The effects of soccer training and timing of balance training on balance ability

Size: px

Start display at page:

Download "The effects of soccer training and timing of balance training on balance ability"

Blaze Matthews
6 years ago
Views:

1 Eur J Appl Physiol (2006) DOI /s ORIGINAL ARTICLE A. Gioftsidou Æ P. Malliou Æ G. Pafis Æ A. Beneka G. Godolias Æ C.N. Maganaris The effects of soccer training and timing of balance training on balance ability Accepted: 9 December 2005 Ó Springer-Verlag 2006 Abstract The purpose of the present study was to investigate the effects of a soccer training session on the balance ability of the players and assess whether the effectiveness of a balance program is affected by its performance before or after the regular soccer training. Thirty-nine soccer players were randomly divided into three subject groups (n=13 each), one control group (C group), one training group that followed a balance program (12 weeks, 3 times per week, 20 min per session) before the regular soccer training (TxB group), and one training group that performed the same balance program after the soccer training (TxA group). Standard testing balance boards and the Biodex Stability System were used to assess balance ability in the C, TxB, and TxA groups at baseline (T0) and after completing the balance program (T12). The same tests and additional isokinetic knee joint moment measurements were carried out in the TxB and TxA groups pre- and post-soccer training. Two main results were obtained: (1) No differences (p>0.05) were found in balance ability and knee joint moment production between pre- and post-soccer training. (2) The balance program increased (p<0.01) the balance ability in the TxB and TxA groups, and the improvement in the TxA group was greater (p<0.05) than that in the TxB group post-soccer training. Result (1) is in contrast to the notion of a link between fatigue induced by a soccer training session or game and injury caused by impaired balance, and result (2) has implications for athletic training and rehabilitation. A. Gioftsidou Æ P. Malliou Æ G. Pafis Æ A. Beneka Æ G. Godolias Department of Physical Education and Sports Science, Democritus University of Thrace, Komotini, Greece C.N. Maganaris (&) Institute for Biophysical and Clinical Research into Human Movement, Manchester Metropolitan University, Hassall Road, ST7 2HL Alsager, UK c.n.maganaris@mmu.ac.uk Tel.: Keywords Soccer Æ Injury Æ Balance Æ Training Æ Fatigue Introduction Soccer is a contact sport associated with an increased preponderance of injuries (Inklaar et al. 1996; Dvorak 2000; Morgan and Oberlander 2001; Junge and Dvorak 2004). Most injuries occur in the second half of a game (Hoy et al. 1992; Hawkins and Fuller 1996, 1999), indicating that they may be mediated by fatigue. This notion is supported by experiments showing that muscular fatigue induced in the laboratory environment in sedentary individuals may adversely affect several motor performance indicators of their balance ability (Nardone et al. 1997; Johnston et al. 1998; Vuillerme et al. 2002; Yaggie and McGregor 2002). However, it is unknown whether the same applies to soccer players (who are accustomed to regular exposure to muscle fatigue), when fatigued in real conditions, as a result of a soccer game or training. Relevant information is also lacking as to whether fatigue may influence the effectiveness of exercise training for improving balance. Although it is well-established that specific training may improve balance ability (Caraffa et al. 1996; Hewett et al. 1999; Wedderkopp et al. 1999), no attempt has so far been made to investigate the outcome of balance training under different fatigue states. It is important to address this issue because if an interaction between fatigue and effectiveness of balance training does exist, then relevant recommendations could be drawn to improve the effectiveness of balance exercises for preventive or rehabilitation purposes in soccer and other sports. In light of the above considerations, the aim of the present study was twofold: (1) To investigate whether a soccer training session affects the players balance ability. (2) To assess whether a balance program is more effective when performed before or after the regular soccer training.

