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Greater gastrocnemius muscle hypertrophy after partial range of motion

training carried out at long muscle lengths

Article  in  The Journal of Strength and Conditioning Research · November 2022

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1 Greater gastrocnemius muscle hypertrophy after partial range of motion training carried

2 out at long muscle lengths

3 Short title: Range of motion and calf muscle hypertrophy

4 Authors: Witalo Kassiano1, Bruna Costa1, Gabriel Kunevaliki1, Danrlei Soares1, Gabriel Zaca-

5 rias1, Ingrid Manske1, Yudi Takaki1, Maria Fernanda Ruggiero1, Natã Stavinski1, Jarlisson

6 Francsuel1, Ian Tricoli1, Marcelo A. S. Carneiro1, Edilson S. Cyrino1

7 Affiliations: 1Metabolism, Nutrition and Exercise Laboratory, Physical Education and Sport

8 Center, State University of Londrina, Londrina, Brazil.

10 *Correspondence author: Witalo Kassiano. e-mail: [email protected] | ORCID number:

11 0000-0002-0868-8634. Metabolism, Nutrition, and Exercise Laboratory. Physical Education and

12 Sport Center, State University of Londrina, Rodovia Celso Garcia, km 380, 86057-970, Londrina,

13 Brazil.

14

15 Affiliation where the research was conducted: Physical Education and Sport Center. State Univer-

16 sity of Londrina, Brazil.

17 ABSTRACT

18 Whether there is an optimal range of motion (ROM) to induce muscle hypertrophy remains elusive,

19 especially for gastrocnemius. This study aimed to compare the changes in gastrocnemius muscle

20 thickness between calf raise exercise performed with full ROM (FULLROM), partial ROM per-

21 formed in the initial (INITIALROM), and final (FINALROM) portions of the ROM. Forty-two young

22 women performed a calf training program for 8 weeks, 3 d·wk–1, with differences in the calf raise

23 ROM configuration. The calf raise exercise was performed in a pin-loaded horizontal leg-press

24 machine, in 3 sets of 15–20 repetitions maximum. The subjects were randomly assigned to 1 of

25 the 3 groups: FULLROM (ankle: -25º to +25º), INITIALROM (ankle: -25º to 0º), and FINALROM

26 (ankle: 0º to +25º), where 0º was defined as an angle of 90º of the foot with the tibia. The muscle

27 thickness measurements of medial and lateral gastrocnemius were taken via B-mode ultrasound.

28 INITIALROM elicited greater medial gastrocnemius increases than FULLROM and FINALROM (INI-

29 TIALROM = +15.2% vs. FULLROM = +6.7% and FINALROM = +3.4%; P ≤ 0.009). Furthermore,

30 INITIALROM elicited greater lateral gastrocnemius increases than FINALROM (INITIALROM =

31 +14.9% vs. FINALROM = +6.2%; P < 0.024) but did not significantly differ from FULLROM

32 (FULLROM = +7.3%; P = 0.060). The current results suggest that calf training performed at longer

33 muscle lengths may optimize gastrocnemius muscle hypertrophy in young women. Therefore,

34 when prescribing hypertrophy-oriented training, the inclusion of the calf raise exercise performed

35 with partial ROM in the initial portion of the excursion should be considered.

36 Keywords: resistance training, muscle mass, joint excursion, triceps surae, length-tension rela-

37 tionship.
38 INTRODUCTION

39 Range of motion (ROM) can be operationally defined as the degree of movement at a spe-

40 cific joint during the execution of an exercise (8). Resistance exercise ROM has the potential to

41 modulate muscular adaptations because depending on the specific ROM used in each repetition,

42 factors such as internal moment arm length, the portion of the force-length relationship to which

43 the stimulus is applied, and muscle activation will be differentially affected (6, 18). ROM has been

44 classified as full (FULLROM) when a given movement is performed without restriction in the de-

45 grees of excursion (13). Notably, ROM may be intentionally limited in the initial (INITIALROM)

46 or final (FINALROM) portions of a full ROM, taking the concentric action as reference (13). Despite

47 the widely held belief that FULLROM is superior to partial ROM to induce muscle hypertrophy,

48 currently, there is not a definitive consensus on this statement (12), with findings suggesting the

49 superiority of full ROM over partial ROM (2), others suggesting similarity (30) and others sug-

50 gesting superiority of partial over full ROM (7, 29).

