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Lunardi M, Sakugawa RL, Furtado FE, Sampaio LT, Diefenthaeler F. Morphological characteristics of the patellar tendon in runners, cyclists, triathletes, and physically active individuals. J Ultrasound 2024; 27:527-535. [PMID: 38393454 DOI: 10.1007/s40477-023-00865-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/19/2023] [Indexed: 02/25/2024] Open
Abstract
The objective of the study was to compare measurements of length, thickness, and cross-section area (CSA) of the patellar tendon (PT) among cyclists, runners, triathletes, and physically active individuals (control group). Forty healthy individuals (10 cyclists, 10 runners, 10 triathletes, and 10 physically active individuals) aged between 18 and 45 years (30.3 ± 8.6 years) participated in the study. PT was measured by a B-mode ultrasound system. To measure the length and thickness (in 5, 10, 15, and 20 mm of the PT length) the probe was positioned parallel to the tendon and to measure the CSA the probe was positioned perpendicularly in 25, 50, and 75% of the PT length. PT length data were analyzed using a one-way ANOVA to compare between groups and PT CSA and thickness were analyzed using a two-way ANOVA (group vs. position) to compare the variables among the groups with the post-hoc Tukey test. All statistical analyses were performed considering p < 0.05. We observed a significant difference, where cyclists had smaller PT thickness (regardless of the location measured) compared to the group of triathletes (p = 0.001) and the physically active group (p = 0.043). All other variables (length, thickness, and CSA) and interactions (local and position) were not significant. We concluded that regardless of the position where PT thickness is measured, cyclists have smaller PT thickness compared to triathletes and physically active individuals but similar when compared to runners. And no differences in the length and CSA of the PT between groups.
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Affiliation(s)
- Morgana Lunardi
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil
| | - Raphael Luiz Sakugawa
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil
| | - Franklin Everaldo Furtado
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil
| | - Lucas Tavares Sampaio
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil
| | - Fernando Diefenthaeler
- Centro de Desportos, Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Campus Universitário, Bairro Trindade, Florianópolis, SC, 88.040-900, Brazil.
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Patel SH, Campbell NW, Emenim CE, Farino DO, Damen FW, Rispoli JV, Goergen CJ, Haus JM, Sabbaghi A, Carroll CC. Patellar tendon biomechanical and morphologic properties and their relationship to serum clinical variables in persons with prediabetes and type 2 diabetes. J Orthop Res 2024; 42:1653-1669. [PMID: 38400550 PMCID: PMC11222058 DOI: 10.1002/jor.25816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/08/2024] [Accepted: 01/27/2024] [Indexed: 02/25/2024]
Abstract
Tendon biomechanical properties and fibril organization are altered in patients with diabetes compared to healthy individuals, yet few biomarkers have been associated with in vivo tendon properties. We investigated the relationships between in vivo imaging-based tendon properties, serum variables, and patient characteristics across healthy controls (n = 14, age: 45 ± 5 years, body mass index [BMI]: 24 ± 1, hemoglobin A1c [HbA1c]: 5.3 ± 0.1%), prediabetes (n = 14, age: 54 ± 5 years, BMI: 29 ± 2; HbA1c: 5.7 ± 0.1), and type 2 diabetes (n = 13, age: 55 ± 3 years, BMI: 33 ± 2, HbA1c: 6.7 ± 0.3). We used ultrasound speckle-tracking and measurements from magnetic resonance imaging (MRI) to estimate the patellar tendon in vivo tangent modulus. Analysis of plasma c-peptide, interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor-α (TNF-α), adiponectin, leptin, insulin-like growth factor 1 (IGF-1), and C-reactive protein (CRP) was completed. We built regression models incorporating statistically significant covariates and indicators for the clinically defined groups. We found that tendon cross-sectional area normalized to body weight (BWN CSA) and modulus were lower in patients with type 2 diabetes than in healthy controls (p < 0.05). Our regression analysis revealed that a model that included BMI, leptin, high-density lipoprotein (HDL), low-density lipoprotein (LDL), age, and group explained ~70% of the variability in BWN CSA (R2 = 0.70, p < 0.001). For modulus, including the main effects LDL, groups, HbA1c, age, BMI, cholesterol, IGF-1, c-peptide, leptin, and IL-6, accounted for ~54% of the variability in modulus (R2 = 0.54, p < 0.05). While BWN CSA and modulus were lower in those with diabetes, group was a poor predicter of tendon properties when considering the selected covariates. These data highlight the multifactorial nature of tendon changes with diabetes and suggest that blood variables could be reliable predictors of tendon properties.
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Affiliation(s)
- Shivam H. Patel
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN
| | | | - Chinonso E. Emenim
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN
| | - Dominick O. Farino
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN
| | - Frederick W. Damen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Joseph V. Rispoli
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Craig J. Goergen
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN
| | - Jacob M. Haus
- School of Kinesiology, University of Michigan, Ann Arbor, MI
| | | | - Chad C. Carroll
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN
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Stone MH, Hornsby G, Mizuguchi S, Sato K, Gahreman D, Duca M, Carroll K, Ramsey MW, Stone ME, Haff GG. The Use of Free Weight Squats in Sports: A Narrative Review-Squatting Movements, Adaptation, and Sports Performance: Physiological. J Strength Cond Res 2024; 38:1494-1508. [PMID: 39072660 DOI: 10.1519/jsc.0000000000004838] [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: 07/30/2024]
Abstract
ABSTRACT Stone, MH, Hornsby, G, Mizuguchi, S, Sato, K, Gahreman, D, Duca, M, Carroll, K, Ramsey, MW, Stone, ME, and Haff, GG. The use of free weight squats in sports: a narrative review-squatting movements, adaptation, and sports performance: physiological. J Strength Cond Res 38(8): 1494-1508, 2024-The squat and its variants can provide numerous benefits including positively affecting sports performance and injury prevention, injury severity reduction, and rehabilitation. The positive benefits of squat are likely the result of training-induced neural alterations and mechanical and morphological adaptations in tendons, skeletal muscles, and bones, resulting in increased tissue stiffness and cross-sectional area (CSA). Although direct evidence is lacking, structural adaptations can also be expected to occur in ligaments. These adaptations are thought to beneficially increase force transmission and mechanical resistance (e.g., resistance to mechanical strain) and reduce the likelihood and severity of injuries. Adaptations such as these, also likely play an important role in rehabilitation, particularly for injuries that require restricted use or immobilization of body parts and thus lead to a consequential reduction in the CSA and alterations in the mechanical properties of tendons, skeletal muscles, and ligaments. Both volume and particularly intensity (e.g., levels of loading used) of training seem to be important for the mechanical and morphological adaptations for at least skeletal muscles, tendons, and bones. Therefore, the training intensity and volume used for the squat and its variations should progressively become greater while adhering to the concept of periodization and recognized training principles.
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Affiliation(s)
- Michael H Stone
- Center of Excellence for Sport Science and Coach Education, Department of Sport, Exercise, Recreation and Kinesiology, East Tennessee State University, Johnson City, Tennessee
| | - Guy Hornsby
- School of Sport Sciences, College of Applied Human Sciences, West Virginia University, Morgantown, West Virginia
| | - Satoshi Mizuguchi
- Center of Excellence for Sport Science and Coach Education, Department of Sport, Exercise, Recreation and Kinesiology, East Tennessee State University, Johnson City, Tennessee
| | | | - Daniel Gahreman
- Center of Excellence for Sport Science and Coach Education, Department of Sport, Exercise, Recreation and Kinesiology, East Tennessee State University, Johnson City, Tennessee
| | - Marco Duca
- Center of Excellence for Sport Science and Coach Education, Department of Sport, Exercise, Recreation and Kinesiology, East Tennessee State University, Johnson City, Tennessee
| | - Kevin Carroll
- Center of Excellence for Sport Science and Coach Education, Department of Sport, Exercise, Recreation and Kinesiology, East Tennessee State University, Johnson City, Tennessee
| | - Michael W Ramsey
- Center of Excellence for Sport Science and Coach Education, Department of Sport, Exercise, Recreation and Kinesiology, East Tennessee State University, Johnson City, Tennessee
| | - Margaret E Stone
- Center of Excellence for Sport Science and Coach Education, Department of Sport, Exercise, Recreation and Kinesiology, East Tennessee State University, Johnson City, Tennessee
| | - G Gregory Haff
- School of Medical and Health Sciences, Edith Cowan University. Joondalup, Western Australia
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Lee J, Tang JCY, Dutton J, Dunn R, Fraser WD, Enright K, Clark DR, Stewart CE, Erskine RM. The Collagen Synthesis Response to an Acute Bout of Resistance Exercise Is Greater when Ingesting 30 g Hydrolyzed Collagen Compared with 15 g and 0 g in Resistance-Trained Young Men. J Nutr 2024; 154:2076-2086. [PMID: 38007183 PMCID: PMC11282471 DOI: 10.1016/j.tjnut.2023.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/27/2023] [Accepted: 10/26/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Resistance exercise (RE) stimulates collagen synthesis in skeletal muscle and tendon but there is limited and equivocal evidence regarding an effect of collagen supplementation and exercise on collagen synthesis. Furthermore, it is not known if a dose-response exists regarding the effect of hydrolyzed collagen (HC) ingestion and RE on collagen synthesis. OBJECTIVE To determine the HC dose-response effect on collagen synthesis after high-intensity RE in resistance-trained young men. METHODS Using a double-blind, randomized crossover design, 10 resistance-trained males (age: 26 ± 3 y; height: 1.77 ± 0.04 m; mass: 79.7 ± 7.0 kg) ingested 0 g, 15 g, or 30 g HC with 50 mg vitamin C 1 h before performing 4 sets' barbell back squat RE at 10-repetition maximum load, after which they rested for 6 h. Blood samples were collected throughout each of the 3 interventions to analyze procollagen type Ⅰ N-terminal propeptide (PINP) and β-isomerized C-terminal telopeptide of type I collagen (β-CTX) concentration, and the concentration of 18 collagen amino acids. RESULTS The serum PINP concentration × time area under the curve (AUC) was greater for 30 g (267 ± 79 μg·L-1·h) than for 15 g (235 ± 70 μg·L-1·h, P = 0.013) and 0 g HC (219 ± 88 μg·L-1·h, P = 0.002) but there was no difference between 0 and 15 g HC (P = 0.225). The AUCs of glycine and proline were greater for 30 g than for 15 and 0 g HC (P < 0.05). Plasma β-CTX concentration decreased from -1 to +6 h (P < 0.05), with no differences between interventions. CONCLUSIONS Ingesting 30 g HC before high-intensity RE augments whole-body collagen synthesis more than 15 g and 0 g HC in resistance-trained young males.
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Affiliation(s)
- Joonsung Lee
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jonathan C Y Tang
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich, UK; Clinical Biochemistry, Departments of Laboratory Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - John Dutton
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Rachel Dunn
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich, UK; Clinical Biochemistry, Departments of Laboratory Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - William D Fraser
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich, UK; Clinical Biochemistry, Departments of Laboratory Medicine, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK; Departments of Diabetes and Endocrinology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
| | - Kevin Enright
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - David R Clark
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
| | - Claire E Stewart
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Robert M Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Institute of Sport, Exercise and Health, University College London, London, UK.
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Carroll CC, Campbell NW, Lewis RL, Preston SE, Garrett CM, Winstone HM, Barker AC, Vanos JM, Stouder LS, Reyes C, Fortino MA, Goergen CJ, Hass ZJ, Campbell WW. Greater Protein Intake Emphasizing Lean Beef Does Not Affect Resistance Training-Induced Adaptations in Skeletal Muscle and Tendon of Older Women: A Randomized Controlled Feeding Trial. J Nutr 2024; 154:1803-1814. [PMID: 38604504 DOI: 10.1016/j.tjnut.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Although experimental research supports that resistance training (RT), especially with greater dietary protein intake, improves muscle mass and strength in older adults, comparable research on tendons is needed. OBJECTIVES We assessed the effects of a protein-rich diet emphasizing lean beef, compared with 2 control diets, on RT-induced changes in skeletal muscle and tendon size and strength in older women. METHODS We randomly assigned women [age: 66 ± 1 y, body mass index (BMI): 28 ± 1] to groups that consumed 1) 0.8 g total protein/kg body weight/day from mixed food sources (normal protein control, n = 16); 2) 1.4 g/kg/d protein from mixed food sources (high protein control, n = 17); or 3) 1.4 g/kg/d protein emphasizing unprocessed lean beef (high protein experimental group, n = 16). Participants were provided with all foods and performed RT 3 times/wk, 70% of 1-repetition maximum for 12 wk. We measured quadriceps muscle volume via magnetic resonance imaging (MRI). We estimated patellar tendon biomechanical properties and cross-sectional area (CSA) using ultrasound and MRI. RESULTS Dietary intake did not influence RT-induced increases in quadriceps strength (P < 0.0001) or muscle volume (P < 0.05). We noted a trend for an RT effect on mean tendon CSA (P = 0.07), with no differences among diets (P > 0.05). Proximal tendon CSA increased with RT (P < 0.05) with no difference between dietary groups (P > 0.05). Among all participants, midtendon CSA increased with RT (P ≤ 0.05). We found a decrease in distal CSA in the 0.8 g group (P < 0.05) but no change in the 1.4 g group (P > 0.05). Patellar tendon MRI signal or biomechanical properties were unchanged. CONCLUSIONS Our findings indicated that greater daily protein intake, emphasizing beef, did not influence RT-induced changes in quadriceps muscle strength or muscle volume of older women. Although we noted trends in tendon CSA, we did not find a statistically significant impact of greater daily protein intake from beef on tendon outcomes. This trial was registered at clinicaltrials.gov as NCT04347447.
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Affiliation(s)
- Chad C Carroll
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States.
| | - Nathan Wc Campbell
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Rebecca L Lewis
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Sarah E Preston
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Chloe M Garrett
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Hannah M Winstone
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Anna C Barker
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Johnny M Vanos
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Lucas S Stouder
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Camila Reyes
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Matthew A Fortino
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Craig J Goergen
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States; Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Zachary J Hass
- School of Nursing, Purdue University, West Lafayette, IN, United States; School of Industrial Engineering, Purdue University, West Lafayette, IN, United States; Regenstrief Center for Healthcare Engineering, Purdue University, West Lafayette, IN, United States
| | - Wayne W Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN, United States
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Létocart AJ, Svensson RB, Mabesoone F, Charleux F, Marin F, Dermigny Q, Magnusson SP, Couppé C, Grosset JF. Structure and function of Achilles and patellar tendons following moderate slow resistance training in young and old men. Eur J Appl Physiol 2024:10.1007/s00421-024-05461-y. [PMID: 38649478 DOI: 10.1007/s00421-024-05461-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/05/2024] [Indexed: 04/25/2024]
Abstract
The aim of this study was to investigate the effect of aging and resistance training with a moderate load on the size and mechanical properties of the patellar (PT) and Achilles tendon (AT) and their associated aponeuroses; medial gastrocnemius (MG) and vastus lateralis (VL). Young (Y55; 24.8 ± 3.8 yrs, n = 11) and old men (O55; 70.0 ± 4.6 yrs, n = 13) were assigned to undergo a training program (12 weeks; 3 times/week) of moderate slow resistance training [55% of one repetition maximum (RM)] of the triceps surae and quadriceps muscles. Tendon dimensions were assessed using 1.5 T magnetic resonance imaging before and after 12 weeks. AT and PT cross sectional area (CSA) were determined every 10% of tendon length. Mechanical properties of the free AT, MG aponeurosis, PT, and VL aponeurosis were assessed using ultrasonography (deformation) and tendon force measurements. CSA of the AT but not PT was greater in O55 compared with Y55. At baseline, mechanical properties were generally lower in O55 than Y55 for AT, MG aponeurosis and VL aponeurosis (Young's modulus) but not for PT. CSA of the AT and PT increased equally in both groups following training. Further, for a given force, stiffness and Young's modulus also increased equally for VL aponeurosis and AT, for boths groups. The present study highlights that except for the PT, older men have lower tendon (AT, MG aponeurosis, and VL aponeurosis) mechanical properties than young men and 12-weeks of moderate slow resistance training appears sufficient to improve tendon size and mechanical adaptations in both young and older men. New and Noteworthy: These novel findings suggest that short-term moderate slow resistance training induces equal improvements in tendon size and mechanics regardless of age.
