Analyzing the Correlation of Static Balance Scores and Functional Movement Screening of Professional Female Wrestlers

Erhan Kara^1*, Sercan Öncen¹, İsa Sağıroğlu² and Özgür Dinçer³

^*Correspondence: Erhan Kara, School of Physical Education and Sport Department, Tekirdağ Namik Kemal University,, Turkey, Email:

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Introduction

Wrestling is one of the popular sports, but one of the first sports disciplines that was included in the old Olympic Games program in 1896 [1]. However, women’s wrestling has increased its popularity internationally since its admission to the 2004 Olympic Games [2,3]. Elite wrestling includes high-intensity short-interval competitions, training, tactical and technical skills [3]. Technical movements are exhibited together with strength, extremity strength and speed during the competition [4]. Thus, an elite wrestler should have a high level of coordination, strength, reaction speed and relative strength. [5]. Additionally, strength, endurance, staticdynamic balance, and flexibility are extremely vital during competition [6].

Balance refers to the ability of an individual to maintain the centre of gravity in a vertical position on the resting area [7]. Upper extremity and core muscles are exposed to high resistance during wrestling competition [8]. Some losses in balance and functional movements and musculoskeletal injuries associated with these losses may occur during the force generation came out [9]. Functional loss in any part of the skeletal-muscular system causes problems such as weakness, high tonus, or pain in another part of the body and affects performance negatively [10]. Therefore, postural stability is quite important in many sports branches that require struggle and close contact such as wrestling [11]. Moreover, it has also been associated with balance, musculoskeletal injuries and poor postural control [12].

Hand interference of opponents during the match may cause a loss of balance. However, wrestlers learn to take advantage of these balance losses over time [11]. This loss that occurs in balance can adversely affect the production of force, as well as causing injuries due to the inability to absorb the force load applied on the muscle [12]. For this reason, a screening test evaluating more than one part of the body and having validity and reliability is of great importance in the prediction of increased injury risk, movement limitation and asymmetric (right and left) problems in athletes and in preventing injuries. The Functional Movement Screen Test (FMST™), developed by Cook et al. is a test that helps to detect increased injury risk, movement limitation and asymmetry (right and left) problems of athletes [13,14].

An improved balance in wrestling is associated with performance capacity [15]. The aim of this study is to examine the relationship between functional movement test and static balance performances of elite female wrestlers who have an improved balance feature. The relationship between FMST™ score and static balance performance scores of elite female wrestlers in the study (hurdle step (HS), shoulder mobilization (SM), trunk stability push- up (TSPU), in-line lunge (ILL), active straight leg raise (ASLR) and double leg static balance, dominant leg static balance, Non-dominant leg static balance) formed sub-hypothesis.

Materials and Methods

19 elite female wrestlers having average age of 22.94 ± 2.67 years, body weight 61.63 ± 7.25 kg, height 165.37 ± 5.17 cm and BMI 22.46 ± 1.60kg / m2 participated in the study. Functional Movement Screen Test ™ (FMST™) battery was used in determining the functional movements of the participants, while Tecnobody Prokin 200 Bergamo/Italy was used to determine the total postural stability index values. All static balance measurements were evaluated as standing Double-Leg Eyes Open (DLEO), Eyes Open Single-Leg Dominant Non- Dominant (EOSL-DM and EOSL-ND).

The facts that the participants do not smoke, do not use drug and do not have chronic diseases (diabetes, asthma, chronic obstructive lung disease, hypertension, metabolic syndrome) in the past medical history have been determined and they have been included in the study. PARQ test evaluation has been implemented to the research group before the study and ACSM (American College of Sports Medicine) risk factor analysis evaluation has been implemented after the study. Only healthy experimental subjects have been included in the study. All participants were asked not to take part in any sport activities in the last 24 before the test to avoid fatigue.

