• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.5-11
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• 2015

Background: The purpose of this study was to investigate the effects of Mulligan's straight leg raise with traction technique and hold-relax technique on flexibility of hamstring in people with shortened hamstring. Methods: Thirty two subjects participated in this study. The subjects were assigned to either the Mulligan's straight leg raise with traction technique group (n=16) or the hold-relax technique group (n=16). 90-90 straight leg raise test was performed for evaluation of hamstring shortening at initial time of study. After intervention, immediate effect (immediately after intervention) and lasted effect (60 min after intervention) were assessed. Results: In the both Mulligan's straight leg raise with traction technique and hold-relax technique groups, significant improvements on flexibility of hamstring was observed in immediately and 60 minute after intervention (p<.05). However, there are no significant difference was observed between groups (p>.05). Conclusion: In the results of this study, both Mulligan's straight leg raise with traction technique and hold-relax technique show immediately and 60 minute after evaluation effectiveness in flexibility of hamstring of people with shortened hamstring. In addition, although the difference is not statistically significant, Mulligan's straight leg raise with traction technique was more increased average extension angle of knee joint at 90-90 straight leg raise test than the hold-relax technique.

• 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.

• 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 Arthroscopy Society
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• v.1 no.1
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• pp.81-85
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• 1997

This article describes a modified arthroscopic technique of anterior cruciate ligament (ACL) reconstruction using quadrupled hamstring tendon graft. The autogenous semitendinosus and gracilis grafts are harvested without detachment of the tibial insertion. To obtain longer graft, the accessory tibial insertions of the hamstring tendons are dissected. The EndoButton(Acupex Microsurgical, Andover, MA) is used for femoral fixation and two spiked staples are used for tibial fixation in a belt buckle fashion. Then the residual anterior laxity is restored by additional absorbable interference screw fixations. In this technique. more viable graft is obtained and firmer distal fixation is achieved by preservation of the tibial insertion of hamstring tendons.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.107-113
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• 1998

This study is retrospective analysis of 31 patients treated by arthroscopically assisted ACL reconstruction, from September 1995 to September 1996. ACL reconstructions using autogenous bone patellar tendon bone (B-PT-B) were done in 18 patients, and using hamstring tendon were done in 13 patients. We used four-stranded hamstring tendon grafts and fixed the grafts using Endobutton and screw. The mean postoperative Lysholm knee score was 87.2 points in B-PT-B. group, and 89.0 points in hamstring tendon group. There were no clinically significant results between two groups in Telos test, quadriceps atrophy, Lachman test, anterior drawer test and pivot shift test, but the incidences of anterior knee pain were lower in hamstring group. Four-stranded hamstring tendon graft showed enough stability and good functional outcome similar to that of patellar tendon graft, and had an advantage of quicker return of quadriceps function and less donor site morbidity.

• Journal of Korean Physical Therapy Science
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• v.27 no.1
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• pp.9-17
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• 2020

Background: This study aimed to examine the repeatability of hamstring strength during maximal voluntary contractions (MVCs) and to examine the sex difference. Design: Quasi-experiment design. Methods: The study recruited 23 healthy young individuals as participants. Hamstring flexibility was measured before and after MVCs by active knee extension test. Five trials of MVCs were performed, and hip extension forces were measured using a strain gauge during MVCs. Repeatability was confirmed by intraclass correlation coefficient (ICC) and coefficient of variation, and the difference between male and female participants was confirmed by independent samples t-test. Results: The forces measured during MVCs were significantly different between men and women over five trials. We observed the minimum and maximum force production at the first and fifth trial of MVCs in both men and women. Excellent to moderate reliability of the hamstring strength during MVCs was found in men (ICC range, 0.70-0.98) and women (ICC range, 0.66-0.90). There was no significant difference in hamstring flexibility between men and women. Conclusion: In clinical settings, we recommend excluding the first trial of MVCs in both men and women. Additionally, performing at least three trials of MVCs would be useful to improve the reliability of the baseline measures in women.

