Neuromuscular training reduces lower limb injuries in elite female basketball players. A cluster randomized controlled trial

The effect of the KNEE program for Netball players on the modified Star Excursion Balance Test - a randomized controlled trial

BACKGROUND

The aim was to investigate the effect of the KNEE program on postural control as measured by the modified Star Excursion Balance test (mSEBT) in Australian club level netball players.

METHODS

Two netball teams from Netball NSW Premier-League were recruited and randomized to complete either the KNEE program or a traditional warm-up. Cumulative, anterior, posteromedial, and posterolateral directions of the mSEBT were measured for both limbs at baseline, 8-weeks, and 5-months. Linear mixed models were used to assess the effect of the intervention on mSEBT outcomes.

RESULTS

When compared to a traditional warm-up, the KNEE program led to improvements in postural control in the PM direction of the mSEBT at 8 weeks (R: p = 0.005; L = 0.016) and 5 months (R: p = 0.006 and L: p = 0.026). For the cumulative score, there was a main effect of time with significant improvements between baseline and subsequent time points (p < 0.03), but there was no effect of group or interaction. No significant changes were found in ANT and PL directions.

CONCLUSION

The KNEE program when implemented as a warm-up prior to training and match-play can improve postural control in the PM direction which is integral to Netball.

Effectiveness of a specific strength program of the gluteus maximus muscle to improve dynamic postural control in female basketball players. A randomized controlled trial

BACKGROUND

Basketball is a team sport in which players perform multidirectional movements, jumps and landings, experiencing abrupt accelerations and decelerations and numerous changes of rhythm. In this sport, speed and intensity are two key factors that are associated with an increased risk of injury. The aim of this randomized controlled trial was to determine the effectiveness of a specific gluteus maximus strength programme as preventive work for young female basketball players, to improve dynamic postural stability and to observe its impact in the rate of lower limb injuries, vertical jump, dynamic knee valgus and pain.

RESEARCH QUESTION

Is effective a strength programme to improve dynamic postural stability, vertical jump and dynamic valgus in female basketball players?

METHODS

A hundred and thirteen female basketball players that play in professional clubs were recruited, reaching the final stage 92 (46 per group). One group (CG) received conventional injury prevention training while the experimental group (EG) added to the conventional team prevention program, a gluteus maximus strength programme of 5 months composed of 4 exercises/2 days per week/2 sets of 10 repetitions per leg.

RESULTS

The total injury incidence decreased from 0.33 to 0.16 cases (control group pre=0.43 to post=0.14 cases, EG pre=022 to post=0.19). The EG improved overall (p = 0.000), posterior (p = 0.001), posteromedial (p = 0.001) and posterolateral (p = 0.000) dynamic stability of the right leg; anterior (p = 0.024), medial (p = 0.07) and posteromedial (p = 0.01) of the left leg. Both groups improved vertical jump (GC: p = 0.045 and GE: p = 0.000). There was no significant improvement in pain or valgus.

SIGNIFICANCE

This strength programme is effective in improving dynamic stability especially of the dominant leg and jump height.

A multicomponent neuromuscular warm-up program reduces lower-extremity injuries in trained basketball players: a cluster randomized controlled trial

OBJECTIVE

To assess the effects of a novel multicomponent neuromuscular warm-up program on lower-extremity injury incidence in basketball players competing at the regional level.

METHODS

A cluster randomized controlled experimental design was adopted to compare injury incidence between players exposed to the injury prevention warm-up program and those exposed to a typical warm-up program across an entire basketball season. Four teams consisting of 57 players (male: n = 42; female: n = 15) were allocated to the intervention group (age: 21.6 ± 2.5 years; height: 186.2 ± 8.8 cm; body mass: 80.0 ± 10.4 kg) and four teams consisting of 55 players (male: n = 43; female: n = 12) were allocated to the control group (age: 21.6 ± 2.6 years; height: 186.9 ± 9.1 cm; body mass: 81.5 ± 10.9 kg). The novel warm-up combined running exercises with active stretching, plyometrics, balance, strength, and agility drills. Coaching and medical staff provided details on injury incidence each week. Data analyses included the use of poisson regression analyses and the incidence rate ratio (IRR) with 95% confidence intervals (CI).

RESULTS

The intervention group experienced a significantly lower ankle sprain incidence rate (IRR = 0.26, 95% CI = 0.05, 0.98, p = 0.02) and a tendency toward a lower knee injury incidence rate (IRR = 0.32, 95% CI = 0.03, 1.78, p = 0.07) compared to the control group. Considering only non-contact lower-extremity injuries of any type, the intervention group experienced a significantly lower incidence rate compared to the control group (IRR = 0.26, 95% CI = 0.05, 0.98, p < 0.001).

