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Sanchez-Sanchez J, Rodriguez-Fernandez A, Granacher U, Afonso J, Ramirez-Campillo R. Plyometric Jump Training Effects on Maximal Strength in Soccer Players: A Systematic Review with Meta-analysis of Randomized-Controlled Studies. SPORTS MEDICINE - OPEN 2024; 10:52. [PMID: 38727944 PMCID: PMC11087442 DOI: 10.1186/s40798-024-00720-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 04/22/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Maximal strength may contribute to soccer players' performance. Several resistance training modalities offer the potential to improve maximal strength. During recent years, a large number of plyometric jump training (PJT) studies showed evidence for maximal strength improvements in soccer players. However, a comprehensive summary of the available data is lacking. OBJECTIVE To examine the effects of PJT compared with active, passive or intervention controls on the maximal strength of soccer players, irrespective of age, sex or competitive level. METHODS To perform a systematic review with meta-analysis following PRISMA 2020. Three electronic databases (PubMed, Web of Science, and SCOPUS) were systematically searched. Studies published from inception until March 2023 were included. A PICOS approach was used to rate studies for eligibility. The PEDro scale was used to assess risk of bias. Meta-analyses were performed using the DerSimonian and Laird random-effects model if ≥ 3 studies were available. Moderator and sensitivity analyses were performed, and meta-regression was conducted when ≥ 10 studies were available for a given comparison. We rated the certainty of evidence using GRADE. RESULTS The search identified 13,029 documents, and from these 30 studies were eligible for the systematic review, and 27 for the meta-analyses. Overall, 1,274 soccer players aged 10.7-25.0 years participated in the included studies. Only one study recruited females. The PJT interventions lasted between 5 and 40 weeks (median = 8 weeks), with 1-3 weekly sessions. Compared to controls, PJT improved maximal dynamic strength (18 studies, 632 participants [7 females], aged 12.7-24.5 y; effect size [ES] = 0.43, 95% confidence interval [CI] = 0.08-0.78, p = 0.017, impact of statistical heterogeneity [I2] = 77.9%), isometric strength (7 studies; 245 participants, males, aged 11.1-22.5 y; ES = 0.58, 95% CI = 0.28-0.87, p < 0.001, I2 = 17.7%), and isokinetic peak torque (5 studies; 183 participants, males, aged 12.6-25.0 y; ES = 0.51, 95% CI = 0.22-0.80, p = 0.001, I2 = 0.0%). The PJT-induced maximal dynamic strength changes were independent of participants' age (median = 18.0 y), weeks of intervention (median = 8 weeks), and total number of training sessions (median = 16 sessions). The certainty of evidence was considered low to very low for the main analyses. CONCLUSIONS Interventions involving PJT are more effective to improve maximal strength in soccer players compared to control conditions involving traditional sport-specific training. Trial Registration The trial registration protocol was published on the Open Science Framework (OSF) platform in December 2022, with the following links to the project ( https://osf.io/rpxjk ) and to the registration ( https://osf.io/3ruyj ).
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Affiliation(s)
- Javier Sanchez-Sanchez
- Research Group Planning and Assessment of Training and Athletic Performance, Universidad Pontificia de Salamanca, 37007, Salamanca, Spain
| | - Alejandro Rodriguez-Fernandez
- Faculty of Physical Activity and Sports Sciences, VALFIS Research Group, Institute of Biomedicine (IBIOMED), Universidad de León, 24071, León, Spain
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, 79102, Freiburg, Germany.
| | - José Afonso
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, 4200-450, Porto, Portugal
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, 7591538, Santiago, Chile
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Falch HN, Hegdahl Gundersen A, Larsen S, Estifanos Haugen M, van den Tillaar R. Comparison of kinematics and electromyography in the last repetition during different maximum repetition sets in the barbell back squat. PeerJ 2024; 12:e16865. [PMID: 38313010 PMCID: PMC10838531 DOI: 10.7717/peerj.16865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024] Open
Abstract
Background The barbell squat is an exercise used to strengthen the lower limbs, with implications for both performance in sports and improving movement during everyday tasks. Although the exercise is being trained across a variety of repetition ranges, the technical requirements may vary, affecting appropriate repetition range for specific training goals. Methods A randomised within-subject design was used to compare kinematics and surface electromyography (EMG) in the lower extremities during different concentric phases (pre-, sticking- and post-sticking region) of the last repetition when performing squats at different repetition maximums (RMs). Thirteen strength-trained men (age: 23.6 ± 1.9 years; height: 181.1 ± 6.5 cm; body mass: 82.2 kg, 1RM: 122.8 ± 16.2, relative strength: 1.5 ± 0.2 x body mass in external load) performed a 1, 3, 6, and 10RM squat, in a randomised order. Results The main findings were that barbell-, ankle-, knee- and hip kinematics were similar across different repetition ranges, except for a smaller trunk lean at 1RM in the pre-sticking region compared to other repetitions and in the sticking region compared to 10RM (p ≤ 0.04). Furthermore, 1RM revealed significantly higher EMG amplitude in the vastus lateralis, gastrocnemius and soleus in the sticking and post-sticking regions when compared to 10RM. It was concluded that 10RM may locally fatigue the vastus lateralis and plantar flexors, explaining the lower EMG amplitude. The observed differences indicate that requirements vary for completing the final repetition of the 10RM compared to the 1RM, an important aspect to consider in training to enhance 1RM strength.
