Acute Effects of Various Stretching Techniques on Range of Motion: A Systematic Review with Meta-Analysis

各种拉伸技术对关节活动范围的急性影响:系统评价与荟萃分析

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Abstract

BACKGROUND: Although stretching can acutely increase joint range of motion (ROM), there are a variety of factors which could influence the extent of stretch-induced flexibility such as participant characteristics, stretching intensities, durations, type (technique), and muscle or joint tested. OBJECTIVE: The objective of this systematic review and meta-analysis was to investigate the acute effects of stretching on ROM including moderating variables such as muscles tested, stretch techniques, intensity, sex, and trained state. METHODS: A random-effect meta-analysis was performed from 47 eligible studies (110 effect sizes). A mixed-effect meta-analysis subgroup analysis was also performed on the moderating variables. A meta-regression was also performed between age and stretch duration. GRADE analysis was used to assess the quality of evidence obtained from this meta-analysis. RESULTS: The meta-analysis revealed a small ROM standard mean difference in favor of an acute bout of stretching compared to non-active control condition (ES = −0.555; Z = −8.939; CI (95%) −0.677 to −0.434; p < 0.001; I(2) = 33.32). While there were ROM increases with sit and reach (P = 0.038), hamstrings (P < 0.001), and triceps surae (P  = 0.002) tests, there was no change with the hip adductor test (P = 0.403). Further subgroup analyses revealed no significant difference in stretch intensity (P  = 0.76), trained state (P  = 0.99), stretching techniques (P  = 0.72), and sex (P  = 0.89). Finally, meta-regression showed no relationship between the ROM standard mean differences to age (R(2) = −0.03; P  = 0.56) and stretch duration (R(2) = 0.00; P = 0.39), respectively. GRADE analysis indicated that we can be moderately confident in the effect estimates. CONCLUSION: A single bout of stretching can be considered effective for providing acute small magnitude ROM improvements for most ROM tests, which are not significantly affected by stretch intensity, participants’ trained state, stretching techniques, and sex. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40798-023-00652-x.

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