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Nunes H, Fernandes LG, Martins PN, Ferreira RM. The Effects of Nordic Hamstring Exercise on Performance and Injury in the Lower Extremities: An Umbrella Review. Healthcare (Basel) 2024; 12:1462. [PMID: 39120165 PMCID: PMC11311354 DOI: 10.3390/healthcare12151462] [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: 06/19/2024] [Revised: 07/17/2024] [Accepted: 07/21/2024] [Indexed: 08/10/2024] Open
Abstract
Due to their potential positive outcomes, hamstring eccentric exercises are becoming increasingly popular in training regimens. Among the various exercises, the Nordic Hamstring Exercise (NHE) is the most common. Despite its popularity, there are still some doubts about its benefits and risks. So, the aim of this umbrella review was to summarize the effects of NHE on performance and injury prevention. Following the PRISMA guidelines, a comprehensive literature search was conducted across multiple e-databases, according to the P (injured and non-injured athletes or recreationally active or healthy individuals) I (NHE) C (no intervention, placebo, or other interventions) O (performance or injury) S (systematic reviews) model. The quality of the studies was accessed with the AMSTAR-2. From the 916 systematic reviews found, only 10 could be included. They encompassed 125 studies, enrolling 17,260 subjects. The results from the studies indicate that NHE interventions demonstrated positive effects on sprint performance, muscle activation, eccentric strength, and muscle architecture (fascicle length, muscle thickness, and pennation angle). Furthermore, NHE is effective in preventing hamstring injuries (up to 51%). In conclusion, NHE should be integrated in training (especially, in the warm-up phase) for both enhancing athletic performance and preventing hamstring injuries. For achieving more positive results, it is recommended that high-volume is followed by low-volume maintenance, targeting 48 reps/week.
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Affiliation(s)
- Hugo Nunes
- Polytechnic Institute of Maia, N2i, Social Sciences, Education and Sports School, Avenida Carlos de Oliveira Campos, Castêlo da Maia, 4475-690 Maia, Portugal; (L.G.F.); (P.N.M.)
| | - Luís Gonçalves Fernandes
- Polytechnic Institute of Maia, N2i, Social Sciences, Education and Sports School, Avenida Carlos de Oliveira Campos, Castêlo da Maia, 4475-690 Maia, Portugal; (L.G.F.); (P.N.M.)
| | - Pedro Nunes Martins
- Polytechnic Institute of Maia, N2i, Social Sciences, Education and Sports School, Avenida Carlos de Oliveira Campos, Castêlo da Maia, 4475-690 Maia, Portugal; (L.G.F.); (P.N.M.)
| | - Ricardo Maia Ferreira
- Polytechnic Institute of Maia, N2i, Social Sciences, Education and Sports School, Avenida Carlos de Oliveira Campos, Castêlo da Maia, 4475-690 Maia, Portugal; (L.G.F.); (P.N.M.)
- Polytechnic Institute of Coimbra, Coimbra Health School, Scientific-Pedagogical Unit of Physiotherapy, Rua 5 de Outubro, São Martinho do Bispo, 3045-043 Coimbra, Portugal
- Sport Physical Activity and Health Research & Innovation Center (SPRINT), 4960-320 Melgaço, Portugal
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Gantzer C, Huff D, Butterick B, Chalmers S, Marshall P, Lovell R, Siegler JC. Performing Lower-Limb Strength Exercises Before or After Training Does not Influence Fatigue Indices in Competitive Youth Soccer Players. J Strength Cond Res 2024:00124278-990000000-00497. [PMID: 39074218 DOI: 10.1519/jsc.0000000000004860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
ABSTRACT Gantzer, C, Huff, D, Butterick, B, Chalmers, S, Marshall, P, Lovell, R, and Siegler, JC. Performing lower-limb strength exercises before or after training does not influence fatigue indices in competitive youth soccer players. J Strength Cond Res XX(X): 000-000, 2024-A multicenter approach was used to conduct a controlled, laboratory-based study (Part A) in conjunction with an ecologically focused, field-based study (Part B) of the influence of timing on hamstring fatigue induced by lower-limb strength exercises. Part A required players to perform the FIFA 11+ warm-up before a simulated soccer training session, whereas the other session involved removing the lower-limb strength exercises from the warm-up and delivering them after the simulated session. For Part B, players completed 2 live training sessions, where one session included the Nordic hamstring exercise (NHE) as part of a standardized warm-up before training and the other session incorporated the NHE at the end of training. Maximal hamstring force (MVC), rate of force development (RFD), countermovement jump (CMJ), and sprint speed (SS) were assessed before, during, and after the simulation and field training, respectively, to quantify fatigue across both study cohorts. There was no suggestion that timing of the intervention had an influence fatigue in either Part A or B, with no condition (MVC [Part A & B]: p > 0.43; RFD: p = 0.43; CMJ: p = 0.10; SS: p = 0.62), time (MVC: p > 0.30; RFD: p = 0.72; CMJ: p = 0.87; SS: p = 0.85), or interactions (MVC: p > 0.93; RFD: p = 0.78; CMJ: p = 0.99; SS: p = 0.94) evident. Our findings suggest youth soccer coaches should not be concerned with the timing of interventions, allowing them to focus instead on adherence and player buy-in.
