| | Abstract | This written report aimed to clarify the acute furnishings of static stretching (SS) and cyclic stretching (CS) on muscle stiffness and hardness of the medial gastrocnemius musculus (MG) by using ultrasonography, range of motion (ROM) of the ankle joint and ankle plantar flexor. Xx healthy men participated in this study. Participants were randomly assigned to SS, CS and command atmospheric condition. Each session consisted of a standard five-minute bicycle warm-up, accompanied by one of the subsequent conditions in another day: (a) 2 minutes static stretching, (b) 2 minutes cyclic stretching, (c) control. Maximum talocrural joint dorsiflexion range of motion (ROM max) and normalized acme torque (NPT) of ankle plantar flexor were measured in the pre- and mail-stretching. To assess muscle stiffness, muscle-tendon junction (MTJ) displacement (the length changes in tendon and muscle) and MTJ angle (the angle made by the tendon of insertion and muscle fascicle) of MG were measured using ultrasonography at an ankle dorsiflexion angle of −10°, 0°, 10° and 20° earlier and afterwards SS and CS for 2 minutes in the pre- and post-stretching. MG hardness was measured using ultrasound existent-time tissue elastography (RTE). The results of this study betoken a significant result of SS for ROM maximum, MTJ angle (0°, ten°, twenty°) and RTE (10°, 20°) compared with CS (p < 0.05). There were no significant differences in MTJ displacement between SS and CS. CS was associated with significantly higher NPT values than SS. This study suggests that SS of 2 minutes' hold duration significantly affected muscle stiffness and hardness compared with CS. In add-on, CS may contribute to the elongation of muscle tissue and increased muscle strength. | Key words: Static stretching, cyclic stretching, muscle stiffness, musculus hardness, real-time tissue elastograpy | Key Points - This study examined the acute furnishings of static and cyclic stretching on muscle stiffness and hardness
- SS of 2 minutes' hold duration significantly affected in musculus stiffness and hardness compared with CS.
- CS may contribute to the elongation of muscle tissue and increased muscle strength.
| Stretching improves skeletal muscle flexibility and physical operation. Sports activities specialized stretching has yielded the most of import outcomes in relation to preventing injuries (Lewis 2014 ; Zakaria et al., 2015 ). Typically, static stretching (SS), which holds the muscles at extended positions without recoil, is used for improving muscle flexibility. SS is widely used in warm-upwardly routines in athletic practice or competitions because it is easy and safe. However, previous enquiry shows SS decreases muscle power and subsequent functioning (Behm and Chaouachi 2011 ; Behm et al. 2016 ; Kay and Blazevich 2012 ). In contrast, previous studies reported that DS may increase musculus forcefulness and physical performance when the DS flow is extended (Ryan et al., 2010 ; Yamaguchi et al. 2007 ). Yet, DS may not be as effective equally SS in increasing muscle viscoelasticity in a single warm-upwards session (Behm and Chaouachi 2011 ; Behm et al. 2016 ). McNair et al. ( 2001 ) found that abiding velocity stretching (cyclic stretching, CS) decreases muscle stiffness by decreasing the dynamic torque at the same angular velocity. CS involves moving the joint at a constant bending and charge per unit using a dynamometer and a continuous passive move device (Nordez et al., 2009 ). Previous studies have shown that the passive torque and stiffness are altered immediately after cyclic stretching protocols (Magnusson et al., 1998 ; McNair et al., 2001 ; Nordez et al., 2008 ). Moss et al., ( 2011 ) reported that a drop landing was not influenced by SS. Furthermore, we found that dynamic residuum after jump and landing was not affected by SS, but CS was suggested to meliorate dynamic residue ability (Maeda et al., 2016 ). However, to our knowledge, the characteristics and differences betwixt SS and CS have not been previously investigated using ultrasonography in good for you men. Peculiarly, it is unknown whether or not an acute result of cyclic stretching changes the passive fascicle stiffness of medial gastrocnemius muscle (MG). This study aimed to clarify the acute effects of SS and CS on muscle stiffness and hardness of MG by using ultrasonography and measuring muscle strength. Muscle stiffness is divers as the ratio of change in force to alter in length along the longitudinal axis of musculus (Murayama et al., 2005 ), while muscle hardness is divers as the resistance that muscle exerts on vertical force per unit area (Alamäki et al., 2007 ). We hypothesized that SS decreases muscle stiffness and hardness compared with CS. However, CS decreases muscle hardness compared with the control status and maintains muscle power compared with SS. Participants A total of 20 salubrious, recreationally agile men (mean, SD: historic period 22.8 ± 1.iv years; peak, 1.70 ± 0.01 m; body mass 63.four ± 8.three kg) voluntarily