2 Methods Subjects and protocol The study was conducted on 39 young male soccer players (age 16±1 years; body mass 66±6 kg; body height 174±6 cm; mean ± SD) participating in the young championship of the first Greek division. The participants were free of injuries in the lower limbs for the past 3 years. The experimental procedures complied with the Helsinki declaration of 1975 and were approved by the Ethical Committee of the Democritus University of Thrace. The participants were randomly divided into three subject groups (n=13 each), one control group (C group), and two intervention groups (Tx groups) that performed a specific balance program for 12 weeks, three times per week, and 20 min per session. One of the two intervention groups performed the balance program immediately before the regular soccer training session (TxB group). The other group performed the balance program immediately after soccer training (TxA group). The dominant leg with respect to ball kicking was the right leg for ten subjects in the C group, ten subjects in the TxA group, and eleven subjects in the TxA group. Balance assessment Balance ability was assessed in all subjects at baseline (T0) and after the completion of the 12-week balance program (T12). Measurements in the TxB and TxA groups were taken before and immediately after a soccer training session (pre-training and post-training, respectively). The balance ability assessment was performed with three different balance boards (boards 1a, 1b, and 2) and the Biodex Stability System (Biodex Medical Systems, USA; Arnold and Schmitz 1998; Testerman and van der Griend 1999; Paterno et al. 2004). Board 1a restricted movement in the anteroposterior direction only, board 1b restricted movement in the medio-lateral direction only, and board 2 allowed movement in both antero-posterior and mediolateral directions. In the balance board tests, the subjects maintained single-limb stance for as long as possible. Three test trials were timed on each balance board and the best trial was considered for further analysis. In the Biodex test, the participants maintained single-limb stance for 20 s, with the Biodex platform set to freely move by up to 20 from level in any direction. From the variance of the platform displacement ( ) in the antero-posterior and medio-lateral directions from level during the test (Fig. 1), an instability index (Ii) was computed from the Biodex system. Three test trials were carried out and the one with the lowest Ii (best performance) was further processed. Fig. 1 Typical raw data from the Biodex Stability System showing the displacement ( ) of the Biodex foot platform from level (0 ) in the antero-posterior direction (top) and medio-lateral direction (bottom) during a 20-s test of single-limb stance Balance program The balance program consisted of the following five postural stability exercises in a random order: (1) A 3- min attempt to move a cursor depicting the position of the center of foot pressure to a specific target on a screen while standing on the Biodex platform. (2) A 45-s attempt to maintain single-limb stance on board 1a. (3) A 45-s attempt to maintain single-limb stance on board 1b. (4) A 45-s attempt to maintain single-limb stance on board 2. (5) A 45-s attempt to maintain single-limb stance on a mini trampoline. In all tasks of single-limb stance, subjects were asked to kick back with their nonstanding leg a soccer ball thrown at them by the experimenter. Both legs were trained, 15 s apart. Dynamometric assessment Measurements of peak isokinetic moment in the knee flexors and extensors were performed in the TxB and TxA groups pre-training and post-training to quantify the degree of muscle fatigue induced by the soccer training session. The subjects were secured with straps on the seated position on the chair of an isokinetic dyanamometer (Cybex 6000, USA) at a hip joint angle of 110 (180 is the supine position), with the dynamometer lever and knee joint axes being visually aligned. After a standardized warm-up, three successive cycles of maximal effort knee extension flexion contractions were performed at two different angular velocities, first at 60 / s and then at 180 /s. More than one angular velocity was examined to assess whether the soccer training session would affect the production of muscular force similarly in slower and faster contractions. The two tests were performed ~2 min apart, and the two legs were tested ~5 min apart. Visual feedback of the recorded joint

