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      Compliance with Sport Injury Prevention Interventions in Randomised Controlled Trials: A Systematic Review

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          Abstract

          Introduction

          Sport injury prevention studies vary in the way compliance with an intervention is defined, measured and adjusted for.

          Objective

          The objective of this systematic review was to assess the extent to which sport injury prevention randomised controlled trials (RCTs) have defined, measured and adjusted results for compliance with an injury prevention intervention.

          Methods

          An electronic search was performed in MEDLINE, PubMed, the Cochrane Center of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database) and SPORTDiscus. English RCTs, quasi-RCTs and cluster-RCTs were considered eligible. Trials that involved physically active individuals or examined the effects of an intervention aimed at the prevention of sport- or physical activity-related injuries were included.

          Results

          Of the total of 100 studies included, 71.6 % mentioned compliance or a related term, 68.8 % provided details on compliance measurement and 51.4 % provided compliance data. Only 19.3 % analysed the effect of compliance rates on study outcomes. While studies used heterogeneous methods, pooled effects could not be presented.

          Conclusions

          Studies that account for compliance demonstrated that compliance significant affects study outcomes. The way compliance is dealt with in preventions studies is subject to a large degree of heterogeneity. Valid and reliable tools to measure and report compliance are needed and should be matched to a uniform definition of compliance.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s40279-016-0470-8) contains supplementary material, which is available to authorized users.

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          Most cited references 127

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          Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload.

          The primary purpose of this study was to evaluate whether a preseason strength training programme for the hamstring muscle group - emphasising eccentric overloading - could affect the occurrence and severity of hamstring injuries during the subsequent competition season in elite male soccer players. Thirty players from two of the best premier-league division teams in Sweden were divided into two groups; one group received additional specific hamstring training, whereas the other did not. The extra training was performed 1-2 times a week for 10 weeks by using a special device aiming at specific eccentric overloading of the hamstrings. Isokinetic hamstring strength and maximal running speed were measured in both groups before and after the training period and all hamstring injuries were registered during the total observational period of 10 months. The results showed that the occurrence of hamstring strain injuries was clearly lower in the training group (3/15) than in the control group (10/15). In addition, there were significant increases in strength and speed in the training group. However, there were no obvious coupling between performance parameters and injury occurrence. These results indicate that addition of specific preseason strength training for the hamstrings - including eccentric overloading - would be beneficial for elite soccer players, both from an injury prevention and from performance enhancement point of view.
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            Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial.

            To investigate the effect of a structured warm-up programme designed to reduce the incidence of knee and ankle injuries in young people participating in sports. Cluster randomised controlled trial with clubs as the unit of randomisation. 120 team handball clubs from central and eastern Norway (61 clubs in the intervention group, 59 in the control group) followed for one league season (eight months). 1837 players aged 15-17 years; 958 players (808 female and 150 male) in the intervention group; 879 players (778 female and 101 male) in the control group. A structured warm-up programme to improve running, cutting, and landing technique as well as neuromuscular control, balance, and strength. The rate of acute injuries to the knee or ankle. During the season, 129 acute knee or ankle injuries occurred, 81 injuries in the control group (0.9 (SE 0.09) injuries per 1000 player hours; 0.3 (SE 0.17) in training v 5.3 (SE 0.06) during matches) and 48 injuries in the intervention group (0.5 (SE 0.11) injuries per 1000 player hours; 0.2 (SE 0.18) in training v 2.5 (SE 0.06) during matches). Fewer injured players were in the intervention group than in the control group (46 (4.8%) v (76 (8.6%); relative risk intervention group v control group 0.53, 95% confidence interval 0.35 to 0.81). A structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing sports. Preventive training should therefore be introduced as an integral part of youth sports programmes.
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              A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players.

              Neuromuscular and proprioceptive training programs can decrease noncontact anterior cruciate ligament injuries; however, they may be difficult to implement within an entire team or the community at large. A simple on-field alternative warm-up program can reduce noncontact ACL injuries. Randomized controlled trial (clustered); Level of evidence, 1. Participating National Collegiate Athletic Association Division I women's soccer teams were assigned randomly to intervention or control groups. Intervention teams were asked to perform the program 3 times per week during the fall 2002 season. All teams reported athletes' participation in games and practices and any knee injuries. Injury rates were calculated based on athlete exposures, expressed as rate per 1000 athlete exposures. A z statistic was used for rate ratio comparisons. Sixty-one teams with 1435 athletes completed the study (852 control athletes; 583 intervention). The overall anterior cruciate ligament injury rate among intervention athletes was 1.7 times less than in control athletes (0.199 vs 0.340; P = .198; 41% decrease). Noncontact anterior cruciate ligament injury rate among intervention athletes was 3.3 times less than in control athletes (0.057 vs 0.189; P = .066; 70% decrease). No anterior cruciate ligament injuries occurred among intervention athletes during practice versus 6 among control athletes (P = .014). Game-related noncontact anterior cruciate ligament injury rates in intervention athletes were reduced by more than half (0.233 vs 0.564; P = .218). Intervention athletes with a history of anterior cruciate ligament injury were significantly less likely to suffer another anterior cruciate ligament injury compared with control athletes with a similar history (P = .046 for noncontact injuries). This program, which focuses on neuromuscular control, appears to reduce the risk of anterior cruciate ligament injuries in collegiate female soccer players, especially those with a history of anterior cruciate ligament injury.
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                Author and article information

                Contributors
                m.vanreijen@vumc.nl
                i.vriend@vumc.nl
                w.vanmechelen@vumc.nl
                c.finch@federation.edu.au
                +31 20444969 , e.verhagen@vumc.nl
                Journal
                Sports Med
                Sports Med
                Sports Medicine (Auckland, N.z.)
                Springer International Publishing (Cham )
                0112-1642
                1179-2035
                11 February 2016
                11 February 2016
                2016
                : 46
                : 1125-1139
                Affiliations
                [1 ]Department of Public & Occupational Health, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands
                [2 ]Amsterdam Collaboration on Health & Safety in Sports, IOC Research Center, AMC/VUmc, Amsterdam, The Netherlands
                [3 ]Consumer Safety Institute VeiligheidNL, Amsterdam, The Netherlands
                [4 ]School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
                [5 ]UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM), Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
                [6 ]Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, VIC Australia
                Article
                470
                10.1007/s40279-016-0470-8
                4963451
                26869058
                © The Author(s) 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001826, Netherlands Organisation for Health Research and Development;
                Award ID: 525001003
                Award Recipient :
                Categories
                Systematic Review
                Custom metadata
                © Springer International Publishing Switzerland 2016

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