Long-Term Enhancement of Botulinum Toxin Injections for Post-Stroke Spasticity by Use of Stretching Exercises-A Randomized Controlled Trial.

Botulinum toxin A (BONT/A) injections play a central role in the treatment of upper limb spasticity in stroke patients. We proposed structured stretching exercises to enhance the effect of post-stroke spasticity relief of the upper limbs following BONT/A injections. A total of 43 patients who had a stroke with grade 2 spasticity or higher on the Modified Ashworth Scale (MAS) in their upper-limb muscles were randomly assigned to the intervention (n = 21) or control group (n = 22). The former received structured stretching exercises after their BONT/A injections for 20 min, 5 days per week, for 6 months at a hospital, while the others conducted self-stretching exercises at home. The outcome measures were assessed before the intervention (T0) and after three (T1) and six months (T2). Significantly greater improvements in the MAS scores of the elbows, wrists, and fingers were found in the intervention group's patients at T1 and T2. The behavioral outcome measures, including shoulder pain, activities of daily living, and quality of life, and our electrophysiological studies also showed a significantly higher enhancement in this patient group. In conclusion, the structured stretching exercises plus BONT/A injections for six months showed a superior effect in relieving post-stroke upper-limb spasticity compared to self-stretching exercises.

Regional and widespread pain sensitivity decreases following stretching in both men and women - Indications of stretch-induced hypoalgesia.

INTRODUCTION: This study aimed to investigate the effect of sex on regional and widespread pain sensitivity following acute bouts of stretching and to investigate the acute effect of stretching on regional and widespread pain sensitivity following stretching. METHODS: 73 healthy adults (36 females; mean age 25.6 ± 6.7 years) with an age range from 19 to 62 years were recruited for this experimental study. Regional and distant pain pressure pain thresholds, passive knee extension range of motion and passive resistive torque were measured before and 30 s after four bouts of 30-s static muscle stretching of the knee flexors with 20-s rest between bouts. RESULTS: No significant sex differences were found for pressure pain thresholds (p > 0.132), range of motion (p = 0.446) or passive resistive torque (p = 0.559) between pre-stretch and post-stretch measures. There were significant increases in pressure pain thresholds (p = 0.010), range of motion (p = 0.001) and passive resistive torque (p = 0.007) between pre-stretch and post-stretch measures. CONCLUSION: Muscle stretching significantly decreased regional and widespread pain sensitivity, indicating that central pain-modulating mechanisms are engaged during muscle stretching, resulting in stretch-induced hypoalgesia. Moreover, the results showed that the effect of stretching on regional and widespread pain sensitivity is not sex-specific.

Exercises with the StretchPole improve shoulder joint range of motion.

The 'StretchPole' foam roller product is mainly used to loosen muscle groups and joints in the deeper layers of the body that are normally inaccessible to the human hand, and to realign the skeletal structure by lying on the pole and performing exercises. It is also used to strengthen the core, which plays an important role in postural maintenance and stability. The purpose of this study was to determine the effects of the 'Solacon' exercise routine using a StretchPole on shoulder joint range of motion. Forty healthy participants performed Solacon exercises using a StretchPole. The specific method of Solacon comprises six movements: (1) chest slide, (2) crescent, (3) cone, (4) twister, (5) shoulder alternating rotation, and (6) chin-in exercise. The joint range of motion of the bilateral shoulder joint flexion, abduction, horizontal abduction, and external rotation (1st and 2nd) were measured before and after the exercises. All measures were significantly higher after exercise compared to before exercise. Solacon exercises improve thoracic spine and scapular mobility and stretch the anterior thoracic muscle groups. The shoulder joint in the broad sense consists of the humerus, scapula, clavicle, sternum, and ribs. These in turn constitute the scapulohumeral joint, acromioclavicular joint, sternoclavicular joint, scapulothoracic joint and functional second shoulder joint. In addition, costovertebral joints and intervertebral joints are also involved because of the added motion of the ribs and the spine. We considered that the ranges of motion of shoulder joint flexion, abduction, horizontal abduction, and external rotation measured in this study were expanded.

Acute and Chronic Effects of Static Stretching on Intramuscular Hamstring Stiffness.

