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  • Dr. Andrea Macaluso obtained a Degree in Medicine (1991), followed by a specialisation in Sport Medicine (1995) and a... moreedit
Objective: This study aimed at investigating the effectiveness of an 8-week training protocol, based on neuromuscular electrical stimulation of the quadriceps, which was superimposed onto voluntary exercise (NMES+), in comparison to a... more
Objective: This study aimed at investigating the effectiveness of an 8-week training protocol, based on neuromuscular electrical stimulation of the quadriceps, which was superimposed onto voluntary exercise (NMES+), in comparison to a traditional heavy slow resistance training (HSRT), in individuals with patellar tendinopathy. Methods: Thirty-two physically active participants, aged: 33.6±10.2 years, were divided into two groups: NMES+ or HSRT. Maximal voluntary isometric contraction (MVIC) of knee extensor and flexor muscles, power during a countermovement jump (CMJ), and VISA-p questionnaire scores were recorded at the start(T0), 2-weeks(T1), 4-weeks(T2), 6-weeks(T3), 8-weeks(T4) and 4-months post-training (T5). Knee pain and rate of perceived exertion (RPE) were recorded at each training session with a 0-10 scale. Results: Knee pain was significantly lower in NMES+ compared to HSRT during all training sessions. No significant between-group differences were found for VISA-p scores and forces recorded during MVICs at T0,T1,T2,T3,T4 and T5. A significant increase of VISA-p and peak forces during MVIC was recorded across-time in both groups. No significant between-group or across-time differences were found for RPE and CMJ parameters. Conclusions: NMES+ and HSRT were equally effective in decreasing tendinopathy symptoms and increasing strength, with NMES+ having the advantage to be a pain-free resistance training modality.
Measurement of maximal power output (Pmax) during an all-out sprint action lasting a few seconds on a frictionallybraked cycle-ergometer commonly requires instrumenting the cycle’s flywheel (Arsac et al, 1996). This study proposes using a... more
Measurement of maximal power output (Pmax) during an all-out sprint action lasting a few seconds on a frictionallybraked cycle-ergometer commonly requires instrumenting the cycle’s flywheel (Arsac et al, 1996). This study proposes using a novel method for measuring instantaneous Pmax by measuring the flywheel’s angular velocity and acceleration through motion analysis (MA). Hence, the purpose of this study is to demonstrate the validity and reliability of using MA against a direct measure of Pmax by means of force transducers (FT) incorporated in a standard pedal. A single leg model is proposed for its applicability to experimental research. With Ethics Committee approval, 8 women (age 23.1±3.4 yrs; stature 1.65±0.06 m; body mass 60.4±5.0 kg; mean±SD) and 8 men (age 28.5±5.2 yrs; stature 1.78±0.04 m; body mass 77.0±11.5 kg), recreationally active, took part in 3 identical sessions, separated by 4-6 days, the first being a familiarisation. During each session testing initially involved determining the participants maximal friction-load turned through two complete pedal revolutions (2-RM; Macaluso et al, 2003). Individuals then performed three 6-s sprints against two different loads, 20% and 50% 2RM, with 3-min rest between trials. All trials were performed using the right leg, while the left leg rested on the bike. Position data of the reflective markers placed on the flywheel, side of the pedal and crank centre were collected using a five camera system (Vicon M2, California, USA) at 250Hz. The flywheel’s acceleration was obtained as double derivative and filtering of kinematic data, transposed from cartesian to polar coordinates, and torque as the sum of the inertial component, angular momentum and friction resistance applied to the flywheel. Technical description of the instrumented pedal has been previously reported (Bibbo et al, 2006). The pedal torque was obtained using force data and crank length. In both