An analysis on muscle tone of lower limb muscles on flexible flat foot

Tibialis posterior muscle stiffness assessment in flat foot subjects by ultrasound based Shear-Wave Elastography

BACKGROUND

Few methodologies are used to assess Tibialis Posterior muscle stiffness. Those present limitations leading to a lack of evidence. Muscle stiffness assessment can help in the injuries risk factors identification while coupling with Ultrasound based Shear-Wave Elastography for its management. However, a precise and reliable methodology needs to be utilized to increase stiffness accuracy among the entire Tibialis Posterior muscle. Therefore, this study aims to investigate the stiffness association between Tibialis posterior deep and superficial layer and between flat and neutral footed subjects.

METHODS

The sample consisted of 18 participants, where 9 subjects represent the flatfoot group and 9 the neutral foot group. Only the subjects who presented a Navicular Drop Test value of > 9 mm were included in the flatfooted group. All participants were submitted to the Tibialis posterior stiffness assessment with the help of Ultrasound base Shear-Wave Elastography in a lying supine position. Association between Tibialis Posterior deep and superficial layers were determined by Pearson's correlation analysis and group differences were assessed using the U-Mann Whitney test in the comparison between flat foot and neutral foot group (p < 0.05).

RESULTS

No significant correlations between Tibialis Posterior layers stiffness were found (p = 0.194), nor in the comparison between both neutral and flat foot groups (p = 0.424/p = 0.258).

CONCLUSION

Among participants, no associations between tibialis posterior layers stiffness were found. Also, we did not find any differences in the stiffness between flat and neutral foot groups. In this study, the stiffness did not differentiate flat-footed subjects from neutral subjects.

High school male basketball athletes exhibit greater hamstring muscle stiffness than females as assessed with shear wave elastography

OBJECTIVE

The purpose of this study was to characterize lower extremity passive muscle stiffness in a young, healthy, athletic population. It was hypothesized that males would exhibit greater stiffness than females and that hamstring stiffness would increase with increased passive hamstring stretch.

METHODS

Male (n = 52, age 16.0 ± 1.3 years, height 180.3 ± 7.9 cm, weight 73.1 ± 11.8 kg) and female (n = 89, age 15.6 ± 1.3 years, height 169.7 ± 8.1 cm, weight 65.2 ± 13.2 kg) high school basketball athletes were recruited for this study. Shear wave elastography (SWE) was used to measure shear wave velocity (m/s) of the biceps femoris muscle at three leg positions (40%, 60%, and 80%) of the maximum passive 90-90 straight-leg raise position for each leg. Hamstring stiffness (kPa) was quantified from the SWE elastogram using custom processing software.

RESULTS

Hamstring stiffness was significantly greater for males than females at every position on both the dominant and non-dominant limbs (p < 0.05). Hamstring stiffness was greater on the non-dominant limb than the dominant for females at the 40% position. Stiffness at 60% was greater than stiffness at 40% for males on both the dominant and non-dominant limbs. However, stiffness at 60% was greater than stiffness at 80% on the male non-dominant limb. Females demonstrated higher stiffness at 40% than both 60% and 80% for the dominant and non-dominant limbs.

CONCLUSION

Healthy male basketball players had higher hamstring muscle stiffness than female players. Future studies may investigate what factors contribute to the large variability observed in muscle stiffness, resulting in mixed results on the effects of leg dominance and stretching positions.

The Acute Effects of Different Intensity Whole-Body Vibration Exposure on Muscle Tone and Strength of the Lower Legs, and Hamstring Flexibility: A Pilot Study

CONTEXT

The research on the change in properties of the lower leg muscles by different intensity sinusoidal vertical whole-body vibration (SV-WBV) exposures has not yet been investigated.

OBJECTIVE

The purpose of this study was to determine effect of a 20-minute different intensity SV-WBV application to the ankle plantar flexor and dorsiflexor muscles properties and hamstring flexibility.

DESIGN

Prospective preintervention-postintervention design.

SETTING

Physiotherapy department.

PARTICIPANTS

A total of 50 recreationally active college-aged individuals with no history of a lower leg injury volunteered.

