Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial

Annika Kruse; Andreas Habersack; Richard T. Jaspers; Norbert Schrapf; Guido Weide; Martin Svehlik; Markus Tilp

doi:10.3390/ijerph191811599

Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial

Annika Kruse^*, Andreas Habersack, Richard T. Jaspers, Norbert Schrapf, Guido Weide, Martin Svehlik, Markus Tilp

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Stretching is considered a clinically effective way to prevent muscle contracture development in children with spastic cerebral palsy (CP). Therefore, in this study, we assessed the effects of a single session of proprioceptive neuromuscular facilitation (PNF) or static stretching (SS) on ankle joint range of motion (RoM) and gastrocnemius muscle-tendon behavior in children with CP. During the SS (n = 8), the ankle joint was held in maximum dorsiflexion (30 s). During the PNF stretching (n = 10), an isometric contraction (3–5 s) was performed, followed by stretching (~25 s). Ten stretches were applied in total. We collected data via dynamometry, 3D motion capture, 2D ultrasound, and electromyography, before and after the stretching sessions. A mixed ANOVA was used for the statistical analysis. Both ankle RoM and maximum dorsiflexion increased over time (F(1,16) = 7.261, p < 0.05, η² = 0.312; and F(1,16) = 4.900, p < 0.05, η² = 0.234, respectively), without any difference between groups. An interaction effect (F(1,12) = 4.768, p = 0.05, η² = 0.284) was observed for muscle-tendon unit elongation (PNF: −8.8%; SS: +14.6%). These findings suggest a positive acute effect of stretching on ankle function. However, SS acutely increased muscle-tendon unit elongation, while this decreased after PNF stretching, indicating different effects on the spastic muscles. Whether PNF stretching has the potential to cause positive alterations in individuals with CP should be elucidated in future studies.

Original language	English
Article number	11599
Pages (from-to)	1-12
Number of pages	12
Journal	International Journal of Environmental Research and Public Health
Volume	19
Issue number	18
DOIs	https://doi.org/10.3390/ijerph191811599
Publication status	Published - 2 Sept 2022

Bibliographical note

Special Issue: Exercises and Musculoskeletal Disorders.

Funding Information:
We acknowledge the support of the Austrian Science Fund for A.K. In addition, we acknowledge the financial support of the Austrian Academy of Sciences for A.H., who is a recipient of a DOC Fellowship (25940) at the Department of Orthopaedics and Trauma, Medical University of Graz, and the Institute of Human Movement Science, Sport and Health, University of Graz. Moreover, we would like to thank Jaap Harlaar for the support in the initial project proposal writing.

Funding Information:
This work was supported by the Austrian Science Fund [Grant Number T 1017]. A.H. is currently funded by the Austrian Academy of Sciences [25940].

Publisher Copyright:
© 2022 by the authors.

Funding

We acknowledge the support of the Austrian Science Fund for A.K. In addition, we acknowledge the financial support of the Austrian Academy of Sciences for A.H., who is a recipient of a DOC Fellowship (25940) at the Department of Orthopaedics and Trauma, Medical University of Graz, and the Institute of Human Movement Science, Sport and Health, University of Graz. Moreover, we would like to thank Jaap Harlaar for the support in the initial project proposal writing. This work was supported by the Austrian Science Fund [Grant Number T 1017]. A.H. is currently funded by the Austrian Academy of Sciences [25940].

Keywords

Achilles tendon
hold-relax PNF stretching
muscle activity
paresis
plantar flexors
spasticity

Access to Document

10.3390/ijerph191811599

Persistent URL (handle)

Persistent link

Fingerprint

Dive into the research topics of 'Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial'. Together they form a unique fingerprint.

Cite this

Kruse, A., Habersack, A., Jaspers, R. T., Schrapf, N., Weide, G., Svehlik, M., & Tilp, M. (2022). Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial. International Journal of Environmental Research and Public Health, 19(18), 1-12. Article 11599. https://doi.org/10.3390/ijerph191811599

Kruse, Annika ; Habersack, Andreas ; Jaspers, Richard T. et al. / Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial. In: International Journal of Environmental Research and Public Health. 2022 ; Vol. 19, No. 18. pp. 1-12.