3 moment values was provided. For each angular velocity, muscle group and leg, the contraction with the highest peak moment value was considered for further analysis. Statistics Two-way repeated measures ANOVA was used to test for differences in (a) isokinetic performance at the velocities examined between pre-training and posttraining (2 2), (b) balance ability in the C, TxB, and TxA groups between T0 and T12 (3 2), and (c) balance ability in the TxB and TxA groups between pre-training and post-training (2 2). The Scheffé test was used for post hoc analysis where appropriate. The level of statistical significance was set at p<0.05. Results The F ratios from the ANOVA tests are shown in Table 1. Post hoc analysis revealed the following results. The isokinetic joint moment measurements post-training were lower by 8 11% than pre-training (p>0.05; Table 2). This had no effect (p>0.05) on any of the balance performance indicators examined (Table 3). No difference (p>0.05) in balance ability was found in the C group between T0 and T12. In contrast, the 12-week balance training program improved (p<0.01) all the balance performance indicators examined in the TxB and TxA groups. The improvement in balance ability for the left leg with boards 1a and 1b was greater (p<0.05) in the TxA group than the TxB group when the assessment was performed post-training. For the right leg, a similar difference (p<0.05) was found between the TxA and TxB groups only in the test with board 1a. In agreement with previous reports (Pincivero et al. 1995; Johnson et al. 2005), intraclass correlation coefficient values for two measurements taken in the same day (p>0.05, Student s t-test) were 0.74 for the Biodex test, 0.72 for the board 1a test, 0.78 for the board 1b test, and 0.67 for the board 2 test. Discussion The main objectives of this study were to investigate (1) whether a soccer training session influences the players balance ability, and (2) whether the effectiveness of a balance program is affected by its performance before or after soccer training. We found that (1) a soccer training session did not affect the balance ability of the players, and (2) the improvement in balance ability was greater when the balance program and assessment were performed after soccer training. In previous studies, deterioration of balance ability in sedentary individuals as a result of fatigue was found after controlled, repeated ankle muscle contractions leading to complete exhaustion or joint moment reduction by at least 50% (Lundin et al. 1993; Nardone et al. 1997; Johnston et al. 1998; Yaggie and McGregor 2002). In the present study, instead, the extent and role of fatigue induced by a soccer training session in soccer players was studied in an attempt to more directly relate to the mechanisms mediating the well-established high incidence of injuries toward the end of a match or a training session (Hoy et al. 1992; Hawkins and Fuller 1996, 1999; Hiemstra et al. 2001). In contrast to the above experimental conditions, our dynamometric measurements in the knee extensor and flexor muscles revealed that soccer training reduced the contractile joint moment by only ~10%. Similar levels of knee muscle fatigue have recently been reported in response to exercise simulating the work rate of competitive soccer (Ranhama et al. 2003). The absence of substantial muscle fatigue following a soccer training session may justify the present finding of maintenance of balance ability. This latter result indicates that the function of relevant systems mediating postural control, including the muscular and proprioceptive systems (Nelson and Hutton 1985; Skinner et al. 1986; Hagbarth and Macefield 1995; Hiemstra et al. 2001; Vuillerme et al. 2002), is not compromised as a result of a soccer training session or game in trained individuals. Further tests are required to assess the applicability of our findings to additional muscles and balance performance indicators, but the present results suggest that the cause-and-effect hypothesis between fatigue-induced instability and high injury incidence in soccer may be unsustainable. The role of other factors that may need to be within certain safety limits to avoid an injury, e.g., explosive muscle power and reaction time, merit investigation. The finding of balance ability improvement in response to balance training agrees with previous reports on sedentary individuals (Caraffa et al. 1996; Rozzi et al. 1996; Chong et al. 2001). However, we must note that we have assessed balance ability with the same exercise devices used for balance training, and this precludes us from generalizing conclusions regarding the effects of the balance program followed. Despite the lack of a training-independent measure of balance performance, the improvement in balance ability was affected by the timing of balance program and evaluation test in relation to the soccer training: when performed after soccer training, the improvements in balance ability were greater, especially in the non-dominant leg for most subjects. This indicates that the mechanisms mediating postural control and balance may be more adaptable to specific training if they have previously been functionally challenged. Although no conclusive statements can be made on the exact underlying mechanisms, the finding of a timing-related improvement in postural balance as a result of training has practical implications and should be considered by athletic coaches and rehabilitation specialists. To conclude, the present findings show that a soccer training session does not deteriorate the balance ability

