Rehabilitation of Acute Hamstring Injuries in Male Athletes
Condition: Strains
Study type: Interventional

Summary: 
      The purpose of the study is to compare the effect of two rehabilitation protocols with
      different emphasis on eccentric exercises after acute hamstring muscle strain injuries on the
      time to return to sports (RTS) and the rate of re-injuries in male athletes.

      The hypothesis is that the addition of early eccentric hamstring exercises being performed at
      longer muscle-tendon length towards end range of motion alter the outcomes RTS and
      re-injuries in a rehabilitation protocol after acute hamstring muscle strain injuries.
    

Detailed description: 
      Background and rationale:

      Acute hamstring muscle strain injuries represent the most prevalent non-contact muscle injury
      reported in sports. Despite the high prevalence and a rapidly expanding body of literature
      investigating hamstring muscle strain injuries, [1] occurrence and re-injury rates have not
      improved over the last three decades [2]. Therefore, rehabilitation and secondary prevention
      are of particular concern, and the primary objective of all rehabilitation protocols is to
      return an athlete to pre-injury level as soon as possible with a minimal risk of injury
      recurrence.There is still a lack of consensus and clinical research regarding the
      effectiveness of various rehabilitation protocols for acute hamstring injuries in athletes
      participating in sports with high sprinting demands [3,4]. To our knowledge, there are no
      prospective, randomised trials investigating the effect of different rehabilitation protocols
      in a Middle-Eastern athletic population. Eccentric strength training has shown to reduce the
      risk of both new acute hamstring injuries as well as re-injuries [5,6], whereas hamstring
      exercises being performed at longer muscle-tendon length, preferentially mimicking movements
      occuring simultaneously at both the knee and hip are reported to be more effective than a
      protocol containing conventional exercises [7], and are suggested to be a key strategy in the
      management of hamstring injuries. However, the preventive effect related to the eccentric
      training remains unclear and is still debated and the optimal intensity of eccentric training
      in rehabilitation of acute hamstring strain injuries and prevention of re-injuries is yet
      unknown [8].

      The primary objective in this study is therefore to compare the effect of two rehabilitation
      protocols after acute hamstring muscle strain injuries on the time to return to sports (RTS)
      and the rate of re-injuries in male athletes in a prospective single-site randomized
      controlled trial.

      The investigators aim to include 90 male athletes with clinical signs and MRI abnormalities
      consistent with an acute hamstring muscle strain injury. The injured athletes will be
      randomised into one of two different rehabilitation protocols with unlike emphasis on
      eccentric exercises.
    

Intervention name(s): Physiotherapy ASPETAR; Physiotherapy ASPETAR+
Intervention type(s): Other; Other
Intervention description(s): Standardized physiotherapy protocol; Standardized physiotherapy protocol including early lengthening exercises
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Hamstring; Muscle; Injury; Treatment; Rehabilitation