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Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial.

ABSTRACT: Objectives: Tight hamstrings contribute to inefficiency of movement and increased risk for injury. Static stretching is the most common intervention for this problem, but the use of alternatives like instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular facilitation (PNF) is increasing among clinicians. This study examined two prospective studies with the common aim of demonstrating the effectiveness of IASTM or PNF over static stretching for improving hamstring tightness. Methods: Nondisabled adults were recruited on a university campus. IASTM study: N = 17 (11 males and 6 females). PNF study: N = 23 (7 males and 16 females). Hip flexion range of motion was measured with a passive straight leg raise (for IASTM) or active straight leg raise (for PNF) before and after stretching. Participants performed a self-static stretch on one leg and received the alternative intervention on the contralateral leg. The two studies were analyzed separately for reliability indices and significant differences between interventions. Results: Hip flexion measures showed good reliability in both studies (intraclass correlation coefficient = 0.97) with a minimal detectable change of <4.26. Both studies showed significant interactions between time and intervention (p < 0.05). Follow-up analyses revealed PNF and IASTM interventions resulted in greater increases in hip flexion range than static stretching. Discussion: These findings demonstrate the effectiveness of PNF and IASTM techniques over static stretching for hamstring flexibility. These interventions provide more efficient alternatives for improving flexibility in the clinic, allowing greater progress in a shorter period of time than an equivalent static stretching program. Level of Evidence: 1b.

SUBMITTER: Gunn LJ

PROVIDER: S-EPMC6338275 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial.

Gunn Leanna J LJ Stewart Jill Campbell JC Morgan Brittany B Metts Steven T ST Magnuson Justin M JM Iglowski Nicholas J NJ Fritz Stacy L SL Arnot Catherine C

The Journal of manual & manipulative therapy 20180801 1

<b>Objectives</b>: Tight hamstrings contribute to inefficiency of movement and increased risk for injury. Static stretching is the most common intervention for this problem, but the use of alternatives like instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular facilitation (PNF) is increasing among clinicians. This study examined two prospective studies with the common aim of demonstrating the effectiveness of IASTM or PNF over static stretching for improving hams ...[more]

PMID: 30692839

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Project description:BackgroundThe association between hamstring tightness and knee osteoarthritis (KOA) is significant because tight hamstrings can put more strain on the knee joint, reduce its range of motion, and cause compensatory movements that worsen the KOA.ObjectiveTo compare the effects of instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular (PNF) on hamstring flexibility in patients with KOA.MethodsData for the randomized controlled trial (NCT05110326) was collected from n = 60 participants randomly divided into group A received IASTM and group B received PNF stretching. In group A, the therapist made 30 strokes gentle strokes with the tool from the origin to the insertion while holding the plane at a 45-degree angle over the treatment area. In group B, PNF stretching was done with three repetitions and 10 seconds rest between each, after isometric contraction of the hamstring muscle using approximately 50% of their maximum strength, holding it for 8 seconds, and then releasing it. A 30-minute session was given to each patient three times per week and was given for 6 weeks. Outcome measures were the visual analog scale (VAS) for pain intensity, the active knee extension test (AKET) for hamstring flexibility, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for the health status of KOA patients.ResultsThe study found a significant interaction (p < 0.001) between interventions and time across several measurements. After 6 weeks, both interventions resulted in significant improvements (p < 0.001) across all dependent variables, with group A (IASTM) showing more significant improvement in hamstring flexibility, pain reduction, and health status (p < 0.001) compared to group B (PNF).ConclusionsBoth the IASTM technique and PNF stretching resulted in increased hamstring flexibility, decreased pain, and enhanced general health. The IASTM technique, however, showed potential benefits over PNF stretching in terms of flexibility, pain relief, and public health enhancement. Physical therapists and manual therapists may prioritize the usage of the IASTM technique for patients who want to make significant changes in these areas.

Project description:BackgroundKnee osteoarthritis (KOA) considered as one of the most common degenerative diseases of synovial joint. KOA is mostly managed by physical therapy, focused on pain management, the range of motion and muscle strengthening but muscle flexibility is usually neglected. A study was conducted to evaluate the effectiveness of dynamic soft tissue mobilization (DSTM) in comparison with the proprioceptive neuromuscular facilitation (PNF) stretching in the management of hamstring tightness, reduction of pain intensity and improvement of physical functionality in KOA.MethodsForty eight patients with KOA were randomly allocated to group A receiving DTSM and group B receiving PNF stretching. The cryotherapy and isometric strengthening exercises were also given to both groups. Total treatment duration consisted of 4 weeks, 3 sessions per week and total 12 sessions per patient. Each treatment session comprised of 30 min. At baseline and post treatment, Active knee extension test(AKET), Visual analogue scale (VAS), and Knee Injury and Osteoarthritis Outcome Score (KOOS) were used to assess hamstring flexibility, pain intensity level and physical functional capability respectively. The continuous variables were shown as mean and standard deviations. For the comparison of outcome within and between groups, paired sample and independent t-test was applied. Considerable p value was less than 0.05.ResultsThe between group analysis of VAS, right AKE test, and left AKE test showed non-significant (p > 0.05) mean difference as 0.2 (95% CI= -0.29, 0.70), 1.79 (95% CI= -1.84, 4.59), 1.78 (95% CI= -1.6, 5.19) respectively. KOOS domains of symptom, pain, ADLs, sports and recreational, and quality of life had also non-significant (p > 0.05) mean difference as 1.12 (95% CI= -4.05, 6.3), -5.12 (95% CI= -12.71, 2.46), -2.55 (95% CI= -7.47, 2.38), -2.7 (95% CI= -9.72, 4.3), and - 0.68 (95% CI= -7.69, 6.36) respectively. Significant (p < 0.001) improvement was shown in both groups for all outcome measures after 12 sessions.ConclusionDSTM and PNF stretching, both treatments are equally beneficial in KOA for hamstring flexibility, pain reduction and functional mobility in terms of AKET, VAS, and KOOS respectively.Trial registrationClincalTrials.Gov with ID: NCT04925895, 14/06/2021, retrospectively registered.

