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Alimoradi M, Hosseini E, Sahebozamani M, Dos’Santos T, Sheikhbahaie S, Bigtashkhani R, Kabiri A. The effects of two different fatigue protocols on movement quality during anticipated and unanticipated change of directions in female soccer players. PLoS One 2024; 19:e0302144. [PMID: 38776356 PMCID: PMC11111049 DOI: 10.1371/journal.pone.0302144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/28/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE This study compared neuromuscular control under two fatigue protocols during anticipated and unanticipated change of direction (COD) maneuvers and evaluated their effects on the risk of non-contact ACL injuries. METHOD Forty-five female soccer players (mean age: 22.22 ± 2.24 years; mean height: 166.24 ± 3.33 cm; mean mass: 59.84 ± 5.03 kg) were divided into three groups: functional fatigue (Soccer specific fatigue ptotocol-SOFT90), non-functional fatigue (Bruce protocol), and control group. Before and after the implementation of neuromuscular control fatigue protocols were evaluated using the cutting motion assessment score tool (CMAS). Two-dimensional (2D) videos were recorded during anticipated and unanticipated COD trials for both dominant and non-dominant legs. RESULTS Significant time effects (p < 0.05) and group-time interactions (p < 0.05) were observed in both anticipated and unanticipated conditions for both dominant and non-dominant legs after the fatigue protocols. The functional fatigue group exhibited higher CMAS changes, indicating poorer movement quality following fatigue. Notably, the non-dominant leg displayed amplified deficits during unanticipated COD maneuvers following the functional fatigue protocol. CONCLUSIONS Fatigue significantly impairs neuromuscular control, particularly in unanticipated COD situations, which increases the risk of non-contact ACL injuries. To mitigate this risk, coaches, trainers, and medical professionals should prioritize targeted training and injury prevention strategies, focusing on the non-dominant leg during unanticipated COD maneuvers.
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Affiliation(s)
- Mohammad Alimoradi
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Elham Hosseini
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Mansour Sahebozamani
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Thomas Dos’Santos
- Musculoskeletal Science and Sports Medicine Research Centre, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Shima Sheikhbahaie
- Department of Sports Injuries and Corrective Exercises, Faculty of Sports Sciences, Shahid Bahonar University, Kerman, Iran
| | - Roya Bigtashkhani
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Aryan Kabiri
- Department of Health and Sport Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
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Taketomi S, Kawaguchi K, Mizutani Y, Takei S, Yamagami R, Kono K, Murakami R, Kage T, Arakawa T, Fujiwara S, Tanaka S, Ogata T. Lower hamstring to quadriceps muscle strength ratio and lower body weight as factors associated with noncontact anterior cruciate ligament injury in male American football players: A prospective cohort study. Asia Pac J Sports Med Arthrosc Rehabil Technol 2024; 35:43-47. [PMID: 38187929 PMCID: PMC10770439 DOI: 10.1016/j.asmart.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/05/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Background Previous studies have aimed to determine the use of certain risk factors in predicting the occurrence of noncontact anterior cruciate ligament (ACL) injuries. Unfortunately, evidence regarding noncontact ACL injuries in male American football players is limited. This prospective cohort study aimed to identify intrinsic risk factors for noncontact ACL injury among male American football players. Methods This study evaluated 152 male American football players in Japan for potential noncontact ACL injury risk factors during a preseason medical assessment, including anthropometric, joint laxity, and flexibility, muscle flexibility, muscle strength, and balance measurements. A total of 25 variables were examined. Participants were monitored during each season for noncontact ACL injury, as diagnosed by physicians. Results Noncontact ACL injuries occurred in 11 knees of 11 players (prevalence; 7.1 %). Injured players were significantly more likely to have lightweight (P = 0.049). No statistically significant between-group differences were found for any other variables. Participants with a lower hamstring to quadriceps (H/Q) ratio (P = 0.04) were more likely to sustain noncontact ACL injuries. Conclusion Lower H/Q ratio and lower body weight were significantly associated with new-onset noncontact ACL injury in male American football players. These findings will help develop strategies to prevent noncontact ACL injuries in male American football players.
