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PubMed2000

[N. thoracicus longus lesion--a rare injury in weight lifting].

The case of long thoracic mononeuropathy associated with sport participation a presented. The diagnosis was confirmed with electromyography. It is suggested that the athletic activity caused a stretch injury to the long thoracic nerve. Degenerative changes and infections were excluded. Conservative management, consisting of range of motion exercises for the shoulder and strengthening of the serratus anterior muscle, resulted in a forable outcome. The 12 month follow-up showed only slight changes in EMG and clinical examination.

Adult↗
PubMed1984

Strength recovery patterns following exercise with an imposed myotatic stretch.

An investigation was conducted to determine the effects of isometric exercise with an imposed myotatic stretch on the resultant pattern of strength recovery in trained and untrained subjects. Thirty 5-second maximal isometric contractions were administered to 12 trained and 12 untrained men with an intertrial interval of 10 seconds. On one day a 1-second stretch was delivered during each 5-second trial, while on another day, only isometric exercise was performed. Results showed that the pattern of strength recovery over the 10-minute recovery period was similar for both groups and both exercise conditions. However, during the first minute of the recovery period, the imposed stretch exercise resulted in a much faster rate of strength recovery than isometric exercise. It is concluded that the recovery of maximal isometric strength can be altered with the type of muscle contraction involved in the exercise task.

Adult↗
PubMed1997

Rib cage mechanics during quiet breathing and exercise in humans.

During exercise, large pleural, abdominal, and transdiaphragmatic pressure swings might produce substantial rib cage (RC) distortions. We used a three-compartment chest wall model (J. Appl. Physiol. 72: 1338-1347, 1992) to measure distortions of lung- and diaphragm-apposed RC compartments (RCp and RCa) along with pleural and abdominal pressures in five normal men. RCp and RCa volumes were calculated from three-dimensional locations of 86 markers on the chest wall, and the undistorted (relaxation) RC configuration was measured. Compliances of RCp and RCa measured during phrenic stimulation against a closed airway were 20 and 0%, respectively, of their values during relaxation. There was marked RC distortion. Thus nonuniform distribution of pressures distorts the RC and markedly stiffens it. However, during steady-state ergometer exercise at 0, 30, 50, and 70% of maximum workload, RC distortions were small because of a coordinated action of respiratory muscles, so that net pressures acting on RCp and RCa were nearly the same throughout the respiratory cycle. This maximizes RC compliance and minimizes the work of RC displacement. During quiet breathing, plots of RCa volume vs. abdominal pressure were to the right of the relaxation curve, indicating an expiratory action on RCa. We attribute this to passive stretching of abdominal muscles, which more than counterbalances the insertional component of transdiaphragmatic pressure.

Abdomen↗
PubMed2006

Acute effects of static stretching on maximal eccentric torque production in women.

The purpose of this study was to examine the acute effects of static stretching on peak torque (PT) and the joint angle at PT during maximal, voluntary, eccentric isokinetic muscle actions of the leg extensors at 60 and 180 degrees x s(-1) for the stretched and unstretched limbs in women. Thirteen women (mean age +/- SD = 20.8 +/- 0.8 yr; weight +/- SD = 63.3 +/- 9.5 kg; height +/- SD = 165.9 +/- 7.9 cm) volunteered to perform separate maximal, voluntary, eccentric isokinetic muscle actions of the leg extensors with the dominant and nondominant limbs on a Cybex 6000 dynamometer at 60 and 180 degrees x s(-1). PT (Nm) and the joint angle at PT (degrees) were recorded by the dynamometer software. Following the initial isokinetic assessments, the dominant leg extensors were stretched (mean stretching time +/- SD = 21.2 +/- 2.0 minutes) using 1 unassisted and 3 assisted static stretching exercises. After the stretching (4.3 +/- 1.4 minutes), the isokinetic assessments were repeated. The statistical analyses indicated no changes (p > 0.05) from pre- to poststretching for PT or the joint angle at PT. These results indicated that static stretching did not affect PT or the joint angle at PT of the leg extensors during maximal, voluntary, eccentric isokinetic muscle actions at 60 and 180 degrees x s(-1) in the stretched or unstretched limbs in women. In conjunction with previous studies, these findings suggested that static stretching may affect torque production during concentric, but not eccentric, muscle actions.

