Effects of occipito-frontal release with dorsiflexion technique (OFRDF) for improvement of superficial back line flexibility

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Chakkid Khunkitti
Lugkana Mato
Torkamol Hunsawong
Aatit Paungmali
Yodchai Boonprakob


Background: Hamstrings tightness is a major risk factor concerning lower back pain and lower extremity injuries. Occipito-frontal release with dorsiflexion technique is a novel technique developed to improve the superficial back line (SBL) flexibility. This technique combines passive and active loading at the cephalic end, and caudal end of the SBL, respectively.  

Objectives: To compare the effects of OFRDF and passive static stretching aimed at improving SBL flexibility in sedentary participants.

Materials and methods: Fifty-six participants demonstrating bilateral hamstring tightness (passive knee extension angle test greater than 20 degrees) were recruited. Participants were allocated via stratified block randomization (block size 4 and 6). Participants in the experimental group partook in OFRDF technique, whereas participants in the control group partook in passive static stretching. Both groups performed each intervention 3 times a week. Outcome measures were passive knee extension angle (PKE), craniovertebral angle (CVA), and sit and reach (SR) distance. Outcomes were measured at baseline, after the primary intervention, and post third intervention. A mixed-model ANOVA was used to compare mean difference within both the OFRDF and control groups and to compare between groups..

Results: A 3 (time) x 2 (group) mixed-model ANOVA demonstrated that both techniques shown to significantly decrease PKE angle on both sides, increase CVA and SR when compared between the third and initial intervention. However, all outcomes exhibited non-significant differences when compared between groups.

Conclusion: OFRDF and passive static stretching of the hamstrings can both similarly improve SBL flexibility.


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Khunkitti, C., Mato, L., Hunsawong, T., Paungmali, A., & Boonprakob, Y. (2020). Effects of occipito-frontal release with dorsiflexion technique (OFRDF) for improvement of superficial back line flexibility. Journal of Associated Medical Sciences, 54(1), 26–34. Retrieved from https://he01.tci-thaijo.org/index.php/bulletinAMS/article/view/242283
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