Relationships Between Plantar Flexor Muscle Stiffness, Strength, and Range of Motion in Subjects With Diabetes-Peripheral Neuropathy Compared to Age-Matched Controls

Abstract Background and Purpose. Patients with diabetes mellitus and peripheral neuropathy (DM and PN) often complain of joint stiffness. Although stiffness may contribute to some of the impairments and functional limitations found in these patients, it has not been quantified in this population. The purpose of this study was to quantify and compare passive ankle stiffness and dorsiflexion (DF) range of motion in subjects with DM and PN versus an age-matched comparison group. Subjects. Thirty-four subjects were tested (17 subjects with DM and PN and 17 subjects in an age-matched comparison group). There were 10 male subjects and 7 female subjects in each group. Methods. A Kin-Com dynamometer was used to measure passive plantar flexor torque as each subject's ankle was moved from plantar flexion into dorsiflexion at 60°/s. The following variables were compared using a Student t test: initial angle (angle of onset of plantar flexor torque), maximal dorsiflexion angle, plantar flexor muscle excursion (difference between initial angle and maximal dorsiflexion angle), slope of the first half of the plantar flexor torque curve (stiffness 1 measurement), and slope of the second half of the plantar flexor torque curve (stiffness 2 measurement). Results. The subjects with DM and PN group had smaller maximal dorsiflexion angles and less plantar flexor muscle excursion than the comparison group. There was no difference in initial angle, stiffness 1 measurement, or stiffness 2 measurement. Conclusion and Discussion. Although the subjects with DM and PN had less dorsiflexion range of motion than did the comparison group, there was no difference in stiffness between the groups. This finding suggests that people with DM and PN have “short” versus “stiff” plantar flexor muscles.

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A Study of Intrinsic Factors in Patients with Stress Fractures of the Tibia

Foot & Ankle International ◽

10.1177/107110079601700808 ◽

1996 ◽

Vol 17 (8) ◽

pp. 477-482 ◽

Cited By ~ 24

Author(s):

Ingrid Ekenman ◽

Li Tsai-Felländer ◽

Pär Westblad ◽

Ibrahim Turan ◽

Christer Rolf

Keyword(s):

Range Of Motion ◽

Stress Fracture ◽

Reference Group ◽

Intrinsic Factor ◽

Gait Pattern ◽

Stress Fractures ◽

Muscle Performance ◽

Plantar Flexor ◽

Flexor Muscle ◽

Intrinsic Factors

We aimed to study intrinsic factors in 29 consecutive patients with well-documented unilateral stress fractures of the tibia. Anthropometry, range of motion, isokinetic plantar flexor muscle performance, and gait pattern were analyzed. The uninjured leg served as the control. A reference group of 30 uninjured subjects was compared regarding gait pattern. Anterior stress fractures of the tibia (N = 10) were localized in the push-off/ landing leg in 9/10 athletes, but were similarly distributed between legs in posteromedial injuries (N = 19). Ten (30%) of the stress fracture subjects had bilateral high foot arches, similar to those found in the reference group. There were no other systematic differences in anthropometry, range of motion, gait pattern, or isokinetic plantar flexor muscle peak torque and endurance between injured and uninjured legs. No other differences were found between anterior and posteromedial stress fractures. We conclude that anterior stress fractures of the tibia occur mainly in the push-off/landing leg in athletes. Within the limitations of our protocol, no registered intrinsic factor was found to be directly associated with the occurrence of a stress fracture of the tibia.

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Effects of Vibration Rolling with and without Dynamic Muscle Contraction on Ankle Range of Motion, Proprioception, Muscle Strength and Agility in Young Adults: A Crossover Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17010354 ◽

2020 ◽

Vol 17 (1) ◽

pp. 354 ◽

Cited By ~ 2

Author(s):

Bo-Jhang Lyu ◽

Chia-Lun Lee ◽

Wen-Dien Chang ◽

Nai-Jen Chang

Keyword(s):

Young Adults ◽

Muscle Strength ◽

Muscle Contraction ◽

Range Of Motion ◽

Exercise Performance ◽

Plantar Flexion ◽

Ankle Dorsiflexion ◽

Plantar Flexor ◽

Flexor Muscle ◽

Warm Up

Vibration rolling (VR) has emerged as a self-myofascial release (SMR) tool to aid exercise performance when warming up. However, the benefits of VR on exercise performance when combined with dynamic muscle contraction are unclear. The purpose of this study was to investigate the immediate effects of the combination of VR with dynamic muscle contraction (DVR), VR, and static stretching (SS) during warm-up on range of motion (ROM), proprioception, muscle strength of the ankle, and agility in young adults. In this crossover design study, 20 recreationally active adults without musculoskeletal disorders completed three test sessions in a randomized order, with 48 h of rest between each session. Participants completed one warm-up intervention and its measurements on the same day; different warm-up interventions and measurements were performed on each of the three days. The measurements included ankle dorsiflexion and plantarflexion ROM, ankle joint proprioception, muscle strength, and agility. After DVR and VR intervention, ankle dorsiflexion ROM (both DVR and VR, p < 0.001), plantarflexion ROM (both DVR and VR, p < 0.001), plantar flexor muscle strength (DVR, p = 0.007; VR, p < 0.001), and agility (DVR, p = 0.016; VR, p = 0.007) significantly improved; after SS intervention, ankle dorsiflexion and plantar flexion ROM (dorsiflexion, p < 0.001; plantar flexion, p = 0.009) significantly improved, but muscle strength and agility were not enhanced. Compared with SS, DVR and VR significantly improved ankle plantar flexor muscle strength (p = 0.008 and p = 0.001, respectively). Furthermore, DVR significantly improved ankle dorsiflexion compared with VR (p < 0.001) and SS (p < 0.001). In conclusion, either DVR, VR, or SS increased ankle ROM, but only DVR and VR increased muscle strength and agility. In addition, DVR produced considerable increases in ankle dorsiflexion. These findings may have implications for warm-up prescription and implementation in both rehabilitative and athletic practice settings.

