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Partial range of motion training elicits favorable improvements in muscular adaptations when carried out at long muscle lengths

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The study compared changes in strength and regional muscle hypertrophy between different ranges of motion (ROM) in the knee extension exercise. Forty-five untrained women were randomized to either a control group or to perform the exercise in one of the following 4 groups (0°=extended knee): Full ROM (FULLROM: 100°-30° of knee flexion); Initial Partial ROM (INITIALROM: 100°-65°); Final Partial ROM (FINALROM: 65°-30°); Varied ROM (VARROM: daily alternation between the ROM of INITIALROM and FINALROM). Pre- and post-training assessments included one repetition maximum (1RM) testing in the ROM corresponding to the initial, final and full ROM, and measurement of cross-sectional areas of the rectus femoris and vastus lateralis muscles at 40%, 50%, 60% and 70% of femur length in regard to regional muscle hypertrophy. Results showed that the INITIALROM group presented a greater relative increase than all groups at 70%, and at 50% and 60% the increases were greater than FINALROM, FULLROM, and non-training control (CON) groups. Moreover, FINALROM group presented similar changes compared to the CON group at 60% and 70%. In regard to 1RM, FINALROM and INITIALROM groups presented greater relative increases at the ROM trained, and no group showed greater increases than VARROM or INITIALROM, regardless the ROM tested. In conclusion, partial ROM training in the initial phase of the knee extension exercise promoted greater relative hypertrophy in certain muscle regions than training in other ROM configurations, and no group promoted a greater 1RM increase than VARROM group, which showed similar 1RM increases in the different ROMs tested.
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Partial range of motion training elicits favorable
improvements in muscular adaptations when
carried out at long muscle lengths
Gustavo F. Pedrosa, Fernando V. Lima, Brad J. Schoenfeld, Lucas T. Lacerda,
Marina G. Simões, Mariano R. Pereira, Rodrigo C.R. Diniz & Mauro H. Chagas
To cite this article: Gustavo F. Pedrosa, Fernando V. Lima, Brad J. Schoenfeld, Lucas T. Lacerda,
Marina G. Simões, Mariano R. Pereira, Rodrigo C.R. Diniz & Mauro H. Chagas (2021): Partial
range of motion training elicits favorable improvements in muscular adaptations when carried out at
long muscle lengths, European Journal of Sport Science, DOI: 10.1080/17461391.2021.1927199
To link to this article: https://doi.org/10.1080/17461391.2021.1927199
View supplementary material Published online: 23 May 2021.
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Partial range of motion training elicits favorable improvements in muscular
adaptations when carried out at long muscle lengths
Gustavo F. Pedrosa
a,b
, Fernando V. Lima
a
, Brad J. Schoenfeld
c
, Lucas T. Lacerda
a,d,e,f
, Marina G. Simões
a
,
Mariano R. Pereira
a
, Rodrigo C.R. Diniz
a
and Mauro H. Chagas
a
a
Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo
Horizonte, Brazil;
b
Brazilian Air Force, Aeronautical Instruction and Adaptation Center, Lagoa Santa, Brazil;
c
Department of Health Sciences,
CUNY Lehman College, Bronx, NY, USA;
d
Department of Physical Education and Sports, Technological Education Federal Center of Minas
Gerais, Belo Horizonte, Brazil;
e
Pontical Catholic University of Minas Gerais, Belo Horizonte, Brazil;
f
State University of Minas Gerais,
Divinópolis, Brazil
ABSTRACT
The study compared changes in strength and regional muscle hypertrophy between dierent
ranges of motion (ROM) in the knee extension exercise. Forty-ve untrained women were
randomized to either a control group or to perform the exercise in one of the following 4
groups (0°=extended knee): Full ROM (FULL
ROM
: 100°30° of knee exion); Initial Partial ROM
(INITIAL
ROM
: 100°65°); Final Partial ROM (FINAL
ROM
: 65°30°); Varied ROM (VAR
ROM
: daily
alternation between the ROM of INITIAL
ROM
and FINAL
ROM
). Pre- and post-training assessments
included one repetition maximum (1RM) testing in the ROM corresponding to the initial, nal
and full ROM, and measurement of cross-sectional areas of the rectus femoris and vastus
lateralis muscles at 40%, 50%, 60% and 70% of femur length in regard to regional muscle
hypertrophy. Results showed that the INITIAL
ROM
group presented a greater relative increase
than all groups at 70%, and at 50% and 60% the increases were greater than FINAL
ROM
,
FULL
ROM
, and non-training control (CON) groups. Moreover, FINAL
ROM
group presented similar
changes compared to the CON group at 60% and 70%. In regard to 1RM, FINAL
ROM
and
INITIAL
ROM
groups presented greater relative increases at the ROM trained, and no group
showed greater increases than VAR
ROM
or INITIAL
ROM
, regardless the ROM tested. In conclusion,
partial ROM training in the initial phase of the knee extension exercise promoted greater
relative hypertrophy in certain muscle regions than training in other ROM congurations, and
no group promoted a greater 1RM increase than VAR
ROM
group, which showed similar 1RM
increases in the dierent ROMs tested.
KEYWORDS
Muscle hypertrophy;
resistance exercise; partial
range of motion; excursion
Introduction
Regional muscle hypertrophy is an adaptive response to
resistance training that occurs when the size of given
muscle region increases to a greater extent than other
muscle regions (Zabaleta-Korta, Fernández-Peña, &
Santos-Concejero, 2020). It has been speculated that train-
ing in dierent joint ranges of motion (ROM) may indeed
promote such non-uniform adaptations (Newmire & Wil-
loughby, 2018; Zabaleta-Korta et al., 2020). Studies by
Bloomquistetal.(2013) and McMahon, Morse, Burden,
Winwood, and Onambélé (2014a) demonstrated that train-
ing in a full ROM (FULL
ROM
) elicited greater muscle hyper-
trophy at distal muscle regions than training in the nal
partial ROM (FINAL
ROM
:i.e.nal half of the angles of a
FULL
ROM
, taking the concentric action as reference). Of
note, both studies observed similar hypertrophic responses
between conditions at the proximal muscle regions. These
ndings suggest that training in a FINAL
ROM
preferentially
induces greater muscle hypertrophy at proximal regions
than in other regions, while training with FULL
ROM
equally hypertrophies the muscle across the regions.
However, neither study compared the hypertrophy
responses between muscle regionswithineachtraining
condition, nor did they compare the hypertrophy of
dierent muscle regions between dierent muscles.
These inter- and intramuscular analyses would provide
greater insight as to whether, and the extent to which,
ROM may inuence a regional hypertrophic response.
The apparent hypertrophic superiority of FULL
ROM
training may be specic to contractions at angles in
which the muscle is elongated (Alegre, Ferri-Morales,
Rodriguez-Casares, & Aguado, 2014; Maeo et al., 2020;
Noorkõiv, Nosaka, & Blazevich, 2014). Previous research
© 2021 European College of Sport Science
CONTACT Mauro H. Chagas mauroufmg@hotmail.com Weight Training Laboratory, School of Physical Education, Physiotherapy and Occupational
Therapy, Federal University of Minas Gerais, Av. Antônio Carlos, 6627, CEP 31270-901, Belo Horizonte, Minas Gerais, Brazil
Supplemental data for this article can be accessed https://doi.org/10.1080/17461391.2021.1927199.
