腓腸肌肌肉複合體在伸展運動後硬度的變化

Changes in Stiffness of the Gastrocnemius Muscle-Tendon Unit After Stretching Exercises

10.6342/NTU201603389

賴冠帆

腓腸肌 ； 伸展運動 ； 硬度 ； 彈性超音波影像 ； gastrocnemius muscle ； stretching exercise ； stiffness ； shear wave elastography

臺灣大學物理治療學研究所學位論文

2016年

碩士

柴惠敏

英文

腓腸肌肌肉肌腱複合體需有足夠的柔軟度來協助完成日常活動或運動動作而不致產生傷害；因此早期學者建議運動前作靜態伸展來暖身，可以降低傷害的發生。近年來有學者發現在靜態伸展會造成最大肌力與運動表現能力的下降而提倡動態伸展。然而這類論文多半直接量測最大肌力與運動表現，沒有探討組織延展性的變化。腓腸肌肌肉肌腱複合體因包含肌肉、腱膜、肌腱三大部分，較其他肌肉適合用來觀察伸展技術後組織延展性的變化。因此，本研究計畫預計利用剪力波彈性影像儀測量腓腸肌肌肉肌腱複合體各部分延展性的變化，以了解不同伸展運動對於組織延展性的影響。 本研究計畫為前瞻性、介入性、單盲性、前後實驗，徵召21名健康且規律運動之成人進行實驗。受試者在簽署研究同意書後，受試者將以隨機次序接受靜態與動態伸展運動，此兩種技術施行時間相隔一週，並於第三週進行施測者間信度的試驗。量測項目將包括以剪力波彈性影像儀測量腓腸肌肌肉肌腱複合體的硬度、以電子量角器測量踝關節的最大背屈角度，並以自製的高度計測量下蹲跳的高度。所有變項皆在介入伸展技術前後各測量一次。所有統計分析將以SAS 9.4進行，以重複量測變異數分析計算前後以及兩種伸展技術之間的差異，並以組內相關係數、量測標準誤與最小可偵測變化值計算各個參數的測試者內與測試者間信度。顯著水準訂在=0.05，而檢定力訂在0.8。 本研究主要結果為：(一)進行二種伸展運動後皆能降低腓腸肌肌肉肌腱複合體的肌腱和腱膜的硬度；二種伸展運動皆沒有對肌肉硬度造成顯著的改變。(二)在二種伸展運動後，最大背屈角度皆會增加，但二者之間沒有顯著差異；(三)在動態伸展運動後，下蹲跳高度沒有顯著差異；然而靜態伸展運動後下蹲跳高度顯著下降。 本研究為第一篇使用剪力波彈性超音波影像檢測腓腸肌肌肉肌腱複合體再進行不同伸展運動後的硬度變化，也是第一篇同時檢測肌腱、腱膜與肌肉三種組織的研究。此結果顯示兩種伸展運動皆能改善肌腱與腱膜組織的延展性，而肌肉的延展性在伸展運動後並沒有顯著改變。此外，動態伸展運動能同時改善組織延展性並不讓運動表現變差。未來研究可藉此探討不同伸展運動對於組織延展性與對運動表現的影響，包括不同的族群、伸展時機，以為臨床運動處方的參考。

Sufficient flexibility of the gastrocnemius muscle-tendon unit (MTU) is necessary to accomplish daily or sports activities in order to prevent from injuries. Static stretching exercises had been widely used as a part of warm up exercises. Decreased force production after static stretching has documented recently and dynamic stretching is suggested instead. However, only changes in the maximal voluntary contraction and sports performance were measured as evidences of effectiveness. The gastrocnemius MTU is more appropriate to be examined the tissue extensibility because it consists of three portions of tissue structures, including the muscle, the aponeurosis, and the free tendon. Therefore, the purpose of this research project will be to investigate the tissue extensibility and functional performance of the gastrocnemius MTU after different stretching exercises using shear wave elastography (SWE). The research was a prospective, randomize-order, single-blinded, and pre-post test design. There were 21 healthy and active adults recruited for the research project. All participants received static and dynamic stretching exercises at one-week interval and intervention order was employed randomly. The interrater reliability test was executed on the third week. The measurements included stiffness of the gastrocnemius MTU using the SWE system, maximum ankle dorsiflexion angle using an electrogoniometer, and countermovement jump height using a self-made jump height measuring board. All variables were acquired before and after intervention in both sessions. A two-way ANOVA with repeated measures was used to compare the differences between conditions, different testing sessions, and their interaction. The intra-class correlation coefficients, standard errors of measurement and minimal detectable change were used to test the intrarater and interrater reliabilities. All statistical analyses were executed using SAS 9.4. The significant level was set at =.05, and the power was set at 0.8. The results of this research were: 1) The stiffness of the tendon and aponeurosis of the gastrocnemius MTU significantly decreased after two kinds of stretching exercises, but no significant difference was noted in stiffness of the gastrocnemius muscle; 2) Both stretching exercises significantly improved the maximum ankle dorsiflexion angle while no significant difference was found between static and dynamic stretching exercise; 3) There was no significant difference in countermovement jump height after dynamic stretching exercise, but the countermovement jump height decreased significantly after static stretching exercise. It was the first research that examined three different portions of the gastrocnemius MTU on tissue extensibility after different kinds of stretching exercises using SWE. The results concluded that both stretching exercises significantly improved extensibility of tendon and aponeurosis, but extensibility of muscle did not change significantly. This research gives an insight that dynamic stretching exercise can improve the tissue extensibility without negative effects on sports performance. Information of tissue extensibility provided by SWE can assist in effects of different stretching exercises on sports performance. Therefore, the application of stretching exercises, including population, timing and duration can be further examined in the future.

