Muscle Length Test Research Articles

The test-induced warm-up effect on hamstring flexibility tests.

Although the effect of active warm-up (WU) on acute flexibility enhancement is well documented, the test-induced WU effect in muscle length test has not been widely studied. This study aimed to verify the test-induced WU effect on hamstring flexibility tests. The active knee extension (AKE) was performed using the right leg, whereas the straight leg raise (SLR) was performed using the left leg. Ten trials of AKE or SLR were performed: two as the pre-intervention trials (Pre); six as the WU intervention; and another two trials as the post-intervention (Post). During WU, subjects in the WO-Hold group performed six trials of the AKE or SLR without hold, and those in the W-Hold group performed six trials of the AKE or SLR with a 5 s hold. A significant difference was noted between Pre-AKE and Post-AKE, and between Pre-SLR and Post-SLR, respectively, in both the groups. The effect of WU is clear when performing consecutive AKE or SLR without any additional hold. Practitioners should be cautious in interpreting the testing result to avoid overestimation of the treatment effect since the test itself may induce substantial WU effect to the target tissues.

Prevalence of Pelvic Crossed Syndrome in Females with Primary Dysmenorrhea and its Impact on Physical Activity: An Observational Study

Context: Pelvic crossed syndrome (PCS) often known as lower crossed syndrome, which is a clinical pattern of muscle imbalance around the pelvis, has been reported more frequently in females than males of the same age. Primary dysmenorrhea (PD), which is another prevalent condition in females, is a leading cause of work absenteeism. As menstrual pain has been reported with change in musculoskeletal structure around the pelvis and lumbar area, this syndrome could be a missing link, which describes the severity of the condition, and may have an impact on physical activity. Aims: The objective of the current study is to find the prevalence of PCS in females with PD and its impact on physical activity. Settings and Design: This was an observational study undertaken in colleges of Belagavi City for a period of 6 months. Subjects and Methods: A total of 305 females with PD were recruited based on the inclusion criteria. They were assessed for PCS using Thomas test and modified Schober’s test for muscle length and manual muscle testing grades for muscle strength, after which were subjected to Simple Physical Activity Questionnaire. Statistical Analysis: The data were analyzed using SPSS version 23 software descriptive statistics and Chi-square test. Results: The prevalence of PCS in females with PD is 28.5% with 44% of those experiencing severe PD, whereas 23% of those with moderate-to-severe PD. The impact of the same on physical activity was found significant with 67% of females with PD involving in only 1 h of physical activity for every 24 h. Conclusions: Pelvic cross syndrome affects physical activity significantly and is prevalent in 28.5% of females with PD.

Prevalence of Upper Trapezius Tightness Due to Chronic Neck Pain and Poor Posture in University going Students

Aim: This study aimed to find out the prevalence of upper trapezius tightness due to chronic neck pain and poor posture in university students. Methods: An observational study design was opted for this research and a sample size of 360 participants were enrolled using non probability convenient sampling technique. Participants were selected on the basis of inclusion criteria which was undergraduate students of both gender above age 18 years. Data was collected using upper trapezius muscle length test to assess muscle tightness and Neck Pain Index Disability (NDI) questionnaire. For statistical analysis, SPSS version.24 was used and prevalence was interpreted using frequency tables and graphs. Association with chronic neck pain and poor posture was determined using chi square. P<0.05 was considered to be significant. Results: Upper trapezius tightness was found quite prevalent among university students. Results showed that 53.9% students could not lift heavy objects. 68.1% students could not read properly, 74.2% students had headache, 60% of students could not concentrate properly, 60.3% students had issues regarding sleep and 51.4% students could not be able to perform their recreational activities because of chronic pain in neck and poor postures while 52% students can drive easily with normal pain intensity due to upper trapezius tightness. Practical implication: This observational study would add and authenticate an evidence to the literature among the certain study population. This study would educate the university students and general population about posture related muscle pain and tightness which would help them identify the association between posture and muscular imbalance. Conclusion: This study concluded that upper trapezius tightness is highly prevalent among university student and it is strongly associated with chronic neck pain and poor posture. Keywords: Trapezius Muscle, Muscle Tightness, Neck Pain, Poor Posture, University Student.

