Factors That Influence the Efficacy of Stretching Programs for Patients With Hypomobility

CONTEXT Passive stretching exercise protocols, as part of outpatient treatment or home exercise programs, are used to improve hypomobility. Despite the cosmopolitan use of stretching exercises, little is known about the forces being applied to the joint during these routine treatments. TYPE OF STUDY Clinical review. EVIDENCE ACQUISITION Articles were identified using MEDLINE and Google Scholar databases, with searches initially limited to those articles published after 1995. Seminal articles that were referenced were also included. RESULTS Many factors contribute to the clinical success of a stretching program, including the frequency, intensity, and duration of the stretching exercises, as well as patient- and joint-specific factors. CONCLUSIONS The goal of a stretching protocol is to maximize total end-range time both in the clinic and at home. Higher intensity, prolonged, and frequent stretching (10- to 15-minute bouts, 3 to 6 times per day) used as an adjunct to high-grade mobilizations may be beneficial for certain hypomobility conditions.