Eccentric Exercise Training: Modalities, Applications and Perspectives

Abstract

Eccentric (ECC) exercise is classically used to improve muscle strength and power in healthy subjects and athletes. Due to its specific physiological and mechanical properties, there is an increasing interest in employing ECC muscle work for rehabilitation and clinical purposes. Nowadays, ECC muscle actions can be generated using various exercise modalities that target small or large muscle masses with minimal or no muscle damage or pain. The most interesting feature of ECC muscle actions is to combine high muscle force with a low energy cost (typically 4- to 5-times lower than concentric muscle work) when measured during leg cycle ergometry at a similar mechanical power output. Therefore, if caution is taken to minimize the occurrence of muscle damage, ECC muscle exercise can be proposed not only to athletes and healthy subjects, but also to individuals with moderately to severely limited exercise capacity, with the ultimate goal being to improve their functional capacity and quality of life. The first part of this review article describes the available exercise modalities to generate ECC muscle work, including strength and conditioning exercises using the body's weight and/or additional external loads, classical isotonic or isokinetic exercises and, in addition, the oldest and newest specifically designed ECC ergometers. The second part highlights the physiological and mechanical properties of ECC muscle actions, such as the well-known higher muscle force-generating capacity and also the often overlooked specific cardiovascular and metabolic responses. This point is particularly emphasized by comparing ECC and concentric muscle work performed at similar mechanical (i.e., cycling mechanical power) or metabolic power (i.e., oxygen uptake, VO2). In particular, at a similar mechanical power, ECC muscle work induces lower metabolic and cardiovascular responses than concentric muscle work. However, when both exercise modes are performed at a similar level of VO2, a greater cardiovascular stress is observed during ECC muscle work. This observation underlines the need of cautious interpretation of the heart rate values for training load management because the same training heart rate actually elicits a lower VO2 in ECC muscle work than in concentric muscle work. The last part of this article reviews the documented applications of ECC exercise training and, when possible, presents information on single-joint movement training and cycling or running training programs, respectively. The available knowledge is then summarized according to the specific training objectives including performance improvement for healthy subjects and athletes, and prevention of and/or rehabilitation after injury. The final part of the article also details the current knowledge on the effects of ECC exercise training in elderly populations and in patients with chronic cardiac, respiratory, metabolic or neurological disease, as well as cancer. In conclusion, ECC exercise is a promising training modality with many different domains of application....

Strength training in seniors: The knowledge of positive aspects of eccentric training in elderly is sparse

“…12 men reported no difference. Reported intensity in concentric exercises was 14.6 ± 4 (BORG-Scale, [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] In women, no myocardial infarct could be detected. Blood pressure was increased in 3 and an Arrhythmia was four times reported.…”

Revisiting the positive aspects of negative work

“…A few authors have speculated that this phenomenon might occur because the actin-myosin bonds are disrupted mechanically rather than undergo an ATP-dependent detachment (Flitney and Hirst, 1978;Menard et al, 1991) , 6-12 weeks) with resistance exercise via negative eccentrically induced work (RENEW) can serve as a potent stimulus for improving muscular function (e.g. quadriceps size, strength and mobility) in a variety of populations ranging from patients with central limitations to individuals with orthopedic injuries and impairments, and competitive athletes (for recent reviews, see Isner-Horobeti et al, 2013;LaStayo et al, 2014). Collectively, these examples highlight the novelty of RENEW training in that only relatively low levels of perceived exertion are required to generate high negative work rates that can induce positive changes in muscular function without producing profound levels of muscle damage.…”

“…On a personal note, our motivation to utilize negative work with patient and athletic populations can be linked directly back to Abbott's investigation. More importantly, this application of negative work is considered a cutting-edge rehabilitation and training modality and has been reviewed in detail in sports medicine (Isner-Horobeti et al, 2013), rehabilitation (LaStayo et al, 2003 and applied physiology journals (LaStayo et al, 2014).…”

“…Specifically, the historic black-and-white photo of the experimental apparatus re-appeared in the literature in 1995 [ fig. 1 Likewise, the story of Bigland quickly tiring out Ritchie has been passed on in the literature (Isner-Horobeti et al, 2013;Lindstedt et al, 2001), laboratory and classroom. Further, our group (Elmer et al, 2013a;Elmer et al, 2013b) recently re-visited this historic work by comparing the cost of positive and negative work during upper body arm cycle ergometry, and the results suggest that the unique physiological characteristics of lengthening contractions are consistent and, for the most part, generalizable across muscle groups.…”

Histomorphometric analysis of the Achilles tendon of Wistar rats treated with laser therapy and eccentric exercise

“…In eccentric exercise, the muscle under contraction is stretched while producing a force. This force is not sufficient to withstand the imposed external load, and the elongation of the tensioned fibers results in important changes in the muscle-tendon unit (Frick 2010, Isner-Horobeti et al 2013.…”