CONCLUSION

This multi-team study demonstrated a novel multicomponent warm-up program resulted in less lower-extremity injuries, particularly ankle sprains and knee injuries, compared to a typical warm-up program in regional-level male and female basketball players.

Beyond athletic development: The effects of parkour-based versus conventional neuromuscular exercises in pre-adolescent basketball players

The purpose of this study was to compare the effects of a parkour-based warm-up to a conventional neuromuscular training (NMT) warm-up on the athletic capabilities of youth basketball players. This was examined through two arms: In Investigation 1, the aims were to measure the effects of the two warm-ups on physical measures of athletic performance in prepubescent basketball players. Using post-intervention semi-structured interviews, Investigation 2 aimed to gain insights from the players in relation to the perceived benefits of the two warm-ups. Pre-adolescent children were recruited from two youth level basketball teams. Participants from one club were randomly assigned to either a conventional NMT warm-up group or a parkour warm-up group, while a control group was formed of participants from the second club. Participants of both experimental groups were required to complete a 15-minute warm-up once per week before their regular basketball practice across 8-weeks. For both groups, the coach adopted the same pedagogical approach, utilising a guided discovery strategy. Pre-post test measures of overhead squat performance, countermovement jump, and 10-metre sprint speed were recorded in all three groups. Additionally, pre-post measures were recorded for a timed parkour-based obstacle course for the two experimental groups. No significant between-group differences were found between pre- and post-test measures. However, analysis using Cohen's d effect sizes revealed improvements in both intervention groups versus the control. Moreover, between group effect size differences were observed between the two experimental groups. Following the intervention, participants from both experimental groups were also invited to take part in a post-intervention semi-structured interview to discuss their experiences. The thematic analysis of these semi-structured interviews revealed three higher order themes: Enjoyment; Physical literacy; and Docility; of which the two former themes appear to align to constructs relating to the wider concept of physical literacy. In summary, warm-ups designed to improve athleticism can include less structured and more diverse movement skills than are typical of conventional NMT warm-ups. Specifically, we provide evidence that advocates for warm ups that include parkour-related activities alongside conventional NMT exercises to preserve physical fitness qualities and to simultaneously evoke a sense of enjoyment, fun, and purpose. The benefit of such activities may extend beyond athletic development and, more broadly, contribute to the development of physical literacy.

Prospective epidemiological study of basketball injuries during one competitive season in professional and amateur Spanish basketball

INTRODUCTION

There are few Spanish epidemiological studies of basketball injuries, even though it is the second most played sport and the leading sport played by females in Spain.

POPULATION

We studied 117 male and female basketball players from ten amateur or professional teams from four leagues in the 2014-2015 season.

RESULTS

There were 11.6 injuries per 1,000 hours of sporting activity, 9.6 injuries per 1,000 hours of training and 47.3 injuries per 1,000 hours of competition. The rate of injuries requiring downtime was 2.99 per 1,000 hours of training, 41.7 per 1,000 hours of competition and 4.1 per 1,000 hours of sporting activity overall. No significant differences were found in the incidence of injuries between leagues, but a higher incidence by season was found in teams participating in international competitions, due to the increased competition time. The ankle was the main site of injuries causing ≥ 8 days of downtime and knee injuries the site of those causing ≥ 29 days of downtime. The most frequent injuries were sprains, bruises, and muscle overloads and 63.8% of players had ≥ 1 potentially-recurring injury. The most prevalent injuries were ankle sprains (50%), thigh muscle injuries (12.2%) and knee tendinitis (7.4%). The only significant predisposing factor for injury was recurrent injury (adjusted OR 1.93, 95% CI 1.029-3.62). Age, sex, height, weight, position, body mass index, and professional/amateur competition were not significantly associated with the number of injuries or ≥ 7 days downtime in the multivariate analysis.

CONCLUSION

Preventive measures should be applied to the team as a whole at an early age, since recurrent injuries only explained a small percentage of the total injuries.

