Compliance With Neuromuscular Training and Anterior Cruciate Ligament Injury Risk Reduction in Female Athletes: A Meta-Analysis

Sugimoto, Dai; Myer, Gregory D.; Bush, Heather; Klugman, Madelyn; McKeon, Jennifer M. Medina; Hewett, Timothy E.

doi:10.4085/1062-6050-47.6.10

Cited by 169 publications

(157 citation statements)

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“…Busy competition schedules and a lack of available time during seasons might have contributed to the lower compliance level of coaches. Because previous researchers identified an inverse dose-response relationship between preventive NMT compliance and traumatic knee (ie, ACL) injury, 1,14,28 future investigators need to focus on finding practical strategies to make NMT a part of regular practice regimens. This will allow coaches to comply with and adhere to preventive NMT, which may protect young athletes from injury.…”

Section: Discussionmentioning

confidence: 99%

“…For neuromuscular-training (NMT) intervention studies, compliance with the protocol is an important variable when determining the success and usefulness of these programs. 1 Many groups [2][3][4][5][6][7][8][9][10][11][12][13][14][15] have measured the effect of NMT compliance in reducing knee-injury rates. Using a prospective, cluster-randomized controlled design, other investigators 16 assessed compliance in 52 young female soccer teams (a total of 1055 players) who participated in a comprehensive soccer specific warm-up program called 11þ.…”

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confidence: 99%

“…Although past researchers 1,16 studied the effect of compliance with NMT intervention on athletic injuries, a few groups [7][8][9][10][11]17,18 did not report NMT compliance in the original manuscripts. Other authors 2,3 cited low NMT compliance as a limitation of their experiments that hindered outcomes.…”

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Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates

Sugimoto

Mattacola

Bush

et al. 2017

Journal of Athletic Training

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Context: Fewer athletic injuries and lower anterior cruciate ligament injury incidence rates were noted in studies of neuromuscular-training (NMT) interventions that had high compliance rates. However, several groups have demonstrated that preventive NMT interventions were limited by low compliance rates.Objective: To descriptively analyze coach and athlete compliance with preventive NMT and compare the compliance between study arms as well as among school levels and sports.Design: Randomized, controlled clinical trial. Setting: Middle and high school athletic programs. Participants or Other Participants: A total of 52 teams, comprising 547 female athletes, were randomly assigned to the experimental or control group and followed for 1 athletic season.Intervention ( [athlete compliance]) was measured descriptively. Using an independent t test, we compared coach and athlete compliance between the study arms. A 2-way analysis of variance was calculated to compare differences between coach and athlete compliance by school level (middle and high schools) and sport (basketball, soccer, and volleyball).Results: The protocols were completed at a mean rate of 1.3 6 1.1 times per week during the preseason and 1.2 6 0.5 times per week in-season. A total of 88.4% of athletes completed 2/3 of the intervention sessions. Coach compliance was greater in the experimental group than in the control group (P ¼ .014). Coach compliance did not differ by sport but was greater at the high school than the middle school (P ¼ .001) level. Athlete compliance did not differ by study arm, sport, or school level.Conclusions: Athletes received instruction in about 50% of each protocol. Nearly 90% of athletes performed more than 2/3 of the assigned NMT interventions. The assigned intervention was performed more often in the experimental arm compared with the control arm. Coaches at the high school level complied with the given protocol more than middle school coaches did. Athletes complied well with the protocol, but coaches did not, especially at the middle school level.Key Words: athletic injuries, knee, anterior cruciate ligament, high school, middle school Key PointsCoaches practiced only 50% of the assigned neuromuscular-training (NMT) intervention sessions. Nearly 90% of athletes complied with more than 2/3 of the NMT interventions. Busy competition schedules and a lack of available time during the season might have hindered compliance with the protocol among coaches, especially at the middle school level. Identifying applicable strategies for successful implementation of preventive NMT and maintaining high compliance rates among coaches are key. 58

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Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates

Sugimoto

Mattacola

Bush

et al. 2017

Journal of Athletic Training

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“…Injury incidence rates for those who are specifically infantry or special forces units are even higher at approximately 10 to 12 injuries per 100 soldiermonths [15]. It is proposed that a portion of the musculoskeletal injuries may be prevented [27], and preliminary work in civilian populations supports this concept [1,32,35].…”

