Acute Effects of Two Hip Flexor Stretching Techniques on Knee Joint Position Sense and Balance

Abstract

Background: Tightness of hip flexor muscles has been recognized as a risk factor for various musculoskeletal injuries in the lower extremities. Purpose:The purpose of this study was to examine the acute effects of two hip flexor stretching techniques (dynamic and hold-relax proprioceptive neuromuscular facilitation, HR-PNF) on hip extension (ROM), knee joint position sense (JPS) and balance in healthy college age students who exhibit tightness in hip flexor muscles.Study Design: Pretest-posttest randomized experimental groups.Methods: Thirty-six healthy college age students (mean = 22.37 years) with tight hip flexors participated in this study. Hip extension ROM, knee joint position sense and dynamic balance were tested pre-and post-stretching using a digital inclinometer, an iPod touch and the Y-Balance test, respectively. Subjects were randomly divided into dynamic and HR-PNF stretching groups. Three-way mixed analysis of variance was utilized to explore if an interaction existed between the groups in tested variables.Results: There was a significant effect of time on hip extension ROM in both groups (p < 0.001). There was also a significant effect of stretch type on hip extension ROM (p = 0.004) favoring hold-relax over dynamic stretching group. There was a non-significant effect of time on mean knee joint position replication error in both groups. There was a significant main effect of time on the Y-Balance test's mean distance of reach to posteromedial and posterolateral directions (p < 0.001). There was also a significant main effect of directions of reach on distances achieved (p < 0.001) favoring posterolateral over posteromedial, and the latter over anterior direction. Conclusions:The results of this study demonstrated the effectiveness of both HR-PNF and dynamic stretching techniques which resulted in a significant acute improvement in hip extension ROM and dynamic balance measures, with HR-PNF being more effective than dynamic stretch. However, there were no significant improvements in knee joint position replication over time in either stretching group.

El perfil óptimo de flexibilidad en jóvenes jugadores de fútbol durante su periodo sensible del desarrollo físico. Batería ROM-SPORT

“…En este sentido, se han observado valores superiores de ROM en los deportistas con un nivel competitivo superior, lo que contribuye a un mayor rendimiento físico-técnico deportivo (Battista et al, 2007;De la Fuente & Gómez-Landero, 2019;Gannon et al, 1999;Sánchez-Sánchez et al, 2014). Estudios previos, que han evaluado la influencia del ROM sobre el rendimiento de determinados tests físico-técnicos, han observado que los deportistas (voleibol, fútbol) y adultos jóvenes físicamente activos con valores más altos de ROM en la cadera (flexión), rodilla (flexión) y tobillo (dorsiflexión) mostraban un mayor rendimiento en el salto vertical (Faiss et al, 2009;García-Pinillos et al, 2015;Lee et al, 1989;Rey et al, 2016), sprint (García-Pinillos et al, 2015), equilibrio dinámico (Aslan et al, 2018;Basnett et al, 2013;Kang et al, 2015;Overmoyer & Reiser, 2015), agilidad (García-Pinillos et al, 2015;Rey et al, 2016).…”

Wireless Motion Sensors—Useful in Assessing the Effectiveness of Physiotherapeutic Methods Used in Patients with Knee Osteoarthritis—Preliminary Report

“…An interesting assessment of exercise effect in terms of its potential impact on knee JPS was presented by Younis et al [49], who compared two kinesitherapy techniques: dynamic stretching and proprioceptive neuromuscular facilitation. Both techniques improved body balance but did not significantly affect the knee JPS.…”

The Influence of Stretching the Hip Flexor Muscles on Performance Parameters. A Systematic Review with Meta-Analysis

“…Endo and Sakamoto [ 10 ] also reported relationships between tight hip flexors and reduced dynamic balance, as assessed by star excursion balance tests in the lateral direction. Hip flexor tightness can also lead to muscle fatigue and can negatively affect movement patterns [ 11 , 12 ]. Furthermore, reduced gluteus maximus activation and lower gluteus maximus to biceps femoris co-activation were reported in female soccer players with lower hip extension ROM, indicating adapted neuromuscular strategies that negatively influence movement patterns, and hence can lead to decreased performance and injury [ 13 ].…”