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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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Ando R, Sato S, Hirata N, Tanimoto H, Imaizumi N, Suzuki Y, Hirata K, Akagi R. Relationship Between Drop Jump Training–Induced Changes in Passive Plantar Flexor Stiffness and Explosive Performance. Front Physiol 2021; 12:777268. [PMID: 35035358 PMCID: PMC8753453 DOI: 10.3389/fphys.2021.777268] [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: 09/15/2021] [Accepted: 10/28/2021] [Indexed: 11/21/2022] Open
Abstract
Passive muscle stiffness is positively associated with explosive performance. Drop jump training may be a strategy to increase passive muscle stiffness in the lower limb muscles. Therefore, the purpose of this study was to examine the effect of 8-week drop jump training on the passive stiffness in the plantar flexor muscles and the association between training-induced changes in passive muscle stiffness and explosive performance. This study was a randomized controlled trial. Twenty-four healthy young men were divided into two groups, control and training. The participants in the training group performed drop jumps (five sets of 20 repetitions each) 3days per week for 8weeks. As an index of passive muscle stiffness, the shear moduli of the medial gastrocnemius and soleus were measured by shear wave elastography before and after the intervention. The participants performed maximal voluntary isometric plantar flexion at an ankle joint angle of 0° and maximal drop jumps from a 15cm high box. The rate of torque development during isometric contraction was calculated. The shear modulus of the medial gastrocnemius decreased for the training group (before: 13.5±2.1kPa, after: 10.6±2.1kPa); however, such a reduction was not observed in the control group. There was no significant group (control and training groups)×time (before and after the intervention) interaction for the shear modulus of the soleus. The drop jump performance for the training group improved, while the rate of torque development did not change. Relative changes in these measurements were not correlated with each other in the training group. These results suggest that drop jump training decreases the passive stiffness in the medial gastrocnemius, and training-induced improvement in explosive performance cannot be attributed to change in passive muscle stiffness.
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Affiliation(s)
- Ryosuke Ando
- Department of Sports Research, Japan Institute of Sports Sciences (JISS), Tokyo, Japan
- *Correspondence: Ryosuke Ando,
| | - Shinya Sato
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Naoya Hirata
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Hiroki Tanimoto
- Graduate School of Health Management, Keio University, Fujisawa, Japan
| | - Naoto Imaizumi
- College of System Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Yasuhiro Suzuki
- Department of Sports Research, Japan Institute of Sports Sciences (JISS), Tokyo, Japan
- Center for General Education, Tokyo Keizai University, Tokyo, Japan
| | - Kosuke Hirata
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Ryota Akagi
- Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
- College of System Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
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Tumkur Anil Kumar N, Oliver JL, Lloyd RS, Pedley JS, Radnor JM. The Influence of Growth, Maturation and Resistance Training on Muscle-Tendon and Neuromuscular Adaptations: A Narrative Review. Sports (Basel) 2021; 9:59. [PMID: 34066778 PMCID: PMC8150311 DOI: 10.3390/sports9050059] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this article is to provide an overview of the growth, maturation and resistance training-related changes in muscle-tendon and neuromuscular mechanisms in youth, and the subsequent effect on performance. Sprinting, jumping, kicking, and throwing are common movements in sport that have been shown to develop naturally with age, with improvements in performance being attributed to growth and maturity-related changes in neuromuscular mechanisms. These changes include moderate to very large increases in muscle physiological cross-sectional area (CSA), muscle volume and thickness, tendon CSA and stiffness, fascicle length, muscle activation, pre-activation, stretch reflex control accompanied by large reductions in electro-mechanical delay and co-contraction. Furthermore, a limited number of training studies examining neuromuscular changes following four to 20 weeks of resistance training have reported trivial to moderate differences in tendon stiffness, muscle CSA, muscle thickness, and motor unit activation accompanied by reductions in electromechanical delay (EMD) in pre-pubertal children. However, the interaction of maturity- and training-related neuromuscular adaptions remains unclear. An understanding of how different neuromuscular mechanisms adapt in response to growth, maturation and training is important in order to optimise training responsiveness in youth populations. Additionally, the impact that these muscle-tendon and neuromuscular changes have on force producing capabilities underpinning performance is unclear.
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Affiliation(s)
- Nakul Tumkur Anil Kumar
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF23 6XD, UK; (J.L.O.); (R.S.L.); (J.S.P.); (J.M.R.)
| | - Jon L. Oliver
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF23 6XD, UK; (J.L.O.); (R.S.L.); (J.S.P.); (J.M.R.)
- Sport Performance Research Institute New Zealand, Auckland University of Technology, 1010 Auckland, New Zealand
| | - Rhodri S. Lloyd
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF23 6XD, UK; (J.L.O.); (R.S.L.); (J.S.P.); (J.M.R.)
- Sport Performance Research Institute New Zealand, Auckland University of Technology, 1010 Auckland, New Zealand
- Centre for Sport Science and Human Performance, Waikato Institute of Technology, 3200 Hamilton, New Zealand
| | - Jason S. Pedley
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF23 6XD, UK; (J.L.O.); (R.S.L.); (J.S.P.); (J.M.R.)
| | - John M. Radnor
- Youth Physical Development Centre, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff CF23 6XD, UK; (J.L.O.); (R.S.L.); (J.S.P.); (J.M.R.)
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Comparison of Modular Control during Side Cutting before and after Fatigue. Appl Bionics Biomech 2021; 2021:8860207. [PMID: 33505517 PMCID: PMC7808840 DOI: 10.1155/2021/8860207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to clarify the coordination between the trunk and lower limb muscles during sidestep and to compare this coordination before and after fatigue intervention. The intervention was lateral jump until exhaustion. Nonnegative matrix factorization (NMF) was used to extract muscle synergies from electromyography. Subsequently, to compare the muscle synergies, a scalar product that evaluates the coincidence of synergies was calculated. Three muscle synergies were extracted before and after the intervention from the NMF analysis. In accordance with the evaluation of the scalar product, these synergies were the same before and after the intervention. One of these synergies that engaged the internal oblique/transversus abdominis, rectus femoris, and adductor muscle was activated from before landing to midstance during sidestep motion; therefore, this synergy is thought to suppress excessive hip abduction. However, the activation timing of this synergy was delayed after the intervention (P = 0.028, effect size: 0.54, Wilcoxon test). This delay is considered to decrease hip stability. Thus, this change may induce a reduction in hip control function.
