Carlos De la Fuente

High-speed resistance training is more effective than low-speed resistance training to increase functional capacity and muscle performance in older women

OBJECTIVE To examine the effects of 12 weeks of high-speed resistance training (RT) versus low-speed RT on muscle strength [one repetition of maximum leg-press (1RMLP) and bench-press (1RMBP), plus dominant (HGd) and non-dominant maximum isometric handgrip], power [counter-movement jump (CMJ), ball throwing (BT) and 10-m walking sprint (S10)], functional performance [8-foot up-and-go test (UG) and sit-to-stand test (STS)], and perceived quality of life in older women. METHODS 45 older women were divided into a high-speed RT group [EG, n=15, age=66.3±3.7y], a low-speed RT group [SG, n=15, age=68.7±6.4y] and a control group [CG, n=15, age=66.7±4.9y]. The SG and EG were submitted to a similar 12-week RT program [3 sets of 8 reps at 40-75% of the one-repetition maximum (1<RM), CMJ and BT] using slow, controlled (3s) concentric muscle actions for the SG and using fast, explosive (<1s) concentric muscle actions for the EG (20% less work per exercise without CMJ and BT). RESULTS Over the 12-week training period, both RT groups showed small to large clinically significant improvements in the dependent variables; however, a significant difference was found between the EG and SG for the performance changes in BT, S10 and UG (20% vs. 11%, p<0.05; 14% vs. 9%, p<0.05; 18% vs. 10%, p<0.01; respectively). No significant changes were observed for the CG. CONCLUSION Both RT interventions are effective in improving functional capacity, muscle performance and quality of life in older women, although a high-speed RT program induces greater improvements in muscle power and functional capacity.

Effects of plyometric training on maximal-intensity exercise and endurance in male and female soccer players

Abstract In a randomised controlled trial design, effects of 6 weeks of plyometric training on maximal-intensity exercise and endurance performance were compared in male and female soccer players. Young (age 21.1 ± 2.7 years) players with similar training load and competitive background were assigned to training (women, n = 19; men, n = 21) and control (women, n = 19; men, n = 21) groups. Players were evaluated for lower- and upper-body maximal-intensity exercise, 30 m sprint, change of direction speed and endurance performance before and after 6 weeks of training. After intervention, the control groups did not change, whereas both training groups improved jumps (effect size (ES) = 0.35–1.76), throwing (ES = 0.62–0.78), sprint (ES = 0.86–1.44), change of direction speed (ES = 0.46–0.85) and endurance performance (ES = 0.42–0.62). There were no differences in performance improvements between the plyometric training groups. Both plyometric groups improved more in all performance tests than the controls. The results suggest that adaptations to plyometric training do not differ between men and women.

Prospective randomized clinical trial of aggressive rehabilitation after acute Achilles tendon ruptures repaired with Dresden technique

BACKGROUND Rupture of the Achilles tendon is a common injury during working years. Aggressive rehabilitation may provide better outcomes, but also a greater chance of re-rupture. OBJECTIVE To determine if aggressive rehabilitation has better clinical outcomes for Achilles tendon function, Triceps surae function, one-leg heel rise capacity and lower complication rate during twelve weeks after percutaneous Achilles tendon repair compared to conventional rehabilitation. DESIGN Randomized controlled trial. METHOD Thirty-nine patients were prospectively randomized. The aggressive group (n=20, 41.4 ± 8.3 years) received rehabilitation from the first day after surgery. The conventional group (n=19, 41.7 ± 10.7 years) rested for 28 days, before rehabilitation started. The statistical parameters were the Achilles tendon rupture score (ATRS), verbal pain scale, time to return to work, pain medication consumption, Achilles tendon strength, dorsiflexion range of motion (RoM), injured-leg calf circumference, calf circumference difference, one-leg heel rise repetition and difference, re-rupture rate, strength deficit rate, and other complication rates. Mixed-ANOVA and Bonferronis post hoc test were performed for multiple comparisons. Students t-test was performed for parameters measured on the 12th week. RESULTS The aggressive group with respect to the conventional group had a higher ATRS; lower verbal pain score; lower pain medication consumption; early return to work; higher Achilles tendon strength; higher one-leg heel rise repetitions; and lower one-leg heel rise difference. The re-rupture rate was 5% and 5%, the strength deficit rate was 42% and 5%, and other complications rate was 11% and 15% in the conventional and aggressive group, respectively. CONCLUSION Patients with Dresden repair and aggressive rehabilitation have better clinical outcomes, Achilles tendon function and one-leg heel rise capacity without increasing the postoperative complications rate after 12 weeks compared to rehabilitation with immobilization and non-weight-bearing during the first 28 days after surgery.

High-speed resistance training in older women: The role of supervision

Older women participated in a 12-week high-speed resistance training program under two supervisor-to-subject ratio methods (i.e., high versus low supervision) to assess its effects on muscle strength, power, functional performance, and quality of life assessed before (T1) and after (T2) intervention. Women were divided into either the control group (CG, n = 15), high supervision group (HSG, n = 30), or low supervision group (LSG, n = 28). The training program included exercises requiring high-speed concentric muscle actions. No differences were observed among groups at T1. Between T1 and T2, the HSG showed a higher (p < .05) improvement in muscle strength (ES = 0.36-1.26), power (ES = 0.5-0.88), functional performance (ES = 0.52-0.78), and quality of life (ES = 0.44-0.82) compared with LSG and CG. High-speed resistance training under closer supervision is more effective for improving muscle strength, power, functional performance, and quality of life in older women.

