Untrained Limb Research Articles

Effects of External Pacing Type on the Cross-Education of Motor Skill

Cross-education (CE) is a phenomenon whereby motor training of one limb leads to improved performance in the opposite untrained limb. External pacing of a motor task can enhance CE; however, the influence of different pacing methods is poorly understood. This study explored how motor training with auditory (AP) and visual pacing (VP) impacts CE with a visuomotor force target task. Sixty-one participants performed a unimanual motor task. Participants were randomized into a visual (n = 31) or auditory (n = 30) pacing stimuli condition. The primary outcome was cumulative error scores for each hand, before and after visuomotor training. Pacing type did not yield different magnitudes of CE. However, after adjusting for baseline differences, a significant hand (trained vs. untrained) × practice side (dominant or non-dominant) interaction (p = .013, η p 2 = .106) and a group main effect (p = .036, η p 2 = .165) were observed. Visual pacing resulted in greater improvements in task performance compared to auditory pacing regardless of hand or practice side, while training the dominant limb resulting in a greater interlimb asymmetry regardless of pacing stimulus. These findings have implications for applying pacing strategies during rehabilitation from unilateral injury or neurological impairment.

Ipsilateral transfer of motor skill from lower to upper limb in healthy adults: A randomized controlled trial.

Whereas motor skills of the untrained upper limb (UL) can improve following practice with the other UL, it has yet to be determined if an UL motor skill can improve following practice of that skill with the lower limb (LL). Forty-five healthy subjects randomly participated in a 10-minute single-session intervention of (1) practicing 50 reaching movement (RM) sequences with the non-dominant left LL toward light switches (LL group); or (2) observing the identical 50 light switches sequences (Switches Observation (SO) group); or (3) observing nature films (Nature Observation (NO) group). RM sequence performance with the left UL toward the light switches was tested before and immediately after the intervention and retested after 24 h. Reaching response time improved in the LL group more than in the SO and NO groups in the posttest (pBonferroni = 0.038 and pBonferroni < 0.001, respectively), and improved in the LL group more than in the NO group in the retest (pBonferroni = 0.004). Percentage of fails did not differ between groups across the timepoints. It appears that the actual practice of the RM sequence skill with the UL together with the cognitive element embedded in the observation of the RM sequences contributes to ipsilateral transfer from LL to UL.

Is there evidence for the asymmetrical transfer of strength to an untrained limb?

PurposeThe literature predominantly addresses cross-education of strength in the dominant limb rather than the non-dominant limb, guided by the hypothesis of an asymmetrical transfer of strength from unilateral training protocols. The purpose of the study was to review the literature and determine how much evidence was available to support this claim. A meta-analysis was performed to estimate the magnitude of this hypothesized asymmetrical transfer of strength.MethodsA literature search of all possible records was implemented using Cochrane Library, PubMed, and Scopus from February 2022 to May 2022. Comparison of randomized controlled trials was computed. The change scores and standard deviations of those change scores were extracted for each group. Only three studies met the criteria, from which a total of five effect sizes were extracted and further analyzed.ResultsThe overall effect of resistance training of the dominant limb on strength transfer to the non-dominant limb relative to the effects of resistance training the non-dominant limb on strength transfer to the dominant (non-training) limb was 0.46 (SE 0.42). The analysis from this study resulted in minimal support for the asymmetry hypothesis. Given the small number of studies available, we provide the effect but note that the estimate is unlikely to be stable.ConclusionAlthough it is repeatedly stated that there is an asymmetrical transfer of strength, our results find little support for that claim. This is not to say that it does not exist, but additional research implementing a control group and a direct comparison between limbs is needed to better understand this question.

Reducing Motor Variability Enhances Myoelectric Control Robustness Across Untrained Limb Positions

Reducing Motor Variability Enhances Myoelectric Control Robustness Across Untrained Limb Positions

Acute Effects of Strength and Skill Training on the Cortical and Spinal Circuits of Contralateral Limb