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Kositsky A, Avela J. The Effects of Cold Water Immersion on the Recovery of Drop Jump Performance and Mechanics: A Pilot Study in Under-20 Soccer Players. Front Sports Act Living 2020; 2:17. [PMID: 33345011 PMCID: PMC7739749 DOI: 10.3389/fspor.2020.00017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/14/2020] [Indexed: 12/22/2022] Open
Abstract
Cold water immersion (CWI) is a popular method used for enhancing recovery from exercise. However, the efficacy of this approach is inconclusive and studies investigating variables contributing to overall performance are scarce. Additionally, few studies have investigated the recovery of stretch-shortening cycle (SSC) performance after a fatiguing SSC task. The SSC occurs naturally in human locomotion and induces a recovery pattern different from isolated muscle contractions (e.g., pure eccentric exercise). Therefore, the main aim of this study was to investigate the effects of a single CWI on jumping performance and mechanics after exhaustive SSC exercise. On a sledge apparatus, 10 male under-20 soccer players (age 18–20 years) performed five sets of 20 maximal drop jumps (DJ) followed by continuous submaximal rebounding. Subjects were equally randomized into a passive recovery control (CON) or CWI group (10 ± 0.5°C for 20 min). Prior to, upon completion of, and at 24 and 48 h follow-ups, subjects performed maximal DJs recorded with a high-speed video camera. Blood samples were taken and subjective muscle soreness was measured. Rebound jump height was impaired immediately after exercise, although significant only for CWI (CON: −12.4 cm, p = 0.083; CWI: −9.9 cm, p = 0.009). The CWI group demonstrated significant recovery of jump height at 24 h (+6.3 cm, p = 0.031) and 48 h (+8.9 cm, p = 0.002) compared to post-exercise. Ankle joint stiffness was decreased for CWI (−2.1 to −2.5 Nm/°, p = 0.005–0.041). Creatine kinase activity was similarly increased for both groups at 24 and 48 h, while there was also no group effect in muscle soreness (p ≥ 0.056). This pilot study demonstrates the potential for CWI to slightly enhance the recovery of DJ performance. However, this occurred in parallel with reduced ankle joint stiffness, signifying that jumps were performed with less efficiency, which would not be favorable for repeated SSC actions. While this should be confirmed with a larger sample size, this highlights the potential for CWI to be detrimental to the mechanical properties of the ankle joint. Therefore, future recovery intervention studies should concomitantly investigate variables contributing to performance, rather than just overall performance itself.
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Affiliation(s)
- Adam Kositsky
- Biology of Physical Activity, Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Janne Avela
- Biology of Physical Activity, Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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McHugh MP, Hickok M, Cohen JA, Virgile A, Connolly DAJ. Is there a biomechanically efficient vertical ground reaction force profile for countermovement jumps? TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Malachy P. McHugh
- Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital New York NY USA
- Faculty of Health and Life Sciences Northumbria University Newcastle UK
| | - Marc Hickok
- College of Nursing and Health Sciences University of Vermont Burlington VT USA
| | - Josef A. Cohen
- Nicholas Institute of Sports Medicine and Athletic Trauma Lenox Hill Hospital New York NY USA
| | - Adam Virgile
- College of Nursing and Health Sciences University of Vermont Burlington VT USA
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Kositsky A, Kidgell DJ, Avela J. Medial Gastrocnemius Muscle Architecture Is Altered After Exhaustive Stretch-Shortening Cycle Exercise. Front Physiol 2020; 10:1511. [PMID: 31920715 PMCID: PMC6933009 DOI: 10.3389/fphys.2019.01511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 11/29/2019] [Indexed: 11/26/2022] Open
Abstract
Muscle architecture is an important component of muscle function, and recent studies have shown changes in muscle architecture with fatigue. The stretch-shortening cycle is a natural way to study human locomotion, but little is known about how muscle architecture is affected by this type of exercise. This study investigated potential changes in medial gastrocnemius (MG) muscle architecture after exhaustive stretch-shortening cycle exercise. Male athletes (n = 10) performed maximal voluntary contractions (MVC) and maximal drop jump (DJ) tests before and after an exercise task consisting of 100 maximal DJs followed by successive rebound jumping to 70% of the initial maximal height. The exercise task ceased upon failure to jump to 50% of maximal height or volitional fatigue. Muscle architecture of MG was measured using ultrasonography at rest and during MVC, and performance variables were calculated via a force plate and motion analysis. After SSC exercise, MVC (−13.1%; p = 0.005; dz = 1.30), rebound jump height (−14.8%, p = 0.004; dz = 1.32), and ankle joint stiffness (−26.3%; p = 0.008; dz = 1.30) decreased. Ankle joint range of motion (+20.2%; p = 0.011; dz = 1.09) and MG muscle-tendon unit length (+12.0%; p = 0.037; dz = 0.91) during the braking phase of DJ, the immediate drop-off in impact force (termed peak force reduction) (Δ27.3%; p = 0.033; dz = 0.86), and lactate (+9.5 mmol/L; p < 0.001; dz = 3.58) increased. Fascicle length increased at rest (+4.9%; p = 0.013; dz = 1.16) and during MVC (+6.8%; p = 0.048; dz = 0.85). Pennation angle decreased at rest (−6.5%; p = 0.034, dz = 0.93) and during MVC (−9.8%; p = 0.012; dz = 1.35). No changes in muscle thickness were found at rest (−2.6%; p = 0.066; dz = 0.77) or during MVC (−1.6%; p = 0.204; dz = 0.49). The greater MG muscle-tendon stretch during the DJ braking phase after exercise indicates that muscle damage likely occurred. The lower peak force reduction and ankle joint stiffness, indicative of decreased active stiffness, suggests activation was likely reduced, causing fascicles to shorten less during MVC.
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Affiliation(s)
- Adam Kositsky
- Biology of Physical Activity, Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Dawson J Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Janne Avela
- Biology of Physical Activity, Neuromuscular Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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König M, Hemmers S, Epro G, McCrum C, Ackermans TMA, Hartmann U, Karamanidis K. Matching Participants for Triceps Surae Muscle Strength and Tendon Stiffness Does Not Eliminate Age-Related Differences in Mechanical Power Output During Jumping. Front Physiol 2018; 9:1345. [PMID: 30356888 PMCID: PMC6190886 DOI: 10.3389/fphys.2018.01345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 09/06/2018] [Indexed: 11/17/2022] Open
Abstract
Reductions in muscular power output and performance during multi-joint motor tasks with aging have often been associated with muscle weakness. This study aimed to examine if matching younger and middle-aged adults for triceps surae (TS) muscle strength and tendon stiffness eliminates age-related differences in muscular power production during drop jump. The maximal ankle plantar flexion moment and gastrocnemius medialis tendon stiffness of 29 middle-aged (40-67 years) and 26 younger (18-30 years) healthy physically active male adults were assessed during isometric voluntary ankle plantar flexion contractions using simultaneous dynamometry and ultrasonography. The elongation of the tendon during the loading phase was assessed by digitizing the myotendinous junction of the gastrocnemius medialis muscle. Eight younger (23 ± 3 years) and eight middle-aged (54 ± 7 years) adults from the larger subject pool were matched for TS muscle strength and tendon stiffness (plantar flexion moment young: 3.1 ± 0.4 Nm/kg; middle-aged: 3.2 ± 0.5 Nm/kg; tendon stiffness: 553 ± 97 vs. 572 ± 100 N/mm) and then performed series of drop jumps from different box heights (13, 23, 33, and 39 cm) onto a force plate (sampling frequency 1000 Hz). The matched young and middle-aged adults showed similar drop jump heights for all conditions (from lowest to highest box height: 18.0 ± 3.7 vs. 19.7 ± 4.8 cm; 22.6 ± 4.2 vs. 22.9 ± 4.9 cm; 24.8 ± 3.8 vs. 23.5 ± 4.9 cm; 25.2 ± 6.2 vs. 22.7 ± 5.0 cm). However, middle-aged adults showed longer ground contact times (on average 36%), lower vertical ground reaction forces (36%) and hence lower average mechanical power (from lowest to highest box height: 2266 ± 563 vs. 1498 ± 545 W; 3563 ± 774 vs. 2222 ± 320 W; 4360 ± 658 vs. 2475 ± 528 W; 5008 ± 919 vs. 3034 ± 435 W) independent of box height. Further, leg stiffness was lower (48%) in middle-aged compared to younger adults for all jumping conditions and we found significant correlations between average mechanical power and leg stiffness (0.70 ≤ r ≤ 0.83; p < 0.01). Thus, while jumping performance appears to be unaffected when leg extensor muscle strength and tendon stiffness are maintained, the reduced muscular power output during lower limb multi-joint tasks seen with aging may be due to age-related changes in motor task execution strategy rather than due to muscle weakness.
