scholarly journals Compliance With Neuromuscular Training and Anterior Cruciate Ligament Injury Risk Reduction in Female Athletes: A Meta-Analysis

2012 ◽  
Vol 47 (6) ◽  
pp. 714-723 ◽  
Author(s):  
Dai Sugimoto ◽  
Gregory D. Myer ◽  
Heather M. Bush ◽  
Maddie F. Klugman ◽  
Jennifer M. Medina McKeon ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Confidence Interval ◽  
Rate Ratio ◽  
Female Athletes ◽  
Incidence Rate Ratio ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Neuromuscular Training ◽  
Acl Injuries ◽  
Anterior Cruciate

Context No consensus exists about the influence of compliance with neuromuscular training programs on reduction of the risk of anterior cruciate ligament (ACL) injury. Objective To systematically review and synthesize the published literature to determine if compliance with neuromuscular training is associated with reduced incidence of ACL injury in young female athletes. Data Sources We searched PubMed, SPORTDiscus, CINAHL, and MEDLINE for articles published from 1995 to 2010 using the key words anterior cruciate ligament prevention, ACL prevention, knee prevention, prospective knee prevention, neuromuscular training, and neuromuscular intervention. Study Selection Criteria for inclusion required that (1) the number of ACL injuries was reported, (2) a neuromuscular training program was used, (3) females were included as participants, (4) the study design was prospective and controlled, and (5) compliance data for the neuromuscular training program were provided. Data Extraction Extracted data included the number of ACL injuries, total number of participants per group, observation time period, number of participants who completed each session, number of sessions completed by an entire team, and number of total sessions. Attendance was calculated as the number of participants who completed each session converted into a percentage of the total number of participants. Intervention completion was calculated as the number of sessions completed by an entire team converted into a percentage of the total number of training sessions. These data were used to calculate an overall rate of compliance. Data Synthesis Six of 205 identified studies were included. Incidence rates of ACL injury were lower in studies with high rates of compliance with neuromuscular training than in studies with low compliance rates (incidence rate ratio = 0.27 [95% confidence interval = 0.07, 0.80]). Tertile analysis indicated rates of ACL injury incidence were lower in studies with high compliance rates than in studies with moderate and low compliance rates (incidence rate ratio = 0.18 [95% confidence interval = 0.02, 0.77]). Conclusions A potential inverse dose-response relationship exists between compliance with neuromuscular training and incidence of ACL injury. Attending and completing recommended neuromuscular sessions appears to be an important factor for preventing ACL injuries.

Gender Differences in Anterior Cruciate Ligament Injury vary with Activity

2007 ◽  
Vol 35 (10) ◽  
pp. 1635-1642 ◽  
Author(s):  
Sally B. Mountcastle ◽  
Matthew Posner ◽  
John F. Kragh ◽  
Dean C. Taylor
Keyword(s):  
Anterior Cruciate Ligament ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Men And Women ◽  
Incidence Proportion ◽  
Anterior Cruciate

Background Previous studies have shown that women involved in similar activities as men are at increased risk for anterior cruciate ligament injuries. Hypothesis The incidence rate of complete anterior cruciate ligament tears for men and women in our athletic, college-aged population is similar. Study Design Descriptive epidemiology study. Methods Students graduating in class years 1994 to 2003 at our institution who sustained complete anterior cruciate ligament tears were assessed for mechanism of injury and type of sport played at time of injury. We calculated the incidence proportion, an estimation of risk, by gender and class year, and the incidence proportion ratio comparing men and women by class year. We also calculated incidence rates by gender and type of sport played and incidence rate ratios comparing men and women. Results There were 353 anterior cruciate ligament injuries in the 10 classes studied. We found an overall, 4-year incidence proportion of 3.24 per 100 (95% confidence interval, 2.89-3.63) for men and 3.51 (95% confidence interval, 2.65-4.65) for women (incidence proportion ratio, 1.09 [95% confidence interval, 0.80-1.47]). The overall anterior cruciate ligament injury rate, excluding male-only sports, was significantly greater in women (incidence rate ratio, 1.51 [95% confidence interval, 1.03-2.21]). We found significantly greater injury rates among women in a gymnastics course (incidence rate ratio, 5.67 [95% confidence interval, 1.99-16.16]), indoor obstacle course test (incidence rate ratio, 3.72 [95% confidence interval, 1.25-11.10]), and basketball (incidence rate ratio, 2.42 [95% confidence interval, 1.05-5.59]). Conclusion We found little gender difference in the overall risk of an anterior cruciate ligament tear; however, there were gender differences in injury rates when specific sports and activities were compared and when male-only sports were removed from the overall rate assessment.