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Affiliation(s)
- Carson Gantzer
- Integrative Human Performance Lab, College of Health Solutions, Arizona State University, Tempe, Arizona
- Neuro Force One, Scottsdale, Arizona
| | - Drake Huff
- Integrative Human Performance Lab, College of Health Solutions, Arizona State University, Tempe, Arizona
- Neuro Force One, Scottsdale, Arizona
| | - Brooke Butterick
- Integrative Human Performance Lab, College of Health Solutions, Arizona State University, Tempe, Arizona
| | - Samuel Chalmers
- UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Paul Marshall
- Department of Exercise Sciences, University of Auckland, Newmarket, Auckland, New Zealand; and
| | - Ric Lovell
- Exercise, Sports Science & Rehabilitation, School of Medicine, University of Wollongong, Wollongong, Australia
| | - Jason C Siegler
- Integrative Human Performance Lab, College of Health Solutions, Arizona State University, Tempe, Arizona
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Medeiros DM, Lima-E-Silva FXD, Aimi M, Vaz MA, Baroni BM. Do athletes with hamstring strain injury have shorter muscle fascicles in the injured limb? J Bodyw Mov Ther 2024; 38:269-273. [PMID: 38763569 DOI: 10.1016/j.jbmt.2024.01.030] [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: 04/27/2023] [Revised: 12/01/2023] [Accepted: 01/25/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Previous studies have suggested that a reduced length of the biceps femoris long head (BFlh) fascicles may increase the risk of hamstring strain injury (HSI). However, it remains unclear whether the BFlh fascicles of the injured limb are shorter than those of the contralateral limb in athletes with an acute HSI. OBJECTIVE To investigate the between-limb asymmetry of BFlh fascicle length in amateur athletes with an acute HSI. METHODS Male amateur athletes were evaluated using ultrasound scans within five days following an HSI. The BFlh fascicle length was estimated using a validated equation. RESULTS Eighteen injured athletes participated in this study. There was no significant difference (p = 0.27) in the length of BFlh fascicles between the injured limb (9.53 ± 2.55 cm; 95%CI 8.26 to 10.80 cm) and the uninjured limb (10.54 ± 2.87 cm; 95%CI 9.11 to 11.97 cm). Individual analysis revealed high heterogeneity, with between-limb asymmetries (percentage difference of the injured limb compared to the uninjured limb) ranging from -42% to 25%. Nine out of the 18 athletes had a fascicle length that was more than 10% shorter in the injured limb compared to the uninjured limb, five athletes had a difference of less than 10%, and four athletes had a fascicle length that was more than 10% longer in the injured limb compared to the uninjured limb. CONCLUSION The architecture characteristics of injured and uninjured muscles is not consistent among athletes with HSI. Therefore, rehabilitation programs focused on fascicle lengthening should be evaluated on a case-by-case basis.
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Affiliation(s)
| | | | - Mateus Aimi
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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McNeill C, Beaven CM, McMaster DT, Ward P, Gill N. Eccentric Force-Velocity-Load Relationship in Trained Rugby Union Athletes. J Strength Cond Res 2024; 38:549-555. [PMID: 38088926 DOI: 10.1519/jsc.0000000000004648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
ABSTRACT McNeill, C, Beaven, CM, McMaster, DT, Ward, P, and Gill, N. Eccentric force-velocity-load relationship in trained rugby union athletes. J Strength Cond Res 38(3): 549-555, 2024-The force-velocity relationship is traditionally believed to resemble a hyperbolic shape, known as the "force-velocity curve." However, there is less evidence regarding this relationship during eccentric muscle action in multijoint isotonic exercise, especially in applied settings. The purpose of this study was to investigate the force-velocity-load relationship in an incremental eccentric back squat test. In addition, 37 professional male rugby union athletes were recruited to participate. Separate generalized linear mixed models were used to analyze the effect of barbell load on relative eccentric peak force (REPF), relative eccentric mean force (REMF), eccentric peak velocity (EPV), and eccentric mean velocity (EMV). A significant effect of load ( p < 0.05) was observed for each of the eccentric variables tested. Each increase in barbell load tended to result in a linear increase in REMF and a decrease in EMV and EPV; however, we observed a plateauing effect for REPF as load increased. These results show that for "peak" variables lighter loads produced similar magnitudes of force, but generally moved at higher velocities than heavier loads. These observations suggest that the eccentric force-velocity-load relationship may vary depending on the parameters used. Quantifying rapid, multijoint eccentric performance is justified as it seems to provide valuable insight into individual athletic capability and training program design. Further research may investigate the responsiveness of the qualities to training and the causal nature of eccentric characteristics and athletic performance.
