Isokinetic Strength Profile of Elite Female Handball Players

Effects of Different Exercise Training on Physical Fitness and Technical Skills in Handball Players. A Systematic Review

ABSTRACT

Akbar, S, Kim Geok, S, Bashir, M, Jazaily Bin Mohd, NN, Luo, S, and He, S. Effects of different exercise training on physical fitness and technical skills in handball players. A systematic review. J Strength Cond Res XX(X): 000-000, 2024-This review aimed to assess the effects of exercise training on handball players' performance. A thorough search was conducted in 5 online databases (ProQuest, PubMed, Science Direct, Web of Science, and EBSCOhost (SPORTDiscus), as well as on Google Scholar and other gray literature references starting on April 11, 2022. The methodological quality of the included research was evaluated using the Physiotherapy Evidence Database scale. This systematic review includes 16 studies. Eight studies received "excellent" ratings (≥6 points), 5 received "good" ratings (5 points), and 3 received "moderate" ratings (4 points). The findings showed that the most frequently examined performance factors in exercise training intervention strategies with handball players were balance (n = 5), agility (n = 8), speed (n = 9), and jumping performance (n = 10). Muscular strength (n = 4), shooting and dribbling skill (n = 3), and muscular endurance (n = 4) were the second most frequently investigated performance factors. Regarding speed and agility, exercise training considerably improved the physical fitness of handball players. However, evidence related to muscular strength, shooting ability, and dribbling skills was limited. To achieve the optimum standard, handball players must have strong physical and physiological qualities. Meanwhile, no evidence was found related to the impacts of exercise training on power, endurance, flexibility, body composition, cardiovascular fitness, and cardiorespiratory fitness. Regarding limitations, there is a need for more research with solid evidence to determine the impacts of exercise training interventions on athletes' performance in handball.

Does ipsilateral and bilateral knee strength status predict lower extremity injuries of elite judokas; a prospective cohort study

The association of pre-participation knee muscle strength status with lower limb injury occurrence was investigated. Knee extensors and flexors muscle strength status including the traditional hamstrings/quadriceps (H/Q), Q/Q, H/H, and the non-dominant H/Q: dominant H/Q, HQ:HQ, ratios were recorded before the 10 month judo activity. Fifteen lower limb sport injuries were recorded for 53 judokas during the follow-up questionnaires. Significant accuracy of dominant H/Q ratio 60º/s (AUC 0.702, 95% CI 0.520 to .883, p = 0.023), as well as HQ:HQ ratios 300º/s (AUC .318, 95% CI 0.138 to 0.497, p = 0.040), and 60 º/s (AUC 0.311, 95% CI 0.130 to 0.491, p = .033) were revealed discriminating between injured and uninjured judokas. The optimum cut-off of dominant H/Q ratio associated with belonging to uninjured judokas group was 43.2% (sensitivity, 0.974; specificity, 0.533). Isokinetic knee muscle dynamometry is useful for predicting the likelihood of lower limb injuries in professional judokas during competitive activity.

Normative Standards for Isokinetic and Anthropometric Classifications of University-Level Netball Players

CONTEXT

The purpose of the study was to develop normative ranges and standards for knee and shoulder isokinetic and anthropometric values. These standards can be qualitatively interpreted and allow practitioners to classify isokinetic and anthropometric values more objectively for university-level netball players.

DESIGN

Posttest only observational study design. All players were only evaluated once during the in-season to generate normative ranges.

METHODS

A total of 51 female players volunteered. Participants were evaluated on an isokinetic dynamometer at 60° per second to obtain knee-extensor and knee-flexor values as well as shoulder-flexor and shoulder-extensor values. A total of 16 anthropometric variables were collected including stature, body mass, 8 skinfolds, and 6 circumferences. Between-group differences were calculated to determine whether playing level was a differentiating factor in data.

RESULTS

Normative standards were developed for isokinetic parameters associated with the knee and shoulder joints as well as skinfolds and circumference measures. No statistically significant between-group differences were evident (χ2Kruskal-Wallis[2] = 3.96, P = .140).

CONCLUSION

These standards can be used by coaches and practitioners to set attainable goals for individual players or those from secondary leagues, classify individual and team-based performances, and facilitate decision-making processes.

