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Journal of Bodywork & Movement Therapies xxx (2017) 1e8

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Journal of Bodywork & Movement Therapies


journal homepage: www.elsevier.com/jbmt

Comparative study

Do isometric, isotonic and/or isokinetic strength trainings produce


different strength outcomes?
Sabrina Eun Kyung Lee a, Claudio Andre Barbosa de Lira b,
Viviane Louise Andree Nouailhetas c, Rodrigo Luiz Vancini d, Marilia Santos Andrade a, *
a
Departamento de Fisiologia, Escola Paulista de Medicina, Universidade Federal de Sa ~o, Sa
~o Paulo, SP, Brazil
b
Setor de Fisiologia Humana e do Exercício, Laborato ~o do Movimento Humano, Faculdade de Educaça
rio de Avaliaça ~o Física e Dança, Universidade Federal
de Goias, Goia^nia, GO, Brazil
c
Departamento de Biofísica, Universidade Federal de Sa ~o Paulo, Sa
~o Paulo, SP, Brazil
d
Centro de Educaça ~o Física e Desportos, Universidade Federal do Espírito Santo, Vioria, ES, Brazil

a r t i c l e i n f o a b s t r a c t

Article history: Introduction: Several studies have been developed to determine which type of muscular action (iso-
Received 21 April 2017 metric, isotonic and isokinetic) elicits more gains in functional strength and muscle mass. The com-
Received in revised form parisons between training outcomes are inconclusive due to lack of exercise standardization.
9 August 2017
Objective: To compare muscle strength, mass, and functional performance in response to isometric,
Accepted 13 August 2017
isotonic, and isokinetic contractions, when training loads (volume and intensity) are equated.
Method: Data were derived from a university community-recruited sample (n ¼ 31 men).
Keywords:
Interventions: Untrained men were assigned to isotonic (IT), isometric (IM), or isokinetic (IK) group, and
Dynamometer
Leg extensors
trained their dominant quadriceps muscle 3 sessions/week for 8 weeks with a dynamometer. Muscle
Concentric strength was assessed using Cybex 6000 dynamometer; the triple-hop-distance test was used to assess
Isometric functional performance, and dual energy x-ray absorptiometry to assess lean muscle mass.
Results: After training, muscle lean muscle mass increased in isometric (þ3.1%, p < 0.01) and isotonic
groups (þ3.9%, p < 0.01); only the isokinetic group showed a significant improvement in the triple-hop-
distance test (4.84%, p < 0.01).
Conclusion: Clinicians should consider isometric training as an alternative for isotonic training to gain
muscle mass, and isokinetic training to improve functional performance of daily activities and/or sports.
© 2017 Elsevier Ltd. All rights reserved.

1. Introduction clinical settings. They are suggested to prevent sarcopenia and loss
of muscle strength (Taaffe et al., 2014), and to be incorporated in
Muscle strength is dependent on pennation angle, fascicle early rehabilitation programs (Okoro et al., 2016) (Jørgensen et al.,
length and muscle cross-sectional area (Malas et al., 2013). 2017).
Considering that, it is timely to understand what type of action will Isometric exercises are another interesting way of improving
optimize muscle strength. muscle function. Such exercises have been used to treat patellar
Isokinetic muscle strengthening has been used with great suc- tendinopathy and to be incorporated in early rehabilitation of the
cess in rehabilitation of: anterior cruciate ligament reconstruction knee, when the range of motion is limited by pain (van Ark et al.,
(Dauty et al., 2014), jumping capacity in athletes (Rouis et al., 2015), 2016). Previous studies reported significant strength gains
osteoarthritis (Coudeyre et al., 2016), and muscle weakness caused (ranging from 20 to 35%) after 3e4 weeks of exercise training (Pucci
by Parkinson's disease (Kakinuma et al., 1998). et al., 2006; Del Balso and Cafarelli, 2007). In this context, it is of
Isotonic exercises also have been widely used in sports and fundamental interest to identify which type of exercise produces
the best structural and functional muscle adaptations.
The studies that have attempted to compare the effectiveness of
isotonic and isokinetic training to enhance strength are contra-
~o
* Corresponding author. Departamento de Fisiologia, Universidade Federal de Sa
~o Paulo, SP, Brazil.
dictory (Kovaleski et al., 1995; Remaud et al., 2010; Chen et al.,
Paulo, Rua Botucatu, 862, 5º andar, 04023-062 Sa
E-mail address: marilia1707@gmail.com (M.S. Andrade). 2015). The lack of standardization of strength training intensity

http://dx.doi.org/10.1016/j.jbmt.2017.08.001
1360-8592/© 2017 Elsevier Ltd. All rights reserved.

