Effects of specific balance and agility training on risk of acute knee and ankle injuries in army recruits: A cluster-randomised controlled trial

The balance and agility training demonstrated no statistically significant effect on overall all lower limb injury incidence (relative risk (RR) for IG relative to CG) = 1.25, 95% CI 0.97-1.53, 90% CI 1.04-1.47), on knee and ankle injury incidence (RR = 1.08, 95% CI 0.83-1.38), or on the incidence of knee and ankle ligament injuries (RR = 0.98, 95% CI 0.64-1.47). This type of structured balance and agility training added to normal military recruit physical training does not significantly reduce lower limb, knee and ankle, or knee and ankle ligament injury risk. In fact, from a risk management perspective, it should be noted that the intervention, implemented in this fashion, is possibly harmful, with our best estimate of effect being a 25% increase in lower limb injury incidence rates. Possible reasons for the lack of effect in this context include the unusual range of injury causes, such as tripping or stumbling on uneven ground and gradual onset. Interconnected may be the robust nature and high levels of cumulative fatigue identified in recruit training. It may also be that the implemented program of balance and agility was not effective in the form used.