Acute Effect of Static Stretching, PNF and Motor Imagery on Hamstring Flexibility

Abstract

Purpose: The aim of the present study is to investigate the effects of a single session of static and proprioceptive neuromuscular facilitation (PNF) stretching and motor imagery (MI) techniques on hamstring flexibility. Methods: Sixty-one volunteers were included in the study. Individuals were randomly assigned as static stretching (SS), PNF and MI groups. Fifteen SS and PNF stretching exercises were applied to the SS and PNF groups for both legs, respectively. MI group was asked to imagine a standard hamstring stretching exercise program with the commands of the physiotherapist, without any movement. Before and after the stretching session, hamstring flexibility was evaluated with the right and left leg active straight leg raise test (ASLR) and sit-reach test (SRT). Results: The statistically significant differences were found in the pre-and post-session right and left ASLR and SRT scores of SS, PNF and MI groups (pSS=0.004, pPNF=0.002, pMI=0.004; pSS<0.001, pPNF<0.001, pMI<0.001; pSS=0.009, pPNF=0.002, pMI=0.003; respectively). In addition, no statistically significant difference was found between the SS, PNF and MI groups in terms of right, left ASLR and SRT scores (F(2;49)=0.396, p=0.675, F(2;49)=0.906, p=0.411, F(2;47)=0.271, p=0.764; respectively). Conclusion: The study presented that a single session application of SS, PNF, and MI have shown positive effects on hamstring flexibility and none of them were not superior to each other. Considering clinical implications of current results, MI may be recommended such as SS and PNF when SS and PNF stretching cannot be performed or as a home exercise program. Further studies that compare the long-term effects of these techniques are needed in the literature.

Keywords

• Motor Imagery
• Static Stretching
• PNF
• Hamstring Flexibility.

References

1. 1. Hori, M., H. Hasegawa, and H. Takasaki, Comparisons of hamstring flexibility between individuals with and without low back pain: systematic review with meta-analysis. Physiotherapy Theory and Practice, 2021. 37(5): p. 559-582.
2. 2. Cayco, C.S., A.V. Labro, and E.J.R. Gorgon, Hold-relax and contract-relax stretching for hamstrings flexibility: A systematic review with meta-analysis. Phys Ther Sport, 2019. 35: p. 42-55.
3. 3. Medeiros, D.M., et al., Influence of static stretching on hamstring flexibility in healthy young adults: Systematic review and meta-analysis. Physiother Theory Pract, 2016. 32(6): p. 438-445.
4. 4. Maniar, N., et al., Hamstring strength and flexibility after hamstring strain injury: a systematic review and meta-analysis. Br J Sports Med, 2016. 50(15): p. 909-20.
5. 5. Konrad, A., S. Stafilidis, and M. Tilp, Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties. Scand J Med Sci Sports, 2017. 27(10): p. 1070-1080.
6. 6. Puentedura, E.J., et al., Immediate effects of quantified hamstring stretching: hold-relax proprioceptive neuromuscular facilitation versus static stretching. Phys Ther Sport, 2011. 12(3): p. 122-6.
7. 7. Lempke, L., et al., The Effectiveness of PNF Versus Static Stretching on Increasing Hip-Flexion Range of Motion. J Sport Rehabil, 2018. 27(3): p. 289-294.
8. 8. Kanthack, T.F.D., et al., Neurophysiological insights on flexibility improvements through motor imagery. Behavioural brain research, 2017. 331: p. 159-168.

9. 9. Ansari, N.N., et al., Immediate Effects of Dry Needling as a Novel Strategy for Hamstring Flexibility: A Single-Blinded Clinical Pilot Study. J Sport Rehabil, 2020. 29(2): p. 156-161.
10. 10. Gunn, L.J., et al., Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial. J Man Manip Ther, 2019. 27(1): p. 15-23.
11. 11. Hill, K.J., et al., Immediate Effects of Proprioceptive Neuromuscular Facilitation Stretching Programs Compared With Passive Stretching Programs for Hamstring Flexibility: A Critically Appraised Topic. J Sport Rehabil, 2017. 26(6): p. 567-572.
12. 12. Nakao, G., K. Taniguchi, and M. Katayose, Acute Effect of Active and Passive Static Stretching on Elastic Modulus of the Hamstrings. Sports Med Int Open, 2018. 2(6): p. E163-E170.
13. 13. Decoster, L.C., et al., The effects of hamstring stretching on range of motion: a systematic literature review. Journal of Orthopaedic & Sports Physical Therapy, 2005. 35(6): p. 377-387.
14. 14. Borges, M.O., et al., Comparison between static stretching and proprioceptive neuromuscular facilitation on hamstring flexibility: systematic review and meta-analysis. European Journal of Physiotherapy, 2018. 20(1): p. 12-19.
15. 15. Wanderley, D., et al., Efficacy of proprioceptive neuromuscular facilitation compared to other stretching modalities in range of motion gain in young healthy adults: A systematic review. Physiother Theory Pract, 2019. 35(2): p. 109-129.
16. 16. Guillot, A., C. Tolleron, and C. Collet, Does motor imagery enhance stretching and flexibility? J Sports Sci, 2010. 28(3): p. 291-8.
17. 17. Williams, J.G., J.L. Odley, and M. Callaghan, Motor Imagery Boosts Proprioceptive Neuromuscular Facilitation in the Attainment and Retention of Range-of -Motion at the Hip Joint. J Sports Sci Med, 2004. 3(3): p. 160-6.
18. 18. Gajdosik, R.L., B.F. LeVeau, and R.W.J.P.t. Bohannon, Effects of ankle dorsiflexion on active and passive unilateral straight leg raising. 1985. 65(10): p. 1478-1482.
19. 19. Exerc, A.C.o.S.M.J.M.S.S., The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. 1998. 30: p. 975-911.
20. 20. Schuster, C., et al., Best practice for motor imagery: a systematic literature review on motor imagery training elements in five different disciplines. BMC Med, 2011. 9: p. 75.
21. 21. Vergeer, I. and J. Roberts, Movement and stretching imagery during flexibility training. J Sports Sci, 2006. 24(2): p. 197-208.
22. 22. Frenkel, M.O., et al., Mental practice maintains range of motion despite forearm immobilization: a pilot study in healthy persons. J Rehabil Med, 2014. 46(3): p. 225-32.
23. 23. Kay, A.D., J. Husbands-Beasley, and A.J. Blazevich, Effects of Contract-Relax, Static Stretching, and Isometric Contractions on Muscle-Tendon Mechanics. Med Sci Sports Exerc, 2015. 47(10): p. 2181-90.
24. 24. Nakamura, M., et al., Acute Effects of Stretching on Passive Properties of Human Gastrocnemius Muscle-Tendon Unit: Analysis of Differences Between Hold-Relax and Static Stretching. J Sport Rehabil, 2015. 24(3): p. 286-92.
25. 25. Freitas, S.R., et al., Responses to static stretching are dependent on stretch intensity and duration. Clin Physiol Funct Imaging, 2015. 35(6): p. 478-84.
26. 26. Li, S., et al., The effect of motor imagery on spinal segmental excitability. J Neurosci, 2004. 24(43): p. 9674-80.
27. 27. Abraham, A., et al., Integrating mental imagery and fascial tissue: A conceptualization for research into movement and cognition. Complement Ther Clin Pract, 2020. 40: p. 101193.