scholarly journals The Effect of Therapeutic Exercise on Long-Standing Adductor-Related Groin Pain in Athletes: Modified Hölmich Protocol

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Abbas Yousefzadeh ◽  
Azadeh Shadmehr ◽  
Gholam Reza Olyaei ◽  
Nasrin Naseri ◽  
Zahra Khazaeipour
Keyword(s):  
Groin Pain ◽  
Recovery Period ◽  
Return To Sport ◽  
Step Test ◽  
Return To Sports ◽  
Therapeutic Exercise ◽  
Sports Activity ◽  
Hip Abduction ◽  
Hop Test ◽  
Mean Time

Objective. The Hölmich protocol in therapeutic exercise is the most appropriate method for the treatment of long-standing adductor-related groin pain (LSAGP). Herein, we evaluated a modified Hölmich protocol to resolve the possible limitations intrinsic to the Hölmich protocol in terms of the rate of return to sport and the recovery period for athletes with LSAGP. Design. The study followed a single-blind, before/after study design, where 15 athletes with LSAGP (mean age = 26.13 years; SD = 4.48) performed a 10-week modified Hölmich therapeutic exercise protocol. Results. Outcome scores related to pain, hip adductor and abductor muscle strengths, and the ratio of maximum isometric and eccentric hip adduction to abduction strength increased significantly. Likewise, hip abduction and internal rotation ROM improved significantly compared to that at baseline. Furthermore, functional records (t-test, Edgren Side Step Test, and Triple Hop Test) showed significant improvement after treatment. Finally, 13 athletes (86.6% of the participants) successfully returned to sports activity in a mean time of 12.06 weeks (SD = 3.41). Conclusion. The findings of this study objectively show that the modified Hölmich protocol may be safer and more effective than the Hölmich protocol in athletes with LSAGP in promoting their return to sports activity. This trial is registered with  IRCT2016080829269N1.

scholarly journals HOP TEST AS A TOOL FOR THE ASSESSMENT AND PREVENTION OF INJURIES IN FOOTBALLERS DURING PRESEASON

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
F García-Bol ◽  
V Posada-Franco ◽  
A Roldán-Valero ◽  
R Del Caño-Espinel
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Reference Values ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Performance Criteria ◽  
Return To Sports ◽  
Hop Tests ◽  
Hop Test ◽  
Anterior Cruciate

Hop Tests (unipodal horizontal jumps) have been recommended as one of the reliable assessment tests when allowing a return to competition for a sportsperson after an anterior cruciate ligament injury1,2,3,4. Currently, comparison is made of the results with the contralateral limb through the symmetry index, a method which might not provide sufficient security upon the return to competitive sport5. Hop tests can be used in preseason to gain reference values prior to a possible injury. The objective of this review is to analise the scientific literature such as the F-Marc6 (reference manual of FIFA) to confirm whether include said tests in preseason for football teams. A search was conducted in the Pubmed y Cochrane databases (17/04/17) with the search terms “Hop Test”, “Football”, “Soccer”, and “Preseason”. Articles in English and Spanish were both accepted. Articles excluded were those that did not make reference to the knee, to football, and those that did not conduct tests during preseason. From a total of 33 articles, 4 with these search criteria were included, 5 articles were added trough the bibliography of other studies, and the F-Marc manual was analised. 4 of the articles used the hop tests in preseason for some type of study, of which 3 were used as part of a prospective assessment for the season. On the other hand, the F-Marc does not consider Hop Tests as an assessment test. Hop tests were not found to be used in preseason as reference values prior to possible future injuries, data which could be beneficial for a safe return to sport. Harris J, Abrams G, Bach B, Williams D, Heidloff D, Bush-Joseph C, Verma N, Forsythe B, Cole B. Return to Sport After ACL Reconstruction. ORTHOPEDICS. 2014; 37: e103-e108. Barber-Westin SD, Noyes FR. Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction. Arthroscopy. 2011 Dec;27(12):1697-705. Thomeé R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D, Tsepis E, Werner S, Wondrasch B, Witvrouw E. Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2011 Nov;19(11):1798-805. Bolgla LA, Keskula DR. Reliability of lower extremity functional performance tests. J Orthop Sports Phys Ther. 1997 Sep;26(3):138-42. Wellsandt E, Failla MJ, Snyder-Mackler L. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury. J Orthop Sports Phys Ther. 2017 Mar 29:1-18. F-MARC. Football Medicine Manual. 2nd Edition. Available from: http://f-marc.com . 2017.

