Neuromuscular Training Improves Single-Limb Stability in Young Female Athletes

Abstract

Study Design: Controlled single-group pretest/posttest design. Objective: The purpose of this study was to determine if a 6-week neuromuscular training program designed to decrease the incidence of anterior cruciate ligament (ACL) injuries would improve single-limb postural stability in young female athletes. We hypothesized neuromuscular training would result in an improvement in postural stability, with the greatest improvement taking place in the medial-lateral direction. Background: Balance training has become a common component of programs designed to prevent ACL injury. Rehabilitation programs can improve postural stability following ACL injury and reconstruction; however, there is limited information available which quantifies improvement of postural stability following neuromuscular training designed to prevent ACL injuries in a healthy population. Methods and Measures: Forty-one healthy female high school athletes (mean age, 15.3 years; age range, 13-17 years) participated in this study. Single-limb postural stability for both lower extremities was assessed with a Biodex Stability System. The neuromuscular training program consisted of three 90-minute training sessions per week for 6 weeks. Following the completion of the training program, each subject was re-evaluated to determine change in total, anteriorposterior, and medial-lateral single-limb stability. Two-way analysis of variance models were used to determine differences between pretraining and posttraining and between limbs. Results: The subjects showed a significant improvement in single-limb total stability (P = .004) and anterior-posterior stability (P = .001), but not medial-lateral stability (P = .650) for both the right and left lower extremity following training. In addition, the subjects demonstrated significantly better total postural stability on the right side as compared to the left (P = .026). Conclusions: A 6-week neuromuscular training program designed to decrease the incidence of ACL injuries improves objective measures of total and anterior-posterior single-limb postural stability in high school female athletes.

The Relationship Between Pre-Operative and Twelve-Week Post-Operative Y-Balance and Quadriceps Strength in Athletes With an Anterior Cruciate Ligament Tear

“…The YBT-LQ assesses ROM, strength, and neuromuscular control of the lower extremity and was chosen to assess the participants' lower limb balance. Numerous prior studies have demonstrated its utility as a clinical test to assess for lower limb balance deficits in the athletic population 10,[13][14][15] . Measurements were taken in three distinct directions of anterior (ANT), posteromedial (PM) and posterolateral (PL) on both the dominant and non-dominant limbs.…”

“…This test not only measures neuromuscular control but has also been correlated to quadriceps and hip strength. 9,10 Particularly the anterior reach portion demonstrates high activation of the vastus medialis and lateralis. 11 The YBT-LQ has not been studied preoperatively in an ACL-R population to date.…”

“…The Y-Balance Test -Lower Quarter (YBT-LQ) is one of the functional tools used to measure single limb performance and neuromuscular control and has been studied in individuals with ACL-R. 9,10 The YBT-LQ requires an individual to load on a single leg and squat while reaching with the contralateral limb. This test not only measures neuromuscular control but has also been correlated to quadriceps and hip strength.…”

The 2012 ABJS Nicolas Andry Award: The Sequence of Prevention: A Systematic Approach to Prevent Anterior Cruciate Ligament Injury

“…The development of neuromuscular imbalances and failure to have a neuromuscular spurt after the onset of puberty may be linked to the increased ACL injury risk in females relative to males [33,37,65,90]. Sex differences in landing mechanics, force absorption, muscle recruitment, and joint stability that occur during maturation can be modified with neuromuscular training programs [41,60,83]. Induction of a neuromuscular spurt in pubertal and postpubertal females may be important for ACL prevention strategies.…”

“…We have evaluated common assessment tools such as the star excursion balance test, functional hop tests, stabilometry, and dynamometry, in addition to developing new techniques to help identify lower extremity asymmetry and high-risk landing and cutting techniques [13,44,69,72,78,83].…”