Please cite this article in press as: Lee, S.E.K., et al., Do isometric, isotonic and/or isokinetic strength trainings produce different strength
outcomes?, Journal of Bodywork & Movement Therapies (2017), http://dx.doi.org/10.1016/j.jbmt.2017.08.001
2 S.E.K. Lee et al. / Journal of Bodywork & Movement Therapies xxx (2017) 1e8

and volume may be partially responsible for the inconsistency of Participants were excluded if they presented any knee pain, insta-
the outcomes. Kovaleski et al. (1995) found greater muscle torque bility, edema and limitation of range of motion, and/or previous
increase in isotonic than in isokinetic exercises, while Chen et al. injury or surgery in their lower limbs. Initially, 48 participants were
(2015) showed better results with isokinetic exercises. Remaud evaluated. From this sample, 42 met all the inclusion criteria.
et al. (2010) found similar significant strength gains in both exer- Eleven participants withdrew from the study for personal reasons,
cises; however, these discrepancies could be due to high speeds of and thirty-one concluded the study (see Fig. 1). The physical char-
isokinetic training (150 and 180 /s) and a relatively low isotonic acteristics of the participants are summarised on Table 1. They were
training load (40% of maximal voluntary isometric torque at 70 ); informed of the intent and procedures of the study, and signed a
probably more pronounced changes could be observed with a more written consent before data collection. The study protocol was
intense program. approved by the Human Research Ethics Committee University and
Although the number of studies on different types of muscle is in accordance in Declaration of Helsinki; it was registered with
contractions is relatively large, few have compared isometric to Brazilian Registry of Clinical Trials (RBR-7dp6hs).
dynamic exercises (Folland et al., 2005; Malas et al., 2013). One
limitation of isometric training is that the strength increases are 2.2. Experimental design
specific to the angle used. To overcome this problem, strength-
training series were proposed to be done at different joint angles On the first visit to the laboratory, participants completed a
(Folland et al., 2005); the authors found that isometric and dynamic questionnaire on their clinical status. Those who fulfilled the in-
exercises showed similar isokinetic strength gain, but the gains in clusion criteria were directed to anthropometric measures and
isometric strength were significantly greater on the isometrically strength tests. Muscle torque was assessed via isokinetic dyna-
trained lower limb. However, the authors stated that a possible bias mometry (Cybex 6000, Ronkonkoma, NY), muscle lean mass were
may be absolute load discrepancies, once the load used in the measured via dual-energy X-ray absorptiometry (DXA, software
different contractions mode was not the same. Therefore, one aim version 12.3, Lunar DPX, Madison, WI) and functional performance
of the study was to compare the changes in muscle torque and mass of lower limbs was measured with the triple-hop-distance test.
in response to isometric, isotonic or isokinetic training matched for Anthropometric measurements and strength tests were done in the
equivalent volume and intensity. same day. Lean muscle mass and triple-hop-distance test were
Another goal of the current study was to find out if the possible measured/performed in another same day. The participants were
strength gains resulting from these different types of training are instructed to maintain their physical fitness habits during the study
effective to improve functionality (i.e. performing a task). Func- period. The two days of tests were performed in the same week.
tional assessment of lower limbs has increased in recent years. Prior to the baseline tests, participants underwent a familiarization
Designed to replicate the demands of sport and exercise, functional test. After the pre-tests, participants were assigned either to the
tests can be used to determine an individual's readiness to return to isometric (IM; n ¼ 15), isotonic (IT; n ¼ 14), or isokinetic (IK; n ¼ 13)
play after injury or illness and to detect abnormal limb symmetry or group.
weakness (Ostenberg et al., 1998). Participants were evenly distributed among the three groups
We hypothesized that training with different muscle actions (i.e. according to maximum voluntary isometric torque at 70
isometric, isotonic or isokinetic) would elicit greater strength only (MVIT70 ). Before allocating a new volunteer in one of the three
for the action trained. We also expect that the performance of the groups, an average of maximum voluntary isometric torque was
triple hop distance test will present the great improvement in assessed and, according to the result of each group, the participant
isotonic training group, since the muscle contraction is similar. was allocated. This allocation strategy is known as stratified
random sampling strategy and has been adopted previously
2. Method (Remaud et al., 2010). We chose to carefully match the participants
according to their level prior to training sessions to avoid differ-
2.1. Study participants ences in the baseline strength levels. Two or three days after the
baseline testing the tree groups performed the strength sessions
The participants were staff and students from Federal University three times a week for eight weeks. Within two or three days upon
~o Paulo (S~
of Sa ao Paulo, Brazil) recruited between January 2013 and completion of the eight-week training period, all participants were
December 2014. The inclusion criteria was to be physically active tested for anthropometric measures, strength and horizontal hop-
(weekly volume of exercise is shown in Table 1), between 18 and 30 test for lower limbs again. The participants were unaware of the
years old, and who had not undertaken any specific lower limb nature of the strength training they would be doing; it was,
strength training in the last 6 months. For weekly activity charac- therefore, a single-blinded study.
terization, we inquired and assessed their asked about daily living
and physical activities. Specifically, participants were involved once 2.3. Participant positioning
or twice a week, one hour per day, of aerobic physical activity, such
as running or walking. Participants were instructed to maintain the Isometric, isotonic and isokinetic torque measurements were
level of physical activity during the experimental protocol. assessed dominant and non-dominant lower limbs were assessed.

