A novel method for accurate division of the gait cycle into seven phases using shank angular velocity.

BACKGROUND: Accurate detection of gait events is crucial for gait analysis, enabling the assessment of gait patterns and abnormalities. Inertial measurement unit (IMU) sensors have gained traction for event detection, mainly focusing on initial contact (IC) and toe-off (TO) events. However, effective detection of other key events such as heel rise (HR), feet adjacent (FA), and tibia vertical (TBV) is essential for comprehensive gait analysis. RESEARCH QUESTION: Can a novel IMU-based method accurately detect HR, TO, FA, and TBV events, and how does its performance compare with existing methods? METHODS: We developed and validated an IMU-based method using cumulative mediolateral shank angular velocity (CSAV) for event detection. A dataset of nearly 25,000 gait cycles from healthy adults walking at varying speeds and footwear conditions was used for validation. The method's accuracy was assessed against force plate and motion capture data and compared with existing TO detection methods. RESULTS: The CSAV method demonstrated high accuracy in detecting TO, FA, and TBV events and moderate accuracy in HR event detection. Comparisons with existing TO detection methods showcased superior performance. The method's stability across speed and shoe variations underscored its robustness. SIGNIFICANCE: This study introduces a highly accurate IMU-based method for detecting gait events needed to divide the gait cycle into seven phases. The effectiveness of the CSAV method in capturing essential events across different scenarios emphasizes its potential applications. Although HR event detection can be further improved, the precision of the CSAV method in TO, FA, and TBV detection advance the field. This study bridges a critical gap in IMU-based gait event detection by introducing a method for subdividing the swing phase into its subphases. Further research can focus on refining HR detection and expanding the method's utility across diverse gait contexts, thereby enhancing its clinical and scientific significance.

Cortical and spinal responses to short-term strength training and detraining in young and older adults in rectus femoris muscle.

INTRODUCTION: Strength training mitigates the age-related decline in strength and muscle activation but limited evidence exists on specific motor pathway adaptations. METHODS: Eleven young (22-34 years) and ten older (66-80 years) adults underwent five testing sessions where lumbar-evoked potentials (LEPs) and motor-evoked potentials (MEPs) were measured during 20 and 60% of maximum voluntary contraction (MVC). Ten stimulations, randomly delivered, targeted 25% of maximum compound action potential for LEPs and 120, 140, and 160% of active motor threshold (aMT) for MEPs. The 7-week whole-body resistance training intervention included five exercises, e.g., knee extension (5 sets) and leg press (3 sets), performed twice weekly and was followed by 4 weeks of detraining. RESULTS: Young had higher MVC (~ 63 N·m, p = 0.006), 1-RM (~ 50 kg, p = 0.002), and lower aMT (~ 9%, p = 0.030) than older adults at baseline. Young increased 1-RM (+ 18 kg, p < 0.001), skeletal muscle mass (SMM) (+ 0.9 kg, p = 0.009), and LEP amplitude (+ 0.174, p < 0.001) during 20% MVC. Older adults increased MVC (+ 13 N·m, p = 0.014), however, they experienced decreased LEP amplitude (- 0.241, p < 0.001) during 20% MVC and MEP amplitude reductions at 120% (- 0.157, p = 0.034), 140% (- 0.196, p = 0.026), and 160% (- 0.210, p = 0.006) aMT during 60% MVC trials. After detraining, young and older adults decreased 1-RM, while young adults decreased SMM. CONCLUSION: Higher aMT and MEP amplitude in older adults were concomitant with lower baseline strength. Training increased strength in both groups, but divergent modifications in cortico-spinal activity occurred. Results suggest that the primary locus of adaptation occurs at the spinal level.

Differential modulation of corticomotor excitability in older compared to young adults following a single bout of strength -exercise.