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Range of motion, neuromechanical, and architectural adaptations to plantar flexor stretch training in humans

Journal of Applied Physiology ◽

10.1152/japplphysiol.00204.2014 ◽

2014 ◽

Vol 117 (5) ◽

pp. 452-462 ◽

Cited By ~ 40

Author(s):

A. J. Blazevich ◽

D. Cannavan ◽

C. M. Waugh ◽

S. C. Miller ◽

J. B. Thorlund ◽

...

Keyword(s):

Range Of Motion ◽

Muscle Activation ◽

Joint Angle ◽

Maximum Voluntary Contraction ◽

Muscle Length ◽

Joint Moment ◽

Muscle Stiffness ◽

Control Group ◽

Plantar Flexor ◽

Passive Joint

The neuromuscular adaptations in response to muscle stretch training have not been clearly described. In the present study, changes in muscle (at fascicular and whole muscle levels) and tendon mechanics, muscle activity, and spinal motoneuron excitability were examined during standardized plantar flexor stretches after 3 wk of twice daily stretch training (4 × 30 s). No changes were observed in a nonexercising control group ( n = 9), however stretch training elicited a 19.9% increase in dorsiflexion range of motion (ROM) and a 28% increase in passive joint moment at end ROM ( n = 12). Only a trend toward a decrease in passive plantar flexor moment during stretch (−9.9%; P = 0.15) was observed, and no changes in electromyographic amplitudes during ROM or at end ROM were detected. Decreases in Hmax:Mmax(tibial nerve stimulation) were observed at plantar flexed (gastrocnemius medialis and soleus) and neutral (soleus only) joint angles, but not with the ankle dorsiflexed. Muscle and fascicle strain increased (12 vs. 23%) along with a decrease in muscle stiffness (−18%) during stretch to a constant target joint angle. Muscle length at end ROM increased (13%) without a change in fascicle length, fascicle rotation, tendon elongation, or tendon stiffness following training. A lack of change in maximum voluntary contraction moment and rate of force development at any joint angle was taken to indicate a lack of change in series compliance of the muscle-tendon unit. Thus, increases in end ROM were underpinned by increases in maximum tolerable passive joint moment (stretch tolerance) and both muscle and fascicle elongation rather than changes in volitional muscle activation or motoneuron pool excitability.

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Effect of plantar flexor muscle stiffness on selected gait characteristics

Gait & Posture ◽

10.1016/s0966-6362(00)00047-3 ◽

2000 ◽

Vol 11 (3) ◽

pp. 207-216 ◽

Cited By ~ 36

Author(s):

Gretchen B Salsich ◽

Michael J Mueller

Keyword(s):

Muscle Stiffness ◽

Plantar Flexor ◽

Flexor Muscle ◽

Gait Characteristics

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Acute Effect of Vibration Roller With and Without Rolling on Various Parts of the Plantar Flexor Muscle

Frontiers in Physiology ◽

10.3389/fphys.2021.716668 ◽

2021 ◽

Vol 12 ◽

Author(s):

Masatoshi Nakamura ◽

Shigeru Sato ◽

Ryosuke Kiyono ◽

Riku Yoshida ◽

Yuta Murakami ◽

...

Keyword(s):

Elastic Modulus ◽

Muscle Strength ◽

Athletic Performance ◽

Muscle Stiffness ◽

Plantar Flexor ◽

Flexor Muscle ◽

Jump Performance ◽

Muscle Belly ◽

Shear Elastic Modulus ◽

Passive Torque

A single use of a vibration foam roller likely increases the range of motion (ROM) without decreasing muscle strength and athletic performance. However, to date, no study compared the effects of a vibration roller with and without rolling on various parts of the plantar flexor muscle. Therefore, this study aimed to compare the effects of the vibration foam roller with rolling or without rolling at the muscle-tendon junction (MTJ) or the muscle belly on dorsiflexion (DF) ROM, passive torque at DF ROM, shear elastic modulus, muscle strength, and jump performance. Fifteen healthy young males performed the following three conditions: (1) vibration rolling over the whole muscle-tendon unit, (2) static vibration on muscle belly, and (3) static vibration on MTJ for three-set 60-s vibration in random order. In this study, DF ROM, passive torque, shear elastic modulus, muscle strength, and single-leg drop jump were measured before and immediately after the interventions. The DF ROM and passive torque at DF ROM were increased after all three conditions, whereas the shear elastic modulus was decreased after vibration rolling and static vibration on the muscle belly, but not following static vibration of the MTJ. In addition, there were no significant changes in muscle strength and jump performance in any group. Our results showed that vibration with rolling or static vibration on muscle belly could be effective to improve ROM and muscle stiffness without adverse effects of muscle strength and athletic performance.

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