Effect of calf-raise training on rapid force production and balance ability in elderly men

Therapeutic Quality Affects Physical Fitness Benefits of Home Exercise Interventions in Older Adults: A Systematic Review, Meta-Analysis, and Meta-Regression

BACKGROUND AND PURPOSE

The international Consensus on Therapeutic Exercise aNd Training (i-CONTENT) tool is a new instrument developed to evaluate the therapeutic quality of exercise interventions. Home-based exercise has been shown to improve physical fitness in older adults, but its effects may be influenced by therapeutic quality. The purpose of this systematic review was to describe the therapeutic quality of home-based exercise interventions for community-dwelling older adults and examine the relationship between therapeutic quality and changes in physical fitness.

METHODS

Six electronic databases and 2 clinical trial registries were searched for randomized controlled trials investigating the effects of home-based exercise on physical fitness in community-dwelling older adults (≥60 years). Therapeutic quality was evaluated using the i-CONTENT tool for items of patient selection, type of exercise, safety, type/timing of outcomes, exercise dose, and adherence. International Consensus on Therapeutic Exercise aNd Training items were used to explain heterogeneity in meta-regression analyses. Risk of bias, certainty of evidence and credibility of analyses were assessed.

RESULTS

Thirty-six trials (n = 6157 participants) were identified. Most studies (≥66.7%) had high or probably high therapeutic quality for i-CONTENT items, except exercise dose (47.2%) and adherence (16.7%). Interventions improved upper- (N = 20 trials; standardized mean difference [SMD] = 0.39; 95% CI, 0.13-0.64; low certainty of evidence) and lower-body strength (N = 28; SMD = 0.42; 95% CI, 0.08-0.77; very low certainty), and aerobic fitness (N = 8; SMD = 0.42; 95% CI, 0.08-0.77; very low certainty). For exercise dose, low- or probably low-quality studies negatively influenced effects on upper- (estimated β = -.48; P = .049; moderate credibility) and lower-body strength (estimated β = -.77; P = .048; moderate credibility). For adherence, low- or probably low-quality studies negatively influenced effects on aerobic fitness (estimated β = -.97; P = .02; low credibility).

CONCLUSIONS

Home-based exercise may improve upper- and lower-body strength, as well as aerobic fitness in older adults. However, the effectiveness of interventions is affected by inadequate dosing of exercise programs and adherence issues. Physical therapists should have the best available evidence to support their clinical decision making, especially when designing and monitoring home programs.

A Comprehensive Review on Managing Fracture Calcaneum by Surgical and Non-surgical Modalities

This comprehensive review delves into the multifaceted landscape of calcaneal fractures, thoroughly examining their aetiology, clinical presentation, and diverse management strategies. Encompassing surgical and non-surgical approaches, the review scrutinises critical aspects such as patient compliance, rehabilitation protocols, and long-term follow-up considerations. Surgical modalities, propelled by recent innovations like minimally invasive techniques and advanced fixation materials, are juxtaposed with non-surgical interventions, emphasising the pivotal role of patient education and adherence to optimise outcomes. The synthesis of critical findings underscores the need for individualised care and multidisciplinary collaboration in clinical practice. Moreover, the review outlines recommendations for healthcare practitioners and identifies promising areas for future research, including biomechanical studies and telerehabilitation. This comprehensive exploration aims to contribute to the ongoing evolution of calcaneal fracture management, ultimately enhancing patient care and outcomes in this complex orthopaedic realm.

Maximal fascicle shortening velocity measurements in human medial gastrocnemius muscle in vivo

