Targeting associated mechanisms of anterior cruciate ligament injury in female community-level athletes

Abstract

This study aims to determine if biomechanically informed injury prevention training can reduce associated factors of anterior cruciate ligament injury risk among a general female athletic population. Female community-level team sport athletes, split into intervention (n = 8) and comparison groups (n = 10), completed a sidestepping movement assessment prior to and following a 9-week training period, in which kinetic, kinematic and neuromuscular data were collected. The intervention group completed a biomechanically informed training protocol, consisting of plyometric, resistance and balance exercises, adjunct to normal training, for 15-20 min twice a week. Following the 9-week intervention, total activation of the muscles crossing the knee (n = 7) decreased for both the training (∆ -15.02%, d = 0.45) and comparison (∆ -9.68%, d = 0.47) groups. This decrease was accompanied by elevated peak knee valgus (∆ +27.78%, d = -0.36) and internal rotation moments (∆ +37.50%, d = -0.56) in the comparison group, suggesting that female community athletes are at an increased risk of injury after a season of play. Peak knee valgus and internal rotation knee moments among athletes who participated in training intervention did not change over the intervention period. Results suggest participation in a biomechanically informed training intervention may mitigate the apparent deleterious effects of community-level sport participation.

The Effect of Training Interventions on Change of Direction Biomechanics Associated with Increased Anterior Cruciate Ligament Loading: A Scoping Review

“…Two studies investigated the effects of COD technique modification training [22, 56], while one study examined the effects of COD speed and footwork training [57]. Five studies examined the effects of a mixed training programme [53, 58–61], while one study investigated the effects of combined COD technique modification and balance training [64], combined trunk stabilisation and resistance training [62], and combined resistance training and intersegmental control training during running and COD drills [65]. Three studies examined the effects of balance training [63, 67, 68], two studies examined resistance training [62, 63], while one study examined the effects of dynamic core-stability training [66], and one other study examined perturbation-enhanced plyometric training [69].…”

“…Several studies have used mixed training programmes (sessions that integrate exercises from several training modalities, i.e. plyometrics, stretching, balance, trunk stabilisation and/or resistance training) [53, 58–61] or a combination of training modalities in an attempt to alter COD biomechanics associated with increased ACL loading (Table 3).…”

“…Weir et al [58] also demonstrated positive changes (reduced IRM) in unanticipated side-stepping biomechanics following a 9-week high-dosage mixed-training intervention (balance, plyometric and resistance training) (4 × 20-min sessions), but no statistically significant changes in frontal plane moments for the whole group were observed. Recently, Staynor et al [53] examined the effects of a mixed programme training intervention, based on the intervention by Weir et al [58] (consisting of plyometric, resistance and balance exercises, performed in-season twice a week for 9 weeks), on unanticipated side-stepping biomechanics in local female community-level athletes. Knee flexor moments increased post-training intervention (ES = 0.77), but no statistically significant changes in peak KAM and IRMs were observed for the training group (ES ≤ 0.16), whereas the control group displayed greater KAMs and IRMs (ES = 0.36–0.56) post-testing (Table 3).…”

“…These include COD technique modification drills [22, 56], COD speed and footwork [57], mixed training programmes (sessions that integrate exercises from several training modalities, e.g. plyometrics, stretching, balance, trunk stabilisation and/or resistance training) [53, 58–61], combined trunk stabilisation and resistance training [62], resistance training [62, 63], combined COD technique modification drills and balance training [64], combined resistance training and intersegmental control training during running and COD drills [65], dynamic core stability training [66], balance training [63, 67, 68], perturbation-enhanced plyometric training [69], and injury-prevention warm-up protocols (i.e. Oslo, Core-Pac, F-MARC 11+) [53, 59, 70–75].…”

Estimulação Elétrica Neuromuscular Proporciona Melhora Do Equilíbrio Funcional E Do Controle Motor Em Atletas De Basquete De Alto Rendimento

“…Diversos fatores, como o desequilíbrio muscular, falta de coordenação na execussão de movimentos e ativação da musculatura podem estar relacionados com a instalação de lesões em atletas (1). Uma forma de prevenir lesões e otimização da performance esportiva é por meio do treinamento de força associado à estimulação elétrica neuromuscular (EENM), que tem se mostrado um recurso eficiente (2).…”