## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c c c c} \hline \hline \multicolumn{6}{c}{**Standard Warm-Up**} & \multicolumn{6}{c}{**Neuromuscular Warm-Up**} \\ \hline \hline  & & & & & & & **Differences** & \\  & & & & & & & **between** & \\  & & & & & & **T1–T0** & & & **Neuromuscular** & \\  & & & & & & & **and Standard** & \\  & & & & & & & **Warm-Up** & \\  & & & & & & & **(\(p\)-Values T1)** & \\ \hline RF (ms) & \(177.9\pm 92.9\) & \(182.0\pm 71.8\) & \(0.609\) & \(181.7\pm 97.7\) & \(335.6\pm 225.9\) & \(0.028\)\({}^{\star}\) & \(0.029\)\({}^{\star}\) & \(0.916\) \\ VM (ms) & \(176.1\pm 72.0\) & \(181.1\pm 60.7\) & \(0.316\) & \(175.2\pm 87.2\) & \(322.6\pm 163.3\) & \(0.004\)\({}^{\star}\) & \(0.013\)\({}^{\star}\) & \(1.148\) \\ BF (ms) & \(127.2\pm 54.9\) & \(128.7\pm 43.4\) & \(0.856\) & \(128.1\pm 64.2\) & \(201.9\pm 103.8\) & \(0.027\)\({}^{\star}\) & \(0.036\)\({}^{\star}\) & \(0.920\) \\ MH (ms) & \(127.4\pm 55.4\) & \(129.3\pm 50.0\) & \(0.628\) & \(130.4\pm 54.1\) & \(204.6\pm 108.6\) & \(<\)0.001 \({}^{\star}\) & \(0.032\)\({}^{\star}\) & \(0.890\) \\ \hline \end{tabular}  
* Means \(\pm\) standard deviations for continuous variables. Statistical analysis performed to assess the intra-group differences was the paired sample \(t\)-test; statistical analysis performed to the assess inter-group difference was the \(t\)-test.
* = \(p<0.05\). Abbreviations: RF: rectus femoris; VF: vastus medialis; BF: biceps femoris; MH: medial hamstrings.  
\end{table} 
Table 3: Differences in pre-activation time (ms) of knee stabilizer muscles before (T0) and after the intervention (T1) comparing the same study population (\(n=11\)), performing firstly standard warm-up and neuromuscular warm-up one week later. occurs in muscles during reinforcement maneuvers and causes an \"arousal\" reaction. The level of fusimotor excitation before an unexpected stretch influences the reaction of the muscle spindle Ia afferents to the stretch. [32]. Polysynaptic input from several afferents identified to cause alpha motoneuron responses arrive to fusimotor neurons. Moreover, the activated spindle afferents have a strong, short-latency influence on the alpha motoneurons [33]. The perturbation should be large and temporally extended to reprogram the transducer for appropriate operation under the conditions anticipated during this extended response [33]. Such an optimized state improves the resolution of the proprioceptive information received by the central nervous system and the afferent signal from unexpected perturbations is driven directly to the final target, in these case the knee stabilizer muscles [33]. Based on these premises, the neuromuscular warm-up represents an appropriately large and temporally extended polysynaptic input and acts as a reinforcement maneuver, exciting the dynamic fusimotor neurons and acutely improving the activation pattern of knee stabilizer muscles. This athlete-oriented training protocol focuses on balance exercises directing on knee control to not only prevent injuries but also improve dynamic balance; a better landing strategy, preferring two-legged landing, and with flexed knee and hip joint reduces the landing load; strength exercise, the \"Nordic hamstring lower\" exercise, and single-limb dead-lift exercise, that can act as ACL agonist [17; 28]. The program also included perturbation training techniques utilizing a balance board that is seen to improve motor control during game actions that are frequently linked to an ACL injury [18]. The exercise program presented in this study is multidimensional considering several aspects that could lower the probability of knee injury (agility, balance, strength, awareness of at-risk positions of the lower limb).