Sports Biomechanics
ISSN: 1476-3141 (Print) 1752-6116 (Online) Journal homepage: http://www.tandfonline.com/loi/rspb20
Knee joint position sense of roller hockey players: a comparative study João Venâncio, Diogo Lopes, Joaquim Lourenço & Fernando Ribeiro To cite this article: João Venâncio, Diogo Lopes, Joaquim Lourenço & Fernando Ribeiro (2016) Knee joint position sense of roller hockey players: a comparative study, Sports Biomechanics, 15:2, 162-168, DOI: 10.1080/14763141.2016.1159323 To link to this article: http://dx.doi.org/10.1080/14763141.2016.1159323
Published online: 25 Apr 2016.
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Date: 28 December 2016, At: 10:24
Sports Biomechanics, 2016 VOL. 15, NO. 2, 162–168 http://dx.doi.org/10.1080/14763141.2016.1159323
Knee joint position sense of roller hockey players: a comparative study João Venâncioa , Diogo Lopesa, Joaquim Lourençoa
and Fernando Ribeirob
a
Advanced Polytechnic and University Cooperative (CESPU), Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra, Portugal; bSchool of Health Sciences and Institute of Biomedicine – iBiMED, University of Aveiro, Aveiro, Portugal
ABSTRACT
This study aimed to compare knee joint position sense of roller hockey players with an age-matched group of non-athletes. Forty-three male participants voluntarily participated in this cross-sectional study: 21 roller hockey players (mean age: 23.2 ± 4.2 years old, mean weight: 81.8 ± 9.8 kg, mean height: 180.5 ± 4.1 cm) and 22 age-matched nonathletes (mean age: 23.7 ± 3.9 years old, mean weight: 85.0 ± 6.2 kg, mean height: 181.5 ± 5.0 cm). Knee joint position sense of the dominant limb was evaluated using a technique of open-kinetic chain and active knee positioning. Joint position sense was reported using absolute, relative and variable angular errors. The main results indicated that the group of roller hockey players showed significantly lower absolute (2.4 ± 1.2º vs. 6.5 ± 3.2º, p ≤ 0.001) and relative (1.7 ± 2.1º vs. 5.8 ± 4.4º, p ≤ 0.001) angular errors in comparison with the non-athletes group. In conclusion, the results from this present study suggest that proprioceptive acuity, assessed by measuring joint position sense, is increased in roller hockey players. The enhanced proprioception of the roller hockey players could contribute to injury prevention and improved performance during sporting activities.
ARTICLE HISTORY
Received 7 July 2015 Accepted 10 November 2015 KEYWORDS
Hardball hockey; in line hockey; proprioception; rink hockey
Introduction Roller hockey, also known as rink hockey or hardball hockey, is a sport played with a fourwheeled squad skates and a two-sided stick in nearly 60 countries worldwide (Coelho-ESilva et al., 2012; Yague, Del Valle, Egocheaga, Linnamo, & Fernandez, 2013). It is played on a rink (40 × 20 m) surrounded by a barrier one metre high by two times of five players (one goalkeeper and four field players per team) (Coelho-E-Silva et al., 2012; Yague et al., 2013). The game has a duration of 50 min, divided by two periods of 25 min, and as an intermittent sport, it has periods of high intensity non-continuous actions interspersed with incomplete recovery periods (Coelho-E-Silva et al., 2012; Yague et al., 2013). The four-wheeled squad skates allow the player to change direction, accelerate and decelerate with an un-estimated
CONTACT João Venâncio
[email protected]
© 2016 Informa UK Limited, trading as Taylor & Francis Group
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knee overload, hence requiring exceptional skills of balance, coordination, flexibility, muscle strength, neuromuscular control and proprioception. Proprioception refers to the perception of tension/force, body/joint movement and limb relative position, as a result of cumulative neural input to the central nervous system from specialised nerve endings called mechanoreceptors (Ribeiro & Oliveira, 2007; Riemann & Lephart, 2002). Among the three submodalities of proprioception, joint position sense refers to the capacity to perceive, memorise and then reproduce a given joint angle (Hiemstra, Lo, & Fowler, 2001; Ribeiro & Oliveira, 2011). Together with the other two submodalities, sense of tension and movement, joint position sense is essential to the control of movement, balance, joint stability and to carry out daily living tasks and sports activities (Ribeiro & Oliveira, 2007; Riemann & Lephart, 2002). Joint position sense measures the accuracy of position replication and can be measured with active (Pickard, Sullivan, Allison, & Singer, 2003), passive (Pickard et al., 2003) or passive–active (Torres, Duarte, & Cabri, 2012) tests in both open (Ribeiro, Venancio, Quintas, & Oliveira, 2011) and closed (Magalhaes, Ribeiro, Pinheiro, & Oliveira, 2010) kinetic chain positions. It can also be assessed using contralateral (Bouet & Gahery, 2000) or ipsilateral (Ribeiro, Moreira, Neto, & Oliveira, 2013) matching responses. Joint angles have been assessed with different instruments, including inclinometers (Dover & Powers, 2003), goniometers and potentiometers (Clark, Roijezon, & Treleaven, 2015), isokinetic dynamometers (Ribeiro et al., 2011), electromagnetic tracking devices (Tripp, Faust, & Jacobs, 2009), video analysis systems (Ribeiro, Mota, & Oliveira, 2007) and more recently biophotogrammetry (Souza, Pasinato, Basso, Corrêa, & da Silva, 2011). In general, athletes present better proprioception than non-athletes; additionally, it was recently shown that the proprioception acuity of elite athletes is positively correlated with the sport competition level achieved (Han, Waddington, Anson, & Adams, 2015). Proprioception, namely joint position sense, has been studied in a wide-range of sports, nonetheless, to our best knowledge, there is no study describing the proprioceptive acuity of roller hockey players. Due to the demands of the roller hockey, which emphasise conscious awareness of body position and movement, we hypothesise that roller hockey players exhibit better proprioception, assessed by measuring joint position sense, than age-matched controls. In this sense, the purpose of this study was to compare knee joint position sense of roller hockey players with an age-matched group of non-athletes.
