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.

Quo Vadis Nordic Hamstring Exercise-Related Research?-A Scoping Review Revealing the Need for Improved Methodology and Reporting

The objective of this scoping review is to assess Nordic Hamstring Exercise quality (ANHEQ) of assessments and interventions according to the ANHEQ rating scales and to present practical recommendations for the expedient design and reporting of future studies. A total of 71 Nordic Hamstring Exercise (NHE) assessments and 83 NHE interventions were selected from the data sources PubMed, Scopus, and SPORTDiscus. Research studies which were presented in peer-reviewed academic journals and implemented the NHE during laboratory-based assessments or multi-week interventions met the eligibility criteria. NHE assessments analyzed force (51%), muscle activation (41%), knee angle kinematics (38%), and bilateral symmetry (37%). NHE interventions lasted 4-8 weeks (56%) and implied an exercise volume of two sessions per week (66%) with two sets per session (41%) and ≥8 repetitions per set (39%). The total ANHEQ scores of the included NHE assessments and interventions were 5.0 ± 2.0 and 2.0 ± 2.0 (median ± interquartile range), respectively. The largest deficits became apparent for consequences of impaired technique (87% 0-point-scores for assessments) and kneeling height (94% 0-point-scores for interventions). The 0-point-scores were generally higher for interventions compared to assessments for rigid fixation (87% vs. 34%), knee position (83% vs. 48%), kneeling height (94% vs. 63%), and separate familiarization (75% vs. 61%). The single ANHEQ criteria, which received the highest score most frequently, were rigid fixation (66% of assessments) and compliance (33% of interventions). The quality of NHE assessments and interventions was generally 'below average' or rather 'poor'. Both NHE assessments and interventions suffered from imprecise reporting or lacking information regarding NHE execution modalities and subsequent analyses. Based on the findings, this scoping review aggregates practical guidelines how to improve the design and reporting of future NHE-related research.

Hamstrings force-length relationships and their implications for angle-specific joint torques: a narrative review

Temporal biomechanical and physiological responses to physical activity vary between individual hamstrings components as well as between exercises, suggesting that hamstring muscles operate differently, and over different lengths, between tasks. Nevertheless, the force-length properties of these muscles have not been thoroughly investigated. The present review examines the factors influencing the hamstrings’ force-length properties and relates them to in vivo function. A search in four databases was performed for studies that examined relations between muscle length and force, torque, activation, or moment arm of hamstring muscles. Evidence was collated in relation to force-length relationships at a sarcomere/fiber level and then moment arm-length, activation-length, and torque-joint angle relations. Five forward simulation models were also used to predict force-length and torque-length relations of hamstring muscles. The results show that, due to architectural differences alone, semitendinosus (ST) produces less peak force and has a flatter active (contractile) fiber force-length relation than both biceps femoris long head (BFlh) and semimembranosus (SM), however BFlh and SM contribute greater forces through much of the hip and knee joint ranges of motion. The hamstrings’ maximum moment arms are greater at the hip than knee, so the muscles tend to act more as force producers at the hip but generate greater joint rotation and angular velocity at the knee for a given muscle shortening length and speed. However, SM moment arm is longer than SM and BFlh, partially alleviating its reduced force capacity but also reducing its otherwise substantial excursion potential. The current evidence, bound by the limitations of electromyography techniques, suggests that joint angle-dependent activation variations have minimal impact on force-length or torque-angle relations. During daily activities such as walking or sitting down, the hamstrings appear to operate on the ascending limbs of their force-length relations while knee flexion exercises performed with hip angles 45–90° promote more optimal force generation. Exercises requiring hip flexion at 45–120° and knee extension 45–0° (e.g. sprint running) may therefore evoke greater muscle forces and, speculatively, provide a more optimum adaptive stimulus. Finally, increases in resistance to stretch during hip flexion beyond 45° result mainly from SM and BFlh muscles.

Is the Integration of Additional Eccentric, Balance and Core Muscles Exercises into a Typical Soccer Program Effective in Improving Strength and Postural Stability?

