Funktionelle Tests als Entscheidungskriterium für die Rückkehr von Spielsportlern nach einer Ruptur des vorderen Kreuzbandes

Zusammenfassung

Eine Ruptur des vorderen Kreuzbandes (VKB) stellt eine schwerwiegende Verletzung im Spielsport dar, die sowohl für den Athleten als auch für den Verein zeit- und kostenintensiv ist. Aufgrund der vielseitigen und anspruchsvollen Belastung der unteren Extremitäten sind vor allem Spielsportler häufig von der schweren Verletzung mit langem Rehabilitationszeitraum betroffen. Bezogen auf den Wiedereinstieg in den Sport variieren die Zeiträume stark. Zur Bestimmung des Zeitpunkts der Rückkehr in den Sport werden bereits verschiedene Ansätze diskutiert, diesen mittels funktioneller Testverfahren zu quantifizieren. Ein Konsens hinsichtlich relevanter Parameter, der verfügbaren Testverfahren und der Interpretation der Testwerte existiert jedoch nicht. Auf der Basis des Anforderungsprofils der Spielsportart Fußball berücksichtigt die vorliegende Arbeit insbesondere funktionelle Tests für die Anforderungen Kraft, Schnelligkeit, Agility und Bewegungsqualität als koordinative Eigenschaft. Neben den Testverfahren für einzelne Beanspruchungsformen werden auch kombinierte Testprotokolle diskutiert. Es werden sowohl die Durchführungsvarianten und wissenschaftlichen Gütekriterien als auch die Anwendbarkeit in der Praxis beschrieben. Während beidbeinige Sprünge Seitenunterschiede nur durch zusätzliches Equipment wie Kraftmessplatten oder Marker ermitteln können, eignen sich vor allem Hop Tests zur Aufdeckung von Seitendifferenzen anhand des Symmetrie-Index. Eine Vielzahl an kombinierten Testprotokollen ist bereits vorhanden, jedoch decken diese bisher nur einen Teilbereich des Anforderungsprofils eines Spielsportlers ab. Für die Praxis sollte eine geeignete Testbatterie mit einer Auswahl der beschriebenen funktionellen Tests zusammengestellt werden, die wissenschaftlichen und praktikablen Richtwerten unterliegen und zudem als Pre-Injury Screening vor und während der Saison eingesetzt werden können.

Abstract

A rupture of the anterior cruciate ligament (ACL) represents a severe injury in game sports, which is time and cost-intensive for athletes and clubs alike. As the lower extremities are subjected to multiple forms of strain and high demands are placed on them, athletes in games like soccer are affected more often than others. The point of return-to-play after such severe injuries is often preceded by long periods of rehabilitation. However, these periods often vary strongly. Multiple approaches are being discussed to estimate the point of return-to-play using functional test procedures. However, no general consensus has been reached regarding the relevant parameters, available test procedures and interpretation of test results. Based on the requirement profile of soccer as a game sport, this review evaluates functional tests regarding the requirements strength, speed, agility, and movement quality as a coordinative feature. In addition to tests regarding individual forms of strain, this review also discusses combined test protocols. It describes performance variants and scientific quality criteria as well as the potential for practical implementation. While jumps can detect side-to-side asymmetries only through additional equipment such as force plates or markers, hop tests are more suitable for implementation and allow for an easier assessment of side-to-side asymmetries. Although several combined test protocols exist, none of them measures the entire requirement profile for games sports. To decrease the number of re-injuries after ACL rupture, a combined test protocol with a selection of the described scientifically reliable functional tests should be created and implemented as a return-to-competition guideline as well as pre-injury screening prior and during the season.

Schlüsselwörter

Return-to-play - Return-to-Competition - Testbatterie - VKB - Funktionelle Tests

Key words

return-to-play - return-to-competition - test protocol - ACL - functional testing

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