Methods Participants A total of 43 male adults with an age range between 20 and 30 years voluntarily participated in this cross-sectional study. Twenty-one roller hockey players were recruited from two teams playing the Portuguese second division at the time of data collection to compose the roller hockey group. Twenty-two age-matched, healthy, non-athletes were recruited in the same geographic area to compose the comparison group. Only male adults were included. The criteria to be included in the roller hockey group were as follows: players had to have more than 10 years of experience playing roller hockey with a frequency of at least three times per week and have a normal knee range of motion. Exclusion criteria were as follows: a major injury in the last 12 months (involving sport cessation for >1 month) (roller hockey group), lower limb or lower back injury in the 6 months before the study (both groups),
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history of knee surgery (both groups), taking medication with an influence on motor control and/or attention (both groups), any cardiorespiratory, neurologic, metabolic or rheumatologic disorders (both groups), and regular recreational or sport participation (>2 training sessions per week) (only for the comparison group). The study procedures were in accordance with the ethical standards on human experimentation and the principles of the declaration of Helsinki. Written informed consent was obtained from all participants. The review board of the Physiotherapy course of Advanced Polytechnic and University Cooperative (CESPU) approved the study. Procedures The same examiner collected all data in the afternoon in a quiet room over the course of a week, with the participants wearing comfortable clothes (t-shirt and shorts). Before the data collection, all participants were informed about the study procedures and then were asked to sign the written informed consent and complete a questionnaire detailing their medical and sports history to determine their eligibility to participate in the study. Then, height and weight measurements were attained using a standard scale and stadiometer (Seca 285, Seca, Birmingham, UK). The joint position sense of the knee was assessed in the dominant limb using an ipsilateral technique of open-kinetic chain and active knee positioning as previously described (Ribeiro et al., 2007; Salgado, Ribeiro, & Oliveira, 2015). In brief, 2 pairs of markers representing the axis of the thigh (apex of the greater trochanter; iliotibial tract, level with the posterior crease of the knee when flexed to 80°) and the axis of the leg (neck of the fibula and prominence of the lateral malleolus) were fixed to the skin. Then, each participant performed three trials in order to reproduce one target angle (between 40° and 60° of knee flexion) as previously described (Ribeiro et al., 2007; Salgado et al., 2015). To determine the knee angles, a sequence of 10 photographs of the target and the repositioning joint positions were taken with a digital camera (Nikon D3200, Nikon, Japan) mounted in a tripod positioned 3 metres away from the participant. After that, five consecutive photographs (from picture number 3 to number 7) of each position were analysed with the Posture Assessment Software (SAPO) (Ferreira, Duarte, Maldonado, Burke, & Marques, 2010) to obtain the knee angle. In this study, the joint position sense is reported using the absolute, relative and variable angular errors (Bennell, Wee, Crossley, Stillman, & Hodges, 2005). Data analysis All data were analysed using IBM SPSS Statistics 20 software (IBM Corporation, Chicago, IL, USA). The normality of data distribution was tested with the Shapiro–Wilk test. Data are reported as group mean ± SD. Independent t-tests were performed to compare the mean differences between groups in age, weight, height and angular errors. The level of significance was set at p 0.05), weight (81.8 ± 9.8 vs. 85.0 ± 6.1 kg, p > 0.05) and height (180.5 ± 4.1 vs. 181.5 ± 4.9 cm, p > 0.05). Both absolute (6.5 ± 3.2º vs. 2.4 ± 1.2º, p ≤ 0.001) and relative (5.8 ± 4.4º vs. 1.7 ± 2.1º, p ≤ 0.001) angular errors were significantly higher in the non-athletes group in comparison with the roller hockey players group (Figure 1). The relative error showed directional bias of repositioning with an overestimation of the target position in both groups. From the start position of 90° of flexion and using the desired movement to extend the knee, 18 participants in the roller hockey players group and 19 in the non-athletes group extended the knee beyond the test position determined by the examiner (Figure 1). Only 3 participants in each group subestimated the target position. No changes were observed in variable error (1.4 ± 1.3º vs. 1.1 ± 1.1º, p = 0.381) between the non-athletes group and the roller hockey group (Figure 1)
