Original Paperstrength test-retest reliability Hip muscle
DOI: 10.5604/20831862.1189202
Biol. Sport 2015;32:351-356
Reliability of concentric and eccentric strength of hip abductor and adductor muscles in young soccer players AUTHORS: Gerodimos V1, Karatrantou K1, Paschalis V1, Zafeiridis A2, Katsareli E3, Bilios P1, Kellis S3 1
epartment of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece D Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece 3 Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, Greece 2
Corresponding author: Vassilis Gerodimos Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece E-mail: [email protected]
ABSTRACT: The concentric and eccentric strength profile and muscular balance of the hip joint are important parameters for success in soccer. This study evaluated the reliability for the assessment of hip abduction and adduction isokinetic strength over a range of angular velocities (30 and 90°/s) and types of muscular actions (concentric and eccentric) in young soccer players. The reliability for the assessment of reciprocal (conventional and functional) and bilateral torque ratios was also examined. Fifteen male soccer players (15±1 years) performed two sessions, separated by three days. The testing protocol consisted of five maximal concentric and eccentric hip abductions and adductions of both legs at angular velocities of 30°/s and 90°/s. The peak torque was evaluated in young soccer players using an isokinetic dynamometer (Cybex Norm), and the reciprocal strength ratios (conventional and functional) and bilateral ratios (non-preferred to preferred leg ratios) were calculated. The test-retest reliability for the assessment of peak torque (ICC=0.71-0.92) and of reciprocal muscle group ratios (ICC=0.44-0.87) was found to be moderate to high. Bilateral torque ratios exhibited low to moderate reliability (ICC=0.11-0.64). In conclusion, isokinetic strength of hip abductor and adductor muscles and the conventional and functional strength ratios can be reliably assessed in young soccer players, especially at low angular velocities. The assessment, however, of bilateral strength ratios for hip abductor/adductor muscles should be interpreted with more caution. CITATION: Gerodimos V, Karatrantou K, Paschalis V et al. Reliability of concentric and eccentric strength of hip abductor and adductor muscles in young soccer players Biol Sport. 2015;32(4):351–356. Received: 2014-06-30; Reviewed: 2015-02-06; Re-submitted: 2015-02-09 ; Accepted:2015-02-27; Published: 2015-12-29.
Key words: isokinetic torque eccentric exercise reciprocal muscle group ratios groin injuries
INTRODUCTION Hip muscle strength is an important physical attribute in soccer for
reliability, however, of strength measurement could be influenced by
several fundamental skills such as kicking, accelerating and sudden
age [13,14]. Differences in motivation, learning effect, and the abil-
change of direction [1]. The intensive nature and increased physical
ity to focus on the task may account for these age-related differ-
demand of soccer may lead to a number of lower limb injuries [2,3],
ences in reliability [13,14].
with groin and hip [4,5] accounting for a great percentage (10-18%)
The only study [15] that has examined the reliability for hip ab-
of these injuries. Adductor-to-abductor strength imbalance was sug-
duction and adduction concentric strength assessment in youths was
gested to be among the main risk factors for adductor injuries and
performed in untrained children (6-10 years), reporting moderate
strain of the hip joint [6]. The evaluation, therefore, of strength of the
reliability (ICC=0.49-0.59). It is known, however, that the reliabil-
hip abductors and adductors and the calculation of reciprocal and
ity of strength measurements may vary when examining a population
bilateral torque ratios are often used in sports medicine to assess the
with different characteristics (e.g., untrained vs. trained) [13,16,17].
strength profile of the hip joint and to monitor potential groin- and
Specifically, there is evidence that training status may improve the
hip-related injuries [1,7,8].
test-retest reliability and increase testing accuracy [16]. The angular
Isokinetic dynamometers have been considered as simple, easily
velocity of movement and the type of muscle action (concentric vs.
