The chronic effects of eccentric exercise interventions in different populations: an umbrella review


Submitted: 14 September 2022
Accepted: 23 September 2022
Published: 21 October 2022
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Authors

The effectiveness of eccentric exercise interventions (EEI) has been extensively explored in different populations. The aim of our umbrella review was to combine all systematic reviews about the chronic efficiency of EEI and to summarize the literature on the chronic effects of different types of eccentric exercise protocols, with or without extra loads and devices (e.g., Flywheel device), compared to other therapeutic interventions, exercise interventions, or no intervention. We screened four major electronic scientific databases (PubMed, Scopus, Web of Science, and PEDro), using one combined string for all included databases (eccentric exercise OR flywheel OR isoinertial exercise OR eccentric training). Included reviews needed to be based on any human population, that executed EEI in comparison with any other type of intervention. The methodological quality of the included reviews was assessed using AMSTAR 2 tool. Considering the inclusion criteria, we included 35 reviews. EEI were found suitable for chronic or long-term pain reduction in patient populations. EEI largely improved muscle performance (muscle strength, and muscle power), muscle architecture (e.g., pennation angle, fascicle length, cross-sectional area, muscle thickness, and muscle mass), decreased risk of injury, incidence, and severity of the injury, and increased range of motion of the joints There is less evidence about the effects of EEI in older adult populations, compared to athletes and younger populations, however, eccentric exercise seems promising for these populations as well.


Jeffrey L. Young, Joel M. The Physiologic Basis of Sports Rehabilitation. Physical Medicine and Rehabilitation Clinics of North America, Volume 5, Issue 1, 1994, 9-36. DOI: https://doi.org/10.1016/S1047-9651(18)30536-9

Lindstedt SL, LaStayo PC, Reich TE. When active muscles lengthen: properties and consequences of eccentric contractions. News Physiol Sci. 2001 Dec;16:256-61. DOI: https://doi.org/10.1152/physiologyonline.2001.16.6.256

Cowell JF, Cronin J, Brughelli M. Eccentric Muscle Actions and How the Strength and Conditioning Specialist Might Use Them for a Variety of Purposes. Strength Cond J. 2012;34(3):33–48. DOI: https://doi.org/10.1519/SSC.0b013e318253f578

Perrey S, Betik A, Candau R, Rouillon JD, Hughson RL. Comparison of oxygen uptake kinetics during concentric and eccentric cycle exercise. J Appl Physiol (1985). 2001 Nov;91(5):2135-42. DOI: https://doi.org/10.1152/jappl.2001.91.5.2135

Bigland-Ritchie B, Woods JJ. Integrated electromyogram and oxygen uptake during positive and negative work. J Physiol. 1976 Sep;260(2):267-77. DOI: https://doi.org/10.1113/jphysiol.1976.sp011515

Ellis R, Shields N, Lim K, Dodd KJ. Eccentric exercise in adults with cardiorespiratory disease: a systematic review. Clin Rehabil. 2015 Dec;29(12):1178-97. Epub 2015 Mar 10. DOI: https://doi.org/10.1177/0269215515574783

Clos P, Laroche D, Stapley PJ, Lepers R. Neuromuscular and Perceptual Responses to Sub-Maximal Eccentric Cycling. Front Physiol. 2019 Mar 28;10:354. Erratum in: Front Physiol. 2020 Aug 12;11:934. DOI: https://doi.org/10.3389/fphys.2019.00354

Lovering RM, Brooks SV. Eccentric exercise in aging and diseased skeletal muscle: good or bad? J Appl Physiol (1985). 2014 Jun 1;116(11):1439-45. Epub 2013 Mar 7. DOI: https://doi.org/10.1152/japplphysiol.00174.2013

Julian V, Thivel D, Costes F, Touron J, Boirie Y, Pereira B, Perrault H, Duclos M, Richard R. Eccentric Training Improves Body Composition by Inducing Mechanical and Metabolic Adaptations: A Promising Approach for Overweight and Obese Individuals. Front Physiol. 2018 Aug 7;9:1013. DOI: https://doi.org/10.3389/fphys.2018.01013

Garrett WE Jr. Muscle strain injuries. Am J Sports Med. 1996;24(6 Suppl):S2-8. DOI: https://doi.org/10.1177/036354659602406S02

Malliaropoulos N, Mendiguchia J, Pehlivanidis H, Papadopoulou S, Valle X, Malliaras P, Maffulli N. Hamstring exercises for track and field athletes: injury and exercise biomechanics, and possible implications for exercise selection and primary prevention. Br J Sports Med. 2012 Sep;46(12):846-51. Epub 2012 Jun 9. DOI: https://doi.org/10.1136/bjsports-2011-090474

