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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↗
PubMed1991

Types of activities and body parts affected in the recommended exercises for VDT operators.

This paper presents results of an analysis of recommended exercises proposed for the reduction of musculoskeletal stress in VDT operation and similar types of work. Fifteen exercise programs consisting of 123 individual exercises were reviewed. Most of the programs exhibited some redeeming features from a practical and a professional standpoint. It was found that recommendations concerning exercises have been directed primarily to muscle stretching and relaxation. The body parts targeted by various exercises were back, leg, neck, shoulder, side and upper extremities. Maximum number of exercises were available for shoulder (35.8%) and upper extremities (17.9%). The exercises reviewed consisted of combinations of thirteen different activities. It was found that rotation (26.8%), stretching (20.3%), and flexing or bending (18.7%) were the most frequently employed activities.

Computer Terminals↗
PubMed1998

Selective gene expression during adaptation of muscle in response to different physiological demands.

Muscle is a very adaptable tissue in which gene expression is to a large extent influenced by physical signals. Adaptation to a different work regime is brought about by changes in fibre type and fibre cross-sectional area. We have shown both mass and phenotype are markedly altered by stretch and force production within a period as short as 4 days. This is associated with quantitative as well as qualitative changes in gene expression. The latter involves the expression of myosin heavy chain isogenes which encode different types of molecular motors. Some species of fish have exploited this and they are able to rebuild their myofibrillar systems for warm and cold temperature swimming by selective myosin gene expression. To understand how the different myosin isoform confer different contractile properties methods have been developed for cloning, sequencing and visualizing the structure of the ATPase site to explain how the molecular motors are designed. With regard to the chemical link between the physical signal and the upregulation of certain muscle genes we have cloned a new growth factor that is only expressed in muscles subjected to stretch and/or exercise and which is designed for autocrine/paracrine action. Experiments indicate that the expression of a local growth factor which induces repair, remodelling and hypertrophy is one of the ways cells respond to mechanical strain.

Adaptation, Biological↗
PubMed1999

Effect of exhausting stretch-shortening cycle exercise on the time course of mechanical behaviour in the drop jump: possible role of muscle damage.

The purpose of the present study was to investigate the effect of stretch-shortening-cycle-induced muscle damage on the time course of mechanical behaviour in the drop jump. Ten healthy male subjects performed submaximal stretch-shortening cycle (SSC) exercise on a special sledge apparatus. Exhaustion occurred on average within 3 min. A drop jump (DJ) test from a 50-cm height was performed before and immediately after the sledge exercise as well as 2 h, 2 days and 4 days later. The fatigue exercise showed relatively high blood lactate concentration [12.5 (SD 2.6) mmol x l(-1)] and an increase of serum creatine kinase (CK) activity delayed by 2 days [540 (SD 407) U x l(-1)]. The initial decline in the jump performance (before - immediately after) was related negatively to the early recovery in performance (immediately after 2 h) (P < 0.05). The early recovery of the knee joint moment at the end of stretch showed a negative correlation to the delayed decrease in DJ performance (2 h 2 days) (P < 0.01). Thus, the DJ performance showed an initial decline followed by an early recovery and a secondary decline. Both the initial decline and early recovery in the knee joint moment at the end of stretch were related to the corresponding initial (after 2 h) (P < 0.05) and secondary increases (2 h - 2 days) (P < 0.01) in CK. It is suggested that the early recovery as well as the initial decline in the knee joint function could depend on the degree of muscle damage. Delayed decrease in initial stiffness (2 h - 2 days) was negatively related to the corresponding changes in the knee joint angle at touch down in DJ (P < 0.001). These interactions would imply that the decrease in the stiffness regulation and the modulation of the prelanding motor control might be attributable to secondary muscle damage during 2 days after the SSC exercise. Therefore, it may be suggested that the changes in the DJ performance after the exhausting SSC exercise accompany the progress of muscle damage observed by the corresponding increase in serum CK concentration and the corresponding deterioration of stiffness regulation and motor control in DJ.

