Koryagina Yu.V., Ter-Akopov G.N., Nopin S.V., Popov A.N. Development of the ADL (Activities of Daily Living) therapy methods for improving strength of weakened muscle groups and optimizing muscle balance in athletes

Publication date: 01.03.2023
DOI: 10.51871/2782-6570_2023_02_01_2
UDC 611.73; 615.825.6

DEVELOPMENT OF THE ADL (ACTIVITIES OF DAILY LIVING) THERAPY METHODS FOR IMPROVING STRENGTH OF WEAKENED MUSCLE GROUPS AND OPTIMIZING MUSCLE BALANCE IN ATHLETES

Yu.V. Koryagina, G.N. Ter-Akopov, S.V. Nopin, A.N. Popov

FSBI “North-Caucasian Federal Research-Clinical Center of the FMBA of Russia”, Essentuki, Russia

Annotation. Normally, specific sports training is directed towards development of strength and strength-speed capabilities of muscles contributing to performance of competitive exercises.
Often, not enough attention is paid to a development of the autochthonous core muscles of athletes. Therefore, a creation of special methods aimed at optimizing muscle balance and improving the said muscles is a relevant task for strenghtening the musculoskeletal system of athletes and prevention of sports injury. The purpose of the study was to develop the ADL (Activities of Daily Living) therapy methods for improving strength of lagging muscle groups and optimizing muscle balance in athletes. The study involved 27 elite athletes (17 women, 10 men). We have conducted research of strength characteristics of the muscle groups before and after applying the developed methods. Prevention-Park, the ADL therapy intellectual system with biofeedback, was used in mechanotherapy for developing strength of lagging muscle groups and optimizing muscle balance. The experimental test results with the Prevention-Park system have revealed a significant improvement of the core muscles among athletes, which was more pronounced in women. According to the study’s findings, the authors have identified main tasks of the ADL mechanotherapy for athletes: increase of functional capabilities of the musculoskeletal system, consisting in optimizing the muscle balance of various muscle groups, increasing the speed and strength abilities of muscles, the development of lagging muscle groups; prevention of overstrain and fatigue of athletes,
including in the middle altitude conditions; formation of a balanced muscular spine corset.

Keywords: musculoskeletal system, neuromuscular system, muscle strength, muscle corset, ADL (Activities of Daily Living) therapy, biofeedback.

Introduction. The musculoskeletal and neuromuscular systems, contributing to performance of movements, are maximally involved and limit effectiveness in all sports [1-2]. Coordinated work of the spine muscle corset allow performing needed movements and preserve stability [1-2]. The acquired motor abilities of elite athletes or the motor dynamicstereotype is a sign of phased dynamic variability of the muscle corset [3].

Normally, specific sports training is aimed at improving strength and speed-strength qualities of muscles that contribute to performance of competitive exercises. Frequently, not enough attention is paid to a development of the autochthonous core muscles of athletes. Therefore, they can be developed insufficiently or unevenly and asymmetrically. Disorder of interaction between muscles that stabilize spine with muscles that perform movements is a spine muscle imbalance [3]. Such disorder causes problems for normal function of the locomotion system, since the muscles responsible for movement are normally stronger than the muscles responsible for stability, consequently – the neuromuscular imbalance of the spine and instability in the spinal motion segment. The neuromuscular imbalance disorders is shown in athletes clinically in the form of pain, burning sensation, fatigue, movement limitation in separate segments of the spine, which leads to a decreased training process intensity and prevents from reaching the peak of athletic form [4].

The ADL (Activities of Daily Living) therapy term is used for describing exercises developed for solving daily tasks. Due to concentration on a chosen joint and special sets of movement, the training does not require significant time costs and has a long-term effect, which corresponds to the most modern trends in sports medicine during medical rehabilitation [5].

Therefore, a creation of special methods aimed at optimizing muscle balance and improving the said muscles is a relevant task for strengthening the musculoskeletal system of athletes and prevention of sports injury.

The purpose of the study – to develop the ADL (Activities of Daily Living) therapy methods for improving strength of weakened muscle groups and optimizing muscle balance in athletes.

