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mance. The purpose of this study was to assess the effect of
a novel self-administered proprioceptive neuromuscular facili- lexibility is an important physical quality in a num-
tation (PNF) paradigm with short periods of stretching and ber of sports such as gymnastics, figure skating, syn-
contraction on quadriceps neuromuscular function, vertical chronized swimming, ice hockey (goalie), some
martial art postures, dance, and other activities
jump performance, and articular range of motion (ROM).
(16). Nevertheless, the potential benefits of good flexibility
Twelve healthy men (age: 27.7 6 7.3 years, height: 178.4 6
on sport performance are still under debate. Despite an
10.4 cm, weight: 73.8 6 16.9 kg) volunteered to participate in
improvement in articular range of motion (ROM) induced
a PNF session and a control session separated by 2–7 days. by stretching, reduced muscle force generating capacity, and
The PNF stretching lasted 2 minutes and consisted of 4 sets of sport-related performance are common findings (for a review
5-second isometric hamstring contraction immediately fol- see [3,28]). The large majority of previous studies have used
lowed by 5 seconds of passive static stretch of the quadriceps relatively long periods of static stretching (generally .90 sec-
immediately followed by 5 seconds isometric quadriceps con- onds, e.g., 3 3 30 seconds), which have been shown to acutely
traction for each leg. For the control session, the participants impair static (1,12–14,24) and dynamic (18) muscle strength,
were asked to walk at a comfortable speed for 2 minutes. vertical jump (4,15,30), and sprint performance (22). Neu-
Active ROM of knee flexion, vertical jump performance, and ral (2,9,11,13,14,24) and contractile-mechanical (8,11,13,14)
quadriceps neuromuscular function were tested before, imme- impairments have been evoked to explain the reduction in
muscle performance induced by passive stretching.
diately after, and 15 minutes after the intervention. The PNF
An alternative to pure static stretching is the combination
stretching procedure did not affect ROM, squat jump, and
of stretching with isometric contractions of the agonist and
countermovement jump performances. Accordingly, we did
antagonist muscles, that is, the so-called proprioceptive
not observe any change in maximal voluntary contraction neuromuscular facilitation (PNF). Compared with conven-
force, voluntary activation level, M-wave and twitch contractile tional stretching, PNF-induced gains in ROM have been
proposed to be partially because of Golgi tendon organ-
Address correspondence to Nicolas Place, nicolas.place@unige.ch. mediated autogenic inhibition (because of prior contraction
27(2)/463–470 of the muscle of interest) and Ia-inhibitory interneurons-
Journal of Strength and Conditioning Research mediated reciprocal inhibition (because of prior contraction
Ó 2013 National Strength and Conditioning Association of the antagonist muscle) (for a review see [26]). Similar to
Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited.
Short PNF Stretching and Quadriceps Muscle Function
pure static stretching, PNF with relatively long stretching testing sessions. The first session (;45 minutes) was used for
bouts (bout usually $30 seconds, with several repetitions and participant familiarization with the testing procedures (PNF
stretching exercises for a total stretching duration of several stretching, vertical jump techniques, voluntary and electrically
minutes) has been shown to acutely impair dynamic strength evoked contractions). The 2 experimental sessions consisted
of quadriceps muscle (20) and vertical jump performance when of testing quadriceps neuromuscular function, flexibility, and
quadriceps, hamstrings, and plantar flexors were stretched (5). vertical jump performance after a quadriceps PNF stretching
Results seem to differ when PNF uses stretches of short dura- or a walking period of similar duration (control condition).
tion; indeed, as opposed to earlier studies using several bouts of The following outcomes were considered as the dependent
static stretching $30 seconds, Murphy et al. (21) demonstrated variables: active ROM of knee flexion and hip extension,
that short-duration static stretches of 6 seconds (6 repetitions) maximal voluntary contraction (MVC) force of quadriceps
increased hamstrings ROM, countermovement jump (CMJ) and hamstring muscles, quadriceps voluntary activation level,
height, static balance, and movement time. Because short- EMG activity of quadriceps and hamstring muscles, M-wave
duration static stretching is less likely to cause functional amplitude and peak twitch of the quadriceps, CMJ, and drop
impairments than longer stretching bouts and could even result jump (DJ) performance. The 2 experimental sessions (dura-
in functional improvements (21), we hypothesize that the tion ;90 minutes) were separated by 2–7 days. Figure 1 gives
reduced stretching time would not reduce quadriceps force a schematic representation of the experimental protocol.
generating capacity and jump height together with an increase The right and left knee extensors were given a sequence of
in ROM. Thus, the purpose of this study was to examine movements which are based on PNF schemes, and consisted
the acute effect of quadriceps
PNF stretching with short
(5-second) periods of stretching
and contraction on neuromus-
cular function, vertical jump
performance, and ROM. Fur-
thermore, to determine the
mechanisms underlying the
eventual changes in perfor-
mance (jump height and
ROM), neuromuscular function
was investigated with noninva-
sive techniques based on volun-
tary and evoked contractions
combined with surface electro-
myography (EMG). The unique
aspect of this short PNF para-
digm is that subjects could
perform the PNF stretching
without the assistance of a part-
ner and thus could be time sav-
ing and costless for warming up
before training and competition.
