Bouts of passive stretching after immobilization of the rat soleus muscle increase collagen macromolecular organization and muscle fiber area

Usefulness of sulfonated azo dyes to evaluate macromolecularly oriented protein substrates

Sulfonated azo dyes are crucial for the histochemical, topochemical, and electrophoretic demonstration of proteins. Additionally, these dyes may reveal the significance of evaluating the anisotropic phenomenon of linear dichroism in macromolecularly oriented stained proteins. However, this requires that the ordered -NH3+ groups available for electrostatic binding of the -SO3- dye groups are present in the protein substrate. Further, the reactive -SO3- dye groups should be positioned in a way to permit selective absorption of polarized light at the level of the dye -NN- chromophore azo groups. This review reports the usefulness of sulfonated azo dyes in revealing the extrinsic phenomenon of linear dichroism in dye-substrate complexes and changes in the oriented state of protein macromolecules.

Physiology of Stretch-Mediated Hypertrophy and Strength Increases: A Narrative Review

Increasing muscle strength and cross-sectional area is of crucial importance to improve or maintain physical function in musculoskeletal rehabilitation and sports performance. Decreases in muscular performance are experienced in phases of reduced physical activity or immobilization. These decrements highlight the need for alternative, easily accessible training regimens for a sedentary population to improve rehabilitation and injury prevention routines. Commonly, muscle hypertrophy and strength increases are associated with resistance training, typically performed in a training facility. Mechanical tension, which is usually induced with resistance machines and devices, is known to be an important factor that stimulates the underlying signaling pathways to enhance protein synthesis. Findings from animal studies suggest an alternative means to induce mechanical tension to enhance protein synthesis, and therefore muscle hypertrophy by inducing high-volume stretching. Thus, this narrative review discusses mechanical tension-induced physiological adaptations and their impact on muscle hypertrophy and strength gains. Furthermore, research addressing stretch-induced hypertrophy is critically analyzed. Derived from animal research, the stretching literature exploring the impact of static stretching on morphological and functional adaptations was reviewed and critically discussed. No studies have investigated the underlying physiological mechanisms in humans yet, and thus the underlying mechanisms remain speculative and must be discussed in the light of animal research. However, studies that reported functional and morphological increases in humans commonly used stretching durations of > 30 min per session of the plantar flexors, indicating the importance of high stretching volume, if the aim is to increase muscle mass and maximum strength. Therefore, the practical applicability seems limited to settings without access to resistance training (e.g., in an immobilized state at the start of rehabilitation), as resistance training seems to be more time efficient. Nevertheless, further research is needed to generate evidence in different human populations (athletes, sedentary individuals, and rehabilitation patients) and to quantify stretching intensity.

Exercise builds the scaffold of life: muscle extracellular matrix biomarker responses to physical activity, inactivity, and aging

Skeletal muscle extracellular matrix (ECM) is critical for muscle force production and the regulation of important physiological processes during growth, regeneration, and remodelling. ECM remodelling is a tightly orchestrated process, sensitive to multi-directional tensile and compressive stresses and damaging stimuli, and its assessment can convey important information on rehabilitation effectiveness, injury, and disease. Despite its profound importance, ECM biomarkers are underused in studies examining the effects of exercise, disuse, or aging on muscle function, growth, and structure. This review examines patterns of short- and long-term changes in the synthesis and concentrations of ECM markers in biofluids and tissues, which may be useful for describing the time course of ECM remodelling following physical activity and disuse. Forces imposed on the ECM during physical activity critically affect cell signalling while disuse causes non-optimal adaptations, including connective tissue proliferation. The goal of this review is to inform researchers, and rehabilitation, medical, and exercise practitioners better about the role of ECM biomarkers in research and clinical environments to accelerate the development of targeted physical activity treatments, improve ECM status assessment, and enhance function in aging, injury, and disease.

Effects of stretching on the basement membrane structure in the soleus muscle of Wistar rats

The basement membrane (BM), mainly composed of collagen IV, plays an important role in the maintenance, protection, and recovery of muscle fibers. Collagen IV expression is maintained by the balance between synthetic and degradative factors, which changes depending on the level of muscle activity. For example, exercise increases collagen IV synthesis, whereas inactivity decreases collagen IV synthesis. However, the effects of stretching on the BM structure remain unclear. Therefore, to investigate the effects of stretching on the BM of the skeletal muscle, we continuously applied stretching to the rat soleus muscle and examined the altered expression of BM-related factors and structure using quantitative polymerase chain reaction (qPCR), western blotting, zymography, immunohistochemistry, and electron microscopy. The results show that stretching increased the matrix metalloproteinase 14 (MMP14) expression and MMP2 activity, and decreased the collagen IV expression and width of the lamina densa in the soleus muscle. These results suggest that stretching promotes BM degradation in the rat soleus muscle. The findings of this study indicate a new influence of stretching on skeletal muscles, and may contribute to the new use of stretching in rehabilitation and sports fields.

