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Ingram LA, Tomkinson GR, d'Unienville NMA, Gower B, Gleadhill S, Boyle T, Bennett H. Optimising the Dose of Static Stretching to Improve Flexibility: A Systematic Review, Meta-analysis and Multivariate Meta-regression. Sports Med 2025; 55:597-617. [PMID: 39614059 DOI: 10.1007/s40279-024-02143-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2024] [Indexed: 12/01/2024]
Abstract
BACKGROUND Static stretching is widely used to increase flexibility. However, there is no consensus regarding the optimal dosage parameters for increasing flexibility. OBJECTIVES We aimed to determine the optimal frequency, intensity and volume to maximise flexibility through static stretching, and to investigate whether this is moderated by muscle group, age, sex, training status and baseline level of flexibility. METHODS Seven databases (CINAHL Complete, Cochrane CENTRAL, Embase, Emcare, MEDLINE, Scopus, and SPORTDiscus) were systematically searched up to June 2024. Randomised and non-randomised controlled trials investigating the effects of a single session (acute) or multiple sessions (chronic) of static stretching on one or more flexibility outcomes (compared to non-stretching passive controls) among adults (aged ≥ 18 years) were included. A multi-level meta-analysis examined the effect of acute and chronic static stretching on flexibility outcomes, while multivariate meta-regression was used to determine the volume at which increases in flexibility were maximised. RESULTS Data from 189 studies representing 6654 adults (61% male; mean [standard deviation] age = 26.8 ± 11.4 years) were included. We found a moderate positive effect of acute static stretching on flexibility (summary Hedges' g = 0.63, 95% confidence interval 0.52-0.75, p < 0.001) and a large positive effect of chronic static stretching on flexibility (summary Hedges' g = 0.96, 95% confidence interval 0.84-1.09, p < 0.001). Neither effect was moderated by stretching intensity, age, sex or training status, or weekly session frequency and intervention length (chronic static stretching only) [p > 0.05]. However, larger improvements were found for adults with poor baseline flexibility compared with adults with average baseline flexibility (p = 0.01). Furthermore, larger improvements in flexibility were found in the hamstrings compared with the spine following acute static stretching (p = 0.04). Improvements in flexibility were maximised by a cumulative stretching volume of 4 min per session (acute) and 10 min per week (chronic). CONCLUSIONS Static stretching improves flexibility in adults, with no additional benefit observed beyond 4 min per session or 10 min per week. Although intensity, frequency, age, sex and training status do not influence improvements in flexibility, lower flexibility levels are associated with greater improvement following both acute and chronic static stretching. These guidelines for static stretching can be used by coaches and therapists to improve flexibility. CLINICAL TRIAL REGISTRATION PROSPERO CRD42023420168.
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Affiliation(s)
- Lewis A Ingram
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia.
| | - Grant R Tomkinson
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Noah M A d'Unienville
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Bethany Gower
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Sam Gleadhill
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Hunter Bennett
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
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Long BC. Treatment Order and Retention of Self-Myofascial Release and Static Stretching on Passive Hip Flexion Range of Motion. J Sport Rehabil 2025:1-5. [PMID: 39914395 DOI: 10.1123/jsr.2024-0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 09/09/2024] [Accepted: 11/26/2024] [Indexed: 02/13/2025]
Abstract
CONTEXT Many healthcare professions incorporate foam rolling (FR) and static stretching (SS) to improve tissue extensibility. Currently, it is unknown if the order an individual performs FR and SS influences flexibility or whether flexibility is retained. This study aimed to determine if FR before, or, following SS influences passive hip flexion range of motion (ROM), and if changes are retained. DESIGN Between-group experimental design. METHODS Thirty-five participants with less than 90° of passive hip flexion ROM volunteered. Over 8 days, 6 days separated by 24 hours, and then 1 week (day 7) and 2 weeks (day 8) following the last treatment, ROM was measured before and following 1 of 5 treatments; FR/SS, SS/FR, SS, FR, or nothing (control). Participants laid supine on a table where a bubble inclinometer was placed on the tibia of the dominant leg with the hip passively flexed to establish pretreatment ROM. Participants then received the treatments. Passive hip flexion ROM was assessed from pretreatment on day 1 to posttreatment on day 6, day 7 (1 wk), and day 8 (2 wk). RESULTS Passive hip flexion ROM increased for those receiving FR/SS, SS/FR, FR, and SS. ROM with FR and SS/FR was retained at day 7 but not day 8. Hip flexion ROM for FR/SS and SS were not retained at day 7 nor 8. SS/FR resulted in greater ROM than FR on day 6. SS/FR, FR/SS, SS, and FR were greater than the control at day 6. SS/FR was also greater than the control on days 7 and 8. CONCLUSION This study revealed that FR the hamstring muscles after SS produces the greatest gains in passive hip flexion and would be appropriate in noninjured patients with less than 90°.
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Affiliation(s)
- Blaine C Long
- The Herbert H. & Grace A. Down College of Health Professions, Central Michigan University, Mount Pleasant, MI, USA
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Hernández-Trujillo JA, González-Rivera MD, González-Hernández JM. Voluntary isometric contractions at maximal shortening as a new technique to achieve neuromuscular re-education in healthy subjects. J Exerc Sci Fit 2025; 23:42-50. [PMID: 39811697 PMCID: PMC11730556 DOI: 10.1016/j.jesf.2024.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 11/16/2024] [Accepted: 12/16/2024] [Indexed: 01/16/2025] Open
Abstract
Background objectives: Neuromuscular re-education has focused on improving motor activities in patients with pathologies by retraining the nervous system. However, this has not yet been investigated in healthy individuals. Voluntary isometric contractions at maximal muscle shortening (VICAMS) is a new technique with the same objective. This study aimed to investigate the chronic effects of these techniques on range of motion, strength, and vertical jump. Methods Sixty healthy, recreationally active participants (mean age: 46.4 ± 5.5), were randomly assigned to three groups (VICAMS, ballistic stretching, and control) who were trained for eight weeks. To assess chronic effects, active range of motion, maximal isometric strength, and countermovement jump height were determined before and after the intervention. Results Main effects of time and time∗group interactions were found for all variables (p < 0.001). Between-group differences were observed in the VICAMS group after the intervention, with significantly higher flexibility and strength values compared to the other groups. Intra-group differences were observed in the VICAMS and ballistic groups, as the values for all variables increased from baseline. In the VICAMS group, increases were observed in both flexibility (19.15 %) and strength (47.63 %). Increases in flexibility (2.59 %) and strength (1.84 %) were also observed in the ballistic group. For jumping, intra-group differences showed that both the VICAMS (16.56 %) and ballistic (4.34 %) groups had improved values compared to baseline values. Conclusion Our findings suggest that VICAMS is an effective, simple, and inexpensive alternative to conventional training methods for improving flexibility and strength in rehabilitation.
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Affiliation(s)
- Julio-Artemi Hernández-Trujillo
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Alcalá de Henares, Madrid, Spain
- BioReed Lab, Tenerife, Canarias, Spain
| | - María-Dolores González-Rivera
- Universidad de Alcalá, Facultad de Medicina y Ciencias de la Salud, Departamento de Ciencias Biomédicas, Alcalá de Henares, Madrid, Spain
| | - Jorge M. González-Hernández
- Faculty of Health Sciences, EVOPRED Research Group, Universidad Europea de Canarias, La Orotava, Tenerife, Spain
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Oba K, Kyotani N, Tanaka M, Komatsuzaki M, Kasahara S, Ogasawara K, Samukawa M. Acute effects of static and dynamic stretching for ankle plantar flexors on postural control during the single-leg standing task. Sports Biomech 2024; 23:3268-3278. [PMID: 38151982 DOI: 10.1080/14763141.2023.2298967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/28/2023] [Indexed: 12/29/2023]
Abstract
Static stretching (SS) and dynamic stretching (DS) are widely used as warm-ups before sports. However, whether stretching affects postural control remains unclear. We compared the effects of SS and DS on the plantar flexors and postural control during single-leg standing. Fifteen healthy young participants performed SS, DS, or no stretching (control). The stretch condition consisted of four sets lasting 30 s each. The control condition was a rest with standing for 210 s. Center of pressure (COP) displacement was measured using a force plate before and after each intervention to assess postural control during the single-leg standing task. The COP area, COP velocity, and anteroposterior (COPAP) and mediolateral (COPML) range were calculated. DS significantly decreased in the COPML range (21.5 ± 4.1 to 19.0 ± 2.5 mm; P = 0.02), COP velocity (33.8 ± 7.6 to 29.8 ± 6.5 mm/s; P < 0.01), and COP area (498.6 ± 148.3 to 393.3 ± 101.1 mm2; P < 0.01), whereas SS did not change in the COP parameters (COP area 457.2 ± 108.3 to 477.8 ± 106.1 mm2, P = .49; COP velocity 31.2 ± 4.2 to 30.7 ± 5.8 mm/s, P = 0.60; COPAP 25.4 ± 3.1 to 25.3 ± 3.2 mm, P = 0.02; COPML 20.7 ± 3.3 to 21.1 ± 2.5 mm, P = 0.94). Therefore, DS of the plantar flexors enhances postural control during single-leg standing and may be effective for both injury prevention and performance enhancement.
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Affiliation(s)
- Kensuke Oba
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
- Department of Rehabilitation, Hitsujigaoka Hospital, Sapporo, Japan
| | - Naoto Kyotani
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Minori Tanaka
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Miho Komatsuzaki
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | | | | | - Mina Samukawa
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Aracı A, Aslan UB. Physical and psychological effects of neuromuscular integrative activity vs Pilates on sedentary females. J Bodyw Mov Ther 2024; 40:1423-1432. [PMID: 39593466 DOI: 10.1016/j.jbmt.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 06/12/2022] [Accepted: 01/03/2023] [Indexed: 01/07/2023]
Abstract
The aim of this study was to compare the effects of Neuromuscular Integrative Action (NIA) and Pilates exercises on physical fitness and psychological effects in sedentary women. The groups were randomly divided into Pilates (n = 22) and NIA (n = 21) groups using the closed envelope method. 43 sedentary women aged 20-45 years were included in the study. The 6 Minute Walking Test (6MWT), the Sit and Reach Test, and the Static Plank Test durations were used for the physical fitness level assessment at baseline and at the end of trainings. In addition, the Rosenberg Self-Esteem Scale, the Beck Anxiety Inventory, and the SF-36 were used to evaluate the psycho-somatic symptoms and health-related quality of life of the participants. Both groups received 60-min exercise sessions 2 days a week for 8 weeks. After treatment, within comparisons revealed that there was a significant improvement in BMI (P = 0.008), 6MWT (P = 0.0001), Sit and Reach Test (P = 0.016), Static Plank Test (p = 0.000), and SF-36 (p = 0.017) values in the NIA group. Additionally, BMI (P = 0.038), 6-min Walk Test (p = 0.0001), Sit and Reach test (p = 0.001), Static Plank test (0.000), Functional Reach distance (p = 0.06), Beck Depression Scale, and SF-36 (p = 0.006) scores improved in comparisons made within the Pilates group after treatment. Between group comparisons showed similar result for all variables in both Pilates and NIA groups. Based on the results of this study, NIA may be an alternative to Pilates for improving the physical fitness level and psychological effects in healthy women.
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Affiliation(s)
- Ayça Aracı
- Alanya Alaaddin Keykubat University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Turkey.
| | - Ummuhan Baş Aslan
- Pamukkale University, Faculty of Physical Therapy and Rehabilitation, Turkey
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Konrad A, Alizadeh S, Anvar SH, Fischer J, Manieu J, Behm DG. Static Stretch Training versus Foam Rolling Training Effects on Range of Motion: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:2311-2326. [PMID: 38760635 PMCID: PMC11393112 DOI: 10.1007/s40279-024-02041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Long-term static stretching as well as foam rolling training can increase a joint's range of motion (ROM). However, to date, it is not clear which method is the most effective for increasing ROM. OBJECTIVE The purpose of this systematic review and meta-analysis was to compare the effects of static stretching and foam rolling training on ROM. METHODS The literature search was performed in PubMed, Scopus, and Web of Science to find the eligible studies. Eighty-five studies (72 on static stretching; and 13 on foam rolling) were found to be eligible with 204 effect sizes (ESs). For the main analyses, a random-effect meta-analysis was applied. To assess the difference between static stretching and foam rolling, subgroup analyses with a mixed-effect model were applied. Moderating variables were sex, total intervention duration, and weeks of intervention. RESULTS Static stretch (ES = - 1.006; p < 0.001), as well as foam rolling training (ES = - 0.729; p = 0.001), can increase joint ROM with a moderate magnitude compared with a control condition. However, we did not detect a significant difference between the two conditions in the subgroup analysis (p = 0.228). When the intervention duration was ≤ 4 weeks, however, a significant change in ROM was shown following static stretching (ES = - 1.436; p < 0.001), but not following foam rolling (ES = - 0.229; p = 0.248). Thus, a subgroup analysis indicated a significant favorable effect with static stretching for increasing ROM compared with foam rolling (p < 0.001) over a shorter term (≤ 4 weeks). Other moderator analyses showed no significant difference between static stretch and foam rolling training on ROM. CONCLUSIONS According to the results, both static stretching and foam rolling training can be similarly recommended to increase joint ROM, unless the training is scheduled for ≤ 4 weeks, in which case static stretching demonstrates a significant advantage. More studies are needed with a high-volume foam rolling training approach as well as foam rolling training in exclusively female participants.
