A training program to improve neuromuscular and performance indices in female high school soccer players.
01 Mar 2012-Journal of Strength and Conditioning Research (J Strength Cond Res)-Vol. 27, Iss: 2, pp 340-351
TL;DR: This program significantly improved lower limb alignment on a drop-jump test and estimated maximal aerobic power and may be implemented preseason or off-season in high school female basketball players.
Abstract: The purpose of this study was to determine if a sports-specific anterior cruciate ligament injury prevention training program could improve neuromuscular and performance indices in female high school soccer players. We combined components from a published knee ligament intervention program for jump and strength training with other exercises and drills to improve speed, agility, overall strength, and aerobic fitness. We hypothesized that this program would significantly improve neuromuscular and athletic performance indices in high school female soccer players. The supervised 6-week program was done 3 d·wk(-1) for 90-120 minutes per session on the soccer fields and weight room facilities in area high schools. In phase 1, 62 athletes underwent a video drop-jump test, t-test, 2 vertical jump tests, and a 37-m sprint test before and upon completion of the training program. In phase 2, 62 other athletes underwent a multistage fitness test before and after training. There were significant improvements in the mean absolute knee separation distance (p < 0.0001), mean absolute ankle separation distance (p < 0.0001), and mean normalized knee separation distance (p < 0.0001) on the drop-jump, indicating a more neutral lower limb alignment on landing. Significant improvements were found in the t-test (p < 0.0001), estimated maximal aerobic power (p < 0.0001), 37-m sprint test (p = 0.02), and in the 2-step approach vertical jump test (p = 0.04). This is the first study we are aware of that demonstrated the effectiveness of a knee ligament injury prevention training program in improving athletic performance indices in high school female soccer players. Future studies will determine if these findings improve athlete compliance and team participation in knee ligament injury intervention training.
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TL;DR: Comparing the magnitude of force, impulse, lower body kinematics and post-COD stride velocity produced between athletes of different strength levels during a COD task suggests individuals with greater relative lower body strength produced higher magnitude plant foot kinetics and modified lower body positioning while producing faster COD performances.
Abstract: Understanding the magnitude of forces and lower body kinematics that occur during a change of direction (COD) task can provide information about the biomechanical demands required to improve performance. To compare the magnitude of force, impulse, lower body kinematics and post-COD stride velocity produced between athletes of different strength levels during a COD task, 12 stronger (8 males, 4 females) and 12 weaker (4 males, 8 females) recreational team sport athletes were recruited. Strength levels were determined by relative peak isometric force of the dominant and non-dominant leg. All athletes performed 10 pre-planned 45° changes of direction (5 left, 5 right) while three-dimensional motion and ground reaction force (GRF) data were collected. Differences in all variables for the dominant leg were examined using a one-way analysis of variance (ANOVA) with a level of significance set at p ≤0.05. The stronger group displayed significantly faster post-COD stride velocity and greater vertical and horizontal braking forces, vertical propulsive force, vertical braking impulse, horizontal propulsive impulse, angle of peak braking force application, hip abduction and knee flexion angle compared to the weaker group. The results suggest that individuals with greater relative lower body strength produced higher magnitude plant foot kinetics and modified lower body positioning while producing faster COD performances. Future investigations should determine if strength training to enable athletes to increase plant foot kinetics while maintaining or adopting a lower body position results in a concomitant increases in post-COD stride velocity.
163 citations
Cites background from "A training program to improve neuro..."
...Whilst this body position has been found to increase performance outcomes (Green et al., 2011; Inaba, Yoshioka, Iida, Hay, & Fukashiro, 2012; Noyes et al., 2012), injury prevention research has identified an upright trunk posture and foot position closer to the centre of the body is beneficial to…...
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...Whilst this body position has been found to increase performance outcomes (Green et al., 2011; Inaba, Yoshioka, Iida, Hay, & Fukashiro, 2012; Noyes et al., 2012), injury prevention research has identified an upright trunk posture and foot position closer to the centre of the body is beneficial to reduce the loading around the knee (Dempsey et al....
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...Therefore, increasing lower body strength (Myer et al., 2005; Noyes et al., 2012) may not only reduce the risk of injury by enhancing neuromuscular control but it will also improve performance by enabling the athletes to overcome the increased force produced during COD movements (Nimphius et al....
