Foam rolling (FR) has been demonstrated to acutely enhance joint range of motion (ROM). However, data syntheses pooling the effect sizes across studies are scarce. It is, furthermore, unknown which ...moderators affect the treatment outcome.
To quantify the immediate effects of FR on ROM in healthy adults.
A multilevel meta-analysis with a robust random effects meta-regression model was used to pool the standardized mean differences (SMD) between FR and no-exercise (NEX) as well as FR and stretching. The influence of the possible effect modifiers treatment duration, speed, targeted muscle, testing mode (active/passive ROM), sex, BMI, and study design was examined in a moderator analysis.
Twenty-six trials with high methodological quality (PEDro scale) were identified. Compared to NEX, FR had a large positive effect on ROM (SMD: 0.74, 95% CI 0.42-1.01, p = 0.0002), but was not superior to stretching (SMD: - 0.02, 95% CI - 0.73 to 0.69, p = 0.95). Although the few individual study findings suggest that FR with vibration may be more effective than NEX or FR without vibration, the pooled results did not reveal significant differences (SMD: 6.75, 95% CI - 76.4 to 89.9, p = 0.49 and SMD: 0.66, 95% CI - 1.5 to 2.8, p = 0.32). According to the moderator analysis, most potential effect modifiers (e.g., BMI, speed or duration) do not have a significant impact (p > 0.05) but FR may be less effective in men (p < 0.05).
FR represents an effective method to induce acute improvements in joint ROM. The impact of moderators should be further elucidated in future research.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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.
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DOBA, FSPLJ, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In this randomized trial, tai chi was more effective than resistance-training or stretching programs in improving the postural stability of patients with Parkinson's disease. Tai chi also was more ...effective than the stretching program in reducing the number of falls.
Movement impairments, especially loss of the ability to maintain standing balance, adversely affect function and quality of life in patients with Parkinson's disease.
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With progression of the disease, patients lose postural stability and have gait dysfunction, difficulty managing activities of daily living, and frequent falls.
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Although some motor dysfunction, such as tremor, may be alleviated with drug therapy, characteristics such as postural instability are less responsive to medication and require alternative approaches.
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Exercise is an integral part of the management of Parkinson's disease because physical activity has been shown to retard the deterioration of motor functions and . . .
The benefits of preexercise muscle stretching have been recently questioned after reports of significant poststretch reductions in force and power production. However, methodological issues and ...equivocal findings have prevented a clear consensus being reached. As no detailed systematic review exists, the literature describing responses to acute static muscle stretch was comprehensively examined.
MEDLINE, ScienceDirect, SPORTDiscus, and Zetoc were searched with recursive reference checking. Selection criteria included randomized or quasi-randomized controlled trials and intervention-based trials published in peer-reviewed scientific journals examining the effect of an acute static stretch intervention on maximal muscular performance.
Searches revealed 4559 possible articles; 106 met the inclusion criteria. Study design was often poor because 30% of studies failed to provide appropriate reliability statistics. Clear evidence exists indicating that short-duration acute static stretch (<30 s) has no detrimental effect (pooled estimate = -1.1%), with overwhelming evidence that stretch durations of 30-45 s also imparted no significant effect (pooled estimate = -1.9%). A sigmoidal dose-response effect was evident between stretch duration and both the likelihood and magnitude of significant decrements, with a significant reduction likely to occur with stretches ≥ 60 s. This strong evidence for a dose-response effect was independent of performance task, contraction mode, or muscle group. Studies have only examined changes in eccentric strength when the stretch durations were >60 s, with limited evidence for an effect on eccentric strength.
The detrimental effects of static stretch are mainly limited to longer durations (≥ 60 s), which may not be typically used during preexercise routines in clinical, healthy, or athletic populations. Shorter durations of stretch (<60 s) can be performed in a preexercise routine without compromising maximal muscle performance.
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.
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BFBNIB, FSPLJ, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
An objective of a warm-up prior to an athletic event is to optimize performance. Warm-ups are typically composed of a submaximal aerobic activity, stretching and a sport-specific activity. The ...stretching portion traditionally incorporated static stretching. However, there are a myriad of studies demonstrating static stretch-induced performance impairments. More recently, there are a substantial number of articles with no detrimental effects associated with prior static stretching. The lack of impairment may be related to a number of factors. These include static stretching that is of short duration (<90 s total) with a stretch intensity less than the point of discomfort. Other factors include the type of performance test measured and implemented on an elite athletic or trained middle aged population. Static stretching may actually provide benefits in some cases such as slower velocity eccentric contractions, and contractions of a more prolonged duration or stretch-shortening cycle. Dynamic stretching has been shown to either have no effect or may augment subsequent performance, especially if the duration of the dynamic stretching is prolonged. Static stretching used in a separate training session can provide health related range of motion benefits. Generally, a warm-up to minimize impairments and enhance performance should be composed of a submaximal intensity aerobic activity followed by large amplitude dynamic stretching and then completed with sport-specific dynamic activities. Sports that necessitate a high degree of static flexibility should use short duration static stretches with lower intensity stretches in a trained population to minimize the possibilities of impairments.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Objective:
To identify effective strengthening exercise programs and provide rehabilitation teams and patients with updated, high-quality recommendations concerning traditional land-based exercises ...for knee osteoarthritis.
