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Applied Physiology, Nutrition, and... Jan 2016Recently, there has been a shift from static stretching (SS) or proprioceptive neuromuscular facilitation (PNF) stretching within a warm-up to a greater emphasis on... (Review)
Review
Recently, there has been a shift from static stretching (SS) or proprioceptive neuromuscular facilitation (PNF) stretching within a warm-up to a greater emphasis on dynamic stretching (DS). The objective of this review was to compare the effects of SS, DS, and PNF on performance, range of motion (ROM), and injury prevention. The data indicated that SS- (-3.7%), DS- (+1.3%), and PNF- (-4.4%) induced performance changes were small to moderate with testing performed immediately after stretching, possibly because of reduced muscle activation after SS and PNF. A dose-response relationship illustrated greater performance deficits with ≥60 s (-4.6%) than with <60 s (-1.1%) SS per muscle group. Conversely, SS demonstrated a moderate (2.2%) performance benefit at longer muscle lengths. Testing was performed on average 3-5 min after stretching, and most studies did not include poststretching dynamic activities; when these activities were included, no clear performance effect was observed. DS produced small-to-moderate performance improvements when completed within minutes of physical activity. SS and PNF stretching had no clear effect on all-cause or overuse injuries; no data are available for DS. All forms of training induced ROM improvements, typically lasting <30 min. Changes may result from acute reductions in muscle and tendon stiffness or from neural adaptations causing an improved stretch tolerance. Considering the small-to-moderate changes immediately after stretching and the study limitations, stretching within a warm-up that includes additional poststretching dynamic activity is recommended for reducing muscle injuries and increasing joint ROM with inconsequential effects on subsequent athletic performance.
Topics: Athletic Performance; Humans; Muscle Stretching Exercises; Muscle, Skeletal; Randomized Controlled Trials as Topic; Range of Motion, Articular
PubMed: 26642915
DOI: 10.1139/apnm-2015-0235 -
International Journal of Environmental... Apr 2021Anterior cruciate ligament (ACL) injuries are the most common ligament injury of the knee, accounting for between 100,000 and 200,000 injuries among athletes per year.... (Review)
Review
Anterior cruciate ligament (ACL) injuries are the most common ligament injury of the knee, accounting for between 100,000 and 200,000 injuries among athletes per year. ACL injuries occur via contact and non-contact mechanisms, with the former being more common in males and the later being more common in females. These injuries typically require surgical repair and have relatively high re-rupture rates, resulting in a significant psychological burden for these individuals and long rehabilitation times. Numerous studies have attempted to determine risk factors for ACL rupture, including hormonal, biomechanical, and sport- and gender-specific factors. However, the incidence of ACL injuries continues to rise. Therefore, we performed a systematic review analyzing both ACL injury video analysis studies and studies on athletes who were pre-screened with eventual ACL injury. We investigated biomechanical mechanisms contributing to ACL injury and considered male and female differences. Factors such as hip angle and strength, knee movement, trunk stability, and ankle motion were considered to give a comprehensive, joint by joint analysis of injury risk and possible roles of prevention. Our review demonstrated that poor core stability, landing with heel strike, weak hip abduction strength, and increased knee valgus may contribute to increased ACL injury risk in young athletes.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Athletes; Biomechanical Phenomena; Female; Humans; Knee Joint; Male
PubMed: 33917488
DOI: 10.3390/ijerph18073826 -
Physiotherapy Mar 2022When treating knee osteoarthritis (KOA), rehabilitation exercise is often combined with low-level (LLLT) or high-intensity laser therapy (HILT). However, the... (Meta-Analysis)
Meta-Analysis Review
Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: a systematic review and meta-analysis.
BACKGROUND
When treating knee osteoarthritis (KOA), rehabilitation exercise is often combined with low-level (LLLT) or high-intensity laser therapy (HILT). However, the effectiveness of these combinations is still uncertain.
OBJECTIVE
To examine the effects of LLLT or HILT combined with rehabilitation exercise (LLLT+E or HILT+E) on pain, stiffness and function in KOA.
DATA SOURCES
Five databases (PubMed, Web of Science, CINAHL, PEDro and SPORTDiscus) were searched for relevant studies published up to 31 December 2019.
STUDY SELECTION
KOA randomised controlled trials, LLLT+E or HILT+E against exercise alone with or without placebo laser, reported clinical outcomes, human studies and English language.
DATA SYNTHESIS
Methodological quality was assessed by the PEDro and Cochrane risk-of-bias scales, and the meta-analysis was undertaken using RevMan 5.3.
RESULTS
Of the 10 retrieved studies, six investigated LLLT+E, three on HILT+E, and one evaluated both. All the studies had high PEDro scores. However, as most of the studies employed a single type of laser therapy, only indirect comparison of LLLT+E and HILT+E was possible. This study found all treatment modalities were effective in reducing KOA symptoms. Interestingly, relative to control, the meta-analysis showed significant improvements in knee pain, stiffness and function for the HILT+E.