cases power was calculated as the product of torque and angular velocity. Pmax was obtained in both systems from the average of the 3 highest peaks in each trial. Validity: MA recorded significantly higher Pmax than FT (P<0.05) on average by 40.9±18.9 W in men and 12.9±6.9 W in women. However, Pmax recorded with the two systems was highly correlated (Pearson’s correlation coefficient 0.85±0.04 in men and 0.98±0.02 in women). Repeatability: average intraclass correlation coefficients of 0.90±0.05 in males and 0.85±0.08 in females indicate a very high degree of repeatability between trials and days for both systems. The novel method of using MA to measure Pmax on a cycle-ergometer has been proven as a valid a reliable method for use in exercise physiology research provided a consistent bias between the measurements is allowed for. References Arsac LM et al (1996). Eur J Appl Physiol 74: 100-106 Macaluso A et al (2003). J Appl Physiol 95: 2544-2553 Bibbo D et al (2006). Proc XVI ISEK Congress, Turin, Italy, p. 199
To investigate the effects of ageing on the neural control strategies governing sprint cycling on a friction-loaded cycle-ergometer, 10 older (aged 70-83 yr) and 8 young (aged 19-35 yr) healthy women completed seven 6-s all-out cycling... more
To investigate the effects of ageing on the neural control strategies governing sprint cycling on a friction-loaded cycle-ergometer, 10 older (aged 70-83 yr) and 8 young (aged 19-35 yr) healthy women completed seven 6-s all-out cycling trials against varying loads. Root mean square (RMS), median frequency and muscle fibre conduction velocity were determined from the vastus lateralis of the dominant limb during each pedal stroke. Peak power was 43% lower in the older group compared to the younger (p < 0.001) and was accompanied by a significantly lower RMS (p < 0.05). No differences were observed in the other electromyography (EMG) parameters between the groups (p > 0.05). ΔRMS from the first to the sixth second during each trial was found to increase significantly with the development of power output in both groups (p < 0.05). For the first time during an all-out 6-s cycle trial, it has been demonstrated that older women's lower mechanical power output was accompanied by a significantly lower RMS, which indicates a decline in either the number of active of motor units or a reduced discharge rate. Hence, changes in motor units can be regarded as a contributory factor to the decline of muscle power with advancing age. Overall, though, similar neural strategies are adopted in both younger and older populations.
Ten male volunteers (age 29.2 ± 5.2 years, mean ± SD) were recruited to test the hypothesis that muscle fibre conduction velocity (MFCV) would decrease with power output during a 30-s Wingate test on a mechanically-braked cycle ergometer.... more
Ten male volunteers (age 29.2 ± 5.2 years, mean ± SD) were recruited to test the hypothesis that muscle fibre conduction velocity (MFCV) would decrease with power output during a 30-s Wingate test on a mechanically-braked cycle ergometer. Prior to the main test, the optimal pre-fixed load corresponding to the highest power output was selected following a random series of six 10-s sprints. Surface electromyographic (EMG) signals were detected from the right vastus lateralis with linear adhesive arrays of eight electrodes. Power output decreased significantly from 6-s until the end of the test (860.9 ± 207.8 vs. 360.9 ± 11.4 W, respectively) and was correlated with MFCV (R=0.543, P<0.01), which also declined significantly by 26.8 ± 11% (P<0.05). There was a tendency for the mean frequency of the EMG power spectrum (MNF) to decrease, but average rectified values (ARV) remained unchanged throughout the test. The parallel decline of MFCV with power output suggests changes in fibre membrane properties. The unaltered ARV, together with the declined MFCV, would indicate either a decrease in discharge rate, de-recruitment of fatigued motor units or elongation of still present motor unit action potentials.
