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Specificity of eccentric hamstring training and the lack of consistency between strength assessments using conventional test devices.

ABSTRACT: Hamstring injuries are endemic, but influences of test-specific training and the application of different test methods on decision making remain elusive. Sport-students were randomised to isokinetic (IG) or Nordic hamstring (NG) exercise or a control group (CG) for six weeks. Training and testing procedures were matched to biomechanical parameters. Hamstring strength (EPT), work, muscle soreness (visual analogue scale (VAS)), biceps femoris (BF_lh) muscle size and architecture were assessed. Anthropometrics and strength parameters did not differ at baseline. Yet, body mass normalised EPT, and work revealed a significant group × time × device effect, with a significant main effect for devices. Experimental conditions triggered meaningful increases in EPT compared to the control group, but the effects were higher when recorded on the training device. Despite significant group × time interactions, normalised average work on the NHD was only higher in the NG compared to CG of the left leg (+ 35%). No effects were found for BF_lh parameters. Hamstrings showed a high training specificity, but adaptations likely remain undetected owing to the low sensitivity of conventional test devices. Moreover, strength increase of ~ 15% does not necessarily have to be reflected in BF_lh parameters.

SUBMITTER: Wiesinger HP

PROVIDER: S-EPMC8239011 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Specificity of eccentric hamstring training and the lack of consistency between strength assessments using conventional test devices.

Wiesinger Hans-Peter HP Scharinger Manuel M Kösters Alexander A Gressenbauer Christoph C Müller Erich E

Scientific reports 20210628 1

Hamstring injuries are endemic, but influences of test-specific training and the application of different test methods on decision making remain elusive. Sport-students were randomised to isokinetic (IG) or Nordic hamstring (NG) exercise or a control group (CG) for six weeks. Training and testing procedures were matched to biomechanical parameters. Hamstring strength (EPT), work, muscle soreness (visual analogue scale (VAS)), biceps femoris (BF<sub>lh</sub>) muscle size and architecture were ass ...[more]

PMID: 34183742

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Project description:BackgroundIsokinetic dynamometry (IKD) is considered as the gold standard method of eccentric hamstring strength measurement, but other devices are more portable, cost-effective, provide real-time data and are thus better suited to the mass testing required in sport. This review aims to synthesise the evidence related to the reliability of and agreement between devices that measure eccentric hamstring strength and isokinetic dynamometers in adults.MethodsThe MEDLINE, EMBASE, PubMed, CINAHL and Sport Discus databases, alongside a search of grey and pre-print literature (from inception to 2021), are used. Forward and backward snowballing will also be used. Studies will be included if the reliability and/or agreement between devices used to quantify eccentric hamstring strength in healthy, recreationally active or amateur/elite sportspeople has been investigated. Studies will be excluded if (1) participants were injured or unwell at the time of testing and (2) concentric strength measurements or if non-hamstring muscle groups were investigated. The COnsenus-based Standards for the selection of health Measurement INstruments (COSMIN) tool will be used to assess the quality of reporting of included studies. If possible, data will be pooled and a meta-analysis and/or meta-regression may be performed if appropriate. We will aim to conduct a narrative synthesis using an adapted Grading of Recommendation, Assessment, Development and Evaluation (GRADE).DiscussionThis systematic review will aim to analyse the reliability of devices that measure eccentric hamstring strength, and the agreement of these devices with isokinetic dynamometers when used in an adult population. It is anticipated that the results of this review could be used to inform clinicians regarding suitable devices that can be employed to monitor eccentric hamstring strength in clinical practice. No ethics approval is required. It is anticipated that this review will be submitted to a leading peer-reviewed journal in this field for publication consideration.Systematic review registrationwww.researchregistry.com (reviewregistry1070).

Project description:BackgroundGiven the severe economic and performance implications of hamstring injuries, there are different attempts to identify their risk factors for subsequently developing injury prevention strategies to reduce the risk of these injuries. One of the strategies reported in the scientific literature is the application of interventions with eccentric exercises. To verify the effectiveness of these interventions, different eccentric strength measurements have been used with low-cost devices as alternatives to the widespread used isokinetic dynamometers and the technically limited handheld dynamometers. Therefore, the purpose of the present systematic review was to summarize the findings of the scientific literature related to the evaluation of eccentric strength of hamstring muscles with these new technologies.MethodsSystematic searches through the PubMed, Scopus, and Web of Science databases, from inception up to April 2020, were conducted for peer reviewed articles written in English, reporting eccentric strength of hamstrings assessed by devices, different to isokinetic and handheld dynamometers, in athletes.ResultsSeventeen studies were finally included in the review with 4 different devices used and 18 parameters identified. The pooled sample consisted of 2893 participants (97% male and 3% female: 22 ± 4 years). The parameters most used were peak force (highest and average), peak torque (average and highest), and between-limb imbalance (left-to-right limb ratio). There is inconsistency regarding the association between eccentric hamstrings strength and both injury risk and athletic performance. There is no standardized definition or standardization of the calculation of the used parameters.ConclusionsThe current evidence is insufficient to recommend a practical guide for sports professionals to use these new technologies in their daily routine, due to the need for standardized definitions and calculations. Furthermore, more studies with female athletes are warranted. Despite these limitations, the eccentric strength of hamstring muscles assessed by different devices may be recommended for monitoring the neuromuscular status of athletes.