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Affiliation(s)
- Adrien J Létocart
- UMR CNRS 7338 Biomécanique et Bioingénierie, Sorbonne Universités, Université de Technologie de Compiègne, 60205, Compiègne Cedex, France.
| | - René B Svensson
- Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospitals, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Frédéric Marin
- UMR CNRS 7338 Biomécanique et Bioingénierie, Sorbonne Universités, Université de Technologie de Compiègne, 60205, Compiègne Cedex, France
| | - Quentin Dermigny
- UMR CNRS 7338 Biomécanique et Bioingénierie, Sorbonne Universités, Université de Technologie de Compiègne, 60205, Compiègne Cedex, France
| | - S Peter Magnusson
- Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospitals, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Christian Couppé
- Department of Physical and Occupational Therapy, Bispebjerg-Frederiksberg Hospitals, Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jean-François Grosset
- UMR CNRS 7338 Biomécanique et Bioingénierie, Sorbonne Universités, Université de Technologie de Compiègne, 60205, Compiègne Cedex, France.
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Kara M, Kara Ö, Durmuş ME, Analay P, Şener FE, Çıtır BN, Korkmaz GO, Ünlü Z, Tiftik T, Gürçay E, Mülkoğlu C, Yalçınkaya B, Bağcıer F, Aksakal MF, Erdoğan K, Sertçelik A, Çakır B, Kaymak B, Özçakar L. The Relationship Among Probable SARCopenia, Osteoporosis and SuprasPinatus Tendon Tears in Postmenopausal Women: The SARCOSP Study. Calcif Tissue Int 2024; 114:340-347. [PMID: 38342790 PMCID: PMC10957602 DOI: 10.1007/s00223-024-01183-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/05/2024] [Indexed: 02/13/2024]
Abstract
We aimed to investigate the relationship among probable sarcopenia, osteoporosis (OP) and supraspinatus tendon (SSP) tears in postmenopausal women. Postmenopausal women screened/followed for OP were recruited. Demographic data, comorbidities, exercise/smoking status, and handgrip strength values were recorded. Probable sarcopenia was diagnosed as handgrip strength values < 20 kg. Achilles and SSP thicknesses were measured using ultrasound. Among 1443 postmenopausal women, 268 (18.6%) subjects had SSP tears. Unilateral tears were on the dominant side in 146 (10.1%) and on the non-dominant side in 55 women (3.8%). In contrast to those without, women with SSP tears had older age, lower level of education, thinner SSP and lower grip strength (all p < 0.05). In addition, they had higher frequencies of hypertension, hyperlipidemia, DM, OP and probable sarcopenia, but lower exercise frequency (all p < 0.05). Binary logistic regression modeling revealed that age [odds ratio (OR): 1.046 (1.024-1.067 95% CI)], hypertension [OR: 1.560 (1.145-2.124 95% CI)], OP [OR: 1.371 (1.022-1.839 95% CI)] and probable sarcopenia [OR: 1.386 (1.031-1.861 95% CI)] were significant predictors for SSP tears (all p < 0.05). This study showed that age, presence of hypertension, probable sarcopenia and OP were related with SSP tears in postmenopausal women. To this end, although OP appeared to be related to SSP tears, SSP tear/thickness evaluation can be recommended for OP patients, especially those who have other risk factors such as older age, higher BMI, hypertension, and probable sarcopenia.
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Affiliation(s)
- Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Özgür Kara
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Mahmut Esad Durmuş
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Pelin Analay
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey.
| | - Fatıma Edibe Şener
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Beyza Nur Çıtır
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Gizem Olgu Korkmaz
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Zeliha Ünlü
- Department of Physical Medicine and Rehabilitation, Celal Bayar University, Manisa, Turkey
| | - Tülay Tiftik
- Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
| | - Eda Gürçay
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey
| | - Cevriye Mülkoğlu
- Department of Physical Medicine and Rehabilitation, Ankara Training and Research Hospital, Ankara, Turkey
| | - Berkay Yalçınkaya
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Fatih Bağcıer
- Department of Physical Medicine and Rehabilitation, Basaksehir Cam Sakura Hospital, Istanbul, Turkey
| | - Mahmud Fazıl Aksakal
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Kübra Erdoğan
- Department of Physical Medicine and Rehabilitation, Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Ahmet Sertçelik
- Department of Public Health, Division of Epidemiology, Hacettepe University Medical School, Ankara, Turkey
| | - Banu Çakır
- Department of Public Health, Division of Epidemiology, Hacettepe University Medical School, Ankara, Turkey
| | - Bayram Kaymak
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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8
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Tsai MS, Domroes T, Pentidis N, Koschinski S, Schroll A, Bohm S, Arampatzis A, Mersmann F. Effect of the temporal coordination and volume of cyclic mechanical loading on human Achilles tendon adaptation in men. Sci Rep 2024; 14:6875. [PMID: 38519507 PMCID: PMC10960029 DOI: 10.1038/s41598-024-56840-6] [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: 11/17/2023] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
Human tendons adapt to mechanical loading, yet there is little information on the effect of the temporal coordination of loading and recovery or the dose-response relationship. For this reason, we assigned adult men to either a control or intervention group. In the intervention group, the two legs were randomly assigned to one of five high-intensity Achilles tendon (AT) loading protocols (i.e., 90% maximum voluntary contraction and approximately 4.5 to 6.5% tendon strain) that were systematically modified in terms of loading frequency (i.e., sessions per week) and overall loading volume (i.e., total time under loading). Before, at mid-term (8 weeks) and after completion of the 16 weeks intervention, AT mechanical properties were determined using a combination of inverse dynamics and ultrasonography. The cross-sectional area (CSA) and length of the free AT were measured using magnetic resonance imaging pre- and post-intervention. The data analysis with a linear mixed model showed significant increases in muscle strength, rest length-normalized AT stiffness, and CSA of the free AT in the intervention group (p < 0.05), yet with no marked differences between protocols. No systematic effects were found considering the temporal coordination of loading and overall loading volume. In all protocols, the major changes in normalized AT stiffness occurred within the first 8 weeks and were mostly due to material rather than morphological changes. Our findings suggest that-in the range of 2.5-5 sessions per week and 180-300 s total high strain loading-the temporal coordination of loading and recovery and overall loading volume is rather secondary for tendon adaptation.
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Affiliation(s)
- Meng-Shiuan Tsai
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Berlin, Germany
| | - Theresa Domroes
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Berlin, Germany
| | - Nikolaos Pentidis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Berlin, Germany
| | - Sophia Koschinski
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Berlin, Germany
| | - Arno Schroll
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Berlin, Germany
| | - Sebastian Bohm
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Berlin, Germany
| | - Adamantios Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Science, Berlin, Germany
| | - Falk Mersmann
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin School of Movement Science, Berlin, Germany.
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9
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Anggoro D, Purba MS, Nishida N, Itoh H, Itamoto K, Nemoto Y, Nakaichi M, Sunahara H, Tani K. Quantitative evaluation of the biomechanical and viscoelastic properties of the dog patellar tendon in response to neuromuscular blockade at different stifle angles. PLoS One 2024; 19:e0292453. [PMID: 38166027 PMCID: PMC10760779 DOI: 10.1371/journal.pone.0292453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/14/2023] [Indexed: 01/04/2024] Open
Abstract
The patellar tendon (PT) is crucial for maintaining stability and facilitating movement in the stifle joint. Elastography has been recognized as a prominent method for evaluating PT properties in humans and dogs. The utilization of oscillation methods in canine studies remains limited despite their extensive documentation in human studies. Our study represents the first effort to quantitatively assess and compare the effects of muscle relaxant on the biomechanical and viscoelastic characteristics of the PT at varying stifle angles in living dogs. Five healthy female beagles were used in this study. Biomechanical (tone, stiffness, and decrement) and viscoelastic (relaxation time and creep) properties of the PT were measured using MyotonPRO (Myoton Ltd, Estonia) prior to and following administration of rocuronium (0.5 mg/kg/body weight) at normal, extended, and flexed positions. Rocuronium was selected for its safety, controllability, and widespread clinical use in veterinary anesthesia. Two-way analysis of variance showed that tone, stiffness, and decrement were significantly higher (P < 0.001) in the control group than in the muscle relaxation group. At the same time, relaxation time and creep were significantly lower (P < 0.001) in the control group than in the muscle relaxation group. The findings indicate that stifle angle position and muscle rexalant administration fundamentally alter the biomechanical loading conditions of the PT, leading to changes in its viscoelastic properties. Therefore, this novel quantitative data could benefit clinical settings that necessitate accurate and objective methods for risk identification and monitoring PT biomechanics in dogs.
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Affiliation(s)
- Dito Anggoro
- Laboratory of Veterinary Surgery, Joint Graduate School of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
- Department of Surgery and Radiology, Faculty of Veterinary Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Melpa Susanti Purba
- Laboratory of Veterinary Surgery, Joint Graduate School of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Norihiro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Harumichi Itoh
- Laboratory of Small Animal Clinical Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kazuhito Itamoto
- Laboratory of Small Animal Clinical Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Yuki Nemoto
- Laboratory of Veterinary Radiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Munekazu Nakaichi
- Laboratory of Veterinary Radiology, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Hiroshi Sunahara
- Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Kenji Tani
- Laboratory of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, Japan
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10
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Bontemps B, Gruet M, Louis J, Owens DJ, Miríc S, Vercruyssen F, Erskine RM. Patellar Tendon Adaptations to Downhill Running Training and Their Relationships With Changes in Mechanical Stress and Loading History. J Strength Cond Res 2024; 38:21-29. [PMID: 38085619 DOI: 10.1519/jsc.0000000000004617] [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: 12/18/2023]
Abstract
ABSTRACT Bontemps, B, Gruet, M, Louis, J, Owens, DJ, Miríc, S, Vercruyssen, F, and Erskine, RM. Patellar tendon adaptations to downhill running training and their relationships with changes in mechanical stress and loading history. J Strength Cond Res 38(1): 21-29, 2024-It is unclear whether human tendon adapts to moderate-intensity, high-volume long-term eccentric exercise, e.g., downhill running (DR) training. This study aimed to investigate the time course of patellar tendon (PT) adaptation to short-term DR training and to determine whether changes in PT properties were related to changes in mechanical stress or loading history. Twelve untrained, young, healthy adults (5 women and 7 men) took part in 4 weeks' DR training, comprising 10 sessions. Running speed was equivalent to 60-65% V̇O2max, and session duration increased gradually (15-30 minutes) throughout training. Isometric knee extensor maximal voluntary torque (MVT), vastus lateralis (VL) muscle physiological cross-sectional area (PCSA) and volume, and PT CSA, stiffness, and Young's modulus were assessed at weeks 0, 2, and 4 using ultrasound and isokinetic dynamometry. Patellar tendon stiffness (+6.4 ± 7.4%), Young's modulus (+6.9 ± 8.8%), isometric MVT (+7.5 ± 12.3%), VL volume (+6.6 ± 3.2%), and PCSA (+3.8 ± 3.3%) increased after 4 weeks' DR (p < 0.05), with no change in PT CSA. Changes in VL PCSA correlated with changes in PT stiffness (r = 0.70; p = 0.02) and Young's modulus (r = 0.63; p = 0.04) from 0 to 4 weeks, whereas changes in MVT did not correlate with changes in PT stiffness and Young's modulus at any time point (p > 0.05). To conclude, 4 weeks' DR training promoted substantial changes in PT stiffness and Young's modulus that are typically observed after high-intensity, low-volume resistance training. These tendon adaptations seemed to be driven primarily by loading history (represented by VL muscle hypertrophy), whereas increased mechanical stress throughout the training period did not seem to contribute to changes in PT stiffness or Young's modulus.
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Affiliation(s)
- Bastien Bontemps
- Université de Toulon, Laboratoire IAPS (n°201723207F), Toulon, France
- Université Côte d'Azur, LAMHESS, Nice, France
| | - Mathieu Gruet
- Université de Toulon, Laboratoire IAPS (n°201723207F), Toulon, France
| | - Julien Louis
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
| | - Daniel J Owens
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
| | - Stella Miríc
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
| | | | - Robert M Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom; and
- Institute of Sport, Exercise and Health, University College London, London, United Kingdom
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11
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Ito N, Sigurðsson HB, Snyder-Mackler L, Grävare Silbernagel K. Time to treat the tendon rupture induced by surgery: early hypertrophy of the patellar tendon graft site predicts strong quadriceps after ACLR with bone-patellar tendon-bone autograft. Knee Surg Sports Traumatol Arthrosc 2023; 31:5791-5798. [PMID: 37934286 PMCID: PMC10842920 DOI: 10.1007/s00167-023-07657-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/25/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE Quadriceps dysfunction is ubiquitous after anterior cruciate ligament reconstruction, especially when using bone-patellar tendon-bone (BPTB) autografts. The role of patellar tendon hypertrophy after graft harvest on knee extensor strength is unknown. The purpose of this study was to determine the predictive ability of patellar tendon (PT) and quadriceps muscle (Quad) cross-sectional area (CSA) on knee extensor strength 1-2 months after ACLR using BPTB autografts. METHODS This is a cross-sectional analysis of a cohort 1-2 months after ACLR using BPTB autograft. Peak knee extensor torque, and PT and Quad CSA measured using ultrasound imaging, were collected in 13 males and 14 females. Simple linear regressions compared quadriceps strength index (QI) against limb symmetry index (LSI) in PT and Quad CSA. Multiple linear regressions with sequential model comparisons predicting peak knee extensor torque were performed for each limb. The base model included demographics. Quad CSA was added in the first model, then PT CSA was added in the second model. RESULTS Both PT (p < 0.001, R2 = 0.693) and Quadriceps CSA (p = 0.013, R2 = 0.223) LSI had a positive linear relationship with QI. In the involved limb, addition of PT CSA significantly improved the model (R2 = 0.781, ΔR2 = 0.211, p for ΔR2 < 0.001). In the uninvolved limb, the addition of Quad CSA improved the model, but the addition of PT CSA did not. CONCLUSION PT LSI was more predictive of QI than Quad CSA LSI. Involved limb PT CSA mattered more in predicting peak knee extensor torque than did Quad CSA, but in the uninvolved limb, Quad CSA was the most important predictor of peak knee extensor torque. Graft site patellar tendon hypertrophy is key for strong quadriceps early after ACLR. Early targeted loading via exercise to promote healing of the graft site patellar tendon may bring patients a step closer to winning their battle against quadriceps dysfunction. LEVEL OF EVIDENCE Level I.