The present work aimed at investigating the effects of local vibration on upper limb postural and kinetic tremor, on manual dexterity and on spinal reflex excitability. Previous studies have demonstrated a decrease in spinal reflex... more
The present work aimed at investigating the effects of local vibration on upper limb postural and kinetic tremor, on manual dexterity and on spinal reflex excitability. Previous studies have demonstrated a decrease in spinal reflex excitability and in force fluctuations in the lower limb but an increase in force fluctuation in the upper limbs. As hand steadiness is of vital importance in many daily-based tasks, and local vibration may also be applied in movement disorders, we decided to further explore this phenomenon. Ten healthy volunteers (26±3years) were tested for H reflex, postural and kinetic tremor and manual dexterity through a Purdue test. EMG was recorded from flexor carpi radialis (FCR) and extensor digitorum communis (EDC). Measurements were repeated at baseline, after a control period during which no vibration was delivered and after vibration. Intervention consisted in holding for two minutes a vibrating handle (frequency 75Hz, displacement∼7mm), control consisted in holding for two minutes the same handle powered off. Reflex excitability decreased after vibration whilst postural tremor and manual dexterity were not affected. Peak kinetic tremor frequency increased from baseline to control measurements (P=0.002). Co-activation EDC/FCR increased from control to vibration (P=0.021). These results show that two minutes local vibration lead to a decrease in spinal excitability, did not compromise manual dexterity and did not increase tremor; however, in contrast with expectations, tremor did not decrease. It is suggested that vibration activated several mechanisms with opposite effects, which resulted in a neutral outcome on postural and kinetic tremor.
Human locomotion is the product of complex dynamic systems, which rely on physical capacities as well as cognitive functions. In our daily life, we mostly experience forward walking, but also backward stepping can occur, as in protective... more
Human locomotion is the product of complex dynamic systems, which rely on physical capacities as well as cognitive functions. In our daily life, we mostly experience forward walking, but also backward stepping can occur, as in protective stepping. In this work, we investigated the electroencephalographic (EEG) correlates of cognitive processing underpinning step initiation by means of movement-related cortical potentials (MRCPs) analysis and force-plates recordings. Healthy young volunteers (N = 11) performed self-paced forward- and backward-oriented steps on two force platforms, which were synchronized to simultaneous EEG recordings. MRCPs and their source localization analyses were computed. Results demonstrate the involvement of cognitive processing during step preparation and execution, as showed by the prefrontal activity, which was enhanced in backward stepping. Further, the parietal activity was larger in forward than backward stepping, while motor-related regions were involved in both step directions. Thus, the neural timing and sources of forward and backward stepping suggest a functional distinction of these two actions, which undergo different cortical organizations. Backward stepping requires enhanced cognitive control and can be regarded as an avoidance behavior, while forward stepping would be assimilated to an oriented-to-action behavior mainly localized over parietal areas. In conclusion, preparing body locomotion involves high cognitive processing, with step direction showing different cortical organization and functional specialization.
The aim of the study was to assess the relationship between performance-based and laboratory tests for muscular strength and power assessment in older women. Thirty-two women aged 68.8 +/- 2.8 years were recruited. All participants were... more
The aim of the study was to assess the relationship between performance-based and laboratory tests for muscular strength and power assessment in older women. Thirty-two women aged 68.8 +/- 2.8 years were recruited. All participants were asessed for: (a) two performance-based tests--the box-stepping test (mean 296 +/- 51 J) and two-revolution maximum test (mean 7.1 +/- 2 kg) performed while pedalling on a cycle ergometer; and (b) muscular function tests--maximal instantaneous peak power jumping on a force platform (mean 1528 +/- 279 W); maximal voluntary contraction (MVC) during knee extension (mean 601 +/- 571 N) and leg press (mean 626 +/- 126 N), and leg press power (mean 483 +/- 98 W) on a dynamometer. Using univariate analysis, performance-based tests were compared with laboratory muscle strength and power measurements. Muscle power correlated most strongly with the performance-based tests for both jumping and leg press power (r-values between 0.67 and 0.75; P < 0.01). The correlation with muscle strength measures ranged between 0.48 and 0.61 (P < 0.01). The proposed tests may have particular relevance in geriatric and rehabilitation environments as they represent an easy, practical, and inexpensive alternative for the assessment of muscular strength and power.
