The Immediate Effect of Adding Lumbar Mobilization to A Static Stretching Program on Hamstrings Range of Motion: An Exploratory Study

Abstract

A contributing risk factor and a byproduct of a hamstrings strain is limited hamstrings range of motion (ROM). Some evidence supports static stretching (SS) and lumbar spinal mobilization therapy (LSMT) as an effective means for increasing hamstrings ROM. However, the efficacy of combining LSMT and SS for increasing hamstrings ROM is unknown. The objective of the study is to quantify the immediate effects of the combination of LSMT and SS compared to LSMT and SS on hamstrings ROM in a healthy population. Thirty participants were randomized by block allocation into one of three intervention groups: (1) LSMT (unilateral lumbar PA mobilization at L-4); (2) SS; or (3) combination of LSMT and SS. Hamstrings ROM was measured pre- and post-intervention by the active knee extension test (AKET). There was no group-by-time interaction effect (p = 0.871). Within group analysis revealed a significant statistical change and a large effect size: LSMT (p = .037, RCI = 3.36, d = 0.771); SS (p = 0.035, RCI = 2.94, d = 0.781); combination (p = .005, RCI = 4.21, d = 1.186. The findings suggest that the combination of LSMT and SS does not have a further effect on hamstrings ROM compared to the individual results of LSMT or SS.

Foam rolling and stretching do not provide superior acute flexibility and stiffness improvements compared to any other warm-up intervention: A systematic review with meta-analysis

“…ROM values showed a moderate certainty of evidence, and stiffness and passive peak torque scores were rated as very low certainty of evidence. We found no significant differences in acute ROM in the 25 studies 27 , 39 , 40 , 41 , 42 , 43 , 45 , 46 , 48 , 49 , 51 , 54 , 55 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 65 , 66 , 70 , 71 , 73 that performed stretching or the 11 studies that used foam rolling, 26 , 30 , 49 , 50 , 51 , 53 , 56 , 58 , 64 , 68 , 69 each of which compared the effects of the activity of interest to those of other interventions. Considering that 7 studies 26 , 44 , 46 , 47 , 53 , 67 , 72 investigating acute changes in stiffness and 3 studies looking at acute passive torque also showed no significant difference, 46 , 47 , 53 we are led to question the necessity of stretching and foam rolling when aiming to acutely enhance ROM and passive peak torque or to decrease stiffness.…”

“…1 , with a total of 38 studies 26 , 27 , 30 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ( n = 1134 participants, male = 567, female = 415, and 4 studies including 152 participants without information regarding sex; 27 , 39 , 40 , 41 ES: n = 140) meeting the inclusion criteria. Of these, 25 papers compared the effects of stretching to those of alternative activities on ROM; 27 , 39 , 40 , 41 , 42 , 43 , 45 , 46 , 48 , 49 , 51 , 54 , 55 , 57 , 58 , 59 , 60 , 61 , 62 ...…”

“… 26 , 30 , 49 , 50 , 51 , 53 , 56 , 58 , 64 , 68 , 69 We included 4 studies (ES: n = 23) 44 , 46 , 47 , 72 investigating the effects of stretching and 3 studies (ES: n = 7) addressing the effects of foam rolling on stiffness, 26 , 53 , 67 while 3 studies (ES: n = 12) addressed the effects on passive peak torque. 46 , 47 , 53 The majority ( n = 37) of the articles addressed muscles of the lower extremities, 26 , 27 , 30 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 72 , 73 while only a single intervention targeted muscles of the upper body.…”

“…While blinding of the participants and therapists was never achieved, investigator-blinding was accomplished in 10 studies. 30 , 41 , 43 , 45 , 48 , 54 , 61 , 62 , 71 , 73 Only 3 studies concealed the allocation 45 , 54 , 58 and adhered to the application of the intention-to-treat principle, 45 , 54 , 73 respectively. In 6 studies, 26 , 27 , 42 , 46 , 56 , 58 the groups were not considered similar at baseline with respect to the most important prognostic factors.…”

Immediate Effects of Isolated Lumbar Extension Resistance Exercise (ILEX) on Spine Posture and Mobility Measured with the IDIAG Spinal Mouse System

“…The other immediate changes related to mobility, displayed as lower flexed lumbar mobility (fLM) and higher sacral mobility (fSM). Researchers have been investigating the immediate effects of exercises with the purpose to understand and find mechanisms that positively influence biophysical aspects of the body for years [ 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 ]. Without treatment, anomalies such as hyperkyphosis, hypolordosis, and mobility deficits can promote pathophysiological processes, leading to musculoskeletal pain conditions (e.g., low back pain) [ 32 , 33 ].…”