51 When trying to reconcile the findings, it is possible to notice that training at longer muscle

52 lengths, through FULLROM or INITIALROM, frequently elicits greater muscle hypertrophy (13).

53 For instance, knee extension exercise performed with FULLROM and INITIALROM, taking the con-

54 centric muscle action as reference (i.e., at longer muscle length), elicited more favorable muscle

55 hypertrophy in rectus femoris and vastus lateralis than FINALROM (i.e., at shorter muscle length)

56 (29). Although not unanimous (7), the superiority of training at longer muscle lengths has been

57 observed in different studies (20, 23, 24). Among the mechanisms proposed to explain these results

58 is the mechanical muscle characteristics; especially the length-tension relationship (10). Thus, if

59 the fibers of given muscle work, for example, on the descending limb of the length-tension rela-

60 tionship, it may experience additional mechanical tension from passive elements (10). Indeed, this
61 may be the case for the rectus femoris and vastus lateralis which work on the plateau and

62 descending limb of the length-tension curve (5, 35). If accepted, this hypothesis implies that opti-

63 mal ROM is muscle-dependent. Considering most research has focused on hypertrophy of the

64 quadriceps (17, 23, 24, 29), findings for other muscles are limited or non-existent, as is the case

65 for the gastrocnemius (13).

66 The gastrocnemius muscles are bi-articular superficial calf muscles crossing the knee and

67 ankle joints (15). With knees fully extended and ankle dorsiflexed, the medial and lateral gas-

68 trocnemius reach longer fascicle lengths than the plantar flexed position (38 to 46 mm vs. 26 to 30

69 mm) (15). Notably, gastrocnemius appears to work on the ascending and plateau portions of the

70 length-tension curve (11, 21, 39), suggesting that it may produce reduced active force at shorter

71 muscle lengths (33). Also, it implies that the gastrocnemius probably needs to reach longer muscle

72 lengths to produce and experience maximum active force levels (10, 16). Theoretically, gas-

73 trocnemius would hypertrophy in a greater magnitude when trained in INITIALROM than in FI-

74 NALROM. As a counter-argument, the internal moment arm reduces at longer muscle lengths (21),

75 decreasing the contribution of these muscles to plantar flexor torque. Thus, it remains elusive

76 whether there would be superiority of INITIALROM over FINALROM. Therefore, this study com-

77 pared the effects of calf training with FULLROM, INITIALROM, and FINALROM on medial and lat-

78 eral gastrocnemius muscle size changes. We hypothesized that INITIALROM could be superior to

79 FINALROM, but similar to FULLROM.

80

81 METHODS

82 Experimental approach to the problem

83 This was a between-group repeated measures design in which subjects were randomly allocated to

84 one of three possible ROM configurations in the calf training: FULLROM (ankle joint: -25º to +25º),

85 INITIALROM taking the concentric muscle action as reference (ankle joint: -25º to 0º), or FI-

86 NALROM taking the concentric muscle action as reference (ankle joint: 0º to +25º) training groups,

87 where 0º was defined as an angle of 90º of the foot with the tibia. The current investigation was

88 executed over 12 weeks. Weeks 1, 2, 11, and 12 were used for muscle thickness measurements,

89 while the calf training program was performed for eight weeks (weeks 3–10). All experimental

90 groups trained three times a week, totaling 24 training sessions. Each training session was composed

91 of three sets of 15–20 repetitions maximum in the bilateral calf raise exercise. Subjects were as-

92 sessed at pre and posttraining for medial and lateral gastrocnemius muscle thickness measured with

93 ultrasound imaging.

