Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory, Indiana State University, Terre Haute.
J Athl Train. 2017 Nov;52(11):1065-1067. doi: 10.4085/1062-6050-52.11.16. Epub 2017 Nov 15.
UNLABELLED: Reference: Schiftan GS, Ross LA, Hahne AJ. The effectiveness of proprioceptive training in preventing ankle sprains in sporting populations: a systematic review and meta-analysis. J Sci Med Sport. 2015;18(3):238-244. CLINICAL QUESTION: Does the use of proprioceptive training as a sole intervention decrease the incidence of initial or recurrent ankle sprains in the athletic population? DATA SOURCES: The authors completed a comprehensive literature search of MEDLINE, CINAHL, SPORTDiscus, and Physiotherapy Evidence Database (PEDro) from inception to October 2013. The reference lists of all identified articles were manually screened to obtain additional studies. The following key words were used. Phase 1 population terms were sport*, athlet*, and a combination of the two. Phase 2 intervention terms were propriocept*, balance, neuromusc* adj5 train*, and combinations thereof. Phase 3 condition terms were ankle adj5 sprain*, sprain* adj5 ankle, and combinations thereof. STUDY SELECTION: Studies were included according to the following criteria: (1) the design was a moderate- to high-level randomized controlled trial (>4/10 on the PEDro scale), (2) the participants were physically active (regardless of previous ankle injury), (3) the intervention group received proprioceptive training only, compared with a control group that received no proprioceptive training, and (4) the rate of ankle sprains was reported as a main outcome. Search results were limited to the English language. No restrictions were placed on publication dates. DATA EXTRACTION: Two authors independently reviewed the studies for eligibility. The quality of the pertinent articles was assessed using the PEDro scale, and data were extracted to calculate the relative risk. Data extracted were number of participants, intervention, frequency, duration, follow-up period, and injury rate. MAIN RESULTS: Of the initial 345 studies screened, 7 were included in this review for a total of 3726 participants. Three analyses were conducted for proprioceptive training used (1) to prevent ankle sprains regardless of history (n = 3654), (2) to prevent recurrent ankle sprains (n = 1542), or (3) as the primary preventive measure for those without a history of ankle sprain (n = 946). Regardless of a history of ankle sprain, participants had a reduction in ankle-sprain rates (relative risk [RR] = 0.65, 95% confidence interval [CI] = 0.55, 0.77; numbers needed to treat [NNT] = 17, 95% CI = 11, 33). For individuals with a history of ankle sprains, proprioceptive training demonstrated a reduction in repeat ankle sprains (RR = 0.64, 95% CI = 0.51, 0.81; NNT = 13, 95% CI = 7, 100). Proprioceptive training as a primary preventive measure demonstrated significant results (RR = 0.57, 95% CI = 0.34, 0.97; NNT = 33, 95% CI = 16, 1000). CONCLUSIONS: Proprioceptive training programs were effective in reducing the incidence rates of ankle sprains in the athletic population, including those with and those without a history of ankle sprains.
背景:Schiftan GS、Ross LA、Hahne AJ. 本体感觉训练在预防运动人群踝关节扭伤中的效果:系统评价和荟萃分析。J 科学医学与运动。2015;18(3):238-244。
临床问题:单独使用本体感觉训练作为单一干预措施是否会降低运动人群中初次或复发性踝关节扭伤的发生率?
数据来源:作者对 MEDLINE、CINAHL、SPORTDiscus 和 Physiotherapy Evidence Database(PEDro)进行了全面的文献检索,检索时间从成立到 2013 年 10 月。所有确定文章的参考文献列表均通过手动筛选以获取其他研究。使用了以下关键词。第一阶段人群术语为 sport*、athlet和两者的组合。第二阶段干预术语为 propriocept、balance、neuromusc* adj5 train和它们的组合。第三阶段疾病术语为 ankle adj5 sprain、sprain*adj5ankle和它们的组合。
研究选择:符合以下标准的研究被纳入:(1)设计为中等到高水平的随机对照试验(PEDro 量表>4/10),(2)参与者为活跃人群(无论以前是否有踝关节损伤),(3)干预组仅接受本体感觉训练,与未接受本体感觉训练的对照组相比,(4)踝关节扭伤率为主要结局。搜索结果仅限于英语。对发表日期没有限制。
数据提取:两位作者独立对研究进行了资格审查。使用 PEDro 量表评估相关文章的质量,并提取数据以计算相对风险。提取的数据包括参与者人数、干预措施、频率、持续时间、随访期和受伤率。
主要结果:在最初筛选出的 345 项研究中,有 7 项研究被纳入本综述,共有 3726 名参与者。对本体感觉训练的使用进行了 3 项分析:(1)用于预防踝关节扭伤,无论既往史如何(n=3654);(2)预防复发性踝关节扭伤(n=1542);或(3)作为无踝关节扭伤史者的主要预防措施(n=946)。无论是否有踝关节扭伤史,参与者的踝关节扭伤率均降低(相对风险 [RR] = 0.65,95%置信区间 [CI] = 0.55,0.77;需要治疗的人数 [NNT] = 17,95%CI = 11,33)。对于有踝关节扭伤史的患者,本体感觉训练可降低重复踝关节扭伤的发生率(RR = 0.64,95%CI = 0.51,0.81;NNT = 13,95%CI = 7,100)。本体感觉训练作为主要预防措施具有显著效果(RR = 0.57,95%CI = 0.34,0.97;NNT = 33,95%CI = 16,1000)。
结论:本体感觉训练方案可有效降低运动人群踝关节扭伤的发生率,包括有和无踝关节扭伤史的人群。
J Athl Train. 2017-11-15
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