Dynamic Oscillatory Stretch Technique Versus Static Stretching In Reduced Hamstring Flexibility

Study Overview
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Brief Summary
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This study compared the effects of dynamic oscillatory stretch technique (DOS) and static stretching (SS) technique in order to improve hamstring extensibility in healthy individuals with asymptomatic hamstring tightness. Half of study participants received DOS whereas other half received static stretching technique.

Detailed Description
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This was a single blind randomized control trial conducted at District Head Quarter teaching hospital Sargodha, Sargodha institute of health sciences Sargodha, Sadiq hospital Sargodha (march 2018-June 2018). Sample size of 83 individuals was calculated through Open Epi tool version 3 with 95 % confidence interval (CI), and power 80%. 83 individuals were screened out on the basis of inclusion and exclusion criteria. Individuals of this selected population were randomly allocated as 42 individuals in Dynamic Oscillatory Stretch(DOS) group and 41 individuals in Static Stretching(SS) group by sealed envelope method. After the application of hot pack treatment of 7-10 minutes to both groups dynamic oscillatory stretch technique (30 repetitions each of 2 seconds stretch duration in one session) was applied to DOS group and SS stretching (2 repetitions each of 30 seconds in one session) was applied to SS group. Assessment was done at baseline, immediate post-intervention levels (immediately) and post-intervention level after 1 hour. At baseline and immediately post-intervention level there was no dropout but after 1 hour post-intervention level there were two dropouts from DOS group and 1 dropout from SS group. 40 individuals were analyzed in each DOS and SS group. Data analysis was done through Statistical Package of Social Sciences(SPSS) version 20. Normality of different variables was assessed. Shapiro-Wilk test provided the basis for normality distribution of data.

Official Title
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Comparison Between Dynamic Oscillatory Stretch Technique and Static Stretching In Reduced Hamstring Flexibility in Healthy Population: A Single Blind Randomized Control Trial

Conditions
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Hamstring Tightness

Intervention / Treatment
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* Other: Group I Experimental DOS
* Other: group II SS group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Males and females with age limit 20 to 40 years, Active knee extension/90-90 test positive for Screening (With AKE range less than 160 degrees), No known history of hip joint or knee joint disease, No history of recent hamstring strain. Exclusion Criteria: History of sub-acute and chronic back pain of lumber region and SI joint in past 6 months, Neurological pathology, Patients with some kind of particularly specific pathology (e.g. infection, tumor, osteoporosis, lumbar spine fracture, structural deformity, inflammatory disorder).

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group I Experimental Dynamic oscillatory stretch(DOS)<br>Dynamic oscillatory stretch technique (30 repetitions each of 2 seconds stretch duration in one session) was applied to DOS group. | Other: Group I Experimental DOS<br>* After the application of hot pack treatment of 7-10 minutes, dynamic oscillatory stretch(DOS) technique (30 repetitions each of 2 seconds stretch duration in one session) was applied to DOS group. An experienced orthopedic manual physical therapist provided these techniques to patients .<br>|
| Active Comparator: Group II Static Stretching(SS) Group<br>Static stretching (2 repetitions each of 30 seconds in one session) was applied to SS group. | Other: group II SS group<br>* After the application of hot pack treatment of 7-10 minutes , Static stretching (2 repetitions each of 30 seconds in one session) was applied to SS group. An experienced orthopedic manual physical therapist provided these techniques to patients .<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Active Straight Leg Raise Test(ASLR) Immediate effect | Changes from baseline Active Straight Leg Raise Test(ASLR) was conducted with the participants in supine lying with both lower limbs initially extended. Then patient actively lifted the leg to be tested at hip joint while stabilizing the leg opposite to that of the testing side by using a stabilization belt. Knee on testing side was essentially sustained in full extension throughout the full testing range. Universal goniometer was used to measure range of motion available at hip joint. Cut off score for the SLR to indicate hamstring tightness is 80 degrees. Therefore, values of SLR below 80 degrees was considered as hamstring tightness. Assessment was done Immediate after giving intervention(10 minutes). | 10 minutes | 
| Active Straight Leg Raise Test(ASLR) 1 hour effects | Changes from Baseline Active Straight Leg Raise Test(ASLR) was conducted with the participants in supine lying with both lower limbs initially extended. Then patient actively lifted the leg to be tested at hip joint while stabilizing the leg opposite to that of the testing side by using a stabilization belt. Knee on testing side was essentially sustained in full extension throughout the full testing range. Universal goniometer was used to measure range of motion available at hip joint. Cut off score for the SLR to indicate hamstring tightness is 80 degrees. Therefore, values of SLR below 80 degrees was considered as hamstring tightness. Assessment was done after 1 hour of intervention. | 1 hour | 
| Active Knee Extension Test (AKE) immediate effect | Changes from Baseline Active knee extension test (AKE), is used to assess hamstring length. It was performed while the participant was in supine lying and involved leg was in 90 degree hip flexion. then participant was asked to extend the knee. For hamstring tightness cut off score AKE angle is 160°. Therefore normal individuals with angle < 160° were considered as individuals with hamstring tightness.Its reliability is 0.94.Assessment was done Immediate after giving intervention(10 minutes). | 10 minutes | 
| Active Knee Extension Test (AKE) 1 hour effects | Changes from Baseline Active knee extension test (AKE), is used to assess hamstring length. It was performed while the participant was in supine lying and involved leg was in 90 degree hip flexion. then participant was asked to extend the knee. For hamstring tightness cut off score AKE angle is 160°. Therefore normal individuals with angle < 160° were considered as individuals with hamstring tightness.Its reliability is 0.94. Assessment was done after 1 hour of intervention. | 1 hour | 
| Sit and Reach Test (SRT) Immediate effects | Changes from Baseline Sit and reach test (SRT) is most commonly employed test to measure hamstring flexibility. This tool is used to measure range of hamstring muscle at knee joint.Each participant was instructed to sits on a couch in long sitting position. participants were seated with elongated legs, with hip flexed to 90 degrees and knees were fully extended and the ankles were in relaxed plantar flexion. A measuring ruler/tape was placed,between the feet with 38 cm score was marked tangent to the sole of the feet. Subjects were asked to reach forward with hands one above the other and palms of the hands facing down, while attempting to touch fingertips to toes or as far beyond on measuring tape while keeping the knees straight. Assessment was done Immediate after giving intervention(10 minutes). | 10 minutes | 
| Sit and Reach Test (SRT) 1 hours effects | Changes from Baseline Sit and reach test (SRT) is most commonly employed test to measure hamstring flexibility. This tool is used to measure range of hamstring muscle at knee joint.Each participant was instructed to sits on a couch in long sitting position. participants were seated with elongated legs, with hip flexed to 90 degrees and knees were fully extended and the ankles were in relaxed plantar flexion. A measuring ruler/tape was placed,between the feet with 38 cm score was marked tangent to the sole of the feet. Subjects were asked to reach forward with hands one above the other and palms of the hands facing down, while attempting to touch fingertips to toes or as far beyond on measuring tape while keeping the knees straight. Assessment was done after 1 hour of intervention. | 1 hour | 
| Passive Straight Leg Raise Test(PSLR) Immediate effects | Changes from Baseline PSLR test was conducted with the participants in supine lying with both lower limbs initially extended. Then therapist lifted the leg to be tested at hip joint while stabilizing the leg opposite to that of the testing side by using a stabilization belt. Knee on testing side was essentially sustained in full extension throughout the full testing range. Universal goniometer was used to measure range of motion available at hip joint. Cut off score for the SLR to indicate hamstring tightness is 80 degrees. Therefore, values of SLR below 80 degrees was considered as hamstring tightness. Assessment was done Immediate after giving intervention(10 minutes). | 10 minutes | 
| Passive Straight Leg Raise Test(PSLR) 1 hour effects | Changes from Baseline PSLR test was conducted with the participants in supine lying with both lower limbs initially extended. Then therapist lifted the leg to be tested at hip joint while stabilizing the leg opposite to that of the testing side by using a stabilization belt. Knee on testing side was essentially sustained in full extension throughout the full testing range. Universal goniometer was used to measure range of motion available at hip joint. Cut off score for the SLR to indicate hamstring tightness is 80 degrees. Therefore, values of SLR below 80 degrees was considered as hamstring tightness. Assessment was done after 1 hour of intervention. | 1 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Numeric Pain Rating Scale (NPRS) Immediate effects | Changes from Baseline Numeric pain scale (NPRS) was used to assess pain intensity. it was used to assess the tolerance ability of individuals for pain produced at the end of passive straight leg raise (PSLR) test.It ranges from 0-10. 0 means No pain and 10 means severe pain. Assessment was done after 10 minutes of intervention. | 10 minutes | 
| Numeric Pain Rating Scale NPRS 1 hour effects | Changes from Baseline Numeric pain scale (NPRS) was used to assess pain intensity. it was used to assess the tolerance ability of individuals for pain produced at the end of passive straight leg raise (PSLR) test.It ranges from 0-10. 0 means No pain and 10 means severe pain.Assessment was done after 1 hour of intervention. | 1 hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Flexibility, Extensibility, Static stretching