Neuromuscular training for ACL injury prevention in collegiate athletes: a four-week program improves biomechanical risk factors and functional performance.

Abstract

Background: Collegiate athletes face a high risk of non-contact ACL injuries during pivoting and landing maneuvers. Current evidence supports neuromuscular training for injury prevention, but optimal program duration and specific adaptations remain unclear. This study investigated whether a four-week neuromuscular training program could enhance functional performance and modifiable biomechanical risk factors in high-risk athletes.

Methods: This single-group pre-/post-test design recruited 30 competitive collegiate athletes (median age: 18.5 years; interquartile range [IQR]: 17-25) who completed a 12-session, four-week neuromuscular training program incorporating dynamic stabilization, plyometrics, proprioceptive exercises, and agility drills. Functional outcomes were assessed pre- and postintervention using the Y-Balance Test (YBT), Single Leg Squat Test (SLST), and Illinois Agility Test (IAT).

Results: Following the four-week intervention, participants demonstrated significant improvements across all outcome measures. The Y-Balance Test (YBT) showed an 11.8% improvement in composite scores (P<0.001, d=1.2), indicating enhanced dynamic balance. Movement quality assessed through the Single Leg Squat Test (SLST) revealed a 27% reduction in errors (P<0.001, d=1.5), reflecting improved lower limb control. For sport-specific performance, athletes completed the Illinois Agility Test (IAT) 8.9% faster (P<0.001, d=0.9), demonstrating gains in change-of-direction speed.

Conclusions: This four-week intervention was associated with improvements in dynamic balance, movement quality, and agility. While these findings suggest that short-duration neuromuscular training may support favorable functional adaptations, the absence of a control group limits causal interpretation. Therefore, results should be considered preliminary and hypothesis-generating. Further controlled trials are required to confirm the effectiveness of this multimodal approach.