BACKGROUND: Stretching is commonly used in physical therapy as a rehabilitation tool to improve range of motion and motor function. However, is stretching an efficient method to improve gait, and if so, for which patient category? METHODS: A systematic review of randomized and non-randomized controlled trials with meta-analysis was conducted using relevant databases. Every patient category and every type of stretching programs were included without multicomponent programs. Data were meta-analysed where possible. Estimates of effect sizes (reported as standard mean difference (SMD)) with their respective 95% confidence interval (95% CI) were reported for each outcome. The PEDro scale was used for the quality assessment. RESULTS: Twelve studies were included in the analysis. Stretching improved gait performance as assessed by walking speed and stride length only in a study with a frail elderly population, with small effect sizes (both SMD 0.49; 95% CI 0.03 to 0.96; PEDro score 3/10). The total distance and the continuous walking distance of the six-minute walking test were also improved only in a study in an elderly population who had symptomatic peripheral artery disease, with large effect sizes (SMD 1.56; 95% CI 0.66 to 2.45 and SMD 3.05; 95% CI 1.86 to 4.23, respectively; PEDro score 5/10). The results were conflicting in healthy older adults or no benefit was found for most of the performance, spatiotemporal, kinetic and angular related variables. Only one study (PEDro score 6/10) showed improvements in stance phase duration (SMD -1.92; 95% CI -3.04 to -0.81), swing phase duration (SMD 1.92; 95 CI 0.81 to 3.04), double support phase duration (SMD -1.69; 95% CI -2.76 to -0.62) and step length (SMD 1.37; 95% CI 0.36 to 2.38) with large effect sizes. CONCLUSIONS: There is no strong evidence supporting the beneficial effect of using stretching to improve gait. Further randomized controlled trials are needed to understand the impact of stretching on human gait.

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