Is Stretching Effective for Reducing Glenohumeral Internal Rotation Deficit? A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Search Strategy
2.3. Eligibility Criteria
2.4. Data Extraction
2.5. Methodological Quality
2.6. Data Synthesis and Analysis
2.7. Certainty of Evidence
3. Results
3.1. Characteristics of the Included Studies
3.2. Methodological Quality
3.3. Synthesis of the Results
3.3.1. Stretching versus Control
3.3.2. Stretching Plus Manual Therapy versus Stretching in Isolation
3.3.3. Stretching versus Stretching
4. Discussion
4.1. Stretching versus Control
4.2. Stretching Plus Manual Therapy versus Stretching in Isolation
4.3. Stretching versus Stretching
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Search Strategy Used in Each Database
- MEDLINE
- (Athletes [MeSH] OR “Upper extremity” OR “young adult” OR handball OR volleyball OR baseball OR waterpolo OR swimmer OR overhead) AND (“rotator cuff tendinopathy” OR “rotator cuff related pain” OR “impingement syndrome” OR “shoulder impingement” OR “non-specific shoulder pain” OR “joint instability” OR “athletic injuries” OR “shoulder injuries” OR “shoulder pain” OR “GIRD” OR “glenohumeral internal rotation deficit”) AND (physical therapy modalities [MeSH] OR exercise [MeSH] OR stretching OR sleeper OR “cross-body stretch” OR “manual therapy” OR “physical therapy” OR physiotherapy) AND (pain [MeSH] OR range of motion [MeSH] OR internal rotation OR “posterior stiffness”)
- Date: 01-02-2024
- Studies retrieved: 244
- PEDro
- Athletes AND overhead
- Date: 1 February 2024
- Studies retrieved: 32
- Glenohumeral internal rotation deficit
- Date: 1 February 2024
- Studies retrieved: 12 (all duplicates)
- Cochrane Library
- (Athletes OR “Upper extremity” OR “young adult” OR handball OR volleyball OR baseball OR waterpolo OR swimmer OR overhead) AND (“rotator cuff tendinopathy” OR “rotator cuff related pain” OR “impingement syndrome” OR “shoulder impingement” OR “non-specific shoulder pain” OR “joint instability” OR “athletic injuries” OR “shoulder injuries” OR “shoulder pain” OR “GIRD” OR “glenohumeral internal rotation deficit”) AND (physical therapy modalities OR exercise OR stretching OR sleeper OR “cross-body stretch” OR “manual therapy” OR “physical therapy” OR physiotherapy) AND (pain OR range of motion OR internal rotation OR “posterior stiffness”)
- Date: 1 February 2024
- Studies retrieved: 624
- Web of Science
- ((((TS = (athletes OR handball OR volleyball OR baseball OR waterpolo OR swimmer OR overhead)) AND TS = (rotator cuff tendinopathy OR rotator cuff related pain OR impingement syndrome OR shoulder impingement OR non-specific shoulder pain OR joint instability OR athletic injuries OR shoulder injuries OR shoulder pain OR GIRD OR glenohumeral internal rotation deficit)) AND TS = (stretching OR sleeper OR cross-body stretch OR manual therapy OR physical therapy OR physiotherapy)) AND TS = (pain OR range of motion OR internal rotation OR posterior stiffness)) AND TS = (clinical trial OR randomized controlled trial OR randomized controlled clinical trial OR randomised controlled trial OR randomised controlled clinical trial)
- Date: 1 February 2024
- Studies retrieved: 268
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Author | Age | Sport | GIRD | EG | CG | Session Duration | Sessions/Week | Total n° of Sessions | Outcome Variables (Tool) | Main Results |
---|---|---|---|---|---|---|---|---|---|---|
Stretching vs. control | ||||||||||
Lo et al., 2021 [38] | EG: 20.51 (1.18) CG: 20.90 (1.45) | Baseball | 10% decrease in total ROM | Sleeper stretch (n = 10) | Control (n = 10) | 5 reps. 30 s each | 1 | 1 | ROM
| ↑ ND ↑ |
Chepeha et al., 2017 [39] | 20.51 (1.18) | Volleyball Tennis Swimming | >15° | Sleeper stretch (n = 20) | Control (n = 17) | 5 reps. 2 min each | 7 | 56 8 sem | ROM
| ↑ ↑ ND |
