Does Prophylactic Stretching Reduce the Occurrence of Exercise-Associated Muscle Cramping? A Critically Appraised Topic.

IF 1.3 4区 医学 Q3 REHABILITATION
Journal of Sport Rehabilitation Pub Date : 2023-09-27 Print Date: 2024-01-01 DOI:10.1123/jsr.2022-0374
John W Evers-Smith, Kevin C Miller
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引用次数: 0

Abstract

Clinical scenario: Exercise-associated muscle cramps (EAMC) are sudden, painful, and involuntary contractions of skeletal muscles during or after physical activity. The best treatment for EAMC is gentle static stretching until abatement. Stretching is theorized to relieve EAMC by normalizing alpha motor neuron control, specifically by increasing Golgi tendon organ activity, and physically separating contractile proteins. However, it is unclear if stretching or flexibility training prevents EAMC via the same mechanisms. Despite this, many clinicians believe prophylactic stretching prevents EAMC occurrence.

Clinical question: Do athletes who experience EAMC during athletic activities perform less prophylactic stretching or flexibility training than athletes who do not develop EAMC during competitions?

Summary of key findings: In 3 cohort studies and 1 case-control study, greater preevent muscle flexibility, stretching, or flexibility training (ie, duration, frequency) was not predictive of who developed EAMC during competition. In one study, athletes who developed EAMC actually stretched more often and 9 times longer (9.8 [23.8] min/wk) than noncrampers (1.1 [2.5] min/wk).

Clinical bottom line: There is minimal evidence that the frequency or duration of prophylactic stretching or flexibility training predicts which athletes developed EAMC during competition. To more effectively prevent EAMC, clinicians should identify athletes' unique intrinsic and extrinsic risk factors and target those risk factors with interventions.

Strength of recommendation: Minimal evidence from 3 prospective cohort studies and 1 case-control study (mostly level 3 studies) that suggests prophylactic stretching or flexibility training can predict which athletes develop EAMC during athletic competitions.

预防性拉伸能减少运动相关肌肉痉挛的发生吗?经过批判性评价的主题。
临床情况:运动相关肌肉痉挛(EAMC)是指在体育活动期间或之后骨骼肌突然、疼痛和不自主的收缩。EAMC的最佳治疗方法是轻柔的静态拉伸,直至缓解。理论上,拉伸可以通过使α运动神经元控制正常化来缓解EAMC,特别是通过增加高尔基肌腱器官活性和物理分离收缩蛋白。然而,目前尚不清楚拉伸或柔韧性训练是否通过同样的机制阻止EAMC。尽管如此,许多临床医生认为预防性拉伸可以预防EAMC的发生。临床问题:在体育活动中经历EAMC的运动员是否比在比赛中没有发生EAMC的选手进行更少的预防性拉伸或灵活性训练?关键研究结果总结:在3项队列研究和1项病例对照研究中,更大的事前肌肉灵活性、拉伸或灵活性训练(即持续时间、频率)不能预测谁在比赛中患上EAMC。在一项研究中,患EAMC的运动员实际上比非运动员(1.1[2.5]分钟/周)伸展得更频繁,时间更长9倍(9.8[23.8]分钟/星期)。临床底线:很少有证据表明,预防性伸展或柔韧性训练的频率或持续时间可以预测哪些运动员在比赛中患EAMC。为了更有效地预防EAMC,临床医生应该识别运动员独特的内在和外在风险因素,并针对这些风险因素进行干预。推荐理由:来自3项前瞻性队列研究和1项病例对照研究(主要是3级研究)的最低证据表明,预防性拉伸或柔韧性训练可以预测哪些运动员在体育比赛中患EAMC。
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来源期刊
Journal of Sport Rehabilitation
Journal of Sport Rehabilitation 医学-康复医学
CiteScore
3.20
自引率
5.90%
发文量
143
审稿时长
>12 weeks
期刊介绍: The Journal of Sport Rehabilitation (JSR) is your source for the latest peer-reviewed research in the field of sport rehabilitation. All members of the sports-medicine team will benefit from the wealth of important information in each issue. JSR is completely devoted to the rehabilitation of sport and exercise injuries, regardless of the age, gender, sport ability, level of fitness, or health status of the participant. JSR publishes peer-reviewed original research, systematic reviews/meta-analyses, critically appraised topics (CATs), case studies/series, and technical reports that directly affect the management and rehabilitation of injuries incurred during sport-related activities, irrespective of the individual’s age, gender, sport ability, level of fitness, or health status. The journal is intended to provide an international, multidisciplinary forum to serve the needs of all members of the sports medicine team, including athletic trainers/therapists, sport physical therapists/physiotherapists, sports medicine physicians, and other health care and medical professionals.
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