• Journal of International Academy of Physical Therapy Research
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• v.9 no.4
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• pp.1642-1650
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• 2018

The purpose of this study was to identify the effect of proprioceptive neuromuscular facilitation (PNF) stretching exercise and joint mobilization on ankle joint range of motion (ROM), plantar pressure, and balance in subjects with stroke. Thirty patients (n=30) were organized into three groups, each of which received different treatments: PNF stretching (n=10), joint mobilization (n=10), and joint mobilization and PNF stretching combined (n=10). Each group received three exercise sessions per week for four weeks. The ankle ROM was measured using a goniometer, and plantar pressure and balance ability were measured using BioResque static posturography. In comparison within each group, the joint mobilization group and the joint mobilization with PNF stretching group showed significant improvements in ankle ROM, plantar pressure, and balance ability (p<.05). In comparison between the groups, a statistically significant difference was found in SECS change between the PNF stretching group, joint mobilization group and the joint mobilization with PNF stretching group. This study found demonstrates that the joint mobilization and joint mobilization with the PNF stretching methods were effective in improving ankle ROM, plantar pressure, and balance ability in stroke patients.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.259-268
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• 2022

Objective: The purpose of this study was to measure the immediate effect of hip hinge exercise stretching on hamstring flexibility, pelvic tilting angle, proprioception, and dynamic balance in individual with tightness of the hamstring. Design: A randomized controlled trial. Methods: A total of 35 healthy young adults (27 males, 8 females) volunteered for this study and randomly divided into three groups (Hip hinge exercise stretching group, passive stretching group, and PNF stretching group). The hamstring flexibility, pelvic tilting angle, knee joint proprioception, dynamic balance was conducted for 3 times. In order to evaluate the hamstring flexibility, the active knee extension test was performed. Forward bending test was performed to examine pelvic tilting angle.The proprioception was tested by the joint position sense test and dynamic balance was evaluated by Y balance test. Results: The hamstring flexibility, pelvic tilting angle and dynamic balance were significantly improved between three groups before and after intervention (p<0.05). Dynamic balance was significantly difference between the three groups in the posterolateral direction (p<0.05). Conclusions: This study result showed that hip hinge exercise stretching was the most effective method for increasing hamstring flexibility, pelvic tilting angle and dynamic balance. In addition, it is necessary to study whether hamstring stretching is effective in low back pain patient with hamstrings tightness.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.55-61
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• 2023

Background: The purpose of this study was to determine whether applying ultrasound after stretching the erector spinae muscle is an effective method for normal adults as a way to restore reduced back flexibility that causes back pain. Methods: The study was conducted on 60 healthy volunteers divided randomly into four groups (control group, stretching group, ultrasound group, ultrasound after stretching group). The flexibility-promoting effects were determined by assessing, each group, at the time of treatment, pre and post by modified fingertip to-floor (MFTF) and active straight leg raising (ASLR). The data were analyzed using the two-way ANOVA repeated measure with significant level α=.05. Results: Each group showed statistically significant changes in MFTF distance and ASLR degree. In the post-hoc test about this result, the length of MFTF and degree of ASLR in ultrasound after stretching group increased significantly compared to the others. Conclusion: The results suggest that using ultrasound after stretching is far more effective in increasing the flexibility of the erector spinae than using stretching or ultrasound intervention.

• Journal of Digital Convergence
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• v.11 no.8
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• pp.265-272
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• 2013

The purpose of this study was to provide a foundation for the methods of stretching in sports activities. The subjects were normal adults, the applied exercise was dynamic and static stretching and the research methods were measuring the jump height and muscle activity during jumping with subsequent data comparison and analysis. Twenty normal adults were randomly divided into 2 groups, and each group performed dynamic or static stretching. Jump height and the vastus lateralis and gastrocnemius muscle activities were measured during jumping, which was performed immediately before and after stretching. Statistical analysis was performed using an analysis of covariance. The results indicated that dynamic stretching was more effective than static stretching with respect to both jump height (p<.05) and muscle activity of the vastus lateralis (p<.05). Consequently, it was believed that dynamic stretching should be applied as a warm-up exercise for athletes who need to build and maintain high muscle strength.