Epidemiology of injuries in elite male and female futsal: a systematic review and meta-analysis

The main purpose of this study was to conduct a systematic review and meta-analysis quantifying the incidence of injuries in futsal players. A systematic search was conducted using MEDLINE, PubMed, Web of Science and Scopus databases and subsequently, six studies (14 cohorts) were selected. Separate meta-analyses for male and female players were conducted using a Poisson random-effect regression model approach. The overall and match incidence rates in elite male futsal players were 6.8 (95% CI = 0.0-15.2) and 44.9 (95% CI = 17.2-72.6) injuries/1000 hours of exposure. Pooled training injury rate in male players was not calculated due to the lack of studies reporting training injuries in this cohort. For females, an overall, training and match incidence rates of 5.3 (95% CI = 3.5-7), 5.1 (95% CI = 2.7-7.6) and 10.3 (95% CI = 0.6-20.1) injuries/1000 hours of exposure were reported. In males, match incidence rate in International tournaments was 8.5 times higher than in national leagues (77.2 [95% CI = 60.0-94.5] vs 9.1 [95% CI = 0.0-19.3] for international tournaments and national leagues, respectively). Elite male and female futsal players are exposed to a substantial risk of sustaining injuries, especially during matches.

Effects of Hypopressive Exercise on Posterior Back Chain Kinematics and Pulmonary Function in Professional Female Basketball Players

CONTEXT

Hypopressive exercise (HE) has been used as an alternative lumbo-pelvic injury prevention program and claimed to be a means of respiratory and flexibility improvement. However, the possible effects of HE on athletic populations and physical performance remain unclear.

OBJECTIVE

Examine the effects of a HE program on posterior back chain kinematics, thoracic mobility, pulmonary function, and lower lumbar pain in female basketball players over an 8-week training period.

DESIGN

Prospective (1) baseline, (2) midpoint (4 wk), and (3) after 8 weeks.

SETTING

Sports field.

PARTICIPANTS

A total of 17 professional female basketball players (mean age 20.7 y, SD: 3.50; body mass index, 21.71, SD: 1.69).

INTERVENTION

Participants performed 8 HE weekly sessions of 30 minutes.

MAIN OUTCOME MEASURES

Back chain kinematics was assessed with the sit and reach and finger to floor test, and back pain was assessed through numerical rating scale. Respiratory parameters were assessed by spirometry and through thoracic mobility.

RESULTS

The analysis of variance revealed significant differences between the 3 measurement periods for thoracic mobility (P > .01); forced expiratory volume in the first second (P < .05) while no statistical differences were found for the rest of spirometry outcomes. Significant differences were also revealed between baseline and after the intervention for the sit and reach test (P > .01), peak expiratory flow (P = .01), and forced expiratory volume in the first 25 seconds (P = .04). Also, significant differences between weeks were found in levels of lumbar pain (P = .003) and the finger to floor test (P = .002).

CONCLUSIONS

These preliminary findings suggest that a HE program can improve posterior back chain and chest wall kinematics as well as lower lumbar pain levels. However, no gains seem to be observed for the majority of pulmonary variables except for peak expiratory flow and forced expiratory volume in the first seconds.

Systematic Review and Meta-Analysis of the Y-Balance Test Lower Quarter: Reliability, Discriminant Validity, and Predictive Validity

BACKGROUND

Deficits in dynamic neuromuscular control have been associated with post-injury sequelae and increased injury risk. The Y-Balance Test Lower Quarter (YBT-LQ) has emerged as a tool to identify these deficits.

PURPOSE

To review the reliability of the YBT-LQ, determine if performance on the YBT-LQ varies among populations (i.e., sex, sport/activity, and competition level), and to determine the injury risk identification validity of the YBT-LQ based on asymmetry, individual reach direction performance, or composite score.

STUDY DESIGN

Systematic Review.

METHODS

A comprehensive search was performed of 10 online databases from inception to October 30, 2019. Only studies that tested dynamic single leg balance using the YBT-LQ were included. Studies were excluded if the Y-Balance Test kit was not utilized during testing or if there was a major deviation from the Y-Balance test procedure. For methodological quality assessment, the modified Downs and Black scale and the Newcastle-Ottawa Scale were used.