Passive hamstring stiffness varies proximo-distally, resulting in inhomogeneous tissue strain during stretching that may affect localized adaptations and risk of muscle injuries. The purpose of the present study was to determine the acute and chronic effects of static stretching (SS) on intramuscular hamstring stiffness. Thirty healthy active participants had acute changes in passive biceps femoris (BF), semimembranosus (SM), and semitendinosus (ST) stiffness measured at 25% (proximal), 50% (middle), and 75% (distal) muscle length, using shear-wave elastography, immediately after SS. Participants then completed 4 weeks of either a SS intervention (n = 15) or no intervention (CON, n = 15) with stiffness measured before and after the interventions. The acute and chronic effects of SS were compared between anatomical regions and between regions on the basis of their relative stiffness pre-intervention. Acutely, SS decreased stiffness throughout the BF and SM (p ≤ 0.05) but not the ST (p = 0.326). However, a regional effect of stretching was observed for SM and ST with greater reduction in stiffness occurring in stiffer muscular regions (p = 0.001-0.013). Chronically, SS increased BF and ST (p < 0.05), but not SM (p = 0.422) stiffness compared with CON, but no regional effect of stretching was observed in any muscle (p = 0.361-0.833). SS resulted in contrasting acute and chronic effects, acutely decreasing stiffness in stiffer regions while chronically increasing stiffness. These results indicate that the acute effects of SS vary along the muscle's length on the basis of the relative stiffness of the muscle and that acute changes in stiffness from SS are unrelated to chronic adaptations.

Effectiveness of novel facial stretching with structured exercise versus conventional exercise for Bell's palsy: a single-blinded randomized clinical trial.

The purpose of the study was to assess the effects of a novel technique involving facial stretching of the unaffected side along with a structured exercise for the affected side on facial symmetry and facial functions as compared to conventional exercise. A hospital-based parallel-group randomized trial was completed among patients with acute Bell's palsy in Mangalore, India. Participants were randomized to receive facial stretching and a structured exercise program (experimental group) or the conventional exercise regimen (conventional group). Primary outcomes were facial symmetry and voluntary movement; assessed by the Sunnybrook Facial Grading System (SFGS). Both regimens were given for 3 weeks, with baseline, 10th day, and 20th day assessments. Out of 31 participants screened, 24 were eligible and 12 participants each were assigned to experimental and conventional groups. Change scores revealed greater improvement in the SFGS score (p = 0.002) for the experimental group participants. Facial stretching and structured exercise program exhibited promising results in enhancing facial symmetry and function in acute Bell's palsy when compared to conventional exercise regimen.

Sustainable effectiveness of kinetic chain stretching on active hip flexion movement and muscle activation for hamstring tightness: A preliminary investigation.

BACKGROUND: Conventional hamstring (HAM) stretching therapeutic effects are not substantiable in neuromusculoskeletal conditions with HAM tightness or shortness. We developed a kinetic chain stabilization exercise to provide a more sustainable effectiveness in adults with HAM tightness. However, its therapeutic effects and underlying motor mechanisms remain unknown. OBJECTIVE: To compare the effects of traditional active HAM stretching (AHS) and kinetic chain stretching (KCS) on electromyographic (EMG) amplitude and hip flexion range of motion (ROM) in participants with HAM tightness. METHODS: In this randomized controlled trial, 18 participants (mean age: 25.01 ± 2.47 years) with HAM tightness were assigned to the AHS or KCS group. Hip joint movement, EMG amplitude, and onset times were recorded in the bilateral erector spinae, HAM, transverse abdominis/internal oblique (IO), external oblique (EO), and rectus abdominis during a straight leg raise test. RESULTS: Compared to AHS, KCS led to greater increase in the hip flexion ROM and EMG activation amplitudes in the left and right EO and left IO. Post-test hip flexion ROM data in both the groups were higher than the pre-test data. CONCLUSION: KCS produced more sustainable effectiveness in hip flexion movement and EMG motor control patterns in participants with HAM tightness than AHS.

Enhanced EEG power density during painful stretching in individuals with cerebral palsy.