Methods and organization. The development and testing of the ADL therapy methods was carried out during the preparatory period in Yug Sport, the organization located in Kislovodsk on the Maloe Sedlo mountain (1240 m) during training camps for elite athletes (the preparatory period). The study involved 27 elite athletes (17 women, 10 men). We have conducted research of strength characteristics of the muscle groups before and after applying the developed methods.

During the study, the athletes were at stage of the preparatory and transition periods of the training process. All subjects gave an informed consent to participate in the study in accordance with the WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects (2013), as well as a permission to process their personal data.

The authors identified strength characteristics of different muscle groups with “Dr. Wolff “Back-Check” (Germany, Physiomed), the diagnostic biofeedback system that conducts an assessment of target-oriented movements to measure peak strength during isometric contraction of muscle groups from the back, core, upper and lower limbs. The result was measured in kilograms. The diagnostic frame of the system has 2 sensors for identifying position in case of bending (fig. 1). Following measurements were carried out: back extension, back flexion, core shifting to the left, core shifting to the right, press, row, arm pulling backwards, leg pulling backwards, leg adduction, hip extension.

Fig. 1. The “Dr. Wolff “Back-Check” diagnostic system

The experts note that this system is a convenient and informative tool for assessing the “muscle corset” state in patients with pathology and healthy athletes [6-7].

After each test, we calculated the functional asymmetry coefficient (Cfa) according to the formula used by a number of authors [8-9]:

where N_r – right body half indicator, N_l – left body half indicator.

The statistical data processing was made with the Statistica 13.0 software. The authors calculated descriptive statistics indicators (mean value, mean square deviation). All data was tabulated. The comparison was made with the non-parametric Wilcoxon test for analyzing dynamics in changing parameters, as well as the Kruskal-Wallis test for identifying differences between athletes of different sports.

The mechanotherapy was carried out with Prevention-Park, the ADL therapy intellectual system with biofeedback. The set allows conducting ADL exercises. The devices have electronic control panels, LED displays that show in real time all main training parameters. It can also read therapeutic smart cards of patients.

Results and discussion.

The ADL therapy method for developing strength of lagging muscle groups and optimizing muscle balance in athletes

Back-Therapy-Center, the training device set with biofeedback by Dr. WOLFF Sports & Prevention GmbH, was used for the ADL therapy. Duration of the mechanotherapy course was 10-14 days, the exercises were done every day, the amplitude is selected individually, and a number of repeats – from 30 with an addition of 5-10 seconds every day. Description and the method of performing the exercises is presented below.

1) Lateral core shifting to the left/right while standing (Lateral-Shifting) (fig. 2).

Fig. 2. Lateral (frontal) core shifting to the right and to the left while standing (Lateral-Shifting 936)

Lateral (frontal) core shifting to the left
An athlete stands on a special “tilted” ledge on the device’s platform, slightly leaning, the left arm is lowered down, the right is bent at the elbow. While resting their left shoulder against the foam cushion of the device fixed at shoulder height, and with their right hip against the cushioning device (a measuring sensor with a cushioning pad), the athlete makes a frontal core shift to the left, with their right hip pushing on the cushioning device on the right, fixing the pressure exerted by the athlete's leg.

Lateral (frontal) core shifting to the right
An athlete stands on a special “tilted” ledge on the device’s platform, slightly leaning, the right arm is lowered down, the left is bent at the elbow. While resting their right shoulder against the foam cushion of the training device fixed at shoulder height, and with their left hip against the cushioning device (a measuring sensor with a cushioning pad), the athlete makes a frontal core shift to the right, with their left hip pushing on the cushioning device on the left, fixing the pressure exerted by the athlete's leg.

2) Transversus abdominis training (Transversus-trainer – a training device for deep transversus abdominis while lying) (fig. 3).