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Affiliation(s)
- Hallvard Nygaard Falch
- Department for Sports Science and Physical Education, Nord University, Levanger, Trøndelag, Norway
| | | | - Stian Larsen
- Department for Sports Science and Physical Education, Nord University, Levanger, Trøndelag, Norway
| | - Markus Estifanos Haugen
- Department for Sports Science and Physical Education, Nord University, Levanger, Trøndelag, Norway
| | - Roland van den Tillaar
- Department for Sports Science and Physical Education, Nord University, Levanger, Trøndelag, Norway
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Durán-Custodio R, Castillo D, Raya-González J, Yanci J. Is a Maximal Strength-Training Program Effective on Physical Fitness, Injury Incidence, and Injury Burden in Semi-Professional Soccer Players? A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:3195. [PMID: 38132085 PMCID: PMC10742471 DOI: 10.3390/healthcare11243195] [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: 10/30/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023] Open
Abstract
The aims of the study were to analyze the effects of a 12-week maximal strength- training program on injury incidence, injury burden, and physical fitness in semi-professional soccer players and to compare the perceived exertion load and well-being state between injured and non-injured soccer players. Twenty semi-professional male soccer players participated in this study. Participants were randomly allocated to an experimental group (EG, n = 10 players), who performed a maximal strength-training program, or to a control group (CG, n = 10 players), who only performed their regular soccer training. Physical fitness was measured at baseline and after the training program. In addition, the injury incidence, burden, training/match load, and the state of well-being of the players were recorded. The EG showed significant improvements in vertical jumps, change in direction ability, linear sprints, repeated sprint ability, isometric strength (p < 0.003; effect size = 1.78-11.86), and quadriceps-hamstring imbalance in both legs (p < 0.001; effect size = 2.37-3.71) in comparison to the CG. In addition, the EG players showed a significantly (p < 0.05) lower injury burden (p < 0.001, relative risk = 5.05, 95% confidence interval = 3.27-7.79). This study demonstrated the beneficial effects of a 12-week maximal strength-training program on physical fitness attributes and injury burden in semi-professional soccer players.
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Affiliation(s)
- Roberto Durán-Custodio
- Faculty of Education and Sport, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain;
- Faculty of Health Sciences, International University of La Rioja (UNIR), 26006 Logroño, Spain
| | - Daniel Castillo
- Valoración del Rendimiento Deportivo, Actividad Física y Salud y Lesiones Deportivas (REDAFLED), Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Education, University of Valladolid, 42004 Soria, Spain
| | | | - Javier Yanci
- Society, Sports and Physical Exercise Research Group (GIKAFIT), Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain;
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Effects of Plyometric Jump Training on the Reactive Strength Index in Healthy Individuals Across the Lifespan: A Systematic Review with Meta-analysis. Sports Med 2023; 53:1029-1053. [PMID: 36906633 PMCID: PMC10115703 DOI: 10.1007/s40279-023-01825-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND The reactive strength index (RSI) is meaningfully associated with independent markers of athletic (e.g., linear sprint speed) and neuromuscular performance [e.g., stretch-shortening cycle (SSC)]. Plyometric jump training (PJT) is particularly suitable to improve the RSI due to exercises performed in the SSC. However, no literature review has attempted to meta-analyse the large number of studies regarding the potential effects of PJT on the RSI in healthy individuals across the lifespan. OBJECTIVE The aim of this systematic review with meta-analysis was to examine the effects of PJT on the RSI of healthy individuals across the lifespan compared with active/specific-active controls. METHODS Three electronic databases (PubMed, Scopus, Web of Science) were searched up to May 2022. According to the PICOS approach, the eligibility criteria were: (1) healthy participants, (2) PJT interventions of ≥ 3 weeks, (3) active (e.g., athletes involved in standard training) and specific-active (e.g., individuals using heavy resistance training) control group(s), (4) a measure of jump-based RSI pre-post training, and (5) controlled studies with multi-groups in randomised and non-randomised designs. The Physiotherapy Evidence Database (PEDro) scale was used to assess the risk of bias. The random-effects model was used to compute the meta-analyses, reporting Hedges' g effect sizes (ES) with 