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Valentin S, Linton L, Sculthorpe NF. Effect of supervision and athlete age and sex on exercise-based injury prevention programme effectiveness in sport: A meta-analysis of 44 studies. Res Sports Med 2024; 32:705-724. [PMID: 37283040 DOI: 10.1080/15438627.2023.2220059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/23/2023] [Indexed: 06/08/2023]
Abstract
We aimed to evaluate the influence of supervision, athlete age and sex and programme duration and adherence on exercise-based injury prevention programme effectiveness in sport. Databases were searched for randomized controlled trials evaluating exercise-based injury prevention programme effectiveness compared to "train-as-normal". A random effects meta-analysis for overall effect and pooled effects by sex and supervision and meta-regression for age, intervention duration and adherence were performed. Programmes were effective overall (risk ratio (RR) 0.71) and equally beneficial for female-only (0.73) and male-only (0.65) cohorts. Supervised programmes were effective (0.67), unlike unsupervised programmes (1.04). No significant association was identified between programme effectiveness and age or intervention duration. The inverse association between injury rate and adherence was significant (β=-0.014, p = 0.004). Supervised programmes reduce injury by 33%, but there is no evidence for the effectiveness of non-supervised programmes. Females and males benefit equally, and age (to early middle age) does not affect programme effectiveness.
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Affiliation(s)
- Stephanie Valentin
- Sport and Physical Activity Research Institute, University of the West of Scotland, Blantyre, UK
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Linda Linton
- Edinburgh Sports Medicine Research Network & UK Collaborating Centre on Injury and Illness Prevention in Sport (UKCCIIS), Institute for Sport, PE and Health Sciences, FASIC Sport and Exercise Medicine Clinic, University of Edinburgh, Edinburgh, UK
| | - Nicholas F Sculthorpe
- Sport and Physical Activity Research Institute, University of the West of Scotland, Blantyre, UK
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Møller M, Nygaard Andersen L, Möller S, Kongsted A, Juhl CB, Roos EM. Health And Performance Promotion in Youth (HAPPY) hybrid effectiveness-implementation cluster randomised trial: comparison of two strategies to implement an injury prevention exercise programme in Danish youth handball. Br J Sports Med 2024:bjsports-2023-107880. [PMID: 39209524 DOI: 10.1136/bjsports-2023-107880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE To investigate if a combination of an online and onsite implementation strategy was superior to an online-only strategy in enhancing the use of an injury prevention exercise programme (IPEP) and in reducing the risk of shoulder, knee and ankle injuries in youth community handball players (age 11-17) over a handball season. METHODS In this 30-week hybrid effectiveness-implementation cluster randomised type 3 study, 20 youth handball clubs were randomly assigned 1:1 to either a combined online and onsite implementation strategy (coach workshop using the health action process approach behaviour change model and health service provider (HSP) support) or an online-only strategy (control group). The primary implementation outcome was coach-reported adherence, measured as the average IPEP exercise usage by the team over 30 weeks. The primary effectiveness outcome was player-reported handball playing time to any new handball-related shoulder, knee and ankle injuries, reported weekly using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. RESULTS We enrolled 63 coaches (27% women) and 945 players (mean age 14.5 years, 55% girls). Intention-to-treat analyses showed no statistically significant difference between implementation strategies in adherence (between-group difference 1.4, 95% CI -0.5 to 3.4) or in cumulative injury risk (between-group difference 5.5% points, 95% CI -2.2 to 13.1). CONCLUSION Our findings demonstrate that in youth community handball, a combined online and onsite implementation strategy, including a coach workshop and HSP support, was not superior to an online-only strategy regarding adherence to an IPEP or in reducing shoulder, knee and ankle injury risk. TRIAL REGISTRATION NUMBER NCT05294237.
