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Chaari F, Boyas S, Rebai H, Rahmani A, Sahli S. Effectiveness of 12-Week Core Stability Training on Postural Balance in Soccer Players With Groin Pain: A Single-Blind Randomized Controlled Pilot Study. Sports Health 2024:19417381241259988. [PMID: 39066655 DOI: 10.1177/19417381241259988] [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: 07/30/2024] Open
Abstract
BACKGROUND Core stability training (CST) is effective in improving postural balance, core endurance, and self-reported outcomes in different populations. This study aimed to investigate the effect of CST in soccer players with groin pain (GP). HYPOTHESIS CST would improve postural balance performance, core endurance, and self-reported outcomes in soccer players with GP. STUDY DESIGN Randomized controlled trial. LEVEL OF EVIDENCE Level 2. METHODS Soccer players with GP who met the selection criteria were assigned randomly to a CST (CSTG, n = 10) or a control (CG, n = 10) group. The CG undertook no additional physical activity program besides their usual training. The CSTG performed a 12-week CST comprising 76 ~75 min sessions. Static (force platform) and dynamic (Y-Balance test) postural balance, core endurance (McGill trunk endurance tests), and self-reported outcomes (Copenhagen Hip and Groin Outcome Score [HAGOS]) were assessed before and immediately after the 12-week CST. RESULTS Significant improvements were seen in dynamic postural balance (P = 0.04 to <0.01), HAGOS scores (P = 0.02 to <0.01), and core endurance measures (P < 0.01) in the CSTG in posttest compared with pretest session and compared with CG. Static bipedal postural balance measures showed significant improvements (eyes open, P = 0.02; eyes closed, P < 0.01) in the CSTG in posttest compared with pretest session. However, no significant differences (P > 0.05) were observed between CSTG and CG after the training period. CONCLUSION A 12-week CST improved static (foam surface) and dynamic postural balance, core endurance measures, and HAGOS scores. CLINICAL RELEVANCE The beneficial effect of CST on improving postural balance, core endurance, and self-reported outcomes in soccer players with GP suggests that this training would be an important feature of rehabilitation programs for these players. Coaches and clinicians should prioritize CST training when designing rehabilitation programs.
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Affiliation(s)
- Fatma Chaari
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
- Le Mans University, Movement - Interactions, Performance, MIP, UR4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France
| | - Sébastien Boyas
- Le Mans University, Movement - Interactions, Performance, MIP, UR4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France
| | - Haithem Rebai
- Tunisian Research Laboratory 'Sports Performance Optimization' (LR09SEP01), National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
| | - Abderrahmane Rahmani
- Le Mans University, Movement - Interactions, Performance, MIP, UR4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France
| | - Sonia Sahli
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
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Bisciotti GN, Di Pietto F, Rusconi G, Bisciotti A, Auci A, Zappia M, Romano S. The Role of MRI in Groin Pain Syndrome in Athletes. Diagnostics (Basel) 2024; 14:814. [PMID: 38667460 PMCID: PMC11049591 DOI: 10.3390/diagnostics14080814] [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: 02/25/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Groin pain syndrome (GPS) is one of the most frequent injuries in competitive sports. Stresses generated in the lower limbs by quick turns and accelerations, such as in soccer, basketball or hockey, can produce localized regions of increased forces, resulting in anatomical lesions. The differential diagnoses are numerous and comprise articular, extra-articular, muscular, tendinous and visceral clinical conditions and a correct diagnosis is crucial if treatment is to be efficient. MRI is the gold standard of diagnostic techniques, especially when an alternative pathology needs to be excluded and/or other imaging techniques such as ultrasound or radiography do not lead to a diagnosis. This paper, based on the current literature, gives a comprehensive review of the anatomy of the pubic region and of the typical MRI findings in those affected by GPS. Many clinical conditions causing GPS can be investigated by MRI within appropriate protocols. However, MRI shows limits in reliability in the investigation of inguinal and femoral hernias and therefore is not the imaging technique of choice for studying these clinical conditions.
