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The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021-05-05Artigo científico Acesso aberto
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datacite.subject.fosCiências Médicas::Outras Ciências Médicas
datacite.subject.fosCiências Naturais::Ciências Biológicas
datacite.subject.sdg04:Educação de Qualidade
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorAfonso, José
dc.contributor.authorClemente, Filipe Manuel
dc.contributor.authorNakamura, Fábio Yuzo
dc.contributor.authorMorouço, Pedro
dc.contributor.authorSarmento, Hugo
dc.contributor.authorInman, Richard A.
dc.contributor.authorRamirez-Campillo, Rodrigo
dc.date.accessioned2026-03-03T15:23:56Z
dc.date.available2026-03-03T15:23:56Z
dc.date.issued2021-05-05
dc.description.abstractBackground: Post-exercise (i.e., cool-down) stretching is commonly prescribed for improving recovery of strength and range of motion (ROM) and diminishing delayed onset muscular soreness (DOMS) after physical exertion. However, the question remains if post-exercise stretching is better for recovery than other post-exercise modalities. Objective: To provide a systematic review and meta-analysis of supervised randomized-controlled trials (RCTs) on the effects of post-exercise stretching on short-term (≤1 h after exercise) and delayed (e.g., ≥24 h) recovery makers (i.e., DOMS, strength, ROM) in comparison with passive recovery or alternative recovery methods (e.g., low-intensity cycling). Methods: This systematic review followed PRISMA guidelines (PROSPERO CRD42020222091). RCTs published in any language or date were eligible, according to P.I.C.O.S. criteria. Searches were performed in eight databases. Risk of bias was assessed using Cochrane RoB 2. Meta-analyses used the inverse variance random-effects model. GRADE was used to assess the methodological quality of the studies. Results: From 17,050 records retrieved, 11 RCTs were included for qualitative analyses and 10 for meta-analysis (n = 229 participants; 17–38 years, mostly males). The exercise protocols varied between studies (e.g., cycling, strength training). Post-exercise stretching included static stretching, passive stretching, and proprioceptive neuromuscular facilitation. Passive recovery (i.e., rest) was used as comparator in eight studies, with additional recovery protocols including low intensity cycling or running, massage, and cold-water immersion. Risk of bias was high in ~70% of the studies. Between-group comparisons showed no effect of post-exercise stretching on strength recovery (ES = −0.08; 95% CI = −0.54–0.39; p = 0.750; I2 = 0.0%; Egger's test p = 0.531) when compared to passive recovery. In addition, no effect of post-exercise stretching on 24, 48, or 72-h post-exercise DOMS was noted when compared to passive recovery (ES = −0.09 to −0.24; 95% CI = −0.70–0.28; p = 0.187–629; I2 = 0.0%; Egger's test p = 0.165–0.880). Conclusion: There wasn't sufficient statistical evidence to reject the null hypothesis that stretching and passive recovery have equivalent influence on recovery. Data is scarce, heterogeneous, and confidence in cumulative evidence is very low. Future research should address the limitations highlighted in our review, to allow for more informed recommendations. For now, evidence-based recommendations on whether post-exercise stretching should be applied for the purposes of recovery should be avoided, as the (insufficient) data that is available does not support related claims. Systematic Review Registration: PROSPERO, identifier: CRD42020222091.eng
dc.description.sponsorshipWe thank Professor Pantelis Nikolaidis and Nefeli Papanikolaki for the help with obtaining and translating the Greek study for which who had to analyze the full text. We thank Lee Saong Min for the translation of the Korean studies to both English and Portuguese. We thank Ana Gracinda Ramos for independent extraction of data from graphs. We thank Professor José Alberto Duarte for providing expert input in suggesting potentially relevant studies to be included in the final sample, after having analyzed the list of studies we had selected, as well as the inclusion and exclusion criteria.
