Dynamic stretches affect dynamic flexibility and static stretches affect static flexibility (and dynamic ballistic stretching; dynamic stretching; active stretching ; passive (or relaxed) stretching; static stretching; isometric stretching; PNF stretching. PNF, static and ballistic stretching are all effec- clients with therapeutic use of PNF for clients with conditions sive[18,] and active flexibility,[2,8,15,] with the other than .. neuromuscular facilitation stretch techniques on trained and. Sady SP, Wortman M, Blanke D: Flexibility training: ballistic, static or proprioceptive neuromuscular facilitation? Arch Phys Med Rehabil, –,
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STRETCHING AND FLEXIBILITY – Types of Stretching
Influence of the stretching frequency using proprioceptive neuromuscular facilitation in the flexibility of the hamstring muscles. Stretching techniques are one of the most used devices in rehabilitation practice. However, some parameters such as frequency have not been studied when proprioceptive neuromuscular facilitation PNF techniques are used. The purpose of this study was to analyze in the short and middle-terms the optimal frequency to increase hamstring muscle flexibility, measured by knee extension range of motion ROM.
Thirty-six female subjects were selected, mean SD age The three stretching groups received the intervention five days a week for two consecutive weeks. The three PNF stretching groups alternated concerning frequency with one, three, and six maneuvers per session.
Data indicated that the PNF stretching groups had a statistically significant ROM gain in relation to the control group, but not among themselves. The results showed that there was no difference in relation to delayed gains when one, three or six stretching maneuvers were used with the hold-relax technique on hamstring muscles.
Movement Articular Breadth MAB or joints mobility depends on the peri and intra-articular soft tissues extensibility. The structures and mechanisms which influence in the passive property of the muscle are: The perimysial constitutes the tissue which contributes the most to the passive resistance of the skeletal muscle 2. Such fact was supported by Harrelson and Leaver-Dunn 3 who suggest that the soft tissues, including the muscular cuff and the connective tissue skeletons are the main responsible for the greatest part of resistance to stretching of the normal relaxed muscle.
In humans, inadequate flexibility is a contributing factor for muscular injuries, especially concerning hamstring muscles 4. Stretching exercises may be used in the sports and therapeutic environment in order to gain MAB. Low magnitude loads for extended periods of time increase the plastic deformation of the non-contractible tissue, allowing a gradual remodeling of the collagen connections and water redistribution for the neighbor tissues 5.
In some studies, the stretching immediate effect may be explained by the viscoelastic characteristics of the muscular components and by the short- term alterations in the muscular extensibility Nevertheless, other studies reveal that the effectiveness of the stretching techniques are more linked to alterations in the individual’s tolerance to stretching than to alterations in the muscles elasticity The main stretching techniques vary in passive or static stretching, ballistic or modalities that utilize Proprioceptive Neuromuscular Facilitation PNF.
Several studies observed the differences in these techniques; the majority of them demonstrates advantage in the MAB gain for the stretching techniques that use PNF Stretching techniques with PNF are characterized by the use of active muscular contraction with the purpose to cause autogenic inhibition of the stretched muscle.
When it is applied, a reflex muscular relaxing occurs, which associated with the passive stretching, promotes an increase in the MAB gain However, massive research has used different stretching frequencies with PNF per session. For instance, with different objectives: In order to better know the passive stretching technique, some researchers verified the influence of frequency and quantity of stretching maneuvers. In order to improve the flexibility gain, Starring et al.
Grandi 18 used four repetitions of 18 seconds and compared with one repetition of 30 seconds in the hamstring musculature for three weeks, stretching once a week. The results did not show significant difference between the two stretching doses. The results also showed that one to three repetitions of 60 seconds are not better than stretching once for 30 seconds.
Nonetheless, the frequency understanding in passive stretching should not be simply applied to techniques which use PNF. Therefore, due to the importance of breadth gain in the sports and therapeutic environment, it is necessary to learn about the effects of the frequency variation in stretching with active inhibition.
The aim of this study was to examine the frequency effects of stretching with PNF, both after 10 stretching sessions and immediately after the stretching, concerning flexibility of the hamstring muscles.
Forty-one female individuals, mean age The sample was limited to the female sex due to the subjects’ availability of this gender; moreover, research has demonstrated that the variations of the female hormonal cycle, seric estradiol level or menstrual proprioveptive do not influence the muscular flexibility The volunteers were young healthy women, without any locomotion dysfunction, with limited flexibility of the hamstrings, with the right knee active extension KAE with the hip at 90 degrees of flexion not being able to surpass degrees.
Subjects who presented body mass index higher than 28; genu flexum or recurvatum; vasomotor or cardiac pathologies; right knee pathologies history; backbone dysfunctions and recent lumbalgia case were excluded.
The volunteers could not be athletes or be under a stretching program propriioceptive the thigh posterior musculature. All volunteers signed a clarified consent form about the possible risks, having the right to withdraw from the research and their identities secret. This study was approved by the Ethics and Human Research Committee of the responsible institution. Proprioceptivf case they miss any session; the exclusion would be immediate, which occurred with five subjects.
The subjects were randomly distributed in four groups. The first group was the control one, which was not submitted to the stretching protocol and had its measurements taken on the first, pre-test and twelfth day-post test. The other groups received the stretching protocol with PNF being only different concerning the number of repetitions of the maneuver per day, being the measurements daily performed, prior and post protocol.
A board developed by Brasileiro et al. The volunteer was positioned on dorsal decubitus and had the right hip sustained at 90 degrees of flexion, with the left lower limb remaining extended on the board. The subject was restrained around the chest, pelvic waist and right and left thighs figure 2.
