Changes in quantitative elasticity in muscle tissue and muscle flexibility on biceps femoris muscle due to stretching exercise

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analysis, the Steel-Dwass and Tukey-Kramer tests were used to compare the NRS values and the increases in PF-CBF among the three experiments, respectively. Results: The NRS value during the high-intensity TENS was significantly lower than those during both the lowintensity TENS and control. The increases in PF-CBF during both the high- and low-intensity TENS were significantly suppressed compared with that during the control. Moreover, the increase in PF-CBF during the high-intensity TENS was also significantly suppressed compared with that during the low-intensity TENS. Conclusion(s): Our results indicate that the high-intensity TENS can provide an excellent pain-relief effect in terms of not only the subjective but also objective aspects. Recent study have pointed out that the large diameter primary afferents from deep somatic tissues are pivotal in causing TENS analgesia based on the spinal gating mechanism. For the activation of these afferents, it is conceivable that higher TENS stimulus intensity will be required. This might be the reason why the pain-relief effect of the high-intensity TENS was better than that of the low-intensity TENS in this study. Implications: It is appropriate to consider that the excellent pain-relief effect of the high-intensity TENS in this study is a narrow result for artificial pain. In the future, it is necessary to investigate the clinical effectiveness of the high-intensity TENS for patients with real pain. Keywords: TENS; Stimulus intensity; Objective indicator Funding acknowledgements: Non funded. Ethics approval: This study was approved by the committee of medical ethics of Hirosaki University Graduate School of Medicine. http://dx.doi.org/10.1016/j.physio.2015.03.3329 Research Report Poster Presentation Number: RR-PO-04-24-Sat Saturday 2 May 2015 13:00 Exhibit halls 401–403 CHANGES IN QUANTITATIVE ELASTICITY IN MUSCLE TISSUE AND MUSCLE FLEXIBILITY ON BICEPS FEMORIS MUSCLE DUE TO STRETCHING EXERCISE S. Kouda 1 , T. Dakeshita 1 , S. Hara 1 , K. Wakimoto 1 , Y. Uchida 2 1 SEISEN

Medical Corporation, Physiotherapy Department, Shizuoka, Japan; 2 SEISEN Medical Corporation, Medical Doctor, Shizuoka, Japan Background: Previous studies have reported that the increase in joint range of motion, decrease in muscle tone, improving blood circulation, mitigating muscles pain and athletic performance enhancement can be anticipated from stretching exercise (Suzuki et al., 2012).

The preventive effect of static stretching on biceps femoris that prevents lower leg athletic injury such as biceps femoris injury is widely recognized (Nakamura et al., 2013). According the report from Taniguchi et al., the effect of static stretching on gastrocnemial muscle is to improve flexibility of foot joint and reduce elasticity on the muscle tissue of gastrocnemial muscle. Purpose: In this study, two types of biceps femoris stretching exercise were conducted and the effect on elasticity and flexibility on the muscle tissue was examined. Methods: Static stretching (SS) and dynamic stretching (DS) using stretching bench were performed by 15 healthy adult subjects (13 males and 2 females with average age 26.8 ± 3.5 years and average weight 64.7 ± 4.5 kg) and the effects on biceps femoris muscle were examined. By using Share Wave elastography (SWE) and measure them quantitatively, as average Young’s modulus (kPa), Straight Leg Raising (SLR) and Finger Floor Distance (FFD) were conducted to examine the change in muscle flexibility, and the elasticity of muscle tissue was assessed at semitendinosus (ST), semimembranosus muscle (SM) and the belly muscle of Long head of Biceps femoris muscle (LB). Before and after conducting SS and DS for one minute, comparative study was held to review the change in muscle flexibility and elasticity of muscle tissue at biceps femoris muscle. As a statistical procedure, t-test was used and the p-value less than 0.05 were considered statistically significant. Results: Statistically significant improvement of muscle flexibility of the subjects was observed at both SS group (SLR: 8.33 ± 6.45◦ , FFD: 5.43 ± 6.27 cm) and DS group (SLR: 8.33 ± 5.56◦ , FFD: 2.53 ± 1.32 cm). Statistically significant decrease in elasticity of muscle tissue was observed in ST, SM and LB at SS group (ST: −24.7 ± 36.7 kPa, SM: −22.8 ± 27.5 kPa, LB: −22.8 ± 29.9 kPa), on the other hand, no significant changes were observed at DS group (ST: 9.1 ± 44.6 kPa, SM: −0.1 ± 25.2 kPa, LB: 5.8 ± 45.7 kPa). Conclusion(s): The improvement in muscle flexibility at both SS group and DS group was observed; therefore the effect of stretching exercise in biceps femoris muscle as previously reported has recognized. However, no statistically significant changes were observed at DS group, even though a statistically significant decrease in elasticity of muscle tissue was observed at SS group. Since there is a possibility that the types of stretching exercise and the length of time spent on exercise had influenced on the above results, further investigations on the effect of stretching exercise at the elasticity of muscle tissue of skeletal muscle are required. Implications: An objective evaluation of elasticity in muscle might be useful to determine the curative effect of treatment and SWE can be used as one of the evaluation tools. Keywords: Stretching exercise; Share Wave elastography; Elasticity; In muscle tissue; Flexibility Funding acknowledgements: This study was unfunded.

