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Grayson J, Hillard D, Antcliff A, Chan C, Nightingale E, Pappas E. The effect of the KNEE program for Netball players on the modified Star Excursion Balance Test - a randomized controlled trial. Phys Ther Sport 2024; 67:83-89. [PMID: 38614047 DOI: 10.1016/j.ptsp.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND The aim was to investigate the effect of the KNEE program on postural control as measured by the modified Star Excursion Balance test (mSEBT) in Australian club level netball players. METHODS Two netball teams from Netball NSW Premier-League were recruited and randomized to complete either the KNEE program or a traditional warm-up. Cumulative, anterior, posteromedial, and posterolateral directions of the mSEBT were measured for both limbs at baseline, 8-weeks, and 5-months. Linear mixed models were used to assess the effect of the intervention on mSEBT outcomes. RESULTS When compared to a traditional warm-up, the KNEE program led to improvements in postural control in the PM direction of the mSEBT at 8 weeks (R: p = 0.005; L = 0.016) and 5 months (R: p = 0.006 and L: p = 0.026). For the cumulative score, there was a main effect of time with significant improvements between baseline and subsequent time points (p < 0.03), but there was no effect of group or interaction. No significant changes were found in ANT and PL directions. CONCLUSION The KNEE program when implemented as a warm-up prior to training and match-play can improve postural control in the PM direction which is integral to Netball.
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Affiliation(s)
- Jane Grayson
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
| | - David Hillard
- Zone 34 Sports Physiotherapy, Sydney, New South Wales, Australia.
| | - Alanna Antcliff
- Netball Australia, Australian Sports Commission, Melbourne, Australia.
| | - Cliffton Chan
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia; Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, New South Wales, Australia.
| | - Elizabeth Nightingale
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
| | - Evangelos Pappas
- Discipline of Physiotherapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia; School of Medicine and Illawarra Medical and Health Research Institute, The University of Wollongong, Wollongong, New South Wales, Australia.
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Dominguez-Navarro F, Casaña J, Perez-Dominguez B, Ricart-Luna B, Cotolí-Suárez P, Calatayud J. Dynamic balance and explosive strength appears to better explain single leg hop test results among young elite female basketball athletes. Sci Rep 2023; 13:5476. [PMID: 37016001 PMCID: PMC10073233 DOI: 10.1038/s41598-023-31178-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/07/2023] [Indexed: 04/06/2023] Open
Abstract
To analyze the impact of balance, lower-limb explosive strength and anthropometric variables on the result of the hop test in young elite female basketball athletes. Ninety young elite female basketball athletes (13-17 years), without current or recent lower-limb injury, were assessed in the off-season period of July 2021. Single leg hop test, countermovement jump, Y balance test and anthropometric outcomes were assessed. A correlation study and a regression model were performed to investigate the influence of such outcomes and the value of their participation on the hop test results. It was found a low-to-moderate correlation effect size for both countermovement jump (distance and power flight) and Y balance test values (except interlimb outcomes) with the single leg hop test results. Anthropometric outcomes did not show significant correlation (p > 0.05). Regression model revealed that for right hop test, countermovement jump values exhibited an adjusted determination coefficient of 0.408, (β = 0.249, p = 0.013), For left hop test, again the countermovement jump values (β = 0.229, p = 0.025), and left Y balance test values (β = 0.331, p = 0.011) jointly obtained an adjusted determination coefficient of 0.263 significant predictive value for countermovement jump outcomes in both right (β = 0.249, p = 0.013; β = 0.301; p = 0.031) and left leg (β = 0.229, p = 0.025; β = 0.365, p = 0.040), as well as certain Y balance outcomes values. Explosive strength, and dynamic balance although to a lesser extent, appear to be the most relevant physical-functional factors influencing the single leg hop test results among young elite female basketball athletes. These findings may a serve as a basis to implement targeted interventions, such as plyometric and balance training, for an enhancement on functional rehabilitation and reducing the risk of injury related to the hop test results.
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Affiliation(s)
- Fernando Dominguez-Navarro
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Calle Gascó Oliag 5, 46010, Valencia, Spain
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, Valencia, Spain
| | - Jose Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Calle Gascó Oliag 5, 46010, Valencia, Spain.
