Effects of a 10-Week Nordic Hamstring Exercise and Russian Belt Training on Posterior Lower-Limb Muscle Strength in Elite Junior Soccer Players

Nordic hamstring exercises in functional knee rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomised, controlled study

To study the effect of using Nordic hamstring exercise method on muscle strength and knee joint stability of patients after ACL reconstruction. 60 patients admitted to our hospital for ACL reconstruction were randomly divided into a test group (n = 30, applying Nordic hamstring exercise) and a control group (n = 30, applying conventional rehabilitation training methods), and the difference in the circumference of the thighs of the patients in the two groups was analysed after training, and the peak torque (PT), total torque (PT), and flexion and extension strength were measured by using the Biodex system3 Multi-joint Isokinetic Testing System at knee joints with an angular velocity of 60°/s and 120°/s. The peak torque (PT), total work (TW), and average peak torque (AVG PT) were measured by extension and flexion strength at angular velocity, and the Lysholm Knee Score was used to assess the knee function of 60 patients. There was no difference in the difference in thigh circumference between the two groups before surgery (P > 0.05); the difference in thigh circumference between the patients in the test group at 12 and 24 weeks after surgery was (- 0.35 ± 0.22) cm and (0.12 ± 0.03) cm, respectively, which were higher than those in the control group, (- 0.51 ± 0.15) cm and (- 0.41 ± 0.34) cm (P < 0.05). At the 12th and 24th postoperative weeks, the popliteal muscle strength of both groups was improved compared with that before surgery; among them, by comparing the popliteal peak moments with different angular velocities, the ratio of popliteal peak moment on the affected side/peak moment on the healthy side of the popliteal muscle of the experimental group was significantly higher than that of the control group, and the difference was significant (P < 0.05), but there was still a gap compared with that of the healthy side. The Lachmen test and the anterior drawer test were negative in the test and control groups at the 24th postoperative week of review, and the anterior tibial shift was < 5 mm in the KT-1000 test, and the difference in the anterior shift was < 3 mm compared with the healthy side, and there was no significant difference between the two groups. By Nordic hamstring exercise can make patients after knee ACL reconstruction reduce patient pain, accelerate the recovery of knee function, improve the swelling of the lower limb, reach the level of flexor strength of the healthy side within 24 weeks, and can increase the stability of the knee joint.

The Single Leg Bridge Test does not replace handheld dynamometer hamstring tests in a clinical setting

OBJECTIVE

To examine the correlation of Single Leg Bridge Test (SLBT) scores with maximum isometric strength values obtained in handheld dynamometer (HHD) hamstring tests performed in a clinical setting.

DESIGN

Cross-sectional study.

SETTING

Physical therapy clinic.

PARTICIPANTS

Fifty healthy and physically active men.

MAIN OUTCOME MEASURES

Correlation between SLBT scores and force values found in three HHD hamstring tests: test 'A', volunteer in prone with hip in neutral position and the knee flexed at ∼90°; test 'B', volunteer in supine with hip and knee flexed at ∼90°; and test 'C', volunteer in the same position used to perform the SLBT.

RESULTS

The volunteers' SLBT score was 27.55 ± 7.81 repetitions. The SLBT scores were poorly associated with mean (r = 0.246) and peak (r = 0.321) results provided by HHD test 'A'. There were no significant correlations between the SLBT scores and mean or peak values obtained in tests 'B' and 'C' (p > 0.05). Similarly, the SLBT between-limb asymmetry was not associated with asymmetries found in HHD hamstring tests (p > 0.05).

CONCLUSIONS

HHD hamstring tests should not be replaced by the SLBT. We recommend for clinicians to applying such tests in a complementary way to assess the hamstring's functional status.

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

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.

Quo Vadis Nordic Hamstring Exercise-Related Research?-A Scoping Review Revealing the Need for Improved Methodology and Reporting

The objective of this scoping review is to assess Nordic Hamstring Exercise quality (ANHEQ) of assessments and interventions according to the ANHEQ rating scales and to present practical recommendations for the expedient design and reporting of future studies. A total of 71 Nordic Hamstring Exercise (NHE) assessments and 83 NHE interventions were selected from the data sources PubMed, Scopus, and SPORTDiscus. Research studies which were presented in peer-reviewed academic journals and implemented the NHE during laboratory-based assessments or multi-week interventions met the eligibility criteria. NHE assessments analyzed force (51%), muscle activation (41%), knee angle kinematics (38%), and bilateral symmetry (37%). NHE interventions lasted 4-8 weeks (56%) and implied an exercise volume of two sessions per week (66%) with two sets per session (41%) and ≥8 repetitions per set (39%). The total ANHEQ scores of the included NHE assessments and interventions were 5.0 ± 2.0 and 2.0 ± 2.0 (median ± interquartile range), respectively. The largest deficits became apparent for consequences of impaired technique (87% 0-point-scores for assessments) and kneeling height (94% 0-point-scores for interventions). The 0-point-scores were generally higher for interventions compared to assessments for rigid fixation (87% vs. 34%), knee position (83% vs. 48%), kneeling height (94% vs. 63%), and separate familiarization (75% vs. 61%). The single ANHEQ criteria, which received the highest score most frequently, were rigid fixation (66% of assessments) and compliance (33% of interventions). The quality of NHE assessments and interventions was generally 'below average' or rather 'poor'. Both NHE assessments and interventions suffered from imprecise reporting or lacking information regarding NHE execution modalities and subsequent analyses. Based on the findings, this scoping review aggregates practical guidelines how to improve the design and reporting of future NHE-related research.

