Neuromuscular factors influencing the maximum stretch limit of the human plantar flexors

ALONGAMENTO INTERMITENTE E CONTÍNUO AUMENTAM A AMPLITUDE DE MOVIMENTO E REDUZEM A FORÇA DOS FLEXORES DE PUNHO

Introdução: A manipulação do intervalo entre séries pode influenciar o desempenho de atividades subsequentes. Objetivo: Comparar o efeito do intervalo de alongamento estático de forma continua e intermitente no desempenho de flexores de punho. Métodos A amostra foi composta por 14 adultos jovens, hígidos, do gênero masculino (idade 31±9 anos; estatura 178±0,7 cm; massa 85±12 Kg). Foi avaliada a amplitude de movimento passivo (ADMP) em extensão de punho, a força isométrica máxima de flexão de punho associado a eletromiografia superficial antes e depois de dois protocolos de alongamento com diferentes intervalos entre séries. Para cada sujeito, um dos membros superiores foi alongado com o protocolo contínuo (CON) e o outro com o intermitente (INT), de forma aleatória. O protocolo CON consistiu na realização do alongamento durante 6 minutos ininterruptos, e o INT consistiu na realização de seis séries de 1 minuto por 20 segundos de intervalo entre as séries. A intensidade foi mantida a 70-90% da percepção subjetiva de desconforto. Resultados Os resultados de ADMP mostraram aumento significante entre as condições pré e pós-intervenção, em ambos os protocolos INT (81°±10 e 94°±10, P<0,001) e CON (87°±12 e 96°±11, P=0,004). Os resultados para o pico de força mostraram redução significante nas condições pós-intervenção para ambos os protocolos: INT (205±54 Kgf e 148±56 Kgf, P<0,001) e CON (211±39 Kgf e 144±36 Kgf, P<0,001). Os resultados para a taxa de produção de força mostraram aumento significante nas condições pré e pós-intervenção, para ambos os protocolos INT (0,52±0,29 Kgf/ms e 1,24±0,45 Kgf/ms, P<0,001) e CON (0,43±0,29 Kgf/ms e 1,11±0,34 Kgf/ms, P<0,001). Conclusão Ambos os protocolos aumentaram a amplitude passiva de movimento, reduziram a força pico e taxa de produção de força, sem modificações na ativação dos flexores de punho.

Acute bouts of upper and lower body static and dynamic stretching increase non-local joint range of motion

PURPOSE

There are conflicts in the literature concerning the crossover or non-local effects of stretching. The objective of this study was to evaluate whether static (SS) and dynamic (DS) stretching of the shoulders would affect hip flexor range of motion (ROM) and performance and reciprocally whether SS and DS of the lower body would affect shoulder extension ROM and performance.

METHODS

A randomized crossover study design examined the acute effects of upper and lower body SS and DS on lower and upper body performance measures, respectively. Experimental sessions included upper and lower body control tests, upper body (shoulder horizontal abduction) SS and lower body (hip abduction) SS, upper body (shoulder horizontal abduction and adduction) DS and lower body DS (hip abduction and adduction). Passive static and dynamic ROM (hip flexion, shoulder extension), leg flexor and elbow flexor maximal voluntary contraction isometric force, fatigue endurance and electromyography were measured.

RESULTS

There were significant shoulder ROM increases following lower body SS (P < 0.010, ∆% = 8.2%) and DS (P < 0.019, ∆% = 9%). There was a significant hip flexor ROM (P < 0.016, ∆% = 5.2%) increase following upper body SS. There were no significant main effects or interactions for dynamic ROM or muscle force and activation variables.

CONCLUSION

The lack of stretch-induced force and fatigue changes suggests that rather than a mechanical or neural drive mechanism, an enhanced stretch tolerance was likely the significant factor in the improved ROM.

The relevance of stretch intensity and position-a systematic review

Stretching exercises to increase the range of motion (ROM) of joints have been used by sports coaches and medical professionals for improving performance and rehabilitation. The ability of connective and muscular tissues to change their architecture in response to stretching is important for their proper function, repair, and performance. Given the dearth of relevant data in the literature, this review examined two key elements of stretching: stretch intensity and stretch position; and their significance to ROM, delayed onset muscle soreness (DOMS), and inflammation in different populations. A search of three databases, Pub-Med, Google Scholar, and Cochrane Reviews, identified 152 articles, which were subsequently categorized into four groups: athletes (24), clinical (29), elderly (12), and general population (87). The use of different populations facilitated a wider examination of the stretching components and their effects. All 152 articles incorporated information regarding duration, frequency and stretch position, whereas only 79 referred to the intensity of stretching and 22 of these 79 studies were deemed high quality. It appears that the intensity of stretching is relatively under-researched, and the importance of body position and its influence on stretch intensity, is largely unknown. In conclusion, this review has highlighted areas for future research, including stretch intensity and position and their effect on musculo-tendinous tissue, in relation to the sensation of pain, delayed onset muscle soreness, inflammation, as well as muscle health and performance.

