Flexibility responses to different stretching methods in young elite basketball players

What We Do Not Know About Stretching in Healthy Athletes: A Scoping Review with Evidence Gap Map from 300 Trials

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 ).

The effects of functional training on physical fitness and skill-related performance among basketball players: a systematic review

Background: Evidence suggests that functional training (FT) positively impacts physical fitness and sports performance. However, a systematic review addressing the effects of FT on basketball players remains absent. This systematic review aims to explore the influence of FT on physical fitness and skill-related performance in basketball players. Methods: We searched six databases: Web of Science, Scopus, PubMed, China National Knowledge Infrastructure (CNKI), EBSCOhost, and Google Scholar. The search utilized a combination of keywords related to FT, physical fitness, and basketball. The Eligibility Criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines were followed in this systematic review. Results: 11 studies were ultimately included in this review, collectively recruiting 333 basketball players. These studies demonstrated that FT significantly improved muscle strength, linear speed, cardiovascular endurance, flexibility, balance, and muscular endurance. However, the effects of FT on power, change-of-direction speed, and basketball-related performance were inconsistent. Most studies showed FT significantly improves these three variables, but a small number of studies did not find positive effects of FT using specific tests including standing long jump, Sargent jump, touch high, lane agility, lateral shuffle, dribbling line drill, and free-throw tests. Conclusion: FT is an effective training method for enhancing physical fitness including muscle strength, linear speed, cardiovascular endurance, flexibility, balance, and muscular endurance. However, the effects of FT on power, change-of-direction speed, and basketball-related performance were divergent. Some tests were not improved after FT potentially due to the short program lengths and training session durations, varied athletic levels of players examined, and different foci of the FT exercises administered. The collective evidence suggests FT programs, especially the specific exercises prescribed, should be tailored to the desired training objectives. More studies investigating the effects of FT on physical fitness and basketball-related performance with established tests are encouraged in the future to expand the current evidence base. Systematic Review Registration: https://inplasy.com/, Identifier INPLASY202360072.

Lower Extremity Flexibility Profile in Basketball Players: Gender Differences and Injury Risk Identification

Analysis of the flexibility profile of basketball players (BPs) can reveal differences in range of motion (ROM) by gender and also identify those players who are at higher risk for sports injuries. A descriptive observational study was conducted to determine the lower extremity flexibility profile of sixty-four basketball players and gender differences to identify players at higher risk of injury due to limited and asymmetric ROM in one or more movements. Participants: Sixty-four (33 male and 31 female) competitive athletes from the national leagues of the Spanish basketball league system participated in the present study (power of sample size ≥0.99). The eight passive ROM tests of the hip, knee and ankle were assessed using the ROM-SPORT battery. Each player completed a questionnaire on age, basic anthropometric data, dominant extremities, and training and sport-related variables. The lower extremity flexibility profile was established at 15° and 10° hip extension (HE), 39° and 38° ankle dorsiflexion with knee extended (ADF-KE), 40° and 39° ankle dorsiflexion with knee flexed (ADF-KF), 43° and 43° hip abduction (HAB), 75° and 61° hip abduction with the hip flexed (HAB-HF), 78° and 83° hip flexion with the knee extended (HF-KE), 134° and 120° knee flexion (KF), and 145° and 144° hip flexion (HF) by male and female basketball players, respectively. Sex differences in HE, HAB-HF, and KF were observed in BPs (p ≤ 0.01; Hedges’ g ≥ 1.04). Players reported limited ROM in ADF-KF, HE, HAB-HF, HF-KE, and KF; and asymmetric ROM mainly in HE, ADF-KE, KF, ADF-KF, and HF-KE. In conclusion, this study provides gender-specific lower extremity flexibility profile scores in BPs that can help athletic trainers and athletic and conditioning trainers to identify those players who are at higher risk of injury due to abnormal ROM scores.

Acute Effects of Proprioceptive Neuromuscular Facilitation on Peak Torque and Muscle Imbalance

BACKGROUND

The effects of proprioceptive neuromuscular facilitation (PNF) stretching on muscle imbalance are not fully understood. The aim of this study was to examine the acute effects of PNF stretching on knee extension and flexion peak torque (PT), as well as the conventional and functional hamstrings to quadriceps (H:Q) ratios.

METHODS

Fifteen men (age = 22 ± 1 years; body mass = 76 ± 12 kg; height = 176 ± 7 cm) and fifteen women (age = 22 ± 2 years; body mass = 63 ± 8 kg; height = 161 ± 5 cm) performed concentric quadriceps and hamstrings, and eccentric hamstrings muscle actions at different angular velocities (60, 180, and 300°·s^-1 concentric; 60 and 180°·s^-1 eccentric) before and after a bout of PNF stretching, and a control condition.

RESULTS

Neither PNF or control conditions affected concentric PT or H:Q ratios (p > 0.05), apart from knee extension at 60°·s^-1 in men (p = 0.001). However, there was a reduction in hamstrings eccentric PT in both control and PNF conditions for men and women (p = 0.003).

CONCLUSIONS

PNF stretching of the hamstrings may not adversely affect the H:Q ratios, and consequently not negatively affect injury risk associated with muscular strength imbalances.