A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players

Background: Neuromuscular and proprioceptive training programs can decrease noncontact anterior cruciate ligament injuries; however, they may be difficult to implement within an entire team or the community at large. Hypothesis: A simple on-field alternative warm-up program can reduce noncontact ACL injuries. Study Design: Randomized controlled trial (clustered); Level of evidence, 1. Methods: Participating National Collegiate Athletic Association Division I women’s soccer teams were assigned randomly to intervention or control groups. Intervention teams were asked to perform the program 3 times per week during the fall 2002 sea-son. All teams reported athletes ’ participation in games and practices and any knee injuries. Injury rates were calculated based on athlete exposures, expressed as rate per 1000 athlete exposures. A z statistic was used for rate ratio comparisons. Results: Sixty-one teams with 1435 athletes completed the study (852 control athletes; 583 intervention). The overall anterior cruciate ligament injury rate among intervention athletes was 1.7 times less than in control athletes (0.199 vs 0.340; P =.198; 41 % decrease). Noncontact anterior cruciate ligament injury rate among intervention athletes was 3.3 times less than in control athletes (0.057 vs 0.189; P =.066; 70 % decrease). No anterior cruciate ligament injuries occurred among intervention athlete