Aerobic fitness in professional soccer players after anterior cruciate ligament reconstruction

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Abstract

Although anterior cruciate ligament (ACL) reconstruction is considered a successful procedure in restoring knee stability, few studies have addressed the issue of aerobic capacity after ACL surgery. Soccer players need technical, tactical and physical skills to succeed, such as good knee function and aerobic capacity. Our purpose is to evaluate aerobic fitness in ACL injured professional football players and six months after ACL reconstruction compared to a control group. Twenty athletes with ACL injury were evaluated and underwent ACL reconstruction with hamstrings autograft, and were compared to twenty healthy professional soccer players. The methods used to evaluate aerobic fitness were maximum oxygen uptake (VO _2max) and ventilatory thresholds with a treadmill protocol, before and six months after surgery, compared to a control group. Knee function questionnaires, isokinetic strength testing and body composition evaluation were also performed. Results: Median ACL-injured patients age was 21 years old, and controls 20.5 years old. (n.s.). Preoperative VO _2max in the ACL injured group was 45.2 ± 4.3 mL/kg/min, postoperative 48.9 ± 3.8 mL/kg/min and controls 56.9 ± 4.2 mL/kg/min. (p< .001 in all comparisons). Body composition evaluation was similar in all situations. Knee function questionnaires and quadriceps peak torque deficit improved after surgery but were significantly lower compared to controls. Conclusion: Aerobic fitness is significantly reduced in professional soccer players with ACL injury, and six months of rehabilitation was not enough to restore aerobic function after ACL reconstruction, compared to non-injured players of the same level.

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Most cited references 33

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Physiology of soccer: an update.

Tomas Stølen, Karim Chamari, Carlo Castagna … (2005)

Soccer is the most popular sport in the world and is performed by men and women, children and adults with different levels of expertise. Soccer performance depends upon a myriad of factors such as technical/biomechanical, tactical, mental and physiological areas. One of the reasons that soccer is so popular worldwide is that players may not need to have an extraordinary capacity within any of these performance areas, but possess a reasonable level within all areas. However, there are trends towards more systematic training and selection influencing the anthropometric profiles of players who compete at the highest level. As with other activities, soccer is not a science, but science may help improve performance. Efforts to improve soccer performance often focus on technique and tactics at the expense of physical fitness. During a 90-minute game, elite-level players run about 10 km at an average intensity close to the anaerobic threshold (80-90% of maximal heart rate). Within this endurance context, numerous explosive bursts of activity are required, including jumping, kicking, tackling, turning, sprinting, changing pace, and sustaining forceful contractions to maintain balance and control of the ball against defensive pressure. The best teams continue to increase their physical capacities, whilst the less well ranked have similar values as reported 30 years ago. Whether this is a result of fewer assessments and training resources, selling the best players, and/or knowledge of how to perform effective exercise training regimens in less well ranked teams, is not known. As there do exist teams from lower divisions with as high aerobic capacity as professional teams, the latter factor probably plays an important role. This article provides an update on the physiology of soccer players and referees, and relevant physiological tests. It also gives examples of effective strength- and endurance-training programmes to improve on-field performance. The cited literature has been accumulated by computer searching of relevant databases and a review of the authors' extensive files. From a total of 9893 papers covering topics discussed in this article, 843 were selected for closer scrutiny, excluding studies where information was redundant, insufficient or the experimental design was inadequate. In this article, 181 were selected and discussed. The information may have important implications for the safety and success of soccer players and hopefully it should be understood and acted upon by coaches and individual soccer players.

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Age-predicted maximal heart rate revisited.

H Tanaka, K. Monahan, D Seals (2001)

We sought to determine a generalized equation for predicting maximal heart rate (HRmax) in healthy adults. The age-predicted HRmax equation (i.e., 220 - age) is commonly used as a basis for prescribing exercise programs, as a criterion for achieving maximal exertion and as a clinical guide during diagnostic exercise testing. Despite its importance and widespread use, the validity of the HRmax equation has never been established in a sample that included a sufficient number of older adults. First, a meta-analytic approach was used to collect group mean HRmax values from 351 studies involving 492 groups and 18,712 subjects. Subsequently, the new equation was cross-validated in a well-controlled, laboratory-based study in which HRmax was measured in 514 healthy subjects. In the meta-analysis, HRmax was strongly related to age (r = -0.90), using the equation of 208 - 0.7 x age. The regression equation obtained in the laboratory-based study (209 - 0.7 x age) was virtually identical to that obtained from the meta-analysis. The regression line was not different between men and women, nor was it influenced by wide variations in habitual physical activity levels. 1) A regression equation to predict HRmax is 208 - 0.7 x age in healthy adults. 2) HRmax is predicted, to a large extent, by age alone and is independent of gender and habitual physical activity status. Our findings suggest that the currently used equation underestimates HRmax in older adults. This would have the effect of underestimating the true level of physical stress imposed during exercise testing and the appropriate intensity of prescribed exercise programs.

