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Behm DG, Alizadeh S, Daneshjoo A, Anvar SH, Graham A, Zahiri A, Goudini R, Edwards C, Culleton R, Scharf C, Konrad A. Acute Effects of Various Stretching Techniques on Range of Motion: A Systematic Review with Meta-Analysis. SPORTS MEDICINE - OPEN 2023; 9:107. [PMID: 37962709 PMCID: PMC10645614 DOI: 10.1186/s40798-023-00652-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 10/22/2023] [Indexed: 11/15/2023]
Abstract
Background Although stretching can acutely increase joint range of motion (ROM), there are a variety of factors which could influence the extent of stretch-induced flexibility such as participant characteristics, stretching intensities, durations, type (technique), and muscle or joint tested. Objective The objective of this systematic review and meta-analysis was to investigate the acute effects of stretching on ROM including moderating variables such as muscles tested, stretch techniques, intensity, sex, and trained state. Methods A random-effect meta-analysis was performed from 47 eligible studies (110 effect sizes). A mixed-effect meta-analysis subgroup analysis was also performed on the moderating variables. A meta-regression was also performed between age and stretch duration. GRADE analysis was used to assess the quality of evidence obtained from this meta-analysis. Results The meta-analysis revealed a small ROM standard mean difference in favor of an acute bout of stretching compared to non-active control condition (ES = −0.555; Z = −8.939; CI (95%) −0.677 to −0.434; p < 0.001; I2 = 33.32). While there were ROM increases with sit and reach (P = 0.038), hamstrings (P < 0.001), and triceps surae (P = 0.002) tests, there was no change with the hip adductor test (P = 0.403). Further subgroup analyses revealed no significant difference in stretch intensity (P = 0.76), trained state (P = 0.99), stretching techniques (P = 0.72), and sex (P = 0.89). Finally, meta-regression showed no relationship between the ROM standard mean differences to age (R2 = −0.03; P = 0.56) and stretch duration (R 2 = 0.00; P = 0.39), respectively. GRADE analysis indicated that we can be moderately confident in the effect estimates. Conclusion A single bout of stretching can be considered effective for providing acute small magnitude ROM improvements for most ROM tests, which are not significantly affected by stretch intensity, participants’ trained state, stretching techniques, and sex. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-023-00652-x. The meta-analysis on joint range of motion (ROM) increases revealed a small effect size in favor of an acute bout of stretching compared to the control condition. Subgroup analysis revealed a significant increase in ROM with sit and reach, hamstrings, and triceps surae tests, but no improvement with the hip adductor tests. Whereas all moderating variables presented significant increases in ROM, further subgroup analyses revealed no significant difference in ROM gains with the stretch intensity, trained state of the participants, stretching techniques, and sex. A meta-regression showed no relationship between the effect sizes to age and stretch duration, respectively.
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Affiliation(s)
- David George 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, 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
| | - Robyn Culleton
- 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, Mozartgasse 14, 8010, Graz, Austria
| | - 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, Mozartgasse 14, 8010, Graz, Austria.
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Kato T, Taniguchi K, Kodesho T, Nakao G, Yokoyama Y, Saito Y, Katayose M. Quantifying the shear modulus of the adductor longus muscle during hip joint motion using shear wave elastography. Sci Rep 2023; 13:9510. [PMID: 37308569 DOI: 10.1038/s41598-023-36698-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/08/2023] [Indexed: 06/14/2023] Open
Abstract
The present study aims to assess the effect of the hip flexion angle on the shear modulus of the adductor longus (AL) muscle associated with passive hip abduction and rotation. Sixteen men participated in the study. For the hip abduction task, the hip flexion angles used were - 20, 0, 20, 40, 60, and 80°, and the hip abduction angles were 0, 10, 20, 30, and 40°. For the hip rotation task, the hip flexion angles used were - 20, 0, 20, 40, 60, and 80°, hip abduction angles were 0 and 40°, and hip rotation angles were 20° internal rotation, 0° rotation, and 20° external rotation. The shear modulus at 20° extension was significantly higher than that at 80° flexion for the 10, 20, 30 and 40° hip abduction (i.e., P < 0.05). The shear modulus at 20° internal rotation and 20° extension was significantly higher than that at 0° rotation and 20° external rotation, regardless of the hip abduction angle (i.e., P < 0.05). The mechanical stress of the AL muscle associated with hip abduction was higher in the extended position. Furthermore, the mechanical stress could increase with internal rotation only at the hip-extended position.
