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| The efficacy of two modified proprioceptive neuromuscular facilitation stretching techniques in subjects with reduced hamstring muscle length |
| Youdas JW, Haeflinger KM, Kreun MK, Holloway AM, Kramer CM, Hollman JH |
| Physiotherapy Theory and Practice 2010;26(4):240-250 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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Difference scores in knee extension angle and electromyographic (EMG) activity were quantified before and after modified proprioceptive neuromuscular facilitation (PNF) hold-relax (HR) and hold-relax-antagonist contraction (HR-AC) stretching procedures in 35 healthy individuals with reduced hamstring muscle length bilaterally (knee extension angle < 160 degrees). Participants were randomly assigned each PNF procedure to opposite lower extremities. Knee extension values were measured by using a goniometer. EMG data were collected for 10 seconds before and immediately after each PNF stretching technique and normalized to maximum voluntary isometric contraction (% MVIC). A significant time by stretch-type interaction was detected (F[1,34] = 21.1; p < 0.001). Angles of knee extension for HR and HR-AC were not different prior to stretching (p = 0.45). Poststretch knee extension angle was greater in the HR-AC condition than the HR condition (p < 0.007). The proportion of subjects who exceeded the minimal detectable change (MDC95) with the HR-AC stretch (97%) did not differ (p = 0.07) from the proportion who exceeded the MDC95 with the HR stretch (80%). Because EMG activation increased (p < 0.013) after the HR-AC procedure, it is doubtful a relationship exists between range of motion improvement after stretching and inhibition of the hamstrings. On average the 10-second modified HR procedure produced an 11 degrees gain in knee extension angle within a single stretch session.
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