International Journal of Osteopathic Medicine, 2013/09, 16(3):153-162. doi: 10.1016/j.ijosm.2013.06.002, type of study: ,rct,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,

Full text    (https://www.sciencedirect.com/science/article/pii/S1746068913000941)

Keywords:

neurodynamics [5]
stretching [22]
manual therapy [169]
tissue mechanics [2]

Abstract:

Recent studies suggest that subjects who perceive their hamstrings to be tight are unlikely to have altered hamstring muscle extensibility or length. Altered neural tissue mobility also referred to as altered neurodynamics could be a significant contributor to “perceived hamstrings tightness”. Conventionally, hamstrings stretching exercises are employed to treat perceived hamstrings tightness. There is a paucity of literature assessing the effectiveness of exercises targeting neural tissue mobility or neurodynamics as opposed to conventional hamstrings stretching exercises. With this aim, a prospective trial of 56 female physiotherapy students with perceived hamstrings tightness was conducted. Study design used was two group pre test–post test design with systematic random sampling. Subjects were randomly divided into 2 groups; Group A received Mulligan's Bent Leg Raise (BLR) technique followed by Two Leg Rotation technique (TLRT) to improve neural tissue mobility and Group B received passive hamstrings stretching to improve hamstrings muscle extensibility. Outcome measures included knee flexion angle during Active Knee Extension test and the Slump test. Intra group analysis showed statistically significant improvement in knee flexion angle for both tests in both the groups. Inter group comparison showed that there was greater improvement in the group receiving neural tissue mobility exercises with statistically significant improvement in Slump test with cervical extension (mean difference was 7.214°, 95% confidence interval −12.67 to −1.75). Thus it was concluded that exercises which target neural tissue mobility are more effective than exercises targeting hamstrings muscle extensibility in treating “perceived hamstrings tightness“.