1. Akagi, R., Tanaka, J., Shikiba, T., & Takahashi, H. (2014). Muscle hardness of the triceps brachii before and after a resistance exercise session: a shear wave ultrasound elastography study. Acta Radiol.
   連結：
2. Albracht, K., & Arampatzis, A. (2006). Influence of the mechanical properties of the muscle-tendon unit on force generation in runners with different running economy. Biol Cybern, 95(1), 87-96.
   連結：
3. Arampatzis, A., Karamanidis, K., Stafilidis, S., Morey-Klapsing, G., DeMonte, G., & Bruggemann, G. P. (2006). Effect of different ankle- and knee-joint positions on gastrocnemius medialis fascicle length and EMG activity during isometric plantar flexion. J Biomech, 39(10), 1891-1902.
   連結：
4. Arampatzis, A., Stafilidis, S., DeMonte, G., Karamanidis, K., Morey-Klapsing, G., & Bruggemann, G. P. (2005). Strain and elongation of the human gastrocnemius tendon and aponeurosis during maximal plantarflexion effort. J Biomech, 38(4), 833-841.
   連結：
5. Arda, K., Ciledag, N., Aktas, E., Aribas, B. K., & Kose, K. (2011). Quantitative assessment of normal soft-tissue elasticity using shear-wave ultrasound elastography. AJR Am J Roentgenol, 197(3), 532-536.
   連結：
6. Basnett, C. R., Hanish, M. J., Wheeler, T. J., Miriovsky, D. J., Danielson, E. L., Barr, J. B., & Grindstaff, T. L. (2013). Ankle dorsiflexion range of motion influences dynamic balance in individuals with chronic ankle instability. Int J Sports Phys Ther, 8(2), 121-128.
   連結：
7. Bell, D. R., Padua, D. A., & Clark, M. A. (2008). Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement. Arch Phys Med Rehabil, 89(7), 1323-1328.
   連結：
8. Bercoff, J., Tanter, M., & Fink, M. (2004). Supersonic Shear Imaging: A new technique for soft tissue elasticity mapping. IEEE Trans Ultrason Ferroelectr Freq Control, 51(4), 396-409.
   連結：
9. Bogaerts, S., Desmet, H., Slagmolen, P., & Peers, K. (2016). Strain mapping in the Achilles tendon - A systematic review. J Biomech, 49(9), 1411-1419.
   連結：
10. Bojsen-Moller, J., Hansen, P., Aagaard, P., Svantesson, U., Kjaer, M., & Magnusson, S. P. (2004). Differential displacement of the human soleus and medial gastrocnemius aponeuroses during isometric plantar flexor contractions in vivo. J Appl Physiol (1985), 97(5), 1908-1914.
    連結：
11. Bojsen-Moller, J., Magnusson, S. P., Rasmussen, L. R., Kjaer, M., & Aagaard, P. (2005). Muscle performance during maximal isometric and dynamic contractions is influenced by the stiffness of the tendinous structures. J Appl Physiol (1985), 99(3), 986-994.
    連結：
12. Brandenburg, J. E., Eby, S. F., Song, P., Zhao, H., Brault, J. S., Chen, S., & An, K. N. (2014). Ultrasound elastography: the new frontier in direct measurement of muscle stiffness. Arch Phys Med Rehabil, 95(11), 2207-2219.
