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Hamstring InjuryNCT04668105

Dose Response of Nordic Hamstring Exercise on Performance in Athletes

A study testing High volume nordic hamstring exercise and Low volume nordic hamstring exercise in people with Hamstring Injury, run by Riphah International University at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this research is to compare the effects of dose response of Nordic hamstring exercise on muscle strength, agility and speed in athletes a randomized controlled trial done at JKD cricket academy and sports centre, Peshawar. The sample size was 34. Read more about this study

Who is it for?
Ages 18 to 30 years
Conditions the study is for
Hamstring Injury
What is being tested?
High volume nordic hamstring exercise and Low volume nordic hamstring exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
34 participants
Where
1 sitePakistan
Study dates
10 Aug 2020to 30 Jan 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 30 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Athletes participating in games for at least 06 months
  • BMI 18.5-24.5

Who cannot join

  • Have injuries (prior 6 months) or instability in knee
  • Have recently had knee or hip surgery
  • Are recovering from injury or surgery involving spine, or neck
  • Have ruptured or torn ligaments in knee or ankle, such as Achilles tendon.

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • JKD cricket academy and sports Centre,

    Peshawar, KPK, 25000

Other trials in Pakistan

About this study

Official title: Effects of Dose Response of Nordic Hamstring Exercise on Muscle Strength, Agility and Speed in Athletes

The aim of this research is to compare the effects of dose response of Nordic hamstring exercise on muscle strength, agility and speed in athletes a randomized controlled trial done at JKD cricket academy and sports centre, Peshawar. The sample size was 34. The subjects were divided in two groups, 17 subjects in Group 1 which will do high volume Nordic hamstring exercise and 17 in Group 2 which will do low volume Nordic hamstring exercise. Study duration was of 6 months. Sampling technique applied was non probability purposive sampling technique. Only 18-30 years athletes with BMI between 18.5-24.5 kg/m2 were included. Tools used in the study are Single leg hamstring bridge (SLHB), Agility t-test, 30-m speed test and muscles size .Data will be analyzed through SPSS 21.

Read the detailed description

One of the most common injury in sports is the Hamstring injury, as hamstring is very susceptible to tears and strains. Hamstring muscle strain-type injuries are common in sports that involve high degree of speed, power and agility such as sprinters, soccer, basketball, tennis and football. Occurring in both recreational and professional sports, these injuries can result in substantial time lost from sport and commonly recur.

When sprinting, the hamstring muscles of the swing leg function concentrically as hip extensors to quickly swing the thigh back, whereas the same muscle group acts eccentrically as knee flexors to decelerate the forward swing leg. This last action is a probable contributing injury mechanism because of the increased peak hamstring musculotendinous stretch, activation, and active lengthening contraction of the hamstring muscles. The Nordic Hamstring Exercise (NHE) was previously termed the 'Russian hamstring exercise'. This is a partner exercise which can be performed easily on the pitch without special equipment. The NHE involves the player attempting to resist a forward-falling motion from a kneeling position, eccentrically contracting hamstring muscles and thought to replicate hamstring function during terminal swing phase. NHE is a preventive strategy which may reduce the incidence of hamstring injury, medical costs, and personal suffering of the injured player keeping in view the training exposure, training intensity, and compliance to preventive measures. Programs that include the NHE reduce hamstring injuries by up to 51%. The NHE essentially halves the rate of hamstring injuries across multiple sports in different athletes. Even in the face of promising NHE preventive effect shown by previous studies,adoption and implementation of the NHE programs is still low. Evidence show improvement in performance, agility and speed in athletes by NHE training but lowest dose of NHE required to enhance athletes' performance , agility and speed is yet to be found. This study attempts to investigate the lowest dose response of NHE by comparing the effects of high volumes of NHE with low volumes of NHE.

Literature review: Mjølsnes et al first demonstrated that a NHE program performed on the training environment of professional soccer players is more effective in developing maximal eccentric hamstring strength than a comparable program based on hamstring curl machine at the fitness center.

Three large prospective trials (two randomized and one non-randomized) reduced injuries by approximately 70% by implementing the NHE in a team's training regime. The results from the meta-analysis suggested that teams using the NHE (in isolation or as part of a larger injury prevention program) reduced hamstring injury rates up to 51%.