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...Therefore, increasing lower body strength (Myer et al., 2005; Noyes et al., 2012) may not only reduce the risk of injury by enhancing neuromuscular control but it will also improve performance by enabling the athletes to overcome the increased force produced during COD movements (Nimphius et al.,…...
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TL;DR: The program described in this clinical commentary was developed with consideration for the modifiable factors related to second-injury risk, the principles of motor learning, and careful selection of the exercises that may most effectively modify aberrant neuromuscular patterns.
Abstract: Synopsis Successful return to previous level of activity following anterior cruciate ligament (ACL) reconstruction is not guaranteed, and the prevalence of second ACL injury may be as high as 30%. In particular, younger athletes who return to sports activities within the first several months after ACL reconstruction may be at significantly greater risk of a second ACL rupture compared to older, less active individuals. Significant neuromuscular deficits and functional limitations are commonly identified in athletes following ACL reconstruction, and these abnormal movement and neuromuscular control profiles may be both residual of deficits existing prior to the initial injury and exacerbated by the injury and subsequent ACL reconstruction surgery. Following ACL reconstruction, neuromuscular deficits are present in both the surgical and nonsurgical limbs, and accurately predict second-ACL injury risk in adolescent athletes. While second ACL injury in highly active individuals may be predicated on a number o...
160 citations
TL;DR: Based on this meta-analysis, strength training should be incorporated prior to power training in order to establish an adequate foundation of strength for power training activities.
Abstract: Numerous national associations and multiple reviews have documented the safety and efficacy of strength training for children and adolescents. The literature highlights the significant training-induced increases in strength associated with youth strength training. However, the effectiveness of youth strength training programs to improve power measures is not as clear. This discrepancy may be related to training and testing specificity. Most prior youth strength training programs emphasized lower intensity resistance with relatively slow movements. Since power activities typically involve higher intensity, explosive-like contractions with higher angular velocities (e.g., plyometrics), there is a conflict between the training medium and testing measures. This meta-analysis compared strength (e.g., training with resistance or body mass) and power training programs (e.g., plyometric training) on proxies of muscle strength, power, and speed. A systematic literature search using a Boolean Search Strategy was conducted in the electronic databases PubMed, SPORT Discus, Web of Science, and Google Scholar and revealed 652 hits. After perusal of title, abstract, and full text, 128 studies were eligible for inclusion in this systematic review and meta-analysis. The meta-analysis showed small to moderate magnitude changes for training specificity with jump measures. In other words, power training was more effective than strength training for improving youth jump height. For sprint measures, strength training was more effective than power training with youth. Furthermore, strength training exhibited consistently large magnitude changes to lower body strength measures, which contrasted with the generally trivial, small and moderate magnitude training improvements of power training upon lower body strength, sprint and jump measures, respectively. Maturity related inadequacies in eccentric strength and balance might influence the lack of training specificity with the unilateral landings and propulsions associated with sprinting. Based on this meta-analysis, strength training should be incorporated prior to power training in order to establish an adequate foundation of strength for power training activities.
156 citations
TL;DR: Implementing ACL injury-prevention training programs may improve an individual's neuromuscular control and lower extremity biomechanics and thereby reduce the risk of injury.
Abstract: Objective: To provide certified athletic trainers, physicians, and other health care and fitness professionals with recommendations based on current evidence regarding the prevention of noncontact and indirect-contact anterior cruciate ligament (ACL) injuries in athletes and physically active individuals. Background: Preventing ACL injuries during sport and physical activity may dramatically decrease medical costs and long-term disability. Implementing ACL injury-prevention training programs may improve an individual's neuromuscular control and lower extremity biomechanics and thereby reduce the risk of injury. Recent evidence indicates that ACL injuries may be prevented through the use of multicomponent neuromuscular-training programs. Recommendations: Multicomponent injury-prevention training programs are recommended for reducing noncontact and indirect-contact ACL injuries and strongly recommended for reducing noncontact and indirect-contact knee injuries during physical activity. These programs are...
119 citations
TL;DR: Three ACL intervention programs successfully reduced noncontact ACL injury incidence rates in female adolescent athletes, with wide variability among all programs in the frequency, duration, and timing of training.