This study evaluated the maximal fascicle shortening velocity under near-no-load conditions. In addition, we determined whether the rate of torque development during ballistic contraction was related to maximal fascicle shortening velocity. Under passive and active conditions, the medial gastrocnemius muscle fascicle shortening velocity was measured using ultrasonography at 300, 400, 500, 600, 700, 800, 900, and 1000 ° s-1 . The maximal fascicle shortening velocity was defined as the fascicle shortening velocity under the lowest angular velocity that satisfied the following two conditions; (1) the difference in torque values between passive and active conditions was below 2.4 Nm and (2) the difference in fascicle shortening velocities between passive and active conditions was below 10 mm s-1 . The rate of torque development was analyzed during the periods of 32, 48, 96, 152, and 200 ms after the onset of contraction during ballistic contraction. At the angular velocity (678.6 ± 147.7 ° s-1 ) that satisfied the two previously mentioned conditions, the exerted torque and the maximal fascicle shortening velocity were 1.4 ± 1.3 Nm and 251.0 ± 40.5 mm s-1 . No significant correlations were found between the maximal fascicle shortening velocity and the rate of torque development at each time point. In conclusion, the maximal fascicle shortening velocity was quantified when the angular velocity satisfied the two conditions. Furthermore, the rate of torque development, often used as an indicator of muscle velocity, did not represent the maximal fascicle shortening velocity.

Can phase angle from bioelectrical impedance analysis associate with neuromuscular properties of the knee extensors?

Maintenance and improvement of neuromuscular functions is crucial for everyone regardless of age. An easy way to assess neuromuscular properties without muscle contraction is useful especially for those who cannot perform strenuous muscular force production, such as older adults and patients with orthopedic or cognitive disorders. Bioelectrical impedance analysis (BIA) can assess body electrical properties e.g., phase angle (PhA) which is regarded as muscle quantity/quality index. The purpose of this study was to investigate associations of PhA with neuromuscular properties of the knee extensors in 55 young (n = 23) and older (n = 32) adults. The values of PhA of the right thigh and whole-body were determined with BIA at 50 kHz. The participants performed 4-s maximal voluntary isometric contraction (MVIC) to measure peak torque (PT_MVIC), and 1-s brief MVIC to assess rate of torque development (RTD) over the time interval of 0–200 ms. As markers of physiological mechanisms of muscle force production, twitch contractile properties (peak twitch torque, rate of twitch torque development, and time-to-peak twitch torque) of the knee extensors obtained by femoral nerve electrical stimulation, and muscle activity assessed as root mean square values of electromyographic activity (EMG-RMS) during PT_MVIC and RTD measurements were measured. Thigh and whole-body PhA significantly correlated with PT_MVIC (r ≥ 0.555, p < 0.001) and electrically evoked twitch parameters (peak twitch torque, rate of twitch torque development, and time-to-peak twitch torque; |r| ≥ 0.420, p ≤ 0.001), but not RTD (r ≤ 0.237, p ≥ 0.081) or EMG-RMSs (|r| ≤ 0.214, p ≥ 0.117). Stepwise multiple linear regression analysis revealed that thigh PhA was selected as a significant variable to predict PT_MVIC but not RTD. Whole-body PhA was not selected as a significant variable to predict PT_MVIC or RTD. In conclusion, both thigh and whole-body PhA can associate with maximal voluntary muscle strength of the knee extensors, and this association may be due to intrinsic contractile properties but not neural aspects. Regarding prediction of the knee extensor strength, thigh PhA is preferable as the predictor rather than whole-body PhA which is used as a widely acknowledged indicator of sarcopenia.

Ballistic strength training in adults with cerebral palsy may increase rate of force development in plantar flexors, but transition to walking remains unclear: a case series

Background

Persons with cerebral palsy (CP) walk with reduced ankle plantar flexor power compared to typically developing. In this study, we investigated whether a ballistic strength-training programme targeting ankle plantar flexors could improve muscle strength, muscle architecture and walking function in adults with CP.

Methods

Eight adults (mildly affected CP) underwent eight weeks of ballistic strength training, with two sessions per week. Before and after the intervention preferred walking speed, ankle plantar flexion rate of force development (RFD), maximal voluntary contraction (MVC), muscle thickness, pennation angle and fascicle length were measured. Data are presented for individuals, as well as for groups. Group changes were analysed using the Wilcoxon signed-rank test.

Results

Data were analysed for eight participants (five women, mean age 37.9 years; six GMFCS I and two GMFCS II). Two participants increased their walking speed, but there were no significant group changes. In terms of muscle strength, there were significant group changes for RFD at 100 ms and MVC. In the case of muscle architecture, there were no group changes.

