Effects of Muscle Architecture on Eccentric Exercise Induced Muscle Damage Responses.

There is a need to investigate the role of muscle architecture on muscle damage responses induced by exercise. The aim of this study was to determine the effect of muscle architecture and muscle length on eccentric exercise-induced muscle damage responses. Eccentric exercise-induced muscle damage was performed randomly to the elbow flexor (EF), knee extensor (KE), and knee flexor (KF) muscle groups with two week intervals in 12 sedentary male subjects. Before and after each eccentric exercise (immediately after, on the 1st, 2nd, 3rd, and 7th days) range of motion, delayed onset muscle soreness, creatine kinase activity, myoglobin concentration and isometric peak torque in short and long muscle positions were evaluated. Furthermore, muscle volume and pennation angle of each muscle group was evaluated before initiating the eccentric exercise protocol. Pennation angle and muscle volume was significantly higher and the workload per unit muscle volume was significantly lower in the KE muscles compared with the KF and EF muscles (p < 0.01). EF muscles showed significantly higher pain levels at post-exercise days 1 and 3 compared with the KE (p < 0.01-0.001) and KF (p < 0.01) muscles. The deficits in range of motion were higher in the EF muscles compared to the KE and KF muscles immediately after (day 0, p < 0.01), day 1 (p < 0.05-0.01), and day 3 (p < 0.05) evaluations. The EF muscles represented significantly greater increases in CK and Mb levels at day 1, 3, and 7 than the KE muscles (p < 0.05-0.01). The CK and Mb levels were also significantly higher in the KF muscles compared with the KE muscles (p < 0.05, p < 0.01 respectively). The KF and EF muscles represented higher isometric peak torque deficits in all the post-exercise evaluations at muscle short position (p < 0.05-0.001) compared with the KE muscle after eccentric exercise. Isometric peak torque deficits in muscle lengthened position was significantly higher in EF in all the post-exercise evaluations compared with the KE muscle (p < 0.05-0.01). According to the results of this study it can be concluded that muscle structural differences may be one of the responsible factors for the different muscle damage responses following eccentric exercise in various muscle groups.

Effect of Upper-Extremity Strengthening Exercises on the Lumbar Strength, Disability and Pain of Patients with Chronic Low Back Pain: A Randomized Controlled Study.

The present study aimed to analyze the impacts of a low back rehabilitation program accompanied with neck, shoulder and upper back exercises on pain, disability, and physical characteristics of patients with chronic low back pain. Twenty sedentary male patients with chronic low back pain participated in the study on a voluntary basis. The patients were randomly allocated into two groups: a conventional low back exercise group (CE) and a supported exercise group (SE; CE plus upper back, neck, and shoulder exercises). The Modified Oswestry Disability Questionnaire (MODQ) was used to evaluate the disability status and the Visual Analog Scale (VAS) was used to identify the pain states of the patients. In addition, neck, lumbar and shoulder isokinetic and isometric strengths of the patients were evaluated. The CE group performed lumbar stretching, mobilization and stabilization exercises in addition to low-back and abdominal isometric and concentric strengthening exercises. The SE group performed static stretching and isotonic exercises for the neck, upper-back, and shoulder muscles, in addition to the exercises performed in CE group. The exercises were implemented 3 days a week for 6 weeks in both groups. Following the 6-week exercise periods in both groups, statistically significant (p < 0.01) improvements were observed in the patients' levels of pain and the scores of MODQ reflecting an easing of disability. With respect to the levels of pain and disability, the improvements observed in the SE group was significantly (p < 0.01) greater than the improvement observed in the CE group. Based on the findings of this study, we can conclude that a low back exercise program used in combination with neck, shoulder and upper back exercises reduces the level of pain and disability in patients with chronic low back pain more prominently than conventional low back exercises.

Effects of Static and Dynamic Stretching on the Isokinetic Peak Torques and Electromyographic Activities of the Antagonist Muscles.

