Performance characteristics and lower limb muscle reflex properties in female volleyball athletes and non-athletes

doi:10.21203/rs.3.rs-3767294/v1

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Performance characteristics and lower limb muscle reflex properties in female volleyball athletes and non-athletes

https://doi.org/10.21203/rs.3.rs-3767294/v1

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Journal Publication

published 25 Jun, 2024

Read the published version in Sport Sciences for Health →

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Purpose

Sports training may lead to alterations in muscle reflex responses of the trained muscles. This study compared performance characteristics and the knee reflex (KR) and soleus Hoffmann (H-)reflex (SR) properties, as well as their potential associations in female volleyball players and non-athletes.

Methods

Nine female amateur volleyball players (VP) in the middle of their competition season and nine age-matched women without athletic background, used as a control group (CG), participated in the study. KR and SR amplitude and latency, handgrip strength (HS), sit-and-reach, jumping performance [countermovement jump (CMJ) using one or both legs, and long jump (LJ)] were assessed.

Results

VP performed better than CG in CMJ-both legs (27.99cm vs 20.02cm; p = 0.006), CMJ-non-dominant leg (13.40cm vs 9.88cm; p = 0.02), HS-dominant arm (33.67kg vs 27.64kg, p = 0.002) and HS-non-dominant arm (32.44kg vs 24.64kg; p = 0.001). There were no significant differences (p > 0.05) in the reflex properties between the groups. A positive correlation was found between SR latency and CMJ-both legs (VP: ρ = 0.7, p < 0.05, CG: ρ = 1, p = 0.01). Interestingly, only in the control group, there was also a positive correlation between KR and SR latencies (ρ = 0.96, p < 0.001) and a negative correlation between KR latency and amplitude (ρ= -0.68, p < 0.05).

Conclusions

Although volleyball players performed better in vertical (CMJ) jumps, the expected training-induced alterations in KR and SR reflex properties were not observed. This finding, combined with the correlations between SR latency and CMJ in both groups, suggests similar neuromuscular function in the trained and untrained subjects.

females

jump

lower limbs

muscle reflex responses

volleyball training

Muscle reflexes are an intrinsic stimulus-response system and elicited as an involuntary movement in response to a stimulus, e.g., the muscle stretch reflex or myotatic reflex, which refers to the contraction of a muscle in response to its passive stretching. It is widely accepted that the response rate of muscle reflexes, such as the (stretch) knee reflex (KR), also called patellar reflex, and the Soleus Hoffmann (H-) reflex (SR), which is an electrical analogue of the stretch reflex, is affected by somatometric characteristics, daily activities, and systematic training. Specifically, reflex responses are influenced by height and gender. Height is found to be linearly correlated to both upper and lower extremity tendon reflex latency. Notably, a strong positive correlation has been found between height and latency of the Achilles and the knee reflexes [1, 2]. Moreover, excessive mechanical stress on the quadriceps muscle has been found to cause a greater decline in the KR response in women than in men [3].

Regarding reflex function, research has shown that exercise-induced fatigue of the upper limb muscles, through repetitive movements, can cause a decline in the peak response and amplitude of the upper limb tendon reflexes [4, 5]. Several studies have suggested that KR and SR reflex responses are altered in athletes and the response rate of the musculoskeletal reflex is correlated with the level of physical activity and performance [6–10]. Interestingly, a greater response time has been noted in the individuals who performed both isometric and isotonic high-intensity exercises with lower extremities [10], as well as a decreased reflex amplitude in those who trained systematically with concentric exercises focusing on the knee joint ^[7]. Regarding professional athletes, significant differences have been reported in the respective reflex functions among athletes of different sports [6, 8], or between endurance training athletes, and untrained individuals [9]. Kamen et al, compared the reflex responses of sprinters to long-distance runners and untrained individuals, and showed that sprinters had the quickest patellar reflex response with an average of 100 ms difference in latency [6]. Another study, comparing long-distance runners with weightlifters, revealed shorter KR latency in the latter group, however, following the same program of interval training of the knee extensors [8] both KR latency and amplitude were equalized between the two groups.

Moreover, interventional studies suggested that SR and KR are affected by exercise [11–14]. Specifically, systematic training involving jumping exercises combined with whole-body vibration seems to attenuate SR [14]. In addition, systematic endurance training has been found to increase SR amplitude, whereas strength training of similar duration did not affect it [13]. Moreover, an interventional study in a non-athlete population showed a reduction of the KR trigger threshold following systematic training [11].

