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“Effect of agility and eccentric training on athletic performance in basketball players – a randomized
controlled trial”
Introduction
Background Information
Basketball is a sport that requires a highly distinct physical skill set and the ability to perform
repetitive high intensity movements. It is estimated that a player may perform at least 35-46 vertical
jumps over the span of a single full-time game. Additionally, there is an estimated need to perform a
change of direction and/or multidirectional movement every 2-3 seconds. Because of the demands of
the sport, agility and change of direction (COD) speed are essential, even more so nowadays with the
evolution of the game leading to a drastic increase in the speed of play, which requires an increased level
of strength and conditioning in athletes. Agility as a skill is affected by numerous factors, including
coordination, joint mobility, dynamic balance, power, the biomechanical structure of movement of a
given athlete. A study by Spori et al in 2010 suggested that agility training is vital to enhance power
performance, which is achieved via enhancements in neuromuscular motor control. Additionally,
eccentric training has been found to be beneficial in improving athletic performance. During sprinting,
such as a fast break after a defensive steal in basketball, while the knee extensors contract concentrically,
the knee flexors antagonistically contract eccentrically in order to decelerate and stabilize the knee joint.
Through resistance training, both the eccentric and concentric components can be developed.
It is important for an adequate testing battery in order to assess progression/regression of an
athlete throughout a season and/or after the implementation of a training program. Physical ability tests
help to assess athletic talent and performance and include tests that measure anaerobic power, speed,
and agility. To assess agility, the T-test is commonly used, as it assesses an athlete’s COD speed and their
ability to maintain both speed of movement and balance throughout the test. To determine acceleration,
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sprint tests are popularly used because of the simplicity of administration and the direct application to
on-field sprinting, as short distance accelerations are quite common in most team sports as a measure of
athletic ability. Vertical jump (VJ) tests are commonly used to assess lower body power and are directly
applicable to team sports like basketball that require high amounts of jumping. Makhlouf et al in 2018
found that soccer athletic performance was improved after the implementation of a combined agility
and plyometric training program. Additionally, a study by Tansel et al in 2008 found that athletic
performance and muscular strength was significantly greater after the implementation of an eccentric
hamstring strength training program when compared to those who only performed basic basketball
skills.
Purpose/Hypothesis
Until the point of publication of this study, no study had been found that analyzed improvements
in basketball athletic performance after the implementation of a combined agility and eccentric training
program. Therefore, the purpose of this study was to evaluate the effect of a combined eccentric and
agility training program on basketball player performance. No hypothesis was stated, but the null
hypothesis would suggest that no significant differences would be present after a combined training
program when compared to the control. The alternate hypothesis would state that there would be a
significant difference between groups.
Methods
Subjects
45 subjects in all were screened, with 36 subjects (26 male, 10 female [22.56±2.063 yrs])
meeting the inclusion criteria being recruited for the study. Eligibility criteria included the following: age
between 19-30 years old, BMI between 18.5-24.9 (normal), enrolled at the Institute of Physiotherapy
(located in Mangalore, Karnataka), and currently an active basketball player. Exclusion criteria for this
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study were as follows: cognitive impairment (mini mental state exam [MMSE] score <2.1), lower limb
injury or surgery within the last six months, previous lower extremity training to improve performance,
osteoporosis, and any lower extremity pathologies or systemic illnesses. Subjects were informed about
the intervention and procedures prior to giving informed consent, after which they were randomized
into two groups. Group A was the intervention group, consisting of 14 males and 4 females. Group B was
the control group, consisting of 12 males and 6 females.
Protocols
This study utilized a blinded randomized controlled study that was conducted over a 12 month
period. Outcome measures of vertical jump (VJ) height (in inches), T-test score (in seconds), and 30 m
sprint time (in seconds) were obtained at baseline and on the fifth week after the intervention was
applied. The intervention group was put through a combined agility and eccentric strength training
program. The researchers did not state the frequency of training sessions for the intervention or control
groups. Agility training for the intervention group consisted of several COD drills. After a 10 minute
warmup (10 total minutes of jogging and static stretching), a 30 minute agility training occurred,
consisting of 10 minutes of ladder drills (lateral shuffles, quick feet ladder sprint, etc) and 15 minutes of
cone drills (oblique shuttle runs, agility T drills, and forward/backward T drills), followed by a 10 minute
cooldown. The intervention group then conducted an eccentric training protocol of Nordic hamstring
curls. Kneeling on a pad with their lower legs stabilized, the subjects performed 3 sets of 8-12 reps (with
a four second eccentric phase), with a 45-60 second rest between sets. Conversely, the control group
performed only basketball training.
