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At least 451 records · Page 25Linked to original sources
PubMed2004

Shoulder function and 3-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program.

BACKGROUND AND PURPOSE: Shoulder impingement syndrome is a common condition and is often managed with an exercise program. The purpose of this study was to examine an exercise program in patients with shoulder impingement syndrome. Specifically, the purpose was to identify changes that might occur in 3-dimensional scapular kinematics, physical impairments, and functional limitations. SUBJECTS: Fifty-nine patients with impingement syndrome were recruited, and 39 patients successfully completed the 6-week rehabilitation program and follow-up testing. Impingement was defined as having at least 3 of 6 predefined clinical signs or symptoms. METHODS: Subjects were assessed before and after a 6-week rehabilitation program and again at 6 months. Pain, satisfaction, and function were measured using the University of Pennsylvania Shoulder Scale. Range of motion, isometric muscle force, and 3-dimensional scapular kinematic data also were collected. Subjects were given a progressive exercise program that included resistive strengthening, stretching, and postural exercises that were done daily at home. Subjects also were given shoulder education related to anatomy, the basic mechanics of impingement, and strategies for reducing load on the shoulder. Each subject attended one physical therapy session per week for a 6-week period, primarily for monitoring and upgrading the exercise program. Pretest and posttest scores were compared using paired t tests and repeated-measures analysis of variance. RESULTS: Passive range of motion increased for both external and internal rotation but not for elevation. Abduction external and internal rotation force all increased. There were no differences in scapular kinematics. Improvements were found for pain, satisfaction, and shoulder function and for Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) scores related to physical function. At 6-month follow-up, improvements made in pain, satisfaction, and function were maintained. DISCUSSION AND CONCLUSION: The use of this exercise protocol in the management of shoulder impingement syndrome may have a positive impact on patients' impairments and functional limitations. Our findings suggest a relatively simple exercise program combined with patient education may be effective and, therefore, merits study in a larger trial using a control group. Changes in scapular kinematics did not appear to be a primary mechanism underlying improvement in symptoms and function.

Adult↗
PubMed1991

Back injury prevention program on a spinal cord injury unit.

A back injury prevention program was developed for the Spinal Cord Injury (SCI) nursing staff at the San Diego Veterans Affairs Medical Center (SDVAMC). This preventive program has the following components: 1. All nursing staff are sent to a one hour "back school" in order to learn and practice proper body mechanics. This program is held in the therapy clinic and conducted by a kinesiotherapist. In addition, each nurse must be certified in transfer techniques by our clinical nurse specialist, before performing transfers on patients. 2. All nursing staff participate in 5-10 minutes of stretching, warm-up exercises at the beginning of their shift. These exercises are helpful as injuries are less likely to occur when muscles have been warmed up prior to lifting and moving patients. 3. All nursing staff wear a lumbar sacral back support while on duty. This device will offer physical support to the lower back as well as provide a mental reminder to use proper body mechanics when transferring patients. This back injury prevention program has been in effect since the opening of the SCI unit in March 1989. The rate of low-back injuries on the SCI unit from October 1989 to September 1990 was compared to the rate of low-back injuries on the other hospital units. As a result of this program, there were only four low-back injuries with six lost work days on the SCI unit. This rate compares favorably with the incidence of low-back injuries in other patient care areas.

Back Pain↗
PubMed1979

Serial isometric contractions under imposed myotatic stretch conditions in high-strength and low-strength men.

The immediate effects of an imposed myotatic stretch on knee extensor force were studied in 12 high-strength and 12 low-strength men. Under nonfatigued pre-exercise conditions, significant tension increases of 6.5% for the high-strength group and 11.0% for low-strength subjects were observed as a result of the imposed stretch. An exercise treatment involving 28 serial isometic contractions, each of 5 s duration, with an intertrial rest period of 10 s was administered. This fatiguing exercise resulted in significant decrements in strength on the order of 28.0% and 18.5% for the high-strength and low-strength groups, respectively. A Similar treatment which included a 1 s imposed myotatic stretch during each trial resulted in a greater strength decrement for the low-strength group (26.4%) than for the high-strength subjects (15.0%). A neural factor involving the stretch reflex is tentatively suggested as a plausible explanation accounting for the observation that high-strength subjects fatigue faster than low-strength subjects under conditions of isometric exercise, while low-strength subjects fatigue faster than high-strength individuals in isometric exercise which is performed with an imposed stretch.