Table 1
Physical characteristics of the participants included in the isometric (IM), isotonic (IT), and isokinetic (IK) groups.

Group Age Body Mass Height MVIT70 Weekly activity (h)


(years) (kg) (cm) (Nm)

IM (n ¼ 11) 21.7 ± 2.8 72.1 ± 6.2 173.7 ± 6.0 231.9 ± 29.0 6.3 ± 3.2
IT (n ¼ 10) 21.4 ± 2.9 73.3 ± 8.3 174.8 ± 7.4 228.8 ± 32.3 7.3 ± 3.3
IK (n ¼ 10) 22.0 ± 3.4 73.2 ± 11.7 175.1 ± 4.4 230.5 ± 20.0 6.4 ± 3.1

Data are presented as mean ± SD. No statistical differences were found between groups for baseline age (p ¼ 0.94), height (p ¼ 0.85), body mass (0.94), MVIT70 (p ¼ 0.96),
weekly activity (p ¼ 0.63).

Please cite this article in press as: Lee, S.E.K., et al., Do isometric, isotonic and/or isokinetic strength trainings produce different strength
outcomes?, Journal of Bodywork & Movement Therapies (2017), http://dx.doi.org/10.1016/j.jbmt.2017.08.001
S.E.K. Lee et al. / Journal of Bodywork & Movement Therapies xxx (2017) 1e8 3

Fig. 1. CONSORT flow diagram.

Limb dominance was determined a the “favorite leg to kick”. Before participants: isometric, isokinetic, and isotonic.
testing, the participants performed a 5-min warm-up on a cycle
ergometer (Cybex Inc., Ronkonkoma, NY, USA) at a resistance of 2.5. Isometric tests
25 W followed by low-intensity dynamic stretch exercises for the
hamstrings and quadriceps (Mascarin et al., 2015). Participants randomly performed 3 maximal, 3-s isometric knee
The participants' position was the same described previously extension at four different joint angles: 90 , 70 , 50 and 30 , with
(Andrade Mdos. et al., 2012). They assumed a seated position on the 20 s of rest interval between each contraction and another 30s rest
dynamometer with their hips flexed at approximately 85 , and interval between each angle. The maximal isometric torque was
standard stabilization strapping was placed across the trunk, waist, measured at each angular speed and was stored for future analysis.
and shin to minimize additional movement and to provide the
same conditions for all participants. The axis of the dynamometer 2.6. Isokinetic tests
was visually aligned with the lateral femoral condyle while the
knees were flexed at 90 . The length of the lever arm was indi- Participants performed 3 maximal isokinetic knee extensions
vidually determined using the length of each participant's lower (random order) at three different angular speeds 45 /s, 90 /s and
leg, and the resistance pad was placed proximal to the medial 180 /s, with 30 s of rest separating them. The highest peak torque
malleolus. Following direct measurement of the mass of the lower measured from each tested angular speed was recorded for future
limb lever system at 30 of knee extension, gravity correction analysis.
procedures were applied according to the manufacturer specifica-
tions to reduce the risk of inaccurate data. The knee was tested from
2.7. Isotonic tests
0 to 90 of knee flexion, with full knee extension considered 0 .
Finally, participants performed isotonic knee extension at
2.4. Strength testing increasing preset torque levels (þ10 Nm) to assess their 1RM,
which corresponds to the maximal preset torque each participant
A 5-min warm up was performed on a stationary cycle ergom- could overcome only once by reaching at least half of the range of
eter at a low rate (25W and ~50 rpm) before starting each strength motion (ROM). The knee ROM was set 90 e0 (0 ¼ leg in hori-
test. The sequence of strength testing was standardized for all zontal position). A 2-min rest interval was given between the three

Please cite this article in press as: Lee, S.E.K., et al., Do isometric, isotonic and/or isokinetic strength trainings produce different strength
outcomes?, Journal of Bodywork & Movement Therapies (2017), http://dx.doi.org/10.1016/j.jbmt.2017.08.001
4 S.E.K. Lee et al. / Journal of Bodywork & Movement Therapies xxx (2017) 1e8

