The Effect of the Copenhagen Adduction Exercise on Groin Injuries Rate Among Soccer Players.

The Effect of the Copenhagen Adduction Exercise on Groin Injuries Rate Among Soccer Players. A Cluster Randomized Controlled Trial.

The effect of the Copenhagen Adduction Exercise on groin injuries rate among soccer players The Copenhagen adduction exercise is a body-weight exercise which mainly works the groin and hip Adductors. It has a large eccentric component, meaning the muscles are working whilst lengthening.

The purpose of this study is to investigate the effect of the Copenhagen adduction exercise on groin injuries among soccer players.

It hypothesized that Copenhagen adduction exercise has a beneficial effect in terms of groin injury prevention.

Study Overview

• Status: Unknown
• Conditions: Groin Injuries
• Intervention / Treatment: Other: Usual warm up; Other: Copenhagen adduction exercise

Detailed Description

Study type Interventional Description of intervention(s) / exposure The intervention group will be instructed to include the Copenhagen adduction exercise into their warm up before training session (3 times per week) during one season (6 months).

Group sessions will be administered by an exercise physiologist and/ or athletic trainer and/ or soccer coaches and/ or strength and conditioning specialists and/ or physiotherapist.

Session attendance checklists will be used to assess or monitor adherence to the intervention.

The Copenhagen adduction exercise is a body-weight exercise which mainly works the groin and hip adductor. It has a large eccentric component, meaning the muscles are working whilst lengthening.

The Copenhagen Adduction exercise is a simple isolated eccentric partner exercise and doesn't require special equipment and can be performed as a warm up activity on the pitch.

The Copenhagen Adduction exercise requires a partner who will hold the player's upper leg in an extended position nearly at the hip level of the partner, with one hand supporting the knee and the other upholding the ankle. Meanwhile, the player will lie on one side and support the body with the forearm on the ground and the top arm being placed along the body. Then, the player will elevate the trunk from the floor and raise the lower leg in a straight line. The player will repeat this for 3 seconds until the feet touch each other. This will be followed by slightly lowering the body just to the ground for 3 seconds until it touches the level of the foot.

It must be performed on both limbs. It is crucial to note that the most accurate performance of the exercise must avoid trunk bending. In terms of the training form, the frequency is three-two sessions per week while the repetition varies according to the different levels of the players ranging from 3-12 times in one-two sets.

Prevention Comparator / control treatment The control group will practice their usual warm up. Usual warm up is defined as any basic exercises performed before a performance or practice to prepare the muscles for vigorous actions.

• Study Type: Interventional
• Enrollment (Anticipated): 400
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Saudi Arabia
  • Mecca, Saudi Arabia, 21955
    • Umm Al Qura University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years to 36 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

Soccer teams Amateur. Male . Training at least three times per week.

Exclusion Criteria:

History of lower extremity injury requiring medical attention in the past 6 months, or systemic diseases, cardiovascular disease, neurological disorders or bone fractures or surgery in the previous year.