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Affiliation(s)
- Merete Møller
- The Faculty of Health Sciences, Department of Sports Science and Clinical Biomechanics, Research Unit of Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lotte Nygaard Andersen
- Faculty of Health Sciences, Department of Sports Science and Clinical Biomechanics, Research Unit of Physical Activity and Health in Working life, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, Research Unit of Open, University of Southern Denmark, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Alice Kongsted
- The Faculty of Health Sciences, Department of Sports Science and Clinical Biomechanics, Research Unit of Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Carsten B Juhl
- The Faculty of Health Sciences, Department of Sports Science and Clinical Biomechanics, Research Unit of Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Ewa M Roos
- The Faculty of Health Sciences, Department of Sports Science and Clinical Biomechanics, Research Unit of Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Odense, Denmark
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Qin Z, Qin Y, Wang J. Neuromuscular Training Effects on Athletes' Jumping and Lower Limb Injury: A Systematic Review. J Mot Behav 2024; 56:600-613. [PMID: 38967242 DOI: 10.1080/00222895.2024.2369699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/28/2024] [Accepted: 06/09/2024] [Indexed: 07/06/2024]
Abstract
This study assessed the impact of integrated neuromuscular training (INT) on athletes' jumping performance and lower limb injury prevention. A thorough search across multiple databases, including PubMed, Web of Science, Science Direct, and the Cochrane Library, identified a sample of 19,805 athletes aged between 8.5 and 27.7 years. Results showed that INT led to a significant improvement in jumping ability (SMD = 0.45, 95% CI 0.30-0.60, P = 0.000) and a reduction in lower limb injuries (SMD = 0.68, 95% CI 0.62-0.74, P = 0.000). The most effective interventions lasted at least 25 minutes, conducted 2-5 times per week, for a minimum of 9 weeks. This approach was particularly beneficial for children and adolescents, as it enhanced their countermovement jump (CMJ) ability and helped in the prevention of injuries.
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Affiliation(s)
- Zhikai Qin
- Capital University of Physical Education and Sports, Beijing, China
| | | | - Junsheng Wang
- Capital University of Physical Education and Sports, Beijing, China
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4
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Zhang ZX, Lai J, Shen L, Krishna L. Effectiveness of exercise-based sports injury prevention programmes in reducing injury rates in adolescents and their implementation in the community: a mixed-methods systematic review. Br J Sports Med 2024; 58:674-684. [PMID: 38749672 DOI: 10.1136/bjsports-2023-107717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVE Despite evidence supporting the efficacy of sport injury prevention programmes (SIPPs) in adolescents, implementation of SIPPs in community settings is low. This review aims to synthesise and integrate evidence on the efficacy of exercise-based SIPPs in reducing injury rates in adolescents with implementation strategies for such programmes in the community. DESIGN A systematic review with meta-analysis, narrative synthesis and meta-aggregation was conducted, followed by a convergent segregated approach to integrate the findings. Sensitivity and subgroup analyses were conducted. Study appraisal was performed using Joanna Briggs Institute Critical Appraisal Checklists and Mixed Methods Appraisal Tool. DATA SOURCES Literature search of nine databases was carried out to identify studies in English from January 2012 to December 2022. ELIGIBILITY CRITERIA Included were randomised controlled trials (RCTs), qualitative or mixed-methods studies. Population included adolescents (10-19 years). Interventions included SIPPs. Outcomes were injury rate and rate ratio (IRR). Phenomena of interest were facilitators and barriers to the implementation of SIPPs. RESULTS 23 studies were included for analysis. Meta-analysis for 16 RCTs showed a protective effect of SIPP (IRR 0.63, 95% CI 0.53 to 0.74, p<0.00001) in adolescents. Meta-aggregation of seven qualitative/mixed-method studies revealed four sets of synthesised findings that impact implementation namely players' perceptions and beliefs, coaches as key facilitators, organisational support and characteristics of the SIPP. CONCLUSION Implementation of SIPPs provides a 37% risk reduction in adolescents but requires targeting key stakeholders through a top-down multifaceted approach for its efficacy to be translated. Future research should investigate the effectiveness of SIPPs and implementation strategies in adolescents in community settings.