@article{71f59916f0504b54983633ad185291bf,

title = "Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial",

abstract = "Stretching is considered a clinically effective way to prevent muscle contracture development in children with spastic cerebral palsy (CP). Therefore, in this study, we assessed the effects of a single session of proprioceptive neuromuscular facilitation (PNF) or static stretching (SS) on ankle joint range of motion (RoM) and gastrocnemius muscle-tendon behavior in children with CP. During the SS (n = 8), the ankle joint was held in maximum dorsiflexion (30 s). During the PNF stretching (n = 10), an isometric contraction (3–5 s) was performed, followed by stretching (~25 s). Ten stretches were applied in total. We collected data via dynamometry, 3D motion capture, 2D ultrasound, and electromyography, before and after the stretching sessions. A mixed ANOVA was used for the statistical analysis. Both ankle RoM and maximum dorsiflexion increased over time (F(1,16) = 7.261, p < 0.05, η² = 0.312; and F(1,16) = 4.900, p < 0.05, η² = 0.234, respectively), without any difference between groups. An interaction effect (F(1,12) = 4.768, p = 0.05, η² = 0.284) was observed for muscle-tendon unit elongation (PNF: −8.8%; SS: +14.6%). These findings suggest a positive acute effect of stretching on ankle function. However, SS acutely increased muscle-tendon unit elongation, while this decreased after PNF stretching, indicating different effects on the spastic muscles. Whether PNF stretching has the potential to cause positive alterations in individuals with CP should be elucidated in future studies.",

keywords = "Achilles tendon, hold-relax PNF stretching, muscle activity, paresis, plantar flexors, spasticity",

author = "Annika Kruse and Andreas Habersack and Jaspers, {Richard T.} and Norbert Schrapf and Guido Weide and Martin Svehlik and Markus Tilp",

note = "Special Issue: Exercises and Musculoskeletal Disorders. Funding Information: We acknowledge the support of the Austrian Science Fund for A.K. In addition, we acknowledge the financial support of the Austrian Academy of Sciences for A.H., who is a recipient of a DOC Fellowship (25940) at the Department of Orthopaedics and Trauma, Medical University of Graz, and the Institute of Human Movement Science, Sport and Health, University of Graz. Moreover, we would like to thank Jaap Harlaar for the support in the initial project proposal writing. Funding Information: This work was supported by the Austrian Science Fund [Grant Number T 1017]. A.H. is currently funded by the Austrian Academy of Sciences [25940]. Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = sep,

day = "2",

doi = "10.3390/ijerph191811599",

language = "English",

volume = "19",

pages = "1--12",

journal = "International Journal of Environmental Research and Public Health",

issn = "1661-7827",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "18",

}

Kruse, A, Habersack, A, Jaspers, RT, Schrapf, N, Weide, G, Svehlik, M & Tilp, M 2022, 'Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial', International Journal of Environmental Research and Public Health, vol. 19, no. 18, 11599, pp. 1-12. https://doi.org/10.3390/ijerph191811599

Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial. / Kruse, Annika; Habersack, Andreas; Jaspers, Richard T. et al.
In: International Journal of Environmental Research and Public Health, Vol. 19, No. 18, 11599, 02.09.2022, p. 1-12.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial

AU - Kruse, Annika

AU - Habersack, Andreas

AU - Jaspers, Richard T.

AU - Schrapf, Norbert

AU - Weide, Guido

AU - Svehlik, Martin

AU - Tilp, Markus

N1 - Special Issue: Exercises and Musculoskeletal Disorders. Funding Information: We acknowledge the support of the Austrian Science Fund for A.K. In addition, we acknowledge the financial support of the Austrian Academy of Sciences for A.H., who is a recipient of a DOC Fellowship (25940) at the Department of Orthopaedics and Trauma, Medical University of Graz, and the Institute of Human Movement Science, Sport and Health, University of Graz. Moreover, we would like to thank Jaap Harlaar for the support in the initial project proposal writing. Funding Information: This work was supported by the Austrian Science Fund [Grant Number T 1017]. A.H. is currently funded by the Austrian Academy of Sciences [25940]. Publisher Copyright: © 2022 by the authors.

