Thermotherapy associated with flexibility training does not increase the knee range of movement of healthy adults: systematic review and meta-analysis of randomized clinical trials

Authors

  • Luis Fernando Ferreira Universidade Federal de Ciências da Saúde de Porto Alegre
  • Arielle Rosa de Oliveira Universidade Federal de Ciências da Saúde de Porto Alegre
  • Luis Henrique Telles da Rosa Universidade Federal de Ciências da Saúde de Porto Alegre

DOI:

https://doi.org/10.11606/issn.2317-0190.v30i1a206076

Keywords:

Muscle Stretching Exercises, Thermotherapy, Hyperthermia, Induced, Cryotherapy

Abstract

The stretching with thermotherapies associated have been related in the literature as a way to increase the range of motion (ROM), but still are not consensus about this efficacy and cost-effectiveness. The muscle stretching is a useful technique in rehabilitation and in physical activities programs, either to gain or maintain the flexibility, as a recovery of musculoskeletal and joint injuries. Objective: To determine the effects of thermotherapies associated to flexibility training in ROM of knee extension in healthy adults. Method: The search strategy was conducted in main databases, as Cochrane Library, LILACS, PEDro, PUBMED/ Medline, Scopus and Web of Science. The searches were done in 2016, and renewed in 2023, in order to achieve new publications along this time. Were selected only randomized clinical trials that have executed a training of hamstrings stretching, associated or not with one or more thermotherapies in healthy young adults, as long as the outcome was knee extension ROM. Only papers in Portuguese or English were assessed. To evaluate risk of bias was used the Cochrane Collaboration’s Risk of Bias Tool, and the methodological quality assessment was rated following the PEDro Scale. Results: Eight articles were included, totalizing 260 participants. The papers showed low methodological quality, and uncertain risk of bias. Only chronic effect of local warming and cryotherapy plus stretching showed a statistically significant difference versus control group. However, the thermotherapy action associated with stretching is still unclear, once the results suggest that even without the thermotherapy there are ROM increases. Conclusion: The stretching is effective in knee extension ROM improvement in healthy adults, with or without thermotherapy. New studies with higher methodological rigor and standardized protocols are needed.

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References

Magalhães FE, Junior AR, Meneses HT, Moreira Santos RP, Rodrigues EC, Gouveia SS, et al. Comparison of the effects of hamstring stretching using proprioceptive neuromuscular facilitation with prior application of cryotherapy or ultrasound therapy. J Phys Ther Sci. 2015;27(5):1549-53. Doi: https://doi.org/10.1589/jpts.27.1549

Nakamura M, Sato S, Murakami Y, Kiyono R, Yahata K, Sanuki F, et al. The Comparison of Different Stretching Intensities on the Range of Motion and Muscle Stiffness of the Quadriceps Muscles. Front Physiol. 2021;11:628870. Doi: https://doi.org/10.3389/fphys.2020.628870

Serefoglu A, Sekir U, Gür H, Akova B. Effects of Static and Dynamic Stretching on the Isokinetic Peak Torques and Electromyographic Activities of the Antagonist Muscles. J Sports Sci Med. 2017;16(1):6-13.

Afonso J, Clemente FM, Nakamura FY, Morouço P, Sarmento H, Inman RA, et al. The effectiveness of post-exercise stretching in short-term and delayed recovery of strength, range of motion and delayed onset muscle soreness: a systematic review and meta-analysis of randomized controlled trials. Front Physiol. 2021;12:677581. Doi: https://doi.org/10.3389/fphys.2021.677581

Konrad A, Močnik R, Titze S, Nakamura M, Tilp M. The influence of stretching the hip flexor muscles on performance parameters. A systematic review with meta-analysis. Int J Environ Res Public Health. 2021;18(4):1936. Doi: https://doi.org/10.3390/ijerph18041936

Reiner M, Tilp M, Guilhem G, Morales-Artacho A, Nakamura M, Konrad A. Effects of a single proprioceptive neuromuscular facilitation stretching exercise with and without post-stretching activation on the muscle function and mechanical properties of the plantar flexor muscles. Front Physiol. 2021;12:732654. Doi: https://doi.org/10.3389/fphys.2021.732654

Reiner MM, Tilp M, Guilhem G, Morales-Artacho A, Konrad A. Comparison of a single vibration foam rolling and static stretching exercise on the muscle function and mechanical properties of the hamstring muscles. J Sports Sci Med. 2022;21(2):287-297. Doi: https://doi.org/10.52082/jssm.2022.287

Petrofsky JS, Laymon M, Lee H. Effect of heat and cold on tendon flexibility and force to flex the human knee. Med Sci Monit. 2013;19:661-7. Doi: https://doi.org/10.12659/MSM.889145

Rosario JL, Foletto Á. Comparative study of stretching modalities in healthy women: heating and application time. J Bodyw Mov Ther. 2015;19(1):3-7. Doi: https://doi.org/10.1016/j.jbmt.2013.12.003

Lu Y, He Y, Ying S, Wang Q, Li J. Effect of Cryotherapy Temperature on the Extension Performance of Healthy Adults' Legs. Biology (Basel). 2021;10(7):591. Doi: https://doi.org/10.3390/biology10070591

Radecka A, Lubkowska A. Direct effect of local cryotherapy on muscle stimulation, pain and strength in male office workers with lateral epicondylitis, non-randomized clinical trial study. Healthcare (Basel). 2022;10(5):879. Doi: https://doi.org/10.3390/healthcare10050879

Costa TV, Reis FA, Carvalho PTC, Belchior ACG, Pereira DM, Silva BAK, et al, Avaliação entre a eficácia do alongamento utilizando calor profundo e crioalongamento. Ter Man. 2008;6(27):293-8.

