The effects of different rehabilitation training modalities on isokinetic muscle function and male athletes' psychological status after anterior cruciate ligament reconstructions.

BACKGROUND: Previously, researchers reported performance enhancements following long-term plyometric training in athletes with anterior cruciate ligament reconstruction (LCA). However, the effects of combined eccentric and plyometric training on measures of isokinetic strength and psychological statues in male athletes have not been examined yet. Knowledge on the effects of combined eccentric and plyometric training help to better plan and program rehabilitations sessions and thus return-to-sports. OBJECTIVE: This study sought to compare the effects of three different rehabilitation training programs, eccentric training (ECC), plyometric training (PLYO), or combined eccentric and plyometric training (COMB), on psychological measures (kinesiophobia [TSK-CF], functional knee assessment, knee injury and osteoarthritis outcome score [KOOS], international knee documentation committee 2000 questionnaire [IKDC], and knee flexor and extensor isokinetic muscle performance (peak torque [PT], total work, ratio [R-HQ], and ratio of total work [R-TW]) at different angular velocities post ACL surgery in male elite athletes. METHODS: Forty elite male athletes from different sports (e.g., athletics, team sports) with ACL reconstruction participated in this study. The study started after a 14-weeks post-surgery rehabilitation program, which was identical for all subjects. After this initial rehabilitation period, athletes were randomly assigned to three experimental groups, ECC (n = 10), PLYO (n = 10), and COMB (n = 10), and a control group (CON: n = 10). Testing was conducted pre- and post-the 6-weeks intervention period and included the TSK-CF, KOOS, and IKDC. Peak torque of the knee extensors/flexors was tested at 90, 180, 240 °/s, after the 6-weeks training program only. RESULTS: Participants' adherence rate was 100% across all groups and none reported any training or test-related injury. No significant between-group baseline differences (pre-6-weeks intervention) were observed for any of the reported psychological and muscle strength parameters. Significant group-by-time interactions were found for TSK-CF (p = 0.001, d = 2.85), KOOS (p = 0.001, d = 1.31), and IKDC (p = 0.001, d = 1.07). The post-hoc analyses indicated that COMB showed larger pre-post improvements for all psychological variables (p < 0.001, d = 2.95 to 13.15), compared with PLYO, ECC, and CON. Contrast analyses demonstrated that COMB yielded significantly greater improvements compared with CON, PLYO, ECC for all isokinetic parameters at all three angular velocities (all p < 0.001, d = 0.99 to 4.61). CONCLUSION: The results showed that COMB induced greater gains for measures of psychological status and isokinetic muscle strength compared with single-mode PLYO and ECC in elite male athletes during a post-surgery ACL rehabilitation period. Accordingly, it is recommended to implement COMB as an effective rehabilitation means to improve knee function in male elite athletes. TRIAL REGISTRATION: This study does not report results related to health care interventions using human participants and therefore it was not prospectively registered.

Association Between Mental Imagery and Change of Direction Performance in Young Elite Soccer Players of Different Maturity Status.

Previous studies have not considered the potential influence of maturity status on the relationship between mental imagery and change of direction (CoD) speed in youth soccer. Accordingly, this cross-sectional study examined the association between mental imagery and CoD performance in young elite soccer players of different maturity status. Forty young male soccer players, aged 10-17 years, were assigned into two groups according to their predicted age at peak height velocity (PHV) (Pre-PHV; n = 20 and Post-PHV; n = 20). Participants were evaluated on soccer-specific tests of CoD with (CoDBall-15m) and without (CoD-15m) the ball. Participants completed the movement imagery questionnaire (MIQ) with the three- dimensional structure, internal visual imagery (IVI), external visual imagery (EVI), as well as kinesthetic imagery (KI). The Post-PHV players achieved significantly better results than Pre-PHV in EVI (ES = 1.58, large; p < 0.001), CoD-15m (ES = 2.09, very large; p < 0.001) and CoDBall-15m (ES = 1.60, large; p < 0.001). Correlations were significantly different between maturity groups, where, for the pre-PHV group, a negative very large correlation was observed between CoDBall-15m and KI (r = -0.73, p = 0.001). For the post-PHV group, large negative correlations were observed between CoD-15m and IVI (r = -0.55, p = 0.011), EVI (r = -062, p = 0.003), and KI (r = -0.52, p = 0.020). A large negative correlation of CoDBall-15m with EVI (r = -0.55, p = 0.012) and very large correlation with KI (r = -0.79, p = 0.001) were also observed. This study provides evidence of the theoretical and practical use for the CoD tasks stimulus with imagery. We recommend that sport psychology specialists, coaches, and athletes integrated imagery for CoD tasks in pre-pubertal soccer players to further improve CoD related performance.

