Background: Anterior cruciate ligament (ACL) injury prevention programs (IPPs) are generally accepted as being valuable for reducing injury risk. However, significant methodological limitations of previous meta-analyses raise questions about the efficacy of these programs and the extent to which meeting current best-practice ACL IPP recommendations influences the protective effect of these programs. Purpose: To (1) estimate the protective effect of ACL IPPs while controlling for common methodological limitations of previous meta-analyses and (2) systematically categorize IPP components and factors related to IPP delivery to assess the validity of current best-practice IPP recommendations. Study Design: Systematic review with meta-analysis. Methods: A systematic search of 5 electronic scientific databases was conducted to identify studies testing the efficacy of ACL IPPs. Studies were included if (1) the intervention aimed to prevent ACL injury, (2) the incidence rate (IR) or other outcome data that made it possible to calculate the IR for both the intervention and control groups were reported, and (3) the study design was a prospective randomized controlled trial (RCT) or cluster-RCT. Results: Of the 2219 studies screened, 8 studies were included in the quantitative synthesis, and their analysis revealed a significant reduction in ACL IR when athletes received IPPs (IR ratio = 0.47; 95% CI, 0.30-0.73; P < .001). The majority of included IPPs tended to meet minimum best-practice recommendations and incorporated plyometric, strengthening, and agility exercises along with feedback on proper landing technique. However, the specific exercises included in each IPP and key factors related to IPP delivery were highly variable. Conclusion: Despite limiting the analysis to only high-quality studies and controlling for time at risk and potential clustering effects, the study showed that ACL IPPs had a significant protective effect and reduced injury rates by 53%. However, significant variability in the specific exercises and the manner of program delivery suggests that ACL IPPs may be able to be designed within an overarching best-practice framework. This may allow practitioners the flexibility to develop IPPs that meet the specific characteristics of the target population and potentially increase the likelihood that these programs will be widely adopted and implemented.

The purpose of this study was to explore the current levels of physical activity among youth with disabilities using meta-analysis. The search identified 11 publications including 729 participants (age 4–20 yr). The overall effect size for 11 studies was Hedges g = 0.60 (SE = 0.18, 95% confidence interval [CI] [0.24, 0.96], p < .05, k = 11) using a random-effects model. The findings suggest that differences in physical activity levels between youth with and without disabilities are complex. Results indicated that youth without disabilities engaged in higher levels of physical activity of moderate to vigorous intensity (g = 0.66, SE = 0.18, p < .05). However, no differences were found in light-intensity physical activity (g = −0.03, SE = 0.16, p > .85). Results also suggested that the differences in physical activity between youth with and without disabilities were affected by age (<12 yr, g = 0.83, SE = 0.24, 95% CI [0.37, 1.29], p < .05, and >13 yr, g = 0.37, SE = 0.10, 95% CI [0.18, 0.57], p < .05; Q value = 3.20, df = 1, p < .05), with children with disabilities engaging in less physical activity than children without disabilities in younger ages. Differences in physical activity level between youth with and without disabilities are functions of intensity of physical activity and age but may not be of type of disability (Q value = 0.22, df = 1, p > .6).

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