A Comparison of Hip Extension and Nordic Hamstring Exercise Programmes on Isokinetic Hamstring Strength

Study Overview
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Brief Summary
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This study aimed to compare the effect of two hamstring strengthening programmes on hamstring muscle strength in Gaelic footballers. 26 Gaelic footballers were recruited and randomly assigned to one of two 4-week hamstring strengthening programmes, namely the hip extension exercise programme and the Nordic hamstring exercise protocol. Isokinetic hamstring and quadriceps strength were measured before and after the intervention.

Detailed Description
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Recruitment: Participants were recruited from the local university sports clubs. Club chairpersons were asked to send an email to club players. Players interested in participating in the study expressed an interest by replying to the email. Potential participants were asked to attend a meeting where they had the study explained to them. Those who were interested were then assessed for inclusion and exclusion criteria. Group allocation: A four block randomisation method was used to allocate participants to the Nordic hamstring exercise protocol or the hip extension exercise protocol. Interventions: The Nordic hamstring exercise protocol or the hip extension exercise protocol Testing procedure: The isokinetic strength of the participants' hamstrings and quadriceps were recorded before and after the exercise intervention. A 10 point visual analogue scale was used to record the level of muscle soreness experienced after each training session.

Official Title
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A Comparison of Hip Extension and Nordic Hamstring Exercise Programmes on Isokinetic Hamstring Strength

Conditions
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Hamstring Injury

Intervention / Treatment
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* Other: Nordic hamstring exercise
* Other: Hip extension exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: male free from hamstring injury in the 6 months prior to the study currently playing Gaelic football at a varsity level on at least three occasions per week Exclusion Criteria: history of a hip or knee injury in the 3 months prior to the study a history of anterior cruciate ligament rupture a history of involvement in a hamstring strengthening, injury prevention programme in the 3 months prior to the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Nordic Hamstring Exercise Group<br>Participants were required to kneel on a gym mat keeping their hips in a slightly flexed position and to slowly lower themselves in a controlled manner as far as they could towards the ground. When they could no longer lower themselves as such, they were instructed to utilise their arms to buffer the fall and touch their chest off the ground, while maintaining tension in their hamstrings. Once their chest touched the ground they were instructed to immediately return to the starting position by pushing up with their hands. | Other: Nordic hamstring exercise<br>* The exercise protocol consisted of the following sets and repetitions Week 1 - 2 sessions with 2 sets of 6 repetitions. Week 2 - 2 sessions with 3 sets of 6 repetitions Week 3 - 2 sessions with 4 sets of 8 repetitions. Week 4 - 2 sessions with 4 sets of 10 repetitions.<br>|
| Experimental: Hip Extension Exercise Group<br>The participant lay on an exercise bench at a 45° angle with their hips held just over the top of the bench, their trunk erect and hips extended and their heel supported. Participants slowly flexed their hip until they reached 90° from the starting position and were then required to return to the starting position by extending through the hip while maintaining a neutral pelvic and trunk posture throughout. This exercise was then repeated on the opposite leg | Other: Hip extension exercise<br>* The exercise protocol consisted of the following sets and repetitions Week 1 - 2 sessions with 2 sets of 6 repetitions. Week 2 - 2 sessions with 3 sets of 6 repetitions Week 3 - 2 sessions with 4 sets of 8 repetitions. Week 4 - 2 sessions with 4 sets of 10 repetitions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Peak isokinetic eccentric hamstring strength at 60°.s-1 | This was measured using an isokinetic dynamometer | Change from baseline assessment at six weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional hamstring-to-quadriceps ratio at 60°.s-1 | This was calculated by dividing the peak isokinetic, eccentric hamstring strength at 60°.s-1 by the peak isokinetic, concentric quadriceps strength at 60°.s-1 | Change from baseline assessment at six weeks | 
| Between limb, isokinetic eccentric hamstring strength asymmetries | Between limb eccentric strength percentage asymmetries were calculated as a non-dominant/dominant ratio converted to percentage difference using log transformation. | Change from baseline assessment at six weeks | 
| Muscle soreness rating following exercise | Participants used a 10 point visual analogue scale to record the level of muscle soreness experienced after training sessions. The scale consisted of a single scale of 0 to 10 where 0 was no soreness at all and 10 was the greatest soreness they could imagine. A higher score indicated a worse outcome. There are no subscales included in this. | 1 minute at the end of each intervention session | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hamstring strength, Isokinetics, Nordic hamstring exercise, Eccentric strength, Hip extension exercise