Management of the female anterior cruciate ligament: current concepts

2020 ◽  
Vol 5 (3) ◽  
pp. 123-127
Author(s):  
Nicholas Vaudreuil ◽  
Justin Roe ◽  
Lucy Salmon ◽  
Elvire Servien ◽  
Carola van Eck
Keyword(s):  
Anterior Cruciate Ligament ◽  
Sports Medicine ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Acl Injury ◽  
Acl Injuries ◽  
Unique Challenge ◽  
Increased Risk ◽  
Anterior Cruciate

Female athletes represent a unique challenge for sports medicine providers. Care for skeletally mature female athletes requires an understanding of the distinct physiology, risk factors and injury patterns that have been described in this population. Anterior cruciate ligament (ACL) injuries are commonly observed in female athletes, especially in high-risk sports such as soccer, basketball, lacrosse and volleyball. Women have been shown to be at a higher risk for ACL injury compared with their male peers, even competing in the same sport. Several factors must be considered when discussing the increased risk of ACL injuries in women. Anatomic factors and altered landing mechanics alignment contribute to increased forces seen at the ACL. A variety of other factors including altered neuromuscular profiles, hormonal factors and genetic factors may all play a role in increased predisposition towards ACL injury. Prevention strategies for ACL such as proprioceptive training may be helpful, especially for at-risk activities such as landing and cutting drills. Optimal surgical management including graft choice is an area of debate. Postoperatively, return to sport protocols are not well standardised for female athletes. Women have a lower return to sport frequency, and psychological factors such as fear of reinjury are often cited as a predominant factor. Overall, the influence of female gender on ACL injury treatment has been an area of heavy research recently. However, more research is needed to elicit the reasons for physical and psychological differences between men and women in order to clarify optimal postoperative management.

scholarly journals Anterior Cruciate Ligament Injury Risk in Sport: A Systematic Review and Meta-Analysis of Injury Incidence by Sex and Sport Classification

2019 ◽  
Vol 54 (5) ◽  
pp. 472-482 ◽  
Author(s):  
Alicia M. Montalvo ◽  
Daniel K. Schneider ◽  
Kate E. Webster ◽  
Laura Yut ◽  
Marc T. Galloway ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Injury Incidence ◽  
Male Athletes ◽  
Acl Injuries ◽  
Sport Type ◽  
Anterior Cruciate

Objective To evaluate sex differences in incidence rates (IRs) of anterior cruciate ligament (ACL) injury by sport type (collision, contact, limited contact, and noncontact). Data Sources A systematic review was performed using the electronic databases PubMed (1969–January 20, 2017) and EBSCOhost (CINAHL, SPORTDiscus; 1969–January 20, 2017) and the search terms anterior cruciate ligament AND injury AND (incidence OR prevalence OR epidemiology). Study Selection Studies were included if they provided the number of ACL injuries and the number of athlete-exposures (AEs) by sex or enough information to allow the number of ACL injuries by sex to be calculated. Studies were excluded if they were analyses of previously reported data or were not written in English. Data Extraction Data on sport classification, number of ACL injuries by sex, person-time in AEs for each sex, year of publication, sport, sport type, and level of play were extracted for analysis. Data Synthesis We conducted IR and IR ratio (IRR) meta-analyses, weighted for study size and calculated. Female and male athletes had similar ACL injury IRs for the following sport types: collision (2.10/10 000 versus 1.12/10 000 AEs, IRR = 1.14, P = .63), limited contact (0.71/10 000 versus 0.29/10 000 AEs, IRR = 1.21, P = .77), and noncontact (0.36/10 000 versus 0.21/10 000 AEs, IRR = 1.49, P = .22) sports. For contact sports, female athletes had a greater risk of injury than male athletes did (1.88/10 000 versus 0.87/10 000 AEs, IRR = 3.00, P < .001). Gymnastics and obstacle-course races were outliers with respect to IR, so we created a sport category of fixed-object, high-impact rotational landing (HIRL). For this sport type, female athletes had a greater risk of ACL injury than male athletes did (4.80/10 000 versus 1.75/10 000 AEs, IRR = 5.51, P < .001), and the overall IRs of ACL injury were greater than all IRs in all other sport categories. Conclusions Fixed-object HIRL sports had the highest IRs of ACL injury for both sexes. Female athletes were at greater risk of ACL injury than male athletes in contact and fixed-object HIRL sports.

scholarly journals Awareness of Anterior Cruciate Ligament Injury-Preventive Training Programs Among Female Collegiate Athletes

