• The Journal of Korean Physical Therapy
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• v.27 no.3
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• pp.164-168
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• 2015

Purpose: Flexibility has been considered one of the most important goals in rehabilitation. This study aimed to investigate the effect of transcutaneous electrical nerve stimulation (TENS) with the static stretching technique on the flexibility of hamstrings. Methods: Twenty-four subjects (15 men, 9 women) with limited hamstrings flexibility received three different intervention sessions in random order. The treatment sessions included static stretching (SS), static stretching with motor-level TENS (SS with motor TENS) and sensory-level TENS (SS with sensory TENS). All sessions of SS were performed in the straight-leg raise position for 30 seconds followed by rest for 15 seconds, in repetitions for 10 minutes using a belt. The TENS groups underwent TENS stimulation ($40{\mu}s$, 100 Hz) during the stretching for 10 minutes. Outcome measures were evaluated according to active knee extension (AKE) and recorded before the session and at 0, 3, 6, 9, and 15 minutes after the session. Results: There was significant improvement in hamstrings flexibility within all groups (p<0.05). SS with TENS (both sensory and motor) maintained significant increases in knee extension range of motion until 15 minutes post-treatment. In contrast, the SS-only group maintained significantly increased hamstrings flexibility only until 6 minutes post-treatment (p<0.05). Conclusion: Improvement in hamstrings flexibility with SS with TENS was maintained longer than with SS-only intervention. Electrical stimulation with stretching may be more effective than SS alone for increased duration of maintained hamstrings flexibility.

• Journal of International Academy of Physical Therapy Research
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• v.9 no.2
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• pp.1461-1467
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• 2018

The purpose of this study was to investigate whether static stretching or Thera-band stretching of hamstrings is more effective in improving the flexibility of hamstrings. A total of 40 participants performed stretching 3 times a week for 4 weeks, and a sitting trunk flexion meter was used to measure the flexibility of the hamstrings. Differences in hamstring flexibility before and after the application of static and Thera-band stretching were analyzed, and differences between the stretching methods were also analyzed. As a result, hamstring flexibility increased significantly after the static stretching program (p=.000), and also increased significantly after the Thera-band stretching program (p=.000). Although both programs were effective in improving hamstring flexibility, but there was no significant difference between the two groups (p=.058). Therefore, static stretching and Thera-band stretching are effective interventions to improve and maintain hamstring flexibility.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.4
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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.

• 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.

• 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.1
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• pp.38-44
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• 2022

Purpose: The purpose of this study was to investigate the effects of complex training on injury, flexibility, and muscle stiffness in high school male football players. Methods: A total of 60 football players were included in the study and were divided into three groups viz. the complex training group (CTG), 11+ training group (11+TG), and traditional training group (TTG). Injuries were recorded based on the prospective investigation method after starting the study, and the flexibility and muscle stiffness of the subjects were evaluated. Results: The research results showed that the injury rate per match was significantly lower in the CTG and 11+TG than the TTG. In the CTG, the flexibility of the hamstrings significantly increased and the stiffness of the rectus femoris (RF), biceps femoris (BF), and tensor fascia latae (TFL) muscles significantly decreased (p<0.05). In the 11+TG, the stiffness of the RF significantly decreased (p<0.05). In the TTG, the flexibility of the hamstrings significantly increased (p<0.05). Hamstring flexibility showed a significantly higher increase in the CTG and TTG compared to the 11+TG (p<0.05). Also, the stiffness of the RF and TFL muscles showed a significantly higher decrease in the CTG compared to the 11+TG and TTG (p<0.05). The stiffness of the BF muscles too showed a more significant decrease in the CTG compared to the TTG (p<0.05). Conclusion: The complex training method of the Fédération International de Football Association (FIFA) 11+ and self-myofascial release (SMFR) as a warm-up program, prevent injuries, enhance flexibility, and lower muscle stiffness of football players in high school. Thus, it is necessary to ensure the widespread use of the complex training program by instructors and players under the supervision of the Korea Football Association (KFA), given its reliability in preventing injuries and improving the performance of football players.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.2
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• pp.2042-2051
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• 2020

