Scientific Basis for Eccentric Quasi-Isometric Resistance Training: A Narrative Review

Exploring the biomechanics and fatigue patterns of eccentric quasi-isometric muscle actions in the knee extensors and flexors

PURPOSE

Eccentric quasi-isometric (EQI) resistance training is emerging as a promising option in sports medicine and rehabilitation. Despite prior research on EQI contractions in quadriceps and biceps brachii, their use in hamstring injury contexts is underexplored. Therefore, our study examines and contrasts the biomechanics and fatigue effects of EQI training on knee extensors and flexors.

METHODS

Following familiarization, 16 healthy, active participants (9 men, 7 women; 23.5 ± 2.6 years, 72.1 ± 12.8 kg, 173.4 ± 10.7 cm) performed, in random order, four EQI contractions for knee extensions and flexions, respectively. EQI contractions were isotonically loaded to 70% of concentric (60°·s-1) maximal voluntary contraction. Rest between repetitions was set at three minutes, while four minutes separated each muscle group. Peak torque, mean torque, and optimal angle were evaluated pre- and post-bouts. Inter-repetition contraction time and angular velocity were also assessed.

RESULTS

Average torque was 160.9 ± 44.2 and 71.5 ± 23.2 Nm for the extensors and flexors. Peak and mean torque significantly decreased for both extensors (p < 0.001, d = 0.70-0.71) and flexors (p ≤ 0.022, d = 0.36) after EQI contractions, respectively. However, the optimal angle increased for extensors (p < 0.001, d = 1.00) but not flexors (p = 0.811, d = 0.06). During EQI contractions, knee flexors exhibited greater intra-repetition velocity than extensors (p = 0.002; η2 = 0.50). Decreases in inter-repetition time and range of motion were more consistent for the extensors.

CONCLUSIONS

Distinct responses exist when comparing EQI contractions of the knee extensors and flexors, particularly their effect on peak torque angles. These findings suggest knee flexors may require lower relative intensities to align more closely with extensor EQI contractions.

Kinetic and kinematic profile of eccentric quasi-isometric loading

Eccentric quasi-isometric (EQI) contractions (maintaining a yielding contraction for as long as possible, beyond task failure) have gained interest in research and applied settings. However, little is known regarding the biomechanical profile of EQIs. Fourteen well-trained males performed four maximal effort knee-extensor EQIs, separated by 180 seconds. Angular impulse, velocity, and time-under-tension through the 30-100º range of motion (ROM), and in eight ROM brackets were quantified. Statistical parametric mapping, analyses of variance, and standardised effects (Hedges' g (ES), %Δ) detected between-contraction joint-angle-specific differences in time-normalised and absolute variables. Mean velocity was 1.34º·s-1 with most (62.5 ± 4.9%) of the angular impulse imparted between 40-70º. Most between-contraction changes occurred between 30-50º (p≤ 0.067, ES = 0.53 ± 0.31, 60 ± 52%), while measures remained constant between 50-100º (= 0.069-0.83, ES = 0.10 ± 0.26, 14.3 ± 24.6%). EQIs are a time-efficient means to impart high cumulative mechanical tension, especially at short to medium muscle lengths. However, angular impulse distribution shifts towards medium to long muscle lengths with repeat contractions. Practitioners may utilise EQIs to emphasize the initial portion of the ROM, and limit ROM, or apply EQIs in a fatigued state to emphasize longer muscle lengths.

Exploring the acute muscle fatigue response in resistance trained individuals during eccentric quasi-isometric elbow flexions-a cross-sectional comparison of repetition and sex

Eccentric quasi-isometrics (EQIs) are a novel, low-velocity resistance exercise technique that incorporates a holding isometric contraction to positional fatigue, followed by voluntary resistance of the resulting eccentric muscle action. As females are typically more fatigue resistant than males during isometric and low-velocity dynamic muscle actions, this study explored sex-differences in the muscle fatigue response to an EQI protocol. Twenty-five (n = 12 female) participants completed 4 unilateral EQI elbow flexions. Absolute and relative surface electromyography (sEMG) amplitude (iEMG, LE peak), mean power frequency (MPF), angular impulse (aIMP), and elbow angle were compared across repetitions and between sexes using discrete values and statistical parametric/non-parametric mapping. There were significant and substantial sex and repetition differences in absolute iEMG, MPF, and aIMP, however, males and females had statistically similar absolute aIMP by repetition 4. When expressed relatively, there were no significant sex-differences. Additionally, there were significant between repetition changes in sEMG amplitude and elbow angle with an increasing number of repetitions, largely in the first-two thirds of repetition time. The current study suggests that there are absolute, but not relative sex-differences in EQI induced muscle fatigue, and the effects across repetitions occur predominately in the first two-thirds of repetition time.