applicable and reliable devices for assessing lower limb muscle
eccentric) may also affect the reliability of isokinetic strength mea-
strength (i.e. knee, ankle and hip) in sports and clinical settings [9,
surement [18]. The only study that has examined the reliability of
10,11]. Previous studies have found moderate to high reliability
isokinetic strength testing of the hip joint in children [15] was lim-
(ICC=0.56-0.90) of isokinetic devices in assessing concentric and
ited to an agonist muscle group using a concentric muscle action at
eccentric strength of hip abductor and adductor muscles in untrained
a single angular velocity. This is despite the fact that (i) the asym-
and physically active adults or in elite hockey players [7,8,12]. The
metry in strength properties of reciprocal and bilateral muscle group Biology
of
Sport, Vol. 32 No4, 2015
351
Gerodimos V et al. ratios is a contributory factor for muscle injury at the hip joint and
legs. The resistance pad was placed proximally to the knee over
(ii) eccentric muscle action is as important as concentric activation
one-half of the thigh. The axis of rotation of the dynamometer was
for performing different fundamental skills in soccer (i.e., kicking,
carefully aligned with the approximate hip joint axis of rotation
sudden change of direction, etc.) [19].
(greater trochanter of the hip) [8]. The non-tested leg was positioned
To the best of our knowledge, there are no reports on test-retest
at approximately 30° of hip flexion in order to avoid contact with the
reliability for the assessment of isokinetic strength profile of the hip
tested leg during adduction movements [8]. The set-up of the subject
joint over a range of muscle actions (concentric and eccentric) and
during testing is shown in the Figure 1.
angular velocities in young soccer players. The reliable evaluation of
After adopting the testing position, the participants performed 8
hip abduction and adduction muscle strength as well as of reciprocal
to 10 preliminary familiarization trials at very low intensity not ca-
and bilateral muscle group ratios in young soccer players is funda-
pable of inducing muscle fatigue. Next, the isokinetic peak torque of
mental for accurate monitoring of strength, training planning, and
hip abductor and adductor muscles was evaluated for two different
injury prevention/rehabilitation. Therefore, the aims of the present
types of muscle action (concentric and eccentric). Both concentric
investigation were to evaluate the test-retest reliability for assessment
and eccentric tests consisted of five continuous maximal hip abduc-
(i) of isokinetic (concentric and eccentric) peak torque of hip abduc-
tions and adductions (concentric or eccentric, according to the test)
tor and adductor muscles over a range of different angular velocities
at two different angular velocities (30°/s and 90°/s). The eccentric
(30 and 90°/s) and types of muscular contraction (concentric and
and concentric tests were performed separately in a randomized
eccentric), (ii) of conventional and functional reciprocal muscle group
order with five-minute rest interval between the muscle action tests
torque ratios at the hip joint and (iii) of bilateral ratios (non-preferred
(concentric and eccentric). A five-minute rest was given between the
to preferred leg ratios) in young soccer players.
angular velocity (30°/s and 90°/s) tests. The testing protocol was performed on both legs (preferred and non-preferred). Following the
MATERIALS AND METHODS
testing of one leg, there was a 10-minute rest prior to the initiation
Fifteen young elite male soccer players (age: 15.0±0.6 years; body
of testing of the other leg. The order of testing the “preferred” and
height: 172.53±6.83 cm; body mass: 63.62±6.39 kg; Tanner stage:
the “non-preferred” legs in test and retest sessions was randomized
3-4), members of the Greek Amateur Soccer Association, volunteered
to avoid cross-over effects. For all participants, the range of motion
to participate in the present study. The participants trained four to six
was set from -10° (full adduction) to 35° (full abduction). The mo-
times per week (4.87±0.64 days/week), for more than three years
ments were corrected for the effects of gravity, and the highest torque
(6.13±1.81 years). The research was conducted according to the
value of 5 attempts was used for the statistical analysis.