The effects of stretching on muscle morphometry of ovariectomized rats

Abstract Introduction: Ageing is responsible for structural alterations, declining of all physiological variables, including range of motion and skeletal muscle function, known as sarcopenia. Objective: The aim of the study was to evaluate the effects of stretching on muscle morphometry in ovariectomized rats. Method: 21 female Wistar rats (12 weeks, 218 ± 22 g) were divided into 4 groups: control (CONTROL, n = 3) intact; ovariectomized and hysterectomized (OH, n = 6); Stretching (STRET, n = 6); ovariectomized and hysterectomized and stretching (OHS, n = 6). The rats were subjected to ovariectomy and hysterectomy. The stretching protocol of the soleus muscle lasted 10 repetitions of 1 minute with 45s interval between each repetition performed 3 times a week for 3 weeks. After 3 weeks, the rats were weighed and the muscles of both hind limbs were removed weighed and analyzed at muscle length; serial sarcomere number; sarcomere length; muscle fiber cross-sectional area (MFCSA) and percentage of connective tissue. Results: The final body weight increased in all groups. The serial sarcomere number of STRET was greater than the OH. The muscle fibers’ cross-sectional area of OHS was higher than CONTROL. Conclusion: It can be concluded that ovariectomy and hysterectomy prevented sarcomerogenesis even when stretching was applied. However, the stretching protocol enhanced muscle trophismof ovariectomized and hysterectomized rats. It might be suggested that longitudinal growth (serial sarcomeres) and radial (ASTFM) are differently regulated by stretching in intact and/or estrogen depleted (ovariectomy and hysterectomy) skeletal muscle.

Effects of mesenchymal stromal cells on motor function and collagen in the skeletal muscles of rats with type I diabetes

The present study aimed to evaluate the effects of mesenchymal stromal cell (MSC) transplantation on motor function and collagen organization in the muscles of rats with type 1 diabetes mellitus. Male Wistar rats were randomly assigned to three groups: control (C), diabetic (DM) and diabetic treated with MSCs (DM-MSCs). Diabetes was induced by streptozotocin (50 µg/kg). Bone marrow cells were isolated from the tibia and femur. After 10 weeks of DM induction, the DM-MSC rats received four i.p. injections of MSCs (1 × 106). Ten weeks after MSC transplantation, motor performance was evaluated by the rotarod test and the anterior tibial (TA) muscles were collected for morphometric and quantification of collagen birefringence by polarizing microscopy analysis. Motor performance of the DM group was significantly reduced when compared to the C group and increased significantly in the DM + MSC group. The TA muscle mass was significantly reduced in the DM and DM + MSC groups compared to the C group. The connective tissue increased in the DM group compared to the C group and decreased in the DM + MSC group. The percentage collagen birefringence decreased significantly in the DM group when compared to the C group and increased in the DM + MSC group. Motor performance was positively correlated with collagen birefringence and negatively correlated with percentage of connective tissue. The results indicate that MSC transplantation improves both motor function and the collagen macromolecular organization in type 1 DM.

The development of a mechanical device to stretch skeletal muscle of young and old rats

OBJECTIVE

How much force is needed to stretch skeletal muscle is still unknown. The aim of this study was to develop a device that mechanically stretches rat muscle to compare the force (N) required to stretch the soleus muscle of young and aged rats and the tibio-tarsal angle joint at neutral and stretched positions.

METHODS

Twelve female Wistar rats were divided into two groups: a young group (YG, n=6, 311±11 g) of rats 3 months old and an aged group (AG, n=6, 351±43 g) of rats 15 months old. The left soleus muscle was mechanically held in full dorsal flexion and submitted to mechanical passive stretching: 1 bout of 10 repetitions, each repetition lasted 60 seconds with an interval of 45 seconds between repetitions, performed once a day, twice a week, for 1 week. The force required during stretching was measured by a load cell, and the tibio-tarsal angle joint was measured by photometry.

RESULTS

The load cell calibration showed excellent reliability, as confirmed by the intraclass correlation coefficient value of 0.93. A decrease in delta force was found in the comparison between YG and AG (0.11±0.03 N vs 0.08±0.02 N, p<0.05, repeated measures ANOVA). There was no difference between the YG and the AG in the tibio-tarsal angle at resting position (87.1±3.8° vs 87.1±3.5°, p=0.35, Kruskal Wallis) and at the end of the stretching protocol (43.9±4.4° vs 42.6±3.4°, p=0.57, Kruskal Wallis).

CONCLUSION

The device presented in this study is able to monitor the force necessary to stretch hindlimb rat muscles. Aged rats required less force than young rats to stretch the soleus muscle, and there was no difference regarding the tibio-tarsal angle between the two groups.

