Fish DE, Krabak BJ, Johnson-Greene D, deLateur BJ: Optimal resistance training: Comparison of DeLorme with Oxford techniques. Am J Phys Med Rehabil 2003;82:903–909.
Objective: Progressive resistive exercises, such as the DeLorme or Oxford techniques, improve strength by adding weights to arrive at the ten-repetition maximum (10RM; DeLorme) or by starting at the 10RM and removing weight (Oxford). The goal of this study was to examine the efficacy of each training method.
Design: In this randomized, prospective, group design, evaluator-blind clinical trial, 50 subjects performed either the Oxford or DeLorme weight-training techniques. Three times a week for 9 wks, subjects completed three sets of ten-repetition knee extensions based on the 10RM measured weekly. Incremental or decremental changes in training weight were utilized in training sessions based on the protocol randomly assigned to each subject.
Results: The mean 10RM increase was 71.9 kg for the DeLorme group and 67.5 kg for the Oxford group, which was not significantly different. Examination with repeated measures multivariate analysis of variance revealed no significant difference between the two groups for 10RM increase, and no significant sex differences were found. Percentage change scores were not significantly different for 1RM and 10RM for both protocols and sexes.
Conclusion: Both protocol groups were able to complete their lifting assignments and progressed similarly in weekly 10RM weight lifted. It can be concluded that both the DeLorme and Oxford protocols improve strength with equivalent efficacy. Further studies involving a larger sample size are needed to address potential sex-specific changes in strength improvement in response to the protocols.
Despite the proven effectiveness of resistance training in building strength, uncertainty still exists as to the most efficient way to train. The work of DeLorme and Watkins 1–3 in the 1940s showed that with training, strength returns more quickly to atrophied muscles if relatively few repetitions are performed at high levels of resistance. They observed that the rate of muscle hypertrophy is proportional to the resistance overcome by the muscle;1 thus, they prescribed a maximum of 20–30 repetitions, because performing >30 would require reducing the resistance and slow the rate of muscle hypertrophy. 2
DeLorme defined the ten-repetition maximum (10RM) as the weight an individual could lift only ten times before temporary failure of the muscle occurred. One of DeLorme’s hypotheses is that the muscle should be warmed up by the time 10RM is reached. Therefore, once the 10RM has been established during testing, the subject begins sets of training by performing the first set of ten at 50% 10RM, the second at 75% 10RM, and the third (final) at the 10RM. He suggested that progressive resistive exercises overloaded a muscle by increasing the magnitude of the weight against which the muscle developed tension. The goal was to lift the heaviest weight; thus, adjustment in the warm-up repetitions should be sought to enable the subject to complete the 10RM.
Factors impeding strength assessment include learning factors, such as an inability to exert maximal effort, fear of injury, or an unwillingness to endure the discomfort accompanying temporary muscle failure. For these reasons, DeLorme believed the initial 10RM was often an inaccurate reflection of a subject’s strength. He noted that it was not unusual with training for strength to double within the first 1 or 2 mos and then to show a smaller increase during subsequent months. 1 Warm-up lifts were not intended to fatigue the muscle to the point that interfered with the subject’s ability to complete the 10RM. 1 Instead, these initial lifts were thought to be important in preventing muscle soreness and in teaching the patient how to complete the exercises, thereby permitting maximal exertion by the final set.
In performing the DeLorme technique, Zinovieff 4 had consistent difficulties due to fatigue of the quadriceps muscle during the last quarter of the session. 5 Temporary failure of the muscle prevented the participant from completing the 10 repetitions at the 10RM. As the quality of performance fell, the full range of motion of the joint was compromised. Only the very athletic or determined individuals could carry out the technique as described by DeLorme. Zinovieff identified another method to strengthen muscle, the Oxford technique, in which heavy resistance and low repetition was maintained as per DeLorme, but the full 10RM was the first set and was subsequently reduced to 75% and to 50% of the 10RM in the remaining two sets. It was thought that this decrement in resistance would mimic the progressive increase in muscle fatigue. Each set of repetitions would continue to exercise the muscle to its maximum capacity, thus preserving the overload principle.
Many authors have suggested that the 10RM may not be the most important goal to reach in weight training. 6–9 Instead, the key to improving strength involves fatiguing the muscle. 9 Linnamo et al. 10 looked at fatigue and recovery of a muscle with explosive loading. He found that young women fatigued less than men. Chilibeck et al. 11 studied women for resistance training and noted that with a short training period, the amount of hypertrophy was less in women when compared with men. Charette et al. 12 proved that the muscles of elderly women are capable of hypertrophy and, therefore, strength gains.
At present it is unclear which technique, DeLorme or Oxford, is more effective at developing strength. The goal of our study was to evaluate the efficacy of each model of progressive resistive training.
From the Department of Physical Medicine and Rehabilitation, Johns Hopkins Medicine, Baltimore, Maryland.
Presented as a poster at the American Academy of Physical Medicine and Rehabilitation National Conference, New Orleans, Louisiana, September 14–17, 2001.
All correspondence and requests for reprints should be addressed to David E. Fish, MD, MPH, Department of Orthopaedic Surgery, UCLA School of Medicine, 200 UCLA Medical Plaza, Suite 140, Los Angeles, CA 90095-1749.