Serner A, Mosler AB, Tol JL, Bahr R, Weir A. Mechanisms of acute adductor longus injuries in male football players: a systematic visual video analysis. Br J Sports Med. 2019 Feb;53(3):158-164. Epub 2018 Jul 13. DOI: https://doi.org/10.1136/bjsports-2018-099246

Kary JM. Diagnosis and management of quadriceps strains and contusions. Curr Rev Musculoskelet Med. 2010 Jul 30;3(1-4):26-31. DOI: https://doi.org/10.1007/s12178-010-9064-5

Mendiguchia J, Alentorn-Geli E, Idoate F, Myer GD. Rectus femoris muscle injuries in football: a clinically relevant review of mechanisms of injury, risk factors and preventive strategies. Br J Sports Med. 2013 Apr;47(6):359-66. Epub 2012 Aug 3. DOI: https://doi.org/10.1136/bjsports-2012-091250

Brockett CL, Morgan DL, Proske U. Predicting hamstring strain injury in elite athletes. Med Sci Sports Exerc. 2004 Mar;36(3):379-87. DOI: https://doi.org/10.1249/01.MSS.0000117165.75832.05

Vogt M, Hoppeler HH. Eccentric exercise: mechanisms and effects when used as training regime or training adjunct. J Appl Physiol (1985). 2014 Jun 1;116(11):1446-54. Epub 2014 Feb 6. DOI: https://doi.org/10.1152/japplphysiol.00146.2013

Goode AP, Reiman MP, Harris L, DeLisa L, Kauffman A, Beltramo D, Poole C, Ledbetter L, Taylor AB. Eccentric training for prevention of hamstring injuries may depend on intervention compliance: a systematic review and meta-analysis. Br J Sports Med. 2015 Mar;49(6):349-56. Epub 2014 Sep 16. DOI: https://doi.org/10.1136/bjsports-2014-093466

LaStayo PC, Woolf JM, Lewek MD, Snyder-Mackler L, Reich T, Lindstedt SL. Eccentric muscle contractions: their contribution to injury, prevention, rehabilitation, and sport. J Orthop Sports Phys Ther. 2003 Oct;33(10):557-71. DOI: https://doi.org/10.2519/jospt.2003.33.10.557

Hoppeler H. Moderate Load Eccentric Exercise; A Distinct Novel Training Modality. Front Physiol. 2016 Nov 16;7:483. DOI: https://doi.org/10.3389/fphys.2016.00483

LaStayo P, Marcus R, Dibble L, Wong B, Pepper G. Eccentric versus traditional resistance exercise for older adult fallers in the community: a randomized trial within a multi-component fall reduction program. BMC Geriatr. 2017 Jul 17;17(1):149. DOI: https://doi.org/10.1186/s12877-017-0539-8

Kulkarni D, Gregory S, Evans M. Effectiveness of eccentric-biased exercise interventions in reducing the incidence of falls and improving functional performance in older adults: a systematic review. Eur Geriatr Med. 2022 Apr;13(2):367-380. Epub 2021 Oct 11. DOI: https://doi.org/10.1007/s41999-021-00571-8

Murphy MC, Travers MJ, Chivers P, Debenham JR, Docking SI, Rio EK, Gibson W. Efficacy of heavy eccentric calf training for treating mid-portion Achilles tendinopathy: a systematic review and meta-analysis. Br J Sports Med. 2019 Sep;53(17):1070-1077. Epub 2019 Jan 13. DOI: https://doi.org/10.1136/bjsports-2018-099934

Roig M, O'Brien K, Kirk G, Murray R, McKinnon P, Shadgan B, Reid WD. The effects of eccentric versus concentric resistance training on muscle strength and mass in healthy adults: a systematic review with meta-analysis. Br J Sports Med. 2009 Aug;43(8):556-68. Epub 2008 Nov 3. DOI: https://doi.org/10.1136/bjsm.2008.051417

Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014 Nov 21;14:579. DOI: https://doi.org/10.1186/s12913-014-0579-0

Aromataris E, Fernandez R, Godfrey CM, Holly C, Khalil H, Tungpunkom P. Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc. 2015 Sep;13(3):132-40. DOI: https://doi.org/10.1097/XEB.0000000000000055

Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017 Sep 21;358:j4008. DOI: https://doi.org/10.1136/bmj.j4008

Allen WJC, De Keijzer KL, Raya-González J, Castillo D, Coratella G, Beato M. Chronic effects of flywheel training on physical capacities in soccer players: a systematic review. Res Sports Med. 2021 Jul 27:1-21. Epub ahead of print. DOI: https://doi.org/10.1080/15438627.2021.1958813

