Effects of transcutaneous electrical nerve stimulation on quadriceps function in individuals with experimental knee pain.

Knee joint pain (KJP) is a cardinal symptom in knee pathologies, and quadriceps inhibition is commonly observed among KJP patients. Previously, KJP independently reduced quadriceps strength and activation. However, it remains unknown how disinhibitory transcutaneous electrical nerve stimulation (TENS) will affect inhibited quadriceps motor function. This study aimed at examining changes in quadriceps maximum voluntary contraction (MVC) and central activation ratio (CAR) before and after sensory TENS following experimental knee pain. Thirty healthy participants were assigned to either the TENS or placebo groups. All participants underwent three separate data collection sessions consisting of two saline infusions and one no infusion control in a crossover design. TENS or placebo treatment was administered to each group for 20 min. Quadriceps MVC and CAR were measured at baseline, infusion, treatment, and post-treatment. Perceived knee pain intensity was measured on a 100-mm visual analogue scale. Post-hoc analysis revealed that hypertonic saline infusion significantly reduced the quadriceps MVC and CAR compared with control sessions (P < 0.05). Sensory TENS, however, significantly restored inhibited quadriceps motor function compared with placebo treatment (P < 0.05). There was a negative correlation between changes in MVC and knee pain (r = 0.33, P < 0.001), and CAR and knee pain (r = 0.62, P < 0.001), respectively.

Whole body vibration as an adjunct to static stretching.

This study was a randomized control trial. The purpose of this study was twofold: 1) to determine if stretching the hamstrings during whole-body-vibration (WBV) is more effective than static stretching alone; and 2) to monitor retention of flexibility changes. The main outcome measure was hamstring flexibility as measured in degrees using a passive knee extension test. Thirty-four recreationally active college-age subjects (23.4+/-1.7 yrs) completed this study (22 males, 12 females, avg. ht.=175.6+/-6.4 cm, avg. wt.=74.9+/-11.8 kg). Subjects were assigned to a control group (C), a static stretch group (SS), or a vibration + static stretch group (V). Subjects stretched 5 days/wk for 4-weeks and were followed for 3-weeks after cessation to monitor retention. Analysis showed a significant difference between treatment groups (p<0.0001), time (p<0.0001), gender (p=0.0002) and in treatment*time (p=0.0119), with 14%+/-3.86% (SEM) and 22%+/-3.86% (SEM) increases in flexibility after 4-weeks of stretching for the SS and V groups respectively. Three-week follow-up showed SS returning to baseline with V group still 6.4 degrees (11%+/-3.88% (SEM)) more flexible than at baseline. Stretching concurrently with vibration on a WBV platform appears to be a good adjunct to static stretching with the potential to enhance retention of flexibility gains.

Whole body vibration does not potentiate the stretch reflex.

Whole body vibration (WBV) is theorized to enhance neural potentiation of the stretch reflex. The purpose of this study was to determine if WBV affects the quadriceps reflex from a patellar tendon tap. Subjects were 22 volunteers (age 23 +/- 2 yrs, ht 172.8 +/- 10.8 cm, body mass 68.6 +/- 12.3 kg). The stretch reflex was elicited from the dominant leg pre, post, and 30-min post WBV treatment. A matched control group repeated the procedure without WBV. WBV treatment consisted of 5, 1-min bouts at 26 Hz with a 1-min rest period between bouts while maintaining a standardized squatting position. Two-way ANOVAs were used to detect differences between groups over time for vastus medialis (VM) and vastus lateralis (VL) latency, EMG amplitude, electromechanical delay (EMD), and force output. No group x time interactions were detected for latency (VM; F ((2,40)) = 1.20, p = .313: VL; F ((2,40)) = 0.617, p = .544), EMG mean amplitude (VM; F ((2,40)) = 0.169, p = .845: VL; F ((2,40)) = 0.944, p = .398), EMD (VM; F ((2,40)) = 0.715, p = .495: VL; F ((2,40)) = 1.24, p = .301), or quadriceps force (F ((2,40)) = 1.11, p = .341) A single session WBV treatment does not affect the quadriceps stretch reflex in terms of timing or amplitude.

Whole body vibration and dynamic restraint.

The purpose of this study was to identify changes due to whole body vibration in peroneus longus (PL) activation following ankle inversion perturbation. Participants were 22 (age 22.1 +/- 1.8 yrs, ht 168.8 +/- 8.2 cm, mass 65.5 +/- 11.2 kg) physically active male and female students with no recent history of lower extremity injury. Measurements of PL electromechanical delay (EMD), reaction time, and muscle activation were collected from two groups (WBV and control) over 3 time intervals (pretreatment, posttreatment, and 30 min posttreatment). Two-way ANOVAs were used to compare groups over time for all dependent variables. No group x time interactions were detected (p < 0.05) for any of the dependent variables. Whole body vibration did not alter PL EMD, reaction time, peak EMG, or average EMG. The use of WBV for enhancing ankle dynamic stability was not supported by this study. However, more data are needed to determine if WBV is an effective intervention in other areas of injury prevention or rehabilitation. These data were not consistent with the hypothesis that WBV enhances muscle spindle sensitivity.

