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Volume 10, Issue 2 (Summer 2023)                   J Prevent Med 2023, 10(2): 170-181 | Back to browse issues page

Ethics code: IR.SSRI.REC.1400.1315


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Mohammadyari S, Nemati N. Effect of Stop-X Program on Jump-landing Mechanics and Quality of Movement in Injury-prone Male Cadets. J Prevent Med 2023; 10 (2) :170-181
URL: http://jpm.hums.ac.ir/article-1-663-en.html
1- Department of Physical Education and Sport Sciences, Faculty of Command and Management, Imam Ali University, Tehran, Iran.
2- Department of Sport Injuries and Corrective Exercises, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran.
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Introduction
Military training exposes cadets to musculoskeletal injuries in the lower extremity. These injuries range from mild to severe ligament sprains. Most of these injuries affect the knee joint, especially anterior cruciate ligament (ACL). ACL injuries have increased in recent years. To prevent ACL injury in military personnel, it is necessary to identify the risk factors and apply proper strategies to reduce the risk. It has been reported that the main mechanism of ACL injury during military training is the non-contact injury, most commonly by landing with the knee in the valgus position. There are numerous biomechanical and neuromuscular risk factors associated with an ACL injury. One of the most important risk factors is poor landing. Studies have shown that individuals with poor jump-landing performance (Tuck Jump test score) are more exposed to ACL injuries. Moreover, individuals with a low score in the Functional Movement Screen (FMS) test are more likely to have ACL injuries. Therefore, identifying these risk factors and using proper injury prevention programs to address these injuries are necessary. The German Knee Society has developed the Stop-X injury prevention to be used during warm-up. Its goal is to improve muscle strength, balance, and core stability, emphasizing on good biomechanical movement patterns. A study showed that using the Stop-X program for eight weeks could reduce the knee valgus angle and improve static and dynamic balance in young male soccer players. However, it could not change their knee flexion angle. Although there are many injury prevention programs, the outcomes are contradictory. Moreover, there are limited studies on the effects of injury prevention programs in military settings. Thus, this study aims to investigate the effect of the Stop-X program on jump-landing mechanics and the movement quality of cadets.

Methods
This is a quasi-experimental study. The study population consists of young male cadets with poor landing mechanics in Imam Ali University. Of these, 116 cadets were assessed for the study. All participants received information about the study and signed a written informed consent form before the study. Inclusion criteria were age 18-20 years, being healthy, and having poor jump-landing performance (Tuck Jump test score >6) and poor movement quality (FMS test score <14). Finally, 40 cadets met the inclusion criteria and participated in the study. All participants had at least a 2-year experience in sports training. They were randomly assigned to two groups of intervention (n=20, age= 19.05±0.68 years, height=1.75±0.06 m, weight=72.70±4.18 kg) and control (n=20, age=18.70±0.65 years, height=1.77±0.06 m, weight=74.10±4.90 kg). Both groups participated in the pre-test and post-test phases. The intervention group used the Stop-X program as a warm-up program before each training session for 8 weeks, three sessions per week. The control group performed their routine warm-up program, including soft running and performing static and dynamic stretching exercises in the upper and lower limbs. Both warm-up programs lasted for 20-25 minutes. Mann-Whitney U and Wilcoxon tests were used to examine the differences. 

Results
The independent t-test results showed no significant difference between the two groups in age, height, weight, BMI, and years of training (P>0.05). There was a significant reduction in the Tuck jump test score (P=0.001) and a significant increase in the FMS score (P=0.001) in the intervention group compared to the control group in the post-test phase. Moreover, there was a significant reduction in the Tuck Jump test score (P=0.001) and a significant increase in the FMS score (P=0.001) between the pre-test and post-test phases in the intervention group, but there were no significant differences in the control group (P>0.05).

Discussion
The main purpose of this study was to investigate the effect of the Stop-X injury prevention program on jump-landing mechanics and movement quality in military cadets. The results showed that the use of Stop-X program for eight weeks could improve jump-landing mechanics and the quality of movement. The Stop-X program consists of strength, core, functional, and balance exercises and emphasizes better knee control during landing. It is a multi-aspect training program that targets neuromuscular factors associated with a knee injury, but routine warm-up program does not include these factors and, thus cannot correct deficiencies in young cadets. Therefore, it seems that the Stop-X injury prevention program can be suitable for improving jump-landing performance and movement quality in young male cadets compared to a traditional warm-up programs. 

Ethical Considerations
Compliance with ethical guidelines

This study was approved by the ethics committee of the Sports Sciences Research Institute of Iran (Code: IR.SSRI.REC.1400.1315).

Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors' contributions
Conceptualization, editing, data analysis: Sajjad Mohammadyari; Writing, performing the intervention, data collection; Nezam Nemati.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors would like to thank the students and officials of Imam Ali Military University for their cooperation.

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Type of Study: Orginal | Subject: General
Received: 2022/10/11 | Accepted: 2022/12/3 | Published: 2023/09/1

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