Background
Methods
Search and evaluation strategy
Inclusion and exclusion criteria
Inclusion Criteria |
---|
Those studies: |
• Which investigated neuromuscular warm-up strategies without the need for additional equipment other than that readily available at training or competition venues |
• for the prevention of any lower limb injury (hip, thigh, knee, ankle, leg) |
• using functional training |
• could be performed anywhere (for example, on-pitch) |
• without the use of specialist apparatus |
• easily incorporated into regular activity |
• Which are detailed enough for replication |
• Where injury incidence was an outcome |
Exclusion Criteria
|
Those studies: |
• Where the intervention is not part of a warm-up program |
• Using home-based exercises due to the poor uptake and regular commitment |
• Using equipment (for example, wobble board training) due to cost and availability |
• Where the intervention included training outside of sporting participation sessions |
• Where participants had an ongoing injury |
• Using no control or comparison group |
• Which were non-peer reviewed articles |
• Of single participant study design |
Quality Assessment
Data extraction and analysis
Results
Literature search
Study | Reason for study exclusion |
---|---|
Tropp et al. 1985 | Ankle discs, orthoses used |
Caraffa et al. 1996 | Balance boards used |
Bahr et al. 1997 | Balance boards used |
Hewett et al. 1999 | Wobble boards used |
Wedderkopp et al. 1999 | Ankle discs used |
Heidt et al. 2000 | Treadmill sessions implemented |
Söderman et al. 2000 | Wobble boards used |
Junge et al. 2002 | Not detailed enough for replication |
Kaminski et al. 2003 | Injury prevention not the primary outcome |
Stasinopoulos et al. 2004 | Orthoses, balance boards used |
Verhagen et al. 2004 | Wobble boards used |
Olsen et al. 2005 | Wobble boards used |
Garrick et al. 2005 | Wobble boards used |
Peterson et al. 2005 | Balance boards used |
Verhagen et al. 2005 | Injury prevention not the primary outcome |
McKuine et al. 2006 | Wobble boards used |
Mykleburst et al. 2007 | Lack of control group, mats and balance boards used |
Mohammadi et al. 2007 | Orthoses, ankle weights, resistance bands, wobble boards used |
McHugh et al. 2007 | Foam stability pad used |
Emery et al. 2007 | Wobble boards used |
Pasanen et al. 2008 | Wobble boards used |
Hupperets et al. 2008 | Wobble boards used |
Steffen et al. 2008 | Injury prevention not the primary outcome |
Hupperets et al. 2009 | Balance boards used |
Kraemer et al. 2009 | Balance boards used |
Lim et al. 2009 | Injury prevention not the primary outcome |
Eils et al. 2010 | Wobble boards used |
Eisen et al. 2010 | Injury prevention not the primary outcome |
Emery et al. 2010 | Wobble boards used |
Parkkari et al. 2011 | Sticks used as part of a training approach |
Methodological quality
Methodological Quality Criteria | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|
Study | Quality Score | A | B | C | D | E | F | G | H | I |
Mandelbaum et al. [1] | 5 | N | N | Y | N | Y | Y | Y | Y | N |
Pfeiffer et al. [1] | 5 | N | N | Y | N | Y | Y | Y | Y | NR |
Gilchrist et al. [1] | 5 | NR | N | Y | N | Y | Y | Y | Y | N |
Kiani et al. [1] | 6 | N | N | Y | Y | Y | Y | Y | Y | NR |
LaBella et al. [1] | 6 | Y | N | N | N | Y | Y | Y | Y | Y |
Soligard et al. [1] | 7 | NR | N | Y | Y | Y | Y | Y | Y | Y |
Steffen et al. [1] | 7 | Y | N | Y | Y | Y | N | Y | Y | Y |
Coppack et al. [1] | 8 | Y | N | Y | Y | Y | Y | Y | Y | Y |
Brushøj et al. [1] | 9 | Y | Y | Y | Y | Y | Y | Y | Y | Y |
Description of Studies
Study | Design | Participants | Neuromuscular warm-up program | Control Group | Outcome |
---|---|---|---|---|---|