94

95 Subjects

96 The present study sample consisted of apparently healthy adult women aged between 18 and 35

97 years. Volunteers were recruited through dissemination on social media and folders distributed in

98 points of greater circulation within the campus of the local University. All volunteers underwent a

99 clinical anamnesis and answered the physical activity readiness questionnaire (PAR-Q). The in-

100 clusion criteria were not responding "yes" to one or more PAR-Q questions; not having osteomy-

101 oarticular problems that could compromise the performance of the calf training program; not being

102 a user of dietary supplements and/or anabolic steroids (self-reported information), and not being

103 engaged in resistance training for at least six months before starting the participation. Participants

104 who did not attend at least 85% of training sessions and/or missed two consecutive training ses-

105 sions were excluded from the analyses. All participants were instructed to maintain their routines
106 and eating habits during the intervention. After being informed about the study proposal and pro-

107 cedures, the participants signed an informed consent form. Written informed consent was obtained

108 from all participants after a detailed description of study procedures was provided. This investiga-

109 tion was conducted according to the Declaration of Helsinki and the project was submitted and

110 approved by the local University Research Ethics Committee (3.930.966). Figure 1 illustrates the

111 sampling process, with information on the number of participants recruited and interviewed, allo-

112 cation to experimental groups, dropouts throughout the training process, and the final number of

113 participants who completed the study and were included in the analyses. Forty-two young women

114 [FULLROM, n = 14 (22.0 ± 4.0 yrs, 69.0 ± 17.6 kg, 165.1 ± 7.7 cm); INITIALROM, n = 12 (22.5 ±

115 2.3 yrs, 61.3 ± 9.2 kg, 162.2 ± 4.5 cm); and FINALROM, n = 16 (22.3 ± 3.4 yrs, 64.8 ± 15.0 kg,

116 161.7 ± 4.8 cm)] ultimately completed the study and were included for final analyses.

117

118 *** PLEASE INSERT FIGURE 1 NEAR HERE ***

119

120 Procedures

121 Gastrocnemius Muscle Thickness Measurement. Medial and lateral gastrocnemius muscle thick-

122 ness were taken via B-mode ultrasound (FIGLABS, FP-102, SAEVO, SP, Brazil) with a 53 mm,

123 7.5-MHz linear probe model L741. On arrival at the laboratory, the participant was placed in a

124 prone position on a stretcher and rested for 10 minutes before the beginning of the assessment. A

125 generous quantity of water-soluble transmission gel was applied over the assessed muscle without

126 compressing the skin. Images were obtained on the right leg with the probe perpendicular to the

127 tissue. Image acquisitions of the medial gastrocnemius were taken with the probe positioned in the

128 thickest and more prominent site of the leg from a posteroanterior view (27). Measurements of the
129 lateral gastrocnemius were taken at the proximal third between the lateral epicondyle of the femur

130 and the lateral malleolus of the fibula (27). Two assessors participated in measurement procedures,

131 with the first handled the probe and the second responsible for freezing the images. When the

132 quality of the image was deemed to be satisfactory, the second assessor obtained muscle thickness

133 dimensions using the machine’s calculation package. The second assessor was blinded to group

134 allocation. Muscle thickness of medial and lateral gastrocnemius was defined as the distance from

135 the superficial to deep aponeuroses that borders the soleus. Reference lines were drawn on the

136 participant’s skin with a dermatographic pen on the sites at which images were obtained and were

137 reinforced and maintained throughout the study to ensure that the measurement was taken at the

138 same place at baseline and posttraining. The muscle thickness assessments were performed in the

139 morning hours (7–11 AM) pre and posttraining. During baseline assessments, 17 subjects were

140 randomly chosen to be evaluated on two days separated by 72 h to determine the reliability of the

141 muscle thickness measurements. The intraclass correlation coefficients for the medial and lateral

142 gastrocnemius were 0.993 and 0.990; the coefficients of variation were 1.4% and 1.6%; the stand-

143 ard errors of measurement were 0.028 cm and 0.029 cm, respectively. Posttraining measurements

144 were performed at an interval of 72–96 h after the last training session.

