Strains Clinical Trial
Official title:
Rehabilitation of Acute Hamstring Injuries in Male Athletes: A Prospective Single-site Randomized Controlled Clinical Trial Comparing Two Rehabilitation Protocols With Different Emphasis on Eccentric Exercises
The purpose of the study is to compare the effect of two rehabilitation protocols with
different emphasis on eccentric exercises after acute hamstring muscle strain injuries on the
time to return to sports (RTS) and the rate of re-injuries in male athletes.
The hypothesis is that the addition of early eccentric hamstring exercises being performed at
longer muscle-tendon length towards end range of motion alter the outcomes RTS and
re-injuries in a rehabilitation protocol after acute hamstring muscle strain injuries.
Background and rationale:
Acute hamstring muscle strain injuries represent the most prevalent non-contact muscle injury
reported in sports. Despite the high prevalence and a rapidly expanding body of literature
investigating hamstring muscle strain injuries, [1] occurrence and re-injury rates have not
improved over the last three decades [2]. Therefore, rehabilitation and secondary prevention
are of particular concern, and the primary objective of all rehabilitation protocols is to
return an athlete to pre-injury level as soon as possible with a minimal risk of injury
recurrence.There is still a lack of consensus and clinical research regarding the
effectiveness of various rehabilitation protocols for acute hamstring injuries in athletes
participating in sports with high sprinting demands [3,4]. To our knowledge, there are no
prospective, randomised trials investigating the effect of different rehabilitation protocols
in a Middle-Eastern athletic population. Eccentric strength training has shown to reduce the
risk of both new acute hamstring injuries as well as re-injuries [5,6], whereas hamstring
exercises being performed at longer muscle-tendon length, preferentially mimicking movements
occuring simultaneously at both the knee and hip are reported to be more effective than a
protocol containing conventional exercises [7], and are suggested to be a key strategy in the
management of hamstring injuries. However, the preventive effect related to the eccentric
training remains unclear and is still debated and the optimal intensity of eccentric training
in rehabilitation of acute hamstring strain injuries and prevention of re-injuries is yet
unknown [8].
The primary objective in this study is therefore to compare the effect of two rehabilitation
protocols after acute hamstring muscle strain injuries on the time to return to sports (RTS)
and the rate of re-injuries in male athletes in a prospective single-site randomized
controlled trial.
The investigators aim to include 90 male athletes with clinical signs and MRI abnormalities
consistent with an acute hamstring muscle strain injury. The injured athletes will be
randomised into one of two different rehabilitation protocols with unlike emphasis on
eccentric exercises.
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