No abstract

ZusammenfassungVerschiedene Untersuchungen in den vergangenen Jahren haben gezeigt, dass innerhalb der Ballsportarten Handballspieler einem besonders hohen Verletzungsrisiko ausgesetzt sind. Dabei ist das Kniegelenk die am häufigsten verletzte Körperregion und ein Riss des vorderen Kreuzbandes die häufigste Verletzung am Knie. Um Folgeschädigungen oder erneuten Verletzungen vorzubeugen, ist eine gute situative Kniestabilität entscheidend. Diese kann nicht nur Verletzungen vorbeugen, sondern ist auch ausschlaggebend für die Optimierung handballspezifischer Bewegungsabläufe und eine verletzungsfreie Ausübung des Sports. Obwohl es zahlreiche Studien zu Verletzungen im Handball gibt (meist an Profisportlern durchgeführt), ist das Forschungsfeld in Bezug auf die situative Kniestabilität defizitär. Dieser Beitrag gibt einen Überblick über den aktuellen Forschungsstand. Zudem werden aktuelle Präventionsansätze aufgegriffen und diskutiert.

Background For future development of machine learning tools for gait impairment assessment after stroke, simple observational whole-body clinical scales are required. Current observational scales regard either only leg movement or discrete overall parameters, neglecting dysfunctions in the trunk and arms. The purpose of this study was to introduce a new multiple-cue observational scale, called the stroke mobility score (SMS). Material/Methods In a group of 131 patients, we developed a 1-page manual involving 6 subscores by Delphi method using the video-based SMS: trunk posture, leg movement of the most affected side, arm movement of the most affected side, walking speed, gait fluency and stability/risk of falling. Six medical raters then validated the SMS on a sample of 60 additional stroke patients. Conventional scales (NIHSS, Timed-Up-And-Go-Test, 10-Meter-Walk-Test, Berg Balance Scale, FIM-Item L, Barthel Index) were also applied. Results (1) High consistency and excellent inter-rater reliability of the SMS were verified (Cronbach’s alpha >0.9). (2) The SMS subscores are non-redundant and reveal much more nuanced whole-body dysfunction details than conventional scores, although evident correlations as e.g. between 10-Meter-Walk-Test and subscore “gait speed” are verified. (3) The analysis of cross-correlations between SMS subscores unveils new functional interrelationships for stroke profiling. Conclusions The SMS proves to be an easy-to-use, tele-applicable, robust, consistent, reliable, and nuanced functional scale of gait impairments after stroke. Due to its sensitivity to whole-body motion criteria, it is ideally suited for machine learning algorithms and for development of new therapy strategies based on instrumented gait analysis.

Handball is one of the most traumatic sports. The knee is the most commonly injured joint. To prevent knee injuries, optimal functional knee stability is of great importance. Nevertheless, there is still no consensus about objective criteria for knee function. Depending on playing class, injury rates seem to differ. The purpose of this study was to evaluate knee function in handball depending on playing class and to establish reference data for functional knee stability. 261 handball players (25.1±5.8 years) performed a functional test including two- and one-legged stability assessments, jump tests, speed and agility analysis. Except for balance, differences between playing classes were detected in all tests with superior performance of high-class players (Germany’s 1st (“Oberliga”) and 2nd (“Verbandsliga”) non-elite playing class). High-class players achieved significant better results in jumping height (p≤0.011–0.029), relative power per body weight in the two-legged counter movement jump (p≤0.023) and speed and agility tests (p≤0.001). This study illustrates the relevance of playing class specific screening. Sports and playing class-specific databases will help to identify individual deficits and strengths in order to prevent injury and increase performance. Moreover, objective criteria for return to sports can be established.

Purpose Despite the great evolvement of sports medicine, there is still a lack of consensus among sports physicians regarding the decision of return to sports after knee injury, especially in non‐elite sports. Currently, no sport‐specific reference data for an objective reliable evaluation of functional knee stability exist. The purpose of this study was to assess objective measures on knee joint stability from an established test battery in non‐elite handball. It was assumed that players’ knee stability differs depending on their field position. Methods One‐hundred and sixty‐five non‐elite handball players with a mean age of 24.3 ± 5.5 years underwent a test battery including two‐legged and one‐legged stability tests, two‐legged and one‐legged counter movement jumps, two‐legged plyometric jumps, one‐legged speedy jumps, and a quick feed test. Results Athletes’ physical performance differs in terms of field position. Significant differences between handball players of different positions were found in regard to two‐legged stability (p < 0.036) and one‐legged stability in the dominant leg (p < 0.009). Players of different positions differed in ground contact time of the plyometric jumps (p < 0.017), whereas the other functional tests did not show significant differences. Conclusion This study is first to report differences in functional knee stability of non‐elite handball players on the basis of objective data. Significant differences of functional performance were noted, which were in congruence with position‐specific demands. These findings demonstrate the importance of position‐specific screening and training to prevent injuries. Level of evidence II.