Reliability, Validity, and Sensitivity of a Novel Smartphone-Based Eccentric Hamstring Strength Test in Professional Football Players

in International Journal of Sports Physiology and Performance
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Purpose: To evaluate the test–retest reliability, sensitivity, and concurrent validity of a smartphone-based method for assessing eccentric hamstring strength among male professional football players. Methods: A total of 25 healthy male professional football players performed the Chinese University of Hong Kong (CUHK) Nordic break-point test, hamstring fatigue protocol, and isokinetic hamstring strength test. The CUHK Nordic break-point test is based on a Nordic hamstring exercise. The Nordic break-point angle was defined as the maximum point where the participant could no longer support the weight of his body against gravity. The criterion for the sensitivity test was the presprinting and postsprinting difference of the Nordic break-point angle with a hamstring fatigue protocol. The hamstring fatigue protocol consists of 12 repetitions of the 30-m sprint with 30-s recoveries between sprints. Hamstring peak torque of the isokinetic hamstring strength test was used as the criterion for validity. Results: A high test–retest reliability (intraclass correlation coefficient = .94; 95% confidence interval, .82–.98) was found in the Nordic break-point angle measurements. The Nordic break-point angle significantly correlated with isokinetic hamstring peak torques at eccentric action of 30°/s (r = .88, r2 = .77, P < .001). The minimal detectable difference was 8.03°. The sensitivity of the measure was good enough that a significance difference (effect size = 0.70, P < .001) was found between presprinting and postsprinting values. Conclusion: The CUHK Nordic break-point test is a simple, portable, quick smartphone-based method to provide reliable and accurate eccentric hamstring strength measures among male professional football players.

The authors are with the Dept of Orthopaedics & Traumatology, Faculty of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.

Lee (justinlee@ort.cuhk.edu.hk) is corresponding author.
  • 1.

    Ekstrand J, Hägglund M, Waldén M. Epidemiology of muscle injuries in professional football (soccer). Am J Sports Med. 2011;39(6):1226–1232. PubMed doi:10.1177/0363546510395879

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Lee JWY, Mok KM, Chan HCK, Yung PSH, Chan KM. A prospective epidemiological study of injury incidence and injury patterns in a Hong Kong male professional football league during the competitive season. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2014;1(4):119–125.

    • Search Google Scholar
    • Export Citation
  • 3.

    Croisier JL, Ganteaume S, Binet J, Genty M, Ferret JM. Strength imbalances and prevention of hamstring injury in professional soccer players. Am J Sports Med. 2008;36(8):1469–1475. PubMed doi:10.1177/0363546508316764

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    van Dyk N, Bahr R, Whiteley R, et al. Hamstring and quadriceps isokinetic strength deficits are weak risk factors for hamstring strain injuries: a 4-year cohort study. Am J Sports Med. 2016;44(7):1789–1795. PubMed doi:10.1177/0363546516632526

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Freckleton G, Cook J, Pizzari T. The predictive validity of a single leg bridge test for hamstring injuries in Australian Rules Football Players. Br J Sports Med. 2013;48(8):713–717. PubMed doi:10.1136/bjsports-2013-092356

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Opar DA, Williams MD, Timmins RG, Hickey J, Duhig SJ, Shield AJ. Eccentric hamstring strength and hamstring injury risk in Australian footballers. Med Sci Sports Exerc. 2014;47(4):857–865. doi:10.1249/MSS.0000000000000465

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Petersen J, Thorborg K, Nielsen MB, Budtz-Jørgensen E, Hölmich P. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer: a cluster-randomized controlled trial. Am J Sports Med. 2011;39(11):2296–2303. PubMed doi:10.1177/0363546511419277

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Arnason A, Andersen TE, Holme I, Engebretsen L, Bahr R. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports. 2008;18(1):40–48. PubMed doi:10.1111/j.1600-0838.2006.00634.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Yeung SS, Suen AMY, Yeung EW. A prospective cohort study of hamstring injuries in competitive sprinters: preseason muscle imbalance as a possible risk factor. Br J Sports Med. 2009;43(8):589–594. PubMed doi:10.1136/bjsm.2008.056283

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Whiteley R, Jacobsen P, Prior S, Skazalski C, Otten R, Johnson A. Correlation of isokinetic and novel hand-held dynamometry measures of knee flexion and extension strength testing. J Sci Med Sport. 2012;15(5):444–450. PubMed doi:10.1016/j.jsams.2012.01.003

