Cross-education strength and activation after eccentric exercise

J Athl Train. 2014 Sep-Oct;49(5):582-9. doi: 10.4085/1062-6050-49.3.24. Epub 2014 Aug 12.


Context: After injury, eccentric exercise of the injured limb is often contraindicated. Cross-education training, whereby the uninvolved limb is exercised, is an alternative that may improve quadriceps muscle strength and activation in the unexercised limb.

Objective: To determine the effect of eccentric exercise on quadriceps strength and activation gains in the unexercised limb.

Patients or other participants: Eighteen healthy individuals were randomly assigned to an eccentric training group or a control group.

Intervention(s): Quadriceps strength and activation measures were collected at preintervention, midintervention, and postintervention. Eccentric training participants exercised their dominant limb with a dynamometer in eccentric mode at 60°/s, 3 times per week for 8 weeks.

Main outcome measure(s): Quadriceps strength was quantified at 30° and 60°/s in concentric and eccentric modes. Quadriceps activation was assessed using the burst superimposition technique and quantified via the central activation ratio. A 2 × 3 repeated-measures analysis of variance was used to detect the effects of group and testing session on quadriceps strength and activation. Where appropriate, post hoc Bonferroni multiple-comparisons procedures were used.

Results: We found greater eccentric strength in the unexercised limbs of eccentric training participants between preintervention and midintervention and between preintervention and postintervention (preintervention to midintervention: 30°/s P = .05; preintervention to postintervention: 30°/s P = .02, 60°/s P = .02). No differences were noted in concentric strength (P > .05). An overall trend toward greater quadriceps activation in the unexercised knee was detected between preintervention and postintervention (P = .063), with the eccentric training group demonstrating a strong effect (Cohen d = 0.83). Control strength did not change (P > .05).

Conclusions: Exercising with eccentric actions resulted in mode-specific and velocity-specific gains in quadriceps strength in the unexercised limb. A trend toward greater quadriceps activation in the unexercised knee was noted, suggesting that strength gains may have occurred because of enhanced neural activity. This type of therapy may be a useful addition to rehabilitation programs designed to improve quadriceps strength.

Keywords: cross-education training; knee; quadriceps muscle; rehabilitation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Athletic Injuries / physiopathology
  • Athletic Injuries / rehabilitation*
  • Exercise / physiology*
  • Exercise Therapy / methods
  • Female
  • Healthy Volunteers
  • Humans
  • Knee / physiology*
  • Knee Injuries / physiopathology
  • Knee Injuries / rehabilitation*
  • Male
  • Muscle Strength / physiology*
  • Quadriceps Muscle / physiology*
  • Young Adult