2020 ◽  
Vol 55 (4) ◽  
pp. 359-364
Author(s):  
Miho J. Tanaka ◽  
Lynne C. Jones ◽  
Jared M. Forman
Keyword(s):  
Anterior Cruciate Ligament ◽  
Female Athletes ◽  
Training Programs ◽  
Cruciate Ligament ◽  
Collegiate Athletes ◽  
Acl Injury ◽  
Ligament Injury ◽  
Acl Injuries ◽  
Female Collegiate Athletes ◽  
Anterior Cruciate

Context Neuromuscular training programs can reduce the rate of noncontact anterior cruciate ligament (ACL) injuries, particularly in female athletes. Objective To assess the awareness of, experience with, and factors associated with participation in preventive training programs (PTPs) among female collegiate athletes and their knowledge of ACL injuries. Design Cross-sectional study. Setting National Collegiate Athletic Association (NCAA) sports programs. Patients or Other Participants A total of 440 female NCAA athletes (age = 20 ± 1 years) representing 20 sports during the 2017–2018 academic year. Main Outcome Measure(s) We used a 12-item survey to collect data on each participant's age, sport, position, college, NCAA division, and awareness of and experience with PTPs. We performed descriptive statistics and used odds ratios (ORs) to assess relationships between demographic data and awareness of or interest in PTPs. Results Of the 440 respondents, 85% (n = 373) knew that female athletes were at higher risk for sustaining ACL injuries than male athletes, and 89% (n = 391) knew that ACL injuries were preventable. Thirty-three percent (n = 143) were familiar with the concept of ACL PTPs. Only 15% (n = 64) had ever performed PTPs, but 89% (n = 391) reported they would perform a daily PTP if it could prevent ACL injuries. Fifty-two of the 64 respondents (81%) who had performed PTPs said athletic trainers or coaches oversaw the PTPs. Participants were more likely to be familiar with ACL PTPs if they (OR = 3.5; 95% confidence interval [CI] = 2.0, 5.8) or a teammate (OR = 4.6; 95% CI = 2.1, 9.8) had sustained an ACL injury. Respondents were more willing to perform PTPs if they (OR = 2.3; 95% CI = 0.80, 6.6) or a teammate (OR = 3.4; 95% CI = 1.8, 6.6) had sustained an ACL injury. Conclusions Although 89% of respondents expressed interest in performing daily ACL PTPs, only 15% had performed such programs, and only 33% were familiar with the concept of ACL PTPs.

scholarly journals No Association Between Risk of Anterior Cruciate Ligament Rupture and Selected Candidate Collagen Gene Variants in Female Elite Athletes From High-Risk Team Sports

2018 ◽  
Vol 47 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Einar Andreas Sivertsen ◽  
Kari Bente Foss Haug ◽  
Eirik Klami Kristianslund ◽  
Anne-Marie Siebke Trøseid ◽  
Jari Parkkari ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Elite Athletes ◽  
Cruciate Ligament ◽  
Team Sports ◽  
Acl Injury ◽  
Acl Rupture ◽  
Acl Injuries ◽  
Genes Encoding ◽  
Anterior Cruciate

Background: Several single-nucleotide variants (SNVs) in collagen genes have been reported as predisposing factors for anterior cruciate ligament (ACL) tears. However, the evidence is conflicting and does not support a clear association between genetic variants and risk of ACL ruptures. Purpose: To assess the association of previously identified candidate SNVs in genes encoding for collagen and the risk of ACL injury in a population of elite female athletes from high-risk team sports. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 851 female Norwegian and Finnish elite athletes from team sports were included from 2007 to 2011. ACL injuries acquired before inclusion in the cohort were registered by interview. The participants were followed prospectively through 2015 to record new complete ACL injuries. Six selected SNVs were genotyped ( COL1A1: rs1800012, rs1107946; COL3A1: rs1800255; COL5A1: rs12722, rs13946; COL12A1: rs970547). Results: No associations were found between ACL rupture and the SNVs tested. Conclusion: The study does not support a role of the 6 selected SNVs in genes encoding for collagen proteins as risk factors for ACL injury. Clinical Relevance: Genetic profiling to identify athletes at high risk for ACL rupture is not yet feasible.

scholarly journals Anterior Cruciate ligament injuries of the knee:

2018 ◽  
Vol 30 (1) ◽  
pp. 1-6
Author(s):  
G Linde Strauss ◽  
D Janse van Rensburg ◽  
C Grant ◽  
A Jansen van Rensburg ◽  
M Velleman ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Mechanism Of Injury ◽  
Mri Scan ◽  
Chi Square ◽  
Valgus Stress ◽  
Acl Injuries ◽  
Anterior Cruciate Ligament Injuries ◽  
Anterior Cruciate