BACKGROUND: Pain perception mechanisms in cerebral palsy remain largely unclear. AIMS: This study investigates brain activity in adults with cerebral palsy during painful and non-painful stretching to elucidate their pain processing characteristics. METHODS AND PROCEDURES: Twenty adults with cerebral palsy and 20 controls underwent EEG in three conditions: rest, non-painful stretching, and painful stretching. Time-frequency power density of theta, alpha, and beta waves in somatosensory and frontal cortices was analyzed, alongside baseline pressure pain thresholds. OUTCOMES AND RESULTS: Cerebral palsy individuals exhibited higher theta, alpha, and beta power density in both cortices during painful stretching compared to rest, and lower during non-painful stretching. Controls showed higher power density during non-painful stretching but lower during painful stretching. Cerebral palsy individuals had higher pain sensitivity, with those more sensitive experiencing greater alpha power density. CONCLUSIONS AND IMPLICATIONS: These findings confirm alterations in the cerebral processing of pain in individuals with cerebral palsy. This knowledge could enhance future approaches to the diagnosis and treatment of pain in this vulnerable population.

Acute effect of static stretching and pilates stretching on the concentric muscle strength of the knee extensors and flexors.

INTRODUCTION: The effects of stretching exercises on muscle strength have been widely researched in the literature, however, there are no studies investigating the effects of Pilates stretching. OBJECTIVE: To compare the effects of static stretching and Pilates stretching on the concentric muscle strength of the knee extensors and flexors. METHOD: 102 trained young adults were randomized into three groups: static stretching (n = 33); Pilates stretching (n = 34); control (n = 35). Isokinetic evaluation of the knee extensor and flexor muscles was performed at 60°/s and 180°/s, pre and post acute intervention with stretching. Interventions in the static stretching and Pilates stretching groups occurred in 3 sets x 30 s for each body region considered (a-knee extensor muscles; b-knee flexor muscles). The control group did not perform any intervention. RESULTS: No difference (p > 0.05) was observed between the groups after the intervention. There was only a significant intragroup improvement for the control group on the isokinetic muscle strength of the knee flexors at 180°/s, with a moderate effect size, considering the entire sample (p = 0.040; d = 0.42) and when considering only male gender (p = 0.010; d = 0.60). CONCLUSION: Static stretching or Pilates stretching performed as a warm-up did not impair or enhance the concentric muscle strength performance of the knee extensors and flexors. In this way, both forms of stretching can be considered as preparatory exercises before muscle strength training.

Effects of stretching exercises on muscle tension, fatigue, strength, and lactic acid accumulation: A pre-experimental study among fish transport workers.

Fish transport workers in Indonesia lift loads more than the specified limits, both in weight and frequency. This could cause lactic acid accumulation, fatigue and reduced physical performance. The aim of this study was to assess the effect of stretching intervention on muscle tension, fatigue, strength, and lactic acid level in fish transport workers in Indonesia. A pre-experimental study design with one group (pre- and post-test) design was conducted among male fish transport workers at the Tawang fish auction, Weleri, Central Java, Indonesia, in June 2022 for two weeks. We created a 1.5-minute stretching exercise video based on the University of New Castle's Manual Handling guideline, involving hand, feet, and shoulder movements. Participants performed these exercises independently before and during work every two hours, guided by the video. Data on lactic acid, muscle tension, fatigue, and strength were collected before and after the 2-week intervention. Data analysis was performed using Wilcoxon and paired Student t-tests to compare the outcome between post- and pre-intervention. A total of 18 fish transport workers were included in the study. The results showed a statistically significant increase in lactic acid levels following the intervention (p=0.016). However, the increase in muscle tension was not statistically significant (p=0.292). There was a significant increase in fatigue levels after the intervention (p=0.000). This could suggest that the stretching intervention may have had an unintended effect of increasing fatigue among the participants. On the other hand, there was a statistically significant decrease in muscle strength after the intervention (p=0.003). In conclusion, this study suggests that while stretching exercises can affect lactic acid accumulation, fatigue, and muscle strength, they do not influence muscle tension. Therefore, it is advised for workers to incorporate stretching exercises into their daily routine to mitigate potential injury risks.

Golfers' Performance Is Improved More by Combining Foam Rolling and Dynamic Stretch to the Lead Hip Than Practice Golf Swinging.