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Affiliation(s)
- Naoaki Ito
- Biomechanics and Movement Science Program, University of Delaware, 540 S. College Ave, Newark, DE, 19713, USA
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | | | - Lynn Snyder-Mackler
- Biomechanics and Movement Science Program, University of Delaware, 540 S. College Ave, Newark, DE, 19713, USA
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Karin Grävare Silbernagel
- Biomechanics and Movement Science Program, University of Delaware, 540 S. College Ave, Newark, DE, 19713, USA.
- Department of Physical Therapy, University of Delaware, Newark, DE, USA.
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12
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Klich S, Michalik K, Rajca J, Ficek K, Fernández-de-Las-Peñas C, Kawczynski A, Madeleine P. Fatigue-induced Alterations of the Patellar Tendon in Elite Sprint Track Cyclists. Int J Sports Med 2023; 44:995-1002. [PMID: 36690028 DOI: 10.1055/a-2018-2781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This study aims to investigate morphological and mechanical properties and echogenicity of the patellar tendon (PT) after acute fatigue-induced alterations in sprint track cyclists. Fourteen elite track cyclists participated in this study. The exercise protocol consisted of three maximal start accelerations (over a distance of 62.5 m), one maximal start acceleration (at both 125 m and 250 m), and sprints from the standing start. Immediately after testing all measurements, PT stiffness and thickness were set at 5-10-15-20 mm distal from the apex of the patella and 5-10 mm proximal to the tibial tuberosity. CSA was set at proximal, middle, and distal, while echogenicity was at proximal and distal points. The results showed significant increases in PT stiffness at all reference points after start acceleration (p<0.001). PT thickness showed similar results for stiffness, except for location placed at TT-5 (p<0.001). CSA increased significantly in proximal, middle, and distal regions (p<0.001), while echogenicity of the tendon increased in proximal and distal regions (p<0.001) after start acceleration. Regional-dependent alterations of PT thickness and stiffness may be related to anatomical and physiological mechanisms due to acute isometric contraction in the initial phase of standing start. Tendon echogenicity might be also useful in monitoring tendon mechanical properties and defining acute fatigue-induced changes.
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Affiliation(s)
- Sebastian Klich
- Department of Paralympic Sport, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Kamil Michalik
- Department of Human Motor Skills, Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Jolanta Rajca
- Department of Science, Innovation and Development, Galen-Orthopaedics, Bieruń, Poland
| | - Krzysztof Ficek
- Department of Physiotherapy, Jerzy Kukuczka Academy of Physical Education In Katowice, Katowice, Poland
- Department of Science, Innovation and Development, Galen-Orthopaedics, Bieruń, Poland
| | - Cesar Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
- Cátedra Institucional En Docencia, Clínica E Investigación En Fisioterapia: Terapia Manual, Punción Seca Y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Adam Kawczynski
- Department of Biomechanics and Sport Engineering, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Pascal Madeleine
- Health Science and Technology, Aalborg University, Aalborg, Denmark
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13
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Lunardi M, Furtado FE, Sakugawa RL, Sonda FC, Sampaio LT, Diefenthaeler F. Reliability of a special device for measuring the cross-sectional area of the patellar tendon by ultrasonography. J Ultrasound 2023; 26:897-903. [PMID: 37743436 PMCID: PMC10632332 DOI: 10.1007/s40477-023-00829-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
The objective of this study was to evaluate the intra- and inter-rater reliability and agreement between conditions with and without a special device (SD) in the evaluation of the patellar tendon (PT) cross-sectional area (CSA). Forty trained adult volunteers participated in the study. With the knee positioned at 90°, the ultrasound probe was placed in the transverse plane at 25, 50, and 75% of the PT length. Two raters and one analyzer obtained the images. We use a two-way ANOVA with a significance level of α = 0.05. No significant differences were found between raters or conditions. Intra-rater reliability ranged from moderate to good. Inter-rater reliability without the SD ranged from low to good, improving from moderate to good when the SD was used. Evaluation of the PT ends showed a lower coefficient of variation with the SD. We observed a moderate correlation at the ends and a strong correlation in the middle between conditions. The mean difference in the three positions is small (~ 0.013 cm2/ ~ 1.7%) with an upper limit of 43.2% and a lower limit of 32.5%. Therefore, we conclude that the use of the SD can be employed for evaluating the PT ends, while for the central region, it becomes optional.
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Affiliation(s)
- Morgana Lunardi
- Laboratório de Biomecânica, Centro de Desportos, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Franklin Everaldo Furtado
- Laboratório de Biomecânica, Centro de Desportos, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Raphael Luiz Sakugawa
- Laboratório de Biomecânica, Centro de Desportos, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Francesca Chaida Sonda
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lucas Tavares Sampaio
- Laboratório de Biomecânica, Centro de Desportos, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Fernando Diefenthaeler
- Laboratório de Biomecânica, Centro de Desportos, Universidade Federal de Santa Catarina, Campus Universitário, Trindade, Florianópolis, SC, 88040-900, Brazil.
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14
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Jerger S, Centner C, Lauber B, Seynnes O, Friedrich T, Lolli D, Gollhofer A, König D. Specific collagen peptides increase adaptions of patellar tendon morphology following 14-weeks of high-load resistance training: A randomized-controlled trial. Eur J Sport Sci 2023; 23:2329-2339. [PMID: 37424319 DOI: 10.1080/17461391.2023.2232758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
ABSTRACTThe purpose of this study was to investigate the effect of a supplementation with specific collagen peptides (SCP) combined with resistance training (RT) on changes in structural properties of the patellar tendon. Furthermore, tendon stiffness as well as maximal voluntary knee extension strength and cross-sectional area (CSA) of the rectus femoris muscle were assessed. In a randomized, placebo-controlled study, 50 healthy, moderately active male participants completed a 14-week resistance training program with three weekly sessions (70-85% of 1 repetition maximum [1RM]) for the knee extensors. While the SCP group received 5g of specific collagen peptides daily, the other group received the same amount of a placebo (PLA) supplement. The SCP supplementation led to a significant greater (p < 0.05) increase in patellar tendon CSA compared with the PLA group at 60% and 70% of the patellar tendon length starting from the proximal insertion. Both groups increased tendon stiffness (p < 0.01), muscle CSA (p < 0.05) and muscular strength (p < 0.001) throughout the intervention without significant differences between the groups. The current study shows that in healthy, moderately active men, supplementation of SCP in combination with RT leads to greater increase in patellar tendon CSA than RT alone. Since underlying mechanisms of tendon hypertrophy are currently unknown, further studies should investigate potential mechanisms causing the increased morphology adaptions following SCP supplementation.Trial registration: German Clinical Trials Register identifier: DRKS00029244..
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Key Words
- 1RM, one repetition maximum
- CSA, cross-sectional area
- ECM, extracellular matrix
- FOV, field of view
- MRI, magnetic resonance imaging
- MVC, maximal voluntary contraction
- Magnetic resonance imaging
- PLA, placebo
- RT, resistance training
- SCP, specific collagen peptides
- SEM, standard error of the mean
- cross sectional area
- supplementation
- tendon properties
- ultrasound
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Affiliation(s)
- Simon Jerger
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
- Praxisklinik Rennbahn, Muttenz, Switzerland
| | - Benedikt Lauber
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
| | - Olivier Seynnes
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Till Friedrich
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
| | - David Lolli
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
| | - Albert Gollhofer
- Department of Sport and Sport Science, University of Freiburg, Freiburg im Breisgau, Germany
| | - Daniel König
- Centre of Sport, Science and University Sports, Department of Sports Science, Division for Nutrition, Exercise and Health, University of Vienna, Wien 1150, Austria
- Faculty of Life Sciences, Department of Nutritional Sciences, Division for Nutrition, Exercise and Health, University of Vienna, Wien 1090, Austria
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15
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Balshaw TG, Funnell MP, McDermott EJ, Maden-Wilkinson TM, Massey GJ, Abela S, Quteishat B, Edsey M, James LJ, Folland JP. The Effect of Specific Bioactive Collagen Peptides on Tendon Remodeling during 15 wk of Lower Body Resistance Training. Med Sci Sports Exerc 2023; 55:2083-2095. [PMID: 37436929 DOI: 10.1249/mss.0000000000003242] [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: 07/14/2023]
Abstract
PURPOSE Collagen peptide supplementation has been reported to enhance synthesis rates or growth in a range of musculoskeletal tissues and could enhance tendinous tissue adaptations to resistance training (RT). This double-blind placebo-controlled study aimed to determine if tendinous tissue adaptations, size (patellar tendon cross-sectional area (CSA) and vastus lateralis (VL) aponeurosis area), and mechanical properties (patellar tendon), after 15 wk of RT, could be augmented with collagen peptide (CP) versus placebo (PLA) supplementation. METHODS Young healthy recreationally active men were randomized to consume either 15 g of CP ( n = 19) or PLA ( n = 20) once every day during a standardized program of lower-body RT (3 times a week). Measurements pre- and post-RT included patellar tendon CSA and VL aponeurosis area (via magnetic resonance imaging), and patellar tendon mechanical properties during isometric knee extension ramp contractions. RESULTS No between-group differences were detected for any of the tendinous tissue adaptations to RT (ANOVA group-time, 0.365 ≤ P ≤ 0.877). There were within-group increases in VL aponeurosis area (CP, +10.0%; PLA, +9.4%), patellar tendon stiffness (CP, +17.3%; PLA, +20.9%) and Young's modulus (CP, +17.8%; PLA, +20.6%) in both groups (paired t -tests (all), P ≤ 0.007). There were also within-group decreases in patellar tendon elongation (CP, -10.8%; PLA, -9.6%) and strain (CP, -10.6%; PLA, -8.9%) in both groups (paired t -tests (all), P ≤ 0.006). Although no within-group changes in patellar tendon CSA (mean or regional) occurred for CP or PLA, a modest overall time effect ( n = 39) was observed for mean (+1.4%) and proximal region (+2.4%) patellar tendon CSA (ANOVA, 0.017 ≤ P ≤ 0.048). CONCLUSIONS In conclusion, CP supplementation did not enhance RT-induced tendinous tissue remodeling (either size or mechanical properties) compared with PLA within a population of healthy young men.
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Affiliation(s)
- Thomas G Balshaw
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Mark P Funnell
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Emmet J McDermott
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Thomas M Maden-Wilkinson
- Academy of Sport and Physical Activity, Faculty of Health and Wellbeing, Collegiate Campus, Sheffield Hallam University, Sheffield, UNITED KINGDOM
| | - Garry J Massey
- School of Sport and Health Sciences, University of Exeter, UNITED KINGDOM
| | - Sean Abela
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Btool Quteishat
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Max Edsey
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
| | - Lewis J James
- School of Sport, Exercise, and Health Sciences, Loughborough University, Leicestershire, UNITED KINGDOM
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16
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Nemska S, Serio S, Larcher V, Beltrame G, Portinaro NM, Bang ML. Whole Genome Expression Profiling of Semitendinosus Tendons from Children with Diplegic and Tetraplegic Cerebral Palsy. Biomedicines 2023; 11:2918. [PMID: 38001919 PMCID: PMC10669597 DOI: 10.3390/biomedicines11112918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/17/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
Cerebral palsy (CP) is the most common movement disorder in children, with a prevalence ranging from 1.5 to 4 per 1000 live births. CP is caused by a non-progressive lesion of the developing brain, leading to progressive alterations of the musculoskeletal system, including spasticity, often leading to the development of fixed contractures, necessitating tendon lengthening surgery. Total RNA-sequencing analysis was performed on semitendinosus tendons from diplegic and tetraplegic CP patients subjected to tendon lengthening surgery compared to control patients undergoing anterior cruciate ligament reconstructive surgery. Tetraplegic CP patients showed increased expression of genes implicated in collagen synthesis and extracellular matrix (ECM) turnover, while only minor changes were observed in diplegic CP patients. In addition, tendons from tetraplegic CP patients showed an enrichment for upregulated genes involved in vesicle-mediated transport and downregulated genes involved in cytokine and apoptotic signaling. Overall, our results indicate increased ECM turnover with increased net synthesis of collagen in tetraplegic CP patients without activation of inflammatory and apoptotic pathways, similar to observations in athletes where ECM remodeling results in increased tendon stiffness and tensile strength. Nevertheless, the resulting increased tendon stiffness is an important issue in clinical practice, where surgery is often required to restore joint mobility.
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Affiliation(s)
- Simona Nemska
- Milan Unit, Institute of Genetic and Biomedical Research (IRGB), National Research Council (CNR), 20138 Milan, Italy; (S.N.); (S.S.)
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Simone Serio
- Milan Unit, Institute of Genetic and Biomedical Research (IRGB), National Research Council (CNR), 20138 Milan, Italy; (S.N.); (S.S.)
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
| | - Veronica Larcher
- Institute of Cardiovascular Regeneration, Goethe University, 60590 Frankfurt, Germany;
| | - Giulia Beltrame
- Residency Program in Orthopedics and Traumatology, University of Milan, 20100 Milan, Italy;
| | - Nicola Marcello Portinaro
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy;
- Department of Pediatric Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Marie-Louise Bang
- Milan Unit, Institute of Genetic and Biomedical Research (IRGB), National Research Council (CNR), 20138 Milan, Italy; (S.N.); (S.S.)
- IRCCS Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
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17
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Hjortshoej MH, Aagaard P, Storgaard CD, Juneja H, Lundbye‐Jensen J, Magnusson SP, Couppé C. Hormonal, immune, and oxidative stress responses to blood flow-restricted exercise. Acta Physiol (Oxf) 2023; 239:e14030. [PMID: 37732509 PMCID: PMC10909497 DOI: 10.1111/apha.14030] [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: 05/23/2023] [Revised: 07/12/2023] [Accepted: 07/30/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Heavy-load free-flow resistance exercise (HL-FFRE) is a widely used training modality. Recently, low-load blood-flow restricted resistance exercise (LL-BFRRE) has gained attention in both athletic and clinical settings as an alternative when conventional HL-FFRE is contraindicated or not tolerated. LL-BFRRE has been shown to result in physiological adaptations in muscle and connective tissue that are comparable to those induced by HL-FFRE. The underlying mechanisms remain unclear; however, evidence suggests that LL-BFRRE involves elevated metabolic stress compared to conventional free-flow resistance exercise (FFRE). AIM The aim was to evaluate the initial (<10 min post-exercise), intermediate (10-20 min), and late (>30 min) hormonal, immune, and oxidative stress responses observed following acute sessions of LL-BFRRE compared to FFRE in healthy adults. METHODS A systematic literature search of randomized and non-randomized studies was conducted in PubMed, Embase, Cochrane Central, CINAHL, and SPORTDiscus. The Cochrane Risk of Bias (RoB2, ROBINS-1) and TESTEX were used to evaluate risk of bias and study quality. Data extractions were based on mean change within groups. RESULTS A total of 12525 hits were identified, of which 29 articles were included. LL-BFRRE demonstrated greater acute increases in growth hormone responses when compared to overall FFRE at intermediate (SMD 2.04; 95% CI 0.87, 3.22) and late (SMD 2.64; 95% CI 1.13, 4.16) post-exercise phases. LL-BFRRE also demonstrated greater increase in testosterone responses compared to late LL-FFRE. CONCLUSION These results indicate that LL-BFRRE can induce increased or similar hormone and immune responses compared to LL-FFRE and HL-FFRE along with attenuated oxidative stress responses compared to HL-FFRE.
