Ludwig N.H. Göeken

Sport stretching: Effect on passive muscle stiffness of short hamstrings

OBJECTIVE To evaluate the effects of one 10-minute stretch on muscle stiffness in subjects with short hamstrings. DESIGN Randomized control trial. SETTING Laboratory for human movement sciences in the department of rehabilitation of a university hospital. SUBJECTS Sixteen students from the Department of Human Movement Sciences participated with informed consent in the experiment. Subjects were limited to men and women without a history of neurological and orthopedic disorders. To select subjects with short hamstrings, the finger-ground distance had to be greater than 0cm (unable to touch the floor when bending forward) and the manual leg lifting was not to exceed 80 degrees. One group of 10 subjects performed static stretching exercises during 10 minutes interspersed with relaxing, whereas the untreated group of 6 subjects was used as a control. MAIN OUTCOME MEASURES The instrumental straight-leg-raising set-up enables the measurement of the force needed to lift the leg, range of motion (ROM), pelvic-femoral angle, and the electromyogram of the hamstrings. These variables provide information about the stiffness, elongation, and state of activity of the hamstring muscles. RESULTS. One 10-minute sport stretch resulted in a significant increase in passive muscle moment, ROM, and elongation of the hamstrings. There was no significant change in the course of the passive muscle stiffness curve with respect to the prestretch stiffness curve. CONCLUSIONS One session of static stretching does not influence the course of the passive muscle stiffness curve. The increased ROM, i.e., the extensibility of the hamstrings, results from an increase in the stretch tolerance.

Repeated passive stretching : acute effect on the passive muscle moment and extensibility of short hamstrings

OBJECTIVE To examine the response of short hamstring muscles to repeated passive stretching. DESIGN A repeated measures design. SETTING A university laboratory for human movement analysis in a department of rehabilitation. SUBJECTS Students (7 men, 10 women) from the Department of Human Movement Sciences. MAIN OUTCOME MEASURES The lift force, range of motion, pelvic-femoral angle, first sensation of pain, and electromyogram of the hamstrings were measured. RESULTS Comparison of the data of the test group (n = 17) after five successive passive stretch tests by means of an instrumental straight-leg raising test showed no significant change of the variables passive muscle stiffness and extensibility (p>.05). CONCLUSION The acute effect of repeated passive stretching of short hamstring muscles is negligible. With an instrumental straight-leg raising test, the relevant muscle variables can be examined noninvasively.

INSTRUMENTAL STRAIGHT-LEG RAISING - RESULTS IN PATIENTS

Straight-leg raising is used as a diagnostic test for both elastogenic (passive muscle stretch test) and nonelastogenic (Lasègues test) pathology in patients unable to bend forward from the standing position while holding the knees in extension. The test assessment is based on the range of the leg excursion and the type of pain that is provoked. An instrumental version of Lasègues test (instrumental straight-leg raising) provides information about the extensibility, elasticity and electrical activity of the hamstrings and back muscles and about pelvic rotation. To investigate the diagnostical value of the additional information, both clinical and instrumental straight-leg raising was done by 30 patients who were unable to touch the ground while bending forward from the standing position with the knees extended. In one group of patients, the electrical activity of the muscles was comparable to that observed in the muscles of a control group of healthy volunteers; in a second group, however, the electrical muscle activity was aberrant. Muscle extensibility and passive muscle elasticity was comparable in patients in the first group and the healthy controls. In the patients with aberrant muscle activity, the elasticity of the passive muscles was not different from the control group, but both leg excursion and muscle extensibility were much smaller. Comparison of the clinically and experimentally diagnosed cause (elastogenic or non-elastogenic) of the movement restriction showed a remarkable discrepancy. We conclude that instrumental straight-leg raising provides valuable additional diagnostical information.

Characteristics of patients supplied with foot orthoses from orthopaedic workshops in The Netherlands

Abstract Objective : As part of a research program on foot orthoses, this study examined epidemiological aspects of patients supplied with foot orthoses in ready-to-wear or extra-depth shoes. Method : Three hundred and forty-five patients were recruited from orthopaedic workshops. Shoe technicians or orthotists interviewed the patients and inspected their feet and legs, recording gender, age, aetiology of health problems, number of previous foot orthoses, and purpose of the prescribed foot orthoses. Furthermore, patients aged 18 or over were asked to complete a questionnaire evaluating co-morbidity and educational level. Results and conclusions : Data indicate that foot orthoses are worn by people of all ages, including very young children. Children and adolescents supplied with foot orthoses included more boys than girls, while adults included more females. Minor orthopaedic problems and cerebral palsy were the most common reasons in younger children and adolescents wearing foot orthoses. These patients had received the devices mainly for stabilisation and for correction. Most of the patients aged 18 or over had degenerative foot disorders. The main purpose of the orthoses in these patients was to optimise pressure distribution. They appeared to have more co-morbidity and a lower educational level than the general population.

Health complaints and disabilities in patients supplied with foot orthoses for degenerative foot disorders

This exploratory study attempted to estimate the severity of health complaints and disabilities in patients supplied with foot orthoses for degenerative foot disorders in the Netherlands. Information on the severity and the distribution of the complaints in these patients is important to acquire insight in the problems which these patients experience, and moreover is essential for further research, especially for evaluating effects of patients undergoing foot orthosis treatment. Patients with degenerative foot disorders aged 18 years and over were recruited from nine orthopaedic workshops over a period of three months in 2000. One hundred and twenty-two (122) patients were included in the study. Two approaches were used to obtain data. Firstly, shoe technicians and orthotists inspected patients’ feet and legs and interviewed them at their initial visit. Data on gender, age, height, weight, existing and prescribed orthotic devices were recorded on a report form. Secondly, patients were asked to fill in a questionnaire assessing type, location, frequency, intensity and duration of health complaints, and disability. Data indicate that females with degenerative foot disorders and foot orthoses are twice as common as men. Patients supplied with foot orthoses are twice as often overweight compared to subjects in the general population. Besides frequent and protracted pain there are also fatigue complaints, particularly in the feet and lower leg. Duration and frequency of the complaints suggest that these patients suffer from a chronic pain syndrome. In addition, the results indicate that the functional level of these patients is below that of the general population, in particular regarding physical activities.