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Aerobic endurance training improves soccer performance.

J Helgerud, L C Engen, U Wisloff … (2001)

The aim of the present study was to study the effects of aerobic training on performance during soccer match and soccer specific tests. Nineteen male elite junior soccer players, age 18.1 +/- 0.8 yr, randomly assigned to the training group (N = 9) and the control group (N = 10) participated in the study. The specific aerobic training consisted of interval training, four times 4 min at 90-95% of maximal heart rate, with a 3-min jog in between, twice per week for 8 wk. Players were monitored by video during two matches, one before and one after training. In the training group: a) maximal oxygen uptake (VO2max) increased from 58.1 +/- 4.5 mL x kg(-1) x min(-1) to 64.3 +/- 3.9 mL x kg(-1) x min(-1) (P < 0.01); b) lactate threshold improved from 47.8 +/- 5.3 mL x kg(-1) x min(-1) to 55.4 +/- 4.1 mL x kg(-1) x min(-1) (P < 0.01); c) running economy was also improved by 6.7% (P < 0.05); d) distance covered during a match increased by 20% in the training group (P < 0.01); e) number of sprints increased by 100% (P < 0.01); f) number of involvements with the ball increased by 24% (P < 0.05); g) the average work intensity during a soccer match, measured as percent of maximal heart rate, was enhanced from 82.7 +/- 3.4% to 85.6 +/- 3.1% (P < 0.05); and h) no changes were found in maximal vertical jumping height, strength, speed, kicking velocity, kicking precision, or quality of passes after the training period. The control group showed no changes in any of the tested parameters. Enhanced aerobic endurance in soccer players improved soccer performance by increasing the distance covered, enhancing work intensity, and increasing the number of sprints and involvements with the ball during a match.

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Author and article information

Contributors

Adriano Marques de Almeida:

ORCID: http://orcid.org/0000-0003-2507-3786

Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: VisualizationRole: Writing – original draftRole: Writing – review & editing

Paulo Roberto Santos Silva: Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ResourcesRole: ValidationRole: Writing – review & editing

André Pedrinelli: Role: ConceptualizationRole: MethodologyRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – review & editing

Arnaldo J. Hernandez: Role: ConceptualizationRole: Data curationRole: MethodologyRole: ResourcesRole: SupervisionRole: VisualizationRole: Writing – review & editing

Riccardo Di Giminiani: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 22 March 2018

Publication date Collection: 2018

Volume: 13

Issue: 3

Electronic Location Identifier: e0194432

Affiliations

[001]Sports Medicine Discipline, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil

University of L'Aquila, ITALY

Author notes

Competing Interests: The authors have declared that no competing interests exist.

[¤]

Current address: Rua Dr. Ovidio Pires de Campos, 333, Cerqueira Cesar, Sao Paulo, Sao Paulo, Brazil

* E-mail: adrianoalmeida@ 123456usp.br

Author information

Adriano Marques de Almeida http://orcid.org/0000-0003-2507-3786

Article

Publisher ID: PONE-D-17-42511

DOI: 10.1371/journal.pone.0194432

PMC ID: 5864031

PubMed ID: 29566090

SO-VID: f6ac84fb-478d-468b-9f06-bee173690ef8

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 5 December 2017

Date accepted : 3 March 2018

Page count

Figures: 0, Tables: 3, Pages: 10

Funding

The authors received no specific funding for this work.

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Data Availability All relevant data are within the paper and its Supporting Information file.

Aerobic fitness in professional soccer players after anterior cruciate ligament reconstruction

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Most cited references 33

Physiology of soccer: an update.

Age-predicted maximal heart rate revisited.

Aerobic endurance training improves soccer performance.

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