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Afonso J, Andrade R, Rocha-Rodrigues S, Nakamura FY, Sarmento H, Freitas SR, Silva AF, Laporta L, Abarghoueinejad M, Akyildiz Z, Chen R, Pizarro A, Ramirez-Campillo R, Clemente FM. What We Do Not Know About Stretching in Healthy Athletes: A Scoping Review with Evidence Gap Map from 300 Trials. Sports Med 2024; 54:1517-1551. [PMID: 38457105 PMCID: PMC11239752 DOI: 10.1007/s40279-024-02002-7] [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: 02/03/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Stretching has garnered significant attention in sports sciences, resulting in numerous studies. However, there is no comprehensive overview on investigation of stretching in healthy athletes. OBJECTIVES To perform a systematic scoping review with an evidence gap map of stretching studies in healthy athletes, identify current gaps in the literature, and provide stakeholders with priorities for future research. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA-ScR guidelines were followed. We included studies comprising healthy athletes exposed to acute and/or chronic stretching interventions. Six databases were searched (CINAHL, EMBASE, PubMed, Scopus, SPORTDiscus, and Web of Science) until 1 January 2023. The relevant data were narratively synthesized; quantitative data summaries were provided for key data items. An evidence gap map was developed to offer an overview of the existing research and relevant gaps. RESULTS Of ~ 220,000 screened records, we included 300 trials involving 7080 athletes [mostly males (~ 65% versus ~ 20% female, and ~ 15% unreported) under 36 years of age; tiers 2 and 3 of the Participant Classification Framework] across 43 sports. Sports requiring extreme range of motion (e.g., gymnastics) were underrepresented. Most trials assessed the acute effects of stretching, with chronic effects being scrutinized in less than 20% of trials. Chronic interventions averaged 7.4 ± 5.1 weeks and never exceeded 6 months. Most trials (~ 85%) implemented stretching within the warm-up, with other application timings (e.g., post-exercise) being under-researched. Most trials examined static active stretching (62.3%), followed by dynamic stretching (38.3%) and proprioceptive neuromuscular facilitation (PNF) stretching (12.0%), with scarce research on alternative methods (e.g., ballistic stretching). Comparators were mostly limited to passive controls, with ~ 25% of trials including active controls (e.g., strength training). The lower limbs were primarily targeted by interventions (~ 75%). Reporting of dose was heterogeneous in style (e.g., 10 repetitions versus 10 s for dynamic stretching) and completeness of information (i.e., with disparities in the comprehensiveness of the provided information). Most trials (~ 90%) reported performance-related outcomes (mainly strength/power and range of motion); sport-specific outcomes were collected in less than 15% of trials. Biomechanical, physiological, and neural/psychological outcomes were assessed sparsely and heterogeneously; only five trials investigated injury-related outcomes. CONCLUSIONS There is room for improvement, with many areas of research on stretching being underexplored and others currently too heterogeneous for reliable comparisons between studies. There is limited representation of elite-level athletes (~ 5% tier 4 and no tier 5) and underpowered sample sizes (≤ 20 participants). Research was biased toward adult male athletes of sports not requiring extreme ranges of motion, and mostly assessed the acute effects of static active stretching and dynamic stretching during the warm-up. Dose-response relationships remain largely underexplored. Outcomes were mostly limited to general performance testing. Injury prevention and other effects of stretching remain poorly investigated. These relevant research gaps should be prioritized by funding policies. REGISTRATION OSF project ( https://osf.io/6auyj/ ) and registration ( https://osf.io/gu8ya ).
