Document Type : Research Paper
Authors
Abstract
The knee positions could be parameters for injury of handball players in landing. Preventive exercise programs may decrease the injury of players. The aim of this study was to investigate the effect of a Neuromuscular Exercise Program on lower limb kinematics and single leg stability in male handball players. 40 handball players (Regular Training: n=20, height 187.7±5.5 cm; weight 89.0±10.1 kg; age 25.4±13.6 years; handball experience 11.6±6.4 years and neuromuscular training: n=20, height 185.3 ±6.4 cm; weight 86.8±13.6 kg; age 24.2±3.8 years; handball experience 10.8±3.3 years) were selected from two clubs participating in Iran Super League on 2012-2013. There were significant differences between the two groups in inward rotation of femur, knee valgus angles and single leg stability. No significant difference was found in knee flexion angle. Neuromuscular training can improve overall performance and reduce lower extremity valgus angle and internal rotation of the knee during landing with one leg. It may help handball players to prevent knee ligaments injuries, especially ACL, during competition season.
Keywords
1. Barendrecht, M. Lezeman, H. C. A. Duysens, J. Smits-Engelsman, B, C, M. (2011). Neuromuscular training improves knee kinematics, in particular in valgus aligned adolescent team handball players of both sexes. J Strength Cond Res. 25(3):575-584.
2. Bell, D. R. Oates, D. C. Clark, M. A. Padua, D. A. (2013). Two and 3-dimensional knee valgus are reduced after an exercise intervention in young adults with demonstrable valgus during squatting. J Athl Training. 48(3):442-449.
3. Boden B P, Torg J S, Knowles S B. 2009. Video analysis of anterior cruciate ligament injury: Abnormalities in hip and ankle kinematics. Am J Sports Med. 37:252–259.
4. Decker, M. J. Torry, M. R. Wyland, D. J. Sterett, W. I. Steadman, J. R. 2003. Gender differences in lower extremity kinematics, kinetics and energy absorption during landing. Clin Biomech (Bristol, Avon). 18(7):662–669.
5. DeMorat, G. Weinhold, P. Blackburn, T. (2004). Aggressive quadriceps loading can induce noncontact anterior cruciate ligament injury. Am J Sports Med. 32:477–483.
6. Dennis, J. C. Harmer, P. Schiff, M. (2010). Epidemiology of injury in Olympic Sports. An IOC Medical Commission Publication by Blackwell Publishing Ltd, City of Hoboken, the state of New Jersey.
7. DiStefano, L. J. Padua, D. A. DiStefano, M. J. Marshall, S. W. (2009). Influence of age, sex, technique, and exercise program on movement patterns after an anterior cruciate ligament injury prevention program in youth soccer players. Am J Sports Med. 37:495–505.
8. Emery, C. A. Cassidy, J. D. Klassen, T. P. Rosychuk, R. J. Rowe, B. H. (2005). Effectiveness of a home-based balance-training program in reducing sports-related injuries among healthy adolescents: A cluster randomized controlled trial. CMAJ. 172:749–754.
9. Ford, K. R. Myer, G. D. Hewett, T. E. (2003). Valgus knee motion during landing in high school female and male basketball players. Med Sci Sport Exer. 35(10):1745-1750.
10. Ford, K. R. Myer, G. D. Toms, H. E. Hewett, T. E. (2005). Gender differences in the kinematics of unanticipated cutting in young athletes. Med Sci Sports Exer. 37(1):124-129.
11. Grandstrand, S. L. Pfeifer, R. P. Sabick, M. B. DeBelisio, M. Shea, K. G. (2006). The effects of a commercially available warm-up program on landing mechanics in female youth soccer players. J Strength Cond Res. 20:331–335.
12. Griffin, L. Y. Albohm, M. J. Arendt, E. A. Bahr, R. Beynnon, B. D. (2006). Understanding and preventing noncontact anterior cruciate ligament injuries: A review of the Hunt Valley II meeting, January 2005. Am J Sports Med. 34:1512–1532.
13. Herrington, L. (2011). Knee valgus angle during landing tasks in female volleyball and basketball players. J Strength Cond Res. 25(1):262-266.
14. Hewett, T. E. Myer, G. D. Ford, K. R. (2005). Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: A prospective study. Am J Sports Med. 33:492–501.
15. Holm, I. Fosdahl, M. A. Friis, A. Risberg, M. A. Myklebust, G. Steen, H. (2004). Effect of neuromuscular training on proprioception, balance, muscle strength, and lower limb function in female team handball players. Clin J Sport Med. 14:88–94.
