1
|
Banky M, Clark RA, Mentiplay BF, Olver JH, Williams G. Hamstring spasticity assessment: does the hip flexion angle impact outcomes? Disabil Rehabil 2023:1-5. [PMID: 38100372 DOI: 10.1080/09638288.2023.2293991] [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: 06/30/2023] [Accepted: 12/06/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Hamstring spasticity is prevalent following neurological injury. The standardized assessment involves passive knee extension, in a position of 90° hip flexion. This creates passive insufficiency of the muscle and lacks ecological validity for walking, whereby the hip typically flexes to a maximum of 40° during swing phase, while the knee extends. This study compared assessment outcomes when completed in 40° and 90° hip flexion. METHODS The Modified Ashworth Scale and Modified Tardieu Scale, were performed on 35 adults with a neurological condition. Each participant was assessed by three assessors, resulting in 105 trials at 40° and 90°. RESULTS There was a significant increase in the proportion of trials rated as spastic using the Modified Ashworth Scale (p=.012, phi=.27), and Modified Tardieu Scale (p<.001, phi=.36), and the severity of spasticity using the Modified Ashworth Scale (p<.001, effect size (ES)=.50), and Modified Tardieu Scale (p<.001 ES=.47), at 90° hip flexion. The angle of reaction occurred 32° earlier at 90° hip flexion (p<.001, ES = 1.61). CONCLUSIONS Completing hamstring assessments in 40° hip flexion may reduce the passive insufficiency and improve the ecological validity of assessment, for walking. This may assist in the selection of patients requiring intervention, when their goal relates to walking.
Collapse
Affiliation(s)
- Megan Banky
- Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| | - Ross A Clark
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Australia
| | - Benjamin F Mentiplay
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | - John H Olver
- Epworth Monash Rehabilitation Medicine Unit, Melbourne, Australia
| | - Gavin Williams
- Department of Physiotherapy, Epworth HealthCare, Melbourne, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
| |
Collapse
|
2
|
Li M, Meng X, Guan L, Kim Y, Kim S. Comparing the Effects of Static Stretching Alone and in Combination with Post-Activation Performance Enhancement on Squat Jump Performance at Different Knee Starting Angles. J Sports Sci Med 2023; 22:769-777. [PMID: 38045747 PMCID: PMC10690507 DOI: 10.52082/jssm.2023.769] [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: 09/21/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023]
Abstract
We aimed to investigate the impact of isolated static stretching (4 sets of 30 seconds) and its combined form with 10 repetitive drop jumps on lower limb performance during squat jumps at different knee joint starting angles (60°, 90°, and 120°). Thirteen participants completed three randomly ordered experimental visits, each including a standardized warm-up and squat jumps at three angles, apart from the intervention or control. Information was gathered through a three-dimensional movement tracking system, electromyography system, and force platform. The electromyography data underwent wavelet analysis to compute the energy values across the four wavelet frequency bands. The average power (Pavg), peak power (Ppeak), peak ground reaction force (GRFpeak), peak center of mass velocity (Vpeak), and force-velocity relationship at peak power (SFv) were extracted from the force and velocity-time data. The results revealed no significant influence of isolated static stretching, or its combined form with drop jumps, on the energy values across the frequency bands of the gastrocnemius, biceps femoris and rectus femoris, or the Pavg or Ppeak (P > 0.05). However, at 120°, static stretching reduced the GRFpeak (P = 0.001, d = 0.86) and SFv (P < 0.001, d = 1.12), and increased the Vpeak (P = 0.001, d = 0.5). The GRFpeak, Pavg, Ppeak, and SFv increased with an increase in the joint angle (P < 0.05), whereas the Vpeak decreased (P < 0.05). These findings suggest that static stretching does not diminish power output during squat jumps at the three angles; however, it alters GRFpeak, Vpeak, and the relative contributions of force and velocity to peak power at 120°, which can be eliminated by post-activation performance enhancement. Moreover, compared to 60° and 90°, 120° was more favorable for power and peak force output.
Collapse
Affiliation(s)
- Ming Li
- Department of Physical Education, Jeonbuk National University, Republic of Korea
| | - Xiangwei Meng
- Department of Physical Education, Jeonbuk National University, Republic of Korea
| | - Lihao Guan
- Department of Physical Education, Jeonbuk National University, Republic of Korea
| | - Youngsuk Kim
- Department of Physical Education, Jeonbuk National University, Republic of Korea
| | - Sukwon Kim
- Department of Physical Education, Jeonbuk National University, Republic of Korea
| |
Collapse
|
3
|
Obst SJ, Randall S, Kunst E, Reeves B, Bielenberg K, Li D, Heales L. The immediate effect of unilaterally applied lumbar mobilisations on the passive straight leg raise and ninety-ninety test in asymptomatic adults: A randomised crossover trial. J Bodyw Mov Ther 2023; 34:87-95. [PMID: 37301563 DOI: 10.1016/j.jbmt.2023.04.045] [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: 11/29/2021] [Revised: 12/12/2022] [Accepted: 04/12/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study assessed the immediate effect of unilateral posterior-anterior lumbar mobilisations on trunk and lower limb flexibility in asymptomatic individuals. STUDY DESIGN Randomised cross-over trial. PARTICIPANTS Twenty-seven participants (age = 26.0 years ±6.4) with no current or recent history of lower back or leg pain/surgery completed the study. MAIN OUTCOME MEASURES Participants attended two sessions, receiving either grade 3 ('treatment') or grade 1 ('sham') unilateral spinal mobilisations. Outcome measures (modified-modified Schober's test [MMST], ninety-ninety test [NNT], and passive straight-leg raise [PSLR]) were assessed immediately before and after (post-1 and post-2) the intervention. An instrumented hand-held dynamometer was used to measure the change in NNT and PSLR joint angle (deg) and passive stiffness (Nm/deg) pre- and post-intervention. RESULTS The mean change in PSLR angle at the first (P1) and maximal (P2) point of discomfort following the treatment was 4.8° and 5.5°, and 5.6° and 5.7°, larger than the sham at post-1 and post-2, respectively. There was no effect of the treatment on the PSLR at P1 or P2 for the contralateral limb at either timepoint. There was no effect of the treatment on MMST distance, NNT angle or passive stiffness, or PSLR passive stiffness, for either limb. CONCLUSIONS Immediate effects of unilateral posterior-anterior lumbar mobilisations in asymptomatic individuals are isolated to treatment side and limited to a small increase in PSLR range, with no change in lumbar motion or the NNT test.
Collapse
Affiliation(s)
- Steven J Obst
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia.
| | - Samantha Randall
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Emily Kunst
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Bronwyn Reeves
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Kate Bielenberg
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Darren Li
- School of Health, Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia
| | - Luke Heales
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| |
Collapse
|
4
|
Villers J, Cardenas A, Gipson T, Man E. The Immediate Effect of Adding Lumbar Mobilization to A Static Stretching Program on Hamstrings Range of Motion: An Exploratory Study. J Sports Sci Med 2022; 21:253-259. [PMID: 35719221 PMCID: PMC9157527 DOI: 10.52082/jssm.2022.253] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/26/2022] [Indexed: 05/31/2023]
Abstract
A contributing risk factor and a byproduct of a hamstrings strain is limited hamstrings range of motion (ROM). Some evidence supports static stretching (SS) and lumbar spinal mobilization therapy (LSMT) as an effective means for increasing hamstrings ROM. However, the efficacy of combining LSMT and SS for increasing hamstrings ROM is unknown. The objective of the study is to quantify the immediate effects of the combination of LSMT and SS compared to LSMT and SS on hamstrings ROM in a healthy population. Thirty participants were randomized by block allocation into one of three intervention groups: (1) LSMT (unilateral lumbar PA mobilization at L-4); (2) SS; or (3) combination of LSMT and SS. Hamstrings ROM was measured pre- and post-intervention by the active knee extension test (AKET). There was no group-by-time interaction effect (p = 0.871). Within group analysis revealed a significant statistical change and a large effect size: LSMT (p = .037, RCI = 3.36, d = 0.771); SS (p = 0.035, RCI = 2.94, d = 0.781); combination (p = .005, RCI = 4.21, d = 1.186. The findings suggest that the combination of LSMT and SS does not have a further effect on hamstrings ROM compared to the individual results of LSMT or SS.
Collapse
Affiliation(s)
- James Villers
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | - Andrew Cardenas
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | - Travis Gipson
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| | - Emily Man
- Department of Physical Therapy, Angelo State University, San Angelo, TX, USA
| |
Collapse
|
5
|
Penailillo L, Santander M, Zbinden-Foncea H, Jannas-Vela S. Metabolic Demand and Indirect Markers of Muscle Damage After Eccentric Cycling With Blood Flow Restriction. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2020; 91:705-712. [PMID: 32023184 DOI: 10.1080/02701367.2019.1699234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
Purpose: To compare the effects of a single bout of eccentric cycling (ECC) and eccentric cycling with blood flow restriction (ECCBFR) on the changes in cardio-metabolic demand and indirect markers of muscle damage in healthy men. Method: Twenty-one young men (24.0 ± 3.2 y) were randomly allocated in two groups to perform a 30-min eccentric cycling bout with or without blood flow restriction. Oxygen consumption, heart rate, rate of perceived exertion and mean arterial blood pressure were monitored during cycling. Blood lactate was measured before and after cycling. Maximal voluntary isometric knee extensor strength and muscle damage were measured before, immediately after and 1-4 days after each eccentric cycling bout. Results: Oxygen consumption, heart rate, rate of perceived exertion and mean arterial blood pressure were similar between bouts. Blood lactate concentrations increased in both groups (p < .01), with ECCBFR showing 60% greater blood lactate concentration than eccentric cycling (p < .01). Maximal voluntary isometric knee extensor strength decreased 19-7% until 48 h and decreased 16-7% until 72 h after ECC and ECCBFR, respectively. Muscle soreness and pressure pain threshold remained elevated until 72 h after ECC and until 96 h after ECCBFR. Conclusion: These results show that ECCBFR induces similar cardiovascular stress, greater lactate production and longer time to recover than ECC alone. Thus, BFR can be safely implemented with eccentric cycling.