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Affiliation(s)
- Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria.
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - Shahab Alizadeh
- Human Performance Lab, Department of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Saman Hadjizadeh Anvar
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Josef Fischer
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria
| | - Josefina Manieu
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
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Hernández-Trujillo JA, González-Rivera MD, Romero-Franco N, González-Hernández JM. Acute effects of voluntary isometric contractions at maximal shortening vs. ballistic stretching on flexibility, strength and jump. PeerJ 2024; 12:e17819. [PMID: 39099661 PMCID: PMC11296302 DOI: 10.7717/peerj.17819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/05/2024] [Indexed: 08/06/2024] Open
Abstract
Background Isometric training is used in sport, conventional physical activity and rehabilitation. Understandably, there is a great deal of research related to its effect on performance. It is known that the length of the muscle at the moment of contraction is a determinant of strength levels. In the literature we find research on isometric training in short muscle lengths, although it has not been studied in maximally shortened positions or the acute effects that occur after its application. Ballistic stretching (BS) is also popular in sport. Their execution involves actively reaching maximally shortened muscle positions. So far, isometric training has not been compared with protocols involving ballistic stretching. Considering the above, the aim of the present study was to investigate the effects of BS and voluntary isometric contraction at maximal shortening (VICAMS) on range of motion, strength and vertical jump. Methods The study involved 60 healthy, physically active individuals (40 and 52 years old) who were randomly assigned to three groups: BS, VICAMS and a control group (CG). To assess acute effects, before and after the intervention, active range of motion (AROM), maximal voluntary isometric force (MVIF) and countermovement jump height (CMJ) were determined. Results Time main effects and time*group interactions were found for all variables (p < 0.001). Between-group differences were shown for the VICAMS group after the intervention, with statistically significant higher AROM values compared to the other groups. MVIF values were also higher in the VICAMS group. Intra-group differences were observed for the VICAMS and Ballistic groups, as values on all variables increased from baseline. For the CMJ, intra-group differences showed that both the VICAMS and BS groups improved values compared to baseline values. Conclusions The application of VICAMS induced acute improvements over BS in AROM, MVIF and CMJ. These results are important for coaches seeking immediate performance improvement and offer an optimal solution to the warm-up protocol.
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Affiliation(s)
- J. Artemi Hernández-Trujillo
- Escuela de Doctorado Area de Ciencias de la Salud, University of Alcalá, Alcalá de Henares, Madrid, Spain
- BioReed Lab, Tenerife, Canarias, Spain
| | | | - Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Jorge M. González-Hernández
- Faculty of Health Sciences, EVOPRED Research Group, Universidad Europea de Canarias, La Orotava, Tenerife, Spain
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Patterson RD, Zettlemoyer A, Plackowski M, Baker R, Cheatham SW, Nasypany A. The Effects of TMR® Fab 6 on Hamstring Flexibility in Healthy Subjects; An Exploratory Observational Investigation. Int J Sports Phys Ther 2024; 19:877-887. [PMID: 38966827 PMCID: PMC11221334 DOI: 10.26603/001c.120203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/29/2024] [Indexed: 07/06/2024] Open
Abstract
Background Stretching programs are designed to improve hamstring flexibility by attempting to mechanically increase the length of the target tissue. However, other manual treatment approaches such as those utilized in Total Motion Release (TMR®), could be beneficial by identifying body asymmetries to assess and treat soft tissue impairments leading to diminished extensibility. Purpose The purpose of this study was to determine the effectiveness of the TMR® Fab 6 assessment and treatment to increase hamstring flexibility in healthy participants following one session of TMR®. Study Design Observational Cohort study. Methods A convenience sample of 20 healthy participants (10 males, 10 females) were recruited from three institutions. Following collection of demographic information and a brief medical history, each participant performed a five minute warm-up on the stationary bike at a moderate intensity (80-90 RPMs) followed immediately by the bilateral performance of the Active Knee Extension Test (AKET) and Passive Straight Leg Raise (PSLR) to assess hamstring muscle length. Participants were randomly placed in the TMR® or control group. The TMR® group completed the "Fab 6" evaluation and treatment, while the control group performed one repetition of standing active hip flexion every 30-seconds for 15-minutes with both knees in full extension. Upon completion of treatment, control and TMR® groups were immediately re-evaluated on the AKET and the PSLR in the same order and fashion as baseline testing. Participants were asked to return in 24-hours for the same objective measurements as previously described. Results A significant time by group interaction was identified across all variables (p ≤ 0.001) for AKET and PSLR except the PSLR preferred leg from post-treatment to 24hr follow-up. The most significant increase in the AKET occurred in the TMR® group between baseline and post-treatment of the non-preferred leg (12.15°±2.94) when compared to the control group (7.15°±1.56). Conclusion The results of the study suggest that implementing a regionally interdependent treatment approach like TMR® results in significant improvements in hamstring extensibility and hip ROM compared to the control group. Level of evidence 3.
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Affiliation(s)
| | | | - Mary Plackowski
- Health Sciences and Human MovementColorado State University Pueblo
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Konrad A, Alizadeh S, Daneshjoo A, Anvar SH, Graham A, Zahiri A, Goudini R, Edwards C, Scharf C, Behm DG. Chronic effects of stretching on range of motion with consideration of potential moderating variables: A systematic review with meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:186-194. [PMID: 37301370 PMCID: PMC10980866 DOI: 10.1016/j.jshs.2023.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 03/31/2023] [Accepted: 05/10/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND It is well known that stretch training can induce prolonged increases in joint range of motion (ROM). However, to date more information is needed regarding which training variables might have greater influence on improvements in flexibility. Thus, the purpose of this meta-analysis was to investigate the effects of stretch training on ROM in healthy participants by considering potential moderating variables, such as stretching technique, intensity, duration, frequency, and muscles stretched, as well as sex-specific, age-specific, and/or trained state-specific adaptations to stretch training. METHODS We searched through PubMed, Scopus, Web of Science, and SportDiscus to find eligible studies and, finally, assessed the results from 77 studies and 186 effect sizes by applying a random-effect meta-analysis. Moreover, by applying a mixed-effect model, we performed the respective subgroup analyses. To find potential relationships between stretch duration or age and effect sizes, we performed a meta-regression. RESULTS We found a significant overall effect, indicating that stretch training can increase ROM with a moderate effect compared to the controls (effect size = -1.002; Z = -12.074; 95% confidence interval: -1.165 to -0.840; p < 0.001; I2 = 74.97). Subgroup analysis showed a significant difference between the stretching techniques (p = 0.01) indicating that proprioceptive neuromuscular facilitation and static stretching produced greater ROM than did ballistic/dynamic stretching. Moreover, there was a significant effect between the sexes (p = 0.04), indicating that females showed higher gains in ROM compared to males. However, further moderating analysis showed no significant relation or difference. CONCLUSION When the goal is to maximize ROM in the long term, proprioceptive neuromuscular facilitation or static stretching, rather than ballistic/dynamic stretching, should be applied. Something to consider in future research as well as sports practice is that neither volume, intensity, nor frequency of stretching were found to play a significant role in ROM yields.
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Affiliation(s)
- Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Graz A-8010, Austria; School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
| | - Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
| | - Abdolhamid Daneshjoo
- Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Shahid Bahonar University of Kerman, Kerman 76169-13439, Iran
| | - Saman Hadjizadeh Anvar
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
| | - Andrew Graham
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
| | - Ali Zahiri
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
| | - Reza Goudini
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
| | - Chris Edwards
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
| | - Carina Scharf
- Institute of Human Movement Science, Sport and Health, Graz University, Graz A-8010, Austria
| | - David George Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada.
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Choi JM, Cho EY, Lee BH. Effects of Dynamic Stretching Combined with Manual Therapy on Pain, ROM, Function, and Quality of Life of Adhesive Capsulitis. Healthcare (Basel) 2023; 12:45. [PMID: 38200951 PMCID: PMC10779350 DOI: 10.3390/healthcare12010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
This study was conducted to evaluate the effects of dynamic stretching combined with manual therapy on pain, range of motion, function, and quality of life in patients with adhesive capsulitis. The participants were randomly divided into two groups: the dynamic stretching combined with manual therapy (DSMT) group (n = 17) and the static stretching combined with manual therapy (SSMT) group (n = 17). Both groups received manual therapy for 10 min and two sessions per week for 4 weeks. The DSMT group also performed additional dynamic stretching for 20 min per session, two sessions per week for 4 weeks. The SSMT group practiced additional static stretching for 20 min per session, two sessions per week for 4 weeks. The pain, ROM, function, and quality of life were measured and evaluated before and after treatment. There were significant improvements in the outcomes of pain, flexion and abduction of shoulder ROM, Shoulder Pain and Disability Index (SPADI), and the physical component score and mental component score of the Short Form-36 (SF-36) in both groups. Additionally, the external and internal rotation of the shoulder ROM and the SF-36 general health factor increased significantly more in the A group (DSMT group) compared to the B group (SSMT). In conclusion, dynamic stretching plus manual therapy offers the same results as static stretching plus manual therapy, but with additional improvement in internal and external rotation.
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Affiliation(s)
- Jeong-Min Choi
- Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Eun-Young Cho
- Institutional Research Center, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea
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Cai P, Liu L, Li H. Dynamic and static stretching on hamstring flexibility and stiffness: A systematic review and meta-analysis. Heliyon 2023; 9:e18795. [PMID: 37560703 PMCID: PMC10407730 DOI: 10.1016/j.heliyon.2023.e18795] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Hamstring injuries are one of the most common types of damage in sports. Insufficient flexibility and high stiffness are important reasons for it. Stretching is often used in warm-up activities before exercises to increase flexibility, among which dynamic stretching (DS) and static stretching (SS) are the most widely used. The effects of these two stretching techniques on the flexibility or stiffness of the hamstring still need to be clarified. OBJECTIVE This study aimed to compare the short-term, medium-term, and long-term effects of DS and SS on improving hamstring flexibility and stiffness via a meta-analysis of RCTs. METHODS RCTs were identified from PubMed, Cochrane Library, Web of Science, and PEDro from inception to July 28, 2022. The methodological quality was evaluated using the PEDro scale. The mean difference and 95% confidence interval of the outcome variables before and after stretching were calculated and the extracted data were quantitatively processed using a random or fixed effects model. RESULTS A total of 27 RCTs and 606 participants were included. In terms of improving the ROM of the hamstring, there was no significant difference in the acute (MD, -0.70, 95% CI, -1.54 to 0.14; Z = 1.63, P > 0.05) and sub-acute effects (MD, 1.71, 95% CI, -2.80 to 6.22; Z = 0.74, P > 0.05) between a single bout of SS and DS, while the acute (MD, -5.13, 95% CI, -7.65 to -2.61; Z = 3.99, P < 0.05) and sub-acute effects (MD, -5.30, 95% CI, -6.33 to -4.27; Z = 10.04, P < 0.05) of multiple bouts of SS was superior to DS; There was no significant difference in the medium-term effect between the two stretching techniques (MD, 3.48, 95% CI, -2.57 to 9.53; Z = 1.13, P > 0.05), but the long-term effect of SS was better than DS (MD, - 10.40, 95% CI, -10.97 to -9.83; Z = 35.57, P < 0.05). Regarding the length of the hamstring, the acute (MD, -0.41, 95% CI, -1.09 to 0.26; Z = 1.20, P > 0.05) and sub-acute effects (MD, -0.73, 95% CI, -1.69 to 0.22; Z = 1.51, P > 0.05) of a single bout of DS and SS were similar. Two studies have compared the effects on hamstring stiffness, with one showing similar effects, and the other showed that DS was superior to SS. One study showed no difference in the magnitude of change in improving passive torque. No studies explored the effect of DS and SS on hamstring myofascial length. Only one study demonstrated no significant difference in hamstring thickness. CONCLUSIONS A single bout of DS and SS have similar short-term effects in improving hamstring ROM and length, while multiple bouts of SS can significantly improve hamstring ROM compared to DS. DS and SS showed similar effects on hamstring myofascial length.
