Hold Relax Technique Research Articles

Effects of muscle energy technique overhold relax on pain and range of motion in patients with post-surgical elbow stiffness

Background. An elbow joint that can move and is stable is important for work, play, and sports. Stiffness in the elbow after surgery is common and can make it difficult to perform daily activities. This is a significant problem for therapy. Therapeutic exercises, especially stretching exercises, are a crucial part of physiotherapy for alleviating elbow stiffness. Muscle Energy Technique (MET) is a manual therapy that uses mild isometric contractions to utilize the muscles’ energy to help with limited limb movement. On the other hand, Proprioceptive Neuromuscular Facilitation (PNF) is one of the best ways to improve motor performance and speed up recovery by increasing the range of motion and flexibility. The goal is to determine how MET over Hold‑Relax affects pain and range of motion when rehabilitating stiffness in the elbow after surgery. Methods. A quasi-experimental study was conducted on 12 patients post-elbow fracture fixation. Group A was given MET, while Group B received the Hold-Relax Technique three times a week for three consecutive weeks after the immobilization period. As baseline treatment, both groups received active ROM exercises. Pain (Visual Analog Scale) and ROM (goniometer) were assessed pre- and post-3 weeks. Results. In the third week, the two treatment groups showed a statistically significant difference in all parametric values (P < 0.05). However, Group B Hold-Relax’s mean difference and paired and unpaired t-test values were greater compared to Group A MET at the end of the third week. Conclusion. This study concludes that implementing PNF stretch (Hold-Relax) in conjunction with conventional treatment techniques in post-surgical stiffness is beneficial in enhancing the subject’s quality of life by reducing pain and restoring ROM. Hence, PNF (Hold-Relax) can be the best treatment option in physiotherapy practice.

Comparative Study of the Effectiveness of Muscle Energy Technique and Hold Relax Technique to Improve the Hamstring Flexibility in Patients with Lower Back Ache

Comparative Study of the Effectiveness of Muscle Energy Technique and Hold Relax Technique to Improve the Hamstring Flexibility in Patients with Lower Back Ache

Effects of proprioceptive neuromuscular facilitation technique on scapular dyskinesis in patients with subacute stroke

Objectives: The objective of this was to compare the effects of the proprioceptive neuromuscular facilitation (PNF) hold-relax technique on pain severity, range of motion (ROM) of the shoulder, shoulder disability, and scapular asymmetry in stroke patients with scapular dyskinesis. Methods: The study used a randomized clinical trial design including 46 patients ranging from 40 to 60 years with at least five months of stroke with type-1 scapular dyskinesia. The participants were divided into two groups, taking the upper limb Diagonal 1 (D1) flexion pattern and Diagonal 2 (D2) flexion pattern, respectively, which were allocated by consecutive sampling using the lottery method. We used a visual analog scale (VAS) for pain, goniometry for shoulder ROM, shoulder pain and disability index (SPADI) for shoulder disability, and lateral scapular slide test for scapular asymmetry. Results: D1 flexion and D2 flexion both improved the ROM in both groups (P < 0.05) and decreased pain and disability, while in-between comparisons did not find a significant difference between the effectiveness of both treatments in terms of pain measured by VAS, ROM, that is, flexion, extension, and abduction (P > 0.05). In terms of external and internal rotation, the D1 flexion pattern of PNF techniques showed more improvement as compared to D2 flexion (P < 0.05). While in terms of SPADI, D2 flexion showed more improvement as compared to D1 flexion (P < 0.05). Conclusion: Scapular PNF substantially influences stroke patients’ shoulder discomfort and ROM.

A Study to Compare the Effectiveness of Static Stretching and Hold Relax Technique Over Hamstring Flexibility for Collegiate Athletes

A Study to Compare the Effectiveness of Static Stretching and Hold Relax Technique Over Hamstring Flexibility for Collegiate Athletes

To Compare the Effects of the Hold-Relax Technique and Foam Roller Exercise On Hamstring Muscle Tightness, Dynamic Balance and Jump Performance Among Students of Health Sciences in Jalandhar City

To Compare the Effects of the Hold-Relax Technique and Foam Roller Exercise On Hamstring Muscle Tightness, Dynamic Balance and Jump Performance Among Students of Health Sciences in Jalandhar City

The Effects of Hold-Relax Technique and Foam Roller Techniques for Stretching the Shortened Hamstrings on Range of Motion, Flexibility and Muscle Tone

The Effects of Hold-Relax Technique and Foam Roller Techniques for Stretching the Shortened Hamstrings on Range of Motion, Flexibility and Muscle Tone

