1
|
Zhai T, Song Y, Su J, Wu R, Wang J, Zhang Z, Feng W. Study protocol for a randomized controlled trial: evaluating the effect of isokinetic eccentric training of the hamstring on knee function and walking function after total knee arthroplasty. Front Med (Lausanne) 2024; 11:1404736. [PMID: 38846149 PMCID: PMC11155448 DOI: 10.3389/fmed.2024.1404736] [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: 03/26/2024] [Accepted: 05/07/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Total knee arthroplasty (TKA) is a widely-used treatment for end-stage knee osteoarthritis. However, it is common for patients to experience issues with knee joint function and abnormal gait following the surgery. Previous studies have primarily focused on concentric contraction of the quadriceps during TKA, neglecting the potential benefits of eccentric isokinetic training for the hamstrings. This protocol outlines a randomized, single-blind, controlled trial aimed at assessing the impact of eccentric isokinetic training for the hamstring muscles on pain, function, and gait in patients after TKA. Methods and analysis Fifty participants between the ages of 50 and 80 with knee osteoarthritis undergo unilateral total knee arthroplasty (TKA) for the first time. They will be transferred to the rehabilitation department 10-14 days after the operation. The participants are randomly divided into two groups, with 25 participants in each group: the control group and the Hamstring training group. The Control group will receive routine rehabilitation treatment, while the Hamstring training group will receive a combination of routine rehabilitation treatment and isokinetic eccentric training of the hamstring. The intervention will last four consecutive weeks. Both groups will be assessed at three different times: before the intervention, after 4 weeks of intervention, and 4 weeks after the interventions (follow-up). The primary outcome will be functional capacity (TUGT) and Hospital for Special knee Score (HSS). Secondary outcomes will be knee-related health status (isokinetic knee position perception, Peak torque of hamstring strength), pain intensity (Visual analog scale, VAS) and 3D gait analysis. Discussion The study aims to provide relevant evidence on the effectiveness of eccentric hamstring muscle contraction training in improving knee joint function and walking function after TKA. Clinical trial registration https://www.chictr.org.cn/showproj.html?proj=195544, Identifier ChiCTR2300073497.
Collapse
Affiliation(s)
- Tianjun Zhai
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Yongjia Song
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Jianqing Su
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Ruiren Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Jie Wang
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Zengqiao Zhang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wei Feng
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Rehabilitation Department, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| |
Collapse
|
2
|
de Keijzer KL, McErlain-Naylor SA, Beato M. Six Weeks of Unilateral Flywheel Hip-Extension and Leg-Curl Training Improves Flywheel Eccentric Peak Power but Does Not Enhance Hamstring Isokinetic or Isometric Strength. Int J Sports Physiol Perform 2024; 19:34-43. [PMID: 37917962 DOI: 10.1123/ijspp.2023-0035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/12/2023] [Accepted: 09/12/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE This preregistered trial investigated how 6 weeks of unilateral flywheel leg-curl and hip-extension training impact isokinetic, isometric, and flywheel strength and power outcomes. METHODS The study involved 11 male university athletes (age 22 [2] y; body mass 77.2 [11.3] kg; height 1.74 [0.09] m) with one leg randomly allocated to flywheel training and one leg to control. Unilateral eccentric and isometric knee-flexion torque and flywheel unilateral leg-curl and hip-extension peak power were tested. Training intensity and volume (3-4 sets of 6 + 2 repetitions) were progressively increased. RESULTS The intervention enhanced hip-extension concentric (P < .01, d = 1.76, large) and eccentric (P < .01, d = 1.33, large) peak power more than the control (significant interaction effect). Similarly, eccentric (P = .023, d = 1.05, moderate) peak power was enhanced for the leg curl. No statistically significant differences between conditions were found for isokinetic eccentric (P = .086, d = 0.77, moderate) and isometric (P = .431, d = 0.36, small) knee-flexor strength or leg-curl concentric peak power (P = .339, d = 0.52, small). Statistical parametric mapping analysis of torque-angle curves also revealed no significant (P > .05) time-limb interaction effect at any joint angle. CONCLUSION Unilateral flywheel hamstring training improved knee-flexor eccentric peak power during unilateral flywheel exercise but not flywheel concentric, isokinetic eccentric, or isometric (long-lever) knee-flexor strength.
