Relationship between the Handball-Specific Complex-Test and Intermittent Field Test performance in professional players.

BACKGROUND: We investigated the relationship between the Handball Complex-Test (HBCT) and two selected field performance tests (the repeated sprint ability [RSA], and the Yo-Yo Intermittent Recovery Test) in elite handball players. METHODS: Nineteen handball players (age: 25.7±5.1 years) were drawn from the First Professional German League. The HBCT consists of four activity series (AS): agility parcours, defensive action, sprint (10 m, 20 m) and throw-on-goal parcours; these activities were completed twice, with five active pauses of 30-35 s, and a follow-up of recovery over the subsequent 10 minutes. The RSA comprised 6 x (15+15 m) sprints starting every 20 s; scoring noted best time (RSAbest), total time (RSATT) and decrement (RSAdec). In the Yo-Yo Intermittent Recover, we recorded the total distance covered (TD). Heart rates (HR) were recorded throughout and recovery was assessed for measurements immediately post-test (R0) and 10 minutes after completing the test (R10). RESULTS: A strong correlation was found between HBCT and fastest 10 m and 20 m RSA sprint times (r=0.811, r=0.815, respectively). Also, the HBCT total 10 m and 20 m sprint times showed a strong positive association with RSATT (r=0.70; r=0.63, respectively), and the RSA heart rate post-test was strongly correlated with the HBCT heart rate after round two (r=0.865). CONCLUSIONS: Data from the match-specific HBCT Test shows a strong positive association with other more generic intermittent field test measurements. These observations support the validity of using the generic tests to monitor current fitness and responses to training in team handball players.

Relationships between the handball-specific complex test, non-specific field tests and the match performance score in elite professional handball players.

BACKGROUND: This study assessed the validity of the handball-specific complex test (HBCT) and two non-specific field tests in professional elite handball athletes, using the match performance score (MPS) as the gold standard of performance. METHODS: Thirteen elite male handball players (age: 27.4±4.8 years; premier German league) performed the HBCT, the Yo-Yo Intermittent Recovery (YYIR) test and a repeated shuttle sprint ability (RSA) test at the beginning of pre-season training. The RSA results were evaluated in terms of best time, total time, and fatigue decrement. Heart rates (HR) were assessed at selected times throughout all tests; the recovery HR was measured immediately post-test and 10 minutes later. The match performance score was based on various handball specific parameters (e.g., field goals, assists, steals, blocks, and technical mistakes) as seen during all matches of the immediately subsequent season (2015/2016). RESULTS: The parameters of run 1, run 2, and HR recovery at minutes 6 and 10 of the RSA test all showed a variance of more than 10% (range: 11-15%). However, the variance of scores for the YYIR test was much smaller (range: 1-7%). The resting HR (r2=0.18), HR recovery at minute 10 (r2=0.10), lactate concentration at rest (r2=0.17), recovery of heart rate from 0 to 10 minutes (r2=0.15), and velocity of second throw at first trial (r2=0.37) were the most valid HBCT parameters. CONCLUSIONS: Much effort is necessary to assess MPS and to develop valid tests. Speed and the rate of functional recovery seem the best predictors of competitive performance for elite handball players.

Differences in anthropometric characteristics in relation to throwing velocity and competitive level in professional male team handball: a tool for talent profiling.

BACKGROUND: The primary aim of the study was to examine the anthropometric characteristics as well as throwing and sprinting performance of professional handball players classified by playing position and competition level. METHODS: 21 male players (age: 25.2±5.1 years) from the first German handball league (FGL) and 34 male players (age: 26.1±4.1 years) from the third German handball league (TGL) were categorized as backs, pivots, wings and goalkeepers. Measurements included anthropometric data (height, mass and body mass index (BMI)), throwing and sprinting performance selected out of a complex handball test (HBCT), which was conducted twice (2 rounds). During the HBCT, the subjects performed two sprints (10, 20 m), two standing throws with run-up (ST) and four vertical jump throws (VJT) over a hurdle (20 cm) with and without precision for goal shot. RESULTS: The anthropometric data revealed a significantly (P=0.038 and η2=0.079) shorter body height for TGL than for FGL players. In the cohort of first league athletes the pivots were the tallest (1.98±0.04 m), backs in the third league showed the maximum body height (1.90±0.05 m). Regarding body mass, pivots were the heaviest players independent from the league membership. The FGL players showed a significantly (P<0.05 and η2>0.10) higher throwing velocity in all type of throws. Body height was significantly related to ST (r=0.53) and VJT (r=0.52) in the first round of HBCT but only for the FGL athletes. Throwing velocity was also correlated with BMI (r=-0.50) among the TGL players. CONCLUSIONS: Substantial differences of body characteristics, throwing and sprinting performance between playing positions and competitive levels underline the importance of a careful scouting and position-specific training for professional handball players.