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Affiliation(s)
| | - Francesco Di Pietto
- Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, 81030 Castel Volturno, Italy
| | - Giovanni Rusconi
- Dipartimento di Diagnostica per Immagini, Pineta Grande Hospital, 81030 Castel Volturno, Italy
| | | | - Alessio Auci
- Dipartimento delle Diagnostiche, Azienda USL Toscana Nord Ovest, 56121 Massa, Italy;
| | - Marcello Zappia
- Department of Medicine and Health Science V. Tiberio, Università degli Studi del Molise, 86100 Campobasso, Italy;
| | - Stefania Romano
- Department of Radiology, S. Maria delle Grazie Hospital, 80078 Pozzuoli, Italy;
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Chaari F, Boyas S, Sahli S, Fendri T, Harrabi MA, Rebai H, Rahmani A. Postural balance asymmetry and subsequent noncontact lower extremity musculoskeletal injuries among Tunisian soccer players with groin pain: A prospective case control study. Gait Posture 2022; 98:134-140. [PMID: 36115130 DOI: 10.1016/j.gaitpost.2022.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 08/08/2022] [Accepted: 09/07/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Recent studies reported postural balance disorders in patients and soccer players with groin pain (GP) compared to controls. Since postural balance asymmetry identified after an initial injury contributes for subsequent injuries, identification of this asymmetry in soccer players with GP may highlight the risk of sustaining subsequent noncontact lower extremity musculoskeletal injuries in these players. Therefore, the aims of this study were to (i) examine static and dynamic unipedal postural balance asymmetry in soccer players with GP compared to healthy ones, and (ii) quantify the risk of subsequent noncontact lower extremity injuries in these players. RESEARCH QUESTION Do soccer players with GP exhibit higher static and dynamic unipedal postural balance asymmetry, and higher risk of sustaining subsequent injuries compared to controls? METHODS In this prospective case control study, 27 soccer players with non-time loss GP (GP group: GPG), and 27 healthy ones (control group: CG) were enrolled. Static and dynamic unipedal postural balance asymmetry were evaluated with a force platform using symmetry index (SI), and Y-balance test (Y-BT), respectively. Additionally, subsequent noncontact lower extremity musculoskeletal injuries were tracked for 10 months. RESULTS The GPG revealed higher (p < 0.01) SI in eyes closed condition, higher (p < 0.001) side-to-side asymmetry in anterior, posteromedial and posterolateral reach distances and in composite Y-BT score compared to CG. They showed lower (p < 0.001) composite score for injured limb and higher (p < 0.001) side-to-side asymmetry in posteromedial reach distance compared to the cut-off values of 89.6 % and 4 cm, respectively. Moreover, GPG exhibited higher odds (OR= 7.48; 95 % CI = 2.15, 26.00; p < 0.01) of sustaining subsequent injuries compared to CG. SIGNIFICANCE The Y-BT should be instituted into existing pre-participation physical examinations to screen for soccer players with non-time loss GP at an elevated risk of sustaining subsequent injuries. This could help coaches and clinicians make valid return to play decisions.
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Affiliation(s)
- Fatma Chaari
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Sébastien Boyas
- Le Mans University, Movement - Interactions, Performance, MIP, EA 4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France.
| | - Sonia Sahli
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Thouraya Fendri
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Mohammed A Harrabi
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Haithem Rebai
- Research laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia.
| | - Abderrahmane Rahmani
- Le Mans University, Movement - Interactions, Performance, MIP, EA 4334, France Faculty of Sciences and Technologies, Avenue Olivier Messiaen, 72000 Le Mans, France.
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Saito M, Niga S, Nihei T, Uomizu M, Ikezawa Y, Tsukada S. The cleft sign may be an independent factor of magnetic resonance imaging findings associated with a delayed return-to-play time in athletes with groin pain. Knee Surg Sports Traumatol Arthrosc 2021; 29:1474-1482. [PMID: 33452578 DOI: 10.1007/s00167-020-06410-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 12/07/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the prevalence of magnetic resonance imaging (MRI) findings and define prognostic factors of the return-to-play time in young athletes with groin pain. METHODS A total of 1091 consecutive athletes were retrospectively screened; 651 athletes, aged 16-40 years, with pain in the groin regions were assessed using MRI. Of these athletes, 356 were included for analysing the time to return-to-play. Univariate and multiple linear regression analyses were used to determine the associations between the time to return-to-play (primary outcome variable) and the following variables: age, sex, body mass index, type of sports, Hip Sports Activity Scale, clear trauma history, and 12 MRI findings. RESULTS Four MRI findings, including cleft sign, pubic bone marrow oedema of both the superior and inferior ramus, and central disc protrusion of the pubic symphysis, appeared together in more than 44% of the cases. The median time to return-to-play was 24.7 weeks for athletes with a cleft sign on MRI, which was significantly longer than the 11.9 weeks for athletes without the sign. The median time to return-to-play was 20.8 weeks for athletes with BMI > 24, which was significantly longer than the 13.6 weeks for athletes with BMI ≦ 24. In multiple linear regression analysis of 356 athletes, in whom hip-related groin pain was excluded, and who were followed-up until the return-to-play, the body mass index and cleft sign were the independent factors associated with a delayed return-to-play. In contrast, iliopsoas muscle strain and other muscle injuries were associated with a shorter return-to-play. CONCLUSIONS Multiple MRI findings were present in almost half of all cases. Body mass index and the cleft sign were independently associated with a delayed return-to-play time in young athletes suffering from groin pain. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Masayoshi Saito
- Department of Orthopaedic Surgery, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Sadao Niga
- JIN Orthopaedic & Sports Clinic, 3-10-7 Suzuya, Chuo-ku, Saitama, Saitama, 338-0013, Japan.