Collapse
|
6
|
THE RELIABILITY AND MINIMAL DETECTABLE CHANGE OF THE ELY AND ACTIVE KNEE EXTENSION TESTS. Int J Sports Phys Ther 2020; 15:776-782. [PMID: 33110697 DOI: 10.26603/ijspt20200776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Muscle length is a common component of the physical therapy examination, which may include the prone knee flexion (Ely) and active knee extension (AKE) tests. Clinicians using these tests should understand the clinimetric properties. Purpose To investigate the reliability and minimal detectable change (MDC95) of the Ely and AKE tests. Study Design Reliability analysis. Methods Seventy-one asymptomatic adults (mean age 24.6 + /- 2.8 years) were recruited based on a convenience sample. Two examiners each performed the Ely and AKE test one time each in an intrasession design for the interrater reliability component, with one examiner repeating the tests one time 48 hours later to determine the intra-rater reliability. Results were recorded based on one trial per test and utilized a pelvic strap for the Ely test and an adjustable bolster for the AKE test. A separate researcher recorded measurements and results were blinded from the examiners. Results The Ely test had excellent intra-rater and inter-rater reliability with an intraclass correlation coefficient (ICC) (3,1) of 0.900 and ICC (2,1) of 0.914 respectively. The intra-rater and inter-rater reliability of the AKE test was good with ICC (3,1) of 0.882 and ICC (2,1) 0.886 respectively. The MDC95 indicated that a change greater than or equal to 8° and 12° is required to exceed the threshold of error for the Ely and AKE test respectively. Conclusion The Ely and AKE tests have good to excellent inter-rater and intra-rater reliability for measuring rectus femoris and hamstring muscle length when stabilization of the pelvis and hip is accounted for. The MDC should be considered as a threshold for true change in the asymptomatic adult population. Levels of Evidence 2b.
Collapse
|
7
|
Shamsi M, Shahsavari S, Safari A, Mirzaei M. A randomized clinical trial for the effect of static stretching and strengthening exercise on pelvic tilt angle in LBP patients. J Bodyw Mov Ther 2020; 24:15-20. [PMID: 32825981 DOI: 10.1016/j.jbmt.2020.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Stretching and strengthening exercises are commonly used to improve muscle shortness of the hamstring as any tension in this muscle can have an effect on the pelvic posture. Thus, the aim of this study was to evaluate the effects of two methods of improving short hamstring on the angle of pelvic tilt in LBP sufferers. METHODS Forty-five low back pain patients aged 19-59 years with hamstring tightness participated in this clinical trial. The patients were categorized randomly into three groups: 1- static stretching, 2-strengthening exercise and 3-control group. The two intervention groups received physical therapy and special exercise program thrice a week in a total of 12 sessions, while the control group received only conventional physical therapy. Before and after the treatment implementation, the pelvic tilt and straight leg raising (SLR) degree were assessed for each group. RESULT After 12 sessions of treatment, the ANCOVA models indicated non-significant differences in pelvic tilt angle and SLR score changes (p > 0.05), among the three groups. In addition, no statistically significant correlation was observed between the pelvic tilt and SLR test [except for the strengthening exercise group (Pearson correlation coefficient = -0.54, P < 0.05)]. CONCLUSIONS In LBP sufferers, both static stretching and strengthening of hamstring muscle in its lengthened position caused elongation and extensibility in the hamstring muscle and increased SLR test score, but did not change pelvic tilt angle.
Collapse
Affiliation(s)
- MohammadBagher Shamsi
- Rehabilitation and Sport Medicine Department, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Soodeh Shahsavari
- Health Information Management Department, Faculty of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Ameneh Safari
- Research Management Office, Faculty of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Maryam Mirzaei
- Faculty of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| |
Collapse
|
8
|
Jiménez-Del-Barrio S, Mingo-Gómez MT, Estébanez-de-Miguel E, Saiz-Cantero E, Del-Salvador-Miguélez AI, Ceballos-Laita L. Adaptations in pelvis, hip and knee kinematics during gait and muscle extensibility in low back pain patients: A cross-sectional study. J Back Musculoskelet Rehabil 2020; 33:49-56. [PMID: 31403939 DOI: 10.3233/bmr-191528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To compare pelvis, hip and knee kinematics during gait and extensibility of hip muscles between low back pain (LBP) and asymptomatic subjects. METHODS Forty adult volunteers (11 men and 29 women) between 18 to 30 years from university population were included in this study. Twenty patients with LBP formed the LBP group, and 20 asymptomatic subjects formed the control group. Pelvic tilt and knee valgus, peak hip and knee joint excursion, and temporo-spatial variables were assessed during gait with Kinovea software. Extensibility of hip muscles was measured by Active Knee Extension test (AKE), modified Ober test, and Thomas test. RESULTS There was a significant increase in pelvic tilt (p< 0.01), valgus angle (p< 0.01), and a significant decrease in hip extension (p< 0.01) in the LBP group compared to the control group. There was a significant decrease in extensibility of the hip flexors (p< 0.05) of the dominant leg and in the hip abductors (p< 0.01) in the LBP group compared to the control group. CONCLUSIONS The findings of this study suggest that non-specific mechanic LBP patients present differences in the pelvis, hip and knee kinematics in sagittal and frontal plane during gait and less hip flexors and abductors muscles extensibility compared to asymptomatic subjects.
Collapse
|
9
|
Straight Leg Raise Test: Influence of Lumbosant© and Assistant Examiner in Hip, Pelvis Tilt and Lumbar Lordosis. Symmetry (Basel) 2020. [DOI: 10.3390/sym12060927] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The passive straight leg raise (PSLR) test is widely used to assess hamstring extensibility. However, to accurately measure hamstring extensibility throughout PSLR, appropriate stabilization of the pelvis must be provided in order to minimize the possible influence of any compensatory movement in the scores reached. The main purpose of this study was to demonstrate the degree of influence of the Lumbosant© and an assistant examiner in hamstring extensibility in healthy young adults. A secondary objective was to verify the variability of the posterior pelvic tilt movement. Hamstring muscle extensibility was measured using the traditional (only an examiner) and new (using a low-back protection support Lumbosant© and two trained [principal and assistant] examiners) PSLR procedures. Correlation coefficients were expressed using r values, accompanying descriptors and 90% confidence intervals. Variance explained was expressed via the R2 statistic. To examine possible differences, the Mann-Whitney U-test was conducted. Additionally, Cohen’s d was calculated for all results, and the magnitudes of the effect were interpreted and statistical significance set at p < 0.05. A stepwise multiple regression analysis was performed to examine the relationship between scores and values. The final score that was determined with the new PSLR is significantly lower (13° approximately) than the one obtained through the traditional procedure (75.3 ± 14.4° vs. 89.2 ± 20.8°; d = −0.777 [moderate]). The data presented in this study suggest that the PSLR may overestimate hamstring extensibility unless lumbopelvic movement is controlled. Therefore, we recommend the use of Lumbosant© and an auxiliary examiner to obtain more accurate hamstring extensibility scores.
Collapse
|
10
|
Wattananon P, Prasertkul W, Sakulsriprasert P, Laskin JJ. Effect of increased relative stiffness of the lumbar spine on hamstring muscle stretching in individuals with a history of low back pain suspected to have a clinical lumbar instability: A randomized crossover design. Clin Biomech (Bristol, Avon) 2020; 75:104996. [PMID: 32339943 DOI: 10.1016/j.clinbiomech.2020.104996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Theoretically, lumbopelvic stabilization techniques during hamstring muscle stretching could increase lumbar stiffness relative to hamstring muscle in individuals with a history of low back pain and suspected clinical lumbar instability. However, evidence to support this theory is limited. This study aimed to 1) determine changes in lumbopelvic, lumbar, and hip motions, and hamstring muscle length after stretching exercises with lumbopelvic stiffening or relaxing techniques, and 2) compare those changes between techniques. METHODS This study used a randomized crossover design. Thirty-two participants with a history of low back pain and bilateral hamstring muscle tightness were recruited. The order of the first technique was randomly assigned. After a 2-day washout, participants were crossed over to the second technique. Motion data during active forward trunk bending and bilateral hamstring muscle length during passive knee extension were collected pre- and post-intervention. FINDINGS Significant increases (P < 0.05) were found in bilateral hamstring muscle length for both techniques. However, stiffening technique demonstrated a significant decrease in lumbar motion (P < 0.05) and increase in hip motion (P < 0.05), while relaxing technique demonstrated trends showing increases in lumbar and hip motions (P = 0.134 and 0.115, respectively). The findings showed significantly greater improvement (P < 0.05) in lumbar and hip motions with stiffening technique. INTERPRETATION The findings suggest increased relative stiffness of the lumbar spine during hamstring muscle stretching can specifically lengthen bilateral hamstring muscle and decrease excessive lumbar motion. This stiffening technique may prevent excessive movement of the lumbar spine, thereby reducing the risk of recurrent low back pain.
