Effectiveness of multicomponent lower extremity injury prevention programmes in team-sport athletes: an umbrella review

Objective To identify which exercise combinations are most effective as part of a lower extremity injury prevention programme for team-sport athletes. Design Umbrella review. Data sources A comprehensive literature search was performed in PubMed, Scopus, Cochrane Library and PEDro databases. Studies published between January 2000 and March 2017 were included in this umbrella review. Study eligibility criteria Moderate to high-quality systematic reviews that investigated the effectiveness of a combination of two or more exercise components, that is, strength, agility, plyometrics, balance, stretching, technique, warm-up and functional activity, regarding injury incidence/rate of lower extremity injuries in team-sport athletes. The methodological quality of the included systematic reviews was independently assessed by two reviewers using the Assessing the Methodological Quality of Systematic Reviews measurement tool and the Grading of Recommendations Assessment, Development and Evaluation guidelines were used to assess the overall quality of evidence for particular outcomes. Results Twenty-four systematic reviews met the inclusion criteria. Multicomponent exercise interventions were effective in reducing the injury incidence/rate of lower extremity, knee, ACL and ankle injuries, but not groin injuries. Strength and balance exercise components were included in 10 of 11 effective injury prevention programmes for the lower extremity, knee, ACL and ankle injuries. Summary/conclusion Lower extremity injury prevention programmes in team sports are effective in preventing lower extremity, knee, ACL and ankle injuries. Lower extremity muscle strength and balance exercises should be prioritised in lower extremity injury prevention programmes for team-sport athletes.