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Warneke K, Behm DG, Alizadeh S, Hillebrecht M, Konrad A, Wirth K. Discussing Conflicting Explanatory Approaches in Flexibility Training Under Consideration of Physiology: A Narrative Review. Sports Med 2024:10.1007/s40279-024-02043-y. [PMID: 38819597 DOI: 10.1007/s40279-024-02043-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 06/01/2024]
Abstract
The mechanisms underlying range of motion enhancements via flexibility training discussed in the literature show high heterogeneity in research methodology and study findings. In addition, scientific conclusions are mostly based on functional observations while studies considering the underlying physiology are less common. However, understanding the underlying mechanisms that contribute to an improved range of motion through stretching is crucial for conducting comparable studies with sound designs, optimising training routines and accurately interpreting resulting outcomes. While there seems to be no evidence to attribute acute range of motion increases as well as changes in muscle and tendon stiffness and pain perception specifically to stretching or foam rolling, the role of general warm-up effects is discussed in this paper. Additionally, the role of mechanical tension applied to greater muscle lengths for range of motion improvement will be discussed. Thus, it is suggested that physical training stressors can be seen as external stimuli that control gene expression via the targeted stimulation of transcription factors, leading to structural adaptations due to enhanced protein synthesis. Hence, the possible role of serial sarcomerogenesis in altering pain perception, reducing muscle stiffness and passive torque, or changes in the optimal joint angle for force development is considered as well as alternative interventions with a potential impact on anabolic pathways. As there are limited possibilities to directly measure serial sarcomere number, longitudinal muscle hypertrophy remains without direct evidence. The available literature does not demonstrate the necessity of only using specific flexibility training routines such as stretching to enhance acute or chronic range of motion.
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Affiliation(s)
- Konstantin Warneke
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria.
- Department of Movement Sciences, Institute of Sport Science, University of Klagenfurt, Universitatsstraße 65, 9020, Klagenfurt Am Wörthersee, Austria.
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
- Human Performance Lab, Department of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Martin Hillebrecht
- University Sports Center, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Andreas Konrad
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
- University Sports Center, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Klaus Wirth
- University of Applied Sciences Wiener Neustadt, Vienna, Austria
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Konrad A, Alizadeh S, Anvar SH, Fischer J, Manieu J, Behm DG. Static Stretch Training versus Foam Rolling Training Effects on Range of Motion: A Systematic Review and Meta-Analysis. Sports Med 2024:10.1007/s40279-024-02041-0. [PMID: 38760635 DOI: 10.1007/s40279-024-02041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Long-term static stretching as well as foam rolling training can increase a joint's range of motion (ROM). However, to date, it is not clear which method is the most effective for increasing ROM. OBJECTIVE The purpose of this systematic review and meta-analysis was to compare the effects of static stretching and foam rolling training on ROM. METHODS The literature search was performed in PubMed, Scopus, and Web of Science to find the eligible studies. Eighty-five studies (72 on static stretching; and 13 on foam rolling) were found to be eligible with 204 effect sizes (ESs). For the main analyses, a random-effect meta-analysis was applied. To assess the difference between static stretching and foam rolling, subgroup analyses with a mixed-effect model were applied. Moderating variables were sex, total intervention duration, and weeks of intervention. RESULTS Static stretch (ES = - 1.006; p < 0.001), as well as foam rolling training (ES = - 0.729; p = 0.001), can increase joint ROM with a moderate magnitude compared with a control condition. However, we did not detect a significant difference between the two conditions in the subgroup analysis (p = 0.228). When the intervention duration was ≤ 4 weeks, however, a significant change in ROM was shown following static stretching (ES = - 1.436; p < 0.001), but not following foam rolling (ES = - 0.229; p = 0.248). Thus, a subgroup analysis indicated a significant favorable effect with static stretching for increasing ROM compared with foam rolling (p < 0.001) over a shorter term (≤ 4 weeks). Other moderator analyses showed no significant difference between static stretch and foam rolling training on ROM. CONCLUSIONS According to the results, both static stretching and foam rolling training can be similarly recommended to increase joint ROM, unless the training is scheduled for ≤ 4 weeks, in which case static stretching demonstrates a significant advantage. More studies are needed with a high-volume foam rolling training approach as well as foam rolling training in exclusively female participants.
