問題背景：在做完一回合30次的高強度離心運動後的第1-6天時，繼續讓損傷的骨骼肌進行相同一回合離心訓練時，並不會進一步加重肌肉的損傷；但是，在第2-7回合訓練時，所完成的總作功僅為第一回合的57-76%而已，此效應稱為重複訓練效應 (repeated bout effect，RBE)。然而這些研究當時讓損傷肌肉進行重複離心訓練時的負荷可能不足，而未能促使肌肉產生進一步的傷害。但是，肌肉因做運動而引起很明顯的損傷、酸痛時，應該繼續給予多少傷害或酸痛前的強度來做訓練，才不會對肌肉造成進一步的傷害或產生酸痛呢? 研究目的：探討受試者進行一回合30次高強度離心運動之後的第三天時，繼續讓損傷肌肉進行一回合30次不同高強度 (運動前80%、90%、100% MVC的強度)的離心收縮訓練，對肌肉損傷的影響，以找出重複訓練效應強度的上限。方法：以51名大學健康男、女性學生做為受試對象，受試者在正式實驗之前先進行3個不同天次的前測，然後再以肌力值做為配對隨機分派的依據，將受試者分成E100組 (100%，n=12)、E90組 (90%，n=13)、E80組 (80%，n=14) 和控制組 (CON，n=12)。在實驗的第一天，受試者以自己在前測的最大 (100%強度) 等長肌力值，做為其進行第一回合30次最大離心收縮運動 (ECC1)，使非慣手的肱二頭肌產生肌肉損傷。另外，E80、E90、E100組的受試者在ECC1後的第3天時，各重複進行一回合30次不同強度 (80%、90% 或100%強度) 的離心收縮訓練 (ECC2)。受試者在ECC1和ECC2之前、後以及在ECC1之後的第1-9天，分別接受：上臂圍 (CIR)、關節活動範圍 (ROM)、最大等長肌力 (MVC)、血液肌酸激酶 (CK)和乳酸脫氫酶 (LDH)的測量。肌肉酸痛的測驗時間，則在ECC1之前以及ECC1之後的第1-9天。超音波影像分析的時間點，安排在ECC1之前、ECC1之後的第2、4、9天。結果：發現不同四組在做完ECC1之後，其肌肉損傷的評估指標 (MVC、ROM、CIR、酸痛、CK、LDH和超音波影像)均在時間上產生顯著的改變 (p<0.05)；E80~E100組在ECC1後的第3天時，重複進行一回合不同強度 (80%~100%強度)的離心訓練時，使用間接評估指標看不出會對肌肉造成更進一步的傷害或阻礙其恢復的速度 (p > 0.05)。但是，E100組在ECC2之後，超音波影像顯示肌肉組織受損的面積卻顯著比E80、E90和控制組來得大 (p<0.05)。結論：1.當僅使用肌肉損傷的間接評估指標 (例如MVC、ROM、CIR、CK、LDH)來做為離心收縮訓練效果的評估時，在第1回合的離心訓練之後，繼續讓已經受到損傷和酸痛的肌肉重複一回合80%~100%強度的離心訓練時，看不出有加重或延緩肌肉損傷的修復情形。2.但使用超音波影像來做為肌肉組織傷害的評估時，讓已受到明顯損傷和酸痛的肌肉，繼續進行一回合100%強度的離心收縮訓練時，其超音波影像中的肌肉組織之橫、縱斷面受到損傷的面積均顯著比E80組、E90組和控制組來得明顯 (p<0.05)。這意指著肌肉的「重複訓練效應」上限，可能在90%強度左右。3.本研究建議，未來運動教練在選手發生肌肉損傷、酸痛還未完全恢復之前，應該使用90%以下的強度來做訓練，才不會對損傷、酸痛的肌肉造成進一步的傷害。
關鍵詞：離心收縮訓練、重複訓練效應、超音波影像、肌肉損傷

BACKGROUND: Previous studies have shown that repeating the same bouts of 30 maximal voluntary eccentric contractions at 1 to 6 days or 3 and 6 days after the first maximal eccentric exercise (ECC1) did not cause further muscle damage. This is referred to as the “repeated bout effect”. However, the amount of total work done during each of the subsequent bouts could only reach about 57%-76% of that done during the ECC1. It may be possible that the repeated bout of 30 maximal eccentric contractions was not stressful enough to produce further damage. What if one were to do the subsequent bout of intensive eccentric exercise, at what intensity would this second bout produce no further muscle damage or retard the recovery process? PURPOSE: This study examined the effects of the repeated bout effect after second bout of intensive eccentric exercise (80%, 90%, and 100% of the pre-ECC1 MVC level) on the indicators of muscle damage. METHODS: Fifty-one college-age males and females were randomly assigned into 100% maximal isometric voluntary contraction strength (MVC)(E100; n =12), 90% MVC (E90; n =13), 80% MVC (E80; n =14), and control (CON; n = 12) groups. The initial exercise was 30 maximal eccentric contraction (ECC1) on non-dominant elbow flexors using a dumbbell that was set at 100% of the pre-ECC1 MVC level. Three days after ECC1, the E80, E90, and E100 groups repeated this same exercise of 30 repetitions, but using a dumbbell that was set at 80%, 90%, and 100%, respectively, of the pre-ECC1 MVC level. This second bout was hereafter referred to as ECC2. Upper arm circumference (CIR), range of motion (ROM), MVC, serum creatine kinase (CK) and lactate dehydrogenase (LDH) activities were measured before, immediately after, and every 24 hours or 9 consecutive days after ECC1. In the E80, E90, and E100 groups, CIR, ROM, MVC, CK, and LDH were also tested immediately after ECC2. Muscle soreness was assessed before and for 9 consecutive days after ECC1. Ultrasound imagines were taken from the upper arm immediately before ECC1, and at 2, 4, and 9 days after ECC1 for all groups. RESULTS: There were significant changes (p < 0.05) in all criterion measures following ECC1 for all groups. Moreover, the E80 to E100 subjects who repeated the second bout of eccentric contraction training at varying intensities 3 days after ECC1, no further muscle damage was observed when the indirect indicators of muscle damage were used. However, the ultrasound imagine showed a significant increased (p < 0.05) in muscle damaged area after ECC2 for the E100 group when compared to the E80, E90, and CON groups. CONCLUSION: 1.When the indirect indicators of muscle damage (e.g. MVC, ROM, CIR, soreness, CK, LDH) were used for the evaluation of eccentric-training effect after repeating a second bout of eccentric exercise on the damaged muscle, at the intensity of 80~100% pre-ECC1 MVC level, no signs of deterioration or retardation in the recovery process were observed. 2.However, when ultrasound images were used for the evaluation of eccentric-training at 100% of pre-ECC1 MVC level, the damage was much more evident. This suggest that the upper limit of repeated bout effect is approximately at 90% of pre-ECC1 MVC. 3.The results of this study may provide new information and serve as a practical reference to strength training for coaches, athletes and the general public during muscle damage and muscle soreness.
KEY WORDS: eccentric contraction training, repeated bout effect, ultrasound imagines,
muscle damage.

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