Effect of PNF-Based Upper Extremity Strengthening With Core Stabilization on Fitness in Amputee Football Players

Not Applicable

Not yet recruiting

• Conditions: Amputation; Lower Limb Amputation
• Interventions: Other: Control Group; Other: Training

• Registration Number: NCT06556082
• Lead Sponsor: Uskudar University

Brief Summary

Amputee football (AF) is a disability-specific football in which amputees can participate. This study aims to determine the effect of PNF-based upper extremity strengthening exercises combined with core stabilization exercises on physical fitness parameters in amputee football players. In the study, amputee soccer players will be randomly divided into two groups training and control groups. In addition to the standard training programs in the off-season, the amputee athletes in the training group will receive PNF-based upper extremity strengthening training combined with core stabilization training by the same physiotherapist 3 days a week for 8 weeks. The amputee football players in the control group will be given upper extremity strengthening training with free weights in addition to core stabilization training 3 days a week for 8 weeks. The physical and demographic characteristics of the cases who signed the consent form will be recorded. Initial evaluations will be made before the start of the exercise training program and secondary evaluations will be made at the end of 8 weeks. Detailed information about the participants will be obtained with the Descriptive Characteristics Information Form. Single Leg Balance Test, Berg Balance Scale and Activity Specific Balance Confidence Scale will be used to obtain information about postural control and balance strategies of the participants. Pressure Feedback Unit will be used to measure the stabilization capacity of deep spinal muscles. Trunk muscle endurance tests developed by McGill will be used to assess the level of core stability. Isokinetic muscle strength of the upper extremity muscles will be measured with the ISOMED 2000 (2017-Germany) device. Hand grip strength will be measured with Jamar Hand Dynanometer. Closed Kinetic Ring Upper Extremity Test will be used to measure the strength, anaerobic power, and closed kinetic chain stability of the upper extremity. The Distance Triple Hop Test will be used to assess the strength, speed, balance, and control ability of a lower extremity with special emphasis on the distance traveled by the lower extremity. Sprint Test will be used to measure the running performance of amputee soccer players. The data will then be analyzed and interpreted with appropriate statistical methods.

Detailed Description

Amputee football (AF) is a disability-specific football in which amputees can participate. Optimum flexibility, strength, endurance, speed, and agility are required to perform adequately in amputee football. However, amputee soccer requires intense strength and stability requirements on the upper extremities and trunk, especially due to the use of crutches. The aim of this study is to determine the effect of PNF-based upper extremity strengthening exercises combined with core stabilization exercises on physical fitness parameters in amputee football players. In the study, amputee soccer players will be randomly divided into two groups training and control groups. In addition to the standard training programs in the off-season, the amputee athletes in the training group will receive PNF-based upper extremity strengthening training combined with core stabilization training by the same physiotherapist 3 days a week for 8 weeks. The amputee football players in the control group will be given upper extremity strengthening training with free weights in addition to core stabilization training 3 days a week for 8 weeks. The physical and demographic characteristics of the cases who signed the consent form will be recorded. Initial evaluations will be made before the start of the exercise training program and secondary evaluations will be made at the end of 8 weeks. Detailed information about the participants will be obtained with the Descriptive Characteristics Information Form. Single Leg Balance Test, Berg Balance Scale, and Activity Specific Balance Confidence Scale will be used to obtain information about postural control and balance strategies of the participants. Pressure Feedback Unit will be used to measure the stabilization capacity of deep spinal muscles. Trunk muscle endurance tests developed by McGill will be used to assess the level of core stability. Isokinetic muscle strength of the upper extremity muscles will be measured with the ISOMED 2000 (2017-Germany) device. Hand grip strength will be measured with Jamar Hand Dynanometer. Closed Kinetic Ring Upper Extremity Test will be used to measure the strength, anaerobic power, and closed kinetic chain stability of the upper extremity. The Distance Triple Hop Test will be used to assess the strength, speed, balance, and control ability of a lower extremity with special emphasis on the distance traveled by the lower extremity. Sprint Test will be used to measure the running performance of amputee soccer players. The data will then be analyzed and interpreted with appropriate statistical methods.