The aim of this study was to investigate if static and dynamic stretching exercises of the knee muscles (quadriceps and hamstring muscles) have any effects on concentric and eccentric isokinetic peak torques and electromyographic amplitudes (EMG) of the antagonist muscles. Twenty healthy male athletes (age between 18-30 years) voluntarily participated in this study. All of the subjects visited the laboratory to complete the following intervention in a randomized order on 5 separate days; (a) non-stretching (control), (b) static stretching of the quadriceps muscles, (c) static stretching of the hamstring muscles, (d) dynamic stretching of the quadriceps muscles, and (e) dynamic stretching of the hamstring muscles. Static stretching exercises either for the quadriceps or the hamstring muscles were carried out at the standing and sitting positions. Subjects performed four successive repetitions of each stretching exercises for 30 seconds in both stretching positions. Similar to static stretching exercises two different stretching modes were designed for dynamic stretching exercises. Concentric and eccentric isokinetic peak torque for the non-stretched antagonist quadriceps or hamstring muscles at angular velocities of 60°/sec and 240°/sec and their concurrent electromyographic (EMG) activities were measured before and immediately after the intervention. Isokinetic peak torques of the non-stretched agonist hamstring and quadriceps muscles did not represent any significant (p > 0.05) differences following static and dynamic stretching of the antagonist quadriceps and hamstring muscles, respectively. Similarly, the EMG activities of the agonist muscles exhibited no significant alterations (p > 0.05) following both stretching exercises of the antagonist muscles. According to the results of the present study it is possible to state that antagonist stretching exercises either in the static or dynamic modes do not affect the isokinetic peak torques and the EMG activities of the non-stretched agonist quadriceps or hamstring muscles.

Eccentric Training Improves Ankle Evertor and Dorsiflexor Strength and Proprioception in Functionally Unstable Ankles.

OBJECTIVE: The aim of this study was to investigate the effects of a combined eccentric-concentric exercise program of the ankle evertors and dorsiflexors on proprioception in functionally unstable ankles. DESIGN: Thirteen male recreational athletes with unilateral functional ankle instability were admitted to this study. The unaffected opposite ankles were used as controls. The functionnaly unstable ankle of the subjects performed an isokinetic exercise program of the ankle evertors and dorsiflexors in a combined eccentric-concentric mode for 3 days per week for 6 wks. Before and after the isokinetic exercise program, active and passive joint position sense and kinesthesia and isokinetic strength of the ankle joint were evaluated. RESULTS: Active and passive joint position sense error scores for inversion (P < 0.01-0.001) and plantarflexion (P < 0.05-0.001) direction and kinesthesia scores for inversion (P < 0.001) and plantarlexion (P < 0.01) direction showed significant reductions after 6 wks of intervention in the functionnaly unstable ankle. In addition, eccentric peak torques for the ankle evertor and dorsiflexors represented significant (P < 0.001) increases in the functionnaly unstable ankle compared with the control ankle. CONCLUSIONS: The results of this study suggest that it is possible to improve proprioceptive acuity of the ankle joint after a 6-wk eccentric-concentric isokinetic training program in functionally unstable ankles.

Early versus late start of isokinetic hamstring-strengthening exercise after anterior cruciate ligament reconstruction with patellar tendon graft.

BACKGROUND: Hamstring strengthening after anterior cruciate ligament reconstruction is a vital component of the rehabilitation program. PURPOSE: The objective of this trial was to investigate the effects of hamstring isokinetic training used in the early phase of the rehabilitation program on the stability, strength, symptoms, and functional outcomes of patients throughout 12 months after anterior cruciate ligament surgery. STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 2. METHODS: Forty-eight men underwent anterior cruciate ligament reconstruction with an ipsilateral bone-patellar tendon-bone autograft. The patients were randomly assigned to perform daily isokinetic hamstring exercises at postoperative 3 weeks (group I) or to perform daily isokinetic hamstring exercises at postoperative 9 weeks (group II). The patients were evaluated monthly for the first 4 months and at the 12th month for postoperative hamstring and quadriceps strength, as well as for knee function via the Cincinnati Knee Rating Scale and International Knee Documentation Committee form. RESULTS: Hamstring isometric strength at 30 degrees of knee flexion (at the first and second months) and concentric isokinetic strength (at 2, 3, 4, and 12 months) at the angular velocity of 60 deg/s were significantly (P <.05-.01) greater in group I compared with group II. Average scores of the Cincinnati Knee Rating Scale for symptoms were significantly (P <.05-.001) higher in group I compared with group II at all evaluation periods. Walking and stair-climbing scores at 1, 2, 3, and 4 months and squatting score at all evaluation periods were also better (P <.05-.01) in group I compared with group II. In addition, group I exhibited better (P <.01-.001) Lachman test results compared with group II for all postoperative evaluation periods. The International Knee Documentation Committee final rating scores were significantly (P <.01) greater at 2, 3, and 4 months in group I compared with group II. CONCLUSION: The results of this study suggest that hamstring as well as quadriceps strength can be increased via early hamstring strengthening after anterior cruciate ligament reconstruction with no negative impact on knee function.

