Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program

Abstract

BackgroundAddressing muscle deficits within a multi-component exercise fall reduction program is a priority, especially for the highest risk older adults, i.e., those who have fallen previously. Eccentric resistance exercise with its high-force producing potential, at a low energetic cost, may be ideally-suited to address muscle impairments in this population. The purpose of this study was to compare the effects of resistance exercise via negative, eccentrically-induced, work (RENEW) versus traditional (TRAD) resistance exercise on mobility, balance confidence, muscle power and cross sectional area, as well as the number of days high fall risk older adults survived without a fall event over a 1 year period.MethodsRandomized, two group, four time point (over 1 year) clinical trial testing RENEW versus TRAD as part of a 3 month multi-component exercise fall reduction program (MCEFRP). Primary outcomes of mobility, balance confidence, muscle power output and cross sectional area were analyzed using mixed effects modeling. The secondary outcomes of days to fall and days to near-fall were analyzed using survival analysis.ResultsThe MCEFRP did have an effect on fall risk factors considered reversible with exercise interventions though there was no differential effect of RENEW versus TRAD (p = 0.896) on mobility, balance confidence, muscle power and cross sectional area. There were also no group differences in the number of days survived without a fall (p = 0.565) or near-fall (p = 0.678). Despite 100% of participants having at least one fall in the year prior to the MCEFRP, however, after 3 months of exercise and 9 months of follow-up <50% had experienced a fall or near fall.ConclusionsThere were no differential effects of RENEW or TRAD as components of a MCEFRP on the primary or secondary outcomes. The two modes of resistance exercise had identical effects on fall risk and fall-free survival.Trial registration NCT01080196; March 2, 2010 (retrospectively registered).

Eccentric cycling is more efficient in reducing fat mass than concentric cycling in adolescents with obesity

“…Nevertheless, the repeated bout effect, which includes neural and structural adaptations, protects against muscle damages from subsequent ECC bouts . Thus, an ECC cycling program can be achieved without undue DOMS provided a progressive ramping protocol is followed …”

“…9,10 Thus, an ECC cycling program can be achieved without undue DOMS provided a progressive ramping protocol is followed. 4,11 Although the impact of ECC training on lean mass (LM) has been extensively studied, the findings are too varied to clearly affirm the superiority of ECC training. [11][12][13][14] Recent meta-analyses demonstrated that when matched for load or work, changes between ECC and CON training were found similar in regard to muscle hypertrophy.…”

“…4,11 Although the impact of ECC training on lean mass (LM) has been extensively studied, the findings are too varied to clearly affirm the superiority of ECC training. [11][12][13][14] Recent meta-analyses demonstrated that when matched for load or work, changes between ECC and CON training were found similar in regard to muscle hypertrophy. 15,16 Considering fat mass (FM), the impact of ECC training remains poorly studied, without direct comparisons between ECC and CON training.…”

Effect of two types of muscle contraction training on muscle thickness, strength, and delayed onset of muscle soreness in persons with chronic stroke

“…A specially designed training system (Eccentron; Baltimore Therapeutic Equipment, Hanover, MD, USA) was used to perform ECT ( Figure 1A) [15]. The knee extensor and ankle plantar flexor muscles were trained using ECT by negatively resisting the Eccentron pedals which are cross-driven at equal speeds using the leg muscles.…”

The “Journal of Functional Morphology and Kinesiology” Journal Club Series: Highlights on Recent Papers in Strength and Conditioning

“…These authors have shown that in patients with severe COPD, 10 weeks of EET led to increases in muscle strength and hypertrophy, at progressively lower levels of perceived fatigue and dyspnea. Similar applications of EET have led to increased lower limb strength in patients with spinal cord injuries [4] and EET is as successful as traditional rehabilitation when addressing fall risks in elderly subjects [5]. The physiological adaptation stimulated by EET in clinical populations has the potential to extend to healthy subjects and in particular to competitive sport, where the continuous search for training methods to enhance performance is paramount.…”