Intra-Rater and Inter-Rater Reliability of Muscle Length Test for Extensor Digitorum Longus

Background A short extensor digitorum longus (EDL) is associated with limited ankle dorsiflexion, toe deformities (such as hammer toe and claw toe), and diabetic plantar ulcers. Therefore, measurement of EDL is important for the evaluation of patients with foot dysfunction. Purpose The aim of this study was to evaluate the intra- and inter-rater reliability of the muscle length test for EDL. Study design Repeated measures for intra- and inter-test reliability. Methods Thirty participants were recruited. Two physical therapists evaluated EDL length based on the difference in passive ankle plantar flexion angle between relaxed and flexed toe positions. Each examiner measured it in each participant three times. The intraclass correlation coefficient was used to assess the intra- and inter-rater reliability of the muscle length test for EDL. Results The intra- and inter-rater reliability values were 0.83 and 0.75, respectively. The standard error of measurement was 1.93° and the minimum detectable change was 5.35°. Conclusions The muscle length test is a reliable method for measuring EDL length in clinical practice.

Correlation between Postural Impairment and Lymphedema in Breast Cancer Survivors

The major complication of breast cancer is secondary lymphedema seen within few days to months after the surgery. Lymphedema has a debilitating effect on posture. The significance of this study is to show the effect of lymphedema on posture. These all have a huge impact on the quality of life of patients, within her family as well as working places. This study provides a platform to assess the spinal posture which may be at risk due to lymphedema in breast cancer survivors. Hence, the study is to find out correlation between spinal postural impairment and lymphedema in breast cancer survivors and to assess the correlation between demographic variables and lymphedema in breast cancer survivors. The aim of the study was to study and find out the correlation between postural impairment and lymphedema in breast cancer survivors. This was an observational study with the total of 116 breast cancer survivor women’s who had undergone radiotherapy and surgery were selected from Krishna Institute of Medical Sciences, Karad. Their age ranged from 35 to 60 years old. The outcome measures which were included are postural examination chart in the anterior, posterior, lateral views by plumb line, muscle length test, muscle strength test, pain assessment using visual analog scale, and lymphedema measurement using inch tape. The obtained results showed statistically high significant increase in the forward head posture, rounded shoulders, thoracic kyphosis and scoliosis, scapular dyskinesis, and increased volume of affected arm. There were high significant correlation between spinal postural impairments and lymphedema in breast cancer survivors and also correlation between demographic variables and lymphedema in breast cancer survivors.

Screening for Upper Cross Syndrome in Asymptomatic Individuals

Upper cross syndrome (UCS) refers to tightness of muscles such as pectoralis major, upper trapezius and levator scapulae and weakness of deep neck flexors, scalene, rhomboids, serratus anterior, middle and lower trapezius. Poor posture is associated with imbalance created in musculoskeletal system and common condition to be reported as upper cross syndrome. It is commonly seen in people with forward head posture, desk job workers, dentist, beauticians etc. The resulting clinical presentation is complaint of pain in neck and shoulder, cervicogenic headache, hunched upper-back and rounded shoulder. Children are not as proactive today and the rate of the UCS is on the rise. This deviated posture and sedentary lifestyle continues, where it progresses more as the age progresses in adulthood. To screen, detect, early treat as well as prevent upper cross syndrome in young individuals. Asymptomatic individual with 20-40 years of age group was explained about the procedure before commencement of the study. Posture was screened using REEDCO Posture Assessment Scale was used for evaluation. Assessment of muscle tightness and weakness was evaluated using muscle length tests and manual muscle testing. From the current study we conclude that prevalence of UCS is significantly less in asymptomatic individuals as compared to symptomatic. Although it is very important to practice good posture in daily routine in order prevent early signs of UCS. The parameters of outcome measures were analyzed by descriptive statistics only. Based on previous data we conclude that it is essential to screen asymptomatic individual to looks for signs of UCS for early detection, prevention and treatment. Keywords: Upper Cross Syndrome, Manual Muscle Testing, Muscle Length Testing.