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS427–eS632

Ethics approval: The target parsons were explained written about the gist of this study, and the parsons who consented became the targets. http://dx.doi.org/10.1016/j.physio.2015.03.3330 Research Report Poster Presentation Number: RR-PO-01-07-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 DECREASED PHYSICAL ACTIVITY IS ASSOCIATED WITH AN INCREASED INCIDENCE OR PROGRESSION OF PERIPHERAL ARTERY DISEASE IN HEMODIALYSIS PATIENTS M. Harada 1 , A. Matsunaga 1 , N. Aoyama 2 , Y. Abe 1 , K. Yoneki 1,3 , R. Ishikawa 1 , T. Watanabe 1 , K. Shigeta 1 , Y. Miyako 1 , T. Kutsuna 2 , R. Matsuzawa 2 , A. Yoshida 3 1 Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; 2 Kitasato University Hospital, Sagamihara, Japan; 3 Sagami Junkanki Clinic, Sagamihara, Japan

Background: Hemodialysis patients are at a higher risk of developing peripheral artery disease (PAD) than the general population. However, factors associated with the incidence or progression of PAD in hemodialysis patients have not been fully elucidated. Furthermore, very few studies have assessed the association between the development of PAD and physical activity levels, although most of hemodialysis patients have low levels of daily physical activity and are thus prone to arteriosclerosis. Purpose: The purpose of this study was to examine whether physical activity levels contribute to the development of PAD in hemodialysis patients using multivariate analyses adjusted for clinical variables. Methods: This prospective study followed Japanese outpatients undergoing maintenance hemodialysis three times a week at the Hemodialysis Center from July 2012 to January 2013 for one year. Patients who had been treated with percutaneous transluminal angioplasty and/or stenting, had an ankle-brachial index (ABI) ≥1.40 at baseline, had noncompliance with prescribed medications (antiplatelet and statin drugs), and showed changes in physical activity levels during the observation period due to adverse clinical events were excluded. Age, sex, body mass index, dialysis vintage, history of smoking, comorbid conditions, blood biochemical data (creatinine, calcium-phosphate products, low and high-density lipoprotein cholesterol, triglyceride, and intact parathyroid hormone), levels (high or low) of physical activity, and ABI were obtained from clinical records at baseline. Patients were classified as having a low physical activity level if they used wheelchair at home/hospital, required walking

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assistance, or had limited ambulation at/around home. For analysis, patients were divided into groups with or without newly diagnosed PAD (ABI ≥1.00 at baseline and ABI ≤0.99 at the endpoint), and with or without progressive PAD (ABI ≤0.99 at baseline and subsequent decrease in ABI to ≥0.10) according to changes in ABI during the study period. Multivariate logistic regression analyses adjusted for baseline clinical variables were performed to identify the prognostic effect of physical activity levels on PAD incidence or progression after one year. Analysis was performed using the Statistical Package for Social Sciences (SPSS version 21, USA). Results: A total of 124 eligible Japanese outpatients (mean age, 65.7 ± 10.7; male, 52.4%; mean hemodialysis vintage, 9.9 ± 8.6 years) were included in the study. During the follow-up period, 13 hemodialysis patients (10.5%) were newly diagnosed or had progressive PAD. Adjusted multivariate logistic regression analyses revealed a significant association between PAD incidence or progression and physical activity levels (odds ratio, 5.504; 95% confidence interval, 1.653–18.326; P = 0.005). Conclusion(s): Decreased physical activity is closely and independently associated with an increased incidence or progression of PAD in hemodialysis patients. Implications: Hemodialysis patients reportedly have significantly lower physical activity levels compared to age-matched community-dwelling people. Regular physical therapy to increase habitual physical activity should be considered as an effective approach to prevent the development of PAD in clinically stable hemodialysis patients. Keywords: Physical activity; Peripheral arterial disease; Hemodialysis Funding acknowledgements: This work was supported by JSPS KAKENHI Grant Number 26350631. Ethics approval: The study protocol was approved by the Research Ethics Committee of Kitasato University School of Allied Health Sciences. http://dx.doi.org/10.1016/j.physio.2015.03.3331