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문제 정의
- Therefore, in the present study, EHS was applied with agonist muscle isometric contraction intensities of 10%, 50%, and 100% MVIC, and the effects on active knee extension ROM were compared. The aim was to determine the most effective contraction intensity for physical therapists utilizing EHS in clinical practice.
제안 방법
- The right knee joint ROM was then measured as the pre-test in all the subjects. After this, the subjects performed EHS (Fig. 2) at an intensity of 10% MVIC in the 10% MVIC group, 50% MVIC in the 50% MVIC group, and 100% MVIC in the 100% MVIC group [25]. The right knee joint ROM was measured immediately afterward as the post-intervention.
- Prior to the experiment, the subjects filled out a consent form, provided information regarding their general characteristics, and underwent an MVIC test. All subjects were assigned randomly to the EHS at 10% MVIC group, EHS at 50% MVIC group, EHS at 100% MVIC group, or control group. The right hamstring muscle group was selected as the intervention muscle to measure the equality of participants in this study [26].
- The MVIC measuring method reported by Kwak [26] was adapted to suit the hamstring muscles. MVIC was measured using a Chattanooga stabilizer (Chattanooga Group Inc., Hixson, USA) before allocating the subjects randomly to one of four groups (10% MVIC group, 50% MVIC group, 100% MVIC group, and control group). The right knee joint ROM was then measured as the pre-test in all the subjects.
- The study was approved by the Human Research Sciences of Local Ethics Committee and registered with the University Clinical Trials Registry. Prior to the experiment, the subjects filled out a consent form, provided information regarding their general characteristics, and underwent an MVIC test. All subjects were assigned randomly to the EHS at 10% MVIC group, EHS at 50% MVIC group, EHS at 100% MVIC group, or control group.
- The isometric contraction intensities of 10%, 50%, and 100% MVIC were used, and the effects of the different isometric contraction intensities on the knee joint ROM were compared. Significant differences in the post-EHS knee joint ROM were detected between the groups, and post hoc testing using the Bonferroni method revealed a significant difference only between the 100% MVIC group and NMVIC group (p<.
- The examiner held the anterior surface of the subject’s right leg with the left hand immediately distal to the knee joint and used the right hand to hold the anterior surface of the leg immediately proximal to the knee joint for stability. The subjects in the control group did not perform EHS, and the right knee joint ROM was measured immediately as a post-intervention. The measurements were performed by a licensed physical therapist with 12 years clinical experience and an orthopedic manual therapist (OMT) certificate for the OMT Kaltenborn-Evjenth concept.
- The study subjects consisted of 48 healthy adult men aged 20-39 years. The subjects were divided randomly into a 10% MVIC group (n1=12), 50% MVIC group (n2=12), 100% MVIC group (n3=12), and Non MVIC (NMVIC) group (n4=12). Table 1 lists the subjects’ general characteristics.
- That is, different results can be obtained depending on the degree of hamstring shortening. Therefore, it is necessary to conduct a comparative study on the MVIC intensity, together with scientific test and evaluation criteria to clearly select the subjects with hamstring shortening. Finally, during static stretching in EHS, objectivity for the stretching end point (soft end feel) is lacking.
- Several studies did not even mention the contraction intensity. Therefore, this study compared the difference in the ROM when EHS was performed at different isometric contraction intensities to determine the more efficient contraction intensity when using EHS clinically. When the study was designed, previous studies to decide which contraction intensities to compare were lacking, so values of 100% (maximum) [22,23,25], 50% (median), and 10% (minimum) MVIC were selected arbitrarily.
대상 데이터
- Based on the inclusion and exclusion criteria for this study, 48 healthy adult men, aged 20–39 years who were living in Daegu, South Korea, were enrolled in this study.
- The study subjects consisted of 48 healthy adult men aged 20-39 years. The subjects were divided randomly into a 10% MVIC group (n1=12), 50% MVIC group (n2=12), 100% MVIC group (n3=12), and Non MVIC (NMVIC) group (n4=12).
데이터처리
- The subjects’ general characteristics were analyzed using the one-way analysis of variance (ANOVA). A paired samples t-test was used to compare the pretest and posttest differences within each group, and one-way ANOVA was used to examine the differences between groups after the intervention. The Bonferroni’s post-hoc test was used to identify the differences among the groups for each intervention time.
- The subjects’ general characteristics were analyzed using the one-way analysis of variance (ANOVA).
이론/모형
- The values in each group are expressed as the mean± standard deviation. Parametric methods were used because the samples involved in the present study were represented by normal distribution curves in the Shapiro-Wilk test. The subjects’ general characteristics were analyzed using the one-way analysis of variance (ANOVA).
- The Bonferroni’s post-hoc test was used to identify the differences among the groups for each intervention time.
