Impact of eccentric exercise on walking functional capacity after severe COVID-19: randomized, controlled open-label trial.

Eccentric training in chronic heart failure: Feasibility and functional effects. Results of a comparative study

Effect of concentric and eccentric hamstring training on sprint recovery, strength and muscle architecture in inexperienced athletes

Both eccentric (ECC) and concentric (CON) exercises improve energy expenditure and blood lipid profile. Although ECC exercise has a more beneficial effect on these factors than CON exercise, its benefits on vital organs are still unclear. This study investigated the mode-of-action-dependent effects on myocardial perfusion index. Seventeen healthy men (age: 26 ± 5 years) were randomly enrolled in CON (n = 9) and ECC (n = 8) groups. Transient exercise and regular training (three-day a week for 4-week) included bicep curl comprising 5-set of 10-repetition, each using 75% one-repetition maximum concentric loading. The ECC group performed one-repetition of ECC for 3-s and CON for 1-s, while the CON group performed one-repetition of CON for 3-s and ECC for 1-s. All participants were assessed for subendocardial viability ratio (SEVR, myocardial perfusion index) and aortic diastolic pressure decay. Before study, these were found to be same for both groups. Transient (ΔSEVR: 20.3 ± 13.3%, p = 0.01; Δdecay: −0.07 ± 0.02 s−1, p < .001) and regular (ΔSEVR: 18.5 ± 12.8%, p = .001; Δdecay: −0.06 ± 0.05 s−1, p = .004) ECC (but not CON) exercises significantly increased SEVR and decelerated decay. Increased SEVR with ECC exercise was associated with decelerated decay (transient ECC: r2 = 0.56, 95% confidence interval [CI] = −0.95 to −0.10, p = .03; regular ECC: r2 = 0.53, 95% CI = −0.95 to −0.05, p = .04). These findings suggest that ECC exercise improves myocardial perfusion and diastolic pressure contour is involved in physiological mechanisms.

Introduction: Eccentric (ECC) exercise is a unique method in the rehabilitation field due to its lower metabolic demands and greater power output. It is considered a safe tool for participants and patients with low exercise tolerance. Cardiovascular disease (CVD), a leading cause of global mortality, continues to rise. During the rehabilitation phase, ECC exercise may be especially beneficial for CVD patients because of its reduced demands on the cardiorespiratory system. This narrative review aims to evaluate the physiological effects of ECC exercises in adults and older adults with CVD and to explore which ECC modalities are feasible and safe for this population. Methods: A literature search was carried out in PubMed, Web of Science, and Scopus databases to identify relevant studies investigating the acute and chronic effects of ECC exercise interventions in CVD patients. Results: The review analysed 13 studies involving 362 predominantly male participants with CVD, focusing on ECC exercise, mainly ECC cycling, with varying intensities and settings. Findings showed that ECC exercise is generally safe, with low heart rate (HR) and perceived exertion even at increasing workloads. Chronic ECC training led to improved cardiac function, reduced HR, and enhanced functional capacity, such as better performance in the 6-minute walk test and stair descent, despite lower oxygen consumption. While some studies reported no significant changes in V̇O2peak or vascular function, overall results support ECC training as a feasible and effective modality for cardiovascular rehabilitation. Discussion: ECC exercise has shown notable advantages for individuals with CVD, offering higher power output with reduced cardiovascular strain compared to concentric (CON) training. Despite some variability in HR responses – likely due to differences in training intensity and adaptation over time – ECC consistently results in lower V̇O2 consumption, making it metabolically efficient and well-suited for CVD patients. Studies also highlight ECC’s positive impact on functional capacity, strength, and mobility, particularly in frail older adults, without increasing thrombotic risk. These findings support ECC as a safe and effective rehabilitation modality for improving both cardiovascular tolerance and physical function in at-risk populations.

Introduction: Time away from training and competition from sport injuries may lead to detrimental effects on muscle strength and endurance. The cross-education effect plays an important role in preserving strength during recovery and rehabilitation; however, the effects have been found to be inconclusive. In addition, the distinct impacts of eccentric and concentric strengthening exercises need to be explored. The objective of this study was to compare the cross-education effects of eccentric and concentric wrist flexor strengthening exercises on hand grip strength among recreational athletes. Methods: A total of 39 recreational athletes aged between 18-25 years old were randomly assigned into two groups of wrist flexor strengthening exercise: eccentric (ECC) and concentric (CON) training groups. The training period for the study was 4 weeks with 3 sessions of strengthening exercises per week. Handgrip strength was measured bilaterally, before and after the intervention using the JAMAR handgrip dynamometer. Results: Significant increases in hand grip strength were observed for the ECC and CON groups in both the trained and untrained hands following 4 weeks of training. However, the handgrip strength between the two groups in the untrained hand was not significantly different (p=0.64). The strength gain in the untrained hand was 9.8% and 10.8%, for ECC and CON groups, respectively. Conclusion: The cross-education effect was significant in improving strength in the untrained hand. There was no difference in strength gains between concentric and eccentric strength training.

