Changes in Hamstring Range of Motion After Neurodynamic Sciatic Sliders: A Critically Appraised Topic

2017 ◽  
Vol 26 (4) ◽  
pp. 311-315
Author(s):  
Robert J. Bonser ◽  
Christy L. Hancock ◽  
Bethany L. Hansberger ◽  
Rick A. Loutsch ◽  
Eric K. Stanford ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Neural System ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Static Stretching ◽  
Common Condition ◽  
Bottom Line ◽  
Active Population ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Hamstring Flexibility

Clinical Scenario:Hamstring tightness is a common condition leading to dysfunctional or restricted movement that is often treated with stretching. Neurodynamics has been proposed as an alternative to stretching by targeting the neural system rather than muscle tissue.Focused Clinical Question:In an active population, what is the effect of using neurodynamic sliders compared with stretching on traditional measures of range of motion (ROM)?Summary of Key Findings:The authors of a well-designed study found that neurodynamic sliders were more effective than static stretching, while the authors of 2 less-well-designed studies reported no difference with static stretching or that proprioceptive neuromuscular facilitation stretching was more effective than neurodynamic sliders.Clinical Bottom Line:Evidence exists to support the use of neurodynamic sliders to increase measures of hamstring ROM in patients who present with limited hamstring flexibility; however, the effectiveness of neurodynamic sliders compared with traditional stretching is inconclusive.Strength of Recommendation:Grade B evidence exists that neurodynamic sliders perform as well as traditional stretching techniques at increasing measures of hamstring ROM in patients with limited hamstring flexibility.

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.

scholarly journals The Effectiveness of PNF Versus Static Stretching on Increasing Hip-Flexion Range of Motion

2018 ◽  
Vol 27 (3) ◽  
pp. 289-294 ◽  
Author(s):  
Landon Lempke ◽  
Rebecca Wilkinson ◽  
Caitlin Murray ◽  
Justin Stanek
Keyword(s):  
Range Of Motion ◽  
Knee Extension ◽  
Static Stretching ◽  
Bottom Line ◽  
Physically Active ◽  
Active Population ◽  
Significant Difference ◽  
Methods And Techniques ◽  
Hip Flexion ◽  
Joint Range

Clinical Scenario:Stretching is applied for the purposes of injury prevention, increasing joint range of motion (ROM), and increasing muscle extensibility. Many researchers have investigated various methods and techniques to determine the most effective way to increase joint ROM and muscle extensibility. Despite the numerous studies conducted, controversy still remains within clinical practice and the literature regarding the best methods and techniques for stretching.Focused Clinical Question:Is proprioceptive neuromuscular facilitation (PNF) stretching more effective than static stretching for increasing hamstring muscle extensibility through increased hip ROM or increased knee extension angle (KEA) in a physically active population?Summary of Key Findings:Five studies met the inclusion criteria and were included. All 5 studies were randomized control trials examining mobility of the hamstring group. The studies measured hamstring ROM in a variety of ways. Three studies measured active KEA, 1 study measured passive KEA, and 1 study measured hip ROM via the single-leg raise test. Of the 5 studies, 1 study found greater improvements using PNF over static stretching for increasing hip flexion, and the remaining 4 studies found no significant difference between PNF stretching and static stretching in increasing muscle extensibility, active KEA, or hip ROM.Clinical Bottom Line:PNF stretching was not demonstrated to be more effective at increasing hamstring extensibility compared to static stretching. The literature reviewed suggests both are effective methods for increasing hip-flexion ROM.Strength of Recommendation:Using level 2 evidence and higher, the results show both static and PNF stretching effectively increase ROM; however, one does not appear to be more effective than the other.

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.

scholarly journals The Effect of Fibular Reposition Taping on Postural Control in Individuals With Chronic Ankle Instability: A Critically Appraised Topic

2019 ◽  
Vol 28 (2) ◽  
pp. 205-210
Author(s):  
Bradley C. Jackson ◽  
Robert T. Medina ◽  
Stephanie H. Clines ◽  
Julie M. Cavallario ◽  
Matthew C. Hoch
Keyword(s):  
Postural Control ◽  
Range Of Motion ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Ankle Sprains ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Bottom Line ◽  
Significant Difference ◽  
History Of

Clinical Scenario: History of acute ankle sprains can result in chronic ankle instability (CAI). Arthrokinematic changes resulting from CAI may restrict range of motion and contribute to postural control deficits. Mulligan or fibular reposition taping (FRT) has been suggested as a means to realign fibular positional faults and may be an effective way to improve postural control and balance in patients with CAI. Clinical Question: Is there evidence to suggest that FRT will improve postural control for patients with CAI in the affected limb compared with no taping? Summary of Key Findings: Three of the 4 included studies found no significant difference in postural control in patients receiving FRT compared with sham or no tape. Clinical Bottom Line: There is moderate evidence refuting the use of FRT to improve postural control in patients with CAI. Strength of Recommendation: There is grade B evidence to support that FRT does not improve postural control in people with CAI.

Immediate effects of static and proprioceptive neuromuscular facilitation stretching of hamstring muscles on straight leg raise, craniovertebral angle, and cervical spine range of motion in neck pain patients with hamstring tightness: A prospective randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Eun-Dong Jeong ◽  
Chang-Yong Kim ◽  
Nack-Hwan Kim ◽  
Hyeong-Dong Kim
Keyword(s):  
Cervical Spine ◽  
Neck Pain ◽  
Range Of Motion ◽  
T Test ◽  
Static Stretching ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Before And After ◽  
Straight Leg Raise ◽  
Pain Patients ◽  
Group Effects

BACKGROUND: The cranio-cervical flexion exercise and sub-occipital muscle inhibition technique have been used to improve a forward head posture among neck pain patients with straight leg raise (SLR) limitation. However, little is known about the cranio-vertebral angle (CVA) and cervical spine range of motion (CROM) after applying stretching methods to the hamstring muscle. OBJECTIVE: To compare the immediate effects of static stretching and proprioceptive neuromuscular facilitation stretching on SLR, CVA, and CROM in neck pain patients with hamstring tightness. METHODS: 64 subjects were randomly allocated to the static stretching (n1= 32) or proprioceptive neuromuscular facilitation (n2= 32) stretching group. The SLR test was performed to measure the hamstring muscle’s flexibility and tightness between the two groups, with CROM and CVA also being measured. The paired t-test was used to compare all the variables within each group before and after the intervention. The independent t-test was used to compare the two groups before and after the stretching exercise. RESULTS: There were no between-group effects for any outcome variables (P> 0.05). However, all SLR, CVA, and CROM outcome variables were significantly improved within-group (P< 0.05). CONCLUSIONS: There were no between-group effects for any outcome variable; however, SLR, CVA, and CROM significantly improved within-group after the one-session intervention in neck pain patients with hamstring tightness.

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 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 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.

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