Effects of Dynamic Extension Exercise and Mulligan Stretching on Hamstring Flexibility

Objectives: By the increase in physically inactive and sedentary lifestyles habits, hamstring tightness has currently become a more common situation. The purpose of this study was to compare the effects of dynamic extension exercise and Mulligan stretching applications on hamstring flexibility in people with hamstring tightness. Methods: This study involved 12 young adults and 24 knees (4 females, 8 males) with bilateral hamstring tightness (active knee extension test angle < 25 degrees). Mean age and mean Body Mass Index (BMI) of the participants were 22.75±2.73 years and 21.52±2.51 kg/m2, respectively. Before the first measurements, all participants were separated into a Dynamic Extension Exercise Group (DEEG, n = 7) and Mulligan Stretching group (MSG, n = 5) according to the simple random table. DEEG received terminal extension exercises consisting of three sets of 10 repetitions, with 30 seconds of rest between each set, performed at predetermined 10 repetition maximum for each subject. MSG received traction straight leg raise technique and bent-leg-raise technique of Mulligan for 1 set each session applied by the physiotherapist. Applications were done 3 sessions a week for 4 weeks. Hamstring flexibility was measured with Active Knee Extension Test (AKET) and Sit and Reach Test (SRT). All measurements were performed four times: before treatment (BT), immediately after 1st session and 24th hour, and after 4-week treatment period (AT). Results: There were no significant differences between the two groups in the baseline demographic characteristics, BMI, and AKET and SRT results (p>0.05). While MSG group experienced a significant increase in the AKET and SRT at measurements of 1st session, 24th hour and AT (p<0.05), there were no significant alterations in values of AKET and SRT in DEEG (p>0.05). Conclusion: The results of our study showed that applying Mulligan stretching three sessions per week for 4 weeks can increase active knee extension angle in people with hamstring tightness. Applying Mulligan stretching instead of dynamic extension exercises can be more effective on hamstring flexibility. However, further data and studies are needed to determine long-term outcomes.

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Effects of two different stretching techniques on proprioception and hamstring flexibility: a pilot study

Journal of Comparative Effectiveness Research ◽

10.2217/cer-2021-0040 ◽

2021 ◽

Author(s):

Ece Mani ◽

Berkiye Kirmizigil ◽

Emine Handan Tüzün

Keyword(s):

Knee Extension ◽

Position Sense ◽

Static Stretching ◽

Isokinetic Dynamometer ◽

Clinical Trial Registration ◽

Long Term Effect ◽

Proprioceptive Neuromuscular Facilitation ◽

Registration Number ◽

Hamstring Flexibility

Aim: This study aimed to compare the immediate and long-term effect of proprioceptive neuromuscular facilitation (PNF) contract-relax-antagonist-contract (CRAC) exercises versus static stretching on proprioception and flexibility in males with hamstring shortness. Patients & methods: Knee extension angle test was used to measure flexibility and isokinetic dynamometer to evaluate proprioception. Assessments were evaluated at baseline, after first exercise and eighth week. The hamstring stretching was applied 3 days a week for 8 weeks. Results: Flexibility and position sense were similar in the immediate and long term (p > 0.05). However, the motion sense increased significantly in long term within the PNF CRAC group (p = 0.02). Conclusion: Both stretching exercises are effective for improving flexibility. Moreover, PNF CRAC improved motion sense more than static stretching in the long term. Clinical trial registration number: NCT04026646 .

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Assessment of Long-Term Efficacy and Safety of Adalimumab in Patients with Ulcerative Colitis: Results from a 6-Year Real-World Clinical Practice

Digestive Diseases ◽

10.1159/000493121 ◽

2018 ◽

Vol 37 (1) ◽

pp. 11-20 ◽

Cited By ~ 1

Author(s):

Ken Sugimoto ◽

Kentaro Ikeya ◽

Masaichi Kato ◽

Ai Matsuura ◽

Fumitoshi Watanabe ◽

...

