ACL Injury Prevention Programs Research Articles

ANTERIOR CRUCIATE LIGAMENT INJURY PREVENTION PROGRAMMES IN WELSH NETBALL: SURVEY OF KNOWLEDGE, IMPLEMENTATION, AND BARRIERS AMONG PLAYERS AND COACHES

IntroductionPerception of ACL injury prevention programs amongst professional netball players and coaches has not been studied. We investigated (1) level of awareness and experience of ACL injury prevention programs; (2) use of ACL injury prevention programs; and (3) barriers to implementing ACL injury prevention program in netball.MethodologyFemale netball players representing Welsh senior and under-21 teams and elite and amateur coaches were invited electronically to this web-based study between 1st May–31st July 2021. Information on ACL injury susceptibility and seriousness, knowledge, experience, and implementation of ACL injury prevention programs were ascertained.ResultsTwenty-eight players (77.8%) and 29 coaches (13.2%) completed the questionnaire. Seventeen (60.7%) players and 15 (51.7%) coaches reported female athletes were at greater risk for sustaining ACL injuries. Over 90% of respondents identified netball as high-risk, whilst 89% of players and 76% of coaches reported these injuries to be preventable. Two (7.1%) players and 6 (20.7%) coaches utilised ACL injury prevention programs with lack of time and engagement from coaches and players identified. Majority of respondents indicated that their club has neither promoted, advocated nor demonstrated exercises for ACL injury prevention. Over 90% of respondents would utilise such programs if it minimised players risk with appropriate training and information.ConclusionStudy highlights limited knowledge of female athletes’ increased susceptibility of ACL injuries with lack of communication and education of ACL injury prevention programs between sporting associations, coaches and players. Results demonstrate willingness of players and coaches to implement ACL injury prevention programs in Welsh netball.

ANTERIOR CRUCIATE LIGAMENT INJURY PREVENTION PROGRAMMES IN WELSH NETBALL: SURVEY OF KNOWLEDGE, IMPLEMENTATION, AND BARRIERS AMONG PLAYERS AND COACHES

IntroductionAnterior Cruciate Ligament (ACL) injury prevention programs can reduce injury risk in various sports. The perception of ACL injury prevention programs amongst professional netball players and coaches has not been studied. The purpose of the study was to determine (1) level of awareness and experience of ACL injury prevention programs; (2) use of ACL injury prevention programs; and (3) barriers and potential facilitators to implementing a sustainable ACL injury prevention program in netball.MethodsThis cross-sectional observational study was undertaken using the CHERRIES checklist. Female netball players representing Welsh senior and under-21 teams and elite and amateur coaches were invited electronically to participate in this web-based study between 1st May – 31st July 2021. Information on ACL injury susceptibility and seriousness, knowledge, experience, and implementation of ACL injury prevention programs were ascertained.ResultsTwenty-eight players (77.8%) and 29 coaches (13.2%) completed the questionnaire. Seventeen (60.7%) players and 15 (51.7%) coaches reported female athletes were at greater risk for sustaining ACL injuries. Over 90% of respondents identified netball as high-risk, whilst 89% of players and 76% of coaches reported these injuries to be preventable. Only two (7.1%) players and 6 (20.7%) coaches utilised an ACL injury prevention program with lack of time and engagement from coaches and players identified. Majority of respondents indicated that their club has neither promoted, advocated the use nor demonstrated exercises for ACL injury prevention. Over 90% of respondents would utilise an ACL injury prevention program if it minimised players risk with appropriate information and demonstration of exercises.ConclusionThis study highlights limited knowledge of female athletes' increased susceptibility of ACL injuries amongst players and coaches with lack of communication and education of ACL injury prevention programs between sporting associations, coaches, and players. However, the results demonstrate willingness amongst both players and coaches to implement an ACL injury prevention program in netball.

