Innovative Use of Mouth Props/Bite Blocks in Postoperative Mouth Opening Exercises.

Context: Postoperative jaw physiotherapy in the form of mouth opening exercises is an integral part of surgical treatment in oral submucous fibrosis and temporomandibular joint ankylosis. The literature has outlined multiple physical therapy modalities and modifications to aid in assisted mouth-opening exercises. Purpose: To overcome shortcomings associated with the use of conventional devices, the authors describe an innovative use and modification of a prefabricated soft silicone bite block/mouth prop as an adjunct to the devices to aid in achieving optimal mouth opening.

Does the sequence of plyometric and dynamic stretching exercises influence subsequent sprint performance? A randomized crossover intervention study.

The objectives of this study were to evaluate the acute effects of the sequence order of drop jumps (DJ) and dynamic stretching (DS) on sprinting performances in competitive athletes and to investigate the relationships between post-activation performance enhancement (PAPE) in sprint performance and lower limb power. Thirteen male jumpers and sprinters participated in this study (19 ± 2 years; 177 ± 7 cm; 71.7 ± 5.6 kg). Through a randomized crossover design, the athletes were exposed to three different conditions after a standardized warm-up: DS+DJ, DJ+DS, and control. Sprinting performance over 40 m was analysed with consideration of initial (0 to 20 m) and final acceleration (20 to 40 m) phases. The effect of intervention was examined by two-way repeated-measures of ANOVA. Pearson's correlation test was used to determine the association between PAPE during sprinting and jump performance. There was no effect of any factor on 40-m sprint performance. Meanwhile, the performance at 20-40 m was higher after the DS+DJ condition when compared to baseline (8.79 ± 0.43 vs. 8.91 ± 0.35 m/s; p = 0.015). However, the initial acceleration was worsened in the DJ+DS condition when compared to baseline (6.26 ± 0.25 vs. 6.22 ± 0.26 m/s; p = 0.002). There was a negative correlation between CMJ height and the improvement in final acceleration (r = -0.741; p = 0.004). The use of DS prior to DJ is an effective strategy to improve performance in the final acceleration phase (20-40 m). The athletes with lower levels of lower limb power benefited the most from this PAPE strategy.

Efficacy of trigger point injection therapy in noncardiac chest pain: A randomized controlled trial.

Objectives: This study aimed to compare the effects of trigger point injections and stretching exercises in patients with noncardiac chest pain (NCCP) associated with myofascial pain syndrome. Patients and methods: This prospective randomized controlled trial included 50 patients with noncardiac chest pain and trigger points in the pectoralis muscles between October 2019 and June 2020. The patients were randomly assigned to receive trigger point injections into the pectoralis muscles and exercise (n=25; 15 males, 10 females; mean age: 42.8±9.2 years; range, 25 to 57 years) or only perform exercise (n=25; 11 males, 14 females; mean age: 41.8±11.2 years; range, 18 to 60 years). The primary outcome was pain intensity at the first month and three months after the first treatment session, measured using the Visual Analog Scale from 0 to 100. The secondary outcome was the Nottingham Health Profile score. Results: Treatment with stretching exercises and trigger point injection resulted in significant pain reduction compared to stretching exercises alone, and the reduction was persistent at the three-month follow-up (p<0.001). A between-group comparison showed no significant difference in the Nottingham Health Profile (p=0.522). Complications related to the procedure or severe adverse events attributable to treatment were not reported. Conclusion: Trigger point injection combined with stretching exercises is an efficient treatment for noncardiac chest pain related to myofascial pain syndrome compared to exercise treatment alone.

A controlled clinical trial investigating the effects of stretching and compression exercises on electromyography of calf muscles in chronic LBP patients with a deep gluteal syndrome.

BACKGROUND: In deep gluteal syndrome (DGS), the piriformis muscle could impinge the sciatic nerve. The FAIR (flexion adduction internal rotation) test is a provocation test used to identify sciatic nerve irritation caused by this muscle. Compression and stretching exercises are usually prescribed to treat this syndrome. The aim of this study was to compare the effects of these two treatments on surface electromyography (sEMG) of the gastrocnemius and tibialis anterior in patients with low back pain (LBP) and DGS. MATERIALS AND METHODS: Forty-five participants were allocated to three groups of stretching exercise, compression or control. In addition to 15 min of heat and 15 min of electrical nerve stimulation for pain relief, participants in the compression exercise (CE) group received self-compression exercise, those in the stretching exercise (SE) group received self-stretching exercise and those in the control group received no extra interventions. For the two intervention groups, three sets of two minutes of exercise with two minutes of rest in between were applied. The sEMG amplitude values of the gastrocnemius and tibialis anterior muscles of the affected buttock side of any one group while performing the FAIR test were compared to the others. Pain and disability were assessed and the changes were compared between the two groups. RESULTS: After the intervention period, no group demonstrated a change in the sEMG of the gastrocnemius or tibialis anterior muscles (p > 0.05). There was no difference in the change in this variable between groups (Mean difference (95% CI) of gastrocnemius was ranged over= -4.04 to 7.72 (-19.44 to 23.14); p = 0.603); (Mean difference (95% CI) of tibialis anterior muscles was ranged from - 2.44 to -6.43 (-18.28 to 9.31); p = 0.550).; Pain and disability also decreased significantly in all three study groups (p < 0.05). However, only the disability of patients who performed stretching exercises improved compared to the compression exercise group (Mean difference (95% CI) = -12.62 (-20.41 to -4.38); p = 0.009). CONCLUSION: Neither stretching nor compression exercises altered the sEMG of the gastrocnemius and tibialis anterior muscles in patients with DGS. Furthermore, performing stretching exercises improved disability compared to the other interventions. TRIAL REGISTRATION: The trial was retrospectively registered in the Iranian Registry of Clinical Trials ( www.irct.ir ) on 10/01/2017 as IRCT201604178035N4. URL of the record: https://en.irct.ir/trial/8473 .

