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.
Sports Med. 2023 Apr;53(4):837-848. doi: 10.1007/s40279-022-01797-7. Epub 2023 Feb 8.
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.
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.
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.
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.
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.
PROSPERO CRD42020221772.
踢足球会有很高的受伤风险。预防受伤是当务之急，因为受伤不仅会对健康产生负面影响，还可能会影响表现。各种基于多组分运动的足球运动员损伤预防计划已经在研究中进行了检验。
我们旨在调查与对照组相比，多组分运动损伤预防计划在所有年龄段的足球运动员中的疗效。
我们对随机和整群随机对照试验进行了系统评价和荟萃分析。从创建到 2022 年 6 月，我们在 CINAHL、Cochrane、PubMed、Scopus 和 Web of Science 数据库中进行了检索。为了确定研究的资格，我们使用了以下纳入标准：（1）包括足球（足球）运动员；（2）调查多组分运动损伤预防计划在足球中的预防效果；（3）包含来自随机或整群随机试验的原始数据；（4）以足球损伤为结局。使用 Cochrane 偏倚风险工具和 Grading of Recommendations Assessment, Development, and Evaluation（GRADE）分别评估风险偏倚和证据质量。结局指标是干预组和对照组在训练和比赛中受伤的总人数以及身体特定部位、接触和非接触伤的风险比（RR）。
15 项随机和整群随机对照试验，共有 22177 名运动员、5080 次损伤和 1587327 小时暴露，符合纳入标准，并报告了所需的结局指标。总体损伤数的点估计值（RR）为 0.71（95%置信区间 [CI] 0.59-0.85；95%预测区间 [PI] 0.38-1.32），证据质量为极低。下肢损伤的点估计值（RR）为 0.82（95% CI 0.71-0.94；95% PI 0.58-1.15），证据质量为中等；髋关节/腹股沟损伤的 RR 为 0.56（95% CI 0.30-1.05；95% PI 0.00-102.92），证据质量低；膝关节损伤的 RR 为 0.69（95% CI 0.52-0.90；95% PI 0.31-1.50），证据质量低；踝关节损伤的 RR 为 0.73（95% CI 0.55-0.96；95% PI 0.36-1.46），证据质量为中等；和腿筋损伤的 RR 为 0.83（95% CI 0.50-1.37），证据质量低。接触伤的点估计值（RR）为 0.70（95% CI 0.56-0.88；95% PI 0.40-1.24），证据质量为中等，而非接触伤的 RR 为 0.78（95% CI 0.55-1.10；95% PI 0.25-2.47），证据质量低。
本系统评价和荟萃分析表明，使用基于多组分运动的损伤预防计划治疗足球运动员的效果不确定且不一致。此外，大多数结果基于低质量证据。因此，需要高质量的试验来提供更可靠的证据。
PROSPERO CRD42020221772。
