1.The background the study :
Korfball was created in 1902 by a Dutch Primary School teacher1.The main factor for the establishment of korfball was a noticed need for a competitive mixed sport that believed on collaboration, where rules were developed to support boys and girls to attend on a level playing field, refuses violence and format an egalitarian game2.In this context, Korfball presented a modernist and fairly essential alternating to single-sex team sports that had been presented to and improved in schools around the same time 3.
Korfball is a team sport that involves components of basketball and netball. The point of the game is to score goals by shooting the ball through the basket, known as the Korf 4, which is designed high enough that ‘dunking’ is not possible 5.To do this, players must escape from their own rival with abilities pass the ball and moving rapidly and efficiently6. Winning a korfball game comes from scoring goals while also preventing the other teams scoring7.Teams are including eight players, with four women and four men on each team8. To provide this equilibrium and remove unfairness, women only mark women and men only mark men, so players are simply playing directly opposite their own sex. This probably debilitates conventional sporting advances of height, muscular strength and speed 9.To prevent possible contact, players have defended ownership of the ball, meaning that while a player has possession no other player can take ownership without the ball leaving their hands 10. To contribute to equality and teamwork, solo play is not allowed 11, this would contain dribbling the ball and running with the ball. The idea of playing together is a key constituent and the rules make teamwork necessary 12. During a korfball match, two men and two women from one team attack, while the other two men and women from that team defense in the opposite section13.Virtually, due to the division of the playing area into two halves, a four-on-four ‘duel’ takes place within each rectangle 14 Once two goals have been scored (by either team, or a compound of the two teams), the defenders and attackers barter ends, and in doing so they also swap roles, so attackers have defenders and vice versa15.A significant structural factor of the korfball game is the should be vocal. As players sign their rivals nearly, often facing them, their teammates report them of the play going on around them. Being vocal is installed deeply into the way korfball is played, with players calling shots by opponents, and informing their teammates if opponents have a good position to feed the ball out for shots.
1.2.INJURIES THE KORFBALL
The possibility that a team is opposing an injury from which a player is not might well (temporarily or for a longer time) play is 4.6 injuries in 1000 hours playing korfball . In this sport, Korfball, the risk to get an injury is quite high.Ordinarily, there are 1.9 injuries in 1000 hours of playing a sport.In korfball, there are 4.6 injuries in 1000 hours of playing korfball
Reasons for sports injuries :
Practically half of the recorded korfball injuries (49%) happen when the player falls.
In approximately one-third of the cases, the injury happens through contact with an object,usually a ball.
A less part of the players are injured by physical contact or acute physical
Most injuries happen while playing a game (69%). Fewer injuries happen during
The top five effect that causes to injuries (according to the injured player)
are as follows:
* contact with players (36%)
* stumbling and twisting (19%)
* wrong landing (15%)
* turning (15%)
* Description (11%)
Epidemiology of the injuries :
32% of injuries to the fingers
33% are ankle injuries (usually an ankle distortion).
8% of the injured players have a knee injury or a knee distortion. An Achilles
tendon rupture is unusual.
Besides this: seven out of ten injuries are acute. The number of injured women and men is the same. The common term of an injury is 31 days.,
( Consument en Veiligheid" Korfbalblessures Augustus 2010) (17)
“The most usually occurring injury in korfball is a sprained or twisted ankle. In most cases, the injury occurs following a landing on the outside of the foot whereby the foot twists too far within. On the outside of the foot, capsule, ligaments and nerve fiber can be damaged due to overstretching. Within cartilage can be damaged by excessive pressure. Contingent upon the severity of the damage, the tissue on the outside is either extended or torn. This injury leads to bleeding in the ankle.Consequently, the ankle swells, (after a short time) contusion and got painful.
The damaged tissue recovers naturally just as a wound on the skin. However, muscle and nerve fiber does not spontaneously regain its original function. Muscle and nerve fibre must be trained. This is possible with basic balance exercises. Also, the ankle must be protected to prevent the risk of repetition.”
” The knee joint is tender to injury. The knee joint usually can be damaged through twisting. In situations such as a twisting case(cruciate) ligaments and meniscus tissue can be damaged. Damage to the meniscus can reason swelling and it may not be possible to properly bend and extend the knee. Critical injury to the cruciate ligaments often reasons inner hemorrhage or accumulation of fluid. The knee then feels swollen and warm, is painful and no more moves well. In case of a serious twisted knee, cruciate ligaments and the inner meniscus are mostly both damaged.”
“The connection of quadriceps under the knee can cause pain problems due to overload. This is a typical event among young sportsmen and women who have experienced a development attack. The bones first growth in height observed only then by the muscles and tendons. Many young sportsmen and women begin to attend more often in sport, particularly in the duration when they experience growth attacks. Accordingly, particularly this muscle connection can become stretched. The pain is usually underneath the patella.”
