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Alsirhani AA, Muaidi QI, Nuhmani S, Thorborg K, Husain MA, Al Attar WSA. The effectiveness of the Copenhagen adduction exercise on improving eccentric hip adduction strength among soccer players with groin injury: a randomized controlled trial. PHYSICIAN SPORTSMED 2024:1-10. [PMID: 38376593 DOI: 10.1080/00913847.2024.2321958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/19/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Groin injuries are common in soccer players and often involve adductor muscle strains. The Copenhagen Adduction Exercise (CAE) is a targeted intervention whose effectiveness in rehabilitation for these injuries warrants investigation. OBJECTIVE To investigate the impact of a rehabilitation program, which includes the CAE, on eccentric hip adduction (EHAD) strength, hip joint range of motion (ROM), self-reported disability, and pain among soccer players with adductor-related groin pain. It was hypothesized that the addition of CAE to the rehabilitation program would yield greater improvements. METHODS Employing a randomized controlled trial with a two-group parallel design, thirty male soccer players with a mean age of 26.4 ± 3.9 years were randomized into an intervention group (IG) including CAE (n = 15) and a control group (CG) without CAE (n = 15), based on a power analysis to ensure 80% power to detect significant differences. Both groups engaged in their respective rehabilitation programs twice a week for eight weeks. The primary outcome measured was EHAD strength, while secondary outcomes included hip joint ROM, self-reported disability measured by the Copenhagen Hip and Groin Outcome Score (HAGOS), and pain levels. RESULTS Significant improvements within groups were observed across all measures (p < 0.001). The IG demonstrated a greater increase in EHAD strength (Mean Difference [MD] = 0.49 Nm/kg, 95% Confidence Interval [CI] [0.31, 0.66]), a more pronounced reduction in pain (MD = -1.60, 95% CI [-2.18, -1.02]), and betterment in all HAGOS subscale scores compared to the CG. There were no significant between-group differences in hip joint ROM. CONCLUSION Incorporating the CAE into rehabilitation programs significantly improves EHAD strength, decreases pain scores, and reduces self-reported disability in soccer players with adductor-related groin pain. REGISTRATION ClinicalTrials.gov identifier: NCT05589623.
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Affiliation(s)
- Ahmed A Alsirhani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
- Department of Physical Therapy, Ministry of Health, Aseer Region, Saudi Arabia
| | - Qassim I Muaidi
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shibili Nuhmani
- Department of Physical Therapy, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
| | - Mohamed A Husain
- Department of Physical Education, College of Health and Sport Sciences, University of Bahrain, Sakhir, Bahrain
| | - Wesam Saleh A Al Attar
- Department of Medical Rehabilitation Sciences, Faculty of Applied Medical Sciences, Umm Al Qura University, Makkah, Saudi Arabia
- Discipline of Exercise and Sport Science, Medicine and Health Sciences, The University of Sydney, Sydney, Australia
- Department of Sport, Exercise and Health, Medicine, University of Basel, Basel, Switzerland
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Siwecka G, Wodka-Natkaniec E, Niedźwiedzki Ł, Świtoń A, Niedźwiedzki T. Relationship between the hip range of motion and functional motor system movement patterns in football players. J Sports Med Phys Fitness 2021; 62:904-909. [PMID: 34275262 DOI: 10.23736/s0022-4707.21.12679-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to determine the hip range of motion and the movement patterns of football players assessed with an aid of a Functional Motor Systems test, and to find an association between these parameters and the risk for hip joint injury. METHODS The study included 50 men aged between 16 and 20 years: 25 footballers and 25 age- and body mass index-matched controls. The hip ranges of motion (flexion, extension, internal and external rotation, adduction and abduction) were determined, and the movement patterns were evaluated with the tests from the Functional Motor Systems battery. RESULTS Football players presented with significantly higher ranges of the hip flexion, extension, internal and external rotation than the controls. Moreover, footballers and controls differed significantly in terms of their mean overall Functional Motor Systems scores (15.77 points ± 2.44 vs. 13.79 ± 3.02 points, P = 0.019). Football players scored best on the shoulder mobility test for the right side and worst on the rotary stability test for the left side. The scores on the trunk stability test and rotary stability test for the left side were significantly higher in footballers than in the controls. Nevertheless, the overall Functional Motor Systems scores of 14 points or less were recorded in the case of as many as 10/25 footballers. CONCLUSIONS Altogether, these findings suggest that some football players present with a strain which may predispose them to future injuries. Future research should center around the etiology of reduced hip ROM observed in footballers. Furthermore, football training seems to result in a considerable motor asymmetry of the trunk which also predisposes to injury.
