Search Results (42)

Background/Objectives: This exploratory systematic review aims to analyze the influence of isolated muscle flexibility training on the reduction of chronic pain symptoms in older adults aged 65 years or more. Articles were selected from the Web of Science, PubMed, and Scopus databases, using the EndNote software for reference management. The selection process followed the PICOS framework and the PRISMA 2020 guidelines, and the review protocol was registered in the PROSPERO database. Methods: The inclusion criteria comprised randomized controlled trials with participants aged 65 or older, evaluating the effect of flexibility training as a standalone intervention on chronic pain, and published in English or Portuguese. Studies were excluded if they involved multimodal training, did not specify participants’ ages, evaluated only acute or postoperative pain, or were not peer-reviewed articles. Results: From an initial pool of 1390 articles, only three met all criteria and were included in the final analysis. These studies—conducted in China (n = 2) and the United States (n = 1)—showed moderate methodological quality (PEDro score = 7/10). Two trials applied Proprioceptive Neuromuscular Facilitation (PNF) in participants with knee osteoarthritis, while the third compared a flexibility-based program to combined strength and aerobic training in a healthy elderly population. All studies reported significant reductions in chronic pain symptoms following flexibility training interventions. Conclusions: The reviewed evidence suggests that muscle flexibility training, particularly using techniques like PNF, may be a promising therapeutic strategy to mitigate specific chronic pain-related symptoms in older adults, particularly reductions in joint stiffness, movement discomfort, and pain intensity associated with osteoarthritis. However, the limited number of high-quality trials and heterogeneity in protocols and pain assessment tools highlight the need for further research. Full article

Background/Objectives: Systemic lupus erythematosus is an autoimmune disease. The musculoskeletal system is affected in 90% of patients. The most common symptoms are myalgia, arthralgia, and arthritis. The objective was to analyze the efficacy of an intervention using myofascial techniques and proprioceptive neuromuscular facilitation in patients with systemic lupus erythematosus. Methods: A randomized, single-blind, crossover clinical trial. Seventeen patients with systemic lupus erythematosus were randomly assigned to two sequences: Sequence A–B (intervention phase first, then control phase) and Sequence B–A (control phase first, then intervention phase). The intervention lasted for four weeks, with two weekly sessions lasting 50 min each. The intervention consisted of myofascial and proprioceptive neuromuscular facilitation techniques. The variables were: pain intensity (Visual Analog Scale), functional capacity of lower limbs (2-Minute Walk Test), physical function (Timed Up and Go Test), and fatigue (Fatigue Assessment Scale). After a 2-week follow-up and a 2-week washout period, the patients switched groups, and the methodology was replicated. Results: None of the patients developed injury or adverse effects as a direct consequence of the intervention. There were statistically significant differences between groups (p < 0.001) in the intensity of ankle (η²_p = 0.38) and knee (η² = 0.37) pain, functional capacity (η² = 0.33), and physical function (η² = 0.56). There were also intergroup changes in fatigue (η² = 0.52), and the relevant mental (η² = 0.26) and physical (η² = 0.45) components. Conclusions: Proprioceptive myofascial and neuromuscular facilitation techniques are safe in patients with systemic lupus erythematosus. This physical therapy protocol can improve the intensity of knee and ankle joint pain in these patients. This intervention can improve functional capacity, physical function, and fatigue in people with systemic lupus erythematosus. Full article

