Eccentric Exercise Research Articles

Advanced therapeutic strategies in patellar ligament tendinopathy: from etiology to clinical practice. A literature review.

Introduction: Tendinopathy of the patellar ligament, often referred to as “jumper's knee,” is a significant health problem for athletes subjected to repeated knee strains. The condition, resulting from microtrauma and degeneration of collagen fibers, leads to chronic pain and impaired function of the patellar ligament. Aim of the study: The aim of this study was to present current knowledge about new techniques to prevent and treat patellar tendinopathy. Analyzing current informations, understanding risk factors, and recognizing pathophysiology of patellar tendinopathy can prevent many sportsmen to withdraw from competitions. Materials and methods: A systematic review of scientific and medical literature from the PubMed and Google Scholar databases was conducted. Results: A review of the literature has identified key risk factors for patellar ligament tendinopathy. An analysis of available studies indicates that various therapeutic interventions, including shockwave therapy, eccentric exercise programs can provide pain relief and improve patellar ligament function. However, the effectiveness of these methods may vary depending on individual patient characteristics. Conclusions: Recognition of risk factors, early education and prevention, and prompt introduction of treatment at an early enough stage of the disease allow for the best treatment results and rapid return of patients to sports activities before the onset of pain, and significantly improve patients' quality of life. These findings underscore the comprehensive nature of the management of patellar ligament tendinopathy, including both therapeutic and preventive interventions. Keywords: patellar tendinopathy, orthopeadics, sport medicine, knee

Effects of concentric and eccentric exercise regimens on bioenergetic efficiency of lymphocytes in sedentary males.

Eccentric exercise training (EET) increases physical performance while having lower metabolic demand than concentric exercise training (CET). Whether EET influences bioenergetic efficiency in peripheral blood mononuclear cells (PBMCs) remains unclear. This study investigates the effects of EET and CET on PBMC phenotypes and mitochondrial functions in blood. Thirty three sedentary healthy males were randomly assigned to either EET (n=11) or CET (n=11) that performed at progressively increased from 60% to 80% of maximal absolute workload for 30min/day, 5days/week for 6weeks, or a control group (n=11) that did not receive any exercise intervention. A graded exercise stress test (GXT) was performed before and after the intervention. PBMC phenotypes and mitochondrial respiratory capacity were analyzed using flowcytometry and high-resolution respirometry, respectively. In the same absolute workload, EET elicited lower heart rate and rating of perceived exertion than CET. However, EET as CET increased the VO2 level at the ventilatory threshold. Notably, both EET and CET increased central memory (CD45RO+/CD62+/CD3+) T cells and decreased effector memory T cells reexpressing CD45RA (CD45RA+/CD62-/CD3+). Moreover, the two exercise regimens diminished the loss of mitochondrial membrane potential (ΔΨm) caused by GXT, increased maximal/reserve O2 consumption rates (OCR), and bioenergetic health index in intact PBMCs and enhanced complex I-/II-related OCR in PBMCs with a substrate-rich environment. EET improves aerobic fitness with a lower cardiovascular response to exercise than CET. Moreover, EET as CET reduces senescent T-cell distribution in blood and improves PBMC bioenergetic efficiency by stabilizing ΔΨm and increasing capacity of oxidative phosphorylation.

Effect of different load during eccentric training with blood flow restriction on muscle size, strength, and performance: A randomized controlled trial✰

Background/Objectivestudies on eccentric training with blood flow restriction (BFR) still has gaps, especially in strength and muscle hypertrophy. Therefore, this study aimed to analyze and compare the effects of six weeks of eccentric training of knee extensors at different load associated or not with BFR on strength, hypertrophy, and performance of knee extensors. Methods61 men, healthy and untrained, performed six weeks of quadriceps muscle eccentric training in isokinetic dynamometer were randomized into four groups: high-load eccentric training with BFR (HLET-BFR), low-load eccentric training with BFR (LLET-BFR), high-load eccentric training (HLET) and low-load eccentric training (LLET). The strength, muscle structure and performance outcomes were evaluated at baseline, after 3 and 6 weeks of training. Resultsfor eccentric peak torque in the first three weeks, HLET was superior to LLET, but similar to LLET-BFR. In the final three weeks, superiority was observed in relation to LLET-BFR; however, there was no difference in relation to HIET-BFR. For the outcomes isometric and concentric peak torque, muscle structure and performance, there were no differences between groups. Conclusioneccentric training led to strengthening of knee extensors and improved performance, but without altering the muscle structure. LLET-BFR promoted gains similar to HLET in the first three weeks of training.

