Fernando Santonja

Reproducibility and criterion-related validity of the sit and reach test and toe touch test for estimating hamstring flexibility in recreationally active young adults

OBJECTIVE 1) to examine the test-retest reproducibility and criterion-related validity of the sit and reach test (SRT) and the toe touch test (TT) for estimating hamstring flexibility measured through the passive straight leg raise test (PSLR); and 2) to determine whether the SRT cut-off scores may be used for the TT test to identify participants in this sample of young healthy adults as having short hamstring flexibility. DESIGN Test-retest design. SETTING Controlled laboratory environment. PARTICIPANTS 243 active recreationally young adults. MAIN OUTCOME MEASURES Participants performed the SRT, the TT test and PSLR twice in a randomized order with a 4-week interval between trials. Reproducibility was examined using typical percentage error (coefficient of variation [CV]) and intraclass correlation coefficient (ICC) as well as their respective confidence limits. Regression and Kappa correlation statistical analyses were performed to study the association of the SRT and TT test with the PSLR test and the 95% limits of agreement (LoA) between SRT and TT test were calculated to explore differences in the mean differences between these measurements. RESULTS The finding showed acceptable reproducibility measures for SRT (8.74% CV; 0.92 ICC), TT test (9.86% CV; 0.89 ICC) and PSLR (5.46% CV; 0.85 ICC). The SRT (R² = 0.63) and TT test (R² = 0.49) were significantly associated with PSLR. The 95% LoA between SRT and TT test reported systematic bias (2.84 cm) and wide 95% random error (±9.72 cm). CONCLUSIONS Reproducibility of SRT, TT test and PSLR is acceptable and the criterion-related validity of SRT and TT test is moderate. Furthermore, the SRT cut-off scores should not be used for TT test for the detection of short hamstring muscles.

Absolute reliability of five clinical tests for assessing hamstring flexibility in professional futsal players.

OBJECTIVES To examine the absolute reliability of five methods for estimating hamstring flexibility in professional futsal players. DESIGN Absolute reliability laboratory study (k=4). METHODS A total of 46 male futsal players (172.9±4.5 cm; 69.7±7.5 Kg) completed the study. All participants performed each measurement test twice in a randomized order on four different occasions. Absolute reliability was examined through typical percentage error, percentage change in the mean and intraclass correlations (ICC) as well as their respective confidence limits. RESULTS The findings showed high reliability for the sit and reach test (SRT) (4.48% typical error; 0.84% change in the mean, 0.95 ICC), toe touch test (TT) (5.89% typical error; 2.31% change in the mean, 0.89 ICC) and back-saver sit and reach test (BSSR) (3.73% typical error; 0.51% change in the mean, 0.97 ICC) compared to the passive straight leg raise test (PSLR) (7.6% typical error; 8.86% change in the mean, 0.77 ICC) and modified sit and reach test (MSR) (11.87% typical error; 7.64% change in the mean, 0.84 ICC) which showed moderate reliability. CONCLUSIONS An observed change larger than 6.72%, 7.55% and 5.59% for baseline SRT, TT and BSSR scores respectively would indicate that a real improvement in hamstring flexibility has occurred. In addition, the clinical reliability of PSLR and MSR are questioned and should be re-evaluated in future research studies.

Absolute reliability of hamstring to quadriceps strength imbalance ratios calculated using peak torque, joint angle-specific torque and joint ROM-specific torque values.