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Affiliation(s)
- Matthias König
- School of Applied Sciences, Sport and Exercise Science Research Centre, London South Bank University, London, United Kingdom
| | - Svenja Hemmers
- Department of Mathematics and Technology, RheinAhrCampus Remagen, Koblenz University of Applied Sciences, Remagen, Germany
| | - Gaspar Epro
- School of Applied Sciences, Sport and Exercise Science Research Centre, London South Bank University, London, United Kingdom
| | - Christopher McCrum
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Nutrition and Movement Sciences, Maastricht University Medical Centre, Maastricht, Netherlands
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, Germany
| | | | - Ulrich Hartmann
- Department of Mathematics and Technology, RheinAhrCampus Remagen, Koblenz University of Applied Sciences, Remagen, Germany
| | - Kiros Karamanidis
- School of Applied Sciences, Sport and Exercise Science Research Centre, London South Bank University, London, United Kingdom
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Wirth K, Hartmann H, Sander A, Mickel C, Szilvas E, Keiner M. The Impact of Back Squat and Leg-Press Exercises on Maximal Strength and Speed-Strength Parameters. J Strength Cond Res 2016; 30:1205-12. [PMID: 26439782 DOI: 10.1519/jsc.0000000000001228] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Strength training-induced increases in speed strength seem indisputable. For trainers and athletes, the most efficient exercise selection in the phase of preparation is of interest. Therefore, this study determined how the selection of training exercise influences the development of speed strength and maximal strength during an 8-week training intervention. Seventy-eight students participated in this study (39 in the training group and 39 as controls). Both groups were divided into 2 subgroups. The first training group (squat training group [SQ]) completed an 8-week strength training protocol using the parallel squat. The second training group (leg-press training group [LP]) used the same training protocol using the leg press (45° leg press). The control group was divided in 2 subgroups as controls for the SQ or the LP. Two-factorial analyses of variance were performed using a repeated measures model for all group comparisons and comparisons between pretest and posttest results. The SQ exhibited a statistically significant (p ≤ 0.05) increase in jump performance in squat jump (SJ, 12.4%) and countermovement jump (CMJ, 12.0%). Whereas, the changes in the LP did not reach statistical significance and amounted to improvements in SJ of 3.5% and CMJ 0.5%. The differences between groups were statistically significant (p ≤ 0.05). There are also indications that the squat exercise is more effective to increase drop jump performance. Therefore, the squat exercise increased the performance in SJ, CMJ, and reactive strength index more effectively compared with the leg-press in a short-term intervention. Consequently, if the strength training aims at improving jump performance, the squat should be preferred because of the better transfer effects.
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Affiliation(s)
- Klaus Wirth
- 1Institute of Sport Science, Johann Wolfgang Goethe-University Frankfurt, Germany; 2University of Applied Sciences Wiener Neustadt, Austria; 3German Luge and Bobsled Federation, Germany; and 4Swimming Federation of the State Lower Saxony, Germany
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Christoforidou Α, Patikas DA, Bassa E, Paraschos I, Lazaridis S, Christoforidis C, Kotzamanidis C. Landing from different heights: Biomechanical and neuromuscular strategies in trained gymnasts and untrained prepubescent girls. J Electromyogr Kinesiol 2016; 32:1-8. [PMID: 27863284 DOI: 10.1016/j.jelekin.2016.11.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 09/17/2016] [Accepted: 11/06/2016] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to examine the biomechanics of the lower limb, during landing in female prepubertal gymnasts and prepubertal untrained girls, aged 9-12years. Ten healthy participants were included in each group and performed five landings from 20, 40, and 60cm. Kinematics, ground reaction forces (GRF) and electromyogram (EMG) from the lateral gastrocnemius, tibialis anterior, and vastus lateralis are presented. Gymnasts had higher vertical GRF and shorter braking phase during landing. Compared to untrained girls, gymnasts exhibited for all examined drop heights more knee flexion before and at ground contact, but less knee flexion at maximum knee flexion position. Especially when increasing drop heights the gymnasts activated their examined muscles earlier, and generally they had higher pre- and post landing EMG amplitudes normalized to the peak EMG at 60cm drop height. Furthermore, gymnasts had lower antagonist EMG for the tibialis anterior compared to untrained girls, especially when landing from higher heights. It is concluded that the landing strategy preferred by gymnasts is influenced by long-term and specialized training and induces a stiffer landing pattern. This could have implications in injury prevention, which requires further investigation.
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Affiliation(s)
- Α Christoforidou
- Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Greece
| | - D A Patikas
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, Greece.
| | - E Bassa
- Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Greece
| | - I Paraschos
- Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Greece
| | - S Lazaridis
- Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Greece
| | - C Christoforidis
- Department of Physical Education and Sport Science, Democritus University of Thrace, Greece
| | - C Kotzamanidis
- Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Greece
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Melo RC, Takahashi AC, Quitério RJ, Salvini TF, Catai AM. Eccentric Torque-Producing Capacity is Influenced by Muscle Length in Older Healthy Adults. J Strength Cond Res 2016; 30:259-66. [DOI: 10.1519/jsc.0000000000001047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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12
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Papadopoulos C, Theodosiou K, Bogdanis GC, Gkantiraga E, Gissis I, Sambanis M, Souglis A, Sotiropoulos A. Multiarticular isokinetic high-load eccentric training induces large increases in eccentric and concentric strength and jumping performance. J Strength Cond Res 2015; 28:2680-8. [PMID: 24626142 DOI: 10.1519/jsc.0000000000000456] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study investigated the effects of short-term eccentric exercise training using a custom-made isokinetic leg press device, on concentric and eccentric strength and explosiveness as well as jumping performance. Nineteen healthy males were divided into an eccentric (ECC, n = 10) and a control group (CG, n = 9). The ECC group trained twice per week for 8 weeks using an isokinetic hydraulic leg press machine against progressively increasing resistance ranging from 70 to 90% of maximal eccentric force. Jumping performance and maximal force generating capacity were measured before and after eccentric training. In the ECC group, drop jump (DJ) height and maximal power were increased by 13.6 ± 3.2% (p < 0.01) and 25.8 ± 1.2% (p < 0.01), whereas ground contact time was decreased by 17.6 ± 2.6% (p < 0.01). Changes in ankle, knee, and hip joint angles were also reduced by 33.9 ± 1.1%, 31.1 ± 1.0%, and 32.4 ± 1.6% (all p < 0.01), respectively, indicating an increase in muscle stiffness during the DJ. Maximal eccentric and concentric leg press force was increased by 64.9 ± 5.5% (p < 0.01) and 32.2 ± 8.8% (p < 0.01), respectively, and explosiveness, measured as force attained in the first 300 milliseconds, was increased by 49.1 ± 4.8% (p < 0.01) and 77.1 ± 7.7% (p < 0.01), respectively. The CG did not show any statistically significant changes in all parameters measured. The main findings of this study were that maximal concentric and eccentric force, explosiveness, and DJ performance were markedly increased after only 16 training sessions, possibly because of the high eccentric load attained during the bilateral eccentric leg press exercise performed on this custom-made device.
