Background: Although rectus femoris (RF) eccentric training and static stretching (SS) have been reported effectively on lumbar flexibility, and muscle architecture, most studies are results using machines and long-term effects. Therefore, we want to investigate the effect of Reverse Nordic Hamstring Exercise (RNHE), a self-eccentric training, by immediately comparing it with SS. Objectives: To compare the RNHE and SS of RF to show the effects of lumbar flexibility, and fascicle length (FL). Design: Randomized controlled trial. Methods: A total of 30 study subjects were randomly allocated into an experimental group(Reverse Nordic Hamstring Exercise) and a control group(Static Stretching). Before and after the intervention, the subject performed fingertip to floor test (FFT) to evaluate the flexibility of the lumbar spine and measured FL through the SONON 300L (Healcerion Inc., Seoul, South Korea). Results: There was a significant effect on lumbar flexibility within both groups (P<.05), also there were clear results between the two groups (P<.05). FL showed a significant increase in RNHE (P<.05), but not in SS, and there was a no significant difference between the two groups. Conclusion: RNHE is effective in improving lumbar flexibility, and FL of RF muscle.

Background: Although it has been reported that both self-myofascial release (SMR) with foam rolling (FR) and active static hamstring stretching (e.g., jackknife stretching) are effective in improving hamstring flexibility, no study has compared the effects of these exercises. Objectives: To compare the effects of SMR with FR and jack-knife stretching on hamstring flexibility. Design: A Randomized controlled trial. Methods: Subjects with hamstring tightness were divided into the SMR with the FR group (n=12) and the jack-knife stretching group (n=12). Subjects groups performed SMR with FR or jack-knife stretching according to group assignment. To identify changes in hamstring flexibility, the finger-to-floor distance (FFD) test, active knee extension (AKE) test, and passive straight leg raising (PSLR) test were performed at pre- and post-exercise. Results: Significant increases occurred in knee extension angle during the AKE test and hip flexion angle during the PSLR test after exercise in both groups (P<.001). Additionally, FFD and anterior pelvic tilt during the FFD test significantly increased (P<.001); however, we observed no significant interaction and main effects for the groups (P>.05). Conclusion: Both SMR with FR and jack-knife stretching are effective in improving hamstring flexibility in subjects with hamstring tightness.

Background: Static hamstring stretching exercises have been widely used to improve flexibility of the hamstring muscles. However, few studies have examined the influence of standing static hamstring stretching (e.g., jack-knife stretching) on movements of the lumbopelvic–hip complex. Objectives: To examine the short-term effects of jack-knife stretching on movements of the lumbopelvic–hip complex. Design: Case series. Methods: Fourteen participants with hamstring tightness (8 male, 6 female) were recruited. Participants performed jack-knife stretching for 150 s. Before and after stretching, participants performed the finger-to-floor distance (FFD), sit and reach (SRT), active knee extension (AKE), passive straight leg raising (PSLA), and active straight leg raising (ASLR) tests as well as pelvic tilt while standing to identify the effects of stretching. Results: There were significant improvements in the FFD, SRT, AKE, PSLA, and ASLR tests after stretching. However, pelvic tilt angle while standing did not significantly change. Conclusion: Jack-knife stretching can be a useful exercise to improve flexibility of the hamstring muscles, but not pelvic alignment while standing.

Background: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.

Background: Limitations in hip flexion caused by tight hamstrings lead to excessive lumbar flexion and low back pain. Accordingly, many studies have examined how to stretch the hamstring muscle. However, no study has focused on the effect of hamstring eccentric exercise for tight hamstrings on trunk forward bending. Objects: We compared the short-term effect of hamstring eccentric exercise (HEE) and hamstring static stretching (HSS) on trunk forward bending in individuals with tight hamstrings. Methods: Thirty individuals with tight hamstrings participated in the study. The subjects were randomly allocated to either a HEE or HSS group. To determine whether the hamstrings were tight, the active knee extension (AKE) test was performed, and the degree of hip flexion was measured. To assess trunk forward bending, subjects performed the fingertip to floor (FTF) and modified modified Schober tests, and the degree of trunk forward bending was measured using an inclinometer. We used paired t-tests to compare the values before and after exercise in each group and independent t-tests to compare the two groups on various measures Results: The FTF test results were improved significantly after the exercise in both groups, and AKE for both legs increased significantly in both groups. There was no significant difference in the hip angles, mmS test results, or degree of trunk forward bending between groups after the exercise. No test results differed significantly between the two groups at baseline or after the exercise. Both groups increased hamstring flexibility and trunk forward bending. Conclusion: HSS and the HEE groups increased hamstring flexibility and trunk forward bending. However, HEE has additional benefits, such as injury prevention and muscle strengthening.

Background: There have been many studies on self-myofascial release (SMR) stretching, but there are few comparative studies on the effects of massages using a release ball, which is a type of the SMR method. Objective: To investigate the immediate effects of release ball massage and self- stretching on proprioceptive sensory, hamstring’s temperature, range of motion (ROM) muscle strength,. Design: Crossover study. Methods: Thirty women in 20’s at S University in Busan voluntarily participated in the study. Participants were random to release ball group (n=15) or selfstretching group (n=15). Both groups performed 3 sets of exercises, stretching for 30 seconds and resting for 15 seconds in each position. The proprioceptive sensory, temperature of the hamstring muscle, ROM, and strength were measured before exercise, 5 minutes after exercise, and 30 minutes after exercise. Results: Release ball group showed significant differences in muscle length and temperature over time (p<.05). The comparison between two group over time showed significant differences in muscle length, temperature, and muscle strength (p<.05). Conclusions: These results demonstrate that release ball massage and selfstretching are beneficial for improving hamstring's temperature, ROM and muscle strength.