IntroductionAchilles tendinopathy is a common musculoskeletal condition driven in part by alterations in muscle performance.1 Whilst eccentric loading has demonstrated clinical efficacy, and superiority to concentric loading, the underlying mechanisms...

Eccentric cycling emphasising a low cardiopulmonary demand increases leg strength equivalent to workload matched concentric cycling in middle age sedentary males

The aim of the present study was to compare the effect of chronic concentric or eccentric training on position sense and joint reaction angle, in healthy, untrained young men. Twenty-four men were randomly assigned into a pure concentric (CT) or a pure eccentric (ET) group and performed for 8 weeks, one training session/week, 75 maximal knee extensors contractions. Before and 48 h after the first (W1) and the last (W8) training sessions, knee joint position sense and joint reaction angle were assessed at three different knee angles (i.e. 30°, 45° and 60°). At the same time points, indirect indices of exercise-induced muscle damage (EIMD) were evaluated (i.e. range of motion [ROM], optimal angle, maximum isometric, concentric and eccentric torques, delayed onset muscle soreness [DOMS] and blood creatine kinase concentrations [CK]). Forty-eight hours post W1, position sense, reaction angle and all EIMD indices were significantly changed for both groups (p < 0.05; η2: 0.125–0.618), however, greater alterations were observed after ET. Significant correlations were found, in both groups, between the training-induced changes of position sense, reaction angles and the changes of EIMD biomarkers (r: −0.855–0.825; p < 0.005). No significant changes were found 48 h post W8 for position sense, reaction angle and EIMD indices (p > 0.285) for both CT or ET groups. In conclusion, exercise-induced changes in position sense and reaction angle, were related to the magnitude of EIMD, and not by the type of muscle contraction per se. Highlights Exercise induced changes in position sense and reaction angle, were related to the magnitude of EIMD, and not by the type of muscle contraction per se. After the 1st training session eccentric exercise caused greater disturbances, compared to concentric exercise, in EIMD indices which caused concomitant disturbances to position sense and knee reaction angle. 8 weeks of either eccentric or concentric training leads to preservation of position sense and knee reaction angle 48 h after maximal intensity exercise of either types of muscle contraction.

Introduction: While eccentric (ECC) training appears to be more efficient than concentric (CON) training at improving body composition in adolescent with obesity, its impact on health-related quality of life (HRQOL) has never been studied. Objective: The aim of this study is to compare the effects of 2 cycling training modalities, i.e., ECC vs. CON, in adolescents with obesity on HRQOL and health perception (HP). Methods: A total of 24 adolescents with obesity, aged 12–16 years, were randomized to either a 12-week ECC or a CON cycling training program performed at the same oxygen consumption (VO₂). Anthropometric measurements, body composition, maximal incremental tests, HRQOL (Vécu et Santé Percue de l’Adolescent [VSP-A], Medical Outcome Study Short Form [SF-36]), and HP were assessed at before and after training. Results and Conclusion: Both CON and ECC cycling trainings promoted significant improvements in BMI, VO_2peak, total fat mass, and fat-free mass, with better improvements in body composition parameters in the ECC group (p < 0.05). The VSP-A total score increased after CON (p < 0.01) and ECC (p < 0.001) training, with better enhancement for the ECC group (p < 0.05). The SF-36 physical score increased after both CON (p < 0.01) and ECC (p < 0.001) trainings. The global HP score increased only after ECC training (p < 0.001). Except for the energy-vitality item, no significant correlation was found between changes in HRQOL and its subdomains and anthropometric, body composition, and functional parameters. Both ECC and CON cycling trainings are associated with positive changes in HRQOL and HP. However, ECC seems to induce greater improvements in HRQL and HP than CON cycling training, which is probably not due to the anthropometric, body composition, and functional changes.

Investigation of pulmonary function, physical activity and functional capacity of people with early-stage relapsing-remitting multiple sclerosis: A controlled study.

