Effect of acute static stretching on the passive mechanical properties of the Achilles tendon: a systematic review and meta-analysis

2021 ◽  
Vol 28 (11) ◽  
pp. 1-10
Author(s):  
Anelize Cini ◽  
Francesca Chaida Sonda ◽  
Mariana de Oliveira Borges ◽  
Marco Aurélio Vaz ◽  
Cláudia Silveira Lima

Background/Aims Little is known about the effectiveness of static stretching on the tendinous structures. The aim of this study was to verify the effect of acute static stretching on the passive mechanical properties of the Achilles tendon. Methods Databases were searched with the descriptors ‘muscle stretching exercises,’ ‘adult’ and ‘Achilles tendon’ with a sample consisting of physically active young adults. Two blind reviewers performed the review. Results A total of four studies were selected. After the meta-analysis, no significant difference was observed for range of motion (−0.73; 95% confidence interval −2.18–0.71; I2=0%), muscle-tendon unit (−0.02; 95% confidence interval −0.23–0.19; I2= 83%), muscle (−0.43; 95% confidence interval −0.92–0.06; I2= 0%) and tendon stiffness (3.70; 95% confidence interval 1.57–5,83; I2=0%; P=0.0007) and passive torque (−1.35; 95% confidence interval −4.75–2.05; I2= 0%). Maximum voluntary isometric contraction showed an alteration with a longer stretching time (1215 seconds). Conclusions Passive static stretching (60–1215 seconds) does not significantly alter the analysed variables.

2020 ◽  
pp. 1-9
Author(s):  
Devin S. Kielur ◽  
Cameron J. Powden

Context: Impaired dorsiflexion range of motion (DFROM) has been established as a predictor of lower-extremity injury. Compression tissue flossing (CTF) may address tissue restrictions associated with impaired DFROM; however, a consensus is yet to support these effects. Objectives: To summarize the available literature regarding CTF on DFROM in physically active individuals. Evidence Acquisition: PubMed and EBSCOhost (CINAHL, MEDLINE, and SPORTDiscus) were searched from 1965 to July 2019 for related articles using combination terms related to CTF and DRFOM. Articles were included if they measured the immediate effects of CTF on DFROM. Methodological quality was assessed using the Physiotherapy Evidence Database scale. The level of evidence was assessed using the Strength of Recommendation Taxonomy. The magnitude of CTF effects from pre-CTF to post-CTF and compared with a control of range of motion activities only were examined using Hedges g effect sizes and 95% confidence intervals. Randomeffects meta-analysis was performed to synthesize DFROM changes. Evidence Synthesis: A total of 6 studies were included in the analysis. The average Physiotherapy Evidence Database score was 60% (range = 30%–80%) with 4 out of 6 studies considered high quality and 2 as low quality. Meta-analysis indicated no DFROM improvements for CTF compared with range of motion activities only (effect size = 0.124; 95% confidence interval, −0.137 to 0.384; P = .352) and moderate improvements from pre-CTF to post-CTF (effect size = 0.455; 95% confidence interval, 0.022 to 0.889; P = .040). Conclusions: There is grade B evidence to suggest CTF may have no effect on DFROM when compared with a control of range of motion activities only and results in moderate improvements from pre-CTF to post-CTF. This suggests that DFROM improvements were most likely due to exercises completed rather than the band application.