Parental Awareness and Attitudes Towards ACL Injury Prevention Programs in Youth Athletes

Background: The incidence of anterior cruciate ligament (ACL) injuries has steadily increased in young athletes and may have long-term implications for physical function and quality of life. ACL injury prevention programs have been developed and refined over the past several decades and have been shown to reduce the risk of ACL injuries by up to 70%. However, awareness and understanding of these programs among parents of athletes is unknown. This study aims to evaluate knowledge and attitudes toward ACL injury prevention programs for parents of young athletes involved in cutting and pivoting sports at varying levels of competition.Methods: A cross-sectional survey was nationally distributed to a convenience sample of parents of young athletes between the ages of 5 and 18. The survey focused on questions relating to demographic information, history of ACL injury, knowledge of ACL injury prevention programs, and factors influencing program awareness. Descriptive statistics were used to summarize participant characteristics and determine prevalence of program awareness.Results: A total of 244 parents completed the survey with 74% indicating their child's primary sport was soccer. Seventy-seven percent of these athletes began specializing in their primary sport at an average age of 8 years old (SD = 2.72). Only 18% of parents reported knowledge of ACL injury prevention programs and just 6% reported their child has ever participated in one. Of the 29 (12%) athletes who had experienced an ACL injury, only 17% had participated in an ACL injury prevention program. The most commonly reported barrier to ACL injury prevention program participation was the lack of awareness of where to get such training and it not being readily offered to their child. Sixty-eight percent of all parents would have their child participate in an ACL injury prevention program if offered to them.Conclusion: There is a lack of awareness of ACL injury prevention programs among parents of young athletes involved in high injury-risk sports. However, most parents would be interested in their child utilizing an ACL injury prevention program if it were offered.Levels of Evidence: Level IVKey Concepts•Given the young age at which athletes are specializing in their sport and other contributing factors, ACL injury prevention programs are becoming increasingly important.•Parents of youth athletes demonstrate a lack of awareness regarding ACL injury prevention programs.•Barriers to the utilization of ACL injury prevention programs include both a lack of knowledge of their availability and where to access this form of training.•Many parents are interested in having their child participate in an ACL injury prevention program.•Spreading awareness of ACL injury prevention programs will require a multi-faceted approach.

Knowledge and awareness of anterior cruciate ligament injury among Turkish professional athletes: an online survey

ABSTRACT The purpose of this study was to assess the awareness and knowledge of professional team sport athletes about ACL injuries, injury prevention programs, and the return to sports after ACL injuries. A total of 419 athletes representing soccer, basketball, volleyball and handball sports were included in the study. We utilized a 15-item self-report survey to assess the awareness of athletes about ACL injury, ACL injury prevention program, and return to sport after ACL injuries. Male and soccer players participated in prevention programs more than female athletes (p = 0.001). Participation in prevention programs was significantly higher in the ≥ 18 years old group than in the < 18 years old group (p = 0.040). Participants who were informed about ACL injuries were 8.4 times more likely to participate in the ACL injuries prevention program than others (OR: 8.38, 95% CI: 3.823–18.376, p < 0.001). The majority of participants believed that return to sport after ACL injury takes 6 months and 81.4% of them thought that it is not possible to do sport without an ACL. This study revealed that the awareness and performance of ACL prevention training programs among professional team sport athletes were insufficient. The athletes’ knowledge regarding return to sports after ACL injuries was also inadequate. Improving athletes’ knowledge of ACL injuries may lead to increased participation in ACL injury prevention programs. Thus, the provision of tailored educational interventions to athletes could potentially enhance their awareness and understanding of ACL injuries, consequently contributing towards the prevention of such injuries.

ANTERIOR CRUCIATE LIGAMENT INJURY PREVENTION PROGRAMMES IN WELSH NETBALL: SURVEY OF KNOWLEDGE, IMPLEMENTATION, AND BARRIERS AMONG PLAYERS AND COACHES