Evidence shows corticomotor plasticity diminishes with age. Nevertheless, whether strength-training, a proven intervention that induces corticomotor plasticity in younger adults, also takes effect in older adults, remains untested. This study examined the effect of a single-session of strength-exercise on corticomotor plasticity in older and younger adults. Thirteen older adults (72.3 ± 6.5 years) and eleven younger adults (29.9 ± 6.9 years), novice to strength-exercise, participated. Strength-exercise involved four sets of 6-8 repetitions of a dumbbell biceps curl at 70-75% of their one-repetition maximum (1-RM). Muscle strength, cortical, corticomotor and spinal excitability, before and up to 60-minutes after the strength-exercise session were assessed. We observed significant changes over time (p < 0.05) and an interaction between time and age group (p < 0.05) indicating a decrease in corticomotor excitability (18% p < 0.05) for older adults at 30- and 60-minutes post strength-exercise and an increase (26% and 40%, all p < 0.05) in younger adults at the same time points. Voluntary activation (VA) declined in older adults immediately post and 60-minutes post strength-exercise (36% and 25%, all p < 0.05). Exercise had no effect on the cortical silent period (cSP) in older adults however, in young adults cSP durations were shorter at both 30- and 60- minute time points (17% 30-minute post and 9% 60-minute post, p < 0.05). There were no differences in short-interval cortical inhibition (SICI) or intracortical facilitation (ICF) between groups. Although the corticomotor responses to strength-exercise were different within groups, overall, the neural responses seem to be independent of age.

Effects of the EXECP Intervention on Motor Function, Muscle Strength, and Joint Flexibility in Individuals with Cerebral Palsy.

PURPOSE: Numerous exercise interventions to enhance motor function in cerebral palsy (CP) have been proposed, with varying degrees of effectiveness. Because motor function requires a combination of muscle strength, joint flexibility, and motor coordination, we designed a supervised multicomponent exercise intervention (EXErcise for Cerebral Palsy, or EXECP) for individuals with CP. Our aim was to evaluate the effects of the EXECP intervention and its retention after it ceased. METHODS: The EXECP intervention combined strength training for the lower limbs and trunk muscles, passive stretching for the lower limb muscles, and inclined treadmill gait training. Eighteen participants with CP (mean age, 14 yr; 13 were male) were tested twice before the 3-month intervention and twice after the intervention, each test separated by 3 months. Seventeen typically developing age- and sex-matched controls were tested twice. Motor function was assessed with the 6-min walking test (6MWT) and the gross motor function measure dimensions D and E. Passive joint flexibility was measured with goniometry. Isometric and concentric muscle strength were assessed at the knee, ankle, and trunk joints. RESULTS: The EXECP intervention successfully increased 6MWT ( P < 0.001), gross motor function measure ( P = 0.004), and muscle strength for knee and trunk muscles ( P < 0.05), although no changes were observed for ankle joint muscles. Hip and knee joint flexibility also increased ( P < 0.05). After the retention period, all tested variables except the 6MWT and knee joint flexibility regressed and were not different from the pretests. CONCLUSIONS: The improvements in strength, flexibility, and possibly motor coordination brought by the EXECP intervention were transferred to significant functional gains. The regression toward baseline after the intervention highlights that training must be a lifelong decision for individuals with CP.

Contraction intensity modulates spinal excitability during transcranial magnetic stimulation-evoked silent period in rectus femoris muscle.

PURPOSE: Reduced spinal excitability during the transcranial magnetic stimulation (TMS) silent period (SP) has recently been shown to last longer than previously thought in the upper limbs, as assessed via spinal electrical stimulation. Further, there is reason to expect that contraction intensity affects the duration of the reduced spinal excitability. METHODS: This study investigated spinal excitability at different time delays within the TMS-evoked SP in m.rectus femoris. Fifteen participants performed non-fatiguing isometric knee extensions at 25%, 50% and 75% of maximum voluntary contraction (MVC). Lumbar stimulation (LS) induced a lumbar-evoked potential (LEP) of 50% resting M-max. TMS stimulator output induced a SP lasting ~ 200 ms. In each contraction, a LEP (unconditioned) was delivered ~ 2-3 s prior to TMS, which was followed by a second LEP (conditioned) 60, 90, 120 or 150 ms into the silent period. Five contractions were performed at each contraction intensity and for each time delay in random order. RESULTS: Compared to the unconditioned LEP, the conditioned LEP amplitude was reduced (- 28 ± 34%, p = 0.007) only at 60 ms during 25% of MVC. Conditioned LEP amplitudes during 50% and 75% of MVC were reduced at 60 ms (- 37 ± 47%, p = 0.009 and - 37 ± 42%, p = 0.005, respectively) and 150 ms (- 30% ± 37%, p = 0.0083 and - 37 ± 43%, p = 0.005, respectively). LEP amplitude at 90 ms during 50% of MVC also reduced (- 25 ± 35%, p = 0.013). CONCLUSION: Reduced spinal excitability is extended during 50% and 75% of MVC. In future, paired TMS-LS could be a potential method to understand changes in spinal excitability during SP (at different contraction intensities) when testing various neurophysiological phenomena.