scholarly journals Return to Sport, integrating the process from conventional rehabilitation up to reconditioning: a narrative review

2021 ◽  
Vol 38 (5) ◽  
pp. 253-260
Author(s):  
Pavel Loeza-Magaña ◽  
Héctor R. Quezada-González ◽  
Pedro I. Arias-Vázquez
Keyword(s):  
Motor Skills ◽  
Meta Analysis ◽  
Sport Activity ◽  
Return To Sport ◽  
Return To Sports ◽  
Sports Performance ◽  
Sports Activity ◽  
Sports Team ◽  
Communication And Coordination ◽  
Sports Activities

Introduction: The process of return to sport after injury, has traditionally been approached in 2 separate stages; first the athlete is treated the medical service through conventional rehabilitation processes and is then referred to the sports team (coach and / or physical trainer) who complete the return to the sport activity. This approach may lack communication and coordination between both teams and may be insufficient for the demands of the current sports environment, causing longer processes of return to sport and greater risk of re-injury. The objective of this manuscript is to document the current models of return to sport, its stages, objectives and contents. Material and method: A comprehensive review of publications was carried out, including observational studies, clinical trials, reviews, consensus, systematic reviews and meta-analysis, related to treatment, rehabilitation, readaptation and return to sport. Results: The description of a model of return to sports of gradual progression that includes 3 stages was found: return to participation, readaptation to sport and return to maximum sports performance. The stage of return to participation aims to eliminate the symptoms and regain the functionality of the athlete in their non-sports activities, through conventional rehabilitation processes. The stage of readaptation to sport aims to achieve asymptomatic performance of training and competition activities, through the rehabilitation of deficiencies caused by the injury and the maintenance and / or development of motor skills with modified training. The stage of return to maximum sports performance includes specific sports training to reach the level of performance prior to the injury. Conclusions: This model could be associated with greater success in returning to sports activity and lower risk of recurrence of the injury.

scholarly journals Performance Function Tests in Healthy Athletes

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0022
Author(s):  
Justin Greisberg ◽  
J. Turner Vosseller ◽  
Peter Gould ◽  
Christopher Ahmad
Keyword(s):  
Performance Test ◽  
Performance Testing ◽  
Return To Sports ◽  
Functional Tests ◽  
Minimum Threshold ◽  
Sports Activity ◽  
Wide Range ◽  
Hop Test ◽  
The Right ◽  
Minimum Performance

Category: Sports Introduction/Purpose: A challenge for physicians is determining when an injured athlete is ready to return to competition. While a wide variety of ankle strength and fitness tests have been described, there are no norms or minimum performance thresholds for any of them. In this study, healthy athletes were given a series of functional tests to complete. We propose that there will be a minimum performance level for each of the tests that all athletes can complete. We also propose, for tests which assess the right and left legs independently, that performance of the right leg will consistently be within 10% of the left. Finally, we propose that performance on one of the functional tests will be predictive of function on all of the tests. Methods: Healthy college athletes were put through a testing protocol, beginning with simple range of motion assessment and progressing through a series of functional ankle tests of increasing difficulty. The athlete began with the dorsiflexion lunge test, and then progressed to single leg heel raising, single leg hopping, side hopping, front-back hopping, functional hop test, and finally 180 degree rotational jump. Right and left legs were recorded separately for the first five tests. For each test, means, ranges, and standard deviations were calculated. Results: Eighty-one athletes (male and female from different sports) completed the protocol; no athlete was unable to finish the testing sequence. There was a wide variation in performance ability between athletes; the standard deviation for any of the individual tests was too high to determine a minimum threshold of normal performance. However, when comparing right to left leg in any one athlete, the difference in performance testing was always less than 10%. Furthermore, performance on any of the hopping tests was predictive of performance on all of them. Conclusion: Ideally, an athlete could be deemed ready to return to sports activity if he or she performed above a certain threshold on a performance test. Unfortunately, athletes had such a wide range of performance that it is not possible to define a minimum threshold for any of these tests. However, right and left leg performance was always within 10% of each other. For an athlete with a single leg injury, we propose that performance on a functional hopping test less than 10% different from the uninjured leg should be the standard.

