UNASSIGNED: Neuromuscular training (NMT) programs delivered by trained personnel have demonstrated protective effects against anterior cruciate ligament (ACL) injury among high school sports participants, but few studies have investigated the impact of education on high school sports coaches\' knowledge and incorporation of NMT programs into daily practice sessions.
UNASSIGNED: We sought to evaluate changes in knowledge and behavior among high school sports coaches who completed an NMT-based injury prevention training program.
UNASSIGNED: High school sports coaches were invited to complete a free online training course in incorporating NMT into daily practice sessions. Anonymized surveys were administered before and after education and at 3 months to evaluate knowledge level and program effectiveness.
UNASSIGNED: Of the 13,640 coaches who enrolled in the training course in 2019, 1641 submitted pre- and post-education and 3-month follow-up surveys. Prior to training, 4.4% reported incorporating NMT into daily training sessions and the mean knowledge score was 1.89 ± 1.55. After training, 92.7% of participants reported that they intended to incorporate NMT into their daily training sessions and the mean knowledge score was 4.87 ± 1.11. At 3-month follow-up, 88.9% of participants reported incorporating NMT into daily training sessions. A chi-square test revealed a significant association between pre- and post-education incorporation of NMT into daily practice sessions, and a multiple regression analysis resulted in a significant model with intent to incorporate NMT into daily practice sessions identified as a significant behavior predictor.
UNASSIGNED: These survey results show that completion of a training course significantly improved ACL injury prevention knowledge among a cohort of high school sports coaches and likely contributed to the sustained incorporation of NMT into their daily practice sessions.

UNASSIGNED: This study aimed to compare the effect of flexi-bar and stabilization exercises on static and dynamic postural control in patients with chronic nonspecific low back pain.
UNASSIGNED: In this randomized controlled study conducted between November 2019 and March 2020, 38 patients (19 males, 19 females; mean age: 33.8±6.2 years; range, 20 to 45 years) were randomly assigned into flexi-bar (n=19) and stabilization (n=19) groups. Both groups received general physiotherapy for three sessions per week, a total of 10 sessions. Besides, the flexi-bar group received flexi-bar exercises, and the stabilization group received stabilization exercises. Postural sway was assessed with a force platform in three difficult conditions, including open eye, close eye, and one-leg standing and dynamic posture with the modified Star Excursion Balance Test.
UNASSIGNED: After the intervention, both groups showed a significant improvement in static and dynamic postural control (p<0.05). However, no significant differences were found between groups after treatment, while only the phase-plane portrait of opened eyes condition was significantly improved (p=0.03), in the flexi-bar group compared to the stabilization group.
UNASSIGNED: Both flexi-bar and stabilization exercises effectively improved static and dynamic postural control, but none of the exercises was superior to the other. Flexi-bar is recommended as an effective tool in low back pain rehabilitation.

BACKGROUND: Ankle sprains are frequent injuries in general practice. However, no effective treatment is available yet.
OBJECTIVE: To examine the effectiveness of an unsupervised e-health-supported neuromuscular training programme in combination with usual care compared with usual care alone in patients with acute lateral ankle sprains in general practice.
METHODS: Randomised controlled trial with 1-year follow-up among patients (14-65 years) who visited the GP with an acute lateral ankle sprain within 3 weeks of injury.
METHODS: The intervention group received, in addition to usual care, an unsupervised e-health-supported neuromuscular training programme and the control group received usual care alone. The primary outcome was self-reported re-sprains during 52 weeks of follow-up. Secondary outcomes were ankle function, pain in rest and during activity, subjective recovery, and return to the same type and level of sport.
RESULTS: In total, 165 participants (mean age 38.3 years and 69 [41.8%] male) were included. No statistically significant difference in the occurrence of a re-sprain were found between the intervention 20.7% (17/82) and control group 24.1% (20/83) (hazard ratio 1.14, 95% confidence interval = 0.59 to 2.21). Also, no statistically significant differences in secondary outcomes were found between groups. The adherence rate to the programme was low (6.1%, 5/82).
CONCLUSIONS: The rate of re-sprains was relatively high and an unsupervised e-health-supported neuromuscular training programme does not yield meaningful effects and does not encourage adherence in preventing re-sprains in patients in general practice. More research is necessary to indicate the best treatment modality and way of delivery for these patients.

