The Immediate Effects Of Thoracolumbar Fascia Inhibition And Suboccipital Muscle Inhibition

July 31, 2025 updated by: Sanem ŞENER, Bulent Ecevit University

Comparison of The Immediate Effects of Thoracolumbar Fascia Inhibition and Suboccipital Muscle Inhibition on Cervical and Lumbar Joint Range of Motion, Flexibility of Back Extensors and Hamstring Muscles, Functional Exercise Capacity, and Balance In Individuals With Hamstring Shortness

This randomized controlled trial aimed to compare the immediate effects of two self-myofascial release techniques-suboccipital muscle inhibition and thoracolumbal fascia inhibition-on hamstring flexibility, spinal range of motion, and balance in healthy adults. A total of 75 participants with hamstring tightness were randomly assigned to one of three groups: suboccipital inhibition, thoracolumbal inhibition, or control. All participants performed hamstring stretching, and the intervention groups received one of the inhibition techniques immediately after. Outcomes were measured at baseline and within 30 minutes post-intervention. The study found that both techniques led to significant improvements in hamstring flexibility and spinal mobility, with region-specific benefits. The thoracolumbal technique was more effective for trunk and hamstring flexibility, while the suboccipital technique provided greater cervical mobility gains. Balance improvements were limited. These findings support the use of targeted myofascial interventions in clinical practice.

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.

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.
75

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 Locations

  • Turkey
    • Zonguldak
      • Kozlu, Zonguldak, Turkey, 67600
        • Zonguldak Bulent Ecevit 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:

  • Healthy volunteers between the ages of 18 and 25
  • Hamstring muscle tightness as defined by Active Knee Extension Test (AKET) ≥ 20°
  • Ability to follow study instructions and provide informed consent
  • No participation in other clinical studies within the last 3 months

Exclusion Criteria:

  • AKET < 20° (i.e., no hamstring tightness)
  • History of musculoskeletal, neurological, or systemic diseases affecting balance or flexibility
  • Recent injury or surgery involving the spine, pelvis, or lower extremities
  • Use of medications affecting muscle tone or balance
  • Inability to perform the required movements or assessments
  • Pregnancy or suspected pregnancy

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: Treatment
  • 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.
Active Comparator: Control Group
Other: hamstring stretching
Participants performed passive hamstring stretching using a sheet for self-assistance. Participants will be asked to lie supine on an appropriate surface and keep their knees in extension. Then, they will be instructed to hold both ends of a sheet and place the middle part of the sheet on the plantar surface of one foot. Using the sheet and performing ankle dorsiflexion, they will pull the leg-kept in knee extension-toward themselves. This position should be held for 30 seconds (8). It is important that the opposite knee does not move into flexion during the exercise. The application will be performed bilaterally.
Experimental: Thoracolumbar fascia inhibition group
Other: hamstring stretching
Participants performed passive hamstring stretching using a sheet for self-assistance. Participants will be asked to lie supine on an appropriate surface and keep their knees in extension. Then, they will be instructed to hold both ends of a sheet and place the middle part of the sheet on the plantar surface of one foot. Using the sheet and performing ankle dorsiflexion, they will pull the leg-kept in knee extension-toward themselves. This position should be held for 30 seconds (8). It is important that the opposite knee does not move into flexion during the exercise. The application will be performed bilaterally.
Other: Thoracolumbar fascia inhibition
Soft tissue mobilization: Participants will be asked to lie on their backs without a pillow in a hook-lying position, placing a foam roller under the inferior part of the scapula and clasping their hands behind the cervical region. Then, they will be instructed to lift their hips off the ground and roll the foam roller in a cranial and caudal direction from the inferior scapular region to the sacral area for 30 seconds, performing flexion and extension movements with their knees. This application will be performed in a total of 4 sets.
Experimental: Suboccipital inhibition group
Other: hamstring stretching
Participants performed passive hamstring stretching using a sheet for self-assistance. Participants will be asked to lie supine on an appropriate surface and keep their knees in extension. Then, they will be instructed to hold both ends of a sheet and place the middle part of the sheet on the plantar surface of one foot. Using the sheet and performing ankle dorsiflexion, they will pull the leg-kept in knee extension-toward themselves. This position should be held for 30 seconds (8). It is important that the opposite knee does not move into flexion during the exercise. The application will be performed bilaterally.
Other: Suboccipital inhibition group
Soft tissue mobilization: Participants will be asked to lie in a supine position on an appropriate surface and keep their knees in extension. Then, they will be instructed to hold both ends of a sheet and place the middle part of the sheet on the plantar surface of one foot. Using the sheet and by dorsiflexing the ankle, they will pull the extended leg toward themselves. This position should be maintained for 30 seconds (8). It is important that the opposite knee does not flex during the exercise. The application will be performed bilaterally.

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
Change in Cervical Range of Motion (degrees) from Baseline to Post-Intervention
Time Frame: Baseline and immediately (within 30 minutes) post-intervention
Cervical range of motion (flexion, extension, lateral flexion, rotation) in healthy individuals with hamstring tightness.
Baseline and immediately (within 30 minutes) post-intervention
Change in Finger-to-Floor Distance from Baseline to Post-Intervention
Time Frame: Baseline and immediately (within 30 minutes) post-intervention
Finger-to-Floor Distance was used to assess hamstring flexibility. Measurements were taken pre-intervention and within 30 minutes following the intervention.
Baseline and immediately (within 30 minutes) post-intervention
Change in Y Balance Test from Baseline to Post-Intervention
Time Frame: Baseline and immediately (within 30 minutes) post-intervention

The Y Balance Test was used to assess dynamic balance, with participants reaching in the anterior, posteromedial, and posterolateral directions while standing on one leg. The average reach distance in centimeters (cm) was recorded for each direction.

The test was administered at baseline and within 30 minutes post-intervention to assess immediate changes in balance performance.
Baseline and immediately (within 30 minutes) post-intervention
Change in Active Knee Extension Angle (degrees) from Baseline to Post-Intervention
Time Frame: Baseline and immediately (within 30 minutes) post-intervention
Active Knee Extension Test (AKET): Degree of knee extension measured using a goniometer. Higher values indicate greater flexibility.
Baseline and immediately (within 30 minutes) post-intervention
Change in The Stork Balance Test from Baseline to Post-Intervention
Time Frame: Baseline and immediately (within 30 minutes) post-intervention
The Stork Balance Test was used to evaluate static balance by measuring how long (in seconds) a participant could maintain a balanced stance on one leg.
Baseline and immediately (within 30 minutes) post-intervention
Change in Lumbal Range of Motion (degrees) from Baseline to Post-Intervention
Time Frame: Baseline and immediately (within 30 minutes) post-intervention
Lumbal range of motion (flexion, extension) in healthy individuals with hamstring tightness.
Baseline and immediately (within 30 minutes) post-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.
Bulent Ecevit 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.
March 28, 2025

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.
June 2, 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.
June 26, 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).
March 25, 2025

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.
July 29, 2025

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.
July 31, 2025

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.
August 5, 2025

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.
July 31, 2025

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.
July 1, 2025

More Information

Terms related to this study

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.
  • NCTHamstring-shortness

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

All procedures involving human participants were conducted in accordance with ethical standards. Written informed consent was obtained from all participants prior to the study. Data other than the participants' personal information (e.g., pre- and post-intervention muscle flexibility measurements) were used solely for research purposes. Participant privacy and confidentiality were strictly protected throughout the study.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

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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