145 Calf Training Program. The resistance training program was performed three times per week

146 (Mondays, Wednesdays, and Fridays) in the afternoon for eight weeks. The calf raise exercise

147 was performed bilaterally, in a pin-loaded horizontal leg-press machine (Ipiranga®, Presidente

148 Prudente, SP, Brazil) in 3 sets of 15–20 repetitions, executed until momentary concentric failure

149 (i.e., when the participant has reached the point where, despite trying to do so, they cannot complete

150 the concentric muscle action of their current repetition). This repetition range was chosen based on

151 their common inclusion in calf hypertrophy-oriented training programs (27, 31). Whenever the
152 participant reached 20 repetitions in a given set and reported that they could perform ≥ 1 repetition,

153 the weight was increased by 2–5% for the next set to ensure that the participants kept performing

154 the sets to (or very near to) failure in the established repetition range. The rest period was 60–90

155 s between sets. The FULLROM group performed calf raise exercise with no degree of movement

156 restrictions (ankle joint: -25º to +25º; 0º = foot 90º relative to the tibia). INITIALROM performed

157 calf raise in the partial ROM at the initial excursion of the concentric muscle action of plantar

158 flexion (ankle joint: -25º to 0º). FINALROM performed calf raise in the partial ROM at the final

159 excursion of the concentric muscle action of plantar flexion (ankle joint: 0º to +25º). An illustration

160 of the training groups can be seen in Figure 2. These ROMs were defined from pilot data collection

161 in which we observed that with overload (i.e., during calf raise exercise), the complete ROM was

162 ~50º, and initial and final ROMs were ~25º. The ankle joint angles of -25º and +25º were validated

163 through the displacement of the weight stack on the stem. Using an inelastic tape measure and a

164 goniometer, we identified that 6 cm of weight stack displacement corresponds to 25º of ankle

165 flexion. This weight stack displacement was the parameter adopted to validate the specific ROM.

166 The research assistants confirmed when the participant had reached the required weight stack dis-

167 placement during the calf raise exercise. In the INITIALROM group, a metallic structure was placed

168 in the stem where the weight stack of the machine run to serve as a limiter at the top part of desired

169 plantar flexion angle (0°). In the FINALROM group, a step in EVA was used to serve as a limiter at

170 the bottom part of desired plantar flexion angle (0°). In INITIALROM and FINALROM groups, the

171 0° angle was identified using a goniometer. The supplementary material illustrates how the me-

172 chanical stops were used to delimit the ROM excursion. The participants performed the calf raise

173 exercise at a tempo of 1:2 seconds (concentric and eccentric phases, respectively), with the knee

174 extended and the foot positioned on the platform supported by metatarsals. Participants performed
175 all sessions under specialized supervision (1:2 participant:supervisor ratio) to ensure safe and proper

176 execution. All weights and repetitions performed were recorded. The volume load was calculated as

177 the number of sets x number of repetitions x load lifted. The average volume load of the first training

178 sessions in week 1 was used as each participant’s reference value. Thereafter, volume load progres-

179 sion was calculated based on percentage differences between the average volume load produced be-

180 tween training sessions 1 and 2–24.

181

182 *** PLEASE INSERT FIGURE 2 NEAR HERE ***

183

184 Statistical analysis

185 Data distribution and variance homogeneity were verified through Shapiro-Wilk's and Levene’s

186 tests, respectively. The one-way analysis of variance (ANOVA) was used to compare the baseline

187 characteristics between the groups. The comparison of different ROM configurations (FULLROM vs.

188 INITIALROM vs. FINALROM) effects on gastrocnemius muscle thickness was made using an analysis

189 of covariance (ANCOVA) of the raw difference between baseline and posttraining measures with

190 the baseline score as a covariate. When the F-ratio was significant, Bonferroni’s post hoc test was

191 used to identify the differences between pre and posttraining raw data. The P values for group com-

192 parisons were also presented. The interpretation of the effect of time was made from the 95% confi-

193 dence interval (95% CI) of the mean difference pre to posttraining (i.e., there was a significant dif-

194 ference when the inferior and superior confidence limits did not cross zero). The effect size (ES)

195 was calculated as posttraining group mean minus the pretraining mean, divided by the groups-

196 pooled pretraining standard deviation (4). The one-way ANOVA was used to compare the initial

197 volume load between groups. The volume-load progression slopes were generated using linear
198 regression and compared through an F-test. For all statistical analyses, significance was accepted at

199 P < 0.05. The data were stored and analyzed using JASP software (version 0.14.1, Amsterdam,

200 NL). The data are presented as mean and standard deviations.

201

202 RESULTS

203 No significant between-group differences for participants' characteristics or dependent var-

204 iables were detected at baseline (P ≥ 0.265). Session attendance was 93.4 ± 5.7% for the FULLROM,

205 91.0 ± 5.6% for the INITIALROM, and 92.0 ± 5.8% for the FINALROM with no difference between

206 groups.