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Affiliation(s)
- Christos Papadopoulos
- 1Laboratory of Sport Biomechanics, Faculty of Physical Education and Sports Science, Aristotle University of Thessaloniki, Serres, Greece; and 2Faculty of Physical Education and Sports Science, University of Athens, Athens, Greece
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Lesinski M, Prieske O, Demps M, Granacher U. Effects of fatigue and surface instability on neuromuscular performance during jumping. Scand J Med Sci Sports 2015; 26:1140-50. [PMID: 26369626 DOI: 10.1111/sms.12548] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 12/01/2022]
Abstract
It has previously been shown that fatigue and unstable surfaces affect jump performance. However, the combination thereof is unresolved. Thus, the purpose of this study was to examine the effects of fatigue and surface instability on jump performance and leg muscle activity. Twenty elite volleyball players (18 ± 2 years) performed repetitive vertical double-leg box jumps until failure. Before and after a fatigue protocol, jump performance (i.e., jump height) and electromyographic activity of selected lower limb muscles were recorded during drop jumps (DJs) and countermovement jumps (CMJs) on a force plate on stable and unstable surfaces (i.e., balance pad on top of force plate). Jump performance (3-7%; P < 0.05; 1.14 ≤ d ≤ 2.82), and muscle activity (2-27%; P < 0.05; 0.59 ≤ d ≤ 3.13) were lower following fatigue during DJs and CMJs, and on unstable compared with stable surfaces during DJs only (jump performance: 8%; P < 0.01; d = 1.90; muscle activity: 9-25%; P < 0.05; 1.08 ≤ d ≤ 2.54). No statistically significant interactions of fatigue by surface condition were observed. Our findings revealed that fatigue impairs neuromuscular performance during DJs and CMJs in elite volleyball players, whereas surface instability affects neuromuscular DJ performance only. Absent fatigue × surface interactions indicate that fatigue-induced changes in jump performance are similar on stable and unstable surfaces in jump-trained athletes.
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Affiliation(s)
- M Lesinski
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany.
| | - O Prieske
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - M Demps
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
| | - U Granacher
- Division of Training and Movement Sciences, Research Focus Cognition Sciences, University of Potsdam, Potsdam, Germany
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Kulmala JP, Korhonen MT, Kuitunen S, Suominen H, Heinonen A, Mikkola A, Avela J. Which muscles compromise human locomotor performance with age? J R Soc Interface 2015; 11:20140858. [PMID: 25209406 DOI: 10.1098/rsif.2014.0858] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Ageing leads to a progressive decline in human locomotor performance. However, it is not known whether this decline results from reduced joint moment and power generation of all lower limb muscle groups or just some of them. To further our understanding of age-related locomotor decline, we compare the amounts of joint moments and powers generated by lower limb muscles during walking (self-selected), running (4 m s(-1)) and sprinting (maximal speed) among young, middle-aged and old adults. We find that age-related deficit in ankle plantarflexor moment and power generation becomes more severe as locomotion change from walking to running to sprinting. As a result, old adults generate more power at the knee and hip extensors than their younger counterparts when walking and running at the same speed. During maximal sprinting, young adults with faster top speeds demonstrate greater moments and powers from the ankle and hip joints, but interestingly, not from the knee joint when compared with the middle-aged and old adults. These findings indicate that propulsive deficit of ankle contributes most to the age-related locomotor decline. In addition, reduced muscular output from the hip rather than from knee limits the sprinting performance in older age.
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Affiliation(s)
- Juha-Pekka Kulmala
- Department of Biology of Physical Activity, University of Jyväskylä, Viveca 223, Rautpohjankatu 8 A, 40014 Jyväskylän Yliopisto, Finland Agora Center, University of Jyväskylä, Viveca 223, Rautpohjankatu 8 A, 40014 Jyväskylän Yliopisto, Finland Department of Mechanical Engineering, Lappeenranta University of Technology, 53850 Lappeenranta, Finland
| | - Marko T Korhonen
- Department of Health Sciences, University of Jyväskylä, Viveca 223, Rautpohjankatu 8 A, 40014 Jyväskylän Yliopisto, Finland
| | - Sami Kuitunen
- Research Institute for Olympic Sports, 40700 Jyväskylä, Finland
| | - Harri Suominen
- Department of Health Sciences, University of Jyväskylä, Viveca 223, Rautpohjankatu 8 A, 40014 Jyväskylän Yliopisto, Finland
| | - Ari Heinonen
- Department of Health Sciences, University of Jyväskylä, Viveca 223, Rautpohjankatu 8 A, 40014 Jyväskylän Yliopisto, Finland
| | - Aki Mikkola
- Department of Mechanical Engineering, Lappeenranta University of Technology, 53850 Lappeenranta, Finland
| | - Janne Avela
- Department of Biology of Physical Activity, University of Jyväskylä, Viveca 223, Rautpohjankatu 8 A, 40014 Jyväskylän Yliopisto, Finland
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15
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Hobara H, Kobayashi Y, Yoshida E, Mochimaru M. Leg stiffness of older and younger individuals over a range of hopping frequencies. J Electromyogr Kinesiol 2015; 25:305-9. [DOI: 10.1016/j.jelekin.2015.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 11/27/2022] Open
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16
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Hoffrén-Mikkola M, Ishikawa M, Rantalainen T, Avela J, Komi PV. Neuromuscular mechanics and hopping training in elderly. Eur J Appl Physiol 2014; 115:863-77. [DOI: 10.1007/s00421-014-3065-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 11/25/2014] [Indexed: 11/25/2022]
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17
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Quirk DA, Hubley-Kozey CL. Age-related changes in trunk neuromuscular activation patterns during a controlled functional transfer task include amplitude and temporal synergies. Hum Mov Sci 2014; 38:262-80. [PMID: 25457424 DOI: 10.1016/j.humov.2014.08.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 07/22/2014] [Accepted: 08/08/2014] [Indexed: 12/01/2022]
Abstract
While healthy aging is associated with physiological changes that can impair control of trunk motion, few studies examine how spinal muscle responses change with increasing age. This study examined whether older (over 65 years) compared to younger (20-45 years) adults had higher overall amplitude and altered temporal recruitment patterns of trunk musculature when performing a functional transfer task. Surface electromyograms from twelve bilateral trunk muscle (24) sites were analyzed using principal component analysis, extracting amplitude and temporal features (PCs) from electromyographic waveforms. Two PCs explained 96% of the waveform variance. Three factor ANOVA models tested main effects (group, muscle and reach) and interactions for PC scores. Significant (p<.0125) group interactions were found for all PC scores. Post hoc analysis revealed that relative to younger adults, older adults recruited higher agonist and antagonistic activity, demonstrated continuous activation levels in specific muscle sites despite changing external moments, and had altered temporal synergies within abdominal and back musculature. In summary both older and younger adults recruit highly organized activation patterns in response to changing external moments. Differences in temporal trunk musculature recruitment patterns suggest that older adults experience different dynamic spinal stiffness and loading compared to younger adults during a functional lifting task.
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Affiliation(s)
- D Adam Quirk
- School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada; School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Cheryl L Hubley-Kozey
- School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada; School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada; School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.