Fig. 3. The transversus abdominis training (Transversus-trainer 916)

An athlete lies down (takes a horizontal position) on the device’s bench, lifts their legs and bends their knees at 90-degree angle, then with both hands holds the short horizontal handles protruding above the head, located shoulder-width apart in the device’s supports, resting their hands on them, and with their back to the bench, the athlete arches their back (lower back) alternately, so that it rises up and lowers down. Movements are registered by the cushioning device protruding from a hole in the bench at the lower back level.

3) Body stabilization while standing (Standing stabilization – training of weakened deep muscles that hold the spine in vertical position) (fig. 4).

Fig. 4. Performing the body stabilization exercise while standing (Standing stabilization 926)

An athlete stands on the device’s rack vertically and rests their back against the backrest, spreading the legs shoulder-width apart, while stretching the arms and hands forward. The athlete must fix the standing position and try not to move. The slightest movements (rack shifting) are recorded and transmitted to the monitor by a cushioning device located in the hole in the backrest. The monitor is located in front of the athlete's eyes, so that they can adjust their balance. For a more advanced level, it is possible to hold dumbbells at arm's length during training.

4) Training of the multifidus muscles of the back (multifidus-trainer – segmentary stabilization while sitting) (fig. 5).

Fig. 5. Training of the multifidus muscles (Multifidus-trainer 906)

An athlete sits on the device’s seat, resting their knees against a special support with the device’s softening cushion, and their back placed against the backrest of the seat. The legs are bent at the knees at 90-degree angle, the back is straight. The athlete, holding on to the handles attached to the cables, alternately performs rows with both hands. A softening device built into the opening of the seat captures the shifts of the back movement and transmits it to the display located in front of the athlete.

5) Rotations while standing (standing rotation – training with the core rotations to the left and right while standing) (fig. 6).

Fig. 6. Rotations while standing (Standing rotation 946)

An athlete stands straight on the platform, legs shoulder width apart. The front sides of both legs are fixed between two supports, one of which has the built-in motion-locking
cushioning device. The grip module (combined handle), consisting of two vertical handles, two shoulder supports and an elongated monitor broadcasting the athlete's movements, is held.

Rotations to the left are carried out in the following position: the athlete stands straight on the platform, legs shoulder width apart. The front sides of both legs are fixed between two supports, the left hip rests against the cushioning device on the left, the grip module (combined handle) is held from the rack on the right, the athlete performs lifts, making alternate movements of the body to the left at an angle of 90°.

Rotations to the right are carried out in the following position: the athlete stands straight on the platform, legs shoulder width apart. The front sides of both legs are fixed between two supports, the right hip rests against the cushioning device on the right, the grip module (combined handle) is held from the rack on the left, then the athlete performs lifts, making alternate body movements to the right at an angle of 90°.

Results of the ADL therapy’s experimental testing of elite athletes with the Prevention-Park biofeedback device

The testing results have revealed that the developed mechanotherapy course on the ADL therapy system with biofeedback for developing strength of lagging muscle groups and optimizing muscle balance in female athletes contributed to an increased strength of muscle groups responsible for following movements: back extension, back flexion, seated rows, lateral core shifting (table 1).

Table 1

Indicators of strength (and its asymmetry) of different muscle groups in female athletes after the mechanotherapy course on L adapters for developing strength of weakened muscle groups and optimizing muscle balance, M±δ

