhance muscle protein synthesis without appreciable muscle fiber damage.
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Affiliation(s)
- Mizuki Sudo
- Department of Engineering Science, Bioscience and Technology Program, University of Electro-communications, Chofu Tokyo, Japan Physical Fitness Research Institute Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Soichi Ando
- Department of Mechanical Engineering and Intelligent Systems, Control Systems Program, University of Electro-communications, Chofu Tokyo, Japan
| | - David C Poole
- Departments of Anatomy & Physiology and Kinesiology, Kansas State University, Manhattan, Kansas
| | - Yutaka Kano
- Department of Engineering Science, Bioscience and Technology Program, University of Electro-communications, Chofu Tokyo, Japan
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Hösl M, Böhm H, Arampatzis A, Döderlein L. Effects of ankle-foot braces on medial gastrocnemius morphometrics and gait in children with cerebral palsy. J Child Orthop 2015; 9:209-19. [PMID: 26108740 PMCID: PMC4486505 DOI: 10.1007/s11832-015-0664-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/09/2015] [Indexed: 02/03/2023] Open
Abstract
PURPOSE In children with cerebral palsy (CP), braces are used to counteract progressive joint and muscle contracture and improve function. We examined the effects of positional ankle-foot braces on contracture of the medial gastrocnemius (MG) and gait in children with CP while referencing to typically developing children. METHODS Seventeen independently ambulant children with CP and calf muscle contracture (age 10.4 ± 3.0y) and 17 untreated typically developing peers (age 9.5 ± 2.6y) participated. Children with CP were analysed before and 16 ± 4 weeks after ankle-foot bracing. MG muscle belly length and thickness, tendon and fascicle length, as well as their extensibility were captured by 2D ultrasound and 3D motion capturing during passive, manually applied stretches. In addition, 3D gait analysis was conducted. RESULTS Prior to bracing, the MG muscle-tendon unit in children with CP was 22 % less extensible. At matched amounts of muscle-tendon unit stretch, the muscle belly and fascicles in CP were 7 % and 14 % shorter while the tendon was 11 % longer. Spastic fascicles displayed 32 % less extensibility than controls. Brace wear increased passive dorsiflexion primarily with the knees flexed. During gait, children walked faster and foot lift in swing improved. MG muscle belly and tendon length showed little change, but fascicles further shortened (-11 %) and muscle thickness (-8 %) decreased. CONCLUSIONS Use of ankle-foot braces improves function but may lead to a loss of sarcomeres in series, which could explain the shortened fascicles. To potentially induce gastrocnemius muscle growth, braces may also need to extend the knee or complementary training may be necessary to offset the immobilizing effects of braces.
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Affiliation(s)
- Matthias Hösl
- />Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229 Aschau i. Chiemgau, Germany
- />Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115 Berlin, Germany
| | - Harald Böhm
- />Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229 Aschau i. Chiemgau, Germany
| | - Adamantios Arampatzis
- />Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115 Berlin, Germany
| | - Leonhard Döderlein
- />Orthopaedic Hospital for Children, Behandlungszentrum Aschau GmbH, Bernauerstr. 18, 83229 Aschau i. Chiemgau, Germany
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Fiorentino NM, Rehorn MR, Chumanov ES, Thelen DG, Blemker SS. Computational models predict larger muscle tissue strains at faster sprinting speeds. Med Sci Sports Exerc 2015; 46:776-86. [PMID: 24145724 DOI: 10.1249/mss.0000000000000172] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Proximal biceps femoris musculotendon strain injury has been well established as a common injury among athletes participating in sports that require sprinting near or at maximum speed; however, little is known about the mechanisms that make this muscle tissue more susceptible to injury at faster speeds. PURPOSE This study aimed to quantify localized tissue strain during sprinting at a range of speeds. METHODS Biceps femoris long head (BFlh) musculotendon dimensions of 14 athletes were measured on magnetic resonance (MR) images and used to generate a finite-element computational model. The model was first validated through comparison with previous dynamic MR experiments. After validation, muscle activation and muscle-tendon unit length change were derived from forward dynamic simulations of sprinting at 70%, 85%, and 100% maximum speed and used as input to the computational model simulations. Simulations ran from midswing to foot contact. RESULTS The model predictions of local muscle tissue strain magnitude compared favorably with in vivo tissue strain measurements determined from dynamic MR experiments of the BFlh. For simulations of sprinting, local fiber strain was nonuniform at all speeds, with the highest muscle tissue strain where injury is often observed (proximal myotendinous junction). At faster sprinting speeds, increases were observed in fiber strain nonuniformity and peak local fiber strain (0.56, 0.67, and 0.72 for sprinting at 70%, 85%, and 100% maximum speed). A histogram of local fiber strains showed that more of the BFlh reached larger local fiber strains at faster speeds. CONCLUSIONS At faster sprinting speeds, peak local fiber strain, fiber strain nonuniformity, and the amount of muscle undergoing larger strains are predicted to increase, likely contributing to the BFlh muscle's higher injury susceptibility at faster speeds.