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18
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Rader EP, Miller GR, Chetlin RD, Wirth O, Baker BA. Volitional Weight-Lifting in Rats Promotes Adaptation via Performance and Muscle Morphology prior to Gains in Muscle Mass. ENVIRONMENTAL HEALTH INSIGHTS 2014; 8:1-9. [PMID: 25392697 PMCID: PMC4216651 DOI: 10.4137/ehi.s15257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 04/15/2014] [Accepted: 04/16/2014] [Indexed: 06/04/2023]
Abstract
Investigation of volitional animal models of resistance training has been instrumental in our understanding of adaptive training. However, these studies have lacked reactive force measurements, a precise performance measure, and morphological analysis at a distinct phase of training - when initial strength gains precede muscle hypertrophy. Our aim was to expose rats to one month of training (70 or 700 g load) on a custom-designed weight-lifting apparatus for analysis of reactive forces and muscle morphology prior to muscle hypertrophy. Exclusively following 700 g load training, forces increased by 21% whereas muscle masses remained unaltered. For soleus (SOL) and tibialis anterior (TA) muscles, 700 g load training increased muscle fiber number per unit area by ∼20% and decreased muscle fiber area by ∼20%. Additionally, number of muscle fibers per section increased by 18% for SOL muscles. These results establish that distinct morphological alterations accompany early strength gains in a volitional animal model of load-dependent adaptive resistance training.
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Affiliation(s)
- Erik P Rader
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - G Roger Miller
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Robert D Chetlin
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
- West Virginia University School of Medicine, Department of Neurology, WV, USA
| | - Oliver Wirth
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Brent A Baker
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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Peak vertical ground reaction force during two-leg landing: a systematic review and mathematical modeling. BIOMED RESEARCH INTERNATIONAL 2014; 2014:126860. [PMID: 25243113 PMCID: PMC4160626 DOI: 10.1155/2014/126860] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/19/2014] [Accepted: 08/05/2014] [Indexed: 11/17/2022]
Abstract
Objectives. (1) To systematically review peak vertical ground reaction force (PvGRF) during two-leg drop landing from specific drop height (DH), (2) to construct a mathematical model describing correlations between PvGRF and DH, and (3) to analyze the effects of some factors on the pooled PvGRF regardless of DH. Methods. A computerized bibliographical search was conducted to extract PvGRF data on a single foot when participants landed with both feet from various DHs. An innovative mathematical model was constructed to analyze effects of gender, landing type, shoes, ankle stabilizers, surface stiffness and sample frequency on PvGRF based on the pooled data. Results. Pooled PvGRF and DH data of 26 articles showed that the square root function fits their relationship well. An experimental validation was also done on the regression equation for the medicum frequency. The PvGRF was not significantly affected by surface stiffness, but was significantly higher in men than women, the platform than suspended landing, the barefoot than shod condition, and ankle stabilizer than control condition, and higher than lower frequencies. Conclusions. The PvGRF and root DH showed a linear relationship. The mathematical modeling method with systematic review is helpful to analyze the influence factors during landing movement without considering DH.
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20
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Váczi M, Nagy SA, Kőszegi T, Ambrus M, Bogner P, Perlaki G, Orsi G, Tóth K, Hortobágyi T. Mechanical, hormonal, and hypertrophic adaptations to 10 weeks of eccentric and stretch-shortening cycle exercise training in old males. Exp Gerontol 2014; 58:69-77. [PMID: 25064038 DOI: 10.1016/j.exger.2014.07.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 07/13/2014] [Accepted: 07/23/2014] [Indexed: 10/25/2022]
Abstract
The growth promoting effects of eccentric (ECC) contractions are well documented but it is unknown if the rate of stretch per se plays a role in such muscular responses in healthy aging human skeletal muscle. We tested the hypothesis that exercise training of the quadriceps muscle with low rate ECC and high rate ECC contractions in the form of stretch-shortening cycles (SSCs) but at equal total mechanical work would produce rate-specific adaptations in healthy old males age 60-70. Both training programs produced similar improvements in maximal voluntary isometric (6%) and ECC torque (23%) and stretch-shortening cycle function (reduced contraction duration [24%] and enhanced elastic energy storage [12%]) (p<0.05). The rate of torque development increased 30% only after SSC exercise (p<0.05). Resting testosterone and cortisol levels were unchanged but after each program the acute exercise-induced cortisol levels were 12-15% lower (p<0.05). Both programs increased quadriceps size 2.5% (p<0.05). It is concluded that both ECC and SSC exercise training produces favorable adaptations in healthy old males' quadriceps muscle. Although the rate of muscle tension during the SSC vs. ECC contractions was about 4-fold greater, the total mechanical work seems to regulate the hypetrophic, hormonal, and most of the mechanical adaptations. However, SSC exercise was uniquely effective in improving a key deficiency of aging muscle, i.e., its ability to produce force rapidly.
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Affiliation(s)
- Márk Váczi
- Institute of Sport Sciences and Physical Education, University of Pécs, Ifjúság útja 6., 7624 Pécs, Hungary.
| | - Szilvia A Nagy
- Diagnostic Center of Pécs, Rét utca 2., 7623 Pécs, Hungary.
| | - Tamás Kőszegi
- Institute of Laboratory Medicine, University of Pécs, Szigeti út 2., 7624 Pécs, Hungary.
| | - Míra Ambrus
- Institute of Sport Sciences and Physical Education, University of Pécs, Ifjúság útja 6., 7624 Pécs, Hungary.
| | - Péter Bogner
- Diagnostic Center of Pécs, Rét utca 2., 7623 Pécs, Hungary.
| | - Gábor Perlaki
- Diagnostic Center of Pécs, Rét utca 2., 7623 Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Rét utca 2., 7623 Pécs, Hungary.
| | - Gergely Orsi
- Diagnostic Center of Pécs, Rét utca 2., 7623 Pécs, Hungary; MTA-PTE Clinical Neuroscience MR Research Group, Rét utca 2., 7623 Pécs, Hungary.
| | - Katalin Tóth
- Department of Radiography, Faculty of Health Sciences, University of Pécs, 7400 Kaposvár, Hungary.
| | - Tibor Hortobágyi
- Center for Human Movement Sciences, University Medical Center Groningen, A. Deusinglaan 1, 9700 AD Groningen, The Netherlands; Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK.
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21
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Hsue BJ, Su FC. Effects of age and gender on dynamic stability during stair descent. Arch Phys Med Rehabil 2014; 95:1860-9. [PMID: 24835752 DOI: 10.1016/j.apmr.2014.05.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 04/21/2014] [Accepted: 05/01/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the effects of age and sex and their interaction effects on dynamic postural stability during stair descent. DESIGN Cross sectional. SETTING Laboratory. PARTICIPANTS Healthy younger adults (N=28) and healthy older adults (N=21). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Spatiotemporal gait parameters, displacement of center of mass (COM), instantaneous velocity of the COM, divergence between vertical projection of the COM, and center of pressure (COP). RESULTS Interaction effects of age and sex were found in stride duration, COM displacement, and instantaneous velocity of the COM in the mediolateral direction. Older adults demonstrated longer stride duration with shorter double-limb stance and longer single-limb stance during stair descent. Women have significantly longer stride duration than men. The effects of sex and age were significant in the data normalized by height. Older adults and women demonstrated larger peak-to-peak COM displacement, peak instantaneous velocity of the COM, and COM-COP divergence than the younger individuals and men, respectively. Peak instantaneous velocity of the COM was significant different in most pairwise comparisons, but the COM-COP divergence was significantly different in several comparisons. CONCLUSIONS This study examined the COM and COP parameters to quantify dynamic stability during stair descent across sex and age. Although older women descended stairs successfully, they demonstrated differences in control of instantaneous velocity of the COM compared with the other participants. Dynamic instability could be detected by examining the control of instantaneous velocity of the COM. In developing a better understanding of the balance control of stair descent in healthy older adults, aging patients with various pathologies can be better assessed, appropriately treated, and provided with proper assistive devices.
