The Immediate Effects Of Thoracolumbar Fascia Inhibition And Suboccipital Muscle Inhibition

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: Completed
• Conditions: Healthy Individuals With Hamstring Tightness
• Intervention / Treatment: Other: hamstring stretching; Other: Thoracolumbar fascia inhibition; Other: Suboccipital inhibition group

• Study Type: Interventional
• Enrollment (Actual): 75
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Zonguldak
    • Kozlu, Zonguldak, Turkey, 67600
      • Zonguldak Bülent Ecevit University

Participation Criteria

Eligibility Criteria

• 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

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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

Outcome Measure	Measure Description	Time Frame
Change in Cervical Range of Motion (degrees) from Baseline to 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	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	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	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	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	Lumbal range of motion (flexion, extension) in healthy individuals with hamstring tightness.	Baseline and immediately (within 30 minutes) post-intervention

Collaborators and Investigators

• Sponsor: Bulent Ecevit University

Study record dates

Study Major Dates

• Study Start (Actual): March 28, 2025
• Primary Completion (Actual): June 2, 2025
• Study Completion (Actual): June 26, 2025

Study Registration Dates

• First Submitted: March 25, 2025
• First Submitted That Met QC Criteria: July 29, 2025
• First Posted (Actual): July 31, 2025

Study Record Updates

• Last Update Posted (Actual): August 5, 2025
• Last Update Submitted That Met QC Criteria: July 31, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Other Study ID 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