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PubMed2003

The effect of stretching during warming-up on the flexibility of junior handball players.

AIM: The purpose of the investigation was to examine in field conditions the acute effects of warming-up on lower extremity joints and trunk flexibility in junior team handball players. METHODS: Forty-seven junior team handball players participated in this study forming an experiment (n=32) and a control group (n=15). The first group performed warming-up and stretching exercises (20 min) whereas the second group only performed warming-up exercises. Passive range of joint motion was determined in hip flexion, hip extension, hip abduction, knee flexion, ankle dorsiflexion and the trunk flexion using a goniometer and a flexometer. RESULTS: The warming-up session induced a significantly increased range in all lower extremity joints and trunk flexion (p<0.01 to p<0.001) of both groups. CONCLUSION: Flexibility improves as a result of muscle elongation during warming-up or even through an incorporated pathetic stretching program.

Adolescent↗
PubMed2004

A randomised controlled trial on the efficacy of hydroelectrophoresis in acute recurrences in chronic low back pain patients.

AIM: Physical therapy efficacy in the treatment of low back pain (LBP) has been widely debated and is far from achieving high levels of evidence. Hydroelectrophoresis (Hydrofor) is a novel method of driving drugs through the dermal tissue, which has been proposed for muscle pain treatment. Aim of this randomised placebo-controlled study was to ascertain the efficacy of Hydrofor treatment on acute relapsing episodes of pain in chronic LBP subjects. METHODS: Eighteen under-50 adults (M/F: 7/11; age 35+/-8 years) suffering from chronic LBP were enrolled within 3 to 4 days of back pain relapse. After a complete clinical and functional assessment patients were randomly divided into 2 equal groups. Group A received 3 Hydrofor applications of a mixture containing both NSAIDs and muscle relaxants, whereas Group B received 3 Hydrofor applications of a drug-free solution. Afterwards, both groups performed the same rehabilitation treatment consisting of 7 group sessions of standard physiotherapy, including stretching, range of motion and extension exercises. The Oswestry disability index (ODI), the Million instrument scale and a visual analogue scale (VAS) were chosen as outcome measures and applied at baseline, after Hydrofor/placebo applications, after completion of rehabilitation sessions and, at last, 2 months later. The two-way Friedman test was used to analyse within-group (time effect) and between-group (time x group effect) differences. RESULTS: All subjects declared a significant pain reduction since the first Hydrofor application. Pain evolution overlapped in the 2 groups until the 3rd session, after which Group A significantly diverged from Group B, as they affirmed a greater symptom reduction than controls (time x group effect: VAS: F = 7.4, p <0.01). Such difference disappeared after the physiotherapy sessions as well as 2 months later (time x group effect: VAS: F = 2.1, p =0.08). Pain-related disability showed a greater reduction in Group A than B immediately after Hydrofor application (time x group effect: ODI: F=3.9 p <0.05; Million: F=4.1 p<0.05), but the mean scores almost overlapped at the 2 month follow-up (time x group effect: ODI: F=2.3 p =0.08; Million: F=1.3 p=0.26). CONCLUSIONS: Hydrofor treatment relieves relapsing LBP and could be recommended to active adults as a safe technique shortening the time needed to achieve functional restoration.

Journal Article↗
PubMed1988

Short-term effect of two therapeutic methods on myofascial pain and dysfunction of the masticatory system.

In conclusion, a short-term intervention with IS therapy was found to result in a substantial decrease in facial pain for most of the subjects treated. Generally, groups were not found to be significantly different in respect to palpation pain change from session 1 to session 2. Neither therapy significantly altered the range of mouth opening. EMG findings were variable but suggest that RI therapy may alter muscle myoelectric activity. From these findings, ice and stretch of the masticatory and neck musculature would appear to be a good short-term adjunctive therapy to control pain with little apparent risk of negative effects.

Adult↗
PubMed1960

A new biological method for the assay of depolarizing substances using the isolated semispinalis muscle of the chick.

The isolated semispinalis cervicis muscle of a 3 to 10 days old chick has been found to provide a very useful assay method for depolarizing substances. There are three main advantages of this preparation over that of the rectus abdominis of the frog: (a) quick relaxation without any artificial stretching of the muscle, (b) greater sensitivity to depolarizing drugs, and (c) no falling off in sensitivity for at least 2 hr.

Animals↗
PubMed1988

Acute somatic pain can refer to sites of chronic abdominal pain.