RESULTS

Fifty-seven studies (four in multiple categories) were included with nine studies assessing reliability, 36 assessing population differences, and 16 assessing injury prediction were included. Intra-rater reliability ranged from 0.85-0.91. Sex differences were observed in the posteromedial direction (males: 109.6 [95%CI 107.4-111.8]; females: 102.3 [95%CI 97.2-107.4; p = 0.01]) and posterolateral direction (males: 107.0 [95%CI 105.0-109.1]; females: 102.0 [95%CI 97.8-106.2]). However, no difference was observed between sexes in the anterior reach direction (males: 71.9 [95%CI 69.5-74.5]; females: 70.8 [95%CI 65.7-75.9]; p=0.708). Differences in composite score were noted between soccer (97.6; 95%CI 95.9-99.3) and basketball (92.8; 95%CI 90.4-95.3; p <0.01), and baseball (97.4; 95%CI 94.6-100.2) and basketball (92.8; 95%CI 90.4-95.3; p=0.02). Given the heterogeneity of injury prediction studies, a meta-analysis of these data was not possible. Three of the 13 studies reported a relationship between anterior reach asymmetry reach and injury risk, three of 10 studies for posteromedial and posterolateral reach asymmetry, and one of 13 studies reported relationship with composite reach asymmetry.

CONCLUSIONS

There was moderate to high quality evidence demonstrating that the YBT-LQ is a reliable dynamic neuromuscular control test. Significant differences in sex and sport were observed. If general cut points (i.e., not population specific) are used, the YBT-LQ may not be predictive of injury. Clinical population specific requirements (e.g., age, sex, sport/activity) should be considered when interpreting YBT-LQ performance, particularly when used to identify risk factors for injury.

LEVEL OF EVIDENCE

1b.

The Effectiveness of Neuromuscular Warmups for Lower Extremity Injury Prevention in Basketball: A Systematic Review

BACKGROUND

Neuromuscular warmups have gained increasing attention as a means of preventing sports-related injuries, but data on effectiveness in basketball are sparse. The objective of this systematic review was to evaluate evidence of the effectiveness of neuromuscular warmup-based strategies for preventing lower extremity injuries among basketball athletes.

METHODS

PubMed and Cochrane Library databases were searched in February 2019. Studies were included if they were English-language randomized controlled, non-randomized comparative, or prospective cohort trials, tested neuromuscular and/or balance-focused warmup interventions among basketball players, and assessed at least one type of lower extremity injury as a primary outcome. Criteria developed by the USPSTF were used to appraise study quality, and GRADE was used to appraise the body of evidence for each outcome. Due to heterogeneity in the included studies, meta-analyses could not be performed.

RESULTS

In total, 825 titles and abstracts were identified. Of the 13 studies which met inclusion criteria for this review, five were balance interventions (3 randomized controlled trials) and eight were multicomponent interventions involving multiple categories of dynamic neuromuscular warmup (5 randomized controlled trials). Authors of four of the studies were contacted to obtain outcome data specific to basketball athletes. Basketball specific results from the studies suggest significant protective effects for the following lower extremity injuries: ankle injuries (significant in 4 out of the 9 studies that assessed this outcome); ACL injuries (2 of 4 studies); knee injuries generally (1 of 5 studies); and overall lower extremity injuries (5 of 7 studies). All but one of the non-significant results were directionally favorable. Evidence was moderate for the effect of multicomponent interventions on lower extremity injuries generally. For all other outcomes, and for balance-based interventions, the quality of evidence was rated as low.

CONCLUSION

Overall, the evidence is supportive of neuromuscular warmups for lower extremity injury prevention among basketball players. However, most studies are underpowered, some used lower-quality research study designs, and outcome and exposure definitions varied. Due to the nature of the study designs, effects could not be attributed to specific intervention components. More research is needed to identify the most effective bundle of warmup activities.

Effect of Integrative Neuromuscular Training for Injury Prevention and Sports Performance of Female Badminton Players

Objectives

Investigate the effects of integrated neuromuscular training (INT) on injury prevention and the performance of professional female badminton athletes by comparing their preintervention and postintervention tests. The study hypothesized that integrated neuromuscular training can improve the asymmetry and improve the sport performance of female badminton players.

Methods

According to pretest value based on functional movement screening, 38 participants were divided into a high-risk group (HG) and a low-risk group (LG) with 22 and 16 people in each group. Two groups of athletes took part in an 8-week INT program consisting of four 90-min sessions each week. The asymmetries in movement, physical fitness, and special abilities were tested before and after the intervention. Independent sample t-test was used for the statistical analysis.

Results

This research found indicated that 8 weeks of INT influenced FMS scores in both groups (HG and LG). The change of inline lunge (ES_H = 0.42, ES_L = 0.21) and trunk stability push-up (ES_H = −0.58, ES_L = −0.20) showed significant differences (P < 0.05), and the change of the FMS scores (ES_H = 0.81, ES_L = 0.65), deep squat (ES_H = 0.6, ES_L = 0.3), and rotation stability (ES_H = −0.65, ES_L = −0.72) showed very significant differences (P < 0.01). Compared to the pretest, most of the physical fitness parameters improved significantly in the HG and LG groups except strength index, and special abilities of the HG and LG group women badminton athletes showed a substantial increase.