Test-retest reliability of cortico-spinal measurements in the rectus femoris at different contraction levels.

Single-pulse Transcranial Magnetic Stimulation (TMS) and, very recently, lumbar stimulation (LS) have been used to measure cortico-spinal excitability from various interventions using maximal or submaximal contractions in the lower limbs. However, reliability studies have overlooked a wide range of contraction intensities for MEPs, and no reliability data is available for LEPs. This study investigated the reliability of motor evoked potentials and lumbar evoked potentials at different stimulation intensities and contraction levels in m.rectus femoris. Twenty-two participants performed non-fatiguing isometric knee extensions at 20 and 60% of maximum voluntary contraction (MVC). LS induced a lumbar-evoked potential (LEP) of 25 and 50% resting maximal compound action potential (M-max). TMS stimulator output was adjusted to 120, 140, and 160% of active motor threshold (aMT). In each contraction, a single MEP or LEP was delivered. Ten contractions were performed at each stimulator intensity and contraction level in random order. Moderate-to-good reliability was found when LEP was normalized to M-max/Root Mean Square in all conditions (ICC:0.74-0.85). Excellent reliability was found when MEP was normalized to Mmax for all conditions (ICC > 0.90) at 60% of MVC. Good reliability was found for the rest of the TMS conditions. Moderate-to-good reliability was found for silent period (SP) elicited by LS (ICC: 0.71-0.83). Good-to-excellent reliability was found for SP elicited by TMS (ICC > 0.82). MEPs and LEPs elicited in m.rectus femoris appear to be reliable to assess changes at different segments of the cortico-spinal tract during different contraction levels and stimulator output intensities. Furthermore, the TMS- and LS- elicited SP was a reliable tool considered to reflect inhibitory processes at spinal and cortical levels.

Corticospinal Adaptation to Short-Term Horizontal Balance Perturbation Training.

Sensorimotor training and strength training can improve balance control. Currently, little is known about how repeated balance perturbation training affects balance performance and its neural mechanisms. This study investigated corticospinal adaptation assessed by transcranial magnetic stimulation (TMS) and Hoffman-reflex (H-reflex) measurements during balance perturbation induced by perturbation training. Fourteen subjects completed three perturbation sessions (PS1, PS2, and PS3). The perturbation system operated at 0.25 m/s, accelerating at 2.5 m/s2 over a 0.3 m displacement in anterior and posterior directions. Subjects were trained by over 200 perturbations in PS2. In PS1 and PS3, TMS and electrical stimulation elicited motor evoked potentials (MEP) and H-reflexes in the right leg soleus muscle, at standing rest and two time points (40 ms and 140 ms) after perturbation. Body sway was assessed using the displacement and velocity of the center of pressure (COP), which showed a decrease in PS3. No significant changes were observed in MEP or H-reflex between sessions. Nevertheless, Δ MEP at 40 ms demonstrated a positive correlation with Δ COP, while Δ H-reflex at 40 ms demonstrated a negative correlation with Δ COP. Balance perturbation training led to less body sway and a potential increase in spinal-level involvement, indicating that movement automaticity may be suggested after perturbation training.

