Does pre-exercise static stretching inhibit maximal muscular performance? A meta-analytical review

Optimizing Post-activation Performance Enhancement in Athletic Tasks: A Systematic Review with Meta-analysis for Prescription Variables and Research Methods

BACKGROUND

Post-activation performance enhancement (PAPE) has demonstrated efficacy in acutely improving athletic performance. However, its distinction from general warm-up (GW) effects remains ambiguous, and experimental designs adopted in most PAPE studies exhibit important limitations.

OBJECTIVES

The aims of this work are to (i) examine the effects of research methodology on PAPE outcomes, (ii) explore PAPE outcomes in relation to comparison methods, performance measures, GW comprehensiveness, recovery duration, participants' characteristics, conditioning activity (CA) parameters, and (iii) make recommendations for future PAPE experimental designs on the basis of the results of the meta-analysis.

METHODS

Four databases were searched for peer-reviewed English-language literature. Risk of bias was assessed using a modified Cochrane Collaboration's tool and PEDro scale. PAPE groups were compared with control groups, pre-conditioning activity (pre-CA) performances were compared with post-conditioning activity (post-CA) performances throughout a verification test in PAPE groups, and control groups were compared before and after the "rest" period using a three-level meta-analysis. Further analyses, including subgroup analysis and both linear and nonlinear meta-regression methods, were used to explore the effect of different moderating factors on PAPE magnitude. A subgroup analysis of GW comprehensiveness was conducted using four classification methods. One method classified GW as non-comprehensive (stretching or jogging only), partially comprehensive (stretching, jogging, and low-intensity self-weighted dynamic exercises), and comprehensive (adding maximal or near-maximal intensity CAs to a partially comprehensive GW). The other three classifications were adjusted according to the type and number of GW exercises. Certainty of evidence was assessed using the GRADE approach.

RESULTS

The final analysis included 62 PAPE studies (1039 participants, male: n = 857, female: n = 182) with a high risk of bias and low certainty of pooled evidence. A trivial PAPE effect was observed from pre- to post-CA (effect size [ES] = 0.12, 95% CI [0.06 to 0.19], prediction intervals [PI] = - 0.29 to 0.54); a small PAPE effect was observed when compared with a control group (ES = 0.30, 95% CI [0.20 to 0.40], PI [- 0.38 to 0.97]). The slightly greater effect against control resulted from a small decrease in performance in control groups (ES = - 0.08, 95% CI [- 0.13 to - 0.03], PI [- 0.30 to 0.14]), but there was no relationship with between PAPE recovery time (β = - 0.005, p = 0.149). Subgroup analyses showed that PAPE magnitude was greater for non-comprehensive GWs (ES = 0.16) than comprehensive (ES = 0.01) and partially comprehensive GWs (ES = 0.11). In contrast, the control group showed a decline in performance after comprehensive GW (ES = - 0.20). An inverted U-shaped PAPE was noted as a function of recovery time. In some cases, PAPE appeared to manifest at < 1 min post CA. Additionally, participants with longer training experience (ES = 0.36) and higher training levels (ES = 0.38) had larger PAPE magnitudes. PAPE effect was higher in females (ES = 0.51) than males (ES = 0.32) and mixed groups (ES = 0.16) but did not reach a significant difference (p > 0.05). Plyometric exercise (ES = 0.42) induced greater PAPE amplitude than traditional resistance exercise (ES = 0.23), maximal isometric voluntary contraction (ES = 0.31) and other CA types (ES = 0.24).

CONCLUSIONS

Although the overall pooled results for both PAPE pre- versus post-CA and PAPE versus control group comparisons showed significant improvement, the wider and past-zero prediction intervals indicate that future studies are still likely to produce negative results. The comprehensiveness of the GW, the time between GW and the pre-CA test, participant sex, training level, training experience, type of CA, number of CA sets, and recovery time after CA all influence the PAPE magnitude. The PAPE magnitude was trivial after comprehensive GW, but it was greater in studies with a control group (i.e., no CA) because performance decreased over the control period, inflating the PAPE effect. Finally, two theoretical models of PAPE experimental design and suggestions for methodological issues are subsequently presented. Future studies can build on this to further explore the effects of PAPE.

PROTOCOL REGISTRATION

The original protocol was prospectively registered (osf.io/v7sbt) with the Open Science Framework.

Effects of static stretching and walking during inter-set intervals of resistance training on muscle fatigue of the quadriceps

Introduction

Inter-set rest intervals are essential to reduce muscle fatigue and increase the total amount of volume of resistance training. Static stretching and walking may increase muscle blood flow and promote recovery during inter-set rest intervals. Therefore, the purpose of this study was to investigate the effects of 20 seconds of static stretching and walking during inter-set rest intervals of leg extension exercises on the number of repetitions to exhaustion, total amount of volume, and flexibility of the quadriceps (joint range of motion and muscle hardness) in untrained healthy males.

Methods

Fourteen healthy, untrained men performed three different interventions (passive rest, static stretching, and walking) during inter-set rest intervals of a leg extension exercise with a 70% load of maximum muscle strength, in random order. The range of motion and muscle hardness of the quadriceps were measured before and immediately after all interventions using a goniometer and a portable muscle hardness meter. The number of repetitions to exhaustion and total amount of volume load (load × repetitions) of the leg extension exercise were assessed. Repeated two-way ANOVA and a Friedman test were used to analyze the variables.

Results

Range of motion and muscle hardness were increased after all interventions (both p < 0.05). There was no significant difference in the number of repetitions to exhaustion (p = 0.651) or total amount of volume load (p = 0.206) between interventions.

Discussion

These results indicated that static stretching and walking during inter-set rest intervals did not influence the change in flexibility and muscle fatigue of the leg extension exercise.

Neuromuscular and balance adaptations following acute stretching exercise: a randomized control trial

Purpose

This study aimed to examine the acute effects of static stretching (SS) and dynamic stretching (DS) on neuromuscular function and balance in recreationally active men.

Method

Sixty participants were randomly assigned to SS, DS, or no stretching (NS) groups. Before and after their respective stretching protocols, participants were assessed using the stork balance test (SBT), Y-balance test (YBT), T-change of direction test (CoD T-test), countermovement jump test (CMJT), squat jump test (SJT), and five-time jump test (FJT).

Results

Significant main effects of time were observed for the SBT, YBT, and CoD T-test. Significant interactions between time and group were found for the SBT, YBT, CoD T-test, and CMJT (P < 0.05). Compared to the NS group, the SS group showed significant improvement in the SBT (P < 0.05), while the DS group demonstrated significant improvements in the SBT, YBT (all directions), CoD T-test, CMJT, and SJT (P < 0.05). Post-training, the DS group showed greater improvements than the SS group in the YBT, CoD T-test, CMJT, and SJT (P < 0.05), with no significant differences in the SBT.

Conclusion

SS acutely improves static balance, while DS has a broader impact, enhancing both neuromuscular function and balance.

Revisiting the stretch-induced force deficit: A systematic review with multilevel meta-analysis of acute effects

BACKGROUND

When recommending avoidance of static stretching prior to athletic performance, authors and practitioners commonly refer to available systematic reviews. However, effect sizes (ES) in previous reviews were extracted in major part from studies lacking control conditions and/or pre-post testing designs. Also, currently available reviews conducted calculations without accounting for multiple study outcomes, with ES: -0.03 to 0.10, which would commonly be classified as trivial.

METHODS

Since new meta-analytical software and controlled research articles have appeared since 2013, we revisited the available literatures and performed a multilevel meta-analysis using robust variance estimation of controlled pre-post trials to provide updated evidence. Furthermore, previous research described reduced electromyography activity-also attributable to fatiguing training routines-as being responsible for decreased subsequent performance. The second part of this study opposed stretching and alternative interventions sufficient to induce general fatigue to examine whether static stretching induces higher performance losses compared to other exercise routines.

RESULTS

Including 83 studies with more than 400 ES from 2012 participants, our results indicate a significant, small ES for a static stretch-induced maximal strength loss (ES = -0.21, p = 0.003), with high magnitude ES (ES = -0.84, p = 0.004) for stretching durations ≥60 s per bout when compared to passive controls. When opposed to active controls, the maximal strength loss ranges between ES: -0.17 to -0.28, p < 0.001 and 0.040 with mostly no to small heterogeneity. However, stretching did not negatively influence athletic performance in general (when compared to both passive and active controls); in fact, a positive effect on subsequent jumping performance (ES = 0.15, p = 0.006) was found in adults.

CONCLUSION

Regarding strength testing of isolated muscles (e.g., leg extensions or calf raises), our results confirm previous findings. Nevertheless, since no (or even positive) effects could be found for athletic performance, our results do not support previous recommendations to exclude static stretching from warm-up routines prior to, for example, jumping or sprinting.

Combining clinically common drugs with hindlimb stretching in spinal cord injured rodents

STUDY DESIGN

Preclinical pilot study.

OBJECTIVES

To explore peripheral and central nociceptive mechanisms that contribute to muscle stretch-induced locomotor deficits following spinal cord injury.

SETTING

Kentucky Spinal Cord Injury Research Center, Louisville, KY, USA.