Adult↗
PubMed2000

Tension changes in the cat soleus muscle following slow stretch or shortening of the contracting muscle.

1. The permanent extra tension after a stretch and the deficit of tension after a shortening in the soleus muscle of the anaesthetised cat were measured using distributed nerve stimulation across five channels. At low rates of stimulation the optimum length for a contraction was several millimetres longer than that when higher rates of stimulation were used, so that movements applied over the same length range could be on the descending limb of the full activation curve but on the ascending limb of the submaximal activation curve. 2. The extra tension after stretch and the depression after shortening were present only near the peak and on the descending limb of the length-tension curve. Effects on final tension of changing the speed and amplitude of stretches or shortenings were found to be small. 3. Statistical analysis showed that variations in the tension excess or deficit due to changing stimulus rate could be entirely attributed to the effect of stimulus rate on the length-tension relation, as when length was expressed relative to optimum for each rate, stimulus rate was no longer a significant determinant of the tension excess or deficit. 4. The extra tension after stretch and the depression after shortening disappeared if stimulation was interrupted and tension briefly fell to zero. 5. These effects were explained in terms of a non-uniform distribution of sarcomere length changes at long muscle lengths. During stretch some sarcomeres are stretched to beyond overlap while others lengthen hardly at all. During shortening some sarcomeres shorten much further than others. 6. These mechanisms have important implications for exercise physiology and sports medicine.

Analysis of Variance↗
PubMed2003

Modulation of physiological angiogenesis in skeletal muscle by mechanical forces: involvement of VEGF and metalloproteinases.

Growth factors are involved in physiological angiogenesis in female reproductive organs but their role in capillary growth in skeletal muscles during activity or exercise training is not proven. Evidence suggests that increases in muscle blood flow and accompanying capillary shear stress and/or wall tension, or mechanical stress due to sarcomere length changes during contraction/relaxation cycles are closely linked with angiogenesis. Time-dependent studies of rat muscles in models with increased shear stress (chronic vasodilator treatment with alpha(1) antagonist prazosin), altered sarcomere length (stretch-induced overload with no increase in blood flow), or both (chronic electrical muscle stimulation) showed a similar increase in capillary supply in all models but by different modes of growth. With prazosin, it occurred by intra-luminal splitting of vessels, with stretch by abluminal sprouting, and in stimulated muscles by both methods. Whole muscle matrix metalloproteinase-2 (MMP-2) was elevated during sprouting growth induced by extravascular tensile forces but not during splitting growth induced by shear. Vascular endothelial growth factor (VEGF) protein was elevated at capillary sites in all three models but with different time courses. With shear as the stimulus, the increase occurred early although there was little capillary proliferation; it matched the rise in proliferation in stretched muscles but lagged behind proliferation in stimulated muscles. Mechanical forces therefore influence MMP and VEGF expression and capillary growth patterns in skeletal muscle differentially depending upon whether they act intra- or ab-luminally. In exercise-trained muscles, the type of capillary growth remains to be determined but the most likely stimuli for angiogenesis are increased blood flow and shear forces to vessel supplying the active fibres, probably linked with metabolic factors.

Animals↗
PubMed1996

Effect of passive stretching and jogging on the series elastic muscle stiffness and range of motion of the ankle joint.

OBJECTIVE: To determine the effect of stretching and jogging on the series elastic muscle stiffness of the plantar flexors and on the range of dorsiflexion at the ankle joint. METHODS: 24 healthy subjects participated in this study. Each subject undertook all of the following protocols, in random order: (1) stretching protocol: five 30 s static stretches with 30 s rest between stretches; (2) aerobic jogging protocol: subjects ran on a treadmill for 10 min at 60% of their maximum age predicted heart rate; (3) combined protocol: subjects ran first and then stretched. A damped oscillation technique was used to measure the series elastic stiffness of the plantar flexors. Dorsiflexion of the ankle was assessed with a weights and pulley system that moved the ankle joint from a neutral position into dorsiflexion passively. Electromyography was used to monitor the activity of the plantar and dorsiflexors during these procedures. The statistical analysis of these data involved an analysis of covariance. RESULTS: For decreasing series elastic muscle stiffness running was more effective than stretching (P < 0.05). In contrast, the results for range of motion showed that the combination protocol and the stretching only protocol were more effective than the running only protocol (P < 0.05) for increasing dorsiflexion range of motion at the ankle. CONCLUSIONS: Both jogging and static stretching exercises appear to be beneficial to individuals participating in sporting activities.

