Efficacy of the hold-relax technique compared to dynamic stretching on hamstring flexibility
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Abstract
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.
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References
Bushman BA. Flexibility exercises and performance. ACSM’s Heal Fit J. 2016;20(5):5–9.
Masood K, Riaz H, Ghous M, Iqbal M. Comparison between dynamic oscillatory stretch technique and static stretching in reduced hamstring flexibility in healthy population: A single blind randomized control trial. J Pak Med Assoc. 2020;70(11):1908–12.
Borges MO, Medeiros DM, Minotto BB, Lima CS. Comparison between static stretching and proprioceptive neuromuscular facilitation on hamstring flexibility: Systematic review and metaanalysis. Eur J Physiother. 2018;20(1):12–9.
Maddigan ME, Peach AA, Behm DG. A comparison of assisted and unassisted proprioceptive neuromuscular facilitation techniques and static stretching. J Strength Cond Res. 2012;26(5):1238–44.
Opplert J, Babault N. Acute effects of dynamic stretching on muscle flexibility and performance: An analysis of the current literature. Sports Medicine. 2018;48:299–325.
Freitas SR, Mendes B, Le Sant G, Andrade RJ, Nordez A, Milanovic Z. Can chronic stretching change the muscle-tendon mechanical properties? A review. Scand J Med Sci Sport. 2018;28(3):794–806.
Muratori LM, Lamberg EM, Quinn L, Duff S V. Applying principles of motor learning and control to upper extremity rehabilitation. J Hand Ther. 2013;26(2):94–103.
Kaneda H, Takahira N, Tsuda K, Tozaki K, Kudo S, Takahashi Y, et al. Effects of tissue flossing and dynamic stretching on hamstring muscles function. J Sport Sci Med. 2020;19(4):681–9.
Kumar GP. Comparison of cyclic loading and hold relax technique in increasing resting length of hamstring muscles. Hong Kong Physiother J. 2011;29(1):31–3.
Wicke J, Gainey K, Figueroa M. A comparison of self-administered proprioceptive neuromuscular facilitation to static stretching on range of motion and flexibility. J Strength Cond Res. 2014;28(1):168–72.
Lim K Il, Nam HC, Jung KS. Effects on hamstring muscle extensibility, muscle activity, and balance of different stretching techniques. J Phys Ther Sci. 2014;26(2):209–13.
Gunn LJ, Stewart JC, Morgan B, Metts ST, Magnuson JM, Iglowski NJ, et al. Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: A randomized clinical trial. J Man Manip Ther. 2019;27(1):15–23.
Medeiros DM, Cini A, Sbruzzi G, Lima CS. Influence of static stretching on hamstring flexibility in healthy young adults: Systematic review and meta-analysis. Physiother Theory Pract. 2016;32(6):438–45.
Danielsson A, Horvath A, Senorski C, Alentorn-Geli E, Garrett WE, Cugat R, et al. The mechanism of hamstring injuries- A systematic review. BMC Musculoskelet Disord. 2020;21(1):641.
Calle P, Muñoz Y Barba M, Catalán D, Fuentes MT. Los efectos de los estiramientos musculares: ¿Qué sabemos realmente? Rev Ibero Fis Kines. 2006;9(1):36–44.
Konrad A, Stafilidis S, Tilp M. Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties. Scand J Med Sci Sport. 2017;27(10):1070–80.
Sharman MJ, Cresswell AG, Riek S. Proprioceptive neuromuscular facilitation stretching: Mechanisms and clinical implications. Sport Med. 2006;36(11):929–39.
Mahieu NN, Cools A, De Wilde B, Boon M, Witvrouw E. Effect of proprioceptive neuromuscular facilitation stretching on the plantar flexor muscle-tendon tissue properties. Scand J Med Sci Sport. 2009;19(4):553–60.
Henricson AS, Fredriksson K, Persson I. The effect of heat and stretching on the range of hip motion. J Orthop Sports Phys Ther. 1984;6(2):110–5.
Etnyre BR, Abraham LD. Gains in range of ankle dorsiflexion using three popular stretching techniques. Am J Phys Med. 1986;65(4):189–96.
Magnusson SP, Simonsen EB, Aagaard P, Dyhre-Poulsen P, McHugh MP, Kjaer M. Mechanical and physiological responses to stretching with and without preisometric contraction in human skeletal muscle. Arch Phys Med Rehabil. 1996;77(4):373–8.
Ferber R, Osternig LR, Gravelle DC. Effect of PNF stretch techniques on knee flexor muscle EMG activity in older adults. J Electromyogr Kinesiol. 2002;12(5):391–7.
