Research summary: comparison of ACL prevention strategies

Reducing ACL injury risk isn't just about biomechanics and S&C. It's one thing have that knowledge, it's another turning into an effective intervention that successfully reduces risk. As a practitioner, it's easy to forget that athletes, coaches and parents have a variety of knowledge and interest in the area. Finding ways to engage everyone and develop their knowledge and interest is just as important as designing good programs. This is a nice study by William Suits and colleagues comparing different strategies. A lot work went into the study and the knowledge to action intervention is very impressive, especially given the size of the cohort involved.

Study Description

This prospective cohort study compared two implementation strategies, an educational handout and a knowledge-to-action (KTA) intervention, for promoting the implementation of an anterior cruciate ligament (ACL) injury prevention program (ACL-IPP) in amateur youth girls' soccer. The primary outcomes measured were the frequency of ACL-IPP implementation and the risk of ACL injury. The study included 671 amateur female soccer players (15.72±1.78 years) whose coaches received either a KTA intervention (n=400) or an educational handout (n=271) regarding implementing an ACL-IPP. Over a single season, the researchers tracked the number of ACL injuries weekly and implementation rates at the end of the season through coach surveys.

Results Analysis

The results showed that the KTA intervention yielded a significantly higher ACL-IPP implementation rate compared to the educational handout (75.5% vs. 56.8%, p<0.001). Implementation of the ACL-IPP at least two times per week was associated with a lower risk of ACL injuries (HR=0.15, 95% CI=0.03, 0.73; p=0.019) compared to implementing it once per week or less. However, the type of implementation intervention (KTA or educational handout) was not significantly associated with a lower risk of ACL injuries (HR=0.39, 95% CI=0.09, 1.61; p=0.191).

Conclusion and Recommendations

The researchers concluded that stakeholder engagement in the process of planning and executing injury prevention programs, such as with a KTA intervention, appears beneficial for increasing implementation rates. Since implementation was significantly associated with lower rates of ACL injuries, this process may lead to improved results in injury prevention in amateur youth soccer. The researchers recommend large-scale randomized hybrid effectiveness trials and assessment of cost-effectiveness to determine the scalability and utility of stakeholder engagement for injury risk reduction implementation in amateur youth soccer. The key points from this study are: 1. A KTA intervention resulted in significantly higher implementation rates of an ACL-IPP compared to an educational handout in amateur youth girls' soccer. 2. Implementation of the ACL-IPP at least two times per week was associated with a lower risk of ACL injuries, regardless of the implementation strategy or specific program used. 3. Stakeholder engagement and allowing some flexibility in the content and delivery of the ACL-IPP may be beneficial for increasing implementation rates in this population. 4. Further research is needed to determine the long-term sustainability and cost-effectiveness of different implementation strategies for injury prevention programs in amateur youth sports.