Self-Mobilization Using a Foam Roller Versus a Roller Massager: Which Is More Effective for Increasing Hamstrings Flexibility?

2017 ◽  
Vol 26 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Danielle M. DeBruyne ◽  
Marina M. Dewhurst ◽  
Katelyn M. Fischer ◽  
Michael S. Wojtanowski ◽  
Chris Durall
Keyword(s):  
Therapeutic Benefit ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Duration Of Treatment ◽  
Bottom Line ◽  
Physically Active ◽  
Foam Rolling ◽  
Treatment Data ◽  
Active Adults ◽  
Level 2

Clinical Scenario:Increasing the length of the muscle–tendon unit may prevent musculotendinous injury. Various methods have been proposed to increase muscle–tendon flexibility, including self-mobilization using foam rollers or roller massagers, although the effectiveness of these devices is uncertain. This review was conducted to determine if the use of foam rollers or roller massagers to improve hamstrings flexibility is supported by moderate- to high-quality evidence.Clinical Question:Are foam rollers or roller massagers effective for increasing hamstrings flexibility in asymptomatic physically active adults?Summary of Key Findings:The literature was searched for studies on the effects of using foam rollers or roller massagers to increase hamstrings flexibility in asymptomatic physically active adults. Four randomized controlled trials were included; 2 studies provided level 2 or 3 evidence regarding foam rollers and 2 studies provided level 2 or 3 evidence regarding roller massagers. Both roller-massager studies reported increases in hamstrings flexibility after treatment. Data from the foam-roller studies did not demonstrate a statistically significant increase in hamstrings flexibility, but 1 study did demonstrate a strong effect size.Clinical Bottom Line:The reviewed moderate-quality studies support the use of roller massagers but provide limited evidence on the effectiveness of foam rolling to increase hamstrings flexibility in asymptomatic physically active adults. Flexibility gains may be improved by a longer duration of treatment and administration by a trained therapist. Gains appear to decline rapidly postrolling. Neither device has been shown to confer a therapeutic benefit superior to static stretching, and the effectiveness of these devices for preventing injury is unknown.Strength of Recommendation:Grade B evidence supports the use of roller massagers to increase hamstrings flexibility in asymptomatic physically active adults.

scholarly journals The Effectiveness of Whole-Body-Vibration Training in Improving Hamstring Flexibility in Physically Active Adults

2015 ◽  
Vol 24 (1) ◽  
pp. 77-82 ◽  
Author(s):  
Megan N. Houston ◽  
Victoria E. Hodson ◽  
Kelda K.E. Adams ◽  
Johanna M. Hoch
Keyword(s):  
Young Adults ◽  
Whole Body Vibration ◽  
Intervention Group ◽  
Whole Body ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Physically Active ◽  
Hamstring Flexibility ◽  
Active Adults

Clinical Scenario:Hamstring tightness is common among physically active individuals. In addition to limiting range of motion and increasing the risk of muscle strain, hamstring tightness contributes to a variety of orthopedic conditions. Therefore, clinicians continue to identify effective methods to increase flexibility. Although hamstring tightness is typically treated with common stretching techniques such as static stretching and proprioceptive neuromuscular facilitation, it has been suggested that whole-body-vibration (WBV) training may improve hamstring flexibility.Clinical Question:Can WBV training, used in isolation or in combination with common stretching protocols or exercise, improve hamstring flexibility in physically active young adults?Summary of Key Findings:Of the included studies, 4 demonstrated statistically significant improvements in hamstring flexibility in the intervention group, and 1 study found minor improvements over time in the intervention group after treatment.Clinical Bottom Line:There is moderate evidence to support the use of WBV training to improve hamstring flexibility in physically active young adults.Strength of Recommendation:There is grade B evidence that WBV training improves hamstring flexibility in physically active adults. The Centre of Evidence Based Medicine recommends a grade of B for level 2 evidence with consistent findings.