Discussion and implication The main findings of this study confirm our hypothesis; roller hockey players have a significantly better knee joint position sense than an age-matched group of non-athletes. In comparison with previous studies using the same methodology to assess knee joint position sense, we found absolute angular errors slightly higher to those reported in volleyball players (Ribeiro, Santos, Gonçalves, & Oliveira, 2008) and slightly lower than those observed in soccer players (Salgado et al., 2015) and karatekas (Magalhaes et al., 2010). Roller hockey requires continuous movement with small to large expressions of motion, the shift of body weight from one lower limb to the other, semi-circular movements of the trunk and limbs, and accelerations and decelerations. These kinds of actions may emphasise conscious awareness of body position and movement, which could contribute to a better proprioceptive acuity. Indeed, it would be expected that athletes exhibited better proprioception than non-athletes, because exercise ameliorates both central and peripheral components of proprioception (Ashton-Miller, Wojtys, Huston, & Fry-Welch, 2001; Ribeiro & Oliveira, 2007). At the peripheral level, exercise seems to induce morphological adaptations in the muscle spindle, which decreases the latency of the stretch reflex response and increases its amplitude (Hutton & Atwater, 1992). At the central nervous system, the habitual practice of exercise may modulate the gain of the muscle spindle and promote plastic changes in the central nervous system, contributing in this way to a better proprioception (Hutton &
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Atwater, 1992). The repetitive movements observed in roller hockey, inducing repetitive afferent inputs from the mechanoreceptors, may over time induce plastic changes in the cortex, hence increasing the cortical representation of the joints leading to enhanced joint proprioception (Ashton-Miller et al., 2001). In addition to the specific demands of the sport, in general the roller hockey players have an early sport starting age, which increases the years of practice when they reach the adult age. Increased years of practice could contribute to adaptations in the central nervous system, which seem to be related to better proprioceptive acuity. A study in Portuguese national team athletes showed that the roller hockey athletes begin the involvement in sports between the ages of 6 and 10 years, which is, for instance, significantly earlier than basketball players (Leite, Baker, & Sampaio, 2009). Relative errors showed a directional bias in the extension movement. Despite not having a definitive explanation for the overestimation of the test position, it could be speculated that it is related with knee flexors/extensors ratio that would shift the equilibrium position in the direction of action of the stronger muscles, i.e. knee extensors (Jaric et al., 1999). The lack of differences in the variable error indicates that the reliability and precision to estimate knee angles is similar between groups, indicating that the errors were consistent. The present results could be important to roller hockey coaches, physical coaches, physiotherapists and researchers, facilitating new researches related to sports performance and injury prevention in roller hockey area. For those in the field, our results could serve as referral/target for those players showing lower proprioception, for instance as a return to play indicator after a sport injury. Some study limitations should be recognised. First, the movement from the starting position to the target knee angle was performed passively by the examiner (while the repositioning movement was active), which was previously showed to be less accurate than the active positioning for the assessment of position sense (Pickard et al., 2003). Second, joint position sense was assessed in open-kinetic chain, which did not mimic the demands of the sport. Additionally, it was previously reported that knee joint position sense assessed with a closed kinetic chain test is more accurate than with an open-kinetic chain test (Magalhaes et al., 2010), mainly because it allows proprioceptive feedback from adjacent joints, namely the hip and ankle, which could contribute to a more accurate position sense (Stillman & McMeeken, 2001). Third, the outcome evaluators were not blinded to the group assignment, an issue that should be taken into consideration in future studies. Some questions remain to be answered in future studies, namely if better joint position sense is accompanied by better sense of movement and sense of tension in roller hockey players. Furthermore, we cannot be certain to whether the results of this study apply to pro/elite roller hockey players or to female players as well, and therefore, future studies should be conducted to answer to these questions.
Conclusions The results from this study suggest that proprioceptive acuity, assessed by measuring joint position sense, is increased in roller hockey players. The better proprioception observed in the roller hockey players could play an important role in both injury prevention and performance during sporting activities.
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Disclosure statement No potential conflict of interest was reported by the authors.
ORCID João Venâncio http://orcid.org/0000-0002-6173-998X Joaquim Lourenço http://orcid.org/0000-0003-0732-3665 Fernando Ribeiro http://orcid.org/0000-0001-9094-1493
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