Project description:BackgroundBalance control has been shown to play a fundamental role both in everyday life and many athletic activities. An important component of balance control is the somatosensory information gained from muscle spindles and Golgi tendon organs. The changes in the muscle-tendon unit stiffness could alter the ability to detect and respond promptly to changes of an unstable environment. One of the procedures affecting muscle stiffness is stretching, and contract-relax PNF stretching (CRS) is considered as one of the safest and most effective techniques. So far, there are no studies on the impact of CRS of hip adductor and abductor muscles on body balance. These muscle groups are responsible for maintaining mediolateral balance which is of particular interest, since it is more affected by ageing and disease and since its deterioration has been associated with an increased risk of falling. In light of the above, the aim of the present study was to investigate the effects of a single dose of contract-relax proprioceptive neuromuscular facilitation stretching of hip adductors and abductors on mediolateral dynamic balance.MethodsThe study involved 45 healthy individuals (age 19-23 years) assigned to the intervention group (IG) or the control group (CG). Balance testing was carried out before (Pre) and immediately after CRS in the intervention group or after 5-minute rest in the control group (Post). There were performed three repetitions of the CRS targeting the adductor and abductor muscles of the hip.ResultsStatistically significant differences between Pre and Post condition were observed only in the intervention group. The values of all measured variables defining the body's dynamic balance were significantly lower immediately after the applied CRS, which indicates an improved body balance: Global Index (p = 0.0001), total area of sway (p = 0.0001), external area of sway (p = 0.00004), external time (p = 0.0004) and reaction time (p = 0.0003).ConclusionsA single dose of contract-relax proprioceptive neuromuscular facilitation stretching of the hip adductor and abductor muscles improved mediolateral dynamic balance.

Project description:Background: In animal studies long-term stretching interventions up to several hours per day have shown large increases in muscle mass as well as maximal strength. The aim of this study was to investigate the effects of a long-term stretching on maximal strength, muscle cross sectional area (MCSA) and range of motion (ROM) in humans. Methods: 52 subjects were divided into an Intervention group (IG, n = 27) and a control group (CG, n = 25). IG stretched the plantar flexors for one hour per day for six weeks using an orthosis. Stretching was performed on one leg only to investigate the contralateral force transfer. Maximal isometric strength (MIS) and 1RM were both measured in extended knee joint. Furthermore, we investigated the MCSA of IG in the lateral head of the gastrocnemius (LG) using sonography. Additionally, ROM in the upper ankle was investigated via the functional "knee to wall stretch" test (KtW) and a goniometer device on the orthosis. A two-way ANOVA was performed in data analysis, using the Scheffé Test as post-hoc test. Results: There were high time-effects (p = 0.003, ƞ² = 0.090) and high interaction-effect (p < 0.001, ƞ²=0.387) for MIS and also high time-effects (p < 0.001, ƞ²=0.193) and interaction-effects (p < 0.001, ƞ²=0,362) for 1RM testing. Furthermore, we measured a significant increase of 15.2% in MCSA of LG with high time-effect (p < 0.001, ƞ²=0.545) and high interaction-effect (p=0.015, ƞ²=0.406). In ROM we found in both tests significant increases up to 27.3% with moderate time-effect (p < 0.001, ƞ²=0.129) and high interaction-effect (p < 0.001, ƞ²=0.199). Additionally, we measured significant contralateral force transfers in maximal strength tests of 11.4% (p < 0.001) in 1RM test and 1.4% (p=0.462) in MIS test. Overall, there we no significant effects in control situations for any parameter (CG and non-intervened leg of IG). Discussion: We hypothesize stretching-induced muscle damage comparable to effects of mechanical load of strength training, that led to hypertrophy and thus to an increase in maximal strength. Increases in ROM could be attributed to longitudinal hypertrophy effects, e.g., increase in serial sarcomeres. Measured cross-education effects could be explained by central neural adaptations due to stimulation of the stretched muscles.

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Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial.

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Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial.

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