Regulation of extracellular matrix elements and sarcomerogenesis in response to different periods of passive stretching in the soleus muscle of rats

Stretching is a common method used to prevent muscle shortening and improve limited mobility. However, the effect of different time periods on stretching-induced adaptation of the extracellular matrix and its regulatory elements have yet to be investigated. We aimed to evaluate the expression of fibrillar collagens, sarcomerogenesis, metalloproteinase (MMP) activity and gene expression of the extracellular matrix (ECM) regulators in the soleus (SOL) muscle of rats submitted to different stretching periods. The soleus muscles were submitted to 10 sets of passive stretching over 10 (St 10d) or 15 days (St 15d) (1 min per set, with 30 seconds' rest between sets). Sarcomerogenesis, muscle cross-sectional area (CSA), and MMP activity and mRNA levels in collagen (type I, III and IV), connective tissue growth factor (CTGF), growth factor-beta (TGF-β), and lysyl oxidase (LOX) were analyzed. Passive stretching over both time periods mitigated COL-I deposition in the SOL muscle of rats. Paradoxically, 10 days of passive stretching induced COL-I and COL-III synthesis, with concomitant upregulation of TGF-β1 and CTGF at a transcriptional level. These responses may be associated with lower LOX mRNA levels in SOL muscles submitted to 10 passive stretching sessions. Moreover, sarcomerogenesis was observed after 15 days of stretching, suggesting that stretching-induced muscle adaptations are time-dependent responses.

Stretching After Heat But Not After Cold Decreases Contractures After Spinal Cord Injury in Rats

BACKGROUND

Contractures are a prevalent and potentially severe complication in patients with neurologic disorders. Although heat, cold, and stretching are commonly used for treatment of contractures and/or spasticity (the cause of many contractures), the sequential effects of these modalities remain unclear.

QUESTIONS/PURPOSES

Using an established rat model with spinal cord injury with knee flexion contracture, we sought to determine what combination of heat or cold before stretching is the most effective for treatment of contractures derived from spastic paralyses and investigated which treatment leads to the best (1) improvement in the loss of ROM; (2) restoration of deterioration in the muscular and articular factors responsible for contractures; and (3) amelioration of histopathologic features such as muscular fibrosis in biceps femoris and shortening of the joint capsule.

METHODS

Forty-two adolescent male Wistar rats were used. After spasticity developed at 2 weeks postinjury, each animal with spinal cord injury underwent the treatment protocol daily for 1 week. Knee extension ROM was measured with a goniometer by two examiners blinded to each other's scores. The muscular and articular factors contributing to contractures were calculated by measuring ROM before and after the myotomies. We quantitatively measured the muscular fibrosis and the synovial intima length, and observed the distribution of collagen of skeletal muscle. The results were confirmed by a blinded observer.

RESULTS

The ROM of heat alone (34° ± 1°) and cold alone (34° ± 2°) rats were not different with the numbers available from that of rats with spinal cord injury (35° ± 2°) (p = 0.92 and 0.89, respectively). Stretching after heat (24° ± 1°) was more effective than stretching alone (27° ± 3°) at increasing ROM (p < 0.001). Contrastingly, there was no difference between stretching after cold (25° ± 1°) and stretching alone (p = 0.352). Stretching after heat was the most effective for percentage improvement of muscular (29%) and articular (50%) factors of contractures. Although quantification of muscular fibrosis in the rats with spinal cord injury (11% ± 1%) was higher than that of controls (9% ± 0.4%) (p = 0.01), no difference was found between spinal cord injury and each treatment protocol. The total synovial intima length of rats with spinal cord injury (5.9 ± 0.2 mm) became shorter than those of the controls (7.6 ± 0.2 mm) (p < 0.001), and those of stretching alone (6.9 ± 0.4 mm), stretching after heat (7.1 ± 0.3 mm), and stretching after cold (6.7 ± 0.4 mm) increased compared with rats with spinal cord injury (p = 0.01, p = 0.001, and p = 0.04, respectively). The staining intensity and pattern of collagen showed no difference among the treatment protocols.

CONCLUSIONS

This animal study implies that heat or cold alone is ineffective, and that stretching is helpful for the correction of contractures after spinal cord injury. In addition, we provide evidence that heat is more beneficial than cold to increase the effectiveness of stretching.

CLINICAL RELEVANCE

Our findings tend to support the idea that stretching after heat can improve the loss of ROM and histopathologic features of joint tissues. However, further studies are warranted to determine if our findings are clinically applicable.

Morphologic study of different treatments for gastrocnemius muscle contusion in rats

Objective

Evaluate the effects of ultrasound and stretching in morphology after rat muscle contusion.

