School-Based Neuromuscular Training Program and
Sport-Related Injury Incidence: A
Randomized Controlled Clinical Trial
Foss KDB,
Thomas S, Khoury JC, Myer GD, Hewett TE. J Athl Train. 2018;53(1):000–000. doi:
Home Message:
Adolescent female athletes had decreased
risk of sports-related injury following a neuromuscular training protocol.
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.
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.
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
Related Posts: