Effect of Manual Technique on Hamstring Flexibility

Study Overview
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Brief Summary
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This study will be a randomized clinical trial. the study will be conducted in Mubarak Hospital Sargodha. a sample size of 44 subjects will be taken. subjects will be divided into two groups using the lottery method. group 1 will be treated with Bowen technique along with heating pad and group 2 will be treated with sustained stretching technique along with heating pads thrice a week for 3 weeks. subjects will come after 1 month for follow up. the follow-up will show which technique is more effective in improving hamstring flexibility and range in healthy females. the outcome measures active knee extension test and sit and reach test will be used to check hamstring flexibility and range at baseline, post-treatment, and follow-up. data were analyzed using spss 26.

Detailed Description
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hamstring muscles are responsible for hip and knee movement during walking, running, squatting, bending knees, and pelvis tilting. hamstring muscles function is to perform flexion at knee and hip extension. hamstring tightness is more common in females than males. once the hamstring were tightened ,incidence of low back pain rose to 15%. hamstring shortening occurred due to maintain same posture for prolong period of time, fatigue, sedentary life style, and poor body mechanics. hamstring tightness can disturb the biomechanics of low back and pelvis in each adolescents and adult. most of the individuals with hamstring tightness were asymptomatic. Throughout daily activities, nerves that innervate the hamstring muscle is exposed to constant pressure throughout sitting, standing can cause hamstring tightness.. Nerve adhesions inside the hamstring may alter neurodynamic inflicting abnormal machan-o-sensitivity of the nerve that will influence hamstring flexibility. This machan-o-sensitivity of the neural tissue could limit hamstring length in traditional healthy people. Shortened hamstrings amendment the curvature of the spine inflicting larger compression masses within the mesial curvatures and increase in intradiscal pressure and also the incidence of larger shear forces, thereby predisposing people to spinal issues various techniques were used to treat hamstring tightness. this study we compare the effects of Bowen technique and sustained stretching on hamstring flexibility in asymptomatic females. group 1 will be treated with Bowen technique .this is a soft tissue mobilization technique This medical care involves short mild rolling moves over the muscles, nerve, ligaments and tendons of flesh utilizing the hands, fingers and thumb. Sequence of receiving bilateral rolling moves over segments of the erector spinae from the lumber toward cervical spine, latissimus dorsi, the gluteal, the hamstring muscles proximally and distally, tensor facia Lata and a medial hip striated muscle move. Treatment will be given thrice a week for 3 weeks. and treatment session will be 20minutes for each leg. group 2 will be treated with sustained stretching technique. Sustained stretching is most common and safest technique used for hamstring tightness. This sort of stretch is applied slowly and bit by bit at a comparatively constant force to avoid eliciting a inborn reflex. The resultant increase in muscle length is said to elastic behavior. Static stretch of thirty seconds at a frequency of 3 continual stretches per single session is ample to extend muscle length. treatment will be given thrice a week for 3 weeks. Treatment session will be 30 seconds for each leg. both groups will come after 1 month for follow up. Outcome measure active knee test and sit and reach test will be used to check hamstring flexibility and range in asymptomatic females at baseline, post-treatment and follow up. the goal of this study is to improve hamstring flexibility in asymptomatic females. active knee extension test and sit and reach test will be used to check hamstring flexibility and range in subjects. these both tests have very high reliability and validity. There is a lack of evidence demonstrating the effects of Bowen technique and sustained stretching on hamstring flexibility. the purpose of this study is to compare the effects of both techniques to assess which technique has more clinical impact than other.

Official Title
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Comparison of Bowen Technique and Sustain Stretching on Hamstring Flexibility in Asymptomatic Females

Conditions
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Muscle Tightness

Intervention / Treatment
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* Other: bowen technique
* Other: sustained stretching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age 25-40 years asymptomatic subjects both hamstring tightness only females Exclusion Criteria: females with past history of hamstring tightness previous surgery pathology female with back pain and spinal deformity

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: bowen technique<br>group 1 will be treated with the Bowen technique and heating pad. this technique will be given to asymptomatic females. 22 subjects will be taken this treatment. treatment will be given thrice a week for 3 weeks. the subjects will come after 1 month for follow-up. | Other: bowen technique<br>* Bowen technique is a soft tissue mobilization technique. This medical care involves short mild rolling moves over the muscles, nerves, ligaments, and tendons of flesh utilizing the hands, fingers and thumb. Sequence of receiving bilateral rolling moves over segments of the erector spinae from the lumber toward cervical spine, latissimus dorsi, the gluteal, the hamstring muscles proximally and distally, tensor facia Lata and a medial hip striated muscle move.<br>|
| Active Comparator: sustained stretching<br>group 1 will be treated with the sustained stretching technique and heating pad. this technique will be given to asymptomatic females. 22 subjects will be taken this treatment. treatment will be given thrice a week for 3 weeks. the subjects will come after 1 month for follow-up | Other: sustained stretching<br>* static stretching is one of the most common and safest technique used for hamstring tightness. A static stretch is performed by inserting muscles at their greatest attainable length and holding that position for an amount of your time.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| active knee extension test | Active Knee Extension test (AKE) or Popliteal angle test or 90/90 test: This test was found as gold standard test for estimating hamstring flexibility. This test is used to assess the hamstring muscle length and range of active knee extension with hip in flexed position. | 3 weeks | 
| sit and reach test | Sit and reach test is a common measure of flexibility. This test help to measure the extensibility of hamstring and lower back. super > +27 > +10.5 > +30 > +11.5 excellent +17 to +27 +6.5 to +10.5 +21 to +30 +8.0 to +11.5 good +6 to +16 +2.5 to +6.0 +11 to +20 +4.5 to +7.5 average 0 to +5 0 to +2.0 +1 to +10 +0.5 to +4.0 fair -8 to -1 -3.0 to -0.5 -7 to 0 -2.5 to 0 poor -20 to -9 -7.5 to -3.5 -15 to -8 -6.0 to -3.0 very poor < -20 < -7.5 < -15 < -6.0 | 3 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sit and reach test, Bowen technique