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Short term effectiveness of neural sliders and neural tensioners as an adjunct to static stretching of hamstrings on knee extension angle in healthy individuals: a randomized controlled trial
Sharma S, Balthillaya G, Rao R, Mani R
Physical Therapy in Sport 2016 Jan;17:30-37
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the added benefit of nerve-biased interventions over static stretching in hamstring flexibility and to compare the effectiveness of two types of nerve-biased interventions over a week. DESIGN: Three-arm assessor-blinded randomized controlled trial. SETTING: University Laboratory. PARTICIPANTS: Sixty healthy individuals (mean age 22 +/- 2.4 years) with reduced hamstring flexibility were randomized to three groups who received static stretching and neurodynamic sliders (NS-SS); static stretching with neurodynamic tensioner (NT-SS) and static stretching (SS) alone. OUTCOME MEASURE: Knee extension angle (KEA) in degrees. RESULTS: Baseline characteristics including demographic, anthropomorphic and KEA between groups were comparable. A significant interaction was observed between group (intervention) and time (F[2,114] = 3.595; p = 0.031). Post-hoc pairwise comparisons analyses revealed significant differences at post-intervention measurement time point between NS-SS and SS (mean difference -6.8; 95% CI -12 to -1.5; p = 0.011) and NT-SS and SS (mean difference -11.6; 95% CI -16.7 to -6.3; p < 0.001). However there was no significant difference between NS-SS and NT-SS groups (mean difference 4.8; 95% CI 0.4 to 9.9; p = 0.074). CONCLUSIONS: Neural sliders and tensioners are both effective in increasing hamstring flexibility as an adjunct to static hamstring stretching when compared to static stretching alone. No neural mobilization technique proved to be superior over another. CLINICAL TRIAL REGISTRATION: This clinical trial is registered in Clinical Trials Registry India (CTRI) with registration number CTRI/2012/05/002619.

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