Background: Many trials have been conducted the methods and types of intervention of form rollers, but no research has been done yet that mixes the methods and types of intervention. Objectives: To analyze the effects of myofascial release on the improvement of range of motion (ROM), flexibility, pain pressure threshold, and balance. Design: Randomized controlled trial. Methods: All subjects measured ROM, flexibility, pressure pain threshold, and dynamic balance by pre-test. After pre-test, subjects were randomized that static-vibration foam rolling group (n=12), dynamic-vibration foam rolling group (n=12), general foam rolling group (n=12). For the intervention, 3 sets of 90 seconds were applied to each group, and rest time was set to 60 seconds between sets. In the post-test and follow-up test after 10 minutes, all three groups were measured the ROM, flexibility, pressure pain threshold, and dynamic balance. Results: The results of comparing ROM, flexibility, pressure pain thresholds, dynamic balance ability appeared higher significant difference in the pre-post-10 minutes follow up test in comparison between time in the intragroup (P<.001). As a result of comparing the change of pre-post-10 minutes follow up, static vibration foam rolling showed higher significant difference compared to control groups (P<.001). Conclusion: Through this study, when foam rolling is applied within the same intervention time, static foam rolling can be expected to have a better effect than the existing dynamic foam rolling as well as vibration foam roller can expect better effect than general foam rolling.

• 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.

• Physical Therapy Korea
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• v.25 no.4
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• pp.46-52
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• 2018

Background: The hamstring muscles in the lower extremity are highly important for knee joint stability and can be classified into medial and lateral hamstrings according to the anatomical position, which have some different functions. To measure the strength of the individual hamstring muscles, manual muscle testing is clinically performed by dividing rotation postures into internal and external postures. However, this has no sufficient scientific background. Objects: This study aimed to test the difference that the tibial rotation would cause in the muscle activity of the medial and lateral hamstrings. Methods: The muscle activities of the biceps femoris, semitendinosus, and semimembranosus were measured in a total of three different postures (neutral position and internal and external rotations) with 3 replications. During the maximal isometric contraction, resistance was constantly provided by the string attached to the strap, not by manual resistance of the examiner. Before and after electromyography measurements, the participants underwent hamstring flexibility measurement using the active knee extension test in the supine position on the treatment table. Results: The semitendinosus had a 12.56% reduction in muscle activity in external rotation as compared with that in neutral position. The biceps femoris and semimembranosus showed reduced muscle activities in both external and internal rotations as compared with those in neutral position. Only the women showed significant decreases in the comparison between pre and post-active knee extension. Conclusion: Only the semitendinosus muscle was consistent with the anatomical speculation. However, the reduction in the muscle activity of the semitendinosus as compared with that in neutral position was only 12.56%, the clinical value of which may be difficult to justify.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.259-268
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• 2022

Objective: The purpose of this study was to measure the immediate effect of hip hinge exercise stretching on hamstring flexibility, pelvic tilting angle, proprioception, and dynamic balance in individual with tightness of the hamstring. Design: A randomized controlled trial. Methods: A total of 35 healthy young adults (27 males, 8 females) volunteered for this study and randomly divided into three groups (Hip hinge exercise stretching group, passive stretching group, and PNF stretching group). The hamstring flexibility, pelvic tilting angle, knee joint proprioception, dynamic balance was conducted for 3 times. In order to evaluate the hamstring flexibility, the active knee extension test was performed. Forward bending test was performed to examine pelvic tilting angle.The proprioception was tested by the joint position sense test and dynamic balance was evaluated by Y balance test. Results: The hamstring flexibility, pelvic tilting angle and dynamic balance were significantly improved between three groups before and after intervention (p<0.05). Dynamic balance was significantly difference between the three groups in the posterolateral direction (p<0.05). Conclusions: This study result showed that hip hinge exercise stretching was the most effective method for increasing hamstring flexibility, pelvic tilting angle and dynamic balance. In addition, it is necessary to study whether hamstring stretching is effective in low back pain patient with hamstrings tightness.