Effects of an anterior cruciate ligament injury prevention program on performance in adolescent female soccer players

Abstract

Female soccer players are three times more likely to suffer a non-contact anterior cruciate ligament (ACL) tear compared with male soccer players. Several ACL injury prevention programs have been developed and are used to reduce injury risk. However, to date there is limited information on how such programs affect physical performance. The aim of this randomized controlled study was to investigate the effects of the Prevent Injury Enhance Performance (PEP) program in adolescent female soccer players. Four soccer teams were randomly assigned to an intervention (PEP) or control (CON) group and assessed at baseline, 6 weeks, and 12 weeks on linear sprinting, countermovement jump (CMJ), and two agility tests. A mixed model factorial ANOVA with repeated measures was used to assess for treatment effects on the dependent variables. Improvements in 27.3 and 36.6 m sprint times (o0.10 s) were evident during the first 6 weeks for PEP, but reverted back to baseline values by 12 weeks; there were no changes for 9.1 or 18.2 m sprint times in either group. There was no change in the CMJ height for PEP; however, there was a decrement at 6 and 12 weeks compared with baseline in CON. Performance on the Illinois and pro-agility tests declined in both groups. Our findings demonstrate that improvements in linear sprint performance were small and transient in adolescent female soccer players, and that there was no benefit of the PEP program on CMJ or agility performance. ACL injury prevention programs designed as a structured warm-up routine seem to lack the necessary stimulus to enhance athletic performance.

No effect on performance tests from a neuromuscular warm-up programme in youth female football: a randomised controlled trial

“…Our results are in agreement with two previous studies in girls' football that both failed to show any performance improvements from "the 11" [17], and the PEP [19]. In contrast, two other studies showed positive effects on performance from similar neuromuscular training programmes [2,12].…”

“…Still, we found no improvements in SEBT from our intervention, unlike another study where significant improvements in the posterolateral and posteromedial directions were seen in youth female football players after an 8-week neuromuscular training programme [3]. Plyometric exercises were included in other similar neuromuscular programmes [2,9,12,17,19] but not in ours, and it is more likely that an improvement in jumping or sprinting performance would have been achieved if a plyometric training component was included. However, there is no clear trend in the literature about the effect of adding plyometrics, where two of the previous studies showed improvements in jumping ability [2,12], and two reported no effects [17,19].…”

“…Third, the player execution of the present programme was lower than in all previous studies (72-92%) [2,12,17,19]. It should be noted, however, that the low player execution of the programme was completely due to players being absent from training while the intervention group teams in fact carried out the warm-up sessions according to instructions (38 of 39 training sessions).…”

“…However, we expect no type II error since not even a trend towards improvement was seen in the intervention group. Importantly, our sample is also within the range of previous studies (24-65 players) [2,12,17,19].…”

“…The performance test battery chosen for the present study were similar to many of the tests used in previous studies to facilitate comparison [12,17,19]. However, it can be argued that there is low resemblance between the neuromuscular warm-up exercises carried out and the evaluated performance tests.…”