title: Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis.
abstract: Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice.
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology and Alberta Children's Hospital Research Institute for Child and Maternal Health, Calgary, Canada Departments of Pediatrics and Community Health Sciences, Cummings School of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Emery
authors.affiliation: Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec City, Canada.
authors.forename: Thierry-Olivier
authors.initials: TO
authors.lastname: Roy
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology and Alberta Children's Hospital Research Institute for Child and Maternal Health, Calgary, Canada Departments of Pediatrics and Community Health Sciences, Cummings School of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Whittaker
authors.affiliation: Sport Injury Prevention Research Centre, Faculty of Kinesiology and Alberta Children's Hospital Research Institute for Child and Maternal Health, Calgary, Canada Departments of Pediatrics and Community Health Sciences, Cummings School of Medicine, University of Calgary, Calgary, Canada.
authors.forename: Alberto
authors.initials: A
authors.lastname: Nettel-Aguirre
authors.affiliation: Department of Public and Occupational Health, the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Willem
authors.initials: W
authors.lastname: van Mechelen
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000517:prevention & control*; D002648:Child; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D009141:Musculoskeletal System / Q000293:injuries*; D010806:Physical Education and Training / Q000379:methods*; D020196:Trauma, Nervous System / Q000517:prevention & control*; D000067009:Youth Sports / Q000502:physiology*
keywords: Adolescent; Athlete; Evidence based review; Injuries; Prevention