We report a case of a latissimus dorsi muscle strain that presented as a recurrence of chronic abdominal pain. One explanation of the referral of acute pain to a site of chronic pain is the convergence-projection theory, which hypothesizes that pain signals of visceral and somatic origin converge at some point in the sensory pathway. Upon reaching the cortex, these signals are interpreted as coming from the afferents which have previously excited this pathway. In this case an extensive gastrointestinal diagnostic evaluation was pursued unsuccessfully before the latissimus dorsi muscle strain was diagnosed. Outpatient therapy of spray and stretch combined with a home stretching program produced a prompt and persistent resolution of the symptoms.

Abdomen↗
PubMed2004

Responses of muscle spindles following a series of eccentric contractions.

To investigate the effects of eccentric exercise on the signalling properties of muscle spindles, experiments were done using the medial gastrocnemius muscle of cats anaesthetised with 40 mg/kg sodium pentobarbitone, i.p. Responses were recorded from single afferent nerve fibres in filaments of dorsal root during slow stretch of the passive muscle and during intrafusal contractions at a range of lengths, before and after a series of eccentric contractions. The sensitivity to slow stretch was measured as the average firing rate between muscle lengths 10.5 and 9.5 mm shorter than the physiological maximum (Lm), during stretch at 1 mm/s over the whole physiological range. The mean sensitivity of both primary and secondary spindle endings increased slightly, but not significantly, after a series of 20-150 eccentric contractions consisting of a 6 mm stretch, at 50 mm/s, to a final length of between Lm -7 mm and Lm, during stimulation of the whole muscle or sometimes of single fusimotor fibres. Discharges were recorded from primary endings during fusimotor stimulation at 100-150 pulses/s, and from secondary endings during static bag intrafusal contractures produced by i.v. injection of 0.2 mg/kg succinyl choline. Spindle responses were recorded, over a range of muscle lengths, in steps covering the whole physiological range. About half of the responses showed a peak in the relation between length and net increase in firing rate, while the remainder either progressively increased or progressively decreased over the physiological range. No large or consistent changes were seen after the eccentric contractions. It is concluded that the intrafusal fibres of muscle spindles are not prone to damage of the kind seen in extrafusal fibres after a series of eccentric contractions.

Action Potentials↗
PubMed1995

The effects of therapeutic application of heat or cold followed by static stretch on hamstring muscle length.

Hamstring stretching is an important part of treatment programs aimed at decreasing the likelihood of hamstring injury. Few studies have examined the use of superficial thermal modalities in conjunction with hamstring stretching. The purpose of this study was to determine if the application of a superficial heating or cooling modality, followed by static stretch, increased the efficacy of static stretching of the hamstring muscles. This study examined 12 male and 12 female subjects, ages 18-38. All subjects received each of the following treatments: heat followed by static stretch, cold followed by static stretch, and static stretch alone. Each treatment was separated by at least 1 week. Pre- and post-treatment measurements of hamstring length were obtained using the Active-Knee-Extension (AKE) test. The data were analyzed via a 2 x 3 analysis of variance experimental design. Results indicated that there was an increase in hamstring length regardless of stretch treatment used, with F(1,23) = 35.49, p < .001. However, no significant differences were detected among stretch treatments, F < 1.0, nor among interaction effects, F < 1.0. The results of this study suggest that adequate hamstring stretching can occur without the use of a superficial thermal modality.

Adolescent↗
PubMed2001

Maximal and submaximal forces of slow fibers in human soleus after bed rest.

The effects of 2 and 4 mo of bed rest, with or without exercise countermeasures, on the contractile properties of slow fibers in the human soleus muscle were examined. Mean fiber diameters were 8 and 36% smaller after 2 and 4 mo of bed rest, respectively, than the pre-bed rest level. Maximum tetanic force (P(o)), maximum activated force (F(max)) per cross-sectional area (CSA), and the common-logarithm value of free Ca(2+) concentration required for half-maximal activation (pCa(50)) also decreased after 2 and 4 mo of bed rest. In contrast, maximum unloaded shortening velocity (V(o)) was increased after 2 and 4 mo of bed rest. After 1 mo of recovery, fiber diameters, P(o), F(max) per CSA (P > 0.05), and pCa(50) were increased and V(o) decreased toward pre-bed rest levels. Effects of knee extension/flexion exercise by wearing an anti-G Penguin suit for 10 h daily, and the effects of loading or unloading of the plantar flexors with (Penguin-1) or without (Penguin-2) placing the elastic loading elements of the suit, respectively, were investigated during ~2 mo of bed rest. In the Penguin-1 group, mean fiber diameter, P(o), F(max) per CSA, V(o), and pCa(50) were similar before and after bed rest. However, the responses of fiber size and contractile properties to bed rest were not prevented in the Penguin-2 group, although the degree of the changes was less than those induced by bed rest without any countermeasure. These results indicate that long-term bed rest results in reductions of fiber size, force-generation capacity, and Ca(2+) sensitivity, and enhancement of shortening velocity in slow fibers of the soleus. The data indicate that continuous mechanical loading on muscle, such as stretching of muscle, is an effective countermeasure for the prevention of muscular adaptations to gravitational unloading.