2021 ◽  
pp. 1-13
Author(s):  
Darin Pauley ◽  
Pim Cuijpers ◽  
Davide Papola ◽  
Clara Miguel ◽  
Eirini Karyotaki

Abstract Background Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder v. wait-list and care-as-usual controls. Methods A systematic search of bibliographic databases identified 15 030 abstracts from inception to 1 January 2020. Forty-seven randomized controlled trials (53 comparisons; 4958 participants) contributed to the meta-analysis. Subgroup analyses were conducted by an anxiety disorder, risk of bias, treatment support, recruitment, location and treatment adherence. Results A large, pooled effect size of g = 0.80 [95% Confidence Interval: 0.68–0.93] was found in favor of digital interventions. Moderate to large pooled effect sizes favoring digital interventions were found for generalized anxiety disorder (g = 0.62), mixed anxiety samples (g = 0.68), panic disorder with or without agoraphobia (g = 1.08) and social anxiety disorder (g = 0.76) subgroups. No subgroups were significantly different or related to the pooled effect size. Notably, the effects of guided interventions (g = 0.84) and unguided interventions (g = 0.64) were not significantly different. Supplemental analysis comparing digital and face-to-face interventions (9 comparisons; 683 participants) found no significant difference in effect [g = 0.14 favoring digital interventions; Confidence Interval: −0.01 to 0.30]. Conclusion The precise and powerful estimates found further justify the application of digital interventions for anxiety disorders in place of wait-list or usual care.


2001 ◽  
Vol 90 (5) ◽  
pp. 1671-1678 ◽  
Author(s):  
Tadashi Muramatsu ◽  
Tetsuro Muraoka ◽  
Daisuke Takeshita ◽  
Yasuo Kawakami ◽  
Yuichi Hirano ◽  
...  

Load-strain characteristics of tendinous tissues (Achilles tendon and aponeurosis) were determined in vivo for human medial gastrocnemius (MG) muscle. Seven male subjects exerted isometric plantar flexion torque while the elongation of tendinous tissues of MG was determined from the tendinous movements by using ultrasonography. The maximal strain of the Achilles tendon and aponeurosis, estimated separately from the elongation data, was 5.1 ± 1.1 and 5.9 ± 1.6%, respectively. There was no significant difference in strain between the Achilles tendon and aponeurosis. In addition, no significant difference in strain was observed between the proximal and distal regions of the aponeurosis. The results indicate that tendinous tissues of the MG are homogenously stretched along their lengths by muscle contraction, which has functional implications for the operation of the human MG muscle-tendon unit in vivo.


2014 ◽  
Vol 568-570 ◽  
pp. 1671-1674
Author(s):  
Gen Yang Cao ◽  
Dan Sheng ◽  
Kai Yang ◽  
Xue Feng Lu ◽  
Wei Lin Xu

The embedded composite spinning technology was applied in spinning the composite yarn of polyamide 66 and nomex .The relationship of the polyamide 66 and nomex’s content with the mechanical properties of composite yarn and hairiness was discussed. The method of cluster analysis was applied in analyzing the four kinds of yarn’s mechanical properties. And the results show that when the confidence interval is 95%, the significance of two kinds yarns were greater than 0.05. There is no significant difference between the programs. While the analysis of the hairiness data showed that the fourth solution’s harmful hairiness was much lower that the first solution’s. Therefore, the best solution is the fourth solution.


2021 ◽  
Vol 11 ◽  
Author(s):  
Hao Liao ◽  
Wenfa Huang ◽  
Yaxin Liu ◽  
Wendi Pei ◽  
Huiping Li