Conclusion

In this study, we found that eight weeks of ballistic strength training improved ankle plantar flexor muscle strength but walking function and muscle architecture were unchanged. Larger studies will be needed to obtain conclusive evidence of the efficacy of this training method.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00487-1.

Association of age-related decrease in intracellular-to-total water ratio with that in explosive strength of the plantar flexors: a cross-sectional study

Background

We aimed to investigate the association of age-related differences in the intracellular-to-total water ratio with explosive strength of the plantar flexors.

Methods

A total of 60 young (21–33 years) and older (64–83 years) individuals were recruited. Intracellular- (ICW) and total-water (TW) content within the right leg was evaluated by bioelectrical impedance spectroscopy as indicators of muscle cell mass and whole muscle mass within the segment, respectively. ICW divided by TW (ICW/TW) was calculated as an index of the occupancy of muscle cells within whole muscle. Rate of torque development (RTD) and electromyography (EMG) activity during maximal voluntary isometric plantar flexion were measured as indicators of explosive muscle strength and neuromuscular activity, respectively. RTD was calculated from three time windows of 0–50, 50–100, and 100–200 ms. Time-to-peak torque (TPT) was assessed from evoked twitch contraction.

Results

Compared with young participants, older participants showed lower ICW/TW (−7%, P < 0.001), RTD (−25 to −40%, P = 0.003 to 0.001), and longer TPT (+11%, P < 0.001). ICW/TW associated positively with RTD (r = 0.377 to 0.408, P = 0.004 to 0.001) and negatively with TPT (r = −0.392, P = 0.002), but not with EMG activity. RTD was associated positively with EMG for each time window (r = 0.527 to 0.607, P < 0.001).

Conclusions

These results indicate that ICW/TW may be a useful predictor of the age-related decrease in RTD, and that the decrease in ICW/TW with age may reflect age-associated changes in intrinsic contractile properties.

Power attenuation from restricting range of motion is minimized in subjects with fast RTD and following isometric training

Time-dependent measures consisting of rate of torque development (RTD), rate of velocity development (RVD), and rate of neuromuscular activation can be used to evaluate explosive muscular performance, which becomes critical when performing movements throughout limited ranges of motion (ROM). Using a HUMAC NORM dynamometer, seven males (27 ± 7 years) and six females (22 ± 3 years) underwent 8 weeks of maximal isometric dorsiflexion training 3 days/week. One leg was trained at 0° (short-muscle tendon unit (MTU) length) and the other at 40° of plantar flexion (long-MTU length). RTD and rate of neuromuscular activation were evaluated during 'fast' maximal isometric contractions. Power, RVD, and rate of neuromuscular activation were assessed during maximal isotonic contractions in four conditions (small (40° to 30° of plantar flexion) ROM at 10 and 50% MVC; large (40° to 0° of plantar flexion) ROM at 10 and 50% MVC) for both legs, pre- and post-training. Despite no change in rate of neuromuscular activation following training, peak power, RTD, and RVD increased at both MTU lengths (p < 0.05). Strong relationships (R²=0.73) were observed between RTD and peak power in the small ROM, indicating that fast time-dependent measures are critical for optimal performance when ROM is constrained. Meanwhile, strong relationships (R²=0.90) between RVD and power were observed at the 50% load, indicating that RVD is critical when limited by load and ROM is not confined. Maximal isometric dorsiflexion training can be used to improve time-dependent measures (RTD, RVD) to minimize power attenuation when ROM is restricted.

Muscle Damage Indicated by Maximal Voluntary Contraction Strength Changes From Immediately to 1 Day After Eccentric Exercise of the Knee Extensors