ethical standards of the Helsinki Declaration. Before the initiation of
For the maximization of the participant’s performance, standard-
the study, the institutional review board committee approved the
ized oral encouragement was given, while feedback for the exercise
experimental protocol and the parents of children signed an informed
intensity, total work production and duration was provided automat-
consent form. All children’s parents completed a physical activity
ically on the computer screen of the isokinetic dynamometer. The two
questionnaire, as modified by Bar-Or [20], and a medical history
testing sessions (test and retest) were performed at the same time of
form. All participants were healthy and had no previous injury of
day, 3 days apart. Participants were asked to follow their normal diet
lower limbs and no previous experience with isokinetic evaluation.
for 2 days before the study, to abstain from intense exercise activity
Three days before the initiation of the study the participants per-
for 48 h before the study, and to have sufficient rest the night before
formed a familiarization session to get acquainted with the isokinet-
the study. All measurements were performed at the same time of day
ic dynamometer. On the same day, the participants’ parents com-
to prevent potential confounding effects of daily biorhythms.
pleted a medical history form, the pubertal stage was determined according to pubic hair development [21], and the assessment of “leg preference” was performed by asking the participant “Which leg do you use to kick a ball?” Following the familiarization session, the participants reported to the laboratory on two separate occasions. Upon each visit, the participants performed a 10-min standardized warm-up that included 5 min of stationary cycling at 70 rpm (Monark, Vansbro, Sweden) and 5 min of dynamic stretching exercises of the evaluated muscle groups. The testing protocols were performed using an isokinetic dynamometer (Cybex Norm, Lumex Corporation, Ronkohoma, NY). The participants lay down on their side with the hip and knee of the tested leg extended and neutrally rotated. Velcro straps were used to stabilize the trunk, waist, and thighs of the tested and non-tested
352
FIG. 1. Position of the subject during the isokinetic evaluation.
Hip muscle strength test-retest reliability The parameters used for analysis were the peak torque (Nm), the reciprocal (conventional and functional), and the bilateral torque
tric torque of hip abductor and adductor muscles of the non-preferred leg by the respective measures of the preferred leg.
ratios (non-preferred to preferred leg ratios) [9,22,23]. Reciprocal
All data are presented as means±SD, and were analysed using
muscle group ratios (conventional and functional) of hip abductor to
SPSS 15.0 (Illinois, USA). Test-retest data were analysed using the
adductor muscles constitute a measure of hip joint stability and may
intraclass correlation coefficient (ICC) for single measures using a
provide information on hip function and injury risk. The hip abduc-
two-way random effect model of absolute agreement. We also as-
tion (HAB) to hip adduction (HAD) torque ratios during concentric
sessed the absolute reliability using the standard error of measurement
(CONHAB/CONHAD) or eccentric action (ECCHAB/ECCHAD), often referred
(SEM) and the 95% limits of agreement (LOA). The SEM was cal-
to as conventional ratios, are the two most common means to estimate
culated by means of the following equation: SEM=SD˙(1-ICC), where
the reciprocal muscle group torque ratios at the hip joint. However,