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Affiliation(s)
- Shuji Taketomi
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
- UTokyo Sports Science Initiative (UTSSI), Japan
| | - Kohei Kawaguchi
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
- UTokyo Sports Science Initiative (UTSSI), Japan
| | | | - Seira Takei
- UTokyo Sports Science Initiative (UTSSI), Japan
| | - Ryota Yamagami
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Kenichi Kono
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Ryo Murakami
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Tomofumi Kage
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Takahiro Arakawa
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Sayaka Fujiwara
- UTokyo Sports Science Initiative (UTSSI), Japan
- Department of Rehabilitation Medicine, The University of Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery Faculty of Medicine, The University of Tokyo, Japan
| | - Toru Ogata
- UTokyo Sports Science Initiative (UTSSI), Japan
- Department of Rehabilitation Medicine, The University of Tokyo, Japan
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Kellis E, Sahinis C, Baltzopoulos V. Is hamstrings-to-quadriceps torque ratio useful for predicting anterior cruciate ligament and hamstring injuries? A systematic and critical review. JOURNAL OF SPORT AND HEALTH SCIENCE 2023; 12:343-358. [PMID: 35065297 DOI: 10.1016/j.jshs.2022.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/11/2021] [Accepted: 12/08/2021] [Indexed: 05/17/2023]
Abstract
BACKGROUND For the past 30 years, the hamstring (H)-to-quadriceps (Q) (H:Q) torque ratio has been considered an important index of muscle strength imbalance around the knee joint. The purpose of this systematic review was to examine the value of H:Q torque ratio as an independent risk factor for hamstring and anterior cruciate ligament (ACL) injuries. METHODS Database searches were performed to identify all relevant articles in PubMed, MEDLINE, Cochrane Library, and Scopus. Prospective studies evaluating the conventional (concentric H:Q), functional (eccentric H: concentric Q), and mixed (eccentric H at 30°/s: concentric Q at 240°/s) H:Q ratios as risk factors for occurrence of hamstring muscle strain or ACL injury were considered. Risk of bias was assessed using the Quality In Prognosis Studies tool. RESULTS Eighteen included studies reported 585 hamstrings injuries in 2945 participants, and 5 studies documented 128 ACL injuries in 2772 participants. Best evidence synthesis analysis indicated that there is very limited evidence that H:Q strength ratio is an independent risk factor for hamstring and ACL injury, and this was not different between various ratio types. Methodological limitations and limited evidence for ACL injuries and some ratio types might have influenced these results. CONCLUSION The H:Q ratio has limited value for the prediction of ACL and hamstring injuries. Monitoring strength imbalances along with other modifiable factors during the entire competitive season may provide a better understanding of the association between H:Q ratio and injury.
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Affiliation(s)
- Eleftherios Kellis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres 62100, Greece.
| | - Chrysostomos Sahinis
- Laboratory of Neuromechanics, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres 62100, Greece
| | - Vasilios Baltzopoulos
- Research Institute for Sport and Exercise Sciences (RISES), Faculty of Science, Liverpool John Moores University, Liverpool L3 5UX, UK
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Tuominen J, Leppänen M, Jarske H, Pasanen K, Vasankari T, Parkkari J. Test-Retest Reliability of Isokinetic Ankle, Knee and Hip Strength in Physically Active Adults Using Biodex System 4 Pro. Methods Protoc 2023; 6:mps6020026. [PMID: 36961046 PMCID: PMC10037623 DOI: 10.3390/mps6020026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/20/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND The isokinetic dynamometry is considered a gold standard in muscle strength testing. The reliability of lower limb isokinetic strength measurements has not been thoroughly evaluated. OBJECTIVE To examine the test-retest reliability of isokinetic ankle plantar and dorsiflexion, ankle inversion and eversion, knee extension and flexion and hip abduction and adduction strength in physically active adults using Biodex System 4 Pro. METHODS Peak torques (PTs) and average peak torques (APTs) of the dominant and nondominant lower limbs were tested twice in 19 physically active adults 7 to 14 days apart. RESULTS The intraclass correlation coefficients (ICC) values varied from excellent to moderate and coefficient of variation of typical error (CVTE) values were 6.6-19.5%. Change in the mean expressed as a percent varied from -3.1% to 9.6%. There was no difference in the reliability between PT and APT values. Dominant lower limb was more reliable in every case if there was difference between limbs. CONCLUSION Test-retest reliability of isokinetic ankle, knee and hip strength in physically active adults using Biodex System 4 is mostly good or excellent. However, the observed range of the random variation has to be noted when using it in scientific follow-up studies or evaluation of patient progress in clinical settings.
