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Abstract

Background: The purpose of this study is to evaluate the changes of muscle strength in lower limbs and knee valgus alignment using the Prevent Injury and Enhance Performance Program (PEP program) to prevent ACL injuries in female soccer players during an entire season. Methods: A longitudinal and prospective study was done in twenty female soccer players at the Universidad Nacional Autónoma de México, from a senior team. During 24 weeks the training program was applied three times a week as a part of the team workouts. Video analysis of dynamic knee valgus alignment and maximal strength of quadriceps, hamstrings and gastrocnemius were evaluated pre and post training. Results: Quadriceps and hamstring strength increased on the right pelvic limb (p<0.001). In addition the quadriceps/hamstrings ratio decreased from 3.38 to 2.3 in the right side, and from 1.99 to 1.09 in the left side. The mechanics of jump improved in 20% of the female soccer players. Muscle strength in quadriceps and hamstrings increased in right pelvic limb (p<0.001), and the quadriceps/hamstrings ratio decreased from 3.38 to 2.3 in right side and from 1.99 to 1.09 in left side. Although injuries did not decrease during this period no ACL injury was registered. Conclusions: Until now there are no reports about muscle strength and jump technique assessment with the application of the PEP program. The neuromuscular training and muscle balance are important to prevent ACL injuries. We advise that this program is integrated to women ́s soccer training.
... Por lo tanto, se genera una mayor estimulación a nivel del huso neuromuscular a cambios de longitud y velocidad en el ciclo de acortamiento y estiramiento del músculo lo que incrementa los impulsos a nivel nervioso y la posibilidad de producción de fuerza muscular (15,23) .Adicionalmente, cuando se aumenta la fuerza muscular se logra mejorar la capacidad de aceleración y desaceleración y la capacidad de controlar el aterrizaje en acciones funcionales como en el salto (16,17,24,25) . Finalmente, el trabajo de prevención debe ser un pilar en los equipos profesionales de fútbol femenino debido a que cuando se realiza un adecuado trabajo, se aumenta la fuerza muscular de cuádriceps e isquiosurales estabilizando las cadenas musculares anterior y posterior lo cual ayuda a realizar un alineamiento a nivel pélvico y evitar el valgo de rodilla en actividades específicas como el salto y el aterrizaje, se incrementa la capacidad de la mujer de generar fuerza muscular en periodos cortos de tiempo evitando lesiones musculares (26,27) . En Colombia, se han dado precedentes de los beneficios de trabajo de sobrecarga excéntrica con dispositivos isoinerciales y su relación con variables especificas tales como; fuerza, aceleración, cambio de ritmo y salto en deportistas (15,17,18) . ...
... La prevención en jugadoras de fútbol, debe hacer un énfasis en fuerza, potencia, velocidad, aceleración, propiocepción, aterrizajes, con el fin de preparar a la jugadora y potencializar sus habilidades para las acciones reales de juego. Los circuitos de prevención han demostrado reducir el índice de lesiones si son desarrollados de forma adecuado y sistematizados donde se realice énfasis en las habilidades anteriormente mencionadas logrando cambios a nivel de alineación de pelvis y rodilla reduciendo el valgo de rodilla en momentos de aterrizaje, aceleración y desaceleración, aumento en la fuerza como cuádriceps, isquiosurales, aductores, abductores generando adaptaciones a la carga y fatiga muscular (26,(40)(41)(42)(43) . ...
