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Acute effects of thermal agents as an adjunct to dynamic stretching on hamstring flexibility, agility, and speed among soccer players in Cebu Doctors' University.


Concepcion G. Adlawan,
Katrina C. Bantilan,
Abbe Kane R. Carungay,
Maria Alma J. Suico

Related Institution

College of Rehabilitative Sciences – Department of Physical Therapy - Cebu Doctors' University

Publication Information

Publication Type
Thesis Degree
Physical Therapy
Publication Date
December 2017


     The purpose of this study was to determine the acute effects of thermal agents such as cold or heat as an adjunct to dynamic stretching on hamstring flexibility agility and speed. This study was conducted in Cebu Doctors' University (CDU). The subjects included 36 male CDU soccer players aged 18-25 years old with tight hamstrings. Three (3) treatment groups were used, namely: dynamic stretching alone (Group A), dynamic stretching with hot moist packs (Group B) and dynamic stretching with cold packs (Group C). The study utilized a randomized, controlled trial design. The outcome measures used were the sit and reach test, T-test and 20-meter speed test.

     The pretest measurement results of each group were as follows: the mean pretest on hamstring flexibility on Group A was 10.0 inches ± 3.13, Group B with 9.06 inches ± 3.64 and Group C with 11.96 inches ± 2.88. The mean pretest Agility of Group A was 15.09 seconds ± 2.25, Group B with 15.84 seconds ± 3.21 and Group C with 14.22 seconds ± 1.92. The mean Pretest Speed of Group A was 3.60 ±0.13, Group B with 4.5 ±0.67 and Group C with 3.44 ± 0.35. Whereas the posttest measurement were as follows: The mean Posttest Hamstring flexibility of Group A was 12.50 inches ± 2.80, Group B with 11.36 inches ± 3.24 and Group C with 13.89 inches ± 2.64. The mean Posttest Agility of Group A was 14.60 seconds ± 1.93, Group B with 15.28 seconds ± 2.79 and Group C with 13.42 seconds ± 1.61. The mean Posttest Speed of Group A was 3.51±0.30, Group B with 3.86 ±0.57 and Group C with 3.38 ± 0.32. There was no significant  difference in the mean pretest and posttest measurement among the three (3) treatment groups. One-Way ANOVA was used to determine the significant difference in the mean change of scores from pretest to posttest on hamstring flexibility, agility and speed. Hamstring flexibility has a p-value of 0.524 and fvalue of (2.33)=1.608, agility with a p-value of 0.595 and f-value of (2.33)=1.252 and speed with a p-value of 0.198 and f-value of (2.33)=1.252 that showed no significance among the three (3) treatment groups.

     In conclusion, thermal agents as an adjunct to dynamic stretching have no acute effect on hamstring flexibility, agility and speed. The researchers recommend the practical use of dynamic stretching to be incorporated in athletes' training without having to necessarily use thermal agents before the game to improve performance. It is also recommended that the use of dynamic stretching  protocol be applied in the Physical Therapy practice for an effective yet time efficient stretching management if the goal is to enhance performance prior to exercise. Future studies should focus on studying through a range of soccer specific exercises designed to address both the common and unique characteristics of each of these soccer components. Although the results showed no significant difference on hamstring flexibility, agility and speed with or without thermal agents, these do not invalidate the effects of thermal agents on muscle length and performance since the study may have been insufficient in terms of duration, number of sessions, choice of application or individual performance of the subjects during intervention to promote significant improvements. Hence, future studies should also focus on these aspects.