Modulation of H-reflex and V-wave responses during dynamic balance perturbations.

Motoneuron excitability is possible to measure using H-reflex and V-wave responses. However, it is not known how the motor control is organized, how the H-reflex and V-wave responses modulate and how repeatable these are during dynamic balance perturbations. To assess the repeatability, 16 participants (8 men, 8 women) went through two, identical measurement sessions with ~ 48 h intervals, where maximal isometric plantar flexion (IMVC) and dynamic balance perturbations in horizontal, anterior-posterior direction were performed. Soleus muscle (SOL) neural modulation during balance perturbations were measured at 40, 70, 100 and 130 ms after ankle movement by using both H-reflex and V-wave methods. V-wave, which depicts the magnitude of efferent motoneuronal output (Bergmann et al. in JAMA 8:e77705, 2013), was significantly enhanced as early as 70 ms after the ankle movement. Both the ratio of M-wave-normalized V-wave (0.022-0.076, p < 0.001) and H-reflex (0.386-0.523, p < 0.001) increased significantly at the latency of 70 ms compared to the latency of 40 ms and remained at these levels at latter latencies. In addition, M-wave normalized V-wave/H-reflex ratio increased from 0.056 to 0.179 (p < 0.001). The repeatability of V-wave demonstrated moderate-to-substantial repeatability (ICC = 0.774-0.912) whereas the H-reflex was more variable showing fair-to-substantial repeatability (ICC = 0.581-0.855). As a conclusion, V-wave was enhanced already at 70 ms after the perturbation, which may indicate that increased activation of motoneurons occurred due to changes in descending drive. Since this is a short time-period for voluntary activity, some other, potentially subcortical responses might be involved for V-wave increment rather than voluntary drive. Our results addressed the usability and repeatability of V-wave method during dynamic conditions, which can be utilized in future studies.

Revising the stretch reflex threshold method to measure stretch hyperreflexia in cerebral palsy.

Hyper-resistance is an increased resistance to passive muscle stretch, a common feature in neurological disorders. Stretch hyperreflexia, an exaggerated stretch reflex response, is the neural velocity-dependent component of hyper-resistance, and has been quantitatively measured using the stretch reflex threshold (i.e., joint angle at the stretch reflex electromyographic onset). In this study, we introduce a correction in how the stretch reflex threshold is calculated, by accounting for the stretch reflex latency (i.e., time between the stretch reflex onset at the muscle spindles and its appearance in the electromyographic signal). Furthermore, we evaluated how this correction affects the stretch reflex threshold in children and young adults with spastic cerebral palsy. A motor-driven ankle dynamometer induced passive ankle dorsiflexions at four incremental velocities in 13 children with cerebral palsy (mean age: 13.5 years, eight males). The stretch reflex threshold for soleus and medial gastrocnemius muscles was calculated as 1) the joint angle corresponding to the stretch reflex electromyographic onset (i.e., original method); and as 2) the joint angle corresponding to the electromyographic onset minus the individual Hoffmann-reflex latency (i.e., latency corrected method). The group linear regression slopes between stretch velocity and stretch reflex threshold differed in both muscles between methods (p < 0.05). While the original stretch reflex threshold was velocity dependent in both muscles (p < 0.05), the latency correction rendered it velocity independent. Thus, the effects of latency correction on the stretch reflex threshold are substantial, especially at higher stretch velocities, and should be considered in future studies.

Reliability of transcranial magnetic stimulation and H-reflex measurement during balance perturbation tasks.

