Foam rolling is thought to improve muscular function, performance, overuse, and joint range of motion (ROM); however, there is no empirical evidence demonstrating this. Thus, the objective of the study was to determine the effect of self-myofascial release (SMR) via foam roller application on knee extensor force and activation and knee joint ROM. Eleven healthy male (height 178.9 ± 3.5 cm, mass 86.3 ± 7.4 kg, age 22.3 ± 3.8 years) subjects who were physically active participated. Subjects' quadriceps maximum voluntary contraction force, evoked force and activation, and knee joint ROM were measured before, 2 minutes, and 10 minutes after 2 conditions: (a) 2, 1-minute trials of SMR of the quadriceps via a foam roller and (b) no SMR (Control). A 2-way analysis of variance (condition × time) with repeated measures was performed on all dependent variables recorded in the precondition and postcondition tests. There were no significant differences between conditions for any of the neuromuscular dependent variables. However, after foam rolling, subjects' ROM significantly (p < 0.001) increased by 10° and 8° at 2 and 10 minutes, respectively. There was a significant (p < 0.01) negative correlation between subjects' force and ROM before foam rolling, which no longer existed after foam rolling. In conclusion, an acute bout of SMR of the quadriceps was an effective treatment to acutely enhance knee joint ROM without a concomitant deficit in muscle performance.

An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force.

Objectives: Previous studies have shown that recovery of recordable grip strength in acute stroke subjects is one of the most sensitive assessments of initial upper limb recovery and a good prognostic factor for latter recovery. The objectives of this study were to test the reliability of maximal voluntary grip force (MVGF) measures and evaluate the relationship between paretic grip strength deficit and paretic upper extremity function in chronic stroke subjects.Design: Over a three-week period, bilateral MVGF was assessed three times with a modified strain gauge dynamometer in 15 chronic stroke subjects and 10 control subjects. The paretic MVGF deficit was expressed in relation to the MVGF of the nonaffected hand.Outcome measures: Upper extremity function in stroke subjects was measured using the Fugl-Meyer, the upper extremity performance test for the elderly (TEMPA), Box and Block and finger-to-nose tests.Results: MVGF measures in both groups of subjects demonstrated good reliability (intraclass correl...

Maximal grip force in chronic stroke subjects and its relationship to global upper extremity function

Effects of self-myofascial release: A systematic review

Neuromotor impairment is a common sequela of severe traumatic brain injury (TBI) but has been understudied relative to neurocognitive outcomes. This multicenter cohort study describes the longitudinal course of neurological examination-based motor abnormalities after severe TBI. Subjects were enrolled from the four lead Department of Veterans Affairs and Defense and Veterans Brain Injury Center sites. The study cohort consisted of 102 consecutive patients (active duty, veteran, or military dependent) with severe TBI who consented during acute rehabilitation for data collection and completed all follow-up evaluations. Paresis, ataxia, and postural instability measures showed a pattern of improvement over time, with the greatest improvement occurring between the inpatient (baseline) and 6-month follow-up assessments. Involuntary movement disorders were rare at all time points. Two years following acute rehabilitation, more than one-third of subjects continued to display a neuromotor abnormality on basic neurological examination. Persistence of tandem gait abnormality was particularly common.

/pdf/motor-impairment-after-severe-traumatic-brain-injury-a-10udzc0781.pdf

Motor Impairment after Severe Traumatic Brain Injury: A Longitudinal Multicenter Study

Background:
Foam rollers are used to mimic myofascial release techniques and have been used by therapists, athletes, and the general public alike to increase range of motion (ROM) and alleviate pressure points. The roller‐massager was designed to serve a similar purpose but is a more portable device that uses the upper body rather than body mass to provide the rolling force.

Roller-massager application to the hamstrings increases sit-and-reach range of motion within five to ten seconds without performance impairments.