Project description:BackgroundHamstring strain injuries (HSI) are one of the most prevalent and serious injuries affecting athletes, particularly those in team ball sports or track and field. Recent evidence demonstrates that eccentric knee flexor weakness and between limb asymmetries are possible risk factors for HSIs. While eccentric hamstring resistance training, e.g. the Nordic hamstring exercise (NHE) significantly increases eccentric hamstring strength and reduces HSI risk, little research has examined whether between limb asymmetries can be reduced with training. As augmented feedback (AF) can produce significant acute and chronic increases in muscular strength and reduce injury risk, one way to address the limitation in the eccentric hamstring training literature may be to provide athletes real-time visual AF of their NHE force outputs with the goal to minimise the between limb asymmetry.MethodsUsing a cross over study design, 44 injury free, male cricket players from two skill levels performed two NHE sessions on a testing device. The two NHE sessions were identical with the exception of AF, with the two groups randomised to perform the sessions with and without visual feedback of each limb's force production in real-time. When performing the NHE with visual AF, the participants were provided with the following instructions to 'reduce limb asymmetries as much as possible using the real-time visual force outputs displayed in front them'. Between limb asymmetries and mean peak force outputs were compared between the two feedback conditions (FB1 and FB2) using independent t-tests to ensure there was no carryover effect, and to determine any period and treatment effects. The magnitude of the differences in the force outputs were also examined using Cohen d effect size.ResultsThere was a significant increase in mean peak force production when feedback was provided (mean difference, 21.7 N; 95% CI [0.2-42.3 N]; P = 0.048; d = 0.61) and no significant difference in between limb asymmetry for feedback or no feedback (mean difference, 5.7%; 95% CI [-2.8% to 14.3%]; P = 0.184; d = 0.41). Increases in force production under feedback were a result of increased weak limb (mean difference, 15.0 N; 95% CI [1.6-28.5 N]; P = 0.029; d = 0.22) force contribution compared to the strong limb.DiscussionThe results of this study further support the potential utility of AF in improving force production and reducing risk in athletic populations. While there are currently some financial limitations to the application of this training approach, even in high-performance sport, such an approach may improve outcomes for HSI prevention programs. Further research with more homogenous populations over greater periods of time that assess the chronic effect of such training practices on injury risk factors and injury rates are also recommended.

Project description:PurposeTo investigate the differences in maximal (isometric and concentric peak torque) and explosive (rate of torque development (RTD)) hamstring and quadriceps strength symmetry between males and females during early- and late-phase rehabilitation after anterior cruciate ligament reconstruction (ACLR) using hamstring tendon (HT) autografts and to determine the interaction of time and sex on maximal and explosive strength symmetry.MethodsA total of 38 female and 51 male participants were assessed during early (3-6 months post-operative) and late (7-12 months post-operative) phases of rehabilitation following ACLR. Maximal (concentric and isometric peak torque) and explosive (isometric RTD) hamstring and quadriceps strength were assessed and presented as limb symmetry index (LSI).ResultsMaximal concentric hamstrings asymmetry (Early: 86 ± 14; Late 92 ± 13; p = 0.005) as well as maximal concentric (Early, 73 ± 15; Late 91 ± 12; p < 0.001) and explosive (Early: 82 ± 30; Late: 92 ± 25; p = 0.03) quadriceps asymmetry decreased from early to late rehabilitation. However, there were no significant changes in maximal isometric quadriceps strength and explosive isometric hamstring strength in the same time period. Females had a larger asymmetry in maximal concentric (Females: 75 ± 17; Males: 81 ± 15; p = 0.001) and explosive (Females: 81 ± 32; Males: 89 ± 25; p = 0.01) quadriceps strength than males throughout rehabilitation. There were no sex differences in maximal and explosive hamstring strength. There were no sex by time interactions for any variables.ConclusionExplosive hamstring strength asymmetry did not improve despite recovery of maximal hamstring strength during rehabilitation following ACLR with HT autografts. While sex did not influence strength recovery, females had larger maximal and explosive quadriceps strength asymmetry compared to males throughout rehabilitation following ACLR.Level of evidenceLevel III.

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Specificity of eccentric hamstring training and the lack of consistency between strength assessments using conventional test devices.

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Specificity of eccentric hamstring training and the lack of consistency between strength assessments using conventional test devices.

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