SD=the sample standard deviation and ICC=the calculated intraclass
several researchers have proposed the implementation of torque
correlation coefficient [24]. The LOA was calculated using the equa-
ratios more relevant to athletic performance to evaluate muscular
tion: LOA=inter-trial mean difference ± 1.96 SD of the inter-trial
balance, that is the eccentric to concentric actions of the antagonist
difference [24]. The presence of heteroscedasticity was tested using
muscles or vice versa (ECCHAB/CONHAD and CONHAB/ECCHAD), often
the Pearson correlation test to examine whether the absolute inter-
referred to as functional ratios. It has been suggested that the estima-
trial difference was associated with the magnitude of the measure-
tion of both conventional and functional strength ratios may provide
ment. All variables were found to be homoscedastic. Paired t-tests
a better and more complete profile of muscle balances or imbal-
were used to identify differences between test and retest values of
ances around a joint [10, 22, 23]. The reliability of measurements
the following parameters: (i) the isokinetic peak torque of hip abduc-
of bilateral torque ratios was also examined. The bilateral torque
tor and adductor muscles, (ii) the ratio for peak torques of non-
ratios were calculated by dividing the maximal concentric or eccen-
preferred to preferred leg and (iii) the ratio for peak torque of con-
TABLE 1. Test and retest values, and indices of relative and absolute reliability of peak torque of hip abductor and adductor muscles at different angular velocities and muscle actions. Variables
Test (Nm)
Retest (Nm)
95% CI Lower Upper
ICC
SEM (Nm)
Bias (Nm)
120.0 ± 27.3 120.0 ± 25.9
95% LOA (Nm) Lower Upper
118.5 ± 24.2 122.5 ± 26.1
-6.9 -13.7
9.9 8.7
0.85 0.73
9.6 12.5
-1.5 ± 14.5 2.5 ± 19.4
-30.0 -35.5
27.0 40.5
106.0 ± 23.0 106.6 ± 21.5
106.4 ± 22.8 103.7 ± 22.5
-6.0 -5.9
5.3 11.7
0.91 0.77
6.7 9.9
0.4 ± 9.9 -2.9 ± 15.2
-18.95 -32.7
19.7 27.0
121.7 ± 33.1 121.7 ± 26.2
127.3 ± 29.5 124.9 ± 27.1
-12.7 -15.1
1.5 0.3
0.91 0.71
9.2 13.2
5.6 ± 12.3 3.2 ± 20.6
-18.5 -37.1
29.7 43.5
117.6 ± 28.9 118.8 ± 24.1
123.4 ± 29.6 120.0 ± 28.0
-11.9 -11.7
0.3 9.3
0.92 0.77
8.1 11.7
5.8 ± 10.6 1.2 ± 18.2
-14.9 -34.4
26.5 36.8
100.5 ± 29.0 102.3 ± 24.3
107.2 ± 28.9 107.8 ± 27.4
-14.2 -13.6
0.8 2.6
0.88 0.84
9.8 10.0
6.7 ± 13.0 5.5 ± 14.1
-18.7 -22.1
32.1 33.1
85.1 ± 28.4 91.9 ± 25.1
94.5 ± 27.3 95.1 ± 24.9
-19.5 -13.5
0.6 6.9
0.77 0.76
12.7 11.5
9.4 ± 17.4 3.3 ± 17.7
-24.6 -31.4
43.5 38.0
111.96 ± 32.4 116.8 ± 29.1
119.7 ± 29.3 115.1 ± 26.9
-15.7 -10.4
0.03 13.7
0.88 0.74
10.4 13.3
7.9 ± 13.7 -1.6 ± 20.9
-18.9 -42.5
34.6 39.3
105.2 ± 25.5 110.7 ± 27.2
112.4 ± 25.4* 110.3 ± 25.7
-13.8 -9.7
0.6 10.5
0.87 0.79
9.0 11.4
7.2 ± 11.4 -0.4 ± 17.5
-15.1 -34.7
29.5 33.9
Abd Con
Ecc
Peak torque 30o/s Preferred leg Non-preferred leg Peak torque 90o/s Preferred leg Non-preferred leg Peak torque 30o/s Preferred leg Non-preferred leg Peak torque 90o/s Preferred leg Non-preferred leg
Add Con
Ecc
Peak torque 30o/s Preferred leg Non-preferred leg Peak torque 90o/s Preferred leg Non-preferred leg Peak torque 30o/s Preferred leg Non-preferred leg Peak torque 90o/s Preferred leg Non-preferred leg
Notes: Abd: abductors, Add: adductors, Con: concentric, Ecc: eccentric, 95% CI: 95% confidence interval of the difference, ICC: intraclass correlation coefficient, SEM: standard error of measurement, Bias: difference between test and retest (retest-test), 95% LOA: 95% limits of agreement. *p < 0.05 vs. test values, d (effect size between test and retest): 0.28 (small effect size).
