Effectiveness of an Unexpected Disturbance Program in the Early Stage of Rehabilitation in Athletes With Unilateral Knee Ligament Injury.

CONTEXT: Sensorimotor, proprioceptive, and neuromuscular programs are critical for the successful rehabilitation of injured athletes, and these decrease reinjury rates. OBJECTIVE: To investigate the effects of an unexpected disturbance program (UDP) on balance and unilateral strength metrics in athletes with unilateral knee ligament injury. DESIGN: A 3-week parallel-group experimental design consisting of 9 rehabilitation sessions. SETTING: National Sports Institute. PARTICIPANTS: Twenty-one national-level athletes (age 21.4 [4.4] y, body mass 63.9 [10.8] kg, height 169.0 [10.2] cm) who had sustained a unilateral knee ligament injury. INTERVENTION: An UDP program designed to evoke rapid sensorimotor responses was compared with traditional training and a nonexercise control group. MAIN OUTCOME MEASURES: Unilateral total, anteroposterior, and mediolateral sway with eyes open and closed and unilateral isometric strength. RESULTS: Traditional exercises tended to outperform the UDP when unilateral balance testing was performed with eyes open; however, balance improvement following UDP tended to be greater in the eyes-closed condition. Significant strength gains in both the injured and uninjured legs were only observed following the UDP. This increase in unilateral isometric strength was 23.4 and 35.1 kg greater than the strength improvements seen in the traditional rehabilitation and control groups (P < .05). CONCLUSIONS: UDP could improve neural aspects of rehabilitation to improve rehabilitation outcomes by improving strength, sensorimotor function, and proprioception. Given the complementary adaptations, an UDP could provide an effective adjunct to traditional rehabilitation protocols and improve return-to-play outcomes.

Improvement of Elite Female Athletes' Physical Performance With a 3-Week Unexpected Disturbance Program.

CONTEXT: Sensorimotor training is commonly used in a rehabilitative setting; however, the effectiveness of an unexpected disturbance program (UDP) to enhance performance measures in uninjured elite athletes is unknown. OBJECTIVE: To assess the impact of a 3-wk UDP program on strength, power, and proprioceptive measures. DESIGN: Matched-group, pre-post design. SETTING: National sport institute. PARTICIPANTS: 21 international-level female field hockey athletes. INTERVENTION: Two 45-min UDP sessions were incorporated into each week of a 3-wk training program (total 6 sessions). MAIN OUTCOME MEASURES: 1-repetition-maximum strength, lower-limb power, 20-m running speed, and proprioception tests were performed before and after the experimental period. RESULTS: Substantial improvements in running sprint speed at 5-m (4.4 ± 2.6%; effect size [ES]: 0.88), 10-m (2.1 ± 1.9%; ES: 0.51), and 20-m (1.0 ± 1.6%; ES: 0.23) were observed in the UDP group. Squat-jump performance was also clearly enhanced when compared to the control group (3.1 ± 6.1%; ES: 0.23). Small but clear improvements in maximal strength were observed in both groups. CONCLUSIONS: A 3-wk UDP can elicit clear enhancements in running sprint speed and concentric-only jump performance. These improvements are suggestive of enhanced explosive strength and are particularly notable given the elite training status of the cohort and relatively short duration of the intervention. Thus, the authors would reiterate the statement by Gruber et al (2004) that sensorimotor training is a "highly efficient" modality for improving explosive strength.