Background

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.

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

Clinical Trial Registration

PROSPERO CRD42020221772.

中文翻译：

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基于运动的多成分损伤预防计划对所有年龄段足球运动员损伤风险的功效：系统评价和荟萃分析

背景

踢足球会带来很高的受伤风险。预防伤害是当务之急，因为伤害不仅会对健康产生负面影响，还会潜在地影响表现。研究已经检验了针对足球运动员的各种基于运动的多成分损伤预防计划。

客观的

我们的目的是调查与对照组相比，所有年龄段的足球运动员基于多成分运动的伤害预防计划的效果。

方法

我们对随机和整群随机对照试验进行了系统回顾和荟萃分析。从成立到 2022 年 6 月，对 CINAHL、Cochrane、PubMed、Scopus 和 Web of Science 数据库进行了检索。研究使用以下纳入标准来确定其资格：他们 (1) 包括足球运动员；(2) 调查足球运动中基于运动的多成分损伤预防计划的预防效果；(3) 包含来自随机或整群随机试验的原始数据；(4) 调查足球伤害作为结果。偏倚风险和证据质量分别使用 Cochrane 偏倚风险工具和建议评估、制定和评估分级 (GRADE) 进行评估。结果指标是干预组和对照组在研究期间训练和比赛期间受伤总数以及特定身体区域、接触性和非接触性损伤的风险比 (RR)。

结果

15 项随机和整群随机对照试验，涉及 22,177 名球员、5080 名受伤人员和 1,587,327 暴露时间，满足纳入标准并报告了所需的结果指标。受伤总数的点估计 (RR) 为 0.71（95% 置信区间 [CI] 0.59–0.85；95% 预测区间 [PI] 0.38–1.32），证据质量非常低。下肢损伤的点估计 (RR) 为 0.82（95% CI 0.71–0.94；95% PI 0.58–1.15），证据质量中等；对于髋部/腹股沟损伤，RR 为 0.56（95% CI 0.30–1.05；95% PI 0.00–102.92），证据质量较低；对于膝关节损伤，RR 为 0.69（95% CI 0.52–0.90；95% PI 0.31–1.50），证据质量较低；对于踝关节损伤，中等质量证据的 RR 为 0.73（95% CI 0.55–0.96；95% PI 0.36–1.46）；对于腿筋损伤，RR 为 0.83（95% CI 0.50-1.37），证据质量较低。接触性损伤的点估计 (RR) 为 0.70（95% CI 0.56–0.88；95% PI 0.40–1.24），证据质量中等，而非接触性损伤的 RR 为 0.78（95% CI 0.55–1.10） ；95% PI 0.25–2.47），证据质量低。

结论

这项系统评价和荟萃分析表明，在足球比赛中使用基于运动的多成分损伤预防计划相关的治疗效果是不确定且不确定的。此外，大多数结果都是基于低质量的证据。因此，未来需要高质量的试验来提供更可靠的证据。

临床试验注册

普洛斯彼罗 CRD42020221772。