Brooks et al studied the effects of the NHE on the incidence and severity of hamstring strains among 546 professional rugby union players. The NH exercise group had a significantly lower hamstring injury rate and severity than the strengthening and the stretching/ strengthening group.

In a 2020, meta-analyses, positive outcomes were reported on jump performance, repeated sprint ability and agility of athletes after NHE protocol.

A study conducted for 6 weeks concluded that NHE resulted in significant improvements in eccentric strength of hamstrings and performance in 10 m sprinters and also in change of direction speed immediately after the training protocol. These improvements remained even after 3 weeks of detraining.

In a study NHE has shown improvements in strength and dynamic control after 10 weeks of training, a reduction in the maximum peak torque (when approaching full knee extension), and a lower incidence rate of hamstring injuries in athletes.

Being tested
High volume nordic hamstring exercise, Low volume nordic hamstring exercise
Keywords
Agility t test, Eccentric strength, Hamstring injuries, Nordic Hamstring exercises, Single leg Hamstring bridges

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • High volume nordic hamstring exerciseOther

    To perform Nordic Hamstring Curls, the person will kneel on a pad (for knee comfort) and lower under control, his ankles must be stabilized and kept in a place with the help of a partner, but can also use a moveable object or a loaded barbell can also be used to achieve the stability. The person must then extend his hamstrings in order to lean forward, he should lean forward from the knee and not from the hip. The movement must be kept controlled and slow. The person should go as forward/low as possible but without the help of hands or arms. The only time one can put his hands in front of him is when he can't rely on his legs and then push himself back to starting position and then repeat the procedure again.Group 1 will do the Nordic hamstring exercise with protocol 3 repetitions × 3sets× 3 times for 4 weeks.

  • Low volume nordic hamstring exerciseOther

    To perform Nordic Hamstring Curls, the person will kneel on a pad (for knee comfort) and lower under control, his ankles must be stabilized and kept in a place with the help of a partner, but can also use a moveable object or a loaded barbell can also be used to achieve the stability. The person must then extend his hamstrings in order to lean forward, he should lean forward from the knee and not from the hip. The movement must be kept controlled and slow. The person should go as forward/low as possible but without the help of hands or arms. The only time one can put his hands in front of him is when he can't rely on his legs and then push himself back to starting position and then repeat the procedure again. Group 2 will do the Nordic hamstring exercise with protocol 3 repetitions × 3 sets × 1 times for 4 weeks.

Study groups in NCT04668105
Study groupRoleWhat they receive
High volume nordic hamstring exerciseExperimentalHigh volume Nordic hamstring exercise
Receives: Other: High volume nordic hamstring exercise
Low volume Nordic Hamstring exerciseExperimentalLow volume Nordic Hamstring exercise
Receives: Other: Low volume nordic hamstring exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Single leg hamstring bridge test

    Single leg hamstring bridge (SLHB) is a clinical test for hamstring function used at elite level for the screening programs. To perform this test, person lies on his back with bent knees, hip distance apart, and feet flat on mat stacked under the knees. Extend one leg long towards the ceiling. Squeeze glutes and lift hips off the mat into a bridge. Lower and lift the hips for desired number of repetitions and repeat on other side

    Measured: 4th week

Secondary outcomes (3)
  1. Agility t- test

    Agility T test is a running test of agility; it involves forward, lateral, and backward movements suitable for a wide range of sports. The subject starts at Cone A. On the command of the timer, the subject sprints to Cone B, and touches the base of the cone with their right hand. They then turn left and shuffle sideways to Cone C, and also touch its base, this time with their left hand. Then shuffling sideways to the right to Cone D and touching the base with their right hand. They then shuffle back to Cone B touching with the left hand, and run backwards to Cone A. The stop watch is stopped as they reach Cone A. We will perform this test for 3 times and will take the best time of the 3 trials.

    Measured: 4th week

  2. 30-m speed test

    30-m Speed test or Sprint test is performed. The time is recorded while the person performs one 30 meters maximum sprint. This test is used to measure the speed and acceleration.

    Measured: 4th week

  3. Muscle size

    Thigh circumference through anthropometric measuring tape to measure the size of hamstring. The tape will be placed at 5, 10 and 15 cm proximal to superior pole of patella.

