Canadian Centre for Activity and Agine

The Flexibility Debate

hamstring stretch

As indicated in Dr. Don Paterson’s systematic review relating to Canada’s Physical Activity Guidelines for Older Adults, exercise interventions (comprised of aerobics and strength training) in older adults can maintain or improve functional abilities.

Less is known about the role of flexibility in the maintenance or improvement of functional abilities. While joint flexibility may decrease with age – and this has the potential to affect normal daily function – there currently does not exist a synthesis of the literature to support the recommendation of the inclusion of a flexibility component to older adult exercise programs.

In younger populations, there is a debate regarding stretching exercises which are regularly recommended and conducted as a part of warm-up protocols. While stretching during warm-up is thought to prevent injury and increase performance, there is little sound empirical evidence to support the utility of this outside of a rehabilitative context.

Rob Little

Rob Little

Rob Little (UWO kinesiology student and research assistant) conducted a systematic review in this area in collaboration with Drs. Don Paterson, Tony Vandervoort, and Liza Stathokostas. The preliminary results were presented by Rob in June at the American College of Sports Medicine Annual Meeting held in Denver, Colorado. The presentation entitled “Flexibility Training Interventions and Functional Outcomes in Aging: A Systematic Review” sought to systematically review the literature assessing the flexibility specific training interventions on functional outcomes in older adults.

The review found that flexibility training interventions in older adults are often effective at increasing joint range of motion in various joints, and various functional outcomes can be improved. However, due to the wide range of intervention protocols, body parts studied, and functional measurements, conclusive recommendations regarding flexibility training for older adults remain ungrounded. As such, a specific prescription of how long to hold a stretch, how many repetitions of each stretch to conduct, and the type of stretches to do, are not yet available.

Because there is conflicting information regarding both the relationship between flexibility training interventions and functional outcomes, and the relationship between improved flexibility and daily functioning, future research studies should attempt to address these issues in order to facilitate the fitness of older adults. The systematic review is set to be submitted for publication early this Summer.

The need for flexibility-specific exercises for older adults as a part of their physical activity and exercise routine is questionable; the positive health benefits are not established, however there is also not the evidence to discontinue stretching exercise. Perhaps the best advice is to perform stretching routines in the post-exercise cool-down if you like, but remember that it is the aerobic exercise and strength routines that maintain health and function into older age.