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Affiliation(s)
- Niccolo M Fiorentino
- 1Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA; 2Department of Biomedical Engineering, University of Virginia, Charlottesville, VA; 3Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI; 4Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI
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Hoffman BW, Cresswell AG, Carroll TJ, Lichtwark GA. Muscle fascicle strains in human gastrocnemius during backward downhill walking. J Appl Physiol (1985) 2014; 116:1455-62. [DOI: 10.1152/japplphysiol.01431.2012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Extensive muscle damage can be induced in isolated muscle preparations by performing a small number of stretches during muscle activation. While typically these fiber strains are large and occur over long lengths, the extent of exercise-induced muscle damage (EIMD) observed in humans is normally less even when multiple high-force lengthening actions are performed. This apparent discrepancy may be due to differences in muscle fiber and tendon dynamics in vivo; however, muscle and tendon strains have not been quantified during muscle-damaging exercise in humans. Ultrasound and an infrared motion analysis system were used to measure medial gastrocnemius fascicle length and lower limb kinematics while humans walked backward, downhill for 1 h (inducing muscle damage), and while they walked briefly forward on the flat (inducing no damage). Supramaximal tibial nerve stimulation, ultrasound, and an isokinetic dynamometer were used to quantify the fascicle length-torque relationship pre- and 2 h postexercise. Torque decreased ∼23%, and optimal fascicle length shifted rightward ∼10%, indicating that EIMD occurred during the damage protocol even though medial gastrocnemius fascicle stretch amplitude was relatively small (∼18% of optimal fascicle length) and occurred predominantly within the ascending limb and plateau region of the length-torque curve. Furthermore, tendon contribution to overall muscle-tendon unit stretch was ∼91%. The data suggest the compliant tendon plays a role in attenuating muscle fascicle strain during backward walking in humans, thus minimizing the extent of EIMD. As such, in situ or in vitro mechanisms of muscle damage may not be applicable to EIMD of the human gastrocnemius muscle.
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Affiliation(s)
- B. W. Hoffman
- Centre for Sensorimotor Neuroscience, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
| | - A. G. Cresswell
- Centre for Sensorimotor Neuroscience, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
| | - T. J. Carroll
- Centre for Sensorimotor Neuroscience, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
| | - G. A. Lichtwark
- Centre for Sensorimotor Neuroscience, School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
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Waters-Banker C, Dupont-Versteegden EE, Kitzman PH, Butterfield TA. Investigating the mechanisms of massage efficacy: the role of mechanical immunomodulation. J Athl Train 2014; 49:266-73. [PMID: 24641083 DOI: 10.4085/1062-6050-49.2.25] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Massage has the potential to attenuate the inflammatory process, facilitate early recovery, and provide pain relief from muscular injuries. In this hypothesis-driven paper, we integrate the concept of mechanotransduction with the application of massage to explore beneficial mechanisms. By altering signaling pathways involved with the inflammatory process, massage may decrease secondary injury, nerve sensitization, and collateral sprouting, resulting in increased recovery from damage and reduction or prevention of pain. Our goal is to provide a framework that describes our current understanding of the mechanisms whereby massage therapy activates potentially beneficial immunomodulatory pathways.