AbstractIntroductionPerception of ACL injury prevention programs amongst professional netball players and coaches has not been studied. We investigated (1) level of awareness and experience of ACL injury prevention programs; (2) use of ACL injury prevention programs; and (3) barriers to implementing ACL injury prevention program in netball.MethodologyFemale netball players representing Welsh senior and under-21 teams and elite and amateur coaches were invited electronically to this web-based study between 1st May–31st July 2021. Information on ACL injury susceptibility and seriousness, knowledge, experience, and implementation of ACL injury prevention programs were ascertained.ResultsTwenty-eight players (77.8%) and 29 coaches (13.2%) completed the questionnaire. Seventeen (60.7%) players and 15 (51.7%) coaches reported female athletes were at greater risk for sustaining ACL injuries. Over 90% of respondents identified netball as high-risk, whilst 89% of players and 76% of coaches reported these injuries to be preventable. Two (7.1%) players and 6 (20.7%) coaches utilised ACL injury prevention programs with lack of time and engagement from coaches and players identified. Majority of respondents indicated that their club has neither promoted, advocated nor demonstrated exercises for ACL injury prevention. Over 90% of respondents would utilise such programs if it minimised players risk with appropriate training and information.ConclusionStudy highlights limited knowledge of female athletes’ increased susceptibility of ACL injuries with lack of communication and education of ACL injury prevention programs between sporting associations, coaches and players. Results demonstrate willingness of players and coaches to implement ACL injury prevention programs in Welsh netball.

How to improve movement execution in sidestep cutting? Involve me and I will learn

Providing choices, i.e., autonomy, to athletes during practice increases intrinsic motivation and positively influences the motor learning process. The effects of autonomy on the timing of feedback (self-controlled timing of feedback) when optimizing the movement execution of sidestep cutting (SSC), a task that is highly related with ACL injury risk, are unknown. The aim of this study was to investigate the effect of self-controlled timing of video and EF-feedback on movement execution of SSC in team sport athletes. Thirty healthy ball team sport athletes (22.9 ± 1.7 years, 185.5 ± 7.2 cm, 79.3 ± 9.2 kg) were recruited from local sports clubs. Participants were alternately assigned to the self-control (SC) or the yoked (YK) group based on arrival and performed five anticipated and five unanticipated 45° SSC trials as pre-, immediate-post and one-week retention test. Movement execution was measured with the Cutting Movement Assessment Score (CMAS). Training consisted of three randomized 45° SSC conditions: one anticipated and two unanticipated conditions. All participants received expert video instructions and were instructed to ‘try to do your best in copying the movement of the expert’. The SC group was allowed to request feedback whenever they wanted during training. The feedback consisted of 1) CMAS score, 2) posterior and sagittal videos of the last trial and 3) an external focus verbal cue on how to improve their execution. The participants were told to lower their score and they knew the lower the score, the better. The YK group received feedback after the same trial on which their matched participant in the SC group had requested feedback. Data of twenty-two participants (50% in SC group) was analyzed. Pre-test and training CMAS scores between groups were equal (p > 0.05). In the anticipated condition, the SC group (1.7 ± 0.9) had better CMAS scores than the YK group (2.4 ± 1.1) at the retention test (p < 0.001). Additionally, in the anticipated condition, the SC group showed improved movement execution during immediate-post (2.0 ± 1.1) compared to pre-test (3.0 ± 1.0), which was maintained during retention (p < 0.001). The YK group also improved in the anticipated condition during immediate-post (1.8 ± 1.1) compared to pre-test (2.6 ± 1.0) (p < 0.001) but showed decreased movement execution during retention compared to immediate-post test (p = 0.001). In conclusion, self-controlled timing of feedback resulted in better learning and greater improvements in movement execution compared to the control group in the anticipated condition. Self-controlled timing of feedback seems beneficial in optimizing movement execution in SSC and is advised to be implemented in ACL injury prevention programs.

The effect of a core training program on jump performance in female handball players

Objectives: To evaluate changes on bilateral and unilateral jump performance and frontal knee projection angle after an implementation of a core strength program in female handball players.&#x0D; Equipment and methods: This is a randomized controlled trial study. A total of 20 participants [age = 17.2 (1.9) years, height = 1.7 (0.1) m, weight = 62.8 (7) kg ] were recruited and split in: a core training group and a control group. The core training group participated in 8 weeks in-season of a core strength program (2 times/week). Pre- and post-intervention jump height, contact time and reactive strength index were collected during bilateral and unilateral drop vertical jumps. Frontal knee projection angle was measured only at unilateral drop jumps.&#x0D; Results: Core training group increased the bilateral jump height by 18.8% and showed a statistically significant difference in reactive strength index from pre-intervention [0.07 (0.03)] to post-intervention [0.10 (0.04)]. The core training group also improved the unilateral jump height by 20%, but only at the non-dominant leg. This improvement was accompanied by a statistically significant decreased in the frontal knee projection angle from pre-intervention [13.8 (7.38) degrees] to post-intervention [9.3 (6.09) degrees]. Statistical significant difference was set at p ˂0.05.&#x0D; Conclusion: A core strength training increased jump performance and it could play a role in ACL injury prevention programs in female team players.&#x0D; &#x0D;