Building for the Future: A Systematic Review of the Effects of Eccentric Resistance Training on Measures of Physical Performance in Youth Athletes

BACKGROUND

Eccentric resistance training is recognised as an effective stimulus for enhancing measures of muscular strength and power in adult populations; however, its value in youth athletes is currently not well understood.

OBJECTIVE

The aim of this systematic review was to critically appraise the effects of eccentric resistance training on measures of physical performance (i.e. muscular strength, jump, sprint and change of direction) in youth athletes 18 years of age and under.

METHODS

Original journal articles published between 1950 and June 2022 were retrieved from electronic search engines of PubMed, SPORTDiscus and Google Scholar's advanced search option. Full journal articles investigating the acute and chronic effects of eccentric resistance training on measures of physical performance in youth athletes (i.e. a person 18 years of age or under who competes in sport) were included. The methodological quality and bias of each study were assessed prior to data extraction using a modified Downs and Black checklist.

RESULTS

The search yielded 749 studies, of which 436 were duplicates. Three-hundred studies were excluded based upon title and abstract review and a further 5 studies were removed following the modified Downs and Black checklist. An additional 14 studies were identified during backward screening. Accordingly, 22 studies were included in our systematic review. The Nordic hamstring exercise and flywheel inertial training were the most frequently used eccentric resistance training methods in youth athletes. Improvements in physical performance following the Nordic hamstring exercise are dependent upon an increase in the breakpoint angle, rather than training volume (sets and repetitions), and are further elevated with the addition of hip extension exercises or high-speed running. A minimum of 3 familiarisation trials is necessary to elicit meaningful adaptations following flywheel inertial training. Furthermore, an emphasis should be placed upon decelerating the rotating flywheel during the final one to two thirds of the eccentric phase, rather than gradually throughout the entire eccentric phase.

CONCLUSIONS

The findings of this systematic review support the inclusion of eccentric resistance training in youth athletes to improve measures of muscular strength, jump, sprint and change of direction performance. The current eccentric resistance training methods are predominantly limited to the Nordic hamstring exercise and flywheel inertial training; however, the efficacy of accentuated eccentric loading to improve jump performance warrants attention in future investigations.

Repeated measurements of Adaptive Force: Maximal holding capacity differs from other maximal strength parameters and preliminary characteristics for non-professional strength vs. endurance athletes

The Adaptive Force (AF) reflects the neuromuscular capacity to adapt to external loads during holding muscle actions and is similar to motions in real life and sports. The maximal isometric AF (AFiso_max) was considered to be the most relevant parameter and was assumed to have major importance regarding injury mechanisms and the development of musculoskeletal pain. The aim of this study was to investigate the behavior of different torque parameters over the course of 30 repeated maximal AF trials. In addition, maximal holding vs. maximal pushing isometric muscle actions were compared. A side consideration was the behavior of torques in the course of repeated AF actions when comparing strength and endurance athletes. The elbow flexors of n = 12 males (six strength/six endurance athletes, non-professionals) were measured 30 times (120 s rest) using a pneumatic device. Maximal voluntary isometric contraction (MVIC) was measured pre and post. MVIC, AFiso_max, and AF_max (maximal torque of one AF measurement) were evaluated regarding different considerations and statistical tests. AF_max and AFiso_max declined in the course of 30 trials [slope regression (mean ± standard deviation): AF_max = -0.323 ± 0.263; AFiso_max = -0.45 ± 0.45]. The decline from start to end amounted to -12.8% ± 8.3% (p < 0.001) for AF_max and -25.41% ± 26.40% (p < 0.001) for AFiso_max. AF parameters declined more in strength vs. endurance athletes. Thereby, strength athletes showed a rather stable decline for AF_max and a plateau formation for AFiso_max after 15 trials. In contrast, endurance athletes reduced their AF_max, especially after the first five trials, and remained on a rather similar level for AFiso_max. The maximum of AFiso_max of all 30 trials amounted 67.67% ± 13.60% of MVIC (p < 0.001, n = 12), supporting the hypothesis of two types of isometric muscle action (holding vs. pushing). The findings provided the first data on the behavior of torque parameters after repeated isometric-eccentric actions and revealed further insights into neuromuscular control strategies. Additionally, they highlight the importance of investigating AF parameters in athletes based on the different behaviors compared to MVIC. This is assumed to be especially relevant regarding injury mechanisms.

