Guido Geusebroek, Jacek Buczny, Han Houdijk, Kirsten A Ziesemer, Huub Maas, Jaap H van Dieën
{"title":"踝关节挛缩的恒定扭矩拉伸比恒定角度或动态拉伸导致更大的运动范围变化：一项系统回顾和荟萃分析。","authors":"Guido Geusebroek, Jacek Buczny, Han Houdijk, Kirsten A Ziesemer, Huub Maas, Jaap H van Dieën","doi":"10.1016/j.apmr.2024.12.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the acute (directly poststretching) and long-term (≥1 week of treatment) effects of stretching type, duration, and intensity on joint range of motion (ROM) and stiffness in ankle contractures.</p><p><strong>Data sources: </strong>PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection, EBSCO/SPORTDiscus, and EBSCO/CINAHL were searched for studies published in English from inception until September 12, 2023.</p><p><strong>Study selection: </strong>Fifty-five studies that met the inclusion criteria were included, covering observational, controlled and noncontrolled studies.</p><p><strong>Data extraction: </strong>Pre- and post-treatment ankle ROM and stiffness, and stretching duration, intensity, and type were extracted from each eligible treatment group by 1 reviewer.</p><p><strong>Data synthesis: </strong>Most studies did not quantify stretching intensity and its effect was not tested. For the acute effects on ROM, 15 effect sizes were obtained from 11 studies. ROM increased more after constant-torque (95% confidence interval [CI] [1.35, 2.15]) than after constant-angle (95% CI [0.44, 1.40] or dynamic stretching (95% CI [0.50, 1.01]), F=11.99, P=.004, I<sup>2</sup>=0%, and increased with duration (95% CI [0.00, 0.05]), F=5.12, P=.011, I<sup>2</sup>=55%. Acute effects on joint stiffness could not be assessed. For the long-term effects, 54 and 12 effect sizes were estimated from 44 and 10 studies, for ROM and stiffness, respectively. No effect of stretching duration on either outcome was found (F=0.32, P=.57, I<sup>2</sup>=78% and F=0.74, P=.409, I<sup>2</sup>=5%, respectively). No effect of stretching type on stiffness was found (F=0.02, P=.888, I<sup>2</sup>=0%). Not enough information was available to assess the long-term effects of stretch type.</p><p><strong>Conclusions: </strong>We conclude that constant-torque stretching acutely increases ROM more than constant-angle and dynamic stretching. To assess if these superior acute effects result in more substantial adaptations over time, future long-term studies should define stretching type more clearly. Also, torque and angle during stretching should be recorded as measures of intensity in future studies.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Constant-Torque Stretching in Ankle Contractures Results in Greater Changes in Range of Motion Than Constant-Angle or Dynamic Stretching: A Systematic Review and Meta-analysis.\",\"authors\":\"Guido Geusebroek, Jacek Buczny, Han Houdijk, Kirsten A Ziesemer, Huub Maas, Jaap H van Dieën\",\"doi\":\"10.1016/j.apmr.2024.12.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To investigate the acute (directly poststretching) and long-term (≥1 week of treatment) effects of stretching type, duration, and intensity on joint range of motion (ROM) and stiffness in ankle contractures.</p><p><strong>Data sources: </strong>PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection, EBSCO/SPORTDiscus, and EBSCO/CINAHL were searched for studies published in English from inception until September 12, 2023.</p><p><strong>Study selection: </strong>Fifty-five studies that met the inclusion criteria were included, covering observational, controlled and noncontrolled studies.</p><p><strong>Data extraction: </strong>Pre- and post-treatment ankle ROM and stiffness, and stretching duration, intensity, and type were extracted from each eligible treatment group by 1 reviewer.</p><p><strong>Data synthesis: </strong>Most studies did not quantify stretching intensity and its effect was not tested. For the acute effects on ROM, 15 effect sizes were obtained from 11 studies. ROM increased more after constant-torque (95% confidence interval [CI] [1.35, 2.15]) than after constant-angle (95% CI [0.44, 1.40] or dynamic stretching (95% CI [0.50, 1.01]), F=11.99, P=.004, I<sup>2</sup>=0%, and increased with duration (95% CI [0.00, 0.05]), F=5.12, P=.011, I<sup>2</sup>=55%. Acute effects on joint stiffness could not be assessed. For the long-term effects, 54 and 12 effect sizes were estimated from 44 and 10 studies, for ROM and stiffness, respectively. No effect of stretching duration on either outcome was found (F=0.32, P=.57, I<sup>2</sup>=78% and F=0.74, P=.409, I<sup>2</sup>=5%, respectively). No effect of stretching type on stiffness was found (F=0.02, P=.888, I<sup>2</sup>=0%). Not enough information was available to assess the long-term effects of stretch type.</p><p><strong>Conclusions: </strong>We conclude that constant-torque stretching acutely increases ROM more than constant-angle and dynamic stretching. To assess if these superior acute effects result in more substantial adaptations over time, future long-term studies should define stretching type more clearly. Also, torque and angle during stretching should be recorded as measures of intensity in future studies.</p>\",\"PeriodicalId\":8313,\"journal\":{\"name\":\"Archives of physical medicine and rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-12-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of physical medicine and rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.apmr.2024.12.004\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.apmr.2024.12.004","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Constant-Torque Stretching in Ankle Contractures Results in Greater Changes in Range of Motion Than Constant-Angle or Dynamic Stretching: A Systematic Review and Meta-analysis.
Objectives: To investigate the acute (directly poststretching) and long-term (≥1 week of treatment) effects of stretching type, duration, and intensity on joint range of motion (ROM) and stiffness in ankle contractures.
Data sources: PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection, EBSCO/SPORTDiscus, and EBSCO/CINAHL were searched for studies published in English from inception until September 12, 2023.
Study selection: Fifty-five studies that met the inclusion criteria were included, covering observational, controlled and noncontrolled studies.
Data extraction: Pre- and post-treatment ankle ROM and stiffness, and stretching duration, intensity, and type were extracted from each eligible treatment group by 1 reviewer.
Data synthesis: Most studies did not quantify stretching intensity and its effect was not tested. For the acute effects on ROM, 15 effect sizes were obtained from 11 studies. ROM increased more after constant-torque (95% confidence interval [CI] [1.35, 2.15]) than after constant-angle (95% CI [0.44, 1.40] or dynamic stretching (95% CI [0.50, 1.01]), F=11.99, P=.004, I2=0%, and increased with duration (95% CI [0.00, 0.05]), F=5.12, P=.011, I2=55%. Acute effects on joint stiffness could not be assessed. For the long-term effects, 54 and 12 effect sizes were estimated from 44 and 10 studies, for ROM and stiffness, respectively. No effect of stretching duration on either outcome was found (F=0.32, P=.57, I2=78% and F=0.74, P=.409, I2=5%, respectively). No effect of stretching type on stiffness was found (F=0.02, P=.888, I2=0%). Not enough information was available to assess the long-term effects of stretch type.
Conclusions: We conclude that constant-torque stretching acutely increases ROM more than constant-angle and dynamic stretching. To assess if these superior acute effects result in more substantial adaptations over time, future long-term studies should define stretching type more clearly. Also, torque and angle during stretching should be recorded as measures of intensity in future studies.
期刊介绍：
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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