Embed Size (px)
Citation preview
STRENGTH AS A RISK FACTOR FOR HAMSTRING STRAIN INJURY -Is it still a piece of the puzzle?
Nicol van DykRehabilitation Department
Contributing Authors
– Rod Whiteley
– Cristiano Eirale
– Bhavesh Kumar
– Bruce Hamilton
– Hans Tol
– Roald Bahr
– Erik Witvrouw
• Hamstring Strain Injuries (HSI) remain the most common muscle injury in football(Hagglund et al 2013, Ekstrand et al 2011, Eirale et al 2013)
Introduction
• Incidence 12-15% (Opar et al 2012)
• 37% of all muscle injuries (Ekstrand et al 2011)
Introduction
Introduction
Fatigue
Core Stability
Neuromuscular Control
FlexibilityStrength
Multifactorial Nature of HSI (Mendiguchia et al 2012)
Psychological Factors
Architecture
Introduction
Aim
Can Strength be identified as a risk factor for Hamstring
Injury?
All Teams in Qatar Stars
League (n=14 teams)
2010-2014
No isokinetic tests performed
(n=52 subjects)
Isokinetic Tests during Periodic Health Evaluation
(n=617 subjects) mean follow up of 2.24 years
Q Con 60°/s(n= 556)
H Con 60°/s(n= 555)
Q Con 300°/s(n= 556)
H Con 300°/s(n=556)
H Ecc 60°/s(n=562)
Materials & Methods
1050Isokinetic
Tests performed
Total Injuries 1871st time injuries
131
617 subjects
187 injuries
• Clustered Logistic Regression Analysis with repeated measures
Confounding Variables
Strength Variables
Statistical Analysis
Season
Q Con 60 BW H Ecc 60
BW
H Con 60 BW
Q Con 300 BW
Q Con 60/H Con 60
Q Con 300/ H Con 300
H Con 60/ H Ecc 60
Q Con 300/ H Ecc 60
H Con 300 BW
PositionPrevious
HSI
Results
Age 24.7 ± 4.7
Height 176.5cm ± 6.7
Weight 71.8 ± 9.1
Odds Ratio p-value 95% CI
Q Con 60 0.99 0.06 0.99 - 1.00
H Con 60 0.99 0.17 0.99 - 1.00
Q Con 300 0.99 0.97 0.99 - 1.00
H Con 300 0.99 0.20 0.99 - 1.00
H Ecc 60 0.99 0.12 0.99 - 1.00
Q Con 60 BW 0.71 0.03* 0.52 - 0.97
H Con 60 BW 0.75 0.29 0.43 -1.29
Q Con 300BW 1.10 0.87 0.56 - 1.89
H Con 300 BW 0.75 0.29 0.43 - 1.29
H Ecc 60 BW 0.73 0.04* 0.54 - 0.99
Q Con 60/ H Con 60 0.76 0.32 0.44 - 1.32
H Con 60/ H Ecc 60 1.08 0.90 0.34 - 3.40
Q Con 300/ H Con 300 1.46 0.26 0.76 - 2.79
Q Con 300/ H Ecc 60 1.46 0.35 0.66 - 3.25
Q Con 60 BW 0.71 0.03* 0.52 - 0.97
H Ecc 60 BW 0.73 0.04* 0.54 - 0.99
Results
Limitations
Population SpecificNo player exposure
Discussion
Hamstrings Eccentric
Quadriceps Concentric
are risk factorsfor HAMSTRING STRAIN INJURIES
Discussion
Q Con 60 234H Ecc 60 186
15%
Q Con 60 227
H Ecc 60 186
41%
Q Con 60 234H Ecc 60 179
36%
P(x)=1
1+𝑒_𝑧Probability of developing HSI
Q Con 60 227H Ecc 60 179
51%
Take Home Message
www.uwrf.edu
Quadriceps Concentric
StrengthCan Strength be identified as a risk factor for
HSI? Hamstrings Eccentric
Thank you