Appropriate Reporting of Exercise Variables in Resistance Training Protocols: Much more than Load and Number of Repetitions

Manipulating resistance training variables is crucial to plan the induced stimuli correctly. When reporting the exercise variables in resistance training protocols, sports scientists and practitioners often refer to the load lifted and the total number of repetitions. The present conceptual review explores all within-exercise variables that may influence the strength and hypertrophic gains, and the changes in muscle architecture. Together with the (1) load and (2) the number of repetitions, (3) performing repetitions to failure or not to failure, (4) the displacement of the load or the range of movement (full or partial), (5) the portion of the partial movement to identify the muscle length at which the exercise is performed, (6) the total time under tension, the duration of each phase and the position of the two isometric phases, (7) whether the concentric, eccentric or concentric-eccentric phase is performed, (8) the use of internal or external focus and (9) the inter-set rest may all have repercussions on the adaptations induced by each resistance exercise. Manipulating one or more variable allows to increase, equalize or decrease the stimuli related to each exercise. Sports scientists and practitioners are invited to list all aforementioned variables for each exercise when reporting resistance training protocols.

Effects of ankle position during the Nordic Hamstring exercise on range of motion, heel contact force and hamstring muscle activation

One of the main benefits of the Nordic Hamstring Exercise (NHE) is that it can be performed without the need of any extra material. However, numerous technical execution variables such as the ankle and pelvis position can influence the performance. The primary aims of this study were to investigate the effects of ankle position (i.e., plantar or dorsal flexion) on Nordic Hamstring Break Point (NHBP), repetition time and heel contact force. A secondary aim was to investigate differences in biceps femoris long head and semitendinosus muscle activation. Male professional field hockey players (n = 12) volunteered for the study. Paired t-tests were used to analyse the effect of ankle position on muscle NHBP, eccentric peak torque and repetition time. Ankle dorsal flexion resulted in a higher NHBP (p = 0.002, effect size [ES] = 1.48 [0.57 to 2.38]), repetition time (p = 0.004, ES = 0.98 [0.24 to 1.72]) and both absolute and relative heel contact force (p = 0.028, ES = 0.67 [0.01 to 1.34], p = 0.017, ES = 0.76 [0.07 to 1.44], respectively) compared to plantar flexion. Muscle activation was not significant different. This study showed a higher NHBP, absolute and relative heel contact force and repetition time with a dorsal flexed ankle vs. a plantar flexed ankle in the NHE, without changes in hamstrings muscle activation.

Paired personal interaction reveals objective differences between pushing and holding isometric muscle action

In sports and movement sciences isometric muscle function is usually measured by pushing against a stable resistance. However, subjectively one can hold or push isometrically. Several investigations suggest a distinction of those forms. The aim of this study was to investigate whether these two forms of isometric muscle action can be distinguished by objective parameters in an interpersonal setting. 20 subjects were grouped in 10 same sex pairs, in which one partner should perform the pushing isometric muscle action (PIMA) and the other partner executed the holding isometric muscle action (HIMA). The partners had contact at the distal forearms via an interface, which included a strain gauge and an acceleration sensor. The mechanical oscillations of the triceps brachii (MMGtri) muscle, its tendon (MTGtri) and the abdominal muscle (MMGobl) were recorded by a piezoelectric-sensor-based measurement system. Each partner performed three 15s (80% MVIC) and two fatiguing trials (90% MVIC) during PIMA and HIMA, respectively. Parameters to compare PIMA and HIMA were the mean frequency, the normalized mean amplitude, the amplitude variation, the power in the frequency range of 8 to 15 Hz, a special power-frequency ratio and the number of task failures during HIMA or PIMA (partner who quit the task). A "HIMA failure" occurred in 85% of trials (p < 0.001). No significant differences between PIMA and HIMA were found for the mean frequency and normalized amplitude. The MMGobl showed significantly higher values of amplitude variation (15s: p = 0.013; fatiguing: p = 0.007) and of power-frequency-ratio (15s: p = 0.040; fatiguing: p = 0.002) during HIMA and a higher power in the range of 8 to 15 Hz during PIMA (15s: p = 0.001; fatiguing: p = 0.011). MMGtri and MTGtri showed no significant differences. Based on the findings it is suggested that a holding and a pushing isometric muscle action can be distinguished objectively, whereby a more complex neural control is assumed for HIMA.

Validity of a Rehab and Reconditioning Program Following an Adductor Longus Injury in Professional Soccer

CONTEXT

The high rates of adductor injuries and reinjuries in soccer have suggested that the current rehabilitation programs may be insufficient; therefore, there is a need to create prevention and reconditioning programs to prepare athletes for the specific demands of the sport.

OBJECTIVE

The aim of this study is to validate a rehab and reconditioning program (RRP) for adductor injuries through a panel of experts and determine the effectiveness of this program through its application in professional soccer.

