PDF(Pubmed)
Abstract：
BACKGROUND: Abnormal posture (e.g. loss of lordosis) has been associated with the occurrence of musculoskeletal pain. Stretching tight muscles while strengthening the antagonists represents the most common method to treat the assumed muscle imbalance. However, despite its high popularity, there is no quantitative synthesis of the available evidence examining the effectiveness of the stretch-and-strengthen approach.
METHODS: A systematic review with meta-analysis was conducted, searching PubMed, Web of Science and Google Scholar. We included controlled clinical trials investigating the effects of stretching or strengthening on spinal and lumbopelvic posture (e.g., pelvic tilt, lumbar lordosis, thoracic kyphosis, head tilt) in healthy individuals. Effect sizes were pooled using robust variance estimation. To rate the certainty about the evidence, the GRADE approach was applied.
RESULTS: A total of 23 studies with 969 participants were identified. Neither acute (d = 0.01, p = 0.97) nor chronic stretching (d=-0.19, p = 0.16) had an impact on posture. Chronic strengthening was associated with large improvements (d=-0.83, p = 0.01), but no study examined acute effects. Strengthening was superior (d = 0.81, p = 0.004) to stretching. Sub-analyses found strengthening to be effective in the thoracic and cervical spine (d=-1.04, p = 0.005) but not in the lumbar and lumbopelvic region (d=-0.23, p = 0.25). Stretching was ineffective in all locations (p > 0.05).
CONCLUSIONS: Moderate-certainty evidence does not support the use of stretching as a treatment of muscle imbalance. In contrast, therapists should focus on strengthening programs targeting weakened muscles.
METHODS: A systematic review with meta-analysis was conducted, searching PubMed, Web of Science and Google Scholar. We included controlled clinical trials investigating the effects of stretching or strengthening on spinal and lumbopelvic posture (e.g., pelvic tilt, lumbar lordosis, thoracic kyphosis, head tilt) in healthy individuals. Effect sizes were pooled using robust variance estimation. To rate the certainty about the evidence, the GRADE approach was applied.
RESULTS: A total of 23 studies with 969 participants were identified. Neither acute (d = 0.01, p = 0.97) nor chronic stretching (d=-0.19, p = 0.16) had an impact on posture. Chronic strengthening was associated with large improvements (d=-0.83, p = 0.01), but no study examined acute effects. Strengthening was superior (d = 0.81, p = 0.004) to stretching. Sub-analyses found strengthening to be effective in the thoracic and cervical spine (d=-1.04, p = 0.005) but not in the lumbar and lumbopelvic region (d=-0.23, p = 0.25). Stretching was ineffective in all locations (p > 0.05).
CONCLUSIONS: Moderate-certainty evidence does not support the use of stretching as a treatment of muscle imbalance. In contrast, therapists should focus on strengthening programs targeting weakened muscles.
摘要：
背景：异常姿势（例如前凸丧失）与肌肉骨骼疼痛的发生有关。在增强拮抗剂的同时拉伸紧绷的肌肉代表了治疗假定的肌肉失衡的最常见方法。然而,尽管它很受欢迎，没有对现有证据进行定量综合，以检查拉伸和强化方法的有效性。
方法：进行了荟萃分析的系统评价，搜索PubMed,WebofScience和谷歌学者。我们纳入了对照临床试验，研究了伸展或加强对脊柱和腰骨盆姿势的影响（例如，骨盆倾斜,腰椎前凸,胸椎后凸,头部倾斜)在健康的个体中。使用稳健的方差估计合并效应大小。为了评估证据的确定性，采用了等级制度。
结果：共确定了23项研究，969名参与者。急性（d=0.01，p=0.97）和慢性拉伸（d=-0.19，p=0.16）均不会对姿势产生影响。慢性强化与大的改善相关(d=-0.83,p=0.01),但没有研究检查急性效应。强化优于拉伸（d=0.81，p=0.004）。子分析发现，加强对胸椎和颈椎有效（d=-1.04，p=0.005），但对腰椎和腰盆腔区域无效（d=-0.23，p=0.25）。拉伸在所有位置无效(p>0.05)。
结论：中度确定性证据不支持使用拉伸治疗肌肉失衡。相比之下,治疗师应该专注于加强针对虚弱肌肉的计划。
方法：进行了荟萃分析的系统评价，搜索PubMed,WebofScience和谷歌学者。我们纳入了对照临床试验，研究了伸展或加强对脊柱和腰骨盆姿势的影响（例如，骨盆倾斜,腰椎前凸,胸椎后凸,头部倾斜)在健康的个体中。使用稳健的方差估计合并效应大小。为了评估证据的确定性，采用了等级制度。
结果：共确定了23项研究，969名参与者。急性（d=0.01，p=0.97）和慢性拉伸（d=-0.19，p=0.16）均不会对姿势产生影响。慢性强化与大的改善相关(d=-0.83,p=0.01),但没有研究检查急性效应。强化优于拉伸（d=0.81，p=0.004）。子分析发现，加强对胸椎和颈椎有效（d=-1.04，p=0.005），但对腰椎和腰盆腔区域无效（d=-0.23，p=0.25）。拉伸在所有位置无效(p>0.05)。
结论：中度确定性证据不支持使用拉伸治疗肌肉失衡。相比之下,治疗师应该专注于加强针对虚弱肌肉的计划。