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Affiliation(s)
- Peng Cai
- Department of Rehabilitation Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Lewen Liu
- Faculty of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Hai Li
- Department of Rehabilitation Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China
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12
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Behm DG, Alizadeh S, Daneshjoo A, Konrad A. Potential Effects of Dynamic Stretching on Injury Incidence of Athletes: A Narrative Review of Risk Factors. Sports Med 2023; 53:1359-1373. [PMID: 37162736 PMCID: PMC10289929 DOI: 10.1007/s40279-023-01847-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2023] [Indexed: 05/11/2023]
Abstract
The use of dynamic stretching as a replacement for static stretching in the warm-up is widespread based on the reports of static stretching-induced performance impairments. While acute and chronic static stretching has been reported to reduce musculotendinous injuries, especially with explosive and change of direction actions, the influence of dynamic stretching on injury incidence lacks a similar volume of literature for acute and chronic responses. It was the objective of this narrative review to examine the acute and training effects of dynamic stretching on injury incidence and possible moderating variables such as dynamic stretching effects on range of motion, strength, balance, proprioception, muscle morphology, and psycho-physiological responses. One study demonstrated no significant difference regarding injury incidence when comparing a dynamic stretching-only group versus a combined dynamic stretching plus static stretching group. The only other study examined functional dynamic stretching training with injured dancers and reported improved ankle joint stability. However, several studies have shown that dynamic activity with some dynamic stretching exercises within a warm-up consistently demonstrates positive effects on injury incidence. Regarding moderating variables, while there is evidence that an acute bout of dynamic stretching can enhance range of motion, the acute and training effects of dynamic stretching on strength, balance, proprioception, and musculotendinous stiffness/compliance are less clear. The acute effects of dynamic stretching on thixotropic effects and psycho-physiological responses could be beneficial for injury reduction. However, the overall conflicting studies and a lack of substantial literature compared with SS effects points to a need for more extensive studies in this area.
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Affiliation(s)
- David G. Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7 Canada
| | - Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7 Canada
| | - Abdolhamid Daneshjoo
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7 Canada
- Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Andreas Konrad
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, NL A1C 5S7 Canada
- Institute of Human Movement Science, Sport and Health, Graz University, Graz, Austria
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13
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Alizadeh S, Daneshjoo A, Zahiri A, Anvar SH, Goudini R, Hicks JP, Konrad A, Behm DG. Resistance Training Induces Improvements in Range of Motion: A Systematic Review and Meta-Analysis. Sports Med 2023; 53:707-722. [PMID: 36622555 PMCID: PMC9935664 DOI: 10.1007/s40279-022-01804-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Although it is known that resistance training can be as effective as stretch training to increase joint range of motion, to date no comprehensive meta-analysis has investigated the effects of resistance training on range of motion with all its potential affecting variables. OBJECTIVE The objective of this systematic review with meta-analysis was to evaluate the effect of chronic resistance training on range of motion compared either to a control condition or stretch training or to a combination of resistance training and stretch training to stretch training, while assessing moderating variables. DESIGN For the main analysis, a random-effect meta-analysis was used and for the subgroup analysis a mixed-effect model was implemented. Whilst subgroup analyses included sex and participants' activity levels, meta-regression included age, frequency, and duration of resistance training. DATA SOURCES Following the systematic search in four databases (PubMed, Scopus, SPORTDiscus, and Web of Science) and reference lists, 55 studies were found to be eligible. ELIGIBILITY CRITERIA Controlled or randomized controlled trials that separately compared the training effects of resistance training exercises with either a control group, stretching group, or combined stretch and resistance training group on range of motion in healthy participants. RESULTS Resistance training increased range of motion (effect size [ES] = 0.73; p < 0.001) with the exception of no significant range of motion improvement with resistance training using only body mass. There were no significant differences between resistance training versus stretch training (ES = 0.08; p = 0.79) or between resistance training and stretch training versus stretch training alone (ES = - 0.001; p = 0.99). Although "trained or active people" increased range of motion (ES = 0.43; p < 0.001) "untrained and sedentary" individuals had significantly (p = 0.005) higher magnitude range of motion changes (ES = 1.042; p < 0.001). There were no detected differences between sex and contraction type. Meta-regression showed no effect of age, training duration, or frequency. CONCLUSIONS As resistance training with external loads can improve range of motion, stretching prior to or after resistance training may not be necessary to enhance flexibility.
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Affiliation(s)
- Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador, St. John's, NL, A1C 5S7, Canada
| | - Abdolhamid Daneshjoo
- Department of Sport Injuries, Physical Education and Sport Sciences Faculty, Shahid Bahonar University, Kerman, Iran
| | - Ali Zahiri
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador, St. John's, NL, A1C 5S7, Canada
| | - Saman Hadjizadeh Anvar
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador, St. John's, NL, A1C 5S7, Canada
| | - Reza Goudini
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador, St. John's, NL, A1C 5S7, Canada
| | - Jared P Hicks
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador, St. John's, NL, A1C 5S7, Canada
| | - Andreas Konrad
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador, St. John's, NL, A1C 5S7, Canada.,Institute of Human Movement Science, Sport and Health, Graz University, Graz, Austria.,Technical University of Munich, Munich, Germany
| | - David George Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's Newfoundland and Labrador, St. John's, NL, A1C 5S7, Canada.
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14
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Takeuchi K, Nakamura M, Matsuo S, Akizuki K, Mizuno T. Effects of Speed and Amplitude of Dynamic Stretching on the Flexibility and Strength of the Hamstrings. J Sports Sci Med 2022; 21:608-615. [PMID: 36523896 PMCID: PMC9741718 DOI: 10.52082/jssm.2022.608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 11/14/2022] [Indexed: 11/22/2022]
Abstract
Dynamic stretching for more than 90 seconds is useful for improving muscle strength, although dynamic stretching for 30 seconds or less is commonly used in sports settings. The effects of dynamic stretching are influenced by the speed and amplitude of stretching, but no study examined these factors for 30 seconds of dynamic stretching. Therefore, the purpose of the present study was to examine the effects of speed (fast- or slow-speed) and amplitude (normal- or wide amplitude) of dynamic stretching for 30 seconds on the strength (peak torque during maximum isokinetic concentric contraction) and flexibility (range of motion, passive torque at maximum knee extension angle, and muscle-tendon unit stiffness) of the hamstrings. The passive torque and muscle-tendon unit stiffness reflect stretching tolerance and viscoelastic properties of the hamstrings, respectively. Fifteen healthy participants performed 4 types of 30 seconds of dynamic stretching. The muscle strength and flexibility were measured before and immediately after the dynamic stretching. The range of motion did not change after dynamic stretching at low speed and normal amplitude (p = 0.12, d = 0.59, 103.3%), but it was increased by other interventions (p < 0.01, d = 0.90-1.25, 104.5-110.1%). In all interventions, the passive torque increased (main effect for time, p < 0.01, d = 0.51 - 0.74, 111.0 - 126.9%), and muscle-tendon unit stiffness did not change. The muscle strength increased only after dynamic stretching at fast speed with normal amplitude (p < 0.01, d = 0.79, 107.1%). The results of the present study indicated that 30 seconds of dynamic stretching at fast speed and with normal amplitude can be beneficial for the measured parameters.
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Affiliation(s)
- Kosuke Takeuchi
- Department of Physical Therapy, Kobe International University, Kobe-shi, Hyogo, Japan, Faculty of Rehabilitation, Kobe International University, 9-1-6 Koyocho-naka, Higashinada-ku, Kobe, Hyogo 658-0032, Japan
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, Kanzaki-cho, Saga, Japan
| | - Shingo Matsuo
- Department of Rehabilitation, Faculty of Health Sciences, Nihon Fukushi University, Handa-shi, Aichi, Japan
| | - Kazunori Akizuki
- Department of Physical Therapy, Mejiro University, Saitama-shi, Saitama, Japan
| | - Takamasa Mizuno
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya-shi, Aichi, Japan
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15
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Inoue T, Nagano K. Differential effects of dynamic and ballistic stretching on contralateral lower limb flexibility. ISOKINET EXERC SCI 2022. [DOI: 10.3233/ies-220033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Dynamic stretching (DS) and ballistic stretching (BS) are similar stretching methods, but the differences between them are unclear. OBJECTIVE: To examine the immediate effects of unilateral hamstring DS and BS on straight leg raise (SLR), knee flexion range of motion (KF-ROM), and KF and knee extension maximal isokinetic peak torque (KF-MIPT and KE-MIPT) of the bilateral limbs. METHODS: Twelve healthy adult men performed four sets of 2 min each of non-stretching, DS, or BS of the right lower extremity. Bilateral SLR, KF-ROM, KF-MIPT, and KE-MIPT were measured pre- and post-intervention; a three-way (intervention × limb × time) repeated-measures analysis of variance (ANOVA) was used. RESULTS: The SLR of the stretched limb (p< 0.01) was higher with DS than that pre-intervention. SLR (p< 0.01) and KF-ROM (p< 0.05) of the stretched limb and SLR (p< 0.05) and KF-ROM (p< 0.05) of the contralateral limb were higher with BS than those pre-intervention. There was no significant main effect or interaction between KF-MIPT and KE-MIPT. CONCLUSION: DS and BS had slightly different effects on ROM, and neither affected muscle strength; thus, combining the techniques during warm-up might be helpful.
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Affiliation(s)
- Taisei Inoue
- Division of Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Katsuhito Nagano
- Department of Physical Therapy, Faculty of Health Sciences, Japan University of Health Sciences, Saitama, Japan
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16
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Kim HK, Parikh S. Patellofemoral Instability in Children: Imaging Findings and Therapeutic Approaches. Korean J Radiol 2022; 23:674-687. [PMID: 35555883 PMCID: PMC9174504 DOI: 10.3348/kjr.2021.0577] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 02/08/2022] [Accepted: 02/19/2022] [Indexed: 11/15/2022] Open
Abstract
Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.
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Affiliation(s)
- Hee Kyung Kim
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Radiology, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.
| | - Shital Parikh
- Devision of Pediatric Orthopedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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17
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Whole-Body Vibration Effects on Flexibility in Artistic Gymnastics—A Systematic Review. Medicina (B Aires) 2022; 58:medicina58050595. [PMID: 35630012 PMCID: PMC9143419 DOI: 10.3390/medicina58050595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 11/28/2022] Open
Abstract
It is well documented that whole body-vibration training has effects on muscle strength and flexibility, blood circulation, decreases pain perception and strengthens bone and tendon. Although whole body-vibration has benefits in athletes’ flexibility, we are not sure what its actual effects are in artistic gymnastics (since they already have stunning flexibility). Hence, the aim of this study was to analyse the studies on whole-body vibration in artistic gymnastics and to present the effects on flexibility. The search and analysis were carried out in accordance with PRISMA guidelines. The databases search (PubMed, Scopus, Google Scholar, Cochrane Library, ProQuest, EBSCOhost and Science Direct) yielded 18,057 potential studies. By the given inclusion criteria (studies from 2005 to 2022; full-text published in English; the study included male and female gymnasts as samples, and that participants were tested for evaluation of flexibility by whole-body vibration method), a total of 9 full-text studies were included, with a total of 210 participants, both male and female. As far as the measured flexibility tests conducted, front split, sit and reach and bridge were evaluated, while obtained results were 9.1–39.1%, 2.79–6.7%, 6.43–7.45%, respectively. All studies have conducted same vibration frequency (30 Hz) with same amplitude of displacements (2 mm), except for the one study who did not show the information of implemented amplitude. After analysing the obtained results, it can be concluded that the usage of whole-body vibration platform shows flexibility improvements in artistic gymnasts, both male and female. In addition, a combination of whole-body vibration and traditional static stretching may enhance the flexibility in artistic gymnasts. However, these results should be taken with caution. Since this review did not reveal the optimal vibrational protocol, it is necessary to invest time during the implementation of various vibrational experimental protocols, so future research is required.
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18
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Rudisill SS, Varady NH, Kucharik MP, Eberlin CT, Martin SD. Evidence-Based Hamstring Injury Prevention and Risk Factor Management: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Sports Med 2022:3635465221083998. [PMID: 35384731 DOI: 10.1177/03635465221083998] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hamstring injuries are common among athletes. Considering the potentially prolonged recovery and high rate of recurrence, effective methods of prevention and risk factor management are of great interest to athletes, trainers, coaches, and therapists, with substantial competitive and financial implications. PURPOSE To systematically review the literature concerning evidence-based hamstring training and quantitatively assess the effectiveness of training programs in (1) reducing injury incidence and (2) managing injury risk factors. STUDY DESIGN Systematic review and meta-analysis; Level of evidence, 1. METHODS A computerized search of MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus with manual screening of selected reference lists was performed in October 2020. Randomized controlled trials investigating methods of hamstring injury prevention and risk factor management in recreational, semiprofessional, and professional adult athletes were included. RESULTS Of 2602 articles identified, 108 were included. Eccentric training reduced the incidence of hamstring injury by 56.8% to 70.0%. Concentric hamstring strength increased with eccentric (mean difference [MD], 14.29 N·m; 95% CI, 8.53-20.05 N·m), concentric, blood flow-restricted, whole-body vibration, heavy back squat, FIFA 11+ (Fédération Internationale de Football Association), and plyometric training methods, whereas eccentric strength benefited from eccentric (MD, 26.94 N·m; 95% CI, 15.59-38.30 N·m), concentric, and plyometric training. Static stretching produced greater flexibility gains (MD, 10.89°; 95% CI, 8.92°-12.86°) than proprioceptive neuromuscular facilitation (MD, 9.73°; 95% CI, 6.53°-12.93°) and dynamic stretching (MD, 6.25°; 95% CI, 2.84°-9.66°), although the effects of static techniques were more transient. Fascicle length increased with eccentric (MD, 0.90 cm; 95% CI, 0.53-1.27 cm) and sprint training and decreased with concentric training. Although the conventional hamstring/quadriceps (H/Q) ratio was unchanged (MD, 0.03; 95% CI, -0.01 to 0.06), the functional H/Q ratio significantly improved with eccentric training (MD, 0.10; 95% CI, 0.03-0.16). In addition, eccentric training reduced limb strength asymmetry, while H/Q ratio and flexibility imbalances were normalized via resistance training and static stretching. CONCLUSION Several strategies exist to prevent hamstring injury and address known risk factors. Eccentric strengthening reduces injury incidence and improves hamstring strength, fascicle length, H/Q ratio, and limb asymmetry, while stretching-based interventions can be implemented to improve flexibility. These results provide valuable insights to athletes, trainers, coaches, and therapists seeking to optimize hamstring training and prevent injury.
