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| Name | Class |
|---|---|
| University College Copenhagen | OTHER |
| University of Copenhagen | OTHER |
| Team Denmark | OTHER |
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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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 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. |
|
| 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. |
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| 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. |
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| Adult Control | Other |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ACL Injury Prevention Training | Other | Supervised ACL injury prevention training twice a week (2 x 15 minutes) over an 8-week period. |
|
| Measure | Description | Time Frame |
|---|---|---|
| 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in isometric strength | Peak isometric hamstring and hip external rotation strength, respectively. Outcome measure is expressed in force (Newtons). | 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 |
| Measure | Description | Time Frame |
|---|---|---|
| Injury monitoring | Type and number of injuries will be collected on a weekly basis using an electronical study-specific questionary. If injured, player's will be asked to complete a detailed questionary about the injury. | Weekly for 16 weeks (from the start of the intervention to the end of the 8-week retention period) |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen | Copenhagen | 2200 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41522287 | Derived | 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. |
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| ID | Term |
|---|---|
| D000070598 | Anterior Cruciate Ligament Injuries |
| ID | Term |
|---|---|
| D007718 | Knee Injuries |
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
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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. |
|
| Control - Shoulder Injury Prevention Training | Other | Supervised shoulder injury prevention training twice a week (2 x 15 minutes) over an 8-week period. |
|
Hip and knee joint kinematic for sidecutting and single-leg landings. This include joint kinetics at initial contact and local maximum and minimums. Outcome is expressed in three-dimensional joint angles (degrees) |
| 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 | Hip and knee joint kinetics for sidecutting and single-leg landings. Outcome is expressed in three-dimensional joint moments (M) | 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 | Hamstring (biceps femoris) and quadriceps (vastus lateralis and medialis) pre-activation (sEMG) during sidecutting and single-leg landings. Outcome measure is expressed in %MVC. | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. |
| Visuomotor Skill Learning | Age-related differences in motor performance, skill acquisition and retention during and following visuomotor skill practice. Specific outcomes measure will be time on target (seconds per target). | 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. |
| Changes in shoulder sensorimoter stability | Shoulder sensorimoter stability measured as CoP length (mm) from force platform data. | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. |
| Changes in Shoulder Rotator Cuff Strength | Peak isometric internal and external rotator cuff strength. Outcome measure is expressed in force (Newtons). | Change from Baseline to Training Completion at 8 weeks. And retention 8-weeks after the prevention program was completed. |
| Training and match exposure |
Number of training and match hours will be collected on a weekly basis using an electronical study-specific questionary |
| Weekly for 16 weeks (from the start of the intervention to the end of the 8-week retention period) |
| Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark | Copenhagen | 2200 | Denmark |
| Human Movement Analysis Laboratory, Department of Orthopaedic Surgery, Copenhagen University Hospital | Hvidovre | 2650 | Denmark |