Range of Motion (ROM) and passive torque have been widely used to evaluate flexibility stretching protocols, but little attention has been given to the reliability of these measurements.
OBJECTIVE:
To verify the interday reliability of isokinetic dynamometer for assessing ROM measures based on discomfort perception(initial and maximum), static and dynamic measures of passive torque during a leg extension movement on a young adult sample.
METHODS:
Twenty students (13 men; 7 women) aged between 18 and 30 years attended the laboratory to perform the test and retest with 2-7 days interval. The evaluations included: Initial Discomfort Angle (IDA), Passive dynamic torque (Stiffness), Passive static torque (Viscoelastic Stress Relaxation-VSR) and Maximal Discomfort Angle (MDA). Reliability was tested by the Intraclass Correlation Coefficient (ICC), one-sample t-test and Bland-Altman charts.
RESULTS:
Stiffness (ICC = 0.93), IDA (ICC = 0.90) and MDA(ICC = 0.87) showed excellent reliability values, while VSR had moderate ones (ICC = 0.59). Bland-Altman plots indicated bias close or equal to zero. The one-sample t-test for all measures reinforced the absence of a systematic error.
CONCLUSIONS:
Dynamic and static stiffness measures and ROM based on the subject's discomfort perception may be applied to relevant clinical issues.
KerriganDC, Xenopoulos-OddssonA, SullivanMJ, LelasJJ, RileyPO. Effect of a hip flexor-stretching program on gait in the elderly. Arch Phys Med Rehabil. 2003; 84(1): 1-6.
2.
AraújoCGS. Teste de sentar-levantar: apresentação de um procedimento para avaliação em Medicina do Exercício e do Esporte. Rev Bras Med Esporte. Rev Bras Med Esporte. 1999; 5(5): 179-82.
3.
BritoLBB, de AraújoDSMS, de AraújoCGS. Does flexibility influence the ability to sit and rise from the floor? Am J Phys Med Rehabil. 2013; 92(3): 241-7.
4.
TeyhenDS, ShafferSW, LorensonCL, GreenbergMD, RogersSM, KoreeratCM, VillenaSL, ZoselKL, WalkerMJ, and ChildsJC. Clinical measures associated with dynamic balance and functional movement. J Strength Cond Res. 2014; 28(5): 1272-83.
5.
PliskyPJ, GormanPP, ButlerRJ, KieselKB, UnderwoodFB, ElkinsB. The reliability of an instrumented device for measuring components of the star excursion balance test. N Am J Sports Phys Ther. 2009; 4(2): 94-9.
6.
LeeDH, KangB, ChoiS, KimT, JangSH, LeeKH, KimMJ, ParkS-B, and HanSH. Change in musculoskeletal pain in patients with work-related musculoskeletal disorder after tailored rehabilitation education: A one-year follow-up survey. Ann Rehabil Med. 2015; 39(5): 726-34.
7.
MalaiS, PichaiyongwongdeeS, SakulsriprasertP. Immediate effect of hold-relax stretching of iliopsoas muscle on transversus abdominis muscle activation in chronic non-specific low back pain with lumbar hyperlordosis. J Med Assoc Thai. 2015; 98(5).
8.
TheisN, KorffT, MohagheghiAA. Does long-term passive stretching alter muscle-tendon unit mechanics in children with spastic cerebral palsy? Clin Biomech. 2015; 30(10): 1071-6.
9.
BehmDG, MuehlbauerT, KibeleA, GranacherU. Effects of strength training using unstable surfaces on strength, power and balance performance across the lifespan: A systematic review and meta-analysis. Sports Med. 2015; 45(12): 1645-69.
10.
WepplerCH, MagnussonSP. Increasing muscle extensibility: A matter of increasing length or modifying sensation? Phys Ther. 2010; 90(3): 438-49.
11.
DecosterLC, ClelandJ, AltieriC, RussellP. The effects of hamstring stretching on range of motion: A systematic literature review. J Orthop Sports Phys Ther. 2005; 35(6): 377-87.
12.
BeltrãoNB, Ritti-DiasRM, PitanguiAC, De AraújoRC. Correlation between acute and short-term changes in flexibility using two stretching techniques. Int J Sports Med. 2014; 35(14). Epub 1154.
13.
PalmerTB, JenkinsND, CramerJT. Reliability of manual versus automated techniques for assessing passive stiffness of the posterior muscles of the hip and thigh. J Sports Sci. 2013; 31(8): 867-77.
CabidoCE, BergaminiJC, AndradeAG, LimaFV, MenzelHJ, ChagasMH. Acute effect of constant torque and angle stretching on range of motion, muscle passive properties, and stretch discomfort perception. J Strength Cond Res. 2014; 28(4): 1050-7.
16.
