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Kay AD, Baxter BA, Hill MW, Blazevich AJ. Effects of Eccentric Resistance Training on Lower-Limb Passive Joint Range of Motion: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2023; 55:710-721. [PMID: 36730587 DOI: 10.1249/mss.0000000000003085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Substantial increases in joint range of motion (ROM) have been reported after eccentric resistance training; however, between-study variability and sample size issues complicate the interpretation of the magnitude of effect. METHODS PubMed, Medline, and SPORTDiscus databases were searched for studies examining the effects of eccentric training on lower-limb passive joint ROM in healthy human participants. Meta-analysis used an inverse-variance random-effects model to calculate the pooled standardized difference (Hedge's g ) with 95% confidence intervals. RESULTS Meta-analysis of 22 ROM outcomes (17 studies, 376 participants) revealed a large increase in lower-limb passive joint ROM ( g = 0.86 (95% confidence intervals, 0.65-1.08)). Subgroup analyses revealed a moderate increase after 4-5 wk ( g = 0.63 (0.27-0.98)), large increase after 6-8 wk ( g = 0.98 (0.73-1.24)), and moderate increase after 9-14 wk ( g = 0.75 (0.03, 1.46)) of training. Large increases were found in dorsiflexion ( g = 1.12 (0.78-1.47)) and knee extension ( g = 0.82 (0.48-1.17)), but a small increase in knee flexion was observed ( g = 0.41 (0.05-0.77)). A large increase was found after isokinetic ( g = 1.07 (0.59-1.54)) and moderate increase after isotonic ( g = 0.77 (0.56-0.99)) training. CONCLUSIONS These findings demonstrate the potential of eccentric training as an effective flexibility training intervention and provide evidence for "best practice" guidelines. The larger effect after isokinetic training despite <50% training sessions being performed is suggestive of a more effective exercise mode, although further research is needed to determine the influence of contraction intensity and to confirm the efficacy of eccentric training in clinical populations.
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Affiliation(s)
- Anthony D Kay
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northamptonshire, UNITED KINGDOM
| | - Brett A Baxter
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northamptonshire, UNITED KINGDOM
| | - Mathew W Hill
- Centre for Sport, Exercise and Life Sciences, School of Life Sciences, Coventry University, Warwickshire, UNITED KINGDOM
| | - Anthony J Blazevich
- Centre for Human Performance (CHP), School of Medical and Health Sciences, Edith Cowan University, Joondalup, AUSTRALIA
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Carvalho RM, Machado J, Santos MJ, Matos LC. Can Acupuncture Improve the Flexibility of Hamstring Muscles? A Randomized, Blinded, and Controlled Pilot Study. Healthcare (Basel) 2023; 11:healthcare11040490. [PMID: 36833023 PMCID: PMC9956164 DOI: 10.3390/healthcare11040490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/25/2023] [Accepted: 02/04/2023] [Indexed: 02/11/2023] Open
Abstract
(1) Background: The lack of flexibility is frequently reported as a risk factor for hamstring muscle damage. Acupuncture, a therapeutic tool of traditional Chinese medicine (TCM), may play a role in both treatment and prevention by improving muscle strength, microcirculation, and reducing muscle soreness. The primary objective of this pilot study was to examine the immediate effects of acupuncture on hamstring muscle stretching and on the pain or discomfort reported during stretching. (2) Methods: To mitigate heterogeneity effects, and due to the small sample size, the study employed a crossover design in which each participant was tested at three different moments of the experimental period with verum (true acupuncture in selected acupoints), sham (fake acupuncture in zones of the skin not corresponding to any known acupoint but near the selected acupoints), and placebo (stimulation of the selected acupoints with a stainless steel wire and cannula, without puncturing) stimulations. Flexibility and pain or discomfort were assessed using the seat and reach test (SR) and a visual analogic scale (VAS). (3) Results: Significant changes in flexibility were observed after verum acupuncture (p = 0.03), while no significant changes were seen in sham and placebo (p = 0.86 and p = 0.18, respectively). No significant differences were found in pain or discomfort during any of the stimulations (verum, p = 0.55; sham, p = 0.50; placebo, p = 0.58). (4) Conclusions: The results of this pilot study suggest that acupuncture may improve flexibility in the hamstring muscles, though it does not significantly affect pain or discomfort during stretching.