The Effects of Antioxidant Supplementation on Soccer Performance and Recovery: A Critical Review of the Available Evidence

Background Soccer is linked to an acute inflammatory response and the release of reactive oxygen species (ROS). Antioxidant supplements have shown promising effects in reducing muscle damage and oxidative stress and enhancing the recovery process after eccentric exercise. This critical review highlights the influence of antioxidant supplements on performance and recovery following soccer-related activity, training, or competition. Methods: English-language publications from the main databases that examine how antioxidant-based nutrition and supplements affect the recovery process before, during, and after soccer practice or competition were used. Results: Coenzyme Q10 (CoQ10), astaxanthin (Asx), red orange juice (ROJS), L-carnitine (LC), N-acetyl cysteine (NAC), beetroot (BET), turmeric root, and tangeretin reduce muscle damage (creatine kinase, myoglobin, cortisol, lactate dehudrogenase, muscle soreness). Tangeretin, docosahexaenoic acid (DHA), turmeric root, and aronia melanocarpa restrict inflammation (leukocytes, prostalagdin E2, C-reactive protein, IL-6 and 10). Q10, DHA, Asx, tangeretin, lippia citriodora, quercetin, allopurinol, turmeric root, ROJS, aronia melanocarpa, vitamins C-E, green tea (GTE), and sour tea (STE) reduce oxidative stress (malondialdehude, glutathione, total antioxidant capacity, superoxide dismutases, protein carbonyls, ascorbate, glutathione peroxidase, and paraoxonase 1). BET and NAC reinforce performance (endurance, jump, speed, strength). Conclusions: Further research is needed to determine the main mechanism and the acute and long-term impacts of antioxidant supplements in soccer.

Resistance but not endurance training suppresses glucocorticoid-induced leucine zipper (GILZ) expression in human skeletal muscle.

Within human skeletal muscle, statin treatment leads to elevated levels of the glucocorticoid-induced leucine zipper (GILZ). Further, GILZ mediates the muscle-related side effects of statins. Physical exercise leads to GILZ suppression, in a mechanosensitive manner. Given that statin treatment is rarely tolerated by habitually exercising individuals due to statin-associated muscle symptoms (SAMS), it appears that the opposing regulation of GILZ facilitates this detrimental interaction of two key measures of cardiovascular prevention, specifically for exercise modalities with high muscle strain. Similarly, opposing regulation of atrophy associated genes (atrogenes) may be a further mechanism. If confirmed, these results might have implications for the exercise prescription of statin-users. A systematic search of the Gene Expression Omnibus (GEO) repository for studies reporting the acute effects of either endurance (END), conventional resistance (RT), or eccentric resistance training (ECC) was conducted. GILZ, as well as the expression of pivotal atrogenes (e.g., muscle atrophy F-box, cathepsin L, etc.) were quantified. 15 studies with 204 participants (22 females; 182 males) were included. RT resulted in the highest GILZ suppression, significantly differing from the expressional change after END ( - 0.46 ± 1.11 vs. - 0.07 ± 1.08), but not from ECC ( - 0.46 ± 1.11 vs. - 0.46 ± 0.95). Similar results were seen for various atrogenes. Our results strengthen the assumption that mechanical loading can be considered a key mediator of exercise-induced changes in GILZ and atrogene expression.

Comparative analysis of acute eccentric contraction-induced changes to the skeletal muscle transcriptome in young and aged mice and humans.

Adaptations to skeletal muscle following resistance exercise are due in part to changes to the skeletal muscle transcriptome. While transcriptional changes in response to resistance exercise occur in young and aged muscle, aging alters this response. Rodent models have served great utility in defining regulatory factors that underscore the influence of mechanical load and aging on changes to skeletal muscle phenotype. Unilateral eccentric contractions in young and aged rodents are widely used to model resistance exercise in humans. However, the extent to which unilateral eccentric contractions in young and aged rodents mimics the transcriptional response in humans remains unknown. We re-analyzed two publicly available RNA sequencing datasets from young and aged mice and humans that were subjected to acute eccentric contractions to define key similarities and differences to the muscle transcriptional response following this exercise modality. The effect of aging on the number of contraction-sensitive genes, the distribution patterns of those genes into unique/common categories, and the cellular pathways associated with the differentially expressed genes (DEGs) were similar in mice and humans. However, there was little overlap between species when comparing specific contraction-sensitive DEGs within the same age group. There were strong intraspecies relationships for the common transcription factors predicted to influence the contraction-sensitive gene sets, whereas interspecies relationships were weak. Overall, these data demonstrate key similarities between mice and humans for the contraction-induced changes to the muscle transcriptome, but we posit species-specific responses exist and should be taken into consideration when attempting to translate rodent eccentric exercise models.

