Influence of age, sex, technique, and exercise program on movement patterns after an anterior cruciate ligament injury prevention program in youth soccer players

Am J Sports Med. 2009 Mar;37(3):495-505. doi: 10.1177/0363546508327542.


Background: Anterior cruciate ligament (ACL) injury prevention programs show promising results with changing movement; however, little information exists regarding whether a program designed for an individual's movements may be effective or how baseline movements may affect outcomes.

Hypothesis: A program designed to change specific movements would be more effective than a "one-size-fits-all" program. Greatest improvement would be observed among individuals with the most baseline error. Subjects of different ages and sexes respond similarly.

Study design: Randomized controlled trial; Level of evidence, 1.

Methods: One hundred seventy-three youth soccer players from 27 teams were randomly assigned to a generalized or stratified program. Subjects were videotaped during jump-landing trials before and after the program and were assessed using the Landing Error Scoring System (LESS), which is a valid clinical movement analysis tool. A high LESS score indicates more errors. Generalized players performed the same exercises, while the stratified players performed exercises to correct their initial movement errors. Change scores were compared between groups of varying baseline errors, ages, sexes, and programs.

Results: Subjects with the highest baseline LESS score improved the most (95% CI, -3.4 to -2.0). High school subjects (95% CI, -1.7 to -0.98) improved their technique more than pre-high school subjects (95% CI, -1.0 to -0.4). There was no difference between the programs or sexes.

Conclusions: Players with the greatest amount of movement errors experienced the most improvement. A program's effectiveness may be enhanced if this population is targeted.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Anterior Cruciate Ligament Injuries*
  • Child
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Knee Injuries / etiology
  • Knee Injuries / prevention & control*
  • Male
  • Movement*
  • Sex Factors
  • Soccer / injuries*
  • Treatment Outcome
  • Videotape Recording