Stretching at the ankle joint: viscoelastic responses to holds and continuous passive motion.
OBJECTIVE
To compare the effect of static holds and continuous passive motion on stiffness and force relaxation of the soft tissue structures resisting ankle joint dorsiflexion.


METHODS
This study used a randomized repeated measures trial design. Twenty-four asymptomatic subjects (15 males and 8 females) with a mean age of 26 yr participated. A Kin-Com dynamometer was used to measure the stiffness and force relaxation response of tissues about the ankle joint in response to a plantar flexor stretch. A comparison was made of the response for a 1 x 60-s hold, 2 x 30-s holds, 4 x 15-s holds, and continuous passive motion for 60 s. All subjects undertook all conditions. The main outcome measures were 1) stiffness at the ankle joint as it moved to 80% of the maximum range of dorsiflexion, and 2) the decrease in force at 80% of the maximum range of motion of the ankle joint.


RESULTS
Stiffness was decreased significantly (P < 0.05) for the continuous passive motion condition only. The mean magnitude of the decrease in stiffness was 16%. Across hold times, force decreased significantly (P < 0.05). Bonferonni contrasts indicated that there was a significant difference (P < 0.05) between the continuous passive motion condition and all other hold conditions. There were no significant differences (P > 0.05) between the 4 x 15-s, 2 x 30-s, and 1 x 60-s holds. The magnitude of the decline in force was 10.5%, 21.5%, 21.7%, and 19% for the 0-, 15-, 30-, and 60-s holds, respectively. The greatest decreases in tension were achieved in the first 20 s of a hold.


CONCLUSIONS
If decreasing stiffness is a key aim of a stretching program, the findings indicate that continuous motion is more effective than holds. In contrast, if relaxation of peak tension is the main aim, then holds are most effective.
Neuromuscular Research Unit, School of Physiotherapy, Auckland University of Technology, Auckland, New Zealand. peter.mcnair@aut.ac.nz
P J
PJ
McNair
E W
EW
Dombroski
D J
DJ
Hewson
S N
SN
Stanley
D000328:Adult; D016512:Ankle Injuries / Q000534:rehabilitation*; D000843:Ankle Joint / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology; D026741:Physical Therapy Modalities; D018583:Pliability; D016059:Range of Motion, Articular; D013718:Tensile Strength