DOI QR코드

DOI QR Code

Effects of Gastrocnemius Stretching on α-Motor Neuron Excitability and Ankle Joint Active Dorsiflexion Range of Motion

비복근 스트레칭이 α-운동 신경원 흥분도와 족관절 능동 배측굴곡 가동범위에 미치는 영향

  • 김종순 (부산가톨릭대학교 보건과학대학 물리치료학과)
  • Published : 2009.09.28

Abstract

The aims of this study were to determined whether excitability of the $\alpha$-motor neuron is modulated by stretching and this changes were associated with flexibility of the muscle. In this study, $\alpha$-motor neuron excitability was measured by using the Hmax/Mmax ratio of the gastrocnemius H-reflex, and muscle flexibility was measured with the range of motion of the ankle dorsiflexion. The gastrocnemii of 10 healthy volunteers were stretched for 4 minutes(2 minutes stretching, 1 minute rest, and 2 minutes stretching) in each session by manual force. The Hmax/Mmax ratio of the H-reflex, as well as the range of motion of the ankle dosiflexion was measured through four different conditions: before stretching, as soon as after $1^{st}$ stretching, as soon as after $2^{nd}$ stretching and at 48 hours after $2^{nd}$ stretching. Excitability of the $\alpha$-motor neuron was decreased significantly after $1^{st}$ and $2^{nd}$ stretching(p<0.05). Furthermore, the range of the dorsiflexion was increased significantly after $1^{st}$ and $2^{nd}$ stretching(p<0.05). However, the excitability of the $\alpha$-motor neuron and range of the dorsiflexion at 48 hours after $2^{nd}$ stretching were not different from those of before stretching. These results suggest that reduced $\alpha$-motor neuron excitability of the gastrocnemius and increased flexibility of the ankle dorsiflexion would be followed by activation of the type III mechanoreceptor which around the ankle joint and the Golgi tendon organ in the gastrocnemius.

본 연구는 스트레칭이 $\alpha$-운동신경원의 흥분도를 변화시키는지의 여부와 이에 따른 유연성의 변화 정도를 알아보고자 시도되었다. 본 연구에서 $\alpha$-운동신경원 흥분도는 비복근 H-반사의 Hmax/Mmax 비로 측정하였으며 근육의 유연성은 족관절의 능동 배측굴곡 가동 범위를 통해 알아보았다. 스트레칭은 10명의 건강한 피검자를 대상으로 총 4분간(2분간의 스트레칭, 1분의 휴식, 2분간의 스트레칭), 각 시기별로 비복근에 적용하였다. $\alpha$-운동신경원 흥분도와 유연성을 분석하기 위해 본 연구에서는 스트레칭 적용 전, 1차 스트레칭 적용 직후, 2차 스트레칭 적용 직후, 그리고 2차 스트레칭 적용 후 48시간 후 Hmax/Hmax와 족관절의 능동 배측굴곡 각도를 측정하였다. 본 연구의 결과 1차와 2차 스트레칭 적용 후 의미 있는 $\alpha$-운동신경원 흥분도의 감소와 족관절 능동 배측굴곡 각도의 증가가 나타났으나 스트레칭을 소거한 48시간 후에는 $\alpha$-운동신경원 흥분도와 족관절의 능동 배측굴곡 가동 범위가 스트레칭 적용전과 비슷한 상태로 되돌아갔다. 이러한 스트레칭에 의한 비복근 $\alpha$-운동신경원 흥분도 감소와 이에 따른 족관절 배측굴곡 유연성 증가는 족관절 주변의 III형 기계적 수용기와 근육에 위치한 골지건 기관의 활성 결과로 사료된다.