Adult↗
PubMed2004

Low-frequency depression of tension in the cat gastrocnemius muscle after eccentric exercise.

Subjecting a muscle to a series of eccentric contractions in which the contracting muscle is lengthened results in a number of changes in its mechanical properties. These include a fall in isometric tension that is particularly pronounced during low-frequency stimulation, a phenomenon known as low-frequency depression (LFD). Reports of LFD have not taken into account the shift in optimum length for active tension generation to longer muscle lengths that takes place after eccentric contractions. Given the length dependence of the stimulation frequency-tension curve, we tested the hypothesis that the change in this relationship after eccentric exercise is due to the shift in optimum length. We measured LFD by recording tension in response to a linearly increasing rate of stimulation of the nerve to medial gastrocnemius of anesthetized cats, over the range 0-100 pulses per second. Tension responses were measured before and after 50 eccentric contractions consisting of 6-mm stretches starting at 3 mm below optimum length and finishing at 3 mm above it. An index of LFD was derived from the tension responses to ramp stimulation. It was found that LFD after the eccentric contractions was partly, but not entirely, due to changes in the muscle's optimum length. An additional factor was the effect of fatigue. These observations led to the conclusion that the muscle length dependence of LFD was reduced by eccentric contractions. All of this means that after eccentric exercise the tension deficit at low rates of muscle activation is likely to be less severe than first thought.

Adaptation, Physiological↗
PubMed2005

Treatment of recalcitrant idiopathic muscular torticollis in infants with botulinum toxin type a.

Congenital muscular torticollis (CMT) is the most common form of torticollis in children, significantly outnumbering orthopedic, neurologic, and ocular causes. CMT may present as a palpable sternomastoid tumor (SMT) or a simple tightness of the sternocleidomastoid muscle (SCM), designated as idiopathic muscular torticollis (IMT). Muscular torticollis has been associated with positional plagiocephaly in neonates who slept in the supine position. We have had difficulty in treating some of these combined cases by traditional methods such as physiotherapy, stretching exercises, and molding helmets. In November 2000, we began injecting botulinum toxin type A in cases in which there was persistent IMT, despite significant physical therapy input. The 15 patients included in this retrospective study all presented with IMT and positional plagiocephaly; all had responded poorly to conservative treatment, including physiotherapy, stretching exercises, or use of a helmet. In the attempt to avoid progression to surgical release, these patients were treated with botulinum toxin injected into the affected SCM and subsequent additional physiotherapy. All appeared to respond well, and a retrospective analysis of this treatment strategy was undertaken. Information gathered included a questionnaire, skull-shape tracings, and photographs. Independent outcome assessment data were then obtained from the regional child development teams and community physiotherapists. These results show that 14 of 15 children with recalcitrant IMT and positional plagiocephaly treated with botulinum toxin obtained sufficient improvement in neck range of motion and head position as to make surgical release of the muscle unnecessary. Our conclusion is that the use of botulinum toxin is a safe and effective adjunct to physical therapy in treating recalcitrant IMT; in selected cases, it may obviate the need for surgical release of a tight but nonfibrotic SCM.

Botulinum Toxins, Type A↗
PubMedDate not supplied

Upper crossed syndrome and its relationship to cervicogenic headache.

OBJECTIVE: To discuss the management of upper crossed syndrome and cervicogenic headache with chiropractic care, myofascial release, and exercise. CLINICAL FEATURES: A 56-year-old male writer had been having constant 1-sided headaches radiating into the right eye twice weekly for the past 5 years. Tenderness to palpation was elicited from the occiput to T4 bilaterally. Trigger points were palpated in the pectoralis major, levator scapulae, upper trapezius, and supraspinatus muscles bilaterally. Range of motion in the cervical region was decreased in all ranges and was painful. Visual examination demonstrated severe forward translation of the head, rounded shoulders, and right cervical translation. INTERVENTION AND OUTCOME: The patient was adjusted using high-velocity, short-lever arm manipulation procedures (diversified technique) and was given interferential myofascial release and cryotherapy 3 times weekly for 2 weeks. He progressed to stretching and isometric exercise, McKenzie retraction exercises, and physioball for proprioception, among other therapies. The patient's initial headache lasted 4 days. He had a second headache for 1.5 days during his exercise training. During the next 7 months while returning to the clinic twice monthly for an elective chiropractic maintenance program, his headaches did not recur. He also had improvement on radiograph. CONCLUSION: The principles of upper crossed syndrome and the use of exercise, chiropractic care, and myofascial release in the treatment of cervicogenic headache are discussed. A review of the literature indicates that analyzing muscle imbalance as well as vertebral subluxation may increase the effectiveness of chiropractic treatment for cervicogenic headache.

