The effectiveness of injury prevention programs to modify risk factors for non-contact anterior cruciate ligament and hamstring injuries in uninjured team sports athletes: a systematic review
Monajati A, Larumbe-Zabala E, Goss-Sampson M, Naclerio F
PLoS ONE 2016 May;11(5):e0155272
BACKGROUND: Hamstring strain and anterior cruciate ligament injuries are, respectively, the most prevalent and serious non-contact occurring injuries in team sports. Specific biomechanical and neuromuscular variables have been used to estimate the risk of incurring a non-contact injury in athletes.
OBJECTIVE: The aim of this study was to systematically review the evidences for the effectiveness of injury prevention protocols to modify biomechanical and neuromuscular anterior cruciate and/or hamstring injuries associated risk factors in uninjured team sport athletes.
DATA SOURCES: PubMed, Science Direct, Web of Science, Cochrane Libraries, US National Institutes of Health ClinicalTrials.gov, Sport Discuss and Google Scholar databases were searched for relevant journal articles published until March 2015. A manual review of relevant articles, authors, and journals, including bibliographies was performed from identified articles.
MAIN RESULTS: Nineteen studies were included in this review. Four assessment categories: (i) landing, (ii) side cutting, (iii) stop-jump, and (iv) muscle strength outcomes, were used to analyze the effectiveness of the preventive protocols. Eight studies using multifaceted interventions supported by video and/or technical feedback showed improvement in landing and/or stop-jump biomechanics, while no effects were observed on side-cutting maneuver. Additionally, multifaceted programs including hamstring eccentric exercises increased hamstring strength, hamstring to quadriceps functional ratio and/or promoted a shift of optimal knee flexion peak torque toward a more open angle position.
CONCLUSIONS: Multifaceted programs, supported by proper video and/or technical feedback, including eccentric hamstring exercises would positively modify the biomechanical and or neuromuscular anterior cruciate and/or hamstring injury risk factors.
Is exercise effective for the management of subacromial impingement syndrome and other soft tissue injuries of the shoulder? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Abdulla SY, Southerst D, Cote P, Shearer HM, Sutton D, Randhawa K, Varatharajan S, Wong JJ, Yu H, Marchand A-A, Chrobak K, Woitzik E, Shergill Y, Ferguson B, Stupar M, Nordin M, Jacobs C, Mior S, Carroll LJ, van der Velde G, Taylor-Vaisey A
Manual Therapy 2015 Oct;20(5):646-656
BACKGROUND: Exercise is a key component of rehabilitation for soft tissue injuries of the shoulder; however its effectiveness remains unclear. OBJECTIVE: Determine the effectiveness of exercise for shoulder pain.
METHODS: We searched seven databases from 1990 to 2015 for randomized controlled trials (RCTs), cohort and case control studies comparing exercise to other interventions for shoulder pain. We critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. We synthesized findings from scientifically admissible studies using best-evidence synthesis methodology.
RESULTS: We retrieved 4,853 articles. Eleven RCTs were appraised and five had a low risk of bias. Four studies addressed subacromial impingement syndrome. One study addressed nonspecific shoulder pain.
For variable duration subacromial impingement syndrome: (1) supervised strengthening leads to greater short-term improvement in pain and disability over wait listing; and (2) supervised and home-based strengthening and stretching leads to greater short-term improvement in pain and disability compared to no treatment.
For persistent subacromial impingement syndrome: (1) supervised and home-based strengthening leads to similar outcomes as surgery; and (2) home-based heavy load eccentric training does not add benefits to home-based rotator cuff strengthening and physiotherapy.
For variable duration low-grade nonspecific shoulder pain, supervised strengthening and stretching leads to similar short-term outcomes as corticosteroid injections or multimodal care.
CONCLUSION: The evidence suggests that supervised and home-based progressive shoulder strengthening and stretching are effective for the management of subacromial impingement syndrome. For low-grade nonspecific shoulder pain, supervised strengthening and stretching are equally effective to corticosteroid injections or multimodal care.