Collapse
Affiliation(s)
- Peemongkon Wattananon
- Motor Control and Neural Plasticity Lab, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand.
| | - Wallika Prasertkul
- Physical Therapy Clinic, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand..
| | - Prasert Sakulsriprasert
- Biomechanics and Sport Lab, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand.
| | - James J Laskin
- School of Physical Therapy and Rehabilitation Science, University of Montana, 135 Skaggs Building, Missoula, MT 59812, USA.
| |
Collapse
|
11
|
Abstract
Patellofemoral pain (PFP) is a common musculoskeletal-related condition that is characterized by insidious onset of poorly defined pain, localized to the anterior retropatellar and/or peripatellar region of the knee. The onset of symptoms can be slow or acutely develop with a worsening of pain accompanying lower-limb loading activities (eg, squatting, prolonged sitting, ascending/descending stairs, jumping, or running). Symptoms can restrict participation in physical activity, sports, and work, as well as recur and persist for years. This clinical practice guideline will allow physical therapists and other rehabilitation specialists to stay up to date with evolving PFP knowledge and practices, and help them to make evidence-based treatment decisions. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95. doi:10.2519/jospt.2019.0302.
Collapse
|
12
|
Chesterton P, Evans W, Livadas N, McLaren SJ. Time-course changes associated with PA lumbar mobilizations on lumbar and hamstring range of motion: a randomized controlled crossover trial. J Man Manip Ther 2019; 27:73-82. [PMID: 30935338 PMCID: PMC6484504 DOI: 10.1080/10669817.2018.1542558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE We aimed to compare the post-intervention time-course changes in active knee extension (AKE) and active lumbar flexion (ALF) range of motion in response to unilateral posterior-anterior (UPA) mobilizations of the lumbar spine (L4/5 zygapophyseal). METHODS Twenty-four asymptomatic participants (maleness: 0.58, age [mean ± standard deviation]: 32 ± 8 years, body mass index 25.9 ± 2.6 kg m2) were recruited to a fully controlled crossover trial. Following either the intervention (L4/5 zygapophyseal mobilizations) or control, participants immediately performed the AKE and ALF tests, which were also performed at baseline. Subsequent tests were made at intervals of 5, 10, 15, 20, 25, 30, 45 and 60 min. RESULTS After adjustment for baseline (mean AKE: 37.2° from full extension, mean ALF: 14.37 cm), sex and age, UPA lumbar mobilizations had a most likely moderate effect on AKE (9.8° closer to full extension; ±1.9) and a likely moderate effect on ALF (1.34 cm; ±90% confidence limits 0.43). The magnitude of the AKE effect became most likely small 20-min posttreatment (5.3; ±1.7) and possibly small/possibly trivial 60-min posttreatment (2.1; ±1.4). For ALF, the magnitude of the effect became most likely small 15-min posttreatment (0.76; ±0.25), possibly small/possibly trivial 25-min posttreatment (0.38; ±0.18) and likely trivial 60-min posttreatment (0.26; ±1.8). DISCUSSION UPA lumbar mobilizations increased lumbar Range of Motion and hamstring extensibility by a moderate magnitude, with the effect reducing after 10-20-min posttreatment. Clinicians should consider these time-course changes when applying UPA lumbar mobilizations. Clinical Trials Registry: NCT03273400 Evidence Level: 2b.
Collapse
Affiliation(s)
- Paul Chesterton
- Department of Physiotherapy, Sport Rehabilitation, Dietetics and Leadership, Teesside University, Middlesbrough, UK
| | - William Evans
- Faculty of Health Sciences and Wellbeing, Sunderland University, UK
| | - Nick Livadas
- Department of Physiotherapy, Sport Rehabilitation, Dietetics and Leadership, Teesside University, Middlesbrough, UK
| | - Shaun J. McLaren
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK
- The Rugby Football League, Leeds, UK
| |
Collapse
|
13
|
Chesterton P, Payton S, McLaren S. Acute effects of centrally- and unilaterally-applied posterior-anterior mobilizations of the lumbar spine on lumbar range of motion, hamstring extensibility and muscle activation. J Back Musculoskelet Rehabil 2019; 31:1013-1023. [PMID: 30347590 DOI: 10.3233/bmr-171000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lumbar mobilizations are used to clinically treat the lumbar and hamstring region. However, evidence is limited regarding the effectiveness of specific mobilization methods. OBJECTIVE To compare central and unilateral posterior-anterior mobilizations (CPA, UPA) of the lumbar spine on lumbar and hamstring range of motion (ROM), and muscle activity (sEMG). METHODS Twenty participants received CPA, UPA, or no mobilization (CON) on separate occasions (crossover design). Post-treatment outcome measures were ROM during active lumbar flexion (ALF) and active knee extension (AKE), as well as sEMG of the Erector Spinae (ES) and Biceps Femoris (BF) during these movements. RESULTS sEMG was possibly to very likely lower following CPA (mean difference range =-5% to -21%) and UPA (-7% to -36%), while ROM was most likely greater (-12% to 25% and -17% to 24%, respectively). Most sEMG measures were possibly to likely lower following UPA versus CPA (-18% to -11%), while AKE ROM was possibly greater (-5.5%). Differences in ES sEMG (-2.5%) and ROM (-1.4%) during ALF were unclear and most likely trivial, respectively. CONCLUSIONS CPA and UPA mobilizations increase lumbar and hamstring ROM whilst reducing local muscle activity. These effects appear to be greater for UPA mobilizations when compared with CPA.
Collapse
Affiliation(s)
- Paul Chesterton
- Department of Psychology, Sports Rehabilitation, Dietetics and Leadership, Teesside University, Middlesbrough, TS1 3BA, UK
| | - Stephen Payton
- Department of Psychology, Sports Rehabilitation, Dietetics and Leadership, Teesside University, Middlesbrough, TS1 3BA, UK
| | - Shaun McLaren
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK.,The Rugby Football League, Leeds, UK
| |
Collapse
|
14
|
Kapron AL, Karns MR, Aoki SK, Adeyemi TF, Baillargeon EA, Hartley MK, Todd JN, Maak TG. Patient-Specific Parameters Associated With Traction in Primary and Revision Hip Arthroscopic Surgery. Orthop J Sports Med 2018; 6:2325967118807707. [PMID: 30480019 PMCID: PMC6243416 DOI: 10.1177/2325967118807707] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Distraction of the hip joint is a necessary step during hip arthroscopic surgery. The force of traction needed to distract the hip is not routinely measured, and little is known about which patient factors may influence this force. Purpose: To quantify the force of traction required for adequate distraction of the hip during arthroscopic surgery and explore the relationship between hip joint stiffness and patient-specific demographics, flexibility, and anatomy. Study Design: Case series; Level of evidence, 4. Methods: A total of 101 patients (61 female) undergoing primary hip arthroscopic surgery were prospectively enrolled. A load cell attached to the traction boot continuously measured traction force. Fluoroscopic images were obtained before and after traction to measure joint displacement. The stiffness coefficient was calculated as the force of traction divided by joint displacement. Relationships between the stiffness coefficient and patient demographics and clinical parameters were investigated using a univariable regression model. The regression analysis was repeated separately by patient sex. Variables significant at P < .05 were included in a multivariable regression model. Results: The instantaneous peak force averaged 80 ± 18 kilogram-force (kgf), after which the force required to maintain distraction decreased to 57 ± 13 kgf. In univariable regression analysis, patient sex, alpha angle, hamstring flexibility, and Beighton hypermobility score were each correlated to stiffness. However, patient sex was the only significant variable in the multivariable regression model. Intrasex analysis demonstrated that increased hamstring flexibility correlated with decreased final holding stiffness in male patients and that higher Beighton scores correlated with decreased maximal stiffness in female patients. Conclusion: Male patients undergoing primary arthroscopic surgery have greater stiffness to hip distraction during arthroscopic surgery compared with female patients. In male patients, stiffness increased with decreasing hamstring flexibility. In female patients, increased Beighton scores corresponded to decreased stiffness. The presence of a labral tear was not correlated with stiffness to distraction. These data may be used to identify patients in whom a specific focus on capsular repair and/or plication may be warranted.