Exercise is important for prevention of sarcopenia in the elderly population. We tested two training modalities, ascending or descending stair walking, representing concentric (CON) and eccentric (ECC) exercise, respectively. We also tested the effects of additional weight during eccentric exercise (ECC+). Thirty-two healthy men and women (70 ± 3 [mean ± SE] yrs.) were randomly assigned to CON, ECC, or ECC+ (carrying +15% of body weight in a vest) in a 3 (n = 32) or 6 (n = 21) week intervention (3 sessions/week). Data was analysed by mixed models approach. Rate of perceived exertion (RPE; Borg scale 6-20; mean values from 3 and 6 weeks) during training did not differ between CON (12.3 ± 0.4), ECC (11.5 ± 0.3), and ECC+ (11.7 ± 0.4). After 6 weeks, leg muscle mass increased more in ECC+ (+0.29 ± 0.09 kg) vs CON (+0.08 ± 0.05 kg) (P<0.05) but not different from ECC (+0.16 ± 0.06 kg). 6-minute walk test (6MWT) increased after 6 weeks more (P<0.05) in ECC+ (+85 ± 23 m) compared with ECC (+37 ± 13 m) and CON (+27 ± 12 m). Intramyocellular glycogen content increased from 359 ± 19 nmol/mg d.w. in CON (to 511 ± 65 and 471 ± 44 after 3 and 6 wks, respectfully (P<0.05)), but not in ECC (to 344 ± 28 after 6 weeks) or in ECC+ (to 389 ± 20 after 6 weeks). Conclusion: carrying extra weight while descending stair walking do not increase RPE, but the ECC+ training resulted in greater muscle responses compared with CON, but glycogen synthesis was stimulated only in CON. Descending stairs is a simple model for prevention and treatment of sarcopenia and the stimulus is enhanced by carrying extra weights.

The study was aimed at comparing the effects of concentric (CONC) and eccentric (ECC) exercises of equivalent (in terms of relative work load expressed as a percentage of VO2max) moderate intensity on selected blood cytokine levels and blood creatine kinase (CK) activity. Twenty recreationally active healthy young male volunteers were randomized between two groups that performed a single 1 h bout of CONC (uphill running) or ECC (downhill running) exercise at 60% of the respective individual VO2max. Venous blood taken 1 h before, at the end, and 24 h after the exercise was processed for plasma and analyzed for CK activity and IL-6, IL-1β and TNFα levels. There was no between-group difference in these cytokines prior to or just after the exercise, and in pre-exercise CK activity. The cytokines elevated significantly and similarly in both groups during the exercise, with no significant change in CK activity. Twenty-four hours later, CK activity and IL-6 were at pre-exercise levels in the CONC group, but showed further major increases in the ECC group, resulting in marked between-group differences in these indices. Changes in IL-1β and TNFα levels during the recovery period showed only minor differences between the study groups and produced no significant between-group difference in these cytokines. However, IL-1β level normalized in the ECC but not in the CONC group. The study suggests that moderate intensity ECC exercise compared to CONC exercise of equivalent relative work load results in considerably greater muscle damage and its related elevation in circulating IL-6, but it does not cause a major systemic inflammatory response.

This study aimed to determine whether chronic Rhodiola rosea (salidroside) supplementation augments neuromuscular and metabolic adaptations to flywheel eccentric (ECC) training. In total, 30 recreationally active female students were randomly assigned to (1) sedentary placebo control (SC, n = 10), (2) ECC training + placebo (ECC, n = 10), or (3) ECC training + salidroside (150 mg day−1; ECC + SA, n = 10) for 4 weeks. Pre- and post-intervention assessments included exhaustive cycling time to volitional fatigue, peak oxygen uptake (VO2 max), drop vertical jump (DJ) reactive strength index (RSI), and blood biomarkers of muscle damage and metabolism. ECC and ECC + SA prolonged time to exhaustion by 33% and 45%, respectively, without altering VO2 max. Across DJ1–DJ160, RSI significantly increased in both ECC groups (p < 0.01). Salidroside conferred an additional 8%–33% RSI advantage during the final 40 contacts (DJ120–DJ160; p < 0.05). The ECC + SA group exhibited lower postcycling creatine kinase (CK) and higher free fatty acids (FFA) than the SC group (p < 0.05). Triacylglycerol and low-density lipoprotein cholesterol decreased in ECC + SA compared with SC (p < 0.05), whereas body composition remained unchanged. In conclusion, four weeks of ECC training improved endurance and stretch–shortening performance. Salidroside further enhanced late-stage RSI, with additive antifatigue and muscle-protective effects during high-load eccentric conditioning in recreationally active women.