ABSTRACT: Hamada, Y, Akasaka, K, Otsudo, T, Sawada, Y, Hattori, H, Kikuchi, Y, and Hall, T. Golfers' performance is improved more by combining foam rolling and dynamic stretch to the lead hip than practice golf swinging. J Strength Cond Res 38(7): e391-e397, 2024-Warming up is considered effective in improving performance and preventing injury. Despite this, there have been few studies investigating warm-up programs in golf and whether specific factors contribute to improved performance. The purpose of this study was to examine the immediate effects of combined foam rolling and dynamic stretch (FR + DS) to the lead hip on golf swing performance, hip range of motion (ROM), and muscle strength in amateur golfers using a randomized crossover design. The study sample comprised 22 men (mean ± SD ; age, 32.6 ± 8.5 years, body mass index (BMI), 23.4 ± 2.7 kg·m -2 ). Subjects were assigned to receive either FR + DS or repetitive golf swing practice (SW) before crossing over to the other intervention for another day. Measurements included golf swing performance (ball speed, club head speed, flight distance ["carry"], spin rate, and launch angle), hip internal rotation (IR), and external rotation (ER) ROM, as well as hip IR and ER muscle strength. Comparisons between groups were made before and after each intervention. For golf swing performance, FR + DS improved "carry" significantly more than SW ( p < 0.05). No significant differences in golf swing performance other than "carry" were found. In addition, IR ROM and IR muscle strength of the lead hip were significantly increased in the FR + DS group ( p < 0.05). FR + DS has effects on improving lead hip IR ROM and IR muscle strength, which may facilitate golfers' swing and "carry." FR + DS shows promise as a warm-up method for amateur golfers who want to improve golf performance.

Restorabite™: Phase II trial of jaw stretching exercises using a novel device for patients with trismus following head and neck cancer.

Patients treated for oral cancer, may experience restricted mouth opening (trismus). Barriers such as cost have limited the utilization of traditional jaw stretching devices, and consequently, patients experience problems with swallowing, oral care, communication, and cancer surveillance. The safety and efficacy of Restorabite™, a new device designed to overcome these barriers, is evaluated prospectively over 12 months. This phase II investigator-led trial included patients with chronic trismus underwent 10-weeks of trismus therapy using Restorabite™. Safety, adherence, changes in mouth opening, and patient-reported outcomes are presented. 114/120 participants with trismus completed the intervention, and 104 had their progress monitored for 12 months. Thirteen participants withdrew due to tumour recurrence. At the completion of the intervention, mouth opening improved by 10.4 mm (p < .001). This increased to 13.7 mm at 12 months (p < .001). Patient reported outcome all significantly improved and 47 participants were no longer classified as having trismus. There were no serious treatment related adverse events. In patients with trismus following head and neck cancer treatment, a 10-week programme of jaw stretching exercises using Restorbite™ safely improves mouth opening and associated quality of life outcomes with high adherence and the benefits are maintained for 12-months.

Effects of different treatments on pain, functional disability, position sense and range of motion in elite bodybuilders with chronic low back pain.

Back pain is one of the major global challenges and is one of the most prevalent musculoskeletal disorders occurring in 80% of people at least once in their lifetime. Therefore, the need to find appropriate treatment methods for this issue is very important. The objective is to examine the short-term and acute effects of a treatment session with dry needling, massage therapy, stretching exercises and Kinesio tape on pain, functional disability, position sense and range of motion in elite bodybuilders with non-specific chronic low back pain. The sample of this quasi-experimental study consisted of 48 bodybuilders with non-specific chronic low back pain (all male, mean age = 25.96 ± 2.18 years; mean weight = 74.45 ± 4.51 kg; mean height = 173.88 ± 3.74 cm; mean BMI = 24.60 ± 0.74 kg/m2) who randomly were placed in 4 dry needling, massage therapy, stretching exercises and Kinesio tape groups. The duration of each intervention was 30 min. The dependent variables in this study included the massage range of motion, position sense tests and visual pain scale that were taken separately from each subject in pretest, posttest (acute effect) and follow-up test (72 h after posttest; short-term effect). The results of a 4 (groups) × 3 (time) the mixed ANOVAs showed that pain in the short-term phase was significantly lower in the dry needling group than in the stretching and massage groups (P < 0.05). Also in the acute effect phase, the flexion range of motion was significantly lower in the dry needling group than in the massage group (P < 0.05). Furthermore, the two groups of stretching and massage exercises showed significantly greater range of motion (P < 0.05). Other comparisons were not significant (P > 0.05). The findings of the study showed that both massage and stretching treatment have higher acute effects, while dry needling treatment was more effective in follow up. On the other hand, these findings show that these treatment methods can have immediate and lasting positive effects in improving the performance in elite bodybuilders with non-specific chronic low back pain.

