Female Soccer Players at High Risk of Injury Maintained Improved Knee Abduction Load 6 Months After Neuromuscular Training Program.

OBJECTIVE

To estimate immediate and long-term (retention) improvements in knee abduction moment (KAM) following a neuromuscular training (NMT) program with augmented biofeedback in individuals at high and low risk for injury.

DESIGN

Secondary analysis of a randomized controlled trial.

METHODS

One hundred fifty adolescent female soccer players were enrolled in a 6-week NMT program and randomized to biofeedback training groups: NMT + Hip-focus (NMT+H), NMT + Knee-focus (NMT+K), or NMT with a sham biofeedback. NMT was completed 3 times each week with augmented biofeedback delivered once per week. Standard 3-dimensional motion analysis of a drop vertical jump over artificial turf with embedded force platforms was performed at baseline (PRE), immediately following training (POST), and 6 months post training (RET). Baseline measures of KAM were used to stratify participants into low- (n = 87, 12.7 ± 2.2 years, 153.0 ± 11.4 cm, 47.2 ± 11.8 kg) and high-risk (n = 44, 14.0 ± 1.8 years, 161.6 ± 5.8 cm, 53.5 ± 9.2 kg) groups, based on a previously determined cut point. A mixed-design analysis of variance with between-group factors of risk (high, low) and training group (NMT+H, NMT+K, NMT), and a repeated within-group factor of session (PRE, POST, RET) were used for the analysis.

RESULTS

A significant interaction was identified between risk and session (P < .001). Within training groups, the high-risk group had a significant reduction in KAM from baseline to posttest, and from baseline to 6 months (PRE: -37.5 ± 9.0 N m; POST: -25.2 ± 11.4 N m; RET: -29.4 ± 14.5 N m). There were no changes in the low-risk group (PRE: -12.2 ± 6.2 N m; POST: -12.2 ± 7.6 N m; RET: -12.9 ± 8.7 N m).

CONCLUSION

Female soccer players with knee biomechanics that put them at high risk for anterior cruciate ligament injury had improved KAM following an NMT program. The changes in KAM remained at 6 months after training. J Orthop Sports Phys Ther 2026;56(10):689-698. Epub 28 Aug 2026. doi:10.2519/jospt.2026.14125.