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Int J Sports Med 2018; 39(02): 110-114
DOI: 10.1055/s-0043-117411
Training & Testing
© Georg Thieme Verlag KG Stuttgart · New York

Contributions of Hamstring Stiffness to Straight-Leg-Raise and Sit-and-Reach Test Scores

Naokazu Miyamoto
1   National Institute of Fitness and Sports in Kanoya, Department of Sports and Life Science, Kanoya, Japan
,
Kosuke Hirata
1   National Institute of Fitness and Sports in Kanoya, Department of Sports and Life Science, Kanoya, Japan
,
Noriko Kimura
1   National Institute of Fitness and Sports in Kanoya, Department of Sports and Life Science, Kanoya, Japan
,
Eri Miyamoto-Mikami
1   National Institute of Fitness and Sports in Kanoya, Department of Sports and Life Science, Kanoya, Japan
› Author Affiliations
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Publication History



accepted after revision 13 July 2017

Publication Date:
30 November 2017 (online)

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Abstract

The passive straight-leg-raise (PSLR) and the sit-and-reach (SR) tests have been widely used to assess hamstring extensibility. However, it remains unclear to what extent hamstring stiffness (a measure of material properties) contributes to PSLR and SR test scores. Therefore, we aimed to clarify the relationship between hamstring stiffness and PSLR and SR scores using ultrasound shear wave elastography. Ninety-eight healthy subjects completed the study. Each subject completed PSLR testing, and classic and modified SR testing of the right leg. Muscle shear modulus of the biceps femoris, semitendinosus, and semimembranosus was quantified as an index of muscle stiffness. The relationships between shear modulus of each muscle and PSLR or SR scores were calculated using Pearson’s product-moment correlation coefficients. Shear modulus of the semitendinosus and semimembranosus showed negative correlations with the two PSLR and two SR scores (absolute r value≤0.484). Shear modulus of the biceps femoris was significantly correlated with the PSLR score determined by the examiner and the modified SR score (absolute r value≤0.308). The present findings suggest that PSLR and SR test scores are strongly influenced by factors other than hamstring stiffness and therefore might not accurately evaluate hamstring stiffness.

Key words

range of motion - ultrasound shear wave elastography - biceps femoris - semitendinosus - semimembranosus
 

