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Injury prevention programmes with plyometric and strengthening exercises improve on-field performance: a systematic review
  1. Daphne I Ling,
  2. Nicholas A Cepeda,
  3. Niv Marom,
  4. Bridget Jivanelli,
  5. Robert G Marx
  1. Hospital for Special Surgery, New York City, New York, USA
  1. Correspondence to Dr Daphne I Ling, Hospital for Special Surgery, New York, NY 10021, USA; lingd{at}hss.edu

Abstract

Importance Injury prevention programmes (IPPs) have been demonstrated to be highly efficacious in protecting young athletes from anterior cruciate ligament and other lower-extremity injuries. However, the effectiveness of these programme in practice has been limited due to poor adherence among coaches of organised sports teams.

Objective A change in messaging from injury reduction to performance enhancement may be an effective strategy for improving adherence. We conducted a systematic review to address whether implementing IPP can also provide benefits on sports performance as measured by on-field tests.

Evidence review Data Sources: PubMed, EMBASE and Cochrane Library databases were searched from January 2000 to August 2018.

Study Selection: English-language studies were selected if they evaluated on-field performance testing before and after participation in the IPP or compared with another programme/control. No limitations were placed on study design or study population. Studies were excluded if they evaluated programme without an explicit focus on injury prevention or reported on injury risk factors that were not related to athletic performance.

Study design Systematic review

Data extraction Study design, population, sport and level, comparison group and duration/frequency of the IPP were extracted from full-text articles. The results of performance testing were summarised into the following categories: balance, sprinting, agility, jumping, physical fitness and sport-specific skills.

Findings The evidence shows that IPP can have beneficial effects on measures of sports performance and physical fitness. Factors that resulted in significant improvement included longer frequency and duration of the programme, as well as inclusion of plyometric and muscle strengthening exercises.

Conclusions There is a wide variety of measures used for athletic performance. IPPs that are done more frequently for longer durations and that include strengthening and plyometric exercises have been shown to improve athletic performance. Enhanced performance with tests that can be conducted on the field with existing equipment may help convince coaches and athletes to improve adherence with the IPP exercises.

Level of evidence Level II

  • ACL / PCL
  • epidemiology
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Footnotes

  • Twitter @LingDaphne

  • Contributors Daphne Ling had substantial contributions to the acquisition, analysis, and interpretation of data for the work and to the conception and design of the work; AND in drafting the work and revising it critically for important intellectual content; AND final approval of the version to be published; AND agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.Nicholas Cepeda had substantial contributions to the acquisition, analysis and interpretation of data for the work and to the conception and design of the work; AND in drafting the work and revising it critically for important intellectual content; AND final approval of the version to be published; AND agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.Niv Marom had substantial contributions to the acquisition, analysis, and interpretation of data for the work and to the conception and design of the work; AND final approval of the version to be published; AND agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Bridget Jivanelli had substantial contributions to the acquisition, analysis, and interpretation of data for the work and to the conception and design of the work; AND agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.Robert Marx had substantial contributions to the acquisition, analysis, and interpretation of data for the work and to the conception and design of the work; AND in drafting the work and revising it critically for important intellectual content; AND final approval of the version to be published; AND agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.

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