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Affiliation(s)
- José Afonso
- Faculty of Sport, Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), University of Porto, Porto, Portugal.
| | - Renato Andrade
- Clínica Espregueira-FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - Sílvia Rocha-Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Alvares, 4900-347, Viana do Castelo, Portugal
- Tumour and Microenvironment Interactions Group, INEB-Institute of Biomedical Engineering, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Rua Alfredo Allen, 4200-153, Porto, Portugal
- Sport Physical Activity and Health Research & Innovation Center, 4900-347, Viana do Castelo, Portugal
| | - Fábio Yuzo Nakamura
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Hugo Sarmento
- University of Coimbra, Research Unit for Sport and Physical Activity (CIDAF), Faculty of Sport Sciences and Physical Education, Coimbra, Portugal
| | - Sandro R Freitas
- Laboratório de Função Neuromuscular, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Ana Filipa Silva
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Alvares, 4900-347, Viana do Castelo, Portugal
- Sport Physical Activity and Health Research & Innovation Center, 4900-347, Viana do Castelo, Portugal
| | - Lorenzo Laporta
- Núcleo de Estudos em Performance Analysis Esportiva (NEPAE/UFSM), Universidade Federal de Santa Maria, Avenida Roraima, nº 1000, Cidade Universitária, Bairro Camobi, Santa Maria, RS, CEP: 97105-900, Brazil
| | | | - Zeki Akyildiz
- Sports Science Faculty, Department of Coaching Education, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Rongzhi Chen
- Faculty of Sport, Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), University of Porto, Porto, Portugal
| | - Andreia Pizarro
- Faculty of Sport, Research Center in Physical Activity, Health and Leisure (CIAFEL), University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy. Faculty of Rehabilitation Sciences, Universidad Andres Bello, 7591538, Santiago, Chile
| | - Filipe Manuel Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Alvares, 4900-347, Viana do Castelo, Portugal
- Sport Physical Activity and Health Research & Innovation Center, 4900-347, Viana do Castelo, Portugal
- Gdańsk University of Physical Education and Sport, 80-336, Gdańsk, Poland
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Alimoradi M, Sahebozamani M, Hosseini E, Konrad A, Noorian S. The Effect on Flexibility and a Variety of Performance Tests of the Addition of 4 Weeks of Soleus Stretching to a Regular Dynamic Stretching Routine in Amateur Female Soccer Players. Sports (Basel) 2023; 11:138. [PMID: 37505625 PMCID: PMC10383580 DOI: 10.3390/sports11070138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 07/29/2023] Open
Abstract
The purpose of this study was to investigate the effects of 4 weeks of soleus stretching on ankle flexibility and dynamic balance, as well as selected monitoring and performance tests in soccer. Forty-five healthy female soccer players were randomly divided into a regular stretching group, a regular stretching group with soleus stretching, and a control group. Dynamic stretching protocols were performed for 4 weeks during three sessions per week as part of routine exercises. The regular group stretched three muscle groups (i.e., gastrocnemius, quadriceps, and hamstrings), while the regular + soleus group also stretched the soleus muscle. Before and after the stretching intervention, the ankle range of motion test, Y-balance test, drop jump test, dynamic knee valgus test, and Illinois Agility Running Test were performed. Ankle ROM, Y-balance, and DJ significantly improved in both intervention groups compared to controls. Only the regular + soleus group showed improvement in the Illinois Agility Running Test. Additionally, athletes performing the additional soleus stretching had greater improvements in ankle ROM and DJ but not in DKV or Y-balance. The results showed that adding soleus stretching into regular protocols can provide benefits for female soccer players in terms of performance parameters.
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Affiliation(s)
- Mohammad Alimoradi
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman 76169-14111, Iran; (M.A.); (M.S.); (E.H.)
| | - Mansour Sahebozamani
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman 76169-14111, Iran; (M.A.); (M.S.); (E.H.)
| | - Elham Hosseini
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman 76169-14111, Iran; (M.A.); (M.S.); (E.H.)
