Neuromuscular Training Intervention Research Articles

Differential neural mechanisms for movement adaptations following neuromuscular training in young female athletes with a history of sports-related concussion

Sports-related concussion (SRC) in adolescent athletes is associated with an increased risk of subsequent lower extremity injury. Neuromuscular training (NMT) has shown promise for reducing lower extremity injuries following SRC, however, neural adaptations in response to changes in lower extremity biomechanics following NMT in athletes with a history of SRC (HxSRC) remains poorly understood. Therefore, the purpose of this study was to identify changes in neural activity associated with lower extremity movement adaptations following a six-week NMT intervention in athletes with a HxSRC. Thirty-two right-hand/foot-dominant female adolescent athletes (16 with self-reported HxSRC, 16 age- and anthropometrically-matched controls) completed a bilateral leg press task with 3D motion analysis during functional magnetic resonance imaging (fMRI). Movement adaptations were defined as a change in frontal and sagittal plane range of motion (ROM) during the fMRI bilateral leg press task. Significant pre- to post-NMT reductions were observed in the non-dominant (left) mean frontal plane ROM. Whole-brain neural correlate analysis revealed that increased cerebellar activity was significantly associated with reduced mean left-knee frontal ROM for matched controls. Exploratory within group analyses identified neural correlates in the postcentral gyrus for the HxSRC group which was associated with reduced mean left-knee frontal plane ROM. These distinct longitudinal changes provide preliminary evidence of differential neural activity associated with NMT to support knee frontal plane control in athletes with and without a HxSRC.

Effects of Neuromuscular Training on Muscle Architecture, Isometric Force Production, and Stretch-Shortening Cycle Function in Trained Young Female Gymnasts.

Moeskops, S, Oliver, JL, Radnor, JM, Haff, GG, Myer, GD, Ramachandran, AK, Kember, LS, Pedley, JS, and Lloyd, RS. Effects of neuromuscular training on muscle architecture, isometric force production, and stretch-shortening cycle function in trained young female gymnasts. J Strength Cond Res 38(9): 1640-1650, 2024-This study evaluated the effects of a 10-month neuromuscular training (NMT) intervention on muscle architecture, isometric force production, and stretch-shortening cycle (SSC) function. Thirty-seven girls aged 6-12 years were placed into gymnastics + NMT (gNMT; n = 15), gymnastics only (GYM; n = 10), or maturity-matched control (CON; n = 12) groups. The gNMT group followed a 10-month NMT program in addition to gymnastics training, whereas the GYM group only participated in gymnastics training. Isometric midthigh pull (IMTP) and drop jump (DJ) kinetics were measured, in addition to muscle thickness, fascicle length, and pennation angle of the gastrocnemius medialis at baseline and at 4, 7, and 10 months. A 3 × 4 (group × time) repeated-measures ANCOVA (covariate, % predicted adult height) was used to evaluate within-group changes. Significance level was set at p < 0.05. Significant interaction effects were observed in muscle thickness, absolute (PF abs ) and relative peak force (PF rel ) in the IMTP and various DJ variables. The gNMT group demonstrated improvements in muscle thickness, IMTP PF abs and PF rel , and DJ kinetics, most commonly evidenced from 7 months onward. The GYM group's muscle thickness also significantly improved, accompanied by improvements in some DJ kinetics. The CON group did not experience any desirable changes. Overall, NMT elicited positive changes in muscle thickness, PF abs and PF rel , and SSC function to a greater extent than gymnastics training alone or growth and maturation. As most adaptations took 7 months, longer-term NMT programs should be implemented with youth female gymnasts.

Lifestyle as a Modulator of the Effects on Fitness of an Integrated Neuromuscular Training in Primary Education.