207 Table 1 displays the pre and posttraining values of gastrocnemius muscle thickness. There

208 were significant increases in muscle thickness of the medial gastrocnemius for FULLROM and IN-

209 ITIALROM (P ≤ 0.001), but not for FINALROM (P = 0.053). A significant group effect was observed

210 for the changes in the medial gastrocnemius muscle thickness (F = 9.254; P < 0.001). There was

211 a greater increase for INITIALROM than FULLROM [Meandiff = 0.13 cm (95% CI: 0.03, 0.23), P =

212 0.009], and greater increases for INITIALROM than FINALROM [Meandiff = 0.17 cm (95% CI: 0.07,

213 0.27), P < 0.001], but no difference was observed between FULLROM and FINALROM [Meandiff =

214 0.04 cm (95% CI: -0.05, 0.13), P = 0.892]. Figure 3 shows the relative changes on muscle thickness

215 of medial gastrocnemius (FULLROM = +6.7%; INITIALROM = +15.2%; and FINALROM = +3.4%).

216 There were increases in muscle thickness of the lateral gastrocnemius for FULLROM, INI-

217 TIALROM, and FINALROM (P ≤ 0.005). A significant group effect was observed for the changes in

218 the lateral gastrocnemius (F = 4.464; P = 0.018). There was a greater increase for INITIALROM

219 than FINALROM [Meandiff = 0.13 cm (95% CI: 0.02, 0.25), P = 0.024], but not significant difference

220 was observed between INITIALROM and FULLROM [Meandiff = 0.12 cm (95% CI: -0.01, 0.24), P =
221 0.060], and between FULLROM and FINALROM [Meandiff = 0.01 cm (95% CI: -0.10, 0.12), P =

222 0.999]. Figure 3 shows the relative changes on muscle thickness of lateral gastrocnemius

223 (FULLROM = +7.3%; INITIALROM = +14.9%; and FINALROM = +6.2%).

224

225 *** PLEASE INSERT TABLE 1 NEAR HERE ***

226 *** PLEASE INSERT FIGURE 3 NEAR HERE ***

227

228 The groups started the training program with similar volume load (FULLROM = 2696.4 ±

229 460.9 kg, INITIALROM = 2687.0 ± 467.8 kg, FINALROM = 2696.4 ± 460.9 kg; F = 0.78, P = 0.469).

230 Volume load progression slopes differed significantly between FULLROM and INITIALROM (F =

231 63.61; P < 0.001), and between FULLROM and FINALROM (F = 21.86; P < 0.001), but not between

232 INITIALROM and FINALROM (F = 2.019; P = 0.162). Figure 4 shows the volume load progression

233 from session to session in the FULLROM, INITIALROM, and FINALROM groups.

234

235 *** PLEASE INSERT FIGURE 4 NEAR HERE ***

236

237 DISCUSSION

238 The purpose of this study was to examine the effects of 3 different ROM configurations

239 (FULLROM, INITIALROM, and FINALROM) on the muscle thickness of gastrocnemius muscles in

240 untrained young women. The main finding of this study is that ROM can influence the magnitude

241 of increases in muscle thickness of the gastrocnemius. Specifically, the INITIALROM induced

242 greater gains on the medial and lateral heads compared to the FINALROM. Moreover, INITIALROM

243 elicited greater increases in the medial gastrocnemius than FULLROM. This indicates that partial
244 ROM training at longer muscle lengths can optimize hypertrophy of the gastrocnemius muscles.

245 Our initial hypothesis that INITIALROM would be superior to FINALROM was confirmed. On the

246 other hand, the assumption that there would be similar gains between INITIALROM and FULLROM

247 was not confirmed, given that there was more favorable gastrocnemius muscle hypertrophy for

248 INITIALROM configuration. Potential mechanisms and explanations for our findings are discussed

249 following.

