The research is to determine the impact of hydrotherapy on the overall recovery of football players after surgical intervention for meniscus injuries. The study challenge centres on the deficiency of rehabilitation approaches using hydrotherapy exercises, specifically addressing the total rehabilitation of football players after surgical intervention for meniscus injuries. The researchers employed an experimental methodology and intentionally selected a sample of six patients who had recently been discharged from the hospital following medical treatment and stabilisation of their health. Subsequently, the researcher devised a series of exercises tailored for execution in a water medium, which were administered to the sample after conducting pre-tests. Following three months of exercise implementation, post-tests were administered, revealing significant differences indicative of improvement in abilities. The research focusses on agility and balance. The researchers concluded that the prepared exercises significantly improved the outcomes of the post-tests compared to the pre-tests, indicating a development in the motor abilities examined. Consequently, they emphasised the importance of incorporating water exercises into the training curricula and utilising the exercises developed by the researchers.
Meniscus injuries are the most prevalent trauma in sports practice among musculoskeletal injuries, occurring in 50% of cases with ligament damage [1]. The research indicates that ACL and meniscus injuries occur in 70% of instances [2]. Meniscus injuries in football result from the intricacies of athletic movement: abrupt stops and starts, rapid rotational forces on the ligaments, sudden directional changes, repetitive jumps, individual skill execution near the backboard, and ball reception, all of which impose heightened demands on the musculoskeletal system [3]. The substantial impairment of limb support and gait function diminishes quality of life, severely restricts motor activity, and precludes participation in sports [4,5]. Meniscus and knee joint injuries are particularly complex, and alongside clinical indications, they influence the decision to employ arthroscopic procedures among various treatment options [6]. Nevertheless, despite successful surgical reconstructions of the knee joint's ligament system, the prolonged rehabilitation period (averaging 5 to 12 months) presents a significant risk of postoperative complications, including biomechanical asymmetry and afferent conduction disorders, which can lead to secondary ruptures in 45% of cases, as well as muscle imbalances during movement [7]. In 11-25% of instances, distorted laundry inflammation commences; meniscus instability persists for an extended duration [8]. The aforementioned factors necessitate the exploration of methods and modalities for physical rehabilitation focused on restoring optimal range of motion and strength attributes of the knee joint in football players, particularly under conditions of muscle imbalance and axial load during movements executed in the sports rehabilitation phase, which involve specific loading parameters [9]. Hydrokinesis treatment, owing to the properties of the water environment and the many body postures (horizontal, vertical, diagonal), enables athletes to execute loading exercises on the damaged knee under ideal circumstances [10]. Athletes with meniscus injuries following treatment for lower limb injuries, who are classified as disabled due to their meniscus condition, require extensive rehabilitation exercises for recovery [4,11]. Their functioning muscles have been atrophied and compromised due to prolonged inactivity while laying down for therapy [12]. Upon concluding medical treatment and stabilising his health, the player must engage in rehabilitation activities and avoid idleness and immobility, as they will exacerbate the injury and intensify its severity [8]. Thus, the significance of the study is in developing qualifying exercises based on scientific principles and using contemporary methods utilising the aquatic environment to transform the training atmosphere, enhance the player's psychology, and foster a spirit of challenge. The aquatic environment possesses unique characteristics, including diminished gravitational effects on the individual, the buoyancy that facilitates standing and movement more easily than in terrestrial settings, and the resistance of water, which complicates certain movements or exercises.
Research Problem
The study topic pertains to the absence of rehabilitation techniques that use water activities to prepare surgical patients for meniscus injuries. Following their departure from medical facilities, there is a decline in the player's health status, accompanied by an escalation in pain and injury severity. Consequently, the regression of the remaining motor talents of the Haves rather than their improvement and development. This prompted the researchers to suggest aquatic activities based on the examined scientific principles and methods. To enhance certain physical capabilities in this group of disabled athletes.
