A comparison of self-administered proprioceptive neuromuscular facilitation to static stretching on range of motion and flexibility

The effects of rhythmic exercise using PNF patterns on gait variables in normal adults

BACKGROUND

Maintaining gait stability is an important factor for preventing falls of normal adults. Thus, it is necessary to conduct research on gait variables in normal adults.

OBJECTIVE

In this study, we conducted research on the effect of rhythmic exercise using proprioceptive neuromuscular facilitation (PNF) patterns on gait variables in normal adults.

METHODS

Thirty-two subjects were divided into two groups, the training and control groups, with 16 subjects in each group. We measured various gait variables step time difference (STD), step length difference (SLD), single support difference (SSD), stance phase difference (STPD) and swing phase difference (SWPD) for the pre-test and post-test in each group.

RESULTS

As a result of paired t-tests on various gait variables (STD, SLD, SSD, STPD, SWPD) of the training and control group, the training group showed significance in SLD, STPD and STD and the control group had no significance in all items.

CONCLUSIONS

In this study, which verified the effect of rhythmic exercise using the PNF patterns on the gait variables of normal adults, there was statistical significance in SLD, STPD, and STD showing that dynamic exercise using the PNF pattern is helpful in improving the walking ability of normal adults.

Gender difference in effects of proprioceptive neuromuscular facilitation stretching on flexibility and stiffness of hamstring muscle

Objective: This study investigated the acute effects of PNF stretching on hamstring flexibility and muscle stiffness of lower limbs between genders.

Methods: 15 male and 15 female university students without any injury histories on lower limbs in the past 3 months were included in this study were selected. All subjects were measured by MyotonPRO before and after stretching to determine the muscle stiffness of the biceps femoris muscle (BF), semitendinosus muscle (ST) of the hamstring and the medial gastrocnemius muscles (MG), lateral gastrocnemius muscles (LG), and the soleus (SOL) of the triceps surae muscles. Additionally, their flexibility was measured using the sit-and-reach test (the SR test) and passive hip range of motion (ROM). Differences based on time (pre-stretching vs. post-stretching) and sex (females vs. males) were assessed using 2 × 2 repeated measures AVONA.

Results: There was a significant decrease in the stiffness of the hamstring and triceps surae muscles after stretching (BF, MG, LG, and SOL: p < 0.001; ST: p = 0.003). The muscle stiffness of the hamstring and triceps surae muscles is larger in males than in females at all time points (p < 0.001). There was a significant increase in hip flexion angle and the SR test in males and females after PNF stretching (p < 0.001); However, there was no difference in the change in the muscle stiffness and the flexibility between genders (p > 0.05).

Conclusion: PNF stretching helped improve hamstring flexibility and decrease muscle stiffness. Stretching the hamstrings can also contribute to a decrease in the stiffness of the triceps surae muscles. The muscle stiffness of males before and after stretching is always greater than that of females. However, there was no difference in the change of improvement in stretching between genders.

Effect of Flexibility Training Associated with Multicomponent Training on Posture and Quality of Movement in Physically Inactive Older Women: A Randomized Study

Background: Multicomponent training has considerable adherence among older populations, but there is a lack of literature on the benefits of this training on older people’s posture. Literature also lacks stretching protocols that work the body in an integrated/unified way and respect the principle of individuality in exercise training. We evaluated the effect of a multicomponent training protocol combined or not with flexibility training in improving the posture and quality of movement in physically inactive older women, according to a score lower than 9.11 in the Modified Baecke Questionnaire for the Elderly (MBQE). Methods: 142 participants were evaluated and randomized in three training groups: multicomponent training (MT = 52), multicomponent and flexibility training (MFT = 43), and a control group (CG = 47). We evaluated joint amplitude using goniometry, flexibility with sit and reach and hands behind the back tests, quality of movement with the functional movement screen, and posture using biophotogammetry. Results: The MFT group had 15 parameters—flexibility and posture—with a very large effect size (ES > 1.30) and nine with average ES (0.50–0.79). MT presented two variables with large ES (0.80–1.25) and seven with average ES. CG presented three variables with high ES and five with average ES. Both interventions improved the quality of movement. Conclusions: These results demonstrate that 14 weeks of multicomponent and flexibility training in a group intervention can improve flexibility and posture levels in physically inactive older women.

Effects of two different stretching techniques on proprioception and hamstring flexibility: a pilot study

Aim: This study aimed to compare the immediate and long-term effect of proprioceptive neuromuscular facilitation (PNF) contract-relax-antagonist-contract (CRAC) exercises versus static stretching on proprioception and flexibility in males with hamstring shortness. Patients & methods: Knee extension angle test was used to measure flexibility and isokinetic dynamometer to evaluate proprioception. Assessments were evaluated at baseline, after first exercise and eighth week. The hamstring stretching was applied 3 days a week for 8 weeks. Results: Flexibility and position sense were similar in the immediate and long term (p > 0.05). However, the motion sense increased significantly in long term within the PNF CRAC group (p = 0.02). Conclusion: Both stretching exercises are effective for improving flexibility. Moreover, PNF CRAC improved motion sense more than static stretching in the long term. Clinical trial registration number: NCT04026646.