Adult↗
PubMed1993

Effects of exercise on hip range of motion, trunk muscle performance, and gait economy.

BACKGROUND AND PURPOSE: The purposes of this study were (1) to examine the effects of a passive hip extension stretching exercise program on hip extension range of motion (ROM), (2) to examine the effects of a trunk flexor exercise program on trunk flexor muscle performance, and (3) to examine the effects of passive hip extension stretching or trunk flexor exercises on walking and running economy. ("Gait economy" is defined as the steady-state oxygen consumption per unit of body weight required to walk or run at a specified velocity.) SUBJECTS: Twenty-five healthy, athletic, male college students (mean age = 21 years, mean weight = 75 kg, mean height = 172 cm) were randomly assigned to one of three groups: a control group (n = 7), a hip extension stretching group (n = 9), or a trunk flexor exercise group (n = 9). METHODS: Before and after 3 weeks of intervention, the following measurements were obtained: right and left hip extension ROM, trunk flexor muscle performance, and walking and running economy. A three x two-way (groups x test sessions) analysis of variance (ANOVA) for repeated measures for unequal subject numbers was performed on each of the five dependent measures, with analysis of simple main effects applied when significant interactions were found. RESULTS: The ANOVA on right and left hip extension ROM revealed a significant interaction. Analyses of simple main effects showed that 3 weeks (six sessions) of passive hip extension stretching significantly improved right hip extension ROM (pretest = -20.4 degrees, posttest = -8.3 degrees) and left hip extension ROM (pretest = -16.8 degrees, posttest = -7.0 degrees). There also was a significant interaction for trunk flexor muscle performance. The analysis of simple main effects revealed that 3 weeks of daily trunk flexor exercises significantly improved trunk flexor muscle performance (pretest = 41.5 degrees, posttest = 60.4 degrees). The 3-week intervention program of hip extension stretching or trunk flexion exercises, however, did not produce significant changes in walking or running economy. CONCLUSION AND DISCUSSION: The results suggest that (1) six treatment sessions of passive stretching were sufficient to improve hip extension ROM; (2) 3 weeks of exercises performed daily improved trunk flexor muscle performance; and (3) training of isolated tasks, such as hip flexibility or trunk strengthening activities, did not produce the desired outcome in the economy of walking or running. Possible reasons for the results are discussed.

Adult↗
PubMed2002

Respiratory muscle stretch gymnastics in patients with post coronary artery bypass grafting pain: impact on respiratory muscle function, activity, mood and exercise capacity.

A new rehabilitation (New-RH) program including respiratory muscle stretch gymnastics (RMSG) was developed to alleviate post-coronary artery bypass grafting pain (PCP). Effects on respiratory muscle function, pain, activities of daily living (ADL), mood and exercise capacity were investigated. Subjects were 16 consecutive patients undergoing median full sternotomy coronary artery bypass grafting (CABG), and were randomly divided into equal New-RH (S-group) and conventional therapy (C-group) groups. Rib cage dominant breathing was observed postoperatively in both groups. With preoperative tan deltaVrc/deltaVab, increases at 1-week postoperatively and decreases at discharge for S-group tended to exceed those of C-group (p > .05). Decreased maximum inspiratory and expiratory pressure status for functional residual capacity and percent forced expiratory volume in one second at discharge again only tended to be smaller for S-group (p > .05). S-group displayed significantly reduced pain around both scapulas at discharge (p = .049), and increased mean overall ADL and profile of mood states (POMS)/Vigor scores (p = .031 and p = .018, respectively). POMS/Tension-Anxiety scores at discharge for S-group were significantly smaller than those preoperatively (p = .025), and S-group displayed significantly increased distance walked over 6-minutes at discharge than C-group (p = .029). New-RH improves patient participation in exercise therapy and increases exercise capacity by reducing PCP, relieving anxiety and tension, and improving ADL.