Unilateral strength and skill training increase strength and performance in the contralateral untrained limb, a phenomenon known as cross-education. Recent evidence suggests that similar neural mechanisms might be responsible for the increase in strength and skill observed in the untrained hand after unimanual training. The aims of this study were to: investigate whether a single session of unimanual strength and skill (force-tracking) training increased strength and skill in the opposite hand; measure ipsilateral (untrained) brain (via transcranial magnetic stimulation, TMS) and spinal (via the monosynaptic reflex) changes in excitability occurring after training; measure ipsilateral (untrained) pathway-specific changes in neural excitability (via TMS-conditioning of the monosynaptic reflex) occurring after training. Participants (N = 13) completed a session of unimanual strength (ballistic isometric wrist flexions) and skill (force-tracking wrist flexions) training on two separate days. Strength increased after training in the untrained hand (p = 0.025) but not in the trained hand (p = 0.611). Force-tracking performance increased in both the trained (p = 0.007) and untrained (p = 0.010) hand. Corticospinal excitability increased after force-tracking and strength training (p = 0.027), while spinal excitability was not affected (p = 0.214). TMS-conditioned monosynaptic reflex increased after force-tracking (p = 0.001) but not strength training (p = 0.689), suggesting a possible role of polysynaptic pathways in the increase of cortical excitability observed after training. The results suggest that cross-education of strength and skill at the acute stage is supported by increased excitability of the untrained motor cortex. New & Noteworthy: A single session of isometric wrist flexion strength and skill straining increased strength and skill in the untrained limb. The excitability of the untrained motor cortex increased after strength and skill training. TMS-conditioned H-reflexes increased after skill but not strength training in the untrained hand, indicating that polysynaptic pathways in the increase of cortical excitability observed after skill training.

Influence of motor imagery training on hip abductor muscle strength and bilateral transfer effect.

Motor imagery training could be an important treatment of reduced muscle function in patients and injured athletes. In this study, we investigated the efficacy of imagery training on maximal force production in a larger muscle group (hip abductors) and potential bilateral transfer effects. Healthy participants (n = 77) took part in two experimental studies using two imagery protocols (∼30min/day, 5days/week for 2 weeks) compared either with no practice (study 1), or with isometric exercise training (study 2). Maximal hip abduction isometric torque, electromyography amplitudes (trained and untrained limbs), handgrip strength, right shoulder abduction (strength and electromyography), and imagery capability were measured before and after the intervention. Post intervention, motor imagery groups of both studies exhibited significant increase in hip abductors strength (∼8%, trained side) and improved imagery capability. Further results showed that imagery training induced bilateral transfer effects on muscle strength and electromyography amplitude of hip abductors. Motor imagery training was effective in creating functional improvements in limb muscles of trained and untrained sides.

Unilateral high-load resistance training influences strength changes in the contralateral arm undergoing low-load training.

Within-subject training models have become common within the exercise literature. However, it is currently unknown if training one arm with a high load would impact muscle size and strength of the opposing arm training with a low load. Parallel group. 116 participants were randomized to one of three groups that completed 6-weeks (18 sessions) of elbow flexion exercise. Group 1 trained their dominant arm only, beginning with a one-repetition maximum test (≤5 attempts), followed by four sets of exercise using a weight equivalent to 8-12 repetition maximum. Group 2 completed the same training as Group 1 in their dominant arm, while the non-dominant arm completed four sets of low-load exercise (30-40 repetition maximum). Group 3 trained their non-dominant arm only, performing the same low-load exercise as Group 2. Participants were compared for changes in muscle thickness and elbow flexion one-repetition maximum. The greatest changes in non-dominant strength were present in Groups 1 (Δ 1.5 kg; untrained arm) and 2 (Δ1.1 kg; low-load arm with high load on opposite arm), compared to Group 3 (Δ 0.3 kg; low-load only). Only the arms being directly trained observed changes in muscle thickness (≈Δ 0.25 cm depending on site). Within-subject training models are potentially problematic when investigating changes in strength (though not muscle growth). This is based on the finding that the untrained limb of Group 1 saw similar changes in strength as the non-dominant limb of Group 2 which were both greater than the low-load training limb of Group 3.

Non-paretic leg movements can facilitate cortical drive to the paretic leg in individuals post stroke with severe motor impairment: Implications for motor priming.

