Neural mobilization (NM) refers to a therapeutic interventions that aim to directly or indirectly influence neural structures and adjacent tissues through manual techniques or exercise. The application of NM has been investigated in both patients and healthy individuals. In this study, participants from an amateur football team will be allocated into three groups, each undergoing pre-training warm-up protocols incorporating NM, dynamic stretching, or static stretching. Following the warm-up protocols, the effects on flexibility and athletic performance will be evaluated and compared across the groups.
Neural mobilization (NM) is an intervention that involves manual techniques or exercises designed to affect neural structures and surrounding tissues. It aims to restore normal neural mechanical and physiological responses to movement and posture by facilitating the sliding and tension of the nerves. NM techniques can be divided into two groups: gliding, which involves different joint movements, and tension, which extends the nerves in more than one joint. Although NM has been linked to various neurophysiological benefits, the precise mechanisms underlying its clinical efficacy remain uncertain. The peripheral nervous system demonstrates the ability to adapt to changing mechanical forces encountered during daily activities and sports through nerve gliding and sliding mechanisms. Impaired gliding may result in increased neural stress and ischemic damage, affecting neural function. NM has been shown to improve lower extremity flexibility, which is crucial for enhancing functionality and minimizing injury risk in athletes. Neurodynamic techniques are frequently used to increase hamstring flexibility and reduce neural mechanosensitivity, contributing positively to athletic performance and injury prevention. The aim of this study is to examine the comparative effects of static stretching, dynamic stretching and neural mobilization techniques used in pre-training warm-up sessions on flexibility and performance in collegiate football players.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
40
Femoral nerve gliding: Mobilization of the femoral nerve will performed while the participant in the prone position and the hip hyperextended. Tension will applied by placing the knee in full flexion and the ankle in plantar flexion. Sciatic nerve gliding: Participants will take turns while sitting with the trunk in thoracic flexion; perform knee extension/dorsiflexion with cervical extension and knee flexion/plantar flexion with cervical flexion. Tension will applied by flexing the hip and dorsiflexing the ankle to the point where stress will felt. Peroneal nerve gliding: The participant will asked to maintain this position in a supine position by placing the ankle in inversion and plantar flexion. From a starting position consisting of ankle dorsiflexion, knee, and hip extension, the patient will return to the starting position by simultaneously performing ankle plantar flexion and inversion, full knee flexion, and 90 degrees of hip flexion.
Exercises will include functional activities that provided dynamic stretching of the hamstrings, quadriceps, hip flexor, extensor, abductor and adductor muscles, and gastrosoleus muscle. All stretching exercises will be performed in two circuits in an area of 15 m2. 4 sets of 10 repetitions will be performed, each exercise cycle lasting 6 seconds, and a 1-minute rest period will be given between sets. This process will be repeated for both extremities.
Static stretching exercises will be described to the participants as given below: Standing quadriceps stretch: The participant will stand upright, fold one knee and bring the heel towards the buttock while holding the foot with one hand. Modified hamstring stretching: The participant will be in a seated position with one leg straight and will place the other foot on the inside of the straight leg and reach forward. Gastrocnemius stretching: The participant stands with feet 60-90 cm from the wall, leaning against the wall with both hands, keeping the back leg straight and the front leg slightly bent. Adductor stretching: Participants will be in a sitting position with an erect spine, bending and releasing their knees with the soles of their feet touching. Lumbar stretching: In a sitting position, participants keep one leg straight and place the other foot on the outside of the straight leg and rotate the body diagonally.
Istanbul Medipol University
Istanbul, Turkey (Türkiye)
Straight Leg Raise Test
The passive straight leg raise test will be used to determine changes in the flexibility of the hamstring muscle. With the participant in the supine position, the lateral condyle of the femur, fibular head, and fibular malleolus will be identified. The axis of a goniometer will be placed over the protrusion of the greater trochanter of the femur. One of the arms of the goniometer will be placed parallel to the table. The knee and ankle will be kept in the extension position. By holding the talus and without rotating the hip, flexion of the hip will be gradually increased. Participants' lower extremities will be elevated until they complain of pain in the rear thigh area. Care will be taken to ensure that they do not bend their knees and that the pelvis is not in retroversion. Then, the other arm of the goniometer will be placed in the direction of the line between the head of the fibula and the fibular malleolus and the degree of height of the straight leg will be noted.
Time frame: From pre-interventional time to post-interventional about an hour
Y Balance Test
Participants will stand on the foot plate in the center of the Y Balance Test area. Participants will be instructed to maintain a single-leg stance while reaching as far as possible with the opposite leg and return to the starting position on the middle platform without losing balance. In the test, participants will be allowed 3 attempts for both lower extremities and will be asked to reach the maximum distance in 3 directions anterior, posteromedial and posterolateral. The maximum reach distance will be recorded for each consecutive attempt.
Time frame: From pre-interventional time to post-interventional about an hour
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