participated in the study. "Recreationally agile" was defined as participation in at to the lowest degree i practice session per week in the preceding two months, and no involvement in any structured power or flexibility preparation during this catamenia (Costa et al., 2009 ). Subjects were excluded if they had current ligamentous defects, history of a sprain of grade II or worse, history of ligament or joint reconstruction or repair, trauma (including fracture, myositis ossificans or burns), or dysfunction of the vestibular system affecting balance. The subjects performed iii different protocols (CS, SS and command) in randomly on three separate days, with an interval of at least 24 h and no more than 48 h between tests. All subjects were able to complete the study. The average elapsing of each condition was 52.0±3.0 minutes. The power for each analysis of variance was not less than 0.65 for an effect size of more than than 0.eighty (Cohen, 1998 ). A priori power assay by G*ability revealed that a static power of 0.75 at an effect size of 0.80 with an alpha level of 0.05 required a sample size of at to the lowest degree 20 subjects. This study was approved by the Center for Integrated Medical Inquiry of Hiroshima University (study protocol ID number: E-341), and all subjects gave informed consent to participate in the study. Experimental pattern and procedures Subjects were assigned to 3 randomly ordered experimental conditions (SS, CS, and control) and their gild was counter-counterbalanced across subjects. Limb stretching was performed on the not-dominant limb for unilateral assessment to clinch consistency in information drove amid the subjects (Hicks et al., 2016 ). The not-dominant limb was defined as the limb that was not used to boot a soccer ball; all subjects were determined to be right-leg ascendant. Stretching weather were randomly performed by all subjects with their hips and knees in total extension while prone on a footplate with the talocrural joint at an bending of −10° (ten° of plantarflexion: control condition) or at maximum dorsiflexion (SS condition). For the CS condition, a stretching device with a Biodex III dynamometer (Sakai Medical Co., Ltd., Tokyo, Japan) was used to produce cycles at x°/s with the ankle moving from plantarflexion to 80% of maximum dorsiflexion. McNair ( 2002 ) reported that CS from 0 to 80% of maximum dorsiflexion does not evoke a stretch reflex Therefore, stretching with the talocrural joint at 80% of maximum dorsiflexion was used in the current study. The stretching time was based on the findings of Kanazawa et al. ( 2009 ) showing that maximum dorsiflexion reached a plateau after two minutes when both the gastrocnemius and Achilles tendons underwent SS at maximum dorsiflexion in a prone position. Surface electromyographic signals (sEMG) of lateral gastrocnemius musculus were too recorded synchronously with the torque and bending data to ensure that no undesirable activation occurred during the stretching protocol. Assessment of maximum ankle dorsiflexion range of move To make up one's mind the upshot of stretching in each stretching condition, we measured the degree of maximum ankle dorsiflexion range of move (ROM max) pre and post-stretching of SS, CS and command protocols. The subjects were placed in the decumbent position, with the knee joint fully extended on the test bed. Measurement of the degree of passive dorsiflexion after each condition was performed three times using a Biodex III that was programmed to automatically move the footplate according to bending measurements. The boilerplate of the 3 trials was used as the measurement value. The maximum degree of ankle dorsiflexion was defined every bit the angle at which the subjects started to experience discomfort or painful. Assessment of normalized peak torque of plantar flexor Subjects lay on a Biodex Iii bed in prone position with 0˚ hip and knee angles, and their non-dominant feet were firmly fixed at 0˚ to the footplate with two non-elastic straps. Normalized peak torque in ankle plantar flexion ability was exerted by the ankle plantar flexor muscles with the maximum force held for 3 southward. For all subjects, isometric musculus power measurements were performed three times for the non-dominant leg. The average of the 3 trials was used as the measurement value. Subjects rested for 1 infinitesimal subsequently each exam to avoid fatigue. Subjects were advised to give maximal attempt with verbal encouragement from the investigator during each measurement. Previous inquiry has demonstrated excellent reliability for this test, with intra-class correlation coefficient test-retest values between 0.94 and 0.99 for isometric dynamometers (Webber and Porter 2010 ). Assessment of B-way ultrasonography and existent-time tissue elastography Axial B-mode and real-time tissue elastography (RTE) images of the non-dominant MG were obtained before and later each stretching status using a digital ultrasound system (Hullo VISION Avius; Hitachi Aloka Medical Japan, Tokyo, Nippon) with