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Affiliation(s)
- M. H. Hjortshoej
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
- Centre for Health and RehabilitationUniversity College AbsalonSlagelseDenmark
| | - P. Aagaard
- Department of Sports Science and Clinical BiomechanicsUniversity of Southern DenmarkOdenseDenmark
| | - C. D. Storgaard
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Nutrition, Exercise and Sports, Section of Integrative PhysiologyUniversity of CopenhagenCopenhagenDenmark
| | - H. Juneja
- Centre for Health and RehabilitationUniversity College AbsalonSlagelseDenmark
| | - J. Lundbye‐Jensen
- Department of Nutrition, Exercise and Sports, Section of Integrative PhysiologyUniversity of CopenhagenCopenhagenDenmark
| | - S. P. Magnusson
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
| | - C. Couppé
- Institute of Sports Medicine Copenhagen, Department of Orthopedic SurgeryCopenhagen University Hospital Bispebjerg and FrederiksbergCopenhagenDenmark
- Center for Healthy Aging, Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
- Department of Physical and Occupational TherapyBispebjerg and Frederiksberg University HospitalCopenhagenDenmark
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18
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Kosaka T, Sasajima S, Yasuda A, Mino S, Kubo K. Effects of tendon elastic energy and electromyographic activity pattern on jumping height and pre-stretch augmentation during jumps with different pre-stretch intensity. J Sports Sci 2023; 41:1317-1325. [PMID: 37847798 DOI: 10.1080/02640414.2023.2269720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023]
Abstract
The present study aimed to investigate the effects of tendon elastic energy and electromyographic activity patterns (ratio of pre-landing to concentric: mEMG PLA/CON; ratio of eccentric to concentric; mEMG ECC/CON) on jump performance. Twenty-nine males performed five kinds of unilateral jumps using only ankle joint (no-countermovement jump: noCMJ; countermovement jump: CMJ; drop jumps at 10, 20 and 30 cm drop height: DJ10, DJ20 and DJ30). Jumping height, pre-stretch augmentation and electromyographic activity of the plantar flexor muscles were measured. The elastic energy of the Achilles tendon was measured during isometric contractions. Relative tendon elastic energy (to body mass) was highly correlated with jumping heights of CMJ, DJ10 and DJ20 but not with noCMJ and DJ30, whereas that was significantly correlated with pre-stretch augmentation in CMJ, but not with three DJs. The mEMG PLA/CON was significantly correlated with the pre-stretch augmentation of DJ20 and DJ30, but not with DJ10, whereas the mEMG ECC/CON was significantly correlated with the pre-stretch augmentation of DJ20 and DJ30, but not with CMJ and DJ10. These results suggested that jumping exercises with low pre-stretch intensity benefited from tendon elastic energy, but those with high pre-stretch intensity benefited from electromyographic activity patterns.
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Affiliation(s)
- Takehiro Kosaka
- Department of Life Science, The University of Tokyo, Meguro, Tokyo, Japan
| | - Shuhei Sasajima
- Department of Life Science, The University of Tokyo, Meguro, Tokyo, Japan
| | - Ayaka Yasuda
- Department of Life Science, The University of Tokyo, Meguro, Tokyo, Japan
| | - Soushi Mino
- Department of Life Science, The University of Tokyo, Meguro, Tokyo, Japan
| | - Keitaro Kubo
- Department of Life Science, The University of Tokyo, Meguro, Tokyo, Japan
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19
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Götschi T, Held V, Klucker G, Niederöst B, Aagaard P, Spörri J, Passini FS, Snedeker JG. PIEZO1 gain-of-function gene variant is associated with elevated tendon stiffness in humans. J Appl Physiol (1985) 2023; 135:165-173. [PMID: 37227181 PMCID: PMC10625831 DOI: 10.1152/japplphysiol.00573.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 05/26/2023] Open
Abstract
Prolonged periods of increased physical demands can elicit anabolic tendon adaptations that increase stiffness and mechanical resilience or conversely can lead to pathological processes that deteriorate tendon structural quality with ensuing pain and potential rupture. Although the mechanisms by which tendon mechanical loads regulate tissue adaptation are largely unknown, the ion channel PIEZO1 has been implicated in tendon mechanotransduction, with human carriers of the PIEZO1 gain-of-function variant E756del displaying improved dynamic vertical jump performance compared with noncarriers. Here, we sought to examine whether increased tendon stiffness in humans could explain this increased performance. We assessed tendon morphological and mechanical properties with ultrasound-based techniques in 77 participants of Middle- and West-African descent, and we measured their vertical jumping performance to assess potential functional consequences in the context of high tendon strain-rate loading. Carrying the E756del gene variant (n = 30) was associated with 46.3 ± 68.3% (P = 0.002) and 45.6 ± 69.2% (P < 0.001) higher patellar tendon stiffness and Young's modulus compared with noncarrying controls, respectively. Although these tissue level measures strongly corroborate the initial postulate that PIEZO1 plays an integral part in regulating tendon material properties and stiffness in humans, we found no detectable correlation between tendon stiffness and jumping performance in the tested population that comprised individuals of highly diverse physical fitness level, dexterity, and jumping ability.NEW & NOTEWORTHY The E756del gene variant causes overactivity of the mechanosensitive membrane channel PIEZO1 and is suspected to upregulate tendon collagen cross linking. In human carriers of E756del, we found increased patellar tendon stiffness but similar tendon lengths and cross-sectional areas, directly supporting the premise that PIEZO1 regulates human tendon stiffness at the level of tissue material properties.
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Affiliation(s)
- Tobias Götschi
- Laboratory for Orthopaedic Biomechanics, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
| | - Victoria Held
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Gianna Klucker
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Barbara Niederöst
- Laboratory for Orthopaedic Biomechanics, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
| | - Per Aagaard
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Department of Orthopaedics, University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
| | - Fabian S Passini
- Laboratory for Orthopaedic Biomechanics, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
| | - Jess G Snedeker
- Laboratory for Orthopaedic Biomechanics, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Zürich, Switzerland
- Institute for Biomechanics, ETH Zurich, Zürich, Switzerland
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20
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Frouin A, Guenanten H, Le Sant G, Lacourpaille L, Liebard M, Sarcher A, McNair PJ, Ellis R, Nordez A. Validity and Reliability of 3-D Ultrasound Imaging to Measure Hamstring Muscle and Tendon Volumes. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1457-1464. [PMID: 36948893 DOI: 10.1016/j.ultrasmedbio.2023.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The validity and reliability of 3-D ultrasound (US) in estimation of muscle and tendon volume was assessed in a very limited number of muscles that can be easily immersed. The objective of the present study was to assess the validity and reliability of muscle volume measurements for all hamstring muscle heads and gracilis (GR), as well as tendon volume for the semitendinosus (ST) and GR using freehand 3-D US. METHODS Three-dimensional US acquisitions were performed for 13 participants in two distinct sessions on separate days, in addition to one session dedicated to magnetic resonance imaging (MRI). Volumes of ST, semimembranosus (SM), biceps femoris short (BFsh) and long (BFlh) heads, and GR muscles and from the tendon from semitendinosus (STtd) and gracilis (GRtd) were collected. RESULTS The bias and the 95% confidence intervals of 3-D US compared with MRI ranged from -1.9 mL (-0.8%) to 1.2 mL (1.0%) for muscle volume and from 0.01 mL (0.2%) to -0.03 mL (-2.6%) for tendon volume. For muscle volume assessed using 3-D US, intraclass correlation coefficients (ICCs) ranged from 0.98 (GR) to 1.00, and coefficients of variation (CV) from 1.1% (SM) to 3.4% (BFsh). For tendon volume, ICCs were 0.99, and CVs between 3.2% (STtd) and 3.4% (GRtd). CONCLUSION Three-dimensional US can provide a valid and reliable inter-day measurement of hamstrings and GR for both muscle and tendon volumes. In the future, this technique could be used as an outcome for strengthening interventions and potentially in clinical environments.
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Affiliation(s)
- Antoine Frouin
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France; Institut Sport Atlantique (ISA), Nantes, France
| | - Hugo Guenanten
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France
| | - Guillaume Le Sant
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France; School of Physiotherapy, IFM3R, Nantes, France
| | - Lilian Lacourpaille
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France
| | - Martin Liebard
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France; School of Physiotherapy, IFM3R, Nantes, France
| | - Aurélie Sarcher
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France
| | - Peter J McNair
- Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Richard Ellis
- Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Active Living and Rehabilitation: Aotearoa, Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Antoine Nordez
- Nantes Université, Movement - Interactions - Performance, MIP, UR 4334, F-44000 Nantes, France; Health and Rehabilitation Research Institute, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand; Institut Universitaire de France (IUF), Paris, France.
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21
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Weidlich K, Mersmann F, Domroes T, Schroll A, Bohm S, Arampatzis A. Quantification of patellar tendon strain and opportunities for personalized tendon loading during back squats. Sci Rep 2023; 13:8661. [PMID: 37248376 DOI: 10.1038/s41598-023-35441-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/18/2023] [Indexed: 05/31/2023] Open
Abstract
Tendon strain during exercise is a critical regulatory factor in tendon adaptive responses and there are indications for an optimal range of strain that promotes tendon adaptation. Back squats are used to improve patellar tendon properties in sport and clinical settings. To date, the operating patellar tendon strain during back squats is unknown and current recommendations for individual exercise loading are based on the one repetition maximum (1RM). Here, we quantified patellar tendon strain during loaded back squats at 40, 60 and 80% of the 1RM and during maximum isometric knee extension contractions (MVC) using ultrasonography. Kinematics, ground reaction forces and muscle electromyographic activity were also recorded. Additionally, maximum tendon strain during the MVC and the percentage of 1RM were used as explanatory variables to estimate the individual patellar tendon strain during the squats. Strain increased with increasing 1RM loading (4.7 to 8.2%), indicating that already medium-loading back squats may provide a sufficient stimulus for tendon adaptation. The individual variability was, however, too high to generalize these findings. Yet, there was a high agreement between the individually estimated and measured patellar tendon strain (R2 = 0.858) during back squats. We argue that this approach may provide new opportunities for personalized tendon exercise.
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Affiliation(s)
- K Weidlich
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany
| | - F Mersmann
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany
| | - T Domroes
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany
| | - A Schroll
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany
| | - S Bohm
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany
| | - A Arampatzis
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Philippstr. 13, Haus 11, 10115, Berlin, Germany.
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22
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Campbell NWC, Patel SH, Ferrandi P, Couture S, Farino DO, Stout J, Sabbaghi A, Carroll CC. Impact of essential amino acid intake, resistance exercise, and aging on the concentration of Achilles peritendinous amino acids and procollagen Iα1 in humans. Amino Acids 2023:10.1007/s00726-023-03268-3. [PMID: 37129720 DOI: 10.1007/s00726-023-03268-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
Recent studies have shown that consuming amino acid-rich compounds improves tendon collagen content and biomechanical properties. Yet, it is unclear if the consumption of amino acids alters local (peritendinous) amino acid concentrations. If aging or exercise influence local amino acid concentrations in conjunction with an amino acid bolus is also not known. We conducted two studies. In Study 1, young women (n = 7, 25 ± 2 years) completed two identical resistance training sessions with either essential amino acid (EAA) or placebo consumption. In Study 2, an EAA bolus identical to Study 1 was given to younger (n = 7; 27 ± 1 year) and older adults (n = 6; 68 ± 2 years). Microdialysis was used to determine Achilles peritendinous amino acid and pro-collagen Iα1 (a marker of collagen synthesis) concentrations. In Study 1, amino acid consumption increased peritendinous concentrations of all EAA except histidine (p < 0.05). In Study 2, the peritendinous concentration of EAAs except for methionine, histidine, and lysine (p > 0.05) increased with time (p < 0.05). Further, the concentrations of most measured amino acids were greater in older adults (p < 0.05). Pro-collagen Iα1 concentration (p > 0.05) was unaffected by exercise, EAA, or aging (p > 0.05). Our findings demonstrate the following: (1) when not combined with exercise, an oral EAA bolus leads to only modest increases in Achilles peritendinous amino acid concentrations; (2) when combined with resistance exercise, EAA consumption resulted in greater peritendinous amino acid concentrations compared to no exercise; (3) the basal concentrations of most amino acids were greater in older adults, and (4) neither the EAA bolus nor exercise altered peritendinous pro-collagen concentrations.
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Affiliation(s)
- Nathan W C Campbell
- Department of Health and Kinesiology, Purdue University, 800 W. Stadium Ave, West Lafayette, IN, 47907, USA
| | - Shivam H Patel
- Department of Health and Kinesiology, Purdue University, 800 W. Stadium Ave, West Lafayette, IN, 47907, USA
| | - Peter Ferrandi
- Department of Health and Kinesiology, Purdue University, 800 W. Stadium Ave, West Lafayette, IN, 47907, USA
| | - Samantha Couture
- Department of Health and Kinesiology, Purdue University, 800 W. Stadium Ave, West Lafayette, IN, 47907, USA
| | - Dominick O Farino
- Department of Health and Kinesiology, Purdue University, 800 W. Stadium Ave, West Lafayette, IN, 47907, USA
| | - Julianne Stout
- College of Veterinary Medicine, Purdue University, 625 Harrison St, West Lafayette, IN, 47907, USA
| | - Arman Sabbaghi
- Department of Statistics, Purdue University, 250 N University St, West Lafayette, IN, 47907, USA
| | - Chad C Carroll
- Department of Health and Kinesiology, Purdue University, 800 W. Stadium Ave, West Lafayette, IN, 47907, USA.
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23
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Holt NC, Mayfield DL. Muscle-tendon unit design and tuning for power enhancement, power attenuation, and reduction of metabolic cost. J Biomech 2023; 153:111585. [PMID: 37126884 PMCID: PMC10949972 DOI: 10.1016/j.jbiomech.2023.111585] [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: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 05/03/2023]
Abstract
The contractile elements in skeletal muscle fibers operate in series with elastic elements, tendons and potentially aponeuroses, in muscle-tendon units (MTUs). Elastic strain energy (ESE), arising from either work done by muscle fibers or the energy of the body, can be stored in these series elastic elements (SEEs). MTUs vary considerably in their design in terms of the relative lengths and stiffnesses of the muscle fibers and SEEs, and the force and work generating capacities of the muscle fibers. However, within an MTU it is thought that contractile and series elastic elements can be matched or tuned to maximize ESE storage. The use of ESE is thought to improve locomotor performance by enhancing contractile element power during activities such as jumping, attenuating contractile element power during activities such as landing, and reducing the metabolic cost of movement during steady-state activities such as walking and running. The effectiveness of MTUs in these potential roles is contingent on factors such as the source of mechanical energy, the control of the flow of energy, and characteristics of SEE recoil. Hence, we suggest that MTUs specialized for ESE storage may vary considerably in the structural, mechanical, and physiological properties of their components depending on their functional role and required versatility.
