The effectiveness of neuromuscular warm-up strategies, that require no additional equipment, for preventing lower limb injuries during sports participation: a systematic review

Abstract

BackgroundLower limb injuries in sport are increasingly prevalent and responsible for large economic as well as personal burdens. In this review we seek to determine which easily implemented functional neuromuscular warm-up strategies are effective in preventing lower limb injuries during sports participation and in which sporting groups they are effective.MethodsSeven electronic databases were searched from inception to January 2012 for studies investigating neuromuscular warm-up strategies and injury prevention. The quality of each included study was evaluated using a modified version of the van Tulder scale. Data were extracted from each study and used to calculate the risk of injury following application of each evaluated strategy.ResultsNine studies were identified including six randomized controlled trials (RCT) and three controlled clinical trials (CCT). Heterogeneity in study design and warm-up strategies prevented pooling of results. Two studies investigated male and female participants, while the remaining seven investigated women only. Risk Ratio (RR) statistics indicated 'The 11+' prevention strategy significantly reduces overall (RR 0.67, confidence interval (CI) 0.54 to 0.84) and overuse (RR 0.45, CI 0.28 to 0.71) lower limb injuries as well as knee (RR 0.48, CI 0.32 to 0.72) injuries among young amateur female footballers. The 'Knee Injury Prevention Program' (KIPP) significantly reduced the risk of noncontact lower limb (RR 0.5, CI 0.33 to 0.76) and overuse (RR 0.44, CI 0.22 to 0.86) injuries in young amateur female football and basketball players. The 'Prevent Injury and Enhance Performance' (PEP) strategy reduces the incidence of anterior cruciate ligament (ACL) injuries (RR 0.18, CI 0.08 to 0.42). The 'HarmoKnee' programme reduces the risk of knee injuries (RR 0.22, CI 0.06 to 0.76) in teenage female footballers. The 'Anterior Knee Pain Prevention Training Programme' (AKP PTP) significantly reduces the incidence of anterior knee pain (RR 0.27, CI 0.14 to 0.54) in military recruits.ConclusionsEffective implementation of practical neuromuscular warm-up strategies can reduce lower extremity injury incidence in young, amateur, female athletes and male and female military recruits. This is typically a warm-up strategy that includes stretching, strengthening, balance exercises, sports-specific agility drills and landing techniques applied consistently for longer than three consecutive months. In order to optimize these strategies, the mechanisms for their effectiveness require further evaluation.

La preactivación neuromuscular durante la maniobra evasiva de salto lateral no se asocia con alteraciones posturales en atletas de ultimate: un estudio transversal

“…Actualmente existen investigaciones que han demostrado que el entrenamiento neuromuscular mejora las capacidades relacionadas con este sistema, como son la sensación de posición y movimiento articular, los patrones de activación muscular y cualidades físicas como la fuerza y el equilibrio 13,46 . Además, en la última década se han desarrollado trabajos que han logrado reducir el número de lesiones deportivas luego de un entrenamiento del control neuromuscular 47 .…”

Evaluación postural y análisis del equilibrio en principiantes de esquí nórdico / Postural Evaluation and Balance Analysis in Nordic Skiing Beginners

“…El sistema nervioso utiliza información sensorial proveniente de tres fuentes para mantener el control postural (Hewett, Paterno & Myer, 2002): los mecanoreceptores periféricos, la visión y el sistema vestibular. Además, existen diferentes estrategias para mantener el equilibrio, que varían dependiendo de la intensidad del estímulo desestabilizador y que impiden que el CDP caiga fuera de los límites de estabilidad; tales como la estrategia de tobillo y la estrategia de cadera (Herdman, 1989;Bernal, Faus & Bernal, 2006;Herman, Barton, Malliaras & Morrissey, 2012). La estrategia de tobillo rota el cuerpo alrededor de la articulación tibio-astragalina, produciendo principalmente esfuerzos de dirección antero-posterior.…”

Neuromuscular Training for Prevention of Anterior Cruciate Ligament Injury in Female Athletes

“…In addition, only 30% to 50% of athletes are able to return to the field successfully. 3 ACL injury often results in knee osteoarthritis, causing knee inflammation and pain that affect athletic performance and shorten athletic careers. 5 Therefore, athletes must focus on preventing ACL injury.…”

“…2 These sex differences indicate that female athletes are more likely to experience ACL injury during high-intensity exercise than male athletes are. 3 In the United States, 95,000 people experience ACL injuries each year. Among female athletes with ACL injuries, 70% decide to undergo surgery.…”