PY - 2022/9/2

Y1 - 2022/9/2

N2 - Stretching is considered a clinically effective way to prevent muscle contracture development in children with spastic cerebral palsy (CP). Therefore, in this study, we assessed the effects of a single session of proprioceptive neuromuscular facilitation (PNF) or static stretching (SS) on ankle joint range of motion (RoM) and gastrocnemius muscle-tendon behavior in children with CP. During the SS (n = 8), the ankle joint was held in maximum dorsiflexion (30 s). During the PNF stretching (n = 10), an isometric contraction (3–5 s) was performed, followed by stretching (~25 s). Ten stretches were applied in total. We collected data via dynamometry, 3D motion capture, 2D ultrasound, and electromyography, before and after the stretching sessions. A mixed ANOVA was used for the statistical analysis. Both ankle RoM and maximum dorsiflexion increased over time (F(1,16) = 7.261, p < 0.05, η² = 0.312; and F(1,16) = 4.900, p < 0.05, η² = 0.234, respectively), without any difference between groups. An interaction effect (F(1,12) = 4.768, p = 0.05, η² = 0.284) was observed for muscle-tendon unit elongation (PNF: −8.8%; SS: +14.6%). These findings suggest a positive acute effect of stretching on ankle function. However, SS acutely increased muscle-tendon unit elongation, while this decreased after PNF stretching, indicating different effects on the spastic muscles. Whether PNF stretching has the potential to cause positive alterations in individuals with CP should be elucidated in future studies.

AB - Stretching is considered a clinically effective way to prevent muscle contracture development in children with spastic cerebral palsy (CP). Therefore, in this study, we assessed the effects of a single session of proprioceptive neuromuscular facilitation (PNF) or static stretching (SS) on ankle joint range of motion (RoM) and gastrocnemius muscle-tendon behavior in children with CP. During the SS (n = 8), the ankle joint was held in maximum dorsiflexion (30 s). During the PNF stretching (n = 10), an isometric contraction (3–5 s) was performed, followed by stretching (~25 s). Ten stretches were applied in total. We collected data via dynamometry, 3D motion capture, 2D ultrasound, and electromyography, before and after the stretching sessions. A mixed ANOVA was used for the statistical analysis. Both ankle RoM and maximum dorsiflexion increased over time (F(1,16) = 7.261, p < 0.05, η² = 0.312; and F(1,16) = 4.900, p < 0.05, η² = 0.234, respectively), without any difference between groups. An interaction effect (F(1,12) = 4.768, p = 0.05, η² = 0.284) was observed for muscle-tendon unit elongation (PNF: −8.8%; SS: +14.6%). These findings suggest a positive acute effect of stretching on ankle function. However, SS acutely increased muscle-tendon unit elongation, while this decreased after PNF stretching, indicating different effects on the spastic muscles. Whether PNF stretching has the potential to cause positive alterations in individuals with CP should be elucidated in future studies.

KW - Achilles tendon

KW - hold-relax PNF stretching

KW - muscle activity

KW - paresis

KW - plantar flexors

KW - spasticity

UR - http://www.scopus.com/inward/record.url?scp=85138389475&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85138389475&partnerID=8YFLogxK

U2 - 10.3390/ijerph191811599

DO - 10.3390/ijerph191811599

M3 - Article

C2 - 36141875

AN - SCOPUS:85138389475

SN - 1661-7827

VL - 19

SP - 1

EP - 12

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

IS - 18

M1 - 11599

ER -

Kruse A, Habersack A, Jaspers RT, Schrapf N, Weide G, Svehlik M et al. Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial. International Journal of Environmental Research and Public Health. 2022 Sept 2;19(18):1-12. 11599. doi: 10.3390/ijerph191811599

Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial

Abstract

Bibliographical note

Funding

Keywords

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Cite this