نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

2 استاد گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

3 دانشیار گروه آسیب شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه اصفهان، اصفهان، ایران

چکیده

ناپایداری مزمن مچ پا منجر به افزایش عدم­تقارن در اندام تحتانی می­شود. با­ این ­حال عدم­تقارن قدرت و سرعت تغییر مسیر بازیکنان فوتبال دارای ناپایداری مزمن مچ پا مورد تجزیه‌وتحلیل قرار نگرفته است. هدف مطالعه حاضر ارزیابی عدم­تقارن قدرت عملکردی و سرعت تغییر مسیر بازیکنان فوتبال دارای ناپایداری مزمن مچ پا می­باشد. سی و دو بازیکن حرفه­ای مرد فوتبال دارای ناپایداری مزمن مچ پا در این مطالعه شرکت کردند. از آزمون­های هاپ یک­گانه-و-سه­گانه تکپا برای ارزیابی عدم­تقارن قدرت افقی و از آزمون­های چرخشo180و برشo90 برای ارزیابی عدم­تقارن سرعت تغییر مسیر پای آسیب­دیده-سالم و غالب-غیرغالب استفاده شد. نتایج نشان داد به ترتیب 25(78%) و 7(22%) بازیکن در پای غالب و غیرغالب به آسیب مبتلا بودند. بین عدم­تقارن هاپ یک­گانه و عملکرد چرخش °180 در پای غیرغالب (0.027P=؛0.392r=)، آسیب­دیده (0.019P=؛0.413r=)، و عدم­تقارن پای آسیب­دیده و سالم (0.009P=؛0.452-r=) ارتباط معناداری مشاهده شد. ارتباط معناداری نیز بین عدم­تقارن هاپ سه­گانه و عملکرد برش °90 در پای غالب (0.042P=؛0.362r=) و پای آسیب­دیده (0.036P=؛0.373r=) مشاهده شد. با این‌ حال، بین سایر متغیرها ارتباط معناداری مشاهده نشد (0.05 P>). توافقات کم برای تشخیص مشابه بین آزمون­های سرعت تغییر مسیر با هاپ (25- 63.%15) و بین آزمون­های سرعت تغییر مسیر (5.%12) نشان داده شد. با توجه ‌به اینکه پای غالب مسئول انجام مهارت­های فوتبال است، می­تواند توانایی بازیکنان فوتبال دارای ناپایداری مزمن مچ پا را حین فعالیت­های عملکردی فوتبال کاهش دهد؛ بنابراین با توجه ‌به ارتباط بین عدم­تقارن قدرت افقی و سرعت تغییر مسیر چندجهته، پیشنهاد می­شود در برنامه‌های آماده‌سازی و توانبخشی، تمریناتی با هدف کاهش عدم­تقارن قدرت افقی به‌منظور بهبود عملکرد سرعت تغییر مسیر طراحی شود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Assessing Functional Strength Asymmetry and Change of Direction Speed in Soccer Players with Chronic Ankle Instability

نویسندگان [English]

  • Mostafa Ziaei 1
  • Vahid Zolaktaf 2
  • Hamed Esmaeili 3

1 PhD student, Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran

2 Professor, Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran

3 Associate Professor, Department of Sport Injuries and Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran

چکیده [English]