Collapse
Affiliation(s)
- Kevin L de Keijzer
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
- Institute of Health and Wellbeing, University of Suffolk, Ipswich, United Kingdom
| | - Stuart A McErlain-Naylor
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
- Institute of Health and Wellbeing, University of Suffolk, Ipswich, United Kingdom
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Marco Beato
- School of Health and Sports Sciences, University of Suffolk, Ipswich, United Kingdom
- Institute of Health and Wellbeing, University of Suffolk, Ipswich, United Kingdom
| |
Collapse
|
3
|
Yagiz G, Dayala VK, Williams K, Owen JA, Kubis HP. Alterations in biceps femoris long head fascicle length, Eccentric hamstring strength qualities and single-leg hop distance throughout the ninety minutes of TSAFT90 simulated football match. PLoS One 2022; 17:e0278222. [PMID: 36490247 PMCID: PMC9733901 DOI: 10.1371/journal.pone.0278222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/12/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Football matches show higher hamstring strain injuries (HSIs) than football training. The occurrence of HSIs increases in the last fifteen minutes of both halves of football matches and shows an incremental trend towards the end of the ninety minutes. OBJECTIVES This study aimed to examine football-specific fatigue-induced alterations in risk factors of the HSIs, including biceps femoris long head fascicle length via ultrasonography (BFlh FL), single-leg hop distance, hamstrings' maximal eccentric strength, and single-leg hamstring bridge test (SLHB) performance. METHODOLOGY During ninety minutes of the TSAFT90 football simulation, the BFlh FL and single-leg hop distance were measured three times (before, at half-time and after 90 minutes of simulated match-play), and maximal hamstrings eccentric strength and SLHB test scores were recorded twice (before and after simulated match-play) for both legs in physically active participants (n = 15). RESULTS Maximal eccentric hamstrings' strength (dominant leg (D): p < 0.001, Hedges' (adjusted) g effect size = -0.969; non-dominant leg (ND): p < 0.001, g = -0.929) and the SLHB performance (D: p < 0.001, g = -1.249; ND: p < 0.001, g = -1.108) showed large decrements immediately after the TSAFT90 intervention. There were no significant alterations in the BFlh FL, and the single-leg hop distance. CONCLUSIONS Maximal eccentric strength and the SLHB performance of hamstrings are reduced after 90 minutes of simulated football match-play. Practitioners may consider focusing on improving eccentric strength and the SLHB performance. Future studies should examine alterations in the BFlh fascicles' dynamic lengthening and shortening ability during a football match.
Collapse
Affiliation(s)
- Gokhan Yagiz
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
- * E-mail:
| | - Vinay Kumar Dayala
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Kevin Williams
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Julian Andrew Owen
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Hans-Peter Kubis
- Institute for Applied Human Physiology, School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| |
Collapse
|
4
|
Amundsen R, Heimland JS, Thorarinsdottir S, Møller M, Bahr R. Effects of High and Low Training Volume with the Nordic Hamstring Exercise on Hamstring Strength, Jump Height, and Sprint Performance in Female Football Players: A Randomised Trial. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:7133928. [PMID: 38655155 PMCID: PMC11022781 DOI: 10.1155/2022/7133928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/04/2022] [Accepted: 07/16/2022] [Indexed: 04/26/2024]
Abstract
The evidence-based hamstring strengthening programme for prevention of hamstring injuries is not adopted by football teams because of its high training volume. This study on female football players investigated if high-volume training with the Nordic hamstring exercise is more effective on hamstring strength, jump height, and sprint performance than low-volume training. We also examined the time course of changes in muscle strength during the intervention period. Forty-five female football players were randomised to a high- (21 sessions, 538 total reps) or low-volume group (10 sessions, 144 total reps) and performed an 8-week training intervention with the Nordic hamstring exercise during the preseason. We tested hamstring strength (maximal eccentric force with NordBord and maximal eccentric torque with isokinetic dynamometer), jump height, and 40 m sprint before and after the intervention. The NordBord test was also performed during training weeks 4 and 6. Both groups increased maximal eccentric force (high-volume: 29 N (10%), 95% CI: 19-38 N, p < 0.001, low-volume: 37 N (13%), 95% CI: 18-55 N, p = 0.001), but there were no between-group differences (p = 0.38). Maximal eccentric torque, jump height, and sprint performance did not change. Maximal eccentric force increased from the pretest to week 6 (20 N (7%), 95% CI: 8 to 31 N, p < 0.001), but not week 4 (8 N (3%), 95% CI: -2 to 18 N, p = 0.22). High training volume with the Nordic hamstrings exercise did not lead to greater adaptations in strength, jump height, or speed than a low-volume programme. Players in both groups had to train for at least 6 weeks to improve maximal eccentric force significantly.