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Affiliation(s)
- Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria.
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada.
| | - Shahab Alizadeh
- Human Performance Lab, Department of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Saman Hadjizadeh Anvar
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Josef Fischer
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria
| | - Josefina Manieu
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
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Kasahara K, Konrad A, Yoshida R, Murakami Y, Koizumi R, Thomas E, Behm DG, Nakamura M. Comparison of the effects of different foam rolling durations on knee extensors function. Biol Sport 2024; 41:139-145. [PMID: 38524819 PMCID: PMC10955735 DOI: 10.5114/biolsport.2024.131820] [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: 04/04/2023] [Revised: 07/30/2023] [Accepted: 09/05/2023] [Indexed: 03/26/2024] Open
Abstract
Foam rolling (FR) intervention has recently attracted attention in sports and rehabilitation settings. However, the effects of FR using different rolling durations have not been fully clarified. Thus, this study focused on FR durations and examined the acute and prolonged (i.e., 20-min; 40-min, 60-min) effects of different FR intervention durations on maximal voluntary concentric contractions (MVC-CON), knee flexion range of motion (ROM), pain pressure threshold (PPT), and tissue hardness. The participants were 10 male university students (22.5 ± 1.0 years), and the target muscles were the dominant leg knee extensors. Three sets of 60-seconds FR interventions were performed in the randomized crossover trials in each condition. The three intervention conditions were fast (1 rolling/2 s, 30-repetition × 3 sets, 90 repetitions), medium (1 rolling/6 s, 10-repetition × 3 sets, 30 repetitions), and slow speed (1 rolling/12 s, 5-repetition × 3 sets, 15 repetitions). Before as well as immediately, 20-min, 40-min, and 60-min after the interventions, MVC-CON, ROM PPT, and tissue hardness were measured. The results showed no interaction effect in the acute effect but a main effect of time for all variables (p < 0.05). Also, no interaction was observed in prolonged effect, but main effects of time were observed in knee flexion ROM, PPT, and tissue hardness (p < 0.01) but not for MVC-CON. Post-hoc tests showed significant PPT (p < 0.05) and knee flexion ROM (p < 0.01) increases up to 20- and 60-minutes respectively after all interventions. Tissue hardness was significantly (p < 0.01) decreased up to 60-minutes after all interventions. This study showed that the FR intervention changed ROM, PPT, tissue hardness, and MVC-CON regardless of rolling duration and that the effects persisted up to 20-60 minutes.
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Affiliation(s)
- Kazuki Kasahara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Riku Yoshida
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Yuta Murakami
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryoma Koizumi
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, 4490-9 Ozaki, Kanzaki, Saga, 842-8585, Japan
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Kasahara K, Konrad A, Yoshida R, Murakami Y, Sato S, Koizumi R, Thomas E, Behm DG, Nakamura M. Comparison of acute and prolonged effects of short-term foam rolling and vibration foam rolling on the properties of knee extensors. Biol Sport 2024; 41:19-26. [PMID: 38524825 PMCID: PMC10955736 DOI: 10.5114/biolsport.2024.129488] [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: 02/05/2023] [Revised: 05/26/2023] [Accepted: 07/03/2023] [Indexed: 03/26/2024] Open
Abstract
Recently, Foam Rolling (FR) and Vibration Foam Rolling (VFR) have attracted attention in sports and rehabilitation fields. Previous studies have shown that FR and VFR acute interventions effectively increase the range of movement (ROM) and decrease tissue hardness. For application to sports and rehabilitation, it is necessary to compare the acute and prolonged effects of short duration FR and VFR. Therefore, this study aimed to compare and investigate the acute and prolonged (15 minutes) effects of short duration (30-s) FR and VFR interventions on knee extensors. The subjects were 14 male university students (22.4 ± 1.0 years old), in which the knee extensors of the dominant leg were tested. In a cross-over trial, 30-s of FR or VFR were performed with 2-s rolling of the anterior thigh (15 rolls). The frequency of VFR was 35 Hz. Measurements included knee flexion ROM, pain pressure threshold (PPT), tissue hardness, and countermovement jump height. The results of this study showed no interaction effects for all variables, but main time effects were observed for knee flexion ROM, PPT, and tissue hardness. Post-hoc tests showed that knee flexion ROM increased up to 10 minutes after the intervention. PPT significantly increased, and tissue hardness significantly decreased up to 15 minutes after intervention. This study showed that 30-s FR and VFR interventions effectively increased ROM, PPT, and decreased tissue hardness. The effects were prolonged up to 10-15 minutes after the intervention. The results of this study show no advantage of VFR over FR with acute short-term interventions.