Accidents, Traffic↗
PubMed2000

The painful shoulder in the swimming athlete.

Given the popularity of swimming and the high risk of injury associated with the sport, many clinicians come into contact with the swimmer's shoulder. This article describes the mechanism of injury, diagnostic tools, and subtle signs of injury for swimmer's shoulder. It focuses on conservative treatment for the injury, including methods for stretching and strengthening and eliminating acute inflammation.

Cumulative Trauma Disorders↗
PubMed1999

Effects of physical and sporting activities on balance control in elderly people.

OBJECTIVE: Balance disorders increase with aging and raise the risk of accidental falls in the elderly. It has been suggested that the practice of physical and sporting activities (PSA) efficiently counteracts these age related disorders, reducing the risk of falling significantly. METHODS: This study, principally based on a period during which the subjects were engaged in PSA, included 65 healthy subjects, aged over 60, who were living at home. Three series of posturographic tests (static, dynamic with a single and fast upward tilt, and dynamic with slow sinusoidal oscillations) analysing the centre of foot pressure displacements or electromyographic responses were conducted to determine the effects of PSA practice on balance control. RESULTS: The major variables of postural control were best in subjects who had always practised PSA (AA group). Those who did not take part in PSA at all (II group) had the worst postural performances, whatever the test. Subjects having lately begun PSA practice (IA group) had good postural performances, close to those of the AA group, whereas the subjects who had stopped the practice of PSA at an early age (AI group) did not perform as well. Overall, the postural control in the group studied decreased in the order AA > IA > AI > II. CONCLUSIONS: The period during which PSA are practised seems to be of major importance, having a positive bearing on postural control. It seems that recent periods of practice have greater beneficial effects on the subject's postural stability than PSA practice only at an early age. These data are compatible with the fact that PSA are extremely useful for elderly people even if it has not been a lifelong habit.

Accidental Falls↗
PubMed1994

Effect of vibratory stimulation training on maximal force and flexibility.

In this study, we investigated a new method of training for maximal strength and flexibility, which included exertion with superimposed vibration (vibratory stimulation, VS) on target muscles. Twenty-eight male athletes were divided into three groups, and trained three times a week for 3 weeks in one of the following conditions: (A) conventional exercises for strength of the arms and VS stretching exercises for the legs; (B) VS strength exercises for the arms and conventional stretching exercises for the legs; (C) irrelevant training (control group). The vibration was applied at 44 Hz while its amplitude was 3 mm. The effect of training was evaluated by means of isotonic maximal force, heel-to-heel length in the two-leg split across, and flex-and-reach test for body flexion. The VS strength training yielded an average increase in isotonic maximal strength of 49.8%, compared with an average gain of 16% with conventional training, while no gain was observed for the control group. The VS flexibility training resulted in an average gain in the legs split of 14.5 cm compared with 4.1 cm for the conventional training and 2 cm for the control groups, respectively. The ANOVA revealed significant pre-post training effects and an interaction between pre-post training and 'treatment' effects (P < 0.001) for the isotonic maximal force and both flexibility tests. It was concluded that superimposed vibrations applied for short periods allow for increased gains in maximal strength and flexibility.

Adult↗
PubMed2004

An acute bout of static stretching: effects on force and jumping performance.