Short-term Effects of Pulsed Electromagnetic Field Therapy for Achilles Tendinopathy: A Randomized Controlled Trial.

Pulsed electromagnetic field (PEMF) therapy is a potential nonoperative treatment for Achilles tendinopathy, but the current published literature on its effects is sparse. To evaluate the therapeutic efficacy of PEMF therapy and eccentric exercise for Achilles tendinopathy. Randomized controlled trial; Level of evidence, 1. A total of 65 participants met the inclusion criteria and were randomly assigned to either the active PEMF group (n = 33) or the sham group (n = 32). The PEMF group received biweekly PEMF therapy (10 minutes per session) for 8 weeks, plus eccentric exercise for 12 weeks. The sham group received the same eccentric exercise for 12 weeks minus active PEMF exposure. The primary outcome was the Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire. The secondary outcomes were numeric pain rating scale (NPRS) score, tendon neovascularity, and total time spent on sports per week. A physical therapist assessed all outcomes at baseline and then 4, 8, and 12 weeks after the commencement of the PEMF treatment. The level of tendon neovascularity was determined by the Öhberg score (range, 0-3). VISA-A scores improved significantly from baseline to 12 weeks posttreatment in both the PEMF group (from 57.9 to 71.7) and the sham group (from 55.1 to 66.8) (P < .001 for both), with no significant difference in scores between treatment groups throughout the 12 weeks (P = .527). NPRS scores during sports also improved significantly from baseline to 12 weeks for the PEMF group (from 6.05 to 2.95) and the sham group (from 6.45 to 3.85) (P < .001), with no group differences (P = .346). PEMF therapy, in addition to eccentric exercise, did not improve outcome scores or tendon neovascularity compared with eccentric exercise alone in participants with Achilles tendinopathy. NCT05316961 (ClinicalTrials.gov identifier).

Achilles Tendon Pain in Male Professional Football Players - A Prospective Five-Season Study of 88 Injuries from the UEFA Elite Club Injury Study.

The objective was to describe the location, examination procedures, diagnoses, and treatment for gradual-onset Achilles tendon pain in male professional football (soccer) players. Forty-seven teams were followed prospectively for at least one season from 2013/14 to 2017/18. Time-loss injuries were recorded by the teams' medical staffs. For all non-contact Achilles tendon injuries, a specific Achilles tendon form was sent to teams. There were 88 time-loss injuries recorded with gradual-onset Achilles tendon pain amongst 72 players; 22 (25%) of them were severe lasting more than four weeks including one career-ending injury. The specific form was returned for 78 injuries (89%) with 55 cases (71%) having midportion and 23 cases (29%) insertional pain. There were 51 cases (65%) being examined with ultrasound and 29 cases (37%) with magnetic resonance imaging, both modalities being used in 18 cases (23%). Tendinopathy was the most frequently reported main diagnosis both for midportion and insertional pain with 60 cases (77%), but multiple diagnoses were recorded in 21 cases (27%). Surgery was performed in six cases (8%), and the majority of players were exposed to several non-surgical treatments in various combinations, with eccentric training and cryotherapy being most frequent with 52 cases (72%) each. Tendinopathy was the most frequent diagnosis both for midportion and insertional pain. Imaging was carried out for most injuries. A majority of injuries were managed non-surgically, with eccentric training and cryotherapy being the most frequently applied treatments.

Re: Rubin et al.: Eccentric Viewing Training for Age-Related Macular Disease: Results of a Randomized Controlled Trial (the EFFECT Study)

Re: Rubin et al.: Eccentric Viewing Training for Age-Related Macular Disease: Results of a Randomized Controlled Trial (the EFFECT Study)

The Influence of Eccentric Muscle Actions on Concentric Muscle Strength: An Exception to the Principle of Specificity?

