Reliability of Repeated Nordic Hamstring Strength in Rugby Players Using a Load Cell Device

Abstract

Hamstring strain injuries are one of the most common injuries in Rugby Union players, representing up to 15% of all sustained injuries. The Nordic eccentric hamstring test assesses the maximal hamstring eccentric strength and imbalances between limbs. Asymmetries and deficits in hamstring strength between legs are commonly assessed and used as screening methods to prevent injuries which can only be proven effective if hamstring strength measures are reliable over time. We conducted a repeated-measures reliability study with 25 male Rugby Union players. Nordic eccentric strength and bilateral strength balance was assessed. Three testing sessions were undertaken over three consecutive weeks. Intrasession and intersession reliabilities were assessed using typical errors (TE), coefficient of variations (CV), and intraclass correlation coefficients (ICC). Our results showed good intrasession reliability (ICC = 0.79-0.90, TE = 26.8 N to 28.9 N, CV = 5.5% to 6.7%), whilst intersession reliability was fair for mean and the max (ICC = 0.52-0.64, TE = 44.1 N to 55.9 N, CV from 7.4% to 12.5%). Regarding the bilateral strength balance ratios, our results showed good intrasession reliability (ICC = 0.62-0.89, TE = 0.5, CV = 4.4% to 7.2%), whilst the intersession reliability for mean and max values was fair (ICC = 0.52-0.54) with a good absolute intersession reliability CV ranging from 8.2% to 9.6%. Assessing the Nordic eccentric hamstring strength and the bilateral strength balance in Rugby players using a load cell device is a feasible method to test, and demonstrated good intrasession and fair intersession reliability. Nordic eccentric strength assessment is a more practical and functional test than isokinetic; we provide data from Rugby Union players to inform clinicians, and to establish normative values in this cohort.