Proprioceptive neuromuscular facilitation in the functionality and lymphatic circulation of the upper limb of women undergoing breast cancer treatment

BACKGROUND

With the increase in survival of women treated for breast cancer, it is necessary to evaluate the effect of therapeutic resources on co-morbidities resulting from the surgical treatment of the disease. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation on the functionality and lymphatic circulation of the upper limb involved in the treatment of breast cancer.

METHODS

The study was conducted according to randomized clinical trial design. Thirty-two women at a mean age of 52.20 (±8.32) years, submitted to breast cancer treatment, divided into two groups, control - women submitted to standard breast cancer treatment, and treated group, composed of women who underwent breast cancer treatment and rehabilitation with the proprioceptive neuromuscular facilitation technique. Palmar grip strength with dynamometer and shoulder range of motion with goniometer were evaluated. Lymphatic circulation analysis was performed in a computerized scintillation chamber, before and after therapeutic intervention.

FINDINGS

In the results obtained, a significant increase (p < 0.05) of palmar grip strength was observed, a significant increase in range of motion of flexion (p < 0.001), extension (p < 0.0012), abduction (p < 0.0001), external rotation (p < 0.0001), internal rotation (p < 0.0001), and not significant for lymphatic flow (p > 0.05).

INTERPRETATION

The results obtained in this study allow us to conclude that proprioceptive neuromuscular facilitation favors an increase in muscle strength, range of motion, but not in lymphatic flow, in women undergoing surgical treatment for breast cancer.

Effects of antagonistic muscle contraction exercises on ankle joint range of motion

[Purpose] Antagonistic stretching is an important therapeutic program in rehabilitation. However, if pain occurs during stretching, other methods should be considered. This study aimed to investigate whether antagonistic muscle contraction exercises alone had an effect in expanding the joint range of motion. [Participants and Methods] Participants included 50 healthy males and females (aged 21.0 ± 3.1 years) who were each randomly assigned to one of four groups that performed either active, resistance, phasic, or isometric exercises or a control group that performed no exercise. Each exercise group performed five sets of 30-second ankle dorsiflexion exercises. Active and passive ranges of motion of ankle dorsiflexion were measured using a goniometer, with the participants in the knee extension and flexion positions. [Results] Ankle joint range of motion was increased in the knee extension position in the isometric exercise group. There were no other differences observed in any of the groups. [Conclusion] Our results indicated that isometric exercises had an immediate effect on increasing ankle joint range of motion. This is presumably attributed to the effects of Golgi tendon organ inhibition (Ib inhibition) or stretch tolerance of the gastrocnemius muscle.

Hip Mobilization at Preterm Age May Accelerate Developmental Dysplasia Recovery

PURPOSE

Few studies have described mobilization approaches in developmental dysplasia of the hip (DDH). The present study describes the hip mobilization of a preterm infant (born at 33 6/7 weeks of gestational age) diagnosed with DDH.

DESIGN AND METHODS

During the 43-day hospital stay, the infant was seen twice a week (ten sessions, 20 minutes each). All sessions included hip approximation maneuvers, with the hip positioned in abduction, lateral rotation and flexion, and lower limbs passive mobilization, which were taught to the mother. Early intervention with auditory, tactile, visual, and vestibular stimulations was also performed. The infant was assessed with hip ultrasound before and after treatment.

RESULTS

At 34 2/7 weeks of gestational age, she was classified as Graf IIa (left: alpha: 55°, beta: 68°; right: alpha: 59°, beta: 64°). At 40 5/7 weeks, she was classified as Graf I for left (alpha: 67°; beta: 42°) and right (alpha: 66°; beta: 42°) hips.

PRACTICAL IMPLICATIONS

The intervention seemed to accelerate the acquisition of stability of dysplasic hips in a preterm infant. The outcome supports further investigation of hip approximation maneuvers as part of early stimulation in preterm infants with DDH during hospital stay.

Efficacy of proprioceptive neuromuscular facilitation compared to other stretching modalities in range of motion gain in young healthy adults: A systematic review

The objective of this study was to evaluate the efficacy of proprioceptive neuromuscular facilitation (PNF) on range of motion (ROM) gain in young healthy adults. We performed a systematic review of randomized controlled trials and quasi-randomized trials, including young healthy adults. The interventions were: PNF compared with different PNF techniques, control, other muscle stretching exercises and musculoskeletal manipulations. The outcome measures were: articular ROM and adverse effects. The final number of included studies was 46, involving 1,864 adults. There was difference on ROM comparing assisted hold-relax (HR) on diagonal plane to control, based on very low-quality evidence. There was also difference on ROM comparing assisted HR to self-HR; self-contract-relax (CR) to control; assisted CR contract to control; and assisted HR contract to control, based on low-quality evidence. Moderate-quality evidence shows that results differ between self HR and control (SMD: 0.95; 95%CI 0.03, 1.86; I²49%; P = 0.16) in terms of ROM gain. When performing the other comparisons, the results were based on low or very low-quality evidence and do not allow to state if PNF is more or less effective than other stretches for improving ROM in healthy young adults. No adverse effects were mentioned.