The objective was to evaluate changes in fitness after an integrated neuromuscular training (INT) intervention in primary school children and to evaluate how lifestyle behaviors and parental education modulate these changes. One hundred and seventy children (7.45 ± 0.34 years; 52% girls) were included. Cardiorespiratory fitness (half-mile run test), a 10 × 5 m shuttle run test, standing broad jump (SBJ), handgrip dynamometer, body mass index (BMI) and fat mass percentage (FM%) were assessed before and after the 3-month intervention (20 min of INT in the physical education class, twice per week). The Mediterranean diet (MD), sleep time and parental education level (PEL) were evaluated by questionnaires, and adherence to physical activity (PA) recommendations was measured with a triaxial accelerometer before the intervention. After the intervention, there were improvements in the 10 × 5 test and the SBJ. Only girls had improvements in the handgrip test, BMI SDS and FM%. After correcting for confounding variables, only BMI was significantly improved whereas strength improved in the participants non-compliant with the PA recommendations or pertaining to families of high PEL. The INT produced improvements in fitness in a brief period and in different subgroups of pupils (inactive and with diverse sociocultural environments).

Efficacy of neuromuscular exercises to promote movement quality and reduce musculoskeletal injury during initial military training in Royal Navy recruits

IntroductionMusculoskeletal injuries (MSKIs) are a significant problem in the Royal Navy, contributing to 48% of all medical discharges from service between 2019 and 2020. The objective of the study was...

Integrated neuromuscular training intervention applied in schools induces a higher increase in salivary high molecular weight adiponectin and a more favorable body mass index, cardiorespiratory fitness and muscle strength in children as compared to the traditional physical education classes.

High-molecular-weight adiponectin (HMW-adiponectin) is a cardio-metabolic health protector. Objectives: (1) to compare body mass index (BMI), cardiorespiratory fitness (CRF) and muscle strength (MS) in healthy school-children depending on their baseline salivary-HMW-adiponectin concentration; and (2) to apply a 3-month integrated neuromuscular training (INT) and evaluate its effects on salivary-HMW-adiponectin concentration, BMI, CRF and MS in the same children. Additional goal: to identify if any potential changes during the 3-month period may be related to a potential change in salivary-HMW-adiponectin concentration. Ninety children (7.4 ± 0.3 years) were recruited in primary schools and randomly allocated into control or intervention group. The intervention consisted of a 3-month INT applied during physical education (PE) classes, twice-weekly, while the control group had traditional PE classes. Body mass and height were measured, BMI was calculated and HMW-adiponectin was quantified in saliva. To assess CRF and MS, 800 m-run and hand-dynamometry were applied, respectively. All measurements were performed twice, at baseline and after 3 months. Children with higher baseline salivary-HMW-adiponectin have more favorable BMI (p = 0.006) and slightly higher CRF (p = 0.017) in comparison to the children with lower baseline salivary-HMW-adiponectin. There were no big changes after the 3-month-period neither in the control, nor the INT group. However, it is worthy to note that the INT induced slightly higher increase in salivary-HMW-adiponectin (p = 0.007), and a slightly higher improvement in BMI (p = 0.028), CRF (p = 0.043) and MS (p = 0.003), as compared to the traditional PE classes. Finally, the INT-induced improvement in CRF was associated with the increased post-salivary-HMW-adiponectin concentration (p = 0.022). Main findings may suggest the potential utility of an INT as a cost-effective strategy that can be applied in schools to induce cardio-protective effects in school-children.

Does Neuromuscular Training Reduce the Risk of Lower-Extremity Musculoskeletal Injury in High School Female Athletes With a History of Sport-Related Concussion?

There is a well-established increased risk of lower-extremity (LE) musculoskeletal (MSK) injury following a sport-related concussion (SRC). Neuromuscular training programs improve biomechanics associated with LE MSK injury and reduce LE MSK injury incidence, but their relative effectiveness in athletes with history of SRC is unknown. The purpose of this study was to evaluate LE MSK injury incidence in female adolescent athletes with history of SRC following a neuromuscular training intervention. Prospective case-control. Seventy-seven adolescent female athletes aged 12-18years who participated in soccer, volleyball, or basketball were recruited from a single institutional sports medicine research and performance center to complete a 6-week neuromuscular training program prior to competitive athletic season. Group (Control, History of SRC) comparisons of athlete exposure and relative LE MSK injury risk and rates during the competitive athletic season were assessed. Ten injuries were recorded by 9 athletes. Female athletes who reported history of SRC had increased injury risk (Risk Ratio 3.9, 95% CI, 1.1-13.8, P = .01) and increased injury rate (rate ratio 4.1, 95% CI, 1.1-15.8, P = .03) compared with female athletes without history of SRC. Female adolescent athletes with history of SRC showed a greater risk of LE MSK injury compared with athletes with no history of SRC. Future work is still needed to understand the underlying mechanisms associated with future LE MSK injury following SRC and interventions that ameliorate elevated injury risk.

