Acute Effects of Stretching, Kinesio Taping, Cold Water Immersion and Foam Rolling on Wrist Strength and Precise Force and Position Control

Design: single-centre, randomised, five-period crossover trial; each participant received all five interventions, one per weekly visit, in an individually randomised order (simple randomisation; random permutations generated at Random.org by a person not involved in testing; the examiner was informed of the intervention on the day of the visit). Six visits in total: familiarisation and baseline measurement (visit 0) and five intervention visits. Each measurement block comprised three maximal isometric wrist-flexion contractions, three 40.2-second force-tracking trials (reference 0-70% of the peak force), one measurement of active palmar-flexion range of motion and three 40.2-second position-tracking trials (reference 65% of the range of motion), on the HAMOCODI (Hand Motor Control Diagnostic) system (S2P Ltd., Ljubljana, Slovenia; sampling rate 1000 hertz). The post-intervention block started 10-20 seconds after the intervention. Interventions (60 seconds each, right forearm flexors): static stretching to the limit of pain tolerance; assisted dynamic stretching (active elbow and wrist extension with passive assistance at the end of the range, about 15 cycles); Kinesio taping (facilitation Y-strip plus mechanical-correction I-strip); cold water immersion of the hand and forearm at 14 degrees Celsius; foam rolling of the forearm flexors. Hypotheses: H1 - dynamic stretching, Kinesio taping and foam rolling improve precise force modulation, precise position modulation and maximal strength; H2 - cold water immersion and static stretching impair them. Analysis: percentage changes (log ratios), linear mixed models with intervention, visit order and sex as fixed effects and participant as random intercept; reliability analyses of all variables. Sample: 58 volunteers attended the introductory meeting; 56 (29 men, 27 women; age 22-36 years) were randomised and analysed. The upper age limit of 35 years was a pragmatic recruitment criterion; one eligible volunteer aged 36 was included by the investigators' decision before enrolment. Retrospective registration: the study was conducted as a doctoral research project on healthy volunteers with low-risk physical interventions, and the requirement to register this type of physiological crossover study was not recognised at the time; it is registered retrospectively, before publication of the results, so that all measured outcomes are publicly documented. The ethics approval (No. 5/2022) was issued on 18 February 2022; data were collected between 4 April and 13 May 2022. The study forms the doctoral dissertation "Movement Control Modulation in Targeted Wrist Joints under Kinesiological and Physical Treatments", University of Zagreb, Faculty of Kinesiology (topic approved by the University Senate on 17 January 2023). The anonymised trial-level dataset and analysis code are available at https://urn.nsk.hr/urn:nbn:hr:117:012259.

• Static stretching (Other): Seated, the participant grasped the fingers and palm of the test hand with the other hand, placed the fingers and wrist in maximal extension with the forearm supinated, extended the elbow fully and held the position for one continuous bout of 60 seconds at an intensity "to the limit of pain tolerance".
• Assisted dynamic stretching (Other): Seated with the forearm supinated, the participant actively extended the elbow and wrist; at the end of the active range the other hand grasped the fingers and palm and added passive extension of the fingers and wrist to the limit of pain tolerance; the position was held for about 2 seconds and the arm returned actively over about 2 seconds, non-ballistically; about 15 cycles in 60 seconds.
• Kinesio taping (Other): Kinesio Tex Gold 5-centimetre tape applied by the examiner: a Y-strip anchored without tension on the medial epicondyle with the tails along the wrist-flexor bellies to the wrist joint line at 30-40% tension (facilitation), and an I-strip across the palmar wrist at 50-75% tension with inward pressure (mechanical correction). The tape remained on during the post-intervention measurement.
• Cold water immersion (Other): Hand and forearm immersed above the elbow in water at 14 degrees Celsius (plus or minus 1 degree) for 60 seconds; arm towel-dried before testing.
• Foam rolling (Other): Standing, the forearm flexors were rolled on a smooth foam roller placed on a table, from distal to proximal and back, for 60 seconds, with pressure "to the limit of pain" and pauses on tender spots.

