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

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.