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Completed

NCT Number: NCT06240013

Acute Effects of Foam Rolling and Proprioceptive Neuromuscular Facilitation Stretching

This randomized, assessor-blinded, parallel-group comparative trial investigated the acute effects of foam rolling (FR) and proprioceptive neuromuscular facilitation (PNF) stretching used as warm-up strategies in amateur athletes. Following a standardized 5-minute aerobic cycling warm-up, participants were randomly allocated to either a foam rolling group or a PNF stretching group. Hamstring flexibility was the prespecified primary outcome. Isometric knee flexion strength, vertical jump performance, pressure pain threshold, and intervention-related perceived exertion were assessed as secondary outcomes. All performance outcomes were assessed before and immediately after the assigned intervention.

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Key information

Conditions

Athletes

Age range

18 year–30 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Acibadem University

Istanbul, None Selected, 34752, Turkey (Türkiye)

About this study

Foam rolling and proprioceptive neuromuscular facilitation stretching are commonly used as warm-up strategies to acutely improve flexibility. However, direct comparisons of their effects on flexibility and performance-related outcomes remain limited. This study was designed to compare the acute effects of foam rolling and proprioceptive neuromuscular facilitation stretching used as warm-up strategies in amateur athletes.

Healthy amateur athletes aged 18 to 30 years were randomly assigned to either a foam rolling group or a proprioceptive neuromuscular facilitation stretching group. All participants first completed a standardized 5-minute light-intensity cycling warm-up. Participants in the foam rolling group performed unilateral hamstring foam rolling on the dominant lower limb for 3 sets of 30 seconds, for a total application time of 90 seconds. Participants in the proprioceptive neuromuscular facilitation stretching group performed four repetitions, each consisting of 5 seconds of maximal isometric hamstring contraction, 5 seconds of relaxation, and 20 seconds of passive stretching, for a total application time of 120 seconds.

Hamstring flexibility was assessed using the sit-and-reach test. Isometric knee flexion strength was assessed using handheld dynamometry, vertical jump performance using a standing vertical jump test, and pressure pain threshold using pressure algometry over the hamstring region. Intervention-related perceived exertion was assessed immediately after the assigned intervention. The main outcome measures were assessed before and immediately after the intervention. Outcome assessors were blinded to group allocation.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age between 18 and 30 years
  • Being actively engaged in training or competition in amateur sport

Exclusion criteria

  • Generalized hypermobility
  • History of hamstring injury within the previous 6 months
  • Diagnosed orthopedic pathology
  • Previous surgery involving the lower extremity or spine
  • Current low back pain
  • Any systemic or neurological disorder that could affect test performance or intervention safety

Treatment and study plan

foam rolling

Other

Participants performed unilateral hamstring foam rolling on the dominant lower limb in a long-sitting position on a firm, flat surface. The foam roller was positioned under the hamstring region, and participants slowly rolled back and forth between the ischial tuberosity and the popliteal fossa under sustained body-weight pressure. The protocol consisted of 3 sets of 30 seconds, for a total application time of 90 seconds. Participants were instructed to apply the maximum tolerable pressure that did not produce pain.

Proprioceptive neuromuscular facilitation stretching

Other

Participants received unilateral PNF stretching of the hamstring on the dominant lower limb in a long-sitting position with the knee fully extended. Each repetition consisted of a 5-second maximal isometric hamstring contraction, followed by 5 seconds of relaxation and 20 seconds of passive stretching. The therapist provided manual resistance during the isometric contraction and guided the participant into the stretch position. Four repetitions were performed, for a total application time of 120 seconds.

Primary outcomes

  1. Hamstring Flexibility Assessed by the Sit-and-Reach Test

    Time frame: Pre-intervention and immediately after the intervention

    Hamstring flexibility was assessed using the Baseline® Sit and Reach Flexibility Tester. Participants sat with both knees fully extended, the lower limbs together, and the soles of the feet placed flat against the testing device. Participants reached forward as far as possible without flexing the knees. Three trials were performed, and the mean value was recorded in centimeters (cm). Higher values indicate greater flexibility.

Secondary outcomes

  1. Vertical Jump Performance

    Time frame: Pre-intervention and immediately after the intervention

    Vertical jump performance was assessed using a standing vertical jump test. Standing reach height was first recorded. Participants then performed a countermovement jump and reached as high as possible. Vertical jump height was calculated as the difference between jump reach height and standing reach height. Three trials were performed, and the highest value was recorded in centimeters (cm). Higher values indicate greater vertical jump performance.

  2. Isometric Knee Flexion Strength

    Time frame: Pre-intervention and immediately after the intervention

    Isometric knee flexion strength was measured using a digital handheld dynamometer (J Tech Commander Muscle Tester). Participants were seated with the hips and knees flexed to 90°. The dynamometer was positioned on the posterior aspect of the lower leg, 5 cm proximal to the lateral malleolus. Participants performed maximal isometric knee flexion for 3 seconds. Three trials were performed with 60 seconds of rest between trials, and the highest force value sustained for more than 0.5 seconds was recorded in kilogram-force (kgf). Higher values indicate greater isometric knee flexion strength.

  3. Hamstring Pressure Pain Threshold

    Time frame: Pre-intervention and immediately after the intervention

    Pressure pain threshold was assessed over the hamstring region using a digital pressure algometer (Baseline FDK 10). Participants were positioned prone, and the algometer probe was applied perpendicular to the most sensitive point of the hamstring region. Pressure was gradually increased at approximately 1 kgf/cm² every 3 seconds until the participant first reported pain. Three measurements were performed with 20-second intervals between trials, and the lowest value was recorded for analysis. Higher values indicate a higher pressure pain threshold.

  4. Intervention-Related Perceived Exertion

    Time frame: Immediately after the intervention

    Intervention-related perceived exertion was assessed immediately after the assigned intervention using a single-item 0-10 numerical rating scale (NRS), anchored from 0 (no exertion) to 10 (maximal exertion). Higher scores indicate greater perceived exertion.

Sponsors and collaborators

Lead sponsor

Acibadem University

Other

Collaborators

  • The Scientific and Technological Research Council of Turkey

Registry information

Official study title

Acute Effects of Foam Rolling and PNF Stretching as Warm-Up Strategies on Muscle Flexibility, Strength, and Pressure Pain Threshold in Amateur Athletes

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Feb 2, 2024
Registry last updated
Sep 2, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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