№	Indicators	Before	After	p<
1	Back extension, kg	52.5±18.9	58.0±18.7	0.01
2	Back flexion, kg	34.0±14.7	39.1±16.0	0.02
3	Cfa flexion / extension	0.21±0.17	0.21±0.10	-
4	Upper back, horizontal press, kg	86.2±26.2	88.1±18.4	-
5	Upper back, seated row, kg	58.8±12.4	63.2±13.6	0.01
6	Core shifting to the left, kg	43.0±16.2	57.6±17.8	0.003
7	Pulling left shoulder backwards, kg	32.9±12.4	38.7±14.5	-
8	Pulling left leg backwards, kg	33.5±7.7	37.6±12.7	-
9	Left leg adduction, kg	36.1±11.4	36.6±12.6	-
10	Left hip extension, kg	44.0±11.9	48.4±15.0	-
11	Core shifting to the right, kg	41.3±16.1	54.3±17.9	0.006
12	Pulling right shoulder backwards, kg	32.7±11.4	37.9±10.4	-
13	Pulling right leg backwards, kg	38.9±13.1	39.3±15.4	-
14	Right leg adduction, kg	37.8±12.8	37.8±11.9	-
15	Right hip extension, kg	45.4±16.8	48.1±16.9	-
16	Cfa core shifting	0.02±0.12	0.03±0.10	-
17	Cfa pulling shoulder backwards	-0.001±0.08	-0.004±0.10	-
18	Cfa pulling leg backwards	-0.06±0.12	-0.008±0.14	-
19	Cfa leg pulling	-0.02±0.09	-0.02±0.06	-
20	Cfa hip extention	-0.003±0.11	0.02±0.13	-

Note: Cfa flexion / extension – strength coefficient of back flexion / extension; К core shifting – functional asymmetry coefficient in tilting to the left / right; Cfa pulling shoulder backwards – functional asymmetry coefficient in pulling right / left shoulder backwards; Cfa pulling leg backwards – functional asymmetry coefficient in pulling right / left leg backwards; Cfa leg adduction – functional asymmetry coefficient in right / left leg adduction; p< – according to the non-parametric Kruskal-Wallis test between all groups

After the mechanotherapy course, male athletes have an increased strength of muscles responsible to lateral core shifting (table 2).

Table 2

Indicators of strength (and its asymmetry) of different muscle groups in male athletes after the mechanotherapy course on L adapters for developing strength of weakened muscle groups and optimizing muscle balance, M±δ

№	Indicators	Before	After	p<
1	Back extension, kg	74.5±22.1	77.8±19.4	-
2	Back flexion, kg	47.0±8.2	54.5±13.3	-
3	Cfa flexion / extension	0.21±0.17	0.17±0.11	-
4	Upper back, horizontal press, kg	122.7±51.5	122.8±51.6	-
5	Upper back, seated row, kg	93.0±32.3	91.1±33.9	-
6	Core shifting to the left, kg	55.6±20.0	74.1±27.8	0.01
7	Pulling left shoulder backwards, kg	48.5±42.3	47.5±32.2	-
8	Pulling left leg backwards, kg	39.3±13.1	38.5±11.3	-
9	Left leg adduction, kg	51.1±18.5	48.0±17.5	-
10	Left hip extension, kg	51.2±36.4	44.8±18.1	-
11	Core shifting to the right, kg	55.7±21.2	74.4±35.8	0.04
12	Pulling right shoulder backwards, kg	55.6±43.5	51.0±31.1	-
13	Pulling right leg backwards, kg	43.5±14.8	42.4±13.5	-
14	Right leg adduction, kg	51.7±18.8	51.0±18.6	-
15	Right hip extension, kg	43.5±23.9	42.7±19.0	-
16	Cfa core shifting	0.01±0.10	0.02±0.09	-
17	Cfa pulling shoulder backwards	-0.08±0.11	-0.04±0.12	-
18	Cfa pulling leg backwards	-0.05±0.05	-0.04±0.06	-
19	Cfa leg pulling	-0.02±0.11	-0.03±0.07	-
20	Cfa hip extention	0.06±0.10	0.03±0.08	-

According to the results, the main tasks of ADL mechanotherapy in athletes were:

- Increasing the functional capabilities of the musculoskeletal system, consisting in optimizing the muscle balance of various muscle groups, increasing the speed-strength abilities of muscles, developing lagging muscle groups;

- Prevention of overstrain and fatigue of the musculoskeletal system of athletes, including training in the middle altitude conditions;

- Formation of a balanced spine muscle corset.

Indications for ADL mechanotherapy in athletes are:

- the need to improve the functional capabilities of the athletes’ musculoskeletal system;

- muscle imbalance, insufficient level of development of separate muscle groups.

Contraindications for ADL mechanotherapy in athletes are:

- acute injuries,

- painful conditions.