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Affiliation(s)
- Kazuki Kasahara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Riku Yoshida
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Yuta Murakami
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Shigeru Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryoma Koizumi
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, Canada
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, 4490-9 Ozaki, Kanzaki, Saga, 842-8585, Japan
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Santos IS, Dibai-Filho AV, Dos Santos PG, Júnior JDA, de Oliveira DD, Rocha DS, Fidelis-de-Paula-Gomes CA. Effects of foam roller on pain intensity in individuals with chronic and acute musculoskeletal pain: a systematic review of randomized trials. BMC Musculoskelet Disord 2024; 25:172. [PMID: 38402150 PMCID: PMC10893730 DOI: 10.1186/s12891-024-07276-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/12/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVE To analyze the effects of using foam roller on pain intensity in individuals with chronic and acute musculoskeletal pain. METHODS This systematic review was registered in the National Institute for Health Research's prospective online registry of systematic reviews (PROSPERO) under CRD42023456841. The databases Pubmed, Medline (via Ovid), Embase, BVS, and PEDro (Physiotherapy Evidence Database) were consulted to carry out this systematic review. Notably, the records of clinical trials characterized as eligible were manually searched. The search terms were: (foam rolling OR foam rolling vibration) AND (acute musculoskeletal pain) AND (chronic musculoskeletal pain). The search was performed until August 22, 2023. For the analysis of the methodological quality, the PEDro scale was used for each of the manuscripts included in the systematic review. Due to the heterogeneity in the studies included in this systematic review, performing a meta-analysis of the analyzed variables was impossible. RESULTS Only six manuscripts were eligible for data analysis. The type of FR used was non-vibrational, being applied by a therapist in only one of the manuscripts. With an application time ranging from at least 45 s to 15 min, the non-vibrational FR was applied within a day up to six weeks. Using the PEDro scale, scores were assigned that varied between 4 and 8 points, with an average of 6 ± 1.29 points. Only two randomized clinical trials found a significant benefit in pain intensity of adding FR associated with a therapeutic exercise protocol in individuals with patellofemoral pain syndrome and chronic neck pain. CONCLUSION The results of this systematic review do not elucidate or reinforce the clinical use of FR in pain intensity in individuals with chronic and acute musculoskeletal pain.
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Affiliation(s)
- Inaê Silva Santos
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, SP, Brazil
| | - Almir Vieira Dibai-Filho
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | | | | | | | - Daniel Santos Rocha
- Postgraduate Program in Physical Education, Universidade Federal do Maranhão, São Luís, MA, Brazil
| | - Cid André Fidelis-de-Paula-Gomes
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, São Paulo, SP, Brazil.
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Nove de Julho, Rua Vergueiro, 235/249, Liberdade, São Paulo, SP, CEP 01504- 001, Brazil.
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Martínez-Aranda LM, Sanz-Matesanz M, García-Mantilla ED, González-Fernández FT. Effects of Self-Myofascial Release on Athletes' Physical Performance: A Systematic Review. J Funct Morphol Kinesiol 2024; 9:20. [PMID: 38249097 PMCID: PMC10801590 DOI: 10.3390/jfmk9010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
Therapists and strength and conditioning specialists use self-myofascial release (SMR) as an intervention tool through foam rollers or massage rollers for soft tissue massage, with the purpose of improving mobility in the muscular fascia. Moreover, the use of SMR by professional and amateur athletes during warm-ups, cool downs, and workouts can have significant effects on their physical performance attributes, such as range of motion (ROM) and strength. The purpose of this study was to analyse the literature pertaining to these types of interventions and their effects found in different physical performance attributes for athletes. A systematic search was carried out using the following databases: PUBMED, ISI Web of Science, ScienceDirect, and Cochrane, including articles up to September 2023. A total of 25 articles with 517 athletes were studied in depth. SMR seems to have acute positive effects on flexibility and range of motion, without affecting muscle performance during maximal strength and power actions, but favouring recovery perception and decreasing delayed-onset muscle soreness. Some positive effects on agility and very short-range high-speed actions were identified, as well. In conclusion, although there is little evidence of its method of application due to the heterogeneity in that regard, according to our findings, SMR could be used as an intervention to improve athletes' perceptual recovery parameters, in addition to flexibility and range of motion, without negatively affecting muscle performance.