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Affiliation(s)
- Rui Miguel Carvalho
- ICBAS—Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
| | - Jorge Machado
- ICBAS—Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- CBSin—Center of BioSciences in Integrative Health, 4405-604 Vila Nova de Gaia, Portugal
- LABIOMEP—Porto Biomechanics Laboratory, University of Porto, 4200-450 Porto, Portugal
| | - Maria João Santos
- Escola Superior de Saúde Jean Piaget, 4405-678 Vila Nova de Gaia, Portugal
| | - Luís Carlos Matos
- CBSin—Center of BioSciences in Integrative Health, 4405-604 Vila Nova de Gaia, Portugal
- Faculdade de Engenharia da Universidade do Porto, 4200-465 Porto, Portugal
- CTEC—Centro Transdisciplinar de Estudos da Consciência, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
- Correspondence:
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Li S, Wang L, Xiong J, Xiao D. Gender-Specific Effects of 8-Week Multi-Modal Strength and Flexibility Training on Hamstring Flexibility and Strength. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15256. [PMID: 36429975 PMCID: PMC9690188 DOI: 10.3390/ijerph192215256] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/26/2022] [Accepted: 11/14/2022] [Indexed: 06/16/2023]
Abstract
The purpose of this study was to investigate the effects of multi-modal strength training or flexibility training on hamstring flexibility and strength in young males and females. A total of 20 male and 20 female college students (aged 18-24 years) participated in this study and were randomly assigned to either a multi-modal flexibility intervention group or strength intervention group. Passive straight leg raise and isokinetic strength test were performed before and after the intervention to determine flexibility and strength of the participants. Multivariate repeated-measure ANOVA was used to determine the effect of training group and gender on hamstring strength and flexibility. Both male and female participants in the strength intervention group significantly increased peak torque, relative peak torque, and flexibility (all p ≤ 0.029). Both male and female participants in the flexibility intervention group significantly increased flexibility (both p ≤ 0.001). Female participants in the flexibility intervention group significantly increased peak torque and relative peak torque (both p ≤ 0.023). However, no change was seen in peak torque and relative peak torque of male participants in the flexibility intervention group (p ≥ 0.676). An 8-week strength training program involving various training components can increase flexibility in both males and females, although the flexibility of male participants only increased slightly. While hamstring flexibility training protocol consisted of different types of stretching improved both flexibility and strength in female participants, male participants increased only flexibility but not strength, indicating such effects were gender-specific. For subjects with relatively low strength (e.g., older adults, sedentary women, postoperative rehabilitation population, etc.), strength training alone or flexibility training alone may increase both strength and flexibility.
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Affiliation(s)
- Shangxiao Li
- Research Center for Sports Psychology and Biomechanics, China Institute of Sport Science, Beijing 100061, China
| | - Liduan Wang
- School of Rehabilitation Medicine, Weifang Medical University, Weifang 261053, China
| | - Jinfeng Xiong
- Institute of Sports Science, Sichuan University, Chengdu 610065, China
| | - Dandan Xiao
- Research Center for Sports Psychology and Biomechanics, China Institute of Sport Science, Beijing 100061, China
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The Biomechanics Effect of Hamstring Flexibility on the Risk of Osgood-Schlatter Disease. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:3733218. [PMID: 35586681 PMCID: PMC9110230 DOI: 10.1155/2022/3733218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 11/21/2022]
Abstract
Background The relationship between hamstring flexibility and the risk of OSD continues to be a debate, and whether hamstring stretching exercises should be considered as one of the conservative treatments of OSD is still unclear. Objectives To investigate the relationship between hamstring flexibility and the risk of OSD by assessing the changes of loading on the tibial tuberosity caused by the changes of hamstring optimal lengths. Methods Experimental data of a young adult running at 4 m/s were used, which were collected by an eight-camera motion capture system together with an instrumented treadmill. Muscle forces were estimated in OpenSim when hamstring optimal lengths changed in the range of 70–130% of the control case in 5% increments. The force and accumulated force of quadriceps muscle were calculated to evaluate the impact of hamstring optimal lengths on the loading on tibial tuberosity. The changes in muscle forces throughout the gait cycle were compared by using statistical parametric mapping (SPM). The average peak force and accumulated force of five gait cycles were compared. Results Although the maximum force of the quadriceps muscle was slightly affected by changes in hamstring optimal lengths, the accumulated force of quadriceps muscle increased by 21.97% with hamstring optimal lengths decreased by 30% of the control case. The increase of the muscle force mainly occurred in the early stance phase and terminal swing phase (P < 0.05). However, when hamstring optimal lengths were longer than the control, it had a little effect on accumulated force of quadriceps muscle. Conclusions The results of this study indicate that a shorter hamstring optimal length, which means lack of flexibility, can cause a high accumulated force on tibial tuberosity, thus increasing the risk of OSD. Hamstring stretching exercise is only effective for people with lack of hamstring flexibility.