dc.identifier.citationAfonso J, Clemente FM, Nakamura FY, Morouço P, Sarmento H, Inman RA and Ramirez-Campillo R (2021) The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front. Physiol. 12:677581. doi: https://doi.org/10.3389/fphys.2021.677581.
dc.identifier.doi10.3389/fphys.2021.677581
dc.identifier.eissn1664-042X
dc.identifier.urihttp://hdl.handle.net/10400.8/15772
dc.language.isoeng
dc.peerreviewedyes
dc.publisherFrontiers Media
dc.relation.hasversionhttps://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2021.677581/full
dc.relation.ispartofFrontiers in Physiology
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectflexibility
dc.subjectpost exercise recovery
dc.subjectmyalgia
dc.subjectcool-down
dc.subjectdelayed onset muscular soreness
dc.subjectstretching
dc.subjectmuscle stretching exercises
dc.subjectarticular range of motion
dc.titleThe Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trialseng
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage25
oaire.citation.startPage1
oaire.citation.titleFrontiers in Physiology
oaire.citation.volume12
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameMorouço
person.givenNamePedro
person.identifier435983
person.identifier.ciencia-idF619-3996-742A
person.identifier.orcid0000-0002-5956-9790
person.identifier.ridK-9545-2013
person.identifier.scopus-author-id24339135400
relation.isAuthorOfPublication05b28d80-9e18-41cc-a66c-f37955bfc8da
relation.isAuthorOfPublication.latestForDiscovery05b28d80-9e18-41cc-a66c-f37955bfc8da

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Background: Post-exercise (i.e., cool-down) stretching is commonly prescribed for improving recovery of strength and range of motion (ROM) and diminishing delayed onset muscular soreness (DOMS) after physical exertion. However, the question remains if post-exercise stretching is better for recovery than other post-exercise modalities. Objective: To provide a systematic review and meta-analysis of supervised randomized-controlled trials (RCTs) on the effects of post-exercise stretching on short-term (≤1 h after exercise) and delayed (e.g., ≥24 h) recovery makers (i.e., DOMS, strength, ROM) in comparison with passive recovery or alternative recovery methods (e.g., low-intensity cycling). Methods: This systematic review followed PRISMA guidelines (PROSPERO CRD42020222091). RCTs published in any language or date were eligible, according to P.I.C.O.S. criteria. Searches were performed in eight databases. Risk of bias was assessed using Cochrane RoB 2. Meta-analyses used the inverse variance random-effects model. GRADE was used to assess the methodological quality of the studies. Results: From 17,050 records retrieved, 11 RCTs were included for qualitative analyses and 10 for meta-analysis (n = 229 participants; 17–38 years, mostly males). The exercise protocols varied between studies (e.g., cycling, strength training). Post-exercise stretching included static stretching, passive stretching, and proprioceptive neuromuscular facilitation. Passive recovery (i.e., rest) was used as comparator in eight studies, with additional recovery protocols including low intensity cycling or running, massage, and cold-water immersion. Risk of bias was high in ~70% of the studies. Between-group comparisons showed no effect of post-exercise stretching on strength recovery (ES = −0.08; 95% CI = −0.54–0.39; p = 0.750; I2 = 0.0%; Egger's test p = 0.531) when compared to passive recovery. In addition, no effect of post-exercise stretching on 24, 48, or 72-h post-exercise DOMS was noted when compared to passive recovery (ES = −0.09 to −0.24; 95% CI = −0.70–0.28; p = 0.187–629; I2 = 0.0%; Egger's test p = 0.165–0.880). Conclusion: There wasn't sufficient statistical evidence to reject the null hypothesis that stretching and passive recovery have equivalent influence on recovery. Data is scarce, heterogeneous, and confidence in cumulative evidence is very low. Future research should address the limitations highlighted in our review, to allow for more informed recommendations. For now, evidence-based recommendations on whether post-exercise stretching should be applied for the purposes of recovery should be avoided, as the (insufficient) data that is available does not support related claims. Systematic Review Registration: PROSPERO, identifier: CRD42020222091.
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