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Konrad A, Reiner M, Manieu J, Fischer J, Schöpflin A, Tilp M, Behm DG. The non-local effects of 7-week foot sole static stretching and foam rolling training on shoulder extension range of motion. Front Sports Act Living 2024; 5:1335872. [PMID: 38283121 PMCID: PMC10810996 DOI: 10.3389/fspor.2023.1335872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/21/2023] [Indexed: 01/30/2024] Open
Abstract
Static stretching and foam rolling can increase the range of motion (ROM) of a joint acutely as well as chronically. Although studies have reported ROM increases of a non-stretched heterologous muscle (non-local) following an acute static stretching or foam rolling session, these effects have not been studied for long-term training interventions. Therefore, the purpose of this study was to investigate the effects of a comprehensive 7-week static stretching and foam rolling training program of the foot sole on shoulder extension ROM. A total of 33 healthy, physically active participants (20 male) were assigned to either the intervention (n = 19) or control (n = 14) group. The intervention group performed a 7-week combined static stretching and foam rolling intervention comprising three sessions a week, including three exercises of the foot sole for 5 min each. Before and after the intervention period, the shoulder extension ROM was tested with three-dimensional (3D) motion caption. The level of significance for all statistical analyses was set to ρ ≤ 0.05. There was no significant time (p = 0.70, F1, 31 = 0.157; η2 = 0.005) or time×group effect (p = 0.38, F1, 31 = 0.785; η2 = 0.025) in shoulder extension ROM, indicating no ROM changes in the intervention or the control group. Although previous studies on the acute effects of stretching and foam rolling reported non-local increases in ROM in heterologous muscles, this study could show that such effects do not occur after chronic SS and foam rolling training for 7 weeks. Consequently, if the goal is to chronically increase the ROM of a specific joint, it is recommended to directly treat the muscles of interest.
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Affiliation(s)
- Andreas Konrad
- Institute of Human Movement Science, Sports and Health, University of Graz, Graz, Austria
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL, Canada
| | - Marina Reiner
- Institute of Human Movement Science, Sports and Health, University of Graz, Graz, Austria
| | - Josefina Manieu
- Institute of Human Movement Science, Sports and Health, University of Graz, Graz, Austria
| | - Josef Fischer
- Institute of Human Movement Science, Sports and Health, University of Graz, Graz, Austria
| | - Adrian Schöpflin
- Institute of Human Movement Science, Sports and Health, University of Graz, Graz, Austria
| | - Markus Tilp
- Institute of Human Movement Science, Sports and Health, University of Graz, Graz, Austria
| | - David G. Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL, Canada
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Lu Y, Chen J, Zhang XL. Low-Intensity Resistance Exercise Based on Myofascial Chains Alters the Lower-Limb Tension and Improves Health Status in Female Individuals With Knee Osteoarthritis. J Sport Rehabil 2023; 32:818-826. [PMID: 37527818 DOI: 10.1123/jsr.2022-0367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 04/25/2023] [Accepted: 05/19/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Low-intensity resistance exercise therapy (LIRET) based on myofascial chains, applied to both affected and nonlocal joints, is an effective method for knee osteoarthritis (OA) rehabilitation. This study applied LIRET in a comparison of prevalues and postvalues of lower-limb tension in female patients with knee OA and asymptomatic participants. METHODS Twenty-four female participants with knee OA and 20 asymptomatic women took part in a 3-month long application of LIRET. Participants' ankle passive torque and ankle range of motion in the sagittal plane were assessed with an isokinetic dynamometer. The collected values were used to estimate the sagittal-plane lower-limb tension. RESULTS Compared with the asymptomatic group, participants with knee OA presented decreased maximum ankle dorsiflexion (P < .001), decreased ankle plantar flexion range (P = .023), ankle resting position more inclined to dorsiflexion (P = .017), increased ankle dorsiflexion stiffness (P = .005), and lower ankle plantar flexion stiffness (P = .034). After exercise intervention, the knee OA group self-reported less knee pain (P < .001), improved physical function (P < .001), increased maximum dorsiflexion (P = .021), and increased plantar flexion range (P < .001). While plantar flexion stiffness increased (P = .037), dorsiflexion stiffness decreased (P = .015) and ankle resting position moved toward dorsiflexion (P = .002). Results suggest possible decreased anterior leg tension and possible increased posterior leg tension in patients with knee OA. CONCLUSIONS The results supported that knee OA patients present imbalanced myofascial tension of lower limbs. LIRET based on myofascial chains appears to decrease pain, and stiffness, and improve physical function of patients with knee OA and change their lower-limb tension.
