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The application of a movement strategy in decreasing biomechanical risk factors for anterior cruciate ligament injury Celebrini, Richard G.


Introduction: Anterior cruciate ligament (ACL) injury remains one of the most common and debilitating knee injuries in sport. Neuromuscular training programs show promise in improving biomechanical risk factors but we do not know which aspects of these programs are effective. There is a need to investigate the effect of specific movement strategies in reducing biomechanical risk factors for ACL injury. Purpose: 1) To evaluate the reproducibility of biomechanical variables at the knee during three soccer-specific tasks (Chapter 2). 2) To determine the feasibility of implementing a novel movement strategy (Core-PAC) into a soccer team warm-up (Chapter 3). 3) To determine whether the Core-PAC would improve biomechanical variables during the three tasks after immediate instruction and after a four-week training program (Chapter 3). 4) To conduct a randomized controlled trial (RCT) to compare a Core-PAC trained group to a control group for biomechanical variables during the three tasks after a six-week training program (Chapter 4). Methods: Design: A test-retest design was used for the reliability study (Chapter 2). A single group pretest-posttest design was used for the feasibility study (Chapter 3). An RCT was used in Chapter 4. Subjects: A cohort of female soccer players (n = 10) participated in the reliability study (Chapter 2) and the feasibility study (Chapter 3). A different cohort of female soccer players participated in the RCT (n = 20) (Chapter 4). Results: Chapter 2: Adequate reproducibility (flexion angles (ICC=0.88-0.95; SEM=1.0-1.9°); abduction moments (ICC=0.62-0.84; SEM=0.1-0.5 Nm/kg) were demonstrated during the three tasks. Chapter 3: Feasibility of implementing the Core-PAC into a soccer warm-up was demonstrated. After immediate instruction, there were significant increases in peak flexion angles (3.5-6.4°) and decreases in abduction moments (0.17-0.27 Nm/kg) during the three tasks. After the training program, some individuals showed improvement. Chapter 4: The Core-PAC group improved (P < 0.05) flexion angles during the side-hop task (6.2°) after training and during the side-cut (8.5°) and side-hop (10°) tasks after reminding them to use the Core-PAC. Conclusions: The results of this study suggest that the Core-PAC may be one method of modifying high-risk movements to reduce the risk of ACL injury.

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