Sports Injuries Prevention And Treatment Pdf
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Arch Intern Med. Increased participation in sports has led to more sports injuries. Evidence-based methods to prevent sports injuries are needed. A systematic review was conducted of the effects of randomized controlled interventions to prevent sports injuries.
A systematic search was performed of various databases and the reference lists of articles and reviews. Two reviewers independently extracted the data and assessed the methodological quality of the included trials. We found evidence of the preventive effect of 3 types of injury prevention interventions. Various interventions may prevent sports injuries. A decreased risk of sports injuries was associated with the use of insoles, external joint supports, and multi-intervention training programs.
More high-quality randomized controlled trials in different sports and populations are needed. Aside from its well-known health benefits, leisure physical activity may cause sports injuries.
At present many different methods to prevent sports injuries are recommended and practiced by sports participants. Several methods of sports injury prevention have been studied in randomized and nonrandomized studies, but the results have often been inconclusive and sometimes conflicting.
Some earlier systematic reviews 7 - 12 have summarized the effects of specific injury prevention methods based on RCTs, and a few of them have also included other controlled trials. To date, only 1 wider review 5 of RCTs of sports injuries covering a variety of preventive methods has been published. This review did not, however, include quality assessment of the included trials, and since its publication many new trials have been published. The aim of this systematic review of published RCTs is to summarize the effects of interventions targeted at preventing sports injuries.
In addition, the manual archives of the senior authors A. Two reviewers S. To be selected for this review a trial had to investigate the effects of any preventive intervention on sports injuries. On the basis of the abstract, we assessed whether the study had the potential to be included, and on the basis of the full article, we decided whether the study met the inclusion criteria. We included trials if they were randomized or quasirandomized, controlled, and published before January 1, Trials that in all likelihood had not been randomized and abstracts unaccompanied by a full article in a peer-reviewed journal were excluded.
In addition, the study report had to contain the injury rate or the number of injured individuals as an outcome, and the intervention protocol and outcome measures of the studies had to be explicitly described. In addition, to evaluate the methodological quality of the included studies, 2 independent reviewers S. If disagreements were not resolved, 3 other reviewers A. The assessment list of methodological quality consists of 11 criteria: randomization, concealed allocation, baseline similarity of the study groups, blinding of participants, blinding of care providers, blinding of assessors, co-interventions, compliance, dropout rate, timing of outcome measures, and intention-to-treat analysis.
The sum score ranged from 0 to We calculated the ORs using the number of injured individuals, except for 3 trials in which we used the number of injuries because information about the number of injured individuals was missing. Subgroups were formed on the basis of similarity of preventive methods despite the fact that the preventive methods reported were not identical in all respects and that study designs were otherwise somewhat methodologically heterogeneous.
In subgroups of studies, first, a qualitative assessment of results on primary outcome measures of studies was performed. Because there were differences between studies in the information available, this calculation was performed on the basis of an OR of 0.
We assessed heterogeneity between studies by using I 2 statistics. For these analyses we used the fixed-effects model in Review Manager version 4. To gather more precise information about the specific intervention methods used the studies were classified into subgroups Table 1. The scores for methodological quality of the 32 trials varied from 1 to 8 of 11 points Table 1 and Table 2. The mean score was 3. In 21 trials, no clear description of the method of randomization was given.
Only 5 of 32 trials provided convincing evidence that the allocation of treatment was adequately concealed. A true intention-to-treat analysis was performed in 12 trials. The full methodological quality assessment is given in Table 2.
Five trials 14 - 18 including 6 different comparisons participants assessed the effectiveness of different insoles to reduce lower extremity injuries compared with no insoles Table 1.
There was variation in the types of insoles used, but all 6 comparisons showed a trend toward preventive effects among those who used insoles compared with controls. In 1 study 15 this trend was statistically nonsignificant.
The effectiveness of custom-made and prefabricated ready-made insoles was similar Table 1. In 1 study 19 different types of orthoses were compared, and no statistically significant differences were found in injury incidence. Knee supports worn by military cadets while playing football 24 also showed a preventive effect on knee injuries. Wrist protectors were tested during snowboarding in 2 studies.
Four trials 21 , 27 - 29 participants testing balance board training to prevent injuries gave contradictory results Table 1. The highest effect size was seen in the study with the fewest participants. Two multi-intervention trials by Wedderkopp et al 30 , 31 that included balance board training participants showed a significant reduction in the number of injuries in the training groups compared with the control groups.