Methods

Male Wistar rats (n = 35, 8–9 weeks, 271 ± 14 g) were divided into five groups: control group (CG = 3); lesion group (LG = 8); lesion + ultrasound group (LUG = 8); lesion + stretching group (LSG = 8); lesion + ultrasound + stretching group (LUSG = 8). The ultrasound was applied in LUG and LUSG from the third to the seventh day, the dose used was 50% pulsed, 0.5 W/cm², 5 min. From the tenth until the twenty first day, passive stretching was performed, in four repetitions lasting 30 s each with 30 s of rest. Initial and final body weight, muscle weight and length, number and sarcomere length, muscle fiber cross-sectional area, and percentage of collagen were evaluated after 22 days.

Results

The final body weight was higher than the initial in all groups. The number of sarcomeres was statistically higher in LSG than LUG and higher in LUSG than LUS and CG; in sarcomere length was higher in LUG when compared with LSG (p < 0.05). The cross sectional area in LG was higher than LSG, and the percentage of collagen was higher in LG when compared with LSG and CG; in LUG when compared with LSG and CG; and in LUSG when compared with CG.

Conclusion

The passive stretching protocol induced sarcomerogenesis and antifibrotic effect over the muscle submitted to contusion. Ultrasound, even in association with stretching, was not sufficient to prevent fibrosis in the injured muscle.

Effects of GaAs laser and stretching on muscle contusion in rats

ABSTRACT Laser and stretching are used to treat skeletal muscle injuries. This study aimed to evaluate the effects of GaAs laser and stretching in the morphology of the tibialis anterior (TA) muscle after contusion. Thirty-six male rats (349±23g) were divided into six groups (n=6): control group (CG); lesion group (LG); lesion and laser group (LLG); lesion and stretching group (LSG); lesion, laser and stretching group (LLSG); and stretching group (SG). TA was wounded by a contusion apparatus. We used GaAs laser 4.5 J/cm2 dose for 32 s each, beginning 48 h after lesion, for 7 days, once a day. Manual passive stretching was applied by 10 repetitions for 1 minute, initiating on the 8th day, once a day, 3 times a week, during 3 weeks. After 4 weeks, rats were euthanized and we analyzed: muscle weight and length, cross sectional area of muscle fibers (CSAMF), serial sarcomere number (SSN), sarcomere length, and percentage of connective tissue. Comparisons among groups were made by ANOVA and post hoc Tukey tests, with the significance level set at ≤ 0.05. The serial sarcomere number of LLSG was higher than LSG. The sarcomere length of LSG was superior to LLG, LLSG, and SG. SG increased SSN compared to CG, while the percentage of connective tissue of SG decreased in comparison to LLSG. Thus, the sarcomerogenesis of injured muscles was enhanced by laser therapy, stretching, and association of both. The stretching protocol was enough to increase SSN of intact muscles.

Acute effects of stretching exercise on the soleus muscle of female aged rats

It has been shown that stretching exercises can improve the flexibility and independence of the elderly. However, although these exercises commonly constitute training programs, the morphological adaptations induced by stretching exercises in aged skeletal muscle are still unclear.

OBJECTIVE

To assess the acute effects of passive mechanical static stretching on the morphology, sarcomerogenesis and modulation of important components of the extracellular matrix of the soleus muscle of aged female rats.

METHODS

Fifteen old female rats with 26 months were divided into two groups: stretching (n=8, SG) and control (n=7, CG): The stretching protocol consisted of 4 repetitions each of 1 min with 30s interval between sets. Stretching was performed on the left soleus muscle, 3 times a week for 1 week. After three sessions, the rats were anesthetized to remove the left soleus muscle, and then euthanized. The following analyses were carried out: muscle fiber cross-sectional area and serial sarcomere number; immunohistochemistry for the quantification of collagen I, III and TGFβ-1.

RESULTS

a decrease in muscle fiber cross-sectional area of the SG was observed when compared to the CG (p=0.0001, Kruskal-Wallis); the percentage of type I collagen was significantly lower in the SG when compared to the CG (p=0.01, Kruskal-Wallis), as well as the percentage of TGFβ-1 (p=0.04, Kruskal-Wallis); collagen III was significantly higher in the SG than in the CG (7.06±6.88% vs 4.92±5.30%, p=0.01, Kruskal-Wallis).

CONCLUSION

Although the acute stretching induced muscle hypotrophy, an antifibrotic action was detected.

Intermittent stretching induces fibrosis in denervated rat muscle

INTRODUCTION

Stretching (St) has been used for treating denervated muscles. However, its effectiveness and safety claims require further study.

METHODS

Rats were divided into: (1) those with denervated (D) muscles, evaluated 7 or 15 days after sciatic nerve crush injury; (2) those with D muscles submitted to St during 7 or 15 days; and (3) those with normal muscles. Muscle fiber cross-sectional area, serial sarcomere number, sarcomere length, and connective tissue density were measured. MMP-2, MMP-9, TIMP-1, TGF-β1, and myostatin mRNAs were determined by real-time polymerase chain reaction. MMP-2 and MMP-9 activity was evaluated by zymography. Collagen I was localized using immunofluorescence.