INTRODUCTION/PURPOSE: The objectives of this study were to examine whether a static stretching (SS) routine decreased isometric force, muscle activation, and jump power while improving range of motion (ROM). Second, the study attempted to compare the duration of the dependent variable changes with the duration of the change in ROM. METHODS: Twelve participants were tested pre- and post- (POST, 30, 60, 90, and 120 min) SS of the quadriceps and plantar flexors (PF) or a similar period of no stretch (control). Measurements during isometric contractions included maximal voluntary force (MVC), evoked contractile properties (peak twitch and tetanus), surface integrated electromyographic (iEMG) activity of the agonist and antagonistic muscle groups, and muscle inactivation as measured by the interpolated twitch technique (ITT). Vertical jump (VJ) measurements included unilateral concentric-only (no countermovement) jump height as well as drop jump height and contact time. ROM associated with seated hip flexion, prone hip extension, and plantar flexion-dorsiflexion was also recorded. RESULTS: After SS, there were significant overall 9.5% and 5.4% decrements in the torque or force of the quadriceps for MVC and ITT, respectively. Force remained significantly decreased for 120 min (10.4%), paralleling significant percentage increases (6%) in sit and reach ROM (120 min). After SS, there were no significant changes in jump performance or PF measures. CONCLUSION: The parallel duration of changes in ROM and quadriceps isometric force might suggest an association between stretch-induced changes in muscle compliance and isometric force output.

Adult↗
PubMed2004

Effects of eccentric phase velocity of plyometric training on the vertical jump.

The aim of this study was to compare the effects of plyometric training performed with rapid or slow stretch contraction on jump performance and muscle properties. Thirty males between the ages of 19 and 22 volunteered for the 8-week experiment. Subjects were divided into the following three groups: training group 1 (TG1), training group 2 (TG2), and control group (CG). Each of the two experimental groups underwent a unique training regimen. For the first group (TG1, n = 12): from a standing position the subject flexed his knees to a 90 degrees angle with velocity standardized and controlled at 0.4 m/s and immediately performed a leg extension as quickly as possible. For the second group (TG2, n = 12): from a standing position, the subject flexed his knees to a 90 degrees angle with velocity standardized at 0.2 m/s and then performed a leg extension as quickly as possible. Each exercise consisted of six sets of ten repetitions with a barbell on the shoulders at 70 % of the maximal isometric force (1 RM). The 70 % load was modified at two-week intervals by evaluating a new 1 RM. Exercises were performed four times a week over the eight-week period. The third group (CG, n = 6), served as the control group. Maximal isometric force (MVC), maximal concentric force, squat jump (SJ) and counter movement jump (CMJ) exercises were performed before and after the training program. Subjects were filmed (100 Hz) and each jump was divided into three phases: eccentric phase (ECC), transition phase (TR) and concentric phase (CON). Surface EMG was used to determine the changes in the electromyographic (EMG) activity before and after the training program. There was an increase in leg extension force, velocity and electrical activity for SJ and CMJ for the two training groups (p < 0.05). However, TG1 showed a significant advantage in CMJ performance as well as a significant decrease in TR compared to the TG2 (p < 0.05). The results of this study show that when plyometric training is performed with rapid stretch contraction the CMJ jump height increases and the TR decreases.

Adult↗
PubMedDate not supplied

Tender points/fibromyalgia vs. trigger points/myofascial pain syndrome: a need for clarity in terminology and differential diagnosis.

OBJECTIVE: This study reviews the clinical distinctions between fibromyalgia (FM) and myofascial pain syndrome (MPS), which represent two separate and distinct soft-tissue syndromes. The major aim of this article is to clarify the terminology associated with these syndromes and clearly define the parameters of differential diagnosis and treatment. DATA SOURCES: Pertinent articles in the chiropractic and medical literature are reviewed with an emphasis on the literature published from 1985-1994. STUDY SELECTION: Studies were selected that emphasized differential diagnosis of FM and MPS, as well as individual articles on either FM or MPS. DATA SYNTHESIS: The literature on fibromyalgia and myofascial pain syndromes has grown considerably since 1985. It is now clear that there are several important differences between FM and MPS. The most important criteria for differential diagnosis are the presence of tender points (TePs) and widespread, nonspecific, soft tissue pain in FM, compared with regional and characteristic referred pain patterns with discrete muscular trigger points (TrPs) and taut bands of skeletal muscle in MPS. The etiology of TePs is still unknown and it is uncertain which specific soft tissues are tender in FM patients. Myofascial TrPs are found within a taut band of skeletal muscle and have a characteristic "nodular" texture upon palpation. TrPs are thought to develop after trauma, overuse or prolonged spasm of muscles. Local treatment applied to TePs is ineffective, yet specific treatment of TrPs is often dramatically effective. CONCLUSION: FM and MPS are two different clinical conditions that require different treatment plans. FM is a systemic disease process, apparently caused by dysfunction of the limbic system and/or neuroendocrine axis. It often requires a multidisciplinary treatment approach including psychotherapy, low dose antidepressant medication and a moderate exercise program. MPS is a condition that arises from the referred pain and muscle dysfunction caused by TrPs, which often respond to manual treatment methods such as ischemic compression and various specific stretching techniques. Both of these conditions are seen routinely in chiropractic offices; therefore, it is important for field practitioners to understand these distinctions.

