Effect of Specific ACL Injury Prevention Training in Female Handball Players

NCT05955599 | Unknown DMC

• 1 other identifier: H-21030337
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 3

Brief Summary

The anterior Cruciate Ligament (ACL) injuries rates in female handball are high, particularly among adolescents. Therefore, the primary purpose of this randomized control trial is to explore the effects of an 8-week ACL injury prevention program on muscle activation of the medial hamstring muscles during sidecutting in female handball players. Secondary aims are to evaluate if training effects are age-related (pre-adolescent: 11-13 year old vs. adults: ≥18 years old). The age-related comparisons Include:

1. 1.Medial hamstring muscles activation during sidecutting;
2. 2.Well-known biomechanical ACL injury-risk factors during high risk movements, such as cutting and landing tasks;
3. 3.Cortical and muscular activity and functional connectivity patterns during controlled knee movements;
4. 4.Visuomotor skill learning during a simple task involving the hamstring muscles.

Conditions

ACL Injury Prevention

Keywords

ACL Injuries; Age-related; Neuromuscular; Motor-Learning

Outcome Measures

Primary Outcomes (1)

• Neuromuscular adaptations during sidecutting

  Semitendinosus muscle pre-activity (sEMG) duirng handball specific sidecutting. Outcome measure is expressed in %MVC.during sidecutting.

  Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Secondary Outcomes (7)

• Changes in isometric strength

  Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

• Changes in 3D hip and knee joint angles

  Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

• Changes in 3D hip and knee joint moments

  Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

• Changes in hamstring and quadriceps pre-activation

  Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

• Visuomotor Skill Learning

  Change from Baseline to Baseline +1 Day, Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed.

Other Outcomes (2)

• Injury monitoring

  Weekly for 16 weeks (from the start of the intervention to the end of the 8-week retention period)

• Training and match exposure

  Weekly for 16 weeks (from the start of the intervention to the end of the 8-week retention period)

Study Arms (4)

Pre-adolescent Intervention

EXPERIMENTAL

11-13 year old female handball players complete a supervised ACL injury prevention program twice a week (2 x 15 minutes) for a duration of 8 weeks. The ACL injury prevention training consists of three tracks focusing on 1) hamstring and hip external rotation strength; 2) medial hamstring activation; 3) single leg landing technique training with a special focus on knee control. The training is integrated in the players/team's normal handball practice.

Other: ACL Injury Prevention Training

Pre-adolescent Control

OTHER

11-13 year old female handball players complete a supervised shoulder injury prevention program twice a week (2 x 15 minutes) for a duration of 8 weeks. The shoulder injury prevention training consists of three tracks focusing on 1) external rotator cuff strength; 2) scapula stability; 3) core strength and trunk rotation. The training is integrated in the players/team's normal handball practice.

Other: Control - Shoulder Injury Prevention Training

Adult Intervention

EXPERIMENTAL

Adult (≥18 year old) female handball players complete a supervised ACL injury prevention program twice a week (2 x 15 minutes) for a duration of 8 weeks. The ACL injury prevention training consists of three tracks focusing on 1) hamstring and hip external rotation strength; 2) medial hamstring activation; 3) single leg landing technique training with a special focus on knee control. The training is integrated in the players/team's normal handball practice.

Other: ACL Injury Prevention Training

Adult Control

OTHER

Adult (≥18 year old) female handball players completed a supervised shoulder injury prevention program twice a week (2 x 15 minutes) for a duration of 8 weeks. The shoulder injury prevention training consists of three tracks focusing on 1) external rotator cuff strength; 2) scapula stability; 3) core strength and trunk rotation. The training is integrated in the players/team's normal handball practice.

Other: Control - Shoulder Injury Prevention Training

Interventions

ACL Injury Prevention Training OTHER

Supervised ACL injury prevention training twice a week (2 x 15 minutes) over an 8-week period.

Adult Intervention; Pre-adolescent Intervention

Control - Shoulder Injury Prevention Training OTHER

Supervised shoulder injury prevention training twice a week (2 x 15 minutes) over an 8-week period.

Adult Control; Pre-adolescent Control

Eligibility Criteria

• Age: 11 Years - 40 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Female handball players playing in youth teams from the age group under 13 (11-13 years old) and adult (≥18 - 40 years old) females playing for elite u19 or senior teams in Denmark
• Have minimum 1 year of experience from playing handball
• Mental and physical skills to complete the electrophysiological and biomechanical tests

You may not qualify if:

• Girls/women outside the age groups listed above
• Prior surgeries to the lower limbs (e.g. ACL-reconstructions, meniscus lesions)
• Current intake of medications that include antidepressants, anxiolytics, anticonvulsants, antipsychotics, antiparkinson, hypnotics, stimulants, and/or antihistamines
• Neurological and/or psychiatric diagnoses
• Pregnant

Sponsors & Collaborators

• Copenhagen University Hospital, Hvidovre: lead
• University College Copenhagen: collaborator
• University of Copenhagen: collaborator
• Team Denmark: collaborator

Study Sites (3)

Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen

Copenhagen, 2200, Denmark

Location

Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark

Copenhagen, 2200, Denmark

Location

Human Movement Analysis Laboratory, Department of Orthopaedic Surgery, Copenhagen University Hospital

Hvidovre, 2650, Denmark

Location

Related Publications (1)

• Nedergaard NJ, Bencke J, Egholm J, Nielsen AL, Karabanov AN, Lundbye-Jensen J, Zebis MK. No Alterations in ACL Injury Risk Factors in Preadolescent Elite Female Handball Players Following an Eight-Week Targeted Training Intervention: A Randomised Controlled Trial. Transl Sports Med. 2026 Jan 2;2026:2570210. doi: 10.1155/tsm2/2570210. eCollection 2026.

  PMID: 41522287 DERIVED

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Sub-Investigator

Study Record Dates

• First Submitted: April 21, 2023
• First Posted: July 21, 2023
• Study Start: January 1, 2022
• Primary Completion: February 28, 2023
• Study Completion: December 31, 2025
• Last Updated: July 21, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will not share

Locations

DK (3)