tests. The maximal torque level was recorded for future analysis. analysis were blinded.
The same order of angular speeds for the isokinetic tests and
joint angles for the isometric tests were maintained between pre 2.11. Statistical analysis
and post-tests sessions. During each maximal voluntary contrac-
tion, participants had direct visual feedback of the force signal and The design and sample size were planned to identify a robust
equal verbal encouragement (“push as hard as possible”). difference between training groups of at least 45% of the maximal
voluntary isometric torque at 70 knee flexion in a relatively ho-
2.8. Lean muscle mass mogeneous group of health adults. For this aim we used data from a
pilot study. The target sample size for a p value of 0.05 and power of
The muscle lean mass of the lower limbs was assessed before 80% was 10 participants in each group. Data are expressed as
and after the experimental training protocol via dual-energy X-ray mean ± SD. A one way analysis of variance (ANOVA) was used to
absorptiometry (DXA, software version 12.3, Lunar DPX, Madison, detect differences between groups for age, height, body mass, and
WI). The “lower limb” was defined as the region extending from the average weekly daily activity prior to training. A two-way repeated-
inferior border of the ischial tuberosity to the distal tip of the toes. measures ANOVA (time x group) was performed to detect differ-
Lean muscle mass was displayed in kilograms (kg). A typical error of ences among absolute isometric, isotonic, and isokinetic data. The
measurement (TEM) for lower limb lean mass is 1.3% (Colyer et al., data were expressed as absolute and relative changes (post/pre-1)
2016). Using the conservative approach of doubling the TEM we in strength. The analyses were performed at all angles. For isotonic
considered 2.6% as minimal change that can be considered a “true” and isokinetic tests, the 1RM and the peak torques determined at
body composition change. each angular speed were considered. The statistical significance
was set at p < 0.05.
2.9. Triple-hop-distance test
3. Results
Functional performance was assessed with the triple-hop-
distance test. Participants performed three consecutive maximal The maximal isometric torque after training increased at all
hops forward with their dominant limb. The distance hopped from angles of all the groups, (see Table 2). The mean increase in
the starting line to the point where the heel touched the ground maximal torque observed at each angle among groups was not
upon completing the third hop was measured (Bolgla and Keskula, significantly different (see Table 2). However, when the torque
1997). All participants performed only three practicing trials for values of all angles were pooled together, the isometric group
each limb to avoid the effects of fatigue. A trial was repeated if the produced overall higher torque (p < 0.0001). The maximal iso-
participant was unable to complete a triple hop without losing metric torque increased on average by 30.2 ± 15.8, 15.8 ± 13.7, and
balance and touching the ground with the opposite lower limb. The 16.8 ± 15.6 Nm, for the IM, IT, and IK groups, respectively (see
maximum distance reached among the three trials was measured Fig. 2).
(in centimeters) for further analysis. Isotonic training increased the 1RM torque by 19 ± 8.1, 36.3 ± 5.6
and 17.9 ± 13.4%, in the IM, IT, and IK groups (p < 0.0001),
2.10. Strength training program respectively (see Table 3).
The peak torque increased in all groups at all angular speeds (see
To compare isometric and dynamic loading, the volume of Table 4). The isokinetic peak torque improvements were not
training and intensity were matched (75% of maximal torque for different among the 3 groups at any angular speed individually
each type of contraction) so that the relative loading was equated (p > 0.05) (see Fig. 3).
among the groups. The training took 8 weeks; each participant Then lean muscle mass of the trained lower limb increased by
visited the laboratory 24 times. Only the dominant lower limb was 3.1 ± 3% (p < 0.0001) in the IM group and 3.9 ± 2.2% in the IT group
trained. (p > 0.0001). The dominant lower limb 1RM gain correlated with
The training sessions consisted of four sets of 10 repetitions of 1- the gain in lean muscle mass (r ¼ 0.51, p < 0.01). Only the IK group
s contractions using the specific muscular action selected for each showed 4.8% increase in the triple-hop distance (p < 0.01).
group (1-min rest interval between sets). The IM training consisted
of 75% of maximal voluntary torque measured at four angles of 4. Discussion
knee flexion (90 , 70 , 50 and 30 ). A target torque, which was
established from baseline testing, was provided for each participant We showed that 8 weeks of either isometric, concentric isotonic,
on the computer screen and the participants were instructed to and concentric isokinetic resistance training leads to increase in
reach or exceed the target torque marker. During each training muscle strength at their corresponding muscle action. Both iso-
session, sets were completed in a different random order and with metric and isotonic trainings significantly increased muscle mass,
1s of rest interval between contractions. The IT training consisted of whereas the isokinetic training did not, although it led to an in-
75% 1RM determined during the pre-test and the participants were crease in the triple-hop distance achieved. The isometric training
instructed to take 1s to lift and 1s to lower. The IK training consisted showed to be the most specific, increasing torque by 30.2%. Our
of angular speed of 90 /s, as the concentric peak torque at 90 /s data showed different outcomes for the three types of training even
corresponded to approximately 75% of the peak isometric torque at when load was equated.
75 of knee flexion (Folland et al., 2002). As ROM of the knee was Although previous studies have already attempted to compare
set at 0e90 and the angular speed was set at 90 /s, the knee the effectiveness of these three types of training, their results are
extension was performed in 1 s, and allowed to passively return to contradictory (Kovaleski et al., 1995; Wojtys et al., 1996; Remaud
the initial position. The level of the preset torque was then pro- et al., 2010; Malas et al., 2013). Wojtys et al. (1996) found greater
gressively increased during the training period for both the IT and strength gains after 6 weeks of isokinetic training performed at 60 /
IK groups (new assessment was performed every third week). The s than after isotonic training performed at 70% of 1RM. However,
number of sets, repetitions, rest interval between sets, rest interval Kovaleski et al. (1995) reported a greater increase in torque pro-
between repetitions, and relative load were the same for all groups. duction after isotonic training (25% of the peak isometric torque at
The participants and the researcher who performed the statistical 70 of knee flexion) than after isokinetic training performed at 120,