UNASSIGNED: Neurofeedback training (NFT) can aid in the treatment of the abnormal patterns of the brain brought on by physical injury, enhancing cognitive and behavioral abilities. The present study aimed to compare the effectiveness of combining neuromuscular training (NMT) and NFT (NMT+NFT) with NMT alone in rehabilitating athletes with chronic ankle instability (CAI).
UNASSIGNED: NMT+NFT will be more effective than NMT alone.
UNASSIGNED: A 3-arm, single-blind randomized controlled trial.
UNASSIGNED: Level 2.
UNASSIGNED: A total number of 62 athletes, aged 18 to 25 years, with CAI, participated in this study. The study subjects were allocated randomly to 3 groups: 21 cases in the control group, 21 cases in the combination group (CG) receiving NMT+NFT, and 20 cases in the neuromuscular group (NG) practicing NMT alone, undergoing exercises related to their groups for 8 weeks. Data were recorded and analyzed before and after the 8-week training program. The primary outcome measures were postural sway indices; secondary outcomes included ankle proprioception and biopsychosocial indices.
UNASSIGNED: NMT+NFT was more effective than NMT alone in terms of improving postural control during single- and 2-legged standing positions under the conditions of eyes closed and eyes open, proprioception at 20° of plantar flexion, as well as anxiety and depression in athletes with CAI. However, the findings revealed that NMT+NFT and NMT alone could both improve such indices.
UNASSIGNED: NMT+NFT as a treatment protocol improved postural control, ankle proprioception, anxiety, and depression greater than NMT alone.
UNASSIGNED: A combined protocol of NFT and NMT led to greater improvement compared with NMT alone. NFT was recommended as an adjunct therapy in the rehabilitation of athletes suffering from CAI.

Aim: The aim of this paper is to determine the effect of 6 weeks of plyometric training on speed, explosive power, pre-planned agility, and reactive agility in young tennis players. Methods: The participants in this study included 35 male tennis players (age 12.14 ± 1.3 years, height 157.35 ± 9.53 cm and body mass 45.84 ± 8.43 kg at the beginning of the experiment). The biological age was calculated and determined for all participants. 18 of the participants were randomly assigned to the control group, and 17 were assigned to the experimental group. Running speed (sprints at 5, 10, and 20 m), change of direction speed (4 × 10, 20 yards, t-test, TENCODS), reactive agility (TENRAG), and explosive power (long jump, single leg triple jump, countermovement jump, squat jump, and single leg countermovement jump) were all tested. The Mixed model (2 × 2) ANOVA was used to determine the interactions and influence of a training program on test results. Furthermore, Bonferroni post hoc test was performed on variables with significant time*group interactions. Results: The results of this research indicate that an experimental training program affected results in a set time period, i.e. 5 out of total 15 variables showed significant improvement after experimental protocol when final testing was conducted. The experimental group showed significantly improved results in the 5 m sprint test in the final testing phase compared to the initial testing phase, this was also the case in comparison to the control group in both measurements. Furthermore, the experimental group showed significant improvement in the single leg countermovement jump in the final test, as well as in comparison to the control group in both measurements. The change of direction speed and reactive agility test also exhibited significant improvement in the final testing phase of the experimental group. Conclusion: The results of this research indicated that a 6-week program dominated by plyometric training can have a significant effect on the improvement of specific motor abilities within younger competitive categories. These results offer valuable insights for coaches in designing diverse tennis-specific scenarios to enhance overall performance, particularly focusing on the neuromuscular fitness of their players.

BACKGROUND: Injury prevention exercise programmes (IPEPs) efficaciously reduce injuries. However, it is challenging to achieve sufficient adherence across a season. The main aim was to describe adherence to IPEPs in three groups of coaches and players partaking in a cluster randomised trial. Secondary aims were to describe perceptions of IPEPs, use of programme material, and overall preventive strategies.
METHODS: This is a sub-study analysing data from a three-armed randomised trial with teams randomised to use either a comprehensive IPEP (extended Knee Control) or an adductor strength programme, and non-randomised teams that already used a self-chosen IPEP regularly at study start (comparison group). Teams were instructed to use their respective intervention across the 2020 football season. Male and female, adolescent (≥ 14 years of age), and adult amateur players took part. Coaches and players responded to weekly and end-of-season questionnaires. Data were presented descriptively.
RESULTS: Weekly player data were reported by 502 players (weekly response rate 65%), 289 (58%) responded to end-of-season questionnaires. Teams in the extended Knee Control and comparison group used their respective IPEP in 483/529 (91%) and 585/641 (91%) of training sessions, and teams in the adductor group in in 199/315 (63%) sessions. Regarding utilisation fidelity, 42-52% of players in each group used 1-10 repetitions per exercise. Seven out of 17 teams in the adductor group had progressed as recommended in terms of number of repetitions. Two teams (10%) in the extended Knee Control group, and 7/24 of comparison teams used the same exercises across the season. Coaches accessed the IPEPs by different means (printed material, films, workshops, etc.), but half did not use the provided digital material. The players appreciated that the IPEPs could reduce injury risk and that they improved their exercise performance, but disliked that they had less time for football and that the exercises were boring. Forty-nine players had experienced pain during IPEP performance.
CONCLUSIONS: Adherence with the IPEPs was generally high. To meet different coach needs, programme material should be available via different digital and printed resources. The number of players reporting pain during IPEP performance is a noteworthy finding.
BACKGROUND: Clinical Trials gov identifier: NCT04272047. Registered February 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04272047 .