Adult↗
PubMed1995

Pseudotumor of infancy and congenital muscular torticollis.

Pseudotumor of infancy presents as a discrete, firm mass in the distal sternocleidomastoid muscle in infants two to four weeks of age. Congenital muscular torticollis may develop from the resultant fibrosis in 10 to 20 percent of cases. Hip dysplasia is an associated feature of congenital muscular torticollis in approximately 10 percent of cases. Pseudotumor of infancy must be differentiated from other causes of cervical soft tissue masses. Diagnostic choices include fine-needle aspiration biopsy, cervical radiography, ultrasonography, computed tomographic scanning of the head and neck, and magnetic resonance imaging. Left untreated, congenital muscular torticollis may lead to significant craniofacial asymmetry and scoliosis. Heat, massage and passive stretching exercises are the preferred initial treatments for pseudotumor and torticollis. More than 70 percent of patients will respond to this approach. Surgery should be reserved for treatment of cases that persist past the first year of life.

Diagnosis, Differential↗
PubMed1988

Light resistance and stretching exercise in elderly women: effect upon strength.

Forty-seven elderly women (63 to 88 years of age, mean = 71 years) were studied to determine the effect of a 25-week light resistance and aerobic exercise program upon arm and leg strength. Three groups were formed: nonexercising controls (C, n = 12), exercise (EN, n = 18) and exercise with light weights on on the wrists and ankles (EW, n = 17). Exercise was performed for one hour, three times/week. Subjects were pretested and posttested for maximal isokinetic muscle strength (angular velocity 60 degrees/sec) for elbow flexion and extension, shoulder internal and external rotation, and knee flexion and extension. Dunn planned contrasts were used to compare C vs exercise groups combined (EN + EW) and EN vs EW. No significant differences were found among groups at baseline. EN + EW improved significantly (p less than 0.05) more than C in elbow extension (17%), shoulder internal rotation (14%), shoulder external rotation (9%), and knee flexion (20%). No significant differences were found between EN and EW. These data indicate that elderly women can achieve substantial gains in the strength of arm and leg musculature as a result of regular light resistance and aerobic exercise, but that the use of light weights on the wrists and ankles for added resistance did not enhance this effect.

Aged↗
PubMed2004

A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains.

STUDY DESIGN: Prospective randomized comparison of 2 rehabilitation programs. OBJECTIVES: The objectives of this study were to compare the effectiveness of 2 rehabilitation programs for acute hamstring strain by evaluating time needed to return to sports and reinjury rate during the first 2 weeks and the first year after return to sport. A third objective was to investigate the relationship between functional testing performance and time to return to sports and reinjury rates after return to sport. BACKGROUND: Hamstring muscle strains are common in sports and often result in chronic pain, recurrent hamstring strains, and reduced sports performance. Current rehabilitation programs are primarily developed anecdotally and lack support from prospective, randomized research. METHODS AND MEASURES: Twenty-four athletes with an acute hamstring strain were randomly assigned to 1 of 2 rehabilitation groups. Eleven athletes were assigned to a protocol consisting of static stretching, isolated progressive hamstring resistance exercise, and icing (STST group). Thirteen athletes were assigned to a program consisting of progressive agility and trunk stabilization exercises and icing (PATS group). The number of days for full return to sports, injury recurrence within the first 2 weeks, injury recurrence within the first year of returning to sports, and lower-extremity functional evaluations were collected for all subjects and compared between groups. RESULTS: The average (+/- SD) time required to return to sports for athletes in the STST group was 37.4 +/- 27.6 days, while the average time for athletes in the PATS group was 22.2 +/- 8.3 days. This difference was not statistically significant (P = .2455). In the first 2 weeks after return to sports, reinjury rate was significantly greater (P = .00343, Fisher's exact test) in the STST group, where 6 of 11 athletes (54.5%) suffered a recurrent hamstring strain after completing the stretching and strengthening program, as compared to none of the 13 athletes (0%) in the PATS group. After 1 year of return to sports, reinjury rate was significantly greater (P = .0059, Fisher's exact test) in the STST group. Seven of 10 athletes (70%) who completed the hamstring stretching and strengthening program, as compared to only 1 of the 13 athletes (7.7%) who completed the progressive agility and trunk stabilization program, suffered a recurrent hamstring strain during that 1-year period. CONCLUSIONS: A rehabilitation program consisting of progressive agility and trunk stabilization exercises is more effective than a program emphasizing isolated hamstring stretching and strengthening in promoting return to sports and preventing injury recurrence in athletes suffering an acute hamstring strain. Future randomized clinical trials should investigate the potential for progressive agility and trunk stabilization programs in the prevention of hamstring strain injury during sports.