Unilateral static and dynamic hamstrings stretching increases contralateral hip flexion range of motion

Static (SS) and dynamic stretching (DS) can lead to subsequent performance impairments or enhancement with the stretched limb. Crossover or non-local muscle fatigue (NLMF) refers to unilateral fatigue-induced impairments in a contralateral or non-exercised muscle. Whereas there are conflicting findings in the NLMF literature, there are few studies examining the effect of an acute bout of SS or DS on contralateral flexibility, torque or power. Fourteen highly trained subjects (means ± standard deviations: 18 ± 2 years; 179·4 ± 4·6 cm; 70·5 ± 6·3 kg; %body fat: 10·7 ± 2·5%) were tested before and following separate sessions of eight repetitions of 30 s of unilateral hip flexion SS or DS. Pre- and postintervention testing at 1 and 10 min included hip flexor range of motion (ROM), isokinetic leg flexion torque and power at 60°.s^-1 and 300°.s^-1 of the stretched and contralateral limbs. The stretched limb had a 6·3% (P = 0·01; ES: 0·91) ROM increase with DS at 10 min. The contralateral non-stretched hip flexors experienced ROM increases with SS of 5·7% (P = 0·02; ES: 0·68) from pretest to 1 min post-test, whereas DS showed 7·1% (P<0·0001; ES: 1·09) and 8·4% (P = 0·005; ES: 0·89) increases, respectively. There were no relative differences in ROM changes between conditions or limbs nor any stretch-induced changes in isokinetic torque or power. In conclusion, unilateral SS and DS augment contralateral limb ROM likely through an increased stretch tolerance.

Intermittent stretch reduces force and central drive more than continuous stretch

INTRODUCTION

The relative contributions of central versus peripheral factors to the force loss induced by acute continuous and intermittent plantarflexor stretches were studied.

METHODS

Eighteen healthy young men with no apparent tissue stiffness limitations randomly performed 1) one 5-min stretch (continuous stretch [CS]), 2) five 1-min stretches (intermittent stretch [IS]), and 3) a control condition, on three separate days. The stretches were constant-torque ankle stretches performed on an isokinetic dynamometer. Gastrocnemius medialis oxygenation status was quantified during stretch using near-infrared spectroscopy. Measures of isometric plantarflexor peak torque (Tpeak), voluntary activation (%VA; interpolated twitch technique), EMG amplitude normalized by Mmax (EMG:M), V-wave amplitude, and excitation-contraction (E-C) coupling efficiency (torque ratio between 20- and 80-Hz tetanic stimulations [20:80]) were taken before, immediately, and 15 and 30 min after each condition.

RESULTS

IS caused substantial cyclic variations in tissue oxygenation, but CS resulted in a greater decrease in oxyhemoglobin concentration. Voluntary Tpeak decreased more after IS (-23.8%) than CS (-14.3%) and remained significantly depressed until 30 min after IS only (-5.6%). EMG:M (-27.7%) and %VA (-15.9%) were reduced only after IS. After CS and IS, the magnitude of decrease in Tpeak was correlated with decreases in EMG:M (r = 0.81 and 0.89, respectively), %VA (r = 0.78 and 0.93), and V-wave (r = 0.51, only after IS). Tetanic torque values (20 and 80 Hz) were decreased after IS (-13.1% and -6.4%, respectively) and CS (-10.9% and -6.7%, respectively), but 20:80 was not different from the control group.

CONCLUSION

These results suggest that IS reduced Tpeak more than CS, and these reductions were strongly associated with a depression in central drive.

Can passive stretch inhibit motoneuron facilitation in the human plantar flexors?