4 Table 1 ANOVA results TxB group TxA group Right extensors Left extensors Right flexors Left flexors Right extensors Left extensors Right flexors Left flexors Isokinetic performance at the two velocities examined pre-training and post-training Velocity F(1,24)=41.697, Time F(1,24)=71.35,, Velocity time F(1,24)=1.891,, p<0.01, op=0.9 F(1,24)=32.227, F(1,24)=78.013, F(1,24)=1.463, p<0.01, op=0.93 F(1,24)=11.767, F(1,24)=131.51, F(1,24)=0.640, p>0.05, op=0.14 F(1,24)=9.718, F(1,24)=57.874, F(1,24)=2.587, p>0.05, op=0.3 F(1,24)= , F(1,24)=34.332, F(1,24)=0.107, p>0.05, op=0.47 F(1,24)=53.227, F(1,24)= , F(1,24)=2.725, p>0.05, op=0.47 F(1,24)=18.870, F(1,24)= , F(1,24)=1.382, p>0.05, op=0.35 F(1,24)=20.142, F(1,24)=75.618, F(1,24)=1.570, p>0.05, op=0.47 Left leg Right leg Board 1a Board 1b Board 2 Biodex Board 1a Board 1b Board 2 Biodex Balance ability in the C, TxA, and TxB groups at T0 and T12 Group F(2,34)=10.960, p<0.01, op=0.8 Time F(1,34)=43.519, Group time F(2,34)=12.327, p<0.01, op=0.92 F(2,34)=7.653, p<0.01, op=0.91 F(1,34)= F(2,34)=8.319, p<0.01, op=0.93 F(2,34)=5.783, p<0.01, op=0.92 F(1,34)=21.905, F(2,34)=6.387, p<0.01, op=0.83 Balance ability in the TxA and TxB groups pre-training and post-training Group F(1,21)=4.855, p<0.05, op=0.58 Time F(1,21)=41.547, <0.01, op=1 Group time F(1,21)=4.750, p<0.01, op=0.91 F(1,21)=4.462, p<0.05, op=0.65 F(1,21)=18.228, p<0.01, op=0.85 F(1,21)=4.385, p<0.05, op=0.66 F(1,21)=0.905, p>0.05, op=0.12 F(1,21)=16.202, p<0.01, op=0.7 F(1,21)=0.503, p>0.05, op=0.33 F(2,34)=2.927, p<0.05, op=0.7 F(1,34)=39.949, F(2,34)=4.588, p<0.05, op=0.8 F(1,21)=0.002, p>0.05, op=0.1 F(1,21)=34.866, p<0.01, op=0.92 F(1,21)=0.003, p>0.05, op=0.15 F(2,34)=17.848, p<0.01, op=0.8 F(1,34)=76.240, F(2,34)=22.908, p<0.01, op=0.84 F(1,21)=4.344, p<0.05, op=0.58 F(1,21)=66.726, p<0.01, op=0.86 F(1,21)=4.466, p<0.05, op=0.6 F(2,34)=6.013, p<0.01, op=0.83 F(1,34)=27.679, F(2,34)=7.341, p<0.01, op=0.9 F(1,21)=4.866, p<0.05, op=0.4 F(1,21)=23.874, F(1,21)=4.673, p<0.05, op=0.71 F(2,34)=9.935, p<0.01, op=0.97 F(1,34)=17.885, p<0.01, op=0.97 F(2,34)=7.572, p<0.01, op=0.8 F(1,21)=1.905, p>0.05, op=0.32 F(1,21)=18.403, F(1,21)=0.765, p>0.05, op=0.14 F(2,34)=3.695, p<0.05, op=0.6 F(1,34)=21.171, F(2,34)=4.511, p<0.05, op=0.7 F(1,21)=0.750, p>0.05, op=0.1 F(1,21)=21.855, p<0.01, op=0.83 F(1,21)=0.109, p>0.05, op=0.32 op observed power

