Hip Flexion Range Of Motion Research Articles

Assessing Cryotherapy and Moist Heat Pack Application With and Without the Use of Proprioceptive Neuromuscular Facilitation-Contract Relax Stretching

Cryotherapy or moist heat packs (MHP) are often used prior to static stretching to enhance range of motion (ROM). Their influence on ROM when applied prior to proprioceptive neuromuscular facilitation-contract relax (PNF-CR) stretching is unknown. The purpose of this study was to determine if an ice bag or MHP influenced passive hip flexion ROM prior to PNF-CR stretching. When compared to the control, all treatment groups had a large effect. Participants receiving MHP PNF-CR, PNF-CR only, and ice bag PNF-CR met or exceeded our meaningful detectable change, thus demonstrating increased ROM. Those receiving an ice bag or MHP only did not demonstrate improvements and failed to present with ROM improvements.

Restricting ankle dorsiflexion does not mitigate the benefits of external focus of attention on landing biomechanics in healthy females.

Restricted ankle dorsiflexion can promote aberrant biomechanics associated with risk for knee injury during dynamic activities. Attentionally focused instructions have been used to improve high-risk knee biomechanics during landing tasks. Yet, it is unknown whether attentionally focused instruction can effectively improve landing patterns in the presence of a mechanical restriction on the ankle. Therefore, our purpose was to determine whether restricting ankle dorsiflexion by use of bracing mitigated the effects of attentional foci on landing biomechanics in healthy females. We used a crossover design to investigate lower extremity biomechanics in 19 healthy females between the ages of 18-35 during a series of jump-landing tasks. Participants completed 6 blocks of 3 jump-landings on separate force platforms in a randomized order based on brace condition (brace, no brace) and mode of attentional foci (neutral, internal focus [IF], external focus [EF]). Attentionally focused instructions were provided immediately prior to 3 practice jump-landings, followed by 5 test jump-landings with self-controlled feedback only. Ankle bracing decreased peak dorsiflexion and sagittal range of motion (ROM) (mean difference: 5.7-5.8°), and peak inversion and frontal ROM (mean difference: 2.4-3.0°). However, hip flexion ROM (mean difference: 1.8°) increased compared to the no brace condition. Regardless of ankle bracing, EF instruction increased peak hip flexion (mean difference: 4.9°) and hip flexion range of motion (mean difference: 3.8-4.6°), while decreasing peak knee valgus (mean difference: 0.8-1.0°) and knee valgus moment (mean difference: 0.04Nm/kg). Additionally, EF instruction increased peak hip abduction to a similar degree when braced (mean difference: 3.6-4.0°) and not braced (mean difference: 2.1-2.5°). Lastly, EF instruction increased hip abduction ROM only when braced (mean difference: 2.3-2.4°), but decreased peak knee valgus power only when not braced (mean difference: 0.18W/kg). Our findings indicate that mechanically restricting ankle dorsiflexion does not mitigate the ability of EF instruction to enhance jump-landing performance by means of improving hip and knee biomechanics in healthy females. However, our findings suggest an improved ability to control the rate of knee valgus loading when not braced. Therefore, we conclude that EF instruction remains a viable clinical strategy to improve landing patterns in the presence of restricted ankle dorsiflexion, yet this approach may be ineffective to reduce the rate of knee joint loading.

Electroacupuncture and Manual Acupuncture Increase Joint Flexibility but Reduce Muscle Strength.

The objective of this study was to investigate the immediate effects of electroacupuncture and manual acupuncture on hip flexion range of motion (ROM), knee joint (flexion replication at 15° and 45°) and quadriceps (strength and activation) function. Forty-five neurologically healthy adults participated in this randomized controlled laboratory study. Straight leg raise test, modified Thomas test, and hip abductors strength test were performed to determine acupoints. Afterwards, one of three 15-min treatments (control—no treatment, electroacupuncture, or manual acupuncture) was randomly applied using determined acupoints. Measurements (hip flexion ROM, and knee joint and quadriceps function) were recorded at baseline, and at 0, 20, and 40 min post treatment. Both electroacupuncture (4.0°, ES = 0.41) and manual acupuncture (5.4°, ES = 0.95) treatment immediately increased hip flexion ROM, and the increased values persisted for 40-min (p = 0.01). Knee flexion replication (at 15°: p = 0.17; 45°: p = 0.19) and quadriceps activation (p = 0.71) did not change at any of the time points. Post-treatment, both electroacupuncture and manual acupuncture decreased quadriceps strength at 0-min (electroacupuncture: 9.2%, p < 0.0001, ES = 0.60) and 40-min (electroacupuncture: 7.3%, p = 0.005, ES = 0.55; manual acupuncture: 8.7%, p = 0.01, ES = 0.54). A single session of either electroacupuncture or manual acupuncture treatment (selected acupoints based on physical examination) may immediately improve joint flexibility but reduce muscle strength.