Effects of diaphragm stretching on posterior chain muscle kinematics and rib cage and abdominal excursion: a randomized controlled trial

Background

Few studies have explored the effects of stretching techniques on diaphragm and spine kinematics.

Objective

To determine whether the application of diaphragm stretching resulted in changes in posterior chain muscle kinematics and ribcage and abdominal excursion in healthy subjects.

Method

Eighty healthy adults were included in this randomized clinical trial. Participants were randomized into two groups: the experimental group, which received a diaphragmatic stretching technique, or the placebo group, which received a sham-ultrasound procedure. The duration of the technique, the position of participants, and the therapist who applied the technique were the same for both treatments. Participant assessment (cervical range of movement, lumbar flexibility, flexibility of the posterior chain, and rib cage and abdominal excursion) was performed at baseline and immediately after the intervention by a blinded assessor.

Results

The mean between-group difference [95% CI] for the ribcage excursion after technique at xiphoid level was 2.48 [0.97 to 3.99], which shows significant differences in this outcome. The remaining between-group analysis showed significant differences in cervical extension, right and left flexion, flexibility of the posterior chain, and ribcage excursion at xiphoid level (p<0.05) in favor of the experimental group.

Conclusion

Diaphragm stretching generates a significant improvement in cervical extension, right and left cervical flexion, flexibility of the posterior chain, and ribcage excursion at xiphoid level compared to a placebo technique in healthy adults.

The relevance of stretch intensity and position-a systematic review

Stretching exercises to increase the range of motion (ROM) of joints have been used by sports coaches and medical professionals for improving performance and rehabilitation. The ability of connective and muscular tissues to change their architecture in response to stretching is important for their proper function, repair, and performance. Given the dearth of relevant data in the literature, this review examined two key elements of stretching: stretch intensity and stretch position; and their significance to ROM, delayed onset muscle soreness (DOMS), and inflammation in different populations. A search of three databases, Pub-Med, Google Scholar, and Cochrane Reviews, identified 152 articles, which were subsequently categorized into four groups: athletes (24), clinical (29), elderly (12), and general population (87). The use of different populations facilitated a wider examination of the stretching components and their effects. All 152 articles incorporated information regarding duration, frequency and stretch position, whereas only 79 referred to the intensity of stretching and 22 of these 79 studies were deemed high quality. It appears that the intensity of stretching is relatively under-researched, and the importance of body position and its influence on stretch intensity, is largely unknown. In conclusion, this review has highlighted areas for future research, including stretch intensity and position and their effect on musculo-tendinous tissue, in relation to the sensation of pain, delayed onset muscle soreness, inflammation, as well as muscle health and performance.

Effects of stretching and warm-up routines on stability and balance during weight-lifting: a pilot investigation

Background

The efficacy of warm-up and stretching in weight-lifting remains unknown, especially for the weight-lifter’s stability and balance during lifting.

Methods

13 subjects were randomly assigned a 10-minute stretching routine (SR) or a 10-minute warm-up routine (WR) and compared against 5 controls (no stretching or warm-up). Before and after the individually assigned routine, the participants’ centre of pressure (CoP) was assessed using plantar-pressure sensors. The subjects were measured during 10 repetitions of air squat (no load, “AS”), front squat (FS; 20 kg/15 kg bar), overhead squat (OHS; m: 20 kg / f: 15 kg bar), and a deadlift lifting exercise (“DL”; 20 kg/15 kg bar). The impact on CoP dynamics of the warm-up and stretching routines were examined with repeated two-factor analysis of variances (ANOVA) of the mean and the coefficient of variance (CV, shown in %), as proxies for stability and balance.

Results

After stretching, the SR athletes shifted the mean CoP towards the toes (≈1 cm; p < 0.01) while the WR athletes shifted the CoP towards the heels (≈1 cm; p < 0.01) during AS. For the remaining exercises, the SR athletes shifted the CoP towards the heels (between 0.8 cm and 5.7 cm) compared to WR (≈1.9 cm towards the heels in FS, no significant change in OHS (≈1 mm) and DL (≈3 mm)). The controls did not show any change between pre- and post-datasets. After stretching, the CV decreased for the AS and OHS exercises (AS: 10.2% to 7.0%, OHS 9.8% to 7.8%), but increased after WR (AS: 7.1% to 10.1%) or did not change significantly (OHS). Both WR and SR resulted in increased CV values for FS and DL. No change of CV was observed in the controls.

Conclusions

SR had a stronger impact on CoP during the assessed exercises than either WR or controls. A reduction in CV after SR exercises (AS, OHS) suggests a clear improvement in stability and balance during weight-lifting. The lack of a significant effect for complex movements (OHS) suggests only a limited effect of a 10-minute warm-up routine on CoP features. 10 minutes stretching might therefore be more efficient for improving stability than a general 10 minute warm-up.