The principle of specificity suggests that the largest changes in strength occur when training resembles the specific strength test. A one-repetition maximum (1RM) test, which tests the maximal concentric strength, is commonly used as a surrogate for strength adaptation. When separating muscle actions into concentric or eccentric phases, multiple lines of evidence suggest that eccentric muscle actions possess several distinct physiological properties compared with concentric actions. In accordance, there are instances where the increases in 1RM strength test were similar between eccentric-only and concentric-only resistance training. This is at odds with the principle of specificity which suggests that individuals who trained with concentric actions would be expected to have an advantage in that specific task. Although the mechanistic reasons why eccentric-biased training carries over to maximal concentric strength remains to be elucidated, the lack of discernible differences in strength gains with eccentrically-biased training (e.g., eccentric-only and accentuated eccentric training) may imply that the effects of eccentric loading in training are transferable to concentric strength. Our review revisits the role of eccentric loading in enhancing concentric maximal muscle strength. We also speculate on potential physiological factors (i.e., molecular and neural factors) that may differentiate the effects of eccentric and concentric resistance training on the changes in muscle strength. Currently, the majority of the studies investigating the changes in strength have been conducted using isokinetic eccentric training. This is important as there is a viewpoint that the magnitude of chronic adaptations with different modalities of eccentric exercises (i.e., isotonic, isokinetic, and isoinertial training) may also differ from each other. While it has been suggested that eccentric action has a greater transferable capacity for strength adaptations compared to concentric actions, future investigations are warranted to investigate with different modalities of eccentric exercises. There also remains a host of unanswered questions related to the role of eccentric action for maximal concentric strength. For example, future studies may examine whether the eccentric action would be additive when the training is already maximally loaded during the concentric action for increasing concentric maximal strength. We suggested a few different designs that could be used to answer some of these questions in future studies.

Efficacy of a combined exercise and nutrition intervention study for outpatients with possible sarcopenia in community-based primary care clinics (ENdSarC): study protocol for a multicenter single-blinded randomized controlled trial

BackgroundSarcopenia is a geriatric disease characterized by loss of muscle mass and strength. Although combined exercise and nutrition intervention are known to be effective for sarcopenia, clinical trials involving outpatients with sarcopenia in primary care are scarce. We describe a protocol for a trial to examine the effects of a 12-week combined exercise and nutrition intervention in Korean older adults with possible sarcopenia in community-based primary care.MethodsThis multicenter, randomized, controlled trial will include 94 community-dwelling older outpatients aged 65–85 years with possible sarcopenia (47 participants in the intervention and control groups each). Resistance exercises, which incorporate concentric and eccentric exercises, will consist of an introductory phase (3 weeks: twice-weekly supervised exercise sessions and once-weekly home exercises; contraction exercises), an expanded phase (3 weeks: twice-weekly supervised exercise sessions and once-weekly home exercises; eccentric exercises), and a maintenance phase (6 weeks: once-weekly supervised exercise sessions and twice-weekly home exercises; power/eccentric exercises). Nutritional supplementation will be provided according to the nutritional status of the participants using a Mini-Nutritional Assessment. Participants will be assessed at baseline, 12 and 24 weeks, and the primary outcome will be the 5-times chair stand test results.DiscussionTo the best of our knowledge, this will be the first clinical trial to evaluate the efficacy of a combined exercise and nutritional supplementation intervention in older outpatients with possible sarcopenia in community-based primary care clinics. These findings will provide new insights to clinicians regarding the long-term usability for doctors and outpatients with possible sarcopenia in community-based primary care.Trial registrationThis trial was prospectively registered at ClinicalTrials.gov on September 16, 2023 (registration number: NCT06049914).