Comparison of the acute effects of different techniques on the ankle joint range of motion in healthy older adults: a randomized controlled trial.

AIM: This study aimed to compare the acute effects of different methods on ankle joint range of motion (ROM) in older adults. MATERIALS AND METHODS: Seventy-eight older adults were randomly divided into three groups. After the warming-up, static stretching, proprioceptive neuromuscular facilitation (PNF) contract-relax, and roller massage were applied, at the same period. Before application, immediately after, 10 and 20 min after application, ankle joint dorsiflexion ROM was measured in the weight-bearing position. RESULTS: No statistically significant difference between the groups in demographic characteristics and baseline ankle ROM (p = 0.413). In all groups, post-application measurements revealed increased ankle joint motion (p < 0.0125). Groups were compared, and a statistically significant difference between the three groups was found (p < 0.05). There was no significant difference in the change of ROM between the Static Stretching and PNF Stretching Groups in the change of ROM group comparisons (p = 0.089). There was a statistically significant difference in ROM changes Roller Massage Group and both Static Stretching and the PNF Stretching Group (p = 0.001). CONCLUSION: The acute effects of roller massage, on ankle ROM, were superior to static and PNF stretching. The application of roller massage, which was shown to be an effective method for increasing ROM, can be safely applied in physiotherapy programs for older adults.

Pattern of maximum voluntary contraction in patients with temporomandibular disorder before and after speech therapy with and without use of elastic bandages / Padrão de contração voluntária máxima em pacientes com disfunção temporomandibular antes e após terapia fonoaudiológica com e sem uso de bandagem elástica

ABSTRACT Purpose: to verify if there is an electromyographic difference during maximal (maximum) voluntary contraction of the masseter and temporalis muscles in patients with temporomandibular disorders, before and after speech therapy intervention with and without the use of therapeutic elastic bandages. Methods: an analysis of secondary data from a clinical intervention study, carried out with 17 adult volunteers, diagnosed with temporomandibular muscle dysfunction with or without disc displacement with reduction. The Bandage Group received manual therapy associated with elastic bandages and the No Bandage Group received only manual therapy. Surface electromyography was performed to record the Maximum Voluntary Contraction before and after four weeks of speech therapy intervention. For exploratory analysis, the Mann Whitney and Wilcoxon paired tests were used, with P<0.05. Results: in the Bandage Group, there was a statistically significant decrease in electrical activity during Maximum Voluntary Contraction in the masseter and temporalis muscles on the left side at the post-therapeutic moment. Comparing the pre- and post-intervention between Bandage Group and No Bandage Group, a statistical difference was found in the electrical activity values of the Maximum Voluntary Contraction in the left temporal muscle. Conclusion: manual myofunctional speech therapy, associated or not with the use of therapeutic elastic bandages, impacts the muscle activity of the masseter and temporal muscles during Maximum Voluntary Contraction, whether the values demonstrate relaxation and/or equivalence of the electromyographic values of the masticatory muscles.

RESUMO Objetivo: verificar se há diferença eletromiográfica durante contração voluntária máxima dos músculos masseter e temporal de pacientes com disfunção temporomandibular, antes e após intervenção fonoaudiológica com e sem uso de bandagem elástica terapêutica. Métodos: foi realizada a análise de dados secundários de estudo do tipo intervenção clínica, com 17 voluntárias, adultas, com diagnóstico de disfunção temporomandibular muscular com ou sem deslocamento de disco com redução. O Grupo Bandagem recebeu terapia manual associada à bandagem elástica e o Grupo Sem Bandagem recebeu apenas terapia manual. Foi realizada eletromiografia de superfície para registro da contração voluntária máxima antes e após quatro semanas de intervenção fonoaudiológica. Para análise exploratória foram utilizados os testes: Mann Whitney e Wilcoxon Pareado, com p<0,05. Resultados: no Grupo Bandagem, houve diminuição estatisticamente significante da atividade elétrica durante a Contração Voluntária Máxima nos músculos masseter e temporal do lado esquerdo no momento pós-terapêutico. Na comparação do pré e pós-intervenção entre Grupo Bandagem e Grupo Sem Bandagem, constatou-se diferença estatística nos valores da atividade elétrica de Contração Voluntária Máxima no músculo temporal esquerdo. Conclusão: a terapia fonoaudiológica miofuncional manual, associada ou não ao uso da bandagem elástica terapêutica, impacta a atividade muscular dos músculos masseter e temporal durante a Contração Voluntária Máxima, sejam os valores demonstrando relaxamento e/ou equivalência dos valores eletromiográficos da musculatura mastigatória.

