Effect of the Perception of Knee Pain on Muscle Strength and Endurance among Elite Female Handball Players

Abstract

Objectives This study aimed to examine the effect of knee pain perception on muscle strength and endurance among elite female handball players.

Methods This study included 60 handball players who participated in training and competition from January to December 2019. Muscle strength, endurance, and hamstring/quadriceps ratio of the knee were estimated using Computer Sports Medicine, INC (Cybex, HUMAC, USA). The independent samples t-test was used for inter-group comparison. The Pearson’s correlation and simple linear regression analyses were used to assess associations among the variables and identify factors affecting pain perception, respectively.

Results No significant differences in knee muscle strength, endurance of both the flexor and extensor muscles, and muscle strength (hamstring/quadriceps ratio) were noted between the high and low groups. However, the ratio of muscle endurance of the flexor and extensor of the knee in the high group was significantly lower than that in the low group. Furthermore, pain was found to correlate only with muscle endurance (hamstring/quadriceps ratio). The pain scale reading increased by 1. Moreover, muscle endurance ratio of the flexor and extensor muscles of the knee decreased by 3.07.

Conclusion Muscle endurance (hamstring/quadriceps ratio) of the flexor and extensor muscles, classified based on an average pain scale, differed between the high and low groups. These results can aid in development of rehabilitation and exercise programs for players involved in handball and similar sports in the future.

Zusammenfassung

Ziele Mit dieser Studie sollte die Auswirkung der Wahrnehmung von Knieschmerzen auf Muskelkraft und Ausdauer bei Elite-Handballerinnen untersucht werden.

Methoden Die Studie wurde von Januar bis Dezember 2019 mit 60 Handballspielerinnen durchgeführt, die in diesem Zeitraum an Training und Wettkämpfen teilnahmen. Muskelkraft, Ausdauer und das Hamstrings/Quadriceps-Verhältnis des Knies wurden mithilfe von Computer Sports Medicine, INC (Cybex, HUMAC, USA) bewertet. Für den Vergleich zwischen den Gruppen wurde der t-Test für unabhängige Stichproben verwendet. Die Pearson-Korrelation und einfache lineare Regressionsanalysen wurden verwendet, um Assoziationen zwischen den Variablen zu bewerten bzw. Faktoren zu identifizieren, die das Schmerzempfinden beeinflussen.

Ergebnisse Es konnten keine signifikanten Unterschiede in der muskulären Kraftfähigkeit des Kniegelenks, der Ausdauer der Beuger- und Streckermuskeln und der Muskelkraft (Verhältnis Hamstring/Quadrizeps) zwischen der hohen und der niedrigen Gruppen festgestellt werden. Allerdings war das Verhältnis der Ausdauer der Beuger- und Streckermuskulatur des Knies in der hohen Gruppe signifikant geringer als in der niedrigen Gruppe. Zudem korrelierte die Schmerzintensität nur mit der Muskelausdauer (Verhältnis Hamstring/Quadriceps). Der Wert auf der Schmerzskala stieg um 1. Außerdem sank das Verhältnis der Muskelausdauer der Beuge- und Streckmuskeln des Knies um 3,07.

Schlussfolgerung Die Ausdauer (Hamstring/Quadrizeps-Verhältnis) der Beuge- und Streckmuskeln, die basierend auf einer gängigen Schmerzskala eingeschätzt wurde, unterschied sich zwischen der hohen und der niedrigen Gruppe. Diese Ergebnisse können bei der Entwicklung von Rehabilitations- und Trainingsprogrammen für Sportler im Handball oder ähnlichen Sportarten in Zukunft hilfreich sein.

