{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T03:07:56Z","timestamp":1787627276818,"version":"build-2736575974"},"reference-count":70,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Physical activity and exercise are effective approaches in prevention and therapy of multiple diseases. Although the specific characteristics of lengthening contractions have the potential to be beneficial in many clinical conditions, eccentric training is not commonly used in clinical populations with metabolic, orthopaedic, or neurologic conditions. The purpose of this pilot study is to investigate the feasibility, functional benefits, and systemic responses of an eccentric exercise program focused on the trunk and lower extremities in people with low back pain (LBP) and multiple sclerosis (MS). A six-week eccentric training program with three weekly sessions is performed by people with LBP and MS. The program consists of ten exercises addressing strength of the trunk and lower extremities. The study follows a four-group design (N = 12 per group) in two study centers (Israel and Germany): three groups perform the eccentric training program: A) control group (healthy, asymptomatic); B) people with LBP; C) people with MS; group D (people with MS) receives standard care physiotherapy. Baseline measurements are conducted before first training, post-measurement takes place after the last session both comprise blood sampling, self-reported questionnaires, mobility, balance, and strength testing. The feasibility of the eccentric training program will be evaluated using quantitative and qualitative measures related to the study process, compliance and adherence, safety, and overall program assessment. For preliminary assessment of potential intervention effects, surrogate parameters related to mobility, postural control, muscle strength and systemic effects are assessed. The presented study will add knowledge regarding safety, feasibility, and initial effects of eccentric training in people with orthopaedic and neurological conditions. The simple exercises, that are easily modifiable in complexity and intensity, are likely beneficial to other populations. Thus, multiple applications and implementation pathways for the herein presented training program are conceivable.<\/jats:p>\n<jats:p><jats:bold>Trial registration:<\/jats:bold> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.drks.de\/DRKS00020483\" xlink:type=\"simple\">DRKS00020483<\/jats:ext-link> (DRKS, German Clinical Trials Register; 24<jats:sup>th<\/jats:sup> January 2020 \u2013retrospectively registered; <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.drks.de\/DRKS00020483\" xlink:type=\"simple\">https:\/\/www.drks.de\/DRKS00020483<\/jats:ext-link>).<\/jats:p>","DOI":"10.1371\/journal.pone.0270875","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T18:51:14Z","timestamp":1671735074000},"page":"e0270875","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Application of eccentric training in various clinical populations: Protocol for a multi-centered pilot and feasibility study in people with low back pain and people with multiple sclerosis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5562-5989","authenticated-orcid":true,"given":"Monique","family":"Wochatz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Schraplau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6988-5626","authenticated-orcid":true,"given":"Tilman","family":"Engel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahli M.","family":"Zecher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadar","family":"Sharon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin","family":"Alt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Mayer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alon","family":"Kalron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"key":"pone.0270875.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/sms.12581","article-title":"Exercise as medicine\u2014Evidence for prescribing exercise as therapy in 26 different chronic diseases.","volume":"25","author":"BK Pedersen","year":"2015","journal-title":"Scand J Med Sci Sport"},{"key":"pone.0270875.ref002","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1111\/obr.12690","article-title":"A cumulative meta-analysis of the effects of individual physical activity interventions targeting healthy adults.","volume":"19","author":"R Love","year":"2018","journal-title":"Obes Rev"},{"key":"pone.0270875.ref003","author":"World Health Organization","year":"2015","journal-title":"Global recommendations on physical activity for health"},{"key":"pone.0270875.ref004","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.ijcard.2016.11.023","article-title":"The effects of resistance training on muscle strength, quality of life and aerobic capacity in patients with chronic heart failure\u2014A meta-analysis","volume":"227","author":"C Giuliano","year":"2017","journal-title":"Int J Cardiol"},{"key":"pone.0270875.ref005","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1177\/0269215520932964","article-title":"Resistance training in stroke rehabilitation: systematic review and meta-analysis","volume":"34","author":"J Veldema","year":"2020","journal-title":"Clin Rehabil"},{"key":"pone.0270875.ref006","first-page":"244","article-title":"Progressive resistance strength training for improving physical function in older adults.","volume":"6","author":"C Liu","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0270875.ref007","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s11764-016-0592-x","article-title":"Evaluation of resistance training to improve muscular strength and body composition in cancer patients undergoing neoadjuvant and adjuvant therapy: a meta-analysis","volume":"11","author":"CS Padilha","year":"2017","journal-title":"J Cancer Surviv"},{"key":"pone.0270875.ref008","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1177\/1534735418807555","article-title":"Effects of Aerobic and Resistance Exercises on Physical Symptoms in Cancer Patients","volume":"17","author":"J Nakano","year":"2018","journal-title":"A Meta-analysis. 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