The present study examined if the magnitude of changes in indirect muscle damage markers could be predicted by maximal voluntary isometric contraction (MVIC) torque changes from immediately to 1 day after eccentric exercise. Twenty-eight young men performed 100 maximal isokinetic (60°/s) eccentric contractions of the knee extensors. MVIC torque, potentiated doublet torque, voluntary activation (VA) during MVIC, shear modulus of rectus femoris (RF), vastus medialis and lateralis, and muscle soreness of these muscles were measured before, immediately after, and 1–3 days post-exercise. Based on the recovery rate of the MVIC torque from immediately to 1-day post-exercise, the participants were placed to a recovery group that showed an increase in the MVIC torque (11.3–79.9%, n = 15) or a no-recovery group that showed no recovery (−71.9 to 0%, n = 13). No significant difference in MVIC torque decrease immediately post-exercise was found between the recovery (−33 ± 12%) and no-recovery (−32 ± 9%) groups. At 1–3 days, changes in MVIC torque (−40 to −26% vs. −22 to −12%), potentiated doublet torque (−37 to −22% vs. −20 to −9%), and proximal RF shear modulus (29–34% vs. 8–15%) were greater (p < 0.05) for the no-recovery than recovery group. No significant group differences were found for muscle soreness. The recovery rate of MVIC torque was correlated (p < 0.05) with the change in MVIC torque from baseline to 2 (r = 0.624) or 3 days post-exercise (r = 0.526), or peak change in potentiated doublet torque at 1–3 days post-exercise from baseline (r = 0.691), but not correlated with the changes in other dependent variables. These results suggest that the recovery rate of MVIC torque predicts changes in neuromuscular function but not muscle soreness and stiffness following eccentric exercise of the knee extensors.

Relationship Between Drop Jump Training–Induced Changes in Passive Plantar Flexor Stiffness and Explosive Performance

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.

Home-based exercise programmes improve physical fitness of healthy older adults: A PRISMA-compliant systematic review and meta-analysis with relevance for COVID-19

This systematic review and meta-analysis aimed to examine the effects of home-based exercise programmes on measures of physical-fitness in healthy older adults. Seventeen randomized-controlled trials were included with a total of 1,477 participants. Results indicated small effects of home-based training on muscle strength (between-study standardised-mean-difference [SMD] = 0.30), muscle power (SMD = 0.43), muscular endurance (SMD = 0.28), and balance (SMD = 0.28). We found no statistically significant effects for single-mode strength vs. multimodal training (e.g., combined balance, strength, and flexibility exercises) on measures of muscle strength and balance. Single-mode strength training had moderate effects on muscle strength (SMD = 0.51) and balance (SMD = 0.65) while multimodal training had no statistically significant effects on muscle strength and balance. Irrespective of the training type, >3 weekly sessions produced larger effects on muscle strength (SMD = 0.45) and balance (SMD = 0.37) compared with ≤3 weekly sessions (muscle strength: SMD = 0.28; balance: SMD = 0.24). For session-duration, only ≤30 min per-session produced small effects on muscle strength (SMD = 0.35) and balance (SMD = 0.34). No statistically significant differences were observed between all independently-computed single-training factors. Home-based exercise appears effective to improve components of health- (i.e., muscle strength and muscular endurance) and skill-related (i.e., muscle power, balance) physical-fitness. Therefore, in times of restricted physical activity due to pandemics, home-based exercises constitute an alternative to counteract physical inactivity and preserve/improve the health and fitness of healthy older adults aged 65-to-83 years.

Relationship between resting medial gastrocnemius stiffness and drop jump performance

Although the influence of the series elastic element of the muscle-tendon unit on jump performance has been investigated, the corresponding effect of the parallel elastic element remains unclear. This study examined the relationship between the resting calf muscle stiffness and drop jump performance. Twenty-four healthy men participated in this study. The shear moduli of the medial gastrocnemius and the soleus were measured at rest as an index of muscle stiffness using ultrasound shear wave elastography. The participants performed drop jumps from a 15 cm high box. The Spearman rank correlation coefficient was used to examine the relationships between shear moduli of the muscles and drop jump performance. The medial gastrocnemius shear modulus showed a significant correlation with the drop jump index (jump height/contact time) (r = 0.414, P = 0.044) and jump height (r = 0.411, P = 0.046), but not with contact time (P > 0.05). The soleus shear modulus did not correlate with these jump parameters (P > 0.05). These results suggest that the resting medial gastrocnemius stiffness can be considered as one of the factors that influence drop jump performance. Therefore, increase in resting muscle stiffness should enhance explosive athletic performance in training regimens.

