No association between static and dynamic postural control and ACL injury risk among female elite handball and football players: a prospective study of 838 players.
BACKGROUND
Research on balance measures as potential risk factors for ACL injury is limited.


OBJECTIVE
To assess whether postural control was associated with an increased risk for ACL injuries in female elite handball and football players.


METHODS
Premier league players were tested in the preseason and followed prospectively for ACL injury risk from 2007 through 2015. At baseline, we recorded player demographics, playing experience, ACL and ankle injury history. We measured centre of pressure velocity in single-leg stabilisation tests and reach distances in the Star Excursion Balance Test. To examine the stability of postural control measures over time, we examined their short-term and long-term reproducibility. We generated logistic regression models, 1 for each of the proposed risk factors.


RESULTS
A total of 55 (6.6%) out of 838 players (age 21±4 years; height 170±6 cm; body mass 66±8 kg) sustained a non-contact ACL injury after baseline testing (1.8±1.8 years). When comparing normalised balance measures between injured and uninjured players in univariate analyses, none of the variables were statistically associated with ACL injury risk. Short-term and long-term reproducibility of the selected variables was poor. Players with a previous ACL injury had a 3-fold higher risk of sustaining a new ACL injury compared with previously uninjured players (OR 2.9, CI 1.4 to 5.7).


CONCLUSIONS
None of postural control measures examined were associated with increased ACL injury risk among female elite handball and football players. Hence, as measured in the current investigation, the variables included cannot be used to predict ACL injury risk.
Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Kathrin
K
Steffen
Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Agnethe
A
Nilstad
Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Tron
T
Krosshaug
Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, Tampere, Finland.
Kati
http://orcid.org/0000-0002-0427-2877
K
Pasanen
Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Aleksander
A
Killingmo
Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Roald
R
Bahr
D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000453:epidemiology; D000070598:Anterior Cruciate Ligament Injuries / Q000453:epidemiology*; D001265:Athletic Injuries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D004856:Postural Balance; D011446:Prospective Studies; D012307:Risk Factors; D012916:Soccer / Q000293:injuries*; D055815:Young Adult
ACL; Football; Handball; Injury prevention; Risk factor