Gait characteristics of children with Williams syndrome with impaired visuospatial recognition: a three-dimensional gait analysis study.

Williams syndrome (WS) is a genetically based neurodevelopmental disorder characterized by intellectual disability and impaired visuospatial recognition. The aim of this study was to analyze the gait characteristics of WS children with impaired visuospatial recognition using a three-dimensional gait analysis (3DGA) to clarify the gait adaptation needed to compensate for it. 3DGA was performed in 8 WS children with impaired visuospatial recognition (mean age, 11.8years) and 9 age-, sex-, height-, and weight-matched controls. Clinical data, fundamental motor tests, and gait variables while walking on a flat surface and walking up a mat were compared between the two groups, and the correlations between variables were analyzed in the WS children. WS children showed impairment of balance function without muscle weakness. In walking on a flat surface, the WS group showed reduced walking speed, short step length, increased variability of step length, increased knee flexion throughout the stance phase, increased horizontal pelvic range of motion (ROM), and a low Gait Deviation Index and a high Gait Profile Score, which are indices of gait quality. In walking up a mat, the WS group showed further reduced walking speed and decreased sagittal hip flexion and ankle dorsiflexion ROM in the swing phase. Impaired balance function was significantly correlated with increased variability of step length and decreased sagittal ankle dorsiflexion ROM in the swing phase. The detailed gait pattern of WS children with impaired visuospatial recognition was presented. These findings show that impaired visuospatial recognition and balance function contribute to gait adaptation.

Change of Direction Performance Is Influenced by Asymmetries in Jumping Ability and Hip and Trunk Strength in Elite Basketball Players

Change of direction (COD) ability is essential for sport performance in high level team sports such as basketball, however, the influence of asymmetries on COD ability is relatively unknown. Forty-three junior and senior level elite basketball players performed isometric hip and trunk strength testing, passive hip and trunk range of motion testing, and unilateral horizontal and vertical jumps, as well as the T-test to measure COD performance. Mean asymmetry values ranged from 0.76% for functional leg length up to 40.35% for rate of torque development during hip flexion. A six-variable regression model explained 48% (R2 = 0.48; p &lt; 0.001) of variation in COD performance. The model included left hip internal/external rotation strength ratio, and inter-limb asymmetries in hip abduction rate of torque development, hip flexion range of motion, functional leg length, single leg triple jump distance, and peak torque during trunk lateral flexion. Results suggest that the magnitude of asymmetries is dependent of task and parameter, and using universal asymmetry thresholds, such as &lt;10 %, is not optimal. The regression model showed the relationship between asymmetries and COD performance. None of tests were sufficient to explain a complex variable like COD performance.

The immediate effects of 5-minute high-force long axis distraction mobilization on the strain on the inferior ilio-femoral ligament and hip range of motion: A cadaveric study

BackgroundThe mechanical effects of hip joint mobilization on hip capsular-ligament tissue have never been studied. ObjectiveTo evaluate the strain on the inferior ilio-femoral (IFF) ligament after 5 min of high-force long-axis distraction mobilization (LADM) and to analyse the immediate effects on hip range of motion (ROM). DesignCross-sectional laboratory cadaveric study. MethodsThirteen hips hip joints were mobilized from nine fresh-frozen cadavers (mean age, 75.6 ± 7.8 years). High-force LADM in open-packed position was maintained during 5 min. Strain on IFF ligament was measured with a microminiature differential variable reluctance transducer at the beginning and just before the end of high-force LADM. Hip flexion, extension, abduction and internal rotation ROM were assessed using a universal goniometer before and after joint mobilization. ResultsThe strain on IIF ligament increased 20.2 ± 8.5% after 5 min of high-force LADM, showing a significant increase (p = 0.004). Hip ROM also increased significantly (p < 0.05) with large effect sizes (d > 0.8). ConclusionThe strain on IIF ligament and hip ROM increased significantly after 5 min of high-force LADM. The improvements on hip ROM appear to be related to the changes in the strain on capsular-ligament tissue after high-force LADM.