• Physical Therapy Korea
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• v.21 no.1
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• pp.47-54
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• 2014

The aim of this study was to compare the duration of hamstring flexibility improvement after 3 stretching interventions in people with limited hamstring flexibility. Twenty-two subjects (12 men, 10 women) with limited hamstring flexibility of the dominant leg received 3 stretching interventions- modified dynamic stretching (MDS), hold-relax (HR), and static stretching (SS)-in a random order. All the subjects received all 3 interventions at intervals of at least 24 hours to minimize any carry-over effect. Modified dynamic stretching was applied as a closed kinetic chain exercise in the supine position by using the sling suspension system (Redcord Trainer(R)). The SS and HR interventions were individually performed in the straight leg raising (SLR) position, and all 3 interventions were performed for 3 minutes. Outcome measures included passive knee extension (PKE) measurements. Five post-test measurements were recorded for all subjects at 3, 6, 9, 15, and 30 minutes after the interventions. MDS was associated with a significant increase in knee extension range of motion even at 30 minutes post-treatment. In contrast, the HR and SS stretching methods showed increased hamstring flexibility for only 6 minutes post-treatment. Improvements in the range of motion of knee extension (indicating enhancement in hamstring flexibility) with MDS were maintained longer than those with the HR and SS interventions. Therefore, MDS may be more effective than the other interventions for maintaining hamstring flexibility.

• The Journal of Korean Physical Therapy
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• v.18 no.2
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• pp.35-45
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• 2006

Purpose: This study was to investigate the effect of isometric exercise and active stretching on joint function in patient with osteoarthritis. Methods: 30(M=1, F=29) subjects with osteoarthritis were divided in three groups: control group, quadriceps isometric exercise group, and hamstring active stretching group. After 6 weeks treatment, ROM(range of motion) and LSS(lysholm scoring scale) were measured. Results: There was a significant increase in knee flexion, extension in post-treat of quadriceps isometric exercise group and hamstring active stretching group(p<0.05). There was a significant increase in LSS in post-treat of quadriceps isometric exercise group and hamstring active stretching group(p<0.05). Conclusion: This study shows that both the active stretching exercise and the quadriceps isometric exercise effectively promote the range of knee extensions for osteoarthritis patients. Also, as measuring the ROM of knee flexion and extension by exercise methods, there is significant increase from knee flexion and extension in both hamstring stretching exercise group and quadriceps isometric exercise group. The increase of the range of knee is more effective in the exercise of knee extension with hamstring stretching exercise groups. And it is found that there are some difference between the experimental group and controlled group in statistics. As it is concerned with the function of knee extension, supporting and squatting are more effective to promote the both knee extension and flexion in its range. Therefore, this shows that the hamstring stretching exercise is required in general with enforcing the quadriceps at a sickbed in the present.

• Physical Therapy Rehabilitation Science
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• v.8 no.4
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• pp.210-217
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• 2019

Objective: This study was conducted to compare the immediate effect of hamstring stretching techniques of static stretching, proprioceptive neuromuscular facilitation (PNF) hold-relax and PNF irradiation on the hamstring muscle. Design: Three-group pretest-posttest design. Methods: Fifty-one subjects with shortened hamstrings were randomly assigned to the static stretching group (n=17), PNF hold-relax group (n=17), and the PNF irradiation group (n=17). All subjects performed an active knee extension (AKE) test to assess for the lower extremity with a shortened hamstring. The static stretching group performed stretches by lifting their leg to the maximum extent (3 times, 30 seconds). The PNF hold-relax group performed maximal isometric contraction against the experimenter's resistance (3 times, 10 seconds). The PNF irradiation group performed maximum isometric contraction against the experimenter's resistance toward the direction of the body (5 times, 5 seconds). The pre and post-tests measured range of motion (ROM), pressure pain thresholds (PPT) and muscle tone. Results: There were significant differences in ROM and PPT between pre and post intervention in each group (p<0.05). There was a significant difference only in the ROM among groups (p<0.05). Post-hoc analysis showed that the changes in ROM occurred in the order of the PNF hold-relax group, static stretching group and PNF irradiation group (p<0.05). Conclusions: The findings of this study suggest that the PNF irradiation technique may improve ROM and may be used to improve ROM similar to other stretching techniques. Therefore, the PNF irradiation technique could be included in stretching programs and can be used as a suitable stretching method depending on the situation.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.3
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• pp.51-59
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• 2020

