• 대한물리치료과학회지
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• 제30권1호
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• pp.31-40
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• 2023

Hamstring flexibility is an important factor that affects muscle performance of the lower extremities and is closely associated with sports injuries. Therefore, evaluation of flexibility is important in clinical practice. Results of evaluation are determined by types of tests and cut-off values used; therefore, accurate and detailed understanding of these is necessary before examination. Although the straight leg raise and sit and reach tests are used to evaluate hamstring extensibility, structures including the nerves, fascia, and other muscles can significantly confound the results of these tests. The knee extension test is performed at 90° of hip flexion to minimize the posterior pelvic tilt that occurs during the straight leg test. The knee extension test is most recommended for selective evaluation of hamstring flexibility. The knee extension test is classified into active and passive tests. The cut-off value is usually set at 20° for the active and at 10° for the passive knee extension test. Although a strong association is observed between the two tests, the active knee extension test is preferred in clinical practice because it can be performed by a single examiner, which serves as an advantage. Age, sex, and warm-up exercise tend to affect flexibility; therefore, results should be interpreted with caution. Detailed understanding of each flexibility test is important for reliable evaluation.

• 대한물리의학회지
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• 제18권4호
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• pp.77-87
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• 2023

PURPOSE: The purpose of this study was to investigate the changes in the flexibility and elasticity of the muscles when the hamstrings were stretched in one direction and when they were stretched in three directions. METHODS: In this study the subjects were divided into two groups, namely the 'one-direction stretching exercise of the hamstring muscle in the neutral position' group (female: 14 people, male: 14 people) and the 'three-way stretching exercise' group (female: 12 people, male: 14 people) considering the positions of the three hamstring muscles. The elasticity and flexibility of the hamstring muscles were measured before and after the self-extension exercise, and the average value of two measurements was noted. To evaluate the flexibility of the hamstring muscle, a 'sit and reach' test was performed, and muscle elasticity was measured using the MyotonPRO® device. RESULTS: After the stretching exercise, flexibility increased in both groups. In terms of muscle elasticity, the body dynamic strength and resonance frequency of the stretching one-direction stretching group decreased after the stretching exercise. CONCLUSION: To alter the muscle characteristics and increase the flexibility when performing a stretching exercise, selecting and stretching only one muscle with the lowest range of motion yields effective results. The ideal technique to be employed appears to be to stretch the entire hamstring muscle in one direction from the neutral position.

• PNF and Movement
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• 제1권1호
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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.

• 한국전문물리치료학회지
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• 제27권1호
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• pp.30-37
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• 2020

Background: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.

• 대한통합의학회지
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• 제10권2호
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• pp.115-123
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• 2022

Purpose : The hamstring is a group of three muscles, biceps femoris, semitendinosus, and semimembranosus, placed behind the thigh. The hamstring is one of the most commonly injured muscles and usually occurs during high-speed, high-intensity exercise. The purpose of this study was to investigate the effect of static stretching and eccentric exercise of hamstrings on flexibility, strength, and functional performance. Methods : This study was conducted on 28 healthy adults. Subjects were divided into a static stretching group (n=15) and an eccentric exercise group (n=13). Subjects measured hamstring flexibility (active knee extension test), hamstring strength (concentric and eccentric peak torque), and functional performance (triple hop for distance and modified 20 m sprint). The intervention was conducted three times a week for six weeks. To compare the difference between values before and after the intervention, paired t-test was used, and an independent t-test was used to compare between groups. Results : In both groups, the active knee extension test, concentric peak torque, triple hop test, and 20 m sprint significantly increased after the intervention compared to before the intervention (p<.05). However, no significant difference was found in eccentric peak torque after intervention in both groups (p>.05). No significant difference was found between the two groups in the effect on the variables (p>.05). Conclusion : Both interventions were found to be effective for flexibility, concentric strength, and functional performance. Eccentric exercise and static stretching are recommended to improve the flexibility and functional performance of the hamstring. This study's results will be considered essential data on the effectiveness of static stretching and eccentric exercise.

• 한국전문물리치료학회지
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• 제24권4호
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• pp.38-45
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• 2017

Background: To improve muscle flexibility, static stretch is the most common type and is considered safe and effective for improving overall flexibility of muscles. During the stretch, the intensity is more likely to be determined by the degree of an athlete's pain and practitioner's skills rather than quantitative measures of stretch. It is necessary to determine the optimal intensity for the stretch. Objects: The purpose of this study is to explore the relationship between hand held dynamometer (HHD) and verbal rating scale (VRS) in comparison of the effects of continuance time on active (walking) and inactive (sitting) movement after static stretch. Methods: A cross-sectional study was conducted with a sample (n=62) recruited from a university. Participants were randomly assigned to 2 different groups (n=31 for each group) based on participants' positions either remaining in sitting or freely walking around for a series of re-assessments. Data was collected at pre-warm up, pre-stretch, post-stretch, and additional assessments at the time of 3, 6, 9, 12, 15, 20 and 30 minutes after the stretch. Results: Relationship between VRS and HHD scores represents very weak correlation (Spearman's p=-.16, p>.05). Pearson's correlation analysis was conducted following the logarithmic transformation of the two scores. Pearson's correlation after the transformation still showed a very low relationship and a poor linear relationship between the two scores (Pearson's r=-.18, p>.05). Conclusion: The optimal intensity for stretch cannot be solely determined by the subjective pain perception. The objective measurement such as HHD could be used in conjunction with the pain perception.

