Immediate Effect of Trunk Flexion And Extension Isometric Exercise Using An External Compression Device On Electromyography of The Hip Extensor And Trunk Range of Motion Of Healthy Subjects

Background: Low back pain (LBP) is a very common symptom experienced by individuals across all age groups. Previous study established that using a device known as Active Therapeutic Movement version 2 (ATM®2) has been developed to improve pain and joint range of motion (ROM) in patients with LBP. However, no study has examined the physiological change in the muscle through ATM®2-based exercise thus far. This study aimed to determine the immediate effects of ATM®2 exercise on the contraction timing, back extension endurance, muscle fatigue, and trunk ROM of lumbar and lower limb muscles in healthy subjects.Methods: Thirty-six healthy subjects (mean age=23.16±2.3) volunteered to participate in this study. Subjects were instructed to perform ROM test using sit and reach test, back extensor endurance test using Biering-Sorensen test, erector spinae (ES), lumbar multifidus (LM) fatigue and onset time of Gluteus maximus (GM) in prone hip extension using electromyography before and after trunk flexion and extension isometric exercises.Results: The ROM in trunk flexion showed a significant increase by 7.9% after exercise compared to that before exercise (p<0.05). Relative GM contraction onset timing significantly decreased after exercise (p<0.05). The result of the Sorensen test after exercise showed a trend of increase in duration time. Muscle fatigue in the LM, however, showed a significant increase (p<0.05), whereas muscle fatigue in the ES was reduced without statistical significance.Conclusions: The results base on this study showed a significant increase in the trunk ROM after trunk flexion and extension isometric exercise using an external compression device, while the relative contraction onset timing in the GM significantly reduced. Furthermore, the muscle endurance test after exercise showed a trend of increase in the duration time with a decreasing trend in muscle fatigue in the ES. Exercise based on ATM®2 is an effective exercise protocol with an effect on biomechanics of healthy subjects. This exercise may be suitable in clinical practice for patients with LBP, for which long-term effects can be expected.

THE EFFECT OF ISOMETRIC EXERCISE ON BLOOD PRESSURE REDUCTION IN HYPERTENSION: A LITERATURE REVIEW

Background: Hypertension is a major factor contributing to cardiovascular disease, which is the number one cause of death globally. Basic Health Research Indonesian Ministry of Health data for 2018 showed that hypertension in East Java Province increased in 2018 by 36.32. So, the authors want to know the effect of isometrics on reducing blood pressure. Objective: The authors want to know the effect of isometrics on reducing blood pressure. Design: This study design is a systematic review to search and review article from database and the theory underlying this study or guidance in this systematic literature review using PRISMA. Data Sources: Based on the results of the literature search through six databases, such as EBSCO, Springer, MedPub, Elsevier, Science Direct, and National Nursing Journal with keywords: Hypertension, High Blood Pressure, Resting Blood Pressure, Isometric Training, Isometric Exercise. The data was search since June 2020. Review Methods: The method used in the preparation of the Literature review using the PRISMA checklist and PICOS. Secondary data obtained from the journal with a predetermined discussion. Results: Based on 18 articles in the literature review, it can be concluded that the results for the research is Isometric exercises that are performed are very effective in reducing blood pressure. Conclusion: Isometric exercises that are performed are very effective in reducing blood pressure. The exercise is doing in 3-4 weeks with 4x2 minutes of exercise with a rest duration of 3 minutes.

