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Forefoot morphotype study and planning method for forefoot osteotomy.

In the reconstruction of the hip, knee, or any other joint, preoperative planning is necessary for avoiding mistakes during surgery. Since 1995, the authors have been doing this before forefoot surgery to increase the accuracy of the surgery. As much as possible, they try to correct only the lesion and to avoid preventive or extensive surgery on adjacent rays, except if the correction leads to a modified dysharmonious new morphotype with high risk of transfer lesion. The tolerance length seems to be 2 mm, particularly on the middle metatarsals (M2 and M3). This surgery should be performed only if the midfoot and backfoot are correct and if the gastrocnemius muscle has been checked on to eliminate a retraction needing stretching exercises before and generally after surgery.

Adult↗

Upper arm radial nerve palsy after muscular effort: report of three cases.

Three healthy men were engaged in continuous repetitive arm exercise when a sudden forceful contraction and stretch of the arm muscles led to a delayed upper arm radial nerve palsy. Radial nerve "entrapment" at the lateral head of the triceps muscles is a recognizable occupational nerve injury.

Action Potentials↗

Effects of plyometric training followed by a reduced training programme on physical performance in prepubescent soccer players.

BACKGROUND: In adult population, stretch-shortening cycle exercise (plyometric exercise) is often used to improve leg muscle power and vertical jump performance. In children, limited information regarding this type of exercise is available. The purpose of this study was to examine the effectiveness of plyometric training and maintenance training on physical performances in prepubescent soccer players. METHODS: Twenty boys aged 12-13 years was divided in two groups (10 in each): jump group (JG) and control group (CG). JG trained 3 days/week during 10 weeks, and performed various plyometric exercises including jumping, hurdling and skipping. The subsequent reduced training period lasted 8 weeks. However, all subjects continued their soccer training. Maximal cycling power (Pmax) was calculated using a force-velocity cycling test. Jumping power was assessed by using the following tests: countermovement jump (CMJ), squat jump (SJ), drop jump (DJ), multiple 5 bounds (MB5) and repeated rebound jump for 15 seconds (RRJ15). Running velocities included: 20, 30 and 40 m (V20, V30, V40 m). Body fat percentage (BF percent) and lean leg volume were estimated by anthropometry. RESULTS: Before training, except for BF percent, all baseline anthropometric characteristics were similar between JG and CG. After the training programme, Pmax (p<0.01), CMJ (p<0.01), SJ (p<0.05), MB5 (p<0.01), RRJ15 (p<0.01) and V20 m (p<0.05), performances increased in the JG. During this period no significant performance increase was obtained in the CG. After the 8-week of reduced training, except Pmax (p<0.05) for CG, any increase was observed in both groups. CONCLUSIONS: These results demonstrate that short-term plyometric training programmes increase athletic performances in prepubescent boys. These improvements were maintained after a period of reduced training.

Adolescent↗

Flexibility and its effects on sports injury and performance.

Flexibility measures can be static [end of ROM (range of motion)], dynamic-passive (stiffness/compliance) or dynamic-active (muscle contracted, stiffness/compliance). Dynamic measures of flexibility are less dependent on patient discomfort and are more objective. Acute and chronic changes in flexibility are likely to occur with stretching exercises, but it is difficult to distinguish between changes in stretch tolerance as opposed to changes in muscle stiffness. How flexibility is measured impacts these findings. There is no scientifically based prescription for flexibility training and no conclusive statements can be made about the relationship of flexibility to athletic injury. The literature reports opposing findings from different samples, frequently does not distinguish between strain, sprain and overuse injury, and rarely uses the proper denominator of exposure. There is basic scientific evidence to suggest that active warm-up may be protective against muscle strain injury but clinical research is equivocal on this point. Typically, specific flexibility patterns are associated with specific sports and even positions within sports. The relationship of flexibility to athletic performance is likely to be sport-dependent. Decreased flexibility has been associated with increased in-line running and walking economy. Increased stiffness may be associated with increased isometric and concentric force generation, and muscle energy storage may be best manifested by closely matching muscle stiffness to the frequency of movement in stretch-shorten type contractions.