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Affiliation(s)
- Bih-Jen Hsue
- Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Fong-Chin Su
- Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
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22
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Iida Y, Kanehisa H, Inaba Y, Nakazawa K. Short-term landing training attenuates landing impact and improves jump height in landing-to-jump movement. J Strength Cond Res 2014; 27:1560-7. [PMID: 23698078 DOI: 10.1519/jsc.0b013e318271276e] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Landing technique is an important factor influencing jump performance in landing-to-jump (L-J) movement. This study examined the effects of short-term landing training on jump performance in L-J. We hypothesized that landing training without jumping decreases landing impact and increases jump height in L-J. Twenty healthy adult men were randomly assigned to the control (CG: n = 10) or the training (TG: n = 10) group. The TG performed a 2-week landing training (3 times per week, 6 sessions) that aims to decrease impact force. Before and after the training period, both groups performed landing and L-J from a 35-cm height and also squat jumps (SJs). Ground reaction forces and kinematic data were obtained during the landing, L-J, and SJ. The CG showed no significant changes in all measured variables. In the TG, the peak vertical ground reaction force up to 100 mseconds after ground contact in L-J, expressed relative to body mass, significantly decreased (pre: 3.04 [0.77] vs. post: 2.35 [0.37], p < 0.01), and the L-J height significantly increased (pre: 47.2 [5.6] cm vs. post: 48.2 [5.5] cm, p < 0.05) without gain in SJ height. Furthermore, the TG showed significant gains (p < 0.01) in hip joint power during the propulsive phase. The current results support our hypothesis and indicate that short-term landing training improves the technique for absorbing landing impact and increasing L-J height. The increased L-J height may be a result of an increase in power generation around the hip joint.
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Affiliation(s)
- Yoshiaki Iida
- Department of Life Sciences (Sports Sciences), University of Tokyo, Tokyo, Japan.
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23
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Nakamura K, Kodama T, Mukaino Y. Effects of active individual muscle stretching on muscle function. J Phys Ther Sci 2014; 26:341-4. [PMID: 24707080 PMCID: PMC3975999 DOI: 10.1589/jpts.26.341] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 09/22/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We investigated the effect of active individual muscle stretching (AID) on
muscle function. [Subjects] We used the right legs of 40 healthy male students. [Methods]
Subjects were divided into an AID group, which performed stretching, and a control group,
which did not. We examined and compared muscle function before and after stretching in the
AID and control groups using a goniometer and Cybex equipment. [Results] A significant
increase in flexibility and a significant decrease in muscle strength output were observed
in the AID group after the intervention. [Conclusion] These results suggest that AID
induces an increase in flexibility and a temporary decrease in muscle output strength.
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Affiliation(s)
- Kouichi Nakamura
- Department of Physical Therapy, Fukuoka Wajiro Rehabilitation College, Japan ; Faculty of Sports and Health Science, Fukuoka University, Japan
| | - Takayuki Kodama
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, Japan
| | - Yoshito Mukaino
- Faculty of Sports and Health Science, Fukuoka University, Japan
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Arai A, Ishikawa M, Ito A. Agonist–antagonist muscle activation during drop jumps. Eur J Sport Sci 2013; 13:490-8. [DOI: 10.1080/17461391.2013.764930] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Allison SJ, Folland JP, Rennie WJ, Summers GD, Brooke-Wavell K. High impact exercise increased femoral neck bone mineral density in older men: a randomised unilateral intervention. Bone 2013; 53:321-8. [PMID: 23291565 DOI: 10.1016/j.bone.2012.12.045] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 12/14/2012] [Accepted: 12/23/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION There is little evidence as to whether exercise can increase BMD in older men with no investigation of high impact exercise. Lifestyle changes and individual variability may confound exercise trials but can be minimised using a within-subject unilateral design (exercise leg [EL] vs. control leg [CL]) that has high statistical power. PURPOSE This study investigated the influence of a 12month high impact unilateral exercise intervention on femoral neck BMD in older men. METHODS Fifty, healthy, community-dwelling older men commenced a 12month high impact unilateral exercise intervention which increased to 50 multidirectional hops, 7days a week on one randomly allocated leg. BMD of both femurs was measured using dual energy X-ray absorptiometry (DXA) before and after 12months of exercise, by an observer blind to the leg allocation. Repeated measures ANOVA with post hoc tests was used to detect significant effects of time, leg and interaction. RESULTS Thirty-five men (mean±SD, age 69.9±4.0years) exercised for 12months and intervention adherence was 90.5±9.1% (304±31 sessions completed out of 336 prescribed sessions). Fourteen men did not complete the 12month exercise intervention due to: health problems or injuries unrelated to the intervention (n=9), time commitments (n=2), or discomfort during exercise (n=3), whilst BMD data were missing for one man. Femoral neck BMD, BMC and cross-sectional area all increased in the EL (+0.7, +0.9 and +1.2 % respectively) compared to the CL (-0.9, -0.4 and -1.2%); interaction effect P<0.05. Although the interaction term was not significant (P>0.05), there were significant main effects of time for section modulus (P=0.044) and minimum neck width (P=0.006). Section modulus increased significantly in the EL (P=0.016) but not in the CL (P=0.465); mean change +2.3% and +0.7% respectively, whereas minimum neck width increased significantly in the CL (P=0.004) but not in the EL (P=0.166); mean changes being +0.7% and +0.3% respectively. CONCLUSION A 12month high impact unilateral exercise intervention was feasible and effective for improving femoral neck BMD, BMC and geometry in older men. Carefully targeted high impact exercises may be suitable for incorporation into exercise interventions aimed at preventing fractures in healthy community-dwelling older men.
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Bassa EI, Patikas DA, Panagiotidou AI, Papadopoulou SD, Pylianidis TC, Kotzamanidis CM. The effect of dropping height on jumping performance in trained and untrained prepubertal boys and girls. J Strength Cond Res 2012; 26:2258-64. [PMID: 22027856 DOI: 10.1519/jsc.0b013e31823c4172] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Plyometric training in children, including different types of jumps, has become common practice during the last few years in different sports, although there is limited information about the adaptability of children with respect to different loads and the differences in performance between various jump types. The purpose of this study was to examine the effect of gender and training background on the optimal drop jump height of 9- to 11-year-old children. Sixty prepubertal (untrained and track and field athletes, boys and girls, equally distributed in each group [n = 15]), performed the following in random order: 3 squat jumps, 3 countermovement jumps (CMJs) and 3 drop jumps from heights of 10, 20, 30, 40, and 50 cm. The trial with the best performance in jump height of each test was used for further analysis. The jump type significantly affected the jump height. The jump height during the CMJ was the highest among all other jump types, resulting in advanced performance for both trained and untrained prepubertal boys and girls. However, increasing the dropping height did not change the jumping height or contact time during the drop jump. This possibly indicates an inability of prepubertal children to use their stored elastic energy to increase jumping height during drop jumps, irrespective of their gender or training status. This indicates that children, independent of gender and training status, have no performance gain during drop jumps from heights up to 50 cm, and therefore, it is recommended that only low drop jump heights be included in plyometric training to limit the probability of sustaining injuries.