Conclusion

Integrated neuromuscular training can effectively improve the asymmetry of female badminton athletes' limbs, prevent sports injury, and improve the athlete's performance ability. However, athletes in different risk groups have certain differences in the degree of improvement in their motor skills.

The Protective Effect of Neuromuscular Training on the Medial Tibial Stress Syndrome in Youth Female Track-and-Field Athletes: A Clinical Trial and Cohort Study

CONTEXT

Few reports have analyzed the effects of neuromuscular (NM) training programs on the injury incidence among youth female track-and-field athletes.

OBJECTIVE

To determine the effects of NM training on reducing lower limb injury incidence and to establish its effects on countermovement jump performance, balance, 30-m sprint, and joint position sense in youth female track-and-field athletes.

DESIGN

Single-blind, randomized controlled clinical trial.

SETTING

Sports research laboratory.

PARTICIPANTS

Twenty-two female athletes were allocated into 2 groups: Conventional (CONV) training (n = 11; age = 15.3 [2.1] y) and NM training (n = 11; age = 15.0 [2.7] y).

INTERVENTIONS

Interventions were performed during the preseason of 6 weeks. The CONV training included anaerobic, strength, and aerobic training. The NM training consisted of a multicomponent program that integrated jumps, landings, and running with strength, endurance, agility, balance, and CORE training.

MAIN OUTCOME MEASURES

A follow-up of the cohorts was carried out through the evaluation of lower limb injuries (main outcome) during a regular season (weeks 7-18). Secondary outcomes were measured before and after the intervention: Y-balance test, active joint repositioning, ground reaction force, and countermovement jump height.

RESULTS

The injury incidence rate was 17.89 injuries per 1000 hours athlete-exposure in CONV training, and 6.58 in NM training (relative risk = 0.38; 95% confidence interval,  0.18 to 0.82; P = .044). Particularly, the medial tibial stress syndrome incidence rate was 5.96 injuries per 1000 hours athlete-exposure in CONV training and 0.82 in NM training (relative risk = 0.17; 95% confidence interval, 0.02 to 1.12; P = .012). In addition, a significant training × time interaction was noted, favoring improvements in 30-m sprint and countermovement jump height after NM.

CONCLUSION

The NM training may improve youth female athlete's physical fitness and reduce their injury relative risk of medial tibial stress syndrome injury.

Sports Injury Prevention and Functional Training: A Literature Review

OBJECTIVES The aim of this review study was to proposes a new paradigm of functional injury prevention(FIP) based on analysis of the effects of sports injury prevention(SIP) and functional training(FT).METHODS The literature used in the study is based on the electronic database and international papers published from 2014 to 2021 related to functional training were searched, screened and evaluated by using the follow keywords: <i>functional training, sports injury, rehabilitation, and prevention</i>.RESULTS FT was divided into the concept of training both improving the sports performance and restoring physical function in the field of rehabilitation. In two areas, FT and SIP are somewhat different in approach method, object and environment, but they are highly correlated that both the activation of proprioceptive sensation and integrated neuromuscular function are reflected in training program. Especially, intrinsic injury factors such as reduced physical ability, skills and conditioning are associated with reduction of sports performance and increased sports injury. In addition, decreased proprioceptive sensation and neuromuscular function is a typical symptom of reduction of sports performance and injury. Therefore, FIP is needed as a training program that not only to prevent sports injury but also to improve sports performance.CONCLUSIONS In this review study, FIP is propose as a new paradigm combining SIP and FT. The follow-up study of FIP should be reviewed on athletes, club members and the general public for the development of programs to prevent sports injury and improve sports performance and the effects by sports events, body parts and age.

Is patellofemoral pain preventable? A systematic review and meta-analysis of randomised controlled trials

OBJECTIVE

To evaluate the effectiveness of interventions to reduce the risk of incident patellofemoral pain.

DESIGN

Systematic review and meta-analysis, with strength of evidence evaluated separately for each intervention type.

DATA SOURCES

MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Randomised controlled trials evaluating the effectiveness of interventions to reduce patellofemoral pain risk compared with a control/non-exposed group.

