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. 2024 Nov;124(11):3153-3173.
doi: 10.1007/s00421-024-05564-6. Epub 2024 Jul 27.

Critical evaluation and recalculation of current systematic reviews with meta-analysis on the effects of acute and chronic stretching on passive properties and passive peak torque

Konstantin Warneke  1   2 , Lars Hubertus Lohmann  3 , Gerit Plöschberger  4   5 , Andreas Konrad  4
Affiliations

Critical evaluation and recalculation of current systematic reviews with meta-analysis on the effects of acute and chronic stretching on passive properties and passive peak torque

Konstantin Warneke et al. Eur J Appl Physiol. 2024 Nov.

Abstract

Purpose: Muscle, tendon, and muscle-tendon unit (MTU) stiffness as well as passive peak torque (PPT) or delayed stretching pain sensation are typical explanatory approaches for stretching adaptations. However, in literature, differences in the study inclusion, as well as applying meta-analytical models without accounting for intrastudy dependency of multiple and heteroscedasticity of data bias the current evidence. Furthermore, most of the recent analyses neglected to investigate PPT adaptations and further moderators.

Methods: The presented review used the recommended meta-analytical calculation method to investigate the effects of stretching on stiffness as well as on passive torque parameters using subgroup analyses for stretching types, stretching duration, and supervision.

Results: Chronic stretching reduced muscle stiffness ( - 0.38, p = 0.01) overall, and also for the supervised ( - 0.49, p = 0.004) and long static stretching interventions ( - 0.61, p < 0.001), while the unsupervised and short duration subgroups did not reach the level of significance (p = 0.21, 0.29). No effects were observed for tendon stiffness or for subgroups (e.g., long-stretching durations). Chronic PPT (0.55, p = 0.005) in end ROM increased. Only long-stretching durations sufficiently decreased muscle stiffness acutely. No effects could be observed for acute PPT.

Conclusion: While partially in accordance with previous literature, the results underline the relevance of long-stretching durations when inducing changes in passive properties. Only four acute PPT in end ROM studies were eligible, while a large number were excluded as they provided mathematical models and/or lacked control conditions, calling for further randomized controlled trials on acute PPT effects.

Keywords: Muscle stiffness; Muscle–tendon unit; Pain threshold; Passive resistance; Stretching pain; Tendon stiffness.

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Conflict of interest statement

No author has financial or any other conflicts of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow chart to illustrate the systematic literature search
Fig. 2
Fig. 2
Forest plot for chronic supervised stretching effects on muscle stiffness (excluding the ND subgroup from Andrade still results in an ES:  – 0.55 ( – 0.996 to  – 0.11), p = 0.02, from 6 studies and 15 outcomes), MD muscle directed, ND nerve directed
Fig. 3
Fig. 3
Graphical illustration of the results and underlying mechanisms
See this image and copyright information in PMC

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