Comparison of the effectiveness of static stretching and hold relax technique on hamstring flexibility - A Randomized Control trial

Aim: In order to manage discomfort and increase range of motion, this study compared the effectiveness of static stretching versus the hold-relax approach on hamstring flexibility. Study design: The study design was Randomized Controlled Trial (RCT). Place & duration: This study was conducted in Physiotherapy Department and Rehabilitation center at Mayo Hospital Lahore.The duration of study was 4 months after approval of synopsis. Methodology: In ‘group A’ Static stretching is applied while in ‘group B’ Hold Relax technique of PNF was applied, while in ‘group C’ conventional physiotherapy was applied. Allocation of patients in two groups had done by computerized generated list. All groups will also receive conventional therapy, which will remain same throughout the study. The conventional therapy will include: Heating pad for 15 minutes, Hamstring isometric exercises, Ankle pumps exercise, Hamstring self-stretches [toe touching while standing or long sitting].Group A will receive static stretching for hamstring muscles while group B will receive PNF hold relax technique, group C will be benefited by the conventional physiotherapy. Treatment frequency will be 3 times a week. The duration of treatment will be 2 weeks in both groups. Results: Pair 1 had shown that the pre and post treatment comparison of Numeric pain rating scale mean score of pair 1 of group A before treatment was 7.5±1.083 which improved to 5.5±1.56. Pre and post treatment comparison of pair 2 of group B had showed that mean score before treatment was 7.6± 1.23 which was improved to 2.2±1.48. Pair 3 of group C improved from 8.3±0.778 to 4.8±1.02. Conclusion: The findings of this study led to the conclusion that static stretching is superior to the hold-relax strategy for treating hamstring stiffness. It lessens pain and enhances muscle function and flexibility. Keywords: Hold relax technique, hamstrings flexibility, static stretching

Modified Hold-Relax Stretching Technique Combined with Moist Heat Therapy to Improve Neuromuscular Properties in College Students with Hamstring Tightness

Introduction: This study aims to evaluate the effect of modified hold-relax stretching combined with moist heat therapy on hamstring muscle flexibility, EMG activity and strength in college students with hamstring tightness.
 Materials and Methods: Thirty-eight college students with hamstring tightness were recruited and were divided into two groups. Group 1 received modified hold-relax stretching plus moist heat therapy and Group 2 received moist heat therapy alone, three days a week for four weeks. The knee range of motion (ROM), muscle strength and Electromyography (EMG) activity before and after the treatment protocol were measured.
 Results: There was no significant difference between the two groups in demographic characteristics. The knee ROM was significantly different between groups in terms of time (P=0.001) and group (P=0.005) effects, but the strength and EMG activity were not significantly different.
 Conclusion: The modified hold-relax technique combined with moist heat therapy is effective in increasing hamstring flexibility, but has no significant effect on the muscle EMG activity and strength.

A Comparative Study on Efficacy of Ballistic Stretching Versus Modified Hold Relax Technique in Increasing Hamstring Flexibility

In the literature, the terms “flexibility” and “muscle length” are often used synonymously when referring to the ability of muscles to be lengthened to their end range. The flexibility of the hamstring muscle is important in the prevention of injury, muscular and postural imbalance and maintenance of a full range of joint movement optimal musculoskeletal function and enhanced performance in day-to-day activities. To evaluate the comparative effectiveness of modified hold-relax technique and ballistic stretching for increasing hamstring flexibility in football players. To evaluate the comparative effectiveness of modified hold-relax technique and ballistic stretching for increasing hamstring flexibility in football players. This study includes (N=50) subjects with hamstring tightness within the age group of 18-28 years. They were randomly assigned into 2 groups (Group A and B). Group A had 25 (N=25) subjects who are treated with Modified hold- relax stretching, Group B had 25 (N=25) who are treated with ballistic stretching. The subjects were given intervention 3 sessions per week for 4 weeks. ANOVA one way classification was used to compare between and within the groups. Test within the subject of effect is highly significant for both the groups. Each group has p=0.000. Test between the subjects were used to compare between the groups, it showed highly significant p=0.000. But clinically modified hold- relax is superior to ballistic stretching. The findings suggest that modified hold- relax and ballistic stretching both was statistically significant in improving hamstring flexibility. But modified hold- relax technique showed better results compared to ballistic stretching.

