Jeam Marcel Geremia

Effect of Light-Emitting Diodes Therapy (LEDT) on Knee Extensor Muscle Fatigue

OBJECTIVE The purpose of this study was to evaluate the effects of light-emitting diodes therapy (LEDT) on quadriceps muscle fatigue by using torque values from the isokinetic dynamometer as an outcome measure. BACKGROUND DATA Light therapy is considered an innovative way to prevent muscle fatigue. Although positive results have been obtained in animal models and in clinical experiments, no results are available on the effects of this therapeutic modality on human performance studies with isokinetic dynamometry. MATERIALS AND METHODS Seventeen healthy and physically active male volunteers were included in a crossover randomized double-blinded placebo-controlled trial. They performed two sessions of an isokinetic fatigue test (30 maximal concentric knee flexion-extension contractions; range of motion, 90 degrees; angular velocity, 180 degrees per second) after LEDT or placebo treatment. Maximal knee extensor muscle isokinetic voluntary contractions were performed before (PRE-MVC) and after (POST-MVC) the fatigue test. LEDT treatment was performed with a multidiode cluster probe (34 red diodes of 660 nm, 10 mW; 35 infrared diodes of 850 nm, 30 mW) at three points of the quadriceps muscle, with a total irradiating dose of 125.1 J. RESULTS No differences were observed in the PRE-MVC between LEDT (284.81 ± 4.52 Nm) and placebo (282.65 ± 52.64 Nm) treatments. However, for the POST-MVC, higher torques (p = 0.034) were observed for LEDT (237.68 ± 48.82 Nm) compared with placebo (225.68 ± 44.14 Nm) treatment. CONCLUSION LEDT treatment produced a smaller maximal isometric torque decrease after high-intensity concentric isokinetic exercise, which is consistent with an increase in performance.

MUSCLE ARCHITECTURE ADAPTATIONS TO KNEE EXTENSOR ECCENTRIC TRAINING: RECTUS FEMORIS VS. VASTUS LATERALIS

Introduction: Changes in muscle architecture induced by eccentric knee extensor training remain unclear, as well the adaptive responses of synergistic knee extensor muscles with different geometrical designs. Methods: Ultrasonography images were taken from rectus femoris (RF) and vastus lateralis (VL) of 20 male volunteers before and after a non‐training control period of 4 weeks, and additional evaluations were performed after 4, 8, and 12 weeks of isokinetic eccentric training. Results: RF and VL had significant changes in muscle architecture within the first 4 training weeks, and the adaptive response throughout the intervention was similar. Muscle thickness increased by around 7–10%, fascicle length increased 17–19%, and pennation angle was unchanged. Conclusions: Increased muscle thickness due to eccentric training was related to increased fascicle length and not to pennation angle changes. Although RF and VL have a different fascicular geometry, they had similar morphological adaptations to eccentric training. Muscle Nerve 48: 498–506, 2013

Time course of neuromuscular adaptations to knee extensor eccentric training.

This study investigated the chronology of neural and morphological adaptations to knee extensor eccentric training and their contribution to strength gains in isometric, concentric and eccentric muscle actions. 20 male healthy subjects performed a 12-week eccentric training program on an isokinetic dynamometer, and neuromuscular evaluations of knee extensors were performed every 4 weeks. After 12 training weeks, significant increases were observed for: isometric (24%), concentric (15%) and eccentric (29%) torques; isometric (29%) and eccentric (33%) electromyographic activity; muscle thickness (10%) and anatomical cross-sectional area (19%). Eccentric and isometric torques increased progressively until the end of the program. Concentric torque and muscle mass parameters increased until the eighth training week, but did not change from this point to the twelfth training week. Eccentric and isometric activation increased at 4 and 8 training weeks, respectively, while no change was found in concentric activation. These results suggest that: 1) the relative increment in concentric strength was minor and does not relate to neural effects; 2) eccentric and isometric strength gains up to 8 training weeks are explained by the increased neural activation and muscle mass, whereas the increments in the last 4 training weeks seem to be associated with other mechanisms.

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis

Knee osteoarthritis (OA) is associated with quadriceps atrophy and weakness, so muscle strengthening is an important point in the rehabilitation process. Since pain and joint stiffness make it often difficult to use conventional strength exercises, neuromuscular electrical stimulation (NMES) may be an alternative approach for these patients. This study was aimed at (1) identifying the associations of knee OA with quadriceps muscle architecture and strength, and (2) quantifying the effects of a NMES training program on these parameters. In phase 1, 20 women with knee OA were compared with 10 healthy female, asymptomatic, age‐matched control subjects. In phase 2, 12 OA patients performed an 8‐week NMES strength training program. OA patients presented smaller vastus lateralis thickness (11.9 mm) and fascicle length (20.5%) than healthy subjects (14.1 mm; 24.5%), and also had a 23% smaller knee extensor torque compared to the control group. NMES training increased vastus lateralis thickness (from 12.6 to 14.2 mm) and fascicle length (from 19.6% to 24.6%). Additionally, NMES training increased the knee extensor torque by 8% and reduced joint pain, stiffness, and functional limitation. In conclusion, OA patients have decreased strength, muscle thickness, and fascicle length in the knee extensor musculature compared to control subjects. NMES training appears to offset the changes in quadriceps structure and function, as well as improve the health status in patients with knee OA.