Biology
of
Sport, Vol. 32 No4, 2015
353
Gerodimos V et al. ventional and functional muscle group ratios. The effect sizes were
d = 0.50, moderate effect size), and for functional ratios (CONHAB/
calculated using the following equation: d=difference between means/
ECCHAD) at 30°/s (p
DOI: 10.5604/20831862.1189202
Biol. Sport 2015;32:351-356
Reliability of concentric and eccentric strength of hip abductor and adductor muscles in young soccer players AUTHORS: Gerodimos V1, Karatrantou K1, Paschalis V1, Zafeiridis A2, Katsareli E3, Bilios P1, Kellis S3 1
epartment of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece D Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Greece 3 Department of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, Greece 2
Corresponding author: Vassilis Gerodimos Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece E-mail: [email protected]
ABSTRACT: The concentric and eccentric strength profile and muscular balance of the hip joint are important parameters for success in soccer. This study evaluated the reliability for the assessment of hip abduction and adduction isokinetic strength over a range of angular velocities (30 and 90°/s) and types of muscular actions (concentric and eccentric) in young soccer players. The reliability for the assessment of reciprocal (conventional and functional) and bilateral torque ratios was also examined. Fifteen male soccer players (15±1 years) performed two sessions, separated by three days. The testing protocol consisted of five maximal concentric and eccentric hip abductions and adductions of both legs at angular velocities of 30°/s and 90°/s. The peak torque was evaluated in young soccer players using an isokinetic dynamometer (Cybex Norm), and the reciprocal strength ratios (conventional and functional) and bilateral ratios (non-preferred to preferred leg ratios) were calculated. The test-retest reliability for the assessment of peak torque (ICC=0.71-0.92) and of reciprocal muscle group ratios (ICC=0.44-0.87) was found to be moderate to high. Bilateral torque ratios exhibited low to moderate reliability (ICC=0.11-0.64). In conclusion, isokinetic strength of hip abductor and adductor muscles and the conventional and functional strength ratios can be reliably assessed in young soccer players, especially at low angular velocities. The assessment, however, of bilateral strength ratios for hip abductor/adductor muscles should be interpreted with more caution. CITATION: Gerodimos V, Karatrantou K, Paschalis V et al. Reliability of concentric and eccentric strength of hip abductor and adductor muscles in young soccer players Biol Sport. 2015;32(4):351–356. Received: 2014-06-30; Reviewed: 2015-02-06; Re-submitted: 2015-02-09 ; Accepted:2015-02-27; Published: 2015-12-29.
Key words: isokinetic torque eccentric exercise reciprocal muscle group ratios groin injuries
INTRODUCTION Hip muscle strength is an important physical attribute in soccer for
reliability, however, of strength measurement could be influenced by
several fundamental skills such as kicking, accelerating and sudden
age [13,14]. Differences in motivation, learning effect, and the abil-
change of direction [1]. The intensive nature and increased physical
ity to focus on the task may account for these age-related differ-
demand of soccer may lead to a number of lower limb injuries [2,3],
ences in reliability [13,14].
with groin and hip [4,5] accounting for a great percentage (10-18%)
The only study [15] that has examined the reliability for hip ab-
of these injuries. Adductor-to-abductor strength imbalance was sug-
duction and adduction concentric strength assessment in youths was
gested to be among the main risk factors for adductor injuries and
performed in untrained children (6-10 years), reporting moderate
strain of the hip joint [6]. The evaluation, therefore, of strength of the
reliability (ICC=0.49-0.59). It is known, however, that the reliabil-
hip abductors and adductors and the calculation of reciprocal and
ity of strength measurements may vary when examining a population
bilateral torque ratios are often used in sports medicine to assess the
with different characteristics (e.g., untrained vs. trained) [13,16,17].
strength profile of the hip joint and to monitor potential groin- and
Specifically, there is evidence that training status may improve the
hip-related injuries [1,7,8].
test-retest reliability and increase testing accuracy [16]. The angular
Isokinetic dynamometers have been considered as simple, easily
velocity of movement and the type of muscle action (concentric vs.