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Affiliation(s)
- Juho Tuominen
- Facualty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
| | - Heidi Jarske
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Tommi Vasankari
- Facualty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland
- Tampere University Hospital, 33520 Tampere, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyvaskyla, Finland
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Mauch M, Ritzmann R, Lambert C, Wenning M, Ebner C, Hartl L, Heitner AH, Paul J, Centner C. Pre-operative knee extensor and flexor torque after secondary ACL rupture: a comparative retrospective analysis. BMC Sports Sci Med Rehabil 2022; 14:135. [PMID: 35854326 PMCID: PMC9295510 DOI: 10.1186/s13102-022-00531-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/13/2022] [Indexed: 11/13/2022]
Abstract
Background Secondary anterior cruciate ligament (ACL) ruptures are a relevant clinical concern after surgical treatment of a primary ACL rupture. However, there is a lack of scientific evidence related to the role of muscle strength prior to revision surgery in a second ACL rupture. The aim of this study was to assess differences in knee extensor and flexor strength in patients before primary and secondary ACL reconstruction compared to healthy controls. Methods In total, n = 69 age, weight and sex matched individuals were included in the study: n = 23 patients with isolated primary ACL rupture, n = 23 with secondary ACL rupture, and n = 23 matched healthy controls. Maximal isokinetic knee extension and flexion torque normalized to body mass was assessed for both legs. Results For patients with secondary ACL ruptures, torques were reduced in the non-injured (extension: 1.94 Nm/kg vs. 2.46 Nm/kg, p < 0.05, flexion: 1.25 Nm/kg vs. 1.59 Nm/kg, p < 0.05) and the injured leg (extension: 1.70 Nm/kg vs. 2.46 Nm/kg, p < 0.05, flexion: 1.14 Nm/kg vs. 1.59 Nm/kg, p < 0.05) compared to healthy controls. For patients with a primary ACL rupture torques were reduced in the non-injured (extension: 1.92 Nm/kg vs. 2.46 Nm/kg, p < 0.05, flexion: 1.24 Nm/kg vs. 1.59 Nm/kg, p < 0.05) and the injured leg (extension: 1.38 Nm/kg vs. 2.46 Nm/kg, p < 0.05, flexion: 1.01 Nm/kg vs. 1.59 Nm/kg, p < 0.05) compared to healthy controls. There were no differences between patients with primary and secondary ruptures, except of the knee extension on the injured leg showing higher values after a secondary ACL rupture (1.38 Nm/kg vs. 1.70 Nm/kg, p < 0.05). Conclusions The findings indicate that maximal knee torques were significantly reduced in patients with primary and secondary ACL ruptures before surgical reconstruction for the non-injured and injured leg as compared to healthy controls. Further investigations are needed to assess strength abilities before and after a second revision within a prospective design.
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Affiliation(s)
| | | | - Christophe Lambert
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Centre, Cologne, Germany
| | - Markus Wenning
- Department of Orthopedic and Trauma Surgery, Medical Faculty, University Medical Center, University of Freiburg, Freiburg, Germany
| | - Clara Ebner
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany
| | - Leonie Hartl
- Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany
| | | | | | - Christoph Centner
- Rennbahnklinik, Muttenz, Switzerland. .,Department of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117, Freiburg, Germany.