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Introducción El fútbol, es el deporte más popular a nivel mundial, está caracterizado por ser de alta demanda fisiológica para los sistemas cardiovascular y osteomuscular. Este, es el de mayor práctica en el género masculino. Sin embargo; en los últimos tiempos se ha visto un incremento también en la práctica en el género femenino. Las deportistas tienen una fisiología diferente al género masculino, se debe trabajar de forma especial para ellas Objetivo Evaluar la efectividad de un programa de prevención de lesiones enfocado en el aumento de fuerza muscular de las cadenas anterior y posterior en mujeres futbolistas Metodología Estudio de intervención mediante un circuito preventivo en veinte y una (21) jugadoras profesionales de fútbol durante un periodo de ocho (8) semanas monitorizado mediante los sistemas SmartCoach PRO, Nordbord y Axon Jump Resultados Se registraron valores iniciales de fuerza de cadena posterior de 174 Newton y que con el trabajo de fuerza excéntrica aumentaron hasta llegar a valores de 216 Newton medido mediante el sistema Nordbord. Con el sistema Smartcoach, se realizó la evaluación de la fuerza muscular de la cadena anterior donde se obtuvo en la primera evaluación un valor de 231 Watts y en la última evaluación un valor de 343 Watts. Con el sistema Axon Jump se registró un valor inicial de 32cm y en la evaluación final un valor de 35cm obteniendo un valor de significancia estadística de P≤0,0001 para cada variable. Conclusiones. Existe una relación entre el entrenamiento excéntrico y con dispositivos isoinerciales en el aumento de variables de fuerza muscular como newton y watts en jugadoras de fútbol. En el presente estudio se registró un valor estadísticamente significativo para el aumento en fuerza de la cadena anterior y posterior con la implementación de un programa de fuerza específico. Se deben continuar realizando estudios con este tipo de tecnología con el fin de determinar perfiles de rendimiento en jugadoras de fútbol profesional.
... To protect players, it is necessary to verify the factors corresponding to the risk of injury that can potentially be enhanced or minimized. Despite known and applied injury prevention programs (i.e., FIFA 11+ and the Prevention Exercise Program) [3,4], serious injuries, such as anterior cruciate ligament rupture, still occur in youth sports [3]. ...
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This study aimed to examine the relationship between knee valgus in the frontal plane projection angle (FPPA) during single-leg squat (SLS), single-leg landing (SLL), and other selected clinical tests in young athletes. Forty-three young healthy elite football players (age: 13.2 (1.7) years) that were regularly training in a local sports club participated in the study. The FPPA was assessed using 2D video analysis. The screening tests included the passive single-leg raise (PSLR), hip external and internal rotation (hip ER and IR), sit and reach test, weight-bearing lunge test (WBLT), modified star excursion balance test (mSEBT), countermovement jump (CMJ), single-leg hop for distance (SLHD), and age peak height velocity (APHV). There was a significant positive relationship between the knee valgus angles in the SLS test and the sit and reach test (r = 0.34) and a negative relationship with the hip ER ROM (r = −0.34) (p < 0.05). The knee valgus angles in the SLL were negatively associated with the hip IR (r = −0.32) and ER ROM (r = −0.34) and positive associated with the WBLT (r = 0.35) and sit and reach test (r = 0.33) (p < 0.05). Linear regression analysis showed that the results of the hip ER ROM and sit and reach tests were independent predictors of the FPPA in the SLS test (r2 = 0.11, p = 0.03 and r2 = 0.12, p = 0.02, respectively). The conducted study showed that individuals with more hip range of motion, more spine flexion extensibility, and less ankle dorsiflexion ROM may be more likely to experience high degrees of knee valgus in FPPA.
... Gaelic games (O'Malley et al., 2017), for particular injuries such as the knee (Herman et al., 2012), and generally to improve an athlete's performance (Rodriguez et al., 2018). However, successful implementation of such warmup strategies, as well as other interventions such as conditioning, requires significant compliance from multiple stakeholders, including the athlete and the coach. ...
... Soccer injuries are more common in the lower limbs, especially the knee joint [6,5]. Therefore, preventing athletes from getting injured is the most significant task in medicine and health [8,9]. Despite all preventive measures, severe injuries such as anterior cruciate ligament (ACL) rupture frequently occur in non-collision situations [8]. ...