Following ankle movement, posterior balance perturbation evokes short- (SLR ∼30-50 ms), medium- (MLR ∼50-60 ms), and long-latency responses (LLR ∼70-90 ms) in soleus muscle before voluntary muscle contraction. Transcranial magnetic stimulation (TMS) and Hoffmann-reflex (H-reflex) measurements can provide insight into the contributions of corticospinal and spinal mechanisms to each response. Motor evoked potential (MEP) and H-reflex responses have shown good reliability in some dynamic muscle contraction tasks. However, it is still unclear how reliable these methods are in dynamic balance perturbation and corticospinal modulation during long amplitude balance perturbation tasks. 14 subjects completed two test sessions in this study to evaluate the reliability of MEPs, H-reflex, and corticospinal modulation during balance perturbation. In each session, the balance perturbation system operated at 0.25 m/s, accelerating at 2.5 m/s2 over 0.3 m displacement. MEPs and H-reflexes were elicited in the right leg soleus muscle at four delays after ankle movement (10 ms, 40 ms, 80 ms, and 140 ms), respectively. Test-retest reliability of MEP and H-reflex amplitudes were assessed via intraclass correlation coefficients (ICC) both between- and within-session. Between-session test-retest reliability for MEPs was excellent (ICC = 0.928-0.947), while H-reflex demonstrated moderate-to-good reliability (ICC = 0.626-0.887). Within-session reliability for both MEPs and H-reflex was excellent (ICC = 0.927-0.983). TMS and H-reflex measurements were reliable at different delays after perturbation between- and within-sessions, which indicated that these methods can be used to measure corticospinal excitability during balance perturbation.

Determining the cortical, spinal and muscular adaptations to strength-training in older adults: A systematic review and meta-analysis.

There are observable decreases in muscle strength as a result of ageing that occur from the age of 40, which are thought to occur as a result of changes within the neuromuscular system. Strength-training in older adults is a suitable intervention that may counteract the age-related loss in force production. The neuromuscular adaptations (i.e., cortical, spinal and muscular) to strength-training in older adults are largely equivocal and a systematic review with meta-analysis will serve to clarify the present circumstances regarding the benefits of strength-training in older adults. 20 studies entered the meta-analysis and were analysed using a random-effects model. A best evidence synthesis that included 36 studies was performed for variables that had insufficient data for meta-analysis. One study entered both. There was strong evidence that strength-training increases maximal force production, rate of force development and muscle activation in older adults. There was limited evidence for strength-training to improve voluntary-activation, the volitional-wave and spinal excitability, but strong evidence for increased muscle mass. The findings suggest that strength-training performed between 2 and 12 weeks increases strength, rate of force development and muscle activation, which likely improves motoneurone excitability by increased motor unit recruitment and improved discharge rates.

Modulations of corticospinal excitability following rapid ankle dorsiflexion in skill- and endurance-trained athletes.

PURPOSE: Long-term sports training, such as skill and endurance training, leads to specific neuroplasticity. However, it remains unclear if muscle stretch-induced proprioceptive feedback influences corticospinal facilitation/inhibition differently between skill- and endurance-trained athletes. This study investigated modulation of corticospinal excitability following rapid ankle dorsiflexion between well-trained skill and endurance athletes. METHODS: Ten skill- and ten endurance-trained athletes participated in the study. Corticospinal excitability was tested by single- and paired-pulse transcranial magnetic stimulations (TMS) at three different latencies following passive rapid ankle dorsiflexion. Motor evoked potential (MEP), short-latency intracortical inhibition (SICI), intracortical facilitation (ICF), and long-latency intracortical inhibition (LICI) were recorded by surface electromyography from the soleus muscle. RESULTS: Compared to immediately before ankle dorsiflexion (Onset), TMS induced significantly greater MEPs during the supraspinal reaction period (~ 120 ms after short-latency reflex, SLR) in the skill group only (from 1.7 ± 1.0 to 2.7 ± 1.8%M-max, P = 0.005) despite both conditions being passive. ICF was significantly greater over all latencies in skill than endurance athletes (F (3, 45) = 4.64, P = 0.007), although no between-group differences for stimulations at specific latencies (e.g., at SLR) were observed. CONCLUSION: The skill group showed higher corticospinal excitability during the supraspinal reaction phase, which may indicate a "priming" of corticospinal excitability following rapid ankle dorsiflexion for a supraspinal reaction post-stretch, which appears absent in endurance-trained athletes.

Determining the Corticospinal Responses and Cross-Transfer of Ballistic Motor Performance in Young and Older Adults: A Systematic Review and Meta-Analysis.