Because athletes may have a lim-
ited time period to warm-up
(e.g., in the case of substitution
in team sports), this study will
provide information about the
potential usefulness of short-
duration PNF stretching before
exercise.
METHODS
Experimental Approach to
Figure 1. Schematic representation of the protocol. ROM = range of motion; MVC = maximal voluntary
the Problem contraction; MVC ITT = maximal voluntary contraction with the interpolated twitch technique; CMJ =
This randomized controlled countermovement jump; DJ = drop jump.
crossover study consisted of 3
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of: a 5-second isometric hamstring contraction (antagonist) per week). They were verbally informed of the procedures
immediately followed by 5 seconds of passive static stretch and read and signed an informed consent form before par-
of the quadriceps immediately followed by a 5-second ticipation. The protocol of the study was approved by the
isometric quadriceps contraction (agonist). The antagonist Ethics Committee of the University Hospital of Geneva
contraction was performed to facilitate the quadriceps (protocol 10-051). All the procedures were conducted
stretching and the sequence was terminated with a quadri- according to the Declaration of Helsinki. All the subjects
ceps contraction to potentiate the muscle, with the expec- received standard testing instructions (nutrition, hydration,
tation that this procedure would not induce any decrement sleep) verbally and written and were asked not to take part in
in jump height. Passive static stretch of the quadriceps was any demanding physical activity for 24 hours before each
performed as follows: while the subject was standing on one testing session.
leg (fully extended), the leg to be stretched was flexed at the
Procedures
knee and the subject pushed the ankle back toward the
Warm-Up. The participants performed a 5-minute sub-
buttocks until the level of discomfort for 5 seconds. Hamstring
maximal warm-up on a cycle ergometer (Fleisch, Metabo,
and quadriceps contractions were performed while the subject
Epalinges, Switzerland). They were instructed to cycle
was standing on one leg, contracting muscles of the other leg
at 70 rpm and to maintain a power output of approxi-
while pushing against a wall with the heel (for the hamstring)
mately 1 W$kg21
or the toes (for the quadriceps) reaching the level of
discomfort (vigorous contraction). The subjects were asked
to keep both legs extended during these contractions. After Pretest and Posttest. Except for vertical jumps where both legs
each 15-second PNF stretching bout, the subjects were were used, all the tests were performed on the right
instructed to stretch the other leg, and the procedure was (dominant) leg. Pretest and posttest, which were performed
repeated four times for each leg. Hence, for this modified PNF before, immediately after, and 15 minutes after the
procedure, each leg was stretched for a total duration of only intervention, consisted in the assessment of (a) active
20 seconds with 20-second contractions of the agonist and ROM, (b) neuromuscular function, and (c) vertical jump
antagonist respectively. An illustration of the PNF procedure performance (Figure 1).
is provided in Figure 2. The intervention during the control Data Collection
session consisted in a 2-minute walking period at a self- Active Range of Motion. For knee flexion active ROM
selected comfortable speed. measurement, the subject laid prone and actively flexed the
Subjects leg as far as possible without assistance from the investigator
Twelve healthy men (age: 27.7 6 7.3 years, height: 178.4 6 (20). Knee flexion angle was recorded at a sampling fre-
10.4 cm, weight: 73.8 6 16.9 kg) volunteered to participate quency of 1 kHz with an electronic goniometer (SG150,
to this randomized crossover study. All the subjects were Biometrics, Cwmfelinfach, United Kingdom) connected to
physically active (i.e., at least 2 hours of physical activity an acquisition system (MP150; Biopac, Goleta, CA, USA).
Figure 2. Pictures of the procedure used for proprioceptive neuromuscular facilitation (PNF) intervention. (A) Hamstring (antagonist) contraction followed by
(B) passive static stretch of the quadriceps followed by (C) quadriceps (agonist) contraction. Each step was sustained for 5 seconds once the level of
discomfort was reached.