Aim: To assess the acute effects of proprioceptive neuromuscular facilitation (PNF), stretching was applied to the hamstring muscles to evaluate deep cervical flexor endurance. Potential variables correlating with endurance adaptations were examined. Methods: This randomized controlled trial performed between September 2023 and June 2024 included healthy female university students aged 18–25 years. Participants were randomly assigned to either the control or the PNF group. Variables included age, height, weight, body mass index, Beighton score, hamstring flexibility, and deep cervical flexor muscle endurance; correlations between changes in hamstring flexibility and DCF endurance were explored. Hamstring flexibility was assessed using the Passive Knee Extension Test, and deep cervical flexor endurance was assessed using the Cranio-Cervical Flexion Test. The PNF group received hold–relax exercises while controls did not receive any intervention. Results: The study included 32 control participants and 32 individuals in the PNF group. The PNF group was marginally but significantly older than the control group [22 (21–23) vs. 21 (21–22); p = 0.038]. At baseline, the PNF group showed greater hamstring flexibility (p = 0.010). Both groups showed significant improvements in hamstring flexibility (p < 0.001 for both), but the improvement in the PNF recipients was far greater (p < 0.001). Regarding deep neck flexor endurance, no significant difference was observed between the groups at baseline (p = 0.958) or in final measurements (p = 0.244), although both groups showed significant improvements from baseline (p < 0.001 for both). There were no significant correlations between the change in deep neck flexor endurance and any of the examined variables. Conclusions: Our study found that a single session of PNF stretching significantly improved hamstring flexibility but did not immediately enhance deep neck flexor endurance. This emphasizes the need for further research into longer-term interventions to assess whether interventions on hamstring flexibility can improve cervical function. Full article

Background and Objectives: Negative-pressure wound therapy (NPWT) expedites tissue repair, yet functional recovery depends on adjunct rehabilitation. Evidence from high-resource settings is difficult to translate to Romanian county hospitals, where advanced devices are scarce. The objective of this study is to determine whether two tiers of low-technology, therapist-delivered exercise improve mobility, oedema resolution, pain and quality-of-life (QoL) beyond NPWT alone in adults with acute lower-limb wounds. Methods: A single-centre, prospective observational study (January 2021–June 2024) enrolled 92 patients and randomised them unevenly into: Group A, NPWT only (n = 39); Group B, NPWT + routine physiotherapy (n = 33); Group C, NPWT + enhanced manual programme (n = 20). All received −125 mmHg continuous suction; rehabilitation started 48 h post-operation. Primary outcomes were ankle dorsiflexion and knee flexion at 12 weeks. Secondary outcomes included calf circumference, ultrasound oedema depth, Manual Muscle Testing (MMT), pain (VAS), analgesic use and SF-36 domains through 24 weeks. Results: Baseline characteristics were similar (p > 0.40). At 12 weeks dorsiflexion reached 20.1 ± 1.8° in Group C, surpassing Group B (18.4 ± 2.1°; p = 0.004) and Group A (16.0 ± 2.3°; p < 0.001). Knee flexion followed the same gradient (140.8 ± 3.2°, 137.6 ± 3.4°, 133.4 ± 3.8° respectively). Oedema depth fell fastest in Group C (0.4 ± 0.2 mm by day 42) versus B (0.6 ± 0.2 mm) and A (0.8 ± 0.3 mm). Week-12 MMT grade ≥ 4.5 was attained by 95% of Group C, 85% of B and 72% of A (χ² = 10.9, p = 0.004). VAS pain fell more steeply with each rehabilitation layer, paralleled by a stepwise decline in daily tramadol. All SF-36 domains were highest in Group C at 24 weeks (Physical Function 88.7 ± 4.8 vs. 85.1 ± 5.4 vs. 78.2 ± 5.9; p < 0.001). Mobility correlated positively with QoL (r = 0.66) and inversely with pain and oedema. Conclusions: In a resource-constrained Romanian setting, adding structured manual physiotherapy to NPWT produced meaningful functional and patient-centred gains, while an “enhanced” programme incorporating daily PNF and elastic-band strengthening delivered the largest observed benefit. These findings justify prioritising therapist-led interventions even where sophisticated equipment is unavailable. Full article