CONCLUSION
Both LLLT and HILT are beneficial as adjuncts to rehabilitation exercise in the management of KOA. Based on an indirect comparison, the HILT+E seems to have higher efficacy in reducing knee pain and stiffness, and in increasing function. To confirm this finding, a direct comparative investigation of the two types of laser therapy may be necessary. Systematic review registration PROSPERO ID CRD42020206228.
Topics: Exercise Therapy; Humans; Laser Therapy; Low-Level Light Therapy; Osteoarthritis, Knee; Pain
PubMed: 34654554
DOI: 10.1016/j.physio.2021.03.011 -
Scandinavian Journal of Medicine &... Aug 2023Stretch training increases the range of motion of a joint. However, to date, the mechanisms behind such a stretching effect are not well understood. An earlier... (Meta-Analysis)
Meta-Analysis Review
Stretch training increases the range of motion of a joint. However, to date, the mechanisms behind such a stretching effect are not well understood. An earlier meta-analysis on several studies reported no changes in the passive properties of a muscle (i.e., muscle stiffness) following long-term stretch training with various types of stretching (static, dynamic, and proprioceptive neuromuscular stretching). However, in recent years, an increasing number of papers have reported the effects of long-term static stretching on muscle stiffness. The purpose of the present study was to examine the long-term (≥2 weeks) effect of static stretching training on muscle stiffness. PubMed, Web of Science, and EBSCO published before December 28, 2022, were searched and 10 papers met the inclusion criteria for meta-analysis. By applying a mixed-effect model, subgroup analyses, which included comparisons of sex (male vs. mixed sex) and type of muscle stiffness assessment (calculated from the muscle-tendon junction vs. shear modulus), were performed. Furthermore, a meta-regression was conducted to examine the effect of total stretching duration on muscle stiffness. The result of the meta-analysis showed a moderate decrease in muscle stiffness after 3-12 weeks of static stretch training compared to a control condition (effect size = -0.749, p < 0.001, I = 56.245). Subgroup analyses revealed no significant differences between sex (p = 0.131) and type of muscle stiffness assessment (p = 0.813). Moreover, there was no significant relationship between total stretching duration and muscle stiffness (p = 0.881).
Topics: Humans; Male; Muscle, Skeletal; Muscle Stretching Exercises; Range of Motion, Articular; Elasticity; Torque
PubMed: 37231582
DOI: 10.1111/sms.14402 -
Medicina (Kaunas, Lithuania) Jul 2021: Osteoarthritis (OA) is among the most common degenerative diseases that induce pain, stiffness and reduced functionality. Various physiotherapy techniques and methods... (Review)
Review
: Osteoarthritis (OA) is among the most common degenerative diseases that induce pain, stiffness and reduced functionality. Various physiotherapy techniques and methods have been used for the treatment of OA, including soft tissue techniques, therapeutic exercises, and manual techniques. The primary aim of this systemic review was to evaluate the short-and long-term efficacy of manual therapy (MT) in patients with knee OA in terms of decreasing pain and improving knee range of motion (ROM) and functionality. : A computerised search on the PubMed, PEDro and CENTRAL databases was performed to identify controlled randomised clinical trials (RCTs) that focused on MT applications in patients with knee OA. The keywords used were 'knee OA', 'knee arthritis', 'MT', 'mobilisation', 'ROM' and 'WOMAC'. : Six RCTs and randomised crossover studies met the inclusion criteria and were included in the final analysis. The available studies indicated that MT can induce a short-term reduction in pain and an increase in knee ROM and functionality in patients with knee OA. MT techniques can contribute positively to the treatment of patients with knee OA by reducing pain and increasing functionality. Further research is needed to strengthen these findings by comparing the efficacy of MT with those of other therapeutic techniques and methods, both in the short and long terms.
Topics: Exercise Therapy; Humans; Knee Joint; Musculoskeletal Manipulations; Osteoarthritis, Knee; Range of Motion, Articular
PubMed: 34356977
DOI: 10.3390/medicina57070696 -
Scandinavian Journal of Medicine &... Apr 2019Isometric training is used in the rehabilitation and physical preparation of athletes, special populations, and the general public. However, little consensus exists...