Volleyball players are trained systematically in fast-moving high-jumps daily, since this kind of jumps is considered as a ‘key-element’ of their performance involved in spike, block, topspin floating serves and setting. A typical training session also includes strengthening exercises of the quadriceps and gastrocnemius muscles. Nevertheless, to date, most of the studies examining the function and the possible training-induced adaptations of the Autonomic Nervous System (ANS) in volleyball players have focused on electrical skin resistance and potential, skin blood flow and temperature, instantaneous heart rate and respiratory frequency [15]. The results of these studies have shown that ANS adaptations are essential for optimal performance in volleyball [15]. However, regarding elite volleyball players, a limited body of evidence correlates reflexes with the jumping performance only in male players. Thus, the aim of the present study was to examine performance characteristics and the properties of the KR and SR, as well as their potential associations, in female volleyball players and to compare them with those in untrained subjects.

Subjects

A total of 18 young females (age: 22 ± 2.4 yrs), 9 amateur volleyball players and 9 individuals with no athletic background who served as control group, volunteered to participate in the study. The somatometric characteristics of the participants are presented in Table 1. Volleyball players had a training experience of 11 ± 2 years, and they participated in a sports-specific training 2 hours/day, 5 days per week. They also performed resistance training of the lower extremities twice a week.

Table 1

Somatometric characteristics of the study participants *[Mean (SD)]*
Variables	Volleyball players (VP) (n = 9)	Control group (CG) (n = 9)	P-value
Age (years)	22.8 (3)	20.5 (0.7)	0.2
Height (m)	1.75 (0.07)	1.69 (0.08)	0.04
Body weight (kg)	65.8 (8.8)	59 (7.4)	0.2
BMI (kg/m²)	21.4 (2.9)	21.3 (1.6)	0.7
Body fat (%)	20.3 (5.3)	22.5 (4.5)	0.6
Iliac Crest to Knee distance (cm)	46.4 (2.3)	45.1 (2.5)	0.2

Experimental Design

All experimental procedures were conducted in accordance with the Declaration of Helsinki for human studies and approved by the Ethics Committee of “Aiginition” Hospital and the Medical School of the University, while all obtained data were handled in compliance with the rules of privacy law. All volunteers were informed about the experimental procedures and signed a written informed consent prior to their participation in the study.

Prior to participation in the study, all volunteers filled in a medical history questionnaire containing information regarding the endocrine function, metabolic health, mental health and the history of potential lesions and surgeries involving their lower extremities. Individuals with recent injuries of the lower limbs were excluded from the study. Moreover, all participants refrained from any kind of physical activity for 24h prior to any measurement and it was ensured that they were in the luteal phase of the menstrual cycle.

Methodology

Knee reflex and Soleus H-reflex

All measurements were performed in the morning (09.00–10.00 am) using the non-dominant leg and made by the same investigator at least three times each and the best was recorded. Knee reflex was measured with the participant in supine position and the knee joints supported by a pillow at about 60⁰ of flexion. The knee reflex was elicited by tapping on the patellar tendon with a hammer (DANTEC 15B-01). Surface recording electrodes were placed on the third distal part of the rectus femoris muscle triggering the sweep of the oscilloscope of the electromyograph. Latencies were measured from the beginning of the sweep to the first deflection from the baseline. Amplitudes were measured peak- to -peak. Soleus H-reflex was elicited with the participant in prone position and a pillow under the ankle. Tibial nerve was stimulated at the tibial fossa and surface recording electrodes were placed on the soleus muscle. Jendrassik maneuver was used for both reflexes to increase their amplitude [16].

Jumping Performance

The height of countermovement jump (CMJ) was used to evaluate jumping performance with the Ergojump Bosco System. All participants were instructed to keep their arms akimbo and not to tuck their legs during the flight phase of the vertical jump. CMJ was performed in three different ways: using both legs, using the dominant and using the non-dominant leg. Standing long jump (SLJ) was also used to evaluate the lower limbs muscular strength and power. The subjects were instructed to stand with their feet in parallel and perform a horizontal jump with both legs using an arm swing. For both jumping tasks, volunteers were familiarized with the correct execution, while for each type of jump they performed three attempts with one minute rest in between and the best one was used for statistical analysis.

Flexibility

The “sit and reach” flexibility test was used to assess the extensibility of hamstrings and lower back muscles. All volunteers stood barefoot with both legs stepping fully extended on a common flexometer, trying to lean forward as far as possible without bending the knees, while they held the position for at least 2 seconds. Two attempts were performed, and the highest score achieved was used.

Handgrip Strength

Grip strength was evaluated with a specialized Jamar® hydraulic hand dynamometer, while its handle was adjusted to each participant based on the size of their hand to fit properly. Standing upright, participants had their arms in a neutral position at the elbow and wrist and they were instructed to exert maximum strength for 3 seconds. A strong verbal encouragement was given by the examiner and after two attempts with each hand, the best effort was recorded.

