The aim of this systematic review was to update the knowledge on risk factors and prevention strategies for shoulder injuries in overhead sports with special emphasis on methodological quality. All methodological procedures were performed in line with a previous systematic review by Asker et al. (2018). The literature search was conducted in the PubMed, Google Scholar, Cochrane, and SPORT-Discuss databases. Due to the risk of bias assessment, only studies with at least an acceptable methodological quality were included. A best-evidence synthesis was performed to clarify the evidence and direction of the risk factors and prevention strategies. A total of nine studies were included in the data extraction process. One study had a high and eight studies had an acceptable methodological quality. Seven cohort studies investigated risk factors and two randomised controlled trails evaluated prevention strategies. Moderate evidence was found for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) that were associated with the shoulder injury risk. All further risk factors had moderate and no association with risk (shoulder rotational ROM, joint position sense) or limited (history of shoulder/elbow pain, age, training experience, training volume, school grade, playing level), and conflicting evidence (setting). There is moderate evidence for two non-modifiable (playing position, gender) and three modifiable factors (shoulder rotational strength, scapular dyskinesia, shoulder prevention programme) being associated with the shoulder injury risk in overhead sports.

中文翻译：

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高架运动中肩部损伤的危险因素和预防策略：更新的系统评价

本系统评价的目的是更新有关高架运动中肩部损伤的危险因素和预防策略的知识，特别强调方法学质量。所有方法程序均按照 Asker 等人先前的系统评价进行。（2018 年）。文献检索在 PubMed、Google Scholar、Cochrane 和 SPORT-Discuss 数据库中进行。由于偏倚评估的风险，仅包括至少具有可接受的方法学质量的研究。进行了最佳证据综合，以阐明风险因素和预防策略的证据和方向。数据提取过程中总共包括九项研究。一项研究具有较高的质量，八项研究具有可接受的方法学质量。七项队列研究调查了风险因素，两项随机对照试验评估了预防策略。发现了与肩部受伤风险相关的两个不可改变的因素（比赛位置、性别）和三个可改变的因素（肩部旋转力量、肩胛骨运动障碍、肩部预防计划）的中等证据。所有进一步的风险因素与风险（肩部旋转 ROM、关节位置感）或有限（肩/肘部疼痛史、年龄、训练经验、训练量、学校成绩、比赛水平）和相互矛盾的证据（设置）。有两个不可改变的因素（比赛位置、性别）和三个可改变的因素（肩部旋转力量、肩胛骨运动障碍、