The purpose of this study was to investigate whether static stretching or Thera-band stretching of hamstrings is more effective in improving the flexibility of hamstrings. A total of 40 participants performed stretching 3 times a week for 4 weeks, and a sitting trunk flexion meter was used to measure the flexibility of the hamstrings. Differences in hamstring flexibility before and after the application of static and Thera-band stretching were analyzed, and differences between the stretching methods were also analyzed. As a result, hamstring flexibility increased significantly after the static stretching program (p=.000), and also increased significantly after the Thera-band stretching program (p=.000). Although both programs were effective in improving hamstring flexibility, but there was no significant difference between the two groups (p=.058). Therefore, static stretching and Thera-band stretching are effective interventions to improve and maintain hamstring flexibility.

This study aims to identify the effects of extracorporeal shock wave therapy and stretching technique on flexibility, muscle tone and pressure pain threshold of a shortened hamstring. A total of 40 patients with hamstring shortening was randomly assigned to either the extracorporeal shock wave therapy group (n=20) or extracorporeal shock wave therapy with stretching technique group (n=20) to identify the effects of the two different forms of physical therapy intervention. All the participants underwent extracorporeal shockwave therapy twice a week for 3 weeks, and the extracorporeal shockwave therapy with stretching technique group performed stretching techniques with the same frequency for 3 weeks. To measure hamstring flexibility before and after intervention, the passive straight leg raising test was performed, and muscle tone and pressure pain threshold were assessed. The flexibility of the hamstrings significantly improved, while the pressure pain threshold increased in both groups. These findings suggest that the effective in improving hamstring flexibility, reducing muscle tone, and increasing pressure pain threshold in adults with hamstring shortening.

Background:Limitation of hamstring extensibility is often associated with various musculoskeletal problems such as alterations in posture and walking patterns. Thus, certain appropriate strategies need to be established for its management.Objects:The aim of this study was to compare the effects of the neural mobilization technique and static stretching exercises on popliteal angle and hamstring compliance in young women with short hamstring syndrome (SHS).Methods:Thirty-three women with SHS were randomly assigned to either group-1 (n1=17) that underwent the neural mobilization technique or group-2 (n2=16) that underwent the static stretching exercises. Outcome measures included the active popliteal angle (APA) and a hamstring’s electromyographic (EMG) activity at a maximum popliteal angle of the baseline. Intervention for each group was performed for a total time of 3-min (6 sets of a 30-sec application).Results:There were significant interactions between time and group in the APA [group-1 (pre-test to post-test): 69.70±8.14° to 74.14±8.07° and group-2: 68.66±7.42° to 70.52±7.92°] (F1,31=6.678, p=.015) and the EMG activity of the hamstring (group-1: 1.12±.30μV to .69±.31μV and group-2: 1.19±.49μV to 1.13±.47 μV)(F1,31=6.678, p=.015). Between-group comparison revealed that the EMG activity of the hamstring was significantly different at post-test between the groups (p<.05). Furthermore, in within-group comparison, group-1 appeared to be significantly different for both variables between pre- and post-test (p<.05); however, group-2 showed significant difference in only the APA between pre- and post-test (p<.05).Conclusion:These findings suggest that the neural mobilization technique and static stretching exercises may be advantageous to improve hamstring compliance in young women with SHS, resulting in a more favorable outcome in the neural mobilization technique.

The aim of this study was to compare the duration of hamstring flexibility improvement after 3 stretching interventions in people with limited hamstring flexibility. Twenty-two subjects (12 men, 10 women) with limited hamstring flexibility of the dominant leg received 3 stretching interventions— modified dynamic stretching (MDS), hold-relax (HR), and static stretching (SS)—in a random order. All the subjects received all 3 interventions at intervals of at least 24 hours to minimize any carry-over effect. Modified dynamic stretching was applied as a closed kinetic chain exercise in the supine position by using the sling suspension system (Redcord Trainer®). The SS and HR interventions were individually performed in the straight leg raising (SLR) position, and all 3 interventions were performed for 3 minutes. Outcome measures included passive knee extension (PKE) measurements. Five post-test measurements were recorded for all subjects at 3, 6, 9, 15, and 30 minutes after the interventions. MDS was associated with a significant increase in knee extension range of motion even at 30 minutes post-treatment. In contrast, the HR and SS stretching methods showed increased hamstring flexibility for only 6 minutes post-treatment. Improvements in the range of motion of knee extension (indicating enhancement in hamstring flexibility) with MDS were maintained longer than those with the HR and SS interventions. Therefore, MDS may be more effective than the other interventions for maintaining hamstring flexibility.

The purpose of this study was to examine the acute effects of nerve mobilization, static stretching, and hold-relax on the flexibility of hamstring muscles and their surface electromyographic (EMG) responses to passive stretches in poststroke hemiparesis. This study was a randomized cross-over trial. Fourteen subjects received three treatment sessions in random order with each consisting of ten repetitions. The treatment sessions included nerve mobilization, static stretching, and hold-relax. The treatment sessions were held at least 24 hours apart to minimize any carryover effect. The outcome was measured by the distance between the greater trochanter and lateral malleolus and hamstring EMG activity during passive knee extension stretching. Repeated-measures analysis of variance showed significant changes in hamstring flexibility and EMG activity in main effect of time pre, post and followup (p<.05). However, no significant differences occurred among the three stretching techniques. No technique was consistently found to be superior. The three stretching techniques in this study make it difficult to determine the most effective technique. Therefore, clinicians use nerve mobilization of effective stretching techniques with other stretching techniques.