Sit to stand transfer: performance in rising power, transfer time and sway by age and sex in senior athletes.

OBJECTIVE: To observe the differences in performance variables of the sit to stand transfer (as measured on the NeuroCom Balance Master) in a population of senior athletes. METHOD: A convenience sample of 173 subjects aged 50 years and older. Data were obtained from voluntary participation in a health fair offered at the annual Huntsman World Senior Games in St George, Utah, USA. All sit to stand tests were performed on the NeuroCom Balance Master. The measured parameters were weight transfer time (WTT), rising power (force exerted to rise), and centre of gravity sway (COG sway) during the rising phase. RESULTS: A significant difference was found between stratified age groups (50-64 and 65+ years) on rising power. There was also a sex difference in rising power. No significant differences were found in weight transfer time or COG sway. CONCLUSION: While rising power decreases with increasing age in senior athletes, WTT and COG sway remain similar regardless of age or sex. The maintenance of these other two variables (WTT and COG sway) may be attributable to physical activity and/or participation in sport.

Effect of submaximal contraction intensity in contract-relax proprioceptive neuromuscular facilitation stretching.

OBJECTIVE: To determine if submaximal contractions used in contract-relax proprioceptive neuromuscular facilitation (CRPNF) stretching of the hamstrings yield comparable gains in hamstring flexibility to maximal voluntary isometric contractions (MVICs). METHOD: Randomised controlled trial. A convenience sample of 72 male subjects aged 18-27 was used. Subjects qualified by demonstrating tight hamstrings, defined as the inability to reach 70 degrees of hip flexion during a straight leg raise. Sixty subjects were randomly assigned to one of three treatment groups: 1, 20% of MVIC; 2, 60% of MVIC; 3, 100% MVIC. Twelve subjects were randomly assigned to a control group (no stretching). Subjects in groups 1-3 performed three separate six second CRPNF stretches at the respective intensity with a 10 second rest between contractions, once a day for five days. Goniometric measurements of hamstring flexibility using a lying passive knee extension test were made before and after the stretching period to determine flexibility changes. RESULTS: Paired t tests showed a significant change in flexibility for all treatment groups. A comparison of least squares means showed that there was no difference in flexibility gains between the treatment groups, but all treatment groups had significantly greater flexibility than the control group. CONCLUSION: CRPNF stretching using submaximal contractions is just as beneficial at improving hamstring flexibility as maximal contractions, and may reduce the risk of injury associated with PNF stretching.

The effect of duration of stretching of the hamstring muscle group for increasing range of motion in people aged 65 years or older.

BACKGROUND AND PURPOSE: Stretching protocols for elderly people (> or = 65 years of age) have not been studied to determine the effectiveness of increasing range of motion (ROM). The purpose of this study was to determine which of 3 durations of stretches would produce and maintain the greatest gains in knee extension ROM with the femur held at 90 degrees of hip flexion in a group of elderly individuals. SUBJECTS: Sixty-two subjects (mean age = 84.7 years, SD = 5.6, range = 65-97) with tight hamstring muscles (defined as the inability to extend the knee to less than 20 degrees of knee flexion) participated. Subjects were recruited from a retirement housing complex and were independent in activities of daily living. METHODS: Subjects were randomly assigned to 1 of 4 groups and completed a physical activity questionnaire. The subjects in group 1 (n = 13, mean age = 85.1 years, SD = 6.4, range = 70-97), a control group, performed no stretching. The randomly selected right or left limb of subjects in group 2 (n = 17, mean age = 85.5 years, SD = 4.5, range = 80-93), group 3 (n = 15, mean age = 85.2 years, SD = 6.5, range = 65-92), and group 4 (n = 17, mean age = 83.2 years, SD = 4.6, range = 68-90) was stretched 5 times per week for 6 weeks for 15, 30, and 60 seconds, respectively. Range of motion was measured once a week for 10 weeks to determine the treatment and residual effects. Data were analyzed using a growth curve model. RESULTS: A 60-second stretch produced a greater rate of gains in ROM (60-second stretch = 2.4 degrees per week, 30-second stretch = 1.3 degrees per week, 15-second stretch = 0.6 degrees per week), which persisted longer than the gains in any other group (group 4 still had 5.4 degrees more ROM 4 weeks after treatment than at pretest as compared with 0.7 degrees and 0.8 degrees for groups 2 and 3, respectively). DISCUSSION AND CONCLUSION: Longer hold times during stretching of the hamstring muscles resulted in a greater rate of gains in ROM and a more sustained increase in ROM in elderly subjects. These results may differ from those of studies performed with younger populations because of age-related physiologic changes.