Objective. To evaluate the methodological quality of hamstring rehabilitation studies found in the current literature. Data sources. Pubmed (1950-2006), MEDLINE, CINAHL (1982-2007), CINAHL Select (1973-2007), SPORTDiscus (1985-2007), Google Scholar, Scirus (1920-2008), Academic Search Premier (1975-2007), and ERIC from July 2006 to January 2007 were searched using the terms hamstring, semimembranosus, semitendinosus , and biceps femoris individually. Second, the term hamstring was combined with each of the following words: rehabilitation, anatomy, strain, epidemiology, injury, exercise, therapy, imaging, study, track and field, soccer, and football. Third, citations were cross-referenced from studies to include literature not found in the original search. Study selection. Studies were selected based on the following inclusion criteria: (1) written in the English language, (2) the term hamstring must be included in the title, (3) the abstract must include the terms hamstring and rehabilitation, program, or treatment, (4) hamstring must be the chief complaint in the study, and (5) study must be a randomized controlled trial. The exclusion criteria included Anterior Cruciate Ligament (ACL) reconstructive surgery studies and studies in which the hamstring is not the chief complaint. Data extraction. There were 127,278 combined hits, of the 127,278 total hits, 3,722 included the term hamstring in the title. Of the 3,722 hits, 32 were studies not involving ACL reconstructive surgery and included hamstring and rehabilitation, program, or treatment in the abstract. Of the 32 studies, 7 met all of the inclusion criteria. All the studies that met the inclusion criteria were then collected and evaluated using the PEDro Scale. First, each was read completely without the use of the PEDro scale. Next, the article was read a second time using the PEDro scale checklist. Based on the checklist the studies were then awarded points ranging from 0 to 10. Finally, once all the studies were evaluated the primary and secondary investigators compared scores. A discrepancy between the investigators was found regarding the grading of a study. The study was evaluated a second time by each investigator and the scores were compared. The final result added a point to the overall methodological quality of the study. Data synthesis. The methodological quality of the studies ranged from 1 to 6 with the mean average score being 3.04. Three did not meet the eligibility criteria. One study included concealed allocation of subjects. Not one study included blinding of all subjects or blinding of all therapists who administered the treatment. Two of the included studies were not randomly allocated and one study measured by the "intent to treat". One study did not report the results of between-group statistical comparisons for at least one key outcome or point measures and measures of variability for at least one key outcome. Three of the seven studies recorded similar baseline measures. Conclusions. The lack of standardization among hamstring protocols has a wider scope than initially hypothesized. Of the current studies, many have a low methodological quality, which reflects the significance of the study to clinical implications.
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