School of Health and Life Sciences, Teesside University, Middlesbrough, TS1 3BA, UK.
School of Sport and Exercise Science, Liverpool John Moores University, Merseyside, UK.
Sports Med. 2024 Mar;54(3):645-658. doi: 10.1007/s40279-023-01950-w. Epub 2023 Oct 27.
Injuries are common in adult recreational athletes. Exercise-based injury prevention programmes offer the potential to reduce the risk of injury and have been a popular research topic. Yet, syntheses and meta-analyses on the effects of exercise-based injury prevention programmes for adult recreational athletes are lacking.
We aimed to synthesise and quantify the pooled intervention effects of exercise-based injury prevention programmes delivered to adults who participate in recreation sports.
Studies were eligible for inclusion if they included adult recreational athletes (aged > 16 years), an exercise-based intervention and used a randomised controlled trial design. Exclusion criteria were studies without a control group, studies using a non-randomised design and studies including participants who were undertaking activity mandatory for their occupation. Eleven literature databases were searched from earliest record, up to 9 June, 2022. The Physiotherapy Evidence Database (PEDro) scale was used to assess the risk of bias in all included studies. Reported risk statistics were synthesised in a random-effects meta-analysis to quantify pooled treatment effects and associated 95% confidence intervals and prediction intervals.
Sixteen studies met the criteria. Risk statistics were reported as risk ratios [RRs] (n = 12) or hazard ratios [HRs] (n = 4). Pooled estimates of RRs and HRs were 0.94 (95% confidence interval 0.80-1.09) and 0.65 (95% confidence interval 0.39-1.08), respectively. Prediction intervals were 0.80-1.09 and 0.16-2.70 for RR and HR, respectively. Heterogeneity was very low for RR studies, but high for HR studies (tau = 0.29, I = 81%). There was evidence of small study effects for RR studies, evidenced by funnel plot asymmetry and Egger's test for small study bias: - 0.99 (CI - 2.08 to 0.10, p = 0.07).
Pooled point estimates were suggestive of a reduced risk of injury in intervention groups. Nevertheless, these risk estimates were insufficiently precise, too heterogeneous and potentially compromised by small study effects to arrive at any robust conclusion. More large-scale studies are required to clarify whether exercise-based injury prevention programmes are effective in adult recreational athletes.
The protocol for this review was prospectively registered in the PROSPERO database (CRD42021232697).
成人娱乐运动员中常见受伤。基于运动的损伤预防计划有可能降低受伤风险，因此一直是一个热门的研究课题。然而，针对成人娱乐运动员的基于运动的损伤预防计划的效果，综合分析和荟萃分析仍然缺乏。
我们旨在综合和量化针对参加娱乐运动的成年人的基于运动的损伤预防计划的综合干预效果。
如果研究包括成年娱乐运动员（年龄大于 16 岁）、基于运动的干预措施，并采用随机对照试验设计，则符合纳入标准。排除标准为无对照组的研究、非随机设计的研究以及包括因职业需要而进行活动的参与者的研究。从最早的记录开始，我们对 11 个文献数据库进行了搜索，截至 2022 年 6 月 9 日。使用 Physiotherapy Evidence Database（PEDro）量表评估所有纳入研究的偏倚风险。以风险比（RR）（n=12）或风险比（HR）（n=4）报告的风险统计数据在随机效应荟萃分析中进行综合，以量化汇总治疗效果及其相关的 95%置信区间和预测区间。
有 16 项研究符合标准。风险统计数据报告为风险比（RR）（n=12）或风险比（HR）（n=4）。RR 和 HR 的汇总估计值分别为 0.94（95%置信区间 0.80-1.09）和 0.65（95%置信区间 0.39-1.08）。RR 和 HR 的预测区间分别为 0.80-1.09 和 0.16-2.70。RR 研究的异质性非常低，而 HR 研究的异质性很高（tau=0.29，I=81%）。RR 研究存在小样本研究效应的证据，表现在漏斗图不对称和 Egger 检验小样本偏倚：-0.99（CI-2.08 至 0.10，p=0.07）。
汇总的点估计表明干预组的受伤风险降低。然而，这些风险估计不够精确，异质性太高，并且可能受到小样本研究效应的影响，因此无法得出任何可靠的结论。需要更多的大规模研究来阐明基于运动的损伤预防计划对成年娱乐运动员是否有效。
本综述的方案在 PROSPERO 数据库（CRD42021232697）中进行了前瞻性注册。
