Effect of Hamstring Viscoelasticity on Pain and Performance in Adolescent Elite Rowers

Sponsor

Istanbul Nisantasi University (Other)

Overall Status

Recruiting

CT.gov ID

NCT05939609

Collaborator

Bezmialem Vakif University (Other), Istanbul University - Cerrahpasa (IUC) (Other)

Enrollment

Location

Arms

Anticipated Duration (Months)

7.5

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Low back pain (LBP) is a prevalent issue among adolescent rowers, particularly males aged 14 to 16 years, with a high lifetime prevalence (94%) and point prevalence (65%). One of the mechanisms of lower back pain in rowing athletes is about the elasticity, stiffness and tone of the hamstring muscle.

Current literature shows that stretching exercises, strengthening exercises and kinesiotaping affects hamstring viscoelasticity in various ways. Stretching exercises affect hamstring muscle tone and elasticity, strengthening exercises affect muscle stiffness and kinesiotaping affects muscle tone. While the effects of each of these interventions on viscoelastic properties individually are examined in the literature, studies comparing the effects of changes in viscoelastic properties caused by these interventions on low back pain, athletic disability index and athletic performance in rowers and their superiority among each other are lacking.

The goal of this study is to change the viscoelasticity of the hamstring muscles and examine its effect on low back pain, disability index and athletic performance.

Condition or Disease	Intervention/Treatment	Phase
Low Back Pain Athletic Injuries	Other: Ballistic Stretching Exercise Other: Extender Exercise Other: Kinesiotaping	N/A

Detailed Description

Volunteer male elite rowing athletes between the ages of 14 and 18 who score 3/10 or higher on the Numeric Pain Rating Scale at the time of activity will be included in the study. Signed voluntary consent will be obtained from participants and their legal representatives. Participants will be divided into three groups. Study groups will be as follows: a) ballistic hamstring stretching exercise b) hamstring extender exercise c) kinesiotaping

Study Design

Study Type:

Interventional

Anticipated Enrollment :

60 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

Participants will be divided into three groups with equal numbers by computer randomization method.Participants will be divided into three groups with equal numbers by computer randomization method.

Masking:

Single (Outcomes Assessor)

Masking Description:

The investigator administering the treatment and the investigator performing the evaluations will be different. The evaluator will not know about the interventions that the participants received.

Primary Purpose:

Treatment

Official Title:

Effects of Changes in Hamstring Viscoelasticity in Adolescent Elite Rowers: Implications for Pain and Athletic Performance

Anticipated Study Start Date :

Aug 1, 2023

Anticipated Primary Completion Date :

Feb 1, 2024

Anticipated Study Completion Date :

Apr 1, 2024

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Ballistic Stretching Exercise Athletes will be asked to reach the floor by leaning over in the standing posture without knee flexion. When they feel the tension in hamstring muscle groups, athletes will be requested to make small rebounding motion at degrees between 3°-5° for half a minute.	Other: Ballistic Stretching Exercise It will be applied 4 times a week for 6 weeks and before starting on-water training.
Active Comparator: Extender Exercise Athletes will lie on his back. Then, athletes will be asked to do 90 degrees of knee and hip flexion at the same time. Finally, the athletes is expected to perform slow repetitive knee extension to the point of maximal possible extension. According to Askling et al. and Aspetar protocol, it will be applied 12 repetitions and 3 sets.	Other: Extender Exercise It will be applied 4 times a week for 6 weeks and before starting on-water training.
Active Comparator: Kinesiotaping Kinesio taping will be applied to the hamstring muscle in the direction of inhibition with a Y-shaped and 25% tension force.	Other: Kinesiotaping It will be applied 4 times a week for 6 weeks and before starting on-water training.

Arm

Intervention/Treatment

Active Comparator: Ballistic Stretching Exercise

Athletes will be asked to reach the floor by leaning over in the standing posture without knee flexion. When they feel the tension in hamstring muscle groups, athletes will be requested to make small rebounding motion at degrees between 3°-5° for half a minute.

Other: Ballistic Stretching Exercise

It will be applied 4 times a week for 6 weeks and before starting on-water training.