Athletic Injuries↗

Effects of twelve-month strength training subsequent to twelve-month stretching exercise in treatment of chronic neck pain.

Previously, in a randomized study, we showed that women with chronic neck pain were able to perform intensive training for neck and shoulder muscles and that the increase in strength was accompanied by a reduction in pain and disability. The changes were significantly greater in the training groups compared with controls. The aim of the present study was to evaluate whether the controls would achieve similar results. Thus, 59 women in the control group initiated high-intensity strength training. Maximal isometric neck strength increased by 44% in both flexion and rotation and 27% in extension at the 2-year follow-up. Statistically and also clinically significant decreases in neck pain and disability indices occurred. Stretching and aerobic exercising during the first follow-up year produced only minor changes in both subjective and functional measures. Adding progressive strength training for the second year led to a significant improvement in neck strength and also to a considerable decrease in the pain and disability scores. Thus, to achieve effective rehabilitation in cases of chronic neck pain, a combination of strength training and stretching exercises are recommended.

Chronic Disease↗

Stretching and injury prevention: an obscure relationship.

It is generally accepted that increasing the flexibility of a muscle-tendon unit promotes better performances and decreases the number of injuries. Stretching exercises are regularly included in warm-up and cooling-down exercises; however, contradictory findings have been reported in the literature. Several authors have suggested that stretching has a beneficial effect on injury prevention. In contrast, clinical evidence suggesting that stretching before exercise does not prevent injuries has also been reported. Apparently, no scientifically based prescription for stretching exercises exists and no conclusive statements can be made about the relationship of stretching and athletic injuries. Stretching recommendations are clouded by misconceptions and conflicting research reports. We believe that part of these contradictions can be explained by considering the type of sports activity in which an individual is participating. Sports involving bouncing and jumping activities with a high intensity of stretch-shortening cycles (SSCs) [e.g. soccer and football] require a muscle-tendon unit that is compliant enough to store and release the high amount of elastic energy that benefits performance in such sports. If the participants of these sports have an insufficient compliant muscle-tendon unit, the demands in energy absorption and release may rapidly exceed the capacity of the muscle-tendon unit. This may lead to an increased risk for injury of this structure. Consequently, the rationale for injury prevention in these sports is to increase the compliance of the muscle-tendon unit. Recent studies have shown that stretching programmes can significantly influence the viscosity of the tendon and make it significantly more compliant, and when a sport demands SSCs of high intensity, stretching may be important for injury prevention. This conjecture is in agreement with the available scientific clinical evidence from these types of sports activities. In contrast, when the type of sports activity contains low-intensity, or limited SSCs (e.g. jogging, cycling and swimming) there is no need for a very compliant muscle-tendon unit since most of its power generation is a consequence of active (contractile) muscle work that needs to be directly transferred (by the tendon) to the articular system to generate motion. Therefore, stretching (and thus making the tendon more compliant) may not be advantageous. This conjecture is supported by the literature, where strong evidence exists that stretching has no beneficial effect on injury prevention in these sports. If this point of view is used when examining research findings concerning stretching and injuries, the reasons for the contrasting findings in the literature are in many instances resolved.

Athletic Injuries↗

Exercise effect on strength and range of motion of hand intrinsic muscles and joints.

The intrinsic muscles of the hand are largely neglected in training, mainly because certain biomechanical principles must be applied in order for these muscles to be involved in hand exercises. Following these principles, a system of stretching and isometric exercises was developed. Twelve men exercised for four weeks, three times daily. Significant improvement in seven out of the 12 strength measurements was noted. Exercise seemed to affect just the metacarpophalangeal joints range of motion, while distal and proximal interphalangeal joints remained largely unaffected.

Finger Joint↗

Considerations for maintenance of postural alignment for voice production.