EUROPEAN JOURNAL OF SPORT SCIENCE
https://doi.org/10.1080/17461391.2021.1927199
reports greater metabolic stress, IGF-1 release, and acti-
vation of proteins Akt/mTOR and p70S6 K after contrac-
tions at longer vs shorter muscle lengths (McMahon,
Morse, Burden, Winwood, & Onambélé, 2014b; Rindom,
Kristensen, Overgaard, Vissing, & de Paoli, 2019; Russ,
2008), all of which have been associated with muscle
hypertrophy. This raises the possibility that training
exclusively in the initial half of the angles of a FULL
ROM
(INITIAL
ROM
, taking the concentric action as reference),
where the muscle is in a lengthened state, may
promote a hypertrophic response even greater than
training throughout a FULL
ROM
.
Recently, researchers have speculated that training
through a variety of ROMs (VAR
ROM
) may enhance
muscle growth (Schoenfeld & Grgic, 2020). One such
variation strategy could be to alternate between training
with INITIAL
ROM
and FINAL
ROM
from session to session.
This undulating model resembles the muscle length vari-
ations that occur during FULL
ROM
training, but allows the
ability to focus on the individual components of the
ROM which conceivably may enhance muscular adap-
tations. However, this hypothesis has yet to be tested.
ROM also has potential implications for the strength-
related response to resistance training. Consistent with
the principle of specicity (McCaerty & Horvath, 1977),
current evidence indicates greater strength increases are
achieved at the ROM trained (Martínez-Cava et al., 2019;
Pallarés, Cava, Courel-Ibáñez, González-Badillo, & Morán-
Navarro, 2020;Weiss,Fry,Wood,Relyea,&Melton,2000).
For example, Bloomquist et al. (2013) found that training
exclusively in the FINAL
ROM
resulted in a greater strength
increase in the one maximum repetition (1RM) test per-
formed at the ROM trained. Thus, the question remains
as to whether strength gains also would be specicto
the ROM tested when training is performed in the
INITIAL
ROM
. Moreover, it is undetermined as to what
eect using a VAR
ROM
would have on specicstrength
changes over time.
To address the aforementioned gaps in the literature,
the present study aimed to compare the eects of train-
ing with INITIAL
ROM,
FINAL
ROM,
FULL
ROM
, and VAR
ROM
on
regional muscle hypertrophy and the 1RM strength
response performed in dierent ROMs. In addition, we
aimed to assess the relationship between the strength
increases in dierent ROMs with the muscle growth in
dierent muscle regions.
Methods
Overview
Participants equally comprised 4 experimental groups
and 1 control group (CON) over a 12-week study
period. The experimental groups trained in one of 4
dierent ROM congurations in the knee extension
machine (INITIAL
ROM:,
FINAL
ROM,
FULL
ROM
, and VAR
ROM
)
for 36 training sessions separated by 4872 h (Figure 1).
To assess regional changes in hypertrophy of the
rectus femoris (RF) and vastus lateralis (VL) muscles,
pre- and post-training measures of muscle cross-sec-
tional area (CSA) were obtained via b-mode ultrasound
at 4 longitudinal regions along the femur (40%, 50%,
60%, and 70% of femur length). Changes in dynamic
muscular strength were assessed via 3 dierent bilateral
1RM tests in the knee extension corresponding to the
INITIAL
ROM
, FINAL
ROM
, and FULL
ROM
.
Subjects
Forty-ve non-trained women with an age range of 18
30 years old (mean ± SD: age = 22.7 ± 2.8 years; weight =
61.5 ± 9.0 kg; height = 1.61 ± 0.01 m; body fat percen-
tage = 25.9 ± 5.1%) participated in the study. The local
ethics committee approved this study, which complied
with international standards. In addition, each subject
was instructed not to perform any physical activity on
the testing sessions days.
Procedures
Pre-training session 1
Height, body mass, and fat percentage (skinfold thickness)
measurements were performed. Thereafter, ultrasound
images were obtained to measure CSA of the RF and VL
muscles. Initially, participants remained still on a stretcher
in the supine position for 15 min. During this period, the
anterior regions of the right thigh were marked to identify
the points of image acquisition. For the marking pro-
cedure, femur length was measured as the distance
between the major trochanter and lateral epicondyle.
From the proximal extremity, mark points were made on
the volunteers thigh at 40%, 50%, 60%, and 70% of
femur length using a tape measure. A laser device was
used to mark the other points and verify their axial align-
ment. This device was placed over the volunteeŕsthigh,
and the lasers indicated points axially aligned across the
thigh (check supplementary material). The procedures
used to acquire images in the pre-training were the
same for the post-training, which was completed
between 7296 h after the last training session.
A b-mode ultrasound device (MindRay DC-7, Shenz-
hen, China) with a 4-cm linear transducer was used in
extended-eld-of-view mode to assess muscle CSA.
The equipment was congured following Lacerda et al.
(2021) and adjusted for each individual participant and
muscle region to produce the clearest possible images.
The same trained evaluator performed the acquisition
2G. F. PEDROSA ET AL.
of 2 images at each percentage of femur length (40%,
50%, 60%, and 70%). The probe was placed transversely
in parallel to the intercondylar line using a coupled
guide on the volunteers thigh. A set of sixteen images
per volunteer were obtained for RF and VL CSA analysis
(8 pre-training + 8 post-training). After obtaining the
images, the CSA of each muscle scan was manually esti-
mated by a blinded examiner using specic software
(OsiriX MD 6.0, Bernex, Switzerland). The RF and VL
CSA regional values were determined by calculating
the mean values of the 2 images acquired at each per-
centage of femur length (Figure 2).
Reliability of CSA measurements was assessed by
analysis of the intraclass correlation coecient (ICC
3,1
)
for both intra- and inter-evaluator. For intra-evaluator,
the 2 CSA measures of each region of the RF and VL
demonstrated ICC
3,1
values between 0.980.99. For
inter-evaluator reliability, an invited radiology technician
measured the CSA of 1/3 of all images. The inter-evalua-
tor reliability showed ICC
3,1
values ranging from 0.94
0.99 along the 4 muscle regions of the two muscles.
We also measured muscle thickness at 50% of length
of the RF muscle, determined as the distance between
the deeper and upper RF muscle aponeurosis (Miyatani,
Kanehisa, Kuno, Nishijima, & Fukunaga, 2002). The
muscle thickness measurement was ranked in order of
size and used as a criterion for the balanced
randomization of the participants into the groups. We
opted to use muscle thickness for randomizing the par-
ticipants because of its ease of measurement compared
to the CSA and given the need to complete the ran-
domization process prior to the ensuing pre-training
session.
Pre-training sessions 2, 3, 4, and 5
During pre-training session 2, participants were familiar-
ized with the bilateral 1RM tests corresponding to the 3
ROM tests (INITIAL
ROM
, FINAL
ROM
, and FULL
ROM
group).
First, the participants were positioned in the knee exten-
sion machine with 110° of hip exion (trunk and thigh)
and the medial malleolus of the tibia positioned 2 cm
below the machine pad. To minimize accessory move-
ments, participants were restrained in the machine by
a four-point seat belt. In addition, a metallic structure
was placed in front of the machine to serve as a refer-
ence (mechanical stop) to the desired knee extension
angle (65° or 30° of knee exion) (see supplementary
material). Also, a potentiometer, coupled to the
rotational axis of the mechanical arm of the knee exten-
sion machine, provided real-time biofeedback on a com-
puter screen as to the ROM excursed by each volunteer.
The use of a potentiometer to analyze the ROMs
excursed during tests and training were described in
previous studies of our group (Diniz et al., 2020;
Lacerda et al., 2021).
