There are more football injury prevention reviews than randomised controlled trials. Time for more RCT action!

Abstract

Introduction: Football is the most popular sport worldwide, and participation in football at any level is associated with numerous health benefits. However, participation in football at any level incurs a risk of sustaining musculoskeletal injuries. Effective injury prevention strategies are needed.

The first formal injury prevention randomised controlled trial (RCT) in football was published in 1983. We performed a scoping systematic review to provide an overview of the published articles on injury prevention in football.

Methods: A study protocol is available online at http://findresearcher.sdu.dk/portal/files/134191319/Protocol_scoping_revire_PURE.pdf. Although we primarily focused on RCTs, we also included systematic reviews and other studies investigating injury prevention strategies/interventions in football regardless of participant age, sex and level of participation.

Results: Our literature search identified 3131 studies, with 98 studies being included after removal of those studies that did not satisfy the inclusion criteria (online supplementary figure A). Reviews were the type of study most often published (43%), followed by RCTs (35%), cohort studies (20%) and surveys (2%) (online supplementary figure B). Of the reviews 55% were narrative and 43% were systematic, of which 47% pooled data in the form of a meta-analysis.

When we assessed the RCTs, exercise-based injury prevention interventions were used in 29 out of 34 studies, of which 18 included warm-up exercises, 9 strength training exercises and 5 balance training exercises. The populations included in exercise-based injury prevention studies were children (aged 8–12 years) in 1 study, adolescents (aged 13–17 years) in 11 studies and adults (≥18 years old) in 12 studies. Five studies included both adolescent and adult players. Non-elite players were included in 21 studies (10 on male players only, 7 on female players only, 3 on male and female players, and finally 1 did not report the sex of players). Elite players were included in 7 studies (6 on male players only, and 1 on male and female players). One study included both elite and non-elite male players. For an expanded overview, see figure 1 and online supplementary table 1.