There is general agreement that postural alignment is important in optimizing voice function. A number of articles have illuminated the way in which posture, particularly of the cervical spine, is directly related to vocal resonance and pitch control. Despite frequent involvement in muscle training, few speech pathologists have the background in exercise physiology necessary to appreciate the contribution of muscular length-tension relationships to postural alignment. The purpose of this article is to provide voice therapists with information to help them formulate appropriate recommendations for improving postural alignment. This article synthesizes information from the literature regarding the role of muscular length-tension balance in the attainment and maintenance of postural alignment. Important considerations in the assessment of muscle tension and weakness are presented along with advice regarding application to the treatment of voice-disordered patients. Concepts detailed include agonist/antagonist relationships, the biomechanics of stretching, postural assessment, and the relationship between muscle tension and muscle weakness. The role of both stretching and strength-based training is discussed. Specific exercises with emphasis on altering the alignment of the cervical and thoracic spine are presented with suggestions for their use in the clinic. There is growing understanding of the physiology behind recommendations of voice teachers and therapists to maintain optimal alignment. To effectively mediate postural misalignment, clinicians must have knowledge of the length-tension relationships between muscles. This understanding will lead to better interventions for postural alignment.

Biomechanical Phenomena↗

Stretching.

Explore the source record for details and available documents.

Diabetic Neuropathies↗

[Stretching in relation to sports and prevention of injuries].

Stretching is a regular item in training programmes and it is employed to increase flexibility, to prevent muscle tenderness, overuse injuries and strains. Stretching is carried out by stretching muscles and connective tissue to the extreme positions of joints. A review of stretching exercises based on the literature is presented in relation to prevention of injuries. The various techniques employed are reviewed.

Athletic Injuries↗

The measurement and lateral comparison of the peak torque caused by the fast abduction exercise of stretched upper extremities in normal and trained adults.

The maximal torque effect of the middle portion of action of the deltoid muscle while raising an out-stretched upper limb was measured from left and right sides of normal untrained young adults and of the same age elite athletes. Seventeen strongly right-handed untrained males and females and 10 elite tennis players were tested. All participants were required to raise (abduct) one arm (right and then left, or vice versa) as fast as possible with maximal amplitude while standing on an electronic platform scale which measured to 0.001 kg. An assumed force at the centre of mass of the entire upper limb was considered. The force consisted of two components, namely static weight force of the upper limb and a dynamic force component created by upward acceleration of the limb. Using regression equations and scaling methods the static weight of the upper limb was derived and combined with the dynamic component to produce the total force, applied to the centre of mass of the limb. The total force multiplied by the distance from the centre of mass to point of rotation of the limb equated to the torque produced by deltoid muscle. Using video system analyses the angle of abduction was measured for each individual exercise. The additional anthropometrical tests identified proportionality and body mass indices for each participant. There was no significant difference in dynamic force and torque between left and right limb from the three groups. Sportsmen demonstrated greater lateral abduction when performing the exercise from the dominant side of the body. Sportsmen also demonstrated greater range of abduction, bigger dynamic force and torque on both sides in comparison to untrained adults. Remarkably, the absolute and relative length of arms of athletes were shorter in comparison to untrained males, but the radius of gyration from the stretched upper limb (from its centre of gravity to the shoulder joint) were greater. This phenomenon may be due to distal shifting of the gravity center of the entire upper limb in elite athletes, perhaps, because greater investment of the distal portion of the limb with skeletal muscle tissue.

Adult↗

[TENS in the treatment of muscle spasm].

This study deals with 60 patients with muscle spasm after the lesion of upper motor neurone. Thirty patients were treated by battery operated TENS unit, which produce biphasic impulses, with possibility of individual determination of impulse duration (0.05-0.25 msec), frequency (2-100 Hz) and intensity (0-80 mA). The electrodes were put on the motor points of m. tibialis anterior and m. extensor digitorum. The parameters of stimulation where determined individually, using the impulses that elicit dorsal flexion of the ankle joint and fingers. In the control group, consisted of 30 patients, passive exercises were performed (increasing range of motion, stretching of the agonistic and antagonistic muscles). At the end of the research, the authors report statistically significant decrease of muscles spasm in patients treated by TENS (p < 0.05), as well as improvement of the passive range of motion in ankle joint in both groups. Reducing of the muscle spasm is more pronounced if longer period of stimulation is applied.

