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Is pre-season eccentric strength testing during the nordic hamstring exercise associated with future hamstring strain injury? A systematic review and meta-analysis
Opar, David A. Timmins, Ryan G. Behan, Fearghal P. Hickey, Jack T. van Dyk, Nicol Price, Kara Maniar, Nirav
Opar, David A.
Timmins, Ryan G.
Behan, Fearghal P.
Hickey, Jack T.
van Dyk, Nicol
Price, Kara
Maniar, Nirav
Abstract
Background
Interventions utilising the Nordic hamstring exercise (NHE) have resulted in reductions in the incidence of hamstring strain injury (HSI). Subsequently, quantifying eccentric knee flexor strength during performance of the NHE to identify an association with the occurrence of future HSI has become increasingly common; however, the data to date are equivocal.
Objective
To systematically review the association between pre-season eccentric knee flexor strength quantified during performance of the NHE and the occurrence of future HSI.
Design
Systematic review and meta-analysis.
Data sources
CINAHL, Cochrane Library, Medline Complete, Embase, Web of Science and SPORTDiscus databases were searched from January 2013 to January 10, 2020.
Eligibility criteria for selecting studies
Prospective cohort studies which assessed the association between pre-season eccentric knee flexor strength quantified during performance of the NHE and the occurrence of future HSI.
Methods
Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against pre-defined criteria then assessed for risk of bias. Meta-analysis was used to pool data across studies, with meta-regression utilised where possible.
Results
A total of six articles were included in the meta-analysis, encompassing 1100 participants. Comparison of eccentric knee flexor strength during performance of the NHE in 156 injured participants and the 944 uninjured participants revealed no significant differences, regardless of whether strength was expressed as absolute (N), relative to body mass (N kg−1) or between-limb asymmetry (%). Meta-regression analysis revealed that the observed effect sizes were generally not moderated by age, mass, height, strength, or sport played.
Conclusion
Eccentric knee flexor strength quantified during performance of the NHE during pre-season provides limited information about the occurrence of a future HSI.
Keywords
Date
2021
Type
Journal article
Journal
Sports Medicine
Book
Volume
51
Issue
9
Page Range
1935-1945
Article Number
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Faculty of Health Sciences
Files
Opar_2021_Is_pre_season_eccentric_strength_testing.pdf
Adobe PDF, 3.4 MB
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Published as green open access
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Open
Controlled
Open
Controlled
Open