• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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• pp.111-119
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• 2020

PURPOSE: In adults with hamstring tightness, stretching is considered a therapeutic exercise that improves flexibility. However, previous studies have reported efficacy of numerous methods, and are inconclusive in determining the most effective stretching techniques. This study aims to compare the outcomes of Evjenth-Hamberg stretching (E-HS), proprioceptive neuromuscular facilitation stretching (PNFS), and static stretching (SS), on muscle tone and flexibility. METHODS: A total of 30 subjects were assigned to each of the three stretching groups:; E-HS (n₁ = 10), PNFS (n₂ = 10), and SS (n₃ = 10). Muscle tone of the hamstring muscle, active knee extension (AKE), and passive knee extension (PKE) were assessed by range of motion. RESULTS: After the intervention, statistically significant differences were obtained between groups for muscle tone (p < .05). The post hoc test, showed statistically significant differences in muscle tone between the E-HS and PNFS groups (p < .05), and PNFS and SS groups (p < .05). Post hoc test after intervention, also revealed statistically significant differences in flexibility (p < .05) between the E-HS and PNFS groups (p < .05), E-HS and SS groups (p < .05), and PNFS and SS groups (p < .05). Moreover, a statistically significant difference was observed in PKE scores between the E-HS and SS groups (p < .05), and PNFS and SS groups (p < .05). CONCLUSION: This study indicates that E-HS may be the most effective stretching technique for muscle tone and flexibility, in adults with hamstring tightness.

• Physical Therapy Korea
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• v.24 no.2
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• pp.9-18
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• 2017

Background: Limitation of hamstring extensibility is often associated with various musculoskeletal problems such as alterations in posture and walking patterns. Thus, certain appropriate strategies need to be established for its management. Objects: The aim of this study was to compare the effects of the neural mobilization technique and static stretching exercises on popliteal angle and hamstring compliance in young women with short hamstring syndrome (SHS). Methods: Thirty-three women with SHS were randomly assigned to either group-1 ($n_1=17$) that underwent the neural mobilization technique or group-2 ($n_2=16$) that underwent the static stretching exercises. Outcome measures included the active popliteal angle (APA) and a hamstring's electromyographic (EMG) activity at a maximum popliteal angle of the baseline. Intervention for each group was performed for a total time of 3-min (6 sets of a 30-sec application). Results: There were significant interactions between time and group in the APA [group-1 (pre-test to post-test): $69.70{\pm}8.14^{\circ}$ to $74.14{\pm}8.07^{\circ}$ and group-2: $68.66{\pm}7.42^{\circ}$ to $70.52{\pm}7.92^{\circ}$] (F1,31=6.678, p=.015) and the EMG activity of the hamstring (group-1: $1.12{\pm}.30{\mu}N$ to $.69{\pm}.31{\mu}V$ and group-2: $1.19{\pm}.49{\mu}V$ to $1.13{\pm}.47{\mu}V$)(F1,31=6.678, p=.015). Between-group comparison revealed that the EMG activity of the hamstring was significantly different at post-test between the groups (p<.05). Furthermore, in within-group comparison, group-1 appeared to be significantly different for both variables between pre- and post-test (p<.05); however, group-2 showed significant difference in only the APA between pre- and post-test (p<.05). Conclusion: These findings suggest that the neural mobilization technique and static stretching exercises may be advantageous to improve hamstring compliance in young women with SHS, resulting in a more favorable outcome in the neural mobilization technique.

• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.266-272
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• 2019

Purpose: This study compared the effects of Static stretching and Mulligan's Two-leg rotation about the Hamstring flexibility, Hip range of motion, and pain. Methods: The subjects were allocated randomly into two groups: Static stretching group (n=13) and Mulligan's two leg rotation group (n=14). The study was designed with stretching protocols for four minutes and thirty seconds per day five times a week for three weeks in total. Measurements, including the Sit and reach test, Active/Passive Straight leg raise, and Visual analogue scale, were conducted before and after the intervention. The data were analyzed using a paired t-test and independent t-test. Results: The flexibility of the two leg rotation group was higher than the static stretching group after the intervention. The post-sit and reach test value of the two leg rotation group was significantly higher than the pre-sit and reach test value of the static stretching group. In addition, the variance of the sit and reach test of the two leg rotation group was significantly higher than that of the static stretching group. Conclusion: These results showed that two leg rotation techniques have a positive effect on the changes in the sit and reach test and active straight leg raise test. Two leg rotation techniques can be recommended as a self-stretching and easier way to stabilize the lumbopelvic rhythm, reduce the stiffness of the muscle and relieve pain. This is effective in preventing muscle damage, enabling muscle relaxation and reducing the risk of injury to the spine during daily lives and in sports activities.