    Measured: 4th week

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Dec 2020
  2. Study start10 Aug 2020
  3. Primary completion30 Dec 2020
  4. Study completion30 Jan 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
34 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04668105
Sponsor's protocol ID
REC/00789 SaeedUllah
Status last verified
Aug 2021
First submitted
9 Dec 2020
Last updated
27 Aug 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • van Dyk N, Behan FP, Whiteley R. Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes. Br J Sports Med. 2019 Nov;53(21):1362-1370. doi: 10.1136/bjsports-2018-100045. Epub 2019 Feb 26.

    PubMed 30808663
  • Goode AP, Reiman MP, Harris L, DeLisa L, Kauffman A, Beltramo D, Poole C, Ledbetter L, Taylor AB. Eccentric training for prevention of hamstring injuries may depend on intervention compliance: a systematic review and meta-analysis. Br J Sports Med. 2015 Mar;49(6):349-56. doi: 10.1136/bjsports-2014-093466. Epub 2014 Sep 16.

    PubMed 25227125
  • Al Attar WSA, Soomro N, Sinclair PJ, Pappas E, Sanders RH. Effect of Injury Prevention Programs that Include the Nordic Hamstring Exercise on Hamstring Injury Rates in Soccer Players: A Systematic Review and Meta-Analysis. Sports Med. 2017 May;47(5):907-916. doi: 10.1007/s40279-016-0638-2.

    PubMed 27752982
  • Jonhagen S, Nemeth G, Eriksson E. Hamstring injuries in sprinters. The role of concentric and eccentric hamstring muscle strength and flexibility. Am J Sports Med. 1994 Mar-Apr;22(2):262-6. doi: 10.1177/036354659402200218.

    PubMed 8198197
  • Mendiguchia J, Arcos AL, Garrues MA, Myer GD, Yanci J, Idoate F. The use of MRI to evaluate posterior thigh muscle activity and damage during nordic hamstring exercise. J Strength Cond Res. 2013 Dec;27(12):3426-35. doi: 10.1519/JSC.0b013e31828fd3e7.

    PubMed 23524362
  • van der Horst N, Smits DW, Petersen J, Goedhart EA, Backx FJ. The preventive effect of the nordic hamstring exercise on hamstring injuries in amateur soccer players: a randomized controlled trial. Am J Sports Med. 2015 Jun;43(6):1316-23. doi: 10.1177/0363546515574057. Epub 2015 Mar 20.

    PubMed 25794868
  • Krist MR, van Beijsterveldt AM, Backx FJ, de Wit GA. Preventive exercises reduced injury-related costs among adult male amateur soccer players: a cluster-randomised trial. J Physiother. 2013 Mar;59(1):15-23. doi: 10.1016/S1836-9553(13)70142-5.

    PubMed 23419911
  • Junge A, Lamprecht M, Stamm H, Hasler H, Bizzini M, Tschopp M, Reuter H, Wyss H, Chilvers C, Dvorak J. Countrywide campaign to prevent soccer injuries in Swiss amateur players. Am J Sports Med. 2011 Jan;39(1):57-63. doi: 10.1177/0363546510377424. Epub 2010 Oct 17.

    PubMed 20956263
  • Petersen J, Thorborg K, Nielsen MB, Budtz-Jorgensen E, Holmich P. Preventive effect of eccentric training on acute hamstring injuries in men's soccer: a cluster-randomized controlled trial. Am J Sports Med. 2011 Nov;39(11):2296-303. doi: 10.1177/0363546511419277. Epub 2011 Aug 8.

    PubMed 21825112
  • Ribeiro-Alvares JB, Marques VB, Vaz MA, Baroni BM. Four Weeks of Nordic Hamstring Exercise Reduce Muscle Injury Risk Factors in Young Adults. J Strength Cond Res. 2018 May;32(5):1254-1262. doi: 10.1519/JSC.0000000000001975.

    PubMed 28459795

Questions about this trial

What is this clinical trial studying?

A study testing High volume nordic hamstring exercise and Low volume nordic hamstring exercise in people with Hamstring Injury, run by Riphah International University at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 27 Aug 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Single leg hamstring bridge test (time frame: 4th week). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04668105, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Aug 2021.

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