95% confidence intervals (95% CIs). Statistical significance was set at p ≤ 0.05. Subgroup analyses were performed (chronological age; PJT duration, frequency, number of sessions, total number of jumps; randomization). A meta-regression was conducted to verify if PJT frequency, duration, and total number of sessions predicted the effects of PJT on the RSI. Certainty or confidence in the body of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Potential adverse health effects derived from PJT were researched and reported. RESULTS Sixty-one articles were meta-analysed, with a median PEDro score of 6.0, a low risk of bias and good methodological quality, comprising 2576 participants with an age range of 8.1-73.1 years (males, ~ 78%; aged under 18 years, ~ 60%); 42 studies included participants with a sport background (e.g., soccer, runners). The PJT duration ranged from 4 to 96 weeks, with one to three weekly exercise sessions. The RSI testing protocols involved the use of contact mats (n = 42) and force platforms (n = 19). Most studies reported RSI as mm/ms (n = 25 studies) from drop jump analysis (n = 47 studies). In general, PJT groups improved RSI compared to controls: ES = 0.54, 95% CI 0.46-0.62, p < 0.001. Training-induced RSI changes were greater (p = 0.023) for adults [i.e., age ≥ 18 years (group mean)] compared with youth. PJT was more effective with a duration of > 7 weeks versus ≤ 7 weeks, > 14 total PJT sessions versus ≤ 14 sessions, and three weekly sessions versus < three sessions (p = 0.027-0.060). Similar RSI improvements were noted after ≤ 1080 versus > 1080 total jumps, and for non-randomised versus randomised studies. Heterogeneity (I2) was low (0.0-22.2%) in nine analyses and moderate in three analyses (29.1-58.1%). According to the meta-regression, none of the analysed training variables explained the effects of PJT on RSI (p = 0.714-0.984, R2 = 0.0). The certainty of the evidence was moderate for the main analysis, and low-to-moderate across the moderator analyses. Most studies did not report soreness, pain, injury or related adverse effects related to PJT. CONCLUSIONS The effects of PJT on the RSI were greater compared with active/specific-active controls, including traditional sport-specific training as well as alternative training interventions (e.g., high-load slow-speed resistance training). This conclusion is derived from 61 articles with low risk of bias (good methodological quality), low heterogeneity, and moderate certainty of evidence, comprising 2576 participants. PJT-related improvements on RSI were greater for adults versus youths, after > 7 training weeks versus ≤ 7 weeks, with > 14 total PJT versus ≤ 14 sessions, and with three versus < three weekly sessions.
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Association of Strength Performance in Bench Press and Squat with Anthropometric Variables between Resistance-Trained Males and Females. J Funct Morphol Kinesiol 2023; 8:jfmk8010019. [PMID: 36810503 PMCID: PMC9944492 DOI: 10.3390/jfmk8010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/28/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Individual differences in the appropriate percentage of 1-RM for a given repetition range could be a result of variation in anthropometrics and/or sex. Strength endurance is the term used to describe the ability to perform a number of repetitions prior to failure (AMRAP) in sub-maximal lifts and is important in determining the appropriate load for the targeted repetition range. Earlier research investigating the association of AMRAP performance and anthropometric variables was often performed in a sample of pooled sexes or one sex only or by utilizing tests with low ecological validity. As such, this randomized cross-over study investigates the association of anthropometrics with different measures of strength (maximal and relative strength and AMRAP) in the squat and bench press for resistance-trained males (n = 19, 24.3 ± 3.5 years, 182 ± 7.3 cm, 87.1 ± 13.3 kg) and females (n = 17, 22.1 ± 3 years, 166.1 ± 3.7 cm, 65.5 ± 5.6 kg) and whether the association differs between the sexes. Participants were tested for 1-RM strength and AMRAP performance, with 60% of 1-RM in the squat and bench press. Correlational analysis revealed that for all participants, lean mass and body height were associated with 1-RM strength in the squat and bench press (0.66, p ≤ 0.01), while body height was inversely associated with AMRAP performance (r ≤ -0.36, p ≤ 0.02). Females had lower maximal and relative strength with a greater AMRAP performance. In the AMRAP squat, thigh length was inversely associated with performance in males, while fat percentage was inversely associated with performance in females. It was concluded that associations between strength performance and anthropometric variables differed for males and females in fat percentage, lean mass, and thigh length.