applicable and reliable devices for assessing lower limb muscle
eccentric) may also affect the reliability of isokinetic strength mea-
strength (i.e. knee, ankle and hip) in sports and clinical settings [9,
surement [18]. The only study that has examined the reliability of
10,11]. Previous studies have found moderate to high reliability
isokinetic strength testing of the hip joint in children [15] was lim-
(ICC=0.56-0.90) of isokinetic devices in assessing concentric and
ited to an agonist muscle group using a concentric muscle action at
eccentric strength of hip abductor and adductor muscles in untrained
a single angular velocity. This is despite the fact that (i) the asym-
and physically active adults or in elite hockey players [7,8,12]. The
metry in strength properties of reciprocal and bilateral muscle group Biology
of
Sport, Vol. 32 No4, 2015
351
Gerodimos V et al. ratios is a contributory factor for muscle injury at the hip joint and
legs. The resistance pad was placed proximally to the knee over
(ii) eccentric muscle action is as important as concentric activation
one-half of the thigh. The axis of rotation of the dynamometer was
for performing different fundamental skills in soccer (i.e., kicking,
carefully aligned with the approximate hip joint axis of rotation
sudden change of direction, etc.) [19].
(greater trochanter of the hip) [8]. The non-tested leg was positioned
To the best of our knowledge, there are no reports on test-retest
at approximately 30° of hip flexion in order to avoid contact with the
reliability for the assessment of isokinetic strength profile of the hip
tested leg during adduction movements [8]. The set-up of the subject
joint over a range of muscle actions (concentric and eccentric) and
during testing is shown in the Figure 1.
angular velocities in young soccer players. The reliable evaluation of
After adopting the testing position, the participants performed 8
hip abduction and adduction muscle strength as well as of reciprocal
to 10 preliminary familiarization trials at very low intensity not ca-
and bilateral muscle group ratios in young soccer players is funda-
pable of inducing muscle fatigue. Next, the isokinetic peak torque of
mental for accurate monitoring of strength, training planning, and
hip abductor and adductor muscles was evaluated for two different
injury prevention/rehabilitation. Therefore, the aims of the present
types of muscle action (concentric and eccentric). Both concentric
investigation were to evaluate the test-retest reliability for assessment
and eccentric tests consisted of five continuous maximal hip abduc-
(i) of isokinetic (concentric and eccentric) peak torque of hip abduc-
tions and adductions (concentric or eccentric, according to the test)
tor and adductor muscles over a range of different angular velocities
at two different angular velocities (30°/s and 90°/s). The eccentric
(30 and 90°/s) and types of muscular contraction (concentric and
and concentric tests were performed separately in a randomized
eccentric), (ii) of conventional and functional reciprocal muscle group
order with five-minute rest interval between the muscle action tests
torque ratios at the hip joint and (iii) of bilateral ratios (non-preferred
(concentric and eccentric). A five-minute rest was given between the
to preferred leg ratios) in young soccer players.
angular velocity (30°/s and 90°/s) tests. The testing protocol was performed on both legs (preferred and non-preferred). Following the
MATERIALS AND METHODS
testing of one leg, there was a 10-minute rest prior to the initiation
Fifteen young elite male soccer players (age: 15.0±0.6 years; body
of testing of the other leg. The order of testing the “preferred” and
height: 172.53±6.83 cm; body mass: 63.62±6.39 kg; Tanner stage:
the “non-preferred” legs in test and retest sessions was randomized
3-4), members of the Greek Amateur Soccer Association, volunteered
to avoid cross-over effects. For all participants, the range of motion
to participate in the present study. The participants trained four to six
was set from -10° (full adduction) to 35° (full abduction). The mo-
times per week (4.87±0.64 days/week), for more than three years
ments were corrected for the effects of gravity, and the highest torque
(6.13±1.81 years). The research was conducted according to the
value of 5 attempts was used for the statistical analysis.