Single Leg Bridge Test is Not a Valid Clinical Tool to Assess Maximum Hamstring Strength

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.

The Relationship between Preseason Common Screening Tests to Identify Inter-Limb Asymmetries in High-Level Senior and Professional Soccer Players

This study sought to examine inter-limb asymmetries in common screening tests performed during preseason and to analyze the relationship between the performance in the different tests. Nineteen high-level senior and professional soccer players (age: 23.2 ± 3.1 years; height: 181 ± 0.06 cm; body mass: 75.2 ± 4.8 kg) performed several common screening tests during preseason: Dorsiflexion lunge test (DLT); bent knee fall out test (BKFO); y-balance anterior test (YBT A); y-balance posterolateral test (YBT PL); Y-balance posteromedial test (YBT PM); Heel-rise test (HRT) and single leg hamstring bridge test (SLHBT). High levels of reliability (ICC > 0.88 and <0.94) were observed in all the studied variables. Inter-limb significant differences were observed in DLT and YBT PM test (p < 0.01) but YBT A, HRT and SLHBT presented trivial effect size (ES) (0.03; 0.07 and 0.13, respectively), contrary to DLT, BKFO and YBT PL, all with small ES (0.20; −0.23 and −0.22) and YBT PM, which revealed very large ES (2.91). Considering all data, high-level senior and professional soccer players present fairly good mean values of lower limb symmetry. Performance considering all tests was different, a fact associated with different biomechanical dynamics (e.g., YBT), nonetheless, the correlations between tests underline the relationship between these, which could represent important evidence to consider for injury prevention and performance enhancement programs.

The Effect of Intensity, Frequency, Duration and Volume of Physical Activity in Children and Adolescents on Skeletal Muscle Fitness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Physical activity could improve the muscle fitness of youth, but the systematic analysis of physical activity elements and muscle fitness was limited. This systematic review and meta-analysis aim to explore the influence of physical activity elements on muscle fitness in children and adolescents. We analyzed literature in Embase, EBSCO, Web of Science, and PubMed databases from January 2000 to September 2020. Only randomized controlled studies with an active control group, which examined at least 1 muscle fitness evaluation index in individuals aged 5–18 years were included. Articles were evaluated using the Jaded scale. Weighted-mean standardized mean differences (SMDs) were calculated using random-effects models. Twenty-one studies and 2267 subjects were included. Physical activity had moderate effects on improving muscle fitness (SMD: 0.58–0.96, p < 0.05). Physical activity element subgroup analysis showed that high-intensity (SMD 0.68–0.99, p < 0.05) physical activity <3 times/week (SMD 0.68–0.99, p < 0.05), and <60 min/session (SMD 0.66–0.76, p < 0.01) effectively improved muscle fitness. Resistance training of ≥3 sets/session (SMD 0.93–2.90, p < 0.01) and <10 repetitions/set (SMD 0.93–1.29, p < 0.05) significantly improved muscle fitness. Low-frequency, high-intensity, and short-duration physical activity more effectively improves muscle fitness in children and adolescents. The major limitation of this meta-analysis was the low quality of included studies. The study was registered in PROSPERO with the registration number CRD42020206963 and was funded mainly by the Ministry of Education of Humanities and Social Science project, China.

sEMG Activity in Superimposed Vibration on Suspended Supine Bridge and Hamstring Curl

Traditionally in strength and conditioning environments, vibration has been transmitted using platforms, barbells, dumbbells, or cables but not suspension devices. This study aimed to examine the effects on the lower limb of applying superimposed vibration on a suspension device. Twenty-one physically active men and women performed supine bridge and hamstring curl exercises in three suspended conditions (non-vibration, vibration at 25 Hz, and vibration at 40 Hz). In each exercise condition, the perceived exertion scale for resistance exercise (OMNI-Res) was registered, and the electromyographic signal was assessed for gastrocnemius (medialis and lateralis), biceps femoris, semitendinosus, gluteus maximus, and rectus femoris. A linear mixed model indicated a significant fixed effect for vibration at 25 Hz and 40 Hz on muscle activity in suspended supine bridge (p < 0.05), but no effect for suspended hamstring curl (p > 0.05). Likewise, the Friedman test showed a significant main effect for vibration at 25 Hz and 40 Hz in suspended supine bridge (p < 0.05) but not for suspended hamstring curl (p > 0.05) on OMNI-Res. Post hoc analysis for suspended supine bridge with vibration at 25 Hz showed a significant activation increase in gastrocnemius lateralis (p = 0.008), gastrocnemius medialis (p = 0.000), semitendinosus (p = 0.003) activity, and for semitendinosus under 40 Hz condition (p = 0.001) compared to the non-vibration condition. Furthermore, OMNI-Res was significantly higher for the suspended supine bridge at 25 Hz (p = 0.003) and 40 Hz (p = 0.000) than for the non-vibration condition. Superimposed vibration at 25 Hz elicits a higher neuromuscular response during the suspended supine bridge, and the increase in vibration frequency also raises the OMNI-Res value.