Research Objectives
The current research aims to:
Preparing rehabilitation exercises in the aquatic medium to develop some motor abilities Comprehensive rehabilitation of football players after surgical intervention for meniscus injury.
Identifying the effect of these exercises on the development of some motor abilities for meniscus injury to the research sample.
Research Hypotheses
The prepared exercises have an effect on the development of some free abilities for meniscus injury of the players in the research sample.
Research Areas
Human Area: Recent Football Players Injured (for Meniscus Injury) in Misan Governorate.
Temporal Area: The period from 26/2/2024 to 29/5/2024.
Spatial Area: Al-Zahrawi Hospital and Closed Swimming Pools in Misan Governorate.
Research Methodology
The researchers adopted the experimental method in one group with pre- and post-tests in order to suit the research objectives.
Research Sample
The researchers adopted the deliberate method as the basis for selecting his research sample, which is represented by players who were injured as a result of meniscus injury and who were given surgical operations in hospitals, and the researchers selected (8) who are homogeneous in the degree of injury according to the medical technical classification and the date of the injury, as they are recent to the injury and are similar to the recovery in a similar period and are close in age and can adhere to the method. The homogeneity of the sample was in the cause, type, and severity of the injury and its effect on the player: all the members of the sample were football players with meniscus injury according to the medical technical classification, and the effect of the injury was close in terms of calculating the degree of strength or muscle capacity of the legs between (40-50) degrees.
For the medical classification of the athletes participating in the competitions, the Misan Governorate League for the third division of the (2023-2024).
Homogeneity in sex:
All members of the sample are male.
Homogeneity in the medical examination
The researchers performed the medical examination on the sample Inside the hospital to ensure the safety of the functional devices and the absence of complications or other disabilities, it was found that all the members of the sample are in good general health and there is nothing that affects their physical activity and undergoing rehabilitation exercises.
Recovery Date:
All the members of the sample have completed medical treatment in the hospital.
They left the hospital a very short time ago.
Research Tools and Information
Collection Tools
Arab and foreign scientific sources and references.
The International Information Network (Internet).
Observation and experimentation.
Personal interviews with experts and specialists.
Tests and measurements.
The form for recording the data and individual results for each player.
Devices and tools used in the research
Indoor swimming pool.
Floating Mattresses number 6.
Rectangular raft (50×30 cm) number 6.
Circular collars suitable for the water medium .6 scale of the listed balance scale.
Electronic stopwatch.
Sony type digital image camera.
Manual calculator.
Computer.
Barriers and plastic barriers .
Whistle.
Small pieces of metal or cash that do not rust
Determining motor abilities
The researchers used a novel approach to ascertain the motor talents to be cultivated by soliciting the player's desired actions and capabilities. To enhance his everyday job and fulfil the game's criteria more effectively, he might do more challenging activities via athletic practice. The researchers devised a questionnaire for this objective, and the responses concentrated on certain abilities and motions that aligned with the needs previously identified in the players. The key abilities include balance, maintaining equilibrium when standing, ambulating with stability, seated balance, standing for suitable durations, walking, jogging, running, ascending stairs, transitioning to and from a seated position, entering and exiting a vehicle, and executing movements with grace while doing tasks. Upon evaluating these requirements and consulting many sources, references, personal interviews, and discussions with academics specialising in training, physiology, and sports medicine rehabilitation for the wounded. The researchers identified many kinetic characteristics to be addressed at this stage for individuals with lower limb paralysis, namely balance and agility.
Research Tests
Agility test
Test name: Running or winding walking [13].
Objective of the test: Measuring walking agility
Tools and supplies: Suitable distance, measuring tape, 5 indicators, marking tools, whistle, stopwatch, referee.
