Efficacy of Hamstring Stretching According to the Neural or Muscle Tissue Involvement

Not Applicable

Completed

• Conditions: Muscle Stretching
• Interventions: Other: Straight-leg-raise (SLR); Other: Passive Knee extension test (PKE); Other: Maximum hip flexion (MHF)

• Registration Number: NCT04763798
• Lead Sponsor: Universitat Internacional de Catalunya

Brief Summary

Background: Muscle stretching is a technique widely used in the clinical practice of physiotherapy and in the field of sports. In the bibliography we find a multitude of stretches and procedures described, some of them being similar to neurodynamic tests, which could direct their effect to a neural and not a musculoskeletal structure. The structural differentiation manoeuvre has been shown to be able to discriminate the increase in tension on the nerve.

Objective: To evaluate the short-term efficacy on ischiosural muscle elongation of three modalities of ischiosural stretching according to neural or muscular involvement, in subjects without previous pathology.

Design: Cross sectional study. Methods: A randomised, blinded, assessor-blinded clinical trial was performed. According to the sample size calculation, a total of 35 subjects will be recruited from the International University of Catalonia. Each subject will undergo three hamstring stretching techniques on their dominant leg, Straight-leg-raise (SLR), Passive knee extension (PKE) and Maximun hip flexion (MHF) with an interval of one week on the dominant leg. Muscle elongation in each stretching modality will be assessed with the modified black saver sit and reach test and whether the technique generates a neural or musculoskeletal response when performing the structural differentiation manoeuvre.

Detailed Description

Background: Muscle stretching is a technique widely used in the clinical practice of physiotherapy and in the field of sports. In the bibliography we find a multitude of stretches and procedures described, some of them being similar to neurodynamic tests, which could direct their effect to a neural and not a musculoskeletal structure. The structural differentiation manoeuvre has been shown to be able to discriminate the increase in tension on the nerve.

Objective: To evaluate the short-term efficacy on ischiosural muscle elongation of three modalities of ischiosural stretching according to neural or muscular involvement, in subjects without previous pathology.

Design: Cross sectional study.

Study Timeline

• Study Start: 2020-12-11
• Primary Completion: 2021-01-11
• Status Verified: 2021-02
• Study First Submitted: 2021-02-12
• Study First Submitted QC: 2021-02-18
• Study Completion: 2021-02-20
• Study First Posted: 2021-02-21
• Last Update Submitted: 2022-09-02
• Last Update Posted: 2022-09-06

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 35

Inclusion Criteria

• Healthy subjects over 18 years old who signed the informed consent.

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Exclusion Criteria

• The exclusion criteria were as follows: 1) injury in the thigh 6 months previously, 2) diagnosis of any orthopaedic problem or surgery in the lower limbs, 3) back pain or previous surgery in the spine or 4) systemic or neurological disorders.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Non dominant	Straight-leg-raise (SLR)	All subjects will receive the three stretching techniques on non dominant leg. Interventions will be performed in three different days and only one of the three stretching exercises will be performed in each session. The rest period between sessions will bé one week. Stretching exercises will be perform in a random order. A random-number generator will bé used for randomization
Dominant	Straight-leg-raise (SLR)	All subjects will receive the three stretching techniques on dominant leg. Interventions will be performed in three different days and only one of the three stretching exercises will be performed in each session. The rest period between sessions will be one week. Stretching exercises will be perform in a random order. A random-number generator will be used for randomization
Dominant	Passive Knee extension test (PKE)	All subjects will receive the three stretching techniques on dominant leg. Interventions will be performed in three different days and only one of the three stretching exercises will be performed in each session. The rest period between sessions will be one week. Stretching exercises will be perform in a random order. A random-number generator will be used for randomization
Dominant	Maximum hip flexion (MHF)	All subjects will receive the three stretching techniques on dominant leg. Interventions will be performed in three different days and only one of the three stretching exercises will be performed in each session. The rest period between sessions will be one week. Stretching exercises will be perform in a random order. A random-number generator will be used for randomization
Non dominant	Maximum hip flexion (MHF)	All subjects will receive the three stretching techniques on non dominant leg. Interventions will be performed in three different days and only one of the three stretching exercises will be performed in each session. The rest period between sessions will bé one week. Stretching exercises will be perform in a random order. A random-number generator will bé used for randomization
Non dominant	Passive Knee extension test (PKE)	All subjects will receive the three stretching techniques on non dominant leg. Interventions will be performed in three different days and only one of the three stretching exercises will be performed in each session. The rest period between sessions will bé one week. Stretching exercises will be perform in a random order. A random-number generator will bé used for randomization

Primary Outcome Measures

Name	Time	Method
Distal sensation	Through study completion, an average of 3 weeks.	Passive ankle dorsiflexion was performed as distal sensation manoeuvre at the final position of all stretching modalities. Subjects were asked to indicate if the sensation during the stretching was modified during the ankle dorsiflexion (neural response) or was the same (musculoskeletal response)
Force intensity applyed	Through study completion, an average of 3 weeks.	The intensity of the force applied during each stretching modality was measured by a manual dynamometer (MicroFET2, Hoggan Scientific, Salt Lake City, Utah). The dynamometer was applied on the distal leg, proximal to the ankle joint. The physiotherapist performed the stretching until a marked resistance was felt and then, the force was registered.
Modified back-saver sit-and-reach test	Through study completion, an average of 3 weeks.	subjects will perform a single-leg sit-and-reach on a bench. The untested leg will be placed on the floor with knee at approximately 90º. A measuring tape will be placed on the bench. Subjects aligned the sole of the foot of the tested leg with the 50-cm mark on the measuring tape. Thereafter, subjects will be asked to reach forward as far as possible while maintaining the knees, arms, and fingers fully extended, and keep in the two hands on tip of each other and palms down

Secondary Outcome Measures

Name	Time	Method
Perceived sensation	Through study completion, an average of 3 weeks.	After the stretching application, all subjects were asked about their perceived sensation. They were asked about the intensity of the tension sensation during the technique. A numeric scale, ranging from 0 ("no tension") to 10 ("worst tension imaginable") was used to indicate the intensity of tension sensation during the stretching technique.

Trial Locations

Locations (1)

Universitat Internacional de Catalunya; 🇪🇸 Sant Cugat Del Vallès, Barcelona, Spain