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Screening Tests for Assessing Athletes at Risk of ACL Injury or Reinjury-A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052864. [PMID: 35270563 PMCID: PMC8910677 DOI: 10.3390/ijerph19052864] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/25/2022] [Accepted: 02/26/2022] [Indexed: 12/23/2022]
Abstract
Various tests are available to assess athletes for factors associated with their susceptibility and risk of anterior cruciate ligament (ACL) injury or reinjury; however, it is unclear which tests are clinically meaningful and what should be considered when using them. Therefore, the aim of this scoping review was to screen and summarize testing and to derive evidence-based recommendations for clinicians, practitioners and future research. Five databases were searched to identify studies addressing musculoskeletal morphology or functional-performance-related screening tests with a clear conceptual link or an evidence-based relationship to ACL (re)injury. A quality rating was carried out using the National Institutes of Health (NIH) Study-Quality Assessment Tool. Six different categories of common screening tests were identified: balance and postural control, gait- and running-related tests, joint laxity, joint morphology and anthropometrics, jump tests and strength tests. Predicting future injury in a complex, dynamic system based on a single screening test is methodologically challenging, which is also reflected in the highly controversial findings in the literature regarding potential associations between specific screening tests and the occurrence of ACL injuries and reinjuries. Nonetheless, various screening tests can provide clinically relevant information on ACL-(re)injury-related factors and help to provide tailored preventive measures. A selection of corresponding evidence-based recommendations is derived and presented in this scoping review.
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Hoseini A, Zarei M, Nobari H, Hovanloo F, Abbasi H, Pérez-Gómez J. Isokinetic muscle strength cannot be related to the odds ratio of musculoskeletal injuries in young elite wrestlers. BMC Sports Sci Med Rehabil 2022; 14:29. [PMID: 35193657 PMCID: PMC8862385 DOI: 10.1186/s13102-022-00423-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/17/2022] [Indexed: 11/12/2022]
Abstract
Background Wrestling is considered one of the oldest sports in the world. There is a high rate of injuries in Wrestling. To prevent injuries, it is necessary to identify the risk factors. Despite the functional importance of strength in wrestling, few studies have investigated the relationship between isokinetic strength and the rate of injuries in the sport. Objectives The objective of the present study was to investigate the relationship between the isokinetic strength of elite wrestlers and the rate of injuries prospectively. Method A total of 72 young wrestlers with at least 2 years of experience in the Tehran Wrestling Premier League participated in this study. Before the start of the competition season, the isokinetic strength of flexor and extensor muscles of the knee and shoulder were measured at different velocities by an isokinetic dynamometer. The injuries and training hours of these wrestlers were then recorded for nine months. Results The study results showed no significant relationship between isokinetic strength of flexor and extensor muscles of the knee or shoulder at different angular speeds of 60, 180, and 300°/s. There was neither significant between the ratio of the strength flexor/extensor for knee and/or shoulder in young elite wrestlers with injuries. Conclusion Isokinetic strength of lower and upper limb muscles alone cannot predict wrestlers' injuries. Therefore, the use of these tests is not recommended to evaluate the risk of injury in this population.
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Affiliation(s)
- Alireza Hoseini
- Department of Sport Rehabilitation and Health, Faculty of Sport Science and Health, Shahid Beheshti University, Tehran, Iran
| | - Mostafa Zarei
- Department of Sport Rehabilitation and Health, Faculty of Sport Science and Health, Shahid Beheshti University, Tehran, Iran
| | - Hadi Nobari
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran. .,Sepahan Football Club, Isfahan, 81887-78473, Iran. .,HEME Research Group, Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain.