Keywords

Handball players - knee pain - muscle strength - muscle endurance

Schlüsselwörter

Handballspieler - Knieschmerzen - Muskelkraft - Ausdauer

Publikationsverlauf

Eingereicht: 20. September 2020

Angenommen: 08. März 2021

Artikel online veröffentlicht:
16. April 2021

• References

• 1 International Handball Federation. 2020; Online https://www.ihf.info/ last accessed: 16.05.2020
• 2 Korea Handball Federation. 2020; Online https://www.handballkorea.com/ last accessed: 16.05.2020
• 3 Chung HK, Baek SS. Analysis of handball strategies of world top class team to prepare rio 2016 olympic games: focusing on women’s team. Sport Sci 2017; 34: 175-180
• 4 Mayer C. RühlemannA, J äger M. Handball injuries and their prevention. Orthopade 2019; 48: 1036-1041
• 5 Kim HC, Park KJ. Correlation analysis of sports injuries and body composition and bone density in national water pool players. J Korean Soc Phys Med 2019; 14: 134-141
• 6 Palmer-Green D, Fuller C, Jaques R. et al The injury/illness performance project (IIPP): A novel epidemiological approach for recording the consequences of sports injuries and illnesses. J Sports Med (Hindawi Publ Corp) 2013; 2013: 523974
• 7 Steffen K, Engebretsen L. More data needed on injury risk among young elite athletes. Br J Sports Med 2010; 44: 485-489
• 8 Kim CW, Park KJ. Injuries in female elite Korean handball athletes: A epidemiological study. J Korean Soc Phys Med 2020; 15: 93-100
• 9 Kim HC, Park KJ. Injuries in male and female elite aquatic sports athletes: An 8-year prospective, epidemiological study. J Sports Sci Med 2020; 19: 390-396
• 10 Park KJ, Kim CW. Injuries in Elite Korean kabaddi athletes: A epidemiological study. J Korean Soc. Phys Med 2020; 15: 57-63
• 11 Kang DH, Yu LY, Lee GC. The effects of knee extensor, flexor muscle strength and joint position sense in squat exercise on variety surface. J Korean Soc Int Med 2013; 1: 47-57
• 12 Bala K, Gakhar M, Jagga V. Effect of endurance training of trunk extensor muscles on pain and endurance in patients with sub acute nonspecific low backache. J Exer Sci Physiother 2012; 8: 82-86
• 13 Bahr R, Clarsen B, Derman W. et al. International Olympic Committee consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 (including STROBE Extension for Sport Injury and Illness Surveillance (STROBE-SIIS)). Br J Sports Med 2020; 54: 372-389
• 14 Kim HC, Park KJ. Analysis of correlation between the inspiratory capacity of the National softball players and the bone density, bone mass, muscle power, muscle endurance. J Korean Soc. Phys Med 2020; 15: 95-104
• 15 Øiestad BE, Juhl CB, Eitzen I. et al. Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis. Osteoarthritis Cartilage 2015; 23: 171-177
• 16 Sward P, Kostogiannis I, Roos H. Risk factors for a contralateral anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc 2010; 18: 277-291
• 17 Ardern CL, Webster KE, Taylor NF. et al. Return to sport following anterior cruciate ligament reconstruction surgery: A systematic review and meta-analysis of the state of play. Br J Sports Med 2011; 45: 596-606
• 18 Angelozzi M, Madama M, Corsica C. et al. Rate of force development as an adjunctive outcome measure for return-to-sport decisions after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 2012; 42: 772-780
• 19 Cheung RTH, Smith AW, Wong DPH. Q ratios and bilateral leg strength in college field and court sports players. J Hum Kinet 2012; 33: 63-71
• 20 Islam MS, De A. Functional hamstring to quadriceps strength ratio (H:Q) and hamstrings injury of soccer players: A qualitative analysis. Orthop Sports Med 2018; 2: 126-132
• 21 Fujita R, Matsui Y, Harada A. et al. Does the Q−H index show a stronger relationship than the H:Q ratio in regard to knee pain during daily activities in patients with knee osteoarthritis?. J Phys Ther Sci 2016; 28: 3320-3324
• 22 Kellis E, Galanis N, Kofotolis N. Hamstring-to-quadriceps ratio in female athletes with a previous hamstring injury, anterior cruciate ligament reconstruction, and controls. Sports (Basel) 2019; 7: 214-223
• 23 Harmon KG, Ireland ML. Gender differences in noncontact anterior cruciate ligament injuries. Clin Sports Med 2000; 19: 287-302
• 24 SmithH C, Vacek P, Johnson RJ. , et al. Risk factors for anterior cruciate ligament injury a review of the literature – part 2: hormonal, genetic, cognitive function, previous injury, and extrinsic risk factors. Sports Health 2012; 4: 155-61
• 25 Fousekis K, Tsepis E, Vagenas G.. Multivariate isokinetic strength asymmetries of the knee and ankle in professional soccer players. J Sports Med Phys Fitness 2010; 50: 465-474
• 26 Aginsky JD, Neophytou N, Charalambous T. Isokinetic hamstring and quadriceps muscle strength profiles of elite South African football players. African J Phys Health Edu Recreation Dance 2015; 203: 1225-1236
• 27 Haghighi FM, Mahbobeh S, Ebrahimian M. et al. A comparison of the Effect of Quadriceps Taping versus Patellar Taping on Balance and Functional Performance in Patients with Knee Osteoarthritis. Phys Med Rehab Kuror 2019; 29: 275-281