Chiropractic↗
PubMed1977

Infantile Erb's palsy (Smellie's palsy).

Our experience with 32 infants seen with Erb's palsy, of whom 11 were followed as long as 18 years, suggests two management axioms. First, it is probably harmful to the infant to use airplane splints. Seocnd, passive stretching of the tight scapulohumeral adductors and passive normal range of motion exercises to shoulder and elbow will usually give a successful outcome in this obstetrical complication. Finally, even though the shoulder muscles regain their strenght, the "Erb engram" may remain as a mark of Erb's palsy.

Child↗
PubMed1989

Conservative treatment of patellofemoral subluxation.

As pointed out in the preface of this book, patellofemoral subluxation is probably the most common knee problem seen in many orthopedists' offices today. Whereas the other authors have emphasized the anatomy and diagnosis, this article should serve as a dry but basic instruction on the exercise program that has been used in our clinic. We have had a success rate with this program of approximately 80 per cent. Certainly not all of the 20 per cent that fail require surgery. The classic exercises are quadricep sets, straight leg raises, hip abductors, hip adductors, hip flexors, and hamstring stretches, which have endured the test of time. The prevention of flexion extension activity, such as running the stadium stairs in order to strengthen the quadriceps of the patient with patellofemoral subluxation should be emphasized. Complications of conservative treatment, such as low back pain, iliopsoas tendinitis, and muscle soreness and the treatment of these is described. Finally, the importance of stretching the hamstring muscles is a cornerstone in the treatment of patellofemoral problems. Likewise, a tight IT band can put abnormal stress on the lateral aspect of the patella. In this article I have tried to point out our approach to conservative treatment of patellofemoral subluxation.

Exercise Therapy↗
PubMed2006

Effects of hypoxia on muscle response to tendon vibration in humans.

Previous animal studies have shown that hypoxia markedly reduces the activation of muscle spindles. The present study was undertaken to determine whether a reduced oxygen supply to muscle affects the tonic vibration reflex (TVR) in humans. In resting healthy volunteers, the effects of inhalation of hypoxic gas, apnea, and total forearm ischemia produced by cuff inflation were studied on separate days. The TVR was recorded in flexor digitorum superficialis and the neuromuscular conduction time (CT) was measured from the compound muscle action potential; the latency and amplitude of the H reflex were also determined. TVR depression began during inhalation of the hypoxic gas, at the end of apnea, and during cuff inflation, and persisted during the recovery period. The H-reflex amplitude concomitantly increased or remained unchanged. Thus, hypoxia seems to directly alter muscle spindle reactivity. Such alterations of sensorimotor control may occur in patients suffering from respiratory or circulatory insufficiency and may contribute to their exercise limitation.

Apnea↗
PubMed2006

Feasibility, motivation, and selective motor control: virtual reality compared to conventional home exercise in children with cerebral palsy.

Children with cerebral palsy (CP) have difficulty controlling and coordinating voluntary muscle, which results in poor selective control of muscle activity. Children with spastic CP completed ankle selective motor control exercises using a virtual reality (VR) exercise system and conventional (Conv) exercises. Ankle movements were recorded with an electrogoniometer. Children and their parents were asked to comment on their interest in the exercise programs. Greater fun and enjoyment were expressed during the VR exercises. Children completed more repetitions of the Conv exercises, but the range of motion and hold time in the stretched position were greater during VR exercises. These data suggest that using VR to elicit or guide exercise may improve exercise compliance and enhance exercise effectiveness.

Adolescent↗