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Abstract
Background: Anterior cruciate ligament (ACL) injuries are a major concern in
female soccer players, with change of direction (COD) movements being a key contributor
to non-contact injuries. Traditional injury prevention programs have shown limited
effectiveness in addressing individual biomechanical deficits. This study aimed to evaluate
the effects of a 10-week unilateral strength training program on COD mechanics and
ACL injury risk factors. Methods: Eleven female soccer players participated in a pre–post
intervention study. Movement mechanics was assessed using the Cutting Movement
Assessment Score (CMAS) at 45◦, 75◦, and 90◦ angles. The training program included
unilateral lower limb strengthening exercises designed to enhance neuromuscular control
and reduce biomechanical risk factors. Risk profiles were analyzed before and after the
intervention. Statistical analyses included paired t-tests and effect size calculations. Results:
Significant improvements in CMAS scores were observed at all COD angles (p < 0.05), with
the largest effect at 90◦ (Cohen’s d = 2.1). The percentage of high-risk players decreased
from 82% to 0%, while the proportion of low-risk players increased from 36% to 73%.
Improved knee alignment, foot placement, and trunk stability were key contributors to
the observed movement enhancements. Conclusions: Unilateral strength training may
effectively improve COD mechanics and reduces biomechanical risk factors associated with
ACL injuries in female soccer players. Our findings suggest that individualized training
interventions can influence current injury prevention strategies.