COACH EDUCATION IMPROVES ADHERENCE TO ACL INJURY PREVENTION PROGRAMS: A CLUSTER-RANDOMIZED CONTROLLED TRIAL

Background:ACL injury prevention programs have demonstrated limited impact on population health, due in part to poor adherence to expert recommendations by sports coaches. Neuromuscular training (NMT) serves as a protective factor against ACL injury and serves as a key component of many ACL injury prevention programs. The objective of this study was to determine the effect of an educational workshop for sports coaches on adherence to neuromuscular training (NMT) implementation recommendations.Methods:In a cluster-randomized controlled trial, 22 teams in 8 high schools were randomized to either the intervention or control group. The intervention schools included 12 teams (5 female), and the control schools included 10 teams (4 female). The sports included basketball, volleyball, track and field, baseball, softball, and lacrosse. Coaches in the intervention group participated in a 60-minute educational workshop designed to teach coaches how to effectively implement a NMT program as a warm-up prior to team practice sessions and games. The schools in the control arm received print materials on recommended NMT exercises. Adherence to NMT implementation recommendation by sports coaches was the primary outcome. Eight data collectors, who were blinded to the teams’ assignment, were trained to observe each team’s practice or game 2-3 times a week. At each session, they completed a study questionnaire to identify the exercises completed by athletes during the team’s warm-up. They then recorded whether the coach 1) delivered exercise instructions, and 2) provided corrective cues. Generalized estimating equations (GEE) were used to account for potential correlations among teams at the same school.Results:A total of 399 practices or games were observed over 2 seasons. A greater proportion of coaches in the intervention group provided cues to correct improper technique compared to coaches in the control group [difference=0.04 (95% CI: 0.01, 0.07, p=0.006]. In addition, more coaches in the intervention group completed a full NMT program [OR=4.62 (1.22, 17.50), p=0.02]. There was a similar proportion of coaches in the intervention and control groups who provided exercise instructions [difference=0.01 (95% CI: -0.02, 0.04), p<0.44].Conclusions:Coach education can improve adherence to NMT implementation recommendations and the delivery of corrective cues during NMT sessions, which are both critical to reducing the risk of ACL injury. All coaches should receive in-person training that highlights the salience of NMT and provides the knowledge and skills required to effectively implement NMT sessions with young athletes.

The Future of Orthopaedic Sports Medicine: What Should We Be Worried About?

How long is a piece of string?- I worry that informal logic will take over from formal logic -- It’s not you, it’s me!- The lost leaders -- BIG DATA: revolution or complication?- The influence of industry -- Are we stifling innovation?- Don`t get dragged into the gloom: Keep the flame!- Pseudoscience and false avenues -- We’d better quit now -- Academic integrity and the God of data -- Research funding – finding a balance -- From science to daily practice: a huge gap! The example of meniscus surgery -- Living on the edge -- The last generation of doctors -- The future of Orthopaedic Sports Medicine: It’s the human connection -- The meniscus is the most important piece of the knee -- Is medicine now a science or still an art?- Surgery is so passe!- We should be worried, about being worried!- The end of sports surgery -- Will our focus on techniques and technology to improve patient outcomes be at the expense of a loss of clinical judgement?- Are we going forward or standing still?- Please take your time: A research perspective -- What’s in it for me?- Social media in Sports Medicine -- Biologic and Regenerative Medicine: The Balance between Promise and Proven -- There are no facts only interpretations -- Increased incidence of sports trauma in children. Is it time to worry?- Persistent lack of patient treatment outcome information for patients, therapists and surgeons -- The perils and potentials of biologic therapies -- Am I a robot or a surgeon?- Who will guard the guardians?- Don’t wait to worry -- The threat of fake news!- The big bang and its fallout!- First the process, then the art of medicine? The Gruyere theory- The complexity of a “rope” -- If you don’t know where you are going any road will take you there!- What’s the use in worrying?- High-Technology technicians versus bedside doctors- Surgery is overvalued and rehabilitation undervalued following anterior cruciate ligament injury -- The professional responsibility of Orthopaedic Sports Medicine Surgeons as advocates for sports injury prevention -- Digitalization and machine learning -- Worried about the vision -- Why are ACL injury prevention programs not being implemented more widely?- Think of the children -- Mentoring in Orthopaedic Sports Medicine -- Challenges of certification and training - looking into the future -- Technology and Sports Medicine: The good, the bad and the ugly -- Will it be possible to perform a 99% perfect ACL reconstruction in the future?- The good and the bad of evidence based medicine, and the challenge of practicing in a time of increased connectivity and artificial intelligence -- Preventing osteoarthritis in young patients after anterior cruciate ligament injury -- The danger of making decisions for evolution, quality of care and education based on National Health data -- When dogmas are not revised soon our sportsmen’s hips and knees will not be preserved but instead replaced -- Ingenuity, intellectual integrity, honesty and collaboration will be the key to our future -- A lot done, more to do!