Kinesiophobia And Knee Self-Efficacy Before And After A Neuromuscular Training Intervention Among Young Adults With History Of Knee Injury

Kinesiophobia And Knee Self-Efficacy Before And After A Neuromuscular Training Intervention Among Young Adults With History Of Knee Injury

FIT Teens RCT for juvenile fibromyalgia: Protocol adaptations in response to the COVID 19 pandemic

ObjectiveTo describe protocol adaptations to the Fibromyalgia Integrative Training for Teens (FIT Teens) randomized controlled trial in response to the COVID-19 pandemic. The overarching aims of the FIT Teens multi-site 3-arm comparative effectiveness trial are to assess whether a specialized neuromuscular exercise training intervention combined with cognitive-behavioral therapy (CBT) is superior to CBT alone or graded aerobic exercise alone. Design/methodsThe trial was originally designed as an in-person, group-based treatment with assessments at baseline, mid- and post-treatment, and four follow-up time points. The original study design and methodology was maintained with specific modifications to screening, consenting, assessments, and group-based treatments to be delivered in remote (telehealth) format in response to COVID-19 restrictions. ResultsStudy enrollment was paused in March 2020 for five months to revise operations manuals, pilot remote treatment sessions for accuracy and fidelity, complete programming of REDCap assent/consent and assessment materials, train study staff for new procedures and obtain regulatory approvals. The trial was relaunched and has been successfully implemented in remote format since July 2020. Trial metrics thus far demonstrate a consistent rate of enrollment, strong attendance at remote treatment sessions, high retention rates and high treatment fidelity after protocol adaptations were implemented. ConclusionsPreliminary findings indicate that FIT Teens protocol adaptations from in-person to remote are feasible and allowed for sustained enrollment, retention, and treatment fidelity comparable to the in-person format. Methodologic and statistical considerations resulting from the adaptations are discussed as well as implications for interpretation of results upon completion of the trial.

Optimal Training for Movement Acquisition and Transfer: Does "Externally Focused" Visual Biofeedback Promote Implicit Motor Learning?

Visual biofeedback has been shown to facilitate injury-resistant movement acquisition in adolescent athletes. Visual biofeedback is typically thought to foster implicit learning by stimulating athletes to focus attention externally (on movement outcome). However, biofeedback may also induce explicit learning if the athlete uses the visual information to consciously guide movement execution (via an internal focus). To determine the degree to which athletes reported statements indicating implicit or explicit motor learning after engaging in a visual biofeedback intervention. Prospective cohort study. Three-dimensional motion-analysis laboratory. Twenty-five adolescent female soccer athletes (age = 15.0 ± 1.5 years, height = 165.7 ± 5.9 cm, mass = 59.4 ± 10.6 kg). Standard 6-week neuromuscular training intervention (three 90-minute sessions/wk), with added visual biofeedback sessions (2 sessions/wk). For the biofeedback training, participants performed squatting and jumping movements while interacting with a visual rectangular stimulus that mapped key parameters associated with injury risk. After the last biofeedback session in each week, participants answered open-ended questions to probe learning strategies. Responses to the open-ended questions were categorized as externally focused (ie, on movement outcome, suggestive of implicit learning), internally focused (ie, on movement itself, suggestive of explicit learning), mixed focus, or other. A total of 171 open-ended responses were collected. Most of the responses that could be categorized (39.2%) were externally focused (41.8%), followed by mixed (38.8%) and internally focused (19.4%). The frequency of externally focused statements increased from week 1 (18%) to week 6 (50%). Although most statements were externally focused (suggesting implicit learning), the relatively large proportion of internal- and mixed-focus statements suggested that many athletes also engaged in explicit motor learning, especially in early practice sessions. Therefore, biofeedback may affect motor learning through a mixture of implicit and explicit learning.