ABSTRACT
Introduction High intensity functional trainings (HIFT), a recent development of high intensity trainings, includes in the same training session components of endurance exercises, elements of Olympic weightlifting and powerlifting,... more
Introduction High intensity functional trainings (HIFT), a recent development of high intensity trainings, includes in the same training session components of endurance exercises, elements of Olympic weightlifting and powerlifting, gymnastics, plyometrics and calisthenics exercises. Therefore, subjects practicing this type of activity are supposed to show physiological features that represent a combination of both endurance and power athletes. The aim of this study was to compare the physiological profile of three groups of age-matched endurance, HIFT and power athletes. Methods A total of 30 participants, 18 to 38-year-old men were enrolled in the study. Participants were divided in three groups: HIFT ( n  = 10), endurance (END, n  = 10), and power (POW, weightlifters, n  = 10) athletes. All were evaluated for anthropometric characteristics, VO 2peak , handgrip, lower limb maximal isometric and isokinetic strength, countermovement vertical jump and anaerobic power through a shuttle run test on the field. Results VO 2peak /kg was higher in END and HIFT than POW athletes ( p  = 0.001 and p  = 0.007, respectively), but there were no significant differences between the first two. POW and HIFT athletes showed significant greater strength at the handgrip, countermovement jump and leg extension/flexion tests than END athletes. HIFT athletes showed highest results at the dynamic isokinetic test, while there were no significant differences at the shuttle run test among groups. Conclusions As HIFT reach aerobic levels similar to END athletes and power and strength output similar to POW athletes, it appears that HIFT programs are effective to improve both endurance-related and power-related physical fitness components.
Introduction: The application of neuromuscular electrical stimulation superimposed on voluntary muscle contractions (NMES+) has demonstrated a considerable potential to enhance or restore muscle function in both healthy and individuals... more
Introduction: The application of neuromuscular electrical stimulation superimposed on voluntary muscle contractions (NMES+) has demonstrated a considerable potential to enhance or restore muscle function in both healthy and individuals with neurological or orthopedic disorders. Improvements in muscle strength and power have been commonly associated with specific neural adaptations. In this study, we investigated changes in the discharge characteristics of the tibialis anterior motor units, following three acute exercises consisting of NMES+, passive NMES and voluntary isometric contractions alone.Methods: Seventeen young participants participated in the study. High-density surface electromyography was used to record myoelectric activity in the tibialis anterior muscle during trapezoidal force trajectories involving isometric contractions of ankle dorsi flexors with target forces set at 35, 50% and 70% of maximal voluntary isometric contraction (MVIC). From decomposition of the elect...
The aim of this study was to assess force and power exertion during a countermovement jump (CMJ) following anterior cruciate ligament (ACL) reconstruction using either semitendinosus and gracilis (STGR) or bone-patellar tendon-bone (BPTB)... more
The aim of this study was to assess force and power exertion during a countermovement jump (CMJ) following anterior cruciate ligament (ACL) reconstruction using either semitendinosus and gracilis (STGR) or bone-patellar tendon-bone (BPTB) graft. One-hundred-nineteen STGR and 146 BPTB participants performed a CMJ on two force platforms after 3 (T1) and 6-9 months (T2) from surgery. Twenty-four healthy participants served as control group (CG). Peak force of eccentric (ECC) and concentric (CON) phases and peak power were obtained from the analysis of vertical components of the ground reaction forces. Asymmetry was quantified by means of limb symmetry index (LSI). ECC peak force was significantly (p < 0.05) lower than CON peak force in both BPTB and STGR at T1 and T2. At T1, BPTB showed higher peak power, but lower LSI in ECC and CON compared to STGR. At T2, BPTB showed higher peak power than STGR, while there were no differences in LSI between the two groups, which however was significantly (p < 0.05) lower in both groups when compared with CG. BPTB and STGR participants showed asymmetries in ECC and CON force during a CMJ. BPTB showed greater asymmetries and a higher peak power respect to STGR participants.