Performance Description:
The indicators are positioned in a linear arrangement, situated between the indicator and the last 2 meters, as well as between the first. The index and the beginning line are 2 meters apart, establishing a distance of 10 meters from the starting line to the end of the indication. The test begins at the sounding of the whistle, during which the participant rapidly navigates in a zigzag pattern between the markers, turning around the fifth marker and zigzagging again, covering a distance of 20 meters. The test concludes upon reaching the starting line.
Registration
The time for the laboratory is recorded from the beginning to the end of the test in the second and its parts.
Second
The Balance Test Chang et al. [14].
Test Name: Climbing and descending on a parallel scale of the gradient balance scale.
Objective of the test: to measure walking balance.
Tools and Supplies: In accordance with official criteria used in hospitals and rehabilitation centres, the gradient balancing ladder is designed to be parallel, whistle, and hermetic.
Performance Description
The tested player stands on the ground near the parallel ladder and holds the parallel with his hands, starts when the whistle is heard, to climb the ladder holding the parallel quickly and descend on the other side to touch the ground with one foot to turn around and return.
Registration
The time from the beginning to the end of the test is calculated in seconds and its parts.
Field Procedures
Pre-Tests: Upon validating the tests and their appropriateness for the research sample, the researchers executed pre-tests on a cohort of eight athletes on February 23, 2024. The outcomes of these pre-tests were corroborated alongside detailed forms for each participant, documenting the nature of their disabilities, the severity from both medical and functional perspectives, the conclusion date of medical treatment, and all pertinent details necessary for the research, including height, weight, and age.
Preparation Exercises
The rehabilitative exercises conducted in the aquatic environment were administered to the research sample over a three-month period, occurring biweekly within the primary rehabilitation units for individuals with disabilities. Each session lasted between 35 to 45 minutes. The experiment commenced on February 27, 2024, and concluded on May 27, 2024. The researchers utilised the levels of fatigue and pain to assess the distances, durations, and repetitions as indicators of intensity in the aquatic rehabilitation exercises.
Trial Duration: 3 months.
Duration of the curriculum in weeks: 12 weeks.
Number of units per week: 2 units.
Total number of units: 24 units.
Post-tests
Upon finalising the execution of the established procedure, the researchers conducted the post-tests on May 28, 2024. The findings were validated in the relevant format under the identical circumstances as the pre-tests.
Statistical Methods
The researchers used Statistical Package for the Social Sciences (SPSS-24) to get the statistical outcomes of the study.
Table 1: Shows the arithmetic mean, standard deviation, total differences, calculated t-value and tabulation for the 20m zigzag walking test for the pre- and post-tests.
Agility test | Pre-tests | Post-test | T | ||
M | DS | M | DS | ||
20m winding walk seconds | 40.09 | 6.56 | 32.20 | 4.47 | 0.616 |
Table 2: Shows the arithmetic mean, standard deviation, total differences, calculated and tabular value of the ascent and descent test on the parallel plateau balance scale of the pre- and post-tests.
Balance Test | Pre-tests | Post-test | T | ||
M | DS | M | DS | ||
Ascent and descent test on a parallel staircase Plateau equilibrium seconds | 42.19 | 8.65 | 24.29 | 6.49 | 0.578 |
View and analyze agility test results
Table 1 presents the outcomes of the 20-metre winding walking test designed to assess agility. The mean of the pre-test computations was 40.09, with a standard deviation of 6.56, but the mean of the post-test was 32.20 with a standard deviation of 4.47, after the application of (c). The estimated value of (T) for the differences between the pre- and post-tests was (0.616), above the tabular value of (0.263) at a significance level of (0.05) with (7) degrees of freedom. This demonstrates that there are very significant changes between the pre- and post-tests, that favour the post-test results.
View and analyze balance test results
Table 2 presents the results of the climb and descent test conducted on the balancing scale's parallel. In Al-Hadabi, the arithmetic mean for the pre-test was (42.19) with a standard deviation of (8.65), while the mean for the post-test was (24.29) with a standard deviation of (6.49). Upon applying the (T) test to assess the differences between the pre- and post-tests, the calculated (T) value was (0.578), exceeding the tabular value of (0.263) at a significance level of (0.05) with (7) degrees of freedom. This demonstrates that there are very significant changes between the pre-tests and post-tests, favouring the post-tests.