An 8-Week Neuromuscular Training Program After Concussion Reduces One-Year Subsequent Injury Risk: A Randomized Clinical Trial

Background:Existing data suggest that after returning to sports post-concussion, athletes are at an increased risk of sustaining a subsequent injury. Exploring methods that may reduce injury risk following successful post-concussion return-to-play may lead to new treatment approaches.Hypothesis/Purpose:Our purpose was to examine the efficacy of a neuromuscular training (NMT) intervention on acute, time-loss sport-related injury over the subsequent year relative to standard-of-care among adolescent athletes, using a prospective randomized clinical trial design. We hypothesized the hazard of injury over the year after concussion RTP would be greater for those randomized to standard-of-care relative to those randomized to the NMT intervention.Methods:Twenty-seven youth athletes were assessed initially post-concussion (median=7; interquartile range [IQR]=5-10 days post-concussion) and following return-to-play clearance (median=40, IQR=15-52 days post-concussion). After return-to-play clearance, they were randomly assigned to NMT intervention (n=11, mean=14.7±1.7 years; 36% female; Table 1) or standard-of-care (n=16, mean=15.3±1.8 years; 44% female; Table 1) groups. The intervention (duration=8 weeks; frequency=2x/week) included guided strength, landing, and stability exercises with landing stabilization focus. Standard-of-care received no recommendations. Randomization strata included age and sex. For the subsequent year, athletes prospectively completed a monthly log documenting sport-related injuries and the number/hours of organized sport competitions. Clinical Trial Registration Number: NCT03917290.Results:During the first year after post-concussion return-to-play clearance, time-loss sport-related injuries were more common among standard-of-care relative to neuromuscular training intervention (75% vs. 36%). After adjusting for the randomization strata (age and sex), the hazard of subsequent injury in the standard-of-care group was 3.56 [95% CI=1.11, 11.49, p=0.0334] times the hazard of subsequent injury in the neuromuscular training intervention group. Sport participation was similar between neuromuscular training intervention and standard-of-care groups during the year-long monitoring period (median=12 [IQR=2.6, 32.1] vs. 15.6 [IQR=3.5, 105.9] hours of organized sports/month; p=0.55). The incidence of injuries was 10.2 per 1,000 competitive exposures [95% CI: 3.7 to 28.4] in the standard-of-care group compared to 3.4 per 1,000 competitive exposures [95% CI: 0.9 to 13.4] in the NMT intervention group.Conclusion:A NMT intervention initiated after post-concussion return-to-play clearance provided significant efficacy in reducing time-loss sport-related injuries over the subsequent year. NMT interventions may be feasibly applied by sports medicine clinicians as a part of return-to-play protocols after concussion to minimize injury risk. Given the relatively small sample size, the findings should be considered preliminary until further definitive trials can be conducted within different geographical locations and/or age groups.Table 1.Comparison of NMT intervention and standard-of-care participant characteristics.Figure 2.Injury free survival in the standard-of-care and NMT intervention groups.

Effects of a 10-Month Neuromuscular Training Program on Strength, Power, Speed, and Vault Performance in Young Female Gymnasts.

This study aimed to evaluate a 10-month neuromuscular training (NMT) intervention on isometric and dynamic kinetics, standing long jump (SLJ) distance, speed, and sport-specific performance. Forty-three prepubertal female gymnasts were allocated into either a gymnastics + NMT (gNMT; n = 16), gymnastics only (GYM, n = 15), or maturity-matched control (CON; n = 12) group. The gNMT followed a 10-month, twice-weekly NMT program that targeted movement competency, strength, power, and speed. Vaulting vertical take-off velocity, speed, SLJ distance, and kinetics during an isometric mid-thigh pull (IMTP), countermovement jump (CMJ), and drop jump (DJ) were measured at baseline and thereafter at 4, 7, and 10 months. Within-group differences were calculated using 3 × 4 repeated-measures ANCOVA. Interaction effects were observed for SLJ distance and various IMTP, DJ, and vaulting variables. The gNMT showed significant improvements in IMTP absolute force and SLJ distance after 4 months and each subsequent testing session. IMTP relative force and various CMJ and DJ kinetics significantly improved in the gNMT from 7 months. Significant gains in speed and vaulting take-off velocity occurred after 10 months. The GYM group achieved some significant improvements in CMJ impulse, absolute isometric strength, and DJ spring-like behavior, whereas the CON group did not experience any changes. The addition of NMT to gymnastics training improved various isometric and dynamic kinetics, SLJ distance, speed, and vaulting take-off velocity in the gNMT, changes that were not equally evidenced for GYM or CON. The threshold for most of the training-induced adaptations observed in IMTP relative force, CMJ and DJ kinetics, sprint speed, and vaulting were achieved after 7 months, emphasizing the efficacy of long-term NMT programs for young gymnasts.

