van der Horst Nick, Smits Dirk-Wouter, Petersen Jesper, Goedhart Edwin A, Backx Frank J G
Department of Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, Utrecht, the Netherlands
Department of Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, Utrecht, the Netherlands.
Am J Sports Med. 2015 Jun;43(6):1316-23. doi: 10.1177/0363546515574057. Epub 2015 Mar 20.
Hamstring injuries are the most common muscle injuries in soccer, and they have a high rate of recurrence. Eccentric hamstrings strength is recognized as an important modifiable risk factor. This led to the development of prevention exercises such as the nordic hamstring exercise (NHE). The effectiveness of the NHE on hamstring injury prevention has never been investigated in amateur soccer.
To investigate the preventive effect of the NHE on the incidence and severity of hamstring injuries in male amateur soccer players.
Randomized controlled trial; Level of evidence, 1.
Male amateur soccer players (age, mean ± SD, 24.5 ± 3.8 years) from 40 teams were randomly allocated to an intervention (n = 20 teams, 292 players) or control group (n = 20 teams, 287 players). The intervention group was instructed to perform 25 sessions of NHE in a 13-week period. Both the intervention and control groups performed regular soccer training and were followed for hamstring injury incidence and severity during the 2013 calendar year. At baseline, personal characteristics (eg, age, injury history, field position) were gathered from all participants via a questionnaire. Primary outcome was injury incidence. Secondary outcomes were injury severity and compliance with the intervention protocol.
A total of 38 hamstring injuries were recorded, affecting 36 of 579 players (6.2%). The overall injury incidence rate was 0.7 (95% CI, 0.6-0.8) per 1000 player hours, 0.33 (95% CI, 0.25-0.46) in training, and 1.2 (95% CI, 0.82-1.94) in matches. Injury incidence rates were significantly different between the intervention (0.25; 95% CI, 0.19-0.35) and control groups (0.8; 95% CI, 0.61-1.15), χ(2)(1, n = 579) = 7.865; P = .005. The risk for hamstring injuries was reduced in the intervention group compared with the control group (odds ratio, 0.282; 95% CI, 0.110-0.721) and was statistically significant (P = .005). No statistically significant differences were identified between the intervention and control groups regarding injury severity. Compliance with the intervention protocol was 91%.
Incorporating the NHE protocol in regular amateur training significantly reduces hamstring injury incidence, but it does not reduce hamstring injury severity. Compliance with the intervention was excellent.
腘绳肌损伤是足球运动中最常见的肌肉损伤，且复发率很高。腘绳肌离心力量被认为是一个重要的可改变风险因素。这促使了诸如北欧腘绳肌练习（NHE）等预防练习的发展。NHE对业余足球运动员腘绳肌损伤预防的有效性从未得到过研究。
探讨NHE对男性业余足球运动员腘绳肌损伤发生率和严重程度的预防效果。
随机对照试验；证据等级为1级。
来自40支球队的男性业余足球运动员（年龄，均值±标准差，24.5±3.8岁）被随机分配到干预组（n = 20支球队，292名运动员）或对照组（n = 20支球队，287名运动员）。干预组被指导在13周内进行25次NHE练习。干预组和对照组都进行常规足球训练，并在2013年全年跟踪观察腘绳肌损伤的发生率和严重程度。在基线时，通过问卷收集所有参与者的个人特征（如年龄、损伤史、场上位置）。主要结局是损伤发生率。次要结局是损伤严重程度和对干预方案的依从性。
共记录到38例腘绳肌损伤，579名运动员中有36名受影响（6.2%）。总体损伤发生率为每1000运动员小时0.7（95%可信区间，0.6 - 0.8），训练时为0.33（95%可信区间，0.25 - 0.46），比赛时为1.2（95%可信区间，0.82 - 1.94）。干预组（0.25；95%可信区间，0.19 - 0.35）和对照组（0.8；95%可信区间，0.61 - 1.15）的损伤发生率有显著差异，χ(2)(1, n = 579) = 7.865；P = 0.005。与对照组相比，干预组腘绳肌损伤风险降低（优势比，0.282；95%可信区间，0.110 - 0.721），且具有统计学意义（P = 0.005）。干预组和对照组在损伤严重程度方面未发现统计学显著差异。对干预方案的依从率为91%。
将NHE方案纳入常规业余训练可显著降低腘绳肌损伤发生率，但不能降低腘绳肌损伤严重程度。对干预的依从性良好。
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