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The Journal of Sports Medicine and Physical Fitness 2021 May 10

DOI: 10.23736/S0022-4707.21.12370-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Quadriceps strength asymmetry as predictor of ankle sprain in male volleyball players

Vedran HADZIC 1 , Tine SATTLER 1, Primož PORI 1, Matjaž VESELKO 2, Edvin DERVIŠEVIĆ 1, Nejc ŠARABON 3, 4, Goran MARKOVIĆ 1, 5

1 Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia; 2 Department of Traumatology, University Clinical Centre Ljubljana, Ljubljana, Slovenia; 3 Faculty of Health Sciences, University of Primorska, Koper, Slovenia; 4 S2P, Science to Practice, Ltd., Laboratory for Motor Control and Motor Behaviour, Ljubljana, Slovenia; 5 Faculty of Kinesiology, University in Zagreb, Zagreb, Croatia


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BACKGROUND: Ankle sprain is the most common acute time-loss injury in volleyball and occurs mainly during landing from a jump. Therefore we have evaluated the role of quadriceps strength and countermovement jump height on ankle sprain occurrence, as these intrinsic modifiable risk factors were not yet evaluated. We have also hypothesised that presence of quadriceps strength asymmetry could be a possible risk factor for ankle sprains in male volleyball players.
METHODS: This was a prospective cohort study. Male volleyball players (N = 99) from Slovenian national league participated in the study. Before the start of the season, all participants completed a preseason questionnaire and underwent evaluation of vertical jump performance and bilateral isokinetic strength of the quadriceps (Q) and hamstrings (H). During the subsequent season the players reported acute time loss injuries because of ankle sprain through a weekly questionnaire.
RESULTS: We have registered 19 ankle sprains during the season. Overall ankle sprain incidence was 0.41±0.24 per 1000 h. Previous ankle sprain (odd ratio 0.86; 95% CI 0.25 - 2.89, p = 0.802) and jump height (1.05; 95% C.I. 0.94 - 1.19, p = 0.393) were not significant risk factors, while Q strength asymmetry was a significant predictor of an ankle sprain (odd ratio 0.956; 95% CI 0.919-0.995, p = 0.026). Compared with the uninjured players, the injured players had higher right concentric Q strength, higher Q strength asymmetry, and lower concentric right H-Q strength ratio (all p<0.03).
CONCLUSIONS: Our results suggest that excessive concentric strength of the right Q, which leads to low H-Q strength ratio, and high bilateral Q strength asymmetry in favor of the right side, could be associated with increased risk of ankle sprains in male volleyball.


KEY WORDS: Isokinetic; Strength asymmetry; Injury prevention; Risk factors

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