    連結：
13. Brandenburg, J. E., Eby, S. F., Song, P., Zhao, H., Landry, B. W., Kingsley-Berg, S., . . . An, K. N. (2015). Feasibility and reliability of quantifying passive muscle stiffness in young children by using shear wave ultrasound elastography. J Ultrasound Med, 34(4), 663-670.
    連結：
14. Brechue, W. F., Mayhew, J. L., & Piper, F. C. (2010). Characteristics of sprint performance in college football players. J Strength Cond Res, 24(5), 1169-1178.
    連結：
15. Bressel, E., Larsen, B. T., McNair, P. J., & Cronin, J. (2004). Ankle joint proprioception and passive mechanical properties of the calf muscles after an Achilles tendon rupture: a comparison with matched controls. Clin Biomech (Bristol, Avon), 19(3), 284-291.
    連結：
16. Bressel, E., & McNair, P. J. (2002). The effect of prolonged static and cyclic stretching on ankle joint stiffness, torque relaxation, and gait in people with stroke. Phys Ther, 82(9), 880-887.
    連結：
17. Bronner, S., Agraharasamakulam, S., & Ojofeitimi, S. (2010). Reliability and validity of a new ankle electrogoniometer. J Med Eng Technol, 34(5-6), 350-355.
    連結：
18. Burgess, K. E., Connick, M. J., Graham-Smith, P., & Pearson, S. J. (2007). Plyometric vs. isometric training influences on tendon properties and muscle output. J Strength Cond Res, 21(3), 986-989.
    連結：
19. Burgess, K. E., Graham-Smith, P., & Pearson, S. J. (2009). Effect of acute tensile loading on gender-specific tendon structural and mechanical properties. J Orthop Res, 27(4), 510-516.
    連結：
20. Carl, T., & Barrett, S. L. (2005). Cadaveric assessment of the gastrocnemius aponeurosis to assist in the pre-operative planning for two-portal endoscopic gastrocnemius recession (EGR). The Foot, 15(3), 137-140.
    連結：
21. Cheung, J. T., Zhang, M., & An, K. N. (2006). Effect of Achilles tendon loading on plantar fascia tension in the standing foot. Clin Biomech (Bristol, Avon), 21(2), 194-203.
    連結：
22. Chinn, L., & Hertel, J. (2010). Rehabilitation of ankle and foot injuries in athletes. Clin Sports Med, 29(1), 157-167, table of contents.
    連結：
23. Chiu, T. C., Ngo, H. C., Lau, L. W., Leung, K. W., Lo, M. H., Yu, H. F., & Ying, M. (2016). An Investigation of the Immediate Effect of Static Stretching on the Morphology and Stiffness of Achilles Tendon in Dominant and Non-Dominant Legs. PLoS One, 11(4), e0154443.
    連結：
24. Chtourou, H., Aloui, A., Hammouda, O., Chaouachi, A., Chamari, K., & Souissi, N. (2013). Effect of static and dynamic stretching on the diurnal variations of jump performance in soccer players. PLoS One, 8(8), e70534.
    連結：
25. Colson, S. S., Pensini, M., Espinosa, J., Garrandes, F., & Legros, P. (2010). Whole-body vibration training effects on the physical performance of basketball players. J Strength Cond Res, 24(4), 999-1006.
    連結：
26. Cornwell, A., Nelson, A. G., & Sidaway, B. (2002). Acute effects of stretching on the neuromechanical properties of the triceps surae muscle complex. Eur J Appl Physiol, 86(5), 428-434.
    連結：
27. De Monte, G., Arampatzis, A., Stogiannari, C., & Karamanidis, K. (2006). In vivo motion transmission in the inactive gastrocnemius medialis muscle-tendon unit during ankle and knee joint rotation. J Electromyogr Kinesiol, 16(5), 413-422.
    連結：
28. DeVries, H. A. (1986). Physiology of exercise for physical education and athletics (4th ed.). Dubuque, Iowa: W.C. Brown.
    連結：
29. Drakonaki, E. E., Allen, G. M., & Wilson, D. J. (2012). Ultrasound elastography for musculoskeletal applications. Br J Radiol, 85(1019), 1435-1445.
    連結：
30. Dubbeldam, R., Buurke, J. H., Simons, C., Groothuis-Oudshoorn, C. G., Baan, H., Nene, A. V., & Hermens, H. J. (2010). The effects of walking speed on forefoot, hindfoot and ankle joint motion. Clin Biomech (Bristol, Avon), 25(8), 796-801.
