Effect of Percussion Massage on Hamstring Flexibility
Condition: Massage; Hamstring Flexibility; Manual Therapies
Study type: Interventional

Summary: 
      Background and aim: Percussion massage, which is one of the applications to increase muscle
      flexibility, is a method that combines vibration and massage therapy elements. With its
      popularity in recent years, it is offered as an alternative to traditional methods that
      increase flexibility. The aim of this study is to examine the acute effect of percussion
      massage and static stretching exercise on hamstring flexibility.

      Method: Individuals with active knee extension angle limited to at least 15 degree were
      included in the study, which was designed as a cross-over. Active Knee Extension test and Sit
      and Reach Test were performed before and after the interventions for the evaluation of
      hamstring flexibility. Participants were divided into 3 groups as percussion massage, static
      stretching and control groups, interventions were made with 3 days intervals and control
      measurements were taken.
    

Detailed description: 
      Active knee extansion test: In this test, which is used to evaluate hamstring flexibility in
      the sitting position, the participant was asked to sit on the edge of the bed and the
      hip-knee flexion angle was adjusted to 90 degree. For the measurement of active knee
      extension degree, a double-arm universal goniometer (Baseline Stainless Steel Goniometer;
      Fabrication Enterprises Inc., Elmsford, NY, USA) was placed on the lateral condyle of the
      femur and the participant was told to actively extend the knee to full extension. The angle
      at the end point of the movement was recorded.

      sit and reach test: While sitting in a long sitting position with their knees straight and
      their bodies upright, the participants were asked to touch the soles of their bare feet to
      the assessment table. In this position, they were told to reach as far as they could reach on
      the coffee table with their elbows straight and palms facing the floor. By measuring the
      distance between the fingertip and the coffee table, those who could reach the table received
      "0" values, those who could reach beyond the table (+) cm and those who could not reach (-)
      cm. The best value after two measurements was recorded.

      Static stretching procedure: For the static stretching exercise, the participant was asked to
      lie down in the supine position. The investigator had the dominant side passively flexed the
      hip to 90 degree, extending the knee to the end that could be tolerated. At the last point,
      it was waited for 30 seconds and then the hamstring muscle was relaxed and rested for 30
      seconds. A total of 5 minutes of application was completed by doing 5 repetitions with 30
      seconds of static stretching and 30 seconds of rest in each period.

      percussion massage procedure: Hypervolt (Hyperice, California, US) device was applied to the
      dominant hamstring muscle for 5 minutes at 53 Hz frequency with the "hard ball" head.
      Semitendinosus and semimembranosus muscles were focused in the first 2.5 minutes of the
      massage treatment, and the biceps femoris muscle in the second 2.5 minutes. By paying
      attention to the equal amount of pressure applied throughout the massage, the massage was
      started from the medial side of the muscle in the first part of the application and the
      massage was completed by moving the device from distal to proximal and from proximal to
      distal in a straight line within 20 seconds. While passing to the last 2.5 minutes, the
      massage device was shifted laterally at the distal end of the muscle, and the application was
      made from distal to proximal and then distally. Thus, the massage for each muscle was started
      from the medial and ended laterally.
    

Intervention name(s): percussion massage; static stretching
Intervention type(s): Procedure; Procedure
Intervention description(s): percussion massage to the dominant leg hamstring muscle for 5 minutes; Static stretching to the dominant hamstring muscle for 5 minutes
Other intervention name(s): vibration massage
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: massage; static stretching; hamstring muscles; flexibilty