Statistical analysis of each variable was conducted, with values being expressed as mean plus
standard deviation and the alpha level of significance was set at p<0.05. A Chi square test compared
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genders according to groups, and a combination of independent and dependent t-tests were performed
to compare characteristics within and between groups and before and after interventions.
Results
An independent t-test determined that baseline characteristics were not significantly different
between groups for age or any testing scores. When comparing pre- and post-values irrespective of
group, significant differences were found (p<.001). Vertical jump scores improved from 17.44±2.50
inches to 18.81±3.27 inches (p<.001), T-test times improved from 10.78±9.64 seconds to 9.64±1.38
seconds (p<.001), and 30 m sprint times improved from 6.22±0.97 seconds to 5.14±0.52 seconds
(p<.001). In the experimental group, vertical jump scores significantly improved from 18.00±2.52 inches
to 20.33±3.25 inches (p<.001). The control group also significantly improved vertical jump scores
between pre- and post-testing (p<.001), with respective values of 16.89±2.42 inches and 18.28±2.84
inches. Confusingly, although results irrespective of groups found significant improvements in t-test and
30 m sprint values (both at p<.001), the data presented for both intervention and control groups in the
results section showed that scores actually worsened. For the experimental group, it was stated that t-
test times increased from 10.57±2.34 seconds to 13.45±1.33 seconds and 30 m sprint times increased
from 6.09±0.91 seconds to 8.84±0.59 seconds. For the control group, it was stated that t-test times
increased from 10.99±0.70 seconds to 12.73±1.23 seconds and 30 m sprint times increased from
6.34±1.02 seconds to 8.44±1.93 seconds. Based on the discussion and conclusion sections, it may be
assumed that there was a recording error when displaying the results of this study. This may be assumed
by the fact that results irrespective of group found significant improvements in all tests, although it will
be discussed as a limitation of this study. Significant differences in changes between groups of pre- and
post-test values were found for all tests (p<.001). However, these values must be questioned due to the
inconsistency of the results presented.
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Discussion
Movements like the vertical jump and other highly distinctive movements are commonplace in
basketball, with changes in body position and direction occurring an estimated every 2-3 seconds. In
relation to sprinting and other performance abilities, eccentric control is essential to minimize risk of
injury and stabilize the joints involved with a given movement. With eccentric contractions, the force of
contraction increases in proportion to the speed of contraction, as well as the intensity. In sports that
require high amounts of maximal sprinting, acceleration, and deceleration, hamstring injuries are highly
prevalent. This study utilized the Nordic hamstring exercise as part of the eccentric training intervention,
which has been found to be more effective in improving maximal eccentric hamstring strength than the
traditional hamstring curl. Based on the researchers’ discussion (despite the results section not
accurately displayed information), it was found that the intervention group showed more significant
differences for all tests both within and between groups. While both the intervention and control groups
improved between pre and post, the effect of combined agility and eccentric training was found to have
more significant effects on athletic performance in the basketball players tested for this study. It is
important to note that basketball training alone still led to significant improvements across all measures,
meaning that the demands of the sport may lead to test-related measures even without the
implementation of a strength/agility training program. However, the greater increases within the
intervention group suggest that additional training outside of the standard practice is warranted in order
to further improve performance.
In comparison to previous studies investigating similar effects, the current study confers with
past findings. A 2020 study by Pradana et al found that Illinois agility test scores significantly improved in
basketball players after undergoing a ladder drill training intervention that emphasized the importance
of quick feet and precise movement control. Wilderman et al in 2009 found significant improvements in
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hamstring activation, knee motion, and impact force that improvement basketball skill performance
after a six week agility training intervention on female basketball players. Additionally, O’Brien et al in
2020 found that an eccentric strength program via flywheel inertial training improved VJ and sprint test
values in female basketball players. These studies support the results of this study that found more
significant improvements in VJ, agility, and sprint ability after a combined agility and eccentric strength
training intervention.
Agility is an essential motor skill in team sports, with reactive agility being an especially
prominent training technique to develop skills that require a perceptual component. It is suggested that
agility has possible effects on various sport-related skills, including speed, COD, and perceptual decision
making ability. By improving agility, there is potential for the athlete to also improve these other abilities
related to their sport. Likewise, hamstring injuries that occur in sport most often are caused by eccentric
hamstring contractions and is thought to be caused by sarcomere length instability, causing non-uniform
sarcomere lengthening. This cascade may lead to severe soft tissue tears within the hamstring group. In
order to mitigate this risk, adequate eccentric hamstring strengthening should occur in a training
program. This study utilized a Nordic hamstring exercise as opposed to traditional hamstring curls, which
was found to increase eccentric hamstring strength more effectively.