Side Differences Regarding the Limb Symmetry Index in Healthy Professional Athletes

2020 ◽  
Author(s):  
Christophe Lambert ◽  
Thomas Pfeiffer ◽  
Maxime Lambert ◽  
Benedikt Brozat ◽  
Daniel Lachmann ◽  
...  
Keyword(s):  
Return To Sport ◽  
Professional Athletes ◽  
P Value ◽  
Return To Sports ◽  
Rehabilitation Process ◽  
Symmetry Index ◽  
Limb Symmetry Index ◽  
Hop Tests ◽  
Chi Squared ◽  
Hop Test

AbstractSide differences in the limb symmetry index during hop tests have been rarely investigated in uninjured athletes. Unknown differences can result in false interpretation of hop tests and affect return to sport decision. Hypothesis was that un-injured athletes in Judo and Taekwondo have side differences in hop test and that asymmetries can be predicted based on the athletes fighting display. Differences, risk relationships were analyzed using the chi-squared test and the odds ratio. A two-tailed p value of<0.05 was considered statistically significant. 115 athletes from the national teams were included (mean age 18.4 years; range 13–27 years). 93, 97.4 and 98.3% did not have symmetric hop distance for three hop tests. Up to a quarter did not reach a limb symmetry index of>90. Moreover, 57.4% (n=66) reached longer jumping distance with the standing leg. Ignoring such pre-existent side differences in evaluation of hop tests and not knowing which limb was dominant prior the injury, can lead to premature or delayed return to sports in the rehabilitation process. Therefore, it might be helpful to refer to individual jump lengths for each limb in case of injury by using hop tests in pre-season screening in professional athletes in Judo and Taekwondo.

scholarly journals Clinical Outcome and Return to Competition after Microfracture in the Athlete’s Knee

Cartilage ◽  
2010 ◽  
Vol 1 (2) ◽  
pp. 113-120 ◽  
Author(s):  
Kai Mithoefer ◽  
Thomas J. Gill ◽  
Brian J. Cole ◽  
Riley J. Williams ◽  
Bert R. Mandelbaum
Keyword(s):  
Functional Outcome ◽  
Cartilage Repair ◽  
Return To Sport ◽  
Sports Participation ◽  
Return To Sports ◽  
Sports Activity ◽  
Systematic Analysis ◽  
Duration Of Symptoms ◽  
Athletic Competition ◽  
Return To Competition

Microfracture is frequently used for articular cartilage repair in athletes. This study aimed to define the strength and weaknesses of this minimally invasive cartilage repair technique in the athletic population in an effort to optimize indications, functional outcome, and athletic participation after microfracture in the athlete’s knee. A systematic analysis of original studies using microfracture in athletes was performed. Functional outcome was assessed by activity outcome scores, ability to return to sports participation, timing of the return to sport, level of postoperative sports activity, and continuation of athletic competition over time. Thirteen studies describing 821 athletes were included in the analysis with an average follow-up of 42 months. Good or excellent results were reported in 67% of athletes with normal International Knee Documentation Committee (IKDC) scores in 80% and significant increase of Lysholm scores, Tegner activity scores, and Knee injury and Osteoarthritis Outcome Score (KOOS) sports subscales. Return to sports was achieved in 66% at an average of 8 months after surgery, with return to competition at the preinjury level in 67%. Forty-nine percent of athletes continued to compete without change in level of play, while decreasing function was observed in 42% after 2 to 5 years. Athlete’s age, preoperative duration of symptoms, level of play, lesion size, and repair tissue morphology affected sports activity after microfracture. Microfracture improves knee function and frequently allows for return to sports at the preinjury level, but deterioration of athletic function occurs in some patients. Several independent factors were identified that can help to optimize the return to athletic competition after microfracture in the athlete’s knee.