Mandelbaum et al. [26] | CCT | 1,041 female soccer players, aged 14 to 18 years | Prevent Injury and Enhance Performance Programme: three basic warm-up exercises, five stretching exercises for the trunk and lower extremities, three strengthening exercises, five plyometric exercises and three soccer-specific agility drills. Performed before matches and training, 20 minutes, for two years | Normal warm-up strategy | ACL injuries |
Pfeiffer et al. [27] | CCT | 1,439 female soccer, basketball and volleyball players, aged 14 to 18 years | Knee Ligament Injury Prevention Programme: four progressive phases of jumping and landing forwards and backwards, two- and one-footed drills, plyometric and agility training. Performed either before or after training sessions twice a week, 20 minutes, for two consecutive seasons | Normal warm-up strategy | ACL injuries |
Gilchrist et al. [28] | RCT | 1,435 female football players, average age 19.9 years | Prevent Injury and Enhance Performance Program: Three basic warm-up exercises, five stretching exercises for the trunk and lower extremities, three strengthening exercises, five plyometric exercises and three soccer-specific agility drills. Before training, 20 minutes three times a week for 12 weeks | Normal warm-up strategy | Undefined knee and ACL injuries |
Kiani et al. [29] | CCT | 1,506 female football players, aged 13 to 19 years | The 'HarmoKnee' program: warm-up, muscle activation, balance, strength, core stability exercises. Performed twice a week preseason (three months), once a week during in-season training session (six months), total duration 20 to 25 minutes | Normal warm-up strategy | All new knee injuries |
LaBella et al. [30] | RCT | 1,558 female football and basketball players, average age 16 years | Knee Injury Prevention Program: combining progressive strengthening, plyometric, balance and agility exercises. In season for one year. Total duration 20 minutes before team practices, an abbreviated version with dynamic motion exercises only before games | Normal warm-up strategy | Gradual-onset lower extremity injuries, acute-onset non-contact lower extremity injuries, non-contact knee, ACL and ankle sprains |
Soligard et al. [31] | RCT | 1,982 female football players, aged 13 to 17 years | The '11+': 10 exercises including slow running, active stretching, controlled contact, exercises for strength, balance, jumping and soccer-specific agility drills. Before training, 20 minutes, only running exercises before match, for eight months | Normal warm-up strategy | Overall and overuse lower limb injuries, groin, posterior and anterior thigh injuries, undefined knee, MTSS and undefined ankle injuries |
Steffen et al. [32] | RCT | 2,020 female football players, aged 13 to 17 years | The '11': 10 exercises for core stability, balance, dynamic stabilization and eccentric hamstring strength. Two months preseason, six months in-season before training, 20 minutes for 15 consecutive training sessions then once a week thereafter | Normal warm-up strategy | Overall lower limb injuries, groin and thigh injuries, undefined knee and ACL injuries, and undefined ankle injuries |
Coppack et al. [33] | RCT | 1,502 male and female army recruits, aged 17 to 25 years | Anterior Knee Pain Prevention Training Programme: warm-up consisted of eight exercises closed chain strengthening exercises, 10 to 14 repetitions each; warm-down involved four stretching exercises, three repetitions. Performed at each training session (mean = seven per week), 15 minutes, for 14 weeks | Normal warm-up strategy (running, stretching, strengthening) | AKP |
Brushøj et al. [34] | RCT | 1,020 female and male army recruits aged 19 to 26 years | Prevention Training Programme: Five exercises for strengthening, balance, stretching performed in three sets of five to 25 repetitions. Before military training, 15 minutes, three times a week for 12 weeks | Strategy for the upper body | Overall and overuse lower limb injuries, AKP, patella tendinopathy, ITBFS, MTSS, ankle sprain and Achilles injuries. |