Acute Disease↗
PubMed2004

Does stretching improve performance? A systematic and critical review of the literature.

OBJECTIVE: The purpose of this article was to evaluate the clinical and basic science evidence surrounding the hypothesis that stretching improves performance. DATA SOURCES AND SELECTION: MEDLINE and Sport Discus were searched using MeSH and textwords for English-language and French-language articles related to stretching and performance (or performance tests). Additional references were reviewed from the bibliographies and from citation searches on key articles. All articles related to stretching and performance (or performance tests) were reviewed. MAIN RESULTS: Of the 23 articles examining the effects of an acute bout of stretching, 22 articles suggested that there was no benefit for the outcomes isometric force, isokinetic torque, or jumping height. There was 1 article that suggested improved running economy. Of 4 articles examining running speed, 1 suggested that stretching was beneficial, 1 suggested that it was detrimental, and 2 had equivocal results. Of the 9 studies examining the effects of regular stretching, 7 suggested that it was beneficial, and the 2 showing no effect examined only the performance test of running economy. There were none that suggested that it was detrimental. CONCLUSIONS: An acute bout of stretching does not improve force or jump height, and the results for running speed are contradictory. Regular stretching improves force, jump height, and speed, although there is no evidence that it improves running economy.

Biomechanical Phenomena↗
PubMed2005

Quantification of muscle fiber strain during in vivo repetitive stretch-shortening cycles.

Muscles subjected to lengthening contractions exhibit evidence of subcellular disruption, arguably a result of fiber strain magnitude. Due to the difficulty associated with measuring fiber strains during lengthening contractions, fiber length estimates have been used to formulate relationships between the magnitude of injury and mechanical measures such as fiber strain. In such protocols, the series compliance is typically minimized by removing the distal tendon and/or preactivating the muscle. These in vitro and in situ experiments do not represent physiological contractions well where fiber strain and muscle strain may be disassociated; thus the mechanisms of in vivo muscle injury remain elusive. The purpose of this paper was to quantify fiber strains during lengthening contractions in vivo and assess the potential role of fiber strain in muscle injury following repetitive stretch-shortening cycles. Using intact New Zealand White rabbit dorsiflexors, fiber strain and joint torque were measured during 50 stretch-shortening cycles. We were able to show that fiber length changes are disassociated from muscle tendon unit length changes and that complex fiber dynamics during these cycles prevent easy estimates of fiber strains. In addition, fiber strains vary, depending on how they are defined, and vary from repetition to repetition, thereby further complicating the potential relationship between muscle injury and fiber strain. We conclude from this study that, during in vivo stretch-shortening cycles, the relationship between fiber strain and muscle injury is complex. This is due, in part, to temporal effects of repeated loading on fiber strain magnitude that may be explained by an increasing compliance of the contractile element as exercise progresses.

Adaptation, Physiological↗
PubMed1997

Comparison of nonballistic active knee extension in neural slump position and static stretch techniques on hamstring flexibility.

Nonballistic, active range of motion exercises have been advocated as more effective than static stretching for increasing range of motion, yet no published data exist to support this claim. This study compared the effect of nonballistic, repetitive active knee extension movements performed in a neural slump sitting position with static stretching technique on hamstring flexibility. Forty healthy, adult volunteer subjects with limited right hamstring flexibility (i.e., minimum of 15 degrees loss of active knee extension measured with femur held at 90 degrees of hip flexion) were randomly assigned to one of three groups. Group 1 (static stretch) performed a 30-second stretch twice daily. Group 2 (active stretch) performed 30 repetitions of active knee extension while sitting in a neural slump position twice daily. Group 3 served as a control. Hamstring flexibility was determined by an active knee extension test before and after 6 weeks of stretching. Goniometric measurement of knee joint flexion angle was obtained from videotape recording of the active knee extension test. A 3 (group) x 2 (test) repeated measures analysis of variance and subsequent Tukey post hoc testing revealed no significant difference in knee joint range of motion gains between the static (mean = 8.9 degrees) and active stretch (mean = 10.2 degrees). Both stretch groups' knee joint range of motion improved significantly (p < .05) more than the control group. We conclude that 6 weeks of nonballistic, repetitive active knee extensions (30 repetitions, twice daily) performed in a neural slump sitting position improves hamstring flexibility in uninjured subjects, but is no different compared with static stretching (30 seconds, twice daily).

