Wilhelm Mark, Matthijs Omer, Browne Kevin, Seeber Gesine, Matthijs Anja, Sizer Phillip S, Brismée Jean-Michel, James C Roger, Gilbert Kerry K
Department of Rehabilitation Sciences, Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Boma, Physical Therapy Outpatient Clinic, Mariazeller Straße 30, 8605 Kapfenberg, Styria, Austria.
Int J Sports Phys Ther. 2017 Feb;12(1):16-24.
Iliotibial Band (ITB) syndrome is a troublesome condition with prevalence as high as 12% in runners. Stretching has been utilized as a conservative treatment. However, there is limited evidence supporting ITB elongation in response to a stretching force.
PURPOSE/HYPOTHESES: The purpose of this study was to describe the iliotibial band tensor fascia lata complex (ITBTFLC) tissue elongation response to a simulated clinical stretch . The authors hypothesized that the ITBTFLC would undergo statistically significant elongation when exposed to a clinical-grade stretching regimen, with the majority of the elongation occurring within the proximal ITBTFLC region.
Within subjects repeated measures design.
The strain response of six un-embalmed ITBTFLCs to a simulated clinical stretch of 2.75% elongation was assessed. Four sets of array marks were placed along the length of the ITBTFLC. Photographic images were taken in resting position (with 1.0% elongation) and with an additional 2.75% elongation. Tissue elongation was compared between proximal, middle, and distal ITBTFLC regions.
A paired samples demonstrated a significantly longer ITBTFLC in the "stretched" versus resting condition ( = 0.001). Significant elongation was observed in the proximal (3.96mm (SD = 1.35); = 0.001), middle (2.12mm (SD = 1.49); = 0.018) and distal (2.25mm (SD = 1.37); = 0.01) regions during the "stretched" versus the resting condition. A one-way ANOVA demonstrated a significant main effect for region ( = 0.002). The proximal region exhibited significantly greater elongation versus the middle ( = 0.003) and distal ( = 0.007) regions, with no significant difference between the middle and distal regions ( = 0.932).
The results of this study demonstrate that the ITBTFLC is capable of elongation in response to a clinically simulated stretch. The proximal ITB region underwent significantly greater elongation than the middle and distal regions and may be more likely to respond to "stretching" in clinical situations. Future investigation should assess the ITBTFLC load/deformation properties to determine whether a short-term clinically available stretch translates into permanent tissue elongation.
III.
髂胫束(ITB)综合征是一种棘手的病症,在跑步者中的患病率高达12%。拉伸已被用作一种保守治疗方法。然而,支持ITB在拉伸力作用下延长的证据有限。
目的/假设:本研究的目的是描述髂胫束阔筋膜张肌复合体(ITBTFLC)组织对模拟临床拉伸的延长反应。作者假设,当暴露于临床级拉伸方案时,ITBTFLC会发生具有统计学意义的延长,且大部分延长发生在近端ITBTFLC区域。
受试者内重复测量设计。
评估了六个未防腐处理的ITBTFLC对2.75%延长的模拟临床拉伸的应变反应。沿着ITBTFLC的长度放置了四组阵列标记。在静止位置(1.0%延长)和额外2.75%延长时拍摄了照片图像。比较了近端、中间和远端ITBTFLC区域之间的组织延长情况。
配对样本显示,与静止状态相比,“拉伸”状态下的ITBTFLC明显更长(P = 0.001)。在“拉伸”状态与静止状态相比时,近端(3.96mm(标准差 = 1.35);P = 0.001)、中间(2.12mm(标准差 = 1.49);P = 0.018)和远端(2.25mm(标准差 = 1.37);P = 0.01)区域均观察到显著延长。单因素方差分析显示区域有显著的主效应(P = 0.002)。近端区域的延长明显大于中间(P = 0.003)和远端(P = 0.007)区域,中间和远端区域之间无显著差异(P = 0.932)。
本研究结果表明,ITBTFLC能够对临床模拟拉伸做出延长反应。近端ITB区域的延长明显大于中间和远端区域,在临床情况下可能更有可能对“拉伸”做出反应。未来的研究应评估ITBTFLC的负荷/变形特性,以确定短期临床可用的拉伸是否能转化为永久性组织延长。
III级。