Isometric exercise versus high-intensity interval training for the management of blood pressure: a systematic review and meta-analysis

ObjectiveWe aimed to compare the efficacy of isometric exercise training (IET) versus high-intensity interval training (HIIT) in the management of resting blood pressure (BP).DesignSystematic review and meta-analysis.Data sourcesPubMed (MEDLINE), the Cochrane library and SPORTDiscus were systematically searched.Eligibility criteriaRandomised controlled trials published between 1 January 2000 and 1 September 2020. Research trials reporting the effects of IET or HIIT on resting BP following a short-term intervention (2–12 weeks).Results38 studies were analysed (18 IET and 20 HIIT), including 1583 (672 IET and 911 HIIT) participants, of which 612 (268 IET and 344 HIIT) were controls.IET produced significantly greater reductions in resting BP compared with HIIT with systolic, diastolic and mean BP effect sizes of 8.50 mm Hg vs 2.86 mm Hg (Q=17.10, p<0.001), 4.07 mm Hg vs 2.48 mm Hg (Q=4.71, p=0.03) and 6.46 mm Hg vs 3.15 mm Hg (Q=4.21, p=0.04) respectively. However, HIIT reduced resting heart rate significantly more than IET (3.17bpm vs 1.34bpm, Q=7.63, p=0.006).ConclusionWhile both modes are efficacious, IET appears to be the superior mode of exercise in the management of resting BP. However, HIIT may achieve wider physiological benefits, with greater reductions in resting heart rate.

Respiratory Responses to Short Term Sustained Isometric Muscle Contraction among Undergraduates

Aim: This study sets out to investigate whether a short-term isometric abdominal exercise can benefit adults with improvement in ventilatory functions. Materials And Methods: The present study was performed in 20 adults from the student population of I-BDS students with no history of smoking and respiratory illness. The participants did a daily 20-minute static abdominal exercise over a period of three days. The lung function test was assessed using spirometry and the values of FVC, FEV1, FEV1/FVC, PEFR, FEF 25-75. Paired dependent t test was done to evaluate the anthropometric variables and changes in lung functions pre-exercise on day 1 and post-isometric exercise on day 3. Results: The study demonstrated a significant increase in the mean values of forced vital capacity and forced expiratory volume in one second. The FEV1/FVC ratio, PEFR, FEF 25-75% did not reveal significant changes. Conclusion: The study concluded an innovative finding that ventilatory functions improved after short term isometric training.

The Role of Central Command in the Increase in Muscle Sympathetic Nerve Activity to Contracting Muscle During High Intensity Isometric Exercise

We previously demonstrated that muscle sympathetic nerve activity (MSNA) increases to contracting muscle as well as to non-contracting muscle, but this was only assessed during isometric exercise at ∼10% of maximum voluntary contraction (MVC). Given that high-intensity isometric contractions will release more metabolites, we tested the hypothesis that the metaboreflex is expressed in the contracting muscle during high-intensity but not low-intensity exercise. MSNA was recorded continuously via a tungsten microelectrode inserted percutaneously into the right common peroneal nerve in 12 participants, performing isometric dorsiflexion of the right ankle at 10, 20, 30, 40, and 50% MVC for 2 min. Contractions were immediately followed by 6 min of post-exercise ischemia (PEI); 6 min of recovery separated contractions. Cross-correlation analysis was performed between the negative-going sympathetic spikes of the raw neurogram and the ECG. MSNA increased as contraction intensity increased, reaching mean values (± SD) of 207 ± 210 spikes/min at 10% MVC (P = 0.04), 270 ± 189 spikes/min at 20% MVC (P &lt; 0.01), 538 ± 329 spikes/min at 30% MVC (P &lt; 0.01), 816 ± 551 spikes/min at 40% MVC (P &lt; 0.01), and 1,097 ± 782 spikes/min at 50% MVC (P &lt; 0.01). Mean arterial pressure also increased in an intensity-dependent manner from 76 ± 3 mmHg at rest to 90 ± 6 mmHg (P &lt; 0.01) during contractions of 50% MVC. At all contraction intensities, blood pressure remained elevated during PEI, but MSNA returned to pre-contraction levels, indicating that the metaboreflex does not contribute to the increase in MSNA to contracting muscle even at these high contraction intensities.

