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Chen Z, Tirosh O, Han J, Adams R, El-Ansary D, Pranata A. Kinematic changes of the trunk and lower limbs during voluntary lateral sway postural control in adults with low back pain. Front Bioeng Biotechnol 2024; 12:1351913. [PMID: 38476964 PMCID: PMC10927732 DOI: 10.3389/fbioe.2024.1351913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/09/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction: Voluntary lateral weight shifting is essential for gait initiation. However, kinematic changes during voluntary lateral weight shifting remain unknown in people with low back pain (LBP). This study aims to explore the differences in kinematics and muscle activation when performing a voluntary lateral weight shifting task between patients with LBP and asymptomatic controls without pain. Methods: Twenty-eight participants volunteered in this study (14 in both the LBP group and the control group). The Sway Discrimination Apparatus (SwayDA) was used to generate a postural sway control task, mimicking lateral weight shifting movements when initiating gait. Kinematic parameters, including range of motion (ROM) and standard deviation of ROM (Std-ROM) of the lumbar spine, pelvis, and lower limb joints, were recorded using a motion capture system during lateral weight shifting. The electroactivity of the trunk and lower limb muscles was measured through surface electromyography using root mean square (RMS). The significant level was 0.05. An independent t-test was employed to compare kinematic parameters, and muscle activation between the LBP group and the control group. A paired-sample t-test, adjusted with Bonferroni correction (significant level of 0.025), was utilized to examine differences between the ipsilateral weight shifting towards side (dominant side) and the contralateral side. Results: The results of kinematic parameters showed significantly decreased ROM and std-ROM of the ipsilateral hip in the transverse plane (tROM = -2.059, p = 0.050; tstd-ROM = -2.670, p = 0.013), as well as decreased ROM of the ipsilateral knee in the coronal plane (t = -2.148, p = 0.042), in the LBP group compared to the control group. For the asymptomatic controls, significantly larger ROM and ROM-std were observed in the hip and knee joints on the ipsilateral side in contrast to the contralateral side (3.287 ≤ t ≤ 4.500, 0.001 ≤ p≤ 0.006), but no significant differences were found between the two sides in the LBP group. In addition, the LBP group showed significantly lower RMS of the biceps femoris than the control group (tRMS = -2.186, p = 0.044). Discussion: Patients with LBP showed a conservative postural control pattern, characterized by reduced ROM of ipsilateral joints and diminished activation of the biceps femoris. These findings suggested the importance of voluntary postural control assessment and intervention to maximize recovery.
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Affiliation(s)
- Zhengquan Chen
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Oren Tirosh
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Jia Han
- Shanghai Yangpu District Mental Health Center, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Roger Adams
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Doa El-Ansary
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
- Department of Surgery, Melbourne Medical School, Melbourne, VIC, Australia
| | - Adrian Pranata
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
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Gronwald T, Klein C, Hoenig T, Pietzonka M, Bloch H, Edouard P, Hollander K. Hamstring injury patterns in professional male football (soccer): a systematic video analysis of 52 cases. Br J Sports Med 2021; 56:165-171. [PMID: 34876406 DOI: 10.1136/bjsports-2021-104769] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To closely describe the injury inciting events of acute hamstring injuries in professional male football (soccer) using systematic video analysis. METHODS Video footage from four seasons (2014-2019) of the two highest divisions in German male football was searched for moderate and severe (ie, time loss of >7 days) acute non-contact and indirect contact match hamstring injuries. Two raters independently categorised inciting events using a standardised procedure to determine specific injury patterns and kinematics. RESULTS 52 cases of hamstring injuries were included for specific pattern analysis. The pattern analysis revealed 25 sprint-related (48%) and 27 stretch-related hamstring injuries (52%). All sprint-related hamstring injuries occured during linear acceleration or high-speed running. Stretch-related hamstring injuries were connected with closed chain movements like braking or stopping with a lunging or landing action and open chain movements like kicking. The kinematic analysis of stretch-related injuries revealed a change of movement involving knee flexion to knee extension and a knee angle of <45° at the assumed injury frame in all open and closed chain movements. Biceps femoris was the most affected muscle (79%) of all included cases. CONCLUSION Despite the variety of inciting events, rapid movements with high eccentric demands of the posterior thigh are likely the main hamstring injury mechanism. This study provides important data about how hamstring injuries occur in professional male football and supports the need for demand-specific multicomponent risk reduction programmes.