Ankle Injuries↗
PubMed1993

Postsurgical temporomandibular joint hypomobility. Rehabilitation technique.

Specific techniques to treat temboromandibular joint (TMJ) hypomobility caused by capsular restriction are explained. Initially inflammation must be controlled. TMJ manipulation by condylar distraction during opening, protrusion, and lateral movements, and a simple stretching exercise to maintain increased mandibular range of motion, are described. Resistive opening and closing exercises at full opening to relax the lateral pterygoid muscles are prescribed. For all exercises five repetitions, repeated five times per day, are prescribed. These techniques are demonstrated in the successful treatment of a child with a presurgically and postsurgically hypomobile right TMJ.

Child↗
PubMed2006

Influences of tendon stiffness, joint stiffness, and electromyographic activity on jump performances using single joint.

The present study aimed to examine the influences of tendon stiffness, joint stiffness, and electromyographic activity on jump performances consisting of a single-joint movement. Twenty-four men performed three kinds of unilateral maximal jump using only the ankle joint (squat jump: SJ; countermovement jump: CMJ; drop jump: DJ) on the sledge apparatus. The relative differences in the jump height of CMJ and DJ compared to SJ were defined as pre-stretch augmentation. During jumping exercises, electromyographic activities (mEMG) were recorded from the plantar flexors. Ankle joint stiffness was calculated as the change in the joint torque divided by the change in ankle joint angle during the eccentric phase of DJ. Achilles tendon stiffness was measured using ultrasonography during isometric plantar flexion. No significant correlations were found between joint stiffness and pre-stretch augmentation in both CMJ and DJ. On the contrary, tendon stiffness was significantly correlated with pre-stretch augmentation in both CMJ (r = -0.471) and DJ (r = -0.502). The relative mEMG value of CMJ (to that of SJ) during the concentric phase was significantly correlated with pre-stretch augmentation (r = 0.481), although this relationship was not found in DJ. These results suggested that (1) the greater jump height in CMJ could be explained by both the tendon elasticity and the increased activation level of muscle, (2) tendon elasticity played a more significant role in the enhancement of jump height during DJ, and (3) joint stiffness was not related to either pre-stretch augmentation or tendon stiffness.

Achilles Tendon↗
PubMed2005

The effects of hamstring stretching on range of motion: a systematic literature review.

STUDY DESIGN: Systematic literature review. OBJECTIVE: Investigate the literature regarding the most effective positions, techniques, and durations of stretching to improve hamstring muscle flexibility. BACKGROUND: Hamstring stretching is popular among physical therapists, athletic trainers, and fitness/coaching professionals; however, numerous stretching methodologies have been proposed in the literature. This fact establishes a need to systematically summarize available evidence in an attempt to determine the most effective stretching approach. METHODS: A list of 28 pertinent manuscripts that included randomized and clinical trials was created according to specific inclusion/exclusion criteria. These manuscripts were critically reviewed for quality according to the Physiotherapy Evidence Database (PEDro) (10-point) scale and descriptive information about the stretching parameters employed in the research. RESULTS: Cumulatively, 1338 healthy subjects were included in the reviewed studies. Methodological quality scores ranged from 2 to 8 (mean +/- SD, 4.3 +/- 1.6). Several methodological flaws were frequently recognized, including failure to conceal group allocation or perform blinded assessment. All studies reported improvements in range of motion after stretching. CONCLUSIONS: Overall, methodological quality was poor, with only 21.4% (6/28) of studies achieving a score between 6 and 8. Thus it was difficult to confidently identify 1 most effective hamstring stretching method. Instead, the evidence appears to indicate that hamstring stretching increases range of motion with a variety of stretching techniques, positions, and durations.

Exercise↗
PubMed2004

[Delayed post effort muscle soreness].