• Physical Therapy Korea
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• v.26 no.3
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• pp.32-41
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• 2019

Background: Limitations in hip flexion caused by tight hamstrings lead to excessive lumbar flexion and low back pain. Accordingly, many studies have examined how to stretch the hamstring muscle. However, no study has focused on the effect of hamstring eccentric exercise for tight hamstrings on trunk forward bending. Objects: We compared the short-term effect of hamstring eccentric exercise (HEE) and hamstring static stretching (HSS) on trunk forward bending in individuals with tight hamstrings. Methods: Thirty individuals with tight hamstrings participated in the study. The subjects were randomly allocated to either a HEE or HSS group. To determine whether the hamstrings were tight, the active knee extension (AKE) test was performed, and the degree of hip flexion was measured. To assess trunk forward bending, subjects performed the fingertip to floor (FTF) and modified modified Schober tests, and the degree of trunk forward bending was measured using an inclinometer. We used paired t-tests to compare the values before and after exercise in each group and independent t-tests to compare the two groups on various measures Results: The FTF test results were improved significantly after the exercise in both groups, and AKE for both legs increased significantly in both groups. There was no significant difference in the hip angles, mmS test results, or degree of trunk forward bending between groups after the exercise. No test results differed significantly between the two groups at baseline or after the exercise. Both groups increased hamstring flexibility and trunk forward bending. Conclusion: HSS and the HEE groups increased hamstring flexibility and trunk forward bending. However, HEE has additional benefits, such as injury prevention and muscle strengthening.

• PNF and Movement
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• v.13 no.3
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• pp.135-143
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• 2015

Purpose: The purpose of this study was to assess the effect of the proprioceptive neuromuscular facilitation (PNF) relaxation technique (hold relax; HR, contract relax; CR) and static stretch (SS) on hamstring flexibility and vertical jump performance in healthy adults over a four-week period. Methods: Twenty-four healthy adults volunteered to participate in PNF and static stretch sessions. The subjects were divided into three groups as follows: 8 subjects in the SS group, 8 subjects in the HR group, and 8 subjects in the CR group. In the HR and CR groups, contractions lasted 15 seconds per trial and consisted of 5 sets of 15 seconds of hamstring contraction immediately followed by 15 seconds of passive static hamstring stretching. For the static group, the participants were asked to stretch by hanging a leg over a table for 30 seconds. Subjects in all groups performed the exercises three days per week for 4 weeks. The active straight leg raising (ASLR) test, active knee extension (AKE) test, and vertical jump test were performed before the intervention and after 1, 2, and 4 weeks. Results: The SS, HR, and CR techniques effected positive improvement in hamstring flexibility and vertical jump performances but neither of the stretching methods had any statistically significant different effects according to group, although there were interactions (between group and time) in the ALSR group from 1 week to 2 week and in the AKE test from pretest to 1 week. Conclusion: Based on the results of the current study, SS, HR, and CR were shown to affect hamstring flexibility and vertical jump performance in healthy adults. In particular, it was determined that within a short period, hamstring flexibility could be attributed more to CR than to SS.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.23-32
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• 2017

PURPOSE: Flexibility and range of motion are very important factors in sports performance, rehabilitation, and musculoskeletal pain. The purpose of this study was to measure the effects of cupping therapy on flexibility, muscle activity, and pain threshold of hamstring muscle compared to passive stretching in healthy subjects. METHODS: Thirty healthy subjects were randomly assigned in a crossover design to cupping therapy and passive stretching. Subjects were tested to compare their effects according to the intervention such as Passive range of motion (PROM) (straight leg raising) and active range of motion (AROM). And algometer (pain) testing and MVC assessment using EMG were performed as dependent variables. RESULTS: The cupping therapy group and passive stretching group showed significant differences in all variables including PROM (p=.00, p=.00), AROM (p=.00, p=.03), Pain Threshold (p=.03, p=.08), Semitendinosus MVC (p=.01, p=.00), and Biceps femoris MVC (p=.01, p=.16). There were no significant differences between the two groups in all variables. CONCLUSION: These findings of this study suggested that cupping therapy has as much positive effect on flexibility, pain threshold, and muscle contraction as passive stretching. Also, it is more convenient and easier to work on patients than passive stretching. Therefore, cupping therapy should be considered as another option to treat range of motion, pain, and muscle activity in the clinical field.