Strategies types on precedent vertical jump stretching / Estrategias sobre los tipos de estiramientos que preceden al salto vertical / Estratégias sobre os tipos de alongamentos que precedem o salto vertical

ABSTRACT Study design: identify a better strategy for static stretching (SS), dynamic stretching (DS), and proprioceptive neuromuscular facilitation (PNF) concerning the performance of their applications in countermovement vertical jump (CVJ). A systematic literature review was conducted in May and June 2021 in the Pubmed/MEDLINE, Scopus, LILACS, SPORTDiscus, and Embase databases. The PRISMA-2020 checklist was used. The Cochrane handbook scale and the Downs and Black scale were used for risk of bias analysis. Seventeen studies were included for qualitative analysis. Motor Unit recruitment and its stimulation frequency favor neural factors and muscle strength performance during contraction. Detailed investigations are necessary on the neural factors that modify the reflex responses and motor control, considering the biological characteristics and plastic deformations. The SS is a negative predictor of vertical jump (VJ) performance. The improvements are reduced when the stretching time is longer than 60 seconds, and when associated with PNF, did not reveal significant results. Using the SS before the DS in short periods of 20 seconds and no more than 60 seconds in the pre-activity to the VJ is suggested. In short stretches, the ROM increased both in the knee and the hip, and the hamstring muscles, when in tension, are unfavorable in sports that frequently use the VJ. Therefore, PNF using the technique that involves a process of contracting and relaxing must be investigated in an isolated and specific way, advocating the antagonist group. Thus, decreasing antagonist strength may be favorable for height gain, although contemporary studies are needed to minimize lower stability and muscle control predictors. Level of Evidence II; Systematic Review Study.

RESUMEN Diseño del estudio: identificar una mejor estrategia de estiramiento estático (EE), estiramiento dinámico (ED) y facilitación neuromuscular propioceptiva (FNP) en relación con el rendimiento de sus aplicaciones en salto vertical con contramovimiento (SCM). Se realizó una revisión sistemática de la literatura en mayo y junio de 2021, en las bases de datos Pubmed/MEDLINE, Scopus, LILACS, SPORTDiscus y Embase. Se utilizó la checklist PRISMA-2020. Para el análisis del riesgo de sesgo se utilizaron la Cochrane handbook y la escala de Downs y Black. Se incluyeron 17 estudios para el análisis cualitativo. El reclutamiento de Unidad Motora y su frecuencia de estimulación favorece los factores neurales y el desempeño de la fuerza muscular durante la contracción. Son necesarias investigaciones detalladas sobre los factores neurales que modifican las respuestas reflejas y el control motor considerando las características biológicas y las deformaciones plásticas. El EE es un predictor negativo para el rendimiento de la salto vertical (SV) y las mejoras se reducen cuando el tiempo de estiramiento es mayor a 60 segundos, y cuando se asocia con FNP no revela resultados significativos. Se sugiere utilizar el EE antes del ED en periodos cortos de 20 segundos y no más de 60 segundos en la preactividad al SV. En tramos cortos, la gama de movimientos se incrementó tanto en la rodilla como en la cadera, y los músculos isquiotibiales, cuando están en tensión, son desfavorables en deportes que utilizan frecuentemente el SV. Por tanto, la FNP mediante la técnica que implica un proceso de contracción y relajación debe investigarse de forma aislada y específica, preconizando el grupo antagonista. Por lo tanto, la disminución de la fuerza del antagonista puede ser favorable para la ganancia de altura, aunque se necesitan estudios contemporáneos para minimizar los predictores de menor estabilidad y/o control muscular. Nível de Evidencia II; Estudio de Revisión Sistematica.