Daily rhythmicity and hibernation in the Anatolian ground squirrel under natural and laboratory conditions.

We studied daily rhythmicity of body temperature (T(b)) before and during hibernation in Anatolian ground squirrels (Spermophilus xanthoprymnus) under natural and laboratory conditions using surgically implanted temperature loggers. Under both conditions, robust daily T(b) rhythmicity with parameters comparable to those of other ground squirrel species was observed before but not during hibernation. Euthermic animals had robust daily T(b) rhythms with a mean of 37.0 degrees C and a range of excursion of approximately 4 degrees C. No T(b) rhythm was detected during torpor bouts, either because T(b) rhythmicity was absent or because the daily range of excursion was smaller than 0.2 degrees C. The general patterns of hibernation that we observed in Anatolian ground squirrels were similar to those previously observed by other investigators in other species of ground squirrels.

Difference in the magnitude of muscle damage between elbow flexors and knee extensors eccentric exercises.

The aim of this study was to investigate the difference in the magnitude of muscle damage between maximal eccentric exercises of the elbow flexors (EF) and knee extensors (KE). Twelve sedentary male volunteers participated in the study. Range of motion (ROM), isometric peak torque (IPT), delayed onset of muscle soreness (DOMS), creatine kinase activity (CK), and myoglobin concentration (Mb) were evaluated before, immediately after, and on the 1(st) , 2(nd), 3(rd) , and 7(th) days following exercise. Total work (TW) during exercises was recorded and corrected by muscle volume (TWc). TWc was greater (p < 0.01) for EF [24 (2) joule·cm-3] than for KE [7 (0.4) joule·cm(-3)]. Increases in CK on the 2(nd) , 3(rd) , and 7(th) days (p < 0.01) and increases in Mb on the 1(st) , 2(nd) , 3(rd) , and 7(th) days were significantly (p<0.01) larger for EF than for KE. The decline in IPT was greater (p < 0.05- 0.01) for EF at all test occasions compared with KE. The results of this study demonstrate that the magnitude of muscle damage is greater and the recovery is slower following maximal eccentric exercise of the EF than of the KE for sedentary males. Key pointsThe magnitude of muscle damage is greater and the recovery is slower following maximal eccentric exercise of the EF than of the KE for sedentary males.This may be because of the higher total eccentric work per muscle unit in elbow flexors.

[A reliability study of the Turkish version of the mornings-evenings questionnaire]. / Sabahçil-Aksamcil Anketi Türkçe Uyarlamasinda Güvenilirlik Calismasi.

PURPOSE: To investigate the reliability of the Turkish version of the self-assessment mornings-evenings questionnaire (MEQ). METHODS: A Turkish version of the MEQ, which was originally designed by Horne and Ostberg (1976), was given to 618 (291 women and 327 men) volunteers, aged 18 to 57 (23.0+/-5.4 years). Participants were recruited from the university student population and staff who were not night-shift workers. Exclusion criteria included sleep disorders and a history of medical and psychiatric diagnoses. The participants completed the questionnaire twice, 15-20 days apart. The reliability was assessed by Cronbach's and Pearson's r coefficient. RESULTS: MEQ scores were 51.9+/-9.0 (range 22-73) and 52.4+/-9.5 (range 21-72) for the 1st and 2nd applications, respectively, and did not differ significantly between the two applications. Of the 618 subjects interviewed, 149 were self-reported as morning types at the 1st application and 169 as morning types at the 2nd application; 79 as evening types at the 1st application and 87 as evening types at the 2nd application; and 390 as intermediate types at the 1st application and 362 as intermediate types at the 2nd application. Cronbach's a was 0.785 and 0.812 for the 1st and 2nd applications, respectively, and the test-retest reliability coefficient was 0.84 (p< 0.0001). DISCUSSION: The Turkish version of the MEQ shows high reliability. Nevertheless, further evaluation using different subject groups such as the elderly, athletes and shift workers is required to confirm the reliability and validity of the Turkish version.

