Baseline Time to Stabilization Identifies Anterior Cruciate Ligament Rupture Risk in Collegiate Athletes

Am J Sports Med. 2016 Jun;44(6):1487-91. doi: 10.1177/0363546516629635. Epub 2016 Feb 26.


Background: There is a need for successful screening methods to identify athletes at increased risk of anterior cruciate ligament (ACL) injury. Previous research showed that collegiate athletes with ACL tears demonstrated slower time to stabilization during jump landing after reconstruction.

Hypothesis: Collegiate athletes with baseline deficiencies in time to stabilization are at increased risk of subsequent ACL rupture.

Study design: Case-control study; Level of evidence, 3.

Methods: A total of 278 National Collegiate Athletic Association Division I college athletes (166 men, 112 women; mean age, 18.5 years; height, 178.8 cm; mass, 79.9 kg) in the high-risk sports of men's football; women's volleyball and field hockey; and men's and women's lacrosse, basketball, and soccer were measured to obtain baseline time to stabilization for backward, forward, medial, and lateral single-legged jump landing tasks. Athletes were followed for ACL rupture over a 4-year period. Independent t tests were used to evaluate differences in time to stabilization for each jump landing task between athletes with subsequent ACL rupture and uninjured athletes. Logistic regression models were used to assess time to stabilization as a predictor for ACL rupture.

Results: Nine athletes sustained noncontact ACL ruptures (5 men, 4 women). These 9 athletes took significantly longer to stabilize compared with uninjured athletes during baseline backward jump landing (1.58 ± 0.39 and 1.09 ± 0.52 seconds, respectively; P = .0052). The odds of ACL rupture increased 3-fold (odds ratio, 2.95; 95% CI, 1.28-6.77) for every second increase in backward time to stabilization observed between injured and uninjured athletes.

Conclusion: Collegiate athletes with slower baseline backward time to stabilization were at increased risk of ACL rupture.

Keywords: anterior cruciate ligament; dynamic postural stability; injury prevention; knee; neuromuscular control; proprioception.

MeSH terms

  • Adolescent
  • Anterior Cruciate Ligament Injuries / diagnosis*
  • Anterior Cruciate Ligament Injuries / surgery
  • Athletic Injuries / diagnosis*
  • Athletic Injuries / surgery
  • Basketball / injuries
  • Case-Control Studies
  • Female
  • Football / injuries
  • Hockey / injuries
  • Humans
  • Male
  • Plyometric Exercise
  • Postural Balance*
  • Prospective Studies
  • Racquet Sports / injuries
  • Recurrence
  • Risk Factors
  • Soccer / injuries
  • Time Factors
  • Universities
  • Volleyball / injuries
  • Young Adult