250 In the present study, we observed more favorable medial and lateral gastrocnemius hyper-

251 trophy for the INITIALROM, especially when contrasted with FINALROM (between-group ES: 0.48–

252 0.66). A possible explanation for this superiority may lie in the muscle length at which the gas-

253 trocnemius muscles were trained. Growing evidence suggests that resistance exercises performed

254 at long muscle lengths promote superior muscle hypertrophy (19, 20, 32). In the present study, the

255 calf raise exercise was performed with the knees extended and, specifically in INITIALROM, the

256 ankle moved exclusively in dorsiflexion angles, in which the gastrocnemius heads reach longer

257 muscle lengths (15). Given that gastrocnemius work on the ascending and plateau portions of the

258 length-tension curve (11, 21), it is possible to propose that the gastrocnemius fibers may have

259 produced maximum active force levels from contractile elements (i.e., actin and myosin filaments)

260 in the INITIALROM configuration due to reach longer muscle lengths (10, 16). Thus, gastrocnemius

261 muscle fibers probably experienced optimal mechanical tension that resulted in a more favorable

262 muscle hypertrophy stimulus (38). On the other hand, the gastrocnemius fibers in the FINALROM

263 group may not have produced maximum active force due to the shorter muscle length in this ROM

264 configuration (15, 16). Thus, experiencing reduced mechanical tension and less favorable muscle

265 hypertrophy stimulus (38). This conceivably helps to explain the greater muscle hypertrophy in

266 the INITIALROM group.

267 Still based on the length-tension relationship, it is possible to suggest that gastrocnemius

268 fibers in the INITIALROM configuration potentially experienced additional passive tension from

269 elastic elements (e.g., titin) and this may have contributed to eliciting superior muscle growth due

270 to the potential additive effects of stretch and contraction (3, 13, 25). This phenomenon has been

271 called stretch-mediated hypertrophy (24). Indeed, it has been suggested that there is an increase in

272 titin stiffness (especially in the PEVK segment) in the active muscle when reaching longer muscle

273 lengths that result in further passive tension in the sarcomere (25). Thus, this would result in greater

274 overall mechanical tension, a primary hypertrophic stimulus (38). Importantly, it has been argued

275 that only muscles that work in the descending limb of the length-tension curve appear to experience

276 stretch-mediated hypertrophy (13, 28). Although there are findings from a cadaver study suggest-

277 ing that gastrocnemius may work in the descending limb (5), it remains questionable whether, in

278 fact, the sarcomeres of the gastrocnemius muscle fibers reach the descending limb in vivo human

279 muscles (11, 21, 39). Therefore, it remains to be determined whether gastrocnemius fibers work

280 in descending limb of the length-tension curve and may experience stretch-mediated hypertrophy.

281 Notably, other factors such as internal moment arm and muscle activation play an im-

282 portant role in muscle capacity for producing force, and then potentially influence the hypertrophic

283 stimulus (13). Theoretically, the longer the internal moment arm length, the greater the capacity

284 of muscle in producing a turning force at a specific joint (36). Some research has found that internal

285 moment arm lengths increase with increasing plantar flexion angle, thereby being greater at shorter

286 muscle lengths (21, 22). This could result in greater force production at a more flexed plantar

287 position and then, a more favorable hypertrophic stimulus for the FINALROM configuration. How-

288 ever, our results do not support this notion. Thus, it is possible to suggest that the change in the

289 internal moment arm length at different ankle joint angles may not be sufficient to substantially
290 affect the gastrocnemius production of plantar flexion torque. Importantly, investigations have

291 been less devoted to understanding potential differences in the internal moment arm lengths of

292 each muscle and how these might alter with changing ankle joint angles. Thus, further research is

293 needed to determine the internal moment arm lengths of individual muscles and explore the po-

294 tential influence of this factor on muscle hypertrophy.