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Affiliation(s)
- Samuel S Rudisill
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA.,Rush Medical College of Rush University, Chicago, Illinois, USA
| | - Nathan H Varady
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA.,Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Michael P Kucharik
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
| | - Christopher T Eberlin
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
| | - Scott D Martin
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
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19
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Hua A, Bai J, Fan Y, Wang J. Comparison of Distance and Angular Analysis for Measurement of Hamstring Flexibility in Preschoolers. CHILDREN (BASEL, SWITZERLAND) 2022; 9:39. [PMID: 35053665 PMCID: PMC8774374 DOI: 10.3390/children9010039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022]
Abstract
The study aimed to (1) investigate the reliability and usefulness of a proposed angular analysis during a modified sit-and-reach (MSR) test, and (2) compare the proposed MSR angular analysis and the commonly used MSR distance to verify the influence of the anthropometric characteristics in preschoolers. 194 preschoolers participated in the study. Before testing, the anthropometric characteristics were collected. Each participant performed the MSR test twice. The MSR distance score was obtained from the starting point to the reaching point, while the MSR angle score was calculated according to the approximate hip flexion angle. Both the relative and absolute reliability were good for the angular analysis during an MSR test in preschoolers (ICC ranging from 0.82 to 0.91, CV% ranging from 8.21 to 9.40). The angular analysis demonstrated good usefulness, with a lower typical error than the smallest worthwhile change in 3- and 5-year-old groups. The MSR angle scores could eliminate the concern of the influence of anthropometric characteristics, while MSR distance and anthropometric characteristics (i.e., sitting height and arm length) were found to be weakly correlated. In conclusion, the angular analysis when performing the MSR test is reliable and appears to eliminate the concern regarding the limb length bias.
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Affiliation(s)
- Anke Hua
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou 310058, China; (A.H.); (J.B.)
| | - Jingyuan Bai
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou 310058, China; (A.H.); (J.B.)
| | - Yong Fan
- Department of Sports, Qianjiang College, Hangzhou Normal University, Hangzhou 311121, China;
| | - Jian Wang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou 310058, China; (A.H.); (J.B.)
- Center for Psychological Sciences, Zhejiang University, Hangzhou 310058, China
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20
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Feland B, Hopkins AC, Behm DG. Acute Hemodynamic Responses to Three Types of Hamstrings Stretching in Senior Athletes. J Sports Sci Med 2021; 20:690-698. [PMID: 35321136 PMCID: PMC8488840 DOI: 10.52082/jssm.2021.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/23/2021] [Indexed: 06/14/2023]
Abstract
Although stretching is recommended for fitness and health, there is little research on the effects of different stretching routines on hemodynamic responses of senior adults. It is not clear whether stretching can be considered an aerobic exercise stimulus or may be contraindicated for the elderly. The purpose of this study was to compare the effect of three stretching techniques; contract/relax proprioceptive neuromuscular facilitation (PNF), passive straight-leg raise (SLR), and static sit-and-reach (SR) on heart rate (HR) and blood pressure (BP) in senior athletes (119 participants: 65.6 ± 7.6 yrs.). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and HR measurements were taken at baseline (after 5-minutes in a supine position), 45 and 90-seconds, during the stretch, and 2-minutes after stretching. Within each stretching group, (SLR, PNF, and SR) DBP, MAP and HR at pre-test and 2-min post-stretch were lower than at 45-s and 90-s during the stretch. SLR induced smaller increases in DBP and MAP than PNF and SR, whereas PNF elicited lower HR responses than SR. In conclusion, trained senior adult athletes experienced small to moderate magnitude increases of hemodynamic responses with SLR, SR and PNF stretching, which recovered to baseline values within 2-min after stretching. Furthermore, the passive SLR induced smaller increases in BP than PNF and SR, while PNF elicited lower HR responses than SR. These increases in hemodynamic responses (HR and BP) were not of a magnitude to be clinically significant, provide an aerobic exercise stimulus or warrant concerns for most senior athletes.
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Affiliation(s)
- Brent Feland
- Faculty Department of Exercise Sciences, College of Life Sciences, Brigham, University, Provo, Utah, USA
| | - Andy C Hopkins
- Department of Exercise Sciences, Brigham University, Provo, Utah, USA
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's NL, Canada
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21
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A Survey on Stretching Practices in Women and Men from Various Sports or Physical Activity Programs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083928. [PMID: 33918033 PMCID: PMC8068839 DOI: 10.3390/ijerph18083928] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/12/2022]
Abstract
Recommendations for prescribing stretching exercises are regularly updated. It appears that coaches progressively follow the published guidelines, but the real stretching practices of athletes are unknown. The present study aimed to investigate stretching practices in individuals from various sports or physical activity programs. A survey was completed online to determine some general aspects of stretching practices. The survey consisted of 32 multiple-choice or open-ended questions to illustrate the general practices of stretching, experiences and reasons for stretching. In total, 3546 questionnaires were analyzed (47.3% women and 52.7% men). Respondents practiced at the national/international level (25.2%), regional level (29.8%), or recreationally (44.9%). Most respondents (89.3%) used stretching for recovery (74.9%) or gains of flexibility (57.2%). Stretching was generally performed after training (72.4%). The respondents also indicated they performed stretching as a pre-exercise routine (for warm-up: 49.9%). Static stretching was primarily used (88.2%) but when applied for warm-up reasons, respondents mostly indicated performing dynamic stretching (86.2%). Only 37.1% of the respondents indicated being supervised. Finally, some gender and practice level differences were noticed. The present survey revealed that the stretching practices were only partly in agreement with recent evidence-based recommendations. The present survey also pointed out the need to improve the supervision of stretching exercises.
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Lee JH, Jang KM, Kim E, Rhim HC, Kim HD. Static and Dynamic Quadriceps Stretching Exercises in Patients With Patellofemoral Pain: A Randomized Controlled Trial. Sports Health 2021; 13:482-489. [PMID: 33615901 DOI: 10.1177/1941738121993777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Limited data are available on the effect of stretching exercise in patients with patellofemoral pain (PFP) who have inflexible quadriceps, which is one of the various causes of PFP syndrome. This study compares quadriceps flexibility, strength, muscle activation time, and patient-reported outcomes after static and dynamic quadriceps stretching exercises in patients with PFP who had inflexible quadriceps. HYPOTHESIS Quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes would improve with dynamic quadriceps stretching as compared with static quadriceps stretching exercises. STUDY DESIGN Randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS Of the 44 patients included in the study, 20 performed static stretching and 24 performed dynamic stretching. Quadriceps flexibility was assessed by measuring the knee flexion angle during knee flexion in the prone position (the Ely test). Muscle strength and muscle activation time were measured using an isokinetic device. The patient-reported outcomes were evaluated using the visual analogue scale for pain and anterior knee pain scale. RESULTS No significant differences in quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes in the involved knees were found between the 2 groups (P values > 0.05). CONCLUSION Quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes in patients with PFP who had inflexible quadriceps showed no significant differences between the static and dynamic quadriceps stretching exercise groups. CLINICAL RELEVANCE Both static and dynamic stretching exercises may be effective for improving pain and function in patients with PFP who have inflexible quadriceps.
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Affiliation(s)
- Jin Hyuck Lee
- Department of Physical Therapy and School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Republic of Korea.,Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Ki-Mo Jang
- Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea.,Korea University College of Medicine and School of Medicine, Seoul, Republic of Korea
| | - Eunseon Kim
- Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Hye Chang Rhim
- Korea University College of Medicine and School of Medicine, Seoul, Republic of Korea
| | - Hyeong-Dong Kim
- Department of Physical Therapy and School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Republic of Korea
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Shamsi M, Mirzaei M, Shahsavari S, Safari A, Saeb M. Modeling the effect of static stretching and strengthening exercise in lengthened position on balance in low back pain subject with shortened hamstring: a randomized controlled clinical trial. BMC Musculoskelet Disord 2020; 21:809. [PMID: 33276764 PMCID: PMC7718700 DOI: 10.1186/s12891-020-03823-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 11/23/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Hamstring shortening may have negative impacts on function and biomechanics of knee and hip joints and lumbo-pelvic rhythm. Many interventions are believed to correct hamstring to its normal length. There are several reports of impairment in postural control of patients with low back pain. The purpose of this study was to compare the effect of stretching exercise and strengthening exercise in lengthened position of the hamstring muscle on improving the dynamic balance of the person in patients with chronic low back pain with short hamstring muscles. METHODS Forty-five patients with hamstring shortening who referred to physiotherapy clinic of Kermanshah university of Medical Sciences, Kermanshah, Iran were randomly allocated to the three groups; static stretching (n = 15), strengthening exercise in lengthened hamstring position (n = 15) and control (n = 15). All groups received conventional physiotherapy for low back pain and the two intervention groups received stretching exercise and strengthening exercise in lengthened position programs as well. All groups performed three treatment sessions for a week, a total of 12 sessions. For balance assessment, Y-Balance test was performed for each participant in three reach directions. To determine the important and significant variables, all variables entered a model (Generalized Estimation Equations method). RESULTS The results indicate that based on GEE model, by controlling other variables, participants of static stretching exercise showed more improvement in balance than control group (β = 9.58, p-value = 0.014). Also, balance status showed significant improvement in the end of study compared to baseline of the study (β = 7.71, P-value< 0.001). In addition, the balance in three reach directions improved significantly and the greatest balance improvement was in the anterior reach direction (β ranged over = 6.16 to 11.59) and the height of patients affected their balance (β = 0.28, P-value = 0.034). CONCLUSIONS Group (type of intervention), phase of intervention, reach direction of test (anterior, posteromedial and posterolateral) and height of participants were associated with balance performance. Static stretching exercise was more effective than muscle strengthening exercise in lengthened position for improving dynamic balance in low back pain patients with hamstring tightness. TRIAL REGISTRATION Iranian Registry of Clinical Trials (I RCT201507258035n2 ). Registered 16th September 2015.
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Affiliation(s)
- MohammadBagher Shamsi
- School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Mirzaei
- School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Soodeh Shahsavari
- Department of Health Information Management, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ameneh Safari
- Esfarayen Facualty of Medical Sciences, Esfarayen, Iran
| | - Morteza Saeb
- Assistant professor of Orthopedic Surgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Ahn JO, Weon JH, Koh EK, Jung DY. Effectiveness of hamstring stretching using a pressure biofeedback unit for 4 weeks: A randomized controlled trial. Hong Kong Physiother J 2020; 40:99-107. [PMID: 33005074 PMCID: PMC7526059 DOI: 10.1142/s1013702520500092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 02/06/2020] [Indexed: 11/18/2022] Open
Abstract
Background Stretching and length test of hamstring muscles have been performed commonly to manage lower back pain (LBP) in sports rehabilitation. Previous literatures addressed that stretching techniques and length test of hamstring muscles should be performed with the pelvic maintained in an anterior tilt position. However, there is no study to determine the effectiveness of pressure biofeedback unit (PBU) to maintain in anterior pelvic tilting (APT) on length test and stretching of hamstring muscles. Objective To determine the effectiveness of hamstring muscles stretching using a PBU. Methods Forty participants with shortness of hamstrings randomized into two groups. Participants performed the active knee extension (AKE) stretching without (control group) or with PBU (intervention group) for four weeks. AKE tests without and with PBU were administered three times before and after hamstrings stretching by each group. Results The AKE test without PBU showed a significant main effect of time ( p < 0 . 01 ) but not of group ( p = 0 . 55 ) on the AKE angle. The AKE test with PBU showed a significant increase in the AKE angle in the post-intervention compared to the pre-intervention assessments in both groups ( p < 0 . 01 ). The difference of AKE angle between the pre- and post-intervention results was significantly greater in the intervention group than in the control group ( p < 0 . 01 ). Conclusion We recommend the use of a PBU to maintain the pelvic anterior tilting position when performing the AKE test or AKE stretching.
