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

Condition(s) studied

Investigational drug(s) / intervention(s)

Training: Proprioceptive Neuromuscular Facilitation(PNF) based upper extremity strengthening exercises to increase upper extremity muscle strength will be applied to the participants in the training group 3 days a week for 8 weeks. PNF-based upper extremity strengthening exercises will be performed with an elastic resistive band using bilateral symmetrical PNF patterns of "Flexion-Adduction-External Rotation-Extension-Abduction-Internal Rotation", "Flexion-Abduction-External Rotation-Extension-Adduction-Internal Rotation" on two different diagonals while individuals are in a sitting position in a supported chair. Core Stabilization Training will be continued for 8 weeks by increasing the difficulty and intensity of the exercises with limb movements and floor modifications after the amputee football players are taught how to find their neutral spine and how to maintain the position.

Control Group: The control group will be trained with isotonic strengthening exercises of upper extremity muscles with free weights and core stabilization training 3 days a week for 8 weeks. Isotonic exercises involve muscle contraction with movement, where the muscle length changes while maintaining constant tension. Free weights such as dumbells will be used in the implementation of the exercises. 1 Repetition Maximum (1RM) method will be used to determine the progression of the exercises.

Study 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.

Eligibility

Primary outcome measure(s)

• 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.

Trial sites (1)

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