The main purpose of this study was to determine the absolute reliability of conventional (H/Q(CONV)) and functional (H/Q(FUNC)) hamstring to quadriceps strength imbalance ratios calculated using peak torque values, 3 different joint angle-specific torque values (10°, 20° and 30° of knee flexion) and 4 different joint ROM-specific average torque values (0-10°, 11-20°, 21-30° and 0-30° of knee flexion) adopting a prone position in recreational athletes. A total of 50 recreational athletes completed the study. H/Q(CONV) and H/Q(FUNC) ratios were recorded at 3 different angular velocities (60, 180 and 240°/s) on 3 different occasions with a 72-96 h rest interval between consecutive testing sessions. Absolute reliability was examined through typical percentage error (CVTE), percentage change in the mean (CM) and intraclass correlations (ICC) as well as their respective confidence limits. H/Q(CONV) and H/Q(FUNC) ratios calculated using peak torque values showed moderate reliability values, with CM scores lower than 2.5%, CV(TE) values ranging from 16 to 20% and ICC values ranging from 0.3 to 0.7. However, poor absolute reliability scores were shown for H/Q(CONV) and H/Q(FUNC) ratios calculated using joint angle-specific torque values and joint ROM-specific average torque values, especially for H/Q(FUNC) ratios (CM: 1-23%; CV(TE): 22-94%; ICC: 0.1-0.7). Therefore, the present study suggests that the CV(TE) values reported for H/Q(CONV) and H/Q(FUNC) (≈18%) calculated using peak torque values may be sensitive enough to detect large changes usually observed after rehabilitation programmes but not acceptable to examine the effect of preventitive training programmes in healthy individuals. The clinical reliability of hamstring to quadriceps strength ratios calculated using joint angle-specific torque values and joint ROM-specific average torque values are questioned and should be re-evaluated in future research studies.

Test-retest reliability of seven common clinical tests for assessing lower extremity muscle flexibility in futsal and handball players

OBJECTIVE To determine the inter-session reliability of seven lower limb muscle flexibility measures obtained from the passive hip extension test (PHE), passive hip flexion test (PHF), passive hip abduction test (PHA), passive straight leg raise test (PSLR), modified Thomas test (MTh), the ankle dorsi-flexion with knee extended (ADFKE) and flexed (ADFKF) tests. DESIGN Repeated measures design. SETTING Controlled laboratory environment. PARTICIPANTS 60 futsal and 30 handball players. MAIN OUTCOME MEASURES Reliability was examined through the change in the mean (ChM), standard error of measurement expressed in absolute values (SEM) and as a percentage of the mean score (%SEM), minimal detectable change (MDC95), and intraclass correlation coefficient (ICC2,k). RESULTS The findings showed negligible ChM values for all the flexibility measures analysed (<1°). Furthermore, the SEM and MDC95 for each flexibility measure ranged from 1.3° to 2.5° and from 3.8° to 6.9°, respectively, with %SEM scores lower than 10% and ICC scores higher than 0.88. CONCLUSIONS Clinicians can be 95% confident that an observed change between 2 measures larger than 3.7°, 6.2°, 5.5°, 6.1°, 6.9°, 4.7°, and 5.0° for the flexibility measures obtained from the PHE, PHF, PHA, PSLR, MTh, ADFKE and ADFKF, respectively, likely indicates a real change in muscle flexibility.

Reproducibility and Concurrent Validity of Hip Joint Angle Test for Estimating Hamstring Flexibility in Recreationally Active Young Men