Effect of Static Stretching on Tendon Hysteresis and Efficiency During Repetitive Jumping.

ABSTRACT: Sasajima, S and Kubo, K. Effect of static stretching on tendon hysteresis and efficiency during repetitive jumping. J Strength Cond Res 38(6): 1041-1047, 2024-To date, no studies have experimentally shown a relationship between tendon hysteresis and exercise efficiency. However, previous studies showed that tendon hysteresis decreased immediately after static stretching. The purposes of this study were to (a) investigate the change in tendon hysteresis during the recovery period after static stretching and (b) determine whether exercise efficiency is enhanced because of the decline of tendon hysteresis after static stretching. For stretching (1 minute × 4 sets) and control conditions, tendon hysteresis was measured during ramp (i.e., lower strain rate of tendon) and ballistic (i.e., higher strain rate of tendon) contractions before, immediately, 15, 30, 45, and 60 minutes after interventions. In addition, electromyograms of the plantar flexor muscles (medial gastrocnemius [MG], lateral gastrocnemius [LG], and soleus muscles [SOL]) and oxygen consumption (V̇O 2 ) were measured during 10 minutes of submaximal repetitive jumping after both interventions. Tendon hysteresis (during ramp and ballistic contractions) reduced by static stretching persisted for up to 60 minutes (effect of time p < 0.001). During repetitive jumping, no differences in electromyograms of the plantar flexor muscles (effect of condition p = 0.786 for MG, p = 0.124 for LG, p = 0.682 for SOL) or V̇O 2 (effect of condition p = 0.534) were found between stretching and control conditions. These results suggest that the reduction in tendon hysteresis because of static stretching continues until 60 minutes after the end of stretching, and static stretching does not change the efficiency (evaluated by electromyograms of the plantar flexor muscles and V̇O 2 ) during submaximal repetitive jumping.

Effective Stretching Positions of the Piriformis Muscle Evaluated Using Shear Wave Elastography.

CONTEXT: Piriformis syndrome is often associated with muscle spasms and shortening of the piriformis muscle (PM). Physical therapy, including static stretching of the PM, is one of the treatments for this syndrome. However, the effective stretching position of the PM is unclear in vivo. This study aimed to determine the effective stretching positions of the PM using ultrasonic shear wave elastography. DESIGN: Observational study. METHODS: Twenty-one healthy young men (22.7 [2.4] y) participated in this study. The shear elastic modulus of the PM was measured at 12 stretching positions using shear wave elastography. Three of the 12 positions were tested with maximum internal rotation at 0°, 20°, or 40° hip adduction in 90° hip flexion. Nine of the 12 positions were tested with maximum external rotation at positions combined with 3 hip-flexion angles (70°, 90°, and 110°) and 3 hip-adduction angles (0°, 20°, and 40°). RESULTS: The shear elastic modulus of the PM was significantly higher in the order of 40°, 20°, and 0° of adduction and higher in external rotation than in internal rotation. The shear elastic modulus of the PM was significantly greater in combined 110° hip flexion and 40° adduction with maximum external rotation than in all other positions. CONCLUSION: This study revealed that the position in which the PM was most stretched was maximum external rotation with 110° hip flexion and 40° hip adduction.

Hamstrings passive and active shear modulus: Implications of conventional static stretching and warmup.

PURPOSE: This study compares the acute effects of a static stretching and a warmup protocol on the active and passive shear modulus of the hamstring muscles. METHODS: Muscle shear modulus was assessed at rest and during isometric contractions at 20 % of maximal voluntary isometric contraction (MVIC). RESULTS: After stretching, the passive shear modulus pattern was not altered, while at 20 % MVIC the biceps femoris short head (BFsh) and semimembranosus showed a shear modulus increase and decrease, respectively, which resulted on BFsh-SM pair differences (pre: 3.8 ±â€¯16.8 vs. post: 39.3 ±â€¯25.1 kPa; p < 0.001; d = 1.66) which was accompanied by a decrease of 18.3 % on MVIC. Following the warmup protocol, passive shear modulus remained unchanged, while active shear modulus was decreased for the semitendinosus (pre: 65.3 ±â€¯13.5 vs. post: 60.3 ±â€¯12.3 kPa; p = 0.035; d = 0.4). However, this difference was within the standard error of measurement (10.54 kPa), and did not impact the force production, since it increased only 1.4 % after the warmup. CONCLUSIONS: The results of this study suggest that the passive and active shear modulus responses of the individual hamstring muscles to static stretching are muscle-specific and that passive and active hamstring shear modulus are not changed by a standard warmup intervention.