INTERVENTIONS

The SV-WBV was applied throughout the session with an amplitude of 2 to 4 mm and a frequency of 25 Hz in moderate-intensity vibration group and 40 Hz in a vigorous-intensity vibration group.

MAIN OUTCOME MEASURES

The gastrocnemius and tibialis anterior muscle tone was assessed with MyotonPRO, and the strength evaluation was made on the same lower leg muscles using hand-held dynamometer. The sit and reach test was used for the lower leg flexibility evaluation.

RESULTS

The gastrocnemius muscle tone decreased on the right side (d = 0.643, P = .01) and increased on the left (d = 0.593, P = .04) when vigorous-intensity vibration was applied. Bilateral gastrocnemius muscle strength did not change in both groups (P > .05). Without differences between groups, bilateral tibialis anterior muscle strength increased in both groups (P < .01). Bilateral gastrocnemius and tibialis anterior muscle tone did not change in the moderate-intensity vibration group (P > .05). Flexibility increased in both groups (P < .01); however, there was no statistically significant difference between the groups (d = 0.169, P = .55).

CONCLUSIONS

According to study results, if SV-WBV is to be used in hamstring flexibility or ankle dorsiflexor muscle strengthening, both vibration exposures should be preferred. Different vibration programs could be proposed to increase ankle plantar flexor muscle strength in the acute results. Vigorous-intensity vibration exposure is effective in altering ankle plantar flexor muscle tone, but it is important to be aware of the differences between the lower legs.

Beneficial effects of a negative ion patch on eccentric exercise-induced muscle damage, inflammation, and exercise performance in badminton athletes

Complementary and alternative medicines (CAMs) are widely applied and accepted for therapeutic purposes because of their numerous benefits. Negative ion treatment belongs to one of the critical categories defined by the National Center for CAM, with such treatment capable of air purification and ameliorating emotional disorders (e.g., depression and seasonal affective disorder). Negative ions can be produced naturally and also by a material with activated energy. Exercise-induced muscle damage (EIMD) often occurs due to inadequate warm up, high-intensity exercise, overload, and inappropriate posture, especially for high-intensive competition. Few studies have investigated the effects of negative ion treatment on muscular injury in the sports science field. In the current study, we enrolled badminton athletes and induced muscle damage in them through eccentric exercise in the form of a high-intensity squat program. We evaluated the effects of negative ion patches of different intensities at three points (preexercise, postexercise, and recovery) by analyzing physiological indexes (tumor necrosis factor [TNF]-α, interleukin [IL]-6, IL-10, creatine kinase [CK], and lactate dehydrogenase [LDH] levels) and performing a functional assessment (a countermovement jump [CMJ] test). We found that a high-intensity negative ion patch could significantly reduce the levels of TNF-α, an injury-associated inflammatory cytokine, and related markers (CK and LDH). In addition, muscular overload-caused fatigue could be also ameliorated, as indicated by the functional CMJ test result, and related muscular characteristics (tone and stiffness) could be effectively improved. Thus, the negative ion treatment could effectively improve physiological adaption and muscular fatigue recovery after EIMD in the current study. The negative ion patch treatment can be further integrated into a taping system to synergistically fulfill exercise-induced damage protection and functional elevation. However, the effects of this treatment require further experimental validation.

Relationship between Subtalar Joint Stiffness and Relaxed Calcaneal Stance Position in Cerebral Palsy Children with Valgus Deformities

Relaxed calcaneal stance position (RCSP) is an important index in the correctional treatment of foot valgus deformities for cerebral palsy (CP) children. However, patients with similar RCSP showed diverse outcomes when accepting similar treatment, as the corrective resistance of subtalar joint (STJ) could be quite different. This study aimed to investigate the relationship between STJ stiffness and RCSP in different loading conditions. 38 valgus feet of 19 CP subjects were included in the study. A reposition force was applied beneath the STJ and pushed the foot from pronated position to neutral position. The STJ stiffness was calculated as the slope of the line fitting the force-displacement data. Correlations between the STJ stiffness, RCSP, and composite spasticity index (CSI) were analyzed. The spearman correlation coefficient indicated that STJ stiffness had no correlation with RCSPs, yet it had negative correlation with the change of RCSP under difference loading conditions (ΔRCSP_1w−0w and ΔRCSP_0.5w−0w). STJ stiffness was also correlated with the composite spasticity index (CSI), implying that this index had an advantage in reflecting the mechanism of valgus deformity and should be considered as a necessary measurement of foot valgus in CP children. The present method for quantification of STJ stiffness could improve the accuracy in the diagnosis and classification of foot deformity and may help increase the understanding of the biomechanical factors in foot deformity rehabilitation.

