The main aim of this review is to discuss some evidence-based physiological and methodological considerations for optimal use of neuromuscular electrical stimulation (NMES) in healthy and impaired skeletal muscles. After a quick overview of the main applications, interests and limits of NMES use, the first section concentrates on two crucial aspects of NMES physiology: the differences in motor unit recruitment pattern between NMES and voluntary contractions, and the involvement of the nervous system during peripheral NMES. The second section of the article focuses on the most common NMES parameters, which entail the characteristics of both the electrical current (the input) and the evoked contraction (the output).

Physiological and methodological considerations for the use of neuromuscular electrical stimulation

Plyometric training (PLY) is a very popular form of physical conditioning of healthy individuals that has been extensively studied over the last 3 decades. In this article, we critically review the available literature related to lower-body PLY and its effects on human neural and musculoskeletal systems, athletic performance and injury prevention. We also considered studies that combined lower-body PLY with other popular training modalities, as well as studies that applied PLY on non-rigid surfaces. The available evidence suggests that PLY, either alone or in combination with other typical training modalities, elicits numerous positive changes in the neural and musculoskeletal systems, muscle function and athletic performance of healthy individuals. Specifically, the studies have shown that long-term PLY (i.e. 3–5 sessions a week for 5–12 months) represents an effective training method for enhancing bone mass in prepubertal/early pubertal children, young women and premenopausal women. Furthermore, short-term PLY (i.e. 2–3 sessions a week for 6–15 weeks) can change the stiffness of various elastic components of the muscle-tendon complex of plantar flexors in both athletes and non-athletes. Short-term PLY also improves the lower-extremity strength, power and stretch-shortening cycle (SSC) muscle function in healthy individuals. These adaptive changes in neuromuscular function are likely the result of (i) an increased neural drive to the agonist muscles; (ii) changes in the muscle activation strategies (i.e. improved intermuscular coordination); (iii) changes in the mechanical characteristics of the muscle-tendon complex of plantar flexors; (iv) changes in muscle size and/or architecture; and (v) changes in single-fibre mechanics. Our results also show that PLY, either alone or in combination with other training modalities, has the potential to (i) enhance a wide range of athletic performance (i.e. jumping, sprinting, agility and endurance performance) in children and young adults of both sexes; and (ii) to reduce the risk of lower-extremity injuries in female athletes. Finally, available evidence suggests that short-term PLY on non-rigid surfaces (i.e. aquatic- or sand-based PLY) could elicit similar increases in jumping and sprinting performance as traditional PLY, but with substantially less muscle soreness. Although many issues related to PLY remain to be resolved, the results of this review allow us to recommend the use of PLY as a safe and effective training modality for improving lower-extremity muscle function and functional performance of healthy individuals. For performance enhancement and injury prevention in competitive sports, we recommend an implementation of PLY into a well designed, sport-specific physical conditioning programme.

Neuro-musculoskeletal and performance adaptations to lower-extremity plyometric training.

Vertical jump is one of the most prevalent acts performed in several sport activities. It is therefore important to ensure that the measurements of vertical jump height made as a part of research or athlete support work have adequate validity and reliability. The aim of this study was to evaluate concurrent validity and reliability of the Optojump photocell system (Microgate, Bolzano, Italy) with force plate measurements for estimating vertical jump height. Twenty subjects were asked to perform maximal squat jumps and countermovement jumps, and flight time-derived jump heights obtained by the force plate were compared with those provided by Optojump, to examine its concurrent (criterion-related) validity (study 1). Twenty other subjects completed the same jump series on 2 different occasions (separated by 1 week), and jump heights of session 1 were compared with session 2, to investigate test-retest reliability of the Optojump system (study 2). Intraclass correlation coefficients (ICCs) for validity were very high (0.997-0.998), even if a systematic difference was consistently observed between force plate and Optojump (-1.06 cm; p < 0.001). Test-retest reliability of the Optojump system was excellent, with ICCs ranging from 0.982 to 0.989, low coefficients of variation (2.7%), and low random errors (±2.81 cm). The Optojump photocell system demonstrated strong concurrent validity and excellent test-retest reliability for the estimation of vertical jump height. We propose the following equation that allows force plate and Optojump results to be used interchangeably: force plate jump height (cm) = 1.02 × Optojump jump height + 0.29. In conclusion, the use of Optojump photoelectric cells is legitimate for field-based assessments of vertical jump height.

