Calatayud Joaquín, Pérez-Alenda Sofía, Carrasco Juan J, Cruz-Montecinos Carlos, Andersen Lars L, Bonanad Santiago, Querol Felipe, Casaña José
Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
National Research Centre for the Working Environment, Copenhagen, Denmark.
Haemophilia. 2021 Jan;27(1):e102-e109. doi: 10.1111/hae.14170. Epub 2020 Oct 4.
Eccentric training has been associated with several specific physiological adaptations. The flywheel machine is one of the easiest ways of performing eccentric overload training. However, no studies evaluated its feasibility, safety and muscle activity in patients with haemophilia (PWH).
To evaluate feasibility and safety and compare muscle activity during flywheel vs weight machine knee extension exercise in severe PWH.
Eleven severe PWH [mean age of 33.5 (8.1) years] participated in this cross-sectional study after receiving prophylactic treatment. Surface electromyography (EMG) signals were recorded for the rectus femoris during the knee extension exercise performed with 2 different conditions (flywheel and weight machine) with matched intensity (6 on the Borg CR10 scale). Kinesiophobia was assessed before and after the experimental session. Participants were asked to rate tolerability of each condition. Adverse effects were evaluated 24 and 48 hours after the session.
Kinesophobia did not increase after the experimental session, and no adverse effects were reported. At 60%-70% of the contraction cycle, the flywheel exercise showed higher (P = .024) eccentric rectus femoris muscle activity than the weight machine. In contrast, during the last 90%-100% of the contraction cycle, the traditional weight machine showed higher (P = .004) rectus femoris activity than the flywheel.
The knee extension exercise performed with the flywheel at moderate intensity is safe and well tolerated among severe PWH under adequate factor coverage. Importantly, the flywheel variation provides higher eccentric rectus femoris activity at the breaking force moment, while it provides lower eccentric muscle activity at the end of the cycle.
离心训练与多种特定的生理适应性变化相关。飞轮训练器是进行离心超负荷训练最简单的方法之一。然而，尚无研究评估其在血友病患者（PWH）中的可行性、安全性及肌肉活动情况。
评估重度PWH进行飞轮训练与传统重量器械膝关节伸展运动时的可行性、安全性，并比较两者的肌肉活动情况。
11名重度PWH（平均年龄33.5[8.1]岁）在接受预防性治疗后参与了这项横断面研究。在两种强度匹配（Borg CR10量表评分为6）的不同条件（飞轮训练器和传统重量器械）下进行膝关节伸展运动时，记录股直肌的表面肌电图（EMG）信号。在实验前后评估运动恐惧程度。要求参与者对每种训练条件的耐受性进行评分。在训练后24小时和48小时评估不良反应。
实验后运动恐惧程度未增加，且未报告不良反应。在收缩周期的60%-70%时，飞轮训练时股直肌的离心肌肉活动高于传统重量器械训练（P = 0.024）。相反，在收缩周期的最后90%-100%时，传统重量器械训练时股直肌的活动高于飞轮训练（P = 0.004）。
在有足够凝血因子覆盖的情况下，重度PWH以中等强度使用飞轮训练器进行膝关节伸展运动是安全且耐受性良好的。重要的是，飞轮训练方式在突破力时刻能提供更高的股直肌离心肌肉活动，而在周期结束时提供较低的离心肌肉活动。