Cross-education, a phenomenon where unilateral strength (or skill) training enhances strength (or skill) in the contralateral untrained limb, has been well studied in able-bodied individuals. Cross-education effect accompanies bilateral changes of corticomotor activity in the motor cortex (M1). Recent reports demonstrated greater cross-education effect in stroke survivors compared to healthy individuals, however, corticomotor responses to cross-education in stroke remains unclear. This study aimed to determine the effects of non-paretic leg movements on corticomotor excitability (CME) and reaction time of the paretic leg in severely impaired stroke survivors. Seventeen post stroke individuals with severe leg motor impairment (Fugl-Meyer lower extremity score less than 21 and absence of motor evoked potential in the paretic leg) performed three 20-min motor trainings using their non-paretic ankle: skill (targeted dynamic movements), strength (isometric resistance) and sham (sub-threshold electrical nerve stimulation). During training, verbal instructions were given to the participants to limit their movement to the non-paretic leg and this was confirmed with visual observation of the paretic leg. Transcranial magnetic stimulation measured CME of the contralateral pathways from the non-lesioned M1 to the non-paretic tibialis anterior (TA) muscle, ipsilateral pathways to the paretic TA and transcallosal inhibition (TCI) from the non-lesioned to lesioned M1. Paretic ankle reaction time was measured using a reaction time paradigm. All outcomes were measured before, immediately post, 30-min post and 60-min post priming. CME of the non-paretic TA increased after skill (.08 ± .10 mV) and strength (.06 ± .05 mV) training (p < .01). Ipsilateral CME of the paretic TA (.02 ± .01 mV) and TCI (.01 ± .01 s, ipsilateral silent period; more inhibition to the lesioned M1) increased after skill (p < .05) but not strength training. Reaction time of the paretic ankle improved after skill and strength training (-.11 ± .2 and -.13 ± .20 s, respectively; p < .05) and was sustained at 60 min. No changes were observed during the sham condition. Our findings may inform future studies for using non-paretic leg movements as a priming modality, especially for those who are contraindicated to other priming paradigms (e.g., brain stimulation) or unable to perform paretic leg movements. Conclusion: Non-paretic leg movements can be used as a priming modality, especially for those who are contraindicated to other priming paradigms (e.g., brain stimulation) or unable to perform paretic leg movements.

Enhancement of awareness through feedback does not lead to interlimb transfer of obstacle crossing in virtual reality

Locomotor skill transfer is an essential feature of motor adaptation and represents the generalization of learned skills. We previously showed that gait adaptation after crossing virtual obstacles did not transfer to the untrained limb and suggested it may be due to missing feedback of performance. This study investigated whether providing feedback and an explicit goal during training would lead to transfer of adaptive skills to the untrained limb. Thirteen young adults crossed 50 virtual obstacles with one (trained) leg. Subsequently, they performed 50 trials with their other (transfer) leg upon notice about the side change. Visual feedback about crossing performance (toe clearance) was provided using a color scale. In addition, joint angles of the ankle, knee, and hip were calculated for the crossing legs. Toe clearance decreased with repeated obstacle crossing from 7.8 ± 2.7 cm to 4.6 ± 1.7 cm for the trained leg and from 6.8 ± 3.0 cm to 4.4 ± 2.0 cm (p < 0.05) for the transfer leg with similar adaptation rates between limbs. Toe clearance was significantly higher for the first trials of the transfer leg compared to the last trials of the training leg (p < 0.05). Furthermore, statistical parametric mapping revealed similar joint kinematics for trained and transfer legs in the initial training trials but differed in knee and hip joints when comparing the last trials of the trained leg with the first trials of the transfer leg. We concluded that locomotor skills acquired during a virtual obstacle crossing task are limb-specific and that enhanced awareness does not seem to improve interlimb transfer.

The effectiveness of unilateral isokinetic resistance training on cross-education is independent of contraction velocity: a case of female dorsiflexors and plantar flexors.

The large body of published literature has shown that the effects of strength training can transfer from trained to untrained homologous limb muscles after unilateral training. These effects on strength have been shown to be very specific to the type and speed of training contraction. The aim of this study was to investigate the effects of a 4-week unilateral slow and fast velocity isokinetic concentric training, to compare the effects, and thus investigate whether these effects are speed-specific. Forty-four healthy female students allocated to slow training, fast training, or control performed 12 isokinetic concentric-concentric plantar/dorsal flexors training sessions (3 × 4 weeks) using their nondominant leg. Participants in the two experimental groups showed statistically significant gains in strength in both the trained (ranging from 8 to 41%) and untrained leg (5-26%), thus showing cross-education on strength effects. The present study demonstrated that 4 weeks (12 training sessions) of unilateral isokinetic resistance training in the concentric mode improved the strength of contralateral, untrained homologous muscles to the same extent, regardless of the contraction velocity used in females. Furthermore, the amount of concentric overload (50% more than during 60°/s) did not appear to affect the increase in strength gains. Therefore, practitioners are encouraged to use both training speeds when strength gains in the contralateral leg are the primary goal. If the training time is limited, however, training with a higher contraction speed is recommended.

