Biomechanical and Neuromuscular Factors Associated With Lower Extremity Injury Risk: A Randomized Controlled Trial

Background: Numerous studies have emphasized the importance of core strength in preventing lower extremity injuries. However, there is a paucity of concrete evidence regarding the effectiveness of core exercise. Objectives: The purpose of this study was to compare the effects of core stabilization exercises (CSE) on biomechanical and neuromuscular factors during the single-leg squat performance in amateur athletes. Methods: Amateur judo and field hockey players with poor single-leg squat performance were randomly assigned to CSE (n=17) or knee strengthening exercises (KSE, n=17). Both groups participated in supervised exercise sessions 3 times per week for 6 weeks. Primary outcomes included hamstring-to-quadriceps muscle activation ratio (H:Q ratio) and dynamic knee valgus angle during the single-leg squat. Measurements were performed at baseline and after 6 weeks, and statistical significance was set at p < 0.05. Results: The CSE group showed significant improvements in the H:Q ratio (difference: CSE -0.35 ± 0.03 vs. KSE 0.04 ± 0.02, p < 0.001) and dynamic knee valgus angle (difference: CSE -10.89 ± 4.43° vs. KSE -1.71 ± 1.19°, p < 0.001) compared to the KSE group. Conclusions: In conclusion, amateur athletes completing a six-week CSE program demonstrated significantly greater improvements in neuromuscular activation patterns and frontal plane knee control during a single-leg squat task compared to those undergoing traditional knee strengthening.