295 Regarding muscle activation at different ankle positions, findings are divergent. For ex-

296 ample, there is a report suggesting that surface electromyographic (sEMG) amplitude is subtly

297 greater for lateral, but not for medial gastrocnemius, at a more dorsiflexed ankle position (i.e.,

298 longer muscle lengths) compared to a more plantar flexed position (i.e., shorter muscle lengths)

299 (1). Conversely, other studies found no differences in sEMG amplitude when comparing a more

300 dorsiflexed versus a more plantar flexed ankle position (9, 34). Interestingly, studies consistently

301 observe greater plantar flexion torque in more dorsiflexed position (1, 9, 21). Based on greater

302 gastrocnemius hypertrophy in the INITIALROM group observed in the present study, and not con-

303 sistent findings on sEMG, it is possible to suggest that the muscle activation, per se, may not

304 indicate the hypertrophic potential when comparing training at different muscle lengths (37). In

305 fact, torque production across a range of joint angles creates discordant muscle sEMG amplitudes

306 (37). In contrast, greater hypertrophy is commonly observed when training at longer compared to

307 shorter muscle lengths (12, 13). Importantly, since the divergent findings on muscle activation at

308 different ankle positions, further studies are needed to characterize this aspect and investigate the

309 potential relationship between muscle activation and gastrocnemius muscle hypertrophy. In addi-

310 tion, other techniques (e.g., magnetic resonance imaging, ultrasonography) have been used to infer

311 the magnitude of the stimulus in a given muscle and should be explored.
312 Interestingly, the INITIALROM group elicited significantly greater increases in medial gas-

313 trocnemius muscle size than FULLROM (between-group ES: 0.48), and, although we did not ob-

314 serve significance for the lateral gastrocnemius, the ES favored the INITIALROM (between-group

315 ES: 0.41). Our findings are according to a recent study that found greater muscle hypertrophy of

316 the vastus lateralis and rectus femoris in the INITIALROM than in the FULLROM when performing

317 the knee extension exercise (29). A potential explanation for such INITIALROM-favorable findings

318 over FULLROM may be an interaction between muscle length and volume load progression (which

319 influences mechanical tension). In fact, higher rates of volume-load progression seems to result in

320 greater muscle hypertrophy (26). The analysis of the training loads in the present study showed

321 that both partial ROM groups (INITIALROM and FINALROM) progressed more than the FULLROM

322 (see Figure 4). Notably, the INITIALROM achieved greater increases in gastrocnemius muscle

323 thickness than the other two ROM configurations. Since the magnitude of volume load progres-

324 sions was similar for the INITIALROM and FINALROM, this seems to indicate that muscle hyper-

325 trophy appears to be optimized through an interaction between volume-load progression—thus,

326 overload—and training at longer muscle lengths.

327 Certainly, our study has limitations that need to be addressed. First, dietary intake and daily

328 physical activity levels were not assessed and remain uncertain whether these factors could exert

329 some influence on muscular adaptations. Importantly, the subjects were instructed to maintain their

330 nutritional habits and not perform any additional exercise on a systematic basis. Second, the train-

331 ing intervention in the present study lasted 8 weeks; it would be interesting to have longer training

332 periods to verify the effects of different ROM configurations on muscular adaptations. Third, since

333 our study exclusively investigated the medial and lateral gastrocnemius muscle hypertrophy, future

334 investigations should consider examining the influence of ROM on the architectural (e.g., fascicle
335 length and pennation angle) and functional parameters (e.g., maximum voluntary isometric con-

336 traction and 1-repetition maximum); as well as the effects of specific ROM on muscle size changes

337 of the soleus and other muscles with limited or non-existent findings such as the hamstrings and

338 pectoralis major. Moreover, given that a resistance training program comprises a variety of exer-

339 cises (14), it is necessary to investigate the effect of different ROM configurations on other exer-

340 cises that target the calf muscles (e.g., seated calf raise). Finally, this experiment was performed

341 on untrained young women, therefore remains to be determined whether such findings are also

342 observed in other populations of different ages, sex, and training status.

343

344 PRACTICAL APPLICATIONS

345 Although FULLROM configuration significantly increased both gastrocnemius heads, INI-

346 TIALROM elicited more favorable muscle hypertrophy; especially compared to FINALROM config-

347 uration. Therefore, from the results of our study, it is possible to suggest that calf raise exercise

348 performed with partial ROM in the initial portion of the movement (i.e., training at longer muscle

349 lengths) may induce greater hypertrophy of the gastrocnemius muscles following 8 weeks of re-

350 sistance training in untrained young women. These results add to the growing evidence suggesting

351 that resistance training performed at long muscle lengths promotes superior muscle hypertrophy.