Collapse
Affiliation(s)
- Ashley L. Kapron
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Michael R. Karns
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Stephen K. Aoki
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Temitope F. Adeyemi
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | | | | | - Jocelyn N. Todd
- Department of Biomedical Engineering, College of Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Travis G. Maak
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Travis G. Maak, MD, Department of Orthopaedics, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT 84108, USA ()
| |
Collapse
|
15
|
Perez-Cruzado D, Cuesta-Vargas A, Vera-Garcia E, Mayoral-Cleries F. Medication and physical activity and physical fitness in severe mental illness. Psychiatry Res 2018; 267:19-24. [PMID: 29879601 DOI: 10.1016/j.psychres.2018.05.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/23/2018] [Accepted: 05/22/2018] [Indexed: 10/16/2022]
Abstract
Anti-psychotic medication has emerged as the primary medical treatment for people with severe mental illness, despite the great risks involved in the use of this medication. In addition, this population suffers from problems of obesity, sedentary lifestyle and poor physical fitness, which is aggravated by the use of this type of medication. The objective of this study is to explore the influence of the most commonly used antipsychotics in this population (Olanzapine and Risperidone) on physical activity and the physical fitness of people with severe mental illness. Sixty-two people between 26 and 61 years of age with severe mental illness were assessed. All participants were evaluated with a battery of 11 physical tests to assess their physical fitness and with the IPAQ-short version questionnaire to determine their level of physical activity. The doses of Risperidone and Olanzapine were also evaluated in all participants. Significant differences were found for physical activity, with higher levels reported in those patients with severe mental illness who did not take any of these medications. Regarding physical fitness, significant differences were only found for the consumption of Risperidone, with better physical fitness levels seen in patients who did not consume this medication; on the other hand, for the consumption of Olanzapine, differences were found in muscular strength, balance and aerobic condition with better values in non-Olanzapine consumers compared with Olanzapine consumers.
Collapse
Affiliation(s)
| | - Antonio Cuesta-Vargas
- Department of Physiotherapy, University of Malaga, Spain; School of Clinical Science, Faculty of Health Science, Queensland University Technology, Australia.
| | - Elisa Vera-Garcia
- Department of Physiotherapy, University of Malaga, Spain; Hospital Regional de Málaga, Grupo de Investigación de Salud Mental, IBIMA, Spain.
| | | |
Collapse
|
16
|
Sefiddashti L, Ghotbi N, Salavati M, Farhadi A, Mazaheri M. The effects of cryotherapy versus cryostretching on clinical and functional outcomes in athletes with acute hamstring strain. J Bodyw Mov Ther 2018; 22:805-809. [DOI: 10.1016/j.jbmt.2017.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 07/22/2017] [Accepted: 07/26/2017] [Indexed: 10/19/2022]
|
17
|
Yıldırım MŞ, Tuna F, Demirbağ Kabayel D, Süt N. The Cut-off Values for the Diagnosis of Hamstring Shortness and Related Factors. Balkan Med J 2018; 35:388-393. [PMID: 29914231 PMCID: PMC6158462 DOI: 10.4274/balkanmedj.2017.1517] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Hamstrings are one of the most frequently evaluated muscle groups for flexibility in the lower extremity. Passive and active knee extension angle values are used as an indirect indicator of hamstring flexibility. However, the lack of consensus on the cut-off values leads to the use of inconsistent angle values in determining the hamstring tightness. Aims: To establish the normative and cut-off values of the passive and active knee extension angles for healthy young adults and to determine the associated factors including the quadriceps strength. Study Design: A cross-sectional study. Methods: A total of 123 volunteer university students, aged 18-24 years, who met the inclusion criteria were included in this study. Passive and active knee extension assessments of the subjects were performed. Subsequently, on the next day, both knee extensor concentric muscle strength of the participants was measured in the isokinetic system. The knee extension angles and the knee extensor strength were recorded as the mean values of the right and the left sides. Results: Passive knee extension angles of 17.1°±9.1° and 9.8°±5.7° and active knee extension angles of 17.8°±9.1° and 13.4°±6° were described as normative values in men and women, respectively. The cut-off values for the diagnosis of hamstring shortness were as follows: passive knee extension angle >32.2° for males and >19.2° for females and active knee extension angle >33.0° for males and >23.4° for females. A significant positive correlation was observed between knee extension angles and isokinetic knee extensor muscle strength in all participants. The knee extension angle and hamstring flexibility were not affected by dominance. Conclusion: The knee extension angles of healthy young people seem to be lower than the results currently reported in the literature. There s a positive correlation between knee extension angles and isokinetic knee extensor muscle strength.
Collapse
Affiliation(s)
- Muhammed Şeref Yıldırım
- Department of Physical Therapy and Rehabilitation, Trakya University School of Health Science, Edirne, Turkey
| | - Filiz Tuna
- Department of Physical Therapy and Rehabilitation, Trakya University School of Health Science, Edirne, Turkey
| | - Derya Demirbağ Kabayel
- Department of Physical Medicine and Rehabilitation, Trakya University School of Medicine, Edirne, Turkey
| | - Necdet Süt
- Department of Biostatistics, Trakya University School of Medicine, Edirne, Turkey
| |
Collapse
|
18
|
Fajolu OK, Pencle FJR, Rosas S, Chin KR. A Prospective Analysis of the Supine and Sitting Straight-Leg Raise Test and Its Performance in Litigation Patients. Int J Spine Surg 2018; 12:58-63. [PMID: 30280084 DOI: 10.14444/5010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background The supine straight-leg raise (SLR) test has the potential to be exploited by malingering patients. The sitting SLR is believed to be less recognizable, therefore decreasing the chance of fabrication. The authors aim to compare the supine and sitting SLR test in patients with radiculopathy. Methods A total of 107 patients with radiculopathy were included in this study. Two groups were created: patients with workman's compensation (Group 1) and a control group of patients without litigation claims (Group 2). Results Mean age was 47.3 ± 1.3 years with a 51% female population. Correlation analysis demonstrated association between mean angles in both positions, r = 0.248 with significance P = .01. There was equivalence in the mean angles in sitting position of 37 ± 3° compared to 35 ± 2° in supine position (P = .549). There was no significant difference in the mean angle at which the test became positive in the litigation group in the sitting or supine position compared to the nonlitigation group, P = .616 and P = .49 respectively. Conclusion This study demonstrated that the SLR test is equivalent in the sitting and supine position. Therefore, patients with a positive test should have similar angles in both positions, decreasing the chance of falsifying the examination. Level of Evidence Prospective analysis. Clinical Relevance Clinical practice.
Collapse
Affiliation(s)
| | | | - Samuel Rosas
- Less Exposure Surgery (LES) Society, Fort Lauderdale, Florida
| | - Kingsley R Chin
- Herbert Wertheim College of Medicine at Florida International University, Miami, Florida.,Charles E. Schmidt College of Medicine at Florida Atlantic University, Boca Raton, Florida.,Less Exposure Surgery Specialists (LESS) Institute, Fort Lauderdale, Florida.,University of Technology, Kingston, Jamaica
| |
Collapse
|
19
|
Homayouni K, Jafari SH, Yari H. Sensitivity and Specificity of Modified Bragard Test in Patients With Lumbosacral Radiculopathy Using Electrodiagnosis as a Reference Standard. J Chiropr Med 2018; 17:36-43. [PMID: 29628807 DOI: 10.1016/j.jcm.2017.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 11/30/2022] Open
Abstract
Objective The purpose of this study was to assess the diagnostic accuracy of a modified Bragard test compared with the straight leg raise (SLR) test in patients presenting with electrodiagnostic evidence of L5 and S1 nerve root compression. Methods This was a cross-sectional study conducted on 506 consecutive patients with signs and symptoms consistent with lumbosacral radiculopathy confirmed by electrodiagnostic study. Patients were evaluated from September 2013 to September 2015 in the physical medicine and rehabilitation outpatient clinic of Shahid Faghihi Teaching Hospital, Shiraz, Iran. The SLR test was investigated concomitantly to determine the sensitivity and specificity. Results Electrodiagnostic study findings indicated lumbosacral radiculopathy in 312 patients. Of these participants, 198 were positive on SLR testing, and of 114 SLR-negative patients, 79 were positive on Modified Bragard testing. Sensitivity of the Modified Bragard test was 69.3%, and specificity was 67.42%. Positive and negative predictive values were 73.15% and 63.16%, respectively. Positive likelihood ratio was 2.13, and negative likelihood ratio was 0.46. Diagnostic odds ratio was 4.63. In patients with symptom duration of less than 3 weeks, SLR sensitivity and specificity decreased as the Modified Bragard test diagnostic accuracy increased. Conclusions The Modified Bragard test is easy to perform and has an acceptable test performance, which can help to increase the discriminative power of clinical examination in patients with L5 or S1 nerve root compression who exhibit a negative SLR test result, especially in the acute phase of disease.
Collapse
Affiliation(s)
- Kaynoosh Homayouni
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Fars, Islamic Republic of Iran
| | - Seyedeh Halimeh Jafari
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Fars, Islamic Republic of Iran
| | - Hossein Yari
- Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Fars, Islamic Republic of Iran
| |
Collapse
|
20
|
Perez-Cruzado D, Cuesta-Vargas AI, Vera-Garcia E, Mayoral-Cleries F. Physical fitness and levels of physical activity in people with severe mental illness: a cross-sectional study. BMC Sports Sci Med Rehabil 2017; 9:17. [PMID: 29204280 PMCID: PMC5702191 DOI: 10.1186/s13102-017-0082-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 11/17/2017] [Indexed: 01/06/2023]
Abstract
Background Physical fitness is a crucial variable in people with severe mental illness as these people could be more independent and improve their job opportunities. The present study compared the physical fitness of physically active and inactive people with severe mental illness. Methods Physical fitness was evaluated in sixty-two people with severe mental illness using 11 physical tests that include strength, flexibility, balance and aerobic condition. Significant differences were found between both groups in muscle strength (handgrip test) and balance (single leg balance test and functional reach) with better performance in the group of physically active people. Results The results of the present study suggest that physical fitness (strength and balance) is higher in people with severe mental illness who practise regular physical activity that those who are inactive people. Conclusions Physical active people may have a reduced risk of falls and fractures due to their higher levels of physical fitness.
