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http://dx.doi.org/10.12674/ptk.2020.27.1.30

The Effects of Proprioceptive Neuromuscular Facilitation and Static Stretching Performed at Various Intensities on Hamstring Flexibility  

Lim, Woo-taek (Department of Physical Therapy, College of Health and Welfare, Woosong University)
Publication Information
Physical Therapy Korea / v.27, no.1, 2020 , pp. 30-37 More about this Journal
Abstract
Background: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.
Keywords
Hamstring muscles; High-intensity; Low-intensity; Proprioceptive neuromuscular; facilitation stretching; Static stretching;
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1 Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Appl Physiol Nutr Metab 2016;41(1):1-11.   DOI
2 Toft E, Espersen GT, Kalund S, Sinkjaer T, Hornemann BC. Passive tension of the ankle before and after stretching. Am J Sports Med 1989;17(4):489-94.   DOI
3 Edman KA, Tsuchiya T. Strain of passive elements during force enhancement by stretch in frog muscle fibres. J Physiol 1996;490:191-205.   DOI
4 Rubini EC, Costa AL, Gomes PS. The effects of stretching on strength performance. Sports Med 2007;37(3):213-24.   DOI
5 Moore MA, Hutton RS. Electromyographic investigation of muscle stretching techniques. Med Sci Sports Exerc 1980;12(5):322-9.   DOI
6 Avela J, Kyrolainen H, Komi PV. Altered reflex sensitivity after repeated and prolonged passive muscle stretching. J Appl Physiol (1985) 1999;86(4):1283-91.   DOI
7 Proske U, Tsay A, Allen T. Muscle thixotropy as a tool in the study of proprioception. Exp Brain Res 2014;232(11):3397-412.   DOI
8 Lakie M, Campbell KS. Muscle thixotropy-where are we now? J Appl Physiol (1985) 2019;126(6):1790-9.   DOI
9 Lim W. The relationship between hip extension force measured by using a hand-held dynamometer and the effect of proprioceptive neuromuscular facilitation stretching on hamstring flexibility. Korean J Stress Res 2016;24(4):252-6.   DOI
10 Askling C, Lund H, Saartok T, Thorstensson A. Self-reported hamstring injuries in student-dancers. Scand J Med Sci Sports 2002;12(4):230-5.   DOI
11 Etnyre BR, Abraham LD. Gains in range of ankle dorsiflexion using three popular stretching techniques. Am J Phys Med 1986;65(4):189-96.
12 Feland JB, Myrer JW, Merrill RM. Acute changes in hamstring flexibility: PNF versus static stretch in senior athletes. Phys Ther Sport 2001;2(4):186-93.   DOI
13 Funk DC, Swank AM, Mikla BM, Fagan TA, Farr BK. Impact of prior exercise on hamstring flexibility: a comparison of proprioceptive neuromuscular facilitation and static stretching. J Strength Cond Res 2003;17(3):489-92.   DOI
14 Behm DG, Kibele A. Effects of differing intensities of static stretching on jump performance. Eur J Appl Physiol 2007;101(5):587-94.   DOI
15 Cornelius WL, Rauschuber MR. The relationship between isometric contraction durations and improvement in acute hip joint flexibility. J Appl Sport Sci Res 1987;1(3):39.
16 Schmitt GD, Pelham TW, Holt LE. A comparison of selected protocols during proprioceptive neuromuscular facilitation stretching. Clin Kinesiol 1999;53(1):16-21.
17 Fullem BW. Overuse lower extremity injuries in sports. Clin Podiatr Med Surg 2015;32(2):239-51.   DOI
18 Bowerman EA, Whatman C, Harris N, Bradshaw E. A review of the risk factors for lower extremity overuse injuries in young elite female ballet dancers. J Dance Med Sci 2015;19(2):51-6.   DOI
19 Mucha MD, Caldwell W, Schlueter EL, Walters C, Hassen A. Hip abductor strength and lower extremity running related injury in distance runners: a systematic review. J Sci Med Sport 2017;20(4):349-55.   DOI
20 Safran MR, Seaber AV, Garrett WE Jr. Warm-up and muscular injury prevention. An update. Sports Med 1989;8(4):239-49.   DOI
21 Woods K, Bishop P, Jones E. Warm-up and stretching in the prevention of muscular injury. Sports Med 2007;37(12):1089-99.   DOI
22 Magnusson SP, Simonsen EB, Aagaard P, Kjaer M. Biomechanical responses to repeated stretches in human hamstring muscle in vivo. Am J Sports Med 1996;24(5):622-8.   DOI
23 McHugh MP, Nesse M. Effect of stretching on strength loss and pain after eccentric exercise. Med Sci Sports Exerc 2008;40(3):566-73.   DOI
24 Herda TJ, Ryan ED, Smith AE, Walter AA, Bemben MG, Stout JR, et al. Acute effects of passive stretching vs vibration on the neuromuscular function of the plantar flexors. Scand J Med Sci Sports 2009;19(5):703-13.   DOI
25 Decoster LC, Cleland J, Altieri C, Russell P. The effects of hamstring stretching on range of motion: a systematic literature review. J Orthop Sports Phys Ther 2005;35(6):377-87.   DOI
26 McHugh MP, Cosgrave CH. To stretch or not to stretch: the role of stretching in injury prevention and performance. Scand J Med Sci Sports 2010;20(2):169-81.   DOI
27 Worrell TW, Smith TL, Winegardner J. Effect of hamstring stretching on hamstring muscle performance. J Orthop Sports Phys Ther 1994;20(3):154-9.   DOI
28 Marek SM, Cramer JT, Fincher AL, Massey LL, Dangelmaier SM, Purkayastha S, et al. Acute effects of static and proprioceptive neuromuscular facilitation stretching on muscle strength and power output. J Athl Train 2005;40(2):94-103.