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Affiliation(s)
- Yao Lu
- Qilu Institute of Technology, Qufu, SD,China
| | - Jie Chen
- Qingdao Hengxing University of Science and Technology, Qingdao, SD,China
- Auckland Bioengineering Institute, The University of Auckland, Auckland,New Zealand
| | - Xue-Lin Zhang
- Department of Physical Science, Qufu Normal University, Qufu, SD,China
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Kodama Y, Masuda S, Ohmori T, Kanamaru A, Tanaka M, Sakaguchi T, Nakagawa M. Response to Mechanical Properties and Physiological Challenges of Fascia: Diagnosis and Rehabilitative Therapeutic Intervention for Myofascial System Disorders. Bioengineering (Basel) 2023; 10:bioengineering10040474. [PMID: 37106661 PMCID: PMC10135675 DOI: 10.3390/bioengineering10040474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Damage to the fascia can cause significant performance deficits in high-performance sports and recreational exercise and may contribute to the development of musculoskeletal disorders and persistent potential pain. The fascia is widely distributed from head to toe, encompassing muscles, bones, blood vessels, nerves, and internal organs and comprising various layers of different depths, indicating the complexity of its pathogenesis. It is a connective tissue composed of irregularly arranged collagen fibers, distinctly different from the regularly arranged collagen fibers found in tendons, ligaments, or periosteum, and mechanical changes in the fascia (stiffness or tension) can produce changes in its connective tissue that can cause pain. While these mechanical changes induce inflammation associated with mechanical loading, they are also affected by biochemical influences such as aging, sex hormones, and obesity. Therefore, this paper will review the current state of knowledge on the molecular level response to the mechanical properties of the fascia and its response to other physiological challenges, including mechanical changes, innervation, injury, and aging; imaging techniques available to study the fascial system; and therapeutic interventions targeting fascial tissue in sports medicine. This article aims to summarize contemporary views.
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Affiliation(s)
- Yuya Kodama
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Shin Masuda
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Toshinori Ohmori
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Akihiro Kanamaru
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Masato Tanaka
- Department of Orthopaedic Surgery, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Tomoyoshi Sakaguchi
- Department of Central Rehabilitation, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
| | - Masami Nakagawa
- Department of Central Rehabilitation, Okayama Rosai Hospital, 1-10-25 Midorimachi, Minamiku, Okayama 702-8055, Japan
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Myofascial force transmission between the calf and the dorsal thigh is dependent on knee angle: an ultrasound study. Sci Rep 2023; 13:3738. [PMID: 36878944 PMCID: PMC9988973 DOI: 10.1038/s41598-023-30407-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/22/2023] [Indexed: 03/08/2023] Open
Abstract
A recent in-vivo experiment has shown that force can be transmitted between the gastrocnemius and the hamstring muscles due to a direct tissue continuity. However, it remains unclear if this mechanical interaction is affected by the stiffness of the structural connection. This study therefore aimed to investigate the impact of the knee angle on myofascial force transmission across the dorsal knee. A randomized, cross-over study was performed, including n = 56 healthy participants (25.36 ± 3.9 years, 25 females). On two separate days, they adopted a prone position on an isokinetic dynamometer (knee extended or 60° flexed). In each condition, the device moved the ankle three times from maximal plantarflexion to maximal dorsal extension. Muscle inactivity was ensured using EMG. High-resolution ultrasound videos of the semimembranosus (SM) and the gastrocnemius medialis (GM) soft tissue were recorded. Maximal horizontal tissue displacement, obtained using cross-correlation, was examined as a surrogate of force transmission. SM tissue displacement was higher at extended (4.83 ± 2.04 mm) than at flexed knees (3.81 ± 2.36 mm). Linear regression demonstrated significant associations between (1) SM and GM soft tissue displacement (extended: R2 = 0.18, p = 0.001; flexed: R2 = 0.17, p = 0.002) as well as (2) SM soft tissue displacement and ankle range of motion (extended: R2 = 0.103, p = 0.017; flexed: R2 = 0.095, p = 0.022). Our results further strengthen the evidence that local stretching induces a force transmission to neighboring muscles. Resulting remote exercise effects such as increased range of motion, seem to depend on the stiffness of the continuity.Trial registration: DRKS (Deutsches Register Klinischer Studien), registration number DRKS00024420, first registered 08/02/2021, https://drks.de/search/de/trial/DRKS00024420 .
