Effect of eccentric exercise on patients with chronic exertional compartment syndrome

Applied Biomedical Research Centre, GKT School of Biomedical Sciences, King's College London, Shepherd's House, Guy's Campus, UK.
Arbeitsphysiologie (Impact Factor: 2.19). 02/2003; 88(6):565-71. DOI: 10.1007/s00421-002-0740-z
Source: PubMed


There are a number of similarities between chronic exertional compartment syndrome (CECS) and the effects of high force eccentric contractions in healthy controls. We hypothesised that CECS patients would be particularly susceptible to pain, fatigue and swelling after eccentric exercise. Ten CECS patients [aged 30.3 (8.0) years, mean (SD)], 7 males) and 14 healthy controls [aged 32.3 (9.0) years, 7 males] performed 40 maximal eccentric contractions of the anterior tibial muscles at an angular velocity of 90(o) s(-1). Maximal voluntary isometric contractions (MVC), force generated by electrical stimulation at 10 Hz and 50 Hz and muscle thickness (measured by real-time ultrasound scanning) were measured before exercise and for 10 min afterwards. Ratings of pain and tenderness were made before exercise, then 24 h and 48 h later. The two groups were comparable for initial isometric strength and muscle size. MVC force immediately after exercise fell to 90 (2.5)% [mean (SEM)] in patients and 86.5 (2.4)% in controls (P<0.0005 for both groups) and had not recovered after 10 min. Preferential loss of force at the low stimulation frequency occurred in both groups to a similar extent (20%, P<0.0005) and continued to decline over 10 min of recovery. There was no significant change in muscle thickness in either group. Only mild pain and tenderness were reported by the controls. The patients showed great individual variation but their mean pain scores were significantly higher during dorsiflexion and palpation (P<0.05) 24 h after exercise. After 48 h the patients reported more pain during dorsiflexion (P=0.005), plantarflexion (P<0.05) and palpation (P<0.05). These results suggest that some, but not all, CECS patients may be more susceptible to the pain associated with eccentric contractions that is thought to be the cause of damage and inflammation of connective tissue.

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    • "to detect clinically important changes (Lexell and Downham 2005). Reliability estimates for test retest measures of muscle thickness in healthy people have demonstrated that ultrasound measures of muscle size have high reliability (Bemben 2002; Birtles et al. 2003; Gondin et al. 2005; Miyatani et al. 2004; Oguri et al. 2004; Rankin and Stokes 1998; Thoirs and English 2009). However, the results of these trials should be considered with some caution, due to shortfalls relating to measurer blinding, sample size and statistical analyses. "
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    • "The response of muscle tissue to eccentric exercise particularly involves the cytoskeletal proteins desmin and actin (Yu and Thornell 2002; Yu et al. 2002; Lieber et al. 2002), as well as causing sarcomere disruption (Morgan and Proske 2004; Friden and Lieber 1998) with resulting sarcomerogenesis/myoWbrillar remodelling (Yu and Thornell 2002; ButterWeld and Herzog 2006). It is speculated that DOMS may be an event occurring in various tissues including epimysium/fascia rather than muscle tissue proper (Malm et al. 2004; Birtles et al. 2003). This is in line with facilitated Xexor-withdrawal response to electrical stimulation found speciWcally at the level of the fascia in rabbit gastrocnemius muscle 48 h post-eccentric exercise (Itoh and Kawakita 2002). "
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