Abstract Ayala, F, Sainz de Baranda, P, De Ste Croix, M, and Santonja, F. Reproducibility and concurrent validity of hip joint angle test for estimating hamstring flexibility in recreationally active young men. J Strength Cond Res 26(9): 2372–2382, 2012—The purposes of this study were twofold: (a) to examine the test-retest reproducibility and concurrent validity of the horizontal hip joint angle test (H-HJA) and vertical hip joint angle test (V-HJA) for estimating hamstring flexibility measured with an inclinometer during the passive straight-leg raise test (PSLR) and (b) to determine whether the H-HJA cutoff scores may be used for V-HJA for the detection of short hamstring flexibility in active recreationally young adults. Fifty young men underwent the H-HJA, V-HJA, and PSLR on the right and left legs 3 times in a randomized order with a 4-week interval between trials under a controlled laboratory environment. Reproducibility was examined using coefficient of variation (CV) and intraclass correlation coefficient (ICC3,1) and their respective confidence limits. Regression and kappa correlation analyses were performed to examine the association of H-HJA and V-HJA with the PSLR test, and the 95% limits of agreement between H-HJA and V-HJA were calculated to check if there were differences in the raising scores. The results demonstrated acceptable reproducibility measures for the H-HJA (4.12% CV; 0.93 ICC), V-HJA (4.99% CV; 0.92 ICC), and PSLR (4.83% CV; 0.88 ICC). The H-HJA (R2 = 0.62) and V-HJA (R2 = 0.63) results were significantly associated with those of the PSLR. The 95% limits of agreement between the H-HJA and V-HJA reported systematic bias (+7.12 cm) and a wide 95% random error ( ±13.72 cm). This study concluded that the test-retest reproducibility of the H-HJA, V-HJA, and PSLR is acceptable and that the validity of H-HJA and V-HJA is moderate. Furthermore, the H-HJA cutoff scores should not be used for V-HJA for the detection of short hamstring muscles in young adults.

Fiabilidad y validez de las pruebas sit-and-reach , revisión sistemática

Resumen Las pruebas de valoracion “dedos planta” o sit-and-reach , son las que con mayor frecuencia, clinicos, entrenadores y preparadores fisico-deportivos emplean para estimar la flexibilidad de la musculatura isquiosural, Son varias las pruebas sit-and-reach descritas en la literatura cientifica, entre las que se destacan: a) el clasico sit-and-reach test, b) el V “sit-and-reach” test , c) el back-saver sit-and-reach test , d) el “modificado sit-and-reach test” y e) el toe-touch test . Existen ciertas diferencias entre ellas con respecto a la posicion del sujeto (unilateral o bilateral, sedentacion o bipedestacion, posicion de la pelvis) y el equipamiento necesario (evaluado con o sin cajon de medicion, ejecutado en una camilla, banco o suelo). La eleccion de uno u otro test va a estar en funcion de: a) la funcionalidad de su metodologia de evaluacion; b) de su fiabilidad absoluta y relativa (intra- e interexaminador) asi como c) de su validez para la estimacion de la flexibilidad isquiosural. Todo este conocimiento permitira a clinicos, entrenadores y profesionales del mundo de la actividad fisica disponer de informacion suficiente para adoptar un juicio de valor cientificamente justificado sobre que prueba de valoracion sit-and-reach utilizar para categorizar a sus deportistas-pacientes (estudio de la validez) y/o monitorizar la eficacia de los tratamientos aplicados (estudio de la fiabilidad absoluta y relativa) para el mantenimiento o mejora de la flexibilidad de la musculatura isquiosural. Los objetivos de esta revision bibliografica son analizar y comparar la fiabilidad y validez de las pruebas sit-and-reach para la estimacion de la flexibilidad de la musculatura isquiosural y lumbar.

Absolute reliability of isokinetic knee flexion and extension measurements adopting a prone position

The main purpose of this study was to determine the absolute and relative reliability of isokinetic peak torque (PT), angle of peak torque (APT), average power (PW) and total work (TW) for knee flexion and extension during concentric and eccentric actions measured in a prone position at 60, 180 and 240° s−1. A total of 50 recreational athletes completed the study. PT, APT, PW and TW for concentric and eccentric knee extension and flexion were recorded at three different angular velocities (60, 180 and 240° s−1) on three different occasions with a 72‐ to 96‐h rest interval between consecutive testing sessions. Absolute reliability was examined through typical percentage error (CVTE), percentage change in the mean (ChM) and relative reliability with intraclass correlations (ICC3,1). For both the knee extensor and flexor muscle groups, all strength data (except APT during knee flexion movements) demonstrated moderate absolute reliability (ChM < 3%; ICCs > 0·70; and CVTE < 20%) independent of the knee movement (flexion and extension), type of muscle action (concentric and eccentric) and angular velocity (60, 180 and 240° s−1). Therefore, the current study suggests that the CVTE values reported for PT (8–20%), APT (8–18%) (only during knee extension movements), PW (14–20%) and TW (12–28%) may be acceptable to detect the large changes usually observed after rehabilitation programmes, but not acceptable to examine the effect of preventative training programmes in healthy individuals.

