Augmented Feedback Supports Skill Transfer and Reduces High-Risk Injury Landing Mechanics A Double-Blind, Randomized Controlled Laboratory Study

Background: There is a current need to produce a simple, yet effective method for screening and targeting possible deficiencies related to increased anterior cruciate ligament (ACL) injury risk. Hypothesis: Frontal plane knee angle (FPKA) during a drop vertical jump will decrease upon implementing augmented feedback into a standardized sport training program. Study Design: Controlled laboratory study. Methods: Thirty-seven female participants (mean +/- SD: age, 14.7 +/- 1.5 years; height, 160.9 +/- 6.8 cm; weight, 54.5 +/- 7.2 kg) were trained over 8 weeks. During each session, each participant received standardized training consisting of strength training, plyometrics, and conditioning. They were also videotaped running on a treadmill at a standardized speed and performing a repeated tuck jump for 10 seconds. Study participants were randomized into 2 groups and received augmented feedback on either their jumping (AF) or sprinting (CTRL) form. Average (mean of 3 trials) and most extreme (trial with greatest knee abduction) FPKA were calculated from 2-dimensional video captured during performance of the drop vertical jump. Results: After testing, a main effect of time was noted, with the AF group reducing their FPKA average by 37.9% over the 3 trials while the CTRL group demonstrated a 26.7% reduction average across the 3 trials (P < .05). Conversely, in the most extreme drop vertical jump trial, a significant time-by-group interaction was noted (P < .05). The AF group reduced their most extreme FPKA by 6.9 degrees (pretest, 18.4 degrees +/- 12.3 degrees; posttest, 11.4 degrees +/- 10.1 degrees) on their right leg and 6.5 degrees (pretest, 16.3 degrees +/- 14.5 degrees; posttest, 9.8 degrees +/- 10.7 degrees) on their left leg, which represented a 37.7% and 40.1% reduction in FPKA, respectively. In the CTRL group, no similar changes were noted in the right (pretest, 16.9 degrees +/- 14.3 degrees; posttest, 14.0 degrees +/- 12.3 degrees) or left leg (pretest, 9.8 degrees +/- 11.1 degrees; posttest, 7.2 degrees +/- 9.2 degrees) after training. Conclusion: Providing athletes with augmented feedback on deficits identified by the tuck jump assessment has a positive effect on their biomechanics during a different drop vertical jump task that is related to increased ACL injury risk. The ability of the augmented feedback to support the transfer of skills and injury risk factor reductions across different tasks provides exciting new evidence related to how neuromuscular training may ultimately cross over into retained biomechanics that reduce ACL injuries during sport. Clinical Relevance: The tuck jump assessment's ease of use makes it a timely and economically favorable method to support ACL prevention strategies in young girls.