THE EFFECTIVENESS OF ONLINE ACL INJURY PREVENTION EDUCATION FOR SPORTS COACHES

Background:The efficacy of ACL injury prevention programs (IPP) have been well-defined by sports medicine researchers over the past decade, but the adoption and implementation of effective ACL IPP is noticeably deficient in real-world situations. One barrier to the widespread implementation of ACL IPP by sports coaches is the limited understanding of how to effectively deliver these programs to young athletes. The ability to effectively identify and correct high-risk movements during the performance of neuromuscular training and athletic activities has been reported as a key factor in the effectiveness of an ACL IPP. Educational opportunities to train sports coaches to effectively deliver ACL IPP programs are not common, but those that do exist are often delivered in live settings. Live educational workshops are resource-intensive and limit the number of participants that can be trained over time. Educational workshops offered online can deliver information efficiently to large numbers of individuals but have not yet demonstrated education outcomes that are equivalent to live education events.Hypothesis/Purpose:The purpose of this study is to investigate the association between participation in an online educational workshop for coaches and knowledge of how to effectively employ an ACL IPP with young athletes. We hypothesize that participation in an online educational workshop is associated with increased knowledge of how to effectively employ an ACL IPP with young athletes and high levels of program satisfaction.Methods:An online educational workshop was developed to teach sports coaches how to effectively employ an ACL IPP program with young athletes. Coaches from throughout the United States were recruited to access the workshop through a computer-based learning management system. A series of instructional videos were used to deliver educational content to participants. Pre- and post-workshop surveys were utilized to determine program effectiveness and participant satisfaction.Results:468 coaches (77% male) participated in the pilot phase of the program. Nearly two-thirds of all participants demonstrated an increase in knowledge immediately post-intervention. Mean knowledge scores increased by 33% (56.5 to 74.9, p < 0.001). 89% of participants rated the workshop favorably and 90% of participants reported that they would recommend the workshop to other coaches.Conclusion:Results indicate that an online workshop for sports coaches improved the knowledge needed to effectively deliver an ACL IPP to young athletes. These findings support the continued evaluation of computer-based learning management systems to deliver online ACL IPP workshops to sports coaches.Table 1.Sports coached by respondents Sports N % Basketball12729%Soccer11526%Football9722%Softball5613%Other5312%Track and field4911%Baseball4811%Volleyball4410%Cross country338%Tennis245%Lacrosse184%Cheerleading184%Table 2.Coaches who answered each knowledge question correctlyQuestionPre NPre %Post NPost %Change p When assessing your athlete’s posture, which parts of the body should be aligned with the hip to demonstrate proper posture?13228.2%28160.0%112.9%0.001During your team’s warm-up, you notice an athlete whose hips are sagging while performing a plank. Which of the following is an appropriate cue to correct their technique?22748.5%29062.0%27.8%0.001Maintaining proper alignment of the hip, knee, and ankle is critical in many sports. What happens when an athlete’s knee rotates inward?41488.5%43192.1%4.1%0.05Which of the following coaching cues is most appropriate when teaching an athlete to absorb forces when landing from a jump?28460.7%40085.5%40.8%0.001Table 3.Level of agreement on SatisfactionStatementStrongly AgreeAgreeNeutralDisagreeStrongly DisagreeI am satisfied with this workshop51.1%38.0%7.7%1.1%2.1%I would recommend this workshop to other coaches54.9%34.8%7.1%1.1%2.1%

Hip biomechanics differ in responders and non-responders to an ACL injury prevention program.