The structural and mechanical properties of the Achilles tendon 2 years after surgical repair.

BACKGROUND Acute ruptures of the Achilles tendon affect the tendons structural and mechanical properties. The long-term effects of surgical repair on these properties remain unclear. PURPOSE To evaluate effects of early mobilization versus traditional immobilization rehabilitation programs 2 years after surgical Achilles tendon repair, by comparing force-elongation and stress-strain relationships of the injured tendon to those of the uninjured tendon. METHODS A group of males with previous Achilles tendon rupture (n=18) and a group of healthy male controls (n=9) participated. Achilles tendon rupture group consisted of patients that had received early mobilization (n=9) and patients that had received traditional immobilization with a plaster cast (n=9). Comparisons of tendon structural and mechanical properties were made between Achilles tendon rupture and healthy control groups, and between the uninjured and injured sides of the two rehabilitation groups in Achilles tendon rupture group. Ultrasound was used to determine bilaterally tendon cross-sectional area, tendon resting length, and tendon elongation as a function of torque during maximal voluntary plantar flexion. From these data, Achilles tendon force-elongation and stress-strain relationships were determined. FINDINGS The Achilles tendon rupture group uninjured side was not different from healthy control group. Structural and mechanical parameters of the injured side were not different between the Achilles tendon rupture early mobilization and the immobilization groups. Compared to the uninjured side, the injured side showed a reduction in stress at maximal voluntary force, in Youngs modulus and in stiffness. INTERPRETATION Two years post-surgical repair, the Achilles tendon mechanical properties had not returned to the uninjured contralateral tendon values.

Maturity Status Does Not Exert Effects on Aerobic Fitness in Soccer Players After Appropriate Normalization for Body Size.

The present study investigated the effects of pubertal status on peak oxygen uptake (VO2peak), respiratory compensation point (RCP), and ventilatory threshold (VT) in young soccer players using different body size descriptors. Seventy-nine soccer players (14 prepubescent, 38 pubescent and 27 postpubescent) participated in this study. A maximal exercise test was performed to determine the VO2peak, RCP, and VT. Ultrasonography was used to measure lower limb muscle volume (LLMV). LLMV (mL-b) was rated as the most effective body size descriptor to normalize VO2peak (mLO2·mL-0.43·min-1), RCP (mLO2·mL-0.48·min-1), and VT (mLO2·mL- 0.40·min-1). The values of VO2peak, RCP, and VT relative to allometric exponents derived by LLMV were similar among groups (p > .05; 0.025 < η2 < 0.059) when the effect of chronological age was controlled. Allometric VO2peak, RCP, and VT values were: 100.1 ± 7.9, 107.5 ± 9.6, and 108.0 ± 10.3 mLO2.mL-0.43·min-1; 51.8 ± 5.3, 54.8 ± 4.7, and 57.3 ± 5.8 mLO2·mL-0.48·min-1; and 75.7 ± 7.1, 79.4 ± 7.0, and 80.9 ± 8.3 mLO2·mL- 0.40·min-1 for prepubertal, pubertal, and postpubertal groups, respectively. Maturity status showed no positive effect on VO2peak, RCP, and VT when the data were properly normalized by LLMV in young soccer players. Allometric normalization using muscle volume as a body size descriptor should be used to compare aerobic fitness between soccer players heterogeneous in chronological age, maturity status, and body size.

Preference and torque asymmetry for elbow joint

Extensively unilateral recruitment for daily activities may determine performance asymmetries in favor of the preferred side eliciting functional adaptation. Our study evaluated asymmetries in elbow torque output between preferred and non-preferred limbs. Eighteen subjects performed maximal elbow flexor and extensor isometric contractions at five different elbow joint angles (0o, 30o, 60o, 90o, 120o) and five different angular velocities (60, 120, 180, 240, 300o.s-1) on an isokinetic dynamometer. Higher flexor torque in favor of preferred arm was observed at 90o of flexion (p<0.05), which also corresponded to the highest torque produced (p<0.05). The fact that joint angle influenced torque asymmetries, whereas angular velocity did not, suggest that the observed asymmetry is likely related to preferential recruitment of elbow flexors at a 90o joint angle for daily tasks requiring high levels of force production. Muscle functional adaptation to frequent stimuli at this joint angle in healthy subjects may explain these results.