The Effectiveness of Foot Orthotics in Improving Postural Control in Individuals With Chronic Ankle Instability: A Critically Appraised Topic

2015 ◽  
Vol 24 (1) ◽  
pp. 68-71 ◽  
Author(s):  
Michael L. Gabriner ◽  
Brittany A. Braun ◽  
Megan N. Houston ◽  
Matthew C. Hoch
Keyword(s):  
Postural Control ◽  
Ankle Instability ◽  
Controlled Trial ◽  
Chronic Ankle Instability ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Physically Active ◽  
Based Medicine ◽  
Level 2

Clinical Scenario:Chronic ankle instability (CAI) is a condition commonly experienced by physically active individuals. It has been suggested that foot orthotics may increase a CAI patient’s postural control.Clinical Question:For patients with CAI, is there evidence to suggest that an orthotic intervention will help improve postural control?Summary of Key Findings:The literature was searched for studies of level 2 evidence or higher that investigated the effects of foot orthotics on postural control in patients with CAI. The search of the literature produced 5 possible studies for inclusion; 2 studies met the inclusion criteria and were included. One randomized controlled trial and 1 outcomes study were included. Foot orthotics appear to be effective at improving postural control in patients with CAI.Clinical Bottom Line:There is moderate evidence to support the use of foot orthotics in the treatment of CAI to help improve postural control.Strength of Recommendation:There is grade B evidence that foot orthotics help improve postural control in people with CAI. The Centre of Evidence Based Medicine recommends a grade of B for level 2 evidence with consistent findings.

The Effectiveness of Open Repair Versus Percutaneous Repair for an Acute Achilles Tendon Rupture

2016 ◽  
Vol 25 (4) ◽  
pp. 404-410 ◽  
Author(s):  
Heidi Krueger ◽  
Shannon David
Keyword(s):  
Achilles Tendon ◽  
Open Repair ◽  
Supporting Evidence ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Physically Active ◽  
Men And Women ◽  
Percutaneous Repair ◽  
Tendon Ruptures

Clinical Scenario:There are 2 approaches available for surgical repair of the Achilles tendon: open or percutaneous. However, there is controversy over which repair is superior.Focused Clinical Question:Which type of surgery is better in providing the best overall patient outcome, open or percutaneous repair, in physically active men and women with acute Achilles tendon ruptures?Summary of Search, “Best Evidence” Appraised, and Key Findings:The literature was searched for studies of level 3 evidence or higher that investigated the effectiveness of open repair versus percutaneous repair on acute Achilles tendon ruptures in physically active men and women. The literature search resulted in 3 studies for possible inclusion. All 3 good-quality studies were included.Clinical Bottom Line:There is supporting evidence to indicate that percutaneous repair is the best option for Achilles tendon surgery when it comes to the physically active population. Percutaneous repair has faster surgery times, less risk of complications, and faster recovery times over having an open repair, although it is acknowledged that every patient has a different situation and best individual option may vary patient to patient.

The Role of Structured Foam Rolling Programs in Improving Hamstring Flexibility: A Critically Appraised Topic

2020 ◽  
pp. 1-5
Author(s):  
Irfan A. Khan ◽  
Kelley Henderson
Keyword(s):  
Clinical Question ◽  
Hamstring Muscle ◽  
Bottom Line ◽  
Significant Evidence ◽  
Foam Rolling ◽  
Hamstring Flexibility ◽  
Active Adults

Focused Clinical Question: What is the efficacy of structured foam rolling protocols at increasing hamstring muscle flexibility in active adults when compared with just maintaining regular levels of activity? Clinical Bottom Line: There is significant evidence to support the use of structured foam rolling programs in active adults to improve hamstring flexibility.

The Effects of Cold Water Immersion on Postexercise Muscle Soreness and Fatigue

2016 ◽  
Vol 21 (2) ◽  
pp. 4-11
Author(s):  
Christina J. Lorete ◽  
Riley N. Fontaine ◽  
Lauren A. Welsch ◽  
Johanna M. Hoch
Keyword(s):  
Muscle Fatigue ◽  
Cold Water ◽  
Water Immersion ◽  
Cold Water Immersion ◽  
Clinical Question ◽  
Bottom Line ◽  
Physically Active ◽  
Postexercise Recovery ◽  
Active Adults ◽  
Quality Evidence

Clinical Question:Is there evidence to suggest continuous cold water immersion (CWI) as a postexercise recovery intervention is more effective at reducing perceived muscle fatigue or soreness as measured using a Visual Analog Scale (VAS) when compared with passive rest in physically active adults?Summary of Key Findings:A systematic search of the literature produced 124 studies, with two randomized controlled trials and two cross-over studies meeting the inclusion criteria.Clinical Bottom Line:There is inconsistent, limited-quality evidence to support that the use of CWI postexercise is more effective at reducing perceived muscle fatigue or soreness in physically active adults when compared with passive rest. The results of the included studies were inconsistent regarding the application of continuous CWI for 10–14 min to reduce perceived muscle fatigue and soreness when compared with passive rest. The good-quality evidence found no difference between conditions and the three limited-quality studies identified differences between the conditions.