To investigate the differences in demographic, anthropometric, biomechanical, and/or performance variables between those that do (responders) and do not (non-responders) exhibit reductions in knee abduction moments after an anterior cruciate ligament injury prevention program (ACL-IPP). Forty-three adolescent female athletes completed biomechanical (3D motion analysis of a drop vertical jump) and performance testing before and after randomization into a 6-week ACL-IPP. Participants were classified into responders and non-responders based on their level of reduction of knee abduction moment from pre- to post-test. Compared to non-responders, responders exhibited increased hip adduction excursion at baseline (p = 0.02) and trended towards attending more training sessions (p = 0.07) and participating in soccer and not basketball (p = 0.07). Responders also showed greater improvements in hip flexion angles (p = 0.02) and moments (p < 0.001), and knee abduction angles (p < 0.001) and excursions (p = 0.001). There were no significant differences in age or experience with prior injury prevention programs (n.s.). After anACL-IPP, athletes that exhibit the greatest reduction in knee abduction moments exhibit greater hip adduction excursion at baseline and show corresponding improvements in hip flexion and knee abduction kinematics and hip flexion moments. These results can help clinicians prospectively identify individuals that may not respond to an ACL-IPP and target individualized training for those at risk of injury. I. Clinicaltrials.gov NCT02530333.

Plyometric Exercises from a Knee Anterior Cruciate Ligament Prevention Program on the Rate of Isometric Torque Development and Vertical Jump Height

Purpose: Plyometric exercises are incorporated in anterior cruciate ligament injures of the knee (ACL) injury prevention programs that have effectively decreased risk factors for anterior cruciate ligament injures of the knee injuries, but the impact on the rate of isometric torque development of the musculature of the knee is unclear. The purpose of this study was to determine the effects of a 6-week plyometric program pulled from a commonly utilized anterior cruciate ligament injures of the knee injury prevention program on rate of isometric torque development (RTD) in healthy active females. Methods: College-aged participants were randomly split into two different groups (16-plyometric training and 15-control). Plyometric exercises included 180° jumps, bounding for distance, bounding in place, broad jump-stick, cone jumps, hop - hop stick, jump into bounding, jump - jump - jump vertical jump, mattress jumps, scissors jump, single-legged jumps for distance, squat jumps, step-jump up-down-vertical jump, tuck jumps, and wall jumps. Participants in the training group performed the exercises three times a week on alternating days, for 30-minute sessions. All participants performed a vertical jump measurement and completed maximum voluntary isometric contractions (MVICs) of ankle plantar flexion, knee extension, and knee flexion rate of torque development. Results: There was a main effect of session for plantar flexion rate of torque development time windows and vertical jump. The analysis revealed no significant differences for group by session interactions for any other rate of torque development measurement or the vertical jump. Conclusions: Plyometric exercises utilized from an anterior cruciate ligament injures of the knee injury prevention program did not change lower body isometric torque development or vertical jump height of active females. Since the plyometric training did not improve vertical jump, the training may not have been performed vigorous enough for the participants to cause a neuromuscular adaptation. Based on findings, 6-weeks of plyometric training from an isolated ACL injury prevention program should not be used to increase the vertical jump of healthy, active females.

Biomechanical Differences of Multidirectional Jump Landings Among Female Basketball and Soccer Players.

