Bodyweight neuromuscular training and lower limbs injuries in female basketball players

INTERVENTION: The bodyweight neuromuscular warm‐up protocol will be developed from theory and findings from previous injury prevention research. None of the subjects have had prior exposure to neuromuscular or specific dynamic balance training, which may have interfered with the validity of the testing protocol. Sessions will take place 4 times a week, during the basketball regular season (32 weeks), before every training session during the warm‐up immediately before regular basketball training. Each 30‐minute session will comprise circuit training consisting of bodyweight neuromuscular exercises divided in: 1. General activation with the ball (e.g. jog line to line, shuttle run, lateral and backward running); 2. Mobility exercises (e.g. leg swing front‐to‐back side to side, lateral squats, lunge superior reach, walking quad stretch, monster walk, inverted hamstring stretch, lateral crossover step); 3. Strength exercises (e.g. multidirectional lunges, nordic hamstrings, single toe raises, lateral bridge); 4. Plyometric exercises (e.g. vertical jumps, lateral hops, single legger hops, forward hops); 5. agility exercises with the ball (fore way close‐out, line drills and sprint, zigzag cones, four cones, pass‐sprint and layup). The exercises will be progressed through three different phases using periodization methods. Initially, low volume high‐intensity exercises will be performed until the technique will be mastered. The volume will be then increase when the exercise will be executed correctly according to the coach’s judgment. Each athlete self regulated the intensity of exercises to be at RPE CR10 to be between 3 and 5 (moderate ‐ strong). The exercises will progress from a stable to an unstable position to increase demands on lower extremity strength (e.g. split squat, Bulgarian split squat, Bulgarian split squat and jump). A certified strength and conditioning coach will conduct the sessions and will give verbal and visual feedback on exercise technique. CONDITION: Lower limb injuries Postural Stability PRIMARY OUTCOME: Number of lower limb injuries occurred during the regular season. ; ; The medical staff will assess and report each injury according to the criteria of the Federation Internationale de Basketball (FIBA) and the criteria proposed by Junge et al. (2008) [Junge A, Engebretsen L, Alonso JM, et al. Injury surveillance in multi‐sport events: the International Olympic Committee approach. Br J Sports Med]. ; ; The type, location, and severity of injuries will be entered into a specifically designed database that was checked weekly by the researchers and the medical staff. Individual player participation in training and matches will also be recorded. In addition, we will receive a monthly standard injury report form from the medical staff. Recorded injuries included any event that will result in a player being unable to train fully or to play matches. A player will be considered injured until the team medical staff allowed return to full training and declared the player available for match selection. SECONDARY OUTCOME: Lower limb stability assessed by Y‐balance test. ; ; The Y‐Balance Test (YBT) will be carried out using a standardized testing protocol that has been shown to be reliable [Plisky PJ, Rauh MJ, Kaminski TW, et al. Star Excursion Balance Test as a predictor of lower extremity injury in high school basketball players. J Orthop Sports Phys Ther. 2009;36:911‐919; Plisky PJ, Gorman PP, Butler RJ, et al. The reliability of an instrumented device for measuring components of the star excursion balance test. N Am J Sports Phys Ther. 2009;4:92‐99.] Lower limb strength assessed by Counter Movement Jump (CMJ) ; INCLUSION CRITERIA: Aged 18‐35 years old, playing at the national level, and practice 4 times a week for more than 2 hours. ; The procedures were carried out as described by Maulder and Cronin [Maulder P, Cronin J. Horizontal and vertical assessment: reliability, symmetry, discriminative and predictive ability. Phys Ther Sport. 2005;6:74‐82] in which three CMJ with both legs during the push‐off phase, were performed on an Optojump Next (Microgate, Bolzano, Italy).