To Compare the Immediate Effect of Hold-Relax Technique Versus Myofascial Release on Delayed Onset Muscle Soreness of Quadriceps Muscle in Runners

Background and purpose: The objectives of the study were to assess and compare the effectiveness of Hold and Relax technique(H&R) with Thera gun and Myofascial release (MFR) with Thera gun on Delayed Onset of Muscle Soreness (DOMS) of quadriceps in runners. Myofascial release and Hold and relax technique both are used for a recovery from exercise induced fatigue which involves pain, soreness and decreased range of motion (ROM) which is crucial for subsequent performance. Along with both these techniques vibrational therapy also helps in alleviating DOMS. Method: This study was an experimental study design. The samples were selected on the basis of Simple Random Sampling method. 40 subjects selected, in the age ranging from 20 to 40 years were assigned in two groups; Group A received hold and relax technique along with Thera gun (20 subjects) and group B received myofascial release technique with Thera gun (20 subjects). Pain, muscle soreness and range of motion was measured using Visual analogue scale (VAS), 7- point Likert scale and Universal goniometer. Both, Pre intervention and post intervention was done. Immediate effect after the technique applied was recorded in the study. Results: Means were analyzed using Paired ‘t’ test as a parametric and Wilcoxon signed rank test as a non-parametric test have been used to analyze the variables from preintervention to post-intervention with calculation of percentage of change, there was a significant improvement in means of VAS, 7-point Likert scale and universal goniometer in terms of pain, muscle soreness and range of motion. Conclusion: Myofascial release technique was marginally more effective in reduction of pain and muscle soreness and increase range of motion. Keywords: delayed onset of muscle soreness, hold and relax, myofascial release, vibrational therapy, Thera gun, visual analogue scale, 7-point Likert scale, universal goniometer, pain, range of motion.

Effect of Novel based Postoperative physiotherapy rehabilitation on functional outcome in Malunited supracondylar fracture of femur and proximal tibia fracture following implant removal

Supracondylar femur fractures are common fractures that represent a management challenge. Despite consistent fracture patterns and predictable challenges associated with reduction and stabilization, complications, including malunion, nonunion, and implant failure, can occur in patients who undergo treatment for the management of a supracondylar femur fracture. A 25-year male patient reported complaints of pain and difficulty to perform movements of hip joint and weakness in the right leg. On investigations patient was diagnosed as a supracondylar fracture and proximal 1/3rd shaft of femur fracture. Patient was operated with open reduction and internal fixation with interlocking plating.Patient was referred to physiotherapy OPD following implant removal with the findings of malunited fracture with complaints of intense pain in right leg and difficulty while walking , sitting, climbing stairs and sudden pain while lifting the affected leg . Post-operative Rehabilitation protocol was given into 4 phases, 5 days per week for 8 weeks. The key treatment of Rehabilitation protocol was paraffin wax bath, CPM, patellar mobilization along with scar mobilization, Mainland's Mobilization and Hold relax technique of PNF and strengthening exercises. So it is concluded that Novel based Postoperative physiotherapy rehabilitation was effective in malunited supracondylar fracture of femur and proximal tibia fracture following implant removal for reduction of pain and early regain of range of motion, strength and functional activities. Keywords: Supracondylar Fracture, Malunion, Implant Removal, Proximal Tibia Fracture, Physiotherapy Management.

Comparison of Hold-Relax Technique and Active Release Technique in Shoulder Impingement Syndrome

Background: One of the common shoulder joint dysfunction is shoulder impingement syndrome, which produces pain in the joint and reduces overhead elevation movement. It represents the third most frequent disease of the musculoskeletal system. The study's objective was to compare the hold-relax technique and active release technique (ART) among people with shoulder impingement syndrome.Methodology: The study design is an experimental study. Patients diagnosed with Shoulder impingement syndrome were selected for this study. The study was conducted at the Outpatient physiotherapy department, ACS Medical College and Hospital, Chennai. A total of 30 subjects with age groups between 40 and 60 years were selected for the study. Simple Random Sampling method used to divide the samples into two equal groups (15) by lottery method. The total duration of the study was four weeks, with four sessions a week. Outcome measures of the study were pain, range of motion, and shoulder function. And measurement tools used were Goniometer, VAS, and SPADI to collect data for this study.Result: The comparative study between group A and group B shows a significant difference in pain effectiveness, external rotation ROM and function with a p-value >0.0001, and no significant difference in the effectiveness of abduction ROM with a p-value >0.1217 among patient with shoulder impingement syndrome.Conclusion: The study concluded that the active release technique is more effective than the hold-relax technique on pain, abduction ROM, external rotation ROM and shoulder function among patients with shoulder impingement syndrome.

Effects of combining both mobilization and hold-relax technique on the function of post-surgical patients with shoulder adhesive capsulitis

Objective: This study investigated the effects of combining both mobilization and hold-relax (HR) technique on the function of post-surgical patients...

