We have limited targets for our sports injury prevention approaches

Rounding upon her PhD thesis, Ingrid Vriend just got a positive reply form Sports Medicine on her review that summarises the target level of published sports injury prevention studies. Prevention of sport injuries is crucial to maximise the health and societal benefits of a physically active lifestyle. To strengthen the translation and implementation of the available evidence base on effective preventive measures, a range of potentially relevant strategies should be considered. The aim of this review was to identify and categorise intervention strategies for the prevention of acute sport injuries evaluated in the scientific literature, applying the Haddon matrix, and identify potential knowledge gaps.  

Five electronic databases were searched (PubMed, EMBASE, SPORTDiscus, CINAHL, Cochrane) for studies that evaluated the effect of interventions on the occurrence of acute sport injuries. Studies were required to include:

  • a control group / condition
  • prospective data collection, and
  • a quantitative injury outcome measure.

A total of 155 studies were included, mostly randomised controlled trials (43%). The majority of studies (55%) focussed on strategies requiring a behavioural change on the part of athletes.

Flow chart of literature search and study selection. CINAHL Cumulative Index to Nursing and Allied Health Literature, Cochrane Cochrane Central Register of Controlled Trials 

Flow chart of literature search and study selection. CINAHL Cumulative Index to Nursing and Allied Health Literature, Cochrane Cochrane Central Register of Controlled Trials 

Studies predominantly evaluated the preventive effect of various training programmes targeted at the ‘pre-event’ phase (n = 73) and the use of equipment to avoid injury in the ‘event phase’ (n = 29). A limited number of studies evaluated the preventive effect of strategies geared at rules and regulations (n = 14), and contextual modifications (n = 18). Studies specifically aimed at preventing re-injuries were a minority (n = 8), and were mostly related to ankle sprains (n = 5).

Absolute number of studies reporting the prevention of acute sport injuries categorised by intervention strategy following the modified Haddon matrix, and the proportion of studies with a statistically significant effect. Colour coding indicates the proportion of studies with a statistically significant effect: white < 25%; grey 25–75%; dark grey > 75%; – no studies 

Absolute number of studies reporting the prevention of acute sport injuries categorised by intervention strategy following the modified Haddon matrix, and the proportion of studies with a statistically significant effect. Colour coding indicates the proportion of studies with a statistically significant effect: white < 25%; grey 25–75%; dark grey > 75%; – no studies 

Valuable insight into the extent of the evi-dence base of sport injury prevention studies was obtained for 20 potential intervention strategies. This approach can be used to monitor potential gaps in the knowledge base on sport injury prevention. 

Vriend I, Gouttebarge V, Finch CF, van Mechelen W, Verhagen E. Intervention Strategies Used in Sport Injury Prevention Studies: A Systematic Review Identifying Studies Applying the Haddon Matrix. Sports Med. 2017 Mar 16;174(6):1–17