Multi-intervention programs without balance board training, including exercise and rehabilitation participants , were assessed as interventions in 4 trials Table 1. In the study by Ekstrand et al, 32 it was not possible to calculate the OR. All 6 multi-intervention training programs participants showed a reduction in the risk of injury in the intervention groups.
None of the 3 trials 36 - 38 on the effect of stretching and warm-up programs participants on the rate of lower extremity injuries showed preventive effects Table 1. The effect of a special mouth guard was assessed in the study by Barbic et al 39 in university football and rugby players.
The number of concussions observed did not differ between the intervention and control groups. In the study by Finch et al 40 it was not possible to calculate the OR, but the use of custom-made mouth guards seemed to prevent head including orofacial injuries among Australian football players. Modified basketball shoes did not display a preventive effect on ankle sprains or other lower extremity injuries.
The study by Arnason et al, which also included an awareness program, did not show the instructional video to have a preventive effect on soccer injuries. In 32 trials with 40 comparisons, a significant effect of different preventive methods in preventing sports injuries was reported for 19 interventions.
We grouped sports injury preventive methods into subgroups. The analysis showed that the use of insoles, external joint supports, and training programs, including different components, was effective in preventing injuries, whereas other prevention methods did not show a consistent preventive effect. We did not perform a comprehensive meta-analysis because of many different limitations related to the clinical and methodological diversity of the studies.
Other possible limitations include selection bias due to inadequate concealment of allocation in 27 trials; performance and detection bias because of inadequate blinding of participants, care providers eg, physicians, research assistant, or trainer , or outcome assessors in all 32 trials; attrition bias because of the lack of intention-to-treat analysis in 20 trials; and heterogeneity of follow-up times.
Because the number of specific types of trials was low, statistical evaluation of publication bias was limited. Overall, 3 trials showing high effect size had low numbers of participants. The best methodological quality score given in this review was 8 of 11 points.
In most sports injury prevention interventions, it is almost impossible to attain the maximum score because it is difficult to blind participants, physicians, and outcome assessors at the same time and to avoid co-interventions. It is possible that in many cases the quality criteria were in fact met but that because of inadequate reporting the studies may have scored lower points.
According to all 6 comparisons evaluated in this systematic review, the use of shock-absorbing insoles tended to reduce lower extremity injuries and stress fractures in military recruits. The present results are in line with the findings of Rome et al. Although recruits usually go through a high-intensity physical training period, the generalization of findings to athletes is not straightforward.
Athletes may already have an optimal shock-absorbing mechanism in their shoes, and thus, additional insoles may not help in injury prevention. The findings among military recruits may, however, have clinical relevance for formerly inactive individuals who start training programs to prevent or treat chronic diseases.
Note that on the basis of the studies available we did not see a difference in the effect size between studies evaluating the effect of custom-made vs prefabricated insoles. These types were directly compared with each other in only 1 study. The effectiveness of external joint supports has been assessed mostly in high-risk sporting activities, such as soccer, American football, basketball, parachute jumping, and snowboarding.
In all 4 of the trials assessed in this review, the use of external ankle supports provided beneficial protection against traumatic ankle injuries. Similar findings were established in a review by Handoll et al, 8 who conducted a meta-analysis of the effects of interventions used in the prevention of ankle ligament injuries.
The nonpreventive effect of modified shoes found by Barrett et al 41 can probably be explained from a biomechanical point of view. It is understandable that shoes cannot support the structures of an ankle to the same extent as more rigid orthoses, braces, and stabilizers.
The shoe may actually contribute to the twisting force during an ankle sprain, and in this situation it clearly does not support the ankle. Promising, but to some extent contradictory, findings were found using a balance board—training program as a preventive strategy.
Interventions were performed in home and in team practice, but the results did not show which of these strategies is more effective. A recent study by McGuine and Keene 50 gives further evidence for the preventive effect of balance training. Caraffa et al 51 conducted a prospective, controlled, nonrandomized study to assess the effect of a proprioceptive training program, including the use of a wobble board, in soccer players.
This study showed a significantly lower incidence of anterior cruciate ligament injuries in the training group compared with controls 0. Although balance board training seems to be effective in preventing ankle injuries, there is some disagreement whether balance board training alone prevents ankle injuries, and there is not enough evidence to date that it has a preventive effect on the risk of knee injuries.