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Affiliation(s)
- Conor McNeill
- Te Huataki Waiora School of Health, Adams Centre for High Performance, The University of Waikato, Tauranga, New Zealand
- New Zealand Rugby Union, Wellington, New Zealand; and
| | - C Martyn Beaven
- Te Huataki Waiora School of Health, Adams Centre for High Performance, The University of Waikato, Tauranga, New Zealand
| | - Daniel T McMaster
- Te Huataki Waiora School of Health, Adams Centre for High Performance, The University of Waikato, Tauranga, New Zealand
- New Zealand Rugby Union, Wellington, New Zealand; and
| | | | - Nicholas Gill
- Te Huataki Waiora School of Health, Adams Centre for High Performance, The University of Waikato, Tauranga, New Zealand
- New Zealand Rugby Union, Wellington, New Zealand; and
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Nutarelli S, Rocchi JE, Salerno M, Sangiorgio A, Deabate L, Filardo G. Higher Eccentric Hamstring Muscle Fatigue After Participation in a Soccer Match in Young Female Athletes. Sports Health 2024:19417381241230613. [PMID: 38406840 DOI: 10.1177/19417381241230613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Hamstring (HS) strength deficits and imbalances have been identified as risk factors for sustaining anterior cruciate ligament (ACL) injuries and muscular strains, with HS injuries being the most prevalent muscle injuries in soccer athletes. The aim of this study was to investigate HS eccentric strength before and after a soccer match in both male and female soccer athletes. HYPOTHESIS Soccer athletes have changes in eccentric HS strength after a soccer game. STUDY DESIGN Cohort observational study. LEVEL OF EVIDENCE Level 3. METHODS HS eccentric strength (mean and absolute peak torque and total work) was measured in 64 healthy male and female competitive football athletes (14-25 years) with an automatic device during the execution of the Nordic hamstring exercise (NHE) test before and after a 90-minute soccer match. The anterior-knee laxity (AKL) was quantified with an arthrometer. RESULTS Mean and absolute eccentric HS peak torque decreased by 24.5 N.m (-12.34%; P < 0.01) and 21.9 N.m (-10.08%; P < 0.01) in female athletes, whereas their male peers improved by 19.9 N.m (+9.01%; P = 0.01) and by 20.9 N.m (+8.51%; P = 0.02), respectively. HS total work in female athletes decreased by 831.1 J (P < 0.01) compared with the male athlete reduction of 235.3 J. Both the pre- versus postmatch intersex mean and absolute eccentric HS peak torque changes were significant (P < 0.01), as were the changes in HS total work (P < 0.01). The pre- versus postmatch AKL difference and the dominant versus nondominant limb comparison of the strength parameters were not significantly different. Younger female athletes (14-19 years old) presented a greater decrease in mean and absolute peak HS eccentric strength compared with those in older female athletes and men. CONCLUSION HS eccentric strength and work differ based on athlete sex, as measured by the NHE test. Mean peak, absolute peak, and total work showed greater reductions in female athletes than those in their male peers. The subgroup of 14- to 19-year-old female athletes experienced the highest reduction in strength parameters.
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Affiliation(s)
- Sebastiano Nutarelli
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Jacopo Emanuele Rocchi
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
- Villa Stuart Sport Clinic-FIFA Medical Centre of Excellence, Rome, Italy
| | - Manuela Salerno
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Alessandro Sangiorgio
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
| | - Luca Deabate
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
| | - Giuseppe Filardo
- Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland
- Applied and Translational Research (ATR) Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Murakami Y, Nishida S, Kasahara K, Yoshida R, Hayakawa R, Nakamura M. Eccentric force and electromyogram comparison between the eccentric phase of the Nordic hamstring exercise and the razor hamstring curl. PLoS One 2023; 18:e0293938. [PMID: 38100489 PMCID: PMC10723670 DOI: 10.1371/journal.pone.0293938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/23/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE Nordic hamstring exercise (NHE) and razor hamstring curl (RHC) are usually performed to train hamstring eccentric contraction strength. However, it is unclear whether there are differences in the intensity of the two methods and the amount of loading on each muscle. Therefore, this study was conducted using peak eccentric force and each muscle surface electromyogram (s-EMG) to provide useful information to decide whether NHE or RHC should be prescribed for training and rehabilitation. METHODS s-EMG electrodes were placed in the medial gastrocnemius, lateral gastrocnemius, biceps femoris, semitendinosus, gluteus maximus, and erector spinae of the dominant leg of the fifteen healthy male university students with exercise habits. Maximum voluntary isometric contractions of 3 seconds were performed on each muscle followed by NHE and RHC in random order. The outcome variables included peak eccentric force and s-EMG of each muscle calculated by means amplitude during the NHE and RHC. RESULTS Peak eccentric force was significantly higher in RHC than in NHE (p = 0.001, r = 0.73). However, NHE was significantly higher in s-EMG of semitendinosus (p = 0.04, r = -0.52) than RHC. However, there were no significant differences in EMG of the medial gastrocnemius (p = 0.202, r = -0.34), lateral gastrocnemius (p = 0.496, r = 0.18), biceps femoris (p = 0.061, r = -0.48), gluteus maximus (p = 0.112, r = -0.41), erector spinae (p = 0.45, r = 0.20) between NHE and RHC. CONCLUSIONS For NHE and RHC, the peak eccentric force exerted during the exercise was significantly higher for RHC, and the s-EMG of semitendinosus was significantly higher for NHE.
