Health  Vol.9 No.3 , March 2017
Effectiveness of a 12-Week Program of Active and Passive Stretching in Improving Low Back and Neck Pain in Japanese Sedentary Men
Abstract: Purpose: Muscle stretching is frequently prescribed in physical therapy to manage lower back and neck pain. However, there is no clear evidence regarding the differences in effectiveness of active and passive stretching. Therefore, we aimed to evaluate the relative effectiveness of a 12-week program of active and passive stretching on selected physical and mental stress variables of sedentary men with lower back and neck pain. Methods: A cohort of 28 sedentary men, 30 - 49 years old, were divided into two intervention groups: the passive stretching group (PSG, n = 15) and the active stretching group (ASG, n = 13). A trainer assisted with static passive stretching, while participants in the ASG were provided with an instructional video. The following outcomes were measured at the start and end of the first and twelfth week of the stretching program: physical measures (visual analogue scale score of lower back and neck pain; finger-to-floor distance, gravimetric assessment of pelvic tilt, muscle hardness of the biceps femoris, and straight-leg raising) and mental stress measures (α-amylase and cortisol levels in saliva samples). Results: Although both active and passive stretching produced acute changes in lower back and neck pain, only passive stretching yielded long-term improvement in pain, finger-to-floor distance, pelvic tilt, hardness of biceps femoris muscle and cortisol levels (p < 0.01). Conclusion: Passive stretching is superior to active stretching in reducing pain, increasing muscle extensibility and correcting posture among a group of sedentary men with lower back and neck pain.
Cite this paper: Naraoka, Y. , Katagiri, M. and Shirasawa, T. (2017) Effectiveness of a 12-Week Program of Active and Passive Stretching in Improving Low Back and Neck Pain in Japanese Sedentary Men. Health, 9, 493-505. doi: 10.4236/health.2017.93035.

[1]   Cassidy, J.D., Carroll, L.J. and Cóté, P. (1998) The Saskatchewan Health and Back Pain Survey. The Prevalence of Low Back Pain and Related Disability in Saskatchewan Adults. Spine, 23, 1860-1866.

[2]   Deyo, R.A. (2002) Diagnostic Evaluation of LBP: Reaching a Specific Diagnosis Is Often Impossible. Archives of Internal Medicine, 162, 1444-1447.

[3]   Iwamoto, J., Abe, H., Tsukimura, Y. and Wakano, K. (2005) Relationship between Radiographic Abnormalities of Lumbar Spine and Incidence of Low Back Pain in High School Rugby Players: A Prospective Study. Scandinavian Journal of Medicine & Science in Sports, 15, 163-168.

[4]   Sairyo, K., Katoh, S., Sakamaki, T., Komatsubara, S., Endo, K. and Yasui, N. (2003) Three Successive Stress Fractures at the Same Vertebral Level in an Adolescent Baseball Player. The American Journal of Sports Medicine, 31, 606-610.

[5]   Deyo, R.A. and Weinstein, J.N. (2001) Low Back Pain. The New England Journal of Medicine, 344, 363-370.

[6]   Feldman, D.E., Shrier, I., Rossignol, M. and Abenhaim, L. (2001) Risk Factors for the Development of Low Back Pain in Adolescence. American Journal of Epidemiology, 154, 30-36.

[7]   Harreby, M., Nygaard, B., Jessen, T., et al. (1999) Risk Factors for Low Back Pain in a Cohort of 1389 Danish School Children: An Epidemiologic Study. European Spine Journal, 8, 444-450.

[8]   Porter, J.L. and Wilkinson, A. (1997) A Comparative Study between Asymptomatic and Chronic Low Back Pain in 18-to 36-Year-Old Men. Spine, 22, 1508-1513.

[9]   Kottke, F.J., Pauley, D.L. and Ptak, R.A. (1966) The Rationale for Prolonged Stretching for Correction of Shortening of Connective Tissue. Archives of Physical Medicine and Rehabilitation, 47, 345-352.

[10]   Mierau, D., Cassidy, J.D. and Yong-Hing, K. (1980) Low-Back Pain and Straight Leg Raising in Children and Adolescents. Spine, 14, 526-528.

[11]   Yabuki, S. (2007) Pathogenesis of the Neck-Shoulder Stiffness. Clinics in Orthopedic Surgery, 42, 413-417. (In Japanese)

[12]   McLean, S.M., May, S., Klaber-Moffett, J., Sharp, D.M. and Gardiner, E. (2010) Risk Factors for the Onset of Non-Specific Neck Pain: A Systematic Review. Journal of Epidemiology and Community Health, 64, 565-572.