RESULTS

St did not prevent muscle atrophy due to denervation, but it increased fibrosis and collagen I deposition at day 15. St also upregulated MMP-9 and TGF-β1 gene expressions at day 7, and myostatin at day 15.

CONCLUSIONS

Stretching denervated muscle does not prevent atrophy, but it increases fibrosis via temporal modulation of TGF-β1/myostatin and MMP-9 cascades.

Intermittent stretch training of rabbit plantarflexor muscles increases soleus mass and serial sarcomere number

In humans, enhanced joint range of motion is observed after static stretch training and results either from an increased stretch tolerance or from a change in the biomechanical properties of the muscle-tendon unit. We investigated the effects of an intermittent stretch training on muscle biomechanical and structural variables. The left plantarflexors muscles of seven anesthetized New Zealand (NZ) White rabbits were passively and statically stretched three times a week for 4 wk, while the corresponding right muscles were used as nonstretched contralateral controls. Before and after the stretching protocol, passive torque produced by the left plantarflexor muscles as a function of the ankle angle was measured. The left and right plantarflexor muscles were harvested from dead rabbits and used to quantify possible changes in muscle structure. Significant mass and serial sarcomere number increases were observed in the stretched soleus but not in the plantaris or medial gastrocnemius. This difference in adaptation between the plantarflexors is thought to be the result of their different fiber type composition and pennation angles. Neither titin isoform nor collagen amount was modified in the stretched compared with the control soleus muscle. Passive torque developed during ankle dorsiflexion was not modified after the stretch training on average, but was decreased in five of the seven experimental rabbits. Thus, an intermittent stretching program similar to those used in humans can produce a change in the muscle structure of NZ White rabbits, which was associated in some rabbits with a change in the biomechanical properties of the muscle-tendon unit.

Biomechanical strain vehicles for fibroblast-directed skeletal myoblast differentiation and myotube functionality in a novel coculture

Skeletal muscle functionality is governed by multiple stimuli, including cytokines and biomechanical strain. Fibroblasts embedded within muscle connective tissue respond to biomechanical strain by secreting cytokines that induce myoblast differentiation and, we hypothesize, regulate myotube function. A coculture was established to allow cross talk between fibroblasts in Bioflex wells and myoblasts on nondeformable coverslips situated above Bioflex wells. Cyclic short-duration strain (CSDS) modeling repetitive stress/injury, acyclic long-duration strain (ALDS) modeling manipulative therapy, and combined strain paradigms (CSDS + ALDS) were applied to fibroblasts. Nonstrained myoblasts in uniculture and coculture served as controls. After fibroblasts had induced myoblast differentiation, myotube contraction was assessed by perfusion of ACh (10(-11)-10(-3) M). CSDS-treated fibroblasts increased myotube contractile sensitivity vs. uniculture (P < 0.05). As contraction is dependent on ACh binding, expression and clustering of nicotinic ACh receptors (nAChRs) were measured. CSDS-treated fibroblasts increased nAChR expression (P < 0.05), which correlated with myotube contraction. ALDS-treated fibroblasts did not significantly affect contraction or nAChR expression. Agrin-treated myotubes were then used to design a computer algorithm to identify α-bungarotoxin-stained nAChR clusters. ALDS-treated fibroblasts increased nAChR clustering (P < 0.05), while CSDS-treated fibroblasts disrupted cluster formation. CSDS-treated fibroblasts produced nAChRs preferentially located in nonclustered regions (P < 0.05). Strain-activated fibroblasts mediate myotube differentiation with multiple functional phenotypes. Similar to muscle injury, CSDS-treated fibroblasts disrupted nAChR clusters and hypersensitized myotube contraction, while ALDS-treated fibroblasts aggregated nAChRs in large clusters, which may have important clinical implications. Cellular strategies aimed at improving muscle functionality, such as through biomechanical strain vehicles that activate fibroblasts to stabilize postsynaptic nAChRs on nearby skeletal muscle, may serve as novel targets in neuromuscular disorders.

Effects of the nerve mobilization technique on lower limb function in patients with poststroke hemiparesis

[Purpose] The purpose of the study was to determine the effects of a sciatic nerve mobilization technique on improvement of lower limb function in patient with poststroke hemiparesis. [Subjects] Twenty- two stroke patients participated in this study. [Methods] They were randomly selected based on selection criteria and divided into two groups. In the subject group (n=10), sciatic nerve mobilization with conventional physical therapy was applied to patients. In the control group (n=10), only conventional physical therapy was applied to stroke patients. [Results] There were significant differences between the two groups in pressure, sway, total pressure, angle of the knee joint, and functional reaching test results in the intervention at two weeks and at four weeks. [Conclusion] The present study showed that sciatic nerve mobilization with conventional physical therapy was more effective for lower limb function than conventional physical therapy alone in patient with poststroke hemiparesis.