The functional movement screen™

No adaptation session was carried out to avoid the learning effect of FMST™ and test kits were introduced only visually. 7 movements in total (deep squat, hurdle step, in-line lunge, shoulder mobility, active straight leg raise, trunk stability push-up and rotary stability pattern) were used to evaluate the limitations and asymmetries of motion profiles in the body. FMST™ each movement was evaluated by a score system between 0 and 3 [16]. While “0” point was the lowest score within these scores and it was stated that there was a feeling of pain, performing the movement in ideal form and without compensation was evaluated as “3” points. The participants were given “2” points on the condition that they perform compensation by using different muscle groups during the performance of the movements and “1 point” was given for loss of balance during the movement. The dominant and non-dominant parts of the body were tested and evaluated separately to determine the asymmetries in the movements. The lowest score was recorded if both sides of the body (for movements where both sides were evaluated) had different scores. The maximum FMST™ total score is 21. FMST™ measurements were taken in real time and the participants were allowed to perform three trials for each movement pattern. All FMST™ measurements were checked and scored by the same person [13,14].

Static balance assessment

Static balance of the participants was determined by measuring the total stability index. All athletes were introduced to the test device (Tecnobody Prokin 200 Bergamo / Italy) and test method one day before the test to provide familiarization to the static balance test, and they were allowed to try it once. The participants were asked to look at the opposite screen that was located on the balance platform so that the arms could remain in a fixed position at point "0" on the sides by placing their feet naked according to the x-axis and y-axis. The calibration of the balance device was checked before each test. The participants were given verbal feedback during the static balance test. As total stability index values obtained at the end of the test come close to “0” degree, it indicates that the static balance is good. If it deviates from "0", it indicates that the static balance gets worse. Balance scores of "0 degrees" were accepted as the maximum balance [17-19].

a) Double Leg Static Balance Eyes Open Test: Participants were asked to stand in an upright position with their eyes open for 30 seconds. The data obtained at the end of the test were recorded.

b) Single-Leg Static Balance Eyes Open Test (dominant non-dominant): All participants were randomly asked to stand upright on the dominant (DM) and non-dominant (ND) leg with their eyes open for 30 seconds each. The data obtained at the end of the test were recorded.

Body weight and height measurements

Measurements were carried out with a metal height scale with a precision of 1 mm. while the participants were in bare feet and in an upright position, and their body weight was measured with bare feet and minimal clothing on the Seca brand electronic scales with a sensitivity of 100 gr [20,21]. Body Mass Index (BMI) was calculated with the formula of weight (kg) / height (m²). Descriptive statistics of the participants (age, body weight, height and body mass index (BMI)) were evaluated. TSI balance and FMST ™ mean scores and standard deviation were evaluated. Spearman correlation analysis was performed to evaluate the relationship between TSI balance and FMST ™ test scores due to their non-parametric distribution. IBM SPSS package program was used in calculating all statistical analysis.

Results and Discussion

Descriptive statistical data of the participants are given in Table 1. The average age of the 19 elite women wrestlers participating in the study was 22.94 ± 2.67; average height 165.37 ± 5.17; body weight average 61.63 ± 7.25; the BMI average has been defined as 22.46 ± 1.60 (Table 1).

Table 1: Descriptive statistics for the physical characteristics of the participants.

The scores that 19 elite female wrestlers obtained from the Functional Movement Screen™ measurement have been given in (Table 2) FMST™ total score average of the participants was found to be 18.42 ± 0.90. The scores obtained from the deep squat, hurdle step, in-line lunge, shoulder mobility, active straight leg raise, trunk stability push-up, rotary stability movement patterns forming the FMST™ scores are respectively 2.57 ± 0.60, 2.39 ± 0.35, 2.81 ± 0.24, 2.63 ± 0.36, 2.86 ± 0.22, 2.94 ± 0.22, 2.18 ± 0.24.

Table 2: Functional movement screen test scores of the participants.

The scores that 19 elite female wrestlers got from the Total Stability Index measurement are given in Table 3. TSI double-leg scores were found as 5.38 ± 1.11, TSI dominant leg 5.24 ± 1.17 and TSI non-dominant leg scores were determined as 4.71 ± 1.10.

Table 3: Total Stability Index scores of the participants.

According to the evaluation of the relationship between TSI and FMST ™ test scores of the participants, a negative correlation of -0.360.-0.135 -0.301 was found in the TSI non-dominant leg and FMST ™ hurdle step, shoulder mobility and trunk stability push-up scores, respectively. Negative correlations of -0.336, -0.055, -0.344 were found in TSI dominant leg and FMST ™ hurdle step, shoulder mobility, and trunk stability push-up scores, respectively. A negative correlation of -0.100, -0.153, -0.172 was observed in TSI double leg and FMST ™ in-line lunge, active straight leg raise, trunk stability push-up scores, respectively (Table 4).

