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7-Sports Medicine/Arthroscopy I
Tuesday, Feb 07, 2012, 4:30 PM - 4:36 PM
A Randomized Trial of Anterior Cruciate Ligament Injury Prevention in Adolescent Female Soccer
Injuries; ACL Deficient; Research / Clinical
, MD, PhD, Kristianstad, Sweden
, MD, Kristianstad, Sweden
, MSc, Linköping, Sweden
, MSc, Lund, Sweden
, PhD, Linkoping, Sweden
In the United States there are more than three million youth soccer players with nearly half of them females. Unfortunately, knee injuries are common, but there is limited evidence on the preventive effect of neuromuscular training.
The study is a two-armed parallel-group cluster randomized trial where female soccer players aged 12-17 years in 309 clubs in Sweden were cluster randomized into an intervention group (n=154) or a control group (n=155). The intervention group was instructed to complete a 15-minute neuromuscular warm-up program, consisting of six exercises focusing on knee control and core stability, twice a week throughout the 2009 season. Each exercise is subdivided into four steps of progressing difficulty and a pair-exercise. Coaches documented individual player exposure during the season, and acute knee injuries were examined by physical therapists and physicians assigned to the clubs. The primary outcome was anterior cruciate ligament (ACL) injury rate and secondary outcomes were rates of severe knee injury (lay-off > four weeks) and any acute knee injury.
In total, 121 intervention clubs (2,479 players) and 109 control clubs (2,085 players) were included for analysis. Unadjusted Cox regression according to intention-to-treat showed a 64% reduction of ACL injury rate in the intervention group (hazard ratio 0.36, 95% confidence interval 0.14 to 0.90, P=0.03), but no significant effect for secondary outcomes. Per-protocol analyses of compliant players, carrying out minimum one exercise session per week, showed preventive effects for ACL injury (HR 0.14, 95% CI 0.04 to 0.50, P=0.003), severe knee injury (HR 0.20, 95% CI 0.08 to 0.55, P=0.001), and acute knee injury (HR 0.53, 95% CI 0.31 to 0.95, P=0.03).
DISCUSSION AND CONCLUSION
A 15-minute neuromuscular warm-up program significantly reduced the ACL injury rate in adolescent female soccer. Compliant players also had significant decrease in rates of severe knee injury and any acute knee injury.
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