Draper DO, Castro JL, Feland B, Schulthies S, Eggett D. Shortwave diathermy and prolonged stretching increase hamstring flexibility more than prolonged stretching alone. J Orthop Sports Phys Ther. 2004;34(1):13-20. Doi: https://doi.org/10.2519/jospt.2004.34.1.13

Taylor BF, Waring CA, Brashear TA. The effects of therapeutic application of heat or cold followed by static stretch on hamstring muscle length. J Orthop Sports Phys Ther. 1995;21(5):283-6. Doi: https://doi.org/10.2519/jospt.1995.21.5.283

Yu S, Lin L, Liang H, Lin M, Deng W, Zhan X, Fu X, Liu C. Gender difference in effects of proprioceptive neuromuscular facilitation stretching on flexibility and stiffness of hamstring muscle. Front Physiol. 2022;13:918176. Doi: 10.3389/fphys.2022.91817

Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Oxford: Cochrane; 2011.

Mancini MC, Cardoso JR, Sampaio RF, Costa LC, Cabral CM, Costa LO. Tutorial for writing systematic reviews for the Brazilian Journal of Physical Therapy (BJPT). Braz J Phys Ther. 2014;18(6):471-80. Doi: https://doi.org/10.1590/bjpt-rbf.2014.0077

Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. Doi: https://doi.org/10.1371/journal.pmed.1000097

Shiwa SR, Costa LO, Costa LC, Moseley A, Hespanhol Junior LC, Venâncio R, et al.. Reproducibility of the Portuguese version of the PEDro Scale. Cad Saude Publica. 2011;27(10):2063-8. Doi: https://doi.org/10.1590/s0102-311x2011001000019

Carvalho APV, Silva V, Grande AJ. Avaliação do risco de viés de ensaios clínicos randomizados pela ferramenta da colaboração Cochrane. Diagn Tratamento. 2013;18(1):38-44.

Brasileiro JS, Faria AF, Queiroz LL. Influência do resfriamento e do aquecimento local na flexibilidade dos músculos isquiotibiais. Braz J Phys Ther. 2007;11(1):57-61. Doi: https://doi.org/10.1590/S1413-35552007000100010

Busarello FO, Souza FT, Paula GF, Vieira L, Nakayama GK, Bertolini GRF. Ganho de extensibilidade dos músculos isquiotibiais comparando o alongamento estático associado ou não à crioterapia. Fisioter Mov. 2011;24(2):247-54. Doi: https://doi.org/10.1590/S0103-51502011000200006

Silva SA, Oliveira DJ, Jaques MJN, Araújo RC. Efeito da crioterapia e termoterapia associados ao alongamento estático na flexibilidade dos músculos isquiotibiais. Motricidade. 2010;6(4):55-62.

Konrad A, Močnik R, Nakamura M, Sudi K, Tilp M. The impact of a single stretching session on running performance and running economy: a scoping review. Front Physiol. 2021;11:630282. Doi: https://doi.org/10.3389/fphys.2020.630282

Panidi I, Bogdanis GC, Terzis G, Donti A, Konrad A, Gaspari V, et al. Muscle architectural and functional adaptations following 12-weeks of stretching in adolescent female athletes. front physiol. 2021;12:701338. Doi: https://doi.org/10.3389/fphys.2021.701338

Brodowicz GR, Welsh R, Wallis J. Comparison of stretching with ice, stretching with heat, or stretching alone on hamstring flexibility. J Athl Train. 1996;31(4):324-7.

Opplert J, Babault N. Acute effects of dynamic stretching on mechanical properties result from both muscle-tendon stretching and muscle warm-up. J Sports Sci Med. 2019;18(2):351-8.

Nakano J, Yamabayashi C, Scott A, Reid WD. The effect of heat applied with stretch to increase range of motion: a systematic review. Phys Ther Sport. 2012;13(3):180-8. Doi: https://doi.org/10.1016/j.ptsp.2011.11.003

Robertson VJ, Ward AR, Jung P. The effect of heat on tissue extensibility: a comparison of deep and superficial heating. Arch Phys Med Rehabil. 2005;86(4):819-25. Doi: https://doi.org/10.1016/j.apmr.2004.07.353

Wang Y, Ikeda S, Ikoma K. Passive repetitive stretching is associated with greater muscle mass and cross-sectional area in the sarcopenic muscle. Sci Rep. 2021;11(1):15302. Doi: https://doi.org/10.1038/s41598-021-94709-0

Aslan H, Buddhadev HH, Suprak DN, San Juan JG. Acute effects of two hip flexor stretching techniques on knee joint position sense and balance. Int J Sports Phys Ther. 2018;13(5):846-59.

Kruse A, Habersack A, Jaspers RT, Schrapf N, Weide G, Svehlik M, et al. Acute Effects of static and proprioceptive neuromuscular facilitation stretching of the plantar flexors on ankle range of motion and muscle-tendon behavior in children with spastic cerebral palsy - a randomized clinical trial. Int J Environ Res Public Health. 2022;19(18):11599. Doi: https://doi.org/10.3390/ijerph191811599

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Published

2023-03-31

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Section

Review Article

How to Cite

1.
Ferreira LF, Oliveira AR de, Rosa LHT da. Thermotherapy associated with flexibility training does not increase the knee range of movement of healthy adults: systematic review and meta-analysis of randomized clinical trials. Acta Fisiátr. [Internet]. 2023 Mar. 31 [cited 2024 May 27];30(1):55-62. Available from: https://www.revistas.usp.br/actafisiatrica/article/view/206076