Normal response to tibial neurodynamic test in asymptomatic subjects

The straight leg raise test (SLR) is one of the most performed physical tests for mechanosensitivity and impairment of the nervous system. According to the anatomy of the tibial nerve, ankle dorsiflexion and eversion movements could be used to perform the tibial neurodynamic test (TNT). To date, no study has documented the normal responses of the TNT. To document normal responses of the TNT in asymptomatic individuals and to investigate influences from sex and leg dominance. A cross-sectional study with 44 asymptomatic volunteer subjects, a total of 88 lower limbs, was carried out. The range of motion (ROM), quality, and distribution of sensory responses were recorded. The hip flexion ROM was measured when subjects reported an intensity of their symptoms of 2/10 (P1) and 8/10 (P2). The mean ROM for hip flexion at P1 was 44.22 ± 13.13∘ and 66.73 ± 14.30∘ at P2. Hip flexion was significantly greater at P2 than P1 (p< 0.001). However, it was not different between sex or limbs (p> 0.05). The descriptor of the quality of sensory responses most often used by participants was stretching (88.6% and 87.5% for P1 and P2, respectively) in the popliteal fossa and posterior calf. This study describes the sensory responses of asymptomatic subjects resulting from the TNT. Our findings indicate that TNT responses are independent of the influence of sex or leg dominance.

The Acute Effect of Match-Play on Hip Isometric Strength and Flexibility in Female Field Hockey Players

The aim of this study was to determine the acute effect of simulated field hockey match-play on isometric knee flexion, adductor (ADD) and abductor (ABD) strength, adductor/abductor (ADD/ABD) strength ratio, countermovement jump height (CMJ), hip flexion and ankle dorsiflexion range of motion (ROM). Thirty competitive female field hockey players (23.0 ± 3.9 years old) participated in the study. Apart from the afore-mentioned variables, external (through GPS) and internal load (through RPE) were measured before (pre-match) and immediately after simulated hockey match-play (post-match) in both limbs. Isometric knee flexion strength (+7.0%, p = 0.047) and hip flexion ROM (+4.4%, p = 0.022) were higher post-match in the non-dominant limb, while CMJ values reduced (−11.33%, p = 0.008) when comparing from pre-match data. In addition, no differences were observed for isometric hip ADD, ABD, ADD/ABD strength ratio, passive hip flexion ROM and ankle dorsiflexion ROM test. A simulated field-hockey match produces an increment in hip isometric strength and hip flexion ROM values in the non-dominant limb and a decrease in jump height capacity. As a result, CMJ assessment should be considered post-match in order to identify players who would require further rest before returning to training.

Does Lower Extremity ROM Asymmetry Or Previous Injury Predict Weight Shift During The FMS Squat?