UNASSIGNED: This study aimed to evaluate the effect of motivational interviewing (MI) and mindfulness (MF) added to neuromuscular (NM) exercises on improving pain, function, balance, and quality of life in patients with knee osteoarthritis (KOA).
UNASSIGNED: This randomized clinical trial was conducted on sixty patients who were randomly assigned to the MI + NM, MF + NM, and NM groups. The groups received four training sessions for six weeks. Physical function with Western Ontario and McMaster Universities Arthritis Index timed up and go, going up and down eight stairs, pain with visual analogue scale, quality of life with SF36, and balance with Biodex were evaluated before and after interventions.
UNASSIGNED: Within-group comparisons showed that NM + MI, NM + MF, and NM groups experienced significant improvement in all factors after six-week (p < 0.05). However, between groups, comparisons in the post-test revealed that the MI + NM group had a more significant effect on pain, function, and static balance than the MF + NM group. Nevertheless, the MF + NM group improved the quality of life better than the MI + NM and NM groups (p < 0.05).
UNASSIGNED: Adding psychological interventions to physical exercises had a better effect on improving the symptoms of patients. Additionally, the MI showed more effectiveness in improving the symptoms of patients.
Adding motivational interviewing to neuromuscular exercises has shown to reduce pain intensity and improved function, balance and quality of life in adults with knee osteoarthritis.Adding mindfulness intervention to neuromuscular exercises has shown to reduce pain intensity and improved function, balance and quality of life in adults with knee osteoarthritis.Among the psychological interventions used, the motivational interviewing significantly showed more effectiveness in improving the pain, function, balance, and quality of life of patients with osteoarthritis.

BACKGROUND: Youth participation in team ball sports is associated with a risk of both acute and gradual onset injuries but today there are several efficacious injury prevention exercise programmes (IPEPs). However, there is limited research about how to implement those programmes and the perceived barriers and facilitators among end-users.
OBJECTIVE: To investigate perceptions of the IPEP Knee Control and facilitators and barriers to programme use among coaches and youth floorball players, and explore factors associated with planned maintenance of Knee Control.
METHODS: This cross-sectional study is a sub-analysis of data from the intervention group of a cluster randomised controlled trial. Perceptions about Knee Control and facilitators and barriers to programme use were evaluated with surveys pre-intervention and post-season. 246 youth floorball players aged 12-17 years, and 35 coaches that reported no use of IPEPs during the preceding year were included. Descriptive statistics and univariate and multivariate ordinal logistic regression models were undertaken with the dependent variables: coaches\' planned maintenance and players\' opinions of maintenance of Knee Control. Independent variables were perceptions, facilitators and barriers regarding use of Knee Control and other potential influencing factors.
RESULTS: 88% of the players believed that Knee Control can reduce injury risk. Common facilitators to Knee Control use among coaches were support, education and high player motivation, and common barriers were that injury prevention training was time-consuming, lack of space to execute the exercises and lack of player motivation. Players who planned to maintain use of Knee Control had higher outcome expectancies and belief in one\'s ability to use Knee Control (action self-efficacy). Coaches who planned to maintain Knee Control had higher action self-efficacy and to a lesser extent considered that Knee Control takes too much time.
CONCLUSIONS: Support, education, and high player motivation are key facilitators, while lack of time and space for injury prevention training and boring exercises are key barriers for coaches and players to use Knee Control. High action self-efficacy among coaches and players seems to be a prerequisite for maintained use of IPEPs.

[This corrects the article DOI: 10.3389/fpsyg.2022.844678.].

UNASSIGNED: To determine the effectiveness of neuromuscular physical Therapy as compared to strength training following anterior cruciate ligament reconstruction in terms of pain, function, quality of life, strength and power of participants.
UNASSIGNED: A randomized clinical trial was conducted at Kanaan Physiotherapy & Spine Clinic, Lahore, Pakistan from July 2020 to December 2020. Seventy-six patients were selected by non-probability convenience sampling technique and randomly divided into either neuromuscular training or strength training group. Sample included 20-40 years aged adults with unilateral anterior cruciate ligament injury who had undergone surgical reconstruction of ACL two months ago using hamstring graft. Patients were assessed using the Cincinnati Knee Score for function, Numeric Pain Rating Scale (NPRS) for pain, SF-36 for quality of life, and Single Leg Hop, Triple Hop, Crossover Hop and 6-meter Hop test for power and strength. Data was analyzed using SPSS Version-21. A t-test was used to assess difference between groups. P<0.05 was considered significant.
UNASSIGNED: Results revealed that neuromuscular training is statistically significant in reducing pain (p<0.001) and improving function (p<0.001), power & strength (p<0.001) and quality of life (p=0.001).
UNASSIGNED: Study concludes that compared to strength training, neuromuscular training was significantly more effective in reducing pain; improving function, quality of life, strength and power.