Adult↗
PubMed1998

The effect of static stretch and dynamic range of motion training on the flexibility of the hamstring muscles.

To date, limited information exists describing a relatively new stretching technique, dynamic range of motion (DROM). The purpose of this study was to compare the effects of DROM with static stretch on hamstring flexibility. Fifty-eight subjects, ranging in age from 21 to 41 years and with limited hamstring flexibility (defined as 30 degrees loss of knee extension measured with the femur held at 90 degrees of hip flexion), were randomly assigned to one of three groups. One group performed DROM 5 days a week by lying supine with the hip held in 90 degrees of flexion. The subject then actively moved the leg into knee extension (5 seconds), held the leg in end range knee extension for 5 seconds, and then slowly lowered the leg to the initial position (5 seconds). These movements were performed six times per session (30 seconds of total actual stretching time). The second group performed one 30-second static stretch, 5 days per week. The third group served as a control group and did not stretch. Before and after 6 weeks of training, flexibility of the hamstring muscles was determined in all three groups by measuring knee extension range of motion (ROM) with the femur maintained in 90 degrees of hip flexion. Data were analyzed with a 2 x 3 (test x group) two-way analysis of variance (ANOVA) with repeated measures on one variable (test) and appropriate post hoc analyses. The results of the two-way ANOVA revealed a significant interaction. Further statistical post hoc analysis of data to interpret the interaction revealed significant differences between the control group (gain = 0.70 degree) and both stretching groups, as well as a significant difference between the static stretch group (gain = 11.42 degrees) and the DROM group (gain = 4.26 degrees). The results of this study suggest that, although both static stretch and DROM will increase hamstring flexibility, a 30-second static stretch was more effective than the newer technique, DROM, for enhancing flexibility. Given the fact that a 30-second static stretch increased ROM more than two times that of DROM, the use of DROM to increase flexibility of muscle must be questioned.

Adult↗
PubMed2002

Effects of transient muscle contractions and stretching on the tendon structures in vivo.

This study compared the effects of static stretching (ST) and repeated muscle contractions (CON) on the viscoelastic properties of tendon structures in vivo. Eight male subjects performed ST (passively flexed to 35 of dorsiflexion) for 5 min and 50 repetitions of isometric maximum voluntary contraction (MVC) for 3 s each with 3 s relaxation. Before and after each task, the elongation of the tendon and aponeurosis of the medial gastrocnemius muscle (MG) was directly measured by ultrasonography, while the subjects performed ramp isometric plantar flexion up to MVC, followed by a ramp relaxation. The relationship between the estimated muscle force (Fm) and tendon elongation (L) during the ascending phase was applied to a linear regression, the slope of which was defined as stiffness of the tendon structures. The percentage of the area within the Fm-L loop to the area beneath the curve during the ascending phase was calculated as an index representing hysteresis. The ST protocol significantly decreased the stiffness (-8%) and hysteresis (29%)., respectively. In contrast, the CON protocol significantly decreased the stiffness, but not the hysteresis. These results suggested that the stretching and repeated contractions would make the tendon structures more complaint, and further decreased the hysteresis of the tendon structures.

Adult↗
PubMed1985

Effects of phosphate on the contractile properties of fast and slow muscle fibres from an Antarctic fish.

Single fast myotomal fibres and small bundles of slow fibres (from the adductor pectoralis profundus muscle) were isolated from the Antarctic teleost Notothenia neglecta. Fibres were skinned by a brief detergent treatment. The effects of phosphate on the mechanical properties and ATPase activity of fast and slow fibres were studied. 20 mM-phosphate inhibited maximum isometric tension in slow fibres by 34%, but by only 11% in fast fibres. A half-maximal response was obtained at approximately 5 mM-phosphate. These concentrations are within the range measured in muscle, and the effect is probably of physiological significance. This species is of particular interest, since there is evidence that the energy supply to the fast muscle is largely based on phosphocreatine breakdown, which would result in large changes in intracellular phosphate concentration during exercise. The maximum contraction velocity of both fast and slow fibres was not affected by 10 mM-phosphate, nor was the ATPase activity of the slow fibres during isometric contraction. The phosphate-induced depression in tension in slow fibres was associated with a proportional decrease in stiffness. The rate of force recovery after rapid, small amplitude stretches and releases was increased by phosphate, as was the rate of rise of force during stretch activation. The results are discussed with reference to the different patterns of energy supply for contraction in muscle, and an attempt is made at explaining the data in terms of changes in cross-bridge kinetics.

Adenosine Triphosphatases↗