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Comparative Effects Of Modified Hölmich Protocol versus Eccentric Training On Strength, Speed And Agility In Young Cricketers With Groin Pain

Protocol summary

Study aim
To determine and compare the effects of modified Hölmich protocol versus eccentric strengthening training in reliving adductor related groin pain, improving strength, speed and agility in young cricketers
Design
Double blind, Pragmatic, community based, Randomised clinical trial
Settings and conduct
Participants will be recruite from following academies/clubs 1. Saeed Ajmal cricket academy, Faisalabad 2. Al-fateh Sports complex, Faisalabad 3. Pakistan Sports Board, Lahore
Participants/Inclusion and exclusion criteria
Participants only those are added to the study which fits to the selection criteria of study. Selection criteria includes following: only male cricketers were added to the study, professional Cricketers aged under 19 years, cricketers ranging from 15-19 years, self-reported groin pain presenting during sport or at rest (unilateral or bilateral) and obvious history of morning groin pain and stiffness. Those who did not met these conditions along with other conditions were not added to the study. Other conditions includes radiating pain or pain with neurogenic and systemic origin, history of pelvic or lower extremity fracture and surgery, trochanteric bursitis, inguinal or femoral hernia and persistent urinary tract disease.
Intervention groups
Group A will perform modified Hölmich protocol training which is in two parts. Part 1 will be used from week 1-3 and Part 2 will be used from week 3 to onwards. Group B will perform eccentric strength training which will include dynamic hip adduction with resistance band wrapped around ankle joint, eccentric hip adduction, isometric hip abduction and isometric hip adduction.
Main outcome variables
Main outcome variables includes improvement in: 1. pain 2. strength 3. speed and agility in young cricketers

General information

Reason for update
Acronym
ARGP (Adductor-Related Groin Pain)
IRCT registration information
IRCT registration number: IRCT20220510054804N2
Registration date: 2025-06-02, 1404/03/12
Registration timing: registered_while_recruiting

Last update: 2025-06-02, 1404/03/12
Update count: 0
Registration date
2025-06-02, 1404/03/12
Registrant information
Name
Muhammad Farhan
Name of organization / entity
Government College University Faisalabad, Pakistan
Country
Pakistan
Phone
+92 309 6670876
Email address
farhangujjar607@gmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2024-07-07, 1403/04/17
Expected recruitment end date
2025-07-22, 1404/04/31
Actual recruitment start date
2025-01-15, 1403/10/26
Actual recruitment end date
2025-08-25, 1404/06/03
Trial completion date
2025-08-28, 1404/06/06
Scientific title
Comparative Effects Of Modified Hölmich Protocol versus Eccentric Training On Strength, Speed And Agility In Young Cricketers With Groin Pain
Public title
Effects Of Modified Hölmich Protocol versus Eccentric Training In Young Cricketers With Groin Pain
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Professional Cricketers aged under 19 years Cricketers ranging from 15-19 years (ICC Player Eligibility Regulations Article 4) Self-reported groin pain presenting during sport or at rest (unilateral or bilateral) Obvious history of morning groin pain and stiffness Only male cricketers
Exclusion criteria:
Radiating pain or pain with neurogenic and systemic origin History of pelvic or lower extremity fracture and surgery Trochanteric bursitis Inguinal or femoral hernia Persistent urinary tract disease
Age
From 15 years old to 19 years old
Gender
Male
Phase
N/A
Groups that have been masked
  • Participant
  • Outcome assessor
Sample size
Target sample size: 46
Actual sample size reached: 42
Randomization (investigator's opinion)
Randomized
Randomization description
After evaluation, individuals will be randomly allocated as a cluster to either the group receiving the intervention (of modified Hölmich protocol) or the group receiving the intervention (eccentric strengthening training). This will be done randomly using table of random numbers to reduce the risk of bias.
Blinding (investigator's opinion)
Double blinded
Blinding description
Blinding in this study will involves making sure that the evaluator who measure outcome variables (pain, power, speed and agility) will be uninformed of which participants will be in which intervention cluster groups and the participants will also be blinded so that they will not be aware of other cluster group. This double-blind strategy will help to avoid measurement bias.
Placebo
Not used
Assignment
Other
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Research and Ethical Committee Riphah College of Rehabilitation Sciences, Faculty of Rehabilitation
Street address
26-M Gulberg III, Lahore
City
Faisalabad
Postal code
54660
Approval date
2024-07-30, 1403/05/09
Ethics committee reference number
REC/RCR & AHS/24/0446

Health conditions studied

1

Description of health condition studied
Groin pain associated with adductor muscle strain inn young cricketers
ICD-10 code
S76.21
ICD-10 code description
Strain of adductor muscle, fascia and tendon of thigh

Primary outcomes

1

Description
Primary outcome includes improvement in groin pain, strength, speed and agility
Timepoint
outcomes are measured at three different time intervals which are base line, at the end of 4th week and at the end of 8th week
Method of measurement
Pain was measured using NPRS, Strength was measured using a dynamometer, Speed and Agility was measured in seconds by performing T-test

