Effects of Flywheel Training With Eccentric Overload on Standing Balance, Mobility, Physical Function, Muscle Thickness, and Muscle Quality in Older Adults

Abstract

Hill, MW, Roberts, M, Price, MJ, and Kay, AD. Effects of flywheel training with eccentric overload on standing balance, mobility, physical function, muscle thickness, and muscle quality in older adults. J Strength Cond Res 36(11): 3190–3199, 2022—This study investigated the effects of a 6-week eccentric overload flywheel training program on vastus lateralis (VL) and gastrocnemius medialis (GM) muscle thickness and muscle quality (echo intensity), mobility (Timed Up and Go [TUG]), physical function (sit-to-stand), and balance (postural sway) performance. Nineteen subjects were assigned to either a flywheel training group (n = 11, age = 66.4 ± 5.2 years) or a control group (n = 8, age = 65.9 ± 3.8 years). The flywheel group underwent twice weekly squat and calf raise exercises for 6 weeks with outcome measures assessed before and after training or a time-matched control period. Throughout the training, subjects were instructed to contract as fast as possible with maximal effort during the concentric phase and to maximally resist the pull during the eccentric phase. The alpha value was a priori set at p < 0.05. Statistically significant (p < 0.05) mean (SD) increases in right and left VL (7.6–9.6 ± 7.7–9.8%) and GM (8.6–8.7 ± 6.4–11.5%) muscle thickness and a reduction in VL (10.2–11.3 ± 5.9–7.9%) and GM (11.7–11.9 ± 5.6–9.6%) echo intensity were accompanied by faster TUG time (13.7 ± 7.0%) improved sit-to-stand performance (17.8–23.5 ± 7.6 – 13.4%) and reduced postural sway (29.7–42.3 ± 13.2–24.2%) after 6 weeks of flywheel training. There were no differences in any outcome measures between the treatment and control group at baseline (p > 0.05). Overall, we observed substantial gains in muscle thickness and muscle quality, in addition to enhanced physical function, balance, and mobility performance among older adults after flywheel training, which may have important implications for preserving the functional capacity of older adults.

Benefits of Eccentric Training with Emphasis on Demands of Daily Living Activities and Feasibility in Older Adults: A Literature Review

“…The majority of studies applied frequencies ranging from two [ 19 , 21 , 59 , 62 , 63 , 64 ] to three [ 58 , 65 ] training sessions per week, with positive improvements in performance. We can also find several other studies with two [ 50 , 53 , 66 ] or three [ 52 , 67 ] eccentric training sessions, which came to similar conclusions regarding the positive changes in outcomes related to daily living activities such as walking, stair climbing, chair raise, and muscular strength. These research studies are consistent regarding eccentric training frequency and its benefits or improvements.…”

“…Many research studies with a varied number of participants of diverse backgrounds (healthy older individuals and older individuals with health problems or other limitations) have demonstrated the successful and safe performance eccentric training with continuously increasing intensity and volume over time [ 19 , 20 , 21 , 52 , 58 , 61 , 63 , 64 , 65 , 66 , 70 , 71 , 72 , 73 , 74 , 75 ]. For instance, in the Ploutz and Snyder’s [ 70 ] study, healthy older women performed eccentric training for a duration of 12 weeks with no reported injuries emerging from the experimental stimuli.…”

Modified Isoinertial-Based Ruffier Test in Healthy Individuals: A Feasibility Study

“…The characteristics of safety, simplicity of operation, and almost absent risk of trauma support the use of isoinertial machines in health care and rehabilitation [ 27 ]; moreover, with these machines it is possible to train different districts of the body, giving also a reduction of the cost for those who implement it in their practice. The torque moment of the system is capable of guiding the subject with a cyclic rhythm, supporting the correct execution of a movement, and stimulating balance [ 28 ]. This training method does not work with the percentage of one-repetition maximum allowing a precise monitoring of the performance and neuromuscular fatigue, maximizing the training [ 29 , 30 ].…”

Initial Muscle Quality Affects Individual Responsiveness of Interleukin-6 and Creatine Kinase following Acute Eccentric Exercise in Sedentary Obese Older Women

“…The most recent recommendations from the National Strength and Conditioning Association highlights the importance of eccentric exercise to improve muscle mass, physical function, and power in older individuals with limited tolerability and diminished muscular strength [10,12,13]. Eccentric resistance exercise has gained considerable attention due to its unique properties, such as low energy cost and high muscle force production compared to concentric action [14,15]. However, the acute physiological response to eccentric exercise in sedentary obese older women with a different MQI remains unclear.…”