Statistical Analysis

Statistical analysis was performed using STATA MP 13.0. The Kernel-density plots and Shapiro – Wilk test was performed to examine if the data follow the normal distribution, while descriptive analysis by mean and standard deviation [mean (SD)] was employed for all quantitative variables. Due to the small number of participants, the non-parametric statistical tests of Spearman's rank correlation coefficient and Wilcoxon Rank-Sum were used. The level of statistical significance was set at p < 0.05.

One athlete didn’t proceed to the neurophysiological measurements, whereas two members of the control group didn’t complete the physical performance measurements.

Knee Reflex and Soleus Reflex

There were no significant differences between the VP and CG in either KR or SR amplitude and latency (Table 2). A positive correlation between KR and SR latencies [spearman rate (ρ) = 0.96, p < 0.001] and a negative correlation between KR latency and KR amplitude; (ρ= -0.68, p < 0.05) was found in the CG. In addition, there was a positive correlation between SR latency and CMJ using both legs in the VP (Ρ = 0.7, p < 0.05) and in the CG (ρ = 1, p = 0.01). Moreover, a negative correlation was revealed between SR latency and S and R test in the VP (ρ= -0.75, p < 0.05).

Table 2

Neurophysiological measurements *[Mean (SD)]*
Variables	Volleyball players (VP) (n = 8)	Control group (CG) (n = 9)	P-value
Knee Reflex Latency (msec)	21.38 (1.1)	21.11 (1.3)	0.8
Knee Reflex Amplitude (mV)	1.19 (0.6)	1.66 (0.8)	0.2
Soleus Hoffmann Reflex Latency (msec)	31.76 (2.51)	30.1 (2.27)	0.3
Soleus Hoffman Reflex Amplitude (mV)	0.41 (0.14)	0.49 (0.19)	0.3

Countermovement Jump

Countermovement jump (CMJ) height using both legs and CMJ height using the non-dominant leg were both significantly greater in VP (p < 0.01 and p < 0.05, respectively (Table 3). However, there were no significant differences between the groups regarding the CMJ using the dominant leg (p > 0.05). Among volleyball players, CMJ height using both legs correlated positively with the long jump distance (ρ = 0.78, p = 0.01) and negatively (ρ= -0.77, p = 0.01) with the “Sit and Reach” performance.

Table 3

Performance measurements *[Mean (SD)]*
Variables	Volleyball players (VP) (n = 9)	Control group (CG) (n = 7)	P-value
CMJ using both legs (cm)	27.99 (3.23)	20.02 (5.68)	0.006
CMJ using the non-dominant leg (cm)	13.4 (2.55)	9.88 (1.6)	0.02
CMJ using the dominant leg (cm)	12.43 (1.82)	10.58 (1.9)	0.1
Long Jump (m)	1.38 (0.15)	1.27 (0.27)	0.1
Sit and Reach (cm)	24.33 (6.44)	17 (11.39)	0.3
Handgrip using the dominant arm	33.67 (3.66)	27.64 (2.25)	0.002
Handgrip using the non-dominant arm	32.44 (1.82)	24.64 (3.28)	0.001

Hand Grip Strength, Long Jump, Sit and Reach test

Handgrip strength was significantly greater in VP compared to CG both using the dominant (33.67 ± 3.66 vs 27.64 ± 2.25, p < 0.05) and the non-dominant arm (32.44 ± 1.82 vs 24.64 ± 3.28, p < 0.05). In the Long Jump and Sit and Reach tests there were no significant differences between the groups (p > 0.05; Table 3).

The main finding of this study is the associations between vertical jump performance and the neurophysiological features of the volleyball players. Based on previous research, an increase in the reflex amplitude and a decrease in reflex latency were expected in volleyball players compared to controls[17, 18]. However, our study revealed no significant differences between non-professional volleyball players and untrained age- and gender-matched subjects regarding these reflexes’ properties. We assume that the discrepancy between the expected and the observed outcome may be due to the effect of training-associated fatigue on the lower limb muscles in the middle of the competition season, when physical demands for the volleyball players were the highest. This assumption is supported by previous studies, which have shown the negative effect of exercise-related fatigue on reflex latency and amplitude[12, 19].

KR is an important autonomic mechanism in humans for maintaining balance [20]while SR participates in the circle of gait [21]. Volleyball matches involve a high number of jumps, directional changes, and high-intensity, explosive movements. It has been calculated that in a 5-set match, a player may perform a range of 65–135 jumps [22]. The spike approach includes 3 explosive steps before the jump, while the energetic block also requires explosive steps. Quick and short displacements are important for blocking and defense. All these elements require balance as well as high neuromuscular and motor coordination to avoid injuries.