Table 4: Statistical analysis of TSI and FMST™ test score correlation of the participants.

The evaluation of the relationship between the TSI and FMST ™ test scores of the participants has been given in Table 5. Negative correlation of - 0.016, - 0.198, -0.043 were found between the FMST ™ and TSI dominant leg, TSI non-dominant leg and TSI double leg scores of the participants respectively P<0.05*.

Table 5: Statistical Analysis of spearman correlation of TSI and FMST ™ scores of the participants.

Discussion

The primary aim of this study was to examine the relationship between functional movement test scores and static and balance performance of the participants. According to the statistical data of the study, it was observed that there was a negative correlation between FMST ™ scores and PSI values of the participants. Although negative correlation is unfavourable statistically, it actually indicates a positive expected situation because the main reason for this situation can be explained by the fact that the improvement in static balance performance decreases the TSI value [17-19]. Thus, this study shows parallelism with the studies in the literature and explains the negative correlation between the variables in the study. Failure to maintain postural stabilization against different resistance during wrestling competitions may cause deterioration of balance performance. However, wrestlers adapt by learning to cope with this situation over time [20-22]. This situation is important for the wrestlers to maintain continuity of the competition. The cerebral cortex and central nervous system play an important role in maintaining postural control [23,24]. In addition, information obtained from the visual, somatosensory, and vestibular systems is combined to perform the necessary corrective actions to maintain balance [25]. Wrestling training is effective in providing postural control [23], lower extremity dynamic balance performance, and increasing exercise capacity [26,27]. It is understood that balance performance is extremely effective in winning wrestling competitions [28-30].

Balance is a multifaceted task involving the integration of sensory (somatosensory, visual, and vestibular), motor and cognitive inputs to perform appropriate neuromuscular activities in order to maintain postural stability [31,32]. Neural activity occurs because of the neural feedback (NFT) training [33] by the individual himself. During NFT, individuals can learn to selectively control their brain waves to improve motor function. In addition, NFT has been proven to have positive effects on static and dynamic balance [25]. Additionally, there is a siğnificant relationship between balance performance, leg muscle strength, hamstring, quadriceps ratio and right / left leg balance performance and injury history [34]. In addition to this, it should be kept in mind that clinical symptoms such as pain, insomnia, fatigue [35], depression and anxiety, muscle weakness, as well as sensory deprivation and cognitive inefficiency may cause balance disorders during balance tests [31]. It is known that there is a relationship between athletes' injury history related to competition or training and identifiable risk factors such as body mass index, body fat ratio, training history, competition and training ground, muscle flexibility, and ligament [36]. it is emphasized that there may be an increase in injury risk under certain score ranges while emphasizing the importance of core stability and mobility requirements for FMST™ movement patterns [21]. Participants in our study have a negative correlation between TSI scores and measurement parameters such as FMST™ measurement HS, SM, TSPU, IIL and ASLR. Among all these parameters, TSI has the highest negative relationship with the nondominant leg, HS r=-0.360 and TSI dominant leg with TSPU r=-0.344. Based on this data, the increase in the static balance performances of elite female wrestlers can provide a small improvement in HS and TSPU functional mobility.

In the study conducted by Bayati et al. [4], the effect of the 12-week wrestling and warm-up protocol on the FMST™ scores of 24 freestyle wrestlers was investigated, and because of the study, a siğnificant increase was observed between the total FMST™ scores of the experimental group and the TSPU, HS, ILL, and TSPU scores while there was no siğnificant difference in SM, ASLR and RS scores [37-39]. The FMST™ total scores of athletes with high levels of achievement are siğnificantly higher (39). At the same time, specific thera-band exercises have positive effects on balance (static and dynamic) and FMST ™ [34].

Conclusion

In conclusion, it is thought in this study that improvement in balance performance which is one of the important factors in delivering sportive performance is extremely siğnificant in terms of competition performance according to the information obtained from the literature. It can be mentioned in the light of the findinğs obtained in this study that there is a relationship between functional movement and postural stabilization in elite female wrestlers.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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