Muscle intolerance to exercise may result from different processes. Diagnosis involves confirming first the source of pain, then potential pathological myalgia. Delayed-onset muscle soreness (DOMS), commonly referred as tiredness, occurs frequently in sport. DOMS usually develops 12-48 h after intensive and/or unusual eccentric muscle action. Symptoms usually involve the quadriceps muscle group but may also affect the hamstring and triceps surae groups. The muscles are sensitive to palpation, contraction and passive stretch. Acidosis, muscle spasm and microlesions in both connective and muscle tissues may explain the symptoms. However, inflammation appears to be the most common explanation. Interestingly, there is strong evidence that the progression of the exercise-induced muscle injury proceeds no further in the absence of inflammation. Even though unpleasant, DOMS should not be considered as an indicator of muscle damage but, rather, a sign of the regenerative process, which is well known to contribute to the increased muscle mass. DOMS can be associated with decreased proprioception and range of motion, as well as maximal force and activation. DOMS disappears 2-10 days before complete functional recovery. This painless period is ripe for additional joint injuries. Similarly, if some treatments are well known to attenuate DOMS, none has been demonstrated to accelerate either structural or functional recovery. In terms of the role of the inflammatory process, these treatments might even delay overall recovery.

Exercise↗
PubMed2002

Delayed-onset muscle soreness does not reflect the magnitude of eccentric exercise-induced muscle damage.

This study investigated the relationship between delayed-onset muscle soreness and other indicators of muscle damage following eccentric exercise. Male students (n = 110) performed 12 (12ECC), 24 (24ECC), or 60 maximal eccentric actions of the elbow flexors (60ECC). Maximal isometric force, relaxed and flexed elbow joint angles, upper arm circumference, and plasma creatine kinase activity were assessed immediately before and after, and for 4 days after exercise. Muscle soreness (SOR) was evaluated by a visual analog scale (a 50-mm line, 0: no pain, 50: extremely painful) when the elbow flexors were palpated (SOR-Pal), flexed (SOR-Flx) and stretched (SOR-Ext). Although 24ECC and 60ECC resulted in significantly (P <; 0.05) larger changes in all indicators and slower recovery compared to 12ECC, no significant differences were evident for SOR-Pal and SOR-Flx between 12ECC and 24ECC, or 12ECC and 60ECC. In contrast, SOR-Ext was significantly (P <; 0.05) lower for 12ECC compared to 24ECC and 60ECC. A Pearson product-moment correlation showed SOR-Pal did not correlate significantly with any indicators, however, SOR-Ext and SOR-Flx showed weak (r <; 0.32) but significant (P <; 0.05) correlations with other indicators. Because of generally poor correlations between DOMS and other indicators, we conclude that use of DOMS is a poor reflector of eccentric exercise-induced muscle damage and inflammation, and changes in indirect markers of muscle damage and inflammation are not necessarily accompanied with DOMS.

Adult↗
PubMed1981

Electromyographic activity of back musculature during Williams' flexion exercises.

The purpose of this investigation was to determine the pattern and magnitude of electromyographic activity recorded from paraspinal musculature at four different vertebral levels while subjects performed six Williams' flexion exercises with anterior and posterior pelvic tilt. Bipolar surface electrodes were placed on the right sides, at C5, T6, L3, and S1, of eight men and eight women. Integrated electromyographic activity was analyzed at the end of range of each exercise. A significant (P less than .05) interaction effect was found between exercises and types of tilt at each vertebral level. The difference in electromyographic activity between the two pelvic positions was most evident in the lumbar and sacral areas, where electromyographic activity recorded for anterior tilt was greater than for posterior tilt. The results support the following conclusions: 1) pelvic tilt, curl up, knees to chest, and hamstring stretch performed with posterior tilt minimize the electromyographic activity in the lumbar and sacral regions that occurs in conjunction with lengthening of these muscles during posterior pelvic tilt, 2) use of the standing exercises and anterior tilt positions should be avoided if minimizing electromyographic activity in the lumbar and sacral regions is desired, and 3) the electromyographic activity of each of the four different vertebral levels responded independently of every other level during performance of Williams' flexion exercises.

Adult↗
PubMed1999

Equine back rehabilitation.

This article introduces the importance of considering all related physical findings, evaluating the whole horse and determining the root cause in order to achieve the best treatment results, prevent recurrence, and return the patient to full function. The roles of shoeing, turnout, teeth, training aids and devices, compensatory lameness, working surface (footing), longing, ponying, hot walkers, and swimming are discussed in relationship to back dysfunction and rehabilitation. Postural analysis and measures for muscle and postural corrections are also presented. Ground and under saddle rehabilitative exercises are explained as to value, concept, and methodology. Rehabilitative modalities including stretching, massage, magnetic therapy, heat, and cold are explored as adjunctive therapy.

Animals↗
PubMed2004

Pulmonary rehabilitation: an integral part of the long-term management of COPD.