Effects of Black Maca supplement on isokinetics muscular performance of elite women's handball players: placebo-controlled, crossover study

Background

The aim of this study was to investigate the changes in isokinetic muscular performance among female adolescent elite handball athletes with the supplementation of Black Maca (BM).

Methods

Eight elite handball athletes were recruited for the present study. The intake capsules contained 2,500 mg of 100% concentrated BM extract and a placebo each, for 4 weeks. Isokinetic muscular performance and physical fitness were measured three times at 4-week intervals after the intake of BM and placebo, including baseline.

Results

The one-way Analysis of Variance (ANOVA) analysis showed a significant improvement in 20 m-shuttle run (P < 0.001), 30°/s flexor (P < 0.01), and 120°/s flexor (P < 0.01) in isokinetic muscle function of the trunk, and 180°/s right extensor (P < 0.05), 180°/s left extensor (P < 0.05), and 180°/s left flexor (P < 0.01) in isokinetic muscle function of the knee, after BM supplementation. Post-hoc analysis indicated that the BM group had significantly higher results compared to the baseline and placebo groups in terms of 20 m-shuttle run, 30°/s flexor and 120°/s flexor of the trunk, 180°/s right extensor, 180°/s left extensor, and 180°/s left flexor of the knee.

Conclusion

BM supplementation can have a positive effect on improving the performance of elite handball players who engage in high-intensity movements by enhancing their isokinetic muscle function and endurance.

Are Previous Joint Injuries Associated with Muscle Performance in Volleyball Athletes?

Objective  The aim of the present study is to determine whether previous shoulder and knee injuries were associated with isokinetic fatigue index and agonist/antagonist ratio of shoulder internal/external rotators and knee flexors/extensors in male volleyball athletes. Methods  The current study is a cross-sectional investigation of 49 male elite volleyball players competing at a high level in Brazil. Isokinetic fatigue index and agonist/antagonist profiles were assessed during the preseason. Additionally, in order to record previous injuries, the athletes answered a standardized questionnaire. We conducted a receiver operating characteristic (ROC) curve analysis to determine the association strength and the clinically relevant cut-off point for variables presenting statistical significance for the area under the curve (AUC) (α = 0.05). An independent t-test was used to compare isokinetic variables between athletes with and without previous injury (α = 0.05). Results  The results of the ROC curve analysis indicated that hamstring fatigue index values at 300 o /s were associated with the presence of previous knee injury (area under the curve [AUC] = 73%, p  = 0.004), and shoulder external rotators fatigue index values at 360°/s were not associated with the presence of previous shoulder injury (AUC = 68%, p  = 0.053). Conclusions  Elite volleyball athletes who reported previous knee injuries were prone to a higher fatigue index than those reporting no injuries. Knee flexor resistance training might be useful for those athletes who reported knee injuries in the previous season.

Dynamometric Strength Profile of Hip Muscles in Youth Soccer Players

BACKGROUND

Soccer is the most widely practiced sport in the world, demanding high-speed activities such as jumps, sprints and changes of direction. Therefore, having optimal levels of muscle strength improves performance and reduces the injury rate.

OBJECTIVES

The objectives of our study were (i) to determine the dynamometric profile of hip muscle strength in young soccer players by position, evaluated at different isokinetic speeds, (ii) to describe the conventional and functional unilateral muscle strength ratios, (iii) to analyze the bilateral balance.

METHODS

Thirty-seven male soccer players (age 17.02 ± 0.92 years) participated in the study. Strength assessment was performed with a functional electromechanical dynamometer, and concentric and eccentric strength of abductors, adductors, extensors and hip flexors were measured bilaterally at 0.5 m/s and 1 m/s.

RESULTS

For eccentric right hip abduction at 0.5 m/s, defenders are significantly stronger than midfielders (p = 0.013) and stronger than forwards (p = 0.140). For eccentric right hip adduction at 0.5 m/s, defenders are significantly stronger than midfielders (p = 0.005) and stronger than forwards (p = 0.253), as for eccentric right hip adduction at 1 m/s, defenders are significantly stronger than midfielders (p = 0.014) and stronger than forwards (p = 0.084). There is a significant effect for the conventional strength ratio of left abduction/adduction at 1 m/s. The conventional strength ratio of forwards is significantly higher than that of defenders (p = 0.045) and higher than that of midfielders (p = 0.152).