Article
Objective Excessive dynamic knee valgus, as a defective movement pattern, predisposes patients to lower limb injuries. Therefore, the aim of the present study was to study dynamic knee valgus in male soccer players. Methods In this review article, an attempt was made to collect studies conducted on the subject of research from 2000 to June 2021. The websites Google Scholar, PubMed, Science Direct, SID, ISC and Magiran were used and keywords related to the topic were used to search for articles. Results According to the search method, 50 articles were found, which were finalized according to the inclusion and exclusion criteria of 12 articles. Finally, 7 articles were reported in the present study. Dynamic knee valgus condition is more common in women than men, and varus are more common with increasing age of male soccer players. Different situations during the game such as tackling, jumping, imbalance after strike to the ball and landing after jumping are also among the situations that are associated with increased dynamic knee valgus and players are exposed to knee injury. The first minutes of the halves due to the lower angle of flexion of the knee and also late in the game due to fatigue can increase the dynamic valgus and increase the risk of knee injury. Conclusion All studies have pointed to the role of dynamic valgus in the incidence of knee joint injuries, especially the anterior cruciate ligament, so it is necessary to identify the mechanism of injury and correct the direction of dynamic valgus among soccer players.
... The PEP programme is a football specific 15-min (10-min dynamic and 5-min stretching) training programme and has been shown to reduce ACL injuries by two to four folds in long-term settings (Rodríguez et al., 2018;Taylor et al., 2015). Since the focus of this trial is the biomechanical landing stability and decision-making quality (number of errors) during a single leg counter movement jump, a modified version of the PEP programme (Mandelbaum et al., 2005) (Table 1) was used. ...
Article
Objective: To investigate acute effects of a single bout of football specific neuromuscular injury preventive warm-up on potential anterior cruciate ligament (ACL) re-injury risk factors during anticipated and unanticipated jump-landings. Design: Crossover. Methods: Fourteen participants (mean ± SD age, 23.4 ± 4.1 years) 6-24 months after ACL reconstruction performed the Prevent Injury and Enhance Performance (PEP) and bicycle ergometer warm-up in a randomised sequence. Washout phase was one week. Countermovement jumps with anticipated and unanticipated single-leg-landings were assessed. Decision-making quality was measured using landing error count. Results: No carry-over effects occurred (p > 0.05). The unanticipated task produced significantly higher peak ground reaction forces (Δ+4%, F(11) = 3.46, p < 0.001, eta2 = 0.21) after PEP warm-up compared to ergometer warm-up. A lower number of decision (Δ+12%, F (5) = 17.1, p < 0.001, eta2 = 0.57) and cumulated (Δ+15%, F (3) =17.2, p < 0.001, eta2=0.57) errors were recorded during the unanticipated condition following PEP compared to ergometer warm-up. Conclusions: Evaluating unanticipated jump-landing ability prior to return to sports clearance may provide information on potential re-injury risk factors. PEP warm-up may be superior to bicycle ergometer warm-up at improving unanticipated decision making quality among athletes cleared to return to sports
... For instance, an exercise program designed to increase glenohumeral internal rotation, external rotation strength and scapular muscle strength was proven effective in reducing the prevalence of shoulder problems in elite handball players [11]. Similarly, injury prevention programs -particularly those focusing on strength and balance exercises -have been reported effective in reducing lower-limb injuries in recreational athletes participating in different sports such as soccer or running [12][13][14]. Given that some injury prevention programs have proven overall effective for reducing injury incidence in both the upper and lower limbs, it is reasonable to hypothesize that similar programs might also be of potential help for CrossFit participants since a variety of whole-body exercises are typically performed in this sport. ...