The neural factors underlying the persistency of quadriceps weakness after anterior cruciate ligament reconstruction (ACLR) have been only partially explained. This study examined muscle fiber conduction velocity (MFCV) as an indirect... more
The neural factors underlying the persistency of quadriceps weakness after anterior cruciate ligament reconstruction (ACLR) have been only partially explained. This study examined muscle fiber conduction velocity (MFCV) as an indirect parameter of motor unit recruitment strategies in the vastus lateralis (VL) and medialis (VM) muscles of soccer players with ACLR. High‐density surface electromyography (HDsEMG) was acquired from VL and VM in nine soccer players (22.7 ± 2.9 years; BMI: 22.08 ± 1.72 kg·m−2; 7.7 ± 2.2 months post‐surgery). Voluntary muscle force and the relative myoelectrical activity from the reconstructed and contralateral sides were recorded during linearly increasing isometric knee extension contractions up to 70% of maximal voluntary isometric force (MVIF). The relation of MFCV and force was examined by linear regression analysis at the individual subject level. The initial (intercept), peak (MFCV70), and rate of change (slope) of MFCV related to force were compared between limbs and muscles. The MVIF was lower in the reconstructed side than in the contralateral side (−%20.5; P < .05). MFCV intercept was similar among limbs and muscles (P > .05). MFCV70 and MFCV slope were lower in the reconstructed side compared to the contralateral for both VL (−28.5% and −10.1%, respectively; P < .001) and VM (−22.6% and −8.1%, respectively; P < .001). The slope of MFCV was lower in the VL than VM, but only in the reconstructed side (−12.4%; P < .001). These results suggest possible impairments in recruitment strategies of high‐threshold motor units (HTMUs) as well as deficits in sarcolemmal excitability, fiber diameter, and discharge rate of knee extensor muscles following ACLR.
Longitudinal changes in compensatory and anticipatory postural adjustments around the knee were investigated from rupture of ACL until return to play after reconstruction. Twelve ACL-injured participants (ACL-P) were asked to respond to... more
Longitudinal changes in compensatory and anticipatory postural adjustments around the knee were investigated from rupture of ACL until return to play after reconstruction. Twelve ACL-injured participants (ACL-P) were asked to respond to unpredictable and predictable perturbations before (T1), 2 (T2) and 6 months after (T3) reconstruction. Twelve healthy participants served as controls. Compensatory and anticipatory latencies of vastus lateralis (VL) and medialis (VM) were measured with respect to the arrival of perturbations. ACL-P showed delayed compensatory latencies compared to controls at T1 for VL (101±32 ms vs 63±7 ms) and VM (117±36 ms vs 75±17 ms) and at T2 for VL (94±20 ms vs 63±7 ms) and VM (94±27 ms vs 71±11 ms). ACL-P showed earlier anticipatory latencies than controls for VL at T1 (-69±44 ms vs -12±12 ms) and T2 (-46±17 ms vs -16±12 ms). At T3, ACL-P showed delayed compensatory latencies for VL (91±18 ms vs 56±21 ms) and VM (95±13 ms vs 66±4 ms), whilst anticipatory lat...
as a novel approach to resistance training increases muscle strength, power and
Transition tasks between static and dynamic situations may challenge head stabilization and balance in older individuals. The study was designed to investigate differences between young and older women in the upper body motion during the... more
Transition tasks between static and dynamic situations may challenge head stabilization and balance in older individuals. The study was designed to investigate differences between young and older women in the upper body motion during the voluntary task of gait initiation. Seven young (25 ± 2.3 years) and seven older healthy women (78 ± 3.4 years) were required to stand on a force platform and initiate walking at their self-selected preferred speed. Angles of head, neck and trunk were measured by motion analysis in the sagittal plane and a cross-correlation analysis was performed on segments pairs. Variability of head and neck angular displacements, as indicated by average standard deviation, was significantly greater in the older than in the young participants. The young women maintained dynamic stability of the upper body, as forward flexion of the trunk was consistently counteracted by coordinated head–neck extension. Differently, movement patterns employed by the older women also...
