Mendiguchia Jurdan, Martinez-Ruiz Enrique, Edouard Pascal, Morin Jean-Benoît, Martinez-Martinez Francisco, Idoate Fernando, Mendez-Villanueva Alberto
1Department of Physical Therapy, ZENTRUM Rehab and Performance Center, Barañain, SPAIN; 2Chair of Sports Traumatology, Catholic University of San Antonio, Murcia, SPAIN; 3Inter-university Laboratory of Human Movement Biology (LIBM EA), University of Lyon, University Jean Monnet, Saint Etienne, FRANCE; 4Department of Clinical and Exercise Physiology, Sports Medicine Unity, University Hospital of Saint-Etienne, Faculty of medicine, Saint-Etienne, FRANCE; 5Medical Commission, French Athletics Federation (FFA), Paris, FRANCE; 6Université Côte d'Azur, LAMHESS, Nice, FRANCE; 7Virgin of Arrixaca University Hospital, Murcia, SPAIN; 8Radiology Department, San Miguel Clinic, Pamplona, SPAIN; and 9ASPIRE Academy for Sports Excellence, Doha, QATAR.
Med Sci Sports Exerc. 2017 Jul;49(7):1482-1492. doi: 10.1249/MSS.0000000000001241.
Given the prevalence of hamstring injuries in football, a rehabilitation program that effectively promotes muscle tissue repair and functional recovery is paramount to minimize reinjury risk and optimize player performance and availability.
This study aimed to assess the concurrent effectiveness of administering an individualized and multifactorial criteria-based algorithm (rehabilitation algorithm [RA]) on hamstring injury rehabilitation in comparison with using a general rehabilitation protocol (RP).
Implementing a double-blind randomized controlled trial approach, two equal groups of 24 football players (48 total) completed either an RA group or a validated RP group 5 d after an acute hamstring injury.
Within 6 months after return to sport, six hamstring reinjuries occurred in RP versus one injury in RA (relative risk = 6, 90% confidence interval = 1-35; clinical inference: very likely beneficial effect). The average duration of return to sport was possibly quicker (effect size = 0.34 ± 0.42) in RP (23.2 ± 11.7 d) compared with RA (25.5 ± 7.8 d) (-13.8%, 90% confidence interval = -34.0% to 3.4%; clinical inference: possibly small effect). At the time to return to sport, RA players showed substantially better 10-m time, maximal sprinting speed, and greater mechanical variables related to speed (i.e., maximum theoretical speed and maximal horizontal power) than the RP.
Although return to sport was slower, male football players who underwent an individualized, multifactorial, criteria-based algorithm with a performance- and primary risk factor-oriented training program from the early stages of the process markedly decreased the risk of reinjury compared with a general protocol where long-length strength training exercises were prioritized.
鉴于足球运动中腘绳肌损伤的普遍性，一个能有效促进肌肉组织修复和功能恢复的康复计划对于将再次受伤风险降至最低、优化球员表现和出勤率至关重要。
本研究旨在评估与使用一般康复方案（RP）相比，实施基于个体化和多因素标准的算法（康复算法[RA]）对腘绳肌损伤康复的同时有效性。
采用双盲随机对照试验方法，两组各24名足球运动员（共48名）在急性腘绳肌损伤后5天，分别完成RA组或经过验证的RP组康复。
在恢复运动后的6个月内，RP组发生了6次腘绳肌再次损伤，而RA组仅1次（相对风险 = 6，90%置信区间 = 1 - 35；临床推断：极有可能有益）。与RA组（25.5 ± 7.8天）相比，RP组（23.2 ± 11.7天）恢复运动的平均时长可能更快（效应量 = 0.34 ± 0.42）（-13.8%，90%置信区间 = -34.0%至3.4%；临床推断：可能有小的效应）。在恢复运动时，RA组球员的10米跑时间、最大冲刺速度以及与速度相关的更大机械变量（即最大理论速度和最大水平功率）明显优于RP组。
尽管恢复运动的速度较慢，但与优先进行长时间力量训练练习的一般方案相比，从过程早期就接受基于个体化、多因素、标准且以表现和主要风险因素为导向的训练计划的男性足球运动员，再次受伤的风险显著降低。