An 8-Week Neuromuscular Training Program After Concussion Reduces 1-Year Subsequent Injury Risk: A Randomized Clinical Trial

Background: Existing data suggest that after concussion, athletes experience an increased risk of subsequent injury. Exploring methods that may reduce injury risk after successful postconcussion return to play may lead to new treatment approaches. Purpose: To examine the efficacy of a neuromuscular training (NMT) intervention on acute sports-related time-loss injury over the subsequent year relative to standard of care. Study Design: Randomized clinical trial; Level of evidence, 1. Methods: A total of 27 youth athletes were assessed initially postconcussion (median, 7 days postconcussion; interquartile range [IQR], 5-10) and after return-to-play clearance (median, 40 days postconcussion; IQR, 15-52). After return-to-play clearance, they were randomly assigned to NMT intervention (n = 11; mean ± SD age, 14.7 ± 1.7 years; 36% female) or standard of care (n = 16; mean ± SD age, 15.3 ± 1.8 years; 44% female). The intervention (duration, 8 weeks; frequency, 2 times per week) included guided strength exercises with landing stabilization focus. Standard of care received no recommendations. For the subsequent year, athletes prospectively completed a monthly log of sports-related injuries and organized sports competitions. Results: During the first year after postconcussion return-to-play clearance, sports-related time-loss injuries were more common among standard of care relative to NMT intervention (75% [95% CI, 48%-93%] vs 36% [95% CI, 11%-69%]). After adjusting for age and sex, the hazard of subsequent injury in the standard-of-care group was 3.56 times (95% CI, 1.11-11.49; P = .0334) that of the NMT intervention group. Sports participation was similar between NMT intervention and standard of care during the year-long monitoring period (hours of organized sports per month; median, 12 [IQR, 2.6-32.1] vs 15.6 [IQR, 3.5-105.9]; P = .55). The age- and sex-adjusted incidence of injuries was 10.2 per 1000 competitive exposures (95% CI, 3.7-28.4) in the standard-of-care group as opposed to 3.4 per 1000 (95% CI, 0.9-13.4) in the NMT intervention group. After adjusting for age and sex, incidence of injuries was higher for standard of care vs NMT intervention (rate ratio, 2.96 [95% CI, 0.89-9.85]; P = .076). Conclusion: Although preliminary, our findings suggest that an NMT intervention initiated after return-to-play clearance may significantly reduce sports-related time-loss injuries over the subsequent year. Registration: NCT03917290 (ClinicalTrials.gov identifier).

Effects of integrative neuromuscular training intervention on physical performance in elite female table tennis players: A randomized controlled trial.

ObjectivesTo investigate the effects of integrative neuromuscular training (INT) on physical performance in elite female table tennis players.MethodsTwenty-four Chinese elite female table tennis players were randomized into either INT (n = 12) group or control group (CON; n = 12). INT group performed four INT sessions every week for 8 weeks, while CON group performed traditional physical fitness training. One repetition maximal (1RM), vertical jump, Y balance test and 30-meter sprinting performance were tested before and after intervention.ResultsNo between groups differences were detected for any tests before intervention. Significant group by time (before or after intervention) interaction effects were observed in 1RM, vertical jump, bilateral lower limb reaching distance at posteromedial and posterolateral directions, and right leg at the anterior direction for the Y balance test (all p < 0.05), but not for the left leg at the anterior direction or the 30-meter sprinting performance (both p > 0.05). Post-hoc analysis for measurements with significant interactions revealed that all significant changes were at the ING group (all p < 0.05), while no changes for the CON group were observed (all p > 0.05).ConclusionEight weeks INT significantly improved strength, power and balance in Chinese elite female table tennis players. Adopting INT in table tennis players may improve their physical performance and lead to better sports performance.

