Page 66 - 《运动与健康科学》(英文)2024年第2期

TaggedAPTARAEnd188 A. Konrad et al.
results of the main variables (flexibility parameters). For the Egger’s regression intercept test and visual inspection of the
flexibility parameters, pre- and post-intervention values plus funnel plot were applied to detect possible publication bias.TaggedAPTARAEnd
SDs of the foam rolling and control groups were extracted. If
some of the required data were missing from the included
TaggedAPTARAH13. ResultsTaggedAPTARAEnd
studies, the authors of the studies were contacted via email or
similar channels (e.g., ResearchGate).TaggedAPTARAEnd TaggedAPTARAH23.1. Results of the searchTaggedAPTARAEnd
TaggedAPTARAPOverall, after removal of the duplicates, 4796 papers were
screened, of which 74 papers were found to be eligible for this
TaggedAPTARAH22.4. Statistics and data synthesisTaggedAPTARAEnd
review. However, following a search of the reference lists and
TaggedAPTARAPThe meta-analysis was performed using Comprehensive
citations (through Google Scholar) of the 74 included papers,
Meta-Analysis software (Biostat, Englewood, NJ, USA) 3 additional papers were identified as relevant. In total,
according to the recommendations of Borenstein et al. 29 By
77 papers were included in this systematic review and
applying a random-effect meta-analysis, we assessed the ES in
meta-analysis. The search process is illustrated in Fig. 1.TaggedAPTARAEnd
terms of the standardized mean difference. If any study
TaggedAPTARAPOverall, 186 ESs were extracted from the 77 eligible
reported >1 ES, the mean of all the outcomes (ES) within the
studies. There were a total of 3870 participants with age = 27.2 §
single study was used for the analysis and was defined as
29 18.3 years (mean § SD). Supplementary Table 1 presents the
combined (as suggested by Borenstein et al. ). Moreover, we
participant characteristics and outcomes of the included
performed subgroup analyses by applying a mixed-effect
29 studies.TaggedAPTARAEnd
model. Although there is no general rule of thumb, we only
performed subgroup analyses when there were 3 studies
included in the respective subgroups. Consequently, we TaggedAPTARAH23.2. Risk of bias assessment and methodological qualityTaggedAPTARAEnd
performed subgroup analyses for the muscles tested (sit and TaggedAPTARAPFig. 2 shows the funnel plot, which includes all 77 studies
reach vs. isolated hamstrings vs. quadriceps vs. triceps surae in this meta-analysis. A visual inspection of the funnel plot
vs. hip flexors vs. shoulder), intensity of stretch (high intensity and the Egger’s regression intercept test (intercept = 3.96;
vs. low intensity), trained state of the participants (recreational p < 0.001) indicated reporting bias. The methodological
active vs. professional athletes vs. sedentary), stretching tech- quality, as assessed with the PEDro scale, revealed a range of
niques (static vs. dynamic/ballistic vs. PNF), supervision of scores between 4 and 10 points (out of 11) for all included
the stretching intervention (fully supervised vs. periodically studies. The average PEDro score value was 7.30 § 1.09, indi-
supervised vs. non supervised), and sex (male vs. female). To cating a low risk of bias. 33,34 The assessors agreed with 100%
determine differences between the ESs of the subgroups, of the 847 criteria (77 studies £ 11 scores). Mismatched
Q-statistics were applied. 29 Moreover, we conducted a outcomes were discussed, and the assessors agreed on the
meta-regression to assess possible relationships between the
scores presented in Supplementary Table 2.TaggedAPTARAEnd
moderating variables (i.e., age of the participants, total stretch
duration, stretch frequency per week). If the moderating
variables could not be clearly defined within a single study TaggedAPTARAH23.3. Overall effectsTaggedAPTARAEnd
(e.g., mixed sex), the study was not considered for the moder- TaggedAPTARAPThe meta-analysis on joint ROM revealed a moderate ES in
ating analyses. According to the recommendations of Hopkins favor of stretching compared to the control condition
et al., 30 the effects for a standardized mean difference of <0.2, (ES = 1.002; Z = 12.07; 95% confidence interval (95%CI):
2
0.20.6, >0.61.2, >1.22.0, >2.04.0, and >4.0 were 1.165 to 0.840; p < 0.001; I = 74.97). Fig. 3 presents
defined as trivial, small, moderate, large, very large, and the forest plot of the meta-analysis, sorted by the standard
2
extremely large, respectively. I statistics were calculated to
difference in means.TaggedAPTARAEnd
assess the heterogeneity among included studies, and thresh-
olds of 25%, 50%, and 75% were defined as having a low,
moderate, and high level of heterogeneity, respectively. 31,32 TaggedAPTARAH23.4. Moderating variablesTaggedAPTARAEnd
An a level of 0.05 was defined for the statistical significance TaggedAPTARAPA summary of all the subgroup analyses is provided in
Table 1. The subgroups analyzed were the muscles tested (sit
of all the tests.TaggedAPTARAEnd
and reach vs. isolated hamstrings vs. quadriceps vs. triceps
surae vs. hip flexors vs. shoulder), intensity of stretch (high
TaggedAPTARAH22.5. Risk of bias assessment and methodological qualityTaggedAPTARAEnd
intensity vs. low intensity), trained state of the participants
TaggedAPTARAPThe methodological quality of the included studies was (recreationally active vs. professional athletes vs. sedentary),
assessed using the PEDro scale. In total, 11 methodological stretching techniques (static vs. dynamic/ballistic vs. PNF),
criteria were rated by 8 independent researchers (SA, SHA, supervision of the stretching intervention (fully supervised vs.
AD, AZ, RG, CE, CS, and AG), and each of the methodologi- periodically supervised vs. non-supervised), and sex (male vs.
cal criteria was assigned either 1 point or no points. Higher female).TaggedAPTARAEnd
scores indicated better methodological quality. In the case of TaggedAPTARAPQ statistics of the subgroup analysis revealed a significant
conflict between researchers, the methodological criteria were difference for sex (p = 0.03). Although both sexes showed an
reassessed and discussed. Moreover, statistics from the increase in ROM (p < 0.001), the increase was more