{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:09:39Z","timestamp":1790176179723,"version":"4.1.0"},"reference-count":74,"publisher":"International Journal of Sports Physical Therapy","issue":"4","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescent females are at much greater risk for ACL injury than their male counterparts when participating in the same sports. Preventative and pre-operative rehabilitation neuromuscular (NM) exercise programs are often recommended to improve knee function and reduce injury rates. The effectiveness of perturbation-based NM training program has been established in an adult population but has yet to be investigated in the at-risk adolescent female population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"purpose\">\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine the effectiveness of a perturbation-based NM exercise program in a group of physically active adolescent females.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"study-design\">\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective randomized trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-four healthy and an exploratory group of 10 ACL-injured females (ages 12-18) were equally randomized into a perturbation-based NM training or control group and evaluated before and after a five-week intervention period. The primary outcome of dynamic balance was measured using the Y-Balance test (YBT); secondary outcome measures included lower limb strength, proprioception, and flexibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The perturbation-based NM training intervention was safely completed by all participants but had no significant effect on YBT scoring, lower limb strength, proprioception or flexibility in either the healthy or ACL-injured groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Perturbation-based NM training is safe, but may offer little preventative benefit for healthy or pre-operative rehabilitation benefit for ACL-injured adolescent females. Future research should examine whether the effectiveness of perturbation-based NM training is influenced by the length of the training intervention, training intensity, or when it is combined with other forms of prophylactic or pre-surgical rehabilitation frequently used with at-risk adolescent females who regularly participate in sport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"level-of-evidence\">\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level 3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.26603\/001c.25685","type":"journal-article","created":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T16:15:32Z","timestamp":1627920932000},"source":"Crossref","is-referenced-by-count":5,"title":["Safety and Effectiveness of a Perturbation-based Neuromuscular Training Program on Dynamic Balance in Adolescent Females: A Randomized Controlled Trial"],"prefix":"10.26603","volume":"16","author":[{"given":"Alison","family":"Bulow","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02gfys938","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Manitoba","department":["Human Anatomy & Cell Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith E","family":"Anderson","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02gfys938","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Manitoba","department":["Biological Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff R S","family":"Leiter","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02gfys938","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Manitoba","department":["Human Anatomy & Cell Science"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter B","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Surgery, University of Manitoba; Pan Am Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason D","family":"Peeler","sequence":"additional","affiliation":[{"name":"Human Anatomy & Cell Science, University of Manitoba; Pan Am Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11140","published-online":{"date-parts":[[2021,8,1]]},"reference":[{"issue":"2","key":"ref1","doi-asserted-by":"crossref","first-page":"80\u201385","DOI":"10.1097\/JSM.0b013e3181ceca45","article-title":"Accuracy and reliability of anterior cruciate ligament clinical examination in a multidisciplinary sports medicine setting","volume":"20","author":"J. 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