Integrative neuromuscular training for injury prevention of lower extremity in athletes: a meta-analysis

doi:10.12307/2022.606

Abstract

Abstract: OBJECTIVE: To evaluate the effect of integrative neuromuscular training for injury prevention of lower extremity in athletes using meta-analysis method, to provide the optimal dose-response of integrative neuromuscular training to prevent injuries in athletes.
METHODS: CNKI, WanFang, PubMed, Web of Science, and The Cochrane Library databases were searched for articles regarding effect of integrative neuromuscular training for injury prevention of lower extremity published from January 1, 2000 to June 20, 2021. The key words were “integrative neuromuscular training, neuromuscular training, neuromuscular warm-up, prevent, reduce, sports injury, lower limb injury” in Chinese, and “integrative neuromuscular training, neuromuscular training, neuromuscular warm-up, neuromuscular, prevent, reduces, lower limb injuries, injury, sport injuries” in English. The Review Manage 5.3 software was used to analyze the included articles. Subgroup analysis was performed in five variables, including training volume, frequency per week, period, sample size, and gender. Random effects model and global effect size were utilized to examine the heterogeneity and publication bias.
RESULTS: Totally 14 randomized controlled trials were included, with 15 932 subjects. (1) Meta-analysis results showed an overall risk reduction of 39% for the lower limbs (RR=0.61, 95% CI:0.53-0.69). (2) Subgroup analysis found that training volume of 16-20 minutes, training frequencies of 2-3 times per week, interventions for 4-6 months revealed the largest risk reduction. (3) The sample size of 50-1 000 produced better effects comparable to those with larger sample size. (4) Integrative neuromuscular training had a significant effect on the prevention of lower limb sports injury in males.
CONCLUSION: (1) Integrative neuromuscular training can effectively prevent athletes' lower limb sports injuries. Heterogeneity between articles can be explained by the country of origin of the subjects. (2) Integrative neuromuscular training with exercise volume of 16-20 minutes, 2-3 times per week for 4-6 months can achieve the optimal preventive effect.

Key words: integrative neuromuscular training, prevention of lower extremity injury, meta-analysis, athlete, training program

CLC Number:

Zhai Haiting, Li Cheng, Xia Jixiang, Wei Hongwen, Qin Shuang. Integrative neuromuscular training for injury prevention of lower extremity in athletes: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(15): 2454-2460.

Figures/Tables 8

(1) 运动时间：对纳入的14篇RCT文献，共计15 932例受试者进行亚组分析。结果显示10-15 min组和16-20 min组间存在中度异质性(I2=51%)。无论在10-15 min或16-20 min的效应量均具有统计学意义(P < 0.01)。其中，运动量在16-20 min组中效应量最明显RR=0.55(95% CI：0.45-0.68；Z=5.53；P < 0.01)。 (2)运动频率：对纳入的12篇RCT文献，共计12 284例受试者进行亚组分析。结果显示1次/周、2-3次/周、大于3次/周3组间的效应量存在中度异质性(I2=60%)。2-3次/周和大于3次/周的效应量均具有统计学意义(P < 0.01)，1次/周的组中只有1篇文献，不具有代表性。其中，2-3次/周产生的效应量最明显RR=0.56(95%CI：0.43-0.72；Z=4.52； P < 0.000 1)。 (3)运动周期：对纳入的12篇RCT文献，共计14 693例受试者进行亚组分析。结果显示4-6个月和大于6个月组间的效应量存在中度异质性(I2=57%)。两组的效应量均具有统计学意义(P < 0.01)。其中，运动周期4-6个月即可以最明显的效应RR=0.56(95% CI：0.45-0.71；Z=4.93；P < 0.000 01)。 (4)样本量：对纳入的14篇RCT文献，共计13 338例受试者进行亚组分析。结果显示样本量50-1 000组和样本量大于1 000组间的效应量存在中度异质性(I2=66%)。两组的效应量均具有统计学意义(P < 0.01)。样本量为50-1 000组的效应量最明显RR=0.60(95% CI：0.49-0.75；Z=4.56；P < 0.000 01)。 (5)性别：对纳入的8篇RCT文献，共计10 549例受试者进行亚组分析。结果显示女性和男性组间的效应量存在中度异质性(I2=64%)。两组的效应量均具有统计学意义(P < 0.01)。男性组的效应量最明显RR=0.44(95% CI：0.33-0.59；Z=5.56； P < 0.000 01)。 2.5 发表偏倚检验通过对整合性神经肌肉训练对下肢损伤预防效果的Meta分析漏斗图显示：大部分的散点分布在偏上且相互对称，只有2篇散布在下侧，与其他研究存在偏倚，但对结果影响不大，表明各研究间无明显的发表偏倚，研究结果可靠，见图6。"

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