Effects of Different Physical Therapy Interventions in Improving Flexibility in University Students with Hamstring Tightness - A Systematic Review and Network Meta-analysis.

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dc.contributor.authorLiyanage, E.
dc.contributor.authorMalwanage, K.
dc.contributor.authorSenarath, D.
dc.contributor.authorWijayasinghe, H.
dc.contributor.authorLiyanage, I.
dc.contributor.authorChellapillai, D.
dc.contributor.authorNishshanka, S.
dc.date.issued2024
dc.description.abstractThe aim of the present study was to identify the different interventions for hamstring flexibility among university students with hamstring tightness and to determine the better treatment method. Design: Systematic review and network meta-analysis. An electronic search of the databases: Medline, Pubmed, Cochrane, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro) was conducted. A total of 11 articles were included in the review. Of these articles, 02 were case-control studies, 02 were interventional pre-post studies and 07 were RCTs. The 07 RCTs were included for network meta-analysis. The findings of the initial network meta-analysis (NMA) which compared control i.e., no intervention with other interventions revealed that all the physical therapy interventions: stretching, electrotherapy combined with stretching, massage, dry needling and neurodynamic exercises combined with stretching and neurodynamics alone were superior to control. Since most studies included stretching as an intervention, a second NMA was conducted to compare the different physical therapy interventions with stretching. The results suggested that US-guided neuromodulation (WMD: -5.80, CI: -12.11, 0.51) had large effects on hamstring flexibility compared to stretching and stretching combined with electrotherapy i.e., cryotherapy and ultrasound (WMD: 0.25, CI: -1.14 to 1.64), MET (WMD: 3.10, CI: -3.28 to 9.48) and massage (WMD: 8.05, CI: -11.90 to 27.18) were inferior to stretching. To further investigate the effects of these interventions three meta-analysis were performed. The results revealed that stretching was more effective (SMD 2.27, 95% 0.72 to 3.81, p < 0.01) compared to control (no intervention). Neurodynamic exercises combined with stretching and neurodynamics alone were found to be superior to stretching alone ((SMD -0.69, 95% -1.35 to -0.03, p < 0.01) and stretching combined with electrotherapy was not significantly better than stretching alone ((SMD -0.07, 95% -1.00 to 0.87, p=0.88). Neurodynamic exercises combined with stretching and neurodynamics alone showed to be superior to the other physical therapy interventions in improving hamstring flexibility for hamstring tightness among university students, however, the reliability of the evidence is low.
dc.description.statementofresponsibilityEsther liyanage, Kavinda Malwanage, Dilhari Senarath, Hashini Wijayasinghe, Indrajith Liyanage, Dhananjee Chellapillai, and Shiromi Nishshanka
dc.identifier.citationInternational Journal of Exercise Science, 2024; 17(3):359-381
dc.identifier.doi10.70252/zolu9336
dc.identifier.issn1939-795X
dc.identifier.issn1939-795X
dc.identifier.urihttps://hdl.handle.net/2440/144973
dc.language.isoen
dc.publisherBerkeley Electronic Press
dc.rights© Author(s) 2024. CC By ND
dc.source.urihttps://doi.org/10.70252/zolu9336
dc.subjectHamstring flexibility
dc.subjectHamstring flexibility; hamstring tightness; physical therapy interventions; stretching; university students
dc.subjecthamstring tightness
dc.subjectphysical therapy interventions
dc.subjectstretching
dc.subjectuniversity students
dc.titleEffects of Different Physical Therapy Interventions in Improving Flexibility in University Students with Hamstring Tightness - A Systematic Review and Network Meta-analysis.
dc.typeJournal article
pubs.publication-statusPublished

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