scholarly journals Arthroscopic Hip Surgery in the Elite Athlete: Comparison of Female and Male Elite Athletes

2017 ◽  
Vol 5 (3_suppl3) ◽  
pp. 2325967117S0010
Author(s):  
Kotaro Shibata ◽  
Marc R. Safran
Keyword(s):  
Hip Arthroscopy ◽  
Elite Athletes ◽  
Hip Surgery ◽  
Return To Sports ◽  
Competitive Sports ◽  
Sports Activity ◽  
Competitive Activity ◽  
Sports Activities ◽  
Athlete Group

Objectives: 1) To compare ability to return to prior competitive sports activity after arthroscopic hip surgery by gender, with an emphasis on the rate of return to the same level of competition. 2) To compare gender differences in type of sports activities, diagnosis and treatment in athletes requiring hip arthroscopy. Methods: Prospectively obtained data on all high-level elite athletes (professional, NCAA collegiate and/or Olympic) treated between 2007 and 2014 were retrospectively reviewed. The clinical and surgical records of 547 hips in 484 consecutive patients who underwent primary hip arthroscopy by the senior author for non-arthritic hip pain during the study period were included. Elite athletes who had a Hip Sports Activity Score (HSAS) of over 6 were identified. Patients completed a pre-operative questionnaire that included medical and sports activity history and level of competition, hip-specific outcome scores (Modified Harris Hip Score [MHHS] and International Hip Outcome Tool-33 [iHOT-33]) at baseline and most recent follow-up. Surgical findings and time to return to competitive sports activity were documented. Results: A total of 98 elite athletes with a mean follow up period of 18.8 months (±12.7) were identified. There were 49 females and 49 males. 27 athletes had bilateral hip arthroscopy, 5 of which had 1 operation elsewhere. All patients were available for follow up. Of the 80 patients desiring to return to their original competitive activity, 38 were female (42 hips) (Female Athlete group [FA]) and 42 were male (54 hips) (Male Athlete group [MA]) their mean ages were 21.5(±3.9) and 20.5(±1.9), duration of pain prior to surgery was 12.1 (±10.3) months and 15.1 (±1.9) months, respectively. 84.2% of FA and 83.3% of MA were able to return to the same level of competition at a mean of 8.3 (±3) and 8.8 (±2.9) months, respectively. Statistically significant improvements between pre- and post-operative mean MHHS and iHOT-33 scores were seen in both groups (p <.0001; p <.0001). FA had significantly higher proportions of hips that were diagnosed with Pincer type FAI (p =.0004), and Instability (p <.0001). Conversely, the MA had significantly higher proportions of hips that were diagnosed with Combined type FAI (p <.0001), had more extensive acetabular cartilage rim damage (p =.0002), and in particularly had more hips that required microfracture treatment (p =.001). When comparing cam lesions (includes Cam and Combined type FAI) the alpha angle was statistically greater in MA (mean 74°±6.7) compared to FA (mean 65.4°±6.8) (p <.0001). The category of sports the FA participated in were more flexibility (11%) and endurance (24%) type sports. MA participated more in cutting (33%), contact (14%) and asymmetric (31%) type sports. Patients who were able to return to same level of competitive activity had a significantly shorter duration of pre-operation symptoms compared to those who could not (p < 0.05). Microfracture treatment did not affect the ability to return to sports. Conclusion: A similar high percentage of both female and male elite athletes were able to return to competitive sports activity after arthroscopic treatment of FAI and/or hip instability. Distinct differences in diagnosis, treatment and participating type of sports activities were seen when comparing female and male athletes. Duration of symptoms negatively correlated with outcomes. Extensive cartilage damage and Microfracture did not affect outcome / return to sports.

scholarly journals Tibial Accelerations During the Single-Leg Hop Test: Influence of Fixation

