Acute Effects of Foam Rolling and Proprioceptive Neuromuscular Facilitation Stretching

August 31, 2026 updated by: Acibadem University

Acute Effects of Foam Rolling and PNF Stretching as Warm-Up Strategies on Muscle Flexibility, Strength, and Pressure Pain Threshold in Amateur Athletes

This randomized, assessor-blinded, parallel-group comparative trial investigated the acute effects of foam rolling (FR) and proprioceptive neuromuscular facilitation (PNF) stretching used as warm-up strategies in amateur athletes. Following a standardized 5-minute aerobic cycling warm-up, participants were randomly allocated to either a foam rolling group or a PNF stretching group. Hamstring flexibility was the prespecified primary outcome. Isometric knee flexion strength, vertical jump performance, pressure pain threshold, and intervention-related perceived exertion were assessed as secondary outcomes. All performance outcomes were assessed before and immediately after the assigned intervention.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Foam rolling and proprioceptive neuromuscular facilitation stretching are commonly used as warm-up strategies to acutely improve flexibility. However, direct comparisons of their effects on flexibility and performance-related outcomes remain limited. This study was designed to compare the acute effects of foam rolling and proprioceptive neuromuscular facilitation stretching used as warm-up strategies in amateur athletes.

Healthy amateur athletes aged 18 to 30 years were randomly assigned to either a foam rolling group or a proprioceptive neuromuscular facilitation stretching group. All participants first completed a standardized 5-minute light-intensity cycling warm-up. Participants in the foam rolling group performed unilateral hamstring foam rolling on the dominant lower limb for 3 sets of 30 seconds, for a total application time of 90 seconds. Participants in the proprioceptive neuromuscular facilitation stretching group performed four repetitions, each consisting of 5 seconds of maximal isometric hamstring contraction, 5 seconds of relaxation, and 20 seconds of passive stretching, for a total application time of 120 seconds.

Hamstring flexibility was assessed using the sit-and-reach test. Isometric knee flexion strength was assessed using handheld dynamometry, vertical jump performance using a standing vertical jump test, and pressure pain threshold using pressure algometry over the hamstring region. Intervention-related perceived exertion was assessed immediately after the assigned intervention. The main outcome measures were assessed before and immediately after the intervention. Outcome assessors were blinded to group allocation.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
80

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • Turkey (Türkiye)
    • None Selected
      • Istanbul, None Selected, Turkey (Türkiye), 34752
        • Acibadem University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Age between 18 and 30 years
  • Being actively engaged in training or competition in amateur sport

Exclusion Criteria:

  • Generalized hypermobility
  • History of hamstring injury within the previous 6 months
  • Diagnosed orthopedic pathology
  • Previous surgery involving the lower extremity or spine
  • Current low back pain
  • Any systemic or neurological disorder that could affect test performance or intervention safety

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Foam Rolling Group
Participants completed a standardized 5-minute light-intensity aerobic cycling warm-up, followed by unilateral hamstring foam rolling on the dominant lower limb. Foam rolling was performed for 3 sets of 30 seconds, for a total application time of 90 seconds.
Other: Foam Rolling
Participants performed unilateral hamstring foam rolling on the dominant lower limb in a long-sitting position on a firm, flat surface. The foam roller was positioned under the hamstring region, and participants slowly rolled back and forth between the ischial tuberosity and the popliteal fossa under sustained body-weight pressure. The protocol consisted of 3 sets of 30 seconds, for a total application time of 90 seconds. Participants were instructed to apply the maximum tolerable pressure that did not produce pain.
Experimental: PNF Stretching Group
Participants completed a standardized 5-minute light-intensity aerobic cycling warm-up, followed by unilateral PNF stretching of the hamstring on the dominant lower limb. Four 30-second repetitions were performed, for a total application time of 120 seconds.
Other: Proprioceptive Neuromuscular Facilitation Stretching
Participants received unilateral PNF stretching of the hamstring on the dominant lower limb in a long-sitting position with the knee fully extended. Each repetition consisted of a 5-second maximal isometric hamstring contraction, followed by 5 seconds of relaxation and 20 seconds of passive stretching. The therapist provided manual resistance during the isometric contraction and guided the participant into the stretch position. Four repetitions were performed, for a total application time of 120 seconds.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Hamstring Flexibility Assessed by the Sit-and-Reach Test
Time Frame: Pre-intervention and immediately after the intervention
Hamstring flexibility was assessed using the Baseline® Sit and Reach Flexibility Tester. Participants sat with both knees fully extended, the lower limbs together, and the soles of the feet placed flat against the testing device. Participants reached forward as far as possible without flexing the knees. Three trials were performed, and the mean value was recorded in centimeters (cm). Higher values indicate greater flexibility.
Pre-intervention and immediately after the intervention

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Vertical Jump Performance
Time Frame: Pre-intervention and immediately after the intervention
Vertical jump performance was assessed using a standing vertical jump test. Standing reach height was first recorded. Participants then performed a countermovement jump and reached as high as possible. Vertical jump height was calculated as the difference between jump reach height and standing reach height. Three trials were performed, and the highest value was recorded in centimeters (cm). Higher values indicate greater vertical jump performance.
Pre-intervention and immediately after the intervention
Isometric Knee Flexion Strength
Time Frame: Pre-intervention and immediately after the intervention
Isometric knee flexion strength was measured using a digital handheld dynamometer (J Tech Commander Muscle Tester). Participants were seated with the hips and knees flexed to 90°. The dynamometer was positioned on the posterior aspect of the lower leg, 5 cm proximal to the lateral malleolus. Participants performed maximal isometric knee flexion for 3 seconds. Three trials were performed with 60 seconds of rest between trials, and the highest force value sustained for more than 0.5 seconds was recorded in kilogram-force (kgf). Higher values indicate greater isometric knee flexion strength.
Pre-intervention and immediately after the intervention
Hamstring Pressure Pain Threshold
Time Frame: Pre-intervention and immediately after the intervention
Pressure pain threshold was assessed over the hamstring region using a digital pressure algometer (Baseline FDK 10). Participants were positioned prone, and the algometer probe was applied perpendicular to the most sensitive point of the hamstring region. Pressure was gradually increased at approximately 1 kgf/cm² every 3 seconds until the participant first reported pain. Three measurements were performed with 20-second intervals between trials, and the lowest value was recorded for analysis. Higher values indicate a higher pressure pain threshold.
Pre-intervention and immediately after the intervention
Intervention-Related Perceived Exertion
Time Frame: Immediately after the intervention
Intervention-related perceived exertion was assessed immediately after the assigned intervention using a single-item 0-10 numerical rating scale (NRS), anchored from 0 (no exertion) to 10 (maximal exertion). Higher scores indicate greater perceived exertion.
Immediately after the intervention

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Acibadem University

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
The Scientific and Technological Research Council of Turkey

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Hayri E Yılmaz, Acibadem University
  • Study Chair: Birce B Çelik, Acibadem University
  • Study Chair: Mahmut E Bükülmez, Acibadem University
  • Study Chair: Eren Çekiç, Acibadem University
  • Study Director: Elif E Bayraktar, asst. prof., Acibadem University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
June 10, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
February 24, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
February 24, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
January 12, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
January 24, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 2, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
September 2, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 31, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 2023-20-683

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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