• 한국전문물리치료학회지
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• 제29권1호
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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.

• 한국전문물리치료학회지
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• 제28권1호
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• pp.65-71
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• 2021

Background: The hamstring is a muscle that crosses two joints, that is the hip and knee, and its flexibility is an important indicator of physical health in its role in many activities of daily living such as sitting, walking, and running. Limited range of motion (ROM) due to hamstring tightness is strongly related to back pain and malfunction of the hip joint. High-frequency diathermy (HFD) therapy is known to be effective in relaxing the muscle and increasing ROM. Objects: To investigate the effects of HFD on active knee extension ROM and hamstring tone and stiffness in participants with hamstring tightness. Methods: Twenty-four participants with hamstring tightness were recruited, and the operational definition of hamstring tightness in this study was active knee extension ROM of below 160° at 90° hip flexion in the supine position. HFD was applied to the hamstring for 15 minutes using the WINBACK device. All participants were examined before and after the intervention, and the results were analyzed using a paired t-test. The outcome measures included knee extension ROM, the viscoelastic property of the hamstring, and peak torque for passive knee extension. Results: The active knee extension ROM significantly increased from 138.8° ± 9.9° (mean ± standard deviation) to 143.9° ± 10.4° after the intervention (p < 0.05), while viscoelastic property of the hamstring significantly decreased (p < 0.05). Also, the peak torque for knee extension significantly decreased (p < 0.05). Conclusion: Application of HFD for 15 minutes to tight hamstrings immediately improves the active ROM and reduces the tone, stiffness, and elasticity of the muscle. However, further experiments are required to examine the long-term effects of HFD on hamstring tightness including pain reduction, postural improvement around the pelvis and lower extremities, and enhanced functional movement.

• 대한통합의학회지
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• 제9권3호
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• pp.165-173
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• 2021

Purpose : Myofascial decompression is frequently mentioned as a method applied to cupping. The purpose of this study is to evaluate and compare active range of motion (AROM), muscle strength, and functional movement by applying myofascial decompression to the hamstrings. Methods : This study evaluated AROM, muscle strength, and functional movement by applying active movement myofascial decompression and static myofascial decompression to the dominant leg, respectively, in a crossover design conducted with normal adults (n=21) in their average 20s enrolled at G University in G city, Gyeongsangbuk-do. Active movement myofascial decompression was implemented for five minutes at a rate of 100 bpm to make the beats in flexion and extension respectively. Static myofascial decompression was only performed for five minutes while at rest. All of these interventions were performed at a cupping depth of two mm. After a one-week washout period, static was applied again to compare the same dependent variables. Results : Regarding AROM and muscle strength, both groups showed significant differences in the before and after results (p<.05). However, in the Functional Reach Aspect and Single Leg Hop test, the active movement myofascial decompression group showed better results. There was no statistical difference between the Active movement myofascial decompression group and Static myofascial decompression group in any dependent variable (p<.05). Conclusion : As a result of this experiment, both active movement myofascial decompression and static myofascial decompression had a positive effect on dependent variable. Therefore this study is meaningful in that it is easier and simpler to see the effect on flexibility, muscle strength, and functional movement just by implementing movement myofascial decompression.

• 대한통합의학회지
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• 제8권4호
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• pp.223-230
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• 2020

Purpose : The purpose of this study was to examine the effects of tools (i., extracorporeal shock wave therapy, massage gun, and foam roller) on range of motion, muscle tone and pain threshold among patients with hamstring stiffness. Methods : Fourteen participants with hamstrings stiffness were recruited. Interventions were performed 6 times, and each session was for 30 seconds using the three tools. The range of motion, muscle tone, and pain threshold were measured. The order of the use of the three tools was randomly determined. The foam roller was made to move from the bottom of the hip crease to the upper part of the back of the hamstring. Additionally, velocity 5 vibration stimulation was performed on the hamstring using a massage gun. Moreover, vibration stimulation was performed on the hamstring with extracorporeal shock wave therapy 5 minutes, 5 Hz, and 1,500 strokes. The flexibility of the posterior thigh muscle was based on maintaining the knee and hip joints in a 90 ° bend in the supine position. The joint angle of the knee was measured, when the knee was actively extended, at the maximum point where the posterior thigh muscle was stretched. The elasticity of the posterior thigh muscle was measured while the subject was prone and in a relaxed state without any force. Measurements were made at the muscle abdominal area of the semitendinosus muscle of the posterior femur, and the area to be measured was marked with a pen. The measurement of the tenderness threshold of the posterior femur was measured using a tenderness meter(Commander Algometer, J-Tech, USA). The force value at the point at which the pressure sensation change to pain was measured after applying vertical pressure to the posterior femur muscle, which was the halfway point between the ischial tuberosity and the popliteal surface of the subject lying on their stomach. Results : The extracorporeal shock wave therapy increased stiffness and, muscle tone, and caused changes in the pain threshold, whereas the other two tools had no effect on these indices. Conclusion : Extracorporeal shock wave therapy has important effects on range of motion and muscle stiffness and can be used in warmup protocols.