Immobilization and therapeutic passive stretching generate thickening and increase the expression of laminin and dystrophin in skeletal muscle

Extracellular matrix and costamere proteins transmit the concentric, isometric, and eccentric forces produced by active muscle contraction. The expression of these proteins after application of passive tension stimuli to muscle remains unknown. This study investigated the expression of laminin and dystrophin in the soleus muscle of rats immobilized with the right ankle in plantar flexion for 10 days and subsequent remobilization, either by isolated free movement in a cage or associated with passive stretching for up to 10 days. The intensity of the macrophage response was also evaluated. One hundred and twenty-eight female Wistar rats were divided into 8 groups: free for 10 days; immobilized for 10 days; immobilized/free for 1, 3, or 10 days; or immobilized/stretched/free for 1, 3, or 10 days. After the experimental procedures, muscle tissue was processed for immunofluorescence (dystrophin/laminin/CD68) and Western blot analysis (dystrophin/laminin). Immobilization increased the expression of dystrophin and laminin but did not alter the number of macrophages in the muscle. In the stretched muscle groups, there was an increase in dystrophin and the number of macrophages after 3 days compared with the other groups; dystrophin showed a discontinuous labeling pattern, and laminin was found in the intracellular space. The amount of laminin was increased in the muscles treated by immobilization followed by free movement for 10 days. In the initial stages of postimmobilization (1 and 3 days), an exacerbated macrophage response and an increase of dystrophin suggested that the therapeutic stretching technique induced additional stress in the muscle fibers and costameres.

Comparison of treatment effects between children with spastic cerebral palsy under and over five years after botulinum toxin type a injection

OBJECTIVE

To evaluate whether age influences a change in the spasticity of the ankle plantar flexor after botulinum toxin type A (BTA) injection in children with spastic cerebral palsy (CP).

METHODS

Sixteen children with spastic CP were enrolled in the study. Seven children (group 1) were under 5 years of age, and nine (group 2) were over 5 years of age. They all received BTA injection in the gastrocnemius muscle (GCM) under ultrasound guidance. Passive range of motion (PROM) of ankle dorsiflexion, Modified Ashworth Scale (MAS) of the ankle plantar flexor, Gross Motor Function Measure (GMFM) and median red pixel intensity (RPI) of the medial GCM on real-time sonoelastography were measured at baseline (pre-injection) and 1-, 3-, and 6-month post-injection.

RESULTS

In both groups, the mean PROM, MAS, and RPI were significantly improved after injection until 6-month post-injection. The change of PROM of ankle dorsiflexion in group 1 was significantly greater than that in group 2, until 6-month post-injection. The change in the MAS and GMFM between baseline and 6-month post-injection in group 1 was greater than that in group 2. The changes in the median RPI between baseline and 3- and 6-month post-injections were greater in group 1 than in group 2.

CONCLUSION

Our pilot study demonstrated the different changes in spasticity of the ankle plantar flexor after BTA injection based on age. Therefore, age may be considered when establishing a treatment plan using BTA injection for children with spastic CP.

Post-immobilization eccentric training promotes greater hypertrophic and angiogenic responses than passive stretching in muscles of weanling rats

This study investigated how different types of remobilization after hind limb immobilization, eccentric exercise and passive static stretching, influenced the adaptive responses of muscles with similar function and fascicle size, but differing in their contractile characteristics. Female Wistar weanling rats (21 days old) were divided into 8 groups: immobilized for 10 days, maintaining the ankle in maximum plantar flexion; immobilized and submitted to eccentric training for 10 or 21 days on a declining treadmill for 40min; immobilized and submitted to passive stretching for 10 or 21 days for 40min by maintaining the ankle in maximum dorsiflexion; control of immobilized; and control of 10 or 21 days. The soleus and plantaris muscles were analyzed using fiber distribution, lesser diameter, capillary/fiber ratio, and morphology. Results showed that the immobilization reduced the diameter of all fiber types, caused changes in fiber distribution and decreased the number of transverse capillaries in both muscles. The recovery period of the soleus muscle is longer than that of the plantaris after detraining. Moreover, eccentric training induced greater hypertrophic and angiogenic responses than passive stretching, especially after 21 days of rehabilitation. Both techniques demonstrated positive effects for muscle rehabilitation with the eccentric exercise being more effective.

Amount of torque and duration of stretching affects correction of knee contracture in a rat model of spinal cord injury

BACKGROUND

Joint contractures are a common complication of many neurologic conditions, and stretching often is advocated to prevent and treat these contractures. However, the magnitude and duration of the stretching done in practice usually are guided by subjective clinical impressions.

QUESTIONS/PURPOSES

Using an established T8 spinal cord injury rat model of knee contracture, we sought to determine what combination of static or intermittent stretching, varied by magnitude (high or low) and duration (long or short), leads to the best (1) improvement in the limitation in ROM; (2) restoration of the muscular and articular factors leading to contractures; and (3) prevention and treatment of contracture-associated histologic alterations of joint capsule and articular cartilage.

