title: Injury risk factors, screening tests and preventative strategies: a systematic review of the evidence that underpins the perceptions and practices of 44 football (soccer) teams from various premier leagues.
abstract: OBJECTIVE
  To systematically review the scientific level of evidence for the 'Top 3' risk factors, screening tests and preventative exercises identified by a previously published survey of 44 premier league football (soccer) teams. Also, to provide an overall scientific level of evidence and graded recommendation based on the current research literature.
  
  
  METHODS
  A systematic literature search (Pubmed [MEDLINE], SportDiscus, PEDRO and Cochrane databases). The quality of the articles was assessed and a level of evidence (1++ to 4) was assigned. Level 1++ corresponded to the highest level of evidence available and 4, the lowest. A graded recommendation (A: strong, B: moderate, C: weak, D: insufficient evidence to assign a specific recommendation) for use in the practical setting was given.
  
  
  RESULTS
  Fourteen studies were analysed. The overall level of evidence for the risk factors previous injury, fatigue and muscle imbalance were 2++, 4 and 'inconclusive', respectively. The graded recommendation for functional movement screen, psychological questionnaire and isokinetic muscle testing were all 'D'. Hamstring eccentric had a weak graded 'C' recommendation, and eccentric exercise for other body parts was 'D'. Balance/proprioception exercise to reduce ankle and knee sprain injury was assigned a graded recommendation 'D'.
  
  
  CONCLUSIONS
  The majority of perceptions and practices of premier league teams have a low level of evidence and low graded recommendation. This does not imply that these perceptions and practices are not important or not valid, as it may simply be that they are yet to be sufficiently validated or refuted by research.
authors.affiliation: Univ Lille Nord de France, UDSL, Lille, France Research and Development Department, LOSC Lille Métropole Football Club, Lille, France.
authors.forename: Alan
authors.initials: A
authors.lastname: McCall
authors.affiliation: Research and Development Department, LOSC Lille Métropole Football Club, Lille, France Institute of Coaching and Performance, University of Central Lancashire, Lancashire, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Carling
authors.affiliation: Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Davison
authors.affiliation: Univ Lille Nord de France, UDSL, Lille, France Research and Development Department, LOSC Lille Métropole Football Club, Lille, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nedelec
authors.affiliation: Research and Development Department, LOSC Lille Métropole Football Club, Lille, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Le Gall
authors.affiliation: Univ Lille Nord de France, UDSL, Lille, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Berthoin
authors.affiliation: Univ Lille Nord de France, UDSL, Lille, France Research and Development Department, LOSC Lille Métropole Football Club, Lille, France.
authors.forename: Gregory
authors.initials: G
authors.lastname: Dupont
mesh_terms: D001265:Athletic Injuries / Q000517:prevention & control; D042241:Early Diagnosis; D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000379:methods; D005221:Fatigue / Q000209:etiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000293:injuries / Q000502:physiology; D004856:Postural Balance / Q000502:physiology; D011434:Proprioception / Q000502:physiology; D018570:Risk Assessment; D012307:Risk Factors; D012916:Soccer / Q000293:injuries*; D011795:Surveys and Questionnaires
keywords: exercise; prevention