Isometric training is used in the rehabilitation and physical preparation of athletes, special populations, and the general public. However, little consensus exists regarding training guidelines for a variety of desired outcomes. Understanding the adaptive response to specific loading parameters would be of benefit to practitioners. The objective of this systematic review, therefore, was to detail the medium- to long-term adaptations of different types of isometric training on morphological, neurological, and performance variables. Exploration of the relevant subject matter was performed through MEDLINE, PubMed, SPORTDiscus, and CINAHL databases. English, full-text, peer-reviewed journal articles and unpublished doctoral dissertations investigating medium- to long-term (≥3 weeks) adaptations to isometric training in humans were identified. These studies were evaluated further for methodological quality. Twenty-six research outputs were reviewed. Isometric training at longer muscle lengths (0.86%-1.69%/week, ES = 0.03-0.09/week) produced greater muscular hypertrophy when compared to equal volumes of shorter muscle length training (0.08%-0.83%/week, ES = -0.003 to 0.07/week). Ballistic intent resulted in greater neuromuscular activation (1.04%-10.5%/week, ES = 0.02-0.31/week vs 1.64%-5.53%/week, ES = 0.03-0.20/week) and rapid force production (1.2%-13.4%/week, ES = 0.05-0.61/week vs 1.01%-8.13%/week, ES = 0.06-0.22/week). Substantial improvements in muscular hypertrophy and maximal force production were reported regardless of training intensity. High-intensity (≥70%) contractions are required for improving tendon structure and function. Additionally, long muscle length training results in greater transference to dynamic performance. Despite relatively few studies meeting the inclusion criteria, this review provides practitioners with insight into which isometric training variables (eg, joint angle, intensity, intent) to manipulate to achieve desired morphological and neuromuscular adaptations.
Topics: Adaptation, Physiological; Humans; Isometric Contraction; Muscle, Skeletal; Resistance Training; Tendons
PubMed: 30580468
DOI: 10.1111/sms.13375 -
Bioscience Reports Jun 2021To assess the efficacy and safety of Curcuma longa extract and curcumin supplements on osteoarthritis (OA). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess the efficacy and safety of Curcuma longa extract and curcumin supplements on osteoarthritis (OA).
METHODS
The databases such as Pubmed and Cochrane Library were searched to collect the article about Curcuma longa extract and curcumin in the treatment of OA. Then, randomized controlled trials (RCTs) were selected and their data were extracted. Finally, the RevMan5.3 was utilized for risk of bias assessment and meta-analysis, the STATA15.0 were utilized for publication bias assessment, and GRADE tool were used for the evidence quality assessment of primary outcomes.
RESULTS
A total of 15 RCTs involving 1621 participants were included. (1) Compared with placebo, Curcuma longa extract and curcumin (C.) can decrease the visual analog scale (VAS) and The Western Ontario and McMaster Universities (WOMAC) score-pain, the WOMAC score-function and the WOMAC score-stiffness. In terms of adverse events, Curcuma longa extract and curcumin are comparable with those of placebo. (2) Compared with non-steroidal anti-inflammatory drugs (NSAIDs), Curcuma longa extract and curcumin have similar effects on joint pain, function and stiffness. The incidence of adverse events in Curcuma longa extract and curcumin was lower. (3) Compared with the NSAIDs group, C.+NSAIDs can also decrease the VAS and WOMAC score-pain, the WOMAC score-function and the WOMAC score-stiffness. In terms of adverse events, the addition of Curcuma longa extract and curcumin to NSAIDs did not increase adverse events.
CONCLUSION
Curcuma longa extract and curcumin may be a safer and effective supplement for OA patients. It is recommended to use Curcuma longa extract and curcumin supplement for OA patients for more than 12 weeks.
Topics: Adult; Aged; Antirheumatic Agents; Curcuma; Dietary Supplements; Female; Humans; Male; Middle Aged; Osteoarthritis; Pain Measurement; Plant Extracts; Randomized Controlled Trials as Topic; Time Factors; Treatment Outcome; Young Adult
PubMed: 34017975
DOI: 10.1042/BSR20210817 -
Journal of Sports Science & Medicine Sep 2023Static stretching can increase the range of motion of a joint. Muscle-tendon unit stiffness (MTS) is potentially one of the main factors that influences the change in... (Meta-Analysis)
Meta-Analysis Review
Static stretching can increase the range of motion of a joint. Muscle-tendon unit stiffness (MTS) is potentially one of the main factors that influences the change in the range of motion after static stretching. However, to date, the effects of acute and long-term static stretching on MTS are not well understood. The purpose of this meta-analysis was to investigate the effects of acute and long-term static stretching training on MTS, in young healthy participants. PubMed, Web of Science, and EBSCO published before January 6, 2023, were searched and finally, 17 papers were included in the meta-analysis. Main meta-analysis was performed with a random-effect model and subgroup analyses, which included comparisons of sex (male vs. mixed sex and female) and muscle (hamstrings vs. plantar flexors) were also performed. Furthermore, a meta-regression was conducted to examine the effect of total stretching duration on MTS. For acute static stretching, the result of the meta-analysis showed a moderate decrease in MTS (effect size = -0.772, Z = -2.374, 95% confidence interval = -1.409 - -0.325, p = 0.018, I = 79.098). For long-term static stretching, there is no significant change in MTS (effect size = -0.608, Z = -1.761, 95% CI = -1.284 - 0.069, p = 0.078, I = 83.061). Subgroup analyses revealed no significant differences between sex (long-term, p = 0.209) or muscle (acute, p =0.295; long-term, p = 0.427). Moreover, there was a significant relationship between total stretching duration and MTS in acute static stretching (p = 0.011, R2 = 0.28), but not in long-term stretching (p = 0.085, R < 0.01). Whilst MTS decreased after acute static stretching, only a tendency of a decrease was seen after long-term stretching.
