• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.49-61
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• 2021

PURPOSE: Hamstring muscle shortening is related to low back pain, and it is important to check the hamstring muscle flexibility and pelvic mobility to analyze the effects of the intervention. This study examined the effects of hamstring muscle shortening on flexibility and pelvic mobility according to the method of stretching the hamstring muscle in patients with low back pain. METHODS: Forty Low Back Pain Patients participated. The subjects performed the Visual Analogue Scale (VAS), Fear Avoidance Belief Questionnaire (FABQ), Korean version of Oswestry Disability Index (KODI), Myovision, and sensbalance therapy cushion (pelvic mobility, proprioception). The subjects were divided into two groups to perform the passive and active stretching protocol. The intervention was conducted three times a week for four weeks. RESULTS: Hamstring muscle flexibility was increased significantly in both groups (p < .05), and there was no difference between the groups. VAS, FABQ was decreased significantly in both groups (p < .01), and there was no difference between the groups. The left lower back muscle impedance was decreased significantly in both groups (p < .05). The passive stretching group showed a significant increase in the pelvic anterior, posterior, and left tilt ROM (p < .05). The active stretching group showed a significant increase in the pelvic anterior, posterior tilt ROM (p < .05). CONCLUSION: Both stretching methods may be useful intervention methods for pelvic mobility and pain recovery and can assess back pain recovery.

• Physical Therapy Korea
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• v.29 no.1
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• pp.37-47
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• 2022

Background: Lower back pain (LBP) is a major cause of disability and a common musculoskeletal disorder encountered at some point in life. Dysfunction of the lumbar vertebrae has been associated with decreased flexibility of the hamstrings, which exhibited a strong positive correlation with LBP. Hamstring tension affects lumbar pelvic rhythm. We aimed to activate pelvic stability with compression by Active Therapeutic Movement (ATM), muscle energy technique (MET) was applied to increase the flexibility of the hamstring. Objects: In this study, we aimed to investigate the effects of MET with ATM and general MET were applied to the hamstring of adults, who were in their twenties with nor without LBP, on their pelvic inclination and the length of their hamstring. Methods: A total of 32 subjects were briefed about the purpose of this study and agreed to participate voluntarily. Before the experiment, all subjects were pre-examined, and they were divided into an LBP group and a no lower back pain group accordingly. Thereafter, all subjects participated in both in a crossover manner. After at least one week, they switched to another group and participated in the same experiment. Results: The study results revealed that both groups demonstrated significant results in the modified active knee extension test (p < 0.01) and the sit and reach test (p < 0.01) performed to assess the hamstring flexibility; an interaction (p < 0.05) was noted. Moreover, a more significant difference was observed between the MET with ATM and the general MET. Although significant results were obtained for the pelvic inclination (p < 0.01), interaction was not noted. Conclusion: Conclusively, in this study, when the MET with ATM was applied to the two groups, there was a significant difference compared to the general MET for hamstring flexibility, but it was confirmed that there was no significant difference for the pelvic inclination.

• Journal of Korean Physical Therapy Science
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• v.24 no.2
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• pp.45-52
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• 2017

Purpose : Most of the moderns have been spent sedentary life style in front of desk or on the chairs, so that their hamstring muscles are shorted commonly and the shortness of hamstring muscles are caused to some problems in functional activities. The purpose of this study was to compare the effectiveness of thermotherapy with hot-pack and ultrasound on the tightness of hamstring muscles in individuals with hamstring tightness. Method : Twenty-eight persons with hamstring tightness participated in this study. They were randomly assigned to three exercise groups: stretching group(n=10), hot-pack group(n=9), and ultrasound group(n=9). Before experiment, this study measured the angle of hip flexion using a inclinometer in all participants. Stretching group conducted actively stretching on their shorted leg for 30 seconds, 3 times, and rest for 10 seconds between each exercises. Hot-pack group have applied hot-pack($70{\sim}75^{\circ}C$) on shorted hamstring muscles for 20 minutes before stretching exercise. Ultrasound group have applied therapeutic ultrasound(1 MHz and 1.5W/cm2) on shorted hamstring muscles for 10 minutes before stretching exercise. All data was analysed using one-way repeated ANOVA. Result : The results revealed that ultrasound therapy before stretching is more effective to the flexibility on hamstring muscles than hot-pack before stretching and stretching only. Conclusion : The results of this study show that thermotherapy with therapeutic ultrasound will be effective on the shortness of hamstring muscles before stretching exercise.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.4
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• pp.501-507
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• 2012