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Affiliation(s)
- Zhe Xin Zhang
- Alice Lee Centre for Nursing Studies, National University of Singapore Yong Loo Lin School of Medicine, Singapore
| | - Joseph Lai
- National University of Singapore Yong Loo Lin School of Medicine, Singapore
| | - Liang Shen
- Biostatistics Unit, National University of Singapore Yong Loo Lin School of Medicine, Singapore
| | - Lingaraj Krishna
- Orthopaedic and Hand Surgery Partners Pte Ltd, Singapore
- Division of Sports, Shoulder & Elbow Surgery, Department of Orthopaedic Surgery, National University Hospital, Singapore
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Lutz D, van den Berg C, Räisänen AM, Shill IJ, Kim J, Vaandering K, Hayden A, Pasanen K, Schneider KJ, Emery CA, Owoeye OBA. Best practices for the dissemination and implementation of neuromuscular training injury prevention warm-ups in youth team sport: a systematic review. Br J Sports Med 2024; 58:615-625. [PMID: 38684329 DOI: 10.1136/bjsports-2023-106906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE To evaluate best practices for neuromuscular training (NMT) injury prevention warm-up programme dissemination and implementation (D&I) in youth team sports, including characteristics, contextual predictors and D&I strategy effectiveness. DESIGN Systematic review. DATA SOURCES Seven databases were searched. ELIGIBILITY The literature search followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. INCLUSION CRITERIA participation in a team sport, ≥70% youth participants (<19 years), D&I outcomes with/without NMT-related D&I strategies. The risk of bias was assessed using the Downs & Black checklist. RESULTS Of 8334 identified papers, 68 were included. Sport participants included boys, girls and coaches. Top sports were soccer, basketball and rugby. Study designs included randomised controlled trials (RCTs) (29.4%), cross-sectional (23.5%) and quasi-experimental studies (13.2%). The median Downs & Black score was 14/33. Injury prevention effectiveness (vs efficacy) was rarely (8.3%) prioritised across the RCTs evaluating NMT programmes. Two RCTs (2.9%) used Type 2/3 hybrid approaches to investigate D&I strategies. 19 studies (31.6%) used D&I frameworks/models. Top barriers were time restrictions, lack of buy-in/support and limited benefit awareness. Top facilitators were comprehensive workshops and resource accessibility. Common D&I strategies included Workshops with supplementary Resources (WR; n=24) and Workshops with Resources plus in-season Personnel support (WRP; n=14). WR (70%) and WRP (64%) were similar in potential D&I effect. WR and WRP had similar injury reduction (36-72%) with higher adherence showing greater effectiveness. CONCLUSIONS Workshops including supplementary resources supported the success of NMT programme implementation, however, few studies examined effectiveness. High-quality D&I studies are needed to optimise the translation of NMT programmes into routine practice in youth sport.
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Affiliation(s)
- Destiny Lutz
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Carla van den Berg
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Anu M Räisänen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Physical Therapy Education - Oregon, Western University of Health Sciences College of Health Sciences - Northwest, Lebanon, Oregon, USA
| | - Isla J Shill
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jemma Kim
- Department of Physical Therapy & Athletic Training, Doisy College of Health Sciences, Saint Louis University, Saint Louis, Missouri, USA
- Interdisciplinary Program in Biomechanics and Movement Science, University of Delaware College of Health Sciences, Newark, Delaware, USA
| | - Kenzie Vaandering
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Alix Hayden
- Libraries and Cultural Resources, University of Calgary, Calgary, Alberta, Canada
| | - Kati Pasanen
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Tampere Research Center for Sports Medicine, Ukk Instituutti, Tampere, Finland
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
- Alberta Chilrden's Hopsital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Kathryn J Schneider
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
- Alberta Chilrden's Hopsital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Sport Medicine Centre, University of Calgary, Calgary, Alberta, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
- Alberta Chilrden's Hopsital Research Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Oluwatoyosi B A Owoeye
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Physical Therapy & Athletic Training, Doisy College of Health Sciences, Saint Louis University, Saint Louis, Missouri, USA