Keywords

References

  1. P. A. Mortenson and J. J. Eng, "The use of casts in the management of joint mobility and hypertonia following brain injury in adults: a systematic review," Phys Ther, Vol.83, No.7, pp.648-658, 2003.
  2. M. Stokes, Physical management of neurological rehabilitation, Elsevier Mosby, 2004.
  3. M. J. Alter, Science of flexibility, Human Kinetics, 1996.
  4. J. M. Gracies, "Pathophysiology of impairment in patients with spasticity and use of stretch as a treatment of spastic hypertonia," Phys Med Rehabil Clin N Am, Vol.12, No.4, pp.747-768, 2001.
  5. J. B. Nielsen, C. Crone, and H. Hultborn, "The spinal pathophysiology of spasticity-from a basic science point of view," Acta Physiol(Oxf), Vol.189, No.2, pp.171-180, 2007. https://doi.org/10.1111/j.1748-1716.2006.01652.x
  6. C. T. Leonard, The neuroscience of human movement, Mosby, 1998.
  7. R. Schleip, "Fascial plasticity-a new neurobiological explanation : Part 1," J Bodyw Mov Ther, Vol.7, No.1, pp.11-19, 2003. https://doi.org/10.1016/S1360-8592(02)00067-0
  8. J. T. Cottingham, Healing through touch-a history and a review of the physiological evidence, Rolf Institute Publications, 1985.
  9. L. Jami, "Golgi tendon organs in mammalian skeletal muscle: functional properties and central actions," Physiol Rev, Vol.73, No.3, pp.623-666, 1992.
  10. A. M. Bakheit, V. Maynard, and S. Shaw, "The effects of isotonic and isokinetic muscle stretch on the excitability of the spinal alpha motor neurones in patients with muscle spasticity," Eur J Neurol, Vol.12, No.9, pp.719-724, 2005. https://doi.org/10.1111/j.1468-1331.2005.01068.x
  11. E. R. Kendel, J. H, Schwartz, and T. M. Jessell, Principles of neural science, McGraw-Hill, 2000.
  12. K. Funase, K. Imanaka, Y. Nishihira, and H. Araki, "Threshold of the soleus muscle H-reflex is less sensitive to the change in excitability of the motoneuron pool during plantarflexion or dorsiflexion in humans," Eur J Appl Physiol Occup Physiol, Vol.69, No.1, pp.21-25, 1994. https://doi.org/10.1007/BF00867922
  13. S. G. Hardy, T. B. Spalding, H. Liu, T. G. Nick, R. H. Pearson, A. V. Hayes, and D. S. Stokic, "The effect of transcutaneous electrical stimulation on spinal motor neuron excitability in people without known neuromuscular diseases: the roles of stimulus intensity and location," Phys Ther, Vol.82, No.4, pp.354-363, 2002.
  14. K. O'Sullivan, E. Murray, and D. Sainsbury, "The effect of warm-up, static stretching and dynamic stretching on hamstring flexibility in previously injured subjects," BMC Musculoskelet Disord, Vol.10, No.1, pp.37, 2009. https://doi.org/10.1186/1471-2474-10-37
  15. S. G. Trevino, W. L. Buford, S. Vallurupalli, M. Rowell, and V. K. Panchbhavi, "Use of a patient-controlled stretching device to improve the ankle range of motion," Foot Ankle Int, Vol.30, No.2, pp.110-114, 2009. https://doi.org/10.3113/FAI.2009.0110
  16. J. M. Fasen, A. M. O'Connor, S. L. Schwartz, J. O. Watson, C. T. Plastaras, C. W. Garvan, C. Bulcao, S. C. Johnson, and V. Akuthota, "A randomized controlled trial of hamstring stretching: comparison of four techniques," J Strength Cond Res, Vol.23, No.2, pp.660-667, 2009. https://doi.org/10.1519/JSC.0b013e318198fbd1
  17. J. Cronin, M. Nash, and C. Whatman, "The acute effects of hamstring stretching and vibration on dynamic knee joint range of motion and jump performance," Phys Ther Sport, Vol.9, No.2, pp.89-96, 2008. https://doi.org/10.1016/j.ptsp.2008.01.003
  18. A. C. Cunha, T. N. Burke, F. J. Franca, and A. P. Marques, "Effect of global posture reeducation and of static stretching on pain, range of motion, and quality of life in women with chronic neck pain: a randomized clinical trial," Clinics, Vol.63, No.6, pp.763-770, 2008. https://doi.org/10.1590/S1807-59322008000600010
