Quantifying the magnitude of torque physiotherapists apply when stretching the hamstring muscles of people with spinal cord injury

Arch Phys Med Rehabil. 2003 Jul;84(7):1072-5. doi: 10.1016/s0003-9993(03)00131-x.


Objective: To quantify the magnitude of stretch that physiotherapists apply to the hamstring muscles of people with spinal cord injury (SCI).

Design: Repeated-measures design.

Setting: SCI unit in Australia.

Participants: Fifteen individuals with motor complete paraplegia or tetraplegia.

Intervention: Twelve physiotherapists manually administered a stretch to the hamstring muscles of each subject. The stretch was applied by flexing the hip with the knee extended.

Main outcome measure: Applied hip flexor torque.

Results: Therapists applied median hip flexor torques of between 30 and 68Nm, although some torques were as large as 121Nm. The stretch applied by different therapists to any 1 subject varied as much as 40-fold.

Conclusion: There is a large range of stretch torques provided by physiotherapists to patients with SCI. Some therapists provide stretch torques well in excess of those tolerated by individuals with intact sensation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adult
  • Australia
  • Clinical Competence / standards
  • Exercise Therapy / adverse effects
  • Exercise Therapy / methods*
  • Exercise Therapy / standards
  • Exercise Therapy / statistics & numerical data
  • Female
  • Hip Joint / physiopathology
  • Humans
  • Linear Models
  • Male
  • Muscle, Skeletal*
  • Pliability
  • Practice Guidelines as Topic / standards
  • Range of Motion, Articular*
  • Spinal Cord Injuries / physiopathology
  • Spinal Cord Injuries / rehabilitation*
  • Thigh*
  • Torque