Arthrogenic muscle inhibition (AMI) is a neuromuscular impairment commonly observed following anterior cruciate ligament reconstruction (ACLR). This condition, characterized by persistent quadricep inhibition due to altered afferent feedback, significantly impacts neuromuscular recovery, delaying return to running and sport. Despite advancements in rehabilitation strategies, AMI may persist for months or even years after ACLR, leading to muscle strength asymmetries, altered biomechanics, and an increased risk of reinjury. The mechanisms underlying AMI involve both peripheral (joint effusion, mechanoreceptor dysfunction) and central (corticospinal inhibition, neuroplasticity alterations) components, which collectively hinder voluntary muscle activation and movement control. AMI alters gait mechanics, reduces knee stability, and promotes compensatory patterns that increase injury risk. Current return-to-sport protocols emphasize strength symmetry and functional performance but often neglect neuromuscular deficits. A comprehensive assessment integrating neuromuscular, biomechanical, and proprioceptive evaluations is needed at specific stages to optimize rehabilitation and minimize reinjury risk. Future research should explore targeted interventions such as neuromuscular stimulation, cognitive–motor training, and advanced gait analysis to mitigate AMI’s impact and facilitate a safer, more effective return to sport. Full article

The present study investigated the acute effects of different stretching modalities applied within a warm-up on flexibility and vertical jump height. Thirty-seven young adults participated in four randomized experimental sessions, each corresponding to a different condition: static stretch (SS), dynamic stretch (DS), contract–relax with antagonist contraction (CRAC) or a control condition with no stretch (CTRL). Conditions were five min in total duration, including 2 × 15 s stretches for each muscle group (knee flexor, knee extensor, and plantar flexor muscles). Ten min and five min of cycling preceded and followed these procedures, respectively. Hamstring flexibility and a series of countermovement jump (CMJ) measurements were interspersed within this procedure. Except for CTRL, hamstring flexibility significantly increased (p < 0.01) after all experimental procedures (7.5 ± 6.6%, 4.1 ± 4.9%, and 2.7 ± 6.0% for CRA, SS, and DS, respectively). The relative increase was significantly greater for CRAC as compared CTRL (p < 0.001). Vertical jump height significantly decreased (p < 0.05) immediately after SS (−2.3 ± 3.9%), CTRL (−2.3 ± 3.5%), and CRAC (−3.2 ± 3.3%). Jump height was unchanged after DS (0.4 ± 4.5%). Whatever the condition, no additional jump height alteration was obtained after the re-warm-up. The main findings of the present study revealed that DS is more appropriate for maintaining vertical jump height. However, stretching has no major effect when performed within a warm-up. In contrast, if the main objective is to increase flexibility, CRAC is recommended. Full article

Background: Adequate hamstring flexibility is crucial for musculoskeletal health as increased muscle tone can lead to stretch-type injuries, muscle weakness, dysfunctional neuromuscular control, postural changes, and lower back pain. The aim was to compare the effectiveness of a program based on Electrical Muscle Elongation (EME), Proprioceptive Neuromuscular Facilitation (PNF), and no intervention in improving flexibility and viscoelastic properties of hamstring and quadriceps muscles in active young adults with functional hamstring disorder (type 2B according to the Munich Consensus). Methods: Sixty-five participants (45 male, 20 female) were randomly assigned to three groups: the EME group (n = 21) received a simultaneous combination of interferential current and stretching, the PNF group (n = 22) underwent active stretching, and the Control group (n = 22) received no intervention. Hamstring and quadricep flexibility and muscle stiffness were measured in both limbs at baseline, post-intervention, and at the 4-week follow-up. Results: The EME group showed significant improvements in hamstring flexibility in the left limb compared to the Control group and in some myotonometric variables of the quadriceps muscle compared to the PNF and Control groups (p < 0.05). Within-groups differences indicated higher improvements in the EME group. Conclusions: This study suggests that EME may offer greater benefits than PNF stretching in young adults with functional hamstring disorder. Full article

