Skip to main content
SpringerLink
Log in

Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes

  • Original Article
  • Published:
European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

Injury prevention effects of neuromuscular training have been partly attributed to postural control adaptations. Uncertainty exists regarding the magnitude of these adaptations and on how they can be adequately monitored. The objective was to determine the time course of neuromuscular training effects on functional, dynamic and static balance measures.

Methods

Thirty youth (14.9 ± 3 years) field hockey athletes were randomised to an intervention or control group. The intervention included a 20-min neuromuscular warm-up program performed twice weekly for 10 weeks. Balance assessments were performed at baseline, week three, week six and post-intervention. They included the star excursion balance test (SEBT), balance error scoring system (BESS), jump-landing time to stabilization (TTS) and center of pressure (COP) sway velocity during single-leg standing.

Results

No baseline differences were found between groups in demographic data and balance measures. Adherence was at 86 %. All balance measures except the medial–lateral TTS improved significantly over time (p < 0.05) in both groups. Significant group by time interactions were found for the BESS score (p < 0.001). The intervention group showed greater improvements (69.3 ± 10.3 %) after 10 weeks in comparison to controls (31.8 ± 22.1 %). There were no significant group by time interactions in the SEBT, TTS and COP sway velocity.

Conclusions

Neuromuscular training was effective in improving postural control in youth team athletes. However, this effect was not reflected in all balance measures suggesting that the neuromuscular training did not influence all dimensions of postural control. Further studies are needed to confirm the potential of specific warm-up programs to improve postural control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

BESS:

Balance error scoring system

COP:

Center of pressure

GRF:

Ground reaction force

SEBT:

Star excursion balance test

TTS:

Time to stabilization

References

  • Aaltonen S, Karjalainen H, Heinonen A, Parkkari J, Kujala UM (2007) Prevention of sports injuries: systematic review of randomized controlled trials. Arch Intern Med 167(15):1585–1592

    Article  PubMed  Google Scholar 

  • Assaiante C, Amblard B (1998) An ontogenetic model of sensorimotor organization of balance control in humans. Neurosci Biobehav Rev 22(4):527–532

    Article  CAS  PubMed  Google Scholar 

  • Bender R, Lange S (2001) Adjusting for multiple testing—when and how? J Clin Epidemiol 54(4):343–349. doi:10.1016/S0895-4356(00)00314-0

    Article  CAS  PubMed  Google Scholar 

  • Clark RC, Saxion CE, Cameron KL, Gerber JP (2010) Associations between three clinical assessment tools for postural stability. N Am J Sports Phys Ther 5(3):122–130

    PubMed Central  PubMed  Google Scholar 

  • Dallinga JM, Benjaminse A, Lemmink KA (2012) Which screening tools can predict injury to the lower extremities in team sports? A systematic review. Sports Med 42(9):791–815. doi:10.2165/11632730-000000000-00000

    PubMed  Google Scholar 

  • de Noronha M, Refshauge KM, Crosbie J, Kilbreath SL (2008) Relationship between functional ankle instability and postural control. J Orthop Sports Phys Ther 38(12):782–789

    Article  PubMed  Google Scholar 

  • Docherty CL, Valovich McLeod TC, Shultz SJ (2006) Postural control deficits in participants with functional ankle instability as measured by the balance error scoring system. Clin J Sport Med 16(3):203–220

    Article  PubMed  Google Scholar 

  • Eechaute C, Vaes P, Duquet W (2009) The dynamic postural control is impaired in patients with chronic ankle instability: reliability and validity of the multiple hop test. Clin J Sport Med 19(2):107–114. doi:10.1097/JSM.0b013e3181948ae8

    Article  PubMed  Google Scholar 

  • Eils E, Schröter R, Schröder M, Gerss J, Rosenbaum D (2010) Multistation proprioceptive exercise program prevents ankle injuries in basketball. Med Sci Sports Exerc 42(11):2098–2105. doi:10.1249/MSS.0b013e3181e03667