The familiarization to 1RM tests was determined
within a maximum of 6 attempts, with 3-minute rest
periods provided between attempts. A 30-minute rest
period was given between the tests (order balanced
between the participants) for familiarization.
In the third, fourth, and fth sessions at pre-training, a
sole 1RM test was performed in each session, which fol-
lowed the procedures, and order of the ROM tested in
familiarization. The data of these 3 sessions were used
for statistical analysis. The range of ICC
3,1
values
between the performance on familiarizations and tests
were 0.940.97.
Training
After the initial testing period, participants carried out a
12-week training programme using their designated
ROM. The experimental protocol consisted of 36 sets
of 7 repetitions (each repetition carried out with 2-
Figure 1. Training groups. VAR
ROM
group daily alternated the ROM between INITIAL
ROM
and FINAL
ROM
.
EUROPEAN JOURNAL OF SPORT SCIENCE 3
second concentric and 2-second eccentric actions, with
the tempo controlled by a metronome) at 60% 1RM
with 3-minute rest periods between sets. The 1RM per-
centage was obtained specic to the ROM performed
in a given group. All training groups started the training
period performing 3 sets. This training load congur-
ation was based on a pilot study, which indicated that
most individuals (similar to the present study) were
unable to perform more than 7 repetitions across 3
sets (intensity at 60% of 1RM, specic to each ROM
with 2-second concentric and 2-second eccentric
actions, and a 180-second rest interval between sets).
During the 3rd to 5th week of training, the women per-
formed 4 sets. Between the 6th and 8th week 5 sets were
performed, and between the 9th and 12th week of train-
ing the participants performed 6 sets. The mechanical
stops used during the 1RM tests to delimitate the ROM
desired and the potentiometer were also used in the
training period. The data provided by the potentiometer
allowed the participants to assess the duration and ROM
data of each muscle action on a laptop screen during all
training sessions and tests. To verify that groups trained
according to their prescribed muscle action duration
and ROM, we randomly analyzed 1/6 of all training ses-
sions. No statistical dierence was observed in the
mean muscle action duration among groups (one-way
ANOVA p>0.05). Also, no dierence was observed
among groups with similar start or end angles (one-
way ANOVA p>0.05).
Every 2 weeks of training, the participants performed
a 1RM test in the ROM trained to maintain the intensity
of load programmed throughout the 12 weeks of train-
ing. These tests occurred before the start of the training
session; a 10-minute rest period separated the com-
pletion of 1RM testing and the onset of the training
session. Assessment of rating of perceived exertion
found that this protocol elicited a mean rating of 15
on the Borg category scale (range of 620) across all
sets, corresponding to a hardlevel of perceived
eort; the nal set tended to be rated as very hard,
Figure 2. Example of extended-eld-of-view of four regions of rectus femoris and vastus lateralis muscles from the same volunteer.
CSA = Cross-sectional area. a) = pre-training. b) = post-training.
4G. F. PEDROSA ET AL.
indicating that workouts were suciently challenging
for all groups.
Post-training sessions 1, 2, and 3
In the rst post-training session, which occurred
between 7296 h after the nal training session, all par-
ticipants were submitted to ultrasound assessment of
the same muscles, regions, and procedures as con-
ducted in pre-training. Afterward, the participants per-
formed the rst 1RM test following the order and
procedures determined at pre-training. In the second
and third sessions of post-training (48 h apart between
sessions) the other two 1RM tests were performed with
the same order and procedures of the pre-training
sessions.
Statistical analyses
Statistical analysis was performed with Sisvar version 5.7
software. We carried out analyses of variance (ANOVA) to
test for dierences in absolute baseline values for all
variables analyzed, with no dierences identied
between groups. To verify the change caused by training
protocols performed by ROM manipulation, we trans-
formed the CSA and 1RM test performance data into
relative responses ((Post Pre)/Pre x 100). The normality
and homogeneity of variances were veried using
ShapiroWilk and Levenes tests, respectively. Eta-
squared (η
2
) was calculated for the main signicant
eect (Fritz, Morris, & Richler, 2012), with the following
interpretation: small<0.06; medium=0.060.14;
large>0.14 (Cohen, 1988). To compare the CSA relative
responses, a three-way ANOVA was performed (Group
x Muscle x Region). Moreover, the 1RM relative
responses were compared with a two-way ANOVA
(Group x ROM). To verify whether the results of the
1RM tests were dierent among groups and ROMs
tested at pre-training, we employed a two-way ANOVA
(Group x ROM). In the case of statistical dierences, the
Scott-Knott post hoc test was employed to determine
which groups diered (Scott & Knott, 1974). Pearson cor-
relation coecient was used to verify the relationship
between the regions CSA relative changes and 1RM
tests performance relative changes. Data are presented
as mean ± SD. Probability was set at α0.05 for statistical
signicance for all responses.
Results
Cross-sectional area
The three-way ANOVA showed a signicant interaction
eect between the factors Group x Muscle (p=0.0154;
η
2
=0.04). For the RF, INITIAL
ROM
and VAR
ROM
groups pre-
sented a greater change than the other groups, and the
FULL
ROM
group presented a greater change than
FINAL
ROM
and CON groups, which showed similar
changes. For the VL, the INITIAL
ROM,
FULL
ROM
, and
VAR
ROM
groups presented similar responses, which
were greater than FINAL
ROM
and CON groups; the
FINAL
ROM
group presented a greater increase than the
CON group. Furthermore, INITIAL
ROM
and VAR
ROM
groups presented a greater increase for the RF than
the VL. For the other groups, both muscles presented
similar changes.
A signicant interaction eect was found between
the factors Group x Region (p=0.0349; η
2
=0.01). The
post hoc test revealed similar changes between the
training groups, which were all greater than the
CON group at 40% of femur length. INITIAL
ROM
and
VAR
ROM
groups presented similar changes and
greater than the other groups at 50%, whereas
FULL
ROM
and FINAL
ROM
groups presented similar
increases, which were greater than the CON group.
INITIAL
ROM
and VAR
ROM
groups presented similar
changes and greater than the other groups at 60%,
followed by the FULL
ROM
. Moreover, FINAL
ROM
and
CON groups showed similar responses. INITIAL
ROM
group presented greater responses than other
groups at 70%. Additionally, FULL
ROM
and VAR
ROM
groups showed similar increases and greater than
FINAL
ROM
and CON groups, which showed similar rela-
tive responses. The CSA changes among the 4 muscle
regions were similar for the INITIAL
ROM
, FULL
ROM
,
VAR
ROM
and CON groups. However, for the FINAL
ROM
group, the CSA changes at 40%, 50% and 60% were
greater than at 70% (Figure 3).
1RM Tests
Two-way ANOVA found an interaction between the
factors Group x ROM (p=0.0394; η
2
=0.14). The post
hoc test revealed that in 1RM testing performed at
the initial ROM, INITIAL
ROM
and VAR
ROM
groups
showed greater changes than the other groups,
and FINAL
ROM
and FULL
ROM
groups showed similar
changes, which were greater than CON group. For
the 1RM test performed at the nal ROM, the train-
ing groups showed similar increases, all of which
were greater than the CON group. In the 1RM test
performed at the full ROM, INITIAL
ROM
, FULL
ROM
,
and VAR
ROM
groups presented similar relative
increases, which were greater than FINAL
ROM
and
CON groups; FINAL
ROM
showed greater changes
than CON group. Additionally, INITIAL
ROM
and
FINAL
ROM
groups presented a greater increase in
EUROPEAN JOURNAL OF SPORT SCIENCE 5
the 1RM test at the respective ROM trained, and the
other groups did not show dierences between the
tests (Figure 4).