Please cite this article in press as: Lee, S.E.K., et al., Do isometric, isotonic and/or isokinetic strength trainings produce different strength
outcomes?, Journal of Bodywork & Movement Therapies (2017), http://dx.doi.org/10.1016/j.jbmt.2017.08.001
S.E.K. Lee et al. / Journal of Bodywork & Movement Therapies xxx (2017) 1e8 5

Table 2
Maximal torque measured during isometric knee extension performed at 90 ,70 ,50 , and 30 (0 ¼ leg in horizontal position) before (PRE) and after (POST) the training period
of the isometric (IM), isotonic (IT) and isokinetic (IK) groups.

Maximal voluntary isometric torque (MVIT)

Joint angle 30 50 70 90

ISOMETRIC
PRE (Nm) 122.6 ± 18.1 178.7 ± 29.3 232 ± 29 230.4 ± 35.1
POST (Nm) 159.8 ± 23*** 228.8 ± 36.5*** 294 ± 50.9*** 307.7 ± 56.9***
POST/PRE-1 (%) 31 ± 14.7 29 ± 15.5 26.6 ± 12.5 34.2 ± 20.5
ISOTONIC
PRE(Nm) 123.1 ± 23.8 178.4 ± 31.2 228.8 ± 32.3 248.3 ± 35.9
POST (Nm) 139.5 ± 20.9** 200.7 ± 34.51* 262.8 ± 51.6*** 297.3 ± 44.9***
POST/PRE-1 (%) 14.9 ± 15.4 13.4 ± 15.95 14.5 ± 13.4 20 ± 10.3
ISOKINETIC
PRE(Nm) 122.3 ± 29.6 187.5 ± 28.4 230.5 ± 20 239.2 ± 37.5
POST (Nm) 144.8 ± 33.3*** 208.3 ± 29.6* 269 ± 33.4*** 277.1 ± 32.3**
POST/PRE-1 (%) 20.9 ± 21.4 12.2 ± 15.6 16.5 ± 7.4 17.3 ± 15.9

* Statistical analysis indicates a main effect of time p < 0.05; ** Statistical analysis indicates a main effect of time p < 0.01; *** Statistical analysis indicates a main effect of time
p < 0.0001. Data are presented as mean ± SD.

Fig. 2. Box plots of relative torque changes (mean ± SD) of dominant lower limb pooled for all angles after 8 weeks of training for the isometric (IM), isotonic (IT) and isokinetic (IK)
group. (***p < 0.0001, Statistical significant difference between the isometric and isotonic/isokinetic group) (extreme value ( ), median (), 25% and 75%- percentile (box)).

Table 3 sets and repetitions for the training programs (Kovaleski et al.,
Isotonic torque measured during the 1RM test, before (PRE) and after (POST) the 1995; Wojtys et al., 1996), while others did not even equalized
training period, of isometric (IM), isotonic (IT) and isokinetic (IK) groups.
training load, let alone adjusted load progression (Folland et al.,
Torque 1RM (Nm) 2005; Malas et al., 2013). Remaud et al. (2010) tried to match the
Groups IM IT IK different trainings for total external work and mean angular speed;
however, by doing it, the training intensity became rather small to
PRE 146.4 ± 21.1 147.0 ± 14.2 151 ± 20.2
POST 173.6 ± 24.2***x 200.5 ± 22.2***x 177 ± 22.6*** elicit strength gains.
POST/PRE-1 (%) 19 ± 8.1 36.3 ± 5.6 17.9 ± 13.4 These different levels of demand placed on the trained muscle
*** Statistical analysis indicates a main effect of time (p < 0.0001); xStatistical
might be the reason for such contradictions. It is clear that load
analysis indicates a group  time interaction (p < 0.05). Data are presented as should be at least similar among groups if one wants to test the
mean ± SD. isolated effect of muscle action on training (Folland et al., 2005). In
the current study we used a methodological approach based on
relative torque and volume to equalize the loads of the three
150, 180 and 210 /s. One possible reason for these inconsistencies different training programs.
may be related to different methods employed. Some of these The increase in the isometric peak torque at 70 was similar
studies standardized the training load by using similar numbers of among our three groups (26.6%, 14.5% and 16.5%, for IM, IT, and IK