Two-weeks of elbow immobilization affects torque production but does not change muscle activation

Contextualizacao: A imobilizacao tem sido amplamente utilizada para recuperacao de lesoes musculoesqueleticas, entretanto essa tecnica causa deficits funcionais no sistema musculoesqueletico. Existe uma serie de evidencias demonstrando reducao da forca devido a hipotrofia muscular e um incremento do percentual de fibras rapidas, embora as contribuicoes relativas a lesao ou a imobilizacao ainda nao estejam totalmente esclarecidas. Objetivo: Verificar a influencia da imobilizacao do cotovelo na relacao torque-ângulo e na ativacao eletrica dos flexores e extensores em sujeitos saudaveis. Metodos: Dezoito sujeitos do sexo masculino (22-42 anos) foram divididos em um grupo controle (n=11) e em um grupo imobilizado (n=7). Todos os sujeitos realizaram os mesmos testes duas vezes, com intervalo de 14 dias. O grupo imobilizado teve seu cotovelo nao-dominante imobilizado com uma tala gessada no ângulo de 90o durante 14 dias. O torque maximo isometrico foi obtido nos ângulos de 150°, 120°, 90° e 60°. Resultados: Houve reducao de 16% no torque maximo apos a imobilizacao, o que nao pode ser explicado por alteracoes na medida de perimetria ou na ativacao eletrica muscular. Conclusoes: A imobilizacao de 14 dias produziu uma reducao no torque maximo isometrico do cotovelo, porem nao alterou a ativacao eletrica em sujeitos saudaveis. Essa reducao parece estar relacionada a hipotrofia muscular e, provavelmente, menos intensa quando comparada a imobilizacao apos lesoes musculoesqueleticas.

Effects of cryotherapy methods on circulatory, metabolic, inflammatory and neural properties: a systematic review

Introduction: The cooling therapy (cryotherapy) is commonly used in clinical environmental for the injuries treatment according to its beneficial effects on pain, local inflammation and the recovery time of patients. However, there is no consensus in the literature about the effects of cryotherapy in the physiological reactions of affected tissues after an injury. Objective: To realize a systematic review to analyze the cryotherapy effects on circulatory, metabolic, inflammatory and neural parameters. Materials and methods: A search was performed in PubMed, SciELO, PEDro and Scopus databases following the eligibility criteria. Included studies were methodologically assessed by PEDro scale. Results: 13 original studies were selected and presented high methodological quality. Discussion: The cryotherapy promotes a significant decrease in blood flow, in venous capillary pressure, oxygen saturation and hemoglobin (only for superficial tissues) and nerve conduction velocity. However, the effect of cryotherapy on the concentration of inflammatory substances induced by exercise, as the creatine kinase enzyme and myoglobin, remains unclear. Conclusion: The physiological reactions to the cryotherapy application are favorable to the use of this therapeutic tool in inflammatory treatment and pain decrease, and demonstrate its importance in the neuromuscular system injuries rehabilitation.

Are the Responses to Resistance Training Different Between the Preferred and Nonpreferred Limbs

Abstract Baroni, BM, Franke, RdA, Rodrigues, R, Geremia, JM, Schimidt, HL, Carpes, FP, and Vaz, MA. Are the responses to resistance training different between the preferred and nonpreferred limbs? J Strength Cond Res 30(3): 733–738, 2016—Humans preferentially recruit limbs to functionally perform a range of daily tasks, which may lead to performance asymmetries. Because initial training status plays an important role in the rate of progression during resistance training, could asymmetries between the preferred and nonpreferred limbs lead to different magnitudes of strengthening during a resistance training program? This issue motivated this study, in which 12 healthy and physically active men completed a 4-week control period followed by a 12-week isokinetic resistance training program, performed twice a week, including 3–5 sets of 10 maximal eccentric contractions for each limb. Every 4 weeks, knee extensor peak torques at concentric, isometric, and eccentric tests were measured using an isokinetic dynamometer and the sum of quadriceps muscle thickness was determined by ultrasound images. Before training, concentric peak torque was similar between limbs but isometric and eccentric peak torques were significantly smaller in the nonpreferred compared with the preferred limb (4.9 and 5.8%, respectively). Bilateral strength symmetry remained constant throughout the training period for concentric tests. For eccentric and isometric tests, symmetry was reached at the fourth and eighth training weeks, respectively. After 12 weeks, between-limb percent nonsignificant differences were −0.62% for isometric and −1.93% for eccentric tests. The sum of knee extensor muscle thickness had similar values before training and presented similar changes throughout the study for both the preferred and the nonpreferred limbs. In conclusion, the nonpreferred limb presents higher strength gain than the preferred limb at the initial phase of an isokinetic resistance training program, and this increased strength gain is not associated with muscle hypertrophy.