Background

Stretching has garnered significant attention in sports sciences, resulting in numerous studies. However, there is no comprehensive overview on investigation of stretching in healthy athletes.

Objectives

To perform a systematic scoping review with an evidence gap map of stretching studies in healthy athletes, identify current gaps in the literature, and provide stakeholders with priorities for future research.

Methods

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and PRISMA-ScR guidelines were followed. We included studies comprising healthy athletes exposed to acute and/or chronic stretching interventions. Six databases were searched (CINAHL, EMBASE, PubMed, Scopus, SPORTDiscus, and Web of Science) until 1 January 2023. The relevant data were narratively synthesized; quantitative data summaries were provided for key data items. An evidence gap map was developed to offer an overview of the existing research and relevant gaps.

Results

Of ~ 220,000 screened records, we included 300 trials involving 7080 athletes [mostly males (~ 65% versus ~ 20% female, and ~ 15% unreported) under 36 years of age; tiers 2 and 3 of the Participant Classification Framework] across 43 sports. Sports requiring extreme range of motion (e.g., gymnastics) were underrepresented. Most trials assessed the acute effects of stretching, with chronic effects being scrutinized in less than 20% of trials. Chronic interventions averaged 7.4 ± 5.1 weeks and never exceeded 6 months. Most trials (~ 85%) implemented stretching within the warm-up, with other application timings (e.g., post-exercise) being under-researched. Most trials examined static active stretching (62.3%), followed by dynamic stretching (38.3%) and proprioceptive neuromuscular facilitation (PNF) stretching (12.0%), with scarce research on alternative methods (e.g., ballistic stretching). Comparators were mostly limited to passive controls, with ~ 25% of trials including active controls (e.g., strength training). The lower limbs were primarily targeted by interventions (~ 75%). Reporting of dose was heterogeneous in style (e.g., 10 repetitions versus 10 s for dynamic stretching) and completeness of information (i.e., with disparities in the comprehensiveness of the provided information). Most trials (~ 90%) reported performance-related outcomes (mainly strength/power and range of motion); sport-specific outcomes were collected in less than 15% of trials. Biomechanical, physiological, and neural/psychological outcomes were assessed sparsely and heterogeneously; only five trials investigated injury-related outcomes.

Conclusions

There is room for improvement, with many areas of research on stretching being underexplored and others currently too heterogeneous for reliable comparisons between studies. There is limited representation of elite-level athletes (~ 5% tier 4 and no tier 5) and underpowered sample sizes (≤ 20 participants). Research was biased toward adult male athletes of sports not requiring extreme ranges of motion, and mostly assessed the acute effects of static active stretching and dynamic stretching during the warm-up. Dose–response relationships remain largely underexplored. Outcomes were mostly limited to general performance testing. Injury prevention and other effects of stretching remain poorly investigated. These relevant research gaps should be prioritized by funding policies.

Registration

OSF project (https://osf.io/6auyj/) and registration (https://osf.io/gu8ya).

中文翻译：

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关于健康运动员的伸展运动，我们所不知道的事情：根据 300 次试验的证据差距图进行范围界定审查

背景

伸展运动在运动科学中引起了极大的关注，产生了大量的研究。然而，目前还没有对健康运动员拉伸研究的全面概述。

目标

通过健康运动员拉伸研究的证据差距图进行系统范围审查，确定文献中当前的差距，并为利益相关者提供未来研究的优先事项。

方法

遵循系统评价和荟萃分析 (PRISMA) 2020 的首选报告项目和 PRISMA-ScR 指南。我们纳入了接受急性和/或慢性拉伸干预的健康运动员的研究。截至 2023 年 1 月 1 日，检索了六个数据库（CINAHL、EMBASE、PubMed、Scopus、SPORTDiscus 和 Web of Science）。相关数据以叙述方式综合；为关键数据项提供了定量数据摘要。制定了证据差距图，以概述现有研究和相关差距。

结果

在约 220,000 条筛选记录中，我们纳入了 300 项试验，涉及 7080 名 36 岁以下的运动员 [主要是男性（约 65% 相对于约 20% 女性，约 15% 未报告）；参与者分类框架的第 2 层和第 3 层]涵盖 43 个运动项目。需要极限运动范围的运动（例如体操）代表性不足。大多数试验评估了拉伸的急性影响，只有不到 20% 的试验对慢性影响进行了详细审查。长期干预平均为 7.4 ± 5.1 周，从未超过 6 个月。大多数试验（约 85%）在热身期间实施拉伸，而其他应用时机（例如运动后）尚未得到充分研究。大多数试验检查静态主动拉伸（62.3%），其次是动态拉伸（38.3%）和本体感觉神经肌肉促进（PNF）拉伸（12.0%），而对替代方法（例如弹道拉伸）的研究很少。比较者大多局限于被动对照，约 25% 的试验包括主动对照（例如力量训练）。下肢是干预的主要目标（~ 75%）。剂量报告的风格（例如，10 次重复与动态拉伸 10 秒）和信息完整性（即，所提供信息的全面性存在差异）存在差异。大多数试验（约 90%）报告了与表现相关的结果（主要是力量/功率和运动范围）；不到 15% 的试验收集了特定运动的结果。生物力学、生理学和神经/心理结果的评估稀疏且不均匀；只有五项试验调查了伤害相关的结果。

结论

仍有改进的空间，许多关于拉伸的研究领域尚未得到充分探索，而其他领域目前过于异质，无法在研究之间进行可靠的比较。精英级运动员的代表性有限（第 4 级运动员约占 5%，没有第 5 级运动员）且样本量不足（≤ 20 名参与者）。研究偏向于不需要极限运动范围的运动的成年男性运动员，并且主要评估热身期间静态主动拉伸和动态拉伸的急性影响。剂量-反应关系在很大程度上仍未得到充分探索。结果大多仅限于一般性能测试。拉伸运动预防损伤和其他作用的研究仍然很少。这些相关的研究空白应通过资助政策优先考虑。

登记

OSF 项目 (https://osf.io/6auyj/) 和注册 (https://osf.io/gu8ya)。