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Do exercises used in injury prevention programmes modify cutting task biomechanics? A systematic review with meta-analysis [with consumer summary]
Pappas E, Nightingale EJ, Simic M, Ford KR, Hewett TE, Myer GD
British Journal of Sports Medicine 2015 May;49(10):673-680
systematic review

OBJECTIVE: Some injury prevention programmes aim to reduce the risk of ACL rupture. Although the most common athletic task leading to ACL rupture is cutting, there is currently no consensus on how injury prevention programmes influence cutting task biomechanics. To systematically review and synthesise the scientific literature regarding the influence of injury prevention programme exercises on cutting task biomechanics. DESIGN: The three largest databases (Medline, Embase and CINAHL) were searched for studies that investigated the effect of injury prevention programmes on cutting task biomechanics. When possible meta-analyses were performed. RESULTS: Seven studies met the inclusion criteria. Across all studies, a total of 100 participants received exercises that are part of ACL injury prevention programmes and 76 participants served in control groups. Most studies evaluated variables associated with the quadriceps dominance theory. The meta-analysis revealed decreased lateral hamstrings electromyography activity (p < 0.05) while single studies revealed decreased quadriceps and increased medial hamstrings activity and decreased peak knee flexion moment. Findings from single studies reported that ACL injury prevention exercises reduce neuromuscular deficits (knee valgus moment, lateral trunk leaning) associated with the ligament and trunk dominance theories, respectively. The programmes we analysed appear most effective when they emphasise individualised biomechanical technique correction and target postpubertal women. CONCLUSIONS: The exercises used in injury prevention programmes have the potential to improve cutting task biomechanics by ameliorating neuromuscular deficits linked to ACL rupture, especially when they emphasise individualised biomechanical technique correction and target postpubertal female athletes.
Reproduced with permission from the BMJ Publishing Group.

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