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Are the effects of stretch sustained? (Authors reply)
- Joshua Burns, Joel A. Radford, Karl B. Landorf, Rachelle Buchbinder, Catherine Cook (4 May 2007)
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Are the effects of stretch sustained?
- Lisa A Harvey (8 September 2006)
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Joshua Burns, NHMRC Australian Clinical Research Fellow Discipline of Paediatrics and Child Health, The University of Sydney, Joel A. Radford, Karl B. Landorf, Rachelle Buchbinder, Catherine Cook
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joshuab2{at}chw.edu.au Joshua Burns, et al.
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Dear editor, Thank you for your interest in our systematic review. In response to your question, we did describe the duration between stretching and measurement for each trial in Table 1, column 4. We reported measurements ranging from ‘immediately’ to 72 hours post-stretch. One of the trials (Peres et al., 2002) measured ankle range of motion after six days of rest from stretching and reported an effect size of + 4.6 degrees between the stretching and control groups. Unfortunately, none of the other four trials included in our review reported follow-up measurements to determine the lasting effects of ankle stretching. Yours sincerely Dr Joshua Burns, Mr Joel A. Radford, Dr Karl B. Landorf, Prof Rachelle Buchbinder, Dr Catherine Cook |
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Lisa A Harvey, physiotherapist Faculty of Medicine, University of Sydney
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l.harvey{at}usyd.edu.au Lisa A Harvey
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Dear editor, I read with interest the recent systematic review examining the effectiveness of stretch on ankle range of motion. The authors are to be commended for such an important piece of work. The treatment effects are very small and in keeping with a number of randomised controlled trials looking at the effects of stretch in patients with neurological conditions. I suspect few clinicians would consider a treatment effect possibly as low as 1 degree as worthwhile. However, I think the effect size would have been even smaller, and possibly non-existent, if a distinction was made between the immediate and lasting effects of stretch. If measurements are made soon after the cessation of the last stretch intervention, range of motion reflects the immediate response of soft tissue structure to stretch. This is due to the effects of viscous deformation. However, presumably, what is of far more importance to clinicians is the lasting effects of stretch. That is, does stretch induce structural and morphological change with a resultant increase in range of motion that lasts for more than a day after the cessation of stretch. Are the authors able to comment on whether the five randomised controlled trials included in the systematic review made this distinction? yours sincerely Dr Lisa Harvey |
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