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Effect of Specific ACL Injury Prevention Training in Female Handball Players

Not Applicable
Active, not recruiting
Conditions
ACL Injury Prevention
Interventions
Other: ACL Injury Prevention Training
Other: Control - Shoulder Injury Prevention Training
Registration Number
NCT05955599
Lead Sponsor
Copenhagen University Hospital, Hvidovre
Brief Summary

The anterior Cruciate Ligament (ACL) injuries rates in female handball are high, particularly among adolescents. Therefore, the primary purpose of this randomized control trial is to explore the effects of an 8-week ACL injury prevention program on muscle activation of the medial hamstring muscles during sidecutting in female handball players.

Secondary aims are to evaluate if training effects are age-related (pre-adolescent: 11-13 year old vs. adults: ≥18 years old). The age-related comparisons Include:

1. Medial hamstring muscles activation during sidecutting;

2. Well-known biomechanical ACL injury-risk factors during high risk movements, such as cutting and landing tasks;

3. Cortical and muscular activity and functional connectivity patterns during controlled knee movements;

4. Visuomotor skill learning during a simple task involving the hamstring muscles.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
Female
Target Recruitment
80
Inclusion Criteria
  • Female handball players playing in youth teams from the age group under 13 (11-13 years old) and adult (≥18 - 40 years old) females playing for elite u19 or senior teams in Denmark
  • Have minimum 1 year of experience from playing handball
  • Mental and physical skills to complete the electrophysiological and biomechanical tests
Exclusion Criteria
  • Girls/women outside the age groups listed above
  • Prior surgeries to the lower limbs (e.g. ACL-reconstructions, meniscus lesions)
  • Current intake of medications that include antidepressants, anxiolytics, anticonvulsants, antipsychotics, antiparkinson, hypnotics, stimulants, and/or antihistamines
  • Neurological and/or psychiatric diagnoses
  • Pregnant

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Adult InterventionACL Injury Prevention TrainingAdult (≥18 year old) female handball players complete a supervised ACL injury prevention program twice a week (2 x 15 minutes) for a duration of 8 weeks. The ACL injury prevention training consists of three tracks focusing on 1) hamstring and hip external rotation strength; 2) medial hamstring activation; 3) single leg landing technique training with a special focus on knee control. The training is integrated in the players/team's normal handball practice.
Pre-adolescent ControlControl - Shoulder Injury Prevention Training11-13 year old female handball players complete a supervised shoulder injury prevention program twice a week (2 x 15 minutes) for a duration of 8 weeks. The shoulder injury prevention training consists of three tracks focusing on 1) external rotator cuff strength; 2) scapula stability; 3) core strength and trunk rotation. The training is integrated in the players/team's normal handball practice.
Adult ControlControl - Shoulder Injury Prevention TrainingAdult (≥18 year old) female handball players completed a supervised shoulder injury prevention program twice a week (2 x 15 minutes) for a duration of 8 weeks. The shoulder injury prevention training consists of three tracks focusing on 1) external rotator cuff strength; 2) scapula stability; 3) core strength and trunk rotation. The training is integrated in the players/team's normal handball practice.
Pre-adolescent InterventionACL Injury Prevention Training11-13 year old female handball players complete a supervised ACL injury prevention program twice a week (2 x 15 minutes) for a duration of 8 weeks. The ACL injury prevention training consists of three tracks focusing on 1) hamstring and hip external rotation strength; 2) medial hamstring activation; 3) single leg landing technique training with a special focus on knee control. The training is integrated in the players/team's normal handball practice.
Primary Outcome Measures
NameTimeMethod
Neuromuscular adaptations during sidecuttingChange from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Semitendinosus muscle pre-activity (sEMG) duirng handball specific sidecutting. Outcome measure is expressed in %MVC.during sidecutting.

Secondary Outcome Measures
NameTimeMethod
Changes in 3D hip and knee joint momentsChange from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Hip and knee joint kinetics for sidecutting and single-leg landings. Outcome is expressed in three-dimensional joint moments (M)

Changes in hamstring and quadriceps pre-activationChange from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Hamstring (biceps femoris) and quadriceps (vastus lateralis and medialis) pre-activation (sEMG) during sidecutting and single-leg landings. Outcome measure is expressed in %MVC.

Changes in shoulder sensorimoter stabilityChange from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Shoulder sensorimoter stability measured as CoP length (mm) from force platform data.

Changes in isometric strengthChange from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Peak isometric hamstring and hip external rotation strength, respectively. Outcome measure is expressed in force (Newtons).

Changes in Shoulder Rotator Cuff StrengthChange from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Peak isometric internal and external rotator cuff strength. Outcome measure is expressed in force (Newtons).

Changes in 3D hip and knee joint anglesChange from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Hip and knee joint kinematic for sidecutting and single-leg landings. This include joint kinetics at initial contact and local maximum and minimums. Outcome is expressed in three-dimensional joint angles (degrees)

Visuomotor Skill LearningChange from Baseline to Baseline +1 Day, Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Age-related differences in motor performance, skill acquisition and retention during and following visuomotor skill practice. Specific outcomes measure will be time on target (seconds per target).

Trial Locations

Locations (3)

Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark

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Copenhagen, Denmark

Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen

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Copenhagen, Denmark

Human Movement Analysis Laboratory, Department of Orthopaedic Surgery, Copenhagen University Hospital

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Hvidovre, Denmark

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