PurposeTo compare the efficacy and safety between pyrotinib (Pyr) and trastuzumab emtansine (T-DM1) in pre-treated human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer (MBC) patients.MethodsA comprehensive literature search of the PubMed, EMBASE, and Web of Science was performed in August 2020. Randomized clinical trials comparing the efficacy and safety between different anti-HER2 regimens in patients pre-treated with trastuzumab (Tra) and a taxane in metastatic settings (≤second-line treatment) were included. A fixed effects network meta-analysis based on the Bayesian inferential framework was conducted for progression-free survival (PFS), overall survival (OS), overall response rate (ORR), and grade ≥3 adverse events (AEs). Values of surface under cumulative ranking probability curve (SUCRA) were calculated to offer a ranking of all regimens.ResultsTwelve studies with 4,353 subjects were identified. Nine regimens were included into the network: T-DM1, lapatinib-capecitabine (Lap-Cap), Tra-Cap, Cap, neratinib (Ner), pertuzumab (Per)-Tra-Cap, Pyr-Cap, atezolizumab (Ate)-T-DM1, and Ner-Cap. For PFS, Pyr-Cap was more favorable than T-DM1 (hazard ratio, 95% confidence interval: 0.77, 0.70–0.86), Lap-Cap (0.64, 0.59–0.69), Tra-Cap (0.63, 0.56–0.70), Cap (0.50, 0.45–0.56), Ner (0.59, 0.51–0.69), Per-Tra-Cap (0.68, 0.59–0.79), and Ner-Cap (0.72, 0.64–0.81). For OS, Pyr-Cap showed further improvement than Lap-Cap (hazard ratio, 95% confidence interval: 0.71, 0.52–0.99), Cap (0.68, 0.49–0.96), and Ner (0.65, 0.45–0.94). For ORR, Pyr-Cap was significantly superior than Cap (odds ratio, 95% confidence interval: 7.87, 1.22–56.51). No significant difference was observed in grade ≥3 AEs among all the regimens. Pyr-Cap ranked in the highest in PFS, OS, ORR, and grade ≥3 AEs (SUCRA = 99.4, 89.7, 86.4, and 89.3%).ConclusionsThese results indicate that Pyr may be more effective than T-DM1 in HER2+ MBC patients pre-treated with Tra and a taxane. However, it may be associated with more grade ≥3 AEs.


Author(s):  
Sofie De Wandel ◽  
Tracey Sulak ◽  
Darryn S. Willoughby

Background of Study: More research studies are being completed advocating for the use of exercise as an intervention and form of treatment for concussions. However, exercise can include many forms of physical activity, intensities, and durations. This systemic review and meta-analysis focused on the use of aerobic exercise, such as cycling or walking, as an intervention and form of treatment for children and young adults suffering from a concussion. Objective: The purpose of this systematic review and meta-analysis was to determine if the addition of aerobic exercise to an individual concussion treatment makes a significant difference when compared to treatments using flexibility as a form of physical activity or traditional methods of treatment following guidelines from the 2016 Berlin Consensus Statement on Concussion in Sport. Method: The search conducted for articles generated 472 studies. Out of these, 5 studies were selected based from the inclusion criteria. Results: Aerobic exercise was shown to significantly decrease the absolute risk difference for the development of prolonged post-concussion symptoms in children and adolescents with concussions when compared to those who reported no physical activity. The mean risk difference for the independent variable (IV) was -0.12 with a 95% confidence interval was reported to be -0.17 to -0.07 and an effect size of Z = 4.94 (P < 0.00001). Aerobic exercise was also shown to have an effect on the change in post-concussion symptom scale scores. The mean IV difference was 8.7 with a 95% confidence interval of 2.05 to 14.35 and an effect size of Z=3.02 (p=0.003). Conclusion: In conclusion, while there is evidence that aerobic exercise is beneficial for children and adolescents with a concussion, more studies need to be completed focusing on this age group and the effects of aerobic exercise on concussion recovery.


2019 ◽  
Vol 14 (40) ◽  
pp. 43-49 ◽  
Author(s):  
Carlos Ortega ◽  
Héctor Menéndez ◽  
Azael J. Herrero