Please cite this article in press as: Lee, S.E.K., et al., Do isometric, isotonic and/or isokinetic strength trainings produce different strength
outcomes?, Journal of Bodywork & Movement Therapies (2017), http://dx.doi.org/10.1016/j.jbmt.2017.08.001
6 S.E.K. Lee et al. / Journal of Bodywork & Movement Therapies xxx (2017) 1e8

Table 4 in dynamic task performance. This may be explained by task


Isokinetic knee extension peak torque performed at distinct angular speeds before specificity, such as static versus dynamic exercise (Jones et al., 1989).
(PRE) and after (POST) isometric (IM), isotonic (IT) and isokinetic (IK) training
period.
Isotonic tests indicate that all 3 groups increased their 1RM
strength. However, there was only a significant difference between
Isokinetic Peak Torque (Nm) the isotonic (higher values) and the isometric (lower values)
Angular speed 45 /s 90 /s 180 /s training programs (p < 0.05). The standardization of the training
ISOMETRIC protocol may have minimized the expression of any specific
PRE 201.3 ± 26.8 179.5 ± 25.3 141.3 ± 18.9 training when 1RM strength was assessed. The isotonic group
POST 230.2 ± 43.8** 199.6 ± 34.2** 157.1 ± 26.4** presented the largest gain in lean muscle mass (3.9%). Colyer et al.
POST/PRE-1 (%) 14.2 ± 12.6 11.5 ± 13.4 11.2 ± 11.6
(2016) performed a study to verify the reliability of DXA; the au-
ISOTONIC
PRE 210.5 ± 33.8 180.2 ± 39 136.2 ± 22.3 thors reported a typical error of 1.3% when lower limbs were
POST 265.5 ± 41.6*** 223.4 ± 31.9*** 162.8 ± 23.7*** assessed. Considering our conservative approach of doubling the
POST/PRE-1 (%) 26.5 ± 11.0 24.6 ± 8.8 21.1 ± 16.0 typical error of measurement, we can classify the lean mass
ISOKINETIC changes observed in this study as “true” body composition changes.
PRE 194.6 ± 45.2 169.2 ± 39 136.9 ± 32.3
The absence any gain in triple-hop distance in the isotonic group
POST 243.0 ± 30.7*** 219.2 ± 32.5*** 165.3 ± 30.1***
POST/PRE-1 (%) 28.6 ± 23.4 32.2 ± 18.0 22.3 ± 13.4 was somehow unexpected. The gain in 1RM did not contribute to
hopping performance. Cordova et al. (1995) also showed that iso-
**Statistical analysis indicates a main effect of time p < 0.01; ***Statistical analysis
indicates a main effect of time p < 0.0001. Data are presented as mean ± SD. kinetic and isotonic strength trainings induced gains in muscle
strength but not in jump performance. In our study, the partici-
pants were instructed to perform the contraction, controlling
groups, respectively). Even though the isometric group (26.6%) cadence (concentric phase completed in 1 s), thus discarding speed
reached the largest for increase, it was not statistically different as a confounding factor. In that case, type IIb fibers and power
from the other two groups. Our results corroborate those from component of the muscles may not have been greatly recruited,
Remaud et al. (2010) that described the lack of angle-specificity what could also partially explain the lack of correlation between
when quadriceps EMG was assessed after training. Nevertheless, gains in strength and triple-hop distance.
when all angles were pooled together, the isometric training All training groups increased peak torque at all speeds tested.
(þ30.2%) was more effective than both, isotonic (þ15.8%) and iso- The more pronounced gains in torque are normally found when
kinetic (þ16.8%) trainings. tested at a speed similar to the trained (Aagaard et al., 1996). Un-
Muscle strength is a sum effect of an early neuromuscular fortunately neither training specificity (muscle action) or speed
adaptation and a later developing muscle fiber growth, which is effects were observed in the current study. A recent study (Murray
evidenced by changes in the muscular cross sectional area (CSA) et al., 2007) also failed to show any speed-specific gain after slow
(Coburn et al., 2006). Despite the 3.1% gain in lean muscle mass due (60 /s) and high (400 /s) speeds. Surprisingly the isokinetic group
to isometric training, this gain was too small to add any extra was the only one that induced no changes in muscle mass.
functional gain. Kanehisa et al. (2002) found only a marginal hy- Apparently training speed plays an important role on muscle
pertrophy induced by isometric training without any improvement hypertrophy when it comes to isokinetic training. Farthing and

Fig. 3. Box plots of relative isocinetic peak torque changes (mean ± SD) of the dominant lower limb pooled for all angular speeds after 8 weeks of isometric (IM), isotonic (IT), and
isokinetic (IK) training (***: p < 0.0001, Statistical significant difference between the isokinetic and isometric groups) (extreme value ( ), median (), 25% and 75%- percentile (box)).

