• Physical Therapy Korea
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• v.22 no.4
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• pp.8-16
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• 2015

The purpose of this study was to evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from $15.32{\pm}5.98$ to $18.16{\pm}6.95kg$) and knee flexor strength (p=.011, from $7.80{\pm}4.80$ to $8.15{\pm}4.24kg$) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.

• 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.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.19-27
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• 2019

PURPOSE: This study examined which stretching exercise had the most positive effect on increasing the range of motion (ROM) of the knee joint in healthy people and whether there was a difference between continuous stretching and intermittent stretching. METHODS: This study included 30 healthy university students from OOO University. The subjects were asked to sit on a mat and perform hamstring-stretching exercise during which the ROM and muscle tone were measured with pre and post-tests. Each subject was assigned randomly to a continuous stretching group (stretching without relaxation time group, n=10, G1) or intermittent stretching group (stretching with 10s relaxing time group, n=10, G2; and stretching with 20s relaxing time group, n=10, G3). The participants conducted hamstring stretching exercises with a sit-and-reach box at three different rest times (0s, 10s, and 20s). Subsequently, they underwent passive knee extension (PKE) tests, in which the ROM of the knee joint was measured with a goniometer, and the muscle tone was evaluated using a MyotonPro. RESULTS: Significant differences in muscle tone, stiffness, and ROM were observed between pre-test and post-test in each groups (p<.05). Although the post hoc tests indicated no significant differences in muscle tone and ROM between the continuous stretching group and intermittent stretching group (p>.05), the rate of change of the ROM showed that the intermittent stretching group developed more effective maintenance of the hamstring flexibility. CONCLUSION: No significant differences in the muscle tone of the hamstring and ROM of the knee joint were observed according to the hamstring stretching exercises with three different rest times. On the other hand, the rate of change of the ROM showed that intermittent stretching maintained the hamstring flexibility more effectively.

• 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.

• 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.

• 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.

• 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.26 no.4
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• pp.63-69
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• 2019

Background: Both the rapid concentric and eccentric contractions during exercise repeatedly impose excessive stress on muscle tissue. The hamstring muscles are very susceptible to injury due to the tensile stress. Various interventions are currently being undertaken to prevent strain injury before exercise. Stretching is the most common method and is known to have a positive effect on flexibility and muscle performance. However, relatively few studies have investigated the potential negative factors of stretching. Objects: The purpose of this study was to examine changes in pain following the different intensity of the stretching and types of physical stress. Methods: The subjects were divided into three groups based on the intensity of stretching: 100% (S100), 75% (S75), and 50% (S50) of the measured force at the point of discomfort in static stretching and 100% (P100), 75% (P75), and 50% (P50) of the maximum voluntary isometric contraction in Proprioceptive Neuromuscular Facilitation (PNF) stretching. The pain individual subjects perceived after stretching was measured via a Visual Analog Scale (VAS) and compared between the groups Results: Despite the decrease in the intensity of static stretching, no decrease in VAS value was observed. In PNF stretching, a significant decrease was observed at P50 compared to P100. S100 was significantly higher than P75 and P50. Conclusion: Previous studies have shown that PNF has a superior or the same effect on flexibility in comparison with static stretching. This effect was maintained even in moderate intensity. PNF stretching performed under moderate rather than high intensive static stretching, which causes pain and discomfort, might be recommended in clinical settings.

• 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.

• PNF and Movement
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• v.8 no.3
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• pp.55-61
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• 2010

Purpose : The purpose of this study was to find out which method was efficient to enhance the flexibility of lower back between PNF(proprioceptive neuromuscular facilitation) and hamstring stretching. Method : subject were 20 young people between the ages 20 and 25. subjects were randomly assigned to one of 2groups; PNF(n=10), static(n=10). respective group received the same stretching does of 3days per week for 4weeks. Trunk flexion forward a measuring instrument and tapeline were performed to measurement the flexibility of lower back at different times(before starting the exercise, 4weeks after starting). Results : The results of the study were as follows: The lower back flexibility was increased significantly in PNF groups. PNF, static groups showed meaningful defference in trunk flexion forward. The finding indicate that PNF may be preferred technique for improving flexibility and that flexibility training results in on increased consistency of flexibility scores.