The purposes of this study were (1) to investigate the effectiveness of two different levels of massage on the depression of spinal motoneuron excitability (as demonstrated by peak-to-peak H-reflex amplitude changes), (2) to investigate the presence of any gender effects in relation to massage, and (3) to describe a method used to quantify the amount of pressure exerted during two different intensities of massage. Two levels of massage were quantified and defined as light massage (LM) and deep massage (DM). These levels of massage corresponded to pressures of 1.25 and 2.50 kPa (5 and 10 in H2O), respectively. The therapist, before beginning the investigation, was trained to deliver these pressures. Ten peak-to-peak H-reflex recordings were elicited from the triceps surae muscle of each of 20 neurologically healthy subjects (10 male, 10 female) (mean age = 22.6 years) during five control and the two massage conditions. Each condition was 3 minutes in duration. Significant differences were found among the resulting means. The peak-to-peak H-reflex amplitudes recorded during the DM condition were reduced in comparison with those recorded during the LM condition. The peak-to-peak H-reflex amplitudes during both massage conditions were reduced in comparison with those recorded during the control conditions. These changes were noted against a stable M-response. This suggests that the mechanism involved in the observed inhibitory response is pressure sensitive, with DM bringing about a greater inhibitory response than did LM. No differential effects attributable to gender differences were found. These results will serve to define massage characteristics in an ongoing study investigating the effect of massage in persons with a spinal cord injury.

The Effect of Two Intensities of Massage on H-Reflex Amplitude

Background and Purpose. The purpose of this study was to determine the intrarater and interrater reliability of measurements of three clinical features of coordination based on the performance of the “finger-to-nose” test. Subjects. Thirty-seven persons with traumatic brain injury (26 male, 11 female), aged 17 to 64 years (X=29.1, SD=9.9), participated in the study. Methods. Each subject's performance was videotaped and evaluated for the right and left upper extremities (UEs) (two trials each) with respect to the following variables: time of execution, degree of dysmetria, and degree of tremor (four-point ordinal ratings). One year later, five experienced physical therapists (including the original investigator) independently rated each patient's videotaped performance in the same manner as described above. Results. Intraclass correlation coefficients (ICC[3,1])for intrarater reliability were .971 and .986 and ICCs for interrater reliability were .920 and .913 for right and left UEs, respectively, for the time of execution. A generalized Kappa statistic of .54 was calculated for the scoring of dysmetria (both UEs), and Kappa statistics calculated for the scoring of tremor were .18 and .31 for right and left UEs, respectively. Interrater reliability was lower for the scoring of these variables and varied from .36 to .40 for dysmetria and from .27 to .26 for tremor (right and left UEs, respectively). Conclusion and Discussion. These results indicate that physical therapists demonstrate low reliability in assessment of the presence of dysmetria and tremor using videotaped performances of the finger-to-nose test. The results suggest, however, that therapists reliably measure the time of execution of this test. If the limitations associated with therapists' capacity for objective measurement of subjective phenomena cannot be overcome (eg, by establishment of more definitive scoring criteria for the measures of dysmetria and tremor), then therapists should seek alternative methods of evaluation of UE coordination.

Reliability of the Scores for the Finger-to-Nose Test in Adults with Traumatic Brain Injury

A prospective longitudinal design was employed to describe early (first 6 weeks post-injury) motor function recovery in 16 individuals with severe traumatic brain injury (TBI). Reliable, standardized testing and scoring protocols were used by a physical therapist to evaluate subjects on several different aspects of motor function, including primitive reflexes, equilibrium/protective reactions, and a wide range of motor skills. The findings revealed that subjects demonstrated significant changes (chi 2, p < or = 0.05) between 1 and 6 weeks for the following variables: equilibrium reactions in sitting, rolling prone to side-lying, sitting (supported and unsupported), kneeling, standing (assisted and independently), walking (assisted and independently), stair climbing with the use of the handrail and walking 25 m on even ground. A significant change in ability to sit supported between 1 and 3 weeks post-injury was also observed. In addition, recovery was found to be a heterogeneous process, in that different patterns of recovery were evident for the 26 variables and among individual subjects. The clinical implications for physical therapists involved in the rehabilitation of adults with a severe TBI are discussed.

S J Sullivan

Papers

The Effect of Two Intensities of Massage on H-Reflex Amplitude

Reliability of the Scores for the Finger-to-Nose Test in Adults with Traumatic Brain Injury

Longitudinal profile of early motor recovery following severe traumatic brain injury