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Affiliation(s)
- Takuya Kato
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
- Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan
| | - Keigo Taniguchi
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan.
| | - Taiki Kodesho
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Gakuto Nakao
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yu Yokoyama
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Yuhei Saito
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Masaki Katayose
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Japan
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Comparison of dry needling and self-stretching in muscle extensibility, pain, stiffness, and physical function in hip osteoarthritis: A randomized controlled trial. Complement Ther Clin Pract 2022; 49:101667. [PMID: 36152527 DOI: 10.1016/j.ctcp.2022.101667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/04/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND PURPOSE Patients with hip osteoarthritis (OA) present myofascial trigger points in the hip muscles that may reduce muscle extensibility, provoke pain and stiffness, and decrease physical function. The purpose of the study was to compare the effects of dry needling (DN) intervention with a self-stretching protocol on muscle extensibility, pain, stiffness, and physical function in patients with hip OA. MATERIALS AND METHODS A single-blinded randomised controlled trial was designed. Thirty-eight participants with hip OA were randomly assigned to the DN group (n = 19) or the stretching group (n = 19). The DN group received three sessions of DN, and the stretching group followed a 3-week protocol. Hip muscle extensibility was the primary outcome and was measured using the Ely test, the modified Ober test, and the Active Knee Extension test. Pain, stiffness, and physical function were the secondary outcomes measured with the WOMAC questionnaire. The variables were assessed before and after treatment by blinded examiners. RESULTS DN was more effective than self-stretching for improving hip flexor and abductor muscles extensibility (p < 0.05). DN and self-stretching techniques improved hip extensor muscles extensibility, pain, stiffness, and physical function in patients with hip OA (<0.05). The DN group showed large effect sizes in all the variables (d > 0.8). CONCLUSION Three sessions of DN were more effective than three weeks of self-stretching to improve hip muscle extensibility in patients with hip OA. DN and self-stretching techniques decreased pain and stiffness and improved physical function in patients with hip OA.
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Chang WG, Chen CY, Li WF, Chou CC, Liao YH. Traditional Chinese acupressure massage ameliorates systemic inflammatory responses and joint mobility limitation after acute repeated jumping exercise. Explore (NY) 2019; 16:26-34. [PMID: 31488342 DOI: 10.1016/j.explore.2019.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 08/01/2019] [Accepted: 08/06/2019] [Indexed: 01/14/2023]
Abstract
CONTEXT Alternative medical and training approaches to accelerate recovery among athletes are growing in popularity. The potential benefits of acupressure massage on attenuating muscle soreness and promoting post-exercise recovery capacity are still unclear. OBJECTIVE This study compares the effects of traditional Chinese acupressure massage (TCAM) and active recovery, on subject recovery capacity after acute repeated jumping exercise. DESIGN Twenty healthy male athletes were randomly assigned to traditional Chinese acupressure massage (TCAM; N = 10) or active recovery (AR; performing low-intensity exercise during post-exercise recovery; N = 10) groups. TCAM and AR intervention were applied after repeated jumping exercise. Pain scale, knee active/passive range of motion (AROM/PROM), jumping performance, quadriceps maximum voluntary contraction force, creatine kinase, and leukocyte subpopulations were measured at baseline, after and 48 h after exercise. RESULTS No significant interaction effects were observed between the jumping performance, quadriceps maximum voluntary contraction (MVC) force, power-to-weight ratio for the two groups before the exercise, after the exercise, and 48 h post exercise. However, the knee flexion AROM/PROM was greater in the TCAM group than that for the AR group (p = 0.005). There were no differences in the VAS, MVC, and jumping performance between treatments. The white blood cell (p = 0.024), and monocytes (p = 0.023) responses were lower in the TCAM group. CONCLUSIONS We demonstrated that TCAM generates beneficial effects on attenuating joint mobility limitations and lowering systemic inflammatory responses after acute exercise in athletes. These findings suggest that TCAM may be a practical alternative approach for athletes participating in consecutive competitions containing eccentric elements.
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Affiliation(s)
- Wei-Gang Chang
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan City, Taiwan
| | - Chung-Yu Chen
- Department of Exercise and Health Sciences, University of Taipei, Taipei City, Taiwan
| | - Wen-Fen Li
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Chun-Chung Chou
- Physical Education Office, National Taipei University of Technology, Taipei City, Taiwan
| | - Yi-Hung Liao
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.
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