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A novel approach to improve hamstring flexibility: a single-blinded randomised clinical trial
Alshammari F, Alzoghbieh E, Abu Kabar M, Hawamdeh M
South African Journal of Physiotherapy 2019 Apr 23;75(465):Epub
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: 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*

BACKGROUND: The hamstrings play a major role in body posture. Shortening or tightness of the hamstrings affects postural alignment and results in possible musculoskeletal pain. OBJECTIVES: The aim of this study was to develop a novel approach to improve hamstring flexibility in young adults. METHOD: A single-blinded randomised clinical trial included 60 participants aged 18 to 24 with shortened hamstrings recruited from the Hashemite University, Zarqa, Jordan. The range of motion of knee extension was measured with the hip at 90degree flexion using a simple goniometer to detect the level of hamstring flexibility. Participants received either a passive hamstring stretch (PS), followed by two sets of 10 tibial nerve neurodynamic technique (ND), or PS followed by three sets of 10 repetitions of active knee extension-quadriceps activation (QA), or PS only. RESULTS: There was a significant improvement of hamstring flexibility in the QA group compared to the PS group (13.4 +/- 12.1degree versus 6.2 +/- 6.4degree, p = 0.05). There was a significant improvement in hamstring flexibility post-intervention compared to pre-intervention in the PS group by 6.2 +/- 6.4 (30.5 +/- 10.8degree versus 36.6 +/- 9.5degree, p = 0.001), ND group by 9.3 +/- 6.2 (26.7 +/- 10.9degree versus 36.0 +/- 9.5degree, p = 0.001) and QA group by 13.4 +/- 12.1 (20.3 +/- 9.0degree versus 33.4 +/- 8.9degree, p = 0.001). CONCLUSION: Quadriceps muscle activation following passive stretching of the hamstrings appears to be superior to the PS and ND techniques in improving hamstring muscle flexibility. CLINICAL IMPLICATIONS: Quadriceps activation following passive hamstring stretching can be used in physiotherapy settings to improve hamstring muscle flexibility.

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