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Affiliation(s)
- Gabriela Siwecka
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Ewa Wodka-Natkaniec
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland -
| | - Łukasz Niedźwiedzki
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Anna Świtoń
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Tadeusz Niedźwiedzki
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
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O'Brien J, Santner E, Finch CF. The inter-tester reliability of the squeeze and bent-knee-fall-out tests in elite academy football players. Phys Ther Sport 2018; 34:8-13. [DOI: 10.1016/j.ptsp.2018.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 06/20/2018] [Accepted: 08/08/2018] [Indexed: 10/28/2022]
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Yousefzadeh A, Shadmehr A, Olyaei GR, Naseri N, Khazaeipour Z. Effect of Holmich protocol exercise therapy on long-standing adductor-related groin pain in athletes: an objective evaluation. BMJ Open Sport Exerc Med 2018; 4:e000343. [PMID: 30018787 PMCID: PMC6045696 DOI: 10.1136/bmjsem-2018-000343] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2018] [Indexed: 11/04/2022] Open
Abstract
Aim To objectively evaluate the effect of Holmich protocol-based exercise therapy on long-standing adductor-related groin pain (LSAGP). Methods We reproduced the Holmich protocol of exercise therapy and objectively evaluated its effect on 17 male athletes (mean age, 25.07±4.96 years) suffering from LSAGP, of whom 14 participants completed the 10 weeks treatment period. The study was designed as a single-blinded, before-and-after clinical trial. Main outcome measures included pain, functional ability, hip range of motion (ROM), hip abductor and adductor muscle strength, and successful return to sports activity. Results Eleven athletes (78.57%) returned to their sports activities in a mean time of 14.2 weeks (range, 10-20 weeks). Visual analogue scale pain score, hip abductor and adductor muscles strength, and function scores improved significantly. Although hip abduction ROM did not show any significant changes (p = 0.609), the extent of progress in the hip internal rotation ROM was significant (p = 0.001). The ratio of hip adduction to abduction strength did not change significantly (p = 0.309 for the isometric and p = 0.957 for the eccentric ratio). Conclusions Exercise therapy according to the Holmich programme may be an effective treatment for LSAGP. However, more emphasis should be paid to the hip adductor muscles' eccentric strength. Trial registration number IRCT2016080829269N1.
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Affiliation(s)
- Abbas Yousefzadeh
- Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Shadmehr
- Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam Reza Olyaei
- Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Naseri
- Department of Physiotherapy, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Khazaeipour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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The Effect of Therapeutic Exercise on Long-Standing Adductor-Related Groin Pain in Athletes: Modified Hölmich Protocol. Rehabil Res Pract 2018; 2018:8146819. [PMID: 29721339 PMCID: PMC5867683 DOI: 10.1155/2018/8146819] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 01/28/2018] [Indexed: 11/17/2022] Open
Abstract
Objective The Hölmich protocol in therapeutic exercise is the most appropriate method for the treatment of long-standing adductor-related groin pain (LSAGP). Herein, we evaluated a modified Hölmich protocol to resolve the possible limitations intrinsic to the Hölmich protocol in terms of the rate of return to sport and the recovery period for athletes with LSAGP. Design The study followed a single-blind, before/after study design, where 15 athletes with LSAGP (mean age = 26.13 years; SD = 4.48) performed a 10-week modified Hölmich therapeutic exercise protocol. Results Outcome scores related to pain, hip adductor and abductor muscle strengths, and the ratio of maximum isometric and eccentric hip adduction to abduction strength increased significantly. Likewise, hip abduction and internal rotation ROM improved significantly compared to that at baseline. Furthermore, functional records (t-test, Edgren Side Step Test, and Triple Hop Test) showed significant improvement after treatment. Finally, 13 athletes (86.6% of the participants) successfully returned to sports activity in a mean time of 12.06 weeks (SD = 3.41). Conclusion The findings of this study objectively show that the modified Hölmich protocol may be safer and more effective than the Hölmich protocol in athletes with LSAGP in promoting their return to sports activity. This trial is registered with IRCT2016080829269N1.
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Toohey LA, de Noronha M, Taylor C, Thomas J. The validity and reliability of the sphygmomanometer for hip strength assessment in Australian football players. Physiother Theory Pract 2017; 34:131-136. [DOI: 10.1080/09593985.2017.1374492] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Liam Anthony Toohey
- Department of Rehabilitation, La Trobe University, Melbourne , Australia
- Australian Institute of Sport, Applied Research Centre, Canberra, Australia
| | - Marcos de Noronha
- Department of Community and Allied Health, Rural Health School, La Trobe University, Bendigo, Australia
| | - Carolyn Taylor
- Department of Community and Allied Health, Rural Health School, La Trobe University, Bendigo, Australia
| | - James Thomas
- Department of Community and Allied Health, Rural Health School, La Trobe University, Bendigo, Australia
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Toohey LA, Noronha MD, Nunes GS. The use of a sphygmomanometer to measure shoulder isometric strength: a validity and reliability study. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.003.ao17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Abstract Introduction: A sphygmomanometer is an instrument commonly used to measure blood pressure that can potentially be used to objectively assess shoulder isometric muscle strength. Objective: To establish the criterion validity and the intra-rater reliability of the sphygmomanometer for the assessment of shoulder isometric muscular strength compared to the handheld dynamometer. To determine if there is a statistically significant difference for shoulder strength between dominant and non-dominant sides. Methods: A test-retest study design was developed, where a rater assessed shoulder flexion and abduction isometric strength of 13 healthy university students, using a commercially available sphygmomanometer and a handheld dynamometer. Results: The criterion validity of the sphygmomanometer was found to be good for both right and left shoulder flexion and abduction strength assessment (Pearson’s r = 0.90-0.97). The intra-rater reliability of the sphygmomanometer was calculated to be good for both right and left flexion and abduction (ICC = 0.96-0.99). The handheld dynamometer also showed good intra-rater reliability for each of the strength measures assessed (ICC = 0.94-0.98). Significant differences (p < 0.01) were identified between dominant and non-dominant sides for shoulder strength. Conclusion: A sphygmomanometer is a simple and easily accessible tool that provides clinicians with accurate objective values for isometric shoulder strength assessment.