    連結：
31. Dugan, S. A., & Bhat, K. P. (2005). Biomechanics and analysis of running gait. Phys Med Rehabil Clin N Am, 16(3), 603-621.
    連結：
32. Eby, S. F., Cloud, B. A., Brandenburg, J. E., Giambini, H., Song, P., Chen, S., . . . An, K. N. (2015). Shear wave elastography of passive skeletal muscle stiffness: influences of sex and age throughout adulthood. Clin Biomech (Bristol, Avon), 30(1), 22-27.
    連結：
33. Elson, D. W., Whiten, S., Hillman, S. J., Johnson, R. J., Lo, S. S., & Robb, J. E. (2007). The conjoint junction of the triceps surae: implications for gastrocnemius tendon lengthening. Clin Anat, 20(8), 924-928.
    連結：
34. Fong, C. M., Blackburn, J. T., Norcross, M. F., McGrath, M., & Padua, D. A. (2011). Ankle-dorsiflexion range of motion and landing biomechanics. J Athl Train, 46(1), 5-10.
    連結：
35. Fukashiro, S., Komi, P. V., Jarvinen, M., & Miyashita, M. (1995). In vivo Achilles tendon loading during jumping in humans. Eur J Appl Physiol Occup Physiol, 71(5), 453-458.
    連結：
36. Fukunaga, T., Kawakami, Y., Kubo, K., & Kanehisa, H. (2002). Muscle and tendon interaction during human movements. Exerc Sport Sci Rev, 30(3), 106-110.
    連結：
37. Fukunaga, T., Kubo, K., Kawakami, Y., Fukashiro, S., Kanehisa, H., & Maganaris, C. N. (2001). In vivo behaviour of human muscle tendon during walking. Proc Biol Sci, 268(1464), 229-233.
    連結：
38. Galley, P. M., & Forster, A. L. (1987). Human movement : an introductory text for physiotherapy students (2nd ed.). Melbourne ; New York: Churchill Livingstone.
    連結：
39. Giddings, V. L., Beaupre, G. S., Whalen, R. T., & Carter, D. R. (2000). Calcaneal loading during walking and running. Med Sci Sports Exerc, 32(3), 627-634.
    連結：
40. Halbertsma, J. P., van Bolhuis, A. I., & Goeken, L. N. (1996). Sport stretching: effect on passive muscle stiffness of short hamstrings. Arch Phys Med Rehabil, 77(7), 688-692.
    連結：
41. Hawkins, D., Lum, C., Gaydos, D., & Dunning, R. (2009). Dynamic creep and pre-conditioning of the Achilles tendon in-vivo. J Biomech, 42(16), 2813-2817.
    連結：
42. Herbert, R. D., Moseley, A. M., Butler, J. E., & Gandevia, S. C. (2002). Change in length of relaxed muscle fascicles and tendons with knee and ankle movement in humans. J Physiol, 539(Pt 2), 637-645.
    連結：
43. Hoch, M. C., Staton, G. S., & McKeon, P. O. (2011). Dorsiflexion range of motion significantly influences dynamic balance. J Sci Med Sport, 14(1), 90-92.
    連結：
44. Holt, B. W., & Lambourne, K. (2008). The impact of different warm-up protocols on vertical jump performance in male collegiate athletes. J Strength Cond Res, 22(1), 226-229.
    連結：
45. Hubley, C. L., Kozey, J. W., & Stanish, W. D. (1984). The effects of static stretching exercises and stationary cycling on range of motion at the hip joint*. J Orthop Sports Phys Ther, 6(2), 104-109.
    連結：
46. Hug, F., Lacourpaille, L., Maisetti, O., & Nordez, A. (2013). Slack length of gastrocnemius medialis and Achilles tendon occurs at different ankle angles. Journal of Biomechanics, 46(14), 2534-2538.
    連結：
47. Jung, D. Y., Koh, E. K., Kwon, O. Y., Yi, C. H., Oh, J. S., & Weon, J. H. (2009). Effect of medial arch support on displacement of the myotendinous junction of the gastrocnemius during standing wall stretching. J Orthop Sports Phys Ther, 39(12), 867-874.
    連結：
48. Kanehisa, H., Ikegawa, S., Tsunoda, N., & Fukunaga, T. (1994). Cross-sectional areas of fat and muscle in limbs during growth and middle age. Int J Sports Med, 15(7), 420-425.
    連結：
49. Kay, A. D., & Blazevich, A. J. (2009). Moderate-duration static stretch reduces active and passive plantar flexor moment but not Achilles tendon stiffness or active muscle length. J Appl Physiol (1985), 106(4), 1249-1256.
