ACL Injury Prevention
Conditions
Keywords
ACL Injuries, Age-related, Neuromuscular, Motor-Learning
Brief summary
The anterior Cruciate Ligament (ACL) injuries rates in female handball are high, particularly among adolescents. Therefore, the primary purpose of this randomized control trial is to explore the effects of an 8-week ACL injury prevention program on muscle activation of the medial hamstring muscles during sidecutting in female handball players. Secondary aims are to evaluate if training effects are age-related (pre-adolescent: 11-13 year old vs. adults: ≥18 years old). The age-related comparisons Include: 1. Medial hamstring muscles activation during sidecutting; 2. Well-known biomechanical ACL injury-risk factors during high risk movements, such as cutting and landing tasks; 3. Cortical and muscular activity and functional connectivity patterns during controlled knee movements; 4. Visuomotor skill learning during a simple task involving the hamstring muscles.
Interventions
OTHERACL Injury Prevention Training
Supervised ACL injury prevention training twice a week (2 x 15 minutes) over an 8-week period.
OTHERControl - Shoulder Injury Prevention Training
Supervised shoulder injury prevention training twice a week (2 x 15 minutes) over an 8-week period.
Sponsors
University College Copenhagen
University of Copenhagen
Team Denmark
Copenhagen University Hospital, Hvidovre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
11 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* Female handball players playing in youth teams from the age group under 13 (11-13 years old) and adult (≥18 - 40 years old) females playing for elite u19 or senior teams in Denmark * Have minimum 1 year of experience from playing handball * Mental and physical skills to complete the electrophysiological and biomechanical tests
Exclusion criteria
* Girls/women outside the age groups listed above * Prior surgeries to the lower limbs (e.g. ACL-reconstructions, meniscus lesions) * Current intake of medications that include antidepressants, anxiolytics, anticonvulsants, antipsychotics, antiparkinson, hypnotics, stimulants, and/or antihistamines * Neurological and/or psychiatric diagnoses * Pregnant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Neuromuscular adaptations during sidecutting | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. | Semitendinosus muscle pre-activity (sEMG) duirng handball specific sidecutting. Outcome measure is expressed in %MVC.during sidecutting. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in isometric strength | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. | Peak isometric hamstring and hip external rotation strength, respectively. Outcome measure is expressed in force (Newtons). |
| Changes in 3D hip and knee joint angles | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. | Hip and knee joint kinematic for sidecutting and single-leg landings. This include joint kinetics at initial contact and local maximum and minimums. Outcome is expressed in three-dimensional joint angles (degrees) |
| Changes in 3D hip and knee joint moments | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. | Hip and knee joint kinetics for sidecutting and single-leg landings. Outcome is expressed in three-dimensional joint moments (M) |
| Changes in hamstring and quadriceps pre-activation | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. | Hamstring (biceps femoris) and quadriceps (vastus lateralis and medialis) pre-activation (sEMG) during sidecutting and single-leg landings. Outcome measure is expressed in %MVC. |
| Changes in shoulder sensorimoter stability | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. | Shoulder sensorimoter stability measured as CoP length (mm) from force platform data. |
| Changes in Shoulder Rotator Cuff Strength | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. | Peak isometric internal and external rotator cuff strength. Outcome measure is expressed in force (Newtons). |
| Visuomotor Skill Learning | Change from Baseline to Baseline +1 Day, Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. | Age-related differences in motor performance, skill acquisition and retention during and following visuomotor skill practice. Specific outcomes measure will be time on target (seconds per target). |
Other
| Measure | Time frame | Description |
|---|---|---|
| Injury monitoring | Weekly for 16 weeks (from the start of the intervention to the end of the 8-week retention period) | Type and number of injuries will be collected on a weekly basis using an electronical study-specific questionary. If injured, player's will be asked to complete a detailed questionary about the injury. |
| Training and match exposure | Weekly for 16 weeks (from the start of the intervention to the end of the 8-week retention period) | Number of training and match hours will be collected on a weekly basis using an electronical study-specific questionary |
Countries
Denmark
Outcome results
None listed