From a loading standpoint, two-way ANOVA only
found a main eect for ROM whereby a similar amount
of weight was lifted at the INITIAL
ROM
and FINAL
ROM
,
and at these two ROMs, a greater amount of weight
was lifted than at the full ROM (p=0.034; η
2
=0.05).
Pearson correlation coecient
For the INITIAL
ROM
group, the Pearson correlation
coecient indicated a signicant, and positive associ-
ation between relative CSA changes of the VL at
60% and 70% and the 1RM tests at the initial and
full ROM (r=0.730.80; p=0.010.02). For the FINAL
ROM
group, a positive and signicant relationship was
observed between the changes of CSA of VL at
Figure 3. The relative increase of cross-sectional area at 40%, 50%, 60%, and 70% of femur length. INITIAL = INITIAL
ROM
; FINAL =
FINAL
ROM
; FULL = FULL
ROM
; VAR = VAR
ROM
. *Greater increase than the other groups; &Greater increase than the FINAL
ROM
and CON
groups; #Greater increase than CON group; $Dierent than at other regions for the same group.
6G. F. PEDROSA ET AL.
40%, 50% and 60% with the 1RM tests at the nal
and full ROM (r=0.720.98; p<0.0010.020), and at
70% with the 1RM test at full ROM (r=0.70;
p=0.037). For the VAR
ROM
group, the CSA increases
of the RF at 60% and 70% presented a signicant
correlation with the 1RM test increase at the initial
ROM (r=0.680.76; p=0.0440.018). For the FULL
ROM
and CON groups, no signicant correlation was
found.
Discussion
Muscle hypertrophy
The INITIAL
ROM
, FULL
ROM
, and VAR
ROM
groups elicited
similar CSA changes across the muscle regions. Although
these groups excursed the initial ROM (100°35° of knee
exion), only the INITIAL
ROM
group exclusively excursed
this ROM. Therefore, excursing a full ROM may not be
causal for inducing homogenous muscle growth across
Figure 4. 1RM tests in dierent ROM. INITIAL = INITIAL
ROM
; FINAL = FINAL
ROM
; FULL = FULL
ROM
; VAR = VAR
ROM
. *Greater than the
other groups at the respective ROM; &greater than groups FINAL
ROM
and CON at the respective ROM; # only greater than CON
Group at the respective ROM. $ dierent than the other ROM for the same group. L = lower values. U = upper values.
EUROPEAN JOURNAL OF SPORT SCIENCE 7
muscle regions, as previously hypothesized (Helms,
Fitschen, Aragon, Cronin, & Schoenfeld, 2014), but
rather due to training at a long muscle length in the
initial ROM. McMahon et al. (2014b) showed that after
8 weeks of training with the knee extension, the
INITIAL
ROM
group presented a greater VL change at the
distal region than the FINAL
ROM
group. This result casts
doubt as to whether the INITIAL
ROM
training does in
fact promote a greater distal muscle change compared
to other regions and raises the alternative possibility
that FINAL
ROM
training elicits less change in the distal
region than at other regions. Overall, the present
results suggest that excursing the initial ROM during
knee extension exercise elicits similar growth across
the muscle regions, while training with nal ROM may
not signicantly hypertrophy the distal muscle regions,
at least in the muscles analyzed. However, the present
study analyzed only four muscle regions of two quadri-
ceps femoris muscles, thus preventing the extrapolation
of these results to other regions and muscles of the
quadriceps femoris.
When considering regional hypertrophic changes
between groups, the INITIAL
ROM
group achieved
greater relative increases in CSA at 50% and 60% com-
pared to FINAL
ROM
, FULL
ROM
, and CON groups, and at
70% adaptations were greater than all groups. Given
that the protocol for FINAL
ROM
, FULL
ROM
, and VAR
ROM
groups included at least some training at shorter
muscle lengths, it is possible a concentrated focus on
training at a longer muscle length by the INITIAL
ROM
group was more advantageous for muscle development.
Indeed, previous research shows a hypertrophic super-
iority to training at longer versus shorter muscle
lengths (Alegre et al., 2014; McMahon et al., 2014b; Noor-
kõiv, Nosaka, & Blazevich, 2015). Our results expand
upon these ndings to indicate that excursing shorter
muscle lengths may be detrimental to hypertrophic
changes even when some of the training is carried out
at longer muscle lengths. Intriguingly, analysis of the
1RM training loads showed that both partial groups
(INITIAL
ROM
and FINAL
ROM
) employed heavier loads
than the FULL
ROM
group, yet the INITIAL
ROM
group
achieved greater increases in CSA than the other two
groups. Since the magnitude of load was similar for
the INITIAL
ROM
and FINAL
ROM
groups, this would seem
to indicate that mechanical stress alone was not respon-
sible for the observed dierences; rather, muscular
development appears to be driven via an interaction
between mechanical stress and muscle length, the
mechanisms of which are not clear.
It is worth noting that the higher relative increases in
CSA between groups occurred at the distal muscle
region (30% for RF and 18% for VL) for the INITIAL
ROM
group, which is in line with prior studies that investi-
gated muscle hypertrophy in dierent regions (proximal,
middle and distal) via ultrasound imaging (McMahon
et al., 2014a;2014b). McMahon et al. (2014b) found
that knee extension training in the initial ROM promoted
a50% CSA increase of the distal VL (75% of femur
length). In another study by the same group,
McMahon et al. (2014a) reported a 40.1% CSA increase
of the distal VL (75% of femur length) after training in
a full ROM using a variety of dierent knee extension
exercises. In both studies, these hypertrophic increases
were relatively greater than that achieved proximally,
and were superior at longer versus shorter muscle
lengths.
Considering the hypertrophic dierences between
the INITIAL
ROM
and FULL
ROM
groups, it seems the combi-
nation of training with a longer time under tension at a
longer muscle length with higher loads (ascertained by
greater pre- 1RM test values at the partial ROMs than
at full ROM) for the INITIAL
ROM
group provided a
greater stimulus for hypertrophy than training in full
ROM, which likely occurred with greater mechanical
work (greater angular displacement). Previous studies
indicate that metabolic stress (Fouré, Ogier, Guye,
Gondin, & Bendahan, 2020; Kooistra, Blaauboer, Born,
de Ruiter, & de Haan, 2005; Ng, Agre, Hanson, Harring-
ton, & Nagle, 1994) and activation of the proteins Akt/
mTOR and p70S6 K (Rindom et al., 2019; Russ, 2008)
can occur to a greater magnitude when performing con-
tractions at longer versus shorter muscle lengths. This
evidence suggests a heightened anabolic milieu at
longer compared to shorter muscle length contractions,
which conceivably may help to explain the discrepancy
of results, as the FULL
ROM
group trained in both a
shorter and longer muscle length, while the INITIAL
ROM
group exclusively trained at a longer muscle length.
However, the mechanisms underpinning regional hyper-
trophy due to contractions at longer and shorter muscle
lengths are still poorly characterized and warrant further
research.
INITIAL
ROM
and VAR
ROM
groups showed similar
regional hypertrophic responses at 40%, 50%, and
60%. We speculated that hypertrophy would be similar
between VAR
ROM
and FULL
ROM
, which excursed of the
spectrum of initial and nal ROMs during each rep-
etition. Contrary to this hypothesis, regional muscular
gains were generally greater in VAR
ROM
than FULL
ROM.