METHODS

Ten female Sprague-Dawley rats received moderate, 25 g/cm T10 contusion injuries and recovered for 4 weeks. Rats were divided into three groups: Morphine/Ibuprofen-treated, Acetaminophen/Baclofen-treated, and saline control. Each group received daily hindlimb muscle stretching during weeks 4, 5, 9, and 10 post-injury and drugs were administered with stretching during weeks 4 and 9 only. Locomotor function was assessed throughout the experiment using the BBB Open Field Locomotor Scale. Hindlimb responses including spasticity, writhing, and clonic-like vibrations during muscle stretching were classified and scored.

RESULTS

Consistent with our previous studies, hindlimb muscle stretching caused significant deficits in locomotor recovery following spinal cord injury. Baclofen and Ibuprofen partially mitigated the stretching effect, but none of the drugs significantly prevented the drop in locomotor function during stretching. Interestingly, treatment with Baclofen or Ibuprofen significantly reduced hindlimb responses such as spasticity and writhing during stretching, while Morphine exacerbated clonic-like vibrations in response to stretching maneuvers.

CONCLUSIONS

These findings suggest that stretching may inhibit locomotor recovery through combined mechanisms of peripheral inflammation and sensitization of nociceptive afferents. When combined with central sprouting and loss of descending controls after SCI, this results in exaggerated nociceptive input during stretching. The inability of the applied clinical drugs to mitigate the detrimental effects of stretching highlights the complexity of the stretching phenomenon and emphasizes the need for further investigation.

Foam rolling and stretching do not provide superior acute flexibility and stiffness improvements compared to any other warm-up intervention: A systematic review with meta-analysis

BACKGROUND

Acute improvement in range of motion (ROM) is a widely reported effect of stretching and foam rolling, which is commonly explained by changes in pain threshold and/or musculotendinous stiffness. Interestingly, these effects were also reported in response to various other active and passive interventions that induce responses such as enhanced muscle temperature. Therefore, we hypothesized that acute ROM enhancements could be induced by a wide variety of interventions other than stretching or foam rolling that promote an increase in muscle temperature.

METHODS

After a systematic search in PubMed, Web of Science, and SPORTDiscus databases, 38 studies comparing the effects of stretching and foam rolling with several other interventions on ROM and passive properties were included. These studies had 1134 participants in total, and the data analysis resulted in 140 effect sizes (ESs). ES calculations were performed using robust variance estimation model with R-package.

RESULTS

Study quality of the included studies was classified as fair (PEDro score = 4.58) with low to moderate certainty of evidence. Results showed no significant differences in ROM (ES = 0.01, p = 0.88), stiffness (ES = 0.09, p = 0.67), or passive peak torque (ES = -0.30, p = 0.14) between stretching or foam rolling and the other identified activities. Funnel plots revealed no publication bias.

CONCLUSION

Based on current literature, our results challenge the established view on stretching and foam rolling as a recommended component of warm-up programs. The lack of significant difference between interventions suggests there is no need to emphasize stretching or foam rolling to induce acute ROM, passive peak torque increases, or stiffness reductions.

Discussing Conflicting Explanatory Approaches in Flexibility Training Under Consideration of Physiology: A Narrative Review

The mechanisms underlying range of motion enhancements via flexibility training discussed in the literature show high heterogeneity in research methodology and study findings. In addition, scientific conclusions are mostly based on functional observations while studies considering the underlying physiology are less common. However, understanding the underlying mechanisms that contribute to an improved range of motion through stretching is crucial for conducting comparable studies with sound designs, optimising training routines and accurately interpreting resulting outcomes. While there seems to be no evidence to attribute acute range of motion increases as well as changes in muscle and tendon stiffness and pain perception specifically to stretching or foam rolling, the role of general warm-up effects is discussed in this paper. Additionally, the role of mechanical tension applied to greater muscle lengths for range of motion improvement will be discussed. Thus, it is suggested that physical training stressors can be seen as external stimuli that control gene expression via the targeted stimulation of transcription factors, leading to structural adaptations due to enhanced protein synthesis. Hence, the possible role of serial sarcomerogenesis in altering pain perception, reducing muscle stiffness and passive torque, or changes in the optimal joint angle for force development is considered as well as alternative interventions with a potential impact on anabolic pathways. As there are limited possibilities to directly measure serial sarcomere number, longitudinal muscle hypertrophy remains without direct evidence. The available literature does not demonstrate the necessity of only using specific flexibility training routines such as stretching to enhance acute or chronic range of motion.

Resistance Training Causes the Stretch-Induced Force Deficit-A Randomized Cross-Over Study

PURPOSE

Stretch-induced force deficit suggests an acute stretch-specific strength capacity loss, which is commonly attributed to EMG reductions. Since those deficits could also be attributed to general fatigue induced by overloading the muscle, this study aimed to compare stretching with an exhausting calf raise programme to compare strength and stretching responses.

METHOD

This study included 16 participants with different, high-duration calf muscle stretching effects (10, 20, 30 min of stretching) with resistance training (RT) (3 × 12 repetitions) performed until muscle failure, by using a cross-over study design with pre-post comparisons. Strength was tested via isometric plantar flexor diagnostics, while flexibility was assessed using the knee-to-wall test (KtW) and an isolated goniometer test.

RESULTS

Using a three-way ANOVA, RT strength decreases were greater compared to 10 and 20 min of stretching (p = 0.01-0.02), but similar to those of 30 min of stretching. ROM in the KtW showed no specific stretch-induced increases, while only the stretching conditions enhanced isolated tested ROM (p < 0.001-0.008). No RT-related isolated ROM increases were observed.

CONCLUSIONS

The results showed both interventions had similar effects on strength and ROM in the calf muscles. More holistic explanatory approaches such as fatigue and warm-up are discussed in the manuscript and call for further research.

Effects of Chronic Static Stretching on Maximal Strength and Muscle Hypertrophy: A Systematic Review and Meta-Analysis with Meta-Regression

BACKGROUND

Increases in maximal strength and muscle volume represent central aims of training interventions. Recent research suggested that the chronic application of stretch may be effective in inducing hypertrophy. The present systematic review therefore aimed to syntheisize the evidence on changes of strength and muscle volume following chronic static stretching.

METHODS

Three data bases were sceened to conduct a systematic review with meta-analysis. Studies using randomized, controlled trials with longitudinal (≥ 2 weeks) design, investigating strength and muscle volume following static stretching in humans, were included. Study quality was rated by two examiners using the PEDro scale.

RESULTS

A total of 42 studies with 1318 cumulative participants were identified. Meta-analyses using robust variance estimation showed small stretch-mediated maximal strength increases (d = 0.30 p < 0.001) with stretching duration and intervention time as significant moderators. Including all studies, stretching induced small magnitude, but significant hypertrophy effects (d = 0.20). Longer stretching durations and intervention periods as well as higher training frequencies revealed small (d = 0.26-0.28), but significant effects (p < 0.001-0.005), while lower dosage did not reach the level of significance (p = 0.13-0.39).

CONCLUSIONS

While of minor effectiveness, chronic static stretching represents a possible alternative to resistance training when aiming to improve strength and increase muscle size. As a dose-response relationship may exist, higher stretch durations and frequencies as well as long program durations should be further elaborated.

Acute effect of static stretching and pilates stretching on the concentric muscle strength of the knee extensors and flexors

INTRODUCTION

The effects of stretching exercises on muscle strength have been widely researched in the literature, however, there are no studies investigating the effects of Pilates stretching.

OBJECTIVE

To compare the effects of static stretching and Pilates stretching on the concentric muscle strength of the knee extensors and flexors.

METHOD

102 trained young adults were randomized into three groups: static stretching (n = 33); Pilates stretching (n = 34); control (n = 35). Isokinetic evaluation of the knee extensor and flexor muscles was performed at 60°/s and 180°/s, pre and post acute intervention with stretching. Interventions in the static stretching and Pilates stretching groups occurred in 3 sets x 30 s for each body region considered (a-knee extensor muscles; b-knee flexor muscles). The control group did not perform any intervention.

RESULTS

No difference (p > 0.05) was observed between the groups after the intervention. There was only a significant intragroup improvement for the control group on the isokinetic muscle strength of the knee flexors at 180°/s, with a moderate effect size, considering the entire sample (p = 0.040; d = 0.42) and when considering only male gender (p = 0.010; d = 0.60).

CONCLUSION

Static stretching or Pilates stretching performed as a warm-up did not impair or enhance the concentric muscle strength performance of the knee extensors and flexors. In this way, both forms of stretching can be considered as preparatory exercises before muscle strength training.