Conclusion. Therefore, the course of specially developed mechanotherapy sets on Prevention-Park, the intelligent ADL therapy system with biofeedback, for the developing strength of weakened muscle groups and optimizing of muscle balance in athletes significantly contributed to the development of core muscles, which was more pronounced in women.

REFERENCES

Zamchij T.P., Koryagina Yu.V. Morphofucntional aspects of adaptation to power sports. Omsk, 2012. 156 p. (in Russ.)
Koryagina Yu.V., Abutalimova S.M., Roguleva L.G., Nopin S.V., Kopanev A.N. To the question of developing effective restoration strategies for athletes during stay in the camp at federal bases of sports training. Modern Issues of Biomedicine, 2020, vol. 4, no. 1 (10), pp. 35-39. (in Russ.)
Kostyuk E.V., Koryagina Yu.V. The method of optimization of the neuromuscular balance of the
muscular corset of the spine in athletes at the robotyzed system “Centaur”. Modern Issues of Biomedicine, 2017, vol. 1, no. 1 (1), pp. 23-30. (in Russ
Kolesnichenko V.A., Prodan A.I., Tyazhelov A.A. Mechanogenesis of overexertion syndromes in sportsmen. Traumatology and Orthopedics of Russia, 2007, no. 1(43), pp. 37-45. (in Russ.)
Wolff Prevention Park. Rehabilitation set for ADL training. Available at: physiocom.ru (accessed 20.02.2023) (in Russ.)
Borodulina I.V., Mukhina A.A., Chesnokova E.I. Features of the application of instrumental methods for lumbosacral muscle groups functional state assessing. Bulletin of Rehabilitation Medicine, 2021, vol. 20, no. 5, pp. 65-72. (in Russ.)
Steidl-Müller L., Patterson C., Luchner R., Ebenbichler C., Hildebrandt C., Raschner C. Trunk flexion to extension strength ratio of 11-to 18-year-old youth ski racers: data from 15 years of talent development in Austria. Journal of Science in Sport and Exercise, 2021, no.3(3), pp. 303-311.
Khomskaya E.D. New approach to neuropsychological diagnosis. Voprosy psikhologii, 1998, no. 2, p. 12. (in Russ.)
Leutin V.P., Nikolaeva E.I. Adaptation strategies and specifics of functional asymmetry of the brain Educational Psychology in Polycultural Space, 2008, vol. 2, no. 3-4, pp. 12-22. (in Russ.)

INFORMATION ABOUT THE AUTHORS:
Yulia Vladislavovna Koryagina – Doctor of Biological Sciences, Professor, Head of the Center of Biomedical Technologies, FSBI “North-Caucasian Federal Research-Clinical Center of Federal Medical and Biological Agency”, Essentuki, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..
Gukas Nikolaevich Ter-Akopov – Candidate of Economic Sciences, General Director of the FSBI “North-Caucasian Federal Research-Clinical Center of Federal Medical and Biological Agency”, Essentuki, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..
Sergej Victorovich Nopin – Candidate of Technical Sciences, Lead Researcher of the Center of Biomedical Technologies, FSBI “North-Caucasian Federal Research-Clinical Center of Federal Medical and Biological Agency”, Essentuki, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..
Aleksandr Nikolaevich Popov – Junior Researcher of the Center of Biomedical Technologies, FSBI “North-Caucasian Federal Research-Clinical Center of the FMBA of Russia”, Essentuki, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it..

For citation: Koryagina Yu.V., Ter-Akopov G.N., Nopin S.V., Popov A.N. Development of the ADL (Activities of Daily Living) therapy methods for improving strength of weakened muscle groups and optimizing muscle balance in athletes. Russian Journal of Sports Science: Medicine, Physiology, Training, 2023, vol. 2, no. 1. DOI: 10.51871/2782-6570_2023_02_01_2

Koryagina Yu.V., Ter-Akopov G.N., Nopin S.V., Popov A.N. Development of the ADL (Activities of Daily Living) therapy methods for improving strength of weakened muscle groups and optimizing muscle balance in athletes

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