SLR - August 2023 - Jini Philip, DPM
Title: Acute Effects of Complex Conditioning Activities on Athletic Performance and Achilles Tendon Stiffness in Male Basketball PlayersReference: Papla M, Ewertowska P, Krzysztofik M. Acute Effects of Complex Conditioning Activities on Athletic Performance and Achilles Tendon Stiffness in Male Basketball Players. J Sports Sci Med. 2023 Jun 1;22(2):281-287.
Level of Evidence: Level 1
Scientific Literature Review
Reviewed By: Jini Philip, DPM
Residency Program:  Hoboken University Medical Center – Hoboken, NJ
Podiatric Relevance: This study compared a bilateral conditioning activity (back squats and drop jumps) with a unilateral one (split squats and depth jumps to lateral hop) over sequentially performed countermovement jump (CMJ), modified t-agility test (MAT), and Achilles tendon stiffness. The authors hypothesized that bilateral conditioning activities would improve CMJ but not MAT, while unilateral ones would improve MAT but not CMJ. They hypothesized that the CAs would have no effect on Achilles tendon stiffness. A podiatric surgeon would find the information in this article useful when treating Achilles tendon pathology in patients, particularly athletes. Knowing which conditioning activities will provide the best results can aid physicians in specifying what their patients’ physical therapy treatments and at home exercises should entail.
Methods: The study analyzed twenty-six basketball players that were randomly assigned to B-CA (bilateral conditioning activity) or U-CA (unilateral conditioning activity) groups. Tests were performed: baseline Achilles tendon stiffness, CMJ performance and MAT time, CA, and post-CA re-test. The B - CA group completed 2 sets of 4 repetitions of back squats at 80% of one-repetition maximum (1RM), then 10 drop jumps. The U - CA group performed 2 sets of 2 repetitions of split squats on each leg at 80% 1RM, followed by 5 depth jumps to lateral hop on each leg as CA complexes. Five minutes before the CA the baseline Achilles tendon stiffness, CMJ, and MAT time measurement were performed. In the sixth minutes after the CA, all tests were re-tested. The measurement of Achilles tendon stiffness was done by the MyotonPro, hand held myometer and was performed 2cm proximal to the superior aspect of the calcaneus. The Shapiro–Wilk, Levene, Mauchly’s tests, and two-way repeated measures mixed ANOVAs were used in this study.
Results: The two-way repeated measures mixed ANOVAs showed that the B - CA and U – CA groups did not demonstrate significant improvements in CMJ and MAT performance. Instead, a significant increase in Achilles stiffness was seen with both protocols.
Conclusions: From their results, the authors concluded that combinations of exercises may lead to excessive fatigue and no post-activation performance enhancement (PAPE) effect. The results of this study further supports the idea that there needs to be a balance between fatigue and potentiation in order for performance improvement to be noted. If the authors had included longer or more frequent rest intervals in their conditioning protocol, there may have been better effects to the patients’ PAPE response. The authors also touched on the effect of gender in recovery time after conditioning activities, and how males require a longer recovery time. Achilles tendon stiffness, especially post operatively is a common complaint and there is much value in research regarding rehabilitation treatments that will best achieve a better long-term outcome. However, since the conclusion of the article was that their conditioning protocols did not yield better results, there is minimal information to take away from the article.