• 한국전문물리치료학회지
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• 제26권4호
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• pp.63-69
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• 2019

Background: Both the rapid concentric and eccentric contractions during exercise repeatedly impose excessive stress on muscle tissue. The hamstring muscles are very susceptible to injury due to the tensile stress. Various interventions are currently being undertaken to prevent strain injury before exercise. Stretching is the most common method and is known to have a positive effect on flexibility and muscle performance. However, relatively few studies have investigated the potential negative factors of stretching. Objects: The purpose of this study was to examine changes in pain following the different intensity of the stretching and types of physical stress. Methods: The subjects were divided into three groups based on the intensity of stretching: 100% (S100), 75% (S75), and 50% (S50) of the measured force at the point of discomfort in static stretching and 100% (P100), 75% (P75), and 50% (P50) of the maximum voluntary isometric contraction in Proprioceptive Neuromuscular Facilitation (PNF) stretching. The pain individual subjects perceived after stretching was measured via a Visual Analog Scale (VAS) and compared between the groups Results: Despite the decrease in the intensity of static stretching, no decrease in VAS value was observed. In PNF stretching, a significant decrease was observed at P50 compared to P100. S100 was significantly higher than P75 and P50. Conclusion: Previous studies have shown that PNF has a superior or the same effect on flexibility in comparison with static stretching. This effect was maintained even in moderate intensity. PNF stretching performed under moderate rather than high intensive static stretching, which causes pain and discomfort, might be recommended in clinical settings.

• PNF and Movement
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• 제13권3호
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• pp.135-143
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• 2015

Purpose: The purpose of this study was to assess the effect of the proprioceptive neuromuscular facilitation (PNF) relaxation technique (hold relax; HR, contract relax; CR) and static stretch (SS) on hamstring flexibility and vertical jump performance in healthy adults over a four-week period. Methods: Twenty-four healthy adults volunteered to participate in PNF and static stretch sessions. The subjects were divided into three groups as follows: 8 subjects in the SS group, 8 subjects in the HR group, and 8 subjects in the CR group. In the HR and CR groups, contractions lasted 15 seconds per trial and consisted of 5 sets of 15 seconds of hamstring contraction immediately followed by 15 seconds of passive static hamstring stretching. For the static group, the participants were asked to stretch by hanging a leg over a table for 30 seconds. Subjects in all groups performed the exercises three days per week for 4 weeks. The active straight leg raising (ASLR) test, active knee extension (AKE) test, and vertical jump test were performed before the intervention and after 1, 2, and 4 weeks. Results: The SS, HR, and CR techniques effected positive improvement in hamstring flexibility and vertical jump performances but neither of the stretching methods had any statistically significant different effects according to group, although there were interactions (between group and time) in the ALSR group from 1 week to 2 week and in the AKE test from pretest to 1 week. Conclusion: Based on the results of the current study, SS, HR, and CR were shown to affect hamstring flexibility and vertical jump performance in healthy adults. In particular, it was determined that within a short period, hamstring flexibility could be attributed more to CR than to SS.

• 대한물리의학회지
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• 제6권2호
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• pp.165-175
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• 2011

Purpose: This study examined the effect of the strengthening exercise and stretching exercise to decrease symptom patellofemoral pain syndrome (PFPS). Methods: The Anterior Knee Pain Scale (AKPS) and Clark's test performed for diagnosis of intrinsic PFPS among young adults. Selected thirty young adults subjects who aged 20~26 years participated in the study. Participants were randomly assigned to strengthening, stretching, or control groups. Strengthening group consisted of quadriceps, hamstring and iliotibia band training used elastic band. Stretching group consisted of quadriceps, hamstring and iliotibia band trainings used stretching exercises program. Participants received 50-minute individualized exercise sessions, 3 times a week for 6 weeks. Results: The results were as follow: there were significantly difference stretching exercise group by all muscles on muscular strength test (p<.05). there were significantly difference both strengthening and stretching exercise group by all muscles on flexibility test (p<.05). There were significantly difference stretching exercise group by all muscles on step-down test (p<.05). There were significantly difference both strengthening and stretching exercise group by all muscles on visual analog scale (p<.05). Conclusion: Results suggest important implications for exercise programs of PFPS that stretching exercise is more improved knee pain, functional performance, patella mobility than strengthening exercise.

