Article Text

Download PDFPDF
Do exercises used in injury prevention programmes modify cutting task biomechanics? A systematic review with meta-analysis
  1. Evangelos Pappas1,2,
  2. Elizabeth J Nightingale1,
  3. Milena Simic1,
  4. Kevin R Ford3,4,5,
  5. Timothy E Hewett4,5,6,
  6. Gregory D Myer4,5,6,7
  1. 1Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Lidcombe, New South Wales, Australia
  2. 2Department of Orthopaedic Surgery, Orthopaedic Sports Medicine Center of Ioannina, School of Medicine, Ioannina, Greece
  3. 3Department of Physical Therapy, School of Health Sciences, High Point University, High Point, North Carolina, USA
  4. 4Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
  5. 5Division of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
  6. 6Departments of Physiology & Cell Biology, Orthopaedic Surgery, Family Medicine and Biomedical Engineering OSU Sports Medicine, The Sports Health & Performance Institute, The Ohio State University, Columbus, Ohio, USA
  7. 7The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts, USA
  1. Correspondence to Dr Evangelos Pappas, Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, 75 East Street, O153, Lidcombe, NSW 2141, Australia; evangelos.pappas{at}


Objective Some injury prevention programmes aim to reduce the risk of ACL rupture. Although the most common athletic task leading to ACL rupture is cutting, there is currently no consensus on how injury prevention programmes influence cutting task biomechanics. To systematically review and synthesise the scientific literature regarding the influence of injury prevention programme exercises on cutting task biomechanics.

Design The three largest databases (Medline, EMBASE and CINAHL) were searched for studies that investigated the effect of injury prevention programmes on cutting task biomechanics. When possible meta-analyses were performed.

Results Seven studies met the inclusion criteria. Across all studies, a total of 100 participants received exercises that are part of ACL injury prevention programmes and 76 participants served in control groups. Most studies evaluated variables associated with the quadriceps dominance theory. The meta-analysis revealed decreased lateral hamstrings electromyography activity (p≤0.05) while single studies revealed decreased quadriceps and increased medial hamstrings activity and decreased peak knee flexion moment. Findings from single studies reported that ACL injury prevention exercises reduce neuromuscular deficits (knee valgus moment, lateral trunk leaning) associated with the ligament and trunk dominance theories, respectively. The programmes we analysed appear most effective when they emphasise individualised biomechanical technique correction and target postpubertal women.

Conclusions The exercises used in injury prevention programmes have the potential to improve cutting task biomechanics by ameliorating neuromuscular deficits linked to ACL rupture, especially when they emphasise individualised biomechanical technique correction and target postpubertal female athletes.

  • ACL
  • Adolescent
  • Biomechanics
  • Injury
  • Knee injuries

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles