Efficacy of integrated neuromuscular training intervention on concurrent reduction of anterior cruciate ligament and hamstring injury risks in adolescent footballers

Mohibullah Khan Marwat; Hummaira Farah; Kashif Mehmood; Sajid Hussain; Taslim Arif; Abdul Basit; Mohammad Asad Khan; Yasmeen Iqbal

doi:10.15561/26649837.2025.0601

Authors

Mohibullah Khan Marwat The University of Lahore https://orcid.org/0009-0002-2718-1772
Hummaira Farah The University of Lahore https://orcid.org/0009-0005-2205-1217
Kashif Mehmood The University of Lahore https://orcid.org/0009-0009-3042-0093
Sajid Hussain The University of Lahore https://orcid.org/0009-0001-9400-3952
Taslim Arif The University of Haripur https://orcid.org/0000-0002-0718-5330
Abdul Basit Gomal University Dera Ismail Khan https://orcid.org/0009-0007-0102-154X
Mohammad Asad Khan Ayub Medical College Abbott Abad https://orcid.org/0009-0007-3080-7787
Yasmeen Iqbal The University of Lahore https://orcid.org/0000-0002-0126-6084

DOI:

https://doi.org/10.15561/26649837.2025.0601

Keywords:

exertion, fitness, limitations, strenuous, rehabilitation

Abstract

Background and Study Aim. Football is a physically demanding sport with a high risk of injuries, particularly anterior cruciate ligament (ACL) and hamstring strain injuries (HSIs). These injuries often lead to re-injury, prolonged rehabilitation, and reduced career longevity. Although various preventive strategies are applied, their relative effectiveness in reducing such risks among adolescent male footballers remains a matter of practical concern. This study aimed to determine the effects of integrated neuromuscular training on key injury-related risk factors. Material and Methods. Sixty-eight male adolescent footballers aged 16–18 years from two academies in Lakki Marwat were recruited for the study. Sixty-two participants completed the intervention, while six withdrew for personal reasons. The intervention group (n = 31) followed an eight-week INT program, consisting of four sessions per week, each lasting 80–90 minutes. The control group (n = 31) continued their routine football training. Pre- and post-test assessments were conducted to evaluate the effects of INT on the dependent variables. The Tuck Jump Assessment (TJA) was used to analyze landing biomechanics, a key risk factor for ACL injury. Isokinetic dynamometry was used to assess hamstring strength and calculate the conventional (Hcon:Qcon) and functional (Hexc:Qcon) hamstring-to-quadriceps ratios. The Active Knee Extension (AKE) test was used to assess hamstring flexibility. Results. The most significant result in the INT group was a 51% reduction in the TJA score, supported by a large effect size (d = 2.41). Overall, large effect sizes (d = 1.56–1.73) confirmed the intervention’s potential effectiveness, as the INT group showed significant improvements from pre- to post-test in all tested variables. Conclusions. Significant positive changes were observed in TJA scores, indicating improved landing mechanics and a lower risk of ACL injury. Additionally, the intervention group demonstrated significant improvements in muscle peak torque, Hcon:Qcon ratio, Hexc:Qcon ratio, and AKE range of motion. These findings confirm that INT can simultaneously reduce key risk factors related to both movement mechanics and muscle strength for ACL and HSIs in adolescent male footballers.

Author Biographies

Mohibullah Khan Marwat, The University of Lahore

Professor; mohibullah.khan@ed.uol.edu.pk; Department of Sports Sciences and Physical Education, Faculty of Allied Health Sciences; Lahore, Pakistan.

Hummaira Farah, The University of Lahore

Associate Professor, hummaira.farah@sps.uol.edu.pk; Department of Sports Sciences and Physical Education, Faculty of Allied Health Sciences; Lahore, Pakistan.

Kashif Mehmood, The University of Lahore

kashif.mehmood@sports.uol.edu.pk; Department of Sports Sciences and Physical Education, Faculty of Allied Health Sciences,; Lahore, Pakistan.

Sajid Hussain, The University of Lahore

sajid.hussain@sports.uol.edu.pk; Department of Sports Sciences and Physical Education, Faculty of Allied Health Sciences; Lahore, Pakistan.

Taslim Arif, The University of Haripur

Assistant Professor; tasleem.arif@uoh.edu.pk; Department of Sports Science and Physical Education; Haripur, Pakistan.

Abdul Basit, Gomal University Dera Ismail Khan

chandabasitchanda@gmail.com; Department of Sports Science and Physical Education; Dera Ismail Khan, Pakistan.

Mohammad Asad Khan, Ayub Medical College Abbott Abad

asad.mrwt.37@gmail.com; Abbot Abad-Khyber Pakhtunkhwah, Pakistan.

Yasmeen Iqbal, The University of Lahore

Professo; yasmeen.iqbal@ahs.uol.edu.pk; Department of Sports Sciences and Physical Education, Faculty of Allied Health Sciences; Lahore, Pakistan.

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