The purpose of the present study was to examine the possible inhibitory effect of passive plantar flexor muscle stretching on the motoneuron facilitatory system. Achilles tendon vibration (70 Hz) and triceps surae electrical stimulation (20 Hz) were imposed simultaneously in 11 subjects to elicit contraction through reflexive pathways in two experiments. In experiment 1, a vibration-stimulation protocol was implemented with the ankle joint plantar flexed (+10°), neutral (0°), and dorsiflexed (-10°). In experiment 2, the vibration-stimulation protocol was performed twice before (control), then immediately, 5, 10, and 15 min after a 5-min intermittent muscle stretch protocol. Plantar flexor torque and medial and lateral gastrocnemius and soleus (EMGSol) EMG amplitudes measured during and after (i.e., self-sustained motor unit firing) the vibration protocol were used as an indicator of this facilitatory pathway. In experiment 1, vibration torque, self-sustained torque and EMGSol were higher with the ankle at -10° compared with 0° and +10°, suggesting that this method is valid to assess motoneuronal facilitation. In experiment 2, torque during vibration was reduced by ∼ 60% immediately after stretch and remained depressed by ∼ 35% at 5 min after stretch (P < 0.05). Self-sustained torque was also reduced by ∼ 65% immediately after stretch (P < 0.05) but recovered by 5 min. Similarly, medial gastrocnemius EMG during vibration was reduced by ∼ 40% immediately after stretch (P < 0.05), and EMGSol during the self-sustained torque period was reduced by 44% immediately after stretch (P < 0.05). In conclusion, passive stretch negatively affected the motoneuronal amplification for at least 5 min, suggesting that motoneuron disfacilitation is a possible mechanism influencing the stretch-induced torque loss.

Acute effects of passive stretching of the plantarflexor muscles on neuromuscular function: the influence of age

The acute effects of stretching on peak force (Fpeak), percent voluntary activation (%VA), electromyographic (EMG) amplitude, maximum range of motion (MROM), peak passive torque, the passive resistance to stretch, and the percentage of ROM at EMG onset (%EMGonset) were examined in 18 young and 19 old men. Participants performed a MROM assessment and a maximal voluntary contraction of the plantarflexors before and immediately after 20 min of passive stretching. Fpeak (-11 %), %VA (-6 %), and MG EMG amplitude (-9 %) decreased after stretching in the young, but not the old (P > 0.05). Changes in Fpeak were related to reductions in all muscle activation variables (r = 0.56-0.75), but unrelated to changes in the passive resistance to stretch (P ≥ 0.24). Both groups experienced increases in MROM and peak passive torque and decreases in the passive resistance to stretch. However, the old men experienced greater changes in MROM (P < 0.001) and passive resistance (P = 0.02-0.06). Changes in MROM were correlated to increases in peak passive torque (r = 0.717), and the old men also experienced a nonsignificant greater (P = 0.08) increase in peak passive torque. %EMGonset did not change from pre- to post-stretching for both groups (P = 0.213), but occurred earlier in the old (P = 0.06). The stretching-induced impairments in strength and activation in the young but not the old men may suggest that the neural impairments following stretching are gamma-loop-mediated. In addition, the augmented changes in MROM and passive torque and the lack of change in %EMGonset for the old men may be a result of age-related changes in muscle-tendon behavior.

Range of motion, neuromechanical, and architectural adaptations to plantar flexor stretch training in humans

The neuromuscular adaptations in response to muscle stretch training have not been clearly described. In the present study, changes in muscle (at fascicular and whole muscle levels) and tendon mechanics, muscle activity, and spinal motoneuron excitability were examined during standardized plantar flexor stretches after 3 wk of twice daily stretch training (4 × 30 s). No changes were observed in a nonexercising control group (n = 9), however stretch training elicited a 19.9% increase in dorsiflexion range of motion (ROM) and a 28% increase in passive joint moment at end ROM (n = 12). Only a trend toward a decrease in passive plantar flexor moment during stretch (-9.9%; P = 0.15) was observed, and no changes in electromyographic amplitudes during ROM or at end ROM were detected. Decreases in H(max):M(max) (tibial nerve stimulation) were observed at plantar flexed (gastrocnemius medialis and soleus) and neutral (soleus only) joint angles, but not with the ankle dorsiflexed. Muscle and fascicle strain increased (12 vs. 23%) along with a decrease in muscle stiffness (-18%) during stretch to a constant target joint angle. Muscle length at end ROM increased (13%) without a change in fascicle length, fascicle rotation, tendon elongation, or tendon stiffness following training. A lack of change in maximum voluntary contraction moment and rate of force development at any joint angle was taken to indicate a lack of change in series compliance of the muscle-tendon unit. Thus, increases in end ROM were underpinned by increases in maximum tolerable passive joint moment (stretch tolerance) and both muscle and fascicle elongation rather than changes in volitional muscle activation or motoneuron pool excitability.

Does acute passive stretching increase muscle length in children with cerebral palsy?

