Spray and stretch

ARTICLE IN PRESS
Journal of Bodywork and Movement Therapies (]]]]) ], ]]]–]]]

Journal of Bodywork and Movement Therapies
www.intl.elsevierhealth.com/journals/jbmt

CLINICAL STUDY

Effect of topical aerosol skin refrigerant (Spray and Stretch technique) on passive and active stretching$
Dimitrios Kostopoulos, PT, PhD, DSc, MCMTÃ, Konstantine Rizopoulos, PT, FABS, MCMT
5 Engineers Road,Roslyn Harbor, NY 11576, USA
Received 18 October 2007; received in revised form 22 November 2007; accepted 23 November 2007

KEYWORDS
Hip flexion; Spray and stretch; Stretching; Physical therapy; Gender; Vapocoolants; Myofascial pain; Myofascial trigger point

Summary Objectives: The purpose of this study was to examine the effects of the use of a vapocoolant blend of pentafluoropropane andtetrafluoroethane (Gebauer’s Spray and Stretch) on hip flexion stretching. Methods: Thirty volunteers were randomly assigned to spray and stretch treatment and stretch only control groups. Each group was assessed pre- and posttest on passive and active hip flexion range of motion (ROM). Results: Findings indicated greater posttest hip flexion gains for the spray and stretch group over the stretch onlygroup for both active and passive ROM. Additionally, females achieved greater pre- and posttest differences on active ROM compared to males. Conclusions: Study findings suggest that spray and stretch techniques can be an effective treatment in increasing hip flexion ROM. & 2007 Elsevier Ltd. All rights reserved.

Introduction
Spray and stretch techniques have been widely used by clinicians totreat myofascial pain due to active trigger points, musculoskeletal dysfunction, and to increase range of motion (ROM) of various
$ This study was sponsored by St. Matthew’s University School of Medicine ohttp://www.stmatthews.edu/4. ÃCorresponding author. Tel.: +1 917 538 2242. E-mail address: dimipt@aol.com (D. Kostopoulos).

1360-8592/$ - see front matter & 2007 Elsevier Ltd. All rightsreserved. doi:10.1016/j.jbmt.2007.11.005 Please cite this article as: Kostopoulos, D., Rizopoulos, K., Effect of topical aerosol skin refrigerant (Spray and Stretch technique) on passive and active stretching. Journal of Bodywork and Movement Therapy (2008), doi:10.1016/j.jbmt.2007.11.005

Clinical Study

joints (Travell, 1990; Simons et al., 1999; Kostopoulos and Rizopoulos, 2001). In 1981, Halkovichet al. (1981) conducted an experiment on hip flexion in which they randomly assigned 15 healthy subjects each to treatment and control conditions. The treatment group received a spray coolant between pre- and posttest assessments on ROM of hip flexion. The mean difference in pelvifemoral angle measurement for the experimental group was 1.211 compared to 0.211 for the control group, which wassignificant at the 0.02 level.

ARTICLE IN PRESS
2 Despite the success of the experiment, the widespread use of refrigerants for a wide variety of physical therapy applications, and its advocacy for treatment of myofascial trigger points (Simons et al., 1999; Simons and Mense, 2003), empirical investigations on the effectiveness of topical vapocoolants for increasing ROM have been practicallynon-existent. Searches of 27 medical and related health field databases, including Medline, Dissertation Abstracts, SciSearch, EMBASE, Allied and Contemporary Medicine, Manual, Alternative and Natural Therapy, and Global Health reveals three empirical investigations. Khalil and associates (1992) successfully used spray and stretch techniques in the alleviation of back pain and ROM in conjunction withseveral other techniques. Because the spray and stretch techniques were used in combination with other modalities, it was difficult to isolate their effects. Bengalia et al. (1999) used coolant and a thermoplastic splint along with exercises to help heal finger injuries in four professional volleyball players with positive results. The small sample size and the combination of therapeutic techniques...