A realização de uma sessão com ações excêntricas provoca dano na estrutura muscular. Durante o processo de recuperação, essa estrutura sofre adaptações que a protegem da ocorrência de dano nas sessões subseqüentes. Essas adaptações são chamadas de Efeito da Carga Repetida (ECR). Esse efeito foi estudado com a realização de apenas duas sessões de exercícios. A velocidade da ação excêntrica também pode contribuir para a variabilidade do dano induzido. O objetivo desse estudo foi investigar através da análise dos indicadores indiretos, creatina quinase (CK), força, dor, circunferência e amplitude de movimento (ADM), o dano induzido por diferentes velocidades da ação excêntrica e o efeito da carga repetida com a realização das diferentes velocidades (60ºs-1 (Exc60) e 180ºs-1 (Exc180)); e verificar se o efeito da carga repetida seria maior com a realização de três sessões de exercícios. Os resultados dos indicadores analisados tiveram alterações semelhantes nos grupos Exc60 e Exc180, sugerindo que as diferentes velocidades parecem não interferir na magnitude do dano induzido. O ECR não foi diferente entre as velocidades, pois o comportamento das variáveis analisadas foi semelhante entre os dois grupos nas duas sessões iniciais. A realização da terceira sessão de exercícios excêntricos não promove o aumento do efeito protetor, visto que não houve diferenças significantes entre a segunda e a terceira sessão. Indicando que o ECR advém principalmente da realização da primeira sessão / Performing a bout of eccentric exercise causes muscle damage. During recovery, some adaptations occur that can protect muscle structure. These adaptations are known as Repeated Bout Effect. However, this phenomenon has been studied with two bouts. Velocity of eccentric action has been referred as one possible factor which can affect the extension of muscle damage. The aim of this study was to investigate muscle damage induced by different velocities, the repeated bout effect with different velocities and to verify if the repeated bout effect could be larger if three bouts of eccentric exercise were performed. Results of indirect markers of muscle damage (CK, DOR, upper-arm circumference, maximal isometric force) showed similar alterations in groups Exc60 and Exc180, suggesting that different velocities do not affect the extension of muscle damage. Repeated bout effect is not different between velocities, because changes in markers were comparable in both groups after the first two bouts. After performing a third bout of eccentric exercise, there was not any significant differences between second and third bouts. It indicates that the first bout is responsible for the adaptations of the repeated bout effect

Bakgrund: Tendinopati är en vanlig diagnos hos patienter inom primärvården, en av de vanligare formerna av tendinopati är epikondyalgi. Det är oklart vad som är den mest effektiva behandlingen för epikondyalgi. Studier har visat lovande resultat av enbart excentrisk träning (ET) samt som del av kombinationsbehandling. Det var därför relevant att kartlägga vilken effekt excentrisk träning har vid epikondyalgi. Syfte: Kartlägga och sammanställa aktuell forskning gällande evidensen för effekten av  ET på smärta och funktion vid epikondyalgi. Metod: En systematisk litteraturstudie. Litteratursökning genomfördes i databaserna PubMed, Cinahl, Web of Science samt Scopus. Åtta artiklar inkluderades. Dessa kvalitétsgranskades enligt PEDro, varefter den sammanvägda evidensen bedömdes enligt GRADE.  Resultat: De inkluderade studiernas kvalité enligt PEDro varierade från medelhög till hög. Begränsat vetenskapligt underlag för att ET inte minskar smärta vid lateral epikondyalgi (LE). Otillräckligt vetenskapligt underlag för att ET ökar funktion vid LE. Otillräckligt vetenskapligt underlag för en jämförelse av ET i olika former eller som del av kombinationsbehandling. Inga resultat för medial epikondyalgi framkom. Slutsats: ET har inte någon effekt på smärta vid LE. Det finns otillräcklig vetenskaplig grund för effekten på funktion vid LE. Interventionerna, i studierna som jämförde ET i olika former eller utvärderade kombinationsbehandlingar, skilde sig åt vilket gjorde att sammanvägningen av dessa resultat inte var möjlig. Vidare forskning behövs för att kunna fastställa effekterna av excentrisk träning vid epikondyalgi. / Background: Tendinopathy is a common diagnosis in primary care, a common form of tendinopathy is epicondylalgia. However, the most effective treatment for epicondylalgia is undetermined. Studies have shown promising results in regard to eccentric training (ET) as a stand-alone treatment as well as adjunct to other treatments. It is therefore relevant to map the effect of ET for patients with epicondylalgia. Objective: Map and compile current evidence on the effect of ET on pain and function for patients with epicondylalgia. Methods: A systematic review. A search was conducted in the PubMed, Cinahl, Web of Science and Scopus database. Eight articles were included. These were assessed for quality according to the PEDro scale and the evidence was assessed according to GRADE. Results: The quality of the included studies ranged from medium to high. Limited evidence showed that ET does not reduce pain for patients with lateral epicondylalgia, LE. Insufficient evidence showed that ET improves function. The evidence on the comparison of ET in different forms or in combination with other treatments was insufficient. No results emerged for medial epicondylalgia. Conclusion: ET does not reduce pain for patients with LE. There is insufficient evidence on the effect of ET on function for patients with LE. Studies comparing different forms of ET alone or in combination with other treatments have used different interventions, preventing the aggregation of results. Further research is needed to determine the effects of ET for patient with epicondylalgia.