1. American Academy of Orthopaedic Surgeons(). Hamstring Muscle Injuries. . Retrieved March 7, 2017, from: http://https://orthoinfo.aaos.org/en/diseases--conditions/hamstring-muscle-injuries/
2. American College of Sports MedicineACSM 2014. . Retrieved from: http://https://books.google.com.ph/books?redir_esc=y&id=TtiCAwAAQBAJ&q=ymca#v=onepage&q&f=false
3. Anoop, S. , Fayaz, R. K. , Vijesh, P. V. . "Effectiveness of stretching protocol in improving hamstring flexibility in football players" International Journal of Current Pharmaceutical Review and Research 4(4): 42-48, 2012. Retrieved from: http://https://www.researchgate.net/publication/307603545_EFFECTIVENESS_OF_STRETCHING_PROTOCOL_IN_IMPROVING_HAMSTRING_FLEXIBILITY_IN_FOOTBALL_PLAYERS.
4. Appleton, B. D. . (). Stretching and flexibility. . Retrieved April 13, 2017, from: http://web.mit.edu/tkd/stretch/stretching_toc.html#SEC6
5. Ayala, F. , Sainz de Baranda, P. , De Ste Croix, M. , Santonja, F. . "Absolute reliability of five clinical tests for assessing hamstrings flexibilityin professional futsal players" Journal of Science and Medicine in Sport 15(2): 142-147, 2012. Retrieved from: http://doi:10.1016/j.jsams.2011.10.002
6. Behm, D. G. , Button, D. C. , Butt, J. C. . "Factors affecting force loss with prolonged stretching" Canadian Journal of Applied Physiology 26(3): 262-272, 2001. Retrieved from: http://doi:10.1139/h01-017
7. Behrens, B. , Beinert, H. . Physical agents theory and practice (3rd ed.) Philadelphia, PA: F.A. Davis Company, 2014.
8. Bolton, P. , Kremmer, R. , Stucky, S. . (). Effects of cold packs on hamstring flexibility. . Retrieved May 25, 2017, from: http://soar.wichita.edu/bitstream/handle/10057/1356/grasp-2008-24.pdf
9. Brasileiro, J. S. , Faria, A. F. , Queiroz, L. L. . "Influence of local cooling and warming on the flexibility of the hamstring muscles" Brazilian Journal of Physical Therapy 11(1): 53-57, 2007. Retrieved from: http://www.scielo.br/pdf/rbfis/v11n1/en_09.pdf
10. Brodowicz, G. R. , Welsh, R. , Wallis, J. . "Comparison of stretching with ice, stretching with heat, or stretching alone on hamstring flexibility" Journal of Athletic Training 31(4): 324–327, 1996. Retrieved from: http://https://www.researchgate.net/publication/7221745_Comparison_of_Stretching_with_Ice_Stretching_with_Heat_or_Stretching_Alone_on_Hamstring_Flexibility
11. Burke, D. G. , Holt, L. E. , Rasmussen, R. , MacKinnon, N. C. , Vossen, J. F. , Pelham, T. W. . "Effects of hot or cold water immersion and modified proprioceptive neuromuscular facilitation flexibility exercise on hamstring length" Journal of Athletic Training 36(1): 16–19, 2000. Retrieved from: http://https://www.ncbi.nlm.nih.gov/pmc/articles/PMC155396/pdf/attr_36_01_0016.pdf
12. Cameron, M. H. . Physical agents in rehabilitation (4th ed.) St. Louise,MO: Saunders, 2013.
13. Caldwell, B. P. , Peters, D. M. . "Seasonal variation in physiological fitness of a semiprofessional soccer team" Journal of Strength and Conditioning Research 23(5): 1370-1377, 2009. Retrieved from: http://doi:10.1519/jsc.0b013e3181a4e82f
14. Ekblom, B. . "Applied physiology of soccer" Sports Medicine 3(1): 50-60, 1986. Retrieved from: http://doi:10.2165/00007256-198603010-00005
15. Fattahi-Bafghi, A. , Amiri-Khorasani, M. . "Acute effect of different stretching methods on power and agility performances in different soccer positions" World Journal of Sport Sciences 7(3): 140-144, 2012. Retrieved from: http://doi:10.5829/idosi.wjss.2012.7.3.71108
16. Fedorczyk, J. . "The role of physical agents in modulating pain" Journal of Hand Therapy 10(2): 110-121, 1997. Retrieved from: http://doi:10.1016/S0894-1130(97)80065-8
17. Fischer, J. , Van Lunen, B. L. , Branch, D. J. , Pirone, J. L. . "Functional performance following an ice bag application to the hamstrings" The Journal of Strength and Conditioning Research 23(1): 44-50, 2009. Retrieved from: http://doi:10.1519/JSC.0b013e3181839e97
18. Fowles, J. R. , Sale, D. G. , MacDougall, J. D. . "Reduced strength after passive stretch of the human plantarflexors" Journal of Applied Physiology 89(3): 1179–1188, 2000. Retrieved from: http://https://www.physiology.org/doi/pdf/10.1152/jappl.2000.89.3.1179
19. Funk, D. , Swank, A. M. , Adams, K. J. , Treolo, D. . "Efficacy of moist heat pack application over static stretching on hamstring flexibility." The Journal of Strength and Conditioning Research 15(1): 123-126, 2001. Retrieved from: http://doi:10.1519/00124278-200102000-00021.
