Does stretching induce lasting increases in joint ROM? A systematic review.
Does stretching induce lasting increases in joint ROM? A systematic review.
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DOI：
10.1002/pri.236
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发表时间：
2002-01-01
期刊：
影响因子：
--
通讯作者：
Crosbie, Jack
中科院分区：
文献类型：
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作者：
Harvey, Lisa;Herbert, Robert;Crosbie, Jack
背景和目的：拉伸（即，对软组织施加张力的干预）引起软组织可伸展性的增加，因此被广泛施用以增加关节活动性和逆转挛缩。然而，目前尚不清楚拉伸的影响是否持久。进行了一项系统回顾，以确定拉伸是否（自我施用、由治疗师手动施用或通过一些外部装置如夹板施用）产生不受手术、创伤或疾病过程直接影响的关节活动性的持久增加。为了确定拉伸的持久效果，仅包括在停止拉伸后至少一天测量关节活动范围（ROM）的研究。检索MEDLINE（1966年至2000年6月）、EMBASE（1988年至2000年6月）、科克伦对照试验注册数据库和PEDro数据库，并使用引文跟踪来识别符合纳入标准的随机研究。每项研究由两名独立的评估员进行PEDro评分，根据标准，如隐藏分配，盲法和意向治疗analysis.Results：13项研究符合纳入标准。所有研究均检查了拉伸（拉伸次数中位数= 8）对无功能显著挛缩的健康受试者关节ROM的影响。四项研究的质量为“中等”，其余九项为“差"。“中等”质量的研究表明，定期拉伸增加关节活动度（ROM平均增加= 8度; 95%CI 6度至9度）超过一天后停止拉伸，可能拉伸的影响更大的肌肉群与有限的伸展性。四项“中等”质量研究的结果表明，拉伸对没有功能性明显挛缩的人有令人信服的效果。这些发现需要高质量的研究加以验证。密集拉伸计划（例如，拉伸超过六周或每天超过20分钟）或拉伸对功能显著挛缩的人的持久影响尚未通过随机研究进行研究。
BACKGROUND AND PURPOSE: Stretching (that is, interventions that apply tension to soft tissues) induces increases in the extensibility of soft tissues, and is therefore widely administered to increase joint mobility and reverse contractures. However, it is not clear whether the effects of stretching are lasting. A systematic review was conducted to determine if stretching (either self-administered, administered manually by therapists or by some external device such as a splint) produces lasting increases in the mobility of joints not directly affected by surgery, trauma or disease processes.METHOD: In order to determine the lasting effects of stretching, only studies that measured joint range of motion (ROM) at least one day after the cessation of stretching were included. MEDLINE (from 1966 to June 2000), EMBASE (from 1988 to June 2000), the Cochrane Controlled Trials Register and PEDro databases were searched, and citation tracking was used to identify randomized studies that met the inclusion criteria. Each study was rated by two independent assessors on the PEDro scale, which rated trials according to criteria such as concealed allocation, blinding and intention-to-treat analysis.RESULTS: Thirteen studies satisfied the inclusion criteria. All examined the effect of stretching (median number of stretch sessions = eight) on joint ROM in healthy subjects without functionally significant contractures. Four studies were of 'moderate' quality and the remaining nine were of 'poor' quality. The 'moderate' quality studies suggest that regular stretching increases joint ROM (mean increase in ROM = 8 degrees; 95% CI 6 degrees to 9 degrees) for more than one day after cessation of stretching and possibly that the effects of stretching are greater in muscle groups with limited extensibility.CONCLUSIONS: The results of four 'moderate' quality studies show a convincing effect of stretching in people without functionally significant contracture. These findings require verification with high-quality studies. Lasting effects of intensive stretching programmes (for example, stretching applied for more than six weeks or for more than 20 minutes a day) or of stretching on people with functionally significant contracture have not yet been investigated with randomized studies.