Comparison of Dry Needling and Cold-Spray-Stretching Treatments by Ultrasonography and Electrophysiology: Prospective, Randomized Controlled Trial.

OBJECTIVES: To compare the efficacy of dry needling (DN) and cold-spray-stretching treatments using surface electromyography (sEMG) and ultrasound (US) in the treatment of patients with myofascial pain syndrome (MPS) with active trigger point (ATrP) in the upper trapezius muscle. METHODS: This prospective randomized single-blind study included 60 MPS patients aged 18-65 years who have ATrP in the upper trapezius muscle. Patients were randomized into two treatment groups as DN and cold spray stretching. Both treatment groups received 1 treatment per week and totally 3 sessions. Evaluation parameters were pain level assessed by Numeric Rating Scale and algometer, neck range of motion angles, neck disability index (NDI). The effects of the treatments on ATrP were evaluated by sEMG and US histogram. All parameters were evaluated at the beginning of the treatment and at the end. Algometer and sEMG were performed also before and after the first and third sessions. RESULTS: There was no significant difference between the two groups regarding demographic data. The mean age of the participants was 39.7 ± 11.6 years. Fifty-one patients were female. Significant improvement in terms of pain level, functionality, sEMG, and US histogram were achieved in both groups (P < .05). When comparing the two groups, algometer scores and the NDI score were statistically higher in the cold-spray-stretching group than in the DN group (P < .008 and P < .028, respectively). CONCLUSION: Both treatment options should be preferred. The efficacy of both treatments was observed via sEMG and US histograms.

Effects of humeral head stabilization intervention during aggressive manual passive stretching exercises in patients with painful stiff shoulder: a prospective, comparative study.

BACKGROUND: No reports have been published verifying the effects of manual interventions such as humeral head stabilization on improving function and reducing pain when applying aggressive manual passive stretching in patients with painful stiff shoulders. The purpose of this study was to compare clinical outcomes, such as range of motion, pain, and disability scores, in patients with painful stiff shoulders with and without humeral head stabilization intervention while applying aggressive manual passive stretching. METHODS: Fifty-six patients with painful stiff shoulders were recruited (31 with humeral head stabilization intervention and 25 without such intervention). Clinical outcomes such as active range of motion (A-ROM), pain, and disability scores were evaluated using a goniometer; measurement of activity visual analog scale (A-VAS); and Disabilities of the Arm, Shoulder and Hand (DASH) and Shoulder Pain and Disability Index (SPADI), respectively. RESULTS: All the parameters, A-ROM, A-VAS, and disability scores (DASH and SPADI) were not significantly different between the 2 groups (P > .05) before the intervention. However, after the intervention, the mean difference in A-ROM for flexion, abduction, and external and internal rotation was 18 (95% confidence interval [CI], 14.1-21.7), 31 (95% CI, 24.9-37.4), 17 (95% CI, 13.4-21.4), and 16 (95% CI, 11.6-20.9), respectively. The mean difference in A-VAS and disability scores for DASH and SPADI was -1 (95% CI, -1.5 to -0.8), -27 (95% CI, 32.3 to -22.6), and -23 (95% CI, -27.8 to -18.3), respectively. All of these measurements favored humeral head stabilization. CONCLUSION: During aggressive manual passive stretching in patients with painful stiff shoulders, humeral head stabilization intervention may be more beneficial in improving clinical outcomes such as A-ROM, A-VAS pain levels, and disability scores.

Examining the Influence of Warm-Up Static and Dynamic Stretching, as well as Post-Activation Potentiation Effects, on the Acute Enhancement of Gymnastic Performance: A Systematic Review with Meta-Analysis.