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Sajad Noorian
- Department of Statistics, Faculty of Science, University of Qom, Qom 37161-46611, Iran;
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Acute Effects of Soleus Stretching on Ankle Flexibility, Dynamic Balance and Speed Performances in Soccer Players. BIOLOGY 2022; 11:biology11030374. [PMID: 35336748 PMCID: PMC8945810 DOI: 10.3390/biology11030374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 11/17/2022]
Abstract
Most dynamic stretching protocols include the gastrocnemius muscle, but soleus stretches are often neglected, which is the key powerful muscle for the push-off (concentric) of all speed movements. The purpose of this study was to examine whether the added soleus stretch in a regular stretching protocol would have greater benefits for ankle flexibility, dynamic balance and functional performance. Fourteen healthy male soccer players received each of the stretching conditions (regular stretching only (Regular), regular stretching with soleus stretching (Soleus) and no stretching (Control)) randomly on different training days, with two-day separation. The ankle flexibility, standing heel-lift balance and speed performances were assessed following each stretching intervention. The active dynamic stretches were performed for 30 s with three repetitions on each of the three (Regular) and four (Soleus) muscles. One-way ANOVA with repeated measures (or the Friedman non-parametric test) was performed to determine any significant effect with alpha = 0.05. Our findings revealed that both the Regular and Soleus stretching groups showed an increased active range of ankle motion compared to the no-stretching control (Ps < 0.05). In the heel raise balance test, both stretching groups experienced a significant increase in maximum plantarflexion strength as well as resultant anterior−posterior and medial−lateral CoP excursions compared to the no-stretching control (Ps < 0.05). In the sprinting tasks, both the Soleus and Regular stretching groups induced faster linear and curved running times (Ps < 0.05). When comparing the two stretching groups, Soleus stretching led to better ankle flexibility, maximum plantarflexion strength and curved running time (Ps < 0.05). Thus, added stretches on the soleus muscles can provide further benefits to speed performances in soccer.
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The Effects of Exercise Difficulty and Time-of-Day on the Perception of the Task and Soccer Performance in Child Soccer Players. CHILDREN-BASEL 2021; 8:children8090793. [PMID: 34572225 PMCID: PMC8464736 DOI: 10.3390/children8090793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022]
Abstract
In soccer, accurate kicking skills are important determinants of successful performance. A successful kick must meet several criteria, including speed, accuracy, and timing. In fact, players who are able to kick the ball more accurately under various difficulties, such as time pressure, space constraints, the opponent’s pressure, and the distance between the kicking point and the goal, have a clear advantage during soccer games. The aim of the present study was to investigate the effect of exercise difficulty and time-of-day on perceived task difficulty and kicking performance. Accordingly, 32 boys (age: 11 ± 0.7 years; height: 1.45 ± 0.07 m; body-mass: 38.9 ± 7.8 kg) performed shooting accuracy tests under two difficulty levels (distance (long-distance (LD) vs. short-distance (SD)) and time pressure (Without-time-pressure (WTP) vs. With-time-pressure (TP)) at 08:00 h and 17:00 h. Absolute-error, variable-error, and constant-error were evaluated during the kicking tasks, in addition to ball velocity and shooting quality. Moreover, rating-of-perceived-exertion score (RPE), feeling-scale (FS), and perceived difficulty were completed immediately at the end of each test. The results showed that shooting quality was not affected by the time-of-day, but it was better in WTP vs. TP (p < 0.05), and in SD vs. LD (p < 0.05), respectively. Higher values for FS and lower values for RPE were observed in the morning compared to the afternoon (p < 0.05) and in WTP vs. TP (p < 0.05). In conclusion, specific soccer skills of boys were not time-of-day dependent, but they may be associated with time pressure and task difficulty.