    連結：
50. Kisner, C., & Colby, L. A. (2007). Therapeutic exercise : foundations and techniques (5th ed.). Philadelphia: F.A. Davis.
    連結：
51. Kisner, C., & Colby, L. A. (2012). Therapeutic exercise : foundations and techniques (6th ed.). Philadelphia: F.A. Davis.
    連結：
52. Kokkonen, J., Nelson, A. G., & Cornwell, A. (1998). Acute muscle stretching inhibits maximal strength performance. Res Q Exerc Sport, 69(4), 411-415.
    連結：
53. Koo, T. K., Guo, J.-Y., Cohen, J. H., & Parker, K. J. (2014). Quantifying the passive stretching response of human tibialis anterior muscle using shear wave elastography. Clinical Biomechanics, 29(1), 33-39.
    連結：
54. Kot, B. C., Zhang, Z. J., Lee, A. W., Leung, V. Y., & Fu, S. N. (2012). Elastic modulus of muscle and tendon with shear wave ultrasound elastography: variations with different technical settings. PLoS One, 7(8), e44348.
    連結：
55. Kubo, K., Kanehisa, H., & Fukunaga, T. (2001). Is passive stiffness in human muscles related to the elasticity of tendon structures? European Journal of Applied Physiology, 85(3-4), 226-232.
    連結：
56. Kubo, K., Kanehisa, H., & Fukunaga, T. (2002). Effects of transient muscle contractions and stretching on the tendon structures in vivo. Acta Physiol Scand, 175(2), 157-164.
    連結：
57. Kubo, K., Kanehisa, H., & Fukunaga, T. (2002). Effect of stretching training on the viscoelastic properties of human tendon structures in vivo. J Appl Physiol (1985), 92(2), 595-601.
    連結：
58. Kubo, K., Kawakami, Y., Kanehisa, H., & Fukunaga, T. (2002). Measurement of viscoelastic properties of tendon structures in vivo. Scand J Med Sci Sports, 12(1), 3-8.
    連結：
59. Kumagai, K., Abe, T., Brechue, W. F., Ryushi, T., Takano, S., & Mizuno, M. (2000). Sprint performance is related to muscle fascicle length in male 100-m sprinters. J Appl Physiol (1985), 88(3), 811-816.
    連結：
60. Lacourpaille, L., Hug, F., Bouillard, K., Hogrel, J. Y., & Nordez, A. (2012). Supersonic shear imaging provides a reliable measurement of resting muscle shear elastic modulus. Physiol Meas, 33(3), N19-28.
    連結：
61. Legnani, G., Zappa, B., Casolo, F., Adamini, R., & Magnani, P. L. (2000). A model of an electro-goniometer and its calibration for biomechanical applications. Medical Engineering & Physics, 22(10), 711-722.
    連結：
62. Lerner, R. M., Huang, S. R., & Parker, K. J. (1990). Sonoelasticity images derived from ultrasound signals in mechanically vibrated tissues. Ultrasound in Medicine and Biology, 16(3), 231-239.
    連結：
63. Li, Y., & Snedeker, J. G. (2011). Elastography: modality-specific approaches, clinical applications, and research horizons. Skeletal Radiol, 40(4), 389-397.
    連結：
64. Lichtwark, G. A., Cresswell, A. G., & Newsham-West, R. J. (2013). Effects of running on human Achilles tendon length–tension properties in the free and gastrocnemius components. Journal of Experimental Biology, 216(23), 4388-4394.
    連結：
65. Little, T., & Williams, A. G. (2006). Effects of differential stretching protocols during warm-ups on high-speed motor capacities in professional soccer players. J Strength Cond Res, 20(1), 203-207.
    連結：
66. Lynn, S. K., & Noffal, G. J. (2012). Lower extremity biomechanics during a regular and counterbalanced squat. J Strength Cond Res, 26(9), 2417-2425.
    連結：
67. Macrum, E., Bell, D. R., Boling, M., Lewek, M., & Padua, D. (2012). Effect of limiting ankle-dorsiflexion range of motion on lower extremity kinematics and muscle-activation patterns during a squat. J Sport Rehabil, 21(2), 144-150.
    連結：
68. Magnusson, S. P. (1998). Passive properties of human skeletal muscle during stretch maneuvers. A review. Scand J Med Sci Sports, 8(2), 65-77.