Activities of Daily Living↗
PubMed1997

The effects of spinal manipulation on cervical kinesthesia in patients with chronic neck pain: a pilot study.

PURPOSE: To determine whether spinal manipulation as an isolated intervention has any effect on proprioception-dependent performance of subjects with chronic neck pain, compared with effects achieved through stretching exercises. DESIGN: Matched, nonrandomized, controlled trial. SETTING: Private chiropractic clinic. PARTICIPANTS: Twenty subjects with chronic (daily, > or = 4 months) neck pain. Volunteers were recruited from a pool of patients visiting the clinic or from those referred by informed clinicians. INTERVENTION: Half of the subjects received six sessions of high-velocity, low-amplitude manipulation to the cervical and upper thoracic regions during a 3-4 wk period. The other half were instructed in stretching exercises for the cervicothoracic muscles, to be performed in two unsupervised sessions daily over the same time period. MAIN OUTCOME MEASURES: Pain levels were assessed at baseline and at each of six follow-up sessions using a 100-mm visual analogue scale. The abilities of the blindfolded subjects to reproduce a neutral head position after moving the head and neck through various planes of motion was the method used to estimate proprioceptive acuity. This was done with the use of a laser pointer affixed to the top of an adjustable cap. Points were marked and measured on a target before and after head movement and repositioning. RESULTS: Subjects receiving manipulation demonstrated a mean reduction in visual analogue scores of 44%, along with a 41% improvement in mean scores for the head repositioning skill. In comparison, a 9% mean reduction in visual analogue scores and a 12% improvement in head repositioning scores was observed for the stretching group. The difference in the outcomes of the head repositioning skill scores was significant (p < or = .05). CONCLUSION: The results suggest a possible effect of manipulation on proprioception in subjects with chronic neck pain. The small sample size, lack of true randomization and lack of blinding of the examiner are factors that weaken these findings. Larger, more controlled studies are needed to determine what specific effects manipulation may have on the function of proprioception.

Adult↗
PubMed2002

A randomized controlled trial of muscle strengthening versus flexibility training in fibromyalgia.

OBJECTIVE: To determine the effectiveness of a muscle strengthening program compared to a stretching program in women with fibromyalgia (FM). METHODS: Sixty-eight women with FM were randomly assigned to a 12 week, twice weekly exercise program consisting of either muscle strengthening or stretching. Outcome measures included muscle strength (main outcome variable), flexibility, weight, body fat, tender point count, and disease and symptom severity scales. RESULTS: No statistically significant differences between groups were found on independent t tests. Paired t tests revealed twice the number of significant improvements in the strengthening group compared to the stretching group. Effect size scores indicated that the magnitude of change was generally greater in the strengthening group than the stretching group. CONCLUSION: Patients with FM can engage in a specially tailored muscle strengthening program and experience an improvement in overall disease activity, without a significant exercise induced flare in pain. Flexibility training alone also results in overall improvements, albeit of a lesser degree.

Adult↗
PubMed1999

Stretching and strengthening exercises: their effect on three-dimensional scapular kinematics.

OBJECTIVE: To quantitatively evaluate the effects of commonly used shoulder exercises on shoulder kinematics and resting posture. STUDY DESIGN: A repeated-measures design was used with measurements performed before and after a 6-week exercise program. METHOD: Twenty asymptomatic subjects with forward shoulder posture were recruited. Stretching exercises for the pectoral muscles and resisted strengthening exercises for the scapular retractors and elevators and the glenohumeral abductors and external rotators were performed three times per week for 6 weeks. A three-dimensional electromechanical digitizer was used to measure thoracic inclination and scapular orientation and position. These measurements were taken with the arm (1) at the side, (2) abducted to 90 degrees, and (3) at maximal abduction. The isometric force of glenohumeral external and internal rotation and horizontal abduction and adduction were measured with a hand-held dynamometer. All subjects were tested before and after the 6-week exercise program. Hotelling's T2 and paired t tests were used for data analysis. RESULTS: The strength of horizontal abduction and internal and external rotation increased after exercise (p < .01). The anterior inclination of the thoracic spine decreased, and the glenohumeral contribution to arm elevation increased (p < .01). Resting scapular posture did not change. As the arm was abducted to 90 degrees, the scapula showed less upward rotation and less superior translation after the exercise program (p < .01). CONCLUSION: The exercise program improved muscle strength, produced a more erect upper trunk posture, increased scapular stability, and altered scapulohumeral rhythm.