A Review on Impact of Lower Extremity Muscle Length

Muscle length is known as the length at which muscle is able to generate the maximum amount of force. This length is determined by the joint angle corresponding to that muscle. Length of muscle is an important parameter of length-tension relationship. Muscle functions and its mechanics helps in surgical decision making, to establish primary ergonomic advice recommendations and to form a structure of recovery program using the benefits of length-tension relation. Understanding the optimal muscle length as well as its comparison between the extremities is very important as a part of examination in physiotherapy, particularly in the cases of musculoskeletal disorders. Several tests are available for testing the muscle length. However standardize and reliable tests are been chosen to prevent the error while testing as such measurement of hamstring, iliopsoas, rectus femoris and gastrocnemius length is been acquired through standard goniometer. The methods used for the assessment comprised of; active knee extension (AKE) tests the hamstrings, Thomas and modified Thomas test to evaluate iliopsoas and rectus femoris while prone, figure-four position accompanied by dorsiflexion for gastrocnemius. Many studies have done and their results had shown that there was difference in the lengths of muscle of lower extremity which was assessed in different players along with that normative data about the length of muscle was established. However there is paucity of study on the muscle length testing of individuals who are completely normal who are not having previous history of trauma to their lower limbs and those who are not an athlete.

Relationship Between Deep Squat And Joint Range Of Ankle Motion In Young Female Hockey Players

BACKGROUND: The "Deep Squat" (DS) is a qualitative functional test that integrates muscle strength, neuromuscular control, mobility and joint stability. This test has been frequently used to identify risk of musculoskeletal injury in varied populations. The active joint range of motion (AROM) is the arc of mobility that an individual performs during a voluntary movement, measured objectively by goniometer. PURPOSE: Identify the relationship between the DS and the AROM of the ankle measured by goniometer in young female hockey players who belong to Gimnasia Esgrima Rosario Club. METHODS: Twenty young and healthy female hockey players (age: 16.12 ± 1.16 years; Weight: 57.40 ± 6.32 Kg; Height: 161.42 ± 6.14 cm), participated in this study. Asymptomatic subjects were included, with no history of lumbar spine, hip, knee or ankle injuries. The functional DS test was measured by goniometer in angular degrees of movement for knee flexion, and three bilateral tests for the AROM of dorsiflexion of the ankle (a- Bipedal position with partial load; b- Seated with knee flexed at 90°; and c- Seated with knee at 0° of flexion). The Intraclass Correlation Coefficient (ICC: 0,832-0,993) and the Standard Error of Measurement (SEM: 0,803-0,971) were established by analysis of variance one way for each variable measured. We have applied matched t-test differences to determine statistical differences (SD) between dominant and non-dominant leg at p<0.05. Correlations were calculated through Pearson coefficient (r) between DS and right and left AROM mean values. RESULTS: No significant differences (ns) were found for dominant and non-dominant leg. Low correlation was found for dorsiflexion in bipedal position with partial load (r = 0.48; p <0.05) and seated with knee flexed at 90° (r = 0.39; p = 0.09 ns). However, a moderate correlation was found between the goniometric measurement of DS and dorsiflexion in the seat with 0° knee flexion (r = 0.61; p <0.01). CONCLUSION: Based on the results, we conclude that the DS measured objectively by goniometer has a moderate r with dorsiflexion seated with knee at 0° of flexion (gastrocnemius muscle length test). Therefore, in this sample, the DS test could be influenced by other determinants factors different from mobility, as they are the muscle strength, neuromuscular control and joint stability.

Joint Range of Motion and Muscle Length Testing, 2nd Edition

Joint Range of Motion and Muscle Length Testing, 2nd Edition

수동적 어깨뼈 정렬이 작은가슴근 단축된 사람의 등세모근 근활성도에 미치는 영향

The purpose of this study was to assess the influence of scapular alignment on the electromyographic (EMG) activity of the trapezius in people with a short pectoralis minor muscle. For the study, we recruited 15 volunteers who had positive results for short on a pectoralis minor muscle length test. We measured the EMG activity of the upper, middle and lower trapezius muscles. The participants lifted their dominant arm to ear level with the thumb up toward the ceiling in the prone position on a table with the shoulder at a flexion angle of 180 degrees and a horizontal abduction angle of 120 degrees. Scapula was manually aligned by an experienced physical therapist prior to arm lift for the scapular alignment condition. A paired t-test was used to compare the effects of scapular alignment on the EMG activity of the trapezius muscles. The EMG activity of the lower trapezius muscle was significantly increased during the test with the scapular alignment compared to that without scapular alignment (p.05). The findings of this study suggest that a scapular alignment may alter the recruitment of the lower trapezius muscle during arm lifting in the prone position in people with a short pectoralis minor muscle.