Taylor, JB, Ford, KR, Schmitz, RJ, Ross, SE, Ackerman, TA, and Shultz, SJ. Biomechanical differences of multidirectional jump landings among female basketball and soccer players. J Strength Cond Res 31(11): 3034-3045, 2017-Anterior cruciate ligament (ACL) injury prevention programs are less successful in basketball than soccer and may be due to distinct movement strategies that these athletes develop from sport-specific training. The purpose of this study was to identify biomechanical differences between female basketball and soccer players during multidirectional jump landings. Lower extremity biomechanics of 89 female athletes who played competitive basketball (n = 40) or soccer (n = 49) at the middle- or high-school level were analyzed with 3-dimensional motion analysis during a drop vertical jump, double- (SAG-DL) and single-leg forward jump (SAG-SL), and double- (FRONT-DL) and single-leg (FRONT-SL) lateral jump. Basketball players landed with either less hip or knee, or both hip and knee excursion during all tasks (p ≤ 0.05) except for the SAGSL task, basketball players landed with greater peak hip flexion angles (p = 0.04). The FRONT-SL task elicited the most distinct sport-specific differences, including decreased hip adduction (p < 0.001) angles, increased hip internal rotation (p = 0.003), and increased relative knee external rotation (p = 0.001) excursions in basketball players. In addition, the FRONT-SL task elicited greater forces in knee abduction (p = 0.003) and lesser forces in hip adduction (p = 0.001) and knee external rotation (p < 0.001) in basketball players. Joint energetics were different during the FRONT-DL task, as basketball players exhibited less sagittal plane energy absorption at the hip (p < 0.001) and greater hip (p < 0.001) and knee (p = 0.001) joint stiffness. Sport-specific movement strategies were identified during all jump landing tasks, such that soccer players exhibited a more protective landing strategy than basketball players, justifying future efforts toward sport-specific ACL injury prevention programs.

Effects of a dynamic core stability program on the biomechanics of cutting maneuvers: A randomized controlled trial.

Deficits in trunk control predict ACL injuries which frequently occur during high-risk activities such as cutting. However, no existing trunk control/core stability program has been found to positively affect trunk kinematics during cutting activities. This study investigated the effectiveness of a 6-week dynamic core stability program (DCS) on the biomechanics of anticipated and unanticipated side and crossover cutting maneuvers. Thirty-one male, varsity footballers participated in this randomized controlled trial. Three-dimensional trunk and lower limb biomechanics were captured in a motion analysis laboratory during the weight acceptance phase of anticipated and unanticipated side and crossover cutting maneuvers at baseline and 6-week follow-up. The DCS group performed a DCS program three times weekly for 6weeks in a university rehabilitation room. Both the DCS and control groups concurrently completed their regular practice and match play. Statistical parametric mapping and repeated measures analysis of variance were used to determine any group (DCS vs control) by time (pre vs post) interactions. The DCS resulted in greater internal hip extensor (P=.017, η2 =0.079), smaller internal knee valgus (P=.026, η2 =0.076), and smaller internal knee external rotator moments (P=.041, η2 =0.066) during anticipated side cutting compared with the control group. It also led to reduced posterior ground reaction forces for all cutting activities (P=.015-.030, η2 =0.074-0.105). A 6-week DCS program did not affect trunk kinematics, but it did reduce a small number of biomechanical risk factors for ACL injury, predominantly during anticipated side cutting. A DCS program could play a role in multimodal ACL injury prevention programs.

Sex Differences in Perceived Achievement after an ACL Injury Prevention and Yoga Program

Sex Differences in Perceived Achievement after an ACL Injury Prevention and Yoga Program

MECHANISMS OF ANTERIOR CRUCIATE LIGAMENT INJURIES IN HIGH SCHOOL ATHLETES

BackgroundAnterior cruciate ligament (ACL) injury is one of the most serious sports injuries. However, few studies have surveyed the details of ACL injury mechanisms in high school athletes.ObjectiveTo investigate the...

TRANSFER OF A JUMP-LANDING TASK TO SIDESTEP CUTTING: IMPLICATIONS FOR ACL INJURY PREVENTION

BackgroundIt is unknown if learned motor skills as practiced in ACL injury prevention training carry over to other tasks.ObjectiveDetermine if training of a jump-landing task results in transfer of improvement...