Myocardial performance and aortic elastic properties in elite basketball and soccer players: relationship with aerobic and anaerobic capacity.

The aims of the present study were to examine the myocardial performance index and aortic elastic properties of athletes engaged in ball sports and to determine their relationships with aerobic and anaerobic characteristics. Standard M-mode and Doppler echocardiography, maximal oxygen uptake and 30 sec Wingate tests were performed for 32 elite male athletes (12 basketball and 20 soccer players) and 12 healthy sedentary volunteers. Data were analyzed by ANOVA and partial correlation coefficient tests. Absolute values of left ventricular internal diameter, left ventricular posterior wall and interventricular septum thicknesses in diastole were significantly (p < 0.05-0.01) greater in athletes than in controls. The left ventricular internal diameter corrected by body surface area was also greater (p < 0.05-0.01) in the athletes compared with the controls. Absolute and body surface area corrected left ventricular mass were significantly greater (p < 0.05-0.001) in athletes than in controls. Isovolumetric relaxation time was higher (p < 0.01) in soccer players than in controls. There were no significant differences among the groups for myocardial performance index and aortic elastic properties. Left ventricular mass index was poorly correlated (p < 0.01) with VO2max (r = 0.410), peak power (r = 0.439) and average power (r = 0.464) in the athletes. Poor correlations (r = 0.333-0.350, p < 0.05) were also observed between aortic elastic properties and average power in athletes. Myocardial performance index and aortic elastic properties are not different in athletes involved in this study compared with sedentary subjects. Aerobic and anaerobic capacities of the athletes used in this study are poorly explained by these resting echocardiographic findings. Key PointsLeft ventricular internal diameter, left ventricular posterior wall and interventricular septum thicknesses in diastole, and left ventricular mass were significantly greater in athletes than in controls.There were no remarkable differences in Doppler velocities and time intervals between athletes and controls.Myocardial performance index and aortic elastic properties are not different in athletes compared with sedentary subjects.Aerobic and anaerobic parameters of athletes are poorly explained by resting echocardiographic characteristics.VO2max and anaerobic power indices are variables that better determines left ventricular mass developed in ball sport specific training.

A multi-station proprioceptive exercise program in patients with bilateral knee osteoarthrosis: functional capacity, pain and sensoriomotor function. A randomized controlled trial.

We investigated the effects of a multi-station proprioceptive exercise program on functional capacity, perceived knee pain, and sensoriomotor function. Twenty-two patients (aged 41-75 years) with grade 2-3 bilateral knee osteoarthrosis were randomly assigned to two groups: treatment (TR; n = 12) and non-treatment (NONTR; n = 10). TR performed 11 different balance/coordination and proprioception exercises, twice a week for 6 weeks. Functional capacity and perceived knee pain during rest and physical activity was measured. Also knee position sense, kinaesthesia, postural control, isometric and isokinetic knee strength (at 60, 120 and 180°·s(-1)) measures were taken at baseline and after 6 weeks of training. There was no significant difference in any of the tested variables between TR and NONTR before the intervention period. In TR perceived knee pain during daily activities and functional tests was lessened following the exercise program (p < 0.05). Perceived knee pain was also lower in TR vs. NONTR after training (p < 0.05). The time for rising from a chair, stair climbing and descending improved in TR (p < 0.05) and these values were faster compared with NONTR after training (p < 0.05). Joint position sense (degrees) for active and passive tests and for weight bearing tests improved in TR (p < 0.05) and the values were lower compared with NONTR after training (p < 0.05). Postural control ('eyes closed') also improved for single leg and tandem tests in TR (p < 0.01) and these values were higher compared with NONTR after training. The isometric quadriceps strength of TR improved (p < 0.05) but the values were not significantly different compared with NONTR after training. There was no change in isokinetic strength for TR and NONTR after the training period. The results suggest that using a multi-station proprioceptive exercise program it is possible to improve postural control, functional capacity and decrease perceived knee pain in patients with bilateral knee osteoarthrosis. Key PointsIt is possible to improve postural control, functional capacity and decrease perceived knee pain in patients with bilateral knee osteoarthrosis with a pure proprioceptive/ balance exercise program used in the present study.The exercise regime used in the present study was as effective as previous studies, but of much shorter duration and utilized unsophisticated, inexpensive equipment which is available in most physiotherapy departments.Therefore, the incorporation of this exercise program into clinical practice is readily feasible.