Effects of isoinertial or machine-based strength training on performance in tennis players.

The objective of this study was to analyze the effects of two 8-week neuromuscular training (NMT) interventions on selected physical indicators in young tennis players. Twenty-four junior male tennis players were assigned to a machine-based (MG) (n = 8), flywheel (FG) (n = 8) or a control training group (CG) (n = 8). Tests at baseline, week 4 and 8 included: countermovement jump (CMJ); speed (S; 5, 10, 15 m); agility (right [AR] and left [AL]); serve velocity (SV) and medicine ball throws (MBT; overhead [O], forehand [FH], backhand [BH]). MG and FG attained large positive effects at week 4 in CMJ, S 10 m; AR, AL and MBT FH only in FG. Regarding inter- to post-test, MG achieved large positive effects in MBT O, FH and both groups in BH. Large negative effects appeared for FG in S 5 and 10 m and AR and AL. Both NMT interventions led to positive effects from baseline to week 4 measures in CMJ, S 5 m, 10 m and agility and at week 8 in MBT. Conducting the same NMT for a longer period of time did not lead to the same improvements and other negative effects in FG appeared. Results indicate that performing these interventions with little exercise variability or load management, especially after technical-tactical sessions, could interpose further beneficial outcomes and initial gains could be impaired.

Investigation of a Three-Week Neuromuscular Training Intervention on Biomechanical Parameters of the Lower Quarter in Female Collegiate Pivoting Athletes

Investigation of a Three-Week Neuromuscular Training Intervention on Biomechanical Parameters of the Lower Quarter in Female Collegiate Pivoting Athletes

Investigation of an Eight-Week Neuromuscular Training Intervention on Biomechanical Parameters of the Lower Quarter in Adolescent Female Soccer Players

Investigation of an Eight-Week Neuromuscular Training Intervention on Biomechanical Parameters of the Lower Quarter in Adolescent Female Soccer Players

Effects of Training Frequency During a 6-Month Neuromuscular Training Intervention on Movement Competency, Strength, and Power in Male Youth.

Background:Youth populations benefit from neuromuscular training; however, the extent to which training frequency, baseline fitness, and maturity status moderate the response to long-term neuromuscular training in male youth remains unclear.Hypothesis:Twice-weekly training (G2x) would induce larger improvements in movement competency and strength and power kinetics compared with once-weekly training (G1x). Maturity status and baseline fitness would also moderate the training response in strength and power kinetics.Study Design:Nonrandomized, repeated-measures design.Level of Evidence:Level 3Methods:Ninety-five male athletes of varying maturity status (pre– or post–peak height velocity) were divided into G2x, G1x, or control (CON) groups. Training groups received G2x or G1x for 28 weeks. Back squat assessment (BSA) movement competency and isometric mid-thigh pull (IMTP), squat jump (SJ), and countermovement jump (CMJ) kinetics were measured pre- and postintervention.Results:The G2x achieved significantly greater adaptations in BSA total score, IMTP allometrically scaled peak force (PFallo), IMTP peak rate-of-force development (PRFD), SJ PFallo and PRFD compared with G1x and CON (P < 0.05; d = 0.3-0.9). Baseline fitness, training frequency and maturity status were significant predictors of IMTP PFallo (R2 = 27.5%) and PRFD (R2 = 42.9%), while a combination of training frequency and baseline fitness explained a small amount of variance in SJ PFallo (R2 = 12.2%) and SJ PRFD (R2 = 6.5%). There were no significant predictors of CMJ kinetics.Conclusion:G2x achieved significantly larger improvements in movement competency, isometric strength and concentric jump variables compared with G1x, with the training response greater in those youth with lower baseline fitness and more advanced maturity status.Clinical Relevance:Exposure to neuromuscular training twice-weekly elicits a greater response than G1x in young male athletes. Practitioners should take maturity status, training frequency, and baseline fitness levels of young male athletes into account when interpreting testing data, as these variables appear to moderate training responsiveness.