20. García-Pinillos, F. , Ruiz-Ariza, A. , Moreno Del Castillo, R. , Latorre-Román, P. A. . "Impact of limited hamstring flexibility on vertical jump, kicking speed, sprint, and agility in young football players" Journal of Sports Sciences 33(12): 1293-1297, 2015. Retrieved from: http://doi:10.1080/02640414.2015.1022577
21. Gkrilias, P. D. , Tsepis, E. M. , Fousekis, K. A. . "The effects of hamstrings’ cooling and cryo stretching on sit and reach flexibility test performance in healthy young adults" British Journal of Medicine and Medical Research 19(6): 1-11, 2017. Retrieved from: http://doi:10.9734/bjmmr/2017/31034
22. Gleim, G. W., , Mchugh, M. P. . "Flexibility and its effects on sports injury and performance" Sports Medicine 24(5): 289-299, 1997. Retrieved from: http://doi:10.2165/00007256-199724050-00001
23. Gomes, T. M. , Simão, R. , Marques, M. C. , Costa, P. B. , da Silva Novaes, J. . "Acute effects of two different stretching methods on local muscular endurance performance" Journal of Strength & Conditioning Research 25(3): 745-752, 2011. Retrieved from: http://doi:10.1519/JSC.0b013e3181cc236a
24. Gregorio, M. S. , Bernabe, R. L. , Bondoc, L. C. , Castillo, J. B. . "Acomparison of stretching with ice vs stretching with heat on hamstring flexibility among physical therapy students" UERM Health Science Journal 5(1): 15-19, 2016. Retrieved from: http://https://ejournals.ph/article.php?id=11301.
25. Hrysomallis, C. . "Relationship between balance ability, training and sports injury risk" Sports Medicine 37(6): 547-556, 2007. Retrieved from: http://https://www.lbreakthrough.co.uk/wp-content/uploads/2016/03/Sport-3.pdf.
26. Khan, S. , Shamsi, S. , Alyaemni, A. A. . "A Comparison of superficial heat, deep heat and cold for improving plantar flexors extensibility" Middle-East Journal of Scientific Research 13(4): 477-482, 2013. Retrieved from: http://doi:10.5829/idosi.mejsr.2013.13.4.72109
27. Kisner, C. , Colby, L. A. . Therapeutic exercise: Foundation and techniques (6th ed.) Philadelphia, PA: F.A. Davis Company, 2013.
28. Konin, J. G. , Jessee, B. . Range of motion and flexibility. Physical rehabilitation of the injured athlete (4th ed.) 2012. . Retrieved from: http://https://books.google.com.ph/books?redir_esc=y&id=_JQZmdxpEboC&q=chapter+6#v=onepage&q&f=false
29. Levangie, P. K. , Norkin, C. C. . Joint structure and function: Acomprehensive analysis (5th ed.) Philadelphia, PA: F.A. Davis Company, 2011.
30. Lin, Y. H. . "Effects of thermal therapy in improving the passive range of knee motion: Comparison of cold and superficial heat applications" Clinical Rehabilitation 17(6): 618-623, 2003. Retrieved from: http://doi:10.1191/0269215503cr656oa
31. Liu, H. , Garrett, W. E. , Moorman, C. T. , Yu, B. . "Injury rate, mechanism,and risk factors of hamstring strain injuries in sports: A review of the literature" Journal of Sport and Health Science 1(2): 92-101, 2012. Retrieved from: http://.doi:10.1016/j.jshs.2012.07.003
32. Lounsberry, N. . "Therapeutic heat: Effects of superficial and deep heating modalities on hamstring flexibility" The Osprey Journal of Ideas and Inquiry , 2001-2008, 2008. Retrieved from: http://digitalcommons.unf.edu/ojii_volumes/138
33. McGlashan, L. . (). The flexibility factor. Oxygen. . Retrieved March 7, 2017, from: http://https://www.oxygenmag.com/training/flexibility-factor-12079
34. Mayorga-Vega, D. , Merino-Marban, R. , Viciana, J. . "Criterion-related validity of sit-and-reach tests for estimating hamstring and lumbar extensibility: A meta-analysis" Journal of Sports Science & Medicine 13(1): 1–14, 2014. Retrieved from: http://jssm.org/volume13/iss1/cap/jssm-13-1.pdf
35. Moir, G. L. , Button, C. , Glaister, M. , Stone, M. . "Influence of familiarization on the reliability of vertical jump and acceleration sprinting performance in physically active men" The Journal of Strength and Conditioning Research 18(2): 276-80, 2004. Retrieved from: http://https://www.researchgate.net/publication/8564115_Influence_of_Familiarization_on_the_Reliability_of_Vertical_Jump_and_Acceleration_Sprinting_Performance_in_Physically_Active_Men
37. Page, P. . "Current concepts in muscle stretching for exercise and rehabilitation" International Journal of Sports Physical Therapy 7(1): 109–119, 2012. Retrieved from: http://https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273886/pdf/ijspt-07-109.pdf