RESUMO Design do estudo: identificar uma melhor estratégia de alongamento estático (AE), Alongamento dinâmico (AD) e facilitação neuromuscular proprioceptiva (FNP) em relação ao rendimento de suas aplicações no salto vertical contramovimento (SCM). Desenvolveu-se uma revisão sistemática da Literatura nos meses de maio e junho de 2021, nas bases de dados Pubmed/MEDLINE, Scopus, LILACS, SPORTDiscus e Embase. Utilizou-se o checklist PRISMA-2020. Para análise de risco de viés utilizou-se a escala do Cochrane handbook e a escala de Downs and Black. 17 estudos foram incluídos para análise qualitativa. O recrutamento da Unidade Motora e a sua frequência de estimulações favorecem os fatores neurais e o desempenho da força muscular durante a contração. Investigações circunstanciadas são necessárias sobre os fatores neurais que modificam as respostas reflexas e controle motor considerando as características biológicas e deformações plásticas. O AE é um preditor negativo para o desempenho do salto vertical (SV) e, as melhorias são reduzidas quando o tempo de alongamento é superior a 60 segundos, e quando associado a FNP não revelou resultados significativos. Sugere-se a utilização do AE antes do AD em períodos curtos de 20 segundos e não mais que 60 segundos na pré-atividade ao SV. Nos alongamentos curtos a gama de movimentos aumentou tanto no joelho quanto no quadril e, a musculatura isquiotibial, quando em tensão, é desfavorável em esportes que utilizam frequentemente o SV. Portanto, a FNP com a utilização da técnica que envolve um processo de contrair e relaxar deve ser investigada de forma isolada e específica preconizando o grupo antagonista. Desta forma, diminuir a força do antagonista pode ser favorável para o ganho de altura, embora estudos atualizados sejam necessários para minimizar os preditores de menor estabilidade e/ou controle muscular. Nível de evidência II; Estudo de Revisão Sistemática.

Comparison of instrument-assisted soft tissue mobilization and proprioceptive neuromuscular stretching on hamstring flexibility in patients with knee osteoarthritis.

Background: The association between hamstring tightness and knee osteoarthritis (KOA) is significant because tight hamstrings can put more strain on the knee joint, reduce its range of motion, and cause compensatory movements that worsen the KOA. Objective: To compare the effects of instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular (PNF) on hamstring flexibility in patients with KOA. Methods: Data for the randomized controlled trial (NCT05110326) was collected from n = 60 participants randomly divided into group A received IASTM and group B received PNF stretching. In group A, the therapist made 30 strokes gentle strokes with the tool from the origin to the insertion while holding the plane at a 45-degree angle over the treatment area. In group B, PNF stretching was done with three repetitions and 10 seconds rest between each, after isometric contraction of the hamstring muscle using approximately 50% of their maximum strength, holding it for 8 seconds, and then releasing it. A 30-minute session was given to each patient three times per week and was given for 6 weeks. Outcome measures were the visual analog scale (VAS) for pain intensity, the active knee extension test (AKET) for hamstring flexibility, and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) for the health status of KOA patients. Results: The study found a significant interaction (p < 0.001) between interventions and time across several measurements. After 6 weeks, both interventions resulted in significant improvements (p < 0.001) across all dependent variables, with group A (IASTM) showing more significant improvement in hamstring flexibility, pain reduction, and health status (p < 0.001) compared to group B (PNF). Conclusions: Both the IASTM technique and PNF stretching resulted in increased hamstring flexibility, decreased pain, and enhanced general health. The IASTM technique, however, showed potential benefits over PNF stretching in terms of flexibility, pain relief, and public health enhancement. Physical therapists and manual therapists may prioritize the usage of the IASTM technique for patients who want to make significant changes in these areas.

Comparative effects of lymphatic drainage and soft tissue mobilization on pain threshold, shoulder mobility and quality of life in patients with axillary web syndrome after mastectomy.

PURPOSE: The purpose was to compare the effects of manual lymphatic drainage and soft tissue mobilization on pain threshold, shoulder mobility and quality of life in patients with axillary web syndrome. METHODS: This randomized clinical trial was conducted on 36 breast cancer patients with developed axillary web; participants were randomly divided into two groups. One group was treated with manual lymphatic drainage; the other group was treated with soft tissue mobilizations in addition to therapeutic exercises, i.e., stretching, strengthening and range of motion (ROM) exercises. The duration of treatment was four weeks (5 sessions/week), with therapeutic exercises as a common treatment protocol. Outcome measures were Breast-Cancer specific quality of life questionnaires, Disabilities of the Arm, Shoulder and Hand (DASH), Numeric Pain Rating Scale (NPRS), Patient Specific Functional Scale (PSFS), Dynamometer and Goniometer. All outcome measure readings were recorded at baseline and the end (4th week) of the treatment. RESULTS: The compliance of the variable distribution with normal distribution was verified using the Shaphiro-Wilk test. Parametric tests were applied, and both groups showed significant effects (p < 0.05) in pairwise comparison (paired t-test). The comparison group analysis (independent t-test) showed that there was no significant difference in pain, upper limb strength, range of motions and fatigue component of quality of life questionnaire parameters (p > 0.05). Two parameters (DASH, PSFS) and one component of the quality of life questionnaire (global health) showed a significant difference (p < 0.05). CONCLUSION: Manual lymphatic drainage showed more improvement in functional movements. It was concluded that both groups, manual lymphatic drainage and soft tissue mobilization groups were clinically equally effective. TRIAL REGISTRATION NUMBER: This trial is registered at ClinicalTrial.gov PRS under trial number NCT05463185 on date 18/07/2022.