The Associations between Rapid Strength Development and Muscle Stiffness in Older Population

BACKGROUND

Previous studies suggest that the capacity for rapid force production of ankle plantar flexors is essential for the prevention of falls in the elderly. In healthy young adults, there were significant associations between rate of force development and muscle stiffness measured by shear wave elastography. However, there has been no study investigating the association of rate of force development with shear elastic modulus in older adults.

METHODS

The muscle strength and shear elastic modulus of the medial gastrocnemius muscle in both legs were measured in 17 elderly men and 10 elderly women (mean ± SD; 70.7 ± 4.1 years; 160.6 ± 8.0 cm; 58.7 ± 9.5 kg). We investigated the rate of force development of plantar flexors and shear elastic modulus of medial gastrocnemius muscle using by shear wave elastography.

RESULTS

Our results showed that there were no significant associations between normalized rate of force development and shear elastic modulus of medial gastrocnemius muscle.

CONCLUSION

This suggests that the capacity of rapid force production could be related not to muscle stiffness of the medial gastrocnemius muscle, but to neuromuscular function in older individuals.

Effects of Combined Balance and Strength Training on Measures of Balance and Muscle Strength in Older Women With a History of Falls

OBJECTIVE

We investigated the effects of combined balance and strength training on measures of balance and muscle strength in older women with a history of falls.

METHODS

Twenty-seven older women aged 70.4 ± 4.1 years (age range: 65 to 75 years) were randomly allocated to either an intervention (IG, n = 12) or an active control (CG, n = 15) group. The IG completed 8 weeks combined balance and strength training program with three sessions per week including visual biofeedback using force plates. The CG received physical therapy and gait training at a rehabilitation center. Training volumes were similar between the groups. Pre and post training, tests were applied for the assessment of muscle strength (weight-bearing squat [WBS] by measuring the percentage of body mass borne by each leg at different knee flexions [0°, 30°, 60°, and 90°], sit-to-stand test [STS]), and balance. Balance tests used the modified clinical test of sensory interaction (mCTSIB) with eyes closed (EC) and opened (EO), on stable (firm) and unstable (foam) surfaces as well as spatial parameters of gait such as step width and length (cm) and walking speed (cm/s).

RESULTS

Significant group × time interactions were found for different degrees of knee flexion during WBS (0.0001 < p < 0.013, 0.441 < d < 0.762). Post hoc tests revealed significant pre-to-post improvements for both legs and for all degrees of flexion (0.0001 < p < 0.002, 0.697 < d < 1.875) for IG compared to CG. Significant group × time interactions were found for firm EO, foam EO, firm EC, and foam EC (0.006 < p < 0.029; 0.302 < d < 0.518). Post hoc tests showed significant pre-to-post improvements for both legs and for all degrees of oscillations (0.0001 < p < 0.004, 0.753 < d < 2.097) for IG compared to CG. This study indicates that combined balance and strength training improved percentage distribution of body weight between legs at different conditions of knee flexion (0°, 30°, 60°, and 90°) and also decreased the sway oscillation on a firm surface with eyes closed, and on foam surface (with eyes opened or closed) in the IG.

CONCLUSION

The higher positive effects of training seen in standing balance tests, compared with dynamic tests, suggests that balance training exercises including lateral, forward, and backward exercises improved static balance to a greater extent in older women.

Plantar flexor strength at different knee positions in older and young males and females

INTRODUCTION

This study examined the effects of age and knee position (fully extended, K0; 90° flexed, K90) on plantar flexor maximal voluntary contraction (MVC) torque and the rate of torque development (RTD) in both sexes.

METHODS

The following parameters were measured in 32 older (66-81 yr, 17 males and 15 females) and 37 young (20-30 yr, 18 males and 19 females) adults: evoked peak twitch torque, time to peak twitch torque, RTD of the twitch torque, MVC torque, RTD at early (0-50 ms, RTD_0-50) and later (100-200 ms, RTD_100-200) time intervals during explosive contractions, voluntary activation (VA%) during MVC, root mean square of the electromyogram (RMS-EMG) during MVC and explosive contractions, thickness of the triceps surae, and pennation angle of the medial gastrocnemius. The magnitudes of the differences were interpreted based on Cohen's d (d).

