Proprioceptive Training and Injury Prevention in a Professional Men's Basketball Team: A Six-Year Prospective Study

Abstract

Single limb stance instability is a risk factor for lower extremity injuries. Therefore, the development of proprioception may play an important role in injury prevention. This investigation considered a professional basketball team for 6 years, integrating systematic proprioceptive activity in the training routine. The purpose was to assess the effectiveness of proprioceptive training programs based on quantifiable instability, to reduce ankle sprains, knee sprains, and low back pain through developing refined and long-lasting proprioceptive control. Fifty-five subjects were studied. In the first biennium (2004-2006), the preventive program consisted of classic proprioceptive exercises. In the second biennium (2006-2008), the proprioceptive training became quantifiable and interactive by means of electronic proprioceptive stations. In the third biennium (2008-2010), the intensity and the training volume increased while the session duration became shorter. Analysis of variance was used to analyze the differences in proprioceptive control between groups, years, and bienniums. Injury rates and rate ratios of injury during practices and games were estimated. The results showed a statistically significant reduction in the occurrence of ankle sprains by 81% from the first to the third biennium (p < 0.001). Low back pain showed similar results with a reduction of 77.8% (p < 0.005). The reduction in knee sprains was 64.5% (not significant). Comparing the third biennium with the level of all new entry players, proprioceptive control improved significantly by 72.2% (p < 0.001). These findings indicate that improvements in proprioceptive control in single stance may be a key factor for an effective reduction in ankle sprains, knee sprains, and low back pain.

Figure 1

A and B, A proprioceptive training session. C, Orientation of the rocking base at −45° to affect different ranges of motion. D, Maintaining vertical stability with the weight-bearing ankle in maximum dorsiflexion. E, The real-time trace (yellow bars) of the rocking base (F) and the trace of the postural reader (blue line). Note the hypersupination in the first test of the season vs. the best test (G). H and I, Dynamic exploration of the ankle range: attempting to maintain 8° of inclination (pronation, eversion). K and L, Attempting to maintain 12° of inclination (supination, inversion). In both cases, the players were asked to minimize postural instability (blue line). J, Performing slalom by moving the rocking base on the sagittal plane (anterior and posterior). M, After the target line by moving the rocking base (yellow line) side-to-side (alternating supination and pronation).

Figure 2

Static single stance test (ST). Annual variations in proprioceptive control and postural control in the second (2006–2008) and third bienniums (2008–2010). EO = eyes open; EC = eyes closed. Mean ± SD; ****p < 0.001.

Figure 3

Static single stance test (ST). Significant improvements in proprioceptive control (EC) and postural control (EO) in the second and third bienniums vs. the initial test of all new entry players (all years). EO = eyes open; EC = eyes closed. Mean ± SD; ****p < 0.001; *p ≤ 0.05.

Figure 4

Dynamic single stance test. Annual variations in entropy (disorder of the system) and in one of its components: Postural instability (PI_xy) in the second and third bienniums. Each pair of columns represents the initial test (left) and the best test of the season (right). Mean ± SD; ****p < 0.001; ***p < 0.005.

Figure 5

Coupling single stance in terrestrial gravity and high-frequency rocking instability induces vertical control reprogramming in a short time. Proprioceptive control endurance (middle-term effect) and structural remodeling (long-term effect) additionally require cumulative and high-density volume of solicitations.