Estimation of return-to-sports-time for athletes with stress fracture - an approach combining risk level of fracture site with severity based on imaging.

BACKGROUND: The aim was to compare the return-to-sports-time (RTST) following stress fractures on the basis of site and severity of injury. This retrospective study was set up at a single institution. Diagnosis was confirmed by an interdisciplinary adjudication panel and images were rated in a blinded-read setting. METHODS: 52 athletes (female, n = 30; male, n = 22; mean age, 22.8 years) with stress fracture (SFX) who had undergone at least one examination, either MRI or bone scintigraphy, were included. Magnetic resonance images (MRI) and/or bone scintigraphy (BS) of SFX were classified as either low- or high-grade SFX, according to existing grading systems. For MRI, high-grade SFX was defined as visibility of a fracture line or bone marrow edema in T1-, T2-weighted and short tau inversion recovery (STIR) sequences, with low-grade SFX showing no fracture line and bone marrow edema only in STIR and/or T2-weighted sequences. In BS images, a mild and poorly defined focal tracer uptake represented a low-grade lesion, whereas an intense and sharply marginated uptake marked a high-grade SFX. In addition, all injuries were categorized by location as high- or low-risk stress fractures. RTST was obtained from the clinical records. All patients were treated according to a non-weight-bearing treatment plan and comprehensive follow-up data was complete until full recovery. Two-sided Wilcoxon's rank sum test was used for group comparisons. RESULTS: High-risk SFX had a mean RTST of 132 days (d) [IQR 64d - 132d] compared to 119d [IQR 50d - 110d] for low-risk sites (p = 0.19). RTST was significantly longer (p = 0.01) in high-grade lesions [mean, 143d; IQR 66d - 134d] than in low-grade [mean, 95d; IQR 42d - 94d]. Analysis of high-risk SFX showed no difference in RTST (p = 0.45) between high- and low-grade [mean, 131d; IQR 72d - 123d vs. mean, 135d; IQR 63d - 132d]. In contrast, the difference was significant for low-risk SFX (p = 0.005) [low-grade; mean, 61d; IQR 35d - 78d vs. high-grade; mean, 153d; IQR 64d - 164d]. CONCLUSION: For SFX at low-risk sites, the significant difference in RTST between low- and high-grade lesions allows more accurate estimation of RTST by this approach. Both location of the injury and severity determined by imaging should therefore be considered for prediction of RTST.

Blinded-read of bone scintigraphy: the impact on diagnosis and healing time for stress injuries with emphasis on the foot.

AIM: This study evaluated the use of bone scintigraphy (BS) for the diagnosis of stress fractures in athletes and its validity for the prediction of healing time, with a focus on foot injuries. METHODS: In our retrospective study, 84 athletes with a total of 93 suspected stress fractures (foot, n = 66; others, n = 27) were included. A blinded-read of BS was performed by 3 observers. The standard of reference was established by an interdisciplinary truth-panel using all imaging data (scintigraphic, radiographic, and magnetic resonance imaging) and follow-up data (>12 month). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for diagnosing stress fractures were calculated. Stress injuries were rated according to a 5-point grading score (0-4) and associated to the healing time. RESULTS: For the diagnosis of stress injuries (n = 50/93), mean sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 97.3%, 67.4%, 77.7%, 95.6%, and 83.5%, respectively. Interobserver analysis showed a high agreement between all 3 readers (mean κ = 0.83). In univariate analysis healing time of grade 3 to 4 stress injuries was significantly higher (median, 87 days; interquartile range, 69-132 days) compared with grade 1 to 2 lesions (median, 63 days; interquartile range, 43-95 days; P = 0.0067). Moreover, healing time of scintigraphic high grade stress injuries was significantly longer in a general linear model with adjustment for cofactors (grade, 3-4 vs. 1-2; P = 0.033). CONCLUSIONS: BS is a sensitive and reliable method for the diagnosis of stress injuries. In addition, the simplified classification for mild and severe stress injuries allows an estimation of healing time.