METHODS

Using a rat animal model, the spinal cord was transected completely at the level of T8. The rats were randomly assigned to seven treatment groups (n = 4 per group), which were composed of static or intermittent stretching in combination with different amounts of applied torque magnitude and duration. We assessed the effect of stretching by measuring the ROM and evaluating the histologic alteration of the capsule and cartilage.

RESULTS

Contractures improved in all treated groups except for the low-torque and short-duration static stretching conditions. High-torque stretching was effective against shortening of the synovial membrane and adhesions in the posterosuperior regions. Collagen Type II and VEGF in the cartilage were increased by stretching.

CONCLUSIONS

High-torque and long-duration static stretching led to greater restoration of ROM than the other torque and duration treatment groups. Stretching was more effective in improving articular components of contractures compared with the muscular components. Stretching in this rat model prevented shortening and adhesion of the joint capsule, and affected biochemical composition, but did not change morphologic features of the cartilage.

CLINICAL RELEVANCE

This animal study tends to support the ideas that static stretching can influence joint ROM and histologic qualities of joint tissues, and that the way stretching is performed influences its efficacy. However, further studies are warranted to determine if our findings are clinically applicable.

Effects of 40min of maintained stretch on the soleus and plantaris muscles of rats applied for different periods of time after hindlimb immobilization

Stretching is frequently used in physiotherapy to minimize or even reverse the alterations that occur after muscle disuse. Alterations that occur after 10 and 21 days of maintained stretch in soleus and plantaris muscles post-disuse were evaluated in the present study in experimental rats. Thirty adult female Wistar rats were divided into seven groups: hindlimb immobilization for 10 days; immobilization and 10 days stretched; immobilized and 21 days stretched; three control groups consisting of animals of different ages and anesthetized group. The right hindlimb was immobilized using a lightweight apparatus composed of two sections: (i) upper part: a small cotton T-shirt and, and (ii) lower part: a steel mesh to fix the ankle in plantar-flexion-shortened position. Fragments of the soleus and plantaris muscle were frozen and processed using histochemical and immunohistochemical methods. Limb immobilization caused important morphological alterations in skeletal muscle including: reduction in the number of type I fibers and an increase in type IIC fibers, reduction in the lesser diameter of type I, IIA and IIAD fibers and in the number of capillaries in soleus muscle. The stretching program applied for 10 days was insufficient to allow recovery from the disuse alterations in both muscles. However, after 21 days there were improved morphological characteristics, size and distribution of the different fibers.

Remobilization through stretching improves gait recovery in the rat

Remobilization of a previously immobilized rat right hindlimb in the ankle plantar-flexion-shortened position by free movement alone or associated with intermittent passive stretching was assessed by analysis of gait variables and dorsiflexion range of motion. The variables were related with the expression of extracellular matrix proteins and the addition of serial sarcomeres. Sixty-four female Wistar rats were divided into 8 groups: immobilized, free for 10 days, immobilized/stretched/free for 1, 3 or 10 days, immobilized/free for 1, 3 or 10 days. Gait variables, range of motion, serial sarcomeres number, localization and staining intensity of fibronectin, and expressions of types I and III collagen were analyzed. The hypokinesia changed the functional variables of gait, reduced the dorsiflexion range of motion (ROM), increased the number of fibers with intracellular fibronectin/total number of fibers (FIF/TNF), and decreased the expression of the type I collagen. After three days, morphological changes were exacerbated and the number of serial sarcomeres was increased in both groups, immobilized/stretched/free and immobilized/free. Functional impairment, ROM restriction and increased FIF/TNF were also observed. Despite the above described alterations, 10 days of stretching program increased the effectiveness of remobilization leading to recovery of the abnormalities observed in the muscle.

Progression of articular cartilage degeneration after application of muscle stretch

The aim of study was to evaluate the progression of the ankle articular cartilage alterations after a post-immobilization muscle stretching. Twenty-nine Wistar rats were separated into five groups: C--control, S--stretched, SR--stretch recovery, IS--immobilized and stretched, and ISR--immobilized stretched recovery. The immobilization was maintained for 4 weeks and the left ankle was then stretched manually through a full dorsal flexion for 10 times for 60 s with a 30 s interval between each 60 s period, 7 days/week for 3 weeks. The recovery period was of 7 weeks. At the end of the experiment, the left ankles were removed, processed in paraffin, and stained in hematoxylin-eosin and safranin O. Two blinded observers evaluated the articular cartilage using the Mankin grading system (cellularity, chondrocyte cloning, and proteoglycan content) through light microscopy, and performed the morphometry (cellularity, total thickness, non-calcified thickness, and calcified thickness measures). Both the Mankin grading system and the morphometric analysis showed that the ISR group presented the most increased cellularity among the groups. The IS and SR groups showed the highest proteoglycan loss, and the ISR group showed the same content of proteoglycan observed in the C group. No significant differences were found in the chondrocyte cloning, the total cartilage thickness, the non-calcified cartilage thickness, and the calcified cartilage thickness among the groups. The results suggest that the cartilage can recover the proteoglycan loss caused by immobilization and stretching, probably because of the increased chondrocyte density. Therefore, the ankle articular cartilage responded as to repair the metabolic deficits.