Collapse
Affiliation(s)
- David Perez-Cruzado
- Department of Physiotherapy, Faculty of Helath Sciences, University of Malaga, Av/ Arquitecto Peñalosa s/n, Malaga, Spain.,Clinimetric Research Group of Biomedicine Research Institute of Malaga (IBIMA) Spain, Regional University Hospital, Málaga, Spain
| | - Antonio I Cuesta-Vargas
- Department of Physiotherapy, Faculty of Helath Sciences, University of Malaga, Av/ Arquitecto Peñalosa s/n, Malaga, Spain.,School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, QLD Australia.,Clinimetric Research Group of Biomedicine Research Institute of Malaga (IBIMA) Spain, Regional University Hospital, Málaga, Spain
| | - Elisa Vera-Garcia
- Department of Physiotherapy, Faculty of Helath Sciences, University of Malaga, Av/ Arquitecto Peñalosa s/n, Malaga, Spain.,Mental Health Research Group of Biomedicine Research Institute of Malaga (IBIMA) Spain, Regional University Hospital, Malaga, Spain
| | - Fermín Mayoral-Cleries
- Mental Health Research Group of Biomedicine Research Institute of Malaga (IBIMA) Spain, Regional University Hospital, Malaga, Spain
| |
Collapse
|
21
|
Kim YW, Chang WH, Kim NY, Kwon JB, Lee SC. Effect of Extracorporeal Shock Wave Therapy on Hamstring Tightness in Healthy Subjects: A Pilot Study. Yonsei Med J 2017; 58:644-649. [PMID: 28332373 PMCID: PMC5368153 DOI: 10.3349/ymj.2017.58.3.644] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/12/2016] [Accepted: 12/13/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To assess the effect of extracorporeal shock wave therapy (ESWT) for healthy participants with hamstring tightness. MATERIALS AND METHODS This study was performed at a university rehabilitation hospital. Twenty nine healthy adults with hamstring tightness were enrolled and randomly allocated into four groups (ESWT, stretching exercise, ESWT with stretching exercise, and control). The effects of individual treatments were compared by the finger-to-floor test and popliteal angle. RESULTS The ESWT group, stretching exercise group and ESWT with stretching exercise group had decreased finger-to-floor distances and right popliteal angles immediately after intervention, compared with the control group (p<0.05). At 4 weeks after completion of the interventions, finger-to-floor distances and the right popliteal angle in only the ESWT with stretching exercise group showed a significant improvement, compared with the control group (p=0.008 and 0.023). CONCLUSION While ESWT and stretching both reduced hamstring tightness immediately after interventions, only ESWT with stretching exercise maintained the significantly improved relief of hamstring tightness significantly after 4 weeks.
Collapse
Affiliation(s)
- Yong Wook Kim
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Na Young Kim
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Beom Kwon
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Chul Lee
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
22
|
Neto T, Freitas SR, Marques M, Gomes L, Andrade R, Oliveira R. Effects of lower body quadrant neural mobilization in healthy and low back pain populations: A systematic review and meta-analysis. Musculoskelet Sci Pract 2017. [PMID: 28637597 DOI: 10.1016/j.msksp.2016.11.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Neural mobilization (NM) is widely used to assess and treat several neuromuscular disorders. However, information regarding the NM effects targeting the lower body quadrant is scarce. OBJECTIVES To determine the effects of NM techniques targeting the lower body quadrant in healthy and low back pain (LBP) populations. DESIGN Systematic review with meta-analysis. METHOD Randomized controlled trials were included if any form of NM was applied to the lower body quadrant. Pain, disability, and lower limb flexibility were the main outcomes. PEDro scale was used to assess methodological quality. RESULTS Forty-five studies were selected for full-text analysis, and ten were included in the meta-analysis, involving 502 participants. Overall, studies presented fair to good quality, with a mean PEDro score of 6.3 (from 4 to 8). Five studies used healthy participants, and five targeted people with LBP. A moderate effect size (g = 0.73, 95% CI: 0.48-0.98) was determined, favoring the use of NM to increase flexibility in healthy adults. Larger effect sizes were found for the effect of NM in pain reduction (g = 0.82, 95% CI 0.56-1.08) and disability improvement (g = 1.59, 95% CI: 1.14-2.03), in people with LBP. CONCLUSION Evidence suggests that there are positive effects from the application of NM to the lower body quadrant. Specifically, NM shows moderate effects on flexibility in healthy participants, and large effects on pain and disability in people with LBP. Nevertheless, more studies with high methodological quality are necessary to support these conclusions.
Collapse
Affiliation(s)
- Tiago Neto
- Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal.
| | - Sandro R Freitas
- Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal; Benfica LAB, Sport Lisboa e Benfica, Lisboa, Portugal.
| | - Marta Marques
- CIPER - Universidade de Lisboa, Faculdade de Motricidade Humana, Lisbon, Portugal
| | - Luis Gomes
- Escola Superior de Saúde, Instituto Politécnico de Setúbal, Portugal
| | - Ricardo Andrade
- Laboratory "Movement, Interactions, Performance" (EA 4334), University of Nantes, UFR STAPS, Nantes, France
| | - Raúl Oliveira
- Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz Quebrada, Dafundo, Portugal
| |
Collapse
|
23
|
Chesterton P, Payton S. Effects of spinal mobilisations on lumbar and hamstring ROM and sEMG: A randomised control trial. ACTA ACUST UNITED AC 2016. [DOI: 10.3233/ppr-160081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
24
|
Three-Year Outcome After a 1-Month Physiotherapy Program of Local and Individualized Global Treatment for Patellofemoral Pain Followed by Self-Management. Clin J Sport Med 2016; 26:190-8. [PMID: 26327289 DOI: 10.1097/jsm.0000000000000226] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The main aim of this study was to assess whether improvements after a 1-month patellofemoral pain (PFP) program addressing local and global deficits were maintained for 3 years. DESIGN This prospective cohort study comprised 4 treatment phases including a randomized trial during week 1. SETTING The study was conducted in a private physiotherapy practice. PATIENTS Thirty-seven patients (55 knees) from an original cohort of 41 patients (60 knees) with PFP were followed for 3 years after referral by doctors to participate in this study. INTERVENTIONS Patients received 4 treatments: local treatment focusing on quadriceps strengthening, quadriceps stretching, and taping for fortnight 1, supplemented with individualized global treatment focusing on lower limb posture and movement patterns for fortnight 2, followed by ongoing self-management. MAIN OUTCOME MEASURES Seven outcome measures, assessed at 4 time points, were quadriceps strength, quadriceps length, eccentric knee control, and 4 pain measures. Long-term measures included return to sporting activity, pain recurrence, exercise compliance, and Kujala score. RESULTS Improvements after fortnight 1 (P < 0.001) and fortnight 2 (P < 0.05) were maintained over 3 years for 6 of 7 measures. On testing, 73% were pain free and the remaining 27% had less pain than pretreatment. Kujala scores improved 27%. Eighty-two percent resumed any sport stopped and 54% of patients started new sports/activities. Patellofemoral pain recurred in 7% and 89% of patients was still exercising 3 years posttreatment. CONCLUSIONS Significant improvements after physiotherapy, incorporating local and individually targeted treatment, were maintained for 3 years in a compliant cohort.
Collapse
|
25
|
Demoulin C, Wolfs S, Chevalier M, Granado C, Grosdent S, Depas Y, Roussel N, Hage R, Vanderthommen M. A comparison of two stretching programs for hamstring muscles: A randomized controlled assessor-blinded study. Physiother Theory Pract 2016; 32:53-62. [DOI: 10.3109/09593985.2015.1091533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
26
|
Mélo TR, Rodacki ALF, Guimarães ATB, Israel VL. Repeatability and comparison of clinical tests in children with spastic diplegia and with typical development,. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.001.ao01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective The aims of this study were to evaluate the reliability of three range of motion tests (Straight Leg Raise, Modified Thomas, and Duncan-Ely) using photographic measurements in children with spastic diplegic cerebral palsy (SD) and with typical development (TD). Methods A cross-sectional test-retest design was applied to compare muscle-tendon unit shortening tests between groups. Results The tests showed reliability that ranged from good to excellent (ICC > 0.8), except for the Thomas Test for the bi-articular hip flexor muscle-tendon unit of the TD group (ICC = 0.7). Differences between groups were found in all tests (p < 0.05), except when the range of motion of the bi-articular hip flexor muscles was assessed using the Thomas test (p > 0.05). Conclusion Children with SD presents a smaller range of motion than the TD group. However, the Thomas Test for the bi-articular hip flexor muscles was unable to determine differences between children with spastic diplegic cerebral palsy from that with typical development.
