title: Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up.
abstract: BACKGROUND
  Among female athletes it has not been established whether a neuromuscular and proprioceptive sports-specific training program will consistently reduce the incidence of anterior cruciate ligament injuries.
  
  
  OBJECTIVE
  To determine whether a neuromuscular and proprioceptive performance program was effective in decreasing the incidence of anterior cruciate ligament injury within a select population of competitive female youth soccer players.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  In 2000, 1041 female subjects from 52 teams received a sports-specific training intervention in a prospective non-randomized trial. The control group consisted of the remaining 1905 female soccer players from 95 teams participating in the same league who were age and skill matched. In the 2001 season, 844 female athletes from 45 teams were enrolled in the study, with 1913 female athletes (from 112 teams) serving as the age- and skill-matched controls. All subjects were female soccer players between the ages of 14 and 18 and participated in either their traditional warm-up or a sports-specific training intervention before athletic activity over a 2-year period. The intervention consisted of education, stretching, strengthening, plyometrics, and sports-specific agility drills designed to replace the traditional warm-up.
  
  
  RESULTS
  During the 2000 season, there was an 88% decrease in anterior cruciate ligament injury in the enrolled subjects compared to the control group. In year 2, during the 2001 season, there was a 74% reduction in anterior cruciate ligament tears in the intervention group compared to the age- and skill-matched controls.
  
  
  CONCLUSIONS
  Using a neuromuscular training program may have a direct benefit in decreasing the number of anterior cruciate ligament injuries in female soccer players.
authors.affiliation: MPT, Santa Monica Orthopaedic and Sports Medicine Research Foundation, 1301 Twentieth Street, Suite 150, Santa Monica, CA 90404, USA.
authors.forename: Bert R
authors.initials: BR
authors.lastname: Mandelbaum
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Silvers
authors.forename: Diane S
authors.initials: DS
authors.lastname: Watanabe
authors.forename: John F
authors.initials: JF
authors.lastname: Knarr
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Thomas
authors.forename: Letha Y
authors.initials: LY
authors.lastname: Griffin
authors.forename: Donald T
authors.initials: DT
authors.lastname: Kirkendall
authors.forename: William
authors.initials: W
authors.lastname: Garrett
mesh_terms: D000293:Adolescent; D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000517:prevention & control; D015444:Exercise; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000517:prevention & control*; D011434:Proprioception; D011446:Prospective Studies; D012916:Soccer / Q000293:injuries*