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Affiliation(s)
- Luis Manuel Martínez-Aranda
- Physical and Sports Performance Research Centre, Faculty of Sports Sciences, Pablo de Olavide University, 41013 Seville, Spain
- SEJ-680: Science-Based Training (SBT) Research Group, Faculty of Sports Sciences, Pablo de Olavide University, 41013 Seville, Spain
| | - Manuel Sanz-Matesanz
- Faculty of Sport, Catholic University of Murcia, Guadalupe, 30107 Murcia, Spain; (M.S.-M.); (E.D.G.-M.)
| | | | - Francisco Tomás González-Fernández
- Department of Physical Education and Sports, Faculty of Education and Sport Sciences, Campus of Melilla, University of Granada, 52006 Melilla, Spain;
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Kasahara K, Konrad A, Murakami Y, Yoshida R, Thomas E, Nakamura M. Acute Effects of Different Foam Roller Intervention Techniques on Knee Extensors. J Sports Sci Med 2023; 22:681-687. [PMID: 38045736 PMCID: PMC10690504 DOI: 10.52082/jssm.2023.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/03/2023] [Indexed: 12/05/2023]
Abstract
The usefulness of Foam Roller (FR) even without a rolling stimulus (e.g., static compression with or without dynamic joint movements) has been recently demonstrated; however, the different effects of these methods remain unclear. Thus, this study aimed to compare and investigate the effects of such FR intervention methods on knee extensors. The dominant knee extensors of 20 male university students were investigated using the following four conditions: control (CON), FR with rolling (FR_rolling), FR with static compression (FR_SC), and FR with static compression + dynamic movement of the knee joint (FR_DM). FR_SC was intervened to compress the muscle belly of the knee extensors. FR_DM involved knee flexion and extension while maintaining the FR_SC condition. Knee flexion ROM, pain pressure threshold (PPT), tissue hardness, and countermovement jump (CMJ) height were outcome variables; they were compared before and immediately after the intervention. The results of this study showed that knee flexion ROM was significantly (p < 0.01) increased in FR_rolling (d = 0.38), FR_SC (d = 0.28), and FR_DM (d = 0.64). Tissue hardness was significantly (p < 0.01) decreased in FR_rolling (d = -0.55), FR_SC (d = -0.28), and FR_DM (d = -0.42). A main effect of time (p < 0.01) was observed in knee flexion ROM, PPT, and tissue hardness, but no change in CMJ was observed. The results of this study suggested that clinicians and athletes could choose any method they like as a warm-up routine.
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Affiliation(s)
- Kazuki Kasahara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Yuta Murakami
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Riku Yoshida
- Maniwa Orthopedic Clinic, Yamakido, Higashi-Ku, Niigata, Japan
| | - Ewan Thomas
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University Kanzaki, Saga, Japan
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Konrad A, Nakamura M, Warneke K, Donti O, Gabriel A. The contralateral effects of foam rolling on range of motion and muscle performance. Eur J Appl Physiol 2023; 123:1167-1178. [PMID: 36694004 PMCID: PMC10191906 DOI: 10.1007/s00421-023-05142-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023]
Abstract
A single bout of foam rolling (FR) can acutely increase joint range of motion (ROM) without detrimental effects on subsequent muscle performance. Similarly, long-term FR training can increase ROM, while muscle performance seems to be unaffected. Although the acute and long-term effects of FR on the treated muscle are understood, the impact of FR on the contralateral side is not well known. Therefore, this scoping review aims to summarize the current evidence on the acute and long-term effect of FR on the ipsilateral limb on ROM and muscle performance (i.e., maximum force, rate of force development, jump height) for the contralateral (non-treated) limb. Potential explanatory mechanisms are also discussed. There is evidence that a single bout of FR on the ipsilateral limb increases ROM of the contralateral limb; however, evidence is limited for long-term effects. The most likely mechanism for contralateral ROM increases is a reduced perception of pain. With regard to isolated muscle contractions, no changes in muscle performance (i.e., maximum voluntary isometric contraction, maximum voluntary dynamic contraction) were found in the contralateral limb after a single bout of FR on the ipsilateral limb. Notably, only one study reported large impairments in rate of force development of the contralateral limb following FR on the ipsilateral leg, possibly due to decreased motor unit recruitment. Furthermore, to date there are only two studies examining the long-term FR training of the ipsilateral limb on performance (i.e., maximal strength and jump performance) which reported moderate improvements. Although, trivial to very large changes on a variety of parameters were found in this study, the functional and practical relevance of our findings should be interpreted with caution.