Does elastic taping on soles improve flexibility? A randomized controlled trial with equivalence test design.

BACKGROUND: Elastic taping that applies shear force affects joint movement. However, it remains uncertain whether elastic taping or stretching is more effective in improving flexibility. OBJECTIVE: We investigated whether elastic taping for flexibility improvement is comparable to traditional stretching. METHODS: In this randomized controlled trial, 64 university students were randomly allocated to two groups: elastic taping on the sole or 30 s of static stretching. The primary outcome measures were the straight leg raising angle, tested with an equivalence margin (± 9.61∘ on changes), and the fingertip-to-floor distance. Secondary outcomes were the hip flexor and knee extensor strength, two-step distance, adverse events, and pain intensity during the intervention, which were compared using conventional statistical methods. RESULTS: The mean differences in straight leg raising between the two groups after the interventions were not greater than the equivalence margin (mean [95% CI]: 1.4 [-6.9, 9.5]; equivalence margin, -9.61∘ to 9.61∘). There were no consistent differences between groups in terms of secondary outcomes except for pain intensity during the intervention (p> 0.05). Elastic taping did not induce pain. CONCLUSION: Elastic taping augments the flexibility-improving effect comparable to static stretching, based on an equivalence margin. Elastic taping of the sole appears to be an alternative method of improving flexibility.

Dynamic and static stretching on hamstring flexibility and stiffness: A systematic review and meta-analysis.

Introduction: Hamstring injuries are one of the most common types of damage in sports. Insufficient flexibility and high stiffness are important reasons for it. Stretching is often used in warm-up activities before exercises to increase flexibility, among which dynamic stretching (DS) and static stretching (SS) are the most widely used. The effects of these two stretching techniques on the flexibility or stiffness of the hamstring still need to be clarified. Objective: This study aimed to compare the short-term, medium-term, and long-term effects of DS and SS on improving hamstring flexibility and stiffness via a meta-analysis of RCTs. Methods: RCTs were identified from PubMed, Cochrane Library, Web of Science, and PEDro from inception to July 28, 2022. The methodological quality was evaluated using the PEDro scale. The mean difference and 95% confidence interval of the outcome variables before and after stretching were calculated and the extracted data were quantitatively processed using a random or fixed effects model. Results: A total of 27 RCTs and 606 participants were included. In terms of improving the ROM of the hamstring, there was no significant difference in the acute (MD, -0.70, 95% CI, -1.54 to 0.14; Z = 1.63, P > 0.05) and sub-acute effects (MD, 1.71, 95% CI, -2.80 to 6.22; Z = 0.74, P > 0.05) between a single bout of SS and DS, while the acute (MD, -5.13, 95% CI, -7.65 to -2.61; Z = 3.99, P < 0.05) and sub-acute effects (MD, -5.30, 95% CI, -6.33 to -4.27; Z = 10.04, P < 0.05) of multiple bouts of SS was superior to DS; There was no significant difference in the medium-term effect between the two stretching techniques (MD, 3.48, 95% CI, -2.57 to 9.53; Z = 1.13, P > 0.05), but the long-term effect of SS was better than DS (MD, - 10.40, 95% CI, -10.97 to -9.83; Z = 35.57, P < 0.05). Regarding the length of the hamstring, the acute (MD, -0.41, 95% CI, -1.09 to 0.26; Z = 1.20, P > 0.05) and sub-acute effects (MD, -0.73, 95% CI, -1.69 to 0.22; Z = 1.51, P > 0.05) of a single bout of DS and SS were similar. Two studies have compared the effects on hamstring stiffness, with one showing similar effects, and the other showed that DS was superior to SS. One study showed no difference in the magnitude of change in improving passive torque. No studies explored the effect of DS and SS on hamstring myofascial length. Only one study demonstrated no significant difference in hamstring thickness. Conclusions: A single bout of DS and SS have similar short-term effects in improving hamstring ROM and length, while multiple bouts of SS can significantly improve hamstring ROM compared to DS. DS and SS showed similar effects on hamstring myofascial length.

Comparing Different Stretching Exercises on Pain, Stiffness, and Physical Function Disability in Older Adults With Knee Osteoarthritis.