Collapse
Affiliation(s)
- Roar Amundsen
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Janita Sæther Heimland
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Solveig Thorarinsdottir
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Merete Møller
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Roald Bahr
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| |
Collapse
|
5
|
Gasparin GB, Ribeiro-Alvares JBA, Baroni BM. Single Leg Bridge Test is Not a Valid Clinical Tool to Assess Maximum Hamstring Strength. Int J Sports Phys Ther 2022; 17:613-621. [PMID: 35693869 PMCID: PMC9159716 DOI: 10.26603/001c.34417] [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: 08/25/2021] [Accepted: 01/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background The single leg bridge test (SLBT) has been introduced in the sports context as a way of estimating hamstring muscle capacity for prevention and rehabilitation of hamstring strain injuries. Purpose The primary aim was to examine the association between SLBT scores with concentric and eccentric knee flexor peak torques. Secondarily, this study aimed examine the association of between-limb asymmetries provided by SLBT and isokinetic tests. Study design Cross-sectional study. Methods One hundred male soccer players (20±3 years) performed the SLBT and the knee flexion-extension isokinetic dynamometry evaluation (60°/s) billaterally during a single visit. SLBT score (i.e., number of repetitions until failure) and concentric and eccentric knee flexor peak torques (normalized per body mass) were considered for analysis. For both SLBT and isokinetic dynamometry, between-limb asymmetry was calculated as the percentage difference between the left limb and the right limb. Associations were assessed through Pearson's correlation coefficient. Results The mean SLBT score was 33.6±9.6 repetitions, concentric peak torque was 2.00±0.22 Nm/kg, and eccentric peak torque was 2.79±0.44 Nm/kg. Between-limb asymmetry was 0.4±9.6%, 1.08±8.5%, and 1.64±14.61% in SLBT, concentric, and eccentric tests, respectively. There was a poor association of SLBT score with concentric (p<0.001, r=0.275) and eccentric (p=0.002, r=0.215) peak torques. The SLBT between-limb asymmetry was poorly associated with asymmetry found in concentric peak torque asymmetry (p=0.033, r=0.213) and was not associated with eccentric peak torque asymmetry (p=0.539, r=0.062). Conclusion The SLBT should not be used as a clinical tool to assess the maximum strength of hamstring muscles. Level of Evidence Level 3.
Collapse
|
6
|
Yagiz G, Akaras E, Kubis HP, Owen JA. Heterogeneous effects of eccentric training and nordic hamstring exercise on the biceps femoris fascicle length based on ultrasound assessment and extrapolation methods: A systematic review of randomised controlled trials with meta-analyses. PLoS One 2021; 16:e0259821. [PMID: 34752499 PMCID: PMC8577763 DOI: 10.1371/journal.pone.0259821] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/26/2021] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To systematically review the effects of eccentric training based on biceps femoris fascicle length using ultrasound assessment and extrapolation methods. DESIGN Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES CENTRAL, CINAHL Plus with full text, PubMed and OpenGrey databases were searched on 6 July 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials (RCTs) lasting at least four weeks and presenting data about biceps femoris (BF) fascicle length (FL) as an outcome. METHOD Searching databases, screening studies, performing risk of bias assessments and determining the level of evidence (LoE) for each meta-analysis were applied during the study. PRISMA 2020 statement and Cochrane Handbook for Systematic Reviews of Interventions were used as the guidelines of this systematic review. RESULTS Eight randomised controlled trials included in meta-analyses. Based on the very low and low LoE, eccentric training has small (g = 0.29, 95% CI [-0.26, 0.85]), moderate (g = 0.72, 95% CI [0.17, 1.28]) and large (g = 2.20, 95% CI [0.99, 3.41]) effect sizes (ES) based on manual linear extrapolation (MLE), panoramic ultrasound scanning and trigonometric equation methods, respectively. Similarly, Nordic hamstring exercise (NHE) has small (g = 0.23 [-1.02, 1.47]), small (g = 0.38, 95% CI [-0.50, 1.27]) and large (g = 1.98, 95% CI [0.52, 3.44]) ES based on the MLE, panoramic ultrasound scanning and trigonometric equation methods, respectively. CONCLUSION ES of eccentric training, including NHE, vary between the MLE, panoramic ultrasound scanning, and equation methods. The relevant scientific community should have a consensus on measurement standards of the BF FL measurements. Further studies can be conducted to compare the effects of eccentric training based on the ultrasound assessment and extrapolation methods.
Collapse
Affiliation(s)
- Gokhan Yagiz
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Esedullah Akaras
- Faculty of Health Sciences, Erzurum Technical University, Erzurum, Turkey
- Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Hans-Peter Kubis
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| | - Julian Andrew Owen
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| |
Collapse
|