Relationship between the interlimb transfer of a visuomotor learning task and interhemispheric inhibition in healthy humans.

The "interlimb transfer" phenomenon consists of improved performance of the trained and untrained contralateral limbs after unilateral motor practice. We here assessed whether a visuomotor learning task can be transferred from one hemisphere to the other, whether this occurs symmetrically, and the cortical neurophysiological correlates of this phenomenon, focusing on interhemispheric connectivity measures. We enrolled 33 healthy subjects (age range: 24-73years). Participants underwent two randomized sessions, which investigated the transfer from the dominant to the nondominant hand and vice versa. Measures of cortical and intracortical excitability and interhemispheric inhibition were assessed through transcranial magnetic stimulation before and after a visuomotor task. The execution of the visuomotor task led to an improvement in motor performance with the dominant and nondominant hands and induced a decrease in intracortical inhibition in the trained hemisphere. Participants were also able to transfer the visuomotor learned skill. The interlimb transfer, however, only occurred from the dominant to the nondominant hand and positively correlated with individual learning-related changes in interhemispheric inhibition. We here demonstrated that the "interlimb transfer" of a visuomotor task occurs asymmetrically and relates to the modulation of specific inhibitory interhemispheric connections. The study results have pathophysiological, clinical, and neuro-rehabilitative implications.

Balance improvements in healthy subjects are independent to postural strategies involved in the training

BackgroundAdequate postural strategies have a pivotal role in ensuring balance during the performance of daily or sport activities. These strategies are responsible for the management of center of mass kinematics and depend on the magnitude of perturbations and posture assumed by a subject. Research questionAre there differences in postural performance after a standardized balance training performed in sitting versus standing posture in healthy subjects? Does a standardized unilateral balance training with the dominant or non-dominant limb improve balance on trained and untrained limbs in healthy subjects? MethodsSeventy-five healthy subjects reporting a right-leg dominance were randomized into a Sitting, Standing, Dominant, Non-dominant or Control groups. In the Experiment 1, Sitting group performed a 3-week balance training in seated posture, whereas Standing group performed the same training in bipedal stance. In the Experiment 2, Dominant and Non-dominant groups underwent a 3-week standardized unilateral balance training on the dominant and non-dominant limbs, respectively. Control group underwent no intervention and was included in both experiments. Dynamic (Lower Quarter Y-Balance Test with the dominant and non-dominant limbs and trunk and lower limb 3D kinematics) and static (center of pressure kinematics in bipedal and bilateral single-limb stance) balance were assessed before and after the training, and at 4 weeks follow-up. ResultsA standardized balance training in sitting or standing posture improved balance without between-group differences, while a unilateral balance training with the dominant or non-dominant limb improved postural stability on the trained and untrained limbs. Trunk and lower limb joints range of motion increased independently to their involvement in the training. SignificanceThese results may allow clinicians to plan effective balance interventions even when a training in standing posture is not possible or in subjects with restricted limb weight-bearing.

Corticospinal and intracortical responses from both motor cortices following unilateral concentric versus eccentric contractions.

Cross-education is the phenomenon where training of one limb can cause neuromuscular adaptations in the opposite untrained limb. This effect has been reported to be greater after eccentric (ECC) than concentric (CON) strength training; however, the underpinning neurophysiological mechanisms remain unclear. Thus, we compared responses to transcranial magnetic stimulation (TMS) in both motor cortices following single sessions of unilateral ECC and CON exercise of the elbow flexors. Fourteen healthy adults performed three sets of 10 ECC and CON right elbow flexor contractions at 75% of respective maximum on separate days. Elbow flexor maximal voluntary isometric contraction (MVIC) torques were measured before and after exercise, and responses to single- and paired-pulse TMS were recorded from the non-exercised left and exercised right biceps brachii. Pre-exercise and post-exercise responses for ECC and CON were compared by repeated measures analyses of variance (ANOVAs). MVIC torque of the exercised arm decreased (p < 0.01) after CON (-30 ± 14%) and ECC (-39 ± 13%) similarly. For the non-exercised left biceps brachii, resting motor threshold (RMT) decreased after CON only (-4.2 ± 3.9% of maximum stimulator output [MSO], p < 0.01), and intracortical facilitation (ICF) decreased (-15.2 ± 20.0%, p = 0.038) after ECC only. For the exercised right biceps, RMT increased after ECC (8.6 ± 6.2% MSO, p = 0.014) but not after CON (6.4 ± 8.1% MSO, p = 0.066). Thus, unilateral ECC and CON elbow flexor exercise modulated excitability differently for the non-exercised hemisphere. These findings suggest that responses after a single bout of exercise may not reflect longer term adaptations.