To compare the effectiveness of passive stretching versus PNF hold relax technique on hamstring tightness in young individuals

To compare the effectiveness of passive stretching versus PNF hold relax technique on hamstring tightness in young individuals

Comparison of effectiveness of hold-relax technique and maitlandfs mobilization in improving range of motion in posttraumatic stiffness of knee joint

Aims: This study aims to compare the effectiveness of Hold-Relax technique and Maitland's Mobilization in improving range of motion (ROM) in posttraumatic stiffness of knee joint. Materials and Methods: This was a randomized interventional comparative study with 30 subjects with posttraumatic stiffness of knee joint with restricted range of knee flexion were randomly allotted into two groups: Group A was given Hold-Relax technique and Group B was given Maitland's Mobilization consisted of Grade 3 posterior glide along with paraffin wax bath and isometric exercises of quadriceps and hamstring as a common baseline treatment for 5 days per week for 4 weeks. The baseline outcome measure was active knee flexion ROM measured by universal Goniometer before and after 4 weeks interventions. Results: Statistical analysis of data was done using paired t-test and unpaired t-test. Paired t-test showed that statistically significant increase in active knee flexion ROM in both the groups. On comparing by unpaired t-test it was found that both the techniques are equally effective in improving ROM. Conclusion: Both the Hold-Relax technique and Maitland's Mobilization are equally effective, in improving the knee flexion ROM.

A Study on the Effect of Modified Hold Relax Technique on Stair Ambulation in Stroke Patients

Objective: The aim of this study was to evaluate the effectiveness of Modified hold-relax on stair ambulation in stroke patients. Methods: In this study, 35 stroke patients were recruited based on the inclusion criteria. The the rapist performed Modified hold-relax for quadriceps i.e.4 repetitions in each session, 5 days a week for 4 weeks, total of 20 sessions. Quadriceps tightness wasassessed using Duncan-Ely’s test, the impact of stroke in individual’s health and life was analyzed using Stroke Impact Scale (SIS) and ability to ambulate the stairs efficiently was analyzed by Timed Up and Down Stairs test (TUDS) before and after the intervention. Results: In this study, there was mean difference of 69.63±15.50 in pre-test and 105.94±11.80 in the post-test score of Duncan-Ely’s test i.e.62.9% improvement. There was mean difference of 113. 80 ± 37.27 in pre-testand76.63±27.88 in post-test of TUDSi.e.31.4% improvement and mean difference of 38.69 ± 11.86 in pre-test and 54.94 ±10.35 in post-test of SIS i.e.48.7% improvement. Conclusion: Modified hold-relax technique for knee extensors had a positive effect in improving stair ambulation in stroke patients.

Effect of Static Stretching and Hold-Relax Techniques for Shortened Iliopsoas Muscle

Purpose: The purpose of this study was to investigate the effect of stretching techniques on pressure pain threshold (PPT) of myofascial trigger points in the iliopsoas muscle and to compare the effect of two stretching techniques (static and hold-relax stretching). Methods: The subjects were randomly assigned into two groups: Static group (n=12); hold-relax group (n=12). For each group, stretching was applied to the dominant leg and performed three times a week for a period of two weeks. PPT of each subject was recorded at pre- and post-tests, respectively. Results: As a result, PPT was different between pre- and post measurements. However, it was not significantly different between groups. In conclusion, two stretching techniques are useful for improving Iliopsoas muscle shortening. Conclusion: This study indicates that the choice for a qualified technique should be decided individually according to the patient and therapist.

The Effects of PNF Relaxation Technique and Graston Technique on Shoulder Pain and Upper Extremity Function of Stroke Patients

The subjects of this study were 30 chronic stroke patients. The subjects were randomly divided into two groups; a PNF relaxation technique and Graston technique group (n=15), and a conventional treatment group (n=15). The first group received the shoulder muscle holdrelax technique and the Graston technique for 30 minutes. The control group received only conventional therapy for 30 minutes. Both groups underwent treatments 3 times a week for 8 weeks. Before and after treatment each subject was randomly evaluated for VAS, PPT, JTT, and MFT. There was a significant difference (p<0.05) between before and after intervention in both groups. However the PNF/Graston technique group showed significantly more improvement compared to the conventional treatment group. In this study, we confirmed that the PNF relaxation technique combined with the Graston technique have positive effects on both the pain and the upper extremity function of chronic stroke patients.