Methods:
A systematic search and adapted selection criteria included comparative controlled trials with strengthening exercise programs for patients with knee osteoarthritis. A panel of experts reached consensus on the recommendations using a Delphi survey. A hierarchical alphabetical grading system (A, B, C+, C, D, D+ or D-) was based on statistical significance (p < 0.5) and clinical importance (⩾15% improvement).
Results:
The 26 high-quality studies identified demonstrated that various strengthening exercise programs with/without other types of therapeutic exercises are generally effective for improving knee osteoarthritis management within a six-month period. Strengthening exercise programs demonstrated a significant improvement for pain relief (four Grade A, ten Grade B, two Grade C+), physical function (four Grade A, eight Grade B) and quality of life (three Grade B). Strengthening in combination with other types of exercises (coordination, balance, functional) showed a significant improvement in pain relief (three Grade A, 11 Grade B, eight Grade C+), physical function (two Grade A, four Grade B, three Grade C+) and quality of life (one Grade A, one Grade C+).
Conclusion:
There are a variety of choices for strengthening exercise programs with positive recommendations for healthcare professionals and knee osteoarthritis patients. There is a need to develop combined behavioral and muscle-strengthening strategies to improve long-term maintenance of regular strengthening exercise programs.
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This study investigated the synergistic difference in the effect of stretching on electromechanical delay (EMD) and its components, using a simultaneous recording of electromyographic, ...mechanomyographic, and force signals. Twenty-six healthy men underwent plantar flexors passive stretching. Before and after stretching, the electrochemical and mechanical components of the EMD and the relaxation EMD (R-EMD) were calculated in gastrocnemius medialis (GM), lateralis (GL) and soleus (SOL) during a supramaximal motor point stimulation. Additionally, joint passive stiffness was assessed. At baseline, the mechanical components of EMD and R-EMD were longer in GM and GL than SOL (Cohen's d from 1.78 to 3.67). Stretching decreased joint passive stiffness -22(8)%, d = -1.96 while overall lengthened the electrochemical and mechanical EMD. The mechanical R-EMD components were affected more in GM 21(2)% and GL 22(2)% than SOL 12(1)%, with d ranging from 0.63 to 1.81. Negative correlations between joint passive stiffness with EMD and R-EMD mechanical components were found before and after stretching in all muscles (r from -0.477 to -0.926; P from 0.007 to <0.001). These results suggest that stretching plantar flexors affected GM and GL more than SOL. Future research should calculate EMD and R-EMD to further investigate the mechanical adaptations induced by passive stretching in synergistic muscles.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To assess and compare the effects of different stretching exercise programs on pain, stiffness, and physical function disability in older adults with knee osteoarthritis (KOA).
This study followed ...the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline for network meta-analysis (NMA). Relevant randomized controlled trials were identified by searching 7 databases up to December 2022.
Inclusion criteria included (1) older adults with KOA; (2) intervention included stretching exercises; (3) control groups received no stretching exercise; and (4) outcome measurements included pain, stiffness, or physical function disability. Methodological quality was assessed using the Cochrane risk-of-bias tool for randomized trials version 2.
NMA was performed using R and MetaInsight, with results presented as a standardized mean difference (SMD) with 95% confidence interval (CI).
We examined 17 studies, and NMA results indicated that proprioceptive neuromuscular facilitation (PNF) stretching, mind-body exercises, and multi-component exercise programs were effective in mitigating pain in older adults with KOA (SMD=2.54 95% CI: 1.23; 3.84, SMD=1.09 95% CI: 0.27; 1.92, SMD=0.57 95% CI: 0.06; 1.09). Moreover, mind-body exercises and multi-component exercises were the most effective programs in reducing stiffness (SMD=1.31 95% CI: 0.12; 2.51) and physical function disability (SMD=1.67 95% CI: 0.01; 3.33) in older adults with KOA, respectively.
Findings suggest that PNF stretching, mind-body exercises, and multi-component exercises can be incorporated into exercise programs to better mitigate pain, stiffness, and physical function disability in older adults with KOA.
We applied a meta‐analytical approach to derive a robust estimate of the acute effects of pre‐exercise static stretching (SS) on strength, power, and explosive muscular performance. A computerized ...search of articles published between 1966 and December 2010 was performed using PubMed, SCOPUS, and Web of Science databases. A total of 104 studies yielding 61 data points for strength, 12 data points for power, and 57 data points for explosive performance met our inclusion criteria. The pooled estimate of the acute effects of SS on strength, power, and explosive performance, expressed in standardized units as well as in percentages, were −0.10 95% confidence interval (CI): −0.15 to −0.04, −0.04 (95% CI: −0.16 to 0.08), and −0.03 (95% CI: −0.07 to 0.01), or −5.4% (95% CI: −6.6% to −4.2%), −1.9% (95% CI: −4.0% to 0.2%), and −2.0% (95% CI: −2.8% to −1.3%). These effects were not related to subject's age, gender, or fitness level; however, they were more pronounced in isometric vs dynamic tests, and were related to the total duration of stretch, with the smallest negative acute effects being observed with stretch duration of ≤45 s. We conclude that the usage of SS as the sole activity during warm‐up routine should generally be avoided.
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