The aim of this study was to compare isokinetic strength performance profiles in elite soccer players across different field positions. A total of 111 elite international players of Polish Ekstraklasa (the top division in Poland) were examined during the 2010–2015 seasons. The players were classified into six positional roles: central defenders (CD), external defenders (ED), central midfielders (CM), external midfielders (EM), forwards (F), and goalkeepers (G). The concentric isokinetic strength (peak torque [PT] of quadriceps and hamstrings, H/Q ratios) was calculated for the dominant leg and the non-dominant leg at angular velocity of 1.05 rad ·s^–1, whereas to assess isokinetic muscle endurance, the total work [TW] at angular velocity of 4.19 rad ·s^–1, was taken into consideration. The results showed that isokinetic strength performance varies significantly among players in different playing positions. The analysis of PT for quadriceps (PT-Q) and hamstrings (PT-H) generally showed that the goalkeepers and central midfielders had lower strength levels compared to other playing positions. In the case of PT-H and hamstring/quadricep (H/Q) peak torque ratios, statistically significant differences were also noted for the legs, where mean values noted for the dominant leg were higher than for the non-dominant leg. For TW for quadriceps (TW-Q) and hamstrings (TW-H), statistically significant differences were noted only between playing positions. TW-Q values for goalkeepers were lower than for central defenders and external midfielders. TW-H values for goalkeepers were lower than for central midfielders, central defenders and external midfielders. This study showed that specific functional activity of players in individual positions on the field influences the varied profile of isokinetic strength performance.

Jadczak, Ł, Grygorowicz, M, Dzudziński, W, and Śliwowski, R. Comparison of static and dynamic balance at different levels of sport competition in professional and junior elite soccer players. J Strength Cond Res 33(12): 3384–3391, 2019—The purpose of this study was to compare body balance control and balance recovery strategies of professional football players, representing various sports levels in static (eyes open, eyes closed) and dynamic conditions, both on the dominant and nondominant leg. Three groups of professional and junior elite soccer players were investigated: a PRO group (n = 52), a U-21 group (n = 55), and a U-19 group (n = 47). The study of body balance control was performed using a Delos Postural Proprioceptive System measurement tool. The analysis of the results showed an effect of group (p < 0.01) and leg significance (p < 0.95) in the dynamic test. Three-way analysis of variance (3 [group] × 2 [leg] × 2 [eyes]) of static test data showed that the main effect of eyes (p < 0.0001), group (p < 0.0001), and leg (p = 0.0092) and the 2-way interaction of eyes × group (p = 0.0003) were significant. To represent statistical significance, the cutoff value was set to be p ≤ 0.005 for all measures. Our results indicate the importance of evaluation and monitoring of dynamic and static balance on both legs, which allows for a comprehensive comparison of body balance control and the balance recovery strategy depending on the represented sport level. Our study indicates that the higher the sport level of football players (the PRO group), the better their balance, which may indirectly contribute to the prevention of injuries and more effective performance of any actions directly related to the game.

Objective: To collect and analyze the 2-year follow-up clinical and MRI results of patients treated with an arthroscopic technique of collagen membrane-based meniscus repair. Design: 53 consecutive patients with combined (horizontal and radial or longitudinal component) and complex meniscal tears (tear extended through avascular zones or/and composed with two or more morphological tear pattern) were treated with an “all-inside” arthroscopic suture of meniscus and wrapping with a collagen membrane (Chondro-Gide) technique with bone marrow blood injection. The IKDC 2000 subjective score, IKDC 2000 clinical evaluation score, Lysholm score and Barret clinical criteria of meniscal healing were recorded. All patients were examinated by MRI 2 years postoperatively, using modified WORMS criteria for meniscal integrity. Results: The 2 year follow-up was achieved in 50 cases. Of these, 2 patients were excluded from the evaluation due to incomplete data and 2 patients underwent partial meniscectomy and were classified as failures. In 46 patients (86.8% of the intended to treat cases), a statistically significant improvement in IKDC 2000 subjective, Lysholm scores and IKDC 2000 clinical assessment between preoperative and the 2-year follow-up time points were obsereved. Barret criteria demonstrated an improved clinical outcome between pre- and post-operative values. MRI revealed a non-homogeneous signal without meniscal tear (WORMS grade 1) in 76% of the operated menisci (13% WORMS grade 2). Conclusions: The 2-year follow-up data demonstrate that this technique is safe and can offer an additional tool to save the meniscus in the patients otherwise scheduled for meniscal removal. Level of evidence IV

To measure the sensitivity and specificity of differences cut-off values for isokinetic H_con/Q_con ratio in order to improve the capacity to evaluate (retrospectively) the injury of hamstring muscles in professional soccer screened with knee isokinetic tests. Retrospective study. Medical and biomechanical data of professional football players playing for the same team for at least one season between 2010 and 2016 were analysed. Hamstring strain injury cases and the reports generated via isokinetic testing were investigated. Isokinetic concentric(con) hamstring(H) and quadriceps(Q) absolute strength in addition with H_con/Q_con ratio were examined for the injured versus uninjured limbs among injured players, and for the injured and non-injured players. 2 x 2 contingency table was used for comparing variables: predicted injured or predicted uninjured with actual injured or actual uninjured. Sensitivity, specificity, accuracy, positive and negative predictive values, and positive and negative likelihood ratio were calculated for three different cut-off values (0.47 vs. 0.6 vs. 0.658) to compare the discriminative power of an isokinetic test, whilst examining the key value of H_con/Q_con ratio which may indicate the highest level of ability to predispose a player to injury. McNemar’s chi² test with Yates’s correction was used to determine agreement between the tests. PQStat software was used for all statistical analysis, and an alpha level of p <0.05 was used for all statistical comparisons. 340 isokinetic test reports on both limbs of 66 professional soccer players were analysed. Eleven players suffered hamstring injuries during the analysed period. None of these players sustained recurrence of hamstring injury. One player sustained hamstring strain injury on both legs, thus the total number of injuries was 12. Application of different cut-off values for H_con/Q_con significantly affected the sensitivity and specificity of isokinetic test used as a tool for muscle injury detection. The use of 0.47 of H_con/Q_con as a discriminate value resulted in significantly lower sensitivity when compared to 0.658 threshold (sensitivity of 16.7% vs. 91.7%, respectively; t = 6.125,p = 0.0133). Calculated values of specificity (when three different cut-off were applied) were also significantly different. Threshold of 0.6 of H_con/Q_con resulted with significantly lower specificity compared to 0.47 value (specificity of 46.9% vs. 94.5%, respectively; t = 153.0,p<0.0001), and significantly higher specificity when compared to 0.658 (specificity of 46.9% vs. 24.1%, respectively; t = 229.0, p<0.0001). The use of different cut-off values for H_con/Q_con significantly affected the sensitivity and specificity of isokinetic testing. The interpretation of usefulness of isokinetic test as a screening tool in a group of male professional football players to predict hamstring injury occurrence within the next 12 months might be therefore significantly biased due to the different threshold values of H_con/Q_con. Using one “normative” value as a cut-off (e.g. 0.47 or 0.60, or 0.658) to quantify soccer players (or not) to the group with a higher risk of knee injury might result in biased outcomes due to the natural strength asymmetry that is observed within the group of soccer players.

Article: The relationship between jumping performance, isokinetic strength and dynamic postural control in elite youth soccer players - The Journal of Sports Medicine and Physical Fitness 2018 September;58(9):1226-33 - Minerva Medica - Journals