Ballistic motor training induces plasticity changes and imparts a cross-transfer effect. However, whether there are age-related differences in these changes remain unclear. Thus, the purpose of this study was to perform a meta-analysis to determine the corticospinal responses and cross-transfer of motor performance following ballistic motor training in young and older adults. Meta-analysis was performed using a random-effects model. A best evidence synthesis was performed for variables that had insufficient data for meta-analysis. There was strong evidence to suggest that young participants exhibited greater cross-transfer of ballistic motor performance than their older counterparts. This meta-analysis showed no significant age-related differences in motor-evoked potentials (MEPs), short-interval intracortical inhibition (SICI) and surface electromyography (sEMG) for both hands following ballistic motor training.

Corticospinal and intracortical excitability is modulated in the knee extensors after acute strength training.

The corticospinal responses to high-intensity and low-intensity strength-training of the upper limb are modulated in an intensity-dependent manner. Whether an intensity-dependent threshold occurs following acute strength training of the knee extensors (KE) remains unclear. We assessed the corticospinal responses following high-intensity (85% of maximal strength) or low-intensity (30% of maximal strength) KE strength-training with measures taken during an isometric KE task at baseline, post-5, 30 and 60-min. Twenty-eight volunteers (23 ± 3 years) were randomized to high-intensity (n = 11), low-intensity (n = 10) or to a control group (n = 7). Corticospinal responses were evoked with transcranial magnetic stimulation at intracortical and corticospinal levels. High- or low-intensity KE strength-training had no effect on maximum voluntary contraction force post-exercise (P > 0.05). High-intensity training increased corticospinal excitability (range 130-180%) from 5 to 60 min post-exercise compared to low-intensity training (17-30% increase). Large effect sizes (ES) showed that short-interval cortical inhibition (SICI) was reduced only for the high-intensity training group from 5-60 min post-exercise (24-44% decrease) compared to low-intensity (ES ranges 1-1.3). These findings show a training-intensity threshold is required to adjust CSE and SICI following strength training in the lower limb.

High Responders to Hypertrophic Strength Training Also Tend to Lose More Muscle Mass and Strength During Detraining Than Low Responders.

ABSTRACT: Räntilä, A, Ahtiainen, JP, Avela, J, Restuccia, J, Kidgell, DJ, and Häkkinen, K. High responders to hypertrophic strength training also tend to lose more muscle mass and strength during detraining than low responders. J Strength Cond Res 35(6): 1500-1511, 2021-This study investigated differences in individual responses to muscle hypertrophy during strength training and detraining. Ten weeks of resistance training was followed by 6 weeks of detraining in men (n = 24). Bilateral leg press (LP) one-repetition maximum (1RM) and maximal electromyography (EMGs) of vastus lateralis (VL) and vastus medialis, maximal voluntary activation (VA), transcranial magnetic stimulation for corticospinal excitability (CE), cross-sectional area of VL (VLCSA), selected serum hormone concentrations were measured before and repeatedly during training and detraining. In the total group, VLCSA increased by 10.7% (p = 0.025) and LP 1RM by 16.3% (p < 0.0001) after training. The subjects were split into 3 groups according to increases in VLCSA: high responders (HR) > 15% (n = 10), medium responders (MR) 15-4.5% (n = 7), and low responders (LR) < 4.5% (n = 7). Vastus lateralis CSA in HR and MR increased statistically significantly from pre to posttraining but not in LR. Only HR increased LP 1RM statistically significantly from pre to post. Maximal EMG activity increased 21.3 ± 22.9% from pre- to posttraining for the total group (p = 0.009) and for MR (p < 0.001). No significant changes occurred in VA and CE or serum hormone concentrations. During detraining, HR showed a decrease of -10.5% in VLCSA, whereas MR and LR did not. None of the subgroups decreased maximal strength during the first 3 weeks of detraining, whereas HR showed a slight (by 2.5%) rebound in strength. The present results suggest that strength gains and muscle activation adaptations may take place faster in HR and decrease also faster compared with other subgroups during detraining.

