Effects of a Single Proprioceptive Neuromuscular Facilitation Stretching Exercise With and Without Post-stretching Activation on the Muscle Function and Mechanical Properties of the Plantar Flexor Muscles

Marina Reiner, Markus Tilp, Gaël Guilhem, Antonio Morales-Artacho, Masatoshi Nakamura, Andreas Konrad, Marina Reiner, Markus Tilp, Gaël Guilhem, Antonio Morales-Artacho, Masatoshi Nakamura, Andreas Konrad

Abstract

A single proprioceptive neuromuscular facilitation (PNF) stretching exercise can increase the range of motion (ROM) of a joint but can lead to a decrease in performance immediately after the stretching exercise. Post-stretching activation (PSA) exercises are known as a possible way to counteract such a drop in performance following a single stretching exercise. However, to date, no study has investigated the combination of PNF stretching with PSA. Thus, the aim of this study was to compare the effects of a PNF stretching exercise with and without PSA on the muscle function (e.g., ROM) and mechanical properties of the plantar flexor muscles. Eighteen physically active males volunteered in the study, which had a crossover design and a random order. The passive shear modulus of the gastrocnemius medialis (GM) and gastrocnemius lateralis (GL) was measured in a neutral position with shear wave elastography, both pre- and post-intervention. Maximum voluntary isometric contraction (MVIC) peak torque, maximum voluntary dynamic contraction peak torque, dorsiflexion ROM, and passive resistive torque (PRT) were also measured with a dynamometer. The interventions were 4×30s of PNF stretching (5s of contraction) and two sets of three exercises with 20 or 40 fast ground contacts (PNF stretching+PSA) and PNF stretching only. ROM was found to have increased in both groups (+4%). In addition, the PNF stretching+PSA group showed a decrease in PRT at a given angle (-7%) and a decrease in GM and mean shear modulus (GM+GL; -6%). Moreover, the MVIC peak torque decreased (-4%) only in the PNF stretching group (without PSA). Therefore, we conclude that, if PNF stretching is used as a warm-up exercise, target-muscle-specific PSA should follow to keep the performance output at the same level while maintaining the benefit of a greater ROM.

Keywords: mechanical properties; muscle function; muscle shear modulus; muscle stiffness; plantar flexor muscles; post-stretching activation; proprioceptive neuromuscular facilitation stretching; specific warm-up.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Copyright © 2021 Reiner, Tilp, Guilhem, Morales-Artacho, Nakamura and Konrad.

Figures

Figure 1
Figure 1
Overview of the test procedure. SWE, shear wave elastography; MVIC, maximum voluntary isometric contraction; MVDC, maximum voluntary dynamic contraction; ROM, range of motion; PRT, passive resistive torque; control condition=4min rest; and post-stretching activation (PSA)=2×(skipping with 40 ground contacts, 20 jumps with straight legs, and high knee running with 40 ground contacts).
Figure 2
Figure 2
Measurement setup in the laboratory. The participant is positioned prone and fixed on the dynamometer to prevent evasive movements. The pillow underneath the non-testing leg was used to increase subjects’ comfort during the measurements.
Figure 3
Figure 3
The standing wall push exercise used for the proprioceptive neuromuscular facilitation (PNF) stretching intervention.
Figure 4
Figure 4
An example for signal changes in shear wave elastography in the GM muscle in the PNF+PSA group. For the analysis, the area within the colored box was analyzed. Each colored pixel has a value according to the scale on the right upper corner (max 300kPa) and the average of the chosen area was taken for further analysis.
Figure 5
Figure 5
Pre- and post-mean shear modulus values of both groups (PNF only and PNF+PSA) and the individual changes. *=significant change between pre- and post-values.
Figure 6
Figure 6
Pre- and post-MVIC peak torque values of both groups (PNF only and PNF+PSA) and the individual changes. *=significant change between pre- and post-values.
Figure 7
Figure 7
Pre- and post-dorsiflexion ROM values of both groups (PNF only and PNF+PSA) and the individual changes. *=significant changes between pre- and post-values.

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