Introduction: In field hockey, injury of to the lower limb is a common occurrence, and particularly to the ankle. Injuries can often prevent athletes from progressing along the pathway to becoming a national senior athlete. Ankle proprioception has been shown to be associated with sport performance level, and with risk of injury to the ankle region. Neuromuscular training (NMT) has potential to improve lower limb proprioception. This study investigated the effectiveness of an NMT intervention to improve proprioception of the ankle region in U18 age-group elite hockey players. Methods: Forty-five national-level U18 hockey players (26F, 19M, Age 17.6yrs ± 0.65) were recruited for a quasi-experimental study, with ethical approval and informed consent. At baseline testing (T1) athletes were tested for proprioceptive acuity on both legs, using the ankle AMEDA, and for other sensorimotor acuity using visual (3 metrics of pupillometry) and vestibular (eye tracking) testing. Athletes with > 1 Z deficit in two or more of these metrics were offered the option to undertake a balance/neuromuscular control training program (NMT group), in addition to their continued hockey participation. The remaining athletes continued normal hockey participation (non-NMT). All athletes were tested again, 8 months later (T2). The mean proprioception score of both legs was used as the primary metric. A two-way ANOVA was conducted to assess the change in proprioception between T1 and T2, with any incidence of lower limb injury as a co-variate. Post-hoc t-tests were used to identify specific points of difference shown within the ANVOA analyses. Results: There were main effects of difference in performance between NMT and non-NMT groups (F = 9.74, p = 0.003 ,n2 = 0.19 ), for the change in proprioception between T1 and T2(F = 35.07, p =<0.001 , n2 = 0.46), and for the interaction between test repeat and neuromuscular training (F = 4.37 , p = 0.04 , n2 = 0.09). There was no interaction effect between proprioception change over time and occurrence of injury within the follow-up period (F = 0.226, p = 0.64 , n2 = 0.005). The difference between the NMT and non-NMT group at T1 (mean diff = 5.92, 95%CI = 2.36 ~ 9.49, p = 0.002) was no longer present at T2 (mean diff = 1.27, 95%CI =-0.84 ~ 3.39, p = 0.24). Discussion: These findings demonstrate that proprioception can be effectively tested in cohorts of hockey players. Normal training routines for hockey, and potentially continued growth and development of adolescents, enhance proprioception performance. However, in the current study the NMT group achieved additional gains in performance beyond routine training. The NMT group proprioceptive deficits returned to the whole-group level of proprioception. These gains in proprioception may have value for this sport`s athletes, as proprioception has been shown to be associated with sport performance level, and with risk of injury to the ankle region. Impact/Application to the field: These findings indicate the value of adding NMT training to specifically address deficits in performance in proprioception. The gains in this area of performance may support sport performance and injury prevention. Declaration: My co-authors and I acknowledge that we have no conflict of interest of relevance to the submission of this abstract.
© Copyright 2024 Journal of Science and Medicine in Sport. Elsevier. Alle Rechte vorbehalten.