Exercise intervention protocol in children and young adults with cerebral palsy: the effects of strength, flexibility and gait training on physical performance, neuromuscular mechanisms and cardiometabolic risk factors (EXECP).

BACKGROUND: Individuals with cerebral palsy (CP) have problems in everyday tasks such as walking and climbing stairs due to a combination of neuromuscular impairments such as spasticity, muscle weakness, reduced joint flexibility and poor coordination. Development of evidence-based interventions are in pivotal role in the development of better targeted rehabilitation of CP, and thus in maintaining their motor function and wellbeing. Our aim is to investigate the efficacy of an individually tailored, multifaceted exercise intervention (EXECP) in children and young adults with CP. EXECP is composed of strength, flexibility and gait training. Furthermore, this study aims to verify the short-term retention of the adaptations three months after the end of the EXECP intervention. METHODS: Twenty-four children and young adults with spastic CP will be recruited to participate in a 9-month research project with a 3-month training intervention, consisting of two to three 90-min sessions per week. In each session, strength training for the lower limbs and trunk muscles, flexibility training for the lower limbs and inclined treadmill gait training will be performed. We will evaluate muscle strength, joint flexibility, neuromuscular and cardiometabolic parameters. A nonconcurrent multiple baseline design with two pre-tests and two post-tests all interspaced by three months is used. In addition to the CP participants, 24 typically developing age and sex-matched participants will perform the two pre-tests (i.e. no intervention) to provide normative data. DISCUSSION: This study has a comprehensive approach examining longitudinal effects of wide variety of variables ranging from physical activity and gross motor function to sensorimotor functions of the brain and neuromuscular and cardiometabolic parameters, providing novel information about the adaptation mechanisms in cerebral palsy. To the best of our knowledge, this is the first intervention study providing supervised combined strength, flexibility and gait training for young individuals with CP. TRIAL REGISTRATION NUMBER: ISRCTN69044459, prospectively registered (21/04/2017).

The Effects of Cold Water Immersion on the Recovery of Drop Jump Performance and Mechanics: A Pilot Study in Under-20 Soccer Players.

Cold water immersion (CWI) is a popular method used for enhancing recovery from exercise. However, the efficacy of this approach is inconclusive and studies investigating variables contributing to overall performance are scarce. Additionally, few studies have investigated the recovery of stretch-shortening cycle (SSC) performance after a fatiguing SSC task. The SSC occurs naturally in human locomotion and induces a recovery pattern different from isolated muscle contractions (e.g., pure eccentric exercise). Therefore, the main aim of this study was to investigate the effects of a single CWI on jumping performance and mechanics after exhaustive SSC exercise. On a sledge apparatus, 10 male under-20 soccer players (age 18-20 years) performed five sets of 20 maximal drop jumps (DJ) followed by continuous submaximal rebounding. Subjects were equally randomized into a passive recovery control (CON) or CWI group (10 ± 0.5°C for 20 min). Prior to, upon completion of, and at 24 and 48 h follow-ups, subjects performed maximal DJs recorded with a high-speed video camera. Blood samples were taken and subjective muscle soreness was measured. Rebound jump height was impaired immediately after exercise, although significant only for CWI (CON: -12.4 cm, p = 0.083; CWI: -9.9 cm, p = 0.009). The CWI group demonstrated significant recovery of jump height at 24 h (+6.3 cm, p = 0.031) and 48 h (+8.9 cm, p = 0.002) compared to post-exercise. Ankle joint stiffness was decreased for CWI (-2.1 to -2.5 Nm/°, p = 0.005-0.041). Creatine kinase activity was similarly increased for both groups at 24 and 48 h, while there was also no group effect in muscle soreness (p ≥ 0.056). This pilot study demonstrates the potential for CWI to slightly enhance the recovery of DJ performance. However, this occurred in parallel with reduced ankle joint stiffness, signifying that jumps were performed with less efficiency, which would not be favorable for repeated SSC actions. While this should be confirmed with a larger sample size, this highlights the potential for CWI to be detrimental to the mechanical properties of the ankle joint. Therefore, future recovery intervention studies should concomitantly investigate variables contributing to performance, rather than just overall performance itself.

