Abstract / Summary
OBJECTIVE: To estimate immediate and long-term (retention) improvements in knee abduction moment (KAM) following a neuromuscular training (NMT) program with augmented biofeedback in individuals at high and low risk for injury. DESIGN: Secondary analysis of a randomized controlled trial. METHODS: One hundred fifty adolescent female soccer players were enrolled in a 6-week NMT program and randomized to biofeedback training groups: NMT + Hip-focus (NMT+H), NMT + Knee-focus (NMT+K), or NMT with a sham biofeedback. NMT was completed 3 times each week with augmented biofeedback delivered once per week. Standard 3-dimensional motion analysis of a drop vertical jump over artificial turf with embedded force platforms was performed at baseline (PRE), immediately following training (POST), and 6 months post training (RET). Baseline measures of KAM were used to stratify participants into low- (n = 87, 12.7 ± 2.2 years, 153.0 ± 11.4 cm, 47.2 ± 11.8 kg) and high-risk (n = 44, 14.0 ± 1.8 years, 161.6 ± 5.8 cm, 53.5 ± 9.2 kg) groups, based on a previously determined cut point. A mixed-design analysis of variance with between-group factors of risk (high, low) and training group (NMT+H, NMT+K, NMT), and a repeated within-group factor of session (PRE, POST, RET) were used for the analysis. RESULTS: A significant interaction was identified between risk and session (P < .001). Within training groups, the high-risk group had a significant reduction in KAM from baseline to posttest, and from baseline to 6 months (PRE: -37.5 ± 9.0 N m; POST: -25.2 ± 11.4 N m; RET: -29.4 ± 14.5 N m). There were no changes in the low-risk group (PRE: -12.2 ± 6.2 N m; POST: -12.2 ± 7.6 N m; RET: -12.9 ± 8.7 N m). CONCLUSION: Female soccer players with knee biomechanics that put them at high risk for anterior cruciate ligament injury had improved KAM following an NMT program. The changes in KAM remained at 6 months after training. J Orthop Sports Phys Ther 2026;56(10):689-698. Epub 28 Aug 2026. doi:10.2519/jospt.2026.14125.