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Affiliation(s)
- Yuta Murakami
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Satoru Nishida
- Faculty of Sports and Health Science, Ryutsu Keizai University, Ibaraki, Japan
| | - Kaziki Kasahara
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Riku Yoshida
- Department of Rehabilitation, Medical Corporation, Maniwa Orthopedic Clinic, Niigata, Japan
| | - Ryo Hayakawa
- Department of Rehabilitation, Medical Corporation Sansuikai, Kitachiba Orthopedic, Makuhari Clinic, Chiba, Japan
| | - Masatoshi Nakamura
- Faculty of Rehabilitation Sciences, Nishi Kyushu University, Saga, Japan
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Crawford SK, Hickey J, Vlisides J, Chambers JS, Mosiman SJ, Heiderscheit BC. The effects of hip- vs. knee-dominant hamstring exercise on biceps femoris morphology, strength, and sprint performance: a randomized intervention trial protocol. BMC Sports Sci Med Rehabil 2023; 15:72. [PMID: 37365624 DOI: 10.1186/s13102-023-00680-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND The hamstrings are an important muscle group that contribute to horizontal force during sprint acceleration and are also the most injured muscle group in running-based sports. Given the significant time loss associated with hamstrings injury and impaired sprinting performance following return to sport, identifying exercises that drive adaptations that are both protective of strain injury and beneficial to sprint performance is important for the strength and conditioning professional. This paper describes the study protocol investigating the effects of a 6-week training program using either the hip-dominant Romanian deadlift (RDL) or the knee-dominant Nordic hamstring exercise (NHE) on hamstring strain injury risk factors and sprint performance. METHODS A permuted block randomized (1:1 allocation) intervention trial will be conducted involving young, physically-active men and women. A target sample size of 32 will be recruited and enrolled participants will undergo baseline testing involving extended-field-of-view ultrasound imaging and shear wave elastography of the biceps femoris long head muscle, maximal hamstrings strength testing in both the RDL and NHE, and on-field sprint performance and biomechanics. Participants will complete the 6-week training intervention using either the RDL or NHE, according to group allocation. Baseline testing will be repeated at the end of the 6-week intervention followed by 2 weeks of detraining and a final testing session. The primary outcome will be regional changes in fascicle length with secondary outcomes including pennation angle, muscle cross sectional area, hamstring strength, and maximal sprint performance and biomechanics. An exploratory aim will determine changes in shear wave velocity. DISCUSSION Despite extensive research showing the benefits of the NHE on reducing hamstring strain injury risk, alternative exercises, such as the RDL, may offer similar or potentially even greater benefits. The findings of this study will aim to inform future researchers and practitioners investigating alternatives to the NHE, such as the RDL, in terms of their effectiveness in reducing rates of hamstring strain injury in larger scale prospective intervention studies. TRIAL REGISTRATION The trial is prospectively registered on ClinicalTrials.gov (NCT05455346; July 15, 2022).
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Affiliation(s)
- Scott K Crawford
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Kinesiology, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 1300 University Ave, Madison, WI, 53706, USA.
| | - Jack Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC, Australia
- Sports Performance, Recovery, Injury and New Technologies Research Centre, Australian Catholic University, Fitzroy, VIC, Australia
- Department of Sport Science and Nutrition, Maynooth University, County Kildare, Ireland
| | - Jessica Vlisides
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Jennifer S Chambers
- Department of Kinesiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Samuel J Mosiman
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, USA
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Bright TE, Handford MJ, Mundy P, Lake J, Theis N, Hughes JD. Building for the Future: A Systematic Review of the Effects of Eccentric Resistance Training on Measures of Physical Performance in Youth Athletes. Sports Med 2023; 53:1219-1254. [PMID: 37097414 PMCID: PMC10185653 DOI: 10.1007/s40279-023-01843-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Eccentric resistance training is recognised as an effective stimulus for enhancing measures of muscular strength and power in adult populations; however, its value in youth athletes is currently not well understood. OBJECTIVE The aim of this systematic review was to critically appraise the effects of eccentric resistance training on measures of physical performance (i.e. muscular strength, jump, sprint and change of direction) in youth athletes 18 years of age and under. METHODS Original journal articles published between 1950 and June 2022 were retrieved from electronic search engines of PubMed, SPORTDiscus and Google Scholar's advanced search option. Full journal articles investigating the acute and chronic effects of eccentric resistance training on measures of physical performance in youth athletes (i.e. a person 18 years of age or under who competes in sport) were included. The methodological quality and bias of each study were assessed prior to data extraction using a modified Downs and Black checklist. RESULTS The search yielded 749 studies, of which 436 were duplicates. Three-hundred studies were excluded based upon title and abstract review and a further 5 studies were removed following the modified Downs and Black checklist. An additional 14 studies were identified during backward screening. Accordingly, 22 studies were included in our systematic review. The Nordic hamstring exercise and flywheel inertial training were the most frequently used eccentric resistance training methods in youth athletes. Improvements in physical performance following the Nordic hamstring exercise are dependent upon an increase in the breakpoint angle, rather than training volume (sets and repetitions), and are further elevated with the addition of hip extension exercises or high-speed running. A minimum of 3 familiarisation trials is necessary to elicit meaningful adaptations following flywheel inertial training. Furthermore, an emphasis should be placed upon decelerating the rotating flywheel during the final one to two thirds of the eccentric phase, rather than gradually throughout the entire eccentric phase. CONCLUSIONS The findings of this systematic review support the inclusion of eccentric resistance training in youth athletes to improve measures of muscular strength, jump, sprint and change of direction performance. The current eccentric resistance training methods are predominantly limited to the Nordic hamstring exercise and flywheel inertial training; however, the efficacy of accentuated eccentric loading to improve jump performance warrants attention in future investigations.