The Functional Movement Screen (FMS) Deep Squat Test (DS) assesses bilateral mobility of the ankle, knee and hip through a movement pattern that is intended to be performed with bilateral symmetry. Past history of lower extremity (LE) injury may influence LE joint range of motion (ROM). Previous studies have examined the influence of LE ROM on squat depth, but not its influence on lateral weight shift (LWS). PURPOSE: The purpose of this study was to determine if bilateral asymmetry in ankle, knee, and hip ROM or previous history of LE injury predicts LWS during the FMS DS. METHODS: Thirty-seven physically active subjects (19 F, 18 M, 20.8 ± 1.4 yrs) completed this IRB approved study. All subjects granted informed consent and completed a health history questionnaire including history of LE orthopedic injury. Subjects’ hip flexion (HF), knee flexion (KF), and ankle dorsiflexion (DF) ROM were measured with a goniometer using standard methodologies. A loaded lunge (LL) measurement was also taken to determine peak closed chain dorsiflexion. ROM asymmetry was calculated for each measurement. Participants then completed three trials of the FMS DS on 2 force plates (1200 Hz) and a Matlab script processed vertical ground reaction force (vGRF) data with a lowpass filter and computed limb symmetry index during the descent phase and full squat position. Multiple regression models were computed for both the descent phase and the full squat position of the DS to determine if ankle, knee, and hip ROM asymmetry, LL asymmetry, and LE injury history are predictors of LWS during the DS. RESULTS: Mean ROM asymmetries for HF (-0.09% ± 3.37), KF (0.24% ± 1.8), DF (-5.30% ± 43.28) and LL (5.14% ± 8.93) were calculated. The overall regression model for the descent phase was not significant, (F(5, 31) = 0.47, p = 0.796, r2 = 0.07) for the prediction of LWS. Additionally, the overall regression model for the full squat position was also not significant (F(5, 31) = 1.67, p = 0.17, r2 = 0.21) for the prediction of LWS. CONCLUSION: Asymmetry in HF, KF, and DF ROM along with LL asymmetry and previous history of LE injury do not predict LWS during FMS DS performance. Further investigation is needed to identify the causes of asymmetric DS performance to aid clinicians in corrective exercise prescription.

Effects Of Hip Range Of Motion On Balance With Presence Or Absence Of A Warm-up

Baseline balance assessments are commonplace in the athletic training field. They are used in comparison with re-evaluations to determine if an injury has occurred. PURPOSE: The specific aim of this study was to evaluate in what manner a warm-up effected hip range of motion (ROM) and balance testing in a collegiate population. The significance of this study is to reduce the inconsistencies surrounding baseline balance assessments. Currently there is limited research looking into how hip ROM directly impacts balance. METHODS: Data was collected from a total of 16 participants. Participants completed two testing periods under the condition of a biking protocol or a waiting protocol. The biking protocol required participants to cycle on an ergometric bike for 20 minutes at 3-5 METs, while the waiting protocol required no movement for 20 minutes. Immediately following each protocol, a manual goniometer was used to collect ROM values for hip flexion, extension, abduction, and internal and external rotation. The two balance assessments were then completed. Test one consisted of the Balance Error Scoring System (BESS) with the second test utilizing a baseline balance test with the use of force plate technology. Hip ROM values and balance scores were compared between the two conditions. RESULTS: A Shapiro test was used to ensure the sample points were approximately normally distributed for the differences between the matched pairs. The flexion values for the left (p-value < .008) and right (p-value < .01) hip joints were found to be significant. All other hip ROM values demonstrated no significance. Significance was found for total errors of the BESS (p-value < .01). No significance was recorded for the force plate balance test. CONCLUSION: These results demonstrate the presence of a warm-up increased hip flexion range of motion in both hip joints and also impacted BESS balance scores. In conclusion, this suggests the addition of a warm-up to baseline balance assessment. A larger sample size is needed to further validate these findings. Supported by American College of Sports Medicine - Central States Region Chapter Undergraduate Research Grant

Evaluation of multimodal analgesia in treatment of avascular necrosis of femoral head with free vascularized fibular grafting