2020 ◽  
pp. 1-4
Author(s):  
Hannah W. Tucker ◽  
Emily R. Tobin ◽  
Matthew F. Moran
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Repeated Measures ◽  
Inertial Measurement Unit ◽  
Intraclass Correlation ◽  
Return To Sport ◽  
Fixation Method ◽  
Measurement Unit ◽  
Inertial Measurement ◽  
Hop Test

Context: Performance on single-leg hopping (SLH) assessments is commonly included within return-to-sport criteria for rehabilitating athletes. Triaxial accelerometers have been used to quantify impact loading in a variety of movements, including hopping; however, they have never been attached to the tibia during SLH, and their method of fixation has not been investigated. Objective: The purpose of this study was to quantify triaxial accelerations and evaluate the influence of the fixation method of a lightweight inertial measurement unit (Blue Trident) mounted to the tibia during SLH performance. Design: Single cohort, repeated-measures experimental design. Participants: Sixteen healthy participants (10 females and 6 males; 20 [0.9] y; 1.67 [0.08] m; 66.0 [8.5] kg) met the inclusion criteria, volunteered, and completed this study. Interventions: Participants performed 2 sets of 3 SLH trials with an inertial measurement unit (1500 Hz) fixated to the tibia, each set with 1 of 2 attachment methods (double-sided tape [DST] with athletic tape and silicon strap [SS] with Velcro adhesion). Main Outcome Measures: Hop distance, peak tibial acceleration (PTA), time to PTA, and the acceleration slope were assessed during each hop landing. Results: Repeated-measures analysis of variance determined no significant effect of the attachment method on hop metrics (P = .252). Across 3 trials, both fixation methods (DST and SS) had excellent reliability values (intraclass correlation coefficient: .868–.941) for PTA and acceleration slope but not for time to PTA (intraclass correlation coefficient: .397–.768). The PTA for DST (27.22 [7.94] g) and SS (26.21 [10.48] g) was comparable and had a moderate, positive relationship (DST: r = .72, P < .01; SS: r = .77, P < .01) to SLH distance. Conclusions: Tibial inertial measurement units with triaxial accelerometers can reliably assess PTA during performance of the SLH, and SS is a viable alternative tibial attachment to DST.

scholarly journals Investigation of Cardiovascular Endurance Levels of Sedentary High School Students

2018 ◽  
Vol 6 (5) ◽  
pp. 144
Author(s):  
Betül Akyol ◽  
Kayhan Söğüt
Keyword(s):  
High School ◽  
Heart Rate ◽  
High School Students ◽  
Oxygen Saturation ◽  
Recovery Period ◽  
Step Test ◽  
School Students ◽  
Walking Test ◽  
Cardiovascular Endurance ◽  
Significant Difference

The aim of our study is to examine the cardiovascular endurance systems of sedentary high school students. The 112 sedentary individual was taken to the 1600 meter walking test run, and the 120 sedentary individual Harward step test. While both individuals were participating in the same test, weight, height, oxygen saturation, and heart rate of participants were measured before starting the test. As soon as the test is finished (recovery period), oxygen saturation and heart rate variability of individuals are measured at 1, 3, 5 minutes. All measured variables were analyzed and compared. Analysis of the data was done according to the SPSS statistical program and the significance level was accepted as p <0.05. In the 1600-meter walking test, it was observed that there was a significant difference in mean heart rate between males and females p<0.05. There was a significant difference between the mean values of the time of completion of the 1600 m running test by males and females (p < 0.05). During the 1600-meter walking and Harward step test recovery period, there was no difference in the participants' parameters. There was no significant difference between oxygen saturations at beginning, recovery 1st, 3rd, and 5th minutes in both tests. Significant differences were found between heart rate and oxygen saturation values (beginning, recovery 1st, 3rd, and 5th minutes) in the intra-group comparisons of both groups. Participants' heart rates began to increase with exercise, but remained above the initial heart rate level during recovery. Participants' body mass indexes were observed to be within normal values. We think that can be increased cardio respiratory and cardiovascular fitness levels and can been created lifelong exercise habits by regular exercise programs are given to Sedentary high school students. Thus, we believe that the young population can be prevented from getting sick by providing healthier, social, active individuals.

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