Joint mobility changes due to low frequency vibration and stretching exercise.

It has been shown that fifteen minutes of locally applied cycloid vibration of low amplitude and frequency is equally as effective as a fifteen minute programme of flexibility exercises in increasing short term mobility of the hip flexors. It is suggested that this mobility change may occur as a result of improved muscle relaxation. INTRODUCTION Review of the Literature Apart from surgical intervention and manipulation under anaesthetic there appear to be two general approaches to the improvement of joint mobility. The first of these is through exercise usually, but not always, mechanical stretching exercise with or without external assistance. The second is through the application of therapeutic treatments such as heat, vibration and massage. Studies have been made of the mobilising effects of some of these methods, e.g. stretching exercises (Weber and Kraus, 1949; Fieldman, 1966), weight training exercises (Massey and Chaudet, 1956; Meyers, 1971), Hatha Yoga (de Vries, 1962), the exercise effects of sports participation (Skvartsov and Sermeev, 1964), exercises following the principles of proprioceptive neuromuscular facilitation (Tanigawa, 1972), relaxation exercises (Warden, 1961), vibration (Bierman, 1960), massage (Kos, 1966) and heat treatment (Kos, 1966; Grobacker and Stull, 1975). Comparisons between the above studies are difficult to make because of the differing experimental conditions and methods of measurement employed, and because specific comparative studies, even of related methods within one class of treatments, are rare. Consequently, it is not easy to decide if one method is better than another. No agreed guide exists to the most appropriate regimen to be adopted even in such long established practices as mobilising exercises except "the clinical experience of the physician and physiotherapist" (Johnson and Buskirk, 1974, P449). Yet such a guide would be helpful to clinicians involved in the rehabilitation of disabled persons and to sportsmen concerned with the achievement of high levels of skilled performance. It is the purpose of this paper to examine the relative merits of two mobilising techniques that have different principles of action. *Supported by a grant from Niagara Therapy (U.K.) Ltd. Joint mobility is limited by the bony and fleshy masses that block movements in the end position, by the muscles, tendons, ligaments and capsules that act as ties and which are put on stretch in the limiting position, by articular pains that inhibit movement, by joint pathology, muscle viscosity, reciprocal muscle co-ordination, neuropathology, and general stress and anxiety (Billig and Loewendahl, 1949). The mobility of joints appears to be independent of physique (Laubach and McConville, 1966) and not as age dependent as is commonly assumed (Greey, 1958) though evidence of mobility peaks at different ages are reported e.g. at 14-15 years (Skvortsov and Sermeev, 1964) and at 25 years (Jervey, 1962). Harris (1967) and Dickinson (1 968) have shown that the range of motion possible in one joint action is little correlated with that in any other. Harris, who has also shown that the mobility of even protagonists and antagonists are not correlated, argues that it is no longer sensible to support a general concept of flexibility. It follows, that if flexibility is as highly joint specific as Harris and Dickinson maintain, then any examination of flexibility must be conducted with reference to specific articulations and that inferences drawn from a study of a single joint should be generalised with reserve. At the same time it must be borne in mind that the tissues around similar joints are similar, so it should not be beyond the limits of ingenuity to develop unifying generalisations of some kind, as have Johns and Wright (1962), about their role in limiting movement. At least two main treatment principles, apart from those underlying the lesser used techniques of massage and heat, may be identified. The first is implicit in those exercises in which a joint is stretched to the point of extreme discomfort (Billig and Loewendahl, 1949; Stafford and Kelley, 1958) and group.bmj.com on June 21, 2017 Published by http://bjsm.bmj.com/ Downloaded from