To prospective study the effectiveness and safety of multimodal analgesia (MA) in treatment of avascular necrosis of the femoral head with free vascularized fibular grafting (FVFG). Sixty patients with avascular necrosis of the femoral head, who were scheduled to unilateral primary FVFG between February 2016 and December 2016 and met the selection criteria, were included in the study. All patients were allocated to two groups according to the method of random number table: MA group ( n=30) and control group ( n=30). There was no significant difference in gender, age, body mass index, side, duration and stage of avascular necrosis of the femoral head, preoperative visual analogue scale (VAS) scores under quiescent and active states, and range of motion (ROM) of hip flexion and abduction before operation ( P>0.05). The patients in the MA group were treated with MA therapy, including oral administration of celecoxib before operation, local anesthetic wound infiltration during operation, and ice compression and oral administration of celecoxib after operation. The patients in control group were only treated with patient-controlled intravenous analgesia pump. The postoperative VAS scores under quiescent and active states, ROM of hip flexion and abduction, prescription of Tramadol and adverse reaction were recorded and compared. The operations were completed successfully in both groups without obvious complications and adverse reaction. The Tramadol was used in 4 cases (13.3%) of MA group and in 11 cases (36.7%) of control group, but no significant difference was found between the two groups ( χ 2=4.356, P=0.072). The VAS scores under quiescent state at 6 and 24 hours postoperatively were significantly lower in MA group than in control group ( P<0.05), while VAS scores under active state at 48 hours postoperatively and on the day of discharge were significantly lower in MA group than in control group ( P<0.05). There was no significant difference in VAS score between two groups at other time points ( P>0.05). The ROM of hip flexion in MA group was better than that in control group at 1 day postoperatively and the day of discharge ( P<0.05), while no significant difference was found at 2 and 3 days postoperatively ( P>0.05). The ROM of hip abduction in MA group was superior to the control group at 1, 2, and 3 days postoperatively and the day of discharge ( P<0.05). The MA can effectively relieve the pain following FVFG and facilitate early functional exercises of the hip. The usage of opioids was also relatively fewer for MA protocol.

Factors associated with health-related quality of life in Japanese patients with hip osteoarthritis: A cross-sectional study

Background/Purpose:Chronic symptoms related with hip osteoarthritis (OA) can negatively affect health-related quality of life (HRQoL). The purpose of this study was to examine factors related to a HRQoL measure that considers an Asian lifestyle in Japanese patients with hip OA.Methods:Forty-seven female subjects participated. The dependent variable was the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ), which assessed HRQoL. Potential factors were measured as independent variables. After screening, potential variables were entered into a multiple regression analysis to determine which variables were related to HRQoL.Results:In the regression model, knee extension muscle strength on the unaffected side and hip flexion range of motion (ROM) on the affected side were associated with HRQoL. Higher strength and higher ROM were related to greater HRQoL.Conclusion:Results can help health-care providers develop appropriate rehabilitation programs for improving HRQoL in patients with hip OA.

Comparison between 4 weeks passive static stretching and proprioceptive neuromuscular facilitation programmes on neuromuscular properties of hamstring muscles: a randomised clinical trial

Background/aims Studies have shown the efficacy of stretching to increase the hip flexion range of motion but studies regarding its effects are not unanimous about the most efficient technique. The aim of this study was to compare the effect of two stretching techniques on the neuromuscular properties of the hamstring muscles. Methods A total of 18 women (aged 24 ± 2.52 years old) participated, and were divided into three groups: a control group, a passive static stretching group and a propioceptive neuromuscular facilitation stretching group. Evaluations of variables of the hamstring muscles were performed before and after the training period. The intervention was carried out for 30 seconds, three times a week for a total of 4 weeks. Results A significant difference was found in the range of motion in the passive static stretching group (pre=80.8° [±11.0] and post=94.5° [±10.2]; t(5)=−3.755; P=0.013) and in concentric torque (passive static stretching group – pre=66.3 Nm [±12.9] and post=70.0 Nm [±8.1]; t(5)=−1.267; P=0.023; propioceptive neuromuscular facilitation stretching group – pre=79.1 Nm [±12.7] and post=83.5 Nm [±11.6]; t(5)=−1.917; P=0.014; control group – pre=71.1 Nm [±10.1] and post=74.1 Nm [±14.6]; t(5)=−1.275; P=0.003). Conclusions Passive static stretching was superior to propioceptive neuromuscular facilitation when comparing the increase range of motion in hip flexion, even without neural and structural changes in hamstring muscles after a 4-week period.

Effect of Static Stretching, Dynamic Stretching, and Myofascial Foam Rolling on Range of Motion During Hip Flexion: A Randomized Crossover Trial.

