Comparative adaptations of lower limb biomechanics during uni-lateral and bi-lateral landings after different neuromuscular-based ACL injury prevention protocols.

Potentially valuable ACL injury prevention strategies are lengthy, limiting training success. Shorter protocols that achieve beneficial biomechanical adaptations may improve training effectiveness. This study examined whether core stability/balance and plyometric training can modify female landing biomechanics compared to the standard neuromuscular and no training models. Forty-three females had lower limb biomechanics analyzed during unilateral and bilateral landings immediately prior to and following a six-week neuromuscular or no training programs. Sagittal and frontal plane hip and knee kinematics and kinetics were submitted to three-way repeated measures ANOVAs to test for the main and interaction effects of training group, landing type and testing time. Greater peak knee flexion was evident in the standard neuromuscular group following training, during both bilateral (P=0.027) and unilateral landings (P=0.076 and d=0.633). The plyometric group demonstrated reduced hip adduction (P=0.010) and greater knee flexion (P =0.065 and d=0.564) during bilateral landings following training. The control group had significant reduction in peak stance knee abduction moment (P=0.003) post- as compared to pre-training. The current outcomes suggest significant biomechanical changes are possible via an isolated plyometric training component. The benefits, however, may not be evident across all landing types, seemingly limited to simplistic, bilateral landings. Integrated training protocols may still be the most effective training model, currently improving knee flexion posture during both bilateral and unilateral landings following training. Future prevention efforts should implement integrated training protocols that include plyometric exercises to reduce ACL injury risk of female athletes.