Study Timeline

• Status Verified: 2024-08
• Study First Submitted: 2024-08-13
• Study First Submitted QC: 2024-08-13
• Last Update Submitted: 2024-08-13
• Study First Posted: 2024-08-15
• Last Update Posted: 2024-08-15
• Study Start: 2024-09-01
• Primary Completion: 2025-01-01
• Study Completion: 2026-06-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 14

Inclusion Criteria

• At least one year of experience in playing amputee soccer.
• Transtibial, knee disarticulation, or transfemoral level amputation.

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Exclusion Criteria

• Presence of upper extremity amputation.
• Bilateral lower extremity amputation.
• Underwent upper or lower extremity surgery within the last 6 months.
• Neurological disease, vestibular or visual problems.
• Use of medication affecting the central nervous system.
• Any pathology that may affect motor performance.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control Group	Control Group	The amputee football players in the control group will be trained 3 days a week for 8 weeks with isotonic strengthening exercises of the upper extremity muscles with free weights and core stabilization training.
Training Group	Training	In addition to the standard training programs in the off-season period; PNF-based upper extremity strengthening training will be performed 3 days a week for 8 weeks in addition to core stabilization training.

Primary Outcome Measures

Name	Time	Method
Isokinetic Upper Extremity Muscle Strength	Baseline (pre-intervention) and at 8 weeks (post-intervention).	The strength of the shoulder, elbow, and wrist muscles will be assessed using an isokinetic dynamometer (ISOMED 2000). Measurements will be taken at angular velocities of 60°/s and 180°/s in concentric-concentric mode for abduction-adduction and internal-external rotation movements. The peak torque values will be recorded.
Core Muscle Strength	Baseline (pre-intervention) and at 8 weeks (post-intervention).	Core muscle strength will be measured using the Stabilizer Pressure Biofeedback Unit (Chattanoga Group,2005). The device will be used to assess the ability of participants to maintain a neutral spine position during various core stabilization exercises.
Sprint Performance	Baseline (pre-intervention) and at 8 weeks (post-intervention).	Sprint performance will be assessed by recording the time it takes for participants to complete 10m, 20m, and 30m sprints using crutches. Two trials will be conducted, and the best times will be recorded.

Secondary Outcome Measures

Name	Time	Method
Postural Stability	Baseline (pre-intervention) and at 8 weeks (post-intervention).	The Berg Balance Scale will be used to assess the overall postural stability and balance of the participants. This test consists of 14 tasks that measure a range of balance activities, each scored from 0 to 4. Higher scores indicate better balance and stability.
Static Balance Assessment	Baseline (pre-intervention) and at 8 weeks (post-intervention).	The Single Leg Stance Test will be used to assess static balance and postural control. Participants will be asked to stand on one leg with their arms either on their hips or crossed over their shoulders. The time (in seconds) they can maintain balance without losing posture will be recorded. The best of three trials will be used for analysis.
Balance Confidence	Baseline (pre-intervention) and at 8 weeks (post-intervention).	Activities-Specific Balance Confidence Scale (ABC) will assess the participants' confidence in maintaining balance during various activities. It includes 16 items scored from 0% (no confidence) to 100% (full confidence).
Upper Extremity Endurance and Stability	Baseline (pre-intervention) and at 8 weeks (post-intervention).	Closed Kinetic Chain Upper Extremity Stability Test will be used to assess upper extremity stability and endurance. Participants will perform in push-up position, touching two lines placed 0.9 meters apart as many times as possible within 15 seconds. The total number of touches will be recorded.
Grip Strength Assessment	Baseline (pre-intervention) and at 8 weeks (post-intervention).	Grip strength will be measured using a Jamar hand dynamometer according to the American Society of Hand Therapists (ASHT) protocol. Participants will perform three trials with their dominant hand, and the average value will be recorded.
Core Stability Level	Baseline (pre-intervention) and at 8 weeks (post-intervention).	Core stability will be evaluated using the McGill core tests, which include the Sorensen test, trunk flexion test, and side bridge tests. These tests measure the endurance of the core muscles by recording the time (in seconds) participants can maintain specific postures.
Athletic Performance (Triple Hop Distance Test)	Baseline (pre-intervention) and at 8 weeks (post-intervention).	The Triple Hop Distance Test will be used to assess the explosive power, balance, and control of the lower extremity. Participants will be asked to hop as far as possible on one leg, three consecutive times without losing balance. The distance from the starting point to the final landing point will be measured and recorded.

Trial Locations

Locations (1)

Uskudar University Physiotherapy and Rehabilitation Application and Research Center; 🇹🇷 Istanbul, Turkey