Background and Purpose
Soccer, a high-intensity sport, involves unilateral actions such as jumping and change of direction speed (CODS) (1). These motor skills are interconnected and essential for achieving successful performance, impacting match outcomes (2). Strength (jumping) and CODS are crucial components of this sport, and the ambition of teams to achieve top rankings has escalated the likelihood of injuries (3). The most common soccer injury is a lateral ankle sprain, often caused by a combination of inversion and plantarflexion during functional movements of soccer like CODS and jumps (4). Chronic ankle instability (CAI) is a common outcome of these sprains, with approximately 32% to 74% of individuals experiencing ongoing problems despite common treatments (5). Research has shown that CAI can lead to increased asymmetry in the lower limbs, increasing the athlete's risk of injury. Therefore, this study aimed to assess functional strength asymmetry and CODS in soccer players with CAI.
 Materials and Methods
A cross-sectional design assessed inter-limb strength asymmetry and CODS in elite soccer players with CAI. Initially, a minimum sample size of 19 participants was calculated using G*Power software based on a squared multiple correlation of 0.36, power of 0.8, and significance level <0.05 (6). However, thirty-two male elite soccer players with unilateral CAI (age=21.78±3.18 years; height=177.28±6.87 cm; mass=68.39±8.82 kg) participated, meeting inclusion criteria based on International Ankle Consortium recommendations. Tests were conducted barefoot on an indoor track. Each athlete performed three trials for each limb in all CODS and strength tests, with the average of these trials used for analysis. The dominant limb was the preferred kicking limb. Horizontal strength asymmetry was evaluated using the Single-leg Hop (SLH) and Triple Hop (SLTH) tests, while CODS asymmetry was assessed through the 180° turn and 90°Cut tests for both injured/uninjured and dominant/non-dominant limbs (6). Inter-limb asymmetries were quantified using the formula: 100/uninjured (and D) limb × injured (and ND) limb × -1 + 100, as recommended for unilateral tests (1). Asymmetry thresholds were determined for strength tests using the formula (mean of asymmetry + (0.2 × SD)) and for CODS tests using the formula (mean of asymmetry - (0.2 × SD)). The similar identification of asymmetry was calculated as (frequency of similar identification / number of athletes) × 100, with agreements ≥80% considered good. Within-session reliability was calculated using intraclass correlation coefficients (ICC) and coefficient of variation (CV), with minimum acceptable reliability set at ICC > 0.7 and CV < 10 (6). Paired t-tests were used to compare differences between limbs, while effect sizes were calculated using Hedges' g method and interpreted based on the Hopkins scale. The relationship between inter-limb strength asymmetry and CODS performance was calculated using Pearson's correlation coefficient and interpreted according to the Hopkins scale.
 Findings
Acceptable reliability and levels of variation were observed for the injured and uninjured limbs in all variables. The mean and SD of CAIT scores for the injured and uninjured limbs were 17.47 ± 2.02 and 28.94 ± 1.08, respectively. Out of the total 32 players, 25 (78%) had CAI in their dominant limbs, while 7 (22%) experienced CAI in their non-dominant limbs. A significant difference was noted between the dominant and non-dominant limbs (p<0.05) as well as between the injured and uninjured limbs (p<0.05) in all tests. However, a more significant directional defect was observed between the injured and uninjured limbs (g SLH = 1.60, g SLTH = 1.10, g Mod505 = -1.97, g 90°Cut = -1.40) compared to the dominant and non-dominant limbs (g SLH = 0.59, g SLTH = 0.58, g Mod505 = -0.90, g 90°Cut = -0.74) (Table 1). A significant correlation was observed between inter-limb (injured/uninjured) asymmetry in the SLH test and Mod505 of the non-dominant limb (r=0.392), Mod505 of the injured limb (r=0.413), and inter-limb (injured/uninjured) asymmetry of Mod505 (r=-0.452). Additionally, a significant correlation was found between inter-limb (injured/uninjured) asymmetry in the SLTH test and 90°Cut of the dominant limb (r=0.362) and 90°Cut of the injured limb (r=0.373). Low levels of agreement were observed in the similar identification of inter-limb asymmetry between Hop and CODS tests (15.63–25%). Additionally, a weak level of agreement was observed in the similar identification of inter-limb asymmetry between Mod505 and 90°Cut (12.5%). The thresholds of asymmetry in Mod505 and 90°Cut were -11.90 and -10.23, respectively (Table 1), and 12 players showed asymmetry greater than these thresholds in both tests. In the SLH test, the asymmetry threshold was 9.68, and 15 players had asymmetry beyond this threshold, of which 8 players showed asymmetry in the Mod505 test and 5 players showed asymmetry in the 90°Cut test. In the SLTH test, the asymmetry threshold was 7.73, and 12 players had asymmetry beyond that, of which 5 players showed asymmetry in the Mod505 test and 5 players showed asymmetry in the 90°Cut test.
 Conclusion
Studies have indicated that turning, cutting, and jumping are common traumatic actions in CAI, leading to increased inter-limb asymmetry (1–4). However, functional strength asymmetry and CODS in elite soccer players with CAI have not been thoroughly analyzed. This study introduced specific asymmetry thresholds for horizontal functional strength and CODS in elite soccer players with CAI. Furthermore, the study highlighted that the dominant limb, crucial for performing soccer skills, sustains significantly more injuries. This can notably impair the performance of soccer players with CAI during functional soccer activities such as turning, cutting, and jumping. While correlations were observed between inter-limb strength asymmetry and CODS, there were low levels of agreement in similar identification of inter-limb asymmetry across tests. This discrepancy highlights that asymmetries are task-specific. Therefore, preparation and rehabilitation programs must include tests that assess these skills to avoid bias in result interpretation and identify deficits in movement patterns.
Article Message
This study can enhance understanding and awareness of inter-limb strength asymmetry and change of direction speed and their mutual effect on elite soccer players with CAI. The findings from this study can also prove effective in optimizing CAI preparation and rehabilitation programs.
 