The height of the restrained trainimg arm for the right leg was adapted according to the dimension of the subject’s limb.
The free arm was propiroceptive having as basis the lateral malleoli of the right leg. A universal goniometer was attached to the steady and mobile axes of the board in order to measure the extensor knee angle.
Flexibility training: ballistic, static or proprioceptive neuromuscular facilitation?
A previous study was conducted with eight subjects in which the measurements obtained with the instrument were compared with photometry.
Two daily measurements were performed; one prior and the other post stretching. The first measurement was preceded by five minutes of stationary cycling with standard resistance at mild intensity 25 Watts. The subject was placed on the board and three maximal active extensions of the right knee were required. The free arm was taken from the board to the maximal reached point. The single arithmetic mean of these three measurements was used. All participants were asked to suitably wear comfortable garments that would not restrict their movements both during the measurements and the stretching protocol.
The study was the blind type, since the researcher who measured the flexibility did not know to which group the evaluated volunteer belong. After the first measurement, the volunteer would go to a reserved room for the stretching protocol.
The intervention was conducted in a rotation system with two other researchers who oriented the volunteer not to reveal the number of stretching maneuvers she was being submitted to. After being submitted to the stretching maneuver sthe volunteer was conducted once again to the room where the second measurement would occur.
Flexibility: static, ballistic, PNF & dynamic by sarah mcloughlin on Prezi
Such procedure was performed five days a week during two consecutive weeks, from Monday to Friday, with a total of 10 interventions for each participant. The maneuvers and the verbal commands were previously standardized between the two researchers responsible for the stretching protocol. The participants were instructed on the maneuver before the procedure. The PNF hold-relax technique was used. The quantity of maneuvers to which each volunteers was submitted was previously defined.
The participant was on prone position and had her left thigh stabilized by the researcher with the aid of a towel figure 3. The therapist passively flexed the participant’s right hip up to her pain threshold, position in which discomfort in the hamstrings was reported.
At the researcher command, the volunteer was asked to perform maximal strength for leg extension, contracting the hip extensors flexivility five seconds and the contraction was resisted by the therapist.
The five seconds contraction was used because according to previous research, the optimum duration of the isometric contraction in the PNF techniques neuromuscualr of three to six seconds After five seconds, the volunteer would relax the musculature and immediately after had the hip passively flexed, with knee extended, until discomfort was reported again.
The limb was kept in this position for 30 seconds, time based on Bandy et al. The volunteers were instructed to totally relax the leg during the stretching, not offering any voluntary resistance.
Such maneuver was repeated the number of times corresponding to the group to which the participant belonged, keeping an interval of 30 seconds in between them. Descriptive statistics was used to analyze the following data: One-way Statoc variance analysis was also used in order to test the homogeneity of the initial angle measurements pre-test and age; weight; height and body mass index characteristics.
Finally, each experimental group was submitted to a one-way ANOVA variance analysis in order to verify in which session significant gain of KAE occurred concerning the pre-test measurement.
The control group was not included in this specific analysis since it did not have daily data. After having confirmed that the groups had different post-test measurements F 3.
In other words, after 10 sessions, the flexibility gain was equal among the experimental groups, regardless the number of series variable table 2. Concerning the immediate effect of stretching with PNF, that is, the difference between the pre and post-stretching measurements of the same session, group 1A increased an average of 4. Nevertheless, in the following session, when the pre-stretching measurement of the KAE was performed, a decrease of the MAB was observed concerning the post-stretching measurement of the previous session, characterizing thus, a loss in the immediate gain.
Therefore, such continuous increase of MAB implied in a total gain higher at each stretching session until it became significant. It was confirmed through a one-way ANOVA variance analysis in which session this accumulated gain became statistically significant concerning the initial measurement of the first day.
Each group was individually evaluated comparing the pre-test KAE with the value found in each day of the stretching protocol. It was then observed that the 3A F 1. Some studies have been conducted with the aim to find the ideal frequency of stretching exercises Nonetheless, none of them have related frequency and stretching techniques which involve active muscular inhibition.
Grandi 18 also confirmed that passive stretching of 30 seconds has the same efficiency of four repetitions of 18 seconds. The results of the present study reveal that as expected, there was significant increase in flexibility of the hamstrings in all stretching with PNF groups after ten sessions, while the control group did not obtain flexibility increase. Trainint, group 1A Nevertheless, this difference among groups was not observed in the groups of three 3A and six repetitions 6A.
However, statistically speaking, there was not significant difference when the late trainong among the three experimental groups was compared. Probably, one 1 inhibition of the neurotendinous organ by active isometric contraction of propioceptive seconds is ballistkc to acquire the expected muscular relaxing in a stretching session in the hamstring muscles. Three or six inhibitions associated with static stretching do not seem to be necessary in order to gain facilitatin.
The three repetitions with PNF group joined with the six group, reached the significant difference concerning the initial measurements on the fifth day; besides that, the stretching with PNF group only ttraining such difference on the eighth day table 3. Such finding leads us to believe that in the middle run, the frequency of three repetitions with PNF would be more appropriate in order to promote a faster gain of flexibility in relation to the frequency of a stretching with PNF, without difference in this gain velocity when this frequency is flexibolity to six repetitions with PNF.
Once in sports rehabilitation the recovery time is a key factor, further studies are needed for the determination of stretching with PNF parameters which improve the MAB gain. The groups which presented significant increase of flexibility first were the ones which had a higher daily gain, suggesting hence, that the optimum velocity for flexibility gain may be related with the decrease of the immediate loss effect, once it affects the daily gain.
The loss of the immediate effect was confirmed in other studies in the shoulder musculature 25 and ballistix