Bautista IJ, Vicente-Mampel J, Baraja-Vegas L, Segarra V, Martín F, Van Hooren B. The effects of the Nordic hamstring exercise on sprint performance and eccentric knee flexor strength: A systematic review and meta-analysis of intervention studies among team sport players. J Sci Med Sport. 2021 Sep;24(9):931-938. Epub 2021 Mar 22. DOI: https://doi.org/10.1016/j.jsams.2021.03.009

Cullinane FL, Boocock MG, Trevelyan FC. Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review. Clin Rehabil. 2014 Jan;28(1):3-19. Epub 2013 Jul 23.

Cullinane FL, Boocock MG, Trevelyan FC. Is eccentric exercise an effective treatment for lateral epicondylitis? A systematic review. Clin Rehabil. 2014 Jan;28(1):3-19. Epub 2013 Jul 23. DOI: https://doi.org/10.1177/0269215513491974

Cuthbert M, Ripley N, McMahon JJ, Evans M, Haff GG, Comfort P. The Effect of Nordic Hamstring Exercise Intervention Volume on Eccentric Strength and Muscle Architecture Adaptations: A Systematic Review and Meta-analyses. Sports Med. 2020 Jan;50(1):83-99. Erratum in: Sports Med. 2019 Nov 7 DOI: https://doi.org/10.1007/s40279-019-01178-7

Douglas J, Pearson S, Ross A, McGuigan M. Chronic Adaptations to Eccentric Training: A Systematic Review. Sports Med. 2017 May;47(5):917-941. DOI: https://doi.org/10.1007/s40279-016-0628-4

Emirzeoğlu M, Fırat T, Ülger Ö. The effects of eccentric training on hamstring muscle architecture: A systematic review. Language (Baltim). 2021;97(2):141–153. DOI: https://doi.org/10.26582/k.53.1.17

Lim HY, Wong SH. Effects of isometric, eccentric, or heavy slow resistance exercises on pain and function in individuals with patellar tendinopathy: A systematic review. Physiother Res Int. 2018 Oct;23(4):e1721. Epub 2018 Jul 4.

Lim HY, Wong SH. Effects of isometric, eccentric, or heavy slow resistance exercises on pain and function in individuals with patellar tendinopathy: A systematic review. Physiother Res Int. 2018 Oct;23(4):e1721. Epub 2018 Jul 4. DOI: https://doi.org/10.1002/pri.1721

Nuñez Sanchez FJ, Sáez de Villarreal E. Does Flywheel Paradigm Training Improve Muscle Volume and Force? A Meta-Analysis. J Strength Cond Res. 2017 Nov;31(11):3177-3186. DOI: https://doi.org/10.1519/JSC.0000000000002095

O'Sullivan K, McAuliffe S, Deburca N. The effects of eccentric training on lower limb flexibility: a systematic review. Br J Sports Med. 2012 Sep;46(12):838-45. DOI: https://doi.org/10.1136/bjsports-2011-090835

Petré H, Wernstål F, Mattsson CM. Effects of Flywheel Training on Strength-Related Variables: a Meta-analysis. Sports Med Open. 2018 Dec 13;4(1):55. DOI: https://doi.org/10.1186/s40798-018-0169-5

Raya-González J, de Keijzer KL, Bishop C, Beato M. Effects of flywheel training on strength-related variables in female populations. A systematic review. Res Sports Med. 2022 Jul-Aug;30(4):353-370. Epub 2021 Jan 5. DOI: https://doi.org/10.1080/15438627.2020.1870977

Roig M, Shadgan B, Reid WD. Eccentric exercise in patients with chronic health conditions: a systematic review. Physiother Can. 2008 Spring;60(2):146-60. Epub 2008 Oct 10. DOI: https://doi.org/10.3138/physio.60.2.146

Schoenfeld BJ, Ogborn DI, Vigotsky AD, Franchi MV, Krieger JW. Hypertrophic Effects of Concentric vs. Eccentric Muscle Actions: A Systematic Review and Meta-analysis. J Strength Cond Res. 2017 Sep;31(9):2599-2608. DOI: https://doi.org/10.1519/JSC.0000000000001983

Al Attar WSA, Soomro N, Sinclair PJ, Pappas E, Sanders RH. Effect of Injury Prevention Programs that Include the Nordic Hamstring Exercise on Hamstring Injury Rates in Soccer Players: A Systematic Review and Meta-Analysis. Sports Med. 2017 May;47(5):907-916. DOI: https://doi.org/10.1007/s40279-016-0638-2

K, Grant A, Beers A, Moizumi T. A systematic review of the effectiveness of eccentric strength training in the prevention of hamstring muscle strains in otherwise healthy individuals. N Am J Sports Phys Ther. 2008 May;3(2):67-81.