A possible explanation could be related to the fact
that the VAR
ROM
group trained with a higher load than
the FULL
ROM
group at a longer muscle length. Conceiva-
bly, the greater mechanical stress imposed under the
condition of a stretched muscle may therefore
promote a synergistic anabolic stimulus.
8G. F. PEDROSA ET AL.
Regarding the individual muscles investigated, the RF
and VL presented similar relative increases in the
FINAL
ROM
and FULL
ROM
groups. Alternatively, the RF
muscle increased to a greater magnitude than the VL
in the INITIAL
ROM
and VAR
ROM
groups. These results
suggest that training at longer muscle lengths may
promote greater hypertrophy for the RF compared to
the VL. This result runs counter to that of Noorkõiv
et al. (2014), who reported similar increases in muscle
volume between the RF and VL when training isometri-
cally at a longer muscle length. Further investigation is
needed to clarify whether training at long muscle
lengths does in fact promote a greater hypertrophy
response for the RF than for the VL.
In regard to the regional muscle hypertrophy within
groups, The FINAL
ROM
group presented greater regional
muscle growth at more proximal regions (40% and 50%)
than at more distal regions (60% and 70%). These results
may help to clarify ndings of previous research, in
which the FINAL
ROM
groups showed a lower hyper-
trophic response at distal regions compared to
FULL
ROM
(Bloomquist et al., 2013; McMahon et al.,
2014a) and INITIAL
ROM
groups (McMahon et al., 2014b).
Bloomquist et al. (2013), despite not having performed
comparisons among muscle regions within each training
group (FINAL
ROM
x FULL
ROM
), performed paired t-tests to
compare longitudinal CSA of pre x post values in 6
regions across the anterior part of the thigh after squat-
ting training. For the FINAL
ROM
group, the results
showed that only the two most proximal muscle
regions increased after training. These data reinforce
our ndings, which suggest that training at shorter
muscle lengths may not promote signicant muscle
hypertrophy at more distal regions in the RF and VL
muscles. On the other hand, training at a longer
muscle length seems to promote a homogeneous
hypertrophic response across the muscle regions, as
occurred for the INITIAL
ROM
FULL
ROM
and VAR
RO.
However, our data are limited to four regions of two
quadriceps femoris muscles. Future studies should
seek to investigate more muscle regions within a given
muscle as well as muscles other than the quadriceps
femoris to enhance our understanding of the eect of
ROM on the regional muscle hypertrophy response.
Dynamic strength
Based on the principle of specicity (McCaerty &
Horvath, 1977), we expected that greater increases in
dynamic strength would occur in the ROM trained.
This hypothesis was partially conrmed, as the FINAL
ROM
and INITIAL
ROM
groups achieved a greater strength
increase in the respective ROM tested; the result of the
FINAL
ROM
group is consistent with those reported in pre-
vious studies (Bloomquist et al., 2013; Martínez-Cava
et al., 2019; Rhea et al., 2016). Although no study to
date has investigated strength changes in the
INITIAL
ROM
, the results of study that investigated iso-
metric torque production across angles after training
with partial ROM corroborate the present ndings, due
to increases in isometric torque occurred near or at the
training angles (Graves, Pollock, Jones, Colvin, &
Leggett, 1989,1992). Additionally, the strength gains
from training at a longer muscle length may also occur
further along the training angle (Noorkõiv et al., 2015;
Thepaut-Mathieu, Van Hoecke, & Maton, 1988). These
results support the present ndings, as the INITIAL
ROM
group demonstrated strength increases similar to the
groups that showed a greater strength increase in the
1RM test at the nal and full ROM.
Previous research suggests that neural adaptations
help to explain joint-angle-specic strength increases,
with increasing muscle activation observed at or near
the angles trained (Alegre et al., 2014; Noorkõiv et al.,
2014; Thepaut-Mathieu et al., 1988). Nevertheless,
regional muscle hypertrophy may also play a role in
this phenomenon (Narici, Roi, Landoni, Minetti, & Cerre-
telli, 1989; Noorkõiv et al., 2014). Noorkõiv et al. (2014)
found positive and signicant correlations between the
relative changes of regional CSA and the torque at
angles near the angle trained during isometric knee
extension exercise. However, these results account
only for the group that trained isometrically at a
longer muscle length, as no signicant correlation was
found when training at a shorter muscle length. Based
on these results, Noorkõiv et al. (2014) speculated that
specic regional CSA increases may be associated with
increasing torque production at or near the angles
trained after training in longer muscle length.
However, the group that trained at a shorter muscle
length in the Noorkõiv et al. (2014) did not show signi-
cant hypertrophy in any muscle analyzed after 6 weeks
of training, but this group did display isometric strength
increases near the training angles. The present study
partly corroborates the ndings of Noorkõiv et al.
(2014), as INITIAL
ROM
and FINAL
ROM
groups presented
positive and signicant correlations between regional
CSA increases and 1RM increases at the ROM trained.
Collectively, the present study suggests that the muscu-
lature can remodel regionally to enhance strength pro-
duction, but this variation seems to be dependent on
the ROM trained.
FULL
ROM
and VAR
ROM
were the unique training
groups that presented similar 1RM test increases
among the ROM tested. These results are consistent
with previous studies, in which the FULL
ROM
group
EUROPEAN JOURNAL OF SPORT SCIENCE 9
showed uniform improvements in 1RM test performance
at the dierent ROM tested (Martínez-Cava et al., 2019;
Pallarés et al., 2020; Weiss et al., 2000). Since both
FULL
ROM
and VAR
ROM
groups excursed the spectrum of
angles investigated (100°30° of knee exion), we
hypothesize that the overload imposed at each joint
angle may have been sucient to promote adaptations
leading to similar strength increases in all ROMs investi-
gated, which would be in accordance with Rhea et al.
(2016). However, VAR
ROM
presented a greater 1RM
increase than FULL
ROM
in the initial ROM, but not in
the nal or full ROM. Despite the observation that the
FULL
ROM
group likely trained with greater mechanical
work across the repetitions, the VAR
ROM
group trained
with a higher load across the angles trained by the
FULL
ROM
group. These data suggest that knee extension
training with a higher load in the initial ROM was more
advantageous to strength increases in the initial ROM
as opposed to training with greater mechanical work
across a full ROM. These ndings possibly may be
explained by the hypertrophic adaptations experienced
by each training group. The VAR
ROM
group presented a
greater muscle hypertrophy increase than FULL
ROM
group at 50% and 60%, and some evidence suggests
that region-specic increases of muscle mass may be
associated with dynamic strength increases at certain
training angles (Noorkõiv et al., 2015). Thus, the
greater muscle hypertrophy increase may have
accounted for the VAR
ROM
group to achieve a greater
1RM increase in the INITIAL
ROM
compared to the
FULL
ROM
. In support of this line of reasoning, the CSA
increases at 60%, and 70% of RF in the VAR
ROM
group
signicantly correlated with the 1RM test increases in
the initial ROM. The implications of these ndings
require further investigation as our analysis is limited
to four muscle regions of two quadriceps muscles.
Intriguingly, despite the fact that the VAR
ROM
group
also trained with a higher load than FULL
ROM
group in
the nal ROM, the 1RM increase in the nal ROM was
similar between these groups. It seems the impact of train-
ing with higher loads in the nal and initial ROMs com-
pared to training in a full ROM induces dierent strength
responses; these ndings require further study as to the
associated morphological and neural adaptations.