Adult↗
PubMed1999

The effects of preexercise stretching on muscular soreness, tenderness and force loss following heavy eccentric exercise.

The present study sought to investigate the effects of preexercise stretching on delayed onset muscle soreness (DOMS), i.e. soreness, tenderness and loss of muscle force, that usually occurs after strenuous or unaccustomed eccentric exercise. Ten female volunteers performed 10 sets of 10 maximal isokinetic eccentric contractions for knee flexion with both legs after a 5-min ergometer cycling warm-up. Prior to the exercise for one leg, randomly chosen, 4 x 20 s of static stretching for the hamstring muscle group was implemented. Rated soreness, tenderness on algometer pressure and loss of maximal eccentric contractile force was evaluated preexercise and 24, 48 and 96 h postexercise. The exercise bout produced severe DOMS, with parameters peaking and troughing at 48 h postexercise. However, no significant differences were found, regarding any of the parameters, when comparing stretched and nonstretched legs. The present study thus suggests that preexercise static stretching has no preventive effect on the muscular soreness, tenderness and force loss that follows heavy eccentric exercise.

Adult↗
PubMed2001

Interventions for preventing lower limb soft-tissue injuries in runners.

BACKGROUND: Overuse musculoskeletal injuries occur frequently in runners. Suggestions for prevention have focused on stretching exercises, modifying training schedules and the use of protective devices such as braces and insoles. To date, no systematic analysis of the literature on the effectiveness of these strategies in the prevention of overuse injuries has been published. OBJECTIVES: The objective of the review was to evaluate the evidence from randomised controlled trials on the prevention of lower limb soft-tissue running injuries. SEARCH STRATEGY: An electronic database search included The Cochrane Musculoskeletal Injuries Group specialised register (date of last search October 2000), The Cochrane Controlled Trials Register (The Cochrane Library, Issue 3, 1999), MEDLINE (from 1966), EMBASE (from 1980), SPORT Discus (1975-2000), HERACLES (1975-2000), ATLANTES (1980-1996), BIOSIS, CINAHL, SCISEARCH, Current Contents, Index To Theses and Dissertation Abstracts. Date of last search for these databses: May 2000. SELECTION CRITERIA: Any randomised or quasi-randomised trials evaluating interventions to prevent lower limb soft-tissue running injuries. DATA COLLECTION AND ANALYSIS: All trials fulfilling the selection criteria were assessed by two reviewers independently. Data were also extracted independently by the two reviewers using a pre-derived data extraction form. Exploratory analyses, including pooling of results from groups of trials of similar designs were undertaken, using a fixed effects model. Results were reported as relative risks (RR) with 95 per cent confidence intervals (95% CI). MAIN RESULTS: Twelve trials with 8,806 participants were included. In one trial, a single control group was matched to three different included intervention groups. The effectiveness of stretching exercises (5 trials, 1944 participants in the intervention groups, 3159 controls), and of insoles and footwear modification (5 trials, 903 participants in the intervention groups, 3006 controls) in the prevention of lower extremity soft tissue injuries associated with running is unknown. Reducing the distance, frequency and duration of running may be effective in the prevention of lower extremity soft tissue injuries associated with running (3 trials, 514 participants in intervention groups, 1663 controls). Wearing a knee brace with a patellar support ring may be effective in the prevention of running-associated anterior knee pain (1 trial, 27 participants in the intervention group, 33 controls). REVIEWER'S CONCLUSIONS: This review provides some evidence for the effectiveness of the modification of training schedules, but there is insufficient evidence to determine the effectiveness of stretching exercises for major lower limb muscle groups in reducing lower limb soft-tissue running injuries. More studies are required to confirm that knee braces may prevent knee pain, to clarify the role of stretching, and to quantify optimal training loads. Generalisability of the results may be limited by the intensive nature of military training (the context for most of the studies) and the inclusion of only small numbers of women.

