Introduction Neuromuscular training (NMT) warm-ups are effective in reducing injury risk in youth. Factors predicting the response to NMT in reducing injury risk are unknown, making this the objective of the present study.
Materials and Methods This is a secondary analysis of the intervention groups of randomized controlled trials evaluating NMT warm-ups among youth (11–18 years) [basketball (n=494), soccer (n=380), physical education (PE; n=919)]. Response was predicted based on age, sex, height, weight, sport/PE, one-year injury history, adherence (weekly sessions) to NMT, and balance ability (timed single-leg on balance pad). Generalized estimating equation analysis was used to estimate odds ratios (OR) with clustering on team/class, exchangeable correlation structure, robust variance estimator, and offset for exposure hours.
Results Adjusting for age, balance, injury history, sex and sport/PE, balance ability reduced the odds of injury [OR=0.955, (95%CI: 0.912–0.999)]. Predictors of non-response include previous injury [OR=1.895, (95%CI: 1.335–2.691), female sex [OR=1.595, (95%CI: 1.119–2.274), and playing basketball [OR=3.151, (95%CI: 1.616–6.142)]. Stratifying by sex, weekly NMT sessions did not predict injury in females, however injury history [OR=2.148, (95% CI: 1.394–3.311)] and basketball [OR=3.677, (95% CI: 1.558–8.679)] were associated with increased odds. Stratifying by sex and sport, female soccer players had lower odds associated with greater weekly mean NMT sessions [OR=0.282, (95%CI: 0.090–0.882)].
Conclusions Predictors of non-response to NMT in youth include being female, playing basketball, and history of injury. Better balance was associated with lower odds of injury. Higher weekly adherence was protective in female soccer players.
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