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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|
|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: 1,837 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.