Effects of Plantar Flexor Muscle Static Stretching Alone and Combined With Massage on Postural Balance

Abstract

ObjectiveTo evaluate and compare the effects of stretching and combined therapy (stretching and massage) on postural balance in people aged 50 to 65 years.MethodsTwenty-three subjects participated in this nonrandomized clinical trial study. Each participant randomly received plantar flexor muscle stretching (3 cycles of 45 seconds with a 30-second recovery period between cycles) alone and in combination with deep stroking massage (an interval of at least 30 minutes separated the two interventions). The data were recorded with a force platform immediately after each condition with eyes open and closed. The center of pressure displacement and velocity along the mediolateral and anteroposterior axes were calculated under each condition. The data were analyzed with multiple-pair t-tests.ResultsThe center of pressure displacement and velocity along the mediolateral axis increased after both stretching and the combined intervention. There were significant differences in both values between participants in the stretching and combined interventions (p<0.05).ConclusionPlantar flexor muscle stretching (for 45 seconds) combined with deep stroking massage may have more detrimental effects on postural balance than stretching alone because each intervention can intensify the effects of the other.

Passive stretching decreases muscle efficiency in balance tasks

“…The present results are partially in line with previous investigations, in which an overall worsening in BC after PS was reported [ 3 , 8 , 9 ]. In particular, an increase in postural sway accompanied by an increase in gastrocnemius lateralis activation was previously reported [ 3 ].…”

“…Particularly, an alteration in the afferent feedback coming from the proprioceptors of the stretched muscle has been advocated as a possible mechanism underlying the PS-induced reduction in muscle force-generating capacity [4,5]. Interestingly, these mechanical and neuromuscular factors may also affect BC [3,8,9], even though the literature on this subject is controversial. Indeed, improvements [10][11][12], worsening [3,8,9], or no changes [10] in BC were reported after PS.…”

Selective effect of static stretching, concentric contractions, and a balance task on ankle force sense

“…However, our results do relate to findings from different authors on the acute effects of static stretching. Such studies reported a significant decrease in postural control after static stretching of calf muscles [23,24,35] which could also be related to deterioration of ankle force sense, and may consequently impair balance control with ankle strategy. Reduced ankle force sense acuity can be also explained as being caused by reduced muscle power output and muscle force after static stretching [36,37] thus affecting force sense perception.…”

“…These changes could be due to mechanical adaptations of muscle-tendon unit and adjustments in the neural system. Static stretching may also cause peripheral changes such as reduced passive MTU stiffness and increased MTU length [24] which affects muscle spindle receptors and Golgi tendon organs. Changes at the neural level are associated with decreased afferent input into the motor neuron pool, and therefore on reduced tonic reflex activity [25].…”

“…Acute decreases in kinaesthetic acuity were observed following proprioceptive neuromuscular facilitation stretching (PNF) [14], while others demonstrated that static muscle stretching has no effect on kinaesthetic senses [15,22,23]. Static stretching could alter kinaesthesia because of reduced passive muscle-tendon unit (MTU) stiffness, increased MTU length [24] and changes in neural level (reduced tonic reflex activity) [25]. It is also known that balance training induces spinal and supraspinal adaptations in all sensory systems [26] and evokes sensory reorganization [27], but there is no evidence on the acute influence of balance training on different tests for measuring kinaesthesia.…”