Background and Objectives: Optimizing functional recovery alongside wound healing remains a challenge in acute wound management. Negative Pressure Wound Therapy (NPWT) is widely used to promote tissue regeneration and reduce edema, yet its impact on functional outcomes and quality of life is less explored. This study evaluates the effects of NPWT alone versus NPWT combined with physiotherapy, focusing on functional recovery and patient-reported outcomes. Materials and Methods: This prospective study included patients with acute wounds at the Timisoara County Emergency Clinical Hospital, treated between 2020 and 2024. Participants were divided into two groups: Group 1, receiving NPWT exclusively, and Group 2, undergoing NPWT combined with physiotherapy (Proprioceptive Neuro-muscular Facilitation, Kabat diagonals, manual lymphatic drainage, and proprioceptive exercises). Assessments included joint mobility (goniometry), edema (circumferential measurements), muscle strength (Manual Muscle Testing), and patient-reported outcomes using WHOQOL-BREF, SF-36, and HADS questionnaires. Results: Results demonstrated that, at 10 days, patients in the specialized physiotherapy group had significantly greater ankle dorsiflexion (18.10 ± 1.63°) compared to the classical group (10.05 ± 1.76°; p < 0.001). Knee flexion in the specialized group was 134.58 ± 5.15° versus 115.57 ± 5.32° in the classical group (p < 0.001). Edema circumference and depth were reduced in both groups, with minor but notable improvements in the specialized group at later follow-ups (p < 0.05). Self-reported quality of life (SF-36, WHOQOL-BREF) and mental health (HADS) scores were slightly better at 10 days in the specialized group, although differences diminished by 6 months. Conclusions: Combining NPWT with specialized physiotherapy techniques enhances functional recovery and quality of life in acute wound patients. These findings support the integration of multi-disciplinary rehabilitation to optimize patient outcomes. Full article

Background: Musculoskeletal disorders associated with excessive smartphone use represent a significant health issue. Text neck syndrome is one such disorder within that group, increasingly affecting individuals worldwide across various age groups. The phenomenon of text neck may occur in individuals who frequently and for prolonged periods adopt a forward-flexed neck and head position while looking at the screens of mobile electronic devices. Various therapeutic methods are used in the treatment of text neck syndrome. However, there is no consensus on text neck rehabilitation, which poses a challenge for physiotherapists. Objective: The aim of this study is to analyze the phenomenon of text neck, with a particular emphasis on current scientific reports regarding the rehabilitation of text neck syndrome. The scoping review was conducted to determine the physiotherapy methods currently used in the treatment of individuals with text neck, assess their impact on symptom reduction, and identify existing knowledge gaps and limitations in the current literature on the rehabilitation of text neck syndrome. Design: A scoping review was conducted on the treatment of text neck syndrome based on electronic databases: PubMed, ResearchGate, Physiotherapy Evidence Database (PEDro), and the Cochrane Library. The databases were searched up to 1 December 2024. The inclusion criteria comprised studies investigating physiotherapy interventions for individuals with text neck, published between 2018 and 2024 and written in English. Results: A total of fifteen papers were reviewed, focusing on various methods used in text neck rehabilitation, including postural correction exercises, stabilization exercises, strengthening and stretching exercises, Pilates, PNF (Proprioceptive Neuromuscular Facilitation), kinesiology taping, Bowen therapy, and manual therapy. Nearly all studies were conducted in the adult population (93%), with the majority of studies taking place in India (60%). Conclusions: In summary, all studies suggest that appropriate physiotherapeutic interventions can provide significant benefits, including pain reduction, posture correction, and improved range of motion in the cervical spine. The best outcomes appear to be achieved by combining various therapeutic techniques. However, further high-quality research is needed to strengthen the evidence and offer reliable recommendations for clinical practice. Additionally, there is limited research on physiotherapy for text neck in the pediatric population, presenting a potential area for future studies. Full article

Background: Peripheral facial paralysis (PFP) affects the facial nerve, the seventh cranial nerve. It has an incidence rate of 20–30 cases per 100,000 habitants. The diagnosis is clinical, though imaging tests may be required in some cases. The treatment protocol includes medication, physiotherapy, and, in certain cases, surgery. Proprioceptive neuromuscular facilitation (PNF) techniques and electrical stimulation have been shown to be significant for recovery. Although PFP has a high recovery rate, up to 40% of patients may experience permanent sequelae. Objective: to assess the efficacy of treatment based on electrical stimulation and/or PNF in patients affected by PFP. Methods: A systematic search was conducted across six databases (PubMed, Medline, SportDiscus, CINAHL, Scopus, and Web of Science) in November 2024. Randomized controlled trials were included. Results: Fourteen articles were analyzed, applying PNF and/or electrical stimulation methods, pharmacological treatment, low-level laser treatment, subcutaneous collagen injections, and physiotherapy protocols involving facial expression exercises, yielding evidence for the variables assessed. Conclusions: PNF and/or electrical stimulation treatment in patients with PFP can be effective when employed early with appropriate parameters, showing promising results in improving quality of life, facial movement quality, and CMAP and reducing both the incidence and degree of synkinesis. Full article

