Is the Frequency of a Targeted Neuromuscular Training Program a Factor in Modifying Knee Joint Loading During Typical Netball Landing Tasks?

Background: Unplanned sidestep cutting and forward single-leg jump-landing contribute to non-contact anterior cruciate ligament (ACL) injuries in netball. Neuromuscular training programs (NMTPs) have shown promising results in reducing injury risk in certain populations when compliance is high. Compliance is easier to achieve when NMTPs are effective yet require minimal time for completion.

Hypothesis: Once- and thrice-weekly intervention groups would be equally effective in reducing knee abduction and internal rotation moments during forward single-leg jump landing and unplanned sidestep cutting.

Study design: Randomized controlled trial.

Level of evidence: Level 3.

Methods: External peak knee abduction and peak knee internal rotation moments during unplanned sidestep cutting and forward single-leg jump-landing were assessed pre- and post-intervention for 17 elite-level female netballers assigned randomly to either a once-weekly or thrice-weekly group. Regular netball training continued throughout the intervention, which lasted 6 weeks (30 minutes/session). One-way analysis of covariance (α = 0.05) was utilized to compare post-intervention peak knee abduction and peak knee internal rotation moments between groups, controlling for pre-intervention knee moments during the forward single-leg jump-landing and unplanned sidestep cut. Paired t tests were used to examine within-group changes in knee moments pre- versus post-intervention.

Results: For unplanned sidestep cuts on the right leg, both groups differed significantly, with the once-weekly group displaying a decrease in peak knee internal rotation moments [F(1,14) = 5.23; P = 0.04] whereas the thrice-weekly group did not. No other significant group interactions were found.

Conclusion: A condensed NMTP with targeted exercises, performed once-weekly as part of regular training, shows potential to reduce peak knee internal rotation moments that are injurious to the ACL during unplanned sidestep cutting in adult female netballers.

Clinical relevance: A once-weekly targeted NMTP would pose minimal disruption to a high-performing athlete's training schedule and likely increase compliance to ensure the success of the NMTP.