352 From a practical perspective, strength and conditioning professionals and practitioners aiming to

353 optimize medial and lateral gastrocnemius muscle growth, should consider including this strategy

354 in the hypertrophy-oriented training program.

355

356 ACKNOWLEDGMENTS
357 We would like to express thanks to all the participants for their engagement in this study, the

358 Coordination of Improvement of Higher Education Personnel (CAPES/Brazil) for the scholarship

359 conferred to WK, BC, GK, NS, JF, IT, and the National Council of Technological and Scientific

360 Development (CNPq/Brazil) for the grants conceded to ESC.

361
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470
 Enrollment

Assessed for eligibility (n = 105)

Excluded (n = 45)
• Not meeting inclusion crite-
ria (n = 45)

Randomized (n = 60)

Allocation

FULLROM INITIALROM FINALROM

(n = 20) (n = 20) (n = 20)

Follow-Up

Completed (n = 14) Completed (n = 12) Completed (n = 16)

Dropped out (n = 6) Dropped out (n = 8) Dropped out (n = 4)
¨ Health problems ¨ Health problems ¨ Health problems
(n = 3) (n = 2) (n = 2)
¨ Adherence < 85% of ¨ Adherence < 85% of ¨ Adherence < 85% of
training sessions training sessions training sessions
(n = 1) (n = 4) (n = 2)
¨ Personal reasons ¨ Personal reasons
(n = 2) (n = 2)

Analysis

Analyzed (n = 42)

Figure 1. CONSORT flow chart. FULLROM = full range of motion, INITIALROM = initial part of the range

of motion, FINALROM = final part of the range of motion.

Figure 2. Illustration of three experimental groups. FULLROM = full range of motion, INITIALROM = initial part of the range of motion, FI-

NALROM = final part of the range of motion.

Figure 3. Changes from pre to posttraining period for medial and lateral gastrocnemius muscle

thickness. †P < 0.05 vs. FINALROM; ‡ P < 0.05 vs. FULLROM. The horizontal lines represent mean

and 95% confidence intervals, whereas each circle represents individual responses. FULLROM =

full range of motion; INITIALROM = initial part of the range of motion; FINALROM = final part of

the range of motion.

Figure 4. Volume load progression per session for the FULLROM, INITIALROM, and FINALROM

configurations, with slopes (continuous straight lines) and 95% confidence intervals (dotted lines).

FULLROM = full range of motion; INITIALROM = initial part of the range of motion; FINALROM =

final part of the range of motion.

Table 1. Medial and lateral gastrocnemius muscle thickness (cm) before and after
eight weeks of the calf raise training with different ROM configurations.
FULLROM INITIALROM FINALROM
Muscle thickness
(n = 14) (n = 12) (n = 16)
Medial gastrocnemius
Pre 1.65 ± 0.29 1.58 ± 0.26 1.75 ± 0.27
Post 1.76 ± 0.30* 1.82 ± 0.27*†‡ 1.81 ± 0.29
Meandiff 0.10 (0.04, 0.17) 0.23 (0.16, 0.31) 0.06 (-0.01, 013)
ES 0.40 0.88 0.22
Lateral gastrocnemius
Pre 1.65 ± 0.32 1.61 ± 0.29 1.62 ± 0.27
Post 1.77 ± 0.34* 1.85 ± 0.34*† 1.72 ± 0.25*
Meandiff 0.12 (0.04, 0.20) 0.24 (0.15, 0.32) 0.10 (0.03, 0.18)
ES 0.41 0.82 0.34
Note. ROM = range of motion; FULLROM = full range of motion; INITIALROM = initial part of the
range of motion (-25º to 0º); FINALROM = final part of the range of motion (0º to +25º); ES = effect
size. *P < 0.05 vs. baseline; †P < 0.05 vs. FINALROM; ‡P < 0.05 vs. FULLROM. Pre- and post-
training data are presented as mean and standard deviation, while meandiff as mean and 95% confi-
dence intervals.
 A B
v

C
C
v

Figure 1. Pin-loaded horizontal leg press machine and the mechanical stops used to delimitate the
range of motion excursion. A participant in horizontal leg press without mechanical stops (Panel
A), mechanical stops for FINALROM group (Panel B), and mechanical stops for INITIALROM group
(Panel C).

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