Clinical Research Directory

Pilates Method in Achilles Tendinopathy Rehabilitation

Achilles Tendinopathy (AT) is characterized by pain, swelling and dysfunction. Rehabilitation strategies focus on conservative treatment, with eccentric exercise being the main and most popular option. Patient education based on the biopsychosocial model is considered important for effective self-management, including modification of activities and loads and pain monitoring. Established exercise protocols are applied in rehabilitation, with eccentric, eccentric- concentric combinations and high-resistance exercises performed at a slow pace being the most popular. The Pilates method , which has gained popularity in recent years, focuses on core stabilization, motor control, correct posture through respiratory patterns during execution as well as flow and mindfulness and is applied to the rehabilitation of various musculoskeletal disorders. Although there is a research background in rehabilitation, the data for its application in AT are limited. The present study aims to investigate the integration of Pilates into clinical practice for AT.

Effects of Exercise-Induced Muscle Damage on Neuromuscular Complexity

This study will examine the effects of exercise-induced muscle damage, induced by eccentric exercise, on torque production, muscle oxygenation, and electromyographic activity of the knee extensors in healthy young men. Eleven participants will perform a sustained submaximal isometric contraction before and 48 hours after a muscle-damaging eccentric exercise protocol. It is anticipated that the eccentric exercise will confirm the presence of muscle damage, by decrease in maximal voluntary isometric torque, increase in muscle soreness, and reduction in pain-free range of motion. The effect of eccentric exercise on the complexity of torque output, which could be reflected by decreased Sample Entropy and increased DFA α, will be indicated by a possible shift toward more predictable and less adaptable motor control patterns. Based on these results, the investigators will know about the effect of eccentric exercise induced muscle damage on neuromuscular efficiency, that is greater neural input could be required to maintain the same mechanical output, as well as increased oxygen consumption in the active muscle.

Metabolic, Respiratory, and Muscle Oxygenation Responses to Sub-maximal Eccentric and Concentric Isokinetic Exercise to Exhaustion

This study aims to measure and compare the metabolic response during sub maximal eccentric and concentric isokinetic exercise performed to exhaustion. Fourteen healthy female participants in the early phase of the menstrual cycle will perform concentric exercise with one lower limb and eccentric exercise with the contralateral limb. The assignment of exercise mode to limb and the order of testing will be randomized. The exercise protocol will consist of repeated knee extensor contractions on an isokinetic dynamometer for 10 minutes at 40% of maximal torque, followed by exercise at 70% of maximal torque until exhaustion. Oxygen consumption and respiratory quotient and will be measured continuously throughout exercise using open-circuit spirometry. Muscle oxygenation will be measured also continuously using near infrared spectroscopy. Lactate and pH concentration will be measured at frequent time points during the exercise to exhaustion.

Effects of Eccentric Training at Long Muscle Length on Functional Capacities of Elderly Adults

As aging leads to a decline in muscle function and overall physical performance, interventions targeting muscle strength and neuromechanical properties are critical for maintaining functional independence in older adults. Long-length eccentric training has shown promise in enhancing muscle performance, but its effects in older adults, particularly in a home-based setting, remain underexplored. The aim of this trial is to assess whether a targeted home-based training intervention incorporating long-length eccentric contractions can enhance functional capacity and neuromechanical properties in healthy older adults. Participants will be semi-randomly allocated to one of two groups: an experimental group incorporating long-length eccentric contractions (Group 1) or a conventional resistance training group (Group 2), with group assignment stratified to ensure an equal number of men and women in each group. Each participant will complete three laboratory-based experimental sessions (i.e., two Pre-training sessions and one Post-training session) , during which five key evaluations will be conducted: (i) the 5-Time Sit to Stand test, serving as the primary outcome measure; (ii) the Timed Up and Go test; (iii) assessments of isometric and dynamic muscle strength in the knee extensors and plantar flexors; (iv) measurements of the cross-sectional areas of the vastus lateralis, rectus femoris, gastrocnemius medialis, and soleus muscles; and (v) evaluation of tendon stiffness. Following the pre-evaluation, each participant will engage in a 24-session, semi-supervised, home-based training protocol over a period of 8 to 11 weeks. The training program will include eight exercises, with four targeting the upper limbs and four focused on the lower limbs. Group 1 will perform the lower limb exercises at long muscle lengths, while Group 2 will perform the same exercises in a conventional manner (i.e., at neutral or shorter muscle lengths). The total training volume (calculated as repetitions × sets, in arbitrary units) will be matched across both groups, ensuring that any observed differences in outcomes are attributable to the specific training modality rather than differences in workload.