DiStefano Lindsay J, Frank Barnett S, Root Hayley J, Padua Darin A
Department of Kinesiology, University of Connecticut, Storrs, Connecticut.
Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Sports Health. 2017 Nov/Dec;9(6):524-531. doi: 10.1177/1941738117731732. Epub 2017 Oct 4.
Neuromuscular preventive training programs effectively reduce injury and improve performance in youth athletes. However, program effectiveness is directly linked to program compliance, fidelity, and dosage. Preventive training programs are not widely adopted by youth sport coaches. One way to promote widespread dissemination and compliance is to identify implementation strategies that influence program adoption and maintenance. It is unknown how previously published programs have followed the elements of an implementation framework. The objective of this review was to evaluate how elements of the 7 steps of implementation, developed by Padua et al, have been performed in the evidence of lower extremity preventive training programs.
A systematic review of the literature from 1996 through September 2016 was conducted using electronic databases. Investigations that documented implementation of a sport team-based neuromuscular preventive training program in youth athletes and measured lower extremity injury rates were included.
Clinical review.
Level 4.
A total of 12 studies met the inclusion criteria and were reviewed. Information regarding the completion of any of the 7 steps within the implementation framework developed by Padua et al was extracted. None of the 12 articles documented completion of all 7 steps. While each study addressed some of the 7 steps, no study addressed maintenance or an exit strategy for youth athletes. Program implementation appears limited in obtaining administrative support, utilizing an interdisciplinary implementation team, and monitoring or promoting fidelity of the intervention.
Despite strong evidence supporting the effectiveness of preventive training programs in youth athletes, there is a gap between short-term improvements and long-term implementation strategies. Future interventions should include all 7 steps of the implementation framework to promote transparent dissemination of preventive training programs.
神经肌肉预防训练计划能有效减少青少年运动员的损伤并提高其运动表现。然而,计划的有效性与计划的依从性、保真度和剂量直接相关。预防训练计划并未被青少年体育教练广泛采用。促进广泛传播和依从性的一种方法是确定影响计划采用和维持的实施策略。此前发表的计划如何遵循实施框架的要素尚不清楚。本综述的目的是评估帕多瓦等人制定的7个实施步骤的要素在下肢预防训练计划的证据中是如何实施的。
使用电子数据库对1996年至2016年9月的文献进行了系统综述。纳入了记录在青少年运动员中实施基于运动队的神经肌肉预防训练计划并测量下肢损伤率的研究。
临床综述。
4级。
共有12项研究符合纳入标准并进行了综述。提取了有关帕多瓦等人制定的实施框架内7个步骤中任何一个步骤完成情况的信息。12篇文章中没有一篇记录了所有7个步骤的完成情况。虽然每项研究都涉及了7个步骤中的一些步骤,但没有一项研究涉及青少年运动员的维持或退出策略。计划实施在获得行政支持、利用跨学科实施团队以及监测或促进干预的保真度方面似乎有限。
尽管有强有力的证据支持预防训练计划对青少年运动员的有效性,但短期改善与长期实施策略之间仍存在差距。未来的干预措施应包括实施框架的所有7个步骤,以促进预防训练计划的透明传播。