Cross-Education Balance Effects after Unilateral Rehabilitation in Individuals with Chronic Ankle Instability: A Systematic Review.

To conduct a systematic review of existing literature of cross-education balance effects after unilateral training in the CAI population. PubMed, SPORTDiscus, CINAHL Plus. To be included in the systematic review, studies were required to be published in English, include participants with chronic ankle instability, have participants undergo a unilateral therapeutic exercise for the lower extremity, and measure balance performance on the untrained lower extremity before and after the intervention. The certainty of evidence within each included study was assessed via the Downs and Black checklist. A score of 24-28 is "excellent" or "very low risk of bias," 19-23 is "good" or "low risk of bias", 14-18 is "fair" or "moderate risk of bias", and less than 14 is "poor" or "high risk of bias." We extracted information from each included study regarding their design, participant characteristics, inclusion criteria, independent and dependent variables, intervention, and results. Baseline and post-intervention balance performance data for participants' untrained limbs were used to calculate Hedge's g effect size and 95% confidence intervals. Our search returned six studies that met the inclusion criteria. The articles' risk of bias ranged from high to low (11-19). Four of five studies that examined unilateral balance training reported a cross-education effect occurred. The lone study that examined resistance training at the ankle joint also reported a cross-education effect occurred. Several cross-education effects were associated with large effect sizes. This study was limited by a small number of studies that varied in methodology and quality. The results of this systematic review suggest that unilateral therapeutic exercise can improve balance performance on the untrained limb of individuals with CAI. More work is needed to determine which training parameters are most effective for generating a cross-education effect.

1894 revisited: Cross-education of skilled muscular control in women and the importance of representation.

In 1894 foundational work showed that training one limb for "muscular power" (i.e. strength) or "muscular control" (i.e. skill) improves performance in both limbs. Despite that the original data were exclusively from two female participants ("Miss Smith" and "Miss Brown"), in the decades that followed, such "cross-education" training interventions have focused predominantly on improving strength in men. Here, in a female cohort, we revisit that early research to underscore that training a task that requires precise movements in a timely fashion (i.e. "muscular control") on one side of the body is transferred to the contralateral untrained limb. With unilateral practice, women reduced time to completion and the number of errors committed during the commercially available game of Operation® Iron Man 2 with both limbs. Modest reductions in bilateral Hoffmann (H-) reflex excitability evoked in the wrist flexors suggest that alterations in the spinal cord circuitry may be related to improvements in performance of a fine motor task. These findings provide a long overdue follow-up to the efforts of Miss Theodate L. Smith from more than 125 years ago, highlight the need to focus on female participants, and advocate more study of cross-education of skilled tasks.

The Effects of Short-Term Resistance Training and Subsequent Detraining on Neuromuscular Function, Muscle Cross-Sectional Area, and Lean Mass

