Effects of β-Hydroxy β-Methylbutyric Supplementation in Combination with Conservative Non-Invasive Treatments in Athletes with Patellar Tendinopathy: A Pilot Study

The aim of the present study was to analyze the effect of conservative non-invasive treatments based on eccentric training, stretching and extracorporeal shock wave therapy (ESWT) supplemented with β-Hydroxy β-methylbutyric (HMB) or placebo (PLAC) on body composition, pain and muscular function (jump ability, muscular power and muscular strength) in athletes with patellar tendinopathy (PT). In a double-blind randomized trial, 8 athletes (4 males and 4 females) performed a physical rehabilitation for 4 weeks. They were randomly divided into two experimental groups (two males and two females in each one) that ingested HMB (HMBG) or PLAC (PLACG). In pre- and post-intervention were assessed body composition, pain, countermovement jump (CMJ), back-squat (BS) for analyzing peak power (W) (PPPP), load (kg) associated to PPPP (PPKG) and mean velocity (m/s) (PPMV) in addition to a 5-RM leg extension tests. An interaction intervention·supplementation (p = 0.049; Ƞ2p = 0.774) was observed in the height reached in the CMJ as an intervention effect in PPPP detected for the HMBG (p = 0.049). In addition, an enhancement in PPKG (p = 0.028; Ƞ2p = 0.842) was detected in the intervention, but not in PPMV, as an increase in the intervention in the 5-RM test (p = 0.001; Ƞ2p = 0.981) was observed. No changes were noted on body composition or pain (p > 0.05). The combination of eccentric training with stretching and ESWT increased concentric muscular power and strength after 4 weeks without changes in body lean mass or pain. In addition, HMB supplementation could enhance the power muscular performance in athletes with PT, optimizing the intervention adaptions.

Effects of eccentric exercise on muscle architecture in adults: A systematic review

Review question / Objective: Question: What is the effect of eccentric training on muscle architecture in the adult population? Objective: This review aims to evaluate the effects of eccentric training on muscle architecture in the adult population. Condition being studied: Healthy individuals who were subjected to eccentric training. Eligibility criteria: Articles that met the following criteria were included in this review: (I) subjects >18 years old, (II) Eccentric training program longer than 4 weeks (III) Studies with randomized clinical trial design, (IV) studies reporting measures of muscle architecture: “pennation angle”, “fascicle length”, “muscle thickness”, (V) full text available, and (VI) articles in English. In addition, we excluded all those articles that (I) Eccentric training programs of less than 4 weeks (II) conference presentations, theses, books, editorials, review articles and expert opinions, (III) duplicate articles, and (IV) articles in which the principal or secondary authors did not respond to e-mail requests.

Effects of an Eccentric Training Protocol Using Gliding Discs on Balance and Lower Body Strength in Healthy Adults

Impaired balance and lower body weakness are the main causes of falls, which are considered to be the major cause of fractures and head injuries in the elderly and are recognised as a serious health problem. The aim of this study is to observe the effect of eccentric training, introducing new technologies (gliding discs), on body composition, lower body strength, balance and quality of life. A quasi-experimental study was carried out with 56 healthy participants who were divided into an experimental group (n = 31) who underwent the protocol consisting of 12 training sessions and a control group (n = 25) who did not undergo the training. Before and after the intervention, all participants underwent a measurement of body composition, the SJ jump, balance with accelerometry and quality of life with the Short Form 12 Health Survey. In the experimental group, statistically significant improvements were found in the variables balance and lower body strength. The application of this training protocol improves lower body strength and the ability to control balance in the adult population.

Heterogeneous effects of eccentric training and nordic hamstring exercise on the biceps femoris fascicle length based on ultrasound assessment and extrapolation methods: A systematic review of randomised controlled trials with meta-analyses

