Eccentric Exercise in Patients with Chronic Health Conditions: A Systematic Review

Abstract

Purpose: The capacity of eccentric actions to produce muscle hypertrophy, strength gains, and neural adaptations without stressing the cardiopulmonary system has led to the prescription of eccentric training programmes in patients with low tolerance to exercise, such as elders or those with chronic health conditions. The purpose of this systematic review was to analyze the evidence regarding the effectiveness and suitability of eccentric training to restore musculoskeletal function in patients with chronic diseases. Summary of Key Points: Relevant articles were identified from nine databases and from the reference lists of key articles. Articles were assessed to determine level of evidence and scientific rigour. Nine studies met the inclusion criteria. According to Sackett's levels of evidence, 7 studies were graded at level IIb, 1 study at level IV, and the remaining study at level V. Articles were also graded for scientific rigour according to the PEDro scale. One study was rated as high quality, 4 studies were rated as moderate, and 2 studies were graded as poor quality. Conclusions: Eccentric training may be safely used to restore musculoskeletal function in patients with some specific chronic conditions. However, the heterogeneity of diseases makes it very difficult to extrapolate results and to standardize clinical recommendations for adequate implementation of this type of exercise. More studies are needed to establish the potential advantages of eccentric training in chronic conditions. Key Words: atrophy, chronic disease, eccentric training, muscle dysfunction RÉ SUMÉObjectif: La capacité des actions excentriques de produire l'hypertrophie musculaire, une masse osseuse accrue et des adaptations neurales sans exercer de fatigue sur le systè me cardiopulmonaire a mené à la prescription de programmes d'entraînement excentrique chez les patients ayant une tolé rance faible à l'exercice, comme les aîné s ou ceux qui sont atteints d'é tats de santé chroniques. Cette é tude mé thodique a pour but d'analyser les preuves scientifiques concernant l'efficacité et la pertinence de l'entraînement excentrique dans le ré tablissement de la fonction musculosquelettique chez les patients atteints de maladies chroniques. Re´sume´des points cle´s: Des articles pertinents ont é té identifié s à partir de 11 bases de donné es et listes de ré fé rence d'articles clé s. Les articles ont é té é valué s afin de dé terminer le niveau de preuves scientifiques et la rigueur scientifique. Neuf é tudes ont satisfait aux critè res d'inclusion. Selon les niveaux de preuve de Sackett, sept é tudes ont é té classé es au niveau IIb, une é tude au niveau IV et la derniè re é tude au niveau V. Des articles ont aussi é té classé s pour leur rigueur scientifique selon l'é chelle PEDro. Une é tude a é té classé e comme é tant de haute qualité , quatre é tudes comme é tant de qualité moyenne et deux é tudes ont é té classé es comme é tant de qualité mé diocre. Conclusions: L'entraînement excentrique peut ê tre utilisé en toute sé curi...

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Preservation of eccentric strength in older adults: Evidence, mechanisms and implications for training and rehabilitation

“…intense muscle work is achieved at a lower metabolic expense) (LaStayo et al, 2000) renders them a powerful tool for restoring muscle strength in people with a limited capacity to train at high intensities such as older adults (Hortobagyi and De Vita, 2000;LaStayo et al, 2003a) and patients with chronic conditions (Dibble et al, 2006;Engardt et al, 1995;Marcus et al, 2008;Rooyackers et al, 2003). Furthermore, although the exact magnitude of this preservation has not yet been quantified, it is reasonable to surmise that this reserve of eccentric strength could be beneficial for the undertaking of resistance-training programs in people with reduced levels of muscle force (Roig et al, 2008a).…”

Cardiovascular Responses During Downhill Treadmill Walking at Self-Selected Intensity in Older Adults

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