Article
The present study aimed to assess the effects of an injury pre- vention program in CrossFit athletes. Thirty-two CrossFit ath- letes were randomized to either an intervention group (n = 16), that performed mobility and stability exercises during the warm-up of all CrossFit sessions for a 10-week period or to a control group (n = 16) that kept performing their usual warm- up. Incidence of injuries (primary outcome) as well as average training loads, fatigue and pain perception were registered during the study. The overall injury incidence rate was 0.04 per 1000 training hours, with no differences between groups (p > 0.05). Similarly, no between-group differences were found for injury severity, nor for average training volume, intensity, training load, pain, or fatigue perception during the study (all p > 0.05 with trivial-to-small effect sizes). In summary, a 10- week injury prevention program consisting of stability and mobility exercises provided no benefits on injury rates, fatigue and pain perception in recreational CrossFit athletes. Further research might corroborate the preliminary evidence reported here.
Article
Purpose. Physiotherapists are trained to prevent, assess, and rehabilitate all kinds of injuries including sports injury. The goal of the physical therapist should be making sure that the athlete is in optimal shape to perform, with a minimal risk for developing an injury. This study aims to assess the physiotherapists’ awareness, implementation, and views of sports injury prevention programs (IPPs) from an international perspective. Materials and methods. A self-administered questionnaire was developed and distributed to physiotherapists worldwide through World Physiotherapy member organizations. The study targeted physiotherapists at an international level. The study included 484 participants, of whom 44.4% were male and 55.6% were female physiotherapists. Results. A total of 287 (59.3%) of the participants were aware of the current sports IPPs, 177 (36.6%) were implementing sports IPPs in their current practice. Participants who implemented the sports IPPs reported a positive opinion about the program efficacy, with a score of 7.3 ± 2.11 out of 10. Conclusions. Globally, physiotherapists have average awareness and low implementation levels of IPPs. Physiotherapists showed a positive score regarding the effectiveness of IPPS, especially the KIPP and the iSPRINT.
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Background and Aims One of the most common and dangerous injuries in sports is an Anterior Cruciate Ligament (ACL) injury. Today, despite the ACL injury prevention programs, the prevalence of this injury remains high. Most of the instructions used in injury prevention programs are based on internal focus, while studies have shown that using external focus can improve performance in individuals. The purpose of this study was to investigate the effect of focus of attention on eight weeks of anterior cruciate ligament injury prevention training on landing skill kinetic variables in soccer players. Methods The current methodology included 35 players from 3 premier league teams in Tehran province. The teams were randomly divided into three groups of Prevent injury and Enhance Performance (PEP) exercises based on the External Focus (EF) (12 people), Internal Focus (IF) (12 people), and control group (11 people). In the pretest of ground reaction force, rate of loading, and time to stabilization during landing skill. The training groups performed pep injury prevention exercises for eight weeks and related instructions instead of warm-up exercises. Control group players were performing the regular activities. ANOVA with repeated measures and one-way ANOVA and Tukey post hoc tests were used to evaluate changes Results The test results showed significant changes in vertical, anterior-posterior ground reaction force and rate of loading in the external focus group (P≤0.05). But there was no critical difference in time to stabilization and internal-external ground reaction force. Conclusion According to the results, external focus instruction has positive effects on kinetic components. Therefore, it is recommended that exercises based on these instructions be used to reduce the risk of ACL injury and to repair this injury.
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The observed dynamic knee valgus and the limited dynamic balance described in the literature are modifiable risk factors for injuries in athletes. Therefore, identification and appropriate prevention are crucial in managing the development of young athletes. The aim of the study was to assess the effectiveness of three exercises strengthening the muscles: gluteal medius, popliteal and tibialis posterior to reduce dynamic knee valgus and improve the dynamic balance of the lower limbs in young football players with poor knee control. A total of 134 footballers were assessed for eligibility, and finally 45 participants (age 12–15) met the inclusion criteria. Participants were assessed with 2D video kinematic analysis during single-leg squats to assess the knee valgus angles and the dynamic balance (Y-Balance Test). No significant interactions between groups (Control and Exercise) and time (baseline and after 6 week) were noted for dynamic valgus for the left and right knee (p > 0.05). For the dynamic balance, there were statistically significant results, but not clinically relevant for anterior, posteromedial, and composite direction for the right lower limbs and for the anterior direction for left lower limbs in the exercise group. However, there were no significant differences (p > 0.05) in all of the YBT scores for both lower limbs between groups. This study demonstrated that there were no statistically significant differences in dynamic knee valgus angles and dynamic balance values after 6 weeks of exercise program in young footballers with poor knee control. Future randomized trials should focus on more comprehensive exercises, where possible using biofeedback methods to improve knee kinematics.