Examining the Influence of Warm-Up Static and Dynamic Stretching, as well as Post-Activation Potentiation Effects, on the Acute Enhancement of Gymnastic Performance: A Systematic Review with Meta-Analysis

The primary objective of this systematic review with meta-analysis is to methodically discern and compare the impact of diverse warm-up strategies, including both static and dynamic stretching, as well as post-activation potentiation techniques, on the immediate performance of gymnasts. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this paper evaluated studies that examined the gymnasts' performance after different warm-up strategies namely stretching (static [SS] or dynamic), vibration platforms (VP) or post-activation, in comparison to control conditions (e.g., mixed warm-up routines; no warm-up). The principal outcomes were centered on technical performance metrics (e.g., split, gymnastic jumps) and physical performance metrics (e.g., squat jump, countermovement jump, drop jump, balance, range of motion). Methodological assessments of the included studies were conducted using the Downs and Black Checklist. From the initial search across PubMed, Scopus, and the Web of Science databases, a total of 591 titles were retrieved, and 19 articles were ultimately incorporated in the analysis. The results revealed a non-significant differences (p > 0.05) between the SS condition and control conditions in squat jump performance, countermovement jump and gymnastic technical performance (e.g., split; split jump). Despite the difference in warm-up strategies and outcomes analyzed, the results suggest that there is no significant impairment of lower-limb power after SS. Additionally, technical elements dependent on flexibility appear to be enhanced by SS. Conversely, dynamic stretching and VP seem to be more effective for augmenting power-related and dynamic performance in gymnasts.

Acute effects of static and proprioceptive neuromuscular facilitation stretching on hamstrings muscle stiffness and range of motion: a randomized cross-over study

This study aimed to compare the acute effects of static stretching (SS) and proprioceptive neuromuscular facilitation (PNF) stretching on hamstrings flexibility and shear modulus. Sixteen recreationally active young volunteers participated in a randomized cross-over study. Participants underwent an aerobic warm-up (WU), followed by either SS or PNF stretching. Range of motion (RoM) during passive straight leg raise and active knee extension, as well as shear modulus of the biceps femoris (BF) and semitendinosus (ST) muscles, were measured at baseline, post-WU, and post-stretching. Both stretching techniques significantly increased RoM, with no differences observed between SS and PNF (p < 0.001; η2 = 0.59-0.68). However, only PNF stretching resulted in a significant decrease in BF shear modulus (time×stretching type interaction: p = 0.045; η2 = 0.19), indicating reduced muscle stiffness. No changes in ST shear modulus were observed after either stretching technique. There was no significant correlation between changes in RoM and shear modulus, suggesting that the increase in RoM was predominantly due to changes in stretch tolerance rather than mechanical properties of the muscles. These findings suggest that both SS and PNF stretching can effectively improve hamstring flexibility, but PNF stretching may additionally reduce BF muscle stiffness. The study highlights the importance of considering individual muscle-specific responses to stretching techniques and provides insights into the mechanisms underpinning acute increases in RoM.

The knowledge of movement experts about stretching effects: Does the science reach practice?

OBJECTIVE

Stretching is performed with numerous purposes in multiple settings such as prevention, rehabilitation, fitness training and sports. Its patterns of use substantially depend on the education and beliefs of health care and exercise professionals as they represent the multiplicators recommending and prescribing interventions to clients, patients and athletes. This study investigated movement experts' knowledge about the scientific evidence on stretching effects.

DESIGN

Survey study.

PARTICIPANTS

A total of 117 exercise and health professionals (physiotherapists, sports scientists, coaches) attending a training convention in Austria (male: n = 44, female: n = 73, 36±11 years) completed a digital survey. With its 22 items, the questionnaire addressed the movement experts' awareness of the evidence on stretching effects regarding a variety of related topics selected based on the findings of topical systematic reviews.

RESULTS

The majority of the individuals (57-88%) assumed positive effects of stretching on recovery, prevention of muscle injury, range of motion, muscular imbalance and artery elasticity. No or adverse effects were mostly claimed on bone injury prevention, maximal/explosive strength, and delayed-onset muscle soreness. In only 10 of 22 items, participants' classifications were in accord with the scientific evidence.

CONCLUSIONS

The awareness of research findings on stretching effects among exercise and health professionals is alarmingly low. Future studies may hence be geared to improve implementation and science communication.

Effects of stretching in a pilates program on musculoskeletal fitness: a randomized clinical trial

BACKGROUND

The scientific literature questions the impact of stretching exercises performed immediately before muscle strengthening exercises on different components of musculoskeletal physical fitness. Pilates is a physical exercise modality that typically uses stretching exercises preceding muscle-strengthening exercises. However, no studies have investigated the effects of stretching in a Pilates program on components of musculoskeletal fitness. The aim of the present study was to verify the effects of stretching in a Pilates exercise program on flexibility, strength, vertical jump height and muscular endurance.

METHODS

Thirty-two sedentary young women were randomized into two groups: traditional Pilates (TP), who performed flexibility and muscle strengthening exercises (n = 16), and nontraditional Pilates (NTP), who only performed muscle-strengthening exercises (n = 16). Sessions took place 3 times a week for 8 weeks. The following tests were performed pre- and postintervention: 10-RM knee extensors, vertical jump, handgrip, 1-min sit-ups, Sorensen and sit-and-reach. The occurrence of adverse events was recorded throughout the intervention and compared between groups using odds ratio (OR). To compare the results of motor tests between groups, ANCOVA or Mann‒Whitney U test was used for parametric and nonparametric data, respectively. The data were analyzed by intention-to-treat.

RESULTS

After intervention, the TP was superior to NTP for the sit-and-reach test, with a large effect size (d = 0.87; p = 0.035), with no differences between groups for the other tests. Intragroup comparisons showed significant differences (p < 0.05) for TP and NTP for improvement in 10-RM knee extensors and vertical jump measurements, while only TP showed significant intragroup improvement (p < 0.05) for the sit-and-reach test. A greater chance of experiencing pain or other discomfort as a result of exercise was shown by NTP (OR = 4.20, CI95% 0.69 to 25.26).

CONCLUSION

Our findings demonstrated that stretching exercises performed at the beginning of sessions in a Pilates program did not impair or enhance the development of strength, vertical jump height and muscular endurance in young women. However, only the Pilates program with stretching improved flexibility and reduced the chances of adverse events such as musculoskeletal pain and other discomfort resulting from the exercise protocol.

CLINICALTRIALS

GOV: NCT05538520, prospectively registered on September 16, 2022.

Acute and Prolonged Effects of 300 sec of Static, Dynamic, and Combined Stretching on Flexibility and Muscle Force

Static stretching (SS), dynamic stretching (DS), and combined stretching (CS; i.e., DS+SS) are commonly performed as warm-up exercises. However, the stretching method with the greatest effect on flexibility and performance remains unclear. This randomized crossover trial examined acute and prolonged effects of SS, DS, and CS on range of motion (ROM), peak passive torque (PPT), passive stiffness, and isometric and concentric muscle forces. Twenty healthy young men performed 300 sec of active SS, DS, or CS (150-sec SS followed by 150-sec DS and 150-sec DS followed by 150-sec SS) of the right knee flexors on four separate days, in random order. Subsequently, we measured ROM, PPT, and passive stiffness during passive knee extension. We also measured maximum voluntary isometric and concentric knee flexion forces and surface electromyographic activities during force measurements immediately before, immediately after, and 20 and 60 min after stretching. All stretching methods significantly increased ROM and PPT, while significantly decreasing isometric knee flexion force (all p < 0.05). These changes lasted 60 min after all stretching methods; the increases in ROM and PPT and the decreases in isometric muscle force were similar. All stretching methods also significantly decreased passive stiffness immediately after stretching (all p < 0.05). Decreases in passive stiffness tended to be longer after CS than after SS or DS. Concentric muscle force was decreased after SS and CS (all p < 0.05). On the other hand, concentric muscle force was unchanged after DS, while the decreases in surface electromyographic activities during concentric force measurements after all stretching methods were similar. Our results suggest that 300 sec of SS, DS, and CS have different acute and prolonged effects on flexibility and muscle force.

Immediate effects of elastic tape application on the foot sole: a randomized controlled trial

[Purpose] In this study, we investigated the effectiveness of elastic tape in increasing the dorsiflexion angle and plantar flexor strength in healthy individuals. [Participants and Methods] This randomized controlled trial included 24 healthy university students who were categorized into the following groups (12 participants in each group): the intervention group (elastic tape was applied to the dominant foot) and the control group (no intervention was performed). We performed intergroup comparison of the pre- and post-intervention dorsiflexion angles and plantar flexor strength. Additionally, we performed subgroup analyses based on a straight-leg raise angle of 70°. [Results] We observed no significant intergroup differences in the dorsiflexion angle or plantar flexor strength. However, the post-intervention dorsiflexion angle was significantly greater than the pre-intervention angle in the subgroup with a straight-leg raise angle of <70° among participants in the elastic tape group. [Conclusion] Elastic tape application may effectively increase the dorsiflexion angle in individuals without hamstring extensibility.