38. Patterson, S. M. , Udermann, B. E. , Doberstein, S. T. , Reineke, D. M. . "The effects of cold whirlpool on power, speed, agility, and range of motion" Journal of Sports Science and Medicine, 7(3): 387-394, 2008. Retrieved from: http://https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761888/pdf/jssm-07-387.pdf
39. Pauole, K. , Madole, K. , Garhammer, J. , Lacourse, M. , Rozenek, R. . "Reliability and validity of the t-test as a measure of agility, leg power, and leg speed in college-aged men and women." Journal of Strength and Conditioning Research 14(4): 443-450, 2000. Retrieved from: http://doi: 10.1519/00124278-200011000-00012
40. Petrofsky, J. , Laymon, M. , Lee, H. . "Effect of heat and cold on tendon flexibility and force to flex the human knee" Medical Science Monitor 19, 661-667, 2013. Retrieved from: http://doi:10.12659/MSM.889145
41. The effects of static and dynamic stretching on reaction time and performance in a counter movement jump. Oregon State University. 2009. (MA) . Retrieved from: http://https://ir.library.oregonstate.edu/downloads/kh04dv01p.
42. Raya, M. A. , Gailey, R. S. , Gaunaurd, I. AS. , Jane, D. M. , Campbell, S. M. , Gagne, E. , Tucker, C. . "Comparison of three agility tests with male service members: edgren side step test, t-test, and illinois agility test" Journal of Rehabilitation Research & Development, 50(7): 951-960, 2013. Retrieved from: http://doi:10.1682/JRRD.2012.05.0096
43. Richendollar, M. L. , Darby, L. A. , Brown, T. M. . "Ice bag application,active warm-up, and 3 measures of maximal functional performance" Journal of Athletic Training 41(4): 364-370, 2006. Retrieved from: http://https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1748415/pdf/i1062-6050-41-4-364.pdf
44. Scheurman, j. , Tiggelen, D. V./ , Daneels, L. , Witvruow, E. . "Susceptibility to hamstring injuries in soccer" The American Journal of Sports Medicine 44(5): 1276-1285, 2016. Retrieved from: http://doi:10.1177/0363546515626538
45. Taylor, B. F. , Waring, C. A. , Brashear, T. A. . "The effects of therapeutic application of heat or cold followed by static stretch on hamstring muscle length" Journal of Orthopaedic & Sports Physical Therapy 21(5): 283-286, 1995. Retrieved from: http://doi:10.2519/jospt.1995.21.5.283
46. Tsang, K. K , Buxton, B. P. , Guion, K. W. , Joyner, B. A. , Browder, K. D. . "The effects of cryo therapy applied through various barriers" Journals of Sport Rehabilitation 6(4): 343-354, 1997. Retrieved from: http://www.humankinetics.com/acucustom/sitename/Documents/DocumentItem/2096.pdf
47. Vasileiou, N. , Michailidis, Y. , Gourtsoulis, S. , Kyranoudis, A. , Zakas, A. . "The acute effect of static or dynamic stretching exercises on speed and flexibility of soccer players" Journal of Sports and Human Performance 1(4): 31-42, 2013. Retrieved from: http://doi:10.12922/jshp.0029.2013
48. Weerapong, P. , Hume, P. A. , Kolt, G. S. . "Stretching: Mechanisms and benefits for sport performance and injury prevention" Physical Therapy Reviews 9(4): 189-206, 2004. Retrieved from: http://doi:10.1179/108331904225007078
49. Weerasekara, I. , Kumari, I. , Weerarathna, N. , Withanage, C. , Wanniarachchi, C. , Mariyanayagam, Y. , Suraweera, H. . "The prevalence ofhamstring tightness among the male athletes of university of Peradeniyain 2010, Sri Lanka" International Journal of Physical Medicine &Rehabilitation 1(1): 108, 2013. Retrieved from: http://doi:10.4172/2329-9096.1000108
50. Witvrouw, E. , Danneels, L. , Asselman, P. , D’Have, T. , Cambier, D. . "Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. A prospective study" The American Journal of Sports Medicine 31(1): 41-46, 2003. Retrieved from: http://doi: 10.1177/03635465030310011801
51. Yamaguchi, T. , Ishii, K. . "An optimal protocol for dynamic stretching toimprove explosive performance" The Journal of Physical Fitness and Sports Medicine 3(1): 121-129, 2014. Retrieved from: http://doi:10.7600/jpfsm.3.121
52. Young, E. , Gamble, D. , Boyle, P. . (). Protocols for the physiological assessment of Gaelic football development squads. . Retrieved March 3, 2017, from: http://www.ulstergaa.ie/wp-content/uploads/2008/01/fitnessdevelopmant-squads-protocol.pdf

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