Abstract Background and problem statement Anterior cruciate ligament injuries are common among athletes and the general public. These injuries may lead to significant absence from activity with an associated financial and social burden. No definitive association has been described between mechanism of injury and pathology to enable us to put preventative measures in place in order to limit these injuries. Aim To determine whether there is an association between the mechanism of injury and the pathology seen on a magnetic resonance imaging (MRI) scan in anterior cruciate ligament (ACL) injuries. Methods This was a cross-sectional analytical study. Eighty seven male patients with an ACL injury, who had an MRI scan of the knee within the last two years participated in this study. Participants were contacted to give consent that their information be used in this study. The mechanism of injury and the pathology seen on the MRI scan was noted and categorised into different mechanism of injury groups and associated pathology groups. Statistical analyses included summaries of the data and a test for association between mechanism of injury and pathology. Since there were multiple pathology responses to each mechanism, a modified version of the chi-square test for independence was used. A 5% level of significance was specified. Results MRI scans of ACL injuries indicated that the mechanism of a solid foot plant with rotation of the knee has a greater tendency to be associated with medial meniscal injuries (77%), and also a 54% possibility to be associated with lateral meniscal injuries. A solid foot plant with a valgus stress on the knee showed a higher incidence of associated medial collateral ligaments (MCL) injuries (41%) and femoral bone bruising (62 %). These two mechanisms of injury are the most common in ACL injuries and contribute to the clinical significance found in this study. The p-value was however not statistically significant (p=0.44, chi-square value=20.27, df=45) for any association between pathology and mechanism of injury. Conclusion Some injury mechanisms causing ACL injury were more common than others and also had more associated pathology. The most common mechanism of injury noted is a solid foot plant with either rotation of the knee or valgus stress on the knee. Strengthening tissue structures involved in those movement patterns that cause these mechanisms can possibly limit ACL injuries in athletes and the general public.  Key words Anterior cruciate ligament injury, mechanism, association, pathology, MRI scan, prevention.

scholarly journals Anterior cruciate ligament injuries in Australian football: should women and girls be playing? You’re asking the wrong question

2020 ◽  
Vol 6 (1) ◽  
pp. e000778 ◽  
Author(s):  
Aaron Fox ◽  
Jason Bonacci ◽  
Samantha Hoffmann ◽  
Sophia Nimphius ◽  
Natalie Saunders
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Early Years ◽  
High Rate ◽  
Acl Injuries ◽  
Sports Science ◽  
Australian Football ◽  
Women And Girls ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injuries have been a rising concern in the early years of the women’s Australian Football League (AFLW), eliciting headlines of a ‘knee crisis’ surrounding the league. There has been a focus on female biology as the primary factor driving the high rate of ACL injuries in the AFLW. Emphasising Australian football (AF) as being dangerous predominantly due to female biology may be misrepresenting a root cause of the ACL injury problem, perpetuating gender stereotypes that can restrict physical development and participation of women and girls in the sport. We propose that an approach addressing environmental and sociocultural factors, along with biological determinants, is required to truly challenge the ACL injury problem in the AFLW. Sports science and medicine must therefore strive to understand the whole system of women in AF, and question how to address inequities for the benefit of the athletes.

scholarly journals The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury–Prevention Program in Elite-Youth Soccer Athletes

2015 ◽  
Vol 50 (6) ◽  
pp. 589-595 ◽  
Author(s):  
Darin A. Padua ◽  
Lindsay J. DiStefano ◽  
Anthony I. Beutler ◽  
Sarah J. de la Motte ◽  
Michael J. DiStefano ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Screening Tool ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Receiver Operator Characteristic ◽  
Acl Injuries ◽  
Youth Soccer ◽  
Jump Landing ◽  
Anterior Cruciate

