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Gastrocnemius tightness on joint angle and work of lower extremity during gait

      Abstract

      Background

      Muscular tightness is a common clinical musculoskeletal disorder and is regarded as a predisposing factor for muscle injuries. In this study, a two-way mixed design ANOVA was applied to investigate the effects of the gastrocnemius tightness on the joint angle and joint work during walking.

      Methods

      Twenty-two patients with muscular tightness of gastrocnemius muscle (<12° of ankle dorsiflexion with knee extended) and 22 age- and gender-matched subjects with normal gastrocnemius flexibility (>15° of ankle dorsiflexion with knee extended) participated in this study. The joint angle and work at hip, knee, and ankle joints during the stance phase were analyzed at two preset cadences of 100 steps/min and 140 steps/min.

      Findings

      Significantly greater flexion angles at hip (P= 0.025) and knee (P= 0.001) were found in the tightness group at the time of maximal ankle dorsiflexion. Significantly less work generation at knee (P= 0.034) and greater work absorption at ankle (P= 0.024) were detected in the tightness group.

      Interpretation

      The subjects with gastrocnemius tightness revealed a compensatory gait pattern, which included the changes in the joint angles and associated work productions. The potential disturbance of the knee control and strain injuries of plantar flexors might be crucial in the clinical considerations for subjects with gastrocnemius tightness.

