Scand J Med Sci Sports. 2018;28:1451–1460. wileyonlinelibrary.com/journal/sms
© 2017 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd
Accepted: 4 December 2017
Neuromuscular training reduces lower limb injuries in elite
female basketball players. A cluster randomized controlled trial
A. La Torre
Department of Biomedical Sciences for
Health, Università degli Studi di Milano,
Matteo Bonato, Department of Biomedical
Sciences for Health, Università degli Studi
di Milano, Milan, Italy.
The study was a two- armed, parallel group, cluster randomized controlled trial in
which 15 teams (160 players) were assigned to either an experimental group (EG, 8
teams n = 86), which warmed- up with bodyweight neuromuscular exercises, or a
control group (CG, 7 teams, n = 74) that performed standard tactical- technical exer-
cises before training. All injuries during the 2015- 2016 regular season were counted.
Epidemiologic incidence proportion and incidence rate were also calculated.
Countermovement jump (CMJ) and composite Y- Excursion Balance test (YBT)
were used to assess lower limb strength and postural control. A total of 111 injuries
were recorded. Chi- square test detected statistically significant differences between
EG and CG (32 vs 79, P = .006). Significant differences in the injuries sustained in
the EG (21 vs 11, P = .024) and CG (52 vs 27, P = .0001) during training and
matches, respectively, were observed. Significant differences in post- intervention
injuries were observed between in EG and CG during training (21 vs 52, P < .0001)
and matches (11 vs 27, P = .006). Significant differences in epidemiologic incidence
(0.37 vs 1.07, P = .023) and incidence rate (1.66 vs 4.69, P = .012) between the EG
and the CG were found. Significant improvement in CMJ (+9.4%, P < .0001;
d = 1.2) and composite YBT (right: +4.4%, P = .001, d = 1.0; left: +3.0%, P = .003;
d = 0.8) for the EG was noted. Significant differences in post- intervention CMJ
(+5.9%, P = .004) and composite YBT scores (right, +3.7%, P = .012; left, +2.3%,
P = .007) between the EG and the CG were observed. Including bodyweight neuro-
muscular training into warm- up routines reduced the incidence of serious lower limb
injuries in elite female basketball players.
basketball, epidemiology, injury prevention, postural control, sports injury
Basketball has become one of the world’s most popular
physical activities: over 450 million players from licensed
to amateur play basketball worldwide.
But as the number
of players has increased, so too has the number of injuries,
particularly those involving the lower extremities. Drakos
reported injuries patterns in elite athletes competing in
the National Basketball Association (NBA). They found that
over 17 championship seasons 62.4% of orthopedic injuries
involved the lower limbs.
Moreover, injury rates are higher
among female players than their male counterparts, with
women reported to sustain 60% more injuries to the knee and
ankle than men in professional basketball.
The higher injury
rates may be ascribed to sex- related neuromuscular imbal-
ances, including ligament and quadriceps imbalance and leg
Several warm- up programs including neuromuscular
training have been shown to reduce the incidence of lower ex-
tremity injuries in female athletes.