Dosage Effects of Neuromuscular Training Intervention to Reduce Anterior Cruciate Ligament Injuries in Female Athletes:
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SYSTEMATIC REVIEW
Dosage Effects of Neuromuscular Training Intervention to Reduce Anterior Cruciate Ligament Injuries in Female Athletes: Meta- and Sub-Group Analyses Dai Sugimoto • Gregory D. Myer • Kim D. Barber Foss • Timothy E. Hewett
Published online: 27 December 2013 Ó Springer International Publishing Switzerland 2013
Abstract Background Although a series of meta-analyses demonstrated neuromuscular training (NMT) is an effective intervention to reduce anterior cruciate ligament (ACL) injury in female athletes, the potential existence of a dosage effect remains unknown. Objective Our objective was to systematically review previously published clinical trials and evaluate potential dosage effects of NMT for ACL injury reduction in female athletes. Design This study took the form of a meta- and subgroup analysis. Setting The keywords ‘knee’, ‘anterior cruciate ligament’, ‘ACL’, ‘prospective’, ‘neuromuscular’, ‘training’, ‘female’, and ‘prevention’ were utilized in PubMed and
EBSCO host for studies published between 1995 and May 2012. Participants Inclusion criteria set for studies in the current analysis were (i) recruited female athletes as subjects, (ii) documented the number of ACL injuries, (iii) employed an NMT intervention aimed to reduce ACL injuries, (iv) had a control group, (v) used a prospective control trial design, and (vi) provided NMT session duration and frequency information. Main outcome measures The number of ACL injuries and female athletes in each group (control and intervention) were compared based on duration, frequency, and volume of NMT via odds ratios (ORs). Results A total of 14 studies were reviewed. Analyses that compared the number of ACL injuries with short versus long NMT duration showed greater ACL injury reduction in female athletes who were in the long NMT
D. Sugimoto G. D. Myer The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
G. D. Myer T. E. Hewett Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
D. Sugimoto Division of Sports Medicine, Department of Orthopedics, Boston Children’s Hospital, Boston, MA, USA
G. D. Myer T. E. Hewett Athletic Training Division, School of Allied Medical Professions, The Ohio State University, Columbus, OH, USA
D. Sugimoto G. D. Myer K. D. Barber Foss T. E. Hewett (&) Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 10001, Cincinnati, OH 45229, USA e-mail: [email protected]
T. E. Hewett Departments of Orthopaedic Surgery, Biomedical Engineering and Rehabilitation Sciences, University of Cincinnati, Cincinnati, OH, USA
D. Sugimoto G. D. Myer K. D. Barber Foss T. E. Hewett Sports Medicine Biodynamics Center and Human Performance Laboratory, Cincinnati, OH, USA D. Sugimoto T. E. Hewett College of Health Science, University of Kentucky, Lexington, KY, USA
T. E. Hewett Sports Health & Performance Institute, The Ohio State University, Columbus, OH, USA
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duration group (OR 0.35, 95 % CI 0.23–0.53, p = 0.001) than in those in the s
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