Effect of Integrative Balance and Plyometric Training on Balance, Ankle Mobility, and Jump Performance in Youth Football Players: A Randomized Controlled Trial

Andrew Rinaldi Sinulingga; Kristaps Slaidiņš; Anastasija Salajeva; Agris Liepa; Inese Pontaga

doi:10.5334/paah.472

Figures & Tables

CONSORT diagram of participants, recruitment, allocation, follow-up, and analysis.

Table 1

Description an eight week of integrative neuromuscular training program.

MATERIALS FOR BALANCE TRAINING	SET × REPETITION				TRAINING DESCRIPTIONS
MATERIALS FOR BALANCE TRAINING	Week 1, 2	Week 3, 4	Week 5,6	Week 7, 8	TRAINING DESCRIPTIONS
Static and dynamic balance
Medicine ball 1.5 Kg + hoops (static balance performance, core stabilization + leg muscle strength endurance)	2 × 40s	3 × 40s	2 × 30s	3 × 30s	Semi-squat position on one or both legs while holding a medicine ball. Place both legs together or stand on a single leg. Stand in a semi-squat position (knee flexion angle to 45°). The head, neck, and back should be on a line. The head should be straight, and the gaze should be forward. Hold a medicine ball with both hands in front of the body for some time, the eyes should be open.
Medicine ball 1.5 Kg (dynamic balance, core stabilization)	2 × 40s	3 × 40s	2 × 30s	3 × 30s	Squat while throwing the medicine ball vertically upwards, then stand up and catch the ball. Stand with feet positioned at shoulder-width to produce maximum power. The position of the head, neck, and back should be in one line. Bend hip and knee joints to 90° (squat position) and return to a stabilized position while throwing the medicine ball vertically. Use the core, shoulders, and arms to throw the ball, engaging your core muscles.
Balance wobble board + resistance band (dynamic balance)	2 × 30s	3 × 30s	2 × 40s	3 × 40s	Standing and keeping a balanced position on the balance wobble board with a resistance band positioned around the thighs above the knee. Put on a resistance band around the thighs above the knees, and stand on both feet on the balance wobble board. Bend the hip and knee joints to 40°. Keep the back straight. Distribute the weight on the body center of pressure.
Balance board + roller+ resistance band (dynamic balance)	2 × 30s	3 × 30s	2 × 40s	3 × 40s	Standing and keeping a balanced position on the roller balance board with a resistance band positioned around the shins below the knee. Put on a resistance band around the shins below the knees, and stand on both feet on the balance wobble board. Bend hip and knee joints to 45° (squat position). Keep the back straight. Sway your body sideways for some time. Shift your weight from side to side to move the board in those directions.
Plyometric training
Hurdle jump++ resistance band. (leg muscle explosive power)	2 × 8	2 × 10	3 × 8	3 × 10	Counter-movement jump on both legs over the hurdle. Start with feet hip-width apart and knees slightly bent. Jump forward and backward over the hurdles. In the landing phase, bend ankles, knees, and hips to absorb impact energy.
Hurdle (leg muscle explosive power)	2 × 8	2 × 10	3 × 8	3 × 10	Lateral hurdle hop. Perform the hop by pushing off the right foot to land on the left foot over the hurdle, and vice versa. In the landing phase, bend ankles, knees, and hips to absorb the impact energy.
Cone triangle hop (Displace triangle cones with a distance of 1 m) (leg muscle explosive power)	2 × 6/leg	2 × 8/leg	3 × 4/leg	3 × 5/leg	Single leg jumps forward and backward, and side to side in front of the cone. Jump forward by taking off on one leg and land on the opposite leg in front of the cone. Bend your knee to 90⁰ to touch the cone with the knee of the landed leg while the opposite leg hangs. Jump backward to the starting point. Second step: hop to the right from one leg to the other, then hop to the left. Repeat the hops starting with the opposite leg.
Skipping Rope (leg muscle explosive power)	Na	Na	3 × 30s	2 × 40s	Skipping rope with single and both legs. Stand with both legs in the middle of the rope. Feet are shoulder-width apart. Jump with a consistent bound and steady rhythm. Use wrists to swing the rope over the head. Align the upper body, hips, knees, and feet. Keep the pelvis horizontal. Continue skipping rope on the right and left leg, respectively.

Illustration of balance and plyometric training.

Table 2

Statistical results of between-group and within-group differences by presenting mean absolute and relative percentage value for pre- and post- test.