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Affiliation(s)
- N C Holt
- Department of Evolution, Ecology and Organismal Biology, University of California Riverside, 900 University Avenue, Riverside, CA 92521, USA.
| | - D L Mayfield
- Department of Evolution, Ecology and Organismal Biology, University of California Riverside, 900 University Avenue, Riverside, CA 92521, USA
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24
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Moran J, Liew B, Ramirez-Campillo R, Granacher U, Negra Y, Chaabene H. The effects of plyometric jump training on lower-limb stiffness in healthy individuals: A meta-analytical comparison. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:236-245. [PMID: 34033984 PMCID: PMC10105022 DOI: 10.1016/j.jshs.2021.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/31/2020] [Accepted: 02/22/2021] [Indexed: 05/09/2023]
Abstract
PURPOSE This study aimed to examine the effects of plyometric jump training (PJT) on lower-limb stiffness. METHODS Systematic searches were conducted in PubMed, Web of Science, and Scopus. Study participants included healthy males and females who undertook a PJT programme isolated from any other training type. RESULTS There was a small effect size (ES) of PJT on lower-limb stiffness (ES = 0.33, 95% confidence interval (95%CI): 0.07-0.60, z = 2.47, p = 0.01). Untrained individuals exhibited a larger ES (ES = 0.46, 95%CI: 0.08-0.84, p = 0.02) than trained individuals (ES = 0.15, 95%CI: ‒0.23 to 0.53, p = 0.45). Interventions lasting a greater number of weeks (>7 weeks) had a larger ES (ES = 0.47, 95%CI: 0.06-0.88, p = 0.03) than those lasting fewer weeks (ES = 0.22, 95%CI: ‒0.12 to 0.55, p = 0.20). Programmes with ≤2 sessions per week exhibited a larger ES (ES = 0.39, 95%CI: 0.01-0.77, p = 0.04) than programmes that incorporated >2 sessions per week (ES = 0.20, 95%CI: -0.10 to 0.50, p = 0.18). Programmes with <250 jumps per week (ES = 0.50, 95%CI: 0.02-0.97, p = 0.04) showed a larger effect than programmes with 250-500 jumps per week (ES = 0.36, 95%CI: 0.00-0.72, p = 0.05). Programmes with >500 jumps per week had negative effects (ES = -0.22, 95%CI: -1.10 to 0.67, p = 0.63). Programmes with >7.5 jumps per set showed larger effect sizes (ES = 0.55, 95%CI: 0.02-1.08, p = 0.04) than those with <7.5 jumps per set (ES = 0.32, 95%CI: 0.01-0.62, p = 0.04). CONCLUSION PJT enhances lower-body stiffness, which can be optimised with lower volumes (<250 jumps per week) over a relatively long period of time (>7 weeks).
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Affiliation(s)
- Jason Moran
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex CO43SQ, UK.
| | - Bernard Liew
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, Essex CO43SQ, UK
| | | | - Urs Granacher
- Division of Training and Movement Science, University of Potsdam, Potsdam 14469, Germany
| | - Yassine Negra
- Higher Institute of Sport and Physical Education of Ksar Saïd University of Manouba, Tunis 2037, Tunisia
| | - Helmi Chaabene
- Division of Training and Movement Science, University of Potsdam, Potsdam 14469, Germany; High Institute of Sports and Physical Education of Kef, University of Jendouba, Jendouba 8189 , Tunisia
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25
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Tsuchiya Y, Takakura H, Osawa S, Izawa T. Impact of high-intensity interval training on tendon related gene expression in rat Achilles tendon. Biochem Biophys Res Commun 2023; 658:116-121. [PMID: 37030065 DOI: 10.1016/j.bbrc.2023.03.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
Immobilization or aging associated with limited physical activity can lead to the functional deterioration of tendons, which has become an important public health concern. Therefore, growing research is focused on the effect of exercise training on preserving tendon function. Exercise training subjects muscles and tendons to repeated mechanical stress, and in vitro studies have revealed that repetitive mechanical loading stimulates tendon cell responses to changes in the extracellular matrix and functional properties of the tendon. However, although several types of exercise training have been shown to be effective in preserving tendon function, no studies have investigated the impact of high-intensity interval training (HIIT), which involves composing short bouts of exercise with high-power output. Here, we determined whether the HIIT program enhanced tenogenic progressions by measuring the mRNA expression in rat Achilles tendons. Sixteen rats were randomly assigned into either a sedentary control group (Con, n = 8) or an HIIT group (n = 8). Rats in the HIIT group performed the program with treadmill running; the training volume was incremental (running speed, number of sets, and inclination), and training was conducted 5 days per week for 9 weeks. The rats in the HIIT group exhibited a marked decrease in the body weight and different types of fat weights, and a marked increase in different types of muscle weights. Real-time reverse transcription polymerase chain reaction analysis revealed that mRNA expressions of tendon-related genes Tnxb, Opn, and Tgfb1 were upregulated in the HIIT group compared to that in the Con group. Cross-links in mRNA expressions of collagen-related Dcn and Fmod in the HIIT group tended to be higher than in those Con group. These results suggest that HIIT induces initiation of tenogenic progression and stimulation of cross-link formation between collagen fibrils in rat Achilles tendons.
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Affiliation(s)
- Yoshifumi Tsuchiya
- Faculty of Health and Sports Science, Doshisha University, 1-3 Tatara-Miyakodani, Kyoto, 610-0394, Japan.
| | - Hisashi Takakura
- Faculty of Health and Sports Science, Doshisha University, 1-3 Tatara-Miyakodani, Kyoto, 610-0394, Japan
| | - Seita Osawa
- Graduate School of Health and Sports Science, Doshisha University, 1-3 Tatara-Miyakodani, Kyoto, 610-0394, Japan
| | - Tetsuya Izawa
- Faculty of Health and Sports Science, Doshisha University, 1-3 Tatara-Miyakodani, Kyoto, 610-0394, Japan
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de Sousa AMM, Cavalcante JGT, Bottaro M, Vieira DCL, Babault N, Geremia JM, Corrigan P, Silbernagel KG, Durigan JLQ, Marqueti RDC. The Influence of Hip and Knee Joint Angles on Quadriceps Muscle-Tendon Unit Properties during Maximal Voluntary Isometric Contraction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3947. [PMID: 36900958 PMCID: PMC10002253 DOI: 10.3390/ijerph20053947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Determining how the quadriceps femoris musculotendinous unit functions, according to hip and knee joint angles, may help with clinical decisions when prescribing knee extension exercises. We aimed to determine the effect of hip and knee joint angles on structure and neuromuscular functioning of all constituents of the quadriceps femoris and patellar tendon properties. Twenty young males were evaluated in four positions: seated and supine in both 20° and 60° of knee flexion (SIT20, SIT60, SUP20, and SUP60). Peak knee extension torque was determined during maximal voluntary isometric contraction (MVIC). Ultrasound imaging was used at rest and during MVIC to characterize quadriceps femoris muscle and tendon aponeurosis complex stiffness. We found that peak torque and neuromuscular efficiency were higher for SUP60 and SIT60 compared to SUP20 and SIT20 position. We found higher fascicle length and lower pennation angle in positions with the knee flexed at 60°. The tendon aponeurosis complex stiffness, tendon force, stiffness, stress, and Young's modulus seemed greater in more elongated positions (60°) than in shortened positions (20°). In conclusion, clinicians should consider positioning at 60° of knee flexion rather than 20°, regardless if seated or supine, during rehabilitation to load the musculotendinous unit enough to stimulate a cellular response.
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Affiliation(s)
- Alessandra Martins Melo de Sousa
- Laboratory of Muscle and Tendon Plasticity, Graduate Program of Rehabilitation Sciences, University of Brasília, Brasília 72220275, Brazil
| | | | - Martim Bottaro
- College of Physical Education, University of Brasília, Brasília 70910900, Brazil
| | - Denis César Leite Vieira
- College of Physical Education, University of Brasília, Brasília 70910900, Brazil
- Centre d’Expertise de la Performance, INSERM U1093 CAPS, Sports Science Faculty, University of Burgundy, 21078 Dijon, France
| | - Nicolas Babault
- Centre d’Expertise de la Performance, INSERM U1093 CAPS, Sports Science Faculty, University of Burgundy, 21078 Dijon, France
| | - Jeam Marcel Geremia
- Exercise Research Laboratory, School of Physical Education, Physical Therapy, and Dance, Federal University of Rio Grande do Sul, Porto Alegre 90690200, Brazil
| | - Patrick Corrigan
- Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, MO 63104, USA
| | | | - João Luiz Quaglioti Durigan
- Laboratory of Muscle and Tendon Plasticity, Graduate Program of Rehabilitation Sciences, University of Brasília, Brasília 72220275, Brazil
| | - Rita de Cássia Marqueti
- Laboratory of Molecular Analysis, Graduate Program of Rehabilitation Sciences, University of Brasília, Brasília 72220275, Brazil
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Marshall SJ, Hicks KM, Howatson G, Cox L, Thomas K. B-Mode Ultrasonography Is a Reliable and Valid Alternative to Magnetic Resonance Imaging for Measuring Patellar Tendon Cross-Sectional Area. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:578-587. [PMID: 36376155 DOI: 10.1016/j.ultrasmedbio.2022.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/27/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the validity and reliability of measuring patellar tendon (PT) cross-sectional area (CSA) using magnetic resonance imaging (MRI) and ultrasound (US) imaging. Nineteen healthy participants (10 women, 9 men) participated in three imaging sessions of the PT, once via MRI and twice via US, with image acquisition conducted by two raters, one experienced (rater 2) and one inexperienced (rater 1). All PT segmentations were analyzed by both raters. The validity of US-derived estimates of PT CSA against MRI estimates was analyzed using linear regression. Within-day reliability of US and MRI measurements and between-day reliability of US measurements were quantified using typical error (TE) and intra-class correlation coefficients (ICC3,1). There was good agreement between US- and MRI-derived estimations of PT CSA (standard errors of the estimate of 3.3 mm2 for rater 1 and 2.6 mm2 for rater 2; Pearson's r = 0.97 and 0.98 for raters 1 and 2, respectively). Within-session reliability for estimations of total PT CSA from US and MRI were excellent (ICC3,1 >0.95, coefficient of variation [CV] <4.1%, TE = 1.3-3.6 mm2. Between-day reliability for US was excellent (ICC3,1 >0.97, CV <2.7%, TE = 1.6-2.3 mm2), with little difference between raters. These findings suggest that MRI and US both provide reliable estimates of PT CSA and that US can provide a valid measure of PT CSA.
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Affiliation(s)
- Steven J Marshall
- Department of Service Sector Management, Sheffield Hallam University, Howard Street, Sheffield, South Yorkshire, UK; Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle City Campus, Newcastle upon Tyne, UK
| | - Kirsty M Hicks
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle City Campus, Newcastle upon Tyne, UK
| | - Glyn Howatson
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle City Campus, Newcastle upon Tyne, UK; Water Research Group, North West University, Potchefstroom, South Africa
| | - Lisa Cox
- Newcastle Clinic, Independent House, Team Valley, Gateshead, UK
| | - Kevin Thomas
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle City Campus, Newcastle upon Tyne, UK
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Lee J, Bridge JE, Clark DR, Stewart CE, Erskine RM. Collagen supplementation augments changes in patellar tendon properties in female soccer players. Front Physiol 2023; 14:1089971. [PMID: 36776971 PMCID: PMC9910607 DOI: 10.3389/fphys.2023.1089971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 01/27/2023] Open
Abstract
We investigated the effect of collagen hydrolysate supplementation on changes in patellar tendon (PT) properties after 10 weeks' training in female soccer players from a Football Association Women's Super League Under 21 s squad. We pair-matched n = 17 players (age: 17 ± 0.9 years; height: 1.66 ± 0.06 m; mass: 58.8 ± 8.1 kg) for baseline knee extension (KE) maximum isometric voluntary contraction (MIVC) torque, age, height, and body mass, and randomly assigned them to collagen (COL) or placebo (PLA) groups (COL n = 8, PLA n = 9). Participants consumed 30 g collagen hydrolysate supplementation or energy-matched PLA (36.5 g maltodextrin, 8.4 g fructose) and plus both groups consumed 500 mg vitamin C, after each training session, which comprised bodyweight strength-, plyometric- and/or pitch-based exercise 3 days/week for 10 weeks in-season. We assessed KE MIVC torque, vastus lateralis muscle thickness and PT properties using isokinetic dynamometry and ultrasonography before and after 10 weeks' soccer training. KE MIVC torque, muscle thickness and tendon cross-sectional area did not change after training in either group. However, COL increased PT stiffness [COL, +18.0 ± 12.2% (d = 1.11) vs. PLA, +5.1 ± 10.4% (d = 0.23), p = 0.049] and Young's modulus [COL, +17.3 ± 11.9% (d = 1.21) vs. PLA, +4.8 ± 10.3% (d = 0.23), p = 0.035] more than PLA. Thus, 10 weeks' in-season soccer training with COL increased PT mechanical and material properties more than soccer training alone in high-level female soccer players. Future studies should investigate if collagen hydrolysate supplementation can improve specific aspects of female soccer performance requiring rapid transference of force, and if it can help mitigate injury risk in this under-researched population.
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Affiliation(s)
- Joonsung Lee
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Josh E. Bridge
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - David R. Clark
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Claire E. Stewart
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Robert M. Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom,Institute of Sport, Exercise and Health, University College London, London, United Kingdom,*Correspondence: Robert M. Erskine,
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Henriksen P, Junge T, Bojsen-Møller J, Juul-Kristensen B, Thorlund JB. Supervised, Heavy Resistance Training Is Tolerated and Potentially Beneficial in Women with Knee Pain and Knee Joint Hypermobility: A Case Series. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:8367134. [PMID: 38655168 PMCID: PMC11022762 DOI: 10.1155/2022/8367134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/28/2022] [Accepted: 12/08/2022] [Indexed: 04/26/2024]
Abstract
Introduction Adults with generalised joint hypermobility including knee joint hypermobility (GJHk) report more knee joint symptoms when compared to adults without GJHk. There is no consensus on best practice for symptom management. For instance, controversy exists regarding the appropriateness and safety of heavy resistance training as an intervention for this specific group. This case series aims to describe a supervised, progressive heavy resistance training program in adults with GJHk and knee pain, the tolerability of the intervention, and the outcomes of knee pain, knee-related quality of life, muscle strength, proprioception, and patellar tendon stiffness through a 12-week period. Materials and Methods Adults with GJHk and knee pain were recruited to perform supervised, progressive heavy resistance training twice a week for 12 weeks. The main outcome was the tolerability of the intervention. Secondary outcomes were knee pain during a self-nominated activity (VASNA); Knee injury and Osteoarthritis Outcome Score (KOOS); Tampa Scale of Kinesiophobia (TSK); maximal quadriceps voluntary isometric contraction and rate of torque development; 5 repetition maximum strength in five different leg exercises; single leg hop for distance; knee proprioception and patellar tendon stiffness. Results In total, 16 women (24.2 years, SD 2.5) completed at least 21/24 training sessions. No major adverse events were observed. On average, VASNA decreased by 32.5 mm (95% CI 21.4-43.6), in addition to improvements in KOOS and TSK scores. These improvements were supported by an increase in all measures of lower extremity muscle strength, knee proprioception, and patellar tendon stiffness. Conclusion Supervised heavy resistance training seems to be well tolerated and potentially beneficial in young women with GJHk and knee pain.