Secondary outcomes

empty

Intervention groups

1

Description
Intervention group: Group 1 After giving participants baseline treatment. Group 1 have performed modified Hölmich protocol training which is in two parts. Part 1 will be used from week 1-3 and Part 2 will be used from week 3 to onwards. Part 1 includes Isometric, pain-free adduction against a soccer ball placed between the knees in the crook lying position, Bilateral straight leg raising in a seated V position, Isometric standing hip adduction using elastic bands (both legs should be trained), Abdominal sit-ups in both straight and oblique directions, Prone bridging on forearms and toes (the back should be completely straight), Unilateral bridge exercise starting from the crook lying position (with one knee flexed and the opposite hip and knee extended so that trunk is in neutral spine alignment, Wobble board balance training (beginning with both feet and gradual increase in difculty by single leg standing and then adding some maneuvers like small knee bends to challenge the balance . Part 2 included Low back extension exercise in the prone position with arms at the sides, Abdominal sit-ups, in both straight and oblique directions, while holding a 3 kg medicine ball in hands, Standing hip add-abd. exercise with elastic bands (both legs) , Folding knife sit-ups beginning from the crook lying position, with a soccer ball located between the knees, simultaneous ab. sit-ups and hip flex , In the prone position with arms stretched overhead, partial lifting of opposite arm and leg for 6 sec and then reverse sides, Prone bridging on forearms and toes with single limb lifting (Rt. arm, Lt. arm, Rt. leg, and Lt. leg are lifted consecutively, Side bridging on the elbow plus single hip abd, Unilateral bridge exercise. Start from crook lying position with one knee flexed and the opposite hip and knee extended while the flexed limb is on an unstable surface such as a Dyna Disc®, Copenhagen Adduction exercise beginning from the 7th week, if it does not provoke pain.
Category
Treatment - Other

2

Description
Intervention group: Group 2 After giving participants baseline treatment. Group B have performed eccentric strength training which included dynamic hip adduction with resistance band wrapped around ankle joint, eccentric hip adduction, isometric hip abduction and isometric hip adduction.
Category
Treatment - Other

Recruitment centers

1

Recruitment center
Name of recruitment center
Saeed Ajmal Cricket Academy, Faisalabad
Full name of responsible person
DC Sports Officer Miss Sajida
Street address
C22R+W6J, Jhang Rd, Firdous Colony Faisalabad
City
Faisalabad
Postal code
38000
Email
farhangujjar607@gmail.com

2

Recruitment center
Name of recruitment center
Al-Fateh Sports Complex
Full name of responsible person
District Sports Officer Mr. M. Tariq Nazeer
Street address
C442+X8H, D Ground Block B People's Colony No 1, Faisalabad
City
Faisalabad
Postal code
38000
Email
farhnagujjar607@gmail.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Riphah International Universtiy, Gulberg Green III, Lahore
Full name of responsible person
Prof. Dr. Sayyed Asadullah Arslan Gillani
Street address
25 Raza Saeed Rd, Bhabra Block M Gulberg III, Lahore, Punjab 25-M Block, Lahore
City
Lahore
Postal code
54660
Phone
Email
54192@students.riphah.edu.pk
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Riphah International Universtiy, Gulberg Green III, Lahore
Proportion provided by this source
100
Public or private sector
Private
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Riphah International University, Lahore
Full name of responsible person
Muhammad Farhan
Position
Student
Latest degree
Bachelor
Other areas of specialty/work
Physiotherapy
Street address
25 Raza Saeed Rd, Bhabra Block M Gulberg III, Lahore, Punjab 25-M Block, Lahore
City
Lahore
Province
Punjab
Postal code
54660
Phone
+92 309 6670876
Email
farhangujjar607@gmail.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Riphah International University, Lahore
Full name of responsible person
Dr.Muhammad Farhan;PT
Position
Master's Student
Latest degree
Bachelor
Other areas of specialty/work
Physiotherapy
Street address
25 Raza Saeed Rd, Bhabra Block M Gulberg III, Lahore, Punjab 25-M Block, Lahore
City
Lahore
Province
Punjab
Postal code
54660
Phone
+92 309 6670876
Email
54192@students.riphah.edu.pk

Person responsible for updating data

Contact
Name of organization / entity
Riphah International University, Lahore
Full name of responsible person
Dr. Muhammad Farhan;PT
Position
Master's Student
Latest degree
Bachelor
Other areas of specialty/work
Physiotherapy
Street address
25 Raza Saeed Rd, Bhabra Block M Gulberg III, Lahore, Punjab 25-M Block, Lahore
City
Lahore
Province
Punjab
Postal code
54660
Phone
+92 309 6670876
Email
54192@students.riphah.edu.pk

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Yes - There is a plan to make this available
Data Dictionary
Yes - There is a plan to make this available
Title and more details about the data/document
Cases of groin pain associated with adductor muscle strain in young cricketers with the primary outcome measures of pain, strength, speed and agility
When the data will become available and for how long
Data will be available after completion of trial (i.e 28 August 2025) and publication period and will be available until removed upon the author's demand
To whom data/document is available
To all the researchers community, analysts and clinicians
Under which criteria data/document could be used
For research purpose and evidence based practice at clinics for the imporved treatment of adductor related groin pain in young cricketers and other athletes (i.e footballers) as well as applicable to the general patients also suffering with the same condition.
From where data/document is obtainable
Google scholar (https://scholar.google.com/) and PubMed (https://pubmed.ncbi.nlm.nih.gov/)
What processes are involved for a request to access data/document
None
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