The cross-education effect (CE) is the transference of neuromuscular adaptations from a single exercised limb to the contralateral nonexercised limb, which seems to differ between exercise modalities. We compared the acute CE of unilateral eccentric (ECC) and concentric (CONC) resistance exercises on neuromuscular function and force production changes of the nonexercised elbow flexors (EF). Healthy men were randomly allocated into ECC (n = 15) or CONC (n = 15) groups. The effects of control (CTRLCONC or CTRLECC: 30 min of sitting) and exercise conditions (5 sets × 10 repetitions at 80% of either ECC or CONC 1-repetition maximum) of the dominant EF were measured. Maximal voluntary isometric contraction (MVIC), rate of torque development (RTD), corticospinal excitability (CSE), voluntary activation (VA), and peripheral factors were measured before and immediately after CTRLCONC/CTRLECC or CONC/ECC. Surface electromyography amplitude integral (sEMGi) from the biceps brachii (BB) muscle was monitored during exercise. Physical-mental demands (NASA-TLX) were assessed after exercise. ECC performed 26.2% greater exercise volume than CONC (P = 0.01). ECC showed lesser BB sEMGi (P = 0.04) than CONC in the exercised EF; however, it induced threefold greater irradiated sEMGi to the nonexercised BB than CONC (P = 0.04) during exercise. NASA-TLX was unchanged (P = 0.81). The nonexercised EF maintained MVIC, VA, cortical silent period, and peripheral factors after ECC and CONC (P > 0.05), but lower RTD was observed after ECC (23.5%-29.4%; P < 0.05) and CONC (10.8%; P < 0.05). Lower CSE at 75% of MVIC occurred after ECC (-17%; P = 0.02) compared with CTRLECC, which was correlated to RTD decreases (r = 0.45-0.56, P = 0.02-0.04). ECC induces acute contralateral reductions in CSE that are associated with decreases in RTD.NEW & NOTEWORTHY Unilateral eccentric and concentric resistance exercises can modulate the neuromuscular response differently, which influences the transference of the force production capacity to the contralateral nonexercised muscle. Unilateral eccentric exercise induced decreases in corticospinal excitability with associated reductions in the early phase of the rate of torque development, which differs from the changes observed after concentric exercise. Thus, both exercise modalities seem to change the excitability differently.

Eccentric (ECC) exercise is classically used to improve muscle strength and power in healthy subjects and athletes. Due to its specific physiological and mechanical properties, there is an increasing interest in employing ECC muscle work for rehabilitation and clinical purposes. Nowadays, ECC muscle actions can be generated using various exercise modalities that target small or large muscle masses with minimal or no muscle damage or pain. The most interesting feature of ECC muscle actions is to combine high muscle force with a low energy cost (typically 4- to 5-times lower than concentric muscle work) when measured during leg cycle ergometry at a similar mechanical power output. Therefore, if caution is taken to minimize the occurrence of muscle damage, ECC muscle exercise can be proposed not only to athletes and healthy subjects, but also to individuals with moderately to severely limited exercise capacity, with the ultimate goal being to improve their functional capacity and quality of life. The first part of this review article describes the available exercise modalities to generate ECC muscle work, including strength and conditioning exercises using the body's weight and/or additional external loads, classical isotonic or isokinetic exercises and, in addition, the oldest and newest specifically designed ECC ergometers. The second part highlights the physiological and mechanical properties of ECC muscle actions, such as the well-known higher muscle force-generating capacity and also the often overlooked specific cardiovascular and metabolic responses. This point is particularly emphasized by comparing ECC and concentric muscle work performed at similar mechanical (i.e., cycling mechanical power) or metabolic power (i.e., oxygen uptake, VO2). In particular, at a similar mechanical power, ECC muscle work induces lower metabolic and cardiovascular responses than concentric muscle work. However, when both exercise modes are performed at a similar level of VO2, a greater cardiovascular stress is observed during ECC muscle work. This observation underlines the need of cautious interpretation of the heart rate values for training load management because the same training heart rate actually elicits a lower VO2 in ECC muscle work than in concentric muscle work. The last part of this article reviews the documented applications of ECC exercise training and, when possible, presents information on single-joint movement training and cycling or running training programs, respectively. The available knowledge is then summarized according to the specific training objectives including performance improvement for healthy subjects and athletes, and prevention of and/or rehabilitation after injury. The final part of the article also details the current knowledge on the effects of ECC exercise training in elderly populations and in patients with chronic cardiac, respiratory, metabolic or neurological disease, as well as cancer. In conclusion, ECC exercise is a promising training modality with many different domains of application. However, more research work is needed to better understand how the neuromuscular system adapts to ECC exercise training in order to optimize and better individualize future ECC training strategies.