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Opar DA, Piatkowski T, Williams MD, Shield AJ. A novel device using the Nordic hamstring exercise to assess eccentric knee flexor strength: a reliability and retrospective injury study. J Orthop Sports Phys Ther. 2013;43(9):636–640. PubMed doi:10.2519/jospt.2013.4837

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    McCall A, Nedelec M, Carling C, Le Gall F, Berthoin S, Dupont G. Reliability and sensitivity of a simple isometric posterior lower limb muscle test in professional football players. J Sport Sci. 2015;33(12):1298–1304. doi:10.1080/02640414.2015.1022579

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Wollin M, Purdam C, Drew MK. Reliability of externally fixed dynamometry hamstring strength testing in elite youth football players. J Sci Med Sport. 2016;19(1):93–96. PubMed doi:10.1016/j.jsams.2015.01.012

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Stark T, Walker B, Phillips JK, Fejer R, Beck R. Hand-held dynamometry correlation with the gold standard isokinetic dynamometry: a systematic review. PM&R. 2011;3(5):472–479. doi:10.1016/j.pmrj.2010.10.025

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Sconce E, Jones P, Turner E, Comfort P, Graham-Smith P. The validity of the Nordic hamstring lower as a field-based assessment of eccentric hamstring strength. J Sport Rehabil. 2015;24(1):13–20. PubMed doi:10.1123/jsr.2013-0097

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2014 update. Int J Sports Med. 2013;34(12):1025–1028. PubMed doi:10.1055/s-0033-1358756

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Lee JWY, Li C, Yung PSH, Chan KM. The reliability and validity of a video-based method for assessing hamstring strength in football players. J Exerc Sci Fitness. 2017;15(1):18–21. doi:10.1016/j.jesf.2017.04.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Wiemann K, Tidow G. Relative activity of hip and knee extensors in sprinting-implications for training. New Stud Athl. 1995;10:29–49.

  • 19.

    Glaister M, Howatson G, Pattison JR, McInnes G. The reliability and validity of fatigue measures during multiple-sprint work: an issue revisited. J Strength Cond Res. 2008;22(5):1597–1601. PubMed doi:10.1519/JSC.0b013e318181ab80

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Perrey S, Racinais S, Saimouaa K, Girard O. Neural and muscular adjustments following repeated running sprints. Eur J Sport Sci. 2010;109(6):1027–1036. PubMed doi:10.1007/s00421-010-1445-3

    • Search Google Scholar
    • Export Citation
  • 21.

    Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005;19(1):231–240. PubMed

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Vincent WJ. Statistics in Kinesiology. 3rd ed. Champaign, IL: Human Kinetics; 2005.

  • 23.

    Hopkins W, Marshall S, Batterham A, Hanin J. Progressive statistics for studies in sports medicine and exercise science. Med Sci Sports Exerc. 2009;41(1):3–13. PubMed doi:10.1249/MSS.0b013e31818cb278

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale, NJ: Erlbaum Associates; 1988.

  • 25.

    Timmins RG, Opar DA, Williams MD, Schache AG, Dear NM, Shield AJ. Reduced biceps femoris myoelectrical activity influences eccentric knee flexor weakness after repeat sprint running. Scand J Med Sci Sports. 2014;24(4):299–305. doi:10.1111/sms.12171

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Greig M. The influence of soccer-specific fatigue on peak isokinetic torque production of the knee flexors and extensors. Am J Sports Med. 2008;36(7):1403–1409. PubMed doi:10.1177/0363546508314413

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Small K, McNaughton LR, Greig M, Lohkamp M, Lovell R. Soccer fatigue, sprinting and hamstring injury risk. Int J Sports Med. 2009;30(8):573–578. PubMed doi:10.1055/s-0029-1202822

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Small K, McNaughton L, Greig M, Lovell R. The effects of multidirectional soccer-specific fatigue on markers of hamstring injury risk. J Sci Med Sport. 2010;13(1):120–125. PubMed doi:10.1016/j.jsams.2008.08.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Sugiura Y, Saito T, Sakuraba K, Sakuma K, Suzuki E. Strength deficits identified with concentric action of the hip extensors and eccentric action of the hamstrings predispose to hamstring injury in elite sprinters. J Orthop Sports Phys Ther. 2008;38(8):457–464. PubMed doi:10.2519/jospt.2008.2575

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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