• The Journal of Korean Physical Therapy
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• v.35 no.6
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• pp.206-212
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• 2023

Purpose: This study aimed to compare the lasting effects of the flossing band technique, dynamic and static stretching on hamstring on range of motion (ROM), muscle activity, and proprioception to identify the most effective pre-exercise method for preventing injuries. Methods: Thirty participants were randomly assigned to the flossing band (FB), dynamic stretching (DS), and static stretching (SS) groups, with 10 subjects in each. Measurements included muscle activity of the biceps femoris vis surface electromyography, knee ROM and proprioception during active knee extension and flexion using a smart joint goniometer. Assessments were conducted before, immediately after, 15, and 30 minutes after each intervention. Results: Proprioception showed no significant differences among groups at any time point. Significant differences in knee ROM were observed in the FB group (except between 15 and 30 minutes after), DS group (except between immediately after and 15 minutes after, and between 15 and 30 minutes after), and SS group (except between before and 15 minutes after, and between before and 30 minutes after). Muscle activity in the FB (except between before and 30 minutes after, and between 15 and 30 minutes after) and SS (between before and immediately after, between immediately after and 30 minutes after, and between 15 and 30 minutes after) groups showed significant differences, while the DS group exhibited no significant changes. Conclusion: Although direct comparisons did not establish superiority, within-group analyses indicated that the flossing band technique exhibited longer-lasting effects than dynamic and static stretching, providing valuable insights for injury prevention program design.

• Physical Therapy Korea
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• v.27 no.1
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• pp.30-37
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• 2020

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.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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• pp.1-9
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• 2020

PURPOSE: The current generation has shortened hamstrings due to a sedentary lifestyle, resulting in reduced flexibility of the hamstring and dysfunction. This study was undertaken to compare effects of three different release exercises on hamstring flexibility, in participants with short hamstrings. METHODS: Totally, 20 subjects having short hamstrings were involved in this study. The inclusion criterion for study participation was active knee extension test (AKET) less than 60°. All participants were subjected to 3 methods: hamstring foam roller release (HFRR), sitting self myofascial release (sitting SMR), and standing self myofascial release (Standing SMR). All participants randomly performed all three methods to avoid bias caused by learning or fatigue. Passive knee extension test (PKET), AKET, finger to floor distance test (FTFT), and pelvic tilting angle test (PTAT) were measured pre- and post-exercises. RESULTS: The PKET, AKET and FTFT were significantly increased after HFRR, sitting SMR, and standing SMR exercise (p < .05). However, PTAT was not significantly increased after the three exercises (p > .05). Furthermore, no significant differences were observed between PKET, AKET, FTFT and PTAT subsequent to HFRR, sitting SMR, and standing SMR (p > .05). CONCLUSION: Our results indicate that HFRR, sitting SMR and standing SMR were immediately effective in improving hamstring flexibility in participants with short hamstrings.

• Physical Therapy Rehabilitation Science
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• v.8 no.1
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• pp.45-51
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• 2019

Objective: The purpose of this study was to investigate the muscle activity ratio of the lower limb according to changes in straight leg raise (SLR) test angles on hamstring muscle shortening during squat exercises. Design: Randomized controlled trial. Methods: The subjects were 14 healthy adults who were informed of and agreed to the method and purpose of the study. The participants were classified into SLR groups according to two angles (over $80^{\circ}$ or under $80^{\circ}$) assessed using the SLR tests. After training and practicing the wall squat posture to be applied to the experiment, electromyography (EMG) was used to measure changes in muscle activity during the performance of a wall squat. After stretching, a sequence of pre-stretch tests were performed again, and the active and passive SLR tests were also reconducted; thereafter, a wall squat was performed again by attaching EMG electrodes. The EMG results before and after stretching were compared. Results: The muscle activity of the vastus lateralis oblique muscle increased in both groups. The muscle activity of the vastus medialis oblique muscle decreased in over both group. Rectus femorus activity increased in the under 80-degree groups but decreased in the over 80-degree group. The muscle activity of the biceps femoris muscle decreased after stretching in the over 80-degree group and increased in the under 80-degree group, and the semitendinosus muscle activity after stretching was decreased. The quadriceps-to-hamstring muscle (Q:H) ratio before and after stretching between groups showed that the hamstring muscle ratio decreased after stretching in both groups. Conclusions: The results of this study showed that the Q:H ratio before and after stretching between groups was not significantly different.