An investigation of commonly prescribed stretches of the ankle plantarflexors in people with Multiple Sclerosis.
Stretches are often prescribed to manage increased limb stiffness in people with Multiple Sclerosis. This study determined the ankle plantarflexor torque magnitude that people with Multiple Sclerosis can apply during four commonly prescribed stretches and determined the relationship between the applied torque and functional ability.



People with Multiple Sclerosis (N=27) were compared to healthy control participants (n=15). Four stretches were investigated; stretching in step standing; using a step; pulling the ankle into dorsiflexion and standing in a frame. Joint position and forces were measured using 3D motion analysis and torque transducers. Baseline ankle strength and stiffness was measured using motor driven ankle perturbations.



People with Multiple Sclerosis (N=27) had higher stretch reflex amplitudes and lower strength compared to the control group (n=15). People with Multiple Sclerosis achieved less lengthening of the plantarflexor muscle-tendon complex when stretching but similar ankle torques compared to controls. While stretching people with Multiple Sclerosis showed greater muscle activation in the ankle plantarflexors. Stretches in weight bearing positions produced higher plantarflexor torques. People with Multiple Sclerosis with lower functional ability preferred the more supported stretches (ankle pull and standing frame).



Stretches in weight bearing positions achieve higher ankle torques but this is in part due to increased postural activity in people with Multiple Sclerosis. Functional ability may limit stretch effectiveness.
School of Health Professions, Faculty of Health and Human Sciences, University of Plymouth, PL6 8BH, UK.
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J
Ofori
School of Health Professions, Faculty of Health and Human Sciences, University of Plymouth, PL6 8BH, UK.
J
J
Freeman
Stroke Rehabilitation Unit, Camborne/Redruth Community Hospital, Barncoose Terrace, Redruth TR15 3ER, UK.
A
A
Logan
Paediatrics and Learning Disabilities, South Devon Healthcare NHS Foundation Trust, Bidwell Brook School, Shinners Bridge, Dartington, TQ9 6JU, UK.
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R
Rapson
Peninsula College of Medicine and Dentistry University of Plymouth, PL6 8BH, UK.
J
J
Zajieck
Peninsula College of Medicine and Dentistry University of Plymouth, PL6 8BH, UK.
J
J
Hobart
School of Health Professions, Faculty of Health and Human Sciences, University of Plymouth, PL6 8BH, UK. Electronic address: jonathan.marsden@plymouth.ac.uk.
J
J
Marsden
D000328:Adult; D000368:Aged; D000842:Ankle / Q000503:physiopathology; D000843:Ankle Joint / Q000503:physiopathology*; D004548:Elasticity / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000534:rehabilitation; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology*; D012026:Reflex, Stretch / Q000502:physiology*; D013710:Tendons / Q000503:physiopathology; D019415:Torque
Multiple Sclerosis; Spasticity; Stiffness; Stretching