OBJECTIVE: To assess and compare the effects of different stretching exercise programs on pain, stiffness, and physical function disability in older adults with knee osteoarthritis (KOA). DATA SOURCES: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline for network meta-analysis (NMA). Relevant randomized controlled trials were identified by searching 7 databases up to December 2022. STUDY SELECTION: Inclusion criteria included (1) older adults with KOA; (2) intervention included stretching exercises; (3) control groups received no stretching exercise; and (4) outcome measurements included pain, stiffness, or physical function disability. Methodological quality was assessed using the Cochrane risk-of-bias tool for randomized trials version 2. DATA EXTRACTION: NMA was performed using R and MetaInsight, with results presented as a standardized mean difference (SMD) with 95% confidence interval (CI). DATA SYNTHESIS: We examined 17 studies, and NMA results indicated that proprioceptive neuromuscular facilitation (PNF) stretching, mind-body exercises, and multi-component exercise programs were effective in mitigating pain in older adults with KOA (SMD=2.54 [95% CI: 1.23; 3.84], SMD=1.09 [95% CI: 0.27; 1.92], SMD=0.57 [95% CI: 0.06; 1.09]). Moreover, mind-body exercises and multi-component exercises were the most effective programs in reducing stiffness (SMD=1.31 [95% CI: 0.12; 2.51]) and physical function disability (SMD=1.67 [95% CI: 0.01; 3.33]) in older adults with KOA, respectively. CONCLUSION: Findings suggest that PNF stretching, mind-body exercises, and multi-component exercises can be incorporated into exercise programs to better mitigate pain, stiffness, and physical function disability in older adults with KOA.

Eficacia de la técnica sostener relajar en comparación con el estiramiento dinámico sobre la flexibilidad de los isquiotibiales / Efficacy of the hold-relax technique compared to dynamic stretching on hamstring flexibility / Eficácia da técnica segurar-relaxar comparada ao alongamento dinâmico na flexibilidade dos isquiotibiais

Objetivo: el estiramiento muscular se aplica con el propósito de aumentar el arco de movimiento. Para este propósito se usan diferentes técnicas, entre ellas: la facilitación neuromuscular propioceptiva (FNP) y el estiramiento dinámico, pero aún no se conoce cuál de ellas es más efectiva. El objetivo de esta investigación fue estimar la eficacia de la técnica sostener relajar en comparación con el estiramiento dinámico sobre la flexibilidad de los isquiotibiales en adultos jóvenes sanos. Metodología: ensayo clínico controlado aleatorizado, con enmascaramiento de dos brazos. En el estudio participaron un total de 32 voluntarios adultos jóvenes con edades entre los 18 y 30 años y fueron aleatorizados a dos grupos de intervención FNP (n = 16), dinámico (n = 16). La flexibilidad de la articulación de la rodilla se evaluó mediante el ángulo poplíteo a través de la goniometría. Resultados: los resultados de las medias edad, peso, talla e índice masa corporal son equivalentes, lo que indica grupos comparables entre sí. No se hallaron diferencias entre los grupos de estiramiento en los promedios ajustados -2.09 (IC95% -7.05 a 2.87). Conclusiones: tanto la técnica dinámica como la FNP aumentaron el arco de movimiento de rodilla, ambas técnicas de estiramiento mostraron diferencias con la línea de base. No se encontraron diferencias entre los grupos de estiramiento.

Objective: Muscle stretching is applied with the purpose of increasing range of motion. Different techniques are used for this purpose, including proprioceptive neuromuscular facilitation (PNF) and dynamic stretching, but it is still unclear which one is more effective. The objective of this research was to estimate the efficacy of the hold-relax technique compared to dynamic stretching on hamstring flexibility in healthy young adults. Methodology: Randomized controlled trial with blinding, consisting of two intervention arms. The study included a total of 32 young adult volunteers aged 18 to 30 years, who were randomized into two intervention groups: PNF (n = 16) and dynamic stretching (n = 16). Knee joint flexibility was assessed using the popliteal angle measured with a goniometer. Results: The mean age, weight, height, and body mass index were found to be equivalent, indicating comparable groups. No significant differences were found between the stretching groups in the adjusted means, with a mean difference of -2.09 (95 % CI -7.05 to 2.87). Conclusions: Both dynamic stretching and PNF demonstrated an increase in knee range of motion, with both stretching techniques showing differences from the baseline. No significant differences were found between the stretching groups.

Finalidade: O alongamento muscular é aplicado com a finalidade de aumentar a ampli-tude de movimento. Para tanto, diversas técnicas são utilizadas, dentre elas: facilitação neuromuscular proprioceptiva (FNP) e alongamento dinâmico, mas ainda não se sabe qual delas é mais eficaz. O objetivo desta investigação foi estimar a eficáciada técnica segurar-relaxar em comparação com o alongamento dinâmico na flexibilidade dos isquiotibiais em adultos jovens saudáveis. Metodologia: Ensaio clínico randomizado, cego, controlado por dois braços. Um total de 32 voluntários adultos jovens com idades entre 18 e 30 anos participaram do estudo e foram randomizados para dois grupos de intervenção FNP (n = 16), dinâmico (n = 16). A flexibilidade da articulação do joelho foi avaliada por meio do ângulo poplíteo por goniometria. Resultados: os resultados das médias de idade, peso, altura e índice de massa corporal são equivalentes, o que indica grupos comparáveis entre si. Não foram encontradas dife-renças entre os grupos de alongamento nas médias ajustadas - 2,09 (IC 95 % -7,05 a 2,87). Conclusões: tanto a técnica dinâmica quanto o PNF aumentaram a amplitude de mo-vimento do joelho, ambas as técnicas de alongamento apresentaram diferenças com a linha de base. Não foram encontradas diferenças entre os grupos de alongamento.

Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial.

BACKGROUND: Muscle stretching exercises preserve corporal flexibility and decrease the retraction and shortening of myofascial and articular structures. These exercises are recommended for the treatment of fibromyalgia (FM). The purpose of the study was to verify and compare the effect of muscle stretching exercises on FM patients based on the global posture reeducation method against segmental muscle stretching exercises, both used in concert with an educational approach rooted in cognitive behavioral therapy. METHODS: Forty adults with FM were randomly allocated into two groups: global and segmental. The two kinds of therapies were performed in 10 individual sessions once a week. Two assessments were made: one at baseline and one at the end of therapy. The primary outcome variable was pain intensity (Visual Analog Scale). The secondary outcome variables were multidimensional pain (McGill Pain Questionnaire), the pain threshold at tender points (dolorimetry), attitudes toward chronic pain (Survey of Pain Attitudes-Brief Version), body posture (Postural Assessment Software Protocol), postural control (Modified Clinical Test of Sensory Interaction on Balance), flexibility (sit-and-reach test), the impact of FM on quality of life (Fibromyalgia Impact Questionnaire, FIQ), and self-reported perceptions and body self-care. RESULTS: At the end of treatment, there were no statistically significant differences between the groups in the outcome variables. Furthermore, the groups presented lower pain intensity (baseline vs. final; global group: 6 ± 1.8 vs. 2.2 ± 1.6 cm, p<0.01; segmental group: 6.3 ± 2.1 vs. 2.5 ± 1.7 cm, p<0.01), higher pain threshold (p ≤ 0.01), lower total FIQ score (p < 0.01), and greater postural control (p < 0.01) after treatment. CONCLUSIONS: Muscle stretching exercises based on global posture reeducation and segmental muscle stretching exercises, both used in concert with an educational approach rooted in cognitive behavioral therapy, reduced the pain intensity and impact of FM on quality of life. These exercises also improved FM patients' pain threshold at tender points, attitudes toward chronic pain, and postural control. There were no differences between global posture reeducation and segmental muscle stretching exercises. TRIAL REGISTRATION: ClinicalTrials.gov NCT02384603 . Registered on 10 March 2015.

Acute effects of a single neurodynamic mobilization session on range of motion and H-reflex in asymptomatic young subjects: A controlled study.

Neurodynamic techniques have yielded good clinical results in the treatment of various pathologies. The objective of this study is to examine the short-term effects of neurodynamic techniques of the sciatic nerve on hip ROM (range of motion) and on the amplitude and latency of the soleus H-reflex and M-waves, in young asymptomatic subjects. In a double-blind controlled trial design, 60 young asymptomatic participants were randomly assigned into six groups with different levels of manipulation of the sciatic nerve. The passive straight leg raise test was used to evaluate the hip ROM amplitude. All evaluations were performed before, 1 min after, and 30 min after intervention. For each time-point, spinal and muscle excitability were also tested. ROM increased in all groups, but none of the treatment groups had superior effects than the group with no treatment. This means that ROM testing maneuvers increased ROM amplitude, with no add-on effect of the proposed neurodynamic techniques. Neurophysiological responses changed similarly in all groups, showing that the aftereffects were not intervention-specific. We observed a significant negative association between the change in limb temperature and the change in latencies of all potentials. ROM-testing procedures performed repeatedly increase ROM amplitude. This observation should be considered when evaluating the aftereffects of therapeutic interventions on ROM amplitude. None of the explored neurodynamic techniques produced acute aftereffects on hip ROM amplitude, spinal or muscle excitability different to the induced by the ROM testing maneuver.

Comparison of utilizing modified hold-relax, muscle energy technique, and instrument-assisted soft tissue mobilization on hamstring muscle length in healthy athletes: Randomized controlled trial.

INTRODUCTION: The hamstring muscle shortness is the primary risk factor for sports-related injuries. Numerous treatments are available for lengthening of hamstring muscle. The main purpose of this study was to compare the immediate effect of modified hold-relax, muscle energy technique (MET), and instrument assisted soft tissue mobilization-Graston techniques (IASTM-GT) on length of hamstring muscle in young healthy athletes. METHODS: 60 athletes comprising of 29 females and 31 males were recruited in the present study. Participants were allocated to 3 groups of IASTM-GT (N = 20, 13 male, 7 female), Modified Hold-relax (N = 20, 8 male, 12 female), and MET (N = 20, 7 male, 13 female). Active knee extension and passive straight leg raising (SLR), and toe touch test were performed before and immediately after the intervention by a blinded assessor. For the comparison of dependent variables across time, 3*2 repeated measure ANOVA was utilized. RESULTS: Interaction of group by time was significant for passive SLR (P < 0.001). Interaction of group by time was not significant for active knee extension (P = 0.17). The results showed that dependent variables increased significantly in all groups. The effect size (Cohen's d) in the groups of IASTM-GT, modified Hold-relax, and MET was 1.7, 3.17, and 3.12, respectively. CONCLUSION: Although the measures were improved in all groups, it seems that IASTM-GT can be used as a safe and efficient treatment, which can be a suitable candidate alongside modified hold-relax and MET for increasing the hamstrings muscle length in healthy athletes.