a xiv–16 MHz linear array transducer (EUP-L65; Hitachi Aloka Medical Nihon). As reference material, an acoustic coupler (EZU-TECPL1; Hitachi Aloka Medical Nihon) was placed onto the transducer with a plastic zipper (EZU-TEATC1; Hitachi Aloka Medical Japan). The elasticity of the audio-visual coupler was 22.vi±2.2 kPa according to cloth testing performed by the manufacturer. Cess of muscle stiffness The muscle-tendon junction (MTJ) deportation and angle for evaluating muscle stiffness were measured and visualized as a continuous sagittal plane ultrasound image using an 8-MHz linear array probe. An acoustically reflective marker was placed on the skin under the ultrasound probe to ostend that the probe did not movement during measurement (Maganaris, 2005 ; Morse et al., 2008 ). The probe was fixed with a transmission fixed frame stock-still with tape to the surface of the target muscle. Ultrasound images of the MTJ displacement and bending were quantified using open up-source digital measurement software (ImageJ, National Institutes of Health, Bethesda, Doctor, USA). For accuracy in measurement, MTJ was identified at the innermost edges of the fascia surrounding the muscle where it fuses with the tendon. MTJ displacement was measured every 10° from 0° to xx° of ankle dorsiflexion and the magnitude of change for each bending from a reference value of −x° was calculated. MTJ angle was fabricated by the tendon of insertion and musculus fascicle (MTJ angle) of MG (Kumamoto et al. 2007 ) and measured every 10° from 0° to 20° after each condition was performed. Assessment of muscle hardness using real-time tissue elastography In this written report, the location of the ultrasound probe was adapted on a line fatigued on the muscle belly of the MG (70% of the distance between the medial point of the knee joint infinite and the central point of the medial malleolus) and so that we could scan the eye region of the MG. The location of the probe was marked with semi-permanent ink on the pare surface and redrawn when fading. The probe was consistently placed on the mark and then that RTE measurement was performed at the same position for every measurement. The scanning caput of the probe was coated with transmission gel to obtain acoustic coupling. RTE images were obtained by manually applying calorie-free repetitive compression (rhythmic pinch-relaxation cycle) with the transducer in the browse position. To obtain appropriate images for investigation, we applied the transducer with abiding repeated pressure, monitoring the pressure indicator incorporated into the ultrasound scanner. The RTE image appeared every bit a translucent, color-coded, real-fourth dimension image superimposed on the B-mode paradigm. The calibration ranged from blue for components with less strain (i.east., the hardest components) to red for components with greater strain (i.e., the softest components). Dark-green indicated boilerplate strain. The sharpest (clearest) is checked in scanning process. The mean strain in the region of interest (ROI) was monitored in a strain graph to arrange and maintain the strength and frequency of the pinch. The frequency was adjusted from 2 Hz to 4 Hz depending on each individual and status so that the elastogram was sufficiently superimposed on the ROI. The strain charge per unit inside each ROI was automatically measured using built-in software, and the strain ratio (reference/muscle ratio, i.due east. the strain measured in the ROI of the reference divided by the strain in the ROI of the musculus) was calculated for each image. The RTE in response to the compression strength is physically smaller in harder tissue than in softer tissue. Therefore, equally the muscle becomes harder, the value of RTE decreases. RTE measurements were performed 3 times, and the mean values were calculated. The same examiner positioned all ROIs and performed all measurements. Loftier intra-observer reproducibility has been previously shown in the muscle/reference ratio of three repeated RTE measurements (Yanagisawa et al., 2011 ). Statistical assay Repeated-measures 2 (time) × 3 (stretching condition) analysis of variance (ANOVA) model was used for comparisons of changes in ROM in both stretching conditions (SS and CS) and the control condition. When appropriate, follow-upwards analyses were performed using paired t-tests betwixt pre- and post- stretching to confirm significant changes within each condition. A repeated-measures ane (time) × 3 (stretching condition) assay of variance (ANOVA) model was used for comparisons of ROM max, NPT, MTJ displacement, MTJ angle and RTE between both stretching weather (SS and CS) and the command condition. When appropriate, follow-up analyses were performed using Bonferroni post hoc tests. An alpha level of .05 was the criterion for rejection of the nil hypothesis for all statistical tests. Outcome sizes were calculated using the Cohen d statistic. The intraclass correlation coefficient (ICCi,3) was used to appraise intraobserver reliability. The ICC1,three was calculated for MTJ displacement, MTJ angle and RTE in the command condition. Result size was calculated using the formula f = d* √1/2k, where d = (one thousandmax − grandmin )/σ and k = the number of treatments. Observed power was generated by SPSS software. Information analysis was conducted using SPSS for Windows, 5. 