Primary outcomes

• Change in Peak Isometric Wrist-Flexion Force [Pre-intervention and 10-20 seconds post-intervention at each of 5 intervention visits (Weeks 2-6)]: Peak force (newtons), defined as the highest 1-second moving average of the force signal in the best of three maximal isometric wrist-flexion contractions. Change is expressed as the percentage change from pre- to post-intervention.
• Change in Normalised Error of the Force-Tracking Task [Pre-intervention and approximately 3-6 minutes post-intervention at each of 5 intervention visits (Weeks 2-6)]: Normalised error (%) while tracking a randomly generated sinusoidal force curve with isometric wrist flexion, calculated as the root-mean-square deviation from the reference curve divided by its amplitude and averaged over three trials. Change is expressed as the percentage change from pre- to post-intervention.
• Change in Normalised Error of the Position-Tracking Task [Pre-intervention and approximately 8-11 minutes post-intervention at each of 5 intervention visits (Weeks 2-6)]: Normalised error (%) while tracking a randomly generated sinusoidal wrist-angle curve with wrist flexion and extension, calculated as the root-mean-square deviation from the reference curve divided by its amplitude and averaged over three trials. Change is expressed as the percentage change from pre- to post-intervention.

Secondary outcomes

• Change in Active Palmar-Flexion Range of Motion [Pre-intervention and approximately 6-8 minutes post-intervention at each of 5 intervention visits (Weeks 2-6)]: Active range of palmar flexion (degrees), measured once with the built-in goniometer of the measurement system.
• Change of Tracking Error Across Visits in the Pre-intervention Measurements (Learning) [Pre-intervention at each of 6 weekly visits (Weeks 1-6)]: Slope of the normalised error of both tracking tasks across visits (percentage change per visit) from a linear mixed model of the log value.
• Change in Mean Absolute Error of the Force-Tracking Task [Pre-intervention and approximately 3-6 minutes post-intervention at each of 5 intervention visits (Weeks 2-6)]: Mean absolute deviation (newtons) of the produced force from the reference curve, averaged over three trials. Change is expressed as the percentage change from pre- to post-intervention.
• Change in Mean Absolute Error of the Position-Tracking Task [Pre-intervention and approximately 8-11 minutes post-intervention at each of 5 intervention visits (Weeks 2-6)]: Mean absolute deviation (degrees) of the produced wrist angle from the reference curve, averaged over three trials. Change is expressed as the percentage change from pre- to post-intervention.
• Change in Peak Force by Repetition Position [Pre-intervention and 10-20 seconds post-intervention at each of 5 intervention visits (Weeks 2-6)]: Percentage change in peak force (newtons) from pre- to post-intervention, calculated separately for the first, second and third maximal contraction of the measurement block.
• Within-Session Intraclass Correlation Coefficient [11 measurement occasions over 6 weeks (Weeks 1-6)]: Intraclass correlation coefficient, ICC(3,1), across the three trials within each measurement occasion (unitless), reported separately for peak force and for the normalised errors of the two tracking tasks.
• Between-Visit Intraclass Correlation Coefficient [Pre-intervention at each of 6 weekly visits (Weeks 1-6)]: Intraclass correlation coefficient, ICC(3,1), of the pre-intervention values across the six visits (unitless), reported separately for peak force and for the normalised errors of the two tracking tasks.
• Standard Error of Measurement of Peak Force [11 measurement occasions over 6 weeks (Weeks 1-6)]: Standard error of measurement of peak force (newtons), from the within-occasion analysis of three trials.
• Standard Error of Measurement of the Normalised Tracking Errors [11 measurement occasions over 6 weeks (Weeks 1-6)]: Standard error of measurement of the normalised error (percentage points), reported separately for the force-tracking and the position-tracking task.
• Minimal Detectable Change of Peak Force [11 measurement occasions over 6 weeks (Weeks 1-6)]: Minimal detectable change at the 95% confidence level (newtons), calculated as 1.96 x square root of 2 x standard error of measurement.
• Minimal Detectable Change of the Normalised Tracking Errors [11 measurement occasions over 6 weeks (Weeks 1-6)]: Minimal detectable change at the 95% confidence level (percentage points), reported separately for the force-tracking and the position-tracking task.
• Dispersion of Individual Responses [Pre-intervention and 10-20 seconds post-intervention at each of 5 intervention visits (Weeks 2-6)]: Standard deviation (percent) of the individual pre-to-post percentage changes in peak force after each intervention.

Sex: All, ages: 20 Years to 35 Years, accepts healthy volunteers

Inclusion Criteria:

* Healthy adults aged 20-35 years recruited through a public call
* Right-hand dominant (dominant hand = throwing hand)
* Written informed consent

Exclusion Criteria:

* Left-hand dominance
* Current pain in the dominant arm at rest, during exertion or movement
* History of injury limiting the function or range of motion of the dominant arm
* Diagnosed neuromuscular disorder
* Participation in competitive sport
* Joint hypermobility on the Beighton scale

• Study Protocol (PDF, 2026-09-28)
• Statistical Analysis Plan (PDF, 2026-09-28)