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The acute effects of hold-relax proprioceptive neuromuscular facilitation with vibration therapy on glenohumeral internal-rotation deficit
Tucker WS, Slone SW
Journal of Sport Rehabilitation 2016;25(3):248-254
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; 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*

CONTEXT: Clinicians use various stretching techniques to prevent the onset of and treat glenohumeral internal-rotation deficit (GIRD). It is unknown which stretching technique is the most effective. OBJECTIVE: To investigate the acute effects of hold-relax proprioceptive neuromuscular facilitation (PNF) with and without vibration therapy on internal rotation in individuals with GIRD. DESIGN: 2-within (stretch x time) comparison with repeated measures. SETTING: Controlled laboratory. PARTICIPANTS: 11 male current and former overhead athletes (19.8 +/- 1.4 y, 184.5 +/- 4.5 cm, 91.8 +/- 11.6 kg) who presented with GIRD. INTERVENTIONS: At 3 separate sessions, participants performed 1 of 3 randomly assigned stretches: hold-relax PNF (PNF), hold-relax PNF in combination with a whole-body-vibration unit set at 30 Hz (PNF-V), and static stretch (SS). Pretest and posttest maximum passive glenohumeral internal-rotation measurements were taken with a digital protractor. MAIN OUTCOME MEASURES: The dependent variables were the mean glenohumeral internal-rotation measurements taken at the pretest and posttest. The influence of stretch (PNF, PNF-V, and SS) and time (pretest and posttest) on mean glenohumeral internal rotation was compared using a 3x2 factorial ANOVA with repeated measures on both variables (p <= 0.05). RESULTS: There was a stretch-by-time interaction (F[2,20] = 34.697, p < 0.001). Post hoc testing revealed that the PNF posttest (73.0 degrees +/- 10.4 degrees) was greater than the PNF pretest (60.0 degrees +/- 11.8 degrees), the PNF-V posttest (74.7 degrees +/- 10.0 degrees) was greater than the PNF-V pretest (57.4 degrees +/- 10.4 degrees), and the SS posttest (67.0 degrees +/- 10.7 degrees) was greater than the SS pretest (60.1 degrees +/- 9.4 degrees). When comparing the posttest values, the PNF-V posttest was greater than the SS posttest. CONCLUSIONS: All 3 stretches (PNF, PNF-V, and SS) resulted in acute increases in glenohumeral internal rotation in individuals presenting with GIRD. The PNF-V stretch resulted in the greatest increase and would be the most clinically beneficial for patients with GIRD.
Copyright Human Kinetics. Reprinted with permission from Human Kinetics (Champaign, IL).

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