    連結：
69. Magnusson, S. P., Aagaard, P., Dyhre-Poulsen, P., & Kjaer, M. (2001). Load-displacement properties of the human triceps surae aponeurosis in vivo. J Physiol, 531(Pt 1), 277-288.
    連結：
70. Magnusson, S. P., Aagard, P., Simonsen, E., & Bojsen-Moller, F. (1998). A biomechanical evaluation of cyclic and static stretch in human skeletal muscle. Int J Sports Med, 19(5), 310-316.
    連結：
71. Magnusson, S. P., Hansen, P., Aagaard, P., Brond, J., Dyhre-Poulsen, P., Bojsen-Moller, J., & Kjaer, M. (2003). Differential strain patterns of the human gastrocnemius aponeurosis and free tendon, in vivo. Acta Physiol Scand, 177(2), 185-195.
    連結：
72. Mahieu, N. N., McNair, P., Cools, A., D'Haen, C., Vandermeulen, K., & Witvrouw, E. (2008). Effect of eccentric training on the plantar flexor muscle-tendon tissue properties. Med Sci Sports Exerc, 40(1), 117-123.
    連結：
73. Mahieu, N. N., McNair, P., De Muynck, M., Stevens, V., Blanckaert, I., Smits, N., & Witvrouw, E. (2007). Effect of static and ballistic stretching on the muscle-tendon tissue properties. Med Sci Sports Exerc, 39(3), 494-501.
    連結：
74. Malliaras, P., Cook, J. L., & Kent, P. (2006). Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. Journal of Science and Medicine in Sport, 9(4), 304-309.
    連結：
75. Markovic, G. (2007). Does plyometric training improve vertical jump height? A meta-analytical review. Br J Sports Med, 41(6), 349-355; discussion 355.
    連結：
76. McElveen, M. T., Riemann, B. L., & Davies, G. J. (2010). Bilateral comparison of propulsion mechanics during single-leg vertical jumping. J Strength Cond Res, 24(2), 375-381.
    連結：
77. McHugh, M. P., Kremenic, I. J., Fox, M. B., & Gleim, G. W. (1998). The role of mechanical and neural restraints to joint range of motion during passive stretch. Med Sci Sports Exerc, 30(6), 928-932.
    連結：
78. McMillian, D. J., Moore, J. H., Hatler, B. S., & Taylor, D. C. (2006). Dynamic vs. static-stretching warm up: the effect on power and agility performance. J Strength Cond Res, 20(3), 492-499.
    連結：
79. McNair, P. J., Dombroski, E. W., Hewson, D. J., & Stanley, S. N. (2001). Stretching at the ankle joint: viscoelastic responses to holds and continuous passive motion. Med Sci Sports Exerc, 33(3), 354-358.
    連結：
80. McNair, P. J., Hewson, D. J., Dombroski, E., & Stanley, S. N. (2002). Stiffness and passive peak force changes at the ankle joint: the effect of different joint angular velocities. Clin Biomech (Bristol, Avon), 17(7), 536-540.
    連結：
81. McNair, P. J., & Stanley, S. N. (1996). Effect of passive stretching and jogging on the series elastic muscle stiffness and range of motion of the ankle joint. Br J Sports Med, 30(4), 313-317, discussion 318.
    連結：
82. Moore, J. C. (1984). The Golgi tendon organ: a review and update. Am J Occup Ther, 38(4), 227-236.
    連結：
83. Morse, C. I., Degens, H., Seynnes, O. R., Maganaris, C. N., & Jones, D. A. (2008). The acute effect of stretching on the passive stiffness of the human gastrocnemius muscle tendon unit. J Physiol, 586(1), 97-106.
    連結：
84. Muramatsu, T., Muraoka, T., Takeshita, D., Kawakami, Y., Hirano, Y., & Fukunaga, T. (2001). Mechanical properties of tendon and aponeurosis of human gastrocnemius muscle in vivo. J Appl Physiol (1985), 90(5), 1671-1678.
    連結：
85. Muraoka, T., Kawakami, Y., Tachi, M., & Fukunaga, T. (2001). Muscle fiber and tendon length changes in the human vastus lateralis during slow pedaling. J Appl Physiol (1985), 91(5), 2035-2040.
    連結：
86. Nakamura, M., Ikezoe, T., Kobayashi, T., Umegaki, H., Takeno, Y., Nishishita, S., & Ichihashi, N. (2014). Acute effects of static stretching on muscle hardness of the medial gastrocnemius muscle belly in humans: An Ultrasonic Shear-Wave Elastography Study. Ultrasound in Medicine & Biology, 40(9), 1991-1997.