Context Identifying neuromuscular screening factors for anterior cruciate ligament (ACL) injury is a critical step toward large-scale deployment of effective ACL injury-prevention programs. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment of jump-landing biomechanics. Objective To investigate the ability of the LESS to identify individuals at risk for ACL injury in an elite-youth soccer population. Design Cohort study. Setting Field-based functional movement screening performed at soccer practice facilities. Patients or Other Participants A total of 829 elite-youth soccer athletes (348 boys, 481 girls; age = 13.9 ± 1.8 years, age range = 11 to 18 years), of whom 25% (n = 207) were less than 13 years of age. Intervention(s) Baseline preseason testing for all participants consisted of a jump-landing task (3 trials). Participants were followed prospectively throughout their soccer seasons for diagnosis of ACL injuries (1217 athlete-seasons of follow-up). Main Outcome Measure(s) Landings were scored for “errors” in technique using the LESS. We used receiver operator characteristic curves to determine a cutpoint on the LESS. Sensitivity and specificity of the LESS in predicting ACL injury were assessed. Results Seven participants sustained ACL injuries during the follow-up period; the mechanism of injury was noncontact or indirect contact for all injuries. Uninjured participants had lower LESS scores (4.43 ± 1.71) than injured participants (6.24 ± 1.75; t1215 = −2.784, P = .005). The receiver operator characteristic curve analyses suggested that 5 was the optimal cutpoint for the LESS, generating a sensitivity of 86% and a specificity of 64%. Conclusions Despite sample-size limitations, the LESS showed potential as a screening tool to determine ACL injury risk in elite-youth soccer athletes.

Lower Extremity Biomechanical Differences Between Female Dancers and Soccer Players

2020 ◽  
Vol 25 (5) ◽  
pp. 254-257
Author(s):  
Hayley M. Ericksen ◽  
Rachele E. Vogelpohl
Keyword(s):  
Lower Extremity ◽  
National Collegiate Athletic Association ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Acl Injuries ◽  
Jump Landing ◽  
Ankle Eversion ◽  
Anterior Cruciate ◽  
Modern Dancers

Anterior cruciate ligament (ACL) injury in female athletes is common. Team sport athletes experience more ACL injuries than ballet and modern dancers. Examining biomechanical differences between these two groups may help to explain the discrepancy in ACL injury rates. The purpose of this study was to examine lower extremity kinematic differences between collegiate dancers and National Collegiate Athletic Association Division I soccer athletes during a rebound jump-landing task. Peak hip, knee, and ankle kinematics were collected during a jump-landing task. Results showed more knee flexion and less ankle eversion in the dancers compared to the soccer athletes. Differences in training and strategies used during landing may explain the kinematic differences between groups.

scholarly journals Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

2019 ◽  
Vol 12 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Alberto Grassi ◽  
Luca Macchiarola ◽  
Matteo Filippini ◽  
Gian Andrea Lucidi ◽  
Francesco Della Villa ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Incidence Rate ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Injury Incidence ◽  
Acl Injuries ◽  
Professional Soccer ◽  
Incidence Proportion ◽  
Anterior Cruciate

Background: The burden of anterior cruciate ligament (ACL) injury in professional soccer players is particularly relevant as it represents a potentially career-threatening injury. Hypothesis: Our hypotheses were that (1) injury incidence rate would be similar to that reported in the literature, (2) we would identify a uniform distribution of the injuries along the season, and (3) injury incidence rate would be similar in high-ranked and lower ranked teams, based on final placement in the league. Study Design: Descriptive epidemiological study. Level of Evidence: Level 4. Methods: Professional male soccer players participating in the Serie A championship league in 7 consecutive seasons (2011-2012 to 2017-2018) were screened to identify ACL injuries through the online football archive transfermarkt.com . Exposure in matches and training were calculated. Results: There were 84 ACL injuries found (mean player age, 25.3 ± 4.2 years). Overall, 25% of ACL injuries were reruptures (15%) or contralateral injuries (10%). ACL incidence rate was 0.4215 per 1000 hours of play during Serie A matches, 0.0305 per 1000 hours of training (rate ratio [RR], 13.8; 95% CI, 8.4-22.7; P < 0.0001), and 0.0618 per 1000 hours of total play. Injury distribution had a bimodal peak, with the highest number of events in October and March. Alternatively, training injuries peaked in June and July. A significantly higher incidence rate was found for the teams ranked from 1st to 4th place compared with those ranked 5th to 20th (0.1256 vs 0.0559 per 1000 hours of play; RR, 2.2; 95% CI, 1.4-3.6; P = 0.0003). A similar finding was found for injury incidence proportion (3.76% vs 1.64%; P = 0.0003). Conclusion: The overall incidence rate of ACL injuries in Italian Serie A was 0.062 per 1000 hours, with a 14-fold risk in matches compared with training. Relevantly, 25% were second injuries. Most injuries occurred in October and March, and an almost 2-fold incidence rate and incidence proportion were noted in those teams ranked in the first 4 positions of the championship league. Clinical Relevance: Knowing the precise epidemiology of ACL injury in one of the most competitive professional football championship leagues could help delineate fields of research aimed to investigate its risk factors.

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