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Br J Sports Med. 2016 Oct;50(20):1259-1266. doi: 10.1136/bjsports-2015-095596. Epub 2016 Jun 1.

Critical components of neuromuscular training to reduce ACL injury risk in female athletes: meta-regression analysis.

Author information

1
The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA Harvard Medical School, Boston, Massachusetts, USA.
2
The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Human Performance Laboratory, Sports Medicine Biodynamics Center, Cincinnati, Ohio, USA Department of Pediatrics and Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA Department of Orthopaedics, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
3
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Human Performance Laboratory, Sports Medicine Biodynamics Center, Cincinnati, Ohio, USA.
4
Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, Massachusetts, USA.
5
Biomechanics Laboratories and Sports Medicine Center, Orthopedic Surgery, Physical Medicine & Rehabilitation Physiology & Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA.

Abstract

OBJECTIVE:

The aim of this study was to determine key components in neuromuscular training that optimise ACL injury reduction in female athletes using meta-regression analyses.

DESIGN:

Systematic review and meta-regression.

DATA SOURCES:

The literature search was performed in PubMed and EBSCO.

ELIGIBILITY CRITERIA:

Inclusion criteria for the current analysis were: (1) documented the number of ACL injuries, (2) employed a neuromuscular training intervention that aimed to reduce ACL injuries, (3) had a comparison group, (4) used a prospective control study design and (5) recruited female athletes as participants. Two independent reviewers extracted studies which met the inclusion criteria. Methodological quality of included study and strength of recommendation were evaluated. Number of ACL injuries and participants in control and intervention groups, age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and status of verbal feedback were extracted.

RESULTS:

The meta-regression analyses identified age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback as significant predictors of ACL injury reduction (p=0.01 in fixed-effects model, p=0.03 in random-effects model). Inclusion of 1 of the 4 components in neuromuscular training could reduce ACL injury risk by 17.2-17.7% in female athletes. No significant heterogeneity and publication bias effects were detected. Strength of recommendation was rated as A (recommendation based on consistent and good-quality patient-oriented study evidence).

CONCLUSIONS:

Age of participants, dosage of neuromuscular training, exercise variations within neuromuscular training and utilisation of verbal feedback are predictors that influence the optimisation of prophylactic effects of neuromuscular training and the resultant ACL injury reduction in female athletes.

KEYWORDS:

ACL; Female; Prevention; Sports medicine; Training

PMID:
27251898
PMCID:
PMC5502078
DOI:
10.1136/bjsports-2015-095596
[Indexed for MEDLINE]
Free PMC Article

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