| | - Borja Perez-Dominguez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Calle Gascó Oliag 5, 46010, Valencia, Spain
| | - Borja Ricart-Luna
- I+D+I Alqueria LAB Department, Valencia Basket Club, Valencia, Spain
| | | | - Joaquin Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Calle Gascó Oliag 5, 46010, Valencia, Spain
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Variability and Complexity of Knee Neuromuscular Control during an Isometric Task in Uninjured Physically Active Adults: A Secondary Analysis Exploring Right/Left and Dominant/Nondominant Asymmetry. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094762] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Work is needed to better understand the control of knee movement and knee health. Specifically, work is needed to further understand knee muscle force control variability and complexity and how it is organized on both sides of the body. The purpose of this study was to explore side-to-side comparisons of magnitude- and complexity-based measures of knee muscle force control to support future interpretations of complexity-based analyses and clinical reasoning in knee injury control. Participants (male/female n = 11/5) performed constant-force isometric efforts at 50% maximal effort. Force variability was quantified during the constant-force efforts using a coefficient of variation (CV%) and force complexity using approximate entropy (ApEn) and detrended fluctuation analysis (DFA) α. Outcomes were right/left and dominant/nondominant group-level and individual-level comparisons. A limb-symmetry index was calculated for each variable and clinically significant absolute asymmetry was defined (>15%). The only significant side-to-side difference was for right/left DFA α (p = 0.00; d = 1.12). Maximum absolute asymmetries were (right/left, dominant/nondominant): CV 18.2%, 18.0%; ApEn 34.5%, 32.3%; DFA α 4.9%, 5.0%. Different side-to-side comparisons yield different findings. Consideration for how side-to-side comparisons are performed (right/left, dominant/nondominant) is required. Because a significant difference existed for complexity but not variability, this indicates that both complexity-based and magnitude-based measures should be used when studying knee muscle force control.
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Parkinson AO, Apps CL, Morris JG, Barnett CT, Lewis MGC. The Calculation, Thresholds and Reporting of Inter-Limb Strength Asymmetry: A Systematic Review. J Sports Sci Med 2021; 20:594-617. [PMID: 35321131 PMCID: PMC8488821 DOI: 10.52082/jssm.2021.594] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/28/2021] [Indexed: 12/20/2022]
Abstract
The prevalence of inter-limb strength differences is well documented in the literature however, there are inconsistencies related to measurement and reporting, and the normative values and effects associated with inter-limb asymmetry. Therefore, the aims of this systematic review were to: 1) assess the appropriateness of existing indices for the calculation of asymmetry, 2) interrogate the evidence basis for literature reported thresholds used to define asymmetry and 3) summarise normative levels of inter-limb strength asymmetry and their effects on injury and performance. To conduct this systematic review, scientific databases (PubMed, Scopus, SPORTDiscus and Web of Science) were searched and a total of 3,594 articles were retrieved and assessed for eligibility and article quality. The robustness of each identified asymmetry index was assessed, and the evidence-basis of the identified asymmetry thresholds was appraised retrospectively using the references provided. Fifty-three articles were included in this review. Only four of the twelve identified indices were unaffected by the limitations associated with selecting a reference limb. Eighteen articles applied a threshold to original research to identify "abnormal" asymmetry, fifteen of which utilised a threshold between 10-15%, yet this threshold was not always supported by appropriate evidence. Asymmetry scores ranged between and within populations from approximate symmetry to asymmetries larger than 15%. When reporting the effects of strength asymmetries, increased injury risk and detriments to performance were often associated with larger asymmetry, however the evidence was inconsistent. Limitations of asymmetry indices should be recognised, particularly those that require selection of a reference limb. Failure to reference the origin of the evidence for an asymmetry threshold reinforces doubt over the use of arbitrary thresholds, such as 10-15%. Therefore, an individual approach to defining asymmetry may be necessary to refine robust calculation methods and to establish appropriate thresholds across various samples and methodologies that enable appropriate conclusions to be drawn.
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Affiliation(s)
- Amy O Parkinson
- Nottingham Trent University, School of Science and Technology, Nottingham, United Kingdom
| | - Charlotte L Apps
- Nottingham Trent University, School of Science and Technology, Nottingham, United Kingdom
| | - John G Morris
- Nottingham Trent University, School of Science and Technology, Nottingham, United Kingdom
| | - Cleveland T Barnett
- Nottingham Trent University, School of Science and Technology, Nottingham, United Kingdom
| | - Martin G C Lewis
- Nottingham Trent University, School of Science and Technology, Nottingham, United Kingdom
- University of Derby, School of Human Sciences, Derby, United Kingdom
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Whitehead S, Weakley J, Cormack S, Alfano H, Kerss J, Mooney M, Jones B. The Applied Sports Science and Medicine of Netball: A Systematic Scoping Review. Sports Med 2021; 51:1715-1731. [PMID: 34086257 PMCID: PMC8310515 DOI: 10.1007/s40279-021-01461-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Netball is the one of the most popular women's sports in the world. Since gaining professional status in 2008 there has been a rapid growth in research in the applied sports science and medicine of the sport. A scoping review of the area would provide practitioners and researchers with an overview of the current scientific literature to support on-court performance, player welfare and reduce injury. OBJECTIVE The primary objective was to identify the current research on the applied sports science and medicine of netball. Additionally, the article provides a brief summary of the research in each topic of sports science and medicine in netball and identifies gaps in the current research. METHODS Systematic searches of PubMed, SPORTDiscus, MEDLINE and CINAHL were undertaken from earliest record to Dec 2020 and reference lists were manually searched. The PRISMA-ScR protocol was followed. Studies were eligible for inclusion if they investigated netball as a sport or the applied sport science and medicine of netball athletes. RESULTS 962 studies were identified in the initial search, 150 of which met the inclusion criteria. Injury was the most highly investigated sport science and medicine topic (n = 45), followed by physical qualities (n = 37), match characteristics (n = 24), biomechanics (n = 15), psychology (n = 13), fatigue and recovery (n = 9), training load (n = 4) and nutrition (n = 3). A range of cohorts were used from school to elite and international standards. All cohorts were female netballers, except for one study. A rapid growth in studies over recent years was demonstrated with 65% of studies published in the last decade. There still remains gaps in the literature, with a low evidence base for nutrition, training load and fatigue and recovery. CONCLUSION This scoping review summarises the current evidence base and key findings that can be used in practice to enhance the applied sport science and medical support to netball athletes across a range of playing standards, and support the growth of the sport. It is evident that netball as a sport is still under-researched.