ethical standards of the Helsinki Declaration. Before the initiation of
For the maximization of the participant’s performance, standard-
the study, the institutional review board committee approved the
ized oral encouragement was given, while feedback for the exercise
experimental protocol and the parents of children signed an informed
intensity, total work production and duration was provided automat-
consent form. All children’s parents completed a physical activity
ically on the computer screen of the isokinetic dynamometer. The two
questionnaire, as modified by Bar-Or [20], and a medical history
testing sessions (test and retest) were performed at the same time of
form. All participants were healthy and had no previous injury of
day, 3 days apart. Participants were asked to follow their normal diet
lower limbs and no previous experience with isokinetic evaluation.
for 2 days before the study, to abstain from intense exercise activity
Three days before the initiation of the study the participants per-
for 48 h before the study, and to have sufficient rest the night before
formed a familiarization session to get acquainted with the isokinet-
the study. All measurements were performed at the same time of day
ic dynamometer. On the same day, the participants’ parents com-
to prevent potential confounding effects of daily biorhythms.
pleted a medical history form, the pubertal stage was determined according to pubic hair development [21], and the assessment of “leg preference” was performed by asking the participant “Which leg do you use to kick a ball?” Following the familiarization session, the participants reported to the laboratory on two separate occasions. Upon each visit, the participants performed a 10-min standardized warm-up that included 5 min of stationary cycling at 70 rpm (Monark, Vansbro, Sweden) and 5 min of dynamic stretching exercises of the evaluated muscle groups. The testing protocols were performed using an isokinetic dynamometer (Cybex Norm, Lumex Corporation, Ronkohoma, NY). The participants lay down on their side with the hip and knee of the tested leg extended and neutrally rotated. Velcro straps were used to stabilize the trunk, waist, and thighs of the tested and non-tested
352
FIG. 1. Position of the subject during the isokinetic evaluation.
Hip muscle strength test-retest reliability The parameters used for analysis were the peak torque (Nm), the reciprocal (conventional and functional), and the bilateral torque
tric torque of hip abductor and adductor muscles of the non-preferred leg by the respective measures of the preferred leg.
ratios (non-preferred to preferred leg ratios) [9,22,23]. Reciprocal
All data are presented as means±SD, and were analysed using
muscle group ratios (conventional and functional) of hip abductor to
SPSS 15.0 (Illinois, USA). Test-retest data were analysed using the
adductor muscles constitute a measure of hip joint stability and may
intraclass correlation coefficient (ICC) for single measures using a
provide information on hip function and injury risk. The hip abduc-
two-way random effect model of absolute agreement. We also as-
tion (HAB) to hip adduction (HAD) torque ratios during concentric
sessed the absolute reliability using the standard error of measurement
(CONHAB/CONHAD) or eccentric action (ECCHAB/ECCHAD), often referred
(SEM) and the 95% limits of agreement (LOA). The SEM was cal-
to as conventional ratios, are the two most common means to estimate
culated by means of the following equation: SEM=SD˙(1-ICC), where
the reciprocal muscle group torque ratios at the hip joint. However,
SD=the sample standard deviation and ICC=the calculated intraclass
several researchers have proposed the implementation of torque
