Over de effectiviteit van stretching wordt in de praktijk veel gespeculeerd en beweerd. De een gelooft er heilig in, de ander vindt het maar onzin. Tijd om de wetenschappelijke bewijzen eens op een rijtje te zetten. Stretching blijkt soms zinnig, en soms onzinnig.
Last year we published a randomised trial demonstrating that stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults (Hallegraeff et al 2012). The results of that study align perfectly with the uncontrolled study of Daniell (1979). In a recent letter to this journal, Daniell and Pentrack (2013) proposed an alternative stretching procedure for preventing nocturnal leg cramps. Some major differences can be identified between their new stretching procedure and the procedure used in our study.
LINK
BACKGROUND: Burn survivors are frequently faced with disfiguring scars. Various techniques exist to improve scar appearance, such as laser treatment and dermabrasion. Next to that, surgical reconstruction, such as scar excision is an option. This randomized controlled trial investigates whether a larger burn scar can be excised using a skin-stretching device for wound closure, thereby optimizing use of adjacent healthy skin. This technique may allow scar excision in a one-step procedure instead of two or more steps, which is necessary for serial excision and tissue expansion.METHODS: Two arms were compared: scar excision and closure by skin stretch and scar excision without additional techniques. The primary outcome measure was scar surface area reduction. In addition, complications were registered.RESULTS: Fifteen patients were randomized for skin stretch and 15 patients were randomized for scar excision only. In the skin stretch group, 10 of 15 scars were completely excised compared with three of 15 in the scar excision-only group (p = 0.025). In the skin stretch group, a significantly larger reduction in scar area was achieved: 95 ± 11 percent of the scar was excised versus 78 ± 17 percent in the scar excision-only group (p = 0.003). One patient in the skin stretch group and three patients in the scar excision-only group experienced partial wound dehiscence (p = 0.598).CONCLUSIONS: In burn scar reconstructions, a significantly larger reduction in scar area can be achieved using a skin-stretching device compared with scar excision with no additional techniques, without an increased risk of complications. It was shown that skin stretching is of added value for scars that cannot be excised in a one-step procedure.
