1. Clinical Bottom Line: Research has demonstrated that biomechanical factors around the knee joint can predispose female athletes to an ACL injury.28 There is evidence that supports the use of neuromuscular training programs to alter biomechanical risk factors associated with noncontact anterior cruciate ligament injuries. Our research found 3 articles supporting the efficacy of neuromuscular training programs for decreasing biomechanical risk factors, such as increased lower extremity valgus angles, that are associated with ACL injury. There is a lack of quality studies supporting the use of a neuromuscular training program to reduce the incidence of ACL injury. Variability in training programs and a lack of randomized controlled studies have prevented there from being definitive conclusive evidence showing that neuromuscular training can reduce the incidence of noncontact ACL injury.
2. Clinical Scenario: An athletic director contacted us inquiring about the effectiveness of knee injury prevention programs. The athletic director was concerned with the high incidence of knee injuries that were occurring among the high school athletes involved in sports programs. The athletic director reported that incidence of knee injuries was especially high for the female athletes. The athletic director also reported that all of the athletes were enrolled in a basic strengthening program consisting of weight lifting. An orthopedic surgeon had recommended that the athletic director hire a physical therapist to implement a knee injury preventive program for his athletes.
3. Our clinically answerable question: Population: The population we are focused on were athletes between the ages of 14-25 who participate in sports that require jumping, cutting, acceleration, and rapid deceleration. Intervention: We wished to determine the efficacy of neuromuscular training programs for the prevention of noncontact anterior cruciate ligament injuries as well as determine the efficacy of neuromuscular training programs in decreasing the factors that are associated with anterior cruciate ligament injury. Comparison: Our comparison group consisted of control subjects who trained as usual; having consisted of little or no neuromuscular training Outcome: Our outcome was the number of noncontact anterior cruciate ligament injuries.
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