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Affiliation(s)
- Jin-Oh Ahn
- Department of KEMA Therapy, Graduate School of Humanities Industry, Joongbu University, Geumsan, South Korea
| | - Jong-Hyuck Weon
- Department of Physical Therapy, College of Health & Welfare, Joongbu University, Geumsan, South Korea
| | - Eun-Kyung Koh
- Department of Physical Therapy, Masan University, Changwon, South Korea
| | - Do-Young Jung
- Department of Physical Therapy, College of College of Health & Welfare, Joongbu University, Geumsan, South Korea
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Lee JH, Jang KM, Kim E, Rhim HC, Kim HD. Effects of Static and Dynamic Stretching With Strengthening Exercises in Patients With Patellofemoral Pain Who Have Inflexible Hamstrings: A Randomized Controlled Trial. Sports Health 2020; 13:49-56. [PMID: 32790575 DOI: 10.1177/1941738120932911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Patellofemoral pain (PFP) syndrome is closely associated with muscle tightness. However, studies regarding the effects of stretching exercises on PFP patients with inflexible hamstrings are scarce. The aim of the study was to compare the effects between static and dynamic hamstring stretching in patients with PFP who have inflexible hamstrings. HYPOTHESIS Compared with static hamstring stretching, dynamic hamstring stretching will improve the parameters of hamstring flexibility, knee muscle strength, muscle activation time, and clinical outcomes in this patient population. STUDY DESIGN Prospective randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS A total of 46 patients (25, static stretching; 21, dynamic stretching) participated. Hamstring flexibility was assessed according to the popliteal angle during active knee extension. Muscle strength and muscle activation time were measured using an isokinetic device. Clinical outcomes were evaluated using the visual analog scale (VAS) for pain and the anterior knee pain scale (AKPS). RESULTS There were no differences in hamstring flexibility and knee muscle strength of the affected knees between the groups (P > 0.05). Significantly improved muscle activation time and clinical outcomes of the affected knees were observed in the dynamic stretching group compared with the static stretching group (all Ps < 0.01 for hamstring, quadriceps, VAS, and AKPS). CONCLUSION In patients with PFP who have inflexible hamstrings, dynamic hamstring stretching with strengthening exercises was superior for improving muscle activation time and clinical outcomes compared with static hamstring stretching with strengthening exercises. CLINICAL RELEVANCE Clinicians and therapists could implement dynamic hamstring stretching to improve function and reduce pain in patients with PFP who have inflexible hamstrings.
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Affiliation(s)
- Jin Hyuck Lee
- Department of Physical Therapy and School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Korea.,Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Ki-Mo Jang
- Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea.,Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eunseon Kim
- Department of Sports Medical Center, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Hye Chang Rhim
- Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyeong-Dong Kim
- Department of Physical Therapy and School of Health and Environmental Science, College of Health Science, Korea University, Seoul, Korea
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Charles ST, Mogle J, Piazza J, Karlamangla A, Almeida DM. Going the distance: The diurnal range of cortisol and its association with cognitive and physiological functioning. Psychoneuroendocrinology 2020; 112:104516. [PMID: 31805455 PMCID: PMC6948931 DOI: 10.1016/j.psyneuen.2019.104516] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/18/2019] [Accepted: 11/12/2019] [Indexed: 12/21/2022]
Abstract
Cortisol features prominently in theories describing how chronic stress wears away at physical and cognitive health. The current study examines composite measures of physiological and cognitive functioning in relation to two aspects of daily cortisol: total daily output and change in levels throughout the day. Participants (N = 1001; aged 28-84 years-old) from the Midlife Development in the United States (MIDUS) study provided 4 daily saliva samples across four consecutive days and underwent a physical exam that provided information about six inter-related physiological systems that were combined into a measure of allostatic load. They also completed a phone-based battery of cognitive tasks, which provided a composite score combining memory, reasoning, and speed of processing performance. Total daily cortisol output was captured using area under the curve with respect to ground (AUCg). Change in cortisol levels was assessed using two methods: slope, calculated through piecewise spline models, and dynamic range, calculated by the difference between the day's highest and lowest log-cortisol levels. Findings indicate that, when examined together, overall cortisol output was not associated with either outcome, but a greater range in cortisol throughout the day was associated with both lower allostatic load and higher cognitive functioning. Results emphasize the importance of dynamic daily processes, assessed either using slopes or dynamic range, to both physiological and cognitive functioning.
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Affiliation(s)
- Susan T. Charles
- Department of Psychological Science, 4568 Social & Behavioral Sciences Gateway, University of California, Irvine, CA 92697-7085 USA
| | - Jacqueline Mogle
- Prevention Research Center, The Pennsylvania State University, v320D Biobehavioral Health Building, University Park, PA 16802, USA.
| | - Jennifer Piazza
- Department of Public Health, KHS 243, California State University, Fullerton Fullerton, CA 92831 USA
| | - Arun Karlamangla
- Department of Medicine, David Geffen School of Medicine, 200 UCLA Medical Plaza Suite 365, Los Angeles, CA 90095, USA.
| | - David M. Almeida
- Department of Human Development and Family Studies, 403 Biobehavioral Health Building, University Park, PA 16802 USA
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Fakhro MA, Chahine H, Srour H, Hijazi K. Effect of deep transverse friction massage vs stretching on football players’ performance. World J Orthop 2020; 11:47-56. [PMID: 31966969 PMCID: PMC6960298 DOI: 10.5312/wjo.v11.i1.47] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 07/04/2019] [Accepted: 11/07/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Flexibility, agility and muscle strength are key factors to either win or lose a game. Recently the effect of a new technique, deep transverse friction massage (DTFM) on muscle extensibility as compared to traditional stretching techniques has been examined.
AIM To compare the effect of DTFM vs static and dynamic stretching techniques on the hamstring’s extensibility, agility, and strength amongst Lebanese and Syrian football players. Recording the incidence of non-contact hamstring muscle injury was a secondary objective.
METHODS This study is a single-blinded prospective longitudinal randomized controlled trial. The experiment took place over a period of four weeks. Football players were randomized into three intervention groups (static stretching; dynamic stretching; DTFM). Participants of each group were followed-up carefully by assessors during their intervention sessions three times per week, for a total of 12 sessions and during the data collection. Extensibility, agility, and strength were compared between intervention groups at (baseline; acute; and chronic) phases. Straight leg raise and 1 repetition maximum tests were used to measure the dominant leg hamstring muscle extensibility and maximal strength respectively. T-drill test was used to assess the lower extremities agility.
RESULTS Of 103 Lebanese and Syrian male football players aged between 18 and 35 were sampled from Damascus-Syria and South of Lebanon to participate in this study. Between-groups measures of acute strength (P = 0.011) and chronic extensibility (P = 0.000) solely showed a significant difference, and the static group showed to be superior as compared to the other groups. No loss to follow-up or protocol violation was recorded.
CONCLUSION Static stretching is showing to be superior to the other techniques used, regarding gaining long-term extensibility and short-term maximal muscle strength. In addition, DTFM showed improvements but did not outweigh the effects on footballers’ performance when comparing it to static and dynamic techniques. Finally, no difference between the interventions is recorded regarding the rate of muscle injuries incidence.
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Affiliation(s)
- Mohammed Ali Fakhro
- Faculty of Public Health, Department of Physical Therapy, Lebanese German University, Sahel Alma, Jounieh 00961, Keserwan, Lebanon
| | - Hussein Chahine
- Faculty of Public Health, Department of Physical Therapy, Lebanese German University, Sahel Alma, Jounieh 00961, Keserwan, Lebanon
| | - Hassan Srour
- Faculty of Public Health, Department of Physical Therapy, Lebanese German University, Sahel Alma, Jounieh 00961, Keserwan, Lebanon
| | - Kasim Hijazi
- Faculty of Public Health, Department of Physical Therapy, Lebanese German University, Sahel Alma, Jounieh 00961, Keserwan, Lebanon
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Effects of ankle position during static stretching for the hamstrings on the decrease in passive stiffness. J Biomech 2019; 96:109358. [PMID: 31640847 DOI: 10.1016/j.jbiomech.2019.109358] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 11/21/2022]
Abstract
Static stretching is frequently performed to improve flexibility of the hamstrings, although the ankle position during hamstring stretching has not been fully investigated. We investigated the effects of ankle position during hamstring stretching on the decrease in passive stiffness. Fourteen healthy men performed static stretching for the hamstrings with the ankle dorsiflexed and plantar-flexed in a randomized order on different days. The hip was passively flexed to the maximum angle which could be tolerated without stretch pain with the knee fully extended; this was maintained for 5 min, with 1-min stretching performed in 5 sessions. Final angles and passive stiffness were measured before and after stretching. The final angle was defined as that formed by the tibia and horizontal plane when the knee was passively extended from hip and knee angles at 90° flexion to the maximum extension angle which could be tolerated without stretch pain. Passive stiffness was determined by the slope of torque-angle curve during the measurement of the final angle. The final angle significantly increased after stretching with the ankle dorsiflexed and plantar-flexed, whereas passive stiffness significantly decreased only after stretching with the ankle planter-flexed. The results suggest that passive stiffness decreases after stretching with the ankle planter-flexed but not after stretching with the ankle dorsiflexed, although the range of joint motion increases regardless of the ankle position during 5-min stretching for the hamstrings. These results indicate that static stretching should be performed with the ankle plantar-flexed when aiming to decrease passive stiffness of the hamstrings.
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Keller AV, Hainline C, Rees K, Krupp S, Prince D, Wood BD, Shum-Siu A, Burke DA, Petruska JC, Magnuson DSK. Nociceptor-dependent locomotor dysfunction after clinically-modeled hindlimb muscle stretching in adult rats with spinal cord injury. Exp Neurol 2019; 318:267-276. [PMID: 30880143 DOI: 10.1016/j.expneurol.2019.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/06/2019] [Accepted: 03/13/2019] [Indexed: 01/10/2023]
Abstract
In the course of investigating how common clinical treatments and adaptive technologies affect recovery after spinal cord injury (SCI), we discovered that a clinically-modeled hindlimb stretching protocol dramatically, but transiently, reduces locomotor function. Nociceptive sensory input is capable of altering motor output at the spinal level, and nociceptive neurons are sensitized after SCI. Here we tested the hypotheses that stretch-induced locomotor deficits are dependent on nociceptive afferents by depleting TRPV1+ sensory afferents using capsaicin injections in neonatal rats. Following maturation, animals received 25g-cm contusive SCI at T10. After plateau of locomotor recovery at 6 weeks, daily stretching was performed for 3 weeks, followed by 2 weeks without stretch, and again for two additional weeks. Animals were sacrificed 2 h after the last stretching session for histological assessments. Consistent with previous findings, stretch-induced drops in locomotor function were observed in nociceptor-intact animals but were nearly absent in nociceptor-depleted animals. These functional changes were accompanied by corresponding increases in the number of c-Fos+ nuclei throughout the lumbar enlargement. As expected, nociceptor-depleted animals had very little CGRP+ axonal innervation of the dorsal horn. Nociceptor-intact stretched animals had significantly higher levels of CGRP+ as compared to non-stretched SCI rats, suggesting that stretching promoted intraspinal CGRP+ sprouting. These results indicate that stretch-induced locomotor dysfunction in animals with incomplete SCI involves C-fibers, adding a negative post-SCI role to their adaptive roles (e.g., bladder control), and suggesting that the clinical use of muscle stretching to combat contractures and spasticity may be unintentionally detrimental to locomotor function.
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Affiliation(s)
- Anastasia V Keller
- Department of Physiology, University of Louisville, School of Medicine, HSC A 1115, 500 South Preston Street, Louisville, KY 40292, USA
| | - Casey Hainline
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA
| | - Kathleen Rees
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA
| | - Sarah Krupp
- Anatomical Sciences and Neurobiology, University of Louisville, School of Medicine, 511 South Floyd, Room 111, Louisville, KY 40202, USA
| | - Daniella Prince
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA
| | - Brittney D Wood
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA
| | - Alice Shum-Siu
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA
| | - Darlene A Burke
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA
| | - Jeffrey C Petruska
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA; Anatomical Sciences and Neurobiology, University of Louisville, School of Medicine, 511 South Floyd, Room 111, Louisville, KY 40202, USA
| | - David S K Magnuson
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, University of Louisville, 220 Abraham Flexner Way, Louisville, KY 40202, USA; Anatomical Sciences and Neurobiology, University of Louisville, School of Medicine, 511 South Floyd, Room 111, Louisville, KY 40202, USA; Department of Physiology, University of Louisville, School of Medicine, HSC A 1115, 500 South Preston Street, Louisville, KY 40292, USA.
