Anterior cruciate ligament prevention strategies

Ladenhauf, Hannah N.; Graziano, Jessica; Marx, Robert G.

doi:10.1097/mop.0b013e32835ad208

Cited by 35 publications

(12 citation statements)

References 65 publications

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“…Multiple randomized controlled trials over the last two decades have demonstrated that ACL injury prevention through regular neuromuscular agility training programs is highly successful in the adolescent population [42,43,44,45]. Essential components of prevention programs in children and adolescents include strengthening, plyometric and balance training, and neuromuscular training with feedback to modify technique [46]. This may artificially induce the neuromuscular spurt and have the potential to reduce the risk of ACL injury in young athletes [46,47].…”

Section: Discussionmentioning

confidence: 99%

“…Essential components of prevention programs in children and adolescents include strengthening, plyometric and balance training, and neuromuscular training with feedback to modify technique [46]. This may artificially induce the neuromuscular spurt and have the potential to reduce the risk of ACL injury in young athletes [46,47]. It is therefore recommended that young athletes be encouraged to partake in preseason training programs focused on strengthening, neuromuscular, and proprioceptive training, under the appropriate supervision of qualified personnel [46].…”

Section: Discussionmentioning

confidence: 99%

“…This may artificially induce the neuromuscular spurt and have the potential to reduce the risk of ACL injury in young athletes [46,47]. It is therefore recommended that young athletes be encouraged to partake in preseason training programs focused on strengthening, neuromuscular, and proprioceptive training, under the appropriate supervision of qualified personnel [46]. Given the increasing rate of ACL injury in Australian children and adolescents, and the demonstrated effectiveness of prevention programs, a national ACL injury prevention program for youth could improve health outcomes while simultaneously reducing medical costs [48].…”

Section: Discussionmentioning

confidence: 99%

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Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

Shaw

Finch

2017

IJERPH

101

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Anterior cruciate ligament (ACL) injuries in children and adolescents have been the focus of recent media attention and parental concern, given their potential for adverse long-term health outcomes and healthcare costs. However, there is limited formal evidence on trends in the incidence of ACL injuries in children. This study utilizes the Victorian Admitted Episodes Dataset (VAED) to characterize epidemiologic trends of hospital-admitted ACL injuries in those aged 5 to 14 years over a period of 10 years from 2005 to 2015. There was a total of 320 cases and the overall annual rate of ACL injuries increased by 147.8% from 2.74 per 100,000 population in 2005/2006 to 6.79 per 100,000 in 2014/2015. The majority (96.9%) of these injuries were in 10- to 14-year-olds. The main in-hospital procedure provided to over 80% of the hospitalized cases involved ACL reconstruction. Sporting activities accounted for 56.6% of ACL injuries. For females, over half (52.4%) of ACL injuries occurred whilst playing ball sports, compared to 35.4% of males. The large increase in ACL injuries in 5- to 14-year-olds in the state of Victoria, Australia over a 10-year period indicates they are a significant and emerging health burden. Population-wide ACL prevention policies are required to halt these trends. Cost effective prevention programs that involve neuromuscular training must be implemented in schools and junior sports teams.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

Shaw

Finch

2017

IJERPH

101

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“…Only 8 studies met inclusion criteria and of these, only three ACL intervention programs (Sportsmetrics, Prevent Injury and Enhance Performance, and Knee Injury Prevention) successfully reduced noncontact ACL injury incidence rates in female adolescent athletes. Ladenhauf et al [109] recommend that young athletes should be encouraged to partake in preseason training programs focused on strengthening, neuromuscular and proprioceptive training units under the appropriate supervision of qualified personnel [109]. …”