Siebert, T, Donath, L, Borsdorf, M, and Stutzig, N. Effect of static stretching, dynamic stretching, and myofascial foam rolling on range of motion during hip flexion: A randomized crossover trial. J Strength Cond Res 36(3): 680-685, 2022-Static and dynamic stretching (DS) are commonly used in sports and physical therapy to increase the range of motion (ROM). However, prolonged static stretching (SS) can deteriorate athletic performance. Alternative methods to increase ROM are thus needed. Foam rolling (FR) may initiate muscle relaxation, improve muscular function, physical performance, and ROM. Previous studies that examined effects of FR on ROM did not control for increased tissue compliance or shifted pain threshold. In this study, the isolated influence of altered tissue compliance on ROM after FR, SS, and DS was investigated using a randomized crossover design. Hip flexion ROM at given joint torques before and after SS, DS, and FR was randomly assessed in 14 young male adults (age: 23.7 ± 1.3 years; height: 182 ± 8 cm; body mass: 79.4 ± 6.9 kg). Hip flexion ROM was measured in the sagittal plane with the subjects lying in a lateral position (no gravitational effects on ROM measurements). Surface electromyographic (EMG) analysis of 2 representative hip extensors (M. biceps femoris and M. semitendinosus) was applied to control for active muscle contribution during ROM measurements. Significant increases in ROM for SS (3.8 ± 1.1°; p < 0.001) and DS (3.7 ± 1.8°; p < 0.001) were observed, but not for FR (0.8 ± 3.1°; p = 0.954). Because stretch forces on tendon and muscle tissue during SS and DS predominately act in longitudinal direction, FR induces mainly transversal forces in the muscle tissue. Thus, increased ROM after FR reported in the literature is more likely due to a shift in the pain threshold. These results provide a better understanding of differential loading conditions during SS, DS, and FR for coaches and practitioners.

Arthrodiastasis in the management of Perthes disease: a systematic review.

This systematic review explores the relevant literature to assess the efficacy of the use of arthrodiastasis in the management of Perthes disease. Until this moment, arthrodiastasis is not well established for its use in Perthes disease as opposed to other containment procedures. Furthermore, there are no clear indications for its use in this disease. Twelve articles were matched to the inclusion criteria and all articles were reviewed and radiological and clinical data were collected and compiled. As regards the hip flexion range of motion, the average preoperative flexion range of motion was 55.32°, while the postoperative was 90°. The average preoperative hip abduction range of motion was 12.28° and postoperative was 35.28°. Mean preoperative hip internal rotation range of motion was 8.69° and postoperatively was 24.93°. Mean preoperative external rotation range of motion was 21.73°, while the postoperative range was 33.71°. Final Stulberg classification was ascertained showing most patients ending with stages two and three. Complications were also assessed with most of which being superficial pin tract infections. The use of arthrodiastasis is a valid treatment option for Perthes disease; however, more articles need to be produced showing comparative data of arthrodiastasis versus other containment procedures. Level of evidence - level 1: systematic review.

How to evaluate the clinical outcome of joint-preserving treatment for osteonecrosis of the femoral head: development of a core outcome set

BackgroundThis study aimed to develop a core outcome set (COS) for clinical trials of joint-preserving treatment for osteonecrosis of the femoral head (ONFH), that is, to define a minimal set of outcomes that should be reported in such trials.MethodsA mixed research method was adopted in this study. First, clinical trials of hip preservation therapy were systematically researched and analyzed. Second, a three-round Delphi survey involving both doctors and patients was carried out to obtain the core outcome indicators. Round 1 was a modified Delphi questionnaire for doctors and patients to determine which outcomes are important to these stakeholders, round 2 determined what clinical evaluation core outcomes should be included for the joint-preserving treatment of ONFH, and round 3 determined how core outcomes should be measured. Finally, a consensus meeting was held to discuss and vote on the established COS.ResultsThe results of the systematic review showed that 42 outcome indicators were classified according to common signs and symptoms, quality of life, long-term outcomes, radiological evaluation, blood biochemistry, and indexes of safety. The three rounds of Delphi surveys completed the selection of indicators for the COS and the determination of the corresponding measurements.A total of 73 orthopedic doctors and 103 patients participated in round 1, and the top 10 indicators selected were basically the same. In round 2, 32 experts identified the following indicators: pain, range of motion (ROM) of hip flexion, walking distance, and stable rating of X-ray images. In round 3, 35 experts defined the measurement of each indicator. Finally, the consensus meeting identified the four indicators aforementioned that constituted the COS.The scores for pain, ROM of hip flexion, and walking distance are from 0 to 10; 0 represents the best scores, while 10 represents the most serious impairment. The stable rating of X-ray images is determined by the morphology of the femoral head and the change in the density of the necrotic area.ConclusionsWe established a COS for hip-preserving treatment of ONFH that includes four indicators: pain, ROM of hip flexion, walking distance, and stable rating of X-ray images.