Neuromuscular training improves insensible motor reactions by stimulating both the afferent signals and focal mechanisms in charge of for dynamic joint control. Dynamic joint-control training is a fundamental segment of damage avoidance programs. (Bennis, Bonato, & Torre, 2016) 18
The NMTP was adjusted from past epidemiologic and interventional examinations that have demonstrated decreases in lower extremity injury risk factors.19,20 The exercises in this program were chosen from injury prevention research to address lower extremity strength and core stability21,22,23,19-24,25,26 . Core stability is characterized as dynamic trunk control which enables the production, transfer, and control of force and motion to the distal part of the kinetic chain. The purpose of this NMTP was to develop the athlete’s capacity to control the center of mass during dynamic activities.27
Efficient stabilization and balance are significant to increase sports capacity. Poor balance has been related to it increased injury risk for athletes. Neuromuscular-training programs have been known injury inhibition, however little is known about the benefits of these programs on balance.Much research supports the use of the neuromuscular program to cause lower extremity injuries19,21,22,23,28. The most influential programs many common segments, containing plyometric training in mixed with biomechanical feedback and technique training.21,28 The form of a NMTP that aims at core stability exercises is used to prohibit lower segment injury, in short in female athletes who have lacked in trunk proprioception and neuromuscular control. 29 Importantly, poor core stability and reduced muscular synergy of the trunk and hip stabilizers have been assumed to decrease performance in power activities and to increase the incidence of injury secondary to lack of control of direct the center of mass, particularly in female athletes.22,30
Targeted NMTP are planned to decrease injury risk, and incorporate interventions that attention on enhanced control of the COM (center of mass). As the COM moves away from the BOS(base of support), there is an increased potential for biomechanical deviations to happen in the lower extremity. An advanced capacity to control this motion has the potential to decrease high forces on the lower extremity and finally reduce injury risk.29
2.The purposes of the study :
This study aims to determine to provide a neuromuscular training program on YBT was effective in increasing the postural control and lower extremity stability in a select population of youth amateur korfball players
This study aims to observe effects of neuromuscular training on function, hip, and knee muscle strength, and knee stability in individuals
To determine whether there are balance gains after participation in a neuromuscular-training program
The purpose of this study was to determine if an 8-week NMTP that focused on lower extremity strength could improve performance on the YBT.
3.The importance of Study :
The importance of the study is that neuromuscular exercises may contribute to the development of balance in the athletes.
5.Rewiev of the literature :
Many articles have been reviewed. There are close to 29,000 articles about neuromuscular training reducing the risk of lower extremity injury .Of 25 potentially appropriate studies, were included. Meta-analysis showed a preventative effect of neuromuscular training in decreasing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84))
Neuromuscular performance can be considered as the capacity of the neuromuscular system to practically control and drive processing by a suitable use and coordination of muscular strength and endurance, muscle improvement model, proprioceptive input, and reflex activity 31,32.
To prevent injury and gain balance programs generally contain exercises purposing static and dynamic balance, plyometrics, as well as lower limb strength and power 33,34,35,36.
The risk of injury to young athletes in competitions has been considered, with incidence rates of up to 34.4/1,000 h of sports exposure noticed in young male ice hockey players for example37,38. These data underline the instant need for improving powerful strategies to prevent injuries. Therefore, an enhance number of injury prevention programs have been improved in recent years, with the generality including various exercise components emphasizing neuromuscular performance 40.
6.Materials and Methods
6.1.Subject and Study Design
This study will be carried on one group ; the experimental group .The experimental group will include 10 voluntary korfball players who healthy athletes playing in university teams .Before starting the study, participants will be informed about the study purposes and procedure and required permission will be granted.The rights of the subjects will be protected , implicating that the patient will be allowed to leave at any time if they will have difficulty in exercises . Inclusion criteria will be age 20-28 years, playing at the amateur level, and practising 3 times a week for 2 hours. The exclusion criterion will a history of lower extremity injury or surgery in the 6 months before testing. Participants’ data will be excluded from analysis if they will not have attended 70% of the training sessions. Experimental groups will present during training and testing but will be blinded to the aim of the warm-up.
Data on medical history, age, height, body mass, training characteristics,injury history, team korfball experience, and performance level will be collected at baseline.
The participants will ask not to engage in forms of physical activity other than their normal routines and to maintain their usual diets for the duration of the study.
Postural-control assessment using the YBT will be performed at baseline (T0) and at the end (T8) of the 8-week study period. Before testing, the participants will perform 10 minutes of standardized warm-up , with 5 minutes of submaximal running will follow by a dynamic stretch routine consisting of functional exercises: front-to back leg swing, side-to-side leg swing, lateral lunge (squat to flow), and sumo squat to stand (Active stretch). For evaluation of the YBT, we will benefit a YBT kit containing a stance platform. The participant will have to reach with the opposite leg in the A, PM, and PL directions and push a target (reach marker) along the pipe that standardized the reach distance; the target will remain over the tape measure after completion of the test. The testing order will be 3 trials standing on the right foot while reaching with the left foot in the A direction, will follow by 3 trials standing on the left foot and reaching with the right foot in the A direction. The method will be repeated for the PM and then the PL-reach directions. During the trials, the reach foot will not be allowed to touch the floor or balance using the reach indicator or support pipe.
The YBT scores will be analyzed using the average of the last 3 trials for each reachdirection for each lower extremity, as well as the average of the total of the reach directions (composite score). PM, and PL directions by 3 times the limb length of the member and then multiplying by 100: (A+PM+ PL/leg length*3)*100. The maximum value will measure for each direction and the summed composite score of the maximums for each lower extremity will be also analyzed.
Figure 1. Participant performing the Y-Balance Test in the A, anterior, B, posteromedial, and C, posterolateral directions.50
6.3.Neuromuscular Training Program :
We improved the neuromuscular-training protocol from injury-prevention research on core stability and plyometrics. Training will be occurred twice a week for 8 weeks (16 sessions) during the warm-up period directly before standard korfball training. Team coach and physiotherapist will manage the sessions and give verbal and visual warning on exercise technique. Each 30-minute period will consist of session training with 10 exercises and 4-minute rests between sessions. The exercises will be progressed through 3 phases using periodization methods. Initially, low-volume, high-intensity exercises were performed until the technique was mastered. The volume will be increased when the exercise will be executed correctly. The exercises will be progressed from a stable to an unstable position to increase demands on lower extremity strength and core stability. The conventional warm-up will have consisted of light aerobic exercises,korfball and team drills, and dynamic stretching of the major muscle groups before the regular practice sessions.