Effects of Stretching or Strengthening Exercise on Spinal and Lumbopelvic Posture: A Systematic Review with Meta-Analysis.

IF 4.1 2区 医学 Q1 SPORT SCIENCES Sports Medicine - Open Pub Date : 2024-06-05 DOI:10.1186/s40798-024-00733-5
Konstantin Warneke, Lars Hubertus Lohmann, Jan Wilke
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Abstract

Background: Abnormal posture (e.g. loss of lordosis) has been associated with the occurrence of musculoskeletal pain. Stretching tight muscles while strengthening the antagonists represents the most common method to treat the assumed muscle imbalance. However, despite its high popularity, there is no quantitative synthesis of the available evidence examining the effectiveness of the stretch-and-strengthen approach.

Methods: A systematic review with meta-analysis was conducted, searching PubMed, Web of Science and Google Scholar. We included controlled clinical trials investigating the effects of stretching or strengthening on spinal and lumbopelvic posture (e.g., pelvic tilt, lumbar lordosis, thoracic kyphosis, head tilt) in healthy individuals. Effect sizes were pooled using robust variance estimation. To rate the certainty about the evidence, the GRADE approach was applied.

Results: A total of 23 studies with 969 participants were identified. Neither acute (d = 0.01, p = 0.97) nor chronic stretching (d=-0.19, p = 0.16) had an impact on posture. Chronic strengthening was associated with large improvements (d=-0.83, p = 0.01), but no study examined acute effects. Strengthening was superior (d = 0.81, p = 0.004) to stretching. Sub-analyses found strengthening to be effective in the thoracic and cervical spine (d=-1.04, p = 0.005) but not in the lumbar and lumbopelvic region (d=-0.23, p = 0.25). Stretching was ineffective in all locations (p > 0.05).

Conclusion: Moderate-certainty evidence does not support the use of stretching as a treatment of muscle imbalance. In contrast, therapists should focus on strengthening programs targeting weakened muscles.

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拉伸或加强锻炼对脊柱和腰椎姿势的影响:系统回顾与元分析》。
背景:姿势异常(如脊柱前凸)与肌肉骨骼疼痛的发生有关。拉伸紧绷的肌肉,同时加强拮抗肌肉的力量是治疗假定的肌肉失衡最常用的方法。然而,尽管这种方法很受欢迎,但目前还没有对现有证据进行定量综合,以研究拉伸和加强方法的有效性:方法:我们搜索了 PubMed、Web of Science 和 Google Scholar,进行了系统性综述和荟萃分析。我们纳入了研究拉伸或加强对健康人脊柱和腰椎姿势(如骨盆倾斜、腰椎前凸、胸椎后凸、头部倾斜)影响的对照临床试验。采用稳健方差估计法汇总效应大小。采用 GRADE 方法对证据的确定性进行评分:结果:共发现 23 项研究,969 名参与者。急性拉伸(d=0.01,p=0.97)和慢性拉伸(d=-0.19,p=0.16)对姿势都没有影响。慢性强化训练对姿势有很大改善(d=-0.83,p=0.01),但没有研究对急性效果进行检查。加强训练优于拉伸训练(d=0.81,p=0.004)。子分析发现,加强训练对胸椎和颈椎有效(d=-1.04,p=0.005),但对腰椎和腰椎骨盆区域无效(d=-0.23,p=0.25)。拉伸在所有部位均无效(p > 0.05):中度确定性证据不支持使用拉伸来治疗肌肉失衡。相反,治疗师应将重点放在针对薄弱肌肉的强化计划上。
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来源期刊
Sports Medicine - Open
Sports Medicine - Open SPORT SCIENCES-
CiteScore
7.00
自引率
4.30%
发文量
142
审稿时长
13 weeks
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