Discussion of the results of physical tests
Discussion of the results of the 20-meter slalom walking test to measure agility: The findings of the 20-meter slalom walking test are provided in Table 1. The findings indicated substantial disparities between the pre-test and post-test, favouring the post-test outcomes. This notable disparity signifies a progression in agility between the pre-test and post-test. The researchers credit this advancement to the training methodology used on the study sample and the efficacy of the workouts conducted in the aquatic environment. The implementation of diverse aquatic exercises, including walking in various patterns and velocities, combined with alterations in direction, posture, and stance, is linked to multiple competencies such as speed and motor response efficiency. Emphasising the correct execution method has facilitated the advancement of the nervous system's functionality. Bashtovenko et al. [15] assert that the nervous system significantly contributes to the enhancement of agility by effectively processing information from the training environment and issuing motor commands to the executing muscles. Wilkerson, Nabhan, and Crane [16] emphasised that the development of agility in individual athletes necessitates the integrity of the neural system, which is essential for the rapid communication and reactions between the nerve and muscular systems. Water exercises, including diving and spinning within the aquarium, significantly influence the fitness development of the research sample [17]. This trait is crucial for athletes, particularly those recovering from injuries, as agility is essential for fulfilling life demands. Versic et al. [18] underscore that agility is a fundamental capability for successfully executing bilateral and triple movements, skills, and various games.
Discuss the results of the ascent and descent test on the parallel of the plateau balance ladder to measure balance
The findings of the climb and descent test were presented and analysed concurrently with Al-Hadabi in Table 2. The findings indicated substantial variations between the pre- and post-tests, favouring the post-test outcomes. This notable disparity signifies a progression in the equilibrium between the pre- and post-test. The researchers credit the improvement in balance among the handicapped to the structured training approach, its efficacy, and its influence on the study participants. Aquatic balance workouts provide comfort, safety, and the capacity to regulate the body in various postures [19]. This enhances the capacity for terrestrial balancing due to a gradient in equilibrium until optimal conditions are attained [20]. Lloret et al. [21] shown that water balancing exercises for individuals with disabilities elicit feelings of satisfaction and enhancement, as well as improved behavioural control, hence facilitating the development of this capability outside aquatic environments. Following an injury, a player's first requisite ability to walk is balance, which may be developed promptly via exercise and conditioning [22]. Gastaldo, Gokeler, and Della Villa [9] proved that during a period of work and practice, individuals with meniscus injuries may adapt to new situations and enhance their balancing abilities immediately post-injury.
Consequently, researchers assert the necessity of developing balance due to its significance in all movements essential for individuals with disabilities. Primarily, this includes maintaining equilibrium while standing, walking, or jogging, thereby optimising the energy expended for motor activities rather than dissipating it on body control or the risk of falling, which can lead to frustration and injury. This objective has been accomplished through the implemented methodology.
By presenting, analyzing, and discussing the results, the researchers were able to reach the following conclusions:
Exercises in the designated aquatic environment enhance the performance levels in motor ability assessments, as shown by the comparison between pre-tests and post-tests, favouring the latter among the participants in the study group.
The workouts implemented for the injured athletes in the study sample demonstrate efficacy and impact on the enhancement of the motor skills under investigation.
Aquatic exercise has enhanced the fitness and balance of individuals with meniscus injuries.
Recommendations
The researchers were able to reach the following recommendations:
The need of incorporating aquatic environments and aquatic activities into many rehabilitation regimens that necessitate such elements.
The need of monitoring the wounded athlete post-medical treatment and providing the necessary resources to facilitate the healing process via structured rehabilitation and sports training programs.
Undertaking further studies and analogous research on other samples with varying injuries and severities.
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