Neuromuscular Training Improves Single-Limb Stability

Pretest/post-test study design, study will try to determine if a 6-week neuromuscular training program designed to decrease the incidence of anterior cruciate ligament (ACL) injuries would improve single-limb stability in young female athletes. Healthy female high school athletes will participate in this study. Single-limb postural stability for both lower extremities will be assessed with Stork balance test, Star Excursion Balance Test for Dynamic Balance and Single leg stance test for static balance. Participants will be included through convenient sampling. Informed consent will be taken from all the participants.

In this Controlled single-group pretest/post-test study design, study will try to determine if a 6-week neuromuscular training program designed to decrease the incidence of anterior cruciate ligament (ACL) injuries would improve single-limb stability in young female athletes. Current study hypothesized that neuromuscular training would result in an improvement of postural stability, with the greatest improvement taking place in the medial-lateral direction. Healthy female high school athletes will participate in this study. Single-limb postural stability for both lower extremities will be assessed with Stork balance test, Star Excursion Balance Test for Dynamic Balance and Single leg stance test for static balance. Participants will be included through convenient sampling. Informed consent will be taken from all the participants. Those individuals who will match the inclusion and exclusion criteria will be a part of the study. The neuromuscular training program will consist of three 90-minute training sessions per week for 6 weeks. Following the completion of the training program, each subject will be re-evaluated to determine change in total, anterior-posterior, and medial-lateral single-limb stability.

The neuromuscular training program will consist of three 90-minute training sessions per week for 6 weeks. The 3 components of the dynamic neuromuscular training protocol utilized in this study include: (1) balance training and hip/pelvis/trunk strengthening, (2) plyometrics and dynamic movement training, and (3) resistance training. Following the completion of the training program, each subject will be re-evaluated to determine change in total, anterior-posterior, and medial-lateral single-limb stability. Two-way analysis of variance models will be used to determine differences between pre-training and post-training and between limbs.

(1) balance training and hip/pelvis/trunk strengthening, (2) plyometrics and dynamic movement training, and (3) resistance training.

dynamic test that requires strength, flexibility, and proprioception. It is a measure of dynamic balance that provides a significant challenge to athletes and physically active individuals. The test can be used to assess physical performance

The Single leg Stance (SLS) Test is used to assess static postural and balance control.Performed with eyes open and hands on the hips.Client must stand unassisted on one leg

The standing stork test monitors the progress of the athletes' abilities to maintain balance in a static position. This test monitors the balance of athletes because the more balance you have as an athlete, the better you may perform on the field and the fewer injuries you are likely to sustain.

Inclusion Criteria: Age will range from 13-20 Female participants Individuals with Postural instability and Impaired balance will be included. Exclusion Criteria: Any malignancy Infection Systemic illness Trauma

Etty Griffin LY. Neuromuscular training and injury prevention in sports. Clin Orthop Relat Res. 2003 Apr;(409):53-60. doi: 10.1097/01.blo.0000057788.10364.aa.

Richmond SA, Kang J, Doyle-Baker PK, Nettel-Aguirre A, Emery CA. A School-Based Injury Prevention Program to Reduce Sport Injury Risk and Improve Healthy Outcomes in Youth: A Pilot Cluster-Randomized Controlled Trial. Clin J Sport Med. 2016 Jul;26(4):291-8. doi: 10.1097/JSM.0000000000000261.

McLeod TC, Armstrong T, Miller M, Sauers JL. Balance improvements in female high school basketball players after a 6-week neuromuscular-training program. J Sport Rehabil. 2009 Nov;18(4):465-81. doi: 10.1123/jsr.18.4.465.

Gianotti SM, Marshall SW, Hume PA, Bunt L. Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study. J Sci Med Sport. 2009 Nov;12(6):622-7. doi: 10.1016/j.jsams.2008.07.005. Epub 2008 Oct 2.

Viola RW, Steadman JR, Mair SD, Briggs KK, Sterett WI. Anterior cruciate ligament injury incidence among male and female professional alpine skiers. Am J Sports Med. 1999 Nov-Dec;27(6):792-5. doi: 10.1177/03635465990270061701.

Bonci CM. Assessment and evaluation of predisposing factors to anterior cruciate ligament injury. J Athl Train. 1999 Apr;34(2):155-64.

Hewett TE, Lindenfeld TN, Riccobene JV, Noyes FR. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med. 1999 Nov-Dec;27(6):699-706. doi: 10.1177/03635465990270060301.

Myer GD, Ford KR, Brent JL, Hewett TE. Differential neuromuscular training effects on ACL injury risk factors in"high-risk" versus "low-risk" athletes. BMC Musculoskelet Disord. 2007 May 8;8:39. doi: 10.1186/1471-2474-8-39.

Chappell JD, Limpisvasti O. Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks. Am J Sports Med. 2008 Jun;36(6):1081-6. doi: 10.1177/0363546508314425. Epub 2008 Mar 21.

Hewett TE, Ford KR, Myer GD. Anterior cruciate ligament injuries in female athletes: Part 2, a meta-analysis of neuromuscular interventions aimed at injury prevention. Am J Sports Med. 2006 Mar;34(3):490-8. doi: 10.1177/0363546505282619. Epub 2005 Dec 28.

Ireland ML. Anterior cruciate ligament injury in female athletes: epidemiology. J Athl Train. 1999 Apr;34(2):150-4.

Myer GD, Sugimoto D, Thomas S, Hewett TE. The influence of age on the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes: a meta-analysis. Am J Sports Med. 2013 Jan;41(1):203-15. doi: 10.1177/0363546512460637. Epub 2012 Oct 9.