Attwood Matthew J, Roberts Simon P, Trewartha Grant, England Mike E, Stokes Keith A
Department for Health, University of Bath, Bath, UK.
School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK.
Br J Sports Med. 2018 Mar;52(6):368-374. doi: 10.1136/bjsports-2017-098005. Epub 2017 Oct 21.
Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men's collision sports such as rugby union is lacking.
To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players.
856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected 'normal practice' exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries.
Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7).
The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden.
旨在减少损伤的运动计划已被证明对一些非碰撞性运动有效，但在成年男子碰撞性运动（如英式橄榄球联盟）方面缺乏证据。
评估一项运动控制损伤预防运动计划对减少成年男子社区英式橄榄球联盟球员比赛损伤的效果。
邀请856个俱乐部参与这项前瞻性整群随机（单盲）对照试验，以俱乐部作为随机分组单位。81个俱乐部自愿参与并被随机分配（干预组/对照组）。整个赛季都遵循一项为期42周的运动计划。对照计划反映“常规做法”练习，而干预则侧重于本体感觉、平衡、切入、落地和阻力练习。结果指标为以下方面的比赛损伤发生率和负担：（1）所有≥8天的失能损伤；（2）目标性（下肢、肩部、头部和颈部，不包括骨折和撕裂伤）≥8天的失能损伤。
泊松回归分析未发现对总体损伤结果有明显影响。在目标性损伤发生率方面发现了可能有益的差异（率比（RR），90%置信区间=0.6，0.4至1.0），干预组下肢损伤发生率降低了40%（RR，90%置信区间=0.6，0.4至1.0），脑震荡发生率降低了60%（RR，90%置信区间=0.4，0.2至0.7）。对依从性最高（≥中位数依从性）的俱乐部组间比较显示，目标性损伤发生率（RR，90%置信区间=0.4，0.2至0.8）和目标性损伤负担（RR，90%置信区间=0.4，0.2至0.7）非常可能有益地降低了60%。
运动控制损伤预防计划可能有益地减少了下肢损伤和脑震荡。更高的干预依从性与降低目标性损伤发生率和负担相关。
