Corrigendum: Neuromuscular and Perceptual Responses to Sub-Maximal Eccentric Cycling

[This corrects the article on p. 354 in vol. 10, PMID: 30984032.].

Neuromuscular and Perceptual Responses to Sub-Maximal Eccentric Cycling

Objective

Eccentric (ECC) cycle-ergometers have recently become commercially-available, offering a novel method for rehabilitation training. Many studies have reported that ECC cycling enables the development of higher levels of muscular force at lower cardiorespiratory and metabolic loads, leading to greater force enhancements after a training period. However, fewer studies have focused on the specific perceptual and neuromuscular changes. As the two latter aspects are of major interest in clinical settings, this review aimed to present an overview of the current literature centered on the neuromuscular and perceptual responses to submaximal ECC cycling in comparison to concentric (CON) cycling.

Design

Narrative review of the literature.

Results

At a given mechanical workload, muscle activation is lower in ECC than in CON while the characteristics of the musculo-articular system (i.e., muscle-tendon unit, fascicle, and tendinous tissue length) are quite similar. At a given heart rate or oxygen consumption, ECC cycling training results in greater muscular hypertrophy and strength gains than CON cycling. On the contrary, CON cycling training seems to enhance more markers of muscle aerobic metabolism than ECC cycling performed at the same heart rate intensity. Data concerning perceptual responses, and neuromuscular mechanisms leading to a lower muscle activation (i.e., neural commands from cortex to muscular system) at a given mechanical workload are scarce.

Conclusion

Even though ECC cycling appears to be a very useful tool for rehabilitation purposes the perceptual and neural commands from cortex to muscular system during exercise need to be further studied.

Shifting the Current Clinical Perspective: Isolated Eccentric Exercise as an Effective Intervention to Promote the Recovery of Muscle After Injury

Eccentric exercise is able to mechanically engage muscle, initiating strain-sensing molecules that promote muscle recovery by inducing beneficial adaptations in neural activity and muscle morphology, 2 critical components of muscle function that are negatively altered after injury. However, due to misinterpreted mathematic modeling and in situ and in vitro stretch protocols, a dogma that exposing muscle to eccentric exercise is associated with injury has been perpetuated in the literature. In response, clinicians have been biased toward using concentric exercise postinjury to improve the recovery of muscle function. Unfortunately, this conventional approach to rehabilitation does not restore muscle function, and reinjury rates remain high. Here, the authors present experimental evidence and theoretical support for the idea that isolated eccentric exercise is ideally suited to combat muscle inhibition and muscle strains and is an attractive alternative to concentric exercise.

Specific joint angle dependency of voluntary activation during eccentric knee extensions

INTRODUCTION

This study compared voluntary activation during isometric, concentric, and eccentric maximal knee extensions at different joint angles.

METHODS

Fifteen participants performed isometric, concentric, and eccentric protocols (9 contractions each). For each protocol, the central activation ratio (CAR) was randomly measured at 50°, 75°, or 100° of knee joint angle (0° = full knee extension) using superimposed supramaximal paired nerve stimulations during contractions.

RESULTS

CAR increased between 50° and 100° during isometric (93.6 ± 3.1 vs. 98.5 ± 1.4%), concentric (92.4 ± 5.4 vs. 99.2 ± 1.2%), and eccentric (93.0 ± 3.5 vs. 96.6 ± 3.8%) contractions. CAR was lower during eccentric than both isometric and concentric contractions at 75° and 100°, but similar between contraction types at 50°.

CONCLUSIONS

The ability to activate muscle maximally is impaired during eccentric contractions compared with other contraction types at 75° and 100°, but not at 50°. Muscle Nerve 56: 750-758, 2017.

