Sports Medicine Research: In the Lab & In the Field: Effectiveness of ACL Injury Prevention Training Programs (Sports Med Res)


Tuesday, April 24, 2012

Effectiveness of ACL Injury Prevention Training Programs

Effectiveness of Anterior Cruciate Ligament Injury Prevention Training Programs

Sadoghi P, von Keudell A, and Vavken P. J Bone Joint Surg Am. 2012; 94:1-8.

Due to the high numbers of anterior cruciate ligament (ACL) injuries, and the potential for long-term joint degeneration, many ACL injury prevention programs have been created and implemented in hopes of preventing ACL injuries from occurring. While many programs exist, the effectiveness of these programs has not been comprehensively evaluated. Therefore, Sadoghi and colleagues performed a systematic review of literature examining if ACL injury prevention programs decrease the risk of ligament injuries. Studies which were prospective, controlled studies that directly compared ACL injury prevention programs with no treatment in human subjects were eligible for inclusion. A total of 723 articles were initially identified but 714 were excluded, leaving 8 articles for analysis. Six of the 8 studies concluded that patients who underwent an ACL injury prevention program had a significantly lower rate of ACL injuries. The remaining 2 studies concluded that there was no difference in the rate of knee injuries following the ACL injury prevention program compared to the control groups. Pooled analysis of the data concluded that, overall, there was a significant reduction in the number of ACL injuries among participants that completed an ACL injury prevention program. This effect was seen in both male and female athletes. The authors also attempted to identify a “best” program for preventing ACL injuries. While the authors concluded that no “best” program exists there was agreement among studies which were successful in decreasing ACL injury rates. Those programs included at least 10 minutes of exercises, 3 times per week, and focused on neuromuscular training.

Overall, this study is interesting because it demonstrated that ACL prevention programs have a positive effect on decreasing the number of ACL injuries in both male and female athletes. These results must be interpreted cautiously though because the length to follow-up was not clearly reported. Interestingly, this study was unable to identify a “best” ACL prevention program but emphasizes that neuromuscular training for 10 minutes, 3 times a week is a minimum. Perhaps this study could not identify a “best” program because one does not exist, or a “best” program does exist but not enough data is available to make that conclusion. Maybe the key to ACL injury prevention lies in finding not which neuromuscular exercises are best for the average athlete but which neuromuscular exercises are most sport specific for the athlete being trained. While little can be inferred from this study alone, it would be interesting for future research to look into whether generalized ACL prevention or sport-specific programs are more effective. Tell us what you have found in your practice with ACL injury prevention programs. This study suggests that there is a decrease in the number of ACL injuries seen but does not give a follow-up time to determine when these gains are seen. A study recently reviewed here concluded that the duration of the prevention program impacts the length of time you benefit from it. Have you seen this in your practice? If so, when do you feel is an appropriate follow-up time?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

Related Posts:
Merging Injury Prevention Programs with Sport-Specific Training
A Human Performance and Injury Prevention Program for the Military
Coach-led Neuromuscular Warm-ups Reduce the Risk of Lower Extremity Injuries
Retention of Movement Pattern Changes After a Lower Extremity Injury Prevention Program Is Affected by Program Duration 

von Keudell, A. (2012). Effectiveness of Anterior Cruciate Ligament Injury Prevention Training Programs The Journal of Bone and Joint Surgery (American), 94 (9) DOI: 10.2106/JBJS.K.00467


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