The primary objective of this systematic review with meta-analysis is to methodically discern and compare the impact of diverse warm-up strategies, including both static and dynamic stretching, as well as post-activation potentiation techniques, on the immediate performance of gymnasts. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this paper evaluated studies that examined the gymnasts' performance after different warm-up strategies namely stretching (static [SS] or dynamic), vibration platforms (VP) or post-activation, in comparison to control conditions (e.g., mixed warm-up routines; no warm-up). The principal outcomes were centered on technical performance metrics (e.g., split, gymnastic jumps) and physical performance metrics (e.g., squat jump, countermovement jump, drop jump, balance, range of motion). Methodological assessments of the included studies were conducted using the Downs and Black Checklist. From the initial search across PubMed, Scopus, and the Web of Science databases, a total of 591 titles were retrieved, and 19 articles were ultimately incorporated in the analysis. The results revealed a non-significant differences (p > 0.05) between the SS condition and control conditions in squat jump performance, countermovement jump and gymnastic technical performance (e.g., split; split jump). Despite the difference in warm-up strategies and outcomes analyzed, the results suggest that there is no significant impairment of lower-limb power after SS. Additionally, technical elements dependent on flexibility appear to be enhanced by SS. Conversely, dynamic stretching and VP seem to be more effective for augmenting power-related and dynamic performance in gymnasts.

Combined Effects of Static and Dynamic Stretching on the Muscle-Tendon Unit Stiffness and Strength of the Hamstrings.

ABSTRACT: Takeuchi, K, Nakamura, M, Matsuo, S, Samukawa, M, Yamaguchi, T, and Mizuno, T. Combined effects of static and dynamic stretching on the muscle-tendon unit stiffness and strength of the hamstrings. J Strength Cond Res 38(4): 681-686, 2024-Combined static and dynamic stretching for 30 seconds is frequently used as a part of a warm-up program. However, a stretching method that can both decrease muscle-tendon unit (MTU) stiffness and increase muscle strength has not been developed. The purpose of this study was to examine the combined effects of 30 seconds of static stretching at different intensities (normal-intensity static stretching [NS] and high-intensity static [HS]) and dynamic stretching at different speeds (low-speed dynamic [LD] and high-speed dynamic stretching [HD]) on the MTU stiffness and muscle strength of the hamstrings. Thirteen healthy subjects (9 men and 4 women, 20.9 ± 0.8 years, 169.3 ± 7.2 cm, 61.1 ± 8.2 kg) performed 4 types of interventions (HS-HD, HS-LD, NS-HD, and NS-LD). Range of motion (ROM), passive torque, MTU stiffness, and muscle strength were measured before and immediately after interventions by using an isokinetic dynamometer machine. In all interventions, the ROM and passive torque significantly increased (p < 0.01). Muscle-tendon unit stiffness significantly decreased in HS-HD and HS-LD (both p < 0.01), but there was no significant change in NS-HD (p = 0.30) or NS-LD (p = 0.42). Muscle strength significantly increased after HS-HD (p = 0.02) and NS-LD (p = 0.03), but there was no significant change in HS-LD (p = 0.23) or NS-LD (p = 0.26). The results indicated that using a combination of 30 seconds of high-intensity static stretching and high-speed dynamic stretching can be beneficial for the MTU stiffness and muscle strength of the hamstrings.

Combined effect of myofascial release and passive stretching on plantar pressure in individual with hamstring tightness- an experimental study.

INTRODUCTION: The lower kinetic chain is known to be affected by hamstring tightness which causes biomechanical alterations. As per the literature, short hamstring might cause prolonged forefoot loading, which can cause higher repeated stress on the plantar fascia. There is evidence supporting the use of various stretching and myofascial release techniques for hamstring tightness, further research is needed to investigate their impact on plantar pressure. Hence the study aims to determine combined effect of myofascial release and passive stretching on plantar pressure in individual with hamstring tightness. METHODS: This was an experimental pre-post study design with 67 randomised screenings from asymptomatic health care science students aged 18 to 25. From this scientific survey, a sample size of 47 students having HMS tightness based on the popliteal angle were recruited using a universal goniometer. An intervention was proposed that included MFR and passive stretching in 3 sessions on alternate days. Plantar pressure of these individuals was noted by using the "Harris and Beath foot printing mat" before and after the intervention. RESULT: Significant pressure changes were observed after intervention: great toe of right side (p = 0.001), toes 2 to 5 of right side (p = 0.010) and left side (p = 0.008), first metatarsal of left side (p = 0.010), lateral forefoot of right side (p = 0.019) and left (p = 0.018), medial heel (p = 0.044), and lateral heel of right side (p = 0.025). These values substantiate the enhancement in plantar pressure. CONCLUSION: The combined effect of Myofascial release and passive stretching in an individual with hamstring tightness resulted in a significant increase in popliteal angle and plantar pressure.