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Affiliation(s)
- Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Christian Klein
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Micha Pietzonka
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Hendrik Bloch
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Pascal Edouard
- Inter-university Laboratory of Human Movement Sciences (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint Etienne, France.,Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Afonso J, Rocha-Rodrigues S, Clemente FM, Aquino M, Nikolaidis PT, Sarmento H, Fílter A, Olivares-Jabalera J, Ramirez-Campillo R. The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk. Front Physiol 2021; 12:694604. [PMID: 34305648 PMCID: PMC8294189 DOI: 10.3389/fphys.2021.694604] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/16/2021] [Indexed: 01/11/2023] Open
Abstract
The incidence and recurrence of hamstrings injuries are very high in sports, posing elevated performance and financial-related costs. Attempts to identify the risk factors involved in predicting vulnerability to hamstrings injury is important for designing exercise-based programs that aim to mitigate the rate and severity of hamstrings injuries and improve rehabilitation strategies. However, research has shown that non-modifiable risk factors may play a greater role than modifiable risk factors. Recognizing non-modifiable risk factors and understanding their implications will afford the prescription of better suited exercise programs, i.e., that are more respectful of the individual characteristics. In a nutshell, non-modifiable risk factors can still be acted upon, even if indirectly. In this context, an underexplored topic is how intra and inter- individual anatomic and physiologic variations in hamstrings (e.g., muscle bellies, fiber types, tendon length, aponeurosis width, attachment sites, sex- and age-related differences) concur to alter hamstrings injuries risk. Some anatomic and physiologic variations may be modifiable through exercise interventions (e.g., cross-sectional area), while others may not (e.g., supernumerary muscle bellies). This apparent dichotomy may hide a greater complexity, i.e., there may be risk factors that are partially modifiable. Therefore, we explored the available information on the anatomic variations of the hamstrings, providing a deeper insight into the individual risk factors for hamstrings injuries and contributing with better knowledge and potential applications toward a more individualized exercise prescription.
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Affiliation(s)
- José Afonso
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sport of the University of Porto, Porto, Portugal
| | - Sílvia Rocha-Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Research Centre in Sports Sciences, Health Sciences and Human Development, Vila Real, Portugal
- Tumor & Microenvironment Interactions Group, Instituto de Investigação e Inovação em Saúde, Porto, Portugal
| | - Filipe M. Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, Covilhã, Portugal
| | - Michele Aquino
- Department of Health and Sport Sciences, Adelphi University, New York, NY, United States
| | | | - Hugo Sarmento
- Research Unit for Sport and Physical Activity, Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Alberto Fílter
- FSI Sport Research Lab, Football Science Institute, Granada, Spain
- Research Group Physical Activity, Health and Sport CTS-948, University of Pablo de Olavide, Seville, Spain
| | - Jesús Olivares-Jabalera
- FSI Sport Research Lab, Football Science Institute, Granada, Spain
- Sport and Health University Research Institute, Department of Physical and Sports Education, University of Granada, Granada, Spain
| | - Rodrigo Ramirez-Campillo
- Department of Physical Activity Sciences, Universidad de Los Lagos, Santiago, Chile
- Centro de Investigación en Fisiología del Ejercicio, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
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Shalaj I, Gjaka M, Bachl N, Wessner B, Tschan H, Tishukaj F. Potential prognostic factors for hamstring muscle injury in elite male soccer players: A prospective study. PLoS One 2020; 15:e0241127. [PMID: 33166289 PMCID: PMC7652257 DOI: 10.1371/journal.pone.0241127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/08/2020] [Indexed: 11/18/2022] Open
Abstract