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Russo L, Montagnani E, Pietrantuono D, D’Angona F, Fratini T, Di Giminiani R, Palermi S, Ceccarini F, Migliaccio GM, Lupu E, Padulo J. Self-Myofascial Release of the Foot Plantar Surface: The Effects of a Single Exercise Session on the Posterior Muscular Chain Flexibility after One Hour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:974. [PMID: 36673731 PMCID: PMC9858880 DOI: 10.3390/ijerph20020974] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 05/31/2023]
Abstract
This study evaluated the effects of a single exercise session of Self-Myofascial Release (SMR) on the posterior muscular chain flexibility after one hour from the intervention. Thirty-six participants performed SMR using a rigid ball under the surface of both feet. Participants were tested with the Sit and Reach (S&R) test at four different times: before (T0), immediately after (T1), 30 (T2), and 60 (T3) minutes after the SMR intervention. The sample (n = 36) was categorized into three groups: (1) flexible, (2) average, and (3) stiff, based on the flexibility level at T0 (S&R values of >10 cm, >0 but <10 cm and <0 cm, respectively). For the whole sample, we detected significant improvements in the S&R test between the T1, T2, and T3 compared to T0. The stiff group showed a significant (p < 0.05) improvement between T1−T2 and T1−T3. Results were similar between the average group and the whole sample. The flexible group did not show any significant difference (p > 0.05) over time. In conclusion, this investigation demonstrated that an SMR session of both feet was able to increase posterior muscular chain flexibility up to one hour after intervention. Considering that a standard training session generally lasts one hour, our study can help professionals take advantage of SMR effects for the entire training period. Furthermore, our results also demonstrate that physical exercise practitioners should also assess individuals’ flexibility before training, as the SMR procedure used in this work does not seem necessary in flexible individuals.
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Affiliation(s)
- Luca Russo
- Department of Human Sciences, Università Telematica degli Studi IUL, 50122 Florence, Italy
| | - Eleonora Montagnani
- Department of Sports and Health Sciences, University of Brighton, Brighton BN2 4AT, UK
| | - Davide Pietrantuono
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
| | - Fabiola D’Angona
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
| | - Tommaso Fratini
- Department of Human Sciences, Università Telematica degli Studi IUL, 50122 Florence, Italy
| | - Riccardo Di Giminiani
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Stefano Palermi
- Public Health Department, University of Naples Federico II, 80132 Naples, Italy
| | - Francesco Ceccarini
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi 129188, United Arab Emirates
| | | | - Elena Lupu
- Department of Motor Activities, Petroleum Gas University Ploiesti, 100600 Ploiesti, Romania
| | - Johnny Padulo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20133 Milan, Italy
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Myofascial force transmission between the ankle and the dorsal knee: A study protocol. PLoS One 2022; 17:e0276240. [PMID: 36327229 PMCID: PMC9632914 DOI: 10.1371/journal.pone.0276240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 10/02/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Connective tissue links the skeletal muscles, creating a body-wide network of continuity. A recent in-vivo experiment demonstrated that passive elongation of the calf caused a caudal displacement of the semimembranosus muscle, indicating force transmission across the dorsal knee joint. However, it remains unclear as to whether this observation is dependent on the joint angle. If force would not be transmitted at flexed knees, this would reduce the number of postures and movements where force transmission is of relevance. Our trial, therefore, aims to investigate the influence of passive calf stretching with the knee in extended and flexed position on dorsal thigh soft tissue displacement. METHODS Participants are positioned prone on an isokinetic dynamometer. The device performs three repetitions of moving the ankle passively (5°/s) between plantar flexion and maximum dorsiflexion. With a washout-period of 24 hours, this procedure is performed twice in randomised order, once with the knee extended (0°) and once with the knee flexed (60°). Two high-resolution ultrasound devices will be used to visualize the soft tissue of the calf and dorsal thigh during the manoeuvre. Maximal horizontal displacement of the soft tissue [mm] during ankle movement will be quantified as a surrogate of force transmission, using a frame-by-frame cross-correlation analysis of the obtained US videos. DISCUSSION Understanding myofascial force transmission under in-vivo conditions is a pre-requisite for the development of exercise interventions specifically targeting the fascial connective tissue. Our study may thus provide health and fitness professional with the anatomical and functional basis for program design. TRIAL REGISTRATION The study is registered at the German Clinical Trials Register (TRN: DRKS00024420), registered 8 Februar 2021, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00024420.