Muscle bleeds in professional athletes – diagnosis, classification, treatment and potential impact in patients with haemophilia

Muscle haematoma represents 10-25% of bleeds in patients with severe haemophilia. There is limited consensus on diagnostic or treatment strategies and little knowledge about the natural history of muscle haematoma and optimal treatment goals. The aim of this review was to perform a systematic description of the natural history of muscle haematoma in healthy athletes, focusing on diagnosis, classification and treatment options. Publications and educational textbooks on management of sports injuries were used as data source. Muscle haematomas occur following contusion, strain, or laceration and can be categorized as mild, moderate, or severe. Muscle haematoma may be inter- or intramuscular. In healthy athletes, the healing process takes 20-40 days. Optimal diagnosis includes history, physical examination (inspection, palpation, active and passive range of motion (ROM) test, muscle length test, isometric strength test, biomechanical examination, full spinal examination, peripheral nerve test and slump test), ultrasound, MRI or CT. Treatment is conducted based on: (i) super-acute stage, control of the bleeding and minimizing the size of the haematoma; (ii) acute stage, restoration of pain-free ROM; (iii) subacute stage, functional rehabilitation; and (iv) gradual return to normal activity. Treatment and preventive strategies include RICE (rest, ice, compression and elevation), protected mobilization, stretching and strengthening exercises, manual therapy (articular, neural and soft tissue mobilization and massage), correction of movement dysfunction, functional rehabilitation and electro-therapeutic interventions. The study reviews the natural history of muscle haematoma and state-of-the-art diagnosis and treatment in healthy athletes. Results may be useful to optimize diagnosis and treatment of muscle haematoma in patients with haemophilia.

Use of Anterior Tibial Translation in the Management of Patellofemoral Pain Syndrome in Older Patients: A Case Series

The currently most plausible pathophysiologic theory for the etiology of pain in patients with patellofemoral pain syndrome involves abnormal mechanical stress to the patellofemoral joint. At this time, there is no consensus nor is there a sufficient body of research evidence to guide management of patients with patellofemoral pain syndrome. This means that clinicians have to rely to some extent on a mechanism-based approach. Decreased quadriceps flexibility and muscular endurance have been identified as possibly relevant impairments in patients with patellofemoral pain syndrome. Surgical anterior translation of the tibial tuberosity with the Maquet procedure has a proven positive effect on patellofemoral contact forces. This case series studied the effects of a physical therapy management approach that included translating the tibia anteriorly while performing open kinetic chain quadriceps training and manual muscle stretching of the rectus femoris muscle. Outcome measures used included the numeric pain rating scale and goniometric measurement of rectus femoris muscle length in a standardized test position. Anterior tibial translation reduced pain during both interventions and also produced clinically and statistically significant pre- to post-intervention improvements in pain during manual muscle testing and rectus femoris length testing in addition to statistically significant pre- to post-intervention increases in rectus femoris muscle length. The results of this quasi-experimental study indicate the need for future experimental study. Future study should include functional in addition to impairment-based outcome measures, standardization and blinding for the rectus femoris muscle length test (should future researchers chose to again use this outcome measure), a pilot study establishing reliability of outcome measures collected by the therapist, younger subjects, and the collection of longer-term outcome data.

The use of tiagabine in pediatric spasticity management

Tiagabine, developed as an anti-epileptic medication, has the potential to reduce spasticity. The purpose of the present study was to assess the effectiveness of tiagabine in decreasing spasticity and improving the functional abilities of children with spastic cerebral palsy (CP). Nine children (seven females, two males) with CP (six spastic quadriplegia, three moderate to severe spastic diplegia) were treated with tiagabine for a mean of 7.2 months. Median age was 4y 5mo (range 3y 2mo-10y). All children were non-ambulatory. According to the Gross Motor Function Classification System, six were Level IV and three were Level V. Only one child showed a median decrease ≥1.0 grade on the modified Ashworth scale in upper extremities, lower extremities, and overall. Another child had significant improvement in the Pediatric Evaluation of Disability Inventory Self-care score and improved feeding. None of the participants was found to have a significant improvement in motor function or a decrease in the number of motions (passive range of motion and muscle length test) that were limited. Reduction of nocturnal awakenings from painful spasms was reported in one child. Eight of the nine children experienced adverse side-effects during treatment. Although tiagabine was not found to be effective in decreasing children's spasticity or improving their function, its potential use in the relief of painful spasms associated with neurological conditions in the pediatric population warrants further investigation.