29 Manoel ME, Harris-Love MO, Danoff JV, Miller TA. Acute effects of static, dynamic, and proprioceptive neuromuscular facilitation stretching on muscle power in women. J Strength Cond Res 2008;22(5):1528-34.   DOI
30 Lempke L, Wilkinson R, Murray C, Stanek J. The effectiveness of PNF versus static stretching on increasing hip-flexion range of motion. J Sport Rehabil 2018;27(3):289-94.   DOI
31 Wallin D, Ekblom B, Grahn R, Nordenborg T. Improvement of muscle flexibility. A comparison between two techniques. Am J Sports Med 1985;13(4):263-8.   DOI
32 Hamid MS, Ali MR, Yusof A. Interrater and intrarater reliability of the active knee extension (AKE) test among healthy adults. J Phys Ther Sci 2013;25(8):957-61.   DOI
33 Neto T, Jacobsohn L, Carita AI, Oliveira R. Reliability of the active-knee-extension and straight-leg-raise tests in subjects with flexibility deficits. J Sport Rehabil 2015;24(4):1-4.   DOI
34 Worrell TW, Karst G, Adamczyk D, Moore R, Stanley C, Steimel B, et al. Influence of joint position on electromyographic and torque generation during maximal voluntary isometric contractions of the hamstrings and gluteus maximus muscles. J Orthop Sports Phys Ther 2001;31(12):730-40.   DOI
35 Lim W. Easy method for measuring stretching intensities in real clinical settings and effects of different stretching intensities on flexibility. J Back Musculoskelet Rehabil 2019;32(4):579-85.   DOI
36 Holt LE, Pelham TW, Campagna PD. Hemodynamics during a machine-aided flexibility protocol. Can J Appl Physiol 1995;20(4):407-16.   DOI
37 Chaouachi A, Castagna C, Chtara M, Brughelli M, Turki O, Galy O, et al. Effect of warm-ups involving static or dynamic stretching on agility, sprinting, and jumping performance in trained individuals. J Strength Cond Res 2010;24(8):2001-11.   DOI
38 Freitas SR, Vilarinho D, Rocha Vaz J, Bruno PM, Costa PB, Milhomens P. Responses to static stretching are dependent on stretch intensity and duration. Clin Physiol Funct Imaging 2015;35(6):478-84.   DOI
39 Apostolopoulos NC, Lahart IM, Plyley MJ, Taunton J, Nevill AM, Koutedakis Y, et al. The effects of different passive static stretching intensities on recovery from unaccustomed eccentric exercise - a randomized controlled trial. Appl Physiol Nutr Metab 2018;43(8):806-15.   DOI
40 Lim W. Optimal intensity of PNF stretching: maintaining the efficacy of stretching while ensuring its safety. J Phys Ther Sci 2018;30(8):1108-11.   DOI
41 Vetter RE. Effects of six warm-up protocols on sprint and jump performance. J Strength Cond Res 2007;21(3):819-23.   DOI
42 Feland JB, Marin HN. Effect of submaximal contraction intensity in contract-relax proprioceptive neuromuscular facilitation stretching. Br J Sports Med 2004;38(4):E18.   DOI
43 Khodayari B, Dehghani Y. The investigation of mid-term effect of different intensity of PNF stretching on improve hamstring flexibility. Procedia-Soc Behav Sci 2012;46:5741-4.   DOI
44 Sheard PW, Paine TJ. Optimal contraction intensity during proprioceptive neuromuscular facilitation for maximal increase of range of motion. J Strength Cond Res 2010;24(2):416-21.   DOI
45 Young W, Elias G, Power J. Effects of static stretching volume and intensity on plantar flexor explosive force production and range of motion. J Sports Med Phys Fitness 2006;46(3):403-11.
46 Freitas SR, Andrade RJ, Nordez A, Mendes B, Mil-Homens P. Acute muscle and joint mechanical responses following a high-intensity stretching protocol. Eur J Appl Physiol 2016;116(8):1519-26.   DOI
47 Gajdosik R, Lusin G. Hamstring muscle tightness. Reliability of an active-knee-extension test. Phys Ther 1983;63(7):1085-90.   DOI
48 Davis DS, Quinn RO, Whiteman CT, Williams JD, Young CR. Concurrent validity of four clinical tests used to measure hamstring flexibility. J Strength Cond Res 2008;22(2):583-8.   DOI
49 Cornwell A, Nelson AG, Sidaway B. Acute effects of stretching on the neuromechanical properties of the triceps surae muscle complex. Eur J Appl Physiol 2002;86(5):428-34.   DOI