Sports Injuries

Retention of Movement Pattern Changes After a Lower Extremity Injury Prevention Program Is Affected by Program Duration

1. Darin A. Padua, PhD, ATC*,†, 
2. Lindsay J. DiStefano, PhD, ATC‡,
3. Stephen W. Marshall, PhD§, 
4. Anthony I. Beutler, MD‖,
5. Sarah J. de la Motte, PhD, ATC‖ and 
6. Michael J. DiStefano, MA, ATC†

+Author Affiliations

1. ^†Department of Exercise and Sports Science, Sports Medicine Research Laboratory, University of North Carolina, Chapel Hill, North Carolina
2. ^‡Department of Kinesiology, University of Connecticut, Storrs, Connecticut
3. ^§Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
4. ^‖Uniformed Services University of the Health Sciences, Bethesda, Maryland
5. Investigation performed at the University of North Carolina, Chapel Hill

1. ↵* Darin A. Padua, PhD, ATC, University of North Carolina at Chapel Hill, 216 Fetzer Gym CB#8700, Chapel Hill, NC 27599 (dpadua@email.unc.edu).

Abstract

Background: Changes in movement patterns have been repeatedly observed immediately after completing a lower extremity injury prevention program. However, it is not known if movement pattern changes are maintained after discontinuing the training program.

Hypothesis: The ability to maintain movement pattern changes after training has ceased may be influenced by the program’s duration. The authors hypothesized that among individuals who completed either a 3-month or 9-month training program and who demonstrated immediate movement pattern changes, only those who completed the 9-month training program would maintain movement pattern changes after a 3-month period of no longer performing the exercises.

Study Design: Cohort study; Level of evidence, 2.

Methods: A total of 140 youth soccer athletes from 15 separate teams volunteered to participate. Athletes’ movement patterns were assessed using the Landing Error Scoring System (LESS) at pretest, posttest, and 3 months after ceasing the program (retention test). Eighty-four of the original 140 participants demonstrated improvements in their LESS scores between pretest and posttest (change in LESS score >0) and were included in the final analyses for this study (n = 84; 20 boys and 64 girls; mean age, 14 ± 2 years; age range, 11-17 years). Teams performed 3-month (short-duration group) and 9-month (extended-duration group) injury prevention programs. The exercises performed were identical for both groups. Teams performed the programs as part of their normal warm-up routine.

Results: Although both groups improved their total LESS scores from pretest to posttest, only the extended-duration training group retained their improvements 3 months after ceasing the injury prevention program (F_2,137 = 3.38; P = .04).

Conclusion: Results suggest that training duration may be an important factor to consider when designing injury prevention programs that facilitate long-term changes in movement control.

Keywords:

• injury prevention
 
• motor learning
 
• ACL
 
• soccer
 
• movement control