Are Acute Effects of Foam-Rolling Attributed to Dynamic Warm Up Effects? A Comparative Study

Over the last decade, acute increases in range of motion (ROM) in response to foam rolling (FR) have been frequently reported. Compared to stretching, FR-induced ROM increases were not typically accompanied by a performance (e.g., force, power, endurance) deficit. Consequently, the inclusion of FR in warm-up routines was frequently recommended, especially since literature pointed out non-local ROM increases after FR. However, to attribute ROM increases to FR it must be ensured that such adaptations do not occur as a result of simple warm-up effects, as significant increases in ROM can also be assumed as a result of active warm-up routines. To answer this research question, 20 participants were recruited using a cross-over design. They performed 4x45 seconds hamstrings rolling under two conditions; FR, and sham rolling (SR) using a roller board to imitate the foam rolling movement without the pressure of the foam rolling. They were also tested in a control condition. Effects on ROM were tested under passive, active dynamic as well as ballistic conditions. Moreover, to examine non-local effects the knee to wall test (KtW) was used. Results showed that both interventions provided significant, moderate to large magnitude increases in passive hamstrings ROM and KtW respectively, compared to the control condition (p = 0.007-0.041, d = 0.62-0.77 and p = 0.002-0.006, d = 0.79-0.88, respectively). However, the ROM increases were not significantly different between the FR and the SR condition (p = 0.801, d = 0.156 and p = 0.933, d = 0.09, respectively). No significant changes could be obtained under the active dynamic (p = 0.65) while there was a significant decrease in the ballistic testing condition with a time effect (p < 0.001). Thus, it can be assumed that potential acute increases in ROM cannot be exclusively attributed to FR. It is therefore speculated that warm up effects could be responsible independent of FR or imitating the rolling movement, which indicates there is no additive effect of FR or SR to the dynamic or ballistic range of motion.

The Combined Effect of Static Stretching and Foam Rolling With or Without Vibration on the Range of Motion, Muscle Performance, and Tissue Hardness of the Knee Extensor

ABSTRACT

Nakamura, M, Konrad, A, Kasahara, K, Yoshida, R, Murakami, Y, Sato, S, Aizawa, K, Koizumi, R, and Wilke, J. The combined effect of static stretching and foam rolling with or without vibration on the range of motion, muscle performance, and tissue hardness of the knee extensor. J Strength Cond Res 37(2): 322-327, 2023-Although the combination of static stretching (SS) and foam rolling (FR) is frequently used for warm-up in sports, the effect of the intervention order is unclear. This study compared mechanical tissue properties, pain sensitivity, and motor function after SS and FR (with and without vibration) performed in different orders. Our randomized, controlled, crossover experiment included 15 healthy male subjects (22.5 ± 3.3 years) who visited the laboratory 5 times (inactive control condition, FR + SS, FR vibration + SS, SS + FR, and SS + FR vibration ) with an interval of ≥48 hours. In each session, subjects completed three 60-second bouts of FR and SS, targeting the anterior thigh. Pressure pain threshold, tissue hardness, knee flexion range of motion (ROM), maximal voluntary isometric (MVC-ISO), and concentric (MVC-CON) torque, as well as countermovement jump height, were determined before and after the intervention. All interventions significantly ( p < 0.01) increased knee flexion ROM ( d = 0.78, d = 0.87, d = 1.39, and d = 0.87, respectively) while decreasing tissue hardness ( d = -1.25, d = -1.09, d = -1.18, and d = -1.24, respectively). However, MVC-ISO torque was significantly reduced only after FR + SS ( p = 0.05, d = -0.59). Our results suggest that SS should be followed by FR when aiming to increase ROM and reduce tissue hardness without concomitant stretch-induced force deficits (MVC-ISO, MVC-CON, and countermovement jump height). Additionally, adding vibration to FR does not seem to affect the magnitude of changes observed in the examined outcomes.

Effects of Myofascial Release Using Finding-Oriented Manual Therapy Combined with Foam Roller on Physical Performance in University Athletes. A Randomized Controlled Study

Sport is a science of constant reinvention that is always searching for strategies to improve performance. Objective: This study seeks to compare the effects of myofascial release with Findings-Oriented Orthopedic Manual Therapy (OMT) combined with Foam Roller (FR), versus FR by itself, on the physical performance of university athletes. A randomized controlled study was conducted with a total of twenty-nine university athletes, measuring Range of Motion (ROM), jump height and flight time, strength and dynamic flexibility using Goniometer pro, CMJ protocol in OptoGait, 1 Repetition Maximum (1RM) and Mean Propulsive Velocity (MPV) and the Sit and Reach (V) test, correspondingly. This study was registered at clinicaltrials.gov prior to the initial measurement of the participants under the code NCT05347303. Through a univariate analysis, together with an analysis of independent groups with ANOVA and an analysis of covariance, it was evidenced that OMT combined with FR generated more and better effects in all the evaluated ROM, jump height and flight time, RM and VMP tests. Finally, it was found that OMT combined with FR is better when it is desired to improve ROM, muscle power, strength and flexibility, while FR alone only improves dynamic flexibility.

Systematic review: exercise training for equinus deformity in children with cerebral palsy

Background

Children with spastic cerebral palsy have motor deficits that can lead to joint contractures. Ankle equinus deformity is the most common foot deformity among children with CP. It is caused by spasticity and muscular imbalance in the gastrocnemius-soleus complex. Exercise enhances ankle function, improves gait in children with CP, and prevents permanent impairment. Therefore, there is a need to investigate the effectiveness of different types of exercise used in equine management. The aim of this review is to assess the evidence of the effectiveness of exercise training on equinus deformity in children with cerebral palsy.

Methodology

The American Academy for Cerebral Palsy and Developmental Medicine and Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology were used to conduct this systematic review. Four databases (PubMed, Cochrane Library, Physiotherapy Evidence Database (PEDro), and Google Scholar) were searched till January 2022 using predefined terms by two independent reviewers. Randomized controlled trials published in English were included. This review included seven studies with 203 participants ranging in age from 5 to 18 years. Methodological quality was assessed using AACPDM, PEDro scale; also, levels of evidence adopted from modified Sacket’s scale were used for each study. Primary outcomes were dorsiflexion angle, plantar flexion angle, and plantar flexors strength.

Results

The quality of studies ranged from good (six studies) to fair (one study). The level of evidence was level 1 (six studies) and level 2 (one study) on modified Sacket’s scale. There is a low risk of bias in the included studies. Meta-analysis revealed a non-significant difference in plantar flexor strength, plantar flexion angle, and dorsiflexion angle between the study and control group.

Conclusions

There is a need for high-quality studies to draw a clear conclusion as the current level of evidence supporting the effectiveness of various types of exercises on equinus deformity in children with cerebral palsy is still weak.

The Effects of a Compensatory Training Program Adding an Isoinertial Device in the Shoulder Function on Young Tennis Players

ABSTRACT

Fernandez-Fernandez, J, Moreno-Perez, V, Cools, A, Nakamura, FY, Teixeira, AS, Ellenbecker, T, Johansson, F, and Sanz-Rivas, D. The effects of a compensatory training program adding an isoinertial device in the shoulder function on young tennis players. J Strength Cond Res 37(5): 1096-1103, 2023-The aim of this study was to analyze whether a compensatory training program, including isoinertial flywheel training, could reduce shoulder imbalances in a group of asymptomatic young tennis players. After an initial evaluation, 26 young tennis players were assigned to either a supervised flywheel training group (FTG, n = 13) or a control group (CG, n = 13). Shoulder passive internal (IR) and external rotation (ER) range of motion (ROM) as well as shoulder IR and ER maximal isometric strength were measured before and after a 12-week training intervention, performed 3 times per week. After the intervention, results showed significant changes for IR ( p < 0.001, effect size [ES] = 1.83) and ER ( p < 0.001, ES = 1.77) on the dominant (D) side, and IR on the nondominant (ND) side ( p < 0.001, ES = 2.24) in the FTG compared with the CG. Regarding the ROM values, results showed that the FTG achieved significantly greater increases for the IR ROM ( p < 0.001, ES = 3.32) and total ROM (TROM) ( p = 0.004, ES = 1.39) on the D and ND sides (IR ROM: p = 0.002, ES = 1.53; TROM: p < 0.001, ES = 2.35) than the CG. Moreover, the CG displayed larger decrements in ER ROM ( p = 0.016, ES = 1.12) on the ND side after the training period than the FTG. The conducted compensatory training program was effective to increase the ER strength and IR mobility of the FTG players, which led to a reduction in the glenohumeral imbalances.

Acute effects of long-lasting stretching and strength training on maximal strength and flexibility in the calf muscle

The so-called “stretch-induced force deficit” is known from a large amount of research. There are many theories trying to explain the stretch-induced force deficit and increases in the range of motion (ROM) which all offer a stretch training-specific explanation. However, when performing a commonly used strength training session, a reduced maximum strength (MSt) capacity can be assumed as well. Based on this, the aim of the study is to investigate the tension-induced force deficit due to a suprathreshold strength or stretching training stimulus. Therefore, 71 participants (age: 24.1 ± 4.2 years, height: 176.3 ± 5.7 cm, weight: 74.1 ± 7.5 kg) were divided into three groups: static stretching group (SST), strength training group (STR), and control group (CG). To investigate possible mechanical tension-induced force deficits, SST performed a long-lasting static stretching intervention for 1 h using an orthosis, while STR executed a common strength training intervention (5 × 12 repetition) for the plantar flexors. The results show a significant reduction of measured MSt as well as increased ROM for both SST and STR following the interventions. Consequently, we found similar acute effects of stretching and strength training regarding MSt and flexibility. We conclude that the decreased MSt capacities can possibly be attributed to mechanical tension-induced damage of the muscle that is not linked to a specific training method. The improvements in flexibility found in both intervention groups might be attributed to warm up effects when inducing high mechanical tension to large ankle joint angles.