• PNF and Movement
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• 제17권2호
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• pp.263-274
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• 2019

Purpose: This article was conducted to determine the immediate effects of unilateral contract-relax (CR) stretching on contralateral knee extension range and to compare both sides of the knee extension range between experimental and control groups. Methods: This study recruited 16 adult males and females with straight leg raising abilities below $90^{\circ}$. The subjects were randomly divided into an experimental group and a control group comprising 8 subjects each. The experimental group performed direct CR stretching on the right hamstring muscles with straight hip extension adduction, and the control group performed indirect CR stretching on the right hamstring muscles with straight hip flexion abduction. Each group performed CR stretching 4 times with 4 repetitions comprising 10 sec of contraction and a 10 sec break between repetitions. Before and after the CR stretching exercises, the subjects' passive knee extensions were measured at the hip in a $90^{\circ}$ flexed position. The subjects' peak force on the right leg and peak pressure on the left leg during each CR stretching exercise were also measured. Results: After doing CR stretching 4 times, each group showed a significantly increased passive knee extension range on both sides, and there was no difference in the passive knee extension ranges between the groups. The peak force on the right leg was significantly higher in the experimental group than the control group. There was no difference in peak pressure between the groups. Conclusion: After applying unilateral CR stretching, the study subjects experienced a significantly increased passive knee extension range on the contralateral side. For patients who find it difficult to apply stretching techniques to knee joints directly, the use of the proprioceptive neuromuscular facilitation technique of CR stretching may be useful in improving the range of the knee joint on the contralateral side without direct treatment.

• Physical Therapy Rehabilitation Science
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• 제8권1호
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• pp.45-51
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• 2019

Objective: The purpose of this study was to investigate the muscle activity ratio of the lower limb according to changes in straight leg raise (SLR) test angles on hamstring muscle shortening during squat exercises. Design: Randomized controlled trial. Methods: The subjects were 14 healthy adults who were informed of and agreed to the method and purpose of the study. The participants were classified into SLR groups according to two angles (over $80^{\circ}$ or under $80^{\circ}$) assessed using the SLR tests. After training and practicing the wall squat posture to be applied to the experiment, electromyography (EMG) was used to measure changes in muscle activity during the performance of a wall squat. After stretching, a sequence of pre-stretch tests were performed again, and the active and passive SLR tests were also reconducted; thereafter, a wall squat was performed again by attaching EMG electrodes. The EMG results before and after stretching were compared. Results: The muscle activity of the vastus lateralis oblique muscle increased in both groups. The muscle activity of the vastus medialis oblique muscle decreased in over both group. Rectus femorus activity increased in the under 80-degree groups but decreased in the over 80-degree group. The muscle activity of the biceps femoris muscle decreased after stretching in the over 80-degree group and increased in the under 80-degree group, and the semitendinosus muscle activity after stretching was decreased. The quadriceps-to-hamstring muscle (Q:H) ratio before and after stretching between groups showed that the hamstring muscle ratio decreased after stretching in both groups. Conclusions: The results of this study showed that the Q:H ratio before and after stretching between groups was not significantly different.

• 대한물리의학회지
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• 제14권3호
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• pp.1-11
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• 2019

PURPOSE: This study compared the changes in the range of motion (ROM ) on the knee joint according to three different isometric contraction intensities when applying Evjenth - Hamberg stretching (EHS) to the hamstring muscles of healthy subjects. METHODS: Forty eight healthy subjects aged between 20 and 39 years were allocated randomly to four groups; performing EHS at 10% maximum voluntary isometric contraction (MVIC) group, EHS at 50% MVIC group, EHS at 100% MVIC group, and control group (CG) pre-, and post-intervention. The flexibility of the hamstring muscles was evaluated using a digital goniometer for measuring the knee joint ROM motion. A Chattanooga stabilizer was used to adjust the MVIC intensity by 10%, 50%, and 100%, respectively. RESULTS: These results show that the pre- and post-intervention knee joint ROM were significantly different in all four groups (p<.05). The post-intervention knee joint ROM showed a significant difference between the 100% MVIC group and non-MVIC group (p<.05). The knee joint ROM difference between the pre- and post-interventions was similar in the 10% MVIC and 50% MVIC groups but significant differences were observed among the other groups (p<.05). CONCLUSION: EHS of the hamstring muscles was effective in improving the knee joint ROM with an isometric contraction intensity of 10%, 50%, or 100% MVIC, and of these, 100% MVIC was most effective.

• PNF and Movement
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• 제14권1호
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• pp.7-14
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• 2016

Purpose: The purpose of this study was to determine the effectiveness of direct and indirect methods of contract-relax techniques in proprioceptive neuromuscular facilitation (PNF) stretching for improving hamstring flexibility. Methods: Twenty-six subjects were randomly assigned to either a direct contract-relax technique group or an indirect contract-relax group. For each group, stretching intervention was performed three times a week for a period of two weeks, with 12 seconds for the contraction and 10 seconds for the relaxation per once. The direct contract-relax technique for hamstring flexibility was applied by asking the subject to press down on the shoulder of the trainer in the straight leg-raising position. Conversely, the indirect contract-relax technique was performed by raising the leg with resistance. To facilitate a comparative analysis of hamstring flexibility between the two groups before and after the stretching intervention, two-way repeated ANOVA was performed. Hamstring flexibility for each group was measured using a passive straight leg-raising test. Results: The results showed significant improvement in hamstring flexibility for all subjects in the two groups. However, there was no significant difference between the groups. Conclusion: In conclusion, both direct and indirect contract-relax techniques are confirmed to be useful for improving hamstring flexibility. The choice of suitable technique has to be made individually according to the condition of each subject.