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Guilfoyle L, Kenny IC, O'Sullivan K, Campbell MJ, Warrington GD, Glynn LG, Comyns T. Coaches of youth field sports as delivery agents of injury prevention programmes: how are we training the trainers? A scoping review. Br J Sports Med 2024; 58:144-153. [PMID: 38216323 PMCID: PMC10894822 DOI: 10.1136/bjsports-2023-106934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVE To systematically map the coach education (CE) component of injury prevention programmes (IPPs) for youth field sports by identifying and synthesising the design, content and facilitation strategies used to address competency drivers and behaviour change. DESIGN Scoping review. DATA SOURCES PubMed, PsycInfo, EMBASE, CINAHL, SportDiscus and Google Scholar electronic databases were searched using keywords related to IPPs and youth field sports. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Studies of IPPs in youth field sports, that provided 'train-the-trainer' education to coaches as designated delivery agents. RESULTS 20 studies from two field sports (soccer/football; n=17, Rugby Union; n=3) fulfilled the eligibility criteria. Eleven CE interventions occurred in the preseason and 18 occurred at one time-point (single day). Five studies cited use of a behavioural change theory or model in the design of their CE, most frequently the Health Action Process Approach model (n=5); and use of behavioural change techniques varied. Twelve of twenty studies (60%) reported some form of ongoing support to coaches following the CE primary intervention concurrent with IPP implementation. CONCLUSION CE that occurs on 1 day (one time-point) is most popular for preparing coaches as delivery agents of IPPs in youth field sports. While recognising pragmatic barriers, more expansive in-service training, support and feedback may enhance the effective implementation of IPPs. TRIAL REGISTRATION NUMBER https://doi.org/10.17605/OSF.IO/FMHGD.
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Affiliation(s)
- Lauren Guilfoyle
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Ian C Kenny
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kieran O'Sullivan
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Mark J Campbell
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Lero, The Science Foundation Ireland Centre for Software Research, University of Limerick, Limerick, Ireland
| | - Giles D Warrington
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Liam G Glynn
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Tom Comyns
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Centre, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Obërtinca R, Hoxha I, Meha R, Lama A, Bimbashi A, Kuqi D, Shabani B, Meyer T, der Fünten KA. Efficacy of Multi-Component Exercise-Based Injury Prevention Programs on Injury Risk Among Footballers of All Age Groups: A Systematic Review and Meta-analysis. Sports Med 2023; 53:837-848. [PMID: 36752977 PMCID: PMC10036279 DOI: 10.1007/s40279-022-01797-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 02/09/2023]
Abstract
BACKGROUND Playing football is associated with a high risk of injury. Injury prevention is a priority as injuries not only negatively impact health but also potentially performance. Various multi-component exercise-based injury prevention programs for football players have been examined in studies. OBJECTIVE We aimed to investigate the efficacy of multi-component exercise-based injury prevention programs among footballers of all age groups in comparison to a control group. METHODS We conducted a systematic review and meta-analysis of randomized and cluster-randomized controlled trials. CINAHL, Cochrane, PubMed, Scopus, and Web of Science databases were searched from inception to June 2022. The following inclusion criteria were used for studies to determine their eligibility: they (1) include football (soccer) players; (2) investigate the preventive effect of multi-component exercise-based injury prevention programs in football; (3) contain original data from a randomized or cluster-randomized trial; and (4) investigate football injuries as the outcome. The risk of bias and quality of evidence were assessed using the Cochrane Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The outcome measures were the risk ratio (RR) between the intervention and the control group for the overall number of injuries and body region-specific, contact, and non-contact injuries sustained during the study period in training and match play. RESULTS Fifteen randomized and cluster-randomized controlled trials with 22,177 players, 5080 injuries, and 1,587,327 exposure hours fulfilled the inclusion criteria and reported the required outcome measures. The point estimate (RR) for the overall number of injuries was 0.71 (95% confidence interval [CI] 0.59-0.85; 95% prediction interval [PI] 0.38-1.32) with very low-quality evidence. The point estimate (RR) for lower limb injuries was 0.82 (95% CI 0.71-0.94; 95% PI 0.58-1.15) with moderate-quality evidence; for hip/groin injuries, the RR was 0.56 (95% CI 0.30-1.05; 95% PI 0.00-102.92) with low-quality evidence; for knee injuries, the RR was 0.69 (95% CI 0.52-0.90; 95% PI 0.31-1.50) with low-quality evidence; for ankle injuries, the RR was 0.73 (95% CI 0.55-0.96; 95% PI 0.36-1.46) with moderate-quality evidence; and for hamstring injuries, the RR was 0.83 (95% CI 0.50-1.37) with low-quality evidence. The point estimate (RR) for contact injuries was 0.70 (95% CI 0.56-0.88; 95% PI 0.40-1.24) with moderate-quality evidence, while for non-contact injuries, the RR was 0.78 (95% CI 0.55-1.10; 95% PI 0.25-2.47) with low-quality evidence. CONCLUSIONS This systematic review and meta-analysis indicated that the treatment effect associated with the use of multi-component exercise-based injury prevention programs in football is uncertain and inconclusive. In addition, the majority of the results are based on low-quality evidence. Therefore, future high-quality trials are needed to provide more reliable evidence. CLINICAL TRIAL REGISTRATION PROSPERO CRD42020221772.
