APTA is a sponsor of the Decade, an international, multidisciplinary initiative to improve health-related quality of life for people with musculoskeletal disorders.Background and Purpose. Stretching protocols for elderly people (Ն65 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 ageϭ84.7 years, SDϭ5.6, rangeϭ 65-97) with tight hamstring muscles (defined as the inability to extend the knee to less than 20°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 (nϭ13, mean ageϭ85.1 years, SDϭ6.4, rangeϭ 70 -97), a control group, performed no stretching. The randomly selected right or left limb of subjects in group 2 (nϭ17, mean ageϭ85.5 years, SDϭ4.5, rangeϭ80 -93), group 3 (nϭ15, mean ageϭ85.2 years, SDϭ6.5, rangeϭ65-92), and group 4 (nϭ17, mean ageϭ83.2 years, SDϭ4.6, rangeϭ68 -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 stretchϭ2.4°per week, 30-second stretchϭ1.3°per week, 15-second stretchϭ0.6°per week), which persisted longer than the gains in any other group (group 4 still had 5.4°more ROM 4 weeks after treatment than at pretest as compared with 0.7°and 0.8°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. [Feland JB, Myrer JW, Schulthies SS, et al. The effect of duration of stretching of the hamstring muscle group for increasing range of motion in people aged 65 years or older. Phys Ther. 2001;81:1100 -1117 Key Words: Age, Elderly, Flexibility, Hamstring muscles, Lower extremity. [1][2][3][4][5] Stretching is important because it is believed to provide many physical benefits, including improved flexibility, 3,6,7 improved muscle or athletic performance, 8,9 improved running economy (decreased energy expenditure at a given speed), 10,11 injury prevention, 3,11 promotion of healing, and possibly decreased delayed-onset muscle soreness. 12,13 Although evidence to support these beliefs is limited, stretching appears to us to be in widespread use.Researchers have looked at the effect of different variables associated wit...
The purpose of this study was to determine whether the vastus medialis oblique muscle (VMO) had greater electrical activity than the vastus lateralis muscle (VL) when hip adduction and medial (internal) tibial rotation exercises were performed. Electrical activity of the VMO and VL was measured on 25 healthy subjects during maximal-effort isometric contractions of hip adduction and medial tibial rotation. The results showed that the electromyographic activity of the VMO was significantly greater than that of the VL during the hip adduction exercise. Differences noted with medial tibial rotation were not significant. The results suggest that the VMO may be selectively activated by performing hip adduction exercises. Resistive hip adduction exercises, therefore, may be advisable in the treatment of patients with lateral malalignment of the patella with accompanying pain or instability.
We assessed the reliability of the KT-2000 knee arthrometer at 67, 89, 134, and 178 N and at manual maximum forces on 30 college students who were free from present or previous knee injuries. Two examiners tested all subjects on two occasions. Anterior laxity (P < 0.0001) and side-to-side difference (P < 0.05) significantly increased as force increased. There was a significant difference (P < 0.0001) between testers for anterior laxity but not for side-to-side difference. We used intraclass correlation coefficients to estimate relative reliability. Anterior laxity intraclass correlation coefficients (2,1) between testers ranged from 0.81 to 0.86 and within tester correlations ranged from 0.92 to 0.95. Intraclass correlation coefficients for between testers for side-to-side differences ranged from 0.38 to 0.58 and within tester correlations ranged from 0.53 to 0.64. Subject-to-subject variability needs to be taken into account when interpreting intraclass correlation coefficient values. Our absolute reliability estimates (95% confidence intervals) were small, indicating little variability. Our data demonstrate the KT-2000 arthrometer to be reliable. Researchers should present both relative and absolute reliability estimates, although we believe absolute estimates are of greater clinical value. Side-to-side differences are better discriminators than individual absolute values. We recommend that a < 3 mm side-to-side difference be used to indicate stable knees.
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