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Affiliation(s)
- Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010, Graz, Austria.
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, Ozaki, Kanzaki, Saga, Japan
| | - Konstantin Warneke
- Institute for Exercise, Sport and Health, Leuphana University, Lüneburg, Germany
| | - Olyvia Donti
- Sports Performance Laboratory, School of Physical Education and Sport Science, National and Kapodistrian, University of Athens, Athens, Greece
| | - Anna Gabriel
- Professorship for Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany
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Warneke K, Aragão-Santos JC, Alizadeh S, Bahrami M, Anvar SH, Konrad A, Behm DG. Are Acute Effects of Foam-Rolling Attributed to Dynamic Warm Up Effects? A Comparative Study. J Sports Sci Med 2023; 22:180-188. [PMID: 37293416 PMCID: PMC10244996 DOI: 10.52082/jssm.2023.180] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/09/2023] [Indexed: 03/22/2023]
Abstract
Over the last decade, acute increases in range of motion (ROM) in response to foam rolling (FR) have been frequently reported. Compared to stretching, FR-induced ROM increases were not typically accompanied by a performance (e.g., force, power, endurance) deficit. Consequently, the inclusion of FR in warm-up routines was frequently recommended, especially since literature pointed out non-local ROM increases after FR. However, to attribute ROM increases to FR it must be ensured that such adaptations do not occur as a result of simple warm-up effects, as significant increases in ROM can also be assumed as a result of active warm-up routines. To answer this research question, 20 participants were recruited using a cross-over design. They performed 4x45 seconds hamstrings rolling under two conditions; FR, and sham rolling (SR) using a roller board to imitate the foam rolling movement without the pressure of the foam rolling. They were also tested in a control condition. Effects on ROM were tested under passive, active dynamic as well as ballistic conditions. Moreover, to examine non-local effects the knee to wall test (KtW) was used. Results showed that both interventions provided significant, moderate to large magnitude increases in passive hamstrings ROM and KtW respectively, compared to the control condition (p = 0.007-0.041, d = 0.62-0.77 and p = 0.002-0.006, d = 0.79-0.88, respectively). However, the ROM increases were not significantly different between the FR and the SR condition (p = 0.801, d = 0.156 and p = 0.933, d = 0.09, respectively). No significant changes could be obtained under the active dynamic (p = 0.65) while there was a significant decrease in the ballistic testing condition with a time effect (p < 0.001). Thus, it can be assumed that potential acute increases in ROM cannot be exclusively attributed to FR. It is therefore speculated that warm up effects could be responsible independent of FR or imitating the rolling movement, which indicates there is no additive effect of FR or SR to the dynamic or ballistic range of motion.
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Affiliation(s)
- Konstantin Warneke
- Institute for Exercise, Sport and Health, Leuphana University, Lüneburg, Germany
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - José Carlos Aragão-Santos
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
- Health Sciences Graduate Program, Federal University of Sergipe, São Cristóvão, Brazil
| | - Shahab Alizadeh
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
- Department for Kinesiology, University of Calgary, Canada
| | - Mahdi Bahrami
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Saman Hadjizadeh Anvar
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - David G Behm
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
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10
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Behm DG, Aragão-Santos JC, Korooshfard N, Anvar SH. Alternative Flexibility Training. Int J Sports Phys Ther 2023; 18:285-287. [PMID: 37020433 PMCID: PMC10069383 DOI: 10.26603/001c.73311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Over the last approximately 20 years, research has reported on performance impairments following prolonged durations of static stretching. This has led to a paradigm shift towards dynamic stretching. There has also been a greater emphasis using foam rollers, vibration devices, and other techniques. Recent commentaries and meta-analyses suggest that stretching need not be listed as a fitness component as other activities such as resistance training can provide similar range of motion benefits. The commentary aims to review and compare the effects of static stretching and alternative exercises for improving range of motion.