SobolewskiEJ, RyanED, ThompsonBJ, McHughMP, ConcholaEC. The influence of age on the viscoelastic stretch response. J Strength Cond Res. 2014; 28(4): 1106-12.
17.
GarberCE, BlissmerB, DeschenesMR, FranklinB, LamonteMJ, LeeI-M, NiemanDC, and SwainDP. American college of sports medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med Sci Sports Exerc. 2011; 43(7): 1334-59.
18.
RobersonL, GiurintanoDJ. Objective measures of joint stiffness. J Hand Ther. 1995; 8(2): 163-6.
19.
MagnussonS, SimonsenEB, AagaardP, BoesenJ, JohannsenF, KjaerM. Determinants of musculoskeletal flexibility: Viscoelastic properties, cross - sectional area, EMG and stretch tolerance. Scand J Med Sci Sports. 1997; 7(4): 195-202.
20.
LawRY, HarveyLA, NicholasMK, TonkinL, De SousaM, FinnissDG. Stretch exercises increase tolerance to stretch in patients with chronic musculoskeletal pain: a randomized controlled trial. Phys Ther. 2009; 89(10): 1016-26.
21.
MahieuN, CoolsA, De WildeB, BoonM, WitvrouwE. Effect of proprioceptive neuromuscular facilitation stretching on the plantar flexor muscle-tendon tissue properties. Scand J Med Sci Sports. 2009; 19(4): 553-60.
22.
MagnussonSP, SimonsenE, AagaardP, SørensenH, KjaerM. A mechanism for altered flexibility in human skeletal muscle. J Physiol. 1996; 497(Pt 1): 291-8.
23.
HambergJ, CrenshawAG. Sensory adaptation after a 2-week stretching regimen of the rectus femoris muscle. Arch Phys Med Rehabil. 2001; 82(9): 1245-50.
24.
LæssøeU, VoigtM. Modification of stretch tolerance in a stooping position. Scand J Med Sci Sports. 2004; 14(4): 239-44.
25.
FolppH, DeallS, HarveyLA, GwinnT. Can apparent increases in muscle extensibility with regular stretch be explained by changes in tolerance to stretch? Aust J Physiother. 2006; 52(1): 45-50.
26.
do Carmo CarvalhaisVO, de AraújoVL, SouzaTR, GonçalvesGGP, de Melo OcarinoJ, FonsecaST. Validity and reliability of clinical tests for assessing hip passive stiffness. Man Ther. 2011; 16(3): 240-5.
27.
BehmDG, BlazevichAJ, KayAD, McHughM. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: A systematic review. Appl Physiol Nutr Metab. 2016; 41(999): 1-11.
28.
PalmerTB, AkehiK, ThieleRM, SmithDB, WarrenAJ, ThompsonBJ. Dorsiflexion, plantar-flexion, and neutral ankle positions during passive resistance assessments of the posterior hip and thigh muscles. J Athl Train. 2015; 50(5): 467-74.
29.
CorreiaM, MenêsesA, LimaA, CavalcanteB, Ritti-DiasR. Efeito do treinamento de força na flexibilidade: Uma revisão sistemática. Rev Bras Ativ Fís Saúde. 2014; 19(1): 3-11.
30.
LamontagneA, MalouinF, RichardsCL, DumasF. Evaluation of reflex-and nonreflex-induced muscle resistance to stretch in adults with spinal cord injury using hand-held and isokinetic dynamometry. Phys Ther. 1998; 78(9): 964-75.
31.
BoiteauM, MalouinF, RichardsCL. Use of a hand-held dynamometer and a Kin-Com#174; dynamometer for evaluating spastic hypertonia in children: A reliability study. Phys Ther. 1995; 75(9): 796-802.
32.
de AquinoCF, GonçalvesGGP, da FonsecaST, ManciniMC. Análise da relação entre flexibilidade e rigidez passiva dos isquiotibiais. Rev Bras Med Esporte. 2006; 12(4): 175-9.
33.
FleissJL. Design and analysis of clinical experiments: John Wiley & Sons; 2011.
34.
HopkinsWG. Measures of reliability in sports medicine and science. Sports Med. 2000; 30(1): 1-15.
35.
BlandJM, AltmanDG. Measuring agreement in method comparison studies. Stat Methods in Med Res. 1999; 8(2): 135-60.
36.
TaylorDC, DaltonJD, SeaberAV, GarrettWE. Viscoelastic properties of muscle-tendon units the biomechanical effects of stretching. Am J Sports Med. 1990; 18(3): 300-9.
37.
BlandJM, AltmanD. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 327(8476): 307-10.
38.
GajdosikRL, BohannonRW. Clinical measurement of range of motion review of goniometry emphasizing reliability and validity. Phys Ther. 1987; 67(12): 1867-72.