Collapse
Affiliation(s)
| | | | | | - Vera Lúcia Israel
- Universidade Federal do Paraná, Brazil; Universidade Federal do Paraná, Brazil
| |
Collapse
|
27
|
Cuesta-Vargas AI, Pérez-Cruzado D. Relationship between Barthel index with physical tests in adults with intellectual disabilities. SPRINGERPLUS 2014; 3:543. [PMID: 25332853 PMCID: PMC4183757 DOI: 10.1186/2193-1801-3-543] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 09/18/2014] [Indexed: 11/10/2022]
Abstract
We usually find low levels of fitness condition affect other aspects of living for people with ID like dependency in carrying out activivities of daily living. Therefore we find high levels of dependency in activities of daily living due to poor fitness condition. The aim of the study is to explore the criterion validity of the Barthel index with a physical fitness test. An observational cross-sectional study was conducted. Data from the Barthel index and a physical fitness test were measured in 122 adults with intellectual disability. The data were analysed to find out the relationship between four categories of the physical fitness test and the Barthel index. It needs to be stressed that the correlations between the Barthel index and leg, abdominal and arm strength can confirm that these physical test are predictive of the Barthel index. The correlations between the balance variables as functional reach and single-leg stance with eyes open shown relationships with Barthel Index. We found important correlations between the physical fitness test and the Barthel index, so we can affirm that some physical fitness features are predictor variables of the Barthel index.
Collapse
Affiliation(s)
- Antonio I Cuesta-Vargas
- Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Malaga, Spain ; School of Clinical Science, Faculty of Health Science, Queensland University Technology, Brisbane, Australia
| | - David Pérez-Cruzado
- Departamento de Psiquiatría y Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Andalucia Tech, Cátedra de Fisioterapia y Discapacidad, Instituto de Biomedicina de Málaga (IBIMA), Grupo de Clinimetria (FE-14), Malaga, Spain
| |
Collapse
|
28
|
Determination of the criterion-related validity of hip joint angle test for estimating hamstring flexibility using a contemporary statistical approach. Clin J Sport Med 2014; 24:320-5. [PMID: 24451690 DOI: 10.1097/jsm.0000000000000079] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the criterion-related validity of the horizontal hip joint angle (H-HJA) test and vertical hip joint angle (V-HJA) test for estimating hamstring flexibility measured through the passive straight-leg raise (PSLR) test using contemporary statistical measures. DESIGN Validity study. SETTING Controlled laboratory environment. PARTICIPANTS One hundred thirty-eight professional trampoline gymnasts (61 women and 77 men). ASSESSMENT OF RISK FACTORS Hamstring flexibility. MAIN OUTCOME MEASURES Each participant performed 2 trials of H-HJA, V-HJA, and PSLR tests in a randomized order. The criterion-related validity of H-HJA and V-HJA tests was measured through the estimation equation, typical error of the estimate (TEEST), validity correlation (β), and their respective confidence limits. RESULTS The findings from this study suggest that although H-HJA and V-HJA tests showed moderate to high validity scores for estimating hamstring flexibility (standardized TEEST = 0.63; β = 0.80), the TEEST statistic reported for both tests was not narrow enough for clinical purposes (H-HJA = 10.3 degrees; V-HJA = 9.5 degrees). Subsequently, the predicted likely thresholds for the true values that were generated were too wide (H-HJA = predicted value ± 13.2 degrees; V-HJA = predicted value ± 12.2 degrees). CONCLUSIONS The results suggest that although the HJA test showed moderate to high validity scores for estimating hamstring flexibility, the prediction intervals between the HJA and PSLR tests are not strong enough to suggest that clinicians and sport medicine practitioners should use the HJA and PSLR tests interchangeably as gold standard measurement tools to evaluate and detect short hamstring muscle flexibility.
Collapse
|
29
|
Keays SL, Mason M, Newcombe PA. Individualized Physiotherapy in the Treatment of Patellofemoral Pain. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2014; 20:22-36. [DOI: 10.1002/pri.1593] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 02/20/2014] [Accepted: 03/11/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Susan L. Keays
- School of Health and Sports Sciences; The University of the Sunshine Coast; Queensland Australia
- Private Practice; Sunshine Coast; Queensland Australia
| | - Marjon Mason
- Private Practice; Sunshine Coast; Queensland Australia
| | - Peter A. Newcombe
- School of Psychology and School of Social Work and Human Services; The University of Queensland; Queensland Australia
| |
Collapse
|
30
|
Hamid MSA, Ali MRM, Yusof A. Interrater and Intrarater Reliability of the Active Knee Extension (AKE) Test among Healthy Adults. J Phys Ther Sci 2013; 25:957-61. [PMID: 24259893 PMCID: PMC3820221 DOI: 10.1589/jpts.25.957] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 03/29/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to determine the reliability of the active knee
extension (AKE) test among healthy adults. [Subjects] Fourteen healthy participants (10
men and 4 women) volunteered and gave informed consent. [Methods] Two raters conducted AKE
tests independently with the aid of a simple and inexpensive stabilizing apparatus. Each
knee was measured twice, and the AKE test was repeated one week later. [Results] The
interrater reliability intraclass correlation coefficients (ICC2,1) were 0.87
for the dominant knee and 0.81 for the nondominant knee. In addition, the intrarater
(test-retest) reliability ICC3,1 values range between 0.78–0.97 and 0.75–0.84
for raters 1 and 2 respectively. The percentages of agreement within 10° for AKE
measurements were 93% for the dominant knee and 79% for the nondominant knee. [Conclusion]
The finding suggests the current AKE test showed excellent interrater and intrarater
reliability for assessing hamstring flexibility in healthy adults.
Collapse
|
31
|
Johnson AW, Mitchell UH, Meek K, Feland JB. Hamstring flexibility increases the same with 3 or 9 repetitions of stretching held for a total time of 90 s. Phys Ther Sport 2013; 15:101-5. [PMID: 23896197 DOI: 10.1016/j.ptsp.2013.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 03/25/2013] [Accepted: 03/28/2013] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine if stretching for a constant total time with differing repetition durations and number of repetitions over a 6-week period produced different changes in hamstring flexibility measured by knee extension range of motion (ROM). DESIGN Randomized Control Trial. SETTING University laboratory. SUBJECTS 34 volunteers, 18-25 years old with tight hamstrings as determined by a greater than 30° loss of knee extension with hip flexed to 90° participated in the study. MAIN OUTCOME MEASURES Change in knee extension ROM was assessed in participants who were randomly assigned to a control, or to a stretching group of either 10 s for 9 repetitions or 30 s for 3 repetitions, for a total stretch time of 90 s. Each group stretched 6 days a week for 6 weeks. RESULTS Pre to post stretch comparison indicated both stretching groups were successful in increasing joint ROM (11.6 ± 5.25°-13.4 ± 5.36°) over the control (F = 19.77, p < 0.003). However, there was no significant difference between the stretching groups (p = 0.9). CONCLUSION Stretching for 6 weeks for total of 90 s showed increased joint ROM regardless of the number of repetitions or the duration of each individual stretch.
Collapse
Affiliation(s)
- A Wayne Johnson
- Brigham Young University, Dept. of Exercise Sciences, Provo, UT 84602, USA.
| | - Ulrike H Mitchell
- Brigham Young University, Dept. of Exercise Sciences, Provo, UT 84602, USA.
| | - Katie Meek
- Brigham Young University, Dept. of Exercise Sciences, Provo, UT 84602, USA.
| | - J Brent Feland
- Brigham Young University, Dept. of Exercise Sciences, Provo, UT 84602, USA.
| |
Collapse
|
32
|
Ayala F, Sainz de Baranda P, De Ste Croix M, Santonja F. Reproducibility and Concurrent Validity of Hip Joint Angle Test for Estimating Hamstring Flexibility in Recreationally Active Young Men. J Strength Cond Res 2012; 26:2372-82. [DOI: 10.1519/jsc.0b013e31823db1e2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
33
|
Azevedo DC, Melo RM, Alves Corrêa RV, Chalmers G. Uninvolved versus target muscle contraction during contract–relax proprioceptive neuromuscular facilitation stretching. Phys Ther Sport 2011; 12:117-21. [DOI: 10.1016/j.ptsp.2011.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 04/15/2011] [Accepted: 04/20/2011] [Indexed: 10/18/2022]
Affiliation(s)
- Daniel Camara Azevedo
- Pontifícia Universidade Católica de Minas Gerais, Department of Physical Therapy, Belo Horizonte, MG, Brazil.
| | | | | | | |
Collapse
|
34
|
Cuesta-Vargas AI, Paz-Lourido B, Rodriguez A. Physical fitness profile in adults with intellectual disabilities: differences between levels of sport practice. RESEARCH IN DEVELOPMENTAL DISABILITIES 2011; 32:788-794. [PMID: 21111572 DOI: 10.1016/j.ridd.2010.10.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2010] [Accepted: 10/28/2010] [Indexed: 05/30/2023]
Abstract
Neuromuscular and aerobic capacity can be reduced in people with intellectual disabilities (ID). Previous studies suggest these individuals might be particularly susceptible to losing basic functions because of poor physical fitness. The aim of this study is to describe the physical fitness profile of adult athletes with ID and identify whether there are differences in the physical performance between the most physically active individuals and less active individuals. A cross-sectional observational study was developed involving 266 athletes with mild ID (187 males and 79 females), recruited from the Spanish Special Olympics Games. A questionnaire was used to evaluate the health status of participants and their frequency of physical activity practice. A battery of 13 fitness tests was applied to assess flexibility, strength/endurance, balance and cardiovascular capabilities. Of the total participants, 44.3% were classified as sportspersons and the remainder as non sportspersons, taking in consideration the frequency of physical activity. Regarding the scores, a significant difference was found in degrees of flexibility between genders, higher for females for one test but higher for males in the other three. A significant difference was not encountered between other variables of physical fitness, although the men's scores were higher in strength/endurance and balance. When the scores of the sportspersons and non sportspersons groups were compared, no significant difference was found between the two, with the exception of one test for flexibility. Differences among groups and gender were not statistically significant in most of the tests. The findings in this study illustrate an unclear and inconclusive relation between the scores and the declared level of physical activity, maybe due to the context in which participants for the study were selected.
