A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 1: an analysis by classical training components

Abstract

Objectives: The primary purposes were (a) to estimate the pooled effects of injury prevention programs (IPPs) on reducing overall and some specific body regions (lower extremity, thigh, knee, and ankle) injury incidence rates (iiRs) and (b) to compare the effects of single- and multi-component IPPs on mitigating injury risk in youth team sport athletes. A secondary objective was to explore the individual effects of different components on these iiRs. Materials and methods: Searches were performed up to 15 January 2024 in PubMed, Web of Science, SPORTDiscus, and Cochrane Library. Eligible criteria were: exercise-based interventions evaluated against a control group, overall iiRs were reported, and youth (≤19 years old) team sport players. Two reviewers extracted data and assessed trial quality using the Consolidated Standards of Reporting Trials (CONSORT) statement, the Physiotherapy Evidence Database Scale (PEDro), and a risk of bias tool (Cochrane Back and Neck Group). Pooled effects were calculated by Frequentist random effects pairwise and network meta-analyses. Results: Twenty-one studies were included. IPPs reduced overall, lower extremities, thigh, knee, and ankle iiRs by an average of approximately 35%. Most of the IPPs demonstrated statistically significant risk mitigation effects for overall and lower extremity injuries compared to control group. Interventions comprised exclusively of strength ([IRR = 0.3 [95%ci = 0.10–0.93]) and flexibility (IRR = 0.49 [95%ci = 0.36–0.68]), as well as those including stability exercises, were the most effective measures for reducing injuries in youth team sports. Conclusions: The implementation of current IPPs in training sessions for several weeks has shown to be an effective strategy for reducing the risk of injury in youth team sport athletes by one-third. Indirect evidence suggests that strength, flexibility, and stability might be exercise components with the highest risk mitigation effects; however, more research is crucial to confirm our estimates with direct evidence