VARIABLE	BALANCE AND PLYOMETRICS TRAINING GROUP					CONTROL GROUP					ANCOVA
VARIABLE	x̄1	x̄2	Δ%	p	d	x̄1	x̄2	Δ%	p	d	F	p	η_p²
Static Balance
Ellipse area [mm²] D	741.94 ± 171.49	645.42 ± 166.95	–13.01	0.033*	0.57	746.95 ± 172.73	799.56 ± 179.27	7.04	0.331	0.29	6.620	0.017^§	0.224
ND	699.28 ± 145.3	598.70 ± 117.76	–14.38	0.045*	0.76	684.39 ± 156.76	723.42 ± 172.75	5.70	0.549	0.23	4.622	0.042^§	0.167
Perimeter [mm] D	1259.77 ± 169.33	1081.75 ± 138.9	–14.13	0.001*	1.14	1271.87 ± 162.87	1295.56 ± 155.08	1.86	0.641	0.14	18.303	0.001^§	0.443
ND	1213.68 ± 187.1	1037.44 ± 166.85	–14.52	0.001*	0.99	1282.21 ± 201.04	1288.13 ± 181.33	0.46	0.908	0.03	14.780	0.001^§	0.391
Anterior-Posterior Speed [mm/s] D	24.70 ± 4.14	21.65 ± 3.7	–12.37	0.015*	0.77	25.44 ± 4.8	28.14 ± 6	10.59	0.172	0.49	10.816	0.003^§	0.320
ND	23.99 ± 3.62	20.19 ± 3.32	–15.84	0.001*	1.09	25.37 ± 6.14	27.24 ± 5.13	7.38	0.312	0.33	17.794	0.001^§	0.436
Medial-Lateral Speed [mm/s] D	28.85 ± 3.27	25.88 ± 4.23	–10.29	0.023*	0.78	30.24 ± 5.69	33.15 ± 6.55	9.62	0.286	0.47	10.599	0.003^§	0.315
ND	27.56 ± 6.57	23.65 ± 4.17	–14.20	0.038*	0.71	27.82 ± 8.55	31.23 ± 6.05	12.23	0.258	0.45	13.521	0.001^§	0.370
Dynamic Balance
Total stability index [°] D	2.29 ± 0.63	1.59 ± 0.74	–30.29	0.002*	1.01	2.33 ± 0.9	2.34 ± 0.87	0.43	0.994	0.01	5.793	0.025^§	0.201
ND	2.15 ± 0.79	1.50 ± 0.44	–30.41	0.013*	1.02	2.17 ± 0.82	2.27 ± 0.78	4.89	0.771	0.12	7.675	0.011^§	0.250
Trunk Total Deviation [°] D	2.56 ± 0.67	1.91 ± 0.59	–25.59	0.013*	1.03	2.60 ± 0.99	2.70 ± 1.49	4.00	0.721	0.08	4.506	0.045^§	0.164
ND	2.36 ± 0.67	1.74 ± 0.72	–26.14	0.007*	0.89	2.37 ± 0.97	2.50 ± 1.38	5.35	0.685	0.13	4.444	0.046^§	0.162
Talocrural Ankle ROM
Plantarflexion [°] D	42.51 ± 5.09	47.71 ± 4.76	12.22	0.002*	1.05	42.49 ± 5.7	43.90 ± 3.72	3.32	0.474	0.29	5.432	0.029^§	0.191
ND	43.11 ± 6.61	48.85 ± 3.81	13.31	0.027*	1.06	42.47 ± 5.38	44.53 ± 5.85	4.83	0.322	0.36	4.751	0.040^§	0.171
Dorsiflexion [°] D	11.07 ± 2.51	14.32 ± 2.57	29.37	0.001*	1.27	10.99 ± 2.75	12.09 ± 2.25	9.99	0.134	0.43	7.645	0.011^§	0.249
ND	11.39 ± 3.55	15.03 ± 2.41	32.03	0.001*	1.19	10.28 ± 3.29	12.05 ± 2.57	17.29	0.067	0.59	5.284	0.031^§	0.187
Shin muscle peak Isometric
Plantarflexor Peak Force [N] D	136.32 ± 33.79	150.52 ± 29.04	10.42	0.006*	0.45	136.71 ± 22.25	142.30 ± 23.35	4.09	0.253	0.24	5.246	0.031^§	0.186
ND	133.50 ± 35.04	147.81 ± 22.35	10.72	0.038*	0.48	133.70 ± 23	138.34 ± 14.66	3.47	0.433	0.24	3.096	0.092	0.119
Plantarflexor Peak Torque [N.m] D	27.93 ± 6.3	32.23 ± 6.02	15.38	0.001*	0.69	28.94 ± 5.83	31.00 ± 6.04	7.11	0.101	0.34	2.156	0.156	0.086
ND	27.37 ± 6.77	31.66 ± 4.56	15.68	0.005*	0.74	28.27 ± 5.74	30.05 ± 3.88	6.31	0.232	0.36	2.347	0.139	0.093
Plantarflexor Relatif Peak Torque[N.m/kg]D	0.46 ± 0.11	0.52 ± 0.10	14.18	0.001*	0.62	0.46 ± 0.10	0.51 ± 0.13	11.74	0.164	0.46	0.160	0.693	0.007
ND	0.45 ± 0.11	0.51 ± 0.09	14.36	0.013*	0.56	0.45 ± 0.1	0.49 ± 0.11	10.56	0.139	0.45	0.268	0.610	0.012
Dorsiflexor Peak Force [N] D	135.23 ± 27.71	160.66 ± 27.83	18.80	0.001*	0.91	136.19 ± 15.99	151.65 ± 26.29	11.35	0.049*	0.71	1.434	0.243	0.059
ND	131.32 ± 28.34	157.53 ± 32.41	19.96	0.001*	0.86	133.38 ± 21.06	142.70 ± 22.35	6.99	0.119	0.42	5.144	0.033^§	0.183
Dorsiflexor Peak Torque [N.m] D	27.87 ± 5.84	34.43 ± 5.70	23.51	0.001*	1.13	28.72 ± 3.80	32.95 ± 6.14	14.74	0.014*	0.82	1.435	0.243	0.059
ND	27.01 ± 5.78	33.72 ± 6.52	24.84	0.001*	1.08	28.14 ± 4.81	31.09 ± 5.77	10.47	0.025*	0.55	5.075	0.034^§	0.181
Dorsiflexor Realatif Torque [N.m/kg] D	0.45 ± 0.08	0.55 ± 0.09	22.81	0.001*	1.21	0.45 ± 0.07	0.54 ± 0.12	19.19	0.012*	0.91	0.191	0.666	0.008
ND	0.43 ± 0.07	0.54 ± 0.09	24.22	0.001*	1.32	0.44 ± 0.07	0.51 ± 0.13	15.66	0.029*	0.67	1.028	0.321	0.043
Countermovement Jump
Height [cm]	39.15 ± 1.75	43.19 ± 4.12	10.34	0.000*	1.27	39.35 ± 2.59	41.56 ± 2.77	5.63	0.008*	0.82	2.389	0.136	0.094
Time Flights [s]	0.55 ± 0.04	0.59 ± 0.05	6.74	0.017*	0.82	0.57 ± 0.02	0.58 ± 0.03	2.23	0.324	0.48	0.543	0.468	0.023
Maximum force [N]	1643.62 ± 189.60	1876.79 ± 242.60	14.19	0.004*	1.07	1717.62 ± 154.61	1816.89 ± 185.11	5.78	0.195	0.580	0.774	0.388	0.033