Active Comparator: Extender Exercise

Athletes will lie on his back. Then, athletes will be asked to do 90 degrees of knee and hip flexion at the same time. Finally, the athletes is expected to perform slow repetitive knee extension to the point of maximal possible extension. According to Askling et al. and Aspetar protocol, it will be applied 12 repetitions and 3 sets.

Other: Extender Exercise

It will be applied 4 times a week for 6 weeks and before starting on-water training.

Active Comparator: Kinesiotaping

Kinesio taping will be applied to the hamstring muscle in the direction of inhibition with a Y-shaped and 25% tension force.

Other: Kinesiotaping

It will be applied 4 times a week for 6 weeks and before starting on-water training.

Outcome Measures

Primary Outcome Measures

Frequency of Biceps Femoris Muscle [change from baseline frequency at 6 weeks]
The tones of muscle is described by frequency of muscle or oscillation frequency (Hz). It will be examined by the MyotonPro, Tallinn, Estonia.
Frequency of Semitendinosus Muscle [change from baseline frequency at 6 weeks]
The tones of muscle is described by frequency of muscle or oscillation frequency (Hz). It will be examined by the MyotonPro, Tallinn, Estonia.
Stiffness of Biceps Femoris Muscle [change from baseline stiffness at 6 weeks]
Stiffness of muscle is described by reaction to contraction or forces from outside of tissue that may cause the original form to deteriorate. It will be examined by the MyotonPro, Tallinn, Estonia.
Stiffness of Semitendinosus Muscle [change from baseline stiffness at 6 weeks]
Stiffness of muscle is described by reaction to contraction or forces from outside of tissue that may cause the original form to deteriorate. It will be examined by the MyotonPro, Tallinn, Estonia.
Decrement of Biceps Femoris Muscle [change from baseline decrement at 6 weeks]
The elasticity of a muscle is described by a logarithmic reduction of tissue's normal amplitude. It is more related with the dissipation of mechanical energy that arises between the deformation of the tissue and its recovery. It is a biomechanical feature of tissue that is called as elasticity. It will be examined by the MyotonPro, Tallinn, Estonia.
Decrement of Semitendinosus Muscle [change from baseline decrement at 6 weeks]
The elasticity of a muscle is described by a logarithmic reduction of tissue's normal amplitude. It is more related with the dissipation of mechanical energy that arises between the deformation of the tissue and its recovery. It is a biomechanical feature of tissue that is called as elasticity. It will be examined by the MyotonPro, Tallinn, Estonia.
Numeric Pain Rating Scale (NPRS) [change from baseline pain at the time of activity at 6 weeks]
The NPRS is a segmented numeric version of the visual analog scale (VAS) in which a respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain. The 11-point numeric scale ranges from '0' representing one pain extreme (e.g. "no pain") to '10' representing the other pain extreme (e.g. "pain as bad as you can imagine" or "worst pain imaginable").

Secondary Outcome Measures

Athletic Disability Index (ADI) [change from baseline disability level at 6 weeks]
The ADI is a self-administered questionnaire for assessing LBP-related disability in athletes. The ADI covers functional disabilities in sports and exercise activities in addition to disability in activities of daily living. The ADI contains 12 questions covering pain intensity, stretching exercises, strengthening/weight training exercises, sport-specific skills (technical skills), rotational back movements/ changing direction, fear of pain or (re)injury, sitting, walking, recreational activities, sexual activity, sleep, and self-care (being able to put on socks and shoes, and go to the restroom).
Standing Long Jump Test (SLJT) [change from baseline performance level at 6 weeks]
It is a horizontal jump test that measures anaerobic performance.
2K-rowing test [change from baseline performance time at 6 weeks]
It is an ergometer test that measures 2,000 meter rowing time as a gold standard.

Eligibility Criteria

Criteria

Ages Eligible for Study:

14 Years to 18 Years

Sexes Eligible for Study:

Male

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Being between ages 14 and 18 and male gender
Having been rowing at an elite level for at least one year with a professional team
Having pain 3/10 or higher on NPRS
Participating to the study in a voluntary basis.

Exclusion Criteria:

Having limitation in lower extremity range of motion that limits completion of interventions
Having a musculoskeletal injury involving the lower extremity in the last 6 months.
Having undergone a operation in the last 6 months.
Failing to complete any of interventions.
Wanting to quit from study.