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Affiliation(s)
- Peter Henriksen
- Health Sciences Research Centre, UCL University College, Odense, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Tina Junge
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Jens Bojsen-Møller
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Birgit Juul-Kristensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Jonas Bloch Thorlund
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Radovanović G, Bohm S, Peper KK, Arampatzis A, Legerlotz K. Evidence-Based High-Loading Tendon Exercise for 12 Weeks Leads to Increased Tendon Stiffness and Cross-Sectional Area in Achilles Tendinopathy: A Controlled Clinical Trial. SPORTS MEDICINE - OPEN 2022; 8:149. [PMID: 36538166 PMCID: PMC9768072 DOI: 10.1186/s40798-022-00545-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Assuming that the mechanisms inducing adaptation in healthy tendons yield similar responses in tendinopathic tendons, we hypothesized that a high-loading exercise protocol that increases tendon stiffness and cross-sectional area in male healthy Achilles tendons may also induce comparable beneficial adaptations in male tendinopathic Achilles tendons in addition to improving pain and function. OBJECTIVES We investigated the effectiveness of high-loading exercise in Achilles tendinopathy in terms of inducing mechanical (tendon stiffness, maximum strain), material (Young's modulus), morphological (tendon cross-sectional area (CSA)), maximum voluntary isometric plantar flexor strength (MVC) as well as clinical adaptations (Victorian Institute of Sports Assessment-Achilles (VISA-A) score and pain (numerical rating scale (NRS))) as the primary outcomes. As secondary outcomes, drop (DJ) and counter-movement jump (CMJ) height and intratendinous vascularity were assessed. METHODS We conducted a controlled clinical trial with a 3-month intervention phase. Eligibility criteria were assessed by researchers and medical doctors. Inclusion criteria were male sex, aged between 20 and 55 years, chronic Achilles tendinopathy confirmed by a medical doctor via ultrasound-assisted assessment, and a severity level of less than 80 points on the VISA-A score. Thirty-nine patients were assigned by sequential allocation to one of three parallel arms: a high-loading intervention (training at ~ 90% of the MVC) (n = 15), eccentric exercise (according to the Alfredson protocol) as the standard therapy (n = 15) and passive therapy (n = 14). Parameters were assessed pre- and-post-intervention. Data analysis was blinded. RESULTS Primary outcomes: Plantar flexor MVC, tendon stiffness, mean CSA and maximum tendon strain improved only in the high-loading intervention group by 7.2 ± 9.9% (p = 0.045), 20.1 ± 20.5% (p = 0.049), 8.98 ± 5.8% (p < 0.001) and -12.4 ± 10.3% (p = 0.001), respectively. Stiffness decreased in the passive therapy group (-7.7 ± 21.2%; p = 0.042). There was no change in Young's modulus in either group (p > 0.05). The VISA-A score increased in all groups on average by 19.8 ± 15.3 points (p < 0.001), while pain (NRS) dropped by -0.55 ± 0.9 points (p < 0.001). SECONDARY OUTCOMES CMJ height decreased for all groups (-0.63 ± 4.07 cm; p = 0.005). There was no change in DJ height and vascularity (p > 0.05) in either group. CONCLUSION Despite an overall clinical improvement, it was exclusively the high-loading intervention that induced significant mechanical and morphological adaptations of the plantar flexor muscle-tendon unit. This might contribute to protecting the tendon from strain-induced injury. Thus, we recommend the high-loading intervention as an effective (alternative) therapeutic protocol in Achilles tendinopathy rehabilitation management in males. CLINICAL TRIALS REGISTRATION NUMBER NCT02732782.
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Affiliation(s)
- Goran Radovanović
- grid.7468.d0000 0001 2248 7639Institute of Sports Sciences, Movement Biomechanics, Humboldt-Universität zu Berlin, Philippstr. 13, 10115 Berlin, Germany ,grid.11500.350000 0000 8919 8412Department Performance, Neuroscience, Therapy and Health, Medical School Hamburg, Faculty of Health Sciences, University of Applied Sciences and Medical University, 20457 Hamburg, Germany ,grid.11500.350000 0000 8919 8412Institute of Interdisciplinary Exercise Science and Sports Medicine, Medical School Hamburg, University of Applied Sciences and Medical University, 20457 Hamburg, Germany
| | - Sebastian Bohm
- grid.7468.d0000 0001 2248 7639Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
| | - Kim Kristin Peper
- grid.6936.a0000000123222966Munich Institute of Robotics and Machine Intelligence, Technische Universität München, 80992 Munich, Germany
| | - Adamantios Arampatzis
- grid.7468.d0000 0001 2248 7639Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, 10099 Berlin, Germany
| | - Kirsten Legerlotz
- grid.7468.d0000 0001 2248 7639Institute of Sports Sciences, Movement Biomechanics, Humboldt-Universität zu Berlin, Philippstr. 13, 10115 Berlin, Germany
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31
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Rieder F, Wiesinger HP, Herfert J, Lampl K, Hecht S, Niebauer J, Maffulli N, Kösters A, Müller E, Seynnes OR. Whole body vibration for chronic patellar tendinopathy: A randomized equivalence trial. Front Physiol 2022; 13:1017931. [PMID: 36338477 PMCID: PMC9633993 DOI: 10.3389/fphys.2022.1017931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/06/2022] [Indexed: 02/02/2023] Open
Abstract
Purpose: Whole body vibration (WBV) triggers anabolic responses in various tissues, including tendons, without requiring high force production. In this waitlist-controlled equivalence trial, we tested its clinical effectiveness as an alternative treatment for patellar tendinopathy against conventional heavy slow resistance training (HSR). Methods: Thirty-nine patients were randomized to either 3 months of WBV training (n = 13), HSR training (n = 11), or a waitlist control (WLC) group (n = 15). In a partly cross-over design, 14 patients of the WLC group were redistributed to one of the two intervention groups (5 in WBV, 9 in HSR). Pre- and post-intervention testing included pain assessments (VAS), functional limitations (VISA-P), knee extension strength and tendon morphological, mechanical and material properties. Follow-up measurements (VAS, VISA-P) were performed in the WBV and HSR groups 6 months after the intervention. Results: Comparisons with the WLC group revealed significant improvements in VISA-P and VAS scores after HSR (41%, p = 003; 54%, p = 0.005) and WBV (22%, p = 0.022; 56%, p = 0.031) training. These improvements continued until follow-up (HSR: 43%, 56%; WBV: 24%, 37%). Pre-post improvements in VAS scores were equivalent between WBV and HSR groups but inconclusive for the VISA-P score and all pre-test to follow up comparisons. The mid-tendon cross-sectional area was significantly reduced after WBV (-5.7%, p = 0.004) and HSR (-3.0%, p = 0.004) training compared to WLC although the equivalence test between interventions was inconclusive. Conclusion: Whole body vibration improved symptoms typically associated with patellar tendinopathy. This type of intervention is as effective as HSR against maximum pain, although equivalence could not be confirmed for other variables. The beneficial responses to WBV and HSR treatments persisted for 6 months after the end of the intervention. Clinical Trial Registration: https://www.drks.de/drks_web/setLocale_EN.do, identifier DRKS00011338.
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Affiliation(s)
- Florian Rieder
- Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria,Department of Sport and Exercise Science, Paris-Lodron University Salzburg, Salzburg, Austria,*Correspondence: Florian Rieder,
| | - Hans-Peter Wiesinger
- Department of Sport and Exercise Science, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Jürgen Herfert
- Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria,Red Bull Athlete Performance Center, Thalgau, Austria
| | - Katrin Lampl
- Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Stefan Hecht
- Institute of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Josef Niebauer
- Institute of Physical Medicine and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria,Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy,Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, United Kingdom,School of Pharmacy and Bioengineering, Keele University School of Medicine, Staffordshire, United Kingdom
| | - Alexander Kösters
- Department of Sport and Exercise Science, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Erich Müller
- Department of Sport and Exercise Science, Paris-Lodron University Salzburg, Salzburg, Austria
| | - Olivier R. Seynnes
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
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Lazarczuk SL, Maniar N, Opar DA, Duhig SJ, Shield A, Barrett RS, Bourne MN. Mechanical, Material and Morphological Adaptations of Healthy Lower Limb Tendons to Mechanical Loading: A Systematic Review and Meta-Analysis. Sports Med 2022; 52:2405-2429. [PMID: 35657492 PMCID: PMC9474511 DOI: 10.1007/s40279-022-01695-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Exposure to increased mechanical loading during physical training can lead to increased tendon stiffness. However, the loading regimen that maximises tendon adaptation and the extent to which adaptation is driven by changes in tendon material properties or tendon geometry is not fully understood. OBJECTIVE To determine (1) the effect of mechanical loading on tendon stiffness, modulus and cross-sectional area (CSA); (2) whether adaptations in stiffness are driven primarily by changes in CSA or modulus; (3) the effect of training type and associated loading parameters (relative intensity; localised strain, load duration, load volume and contraction mode) on stiffness, modulus or CSA; and (4) whether the magnitude of adaptation in tendon properties differs between age groups. METHODS Five databases (PubMed, Scopus, CINAHL, SPORTDiscus, EMBASE) were searched for studies detailing load-induced adaptations in tendon morphological, material or mechanical properties. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated and data were pooled using a random effects model to estimate variance. Meta regression was used to examine the moderating effects of changes in tendon CSA and modulus on tendon stiffness. RESULTS Sixty-one articles met the inclusion criteria. The total number of participants in the included studies was 763. The Achilles tendon (33 studies) and the patella tendon (24 studies) were the most commonly studied regions. Resistance training was the main type of intervention (49 studies). Mechanical loading produced moderate increases in stiffness (standardised mean difference (SMD) 0.74; 95% confidence interval (CI) 0.62-0.86), large increases in modulus (SMD 0.82; 95% CI 0.58-1.07), and small increases in CSA (SMD 0.22; 95% CI 0.12-0.33). Meta-regression revealed that the main moderator of increased stiffness was modulus. Resistance training interventions induced greater increases in modulus than other training types (SMD 0.90; 95% CI 0.65-1.15) and higher strain resistance training protocols induced greater increases in modulus (SMD 0.82; 95% CI 0.44-1.20; p = 0.009) and stiffness (SMD 1.04; 95% CI 0.65-1.43; p = 0.007) than low-strain protocols. The magnitude of stiffness and modulus differences were greater in adult participants. CONCLUSIONS Mechanical loading leads to positive adaptation in lower limb tendon stiffness, modulus and CSA. Studies to date indicate that the main mechanism of increased tendon stiffness due to physical training is increased tendon modulus, and that resistance training performed at high compared to low localised tendon strains is associated with the greatest positive tendon adaptation. PROSPERO registration no.: CRD42019141299.
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Affiliation(s)
- Stephanie L Lazarczuk
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia.
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
| | - Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, VIC, Australia
| | - David A Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, VIC, Australia
| | - Steven J Duhig
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Anthony Shield
- School of Exercise and Nutrition Sciences and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rod S Barrett
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Matthew N Bourne
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
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33
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Viecelli C, Ewald CY. The non-modifiable factors age, gender, and genetics influence resistance exercise. FRONTIERS IN AGING 2022; 3:1005848. [PMID: 36172603 PMCID: PMC9510838 DOI: 10.3389/fragi.2022.1005848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 08/26/2022] [Indexed: 06/13/2023]
Abstract
Muscle mass and force are key for movement, life quality, and health. It is well established that resistance exercise is a potent anabolic stimulus increasing muscle mass and force. The response of a physiological system to resistance exercise is composed of non-modifiable (i.e., age, gender, genetics) and modifiable factors (i.e., exercise, nutrition, training status, etc.). Both factors are integrated by systemic responses (i.e., molecular signaling, genetic responses, protein metabolism, etc.), consequently resulting in functional and physiological adaptations. Herein, we discuss the influence of non-modifiable factors on resistance exercise: age, gender, and genetics. A solid understanding of the role of non-modifiable factors might help to adjust training regimes towards optimal muscle mass maintenance and health.
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Affiliation(s)
- Claudio Viecelli
- Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland
| | - Collin Y. Ewald
- Institute of Translational Medicine, Department of Health Sciences and Technology, ETH Zürich, Schwerzenbach, Switzerland
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Dickson DM, Smith SL, Hendry GJ. Strain sonoelastography in asymptomatic individuals and individuals with knee osteoarthritis: an evaluation of quadriceps and patellar tendon. Rheumatol Int 2022; 42:2241-2251. [PMID: 35974116 PMCID: PMC9548467 DOI: 10.1007/s00296-022-05184-3] [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: 05/18/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
An advanced ultrasound imaging technique, sonoelastography (SE) is used to evaluate tissue elasticity. To determine SE potential to detect pathological-related changes, and characteristics related to tendon pathology we aimed to (1) compare quadriceps and patellar tendon findings in individuals with knee osteoarthritis (KOA) and asymptomatic older adults (AC), and (2) explore associations between SE, participant characteristics (age, BMI, and leg circumference) and KOA status. 84 participants (47; KOA and 37; asymptomatic older adults) underwent SE examination of quadriceps (distal) and patellar (distal, proximal) tendon in a supine position with the knee bent at 30°. Colour score (CS) and Elasticity Ratio (ER) analysis were performed by a blinded experienced operator using Esaote Mylab 70 XVG Ultrasound equipment. Significantly reduced elasticity in the distal quadriceps (median (IQR) 2(2), 3(1), p = 0.033 for KOA and AC, respectively) and proximal patellar (3(1), 3(0), p = 0.001) tendons and more elastic distal patellar (1.50 (0.55), 1.87 (0.72), p = 0.034) tendons were observed in the KOA group. Significant associations) were identified between SE and participant BMI (Rs = − 0.249–0.750, p < 0.05) and leg circumference (Rs = − 0.260–0.903, p < 0.05). Age, BMI and KOA status, were independent explanatory variables of SE CS findings at the distal quadriceps tendon patellar tendon, proximal patellar tendon and distal patellar tendon, explaining 66%, 81% and 64% of variance, respectively. Age, BMI and KOA status were independent explanatory variables of SE ER findings at the distal patellar tendon explaining 19% of variance. Potentially clinically relevant altered tendon stiffness were observed between individuals with KOA and asymptomatic controls. Key KOA risk factors and participant characteristics explained variance in tendon stiffness. Findings provide context for future studies to investigate the potential for targeted SE detected early clinical management based on associated participant characteristics.
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Affiliation(s)
- Diane M Dickson
- Research Centre for Health, Department of Podiatry and Radiography, School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK.
| | - Stephanie L Smith
- Research Centre for Health, Department of Podiatry and Radiography, School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK.,Pain Centre Versus Arthritis, Academic Rheumatology, Injury Recover and Inflammation Sciences, School of Medicine, University of Nottingham, Clinical Sciences Building, Nottingham, NG5 1PB, UK
| | - Gordon J Hendry
- Research Centre for Health, Department of Podiatry and Radiography, School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow, G4 0BA, UK
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35
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Zhu Y, Feng Y, Huang F, Li Y, Wang W, Wang X, Cao X, Zhang Z. Changes in stiffness of the specific regions of knee extensor mechanism after static stretching. Front Bioeng Biotechnol 2022; 10:958242. [PMID: 36046676 PMCID: PMC9420945 DOI: 10.3389/fbioe.2022.958242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Decreased muscle stiffness could reduce musculotendinous injury risk in sports and rehabilitation settings. Static stretching (SS) has been used to increase the flexibility of muscles and reduce muscle stiffness, but the effects of SS on the stiffness of specific regions of the knee extensor mechanism are unclear. The quadriceps femoris and patellar tendon are essential components of the knee extensor mechanism and play an important role in knee motion. Therefore, we explored the acute and prolonged effects of SS on the stiffness of the quadriceps femoris and patellar tendon and knee flexion range of motion (ROM). Thirty healthy male subjects participated in the study. Three 60-s SS with 30-s intervals were conducted in right knee flexion with 30° hip extension. We measured the ROM and stiffness of the vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) and the proximal-(PPT), middle-(MPT), and distal-(DPT) region stiffness of the patellar tendon before and immediately after SS intervention, or 5 and 10 min after SS. The stiffness of the quadriceps muscle and patellar tendon were measured using MyotonPRO, and the knee flexion ROM was evaluated using a medical goniometer. Our outcomes showed that the ROM was increased after SS intervention in all-time conditions (p < 0.01). Additionally, the results showed that the stiffness of RF (p < 0.01) and PPT (p = 0.03) were decreased immediately after SS intervention. These results suggested that SS intervention could be useful to increase knee flexion ROM and temporarily reduce the stiffness of specific regions of the knee extensor mechanism.