The effect of two different stretching exercises on the muscle tendon unit and range of motion

BACKGROUND: Stretching is commonly used for clinical and sports reason but the effects vary on time and the technique used. PURPOSE: To determine the acute effects of static and dynamic stretching of gastrocnemius muscle on muscle-tendon unit (MTU) and dorsiflexion range of motion (ROM) in the same individuals; to find out how long the stretching effects endure. METHODS: Twenty-eight males (mean age: 22.18 ± 2.58 years) were included in the study. A 45-s static stretching (SS) exercise was applied to the right leg 5 times and dynamic stretching (DS) of same duration to the other leg. Change in MTU was assessed by ultrasonography and active and passive ROM was measured with goniometer. All evaluations were performed before, immediately following, 5-min, 15-min and 30-min after stretching. RESULTS: Muscle thickness and pennation angle did not change over time with either techniques (p> 0.05). A significant muscle-tendon junction (MTJ) displacement occurred after the techniques (p< 0.05); the highest change was achieved after DS (p< 0.05). Both techniques improved active ROM values similarly (p< 0.05), but only dynamic stretching increased passive ROM significantly (p< 0.05). Active and passive ROM and MTJ displacement values at 30th – min were still higher than the baseline ones on the DS side (p< 0.05). However, SS increased active ROM angle immediately after application but this increment declined until the final measurement. CONCLUSION: We recommend using the dynamic stretching technique to achieve greater and longer lasting increases in tendon length and range of motion.

The Time-Course Changes in Knee Flexion Range of Motion, Muscle Strength, and Rate of Force Development After Static Stretching

Previous studies have shown that longer-duration static stretching (SS) interventions can cause a decrease in muscle strength, especially explosive muscle strength. Furthermore, force steadiness is an important aspect of muscle force control, which should also be considered. However, the time course of the changes in these variables after an SS intervention remains unclear. Nevertheless, this information is essential for athletes and coaches to establish optimal warm-up routines. The aim of this study was to investigate the time course of changes in knee flexion range of motion (ROM), maximal voluntary isometric contraction (MVIC), rate of force development (RFD), and force steadiness (at 5 and 20% of MVIC) after three 60-s SS interventions. Study participants were sedentary healthy adult volunteers (n = 20) who performed three 60-s SS interventions of the knee extensors, where these variables were measured before and after SS intervention at three different periods, i.e., immediately after, 10 min, and 20 min the SS intervention (crossover design). The results showed an increase in ROM at all time points (d = 0.86-1.01). MVIC was decreased immediately after the SS intervention (d = -0.30), but MVIC showed a recovery trend for both 10 min (d = -0.17) and 20 min (d = -0.20) after the SS intervention. However, there were significant impairments in RFD at 100 m (p = 0.014, F = 6.37, η_p ² = 0.101) and 200 m (p < 0.01, F = 28.0, η_p ² = 0.33) up to 20 min after the SS intervention. Similarly, there were significant impairments in force steadiness of 5% (p < 0.01, F = 16.2, η_p ² = 0.221) and 20% MVIC (p < 0.01, F = 16.0, η_p ² = 0.219) at 20 min after the SS intervention. Therefore, it is concluded that three 60-s SS interventions could increase knee flexion ROM but impair explosive muscle strength and muscle control function until 20 min after the SS intervention.

The Effects of Body Tempering on Force Production, Flexibility and Muscle Soreness in Collegiate Football Athletes

There has been limited research to explore the use of body tempering and when the use of this modality would be most appropriate. This study aimed to determine if a body tempering intervention would be appropriate pre-exercise by examining its effects on perceived soreness, range of motion (ROM), and force production compared to an intervention of traditional stretching. The subjects for this study were ten Division 1 (D1) football linemen from Sacred Heart University (Age: 19.9 ± 1.5 years, body mass: 130.9 ± 12.0 kg, height: 188.4 ± 5.1 cm, training age: 8.0 ± 3.5 years). Subjects participated in three sessions with the first session being baseline testing. The second and third sessions involved the participants being randomized to receive either the body tempering or stretching intervention for the second session and then receiving the other intervention the final week. Soreness using a visual analog scale (VAS), ROM, counter movement jump (CMJ) peak force and jump height, static jump (SJ) peak force and jump height, and isometric mid-thigh pull max force production were assessed. The results of the study concluded that body tempering does not have a negative effect on muscle performance but did practically reduce perceived muscle soreness. Since body tempering is effective at reducing soreness in athletes, it can be recommended for athletes as part of their pre-exercise warmup without negatively effecting isometric or dynamic force production.

The effect of static stretching on key hits and subjective fatigue in eSports

[Purpose] To explore the effects of static stretching for 20 s on key hits and subjective fatigue in an eSports-like setting. [Participants and Methods] The participants comprised of 15 healthy males who were instructed to hit a particular key on a computer keyboard using the left ring finger to achieve the maximum number of hits possible over a period of 30 s. Subjective fatigue of the forearm was assessed using a visual analog scale (VAS) before the experiment and after each trial. Trials 1, 2, and 3 were conducted in succession, with an inter-trial interval of 60 s to ensure a loaded state. Static stretching for 20 s preceded Trial 4. [Results] Over the first three trials, the number of key hits in the first 10 s gradually decreased, while the feeling of subjective fatigue gradually increased. After stretching, the number of key hits in the first 10 s of Trial 4 was similar to that observed in Trial 1, and there was no increase in subjective fatigue. [Conclusion] Static stretching for 20 s restored the number of key hits for 10 s after stretching to that before the load application and suppressed the increase in subjective fatigue.

Relationship between changes in passive properties and muscle strength after static stretching

BACKGROUND

The association between decreased muscle strength of rate of force development (RFD) immediately after static stretching (SS) and change in muscle stiffness or muscle slack has remained unclear.

OBJECTIVE

This study aimed to investigate the association between changes in muscle strength and RFD and muscle stiffness or muscle slack immediately after SS.

METHODS

Sixteen healthy male non-athlete volunteers participated in this study. The maximal voluntary contraction torque and shear elastic modulus of medial gastrocnemius muscle were measured before and after 300 s of SS intervention.

RESULTS

The results showed that maximal voluntary contraction torque and RFD at 100, 150, and 200 ms decreased significantly after the 300-s SS (p < 0.01). Additionally, shear elastic modulus at 0° (decrease in muscle stiffness) and slack angle decreased (increase in slack length) significantly after the 300-second SS (p < 0.01). However, no significant association was observed between changes in muscle strength and changes in mechanical properties of the MG.

CONCLUSION

These results suggested that the decrease in muscle strength and RFD could not be associated with changes in the passive mechanical properties of the medial gastrocnemius muscle.

Effect of vibration foam rolling on the range of motion in healthy adults: a systematic review and meta-analysis

Professionals use foam rollers to improve range of motion (ROM). Recently, a vibrating foam roller (VFR) that combines the vibration function with a foam roller (FR) has been used. The purpose of this systematic review and meta-analysis was to determine the effects of a VFR on the improvement of ROM in healthy individuals. A systematic literature search was carried out in five international databases: PubMed, Embase, PEDro, Cochrane Library, and Google Scholar. Eight clinical studies, composed of six randomized controlled trials and two randomized crossover trials that involved 230 healthy participants were selected for analysis. Methodological quality was identified using the PEDro scale. The mean scores, 4.75±0.71, of the eight included studies, were classified as fair. The results demonstrated that the VFR achieved better gains than the FR in improving ROM (standardized mean difference [SMD], 0.53; 95% confidence intervals [CIs], 0.29–0.77; I²=55%). The VFR was more effective in improving the ROM than the FR in the hip and knee joints (hip: SMD, 0.56; 95% CI, 0.28–0.85; I²=0%; knee: SMD, 0.86; 95% CI, 0.42–1.30; I²=79%). The VFR may be an additional option to improve the ROM in healthy adults and athletes.

Changes in neural drive to calf muscles during steady submaximal contractions after repeated static stretches

KEY POINTS

Repeated static-stretching interventions consistently increase the range of motion about a joint and decrease total joint stiffness, but findings on the changes in muscle and connective-tissue properties are mixed. The influence of these stretch-induced changes on muscle function at submaximal forces is unknown. To address this gap in knowledge, the changes in neural drive to the plantar flexor muscles after a static-stretch intervention were estimated. Neural drive to the plantar flexor muscles during a low-force contraction increased after repeated static stretches. These findings suggest that adjustments in motor unit activity are necessary at low forces to accommodate reductions in the force-generating and transmission capabilities of the muscle-tendon unit after repeated static stretches of the calf muscles.