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Affiliation(s)
- Eleni I Bassa
- Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
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27
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Neuromuscular function during drop jumps in young and elderly males. J Electromyogr Kinesiol 2012; 22:852-8. [DOI: 10.1016/j.jelekin.2012.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 05/15/2012] [Accepted: 05/16/2012] [Indexed: 11/19/2022] Open
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28
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Ball NB, Zanetti S. Relationship Between Reactive Strength Variables in Horizontal and Vertical Drop Jumps. J Strength Cond Res 2012; 26:1407-12. [DOI: 10.1519/jsc.0b013e3182510870] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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29
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Hoffrén M, Ishikawa M, Avela J, Komi PV. Age-related fascicle-tendon interaction in repetitive hopping. Eur J Appl Physiol 2012; 112:4035-43. [PMID: 22466309 DOI: 10.1007/s00421-012-2393-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 03/19/2012] [Indexed: 10/28/2022]
Abstract
Increasing age can influence the interaction of muscle fascicles and tendon during dynamic movements. The object of the present study was to examine occurrence and possible reasons for the age-specific behavior of fascicles and tendons and their interaction during hopping with different intensities. Nine young and 24 elderly subjects performed repetitive hopping with maximal effort as well as with 50, 65, 75 and 90 % intensities. During hopping joint kinematics and ground reaction, forces were measured together with recordings of ultrasound images of both the fascicle and the muscle-tendon junction part of the gastrocnemius medialis (GaM) muscle. The results showed that fascicle behavior during the braking phase of hopping was clearly age specific in nature with more fascicle shortening in the young (p < 0.001). In addition, the fascicle shortening increased in young subjects with increasing intensity (p < 0.05). At the instant of ground contact, the elderly subjects demonstrated decreased fascicle length with increasing hopping intensity (p < 0.01). Thereafter in the braking phase, the elderly showed much smaller changes in fascicle length as compared to the young. In contrast to the fascicles, the GaM outer tendon did not show major age-specific differences in stretching and shortening amplitudes during hopping although the peak tendon forces were clearly lower in the elderly (p < 0.001). These results suggest that GaM outer tendon behavior is not influenced greatly with increasing age. It is further suggested that when aging modifies the fascicle-tendon interaction, it is primarily due to the age-specific difference in the fascicle level. This notion poses a question that as compared to the young, the elderly individuals may have a different fascicle behavior for optimal SSC locomotion such as hopping.
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Affiliation(s)
- Merja Hoffrén
- Department of Biology of Physical Activity, Neuromuscular Research Center, University of Jyväskylä, Jyväskylä, Finland.
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Role of the coordinated activities of trunk and lower limb muscles during the landing-to-jump movement. Eur J Appl Physiol 2011; 112:2223-32. [DOI: 10.1007/s00421-011-2199-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Accepted: 09/29/2011] [Indexed: 10/16/2022]
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Iida Y, Kanehisa H, Inaba Y, Nakazawa K. Activity modulations of trunk and lower limb muscles during impact-absorbing landing. J Electromyogr Kinesiol 2011; 21:602-9. [PMID: 21549617 DOI: 10.1016/j.jelekin.2011.04.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 02/23/2011] [Accepted: 04/04/2011] [Indexed: 11/25/2022] Open
Abstract
This study aimed to investigate the activity patterns of trunk and lower limb muscles during impact-absorbing landing. Electromyogram activities of the trunk and lower limb muscles along with kinematic and ground reaction forces were measured while subjects (n=17) performed 10 landings from a height of 35 cm. Landing motions were divided into three phases: 100 ms preceding ground contact (GC) (PRE phase), from GC through 100 ms (ABSORPTION phase), and from the end of the ABSORPTION phase until the vertical position of the center of mass was minimized (BRAKING phase). During the PRE phase, the rectus abdominis, external oblique, and medial gastrocnemius were highly activated. Upon GC, the hip and knee joints were in a flexed position; the ankle joints, in a plantarflexed position. After GC, peak timings of muscle activities and lower limb joint rotations were characterized by distal-to-proximal sequential patterns. The peak vertical ground reaction force in the ABSORPTION phase relative to body weight positively correlated with the activity levels of the vastus lateralis and gluteus maximus in the PRE phase and that of rectus abdominis in the ABSORPTION phase. These findings indicate that the intensities and peak timings of muscle activities in the trunk and lower limb are coordinated to absorb landing impact.
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Affiliation(s)
- Yoshiaki Iida
- Department of Life Sciences (Sports Sciences), University of Tokyo, 3-8-1 Komaba, Meguro, Tokyo 153-8902, Japan.
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Hoffrén M, Ishikawa M, Rantalainen T, Avela J, Komi PV. Age-related muscle activation profiles and joint stiffness regulation in repetitive hopping. J Electromyogr Kinesiol 2011; 21:483-91. [PMID: 21458294 DOI: 10.1016/j.jelekin.2011.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 12/22/2010] [Accepted: 01/15/2011] [Indexed: 11/25/2022] Open
Abstract
It is well documented that increasing effort during exercise is characterized by an increase in electromyographic activity of the relevant muscles. How aging influences this relationship is a matter of great interest. In the present study, nine young and 24 elderly subjects did repetitive hopping with maximal effort as well as with 50%, 65%, 75% and 90% intensities. During hopping joint kinematics were measured together with electromyographic activity (EMG) from the soleus, gastrocnemius medialis, gastrocnemius lateralis and tibialis anterior muscles. The results showed that agonist activation increased in both age groups with increasing intensity. The highest jumping efficiency (EMG ratio of the braking phase to the push off-phase activation) was achieved with moderate hopping intensities (65-75%) in both the young and in the elderly. Age-comparison showed that elderly subjects had high agonist preactivation but thereafter lower activation during the braking phase. Antagonist coactivation was minimal and did not show age- or intensity-specificity. The elderly had more flexed knees at the instant of ground contact. When intensity increased, the elderly also plantarflexed their ankles more before ground contact. Ankle joint stiffness was lower in elderly subjects only in high hopping intensities (90% and Max). These results confirm that age-specific agonist muscle activation profiles exist during hopping even when exercise intensities are matched on the relative scale. The results suggest further that the elderly can adjust their reduced neuromuscular capacity to match the demands set by different exercise intensities.
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Affiliation(s)
- Merja Hoffrén
- Neuromuscular Research Center, Department of Biology of Physical Activity, University of Jyväskylä, Finland.
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Taube W, Leukel C, Lauber B, Gollhofer A. The drop height determines neuromuscular adaptations and changes in jump performance in stretch-shortening cycle training. Scand J Med Sci Sports 2011; 22:671-83. [PMID: 21457355 DOI: 10.1111/j.1600-0838.2011.01293.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- W Taube
- Department of Medicine, Unit of Sport Science, University of Fribourg, Fribourg, Switzerland.