  19. J. D. Dishman and J. Burke, "Spinal excitability changes after cervical and lumbar spinal manipulation: a comparative study," Spine J, Vol.3, No.3, pp.204-212, 2003. https://doi.org/10.1016/S1529-9430(02)00587-9
  20. C. J. Frijins, D. M. Laman, M. A. van Duijn, and H. van Duijn, "Normal values of patellar and ankle tendon reflex latencies," Clin Neurol Neurosurg, Vol.99, No.1, pp.31-36, 1997. https://doi.org/10.1016/S0303-8467(96)00593-8
  21. N. Guissard and J. Duchateau, "Effect of static stretch training on neural and mechanical properties of the human plantar-flexor muscles," Muscle Nerve, Vol.29, No.2, pp.248-255, 2004. https://doi.org/10.1002/mus.10549
  22. C. Y. Yeh, K. H. Tsai, and J. J. Chen, "Effects of prolonged muscle stretching with constant torque or constant angle on hypertonic calf muscles," Arch Phys Med Rehabil, Vol.86, No.2, pp.235-241, 2005. https://doi.org/10.1016/j.apmr.2004.03.032
  23. J. Nielsen, N. Petersen, M. Ballegaard, F. Biering-Sorensen, and O. Kiehn, "H-reflexes are less depressed following muscle stretch in spastic spinal cord injured patients than in healthy subjects," Exp Brain Res, Vol.97, No.1, pp.173-176, 1993. https://doi.org/10.1016/S0079-6123(08)62275-X
  24. D. Kanter, Y. Zhu, M. McNulty, and R. Weber, Soleus H-reflex is depressed during passive stretch of soleus muscle, Clin Neurophysiol, Vol.117, No.(Suppl)1, pp.162-163, 2006.
  25. Y. Tanino, K. Takasaki, S. Daikuya, and T. Suzuki, "Introduction of the vastus medialis oblique H-reflex during traction of the leg," Electromyogr Clin Neurophysiol, Vol.47, No.7-8, pp.369-372, 2007.
  26. J. D. Dishman and J. Burke, "Spinal reflex excitability changes after cervical and lumbar spinal manipulation: a comparative study," Spine J, Vol.3, No.3, pp.204-212, 2003. https://doi.org/10.1016/S1529-9430(02)00587-9
  27. M. Johanson, J. Baer, H. Hovermale, and P. Phouthavong, "Subtalar joint position during gastrocnemius stretching and ankle dorsiflexion range of motion," J Athl Train, Vol.43, No.2, pp.172-178, 2008. https://doi.org/10.4085/1062-6050-43.2.172
  28. E. Johnson, B. Bradley, K. Witkowski, R. McKee, C. Telesmanic, A. Chavez, K. Kennedy, and G. Zimmerman, "Effect of a static calf muscle-tendon unit stretching program on ankle dorsiflexion range of motion of older women," J Geriatr Phys Ther, Vol.30, No.2, pp.49-52, 2007. https://doi.org/10.1519/00139143-200708000-00003
  29. J. W. Youdas, D. A. Krause, K. S. Egan, T. M. Therneau, and E. R. Laskowski, "The effect of static stretching of the calf muscle-tendon unit on active ankle dorsiflexion range of motion," J Orthop Sports Phys Ther, Vol.33, No.7, pp.408-417, 2003. https://doi.org/10.2519/jospt.2003.33.7.408
  30. 김선엽, "관절가동운동(mobilization)이 관절감 수기(joint receptor)에 미치는 영향", 한국전문물리치료학회지, 제3권, 제2호, pp.95-105, 1996.
  31. E. Lederman, Fundamentals of manual therapy : Physiology, neurology and psychology, Harcout Health Sciences, 1997.
  32. O. Grimsby, Modern manual therapy of the extremities : A course workbook, The Ola Grimsby institute, 1995.
  33. M. R. Moraes, M. L. Cavalcante, J. A. Leite, and F. V. Ferreira, A. J. Castro, M. G. Santana, Histomorphometric evaluation of mechanoreceptors and free nerve endings in human lateral ankle ligaments. Foot Ankle Int. Vol.29, No.1, pp.87-90, 2008. https://doi.org/10.3113/FAI.2008.0087
  34. M. R. Gossman, S. A. Sahrmann, and S. J. Rose, "Review of length-associated changes in muscle. Experimental evidence and clinical implications," Phys Ther, Vol.62, No.12, pp.1799-1808, 1982. https://doi.org/10.1093/ptj/62.12.1799

Cited by

  1. Changes in Pain, Muscle Strength and Flexibility according to Pinch Lift and Rubbing Manual Therapy and Stretching Application for Low Back Pain vol.16, pp.1, 2014, https://doi.org/10.7586/jkbns.2014.16.1.1
  2. Health Habit, Perceived Health Status and Physical Health Status of Young Korean and Korean-Chinese Women: A Comparative Study vol.26, pp.3, 2015, https://doi.org/10.12799/jkachn.2015.26.3.312