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Affiliation(s)
- David G Behm
- School of Human Kinetics and Recreation Memorial University of Newfoundland
| | - Jose Carlos Aragão-Santos
- School of Human Kinetics and Recreation Memorial University of Newfoundland
- Universidade Federal de Sergipe
| | - Negar Korooshfard
- School of Human Kinetics and Recreation Memorial University of Newfoundland
- Department of Sport Sciences, Faculties of Educational Science and Psychology University of Shiraz
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Yokochi M, Nakamura M, Iwata A, Kaneko R, Watanabe S, Konrad A, Yamada N. A 1-Week Comprehensive Foam Rolling Intervention Program Can Improve Knee Pain but Not Muscle Function and Range of Motion in Patients with Total Knee Arthroplasty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3351. [PMID: 36834043 PMCID: PMC9961826 DOI: 10.3390/ijerph20043351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
We investigate the effect of a 1-week comprehensive foam rolling (FR) intervention program on knee pain, range of motion (ROM), and muscle function in patients with TKA.Thirty patients with TKA were randomly allocated to FR (n = 15) or control (n = 15) groups. The control group received only regular physical therapy. Patients in the FR group performed the FR intervention in addition to their regular physical therapy twice daily from postoperative weeks two to three (60 s × 3 repetitions × 2 times/day × 6 days: total = 2160 s). Pain score, knee flexion and extension ROM, muscle strength, walking function, and balance function were measured before and after the FR intervention. From the second to third postoperative weeks, there were significant improvements in all variables, and the reduction in pain score at stretching was significantly greater in the FR group (-26.0 ± 1.4; p < 0.05) than in the control group (-12.5 ± 1.9). However, there was no significant difference in changes in the other variables except for the pain score at stretching between FR and control groups. A 1-week comprehensive FR intervention program in patients with TKA could reduce pain scores at stretching without a synergistic effect on physical function, i.e., walking speed, balance function, and muscle strength of the knee extensors muscles.
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Affiliation(s)
- Masanobu Yokochi
- Department of Rehabilitation, Takeda General Hospital, 3-27 Yamagamachi, Aizuwakamatsu 965-8585, Fukushima, Japan
- Department of Rehabilitation, Fukushima Medical University, 1 Hikarigaoka, Fukushima City 960-1295, Fukushima, Japan
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, 4490-9 Ozaki, Kanzaki 842-8585, Saga, Japan
| | - Ayaka Iwata
- Department of Rehabilitation, Takeda General Hospital, 3-27 Yamagamachi, Aizuwakamatsu 965-8585, Fukushima, Japan
| | - Ryota Kaneko
- Department of Rehabilitation, Takeda General Hospital, 3-27 Yamagamachi, Aizuwakamatsu 965-8585, Fukushima, Japan
| | - Shiho Watanabe
- Department of Rehabilitation, Takeda General Hospital, 3-27 Yamagamachi, Aizuwakamatsu 965-8585, Fukushima, Japan
| | - Andreas Konrad
- Institute of Human Movement Science, Sport and Health, Graz University, Mozartgasse 14, 8010 Graz, Austria
| | - Noboru Yamada
- Department of Orthopaedic Surgery, Takeda General Hospital, 3-27 Yamagamachi, Aizuwakamatsu 965-8585, Fukushima, Japan
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Pérez-Bellmunt A, Casasayas-Cos O, Ragazzi P, Rodríguez-Sanz J, Hidalgo-García C, Canet-Vintró M, Caballero-Martínez I, Pacheco L, López-de-Celis C. Foam Rolling vs. Proprioceptive Neuromuscular Facilitation Stretching in the Hamstring Flexibility of Amateur Athletes: Control Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1439. [PMID: 36674197 PMCID: PMC9861030 DOI: 10.3390/ijerph20021439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND the use of stretching techniques in the sports world is frequent and common thanks to their many effects. One of the main benefits of stretching is an increased range of motion (ROM). Recently, the use of a foam roller has spread in sports practice due to benefits that are similar to those of shoes observed in stretching. The objective of the following study was to compare the results of proprioceptive neuromuscular facilitation stretching (PNF) with foam rolling (FR). METHODS The design of the study was a single-blind, randomized controlled trial (clinicaltrial.gov NCT05134883), and the participants were 80 healthy young athletes. The range of motion was evaluated with a modified sit-and-reach test before, during (at 30 s), and at the end of the intervention (at 2 min). The subject's discomfort sensation was measured using the Borg scale. Effect sizes were calculated using Cohen's d coefficient. Volunteers were randomized into the PNF group or FR group. RESULTS the differences were statistically significant (p < 0.001) during the intervention in favor of PNF group. The differences at the end of intervention showed that the PNF group had a greater increase in flexibility, with this difference being statically significant (p < 0.001). The sensation of perceived exertion with PNF at the end of the intervention was similarly classified as moderate for both groups. CONCLUSION Despite the fact that the use of FR is spreading in the field of sports and rehabilitation, the results of the present study suggest that the gain in flexibility in the hamstrings is greater if PNF-type stretches are used instead of FR.
