{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T14:34:00Z","timestamp":1761921240598,"version":"build-2065373602"},"reference-count":61,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T00:00:00Z","timestamp":1715212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Jerzy Kukuczka Academy of Physical Education in Katowice, Poland"},{"name":"Galen-Orthopaedics Jerzego 6, 43-150 Bieru\u0144, Poland"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The aim of the study was to determine the effect of step load in hypoxia on the effectiveness of preoperative rehabilitation (PR) and hormone levels based on a case study. Introduction: We assessed the impact of variables such as rate of movement and time under tension (TUT) in normobaric hypoxia on the levels of growth hormone (GH), insulin-like growth factor 1 (IGF-1), and erythropoietin (EPO). Additionally, the impact of step load on the hypertrophy and strength of knee extensors and flexors was assessed. Methods: The work uses a case study, the research subject of which was a 23-year-old female professional handball player. The tests included an isokinetic assessment of the peak torque of knee extensors and flexors as well as body composition analysis. Results: The results showed a more than (10.81-fold) increase in GH after the microcycle with time under tension (TUT). The deficit between the lower limbs was also reduced. Conclusions: Using a hypoxic environment based on an appropriate altitude, combined with changes such as a short rest break between sets and a controlled tempo of movement with an eccentric phase, TUT may offer an alternative to the PR process, especially among athletes who care about fast RTS.<\/jats:p>","DOI":"10.3390\/jcm13102792","type":"journal-article","created":{"date-parts":[[2024,5,9]],"date-time":"2024-05-09T10:31:16Z","timestamp":1715250676000},"page":"2792","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of Step Load Based on Time under Tension in Hypoxia on the ACL Pre-Operative Rehabilitation and Hormone Levels: A Case Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Joanna","family":"Motowid\u0142o","sequence":"first","affiliation":[{"name":"Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Stronska-Garbien","sequence":"additional","affiliation":[{"name":"Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-9879","authenticated-orcid":false,"given":"Marta","family":"Bichowska-Paw\u0119ska","sequence":"additional","affiliation":[{"name":"Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2209-0839","authenticated-orcid":false,"given":"Maciej","family":"Kostrzewa","sequence":"additional","affiliation":[{"name":"Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4374-4822","authenticated-orcid":false,"given":"Adam","family":"Zaj\u0105c","sequence":"additional","affiliation":[{"name":"Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3027-9984","authenticated-orcid":false,"given":"Krzysztof","family":"Ficek","sequence":"additional","affiliation":[{"name":"Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4477-2390","authenticated-orcid":false,"given":"Mi\u0142osz","family":"Drozd","sequence":"additional","affiliation":[{"name":"Department of Sports Training, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1034\/j.1600-0838.2003.00329.x","article-title":"Relationship between Floor Type and Risk of ACL Injury in Team Handball","volume":"13","author":"Olsen","year":"2003","journal-title":"Scand. 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