This study contained many limitations. The results provided were not consistent, as the stated
values between groups did not match the stated values of the participants as a whole or with the
discussion. There most likely was an error in displaying the statistics, making it difficult to confirm the
results. A small sample size was used, making it difficult to generalize results. Even taking into
consideration the sample size, the researchers did not state the frequency of training interventions or
provide adequate participant baseline or anthropometric information (i.e. height, weight, training age,
basketball experience, level of competition), further making generalizations difficult. Despite having an
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even number of male and female participants, the intervention and control groups were not uniform in
size. Although this most likely did not affect the results, a study should have a relatively even number of
participants between groups if possible. Finally, the split times (i.e. 5, 10, and/or 20 m) of the 30 m sprint
test were not assessed. Having that differentiation between acceleration and max speed may have
assisted in estimating the effects and relationships of the training intervention, especially since COD tests
like the T-test are more associated with acceleration/deceleration ability than max speed due to the
short distances of the testing procedures. Since basketball athletes most likely don’t reach max speed
during a given play, understanding their acceleration ability may be more practical when assessing their
performance capabilities.
In conclusion, basketball is a sport that requires a high level of explosive strength and rate of
force development, emphasizing the importance of developing the characteristics of speed, COD, and
power that is essential to be successful in the sport. This study found that a combined eccentric strength
and agility training program yielded greater improvements in speed and agility performance than
basketball training alone. Therefore, a training program containing both agility and eccentric
components should be implemented in order improve performance and reduce the risk of basketball-
related injury.
Analysis and Critique
Overall, the design of this study was simple but effective. The exercise intervention of ladder
drills, agility drills, and eccentric Nordic curls is a simple, cost-effective way to provide training outside of
just sport-related practice. It may have been beneficial to include a third group that performed both the
interventional training program and controlled basketball training to identify whether further
performance benefits may have been achieved. However, this would have most likely required a much
larger sample size, as three groups would have been too many based on how many participants took
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part in this study. Generalization of the findings from this study (taken in isolation) is difficult, as the data
was displayed seemingly incorrect (as discussed previously) and the training age and competition level of
the athletes was never stated. However, the comparisons made with other studies appear to emulate
the findings of this study, despite the results section being what it was. A longer interventional period
may have been more beneficial in determining the long-term effects and/or dose response of the
implemented training program. Also, differences in improvements between sexes was not discussed
either. Providing such information may have given insight to the magnitude of training adaptations for
both the control and intervention groups between sexes. It is common knowledge that males are
generally more powerful than females, even when taking into consideration relative strength. However, I
am unsure as to whether this also linearly relates to COD/agility ability. It would have been insightful to
know if the magnitude of improvements was different between male and female participants to
establish the efficacy of the control and intervention between sexes and understand how both sexes
potentially respond different to training.
Practical Application
If the conclusions were true, despite inconsistent results being provided, it emphasizes the
importance of implementing both agility and eccentric strength training into a basketball training
program. Even in sports besides basketball, this kind of training would be beneficial to team sports that
require high levels of short sprints and reactive CODs. It is important to note that basketball training
alone still improved performance, meaning that the very nature of the sport is highly agility- and speed-
based. However, because of the greater magnitude of improvements after the training intervention,
basketball training alone does not provide enough of a stimulus to improve an athlete’s performance as
much when compared to the intervention. Finding a balance between the two, specifically while in-
season, may be an essential component of the training mesocycle. Outside of performance
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improvements, because it has been found that eccentric training reduces the risk of sport-related injury,
such training protocol should be implemented throughout the season. This study provided a feasible,
cost-effective way of training that did not require access to a gym or expensive equipment. For
application purposes, school programs that are not well-funded (regardless of level) would be able to
apply this study’s training intervention and, based on the results, still yield significant improvements in
COD and speed ability. Personally, I would provide split times at the 5 and 10 m marks during sprint
testing in order to measure first step quickness and acceleration. In doing so, the coach would have
additional information on a given athlete’s performance abilities.
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Reference
Thomas, L., Poojary, S., & Srivastava, S. (2023). Effect of agility and eccentric training on athletic
performance in basketball players - a randomized controlled trial. Journal of Pharmaceutical
Negative Results, 14(1). https://doi.org/https://doi.org/10.47750/pnr.2023.14.S01.171
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