    連結：
87. Nelson, A. G., Allen, J. D., Cornwell, A., & Kokkonen, J. (2001). Inhibition of maximal voluntary isometric torque production by acute stretching is joint-angle specific. Res Q Exerc Sport, 72(1), 68-70.
    連結：
88. Nelson, A. G., Guillory, I. K., Cornwell, A., & Kokkonen, J. (2001). Inhibition of maximal voluntary isokinetic torque production following stretching is velocity-specific. Journal of Strength and Conditioning Research, 15(2), 241-246.
    連結：
89. Nelson, A. G., & Kokkonen, J. (2001). Acute ballistic muscle stretching inhibits maximal strength performance. Res Q Exerc Sport, 72(4), 415-419. doi:10.1080/02701367.2001.10608978
    連結：
90. Novacheck, T. F. (1998). The biomechanics of running. Gait Posture, 7(1), 77-95.
    連結：
91. Ophir, J., Cespedes, I., Ponnekanti, H., Yazdi, Y., & Li, X. (1991). Elastography - a Quantitative method for imaging the elasticity of biological tissues. Ultrasonic Imaging, 13(2), 111-134.
    連結：
92. Parker, K. J., Huang, S. R., Musulin, R. A., & Lerner, R. M. (1990). Tissue-Response to Mechanical Vibrations for Sonoelasticity Imaging. Ultrasound in Medicine and Biology, 16(3), 241-246.
    連結：
93. Peltz, C. D., Haladik, J. A., Divine, G., Siegal, D., van Holsbeeck, M., & Bey, M. J. (2013). ShearWave elastography: repeatability for measurement of tendon stiffness. Skeletal Radiol, 42(8), 1151-1156.
    連結：
94. Perrier, E. T., Pavol, M. J., & Hoffman, M. A. (2011). The acute effects of a warm-up including static or dynamic stretching on countermovement jump height, reaction time, and flexibility. J Strength Cond Res, 25(7), 1925-1931.
    連結：
95. Pinney, S. J., Sangeorzan, B. J., & Hansen, S. T., Jr. (2004). Surgical anatomy of the gastrocnemius recession (Strayer procedure). Foot Ankle Int, 25(4), 247-250.
    連結：
96. Portney, L. G., Watkins, M.P. (2009). Foundations of clinical research: applications to practice (3rd ed.): Upper Saddle River. N.J.: Pearson/Prentice Hall.
    連結：
97. Protopapadaki, A., Drechsler, W. I., Cramp, M. C., Coutts, F. J., & Scott, O. M. (2007). Hip, knee, ankle kinematics and kinetics during stair ascent and descent in healthy young individuals. Clin Biomech (Bristol, Avon), 22(2), 203-210.
    連結：
98. Radford, J. A., Burns, J., Buchbinder, R., Landorf, K. B., & Cook, C. (2006). Does stretching increase ankle dorsiflexion range of motion? A systematic review. Br J Sports Med, 40(10), 870-875; discussion 875.
    連結：
99. Recinos, V. R., Bekelis, K., Ziegler, S. G., Vick, D., Hertig, S., Tyler, B. M., . . . Olivi, A. (2010). Epirubicin exhibits potent anti-tumor activity in an animal model of malignant glioma when administered via controlled-release polymers. J Neurooncol, 97(1), 1-10.
    連結：
100. Robbins, J. W., & Scheuermann, B. W. (2008). Varying amounts of acute static stretching and its effect on vertical jump performance. J Strength Cond Res, 22(3), 781-786.
     連結：
101. Rosager, S., Aagaard, P., Dyhre-Poulsen, P., Neergaard, K., Kjaer, M., & Magnusson, S. P. (2002). Load-displacement properties of the human triceps surae aponeurosis and tendon in runners and non-runners. Scand J Med Sci Sports, 12(2), 90-98.
     連結：
102. Ryan, E. D., Beck, T. W., Herda, T. J., Hull, H. R., Hartman, M. J., Costa, P. B., Cramer, J. T. (2008). The time course of musculotendinous stiffness responses following different durations of passive stretching. J Orthop Sports Phys Ther, 38(10), 632-639.
     連結：
103. Ryan, E. D., Herda, T. J., Costa, P. B., Walter, A. A., & Cramer, J. T. (2012). Dynamics of viscoelastic creep during repeated stretches. Scand J Med Sci Sports, 22(2), 179-184.
     連結：
104. Safran, M. R., Seaber, A. V., & Garrett, W. E. (1989). Warm-up and muscular injury prevention an update. Sports Medicine, 8(4), 239-249.
