12/15/2015. Need for High Movement Quality. Need for High Movement Quality. Need for High Movement Quality

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1 Strategies for ACL Injury Prevention: Practical Applications Lindsay J. DiStefano, PhD, ATC Associate Professor Department of Kinesiology University of Connecticut What is in Injury Prevention Program/Preventive Training Program? Exercise-based program Multi-faceted program consists of: Plyometric Balance Agility Flexibility Strengthening (Steffen, 2008; Gilchrist, 2008; LaBella, 2011; Walden, 2012) 1 2 Dynamic Warm-up/Injury Prevention Program Need for High Movement Quality ~4 meters ~8 meters P-1 P-2 Dynamic activity Acceleration Action Jog Recovery 3 4 Need for High Movement Quality Need for High Movement Quality 6 1

2 How Can We Promote COMPLIANCE? Adapted from Padua, 2014 Perform PTP Routine Positive reinforcement Initiation of training Cue Desire for reward Ready to perform DO AN INJURY PREVENTION PROGRAM Injury Prevention Modify Risk Factors Early Fundamental Movement Skills Create Habits Coach Captain Coach AT Team MD Coach Captain Athletic Director 9 10 Are they ready for change? Knowledge Perceptions Risk Benefits Self-efficacy Social norm Session & of Day Support 11 Padua,

3 Impact of Injury in Sports Disability Number of games missed due to injury is predictive of the number of team wins during a season NBA Seasons Cost What matters to them? Warm-up, performance, sport-specificity Educate 13 Performance Must develop systematic processes to prevent musculoskeletal injury and optimize performance Padua, 2014 Academic Classes (10) & Exams missed (2) Test failure rate (36%) GPA (0.3) Individual Player efficiency rating (NBA) Power rating & Durability (NFL) Team Team ranking (r =.93) Games won (r =.88) Points scored (r =.89) Point differential (r =.82) 14 points over season (r =.93) 1 16 Acute Performance Changes Power (Yamaguchi, 200) Strength (Yamaguchi, 2007) Sprint time (Goodwin, 2002; Fletcher, 2007; Faigenbaum, 2006) Vertical jump (Faigenbaum, 2006; Thompsen, 2007) Agility tasks (McMillan, 2006) Performance Changes over Vertical jump (Chappell, 2008; DiStefano, 2012; Kilding, 2008; Hewett, 1996; Noyes, 200) Hop distance (Herrington, 2010; Barber- Westin, 2010) Hop speed (Chappell, 2008) Sprint speed (Kilding, 2008; Barber-Westin, 2010)

4 al Goals al ideas : Sport Specificity Majority of programs are generic Tested in soccer or handball Do not include true sport-specific activities Sport-specificity Makes it relatable Perceived effectiveness Options for increasing difficulty Not boring Fun! 19 Peck, Where? When? How? -Individual? -Team-based? Relative Advantage 21 Relative Advantage Current Activities Revised Activities Hip Gates Hip Gates Quad Pulls Quad Pulls Butt Kicks Butt Kicks Hamstring Sits Hamstring Sits Hamstring Kicks Front Hamstring Kicks Front Hamstring Kicks Across Hamstring Kicks Across Walking Lunges Walking Lunges High Knees High Knees Side Lunges Side Lunges Side Shuffle Side Shuffle Carioca Carioca Power Skips Power Skips Forward Hops to Balance Forward Hops to Balance Missing: Add: Core Exercises Plank Series Additional Balance Side Hop to Balance Plyometrics Squat Jumps 22 Barrier: Session & of Day Support More is better Minimum al constraints dosage 10 min/day 3 days/week 6 weeks 10x3x6=180 min

5 CT Coaches Survey Minutes Willing to Perform an IPP 8 7 Retention of ACL IPP IPP % 26% No 0% Yes 79% 88% Number of Respondents Martinez, LESS Extended Traditional 0 Pre-test Post-test Retention-test *P< Padua, 2012 Session & of Day Support 28 Session & of Day Support Who will implement? Athletic Trainer Coach Athletes Strength & Conditioning staff Parent Teacher 29 30

6 Steps for Training Establish: Knowledge of effectiveness Alignment with goals of trainer & organization Knowledge of program Self-efficacy Feedback Maintenance 31 Pryor, Summary Acknowledgements 7) Maintenance/exit 6) Fidelity control ) Train the trainers & users 4) Develop a scalable PTP 3) ID barriers & solutions 2) Develop an interdisciplinary team Key Points Identify implementation barriers & develop solutions prior to developing a PTP Establish high level of selfefficacy, not just knowledge Regular, targeted feedback on implementation fidelity Goal oriented exit strategy Maintenance support plan R01 AR00461 R03 AR07489 P60 AR W81XWH CDMRP Peer Reviewed Medical Research Program Pilot Research Award 1) Establish administrative support Padua et al., Thank you! 3 6