• 대한물리의학회지
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• 제15권4호
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• pp.1-9
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• 2020

PURPOSE: The current generation has shortened hamstrings due to a sedentary lifestyle, resulting in reduced flexibility of the hamstring and dysfunction. This study was undertaken to compare effects of three different release exercises on hamstring flexibility, in participants with short hamstrings. METHODS: Totally, 20 subjects having short hamstrings were involved in this study. The inclusion criterion for study participation was active knee extension test (AKET) less than 60°. All participants were subjected to 3 methods: hamstring foam roller release (HFRR), sitting self myofascial release (sitting SMR), and standing self myofascial release (Standing SMR). All participants randomly performed all three methods to avoid bias caused by learning or fatigue. Passive knee extension test (PKET), AKET, finger to floor distance test (FTFT), and pelvic tilting angle test (PTAT) were measured pre- and post-exercises. RESULTS: The PKET, AKET and FTFT were significantly increased after HFRR, sitting SMR, and standing SMR exercise (p < .05). However, PTAT was not significantly increased after the three exercises (p > .05). Furthermore, no significant differences were observed between PKET, AKET, FTFT and PTAT subsequent to HFRR, sitting SMR, and standing SMR (p > .05). CONCLUSION: Our results indicate that HFRR, sitting SMR and standing SMR were immediately effective in improving hamstring flexibility in participants with short hamstrings.

• The Journal of Korean Physical Therapy
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• 제23권6호
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• pp.37-42
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• 2011

Purpose: The aim of this study is to suggest the basic materials for proposing effective and efficient methods when stretching by measuring isokinetic muscular strength according to static, dynamic and PNF stretching. Methods: This study was conducted on 45 healthy persons (male and female) in their twenties who are attending universities. The subjects are randomly divided into three (3) groups, and static stretching is applied in group 1, dynamic stretching is applied in group 2 and PNF stretching is applied in group 3. After carrying out static, dynamic and PNF stretching, peak torque was measured using isokinetic muscular strength measurement. Results: According to the results, at $60^{\circ}$/sec and $180^{\circ}$/sec isokinetic peak torque of the knee joint according to types of stretching, the largest changes were shown in Group 2 extension and flexion, and the least changes were shown in Group 1. There were significant differences among the three groups (p<0.05), and the result of after-analysis by LSD showed that there were significant differences between Groups 1 and 2, and Groups 1 and 3 (p<0.05). Conclusion: The intention of this study was to determine the peak torque using Cybex after applying three stretching methods to hamstring muscles, and the case of dynamic and PNF stretching was found to be more significant in both the $60^{\circ}$/sec and $180^{\circ}$/sec angular speeds than that of static stretching. Using the results of such studies, if dynamic and PNF stretching are applied together with warming-up before performing sports, the risk of suffering wounds would reduce and the exactness of sports would increase.

• 대한물리의학회지
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• 제6권4호
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• pp.369-379
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• 2011

Purpose : The purpose of this study is to compare the initial effect of nerve mobilization (NM), static stretching (SS), and contract-relax (CR) techniques to find the best method in improving hamstring flexibility and gait function in patients with hemiplegia. Methods : Eleven patients with hemiplegia were included in this study. Passive knee extension (PKE) range of motion and the sit and reach (SR) test were used to measure hamstring flexibility, while timed up and go (TUG) and the 10m walking (10MW) test were used to measure the subject's gait. Measurements on each test were assessed prior to the experiment, immediately following the experiment, and 30 minutes after the experiment. Analysis of the results utilized a repeated measures analysis of variance to examine hamstring flexibility and the difference in walking ability. Results : The results suggest significant increases in NM, SS, and CR techniques as they relate to hamstring flexibility (p<.05) following (both immediate and 30 minutes post experiment) PKE range of motion and the SR test, but post-hoc showed no significant difference between the three techniques (p>.05). Additionally, the results suggest significant increases in NM, SS, and CR techniques as they relate to gait function (p<.05) following the TUG test, but found no significant difference in the 10MW test (p>.05). Post-hoc analysis between the three techniques suggests that only the NM technique significantly changed gait function. The time of TUG and 10MW test showed no significant difference between the three techniques before an experiment, just after an experiment, and 30 minutes following the experiment according to the measurement points in time (p>.05). Conclusion : This study suggests NM, SS, and CR techniques immediately improve hamstring length and flexibility while improving gait function in patients with hemiplegia.