Lower Extremity Joint Work During Acceleration, Deceleration, and Steady State Running

Running during sports and for physical activity often requires changes in velocity through acceleration and deceleration. While it is clear that lower extremity biomechanics vary during these accelerations and decelerations, the work requirements of the individual joints are not well understood. The purpose of this investigation was to measure the sagittal plane mechanical work of the individual lower extremity joints during acceleration, deceleration, and steady-state running. Ten runners were compared during acceleration, deceleration, and steady-state running using three-dimensional kinematics and kinetics measures. Total positive and negative joint work, and relative joint contributions to total work were compared between conditions. Total positive work progressively increased from deceleration to acceleration. This was due to greater ankle joint work during acceleration. While there was no significant change in total negative work during deceleration, there was a greater relative contribution of the knee to total negative work with a subsequent lower relative ankle negative work. Each lower extremity joint exhibits distinct functional roles in acceleration compared with deceleration during level running. Deceleration is dominated by greater contributions of the knee to negative work while acceleration is associated with a greater ankle contribution to positive work.

Lower Extremity Biomechanics and Self-Reported Foot-Strike Patterns Among Runners in Traditional and Minimalist Shoes

CONTEXT

The injury incidence rate among runners is approximately 50%. Some individuals have advocated using an anterior-foot-strike pattern to reduce ground reaction forces and injury rates that they attribute to a rear-foot-strike pattern. The proportion of minimalist shoe wearers who adopt an anterior-foot-strike pattern remains unclear.

OBJECTIVE

To evaluate the accuracy of self-reported foot-strike patterns, compare negative ankle- and knee-joint angular work among runners using different foot-strike patterns and wearing traditional or minimalist shoes, and describe average vertical-loading rates.

DESIGN

Descriptive laboratory study.

SETTING

Research laboratory.

PATIENTS OR OTHER PARTICIPANTS

A total of 60 healthy volunteers (37 men, 23 women; age = 34.9 ± 8.9 years, height = 1.74 ± 0.08 m, mass = 70.9 ± 13.4 kg) with more than 6 months of experience wearing traditional or minimalist shoes were instructed to classify their foot-strike patterns.

INTERVENTION(S)

Participants ran in their preferred shoes on an instrumented treadmill with 3-dimensional motion capture.

MAIN OUTCOME MEASURE(S)

Self-reported foot-strike patterns were compared with 2-dimensional video assessments. Runners were classified into 3 groups based on video assessment: traditional-shoe rear-foot strikers (TSR; n = 22), minimalist-shoe anterior-foot strikers (MSA; n = 21), and minimalist-shoe rear-foot strikers (MSR; n = 17). Ankle and knee negative angular work and average vertical-loading rates during stance phase were compared among groups.

RESULTS

Only 41 (68.3%) runners reported foot-strike patterns that agreed with the video assessment (κ = 0.42, P < .001). The TSR runners demonstrated greater ankle-dorsiflexion and knee-extension negative work than MSA and MSR runners (P < .05). The MSA (P < .001) and MSR (P = .01) runners demonstrated greater ankle plantar-flexion negative work than TSR runners. The MSR runners demonstrated a greater average vertical-loading rate than MSA and TSR runners (P < .001).

CONCLUSIONS

Runners often cannot report their foot-strike patterns accurately and may not automatically adopt an anterior-foot-strike pattern after transitioning to minimalist running shoes.

The role and implementation of eccentric training in athletic rehabilitation: tendinopathy, hamstring strains, and acl reconstruction

The benefits and proposed physiological mechanisms of eccentric exercise have previously been elucidated and eccentric exercise has been used for well over seventy years. Traditionally, eccentric exercise has been used as a regular component of strength training. However, in recent years, eccentric exercise has been used in rehabilitation to manage a host of conditions. Of note, there is evidence in the literature supporting eccentric exercise for the rehabilitation of tendinopathies, muscle strains, and in anterior cruciate ligament (ACL) rehabilitation. The purpose of this Clinical Commentary is to discuss the physiologic mechanism of eccentric exercise as well as to review the literature regarding the utilization of eccentric training during rehabilitation. A secondary purpose of this commentary is to provide the reader with a framework for the implementation of eccentric training during rehabilitation of tendinopathies, muscle strains, and after ACL reconstruction.