This study was undertaken to determine whether combined elastic and free weight resistance (CR) provides different strength and power adaptations than free weight resistance (FWR) training alone. Forty-four young (age 20 +/- 1 years), resistance-trained (4 +/- 2 years' experience) subjects were recruited from men's basketball and wrestling teams and women's basketball and hockey teams at Cornell University. Subjects were stratified according to team, then randomly assigned to the control (C; n = 21) or experimental group (E; n = 23). Before and after 7 weeks of resistance training, subjects were tested for lean body mass, 1 repetition maximum back squat and bench press, and peak and average power. Both C and E groups performed identical workouts except that E used CR (i.e., elastic resistance) for the back squat and bench press, whereas the C group used FWR alone. CR was performed using an elastic bungee cord attached to a standard barbell loaded with plates. Elastic tension was accounted for in an attempt to equalize the total work done by each group. Statistical analyses revealed significant (P < 0.05) between-group differences after training. Compared with C, improvement for E was nearly three times greater for back squat (16.47 +/- 5.67 vs. 6.84 +/- 4.42 kg increase), two times greater for bench press (6.68 +/- 3.41 vs. 3.34 +/- 2.67 kg increase), and nearly three times greater for average power (68.55 +/- 84.35 vs. 23.66 +/- 40.56 watt increase). Training with CR may be better than FWR alone for developing lower and upper body strength, and lower body power in resistance-trained individuals. Long-term effects are unclear, but CR training makes a meaningful contribution in the short term to performance adaptations of experienced athletes.

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Background and Purpose: In these guidelines, we aimed to develop evidence-based recommendations for the use of screening questionnaires and diagnostic tests in patients with neuropathic pain (NeP). Methods:We systematically reviewed studies providing information on the sensitivity and specificity of screening questionnaires, and quantitative sensory testing, neurophysiology, skin biopsy, and corneal confocal microscopy. We also analysed how functional neuroimaging, peripheral nerve blocks, and genetic testing might provide useful information in diagnosing NeP. Results: Of the screening questionnaires, Douleur Neuropathique en 4 Questions (DN4), I-DN4 (self-administered DN4), and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) received a strong recommendation, and S-LANSS (self-administered LANSS) and PainDETECT weak recommendations for their use in the diagnostic pathway for patients with possible NeP. We devised a strong recommendation for the use of skin biopsy and a weak recommendation for quantitative sensory testing and nociceptive evoked potentials in the NeP diagnosis. Trigeminal reflex testing received a strong recommendation in diagnosing secondary trigeminal neuralgia. Although many studies support the usefulness of corneal confocal microscopy in diagnosing peripheral neuropathy, no study specifically investigated the diagnostic accuracy of this technique in patients with NeP. Functional neuroimaging and peripheral nerve blocks are helpful in disclosing pathophysiology and/or predicting outcomes, but current literature does not support their use for diagnosing NeP. Genetic testing may be considered at specialist centres, in selected cases. Conclusions: These recommendations provide evidence-based clinical practice guidelines for NeP diagnosis. Due to the poor-to-moderate quality of evidence identified by this review, future large-scale, well-designed, multicentre studies assessing the accuracy of diagnostic tests for NeP are needed.

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