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Raţă BC, Raţă M, Antohe B. Morpho-functional implications of myofascial stretching applied to muscle chains: A case study. J Back Musculoskelet Rehabil 2018; 31:749-758. [PMID: 29578477 DOI: 10.3233/bmr-170998] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Most lesions of the soft tissues, especially those at the muscle level, are due to the lack of elasticity of the connective tissue and fascia. Stretching is one of the most commonly used methods of treatment for such musculoskeletal issues. OBJECTIVE This study tracks the effects of stretching on the electromyographic activity of muscle chains, applied to a 24-year-old athlete diagnosed with the Haglund's disease. METHOD For the evaluation, we used visual examination and surface electromyography (maximum volumetric isometric contraction). The therapeutic intervention consisted in the application of the static stretching positions, which intended the elongation of the shortened muscle chains. The treatment program had a duration of 2 months, with a frequency of 2 sessions per week and an average duration of 60 minutes. RESULTS The posterior muscle chains recorded an increase in the EMG activity, while the anterior muscle chains tended to diminish their EMG activity. As a result of the applied treatment, all the evaluated muscle chains recorded a rebalancing of the electromyographic activity, demonstrating the efficiency of stretching as a method of global treatment of muscle chains. CONCLUSIONS By analysing all the data, we have come to the conclusion that static stretching is an effective treatment method for shortened muscle chains.
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Acute Effects of Dynamic Stretching on Muscle Flexibility and Performance: An Analysis of the Current Literature. Sports Med 2018; 48:299-325. [PMID: 29063454 DOI: 10.1007/s40279-017-0797-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Stretching has long been used in many physical activities to increase range of motion (ROM) around a joint. Stretching also has other acute effects on the neuromuscular system. For instance, significant reductions in maximal voluntary strength, muscle power or evoked contractile properties have been recorded immediately after a single bout of static stretching, raising interest in other stretching modalities. Thus, the effects of dynamic stretching on subsequent muscular performance have been questioned. This review aimed to investigate performance and physiological alterations following dynamic stretching. There is a substantial amount of evidence pointing out the positive effects on ROM and subsequent performance (force, power, sprint and jump). The larger ROM would be mainly attributable to reduced stiffness of the muscle-tendon unit, while the improved muscular performance to temperature and potentiation-related mechanisms caused by the voluntary contraction associated with dynamic stretching. Therefore, if the goal of a warm-up is to increase joint ROM and to enhance muscle force and/or power, dynamic stretching seems to be a suitable alternative to static stretching. Nevertheless, numerous studies reporting no alteration or even performance impairment have highlighted possible mitigating factors (such as stretch duration, amplitude or velocity). Accordingly, ballistic stretching, a form of dynamic stretching with greater velocities, would be less beneficial than controlled dynamic stretching. Notwithstanding, the literature shows that inconsistent description of stretch procedures has been an important deterrent to reaching a clear consensus. In this review, we highlight the need for future studies reporting homogeneous, clearly described stretching protocols, and propose a clarified stretching terminology and methodology.
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Barbosa GM, Figueirêdo Dantas GA, Silva BR, Souza TO, Brito Vieira WH. Static or dynamic stretching program does not change the acute responses of neuromuscular and functional performance in healthy subjects: a single-blind randomized controlled trial. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2018. [DOI: 10.1016/j.rbce.2018.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Pamboris GM, Noorkoiv M, Baltzopoulos V, Gokalp H, Marzilger R, Mohagheghi AA. Effects of an acute bout of dynamic stretching on biomechanical properties of the gastrocnemius muscle determined by shear wave elastography. PLoS One 2018; 13:e0196724. [PMID: 29723229 PMCID: PMC5933711 DOI: 10.1371/journal.pone.0196724] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 04/18/2018] [Indexed: 01/01/2023] Open
Abstract
AIMS The aim of this study was to examine the acute effects of dynamic stretching (DS) exercise on passive ankle range of motion (RoM), resting localized muscle stiffness, as measured by shear wave speed (SWS) of medial gastrocnemius muscle, fascicle strain, and thickness. METHODS/RESULTS Twenty-three participants performed a DS protocol. Before and after stretching, SWS was measured in the belly of the resting medial gastrocnemius muscle (MGM) using shear wave elastography. DS produced small improvements in maximum dorsiflexion (+1.5° ±1.5; mean difference ±90% confidence limits) and maximum plantarflexion (+2.3° ±1.8), a small decrease in fascicle strain (-2.6% ±4.4) and a small increase in SWS at neutral resting angle (+11.4% ±1.5). There was also a small increase in muscle thickness (+4.1mm ±2.0). CONCLUSIONS Through the use of elastography, this is the first study to suggest that DS increases muscle stiffness, decreases fascicle strain and increases muscle thickness as a result of improved RoM. These results can be beneficial to coaches, exercise and clinical scientists when choosing DS as a muscle conditioning or rehabilitation intervention.
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Affiliation(s)
- George M. Pamboris
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - Marika Noorkoiv
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
- Institute of Environment, Health and Societies, Brunel University London, Uxbridge, United Kingdom
| | - Vasilios Baltzopoulos
- Liverpool John Moores University, Research Institute for Sport and Exercise Sciences (RISES), Liverpool, United Kingdom
| | - Hulya Gokalp
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - Robert Marzilger
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Amir A. Mohagheghi
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
- Institute of Environment, Health and Societies, Brunel University London, Uxbridge, United Kingdom
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Medeiros DM, Martini TF. Chronic effect of different types of stretching on ankle dorsiflexion range of motion: Systematic review and meta-analysis. Foot (Edinb) 2018; 34:28-35. [PMID: 29223884 DOI: 10.1016/j.foot.2017.09.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/08/2017] [Accepted: 09/23/2017] [Indexed: 02/04/2023]
Abstract
The calf muscles are one of the muscle groups that have the most need for adequate flexibility since they are deeply related to normal lower limb function. When the goal is to increase flexibility, the most commonly used technique is stretching. However, it remains unknown which stretching technique and parameters are the most effective to increase flexibility. Hence, the aim of the current review was to investigate the influence of chronic stretching on ankle dorsiflexion range of motion (DFROM) of healthy individuals. The search strategy included MEDLINE, PEDro, Cochrane CENTRAL, LILACS, and manual search from inception to February 2017. Randomized and controlled clinical trials that have analyzed the influence of chronic stretching on DFROM were included. On the other hand, studies with special populations (children, and people with any dysfunction/disease), and articles with no control group were excluded. Twenty studies were included out of 493 identified. The meta-analysis was performed according to the stretching technique used in the study. The results show that static stretching (5.17°; 95% CI: 4.39-5.95; I2: 0%) and proprioceptive neuromuscular facilitation (4.32°; 95% CI: 1.59-7.04; I2: 46%) are effective in increasing DFROM. Ballistic stretching did not show positive results to increase DFROM (3.77°; 95% CI: -0.03 to 7.56; I2: 46%). In conclusion, chronic stretching is an effective way of improving ankle mobility in healthy individuals, especially when it contains a static component.
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Affiliation(s)
- Diulian Muniz Medeiros
- Federal University of Health Sciences of Porto Alegre, Graduate Program of Rehabilitation Sciences, Physical Therapy Department, Porto Alegre, Brazil.
| | - Tamara Fenner Martini
- Federal University of Health Sciences of Porto Alegre, Graduate Program of Rehabilitation Sciences, Physical Therapy Department, Porto Alegre, Brazil.
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Brusco CM, Blazevich AJ, Radaelli R, Botton CE, Cadore EL, Baroni BM, Trajano GS, Pinto RS. The effects of flexibility training on exercise-induced muscle damage in young men with limited hamstrings flexibility. Scand J Med Sci Sports 2018; 28:1671-1680. [PMID: 29396987 DOI: 10.1111/sms.13068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2018] [Indexed: 11/30/2022]
Abstract
Adaptations to 6 weeks of supervised hamstring stretching training and its potential impact on symptoms of eccentric exercise-induced muscle damage (EIMD) were studied in 10 young, untrained men with limited hamstrings flexibility. Participants performed unilateral flexibility training (experimental leg; EL) on an isokinetic dynamometer, while the contralateral limb acted as control (CL). Hip range of motion (ROM), passive, isometric, and concentric torques, active optimum angle, and biceps femoris and semitendinosus muscle thickness and ultrasound echo intensity were assessed both before and after the training. Additionally, muscle soreness was assessed before and after an acute eccentric exercise bout in both legs (EL and CL) at post-training only. Hip ROM increased (P < .001) only in EL after the training (EL = 10.6° vs CL = 1.6°), but no changes (P > .05) in other criterion measurements were observed. After a bout of eccentric exercise at the end of the program, isometric and dynamic peak torques and muscle soreness ratings were significantly altered at all time points equally in EL and CL. Also, active optimum angle was reduced immediately, 48 and 72 hours post-exercise, and hip ROM was reduced at 48 and 72 hours equally in EL and CL. Finally, biceps femoris muscle thickness was significantly increased at all time points, and semitendinosus thickness and echo intensity significantly increased at 72 hours, with no significant differences between legs. The stretching training protocol significantly increased hip ROM; however, it did not induce a protective effect on EIMD in men with tight hamstrings.
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Affiliation(s)
- C M Brusco
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - A J Blazevich
- Centre for Exercise and Sports Science Research, School of Exercise and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - R Radaelli
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - C E Botton
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - E L Cadore
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - B M Baroni
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - G S Trajano
- School of Exercise& Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - R S Pinto
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Park HK, Jung MK, Park E, Lee CY, Jee YS, Eun D, Cha JY, Yoo J. The effect of warm-ups with stretching on the isokinetic moments of collegiate men. J Exerc Rehabil 2018; 14:78-82. [PMID: 29511656 PMCID: PMC5833972 DOI: 10.12965/jer.1835210.605] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 01/17/2018] [Indexed: 11/22/2022] Open
Abstract
Performing warm-ups increases muscle temperature and blood flow, which contributes to improved exercise performance and reduced risk of injuries to muscles and tendons. Stretching increases the range of motion of the joints and is effective for the maintenance and enhancement of exercise performance and flexibility, as well as for injury prevention. However, stretching as a warm-up activity may temporarily decrease muscle strength, muscle power, and exercise performance. This study aimed to clarify the effect of stretching during warm-ups on muscle strength, muscle power, and muscle endurance in a nonathletic population. The subjects of this study consisted of 13 physically active male collegiate students with no medical conditions. A self-assessment questionnaire regarding how well the subjects felt about their physical abilities was administered to measure psychological readiness before and after the warm-up. Subjects performed a non-warm-up, warm-up, or warm-up regimen with stretching prior to the assessment of the isokinetic moments of knee joints. After the measurements, the respective variables were analyzed using nonparametric tests. First, no statistically significant intergroup differences were found in the flexor and extensor peak torques of the knee joints at 60°/sec, which were assessed to measure muscle strength. Second, no statistically significant intergroup differences were found in the flexor and extensor peak torques of the knee joints at 180°/sec, which were assessed to measure muscle power. Third, the total work of the knee joints at 240°/sec, intended to measure muscle endurance, was highest in the aerobic-stretch-warm-ups (ASW) group, but no statistically significant differences were found among the groups. Finally, the psychological readiness for physical activity according to the type of warm-up was significantly higher in ASW. Simple stretching during warm-ups appears to have no effect on variables of exercise physiology in nonathletes who participate in routine recreational sport activities. However, they seem to have a meaningful effect on exercise performance by affording psychological stability, preparation, and confidence in exercise performance.
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Affiliation(s)
- Hyoung-Kil Park
- Department of Physical Education, Seoul National University, Seoul,
Korea
| | - Min-Kyung Jung
- Department of Health and Human Performance, Sahmyook University, Seoul,
Korea
| | - Eunkyung Park
- Department of Health and Human Performance, University of Texas Rio Grande Valley, McAllen, TX,
USA
| | | | - Yong-Seok Jee
- Department of Physical Activity Design, Hanseo University, Seosan,
Korea
| | - Denny Eun
- Department of Physical Activity Design, Hanseo University, Seosan,
Korea
| | - Jun-Youl Cha
- Department of Sports and Guard, Howon University, Gunsan,
Korea
| | - Jaehyun Yoo
- Department of Health and Human Performance, Sahmyook University, Seoul,
Korea
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LENGTH CHANGE OF THE SHORT EXTERNAL ROTATORS OF THE HIP IN COMMON STRETCH POSITIONS: A CADAVERIC STUDY. Int J Sports Phys Ther 2017; 12:1068-1077. [PMID: 29234558 DOI: 10.26603/ijspt20171068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Stretching of the deep rotators of the hip is commonly employed in patients with lumbosacral, sacroiliac, posterior hip, and buttock pain. There is limited research demonstrating the effectiveness of common stretching techniques on the short external rotators of the hip. Purpose The objective of this study was to evaluate length change during stretching of the superior and inferior fibers of the piriformis, superior gemellus, obturator internus, and inferior gemellus. Study Design Repeated-measures laboratory controlled cadaveric study. Methods Seventeen hip joints from nine embalmed cadavers (5 male; 4 female) with an age between 49-96 years were skeletonized. Polypropylene strings were attached from the origin to insertion sites of the short external rotators. The change of length (mm) noted by excursion of the strings was used as a proxy for change in muscle length, when the hip was moved from the anatomical position to four specific stretch positions: 1) 45 ° internal rotation from hip neutral flexion/extension, 2) 45 ° external rotation from 90 ° hip and knee flexion, 3) 30 ° adduction from 90 ° of hip and knee flexion, and 4) 30 ° of adduction with the hip and knee flexed so the lateral malleolus contacted the lateral femoral epicondyle of the contralateral limb , were recorded. Results There was a significant effect on string displacement by stretch position, F (15,166) = 14.67, p < .0005; Wilk's L = .097, partial n2 = .540. The greatest displacement of the strings corresponding to the superior piriformis, inferior piriformis, and the superior gemellus occurred in 30 ° adduction from 90 ° of hip and knee flexion. The obturator internus and inferior gemellus had the largest string displacement with 45 ° internal rotation from neutral flexion/extension. Conclusions While all stretch positions caused a significant string displacement indicating length changes of the deep rotators of the hip, the three stretch positions that caused the greatest change were: 1) 30 ° adduction from 90 ° of hip and knee flexion, 2) 45 ° internal rotation from neutral flexion/extension, and 3) 45 ° external rotation with 90 ° hip and knee flexion. Clinical Relevance This study has clinical implications for the effectiveness of specific stretching techniques on the short external rotators of the hip with the potential to improve the validity of stretching protocols for patients with posterior hip or buttock pain. The piriformis and superior gemellus had a larger change in length when adducting the hip from 90 ° degrees of hip and knee flexion. The obturator internus and inferior gemellus had a greater length change when internally rotating the hip from neutral flexion/extension. Level of Evidence 3.
