Does an In-Season Only Neuromuscular Training Protocol Reduce Deficits Quantified by the Tuck Jump Assessment?

Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Clinics in sports medicine (Impact Factor: 1.22). 10/2011; 30(4):825-40. DOI: 10.1016/j.csm.2011.07.001
Source: PubMed


Female athletes are 4-6 times more likely to suffer an ACL injury than males in comparable sports. A link between landing biomechanics and ACL injury has led to the development of injury prevention focused training protocols. It is often difficult to measure the protocols’ efficacy of different protocols on reduction of ACL injury-related factors.

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Available from: Jensen L Brent, Jun 08, 2015
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    • "(peak of jump), (3) thighs not equal side-to-side (during flight), (4) foot placement not shoulder width apart, (5) foot placement not parallel (front to back), (6) foot contact timing not equal, (7) excessive landing contact noise, (8) pause between jumps, (9) technique declines prior to 10 seconds, and (10) does not land in same footprint (excessive in-flight motion) [8]. Additional figures depicting these technique flaws can be found in previously published TJA studies [6] [8] [10]. The participants were rated as either demonstrating a technique flaw or not. "
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    ABSTRACT: Objective. The Tuck Jump Assessment (TJA), a clinical plyometric assessment, identifies 10 jumping and landing technique flaws. The study objective was to investigate TJA interrater and intrarater reliability with raters of different educational and clinical backgrounds. Methods. 40 participants were video recorded performing the TJA using published protocol and instructions. Five raters of varied educational and clinical backgrounds scored the TJA. Each score of the 10 technique flaws was summed for the total TJA score. Approximately one month later, 3 raters scored the videos again. Intraclass correlation coefficients determined interrater (5 and 3 raters for first and second session, resp.) and intrarater (3 raters) reliability. Results. Interrater reliability with 5 raters was poor (ICC = 0.47). Interrater reliability between 3 raters who completed 2 scoring sessions improved from 0.52 for session one to 0.69 for session two. Intrarater reliability was poor to moderate, ranging from 0.44 to 0.72 Conclusion. Published protocol and training of raters were insufficient to allow consistent TJA scoring. There may be a learned effect with the TJA since interrater reliability improved with repetition. TJA instructions and training should be modified and enhanced before clinical implementation.
    The Journal of sports medicine 12/2013;
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    ABSTRACT: Context: A number of comprehensive injury-prevention programs have demonstrated injury risk-reduction effects but have had limited adoption across athletic settings. This may be due to program noncompliance, minimal exercise supervision, lack of exercise progression, and sport specificity. A soccerspecific program described as the F-MARC 11p was developed by an expert group in association with the Federation Internationale de Football Association (FIFA) Medical Assessment and Research Centre (F-MARC) to require minimal equipment and implementation as part of regular soccer training. The F-MARC 11phas been shown to reduce injury risk in youth female soccer players but has not been evaluated in an American male collegiate population. Objective: To investigate the effects of a soccer-specific warm-up program (F-MARC 11p) on lower extremity injury incidence in male collegiate soccer players. Design: Cohort study. Setting: One American collegiate soccer team followed for 2 seasons. Patients or Other Participants: Forty-one male collegiate athletes aged 18-25 years. Intervention(s): The F-MARC 11p program is a comprehensive warm-up program targeting muscular strength, body kinesthetic awareness, and neuromuscular control during static and dynamic movements. Training sessions and program progression were monitored by a certified athletic trainer. Main Outcome Measure(s): Lower extremity injury risk and time lost to lower extremity injury. Results: The injury rate in the referent season was 8.1 injuries per 1000 exposures with 291 days lost and 2.2 injuries per 1000 exposures and 52 days lost in the intervention season. The intervention season had reductions in the relative risk (RR) of lower extremity injury of 72% (RR = 0.28, 95% confidence interval=0.09, 0.85) and time lost to lower extremity injury (P , .01). Conclusions: This F-MARC 11p program reduced overall risk and severity of lower extremity injury compared with controls in collegiate-aged male soccer athletes.
    Journal of athletic training 07/2013; 48(6). DOI:10.4085/1062-6050-48.4.08 · 2.02 Impact Factor
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    ABSTRACT: Identifying risk factors for knee pain and anterior cruciate ligament (ACL) injury can be an important step in the injury prevention cycle. We evaluated two unique prospective cohorts with similar populations and methodologies to compare the incidence rates and risk factors associated with patellofemoral pain (PFP) and ACL injury. The 'PFP cohort' consisted of 240 middle and high school female athletes. They were evaluated by a physician and underwent anthropometric assessment, strength testing and three-dimensional landing biomechanical analyses prior to their basketball season. 145 of these athletes met inclusion for surveillance of incident (new) PFP by certified athletic trainers during their competitive season. The 'ACL cohort' included 205 high school female volleyball, soccer and basketball athletes who underwent the same anthropometric, strength and biomechanical assessment prior to their competitive season and were subsequently followed up for incidence of ACL injury. A one-way analysis of variance was used to evaluate potential group (incident PFP vs ACL injured) differences in anthropometrics, strength and landing biomechanics. Knee abduction moment (KAM) cut-scores that provided the maximal sensitivity and specificity for prediction of PFP or ACL injury risk were also compared between the cohorts. KAM during landing above 15.4 Nm was associated with a 6.8% risk to develop PFP compared to a 2.9% risk if below the PFP risk threshold in our sample. Likewise, a KAM above 25.3 Nm was associated with a 6.8% risk for subsequent ACL injury compared to a 0.4% risk if below the established ACL risk threshold. The ACL-injured athletes initiated landing with a greater knee abduction angle and a reduced hamstrings-to-quadriceps strength ratio relative to the incident PFP group. Also, when comparing across cohorts, the athletes who suffered ACL injury also had lower hamstring/quadriceps ratio than the players in the PFP sample (p<0.05). In adolescent girls aged 13.3 years, >15 Nm of knee abduction load during landing is associated with greater likelihood of developing PFP. Also, in girls aged 16.1 years who land with >25 Nm of knee abduction load during landing are at increased risk for both PFP and ACL injury.
    British Journal of Sports Medicine 03/2014; 49(2). DOI:10.1136/bjsports-2013-092536 · 5.03 Impact Factor