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Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial [with consumer summary]
Olsen OE, Myklebust G, Engebretsen L, Holme I, Bahr R
BMJ 2005 Feb 26;330(7489):449-455
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effect of a structured warm-up programme designed to reduce the incidence of knee and ankle injuries in young people participating in sports. DESIGN: Cluster randomised controlled trial with clubs as the unit of randomisation. SETTING: 120 team handball clubs from central and eastern Norway (61 clubs in the intervention group, 59 in the control group) followed for one league season (eight months). PARTICIPANTS: 1837 players aged 15 to 17 years; 958 players (808 female and 150 male) in the intervention group; 879 players (778 female and 101 male) in the control group. INTERVENTION: A structured warm-up programme to improve running, cutting, and landing technique as well as neuromuscular control, balance, and strength. MAIN OUTCOME MEASURE: The rate of acute injuries to the knee or ankle. RESULTS: During the season, 129 acute knee or ankle injuries occurred, 81 injuries in the control group (0.9 (SE 0.09) injuries per 1,000 player hours; 0.3 (SE 0.17) in training versus 5.3 (SE 0.06) during matches) and 48 injuries in the intervention group (0.5 (SE 0.11) injuries per 1,000 player hours; 0.2 (SE 0.18) in training versus 2.5 (SE 0.06) during matches). Fewer injured players were in the intervention group than in the control group (46 (4.8%) versus (76 (8.6%); relative risk intervention group versus control group 0.53, 95% confidence interval 0.35 to 0.81). CONCLUSION: A structured programme of warm-up exercises can prevent knee and ankle injuries in young people playing sports. Preventive training should therefore be introduced as an integral part of youth sports programmes.
Reproduced with permission from the BMJ Publishing Group.

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