Clinical Efficacy of Jump Training Augmented With Body Weight Support After ACL Reconstruction: A Randomized Controlled Trial

Secondary Anterior Cruciate Ligament Injury Prevention Training in Athletes: What Is the Missing Link?

After reconstruction, the return to full competition rate of athletes is low, while the re-injury rate remains high despite the completion of a rehabilitation programme. Primary ACL prevention programmes are well developed, yet few research papers focus on secondary ACL injury prevention. The aim of current review is to determine if current ACL secondary prevention training has a positive influence on the re-injury rate, the clinical or functional outcomes, or the risk of re-injury in athletes. Studies investigating secondary prevention of ACL were searched in PubMed and EBSCOhost, followed by a review of the references in the identified articles. The existing evidence suggests that neuromuscular training, eccentric strengthening, and plyometric exercises may have a potential impact on improving biomechanical, functional, and psychological outcomes in athletes; however, the studies on the prevention of second ACL injury in athletes is scarce and inconclusive. Future research is needed to investigate the effectiveness of secondary ACL prevention in reducing the re-injury rates. (PROSPERO Registration number: CRD42021291308).

Young athletes after ACL reconstruction with asymmetric quadriceps strength at the time of return-to-sport clearance demonstrate drop-landing asymmetries two years later

BACKGROUND

Quadriceps strength asymmetry at the time of return-to-sport (RTS) after anterior cruciate ligament reconstruction (ACLR) contributes to altered landing mechanics. However, the impact of RTS quadriceps strength on longitudinal alterations in landing mechanics, a risk factor for poor knee joint health over time, is not understood. The purpose of this study was to test the hypothesis that young athletes with quadriceps strength asymmetry at the time of RTS clearance after ACLR would demonstrate asymmetric landing mechanics 2 years later compared to those without quadriceps strength asymmetry.

METHODS

We followed 57 young athletes (age at RTS = 17.6 ± 3.0 years; 77% females) with primary, unilateral ACLR for 2 years following RTS clearance. At RTS, we measured isometric quadriceps strength bilaterally and calculated limb-symmetry indices [LSI = (involved/uninvolved)×100%]. Using RTS quadriceps LSI, we divided participants into High-Quadriceps (HQ; LSI ≥ 90%) and Low-Quadriceps (LQ; LSI < 85%) groups. Two years later, we assessed landing mechanics during a drop-vertical jump (DVJ) task using three-dimensional motion analysis. We compared involved/uninvolved limb values and LSI between the HQ and LQ groups using Mann-Whitney U tests.

RESULTS

The LQ group (n = 26) demonstrated greater asymmetry (lower LSI) during landing at 2 years post-RTS for knee flexion excursion (p = 0.016) and peak vertical ground reaction force (p = 0.006) compared to the HQ group (n = 28). There were no group differences in uninvolved or involved limb values for all variables (all p > 0.093).

CONCLUSION

Young athletes after ACLR with quadriceps strength asymmetry at the time of RTS favored the uninvolved limb during DVJ landing 2 years later. These landing asymmetries may relate to long-term knee joint health after ACLR.

Effects of plyometric jump training in female soccer player's vertical jump height: A systematic review with meta-analysis

To assess the effects of plyometric jump training (PJT) in female soccer player's vertical jump height, a review was conducted using the data sources PubMed, MEDLINE, Web Of Science and SCOPUS. Only peer-review articles were included. To qualify for inclusion in the meta-analysis, studies must have included (i) a PJT programme of at least 2 weeks, (ii) cohorts of healthy female soccer players with no restriction for age, (iii) a control group, (iv) a measure of countermovement jump (CMJ). The inverse variance random-effects model for meta-analyses was used. From 7,136 records initially identified through database searching, 8 were eligible for meta-analysis, comprising 9 training groups (n = 99) and 9 control groups (n = 94). The magnitude of the main effect was moderate (ES = 1.01 [95%CI = 0.36-1.66], Z = 3.04, p = 0.002). Sub-group analyses were performed (i.e., PJT frequency, duration and total number of sessions), revealing no significant subgroup differences (p = 0.34-0.96). Among the studies included in this review, none reported injury or other adverse effects. In conclusion, PJT is effective in female soccer players for the improvement of vertical jump height. In future, research must identify specific dose-response relationships following PJT, particularly in the long term.