Collapse
|
35
|
A new hamstring test to complement the common clinical examination before return to sport after injury. Knee Surg Sports Traumatol Arthrosc 2010; 18:1798-803. [PMID: 20852842 DOI: 10.1007/s00167-010-1265-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 08/31/2010] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim was to introduce and evaluate the reliability and validity of an active hamstring flexibility test as a complement to common clinical examination when determining safe return to sport after hamstring injury. METHODS Eleven healthy subjects (28 years) were tested on repeated occasions, and 11 athletes (21 years) with MRI-verified acute hamstring strain were tested when common clinical examination revealed no signs of remaining injury, i.e. there was no differences between the legs in palpation pain, manual strength tests, and passive straight leg raise. Flexibility, i.e. highest range of motion of three consecutive trials, was calculated from electrogoniometer data during active ballistic hip flexions and conventional passive slow hip-flexions in a supine position. A VAS-scale (0-100) was used to estimate experience of insecurity during active tests. RESULTS No significant test-retest differences were observed. Intra-class correlation coefficients ranged 0.94-0.99 and coefficients of variation 1.52-4.53%. Active flexibility was greater (23%) than passive flexibility. In the athletes, the injured leg showed smaller (8%) active, but not passive, flexibility than the uninjured leg. Average insecurity estimation was 52 (range 28-98) for the injured and 0 for the uninjured leg, respectively. CONCLUSION The new test showed high reliability and construct validity; furthermore, it seems to be sensitive enough to detect differences both in active flexibility and in insecurity after acute hamstring strains at a point in time when the commonly used clinical examination fails to reveal injury signs. Thus, the test could be a complement to the common clinical examination before the final decision to return to sport is made.
Collapse
|
36
|
Covert CA, Alexander MP, Petronis JJ, Davis DS. Comparison of Ballistic and Static Stretching on Hamstring Muscle Length Using an Equal Stretching Dose. J Strength Cond Res 2010; 24:3008-14. [DOI: 10.1519/jsc.0b013e3181bf3bb0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
37
|
Borman NP, Trudelle-Jackson E, Smith SS. Effect of stretch positions on hamstring muscle length, lumbar flexion range of motion, and lumbar curvature in healthy adults. Physiother Theory Pract 2010; 27:146-54. [PMID: 20690869 DOI: 10.3109/09593981003703030] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hamstring stretching is a common practice in physical therapy to change not only hamstring muscle length (HML), but also lumbar flexion range of motion (LROM) or lumbar curvature (LC). Yet limited published research compares the effectiveness of two commonly used hamstring stretch positions, sitting and standing. The purposes of this study were to determine the effect of (1) stretch position on HML; and 2) HML on LROM and LC. Thirty-six participants (M=44.8 years, SD=17.1) with short HML (i.e., with shortness for men ≥45° and for women ≥ 24° of active knee flexion with 90° hip flexion) were measured for HML, LROM, and LC; randomly allocated to one of three groups: (1) hamstring stretching in sitting (SI); (2) standing (ST); or (3) no stretching (control); and remeasured after 4 weeks. Participants in the stretching groups performed two 30-second static stretches 4 days per week for 4 weeks. Multivariate analysis of covariance (MANCOVA) showed significance between the stretching groups and nonstretching group for HML only. Nonsignificance was shown for HML between the stretch positions (i.e., SI-active knee extension (AKE) and ST-AKE), indicating that both were equally effective for increasing HML. However, there was no change in LROM or in LC even though HML increased.
Collapse
Affiliation(s)
- Nicole P Borman
- Texas Woman's University, School of Physical Therapy--Dallas Presbyterian Campus, Dallas, Texas, USA.
| | | | | |
Collapse
|
38
|
Ylinen JJ, Kautiainen HJ, Häkkinen AH. Comparison of Active, Manual, and Instrumental Straight Leg Raise in Measuring Hamstring Extensibility. J Strength Cond Res 2010; 24:972-7. [DOI: 10.1519/jsc.0b013e3181d0a55f] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
39
|
Abstract
Various theories have been proposed to explain increases in muscle extensibility observed after intermittent stretching. Most of these theories advocate a mechanical increase in length of the stretched muscle. More recently, a sensory theory has been proposed suggesting instead that increases in muscle extensibility are due to a modification of sensation only. Studies that evaluated the biomechanical effect of stretching showed that muscle length does increase during stretch application due to the viscoelastic properties of muscle. However, this length increase is transient, its magnitude and duration being dependent upon the duration and type of stretching applied. Most of these studies suggest that increases in muscle extensibility observed after a single stretching session and after short-term (3- to 8-week) stretching programs are due to modified sensation. The biomechanical effects of long-term (>8 weeks) and chronic stretching programs have not yet been evaluated. The purposes of this article are to review each of these proposed theories and to discuss the implications for research and clinical practice.
Collapse
|
40
|
Kuo YL, Tully EA, Galea MP. Lumbofemoral rhythm during active hip flexion in standing in healthy older adults. ACTA ACUST UNITED AC 2010; 15:88-92. [DOI: 10.1016/j.math.2009.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 07/14/2009] [Accepted: 08/06/2009] [Indexed: 11/17/2022]
|
41
|
Whyte EF, Moran K, Shortt CP, Marshall B. The influence of reduced hamstring length on patellofemoral joint stress during squatting in healthy male adults. Gait Posture 2010; 31:47-51. [PMID: 19818627 DOI: 10.1016/j.gaitpost.2009.08.243] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 08/28/2009] [Accepted: 08/31/2009] [Indexed: 02/02/2023]
Abstract
Increased patellofemoral joint (PFJ) stress has been implicated in the development of PFJ pathologies. Previous studies have identified a relationship between reduced hamstring length and patellofemoral pain syndrome. Hamstring stretching is also recommended in the management thereof. However, the relationship between reduced hamstring length and PFJ stress has not been explored in vivo during activities that load the PFJ, such as squatting. The objective of this study was to determine if persons with reduced hamstring length demonstrate increased PFJ stress during squatting compared with individuals without reduced hamstring length. Eight participants with, and eight participants without, reduced hamstring length were assessed to determine their PFJ contact area using magnetic resonance imaging, and their PFJ reaction force during squatting using motion analysis. Data collected were entered into a biomechanical model to calculate medial, lateral and total PFJ stress. It was found that participants with reduced hamstring length had significantly greater total (393.39 Pa/kg vs. 213.01 Pa/kg) and lateral (311.23 Pa/kg vs. 142.55 Pa/kg) PFJ stress at 60 degrees knee flexion during squat descent and ascent (427.75 Pa/kg vs. 255.64 Pa/kg and 337.75 Pa/kg vs. 170.63 Pa/kg, respectively). This was due to significantly increased PFJ reaction force at 60 degrees knee flexion during squat descent (12.18 N/kg vs. 7.21 N/kg) and ascent (13.03 N/kg vs. 8.72 N/kg), and lower medial PFJ contact area at 60 degrees knee flexion (88 mm(2) vs. 160 mm(2)). The results of this study demonstrate a relationship between reduced hamstring length and increased PFJ stress during squatting due to increased PFJ reaction force and reduced medial PFJ contact area.
