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Regarding the acute responses after leg-press strength training with or without serial stretch-loading stimuli, visible changes were observed in the muscle force, rate of force development, and hormonal concentrations between pre- and postmenopausal women (only one study). Long-term studies revealed different training adaptations after performing leg-press strength training with unique serial stretch-loading stimuli. A positive trend for leg-press strength training with serial stretch-loading was recorded in the young population and athletes; however, more variable training effects favoring one or the other approach were achieved in the older population.
proprioception
isokinetic
strength
power
musculoskeletal injuries
1. Introduction
Currently, using the terms “machine” or “training device” in reference to training and rehabilitation is somewhat controversial and/or sensitive for many practitioners from many areas of sports training and medicine. Some object to the nonfunctionality of these devices, while others use these devices during training alone or during the rehabilitation process. However, in both the abovementioned areas of sports training and medicine, the employment of machines is widely accepted and can play an important role in various situations. For instance, before and after operation, injured athletes noticed various deficits in addition to the safer and more controllable environments during complex solution processes [1]. When referencing the term ‘machine’, we must understand that these machines have progressed over time and are now very sophisticated, with multiple functions, modes, and outcomes, especially in terms of rehabilitation, where they accelerate recovery after injuries, operations, and other health-related complications [2]. In particular, robots are frequently applied for the rehabilitation of upper and lower extremities, and they can include grounded and wearable exoskeletons and grounded end-effector devices for controlling single or multiple joints. However, this area requires further exploration due to the limited number of studies [3]. Among many other sophisticated machines, the researchers' laboratory has developed in collaboration with the University of Vienna a linear motor-driven leg press dynamometer (Figure 1) that presents a unique serial stretch loading mode that allows for the generation of force peaks during exercise.
Figure 1. Represents unique linear motor-driven leg press dynamometer (A) and position during testing/training (B).
Strength and power are two factors that affect sports performance, and they are also the subject of wider research by many researchers, mainly in connection with the elderly population and/or rehabilitation [4][5][6], which is one of the reasons that led us to build a unique linear motor-driven leg press dynamometer. The main aim was to build a diagnostic and training device that could be used for multiple purposes in both younger and older subjects as well as for rehabilitation. The uniqueness of this device lies in the fact that it can generate force peaks by rapid changes in the direction or velocity of the movement during the concentric and eccentric phases of the movement.
2. Leg Press Used for Testing and Acute Responses
Five studies used a leg press device as a testing device only [7][8] or in combination for testing and determining the acute effects after a strength loading protocol [7][9][10][11]. In the study of Sedliak et al. [7], leg presses were used to test the bilateral MVC force before and after the training program. In this study, acute responses after bilateral isokinetic leg extensions were monitored. Except for these two studies, a leg press was used for both testing and as an acute loading protocol in the remaining studies. Altogether, when summarizing all these studies, all possible modes were used for testing and acute loading, including isometric, isokinetic, isoinertial (constant), and isokinetic with SSL stimuli. Only two studies used this device to directly compare acute responses after isokinetic strength training with SSL stimuli and without them [10][11]. Kovárová et al. [10] compared the acute responses of the isokinetic bilateral strength protocol with SSL stimuli and the isoinertial protocol (75% 1RM) on bone metabolism outcomes (bone alkaline phosphatase and sclerostin). Their results indicate no significant effect of any of the strength protocols. It should be noted that the results may be hindered by the number of subjects in the study, which was relatively low (n = 7), and the selected markers of bone metabolism; moreover, for minor changes, other parameters could be more appropriate (e.g., β-CTX, P1NP, and others) [12]. In another study, Vajda et al. [11] also compared acute responses after isokinetic bilateral strength training, including SSL stimuli and isoinertial (constant) resistance (75% 1RM), in pre- and postmenopausal women. The results indicated possible different acute responses of muscle force, RFD, and hormonal concentrations between pre- and postmenopausal women after the protocol with SSL and isoinertial training. MVC and RFD were significantly decreased after the protocol with SSL in premenopausal women and significantly decreased in postmenopausal women after the isoinertial protocol. The hormone concentration was affected after both protocols only in the premenopausal women. A possible explanation may be age-dependent effects because some data showed that middle-aged women react differently to loading strategies (more resistant to fatigue than younger women) [13]. However, this supposition needs to be further examined due to the limited number of studies that have reported isokinetic strength training (whether acute or long-term) alone and because of the unique nature of the SSL stimuli, compared to the traditional training provided to postmenopausal women and other populations.