[13]   Takagishi, K., Hoshino, Y. and Ide, J. (2008) A Project Study for Katakori, 2004-2006 (Commentary). Nihon Seikeigeka Gakkai Zasshi, 82, 901-911. (In Japanese)

[14]   Fujii, T., Matsudaira, K., Noma, K., et al. (2012) Objective Measurement of Neck-Shoulder Discomfort and Analysis of Associated Factors. Rinsho Seikeigeka, 47, 619-624. (In Japanese)

[15]   Kimura, T., Tsuda, Y., Uchida, S. and Eboshida, A. (2006) Association of Perceived Stress and Stiff Neck/Shoulder with Health Status: Multiple Regression Models by Gender. Hiroshima Journal of Medical Sciences, 55, 101-107.

[16]   Ogston, J.B., Crowell, R.D. and Konowalchuk, B.K. (2016) Graded Group Exercise and Fear Avoidance Behavior Modification in the Treatment of Chronic Low Back Pain. Journal of Back and Musculoskeletal Rehabilitation, 29, 673-684.

[17]   Ohtsuki, K. (2014) A 3-Month Follow-Up Study of the Long-Term Effects of Direct Stretching of the Tensor Fasciae Latae Muscle in Patients with Acute Lumbago Using a Single-Case Design. Journal of Physical Therapy Science, 26, 755-758.

[18]   Sairyo, K., Kawamura, T., Mase, Y., et al. (2013) Jack-Knife Stretching Promotes Flexibility of Tight Hamstrings after 4 Weeks: A Pilot Study. European Journal of Orthopaedic Surgery & Traumatology, 23, 657-663.

[19]   Raftry, S.M. and Marshall, P.W. (2012) Does a “Tight” Hamstring Predict Low Back Pain Reporting during Prolonged Standing? Journal of Electromyography and Kinesiology, 22, 407-411.

[20]   Marshall, P.W., Cashman, A. and Cheema, B.S. (2011) A Randomized Controlled Trial for the Effect of Passive Stretching on Measures of Hamstring Extensibility, Passive Stiffness, Strength, and Stretch Tolerance. Journal of Science and Medicine in Sport, 14, 535-540.

[21]   Shadmehr, A., Hadian, M.R., Naiemi, S.S. and Jalaie, S. (2009) Hamstring Flexibility in Young Women Following Passive Stretch and Muscle Energy Technique. Journal of Back and Musculoskeletal Rehabilitation, 22, 143-148.

[22]   Winters, M.V., Blake, C.G., Trost, J.S., et al. (2004) Passive versus Active Stretching of Hip Flexor Muscles in Subjects with Limited Hip Extension: A Randomized Clinical Trial. Physical Therapy, 84, 800-807.

[23]   Kippers, V. and Parker, A.W. (1987) Toe-Touch Test. A Measure of Its Validity. Physical Therapy, 67, 1680-1684.

[24]   Hasebe, K., Sairyo, K., Hada, Y., et al. (2014) Spino-Pelvic-Rhythm with forward Trunk Bending in Normal Subjects without Low Back Pain. European Journal of Orthopaedic Surgery & Traumatology, 24, S193-S199.

[25]   Fasen, J.M., O’Connor, A.M., et al. (2009) A Randomized Controlled Trial of Hamstring Stretching: Comparison of Four Techniques. The Journal of Strength & Conditioning Research, 23, 660-667.

[26]   Halbertsma, J.P., van Bolhuis, A.I. and Göeken, L.N. (1996) Sport Stretching: Effect on Passive Muscle Stiffness of Short Hamstrings. Archives of Physical Medicine and Rehabilitation, 77, 688-692.

[27]   Sjolie, A.N. (2004) Low-Back Pain in Adolescents Is Associated with Poor Hip Mobility and High Body Mass Index. Scandinavian Journal of Medicine & Science in Sports, 14, 168-175.

[28]   Esola, M.A., McClure, P.W., Fitzgerald, G.K. and Siegler, S. (1996) Analysis of Lumbar Spine and Hip Motion during forward Bending in Subjects with and without a History of Low Back Pain. Spine, 21, 71-78.

[29]   Hallman, D.M., Ekman, A.H. and Lyskov, E. (2014) Changes in Physical Activity and Heart Rate Variability in Chronic Neck-Shoulder Pain: Monitoring during Work and Leisure Time. International Archives of Occupational and Environmental Health, 87, 73-744.

[30]   Sawada, T., Matsudaira, K., Muto, Y., Koga, T. and Takahashi, M. (2016) Potential Risk Factors for Onset of Severe Neck and Shoulder Discomfort in Urban Japanese Workers. Industrial Health, 54, 230-236.

[31]   Matsudaira, K., Isomura, T., Miyoshi, K., Okazaki, H. and Konishi, H. (2014) Risk Factors for Low Back Pain: A New Concept. Nihon Rinsho, 72, 244-250. (In Japanese)

[32]   Krantz, G., Forsman, M. and Lundberg, U. (2004) Consistency in Physiological Stress Responses and Electromyographic Activity during Induced Stress Exposure in Women and Men. Integrative Psychological and Behavioral Science, 39, 105-118.