Ann Rehabil Med.  2016 Oct;40(5):845-850. 10.5535/arm.2016.40.5.845.

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

• Hemmati L
• Rojhani-Shirazi Z
• Ebrahimi S

• KMID: 2382916
• DOI: http://doi.org/10.5535/arm.2016.40.5.845

Abstract

OBJECTIVE
To evaluate and compare the effects of stretching and combined therapy (stretching and massage) on postural balance in people aged 50 to 65 years.
METHODS
Twenty-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.
RESULTS
The 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).
CONCLUSION
Plantar 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.

Keyword

Postural balance; Muscle stretching exercises; Massage

MeSH Terms

Massage*
Muscle Stretching Exercises*
Non-Randomized Controlled Trials as Topic
Postural Balance*
Stroke

Figure

• 

  Fig. 1 Schematic diagram of the device and position used for the stretching.

Reference

1. Ferber R, Osternig L, Gravelle D. Effect of PNF stretch techniques on knee flexor muscle EMG activity in older adults. J Electromyogr Kinesiol. 2002; 12:391–397. PMID: 12223172.

2. Harvey LA, Herbert RD. Muscle stretching for treatment and prevention of contracture in people with spinal cord injury. Spinal Cord. 2002; 40:1–9. PMID: 11821963.

3. Wilson GJ, Wood GA, Elliott BC. The relationship between stiffness of the musculature and static flexibility: an alternative explanation for the occurrence of muscular injury. Int J Sports Med. 1991; 12:403–407. PMID: 1917225.

4. Fowles JR, Sale DG, MacDougall JD. Reduced strength after passive stretch of the human plantarflexors. J Appl Physiol (1985). 2000; 89:1179–1188. PMID: 10956367.

5. Behm DG, Button DC, Butt JC. Factors affecting force loss with prolonged stretching. Can J Appl Physiol. 2001; 26:261–272. PMID: 11441230.

6. Young W, Elliott S. Acute effects of static stretching, proprioceptive neuromuscular facilitation stretching, and maximum voluntary contractions on explosive force production and jumping performance. Res Q Exerc Sport. 2001; 72:273–279. PMID: 11561392.

7. Cornwell A, Nelson AG, Sidaway B. Acute effects of stretching on the neuromechanical properties of the triceps surae muscle complex. Eur J Appl Physiol. 2002; 86:428–434. PMID: 11882929.

8. Taylor DC, Dalton JD Jr, Seaber AV, Garrett WE Jr. Viscoelastic properties of muscle-tendon unit: the biomechanical effects of stretching. Am J Sports Med. 1990; 18:300–309. PMID: 2372082.

9. Avela J, Kyrolainen H, Komi PV. Altered reflex sensitivity after repeated and prolonged passive muscle stretching. J Appl Physiol (1985). 1999; 86:1283–1291. PMID: 10194214.

10. Khanna P, Kapoor G, Zutshi K. Balance deficits and recovery timeline after different fatigue protocols. Indian J Physiother Occup Ther. 2008; 2:42–54.

11. Behm DG, Bambury A, Cahill F, Power K. Effect of acute static stretching on force, balance, reaction time, and movement time. Med Sci Sports Exerc. 2004; 36:1397–1402. PMID: 15292749.

12. Nagano A, Yoshioka S, Hay DC, Himeno R, Fukashiro S. Influence of vision and static stretch of the calf muscles on postural sway during quiet standing. Hum Mov Sci. 2006; 25:422–434. PMID: 16563540.

13. Shirazi ZR, Jahromi FN. Comparison of the effect of selected muscle groups fatigue on postural control during bipedal stance in healthy young women. Niger Med J. 2013; 54:306–309. PMID: 24403706.

14. Holt KR, Haavik H, Elley CR. The effects of manual therapy on balance and falls: a systematic review. J Manipulative Physiol Ther. 2012; 35:227–234. PMID: 22343006.

15. Vaillant J, Rouland A, Martigne P, Braujou R, Nissen MJ, Caillat-Miousse JL, et al. Massage and mobilization of the feet and ankles in elderly adults: effect on clinical balance performance. Man Ther. 2009; 14:661–664. PMID: 19427810.

16. Goodwin J. A comparison of massage and sub-maximal exercise as warm-up protocols combined with a stretch for vertical jump performance. J Sports Sci. 2002; 20:48–49.

17. Zhao H, Wu YN, Hwang M, Ren Y, Gao F, Gaebler-Spira D, et al. Changes of calf muscle-tendon biomechanical properties induced by passive-stretching and active-movement training in children with cerebral palsy. J Appl Physiol (1985). 2011; 111:435–442. PMID: 21596920.

18. Vaillant J, Vuillerme N, Janvey A, Louis F, Braujou R, Juvin R, et al. Effect of manipulation of the feet and ankles on postural control in elderly adults. Brain Res Bull. 2008; 75:18–22. PMID: 18158091.

19. Hunter AM, Watt JM, Watt V, Galloway SD. Effect of lower limb massage on electromyography and force production of the knee extensors. Br J Sports Med. 2006; 40:114–118. PMID: 16431996.

20. James B, Parker AW. Active and passive mobility of lower limb joints in elderly men and women. Am J Phys Med Rehabil. 1989; 68:162–167. PMID: 2765206.

21. Friel K, McLean N, Myers C, Caceres M. Ipsilateral hip abductor weakness after inversion ankle sprain. J Athl Train. 2006; 41:74–78. PMID: 16619098.

22. Padua DA, Clark MA. Knee injury prevention: hip and ankle strategies [Internet]. Albany: Lower Extremity Review Magazine;2014. cited 2016 Jul 15. Available from: http://lermagazine.com/article/knee-injury-prevention-hip-and-ankle-strategies.

23. Serratrice G, Roux H, Aquaron R. Proximal muscular weakness in elderly subjects: report of 12 cases. J Neurol Sci. 1968; 7:275–299. PMID: 5707078.

24. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. 3rd ed. Philadelphia: Lippincott Williams & Wilkins;2007. p. 158–162.