Section: Introductionmentioning

confidence: 99%

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Teyhen¹,

Shaffer

Butler

et al. 2015

Clinical Orthopaedics &Amp; Related Research

110

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Background Musculoskeletal injury is the most common reason that soldiers are medically not ready to deploy. Understanding intrinsic risk factors that may place an elite soldier at risk of musculoskeletal injury may be beneficial in preventing musculoskeletal injury and maintaining operational military readiness. Findings from this population may also be useful as hypothesis-generating work for particular civilian settings such as law enforcement officers (SWAT teams), firefighters (smoke jumpers), or others in physically demanding professions.Questions/purposes The purposes of this study were (1) to examine whether using baseline measures of self-report and physical performance can identify musculoskeletal injury risk; and (2) to determine whether a combination of predictors would enhance the accuracy for determining future musculoskeletal injury risk in US Army Rangers. Methods Our study was a planned secondary analysis from a prospective cohort examining how baseline factors predict musculoskeletal injury. Baseline predictors associated with musculoskeletal injury were collected using surveys and physical performance measures. Army Physical Fitness Test (consisting of a 2-mile run and 2 minutes of sit-ups and push-ups). A total of 320 Rangers were invited to enroll and 211 participated (66%). Occurrence of musculoskeletal injury was tracked for 1 year using monthly injury surveillance surveys, medical record reviews, and a query of the Department of Defense healthcare utilization database. Injury surveillance data were available on 100% of the subjects. Receiver operator characteristic curves and accuracy statistics were calculated to identify predictors of interest. A logistic regression equation was then calculated to find the most pertinent set of predictors. Of the 188 Rangers (age, 23.3 ± 3.7 years; body mass index, 26.0 ± 2.4 kg/m 2 ) remaining in the cohort, 85 (45.2%) sustained a musculoskeletal injury of interest. Results Smoking, prior surgery, recurrent prior musculoskeletal injury, limited-duty days in the prior year for musculoskeletal injury, asymmetrical ankle dorsiflexion, pain with Functional Movement Screen clearing tests, and decreased performance on the 2-mile run and 2-minute situp test were associated with increased injury risk. Presenting with one or fewer predictors resulted in a sensitivity of 0.90 (95% confidence interval [CI], 0.83-0.95), and having three or more predictors resulted in a specificity of 0.98 (95% CI, 0.93-0.99). The combined factors that contribute to the final multivariable logistic regression equation yielded an odds ratio of 4.3 (95% CI, 2.0-9.2), relative risk of 1.9 (95% CI, 1.4-2.6), and an area under the curve of 0.64. Conclusions Multiple factors (musculoskeletal injury history, smoking, pain provocation, movement tests, and lower scores on physical performance measures) were associated with individuals at risk for musculoskeletal injury. The summation of the number of risk factors produced a highly sensitive (one or less factor) and specific (three o...

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“…A positive dose-response relationship has been demonstrated, and a minimum of 6 to 8 weeks of training appeared necessary for induction of positive changes toward enhanced injury prevention profiles. 9,22 While the total elimination of sportsrelated injuries is an unrealistic goal, appropriately designed and sensibly progressed preseason neuromuscular training and conditioning, with ready access to sports medicine professionals and qualified strength and conditioning coaches, may help reduce the likelihood of sportsrelated injuries in all athletes. If risk factors associated with sport injuries are properly addressed (eg, low fitness level, muscle imbalances, neuromuscular deficits, and errors in training), both acute and overuse injuries can be reduced.…”

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Did the NFL Lockout Expose the Achilles Heel of Competitive Sports?

Myer¹,

Faigenbaum²,

Cherny³

et al. 2011

Journal of Orthopaedic & Sports Physical Therapy

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Over the past few months we have been afforded a unique opportunity to evaluate injury rate data prior to, during, and following the historical aberration created by the recent National Football League (NFL) Lockout. During this period (March 11th to July 25th, 2011), professional football players underwent an uncommon offseason, without the normal access to their team's healthcare providers, strength and conditioning professionals, and high-level coaches. With limited access to these professionals and an absence of the structured preseason preparatory conditioning normally progressed over a 14-week period between May and July, we had a unique window of opportunity to evaluate the effects of an alarmingly rapid transition from the start of training camp, which took place 2 days after the end of the Lockout, to the initiation of preseason competition. A glimpse at early data, limited to Achilles tendon injuries, is cause for concern due to an unprecedented number of Achilles tendon ruptures in training camp and the beginning of preseason. J Orthop Sports Phys Ther 2011;41(10):702–705. doi:10.2519/jospt.2011.0107

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Compliance With Neuromuscular Training and Anterior Cruciate Ligament Injury Risk Reduction in Female Athletes: A Meta-Analysis

Cited by 169 publications

References 35 publications

Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates

Preventive Neuromuscular Training for Young Female Athletes: Comparison of Coach and Athlete Compliance Rates

What Risk Factors Are Associated With Musculoskeletal Injury in US Army Rangers? A Prospective Prognostic Study

Did the NFL Lockout Expose the Achilles Heel of Competitive Sports?

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