Immediate Effects of Proprioceptive Neuromuscular Facilitation Stretching Programs Compared With Passive Stretching Programs for Hamstring Flexibility: A Critically Appraised Topic

2017 ◽  
Vol 26 (6) ◽  
pp. 567-572 ◽  
Author(s):  
Kristian J. Hill ◽  
Kendall P. Robinson ◽  
Jennifer W. Cuchna ◽  
Matthew C. Hoch
Keyword(s):  
Effective Means ◽  
Current Evidence ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Static Stretching ◽  
Bottom Line ◽  
Physically Active ◽  
Hamstring Injuries ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Hamstring Flexibility

Clinical Scenario:Increasing hamstring flexibility through clinical stretching interventions may be an effective means to prevent hamstring injuries. However the most effective method to increase hamstring flexibility has yet to be determined.Clinical Question:For a healthy individual, are proprioceptive neuromuscular facilitation (PNF) stretching programs more effective in immediately improving hamstring flexibility when compared with static stretching programs?Summary of Key Findings:A thorough literature search returned 195 possible studies; 5 studies met the inclusion criteria and were included. Current evidence supports the use of PNF stretching or static stretching programs for increasing hamstring flexibility. However, neither program demonstrated superior effectiveness when examining immediate increases in hamstring flexibility.Clinical Bottom Line:There were consistent findings from multiple low-quality studies that indicate there is no difference in the immediate improvements in hamstring flexibility when comparing PNF stretching programs to static stretching programs in physically active adults.Strength of Recommendation:Grade B evidence exists that PNF and static stretching programs equally increase hamstring flexibility immediately following the stretching program.

The Use of Breathing Exercises in the Treatment of Chronic, Nonspecific Low Back Pain

2017 ◽  
Vol 26 (5) ◽  
pp. 452-458 ◽  
Author(s):  
Barton E. Anderson ◽  
Kellie C. Huxel Bliven
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Lung Function ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Low Back ◽  
Bottom Line ◽  
Breathing Exercises

Clinical Scenario:Research has shown a link between poor core stability and chronic, nonspecific low back pain, with data to suggest that alterations in core muscle activation patterns, breathing patterns, lung function, and diaphragm mechanics may occur. Traditional treatment approaches for chronic, nonspecific low back pain focus on exercise and manual therapy interventions, however it is not clear whether breathing exercises are effective in treating back pain.Focused Clinical Question:In adults with chronic, nonspecific low back pain, are breathing exercises effective in reducing pain, improving respiratory function, and/or health related quality of life?Summary of Key Findings:Following a literature search, 3 studies were identified for inclusion in the review. All reviewed studies were critically appraised at level 2 evidence and reported improvements in either low back pain or quality of life following breathing program intervention.Clinical Bottom Line:Exercise programs were shown to be effective in improving lung function, reducing back pain, and improving quality of life. Breathing program frequencies ranged from daily to 2–3 times per week, with durations ranging from 4 to 8 weeks. Based on these results, athletic trainers and physical therapists caring for patients with chronic, nonspecific low back pain should consider the inclusion of breathing exercises for the treatment of back pain when such treatments align with the clinician’s own judgment and clinical expertise and the patient’s preferences and values.Strength of Recommendation:Grade B evidence exists to support the use of breathing exercises in the treatment of chronic, nonspecific low back pain.

The Effect of Dry Needling on Patient-Reported Outcomes in Individuals With Chronic Ankle Instability: A Critically Appraised Topic

2019 ◽  
Vol 24 (5) ◽  
pp. 186-192
Author(s):  
Jennifer F. Mullins ◽  
Arthur J. Nitz ◽  
Matthew C. Hoch
Keyword(s):  
Patient Reported Outcomes ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
The Other ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Dry Needling ◽  
Bottom Line ◽  
Patient Reported

