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PubMed2002

The effect of either a pre or post exercise stretch on straight leg raise range of motion (SLR-ROM) in females.

This study examined the order effect of a hamstring muscle stretch and resisted hamstring exercises on straight leg raise range of movement (SLR-ROM), in a group of twenty females aged 20-34 years. The stretch was applied either immediately before or Immediately after a resisted hamstring exercise. Exercise significantly decreased SLR-ROM (p < 0.05) and stretching significantly increased SLR-ROM (p < 0.05). The overall change in SLR-ROM for the two groups showed that a significant increase in SLR-ROM was detected (at a low force level) in Group 1 subjects who performed exercise and then stretched. A non-significant increase in SLR-ROM was detected by the higher force level in Group 1 subjects. In contrast, Group 2 subjects (stretch then exercise) showed a non-significant reduction in SLR-ROM at both levels of force.

Adult↗
PubMed1996

Stretch shortening cycle fatigue: interactions among joint stiffness, reflex, and muscle mechanical performance in the drop jump [corrected].

The purpose of the present study was to investigate the effect of strenuous stretch-shortening cycle exercise on the relationship between reflex and stiffness regulation during the drop jump. Ten healthy male subjects performed submaximal stretch-shortening cycle exercise on a special sledge apparatus. Exhaustion occurred on average within 3 min. A drop jump test from a 50-cm height was performed immediately before and after the sledge exercise, as well as 2 h, 2 days and 4 days later. The fatigue exercise showed relatively high blood lactate concentrations 12.5 (SD 2.6) mmol.l-1 and a 2-day delayed increase of serum cretaine kinase concentration. In drop jumps, the short latency M1 component of the vastus lateralis muscle electromyogram (EMG) response showed a continuous decline throughout the entire follow-up period after fatigue (NS), whereas the medium latency EMG component increased 2 days after the postfatigue sessions (P < 0.05). Immediately after the fatigue exercise a positive correlation (P < 0.05) was found between the changes in the short latency EMG response and in the amount of knee joint stiffness during the early postlanding phase of the drop jump. This suggests that the M1 response was closely related to the stiffness changes during the initial braking phase of the drop jump. Increase of creatine kinase concentration on the 2nd day correlated negatively with the changes in the drop jump performance (P < 0.05). Since the short latency EMG component has almost recovered on the 2nd day, impairment of the mechanical function of the muscle might have taken place. In conclusion, exhausting stretch-shortening cycle exercise induced local muscle impairment, which resulted in modulation of the reflex and stiffness interaction in the drop jump as well as compensation by central motor command.

Adult↗
PubMedDate not supplied

Aesthetic resection of the gastrocnemius muscle in postpoliomyelitis calf hypertrophy: an uncommon case report.

Muscle hypertrophy is a rare finding in neurologic lesions. Infiltration, stretching, and exercise of the muscle are causative factors of enlargement and hypertrophy. We report a case of unilateral calf hypertrophy postpoliomyelitis. The resection of the total medial and partial lateral gastrocnemius muscle was performed to achieve left calf reduction and a symmetrical contour of both legs. The patient is satisfied with the results and has not complained of any instability in walking or running after 2 years of follow-up.

Adult↗
PubMedDate not supplied

Back school programs. The young patient.

CC's treatment goals were all met with the exception of eliminating the AMNT sign. Slump-sit right knee extension (-15 degrees), right SLR (80 degrees coupled with dorsiflexion), and lumbar flexion (85% coupled with neck flexion) all continued to reproduce right buttock cramping and pain. Currently he is playing basketball without restriction, performing an individualized exercise program that emphasizes lower extremity muscle stretching, AMNT stretching, and advanced truncal stabilization exercises. He has a very good understanding of body mechanics and an awareness of safe SFP during activities of daily living and on the basketball court. His motivation, along with the motivation of parents, coaches, athletic trainer, and physical therapist, greatly assisted CC in returning to competitive basketball. CC is intermittently evaluated to monitor the AMNT sign and the effectiveness of the home exercise program. Currently CC's AMNT appears to regress if he is not monitored on a monthly basis; thus he warrants intermittent treatment. Monitoring of the patient is an integral aspect of long-term management of chronic discogenic disease that is often neglected. It can be hypothesized that monitoring may prevent serious complications in the future for many patients. CC is a patient who needed specific therapeutic intervention beyond rest, general instructions about body mechanics and exercise, modalities, and traditional back school. The history of this patient's problem revealed that rest and general exercises had failed, thus necessitating specific therapeutic treatment. This patient is an excellent example of how physical therapy in the form of manual therapy, specific therapeutic exercise, education through repetition of functional tasks, and the team approach to patient care can lead to a successful treatment outcome.