On-Ice and Off-Ice Fitness Profiles of Elite and U20 Male Ice Hockey Players of Two Different National Standards.

Vigh-Larsen, JF, Haverinen, MT, Panduro, J, Ermidis, G, Andersen, TB, Overgaard, K, Krustrup, P, Parkkari, J, Avela, J, Kyröläinen, H, and Mohr, M. On-ice and off-ice fitness profiles of elite and U20 male ice hockey players of two different national standards. J Strength Cond Res 34(12): 3369-3376, 2020-Differences in body composition and performance were investigated between elite and U20 male ice hockey players of 2 different national standards. One hundred seventy-nine players were recruited from the highest Finnish (n = 82) and Danish (n = 61) national level, as well as from 1 U20 team from Finland (n = 19) and Denmark (n = 17). Body composition and countermovement jump performance (CMJ) were measured off-ice in addition to on-ice assessments of agility, 10- and 30-m sprint performance, and endurance capacity (the maximal Yo-Yo Intermittent Recovery Level 1 Ice Hockey Test, Yo-Yo IR1-IHmax). Large differences in on-ice performances were demonstrated between Finnish and Danish elite players for agility, 10- and 30-m sprint performance (2-3%, P ≤ 0.05), and Yo-Yo IR1-IHmax performance (15%, P ≤ 0.05). By contrast, no differences (P > 0.05) were present between elite players for CMJ ability or body composition. However, elite players possessed more body and muscle mass than U20 players. Finally, the Finnish U20 cohort had a similar performance level as the Danish elite players and superior 10-m sprint performance, whereas the Danish U20 level was inferior to the other groups in every performance assessment (P ≤ 0.05). In conclusion, on-ice speed and endurance differ markedly between elite players of 2 different national standards with no distinction in body composition or CMJ ability. Moreover, the most consistent difference between U20 and senior elite players was related to body and muscle mass. These results highlight the usefulness of on-ice assessments and suggest the importance of on-ice high-intensity training in elite players in addition to training targeted the development of lean body mass in youth prospects.

Older Age Increases the Amplitude of Muscle Stretch-Induced Cortical Beta-Band Suppression But Does not Affect Rebound Strength.

Healthy aging is associated with deterioration of the sensorimotor system, which impairs balance and somatosensation. However, the exact age-related changes in the cortical processing of sensorimotor integration are unclear. This study investigated primary sensorimotor cortex (SM1) oscillations in the 15-30 Hz beta band at rest and following (involuntary) rapid stretches to the triceps surae muscles (i.e., proprioceptive stimulation) of young and older adults. A custom-built, magnetoencephalography (MEG)-compatible device was used to deliver rapid (190°·s-1) ankle rotations as subjects sat passively in a magnetically-shielded room while MEG recorded their cortical signals. Eleven young (age 25 ± 3 years) and 12 older (age 70 ± 3 years) adults matched for physical activity level demonstrated clear 15-30 Hz beta band suppression and rebound in response to the stretches. A sub-sample (10 young and nine older) were tested for dynamic balance control on a sliding platform. Older adults had greater cortical beta power pre-stretch (e.g., right leg: 4.0 ± 1.6 fT vs. 5.6 ± 1.7 fT, P = 0.044) and, subsequently, greater normalized movement-related cortical beta suppression post-proprioceptive stimulation (e.g., right leg: -5.8 ± 1.3 vs. -7.6 ± 1.7, P = 0.01) than young adults. Furthermore, poorer balance was associated with stronger cortical beta suppression following proprioceptive stimulation (r = -0.478, P = 0.038, n = 19). These results provide further support that cortical processing of proprioception is hindered in older adults, potentially (adversely) influencing sensorimotor integration. This was demonstrated by the impairment of prompt motor action control, i.e., regaining perturbed balance. Finally, SM1 cortex beta suppression to a proprioceptive stimulus seems to indicate poorer sensorimotor functioning in older adults.