Bakgrund: Besvär från akillessenan är ett vanligt problem hos såväl motionärer som elitidrottare och kan leda till båda smärta och funktionsförlust. Excentrisk träning är en vanlig behandlingsmetod i klinik, trots att evidensen är begränsad och motstridig. Syfte: Att kartlägga vilken evidens som finns för excentrisk träning som behandling av akillestendinopati. Metod: Systematisk litteraturstudie. Sökningen genomfördes i databasen PubMed. Studierna granskades med PEDro-skalan och den sammanlagda evidensen graderades enligt GRADEstud. Resultat: Litteratursökningen resulterade i att 7 studier med totalt 448 deltagare inkluderades. Studierna fick medelhög-hög kvalitet enligt PEDro. Evidensen för excentrisk träning vid 8-16 veckor var måttligt hög (+++) och vid 52 veckor mycket låg (+). Excentrisk träning hade en lägre effekt än hälinlägg och akupunktur mätt med VISA-A vid 8-16 veckor. Effekten av excentrisk träning mätt med VISA-A hade en likvärdig effekt som passiv stretch och tung långsam styrketräning vid 8-16 veckor. Vid 52 veckor var effekten mätt med VISA-A densamma av excentrisk träning som proloterapiinjektioner och tung långsam styrketräning. Konklusion: Excentrisk träning kan ha en effekt vid achillestendinopati. Effekten är densamma som eller lägre sett till poäng på VISA-A än andra behandlingsmetoder och skulle kunna bero på naturlig läkning över tid eller deltagandet i en studie. Evidensen för excentrisk träning graderades vid 8-16 respektive 52 veckor till måttligt hög (+++) och mycket låg (+). Detta grundar sig på studier av medelgod till hög kvalitet. / Background: Achilles tendon issues is a common problem among athletes on all levels. The problem can cause pain and loss of function. Eccentric exercise is a somewhat gold standard and often used in the clinical setting although the level of evidence is limited and conflicting. Objective: Map the evidence of eccentric exercise as a treatment for achilles tendinopathy. Method: A systematic review. The search was conducted in the Pubmed database. The included studies were analyzed using the PEDro scale and the evidence was graded using the GRADEstud. Results: The literature search identified 7 studies that were included with a total of 448 participants. The studies received a moderate-high quality on PEDro. The level of evidence at 8-16 weeks was moderate (+++) and at 52 weeks very low (+). Eccentric exercise had a lower effect than heel lifts and acupuncture measured with VISA-A. Eccentric exercise had a similar effect on VISA-A as passive stretch and heavy slow resistance. At 52 weeks the effect of eccentric exercise was the same as prolotherapy injections and heavy slow resistance. Conclusion: Eccentric exercise might have an effect as treatment for achilles tendinopathy, but the effect is the same or lower than other treatment options measured with VISA-A and might depend on the natural healing process or the participation in a study. The level of evidence for eccentric exercise was graded at 8-16 and 52 weeks respectively, as moderate (+++) and very low (+). This is based on studies of moderate to high quality.

