Sampling
Sixty (n = 60) National Kho-Kho players were recruited for one month camp at Manav Rachna Sports science center (35 males and 25 females). During this camp, two weeks training session11 was given to the players and physical fitness assessment like functional movement screening, balance both static and dynamic, sprint and agility were recorded before and after the training (Figure 1). The approval was taken from Departmental Ethics Committee. Written informed consent was obtained from all subjects in accordance with the tenets of the Declaration of Helsinki. All subjects were familiar with all the testing that took place, which included both field and laboratory assessments.
Inclusion Criteria:
1. All players were in between the age of 18 and 25 years; athletics comprised national level Kho-Kho players; 2. Both male and female players were included as athletes in the study of national level.
3. Participants must be currently participating in a single sport i.e. Kho-Kho and to be eager to participate in the camp and the training.
Exclusion Criteria:
Participants who failed to perform the tests and training were eliminated. 2. Participants who developed low back pain, vestibular problems, or lower extremity injuries such as ankle sprains or meniscal tears during camp training were omitted.
Functional Training:
All players were subjected to intensive short-term functional strength training for 2 weeks (6 days in a week). Participants were randomly divided into 2 groups equally. At a time, one group did strength training which included pushups, sit ups, crunches, leg squats just to name a few and other group did balance training respectively and the same was reversed. Each training session was approximately 2 hours in a day (i.e. 1-hour strength and 1 hour of balance training) involving warm up (10 minutes), strength training for multiple joint including both upper and lower limb, core (40 minutes) and cool down (10 minutes).
Following this training, break for half an hour was given and after break balance training was initiated in same manner i.e., warm up (10 minutes), then balance training (40 minutes) which included coordination and balance exercise, and followed with cool down (10 minutes). Following this training the pre and post data pertaining to this study were collected by administering the standardized tests, i.e., functional movement screen test for assessing the functional movements, balance (both static and dynamic) through open and closed eyes and both feet and single feet and SEMO test, 40 m run test and Illinois test for agility.
The Functional Movement Screen (FMS)
The Functional Movement Screen (FMS) is a screening tool used to assess seven fundamental movement patterns in adults who do not have a current complaint of pain or musculoskeletal injury. The FMS is not intended to diagnose orthopedic disorders; rather, it is intended to demonstrate opportunities for individuals to improve their movement. FMS consists of seven motor tasks, which include overhead squats, inline lunges, step down, shoulder flexibility, straight leg lifted, trunk, and pushups (Figure 2). The FMS used the conventional 0-3 ordinal system. A score of 3 indicated that specific movements were performed correctly without pain or compensatory movement, a score of 2 indicated that compensatory movement was observed, a score of 1 indicated that the subject was unable to complete the movement or task, and a score of 0 indicated that there was no pain present during the movement12,13. Each exercise was repeated three times, with the best one being recorded. The FMS has a maximum score of 21, and a total score of less than or equal to 14 points implies a greater likelihood of developing a sports injury14. Detailed procedures for FMS testing have previously been detailed15.
Balance:
The biomechanical examination of stability was used to perform the balance study. Tecnobody Italy's Prokin 252N system was utilized to evaluate the stability of both the static and dynamic components16. Stability can be assessed using four load cells and a trunk sensor, which provides a comprehensive and accurate picture. Proper software analyses and incorporates data from the patient's on-screen movements (with an emphasis on the articulation of ankle) into rehabilitation plans that are specifically tailored to the patient's proprioceptive deficits, a breakthrough in the field of orthopedic medicine. Stabilometric tests with open and closed eyes were used to determine static stability. On one foot (in the Romberg position) and both feet (in the sharpened Romberg posture), the Stability Index was evaluated to determine dynamic stability balance. To conduct all of the examinations, MRIIRS' Sports Science Center used Tecnobody machines. Postural sway in degrees was measured both for static and dynamic balance.
Agility test:
Three types of agility performed by players i.e., SEMO test, 40-meter run test, and Illinois agility test.
Measurement of SEMO agility:
Four cones were arranged diagonally to each other i.e., cone 1 diagonal to cone 4 and cone 2 was diagonal to cone 3. Players stand at cone 1 with facing forward and start with one foot behind the start line. Starting from the cone 1 and moving towards cone 2 using side steeping movement, then turn around the cone and with backpedal run towards cone 3, once the player turn around cone 3 it sprint forward towards cone 1 and go around the cone and then run towards cone 4 by backpedals then again sprint towards cone 2 and then come back to the cone by side steeping with facing forward towards the baseline.
Measurement of agility using 40-meter run test-
In this test players run between two parallel lines with distance of 40 meters as fast as they can. On the command “Ready? Go!” players run from starting point and reach to other end. Hands should be ground simultaneously beyond the line during this.
Measurement of Illinois agility:
Four cones (10 meters long x 5 meters wide) define the agility area. Cone at point A, indicating the beginning. Cones at B and C indicate the turning points. At point D, a cone marks the finish line. Place four cones 3.3 meters apart in the center of the testing area. On the "go" instruction, the athlete begins and the timing is manually recorded using a stopwatch set to 0.01 seconds mode. Remain upright and run the course on the designated path. Athletes should contact the cones on turn points B and C with their hand. The trial is over when all athletes have crossed the finish line and no cones have been knocked down. Each subject was administered three trials of the Illinois agility test, with rest periods in between17. The agility test was reported using the fastest of the three results. (Figure 3)
Statistical Analysis
SPSS software was used to examine the data (version 25; SPSS Inc., Chicago, IL., USA). The mean and standard deviation of participant demographics (age, height, and body mass) were calculated and represented. Normality analysis was performed using the Shapiro-Wilk test, and the result indicated a non-normal distribution. As a result, the data were analyzed using a nonparametric technique. The ’t’ test was used to evaluate male and female Kho-Kho players' FMS, balance, and agility. An alpha (α) level was 0.05 was statistically significant.