The Effect of a 3-Week Neuromuscular Training Program and Its Retention on the Movement Pattern of Drop Vertical Jump in Active Girls with Knee Valgus

Document Type: Research Paper


1 Ph.D Student of Corrective Exercises, Faculty of Physical Education, University of Guilan, Rasht, Iran2

2 Professor, Faculty of Physical Education, University of Guilan, Rasht, Iran


Dynamic knee valgus during deceleration and drop landing in sport activities can be the cause of many acute and chronic knee injuries in female athletes. This study examined the effect of 3 weeks of neuromuscular training and its retention after 3 months on the movement pattern of drop vertical jump in 15-18-year-old active girls with dynamic knee valgus. Volunteers were screened by double legged squat test and finally, 24 subjects with dynamic knee valgus (12 subjects in the training group and 12 subjects in the control group) were selected as the sample. Knee valgus and flexion angles were calculated using two dimensional evaluation method with two video cameras (CASIO-Ex-F1, made in Japan) before and immediately after the training program in both groups and knee valgus angle was again calculated 3 months later during drop vertical jump test. Repeated measures was used to compare knee valgus and flexion angles before and immediately after and 3 months after the training intervention in control and training groups. In case of significance, independent and dependent t tests were used to recognize within- and between-group differences. The results showed that knee valgus angle mean decreased after training in the training group and this difference was significant (P=0.001). Also, knee flexion angle mean in the training group increased significantly (P=0.04). The results of paired sample t test showed a significant increase in this variable after the training and 3 months later in knee valgus angle in the training group (P=0.05). Results showed that although a 3-week neuromuscular training intervention improved movement pattern of drop vertical jump in active female students, the retention of the effect of this training decreased after 3 months.