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Affiliation(s)
- Rilind Obërtinca
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany.
- Department of Physiotherapy, University of Gjakova "Fehmi Agani", Gjakova, Kosovo.
| | - Ilir Hoxha
- Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA
- Research Unit, Heimerer College, Pristina, Kosovo
- Evidence Synthesis Group, Pristina, Kosovo
| | - Rina Meha
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
- Research Unit, Heimerer College, Pristina, Kosovo
| | - Arber Lama
- Research Unit, Heimerer College, Pristina, Kosovo
- Evidence Synthesis Group, Pristina, Kosovo
- University Clinical Center of Kosovo, Pristina, Kosovo
| | | | | | - Bujar Shabani
- Research Unit, Heimerer College, Pristina, Kosovo
- University Clinical Center of Kosovo, Pristina, Kosovo
| | - Tim Meyer
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
| | - Karen Aus der Fünten
- Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken Campus, Building B8 2, 66123, Saarbrücken, Germany
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8
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Hu C, Du Z, Tao M, Song Y. Effects of Different Hamstring Eccentric Exercise Programs on Preventing Lower Extremity Injuries: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2057. [PMID: 36767424 PMCID: PMC9916392 DOI: 10.3390/ijerph20032057] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
This systematic review and meta-analysis aims to investigate the effects and differences of various hamstring eccentric training protocols for the prevention of lower limb injuries, and we further propose a more refined hamstring eccentric training protocol for the prevention of lower limb injuries. A literature search for the effects of hamstring eccentric training on lower extremity sports injuries was conducted using the PubMed, Web of Science, and EMBASE databases, and the literature was searched covering the period from the date of the database's creation to 20 August 2022. A meta-analysis of the included literature was performed using R.4.21 for lower extremity injuries, injuries in various parts of the lower extremity, and subgroup analysis for exercise frequency, exercise cycle, and exercise population. A total of 23 randomized controlled trial (RCT) studies were found to be included in the meta-analysis, and 15 of these trials, totaling 14,721 patients, were determined to be included in the overall lower extremity injury prevention effect. The analysis showed that the implementation of a hamstring eccentric training program reduced lower extremity injuries by 28%, and it resulted in a 46% decrease in hamstring injury rate and a 34% decrease in knee injury rate. The subgroup analysis revealed that the frequency of exercise was most significant in the twice-a-week exercise group, that the exercise program was most effective in preventing injuries in the 21-30-week exercise period, and that the program was most effective in preventing injuries in elite athletes and amateur adult athletic populations, compared with adolescents.