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Short PNF Stretching and Quadriceps Muscle Function
The goniometer was positioned on the lateral aspect of the electrodes (Kendall Meditrace 100, Tyco, Canada), with
right knee as already described (20). Briefly, the proximal a recording diameter of 1 cm. Electrodes were positioned
arm was taped along the femur using the greater trochanter lengthwise over the middle of the muscle belly with an
as a reference, and the distal arm was aligned with the shank interelectrode (center-to-center) distance of 2 cm. The
using the lateral malleolus as a reference. Hip extension electrodes were placed at a distance of two-thirds between
active ROM was also investigated because the biarticular the anterior spina iliaca superior and the lateral femoral
rectus femoris (RF) is both a knee extensor and a hip flexor condyle for the VL, at four-fifths of the distance between the
muscle. For hip extension ROM assessment, the subjects anterior spina iliaca superior and the medial femoral condyle
were lying prone on a table. With their anterior superior iliac for the VM, midway between the anterior spina iliaca
spine in contact with the table, they attempted to lift their superior an upper border of the patella for the RF, and
leg as far as possible off the table. The vertical distance from midway between the ischial tuberosity and the lateral tibial
the table to the anterior aspect of the patella was measured condyle for the BF (23). Electrode positions were marked to
using a tape measure (24). Two trials of each stretch were ensure similar placement during the second experimental
performed at both pretest and posttest. session. The reference electrode was placed over the patella.
Low resistance between the 2 electrodes (,10 kV) was
Evoked Contractions. Electrically evoked contractions of the obtained by abrading and cleaning the skin with alcohol.
quadriceps were induced with a high-voltage (maximal voltage The EMG signals were amplified with a bandwidth fre-
400 V) constant-current stimulator (model DS7AH, Digitimer, quency ranging from 10 to 500 Hz (gain: 1,000), digitized
Hertfordshire, United Kingdom). The femoral nerve was online at a sampling frequency of 2 kHz, and recorded
stimulated transcutaneously using a circular (diameter: 5.1 (MP150; Biopac, Goleta, CA, USA).
cm) self-adhesive electrode (Dermatrode; American Imex,
Vertical Jump Performance. All the jumps were performed on
Irvine, CA, USA) positioned in the femoral triangle, 3–5 cm
a force plate (9281B, Kistler, Winterthur, Switzerland)
below the inguinal ligament. A large (5 3 10 cm) rectangular
connected to an amplifier (9865B, Kistler), and vertical
electrode (Compex, Ecublens, Switzerland) was fixed over the
ground reaction force (Rz) data were recorded at a sampling
gluteal fold to close the stimulation current loop. Current
frequency of 1 kHz (MP150; Biopac, Goleta, CA, USA).
intensity was progressively increased from 0 mA to full motor
Jump height was measured for the CMJ and DJ. Two CMJ
unit recruitment, as verified by M-wave and twitch force
and DJ were performed at pretest; if the difference in jump
recordings, and this was further increased by 10% to provide
height between the 2 trials was .5%, a third jump was
supramaximal stimuli. Once this stimulation intensity was
requested. Only 1 jump per modality was performed at post-
found, it was kept constant throughout the session for each
test to minimize fatigue. The interval between 2 consecutive
subject. The site of stimulation was marked on the skin so that
jumps was 10 seconds. For the CMJ, the subjects were
it could be repeated between the sessions. The stimulus dura-
instructed to keep their hands on the hips. After a rapid knee
tion was 1 millisecond, and the interstimulus interval in the
flexion to approximately 908, they left the force plate with
doublet was 10 milliseconds.
knees and ankles fully extended and were asked to land in
Force Recordings. Isometric MVC and electrically evoked a similarly extended position to ensure valid test conditions.
force of the quadriceps and hamstring muscles were For the DJ, the subjects started from a 30-cm-high step (24)
recorded using a custom-built ergometer that comprised and were instructed to keep their hands on the hips and step
a chair connected to a strain gauge (STS 2,500 N, sensitivity off the platform with the leading leg straight to avoid any
2 mV$V21 and 0.0017 V$N21, SWJ, Shenzhen, China). The initial upward propulsion (thus ensuring a drop height of
subjects were comfortably seated with a knee angle of 908 30 cm). They were instructed to jump for maximal height
and a trunk-thigh angle of 1008 (1808 = full extension). The and minimum ground contact time. As for CMJ, the partic-
strain gauge was securely strapped between the ankle and ipants were instructed to leave the force plate with knees and
the chair. Extraneous movements of the upper body were ankles fully extended and to land in a similarly extended
limited by 2 crossover shoulder harnesses and a belt across position. Vertical jumps were performed to assess the influ-
the abdomen. Two quadriceps MVC and 2 hamstring MVC ence of PNF stretching on slow (CMJ) and fast (DJ) stretch-
were performed at pretest; if the difference in MVC force shortening cycle.
between the 2 trials was .5%, a third attempt was requested. Data Analysis
Only 1 MVC per muscle group was performed at posttest Active Range of Motion. For pretest and posttest, only the best
to minimize fatigue. attempt for knee flexion and hip extension active ROMs was
considered for further analysis.