Abstract: Purpose: The purpose of this study was to identify neuromuscular training intervention programs that significantly reduced the incidence of noncontact anterior cruciate ligament (ACL) injury rates in female adolescent athletes. Methods: A systematic search of PubMed was conducted to determine the outcome of ACL neuromuscular retraining programs in a specific population. The inclusion criteria were English language, published from 1994-2013, original clinical trials, all evidence levels, female athletes aged 19 years or younger, and noncontact ACL injury incidence rates determined by athlete-exposures. Results: Of 694 articles identified, 8 met the inclusion criteria. Three training programs significantly reduced noncontact ACL injury incidence rates in female adolescent athletes. These were the Sportsmetrics, Prevent Injury and Enhance Performance, and Knee Injury Prevention programs. The estimated number of athletes who needed to train to prevent 1 ACL injury in these 3 studies ranged from 70 to 98, and the relative risk reduction ranged from 75% to 100%. Five programs did not significantly reduce noncontact ACL injury incidence rates. The ACL injury incidence rates for control subjects were lower in these studies (0.03 to 0.08 per 1,000 athlete-exposures) than in those investigations that had a significant effect (0.21 to 0.49 per 1,000 athlete-exposures). There was wide variability among all programs in the frequency, duration, and timing of training; how training was conducted, supervised, or controlled; the components of the program; how exposure data were calculated; noncontact ACL injury incidence rates in the control groups; and compliance with training. Conclusions: Three ACL intervention programs successfully reduced noncontact ACL injury incidence rates in female adolescent athletes. Pooling of data of all ACL intervention programs is not recommended because of numerous methodologic differences among studies. Level of Evidence: Level II, systematic review of Level I and II studies.
91 citations
References
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Book•
01 Dec 1969TL;DR: The concepts of power analysis are discussed in this paper, where Chi-square Tests for Goodness of Fit and Contingency Tables, t-Test for Means, and Sign Test are used.
Abstract: Contents: Prefaces. The Concepts of Power Analysis. The t-Test for Means. The Significance of a Product Moment rs (subscript s). Differences Between Correlation Coefficients. The Test That a Proportion is .50 and the Sign Test. Differences Between Proportions. Chi-Square Tests for Goodness of Fit and Contingency Tables. The Analysis of Variance and Covariance. Multiple Regression and Correlation Analysis. Set Correlation and Multivariate Methods. Some Issues in Power Analysis. Computational Procedures.
115,069 citations
Book•
01 Jan 2014
TL;DR: In this paper, the authors discuss the benefits and risks associated with physical activity and propose a general principles of exercise prescription for healthy populations with special consideration and environmental consideration, as well as a prescription for patients with chronic diseases and health conditions.
Abstract: SECTION I: HEALTH APPRAISAL AND RISK ASSESSMENT 1 Benefits and Risks Associated with Physical Activity 2 Preparticipation Health Screening SECTION II: EXERCISE TESTING 3 Preexercise Evaluation 4 Health-Related Physical Fitness Testing and Interpretation 5 Clinical Exercise Testing 6 Interpretation of Clinical Exercise Test Results SECTION III: EXERCISE PRESCRIPTION 7 General Principles of Exercise Prescription 8 Exercise Prescription for Healthy Populations With Special Considerations and Environmental Considerations 9 Exercise Prescription For Patients With Cardiovascular and Cerebrovascular Disease 10 Exercise Prescription for Populations With Other Chronic Diseases and Health Conditions 11 Behavioral Theories and Strategies for Promoting Exercise SECTION IV: APPENDICES Appendix A Common Medications Appendix B Medical Emergency Management Appendix C Electrocardiogram Interpretation Appendix D American College of Sports Medicine Certifications Appendix E Contributing Authors to the Previous Two Editions
10,477 citations
TL;DR: Knee motion and knee loading during a landing task are predictors of anterior cruciate ligament injury risk in female athletes and may help develop simpler measures of neuromuscular control that can be used to direct female athletes to more effective, targeted interventions.
Abstract: BackgroundFemale athletes participating in high-risk sports suffer anterior cruciate ligament injury at a 4- to 6-fold greater rate than do male athletes.HypothesisPrescreened female athletes with subsequent anterior cruciate ligament injury will demonstrate decreased neuromuscular control and increased valgus joint loading, predicting anterior cruciate ligament injury risk.Study DesignCohort study; Level of evidence, 2.MethodsThere were 205 female athletes in the high-risk sports of soccer, basketball, and volleyball prospectively measured for neuromuscular control using 3-dimensional kinematics (joint angles) and joint loads using kinetics (joint moments) during a jump-landing task. Analysis of variance as well as linear and logistic regression were used to isolate predictors of risk in athletes who subsequently ruptured the anterior cruciate ligament.ResultsNine athletes had a confirmed anterior cruciate ligament rupture; these 9 had significantly different knee posture and loading compared to the 196 ...