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Ball NB, Stock CG, Scurr JC. Bilateral contact ground reaction forces and contact times during plyometric drop jumping. J Strength Cond Res 2011; 24:2762-9. [PMID: 20613651 DOI: 10.1519/jsc.0b013e3181cc2408] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Drop jumping (DJ) is used in training programs aimed to improve lower extremity explosive power. When performing double-leg drop jumps, it is important to provide an equal stimulus to both legs to ensure balanced development of the lower legs. The aim of this study was to bilaterally analyze the ground reactions forces and temporal components of drop jumping from 3 heights. Ten recreationally active male subjects completed 3 bounce-drop jumps from 3 starting heights (0.2, 0.4, and 0.6 m). Two linked force platforms were used to record left- and right-leg peak vertical force, time to peak force, average force, ground contact time, impulse and time differential. Between-height and between-leg comparisons for each variable were made using a multivariate analysis of variance with post hoc Wilcoxon tests (p < 0.05). Results indicated that force and time variables increased as drop jump height increased (p < 0.0001). Post hoc analyses showed that at 0.2- and 0.4-m bilateral differences were present in the time to peak force, average force, and impulse. No bilateral differences for any variables were shown at 0.6-m starting height. The contact time for all jumps was <0.26 seconds. At 0.2 m, only 63% of the subjects had a starting time differential of <0.01 seconds, rising to 96.3% at 0.6 m. The results indicated that 0.6 m is the suggested drop jump height to ensure that no bilateral differences in vertical forces and temporal components occur; however, shorter contact times were found at the lower heights.
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Affiliation(s)
- Nick B Ball
- National Institute of Sports Studies, University of Canberra, Bruce, Australia.
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Tsimahidis K, Galazoulas C, Skoufas D, Papaiakovou G, Bassa E, Patikas D, Kotzamanidis C. The effect of sprinting after each set of heavy resistance training on the running speed and jumping performance of young basketball players. J Strength Cond Res 2010; 24:2102-8. [PMID: 20613645 DOI: 10.1519/jsc.0b013e3181e2e1ed] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The purpose of this study was to investigate the effect of a 10-week heavy resistance combined with a running training program on the strength, running speed (RS), and vertical jump performance of young basketball players. Twenty-six junior basketball players were equally divided in 2 groups. The control (CON) group performed only technical preparation and the group that followed the combined training program (CTP) performed additionally 5 sets of 8-5 repetition maximum (RM) half squat with 1 30-m sprint after each set. The evaluation took place before training and after the 5th and 10th weeks of training. Apart from the 1RM half squat test, the 10- and 30-m running time was measured using photocells and the jump height (squat, countermovement jump, and drop jump) was estimated taking into account the flight time. The 1RM increased by 30.3 +/- 1.5% at the 10th week of training for the CTP group (p < 0.05), whereas the CON group showed no significant increase (1.1 +/- 1.6%, p > 0.05). In general, all measured parameters showed a statistically significant increase after the 5th and 10th weeks (p < 0.05), in contrast to the CON group (p > 0.05). This suggests that the applied CTP is beneficial for the strength, RS, and jump height of young basketball players. The observed adaptations in the CTP group could be attributed to learning factors and to a more optimal transfer of the strength gain to running and jumping performance.
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Affiliation(s)
- Konstantinos Tsimahidis
- Laboratory of Coaching and Sport Performance, Department of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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Cronin NJ, af Klint R, Grey MJ, Sinkjaer T. Ultrasonography as a tool to study afferent feedback from the muscle-tendon complex during human walking. J Electromyogr Kinesiol 2010; 21:197-207. [PMID: 20833562 DOI: 10.1016/j.jelekin.2010.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 08/06/2010] [Accepted: 08/06/2010] [Indexed: 10/19/2022] Open
Abstract
In humans, one of the most common tasks in everyday life is walking, and sensory afferent feedback from peripheral receptors, particularly the muscle spindles and Golgi tendon organs (GTO), makes an important contribution to the motor control of this task. One factor that can complicate the ability of these receptors to act as length, velocity and force transducers is the complex pattern of interaction between muscle and tendinous tissues, as tendon length is often considerably greater than muscle fibre length in the human lower limb. In essence, changes in muscle-tendon mechanics can influence the firing behaviour of afferent receptors, which may in turn affect the motor control. In this review we first summarise research that has incorporated the use of ultrasound-based techniques to study muscle-tendon interaction, predominantly during walking. We then review recent research that has combined this method with an examination of muscle activation to give a broader insight to neuromuscular interaction during walking. Despite the advances in understanding that these techniques have brought, there is clearly still a need for more direct methods to study both neural and mechanical parameters during human walking in order to unravel the vast complexity of this seemingly simple task.
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Affiliation(s)
- Neil J Cronin
- School of Physiotherapy and Exercise Science, Griffith University, Queensland, Australia
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Lazaridis S, Bassa E, Patikas D, Giakas G, Gollhofer A, Kotzamanidis C. Neuromuscular differences between prepubescents boys and adult men during drop jump. Eur J Appl Physiol 2010; 110:67-74. [PMID: 20397025 DOI: 10.1007/s00421-010-1452-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2010] [Indexed: 12/12/2022]
Abstract
The purpose of the present study was to determine the lower extremities biomechanical differences between prepubescent and adult males during drop jumps (DJs). Twenty-four untrained males (12 prepubescents, 12 adults) performed DJs from 20 cm height. Kinematics of the lower extremities were captured, in addition with vertical ground reaction forces (vGRFs) and EMG activity of the gastrocnemius medialis (GM), soleus (SOL) and tibialis anterior (TA) muscles. The results showed that men jumped higher, as expected, but their knees were more flexed prior to landing, and their preactivation level was higher and longer in duration compared to prepubescent boys. During landing, men had shorter contact times, lower vGRF normalized to body mass, and less maximal knee joint flexion. Regarding EMG activity men presented higher stretch reflex and higher EMG activity during the braking phase but the level of coactivation (TA to GM + SOL ratio) was lower. It is seems that pre-landing and landing patterns during a complex task such as DJ are affected by physical development. There are indications that men had higher performance in a DJ than prepubescent boys because they activated more effectively their muscles during the preactivation and braking phase. The above-mentioned data support the hypothesis that prepubescent boys might be inferior in optimal regulation of their muscle-tendon unit stiffness.
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Affiliation(s)
- Savvas Lazaridis
- Laboratory of Coaching and Sport Performance, Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54006 Thessaloníki, Greece
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Boyer KA, Beaupre GS, Andriacchi TP. Gender differences exist in the hip joint moments of healthy older walkers. J Biomech 2008; 41:3360-5. [PMID: 19022448 DOI: 10.1016/j.jbiomech.2008.09.030] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 09/18/2008] [Accepted: 09/23/2008] [Indexed: 11/18/2022]
Abstract
Gender differences in the incidence of symptomatic hip osteoarthritis (OA), changes in hip cartilage volume and hip joint space and rates hip arthroplasty of older people are reported in the literature. As the rate of progression of OA is in part mechanically modulated it is possible that this gender bias may be related to inherent differences (if they exist) in walking mechanics between older males and females. The purpose of this study was to examine potential mechanisms for gender differences in hip joint mechanics during walking by testing the hypotheses that females would exhibit higher hip flexion, adduction and internal rotation moments but not significantly greater normalized ground reaction forces (GRFs). Forty-two healthy subjects (21 male, 21 female), ages 50-79yr were recruited for gait analysis. In support of the hypotheses, greater external hip adduction and internal rotation along with hip extension moments were found for females compared to males after normalizing for body size for all self-selected walking speeds. Differences in walking style (kinematics) were the main determinants in the joint kinetic differences as no differences in the normalized GRFs were found. As external joint moments are surrogate measures of the joint contact forces, the results of this study suggest the hip joint stress for the female population is higher compared to male population. This is in favor of a hypothesis that the increased joint contact stress in a female population could contribute to a greater joint degeneration at the hip in females as compared with males.
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Affiliation(s)
- Katherine A Boyer
- VA Palo Alto Health Care System, Bone and Joint Rehabilitation R&D Center of Excellence, Palo Alto, CA 94304, USA.
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