Brown Tyler N, Palmieri-Smith Riann M, McLean Scott G
1U.S. Army Natick Soldier Research, Development and Engineering Center, Natick, Massachusetts; and 2School of Kinesiology, The University of Michigan, Ann Arbor, Michigan.
J Strength Cond Res. 2014 Oct;28(10):2859-71. doi: 10.1519/JSC.0000000000000472.
Potentially valuable anterior cruciate ligament (ACL) injury prevention strategies are lengthy, limiting training success. Shorter protocols that achieve beneficial biomechanical adaptations may improve training effectiveness. This study examined whether core stability/balance and plyometric training can modify female landing biomechanics compared with the standard neuromuscular and no training models. Forty-three females had lower limb biomechanics analyzed during unilateral and bilateral landings immediately before and after a 6-week neuromuscular or no training programs. Sagittal and frontal plane hip and knee kinematics and kinetics were submitted to 3-way repeated-measures analyses of variance to test for the main and interaction effects of training group, landing type, and testing time. Greater peak knee flexion was evident in the standard neuromuscular group following training, during both bilateral (p = 0.027) and unilateral landings (p = 0.076 and d = 0.633). The plyometric group demonstrated reduced hip adduction (p = 0.010) and greater knee flexion (p = 0.065 and d = 0.564) during bilateral landings following training. The control group had significant reduction in peak stance knee abduction moment (p = 0.003) posttraining as compared with pretraining. The current outcomes suggest that significant biomechanical changes are possible by an isolated plyometric training component. The benefits, however, may not be evident across all landing types, seemingly limited to simplistic, bilateral landings. Integrated training protocols may still be the most effective training model, currently improving knee flexion posture during both bilateral and unilateral landings following training. Future prevention efforts should implement integrated training protocols that include plyometric exercises to reduce ACL injury risk of female athletes.
潜在有价值的前交叉韧带（ACL）损伤预防策略耗时较长，限制了训练成效。能实现有益生物力学适应性改变的较短方案可能会提高训练效果。本研究探讨了与标准神经肌肉训练模型和无训练模型相比，核心稳定性/平衡训练和增强式训练能否改变女性着陆时的生物力学特征。43名女性在参加为期6周的神经肌肉训练计划或无训练计划前后，分别对其单腿和双腿着陆时的下肢生物力学进行分析。矢状面和额状面的髋部和膝部运动学及动力学数据进行了三因素重复测量方差分析，以检验训练组、着陆类型和测试时间的主效应及交互效应。训练后，标准神经肌肉训练组在双腿（p = 0.027）和单腿着陆（p = 0.076，d = 0.633）时，膝关节屈曲峰值均更明显。增强式训练组在训练后的双腿着陆时，髋关节内收减少（p = 0.010），膝关节屈曲增加（p = 0.065，d = 0.564）。与训练前相比，对照组训练后站立期膝关节外展力矩峰值显著降低（p = 0.003）。目前的研究结果表明，单独的增强式训练部分可能会带来显著的生物力学变化。然而，这些益处可能并非在所有着陆类型中都明显，似乎仅限于简单的双腿着陆。综合训练方案可能仍然是最有效的训练模式，目前可在训练后的双腿和单腿着陆时改善膝关节屈曲姿势。未来的预防措施应采用包括增强式练习的综合训练方案，以降低女性运动员ACL损伤风险。