Collapse
Affiliation(s)
- Enda F Whyte
- School of Health and Human Performance, Dublin City University, Collins Avenue, Glasnevin, Dublin 9, Ireland.
| | | | | | | |
Collapse
|
42
|
Corben T, Lewis JS, Petty NJ. Contribution of lumbar spine and hip movement during the palms to floor test in individuals with diagnosed hypermobility syndrome. Physiother Theory Pract 2009; 24:1-12. [DOI: 10.1080/09593980701686708] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
43
|
O'Sullivan K, Murray E, Sainsbury D. The effect of warm-up, static stretching and dynamic stretching on hamstring flexibility in previously injured subjects. BMC Musculoskelet Disord 2009; 10:37. [PMID: 19371432 PMCID: PMC2679703 DOI: 10.1186/1471-2474-10-37] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 04/16/2009] [Indexed: 01/30/2023] Open
Abstract
Background Warm-up and stretching are suggested to increase hamstring flexibility and reduce the risk of injury. This study examined the short-term effects of warm-up, static stretching and dynamic stretching on hamstring flexibility in individuals with previous hamstring injury and uninjured controls. Methods A randomised crossover study design, over 2 separate days. Hamstring flexibility was assessed using passive knee extension range of motion (PKE ROM). 18 previously injured individuals and 18 uninjured controls participated. On both days, four measurements of PKE ROM were recorded: (1) at baseline; (2) after warm-up; (3) after stretch (static or dynamic) and (4) after a 15-minute rest. Participants carried out both static and dynamic stretches, but on different days. Data were analysed using Anova. Results Across both groups, there was a significant main effect for time (p < 0.001). PKE ROM significantly increased with warm-up (p < 0.001). From warm-up, PKE ROM further increased with static stretching (p = 0.04) but significantly decreased after dynamic stretching (p = 0.013). The increased flexibility after warm-up and static stretching reduced significantly (p < 0.001) after 15 minutes of rest, but remained significantly greater than at baseline (p < 0.001). Between groups, there was no main effect for group (p = 0.462), with no difference in mean PKE ROM values at any individual stage of the protocol (p > 0.05). Using ANCOVA to adjust for the non-significant (p = 0.141) baseline difference between groups, the previously injured group demonstrated a greater response to warm-up and static stretching, however this was not statistically significant (p = 0.05). Conclusion Warm-up significantly increased hamstring flexibility. Static stretching also increased hamstring flexibility, whereas dynamic did not, in agreement with previous findings on uninjured controls. The effect of warm-up and static stretching on flexibility was greater in those with reduced flexibility post-injury, but this did not reach statistical significance. Further prospective research is required to validate the hypothesis that increased flexibility improves outcomes. Trial Registration ACTRN12608000638336
Collapse
Affiliation(s)
- Kieran O'Sullivan
- Physiotherapy Department, University of Limerick, Limerick, Ireland.
| | | | | |
Collapse
|
44
|
Potier TG, Alexander CM, Seynnes OR. Effects of eccentric strength training on biceps femoris muscle architecture and knee joint range of movement. Eur J Appl Physiol 2009; 105:939-44. [PMID: 19271232 DOI: 10.1007/s00421-008-0980-7] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2008] [Indexed: 11/29/2022]
Abstract
The aim was to determine whether eccentric strengthening changed the muscle architecture of human biceps femoris and consequently, knee range of motion. Twenty-two subjects were randomly assigned to control and experimental groups. The experimental group completed an eccentric strengthening programme for 8 weeks. Outcome measures included hamstring muscle strength (one repetition maximum), the passive knee extension test (PKE) (knee joint angle at which the onset of passive tension occurs), fascicle length (FL) and pennation angle (PA). One repetition maximum increased by 34% (P < 0.01), the PKE test revealed a 5% increase in joint range of motion (P = 0.01), FL increased by 34% (P = 0.01) and PA did not change (P = 0.38). This is the first report of an increase in FL in the biceps femoris following eccentric resistance training. In addition, the results might imply that this fascicle lengthening could lead to an increase in the range of motion of the knee. Clinical implications for rehabilitation and injury prevention are discussed.
Collapse
Affiliation(s)
- Tara G Potier
- Imperial College Healthcare NHS Trust, Department of Physiotherapy, Charing Cross Hospital, London, UK.
| | | | | |
Collapse
|
45
|
Lee GPS, Ng GYF. Effects of stretching and heat treatment on hamstring extensibility in children with severe mental retardation and hypertonia. Clin Rehabil 2008; 22:771-9. [DOI: 10.1177/0269215508090067] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To examine the effect of heat and duration of stretching on the extensibility of hamstring muscles and their electromyographic responses to passive stretch in children with hypertonia and severe mental retardation. Design: Randomized cross-over trial. Setting: Developmental disability unit in a local hospital. Participants: Twenty-nine subjects (9 females) with ages ranged from 4 to 13 years with spastic and/or dystonic hypertonia and hamstring tightness. Interventions: Subjects received four treatment sessions in random order with each consisting of five repetitions of stretching: (A) 10-second stretching, (B) 30-second stretching, (C) hot pack followed by 10-second stretching, and (D) hot pack followed by 30-second stretching. Each treatment session comprised five repetitions of stretch and successive treatments were separated by at least 24 hours. Main outcome measures: The distance between greater trochanter and lateral malleolus and hamstring electromyographic (EMG) activity during passive knee extension stretching. Results: Two-way ANOVA showed a larger increase in hamstring extensibility in conditions C and D (1.3 ± 1.1 cm) than conditions A and B (0.7 ± 0.9 cm) (P<0.001). For the EMG recordings, conditions B and D (-25.1 ± 58.4μV) had greater decrease than conditions A and C (-3.5 ± 36.6 μV) (P= 0.039). Conclusions: Heat application to the hamstrings before stretching could result in greater increase in extensibility than stretching alone in children with hypertonia and severe mental retardation. Stretching could promote relaxation of the hamstring muscles regardless of prior heat treatment. Stretching sustained for 30 seconds led to greater relaxation than that for 10 seconds.
Collapse
Affiliation(s)
| | - Gabriel YF Ng
- Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hung Hom, Hong Kong, China,
| |
Collapse
|
46
|
Davis DS, Quinn RO, Whiteman CT, Williams JD, Young CR. Concurrent Validity of Four Clinical Tests Used to Measure Hamstring Flexibility. J Strength Cond Res 2008; 22:583-8. [DOI: 10.1519/jsc.0b013e31816359f2] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
47
|
Measuring deterioration in international classification of functioning domains of people with multiple sclerosis who are ambulatory. Phys Ther 2008; 88:176-90. [PMID: 18029390 DOI: 10.2522/ptj.20070064] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE Measures to detect important effects related to physical therapy interventions must be able to detect an important change. The purpose of this study was to select the most responsive physical functioning measures for multiple sclerosis (MS) using the International Classification of Functioning, Disability and Health (ICF) as a framework. SUBJECTS The participants were 120 people with MS who were ambulatory from a population-based sample. METHODS Physical functioning was assessed by quantitative clinical measures of activities (n=5) and body functions (n=7) and by self-reported performance in self-care, mobility, and domestic life domains in the activities and participation component of the ICF at baseline and 2 years later. A participant's perception of change and a change in Expanded Disability Status Scale (EDSS) scores were used as external criteria in the analysis of the receiver operating characteristic curve and the minimally important change score. The minimal detectable change was calculated as distribution-based responsiveness. RESULTS According to the external criteria, 51% of the participants showed deterioration as measured by their own perceptions compared with the 26% of the participants who showed deterioration as rated by the clinician. Regardless of the external criterion applied, the measures most responsive to deterioration were self-reported scores in self-care, mobility, and domestic life; distance walked and change in heart rate during a 6-minute walk test; 10-m walk test speeds, stride length, and cadence; repetitive squatting; and Box and Block Test scores. DISCUSSION AND CONCLUSION The results show the relative responsiveness of different measures in the subsample who deteriorated and provide data that can facilitate the interpretation of score changes in people with MS who are ambulatory for future studies and in clinical practice.
Collapse
|
48
|
Youdas JW, Krause DA, Hollman JH. Validity of Hamstring Muscle Length Assessment during the Sit-and-Reach Test Using an Inclinometer to Measure Hip Joint Angle. J Strength Cond Res 2008; 22:303-9. [DOI: 10.1519/jsc.0b013e31815f5b7d] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
49
|
Corkery M, Briscoe H, Ciccone N, Foglia G, Johnson P, Kinsman S, Legere L, Lum B, Canavan PK. Establishing normal values for lower extremity muscle length in college-age students. Phys Ther Sport 2007. [DOI: 10.1016/j.ptsp.2006.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
50
|
Gama ZADS, Medeiros CADS, Dantas AVR, Souza TOD. Influência da freqüência de alongamento utilizando facilitação neuromuscular proprioceptiva na flexibilidade dos músculos isquiotibiais. REV BRAS MED ESPORTE 2007. [DOI: 10.1590/s1517-86922007000100008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A utilização de manobras de alongamento é um dos recursos mais utilizados na prática de reabilitação. Porém, alguns parâmetros, como a freqüência, não têm sido estudados quando se utilizam as técnicas de facilitação neuromuscular proprioceptiva (FNP). O objetivo deste estudo foi analisar a freqüência ótima visando aumentar a flexibilidade dos músculos isquiotibiais, medida pela amplitude ativa de extensão do joelho. Selecionaram-se 36 sujeitos do sexo feminino (média de idade (DP) de 21,7 (1,9) anos), com limitação da flexibilidade dos músculos isquiotibiais. Os sujeitos foram distribuídos aleatoriamente em quatro grupos (n = 9). Os três grupos de alongamento receberam a intervenção cinco dias por semana durante duas semanas consecutivas. O quarto grupo, que serviu como controle, não foi alongado. Os grupos de alongamento com FNP variaram quanto à freqüência em uma, três e seis manobras por sessão. Uma análise de variância (ANOVA) foi utilizada para as medidas iniciais e finais (p < 0,05). Em seguida, foi realizada uma análise post hoc por meio do teste de Tukey (p < 0,05). A análise estatística dos dados indicou que os grupos de alongamento tiveram ganho de amplitude significativo em relação ao grupo controle, mas não entre eles mesmos. Em relação à velocidade do ganho, os grupos que utilizaram três e seis manobras alongaram (p < 0,05) mais rapidamente que o grupo que utilizou apenas uma manobra. Conclui-se, portanto, não haver diferença em relação ao ganho tardio quando se utilizam uma, três ou seis manobras de alongamento com a técnica de sustentar-relaxar nos isquiotibiais.
Collapse
|