| | - Tadahiro Nihei
- JIN Orthopaedic & Sports Clinic, 3-10-7 Suzuya, Chuo-ku, Saitama, Saitama, 338-0013, Japan
| | - Mari Uomizu
- Department of Orthopaedic Surgery, Nerima General Hospital, 1-24-1 Asahigaoka, Nerima-ku, Tokyo, 176-8530, Japan
| | - Yuji Ikezawa
- JIN Orthopaedic & Sports Clinic, 3-10-7 Suzuya, Chuo-ku, Saitama, Saitama, 338-0013, Japan
| | - Sachiyuki Tsukada
- Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, Ibaraki, 310-0035, Japan
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Gerhardt M, Christiansen J, Sherman B, Miranda A, Hutchinson W, Chahla J. Outcomes following surgical management of inguinal-related groin pain in athletes: a case series. J Hip Preserv Surg 2020; 7:103-108. [PMID: 32382436 PMCID: PMC7195923 DOI: 10.1093/jhps/hnz068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 12/19/2019] [Accepted: 12/24/2019] [Indexed: 12/18/2022] Open
Abstract
To determine the outcomes of a limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement of adhesions based on intraoperative findings. Retrospective case series. Outpatient orthopedic/general surgery clinic. Fifty-one athletes treated surgically for inguinal-related groin pain from 2009 to 2015. Limited surgical intervention, consisting of neurolysis, inguinal wall repair and/or adductor debridement based on intra-operative findings. Ability to return to sport at the same level, time to return to play. Fifty-one athletes were included in the study with an average follow-up of 4.42 years (range 2.02–7.01). The average age was 24.2 years (range 16–49) and consisted of 94.0% males and 6.0% females. Nerve entrapment was demonstrated in 96.2% of cases with involvement of the ilioinguinal in 92.5%, the iliohypogastric in 30.8% and the genitofemoral in 13.2%. Attenuation of the posterior inguinal wall was present and repaired in 79.3% of cases. Scar tissue was present around the adductor origin and required debridement in 56.7% of cases. Forty-nine (96.1%) athletes returned to sport at the same level of play at an average of 5.9 weeks. Two athletes required a revision surgery. High rates of return to sport were achieved after surgery for inguinal-related groin pain that addresses the varying pathology and associated nerve entrapment.
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Affiliation(s)
- Michael Gerhardt
- Cedars-Sinai Kerlan-Jobe Institute, 2020 Santa Monica Blvd. Suite 400, Santa Monica, CA 90404, USA
| | - Josh Christiansen
- Cedars-Sinai Kerlan-Jobe Institute, 2020 Santa Monica Blvd. Suite 400, Santa Monica, CA 90404, USA
| | - Benjamin Sherman
- Riverside University Health System, Department of Orthopedic Surgery, 26520 Cactus Ave. Suite B2042, Moreno Valley, CA 92555, USA
| | - Alejandro Miranda
- Cedars-Sinai Kerlan-Jobe Institute, 2020 Santa Monica Blvd. Suite 400, Santa Monica, CA 90404, USA
| | - William Hutchinson
- Pacific Coast Hernia Center, 2001 Santa Monica Blvd. Suite 890, Santa Monica, CA 90404, USA
| | - Jorge Chahla
- Rush University Medical Center, Midwest Orthopaedics, 1611 W. Harrison Ave. Suite 300, Chicago, IL 60612, USA
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