All 6 of the multi-intervention training trials assessed implied that sports-related injuries could be prevented by using different prophylactic programs. It is likely that the preventive effect of these programs is the sum of several individual methods. Because of the complexity of study designs, it is almost impossible to clarify which component of the intervention program is effective and which part of the intervention is not.
Such multifactorial approaches are also usually highly labor intensive. The finding on the stretching and warm-up interventions reviewed is consistent with the results of 3 other reviews. The role of different stretching protocols should also be studied among populations other than military recruits and focusing on specific types of injuries.
The prospective nonrandomized controlled study by Jakobsen et al 52 investigated the preventive effect of an individual training program including stretching, warm-up, and cooldown in recreational long-distance runners. Again, in this study the rate of lower limb injuries did not differ between the intervention and control groups. A few RCTs have investigated the effects of other interventions, such as the use of instructional videos 44 , 45 and modified shoes.
Two studies 39 , 40 on mouth guards gave contradictory results, which could mainly be explained by the difference in injury outcomes, since mouth guards provide impact energy attenuation only during impacts to the mouth and therefore have limited function in preventing concussions.
Sports injuries occur during exercise or while participating in a sport. Children are particularly at risk for these types of injuries, but adults can get them, too. Read on to learn more about sports injuries, your treatment options, and tips for preventing them in the first place. Different sports injuries produce different symptoms and complications. The most common types of sports injuries include:. This treatment method is helpful for mild sports injuries.
Edited by CRC Press. Boca Raton, Florida - This popular handbook comprehensively covers the prevention and treatment of sports injuries, and is thus essential reading for all athletes, trainers, physio-therapists and doctors. It covers all international sports and features extensive use of action photographs. This easy-to-follow textbook features a glossary of key terms and protocols with rehabilitation exercises to provide readers with a solid understanding about how to effectively treat, rehabilitate, and prevent sports injuries. The search will be preserved in your account and can be re-run at any time.
Arch Intern Med. Increased participation in sports has led to more sports injuries. Evidence-based methods to prevent sports injuries are needed. A systematic review was conducted of the effects of randomized controlled interventions to prevent sports injuries. A systematic search was performed of various databases and the reference lists of articles and reviews. Two reviewers independently extracted the data and assessed the methodological quality of the included trials.
PDF | Introduction: It is widely recognised that physically active lifestyle and sport participation Recently, a growing interest in the issue of sports injury prevention has been registered. treatment and prevention of sports.
Sports Injuries Their Prevention and Treatment.pdf
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. 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.
It seems that you're in Germany. We have a dedicated site for Germany. Editors: Doral , M. In recent years, research studies into sports injuries have provided healthcare professionals with a better understanding of their etiology and natural history.
Traumatic Injuries. These knee injuries can adversely affect a player's longterm involvement in the sport. Football players also have a higher chance of ankle sprains due to the surfaces played on and cutting motions. Shoulder injuries are also quite common and the labrum cartilage bumper surrounding the socket part of the shoulder is particularly susceptible to injury, especially in offensive and defensive linemen.
Sports injuries are injuries that occur during sport , athletic activities, or exercising. In the United States , there are approximately 30 million teenagers and children combined who participate in some form of organized sport. An example of a format used to guide an examination and treatment plan is a S. P note or, subjective, objective, assessment, plan. Another important aspect of sport injury is prevention, which helps to reduce potential sport injuries. It is important to establish sport-specific dynamic warm-ups, stretching, and exercises that can help prevent injuries common to each individual sport.
Edited by CRC Press. Boca Raton, Florida - This popular handbook comprehensively covers the prevention and treatment of sports injuries, and is thus essential reading for all athletes, trainers, physio-therapists and doctors. It covers all international sports and features extensive use of action photographs. This easy-to-follow textbook features a glossary of key terms and protocols with rehabilitation exercises to provide readers with a solid understanding about how to effectively treat, rehabilitate, and prevent sports injuries. The search will be preserved in your account and can be re-run at any time. Subscribe to events in the category and receive new items by email.
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Sports injuries occur during exercise or while participating in a sport. Children are particularly at risk for these types of injuries, but adults can get them, too. Read on to learn more about sports injuries, your treatment options, and tips for preventing them in the first place. Different sports injuries produce different symptoms and complications. The most common types of sports injuries include:.
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