5 Table 2 Isokinetic knee joint moment measurements Pre-training Post-training TxB group TxA group TxB group TxA group Right knee extensors at 60 /s (N m) 194±39 206±30 179±34 182±26 Right knee extensors at 180 /s (N m) 122±21 a 136±18 a 110±19 a 117±18 a Left knee extensors at 60 /s (N m) 195±41 216±33 179±35 195±32 Left knee extensors at 180 /s (N m) 123±20 a 139±20 a 109±21 a 114±17 a Right knee flexors at 60 /s (N m) 111±24 115±25 101±24 104±22 Right knee flexors at 180 /s (N m) 84±16 b 83±13 a 75±14 b 75±15 a Left knee flexors at 60 /s (N m) 107±26 114±21 97±24 101±19 Left knee flexors at 180 /s (N m) 77±23 b 80±18 a 69±21 b 70±19 a Data are presented as the mean ± SD (n=13 in each group) a Indicates lower joint moments (p<0.001) than at 60 /s (for any given leg and subject group pre-training and post-training) b Indicates lower joint moments (p<0.01) than at 60 /s (for any given leg and subject group pre-training and post-training) Table 3 Balance assessment T0 T12 Pre-training Post-training Pre-training Post-training TxB group TxA group C group TxB group TxA group TxB group TxA group C group TxB group TxA group Right leg Ii ( ) 7.7± ± ± ± ± ±1.9 a 4.9±1.9 a 7.4±2.2 b 5.1±1.9 a 4.9±1.9 a Board 1a (s) 2.8± ± ± ± ± ±3.8 a 13.0±6.1 a 2.9±1.1 b 9.3±3.5 a 13.1±6.2 a,c Board 1b (s) 2.6± ± ± ± ± ±7.7 a 19.9±9.6 a 4.0±1.2 b 16.0±10.0 a 18.1±20.6 a Board 2 (s) 4.3± ± ± ± ± ±1.8 a 7.5±1.5 a 4.1±2.4 b 7.5±1.8 a 7.9±1.5 a Left leg Ii ( ) 7.4± ± ± ± ± ±1.8 a 5.1±1.9 a 7.6±3.1 b 5.1±1.9 a 5.1±1.9 a Board 1a (s) 2.4± ± ± ± ± ±6.5 a 13.5±8.8 a 2.9± 0.9 b 9.4±5.0 a 13.7±8.4 a,c Board 1b (s) 2.9± ± ± ± ± ±8.7 a 17.5±9.8 a 4.1±1.8 b 14.0±9.1 a 20.7±28.7 a,c Board 2 (s) 4.3± ± ± ± ± ±1.8 a 7.5±1.5 a 3.3±0.6 b 7.5±1.8 a 7.9±1.4 a Data are presented as the mean ± SD (n=13 in each group) a Indicates p<0.01 between T0 and T12 (for any given leg) b Indicates p<0.05 between the C group and the TxB and TxA groups post-training (for any given leg) c Indicates p<0.05 between the TxB and TxA groups (for any given leg) of the players, indicating that the hypothesis for a link between fatigue-induced instability and high injury incidence in soccer may be unsustainable. However, balance exercises were effective in increasing the balance ability of the players, and the improvements were greater when the exercises were performed after soccer training. Therefore, it is advisable that balance exercises are performed by athletes following rather than before the sport-specific practice and training. References Arnold BL, Schmitz RJ (1998) Examination of balance measures produced by the Biodex Stability System. J Athl Train 33: Caraffa A, Cerulli G, Projetti M, Aisa G, Rizzo1 A (1996) Prevention of anterior cruciate ligament injuries in soccer. A prospective controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc 4:19 21 Chong RK, Ambrose A, Carzoli J, Hardison L, Jacobson B (2001) Source of improvement in balance control after a training program for ankle proprioception. Percept Mot Skills 92: Dvorak J (2000) Football injuries and physical symptoms. Am J Sports Med 28:S69 S74 Hagbarth KE, Macefield VG (1995) The fusimotor system. Its role in fatigue. Neurobiology of muscle fatigue. Advances and issues. In: Gandevia SC, Enoka RM, McComas AJ, Stuart DG, Thomas CK (eds) Fatigue. Neural and muscular mechanisms. Plenum, New York, pp Hawkins RD, Fuller CW (1996) Risk assessment in professional football: an examination of accidents and incidents in the 1994 World Cup finals. Br J Sports Med 30: Hawkins RD, Fuller CW (1999) A prospective epidemiological study of injuries in four English professional football clubs. Br J Sports Med 33: Hewett TE, Lindenfeld TN, Riccobene JV, Noyes FR (1999) The effect of neuromuscular training of the incidence of knee injury in female athletes. Am J Sports Med 27: Hiemstra LA, Lo IK, Fowler PJ (2001) Effect of fatigue on knee proprioception: implications for dynamic stabilization. J Orthop Sports Phys Ther 31: Hoy K, Lindblad BE, Terkelsen CJ, Helleland HE, Terkelsen CJ (1992) European soccer injuries. A prospective epidemiologic and socioeconomic study. Am J Sports Med 20: Inklaar H, Bol E, Schmikli SL, Mosterd WL (1996) Injuries in male soccer players: team risk analysis. Int J Sports Med 17: Johnson BG, Simmons J, Wright AD, Hillenbrand P, Beazley MF, Sutton I, Imray CHE, the Birmingham Medical Research