Karagiannis C, Savva C, Mamais I, Efstathiou M, Monticone M, Xanthos T. Eccentric exercise in ischemic cardiac patients and functional capacity: A systematic review and meta-analysis of randomized controlled trials. Ann Phys Rehabil Med. 2017 Jan;60(1):58-64. Epub 2016 Dec 14. DOI: https://doi.org/10.1016/j.rehab.2016.10.007

Medeiros DM, Marchiori C, Baroni BM. Effect of Nordic Hamstring Exercise Training on Knee Flexors Eccentric Strength and Fascicle Length: A Systematic Review and Meta-Analysis. J Sport Rehabil. 2020 Oct 12;30(3):482-491. DOI: https://doi.org/10.1123/jsr.2019-0388

Raya-González J, Prat-Luri A, López-Valenciano A, Sabido R, Hernández-Davó JL. Effects of Flywheel Resistance Training on Sport Actions. A Systematic Review and Meta-Analysis. J Hum Kinet. 2021 Jan 30;77:191-204. DOI: https://doi.org/10.2478/hukin-2021-0020

Larsson R, Bernhardsson S, Nordeman L. Effects of eccentric exercise in patients with subacromial impingement syndrome: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2019 Oct 14;20(1):446. DOI: https://doi.org/10.1186/s12891-019-2796-5

Ortega-Castillo M, Medina-Porqueres I. Effectiveness of the eccentric exercise therapy in physically active adults with symptomatic shoulder impingement or lateral epicondylar tendinopathy: A systematic review. J Sci Med Sport. 2016 Jun;19(6):438-53. Epub 2015 Jun 15. DOI: https://doi.org/10.1016/j.jsams.2015.06.007

Raman J, MacDermid JC, Grewal R. Effectiveness of different methods of resistance exercises in lateral epicondylosis - A systematic review. J Hand Ther. United States: Hanley & Belfus; 2012;25(1):5–26. DOI: https://doi.org/10.1016/j.jht.2011.09.001

Wasielewski NJ, Kotsko KM. Does eccentric exercise reduce pain and improve strength in physically active adults with symptomatic lower extremity tendinosis? A systematic review. J Athl Train. 2007 Jul-Sep;42(3):409-21.

Yoon SY, Kim YW, Shin IS, Kang S, Moon HI, Lee SC. The Beneficial Effects of Eccentric Exercise in the Management of Lateral Elbow Tendinopathy: A Systematic Review and Meta-Analysis. J Clin Med. 2021 Sep 1;10(17):3968. DOI: https://doi.org/10.3390/jcm10173968

Dominguez-Romero JG, Jiménez-Rejano JJ, Ridao-Fernández C, Chamorro-Moriana G. Exercise-Based Muscle Development Programmes and Their Effectiveness in the Functional Recovery of Rotator Cuff Tendinopathy: A Systematic Review. Diagnostics (Basel). 2021 Mar 16;11(3):529. DOI: https://doi.org/10.3390/diagnostics11030529

Gérard R, Gojon L, Decleve P, Van Cant J. The effects of eccentric training on biceps femoris architecture and strength: A systematic review with meta-analysis. J Athl Train. 2020;55(5):501–514. DOI: https://doi.org/10.4085/1062-6050-194-19

Liu R, Liu J, Clarke CV, An R. Effect of eccentric overload training on change of direction speed performance: A systematic review and meta-analysis. J Sports Sci. 2020 Nov;38(22):2579-2587. Epub 2020 Jul 17. DOI: https://doi.org/10.1080/02640414.2020.1794247

Molinari T, Steffens T, Roncada C, Rodrigues R, Dias CP. Effects of Eccentric-Focused Versus Conventional Training on Lower Limb Muscular Strength in Older People: A Systematic Review With Meta-Analysis. J Aging Phys Act. 2019 Dec 1;27(4):823-830. DOI: https://doi.org/10.1123/japa.2018-0294

Woodley BL, Newsham-West RJ, Baxter GD. Chronic tendinopathy: effectiveness of eccentric exercise. Br J Sports Med. 2007 Apr;41(4):188-98; discussion 199. Epub 2006 Oct 24.

Križaj, L., Kozinc, Žiga, Löfler, S., & Šarabon, N. (2022). The chronic effects of eccentric exercise interventions in different populations: an umbrella review. European Journal of Translational Myology, 32(4). https://doi.org/10.4081/ejtm.2022.10876

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