Interventions for preventing hamstring injuries.

Goldman, Elliott and Jones, Diana (2010) Interventions for preventing hamstring injuries. Cochrane Database of Systematic Reviews 2010. ISSN 1469-493X

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Official URL: http://dx.doi.org/10.1002/14651858.CD006782.pub2

Abstract

Background
Some sports, such as football, have a high incidence of hamstring injuries. Various interventions targeting the prevention of such injuries are in common use.

Objectives
To assess the effects (primarily, on the incidence of hamstring injuries) of interventions used for preventing hamstring injuries in physically active individuals.

Search Strategy
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (to December 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2008, Issue 4), MEDLINE and other databases (to December 2008), reference lists and clinical trials registers.

Selection criteria
Randomised or quasi-randomised trials of interventions for preventing hamstring injuries were included; as were trials testing interventions for the prevention of lower-limb injuries, provided that hamstring injuries were reported. Secondary outcomes included compliance, severity and the occurrence of other leg injuries.

Data Collection and Analysis
Two authors independently screened search results, assessed methodological quality and extracted data. Risk ratios (RR) and 95% confidence intervals (95% CI) were calculated for dichotomous variables and are reported for individual and pooled data.

Main Results
Seven randomised controlled trials involving 1919 participants were included. All trials involved people, predominantly young adults, participating in regular sporting activities. Some trials were compromised by poor methodology, including lack of blinding and incomplete outcome data.Four trials, including 287 participants, examined interventions directly targeted at preventing hamstring injuries. Three of these trials, which tested hamstring strengthening protocols, had contradictory findings, with one small trial showing benefit (although the control rate of mainly minor hamstring injury was unusually high). The other two trials found no benefit, with a greater incidence of hamstring injury in the intervention group. One unpublished and underpowered trial provided some evidence that manual therapy may prevent lower-limb muscle strain (RR 0.13, 95% CI 0.02 to 0.97), although the finding for hamstring injury did not reach statistical significance (RR 0.21, 95% CI 0.03 to 1.66).Three trials testing interventions for preventing lower limb injuries for which data for hamstring injury were available found no statistically significant effect for hamstring injury for either proprioceptive protocols (two cluster randomised trials) or a warm up/cool down and stretching protocol (one trial).

Authors' Conclusions
There is insufficient evidence from randomised controlled trials to draw conclusions on the effectiveness of interventions used to prevent hamstring injuries in people participating in football or other high risk activities for these injuries. The findings for manual therapy need confirmation.

Item Type: Article
Additional Information: Issue 1. Art. No.: CD006782
Subjects: B900 Others in Subjects allied to Medicine
C600 Sports Science
Department: Faculties > Health and Life Sciences > School of Health, Community and Education Studies > Public Health and Wellbeing
Depositing User: EPrint Services
Date Deposited: 12 Feb 2010 15:32
Last Modified: 10 Aug 2015 11:40
URI: http://nrl.northumbria.ac.uk/id/eprint/3605

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