ABSTRACT

Static stretching decreases stiffness about a joint, but its influence on muscle-tendon unit function and muscle activation is unclear. We investigated the influence of three static stretches on changes in neural drive to the plantar flexor muscles, both after a stretch intervention and after a set of maximal voluntary contractions (MVCs). Estimates of neural drive were obtained during submaximal isometric contractions by decomposing high-density electromyographic signals into the activity of individual motor units from medial gastrocnemius, lateral gastrocnemius and soleus. Motor units were matched across contractions and an estimate of neural drive to the plantar flexors was calculated by normalizing the cumulative spike train to the number of active motor units (normalized neural drive). Mean discharge rate increased after the stretch intervention during the 10% MVC task for all recorded motor units and those matched across conditions (all, P = 0.0046; matched only, P = 0.002), recruitment threshold decreased for motor units matched across contractions (P = 0.022), and discharge rate at recruitment was elevated (P = 0.004). Similarly, the estimate of normalized neural drive was significantly greater after the stretch intervention at 10% MVC torque (P = 0.029), but not at 35% MVC torque. The adjustments in motor unit activity required to complete the 10% MVC task after stretch may have been partially attenuated by a set of plantar flexor MVCs. The increase in neural drive required to produce low plantar-flexion torques after repeated static stretches of the calf muscles suggests stretch-induced changes in muscle and connective tissue properties.

Chronic Effects of a Static Stretching Program on Hamstring Strength

ABSTRACT

Nakao, S, Ikezoe, T, Nakamura, M, Umegaki, H, Fujita, K, Umehara, J, Kobayashi, T, Ibuki, S, and Ichihashi, N. Chronic effects of a static stretching program on hamstring strength. J Strength Cond Res 35(7): 1924-1929, 2021-This study investigated the effects of a 4-week static stretching (SS) program on isokinetic and isometric knee flexor peak torque and angle of peak torque. Thirty healthy men (age, 22.7 ± 2.2 years) were randomized to receive either of the following: (a) a 4-week stretch intervention for the hamstrings (SS intervention group; n = 15) or (b) no intervention (control group; n = 15). The maximum pain-free knee angle, passive stiffness, which was determined by a slope of torque-angle curve, isometric and isokinetic (at 60°·s-1 and 180°·s-1) peak torque, and angle of peak torque for knee flexors were measured before and after 4 weeks. After 4 weeks, passive stiffness decreased significantly in the intervention group. There were no significant changes in isometric and isokinetic (neither at 60°·s-1 nor at 180°·s-1) peak torque, or angle of peak torque at 180°·s-1. A significantly increased peak extension angle at 60°·s-1 was observed in the intervention group. These results suggest that SS intervention is effective for decreasing musculotendinous unit stiffness of the hamstrings and that an SS program influences the angle of peak torque, whereas no significant changes occur in peak torque. Because a previous study suggests that angle of peak torque is associated with hamstring strain injuries, the results of this study would be helpful when considering the training program for preventing or treating hamstring strain injuries.

Effectiveness of Whole-Body Vibration Training to Improve Muscle Strength and Physical Performance in Older Adults: Prospective, Single-Blinded, Randomized Controlled Trial

Whole-body vibration training (WBVT) is emerging as an alternative exercise method that be easily performed by older adults. This clinical trial investigates the efficacy of WBVT in improving muscle strength and physical performance before resistance exercise, in comparison to conventional resistance exercise after stretching exercise in older adults. The WBVT group (n = 20) performed WBVT using a vibrating platform (SW-VC15™), followed by strengthening exercises. The control group (n = 20) performed stretching instead of WBVT. Both groups underwent a total of 12 sessions (50 min per session). The primary outcome was isokinetic dynamometer. The secondary outcomes were grip strength, short physical performance battery (SPPB), a 36-Item Short Form Survey (SF-36), and body composition analysis. In all results, only the time effect was significant, and the group effect or time x group effect was not. Both groups showed a significant increase in isokinetic dynamometer. Although there was no significant group effect, the increase in mean peak torque was greater in the WBVT group. The only WBVT group showed significant improvement in SPPB. In SF-36, only the control group showed significant improvements. WBVT can be safely performed by older adults and may be an alternative exercise method to boost the effect of strengthening exercise.

Effects of a high-volume static stretching programme on plantar-flexor muscle strength and architecture

PURPOSE

Static stretching (SS) is performed in various settings, but there is no consensus about the effects of SS programmes on changes in muscle morphofunction. This study aimed to investigate the effects of a high-volume SS programme on muscle strength and architecture.

METHODS

Sixteen healthy young male adults participated, and the dominant leg was defined as the intervention side, with the non-dominant leg as the control side. Stretching exercises were performed two times per week (6 sets of 5 min, totally 30 min per session,) for 5-week using a stretching board under the supervision of the research team. Before and after SS intervention programme, plantar-flexor strength (maximum voluntary isometric contraction, MVC-ISO; maximum voluntary concentric contraction, MVC-CON) and architecture (muscle thickness, pennation angle, and fascicle length) were measured via dynamometer and ultrasound, respectively.

RESULTS

Following the SS-training programme, significant increases were observed for stretching side in MVIC-ISO at neutral ankle position (p = 0.02, d = 0.31, Δ = 6.4 ± 9.9%) and MVC-CON at 120°/s (p = 0.02, d = 0.30, Δ = 7.8 ± 9.1%), with no significant change on the control side. There was no significant change in any measure of muscle architecture for both intervention and control sides.

CONCLUSION

Five-week high-volume SS induced positive changes on some measures of muscle strength but not hypertrophy of plantar-flexor muscles. Even with a volume much greater than already tested, the low strain offered by the SS per set seems be insufficient to induce architectural changes on skeletal muscle.

Plantar flexor muscle stretching depresses the soleus late response but not tendon tap reflexes

The purpose of this study was to investigate changes in muscle spindle sensitivity with early and late soleus reflex responses via tendon taps and transcranial magnetic stimulation, respectively, after an acute bout of prolonged static plantar flexor muscle stretching. Seventeen healthy males were tested before and after 5 min (5 × 60-s stretches) of passive static stretching of the plantar flexor muscles. Maximal voluntary isometric torque and M wave-normalized triceps surae muscle surface electromyographic activity were recorded. Both soleus tendon reflexes, evoked by percussion of the Achilles tendon during rest and transcranial magnetic stimulation-evoked soleus late responses during submaximal isometric dorsiflexion were also quantified. Significant decreases in maximal voluntary isometric plantar flexion torque (-19.2 ± 13.6%, p = .002) and soleus electromyographic activity (-20.1 ± 11.4%, p < .001) were observed immediately after stretching, and these changes were highly correlated (r = 0.76, p < .001). No changes were observed in tendon reflex amplitude or latency or peak muscle twitch torque (p > .05). Significant reductions in soleus late response amplitudes (-46.9 ± 36.0%, p = .002) were detected, although these changes were not correlated with changes in maximal electromyographic activity, torque or tendon reflex amplitudes. No changes in soleus late response latency were detected. In conclusion, impaired neural drive was implicated in the stretch-induced force loss; however, no evidence was found that this loss was related to changes in muscle spindle sensitivity. We hypothesize that the decrease in soleus late response indicates a stretch-induced reduction in a polysynaptic postural reflex rather than spindle reflex sensitivity.

The effects of 12 weeks of static stretch training on the functional, mechanical, and architectural characteristics of the triceps surae muscle-tendon complex

PURPOSE

We investigated the effects of 12 weeks of passive static stretching training (PST) on force-generating capacity, passive stiffness, muscle architecture of plantarflexor muscles.

METHODS

Thirty healthy adults participated in the study. Fifteen participants (STR, 6 women, 9 men) underwent 12-week plantarflexor muscles PST [(5 × 45 s-on/15 s-off) × 2exercises] × 5times/week (duration: 2250 s/week), while 15 participants (CTRL, 6 women, 9 men) served as control (no PST). Range of motion (ROM), maximum passive resistive torque (PRT_max), triceps surae architecture [fascicle length, fascicle angle, and thickness], passive stiffness [muscle-tendon complex (MTC) and muscle stiffness], and plantarflexors maximun force-generating capacity variables (maximum voluntary contraction, maximum muscle activation, rate of torque development, electromechanical delay) were calculated Pre, at the 6th (Wk6), and the 12th week (Wk12) of the protocol in both groups.

RESULTS

Compared to Pre, STR ROM increased (P < 0.05) at Wk6 (8%) and Wk12 (23%). PRT_max increased at Wk12 (30%, P < 0.05), while MTC stiffness decreased (16%, P < 0.05). Muscle stiffness decreased (P < 0.05) at Wk6 (11%) and Wk12 (16%). No changes in triceps surae architecture and plantarflexors maximum force-generating capacity variables were found in STR (P > 0.05). Percentage changes in ROM correlated with percentage changes in PRT_max (ρ = 0.62, P = 0.01) and MTC stiffness (ρ = - 0.78, P = 0.001). In CTRL, no changes (P > 0.05) occurred in any variables at any time point.

CONCLUSION

The expected long-term PST-induced changes in ROM were associated with modifications in the whole passive mechanical properties of the ankle joint, while maximum force-generating capacity characteristics were preserved. 12 weeks of PST do not seem a sufficient stimulus to induce triceps surae architectural changes.