Cumulative Trauma Disorders↗
PubMed2000

Influence of water exercise and land stretching on salivary cortisol concentrations and anxiety in chronic low back pain patients.

Land stretching exercises are common exercise therapy for low back pain (LBP) patients. However, recently, water exercise became a popular rehabilitation for LBP patients, and many studies have reported the physical benefits of water exercise. This study compared the psychological and endocrinological effects of water exercise and land stretching by measuring salivary cortisol concentration and anxiety in chronic LBP patients. Seven volunteers (4 female and 3 male, mean age: 61.9 +/- 11.8 yrs) who suffered from chronic LBP (pain duration: 4.5 +/- 1.3 yrs) participated in the sessions of water exercise and land stretching programs (90 minutes) on different days. The land stretching program consisted mainly of stretching, and the water exercise program contained not only stretching, but also walking, jogging, muscle strengthening, swimming and relaxation. After both exercise programs, the subjective pain scores of the patients showed a significant decrease. Salivary cortisol concentrations were also significantly decreased during pre- to post-90 minute water exercise. (P < 0.05). With land stretching, salivary cortisol concentrations also decreased significantly (P < 0.05). State anxiety decreased significantly (P < 0.05) after both water exercise and land stretching compared with pre-exercise scores (P < 0.05), though no significant changes were found in the patients' trait anxiety scores. No significant correlation was found between salivary cortisol concentrations and state anxiety with water exercise and land stretching. The findings of the present study suggested both exercises showed similar tendencies, and had decreased salivary cortisol level and state anxiety.

Anxiety↗
PubMed2004

[Injuries and muscle tightness in soccer].

Soccer is one of the most popular sports worldwide. Due to its characteristic many injuries are expected. Muscular tightness is postulated as an intrinsic risk factor for the developement of a muscle injury. Muscle flexibility testing can identify soccer players at risk for musculoskeletal lesions. One-hundred-and-seventeen male amateur soccer players aged 4 to 29 were examined for former injuries and muscular flexibility by using Janda's "functional muscular diagnostic". Muscle injuries and ankle lesions predominated among the injuries. The "functional muscular diagnostic" is suitable for screening muscular flexibility in soccer players. You found comprehensive muscular tightness among the soccer players. The value of stretching for preventing exercise-related muscle injury is still unclear.

Adolescent↗
PubMed1977

Traumatic injuries: office treatment of strain.

Strain, defined as trauma to a musculotendinous unit, is characterized by pain, muscle spasm, swelling, and loss of range of motion. Conservative treatment consists of rest and elevation of the affected muscle, application of ice and compression, active and passive stretching, and resisted motion exercises. If rupture of muscle and fascia is extensive, surgery may be required. Chronic strain may result from repeated injuries. It is usually treated with rest and administration of an anti-inflammatory agent, such as oxyphenbutazone or a corticosteroid preparation. In the event that this regimen does not provide relief from pain and disability, surgery may be necessary.

Anti-Inflammatory Agents↗
PubMed2006

Quality of life of rural menopausal women in response to a customized exercise programme.

