Effect of static stretching of muscles surrounding the knee on knee joint position sense

Abstract

Background: Muscle stretching is widely used in sport training and in rehabilitation. Considering the important contribution of joint position sense (JPS) to knee joint stability and function, it is legitimate to question if stretching might alter the knee JPS. Objective: To evaluate if a stretch regimen consisting of three 30 s stretches alters the knee JPS. Design and setting: A blinded, randomised design with a washout time of 24 h was used. Subjects: 39 healthy students (21 women, 18 men) volunteered to participate in this study. Methods and main outcome measures: JPS was estimated by the ability to reproduce the two target positions (20˚and 45˚of flexion) in the dominant knee. The absolute angular error (AAE) was defined as the absolute difference between the target angle and the subject perceived angle of knee flexion. AAE values were measured before and immediately after the static stretch. Measurements were repeated three times. The static stretch comprised a 30 s stretch followed by a 30 s pause, three times for each muscle. Results: The AAE decreased significantly after the stretching protocols for quadriceps (3.5 (1.3) vs 0.7 (2.4); p,0.001), hamstring (3.6 (2.2) vs 1.6 (3.1); p = 0.016) and adductors (3.7 (2.8) vs 1.7 (2.4); p = 0.016) in 45˚of flexion, but no differences were found for values of the gastrocnemius and popliteus muscles in this angle and for the values of all muscles in 20˚of flexion (p.0.05). Conclusion: The accuracy of the knee JPS in 45˚of flexion is improved subsequent to a static stretch regimen of quadriceps, hamstring and adductors in healthy subjects.

Cryotherapy and Joint Position Sense in Healthy Participants: A Systematic Review

“…Active joint repositioning was selected primarily because active testing is believed to be more functional than passive testing. 16 Two methods of limb positioning or placement at the target angle were reported in the literature, namely passive 12,20,27,28,30 and active. 29 Three groups 12,25,28 assessed individuals' self-reported dominant limb, classified as one's kicking leg or throwing shoulder arm; 1 group 30 chose the left limb only; 2 groups 26,29 randomly choose the tested limb; and only 1 group 27 assessed both limbs.…”

“…14,15 The conscious ability to position a limb is a highly specialized proprioceptive function and is a vitally important clinical outcome measure, involving both the control of movement and stability. 16 The JPS tests are routinely administered by clinicians to assess any proprioceptive deficits in the knee joint after anterior cruciate ligament injury, 7,[17][18][19] stretching, 20 fatigue, 14,21,22 pain, 16 patellar taping, 23,24 and cooling. 12,[25][26][27][28][29][30] The primary reason JPS is assessed by clinicians is to identify any reduction that may predispose an individual to proprioception-related injury.…”

Effects of Quadriceps and Hamstrings Proprioceptive Neuromuscular Facilitation Stretching on Knee Movement Sensation

“…However, it is important to point out that the decrease in sensitivity to knee joint movement observed as a consequence of PNF stretching in this study occurred with the leg fully suspended in a non-weight bearing position and with the knee being moved passively. It is possible that under weight-bearing conditions with the hamstrings and quadriceps actively involved in controlling and moving the knee, a more likely scenario in athletic competition, that PNF stretching may have little negative impact on knee joint position sense or even could still enhance it (5). Before PNF stretching can be considered detrimental to position sense, further studies must be done to examine its impact on proprioception during active movement.…”

Efeito agudo de diferentes rotinas de alongamento estático sobre o salto com contramovimento.

“…Estímulos de alongamento estático vão resultar em um feedback proprioceptivo aumentado para o sistema nervoso central através do aumento do impulso aferente do órgão tendinoso de Golgi (OTG) e do fuso muscular para a medula espinhal, córtex cerebral e cerebelo, o que melhoraria à sensibilidade e percepção espaço temporal (GHAFFARINEJAD; TAGHIZADEH; MOHAMMADI, 2007). No entanto, rotinas contínuas de alongamento estático submeteriam o sujeito à maior exposição ao desconforto, prejudicando assim o drive motor eferente, podendo prejudicar a ativação muscular (FARINA; ARENDT-NIELSEN; GRAVEN-NIELSEN, 2005).…”

“…De certa forma, pode-se sugerir que a ausência de aumento agudo na ADM após o AL-10s esteja diretamente ligada ao aumento significativo na altura do salto uma vez que a queda na rigidez passiva da unidade músculo-tendínea é uma das responsáveis pelo aumento da ADM e também pela queda no desempenho da força (MIZUNO; MATSUMOTO; UMEMURA, 2014). Como no presente estudo não houve aumento na ADM com a rotina fracionada de alongamento, pode-se sugerir que não tenha ocorrido queda na rigidez passiva, e que a melhora no desempenho do salto tenha ocorrido em função de um feedback proprioceptivo aumentado (GHAFFARINEJAD; TAGHIZADEH; MOHAMMADI, 2007), o que explicaria tais achados. Deve-se frisar, no entanto, que a rotina mais longa de alongamentos (AL-30) promoveu aumento agudo na ADM sem prejudicar o desempenho do salto, corroborando outros trabalhos na literatura (OGURA et al, 2007;RYAN et al, 2008).…”