Efeitos imediatos do alongamento em diferentes posicionamentos

INTRODUÇÃO: Exercícios de alongamento aumentam a extensibilidade dos tecidos moles e restauram o comprimento muscular. O alongamento produz efeitos imediatos e uma única sessão é capaz de melhorar a extensibilidade muscular e mobilidade articular. A técnica de alongamento e o posicionamento influenciam no nível de tensão muscular. OBJETIVO: O objetivo geral deste estudo foi determinar os efeitos imediatos do alongamento na flexibilidade do músculo iliopsoas em diferentes posicionamentos, em uma única sessão, identificando máxima tensão desta musculatura e relacionando o alongamento com alterações comuns do alinhamento lombo-pélvico no plano sagital. METODOLOGIA: Trata-se de um ensaio clínico controlado randomizado unicego. A população compreendeu estudantes com encurtamento do músculo iliopsoas. Foi realizada uma sessão de alongamento estático por um minuto com a extensão da articulação do quadril nos posicionamentos decúbito dorsal, semiflexão de joelhos, decúbito ventral e decúbito lateral. Para análise pareada das posições para o alongamento, foi utilizado o teste Wilcoxon (α < 0,01). RESULTADOS: Participaram do estudo 40 estudantes, divididos em grupos compostos por dez indivíduos. A média da idade foi de 22 ± 1,7 anos. A maioria dos participantes era do sexo feminino (77,5%) e 75% relataram episódio de dor lombar em alguma fase da vida. Observou-se, como efeitos imediatos do alongamento, um ganho na flexibilidade muscular nos posicionamentos decúbito dorsal, semiflexão de joelhos e decúbito lateral. Observou-se também tendência à retroversão e neutralização da pelve. CONCLUSÃO: Os diferentes posicionamentos fornecem maior variabilidade de posições, permitindo ao fisioterapeuta escolher qual a mais adequada para cada indivíduo.

Propriedades mecânicas do músculo gastrocnêmio de ratas, imobilizado e posteriormente submetido a diferentes protocolos de alongamento

O alongamento é amplamente utilizado na prática clínica da fisioterapia e no desporto, porém, as alterações mecânicas que essa técnica gera no músculo esquelético são pouco exploradas cientificamente. Este estudo avaliou as alterações mecânicas que acometem o músculo gastrocnêmio de ratas Wistar, adultas jovens, após 14 dias de imobilização e, secundariamente, submetido a alongamento manual passivo por 10 dias consecutivos, aplicado uma ou duas vezes ao dia. Foram utilizados 50 animais, sendo 10 para cada grupo: Controle (GC); Imobilizado (GI); Imobilizado e Liberado (GIL); Imobilizado e alongado uma vez ao dia (GIA1); e Imobilizado e alongado duas vezes ao dia (GIA2). O músculo gastrocnêmio foi submetido ao ensaio mecânico de tração, onde foram avaliadas as propriedades de carga e alongamento nos limites máximo e proporcional, além de rigidez e resiliência. A imobilização reduziu os valores das propriedades mecânicas de carga no limite máximo (CLM), carga no limite proporcional (CLP), alongamento no limite máximo (ALM), rigidez e resiliência, em 44,4%, 34,4%, 27,6%, 64,4% e 54%, respectivamente, quando comparados com os valores do GC. A remobilização livre e o alongamento restauraram as propriedades de CLM, CLP, ALM, rigidez e resiliência do músculo, exceto para o GIA2, que foi incapaz de restabelecer a propriedade de ALM (31,3% menor que GC). Concluí-se, portanto que, após 14 dias de imobilização segmentar, cargas individuais de alongamento e a livre movimentação permitem restituir as propriedades mecânicas do tecido muscular.

Changes in postnatal skeletal muscle development induced by alternative immobilization model in female rat

The objective of this study was to adapt a model of hind limb immobilization to newly weaned female rats and to determine the morphology of shortened soleus and plantaris muscles. Female Wistar rats were divided into three groups: control zero (n = 3) and control and free (n = 8), animals aged 21 and 31 days, respectively, submitted to no intervention, and immobilized (n = 25), animals aged 21 days submitted to immobilization for 10 days and sacrificed at 31 days of age. The device used for immobilization had advantages such as easy connection, good fit, and low cost. The immobilized rats showed a reduction in muscle fiber area and in connective tissue. The adaptation of this immobilization model originally used for adult rats was an excellent alternative for newly weaned rats and was also efficient in inducing significant hind limb disuse.