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Effectiveness analysis of active stretching versus active stretching plus low-frequency electrical stimulation in children who play soccer and who have the short hamstring syndrome
Piqueras-Rodriguez F, Palazon-Bru A, Gil-Guillen VF
Clinical Journal of Sport Medicine 2016 Jan;26(1):59-68
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; 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*

OBJECTIVE: To determine the effectiveness of active stretching (AS) versus AS plus electrical stimulation (stretching+TENS) in young soccer players with the short hamstring syndrome (SHS). DESIGN: Randomized, controlled, single-blind parallel clinical trial with 3 arms and a 2-month follow-up. The assignment ratio was 1:1:1. SETTING: The study involved young federated soccer players in the town of Jumilla, in the region of Murcia (Spain), who were controlled in a physiotherapy office in 2012. PARTICIPANTS: Fifty-one young soccer players (10 to 16 years) with SHS. INTERVENTIONS: Stretching+TENS, AS, and conventional stretching. MAIN OUTCOME MEASURES: Straight leg raise (SLR) test, popliteal angle with the passive knee extension (PKE) test, and the toe-touch test (TT). RESULTS: Significant results (p < 0.05) were group 1 versus 2: (1) SLR -5.5 degrees right; (2) PKE +10.2 degrees right and +6.2 degrees left; and (3) range of values of clinically relevant parameters (RVCRP) relative risk (RR) 0.35 to 0.38; relative risk reduction (RRR) 0.62 to 0.65; absolute risk reduction (ARR) 0.32 to 0.39; number needed to treat (NNT) 3 to 4. Group 1 versus 3: (1) SLR -12.3 degrees right and -10 degrees left; (2) PKE +12.9 degrees right and +8.5 degrees left; (3) TT -8.9 cm; and (4) RVCRP RR 0.12 to 0.28; RRR 0.72 to 0.88; ARR 0.60 to 0.83; NNT 2 to 2. Group 2 versus 3: (1) SLR -6.8 degrees right and -6.2 degrees left; (2) TT -6.7 cm; (3) RVCRP RR 0.44 to 0.53; RRR 0.47 to 0.56; ARR 0.40 to 0.56; NNT 2 to 3. CONCLUSIONS: Stretching+TENS produces greater improvement than AS alone, and these are both better than conventional stretching. CLINICAL RELEVANCE: The use of electrical stimulation combined with AS is a relevant technique for habitual clinical practice that should be systematically integrated in children aged 10 to 16 years who play soccer and who have the SHS.
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