 
 

کلیدواژه‌ها [English]

  • Soccer
  • Asymmetry
  • Functional Strength
  • Change of Direction Speed
  • Ankle
  1.  

    1. Junge A, Dvorak J. Soccer injuries: a review on incidence and prevention. Sports Med. 2004 Nov; 34:929-38.
    2. Owoeye OB, VanderWey MJ, Pike I. Reducing injuries in soccer (football): an umbrella review of best evidence across the epidemiological framework for prevention. Sports Med Int Open. 2020 Dec;6(1): e36-46.
    3. Ziaei M, Esmaeili H, Mirshkar M. Effect of Plyometric and Theraband Trainings on Ankle Proprioception and Strength in Adolescent Soccer Players. J Paramed Sci Rehabil. 2020 Jul 22;9(2):16-29.
    4. Hawkins RD, Hulse MA, Wilkinson C, Hodson A, Gibson M. The association football medical research programme: an audit of injuries in professional football. Br J Sports Med. 2001 Feb 1;35(1):43-7.
    5. Hootman JM, Dick R, Agel J. Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives. J Athl Train. 2007 Apr;42(2):311-9.
    6. Dos’Santos T, Thomas C, Jones PA, Comfort P. Asymmetries in single and triple hop are not detrimental to change of direction speed. J Trainol. 2017 Jun 17;6(2):35-41.
    7. Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med. 1977 Nov;5(6):241-2.
    8. Khalaj N, Vicenzino B, Smith MD. Hip and knee muscle torque and its relationship with dynamic balance in chronic ankle instability, copers and controls. J Sci Med Sport. 2021 Jul 1;24(7):647-52.
    9. Park YH, Park SH, Kim SH, Choi GW, Kim HJ. Relationship between isokinetic muscle strength and functional tests in chronic ankle instability. J Foot Ankle Surg. 2019 Nov 1;58(6):1187-91.
    10. Bishop C, Turner A, Read P. Effects of inter-limb asymmetries on physical and sports performance: A systematic review. J Sports Sci. 2018 May 19;36(10):1135-44.
    11. Guan Y, Bredin SS, Taunton J, Jiang Q, Wu N, Warburton DE. Association between inter-limb asymmetries in lower-limb functional performance and sport injury: a systematic review of prospective cohort studies. J Clin Med. 2022 Jan 12;11(2):360.
    12. Helme M, Tee J, Emmonds S, Low C. Does lower-limb asymmetry increase injury risk in sport? A systematic review. J Orthop Sports Phys Ther. 2021 May 1;51(5):204-13.
    13. Brughelli M, Cronin J, Levin G, Chaouachi A. Understanding change of direction ability in sport: a review of resistance training studies. Sports Med. 2008 Dec;38(12):1045-63.
    14. Demeritt KM, Shultz SJ, Docherty CL, Gansneder BM, Perrin DH. Chronic ankle instability does not affect lower extremity functional performance. J Athl Train. 2002 Oct;37(4):507-11.
    15. Jamsandekar MS, Patel VD, Prabhakar AJ, Eapen C, Keogh JW. Ability of functional performance assessments to discriminate athletes with and without chronic ankle instability: a case-control study. PeerJ. 2022 May 27;10:e13390.
    16. Maloney SJ, Richards J, Nixon DG, Harvey LJ, Fletcher IM. Do stiffness and asymmetries predict change of direction performance?. J Sports Sci. 2017 Mar 19;35(6):547-56.