RESULTS

Age-related difference in RTD_0-50 was greater for females (d = 1.36) than males (d = 1.03) and vice versa for MVC torque and RTD_100-200. For young adults, MVC torque, RTDs, and RMS-EMGs of the gastrocnemius but not the soleus were significantly higher in K0 than in K90. For older adults, no differences in voluntary RTDs were observed between K0 and K90, and RMS-EMGs of the gastrocnemius were higher in K90 than in K0, except for that of the lateral gastrocnemius in the early time intervals during explosive contraction. The age-related difference in the effect of knee position for RTD_0-50 was higher in females than males, and vice versa for MVC torque and RTD_100-200.

CONCLUSION

The results suggested that the effects of age and knee joint angle on the plantar flexor performance were more prominent in the early phase of force production for females and were more apparent in the later phase and maximal force for males.

Age-Related Differences in the Effect of Prolonged Vibration on Maximal and Rapid Force Production and Balance Ability

We tested the hypothesis that older adults would not likely experience deficits in maximal and explosive plantar flexion strength and standing balance performance induced by prolonged Achilles tendon vibration compared with young adults. Fifteen older men (OM, 73 ± 5 years) and 15 young men (YM, 24 ± 4 years) participated in two interventions on different days: lying in a quiet supine position for 30 min with or without prolonged vibration to the Achilles tendon. Before and after the interventions, maximal voluntary contraction (MVC) torque during plantar flexion, rate of torque development (RTD), and center of pressure (COP) speed during single-leg standing were measured. The root mean square of the electromyogram (RMS-EMG) during performance and V-wave and voluntary activation during MVC were assessed. The MVC torque (7 ± 7%) and RTD (16 ± 15%) of YM but not OM significantly decreased after vibration. In addition, the relative changes observed in YM positively correlated with changes in RMS-EMG of the medial gastrocnemius (MG) (MVC torque and RTD) and in MG V-wave and voluntary activation (MVC torque). COP speed significantly increased (16 ± 20%) in YM only after vibration and was accompanied by increased activation of the lateral gastrocnemius. This is the first study to show that the effects of prolonged Achilles tendon vibration on strength and balance performances were apparent in young adults only. The differences between the age groups may be related to the attenuated gastrocnemius neuromuscular function in older adults.

Comparison between eccentric and concentric resistance exercise training without equipment for changes in muscle strength and functional fitness of older adults

PURPOSE

The present study tested the hypothesis that resistance exercise training focusing on eccentric muscle contractions would improve muscle strength and functional physical fitness more than concentric contraction-focused resistance training in older adults.

METHODS

Healthy older adults (65-84 years) were placed into eccentric (ECC; n = 9) or concentric training group (CON; n = 8). They performed 4-6 basic manual resistance exercises focusing on either eccentric or concentric muscle contractions once at a community centre and at least twice at home a week for 8 weeks. Muscle thickness of the quadriceps femoris (MT), knee extensor maximal voluntary isometric contraction strength (MVC), 30-second chair stand (CS), 3-metre timed up and go (TUG), 2-minute step (2MS), sit and reach (SR), and static balance with eyes open and closed (Bal-EC) were assessed before and 7 days after the last community centre session.

RESULTS

Changes in MT (ECC: 21.6 ± 9.2% vs CON: 6.7 ± 7.1%), MVC (38.3 ± 22.6% vs 8.2 ± 8.4%), CS (51.0 ± 21.7% vs 34.6 ± 28.3%), TUG (16.7 ± 9.9% vs 6.3 ± 7.7%), 2MS (9.9 ± 6.0% vs 6.0 ± 7.3%) and Bal-EC (35.1 ± 6.7% vs 8.8 ± 16.2%) from baseline were greater (P < 0.05) for the ECC than the CON group.

CONCLUSION

These results show that the eccentric manual resistance exercise training was more effective for improving lower limb strength, mobility, and postural stability of older adults when compared with the concentric training. This suggests the significance of emphasising eccentric muscle contractions in movements to maintain and improve physical function.