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Affiliation(s)
- Albert Pérez-Bellmunt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Oriol Casasayas-Cos
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Paolo Ragazzi
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Jacobo Rodríguez-Sanz
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - César Hidalgo-García
- Departamento de Fisiatría y Enfermería, Unidad de Investigación en Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain
| | - Max Canet-Vintró
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Iván Caballero-Martínez
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Laura Pacheco
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Sant Cugat del Vallès, Spain
| | - Carlos López-de-Celis
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08017 Sant Cugat del Vallès, Spain
- ACTIUM Functional Anatomy Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
- Institut Universitari per a la Recerca a I’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
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Desai P, Jungmalm J, Börjesson M, Karlsson J, Grau S. Effectiveness of an 18-week general strength and foam-rolling intervention on running-related injuries in recreational runners. Scand J Med Sci Sports 2023; 33:766-775. [PMID: 36630577 DOI: 10.1111/sms.14313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/21/2022] [Accepted: 01/05/2023] [Indexed: 01/13/2023]
Abstract
RATIONALE More research is needed to uncover the effectiveness of combined strength and foam-rolling interventions to prevent running-related injuries. OBJECTIVES To evaluate effectiveness of an 18-week general strength and foam-rolling intervention on the incidence of running-related injuries. METHOD This is an 18-week observational comparative study. A total of 433 recreational runners participated (n = 203 female). The intervention group (n = 228) performed general strength and foam-rolling exercises twice weekly for 18 weeks, the control group (n = 205) maintained their regular training habits. Running volume and running-related pain were reported weekly. Secondary analyses were performed on the subgroups of the intervention group based on compliance; low compliance (n = 100), intermediate compliance (n = 63), and high compliance (n = 65). Cumulative incidence proportions were calculated and time-to-event statistics were performed to compare survival times between groups. Univariate cox proportional hazards ratio was calculated to estimate the risk of running-related injuries at 18 weeks. RESULTS A total of 100 running-related injuries were sustained. The cumulative incidence proportion for the control and intervention groups was 27.1% (95% CI: 21.4-33.9) and 23.0% (95% CI: 17.8-29.4), respectively. No statistically significant difference was found between the overall intervention group and control group (log-rank p = 0.31). A significant difference existed between the high-compliance subgroup and the control group (log-rank p = 0.00). Highly compliant runners were 85% less likely (hazard rate ratio = 0.15; 95% CI: 0.05-0.46) to sustain an injury during the study compared with controls. CONCLUSION Recreational runners highly compliant with the intervention were 85% less likely and took on average 57 days longer to sustain a running-related injury when compared with controls, with a cumulative incidence proportion of 4.6% after 18 weeks.
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Affiliation(s)
- Pia Desai
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Center for Health and Performance, Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Jonatan Jungmalm
- Center for Health and Performance, Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Mats Börjesson
- Center for Health and Performance, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Jón Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Grau
- Center for Health and Performance, Department of Food and Nutrition and Sport Science, University of Gothenburg, Gothenburg, Sweden
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