TMG Symmetry and Kinematic Analysis of the Impact of Different Plyometric Programs on Female Athletes’ Lower-Body Muscles

Asymmetries in sports are common and can lead to various issues; however, different training programs can facilitate change. This study aimed to assess the effects of opposing plyometric programs on tensiomyography lateral symmetry (TMG LS)/inter-limb asymmetry in female athletes’ lower-body muscles, alongside kinematic and body composition parameters. Twenty female subjects from basketball, volleyball, and track and field (sprinting disciplines) were divided into two experimental groups (n = 10 each). Two six-week plyometric programs (two sessions/week) were implemented: the first program (E1) focused on eccentric exercises, depth landings, while the second (E2) emphasized concentric exercises, squat jumps. TMG assessed LS in six muscles: vastus lateralis, vastus medialis, biceps femoris, semitendinosus, gastrocnemius lateralis, and gastrocnemius medialis. A kinematic analysis of the countermovement jump (CMJ) and body composition was conducted using “Kinovea; Version 0.9.4” software and InBody 770, respectively. The results showed significant increases in LS percentages (E1—VL 9.9%, BF 18.0%, GM 10.6% and E2—BF 22.5%, p &lt; 0.05), and a significant large effect in E1 for VL, and in E2 for BF, p &lt; 0.01). They also showed that E1 had a significant effect on VL, and that E2 had a significant large effect on BF (p &lt; 0.01). E1 also led to increased lean muscle mass in both legs (left: 1.88%, right: 2.74%) and decreased BMIs (−0.4, p &lt; 0.05). Both programs improved LS, with E1 enhancing muscle mass and lower-body positioning in CMJ. We recommend future studies use varied jump tests, incorporate 3D kinematic analysis, include male subjects, and examine more muscles to enhance TMG LS analysis.

The effect of eccentric arm cycling on muscle damage and injury-related biomarkers.

There is a scarcity of information regarding the effect of upper-body eccentric exercise on biomarkers of muscle damage. This study sought to investigate the effect of eccentric arm cycling on muscle damage [exercise-induced muscle damage (EIMD)]. Ten subjects performed a 15 min eccentric arm cycling protocol (cadence 49 ± 7 rpm, power absorbed 248 ± 34 W). Maximal voluntary contraction (MVC) of the elbow flexors was evaluated at rest and at 5 min, 24 h, and 48 h post-exercise. In addition, blood samples were drawn at rest and thereafter at 30 min, 24 h, and 48 h intervals after exercise for quantification of creatine kinase (CK), myoglobin, lactate dehydrogenase (LDH) and endothelin (ET-1) concentrations. Delayed onset muscle soreness (DOMS) was assessed using a category ratio scale (0-10). Myoglobin was increased from baseline at 30 min post-exercise (+114%, 46.08 ± 22.17 µg/L, p = 0.018). Individual peak values were higher than baseline values for CK (+72.8%, 204 ± 138 U/L, p = 0.046) and LDH (+17%, 3.3 ± 0.88 nmole/min/mL, p = 0.017), but not for ET-1 (+9%, 1.4 ± 0.48 pg/mL, p = 0.45). DOMS was reported at 24 h (median 4) and 48 h (median 4) post-exercise and MVC of the elbow flexors were reduced from baseline (216 ± 44 N) at 5 min (-34%, 147 ± 61 N, p < 0.001), 24 h (-17%, 181 ± 56 N, p = 0.005) and 48 h (-9%, 191 ± 54 N, p = 0.003). Eccentric arm cycling incites EIMD with reduced MVC and elevation of myoglobin, CK and LDH.

Submaximal eccentric resistance training increases serial sarcomere number and improves dynamic muscle performance in old rats.

The age-related loss of muscle mass is partly accounted for by the loss of sarcomeres in series, contributing to declines in muscle mechanical performance. Resistance training biased to eccentric contractions increases serial sarcomere number (SSN) in young muscle, however, maximal eccentric training in old rats previously did not alter SSN and worsened performance. A submaximal eccentric training stimulus may be more conducive to adaptation for aged muscle. The purpose of this study was to assess whether submaximal eccentric training can increase SSN and improve mechanical function in old rats. Twelve 32-month-old male F344/BN rats completed 4 weeks of submaximal (60% maximum) eccentric plantar-flexion training 3 days/week. Pre- and post-training, we assessed in-vivo maximum isometric torque at a stretched and neutral ankle angle, the passive torque-angle relationship, and the isotonic torque-velocity-power relationship. The soleus and medial gastrocnemius (MG) were harvested for SSN measurements via laser diffraction, with the untrained leg as a control. SSN increased 11% and 8% in the soleus and MG, respectively. Training also shifted optimal torque production towards longer muscle lengths, reduced passive torque 42%, and increased peak isotonic power 23%. Submaximal eccentric training was beneficial for aged muscle adaptations, increasing SSN, reducing muscle passive tension, and improving dynamic contractile performance.