Adolescent↗
PubMed1999

Physiotherapy for the treatment of articular contractures in haemophilia.

Articular contractures in haemophilia are impairments that can not be cured by means of physiotherapy because of the pathophysiology of the joint. Rehabilitation, however, tries to diminish the disabilities and prevent handicaps caused by the impairments. Physiotherapy aims at pain reduction by means of manual traction. Next to manual traction the intensive physiotherapy programme includes mobilization techniques, muscle strengthening exercises and stretching, joint stability training, postural and gait, training, and functional training. In all 50 haemophilia patients have undergone this intensive 4-week clinical rehabilitation programme. Data of 20 of these severe haemophilia patients show that the mean range of motion at the start of the rehabilitation period, after 4 weeks and after 5 years do not differ. In spite of progressing arthropathy after 5 years the activities of daily living (ADL), walking range and pain are equal or better according to 13 of 15 patients.

Contracture↗
PubMed1985

Effects of intense "stretching"-flexibility training on the mechanical profile of the knee extensors and on the range of motion of the hip joint.

The sample for the study involved 12 volunteer male, active but not specially trained secondary school students. They averaged 15.33 years with a mean height of 168.20 cm, and a mean mass of 55.08 kg. Changes, if any, in the mechanical properties (MVC, half-relaxation time, fast isometric contraction, concentric contraction of the knee extensors) and flexibility of the hip joints were studied. The subjects executed passive, purely slow stretching as well as range-of-motion flexibility exercises for the knee extensors and the hip joints for 7 weeks three times a week. Pre- and post-measurements for flexibility and stride frequency on the spot showed significant improvement as did half-relaxation time, fast isometric force development, and speed of concentric contractions when low loads were to be overcome. In addition to studies in which improvements reported were attributed to and related to myoelectrical, reflex, and connective tissue changes, in the present study it was concluded that stretching exercises influence intrinsic muscle mechanical character along with a simultaneous improvement in range of motion of the joints exercised.

Adolescent↗
PubMed2001

[The effects of pulmonary rehabilitation with chronic obstructive pulmonary disease (COPD)].

It is controversial whether pulmonary rehabilitation is effective in patients with chronic obstructive pulmonary disease (COPD). To test the effect of pulmonary rehabilitation, 7 patients with COPD (aged 76.0 +/- 2.6 years) were enrolled in pulmonary rehabilitation program for 6 weeks. The program consisted of relaxation, pursed lip breathing, diaphragmatic breathing, panic control, muscle stretch gymnastics, and exercise training. The distance of the 6-minute walking test increased significantly from 246.4 +/- 38.0 (m) to 304.3 +/- 28.4 (m) (p < 0.05). The minimum SpO2 during the 6-minute walking test increased from 86.0 +/- 2.8 (%) to 90.1 +/- 1.3 (%) and dyspnea as measured with Borg scale decreased from 5.6 +/- 1.1 to 4.6 +/- 0.5, although they were not significantly different. These results suggest that pulmonary rehabilitation might improve exercise tolerance in elderly patients with COPD.

Aged↗
PubMed2005

[Rehabilitation for the patients with low-back pain].

The first choice for the treatment of low-back pain should be physical therapy, or rehabilitation. These are mainly divided into two modalities; passive and active modality. The former includes bed rest, hot pack, massage, and brace. The latter includes therapeutic exercise. The modality used should be dependent of the stages in each patient. Bed rest is indicated in the acute stage within a week after the occurrence low-back pain. The rest longer than a week is basically contraindicated, because of disuse syndrome such as muscle weakness, osteoporosis, and soft tissue contracture. Therapeutic exercise is the mainstay in the chronic stage. It includes trunk muscles strengthening exercise and stretching. Lumbar stabilization exercise has currently drawn attention for the treatment of low-back pain. Patient education such as back-school also plays an important role to manage low-back pain.