Keyword(s):

Risk Factors ◽

Ulcerative Colitis ◽

Survival Rate ◽

Long Term Outcomes ◽

Factors Affecting ◽

Term Efficacy ◽

Steroid Dependent ◽

Adalimumab Treatment ◽

Baseline Demographic

Background: Although evidence for the short- to medium-term efficacy of adalimumab in ulcerative colitis (UC) patients is emerging, there are a limited number of reports on the long-term efficacy of adalimumab. This study was to understand baseline demographic features, which potentially could be risk factors for relapse or colectomy following induction of remission by adalimumab in UC patients. Additionally, factors affecting long-term outcomes were to be identified. Methods: Twenty-one patients with UC who had been treated with adalimumab were reviewed retrospectively. Comparative analyses were undertaken by factoring steroid withdrawal versus non-withdrawal, long-term remission versus relapse following remission, and requiring surgical intervention for UC versus surgery-free. Results: Adalimumab treatment was associated with steroid tapering in steroid-dependent cases in the long term. Of the 14 patients in whom clinical remission was achieved, the cumulative nonrelapse survival rate at 350 weeks was 43.8% and the cumulative nonoperative survival rate was 85.7%. Risk factors for surgery included intolerance to salicylates (p = 0.005) and past treatment with tacrolimus (p = 0.023). Conclusions: Adalimumab treatment was associated with long-term efficacy in patients with mild UC – patients achieved a high cumulative nonoperative survival rate over a long period of time, beyond 6 years.

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A comparative study on the effectiveness of PNF stretching versus static stretching on Pain and Hamstring flexibility in osteoarthritis knee patients

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i3.1312 ◽

2019 ◽

Vol 10 (3) ◽

pp. 1789-1794

Author(s):

Arul Pragassame S ◽

Mohandas Kurup VK ◽

Soundarya N

Keyword(s):

Rating Scale ◽

Knee Extension ◽

Functional Mobility ◽

Static Stretching ◽

Timed Up And Go ◽

Osteoarthritis Knee ◽

Group A ◽

Hamstring Flexibility ◽

Group B

Osteoarthritis (OA) knee is a long-term chronic disease characterized by the destruction of articular cartilage and underlying bone. Pain, limitation of motion and functional impairment are common clinical features. Poor hamstring flexibility is a major problem for patients with OA knee. The stretching of the hamstring is a necessary intervention in the management of the OA knee. This study is therefore intended to compare the effectiveness of static stretching vs PNF stretching for pain, hamstring flexibility and functional mobility in OA Knee patients. 30 patients were randomly divided into two groups. Group A (N=15) received PNF stretching, wax therapy and isometric quadriceps exercises, and group B (N=15) received static stretching, wax therapy and isometric quadriceps exercises. The intensity of the pain was measured using the NPRS (Numerical Pain Rating Scale), hamstring flexibility by AKET (Active Knee Extension Test) and functional mobility by TUG (Timed up and Go) test. The results showed that significant differences in NPRS (Z=4.64, P=0.001), AKET (t=9.61, P=0.001) and TUG (t=8.19, P=0.001) were observed in group A patients when compared to group B. In conclusion, the PNF stretching treatment program is effective in reducing pain, improving hamstring flexibility and functional mobility in patients with OA knee compared to static stretching.

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Acute Lower Extremity Running Kinematics After a Hamstring Stretch

Journal of Athletic Training ◽

10.4085/1062-6050-47.1.5 ◽

2012 ◽

Vol 47 (1) ◽

pp. 5-14 ◽

Cited By ~ 4

Author(s):

Autumn L. Davis Hammonds ◽

Kevin G. Laudner ◽

Steve McCaw ◽

Todd A. McLoda

Keyword(s):