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9
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Leppänen M, Uotila A, Tokola K, Forsman-Lampinen H, Kujala UM, Parkkari J, Kannus P, Pasanen K, Vasankari T. Players with high physical fitness are at greater risk of injury in youth football. Scand J Med Sci Sports 2022; 32:1625-1638. [PMID: 35621388 DOI: 10.1111/sms.14199] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Abstract
The aim of this study was to investigate physical fitness, football-specific skills, and their association with injury risk in youth football. Altogether 447 male and female players aged 9-14 years (median 12 years) participated in performance tests and prospective follow-up. The physical fitness tests included five-jump test for distance, 30-m sprint, football-specific figure of eight agility, countermovement jump, and Yo-Yo intermittent endurance test level 1. The football-specific skill tests included dribbling and passing tests. Injuries and exposure were registered during the 20-week follow-up. Our candidate risk factors were low/high level of physical fitness measured with a composite score of physical fitness tests and low/high level of football-specific skills measured with a composite score of dribbling and passing tests. Secondarily, we investigated performance in individual tests and their association with injury risk. During the follow-up, players reported 565 injuries (264 acute and 301 overuse injuries). High level of physical fitness was associated with increased rate of all injuries (age-, sex-, and mean team exposure-adjusted IRR: 1.28, 95% CI: 1.04-1.58). The level of football-specific skills had no influence on the overall injury rate. Burden of overuse injuries, but not acute injuries was significantly higher in most fit players compared with the players in the reference group (IRR: 2.09, 95% CI: 1.04-4.24). In conclusion, most fit players were at greater risk of sustaining injuries in youth competitive football.
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Affiliation(s)
- Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Tampere University Hospital, Tampere, Finland
| | - Aliisa Uotila
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
| | | | | | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute, Tampere, Finland.,Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Alberta, Canada
| | - Tommi Vasankari
- UKK Institute, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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10
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The "SHRed Injuries Basketball" Neuromuscular Training Warm-up Program Reduces Ankle and Knee Injury Rates by 36% in Youth Basketball. J Orthop Sports Phys Ther 2022; 52:40-48. [PMID: 34972488 DOI: 10.2519/jospt.2022.10959] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of a neuromuscular training warm-up prevention program, Surveillance in High school and community sport to Reduce (SHRed) Injuries Basketball, for reducing all-complaint ankle and knee injuries in youth basketball players. DESIGN Quasi-experimental study. METHODS High school/club basketball teams (male and female players aged 11-18 years) in Calgary, Canada participated in 2016-2017 (control; season 1) and 2017-2018 (intervention; season 2). The control season included a standard-of-practice warm-up. In season 2, a SHRed Injuries Basketball coach workshop was completed by participating team coaches. Teams were randomized by school/club to an unsupervised or a supervised (weekly supervision by study personnel) implementation of the coach-delivered SHRed Injuries Basketball program. The 10-minute SHRed Injuries Basketball program included 13 exercises (ie, aerobic, agility, strength, balance). All-complaint ankle and knee injuries were collected weekly using validated injury surveillance. Multilevel, multivariable Poisson regression analyses (considering important covariates, clustering by team and individual, and offset by exposure hours) estimated incidence rate ratios (IRRs) by intervention group (season 1 versus season 2) and secondarily considered the control versus completion of the SHRed Injuries Basketball program, unsupervised and supervised. RESULTS Sixty-three teams (n = 502 players) participated in season 1 and 31 teams (n = 307 players: 143 unsupervised, 164 supervised) participated in season 2. The SHRed Injuries Basketball program was protective against all-complaint knee and ankle injuries (IRR = 0.64; 95% confidence interval [CI]: 0.51, 0.79). Unsupervised (IRR = 0.62; 95% CI: 0.47, 0.83) and supervised (IRR = 0.64; 95% CI: 0.49, 0.85) implementations of the SHRed Injuries Basketball program had similar protective effects. CONCLUSION The SHRed Injuries Basketball program was associated with a 36% lower rate of ankle and knee injuries. Neuromuscular training warm-ups are recommended as the minimal standard of practice for injury prevention in youth basketball. J Orthop Sports Phys Ther 2022;52(1):40-48. doi:10.2519/jospt.2022.10959.