Clinical Scenario: Chronic ankle instability (CAI) and its associated recurrent sprains, feelings of instability, and decreased function occur in approximately 40% of individuals that suffer an ankle sprain. Despite these continued deficits, more effective treatment has yet to be established. Decreased sensorimotor function has been associated with CAI and may be amenable to dry needling treatment, thereby improving patient-reported outcomes (PROs). Focused Clinical Question: Does dry needling improve PROs in individuals with CAI? Summary of Key Findings: Two studies were identified that examined dry needling in participants with CAI. One of the two studies reported improvements in PROs (PEDro score 7/10) while the other study did not identify any changes (PEDro score 9/10). The inconsistent results were likely related to different treatment durations and follow-up timelines across the included evidence. Clinical Bottom Line: Based on the included studies, there is inconsistent evidence that dry needling can improve PROs in individuals with CAI. Strength of Recommendation: Utilizing the Strength of Recommendation Taxonomy (SORT) guidelines, level B evidence exists to recommend dry needling treatment to improve PROs for individuals with CAI.

The Diagnostic Accuracy of Screening Tools to Detect Eating Disorders in Female Athletes

2016 ◽  
Vol 25 (4) ◽  
pp. 395-398 ◽  
Author(s):  
Alyssa J. Wagner ◽  
Casey D. Erickson ◽  
Dayna K. Tierney ◽  
Megan N. Houston ◽  
Cailee E. Welch Bacon
Keyword(s):  
At Risk ◽  
Eating Disorders ◽  
Eating Disorder ◽  
Sensitivity And Specificity ◽  
Female Athletes ◽  
Screening Tools ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Questionnaire Version

Clinical Scenario:Eating disorders in female athletes are a commonly underdiagnosed condition. Better screening tools for eating disorders in athletic females could help increase diagnosis and help athletes get the treatment they need.Focused Clinical Question:Should screening tools be used to detect eating disorders in female athletes?Summary of Key Findings:The literature was searched for studies that included information regarding the sensitivity and specificity of screening tools for eating disorders in female athletes. The search returned 5 possible articles related to the clinical question; 3 studies met the inclusion criteria (2 cross-sectional studies, 1 cohort study) and were included. All 3 studies reported sensitivity and specificity for the Athletic Milieu Direct Questionnaire version 2, the Brief Eating Disorder in Athletes Questionnaire version 2, and the Physiologic Screening Test to Detect Eating Disorders Among Female Athletes. All 3 studies found that the respective screening tool was able to accurately identify female athletes with eating disorders; however, the screening tools varied in sensitivity and specificity values.Clinical Bottom Line:There is strong evidence to support the use of screening tools to detect eating disorders in female athletes. Screening tools with higher sensitivity and specificity have demonstrated a successful outcome of determining athletes with eating disorders or at risk for developing an eating disorder.Strength of Recommendation:There is grade A evidence available to demonstrate that screening tools accurately detect female athletes at risk for eating disorders.

The Effects of Low-Level Laser Therapy on Pain Associated With Tendinopathy: A Critically Appraised Topic

2016 ◽  
Vol 25 (1) ◽  
pp. 83-90 ◽  
Author(s):  
Andrew T. Doyle ◽  
Christine Lauber ◽  
Kendra Sabine
Keyword(s):  
Electrical Stimulation ◽  
Laser Therapy ◽  
Low Level Laser Therapy ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Low Level ◽  
Moist Heat ◽  
Low Level Laser ◽  
Level Laser

Clinical Scenario:Tendinopathies plague many active individuals, causing pain and reducing sport activity by decreasing range of motion and strength. There are many modalities that have been used to treat pain associated with chronic inflammation, such as ultrasound, moist heat packs, and electrical stimulation. Low-level laser therapy (LLLT) is one such modality. Potential benefits of managing pain associated with tendinopathies have been investigated using LLLT. Cellular respiration and metabolism are thought to be increased by LLLT acting on the mitochondrial cytochromes. The effects LLLT may have on cellular activity could increase blood flow to progress the healing process by reducing the pain-spasm cycle. The purpose of this critically appraised topic is to identify the clinical effectiveness of LLLT on pain associated with tendinopathy and to identify the parameters used to achieve statistically and clinically relevant pain outcomes.Focused Clinical Question:What is the effect of LLLT on pain associated with tendinopathy?Clinical Bottom Line:Although LLLT significantly decreases pain from baseline, its use may be no better than placebo or traditional treatments such as ultrasound, moist heat packs, electrical stimulation, or therapeutic exercise to reduce pain associated with tendinopathy. Total accumulated joules across the treatment sessions may need to be taken into account as a parameter.

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