Assessment of the impact of Hold-Relax and Contract-Relax techniques on the compression pain threshold in patients with lateral humeral epicondylitis

Background. The method of proprioceptive neuromuscular paving (PNF) is unique in that it has its own principles of working with the patient. The overriding therapeutic goal during PNF therapy is to work on a lost function that is important for the patient. Objective. The aim of the study was to assess the impact of Hold-Relax and Contract-Relax techniques on the compression pain threshold in patients with lateral humeral epicondylitis. Material and method. The study involved 60 patients aged 47.8 ± 4.3 with inflammation of the lateral humeral epicondyle. There were 35 women and 25 men in the study group. In each examined person it was the first incident of lateral humeral epicondylitis. In each of the probands, subjective and physical physiotherapeutic examination was carried out. 41 left and 19 right limbs were tested. Measurements were made under standard conditions. Among the physiotherapeutic tests performed were: examination of the range of motion, assessment of the compression pain threshold using an algometer, and pain assessment during extension and radial deviation of the wrist with a load. The study of the range of movement was carried out using an electronic goniometer. Then, the subjects were randomly divided into two groups: group "A" in which the Hold-Relax technique was performed on the muscle group that extends and radially deviates the wrist and group "B" in which Contract-Relax was applied to the same muscle group. The therapy lasted 30 minutes and was continued for the next 10 days. In each group, apart from the mentioned techniques, physiotherapy treatments were applied as indicated. After the therapy, the tests that preceded the therapies were repeated. The obtained results were placed in the database and subjected to statistical analysis using the Statistica program. Results. The mean extent of the extension movement in the radiocarpal joint before the therapy in group "A" was 45.7 ± 4.7 while in group "B" it was 40.1 ± 3.79. After treatment, the mean range of motion increased in the "A" group to 67.46 ± 8.69 and in the "B" group to 71.6 ± 8.3. In both groups, changes were observed at the statistically significant level p = 0. Conclusion. 1. The use of both the Hold-Relax and Contract-Relax techniques had an impact on the change of the compression pain threshold.2. The use of Hold Relax and Contract Relax techniques has an impact on increasing the range of motion in patients with lateral epicondylitis.

Comparative Study of Mulligan Bent Leg Raise vs. Hold Relax Proprioceptive Neuromuscular Facilitation on Hamstring Tightness in High School Student

Background: Hamstring group of muscle are postural muscle and as they are biarticular, they has tendency to shorten even under normal circumstances. Since they are superficial two joint muscle, they tend to become very tight leading to muscle imbalance, which can give rise to number of postural problems and leave us with open muscle injury. Prevalence & incidence of Hamstrings tightness in normal individuals in day today life is high due to limited activity and lack of regular exercise. It has been observed that 75% of boys and 35% of girls aged 10 revealed reduced flexibility of hamstrings. Aim & Objectives: To study and compare the effectiveness of Mulligan Bent Leg Raise technique and Hold Relax PNF technique in High school going students with hamstring muscle tightness. Methodology: Sixty students were selected from high schools and study group were formed by alternate method of sampling. Group A underwent mulligan bent leg raise (BLR) and Group B underwent Proprioceptive neuromuscular facilitation (PNF) hold relax technique. The two groups were evaluated on the basis of Active knee extension test (AKE) test. Intervention used to improve AKE range of motion consisted of 15 session conducted over duration of 3 weeks. Each session lasted for 15 minutes consisting of 3 repetitions respectively done on 5 consecutive days per week. The two groups were compared and results obtained using unpaired t test and repetitive measure ANOVA test. Results: In Group A 43.3% were male and 56.7% were females, in Group B 53.3% were male 46.7% were female. Comparison of baseline values of mean AKE ROM of Right side in Group A was 135.2 and in Group B was 138.8. For left side the mean AKE ROM value in Group A was 136.3 and in Group B were 140.3. There is no significant statistical difference between baseline values. Comparison of mean of difference in AKE ROM from post intervention value of right side the mean of difference on 5 day for group A was 19.1 and for group B it was 6.93. On day 10 for Group A, it was 33.16 and for Group B it was 19.9, on day 15 for Group A it was 42.5 and for Group B it was 33.76. Comparison was done with unpaired t-test. On comparison there was statistically significant difference between group A and B p-value <0.0001. Mean of difference in AKE ROM from pre intervention value of left side the mean of difference on 5 day for Group A was 18.8 and for Group B it was 7.13. On day 10 for Group A it was 33.13 and for Group B it was 20.5. On day 15 for Group A it was 42.36 and for Group B it was 34.67. Comparison was done with unpaired t-test. On comparison there was statistically significant difference between Group A and B, p-value <0.0001. Conclusion: Effect of Mulligan Bent Leg Raise Technique shown more reduction in hamstring tightness, and improves Active knee extension range of motion compare to PNF hold relax technique.