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Park JC, Shim JH, Chung SH. The effects of three types of piriform muscle stretching on muscle thickness and the medial rotation angle of the coxal articulation. J Phys Ther Sci 2017; 29:1811-1814. [PMID: 29184293 PMCID: PMC5684014 DOI: 10.1589/jpts.29.1811] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 07/12/2017] [Indexed: 12/02/2022] Open
Abstract
[Purpose] The purpose of this study was three kinds of stretching methods and measured
the change in the thickness of the piriform muscle in real time using ultrasound images
and compared the medial rotation angle of the coxal articulation. [Subjects and Methods]
Fourty-five subjects who attend B University in Cheonan, divided into three groups. The
subjects in these three groups then underwent stretching with flexion of coxal
articulation over 90°, stretching with flexion of coxal articulation under 90°, and muscle
energy technique (MET) application. The main outcome measures were piriform muscle
thickness and medial rotation angle of the coxal articulation. [Results] All groups showed
decreased piriform muscle thickness and increased medial rotation angle of the coxal
articulation. [Conclusion] Based on the above results, three kinds of piriform muscle
stretching methods are effective of reduce muscle thickness and increase medial rotation
angle of the coxal articulation.
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Affiliation(s)
- Jun Chul Park
- Department of Physical Therapy, Baekseok University, Republic of Korea
| | - Jae Hun Shim
- Department of Physical Therapy, Baekseok University, Republic of Korea
| | - Sin Ho Chung
- Hanyang University Medical Center: 222-1 Wangsimni-ro, Seongdong-gu, Seoul 133-792, Republic of Korea
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Petrov L, Alexandrova A, Lefterov E. A NEW APPROACH TO INTERPRETATION OF SALIVARY ALFA AMYLASE ACTIVITY CHANGES AS A STRESS INDICATOR. JOURNAL OF APPLIED SPORTS SCIENCES 2017. [DOI: 10.37393/jass.2017.01.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kim YW, Chang WH, Kim NY, Kwon JB, Lee SC. Effect of Extracorporeal Shock Wave Therapy on Hamstring Tightness in Healthy Subjects: A Pilot Study. Yonsei Med J 2017; 58:644-649. [PMID: 28332373 PMCID: PMC5368153 DOI: 10.3349/ymj.2017.58.3.644] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/12/2016] [Accepted: 12/13/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To assess the effect of extracorporeal shock wave therapy (ESWT) for healthy participants with hamstring tightness. MATERIALS AND METHODS This study was performed at a university rehabilitation hospital. Twenty nine healthy adults with hamstring tightness were enrolled and randomly allocated into four groups (ESWT, stretching exercise, ESWT with stretching exercise, and control). The effects of individual treatments were compared by the finger-to-floor test and popliteal angle. RESULTS The ESWT group, stretching exercise group and ESWT with stretching exercise group had decreased finger-to-floor distances and right popliteal angles immediately after intervention, compared with the control group (p<0.05). At 4 weeks after completion of the interventions, finger-to-floor distances and the right popliteal angle in only the ESWT with stretching exercise group showed a significant improvement, compared with the control group (p=0.008 and 0.023). CONCLUSION While ESWT and stretching both reduced hamstring tightness immediately after interventions, only ESWT with stretching exercise maintained the significantly improved relief of hamstring tightness significantly after 4 weeks.
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Affiliation(s)
- Yong Wook Kim
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won Hyuk Chang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Na Young Kim
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Beom Kwon
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Chul Lee
- Department of Rehabilitation Medicine and Research Institute, Yonsei University College of Medicine, Seoul, Korea.
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Crowther F, Sealey R, Crowe M, Edwards A, Halson S. Team sport athletes' perceptions and use of recovery strategies: a mixed-methods survey study. BMC Sports Sci Med Rehabil 2017; 9:6. [PMID: 28250934 PMCID: PMC5326499 DOI: 10.1186/s13102-017-0071-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/17/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND A variety of recovery strategies are used by athletes, although there is currently no research that investigates perceptions and usage of recovery by different competition levels of team sport athletes. METHODS The recovery techniques used by team sport athletes of different competition levels was investigated by survey. Specifically this study investigated if, when, why and how the following recovery strategies were used: active land-based recovery (ALB), active water-based recovery (AWB), stretching (STR), cold water immersion (CWI) and contrast water therapy (CWT). RESULTS Three hundred and thirty-one athletes were surveyed. Fifty-seven percent were found to utilise one or more recovery strategies. Stretching was rated the most effective recovery strategy (4.4/5) with ALB considered the least effective by its users (3.6/5). The water immersion strategies were considered effective/ineffective mainly due to psychological reasons; in contrast STR and ALB were considered to be effective/ineffective mainly due to physical reasons. CONCLUSIONS This study demonstrates that athletes may not be aware of the specific effects that a recovery strategy has upon their physical recovery and thus athlete and coach recovery education is encouraged. This study also provides new information on the prevalence of different recovery strategies and contextual information that may be useful to inform best practice among coaches and athletes.
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Affiliation(s)
- Fiona Crowther
- College of Healthcare Sciences, James Cook University, Townsville, QLD Australia
| | - Rebecca Sealey
- College of Healthcare Sciences, James Cook University, Townsville, QLD Australia
| | - Melissa Crowe
- Division of Tropical Health and Medicine, James Cook University, Townsville, QLD Australia
| | - Andrew Edwards
- Sport & Health Sciences, University of St Mark and St John, Plymouth, Devon UK
| | - Shona Halson
- Australian Institute of Sport, Canberra, ACT Australia
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Abstract
BACKGROUND No studies have been reported on how strength, agility, and flexibility training reduce the occurrence of hamstring injuries in sprinters. Therefore, a program for preventing hamstring injury in these athletes has not been established. PURPOSE To document the incidence of hamstring injuries during times when different prevention strategies were employed to see whether a particular prevention program reduced their occurrence. STUDY DESIGN Descriptive epidemiology study. METHODS The study subjects were a total of 613 collegiate male sprinters trained by the same coach over 24 seasons. Tow training was used throughout the research period as a normal sprint training method. The hamstring injury prevention program evolved over time. From 1988 to 1991 (period 1), prevention focused on strength training alone; from 1992 to 1999 (period 2), a combination of strength and agility training was used; and from 2000 to 2011 (period 3), the program incorporated strength, agility, and flexibility training. The incidence of hamstring injuries was compared for each of the 3 prevention strategies. RESULTS The incidence of hamstring injuries per athlete-seasons was 137.9 for period 1, 60.6 for period 2, and 6.7 for period 3. A significant difference was observed in the incidence of hamstring injury according to the different prevention programs (χ2(2) = 31.78, P < .001, effect size: Cramer V = 0.23, 1 - β = 0.999). Residual analysis showed that the number of hamstring injuries for period 1 was significantly greater than the expected value (P < .01), whereas that for period 3 was significantly lower than the expected value (P < .01). CONCLUSION The incidence of hamstring injuries in sprinters decreased as agility and flexibility were added to strength training.
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Affiliation(s)
- Yusaku Sugiura
- Laboratory of Sports Science, Meikai University, Chiba, Japan
| | - Kazuhiko Sakuma
- Department of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Keishoku Sakuraba
- Department of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Yamato Sato
- Laboratory of Sports Science, Chiba Institute of Technology, Chiba, Japan
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Mizuno T. Changes in joint range of motion and muscle-tendon unit stiffness after varying amounts of dynamic stretching. J Sports Sci 2016; 35:2157-2163. [PMID: 27892823 DOI: 10.1080/02640414.2016.1260149] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to examine the effects of varying amounts of dynamic stretching (DS) on joint range of motion (ROM) and stiffness of the muscle-tendon unit (MTU). Fifteen healthy participants participated in four randomly ordered experimental trials, which involved one (DS1), four (DS4) and seven (DS7) sets of DS, or control conditions/seated at rest (CON). Each DS set consisted of 15 repetitions of an ankle dorsiflexion-plantarflexion movement. The displacement of the muscle-tendon junction (MTJ) was measured using ultrasonography while the ankle was passively dorsiflexed at 0.0174 rad · s‒1 to its maximal dorsiflexion angle. Passive torque was also measured using an isokinetic dynamometer. Ankle ROM was significantly increased after DS4 and DS7 compared with the pre-intervention values (P < 0.05), but there were no significant differences in ankle ROM between DS4 and DS7. No differences were observed in ankle ROM after DS1 and CON. In addition, the stiffness of the MTU, passive torque and displacement of the MTJ at submaximal dorsiflexion angles did not change in any of the experimental conditions. These results indicate that DS4 increased ankle ROM without changing the mechanical properties of the MTU, and that this increase in ankle ROM plateaued after DS4.
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Affiliation(s)
- Takamasa Mizuno
- a Laboratory for Exercise Physiology and Biomechanics, School of Health and Sport Sciences , Chukyo University , Toyota , Japan
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44
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Medeiros DM, Cini A, Sbruzzi G, Lima CS. Influence of static stretching on hamstring flexibility in healthy young adults: Systematic review and meta-analysis. Physiother Theory Pract 2016; 32:438-445. [PMID: 27458757 DOI: 10.1080/09593985.2016.1204401] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of the current study was to investigate the influence of static stretching on hamstring flexibility in healthy young adults by means of systematic review and meta-analysis. The search strategy included MEDLINE, PEDro, Cochrane CENTRAL, EMBASE, LILACS, and manual search from inception to June 2015. Randomized and controlled clinical trials studies that have compared static stretching to control group, and evaluated range of motion (ROM), were included. On the other hand, studies that have worked with special population such as children, elderly people, athletes, and people with any dysfunction/disease were excluded, as well as articles that have used contralateral leg as control group or have not performed static stretching. The meta-analysis was divided according to three types of tests. Nineteen studies were included out of the 813 articles identified. In all tests, the results favored static stretching compared to control group: passive straight leg raise (12.04; 95% CI: 9.61 to 14.47), passive knee extension test (8.58; 95% CI: 6.31 to 10.84), and active knee extension test (8.35; 95% CI: 5.15 to 11.55). In conclusion, static stretching was effective in increasing hamstring flexibility in healthy young adults.
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Affiliation(s)
- Diulian M Medeiros
- a Physical Therapy Course , Federal University of Rio Grande do Sul , Porto Alegre , Brazil
| | - Anelize Cini
- a Physical Therapy Course , Federal University of Rio Grande do Sul , Porto Alegre , Brazil
| | - Graciele Sbruzzi
- a Physical Therapy Course , Federal University of Rio Grande do Sul , Porto Alegre , Brazil
| | - Cláudia S Lima
- a Physical Therapy Course , Federal University of Rio Grande do Sul , Porto Alegre , Brazil
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45
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Yıldırım MS, Ozyurek S, Tosun O, Uzer S, Gelecek N. Comparison of effects of static, proprioceptive neuromuscular facilitation and Mulligan stretching on hip flexion range of motion: a randomized controlled trial. Biol Sport 2016; 33:89-94. [PMID: 26929476 PMCID: PMC4763548 DOI: 10.5604/20831862.1194126] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 08/12/2015] [Accepted: 08/21/2015] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to compare the effects of static stretching, proprioceptive neuromuscular facilitation (PNF) stretching and Mulligan technique on hip flexion range of motion (ROM) in subjects with bilateral hamstring tightness. A total of 40 students (mean age: 21.5±1.3 years, mean body height: 172.8±8.2 cm, mean body mass index: 21.9±3.0 kg · m-2) with bilateral hamstring tightness were enrolled in this randomized trial, of whom 26 completed the study. Subjects were divided into 4 groups performing (I) typical static stretching, (II) PNF stretching, (III) Mulligan traction straight leg raise (TSLR) technique, (IV) no intervention. Hip flexion ROM was measured using a digital goniometer with the passive straight leg raise test before and after 4 weeks by two physiotherapists blinded to the groups. 52 extremities of 26 subjects were analyzed. Hip flexion ROM increased in all three intervention groups (p<0.05) but not in the no-intervention group after 4 weeks. A statistically significant change in initial–final assessment differences of hip flexion ROM was found between groups (p<0.001) in favour of PNF stretching and Mulligan TSLR technique in comparison to typical static stretching (p=0.016 and p=0.02, respectively). No significant difference was found between Mulligan TSLR technique and PNF stretching (p=0.920). The initial–final assessment difference of hip flexion ROM was similar in typical static stretching and no intervention (p=0.491). A 4-week stretching intervention is beneficial for increasing hip flexion ROM in bilateral hamstring tightness. However, PNF stretching and Mulligan TSLR technique are superior to typical static stretching. These two interventions can be alternatively used for stretching in hamstring tightness.