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Affiliation(s)
- Sarah Whitehead
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK.
- Leeds Rhinos Netball, Leeds, UK.
- Leeds Rhinos Rugby League Club, Leeds, UK.
| | - Jonathon Weakley
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Stuart Cormack
- School of Behavioral and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Melbourne, Australia
| | | | - Jim Kerss
- English Institute of Sport, Manchester, UK
| | - Mitch Mooney
- School of Behavioral and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
- High Performance Pillar, Netball Australia, Melbourne, Australia
| | - Ben Jones
- Carnegie Applied Rugby Research (CARR) Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
- England Performance Unit, The Rugby Football League, Leeds, UK
- School of Science and Technology, University of New England, Armidale, NSW, Australia
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, The University of Cape Town and the Sports Science Institute of South Africa, Cape Town, South Africa
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Clark NC, Campbell SD. Preseason weight-bearing ankle dorsiflexion in male professional football players with and without a history of severe ankle injury: A novel analysis in an English Premier League club. Phys Ther Sport 2021; 52:21-29. [PMID: 34365086 DOI: 10.1016/j.ptsp.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Ankle injuries are common in professional football and have profound player/team/club consequences. The weight-bearing lunge-test (WBLT) assesses ankle dorsiflexion range-of-motion in football primary/secondary injury prevention and performance contexts. Data for uninjured and previously ankle-injured players in the English Premier League (EPL) is not available. This study analysed WBLT measurements (cm) within and between uninjured and previously severe ankle-injured players (injured-stiff group, injured-lax group) in one EPL club. DESIGN Cross-sectional. SETTING Preseason. PARTICIPANTS Forty-nine players (age 22.9 ± 4.6 yr; height 181.6 ± 5.2 cm; mass 77.7 ± 7.6 kg). MAIN OUTCOME MEASURES Prevalence (%) of previous unilateral severe ankle injury (USAI). Side-to-side (right/left, dominant/nondominant, injured/uninjured) WBLT comparisons at group-level (t-test [within-group]; Welch's ANOVA [between-group]; effect sizes [within-/between-group]) and individual-level (limb symmetry index [%]; absolute-asymmetry [%]). RESULTS Prevalence of USAI was 38.7%. There were no statistically-significant side-to-side differences for within-/between-group comparisons. Effect sizes: just-below-large (injured-stiff) and extremely-large (injured-lax) for within-group injured-side/uninjured-side comparisons; just-below-medium (injured-lax) to just-above-medium (injured-stiff) for injured-side comparisons to uninjured players. Absolute-asymmetries: uninjured players, 15.4±13.2%; injured-stiff, 21.8±33.6%; injured-lax 20.4±13.6%. CONCLUSIONS Over one-third of players had previous USAI. Effect sizes indicate substantial within-group side-to-side differences and less substantial between-group differences. Across groups, some players had absolute-asymmetries that may elicit concern in ankle primary/secondary injury prevention and performance contexts.
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Affiliation(s)
- Nicholas C Clark
- School of Sport, Rehabilitation, and Exercise Sciences. University of Essex. Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK.
| | - Stuart D Campbell
- Tottenham Hotspur Football Club. Hotspur Way, Enfield, Middlesex, EN2 9AP, UK.
