A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial

Abstract

Objectives: To compare the different stretching techniques, proprioceptive neuromuscular facilitation (PNF) stretching and static stretching, in patients with elbow stiffness after a treated elbow fracture. Design: Randomized-controlled, single-blind study. Setting: Department of physiotherapy and rehabilitation. Subjects: Forty patients with posttraumatic elbow stiffness (24 women; mean age, 41.34 ± 7.57 years). Intervention: PNF stretching group (n = 20), hold-relax PNF stretching combined with a structured exercise programme (two days per week for six weeks); static stretching group (n = 20), static stretching combined with a structured exercise programme (two days per week for six weeks). Main measures: The primary outcome is the Disabilities of the Arm, Shoulder and Hand (DASH). The secondary outcomes are active range of motion (AROM), visual analogue scale (VAS), Tampa Scale for Kinesiophobia, Short Form-12 and Global Rating of Change. Participants were assessed at baseline, after a six-week intervention period and one-month later (follow-up). Results: After treatment, improvement in the mean DASH score was slightly better in the PNF stretching group (8.66 ± 6.15) compared with the static stretching group (19.25 ± 10.30) (p = 0.03). The overall group-by-time interaction for the 2 × 3 mixed-model analysis of covariance (ANCOVA) was also significant for elbow flexion AROM (mean change for PNF stretching group; static stretching group; 41.10, 34.42, p = 0.04), VAS-rest (-1.31,-1.08, p = 0.03) and VAS-activity (-3.78,-3.47, p = 0.01) in favour of PNF stretching group. The other outcomes did not differ significantly between the two groups.

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

“…It is thought that the increase in ROM and the extension of soft tissues affect muscle strength, thus reducing the range of pain. This proved that the HR technique affected VAS and SPADI more than MWM [31,32].…”

A Mixed Comparison of Interventions for Kinesiophobia in Individuals With Musculoskeletal Pain: Systematic Review and Network Meta-Analysis

“…Thirty-one studies were included in the final analysis (Beltran-Alacreu et al, 2015 ; Hidalgo et al, 2015 ; Pires et al, 2015 ; Sarig Bahat et al, 2015 ; Castro-Sánchez et al, 2016 ; Pillastrini et al, 2016 ; Cruz-Díaz et al, 2017 ; Martínez-Cervera et al, 2017 ; Yilmaz Yelvar et al, 2017 ; Birinci et al, 2019 ; Gholami et al, 2020 ). The identification process is shown by a flow diagram in Figure 1 (Moher et al, 2009 ).…”

Effect of Proprioceptive Neuromuscular Facilitation Stretching on Pain, Hip Joint Range of Motion, and Functional Disability in Patients with Chronic Low Back Pain

“…Although both the methods improved hamstring flexibility, there was no difference in the efficacy of the two methods. However, when Birinci et al [11] randomly allocated PNF and static stretching to patients with elbow stiffness after a treated elbow fracture, they observed improvement in arm pain, ROM, and function particularly in the PNF stretching group. Tucker and Slone [24] applied PNF stretching, PNF stretching combined with vibration, and static stretching to patients with glenohumeral internal rotation deficit.…”

“…Jeong and Kim [10] observed that application of PNF stretching significantly reduces low back pain and dysfunction in patients with chronic low back pain. Birinci et al [11] reported significant improvements in elbow pain, range of motion (ROM), and arm function upon the application of PNF stretching in patients with elbow stiffness. Gunn et al [12] reported that PNF stretching is more effective for hamstring flexibility than static stretching.…”