Acute Effects of Static and Proprioceptive Neuromuscular Facilitation Stretching of the Plantar Flexors on Ankle Range of Motion and Muscle-Tendon Behavior in Children with Spastic Cerebral Palsy—A Randomized Clinical Trial

Annika Kruse (), Andreas Habersack, Richard T. Jaspers, Norbert Schrapf, Guido Weide, Martin Svehlik and Markus Tilp
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Annika Kruse: Department of Biomechanics, Training and Movement Science, Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
Andreas Habersack: Department of Biomechanics, Training and Movement Science, Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
Richard T. Jaspers: Department of Human Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 HZ Amsterdam, The Netherlands
Norbert Schrapf: Department of Biomechanics, Training and Movement Science, Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
Guido Weide: Department of Human Movement Science, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 HZ Amsterdam, The Netherlands
Martin Svehlik: Department of Orthopaedics and Trauma, Medical University of Graz, 8036 Graz, Austria
Markus Tilp: Department of Biomechanics, Training and Movement Science, Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria

IJERPH, 2022, vol. 19, issue 18, 1-12

Abstract: Stretching is considered a clinically effective way to prevent muscle contracture development in children with spastic cerebral palsy (CP). Therefore, in this study, we assessed the effects of a single session of proprioceptive neuromuscular facilitation (PNF) or static stretching (SS) on ankle joint range of motion (RoM) and gastrocnemius muscle-tendon behavior in children with CP. During the SS ( n = 8), the ankle joint was held in maximum dorsiflexion (30 s). During the PNF stretching ( n = 10), an isometric contraction (3–5 s) was performed, followed by stretching (~25 s). Ten stretches were applied in total. We collected data via dynamometry, 3D motion capture, 2D ultrasound, and electromyography, before and after the stretching sessions. A mixed ANOVA was used for the statistical analysis. Both ankle RoM and maximum dorsiflexion increased over time (F(1,16) = 7.261, p < 0.05, η² = 0.312; and F(1,16) = 4.900, p < 0.05, η² = 0.234, respectively), without any difference between groups. An interaction effect (F(1,12) = 4.768, p = 0.05, η² = 0.284) was observed for muscle-tendon unit elongation (PNF: −8.8%; SS: +14.6%). These findings suggest a positive acute effect of stretching on ankle function. However, SS acutely increased muscle-tendon unit elongation, while this decreased after PNF stretching, indicating different effects on the spastic muscles. Whether PNF stretching has the potential to cause positive alterations in individuals with CP should be elucidated in future studies.

Keywords: paresis; Achilles tendon; plantar flexors; hold-relax PNF stretching; muscle activity; spasticity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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