Objective To systematically review the effects of eccentric training based on biceps femoris fascicle length using ultrasound assessment and extrapolation methods. Design Systematic review and meta-analysis of randomised controlled trials. Data sources CENTRAL, CINAHL Plus with full text, PubMed and OpenGrey databases were searched on 6 July 2021. Eligibility criteria for selecting studies Randomised controlled trials (RCTs) lasting at least four weeks and presenting data about biceps femoris (BF) fascicle length (FL) as an outcome. Method Searching databases, screening studies, performing risk of bias assessments and determining the level of evidence (LoE) for each meta-analysis were applied during the study. PRISMA 2020 statement and Cochrane Handbook for Systematic Reviews of Interventions were used as the guidelines of this systematic review. Results Eight randomised controlled trials included in meta-analyses. Based on the very low and low LoE, eccentric training has small (g = 0.29, 95% CI [-0.26, 0.85]), moderate (g = 0.72, 95% CI [0.17, 1.28]) and large (g = 2.20, 95% CI [0.99, 3.41]) effect sizes (ES) based on manual linear extrapolation (MLE), panoramic ultrasound scanning and trigonometric equation methods, respectively. Similarly, Nordic hamstring exercise (NHE) has small (g = 0.23 [-1.02, 1.47]), small (g = 0.38, 95% CI [-0.50, 1.27]) and large (g = 1.98, 95% CI [0.52, 3.44]) ES based on the MLE, panoramic ultrasound scanning and trigonometric equation methods, respectively. Conclusion ES of eccentric training, including NHE, vary between the MLE, panoramic ultrasound scanning, and equation methods. The relevant scientific community should have a consensus on measurement standards of the BF FL measurements. Further studies can be conducted to compare the effects of eccentric training based on the ultrasound assessment and extrapolation methods.

An Overview of Achilles Tendinopathy Management

Background: Persistent tendon pain and swelling related to mechanical loading are the main signs of Achilles tendinopathy (AT). This condition is one of the most common tendinopathies of the lower limb affecting mainly athletes involved in running and jumping sports. Methods: we included pivotal papers retrieved from the literature (Pubmed, Google Scholar, PEDro, and Scopus) to present an overview of the management of AT, with a specific focus on conservative management. Results: An accurate and timely diagnosis of AT is necessary to set up early treatments and to manage the problem conservatively. Diagnosis is primarily based on clinical assessment; instrumental imaging may be helpful in confirming the clinical diagnosis. Conservative treatment is effective in most cases, mainly using physical exercise based on eccentric training. Other non-surgical treatments such as extracorporeal shock wave therapy, thermotherapies, and injections can be added to exercise. Surgical treatment is indicated for patients where the conservative treatments of at least six months fails. Conclusions: Conflicting results from numerous studies hamper to identify gold standard treatments asking for further well-conducted level I and II research about the management of AT.

Impact of Askling L-PROTOCOL on muscle architecture, flexibility and sprint performance.

Eccentric training has been shown to be important for hamstring strain injuries rehabilitation and prevention. The Askling L-PROTOCOL (L-P), comprising three exercises aimed at eccentric training and hamstring lengthening, was shown to improve this injuries recovery and relapse times in comparison with other traditional exercise-based protocols. However, the causes of these results remain unclear. This study looks at the impact of an 8-week L-P followed by 4 weeks of detraining on the architecture of the biceps femoris long head, hamstring flexibility and sprint performance. Twenty-eight healthy individuals were divided into two groups: an experimental group, which carried out the L-P, and a control group with no training. Muscle architecture was measured using 2Dultrasound, hamstring flexibility using goniometry and sprint performance using sports radar equipment before(M1) and after(M2) the training period and after detraining(M3). No significant changes were observed between M1 and M2 in the experimental group with regard to fascicle length(t=-0.79,P>.05), theoretical maximum speed (t=-1.43,P>.05), horizontal force (t=0.09,P>.05), force application during sprint running(t=-0.09,P>.05) and horizontal power (t =-0.97,P>.05), but, however, changes were observed in hamstring flexibility (t=-4.42,d=0.98,P<.001) returning to pre-training values after detraining period(t=-1.11,P>.05). L-P has been shown to be an eccentric protocol of moderate intensity and easy implementation that could be interesting to include throughout a sport season.

The Role of Eccentric Training and Pain Neuroscience Education (PNE) to Improve Quadriceps Muscle Strength, and Function in Post ACL Repair: A Case Report

Background: A 19-year-old man presented with right knee pain while bearing weight on the right leg and difficulty bending the right knee. He was diagnosed with a complete -tear of the anterior cruciate ligament. After ACL reconstruction this individual was referred to physical therapy treatment. Objective: To investigate if neuroscience pain education, and eccentric training, have any therapeutic significance in post-ACL reconstructive patients. Method: After assessment, the first day of the first week, introduced a treatment protocol consisting of basic range of motion (ROM) and isometric exercises for three sets of 10–30 sec hold. From first to fourth week eccentric exercises along with pain neuroscience education (PNE) sessions were given on alternate days, with three sessions for PNE and eccentric exercises until fourth week. Result: As shown in this study, treatment with a combination of PNE and eccentric training results in improved quadriceps muscle strength, range of motion, and overall function. Conclusion: This report suggested that PNE in conjunction with eccentric exercise has clinical merit. Clinical implication of study is examining the effectiveness of this approach should be conducted in the form of well-designed, clinical studies.