Comparison of the Effectiveness of Isometric, Isotonic Eccentric And Isotonic Concentric Exercises in Pain Management

Aim: To compare the effect of isometrics, isotonic concentric and isotonic eccentric strengthening techniques on patients diagnosed with subacromial impingement syndrome. Methods: The study design used is randomized clinical trial. 36 patients are allocated in 3 groups with 12 patients in each group with age limit from 30-50 years treated for 6 weeks on alternate days with isometrics, isotonic concentric and isotonic eccentric with baseline exercise plan respectively. Each patient received 18 sessions of exercise plan. Intervention plan is divided into 2 phases, with each phase of 3 weeks. Outcome measuring tools used are Numeric Pain Rating Scale(NPRS) to measure pain, Manual Muscle Testing (MMT) to measure muscle strength was assessed at Day 0, Week3, and Week 6. Result: Results are generated by using SPSS 21. Post treatment ONE WAY ANOVA showed no significant difference in reduction of pain assessed by NPRS in GROUP1 treated with isometric exercise plan and GROUP2 & GROUP3 treated with isotonic eccentric and isotonic concentric exercise plan respectively. Post treatment One way anova showed p value .117 which is greater than 0.05. Post treatment ONE WAY ANOVA showed significant difference for strength of all the rotator cuff muscles. Conclusion: Isometric exercise plan conclusively proved to be better as compared to isotonic eccentric and isotonic concentric program in strengthening of patients with subacromial impingement syndrome. Keywords: Subacromial Impingement Syndrome, Isometric, Isotonic Eccentric, Isotonic Concentric.

Efficacy of Exercise on Postneedling Soreness: A Randomized Controlled Trial

This study aimed to investigate the efficacy of concentric, eccentric, and isometric exercise protocols on the postneedling soreness (PNS) after the dry needling (DN) of latent myofascial trigger points (MTrP) in the medial gastrocnemius muscle. A randomized clinical trial was carried out. Volunteers, ≥18 years old, with a latent MTrP in the medial gastrocnemius muscle were included. Subjects with contraindications to DN, active MTrPs, and/or other treatments in MTrPs in the 3 months prior to recruitment were excluded. A total of 69 participants were randomly allocated to four groups, where post-DN intervention consisted of an eccentric, concentric, or isometric exercise, or no exercise, and they were assessed for PNS intensity (visual analog scale (pVAS)), pressure pain threshold (PPT, analog algometer), pain intensity (nVAS), and local twitch responses (LTRs) during DN, as well as demographics and anthropometrics. The mixed-model analyses of variance showed significant interaction between time and pVAS, and between time and PPT (p < 0.001). While the multivariate test confirmed that PNS and PPT improved over time within each group, specifically between 6–12 h post-intervention, the post hoc analyses did not show significant differences between groups. The mixed-model analyses of covariance showed a significant nVAS effect (p < 0.01) on PNS decrease, and some effect of the LTRs (p < 0.01) and sex (p = 0.08) on PPT changes. All groups improved PNS and PPT, but none of them showed a greater improvement above the others. The most dramatic decrease was observed between 6–12 h post-exercise, although concentric and eccentric exercise had an effect immediately after the intervention. Between all potential modifiers, pain during DN significantly influenced PNS progression, while LTRs and sex seemed to determine PPT course over time.

Effect of Sustained Isometric and Isotonic Exercises on Blood Pressure and Heart Rate Variability – A Comparative Study

Introduction: Isometric exercises are contractions of a particular muscle which doesn’t noticeably change length and the affected joint doesn’t move [1]. Isotonic exercises involve contracting muscle shortens against a constant weight, as when lifting as weight [2,3]. These two different types of exercise have profound changes in the body affecting the respiratory and cardiovascular systems [4]. Studies comparing the effectiveness of isotonic and isometric exercises on blood pressure and heart rate variability (HRV) were scanty [5]. Objective: The present study planned to investigate and compare the efficacy of isometric as well as isotonic exercises on changes in blood pressure, heart rate and HRV. Materials and methods: 10 normal healthy subjects in the age group 17-20 years of both genders participated in the study. All the subjects were assessed under three different conditions: Resting state, After isotonic exercises (20 repetitions of straight leg raise) and After isometric exercises 2 mins of sustained abdominal exercises). After each procedure, blood pressure and heart rate variability were calculated. Results: Isometric exercises cause reduction of systolic and diastolic blood pressure, mean arterial pressure while pulse rate increases significantly. Isotonic exercises increase the systolic and diastolic blood pressure and mean arterial pressure significantly. The result is statistically significant with p<0.050. Conclusion: Thus it can be concluded an innovative finding that isometric exercise causes profound decline in blood pressure and increased heart rate variability thus showing a negative impact on cardiovascular health. So it can be concluded that isotonic exercise improves the circulation and supports the cardiovascular system and strengthens the muscle, improves bone density and boosts cardiac function