RESULTS

Thirteen trials of mostly military recruits and young athletes analysed six different interventions. There was low certainty evidence from two trials (227 participants) that patellofemoral braces worn during physical activity (compared with no brace) effectively reduced the risk of patellofemoral pain (risk ratio (RR) 0.40, 95% CI 0.22 to 0.73; I2=24.0%). There was low certainty evidence from one trial (320 participants) that running technique retraining to (run softer) reduced patellofemoral pain risk (RR 0.21, 95% CI 0.07 to 0.60). There was low certainty evidence from four trials (3364 participants) that multicomponent (strengthening/neuromuscular) exercise programmes did not significantly reduce the risk of patellofemoral pain (RR 0.49, 95% CI 0.18 to 1.36; I2=64.9%), although broad CIs may reflect exercise dose variations among studies. There was very low certainty evidence from four trials (2314 participants) that foot orthoses (compared with flat inserts/no orthosis) did not significantly reduce the risk of patellofemoral pain (RR 0.63, 95% CI 0.35 to 1.13; I2=0.0%). Static stretching and a running programme that progressed intensity (compared with volume) did not significantly influence patellofemoral pain risk (single studies).

CONCLUSION

There is low-level evidence that patellofemoral braces and running technique retraining can reduce the risk of patellofemoral pain by 60%-79%.

Effects of an 8-week basketball-specific proprioceptive training with a single-plane instability balance platform

BACKGROUND

To avoid injuries in basketball players, they are recommended to pay more attention to improve their body balance. Therefore new training methods and equipment need to be devised. This study examined the effects of an 8-week basketball-specific proprioception training program while using a new developed one plane instability balance board during warm-up for improving balance ability in basketball players. Players who obtained basketball-specific balance training were compared to a control group.

METHODS

Thirty-one male university basketball players (age: 21.35, SD = 0.605 years; height: 190.97, SD = 1.88; body mass: 86.95, SD = 2.61) participated in this study. Seventeen participants were assigned to the basketball-specific 8-week balance training group (BTG) while 14 participants served as a control group (CG). Both groups were tested with the Y balance test (YBT) and postural stability test (PST) at baseline and 8 weeks later.

RESULTS

The results indicate significant improvements in the overall YBT for both legs in BTG, but not in CG. However, no group differences were found for dynamic balance performance, but static balance (i.e., postural stability) differed between groups after 8 weeks. A statistically significant moderate inverse correlation was computed between the total score of YBT and the total score of the overall stability index (r=-0.404; p= 0.041).

CONCLUSIONS

An 8-week basketball-specific proprioception training program with a single-plane instability balance platform improved balance ability (Y balance test and postural stability test) of basketball players.

Comparison of Functional Movement Screen, Star Excursion Balance Test, and Physical Fitness in Junior Athletes with Different Sports Injury Risk

Objectives

The aim of this study was to assess the relationships between functional movement screen (FMS), star excursion balance test (SEBT), agility T test, and vertical jump test scores and sports injury risk in junior athletes. We compared these assessments and the differences between groups with high and low risks of sports injury. Subjects and Methods. Eleven volleyball, 12 basketball, and 9 handball athletes were recruited. All participants followed the routine training in school sports teams. Weekly training schedules followed a similar pattern. The 32 junior athletes (age = 16.06 ± 0.21 years; height = 167.28 ± 6.32 cm; and body mass = 68.45 ± 9.67 kg) were assessed using the FMS, SEBT, agility T test, and vertical jump test in random order. The correlations of composite and individual item scores of these assessments were analyzed, and the differences between groups with high and low risks of sports injury were compared.

Results

All participants completed the study protocol. No significant differences were observed between FMS, SEBT, agility T test, and vertical jump test scores in groups with high and low risks of sports injuries. Fair and moderate-to-good correlations were observed for anterior reach maximum of SEBT and deep squat (r = 0.47, P = 0.02) as well as inline lunge (r = 0.53, P = 0.01) of FMS. The hurdle step of FMS also exhibited moderate-to-good (r = 0.52, P = 0.01) and fair (r = 0.42, P = 0.04) correlations with posterior medial and posterior lateral reach maximum of SEBT, respectively. A fair correlation was observed between posterior lateral reach maximum of SEBT and rotary stability of FMS (r = −0.23, P = 0.03). Fair and moderate-to-good correlations were identified for agility T test and maximum anterior reach in the SEBT (r = −0.42, P = 0.04) and trunk stability push-up in the FMS, respectively (r = −0.57 and P = 0.006).