CONCLUSIONS

Concentric and eccentric hip strength values differ according to playing position.

Lower extremity isokinetic strength characteristics of amateur boxers

Aim: Sufficient strength and dynamic stability of the lower limbs are essential for improving punching force and preventing injury in amateur boxers. However, there are still no comprehensive reports on the isokinetic knee strength of boxers with different performance levels. The current study aimed to profile the isokinetic muscle strength of flexion and extension of the knee in boxers, as well as bilateral, unilateral, and functional ratios, and investigate the variation in these muscle strength characteristics associated with different performance levels.

Methods: Boxers were divided in two performance groups, elite (five males and four females) and non-elite groups (five males and four females). Muscle strength of the knee was determined via an IsoMed2000 device. Parameters examined included peak torque of the hamstring (H) and quadriceps (Q) during concentric (con) and eccentric (ecc) contractions at low (60°/S), medium (180°/S), and high (240°/S) speed and bilateral ratios (BLs), unilateral ratios (ULs), and functional ratios of dominant (D) and non-dominant limbs.

Results: In all angular velocities, the peak torque of H and Q was stronger in the elite group than in the non-elite group. ULs were lower in the elite group than in the non-elite group in Hcon/Qcon at 180D (p < 0.01) and 180ND (p < 0.05) and in Hecc/Qecc at 60D, 180D (p < 0.05) and 240D (p < 0.01). The elite group had higher BLs than the non-elite group in Hcon at 60°/S (p < 0.05) and Qcon at 180°/S (p < 0.05). The non-elite group had a higher functional ratio than elite boxers in Hecc/Qcon at 180D and 240D (p < 0.01).

Conclusion: Elite boxers had stronger knee strength in con and ecc contractions. All boxers had normal Hecc/Qecc and Hcon/Qecc. Hcon/Qcon and Hecc/Qcon were abnormal at lower angular velocity. Elite boxers had higher BLs and lower ULs, indicating that they are at a higher risk of injury.

The Effect of a Handball Warm-Up Program on Dynamic Balance among Elite Adolescent Handball Players

This study examined the effect of the handball warm-up program (HWP) on dynamic balance among elite adolescent handball players. In this case, 24 handball players were randomly assigned into experimental warm-up and control groups. The HWP was performed over 8 weeks (3 times per week). Dynamic balance before and after the intervention training programs were measured by the Biodex Balance System (BBS) and Y Balance test for the dominant (DL) and non-dominant legs (non-DL). After HWP training, BBS scores significantly improved in the overall (OSI) (30.4% and 31.1%), anterior-posterior (APSI) (44.6% and 35.2%), and medial-lateral stability indexes (MLSI) (38.8% and 43%) for both DL and non-DL. Post-training, the Y Balance test exhibited significant improvements in OSI (13.2% and 10.6%), anterior (17.2% and 12.6%), posteriolateral (12.8% and 11.3%), and posteriomedial stability indexes (9.2% and 7.9%) with DL and non-DL, respectively. In conclusion, dynamic balance improved overall after eight weeks of the HWP, with this improvement significantly greater with the trained versus the control group. Optimal balance during handball is an important factor to ensure coordinated and efficient movements and it is speculated that improved balance could positively impact injury prevention. Hence, the HWP program can be used as an alternative to a conventional warm-up program.

Specificity of isokinetic assessment in noncontact knee injury prevention screening: A novel assessment procedure with relationships between variables in amateur adult agility-sport athletes

OBJECTIVES

To present a new knee isokinetic assessment procedure linked to noncontact knee injury mechanisms and examine correlations between variables relevant to noncontact knee injury prevention screening (peak torque [PT, Nm], time-to-peak torque [TTPT, ms], angle-of-peak torque [APT, °], mean PT [MPT, Nm]).

DESIGN

Cross-sectional.

SETTING

Sports medicine laboratory.

PARTICIPANTS

Thirty-four agility-sport athletes (male/female n = 18/16, age 24.1 ± 3.5yr, height 171.8 ± 9.6 cm, mass 70.6 ± 12 kg).

MAIN OUTCOME MEASURES

Pearson's/Spearman's correlation (r/r_s), coefficient of determination (r²/r_s²).