Improvement of Physical Performance Following a 6 Week Change-of-Direction Training Program in Elite Youth Soccer Players of Different Maturity Levels.

Background: Change-of-direction (CoD) is a necessary physical ability of a field sport and may vary in youth players according to their maturation status. Objectives: The aim of this study is: to compare the effectiveness of a 6-week CoD training intervention on dynamic balance (CS-YBT), horizontal jump (5JT), speed (10 and 30-m linear sprint times), CoD with (15 m-CoD + B) and without (15 m-CoD) the ball, in youth male soccer players at different levels of maturity [pre- and post-peak height velocity (PHV)]. Materials and Methods: Thirty elite male youth soccer players aged 10-17 years from the Tunisian first division participated in this study. The players were divided into pre- (G1, n = 15) and post-PHV (G2, n = 15) groups. Both groups completed a similar 6-week training program with two sessions per week of four CoD exercises. All players completed the following tests before and after intervention: CS-YBT; 5 JT; 10, 30, and 15 m-CoD; and 15 m-CoD + B, and data were analyzed using ANCOVA. Results: All 30 players completed the study according to the study design and methodology. Adherence rate was 100% across all groups, and no training or test-related injuries were reported. Pre-PHV and post-PHV groups showed significant amelioration post-intervention for all dependent variables (after test > before test; p < 0.01, d = 0.09-1.51). ANOVA revealed a significant group × time interaction only for CS-YBT (F = 4.45; p < 0.04; η2 = 0.14), 5JT (F = 6.39; p < 0.02; η2 = 0.18), and 15 m-CoD (F = 7.88; p < 0.01; η2 = 0.22). CS-YBT, 5JT, and 15 m-CoD improved significantly in the post-PHV group (+ 4.56%, effect size = 1.51; + 4.51%, effect size = 1.05; and -3.08%, effect size = 0.51, respectively), more than the pre-PHV group (+ 2.77%, effect size = 0.85; + 2.91%, effect size = 0.54; and -1.56%, effect size = 0.20, respectively). Conclusion: The CoD training program improved balance, horizontal jump, and CoD without the ball in male preadolescent and adolescent soccer players, and this improvement was greater in the post-PHV players. The maturity status of the athletes should be considered when programming CoD training for soccer players.

Change-of-Direction Performance in Elite Soccer Players: Preliminary Analysis According to Their Playing Positions.

Our objective was to examine the relationship between change of direction (CoD) performance, with (CoDb), and without the ball (CoDwb), and selected measures of physical fitness (jump performance, speed, balance) in elite soccer players, according to players' positions. Forty elite male soccer players performed the change-of-direction and acceleration test (CODAT) with (CODATb), and without the ball (CODATwb), 5- and 20-m sprint tests, the 5-jump test (5JT), and the Y-balance test (YBT). Analyses of the whole sample showed significant correlations between all CODAT measures (CODATwb and CODATb, respectively) and sprint 5-m (r = 0.72, p < 0.001; r = 0.52, p < 0.01), sprint 20-m (r = 0.54, p < 0.03; r = 0.45, p < 0.05), jump (r = -0.62, p < 0.01; r = -0.64, p < 0.01) and balance (r = -0.50, p < 0.01; r = -0.83, p < 0.001) performances. Correlations were significantly different between player positions (defender, midfielder and striker). When examining the entire sample, the single best predictor of CODATwb was performance in the 5-m test with an explained variance of 52% (p < 0.001). For CODATb, the Y-balance performance explained 68% of the variance of performance (p < 0.001). In conclusion, soccer coaches and fitness trainers are advised to improve players' CoD using neuromuscular training that mimic crucial match actions. Meanwhile, CoD testing and training should be designed in line with the demands of playing position.