      Keywords

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      References

        • Armand S.
        • Watelain E.
        • Mercier M.
        • Lensel G.
        • Lepoutre F.X.
        Identification and classification of toe-walkers based on ankle kinematics, using a data-mining method.
        Gait Posture. 2006; 23: 240-248
        • Baddar A.
        • Granata K.
        • Damiano D.L.
        • Carmines D.V.
        • Blanco J.S.
        • Abel M.F.
        Ankle and knee coupling in patients with spastic diplegia: effects of gastrocnemius-soleus lengthening.
        Bone Joint Surg. Am. 2002; 84-A: 736-744
        • Barr A.E.
        • Backus S.I.
        Biomechanics of gait.
        in: Nordin M. Frankel V.H. Basic Biomechanics of the Musculosketeal System. third ed. Lippincott Williams & Wikins, Baltimore2001
        • Chen I.H.
        • Kuo K.N.
        • Andriacchi T.P.
        The influence of walking speed on mechanical joint power during gait.
        Gait Posture. 1997; 6: 171-176
        • Ekstrand J.
        • Gillquist J.
        The frequency of muscle tightness and injuries in soccer players.
        Am. J. Sports Med. 1982; 10: 75-78
        • Ekstrand J.
        • Gillquist J.
        The avoidability of soccer injuries.
        Int. J. Sports Med. 1983; 4: 124-128
        • Graf A.
        • Judge J.
        • Ounpuu S.
        • Thelen D.G.
        The effect of walking speed on lower-extremity joint powers among elderly adults who exhibit low physical performance.
        Arch. Phys. Med. Rehabil. 2005; 86: 2177-2183
        • Hansen A.H.
        • Childress D.S.
        • Miff S.C.
        • Gard S.A.
        • Mesplay K.P.
        The human ankle during walking: implications for design of biomimetic ankle prostheses.
        J. Biomech. 2004; 37: 1467-1474
        • Hertling D.
        • Kessler R.M.
        Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods.
        Lippincott Williams & Wilkins, Philadelphia, PA2006
        • Inman V.T.
        • Ralston H.J.
        • Todd F.
        Human Walking.
        Williams & Wikins, Baltimore1981
        • Johanson M.
        • Baer J.
        • Hovermale H.
        • Phouthavong P.
        Subtalar joint position during gastrocnemius stretching and ankle dorsiflexion range of motion.
        J. Athl. Train. 2008; 43: 172-178
        • Kadaba M.P.
        • Ramakrishnan H.K.
        • Wootten M.E.
        Measurement of lower extremity kinematics during level walking.
        J. Orthop. Res. 1990; 8: 383-392
        • Kaufman K.R.
        • Brodine S.K.
        • Shaffer R.A.
        • Johnson C.W.
        • Cullison T.R.
        The effect of foot structure and range of motion on musculoskeletal overuse injuries.
        Am. J. Sports Med. 1999; 27: 585-593
        • Kerrigan D.C.
        • Todd M.K.
        • Croce U.D.
        • Lipsitz L.A.
        • Collins J.J.
        Biomechanical gait alterations independent of speed in the healthy elderly: evidence for specific limiting impairments.
        Arch. Phys. Med. Rehabil. 1997; 79: 317-322
        • Kisner C.
        • Colby L.A.
        Therapeutic Exercise: Foundations and Techniques.
        FA Davis Co, Philadelphia, PA2007
        • Lun V.
        • Meeuwisse W.H.
        • Stergiou P.
        • Stefanyshyn D.
        Relation between running injury and static lower limb alignment in recreational runners.
        Brit. J. Sports Med. 2004; 38: 576-580
        • Maluf K.S.
        • Mueller M.J.
        • Strube M.J.
        • Engsberg J.R.
        • Johnson J.E.
        Tendon Achilles lengthening for the treatment of neuropathic ulcers causes a temporary reduction in forefoot pressure associated with changes in plantar flexor power rather than ankle motion during gait.
        J. Biomech. 2004; 37: 897-906
        • Matjacić Z.
        • Olensek A.
        • Bajd T.
        Biomechanical characterization and clinical implications of artificially induced toe-walking: differences between pure soleus, pure gastrocnemius and combination of soleus and gastrocnemius contractures.
        J. Biomech. 2006; 39: 255-266
        • Messier S.P.
        • Pittala K.A.
        Etiologic factors associated with selected running injuries.
        Med. Sci. Sports Exerc. 1988; 20: 501-505
        • Mian O.S.
        • Thom J.M.
        • Ardigò L.P.
        • Minetti A.E.
        • Narici M.V.
        Gastrocnemius muscle–tendon behaviour during walking in young and older adults.
        Acta Physiol. 2007; 189: 57-65
        • Moseley A.M.
        • Crosbie J.
        • Adams R.
        High- and low-ankle flexibility and motor task performance.
        Gait Posture. 2003; 18: 73-80
        • Mueller M.J.
        • Minor S.D.
        • Schaaf J.A.
        • Strube M.J.
        • Sahrmann S.A.
        Relationship of plantar-flexor peak torque and dorsiflexion range of motion to kinetic variables during walking.
        Phys. Ther. 1995; 75: 684-693
        • Neely F.G.
        Biomechanical risk factors for exercise-related lower limb injuries.
        Sports Med. 1998; 26: 395-413
        • Norkin C.C.
        • White D.J.
        Measurement of Joint Motion – A Guide to Goniometry.
        FA Davis Co, Philadelphia, PA2003
        • Olney S.J.
        • Macphail H.A.
        • Hedden D.M.
        • Boyce W.F.
        Work and power in hemiplegic cerebral palsy gait.
        Phys. Ther. 1990; 70: 431-438
        • Orendurff M.S.
        • Segal A.D.
        • Aiona M.D.
        • Dorociak R.D.
        Triceps surae force, length and velocity during walking.
        Gait Posture. 2005; 21: 157-163
        • Prince F.
        • Corriveau H.
        • Hebert R.
        • Winter D.A.
        Gait in the elderly.
        Gait Posture. 1997; 5: 128-135
        • Proske U.
        • Morgan D.L.
        • Brockett C.L.
        • Percival P.
        Identifying athletes at risk of hamstring strains and how to protect them.
        Clin. Exp. Pharmacol. Physiol. 2004; 31: 546-550
        • Riddle D.L.
        • Pulisic M.
        • Pidcoe P.
        • Johnson R.E.
        Risk factors for plantar fasciitis: a matched case-control study.
        Bone Joint Surg. Am. 2003; 85-A: 872-877
        • Rose J.
        • Gamble J.G.
        Human Walking.
        Lippincott Williams & Wikins, Baltimore1994
        • Schache A.G.
        • Wrigley T.V.
        • Baker R.
        • Pandy M.G.
        Biomechanical response to hamstring muscle strain injury.
        Gait Posture. 2009; 29: 332-338
        • Smith L.K.
        • Weiss E.L.
        • Lehmkuhl L.D.
        Brunnstrom’s Clinical Kinesiology.
        FA Davis Co, Philadelphia1996
        • Teixeira-Salmela L.F.
        • Nadeau S.
        • Milot M.-H.
        • Gravel D.
        • Requiao L.F.
        Effects of cadence on energy generation and absorption at lower extremity joints during gait.
        Clin. Biomech. 2008; 23: 769-778
        • Wang S.S.
        • Whitney S.L.
        • Burdett R.G.
        • Janosky J.E.
        Lower extremity muscular flexibility in long distance runners.
        J. Orthop. Sports Phys. Ther. 1993; 17: 102-107
        • Wilder R.P.
        • Sethi S.
        Overuse injuries: tendinopathies, stress fractures, compartment syndrome, and shin splints.
        Clin. Sports Med. 2004; 23: 55-81
        • Wren T.A.
        • Do K.P.
        • Kay R.M.
        Gastrocnemius and soleus lengths in cerebral palsy equinus gait – differences between children with and without static contracture and effects of gastrocnemius recession.
        J. Biomech. 2004; 37: 1321-1327
        • Wu S.K.
        • Hong C.Z.
        • You J.Y.
        • Chen C.L.
        • Wang L.H.
        • Su F.C.
        Therapeutic effect on the change of gait performance in chronic calf myofascial pain syndrome: a time series case study.
        J. Muscoskel. Pain. 2005; 13: 33-43