Players who joined a participating team after the start of the trial will be excluded.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention group; The intervention group will be instructed to include the Copenhagen adduction exercise into their warm up before training session (3 times per week) during one season (6 months). The Copenhagen adduction exercise is a body-weight exercise which mainly works the groin and hip adductor. It has a large eccentric component, meaning the muscles are working whilst lengthening.	Other: Copenhagen adduction exercise; The Copenhagen Adduction exercise is a simple isolated eccentric partner exercise and doesn't require special equipment and can be performed as a warm up activity on the pitch.
Active Comparator: Control group; The control group will practice their usual warm up. Usual warm up is defined as any basic exercises performed before a performance or practice to prepare the muscles for vigorous actions.	Other: Usual warm up; Usual warm up is defined as any basic exercises performed before a performance or practice to prepare the muscles for vigorous actions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of initial injuries	Injury is defined according to a consensus statement on injury definitions and data collection procedures in soccer studies; an injury will be recorded if it caused the player to be unable to completely participate in the following match or training session.Injury rates will be summarised as number of injuries per 1000 player-hours for both matches and training. Exposure time in hours will be calculated for each team over a 6-month period. Data will be collected from Sports Injury Tracker injury reporting form. Coaches in both the experimental and control groups will be reporting injuries during training and matches by filling in forms once per week and submitting the information using the Sports Injury Tracker injury reporting form (Sports Medicine Australia). Injury rates will be summarised as number of injuries per 1000 player-hours for both matches and training. Exposure time in hours will be calculated for each team over a 6-month period.	At the end of the intervention season (6 months)
The incidence of recurrent injuries	Recurrent injury is defined as a repeat episode of a fully recovered injury. Injury is defined according to a consensus statement on injury definitions and data collection procedures in soccer studies; an injury will be recorded if it caused the player to be unable to completely participate in the following match or training session. Data will be collected from Sports Injury Tracker injury reporting form.	At the end of the intervention season (6 months)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Injury severity	Defined as time loss in days (days unable to train): minor (1 to 7 days lost), moderate (8 to 21 days lost), or severe (>21 days lost). Injury severity data will be collected from Sports Injury Tracker injury reporting form.	At time of any injury occurring throughout intervention soccer season (6 months)
Compliance with the intervention	The rate of compliance using attendance log.	At the end of the intervention season (6 months)

Collaborators and Investigators

• Sponsor: Umm Al-Qura University

Publications and helpful links

General Publications

• Holmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM, Krogsgaard K. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet. 1999 Feb 6;353(9151):439-43. doi: 10.1016/S0140-6736(98)03340-6.
• Ishoi L, Sorensen CN, Kaae NM, Jorgensen LB, Holmich P, Serner A. Large eccentric strength increase using the Copenhagen Adduction exercise in football: A randomized controlled trial. Scand J Med Sci Sports. 2016 Nov;26(11):1334-1342. doi: 10.1111/sms.12585. Epub 2015 Nov 21.
• Haroy J, Clarsen B, Wiger EG, Oyen MG, Serner A, Thorborg K, Holmich P, Andersen TE, Bahr R. The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial. Br J Sports Med. 2019 Feb;53(3):150-157. doi: 10.1136/bjsports-2017-098937. Epub 2018 Jun 10.
• Holmich P. Groin injuries in athletes--development of clinical entities, treatment, and prevention. Dan Med J. 2015 Dec;62(12):B5184.
• Haroy J, Thorborg K, Serner A, Bjorkheim A, Rolstad LE, Holmich P, Bahr R, Andersen TE. Including the Copenhagen Adduction Exercise in the FIFA 11+ Provides Missing Eccentric Hip Adduction Strength Effect in Male Soccer Players: A Randomized Controlled Trial. Am J Sports Med. 2017 Nov;45(13):3052-3059. doi: 10.1177/0363546517720194. Epub 2017 Aug 14.

Study record dates

Study Major Dates

• Study Start (Anticipated): January 16, 2021
• Primary Completion (Anticipated): June 16, 2021
• Study Completion (Anticipated): July 16, 2021

Study Registration Dates

• First Submitted: December 8, 2020
• First Submitted That Met QC Criteria: December 12, 2020
• First Posted (Actual): December 17, 2020

Study Record Updates

• Last Update Posted (Actual): December 17, 2020
• Last Update Submitted That Met QC Criteria: December 12, 2020
• Last Verified: December 1, 2020

More Information

Terms related to this study

• Keywords: Soccer; Copenhagen Adduction Exercise; Groin injuries
• Additional Relevant MeSH Terms: Wounds and Injuries
• Other Study ID Numbers: HAPO-02-K-012-2020-11-481

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Yes
• IPD Plan Description: All of the individual participant data collected during the trial, after de-identification will be shared.
• IPD Sharing Time Frame: Start: Immediately following publication for 5 years.
• IPD Sharing Access Criteria: Access subject to approvals by Principal Investigator. The Principal Investigator can be contacted by email wsattar@uqu.edu.sa
• IPD Sharing Supporting Information Type: Study Protocol; Statistical Analysis Plan (SAP)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No