Section: Injury Preventionmentioning

confidence: 99%

The child and adolescent athlete: a review of three potentially serious injuries

Caine

Purcell

Maffulli

2014

BMC Sports Sci Med Rehabil

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The increased participation of children and adolescents in organized sports worldwide is a welcome trend given evidence of lower physical fitness and increased prevalence of overweight in this population. However, the increased sports activity of children from an early age and continued through the years of growth, against a background of their unique vulnerability to injury, gives rise to concern about the risk and severity of injury. Three types of injury–anterior cruciate ligament (ACL) injury, concussion, and physeal injury – are considered potentially serious given their frequency, potential for adverse long-term health outcomes, and escalating healthcare costs. Concussion is probably the hottest topic in sports injury currently with voracious media coverage and exploding research interest. Given the negative cognitive effects of concussion, it has the potential to have a great impact on children and adolescents during their formative years and potentially impair school achievement and, if concussion management is not managed appropriately, there can be long term negative impact on cognitive development and ability to resume sports participation. Sudden and gradual onset physeal injury is a unique injury to the pediatric population which can adversely affect growth if not managed correctly. Although data are lacking, the frequency of stress-related physeal injury appears to be increasing. If mismanaged, physeal injuries can also lead to long-term complications which could negatively affect ability to participate in sports. Management of ACL injuries is an area of controversy and if not managed appropriately, can affect long-term growth and recovery as well as the ability to participate in sports. This article considers the young athlete’s vulnerability to injury, with special reference to ACL injury, concussion, and physeal injury, and reviews current research on epidemiology, diagnosis, treatment, and prevention of these injury types. This article is intended as an overview of these injury types for medical students, healthcare professionals and researchers.

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“…9,10,18 A recent review of injury prevention programs in youth athletes concluded that the benefit of preventive exercises in children remains unknown. 30 …”

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confidence: 99%

Biomechanical Effects of an Injury Prevention Program in Preadolescent Female Soccer Athletes

et al. 2016

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Background Anterior cruciate ligament (ACL) injuries are common, and children as young as 10 years of age exhibit movement patterns associated with an ACL injury risk. Prevention programs have been shown to reduce injury rates, but the mechanisms behind these programs are largely unknown. Few studies have investigated biomechanical changes after injury prevention programs in children. Purpose/Hypothesis To investigate the effects of the F-MARC 11+ injury prevention warm-up program on changes to biomechanical risk factors for an ACL injury in preadolescent female soccer players. We hypothesized that the primary ACL injury risk factor of peak knee valgus moment would improve after training. In addition, we explored other kinematic and kinetic variables associated with ACL injuries. Study Design Controlled laboratory study. Methods A total of 51 female athletes aged 10 to 12 years were recruited from soccer clubs and were placed into an intervention group (n = 28; mean [±SD] age, 11.8 ± 0.8 years) and a control group (n = 23; mean age, 11.2 ± 0.6 years). The intervention group participated in 15 in-season sessions of the F-MARC 11+ program (2 times/wk). Pre- and postseason motion capture data were collected during preplanned cutting, unanticipated cutting, double-leg jump, and single-leg jump tasks. Lower extremity joint angles and moments were estimated using OpenSim, a biomechanical modeling system. Results Athletes in the intervention group reduced their peak knee valgus moment compared with the control group during the double-leg jump (mean [±standard error of the mean] pre- to posttest change, −0.57 ± 0.27 %BW×HT vs 0.25 ± 0.25 %BW×HT, respectively; P = .034). No significant differences in the change in peak knee valgus moment were found between the groups for any other activity; however, the intervention group displayed a significant pre- to posttest increase in peak knee valgus moment during unanticipated cutting (P = .044). Additional analyses revealed an improvement in peak ankle eversion moment after training during preplanned cutting (P = .015), unanticipated cutting (P = .004), and the double-leg jump (P = .016) compared with the control group. Other secondary risk factors did not significantly improve after training, although the peak knee valgus angle improved in the control group compared with the intervention group during unanticipated cutting (P = .018). Conclusion The F-MARC 11+ program may be effective in improving some risk factors for an ACL injury during a double-leg jump in preadolescent athletes, most notably by reducing peak knee valgus moment. Clinical Relevance This study provides motivation for enhancing injury prevention programs to produce improvement in other ACL risk factors, particularly during cutting and single-leg tasks.

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Anterior cruciate ligament prevention strategies

Cited by 35 publications

References 65 publications

Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

Trends in Pediatric and Adolescent Anterior Cruciate Ligament Injuries in Victoria, Australia 2005–2015

The child and adolescent athlete: a review of three potentially serious injuries

Biomechanical Effects of an Injury Prevention Program in Preadolescent Female Soccer Athletes

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