- Of these, the Evjenth-Hamberg stretching (EHS) method combines static stretching with isometric contraction of the agonist and antagonist muscles [22]. The concept that stimulation of both muscles is important for restoring the normal function in the antagonist muscle was introduced using the EHS method [23]. In relation to this method, Park [24] applied EHS to the sternocleidomastoid, upper trapezius, and pectoralis major muscles and found that it was effective in improving the forward head posture; the isometric contraction intensity for EHS was not reported.
- The subjects in the control group did not perform EHS, and the right knee joint ROM was measured immediately as a post-intervention. The measurements were performed by a licensed physical therapist with 12 years clinical experience and an orthopedic manual therapist (OMT) certificate for the OMT Kaltenborn-Evjenth concept. Training sessions for all groups were carried out at the university laboratory.
성능/효과
- This study showed that when using EHS on shortened hamstring muscles, isometric contraction intensities of 10%, 50%, and 100% MVIC are all effective in restoring hamstring muscle flexibility. In terms of the differences in effectiveness between the different isometric contraction intensities, 100% MVIC was more effective in restoring the hamstring muscle flexibility than 10% or 50% MVIC. The use of EHS with 100% MVIC will be more effective clinically, but further research on the clinical application and long-term effects on more muscle groups will be needed.
- First, as a cross-sectional pilot study, only the immediate effect was measured and only a temporary increase for healthy adult men was reported (Smith 1994). Second, the reliability of the digital goniometer used to measure the ROM in this study was too low (r=.47-.69), and the method of measurement was unscientific because the results can vary according to the examiner. Third, evidence for a comparison between 10% MVIC, 50% MVIC, and 100% MVIC is rare because previous studies that compared the effects of EHS at different isometric contraction intensities are rare.
- Significant differences in the post-EHS knee joint ROM were detected between the groups, and post hoc testing using the Bonferroni method revealed a significant difference only between the 100% MVIC group and NMVIC group (p<.05).
- On the other hand, few studies have compared the effects of the agonist muscle isometric contraction intensity on the outcomes of EHS, which combines static stretching with isometric contraction of the agonist and antagonist muscles. Therefore, in the present study, EHS was applied with agonist muscle isometric contraction intensities of 10%, 50%, and 100% MVIC, and the effects on active knee extension ROM were compared. The aim was to determine the most effective contraction intensity for physical therapists utilizing EHS in clinical practice.
- 05). Therefore, when performing EHS, an isometric contraction intensity of 100% MVIC was more effective in restoring the hamstring muscle flexibility than 10% or 50% MVIC, and no significant differences in the effects of 10% and 50% MVIC were found. In addition, the 10%, 50%, and 100% MVIC groups all showed a significant increase in the knee joint ROM following EHS.
- 69), and the method of measurement was unscientific because the results can vary according to the examiner. Third, evidence for a comparison between 10% MVIC, 50% MVIC, and 100% MVIC is rare because previous studies that compared the effects of EHS at different isometric contraction intensities are rare. That is, different results can be obtained depending on the degree of hamstring shortening.
- This study showed that when using EHS on shortened hamstring muscles, isometric contraction intensities of 10%, 50%, and 100% MVIC are all effective in restoring hamstring muscle flexibility. In terms of the differences in effectiveness between the different isometric contraction intensities, 100% MVIC was more effective in restoring the hamstring muscle flexibility than 10% or 50% MVIC.
- Using a visual analog scale, Lequesne’ s index, knee joint ROM, and peak muscle torque, they reported a massive decrease in pain and disability, an increase in knee joint ROM, and improvements in muscular strength for both static and PNF stretching, with PNF stretching being more effective in all areas.
- Therefore, this study compared the difference in the ROM when EHS was performed at different isometric contraction intensities to determine the more efficient contraction intensity when using EHS clinically. When the study was designed, previous studies to decide which contraction intensities to compare were lacking, so values of 100% (maximum) [22,23,25], 50% (median), and 10% (minimum) MVIC were selected arbitrarily. In studies that examined the effects of stretching, several factors influenced the results, including the study duration, number of subjects, and restricted muscle length differences between subjects [20].
후속연구
- Finally, during static stretching in EHS, objectivity for the stretching end point (soft end feel) is lacking. Future research will compare the treatment effects when other variables are altered, examine the duration for which the treatment effect is maintained, and account thoroughly for the limitations of the present study.
- In terms of the differences in effectiveness between the different isometric contraction intensities, 100% MVIC was more effective in restoring the hamstring muscle flexibility than 10% or 50% MVIC. The use of EHS with 100% MVIC will be more effective clinically, but further research on the clinical application and long-term effects on more muscle groups will be needed.
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