Please cite this article in press as: Lee, S.E.K., et al., Do isometric, isotonic and/or isokinetic strength trainings produce different strength
outcomes?, Journal of Bodywork & Movement Therapies (2017), http://dx.doi.org/10.1016/j.jbmt.2017.08.001
S.E.K. Lee et al. / Journal of Bodywork & Movement Therapies xxx (2017) 1e8 7

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training at two speeds, i.e. fast 180 /s and slow 30 /s. They found
mance tests. J. Orthop. Sports Phys. Ther. 26, 138e142.
that high-speed-eccentric training and the low-concentric training Chen, C.L., Chang, K.J., Wu, P.Y., Chi, C.H., Chang, S.T., Cheng, Y.Y., 2015. Comparison
were the most effective to induce muscle gain. Indeed, Malas et al. of the effects between isokinetic and isotonic strength training in subacute
(2013) showed an increase in muscle mass with isokinetic training stroke patients. J. Stroke Cerebrovasc. Dis. 24, 1317e1323. http://dx.doi.org/10.
1016/j.jstrokecerebrovasdis.2015.02.002.
when speeds were set at 60 /s, what was much lower than the Coburn, J.W., Housh, T.J., Malek, M.H., Weir, J.P., Cramer, J.T., Beck, T.W.,
speed (90 /s) used in your study. Johnson, G.O., 2006. Neuromuscular responses to three days of velocity-specific
Interestingly only isokinetic training was able to improve the isokinetic training. J. Strength Cond. Res. 20, 892e898.
Colyer, S.L., Roberts, S.P., Robinson, J.B., Thompson, D., Stokes, K.A., Bilzon, J.L.,
triple-hop-distance. It is possible that the speed set at training may Salo, A.I., 2016. Detecting meaningful body composition changes in athletes
be closer to the joint speed performed during the hop test, making using dual-energy x-ray absorptiometry. Physiol. Meas. 37, 596e609. http://dx.
the training more specific and therefore enables a more efficient doi.org/10.1088/0967-3334/37/4/596.
Cordova, M.L., Ingersoll, C.D., Kovaleski, J.E., Knight, K.L., 1995. A comparison of
jumping task. isokinetic and isotonic predictions of a functional task. J. Athl. Train. 30,
There is controversy on whether isokinetic or isotonic training 319e322.
produce more functional gains in strength (Wilson and Murphy, Coudeyre, E., Jegu, A.G., Giustanini, M., Marrel, J.P., Edouard, P., Pereira, B., 2016.
Isokinetic muscle strengthening for knee osteoarthritis: a systematic review of
1995). Studies (Helling, 1980; Smith and Melton, 1981) compared randomized controlled trials with meta-analysis. Ann. Phys. Rehabil. Med. 59,
isokinetic training to isotonic training effects on vertical jump 207e215. http://dx.doi.org/10.1016/j.rehab.2016.01.013.
performance. Helling (1980) reported an 18.2% increase in vertical Dauty, M., Menu, P., Fouasson-Chailloux, A., Dubois, C., 2014. Muscular isokinetic
strength recovery after knee anterior cruciate ligament reconstruction revision:
jump height following isokinetic training, and only an 11.7%
preliminary study. Ann. Phys. Rehabil. Med. 57, 55e65. http://dx.doi.org/10.
following isotonic training. In another study, two-legged vertical 1016/j.rehab.2013.10.005.
jump height increased by 5.4% following high speed isokinetic and Del Balso, C., Cafarelli, E., 2007. Adaptations in the activation of human skeletal
3.9% following low isokinetic speed training while their isotonic muscle induced by short-term isometric resistance training. J. Appl. Physiol.
103, 402e411.
group experienced only a marginal increase (1.6%) (Smith and Farthing, J.P., Chilibeck, P.D., 2003. The effects of eccentric and concentric training at
Melton, 1981). Training at high speeds apparently stimulates type different velocities on muscle hypertrophy. Eur. J. Appl. Physiol. 89, 578e586.
II muscle fibers and increases muscle ability to generate power Folland, J.P., Hawker, K., Leach, B., Little, T., Jones, D.A., 2005. Strength training:
isometric training at a range of joint angles versus dynamic training. J. Sports
(Kovaleski et al., 1992). Specificity of speed in training is important Sci. 23, 817e824.
during ballistic contractions when activation of high threshold Folland, J.P., Irish, C.S., Roberts, J.C., Tarr, J.E., Jones, D.A., 2002. Fatigue is not a
motor units may occur preferably (Sale, 1988). In our study, the necessary stimulus for strength gains during resistance training. Br. J. Sports
Med. 36, 370e373.
training was set at 90 /s, which may explain the small improve- Hamilton, R.T., Shultz, S.J., Schmitz, R.J., Perrin, D.H., 2008. Triple-hop distance as a
ment in triple-hop-distance. Previously Hamilton et al. (2008) valid predictor of lower limb strength and power. J. Athl. Train. 43, 144e151.
