To all:
The other day, I was thinking back to the days of been an undergraduate
student, and I was going through my notes on Maitland's mobilisation.
Something strange appeared on the page that I was not aware of earlier, and
that was the issue of muscle contractures. From what I know, Maitland's
texts tends to believe that muscle spasm is a result of a "reflex response
to pain provoked by movement" or is related to "what is wrong with the joint
rather than being directly related to a pain response." The former seemed to
me to be contradictory to what I know, which is that pain tends to INHIBIT
muscle contraction, but according to Maitland, if you have pain, you should
have muscles contraction. Can anybody clears this up for me please??
Henry***
>From: "Underwood, Frank" <[log in to unmask]>
>Reply-To: [log in to unmask]
>To: "[log in to unmask] '" <[log in to unmask]>
>Subject: RE: pre-exercise stretching
>Date: Sun, 15 Oct 2000 20:04:10 -0500
>
>The report Dave was referring to is pretty easy to find using a database
>such as PubMed. I've included the citation and abstract below. More
>importantly, the issue of having 1538 subjects and difficulty controlling
>all variables, and Henry's contention that this may make it a poor study
>should be addressed.
>
>If you use a small, homogenous sample, you may be able to control many
>confounding variables, and find a treatment effect if one exists. This
>concept is referred to as "internal validity", and in essence means that
>the
>researcher can attribute the treatment effect to the treatment applied with
>confidence. However, the price paid for high internal validity is low
>external validity, or the ability to generalize the results outside the
>experimental setting or to subjects who are not similar to those included
>in
>the study.
>
>The clear advantage to an RCT is the first word; randomized. The process
>of
>randomization is the absolute best means to control for the effects of ALL
>confounding variables, even those whose existance the researcher is
>ignorant
>to. With a small sample, randomization is not very effective, but with
>larger samples, randomization works. Therefore, if 1538 subjects were
>randomized to either a control or a treatment group, even without rigorous
>supervision of the stretching, randomization would likely have taken care
>of
>the confounding variables.
>
>One cannot make any definitive statements about research by reading only
>the
>abstract. Because the research by Pope et al did not find a statistically
>significant difference between the control and stretch groups, the issue of
>statistical power should be addressed. If the power was sufficiently high,
>then the researchers can state with confidence that a type II statistical
>error (failing to reject a false null hypothesis) is improbable.
>
>Frank Underwood
>
>
>
>Pope RP, Herbert RD, Kirwan JD, Graham BJ. A randomized trial of
>preexercise stretching for prevention of lower-limb injury. Med Sci Sports
>Exerc 2000 Feb;32(2):271-7
>
>Physiotherapy Department, Kapooka Health Centre, New South Wales,
>Australia.
>[log in to unmask]
>
>PURPOSE: This study investigated the effect of muscle stretching during
>warm-up on the risk of exercise-related injury. METHODS: 1538 male army
>recruits were randomly allocated to stretch or control groups. During the
>ensuing 12 wk of training, both groups performed active warm-up exercises
>before physical training sessions. In addition, the stretch group performed
>one 20-s static stretch under supervision for each of six major leg muscle
>groups during every warm-up. The control group did not stretch. RESULTS:
>333
>lower-limb injuries were recorded during the training period, including 214
>soft-tissue injuries. There were 158 injuries in the stretch group and 175
>in the control group. There was no significant effect of preexercise
>stretching on all-injuries risk (hazard ratio [HR] = 0.95, 95% CI
>0.77-1.18), soft-tissue injury risk (HR = 0.83, 95% CI 0.63-1.09), or bone
>injury risk (HR = 1.22, 95% CI 0.86-1.76). Fitness (20-m progressive
>shuttle
>run test score), age, and enlistment date all significantly predicted
>injury
>risk (P < 0.01 for each), but height, weight, and body mass index did not.
>CONCLUSION: A typical muscle stretching protocol performed during
>preexercise warm-ups does not produce clinically meaningful reductions in
>risk of exercise-related injury in army recruits. Fitness may be an
>important, modifiable risk factor.
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