RESULTS

Most correlations were statistically non-significant or statistically-significant with only weak-to-moderate coefficients. For both knee extension and flexion, PT and MPT were significantly and strongly correlated (r = 0.99, r² = 0.98, p = 0.001). Graphical analyses revealed two datapoint clusters for knee flexion TTPT and APT. One cluster indicated some participants could generate knee flexor PT rapidly (<150 ms) at low knee flexion angles (<45°) and the other cluster indicated that other participants could not (>200 ms, >50°).

CONCLUSIONS

In this study, most isokinetic variables represented distinct knee neuromuscular characteristics. For both knee extension and flexion, only PT or MPT need be used to represent isokinetic maximal strength. Knee flexion TTPT and APT may have utility in noncontact knee injury prevention screening with amateur adult agility-sport athletes.

Determining the number of repetitions to establish isokinetic knee evaluation protocols specific to angular velocities of 60°/second and 180°/second

INTRODUCTION

This study aims to develop a standard number of repetition at angular velocities of 60°/sec and 180°/sec and define the difference of number of repetitions between genders.

METHOD

One hundred ninety-six athletes (judo, volleyball, Greco-Roman wrestling, runners, and gymnastics) were involved. Concentric-concentric isokinetic muscle strength of the knee flexor-extensor muscles of the athletes were performed with an ISOMED 2000 isokinetic dynamometer. The evaluation test protocol consisted of 10 repetition of knee flexion-extension at 60°/sec and 30 repetitions at 180°/sec.

RESULTS

Athletes performed with maximal knee flexion strength at their second and third trial at 60°/sec and third-forth trial at 180°/sec. It was found that 2 repetitions and 2-3 repetitions were needed for knee extension peak torque at 60°/sec and 180°/sec respectively. The difference between the genders was significant at 60°/sec for knee flexion and extension on the dominant side; at 180°/sec for knee extension on the dominant and non-dominant side. It was determined that 3 repetitions for 60°/sec, 4 repetitions for 180°/sec were enough to determine peak torque values.

DISCUSSION

Optimal number of repetitions is crucial so that athletes could have the opportunity to reach maximal strength without unnecessary workload or waste of time.

CONCLUSIONS

Protocols involving 3 repetitions for 60°/sec, 4 repetitions for 180°/sec were enough to determine peak torque values. Gender of athletes should be considered when establishing isokinetic knee evaluation protocols.

The effect of deafness on the physical fitness parameters of elite athletes

The purpose of this study is to determine the health-related physical fitness parameters of athletes, who are deaf. The study group consisted of 137 deaf athletes (52 females and 85 males with a mean age of 23.99±6.56 years) who have participated in the 2017 Deaflympics games. The assessed parameters included the isokinetic muscle strength, core endurance, balance assessments, grip strength, and body composition. At the end of the study, the following results were obtained. Hamstring/quadriceps ratio was in the range of 53%–54%, which was within 50%–60% of the normal limit. Endurance of the anterior and posterior core muscles was low as compared to the normative data. The athletes’ balance was better with their eyes open than closed; and the grip strength was low as compared to the normative data in the literature. Also, the body fat percentage of deaf female athletes were similar to ones in healthy individuals with sedentary lifestyle, whereas male ones had slightly lower body fat mass percentage. These results can be used as the initial reference parameters to define the training program requirements of deaf athletes.

Morphological and Isokinetic Strength Differences: Bilateral and Ipsilateral Variation by Different Sport Activity

BACKGROUND

The purpose of this study was to investigate the morphological and isokinetic strength asymmetry and magnitude in young athletes.

METHODS

One hundred and thirty nine male subjects (soccer, floorball, non-athletes) were measured for proportion of muscle mass between upper extremities (BADΔ) and lower extremities (BLDΔ). Moreover, the peak muscle torque of knee extensors (PTE) and flexors (PTF), ipsilateral (H:Q) and bilateral strength ratio (Q:Q, H:H) were measured.

RESULTS

We found significant differences in observed parameters with respect to different sport activities (F = 13.02, p = 0.00, η p 2 = 0.80). Higher values of BADΔ were observed in the non-active (0.19 ± 0.11 kg) group compared with soccer players (0.10 ± 0.11 kg). We found a lower value of BLDΔ in floorball players (0.32 ± 0.11 kg) compared with soccer players (0.58 ± 0.27 kg) and non-active boys (0.63 ± 0.28 kg). Results revealed significantly higher PTE in soccer players compared with non-active boys and floorball players and higher Q:Q ratio in soccer players (10.99 ± 7.75%) compared with non-active boys (7.47 ± 5.92%).