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Buhmann R, Stuelcken M, Sayers M. Alternatives to common approaches for training change of direction performance: a scoping review. BMC Sports Sci Med Rehabil 2022; 14:151. [PMID: 35922872 PMCID: PMC9347107 DOI: 10.1186/s13102-022-00544-9] [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: 03/29/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Research focuses heavily upon the effect of strength and power training on change of direction performance. The objective of this scoping review is to highlight alternative approaches to training change of direction. METHODS Four databases (Scopus, PubMed, Web of Science and SPORTDiscus) were searched with no date restrictions. To be included studies must (i) investigate change of direction performance following an intervention or investigate the relationships between variables of interest and change of direction performance; (ii) recruit participants > 18 years old; (iii) recruit participants involved in competitive sport. The majority of included studies investigated the effect of strength and/or power training, or, relationships between strength and/or power variables with change of direction performance. RESULTS Despite fewer studies, alternative training methods resulted in greater improvements (compared with strength and/or power) in change of direction performance, with smaller training durations. Few studies included reactive agility as an outcome measure. CONCLUSION Despite much of the literature focusing on strength and/or power, there are alternative training modalities that demonstrate merit for improving change of direction performance. Future studies should investigate the effect of alternative training interventions on reactive agility performance, to provide a more valid indication of transfer to competition.
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Affiliation(s)
- Robert Buhmann
- School of Health and Behaviour Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4556, Australia.
| | - Max Stuelcken
- School of Health and Behaviour Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4556, Australia
| | - Mark Sayers
- School of Health and Behaviour Sciences, University of the Sunshine Coast, Maroochydore, QLD, 4556, Australia
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Effect of Strength vs. Plyometric Training upon Change of Direction Performance in Young Female Handball Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116946. [PMID: 35682528 PMCID: PMC9180755 DOI: 10.3390/ijerph19116946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 12/10/2022]
Abstract
The aim of the current study was to investigate the effect of six weeks of strength vs. plyometric training upon change of direction (COD) performance. A total of 21 young female handball players were randomly assigned to either a strength group: (n = 11, age: 17.5 ± 2.3 years, height: 1.69 ± 0.05 m, weight: 65.8 ± 5.9 kg) training bilateral, unilateral and later squats; or a plyometric training group (n = 10, age: 17.1 ± 2.4 years, height: 1.73 ± 0.07 m, weight: 67.1 ± 9.3 kg) training drop jumps, unilateral countermovement jumps and skate-jumps. Groups were assigned after being pair-matched based upon baseline COD performance. The training modalities were matched in training impulse. A force- (180°) and velocity-oriented (45°) COD of 20 m was used to measure changes in COD performance (10 m + COD + 10 m). Total time (s) to complete the COD test was defined as the performance variable. The level of significance was set at p < 0.05. The two-way ANOVA showed no group effect upon COD performance. A significant effect was only observed for the strength training group in the last 10 m and total 20 m of the force-oriented COD (F ≥ 5.51; p ≤ 0.04; η2 ≥ 0.36). Both groups improved performance in other strength- and power-related tests. It was concluded that only the strength training program was effective in developing force-oriented COD performance in the studied population, while the plyometric training program was not sufficient. Both training modalities are useful for improving performance in different strength and power tests in young female handball players.
