Alci E, et al. Ann Surg Treat Res. 2023 Sep;105(3):119-125. https://doi.org/10.4174/astr.2023.105.3.119

Eccentric exercise is widely used to enhance muscle strength and performance, yet its specific effects on muscle architecture and functional outcomes in adolescent athletes remain insufficiently explored. This randomized controlled trial examined the effects of an eight-week eccentric heel-drop program on triceps surae architecture, strength, and jump performance in adolescent female volleyball players. Twenty-six athletes were randomized to an exercise group (n = 14) or control group (n = 12). The exercise group performed supervised heel-drops three times weekly, while controls continued regular training. Ultrasound assessed the muscle thickness, fascicle length, and pennation angle of the gastrocnemius medialis, gastrocnemius lateralis, and soleus. Strength was measured via dynamometry, and vertical jumps (squat, countermovement, block, attack) were evaluated. The exercise group showed significant increases in gastrocnemius medialis muscle thickness (p = 0.03) and fascicle length (p = 0.002), with no changes in other muscles. While both groups improved strength, no between-group differences emerged. However, the exercise group demonstrated significant improvements in squat, block, and attack jump performance (p < 0.05). Consequently, eccentric plantar flexor training elicited muscle-specific architectural adaptations and improved sport-specific jump performance. Progressive eccentric heel-drop exercises serve as an effective addition to youth conditioning programs to enhance structural and functional outcomes.

Purpose: This pilot study aimed to compare the effects of face-to-face and telerehabilitation approaches on thoracic hyperkyphosis, back extensor muscle strength, and discomfort in children. Methods: A randomized clinical trial was conducted in Türkiye with twenty children (aged 9–12 years) diagnosed with thoracic hyperkyphosis (thoracic kyphosis angle >40°). Participants were randomly allocated to a face-to-face rehabilitation group (n = 10) or a telerehabilitation group (n = 10) using the Fiziu Digital Exercise Platform. Both groups performed the same supervised exercise program three times per week for six weeks. Thoracic kyphosis angle (TKA), manual muscle testing (MMT) of the back extensors, and Visual Analog Scale (VAS) scores for discomfort were assessed pre- and post-intervention. Results: In the face-to-face group, significant improvements were observed in all outcome measures. TKA decreased by 2.00° (p < .001), MMT increased by 0.50 points (p = .037), and VAS decreased by 1.90 points (p < .001). In the telerehabilitation group, TKA also showed a significant reduction of 1.55° (p = .002), and VAS decreased significantly by 1.30 points (p = .009). Although MMT increased by 0.40 points in the telerehabilitation group, this change did not reach statistical significance (p = .072). No significant between-group differences were observed for any outcome at post-intervention (TKA p = .34; MMT p = .693; VAS p = .27). Conclusions: Both face-to-face and telerehabilitation approaches improved posture, muscle strength, and discomfort in children with thoracic hyperkyphosis. Telerehabilitation using the Fiziu platform may be a practical and accessible alternative in pediatric rehabilitation.