Plyometric Training With or Without Hamstring Strengthening for Preventing ACL Injuries in Female Amateur Athletes

NCT07047833 | Completed DMC

• 1 other identifier: Rec-UOL-/287/08/24
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial explored the effect of plyometric training with or without hamstring strengthening in preventing anterior cruciate ligament (ACL) injuries among female amateur athletes aged 18 to 30. Sixty participants were divided equally into two groups: one received plyometric training combined with hamstring strengthening, and the other received plyometric training only. Both groups trained twice per week over a six-week period. Outcomes measured included knee strength (flexion and extension), dynamic balance (Star Excursion Test), and functional mobility (KOOS).

Conditions

ACL Injuries

Keywords

ACL injury prevention; Plyometric training; Hamstring strengthening; Female athletes; Functional mobility; Dynamic balance

Outcome Measures

Primary Outcomes (1)

• Knee Flexion and Extension Strength (Measured Using Handheld Dynamometer)

  Lower limb strength was assessed through a handheld dynamometer measuring knee flexion and extension in kilograms. This tool has high reliability for assessing muscle strength and functional performance in athletic populations. Measurements were taken at baseline, Week 3, and Week 6 to evaluate changes over time due to the training interventions.

  Baseline, Week 3, and Week 6

Secondary Outcomes (2)

• Dynamic Balance (Assessed Using Star Excursion Balance Test - SEBT)

  Baseline, Week 3, and Week 6

• Functional Mobility (Assessed Using KOOS - Knee Injury and Osteoarthritis Outcome Score)

  Baseline, Week 3, and Week 6

Study Arms (2)

Plyometric Training with Hamstring Strengthening

EXPERIMENTAL

Participants in this group received a six-week intervention consisting of plyometric training combined with targeted hamstring strengthening exercises. Each session was 60 minutes long and conducted twice per week. Plyometric drills included squat jumps, depth jumps, and lateral jumps. Hamstring strengthening included Nordic curls and machine-based leg curls. All participants completed standardized warm-up and cool-down routines. The goal was to assess the additive effect of hamstring strengthening on ACL injury prevention metrics such as strength, balance, and functional mobility.

Behavioral: Plyometric Training with Hamstring Strengthening

Plyometric Training Only

EXPERIMENTAL

This group received plyometric training only over a six-week period, with sessions lasting 40 minutes and conducted twice weekly. Exercises included squat jumps, depth jumps, and lateral jumps, performed with progressive intensity. Participants underwent a standardized warm-up and cool-down in each session. The purpose of this arm was to evaluate the effectiveness of plyometric training alone in improving strength, balance, and functional mobility for ACL injury prevention.

Behavioral: Plyometric Training Only

Interventions

Plyometric Training with Hamstring Strengthening BEHAVIORAL

This intervention consisted of a six-week training protocol involving both plyometric exercises and targeted hamstring strengthening. Sessions were conducted twice per week, lasting 60 minutes each. Plyometric drills included squat jumps, depth jumps, and lateral jumps, while hamstring exercises included Nordic hamstring curls and machine-based leg curls. All sessions included a standardized 15-minute warm-up and a 5-minute cool-down. The program was designed to enhance lower limb strength, balance, and neuromuscular control for ACL injury prevention in female amateur athletes.

Plyometric Training with Hamstring Strengthening

Plyometric Training Only BEHAVIORAL

This intervention involved a six-week plyometric-only training program delivered twice weekly for 40-minute sessions. Exercises included squat jumps, depth jumps, and lateral jumps, performed with progressive intensity and control. Each session included a standardized 15-minute warm-up and a 5-minute cool-down. The program aimed to improve lower limb power, balance, and functional mobility to reduce the risk of ACL injuries in female amateur athletes.

Plyometric Training Only

Eligibility Criteria

• Age: 18 Years - 30 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Female amateur athletes between the ages of 18-30 years old.
• Participating in sports that involve jumping, cutting and pivoting movements (e.g. basketball, soccer).
• On average, athletes exercised between six and eight times per week including competition.
• Able to perform basic jumping and landing mechanics safely.

You may not qualify if:

• Recreational athlete or untrained individual
• Athletes with less than five training sessions per week.
• Athletes who were operated with techniques other than the bone patellar-tendon, bone graft (BPTB), or who were operated by different surgeons and rehabilitated by several physical therapist.
• Athletes with a history of muscle or joint injuries.
• Athletes who had already followed a pre-operative rehabilitation program.

Sponsors & Collaborators

• University of Lahore: lead

Study Sites (1)

The University of Lahore Teaching Hospital

Lahore, 54590, Pakistan

Location

Related Publications (1)

• Kasmi S, Zouhal H, Hammami R, Clark CCT, Hackney AC, Hammami A, Chtara M, Chortane SG, Salah FZB, Granacher U, Ounis OB. The Effects of Eccentric and Plyometric Training Programs and Their Combination on Stability and the Functional Performance in the Post-ACL-Surgical Rehabilitation Period of Elite Female Athletes. Front Physiol. 2021 Jul 2;12:688385. doi: 10.3389/fphys.2021.688385. eCollection 2021.

  PMID: 34276409 BACKGROUND

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Interventions

Plyometric Exercise

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Student

Study Record Dates

• First Submitted: April 4, 2025
• First Posted: July 2, 2025
• Study Start: May 21, 2024
• Primary Completion: January 30, 2025
• Study Completion: March 25, 2025
• Last Updated: July 2, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)