Validity and reliability of Optojump photoelectric cells for estimating vertical jump height.

The aim of this study was to determine the precise effect of plyometric training (PT) on vertical jump height in healthy individuals. Meta-analyses of randomised and non-randomised controlled trials that evaluated the effect of PT on four typical vertical jump height tests were carried out: squat jump (SJ); countermovement jump (CMJ); countermovement jump with the arm swing (CMJA); and drop jump (DJ). Studies were identified by computerised and manual searches of the literature. Data on changes in jump height for the plyometric and control groups were extracted and statistically pooled in a meta-analysis, separately for each type of jump. A total of 26 studies yielding 13 data points for SJ, 19 data points for CMJ, 14 data points for CMJA and 7 data points for DJ met the initial inclusion criteria. The pooled estimate of the effect of PT on vertical jump height was 4.7% (95% CI 1.8 to 7.6%), 8.7% (95% CI 7.0 to 10.4%), 7.5% (95% CI 4.2 to 10.8%) and 4.7% (95% CI 0.8 to 8.6%) for the SJ, CMJ, CMJA and DJ, respectively. When expressed in standardised units (ie, effect sizes), the effect of PT on vertical jump height was 0.44 (95% CI 0.15 to 0.72), 0.88 (95% CI 0.64 to 1.11), 0.74 (95% CI 0.47 to 1.02) and 0.62 (95% CI 0.18 to 1.05) for the SJ, CMJ, CMJA and DJ, respectively. PT provides a statistically significant and practically relevant improvement in vertical jump height with the mean effect ranging from 4.7% (SJ and DJ), over 7.5% (CMJA) to 8.7% (CMJ). These results justify the application of PT for the purpose of development of vertical jump performance in healthy individuals.

https://bjsm.bmj.com/content/bjsports/41/6/349.full.pdf

Does plyometric training improve vertical jump height? A meta‐analytical review

Plyometric training improves vertical jump height (VJH). However, the effectiveness of plyometric training depends on various factors. A meta-analysis of 56 studies with a total of 225 effect sizes (ESs) was carried out to analyze the role of various factors on the effects of plyometrics on VJH performance. The inclusion criteria for the analysis were a) studies using plyometric programs for lower-limb muscles, b) studies employing true experimental designs and valid and reliable measurements, and c) studies including enough data to calculate ESs. Subjects with more experience in sport obtained greater enhancements in VJH performance (p < 0.01). Subjects in either good or bad physical condition benefit equally from plyometric work (p < 0.05), although men tend to obtain better power results than women after plyometric training (p < 0.05). With relation to the variables of performance, training volumes of more than 10 weeks and more than 20 sessions, using high-intensity programs (with more than 50 jumps per session), were the strategies that seemed to maximize the probability of obtaining significantly greater improvements in performance (p < 0.05). To optimize jumping enhancement, the combination of different types of plyometrics (squat jump + countermovement jump + drop jump) is recommended rather than using only 1 form (p < 0.05). However, no extra benefits were found to be gained from doing plyometrics with added weight. The responses identified in this analysis are essential and should be considered by strength and conditioning professionals with regard to the most appropriate dose-response trends for optimizing plyometric-induced gains.

Determining variables of plyometric training for improving vertical jump height performance: a meta-analysis.

MAFFIULETTI, N. A., S. DUGNANI, M. FOLZ, E. DI PIERNO, and F. MAURO. Effect of combined electrostimulation and plyometric training on vertical jump height. Med. Sci. Sports Exerc. Vol. 34, No. 10, pp. 1638–1644, 2002.PurposeThis study investigated the influence of a 4-wk combined electromyostimulati

Ermano Di Pierno

Papers

Effect of combined electrostimulation and plyometric training on vertical jump height.