VAR
ROM
group was the only group that presented a
relative increase similar to the INITIAL
ROM
group in the
initial 1RM test. Moreover, the VAR
ROM
group presented
similar relative increases in dynamic strength across the
employed 1RM tests. These results indicate that daily
undulating training between the initial and nal ROMs
can promote similar increases in dynamic strength
across both partial and full ROMs. Moreover, these
strength gains are equivalent to the groups that
trained exclusively in one of these ROMs. Further
research is needed to better characterize potential
mechanisms and the application of undulating training
between dierent partial ROMs.
Conclusion
The present study indicates that training in dierent ROM
congurations may lead to regional changes in muscle
CSA and dynamic strength performance. Resistance train-
ing at the initial ROM generally showed superiority in
comparison to nal, full, and varied ROM training. In
addition, maximum strength performance is aected by
the ROM trained, and a joint-angle specic strength
increase may occur after partial ROM training. Further-
more, alternating sessions between the initial and nal
ROMs may increase the maximum strength uniformly
among dierent ROMs, reaching values similar to that
achieved from partial ROM training.
Disclosure statement
No potential conict of interest was reported by the author(s).
ORCID
Fernando V. Lima http://orcid.org/0000-0001-9293-7340
Brad J. Schoenfeld http://orcid.org/0000-0003-4979-5783
Lucas T. Lacerda http://orcid.org/0000-0002-0735-8131
Rodrigo C.R. Diniz http://orcid.org/0000-0001-9425-4447
Mauro H. Chagas http://orcid.org/0000-0002-1955-8990
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EUROPEAN JOURNAL OF SPORT SCIENCE 11
... The effects of manipulating range of motion (ROM) during RT have been extensively studied, with many investigations focusing on training at longer muscle lengths (Wolf et al., 2023). While generally lacking ecological validity, five studies have compared longer vs. shorter muscle length isometric contraction (Akagi, Hinks & Power, 2020;Alegre et al., 2014;Hinks et al., 2021;Kubo et al., 2006;Noorkõiv, Nosaka & Blazevich, 2014), and nine studies have compared partial ROM at longer muscle lengths (referred to as lengthened partials and abbreviated as LPs) vs. shorter muscle lengths (referred to as shortened partials and abbreviated as SPs) on muscle hypertrophy (Kassiano et al., 2022a;Larsen et al., 2024a;Maeo et al., 2020Maeo et al., , 2022Mcmahon et al., 2014b;Pedrosa et al., 2022Pedrosa et al., , 2023Sato et al., 2021;Stasinaki et al., 2018) 1 . Additionally, a recent study compared employing LPs following momentary failure using full ROM vs. full ROM alone and found that the former intervention resulted in greater muscle hypertrophy vs. full ROM (Larsen et al., 2024b) 1 . ...
... More importantly, four studies have compared LPs to full ROM resistance training (Goto et al., 2019;Kassiano et al., 2022b;Pedrosa et al., 2022;Werkhausen et al., 2021). With the exception of Werkhausen et al. (2021), all remaining studies showed that training at longer muscle lengths elicited greater hypertrophy, suggesting that trainees aiming to maximize muscle growth should emphasize training at longer muscle lengths. ...
... Notably, the unique findings of Werkhausen et al. (2021) may be attributable to their use of a concentric-only protocol and the extreme limited range of motion (a 9 change in knee angle) used by the partials group. For strength, when comparing full ROM to LPs, previous studies have found that 1 RM increases are ROM specific (Pedrosa et al., 2022;Kassiano et al., 2022b). ...
Article
Full-text available
Purpose Resistance training using different ranges of motion may produce varying effects on musclular adaptations. The purpose of this study was to compare the effects of lengthened partial repetitions (LPs) vs . full range of motion (ROM) resistance training (RT) on muscular adaptations. Methods In this within-participant study, thirty healthy, resistance-trained participants had their upper extremities randomly assigned to either a lengthened partial or full ROM condition; all other training variables were equivalent between limbs. The RT intervention was an 8-week program targeting upper-body musculature. Training consisted of two training sessions per week, with four exercises per session and four sets per exercise. Muscle hypertrophy of the elbow flexors and elbow extensors was evaluated using B-mode ultrasonography at 45% and 55% of humeral length. Muscle strength-endurance was assessed using a 10-repetition-maximum test on the lat pulldown exercise, both with a partial and full ROM. Data analysis employed a Bayesian framework with inferences made from posterior distributions and the strength of evidence for the existence of a difference through Bayes factors. Results Both muscle thickness and unilateral lat pulldown 10-repetition-maximum improvements were similar between the two conditions. Results were consistent across outcomes with point estimates close to zero, and Bayes factors (0.16 to 0.3) generally providing “moderate” support for the null hypothesis of equal improvement across interventions. Conclusions Trainees seeking to maximize muscle size should likely emphasize the stretched position, either by using a full ROM or LPs during upper-body resistance training. For muscle strength-endurance, our findings suggest that LPs and full ROM elicit similar adaptations.
... Also, the quadriceps femoris do appear to function within both the ascending limb, plateau region and the descending limb of the length-tension-relationship (Cutts, 1988(Cutts, , 1989Son et al., 2018), suggesting that training the quadriceps femoris at longer muscle lengths could be beneficial when training for muscle growth (Ottinger et al., 2023). For example, Pedrosa et al. (2022) compared regional muscle hypertrophy in the rectus femoris and vastus lateralis in the leg extension exercise when training with different ranges of motion (ROM) with a standardized eccentric and concentric duration of two seconds. The researchers observed that training in the initial ROM (100-65° of knee flexion) resulted in superior hypertrophic outcomes in both the distal rectus femoris and vastus lateralis compared to the groups training with both a full ROM (100-30°), in the final partial ROM (65-30°), and with a variable ROM. ...
... The observed changes in the rectus femoris thickness and the vastus lateralis thickness align with values from previous studies investigating the leg extension resistance training (rectus femoris: +8.8-24%, vastus lateralis: +2.8-15%) (Maeo et al., 2018;Pedrosa et al., 2022;Zabaleta-Korta et al., 2021). However, it should be noted that these studies did not manipulate hip flexion angle as an independent variable. ...
... This distinction is notable, as proximity-to-failure is a factor known to influence hypertrophic adaptations (Robinson et al., 2023). Additionally, set volume varied between protocols, with the current study using eight weekly sets, whereas Zabaleta-Korta et al. (2021) used twelve weekly sets, and Pedrosa et al. (2022) increased set volume during the intervention. Recent findings by Pelland et al. (2024) suggest that weekly set volume significantly impacts muscle hypertrophy, further complicating direct comparisons. ...
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Full-text available
This study compared the effects of 90° versus 40° hip flexion in the leg extension exercise on quadriceps femoris muscle hypertrophy. Twenty-two untrained men completed a ten-week intervention comprising two resistance training sessions per week. A within-participant design was used, with the lower limb side randomly allocated to the 40 or 90° condition. Muscle thickness of distal and proximal rectus femoris and vastus lateralis was quantified via ultrasound. Data were analysed within a Bayesian framework including univariate and multivariate mixed effect models with random effects to account for the within participant design. Differences between conditions were estimated as average treatment effects (ATE) and inferences were made based on posterior distributions and Bayes Factors (BF). Results indicated a greater hyper-trophic response in the rectus femoris for the 40° condition, with "extreme" evidence supporting a hypertrophic response favouring the 40° hip angle for the rectus femoris (BF > 100; p(Distal/ATE & Proximal/ATE >0) > 0.999), and "strong" evidence supporting no difference in hypertrophic response for the vastus lateralis (BF = 0.07). Therefore, both conditions could be viable options for increasing quad-riceps femoris hypertrophy. However, when training for maximizing rectus femoris hypertrophy among untrained men, we suggest training with a reduced hip flexion in the leg extension exercise.