    Article  PubMed  Google Scholar 

  • Erkmen N, Taskin H, Kaplan T, Sanioglu A (2009) The effect of fatiguing exercise on balance performance as measured by the Balance Error Scoring System. Isokinet Exerc Sci 17(2):121–127. doi:10.3233/IES-2009-0343

    Google Scholar 

  • Fitzpatrick R, McCloskey DI (1994) Proprioceptive, visual and vestibular thresholds for the perception of sway during standing in humans. J Physiol 478(Pt 1):173–186

    PubMed  Google Scholar 

  • Gribble P, Hertel J (2003) Considerations for normalizing measures of the Star Excursion Balance Test. Meas Phys Educ Exerc Sci 7(2):89–100

    Article  Google Scholar 

  • Gribble P, Robinson R (2010) Differences in spatiotemporal landing variables during a dynamic stability task in subjects with CAI. Scand J Med Sci Sports 20(1):e63–e71. doi:10.1111/j.1600-0838.2009.00899.x

    Article  CAS  PubMed  Google Scholar 

  • Gribble PA, Hertel J, Denegar CR (2007) Chronic ankle instability and fatigue create proximal joint alterations during performance of the Star Excursion Balance Test. Int J Sports Med 28(3):236–242

    Article  CAS  PubMed  Google Scholar 

  • Gribble PA, Hertel J, Plisky P (2012) Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. J Athl Train 47(3):339–357. doi:10.4085/1062-6050-47.3.08

    PubMed Central  PubMed  Google Scholar 

  • Hertel J, Braham RA, Hale SA, Olmsted-Kramer LC (2006) Simplifying the star excursion balance test: analyses of subjects with and without chronic ankle instability. J Orthop Sports Phys Ther 36(3):131–137

    Article  PubMed  Google Scholar 

  • Horak FB (1997) Clinical assessment of balance disorders. Gait Posture 6(1):76–84

    Article  Google Scholar 

  • Hübscher M, Zech A, Pfeifer K, Hänsel F, Vogt L, Banzer W (2010) Neuromuscular training for sports injury prevention: a systematic review. Med Sci Sports Exerc 42(3):413–421. doi:10.1249/MSS.0b013e3181b88d37

    Article  PubMed  Google Scholar 

  • Hupperets MD, Verhagen EA, van Mechelen W (2009) Effect of sensorimotor training on morphological, neurophysiological and functional characteristics of the ankle: a critical review. Sports Med 39(7):591–605. doi:10.2165/00007256-200939070-00005

    Article  PubMed  Google Scholar 

  • Junge A, Lamprecht M, Stamm H, Hasler H, Bizzini M, Tschopp M, Reuter H, Wyss H, Chilvers C, Dvorak J (2011) Countrywide campaign to prevent soccer injuries in Swiss amateur players. Am J Sports Med 39(1):57–63. doi:10.1177/0363546510377424

    Article  PubMed  Google Scholar 

  • Leavey VJ, Sandrey MA, Dahmer G (2010) Comparative effects of 6-week balance, gluteus medius strength, and combined programs on dynamic postural control. J Sport Rehabil 19(3):268–287

    PubMed  Google Scholar 

  • McLeod TC, Armstrong T, Miller M, Sauers JL (2009) Balance improvements in female high school basketball players after a 6-week neuromuscular-training program. J Sport Rehabil 18(4):465–481

    PubMed  Google Scholar 

  • Meeuwisse WH, Tyreman H, Hagel B, Emery C (2007) A dynamic model of etiology in sport injury: the recursive nature of risk and causation. Clin J Sport Med 17(3):215–219

    Article  PubMed  Google Scholar 

  • Peterka RJ (2002) Sensorimotor integration in human postural control. J Neurophysiol 88(3):1097–1118

    CAS  PubMed  Google Scholar 

  • Plisky PJ, Rauh MJ, Kaminski TW, Underwood FB (2006) Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther 36(12):911–919