PURPOSE: The purpose of this study was to provide clinical basic data to reduce pain and improve function by comparing neck muscle activity and neck alignment using self-stretching and passive stretching exercises for chronic neck pain caused by forward head posture. METHODS: The subjects were divided into 15 subjects assigned to perform self-stretching exercise and 15 subjects assigned to perform passive stretching exercise. The intervention was conducted for a total of 4 weeks. The muscle activity in the neck was measured by surface electromyography (EMG) before intervention, and craniovertebral and cranial rotation angles were measured by X-ray. The 4-week intervention was conducted and the above items re-measured in the same manner and analyzed. RESULTS: Muscle activity within both groups after intervention using self-stretching or passive stretching exercise was significantly different (p < .05)(p < .01). Neck alignment of both groups was significantly different (p < .001)(p < .01). Further, muscle activities of the upper trapezius and splenius capitis muscles showed significant differences (p<.05). Lastly, neck alignment showed statistically significant difference (p < .05). CONCLUSION: Self-stretching exercise activated motor nerves as a posture correction exercise, thereby improving inhibition of muscle activity, muscle contraction delay, and pathological conditions of the muscle. For future research, interventions of self-stretching exercise will be needed for patients with chronic back pain accompanied by forward head posture, and various clinical studies on postural improvement of forward head posture by maintaining a normal muscle tone state are needed.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.10-15
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• 2021

Objective: Limited ankle dorsiflexion is related to ankle injuries. There are various exercises to increase the flexibility of the gastrocnemius for improving the passive range of motion in ankle dorsiflexion. However, to performances in daily activities and athletic sports and higher efficiency of walking and running, both ankle dorsiflexion passive and active range of motion are needed. To investigate the effects of combined gastrocnemius stretching and tibialis anterior resistance exercise on ankle kinematics (passive and active range of motion of ankle dorsiflexion) and tibialis anterior muscle activity in subjects with limited ankle dorsiflexion. Design: Cross-sectional single-group repeated measures design. Methods: Fourteen subjects with limited ankle dorsiflexion were recruited (in the right ankle in 7 and the left ankle in 7). All subjects performed gastrocnemius stretching alone and tibialis anterior resistance exercise after gastrocnemius stretching. The passive and active range of motion of ankle dorsiflexion were measured after interventions immediately. The tibialis anterior activity was measured during active range of motion of ankle dorsiflexion measurement. Results: There was no significant difference of ankle dorsiflexion passive range of motion between gastrocnemius stretching alone and the tibialis anterior resistance exercise after gastrocnemius stretching. The tibialis anterior resistance exercise after gastrocnemius stretching significantly increased active range of motion of ankle dorsiflexion compared to gastrocnemius stretching alone (p<0.05). The tibialis anterior resistance exercise after gastrocnemius stretching significantly increased tibialis anterior activity better than did gastrocnemius stretching alone. Conclusions: Thus, subjects with limited ankle dorsiflexion should be encouraged to perform tibialis anterior resistance exercises.

• The Journal of the Korea Contents Association
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• v.9 no.9
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• pp.278-286
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• 2009

The aims of this study were to determined whether excitability of the $\alpha$-motor neuron is modulated by stretching and this changes were associated with flexibility of the muscle. In this study, $\alpha$-motor neuron excitability was measured by using the Hmax/Mmax ratio of the gastrocnemius H-reflex, and muscle flexibility was measured with the range of motion of the ankle dorsiflexion. The gastrocnemii of 10 healthy volunteers were stretched for 4 minutes(2 minutes stretching, 1 minute rest, and 2 minutes stretching) in each session by manual force. The Hmax/Mmax ratio of the H-reflex, as well as the range of motion of the ankle dosiflexion was measured through four different conditions: before stretching, as soon as after $1^{st}$ stretching, as soon as after $2^{nd}$ stretching and at 48 hours after $2^{nd}$ stretching. Excitability of the $\alpha$-motor neuron was decreased significantly after $1^{st}$ and $2^{nd}$ stretching(p<0.05). Furthermore, the range of the dorsiflexion was increased significantly after $1^{st}$ and $2^{nd}$ stretching(p<0.05). However, the excitability of the $\alpha$-motor neuron and range of the dorsiflexion at 48 hours after $2^{nd}$ stretching were not different from those of before stretching. These results suggest that reduced $\alpha$-motor neuron excitability of the gastrocnemius and increased flexibility of the ankle dorsiflexion would be followed by activation of the type III mechanoreceptor which around the ankle joint and the Golgi tendon organ in the gastrocnemius.