Extract:

PHY 202 Evidence based written summary for patient education leaflet "Integrating exercise into a daily routine as part of a physiotherapy approach to the management of a person with either Guillan Barre Syndrome or Multiple Sclerosis.

There is much debate over the optimal time period to sustain a stretch. Bandy and Irion (1994) examined the length of time a muscle should be sustained in a stretched position to maximally increase flexibility. They compared the effect of holding a stretch for fifteen, thirty or sixty seconds on fifty-seven subjects with limited hamstring muscle flexibility, once daily, for a six-week period. The results showed that thirty or sixty seconds is the most effective time period in terms of increasing ROM. Similarly, a study by Roberts and Wilson (1999) investigated the effect of stretching duration but for 5 or 15 seconds, in muscles of the lower limb such as hip flexors and plantarflexors. They discovered fifteen seconds was more beneficial than five. The authors suggest that an increase in time to thirty or sixty seconds may provide additional benefits in these muscle groups, supporting Bandy and Irion's (1994) results.

However the above mentioned studies do not give a long term view into the effect of stretching as they only ran for five and six weeks. This is significant in a condition such as MS as it is chronic and therefore a longer-term look into the effects of stretching would be more viable. Furthermore, the age of the samples used are not representative of the whole population. The mean age of participants in the first study was twenty to forty. MS has its peak incidence between twenty-five to thirty-five (Stokes 2004) so this age range would only accommodate younger MS sufferers.

Other authors such as Harvey et al (2002) have investigated prolonged stretches such as that for thirty minutes and argue that time periods such as this are required in order to gain a physiological effect. However, it is likely that compliance would be low if patients were advised to hold each stretch for this time period. Although the optimal dosage for stretching is not clear, thirty to sixty seconds stretching once a day has been chosen as the guidance to put in the leaflet based on the literature analysed above.