Exercise Therapy↗
PubMed1998

[Stretching--possibilities and limits].

The basic scientific knowledge about stretching remains incomplete in spite of its wide use in sports and physiotherapy. This article deals with the assessment of the flexibility and with the anatomical and physiological basis and limitations of stretching. The effects of stretching on delayed onset muscle soreness (DOMS), performance and regeneration are discussed. Recommendations are given for stretching as a measure of warming-up and cooling-down, for stretching before exercises, which demand explosive maximum muscle strength, and for stretching after training for strength endurance.

Humans↗
PubMed2001

A review of resistance exercise and posture realignment.

Exercise has been promoted in an attempt to correct postural deviations, such as excessive lumbar lordosis, scoliosis, kyphosis, and abducted scapulae. One of the assumed causes of these conditions is a weak and lengthened agonist muscle group combined with a strong and tight antagonist muscle group. Strengthening and stretching exercises have been prescribed accordingly. It is implied that strengthening exercises will encourage adaptive shortening of the muscle-tendon length, reposition skeletal segments, and produce static posture realignment. A review of the literature has found a lack of reliable, valid data collected in controlled settings to support the contention that exercise will correct existing postural deviations. Likewise, objective data to indicate that exercise will lead to postural deviations are lacking. It is likely that exercise programs are of insufficient duration and frequency to induce adaptive changes in muscle-tendon length. Additionally, any adaptations from restricted range-of-movement exercise would likely be offset by daily living activities that frequently require the body segments to go through full ranges of motion.

Adaptation, Physiological↗
PubMed1982

Effect of elastic energy and myoelectrical potentiation of triceps surae during stretch-shortening cycle exercise.

Stretching of an activated muscle prior to its shortening enhances its performance during the concentric contraction. This phenomenon has been interpreted to be primarily due to the utilization of elastic energy stored in the series elastic elements of the muscle during the stretch. However, reflex potential has also been suggested as an additional cause for performance increase. To examine this hypothesis five subjects performed maximal vertical jumps on a force platform from two different starting positions: (a) maximal plantar flexion from a static position (SJ) (pure concentric contraction), (b) a toe-standing position with preliminary counter-movement (CMJ). In this condition the calf muscles were actively stretched before concentric work. In both conditions the knee and hip joints were fixed. The results indicated that the utilization of the stretch-shortening cycle enhanced the performance over that of the pure concentric contraction (P less than 0.001). Similarly, the EMG recording demonstrated that in all five subjects the myoelectrical activity of the calf muscles (mm. gastrocnemius and soleus) was potentiated during the concentric phase in CMJ when compared to SJ (P less than 0.001). Therefore, the increase in performance was attributed to a combination of utilization of elastic energy and myoelectrical potentiation of muscle activation.

Adult↗
PubMedDate not supplied

Bedtime diazepam enhances well-being in children with spastic cerebral palsy.

In work with children with cerebral palsy at Ashirvad, Child Development and Research Centre, Chennai, India, the authors were confronted with fretful children who resisted any attempt to mobilize their limbs due to hypertonia and muscle spasm. It was found that administering a bedtime dose of diazepam to reduce hypertonia and muscle spasm alongside passive stretching exercises significantly improved the behaviour of the child. There was significant improvement in the well-being of the child during the activities of daily living and this reduced the family's burden of caring for the child. In this double blind, placebo-controlled, randomized clinical trial, each child received a bedtime dose of diazepam or placebo. The bedtime diazepam relaxed the muscles and this made the passive stretching easy and the movements sustained the muscle relaxation during the day. There were fewer unwarranted crying spells during the day and less wakefulness during the night. The adverse effect of day time sedation was not observed with the use of a single dose of diazepam at bedtime.

Activities of Daily Living↗
PubMed2006

Fatigue and muscle-tendon stiffness after stretch-shortening cycle and isometric exercise.