1.Comfort P, Colclough A, Herrington L. A comparison of frontal plane projection angle across landing tasks in female gymnasts. International Journal of Athletic Therapy and Training. 2016;21(5):42-7.
2.Ford KR, Nguyen A-D, Dischiavi SL, Hegedus EJ, Zuk EF, Taylor JB. An evidence-based review of hip-focused neuromuscular exercise interventions to address dynamic lower extremity valgus. Open access journal of sports medicine. 2015;6:291.
3.Goto S. The effects of an integrated exercise program on lower extremity biomechanics in females with medial knee displacement: THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL; 2015.
4. Bell DR, Padua DA, Clark MA. Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement. Archives of physical medicine and rehabilitation. 2008;89(7):1323-8.
5.Bell DR, Oates DC, Clark MA, Padua DA. Two-and 3-dimensional knee valgus are reduced after an exercise intervention in young adults with demonstrable valgus during squatting. Journal of athletic training. 2013;48(4):442-9.
6. Padua DA, Bell DR, Clark MA. Neuromuscular characteristics of individuals displaying excessive medial knee displacement. Journal of athletic training. 2012;47(5):525-36.
7.Rabin A, Kozol Z. Measures of range of motion and strength among healthy women with differing quality of lower extremity movement during the lateral step-down test. Journal of orthopaedic & sports physical therapy. 2010;40(12):792-800.
8.Malloy P, Morgan A, Meinerz C, Geiser C, Kipp K. The association of dorsiflexion flexibility on knee kinematics and kinetics during a drop vertical jump in healthy female athletes. Knee Surgery, Sports Traumatology, Arthroscopy. 2015;23(12):3550-5.
9.Myer GD, Ford KR, Brent JL, Hewett TE. Differential neuromuscular training effects onACL injury risk factors in" high-risk" versus" low-risk" athletes. BMC musculoskeletal disorders. 2007;8(39):1-7.
10.DiStefano LJ, Padua DA, DiStefano MJ, Marshall SW. Influence of age, sex, technique, and exercise program on movement patterns after an anterior cruciate ligament injury prevention program in youth soccer players. The American Journal of Sports Medicine. 2009;37(3):495-505.
11.Herman DC, Weinhold PS, Guskiewicz KM, Garrett WE, Yu B, Padua DA. The effects of strength training on the lower extremity biomechanics of female recreational athletes during a stop-jump task. The American journal of sports medicine. 2008;36(4):733-40.
12.McCurdy K, Walker J, Saxe J, Woods J. The effect of short-term resistance training on hip and knee kinematics during vertical drop jumps. The Journal of Strength & Conditioning Research. 2012;26(5):1257-64.
13.Nagano Y, Ida H, Akia M, Fukubayashi T. Effects of jump and balance training on knee kinematics and electromyography of female basketball athletes during a single limb drop landing: pre-post intervention study. Sports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology. 2011;3(14):1-9.
14.Pfile KR, Hart JM, Herman DC, Hertel J, Kerrigan DC, Ingersoll CD. Different exercise training interventions and drop-landing biomechanics in high school female athletes. Journal of athletic training. 2013;48(4):450-62.
15.Hopper, haff, joyce, lioyd, haff. Neuromuscular Training Improves Lower Extremity Biomechanics Associated with Knee Injury during Landing in 11–13 Year Old Female Netball Athletes: A Randomized Control Study. Frontiers in Physiology. 2017;8(883):1-13.
16.Olson TJ, Chebny C, Willson JD, Kernozek TW, Straker JS. Comparison of 2D and 3D kinematic changes during a single leg step down following neuromuscular training. Physical Therapy in Sport. 2011;12(2):93-9.
17.Barber-Westin SD, Smith ST, Campbell T, Noyes FR. The drop-jump video screening test: retention of improvement in neuromuscular control in female volleyball players. The Journal of Strength & Conditioning Research. 2010;24(11):3055-62.
18.Barendrecht, Lezeman, Duysens, Smits-Engelsman. Neuromuscular training improves knee kinematics, in particular in valgus aligned adolescent team handball pllayers of both sexes. Journal of Strength and Conditioning Research. 2011;25(3):575–84.
19. Schmidt E, Harris-Hayes M, Salsich GB. Dynamic knee valgus kinematics and their relationship to pain in women with patellofemoral pain compared to women with chronic hip joint pain. Journal of Sport and Health Science. 2017.
20. Tamura A, Akasaka K, Otsudo T, Shiozawa J, Toda Y, Yamada K. Dynamic knee valgus alignment influences impact attenuation in the lower extremity during the deceleration phase of a single-leg landing. PloS one. 2017;12(6):e0179-810.
21. Snyder KR, Earl JE, O’Connor KM, Ebersole KT. Resistance training is accompanied by increases in hip strength and changes in lower extremity biomechanics during running. Clinical Biomechanics. 2009;24(1):26-34.
22. Risberg MA, Mork M, Jenssen HK, Holm I. Design and Implementation of a NeuomusculaTra ining Program Following Anterior Cruciate Ligament Reconstruction. Journal of Orthopaedic & Sports Physical Therapy. 2001;31(11):620-31.
23. Chappell, Limpisvasti. Effect of a neuromuscular training program on the kinetics and kinematics of jumping tasks. Am J Sports Med. 2008;36(6):1081-6.
24. Noyes, SD B-W, ST S, T C. A training program to improve neuromuscular and performance indices in female high school soccer players. Journal of Strength and Conditioning Research. 2013;27(2):340-51.
25. Aerts I, Cumps E, Verhagen E, Wuyts B, Van De Gucht S, Meeusen R. The effect of a 3-month prevention program on the jump-landing technique in basketball: a randomized controlled trial. Journal of sport rehabilitation. 2015;2. 4(1); 21-30.
26. Herrington L. The effects of 4 weeks of jump training on landing knee valgus and crossover hop performance in female basketball players. The Journal of Strength & Conditioning Research. 2010;24(12):3427-32.
27. Herrington, Munro. Drop jump landing knee valgus angle; normative data in a physically active population. Phys Ther Sport. 2010;11(2):56-9.
28. Dai B. The effects of detraining on knee biomechanics in a stop-jump task: implications for ACL injury. A thesis submitted to the graduate faculty in partial fulfillment of the requirements for the degree of Master of Science. 2009.