Acute and Prolonged Effects of Stretching on Shear Modulus of the Pectoralis Minor Muscle

Increased muscle stiffness of the pectoralis minor (PMi) could deteriorate shoulder function. Stretching is useful for maintaining and improving muscle stiffness in rehabilitation and sport practice. However, the acute and prolonged effect of stretching on the PMi muscle stiffness is unclear due to limited methodology for assessing individual muscle stiffness. Using shear wave elastography, we explored the responses of shear modulus to stretching in the PMi over time. The first experiment (n = 20) aimed to clarify the acute change in the shear modulus during stretching. The shear modulus was measured at intervals of 30 s × 10 sets. The second experiment (n = 16) aimed to observe and compare the prolonged effect of different durations of stretching on the shear modulus. Short and long stretching duration groups underwent 30s × 1 set and 30s × 10 sets, respectively. The assessments of shear modulus were conducted before, immediately after, and at 5, 10, and 15 min post-stretching. In experiment I, the shear modulus decreased immediately after a bout (30 s) of stretching (p < 0.001, change: -2.3 kPa, effect size: r = 0.72) and further decreased after 3 repetitions (i.e., 90 s) of stretching (p = 0.03, change: -1.0 kPa, effect size: r = 0.53). In experiment II, the change in the shear modulus after stretching was greater in the long duration group than in the short duration group (p = 0.013, group mean difference: -2.5 kPa, partial η ² = 0.36). The shear modulus of PMi decreased immediately after stretching, and stretching for a long duration was promising to maintain the decreased shear modulus. The acute and prolonged effects on the PMi shear modulus provide information relevant to minimum and persistent stretching time in rehabilitation and sport practice.

Comparison of the Acute Effects of Kinesio Taping and Sleeper Stretching on the Shoulder Rotation Range of Motion, Manual Muscle Strength, and Sub-Acromial Space in Pitchers with Glenohumeral Internal Rotation Deficit

BACKGROUND AND OBJECTIVES

Sleeper stretching (SS) can improve the shoulder's range of motion (ROM) for pitchers with glenohumeral internal rotation deficit (GIRD). However, no evidence has proven the effect of Kinesio taping (KT) on shoulder strength and ROM. Therefore, this study compared the effects of SS and KT on shoulder rotation ROM, muscle strength, and sub-acromial distance in pitchers with GIRD.

MATERIALS AND METHODS

Thirty-one pitchers with GIRD were allocated into control, KT, and SS groups. Shoulder rotation ROM, muscle strength, and sub-acromial space were measured before and after treatment with SS or KT.

RESULTS

The results revealed that KT and SS significantly enhanced shoulder rotation ROM in pitchers with GIRD. External rotator strength significantly increased following KT but significantly decreased after SS. KT and SS exerted no effects on the sub-acromial space.

CONCLUSIONS

KT and SS improve shoulder rotation ROM in pitchers with GIRD. In addition, KT improves shoulder external rotator strength, and SS reduces it.

The effects of using a combination of static stretching and aerobic exercise on muscle tendon unit stiffness and strength in ankle plantar-flexor muscles

The purpose of the present study was to investigate the effects of using a combination of static stretching and aerobic exercise on muscle tendon unit stiffness and muscle strength in the ankle plantar-flexor muscles. Fifteen healthy males (23.3 ± 2.7 years, 170.3 ± 6.5 cm, 64.9 ± 8.7 kg) received three different interventions, in random order. Intervention 1 received 10 min of aerobic exercise after five cycles of one minute of static stretching. Intervention 2 received 10 min of aerobic exercise before the static stretching. Intervention 3 received 5 min of aerobic exercise both before and after the static stretching. The range of motion of ankle dorsiflexion, stretch tolerance, muscle tendon unit stiffness, peak torque of ankle plantarflexion, and the amplitude of electromyography were measured. In all interventions, the range of motion and stretch tolerance significantly increased (p < 0.05), but muscle tendon unit stiffness decreased significantly for all interventions (p < 0.05). Peak torque of ankle plantar flexion and amplitude of electromyography significantly increased for Interventions 1 and 3 (p < 0.05), while these significantly decreased for Intervention 2 (p < 0.05). These data indicated that range of motion and stretch tolerance were increased, but muscle tendon unit stiffness was decreased regardless of the order of static stretching and aerobic exercise. Aerobic exercise after static stretching increased the peak torque and amplitude of electromyography.

Effect of Stretching Protocols on Glenohumeral-Joint Muscle Activation in Elite Table Tennis Players

CONTEXT

Several studies report static-stretch-induced deficits and dynamic-stretch performance improvement after intervention.

PURPOSE

To investigate the muscle activation of the forehand and backhand in table tennis players after experiencing static- and dynamic-stretching protocols.

METHODS

A total of 24 elite male table tennis players (age 22.7 [3.46] y, height 1.78 [0.03] m) were tested before and 0, 10, 20, and 30 min after the 3 conditions (dynamic stretch, static stretch, and no stretch). The MEGA ME6000 (Mega Electronics, Kuopio, Finland) was used to capture the surface EMG data of the anterior deltoid, middle deltoid, posterior deltoid, biceps, and triceps muscles. Muscle activation data of the pretest were compared with posttest 0, 10, 20, and 30 min. These data were also compared between 3 different conditions (dynamic stretch, static stretch, and no stretch).

RESULTS

A 2-way repeated-measures analysis of variance indicated significant differences in the forehand and backhand, and Bonferroni test as a post hoc comparison revealed significant differences between the pretest and posttests in several muscles (P < .05). Furthermore, there were significant differences in the posttest between the 3 conditions (P < .05).

CONCLUSIONS

In general, there was a short-term effect of static- and dynamic-stretching protocols on glenohumeral-joint muscle activation in elite table tennis players. The static and dynamic stretching presented a decrease and increase, respectively, in muscle activation up to 30 min after stretching. In conclusion, the additive and subtractive effects of dynamic- and static-stretching protocols on muscle activation seem to persist after 30 min.

Influence of Aerobic Exercise After Static Stretching on Flexibility and Strength in Plantar Flexor Muscles

Aerobic exercise could improve stretch-induced strength deficits. However, mechanisms of the improvement were unclear. The purpose of the study was to examine the effects of aerobic exercise after static stretching (SS) on flexibility and isometric strength in ankle plantar-flexor muscles. Fifteen healthy males received two interventions after SS of their ankle plantar-flexor muscles for 5 min. One was aerobic exercise for 10-min on a cycling ergometer, and the other was a 10-min rest as a control. Range of motion (ROM) of ankle dorsiflexion, passive torque at terminal ROM, muscle-tendon unit (MTU) stiffness, muscle tendon junction displacement, peak torque of ankle plantarflexion, and the amplitude of electromyography (EMG) were measured. Immediately after the SS, in both interventions, ROM, passive torque, and muscle tendon junction displacement increased significantly (p < 0.05), while MTU stiffness, peak torque, and the amplitude of EMG were significantly decreased (p < 0.05). After 10-min on a cycling ergometer, the decreased peak torque and amplitude of EMG indicated higher values than those before SS (p < 0.05), while MTU stiffness was no change. In conclusion, SS increased ROM because of the decreased MTU stiffness as well as increased tolerance for stretching. Aerobic exercise could increase the muscle strength and amplitude of EMG which decreased after static stretching.

INFLUENCE OF AN ACUTE BOUT OF SELF-MYOFASCIAL RELEASE ON KNEE EXTENSION FORCE OUTPUT AND ELECTRO-MECHANICAL ACTIVATION OF THE QUADRICEPS

Background

In contrast to static stretching (SS), previous research has demonstrated increases in flexibility after an acute bout of self-myofascial release (SMR) without any subsequent decreases in force output. Previous research has utilized measures of surface electromyography (sEMG) and mechanomyography (MMG) to examine the influence of SS on the electrical and mechanical processes of muscle activation, respectively. However, there is a lack of research examining the potential changes in electro-mechanical muscle activation post-SMR.

Purpose

To examine the influence of SMR, via an acute bout of foam rolling (FR) to the vastus lateralis (VL), on the expression of knee extension force output and the inter-muscular electro-mechanical activation of the quadriceps musculature.

Study Design

Randomized crossover trial.

Methods

Twenty (10 males, 10 females) recreationally-active participants with prior FR experience completed both SMR and control (CON) testing protocols during separate testing sessions that were conducted in a randomized order 48 hours apart. During the SMR protocol, participants performed 3 sets of 60 seconds of FR over the VL portion of their quadriceps musculature, with 60 seconds of rest between sets. During the CON protocol, participants quietly sat upright for 10 minutes. Peak knee extension force output -(Force_peak) data, as well as sEMG and MMG data from the VL and the rectus femoris (RF) were collected during maximal voluntary isometric contractions (MVICs) before and after both testing protocols. Root mean square sEMG and MMG amplitudes were calculated to represent electro-mechanical muscle activation of the VL (VL-sEMG_RMS, VL-MMG_RMS) and RF (RF-sEMG_RMS, RF-MMG_RMS) musculature.