Wallin D, Ekblom B, Grahn R, Nordenborg T. Improvement of muscle flexibility: A comparison between two techniques. Am J Sports Med. 1985;13(4):263–8.
O’Sullivan K, Murray E, Sainsbury D. The effect of warm-up, static stretching and dynamic stretching on hamstring flexibility in previously injured subjects. BMC Musculoskelet Disord. 2009;10:37.
Ayala F, De Baranda PS, Cejudo A. El entrenamiento de la flexibilidad: Técnicas de estiramiento. Rev And Med Dep. 2012;5:105–12.
Nelson RT. A Comparison of the immediate effects of eccentric training vs static stretch on hamstring flexibility in high school and college athletes. N Am J Sports Phys Ther. 2006;1(2):56–61.
Fletcher IM, Jones B. The effect of different warm-up stretch protocols on 20 meter sprint performance in trained rugby union players. J Strength Cond Res. 2004;18(4):885–8.
Mizuno T. Changes in joint range of motion and muscle–tendon unit stiffness after varying amounts of dynamic stretching. J Sports Sci. 2017;35(21):2157–63.
Perrier ET, Pavol MJ, Hoffman MA. The acute effects of a warm-up including static or dynamic stretching on countermovement jump height, reaction time, and flexibility. J Strength Cond Res. 2011;25(7):1925–31.
Zhou WS, Lin JH, Chen SC, Chien KY. Effects of dynamic stretching with different loads on hip joint range of motion in the elderly. J Sport Sci Med. 2019;18(1):52–7.
Lee JH, Jang KM, Kim E, Rhim HC, Kim HD. Effects of static and dynamic stretching with strengthening exercises in patients with patellofemoral pain who have inflexible hamstrings: A randomized controlled trial. Sports Health. 2021;13(1):49–56.
Su H, Chang NJ, Wu WL, Guo LY, Chu IH. Acute effects of foam rolling, static stretching, and dynamic stretching during warm-ups on muscular flexibility and strength in young adults. J Sport Rehabil. 2017;26(6):469–77.
Lempke L, Wilkinson R, Murray C, Stanek J. The effectiveness of PNF versus static stretching on increasing hip-flexion range of motion. J Sport Rehabil. 2018;27(3):289–94.
Iwata M, Yamamoto A, Matsuo S, Hatano G, Miyazaki M, Fukaya T, et al. Dynamic stretching has sustained effects on range of motion and passive stiffness of the hamstring muscles. J Sport Sci Med. 2019;18(1):13–20.
Park S, Lim W. Effects of proprioceptive neuromuscular facilitation stretching at low-intensities with standing toe touch on developing and maintaining hamstring flexibility. J Bodyw Mov Ther. 2020;24(4):561–7.
Younis HI, Buddhadev HH, Suprak DN, San Juan JG. Acute effects of two hip flexor stretching techniques on knee joint position sense and balance. Int J Sports Phys Ther. 2018;13(5):846–59.
Siebert T, Donath L, Borsdorf M, Stutzig N. Effect of static stretching, dynamic stretching, and myofascial foam rolling on range of motion during hip flexion: A randomized crossover trial. J Strength Cond Res. 2022;36(3):680–5.
Etnyre BR, Lee EJ. Chronic and acute flexibility of men and women using three different stretching techniques. Res Q Exerc Sport. 1988;59(3):222–8.
Rowlands AV, Marginson VF, Lee J. Chronic flexibility gains: Effect of isometric contraction duration during proprioceptive neuromuscular facilitation stretching techniques. Res Q Exerc Sport. 2003;74(1):47–51.
Thomas E, Bianco A, Paoli A, Palma A. The relation between stretching typology and stretching duration: The effects on range of motion. International Journal of Sports Medicine. 2018;39:243–54.
Roberts JM, Wilson K. Effect of stretching duration on active and passive range of motion in the lower extremity. Br J Sports Med. 1999;33(4):259–63.
Birinci T, Razak A, Altun S, Kural C. A structured exercise program combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: A randomized controlled trial. Clin Rehabil. 2019;33(2):241–52.
Ballantyne F, Fryer G, McLaughlin P. The effect of muscle energy technique on hamstring extensibility: the mechanism of altered flexibility. J Osteopath Med. 2003;6(2):59–63.
Kumar A, Nagaraj S, Man R, Neupane B. Neurodynamic sliding versus PNF stretching on hamstring flexibility in collegiate students: A comparative study. Int J Phys Educ Sport Heal. 2017;4(1):29–33.