동적 신경근 안정화 운동 적용에 따른 기계적 목 통증 사무직 여성의 통증, 목뼈 위치각 및 근력의 차이

The purpose of the current study is to assess the effectiveness of a dynamic neuromuscular stabilization training intervention for sedentary female worker with mechanical neck pain after analyzing neck pain, cervical position angle, and muscle strength.<BR> Thirty sedentary female workers were assigned to two experimental groups (dynamic neuromuscular training group, n=16, control group, n=14). The subjects in the dynamic neuromuscular training group were participated for 60 minutes/day and three times/wk for 12 weeks. Whereas subjects in control group were asked to maintain normal lifestyle during the same intervention period. The neck pain, cervical position angle, and muscle strength were measured before and after the twelve-weeks intervention.<BR> Study results showed that NRS(p<.001), NDI(p<.001), and CRA(p<.001) were significantly decreased in the dynamic neuromuscular stabilization training group, and CVA(p<.01) and neck flexor(p<.001) were also significantly increased in the dynamic neuromuscular stabilization training group.<BR> These findings suggest that dynamic neuromuscular stabilization training may have a positive effect on the neck pain, cervical position angle, and neck flexor in mechanical neck pain.

Safety and Effectiveness of a Perturbation-based Neuromuscular Training Program on Dynamic Balance in Adolescent Females: A Randomized Controlled Trial.

BackgroundAdolescent females are at much greater risk for ACL injury than their male counterparts when participating in the same sports. Preventative and pre-operative rehabilitation neuromuscular (NM) exercise programs are often recommended to improve knee function and reduce injury rates. The effectiveness of perturbation-based NM training program has been established in an adult population but has yet to be investigated in the at-risk adolescent female population.PurposeTo determine the effectiveness of a perturbation-based NM exercise program in a group of physically active adolescent females.Study DesignProspective randomized trial.MethodsTwenty-four healthy and an exploratory group of 10 ACL-injured females (ages 12-18) were equally randomized into a perturbation-based NM training or control group and evaluated before and after a five-week intervention period. The primary outcome of dynamic balance was measured using the Y-Balance test (YBT); secondary outcome measures included lower limb strength, proprioception, and flexibility.ResultsThe perturbation-based NM training intervention was safely completed by all participants but had no significant effect on YBT scoring, lower limb strength, proprioception or flexibility in either the healthy or ACL-injured groups.ConclusionsPerturbation-based NM training is safe, but may offer little preventative benefit for healthy or pre-operative rehabilitation benefit for ACL-injured adolescent females. Future research should examine whether the effectiveness of perturbation-based NM training is influenced by the length of the training intervention, training intensity, or when it is combined with other forms of prophylactic or pre-surgical rehabilitation frequently used with at-risk adolescent females who regularly participate in sport.Level of EvidenceLevel 3.

Defining The Optimal Duration Of Familiarization For An INT Intervention For Children With Autism

PURPOSE: A period of familiarization to exercise interventions is recommended for children with autism spectrum disorder (ASD). Unknown, however, is how long this familiarization period should be to ensure optimal engagement in the exercise intervention. To address this gap in understanding, this study sought to define the required duration needed for a familiarization period for a school-based integrative neuromuscular training (INT) intervention for children with ASD. METHODS: Nine children (6.9 years ±1.5) with a diagnosis of ASD were recruited to complete a school-based INT intervention, partaking in three, one-hour weekly sessions for seven weeks. The INT intervention was implemented via games aimed at the interests of the children and was adapted to each child’s specific needs. Pedometer data were collected for seven weeks, and the average number of steps taken per week were calculated. Completion of the familiarization period was denoted by a significant increase in step count between weeks, followed by a plateau or continued increase in subsequent weeks. Data were analysed using a one-way ANOVA, and Tukey's post hoc analysis, to identify changes in step counts over time. Statistical significance was set at an alpha level of p < 0.05. RESULTS: There was a significant effect for time over the seven weeks (p < 0.01). Post hoc analysis displayed significant differences and a greater number of steps taken following week five (p < 0.05) with no significant increases in steps between weeks five, six, and seven suggesting a plateau occurred. Steps averaged 48 ± 9.6 per minute for week one and increased to an average of 68 ± 4.9 per minute for week seven. CONCLUSIONS: Results indicate that a familiarization period of four weeks is needed when introducing an INT intervention to children with ASD.