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Mosler AB, Agricola R, Weir A, Hölmich P, Crossley KM. Which factors differentiate athletes with hip/groin pain from those without? A systematic review with meta-analysis. Br J Sports Med 2016; 49:810. [PMID: 26031646 PMCID: PMC4484362 DOI: 10.1136/bjsports-2015-094602] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Hip and groin injuries are common in many sports. Understanding the factors differentiating athletes with hip/groin pain from those without these injuries could facilitate management and prevention. Objective Conduct a systematic review and meta-analysis of the literature on factors differentiating athletes with and without hip/groin pain. Methods The review was registered as PROSPERO CRD42014007416 and a comprehensive, systematic search was conducted in June 2014. Inclusion criteria were: cross-sectional, cohort or case–control study designs of n>10 that examined outcome measures differentiating athletes with and without hip/groin pain. Two authors independently screened search results, assessed study quality, and performed data extraction. Methodological heterogeneity was determined and data pooled for meta-analysis when appropriate. A best evidence synthesis was performed on the remaining outcome measures. Results Of 2251 titles identified, 17 articles were included of which 10 were high quality. Sixty two different outcome measures were examined, 8 underwent meta-analysis. Pooled data showed strong evidence that athletes with hip/groin pain demonstrated: pain and lower strength on the adductor squeeze test, reduced range of motion in hip internal rotation and bent knee fall out; however, hip external rotation range was equivalent to controls. Strong evidence was found that lower patient-reported outcome (PRO) scores, altered trunk muscle function, and moderate evidence of bone oedema and secondary cleft sign were associated with hip/groin pain. Conclusions PROs, pain and reduced strength on the adductor squeeze test, reduced range of motion in internal rotation and bent knee fall out are the outcome measures that best differentiate athletes with hip/groin pain from those without this pain.
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Affiliation(s)
- Andrea B Mosler
- Rehabilitation Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Rintje Agricola
- Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Adam Weir
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Per Hölmich
- Sports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, Denmark
| | - Kay M Crossley
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia School of Allied Health, La Trobe University, Victoria, Australia
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Coughlan GF, Delahunt E, Caulfield BM, Forde C, Green BS. Normative adductor squeeze test values in elite junior rugby union players. Clin J Sport Med 2014; 24:315-9. [PMID: 24561635 DOI: 10.1097/jsm.0000000000000046] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To establish normative adductor squeeze test (AST) values in elite junior rugby union players and investigate if differences existed between field position units and categorizations. DESIGN Cross-sectional study. SETTING National underage screening camp. PARTICIPANTS One hundred four healthy players attending an under-19 and under-18 national musculoskeletal and fitness screening camp. Players had no history of surgery, no self-reported history of groin or pelvic pain in either limb and no other lower limb injury in the past 3 months, and no pain reported during the testing procedure. MAIN OUTCOME MEASURES The AST in 3 positions of hip flexion (0, 45, and 90 degrees), position unit, and categorizations. RESULTS The highest AST values were observed at 45 degrees of hip flexion in all field position categories. No differences were observed between position units and categorizations. CONCLUSIONS Normative AST values in an elite junior rugby union population were established in this investigation. Clinically, the sports medicine professional may use these results in making decisions on the management of both symptomatic and asymptomatic players.
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Affiliation(s)
- Garrett F Coughlan
- *Medical Department, Irish Rugby Football Union, Dublin, Ireland; †School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland; ‡Institute for Sport and Health, University College Dublin, Dublin, Ireland; §School of Public Health, Physiotherapy and Population Science, Health Sciences Centre, University College Dublin, Dublin, Ireland; and ¶USA Rugby, Denver, Colorado
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A Comparison between Australian Football League (AFL) Injuries in Australian Indigenous versus Non-indigenous Players. Sports (Basel) 2013. [DOI: 10.3390/sports1030069] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Chalmers S, Magarey ME, Scase E. Junior Australian football injury research: Are we moving forward? Phys Ther Sport 2013; 14:175-82. [DOI: 10.1016/j.ptsp.2013.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 05/17/2013] [Accepted: 06/04/2013] [Indexed: 10/26/2022]
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