... The findings for strength outcomes in ROM studies are not unexpected due to the principle of specificity; however, more nuance is needed regarding hypertrophy and resistance training ROM. Specifically, the muscle length (i.e., shortened or lengthened position) at which an exercise is performed (5,6,7,23,24) may affect muscle growth and temporal recovery (8,22). Additionally, the muscle length at which peak torque (i.e., the point in the ROM where force demand is highest due to the relationship between internal and external moments) is experienced in an exercise (25) may be crucial to consider. ...
... Indeed, various studies (5,6,7,23,24) have compared training at different muscle lengths and found that training at long muscle lengths may enhance hypertrophy, with fewer studies (35,39) reporting no substantial differences in hypertrophy when training through different muscle lengths. Maeo et al. (6,7) observed greater hypertrophy in biarticular muscles when training through a full ROM at a longer muscle length compared to a shorter muscle length. ...
... versus +13.9%, respectively, d = 0.54, p < 0.001). Importantly, regional hypertrophy within the same muscle (5,23) may also be affected by the length a muscle is trained. For example, Pedrosa et al. (5) found that performing partial ROM leg extensions for 12 weeks at a longer muscle length led to greater distal rectus femoris growth at 70% of femur length compared to training through only the final ROM or varied ROM (short and long) in untrained women. ...
... Resistance training is widely recognised as an effective strategy for promoting skeletal muscle hypertrophy in humans [1]. The influence of joint range of motion (ROM) on subsequent muscle growth has garnered significant attention in resistance training research [2][3][4]. Evidence suggests that training at longer-muscle lengths-whether through a lengthened partial ROM or a full ROM-may enhance hypertrophy in certain muscle groups, including the quadriceps femoris, biceps brachii, and triceps brachii [5]. ...
... However, this topic remains contentious [1], as some studies report superior muscle growth when performing resistance training at longer-muscle lengths [2,[6][7][8][9][10][11][12], whereas others do not [12][13][14]. ...
... Though some studies have observed greater muscular adaptations for training with full ROM compared to partial ROM at shorter muscle lengths, a recent meta-analysis by Wolf et al. (2023) revealed favourable effects of partial ROM performed at longer muscle lengths. For example, Pedrosa et al. (2022) observed larger distal quadriceps femoris hypertrophy in a cohort of untrained women when performing the leg extension exercise in a lengthened partial ROM (100-65° of knee flexion) compared to full ROM (100-30°) and shortened partial ROM (65-30°) conditions. Therefore, though the mechanisms remain largely unclear, it has been hypothesised that resistance training at longer-muscle lengths is beneficial when the desired outcome is hypertrophy, potentially due to the muscle reaching the plateau or descending limb increasing mechanical tension experienced at the sarcomere level (Ottinger et al., 2023). ...
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Muscle hypertrophy is often a desired goal of resistance training, and strategies that extend training beyond momentary failure may enhance muscular adaptations. Thus, the objective of this study was to assess whether performing additional past-failure partial repetitions beyond momentary failure increased muscle hypertrophy. A total of 23 untrained men completed a 10-week within-participant intervention study. This study comprised two weekly resistance training sessions of four sets of standing Smith machine calf raises. One limb was randomly allocated to the control condition performing sets to momentary failure (PLANTAR MF), and the other limb was allocated to the test intervention that included additional past-failure partial repetitions in the lengthened position (DORSI vf). Muscle thickness of the medial gastrocnemius muscle was measured both pre-and post-intervention via ultrasound. Data were analysed within a Bayesian framework using a mixed-effect model with random effects to account for the within-participant design. The average treatment effect (ATE) was measured to assess any difference in condition and inferences made based on the ATE posterior distribution and associated Bayes Factor (BF). The main findings were that the PLANTAR MF and DORSI VF legs increased medial gastrocnemius hypertrophy by 6.7 and +9.6%, respectively. The results identified an ATE favouring the inclusion of additional partial repetitions (0.62 [95%CrI: 0.21-1.0 mm; p(>0) = 0.998]) with 'strong' evidence (BF = 13.3) supporting a priori hypothesis. Therefore, when the goal is to train for maximum gastrocnemius hypertrophy over a relatively short time period, we suggest performing sets beyond momentary failure as a likely superior option.
... Over the past decade, the range of motion (ROM) used in various resistance exercises has received increased attention and remains a controversial topic in the research community 2 . One muscle group reported to be influenced by knee flexion ROM is the quadriceps femoris [3][4][5][6] . In multi-joint exercises like the squat, superior muscle growth of the monoarticular vastii muscles has been reported with a greater knee flexion ROM 7 . ...
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This chapter explores the concept of prehabilitation in spine surgery and joint arthroplasty, tracing its evolution from injury prevention to a proactive approach for improving surgical outcomes. Prehabilitation has gained prominence in recent years, aligning with the shift towards value-based care and enhanced recovery after surgery (ERAS) protocols. The chapter discusses the significance of prehabilitation in addressing the global burden of musculoskeletal disorders, particularly low back pain and joint disease. It outlines the continuum of care, from conservative treatments to the decision for surgery, emphasizing shared decision-making and patient education. Key components of prehabilitation are examined, including nutritional optimization, weight management, exercise interventions, pain management, and psychoeducative approaches. The chapter highlights the importance of addressing modifiable risk factors such as obesity, smoking, and uncontrolled diabetes. It also discusses the role of preoperative risk screening, including frailty assessments. Specific prehabilitation strategies for spine surgery and joint arthroplasty are explored, including aerobic capacity interventions, resistance training, and pain management techniques. The chapter also addresses the challenges of opioid use in the preoperative period. It discusses alternative pain management strategies within the unique risk profile when anticipating joint replacement and spine surgeries. Overall, this chapter provides a comprehensive overview of prehabilitation in orthopedic surgery, emphasizing its potential to improve patient outcomes, reduce complications, and enhance the overall surgical experience.
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Background. This study investigated the effects of two 14-week resistance training protocols with different repetition duration (RD) performed to muscle failure (MF) on gains in strength and muscle hypertrophy as well as on normalized electromyographic (EMG) amplitude and force-angle relationships. Methods. The left and right legs of ten untrained males were assigned to either one of the two protocols (2-s or 6-s RD) incorporating unilateral knee extension exercise. Both protocols were performed with 3-4 sets, 50-60% of the one-repetition maximum (1RM), and 3 min rest. Rectus femoris and vastus lateralis muscles cross-sectional areas (CSA), maximal voluntary isometric contraction (MVIC) at 30o and 90o of knee flexion and 1RM performance were assessed before and after the training period. In addition, normalized EMG amplitude-angle and force-angle relationships were assessed in the 6th and 39th experimental sessions. Results. The 6-s RD protocol induced larger gains in MVIC in the 30o of knee angle measurement than the 2-s RD protocol. Increases in MVIC in the 90o of knee angle and 1RM were indifferent between the 2-s and 6-s RD protocols. For the rectus femoris muscle growth, inconclusive changes were found across the ten subjects. In contrast, the 2-s RD protocol may have resulted in superior vastus lateralis muscle hypertrophy. Moreover, different normalized EMG amplitude-angle and force-angle values were detected between protocols over most of the angles analyzed. Conclusion. Performing longer RD could be a more appropriate strategy to provide greater gains in isometric maximal muscle strength at shortened knee positions. However, similar maximum dynamic strength and muscle hypertrophy gains would be provided by protocols with different RD.