Bakgrund: Excentrisk träning (ECC) har varit det dominerande träningssättet vid patellar tendinopati (PT) under de senaste 15 åren. Det skulle vara av värde för kliniker att veta vilken effekt ECC har på kort sikt efter en träningsperiod. Syfte: Systematiskt granska enskilda artiklar och bedöma tillförlitligheten i det sammanvägda resultatet gällande effekten på funktion och smärta samt förmåga att delta i sport eller fysiska aktiviteter som excentrisk träning har efter en träningsperiod på 12 veckor hos idrottande personer med PT. Design: Systematisk granskning av randomiserade kontrollerade studier. Metod: Sökningar utfördes i PubMed, CINAHL, PEDro och Cochrane library. Sju studier inkluderades och granskades med PEDro Scale. GRADEstud användes för att bedöma tillförlitligheten i resultatet. Resultat: Inkluderade studiers kvalitet varierade mellan acceptabel och hög kvalitet, enligt PEDro Scale. Det var inga skillnader mellan ECC och kontrollbehandlingar. Vid sammanvägningen av studiernas respektive resultat ansågs tillförlitligheten enligt GRADEstud vara måttligt hög (+++) p.g.a. hög samstämmighet, men bristande precision. Slutsats: ECC är inte mer effektivt än andra undersökta kontrollbehandlingar, därav kan denna studie inte säkerställa att förbättringar som sker efter 12 veckor beror på ECC. / Background: Eccentric exercise (ECC) has been the dominant treatment option for patellar tendinopathy (PT) in the last 15 years. It would be of value to clinicians to know about the short-term effect ECC has after a training period. Objective: Systematically review individual articles and assess the certainty in the weighted result regarding the effect on function, pain, and the ability to participate in sport and physical activities that eccentric training has after a 12week period of training on athletes with PT. Design: Systematic review of randomized controlled trials.                                           Method: Searches were conducted in PubMed, CINAHL, PEDro and Cochrane Library. Seven studies were included and reviewed with the PEDro Scale. GRADE-stud was used to assess the certainty in the result.  Results: Included studies quality varied between acceptable and high quality, according to the PEDro Scale. There were no differences between ECC and control treatments. When weighing the respective results of the studies, the certainty was considered moderately high (+++) according to GRADEstud, due to high coherence in all included studies, but a lack of precision. Conclusion: ECC is not more effective than other control therapies studied. Therefore, this study cannot ensure that improvements that occur after 12 weeks are due to ECC.

Objective: Aortic stenosis (AS) patients with eccentric hypertrophy (Ecc-LVH) have increased left ventricular (LV) size and possibly reduced ejection fraction (EF). However, previous studies suggest worse outcomes with concentric remodeling and hypertrophy. We hypothesized that Ecc-LVH pattern in AS patients will also be associated with greater heart failure (HF) and all-cause mortality (ACM). Methods: We queried the electronic medical record from a community-based university practice for all AS patients. We included patients with >60 days follow-up and interpretable Doppler echocardiograms. We recorded demographics, Doppler-echo parameters, laboratories, HF readmission and ACM with follow-up to 2083 days. There were 329 patients divided into 4 groups based on the presence of LV hypertrophy (LVH) and relative wall thickness (RWT) by echocardiography. Ecc-LVH had RWT<0.43 and LVH. Results: Patients with severe AS were older, had greater coronary disease prevalence, lower hemoglobin, greater LV mass index, more abnormal diastolic function, greater HF and ACM. Multivariate Cox proportional analysis revealed that valvulo-arterial impedance (p=0.017) and Ecc-LVH (p=0.033) were HF predictors. Brain natriuretic peptide>100 pg/ml (p<0.001) and Ecc-LVH (p=0.019) were ACM predictors. ACM was increased in Ecc-LVH patients with both moderate (HR=3.67-8.18 vs other geometries, p=0.007-0.0007) and severe AS (HR=3.94-9.48 vs normal and concentric remodeling, p=0.0002). In patients with HF, Ecc-LVH was associated with greater HF in moderate AS vs normal geometry (HR=3.28, p=0.0135) and concentric remodeling (HR=2.66, p=0.0472). Conclusions: Patients with AS and Ecc-LVH have greater ACM than other LV geometries with both moderate and severe AS and greater HF in moderate AS.

No description available.

Introduction: Resistance training overloading the eccentric phase of exercises (termed accentuated eccentric loaded; AEL) has been hypothesized to optimize adaptations to force production and muscle mass via acute postactivation potentiation (PAP). Though enhancement of performance variables via AEL or PAP is equivocal in the literature, it is understood that AEL and/or PAP will result in either positive adaptations or a lack of maladaptations. Purpose: The purpose of this work was identifying any effect of AEL squats on measures of muscle activation in collegiate weightlifters. Subjects: Eight weightlifters (age = 24.63 ± 5.58 yrs; body mass = 83.39 ± 19.40 kg; height = 169.63 ± 8.68 cm; 1.91 ± 0.63 1RM:Body Mass) completed all testing sessions. Methods: Subjects completed AEL and NOR squat sessions being nearly identical to their normal scheduled training and sEMG data from the VM, VL, and BF muscles were collected during the entirety of each session. Statistics: Nested within RMANOVAs determined any session-long effect of AEL squats and paired samples t-tests determined any PAP on activation of the VM, VL, and BF. Results: Nonsignificant differences between the AEL CON and NOR CON phases on measures of muscle activation while trends to increase activation for all muscles were evident. There was also no evidence of PAP, identified by comparing identical sets within each session. Conclusions: There was no special effect of AEL squats on thigh musculature activation and no acute PAP was elucidated on activation levels.

No description available.

No description available.

No description available.