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Affiliation(s)
- Yuanchun Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yanan Feng
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Fangchao Huang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Yapeng Li
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Wenjing Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xiangyang Cao
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Zhijie Zhang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
- *Correspondence: Zhijie Zhang,
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36
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Crossland H, Brook MS, Quinlan JI, Franchi MV, Phillips BE, Wilkinson DJ, Maganaris CN, Greenhaff PL, Szewczyk NJ, Smith K, Narici MV, Atherton PJ. Metabolic and molecular responses of human patellar tendon to concentric- and eccentric-type exercise in youth and older age. GeroScience 2022; 45:331-344. [PMID: 35948859 PMCID: PMC9886711 DOI: 10.1007/s11357-022-00636-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 07/28/2022] [Indexed: 02/03/2023] Open
Abstract
Exercise training can induce adaptive changes to tendon tissue both structurally and mechanically; however, the underlying compositional changes that contribute to these alterations remain uncertain in humans, particularly in the context of the ageing tendon. The aims of the present study were to determine the molecular changes with ageing in patellar tendons in humans, as well as the responses to exercise and exercise type (eccentric (ECC) and concentric (CON)) in young and old patellar tendon. Healthy younger males (age 23.5 ± 6.1 years; n = 27) and older males (age 68.5 ± 1.9 years; n = 27) undertook 8 weeks of CON or ECC training (3 times per week; at 60% of 1 repetition maximum (1RM)) or no training. Subjects consumed D2O throughout the protocol and tendon biopsies were collected after 4 and 8 weeks for measurement of fractional synthetic rates (FSR) of tendon protein synthesis and gene expression. There were increases in tendon protein synthesis following 4 weeks of CON and ECC training (P < 0.01; main effect by ANOVA), with no differences observed between young and old males, or training type. At the transcriptional level however, ECC in young adults generally induced greater responses of collagen and extracellular matrix-related genes than CON, while older individuals had reduced gene expression responses to training. Different training types did not appear to induce differential tendon responses in terms of protein synthesis, and while tendons from older adults exhibited different transcriptional responses to younger individuals, protein turnover changes with training were similar for both age groups.
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Affiliation(s)
- Hannah Crossland
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | - Matthew S Brook
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | - Jonathan I Quinlan
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- 3National Institute for Health Research, Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Martino V Franchi
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Bethan E Phillips
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | - Daniel J Wilkinson
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | | | - Paul L Greenhaff
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | - Nathaniel J Szewczyk
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
- Ohio Musculoskeletal and Neurological Institute (OMNI) and Department of Biomedical Sciences, Ohio University, Athens, OH, 45701, USA
| | - Kenneth Smith
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
| | - Marco V Narici
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK
- Department of Biomedical Sciences, University of Padova, Padua, Italy
- CIR-MYO Myology Center, University of Padova, Padua, Italy
| | - Philip J Atherton
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research and NIHR Nottingham Biomedical Research Centre, University of Nottingham, Royal Derby Hospital Centre, Derby, DE22 3DT, UK.
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Martínez F, Abián P, Jiménez F, Abián-Vicén J. The Effects of Eccentric Contraction Execution Time on the Properties of the Patellar Tendon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159296. [PMID: 35954651 PMCID: PMC9367933 DOI: 10.3390/ijerph19159296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to assess the effects of eccentric contraction execution time on the morphological and elastic properties of the patellar tendon (PT) in a six-week, single-leg decline squat (SLDS) exercise training program. In addition, the effects of a six-week detraining period on the same variables were evaluated. Fifty participants were randomized into the control group (CG; n = 15), experimental group 1 (EG6s; n = 17; eccentric contraction execution time = 6 s) and experimental group 2 (EG3s; n = 18; eccentric contraction execution time = 3 s). The thickness and elastographic index (EI) in different regions of interest (ROIs) in the PT were measured after 6 weeks of eccentric training using the single-leg decline squat exercise (three sessions per week, 80% of the eccentric one-repetition maximum) and after 6 weeks of detraining. There was an increase in the thickness of the PT in the different ROIs analyzed in both experimental groups at the end of the training period. Especially worth noting was the increase in the thickness of the PT at the proximal level in EG3s (p = 0.001), and the increase at the distal level in EG6s (p = 0.001). On the other hand, there was a reduction in EI in EG6S at the end of the intervention program (p = 0.021), and both experimental groups increased EI in the three regions of interest analyzed after the detraining period (p < 0.01). In conclusion, the execution time of the eccentric contraction in the SLDS exercise determines the anatomical level of the morphological adaptations in the PT. These morphological adaptations are lost after 6 weeks of detraining, producing an increase in tendon stiffness.
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Affiliation(s)
- Fernando Martínez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.M.); (F.J.)
| | - Pablo Abián
- Faculty of Humanities and Social Sciences, Comillas Pontifical University, 28049 Madrid, Spain;
| | - Fernando Jiménez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.M.); (F.J.)
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, 45071 Toledo, Spain; (F.M.); (F.J.)
- Correspondence: ; Tel.: +34-925268800 (ext. 5522)
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38
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McMahon G. No Strain, No Gain? The Role of Strain and Load Magnitude in Human Tendon Responses and Adaptation to Loading. J Strength Cond Res 2022; 36:2950-2956. [DOI: 10.1519/jsc.0000000000004288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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39
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Klich S, Kosendiak A, Krymski I, Kawczyński A, Madeleine P, Fernández-de-las-Peñas C. Ultrasound imaging of patellar tendon thickness in elite sprint track cyclists and elite soccer players: An intra-rater and inter-rater reliability study. PLoS One 2022; 17:e0270871. [PMID: 35789336 PMCID: PMC9255822 DOI: 10.1371/journal.pone.0270871] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 06/19/2022] [Indexed: 12/02/2022] Open
Abstract
The goal of our study was to investigate the relative and absolute intra-rater and inter-rater reliability of ultrasound assessment of patellar tendon (PT) thickness assessed over four locations, in track cyclists and soccer players. Fifteen male elite track cyclists and 15 male elite soccer players participated. Tendon thickness was measured over 4 locations placed at 5-10-15-20 mm inferior to the apex of the patella by two experienced examiners. Each examiner took two US images for the test measurements with a 10-min rest period. After a 30-min period, the subjects underwent a retest measurements that were also repeated 1-week after. A two-way analysis of variance revealed a significant group x location interaction on PT thickness for Examiner 1 (p = .001, η2 = .81) and Examiner 2 (p = 0.001, η2 = 0.78). Intra-rater reliability ranged from good to excellent (ICC2,k ≥ 0.75), whereas inter-rater reliability was good (ICC2,k ≥ 0.75) in both groups. Ultrasonographic assessment of PT was found to be a reliable method to assess tendon thickness. The middle location of the PT (corresponding to 15 and 20 mm) can be considered the most reliable spot to measure PT thickness. The PT thickness was larger among track cyclists than soccer players, with larger differences over the distal location (15 mm). Ultrasonographic assessment of PT was found to be a reliable method to assess tendon thickness. The middle location of the PT corresponding to 15 mm and 20 mm can be considered the most reliable area to measure PT thickness.
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Affiliation(s)
- Sebastian Klich
- Department of Paralympic Sport, Wrocław University of Health and Sport Science, Wrocław, Poland
- * E-mail:
| | - Aureliusz Kosendiak
- Study of Physical Education and Sport, Wrocław Medical University, Wrocław, Poland
| | | | - Adam Kawczyński
- Department of Paralympic Sport, Wrocław University of Health and Sport Science, Wrocław, Poland
| | - Pascal Madeleine
- Department of Health Science and Technology, Sport Sciences–Performance and Technology, Aalborg University, Aalborg, Denmark
| | - Cesar Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Madrid, Spain
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40
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Lambrianides Y, Epro G, Smith K, Mileva KN, James D, Karamanidis K. Impact of Different Mechanical and Metabolic Stimuli on the Temporal Dynamics of Muscle Strength Adaptation. J Strength Cond Res 2022; 36:3246-3255. [DOI: 10.1519/jsc.0000000000004300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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41
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Götschi T, Hanimann J, Schulz N, Huser S, Held V, Frey WO, Snedeker JG, Spörri J. Patellar Tendon Shear Wave Velocity Is Higher and has Different Regional Patterns in Elite Competitive Alpine Skiers than in Healthy Controls. Front Bioeng Biotechnol 2022; 10:858610. [PMID: 35757800 PMCID: PMC9218688 DOI: 10.3389/fbioe.2022.858610] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
Competitive alpine skiers are exposed to enormous forces acting on their bodies–particularly on the knee joint and hence the patellar tendon - during both the off-season preparation and in-season competition phases. However, factors influencing patellar tendon adaptation and regional pattern differences between alpine skiers and healthy controls are not yet fully understood, but are essential for deriving effective screening approaches and preventative countermeasures. Thirty elite competitive alpine skiers, all members of the Swiss Alpine Ski Team, and 38 healthy age-matched controls were recruited. A set of two-dimensional shear wave elastography measurements of the PT was acquired and projected into three-dimensional space yielding a volumetric representation of the shear wave velocity profile of the patellar tendon. Multivariate linear models served to quantify differences between the two cohorts and effects of other confounding variables with respect to regional shear wave velocity. A significant (p < 0.001) intergroup difference was found between skiers (mean ± SD = 10.4 ± 1.32 m/s) and controls (mean ± SD = 8.9 ± 1.59 m/s). A significant sex difference was found within skiers (p = 0.024), but no such difference was found in the control group (p = 0.842). Regional SWV pattern alterations between skiers and controls were found for the distal region when compared to the mid-portion (p = 0.023). Competitive alpine skiers exhibit higher SWV in all PT regions than healthy controls, potentially caused by long-term adaptations to heavy tendon loading. The presence of sex-specific differences in PT SWV in skiers but not in controls indicates that sex effects have load-dependent dimensions. Alterations in regional SWV patterns between skiers and controls suggest that patellar tendon adaptation is region specific. In addition to the implementation of 3D SWE, deeper insights into long-term tendon adaptation and normative values for the purpose of preventative screening are provided.
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Affiliation(s)
- Tobias Götschi
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Jonas Hanimann
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Nicole Schulz
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Simon Huser
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Victoria Held
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Walter O Frey
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jess G Snedeker
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Jörg Spörri
- Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.,University Centre for Prevention and Sports Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
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42
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Konrad A, Nakamura M, Tilp M, Donti O, Behm DG. Foam Rolling Training Effects on Range of Motion: A Systematic Review and Meta-Analysis. Sports Med 2022; 52:2523-2535. [PMID: 35616852 PMCID: PMC9474417 DOI: 10.1007/s40279-022-01699-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 11/24/2022]
Abstract
Background A single foam-rolling exercise can acutely increase the range of motion (ROM) of a joint. However, to date the adaptational effects of foam-rolling training over several weeks on joint ROM are not well understood. Objective The purpose of this meta-analysis was to investigate the effects of foam-rolling training interventions on joint ROM in healthy participants. Methods Results were assessed from 11 studies (either controlled trials [CT] or randomized controlled trials [RCTs]) and 46 effect sizes by applying a random-effect meta-analysis. Moreover, by applying a mixed-effect model, we performed subgroup analyses, which included comparisons of the intervention duration (≤ 4 weeks vs > 4 weeks), comparisons between muscles tested (e.g., hamstrings vs quadriceps vs triceps surae), and study designs (RCT vs CT). Results Our main analysis of 290 participants with a mean age of 23.9 (± 6.3 years) indicated a moderate effect of foam-rolling training on ROM increases in the experimental compared to the control group (ES = 0.823; Z = 3.237; 95% CI 0.325–1.322; p = 0.001; I2 = 72.76). Subgroup analyses revealed no significant differences between study designs (p = 0.36). However, a significant difference was observed in the intervention duration in favor of interventions > 4 weeks compared to ≤ 4 weeks for ROM increases (p = 0.049). Moreover, a further subgroup analysis showed significant differences between the muscles tested (p = 0.047) in the eligible studies. Foam rolling increased joint ROM when applied to hamstrings and quadriceps, while no improvement in ankle dorsiflexion was observed when foam rolling was applied to triceps surae. Conclusion Longer duration interventions (> 4 weeks) are needed to induce ROM gains while there is evidence that responses are muscle or joint specific. Future research should examine possible mechanisms underpinning ROM increases following different foam-rolling protocols, to allow for informed recommendations in healthy and clinical populations.
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Affiliation(s)
- Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria. .,School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
| | - Masatoshi Nakamura
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Markus Tilp
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria
| | - Olyvia Donti
- Sports Performance Laboratory, School of Physical Education and Sport Science, National and Kapodistrian, University of Athens, Athens, Greece
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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43
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Costa BDDV, Kassiano W, Nunes JP, Kunevaliki G, Castro-E-Souza P, Sugihara Junior P, Fernandes RR, Cyrino ES, Fortes LDS. Does Varying Resistance Exercises for the Same Muscle Group Promote Greater Strength Gains? J Strength Cond Res 2022; 36:3032-3039. [PMID: 35481889 DOI: 10.1519/jsc.0000000000004042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Costa, BDV, Kassiano, W, Nunes, JP, Kunevaliki, G, Castro-E-Souza, P, Sugihara-Junior, P, Fernandes, RR, Cyrino, ES, and de Fortes, LS. Does varying resistance exercises for the same muscle group promote greater strength gains? J Strength Cond Res XX(X): 000-000, 2021-Two of the foremost principles of progression are progressive overload and variation. A way to vary within a resistance training (RT) program is to perform different exercises for the same muscle group; however, this strategy is still overlooked. The purpose of the present study was to compare strength adaptations between an RT routine that maintained the exercises fixed (N-VAR) and another that varied the exercises for the same muscle group during the weekly sessions (VAR). Twenty-three young men (23.3 ± 4.1 years) were randomly allocated to N-VAR (n = 11) and VAR (n = 12) conditions. The RT was performed 3 times a week for 9 weeks and consisted of a whole-body routine (3 sets of 8-12 repetitions). Maximum dynamic strength was assessed using the 1-repetition maximum test (1RM), and the isometric strength was assessed using an isokinetic dynamometer, before and after training. Following the training period, both groups increased the 1RM values in all exercises (p ≤ 0.002), without significant differences between them (p ≥ 0.20). In contrast, a greater increase (p = 0.02) in isometric knee extension strength was showed to N-VAR (+12%) compared with VAR (+7%). There was no significant increase in both groups for isometric knee flexion strength (N-VAR, p = 0.10; VAR, p = 0.18). Our findings indicate that maintaining or varying the exercises for the same muscle group promotes similar adaptations in the maximum dynamic strength. In contrast, for the isometric strength in knee extension, maintaining the fixed exercises seems to be more interesting.