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Affiliation(s)
- Thomas E. Bright
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
- School of Sport, Health and Wellbeing, Plymouth Marjon University, Derriford Rd, Plymouth, PL6 8BH UK
| | - Matthew J. Handford
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | | | - Jason Lake
- Department of Sport and Exercise Sciences, Chichester University, Chichester, UK
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA Australia
| | - Nicola Theis
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
| | - Jonathan D. Hughes
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UK
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Kang YH, Ha WB, Geum JH, Woo H, Han YH, Park SH, Lee JH. Effect of Muscle Energy Technique on Hamstring Flexibility: Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:1089. [PMID: 37107922 PMCID: PMC10137847 DOI: 10.3390/healthcare11081089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/28/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
Since 2005, there have been no systematic reviews on the effects of multiple manual therapies, including muscle energy technique (MET), on the hamstrings. Therefore, this systematic review aimed to provide clinical evidence for the effectiveness of the MET on hamstring flexibility. We queried 10 electronic databases (PubMed, EMBASE, The Cochrane Library, KISS, NDSL, KMBASE, KISTI, RISS, Dbpia, and OASIS) up to the end of March 2022. This study only included randomized controlled trials (RCTs) investigating the use of MET for the hamstring. The literature was organized using Endnote. Literature screening and data extraction were conducted by two researchers independently. The methodological quality of the included RCTs was evaluated using the Cochrane risk-of-bias tool 1.0, and the meta-analysis was performed using RevMan 5.4. In total, 949 patients from 19 RCTs were selected according to the inclusion criteria. During active knee extension tests, the efficacy between MET and other manipulations did not significantly differ. For sit and reach tests, MET groups had higher flexibility compared to stretching (MD = 1.69, 95% CI: 0.66 to 2.73, p = 0.001) and no treatment (MD = 2.02, 95% CI: 0.70 to 3.33, p = 0.003) groups. No significant differences were observed in the occurrence of adverse reactions. Overall, we found that MET is more efficacious for improving hamstring flexibility compared to stretching and having no treatment during sit and reach tests because it combines isometric contraction with stretching. Owing to clinical heterogeneity, uncertain risk of bias, and the small number of included studies, further high-quality studies should assess the effectiveness of MET.
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Affiliation(s)
- Yeh-Hyun Kang
- Chuna Manual Medicine Research Group, College of Korean Medicine, Won-Kwang University, 460 Iksan-daero, Iksan 54538, Republic of Korea
| | - Won-Bae Ha
- Chuna Manual Medicine Research Group, College of Korean Medicine, Won-Kwang University, 460 Iksan-daero, Iksan 54538, Republic of Korea
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Won-Kwang University, 895 Muwang-ro, Iksan 54538, Republic of Korea
| | - Ji-Hye Geum
- Chuna Manual Medicine Research Group, College of Korean Medicine, Won-Kwang University, 460 Iksan-daero, Iksan 54538, Republic of Korea
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Won-Kwang University, 895 Muwang-ro, Iksan 54538, Republic of Korea
| | - Hyeonjun Woo
- Chuna Manual Medicine Research Group, College of Korean Medicine, Won-Kwang University, 460 Iksan-daero, Iksan 54538, Republic of Korea
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Won-Kwang University, 895 Muwang-ro, Iksan 54538, Republic of Korea
| | - Yun-Hee Han
- Chuna Manual Medicine Research Group, College of Korean Medicine, Won-Kwang University, 460 Iksan-daero, Iksan 54538, Republic of Korea
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Won-Kwang University, 895 Muwang-ro, Iksan 54538, Republic of Korea
| | - Shin-Hyeok Park
- Chuna Manual Medicine Research Group, College of Korean Medicine, Won-Kwang University, 460 Iksan-daero, Iksan 54538, Republic of Korea
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Won-Kwang University, 895 Muwang-ro, Iksan 54538, Republic of Korea
| | - Jung-Han Lee
- Chuna Manual Medicine Research Group, College of Korean Medicine, Won-Kwang University, 460 Iksan-daero, Iksan 54538, Republic of Korea
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Won-Kwang University, 895 Muwang-ro, Iksan 54538, Republic of Korea
- Research Center of Traditional Korean Medicine, College of Korean Medicine, Won-Kwang University, 895 Muwang-ro, Iksan 54538, Republic of Korea