Background: Hamstring muscle injuries are common in basketball and result in long periods of inactivity. To reduce their incidence, preventive protocols, including proprioceptive neuromuscular facilitation (PNF) stretches, have been proposed. The aim of this study is to compare the short-term effects of PNF and PNF + neuromuscular electrical stimulation (NMES) on hamstring extensibility and, secondarily, on vertical jump capacity in young basketball players. Materials and Methods: The study was a randomized controlled trial. One group performed a PNF stretching protocol and the other PNF + NMES. Hamstring extensibility was measured using the Sit and Reach test and the popliteal angle and jump capacity were measured using the Counter Movement Jump, both before and immediately after the intervention. Results: Forty-five young male players participated. Both groups showed significant intra-group improvements (p < 0.001) in hamstring flexibility after the intervention. However, there were no significant intra-group differences (p > 0.05) in jump capacity. Additionally, no significant differences (p > 0.05) were observed between the two groups for any of the measured variables. Conclusions: Both programs are effective in increasing hamstring flexibility in the short term without impairing vertical jump capacity in young basketball players. Full article

We aimed to investigate the effect of stretching exercises applied to the hamstring, one of the posterior muscle chains, on musculoskeletal flexibility, chest mobility, and respiratory function. Proprioceptive neuromuscular facilitation and static stretching exercises were applied to 30 healthcare personnel caring for children with developmental delays using a crossover randomized study design. Posterior muscle chain mobility was assessed using the popliteal angle test (PAT) for the hamstring muscle, the mobility of the lumbar muscles was assessed using the Schober test (ST), and the mobility of the posterior chain muscles as a whole was assessed using the finger-to-floor distance test. Chest mobility was measured using chest circumference measurements and lung volumes were measured using the pulmonary function test (PFT). The results showed that stretching exercises applied to the hamstrings led to significant improvements in PAT, ST, and chest mobility in the direction of maximal expiration (p < 0.05), without being superior to each other. Ten males (33.3%) and twenty females (66.7%) who met the inclusion criteria were analyzed. The mean age of the participants was 26.6 ± 5.9 years, the mean height was 169.53 ± 8.67 cm, the mean weight was 65.26 ± 12.03 kg, and the mean body mass index was 22.58 ± 3 kg/m². Chest inspiratory mechanics also showed a low positive correlation with posterior muscle mobility (r = 0.381; p = 0.038). There was no significant change in PAT. Within the framework of the myofascial theory, stretching exercises that can contribute positively to the musculoskeletal and respiratory system structures of healthcare professionals can be recommended and encouraged to healthcare professionals. Full article

The aim of this research was to investigate the effects of different stretching techniques used during warm-up exercises prior to post-activation performance enhancement (PAPE) on the explosive lower extremity strength performance of soccer players. This cross-sectional study involved the participation of 13 male soccer players with an average age of 22.38 ± 1.75, body height of 174.38 ± 3.94, and body mass of 72.30 ± 4.13. To determine the participants’ maximal strength performance, one repeated maximal strength (1-RM) squat exercise was applied. The PAPE protocol was then implemented with a squat exercise consisting of three repetitions at 80% of 1-RM. The warm-up protocols consisted of 5 min of cycling, followed by dynamic stretching, static stretching, or proprioceptive neuromuscular facilitation (PNF) stretching exercises. These protocols were applied on four different days with a 72 h interval. A vertical jump test was conducted to measure the participants’ explosive strength performance. The research data were analyzed using IBM Statistics (SPSS version 26.0, Armonk, NY, USA) software. The findings of this study revealed statistically significant differences in vertical jump performance values after PAPE among participants based on the different stretching techniques used during warm-up (p = 0.00). In this context, the research concluded that dynamic stretching is the optimal stretching technique during warm-up exercises before PAPE to maximize its effects. On the other hand, static stretching was found to negatively affect performance by absorbing the PAPE effect. Full article