16. Hrysomallis, C. (2007). Relationship between balance ability, training and Sports injury risk. Sports Med. 37(6):547–556.
17. Irmischer, B. S. Harris, C. Pfeiffer, R. P. DeBeliso, M. A. Adams, K. J. Shea, K. G. (2004). Effects of a knee ligament injury prevention exercise program on impact forces in women. J Strength Cond Res. 18:703–707.
18. Junge, A. Langevoort, G. Pipe, A. Peytavin, A. Wong, F. Mountjoy, M. et al. (2006). Injuries in team sport tournaments during the 2004 Olympic Games. Am J Sports Med. 34:565-576.
19. Kernozek, T. W. Torry, M. R. Hoof, H. Cowley, H. Tanner, S. (2005). Gender differences in frontal and sagittal plane biomechanics during drop landings. Med Sci Sports Exer. 37(6):1003-1012.
20. Krosshaug, T. Nakamae, A. Boden, B. P. (2007). Mechanisms of anterior cruciate ligament injury in basketball: Video analysis of 39 cases. Am J Sports Med. 35:359–367.
21. Lee, S. Y. Hertel, J. (2012). Arch height and maximum rearfoot eversion during jogging in 2 static neutral positions. J Athl Training. 47(1):83-90.
22. Mandelbaum, B. R. Silvers, H. J. Watanabe, D. S. Knarr, J. F. Thomas, S. D. Griffin LY, et al. (2005). Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes. 2-year follow-up. Am J Sports Med. 33:1003–1010.
23. Myer, G. D. Ford, K. R. Brent, J. L. Hewett, T. E. (2007). Differential neuromuscular training effects on ACL injury risk factors in "high-risk" versus "low-risk" athletes. BMC Musculoskelet Disord. 8:39-45.
24. Myer, G. D. Ford, K. R. Hewett, T. E. (2004). Rationale and clinical techniques for anterior cruciate ligament injury prevention among female athletes. J Athl Train. 39:352–364.
25. Myer, G. D. Ford, K. R. Palumbo, J. P. (2005). Neuromuscular training improves performance and lower-extremity biomechanics in female athletes. J Strength Cond Res. 19:51–60.
26. Myklebust, G. Engebretsen, L. Braekken, I. H. Skjolberg, A. Olsen, O. E. Bahr, R. (2003). Prevention of anterior cruciate ligament injuries in female team handball players: A prospective intervention study over three seasons. Clin J Sport Med. 13:71–78.
27. Nakao, S. Komatsu, K. Sakai, W. Kashihara, M. Masuda, Y. Nishikawa, K. et al. (2011). Gait and posture assessments of a patient treated with deep brain stimulation in dystonia using three-dimensional motion analysis systems. The Journal of Medical Investigation. 58:264-272.
28. Noyes, F. R. Barber, S. D. Mangine, R. E. (1991). Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. Am J Sports Med. 19:513–518.
29. Noyes, F. R. Barber-Westin, S. D. Fleckenstein, C. Walsh, C. West, J. (2005). The drop jump screening test, difference in lower limb control by gender and effect of neuromuscular training in female athletes. Is J Sports Med. 33:378–387
30. Olsen, O. E. Myklebust, G. Engebretsen, L. Bahr, R. (2006). Injury pattern in youth team handball: A comparison of two prospective registration methods. Scand J Med Sci Sports. 16:426–432.
31. Olsen O E, Myklebust G, Engebretsen L, Holme I Bahr R. 2009. Exercises to prevent lower limb injuries in youth sports: Cluster randomised controlled trial. BMJ. 330:449.
32. Olsen, O. E. Myklebust, G. Engebretsen, L. (2004). Injury mechanisms for anterior cruciate ligament injuries in team handball: a systematic video analysis. Am J Sports Med. 32:1002–1012.
33. Olson, T. J. Chebny, C. Willson, J. D. Kernozek, T. W. Straker, J. S. (2011). Comparison of 2D and 3D kinematic changes during a single leg step down following neuromuscular training. Phys Ther Sport. 12(2):93-99.
34. Pánics, G. Tállay, A. Pavlik, A. Berkes, I. (2008). Effect of proprioception training on knee joint position sense in female team handball players. Br J Sports Med. 42(6):472–476.
35. Prentice, W. E. (2004). Rehabilitation techniques f or sports medicine and athletic training. 4th ed. Published by McGraw-Hill in Canada.
36. Winter, D. (2009). The biomechanics and motor control of human gait. 4th ed. Canada: Waterloo: University of Waterloo Press.
37. Yu, B. Garrett, W. E. (2007). Mechanisms of non-contact ACL injuries. Br J Sports Med. 41(1): 47–51.
)