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Hilska M, Leppänen M, Vasankari T, Aaltonen S, Raitanen J, Räisänen AM, Steffen K, Forsman H, Konttinen N, Kujala UM, Pasanen K. Adherence to an Injury Prevention Warm-Up Program in Children's Soccer-A Secondary Analysis of a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13134. [PMID: 34948744 PMCID: PMC8701740 DOI: 10.3390/ijerph182413134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022]
Abstract
This study examined the impact of high adherence to a neuromuscular training (NMT) warm-up on the risk of lower extremity (LE) injuries in children's soccer. Twenty U11-U14 youth clubs (n = 92 teams, 1409 players) were randomized into intervention (n = 44 teams) and control (n = 48 teams) groups. The intervention group was advised to perform an NMT warm-up 2 to 3 times a week for 20 weeks. Team adherence, injuries, and exposure were registered throughout the follow-up. Primary outcomes were the incidence of soccer-related acute LE injuries and the prevalence of overuse LE injuries. Intervention teams conducted mean 1.7 (SD 1.0) NMT warm-ups weekly through follow-up. The seasonal trend for adherence declined significantly by -1.9% (95% CI -0.8% to -3.1%) a week. There was no difference in the incidence of acute injuries nor the prevalence of overuse LE injuries in high team adherence group (n = 17 teams) compared to controls. However, the risk for acute noncontact LE injuries was 31% lower in the high team adherence group compared to controls (IRR 0.69, 95% CI 0.49 to 0.97). In an efficacy analysis (n = 7 teams), there was a significant reduction of 47% in the rate of noncontact LE injuries (IRR 0.53, 95% CI 0.29 to 0.97). In conclusion, teams conducted NMT warm-up sessions regularly, but with a declining trend. A greater protective effect was seen in teams with the highest adherence to the NMT warm-up.
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Affiliation(s)
- Matias Hilska
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (M.L.); (K.P.)
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (M.L.); (K.P.)
- Tampere University Hospital, 33500 Tampere, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (T.V.); (J.R.)
- Faculty of Medicine and Health Technology, Tampere University, 33520 Tampere, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine (FIMM), University of Helsinki, 00290 Helsinki, Finland;
| | - Jani Raitanen
- UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (T.V.); (J.R.)
- Faculty of Social Sciences (Health Sciences), Tampere University, 33520 Tampere, Finland
| | - Anu M. Räisänen
- Department of Physical Therapy Education—Oregon, College of Health Sciences—Northwest, Western University of Health Sciences, Lebanon, OR 97355, USA;
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Kathrin Steffen
- Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, 0806 Oslo, Norway;
| | - Hannele Forsman
- Eerikkilä Sports Institute Training Center, Eerikkilä, 31370 Tammela, Finland;
| | - Niilo Konttinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland; (N.K.); (U.M.K.)
- Research Institute for Olympic Sports, 40700 Jyväskylä, Finland
| | - Urho M. Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland; (N.K.); (U.M.K.)
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine, UKK Institute for Health Promotion Research, 33500 Tampere, Finland; (M.L.); (K.P.)
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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Hilska M, Leppänen M, Vasankari T, Clarsen B, Aaltonen S, Bahr R, Haapasalo H, Parkkari J, Kannus P, Pasanen K. Neuromuscular training warm‐up in the prevention of overuse lower extremity injuries in children's football: A cluster‐randomized controlled trial. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Matias Hilska
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
| | - Mari Leppänen
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
- Tampere University Hospital Tampere Finland
| | - Tommi Vasankari
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Benjamin Clarsen
- Oslo Sports Trauma Research Center Norwegian School of Sport Sciences Oslo Norway
| | - Sari Aaltonen
- Institute for Molecular Medicine (FIMM) University of Helsinki Helsinki Finland
| | - Roald Bahr
- Oslo Sports Trauma Research Center Norwegian School of Sport Sciences Oslo Norway
| | - Heidi Haapasalo
- Department of Orthopaedics and Traumatology Tampere University Hospital Tampere Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
- Tampere University Hospital Tampere Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
| | - Kati Pasanen
- Tampere Research Center of Sports Medicine UKK Institute for Health Promotion Research Tampere Finland
- Sport Injury Prevention Research Centre Faculty of Kinesiology University of Calgary Calgary AB Canada
