Effect of Exercises on Hamstring Muscle Function, Injury Risk, Agility and Cognitive Function

Hamstring muscle injuries (HMI) occurs frequently during excessive motions of the physiologic capability of these muscles. It is reported in the literature that impairments in muscle architecture, such as a decrease in the eccentric strength of the hamstring muscles of the knee (lengthening and contraction of the muscle), delay in the reaction time of the hamstring muscles, overactivity of the hamstring muscles, a decrease in the length of the hamstring muscle fibers, and inadequate cognitive functions may lead to HMI. Preventive and therapeutic exercises of HMI consist many different eccentric exercises, such as the Askling L-protocol and particularly Nordic hamstring exercise, for increasing the hamstring flexibility. However, it has been stated in recent studies that hamstring muscles should not be focused on alone, and a holistic exercise intervention that includes and addresses the present risk factors related to HMI is needed. Within our knowledge, the effect of a defined or improved holistic exercise approach to prevent and/or treat HMI has not been studied in the literature. Considering the risk factors underlying HMI, an exercise involving a holistic approach is needed to prevent all the risk factors. Turkish Get Up (TGU) exercise is a kind of cognitive exercise which activates all muscles and let to contract simultaneously during standing up from the supine position and turning back in 7 stages. Since the exercise originates from former Turkish athletes, it has been included in the literature as TGU. Hence, the exercise originates from former Turkish athletes, it has called as TGU. TGU exercise improves the effective and strong transition ability of the body while developing the pattern of standing up from the lying position on the floor and turning back by increasing condition/ endurance. Meanwhile, this exercise is a progressive coordinative and cognitive exercise, it requires completing each step before the next movement.

The role of cognitive skills and neuroscience in the interpretation, prediction and improvement of sports performance is getting popular in recent years. Previous researches reported that athletes with reduced cognitive skills had lower sportive achievements. It has also stated that the impairment in cognitive skills tend muscles to be injured. However, no studies that investigate the effectiveness of cognitive function in preventing HMI have been encountered. So, the present study will be the first study investigating effects of a special exercise addressing cognitive function which is generally ignored in the treatment of HMI.

It is aimed to figure out whether Turkish Get Up exercise or Supine sliding leg curls and Nordic Hamstring exercises are more effective on hamstring muscle function, ınjury risk, agility and cognitive function.

Healthy recreational people aged between 18-25 will assign to this study. The participants will randomly be allocated four groups (Nordic protocol group, Supine sliding leg curls group, Turkish Get Up (TGU) and control group). The exercise protocols will be applied two days a week for 6 weeks, and the control group will receive no special exercise training. Participants' hamstring muscle strengths will be evaluated with ISOMED 2000 isokinetic dynamometer, the hamstring flexibility with digital inclinometer device, injury risk with FMS™, agility with T-agility test, and the cognitive function with CNS Vital Signs in computer environment at baseline and 6 weeks after interventions.


Eligibility Criteria:
Inclusion Criteria:

1. Being between the ages of 18-25
2. Body mass index (BMI) being between 18.5-24.9 kg / m 2
3. Volunteering to participate in the study
4. Having the skills to do the tests and exercises to be applied
5. Being a healthy recreationally active male individual (Individuals with sufficient physical activity level according to the International Physical Activity Questionnaire (IPAQ) Short form (\> 3000 metabolic equivalent (MET) -min / week) will be included)

Exclusion Criteria:

1. Having a history of lower extremity injury and / or hamstring strain within the past year
2. Having a sensory problem that prevents participation in the study
3. Have any musculoskeletal, neurological, respiratory, or cardiovascular risk factors that limit exercise
4. Using drugs or nutritional supplements that can be considered doping according to the World Anti-Doping Agency (WADA)
5. Having a history of malignant disease