Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study

# Background Reduced activation of the hamstring muscles and specifically the medial semitendinosus muscle (ST) has been shown to be a risk factor for non-contact anterior cruciate ligament (ACL) injury. Specific hamstring strength exercises may show high ST activity, however the effect of unilater...

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Autores principales:	Brian Sørensen, Per Aagaard, Lasse Malchow-Møller, Mette Kreutzfeldt Zebis, Jesper Bencke
Formato:	article
Lenguaje:	EN
Publicado:	North American Sports Medicine Institute 2021
Materias:	Sports medicine RC1200-1245
Acceso en línea:	https://doaj.org/article/91abf4bd8a45434dbface8839f2cf9eb
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spelling	oai:doaj.org-article:91abf4bd8a45434dbface8839f2cf9eb2021-12-02T17:11:31ZMedio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study10.26603/001c.241502159-2896https://doaj.org/article/91abf4bd8a45434dbface8839f2cf9eb2021-06-01T00:00:00Zhttps://ijspt.scholasticahq.com/article/24150-medio-lateral-hamstring-muscle-activity-in-unilateral-vs-bilateral-strength-exercises-in-female-team-handball-players-a-cross-sectional-study.pdfhttps://doaj.org/toc/2159-2896# Background Reduced activation of the hamstring muscles and specifically the medial semitendinosus muscle (ST) has been shown to be a risk factor for non-contact anterior cruciate ligament (ACL) injury. Specific hamstring strength exercises may show high ST activity, however the effect of unilateral vs. bilateral exercise execution on ST activation remains unknown. # Purpose To investigate selected lower limb strengthening exercises performed either unilaterally or bilaterally to identify 1) which exercise elicited the highest hamstring activation, 2) which exercise elicited the highest ST activation, and 3) to examine if unilateral exercise execution altered the medio-lateral hamstring activation pattern. Furthermore, the kinematic characteristics of each specific exercise and execution modality were determined to reveal possible causes for differences in medio-lateral hamstring activation between the different exercise conditions. # Study design Cross-sectional study. # Methods Single-session repeated measures were obtained in a randomized manner. Twenty-three female elite team handball players were recruited. Hamstring electromyographic (EMG) activity and 3D kinematics were obtained during selected lower limb exercises (hip thrust, kettlebell swing, Romanian deadlift). Hamstring EMG activity, normalized to maximal voluntary contraction (MVC) (nEMG), and inter-muscular activation difference between the ST and lateral hamstring biceps femoris (BF) were compared across exercises using two-way repeated measures ANOVA. # Results Bilateral hip thrust demonstrated highest overall hamstring activity (68.9±16.6 %). Kettlebell swing (Δ13%-point, p\<0.01) and Romanian deadlift (Δ20-24%-point, p\<0.01) demonstrated greater ST-BF activation differences (Δ=ST-BF) in favor of ST compared to hip thrust (Δ2-7%). Positive correlations were observed between knee joint angle and ST activity in kettlebell swing and deadlift. # Conclusion Kettlebell swing, deadlift and hip thrust all produced high activation of the hamstring muscles. Kettlebell swing and both deadlift exercises were superior in activating ST over BF, favoring these exercises in the prevention of non-contact ACL injury in female athletes, which should be evaluated in future intervention studies. # Level of evidence 3Brian SørensenPer AagaardLasse Malchow-MøllerMette Kreutzfeldt ZebisJesper BenckeNorth American Sports Medicine InstitutearticleSports medicineRC1200-1245ENInternational Journal of Sports Physical Therapy, Vol 16, Iss 3 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Sports medicine RC1200-1245
spellingShingle	Sports medicine RC1200-1245 Brian Sørensen Per Aagaard Lasse Malchow-Møller Mette Kreutzfeldt Zebis Jesper Bencke Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study
description	# Background Reduced activation of the hamstring muscles and specifically the medial semitendinosus muscle (ST) has been shown to be a risk factor for non-contact anterior cruciate ligament (ACL) injury. Specific hamstring strength exercises may show high ST activity, however the effect of unilateral vs. bilateral exercise execution on ST activation remains unknown. # Purpose To investigate selected lower limb strengthening exercises performed either unilaterally or bilaterally to identify 1) which exercise elicited the highest hamstring activation, 2) which exercise elicited the highest ST activation, and 3) to examine if unilateral exercise execution altered the medio-lateral hamstring activation pattern. Furthermore, the kinematic characteristics of each specific exercise and execution modality were determined to reveal possible causes for differences in medio-lateral hamstring activation between the different exercise conditions. # Study design Cross-sectional study. # Methods Single-session repeated measures were obtained in a randomized manner. Twenty-three female elite team handball players were recruited. Hamstring electromyographic (EMG) activity and 3D kinematics were obtained during selected lower limb exercises (hip thrust, kettlebell swing, Romanian deadlift). Hamstring EMG activity, normalized to maximal voluntary contraction (MVC) (nEMG), and inter-muscular activation difference between the ST and lateral hamstring biceps femoris (BF) were compared across exercises using two-way repeated measures ANOVA. # Results Bilateral hip thrust demonstrated highest overall hamstring activity (68.9±16.6 %). Kettlebell swing (Δ13%-point, p\<0.01) and Romanian deadlift (Δ20-24%-point, p\<0.01) demonstrated greater ST-BF activation differences (Δ=ST-BF) in favor of ST compared to hip thrust (Δ2-7%). Positive correlations were observed between knee joint angle and ST activity in kettlebell swing and deadlift. # Conclusion Kettlebell swing, deadlift and hip thrust all produced high activation of the hamstring muscles. Kettlebell swing and both deadlift exercises were superior in activating ST over BF, favoring these exercises in the prevention of non-contact ACL injury in female athletes, which should be evaluated in future intervention studies. # Level of evidence 3
format	article
author	Brian Sørensen Per Aagaard Lasse Malchow-Møller Mette Kreutzfeldt Zebis Jesper Bencke
author_facet	Brian Sørensen Per Aagaard Lasse Malchow-Møller Mette Kreutzfeldt Zebis Jesper Bencke
author_sort	Brian Sørensen
title	Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study
title_short	Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study
title_full	Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study
title_fullStr	Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study
title_full_unstemmed	Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study
title_sort	medio-lateral hamstring muscle activity in unilateral vs. bilateral strength exercises in female team handball players – a cross-sectional study
publisher	North American Sports Medicine Institute
publishDate	2021
url	https://doaj.org/article/91abf4bd8a45434dbface8839f2cf9eb
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Medio-Lateral Hamstring Muscle Activity in Unilateral vs. Bilateral Strength Exercises in Female Team Handball Players – A Cross-Sectional Study

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