Examination of the effectiveness of a balance training program in improving balance and reducing low

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Examination of the effectiveness of a balance
training program in improving balance and
reducing lower extremity sport injury in
adolescent female basketball players. A pilot
study.

• Presenter Priscilla Liu
• Supervisor Dr. Carolyn Emery

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Agenda

• Background
• Methods
• Results
• Discussion
• Conclusion
• Acknowledgements

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Background

• Epidemiology of basketball injuries in
  adolescents
• Sport participation
• Injury Rate
• Injury location and severity
• Risk factors
• - intrinsic and extrinsic

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Prevention of Basketball Injuries

• Prevention of lower extremity injuries
• Taping, bracing, shoes, multi-dimensional
  training program
• Proprioceptive balance training program in
  soccer, European handball
• Emery et al proprioceptive balance training in
  healthy adolescents

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Study Objectives

• Effectiveness of a 6 weeks proprioceptive wobble
  training program in
• 1) improving dynamic balance
• 2) reducing lower extremity injuries

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Study Design

• Non-randomized prospective intervention study
• U of C summer Dinos Athletics female basketball
  camp in July

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Subjects

• Adolescents females between age 11-17
• 44 girls from first week of camp
• 45 girls from second week of camp

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Methods

• Baseline Measurements
• Baseline questionnaire age, past history on
  injury and sport participation
• Tanner staging skeletal assessment
• Height, weight, leg dominance, vertical jump,
  ankle dorsiflexion, popliteal angle, VO2 max
• Eyes closed unipedal dynamic (ECD) balance

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Data Collection

• 6 week follow-up
• ECD balance
• 16 week follow-up
• 1) Sport participation journals
• 2) Injury report

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Strength and Endurance
Vertical Jump Shuttle Run (functional
strength) (predicted VO2 max)
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Unipedal Dynamic Balance Test
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Training Group

• 6-week balance training program using a wobble
  board
• Performed wobble board exercises during warm-up
  in the week of camp
• Followed home-based wobble board training program
  post camp
• 5 times a week for 20 minutes with progression

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Results

• 45/89 (50.6 95CI 39.8-61.3) completed all
  follow up components
• 64/89 (71.9 95CI 61.4-80.9) completed all
  components except 6 week follow up assessment

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Results

• No significant differences between the groups at
  baseline except tanner staging
• Training group was younger in physiological
  maturity
• No significant differences between dropouts and
  those completing study

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Wobble Board Compliance
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Difference between baseline and six-weeks
follow-up for ECD balance (seconds) on
non-dominant leg
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Difference between baseline and six-weeks
follow-up for ECD balance (seconds) on dominant
leg
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Sport injuries requiring medical attention or
time loss from sport
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Injury Region and Time Loss

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Mean hours and injuries for basketball and all
sports played
 
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Sport participation hours and number of injuries
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Relative risk of injury with injury in the past
year
RR 4.2 (95 CI 1.01, 24.79)
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Discussion

• No significant difference in ECD balance
• No significant difference in injury incidence

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Discussion

• Limitations
• 1)Summer season
• 2) Only 50.6 of participants returned for 6 week
  follow up

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Discussion

• 3) Dropouts for control and training group were
  34 and 22
• 4) 51.2(95CI 35.8-66.3) reported less than 5
  wobble board sessions post camp
• 5) Incomplete data on sport participation
  journals and injury report forms

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Discussion

• Other risk factors
• Past injury RR 4.2 (95CI 1.01, 24.79)
• Reasons could be persistent symptoms, underlying
  physiological deficiencies from previous injury,
  inadequate rehabilitation

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Discussion

• Lessons Learned
• Challenges in adapting injury prevention model
  that can be incorporated into daily lives of
  adolescents
• Motivational strategies to establish adherence

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Discussion

• Lessons Learned
• Understanding of behaviour, attitude, social
  influence and self efficacy of the adolescent age
  group
• Need for group level involvement in developing
  prevention plan

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Discussion

• Future Studies
• Sport specific injury prevention programs for
  adolescents
• Prevention program adherence
• Prevention program evaluation effectiveness,
  acceptability and applicability

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Acknowledgements

• Dr. Carolyn Emery and research staff
• Dr. Aaron Tubman and Markin-Flanagan Studentship
  Undergraduate Research Project
• Dinos basketball coaches, participants and
  parents

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Thank you