Mulligan Techniques for Gait and Pelvic Motion in Short Hamstrings
The Effect of Two Different Mulligan Techniques on Spatiotemporal Parameters and Pelvic Oscillation in Individuals With Hamstring Tightness: A Randomized Controlled Trial
Various stretching methods have been developed to reduce hamstring tightness and improve flexibility. Static stretching is one of the safest and most common methods used to increase muscle length; however, its effect is temporary and diminishes rapidly. Additionally, such conventional methods can be uncomfortable and require longer periods to yield visible results. Unlike other mobilization procedures, the Mulligan concept is performed while patients execute a resisted muscle contraction or move actively or passively. Distinct from many other manual therapy approaches, this technique is applied within a symptom-free range of motion, which likely enhances its safety. Traction Straight Leg Raise (TSLR) and Bent Leg Raise (BLR) techniques are specific interventions defined by Mulligan. There are limited studies in the literature investigating the effects of these two techniques on hamstring flexibility. However, no study has compared these two techniques in terms of spatiotemporal gait parameters and pelvic oscillations. Therefore, the purpose of this study is to compare the effects of BLR and TSLR techniques applied to individuals with hamstring tightness on hamstring flexibility, spatiotemporal parameters of gait, and pelvic oscillations.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
Flexibility holds a significant place among health-related physical fitness parameters and is defined as the normal range of motion achievable by a joint and/or joint complexes. Muscle flexibility is crucial for maintaining optimal muscle functionality and proper biomechanics. Limited flexibility leads to various musculoskeletal symptoms, postural deformities, and gait limitations. Reduced flexibility is commonly observed in fast-twitch and biarticular muscles, with the hamstring muscles being a prime example. The length of the hamstring muscles plays an essential role in human movement, including gait. Hamstring tightness reduces the ability to absorb shocks applied to the lower extremity and knee extension during walking, thereby decreasing step length. Individuals with hamstring tightness do not exhibit a normal gait pattern, particularly during the mid-swing and terminal swing phases. Furthermore, hamstring tightness results in reduced pelvic mobility. Decreased hamstring flexibility is a frequently observed finding in numerous musculoskeletal problems of the knee, hip, and lumbar regions. By disrupting the muscle length-tension relationship in the posterior kinetic chain, it has been specifically associated with clinical conditions such as low back pain, patellofemoral pain syndrome, and posterior pelvic tilt. Therefore, addressing this tightness stands out as a major goal in rehabilitation and exercise programs. Traction Straight Leg Raise (TSLR) and Bent Leg Raise (BLR) techniques are specific interventions. Only a limited number of studies have compared these two methods in individuals with hamstring tightness. Kapadia and Meshram reported that both of Mulligan's TSLR and BLR techniques are effective in improving hamstring muscle flexibility in healthy individuals; however, they noted that the TSLR technique was superior in enhancing flexibility. Priyanka et al. applied TSLR and BLR interventions to collegiate cricket players for a duration of two weeks and concluded that the BLR technique was more effective in increasing hamstring muscle flexibility compared to the TSLR technique. Furthermore, Bhosle and Rizvi investigated the treatment of sewing machine operators with hamstring tightness and low back pain, finding that both Mulligan BLR and TSLR techniques were effective in increasing hamstring flexibility and reducing low back pain-related disability, with no significant superiority of one technique over the other.
A review of the current literature reveals conflicting results regarding the efficacy of these techniques on hamstring flexibility. Furthermore, no study to date has compared these two techniques in terms of spatiotemporal gait parameters and pelvic oscillations. Therefore, the purpose of this study is to compare the effects of Mulligan TSLR and BLR techniques on hamstring flexibility, spatiotemporal gait parameters, and pelvic oscillations in individuals with hamstring tightness.
Studietyp
Inskrivning (Faktisk)
Fas
- Inte tillämpbar
Kontakter och platser
Studieorter
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Ankara
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Pursaklar, Ankara, Turkiet (Türkiye), 06145
- Gazi University
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- Individuals between the ages of 18 and 35
- Individuals who bilateral hamstring shortness
Exclusion Criteria:
- A passive knee extension angle of 20° or less
- A history of lower extremity pain or injury within the last 6 months
- Previous lower extremity surgery
- Neurological, rheumatological, or systemic diseases
- Poor cooperation for activities
- Regular participation in sports.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Enda
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
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Experimentell: Mulligan Bent Leg Raise (BLR) Technique
17 individuals in this group, after evaluations, mobilization with movement technique applied by clinians and after that same evaluations will be applied. |
The participant's flexed knee was supported on the therapist's shoulder. Following a resisted leg push and relaxation, the therapist passively moved the knee toward the ipsilateral shoulder to the maximum pain-free range. If pain occurred, the leg was shifted medially or laterally to find a pain-free pathway. |
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Experimentell: Mulligan Traction Straight Leg Raise (TSLR) Technique
17 individuals in this group, after evaluations, mobilization with movement technique applied by clinians and after that same evaluations will be applied. |
In a supine position with the knee extended and hip neutral, maximum longitudinal traction was applied to the lower extremity. The limb was passively raised (SLR) until the onset of discomfort and immediately returned to the resting position. If pain was indicated, the movement direction was modified by adding abduction and/or rotation to ensure a pain-free pathway. |
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Passive knee extension test
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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the participant was supine with the tested hip flexed to 90° and the femur stabilized. The contralateral leg remained flat on the table. A goniometer was placed with its axis on the lateral femoral epicondyle, the stationary arm aligned with the greater trochanter, and the moving arm with the lateral malleolus. The knee was passively extended until a stretch was felt or hip flexion was compromised, marking the test endpoint. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
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Cadence (step / min) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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"Cadence" (steps/min) is the number of steps in a minute. Cadence during gait was assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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Speed (m / s) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later
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Speed (m/s) parameters is average walking speed. Speed during gait was assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later
|
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Gait cycle duration (s) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later
|
Gait cycle duration (s) parameter is average value of the time interval between two consecutive heel strikes of the same foot. Gait cycle duration were assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later
|
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Stride length (m) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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Stride length (m) is the average value of distances between each initial contact and the next one of the same side. Stride length during gait was assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
|
|
Stance phase (% cycle) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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Stance phase (% cycle) is the average value of the duration of the right and left foot support phase as percentage of the gait cycle. Stance phase during gait was assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
|
|
Swing phase (% cycle) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
|
Swing phase (% cycle) is average value of the duration of the right and left swing phase as percentage of the gait cycle. Swing phase during gait was assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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Pelvic tilt range (degrees) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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The angles average value described by the pelvis in the 3 main body planes (sagittal, frontal and transversal), are represented in three graphs: The sagittal plane component describes the pelvic tilt. Pelvic tilt range during gait were assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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Pelvic obliquity range (degrees) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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The angles average value described by the pelvis in the 3 main body planes (sagittal, frontal and transversal), are represented in three graphs: the frontal plane component describes the pelvic obliquity. Pelvic obliquity range during gait analysis was assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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Pelvic rotation range (degrees) during gait
Tidsram: Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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The angles average value described by the pelvis in the 3 main body planes (sagittal, frontal and transversal), are represented in three graphs: the transversal plane component describes the pelvic rotation. Pelvic rotation range during gait were assessed using a BTS G-Walk accelerometer secured at the L4-L5 level. Participants walked at a normal pace along a 10-meter marked track and returned. Data were transmitted via Bluetooth to G-Studio software for analysis. |
Measurements were taken at three time points: before the intervention, immediately following the intervention, and 24 hours later.
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