• Physical Therapy Korea
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• v.21 no.2
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• pp.57-66
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• 2014

The objective of this study was to determine the duration of maintained calf muscle flexibility gained in young adults with calf muscle tightness, as measured by increases in ankle active and passive dorsiflexion range of motion (DFROM) after three stretching interventions. Twenty subjects (5 men and 15 women) with calf muscle tightness received the following three stretching interventions in one leg (assigned at random): static stretching (SS), eccentric training on stable surface (ETS), and eccentric training on unstable surfaces (ETU). The subjects received all three interventions to the same leg, applied in a random order. Each intervention had a break of at least 24 h in-between, in order to minimize any carryover effect. Each intervention used two types of stretching: with the calf muscle stretched and both knees straight, and with the knee slightly bent in order to maximize the activation of the soleus muscle. All three interventions were performed for 200 seconds. We measured the duration of maintained calf muscle flexibility through active and passive ankle DFROM before intervention, immediately after intervention (time 0), and then 3, 6, 9, 15, and 30 min after intervention. We found a difference in the duration of maintained calf muscle flexibility between the three interventions. In the ETS and ETU interventions, a significant improvement in calf muscle flexibility, both ankle active and passive dorsiflexion ranges of motion (ADFROM and PDFROM), was maintained for 30 min. In the SS intervention, however, ADFROM before 9 min and PDFROM before 6 min were statistically different from the baseline. Our results suggest that ETS and ETU may be more effective than SS for maintaining calf muscle flexibility in young adults.

• The Journal of Korean Physical Therapy
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• v.31 no.6
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• pp.346-350
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• 2019

Purpose: The purpose of this study was to investigate the effects of calf tightness on gait, plantar pressure, and balance in adults. Methods: A total of 60 participants were divided into a normal group of 30 subjects with normal dorsiflexion angle (20-25 degrees) and an experimental group of 30 subjects with limited dorsiflexion angle (0-15 degrees) due to calf tightness. Gait ability and foot pressure of the subjects was measured with a treadmill, and the balance ability was measured by PROKIN system. Results: A significant difference in COP length, loading response, and single limb support was observed between groups. The COP length and single limb support ratio in the normal group was greater than in the experimental group, but the experimental group showed a higher ratio for loading response in the gait ratio. Conclusion: Our results indicated that calf tightness was negative effects on balance and gait ability, so assessment of the muscle tightness should be considered during exercise and treatment.

• Physical Therapy Korea
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• v.27 no.2
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• pp.133-139
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• 2020

Background: The gastrocnemius (GCM) is one of the lower extremity muscles that tend to tighten easily. GCM tightness results in limited ankle dorsi-flexion (DF), especially when the knee joint is fully extended. Joint flexibility is determined by the morphological and physiological characteristics of joints, muscles, tendons, and ligaments. Impaired joint flexibility can be attributed to increased susceptibility to muscle injury. High-frequency diathermy is clinically used to reduce pain and muscle tightness and to improve limited range of motion. Objects: This study aimed to investigate the immediate effects of high-frequency therapy in subjects with GCM tightness. Methods: The study was designed as a one-group before-after trial. The subjects included 28 volunteers with GCM tightness (an active ankle DF angle of less than 12°) without any known neurological and musculoskeletal pathologies in the ankle and calf areas. WINBACK Transfer Electrode Capacitive and Resistive Therapy equipment was used to apply high-frequency therapy to the subjects' GCMs for 10-15 minutes. The pennation angle and the fascicle length of the GCM were measured using ultrasonography. The flexibility of the ankle joint, peak torque to the passive ankle DF (Biodex), and soft tissue stiffness (MyotonPRO) were also measured. Results: The pennation angle was significantly decreased following the treatment; however, no significant difference in the fascicle length was found (p < 0.05). The flexibility was significantly increased and both the passive peak torque to passive ankle DF and the soft tissue stiffness significantly decreased (p < 0.05). Conclusion: High-frequency therapy is immediately effective for improving the muscle's architectural properties and functional factors in subjects with GCM tightness. Further longitudinal clinical studies are required to investigate the long-term effects of high-frequency therapy on subjects with GCM tightness from various causes.

• Physical Therapy Korea
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• v.2 no.2
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• pp.56-65
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• 1995

The purpose of this study was to compare the effects of one proprioceptive neuromuscular facilitation technique and static stretching on calf muscle tightness. The subjects consist of 9 hemiplegics, and 9 quadriplegics. The eighteen subjects were randomly divided into 3 groups: prorioceptive neuromuscular facilitation(6 persons), static stretching(6 persons) and control(6 persons). Contract relax antagonist contract and static stretching techniques were applied continuously for twenty minutes each. Of the many proprioceptive neuromuscular facilitation techniques, only the contract relax antagonist contract technique was applied. The static stretching technique was applied with the subject placed in standing on a seventy degree inclined tilt table for twenty minutes. A wedge was placed under the feet to obtain maximum dorsiflexion. Wedge thickness varied with each subject. Results revealed: (1) a significant difference between the experimental and the control groups(p<0.05). (2) a significant difference between contract relax antagonist contract and static stretching groups(p<0.05). (3) At day five, the final increments were: contract relax antagonist contract $11.9{\pm}1.90^{\circ}$, static stretching $7.7{\pm}2.3^{\circ}$(mean${\pm}$standard deviation).

• The Journal of Korean Physical Therapy
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• v.32 no.5
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• pp.302-306
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• 2020

Purpose: The purpose of this study was to investigate comparisons of vastus medialis (VMO) and vastus lateralis (VL) muscle activities according to different heights during drop landing in flatfooted adults. Methods: Fifteen subjects with a flat foot arch and 15 subjects with a normal feet arch were participated. Subjects performed a double limb drop landing task from 20, 40, and 60 cm heights. Surface electromyography was used to measure the muscle activities of the VMO and VL during drop landing. Results: There were significant differences of muscle activities in the VMO, VL, and the VMO and VL ratio between groups. The electromyography values of VMO, VL, and the VMO and VL ratio in the normal group were significantly greater than in the flat foot group, and muscle activities and the VMO and VL ratio significantly increased with landing heights in the both groups. Conclusion: Our results indicated that muscle activity patterns of VOM and VL in the flat foot group were lower at heights than in the normal group, so calf tightness was negative effects on balance and gait ability, so assessment of muscle activation patterns in the knee extensors should be considered during exercise and treatment of flat feet.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.105-108
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• 2021

Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.