BACKGROUND

Children with spastic cerebral palsy experience increased muscle stiffness and reduced muscle length, which may prevent elongation of the muscle during stretch. Stretching performed either by the clinician, or children themselves is used as a treatment modality to increase/maintain joint range of motion. It is not clear whether the associated increases in muscle-tendon unit length are due to increases in muscle or tendon length. The purpose was to determine whether alterations in ankle range of motion in response to acute stretching were accompanied by increases in muscle length, and whether any effects would be dependent upon stretch technique.

METHODS

Eight children (6-14 y) with cerebral palsy received a passive dorsiflexion stretch for 5 × 20 s to each leg, which was applied by a physiotherapist or the children themselves. Maximum dorsiflexion angle, medial gastrocnemius muscle and fascicle lengths, and Achilles tendon length were calculated at a reference angle of 10 ° plantarflexion, and at maximum dorsiflexion in the pre- and post-stretch trials.

FINDINGS

All variables were significantly greater during pre- and post-stretch trials compared to the resting angle, and were independent of stretch technique. There was an approximate 10 ° increase in maximum dorsiflexion post-stretch, and this was accounted for by elongation of both muscle (0.8 cm) and tendon (1.0 cm). Muscle fascicle length increased significantly (0.6 cm) from pre- to post-stretch.

INTERPRETATION

The results provide evidence that commonly used stretching techniques can increase overall muscle, and fascicle lengths immediately post-stretch in children with cerebral palsy.

Lower limb body composition is associated to knee passive extension torque-angle response

PURPOSE

People vary in flexibility regarding maximum joint angle, resistance to stretch and mechanical responses during stretching exercises. Body composition (BC) has been been mentioned as one of the factors for flexibility differences. The aim of this study was to determine how body composition and anthropometric measures of the lower limb is associated with passive knee extension (PKE) torque-angle (T-A) response.

METHODS

Twenty-five male subjects with poor flexibility performed a maximal PKE repetition (velocity of 2°/s; 90 seconds in the static phase). Knee passive T-A, vastus medialis and semitendinosous electromyographic activity were recorded during the protocol. Viscoelastic stress relaxation (VSR) amplitude, knee passive stiffness (KPS), lower limb body composition assessed by dual energy x-ray absorptiometry, and anthropometry measures were determined.

RESULTS

Thigh skeletal muscle and bone mass, as well as thigh perimeter, showed a moderated correlation with passive torque (r = 0.45; r = 0.6; r = 0.59, respectively), joint angle (r = 0.46; r = 0.5; r = 0.5), and VSR (r = 0.46; r = 0.49; r = 0.5). Thigh skeletal muscle was also correlated with KPS (r = 0.42). All these correlations were statistically significant (p < 0.05).

CONCLUSIONS

Passive knee extension T-A was found to be moderately correlated with lower limb BC. In particular, thigh perimeter and skeletal muscle mass were associated with knee passive stiffness and viscoelastic stress relaxation. More research is needed to understand what influences joint maximum angle, resistance to stretch and mechanical response to stretching.

Contribution of central vs. peripheral factors to the force loss induced by passive stretch of the human plantar flexors

The purpose of the present research was to identify the contribution of central vs. peripheral factors to the force loss after passive muscle stretching. Thirteen men randomly performed both a 5-min constant-torque stretch of the plantar flexors on an isokinetic dynamometer and a resting condition on 2 separate days. The triceps surae electromyogram (EMG) was recorded simultaneously with plantar flexor isometric torque. Measures of central drive, including the EMG amplitude normalized to the muscle compound action potential amplitude (EMG/M), percent voluntary activation and first volitional wave amplitude, and measures of peripheral function, including the twitch peak torque, 20-to-80-Hz tetanic torque ratio and torque during 20-Hz stimulation preceded by a doublet, were taken before and immediately and 15 min after each condition. Peak torque (-15.7%), EMG/M (-8.2%), and both twitch (-9.4%) and 20-Hz peak torques (-11.5%) were reduced immediately after stretch but recovered by 15 min. There were strong correlations between the torque loss and the reductions in central drive parameters (r = 0.65-0.93). Torque recovery was also strongly correlated with the recovery in EMG/M and percent voluntary activation (r = 0.77-0.81). The moderate decreases in measures of peripheral function were not related to the torque loss or recovery. These results suggest that 1) central factors were strongly related to the torque reduction immediately after stretch and during torque recovery; and 2) the muscle's contractile capacity was moderately reduced, although these changes were not associated with the torque reduction, and changes in excitation-contraction coupling efficiency were not observed.