Pulmonary rehabilitation comprises a variety of interventions grouped into three main categories: exercise training, education, and psychological support. Typically, patients participate in a programme of exercise rehabilitation 2-3 times a week for 6-12 weeks, at the same time being encouraged to incorporate breathing and stretching exercises as part of their daily routine. The physiological rationale for pulmonary rehabilitation in COPD is primarily based on its effect on peripheral muscle dysfunction. A recent meta-analysis demonstrated that pulmonary rehabilitation is effective in reducing dyspnoea and fatigue as well as improving patients' sense of control (mastery) over their condition. Without compliance with a maintenance programme these improvements will diminish with time. The value of various components of rehabilitation, programme length, the required degree of supervision, the intensity of training and the best approach to maintaining programme adherence represent issues that remain to be explored.

Breathing Exercises↗
PubMed1992

Long thoracic neuropathy from athletic activity.

Four cases of long thoracic mononeuropathy associated with sports participation are presented. Each patient developed shoulder pain or dysfunction after an acute event or vigorous activity, and demonstrated scapular winging consistent with serratus anterior weakness. The diagnosis was confirmed with electromyography in each case. It is suggested that the athletic activity caused a stretch injury to the long thoracic nerve. Conservative management, consisting of range of motion exercises for the shoulder and strengthening of the serratus anterior muscle, resulted in a favorable outcome in all patients.

Adolescent↗
PubMed1989

Energy cost of level walking.

Devices and methods have been developed for determining speed and oxygen cost of level walking. Speed was recorded and controlled using a speedometer cart. Oxygen uptake was determined with an argon-dilution method using a mixing box mounted on a backpack. The method was found valid, coefficient of variation (cv) less than 2.1%, and to give excellent reproducibility with regard to self-selected speed, cv less than 1.9%, predetermined speed, cv less than 1.3%, and to oxygen cost, cv less than 3.2%. Artificially arranged immobility of the knee or instability of the ankle decreased comfortable walking speed 23% and 4% respectively. Oxygen cost increased 23% and 10% respectively. Stabilizing splints allowing some flexion could if possible be advocated, particularly with elderly patients. Patients with coxarthrosis were studied before and after THA. One year after surgery the Harris hip score had increased from 35 to 85 points and maximal walking speed from 62 to 80 m min-1 Oxygen cost had decreased from 0.267 to 0.221 ml kg-1m-1. The onset of and the recovery from complications, as well as differences between patients with uni- and bilateral diseases, were reflected in change in oxygen cost but not in clinical scoring. Patients with moderate gonarthrosis were studied before and after unicompartmental knee prosthetic replacement. No major benefit of preoperative physical therapy, mainly aiming to improve thigh muscle strength, was observed three months after surgery. One year after surgery the patients had improved in clinical score rating and recovered an almost normal walking ability. Measurements of pain and self-selected walking speed were found to be sufficient for assessing effects of treatment in these patients. Patients with severe gonarthrosis had improved in clinical score rating one year after TKR. Oxygen cost of walking was unchanged. An acquired uneconomic walking pattern was considered to be the reason for unimproved walking efficiency. Patients with spastic paraparesis were treated with long-term stretch of the hip adductor muscles. Either the oxygen cost or the blood lactate level was decreased during walking, indicating that even during moderate exercise blood lactate must be taken into consideration when energy cost is measured in these patients. Measurements of walking speed and oxygen cost of level walking were found to be useful objective parametres for assessing walking and to be a valuable supplement to clinical assessment of effects of treatment in patients with walking disorders.

Adult↗
PubMed1988

The cause of leg cramps and knee pains: an hypothesis and effective treatment.

Cramps and pains of the lower extremities along with stiffness and pains in the knees are common complaints in the general population. Because the etiology and development of these disorders are poorly understood, treatment has been haphazard, for the most part unsuccessful, and occasionally dangerous. The diagnosis of "arthritis" is often incorrect; when osteoarthritis is present it is frequently not the cause of the pain. We name these maladies the "stiff leg syndrome" and hypothesise that they are caused by muscle and tendon shortening which came about as a direct result of modern civilization; the popular practice of squatting close to the ground to defecate, cook and eat was replaced by a more "civilized" practice of sitting high on toilets and chairs. We discuss several simple stretching exercises which mimic the effects of squatting and frequently result in immediate and dramatic relief of symptoms.

Aged↗