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      The effects of three types of piriform muscle stretching on muscle thickness and the medial rotation angle of the coxal articulation

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          Abstract

          [Purpose] The purpose of this study was three kinds of stretching methods and measured the change in the thickness of the piriform muscle in real time using ultrasound images and compared the medial rotation angle of the coxal articulation. [Subjects and Methods] Fourty-five subjects who attend B University in Cheonan, divided into three groups. The subjects in these three groups then underwent stretching with flexion of coxal articulation over 90°, stretching with flexion of coxal articulation under 90°, and muscle energy technique (MET) application. The main outcome measures were piriform muscle thickness and medial rotation angle of the coxal articulation. [Results] All groups showed decreased piriform muscle thickness and increased medial rotation angle of the coxal articulation. [Conclusion] Based on the above results, three kinds of piriform muscle stretching methods are effective of reduce muscle thickness and increase medial rotation angle of the coxal articulation.

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          Neural and mechanical responses of the triceps surae muscle group after 1 h of repeated fast passive stretches.

          Janne Avela, Taija Finni, Tuomas Liikavainio … (2004)
          Experiments were carried out to examine interaction between mechanical changes of the muscle-tendon unit and reduced reflex sensitivity after repeated and prolonged passive muscle stretching (RPS). There is some evidence that this interaction might be relevant also during active stretch-shortening cycle type of fatigue tasks. The results demonstrated a clear deterioration of voluntarily and electrically induced muscle contractions after RPS. Maximal voluntary contraction (MVC), average electromyographic activities of the gastrocnemius and soleus muscles, and maximal twitch contraction decreased on average by 13.8, 10.4, 7.6, and 16.8%, respectively. In addition, there was a 14% lengthening in the total duration of the twitch. MVCs measured at different ankle joint angles revealed a downward and rightward shift in the torque-fascicle length curve after RPS. Interestingly, there was a crossing in the torque-fascicle length curves while measured at different activation levels but at the same joint angle before and after RPS. Even though no changes were observed in the activation level during MVCs, all the reflex parameters showed a clear reduction after RPS. This study presents evidence that repeated and prolonged passive muscle stretching can lead to some modification of material behavior of the aponeurosis-tendon system, such as stress relaxation and/or plastic deformation. In addition, altered material properties seem to affect proprioceptive feedback and, therefore, the motor unit activation in proportion to the contractile failure.
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            The effect of static stretch and dynamic range of motion training on the flexibility of the hamstring muscles.

            M Briggler, D Bandy, J Irion (1998)
            To date, limited information exists describing a relatively new stretching technique, dynamic range of motion (DROM). The purpose of this study was to compare the effects of DROM with static stretch on hamstring flexibility. Fifty-eight subjects, ranging in age from 21 to 41 years and with limited hamstring flexibility (defined as 30 degrees loss of knee extension measured with the femur held at 90 degrees of hip flexion), were randomly assigned to one of three groups. One group performed DROM 5 days a week by lying supine with the hip held in 90 degrees of flexion. The subject then actively moved the leg into knee extension (5 seconds), held the leg in end range knee extension for 5 seconds, and then slowly lowered the leg to the initial position (5 seconds). These movements were performed six times per session (30 seconds of total actual stretching time). The second group performed one 30-second static stretch, 5 days per week. The third group served as a control group and did not stretch. Before and after 6 weeks of training, flexibility of the hamstring muscles was determined in all three groups by measuring knee extension range of motion (ROM) with the femur maintained in 90 degrees of hip flexion. Data were analyzed with a 2 x 3 (test x group) two-way analysis of variance (ANOVA) with repeated measures on one variable (test) and appropriate post hoc analyses. The results of the two-way ANOVA revealed a significant interaction. Further statistical post hoc analysis of data to interpret the interaction revealed significant differences between the control group (gain = 0.70 degree) and both stretching groups, as well as a significant difference between the static stretch group (gain = 11.42 degrees) and the DROM group (gain = 4.26 degrees). The results of this study suggest that, although both static stretch and DROM will increase hamstring flexibility, a 30-second static stretch was more effective than the newer technique, DROM, for enhancing flexibility. Given the fact that a 30-second static stretch increased ROM more than two times that of DROM, the use of DROM to increase flexibility of muscle must be questioned.
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              Piriformis syndrome, diagnosis and treatment.

              Lawrence Kirschner, M Foye, Anthony Cole (2009)
              Piriformis syndrome (PS) is an uncommon cause of sciatica that involves buttock pain referred to the leg. Diagnosis is often difficult, and it is one of exclusion due to few validated and standardized diagnostic tests. Treatment for PS has historically focused on stretching and physical therapy modalities, with refractory patients also receiving anesthetic and corticosteroid injections into the piriformis muscle origin, belly, muscle sheath, or sciatic nerve sheath. Recently, the use of botulinum toxin (BTX) to treat PS has gained popularity. Its use is aimed at relieving sciatic nerve compression and inherent muscle pain from a tight piriformis. BTX is being used increasingly for myofascial pain syndromes, and some studies have demonstrated superior efficacy to corticosteroid injection. The success of BTX in treating PS supports the prevailing pathoanatomic etiology of the condition and suggests a promising future for BTX in the treatment of other myofascial pain syndromes.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Phys Ther Sci
                Journal ID (iso-abbrev): J Phys Ther Sci
                Journal ID (publisher-id): JPTS
                Title: Journal of Physical Therapy Science
                Publisher: The Society of Physical Therapy Science
                ISSN (Print): 0915-5287
                ISSN (Electronic): 2187-5626
                Publication date (Electronic): 21 October 2017
                Publication date (Print): October 2017
                Volume: 29
                Issue: 10
                Pages: 1811-1814
                Affiliations
                [1) ] Department of Physical Therapy, Baekseok University, Republic of Korea
                [2) ] Hanyang University Medical Center: 222-1 Wangsimni-ro, Seongdong-gu, Seoul 133-792, Republic of Korea
                Author notes
                [* ]Corresponding author. Sin Ho Chung (E-mail: wwin72@ 123456empal.com )
                Article
                Publisher ID: jpts-2017-295
                DOI: 10.1589/jpts.29.1811
                PMC ID: 5684014
                PubMed ID: 29184293
                SO-VID: c5b4801a-ef65-4186-ae0c-9d6384b5cf64
                Copyright © 2017©by the Society of Physical Therapy Science. Published by IPEC Inc.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: http://creativecommons.org/licenses/by-nc-nd/4.0/ )

                History
                Date received : 07 June 2017
                Date accepted : 12 July 2017
                Categories
                Subject: Original Article

                Keywords: piriform muscle stretching,muscle thickness,medial rotation angle
                Data availability:
                Keywords: piriform muscle stretching, muscle thickness, medial rotation angle

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