Results

Repeated measures analyses of variance (RM ANOVAs) identified a significant (p < 0.05) increase in Force_peak within the SMR protocol among males, but no change among females. No statistically significant changes in any electro-mechanical muscle activation measures were identified pre-to-post-SMR within either sex.

Conclusion

In contrast to the SS literature body, these results suggest that SMR does not influence the electro-mechanical aspects of muscle activation during MVICs. These results provide support for the absence of decreases in force output post-SMR, but further examination regarding the potential muscle mass influence of SMR on electro-mechanical muscle function remains warranted.

Level of Evidence

2c.

Effects of 5-Week Foam Rolling Intervention on Range of Motion and Muscle Stiffness

Kiyono, R, Onuma, R, Yasaka, K, Sato, S, Yahata, K, and Nakamura, M. Effects of 5-week foam rolling intervention on range of motion and muscle stiffness. J Strength Cond Res XX(X): 000-000, 2020-In clinical and sports settings, foam rolling (FR) intervention is widely used to increase the range of motion (ROM). But, the chronic effects of FR on ROM and muscle stiffness are unclear. This study aimed to investigate the effects of 5-weeks FR intervention on dorsiflexion ROM (DFROM) and shear elastic modulus of the medial gastrocnemius (MG) muscle. Accordingly, 30 healthy young adults were enrolled and randomly assigned to either the FR or control group with the former receiving 90 seconds of FR thrice per week over 5-weeks. Thereafter, DFROM, passive torque at DFROM, and shear elastic modulus of the MG during passive ankle dorsiflexion were assessed using a dynamometer and ultrasonography before and after 5-weeks. Our results showed that the FR group exhibited a significant increase in DFROM (Δ = 11.7%, p < 0.05, effect size = 0.39), but no changes in passive torque at DFROM, and shear elastic modulus at 0° and 10° dorsiflexion. Moreover, significant correlations were observed between change in DFROM and change in passive torque at DFROM in the FR group (rs = 0.607; p = 0.016). These results suggested that FR was an effective method to increase DFROM given its ability to change passive torque at DFROM (stretch tolerance) without altering muscle stiffness.

Effects of Combining Running and Practical Duration Stretching on Proprioceptive Skills of National Sprinters

Romero-Franco, N, Párraga-Montilla, JA, Molina-Flores, EM, and Jiménez-Reyes, P. Effects of combining running and practical duration stretching on proprioceptive skills of national sprinters. J Strength Cond Res 34(4): 1158-1165, 2020-Practical duration stretching after aerobic activities is a recommended component of the first part of warm-up because of its effects on performance. However, its effects on proprioceptive skills are unknown. This study aimed to analyze the effects of running and practical duration static stretching (SS) and dynamic stretching (DS) on postural balance and the joint position sense (JPS) of national sprinters. Thirty-two national sprinters were randomly classified into a SS group (n = 11), DS group (n = 11), or control group (n = 10). Static stretching performed 5 minutes of running and short-duration (20 seconds) static stretches; DS performed 5 minutes of running and short-duration dynamic (20 seconds) stretches; and the control group performed 5 minutes of running. Before and after the intervention, unipedal static postural balance and knee JPS were evaluated. Static stretching exhibited a more centralized center of pressure in the medial-lateral plane for unipedal static postural balance in right-leg support after stretching (p = 0.005, d = 1.24), whereas DS showed values further from the center after stretching for the same unipedal support compared with baseline (p = 0.042, d = 0.49), and the control group remained stable (p > 0.05). Joint position sense did not show significant differences in any group (p > 0.05). In conclusion, combining running and practical duration SS may be beneficial for right-leg postural stabilization, whereas DS may be partly and slightly deleterious. Both SS and DS combined with running and running alone have neutral effects on knee JPS. Sports professionals should consider running and practical duration SS as part of the warm-up of sprinters to partly improve unipedal static postural balance.

Muscle excitation, force response, and efficiency during explosive force production after diacutaneous fibrolysis on lateral gastrocnemius of recreational athletes

OBJECTIVE

Fibrous adhesions impair normal muscle mechanics. The present study aimed to assess lateral gastrocnemius muscle excitation, isometric force response, and neuromuscular efficiency during explosive force in plantarflexion before and after diacutaneous fibrolysis.

METHODS

Thirty-five recreational athletes were allocated in the intervention group (n = 20) treated with diacutaneous fibrolysis, while the sham group (n = 15) was treated with placebo diacutaneous fibrolysis. Force response synchronized with surface electromyography during a plantarflexion task was collected.

RESULTS

Differences between Pre- and Post-diacutaneous fibrolysis were observed for all variables, except for the placebo group.

CONCLUSIONS

Diacutaneous fibrolysis was effective to increase force, muscle excitation, and neuromuscular efficiency on lateral gastrocnemius.

PhysIOpathology of NEuromuscular function rElated to fatigue in chronic Renal disease in the elderly (PIONEER): study protocol

BACKGROUND

Chronic Kidney Disease (CKD) is associated with reduced muscular strength resulting in profound fatigue. The physiopathology of these changes, their prevalence and evolution are still debated. Moreover, we have little data on elderly CKD patients. The present study protocol aims to 1) quantify the prevalence of low muscle strength (dynapenia) in a cohort of elderly patients with advanced CKD and to 2) characterize their force production coupled with electromyographic features and the symptoms of fatigue compared to a matched control group.

METHODS

This is a case-control, prospective, interventional study.

INCLUSION CRITERIA

age ≥ 60 years; CKD Stage 3b-5; clinical stability (i.e. no hospitalization and ≤ 25% in creatinine increase in the previous 3 months). Controls with normal kidney function will be matched in terms of age, gender and diabetes mellitus (requisite: estimated glomerular filtration rate ≥ 60 ml/min/1.73m² available in the last 6 months). Exclusion criteria for cases and controls: neuromuscular disease, life expectancy < 3 months. The handgrip strength protocol is an intermittent test consisting in 6 series of 9 repetitions of 3-s sub-maximum contractions at 40% of the maximum voluntary contraction (MVC) and 2 s of resting time between contractions. Each series is separated by one fast sub-maximum contraction and one MVC. Strength is assessed with a high-frequency handgrip dynamometer paired with surface electromyography. Symptoms of fatigue are assessed using MFI-20 and FACIT-F questionnaires. In order to reach a statistical power of 96%, we plan to enroll 110 subjects in each group.

DISCUSSION

The novelty of this study resides in the application of an already validated set of tests in a population in which this combination (dynamometer, electromyography and questionnaires) has not previously been explored. We expect a high prevalence of dynapenia and a higher fatigability in CKD patients. A positive correlation is expected between reported fatigue and fatigability. Better appreciation of the prevalence and the relationship between fatigability and a sensation of fatigue can help us target interventions in CKD patients to improve quality of life and survival.

TRIAL REGISTRATION

The study was approved by Ethical Committee EST III n°20.03.01 and was recorded as a Clinical Trial (NCT04330807) on April 2, 2020.

High-impact Routines to Ameliorate Trunk and Lower Limbs Flexibility in Women

Several types of routines and methods have been experimented to gain neuro/muscular advantages, in terms of overall range of motion, in athletes and fitness enthusiasts. The aim of the present study was to evaluate the impact of different routines on trunk- and lower limbs flexibility in a sample of young women. In a randomized-crossover fashion, eleven subjects underwent to: hamstrings stretching [S]; hamstrings stretching plus whole-body vibration [S+WBV]; partial-body cryotherapy [Cryo]; rest [Control]. Standing hamstrings stretch performance and sit-and-reach amplitude resulted to be improved with [S+WBV] compared to all other protocols (p<0.05). [Cryo] ameliorated the active knee extension performance with respect to all other interventions (p<0.05). These flexibility improvements were obtained without a loss in the trunk position sense proprioception. These results represent the first evidence that a single session of either vibration or cryotherapy can ameliorate flexibility without losing the trunk position sense proprioception in young women.

The effects of static stretching programs on muscle strength and muscle architecture of the medial gastrocnemius

Introduction

Static stretching (SS) program are widely used in clinical and athletic settings. Many previous studies investigate the effect of SS program on muscle strength and muscle architecture (muscle thickness, and pennation angleh). However, no consensus has been reached about the effect of SS programs on muscle strength and muscle architecture. The aim of this study was to investigate the effects of 6-week SS programs performed at different weekly frequencies on muscle strength, muscle thickness and pennation angle at different ankle joint positions.

Methods

A total of 24 healthy male volunteers were performed 6-week SS programs (2,160 s of SS: 360 s/week*6 weeks) and were randomized to a group that performed SS once a week, or a group that performed SS three times per week. Total time under stretching was equated between groups. The muscle strength (maximum voluntary isometric contraction) at three different ankle joints were assessed before and after the 6-week SS program. In addition, muscle thickness and pennation angle were assessed by ultrasonography before and after 6-week SS program.

Results

There were no significant changes in all variables before and after the 6-week SS program, regardless of weekly frequency (p > 0.05).

Conclusions

Our results suggest that 6-week SS programs do not increase muscle strength or muscle architecture at different ankle joint positions, regardless of stretching frequency; however, no negative effect on these outcomes was observed, contrary to evidence on the immediate, detrimental effects of SS.