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Pain sensitivity and torque used during measurement predicts change in range of motion at the knee

Authors Bishop MD, George SZ

Received 4 September 2017

Accepted for publication 22 October 2017

Published 29 November 2017 Volume 2017:10 Pages 2711—2716

DOI https://doi.org/10.2147/JPR.S150775

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 4

Editor who approved publication: Dr Katherine Hanlon

Mark D Bishop,1 Steven Z George2
 
1Department of Physical Therapy, University of Florida, Gainesville, FL, USA; 2Duke Clinical Research Institute, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
 
Objective: To determine the extent to which changes in knee range of motion (ROM) after a stretching program are related to sensory factors at the time of testing and the amount of force used during the measurement of ROM, rather than changes in soft-tissue properties.
Design: Randomized, single-blind design. Participants were randomly assigned to a control or stretching group.
Setting: Research laboratory.
Participants: Forty-four healthy volunteers (22.8±2.8 years of age; 23 men).
Interventions: The stretching group undertook static stretching twice a day for 8 weeks. The control group continued with routine activity, but was discouraged from starting a flexibility program.
Main outcome measures: ROM and tissue extensibility was assessed using a Biodex3 dynamometer, and ratings of thermal pain were collected at baseline and at 4 and 8 weeks by an examiner blinded to group assignment. Multilevel modeling was used to examine predictors of ROM across time.
Results: The stretching group showed a 6% increase, and the control group had a 2% increase, in ROM over the 8-week program. However, when fixed and random effects were tested in a complete model, the group assignment was not significant. End-point torque during ROM testing (p=0.021) and the ratings in response to thermal testing (p<0.001) were significant, however.
Conclusion: ROM measured in a testing session was not predicted by assignment to a stretching program. Rather, ROM was predicted by the ratings of thermal stimuli and the peak torque used to apply the stretch.

Keywords: sensory tolerance, stretching, rehabilitation, torque, pain

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