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Affiliation(s)
| | - Witalo Kassiano
- GEPEMENE, Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Paraná, Brazil; and
| | - João Pedro Nunes
- GEPEMENE, Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Paraná, Brazil; and
| | - Gabriel Kunevaliki
- GEPEMENE, Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Paraná, Brazil; and
| | - Pâmela Castro-E-Souza
- GEPEMENE, Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Paraná, Brazil; and
| | - Paulo Sugihara Junior
- GEPEMENE, Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Paraná, Brazil; and
| | - Rodrigo R Fernandes
- GEPEMENE, Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Paraná, Brazil; and
| | - Edilson Serpeloni Cyrino
- GEPEMENE, Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Paraná, Brazil; and
| | - Leonardo de Sousa Fortes
- Graduate Program in Physical Education of Federal, University of Paraíba (UFPB), Paraíba, Brazil
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44
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Merza EY, Pearson SJ, Lichtwark GA, Malliaras P. The acute effects of higher versus lower load duration and intensity on morphological and mechanical properties of the healthy Achilles tendon: a randomized crossover trial. J Exp Biol 2022; 225:275126. [PMID: 35470387 PMCID: PMC9167578 DOI: 10.1242/jeb.243741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/19/2022] [Indexed: 11/20/2022]
Abstract
The Achilles tendon (AT) exhibits volume changes related to fluid flow under acute load which may be linked to changes in stiffness. Fluid flow provides a mechanical signal for cellular activity and may be one mechanism that facilitates tendon adaptation. This study aimed to investigate whether isometric intervention involving a high level of load duration and intensity could maximize the immediate reduction in AT volume and stiffness compared with interventions involving a lower level of load duration and intensity. Sixteen healthy participants (12 males, 4 females; age 24.4±9.4 years, body mass 70.9±16.1 kg, height 1.7±0.1 m) performed three isometric interventions of varying levels of load duration (2 s and 8 s) and intensity (35% and 75% maximal voluntary isometric contraction) over a 3 week period. Freehand 3D ultrasound was used to measure free AT volume (at rest) and length (at 35%, 55% and 75% of maximum plantarflexion force) pre- and post-interventions. The slope of the force–elongation curve over these force levels represented individual stiffness (N mm−1). Large reductions in free AT volume and stiffness resulted in response to long-duration high-intensity loading whilst less reduction was produced with a lower load intensity. In contrast, no change in free AT volume and a small increase in AT stiffness occurred with lower load duration. These findings suggest that the applied load on the AT must be heavy and sustained for a long duration to maximize immediate volume reduction, which might be an acute response that enables optimal long-term tendon adaptation via mechanotransduction pathways. Summary: High levels of load duration and intensity have the greatest acute effect on the free Achilles tendon volume and stiffness.
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Affiliation(s)
- Eman Y Merza
- Department of physiotherapy, Faculty of Medicine, Nursing and Health Science, Monash University, Frankston Vic 3199, Melbourne, Australia
| | - Stephen J Pearson
- Centre for Health, Sport and Rehabilitation Sciences Research, University of Salford, Greater Manchester, M5 4WT, UK
| | - Glen A Lichtwark
- Centre for Sensorimotor Performance, School of Human Movement and Nutrition Sciences, The University of Queensland, St. Lucia, QLD 4072, Brisbane, Australia
| | - Peter Malliaras
- Department of physiotherapy, Faculty of Medicine, Nursing and Health Science, Monash University, Frankston Vic 3199, Melbourne, Australia
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45
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Ramírez-delaCruz M, Bravo-Sánchez A, Esteban-García P, Jiménez F, Abián-Vicén J. Effects of Plyometric Training on Lower Body Muscle Architecture, Tendon Structure, Stiffness and Physical Performance: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:40. [PMID: 35312884 PMCID: PMC8938535 DOI: 10.1186/s40798-022-00431-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Plyometric training (PT) has been widely studied in sport science. However, there is no review that determines the impact of PT on the structural variables and mechanical properties of the lower limbs and physical performance. OBJECTIVE The aim of this systematic review and meta-analysis was to determine the effects of PT on lower body muscle architecture, tendon structure, stiffness and physical performance. METHODS Five electronic databases were analysed. The inclusion criteria were: (1) Availability in English; (2) Experimental studies that included a PT of at least eight sessions; and (3) Healthy adults subjects. Four meta-analyses were performed using Review Manager software: (1) muscle architecture; (2) tendon structure; (3) muscle and tendon stiffness; (4) physical performance. RESULTS From 1008 search records, 32 studies were eligible for meta-analysis. Muscle architecture meta-analysis found a moderate effect of PT on muscle thickness (Standard Mean Difference (SMD): 0.59; [95% Confidence Interval (CI) 0.47, 0.71]) and fascicle length (SMD: 0.51; [95% CI 0.26, 0.76]), and a small effect of PT on pennation angle (SMD: 0.29; [95% CI 0.02, 0.57]). The meta-analysis found a moderate effect of PT on tendon stiffness (SMD: 0.55; [95% CI 0.28, 0.82]). The lower body physical performance meta-analysis found a moderate effect of PT on jumping (SMD: 0.61; [95% CI 0.47, 0.74]) and strength (SMD: 0.57; [95% CI 0.42, 0.73]). CONCLUSION PT increased the thickness, pennation angle and fascicle length of the evaluated muscles. In addition, plyometrics is an effective tool for increasing tendon stiffness and improving jump and strength performance of the lower body.
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Affiliation(s)
- María Ramírez-delaCruz
- Performance and Sport Rehabilitation Laboratory, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
| | - Alfredo Bravo-Sánchez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
| | - Paula Esteban-García
- Performance and Sport Rehabilitation Laboratory, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
| | - Fernando Jiménez
- Performance and Sport Rehabilitation Laboratory, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
| | - Javier Abián-Vicén
- Performance and Sport Rehabilitation Laboratory, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain.
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Zhu Y, Chang T, Wang X, Zhang Z. Bibliometric Study of Exercise and Tendinopathy Research from 2001 to 2020. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022; 28:e934016. [PMID: 35110518 PMCID: PMC8822849 DOI: 10.12659/msm.934016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background Tendinopathy is a tendon disease that often occurs in athletes. Many studies have revealed that exercise therapy is beneficial for the nonoperative management of tendinopathy. However, the general aspect bibliometric analysis of this global research topic associated with exercise and tendinopathy is lacking. The present study aimed to make a bibliometric analysis of worldwide development tendency and research hotspots in exercise and tendinopathy research from 2001 to 2020. Material/Methods Using the Web of Science, articles and reviews published between 2001 and 2020 were retrieved from the Science Citation Index Expanded database. CiteSpace was used to analyze the relationship among publications, countries, institutions, journals, authors, references, and keywords. Results In total, 857 articles were found in this study. Over the past 20 years, there was a marked increase in the number of publications. A total of 194 different scholarly journals were dedicated to the categories Sport Sciences, Orthopedics, and Rehabilitation. The USA and La Trobe University were the most prolific country and institution, respectively. The British Journal of Sports Medicine was the prominent journal for research on exercise and tendinopathy and had the most publications. The analysis of keywords showed that rehabilitation, rotator cuff tendinopathy, stiffness, and disability of individuals with tendinopathy had become the research focus in this field. Conclusions Bibliometric analysis provides a historical and scientific perspective on exercise and tendinopathy research, providing relevant researchers, funding agencies, and policymakers with valuable information to explore the current research status, hotspots, and new directions for future research.
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Affiliation(s)
- Yuanchun Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland)
| | - Tiantian Chang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland)
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China (mainland)
| | - Zhijie Zhang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, Henan, China (mainland)
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Viecelli C, Aguayo D. May the Force and Mass Be With You-Evidence-Based Contribution of Mechano-Biological Descriptors of Resistance Exercise. Front Physiol 2022; 12:686119. [PMID: 35069229 PMCID: PMC8769283 DOI: 10.3389/fphys.2021.686119] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/13/2021] [Indexed: 12/28/2022] Open
Abstract
Skeletal muscle is one of the most important tissues of the human body. It comprises up to 40% of the body mass and is crucial to survival. Hence, the maintenance of skeletal muscle mass and strength is pivotal. It is well-established that resistance exercise provides a potent anabolic stimulus to increase muscle mass and strength in men and women of all ages. Resistance exercise consists of mechano-biological descriptors, such as load, muscle action, number of repetitions, repetition duration, number of sets, rest interval between sets, frequency, volitional muscular failure, and range of motion, which can be manipulated. Herein, we discuss the evidence-based contribution of these mechano-biological descriptors to muscle mass and strength.
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Affiliation(s)
- Claudio Viecelli
- Institute of Molecular Systems Biology, ETH Zurich, Zurich, Switzerland
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Machado E, Lanferdini FJ, da Silva ES, Geremia JM, Sonda FC, Fletcher JR, Vaz MA, Peyré-Tartaruga LA. Triceps Surae Muscle-Tendon Properties as Determinants of the Metabolic Cost in Trained Long-Distance Runners. Front Physiol 2022; 12:767445. [PMID: 35058793 PMCID: PMC8764303 DOI: 10.3389/fphys.2021.767445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: This study aimed to determine whether triceps surae's muscle architecture and Achilles tendon parameters are related to running metabolic cost (C) in trained long-distance runners. Methods: Seventeen trained male recreational long-distance runners (mean age = 34 years) participated in this study. C was measured during submaximal steady-state running (5 min) at 12 and 16 km h-1 on a treadmill. Ultrasound was used to determine the gastrocnemius medialis (GM), gastrocnemius lateralis (GL), and soleus (SO) muscle architecture, including fascicle length (FL) and pennation angle (PA), and the Achilles tendon cross-sectional area (CSA), resting length and elongation as a function of plantar flexion torque during maximal voluntary plantar flexion. Achilles tendon mechanical (force, elongation, and stiffness) and material (stress, strain, and Young's modulus) properties were determined. Stepwise multiple linear regressions were used to determine the relationship between independent variables (tendon resting length, CSA, force, elongation, stiffness, stress, strain, Young's modulus, and FL and PA of triceps surae muscles) and C (J kg-1m-1) at 12 and 16 km h-1. Results: SO PA and Achilles tendon CSA were negatively associated with C (r 2 = 0.69; p < 0.001) at 12 km h-1, whereas SO PA was negatively and Achilles tendon stress was positively associated with C (r 2 = 0.63; p = 0.001) at 16 km h-1, respectively. Our results presented a small power, and the multiple linear regression's cause-effect relation was limited due to the low sample size. Conclusion: For a given muscle length, greater SO PA, probably related to short muscle fibers and to a large physiological cross-sectional area, may be beneficial to C. Larger Achilles tendon CSA may determine a better force distribution per tendon area, thereby reducing tendon stress and C at submaximal speeds (12 and 16 km h-1). Furthermore, Achilles tendon morphological and mechanical properties (CSA, stress, and Young's modulus) and triceps surae muscle architecture (GM PA, GM FL, SO PA, and SO FL) presented large correlations with C.
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Affiliation(s)
- Esthevan Machado
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Health and Physical Education, Mount Royal University, Calgary, AB, Canada
| | - Fábio Juner Lanferdini
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Laboratório de Biomecânica, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Edson Soares da Silva
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jeam Marcel Geremia
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Francesca Chaida Sonda
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jared R. Fletcher
- Department of Health and Physical Education, Mount Royal University, Calgary, AB, Canada
| | - Marco Aurélio Vaz
- Laboratório de Pesquisa do Exercício, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Centner C, Jerger S, Lauber B, Seynnes O, Friedrich T, Lolli D, Gollhofer A, König D. Low-Load Blood Flow Restriction and High-Load Resistance Training Induce Comparable Changes in Patellar Tendon Properties. Med Sci Sports Exerc 2021; 54:582-589. [PMID: 34772900 DOI: 10.1249/mss.0000000000002824] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Low-load resistance training with blood flow restriction (LL-BFR) has emerged as a viable alternative to conventional high-load (HL) resistance training regimens. Despite increasing evidence confirming comparable muscle adaptations between LL-BFR and HL resistance exercise, only very little is known about tendinous mechanical and morphological adaptations following LL-BFR. Therefore, the aim of the present study was to examine the effects of 14 weeks of LL-BFR and HL training on patellar tendon adaptations. METHODS N = 29 recreationally active male participants were randomly allocated into the following two groups: LL-BFR resistance training (20-35% one repetition maximum/1RM) or HL resistance training (70-85% 1RM). Both groups trained three times per week for 14 weeks. One week before and after the intervention, patellar tendon mechanical and morphological properties were assessed via ultrasound and magnetic resonance imaging (MRI). Additionally, changes in muscle cross-sectional area (CSA) were quantified by MRI and muscle strength via dynamic 1RM measurements. RESULTS The findings demonstrated that both LL-BFR and HL training resulted in comparable changes in patellar tendon stiffness (LL-BFR: + 25.2%, p = 0.003; HL: + 22.5%, p = 0.024) without significant differences between groups. Similar increases in tendon CSA were observed in HL and LL-BFR. Muscle mass and strength also significantly increased in both groups but were not statistically different between HL (+ 38%) and LL-BFR (+ 34%), except for knee extension 1RM where higher changes were seen in LL-BFR. CONCLUSION The present results support the notion that both HL and LL-BFR cause substantial changes in patellar tendon properties and the magnitude of changes are not significantly different between conditions. Further studies are needed which examine the physiological mechanisms underlying the altered tendon properties following LL-BFR training.
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Affiliation(s)
- Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Germany Praxisklinik Rennbahn, Muttenz, Switzerland Department of Neurosciences and Movement Sciences, Université de Fribourg, Switzerland Department of Physical Performance, Norwegian School of Sport Sciences, Norway Department of Sports Science, Institute for Nutrition, Sports and Health, University of Vienna, Vienna, Austria
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Burton I. Combined extracorporeal shockwave therapy and exercise for the treatment of tendinopathy: A narrative review. SPORTS MEDICINE AND HEALTH SCIENCE 2021; 4:8-17. [PMID: 35782779 PMCID: PMC9219268 DOI: 10.1016/j.smhs.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022] Open
Abstract
Tendinopathy is a chronic degenerative musculoskeletal disorder that is common in both athletes and the general population. Exercise and extracorporeal shockwave therapy (ESWT) is among the most common treatments used to mediate tendon healing and regeneration. The review presents the current understanding of mechanisms of action of ESWT and exercise in isolation and briefly synthesises evidence of their effectiveness for various tendinopathies. The central purpose of the review is to synthesize research findings investigating the combination of ESWT and exercise for five common tendinopathies (plantar heel pain, rotator cuff, lateral elbow, Achilles, and patellar tendinopathy) and provide recommendations on clinical applicability. Collectively, the available evidence indicates that ESWT combined with exercise in the form of eccentric training, tissue-specific stretching, or heavy slow resistance training are effective for specific tendinopathies and can therefore be recommended in treatment. Whilst there are at present a limited number of studies investigating combined EWST and exercise approaches, there is evidence to suggest that the combination improves outcomes in the treatment of plantar heel pain, Achilles, lateral elbow, and rotator cuff tendinopathy. However, despite overall positive outcomes in patellar tendinopathy, the combined treatment has not been shown at present to offer additional benefit over eccentric exercise alone.
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