Abstract
Modifiable risk factors for hamstring injury include lack of strength, fatigue and muscle strength asymmetry. Assessing lower body strength in the field is problematic as “gold standard assessment” are expensive, non-portable and assessment is time-consuming. Therefore, the objective of this study was to examine the validity and reliability of an adapted aneroid sphygmomanometer test of hamstring and quadricep strength. In 14 active males (age 23.1 ± 2.5 years; height 180.9 ± 8.2 cm; weight 88.4 ± 8.5 kg). concurrent validity was assessed by comparing the adapted sphygmomanometer assessment at 30 and 90° of knee flexion to isokinetic dynamometry using Pearson product-moment correlation. The reliability of the adapted sphygmomanometer was assessed in 10 professional rugby players (age 21.5 ± 2.6 years; height 177.2 ± 5.8 cm; weight 92.7 ± 5.8 kg ) across two visits. Sphygmomanometer strength assessments of hamstring and quadriceps were associated with isokinetic measures (Quadricep: right, r = 0.386, 95% CI = 0.136–0.866, p < 0.05; left, r = 0.431, 95% CI = 0.193–0.880, p < 0.05), hamstring strength at 90° of knee flexion (Hamstring: right, r = 0.545, 95% CI = 0.342–0.912, p < 0.01; left, r = 0.643, 95% CI = 0.473–0.935, p < 0.001) and hamstring strength at 30° of knee flexion (right, r = 0.329, 95% CI = 0.062–0.846, p < 0.05; left, r = 0.387, 95% CI = 0.138–0.867, p < 0.05). However, the adapted test was not able to identify bilateral or hamstring to quadricep asymmetry. Test–retest reliability was high for most assessments (ICC range: 0.64–0.92), and SEM measures ranged between 5 and 12%, with the smallest change representing a change in strength ranging between 3 and 4%. In conclusion, an adapted sphygmomanometer test for hamstring and quadricep strength assessment was valid and reliable in assessing hamstring and quadricep strength but not bilateral or hamstring and quadricep asymmetry.
Highlights
Hamstring strains are one of the most frequent non-contact injuries in sport, especially in those that involve repetitive bouts of maximal sprinting (Schache et al, 2011)
For the remaining dataset there was a positive correlation between the isokinetic dynamometer and adapted sphygmomanometer for the measurement of quadricep strength at 90◦ of knee flexion (Quadricep: right, r = 0.386, 95% confidence intervals (CI) = 0.136–0.866, p < 0.05; left, r = 0.431, 95% CI = 0.193–0.880, p < 0.05), hamstring strength at 90◦ of knee flexion (Hamstring: right, r = 0.545, 95% CI = 0.342–0.912, p < 0.01; left, r = 0.643, 95% CI = 0.473–0.935, p < 0.001) and hamstring strength at 30◦ of knee flexion
When analyzing the efficacy of the adapted sphygmomanometer test to detect strength asymmetries between dominant and nondominant legs, no relationship was found between tests at either 30 or 90◦ of knee flexion compared with isokinetic assessments
Summary
Hamstring strains are one of the most frequent non-contact injuries in sport, especially in those that involve repetitive bouts of maximal sprinting (Schache et al, 2011). Whereas modifiable risk factors of hamstring injury include, lack of hamstring strength, hamstring fatigue, strength asymmetries between quadricep and hamstring, and between left and right legs (Croisier et al, 2002; McCall et al, 2014, 2015). Tests that are appropriate to the applied setting include; measures of eccentric bilateral strength such as the nordic hamstring test and assessments of explosive strength such as vertical jump testing. These tests are reliable, there is an increased risk of injury with eccentric loading (Brown and Weir, 2001; McCall et al, 2015). One repetition maximum (1 RM) tests represent a valid means to evaluate leg strength but precludes the assessment of specific muscle imbalances or bilateral asymmetry (Verdijk et al, 2009)
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