PURPOSE: This study aims to examine the effects of trunk flexion on the kinetic characteristics of the lumbar according to the degree of hamstring flexibility. METHODS: This study has as its subjects 29 young adults and divides them into the group (NSRTG, n=15) with the normal length of hamstrings according to SRT and the group (SSRTG, n=14) tending to have shortened hamstrings. Sit and Reach Test was conducted to evaluate the degree of hamstring flexibility. And to examine the kinetic difference of the lumbar at the trunk flexion, it was compared and analyzed by using the picture archiving and communication system (PACS). RESULTS: SSRTG showed more significant difference than NSRTG in the analysis on the trunk flexion of NSRTG and SSRTG. CONCLUSION: According to the analysis, the shortening of hamstrings is the factor that affects the dynamic stability of the lower lumbar through the reduction of the pelvic anterior tilt at the trunk flexion.

• PNF and Movement
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• v.22 no.1
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• pp.55-70
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• 2024

Purpose: The purpose of this study was to investigate the effects of three relaxation techniques, namely, Static Stretching Exercise (SSE), Eccentric Contraction Exercise (ECE), and Suboccipital Muscle Release (SMR) on the flexibility and balance of the lower limb in adults with hamstring shortening. Methods: The participants were 45 adults in their 20s with hamstring shortening. They performed three exercises (i.e., SSE, ECE, and SMR) for two weeks. We measured flexibility, muscle tone and stiffness, proprioception, and balance before and after the intervention, applying each relaxation technique. Data were analyzed using two-way repeated measures analysis of variance (ANOVA). The significance level was set at α=0.05. Results: Flexibility increased in the SSE, ECE, and SMR groups, with the SSE group showing the greatest improvement. Muscle tone and stiffness decreased in all groups, with the ECE group exhibiting the highest reduction. Proprioception increased in the SSE, ECE, and SMR groups, with SSE demonstrating the greatest enhancement. Balance also increased in all groups, with the ECE group showing the most pronounced improvement. Conclusion: Overall, all three relaxation techniques for hamstring shortening resulted in improved flexibility, muscle tone and stiffness, proprioception, and balance of the lower limb in adults with hamstring shortening. The findings of this study underscore the importance of selecting an appropriate technique according to the purpose of treatment and the condition of the patient.

• Physical Therapy Korea
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• v.26 no.3
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• pp.32-41
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• 2019

Background: Limitations in hip flexion caused by tight hamstrings lead to excessive lumbar flexion and low back pain. Accordingly, many studies have examined how to stretch the hamstring muscle. However, no study has focused on the effect of hamstring eccentric exercise for tight hamstrings on trunk forward bending. Objects: We compared the short-term effect of hamstring eccentric exercise (HEE) and hamstring static stretching (HSS) on trunk forward bending in individuals with tight hamstrings. Methods: Thirty individuals with tight hamstrings participated in the study. The subjects were randomly allocated to either a HEE or HSS group. To determine whether the hamstrings were tight, the active knee extension (AKE) test was performed, and the degree of hip flexion was measured. To assess trunk forward bending, subjects performed the fingertip to floor (FTF) and modified modified Schober tests, and the degree of trunk forward bending was measured using an inclinometer. We used paired t-tests to compare the values before and after exercise in each group and independent t-tests to compare the two groups on various measures Results: The FTF test results were improved significantly after the exercise in both groups, and AKE for both legs increased significantly in both groups. There was no significant difference in the hip angles, mmS test results, or degree of trunk forward bending between groups after the exercise. No test results differed significantly between the two groups at baseline or after the exercise. Both groups increased hamstring flexibility and trunk forward bending. Conclusion: HSS and the HEE groups increased hamstring flexibility and trunk forward bending. However, HEE has additional benefits, such as injury prevention and muscle strengthening.

