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      KNEE ISOKINETIC TORQUE IMBALANCE IN FEMALE FUTSAL PLAYERS Translated title: DESEQUILIBRIO DEL TORQUE ISOCINÉTICO DE LA RODILLA EN JUGADORAS DE FUTSAL FEMENINO Translated title: DESEQUILÍBRIO DO TORQUE ISOCINÉTICO DO JOELHO EM JOGADORAS DE FUTSAL FEMININO

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          Abstract

          ABSTRACT Introduction: The specificity of sports training can lead to muscle specialization with a possible change in the natural hamstring/quadriceps torque ratio (HQ ratio), constituting a risk factor for muscle injury at the joint angles in which muscle imbalance may impair dynamic stability. Objective: The aim was to evaluate the torque distribution of the hamstrings and quadriceps and the HQ ratio throughout the range of motion in order to identify possible muscle imbalances at the knee of female futsal athletes. Methods: Nineteen amateur female futsal athletes had their dominant limb HQ ratio evaluated in a series of five maximum repetitions of flexion/extension of the knee at 180°/second in the total joint range of motion (30° to 80°). The peak flexor and extensor torque and the HQ ratio (%) were compared each 5° of knee motion using one-way repeated measures ANOVA and Tukey’s post hoc test (p<0.05) to determine the joint angles that present muscular imbalance. Results: Quadriceps torque was higher than 50° to 60° of knee flexion, while hamstrings torque was higher than 55° to 65°. The HQ ratio presented lower values than 30° to 45° of knee flexion and four athletes presented values lower than 60%, which may represent a risk of injury. However, the HQ ratio calculated by the peak torque showed only one athlete with less than 60%. Conclusion: The HQ ratio analyzed throughout the knee range of motion allowed identifying muscle imbalance at specific joint angles in female futsal players.

          Translated abstract

          RESUMEN Introducción: La especificidad del entrenamiento deportivo puede llevar a la especialización muscular, con posible cambio de la razón de torque entre isquiotibiales/cuádriceps (razón IC) natural, constituyendo un factor de riesgo de lesión muscular en los ángulos de las articulaciones, en el que el desequilibrio muscular puede perjudicar la estabilidad dinámica. Objetivo ; El objetivo fue evaluar la distribución del torque de los músculos isquiotibiales y cuádriceps y la razón IC a lo largo de todo el rango de movimiento para identificar posibles desequilibrios musculares en la rodilla en atletas de futsal femenino. Métodos: Diecinueve atletas amateurs de futsal femenino tuvieron la razón IC de la extremidad dominante evaluada en una serie de cinco repeticiones máximas de flexión/extensión de la rodilla a 180°/segundo en el rango de movimiento total (30° a 80°). El pico de torque flexor y extensor y la razón IC (%) fueron comparados a cada 5° de movimiento de la rodilla por el ANOVA one-way de medidas repetidas y de la prueba post hoc de Tukey (p < 0,05) para determinar los ángulos articulares que presentan desequilibrio muscular. Resultados: El torque del cuádriceps fue mayor que 50° a 60° de flexión de la rodilla, mientras que el torque de los isquiotibiales fue mayor que 55° a 65°. La razón IC presentó los valores más bajos que 30° a 45° de flexión de la rodilla y cuatro atletas presentaron valores inferiores al 60%, lo que puede representar riesgo de lesión. Sin embargo, la razón IC calculada por el pico de torque máximo, mostró sólo una atleta con menos del 60%. Conclusión . La razón IC analizada a lo largo de todo el rango de movimiento permitió identificar desequilibrio muscular en ángulos articulares específicos en atletas de futsal femenino.

          Translated abstract

          RESUMO Introdução: A especificidade do treinamento esportivo pode levar à especialização muscular, com possível alteração da razão do torque isquiotibiais/quadríceps (razão IQ) natural, constituindo um fator de risco de lesão muscular nos ângulos articulares em que o desequilíbrio muscular pode prejudicar a estabilidade dinâmica. Objetivo: O objetivo foi avaliar a distribuição do torque dos músculos isquiotibiais e quadríceps e da razão IQ ao longo de toda a amplitude de movimento, de modo a identificar possíveis desequilíbrios musculares no joelho de atletas de futsal feminino. Métodos: Dezenove atletas amadoras de futsal feminino tiveram a razão IQ do membro dominante avaliada em uma série de cinco repetições máximas de flexão/extensão do joelho a 180°/segundo na amplitude de movimento total (30° a 80°). O pico de torque flexor e extensor e a razão IQ (%) foram comparados a cada 5° de movimento do joelho pela one-way ANOVA de medidas repetidas e do teste post hoc de Tukey (p < 0,05) para determinar os ângulos articulares que apresentam desequilíbrio muscular. Resultados: O torque do quadríceps foi maior que 50° a 60° de flexão do joelho, enquanto o torque dos isquiotibiais foi maior que 55° a 65°. A razão IQ apresentou menores valores que 30° a 45° de flexão do joelho e quatro atletas apresentaram valores abaixo de 60%, o que pode representar risco de lesão. No entanto, a razão IQ calculada pelo pico de torque mostrou apenas uma atleta com menos de 60%. Conclusão: A razão IQ analisada ao longo de toda a amplitude de movimento permitiu identificar desequilíbrio muscular em ângulos articulares específicos em atletas de futsal feminino.

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          Most cited references27

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          Non-contact ACL injuries in female athletes: an International Olympic Committee current concepts statement.