| | - Fariborz Hovanloo
- Department of Sport Injuries and Corrective Exercises, Sport Sciences Research Institute, Tehran, Iran
| | - Hamed Abbasi
- Department of Sport Rehabilitation and Health, Faculty of Sport Science and Health, Shahid Beheshti University, Tehran, Iran
| | - Jorge Pérez-Gómez
- HEME Research Group, Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
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Hietamo J, Rantala A, Parkkari J, Leppänen M, Rossi M, Heinonen A, Steffen K, Kannus P, Mattila V, Pasanen K. Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes. Sports Health 2022; 15:26-35. [PMID: 35037493 PMCID: PMC9808828 DOI: 10.1177/19417381211065443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The identification of risk factors for sports injuries is essential before injury prevention strategies can be planned. HYPOTHESIS Previous acute knee injury and lower perceived knee function measured by Knee injury and Osteoarthritis Outcome Score (KOOS) will increase the risk of acute knee injury in youth team-sports athletes. STUDY DESIGN Prospective cohort study. LEVEL OF EVIDENCE Level 3. METHODS At baseline, youth (≤21 years old) male and female basketball and floorball athletes completed a questionnaire on previous acute knee injuries and perceived knee function (KOOS). A total of 211 male and 183 female athletes were followed for an acute knee injury up to 3 years. Unadjusted and adjusted Cox regression models were used in risk factor analyses. RESULTS In male athletes, previous acute knee injury and lower KOOS Pain, Activities of Daily Living, Sport and Recreation, and knee-related Quality of Life subscale scores increased the risk of acute knee injury in the unadjusted analyses. Adjusted analyses for male injuries were not performed because of low number of acute knee injuries (n = 18). In female athletes, previous acute knee injury increased the risk of acute knee injury when adjusted for athletes' age and body mass index (hazard ratio, 2.6 [95% CI, 1.3-5.2]). In female athletes, none of the KOOS subscale scores were associated with the increased risk of acute knee injury in the adjusted analyses. CONCLUSION Previous acute knee injury was associated with the risk of new acute knee injury in youth male and female athletes. In youth male athletes, additionally, lower perceived knee function in 4 out of 5 KOOS subscale scores were associated with the increased risk of new acute knee injury. CLINICAL RELEVANCE The treatment and rehabilitation of the present acute knee injury and secondary prevention of reinjury should be emphasized in youth team-sports athletes.
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Affiliation(s)
- Jussi Hietamo
- Jussi Hietamo, MD, Tampere
Research Center of Sport Medicine, UKK Institute for Health Promotion Research,
Laavukatu 8 C 11, Tampere, 33580, Finland (
)
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J H, K P, M L, K S, P K, A H, Vm M, J P. Association between lower extremity muscle strength and acute ankle injury in youth team-sports athletes. Phys Ther Sport 2021; 48:188-195. [PMID: 33508694 DOI: 10.1016/j.ptsp.2021.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/12/2021] [Accepted: 01/16/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To investigate lower extremity muscle strength as risk factor for an acute ankle injury in youth athletes. DESIGN Cohort study. SETTING Basketball and floorball clubs. PARTICIPANTS 188 youth (≤21) male and 174 female athletes. MAIN OUTCOME MEASURES 1RM leg press, maximal concentric isokinetic quadriceps and hamstrings as well as maximal isometric hip abductor strength were measured and athletes were followed for an acute ankle injury up to three years. Cox regression models were used in statistical analyses. RESULTS In males, greater 1RM leg press and maximal quadriceps strength increased the risk of any type of acute ankle injury (Hazard ratio [HR] for 1 SD increase, 1.63 [95% CI, 1.12-2.39] and 1.43 [95% CI, 1.01-2.01], respectively). In females, greater 1RM leg press and difference between legs in hip abduction strength increased the risk of acute non-contact ankle injury (HR for 1 SD increase, 1.44 [95% CI, 1.03-2.02] and 1.44 [95% CI, 1.03-2.00], respectively). However, ROC curve analyses showed AUC:s of 0.57-0.64 indicating "fail" to "poor" combined sensitivity and specifity of these tests. CONCLUSION Greater strength in both sexes along with asymmetry in hip abductor strength in females increased the risk of acute ankle injury.
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Affiliation(s)
- Hietamo J
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland; KHKS, Hämeenlinna, Finland.
| | - Pasanen K
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland; Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada; McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leppänen M
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland
| | - Steffen K
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kannus P
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland; Departement of Orthopedics and Traumatology, Tampere University Hospital, and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Heinonen A
- University of Jyväskylä, Jyväskylä, Finland
| | - Mattila Vm
- Departement of Orthopedics and Traumatology, Tampere University Hospital, and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Parkkari J
- Tampere Research Center of Sport Medicine, UKK Institute for Health Promotion Research, Tampere, Finland; Departement of Orthopedics and Traumatology, Tampere University Hospital, and Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
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