3. Leg Press Used for Training and Its Effect on Various Outcomes
Eight studies used leg press devices for training purposes, and unique SSL stimuli were used directly during the training process [14][15][16][17][18][19][20][21]. Two studies directly compared LP strength training with and without SSL stimuli [14][15], five studies compared LP strength training with SSL stimuli and ES (electrical stimulation) training [16][17][18][19][21], and one study also compared LP strength training with SSL stimuli and standard physiotherapeutic training [12].
For instance, Cvečka et al. [14] compared LP strength training with and without SSL stimuli in a group of young men who trained regularly. The results of their study suggest that the group that trained with the unique SSL stimuli achieved almost double the increments in almost all measured outcomes, except for RFD, maximal concentric force, and CMJ %. However, there was no between-group statistical significance in any of the outcomes measured. Similar results were obtained in the study by Kern et al. [15], who also compared LP strength training with and without SLL stimuli in a group of young men who trained regularly. The results suggested no significant differences between the groups in muscular strength or jump and sprint performance. However, only the group with SSL stimuli significantly improved the RFD and 30 m sprint time results and increased the fast muscle fiber diameter. The above studies indicate that using unique SSL stimuli that can generate force peaks may have a more beneficial effect or produce trends toward greater improvements compared to standard stimuli in young males.
The effects of training between LP strength training with SSL stimuli and ES training were only determined in elderly populations. The results from these studies were somewhat similar, with no significant differences between the groups, as shown in Table 1. However, few studies clearly showed the beneficial effects of one training alternative. For instance, Šarabon et al. [17] compared the effects of LP strength training with SSL stimuli and ES training in seniors on static balance. The results suggest that LP strength training with SSL stimuli led to significant CoP velocity improvement in all measured directions as well as anterior–posterior amplitude improvements compared to the ES group, where only the mediolateral CoP velocity was improved. However, no significant differences between groups were reported. In contrast, Zampieri et al. [19] compared LP strength training with SSL stimuli and ES training and showed that the ES group presented significant improvements in almost all measured outcomes compared to the LP SSL group (only chair raise test and 10 m fast walking test). Similarly, another study by Zampieri et al. [21] compared LP strength training with SSL stimuli and ES straining, and the results suggested that only the ES group presented significant improvements in isometric MVC torque, increased myofiber and mitochondria size, and upregulated IGF1 pan, IGF-1a, IGF-1b, and IGF-1c isoforms. The isokinetic LP SSL group only significantly induced IGF1b isoforms and significantly improved the chair raise test. Only one study [20] was focused on comparing the potential differences between LP strength training with SSL stimuli and standard physiotherapy training. As shown in Table 1, both groups improved all measured outcomes, with no significant differences between the groups.
Table 1. Long-term training studies using a leg press dynamometer during strength training.
Note: n = sample size, MVC = maximal voluntary contraction, CMJ = countermovement jump height, SJ = squat jump height, ES = electrical stimulation group, CoP = center of pressure, μm = micrometer, s = seconds, m/s = meters per seconds, sig. = significant, RFD = rate of force development, N = Newton, Nm = Newton meter, M = male, F = female, TUG = timed up and go test.
In the above studies, different training adaptations can be seen after performing LP strength training with unique SSL stimuli. Similar training effects with a positive trend for the LP SSL group were recorded in young males [14] and athletes [15]; however, more variable training effects favoring one or the other approach were achieved in the older population. It should also be noted that only the ES protocol was performed in the senior population; thus, direct comparison of strength training with and without SSL cannot be performed.
Altogether, the studies show that using an LP device with or without SSL stimuli seems to be a very useful alternative because it offers several modes that can be adjusted according to the subject’s needs (i.e., training and testing mode—isokinetic, isometric, isoinertial, SSL mode, bilateral or unilateral adjustment). As shown in Table 1, except for two studies, only an older population was included. This finding suggests that the mentioned LP device with SSL stimuli may be a suitable alternative for the rehabilitation process, which is currently very complex, and strength training overall has its own place in the modern physiotherapy approach [22]. This finding has been documented by numerous research studies, such as the inclusion of strength training after total knee arthroplasty [23][24][25].
References
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