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Ajimsha M, Shenoy PD, Surendran PJ, Jacob P, Bilal MJ. Evidence of in-vivo myofascial force transfer in humans; a systematic scoping review. J Bodyw Mov Ther 2022; 32:183-195. [DOI: 10.1016/j.jbmt.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 02/16/2022] [Accepted: 05/15/2022] [Indexed: 10/18/2022]
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Zullo A, Fleckenstein J, Schleip R, Hoppe K, Wearing S, Klingler W. Structural and Functional Changes in the Coupling of Fascial Tissue, Skeletal Muscle, and Nerves During Aging. Front Physiol 2020; 11:592. [PMID: 32670080 PMCID: PMC7327116 DOI: 10.3389/fphys.2020.00592] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022] Open
Abstract
Aging is a one-way process associated with profound structural and functional changes in the organism. Indeed, the neuromuscular system undergoes a wide remodeling, which involves muscles, fascia, and the central and peripheral nervous systems. As a result, intrinsic features of tissues, as well as their functional and structural coupling, are affected and a decline in overall physical performance occurs. Evidence from the scientific literature demonstrates that senescence is associated with increased stiffness and reduced elasticity of fascia, as well as loss of skeletal muscle mass, strength, and regenerative potential. The interaction between muscular and fascial structures is also weakened. As for the nervous system, aging leads to motor cortex atrophy, reduced motor cortical excitability, and plasticity, thus leading to accumulation of denervated muscle fibers. As a result, the magnitude of force generated by the neuromuscular apparatus, its transmission along the myofascial chain, joint mobility, and movement coordination are impaired. In this review, we summarize the evidence about the deleterious effect of aging on skeletal muscle, fascial tissue, and the nervous system. In particular, we address the structural and functional changes occurring within and between these tissues and discuss the effect of inflammation in aging. From the clinical perspective, this article outlines promising approaches for analyzing the composition and the viscoelastic properties of skeletal muscle, such as ultrasonography and elastography, which could be applied for a better understanding of musculoskeletal modifications occurring with aging. Moreover, we describe the use of tissue manipulation techniques, such as massage, traction, mobilization as well as acupuncture, dry needling, and nerve block, to enhance fascial repair.
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Affiliation(s)
- Alberto Zullo
- Department of Sciences and Technologies, University of Sannio, Benevento, Italy
- CEINGE Advanced Biotechnologies, Naples, Italy
| | - Johannes Fleckenstein
- Department of Sports Medicine, Institute of Sports Sciences, Goethe-University Frankfurt, Frankfurt, Germany
| | - Robert Schleip
- Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller University Jena, Jena, Germany
| | - Kerstin Hoppe
- Department of Anaesthesiology, Würzburg University, Würzburg, Germany
| | - Scott Wearing
- Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
- Faculty of Health School, Queensland University of Technology, Brisbane, QLD, Australia
| | - Werner Klingler
- Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
- Faculty of Health School, Queensland University of Technology, Brisbane, QLD, Australia
- Fascia Research Group, Department of Experimental Anaesthesiology, Ulm University, Ulm, Germany
- Department of Anaesthesiology, SRH Hospital Sigmaringen, Sigmaringen, Germany
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Wilke J, Debelle H, Tenberg S, Dilley A, Maganaris C. Ankle Motion Is Associated With Soft Tissue Displacement in the Dorsal Thigh: An in vivo Investigation Suggesting Myofascial Force Transmission Across the Knee Joint. Front Physiol 2020; 11:180. [PMID: 32210836 PMCID: PMC7069338 DOI: 10.3389/fphys.2020.00180] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/17/2020] [Indexed: 12/23/2022] Open
Abstract
Experiments in cadavers have demonstrated significant mechanical interactions between constituents of myofascial chains. However, evidence for such force transmission effects is scarce under in vivo conditions. The purpose of this trial was to examine the impact of ankle motion on soft tissue displacement of the dorsal thigh. Eleven healthy active individuals (26.8 ± 4.3 years, six males), in prone position and with the knee extended, underwent passive calf stretches (ankle dorsal extension) imposed by an isokinetic dynamometer. High-resolution ultrasound was used to simultaneously capture the displacement of the semimembranosus muscle, which was quantified by means of cross-correlation analysis. Inactivity of the leg muscles was controlled using surface electromyography (EMG). One participant had to be excluded due to major EMG activity during the experiment. According to a one-sample t test testing the difference to the neutral zero position, ankle dorsal extension induced substantial caudal muscle displacements (5.76 ± 2.67 mm, p < 0.0001). Correlation analysis (Spearman), furthermore, revealed a strong association between maximal dorsal extension and semimembranosus motion (rho = 0.76, p = 0.02). In conclusion, the present trial provides initial in vivo evidence for a mechanical force transmission between serially connected skeletal muscles. This means that local alterations of the mechanical tissue properties may modify flexibility in neighboring (superior or inferior) joints.
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Affiliation(s)
- Jan Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Heloise Debelle
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Sarah Tenberg
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Andrew Dilley
- Department of Neuroscience, University of Sussex, Brighton, United Kingdom
| | - Constantinos Maganaris
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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