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Suskens JJM, Secondulfo L, Kiliç Ö, Hooijmans MT, Reurink G, Froeling M, Nederveen AJ, Strijkers GJ, Tol JL. Effect of two eccentric hamstring exercises on muscle architectural characteristics assessed with diffusion tensor MRI. Scand J Med Sci Sports 2023; 33:393-406. [PMID: 36514886 DOI: 10.1111/sms.14283] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 11/08/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To evaluate the effect of a Nordic hamstring exercise or Diver hamstring exercise intervention on biceps femoris long head, semitendinosus and semimembranosus muscle's fascicle length and orientation through diffusion tensor imaging (DTI) with magnetic resonance imaging. METHODS In this three-arm, single-center, randomized controlled trial, injury-free male basketball players were randomly assigned to a Nordic, Diver hamstring exercise intervention or control group. The primary outcome was the DTI-derived fascicle length and orientation of muscles over 12 weeks. RESULTS Fifty-three participants were included for analysis (mean age 22 ± 7 years). Fascicle length in the semitendinosus over 12 weeks significantly increased in the Nordic-group (mean [M]: 20.8 mm, 95% confidence interval [95% CI]: 7.8 to 33.8) compared with the Control-group (M: 0.9 mm, 95% CI: -7.1 to 8.9), mean between-groups difference: 19.9 mm, 95% CI: 1.9 to 37.9, p = 0.026. Fascicle orientation in the biceps femoris long head over 12 weeks significantly decreased in the Diver-group (mean: -2.6°, 95% CI: -4.1 to -1.0) compared with the Control-group (mean: -0.2°, 95% CI: -1.4 to 1.0), mean between-groups difference: -2.4°, 95% CI: -4.7 to -0.1, p = 0.039. CONCLUSION The Nordic hamstring exercise intervention did significantly increase the fascicle length of the semitendinosus and the Diver hamstring exercise intervention did significantly change the orientation of fascicles of the biceps femoris long head. As both exercises are complementary to each other, the combination is relevant for preventing hamstring injuries.
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Affiliation(s)
- Jozef J M Suskens
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Laura Secondulfo
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Biomedical Engineering & Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Özgür Kiliç
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Melissa T Hooijmans
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Gustaaf Reurink
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands
| | - Martijn Froeling
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Aart J Nederveen
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Gustav J Strijkers
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,Department of Biomedical Engineering & Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes L Tol
- Amsterdam Movement Sciences, Sports, Amsterdam, The Netherlands.,AMC/VUmc IOC Research Center, Amsterdam Collaboration on Health & Safety in Sports (ACHSS), Amsterdam, Netherlands.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
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11
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Abad CCC, Lopes MWR, Lara JPR, Oliveira AJS, da Silva RPC, Facin EA, Izar AJ, Teixeira FG. Long-Term Changes in Vertical Jump, H:Q Ratio and Interlimb Asymmetries in Young Female Volleyball Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16420. [PMID: 36554299 PMCID: PMC9778845 DOI: 10.3390/ijerph192416420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
The present study aimed to examine the changes that occurred in vertical jump and isokinetic dynamometer (ISK) performances at the beginning of a preparatory period (PRE) and at the start of the competitive period (POST). Sixteen U-17 elite female volleyball players, from a national level (15.34 ± 1.19 years; 66.35 ± 7.95 kg; 169.22 ± 24.79 cm), performed bilateral squat jump (SJ), bilateral and unilateral countermovement jump (CMJ) and unilateral ISK tests for knee flexors (Fl) and extensors (Ex) both at 60°/s and at 300°/s. Peak torque (PT) and the hamstring-to-quadriceps (H:Q) ratio were assessed by concentric actions. Asymmetries were calculated by the percentage differences between dominant (DOM) and nondominant legs (NDOM). The paired Student's t-test was used for comparisons at a level of significance of 5%. The effect size was also calculated. A significant increase was found for both SJ (15%; p = 0.004; ES = 0.82) and CMJ (12%; p = 0.017; ES = 0.62). The PT of NDOM flexors at 60°/s was significantly lower than DOM both at PRE (4.6%; p = 0.048; ES = -0.22) and POST (6.3%; p = 0.037; ES = -0.33). The NDOM extensors at 60°/s had a significantly lower PT than DOM at POST (7.0%; p = 0.048; ES = -0.23). Both DOM and NDOM flexors at 60°/s had a PT enhancement at POST related to PRE (6.7%; p = 0.031; ES = 0.51 and 5.6%; p = 0.037; ES = 0.48, respectively). The PT of NDOM extensors at 300°/s increased at POST in comparison to PRE (7.9%; p = 0.038; ES = 0.27). The NDOM at 300°/s had a H:Q ratio higher than DOM both in PRE and POST (8.6%; p = 0.041; ES = 0.37 and 11.6%; p = 0.013; ES = 0.71, respectively), and the highest H:Q ratios were lower than the reference values (<80%). The asymmetry of the unilateral CMJ was higher at POST than at PRE (102%; p = 0.03; ES = 0.81). The PT for the flexors at 300°/s and the H:Q ratio at POST exceeded 10%. In conclusion, a training program of 15 weeks increased the neuromuscular performance of young volleyball athletes, but many H:Q ratios and asymmetries remained out of the normal recommendation. Volleyball professionals should carefully apply an adequate training program to enhance physical fitness performance without increasing the risk of lower limb injuries concurrently.