Pelvic Tilt ◽

Knee Extension ◽

Swing Phase ◽

Treadmill Running ◽

Control Group ◽

Single Session ◽

Anterior Pelvic Tilt ◽

Hamstring Flexibility ◽

Hip Flexion ◽

Straight Leg Raise

Context: Limited passive hamstring flexibility might affect kinematics, performance, and injury risk during running. Pre-activity static straight-leg raise stretching often is used to gain passive hamstring flexibility. Objective: To investigate the acute effects of a single session of passive hamstring stretching on pelvic, hip, and knee kinematics during the swing phase of running. Design: Randomized controlled clinical trial. Setting: Biomechanics research laboratory. Patients or Other Participants: Thirty-four male (age = 21.2 ± 1.4 years) and female (age = 21.3±2.0 years) recreational athletes. Intervention(s): Participants performed treadmill running pretests and posttests at 70% of their age-predicted maximum heart rate. Pelvis, hip, and knee joint angles during the swing phase of 5 consecutive gait cycles were collected using a motion analysis system. Right and left hamstrings of the intervention group participants were passively stretched 3 times for 30 seconds in random order immediately after the pretest. Control group participants performed no stretching or movement between running sessions. Main Outcome Measure(s): Six 2-way analyses of variance to determine joint angle differences between groups at maximum hip flexion and maximum knee extension with an α level of .008. Results: Flexibility increased between pretest and post-test in all participants (F1,30 = 80.61, P<.001). Anterior pelvic tilt (F1,30 = 0.73, P=.40), hip flexion (F1,30 = 2.44, P=.13), and knee extension (F1,30 = 0.06, P=.80) at maximum hip flexion were similar between groups throughout testing. Anterior pelvic tilt (F1,30 = 0.69, P=.41), hip flexion (F1,30 = 0.23, P=.64), and knee extension (F1,30 = 3.38, P=.62) at maximum knee extension were similar between groups throughout testing. Men demonstrated greater anterior pelvic tilt than women at maximum knee extension (F1,30 = 13.62, P=.001). Conclusions: A single session of 3 straight-leg raise hamstring stretches did not change pelvis, hip, or knee running kinematics.

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Effects of Static and Hold-Relax Stretching on Hamstring Range of Motion Using the FlexAbility LE1000

Journal of Sport Rehabilitation ◽

10.1123/jsr.8.3.195 ◽

1999 ◽

Vol 8 (3) ◽

pp. 195-208 ◽

Cited By ~ 19

Author(s):

Phillip A. Gribble ◽

Kevin M. Guskiewicz ◽

William E. Prentice ◽

Edgar W. Shields

Keyword(s):

Range Of Motion ◽

Measurement Technique ◽

Training Group ◽

Knee Extension ◽

Hamstring Flexibility ◽

Hip Flexion ◽

Straight Leg Raise

The purposes of this study were to determine the effects of static and hold-relax stretching on hamstring range of motion and to examine the reliability of the FlexAbility LE1000 compared with the goniometrically measured active knee-extension test. Forty-two participants (18–25 years old) were assigned to either a control, static, or hold-relax training group. Participants were stretched four times a week over a 6-week period, with four 30-s stretches per session using a straight-leg-raise method on the FlexAbility LE1000. It was determined that both static and hold-relax techniques significantly improved hamstring flexibility (ISLR: +33.08° ± 9.08° and +35.17° ± 10.39°, respectively). Participants of both techniques reached a plateau in flexibility improvement between Weeks 4 and 5. Thus, static and hold-relax stretching are equally effective in improving hamstring ROM. The FlexAbility LE1000 and the goniometer were both found to be highly reliable. Therefore, either measurement technique could be used successfully to measure hip-flexion ROM.

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Traumatic Brain Injury: A Trauma Surgeon's Perspective

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld22.3.82 ◽

2012 ◽

Vol 22 (3) ◽

pp. 82-89

Author(s):

Oscar D. Guillamondegui

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Multidisciplinary Approach ◽

Trauma Team ◽

The United States ◽

Long Term Outcomes ◽

Term Care ◽

Injured Brain ◽

The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

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