• PNF and Movement
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• v.19 no.1
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• pp.1-8
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• 2021

Purpose: The purpose of this study was to determine how the position of tibial rotation affects peak force and hamstring muscle activation during isometric knee flexion in healthy women. Methods: Seventeen healthy women performed maximum isometric knee flexion at 30˚ with three tibial rotation positions (tibial internal rotation, neutral position, and tibial external rotation). Surface electromyographic (EMG) activity was recorded from the medial hamstring (MH) and lateral hamstring (LH) muscles. The strength of the knee flexor was measured with a load-cell-type strength-measurement sensor. Data were analyzed using one-way repeated analysis of variance. Results: The results showed that MH and LH activities and peak force were significantly different among the three tibial rotation conditions (p < 0.01). The post-hoc comparison revealed that the MH EMG activity in tibial neutral and internal rotation positions were significantly greater than tibial external rotation (p < 0.01). The LH activity in tibial external rotation was significantly greater than the tibial neutral position and internal rotation (p < 0.01). The peak force of the knee flexor was also greater in the external tibial rotation position compared with the tibial neutral and internal rotation positions (p < 0.01). Conclusion: Our findings suggest that hamstring muscle activation could be changed by tibial rotation.

• Journal of Korean Physical Therapy Science
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• v.28 no.1
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• pp.76-84
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• 2021

Background: In clinical practice, active knee extension (AKE) test has been widely used to measure hamstring flexibility. During the AKE test, the knee extension is repeated six times. The first five repetitions are considered as warm-up, and the sixth is used as baseline. In order to accurately measure the subject's inherent flexibility, warm-up trials have been proposed as mentioned above; but currently, the evidence is insufficient. Design: Cross-sectional study. Methods: Forty-three healthy adults participated in this study. The AKE was performed slowly after flexing the hip and knee joints by 90° in a supine position. The knee was extended as far as could be done without causing discomfort or pain. When reaching the end range, knee flexion was performed without stopping. As per standard protocol, the subjects performed the knee extension six times. Results: There was no significant difference between the AKE value in the first trial with those in the other five trials. During the repetitions, the average value in the group with higher flexibility tended to decrease and the Intraclass correlation coefficient gradually decreased. Conclusion: Successive repetitions of the AKE test can misrepresent an individual's inherent hamstring flexibility. In order to avoid a decrease in hamstring flexibility, it is strongly recommended that individuals with high initial hamstring flexibility avoid unnecessary repetitions of the AKE test.

• The Journal of Korean Physical Therapy
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• v.35 no.5
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• pp.125-131
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• 2023

Purpose: This study examined the acute effects of static and dynamic stretching on the flexibility of the hamstring, dynamic balance ability, and function of the lower extremities in healthy adults. Methods: Thirty participants were assigned randomly to three groups: static stretching group (SSG), basic dynamic stretching group (BDSG), and 5 sec dynamic stretching group (5DSG). SSG performed three sets of 30 seconds of static stretching. BDSG performed a single-leg deadlift (SLD) at the same time as SSG, and 5DSG performed SLD held for five seconds. Hamstring flexibility, dynamic balance ability, and lower extremity function were evaluated before and after intervention. Results: The hamstring flexibility significantly improved in all groups (p<0.05). The dynamic balance ability improved significantly after intervention in all groups except BDSG in the anterior direction (p<0.05). There were significant differences in the posterolateral and posteromedial direction in all groups. The function of the lower extremity showed significant improvement over time only in BDSG (p<0.05). Conclusion: This study suggested that basic dynamic stretching and 5 sec dynamic stretching positively affect the hamstring flexibility, dynamic balance ability, and lower extremity function. Therefore, it is recommended to include dynamic stretching in a program for improving the hamstring flexibility, dynamic balance ability, and the lower extremity function. In addition, it is recommended to apply it at different times depending on the purpose.

• Physical Therapy Korea
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• v.30 no.4
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• pp.275-280
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• 2023

Background: Although warm-ups before exercise are widely accepted, research on sex differences in improving hamstring flexibility is limited. Differences in the physical and physiological characteristics between males and females may result in different responses to warm-ups. Objects: This study aimed to examine sex differences in the effects of specific warm-up on hamstring flexibility. Methods: This study included 24 young adults with hamstring tightness. The participants performed five maximal knee extensions and flexions at 90° flexion of the hip, and the maximal knee extension angle was measured in real-time using a smartphone clinometer application. Results: The groups did not significantly affect the maximal knee extension angle but showed a significant effect for repetition (p = 0.002) and group-repetition interaction (p = 0.002). Males had no significant change in hamstring flexibility; however, females showed a significant increase in flexibility in the 5^th trial compared with the 1^st trial (p = 0.041). These results demonstrated sex-specific differences in flexibility improvement over time. Conclusion: The findings of this study suggest that specific warm-up can successfully improve hamstring flexibility in females. This may be due to various factors, such as muscle stiffness of the lower extremity, estrogen levels, and temperature sensitivity. In clinical settings, specific warm-up might be helpful for females who participate in sports or activities, such as running or jumping, which require a full range of motion in the hip and knee joints.