Article
Objectives To assess the current opinions and state of knowledge in primary sports injury prevention among members of the German-Speaking Society for Orthopaedic and Traumatologic Sports Medicine (GOTS). Methods On 21 August 2019, a web-based questionnaire was sent to the members of the tri-national society GOTS (Austria, Germany and Switzerland). The survey was online until 21 November 2019 and included twenty-two questions, which were divided into five sections: 1) general importance of prevention (n = 4), 2) specifications of the study population (n = 3), 3) implementation of prevention (n = 8), 4) improvement opportunities in prevention (n = 4) and 5) future research areas (n = 3). Results A total of 272 participants completed the survey, representing a total survey participation of 17.7 % of all members. The study population consisted of orthopaedic surgeons (55 % with surgical and 21 % with non-operative orientation), medical students (10 %), physical therapists (8 %) and sports scientists (4 %). Ninety-four percent of all participants stated that they considered the importance of sports injury prevention to be “very high” (68 %) or “high” (26 %). However, almost 70 % of all participants stated that they spend less than one hour per week on injury prevention work. The term “prevention” was clearly defined and practicable for only 40 %, understandable but difficult to implement for 51 %, and unclear and difficult to implement for 9 % of the participants. Seventy-two percent of respondents were aware of existing prevention programs such as “Stop-X” or “FIFA 11 +”, whereas 28 % of participants were uninformed regarding these programs. Conclusions A strong divergence was identified between participants’ perception of the importance of sports injury prevention and the existing implementation of preventive measures. Future funding of prevention programs, expansion of research strategies for injury prevention and better financial reimbursement are of utmost importance.
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This study intends to look at the role of leg dominance in anterior cruciate ligament (ACL) injury risk among soccer (football) athletes. The purpose of this study was to test the hypothesis that soccer players rupture the ACL of their preferred support leg more frequently than the ACL in their preferred kicking leg, particularly in non-contact injuries, despite differences in gender. Retrospective observational study. Outpatient orthopaedic practice. Subjects who had sustained an ACL injury due to direct participation in soccer. N=93 (41 male, 52 female). These noncontact injuries were sustained while playing soccer. For non-contact injuries, roughly half of the injuries occurred in the preferred kicking leg (30) and the contralateral leg (28). However, by gender, there was a significant difference in the distribution of non-contact injury, as 74.1% of males (20/27) were injured on the dominant kicking leg compared with 32% (10/31) of females (p<0.002). When limited to a non-contact injury mechanism, females are more likely to injure the ACL in their supporting leg, whereas males tend to injure their kicking leg. This research suggests that limb dominance does serve as an aetiological factor with regard to ACL injuries sustained while playing soccer. If follow-up studies confirm that females are more likely to injure their preferred supporting leg, future research should investigate the cause for this discrepancy, which could result from underlying gender-based anatomical differences as well as differences in neuromuscular patterns during cutting manoeuvres or kicking.
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The purpose of this study was to test the effect of a jump-training program on landing mechanics and lower extremity strength in female athletes involved in jumping sports. These parameters were compared before and after training with those of male athletes. The program was designed to decrease landing forces by teaching neuromuscular control of the lower limb during landing and to increase vertical jump height. After training, peak landing forces from a volleyball block jump decreased 22%, and knee adduction and abduction moments (medially and laterally directed torques) decreased approximately 50%. Multiple regression analysis revealed that these moments were significant predictors of peak landing forces. Female athletes demonstrated lower landing forces than male athletes and lower adduction and abduction moments after training. External knee extension moments (hamstring muscle-dominant) of male athletes were threefold higher than those of female athletes. Hamstring-to-quadriceps muscle peak torque ratios increased 26% on the nondominant side and 13% on the dominant side, correcting side-to-side imbalances. Hamstring muscle power increased 44% with training on the dominant side and 21% on the nondominant. Peak torque ratios of male athletes were significantly greater than those of untrained female athletes, but similar to those of trained females. Mean vertical jump height increased approximately 10%. This training may have a significant effect on knee stabilization and prevention of serious knee injury among female athletes.
