Objective
Lack of flexibility of calf muscle that is generally called as tightness of Achilles tendon becomes a cause of pain, injury of feet, calf and a contributory factor of plantar fasciitis, hallux valgus, secondary planus
Regular stretching of calf muscle and plantar fascia is generally recommended as early treatment method having advantage of low-risk and minimal-cost intervention, compared with other treatment method. It is hard to discriminate which method is more convenient to be implemented and effective for patients as there is no study comparing incline board training with leaning wall stretching exercise that are typical methods of being able to stretch Achilles tendon.
In this study, in order to compare therapeutic effect of two exercises, during each exercise, stretching level of Achilles tendon was measured through elongation distance and ankle joint movement range through X-ray. In addition, which exercise method is more effective was intended to be confirmed by comparing fatigue condition through EMG after confirming a subjective pain at the time of elongation.
Methods
2 types of exercise were performed by targeting 30 healthy volunteers without structural, physiological abnormality in lower limb. After giving education for each exercise sufficiently, X-ray and EMG(electromyogram) examination were performed after progressing motion for a count of ten and repeat it ten times. 1 hour interval was given between two exercises.
X-ray was performed in 3 positions; 1 in neutral stance, and 2 positions of each elongation exercises of Achilles tendon. Stretching level was measured through distance separated by X-ray screening and joint ROM and as separated distance, up to lateral condyle of femur that is origin of GCM in lateral X-ray and mid-posterior of calcaneous that is insertion of GCM were measured.
Electrode was attached to mid portion of lateral GCM muscle, and muscle tension and fatigue level of lateral GCM muscle were indirectly measured based on mean value after measuring surface EMG based on 10 times per second for 10 sessions.
Results
Statistical difference in ankle dorsiflexion ROM(range of motion) being measured at the X-ray screening was not represented but elongation length of incline board training was significantly longer than that of leaning wall stretching exercise (p=0.019).
In GCM (gastrocnemius muscle) EMG test, amplitude of incline board training was significantly smaller than that of leaning wall stretching exercise (p=0.001) and VAS pain index was more high (p=0.000).
Conclusion
In this study, as a method of Achilles tendon elongation, both incline board training and leaning wall stretching exercise were effective but it is considered that incline board training would be more effective for stretching than leaning wall stretching exercise. Therefore, incline board training could be used as stretching exercise in a group with various diseases requiring elongation of Achilles tendon. |