[i] Abbreviation: x̄1 = mean pre-test, x̄2 = mean post-test, Δ % = percentage change from pre to post test, D = Dominant, ND = Non-dominant, mm² = Millimeter square, mm = Millimeter, mm/s = millimeter per second, ° = degree, s = Second. N = Newton, cm = Centimeter, m = meter, kg = kilograms, ηp² = Partial eta square. * Significant difference: p < 0.05 between pre- and post-test within groups; § significant difference: p < 0.05 between intervention and control groups.

Absolute **(A, C, E, F, H, J, L)** and relative percentage **(B, D, G, I, K, M)** value change (pre-to-post) for all variables test.
Abbreviation: ellipse area [EA], perimeter length [P], average anterior-posterior speed [AAPS], average medial-lateral speed [AMLS], total stability index [TSI], total trunk deviation angle [TTD], Plantar flexion [PF], dorsiflexion [DF], peak force (PR), peak torque (PT), relative peak torque(RPT), height jump [HJ], flight time [FT], maximum force [MF]). IG.D intervention group dominant leg, CG.D control group dominant leg, IG.ND intervention group non-dominant leg, CG.ND control group non-dominant leg.

Effect of Integrative Balance and Plyometric Training on Balance, Ankle Mobility, and Jump Performance in Youth Football Players: A Randomized Controlled Trial

Figures & Tables

Figure 1

Table 1

Figure 2

Table 2

Figure 3

Paradigm

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