Therapeutic effects of massage and electrotherapy on muscle tone, stiffness and muscle contraction following gastrocnemius muscle fatigue

[Purpose] This study aimed to examine the effects of a combined intervention consisting of massage therapy and transcutaneous electrical nerve stimulation on gastrocnemius muscle fatigue, assessing whether the intervention improved muscle tone, stiffness, and muscle contraction. [Subjects and Methods] The subjects were 20 healthy males in their 20s who were equally divided into a transcutaneous electrical nerve stimulation group and a combined therapy group that received a combination of massage therapy and transcutaneous electrical nerve stimulation. Muscle fatigue was triggered on the gastrocnemius muscle, and the effects of intervention method on muscle tone, stiffness, and muscle contraction were examined over time. [Results] Lateral and medial gastrocnemius muscle tone and stiffness significantly increased and gastrocnemius muscle contraction significantly decreased in each group immediately after fatigue was triggered on the gastrocnemius muscle. There was no difference in the effects of the two intervention methods over time. [Conclusion] This study verified that a combined therapy of massage therapy and transcutaneous electrical nerve stimulation was able to be used effectively in improving muscle tone, stiffness, muscle contraction, thereby reducing gastrocnemius muscle fatigue.

Effectiveness of surgically treated symptomatic plano-valgus deformity by the calcaneo stop procedure according to radiological, functional and gait parameters

Background

The incidence of flatfoot is approximately 5% in children and adults. The symptomatic form of a flexible flatfoot produces subjective and objective complaints, including gait disturbances. Surgical intervention is considered when conservative management fails. The arthroereisis procedure provides a stable foot and durable correction. However, to the best of our knowledge, no study has evaluated the effectiveness of this procedure on gait parameters.

Methods

Fifteen children with painful flatfeet (10 males; 5 females) with a mean age of 12 years and 6 months underwent the calcaneo stop procedure. Radiographic, gait analysis and functional measures were evaluated to assess the changes pre- and post-operatively.

Results

All children were followed up for a mean period of 4 years and 6 months. The overall results of the study exhibited statistically significant improvement for all radiographic variables, functional measures and range of motion investigated in the study (p < 0.05). Although the study showed improvement in all temporal parameters (p < 0.05) measured in the gait analysis, the results demonstrated there were no statistically significant differences in the kinematic and kinetic variables (p > 0.05) before and after surgery.

Conclusions

Although there was no significant improvement in the kinematic and kinetic variables investigated, this study supports the calcaneo-stop procedure as a reliable and effective procedure for treating paediatric flexible flatfoot.

Immediate effects of kinematic taping on lower extremity muscle tone and stiffness in flexible flat feet

[Purpose] This study aimed to examine the immediate effects of kinematic taping on the tone and stiffness in the leg muscles of subjects with flexible flat feet. [Subjects and Methods] A total of 30 subjects, 15 in the kinematic taping and 15 in the sham taping group, were administered respective taping interventions. Subsequently, the foot pressure and the tone and stiffness in the tibialis anterior, rectus femoris, medial gastrocnemius, and the long head of the biceps femoris muscles of both the lower extremities were measured. [Results] The foot pressure of the dominant leg significantly decreased in the kinematic taping group. The muscle tone and stiffness in the rectus femoris muscle of the dominant and non-dominant leg, tibialis anterior muscle of the dominant leg, medial gastrocnemius muscle of the non-dominant leg, and the stiffness in the dominant leg significantly decreased. The muscle tone and stiffness generally increased in the sham taping group. However, no significant difference was observed between the 2 groups. [Conclusion] This study demonstrated that kinematic taping on flexible flat feet had positive effects of immediately reducing the abnormally increased foot pressure and the tone and stiffness in the lower extremity muscles.