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Afonso J, Ramirez-Campillo R, Moscão J, Rocha T, Zacca R, Martins A, Milheiro AA, Ferreira J, Sarmento H, Clemente FM. Strength Training versus Stretching for Improving Range of Motion: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:427. [PMID: 33917036 PMCID: PMC8067745 DOI: 10.3390/healthcare9040427] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Stretching is known to improve range of motion (ROM), and evidence has suggested that strength training (ST) is effective too. However, it is unclear whether its efficacy is comparable to stretching. The goal was to systematically review and meta-analyze randomized controlled trials (RCTs) assessing the effects of ST and stretching on ROM (INPLASY 10.37766/inplasy2020.9.0098). (2) Methods: Cochrane Library, EBSCO, PubMed, Scielo, Scopus, and Web of Science were consulted in October 2020 and updated in March 2021, followed by search within reference lists and expert suggestions (no constraints on language or year). Eligibility criteria: (P) Humans of any condition; (I) ST interventions; (C) stretching (O) ROM; (S) supervised RCTs. (3) Results: Eleven articles (n = 452 participants) were included. Pooled data showed no differences between ST and stretching on ROM (ES = -0.22; 95% CI = -0.55 to 0.12; p = 0.206). Sub-group analyses based on risk of bias, active vs. passive ROM, and movement-per-joint analyses showed no between-protocol differences in ROM gains. (4) Conclusions: ST and stretching were not different in their effects on ROM, but the studies were highly heterogeneous in terms of design, protocols and populations, and so further research is warranted. However, the qualitative effects of all the studies were quite homogeneous.
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Affiliation(s)
- José Afonso
- Centre for Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; (J.A.); (R.Z.); (A.M.); (A.A.M.)
| | - Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences, Universidad de Los Lagos, Lord Cochrane 1046, Osorno 5290000, Chile;
- Centro de Investigación en Fisiología del Ejercicio, Facultad de Ciencias, Universidad Mayor, San Pio X, 2422, Providencia, Santiago 7500000, Chile
| | - João Moscão
- REP Exercise Institute, Rua Manuel Francisco 75-A 2 °C, 2645-558 Alcabideche, Portugal;
| | - Tiago Rocha
- Polytechnic of Leiria, Rua General Norton de Matos, Apartado 4133, 2411-901 Leiria, Portugal;
| | - Rodrigo Zacca
- Centre for Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; (J.A.); (R.Z.); (A.M.); (A.A.M.)
- Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal
- Coordination for the Improvement of Higher Educational Personnel Foundation (CAPES), Ministry of Education of Brazil, Brasília 70040-020, Brazil
| | - Alexandre Martins
- Centre for Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; (J.A.); (R.Z.); (A.M.); (A.A.M.)
| | - André A. Milheiro
- Centre for Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto, Rua Dr. Plácido Costa, 91, 4200-450 Porto, Portugal; (J.A.); (R.Z.); (A.M.); (A.A.M.)
| | - João Ferreira
- Superior Institute of Engineering of Porto, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 431, 4249-015 Porto, Portugal;
| | - Hugo Sarmento
- Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-256 Coimbra, Portugal;
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Instituto de Telecomunicações, Department of Covilhã, 1049-001 Lisboa, Portugal
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Wan X, Li S, Best TM, Liu H, Li H, Yu B. Effects of flexibility and strength training on peak hamstring musculotendinous strains during sprinting. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:222-229. [PMID: 32795623 PMCID: PMC7987790 DOI: 10.1016/j.jshs.2020.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/13/2020] [Accepted: 07/10/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Hamstring injury is one of the most common injuries in sports involving sprinting. Hamstring flexibility and strength are often considered to be modifiable risk factors in hamstring injury. Understanding the effects of hamstring flexibility or strength training on the biomechanics of the hamstring muscles during sprinting could assist in improving prevention strategies and rehabilitation related to these injuries. The purpose of this study was to determine the effects of altering hamstring flexibility or strength on peak hamstring musculotendinous strain during sprinting. METHODS A total of 20 male college students (aged 18-24 years) participated and were randomly assigned to either a flexibility intervention group or a strength intervention group. Each participant executed exercise training 3 times a week for 8 weeks. Flexibility, sprinting, and isokinetic strength testing were performed before and after the 2 interventions. Paired t tests were performed to determine hamstring flexibility or strength intervention effects on optimal hamstring musculotendinous lengths and peak hamstring musculotendinous strains during sprinting. RESULTS Participants in the flexibility intervention group significantly increased the optimal musculotendinous lengths of the semimembranosus and biceps long head (p ≤ 0.026) and decreased peak musculotendinous strains in all 3 bi-articulate hamstring muscles (p ≤ 0.004). Participants in the strength-intervention group significantly increased the optimal musculotendinous lengths of all 3 hamstring muscles (p ≤ 0.041) and significantly decreased their peak musculotendinous strain during sprinting (p ≤ 0.017). CONCLUSION Increasing hamstring flexibility or strength through exercise training may assist in reducing the risk of hamstring injury during sprinting for recreational male athletes.
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Affiliation(s)
- Xianglin Wan
- Biomechanics Laboratory, Beijing Sport University, Beijing 100084, China
| | - Shangxiao Li
- Biomechanics Laboratory, Beijing Sport University, Beijing 100084, China
| | - Thomas M Best
- UHealth Sports Medicine Institute, University of Miami, Miami, FL 33136, USA
| | - Hui Liu
- Biomechanics Laboratory, Beijing Sport University, Beijing 100084, China
| | - Hanjun Li
- Biomechanics Laboratory, Beijing Sport University, Beijing 100084, China.
| | - Bing Yu
- Center for Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7135, USA.
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