<BMJ> 论文：运动干预在防止运动损伤上的有效性：随机控制试验的一个系统检查和META分析

论文： 
运动干预在防止运动损伤上的有效性：随机控制试验的一个系统检查和META分析

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

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论文摘要 

背景 
体育锻炼对许多常见疾病的预防和治疗来说非常重要，但运动损伤却可能会引起严重问题。 

Background 

Physical activity is important in both prevention and treatment of many common diseases, but sports injuries can pose serious problems. 

目标 
我们要确认物理锻炼是否可以减少运动损伤，并对力量训练、伸展、本体感觉和这些运动的组合进行分层分析，此外还要提供单独的急性及过度性损伤估计。

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. 

材料和方法 
我们搜索了PubMed, EMBASE, Web of Science 和SPORTDiscus 网站得到了3462个相关结果。两个独立的作者选择了相对随机的对照试验，所有本文的作者通过运用基于域协作的Cochrane质量评估工具对质量检测做了控制。我们对12个被忽略会引起聚类效果的研究进行了调整。我们还在STATA V.12中进行了定量分析，同时还运用意向性治疗对敏感性进行了分析。我们还对异质性（I^2）和发表偏倚（Harbord小研究效应）进行了正式测试。 

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. 

结果 
我们对包括26 610个共身患3464处损伤的参与者在内的25项试验进行了分析。对损伤预防所做的整体效应估计多种多样。分层曝光分析证明了拉伸运动没有任何有益效应（RR =0.963（0.846-1.095）），然而对多重曝光（RR=0.655（0.520-0.826）），本体感觉训练（RR=0.550 （0.347-0.869）） ，以及力量训练（研究RR 0.315（0.207-0.480））的研究则表现出具有增强效果的倾向。急性损伤（RR=0.647（0.502-0.836））和过劳性损伤（RR=0.527（0.373-0.746））都可以通过体育锻炼项目减少。意向性治疗的敏感性分析持续地揭示了更高的强壮效应估计。 

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. 

结论 
尽管存在着一些偏远研究，我们仍然得到了除拉伸运动外对所有损伤的预防措施持续乐观的估计。力量训练使运动损伤减少至不到1 /3，且过劳性损伤几乎可以减少至一半。

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. 

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