The purpose of the present study was to compare vertical jump performance after 2 different fatigue protocols. In the first protocol, subjects performed consecutive sets of 10 repetitions of stretch-shortening cycle (SSC) contractions. In the second protocol, successive sets of 10 repetitions of isometric contractions were performed for 10 s with the knee at 90 degrees of flexion. The exercises were stopped when the subjects failed to reach 50% of their maximum voluntary isometric contractions. Maximal isometric force and maximal concentric power were assessed by performing supine leg presses, squat jumps, and drop jumps. Surface EMG was used to determine changes in muscle activation before and after fatigue. In both groups, the fatigue exercises reduced voluntary isometric force, maximal concentric power, and drop jump performance. Kinematic data showed a decrease in knee muscle-tendon stiffness accompanied by a lengthened ground contact time. EMG analysis showed that the squat and drop jumps were performed similarly before and after the fatigue exercise for both groups. Although it was expected that the stiffness would decrease more after SSC than after isometric fatigue (as a result of a greater alteration of the reflex sensitivity SSC), our results showed that both protocols had a similar effect on knee muscle stiffness during jumping exercises. Both fatigue protocols induced muscle fatigue, and the decrease in jump performance was linked to a decrease in the strength and stiffness of the knee extensor muscles.

Adult↗
PubMed2006

[An asymmetrical face due to torticollis in two young children].

In 2 girls, 4 years and 8 months of age, respectively, torticollis had been diagnosed a few weeks after birth. Kinesiotherapy, given for a period of 1 year and 6 months, respectively, had little effect. Both girls were then referred to the Orthopaedic Outpatient Clinic where a shortened sternocleidomastoid muscle and an asymmetrical face were diagnosed. The shortened muscle was cleaved surgically. Over half a year later, the face of the older child was still asymmetrical but that of the younger child symmetric. It is recommended that children with torticollis due to a shortened sternocleidomastoid muscle first be given stretch exercises under the guidance of a physiotherapist. If the result at the age of 1 year is unsatisfactory, an orthopaedic surgeon can then cleave the muscle.

Child, Preschool↗
PubMed1991

[Supracondylar knee-ankle-foot orthosis for post-polio syndrome].

We report a 69-year-old female suffering from post-polio syndrome. Though she experienced acute poliomyelitis at one year of age, she had been well until 67 years of age when she complained of muscle weakness and pain in her right lower extremity and gait disturbance. As she was admitted to our hospital for further evaluation and rehabilitation, we prescribed for her the rehabilitation program consisting of gait training with a supracondylar knee-ankle-foot orthosis, low-load repetitive muscle strengthening exercises, and continuous stretching of her right knee joint after heat treatment. She regained a stable gait with the orthosis. We thought that the disuse and overuse of the lower extremities played a part in the onset of post-polio syndrome and that the rehabilitation including the low-load repetitive muscle strengthening exercises and gait training with a supracondylar knee-ankle-foot orthosis was effective against her disability.

Aged↗
PubMed1997

Changes in the mechanical properties of human and amphibian muscle after eccentric exercise.

Following a series of eccentric contractions, that is stretching of the muscle while generating active tension, the length-tension relationship of isolated amphibian muscle has been shown to shift towards longer muscle length (Katz 1939; Wood et al. 1993). Here we report observations of electrically stimulated ankle extensor muscles of nine human subjects, demonstrating a similar shift in optimum angle for torque generation [3.9 (1.5) degrees] following exercise on an inclined treadmill that involved eccentric contractions in one leg. (All values are means with the SEMs in parentheses). The shift in the unexercised, control leg was significantly less [mean 0.4 (0.7) degree P < 0.05]. Correlated with this shift was a drop in torque [25.1 (5.6)% for the experimental leg; 1.6 (0.7)% for the control leg, P < 0.002]. Optimum angles returned to pre-exercise values by 2 days post-exercise, while torque took a week to recover. A similar shift in optimum length [12 (1.3)% of rest length] was obtained for five toad (Bufo marinus) sartorius muscles subjected to 25 eccentric contractions. Isometrically contracted control muscles showed a smaller shift [3.5 (1.6)%, n = 5]. Accompanying the shift was a drop in tension of 46 (3)% after the eccentric contractions [control isometric, 23 (6)%, P < 0.0001]. By 5 h after the eccentric contractions the shift had returned to control values, while tension had not recovered. When viewed with an electron microscope, sartorius muscles fixed immediately after the eccentric contractions exhibited many small, and a few larger, regions of myofilament disruption. In muscles fixed 5 h after the contractions, no small regions of disruption were visible, and the number of large regions was no greater than in those muscles fixed immediately after the eccentric contractions. These disruptions are interpreted as the cause of the shift in length-tension relationship.

Adult↗