AIM: This paper reports a study examining the effects of physical exercise on the quality of life of menopausal women. BACKGROUND: People who perform no type of physical activity have poorer physical and mental health. Despite the well-documented benefits of exercise, ageing women remain largely sedentary, and interventions designed to help them to maintain exercise programmes may prove particularly valuable. Measures should focus on increasing women's confidence so that they can overcome barriers to exercise. Conflicting results have been reported in intervention studies to promote exercise in postmenopausal women. METHODS: Forty-eight menopausal women aged 55-72 years were recruited at a primary care centre as voluntary participants in a quasi-experimental study. They were randomly assigned to one of two groups: control (n = 24) and experimental (n = 24). The experimental group participated in a 12-month programme of cardiorespiratory, stretching, muscle-strengthening and relaxation exercises carried out during two fully supervised exercise sessions per week (total of 3 hours weekly). Health-related quality of life was assessed by using the Quality of Life Profile for Chronically Ill Patients, a generic questionnaire widely used in epidemiological and clinical studies to measure well-being and function, incorporating as an optional module the Kupperman Index of Menopausal Symptomatology. RESULTS: There was a statistically significant improvement in the health-related quality of life of the experimental group, whereas the health-related quality of life of the control group significantly worsened. Menopausal symptoms also significantly improved in the experimental group and significantly worsened in the control group over the 12-month study period. CONCLUSIONS: A customized exercise programme is valuable for improving the health-related quality of life of menopausal women.

Aged↗
PubMed2005

Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching on Muscle Strength and Power Output.

Context: Stretching is commonly used as a technique for injury prevention in the clinical setting. Our findings may improve the understanding of the neuromuscular responses to stretching and help clinicians make decisions for rehabilitation progression and return to play.Objective: To examine the short-term effects of static and proprioceptive neuromuscular facilitation stretching on peak torque (PT), mean power output (MP), active range of motion (AROM), passive range of motion (PROM), electromyographic (EMG) amplitude, and mechanomyographic (MMG) amplitude of the vastus lateralis and rectus femoris muscles during voluntary maximal concentric isokinetic leg extensions at 60 and 300 degrees .s.Design: A randomized, counterbalanced, cross-sectional, repeated-measures design.Setting: A university human research laboratory.Patients or Other Participants: Ten female (age, 23 +/- 3 years) and 9 male (age, 21 +/- 3 years) apparently healthy and recreationally active volunteers.Intervention(s): Four static or proprioceptive neuromuscular facilitation stretching exercises to stretch the leg extensor muscles of the dominant limb during 2 separate, randomly ordered laboratory visits.Main Outcome Measure(s): The PT and MP were measured at 60 and 300 degrees .s, EMG and MMG signals were recorded, and AROM and PROM were measured at the knee joint before and after the stretching exercises.Results: Static and proprioceptive neuromuscular facilitation stretching reduced PT (P = .051), MP (P = .041), and EMG amplitude (P = .013) from prestretching to poststretching at 60 and 300 degrees .s (P < .05). The AROM (P < .001) and PROM (P = .001) increased as a result of the static and proprioceptive neuromuscular facilitation stretching. The MMG amplitude increased in the rectus femoris muscle in response to the static stretching at 60 degrees .s (P = .031), but no other changes in MMG amplitude were observed (P > .05).Conclusions: Both static and proprioceptive neuromuscular facilitation stretching caused similar deficits in strength, power output, and muscle activation at both slow (60 degrees .s) and fast (300 degrees .s) velocities. The effect sizes, however, corresponding to these stretching-induced changes were small, which suggests the need for practitioners to consider a risk-to-benefit ratio when incorporating static or proprioceptive neuromuscular facilitation stretching.

Journal Article↗
PubMed1995

Mandibular exercises to control bruxism and deviation problems.

A discussion of bruxism, mandibular deviation and hypermobility problems producing temporomandibular joint (TMJ) and masticatory muscle pathology is presented. The pathophysiology of painful masticatory muscle hyperactivity, TMJ dysfunction and chondromalacia are presented. The role that pain mediators play in the degradation of TMJ fibrocartilage, acute synovitis and joint and muscle pain is analyzed. Isokinetic and stretching exercises are described to assist in correcting or preventing pathology and dysfunction of these structures.

Bruxism↗