Hamstring injuries remain the most common injury type across many professional sports. Despite a variety of intervention strategies, its incidence in soccer players playing in the UEFA Champions League has increased by 4% per year over the last decade. Test batteries trying to identify potential risk factors have produced inconclusive results. The purpose of the current study was to prospectively record hamstring injuries, to investigate the incidence and characteristics of the injuries, and to identify possible risk factors in elite male soccer players, playing in the Kosovo national premier league. A total of 143 soccer players from 11 teams in Kosovo were recruited. To identify possible prevalent musculoskeletal or medical conditions a widespread health and fitness assessment was performed including isokinetic strength testing, Nordic hamstring strength test, functional tests, and a comprehensive anamnesis surveying previous hamstring injuries. On average 27.9% of the players sustained at least one hamstring injury with three players suffering bilateral strains with the re-injury rate being 23%. Injured players were significantly older and heavier and had a higher body mass index compared to non-injured ones (p < 0.05). There was a lower passing rate in the Nordic hamstring strength test and a higher injury incidence among the previously injured players compared to non-injured ones (p < 0.05). Except for hamstring/quadriceps ratio and relative torque at 60°/sec (p < 0.05) for dominant and non-dominant leg, there were no other significant differences in isokinetic strength regardless of the angular velocity. No differences were observed for functional tests between cohorts. Regression analysis revealed that age, Nordic hamstring strength test, previous injury history, and isokinetic concentric torque at 240°/sec could determine hamstring injuries by 25.9%, with no other significant predicting risk factors. The battery of laboratory and field-based tests performed during preseason to determine performance related skills showed limited diagnostic conclusiveness, making it difficult to detect players at risk for future hamstring injuries.
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Affiliation(s)
- Ismet Shalaj
- Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Masar Gjaka
- Department of Human Movement and Sport Sciences, University of Rome "Foro Italico", Rome, Italy
- Department of Sport and Movement Science, University for Business and Technology, Pristina, Kosovo
| | - Norbert Bachl
- Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
| | - Barbara Wessner
- Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
- Research Platform Active Ageing, University of Vienna, Vienna, Austria
| | - Harald Tschan
- Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
- * E-mail:
| | - Faton Tishukaj
- Centre for Sport Science and University Sports, University of Vienna, Vienna, Austria
- University of Pristina “Hasan Prishtina”, Faculty of Physical Education and Sports, Pristina, Kosovo
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ERTELT THOMAS, GRONWALD THOMAS. THE CRITICAL BEHAVIOR OF THE M. BICEPS FEMORIS FOR THE RISK OF INJURY — A SIMULATION STUDY. J MECH MED BIOL 2020. [DOI: 10.1142/s0219519419500696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The behavior of the M. biceps femoris with regard to its enormous vulnerability to injuries in sport remains unclear. Despite prevention programs, the rate of injuries of the hamstring muscles has risen by more than 4% in recent years. To get more insights into its function, the aim of this study was to examine the effect of different muscle insertion characteristics and activation levels using a simulation. We created a multi-segmented muscle model for evaluating the critical behavior of M. biceps femoris during a one-legged stopping maneuver. We analyzed muscle function, movement of the knee angle after initial ground contact, the simulated muscle force and the stop torques in the knee joint. The insertion geometry has an elementary effect on knee joint function and contributes to knee extension. The muscle activity plays a decisive role in elementary muscle function regarding the knee joint and in this regard the internal load of the M. biceps femoris increased without showing any visible effects on the kinematics. The anthropometry and function of this muscle needs to be taken into account to assess its effects on injury risk.
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Affiliation(s)
- THOMAS ERTELT
- Research and Development, Senmotion GmbH, Martin-Hoffmann-Straße 26, 12435 Berlin, Germany
| | - THOMAS GRONWALD
- Research and Development, Senmotion GmbH, Martin-Hoffmann-Straße 26, 12435 Berlin, Germany
- Exercise Science, Department of Performance Neuroscience, Therapy and Health, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457 Hamburg, Germany
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Ertelt T, Gronwald T. Hamstring injury risk factors in elite sports: The role of muscle geometry and function. Acta Physiol (Oxf) 2019; 227:e13253. [PMID: 30635989 DOI: 10.1111/apha.13253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/20/2018] [Accepted: 01/08/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Ertelt
- Motions Science and Biomechanics, Faculty of Sport Science; University of Applied Science in Health and Sports (DHGS); Berlin Germany
| | - Thomas Gronwald
- Exercise and Training Science, Department of Performance, Neuroscience, Therapy and Health, MSH Medical School Hamburg; University of Applied Sciences and Medical University; Hamburg Germany
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