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12
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Križaj L, Kozinc Ž, Löfler S, Šarabon N. The chronic effects of eccentric exercise interventions in different populations: an umbrella review. Eur J Transl Myol 2022; 32:10876. [PMID: 36269123 PMCID: PMC9830406 DOI: 10.4081/ejtm.2022.10876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 01/13/2023] Open
Abstract
The effectiveness of eccentric exercise interventions (EEI) has been extensively explored in different populations. The aim of our umbrella review was to combine all systematic reviews about the chronic efficiency of EEI and to summarize the literature on the chronic effects of different types of eccentric exercise protocols, with or without extra loads and devices (e.g., Flywheel device), compared to other therapeutic interventions, exercise interventions, or no intervention. We screened four major electronic scientific databases (PubMed, Scopus, Web of Science, and PEDro), using one combined string for all included databases (eccentric exercise OR flywheel OR isoinertial exercise OR eccentric training). Included reviews needed to be based on any human population, that executed EEI in comparison with any other type of intervention. The methodological quality of the included reviews was assessed using AMSTAR 2 tool. Considering the inclusion criteria, we included 35 reviews. EEI were found suitable for chronic or long-term pain reduction in patient populations. EEI largely improved muscle performance (muscle strength, and muscle power), muscle architecture (e.g., pennation angle, fascicle length, cross-sectional area, muscle thickness, and muscle mass), decreased risk of injury, incidence, and severity of the injury, and increased range of motion of the joints There is less evidence about the effects of EEI in older adult populations, compared to athletes and younger populations, however, eccentric exercise seems promising for these populations as well.
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Affiliation(s)
- Luka Križaj
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia
| | - Žiga Kozinc
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia, University of Primorska, Andrej Marušič Institute, Koper, Slovenia
| | - Stefan Löfler
- Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria
| | - Nejc Šarabon
- University of Primorska, Faculty of Health Sciences, Izola, Slovenia,Ludwig Boltzmann Institute for Rehabilitation Research, Vienna, Austria, InnoRenew CoE, Human Health Department, Izola, Slovenia, S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behavior, Ljubljana, Slovenia,University of Primorska Faculty of Health Sciences, Polje 42, SI-6310 Izola, Slovenia ORCID ID: 0000-0003-0747-3735
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13
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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.
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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
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14
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Vetter S, Schleichardt A, Köhler HP, Witt M. The Effects of Eccentric Strength Training on Flexibility and Strength in Healthy Samples and Laboratory Settings: A Systematic Review. Front Physiol 2022; 13:873370. [PMID: 35574461 PMCID: PMC9100951 DOI: 10.3389/fphys.2022.873370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
Background: The risk of future injury appears to be influenced by agonist fascicle length (FL), joint range of motion (ROM) and eccentric strength. Biomechanical observations of the torque-angle-relationship further reveal a strong dependence on these factors. In practice, a longer FL improves sprinting performance and lowers injury risk. Classical stretching is a popular and evidenced-based training for enhancing ROM but does not have any effects on FL and injury risk. However, recent studies show that eccentric-only training (ECC) improves both flexibility and strength, and effectively lowers risk of injury. Objectives: To review the evidence on benefits of ECC for flexibility and strength. Methods: COCHRANE, PUBMED, SCOPUS, SPOLIT, and SPONET were searched for laboratory trials that compare ECC to at least one comparison group. Studies were eligible if they examined both strength and flexibility metrics in a healthy sample (<65 years) and met criteria for controlled or randomized clinical trials (CCT, RCT). 18 studies have been included and successfully rated using the PEDro scale. Results: 16 of 18 studies show strong evidence of strength and flexibility enhancements for the lower limb. While improvements between ECC and concentric training (CONC) were similar for eccentric (+19 ± 10% vs. +19 ± 11%) and isometric strength (+16 ± 10% vs. +13 ± 6%), CONC showed larger improvements for concentric strength (+9 ± 6% vs. +16 ± 7%). While for ROM ECC showed improvements (+9 ± 7%), no results could be found for CONC. The overall effectiveness of ECC seems to be higher than of CONC. Conclusion: There is clear evidence that ECC is an effective method for changes in muscle architecture, leading to both flexibility and strength improvements for the lower limb. Due to limited data no shoulder study could be included. Further research is needed for the upper body joints with a focus on functional and structural adaptions. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021283248, identifier CRD42021283248
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Affiliation(s)
- Sebastian Vetter
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
| | - Axel Schleichardt
- Department of Biomechanics, Institute for Applied Training Science, Leipzig, Germany