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Affiliation(s)
- Christine Waters-Banker
- Department of Rehabilitation Sciences, University of Kentucky, Lexington. Dr Waters-Banker is currently at the Department of Kinesiology, University of Calgary, AB, Canada
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Hyldahl RD, Hubal MJ. Lengthening our perspective: Morphological, cellular, and molecular responses to eccentric exercise. Muscle Nerve 2013; 49:155-70. [DOI: 10.1002/mus.24077] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 08/23/2013] [Accepted: 08/26/2013] [Indexed: 12/25/2022]
Affiliation(s)
- Robert D. Hyldahl
- Department of Exercise Science; 106 Smith Fieldhouse; Brigham Young University; Provo Utah 84003 USA
| | - Monica J. Hubal
- Research Center for Genetic Medicine; Children's National Medical Center; Washington DC USA
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Markworth JF, Vella L, Lingard BS, Tull DL, Rupasinghe TW, Sinclair AJ, Maddipati KR, Cameron-Smith D. Human inflammatory and resolving lipid mediator responses to resistance exercise and ibuprofen treatment. Am J Physiol Regul Integr Comp Physiol 2013; 305:R1281-96. [PMID: 24089379 DOI: 10.1152/ajpregu.00128.2013] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Classical proinflammatory eicosanoids, and more recently discovered lipid mediators with anti-inflammatory and proresolving bioactivity, exert a complex role in the initiation, control, and resolution of inflammation. Using a targeted lipidomics approach, we investigated circulating lipid mediator responses to resistance exercise and treatment with the NSAID ibuprofen. Human subjects undertook a single bout of unaccustomed resistance exercise (80% of one repetition maximum) following oral ingestion of ibuprofen (400 mg) or placebo control. Venous blood was collected during early recovery (0-3 h and 24 h postexercise), and serum lipid mediator composition was analyzed by LC-MS-based targeted lipidomics. Postexercise recovery was characterized by elevated levels of cyclooxygenase (COX)-1 and 2-derived prostanoids (TXB2, PGE2, PGD2, PGF2α, and PGI2), lipooxygenase (5-LOX, 12-LOX, and 15-LOX)-derived hydroxyeicosatetraenoic acids (HETEs), and leukotrienes (e.g., LTB4), and epoxygenase (CYP)-derived epoxy/dihydroxy eicosatrienoic acids (EpETrEs/DiHETrEs). Additionally, we detected elevated levels of bioactive lipid mediators with anti-inflammatory and proresolving properties, including arachidonic acid-derived lipoxins (LXA4 and LXB4), and the EPA (E-series) and DHA (D-series)-derived resolvins (RvD1 and RvE1), and protectins (PD1 isomer 10S, 17S-diHDoHE). Ibuprofen treatment blocked exercise-induced increases in COX-1 and COX-2-derived prostanoids but also resulted in off-target reductions in leukotriene biosynthesis, and a diminished proresolving lipid mediator response. CYP pathway product metabolism was also altered by ibuprofen treatment, as indicated by elevated postexercise serum 5,6-DiHETrE and 8,9-DiHETrE only in those receiving ibuprofen. These findings characterize the blood inflammatory lipid mediator response to unaccustomed resistance exercise in humans and show that acute proinflammatory signals are mechanistically linked to the induction of a biological active inflammatory resolution program, regulated by proresolving lipid mediators during postexercise recovery.
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Affiliation(s)
- James F Markworth
- School of Exercise and Nutrition Science, Deakin University, Melbourne, Victoria, Australia
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Kibler WB, Wilkes T, Sciascia A. Mechanics and Pathomechanics in the Overhead Athlete. Clin Sports Med 2013; 32:637-51. [DOI: 10.1016/j.csm.2013.07.003] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Noninvasive monitoring of training induced muscle adaptation with 31P-MRS: fibre type shifts correlate with metabolic changes. BIOMED RESEARCH INTERNATIONAL 2013; 2013:417901. [PMID: 23998123 PMCID: PMC3749530 DOI: 10.1155/2013/417901] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Revised: 06/02/2013] [Accepted: 06/11/2013] [Indexed: 11/23/2022]
Abstract
Purpose. To evaluate training induced metabolic changes noninvasively with 31P magnetic resonance spectroscopy (31P-MRS) for measuring muscle fibre type adaptation.
Methods. Eleven volunteers underwent a 24-week training, consisting of speed-strength, endurance, and detraining (each 8 weeks). Prior to and following each training period, needle biopsies and 31P-MRS of the resting gastrocnemius muscle were performed. Fibre type distribution was analyzed histologically and tested for correlation with the ratios of high energy phosphates ([PCr]/[Pi], [PCr]/[βATP] and [PCr + Pi]/[βATP]). The correlation between the changes of the 31P-MRS parameters during training and the resulting changes in fibre composition were also analysed. Results. We observed an increased type-II-fibre proportion after speed-strength and detraining. After endurance training the percentage of fast-twitch fibres was reduced. The progression of the [PCr]/[Pi]-ratio was similar to that of the fast-twitch fibres during the training. We found a correlation between the type-II-fibre proportion and [PCr]/[Pi] (r = 0.70, P < 0.01) or [PCr]/[βATP] (r = 0.69, P < 0.01); the correlations between its changes (delta) and the fibre-shift were significant as well (delta[PCr]/[Pi] r = 0.66, delta[PCr]/[βATP] r = 0.55, P < 0.01). Conclusion. Shifts in fibre type composition and high energy phosphate metabolite content covary in human gastrocnemius muscle. Therefore 31P-MRS might be a feasible method for noninvasive monitoring of exercise-induced fibre type transformation.
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Samarawickrame SD, Hashish R, Gaur K, Salem G. Adaptations in plantar-flexor performance and length-tension relationship following a transition from shod to barefoot running. FOOTWEAR SCIENCE 2013. [DOI: 10.1080/19424280.2013.799569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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