CONCLUSIONS

This study revealed that there are morphological and strength asymmetries in the observed groups, which may have potential maladaptive effects (e.g. uncompensated overload of extremity) in athletes affected by specific load.

Muscle Strength Variations of Knee Joint Muscles in Elite Female Handball Players after Pre-Season Conditioning

Monitoring seasonal variations in strength performance and the relative risk of injury indicators related to strength of hamstring (H) and quadriceps (Q) in female elite athletes is beneficial for the training process. The aim of this study was to examine and compare the level of muscle strength, the conventional ratio (HCONC/QCONC) as well as two functional and strength ratios reflecting the movement of knee extension (HECC/QCONC) and flexion (HCONC/QECC), and the bilateral percentage strength deficit (BSD) in elite female handball players. The concentric and eccentric isokinetic peak torque was measured at an angular velocity of 60°/s on three occasions (in-season cessation, 4 weeks of rest followed by 4 weeks of individual conditioning and 6 weeks of group conditioning) in eleven female handball players (age: 23.1 ± 3.5 years, body height: 1.73 ± 0.6 m). According to ANOVA results, the BSD of H muscles in the concentric mode decreased between the in-season cessation and the end of the pre-season, and HCONC/QCONC increased at the beginning of the pre-season and at the end of the pre-season in comparison with inseason cessation measurement. The effect size analyses showed that the off-season rest followed by 10 weeks of the conditioning programme increased Q and H strength in comparison with the previous season with a large effect. Coaches should include progressive conditioning in the pre-season phase to decrease the bilateral strength deficit and to support further conditioning development.

Profiling the Isokinetic Muscle Strength of Athletes Involved in Sports Characterized by Constantly Varied Functional Movements Performed at High Intensity: A Cross-Sectional Study

BACKGROUND

Constantly varied functional movements performed at high intensity (FMHI) is a type of strength and general conditioning program that has gained widespread popularity in recent years. The very intense exercises performed with lower and upper limbs may create muscular asymmetry or imbalance between agonist and antagonist muscles, and therefore the characterization of isokinetic muscle strength, side-to-side difference, and balance ratios for lower and upper limbs may contribute to a better understanding of the modality characteristics.

OBJECTIVE

To evaluate the knee and shoulder strength of FMHI athletes of both sexes.

DESIGN

Cross-sectional study.

SETTING

Exercise physiology laboratory.

PARTICIPANTS

Sixty FMHI athletes (30 M/30 W) with more than 2 years' experience.

METHODS

Athletes performed isokinetic tests in both lower and upper limbs: concentrically at 60°/s and 240°/s and eccentrically at 240°/s.

MAIN OUTCOME MEASUREMENTS

Isokinetic peak torque of knee flexor and extensor and shoulder internal and external rotator muscles. Conventional and functional strength balance ratios and side-to-side strength difference.

RESULTS

Concentric peak torque values relative to total body mass for shoulder and knee joints were higher in men than women on both sides. Eccentric peak torque values for knee flexor-dominant and extensor-nondominant limbs showed no difference between the sexes. The knee conventional strength balance ratio for dominant and nondominant sides in women (51.5% ± 7.0% and 51.0% ± 7.1%, respectively) and for dominant and nondominant sides in men (54.4% ± 15.2% and 51.5% ± 9.9%, respectively) were no different between the sexes or limbs. The shoulder conventional strength balance ratio was higher in women (78.1 ± 13.2%) than in men (67.6% ± 10.9%) on the nondominant side. Knee and shoulder functional strength balance ratios in nondominant limbs were higher for women than men. Both sexes presented no side-to-side difference for knee joints or muscles, or for shoulder IR muscles, but ER was stronger in dominant limbs.

CONCLUSIONS

These data from highly trained FMHI athletes can be compared to that of other athletes to help determine individual weaknesses, strengths, and imbalances, and may be useful for designing training programs.

LEVEL OF EVIDENCE

III.

