The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials

Abstract

I Brage finner du siste tekst-versjon av artikkelen, og den kan inneholde små forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på bjsm.bmj.com: http://dx.doi.org/10.1136/bjsports-2013-092538 / In Brage you'll find the final text version of the article, and it may contain minor differences from the journal's pdf version. The original publication is available at bjsm.bmj.com: http://dx.doi.org/10.1136/bjsports-2013-092538

BACKGROUND: Physical activity is important in both prevention and treatment of
 many common diseases, but sports injuries can pose serious problems. OBJECTIVE:
 To determine whether physical activity exercises can reduce sports injuries and
 perform stratified analyses of strength training, stretching, proprioception and 
 combinations of these, and provide separate acute and overuse injury estimates.
 MATERIAL AND METHODS: PubMed, EMBASE, Web of Science and SPORTDiscus were
 searched and yielded 3462 results. Two independent authors selected relevant
 randomised, controlled trials and quality assessments were conducted by all
 authors of this paper using the Cochrane collaboration domain-based quality
 assessment tool. Twelve studies that neglected to account for clustering effects 
 were adjusted. Quantitative analyses were performed in STATA V.12 and sensitivity
 analysed by intention-to-treat. Heterogeneity (I(2)) and publication bias
 (Harbord's small-study effects) were formally tested. RESULTS: 25 trials,
 including 26 610 participants with 3464 injuries, were analysed. The overall
 effect estimate on injury prevention was heterogeneous. Stratified exposure
 analyses proved no beneficial effect for stretching (RR 0.963 (0.846-1.095)),
 whereas studies with multiple exposures (RR 0.655 (0.520-0.826)), proprioception 
 training (RR 0.550 (0.347-0.869)), and strength training (RR 0.315 (0.207-0.480))
 showed a tendency towards increasing effect. Both acute injuries (RR 0.647
 (0.502-0.836)) and overuse injuries (RR 0.527 (0.373-0.746)) could be reduced by 
 physical activity programmes. Intention-to-treat sensitivity analyses
 consistently revealed even more robust effect estimates. CONCLUSIONS: Despite a
 few outlying studies, consistently favourable estimates were obtained for all
 injury prevention measures except for stretching. Strength training reduced
 sports injuries to less than 1/3 and overuse injuries could be almost halved.

Seksjon for idrettsmedisinske fag / Department of Sports Medicine