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• W4387444882 abstract "Introduction: Girls and women playing team field and court sports have high rates of anterior cruciate ligament (ACL) injury and are at 2-8 times greater risk of non-contact ACL injury than males. Multimodal injury prevention training programs reduce the risk of ACL injury in women by 45-67%. It is postulated that one mechanism by which exercise interventions are effective in reducing ACL injury risk is through changes in lower limb biomechanics; thus, understanding how training programs affect lower-limb kinematics and kinetics may help refine injury prevention programs. The aim of this systematic review was to assess the effect of injury prevention programs on lower limb kinematics and kinetics during high-risk dynamic tasks related to ACL injury in female team court and field sports. Methods: Eligibility criteria included: female athletes participating in team court and field sports; injury prevention program with a control group exposed to no intervention (usual training or wait-and-see approach); a measure of kinematics or kinetics assessed during a dynamic task related to ACL injury (jumping, landing, cutting, hopping); randomised controlled trial design. Five databases were searched: PubMed, EMBASE, CINAHL, Scopus and SPORTDiscus from inception to October 2022. We used the Grading of Recommendations Assessment, Development and Evaluation to assess the certainty of the evidence. Point estimates for the mean difference (MD) and standard deviations immediately post intervention between intervention and control groups were retrieved. Outcomes extracted for meta-analyses included: hip, knee and ankle angles, hip and knee moments, and vertical ground reaction forces. Results: Sixteen studies were included. Most included multimodal interventions (12/16). Commonly used components were plyometrics (12/16), strength (8/16) and balance/stability (7/16). Half of the studies had high risk of bias and half had some concerns. A total of 976 female athletes were included. Injury prevention programs increased knee flexion angles (MD = 3.1°, 95% Confidence Interval = 0.8°-5.5°), but had no effect on other measures. Discussion: Very low certainty evidence suggests that injury prevention programs can increase knee flexion angle compared to no intervention in females playing team court and field sports. At lower knee flexion angles, the ACL is considered the main restrictor of anterior tibial shear force, which may explain why most ACL injuries happen when the knee is close to full extension. Increasing knee flexion angles with training might be one of the mechanisms by which injury prevention programs are effective. Very low to low certainty evidence suggests that injury prevention programs have no effect on other lower limb biomechanical variables. As such, the benefits of injury prevention programs may be mediated by factors other than altered biomechanics and/or may happen through other biomechanical measures not included in this review. Impact/Application to the field:•Clinicians might aim to increase knee flexion angles when delivering injury prevention programs to mediate reduction in ACL injury risk in females playing team court and field sports.•New training programs may be required to elicit changes in other important biomechanical variables that contribute to ACL loading. Declaration: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract." @default.
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• W4387444882 date "2023-10-01" @default.
• W4387444882 modified "2023-10-11" @default.
• W4387444882 title "Injury prevention programs fail to change most lower limb kinematics and kinetics in female team court-and-field sports: A systematic review and meta-analysis of randomised trials." @default.
• W4387444882 doi "https://doi.org/10.1016/j.jsams.2023.08.118" @default.
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