Conclusions

Junior athletes with a high risk of sports injury did not exhibit differences in terms of FMS, SEBT, and physical fitness test scores. Deep squat, hurdle step, inline lunge, and rotary stability scores in the FMS were correlated with the item scores in the SEBT, which may be due to the use of similar movement patterns. Scores for anterior reach maximum in the SEBT and trunk stability push-up in the FMS were correlated with agility T test scores, suggesting a similar task requirement of trunk stability and dynamic weight shifting ability.

Injury prevention programmes with plyometric and strengthening exercises improve on-field performance: a systematic review

Importance

Injury prevention programmes (IPPs) have been demonstrated to be highly efficacious in protecting young athletes from anterior cruciate ligament and other lower-extremity injuries. However, the effectiveness of these programme in practice has been limited due to poor adherence among coaches of organised sports teams.

Objective

A change in messaging from injury reduction to performance enhancement may be an effective strategy for improving adherence. We conducted a systematic review to address whether implementing IPP can also provide benefits on sports performance as measured by on-field tests.

Evidence review

Data Sources: PubMed, EMBASE and Cochrane Library databases were searched from January 2000 to August 2018.

Study Selection: English-language studies were selected if they evaluated on-field performance testing before and after participation in the IPP or compared with another programme/control. No limitations were placed on study design or study population. Studies were excluded if they evaluated programme without an explicit focus on injury prevention or reported on injury risk factors that were not related to athletic performance.

Study design

Systematic review

Data extraction

Study design, population, sport and level, comparison group and duration/frequency of the IPP were extracted from full-text articles. The results of performance testing were summarised into the following categories: balance, sprinting, agility, jumping, physical fitness and sport-specific skills.

Findings

The evidence shows that IPP can have beneficial effects on measures of sports performance and physical fitness. Factors that resulted in significant improvement included longer frequency and duration of the programme, as well as inclusion of plyometric and muscle strengthening exercises.

Conclusions

There is a wide variety of measures used for athletic performance. IPPs that are done more frequently for longer durations and that include strengthening and plyometric exercises have been shown to improve athletic performance. Enhanced performance with tests that can be conducted on the field with existing equipment may help convince coaches and athletes to improve adherence with the IPP exercises.

Level of evidence

Level II

Effects of neuromuscular training on pain intensity and self-reported functionality for patellofemoral pain syndrome in runners: study protocol for a randomized controlled clinical trial

BACKGROUND

Patellofemoral pain syndrome (PFPS) is common and affects approximately 15% of individuals at different ages and activity levels. As a non-surgical intervention, physiotherapy is widely used to treat PFPS. Neuromuscular training exercise is one of the most effective methods for decreasing musculoskeletal pain and improving knee function. However, the effectiveness of neuromuscular training exercise for treating PFPS is not without argument. The purpose of this study is to evaluate the effect of neuromuscular training exercise on patellofemoral pain and whether the neuromuscular training exercise have more advantage effects than taping and health education.

METHODS

We will operate a prospective, single-blind, randomized controlled trial of 60 patients with patellofemoral pain. Individuals will be indiscriminately assigned to two intervention groups and a health education group. The neuromuscular training exercise which includes the muscle strength training, balance training and knee joint proprioception training, and taping group will use "Y" and "I" type taping on the participants three times a week for three months. The health education group will be given education lectures once each week and which last for three months. The primary outcome measures include the adverse events, visual analog scale for pain, and Anterior Knee Pain Scale Index, which is a knee function self-report questionnaire to evaluate the function of the knee especially for PFPS patients. The secondary outcome measures are the muscle strength and endurance of knee joint flexion and extensor muscles, knee joint proprioception, muscle thickness of the quadriceps femoris, knee function ability, and quality of life. We will manage the intention-to-treat analysis for individuals who will withdraw from this study.

DISCUSSION

According to previous studies, neuromuscular training exercise and the taping method are effective treatment for PFPS patients. In this study, we will perform a neuromuscular training exercise for patients with PFPS. We believe that this study may prove the effectiveness of neuromuscular training exercise in treating PFPS.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR1800014995 . Registered on 27 February 2018.