Effects of stretching intervention on musculoskeletal pain in dental professionals.

OBJECTIVE: This study aimed to quantitatively confirm the effects of dental specialists' work and stretching on musculoskeletal pain. METHODS: The pain pressure threshold was divided into five parts (neck, shoulder, trunk, lower back, and hand/arm) of the upper body and measured at 15 muscle trigger points. The pain pressure threshold before and after work was measured, and 30 min of stretching and rest were stipulated as an intervention. RESULTS: The pain pressure thresholds reduced significantly in all muscles after work (P < .05). In the stretching group, the pain pressure thresholds increased significantly in all muscles (P < .05). In particular, the iliocostalis lumborum (lower back), rhomboid (trunk), transverse carpal ligament (hand/arm), levator scapulae-superior angle (neck), and upper trapezius (shoulder) muscles showed the greatest decrease in pain pressure threshold after work and the greatest increase after stretching. CONCLUSIONS: Stretching helps immediately relieve musculoskeletal pain in dental professionals and can prevent and manage work-related musculoskeletal disorders.

Bilateral Idiopathic Carpal Tunnel Syndrome: Clinical-Functional Characterization and Efficacy of Two Combined Postoperative Physiotherapeutic Treatments.

OBJECTIVE: To evaluate the efficacy of combined association instrument myofascial mobilization (IASTM) and stretching in patients with idiopathic bilateral carpal tunnel syndrome (CTS) operated on one hand and to analyze the response of the operated (OH) and non-operated (NH) hand according to the sequence of therapies. Research on these parameters has not yet been found in the literature. METHODS: Randomized controlled crossover study with 43 participants using the objective and subjective outcome variables. Patients were randomly assigned to two groups: starting with stretching followed by IASTM and starting with IASTM followed by stretching. Then patients underwent surgery on the hand with more severe involvement and physical therapy rehabilitation was started 30 days after for a period of 4 weeks. After the 1-week interval the participants who started with stretching were referred to IASTM and vice versa, following the same previous patterns. The outpatient reassessments took place at 3 to 6 months. Crossover ANOVA and effect sizes were used as analysis methods. RESULTS: Time was the most significant outcome for all variables both during therapies and at 6-month follow-up. Regarding response to the combined therapies between OH and NH, there were differences for both OH and NH, with the greatest impact on NH for the palmar grip and VAS variables. The treatment sequences were significant for pain on the NH and mental SF-12, suggesting that starting with IASTM followed by stretching had a superior outcome for these outcomes. CONCLUSION: The combination of IASTM with stretching, used in the postoperative period of bilateral idiopathic CTS, proved to be supplementary, with significant results and large effect sizes for most of the outcomes assessed, both during the time of application of the therapies and in the 6-month follow-up for both hands, and may constitute a viable therapeutic alternative for this population.

Effect of Core Stability Training on Postpartum Mother's Sexual Desire.

Background: Women may experience different problems in every aspect of their sexual life throughout their lives; therefore, it is essential to check women's sexual health and try to improve it. The present research aims to assess core stability trainings on postpartum mothers' sexual desire. Materials and Methods: This quasi-experimental research was conducted by random sampling on 72 mothers who referred to comprehensive health centers in Isfahan in 2019 in postpartum period. The samples were divided into experimental and control groups by random placement method (blocking). Core stability exercises were performed in the experimental group for 24 sessions. The demographic questionnaire and Female Sexual Function Index (FSFI) were filled out in two stages (before and one month after the intervention) by the samples, and the data were analyzed by Mann-Whitney, independent t-test, paired t-test, Chi-square. Results: The result of this study showed that the average score of the sexual desire after intervention in the experimental group was significantly higher than that in the control group (p = 0.03). The average score of the sexual desire after the intervention in the experimental group was significantly higher than that before the intervention (p < 0.001). The average scores of the sexual desire before and after the intervention in the control group were not significantly different (p = 0.40). Conclusions: Eight weeks of core stabilization exercises can improve endurance of the pelvic floor muscles and the central part of the body, subsequently promoting females' sexual desire. The findings of this study can be considered in the fields of education, health, clinical, and policy.

Corrigendum: Warm-up stretching exercises and physical performance of youth soccer players.

[This corrects the article DOI: 10.3389/fphys.2023.1127669.].