Muscle mass, isokinetic torque, and functional capacity in women with osteoarthritis of the knee.

OBJECTIVES: To investigate the relations between cross-sectional area and concentric and eccentric torques in the quadriceps and hamstring muscles and to determine how functional capacity relates to pain, muscle mass, and concentric and eccentric knee torques in women who have bilateral osteoarthritis (OA) of the knee. DESIGN: Randomized, descriptive study. SETTING: A university exercise physiology laboratory in Turkey. PARTICIPANTS: Eighteen women with bilateral knee OA (grades 2 or 3) graded radiographically. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Selected functional tests included the 15-m walk, rising from a chair, descending stairs, and stair climbing. Pain during the functional tests was subjectively measured on an 11-point scale (range, 0-10). Concentric and eccentric torques of the quadriceps and hamstring muscles were measured by isokinetic dynamometry with angular velocities of 60 degrees, 120 degrees, and 180 degrees /s; cross-sectional areas of the quadriceps and hamstring muscles were measured by computed tomography. RESULTS: Eccentric torque was significantly (P range, <.05 to.001) greater than concentric torque for the quadriceps (range, 16%-100%) and hamstring (range, 50%-158%) muscles at all angular velocities. Torque-velocity curves for concentric and eccentric contractions were almost identical to those found in healthy young and elderly people. According to r(2) values, cross-sectional area of the quadriceps and hamstring muscles explained 24% to 61% (r(2) range,.24-.61) and 38% to 51% (r(2) range,.38-.51) of the variations in concentric and eccentric peak torques, respectively. Very small to moderate correlations (.01-.75) were observed among torque at any velocity and the variables of functional capacity and pain. For stair-climbing times, the best predictor variable was the eccentric hamstring to concentric quadriceps torque ratio. For stair descending, it was the concentric hamstring to eccentric quadriceps torque ratios. These torque ratios explained 81% (r(2)=.81) and 61% (r(2)=.61) of the variations, respectively. CONCLUSIONS: The findings in a patient group with bilateral OA of the knee showed that (1) eccentric torque is greater than concentric torque in knee muscles; (2) the correlation coefficients (r) between concentric and eccentric torques at different velocities (r range,.63-.86), but not between reciprocal torque ratios (r range,.02-.69), are good; (3) cross-sectional area cannot be considered as a single predictor of peak torque for either quadriceps or hamstring muscles; and (4) the variation in descending stairs and stair-climbing capacities can be explained by the reciprocal torque ratios of knee muscles.

Influence of acute exercise on oxidative stress in chronic smokers.

The relative oxidative insult caused by exercise and smoking on biological systems are well documented, however, their cumulative influence needs to be clarified. In order to examine the collective effects of exercise and smoking on oxidant and antioxidant parameters, young male smokers (n=10) and non-smokers (n=10) made to perform a negative slope (10%) cycling exercise for 30 minutes at individual load equivalent to 60% maximal oxygen consumption (VO2max). Pre- and post-exercise (post-ex) haematocrit, haemoglobin, white blood cells, plasma malondialdehyde (MDA) levels, protein carbonyl formation and non-HDL oxidation, erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities, serum ceruloplasmin (CER) and urinary cotinine concentrations were evaluated. Pre-ex CER and urinary cotinine concentrations of smokers were significantly higher (p<0.05 and p<0.01, respectively) compared to that of non-smokers and pre-ex CER concentrations were significantly correlated with cotinine levels in all subjects (p<0.05). Significant (p<0.01) increases were observed in non-HDL oxidation following the exercise in both groups and the elevations were more pronounced in smokers. Pre-ex SOD and GPX activities were not different between the two groups, however post-ex enzyme activities were significantly reduced in smokers (p<0.05). MDA and protein carbonyl concentrations were not different between the two groups and there were not any significant changes due to exercise.In conclusion, according to the results of the present study, we suggest that erythrocyte antioxidants SOD and GPX and plasma non-HDL are more prone to the possible oxidant damage of acute physical exercise in chronic smokers.

