Prevention of groin injuries in sports: a systematic review with meta-analysis of randomised controlled trials.
OBJECTIVE
Groin injuries are common in football and ice hockey, and previous groin injury is a strong risk factor for future groin injuries, which calls for primary prevention. The aim of this systematic review was to evaluate the effect of specific groin-injury prevention programmes in sports.


METHODS
A comprehensive search was performed in May 2014 yielding 1747 potentially relevant references. Two independent assessors evaluated randomised controlled trials for inclusion, extracted data and performed quality assessments using Cochrane's risk of bias tool. Quantitative analyses were performed in Review Manager 5.3.


RESULTS
Seven trials were included: six on football players (four male and two female populations) and one on male handball players. In total there were 4191 participants with a total of 157 injuries. The primary analysis, including all participants, did not show a significant reduction in the number of groin injuries after completing a groin injury prevention programme (relative risk (RR) 0.81; 95% CI 0.60 to 1.09). Subgroup analysis based on type of sports, gender and type of prevention programme showed similar non-significant estimates with RR ranging from 0.48 to 0.81.


CONCLUSIONS
Meta-analysis revealed a potential clinically meaningful groin injury reduction of 19%, even though no statistical significant reduction in sport-related groin injuries could be documented.


BACKGROUND
PROSPERO registration ID CRD42014009614.
Department of Physical Therapy, Universitat Internacional de Catalunya, Barcelona, Spain.
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Esteve
Department of Occupational Therapy and Physiotherapy, Aalborg University Hospital, Aalborg, Denmark Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark.
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Rathleff
Department of Physical Therapy, Universitat Internacional de Catalunya, Barcelona, Spain.
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Bagur-Calafat
Iberoamerican Cochrane Centre, Sant Pau Biomedical Research Institute, Barcelona, Spain.
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Urrútia
Faculty of Health Sciences, Sports Orthopedic Research Center, Arthroscopic Centre Amager, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark Physical Medicine and Rehabilitation-Copenhagen (PMR-C), Amager-Hvidovre Hospital, Copenhagen University Hospital, Copenhagen, Denmark.
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Thorborg
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000517:prevention & control; D005260:Female; D006119:Groin / Q000293:injuries*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012916:Soccer / Q000293:injuries*; D014142:Track and Field / Q000293:injuries*; D055815:Young Adult