Superficial heat administration and foam rolling increase hamstring flexibility acutely; with amplifying effects

ObjectivesTo compare the objective and subjective efficacy of three treatments on acute hip-flexion range of motion (ROM). DesignAssessor-blind, randomized within-subject cross-over. SettingUniversity athletic training clinic. ParticipantsTwenty-two female collegiate lacrosse and soccer athletes. Main outcome measuresThe passive straight-leg-raise (PSLR) was used to measure acute hip-flexion ROM pre- and post foam rolling (FR), superficial heating (SH), combination (SH + FR) and control treatments. A seven-point Likert scale statement measured the perceived effectiveness of each treatment. ResultsSuperficial heat (+10.4%, ES = 0.78), FR (+7.26%, ES = 0.52), and SH + FR treatment (+12.9%, ES = 1.26) improved hip ROM when compared to the control (+2.4%, ES = 0.24) (all p < 0.001). The SH + FR treatment resulted in a greater improvement in hip ROM compared to FR (p = 0.001, ES = 0.95), whereas no significant difference was observed between the SH and FR (p = 0.083, ES = 0.68) or SH and SH + FR treatment (p = 0.270, ES = 0.43). SH + FR was perceived as more effective than FR (p = 0.033, ES = 1.21), but not SH (p = 0.193, ES = 0.63). However, only a moderately positive correlation (r = 0.508) between objective and subjective measures of hamstring flexibility was found. ConclusionsAll treatments significantly improve hamstring flexibility with SH + FR being the most effective. Rehabilitation professionals should practice caution when relying on athlete perception and should prescribe treatments on an individual basis.

Lower limb kinematics and hip extensors strengths are associated with performance of runners at high risk of injury during the modified Star Excursion Balance Test

BackgroundReduced trunk and lower limb movement and hip and trunk muscles weakness may compromise the athletes’ performance on the modified Star Excursion Balance Test (mSEBT). ObjectiveTo investigate the relationship of trunk and lower limb kinematics and strength with the performance on the mSEBT of runners at high risk of injury. MethodsThirty-nine runners performed the mSEBT with the dominant limb as the support limb. An Inertial System was used to capture the trunk, hip, knee and ankle movement during the mSEBT. A handheld dynamometer was used to measure the strength of trunk extensors and lateral flexors muscles, and hip extensors, lateral rotators and abductors of the support limb. Multiple regressions were used to investigate if trunk and lower limbs kinematics and trunk and hip muscles strength are associated with performance during the mSEBT. ResultsReduced hip flexion and greater knee flexion range of motion (ROM) were associated with anterior reach in the mSEBT (r2=0.45; p<.001), greater hip flexion ROM was associated with posteromedial reach (r2=0.15; p=.012) and greater knee flexion ROM was associated with posterolateral reach (r2=0.23; p<.001). Hip extensor strength was associated with posteromedial (r2=0.14; p=.017), posterolateral (r2=0.10; p=.038) and composite reaches (r2=0.16; p=.009). ConclusionHip and knee kinematics in the sagittal plane explained 15–45% of the runners’ performance on the mSEBT and hip extensor strength explained 10–16% of the mSEBT performance. These findings provide useful information on the contribution of joints kinematics and strength when evaluating dynamic postural control in runners at high risk of injury.