Effects of Ball Drills and Repeated-Sprint-Ability Training in Basketball Players

Purpose: To investigate the effects of ball drills and repeated-sprint-ability training during the regular season in basketball players. Methods: A total of 30 players were randomized into 3 groups: ball-drills training (BDT, n = 12, 4 × 4 min, 3 vs 3 with 3-min passive recovery), repeated-sprint-ability training (RSAT, n = 9, 3 × 6 × 20-m shuttle running with 20-s and 4-min recovery), and general basketball training (n = 9, basketball technical/tactical exercises), as control group. Players were tested before and after 8 wk of training using the following tests: V˙O2max , squat jump, countermovement jump, Yo-Yo Intermittent Recovery Test Level 1 (YIRT1), agility T test, line-drill test, 5-/10-/20-m sprints, and blood lactate concentration. A custom-developed survey was used to analyze players' technical skills. Results: After training, significant improvements were seen in YIRT1 (BDT P = .014, effect size [ES] ± 90% CI = 0.8 ± 0.3; RSAT P = .022, ES ± 90% CI = 0.7 ± 0.3), the agility T test (BDT P = .018, ES ± 90% CI = 0.7 ± 0.5; RSAT P = .037, ES ± 90% CI = 0.7 ± 0.5), and the line-drill test (BDT P = .010, ES ± 90% CI = 0.3 ± 0.1; RSAT P < .0001, ES ± 90% CI = 0.4 ± 0.1). In the RSAT group, only 10-m sprint speeds (P = .039, ES ± 90% CI = 0.3 ± 0.2) and blood lactate concentration (P = .004, ES ± 90% CI = 0.8 ± 1.1) were improved. Finally, technical skills were increased in BDT regarding dribbling (P = .038, ES ± 90% CI = 0.8 ± 0.6), shooting (P = .036, ES ± 90% CI = 0.8 ± 0.8), passing (P = .034, ES ± 90% CI = 0.9 ± 0.3), rebounding (P = .023, ES ± 90% CI = 1.1 ± 0.3), defense (P = .042, ES ± 90% CI = 0.5 ± 0.5), and offense (P = .044, ES ± 90% CI = 0.4 ± 0.4) skills. Conclusions: BDT and RSAT are both effective in improving the physical performance of basketball players. BDT had also a positive impact on technical skills. Basketball strength and conditioning professionals should include BDT as a routine tool to improve technical skills and physical performance simultaneously throughout the regular training season.

Evidence-Based Best-Practice Guidelines for Preventing Anterior Cruciate Ligament Injuries in Young Female Athletes: A Systematic Review and Meta-analysis

BACKGROUND

Injury prevention neuromuscular training (NMT) programs reduce the risk for anterior cruciate ligament (ACL) injury. However, variation in program characteristics limits the potential to delineate the most effective practices to optimize injury risk reduction.

PURPOSE

To evaluate the common and effective components included in ACL NMT programs and develop an efficient, user-friendly tool to assess the quality of ACL NMT programs.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

Study inclusion required (1) a prospective controlled trial study design, (2) an NMT intervention aimed to reduce incidence of ACL injury, (3) a comparison group, (4) ACL injury incidence, and (5) female participants. The following data were extracted: year of publication, study design, sample size and characteristics, and NMT characteristics including exercise type and number per session, volume, duration, training time, and implementer training. Analysis entailed both univariate subgroup and meta-regression techniques using random-effects models.

RESULTS

Eighteen studies were included in the meta-analyses, with a total of 27,231 participants, 347 sustaining an ACL injury. NMT reduced the risk for ACL injury from 1 in 54 to 1 in 111 (odds ratio [OR], 0.51; 95% CI, 0.37-0.69]). The overall mean training volume was 18.17 hours for the entire NMT (24.1 minutes per session, 2.51 times per week). Interventions targeting middle school or high school-aged athletes reduced injury risk (OR, 0.38; 95% CI, 0.24-0.60) to a greater degree than did interventions for college- or professional-aged athletes (OR, 0.65; 95% CI, 0.48-0.89). All interventions included some form of implementer training. Increased landing stabilization and lower body strength exercises during each session improved prophylactic benefits. A meta-regression model and simple checklist based on the aforementioned effective components (slope = -0.15, P = .0008; intercept = 0.04, P = .51) were developed to allow practitioners to evaluate the potential efficacy of their ACL NMT and optimize injury prevention effects.

CONCLUSION

Considering the aggregated evidence, we recommend that ACL NMT programs target younger athletes and use trained implementers who incorporate lower body strength exercises (ie, Nordic hamstrings, lunges, and heel-calf raises) with a specific focus on landing stabilization (jump/hop and hold) throughout their sport seasons.

CLINICAL RELEVANCE

Clinicians, coaches, athletes, parents, and practitioners can use the developed checklist to gain insight into the quality of their current ACL NMT practices and can use the tool to optimize programming for future ACL NMT to reduce ACL injury risk.