Electromyography Recordings. The EMG activity of the knee
extensors vastus lateralis (VL), vastus medialis (VM), and RF Vertical Jump Performance. Vertical jump height was calculated
and that of the knee flexor biceps femoris (BF) were as h = g 3 flight time2/8. For each pretest and posttest, the
recorded with pairs of silver chloride circular surface jump achieving the greatest height was used for analysis (4).
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PNF Control
MVC (N)z 420.5 6 79.7 394.3 6 63.1 394.6 6 66.4 431.8 6 73.8 411.1 6 78.7 402.2 6 83.6
VAL (%) 88.4 6 7.2 89.2 6 5.1 87.1 6 8.9 85.4 6 8.1 86.6 6 8.0 86.9 6 8.1
Pt (N)§ 65.8 6 9.7 68.0 6 11.6 60.9 6 7.9 68.5 6 12.6 69.5 6 9.9 65.2 6 8.3
VL PPA (mV) 12.8 6 6.0 13.2 6 6.5 12.6 6 5.2 14.7 6 4.3 15.4 6 4.3 14.5 6 4.5
VM PPA (mV) 15.2 6 4.5 16.4 6 4.8 13.8 6 4.4 14.9 6 3.44 14.9 6 3.7 14.7 6 3.2
RF PPA (mV) 5.4 6 2.4 5.4 6 2.5 6.1 6 4.1 5.8 6 1.9 5.7 6 2.3 5.9 6 2.1
*MVC = maximal voluntary contraction force; VAL = voluntary activation level; Pt = peak twitch; VL = vastus lateralis; PPA = M-
wave peak-to-peak amplitude; VM = vastus medialis; RF = rectus femoris.
†Values (mean 6 SD, N = 12) were collected before (Pre), immediately after (Post) and 15 minutes after 2 minutes of PNF
stretching or walking (control).
zSignificant main time effect (Post and Post 15 minutes different from Pre, p , 0.01).
§Significant main time effect (Post 15 min different from Pre and Post, p , 0.01).
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Short PNF Stretching and Quadriceps Muscle Function
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measurements in this study. Moreover, the stretching pro- decrease in muscle temperature (10), although not mea-
cedure used here was unique compared with previous PNF sured in this study.
studies. In contrast to the classical partner-assisted PNF
stretching, the agonist and antagonist contractions used in PRACTICAL APPLICATIONS
this study (Figure 2) were performed by the subjects them- Self-administered PNF stretching including 5-second static
selves (as is often the case in sports activities) while the stretches of the quadriceps did not improve active ROM of
quadriceps was not at the end point of the ROM. Finally, knee flexion. Thus, although this PNF procedure did not
it may also be that ROM was transiently changed for a very have any detrimental effect on quadriceps muscle function,
short period (,1 minute) with this PNF scheme; even if that we do not recommend this stretching modality (5-second
was the case, the athlete would not take advantage of this isometric hamstring contraction immediately followed by 5
procedure during competition, as already suggested (25). seconds of passive static stretch of the quadriceps immedi-
Our results of similar MVC force and jump performance ately followed by 5-second isometric quadriceps contrac-
after both PNF and control sessions are in accordance with tion) for sports activities in which flexibility is a key factor.
our active ROM measurements. Indeed, it is unlikely that Nevertheless, stretching is routinely used by many athletes as
unchanged ROM (which can be explained by unaltered an important component of warm-up procedures and,
proprioceptive information and/or musculotendinous visco- although physiological benefits are contestable, it is certainly
elastic properties and/or stretch perception) induced a sig- psychologically beneficial.
nificant alteration in force-power generating capacity. Again,
the low stretching duration might explain the absence of ACKNOWLEDGMENTS
MVC reduction as compared with the control session, The authors thank Marc Buclin for the design and concep-
because the reduction in MVC force after passive stretching tion of the ergometer and all the subjects who volunteered to
has been suggested to be governed by a dose-response participate. This study was supported by De Reuter foun-
relationship (25). Our results confirm those of Young and dation, Geneva Academic Society and Ernest Boninchi
Elliott (31), who reported no change in vertical jump per- foundation. The results of this study do not constitute
formance after a relatively short PNF stretching procedure endorsement of the product by the authors or the National
on quadriceps, gluteus, and plantar flexors (including 15-sec- Strength and Conditioning Association.
ond static stretching bouts for a total stretching duration of
45 seconds for each muscle group). Furthermore, the un-
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