Increased height of CMJ requires strengthening of the lower limb muscles, primarily the gastrocnemius and the rectus femoris. Strength training of these muscles at elite and non-professional levels includes repetitive targeted resistance exercises. It has been reported that repeated Achilles tendon vibration results in increased amplitude of the SR in healthy individuals who did not previously exercise daily[17]. One proposed mechanism for the increase in reflex amplitude following systematic training is the inhibition of the antagonistically acting Golgi tendon reflex (also called inverse stretch reflex or tendon reflex)^{[23, 24]}. The fact that, in our study, there were no significant differences in reflex amplitude between the two groups suggests that Golgi tendon reflex inhibition doesn’t instate for long, even if stimuli in this direction are received daily and repetitively for years. Furthermore, we may hypothesize that in the case of volleyball players, the Golgi tendon reflex response is upregulated as an adaptive protective mechanism to safeguard these athletes from muscle and/or ligament injuries caused by joint hyperextension. Increased reflex amplitude indicates synchronized depolarization of muscle fibers [25]. Among volleyball players who perform repetitive high jumps, a gradual, instead of an instantaneous, synchronized muscle fiber recruitment, may be preferable to prevent knee-joint hyperextension. To the best of the authors knowledge, there are no studies associating reflex properties to landing-kinetics measurements. Taking into consideration our findings, more research is needed to investigate potential associations between KR amplitude and latency and prelanding and early-landing knee flexion angles and velocities. A previous investigation focused on untrained individuals and assessed short-term adaptations to repetitive stimulation [17]. However, our findings suggest that long-term adaptations in athletes, following years of systematic training, may work in the opposite direction. It would be interesting to assess the reflex properties of athletes across different time points after the onset of a sport-specific systematic training, to reveal the natural course of reflex response adaptations. Moreover, in parallel with KR and SR responses, the Golgi tendon reflex responses and adaptations to exercise training should be also investigated.

Another notable finding of this study is the positive correlation between the latency of both the KR and SR and the CMJ, since slower reaction times increase the chances of sports-related injuries, especially ligament injuries [26, 27]. Lastly, the lack of a significant association between KR and SR in volleyball players suggest that these reflexes may be training movements-specific, i.e., KR may be mostly associated with spike jump, whereas SR might be more affected by continuous hip training necessary for defense and by the overall body vibration [14, 28–30].

Practical applications and future research

This study included a small sample of amateur athletes who had neither identical training programs (as members of different sport clubs) nor identical lifestyles. Nevertheless, it provides evidence supporting the individualization of strength training of female volleyball athletes, to limit the possible increase in SR and KR latencies caused by the repetitive exercises of the associated muscles. Further research is needed to assess the effect of SR and KR reflex latency increases on the risk of anterior cruciate ligament (ACL) injury. In addition, detailed measurements of the KR, SR, and Golgi tendon reflexes in different periods of the season (e.g., both in competitive and tapering periods) are recommended, to verify our findings regarding the effects of training-associated fatigue in the period of maximum training load, or as a result of specific training programs. Moreover, further research is recommended focusing on the effect of each particular exercise/movement, habitually performed by volleyball players, on the SR and KR reflex latencies. This would help establish the best approach to an individualized training plan and support the safe training of the athletes.

This study focused on the potential neuromuscular adaptations following volleyball training in young women. The lower limb muscle reflex responses of these athletes found to be within the normal values and not different from those of age- and gender-matched untrained individuals. Training-associated muscle fatigue and/or physiological chronic adaptations to systematic training may account for the lack of the expected alterations in the muscle reflex properties in the volleyball players. Further research is warranted to assess the muscle reflexes KR, SR, and Golgi tendon reflexes in different periods of the training season, to verify the possible effects of fatigue during the period of maximum training load on the neuromuscular function of these athletes.

Author Contribution

Conceptualization: Evmorfia Pechlivanidou, Maria Effrosyni Livanou; Methodology: Evmorfia Pechlivanidou, Maria Effrosyni Livanou, Argyro Papadopetraki; Formal analysis and investigation: Evmorfia Pechlivanidou, Maria Effrosyni Livanou; Writing - original draft preparation: Evmorfia Pechlivanidou, Maria Effrosyni Livanou; Writing - review and editing: Argyro Papadopetraki, Anastassios Philippou; Supervision: Argyro Papadopetraki, Anastassios Philippou

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No competing interests reported.

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published 25 Jun, 2024

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Editorial decision: Revision requested
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You are reading this latest preprint version

Performance characteristics and lower limb muscle reflex properties in female volleyball athletes and non-athletes

Status:

Journal Publication

Version 1

Abstract

Purpose

Methods

Results

Conclusions

Introduction

Methods

Subjects

Experimental Design

Methodology

Statistical Analysis

Results

Knee Reflex and Soleus Reflex

Countermovement Jump

Hand Grip Strength, Long Jump, Sit and Reach test

Discussion

Practical applications and future research

Conclusions

Declarations

Author Contribution

References

Additional Declarations

Status:

Journal Publication

Version 1