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Injury Prevention Programmes Fail to Change Most Lower Limb Kinematics and Kinetics in Female Team Field and Court Sports: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

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Abstract

Background

One mechanism by which exercise interventions may be effective in reducing anterior cruciate ligament (ACL) injury risk is through changes in lower limb biomechanics. Understanding how training programmes affect lower-limb kinematics and kinetics may help refine injury prevention programmes.

Objective

The aim of this systematic review and meta-analysis was to assess the effect of injury prevention programmes on kinematics and kinetics during tasks related to ACL injury in female team field and court sports.

Data Sources

Five databases were searched in October 2022.

Eligibility Criteria

Randomised controlled trials assessing the effect of injury prevention programmes compared with usual training/no training on lower limb kinematics and kinetics in female team field and court sports were eligible for review.

Results

Sixteen studies were included. A total of 976 female athletes were included. Most of the studies included interventions with multiple components (12/16). Commonly used components were plyometrics (12/16), strength (8/16), and balance/stability (7/16). Thirteen studies had routine training or sham interventions as the control group and three studies had no training. Very low certainty evidence suggests that injury prevention programmes increase knee flexion angles (mean difference = 3.1° [95% confidence interval 0.8–5.5]); however, very low to low certainty evidence suggests no effect on hip flexion angles/moments, knee flexion moments, hip adduction angles/moments, knee adduction angles/moments, hip internal rotation angles/moments, ankle dorsiflexion angles, and ground reaction forces, compared with usual training/no training.

Conclusion

Injury prevention programmes may be effective in increasing knee flexion angles during dynamic landing and cutting tasks but may have no effect on other lower limb biomechanical variables. As such, the benefits of injury prevention programmes may be mediated by factors other than altered biomechanics and/or may happen through other biomechanical measures not included in this review.

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Authors and Affiliations

  1. School of Health Sciences and Social Work, Clinical Sciences G02, Griffith University, Parklands Drive, Southport, QLD, 4215, Australia

    Yuri Lopes Lima, Tyler J. Collings, Matthew N. Bourne & Laura E. Diamond

  2. Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Griffith University, Southport, Australia

    Yuri Lopes Lima, Tyler J. Collings, Matthew N. Bourne & Laura E. Diamond

  3. Sydney Musculoskeletal Health, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia

    Michelle Hall

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  1. Yuri Lopes Lima
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Correspondence to Yuri Lopes Lima.

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Funding

No funding was received to conduct this review. LED is supported by a National Health and Medical Research Council (NHMRC) Investigator Grant Emerging Leadership Level 1 (#2017012). MH is supported by an NHMRC Investigator Grant Emerging Leadership Level 1 (#1172928).

Conflict of interest

The authors declare no competing interests.

Availability of data and material

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Author contributions

YLL, TC, LED, and MNB conceived and designed the study. YLL conducted the search. YLL and TC conducted the quality appraisal and data extraction. All authors contributed to data analysis and interpretation of results. YLL drafted the manuscript with input from TC, ML, LED, and MNB. All authors have read and approved the final manuscript.

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Lima, Y.L., Collings, T.J., Hall, M. et al. Injury Prevention Programmes Fail to Change Most Lower Limb Kinematics and Kinetics in Female Team Field and Court Sports: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Sports Med 54, 933–952 (2024). https://doi.org/10.1007/s40279-023-01974-2

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