Which Technique is More Effective for People With Hamstring Tightness in Terms of Balance, Flexibility, and Performance?

Study Overview
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Brief Summary
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Percussion massage therapy has gained popularity in the therapeutic and athletic communities over the past few years. Percussion massage therapy devices are extremely convenient to use, both for self-administration and by a physiotherapist. Percussion massage therapy in deep and superficial tissues; is used in many areas such as reducing pain, increasing blood circulation, improving scar tissue, reducing lactate level and muscle spasms, increasing lymphatic flow, inhibiting Golgi reflex, increasing range of motion, and is frequently used today. Vibratory massage techniques have been shown in many studies to improve joint range of motion and muscular strength. It has been argued that there aren't enough studies on this topic in the literature. Specially tailored treatments are utilized in the clinic to reduce injury frequency, improve muscular performance, and increase the flexibility of musculotendinous components. Various stretching methods are used to increase muscle length. Athletes use stretching exercises to improve joint range of motion and long-term performance. Furthermore, it is incorporated in the warm-up period of athletes' training plans to prepare for an activity or to cool down after an applied exercise. Many studies using the dynamic stretching approach have found that dynamic stretching exercises performed before an activity or a sport have a positive effect on performance and flexibility parameters. Instrument-assisted soft tissue mobilization (IASTM) is a treatment method used to reduce pain, improve joint range of motion, and mobilize soft tissue using specially designed stainless steel instruments based on the principles developed by James Cyriax. The removal of scar tissue is one of the most important goals of IASTM. Microvascular bleeding occurs with localized inflammation as a result of IASTM application, nutrient and oxygen flow is delivered, fibroblast migration increases and the healing process begins again. At the same time, secondary collagen synthesis begins and is rearranged, which allows the regeneration of the injured tissue. As a result, it treats scar tissue, adhesions, and adhesions in the fascia. IASTM is a very effective approach in fascia tissue and is widely used to offer a mobilizing stimulus in the treatment of myofascial problems.

Detailed Description
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However, when the literature is reviewed, studies investigating the acute effects of instrument-assisted soft tissue mobilization, percussion massage therapy, and dynamic stretching exercises on performance parameters and functionality are limited. Based on all this information, it was aimed to investigate the acute effects of percussion massage therapy, stretching exercises, and Graston soft tissue mobilization on jumping, running performance, balance, and functional reaching parameters.

Official Title
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Evaluation of the Acute Effects of Graston, Percussion Massage Therapy, and Dynamic Stretching on Balance, Flexibility, and Performance Parameters in Individuals With Hamstring Tightness.

Conditions
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Musculoskeletal Diseases or Conditions, Sports Physical Therapy

Intervention / Treatment
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* Device: Percussion Massage Therapy
* Device: Graston
* Other: Dynamic Stretching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Those who are at a level to be able to perform a performance test With hamstring muscle tightness Those who have not undergone orthopedic surgery from any region Individuals who do not have a professional sports background Exclusion Criteria: Trauma history Anatomical deformities and skeletal system fractures Diagnosed orthopedic or rheumatological diseases Being included in a physiotherapy program in the last six months Individuals with pain in any part of the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Percussion Massage Therapy Group<br>The group to which percussion massage therapy will be applied to the posterior leg muscles. | Device: Percussion Massage Therapy<br>* Individuals in the percussion massage therapy group will get 3 minutes of percussion massage therapy on the hamstring and gastrocnemius muscles along the origo-insertion in the mid-frequency range.<br>|
| Experimental: Graston (IASTM) Group<br>The group in which instrument-assisted soft tissue mobilization will be applied to the posterior leg muscles. | Device: Graston<br>* Instrument-assisted soft tissue mobilization will be used on the hamstring and gastrocnemius muscles along the 5-minute origo insertion line in the Graston group.<br>* Other names: IASTM;|
| Experimental: Dynamic Stretching Group<br>The group to which dynamic stretching exercises will be applied to the posterior leg muscles. | Other: Dynamic Stretching<br>* Dynamic stretching exercises for the hamstring and gastrocnemius muscles will be performed in the dynamic stretching exercise group.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sit and Reach Test | The sit and reach test is one of the linear flexibility tests that helps measure the flexibility of the hamstrings and lower back. It was first described by Wells and Dillon in 1952 and is probably the most widely used flexibility test. It has a simple procedure, is easy to administer, requires minimal skill training to perform, and costs the equipment required to perform the test. It is argued that the hamstrings and lower back should have a good level of flexibility, as they play an important role in health-related fitness. In a sitting position on the floor, the soles of the feet are placed on the sit-and-reach bench with the legs fully stretched. Without bending the legs, reach forward with the fingertips on the table and wait 2 seconds at the end point, and the score is recorded in centimeters. | from pre-interventional time to post-interventional about 1st hour | 
| Y Balance Test | Y Balance Test (YBT) is a functional test that requires strength, flexibility, neuromuscular control, balance, stability, and range of motion (ROM). As an integral part of Functional Movement Systems (FMS), YBT is a thoroughly researched test to test and simultaneously demonstrate an individual's functional symmetry of motor control. YDT gives us the function of each central extremity that is under the weight of a quarter of the body. Six application trials are conducted before the application of this test. The maximum reach analysis in each direction is then performed using three trials in three directions for each leg. Standing on one foot on the midfoot plate with the most distal aspect of the athletic shoe at the baseline, the person being examined stands. The subject is instructed to reach anterior, posteromedial, and posterolateral directions with the free extremity relative to the stance foot while maintaining the single-leg stance, and the distance traveled is measured. | from pre-interventional time to post-interventional about 1st hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Horizontal Jump Test | On a flat surface, a starting line is drawn. From the starting line forward, a tape measure is set on the floor, and the athletes are instructed to stand with the tips of both toes pointed towards the back of the previously decided line. The distance jumped is measured in centimeters after the athletes are instructed to bend their knees while keeping their arms parallel to the floor and knees, and to jump as far forward as possible by swinging their arms and legs fast. | from pre-interventional time to post-interventional about 1st hour | 
| Illinois Test | A test track is set up with three cones lined up in a straight line at intervals of 5 meters(m) in width, 10m in length, and 3.3m in the middle part. The course consists of a 40m straight and a 20m slalom between cones, with 180º bends every 10 meters. Before the test, the subjects are allowed to make 3-4 attempts at low tempo after the introduction of the track and necessary explanations. After that, the subjects are made to do warm-up and stretching exercises for 5-6 minutes at a low tempo that they determine. The test subjects exit the starting line of the test track in a prone position, with their hands at shoulder level in touch with the ground. The time it takes to complete the track is measured in seconds. The test is done two times with full rest between each time, with the better value being recorded. | from pre-interventional time to post-interventional about 1st hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Percussion Massage Therapy, Vibration, Dynamic Stretching, Balance, Flexibility, Performance Parameters, Hamstring Tightness, Hamstring, IASTM, Graston