correlation coefficient [24]. The LOA was calculated using the equa-
ratios more relevant to athletic performance to evaluate muscular
tion: LOA=inter-trial mean difference ± 1.96 SD of the inter-trial
balance, that is the eccentric to concentric actions of the antagonist
difference [24]. The presence of heteroscedasticity was tested using
muscles or vice versa (ECCHAB/CONHAD and CONHAB/ECCHAD), often
the Pearson correlation test to examine whether the absolute inter-
referred to as functional ratios. It has been suggested that the estima-
trial difference was associated with the magnitude of the measure-
tion of both conventional and functional strength ratios may provide
ment. All variables were found to be homoscedastic. Paired t-tests
a better and more complete profile of muscle balances or imbal-
were used to identify differences between test and retest values of
ances around a joint [10, 22, 23]. The reliability of measurements
the following parameters: (i) the isokinetic peak torque of hip abduc-
of bilateral torque ratios was also examined. The bilateral torque
tor and adductor muscles, (ii) the ratio for peak torques of non-
ratios were calculated by dividing the maximal concentric or eccen-
preferred to preferred leg and (iii) the ratio for peak torque of con-
TABLE 1. Test and retest values, and indices of relative and absolute reliability of peak torque of hip abductor and adductor muscles at different angular velocities and muscle actions. Variables
Test (Nm)
Retest (Nm)
95% CI Lower Upper
ICC
SEM (Nm)
Bias (Nm)
120.0 ± 27.3 120.0 ± 25.9
95% LOA (Nm) Lower Upper
118.5 ± 24.2 122.5 ± 26.1
-6.9 -13.7
9.9 8.7
0.85 0.73
9.6 12.5
-1.5 ± 14.5 2.5 ± 19.4
-30.0 -35.5
27.0 40.5
106.0 ± 23.0 106.6 ± 21.5
106.4 ± 22.8 103.7 ± 22.5
-6.0 -5.9
5.3 11.7
0.91 0.77
6.7 9.9
0.4 ± 9.9 -2.9 ± 15.2
-18.95 -32.7
19.7 27.0
121.7 ± 33.1 121.7 ± 26.2
127.3 ± 29.5 124.9 ± 27.1
-12.7 -15.1
1.5 0.3
0.91 0.71
9.2 13.2
5.6 ± 12.3 3.2 ± 20.6
-18.5 -37.1
29.7 43.5
117.6 ± 28.9 118.8 ± 24.1
123.4 ± 29.6 120.0 ± 28.0
-11.9 -11.7
0.3 9.3
0.92 0.77
8.1 11.7
5.8 ± 10.6 1.2 ± 18.2
-14.9 -34.4
26.5 36.8
100.5 ± 29.0 102.3 ± 24.3
107.2 ± 28.9 107.8 ± 27.4
-14.2 -13.6
0.8 2.6
0.88 0.84
9.8 10.0
6.7 ± 13.0 5.5 ± 14.1
-18.7 -22.1
32.1 33.1
85.1 ± 28.4 91.9 ± 25.1
94.5 ± 27.3 95.1 ± 24.9
-19.5 -13.5
0.6 6.9
0.77 0.76
12.7 11.5
9.4 ± 17.4 3.3 ± 17.7
-24.6 -31.4
43.5 38.0
111.96 ± 32.4 116.8 ± 29.1
119.7 ± 29.3 115.1 ± 26.9
-15.7 -10.4
0.03 13.7
0.88 0.74
10.4 13.3
7.9 ± 13.7 -1.6 ± 20.9
-18.9 -42.5
34.6 39.3
105.2 ± 25.5 110.7 ± 27.2
112.4 ± 25.4* 110.3 ± 25.7
-13.8 -9.7
0.6 10.5
0.87 0.79
9.0 11.4
7.2 ± 11.4 -0.4 ± 17.5
-15.1 -34.7
29.5 33.9
Abd Con
Ecc
Peak torque 30o/s Preferred leg Non-preferred leg Peak torque 90o/s Preferred leg Non-preferred leg Peak torque 30o/s Preferred leg Non-preferred leg Peak torque 90o/s Preferred leg Non-preferred leg
Add Con
Ecc
Peak torque 30o/s Preferred leg Non-preferred leg Peak torque 90o/s Preferred leg Non-preferred leg Peak torque 30o/s Preferred leg Non-preferred leg Peak torque 90o/s Preferred leg Non-preferred leg
Notes: Abd: abductors, Add: adductors, Con: concentric, Ecc: eccentric, 95% CI: 95% confidence interval of the difference, ICC: intraclass correlation coefficient, SEM: standard error of measurement, Bias: difference between test and retest (retest-test), 95% LOA: 95% limits of agreement. *p < 0.05 vs. test values, d (effect size between test and retest): 0.28 (small effect size).
Biology
of
Sport, Vol. 32 No4, 2015
353
Gerodimos V et al. ventional and functional muscle group ratios. The effect sizes were
d = 0.50, moderate effect size), and for functional ratios (CONHAB/
calculated using the following equation: d=difference between means/
ECCHAD) at 30°/s (p
