Sports Medicine Research: In the Lab & In the Field: Neuromuscular Preventative Training Protocol Decreases Female Adolescent Sport-Related Injury Incidence (Sports Med Res)


Thursday, February 22, 2018

Neuromuscular Preventative Training Protocol Decreases Female Adolescent Sport-Related Injury Incidence

A School-Based Neuromuscular Training Program and Sport-Related Injury Incidence: A Prospective Randomized Controlled Clinical Trial

Foss KDB, Thomas S, Khoury JC, Myer GD, Hewett TE. J Athl Train. 2018;53(1):000–000. doi: 10.4085/1062-6050-173-16

Take Home Message: Adolescent female athletes had decreased risk of sports-related injury following a neuromuscular training protocol.
Female adolescent athletes are at an increased risk for injuries compared to male counterparts, especially when considering knee and ankle injuries. Therefore, injury-prevention programs are important to implement in this population to increase the benefits of sports participation while decreasing the negative effects of injury. Therefore, the authors conducted a randomized trial to evaluate the effects of a neuromuscular training program on sports-related injury incidence in middle school and high school basketball, soccer, and volleyball female athletes. The athletes were randomized by teams into a targeted neuromuscular training protocol or a non-specific resisted running program. The neuromuscular protocol consisted of exercises that focused on the trunk and lower extremity (for more information on the intervention, see Full Text). The training protocols began at the start of the season, performed for 20 to 25 minutes 3 times per week. Once competition began, the protocols were reduced to 10 to 15 minutes/session performed 2 times per week and continued until the last competition. An athletic trainer tracked sports-related injuries on weekly basis, and coaches tracked how often athletes participated in structured activity (athletic exposure). Overall, the neuromuscular training group had only of 5.3 injuries per 1000 athletic-exposures compared to the 8.5 injuries per 1000 athletic exposures in the non-specific intervention group. The authors observed this benefit in middle and high school athletes.

These results add to the growing list of evidence that suggests a protective effect of implementing a targeted injury-prevention protocol in female adolescent athletes. The neuromuscular training program requires minimal equipment and time and is a low-cost intervention that decreases overall injury incidence in this at-risk group. The authors did not specify if the athletic trainers or coaches were prescribing the interventions. This information would be important to know to translate these findings to clinical practice. The authors offered results by sport and by ankle or knee injury, but these results were based on smaller numbers that may not offer precise estimates of how effective these programs are for these subsets. It would be interesting to see if the protective effects of the training protocol would occur in a larger adolescent female population. The results of this study also cannot be extrapolated to other sports nor to male athletes as these factors were not included in the scope of this study. Another limitation is the lack of adherence/compliance with the programs and the lack of patient-reported outcomes for athlete response to the training programs. This information would be important to understand future athlete compliance to this additional training program. This will be vital because high compliance is a key to successful injury prevention program. Despite the limitations above, these results are further evidence that we need to encourage our middle school and high school coaches to implement injury prevention programs for our female athletes.

Questions for Discussion: What are some other forms of neuromuscular training protocols that you have implemented successfully in your own clinical settings? What are some of the barriers to implementing these and other like protocols into practice? How do you think athletes would respond to this additional protocol?

Written by: Alexandra F. DeJong
Reviewed by: Jeffrey Driban

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