Topics: Female; Male; Humans; Muscle Stretching Exercises; Tendons; Muscles; Hamstring Muscles
PubMed: 37711702
DOI: 10.52082/jssm.2023.465 -
Journal of Sports Science & Medicine Mar 2020Although the role of shoe constructions on running injury and performance has been widely investigated, systematic reviews on the shoe construction effects on running...
Although the role of shoe constructions on running injury and performance has been widely investigated, systematic reviews on the shoe construction effects on running biomechanics were rarely reported. Therefore, this review focuses on the relevant research studies examining the biomechanical effect of running shoe constructions on reducing running-related injury and optimising performance. Searches of five databases and Footwear Science from January 1994 to September 2018 for related biomechanical studies which investigated running footwear constructions yielded a total of 1260 articles. After duplications were removed and exclusion criteria applied to the titles, abstracts and full text, 63 studies remained and categorised into following constructions: (a) shoe lace, (b) midsole, (c) heel flare, (d) heel-toe drop, (e) minimalist shoes, (f) Masai Barefoot Technologies, (g) heel cup, (h) upper, and (i) bending stiffness. Some running shoe constructions positively affect athletic performance-related and injury-related variables: 1) increasing the stiffness of running shoes at the optimal range can benefit performance-related variables; 2) softer midsoles can reduce impact forces and loading rates; 3) thicker midsoles can provide better cushioning effects and attenuate shock during impacts but may also decrease plantar sensations of a foot; 4) minimalist shoes can improve running economy and increase the cross-sectional area and stiffness of Achilles tendon but it would increase the metatarsophalangeal and ankle joint loading compared to the conventional shoes. While shoe constructions can effectively influence running biomechanics, research on some constructions including shoe lace, heel flare, heel-toe drop, Masai Barefoot Technologies, heel cup, and upper requires further investigation before a viable scientific guideline can be made. Future research is also needed to develop standard testing protocols to determine the optimal stiffness, thickness, and heel-toe drop of running shoes to optimise performance-related variables and prevent running-related injuries.
Topics: Achilles Tendon; Ankle Joint; Athletic Performance; Biomechanical Phenomena; Equipment Design; Forefoot, Human; Humans; Metatarsophalangeal Joint; Running; Shoes; Stress, Mechanical
PubMed: 32132824
DOI: No ID Found -
Scandinavian Journal of Medicine &... Mar 2018It is recognized that stretching is an effective method to chronically increase the joint range of motion. However, the effects of stretching training on the... (Meta-Analysis)
Meta-Analysis Review
It is recognized that stretching is an effective method to chronically increase the joint range of motion. However, the effects of stretching training on the muscle-tendon structural properties remain unclear. This systematic review with meta-analysis aimed to determine whether chronic stretching alter the muscle-tendon structural properties. Published papers regarding longitudinal stretching (static, dynamic and/or PNF) intervention (either randomized or not) in humans of any age and health status, with more than 2 weeks in duration and at least 2 sessions per week, were searched in PubMed, PEDro, ScienceDirect and ResearchGate databases. Structural or mechanical variables from joint (maximal tolerated passive torque or resistance to stretch) or muscle-tendon unit (muscle architecture, stiffness, extensibility, shear modulus, volume, thickness, cross-sectional area, and slack length) were extracted from those papers. A total of 26 studies were selected, with a duration ranging from 3 to 8 weeks, and an average total time under stretching of 1165 seconds per week. Small effects were seen for maximal tolerated passive torque, but trivial effects were seen for joint resistance to stretch, muscle architecture, muscle stiffness, and tendon stiffness. A large heterogeneity was seen for most of the variables. Stretching interventions with 3- to 8-week duration do not seem to change either the muscle or the tendon properties, although it increases the extensibility and tolerance to a greater tensile force. Adaptations to chronic stretching protocols shorter than 8 weeks seem to mostly occur at a sensory level.
Topics: Adaptation, Physiological; Elasticity; Humans; Muscle Stretching Exercises; Muscle, Skeletal; Non-Randomized Controlled Trials as Topic; Randomized Controlled Trials as Topic; Range of Motion, Articular; Tendons; Torque
PubMed: 28801950
DOI: 10.1111/sms.12957