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Falch HN, Kristiansen EL, Haugen ME, van den Tillaar R. Association of Performance in Strength and Plyometric Tests with Change of Direction Performance in Young Female Team-Sport Athletes. J Funct Morphol Kinesiol 2021; 6:83. [PMID: 34698245 PMCID: PMC8544401 DOI: 10.3390/jfmk6040083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/06/2021] [Accepted: 10/12/2021] [Indexed: 12/05/2022] Open
Abstract
The change of direction (COD) ability is a task-specific skill dependent on different factors such as the degree of the turn, which has led to differentiating CODs as more force- (>90°) or velocity-oriented (<90°). Considering force and velocity requirements is of importance when designing sport-specific training programs for enhancing COD performance. Thus, 25 female handball and soccer players participated in this study, which investigated the association between three different strength and plyometric exercises and force- and velocity-oriented COD performance. By utilizing the median split analysis, the participants were further divided into a fast (n = 8) and a slow (n = 8) COD group, to investigate differences in step kinematics between fast and slow performers. The correlational analysis revealed that the bilateral back squat and unilateral quarter squat were significantly associated with several force- and velocity-oriented COD performance (r = -0.46 to -0.64), while the association between plyometric and COD performance was limited (r < 0.44). The fast COD group revealed higher levels of strength, jump height, peak velocities, higher step frequencies, shorter ground contact times, and greater acceleration and braking power (d > 1.29, p < 0.03). It was concluded that the observed correlation between strength and COD performance might be due to stronger athletes being able to produce more workload in a shorter time, which was supported by the step kinematics.
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Affiliation(s)
| | | | | | - Roland van den Tillaar
- Department of Sport Sciences and Physical Education, Nord University, 7600 Levanger, Norway; (H.N.F.); (E.L.K.); (M.E.H.)
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Aloui G, Hermassi S, Khemiri A, Bartels T, Hayes LD, Bouhafs EG, Souhaiel Chelly M, Schwesig R. An 8-Week Program of Plyometrics and Sprints with Changes of Direction Improved Anaerobic Fitness in Young Male Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10446. [PMID: 34639746 PMCID: PMC8508367 DOI: 10.3390/ijerph181910446] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 11/21/2022]
Abstract
This study examined the effects of 8 weeks of twice-weekly combined plyometric and sprint with change-of-direction (CPSCoD) training into habitual training regimes of young male soccer players. Participants were randomly allocated to an experimental group (n = 17, age: 14.6 ± 0.44 years, body mass: 61.2 ± 7.34 kg, height: 1.67 ± 0.09 m, body fat: 11.2 ± 1.56%) and a control group (n = 16, age: 14.6 ± 0.39 years, body mass: 61.1 ± 3.96 kg, height: 1.67 ± 0.05 m, body fat: 11.8 ± 1.47%). Measures obtained pre- and post intervention included vertical and horizontal jump performance (i.e., squat jump (SJ), countermovement jump (CMJ), and standing long jump (SLJ)), and sprint performance (i.e., 5 m and 20 m sprint). In addition, Measures obtained pre- and post-intervention included change-of-direction ability (4 × 5 m sprint test (S 4 × 5 m) and sprint 9-3-6-3-9 m with backward and forward running (SBF)), repeated change of direction (RCoD), and static balance performance (stork balance test). The training group experienced superior jump (all p < 0.05; d ≥ 0.61), sprint (all p < 0.05; d ≥ 0.58), change-of-direction (CoD) ability (all p < 0.05; d ≥ 0.58), RCoD (all parameters except the fatigue index p < 0.01; effect size (d) ≥ 0.71), and static balance (all p < 0.05; d ≥ 0.66) improvement. Adding twice-weekly CPSCoD training to standard training improves the anaerobic performance of U15 male soccer players.
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Affiliation(s)
- Ghaith Aloui
- Research Unit (UR17JS01) Sport Performance, Health & Society, Higher Institute of Sport and Physical Education, University of La Manouba, Ksar-Saîd, Tunis 2010, Tunisia; (G.A.); (A.K.); (M.S.C.)
| | - Souhail Hermassi
- Physical Education Department, College of Education, Qatar University, Doha 2713, Qatar
| | - Aymen Khemiri
- Research Unit (UR17JS01) Sport Performance, Health & Society, Higher Institute of Sport and Physical Education, University of La Manouba, Ksar-Saîd, Tunis 2010, Tunisia; (G.A.); (A.K.); (M.S.C.)
| | - Thomas Bartels
- Center of Joint Surgery, Sports Clinic Halle, 06108 Halle (Saale), Germany;
| | - Lawrence D. Hayes
- School of Health and Life Sciences, University of the West of Scotland, Glasgow G72 0LH, UK;
| | - El Ghali Bouhafs
- Department of Sports Science, Martin-Luther-University Halle-Wittenberg, Von-Seckendorff-Platz 2, 06120 Halle (Saale), Germany;
| | - Mohamed Souhaiel Chelly
- Research Unit (UR17JS01) Sport Performance, Health & Society, Higher Institute of Sport and Physical Education, University of La Manouba, Ksar-Saîd, Tunis 2010, Tunisia; (G.A.); (A.K.); (M.S.C.)
| | - René Schwesig
- Department of Orthopaedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany;
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