BACKGROUND Chronic low back pain (CLBP) is associated with an increased trunk stiffness and muscle coactivation during walking. However, it is still unclear whether CLBP individuals are unable to control neuromechanically their upper body... more
BACKGROUND Chronic low back pain (CLBP) is associated with an increased trunk stiffness and muscle coactivation during walking. However, it is still unclear whether CLBP individuals are unable to control neuromechanically their upper body motion during a sudden termination of gait (GT), which involves a challenging balance transition from walking to standing. RESEARCH QUESTION Does CLBP elicit neuromuscular and kinematic changes which are specific to walking and GT?. METHODS Eleven individuals with non-specific CLBP and 11 healthy controls performed walking and sudden GT in response to an external visual cue. 3D kinematic characteristics of thorax, lumbar and pelvis were obtained, with measures of range of motion (ROM) and intra-subject variability of segmental movement being calculated. Electromyographic activity of lumbar and abdominal muscles was recorded to calculate bilateral as well as dorsoventral muscle coactivation. RESULTS CLBP group reported greater transverse ROM of the lumbar segment during walking and GT compared to healthy controls. Thorax sagittal ROM was higher in CLBP than healthy participants during GT. Greater overall movement variability in the transverse plane was observed in the CLBP group while walking, whereas GT produced greater variability of lumbar frontal motion. CLBP participants showed higher bilateral lumbar coactivation compared to healthy participants after the stopping stimulus delivery during GT. SIGNIFICANCE These results suggest that CLBP can elicit a wider and more variable movement of the upper body during walking and GT, especially in the transverse plane and at lumbar level. Alterations in upper body motor control appeared to depend on task, plane of motion and segmental level. Therefore, these findings should be considered by practitioners when screening before planning specific training interventions for recovery of motor control patterns in CLBP population.
This systematic review of the literature aimed to highlight which criteria are described in the literature to define when a patient, after rotator cuff repair (RCR), is ready for return-to-play (RTP), which includes return to unrestricted... more
This systematic review of the literature aimed to highlight which criteria are described in the literature to define when a patient, after rotator cuff repair (RCR), is ready for return-to-play (RTP), which includes return to unrestricted activities, return to work, leisure, and sport activities. An online systematic search on the US National Library of Medicine (PubMed/MEDLINE), SCOPUS, Web of Science (WOS), and the Cochrane Database of Systematic Reviews, was performed with no data limit until December 2021. A total of 24 studies that reported at least one criterion after RCR were included. Nine criteria were identified and among these, the most reported criterion was the time from surgery, which was used by 78% of the studies; time from surgery was used as the only criterion by 54% of the studies, and in combination with other criteria, in 24% of the studies. Strength and ROM were the most reported criteria after time (25%). These results are in line with a previous systematic re...
The study aimed at investigating the effects of neuromuscular electrical stimulation superimposed on functional exercises (NMES+) early after anterior cruciate ligament reconstruction (ACLr) with hamstring graft, on muscle strength, knee... more
The study aimed at investigating the effects of neuromuscular electrical stimulation superimposed on functional exercises (NMES+) early after anterior cruciate ligament reconstruction (ACLr) with hamstring graft, on muscle strength, knee function, and morphology of thigh muscles and harvested tendons. Thirty-four participants were randomly allocated to either NMES+ group, who received standard rehabilitation with additional NMES of knee flexor and extensor muscles, superimposed on functional movements, or to a control group, who received no additional training (NAT) to traditional rehabilitation. Participants were assessed 15 (T1), 30 (T2), 60 (T3), 90 (T4) and at a mean of 380 days (T5) after ACLr. Knee strength of flexors and extensors was measured at T3, T4 and T5. Lower limb loading asymmetry was measured during a sit-to-stand-to-sit movement at T1, T2, T3, T4 and T5, and a countermovement-jump at T4 and T5. An MRI was performed at T5 to assess morphology of thigh muscles and re...

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