DESIGN

A 20-item RRP was developed, which was validated by a panel of experts anonymously and then applied to 12 injured male professional soccer players.

SETTING

Soccer pitch and indoor gym.

PARTICIPANTS

Eight rehabilitation fitness coaches (age = 33.25 [2.49] y) and 8 academic researchers (age = 38.50 [3.74] y) with PhDs in sports science and/or physiotherapy. The RRP was applied to 12 male professional players (age = 23.75 [4.97] y; height = 180.56 [8.41] cm; mass = 76.89 [3.43] kg) of the Spanish First and Second Division (La Liga).

INTERVENTIONS

The experts validated an indoor and on-field reconditioning program, which was based on strengthening the injured muscle and retraining conditional capacities with the aim of reducing the risk of reinjury.

MAIN OUTCOME MEASURES

Aiken V for each item of the program and number of days taken by the players to return to full team training.

RESULTS

The experts evaluated all items of the program very highly as seen from Aiken V values between 0.77 and 0.94 (range: 0.61-0.98) for all drills, and the return to training was in 13.08 (±1.42) days.

CONCLUSION

This RRP following an injury to the adductor longus was validated by injury experts, and initial results suggested that it could permit a faster return to team training.

Ultrasound-Guided Percutaneous Needle Electrolysis and Rehab and Reconditioning Program for Rectus Femoris Muscle Injuries: A Cohort Study with Professional Soccer Players and a 20-Week Follow-Up

Rectus femoris muscle strains are one of the most common injuries occurring in sports such as soccer. The purpose of this study was to describe the safety and feasibility of a combination of percutaneous needle electrolysis (PNE) and a specific rehab and reconditioning program (RRP) following an injury to the rectus femoris in professional soccer players. Thirteen professional soccer players received PNE treatment 48 h after a grade II rectus femoris muscle injury, followed by a the RRP 24 h later. Assessment of recovery from injury was done by registering the days taken to return to train (RTT), return to play (RTP), and structural and functional progress of the injured muscle was registered through ultrasound imaging and match-GPS parameters. Also, adverse events and reinjuries were recorded in the follow up period of twenty weeks. The RTT registered was 15.62 ± 1.80 days and RTP was 20.15 ± 2.79 days. After fourteen days, the ultrasound image showed optimal repair. Match-GPS parameters were similar before and after injury. There were no relapses nor were any serious adverse effects reported during the 20-week follow-up after the RTP. A combination of PNE and a specific RRP facilitated a faster RTP in previously injured professional soccer players enabling them to sustain performance and avoid reinjuries.

Short-term neuromuscular, morphological, and architectural responses to eccentric quasi-isometric muscle actions

PURPOSE

Eccentric quasi-isometric (EQI) contractions have been proposed as a novel training method for safely exposing the musculotendinous system to a large mechanical load/impulse, with few repetitions. However, understanding of this contraction type is rudimentary. We aimed to compare the acute effects of a single session of isotonic EQIs with isokinetic eccentric (ECC) contractions.

METHODS

Fifteen well-trained men performed a session of impulse-equated EQI and ECC knee extensions, with each limb randomly allocated to one contraction type. Immediately PRE, POST, 24/48/72 h, and 7 days post-exercise, regional soreness, quadriceps swelling, architecture, and echo intensity were evaluated. Peak concentric and isometric torque, rate of torque development (RTD), and angle-specific impulse were evaluated at each time point.

RESULTS

There were substantial differences in the number of contractions (ECC: 100.8 ± 54; EQI: 3.85 ± 1.1) and peak torque (mean: ECC: 215 ± 54 Nm; EQI: 179 ± 28.5 Nm). Both conditions elicited similar responses in 21/53 evaluated variables. EQIs resulted in greater vastus intermedius swelling (7.1-8.8%, ES = 0.20-0.29), whereas ECC resulted in greater soreness at the distal and middle vastus lateralis and distal rectus femoris (16.5-30.4%, ES = 0.32-0.54) and larger echogenicity increases at the distal rectus femoris and lateral vastus intermedius (11.9-15.1%, ES = 0.26--0.54). Furthermore, ECC led to larger reductions in concentric (8.3-19.7%, ES = 0.45-0.62) and isometric (6.3-32.3%, ES = 0.18-0.70) torque and RTD at medium-long muscle lengths.

CONCLUSION

A single session of EQIs resulted in less soreness and smaller reductions in peak torque and RTD versus impulse-equated ECC contractions, yet morphological shifts were largely similar. Long-term morphological, architectural, and neuromuscular adaptations to EQI training requires investigation.