23.0 (IBM Japan Co., Tokyo, Japan). The ICC1,3 values of MTJ displacement, MTJ angle and RTE from 0° to 20° in the control condition are shown in Table 1. Overall, intraobserver reliability of MTJ displacement, MTJ angle and RTE were high. The range of ICCone,3 values observed was 0.99–1.00 for MTJ displacement, 0.92–0.99 for MTJ bending and 0.90–0.99 for RTE. Repeated-measures ANOVA did detect significant intervention (stretching condition)×time (pre- and post-intervention) interaction (p < 0.01). The paired t-exam analyses indicated that SS and CS condition significantly between pre and post-stretching. The angle and modify in range of dorsiflexion pre and post-stretching are shown in Table 2. ROM max, NPT, MTJ displacement, MTJ bending and RTE later on the three conditions are shown in Tabular array 3 and Tabular array 4. The value of ROM max after SS was significantly higher than afterwards CS and control. The value of ROM max after CS was significantly college than afterward command. NPT after CS was significantly higher than after SS. MTJ deportation of 0°, 10° and 20° later SS was significantly higher than after control. MTJ displacement of 10° and xx° after CS was significantly college than later command. MTJ angle of 0°, 10° and xx° later on SS was significantly lower than afterward CS. RTE of 0° afterwards SS and CS was significantly higher than afterward control. RTE of 10° and twenty° after SS was significantly higher than after CS and control. RTE of 0° and 20° afterwards CS was significantly higher than after control. The aim of this study was to examine the acute effects of stretching MG of the non-dominant limb on muscle stiffness and hardness, dorsiflexion bending and isometric musculus ability, after SS with the ankle, CS at a repeated constant velocity of 10°/s, or no stretching intervention (control) for 2 minutes. The caste of ROM max was significantly increased later SS and CS compared with the control status. Siatras et al. ( 2008 ) plant that the ankle ROM increased significantly afterward SS of more xxx s. Previous studies have too shown that ROM max increased significantly after SS and CS (Avela et al. 1999 ; Chaouachi et al. 2017 ; Ryan et al. 2010 ; Witvrouw et al. 2004 ). Thus, the findings of the present study are like to those of previous studies. Furthermore, ROM max after SS was significantly increased compared with CS. However, the electric current study was non clear the physiological reason that there was significant deviation between SS and CS. Subsequently SS, Nakamura et al. ( 2011 ) reported that decrease of muscle stiffness was caused by increasing the flexibility and movement of the aponeurosis and the connective tissue, e.g., endomysium, perimysium, and epimysium, instead of lengthening muscle cobweb. After CS, previous written report reported that bonds between actin and myosin filament contributed to the muscle passive tension, and these bonds were broken past increasing muscle length on using brusk-range experiments in isolated muscle (Proske et al. 1999 ; Whitehead et al. 2001 ). In addition, changes in structural organization of muscle could possibly occurred during motion and induce muscle thixotropy. For example, more mobile constituents such equally the polysaccharides and water might exist redistributed during cyclic stretching (McNair et al. 2001 ). It was considered that difference in the ROM betwixt weather condition due to the deviation of machinery in decreasing the muscle stiffness. NPT of the plantar flexor was significantly higher after CS compared with SS. CS tended to increment NPT compared with the control condition. McNair et al. ( 2001 ) reported that dynamic torque and muscle stiffness were maintained later on CS simply not later on SS. Additionally, Çelik ( 2017 ) reported an increase in muscle strength after CS for volleyball players. This study'southward results suggest that CS may be beneficial, as it increases both flexibility and strength in MG of immature males. Therefore, CS may contribute non only to flexibility but as well to increase in musculus strength. MTJ displacement and RTE were significantly increased after SS and CS compared with the control condition. Furthermore, MTJ angle (each bending) and RTE (10°, 20°) subsequently SS were significantly different compared with CS. Decreased muscle stiffness after SS was also reported by Kay et al. ( 2015 ). In the present study, RTE and MTJ bending after CS was significantly college than the control condition. This indicates that CS decreases muscle stiffness and hardness, and suggests the possibility of CS existence stretching method that does not farther decrease muscle strength. Bressel et al. ( 2002 ) showed that torque