Different volumes and intensities of static stretching affect the range of motion and muscle force output in well-trained subjects

ABSTRACT The manipulation of the volume and intensity of static stretching (SS) can affect the range of motion (ROM) and muscle force output. The purpose of this study was to investigate the effect of two different SS protocols with different intensities (50% and 85% POD) and volumes (120-s and 240-s) on ROM, peak force, and muscle activity during maximal isometric leg curl exercise in well-trained participants. Fifteen young males (age:27.5 ± 6.1years, height:175.6 ± 4.7cm, and body mass:81.5 ± 10.4kg, 6 ± 2 years of resistance training experience) performed passive hip flexion with two different SS protocols: six stretches of 40-s, with 15-sec rest between each stretch at 50% of the point of discomfort (POD) and three stretches of 40-s, with 15-sec rest between each stretch at 85%POD. The passive hip flexion ROM, biceps femoris muscle activation (integrated electromyography: IEMG), and knee flexors force were monitored during a 3-s maximal voluntary isometric leg curl exercise. ROM increased between pre- and post-intervention for both SS protocols (50%POD: p = 0.016, Δ% = 4.6% and 85%POD: p < 0.001, Δ% = 11.42%). Peak force decreased between pre- and post-intervention only for 85%POD (p = 0.004, Δ% = 23.6%). There were no significant IEMG differences. In conclusion, both SS protocols increased ROM, however, the high-intensity and short-duration SS protocol decreased peak force.

Efectos de un programa de estiramientos FNP sobre el salto y la flexibilidad en jugadores profesionales de fútbol sala

El objetivo de este estudio fue comprobar los efectos de un programa de estiramiento con la técnica contracción-relajación-agonista-contracción (CRAC) sobre la capacidad de salto (CS) y el rango de movimiento (ROM). Un total de 21 jugadores de élite de fútbol sala participaron en el presente trabajo. Los participantes fueron asignados a un grupo control (GC) y a un grupo experimental (GE) según su CS. Antes y después de la intervención se midió la CS y el ROM de flexión de cadera con la rodilla extendida (FCRE) y dorsi-flexión de tobillo (DFTRE). Para la medición del CS y del ROM se utilizó una plataforma de contacto y un inclinómetro ISOMED, respectivamente. El GE realizó un programa de estiramientos en los isquiosurales y tríceps sural durante 4 semanas con una frecuencia semanal de 5 días. Los jugadores aumento significativamente el ROM FCRE (p = 0,02) con efecto fuerte (hp2 = 0,730) y ROM DFTRE (p = 0,01) con efecto moderado (hp2 = 0,546), de los valores de CMJ (p = 0,03) con efecto fuerte (hp2 = 0,650) y de los valores de índice de aprovechamiento de la capacidad elástica [IACE] (p = 0,04) con efecto fuerte (hp2 = 0,742) en el GE después de los estiramientos. Los jugadores del GC aumentaron significativamente el rendimiento en el CMJ (p = 0,02) con efecto moderado (hp2 = 0,519) e IACE (p = 0,04) con efecto moderado (hp2 = 0,548); además, se observaron diferencias significativas en los valores de IACE (p = 0,02) entre ambos grupos. Los resultados de este estudio permiten concluir que un periodo de entrenamiento con el método CRAC mejora el ROM y la CS en jugadores profesionales de fútbol sala. The purpose of this study was to examine the effects of a stretching program with the contraction-relaxation-agonist-contraction technique (CRAC) on jumping performance (JP) and range of motion (ROM). A total of 21 elite futsal players participated in the present study. Participants were assigned to a control group (CG) and an experimental group (EG) according to their jumping ability. Before and after the intervention, the JP and ROM of hip flexion with the extended knee (FCRE) and dorsi-flexion of the ankle (DFTRE) were measured. For the measurement of the JP and the ROM, a contact platform and an ISOMED inclinometer were used, respectively. The EG performed a stretching program in the hamstrings and triceps sural for 4 weeks with a weekly frequency of 5 days. The players significantly increased the FCRE ROM (p = 0.02) with strong effect (hp2 = 0.730) and ROM DFTRE (p = 0.01) with moderate effect (hp2 = 0.546), of the values ​​of CMJ (p = 0.03) with strong effect (hp2 = 0.650) and of the values ​​of index of utilization of the elastic capacity [IACE] (p = 0.04) with strong effect (hp2 = 0,742) in the EG after the stretching. The CG players significantly increased the performance in the CMJ ​​(p = 0.02) with moderate effect (hp2 = 0.519) and IACE (p = 0.04) with moderate effect (hp2 = 0.548); in addition, significant differences were observed in the values ​​of IACE (p = 0.02) between both groups. The results of this study allow us to conclude that a training period with the CRAC technique improves ROM and JP in professional futsal players.