6 Expeditionary Society (2005) Ataxia at altitude measured on a wobble board. Wilderness Environ Med 16:42 46 Johnston RB, Howard ME, Cawley PW, Losse GM (1998) Effect of lower extremity muscular fatigue on motor control performance. Med Sci Sports Exerc 30: Junge A, Dvorak J (2004) Soccer injuries. A review on incidence and prevention. Sports Med 13: Lundin TM, Feuerbach JW, Grabiner MD (1993) Effect of plantar flexor and dorsiflexor fatigue on unilateral postural control. J Appl Biomech 9: Morgan B, Oberlander M (2001) An examination of injuries in major league soccer. Am J Sports Med 29: Nardone A, Tarantola J, Giordano A, Schieppati M (1997) Fatigue effects on body balance. Electroencephalogr Clin Neurophysiol/ Electromyogr Motor Control 105: Nelson DL, Hutton RS (1985) Dynamic and static stretch responses in muscle spindle receptors in fatigued muscles. Med Sci Sports Exerc 17: Paterno MV, Myer GD, Ford KR, Hewett TE (2004) Neuromuscular training improves single-limb stability in young female athletes. J Orthop Sports Phys Ther 34: Pincivero D, Lephart SM, Henry T (1995) Learning effects and reliability of the Biodex Stability System. J Athl Train 30:S35 Ranhama N, Reilly T, Lees A, Graham-Smith P (2003) Muscle fatigue induced by exercise simulating the work rate of competitive soccer. J Sports Sci 21: Rozzi SL, Lephart SM, Sterner R, Kuligowski L (1999) Balance training for persons with functionally unstable ankles. J Orthop Sports Phys Ther 29: Skinner HB, Wyatt MP, Hodgdon JA, Conard DW, Barrack RL (1986) Effect of fatigue on joint position sense of the knee. J Orthop Res 4: Testerman C, van der Griend R (1999) Evaluation of ankle stability using the Biodex Stability System. Ankle Foot Int 20: Vuillerme N, Forestier N, Nougier V (2002) Attentional demands and postural sway: the effect of the calf muscles fatigue. Med Sci Sports Exerc 34: Wedderkopp N, Kaltoft M, Lundgaard B, Rosendahl M, Froberg K (1999) Prevention of injuries in young female players in European team handball. A prospective intervention study. Scand J Med Sci Sports 9:41 47 Yaggie JA, McGregor SJ (2002) Effects of isokinetic ankle fatigue on the maintenance of balance and postural limits. Arch Phys Med Rehabil 83:

Effect of cold treatment on the concentric and eccentric torque-velocity relationship of the quadriceps femoris

Effect of cold treatment on the concentric and eccentric torque-velocity relationship of the quadriceps femoris By: Kerriann Catlaw *, Brent L. Arnold, and David H. Perrin Catlaw, K., Arnold, B.L., & Perrin,