Effects of Combined Strength and Power Training on Physical Performance and Interlimb Asymmetries in Adolescent Female Soccer Players

PURPOSE

To examine the effects of an 8-week combined strength and power training intervention on physical performance and interlimb asymmetries in adolescent female soccer players.

METHODS

Thirty-seven adolescent female soccer players (age 16.1 [1.1] y) were randomly assigned to a control group (n = 18) or experimental group (n = 19). The experimental group performed combined strength and power training twice a week, which consisted of strength and power exercises that trained the major muscles of the lower body and trunk musculature. Preintervention and postintervention tests included unilateral and bilateral horizontal and countermovement jump tests, a 40-m sprint test (10- and 30-m split times), a 10-m sprint with a 180° change-of-direction (COD) test, and a multiple-COD test (V-cut test). Asymmetries were also analyzed in the unilateral tests.

RESULTS

Significant group-by-time interaction of the improvement between pretest and posttest was observed for speed (effect size [ES]: -1.30 to -1.16) and COD tests (ES: -0.62 to -0.61) but not in jumping (ES: -0.09 to 0.28) and interlimb-asymmetry tests (ES: -0.13 to 0.57).

CONCLUSIONS

The short-term in-season combined strength and power training program induced greater speed and COD performance improvements than soccer training alone in adolescent female soccer players.

Eccentric Training Interventions and Team Sport Athletes

Eccentric resistance training has been shown to improve performance outcomes in a range of populations, making it a popular choice for practitioners. Evidence suggests that neuromuscular adaptations resulting from eccentric overload (EO) and accentuated eccentric loading (AEL) methods could benefit athletic populations competing in team sports. The purpose of this review was to determine the effects of eccentric resistance training on performance qualities in trained male team sport athletes. A systematic review was conducted using electronic databases PubMed, SPORTDiscus and Web of Science in May 2019. The literature search resulted in 1402 initial articles, with 14 included in the final analysis. Variables related to strength, speed, power and change of direction ability were extracted and effect sizes were calculated with a correction for small sample size. Trivial, moderate and large effect sizes were reported for strength (-0.17 to 1.67), speed (-0.08 to 1.06), power (0.27 to 1.63) and change of direction (0.48 to 1.46) outcomes. Eccentric resistance training appears to be an effective stimulus for developing neuromuscular qualities in trained male team sport athletes. However, the range of effect sizes, testing protocols and training interventions suggest that more research is needed to better implement this type of training in athletic populations.

Adolescent female soccer players' soccer-specific warm-up effects on performance and inter-limb asymmetries

No studies have assessed whether changes in physical performance and inter-limb asymmetries (ILA) can be achieved with the FIFA 11+ prevention programme in adolescent female soccer players. The aim of this study was to assess the effect of the FIFA 11+ programme compared with a standard warm-up on physical performance and ILA in adolescent female soccer players. Thirty-six adolescent female soccer players were randomly assigned to an experimental (EG; n = 19) or a control group (CG; n = 17). Unilateral/bilateral countermovement jump (CMJ), drop jump (DJ) and horizontal jump tests, two different change of direction tests, an ankle dorsiflexion test, the Y-Balance test (YBT) and inter-limb asymmetries were measured before and after 10 weeks of training. The results revealed no significant group-by-time interactions in the vast majority of variables (p>0.05). Paired t-test revealed significant improvements of the right [effect size (ES):0.56] and left (ES:0.49) CMJ, right (ES:0.74) and left (ES:0.54) DJ (ES:0.74), right (ES:1.27) and left (ES:1.26) posteromedial direction and right (ES:0.89) and left (ES:0.84) posterolateral direction in the YBT in the EG (p < 0.05). Right anterior direction in the YBT and V-cut test were significantly improved in both groups (p<0.05). For inter-limb asymmetry variables, no significant group-by-time interactions (ES:0 to 0.93) and an improvement between pre- and post-tests (ES:-0.76 to 0.49) were observed. Therefore, the FIFA 11+ programme led to improved unilateral jumping, dynamic balance and reduced lower extremity symmetries of several tests in adolescent female soccer players.