Yu et al., 2017 [40] | EG: 17.25 (1.35) CG: 16.90 (1.52) | baseball | >15° | Sleeper stretch + standard care (n = 12) | Standard care (n = 12) | 3 reps. 30 s each | 3 | 18 6 sem | ROM
| ↑ ↑ ND |
Park et al., 2014 [43] | EG: 23.3 (2.0) CG: 23.3 (2.0) | No data | >10° | Cross-body stretch (n = 29) | Control (n = 29) | 6 reps. 30 s each | 1 | 1 | ROM
| ↑ ↑ |
Maenhout et al., 2012 [42] | EG: 21.4 (2.5) CG: 21.1 (2.2) | Volleyball Tennis Waterpolo Squash badminton | >15° | Sleeper stretch (n = 30) | Control (n = 32) | 3 reps. 30 s each | 7 | 42 6 weeks | ROM
| ↑ ND ↑ |
Moore et al., 2011 A [41] | EG: 19.5 (1.0) CG: 19.8 (1.1) | Baseball | <8° in total ROM | Cross-body stretch (n = 19) | Control (n = 20) | 3 reps. 2 min in total | 1 | 1 | ROM
| ↑ ↑ |
Moore et al., 2011 B [41] | EG: 20.4 (1.1) CG: 19.8 (1.1) | Baseball | <8° in total ROM | Sleeper stretch (n = 22) | Control (n = 20) | 3 reps. 2 min in total | 1 | 1 | ROM
| ND ND |
McClure et al., 2007 A [44] | EG: 23.5 (1.7) CG: 23.5 (1.8) | No data | >10° | Sleeper stretch (n = 15) | Control (n = 24) | 5 reps. 30 s each. | 1 | 28 4 weeks | ROM
| ↑ ND |
McClure et al., 2007 B [44] | EG: 22.9 (1.5) CG: 23.5 (1.8) | No data | >10° | Cross-body stretch (n = 15) | Control (n = 24) | 5 reps. 30 s each. | 1 | 28 4 weeks | ROM
| ↑ ND |
Stretching plus manual therapy vs. stretching in isolation | ||||||||||
Manske et al., 2010 [18] | No data | No data | >10° | GH dorsal glide + cross-body stretch (n = 19) | Cross-body stretch (n = 20) | Stretching: 5 reps. 30 s each Dorsal glide: 10 min | Stretching 3–4 Manual therapy 2–3 | 4 weeks | ROM
| ND ND |
Fairall et al., 2017 [21] | 36.9 (11.1) | Softball | >20° | Myofascial release + sleeper and cross-body stretch (n = 4) | sleeper and cross-body stretch (n = 4) | Stretching: 3 reps. 30 s each Myofascial release: 2 reps. 60 s each | 1 | 1 | ROM
| ND |
Bailey et al., 2017 [22] | EG: 18.8 (2.6) CG: 18.6 (2.1) | Baseball | >15° | Manual therapy + stretching (sleeper and cross-body stretch) (n = 30) | Stretching (sleeper and cross-body stretch) (n = 30) | Stretching: 2 reps. 1 min each Manual therapy: friction in teres minor and infraspinatus | 1 | 1 | ROM
| ↑ ↑ ↑ |
Kang et al., 2020 [17] | EG: 22.2 (2.7) CG: 22.4 (2.3) | No data | >10° | GH dorsal glide + cross-body stretch (n = 20) | Cross-body stretch (n = 20) | 2 reps. 30 s each | 1 | 1 | ROM
| ↑ ↑ |
Kamali et al., 2021 [16] | EG: 21.26 (2.98) CG: 23.40 (4.79) | Volleyball | >15° | GH dorsal glide + stretching (sleeper and cross-body stretch) (n = 15) | Stretching (sleeper and cross-body stretch) (n = 15) | Stretching: 5 reps. 30 s each Mobilization: 3 sets of 10 reps | 3 | 3 | ROM
| ND ND |
Stretching vs. stretching | ||||||||||
Mcclure et al., 2007 [44] | EG: 23.5 (1.7) CG: 22.9 (1.5) | No data | >10° | Sleeper stretch (n = 15) | Cross-body stretch (n = 15) | 5 reps. 30 s each | 7 | 28 4 weeks | ROM
| ND |
Cools et al., 2011 A [45] | 24.5 (7.8) | Volleyball Tennis Squash Badminton | 20° | Sleeper and cross-body stretch (n = 15) | Dorsal and caudal gliding (n = 15) | 15 m | 3 | 9 3 weeks | ROM
| ND |
Cools et al., 2011 B [45] | 25.4 (6.7) | Volleyball Tennis Squash Badminton | 20° | Sleeper and cross-body stretch (n = 15) | Dorsal and caudal gliding (n = 15) | 15 m | 3 | 9 3 weeks | ROM
| ND |
Salamh et al., 2014 [46] | EG: 16.1 (1.2) CG: 16.5 (1.5) | Volleyball | >10° | Cross-body stretch with manual stabilization (n = 30) | Cross-body stretch (n = 30) | 2 reps. 30 s each | 1 | 1 | ROM
| ↑ ↑ |
Guney et al., 2015 A [47] | EG: 23.8 (1.7) CG: 24.1 (4.1) | No data | >18° | Sleeper stretch (n = 24) | Cross-body stretch (n = 23) | 3 reps. 30 s each | 7 | 1 | ROM
| ND ND ND |
Guney et al., 2015 B [47] | EG: 23.9 (1.5) CG: 24.1 (4.1) | No data | >18° | Cross-body stretch with manual stabilization (n = 24) | Cross-body stretch (n = 23) | 3 reps. 30 s each | 7 | 1 | ROM
| ↑ ↑ ↑ |
