Comparative Effectiveness of Active Release Technique versus Mulligan Bent Leg Raise Technique in Improving Hamstring Flexibility in Asymptomatic Healthy Subjects: A Randomised Controlled Trial
Abstract
Objective: Hamstring flexibility is essential for maintaining optimal musculoskeletal function and preventing injuries. Manual therapy techniques such as Active Release Technique (ART) and Mulligan Bent Leg Raise (MBLR) have been explored to enhance flexibility, yet their comparative effectiveness remains unclear. This study aimed to compare the effectiveness of ART, MBLR, and conventional hamstring stretching in improving hamstring flexibility among asymptomatic healthy subjects.
Material and Methods: Thirty-six asymptomatic healthy subjects were randomly assigned to three groups: Group 1 (n=12) received ART, Group 2 (n=12) received MBLR, and Group 3 (n=12) received conventional hamstring stretching. Interventions were administered six days in the 1st week. Hamstring flexibility was assessed using the Active Knee Extension (AKE) at three time points: baseline, at post 1 week, and at post 2 weeks. Data were analyzed using repeated measures ANOVA to evaluate the effects of time and group on AKE ROM, followed by Tukey-Kramer post-hoc tests for pairwise comparisons.
Results: Repeated measures ANOVA showed a significant main effect of time on AKE ROM (F(2,66)=24.78, p-value<0.001), with improvements from baseline to weeks 1 and 2 (p-value<0.001). No significant group effect (F(2,33)=0.80, p-value=0.458) or group × time interaction (F(4,66)=1.01, p-value=0.409) was found.
Conclusion: All three interventions—ART, MBLR, and conventional stretching—produced statistically significant improvements in hamstring flexibility, with no significant differences between groups. However, the changes did not exceed the minimal clinically detectable threshold, limiting any conclusions about functional relevance. Future trials with larger samples may offer clearer insights into their comparative effectiveness.
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