Hickey, Jack and Timmins, Ryan G. and Maniar, Nirav and Rio, Ebonie and Hickey, Peter F. and Pitcher, Christian A. and Williams, Morgan D. and Opar, David A.
(2020)
Pain-Free Versus Pain-Threshold Rehabilitation Following Acute Hamstring Strain Injury: A Randomized Controlled Trial.
Journal of Orthopaedic & Sports Physical Therapy (JOSPT), 50 (2).
pp. 91-103.
ISSN 0190-6011
Abstract
OBJECTIVE: The primary aim was to compare
time from acute hamstring strain injury (HSI) to
return-to-play (RTP) clearance following a standardized rehabilitation protocol performed within
either pain-free or pain-threshold limits. Secondary aims were to compare isometric knee flexor
strength, biceps femoris long head (BFLH) fascicle
length, fear of movement, and reinjury occurrence
at the 6-month follow-up between pain-free and
pain-threshold groups.
DESIGN: Randomized controlled trial.
METHODS: Forty-three men with acute HSIs were
randomly allocated to a pain-free (n = 22) or pain-threshold (n = 21) rehabilitation group. Days from
HSI to RTP clearance, isometric knee flexor strength,
BFLH fascicle length, fear of movement, and reinjury
occurrence at the 6-month follow-up were reported.
RESULTS: Median time from HSI to RTP clearance was 15 days (95% confidence interval [CI]:
13, 17) in the pain-free group and 17 days (95% CI:
11, 24) in the pain-threshold group, which was not
significantly different (P = .37). Isometric knee flex or strength recovery at 90° of hip and 90° of knee
flexion was greater in the pain-threshold group
at RTP clearance by 15% (95% CI: 1%, 28%) and
by 15% (95% CI: 1%, 29%) at 2-month follow-up,
respectively. Improvement in BFLH fascicle length
from baseline was 0.91 cm (95% CI: 0.34, 1.48)
greater at 2-month follow-up in the pain-threshold
group. Two reinjuries occurred in both the pain-free
and pain-threshold groups between RTP clearance
and the 6-month follow-up.
CONCLUSION: Pain-threshold rehabilitation
did not accelerate RTP clearance, but resulted in
greater recovery of isometric knee flexor strength
and better maintenance of BFLH fascicle length,
compared to pain-free rehabilitation.
| Item Type: |
Article
|
| Keywords: |
hamstring strain injury; muscle;
pain; rehabilitation; return to play; |
| Academic Unit: |
Faculty of Science and Engineering > Sports Science and Nutrition |
| Item ID: |
17929 |
| Identification Number: |
https://doi.org/10.2519/jospt.2020.8895 |
| Depositing User: |
Jack Hickey
|
| Date Deposited: |
12 Dec 2023 12:05 |
| Journal or Publication Title: |
Journal of Orthopaedic & Sports Physical Therapy (JOSPT) |
| Publisher: |
Journal of Orthopaedic and Sports Physical Therapy |
| Refereed: |
Yes |
| URI: |
|
| Use Licence: |
This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available
here |
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