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Sports Medicine
Published in: Sports Medicine 9/2021

01-09-2021 | Systematic Review

Is Pre-season Eccentric Strength Testing During the Nordic Hamstring Exercise Associated with Future Hamstring Strain Injury? A Systematic Review and Meta-analysis

Authors: David A. Opar, Ryan G. Timmins, Fearghal P. Behan, Jack T. Hickey, Nicol van Dyk, Kara Price, Nirav Maniar

Published in: Sports Medicine | Issue 9/2021

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Abstract

Background

Interventions utilising the Nordic hamstring exercise (NHE) have resulted in reductions in the incidence of hamstring strain injury (HSI). Subsequently, quantifying eccentric knee flexor strength during performance of the NHE to identify an association with the occurrence of future HSI has become increasingly common; however, the data to date are equivocal.

Objective

To systematically review the association between pre-season eccentric knee flexor strength quantified during performance of the NHE and the occurrence of future HSI.

Design

Systematic review and meta-analysis.

Data sources

CINAHL, Cochrane Library, Medline Complete, Embase, Web of Science and SPORTDiscus databases were searched from January 2013 to January 10, 2020.

Eligibility criteria for selecting studies

Prospective cohort studies which assessed the association between pre-season eccentric knee flexor strength quantified during performance of the NHE and the occurrence of future HSI.

Methods

Following database search, article retrieval and title and abstract screening, articles were assessed for eligibility against pre-defined criteria then assessed for risk of bias. Meta-analysis was used to pool data across studies, with meta-regression utilised where possible.

Results

A total of six articles were included in the meta-analysis, encompassing 1100 participants. Comparison of eccentric knee flexor strength during performance of the NHE in 156 injured participants and the 944 uninjured participants revealed no significant differences, regardless of whether strength was expressed as absolute (N), relative to body mass (N kg−1) or between-limb asymmetry (%). Meta-regression analysis revealed that the observed effect sizes were generally not moderated by age, mass, height, strength, or sport played.

Conclusion

Eccentric knee flexor strength quantified during performance of the NHE during pre-season provides limited information about the occurrence of a future HSI.
Appendix
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Metadata
Title
Is Pre-season Eccentric Strength Testing During the Nordic Hamstring Exercise Associated with Future Hamstring Strain Injury? A Systematic Review and Meta-analysis
Authors
David A. Opar
Ryan G. Timmins
Fearghal P. Behan
Jack T. Hickey
Nicol van Dyk
Kara Price
Nirav Maniar
Publication date
01-09-2021
Publisher
Springer International Publishing
Published in
Sports Medicine / Issue 9/2021
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-021-01474-1

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