    Article  PubMed  Google Scholar 

  • Riemann BL, Schmitz R (2012) The relationship between various modes of single leg postural control assessment. Int J Sports Phys Ther 7(3):257–266

    PubMed Central  PubMed  Google Scholar 

  • Risberg MA, Mørk M, Jenssen HK, Holm I (2001) Design and implementation of a neuromuscular training program following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 31(11):620–631

    Article  CAS  PubMed  Google Scholar 

  • Ross SE, Guskiewicz KM (2003) Time to stabilization: a method for analyzing dynamic postural stability. Athl Ther Today 8:37–39

    Google Scholar 

  • Soligard T, Myklebust G, Steffen K, Holme I, Silvers H, Bizzini M, Junge A, Dvorak J, Bahr R, Andersen TE (2008) Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ 337:a2469. doi:10.1136/bmj.a2469

    Article  PubMed Central  PubMed  Google Scholar 

  • Steffen K, Meeuwisse WH, Romiti M, Kang J, McKay C, Bizzini M, Dvorak J, Finch C, Myklebust G, Emery CA (2013a) Evaluation of how different implementation strategies of an injury prevention programme (FIFA 11+) impact team adherence and injury risk in Canadian female youth football players: a cluster-randomised trial. Br J Sports Med 47(8):480–487. doi:10.1136/bjsports-2012-091887

    Article  PubMed  Google Scholar 

  • Steffen K, Emery CA, Romiti M, Kang J, Bizzini M, Dvorak J, Finch CF, Meeuwisse WH (2013b) High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players: a cluster randomised trial. Br J Sports Med 47(12):794–802. doi:10.1136/bjsports-2012-091886

    Article  PubMed  Google Scholar 

  • Steib S, Zech A, Hentschke C, Pfeifer K (2013) Fatigue-induced alterations of static and dynamic postural control in athletes with a history of ankle sprain. J Athl Train 48(2):203–208. doi:10.4085/1062-6050-48.1.08

    Article  PubMed  Google Scholar 

  • Valovich TC, Perrin DH, Gansneder BM (2003) Repeat administration elicits a practice effect with the balance error scoring system but not with the standardized assessment of concussion in high school athletes. J Athl Train 38:51–56

    PubMed Central  PubMed  Google Scholar 

  • Verhagen EA, Bay K (2010) Optimising ankle sprain prevention: a critical review and practical appraisal of the literature. Br J Sports Med 44(15):1082–1088. doi:10.1136/bjsm.2010.076406

    Article  CAS  PubMed  Google Scholar 

  • Zech A, Hübscher M, Vogt L, Banzer W, Hänsel F, Pfeifer K (2010) Balance training for neuromuscular control and performance enhancement: a systematic review. J Athl Train 45(4):392–403. doi:10.4085/1062-6050-45.4.392

    Article  PubMed Central  PubMed  Google Scholar 

  • Zech A, Steib S, Hentschke C, Eckhardt H, Pfeifer K (2012) Effects of localized and general fatigue on static and dynamic postural control in male team handball athletes. J Strength Cond Res 26(4):1162–1168. doi:10.1519/JSC.0b013e31822dfbbb

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest related to the publication of this article.

Author information

Authors and Affiliations

  1. Department of Human Movement Science, University of Hamburg, Mollerstraße 2, 20148, Hamburg, Germany

    Astrid Zech, Philipp Klahn & Jon Hoeft

  2. Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Christine zu Eulenburg

  3. Institute of Sport Science and Sport, University of Erlangen-Nuremberg, Erlangen, Germany

    Simon Steib

Authors
  1. Astrid Zech
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Philipp Klahn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jon Hoeft
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christine zu Eulenburg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Simon Steib
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Astrid Zech.

Additional information

Communicated by Fausto Baldissera.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zech, A., Klahn, P., Hoeft, J. et al. Time course and dimensions of postural control changes following neuromuscular training in youth field hockey athletes. Eur J Appl Physiol 114, 395–403 (2014). https://doi.org/10.1007/s00421-013-2786-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00421-013-2786-5

Keywords

Search

Navigation