Influence of increasing knee flexion angle on knee-ankle varus stress during single-leg jump landing

Objectives

The primary aim of this study was to identify the relationship between the peak knee flexion angle and knee-ankle varus stress in the landing phase of the single-leg jump during running.

Methods

Fifteen male handball players from the first Saudi Arabian handball team were incorporated in this study. Each player performed a single-leg jump-land after running a fixed distance of 450 cm. The data were measured using a 3D motion analysis system. The maximum knee flexion angle, knee varus angle, centre of pressure pathway in the medio-lateral direction, and ankle varus moment were measured.

Results

The Pearson Product Moment Correlation showed that a greater knee flexion angle was related to a greater lateral displacement of the centre of pressure (r = 0.794, P = 0.000), a greater ankle varus moment (r = 0.707, P = 0.003), and a greater knee varus angle (r = 0.753, P = 0.001). In addition, the greater ankle varus moment was related to the greater lateral displacement of the centre of pressure (r = 0.734, P = 0.002).

Conclusions

These findings may help physical therapists and conditioning professionals to understand the impact of increasing knee flexion angle on the lower limb joints. Such findings may help to develop training protocols for enhancing the lateral body reaction during the landing phase of the single-leg jump, which may protect the knee and ankle joints from excessive varus stresses.

Lower-extremity isokinetic strength ratios of elite springboard and platform diving athletes

OBJECTIVES

The purpose of the present study was to examine knee extensor and flexor muscle strength ratios of an elite group of diving athletes.

METHODS

Sixteen divers (10 females and 6 males) from the Brazil national team were assessed for lower-body strength. They had participated in international competitions such as the 2016 Olympic Games and 2015 Pan American Games. The dynamic concentric torque of their knee flexor and extensor muscles were evaluated using a Biodex isokinetic dynamometer. Bilateral tests were performed at 60º s^-1. Flexor to extensor (F/E) peak torque ratio and percentage bilateral difference (BD%) was also measured.

RESULTS

The results revealed that elite diving athletes produced higher than usual reported in previous studies for relative knee extension torque (3.2 for females and 3.6 for males N∙m∙kg^-1). However, they presented low levels of knee flexor torque (1.5 for females and 1.8 for males N∙m∙kg^-1). These results are reflected in a low F/E ratio (0.39 to 0.49). Males presented a greater BD% in knee flexors when compared to females (12.4% vs 6.6%).

CONCLUSION

Elite diving athletes demonstrated high knee extensor and low knee flexor strength. This partially explains their low F/E ratio, which might increase risk of knee injuries. Strength and conditioning programs should strive to correct knee strength imbalances in diving athletes where necessary.

Training-induced changes in physical performance can be achieved without body mass reduction after eight week of strength and injury prevention oriented programme in volleyball female players

The purpose of the study was to analyse the changes in muscle strength, power, and somatic parameters in elite volleyball players after a specific pre-season training programme aimed at improving jumping and strength performance and injury prevention. Twelve junior female volleyball players participated in an 8-week training programme. Anthropometric characteristics, isokinetic peak torque (PT) single-joint knee flexion (H) and extension (Q) at 60º/s and 180º/s, counter movement jump (CMJ), squat jump (SJ), and reactive strength index (RSI) were measured before and after intervention. Significant moderate effects were found in flexor concentric PT at 60º/s and at 180 º/s in the dominant leg (DL) (18.3±15.1%, likely; 17.8±11.2%, very likely) and in extensor concentric PT at 180º/s (7.4%±7.8%, very likely) in the DL. In the non-dominant leg (NL) significant moderate effects were found in flexor concentric PT at 60º/s and at 180º/s (13.7±11.3%, likely; 13.4±8.0%, very likely) and in extensor concentric PT at 180º/s (10.7±11.5%, very likely). Small to moderate changes were observed for H/Q_CONV in the DL at 60º/s and 180º/s (15.9±14.1%; 9.6±10.4%, both likely) and in the NL at 60º/s (moderate change, 9.6±11.8%, likely), and small to moderate decreases were detected for H/Q_FUNC at 180º/s, in both the DL and NL (-7.0±8.3%, likely; -9.5±10.0%, likely). Training-induced changes in jumping performance were trivial (for RSI) to small (for CMJ and SJ). The applied pre-season training programme induced a number of positive changes in physical performance and risk of injury, despite a lack of changes in body mass and composition.