Gharisia et al., 2021 [48] | EG: 26.0 (2.5) CG: 25.9 (2.6) | Volleyball Tennis Waterpolo Squash Baseball Swimming | 15.6 (5.5) | Sleeper stretch (n = 20) | Passive Internal rotation with clam shell bridging (n = 20) | 3 reps. 30 s each | 3 | 12 4 weeks | ROM
| ND ↑ CG vs. EG |
Author | Items | Total | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | ||
Stretching vs. control | ||||||||||||
Lo et al., 2021 [38] | Y | Y | N | Y | N | N | N | Y | Y | Y | Y | 6/10 |
Chepeha et al., 2018 [39] | Y | Y | N | Y | N | N | Y | Y | N | Y | Y | 6/10 |
Yu et al., 2017 [40] | N | Y | Y | Y | N | N | N | Y | Y | Y | Y | 7/10 |
Park et al., 2014 [43] | Y | Y | N | N | N | N | Y | N | N | Y | N | 3/10 |
Maenhout et al., 2012 [42] | N | Y | N | Y | N | N | N | N | N | Y | Y | 4/10 |
Moore et al., 2011 [41] | Y | Y | N | Y | N | N | Y | Y | N | Y | Y | 6/10 |
Stretching plus manual therapy vs. stretching in isolation | ||||||||||||
Manske et al., 2010 [18] | N | Y | N | Y | N | N | Y | Y | N | Y | Y | 6/10 |
Fairall et al., 2017 [21] | Y | N | N | Y | N | N | N | Y | Y | N | Y | 4/10 |
Baley et al., 2017 [22] | N | Y | N | Y | N | N | N | Y | N | Y | Y | 5/10 |
Kang et al., 2020 [17] | Y | Y | Y | Y | N | N | N | Y | Y | Y | Y | 7/10 |
Kamali et al., 2021 [16] | Y | Y | Y | N | N | Y | Y | Y | Y | Y | Y | 8/10 |
Stretching vs. stretching | ||||||||||||
Mcclure et al., 2007 [44] | Y | Y | N | Y | N | N | Y | Y | N | Y | Y | 6/10 |
Cools et al., 2011 [45] | Y | Y | N | Y | N | N | N | N | N | Y | Y | 4/10 |
Salamh et al., 2014 [46] | Y | Y | N | Y | N | N | Y | N | N | Y | Y | 5/10 |
Guney et al., 2015 [47] | Y | Y | Y | Y | N | N | Y | Y | Y | Y | Y | 8/10 |
Gharisia et al., 2021 [48] | Y | Y | Y | Y | N | N | Y | Y | Y | Y | Y | 8/10 |
Outcome | No. of Studies (Participants) | Risk of Bias | Inconsistency | Indirectness | Imprecision | Certainty of Evidence |
---|---|---|---|---|---|---|
Stretching vs. control | ||||||
IR ROM | 6 (258) | Very serious a | Very serious c | Serious e | None | Very low |
HA ROM | 4 (180) | Very serious a | Very serious c | Serious e | Serious f | Very low |
ER ROM | 2 (82) | Very serious a | Very serious c | Serious e | Serious f | Very low |
Pain | 2 (61) | serious b | None | Serious e | Serious f | Very low |
Dorsal gliding + stretching vs. stretching | ||||||
IR ROM | 3 (109) | serious b | None | Serious e | Serious f | Very low |
ER ROM | 2 (69) | serious b | None | Serious e | Serious f | Very low |
Soft-tissue therapy + stretching vs. stretching | ||||||
IR ROM | 2 (68) | Very serious a | Very serious c | Serious e | Serious f | Very low |
Cross-body stretch + stabilization vs. cross-body stretch | ||||||
IR ROM | 2 (107) | serious b | serious d | None | Serious f | Very low |
Sleeper stretch vs. cross-body stretch | ||||||
IR ROM | 2 (77) | serious b | Very serious c | None | Serious f | Very low |
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Ceballos-Laita, L.; Robles-Pérez, R.; Carrasco-Uribarren, A.; Cabanillas-Barea, S.; Pérez-Guillén, S.; Greidane, E.; Jiménez-del-Barrio, S. Is Stretching Effective for Reducing Glenohumeral Internal Rotation Deficit? A Systematic Review and Meta-Analysis. Appl. Sci. 2024, 14, 7166. https://doi.org/10.3390/app14167166
Ceballos-Laita L, Robles-Pérez R, Carrasco-Uribarren A, Cabanillas-Barea S, Pérez-Guillén S, Greidane E, Jiménez-del-Barrio S. Is Stretching Effective for Reducing Glenohumeral Internal Rotation Deficit? A Systematic Review and Meta-Analysis. Applied Sciences. 2024; 14(16):7166. https://doi.org/10.3390/app14167166
Chicago/Turabian StyleCeballos-Laita, Luis, Román Robles-Pérez, Andoni Carrasco-Uribarren, Sara Cabanillas-Barea, Silvia Pérez-Guillén, Evita Greidane, and Sandra Jiménez-del-Barrio. 2024. "Is Stretching Effective for Reducing Glenohumeral Internal Rotation Deficit? A Systematic Review and Meta-Analysis" Applied Sciences 14, no. 16: 7166. https://doi.org/10.3390/app14167166