Multiscale hamstring muscle adaptations following 9 weeks of eccentric training.

Eccentric training, such as Nordic hamstring exercise (NHE) training, is commonly used as a preventive measure for hamstring strains. Eccentric training is believed to induce lengthening of muscle fascicles and to be associated with the addition of sarcomeres in series within muscle fibers. However, the difficulty in measuring sarcomere adaptation in human muscles has severely limited information about the precise mechanisms of adaptation. This study addressed this limitation by measuring the multiscale hamstring muscle adaptations in response to 9 weeks of NHE training and 3 weeks of detraining. Twelve participants completed 9 weeks of supervised NHE training, followed by a 3-week detraining period. We assessed biceps femoris long-head (BFlh) muscle fascicle length, sarcomere length, and serial sarcomere number in the central and distal regions of the muscle. Additionally, we measured muscle volume and eccentric strength at baseline, post-training, and post-detraining. NHE training over 9 weeks induced significant architectural and strength adaptations in the BFlh muscle. Fascicle length increased by 19% in the central muscle region and 33% in the distal muscle region. NHE also induced increases in serial sarcomere number (25% in the central region and 49% in the distal region). BFlh muscle volume increased by 8%, and knee flexion strength increased by 40% with training. Following 3 weeks of detraining, fascicle length decreased by 12% in the central region and 16% in the distal region along with reductions in serial sarcomere number. Nine weeks of NHE training produced substantial, region-specific increases in BFlh muscle fascicle length, muscle volume, and force generation. The direct measurement of sarcomere lengths revealed that the increased fascicle length was accompanied by the addition of sarcomeres in series within the muscle fascicles.

Skeletal muscle adaptations following eccentric contractions are not mediated by keratin 18.

The molecular mechanisms that drive muscle adaptations after eccentric exercise training are multifaceted and likely impacted by age. Previous studies have reported that many genes and proteins respond differently in young and older muscles following training. Keratin 18 (Krt18), a cytoskeletal protein involved in force transduction and organization, was found to be upregulated after muscles performed repeated bouts of eccentric contractions, with higher levels observed in young muscle compared with older muscle. Therefore, the purpose of this study was to determine if Krt18 mediates skeletal muscle adaptations following eccentric exercise training. The anterior crural muscles of Krt18 knockout (KO) and wild-type (WT) mice were subjected to either a single bout or repeated bouts of eccentric contractions, with isometric torque assessed across the initial and final bouts. Functionally, Krt18 KO and WT mice did not differ prior to performing any eccentric contractions (P ≥ 0.100). Muscle strength (tetanic isometric torques) and the ability to adapt to eccentric exercise training were also consistent across strains at all time points (P ≥ 0.169). Stated differently, immediate strength deficits and the recovery of strength following a single bout or multiple bouts of eccentric contractions were similar between Krt18 KO and WT mice. In summary, the absence of Krt18 does not impede the muscle's ability to adapt to repeated eccentric contractions, suggesting it is not essential for exercise-induced remodeling.NEW & NOTEWORTHY The molecular processes that underlie the changes in skeletal muscle following eccentric exercise training are complex and involve multiple factors. Our findings indicate that Krt18 may not play a significant role in muscle adaptations following eccentric exercise training, likely due to its low expression in skeletal muscle. These results underscore the complexity of the molecular mechanisms that contribute to muscle plasticity and highlight the need for further research in this area.

Changes In Anatomical Cross-sectional Area Following 6 Weeks Of Eccentric Hamstring Training

Changes In Anatomical Cross-sectional Area Following 6 Weeks Of Eccentric Hamstring Training

Force-velocity Profiling Of A 60 M Sprint Following 6 Weeks Of Eccentric Strength Training

Force-velocity Profiling Of A 60 M Sprint Following 6 Weeks Of Eccentric Strength Training

Cross-education Of The Repeated-bout Effect After Unilateral Eccentric Exercise With And Without Mirror Visual Feedback

Cross-education Of The Repeated-bout Effect After Unilateral Eccentric Exercise With And Without Mirror Visual Feedback

Effects Of Eccentric Training Intervention On Performance During The Sprint, Drag, Carry Event Of The Army Combat Fitness Test

Effects Of Eccentric Training Intervention On Performance During The Sprint, Drag, Carry Event Of The Army Combat Fitness Test