Effects of Training Program wearing Balance Shoes to Reduce Knee and Lower Extremity Injuries in Junior Athletes: A Randomized Controlled Trial

Abstract

Objective: The purpose of this randomized controlled trial was to compare the effectiveness of an original 15-minute exercise program wearing the ReaLine Balanceshoes (RBS) and a conventional injury prevention program in reducing lower extremity injuries. Methods: We recruited athletic club teams from local junior high schools. Inclusion criteria were adolescents who were a member of their interscholastic athletic club team. Players with an injury within 6 weeks that prevented full participation in sports, a history of systemic disease or neurologic disorder at the start of the intervention, and those already using an injury prevention program were excluded. Participants were individually randomized within a team into one of the study groups (RBS or control). The RBS group used the RBS, a shoe-type training device designed for correcting dynamic knee valgus. A 6-staged progressive exercise program was developed, including slow closed kinetic chain strengthening, joint realignment, balancing, feedforward, feedback, and plyometric components. The control group performed an injury prevention program previously used to reduce injury risk. One 15-minute session was performed 3 days/week for 12 months. The primary outcome was incidence of anterior cruciate ligament (ACL) injury and acute knee injuries. Results: One hundred twenty three players completed the study (RBS, n=65; control, n=58). No ACL injury or acute knee injury occurred among RBS athletes versus 1 ACL injury [RR 0.298, 95% CI (0.012, 7.175)] and 3 acute knee injuries [RR 0.127, 95%CI (0.007, 2.421)] among control athletes. Conclusion: The RBS program was not significantly more effective than a conventional injury prevention program in reducing the incidence of ACL injury and other acute lower extremity injuries in junior athletes.