Effect of frequency of static stretching on flexibility, hamstring tightness and electromyographic activity

We compared the effect of the number of weekly repetitions of a static stretching program on the flexibility, hamstring tightness and electromyographic activity of the hamstring and of the triceps surae muscles. Thirty-one healthy subjects with hamstring tightness, defined as the inability to perform total knee extension, and shortened triceps surae, defined by a tibiotarsal angle wider than 90° during trunk flexion, were divided into three groups: G1 performed the stretching exercises once a week; G2, three times a week, and G3, five times a week. The parameters were determined before and after the stretching program. Flexibility improved in all groups after intervention, from 7.65 ± 10.38 to 3.67 ± 12.08 in G1, from 10.73 ± 12.07 to 0.77 ± 10.45 in G2, and from 14.20 ± 10.75 to 6.85 ± 12.19 cm in G3 (P < 0.05 for all comparisons). The increase in flexibility was higher in G2 than in G1 (P = 0.018), while G2 and G3 showed no significant difference (G1: 4 ± 2.17, G2: 10 ± 5.27; G3: 7.5 ± 4.77 cm). Hamstring tightness improved in all groups, from 37.90 ± 6.44 to 29 ± 11.65 in G1, from 39.82 ± 9.63 to 21.91 ± 8.40 in G2, and from 37.20 ± 6.63 to 26.10 ± 5.72° in G3 (P < 0.05 for all comparisons). During stretching, a statistically significant difference was observed in electromyographic activity of biceps femoris muscle between G1 and G3 (P = 0.048) and G2 and G3 (P = 0.0009). No significant differences were found in electromyographic activity during maximal isometric contraction. Stretching exercises performed three times a week were sufficient to improve flexibility and range of motion compared to subjects exercising once a week, with results similar to those of subjects who exercised five times a week.

Efeitos do alongamento muscular e condicionamento físico no tratamento fisioterápico de pacientes com fibromialgia / Effects of muscle stretching and physical conditioning as physical therapy treatment for patients with fibromyalgia

OBJETIVO: Verificar os efeitos de exercícios de alongamento muscular e condicionamento físico no tratamento fisioterápico da fibromialgia (FM). CASUÍSTICA E MÉTODOS: Foram avaliadas 15 mulheres com diagnóstico de FM, segundo os critérios do Colégio Americano de Reumatologia, divididas em dois grupos: Grupo 1 (G1) com oito pacientes, realizou tratamento por meio de alongamentos musculares e Grupo 2 (G2), sete pacientes, condicionamento físico. Foram avaliados qualidade do sono, fatores de piora e melhora da dor, sintomas associados e medicamentos utilizados. Além disso, foi aplicado o Fibromyalgia Impact Questionnaire (FIQ), para avaliar o impacto da FM. O tratamento durou oito semanas, sendo uma sessão semanal com duração de 40 a 45 minutos. As variáveis do FIQ antes e depois dos tratamentos foram comparadas pelo teste t para amostras dependentes (alfa< 0,05) e as demais foram analisadas descritivamente. RESULTADOS: A maioria das pacientes apresentava sono não reparador (86,67 por cento), piora da dor com serviços domésticos (40 por cento), nenhum fator de melhora da dor (28,57 por cento), distúrbios do sono como sintomas associados (100 por cento) e utilizava antidepressivos (69,23 por cento). Em relação às variáveis do FIQ, observaram-se diferenças estatisticamente significantes no sono (p= 0,0428) e rigidez matinal (p= 0,0130) nas pacientes do G1. Já no G2, não foram observadas diferenças significantes após o tratamento. CONCLUSÕES: Sugere-se que os alongamentos musculares realizados podem gerar impacto positivo na FM, promovendo melhora do sono e rigidez matinal das pacientes avaliadas.

OBJECTIVE: To investigate the effects of muscle stretching exercises and physical conditioning as physical therapy treatment for fibromyalgia. METHODS: Fifteen women with a diagnosis of fibromyalgia in accordance with the criteria of the American College of Rheumatology were evaluated and divided into two groups: Group 1 (G1, eight patients) underwent treatment consisting of muscle stretching and Group 2 (G2, seven patients), participated in a physical conditioning program. Sleep quality, pain-modulating factors, associated symptoms and medications used were evaluated. Furthermore, the Fibromyalgia Impact Questionnaire (FIQ) was applied to evaluate the impact of fibromyalgia. The treatment lasted for eight weeks, with one session per week of 40 to 45 minutes in duration. The FIQ data obtained before and after treatment were analyzed by means of Student's t test for dependent samples (alpha< 0.05) and other variables were analyzed descriptively. RESULTS: Most of the patients presented poor quality of sleep (86.67 percent). Many presented worsening of their pain when doing domestic tasks (40 percent) and there were no factors that relieved their pain (28.57 percent). All presented sleep disorders with associated symptoms (100 percent) and most used antidepressives (69.23 percent). For the FIQ data, statistically significant differences were observed in morning tiredness (p= 0.0428) and stiffness (p= 0.0130) among the G1 patients. Conversely, no difference was observed in G2 after the treatment. CONCLUSIONS: It is suggested that the muscle stretching may have had a positive impact on fibromyalgia, with reductions in morning tiredness and stiffness among the patients evaluated.

Recuperacao funcional de individuos com disfuncao femoro-patelar por meio de exercicios em cadeia cinetica fechada: revisao da literatura / Functional recovery of patients suffering from patellofemoral dysfunction through closed kinetic chain exercices

A disfuncao femoro-patelar constitui importante lesao musculo-esqueletica, acometendo adultos jovens e uma grande porcentagem de atletas. Varios fatores etiologicos estao envolvidos nessa patologia da articulacao femoro-patelar, a qual e estabilizada principalmentepor estruturas dinamicas - musculos. Somente apos o correto conhecimento dos estabilizadores dinamicos da articulacao femoro-patelar e dos principais fatores envolvidos em sua etiologia pode-se prescrever um correto protocolo de exercicios na reabilitacao funcional. Dentre os mais utilizados estao os exercicios em cadeia cinetica fechada, realizados com o segmento distal do membro inferior fixo. Exemplos desses exercicios sao o agachamento e os exercicios realizados no leg-press e no step. Apesar de varios estudos terem analisado os estabilizadores dinamicos da articulacao femoro-patelar nesses exercicios em cadeia cinetica fechada, faltam evidencias cientificas que comprovem o aumento da hipertrofia ou do desempenho muscular. Dessa forma, mais estudos biomecanicos, anatomicos e eletromiograficos tornam-se necessarios para embasar em cadeia cinetica fechada na reabilitacao de pacientes com disfuncao femoro-patelar