  • References

  • 1 Ayala F, Sainz de Baranda P, De Ste Croix M, Santonja F. Criterion-related validity of four clinical tests used to measure hamstring flexibility in professional futsal players. Phys Ther Sport 2011; 12: 175-181
    CrossrefPubMedSearch in Google Scholar
  • 2 Ayala F, Sainz de Baranda P, De Ste Croix M, Santonja F. Absolute reliability of five clinical tests for assessing hamstring flexibility in professional futsal players. J Sci Med Sport 2012; 15: 142-147
    CrossrefPubMedSearch in Google Scholar
  • 3 Ayala F, Sainz de Baranda P, De Ste Croix M, Santonja F. Reproducibility and concurrent validity of hip joint angle test for estimating hamstring flexibility in recreationally active young men. J Strength Cond Res 2012; 26: 2372-2382
    CrossrefPubMedSearch in Google Scholar
  • 4 Baumgart E. Stiffness–an unknown world of mechanical science?. Injury 2000; 31 (Suppl. 02) S-B14-S-B23
    PubMedSearch in Google Scholar
  • 5 Bercoff J, Tanter M, Fink M. Supersonic shear imaging: a new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control 2004; 51: 396-409
    CrossrefPubMedSearch in Google Scholar
  • 6 Castro-Piñero J, Chillon P, Ortega FB, Montesinos JL, Sjostrom M, Ruiz JR. Criterion-related validity of sit-and-reach and modified sit-and-reach test for estimating hamstring flexibility in children and adolescents aged 6-17 years. Int J Sports Med 2009; 30: 658-662
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Eby SF, Song P, Chen S, Chen Q, Greenleaf JF, An KN. Validation of shear wave elastography in skeletal muscle. J Biomech 2013; 46: 2381-2387
    CrossrefPubMedSearch in Google Scholar
  • 8 Gajdosik RL. Passive extensibility of skeletal muscle: Review of the literature with clinical implications. Clin Biomech (Bristol, Avon) 2001; 16: 87-101
    CrossrefPubMedSearch in Google Scholar
  • 9 Goeken LN, Hof AL. Instrumental straight-leg raising: Results in patients. Arch Phys Med Rehabil 1994; 75: 470-477
    CrossrefPubMedSearch in Google Scholar
  • 10 Halbertsma JP, Goeken LN, Hof AL, Groothoff JW, Eisma WH. Extensibility and stiffness of the hamstrings in patients with nonspecific low back pain. Arch Phys Med Rehabil 2001; 82: 232-238
    CrossrefPubMedSearch in Google Scholar
  • 11 Harriss DJ, Atkinson G. Ethical Standards in Sport and Exercise Science Research: 2016 Update. Int J Sports Med 2015; 36: 1121-1124
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Hartig DE, Henderson JM. Increasing hamstring flexibility decreases lower extremity overuse injuries in military basic trainees. Am J Sports Med 1999; 27: 173-176
    CrossrefPubMedSearch in Google Scholar
  • 13 Hatta T, Giambini H, Uehara K, Okamoto S, Chen S, Sperling JW, Itoi E, An KN. Quantitative assessment of rotator cuff muscle elasticity: Reliability and feasibility of shear wave elastography. J Biomech 2015; 48: 3853-3858
    CrossrefPubMedSearch in Google Scholar
  • 14 Hirata K, Miyamoto-Mikami E, Kanehisa H, Miyamoto N. Muscle-specific acute changes in passive stiffness of human triceps surae after stretching. Eur J Appl Physiol 2016; 116: 911-918
    CrossrefPubMedSearch in Google Scholar
  • 15 Johns RJ, Wright V. Relative importance of various tissues in joint stiffness. J Appl Physiol 1962; 17: 824-828
    CrossrefPubMedSearch in Google Scholar
  • 16 Jones MA, Stratton G, Reilly T, Unnithan VB. Biological risk indicators for recurrent non-specific low back pain in adolescents. Br J Sports Med 2005; 39: 137-140
    CrossrefPubMedSearch in Google Scholar
  • 17 Kellis E, Ellinoudis A, Kofotolis N. Hamstring elongation quantified using ultrasonography during the straight leg raise test in individuals with low back pain. PM R 2015; 7: 576-583
    CrossrefPubMedSearch in Google Scholar
  • 18 Le Sant G, Nordez A, Andrade R, Hug F, Freitas S, Gross R. Stiffness mapping of lower leg muscles during passive dorsiflexion. J Anat 2017; 230: 639-650
    CrossrefPubMedSearch in Google Scholar
  • 19 Lopez-Minarro PA, Rodriguez-Garcia PL. Hamstring muscle extensibility influences the criterion-related validity of sit-and-reach and toe-touch tests. J Strength Cond Res 2010; 24: 1013-1018
    CrossrefPubMedSearch in Google Scholar
  • 20 Magnusson SP, Simonsen EB, Aagaard P, Boesen J, Johannsen F, Kjaer M. Determinants of musculoskeletal flexibility: Viscoelastic properties, cross-sectional area, EMG and stretch tolerance. Scand J Med Sci Sports 1997; 7: 195-202
    CrossrefPubMedSearch in Google Scholar
  • 21 Marshall PW, Cashman A, Cheema BS. A randomized controlled trial for the effect of passive stretching on measures of hamstring extensibility, passive stiffness, strength, and stretch tolerance. J Sci Med Sport 2011; 14: 535-540
    CrossrefPubMedSearch in Google Scholar
  • 22 Mayorga-Vega D, Merino-Marban R, Viciana J. Criterion-related validity of sit-and-reach tests for estimating hamstring and lumbar extensibility: A meta-analysis. JSSM 2014; 13: 1-14
    PubMedSearch in Google Scholar
  • 23 Mier CM, Shapiro BS. Sex differences in pelvic and hip flexibility in men and women matched for sit-and-reach score. J Strength Cond Res 2013; 27: 1031-1035
    CrossrefPubMedSearch in Google Scholar
  • 24 Miyamoto N, Hirata K, Kanehisa H. Effects of hamstring stretching on passive muscle stiffness vary between hip flexion and knee extension maneuvers. Scand J Med Sci Sports 2017; 27: 99-106
    CrossrefPubMedSearch in Google Scholar
  • 25 Miyamoto N, Hirata K, Kanehisa H, Yoshitake Y. Validity of measurement of shear modulus by ultrasound shear wave elastography in human pennate muscle. PLoS One 2015; 10: e0124311
    CrossrefPubMedSearch in Google Scholar
  • 26 Muyor JM, Vaquero-Cristobal R, Alacid F, Lopez-Minarro PA. Criterion-related validity of sit-and-reach and toe-touch tests as a measure of hamstring extensibility in athletes. J Strength Cond Res 2014; 28: 546-555
    CrossrefPubMedSearch in Google Scholar
  • 27 Nordez A, Gross R, Andrade R, Le Sant G, Freitas S, Ellis R, McNair PJ, Hug F. Non-muscular structures can limit the maximal joint range of motion during stretching. Sports Med 2017;
    CrossrefPubMedSearch in Google Scholar
  • 28 Palmeri ML, Wang MH, Dahl JJ, Frinkley KD, Nightingale KR. Quantifying hepatic shear modulus in vivo using acoustic radiation force. Ultrasound Med Biol 2008; 34: 546-558
    CrossrefPubMedSearch in Google Scholar
  • 29 Ryan ED, Herda TJ, Costa PB, Defreitas JM, Beck TW, Stout JR, Cramer JT. Passive properties of the muscle-tendon unit: The influence of muscle cross-sectional area. Muscle Nerve 2009; 39: 227-229
    CrossrefPubMedSearch in Google Scholar
  • 30 Weppler CH, Magnusson SP. Increasing muscle extensibility: A matter of increasing length or modifying sensation?. Phys Ther 2010; 90: 438-449
    CrossrefPubMedSearch in Google Scholar
  • 31 Witvrouw E, Bellemans J, Lysens R, Danneels L, Cambier D. Intrinsic risk factors for the development of patellar tendinitis in an athletic population. A two-year prospective study. Am J Sports Med 2001; 29: 190-195
    CrossrefPubMedSearch in Google Scholar
  • 32 Witvrouw E, Danneels L, Asselman P, D'Have T, Cambier D. Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. A prospective study. Am J Sports Med 2003; 31: 41-46
    CrossrefPubMedSearch in Google Scholar