Aim. The purpose of this study was to investigate the acute effects of the static stretching (SS), neuromuscular electrical stimulation (NEMS), wholebody vibration (WBV) and the combination of all these protocols (WBV+NEMS) on the flexibility of hamstrings. Methods. Fifteen males received four stretching protocols in a crossover design, one protocol per week: static stretching (SS); stretching with superimposed NEMS; stretching combined with WBV; and stretching with superimposed NEMS combined with WBV (WBV+NEMS). All protocols lasted one minute. The flexibility was assessed by both the Back Saver Sit and Reach (BSSR) and the Active Knee Extension (AKE) test. Flexibility measurements were performed before (baseline), immediately after the protocol (post) and 1, 3, 5 and 10 min post protocol. Outcomes. The BSSR at post was greater than the baseline value for NEMS (18.3%, p<0.001), WBV (10.1%, p<0.05), and WBV+NMES (14.9%, p<0.01). Ten minutes after the application of each protocol the BSSR was higher in respect to baseline value for SS (12.0%, p<0.001), NMES (18.8%, p<0.001), WBV (12.7%, p<0.01), and WBV+NEMS (13.6%, p<0.001). All protocols improved AKE in the same way. Conclusion. Our data indicates that SS, NEMS, WBV and the combination of both methods are effective to improve the flexibility of hamstrings. Furthermore, this improvement may be maintained for at least 10 min after the cessation of the exercise, irrespectively of the stretching protocol. Key words: Muscle stretching exercises, proprioception, training, electric stimulation, vibration.


Author(s):  
Alfredo Bravo-Sánchez ◽  
Pablo Abián ◽  
Filipa Sousa ◽  
Fernando Jimenez ◽  
Javier Abián-Vicén

Regular sport practice could prevent age-related changes in tendinous tissues. The purpose of the study was to investigate the effect of regular badminton practice on patellar and Achilles tendon mechanical properties in senior competitive badminton players (>35 years old) and to compare the results with physically active people matched by age. One hundred ninety-two badminton players and 193 physically active people were divided by age into four groups, between 35 and 44 (U45), between 45 and 54 (U55), between 55 and 64 (U65), and over 65 (O65) years old. A LogiqS8 transducer in elastography mode and a MyotonPRO myotonometer were used to assess patellar and Achilles mechanical properties. Achilles tendon stiffness was higher in the control group than the badminton players for the U45, U55, and O65 age groups (p < .01). Also, the elastography index was higher in the control group than the badminton players for the U45, U55, U65, and O65 age groups (p < .05). In conclusion, regular badminton practice could prevent the decline in mechanical properties of the patellar and Achilles tendons.


2021 ◽  
Vol 10 (2) ◽  
pp. 103-110
Author(s):  
Suresh K Sharma ◽  
Kalpana Thakur ◽  
Shiv K Mudgal ◽  
Barun Kumar

ABSTRACT Introduction: There is lack consensus on superiority of transparent vs. pressure dressing for prevention of post-cardiac catheterization pain, discomfort and hematoma. Therefore, we conducted this systematic review and meta-analysis of available RCTs on this subject. Methods: We performed a systematic search of RCTs published between in 2000-2019 in English language using databases including PubMed Medline, EMBASE, CINAHL, Cochrane Library, ERMED Journals, Clinical trials database, DELNET, Google Scholar and Discovery Search. Studies conducted on adult patients with femoral dressing after cardiac catheterization measuring pain, discomfort, hematoma as intended outcomes have been included. Data extraction, critical appraisal, assessment of risk bias was done and decisions on quality were made on mutual consensus. Mantel-Haenszel (MH) and odds ratio for dichotomous variables was calculated by Review Manager 5.3 software. Results: Out of all identified studies, only 5 studies comprising 664 patients fulfilled the inclusion criteria and met the quality assessment. Incidence of discomfort (25, 333) were significantly less in transparent dressing group as compared to pressure dressing group (149, 331); odds ratio 0.10, 95% confidence interval [CI] 0.06-0.15; I2 = 0%, P= 0.00. Four studies reported significantly lower number of pain cases in transparent dressing (17, 203) as compared to pressure dressing (57, 201); odds ratio 0.13, 95% confidence interval [CI] 0.03-0.59; I2 = 47%, P= 0.01). However, incidence of hematoma did not reveal any significant difference between two groups. Conclusion: Transparent dressing is a better option in patients with femoral/groin dressing after cardiac catheterization as it is more effective in prevention of pain and discomfort.


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