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      Core-Muscle Training and Neuromuscular Control of the Lower Limb and Trunk

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          Abstract

          Context

          Comprehensive injury-prevention training (plyometric, agility, balance, and core-stability exercises) has been shown to decrease sport-related injury. The relationship between trunk control and sport-related injury has been emphasized; however, the isolated effects of core-muscle training are unclear.

          Objective

          To investigate the effect of a simple 8-week core-muscle–training program on the neuromuscular control of the lower limb and trunk during jump landing and single-legged squatting.

          Design

          Controlled laboratory study.

          Setting

          Laboratory.

          Patients or Other Participants

          Seventeen female collegiate basketball players were randomly divided into training (n = 9; age = 19.7 ± 0.9 years) and control (n = 8; age = 20.3 ± 2.5 years) groups.

          Intervention(s)

          The training group completed the core-muscle–training program in addition to daily practice, and the control group performed only daily practice. Kinematic and kinetic data during a drop-jump test and single-legged squat were acquired using a 3-dimensional motion-analysis system.

          Main Outcome Measure(s)

          Three-dimensional hip, knee, and trunk kinematics; knee kinetics; and isokinetic muscle strength were measured at the pretraining and posttraining phases.

          Results

          For the drop-jump test, the maximal trunk-flexion angle increased (P = .008), and peak knee-valgus moment (P = .008) decreased in the training group. For the single-legged squat, the peak trunk-flexion angle increased (P = .04), and the total amount of trunk lateral-inclination angle (P = .02) and peak knee-valgus moment (P = .008) decreased in the training group. We observed no changes in the control group.

          Conclusions

          A consecutive 8-week core-muscle–training program improved lower limb and trunk biomechanics. These altered biomechanical patterns could be favorable to preventing sport-related injuries.

          Related collections

          Most cited references20

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          Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball.

          The mechanism for noncontact anterior cruciate ligament injury is still a matter of controversy. Video analysis of injury tapes is the only method available to extract biomechanical information from actual anterior cruciate ligament injury cases.
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            Anterior cruciate ligament injuries in female athletes: Part 1, mechanisms and risk factors.

            The mechanism underlying gender disparity in anterior cruciate ligament injury risk is likely multifactorial in nature. Several theories have been proposed to explain the mechanisms underlying the gender difference in anterior cruciate ligament injury rates. These theories include the intrinsic variables of anatomical, hormonal, neuromuscular, and biomechanical differences between genders and extrinsic variables. Identification of both extrinsic and intrinsic risk factors associated with the anterior cruciate ligament injury mechanism may provide direction for targeted prophylactic treatment to high-risk individuals.
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              Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study.

              Female athletes are at significantly greater risk of anterior cruciate ligament (ACL) injury than male athletes in the same high-risk sports. Decreased trunk (core) neuromuscular control may compromise dynamic knee stability. (1) Increased trunk displacement after sudden force release would be associated with increased knee injury risk; (2) coronal (lateral), not sagittal, plane displacement would be the strongest predictor of knee ligament injury; (3) logistic regression of factors related to core stability would accurately predict knee, ligament, and ACL injury risk; and (4) the predictive value of these models would differ between genders. Cohort study (prognosis); Level of evidence, 2. In this study, 277 collegiate athletes (140 female and 137 male) were prospectively tested for trunk displacement after a sudden force release. Analysis of variance and multivariate logistic regression identified predictors of risk in athletes who sustained knee injury. Twenty-five athletes (11 female and 14 male) sustained knee injuries over a 3-year period. Trunk displacement was greater in athletes with knee, ligament, and ACL injuries than in uninjured athletes (P < .05). Lateral displacement was the strongest predictor of ligament injury (P = .009). A logistic regression model, consisting of trunk displacements, proprioception, and history of low back pain, predicted knee ligament injury with 91% sensitivity and 68% specificity (P = .001). This model predicted knee, ligament, and ACL injury risk in female athletes with 84%, 89%, and 91% accuracy, but only history of low back pain was a significant predictor of knee ligament injury risk in male athletes. Factors related to core stability predicted risk of athletic knee, ligament, and ACL injuries with high sensitivity and moderate specificity in female, but not male, athletes.
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                Author and article information

                Journal
                Journal of Athletic Training
                Journal of Athletic Training/NATA
                1062-6050
                September 01 2019
                September 01 2019
                : 54
                : 9
                : 959-969
                Affiliations
                [1 ]Department of Orthopaedic Surgery, Graduate School of Medicine, Hirosaki University, Aomori, Japan
                Article
                10.4085/1062-6050-113-17
                6795098
                31386583
                5e03404a-a74d-4677-aebc-f0d7cd9f2b45
                © 2019
                History

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