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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.
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Female athletes who participate in jumping and cutting sports are 4 to 6 times more likely to sustain a serious knee injury than male athletes participating in the same sports. More than 30,000 serious knee injuries are projected to occur in female intercollegiate and high school athletics in the US each year. The majority of these injuries occur by non-contact mechanisms, most often during landing from a jump or making a lateral pivot while running. Knee instability, due possibly to decreased neuromuscular strength and coordination or increased ligamentous laxity, may underlie the increased incidence of knee injury in females. Neuromuscular training can significantly increase dynamic knee stability in female athletes. Female sex hormones (i.e. estrogen, progesterone and relaxin) fluctuate radically during the menstrual cycle and are reported to increase ligamentous laxity and decrease neuromuscular performance and, thus, are a possible cause of decreases in both passive and active knee stability in female athletes. Oral contraceptives stabilise hormone levels during the menstrual cycle and may function to either passively or actively stabilise the knee joint. The long term objective of clinicians and researchers should be to determine the factors that make women more susceptible than men to knee ligament injury and to develop treatment modalities to aid in the prevention of these injuries. The immediate objectives of this review are to examine how female and male athletes differ in neuromuscular and ligamentous control of the lower extremity. The review will examine the effects of neuromuscular training on knee stability. The effects of female hormone levels and oral contraceptives on neuromuscular control of the female athletes' knee will also be discussed.
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OBJECTIVE: To assess performance changes induced by a 6- week plyometric jump-training program. DESIGN AND SETTING: We used a quasiexperimental design to compare groups formed on the basis of team membership. Testing was conducted in an athletic training research laboratory, both before and after a 6-week period of preseason basketball conditioning. SUBJECTS: Nineteen female collegiate basketball players from a National Collegiate Athletic Association Division I program (8 subjects) and a National Association of Intercollegiate Athletics Division II program (11 subjects) who had no history of anterior cruciate ligament injury and who had no history of any lower extremity injury during the preceding 6 months. MEASUREMENTS: The variables of primary interest were hamstrings and quadriceps isokinetic peak torque. Of secondary interest were 5 variables derived from step-down and lunging maneuvers performed on a computerized forceplate system and 4 variables derived from tracking the position of the body core during performance of a T-pattern agility drill with a computerized infrared tracking system. RESULTS: A significant group x trial interaction was found for hamstrings peak torque at 60 degrees.s(-1) (F(1,17) = 9.16, P =.008.), and the proportion of total variance attributable to the treatment effect produced by the jump-training program was relatively large (eta(2) =.35, omega(2) =.30). None of the other variables demonstrated statistically significant changes. CONCLUSIONS: Our primary results support plyometric jump training as a strategy for improving neuromuscular attributes that are believed to reduce the risk of anterior cruciate ligament injury in female college basketball players. They also provide the basis for reasonable isokinetic strength goals.