relaxation for prolonged interventions is greater subsequently SS than after CS. Thus, this is the first study to show an acute outcome of CS of decreased muscle stiffness and hardness with increased musculus ability compared with SS. A few limitations of the nowadays study need to be considered. It had a small sample size; future epidemiological studies should be conducted in a consistent style with a large number of participants. Second, despite the fact that MG and lateral gastrocnemius musculus are the two-articulation muscles that intersect for the knee and talocrural joint joints, passive elongation and stretching are performed simply in the genu extension position. Thus, it is unclear whether the differences in passive muscle stiffness betwixt MG and LG in the knee extended position can exist observed in the knee flexed position. Finally, the acute effects later on SS and CS stretching were examined, not the long-term effect. Previous studies have examined the furnishings of long-term SS or CS on joint ROM (Gajdosik et al., 2007 ), just at that place are few reports on the deviation in the effects of intervention of SS versus CS on muscle stiffness, hardness and power. Further studies are needed to verify the effects of long-term SS and CS. More detailed exam of the effects of different stretching-speed changes of CS on the viscoelastic properties of connective tissues surrounding the muscles is too required. Conclusions This study examined the effects of SS and CS on ROM, NPT, muscle stiffness and hardness. The results bespeak that the ROM max after SS was significantly greater compared with CS and Command. NPT after CS was significantly higher than after SS. A significant decrease in muscle stiffness and hardness subsequently SS was observed compared with CS. Still, CS suggests the possibility of being a muscle stiffness method that does not further decrease musculus power. ACKNOWLEDGEMENTS | We would like to give thanks all volunteers for participating in this study. This work was supported by JSPS KAKENHI Grant Number 17K01672. The authors declare that they have no conflict of involvement. The experiments comply with the electric current laws of the state. | | AUTHOR BIOGRAPHY | | Noriaki Maeda | Employment: Lecturer, Department of Sport Rehabilitation, Graduate of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan | Degree: hD | Research interests: Disabled sports, evaluation for physical performance, Physical conditioning | E-mail: norimmi@hiroshima-u.ac.jp | | | Yukio Urabe | Employment: Professor, Department of Sport Rehabilitation, Graduate of Biomedical & Wellness Sciences, Hiroshima University, Hiroshima, Nihon | Degree: PhD | Research interests: ACL injury and prevention, Prevent the elderly from falling | E-mail: yurabe@hiroshima-u.ac.jp | | | Shogo Tsutsumi | Employment: Section of Sport Rehabilitation, Graduate of Biomedical & Wellness Sciences, Hiroshima University, Hiroshima, Japan | Degree: MSc | Research interests: Biomechanics, stretching, injury prevention | E-post: stutumi151@gmail.com | | | Shogo Sakai | Employment: Section of Sport Rehabilitation, Graduate of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan | Degree: MSc | Inquiry interests: Stretching, injury prevention, evaluation for physical performance | E-mail: shogo-sakai@hiroshima-u.ac.jp | | | Hironori Fujishita | Employment: Department of Sport Rehabilitation, Graduate of Biomedical & Wellness Sciences, Hiroshima University, Hiroshima, Japan | Caste: MSc | Research interests: Disabled sports, biomechanics, injury prevention | E-mail: h-fujishita@hiroshima-u.air conditioning.jp | | | Toshiki Kobayashi | Employment: Professor, Department of Prosthetics and Orthotics, Kinesthesia of Health Sciences, Hokkaido University of Science, Hokkaido, Japan | Degree: PhD | Research interests: Biomechanics, gait analysis, ankle –pes orthosis, prosthetics | E-mail: kobayashi-t@hus.air conditioning.jp | | | Makoto Asaeda | Employment: Physical Therapist, Section of Sports Medical Center, Hiroshima University, Hiroshima, Japan | Degree: PhD | Research interests: Biomechanics, ACL injury, Orthopedic disease | Email: asaeda@hiroshima-u.ac.jp | | | Kazuhiko Hirata | Employment: Physical Therapist, Department of Sports Medical Center, Hiroshima Academy, Hiroshima, Japan | Degree: PhD | Research interests: Biomechanics, ACL injury, Orthopedic disease | E-mail: hiratakz@hiroshima-u.ac.jp | | | Yukio Mikami | Employment: Doctor, Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Nippon | Degree: PhD | Research interests: Physical rehabilitation, Human Medical Technology, Musculoskeletal disorder | Eastward-mail: ymikami@outlook.com | | | Hiroaki Kimura | Employment: Doc, Department of Rehabilitation, Hiroshima University Hospital, Hiroshima, Japan | Caste: PhD | Research interests: Human Medical Engineering science, Medical organisation | Email: luna@hiroshima-u.ac.jp | | | | REFERENCES | Alamäki A., Häkkinen A., Mälkiä Due east., Ylinen J. 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