2,997 citations
"A training program to improve neuro..." refers background in this paper
...ACL injury (24), although _ VO2max, vertical jump height, and sprinting speed are essential...
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...to a more neutral position is believed to be beneficial in preventing noncontact ACL injuries (24,39)....
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Journal Article•
TL;DR: Modifiable factors that, if addressed through injury prevention initiatives, may contribute to lower injury rates in collegiate sports are indicated.
Abstract: Objective: To summarize 16 years of National Collegiate Athletic Association (NCAA) injury surveillance data for 15 sports and to identify potential modifiable risk factors to target for injury prevention initiatives. Background: In 1982, the NCAA began collecting standardized injury and exposure data for collegiate sports through its Injury Surveillance System (ISS). This special issue reviews 182 000 injuries and slightly more than 1 million exposure records captured over a 16-year time period (1988–1989 through 2003–2004). Game and practice injuries that required medical attention and resulted in at least 1 day of time loss were included. An exposure was defined as 1 athlete participating in 1 practice or game and is expressed as an athlete-exposure (AE). Main Results: Combining data for all sports, injury rates were statistically significantly higher in games (13.8 injuries per 1000 A-Es) than in practices (4.0 injuries per 1000 A-Es), and preseason practice injury rates (6.6 injuries per 1000 A-Es) were significantly higher than both in-season (2.3 injuries per 1000 A-Es) and postseason (1.4 injuries per 1000 A-Es) practice rates. No significant change in game or practice injury rates was noted over the 16 years. More than 50% of all injuries were to the lower extremity. Ankle ligament sprains were the most common injury over all sports, accounting for 15% of all reported injuries. Rates of concussions and anterior cruciate ligament injuries increased significantly (average annual increases of 7.0% and 1.3%, respectively) over the sample period. These trends may reflect improvements in identification of these injuries, especially for concussion, over time. Football had the highest injury rates for both practices (9.6 injuries per 1000 AEs) and games (35.9 injuries per 1000 A-Es), whereas men’s baseball had the lowest rate in practice (1.9 injuries per 1000 A-Es) and women’s softball had the lowest rate in games (4.3 injuries per 1000 A-Es). Recommendations: In general, participation in college athletics is safe, but these data indicate modifiable factors that, if addressed through injury prevention initiatives, may contribute to lower injury rates in collegiate sports.
2,078 citations
"A training program to improve neuro..." refers background in this paper
...(25) also reported a difference in the ACL injury rate over a 16-year period between female and male athletes involved in collegiate basketball (0....
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TL;DR: This prospective study demonstrated a decreased incidence of knee injury in female athletes after a specific plyometric training program.
Abstract: To prospectively evaluate the effect of neuromuscular training on the incidence of knee injury in female athletes, we monitored two groups of female athletes, one trained before sports participation and the other not trained, and a group of untrained male athletes throughout the high school soccer, volleyball, and basketball seasons. Weekly reports included the number of practice and competition exposures and mechanism of injury. There were 14 serious knee injuries in the 1263 athletes tracked through the study. Ten of 463 untrained female athletes sustained serious knee injuries (8 noncontact), 2 of 366 trained female athletes sustained serious knee injuries (0 noncontact), and 2 of 434 male athletes sustained serious knee injuries (1 noncontact). The knee injury incidence per 1000 athlete-exposures was 0.43 in untrained female athletes, 0.12 in trained female athletes, and 0.09 in male athletes (P = 0.02, chi-square analysis). Untrained female athletes had a 3.6 times higher incidence of knee injury than trained female athletes (P = 0.05) and 4.8 times higher than male athletes (P = 0.03). The incidence of knee injury in trained female athletes was not significantly different from that in untrained male athletes (P = 0.86). The difference in the incidence of noncontact injuries between the female groups was also significant (P = 0.01). This prospective study demonstrated a decreased incidence of knee injury in female athletes after a specific plyometric training program.
1,530 citations