     連結：
105. Samukawa, M., Hattori, M., Sugama, N., & Takeda, N. (2011). The effects of dynamic stretching on plantar flexor muscle-tendon tissue properties. Man Ther, 16(6), 618-622.
     連結：
106. Sandrin, L., Fourquet, B., Hasquenoph, J. M., Yon, S., Fournier, C., Mal, F., Palau, R. (2003). Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol, 29(12), 1705-1713.
     連結：
107. Schmitz, R. J., Cone, J. C., Copple, T. J., Henson, R. A., & Shultz, S. J. (2014). Lower- extremity biomechanics and maintenance of vertical-jump height during prolonged intermittent exercise. J Sport Rehabil, 23(4), 319-329.
     連結：
108. Sebag, F., Vaillant-Lombard, J., Berbis, J., Griset, V., Henry, J. F., Petit, P., & Oliver, C. (2010). Shear wave elastography: a new ultrasound imaging mode for the differential diagnosis of benign and malignant thyroid nodules. J Clin Endocrinol Metab, 95(12), 5281-5288.
     連結：
109. Shiina, T. (2013). JSUM ultrasound elastography practice guidelines: basics and terminology. Journal of Medical Ultrasonics, 40(4), 309-323.
     連結：
110. Siu, W. L., Chan, C. H., Lam, C. H., Lee, C. M., & Ying, M. (2016). Sonographic evaluation of the effect of long-term exercise on Achilles tendon stiffness using shear wave elastography. J Sci Med Sport.
     連結：
111. Tanter, M., Bercoff, J., Athanasiou, A., Deffieux, T., Gennisson, J. L., Montaldo, G., Fink, M. (2008). Quantitative assessment of breast lesion viscoelasticity: initial clinical results using supersonic shear imaging. Ultrasound Med Biol, 34(9), 1373-1386.
     連結：
112. Tashjian, R. Z., Appel, A. J., Banerjee, R., & DiGiovanni, C. W. (2003). Anatomic study of the gastrocnemius-soleus junction and its relationship to the sural nerve. Foot Ankle Int, 24(6), 473-476.
     連結：
113. Taylor, D. C., Dalton, J. D., Jr., Seaber, A. V., & Garrett, W. E., Jr. (1990). Viscoelastic properties of muscle-tendon units. The biomechanical effects of stretching. Am J Sports Med, 18(3), 300-309.
     連結：
114. Voss, D. E., & Knott, M. (1954). Patterns of motion for proprioceptive neuromuscular facilitation. Br J Phys Med, 17(9), 191-198.
     連結：
115. Witvrouw, E., Lysens, R., Bellemans, J., Cambier, D., & Vanderstraeten, G. (2000). Intrinsic risk factors for the development of anterior knee pain in an athletic population. A two-year prospective study. Am J Sports Med, 28(4), 480-489.
     連結：
116. Wren, T. A., Lindsey, D. P., Beaupre, G. S., & Carter, D. R. (2003). Effects of creep and cyclic loading on the mechanical properties and failure of human Achilles tendons. Ann Biomed Eng, 31(6), 710-717.
     連結：
117. Zhang, M., Nigwekar, P., Castaneda, B., Hoyt, K., Joseph, J. V., di Sant'Agnese, A., Parker, K. J. (2008). Quantitative characterization of viscoelastic properties of human prostate correlated with histology. Ultrasound Med Biol, 34(7), 1033-1042.
     連結：
118. Alter, M. J. (2004). Science of flexibility (3rd ed.). Champaign, IL: Human Kinetics.
119. Enoka, R. M. (2015). Neuromechanics of human movement (Fifth edition. ed.). Champaign, IL: Human Kinetics.
120. Fukunaga, T., Kawakarni, Y., Muraoka, T., & Kanehisa, H. (2002). Muscle and tendon relations in humans: power enhancement in counter-movement exercise. Adv Exp Med Biol, 508, 501-505.
121. Goodridge, J. P. (1981). Muscle energy technique: definition, explanation, methods of procedure. J Am Osteopath Assoc, 81(4), 249-254.
122. Magnusson, S. P., Julsgaard, C., Aagaard, P., Zacharie, C., Ullman, S., Kobayasi, T., & Kjaer, M. (2001). Viscoelastic properties and flexibility of the human muscle-tendon unit in benign joint hypermobility syndrome. J Rheumatol, 28(12), 2720-2725.
123. Siff, M. C., & Isaacs, H. (1982). Ballistic technique for analysis of knee stability. South African Journal of Science, 78(11-1), 465-465.