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Affiliation(s)
- M S Yıldırım
- Dokuz Eylül University, School of Physical Therapy and Rehabilitation, Turkey
| | - S Ozyurek
- Dokuz Eylül University, School of Physical Therapy and Rehabilitation, Turkey
| | - Oç Tosun
- Dokuz Eylül University, School of Physical Therapy and Rehabilitation, Turkey
| | - S Uzer
- Dokuz Eylül University, School of Physical Therapy and Rehabilitation, Turkey
| | - N Gelecek
- Dokuz Eylül University, School of Physical Therapy and Rehabilitation, Turkey
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Effectiveness Analysis of Active Stretching Versus Active Stretching Plus Low-Frequency Electrical Stimulation in Children Who Play Soccer and Who Have the Short Hamstring Syndrome. Clin J Sport Med 2016; 26:59-68. [PMID: 25831408 DOI: 10.1097/jsm.0000000000000188] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effectiveness of active stretching (AS) versus AS plus electrical stimulation (stretching + TENS) in young soccer players with the short hamstring syndrome (SHS). DESIGN Randomized, controlled, single-blind parallel clinical trial with 3 arms and a 2-month follow-up. The assignment ratio was 1:1:1. SETTING The study involved young federated soccer players in the town of Jumilla, in the region of Murcia (Spain), who were controlled in a physiotherapy office in 2012. PARTICIPANTS Fifty-one young soccer players (10-16 years) with SHS. INTERVENTIONS Stretching + TENS, AS, and conventional stretching. MAIN OUTCOME MEASURES Straight leg raise (SLR) test, popliteal angle with the passive knee extension (PKE) test, and the toe-touch test (TT). RESULTS Significant results (P < 0.05) were group 1 versus 2: (1) SLR, -5.5 degrees right; (2) PKE, +10.2 degrees right and +6.2 degrees left; and (3) range of values of clinically relevant parameters (RVCRP): relative risk (RR), 0.35 to 0.38; relative risk reduction (RRR), 0.62 to 0.65; absolute risk reduction (ARR), 0.32 to 0.39; number needed to treat (NNT), 3 to 4. Group 1 versus 3: (1) SLR, -12.3 degrees right and -10 degrees left; (2) PKE, +12.9 degrees right and +8.5 degrees left; (3) TT, -8.9 cm; and (4) RVCRP: RR, 0.12 to 0.28; RRR, 0.72 to 0.88; ARR, 0.60 to 0.83; NNT, 2 to 2. Group 2 versus 3: (1) SLR, -6.8 degrees right and -6.2 degrees left; (2) TT, -6.7 cm; (3) RVCRP: RR, 0.44 to 0.53; RRR, 0.47 to 0.56; ARR, 0.40 to 0.56; NNT, 2 to 3. CONCLUSIONS Stretching + TENS produces greater improvement than AS alone, and these are both better than conventional stretching. CLINICAL RELEVANCE The use of electrical stimulation combined with AS is a relevant technique for habitual clinical practice that should be systematically integrated in children aged 10 to 16 years who play soccer and who have the SHS.
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Nishikawa Y, Aizawa J, Kanemura N, Takahashi T, Hosomi N, Maruyama H, Kimura H, Matsumoto M, Takayanagi K. Immediate effect of passive and active stretching on hamstrings flexibility: a single-blinded randomized control trial. J Phys Ther Sci 2015; 27:3167-70. [PMID: 26644667 PMCID: PMC4668158 DOI: 10.1589/jpts.27.3167] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 07/10/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study compared the efficacy of passive and active stretching techniques on hamstring flexibility. [Subjects] Fifty-four healthy young subjects were randomly assigned to one of three groups (2 treatment groups and 1 control group). [Methods] Subjects in the passive stretching group had their knees extended by an examiner while lying supine 90° of hip flexion. In the same position, subjects in the active stretching group extended their knees. The groups performed 3 sets of the assigned stretch, with each stretch held for 10 seconds at the point where tightness in the hamstring muscles was felt. Subjects in the control group did not perform stretching. Before and immediately after stretching, hamstring flexibility was assessed by a blinded assessor, using the active knee-extension test. [Results] After stretching, there was a significant improvement in the hamstring flexibilities of the active and passive stretching groups compared with the control group. Furthermore, the passive stretching group showed significantly greater improvement in hamstring flexibility than the active stretching group. [Conclusion] Improvement in hamstring flexibility measured by the active knee-extension test was achieved by both stretching techniques; however, passive stretching was more effective than active stretching at achieving an immediate increase in hamstring flexibility.
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Affiliation(s)
- Yuichi Nishikawa
- Department of Clinical Neurosciences and Therapeutics,
Graduate School of Biomedical and Health Science, Hiroshima University, Japan
- Department of Clinical Support, Hiroshima University
Hospital, Japan
| | - Junya Aizawa
- Clinical Center for Sports Medicine and Dentistry, Tokyo
Medical and Dental University, Japan
| | - Naohiko Kanemura
- Department of Physical Therapy, School of Health and Social
Services, Saitama Prefectural University, Japan
| | - Tetsuya Takahashi
- Department of Clinical Neurosciences and Therapeutics,
Graduate School of Biomedical and Health Science, Hiroshima University, Japan
| | - Naohisa Hosomi
- Department of Clinical Neurosciences and Therapeutics,
Graduate School of Biomedical and Health Science, Hiroshima University, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neurosciences and Therapeutics,
Graduate School of Biomedical and Health Science, Hiroshima University, Japan
| | - Hiroaki Kimura
- Department of Rehabilitation Medicine, Hiroshima University
Hospital, Japan
| | - Masayasu Matsumoto
- Department of Clinical Neurosciences and Therapeutics,
Graduate School of Biomedical and Health Science, Hiroshima University, Japan
| | - Kiyomi Takayanagi
- Department of Physical Therapy, School of Health and Social
Services, Saitama Prefectural University, Japan
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Apostolopoulos N, Metsios GS, Flouris AD, Koutedakis Y, Wyon MA. The relevance of stretch intensity and position-a systematic review. Front Psychol 2015; 6:1128. [PMID: 26347668 PMCID: PMC4540085 DOI: 10.3389/fpsyg.2015.01128] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 07/20/2015] [Indexed: 11/13/2022] Open
Abstract
Stretching exercises to increase the range of motion (ROM) of joints have been used by sports coaches and medical professionals for improving performance and rehabilitation. The ability of connective and muscular tissues to change their architecture in response to stretching is important for their proper function, repair, and performance. Given the dearth of relevant data in the literature, this review examined two key elements of stretching: stretch intensity and stretch position; and their significance to ROM, delayed onset muscle soreness (DOMS), and inflammation in different populations. A search of three databases, Pub-Med, Google Scholar, and Cochrane Reviews, identified 152 articles, which were subsequently categorized into four groups: athletes (24), clinical (29), elderly (12), and general population (87). The use of different populations facilitated a wider examination of the stretching components and their effects. All 152 articles incorporated information regarding duration, frequency and stretch position, whereas only 79 referred to the intensity of stretching and 22 of these 79 studies were deemed high quality. It appears that the intensity of stretching is relatively under-researched, and the importance of body position and its influence on stretch intensity, is largely unknown. In conclusion, this review has highlighted areas for future research, including stretch intensity and position and their effect on musculo-tendinous tissue, in relation to the sensation of pain, delayed onset muscle soreness, inflammation, as well as muscle health and performance.
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Affiliation(s)
- Nikos Apostolopoulos
- Research Centre for Sport, Exercise and Performance, Institute of Sport, University of WolverhamptonWalsall, UK
| | - George S. Metsios
- Research Centre for Sport, Exercise and Performance, Institute of Sport, University of WolverhamptonWalsall, UK
| | | | - Yiannis Koutedakis
- Research Centre for Sport, Exercise and Performance, Institute of Sport, University of WolverhamptonWalsall, UK
- Department of Exercise Sciences, University of ThessalyTrikala, Greece
| | - Matthew A. Wyon
- Research Centre for Sport, Exercise and Performance, Institute of Sport, University of WolverhamptonWalsall, UK
- National Institute of Dance Medicine and ScienceLondon, UK
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Sim YJ, Byun YH, Yoo J. Comparison of isokinetic muscle strength and muscle power by types of warm-up. J Phys Ther Sci 2015; 27:1491-4. [PMID: 26157247 PMCID: PMC4483425 DOI: 10.1589/jpts.27.1491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/20/2015] [Indexed: 12/01/2022] Open
Abstract
[Purpose] The purpose of this study was to clarify the influence of static stretching at
warm-up on the isokinetic muscle torque (at 60°/sec) and muscle power (at 180°/sec) of the
flexor muscle and extensor muscle of the knee joint. [Subjects and Methods] The subjects
of this study were 10 healthy students with no medically specific findings. The warm-up
group and warm-up with stretching group performed their respective warm-up prior to the
isokinetic muscle torque evaluation of the knee joint. One-way ANOVA was performed by
randomized block design for each variable. [Results] The results were as follows: First,
the flexor peak torque and extensor peak torque of the knee joint tended to decrease at
60°/sec in the warm-up with stretching group compared with the control group and warm-up
group, but without statistical significance. Second, extensor power at 180°/sec was also
not statistically significant. However, it was found that flexor power increased
significantly in the warm-up with stretching group at 180°/sec compared with the control
group and warm-up group in which stretching was not performed. [Conclusion] Therefore, it
is considered that in healthy adults, warm-up including two sets of stretching for 20
seconds per muscle group does not decrease muscle strength and muscle power.
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Affiliation(s)
- Young-Je Sim
- Department of Physical Education, Kunsan National University, Republic of Korea
| | - Yong-Hyun Byun
- Department of Sports Medicine, Graduate School of Sports Science, Dankook University, Republic of Korea
| | - Jaehyun Yoo
- Department of Health Management, Sahmyook University, Republic of Korea
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Mostagi FQRC, Dias JM, Pereira LM, Obara K, Mazuquin BF, Silva MF, Silva MAC, de Campos RR, Barreto MST, Nogueira JF, Lima TB, Carregaro RL, Cardoso JR. Pilates versus general exercise effectiveness on pain and functionality in non-specific chronic low back pain subjects. J Bodyw Mov Ther 2014; 19:636-45. [PMID: 26592221 DOI: 10.1016/j.jbmt.2014.11.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 11/05/2014] [Accepted: 11/11/2014] [Indexed: 11/25/2022]
Abstract
Low back pain (LBP) is one of the most common causes of disability, and the Pilates method has been associated with improvements in symptoms. The purpose of this study was to assess the effectiveness of the Pilates method, when compared to general exercises, on pain and functionality after eight weeks (16 sessions, 2×/week) and a follow-up of three months, in subjects with non-specific chronic low back pain (NSCLBP). A randomised controlled trial composed of 22 subjects was proposed. Subjects were allocated into two groups: the Pilates group (PG) (n = 11) and the general exercise group (GEG) (n = 11). The PG protocol was based on the Pilates method and the GEG performed exercises to manage NSCLBP. There were no differences between the groups. When analysed over time, the GEG demonstrated improvements in functionality between baseline and the end of treatment (P = .02; Cohen'sd¯ = 0.34) and baseline and follow-up (P = .04; Cohen'sd¯ = 0.31). There were no differences between the Pilates and general exercises with regard to pain and functionality in NSCLBP subjects but general exercises were better than Pilates for increasing functionality and flexibility.
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Affiliation(s)
| | - Josilainne Marcelino Dias
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Ligia Maxwell Pereira
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Karen Obara
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | - Bruno Fles Mazuquin
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil; Allied Health Research Unit, University of Central Lancashire, Preston, United Kingdom
| | - Mariana Felipe Silva
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | | | - Renata Rosa de Campos
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | | | - Jéssyca Fernandes Nogueira
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil
| | | | | | - Jefferson Rosa Cardoso
- Laboratory of Biomechanics and Clinical Epidemiology, Universidade Estadual de Londrina, Londrina, PR, Brazil.
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