    17. Young WB, James R, Montgomery I. Is muscle power related to running speed with changes of direction?. J Sports Med Phys Fitness. 2002 Sep 1;42(3):282-8.
    18. Lockie RG, Schultz AB, Jeffriess MD, Callaghan SJ. The relationship between bilateral differences of knee flexor and extensor isokinetic strength and multi-directional speed. Isokinet Exerc Sci. 2012 Jan 1;20(3):211-9.
    19. Hoffman JR, Ratamess NA, Klatt M, Faigenbaum AD, Kang J. Do bilateral power deficits influence direction-specific movement patterns?. Res Sports Med. 2007 Jun 14;15(2):125-32.
    20. Lockie RG, Callaghan SJ, Berry SP, Cooke ER, Jordan CA, Luczo TM, Jeffriess MD. Relationship between unilateral jumping ability and asymmetry on multidirectional speed in team-sport athletes. J Strength Cond Res. 2014 Dec 1;28(12):3557-66.
    21. Gribble PA, Delahunt E, Bleakley C, Caulfield B, Docherty C, Fourchet F, Fong D, et al. Selection criteria for patients with chronic ankle instability in controlled research: a position statement of the International Ankle Consortium. J Orthop Sports Phys Ther. 2013 Aug;43(8):585-91.
    22. Madruga-Parera M, Bishop C, Beato M, Fort-Vanmeerhaeghe A, Gonzalo-Skok O, Romero-Rodríguez D. Relationship between interlimb asymmetries and speed and change of direction speed in youth handball players. J Strength Cond Res. 2021 Dec 29;35(12):3482-90.
    23. Yeung MS, Chan KM, So CH, Yuan WY. An epidemiological survey on ankle sprain. Br J Sports Med. 1994 Jun;28(2):112-6.
    24. Sekir U, Yildiz Y, Hazneci B, Ors F, Aydin T. Effect of isokinetic training on strength, functionality and proprioception in athletes with functional ankle instability. Knee Surg Sports Traumatol Arthrosc. 2007 May;15(5):654-64.
    25. Sarvestan J, Alaei F, Kazemi NS, Khial HP, Shirzad E, Svoboda Z. Agility profile in collegiate athletes with chronic ankle sprain: the effect of Athletic and Kinesio taping among both genders. Sport Sci Health. 2018 Aug;14(1):407-14.
    26. Markovic G. Poor relationship between strength and power qualities and agility performance. J Sports Med Phys Fitness. 2007 Sep 1;47(3):276-83.
    27. Peterson MD, Alvar BA, Rhea MR. The contribution of maximal force production to explosive movement among young collegiate athletes. J Strength Cond Res. 2006 Nov 1;20(4):867-73.
    28. Negrete R, Brophy J. The relationship between isokinetic open and closed chain lower extremity strength and functional performance. J Sport Rehabil. 2000 Feb 1;9(1):46-61.
    29. Loturco I, Pereira LA, Abad CC, D'Angelo RA, Fernandes V, Kitamura K, et al. Vertical and horizontal jump tests are strongly associated with competitive performance in 100-m dash events. J Strength Cond Res. 2015 Jul 1;29(7):1966-71.
    30. Nobari H, Clemente FM, Vali N, Silva AF, van den Hoek D, Ramirez-Campillo R. Effects of horizontal compared to vertical-based plyometric jump training on semi-professional soccer player's performance. Sci Rep. 2023 Jun 20;13(1):10039.