This study delves into the multifaceted approaches to treating Parkinson’s disease (PD), a neurodegenerative disorder primarily affecting motor function but also manifesting in a variety of symptoms that vary greatly among individuals. The complexity of PD symptoms necessitates a comprehensive treatment strategy that integrates surgical interventions, pharmacotherapy, and physical therapy to tailor to the unique needs of each patient. Surgical options, such as deep brain stimulation (DBS), have been pivotal for patients not responding adequately to medication, offering significant symptom relief. Pharmacotherapy remains a cornerstone of PD management, utilizing drugs like levodopa, dopamine agonists, and others to manage symptoms and, in some cases, slow down disease progression. However, these treatments often lead to complications over time, such as motor fluctuations and dyskinesias, highlighting the need for precise dosage adjustments and sometimes combination therapies to optimize patient outcomes. Physical therapy plays a critical role in addressing the motor symptoms of PD, including bradykinesia, muscle rigidity, tremors, postural instability, and akinesia. PT techniques are tailored to improve mobility, balance, strength, and overall quality of life. Strategies such as gait and balance training, strengthening exercises, stretching, and functional training are employed to mitigate symptoms and enhance functional independence. Specialized approaches like proprioceptive neuromuscular facilitation (PNF), the Bobath concept, and the use of assistive devices are also integral to the rehabilitation process, aimed at improving patients’ ability to perform daily activities and reducing the risk of falls. Innovations in technology have introduced robotic-assisted gait training (RAGT) and other assistive devices, offering new possibilities for patient care. These tools provide targeted support and feedback, allowing for more intensive and personalized rehabilitation sessions. Despite these advancements, high costs and accessibility issues remain challenges that need addressing. The inclusion of exercise and activity beyond structured PT sessions is encouraged, with evidence suggesting that regular physical activity can have neuroprotective effects, potentially slowing disease progression. Activities such as treadmill walking, cycling, and aquatic exercises not only improve physical symptoms but also contribute to emotional well-being and social interactions. In conclusion, treating PD requires a holistic approach that combines medical, surgical, and therapeutic strategies. While there is no cure, the goal is to maximize patients’ functional abilities and quality of life through personalized treatment plans. This integrated approach, along with ongoing research and development of new therapies, offers hope for improving the management of PD and the lives of those affected by this challenging disease. Full article

Participating in sports has been shown to promote overall wellness and, at the same time, reduce health risks. As more people are participating in sports, competitions have increased, and every aspect of the game has been focused by coaches and athletes in order to improve performance. One of these aspects is the warm-up session. The purpose of this study was to investigate the acute effect of a dynamic warm-up versus a proprioceptive neuromuscular facilitation (PNF) warm-up on the sprint and jump performance of recreationally active men. Thirty (n = 30) males were randomly assigned to undergo three sessions of different warm-up types, 72 h apart, involving either proprioceptive neuromuscular facilitation (PNF), dynamic stretching (DS), or no stretching session (control). The PNF and dynamic modes of stretching improved vertical jump performance, F (2.58) = 5.49, p = 0.046, to a certain extent (mean + 3.32% vs. control, p = 0.002 for dynamic and mean + 1.53% vs. control, p = 0.048 for PNF stretching). Dynamic stretching is best used to get a better vertical jump height. Sprint performance was also increased to a greater extent following the stretching session, F (2.58) = 5.60, p = 0.01. Sprint time was +1.05% faster vs. the control, with a value of p = 0.002 after dynamic stretching, while PNF stretching demonstrated a sprint time of +0.35% vs. the control, with a value of p = 0.049. Dynamic stretching showed a better sprint performance and also vertical jump height performance in this study. PNF and dynamic stretching prove to be equally efficacious in flexibility conditioning depending on the type of movement involved. This type of stretching should be utilized to help preserve or improve the performance output of physical activity, especially in sprinting and jumping events. Full article