The use of tiagabine in pediatric spasticity management

Tiagabine, developed as an anti-epileptic medication, has the potential to reduce spasticity. The purpose of the present study was to assess the effectiveness of tiagabine in decreasing spasticity and improving the functional abilities of children with spastic cerebral palsy (CP). Nine children (seven females, two males) with CP (six spastic quadriplegia, three moderate to severe spastic diplegia) were treated with tiagabine for a mean of 7.2 months. Median age was 4y 5mo (range 3y 2mo-10y). All children were non-ambulatory. According to the Gross Motor Function Classification System, six were Level IV and three were Level V. Only one child showed a median decrease >or=1.0 grade on the modified Ashworth scale in upper extremities, lower extremities, and overall. Another child had significant improvement in the Pediatric Evaluation of Disability Inventory Self-care score and improved feeding. None of the participants was found to have a significant improvement in motor function or a decrease in the number of motions (passive range of motion and muscle length test) that were limited. Reduction of nocturnal awakenings from painful spasms was reported in one child. Eight of the nine children experienced adverse side-effects during treatment. Although tiagabine was not found to be effective in decreasing children's spasticity or improving their function, its potential use in the relief of painful spasms associated with neurological conditions in the pediatric population warrants further investigation.

Muscle length effect on the pendulum test

Objective: An investigation of the effect of the length of knee extensor muscles on the pendulum test. Design: Descriptive. Statistical analysis utilized analysis of variance with planned comparisons. Setting: Community clubs and a stroke rehabilitation unit. Participants: Twenty subjects aged 54 to 83yrs, more than 6 weeks after stroke, and 31 healthy subjects aged 60 to 79yrs. Outcome Measures: Two tests: pendulum test and knee extensor muscle length test. Results: For both affected and intact legs, stroke subjects had significantly smaller angle of reversal ( p < .001), peak angular velocity ( p < .001), and maximum passive knee flexion ( p < .001) than healthy subjects. When angle of reversal was normalized for passive knee flexion, there were no significant differences between healthy and stroke subjects. There were no significant differences in any variable between the intact and affected legs of the stroke subjects. Conclusion: Soft tissue changes, rather than hyperreflexia, may explain the decreased angle of reversal and peak angular velocity in the stroke subjects studied.

The Effect of Levator Scapula Tightness on the Cervical Spine: Proposal of Another Length Test

Levator scapulae is a “twisted” muscle with four separate origins from upper cervical vertebrae and two folds at its attachment on the scapula. It is active with every movement of the arm and is frequently in static contraction in order to stabilise the scapulae during precision use of the hand. Although its role in shoulder movement has been well researched, its effect on cervical function has seldom been investigated. Described tests for length and tone seem to test only the more vertical fibres or do not make use of enough cervical rotation to test the more horizontal fibres.The hypothesis is made that the more horizontal fibres have a stronger tendency to become tight. An alternative muscle length test, emphasising C2 contralateral rotation, is described and substantiated from anatomy and possible biomechanics.102 subjects were assessed to determine the most effective way to test the length of levator scapula. The tests described by Janda, Travell and Simons were compared with the suggested alternative test. It was found that more subjects tested positive for decreased length in levator scapula in the C2 rotation test than in any of the others. A combination of this test and Janda's length test is suggested as a true assessment of levator scapula dysfunction.

Stretching

Static stretching exercises have become very popular over the past fifteen years both in professional and amateur sports. In the fields of physical therapy and in manual therapy, in particular, static stretching has become part of a standard and successful treatment modality. Together with an appropriate strengthening program, static stretching techniques have become the therapy of choice for treatment of muscle imbalances associated with functional disturbances of the musculoskeletal system. Specific muscle length testing procedures have been developed to determine muscle shortening in clinical practice. In this article, the fundamental principles of the different types of muscle stretching techniques are described, including the dynamic stretching and static stretching techniques. The exercises are organized along the concepts of passive static or neuromuscular stretching principles. The pertaining neurophysiologic fundamentals are discussed, as are the benefits of the individual methods of a functional exercise program. Examples are provided for the most important muscle groups.