Abstract：
OBJECTIVE: Studies on adherence to neuromuscular training (NMT) for anterior cruciate ligament (ACL) injury prevention are frequently biased due to the use of self-reporting by coaches or the athletes themselves. Few NMT studies use data collectors (aside from the athletes or the individuals administering the NMT program) to decrease bias when assessing the adherence of coaches and sports teams. We hypothesized that the use of a data collector who is independent of the team to evaluate adherence to NMT programs would be reliable.
METHODS: In a prior a cluster-randomized controlled trial evaluating adherence to NMT training trial, twelve boys\' and nine girls\' high school athletic teams in a variety of sports were enrolled. Eight data collectors (unaffiliated with the NMT program) were hired specifically to record adherence of the athletes to the NMT exercises at each team\'s warm-ups 2-3 times a week, prior to practices and games. In addition to the data collectors, a control group of independent observers made visits throughout the season to also record adherence (solely for the purpose of this study, alongside the data collectors and in the same fashion) in order to evaluate the data collectors\' performance and determine inter-observer reliability. The inter-observer reliability between data collectors and independent observers was measured using the Kappa statistic.
RESULTS: A total of 399 warm-ups for practices or games were observed by data collectors to obtain adherence data. Independent observers also measured adherence at 58 practices or games for inter-observer reliability. Exercise instruction and alignment cues for 29 different exercises were analysed. The Kappa values ranged from 0.63 to 1.0, indicating substantial to perfect agreement. The overall Kappa values of 0.89 and 0.90 for exercise instruction and alignment cues, respectively, indicated almost perfect agreement.
CONCLUSIONS: The use of a data collector who is independent of the team to evaluate adherence to NMT programs (rather than athlete or coach self-reporting), was shown to be a reliable method for measurement of adherence in studies of NMT for injury prevention. Avoiding self-reporting in adherence research to NMT training may decrease bias.
METHODS: I.
METHODS: In a prior a cluster-randomized controlled trial evaluating adherence to NMT training trial, twelve boys\' and nine girls\' high school athletic teams in a variety of sports were enrolled. Eight data collectors (unaffiliated with the NMT program) were hired specifically to record adherence of the athletes to the NMT exercises at each team\'s warm-ups 2-3 times a week, prior to practices and games. In addition to the data collectors, a control group of independent observers made visits throughout the season to also record adherence (solely for the purpose of this study, alongside the data collectors and in the same fashion) in order to evaluate the data collectors\' performance and determine inter-observer reliability. The inter-observer reliability between data collectors and independent observers was measured using the Kappa statistic.
RESULTS: A total of 399 warm-ups for practices or games were observed by data collectors to obtain adherence data. Independent observers also measured adherence at 58 practices or games for inter-observer reliability. Exercise instruction and alignment cues for 29 different exercises were analysed. The Kappa values ranged from 0.63 to 1.0, indicating substantial to perfect agreement. The overall Kappa values of 0.89 and 0.90 for exercise instruction and alignment cues, respectively, indicated almost perfect agreement.
CONCLUSIONS: The use of a data collector who is independent of the team to evaluate adherence to NMT programs (rather than athlete or coach self-reporting), was shown to be a reliable method for measurement of adherence in studies of NMT for injury prevention. Avoiding self-reporting in adherence research to NMT training may decrease bias.
METHODS: I.
摘要：
目的：关于神经肌肉训练（NMT）对预防前交叉韧带（ACL）损伤的依从性的研究经常由于教练或运动员自己使用自我报告而存在偏见。在评估教练和运动队的依从性时，很少有NMT研究使用数据收集器（除了运动员或管理NMT计划的个人）来减少偏见。我们假设使用独立于团队的数据收集器来评估对NMT计划的遵守情况是可靠的。
方法：在之前的一项评估NMT训练试验依从性的集群随机对照试验中，参加了12个男孩和9个女孩的高中运动队，参加了各种运动。专门聘请了八名数据收集者（与NMT计划无关），以记录运动员每周2-3次在每支球队热身时对NMT练习的依从性，在练习和游戏之前。除了数据收集器，对照组的独立观察员在整个季节进行访问，以记录依从性（仅用于本研究的目的，沿着数据收集器并以相同的方式），以评估数据收集器的性能并确定观察者间的可靠性。使用Kappa统计量测量数据采集器和独立观察者之间的观察者间可靠性。
结果：数据收集者总共观察到399次练习或游戏的热身，以获取依从性数据。独立观察者还测量了58种实践或游戏的依从性，以确保观察者之间的可靠性。分析了29种不同运动的运动指导和对齐提示。Kappa值范围为0.63-1.0,表明实质到完美的一致性。运动指导和对齐提示的总体Kappa值为0.89和0.90，分别,表示几乎完美的协议。
结论：使用独立于团队的数据收集器来评估对NMT计划的依从性（而不是运动员或教练自我报告），在NMT预防伤害的研究中，被证明是测量依从性的可靠方法。在对NMT培训的依从性研究中避免自我报告可能会减少偏见。
方法：I.
方法：在之前的一项评估NMT训练试验依从性的集群随机对照试验中，参加了12个男孩和9个女孩的高中运动队，参加了各种运动。专门聘请了八名数据收集者（与NMT计划无关），以记录运动员每周2-3次在每支球队热身时对NMT练习的依从性，在练习和游戏之前。除了数据收集器，对照组的独立观察员在整个季节进行访问，以记录依从性（仅用于本研究的目的，沿着数据收集器并以相同的方式），以评估数据收集器的性能并确定观察者间的可靠性。使用Kappa统计量测量数据采集器和独立观察者之间的观察者间可靠性。
结果：数据收集者总共观察到399次练习或游戏的热身，以获取依从性数据。独立观察者还测量了58种实践或游戏的依从性，以确保观察者之间的可靠性。分析了29种不同运动的运动指导和对齐提示。Kappa值范围为0.63-1.0,表明实质到完美的一致性。运动指导和对齐提示的总体Kappa值为0.89和0.90，分别,表示几乎完美的协议。
结论：使用独立于团队的数据收集器来评估对NMT计划的依从性（而不是运动员或教练自我报告），在NMT预防伤害的研究中，被证明是测量依从性的可靠方法。在对NMT培训的依从性研究中避免自我报告可能会减少偏见。
方法：I.
