Department of Sports Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
Br J Sports Med. 2012 Nov;46(14):979-88. doi: 10.1136/bjsports-2011-090895. Epub 2012 Jun 28.
Since previous numbers-needed-to-treat (NNT) and relative risk reduction (RRR) report, a few studies were published to evaluate prophylactic effectiveness of neuromuscular training for anterior cruciate ligament (ACL) injury in female athletes. The purpose of the current analyses was to determine the effectiveness of neuromuscular training interventions in reducing both non-contact and overall ACL injury risk in female athletes through RRR and NNT. The keywords 'knee', 'anterior cruciate ligament', 'ACL', 'prospective', 'neuromuscular', 'training', 'female' and 'prevention' were searched to find studies published from 1995 to 2011 in PubMed and EBSCO (CINAHL, Health source, MEDLINE and SPORT Discus). Inclusion criteria required that relevant studies: recruited physically active young girls as subjects, documented the number of ACL injuries, employed a neuromuscular training intervention, and used a prospective controlled study design. The numbers of non-contact and overall ACL injuries, subjects and observation time period were used to calculate RRR and NNT for each study. A total of 12 studies met the inclusion criteria. There was a 73.4% (95% CI 62.5% to 81.1%) and 43.8% (95% CI 28.9% to 55.5%) of RRR for non-contact and overall ACL injuries. From the NNT analysis, it was determined that, respectively, 108 (95% CI 86 to 150) and 120 (95% CI 74 to 316) individuals would need to be trained to prevent one non-contact or one overall ACL injury over the course of one competitive season. Although the RRR analysis indicated prophylactic benefits of neuromuscular training, the relatively large NNT indicated that many athletes are needed to prevent one ACL injury. A future direction to reduce NNT and improve the efficiency of ACL injury-prevention strategies is to develop a screening system for identifying at-risk athletes.
自先前的需要治疗人数（NNT）和相对风险降低（RRR）报告以来，已经发表了一些研究来评估神经肌肉训练对女性运动员前交叉韧带（ACL）损伤的预防效果。目前分析的目的是通过 RRR 和 NNT 确定神经肌肉训练干预在降低女性运动员非接触性和总体 ACL 损伤风险方面的有效性。在 PubMed 和 EBSCO（CINAHL、Health source、MEDLINE 和 SPORT Discus）中，使用“膝盖”、“前交叉韧带”、“ACL”、“前瞻性”、“神经肌肉”、“训练”、“女性”和“预防”等关键词搜索 1995 年至 2011 年发表的研究。纳入标准要求相关研究：招募身体活跃的年轻女孩作为研究对象，记录 ACL 损伤的数量，采用神经肌肉训练干预，并使用前瞻性对照研究设计。每个研究的非接触性和总体 ACL 损伤数量、受试者和观察时间用于计算 RRR 和 NNT。共有 12 项研究符合纳入标准。非接触性和总体 ACL 损伤的 RRR 分别为 73.4%（95% CI 62.5%至 81.1%）和 43.8%（95% CI 28.9%至 55.5%）。从 NNT 分析来看，分别需要 108 人（95% CI 86 至 150 人）和 120 人（95% CI 74 至 316 人）接受训练，以在一个竞技赛季内预防一次非接触性或一次总体 ACL 损伤。尽管 RRR 分析表明神经肌肉训练具有预防效果，但相对较大的 NNT 表明需要许多运动员来预防一次 ACL 损伤。减少 NNT 和提高 ACL 损伤预防策略效率的未来方向是开发一种筛选系统，以识别高危运动员。