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Acute Effects of Warm-Up, Exercise and Recovery-Related Strategies on Assessments of Soccer Kicking Performance: A Critical and Systematic Review. Sports Med 2021; 51:661-705. [PMID: 33332012 DOI: 10.1007/s40279-020-01391-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND A number of reviews have collated information on the impact of warming-up, physical exertion and recovery strategies on physical, subjective and physiological markers in soccer players yet none have solely analyzed their potential effects on components of kicking performance. OBJECTIVE To systematically analyse the influence of warm-up, exercise and/or recovery-related strategies on kicking performance in male soccer players and provide a critical appraisal on research paradigm related to kicking testing constraints and data acquisition methods. METHODS A systematic literature search was performed (until July 2020) in PubMed, Web of Science, SPORTDiscus, Scopus and ProQuest. Studies in male soccer populations, which included the effects of warm-up routines, physical exercise and/or recovery-related interventions, reported on comparisons pre-post or between experimental conditions and that computed at least one measure of kicking kinematics and/or performance were considered. Methodological quality and risk of bias were determined for the included studies. Constraints related to kicking testing and data acquisition methods were also summarized and discussed. RESULTS Altogether, 52 studies were included. Of these, 10 examined the respective effects of a warm-up, 34 physical exercise, and 21 recovery-related strategies. The results of eight studies showed that lower limb kinematics, kicking accuracy or ball velocity were improved following warm-ups involving dynamic but not static stretching. Declines in ball velocity occurred notably following intermittent endurance or graded until exhaustion exercise (three studies in both cases) without inclusion of any ball skills. In contrast, conflicting evidence in five studies was observed regarding ball velocity following intermittent endurance exercise interspersed with execution of ball skills. Kicking accuracy was less frequently affected by physical exercise (remained stable across 14 of 19 studies). One investigation indicated that consumption of a carbohydrate beverage pre- and mid-exercise demonstrated benefits in counteracting the potentially deleterious consequences of exercise on ball velocity, while four studies reported conflicting results regarding kicking accuracy. Most evidence synthesized for the interventions demonstrated moderate level (77%) and unclear-to-high risk of bias in at least one item evaluated (98%). The main limitations identified across studies were kicks generally performed over short distances (50%), in the absence of opposition (96%), and following experimental instructions which did not concomitantly consider velocity and accuracy (62%). Also, notational-based metrics were predominantly used to obtain accuracy outcomes (54%). CONCLUSIONS The results from this review can help inform future research and practical interventions in an attempt to measure and optimise soccer kicking performance. However, given the risk of bias and a relative lack of strong evidence, caution is required when applying some of the current findings in practice. PROSPERO ID CRD42018096942.
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Warm-up durations in a hot-dry climate affect thermoregulation, mean power-output and fatigue, but not peak power in specific soccer repeated-sprint ability. BMC Sports Sci Med Rehabil 2020; 12:76. [PMID: 33298114 PMCID: PMC7724813 DOI: 10.1186/s13102-020-00221-9] [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: 07/08/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022]
Abstract
Background This study addressed the lack of data on the effect of warm-up (WU) duration in hot-dry climate (~ 30 °C; ~ 18% RH), on thermoregulation, muscular power-output, and fatigue after specific soccer repeated-sprint test (RSA). Methods Eleven amateur soccer players participated in a cross-over randomized study and they underwent the Bangsbo repeated-sprint test, after three WU durations (i.e. WU10, WU15 and WU20 min) at 70% of MAV, and on different days. Peak power (PP), mean power (MP) and the fatigue index (FI) were recorded and analyzed. Likewise, heart rate (HR), tympanic temperature (Ttym), mean body temperature (MBT) and rating of perceived exertion (RPE) were recorded during each session. Results The repeated measure ANOVA showed that MP improved after WU15 in comparison to WU10 and WU20 (p = 0.04 and p = 0.001; respectively). Nonetheless, no significant effect on PP was recorded after all WU durations. FI during RSA increased after WU20 in comparison to WU15 and WU10 (p < 0.001 and p = 0.003; respectively). Higher RPE values (p < 0.001) were recorded after WU15 and WU20 in comparison to WU10 duration. The two-way ANOVA showed higher ΔTtym and ΔMBT values after WU15 and WU20 compared to WU10 (p = 0.039 and p < 0.001for Ttym; p = 0.005 and p < 0.001 for MBT, respectively). Conclusions The WU15 at 70% of MAV better assists mean power-output during soccer RSA in hot-dry (~ 30 °C; 18% RH) climate, but not peak power. Reducing WU duration up to 10 min seems to be insufficient to induce beneficial physiological changes necessary for optimizing repeated-sprint performance, while its extension up to 20 min remains detrimental for muscular power and induces higher fatigue.
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