showed that the triple-hop-distance test was a strong predictor Helling, T., 1980. Effects of Isotonic Training, Isokinetic Training and Jumping.
Practice on the Vertical Jump Performance of College Age Women. Thesis. South
of vertical jump height. Dakota State University, Brookings.
Our limitation was the absence randomization. We had a main Jones, D.A., Rutherford, O.M., Parker, D.F., 1989. Physiological changes in skeletal
reasons to choose to assign each athlete to a specific group. We muscle as a result of strength training. Q. J. Exp. Physiol. 74, 233e256.
Jørgensen, P.,B., Bogh, S.B., Kierkegaard, S., Sørensen, H., Odgaard, A., Søballe, K.,
wanted to balance the muscle strength of different participants,
Mechlenburg, I., 2017. The efficacy of early initiated, supervised, progressive
because if the baseline strength values were different, the response resistance training compared to unsupervised, home-based exercise after uni-
to the training could be affected. Moreover, the whole protocol was compartmental knee arthroplasty: a single-blinded randomized controlled
relatively long (10 weeks) and it was predictable that some vol- trial. Clin. Rehabil. 31, 61e70. http://dx.doi.org/10.1177/0269215516640035.
Kakinuma, S., Nogaki, H., Pramanik, B., Morimatsu, M., 1998. Muscle weakness in
unteers would withdraw, and choosing to assign each athlete to a Parkinson's disease: isokinetic study of the lower limbs. Eur. Neurol. 39,
group, we ensure the same volunteers number in each group. 218e222.
In summary, our study showed that isometric and concentric Kanehisa, H., Nagareda, H., Kawakami, Y., Akima, H., Masani, K., Kouzaki, M.,
Fukunaga, T., 2002. Effects of equivolume isometric training programs
isotonic trainings are similarly effective at increasing muscle torque comprising medium or high resistance on muscle size and strength. Eur. J. Appl.
and mass. Isometric training was the most specific among them, Physiol. 87, 112e119.
and isokinetic may be a good exercise to improve explosive Kovaleski, J.E., Heitman, R.H., Trundle, T.L., Gilley, W.F., 1995. Isotonic preload versus
isokinetic knee extension resistance training. Med. Sci. Sports Exerc 27,
strength. Based on the current data, isometric training should be 895e899.
considered as an alternative strength training since it elicits the Kovaleski, J.E., Heitman, R.J., Scaffidi, F.M., Fondren, F.B., 1992. Effects of isokinetic
most pronounced and fastest increase in muscle torque and also velocity spectrum exercise on average power and total work. J. Athl. Train. 27,
54e56.
showed to be effective at augmenting muscle mass. Further Malas, F.Ü., Ozçakar, L., Kaymak, B., Ulaşlı, A., Güner, S., Kara, M., Akıncı, A., 2013.
research is recommended to investigate the neuromuscular Effects of different strength training on muscle architecture: clinical and ul-
mechanism underlying the strength and hopping performance trasonographic evaluation in knee osteoarthritis. PM R. 5, 655e662. http://dx.
doi.org/10.1016/j.pmrj.2013.03.005.
gains, as well as extend these results to female subjects or to males
Mascarin, N.C., Vancini, R.L., Lira, C.A., Andrade, M.S., 2015. Stretch-induced re-
from different ages or physical training levels. ductions in throwing performance are attenuated by warm-up before exercise.
J. Strength Cond. Res. 29, 1393e1398. http://dx.doi.org/10.1519/JSC.
0000000000000752.
Acknowledgements Murray, D.P., Brown, L.E., Zinder, S.M., Noffal, G.J., Bera, S.G., Garrett, N.M., 2007.
Effects of velocity-specific training on rate of velocity development, peak tor-
We thank all the participants who volunteered to be part of this que, and performance. J. Strength Cond. Res. 21, 870e874.
Okoro, T., Whitaker, R., Gardner, A., Maddison, P., Andrew, J.G., Lemmey, A., 2016.
study, and the directors of the Centro Olímpico de Treinamento e Does an early home-based progressive resistance training program improve
~o Paulo, Brazil).
Pesquisa (Sa function following total hip replacement? Results of a randomized controlled
study. BMC Musculoskelet. Disord. 17 (173). http://dx.doi.org/10.1186/s12891-
016-1023-x.
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Please cite this article in press as: Lee, S.E.K., et al., Do isometric, isotonic and/or isokinetic strength trainings produce different strength
outcomes?, Journal of Bodywork & Movement Therapies (2017), http://dx.doi.org/10.1016/j.jbmt.2017.08.001
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Please cite this article in press as: Lee, S.E.K., et al., Do isometric, isotonic and/or isokinetic strength trainings produce different strength
outcomes?, Journal of Bodywork & Movement Therapies (2017), http://dx.doi.org/10.1016/j.jbmt.2017.08.001