A simplified version of the weight-bearing ankle lunge test: description and test-retest reliability.

The purpose of this study was twofold: (1) to describe a new version of the weight-bearing ankle lunge test (WBLT) that is simple to administer, that allows clinicians and sports medicine practitioners to directly assess (in degrees) the ankle dorsiflexion range of motion in a very short period of time while adopting a comfortable testing position; as well as (2) to determine the test-retest reliability of the ankle dorsiflexion range of motion measure obtained from the new version of the WBLT. A total of 50 active adults completed this study. All participants performed the new version of the WBLT on three different occasions, with a two-week interval between testing sessions. Reliability was examined through the change in the mean between consecutive pairs of testing sessions (ChM), standard error of measurement (SEM), minimal detectable change at 95% confidence interval (MDC95), and intraclass correlation coefficient (ICC2,k). The findings showed negligible or trivial ChM values for all the flexibility measures analysed (<1°). Furthermore, the SEM and MDC95 scores for the ankle dorsiflexion measure were 1.3 and 3.8 respectively, and the ICC2k was 0.95. Therefore, this study demonstrated that the ankle dorsiflexion measure obtained from the new version of the WBLT has excellent test-retest reliability scores. Thus, an observed change larger than 3.8° from baseline scores after performing a treatment would indicate that a real change in ankle dorsiflexion range of motion was likely.

Acute effects of static and dynamic stretching on hamstrings’ response times

Abstract The main purposes of this study were to (a) investigate acute effects of static and dynamic lower limb stretching routines on total response time, pre-motor time and motor time of the medial and lateral hamstrings during maximal eccentric isokinetic knee flexion; and (b) determine whether static and dynamic routines elicit similar responses. A total of 38 active adults completed the following intervention protocols in a randomised order on separate days: (a) non-stretching (control condition), (b) static stretching and (c) dynamic stretching. After the stretching or control intervention, total response time, pre-motor time and motor time of the medial and lateral hamstrings were assessed during eccentric knee flexion movements with participants prone. Measures were compared via a mixed-design factorial ANOVA. There were no main effects for total response time, pre-motor time and motor time. The results suggest that dynamic and static stretching has no influence on hamstrings response times (total response time, pre-motor time and motor time) and hence neither form of stretching reduces this primary risk factor for anterior cruciate ligament injury.

Acute effects of static and dynamic stretching on hamstring eccentric isokinetic strength and unilateral hamstring to quadriceps strength ratios

Abstract The main purposes of this study were to investigate the acute effects of static and dynamic lower limb stretching routines: (a) on peak torque, total external work and joint angle at peak torque of the hamstrings during maximal eccentric isokinetic leg flexion; (b) on unilateral hamstring to quadriceps (H/Q) strength ratios; as well as (c) to determine whether static and dynamic routines elicit similar responses. A total of 49 active adults completed the following intervention protocols in a randomised order on separate days: (a) non-stretching (control condition), (b) static stretching, and (c) dynamic stretching. After the stretching or control intervention, eccentric isokinetic peak torque, the angle of peak torque and total external work were assessed with participants prone at 1.04 and 3.14 rad · s−1. Unilateral strength ratios of the knee were also recorded. Measures were compared via a fully-within-groups factorial analysis of variance (ANOVA). There were no main effects for eccentric isokinetic peak torque, angle of peak torque, total external work and unilateral H/Q strength ratios. The results suggest that dynamic and static stretching has no influence on eccentric strength profile and unilateral H/Q strength ratios and hence both forms of stretching do not reduce these two primary risk factors for muscle injury.