• The Journal of Korean Physical Therapy
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• v.34 no.3
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• pp.116-120
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• 2022

Purpose: This study aimed to determine which interventions are effective in increasing hamstring flexibility due to changes in the range of motion (ROM) and pennation angle (PA) when foam rolling (FR) and proprioceptive neuromuscular facilitation (PNF) stretching were performed. Methods: A total of 24 healthy participants who agreed to participate in the study were randomly chosen. The participants were divided into three groups of eight people: Control, FR, and PNF stretching groups. The hip flexion angle (ROM) and PA of the hamstrings were measured before and after the experiment. The Wilcoxon signed-rank test was used to analyze the ROM and PA for each group by comparing the before and after results. The Kruskal-Wallis test and the Mann-Whitney U test were used to analyze the increase in hamstring flexibility between the groups. Results: A statistically significant difference was observed in the ROM and PA within all groups, and only the ROM was significant in the comparison between the three groups. In the comparison between the control and other two groups, a significant difference was noted in both the ROM and PA in the FR group and only the ROM in the PNF stretching group (p<0.05). In the comparison between the FR and PNF stretching groups, no significant difference was observed (p>0.05). Conclusion: These findings FR and PNF stretching increased the ROM; however, no change in PA was observed. Therefore, FR and PNF stretching were considered effective interventions in immediately increasing hamstring flexibility.

• PNF and Movement
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• v.1 no.1
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• pp.11-18
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• 2003

Objectives: Few studies have reported on the flexibility of the hamstrings resulting from variable stretching method, and little studies of length adaptation at 1 day after intervention. Methods: Fifty-four healthy a woman in her twenties with no history of musculoskeletal or neurogenic disorder volunteered for this study. Subjects were randomly assigned to either a contract-relax group or a passive stretching group. Methods: Hamstring flexibility was measured with a sit and reach test(SRT) (RF-D18; SPC) before, immediatly after interventions, and 1 day after interventions. Results: Flexibility scores for participants in each of the groups significantly increased from pre-interventions to immediate and 1 day after interventions. However, the length of 1 day after interventions was shorter than immediate length after interventions. Difference in length between immediate and 1 day after interventions was some shorter in the contract-relax group versus the static group but, not significantly. Conclusions: The results of this study suggest that a contract-relax is an effective length adaptation of hamstring muscles by 1 day after intervention.

• PNF and Movement
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• v.13 no.1
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• pp.31-37
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• 2015

Purpose: The purpose of this study is to compare changes in the flexibility of hamstring muscles which are relaxed on suboccipital muscle through suboccipital muscle inhibition and combination technique. Methods: Thirty sample subjects (16 male and 14 female) were randomly divided into an experimental group (n=15) and a control group (n=15). 1. Suboccipital muscle inhibition: Suboccipital muscles of the patients were placed on a bed. The occipital region was placed on a therapist's fingers, and the posture was maintained for three minutes before remeasurement. 2. Treatment with combination technique (body bolster and wooden pillow): Wooden pillows were placed where the participants could relax the posterior arch of the atlas; additional body bolsters were also placed to avoid high pressure, and the treatment was maintained for three minutes before remeasurement. Results: There was a statistical difference in finger floor distance (FFD) and straight leg raise (SLR) results for those treated with SMI (P<0.05). There was no statistical difference in FFD and SLR results for those treated with the combination technique (P>0.05). Conclusion: Between the two intervention methods; the suboccipital muscle inhibition technique was more effective in increasing the flexibility of subjects with a shortened hamstring than was the combination technique.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.4
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• pp.19-27
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• 2019

PURPOSE: This study examined which stretching exercise had the most positive effect on increasing the range of motion (ROM) of the knee joint in healthy people and whether there was a difference between continuous stretching and intermittent stretching. METHODS: This study included 30 healthy university students from OOO University. The subjects were asked to sit on a mat and perform hamstring-stretching exercise during which the ROM and muscle tone were measured with pre and post-tests. Each subject was assigned randomly to a continuous stretching group (stretching without relaxation time group, n=10, G1) or intermittent stretching group (stretching with 10s relaxing time group, n=10, G2; and stretching with 20s relaxing time group, n=10, G3). The participants conducted hamstring stretching exercises with a sit-and-reach box at three different rest times (0s, 10s, and 20s). Subsequently, they underwent passive knee extension (PKE) tests, in which the ROM of the knee joint was measured with a goniometer, and the muscle tone was evaluated using a MyotonPro. RESULTS: Significant differences in muscle tone, stiffness, and ROM were observed between pre-test and post-test in each groups (p<.05). Although the post hoc tests indicated no significant differences in muscle tone and ROM between the continuous stretching group and intermittent stretching group (p>.05), the rate of change of the ROM showed that the intermittent stretching group developed more effective maintenance of the hamstring flexibility. CONCLUSION: No significant differences in the muscle tone of the hamstring and ROM of the knee joint were observed according to the hamstring stretching exercises with three different rest times. On the other hand, the rate of change of the ROM showed that intermittent stretching maintained the hamstring flexibility more effectively.