PurposeTo examine and compare the effects of three days of dynamic constant external resistance (DCER) and isokinetic (ISOK) training and subsequent detraining on thigh muscle cross-sectional area (TMCSA) and thigh lean mass (TLM), ISOK peak torque (PT), DCER strength, isometric force, muscle activation, and percent voluntary activation (%VA).MethodsThirty-one apparently-healthy untrained men (mean ± SD age = 22.2 ± 4.2 years; body mass = 77.9 ± 12.9 kg; height = 173.9 ± 5.4 cm) were randomly assigned to a DCER training group (n = 11), ISOK training group (n = 10) or control (CONT) group (n = 10). Subjects visited the laboratory eight times. The first visit was a familiarization session, the second visit was a pre-training assessment, the subsequent three visits were for unilateral training of the quadriceps (if assigned to a training group), and the last three visits were the post-training assessments conducted at three days, one week, and two weeks after training ended.ResultsDCER strength increased from pre- to post-training assessment 1 in both limbs for the DCER group only, and remained elevated during post-training assessments 2 and 3 (P < 0.05). In addition, surface EMG for the biceps femoris was higher at post-training assessment 3 than at the pre-training assessment, and post-training assessments 1 and 2 (P < 0.05). No other training-related changes were found.ConclusionThe primary finding of this study was that DCER strength of the trained and untrained limbs can be increased with three days of training. This has important implications for injury rehabilitation, where in the initial period post-injury strength gains on an injured limb can possibly be obtained with short-term contralateral resistance training.

A proposed model to test the hypothesis of exercise-induced localized fat reduction (spot reduction), including a systematic review with meta-analysis

PurposeThe process in which specific exercises reduce localized adipose tissue depots (targeted fat loss) and modify fat distribution is commonly termed spot reduction. According to this long-held popular belief, exercising a limb would lead to greater reduction in the adjacent adipose tissue in comparison with the contralateral limb. Aside from popular wisdom, scientific evidence from the 20th and 21st century seems to offer inconclusive results. The study aim was to summarize peer-reviewed literature assessing the effects of unilateral limb training, compared with the contralateral limb, on the localized adipose tissue depots in healthy participants, and to meta-analyse its results.MethodsWe followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched PubMed, Web of Science, and Scopus electronic databases using several relevant keyword combinations. Independent experts were contacted to help identify additional relevant articles. Following the PICOS approach, we included controlled studies that incorporated a localized exercise intervention (i.e., single-leg training) to cohorts of healthy participants (i.e., no restriction for fitness, age, or sex) compared with a control condition (i.e., contralateral limb), where the main outcome was the pre-to-post-intervention change of localized fat. The methodological quality of the studies was assessed with the Physiotherapy Evidence Database scale. Pre- and post-intervention means ± standard deviations of the fat-related outcome in the trained and control groups (limbs) were converted to Hedges’ g effect size (ES; with 95% confidence intervals [CI]) by using a random-effects model. The impact of heterogeneity was assessed with the I&lt;SUP&gt;2&lt;/SUP&gt; statistic. Extended Egger’s test served to explore the risk of reporting bias. The statistical significance threshold was set at &lt;i&gt;p&lt;/i&gt; &lt; 0.05.ResultsFrom 1833 search records initially identified, 13 were included in the meta-analysis, involving 1158 male and female participants (age, 14–71 years). The 13 studies achieved a high methodological quality, and presented results with low heterogeneity (I&lt;SUP&gt;2&lt;/SUP&gt; = 24.3%) and no bias (Egger’s test &lt;i&gt;p&lt;/i&gt; = 0.133). The meta-analysis involved 37 comparisons, with 17 of these favouring (i.e., greater reduction of localized fat) the trained limb, and 20 favouring the untrained limb, but the ES ranged between –1.21 and 1.07. The effects were consistent, with a pooled ES = –0.03, 95% CI: –0.10 to 0.05, &lt;i&gt;p&lt;/i&gt; = 0.508, meaning that spot reduction was not observed.ConclusionsLocalized muscle training had no effect on localized adipose tissue depots, i.e., there was no spot reduction, regardless of the characteristics of the population and of the exercise program. The popular belief concerning spot reduction is probably derived from wishful thinking and convenient marketing strategies, such as influencers seeking increased popularity and procedure sellers interested in increasing advertising.

Effects of Cross-Education After 6 Weeks of Eccentric Single-Leg Decline Squats Performed With Different Execution Times: A Randomized Controlled Trial.

