Sports Medicine ( IF 9.3 ) Pub Date : 2023-01-31 , DOI: 10.1007/s40279-022-01806-9 Fabian Arntz 1 , Adrian Markov 2 , David G Behm 3 , Martin Behrens 4, 5 , Yassine Negra 6 , Masatoshi Nakamura 7 , Jason Moran 8 , Helmi Chaabene 2, 9
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Background
The current literature on the chronic effects of static stretching (SS) exercises on muscle strength and power is unclear and controversial.
Objective
We aimed to examine the chronic effects of SS exercises on muscle strength and power as well as flexibility in healthy individuals across the lifespan.
Design
Systematic review with meta-analysis of (randomized) controlled trials.
Data Sources
A systematic literature search was conducted in the databases PubMed, Web of Science, Cochrane Library, and SPORTDiscus up to May 2022.
Eligibility Criteria for Selecting Studies
We included studies that investigated the chronic effects of SS exercises on at least one muscle strength and power outcome compared to an active/passive control group or the contralateral leg (i.e., using between- or within-study designs, respectively) in healthy individuals, irrespective of age, sex, and training status.
Results
The main findings of 41 studies indicated trivial-to-small positive effects of chronic SS exercises on muscle strength (standardized mean difference [SMD] = 0.21, [95% confidence interval 0.10–0.32], p = 0.001) and power (SMD = 0.19, 95% confidence interval 0.12–0.26], p < 0.001). For flexibility, moderate-to-large increases were observed (SMD = 0.96, [95% confidence interval 0.70–1.22], p < 0.001). Subgroup analyses, taking the participants’ training status into account, revealed a larger muscle strength improvement for sedentary (SMD = 0.58, p < 0.001) compared with recreationally active participants (SMD = 0.16, p = 0.029). Additionally, larger flexibility gains were observed following passive (SMD = 0.97, p < 0.001) compared with active SS exercises (SMD = 0.59, p = 0.001). The chronic effects of SS on muscle strength were moderated by the proportion of female individuals in the sample (β = 0.004, p = 0.042), with higher proportions experiencing larger gains. Other moderating variables included mean age (β = 0.011, p < 0.001), with older individuals showing larger muscle strength gains, and the number of repetitions per stretching exercise and session (β = 0.023, p = 0.004 and β = 0.013, p = 0.008, respectively), with more repetitions associated with larger muscle strength improvements. Muscle power was also moderated by mean age (β = 0.006, p = 0.007) with larger gains in older individuals. The meta-regression analysis indicated larger flexibility gains with more repetitions per session (β = 0.094, p = 0.016), more time under stretching per session (β = 0.090, p = 0.026), and more total time under stretching (β = 0.078, p = 0.034).
Conclusions
The main findings indicated that chronic SS exercises have the potential to improve muscle strength and power. Such improvements appear to benefit sedentary more than recreationally active participants. Likewise, chronic SS exercises result in a marked enhancement in flexibility with larger effects of passive, as compared with active, SS. The results of the meta-regression analysis for muscle strength indicated larger benefits of chronic SS exercises in samples with higher proportions of female, older participants, and a higher number of repetitions per stretching exercise and session. For muscle power, results suggested larger gains for older participants. Regarding flexibility, findings indicated larger benefits following a higher number of repetitions per exercise and a longer time under stretching per session as well as a longer total time under stretching.
中文翻译：
静态伸展运动对健康个体一生中肌肉力量和力量的慢性影响：多层次荟萃分析的系统评价
背景
目前关于静态拉伸（SS）练习对肌肉力量和力量的慢性影响的文献尚不清楚且存在争议。
客观的
我们的目的是研究 SS 练习对健康个体一生中肌肉力量和力量以及灵活性的长期影响。
设计
对（随机）对照试验进行荟萃分析的系统评价。
数据来源
截至 2022 年 5 月，我们在 PubMed、Web of Science、Cochrane Library 和 SPORTDiscus 数据库中进行了系统文献检索。
选择研究的资格标准
我们纳入的研究调查了健康个体中与主动/被动对照组或对侧腿（即分别使用研究间或研究内设计）相比，SS 练习对至少一种肌肉力量和力量结果的慢性影响，不论年龄、性别和训练状况。
结果
41 项研究的主要结果表明，长期 SS 锻炼对肌肉力量（标准化平均差 [SMD] = 0.21，[95% 置信区间 0.10–0.32]， p = 0.001）和功率（SMD = 0.19，95% 置信区间 0.12–0.26]， p < 0.001）。就灵活性而言，观察到中等到大幅增加（SMD = 0.96，[95% 置信区间 0.70–1.22]， p < 0.001）。考虑到参与者的训练状态，亚组分析显示，与休闲活动的参与者（SMD = 0.16， p = 0.029）相比，久坐的参与者（SMD = 0.58， p < 0.001）的肌肉力量改善更大。此外，与主动 SS 练习（SMD = 0.59， p = 0.001）相比，被动练习（SMD = 0.97， p < 0.001）后观察到更大的灵活性增益。 SS 对肌肉力量的慢性影响受到样本中女性个体比例的调节（ β = 0.004， p = 0.042），比例越高，获得的收益就越大。其他调节变量包括平均年龄（ β = 0.011， p < 0.001），年龄较大的个体显示出更大的肌肉力量增益，以及每次伸展运动和训练的重复次数（ β = 0.023， p = 0.004 和β = 0.013， p = 0.008，分别），更多的重复次数与更大的肌肉力量改善相关。肌肉力量也受到平均年龄的影响（ β =0.006， p =0.007），年龄较大的个体获得的肌肉力量更大。元回归分析表明，每次训练的重复次数越多，灵活性增益就越大（ β = 0.094， p = 0。016），每次拉伸的时间更长（ β = 0.090， p = 0.026），拉伸的总时间更长（ β = 0.078， p = 0.034）。
结论
主要研究结果表明，长期 SS 练习有可能提高肌肉力量和爆发力。这些改进似乎对久坐的参与者比休闲活跃的参与者更有利。同样，与主动 SS 相比，长期 SS 练习会导致灵活性显着增强，被动 SS 的效果更大。肌肉力量元回归分析的结果表明，在女性、老年参与者比例较高、每次伸展运动和训练的重复次数较多的样本中，长期 SS 运动具有更大的益处。对于肌肉力量，结果表明老年参与者的肌肉力量增长更大。关于灵活性，研究结果表明，每次锻炼的重复次数越多、每次拉伸的时间越长以及拉伸的总时间越长，好处就越大。
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