Soccer teams integrate specific exercises into their typical workout programs for injury prevention. The purpose of this study was to investigate whether the incorporation of a brief and supplementary training program that involves eccentric, balance, and core exercises into the weekly soccer schedule can cause positive neuromuscular adaptations. Twenty-one soccer players were randomly allocated to either a training (n = 11) or a control group (n = 10). All players followed their teams’ typical program, consisting of 4–5 soccer-specific sessions plus 1 match, weekly. Training group players additionally performed biweekly, hamstring eccentric, balance, and core stability exercises for 8 weeks. Isokinetic concentric and eccentric peak torque (PT) of the hamstrings and quadriceps, changes in the center of pressure (COP) during a 30 s single-leg stance, and a supine bridge (trunk stability) test were assessed before and after the intervention. After the intervention, a 27% increase in hamstring concentric PT and a 33% reduction in COP sway in the stance test, were observed for the training group only (p < 0.05). These improvements were significant only for the non-dominant leg. Furthermore, the control group displayed an increase in COP sway during the bridge test compared to baseline values (p < 0.05), which reflects a deterioration in postural balance over time. Consequently, incorporating small doses of hamstring eccentric, proprioception, and core stability exercises into a typical training program of youth soccer players improves strength and postural balance in the non-dominant leg, as well as core muscle performance.

Hip and Knee Extensor Activation During the Hip Thrust and Rear-Foot-Elevated Split Squat in Trained Females

ABSTRACT

McCurdy, K, Walker, J, Kelly, C, and Polinski, M. Hip and knee extensor activation during the hip thrust and rear-foot-elevated split squat in trained females. J Strength Cond Res 35(5): 1201-1207, 2021-The aim of the study was to compare hip and knee extensor muscle activation between the hip thrust (HT) and rear-foot-elevated split squat (RFESS) within different depths and the entire range of motion. Twenty, young adult female subjects (age, 20.9 ± 1.3 years; height, 164.6 ± 7.5 cm; mass 63.2 ± 8.8 kg) with an intermediate level of resistance training experience completed the study. Three repetitions were completed at 80% of the 1-repetition maximum. Gluteus maximus, vastus lateralis, and the medial (semitendinosus and semimembranosus) and lateral (biceps femoris) hamstrings electromyographic data were compared at the top, middle, and bottom one-third of the hip range of motion and for the entire repetition. A repeated-measures analysis of variance was used to test significance set at p ≤ 0.05. All 4 muscles revealed higher (p < 0.001) activation at the top position of the HT compared with the middle and bottom, whereas higher scores (p < 0.001) were found in the bottom position during the RFESS. The HT revealed greater activity (p < 0.001) than the RFESS in all muscles at the top, whereas the RFESS showed higher scores (p < 0.001) than the HT in all muscles in the bottom position. For the entire repetition, the RFESS produce significantly greater vastus lateralis activation (59.4 vs 43.6%). The data indicate that the greatest effect for the HT is demonstrated in the top position and at the bottom for the RFESS. Thus, we recommend to implement both exercises in a training program to maximize gluteus maximus and hamstring activation across the full range of motion. For the greatest vastus lateralis activation, the RFESS is recommended.

Effect of Nordic Hamstring Exercise Training on Knee Flexors Eccentric Strength and Fascicle Length: A Systematic Review and Meta-Analysis

CONTEXT

Nordic hamstring exercise (NHE) has been widely employed to prevent hamstring strain injuries. However, it is still not clear which adaptations are responsible for the NHE preventive effects.

OBJECTIVES

The aim of this study was to investigate the effects of NHE on knee flexors eccentric strength and fascicle length.

EVIDENCE ACQUISITION

The search strategy included MEDLINE, PEDro, and Cochrane CENTRAL from inception to April 2020. Randomized clinical trials that have analyzed the effects of NHE training on hamstring eccentric strength and/or fascicle length were included.

EVIDENCE SYNTHESIS

From the 1932 studies identified, 12 were included in the systematic review, and 9 studies presented suitable data for the meta-analysis. All studies demonstrated strength increments in response to NHE training (10%-15% and 16%-26% in tests performed on the isokinetic dynamometer and on the NHE device, respectively), as well as significant enhancement of biceps femoris long head fascicle length (12%-22%). Meta-analysis showed NHE training was effective to increase knee flexors eccentric strength assessed with both isokinetic tests (0.68; 95% confidence interval, 0.29 to 1.06) and NHE tests (1.11; 95% confidence interval, 0.62 to 1.61). NHE training was also effective to increase fascicle length (0.97; 95% confidence interval, 0.46 to 1.48).

CONCLUSIONS

NHE training has the potential of increasing both knee flexors eccentric strength and biceps femoris long head fascicle length.