- Alberta Children's Hospital Research InstituteUniversity of Calgary Calgary AB Canada
- McCaig Institute for Bone and Joint Health Cumming School of Medicine University of Calgary Calgary AB Canada
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Befus K, McDonough MH, Räisänen AM, Owoeye OBA, Pasanen K, Emery CA. Player adherence to SHRed injuries Basketball neuromuscular training warm‐up program: Can exercise fidelity be objectively measured? TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Kimberley Befus
- Sport Injury Prevention Research Centre Faculty of Kinesiology University of Calgary Calgary Alberta Canada
| | - Meghan H. McDonough
- Faculty of Kinesiology University of Calgary Calgary Alberta Canada
- O’Brien Institute of Public Health University of Calgary Calgary Alberta Canada
| | - Anu M. Räisänen
- Sport Injury Prevention Research Centre Faculty of Kinesiology University of Calgary Calgary Alberta Canada
- Department of Physical Therapy Education College of Health Sciences – Northwest Western University of Health Sciences Lebanon Oregon USA
| | - Oluwatoyosi B. A. Owoeye
- Sport Injury Prevention Research Centre Faculty of Kinesiology University of Calgary Calgary Alberta Canada
- Department of Physical Therapy and Athletic Training Doisy College of Health Sciences Saint Louis University Saint Louis Missouri USA
| | - Kati Pasanen
- Alberta Children’s Hospital Research Institute University of Calgary Calgary Alberta Canada
- McCaig Institute for Bone and Joint Health University of Calgary Calgary Alberta Canada
- Tampere Research Center of Sports Medicine UKK Institute Tampere Finland
| | - Carolyn A. Emery
- Sport Injury Prevention Research Centre Faculty of Kinesiology University of Calgary Calgary Alberta Canada
- O’Brien Institute of Public Health University of Calgary Calgary Alberta Canada
- Alberta Children’s Hospital Research Institute University of Calgary Calgary Alberta Canada
- McCaig Institute for Bone and Joint Health University of Calgary Calgary Alberta Canada
- Department of Pediatrics Cumming School of Medicine University of Calgary Calgary Alberta Canada
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Petushek EJ, Mørtvedt AI, Nelson BL, Hamati MC. The Effect of a Brief, Web-Based Animated Video for Improving Comprehension and Implementation Feasibility for Reducing Anterior Cruciate Ligament Injury: A Three-Arm Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9092. [PMID: 34501680 PMCID: PMC8431316 DOI: 10.3390/ijerph18179092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/20/2021] [Accepted: 08/20/2021] [Indexed: 11/27/2022]
Abstract
Neuromuscular injury prevention training (IPT) has been shown to reduce anterior cruciate ligament (ACL) injury risk by approximately 50%, but the implementation rate is low. One of the most important modifiable barriers for implementation is coaches' comprehension of risk and intervention strategies. This study aimed to evaluate the effect of a brief, web-based, animated video on ACL injury prevention comprehension and IPT implementation feasibility. Coaches in landing and cutting sports were recruited and randomized into three groups. (1) Intervention: brief multimedia animated video about ACL injury and prevention. (2) Active control: commonly accessed, text-based web resource about ACL injury and prevention. (3) Placebo control: brief multimedia video about concussions. Overall ACL comprehension-composed of basic ACL knowledge, risk knowledge, prevention knowledge, and severity knowledge-as well as implementation feasibility were all measured prior to and immediately following the interventions. Overall ACL comprehension improved the most in the animated video group (Cohen's d = 0.86) and, to a lesser degree, in the active control web-based article group (Cohen's d = 0.39). Both video and web-based article groups had greater implementation feasibility compared to the control group (p = 0.01). Overall, these initial results suggest that a brief, web-based, animated video has the potential to be a superior method for informing stakeholders in order to reduce traumatic injuries in sport.
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Affiliation(s)
- Erich J. Petushek
- Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, MI 49931, USA; (A.I.M.); (B.L.N.)
- Health Research Institute, Michigan Technological University, Houghton, MI 49931, USA
| | - Anne Inger Mørtvedt
- Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, MI 49931, USA; (A.I.M.); (B.L.N.)
| | - Brittany L. Nelson
- Department of Cognitive and Learning Sciences, Michigan Technological University, Houghton, MI 49931, USA; (A.I.M.); (B.L.N.)
| | - Mary C. Hamati
- Department of Orthopedics, School of Medicine, University of Colorado, Aurora, CO 80045, USA;
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