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A valgus lower limb alignment has been noted during noncontact anterior cruciate ligament injuries. A video drop-jump test can indicate an athlete's ability to control lower limb axial alignment in the coronal plane. Female athletes have decreased knee separation distances on landing and acceleration; male athletes have a neutrally aligned lower limb position. A neuromuscular training program will significantly increase knee separation distance in female athletes. Cohort study; Level of evidence, 2. The authors tested 325 female and 130 male athletes aged 11 to 19 years. The distance between the hips, knees, and ankles was measured during a drop-jump test. The separation distance between the knees and ankles was normalized by the hip separation distance. A neuromuscular training program (Sportsmetrics) was completed by 62 female athletes, and their jump-landing characteristics were reexamined. A marked decrease in knee separation distance was found on takeoff in 80% of female athletes and in 72% of male athletes. There was no difference between male and female athletes in the normalized knee and ankle separation distance during the landing and takeoff phases. The knee separation distance on landing was 23 +/- 9 cm in the female athletes and 22 +/- 8 cm in the male athletes. The normalized knee separation distance was 51% +/- 19% in the female athletes and 51% +/- 15% in the male athletes. After training, statistically significant increases were found in the female athletes in the knee separation distance on landing (29 +/- 8 cm, P < .0001) and in the normalized knee separation distance (68% +/- 18%, P < .0001). The trained female athletes had significantly greater knee separation distance and normalized knee separation distance than did the males (P < .0001). The majority of untrained female and male athletes demonstrated a valgus alignment appearance on the video test. After neuromuscular training, female athletes had improved knee separation distances and a more neutral lower limb alignment on landing and takeoff.
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Female athletes have a 4 to 6 times higher incidence of anterior cruciate ligament injury than do male athletes participating in the same landing and pivoting sports. This greater risk of anterior cruciate ligament injury, coupled with a geometric increase in participation (doubling each decade), has led to a significant rise in anterior cruciate ligament injuries in female athletes. The gender gap in anterior cruciate ligament injury, combined with evidence that the underpinnings of this serious health problem are neuromuscular in nature, leads to the development of neuromuscular interventions designed to prevent injury. A systematic review of the published literature yielded 6 published interventions targeted toward anterior cruciate ligament injury prevention in female athletes. Four of 6 significantly reduced knee injury incidence, and 3 of 6 significantly reduced anterior cruciate ligament injury incidence in female athletes. A meta-analysis of these 6 studies demonstrates a significant effect of neuromuscular training programs on anterior cruciate ligament injury incidence in female athletes (test for overall effect, Z = 4.31, P < .0001). Examination of the similarities and differences between the training regimens gives insight into the development of more effective and efficient interventions. The purpose of this "Current Concepts" review is to highlight the relative effectiveness of these interventions in reducing anterior cruciate ligament injury rates and to evaluate the common training components between the training studies. In addition, the level of rigor of these interventions, the costs and the difficulty of implementation, the compliance with these interventions, and the performance benefits are discussed. This review summarizes conclusions based on evidence from the common components of the various interventions to discuss their potential to reduce anterior cruciate ligament injury risk and assess their potential for combined use in more effective and efficient intervention protocols.
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Hip strength assessment plays an important role in the clinical examination of the hip and groin region. The primary aim of this study was to examine the absolute test-retest measurement variation concerning standardized strength assessments of hip abduction (ABD), adduction (ADD), external rotation (ER), internal rotation (IR), flexion (FLEX) and extension (EXT) using a hand-held dynamometer. Nine subjects (five males, four females), physically active for at least 2.5 h a week, were included. Twelve standardized isometric strength tests were performed twice with a 1-week interval in between by the same examiner. The test order was randomized to avoid systematic bias. Measurement variation between sessions was 3-12%. When the maximum value of four measurements was used, test-retest measurement variation was below 10% in 11 of the 12 individual hip strength tests and below 5% in five of the 12 tests. No systematic differences were present. Standardized strength assessment procedures of hip ABD, ER, IR, FLEX, with test-retest measurement variation below 5%, hip ADD below 6% and hip EXT below 8%, make it possible to determine even small changes in hip strength at the individual level.
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  • I Fii
I. Fii'a 2006 [n:eruet]. Avcilable iiorn h@:/les.fi fa.comit¡ig¡oun¡i006 [cited 2017; §ov l4].
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  • C Rodriguez
Rodriguez C," §chego¡ren §. Lesiones en el t'utbol i soccer ipjuries: Universidad Nacional Autonoma; 2003. ',