Adult↗

The effect of static stretch and warm-up exercise on hamstring length over the course of 24 hours.

STUDY DESIGN: Experimental pretest-posttest control design. OBJECTIVES: The purpose of the study was twofold: (1) to determine the lasting effect of static stretch on hamstring length for up to 24 hours and (2) to compare the efficacy of static stretch with and without warm-up exercise on hamstring length. BACKGROUND: Research is limited on the lasting effects of static stretching and is controversial on the combined effects of warm-up activities and static stretching on muscle lengthening. METHODS AND MEASURES: Fifty-six volunteer subjects (ages 18-42 years) with limited bilateral hamstring length were assigned to 1 of 4 groups: (1) warm-up and static stretch, (2) static stretch only, (3) warm-up only, and (4) control. The warm-up was 10 minutes of stair climbing at 70% of maximum heart rate. Static stretch consisted of a single session of three 30-second passive stretches of the hamstring. Hamstring length was measured preintervention and at several intervals postintervention (immediately and then at 15 minutes, 60 minutes, 4 hours, and 24 hours) using the active knee extension (AKE) test. Data were analyzed using a mixed-model analysis of variance. RESULTS: The warm-up-and-static-stretch group and the static-stretch-only group showed a significant increase in hamstring length between preintervention and all postintervention measurements. At 24 hours poststretch, the warm-up-and-static-stretch group had a mean increase of 10.3 degrees (95% confidence interval, 7.7-12.9) and the static-stretch-only group had a mean increase of 7.7 degrees (95% confidence interval, 4.7-10.7) in AKE range of motion (ROM). Both of these groups did show significant decrease (2.9 degrees and 4.0 degrees, respectively) in hamstring muscle length (AKE ROM) at 15 minutes poststretch when compared to immediate poststretch values. The static-stretch-only and the warm-up-and-static-stretch groups did not differ significantly from each other. Control and warm-up-only groups showed no significant increase in hamstring length between preintervention and any of the postintervention measurements. CONCLUSIONS: A significant increase in hamstring length can be maintained for up to 24 hours when using static stretching. Muscle length gains are greatest immediately after stretching and decline within 15 minutes. The addition of a warm-up exercise prior to stretching does not appear to significantly increase the effectiveness of static hamstring stretching.

Adolescent↗

Renal sympathetic and circulatory responses to activation of the exercise pressor reflex in rats.

We investigated the role played by the exercise pressor reflex in sympathetic regulation of the renal circulation in rats. In mid-collicular decerebrate rats, mean arterial pressure (MAP), heart rate (HR), left renal cortical blood flow (RCBF) and left renal sympathetic nerve activity (RSNA) were recorded before and during 30 s of static contraction of the left triceps surae muscles evoked by electrical stimulation of the tibial nerve, which activates both metabo- and mechanosensitive muscle afferents, and during 30 s of passive stretch of the left Achilles tendon, which selectively activates mechanosensitive muscle afferents. Static contraction (n = 17, +344 +/- 34 g developed tension) significantly (P < 0.05) increased MAP (+14 +/- 3 mmHg), HR (+6 +/- 1 beats min(-1)) and RSNA (n = 11, +19 +/- 5%) and significantly decreased renal cortical vascular conductance (RCVC, n = 11, -11 +/- 2%). Passive stretch (n = 20, +378 +/- 11 g) also significantly increased MAP (+11 +/- 2 mmHg), HR (+7 +/- 2 beats min(-1)) and RSNA (n = 15, +14 +/- 4%) and significantly decreased RCVC (n = 11, -12 +/- 3%). RCBF showed no significant changes during static contraction or passive stretch. Renal denervation abolished the decrease in RCVC during contraction (n = 12) or stretch (n = 13). These data indicate that both the exercise pressor reflex and its mechanically sensitive component, the muscle mechanoreflex, induced renal cortical vasoconstriction through sympathetic activation in rats.

Achilles Tendon↗