Effects of Dynamic Extension Exercise and Mulligan Stretching on Hamstring Flexibility

OBJECTIVES: By the increase in physically inactive and sedentary lifestyles habits, hamstring tightness has currently become a more common situation. The purpose of this study was to compare the effects of dynamic extension exercise and Mulligan stretching applications on hamstring flexibility in people with hamstring tightness. METHODS: This study involved 12 young adults and 24 knees (4 females, 8 males) with bilateral hamstring tightness (active knee extension test angle < 25 degrees). Mean age and mean Body Mass Index (BMI) of the participants were 22.75±2.73 years and 21.52±2.51 kg/m2, respectively. Before the first measurements, all participants were separated into a Dynamic Extension Exercise Group (DEEG, n = 7) and Mulligan Stretching group (MSG, n = 5) according to the simple random table. DEEG received terminal extension exercises consisting of three sets of 10 repetitions, with 30 seconds of rest between each set, performed at predetermined 10 repetition maximum for each subject. MSG received traction straight leg raise technique and bent-leg-raise technique of Mulligan for 1 set each session applied by the physiotherapist. Applications were done 3 sessions a week for 4 weeks. Hamstring flexibility was measured with Active Knee Extension Test (AKET) and Sit and Reach Test (SRT). All measurements were performed four times: before treatment (BT), immediately after 1st session and 24th hour, and after 4-week treatment period (AT). RESULTS: There were no significant differences between the two groups in the baseline demographic characteristics, BMI, and AKET and SRT results (p>0.05). While MSG group experienced a significant increase in the AKET and SRT at measurements of 1st session, 24th hour and AT (p<0.05), there were no significant alterations in values of AKET and SRT in DEEG (p>0.05). CONCLUSION: The results of our study showed that applying Mulligan stretching three sessions per week for 4 weeks can increase active knee extension angle in people with hamstring tightness. Applying Mulligan stretching instead of dynamic extension exercises can be more effective on hamstring flexibility. However, further data and studies are needed to determine long-term outcomes.