Author(s): MAGRIS, R.1, TRINCHI, M.1, NARDELLO, F.1, MONTE, A.1, NEGRI, C.2, VIGOLO, N.1, MOGHETTI, P.1, ZAMPARO, P.1 , Institution: UNIVERSITY OF VERONA, Country: ITALY, Abstract-ID: 454

INTRODUCTION:
Type 2 diabetes is a chronic, degenerative, metabolic disorder characterized by an increased accumulation of advanced glycation end products (AGEs) that can impair muscle and tendon function by increasing their stiffness (1). An increased Achilles tendon (AT) stiffness in this population was associated to an increase in the energy cost (C) of walking (2); thus, a reduction in AT stiffness could be expected to lead to a decrease in C. Recently, Ikeda and colleagues (3) proposed a stretching modality (minute oscillation stretching, MOS) effective in reducing AT stiffness without impairing contractile capacity. The aim of this study was to investigate the effect of MOS training on AT and muscle stiffness (gastrocnemius medialis) and on the energetics of walking in type 2 diabetic patients.
METHODS:
Type 2 diabetes is a chronic, degenerative, metabolic disorder characterized by an increased accumulation of advanced glycation end products (AGEs) that can impair muscle and tendon function by increasing their stiffness (1). An increased Achilles tendon (AT) stiffness in this population was associated to an increase in the energy cost (C) of walking (2); thus, a reduction in AT stiffness could be expected to lead to a decrease in C. Recently, Ikeda and colleagues (3) proposed a stretching modality (minute oscillation stretching, MOS) effective in reducing AT stiffness without impairing contractile capacity. The aim of this study was to investigate the effect of MOS training on AT and muscle stiffness (gastrocnemius medialis) and on the energetics of walking in type 2 diabetic patients.
RESULTS:
No differences were observed in MVT, RTD or MS after training. Differences in TS were observed in the lowest range of torque values (e.g at 10 Nm) (6.9±3.1 and 4.9±2.8 Nm/mm from pre to post, p=0.03). No changes in Vopt were observed (about 4.7 km/h) but Copt significantly decreased after training (2.3±0.4 and 2.1±0.3 J/m kg from pre to post, p=0.01); a decrease in C was also observed at the slowest tested speed (2 km/h: 3.1±0.4 and 2.8±0.5 J/m kg from pre to post, p=0.01). Training-induced changes were also observed in stride length (increased after training, p < 0.05) and stride frequency (decreased after training, p<0.05) at speeds between 2 and 4 km/h.
CONCLUSION:
These results allow for a better understanding of the altered muscle and tendon mechanical properties in diabetic patients and of the effects that these alterations have on muscle contraction and locomotion capability. Our study suggests the effectiveness of a new stretching protocol in decreasing tendon stiffness without affecting muscle stiffness and, more importantly, in decreasing whole bodys energy consumption during walking. These data can help in improving our understanding on how diabetes may affect physical capacity, leading to inactivity.
REFERENCES:
1) Couppé et al, J Appl Physiol, 2016
2) Petrovic et al, J Appl Physiol, 2015
3) Ikeda et al, Scand J Med Sci Sport, 2020