Evaluation of the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes: a critical review of relative risk reduction and numbers-needed-to-treat analyses
British Journal of Sports Medicine, 07/11/2012
Exclusive author commentary
Sugimoto D et al. – It was determined that, respectively, 108 and 120 individuals would need to be trained to prevent one non–contact or one overall anterior cruciate ligament (ACL) injury over the course of one competitive season. Although the relative risk reduction analysis indicated prophylactic benefits of neuromuscular training, the relatively large numbers–needed–to–treat indicated that many athletes are needed to prevent one ACL injury.
Dr Dai Sugimoto (07/20/2012) comments:
Based on 12 reviewed studies, a relative risk reduction (RRR) 73.4% (95% confidence interval (CI): 62.5% to 81.1%) and 43.8% (95% CI: 28.9% to 55.5%) for noncontact and overall ACL injuries was documented. From the numbers-needed-to treat (NNT) analysis, it was determined that 108 (95% CI: 86 to 150) and 120 (95% CI: 74 to 316) individuals would need to be trained to prevent one noncontact or one overall ACL injury during a course of one competitive athletic season. Although the RRR analysis indicated prophylactic effectiveness and benefits of neuromuscular training, the relatively large NNT indicated that many athletes are needed to be trained to prevent one ACL injury. A future direction to reduce NNT and improve the efficiency of ACL injury prevention strategies is to develop a screening system for identifying at risk athletes.