Cross-education of strength refers to the strength gain that is transferred to the contralateral limb after a unilateral training program. Unilateral eccentric training using different muscle contraction times would improve the structural and functional properties of the untrained contralateral limb. Randomized controlled trial. Level 2. Thirty-six participants were randomized into a control group, experimental group 1 (EG6s; eccentric contraction runtime = 6 seconds) and experimental group 2 (EG3s; eccentric contraction runtime = 3 seconds). The thickness and elastographic index of the patellar tendon (PT), lean mass and fat percentage of the thigh, contractile properties of the vastus lateralis (VL), as well as isometric, concentric, and eccentric knee extensor peak torques, and eccentric single-leg decline squat (SLDSe) 1 repetition maximum (1-RM) were measured after 6 weeks of SLDSe training (3 times per week, 80% of 1-RM) and after 6 weeks of detraining in the untrained contralateral limb. After training, there was an increase in lean thigh mass of the untrained limb in both groups: EG6s (0.17 ± 0.29 kg;P = 0.03; effect size [ES] = 0.15) and EG3s (0.15 ± 0.23 kg; P = 0.04; ES = 0.19). Likewise, both EG6s (62.30 ± 19.09 kg; P < 0.001; ES = 4.23) and EG3s (68.09 ± 27.49 kg; P < 0.001; ES = 3.40) increased their 1-RM, isometric (EG6s: 48.64 ± 44.82 N·m, P < 0.001, ES = 0.63; EG3s: 34.81 ± 47.30 N·m, P = 0.004, ES = 0.38), concentric at 60 deg/s and 180 deg/s and eccentric at 60 deg/s and 180 deg/s knee extensor peak torques (P < 0.05) in the untrained limb. However, no differences were found in the contractile properties of the VL or in the thickness of the PT after eccentric training in either of the 2 experimental groups. Regardless of the runtime of the contraction, 6 weeks of SLSDe was effective for inducing structural and strength adaptations in the contralateral untrained limb. However, most of these adaptations were lost after 6 weeks of detraining. Our study suggests that cross-education training can be of great importance for clinical application and musculoskeletal and neuromuscular rehabilitative processes after unilateral injury.

Does partial activation of the neuromuscular system induce cross-education training effect? Case of a pilot study on motor imagery and neuromuscular electrical stimulation.

Cross education defines the gains observed in the contralateral limb following unilateral strength training of the other limb. The present study questioned the neural mechanisms associated with cross education following training by motor imagery (MI) or submaximal neuromuscular electrical stimulation (NMES), both representing a partial activation of the motor system as compared to conventional strength training. Twenty-seven participants were distributed in three groups: MI, NMES and control. Training groups underwent a training program of ten sessions in two weeks targeting plantar flexor muscles of one limb. In both legs, neuromuscular plasticity was assessed through maximal voluntary isometric contraction (MViC) and triceps surae electrophysiological responses evoked by electrical nerve stimulation (H-reflexes and V-waves). NMES and MI training improved MViC torque of the trained limb by 11.3% (P < 0.001) and 13.8% (P < 0.001), respectively. MViC of the untrained limb increased by 10.3% (P < 0.003) in the MI group only, accompanied with increases in V-waves on both sides. In the NMES group, V-waves only increased in the trained limb. In the MI group, rest H-reflexes increased in both the trained and the untrained triceps suraes. MI seems to be effective to induce cross education, probably because of the activation of cortical motor regions that impact the corticospinal neural drive of both trained and untrained sides. Conversely, submaximal NMES did not lead to cross education. The present results emphasize that cross education does not necessarily require muscle activity of the trained limb.

Using Modified Equipment in Field Hockey Leads to Positive Transfer of Learning Effect.

Cross-education is the phenomenon in which repeated practice of a unilateral motor task does not only result in performance improvement of the trained limb, but also in the untrained contralateral limb. The aim of this study was to test whether cross-education or positive transfer of learning is also achieved for tasks in which both limbs contribute in different ways by using modified equipment that switches the limbs’ role. To this end, a reverse field hockey stick was used that requires a mirroring of arm and hand use and dominance (i.e., right hand on top of the hockey stick instead of the left hand). Two groups of young skilled female field hockey players participated in a crossover-design, in which participants received four training sessions with a reverse hockey stick followed by four training sessions with a regular hockey stick, or vice versa. In a pre-test, intermediate test (following the first intervention period), a post-test (after the second intervention period) and a retention test, participants’ performance on a field hockey skill test with a regular hockey stick was measured. The results revealed that training with the reversed hockey stick led to significantly increased improvements compared to training with a regular hockey stick. We conclude that modified equipment can be used to exploit positive transfer of learning by switching the limbs’ roles. The findings are discussed by referring to the symmetry preservation principle in dynamic systems theory and have clear practical relevance for field hockey trainers and players seeking to further improve field hockey skills.