Improving Postoperative Care Through Mindfulness-Based Cognitive Therapy and Isometric Exercise Interventions: A Systemic Review (Preprint)

BACKGROUND This review identifies the impacts of mindfulness-based cognitive therapy (MBCT) and isometric exercise interventions (IEIs) in postoperative care settings. Both interventions are relatively new approaches to maintain physical functioning, alleviate pain, prevent joint stiffness and muscular atrophy, and positively influence other postoperative care outcomes. OBJECTIVE To our knowledge, a review of the impacts of these interventions and, more specifically, of their combination has not been done before. This review will be the first to do so. METHODS Studies were identified by searching “PubMed” and “Cochrane databases” within PPRISMA algorithm format and using the relevant keyword combinations, which resulted in 39 studies meeting the inclusion criteria. RESULTS In general, MBCT was shown to positively impact both pain relief and physical functioning while IEIs positively impacted physical functioning. Numerous other benefits were also described from both interventions and further research is needed to confirm these findings as well as to determine other possible benefits. However, no studies were found that combined MBCT and IEIs. CONCLUSIONS While there are many positive results from each individual intervention, there is a lack of information about how the combination of MBCT and IEIs might impact postoperative care. The combination of the two interventions might prove to be more effective than each individual intervention alone and the findings from this review show that they could even be complementary. Going forward, research should be expanded to study the possible benefits of the combination of MBCT and IEIs in postoperative care routines as well as other possible combinations.

Management of patellar tendinopathy: a systematic review and network meta-analysis of randomised studies

ObjectivesWe performed a systematic review and network meta-analysis (NMA) of randomised controlled trials (RCTs) to provide insights into the effectiveness of available treatment modalities in patellar tendinopathy(PT).MethodsSeveral databases were searched in May 2021 for RCTs assessing the effectiveness of any intervention compared with any other intervention, placebo or no treatment for pain and/or function in PT. The risk of bias and strength of evidence were assessed with the Cochrane Collaboration and GRADE (Grading of Recommendations, Assessment, Development and Evaluations)/GRADE-NMA tools.ResultsA total of 37 RCTs were eligible that assessed 33 different interventions and their combinations, most represented by single studies. Based on pairwise meta-analyses of two RCTs, extracorporeal shockwave therapy (ESWT) does not appear to be superior to sham ESWT (eccentric exercise in both groups) for short-term pain (mean differences (MD) +0.1, 95% CI (−0.8 to 1), p=0.84) or function (MD −1.8, 95% CI (–8 to 4.4), p=0.57). Based on a pairwise meta-analysis of three RCTs, isometric exercise appears as effective as isotonic exercise for immediate postintervention pain relief (MD −1.03, 95% CI (−2.6 to 0.5), p=0.19). Our NMA showed that topical glyceryl trinitrate (GTN) and hyaluronic acid injection, both combined with eccentric exercise and moderate, slow resistance exercise had the highest probability of being the most effective interventions (low/very low strength of evidence).ConclusionsPromising interventions with inadequate evidence, such as topical GTN, hyaluronic acid injections and isometric and slow resistance exercise, should be further investigated through high-quality RCTs. Meanwhile, eccentric loading with or without adjuncts should remain the first-line treatment for all individuals with patellar tendinopathy.