Feland J B, Myrer J W, Schulthies S S, Fellingham G W, Measom G W
Department of Physical Education, College of Health and Human Performance, Brigham Young University, RB 120A, Provo, UT 84602, USA.
Phys Ther. 2001 May;81(5):1110-7.
Stretching protocols for elderly people (> or = 65 years of age) have not been studied to determine the effectiveness of increasing range of motion (ROM). The purpose of this study was to determine which of 3 durations of stretches would produce and maintain the greatest gains in knee extension ROM with the femur held at 90 degrees of hip flexion in a group of elderly individuals.
Sixty-two subjects (mean age = 84.7 years, SD = 5.6, range = 65-97) with tight hamstring muscles (defined as the inability to extend the knee to less than 20 degrees of knee flexion) participated. Subjects were recruited from a retirement housing complex and were independent in activities of daily living.
Subjects were randomly assigned to 1 of 4 groups and completed a physical activity questionnaire. The subjects in group 1 (n = 13, mean age = 85.1 years, SD = 6.4, range = 70-97), a control group, performed no stretching. The randomly selected right or left limb of subjects in group 2 (n = 17, mean age = 85.5 years, SD = 4.5, range = 80-93), group 3 (n = 15, mean age = 85.2 years, SD = 6.5, range = 65-92), and group 4 (n = 17, mean age = 83.2 years, SD = 4.6, range = 68-90) was stretched 5 times per week for 6 weeks for 15, 30, and 60 seconds, respectively. Range of motion was measured once a week for 10 weeks to determine the treatment and residual effects. Data were analyzed using a growth curve model.
A 60-second stretch produced a greater rate of gains in ROM (60-second stretch = 2.4 degrees per week, 30-second stretch = 1.3 degrees per week, 15-second stretch = 0.6 degrees per week), which persisted longer than the gains in any other group (group 4 still had 5.4 degrees more ROM 4 weeks after treatment than at pretest as compared with 0.7 degrees and 0.8 degrees for groups 2 and 3, respectively).
Longer hold times during stretching of the hamstring muscles resulted in a greater rate of gains in ROM and a more sustained increase in ROM in elderly subjects. These results may differ from those of studies performed with younger populations because of age-related physiologic changes.
针对老年人（年龄≥65岁）的伸展训练方案尚未进行研究以确定增加关节活动范围（ROM）的有效性。本研究的目的是确定在一组老年人中，将股骨保持在髋关节屈曲90度时，3种不同时长的伸展训练中哪种能使膝关节伸展ROM产生并维持最大的增加。
62名受试者（平均年龄 = 84.7岁，标准差 = 5.6，年龄范围 = 65 - 97岁）参与研究，他们的绳肌紧张（定义为无法将膝关节伸展至小于20度的屈膝角度）。受试者从一个退休人员居住社区招募，且日常生活能够自理。
受试者被随机分配到4组中的1组，并完成一份身体活动问卷。第1组（n = 13，平均年龄 = 85.1岁，标准差 = 6.4，年龄范围 = 70 - 97岁）为对照组，不进行伸展训练。第2组（n = 17，平均年龄 = 85.5岁，标准差 = 4.5，年龄范围 = 80 - 93岁）、第3组（n = 15，平均年龄 = 85.2岁，标准差 = 6.5，年龄范围 = 65 - 92岁）和第4组（n = 17，平均年龄 = 83.2岁，标准差 = 4.6，年龄范围 = 68 - 90岁）的受试者，其随机选择的右下肢或左下肢分别每周伸展5次，持续6周，每次伸展时长分别为15秒、30秒和60秒。在10周内每周测量一次关节活动范围，以确定治疗效果和残留效应。数据采用生长曲线模型进行分析。
60秒的伸展训练使ROM增加的速率更大（60秒伸展训练 = 每周2.4度，30秒伸展训练 = 每周1.3度，15秒伸展训练 = 每周0.6度），且这种增加比其他任何组持续的时间都更长（治疗后4周，第4组的ROM仍比测试前多5.4度，而第2组和第3组分别为0.7度和0.8度）。
在老年人中，绳肌伸展训练的保持时间越长，ROM增加的速率越大，且ROM增加的持续性越强。由于与年龄相关的生理变化，这些结果可能与针对年轻人群的研究结果不同。