          The incidence of anterior cruciate ligament (ACL) injury remains high in young athletes. Because female athletes have a much higher incidence of ACL injuries in sports such as basketball and team handball than male athletes, the IOC Medical Commission invited a multidisciplinary group of ACL expert clinicians and scientists to (1) review current evidence including data from the new Scandinavian ACL registries; (2) critically evaluate high-quality studies of injury mechanics; (3) consider the key elements of successful prevention programmes; (4) summarise clinical management including surgery and conservative management; and (5) identify areas for further research. Risk factors for female athletes suffering ACL injury include: (1) being in the preovulatory phase of the menstrual cycle compared with the postovulatory phase; (2) having decreased intercondylar notch width on plain radiography; and (3) developing increased knee abduction moment (a valgus intersegmental torque) during impact on landing. Well-designed injury prevention programmes reduce the risk of ACL for athletes, particularly women. These programmes attempt to alter dynamic loading of the tibiofemoral joint through neuromuscular and proprioceptive training. They emphasise proper landing and cutting techniques. This includes landing softly on the forefoot and rolling back to the rearfoot, engaging knee and hip flexion and, where possible, landing on two feet. Players are trained to avoid excessive dynamic valgus of the knee and to focus on the "knee over toe position" when cutting.
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            Predicting hamstring strain injury in elite athletes.

            Eccentric exercise, where the contracting muscle is lengthened, produces microscopic damage in muscle fibers, and sensations of stiffness and soreness, the next day. These normally resolve within a week. A more major sports injury is the muscle strain. Because strain injuries are known to occur during eccentric contractions, it is hypothesized that the microscopic damage from eccentric exercise can, at times, progress to a muscle strain. As the amount of microscopic damage depends on the muscle's optimum length for active tension, it is further proposed that optimum length is a measure of susceptibility for muscle strains. The athletes most at risk of a hamstring strain are those with a previous history of such injuries. Here the prediction is tested that optimum lengths of previously injured hamstrings are shorter and therefore more prone to eccentric damage than uninjured muscles. Mean optimum angle for peak torque in a previously injured muscle of nine athletes with a history of unilateral hamstring strains was compared with the uninjured muscle of the other leg and with muscles of 18 uninjured athletes. Optimum angle was determined with isokinetic dynamometry. In previously injured muscles, torque peaked at significantly shorter lengths than for uninjured muscles. Peak torque and quadriceps:hamstrings torque ratios were not significantly different. The shorter optimum of previously injured muscles makes them more prone to damage from eccentric exercise than uninjured muscles and this may account for the high reinjury rate. The shorter optimum may reflect the muscle's preinjury state or be a consequence of the healing process. To reduce the incidence of strain injuries, it is recommended that a combined program of eccentric exercise and muscle testing be carried out.
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              Hamstrings to quadriceps peak torque ratios diverge between sexes with increasing isokinetic angular velocity.

              Our purpose was to determine if females demonstrate decreased hamstrings to quadriceps peak torque (H/Q) ratios compared to males and if H/Q ratios increase with increased isokinetic velocity in both sexes. Maturation disproportionately increases hamstrings peak torque at high velocity in males, but not females. Therefore, we hypothesised that mature females would demonstrate decreased H/Q ratios compared to males and the difference in H/Q ratio between sexes would increase as isokinetic velocity increased. Studies that analysed the H/Q ratio with gravity corrected isokinetic strength testing reported between 1967 and 2004 were included in our review and analysis. Keywords were hamstrings/quadriceps, isokinetics, peak torque and gravity corrected. Medline and Smart databases were searched combined with cross-checked bibliographic reference lists of the publications to determine studies to be included. Twenty-two studies were included with a total of 1568 subjects (1145 male, 423 female). Males demonstrated a significant correlation between H/Q ratio and isokinetic velocity (R=0.634, p<0.0001), and a significant difference in the isokinetic H/Q ratio at the lowest angular velocity (47.8+/-2.2% at 30 degrees /s) compared to the highest velocity (81.4+/-1.1% at 360 degrees /s, p<0.001). In contrast, females did not demonstrate a significant relationship between H/Q ratio and isokinetic velocity (R=0.065, p=0.77) or a change in relative hamstrings strength as the speed increased (49.5+/-8.8% at 30 degrees /s; 51.0+/-5.7% at 360 degrees /s, p=0.84). Gender differences in isokinetic H/Q ratios were not observed at slower angular velocities. However, at high knee flexion/extension angular velocities, approaching those that occur during sports activities, significant gender differences were observed in the H/Q ratio. Females, unlike males, do not increase hamstrings to quadriceps torque ratios at velocities that approach those of functional activities.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbme
                Revista Brasileira de Medicina do Esporte
                Rev Bras Med Esporte
                Sociedade Brasileira de Medicina do Exercício e do Esporte (São Paulo, SP, Brazil )
                1517-8692
                1806-9940
                September 2017
                : 23
                : 5
                : 352-356
                Affiliations
                [1] Campinas São Paulo orgnameUniversidade Estadual de Campinas orgdiv1Escola de Educação Física orgdiv2Laboratório de Instrumentação para Biomecânica Brazil
                [2] Porto Alegre Rio Grande do Sul orgnameUniversidade Federal do Rio Grande do Sul orgdiv1Escola de Educação Física, Fisioterapia e Dança Brazil
                Article
                S1517-86922017000500352
                10.1590/1517-869220172305170768
                0af73cd5-2338-4a3b-a292-7ffce57f3aa3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 29 March 2017
                : 24 October 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 5
                Product

                SciELO Brazil


                músculo esquelético/fisiopatologia.,articulação do joelho,futebol,torque,muscle, skeletal/physiopathology.,knee joint,soccer,músculo esquelético/fisiopatología.,articulación de la rodilla,fútbol

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