Concentric versus combined concentric-eccentric isokinetic training: effects on functional capacity and symptoms in patients with osteoarthrosis of the knee.

OBJECTIVE: To compare the effects of concentric and coupled concentric-eccentric isokinetic resistance training on functional capacity and symptoms of patients with osteoarthrosis (OA) of both knees. DESIGN: Repeated measures. SETTING: A university exercise physiology laboratory. PARTICIPANTS: Twenty-three volunteers, ages 41 to 75 years. Patients were randomly assigned to 3 groups: concentric (CON, n = 9), concentric-eccentric (CON-ECC, n = 8), and nontreatment (NONTX, n = 6). INTERVENTIONS: The CON group performed 12 concentric contractions of each knee extensor and flexor muscles; the CON-ECC group performed 6 concentric and 6 eccentric contractions of each knee muscle group by using a spectrum of angular velocities ranging from 30 degrees/s to 180 degrees/s with 30 degrees/s intervals, for both sides, 3 days a week for 8 weeks. MAIN OUTCOME MEASURES: Functional capacity (rising from a chair, walking, stair climbing and descending) and pain during rest and activities, peak torque, and cross-sectional area (CSA) of knee muscle groups of subjects were tested before and after training. RESULTS: Both training groups showed marked decreases (P <.001) in pain scores and increases (P <.001) in functional capacity together with increases (P <.05--.01) in peak torque and CSA of knee muscles. However, the NONTX group did not display these marked changes after the 8-week period. The results also indicated that concentric-eccentric training has a greater influence on functional capacity, especially stair climbing and descending, than that of concentric training when compared with NONTX group; however, the improvements in pain measurements were better in the CON group compared with the CON-ECC group after the training. CONCLUSIONS: The results suggest that with the isokinetic resistance training used in this study, it is possible to improve functional capacity and decrease pain in patients with OA of the knee. The results also showed that extensive training involving a high number of repetitions and eccentric contractions was safe, effective, and well tolerated for the patients with knee OA.

Effect of time of day on the relationship between lactate and ventilatory thresholds: a brief report.

The purpose of this investigation was to study the effect of time of day on the relationship between lactate (LT) and ventilatory thresholds (VT) of pulmonary oxygen uptake (VO2). Seven moderately active male volunteers (26.3 ± 3.0 years, 1.74 ± 0.08 m, 76 ± 5 kg) performed a maximal incremental test (increases of 30 W every 2 min) on a cycle ergometer on consecutive days at 0900 h, 1400h and 1900 h in a randomized fashion. The anaerobic threshold was determined using both ventilatory gas analysis and blood lactate measures. Each of the following variables was recorded both at VT and the LT; heart rate (HR, beats.min(-1)), minute ventilation (VE, L.min(-1)), respiratory exchange ratio (RER), time to threshold (Time, sec), oxygen uptake (VO2, ml·kg(-1).min(-1)) and VO2 as a percentage of maximal oxygen uptake (%VO2max). The correlations between VT and LT variables analyzed by Pearson product moment correlations for each time of day. ANOVA was used to compare the data obtained at different times of the day. There were no significant differences for the data related to time of day either for ventilatory gas analysis or lactate measurements. The correlation coefficients between VT and LT variables were moderate to high (r=0.56-0.94) for time of day. However, the correlations for HR, VO2, and %VO2max (r=0.81-0.94) were slightly stronger compared with Time, VE and RER (r=0.56-0.88). It was concluded that, the data at VT and LT were not influenced by time of day.