Balance As a Predictor of Ankle Injuries in High School Basketball Players

Objective: The purpose of this study was to determine if a preseason measurement of balance while in a unilateral stance could predict susceptibility to ankle injury in a cohort of high school basketball players. Predicting risk for ankle injury could be important in helping to reduce the risk of these injuries and furthermore save health care costs.

Design: Cohort study.

Setting: Data were collected at five high schools during the first 2 weeks of the 1997-1998 and 1998-1999 basketball seasons.

Subjects: 210 (119 male, age = 16.1 ± 1.1 yr; height = 182.98 ± 7.4 cm; weight = 76.4 ± 10.9 kg; and 91 female, age = 16.3 ± 1.3 yr; height = 170.9 ± 7.8 cm; weight = 63.4 ± 8.4 kg) high school basketball players who did not sustain a time loss ankle or knee injury within the previous 12 months served as subjects. Subjects did not use prophylactic ankle taping or bracing during the season.

Assessment of Risk Factors: Balance was quantified from postural sway scores measured while subjects performed unilateral balance tests with eyes both open and closed. Logistic regression analysis was carried out to determine if gender, dominant leg, and balance scores were related to ankle sprain injuries. In addition, Fischer's exact test was used to determine if the rate of ankle injuries was the same whether the subject had poor, average, or good balance. Balance was assessed by measuring postural sway with the NeuroCom New Balance Master version 6.0 (NeuroCom International, Clackamas, OR, U.S.A.). Testing to determine postural sway consisted of having subjects stand on one leg for three trials of 10 seconds with their eyes open, then repeated with their eyes closed. Subjects then underwent the same assessment while standing on the other leg. Postural sway was defined as the average degrees of sway per second (°S/S) for the 12 trials producing a compilation (COMP) score.

Outcome Measures: Ankle injury resulting in missed participation.

Results: Subjects who sustained ankle sprains had a preseason COMP score of 2.01 ± 0.32 (Mean ± SD), while athletes who did not sustain ankle injuries had a score of 1.74 ± 0.31. Higher postural sway scores corresponded to increased ankle sprain injury rates (p = 0.001). Subjects who demonstrated poor balance (high sway scores) had nearly seven times as many ankle sprains as subjects who had good balance (low sway scores) (p = 0.0002.)

Conclusion: In this cohort of high school basketball players, preseason balance measurement (postural sway) served as a predictor of ankle sprain susceptibility.

McGuine, Timothy A. MS ATC; Greene, Joe J. MS ATC; Best, Thomas MD, PhD; Leverson, Glen PhD

Basketball, ACL and Biomechanical Sports Injury Prenvention Training

Effects of Sports Injury Prevention Training on the Biomechanical Risk Factors of Anterior Cruciate Ligament Injury in High School Female Basketball Playersfrom The American Journal of Sports Medicine current issue by Lim, B.-O., Lee, Y. S., Kim, J. G., An, K. O., Yoo, J., Kwon, Y. H.1 person liked this
Background
Female athletes have a higher risk of anterior cruciate ligament injury than their male counterparts who play at similar levels in sports involving pivoting and landing.

Hypothesis
The competitive female basketball players who participated in a sports injury prevention training program would show better muscle strength and flexibility and improved biomechanical properties associated with anterior cruciate ligament injury than during the pretraining period and than posttraining parameters in a control group.

Study Design
Controlled laboratory study.

Methods
A total of 22 high school female basketball players were recruited and randomly divided into 2 groups (the experimental group and the control group, 11 participants each). The experimental group was instructed in the 6 parts of the sports injury prevention training program and performed it during the first 20 minutes of team practice for the next 8 weeks, while the control group performed their regular training program. Both groups were tested with a rebound-jump task before and after the 8-week period. A total of 21 reflective markers were placed in preassigned positions. In this controlled laboratory study, a 2-way analysis of variance (2 x 2) experimental design was used for the statistical analysis (P < .05) using the experimental group and a testing session as within and between factors, respectively. Post hoc tests with Sidak correction were used when significant factor effects and/or interactions were observed. Results A comparison of the experimental group’s pretraining and posttraining results identified training effects on all strength parameters (P = .004 to .043) and on knee flexion, which reflects increased flexibility (P = .022). The experimental group showed higher knee flexion angles (P = .024), greater interknee distances (P = .004), lower hamstring-quadriceps ratios (P = .023), and lower maximum knee extension torques (P = .043) after training. In the control group, no statistical differences were observed between pretraining and posttraining findings (P = .084 to .873). At pretraining, no significant differences were observed between the 2 groups for any parameter (P = .067 to .784). However, a comparison of the 2 groups after training revealed that the experimental group had significantly higher knee flexion angles (P = .023), greater knee distances (P = .005), lower hamstring-quadriceps ratios (P = .021), lower maximum knee extension torques (P = .124), and higher maximum knee abduction torques P (= .043) than the control group. Conclusion The sports injury prevention training program improved the strength and flexibility of the competitive female basketball players tested and biomechanical properties associated with anterior cruciate ligament injury as compared with pretraining parameters and with posttraining parameters in the control group. Clinical Relevance This injury prevention program could potentially modify the flexibility, strength, and biomechanical properties associated with ACL injury and lower the athlete’s risk for injury.