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Clark NC. Noncontact Knee Ligament Injury Prevention Screening in Netball: A Clinical Commentary with Clinical Practice Suggestions for Community-Level Players. Int J Sports Phys Ther 2021; 16:911-929. [PMID: 34123542 PMCID: PMC8169033 DOI: 10.26603/001c.23553] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 04/22/2021] [Indexed: 12/20/2022] Open
Abstract
Netball is a predominantly female team court-sport which is played worldwide. Netball is becoming more popular in the United States following its countrywide introduction to schools and community centers. A unique characteristic of netball is the footwork rule which restricts players to a one-step landing after catching the ball. Most netball landings are single-leg landings resulting in high vertical ground reaction forces and high skeletal tissue forces. Thus, high-risk landing events that have the biomechanical potential for injury occur frequently. Noncontact knee ligament injuries are common following a knee abduction collapse when landing. Because the consequences of noncontact knee ligament injury are profound, strategies are needed to mitigate the burden of such injury for players, teams, and society. The purpose of this clinical commentary is to demonstrate how theoretical principles, different types of research, and different levels of evidence underpin a rational clinical reasoning process for developing noncontact knee ligament injury prevention screening procedures in netball. The theoretical principles that are discussed in this commentary include injury control, the sequence of prevention, principles of screening in injury prevention, the multifactorial model of injury etiology, complex systems theory, and systems science. The different types of research that are reviewed include descriptive and analytic-observational studies. The different levels of evidence that are discussed include prospective studies, cross-sectional studies, and clinicians' own kinesiological modelling. Subsequently, an integrated approach to the evidence-informed development of noncontact knee ligament injury prevention screening procedures is presented. Clinical practice suggestions include a selection of evidence-informed screening tests that are quickly and easily implemented with netball players in local communities. The need for repeated screening at strategic timepoints across a season/year is explained. Sports physical therapists will find this commentary useful as an example for how to undertake clinical reasoning processes that justify the content of screening procedures contributing to noncontact knee ligament injury prevention in community-level netball. LEVEL OF EVIDENCE 5.
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Relationship Between 3 Single-Leg Functional Performance Tests for Netball Noncontact Knee Injury Prevention Screening in Uninjured Female Adult Players. J Sport Rehabil 2021; 30:981-987. [PMID: 33662933 DOI: 10.1123/jsr.2020-0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/30/2020] [Accepted: 01/04/2021] [Indexed: 12/16/2022]
Abstract
CONTEXT Single- versus double-leg landing events occur the majority of the time in a netball match. Landings are involved in large proportions of netball noncontact knee injury events. Of all landing-induced anterior cruciate ligament injuries, most occur during single-leg landings. Knowledge of whether different single-leg functional performance tests capture the same or different aspects of lower-limb motor performance will therefore inform clinicians' reasoning processes and assist in netball noncontact knee injury prevention screening. OBJECTIVE To determine the correlation between the triple hop for distance (THD), single hop for distance (SHD), and vertical hop (VH) for the right and left lower limbs in adult female netball players. DESIGN Cross-sectional. SETTING Local community netball club. PARTICIPANTS A total of 23 players (age 28.7 [6.2] y; height 171.6 [7.0] cm; mass 68.2 [9.8] kg). INTERVENTIONS There were 3 measured trials (right and left) for THD, SHD, and VH, respectively. MAIN OUTCOME MEASURES Mean hop distance (percentage of leg length [%LL]), Pearson intertest correlation (r), and coefficient of determination (r2). RESULTS Values (right and left; mean [SD]) were as follows: THD, 508.5 (71.8) %LL and 510.9 (56.7) %LL; SHD, 183.4 (24.6) %LL and 183.0 (21.5) %LL; and VH, 21.3 (5.2) %LL and 20.6 (5.0) %LL. All correlations were significant (P ≤ .05), r/r2 values (right and left) were THD-SHD, .91/.83 and .87/.76; THD-VH, .59/.35 and .51/.26; and SHD-VH, .50/.25 and .37/.17. A very large proportion of variance (76%-83%) was shared between the THD and SHD. A small proportion of variance was shared between the THD and VH (25%-35%) and SHD and VH (17%-25%). CONCLUSION The THD and SHD capture highly similar aspects of lower-limb motor performance. In contrast, the VH captures aspects of lower-limb motor performance different to the THD or SHD. Either the THD or the SHD can be chosen for use within netball knee injury prevention screening protocols according to which is reasoned as most appropriate at a specific point in time. The VH, however, should be employed consistently alongside rather than in place of the THD or SHD.
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Mullally EM, Clark NC. Noncontact Knee Soft-Tissue Injury Prevention Considerations and Practical Applications for Netball Players. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Clark NC, Clacher LH. Lower-limb motor-performance asymmetries in English community-level female field hockey players: Implications for knee and ankle injury prevention. Phys Ther Sport 2020; 43:43-51. [DOI: 10.1016/j.ptsp.2020.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 01/30/2020] [Accepted: 02/04/2020] [Indexed: 02/04/2023]
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