| | - Hans-Peter Köhler
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
| | - Maren Witt
- Department of Biomechanics in Sports, Faculty of Sports Science, Leipzig University, Leipzig, Germany
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15
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The Effects of Resistance Training on Architecture and Volume of the Upper Extremity Muscles: A Systematic Review of Randomised Controlled Trials and Meta-Analyses. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031593] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
To systematically review the effects of exercise on fascicle geometry and muscle size parameters of the upper extremity muscles, the CENTRAL, CINAHL, PubMed and OpenGrey databases were searched on 31 July 2021. Finally, 17 randomised controlled trials (RCTs) were included in this systematic review. High-intensity bench press training (g = 1.03) and 12 RM bench press exercises (g = 1.21) showed a large effect size on increasing pectoralis major muscle size. In the elbow extensors, large effects were reported for an increase in muscle size with isometric maximal voluntary co-contraction training (g = 1.97), lying triceps extension exercise (g = 1.25), and nonlinear periodised resistance training (g = 2.07). In addition, further large effects were achieved in the elbow flexors via traditional elbow flexion exercises (g = 0.93), concentric low-load forearm flexion-extension training (g = 0.94, g = 1), isometric maximal voluntary co-contraction training (g = 1.01), concentric low-load forearm flexion-extension training with blood flow restriction (g = 1.02, g = 1.07), and nonlinear periodised resistance training (g = 1.13, g = 1.34). Regarding the forearm muscles, isometric ulnar deviation training showed a large effect (g = 2.22) on increasing the flexor carpi ulnaris and radialis muscle size. Results show that these training modalities are suitable for gaining hypertrophy in the relevant muscles with at least four weeks of training duration. Future RCTs should investigate the effects of exercise modalities on the triceps brachii fascicle geometry, the infraspinatus muscle thickness (MT) and the subscapular MT due to their associations with sports performance.
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16
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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.
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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
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Biceps Femoris Activation during Hamstring Strength Exercises: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168733. [PMID: 34444481 PMCID: PMC8393607 DOI: 10.3390/ijerph18168733] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of the study was to systematically evaluate the biceps femoris long head activation across cross-sectional hamstring strength exercise studies. METHODS A systematic review design was followed. The search strategy conducted in PubMed, Cochrane Library, and Web of Sciences databases found a total of 3643 studies. Once inclusion and exclusion criteria were applied, 29 studies were finally included in this systematic review. A total of 507 participants and 114 different exercises were analyzed. Exercises were evaluated individually and grouped into several categories: Nordics, isokinetic exercises, lunges, squats, deadlifts, good mornings, hip thrusts, bridges, leg curls, swings, hip and back extensions, and others. RESULTS Results showed the isokinetic and Nordic exercises as the categories with highest biceps femoris activation (>60% of Maximal Voluntary Isometric Contraction). Nordic hamstring exercise ankle dorsiflexion was the exercise that achieved the highest biceps femoris long head activation (128.1% of its Maximal Voluntary Isometric Contraction). CONCLUSIONS The results from this systematic review suggest that isokinetic and Nordic exercises seem to be the best option to activate biceps femoris long head. Future studies evaluating the implementation of these exercises in prevention programs are needed.
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Jakobsen JR, Krogsgaard MR. The Myotendinous Junction-A Vulnerable Companion in Sports. A Narrative Review. Front Physiol 2021; 12:635561. [PMID: 33841171 PMCID: PMC8032995 DOI: 10.3389/fphys.2021.635561] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/15/2021] [Indexed: 01/17/2023] Open
Abstract
The incidence of strain injuries continues to be high in many popular sports, especially hamstring strain injuries in football, despite a documented important effect of eccentric exercise to prevent strains. Studies investigating the anatomical properties of these injuries in humans are sparse. The majority of strains are seen at the interface between muscle fibers and tendon: the myotendinous junction (MTJ). It has a unique morphology with a highly folded muscle membrane filled with invaginations of collagen fibrils from the tendon, establishing an increased area of force transmission between muscle and tendon. There is a very high rate of remodeling of the muscle cells approaching the MTJ, but little is known about how the tissue adapts to exercise and which structural changes heavy eccentric exercise may introduce. This review summarizes the current knowledge about the anatomy, composition and adaptability of the MTJ, and discusses reasons why strain injuries can be prevented by eccentric exercise.
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Affiliation(s)
- Jens Rithamer Jakobsen
- Section of Sports Traumatology, M51, A Part of IOC Research Center, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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