The effect of performance demands on lower extremity biomechanics during landing and cutting tasks

BackgroundAnterior cruciate ligament (ACL) injuries commonly occur during the early phase of landing and cutting tasks that involve sudden decelerations. The purpose of this study was to investigate the effects of jump height and jump speed on lower extremity biomechanics during a stop-jump task and the effect of cutting speed on lower extremity biomechanics during a side-cutting task. MethodsThirty-six recreational athletes performed a stop-jump task under 3 conditions: jumping fast, jumping for maximum height, and jumping for 60% of maximum height. Participants also performed a side-cutting task under 2 conditions: cutting at maximum speed and cutting at 60% of maximum speed. Three-dimensional kinematic and kinetic data were collected. ResultsThe jumping fast condition resulted in increased peak posterior ground reaction force (PPGRF), knee extension moment at PPGRF, and knee joint stiffness and decreased knee flexion angle compared with the jumping for maximum height condition. The jumping for 60% of maximum height condition resulted in decreased knee flexion angle compared with the jumping for maximum height condition. Participants demonstrated greater PPGRF, knee extension moment at PPGRF, knee valgus angle and varus moment at PPGRF, knee joint stiffness, and knee flexion angle during the cutting at maximum speed condition compared with the cutting at 60% maximum speed condition. ConclusionPerforming jump landing at an increased jump speed resulted in lower extremity movement patterns that have been previously associated with an increase in ACL loading. Cutting speed also affected lower extremity biomechanics. Jump speed and cutting speed need to be considered when designing ACL injury risk screening and injury prevention programs.

Biomechanical Comparison of Single- and Double-Leg Jump Landings in the Sagittal and Frontal Plane

Background:Double-leg forward or drop-jump landing activities are typically used to screen for high-risk movement strategies and to determine the success of neuromuscular injury prevention programs. However, research suggests that these tasks that occur primarily in the sagittal plane may not adequately represent the lower extremity biomechanics that occur during unilateral foot contact or non–sagittal plane movements that are characteristic of many multidirectional sports.Purpose:To examine the extent to which lower extremity biomechanics measured during a jump landing on a double leg (DL) after a sagittal plane (SAG) movement is representative of biomechanics measured during single-leg (SL) or frontal plane (FRONT) jump landing tasks.Study Design:Controlled laboratory study.Methods:Lower extremity biomechanics were measured in 15 recreationally active females (mean age [±SD], 19.4 ± 2.1 years; mean height, 163.3 ± 5.9 cm; mean weight, 61.1 ± 7.1 kg) while performing SAGDL, SAGSL, FRONTDL, and FRONTSL jump landing tasks. Repeated-measures analyses of variance examined differences in lower extremity biomechanics between the 4 tasks, and linear regressions examined the extent to which an individual’s biomechanics during SAGDL were representative of their biomechanics during SAGSL, FRONTDL, and FRONTSL.Results:Lower extremity kinematics and kinetics differed by condition, with the SAGDL task generally eliciting greater hip and knee flexion angles and lower hip and knee forces than the other tasks (P < .05). Although biomechanics during the SAGDL task were strongly associated with those during the FRONTDL task (R 2, 0.41-0.82), weaker associations were observed between SAGDL and single-leg tasks for hip kinematics (R 2, 0.03-0.25) and kinetics (R 2, 0.05-0.20) and knee abduction moments (R 2, 0.06-0.18) (P < .05).Conclusion:Standard double-leg sagittal plane jump landing tasks used to screen for ACL injury risk and the effectiveness of ACL injury prevention programs may not adequately represent the lower extremity biomechanics that occur during single-leg activities.Clinical Relevance:These results support further investigation of single-leg multidirectional landings to identify high-risk movement strategies in female athletes playing multidirectional sports.

ACL injury in football: a literature overview of the prevention programs.

The ACL prevention programs are addressed to the control and/or modification of the so-called "modifiable risk factors". All these programs focus on different intervention strategies aimed to decrease the ACL injury risk, particularly in female athletes population. To furnish an overview of the most used ACL injury prevention program through a narrative review. In literature there are many reports on prevention programs whose common denominator is the proper alignment of the lower limb joints and proper motor control during movements that are considered at risk for ACL integrity, as the landing phase after a jump. Nevertheless, some programs would appear more effective than others. In any cases a major problem remains the lack of sufficient compliance in respect of prevention programs. Finally, it is important to remember that the ethiology of ACL injuries is multifactorial. For this reason a prevention program able to prevent all the risk situations is utopian. Narrative review.