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Purpose This study aimed at determining through MRI investigations, force and soreness assessments whether the modulation of muscle length is a relevant strategy for minimising neuromuscular electrical stimulation (NMES)-induced muscle damage in young healthy participants. Methods Comparison of 2 NMES sessions (40 isometric electrically-evoked contractions of the knee extensors) was randomly performed on 1 knee flexed at 50° (short muscle length) and the contralateral at 100° (long muscle length) in a single group of healthy participants. Indirect markers of muscle damage including changes in maximal voluntary isometric contraction (MVC) force, muscle volume and transverse relaxation time (T2) were measured before, 2 days (D2), 4 days (D4) and 7 days (D7) after the NMES sessions in each limb of the ten participants. Results Although stimulation intensity was similar during the NMES session on both limbs, significantly lower force production was recorded at long muscle length (peak at 30 ± 5% MVC force) as compared to short muscle length (peak at 61 ± 12% MVC force). In the following days, MVC force at long muscle length was decreased from D2 to D7, whereas no significant change occurred at short muscle length. Increases in muscle volume and T2 were found at each time point in stimulated muscles at long muscle length, whereas no change was found at short muscle length. Conclusion For the same stimulation intensity, NMES-induced isometric contractions generate higher knee extension force output and result in lower muscle tissues alterations that could be related to a lower intramuscular shear strain when exercise is performed at short muscle length.
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Martínez-Cava, A, Hernández-Belmonte, A, Courel-Ibáñez, J, Morán-Navarro, R, González-Badillo, JJ, and Pallarés, JG. Bench press at full range of motion produces greater neuromuscular adaptations than partial executions after prolonged resistance training. J Strength Cond Res XX(X): 000-000, 2019-Training at a particular range of motion (ROM) produces specific neuromuscular adaptations. However, the effects of full and partial ROM in one of the most common upper-limb exercises such as the bench press (BP) remain controversial. In this study, 50 recreationally to highly resistance trained men were randomly assigned to 1 of 4 training groups: full bench press (BPFULL), two-thirds bench press (BP2/3), and one-third bench press (BP1/3) and control (training cessation). Experimental groups completed a 10-week velocity-based resistance training program using the same relative load (linear periodization, 60-80% 1 repetition maximum [1RM]), only differing in the ROM trained. Individual ROM for each BP variation was determined in the familiarization and subsequently replicated in every lift during training and testing sessions. Neuromuscular adaptations were evaluated by 1RM strength and mean propulsive velocity (MPV). The BPFULL group obtained the best results for the 3 BP variations (effect size [ES] = 0.52-1.96); in turn, partial BP produced smaller improvements as the ROM decreased (BP2/3: ES = 0.29-0.78; BP1/3: ES = -0.01 to 0.66). After 10-week of training cessation, the control group declined in all neuromuscular parameters (ES = 0.86-0.92) except in MPV against low loads. Based on these findings, the BPFULL stands as the most effective exercise to maximize neuromuscular improvements in recreational and well-trained athletes compared with partial ROM variations.
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Aim: mTORC1 is regarded as an important key regulator of protein synthesis and hypertrophy following mechanical stimuli in skeletal muscle. However, as excitation and tension development is tightly coupled in most experimental models, very little and largely indirect evidence exist for such a mechanosensitive pathway. Here, we sought to examine whether activation of mTORC1 signaling is dependent on tension per se in rat skeletal muscle. Methods: To examine the mechanosensitivity of mTORC1, rat EDL muscles were exposed to either excitation-induced eccentric contractions (ECC), passive stretching (PAS) with identical peak tension (Tpeak ) and Tension-Time-Integral (TTI), or ECC with addition of inhibitors of the myosin ATPases (IMA ). To further explore the relationship between tension and mTORC1 signaling, rat EDL muscles were subjected to PAS of different magnitudes of Tpeak while standardizing TTI and vice versa. Results: PAS and ECC with equal Tpeak and TTI produced similar responses in mTORC1 signaling despite different modes of tension development. When active tension during ECC was nearly abolished by addition of IMA , mTORC1 signaling was reduced to a level comparable to non-stimulated controls. In addition, when muscles were exposed to PAS of varying levels of Tpeak with standardized TTI, activation of mTORC1 signaling displayed a positive relationship with peak tension. Conclusions: The current study directly links tension per se to activation of mTORC1 signaling, which is independent of an active EC-coupling sequence. Moreover, activation of mTORC1 signaling displays a positive dose-response relationship with peak tension. This article is protected by copyright. All rights reserved.
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The choice of the optimal squatting depth for resistance training (RT) has been a matter of debate for decades and is still controversial. In this study, fifty-three resistance-trained men were randomly assigned to one of four training groups: full squat (F-SQ), parallel squat (P-SQ), half squat (H-SQ), and Control (training cessation). Experimental groups completed a 10-week velocity-based RT programme using the same relative load (linear periodization from 60% to 80% 1RM), only differing in the depth of the squat trained. The individual range of motion and spinal curvatures for each squat variation were determined in the familiarization and subsequently replicated in every lift during the training and testing sessions. Neuromuscular adaptations were evaluated by one-repetition maximum strength (1RM) and mean propulsive velocity (MPV) at each squatting depth. Functional performance was assessed by countermovement jump, 20-m sprint and Wingate tests. Physical functional disability included pain and stiffness records. F-SQ was the only group that increased 1RM and MPV in the three squat variations (ES = 0.77–2.36), and achieved the highest functional performance (ES = 0.35–0.85). P-SQ group obtained the second best results (ES = 0.15–0.56). H-SQ produced no increments in neuromuscular and functional performance (ES = −0.11–0.28) and was the only group reporting significant increases in pain, stiffness and physical functional disability (ES = 1.21–0.87). Controls declined on all tests (ES = 0.02–1.32). We recommend using F-SQ or P-SQ exercises to improve strength and functional performance in well-trained athletes. In turn, the use of H-SQ is inadvisable due to the limited performance improvements and the increments in pain and discomfort after continued training.
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The manipulation of the muscle action duration (MAD) can influence the instantaneous torque along the range of motion, which can lead to adaptations of regional muscle hypertrophy. The aim of this study was to compare the effects of matched resistance training (RT) on the knee extension machine with different MAD in the cross-sectional area (CSA) responses within the quadriceps femoris (QF) and its muscles. Forty-four subjects were allocated into a control and 3 experimental groups. For a period of 10 weeks, subjects in the experimental groups performed the training protocols that were different only by the MAD: group 5c1e (5s concentric action [CON] and 1s eccentric action [ECC]; group 3c3e (3s CON and 3s ECC) and group 1c5e (1s CON and 5s ECC). Magnetic resonance imaging was performed (before and after the intervention) to determine the relative change (%) in CSA of the QF muscles along proximal (30%), middle (50%), and distal regions (70% distal of the femur). The change in CSA of the rectus femoris at the middle region are greater in 5c1e (6.8 ± 6.5%) and 1c5e (7.4 ± 6.0%) groups than 3c3e (3.4 ± 6.6%) and control groups (0.2 ± 1.8%). In addition, vastus lateralis at the distal region (5c1e = 15.9 ± 11.8%; 1c5e = 14.4 ± 10.0%) presenting greater increases in change of CSA than the others vastus only 5c1e (vastus lateralis [VI] = 5.0 ± 4.7%; vastus medialis [VM] = 4.2 ± 3.2%) and 1c5e groups (VI = 4.7 ± 3.6%; VM = 3.4 ± 3.1%). In conclusion, this study showed that matched RT protocols with different MAD resulted in different region-specific muscle hypertrophic across the individual muscles of QF.