Medial Gastrocnemius Myotendinous Junction Displacement and Plantar-Flexion Strength in Patients Treated With Immediate Rehabilitation After Achilles Tendon Repair

CONTEXT Pathologic plantar flexion frequently occurs after operative repair of the Achilles tendon (AT) because of immobilization and non-weight bearing in the first weeks of traditional rehabilitation. Novel rehabilitation strategies that apply mobilization and weight bearing have been proposed, but their effects on medial gastrocnemius myotendinous junction displacement (MJD) and isometric plantar-flexion strength (PFS) are unknown. OBJECTIVE To compare the effects of 12 weeks of immediate versus traditional rehabilitation on MJD and PFS in patients with percutaneous AT repair and to compare AT rupture scores (ATRSs) during follow-up. DESIGN Controlled laboratory study. SETTING Human performance laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 26 amateur soccer players (age = 42.3 ± 9.7 years, body mass index = 29.5 ± 3.9 kg/m2) with percutaneous AT repair. INTERVENTION(S) Athletes were randomly divided into 2 groups: an immediate group, given physical therapy from day 1 to day 84, and a traditional group, given physical therapy from day 29 to day 84. We used repeated-measures analysis of variance to compare the data. MAIN OUTCOME MEASURE(S) We measured MJD and PFS at days 28 (fourth week), 56 (eighth week), and 84 (12th week) after AT repair. RESULTS After 12 weeks of rehabilitation, we observed a large clinically meaningful effect and statistical difference between groups. At day 28, the immediate group showed higher values for PFS (P = .002), MJD (P = .02), and ATRS (P = .002) than the traditional group. At day 56, the immediate group presented higher values for MJD (P = .02) and ATRS (P = .009). At day 84, the immediate group registered more MJD (P = .001). CONCLUSIONS Compared with traditional rehabilitation, 12 weeks of immediate rehabilitation after percutaneous AT repair resulted in better MJD, PFS, and ATRS after 4 weeks; better MJD and ATRS after 8 weeks; and better MJD after 12 weeks.

Biomechanical properties of different techniques used in vitro for suturing mid-substance Achilles tendon ruptures

Background: The Dresden technique preserves the paratenon during Achilles tendon repair and may improve the plantarflexor mechanism when combined with mobilization during early rehabilitation. However, the surgical repair design for Achilles tendon ruptures can affect rates of re‐rupture or lengthening. Therefore, the aim of this study was to determine the biomechanical properties of the Krackow, Double‐Kessler, Double‐Dresden, and Triple‐Dresden techniques used for repairing mid‐substance Achilles tendon ruptures during cyclical and maximum traction. Methods: Sixty mid‐substance bovine tendons repaired after transverse rupturing were divided randomly into four groups by repair technique: Krackow, Double‐Kessler, Double‐Dresden, and Triple‐Dresden. Cyclical tractions of 4.7, 5.8, 7.9, and 11.7 mm (equivalent to 5°, 8°, 10°, and 15° of dorsal flexion, respectively) were applied to determine gapping, tensile strength, nominal suture stress, repair deformation, and specimens with clinical failure (gap > 5 mm). Maximal traction was applied to measure maximum strength and failure type (i.e. suture, knot, or tendon). Findings: The Triple‐Dresden technique resulted in decreased gapping, nominal suture stress, repair deformation, and quantity of specimens with clinical failure as compared to the other techniques. Furthermore, Triple‐Dresden tendons showed greater comparative tensile and maximum strength. During maximal traction testing, this technique presented tendon failure, whereas the Krackow, Double‐Kessler, and Double‐Dresden techniques had suture failures. Interpretation: Triple‐Dresden repair results in better cyclical and maximum traction strengths, suggesting that this technique might be more appropriate when performing early mobilization after mid‐substance Achilles tendon rupture repair. HighlightsTriple‐Dresden technique prevents gap generation during cyclical traction of Achilles tendon.Triple‐Dresden technique provides greater strength capacity after mid‐substance rupture.Triple‐Dresden technique tolerates clinical failure in Achilles tendon until 10° of dorsal flexion.Triple‐Dresden might be more appropriate when performing early mobilization after mid‐substance.

Absolute reliability and concurrent validity of hand held dynamometry and isokinetic dynamometry in the hip, knee and ankle joint: Systematic review and meta-analysis

Abstract The purpose of the study is to establish absolute reliability and concurrent validity between hand-held dynamometers (HHDs) and isokinetic dynamometers (IDs) in lower extremity peak torque assessment. Medline, Embase, CINAHL databases were searched for studies related to psychometric properties in muscle dynamometry. Studies considering standard error of measurement SEM (%) or limit of agreement LOA (%) expressed as percentage of the mean, were considered to establish absolute reliability while studies using intra-class correlation coefficient (ICC) were considered to establish concurrent validity between dynamometers. In total, 17 studies were included in the meta-analysis. The COSMIN checklist classified them between fair and poor. Using HHDs, knee extension LOA (%) was 33.59%, 95% confidence interval (CI) 23.91 to 43.26 and ankle plantar flexion LOA (%) was 48.87%, CI 35.19 to 62.56. Using IDs, hip adduction and extension; knee flexion and extension; and ankle dorsiflexion showed LOA (%) under 15%. Lower hip, knee, and ankle LOA (%) were obtained using an ID compared to HHD. ICC between devices ranged between 0.62, CI (0.37 to 0.87) for ankle dorsiflexion to 0.94, IC (0.91to 0.98) for hip adduction. Very high correlation were found for hip adductors and hip flexors and moderate correlations for knee flexors/extensors and ankle plantar/dorsiflexors.