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THE JOURNAL OF SPORTS MEDICINE AND PHYSICAL FITNESS
Rivista di Medicina, Traumatologia e Psicologia dello Sport
Indexed/Abstracted in: Chemical Abstracts, CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,111
Review articles SPORT INJURIES AND REHABILITATION
The Journal of Sports Medicine and Physical Fitness 2003 June;43(2):165-79
Prevention of knee injuries in sports. A systematic review of the literature
Thacker S. B. 1, 2, Stroup D. F. 1, Branche C. M. 2, Gilchrist J. 2, Goodman R. A. 3, Porter Kelling E. 1
1 Epidemiology Program Office Centers for Disease Control and Prevention Atlanta, GA, USA
2 National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta, GA, USA
3 Financial Management Office Centers for Disease Control and Prevention Atlanta, GA, USA
Aim. We reviewed evidence regarding risk factors associated with incidence of knee injuries both to assess the effectiveness of prevention strategies, and to offer evidence-based recommendations to physicians, coaches, trainers, athletes, and researchers.
Methods. We searched electronic data bases without language restriction for the years 1966 - September 1, 2001, identified citations from reference sections of research papers retrieved, contacted experts in the field, and searched the Cochrane Collaboration. Of the 328 citations identified, we emphasized the results from the 13 reports that compared alternative methods to prevent knee injury and assessed the methodologic quality of these reports using a standardized instrument.
Results. Five studies addressed the effectiveness of bracing in football players; these studies showed no consistent evidence of benefit. Two studies comparing alternative cleat designs and a controlled study testing the effects of adjustments in the ski boot/binding system were difficult to interpret because of inadequate reporting of methodology. Six prospective studies that addressed the impact of conditioning and training showed promise of proprioception and neuromuscular training for protection against knee injury. We identified serious flaws in study design, control of bias, and statistical methods; the median quality scores ranged from 11 to 56 (out of 100).
Conclusion. Structured training programs that emphasize neuromuscular and proprioceptive training offer encouraging evidence for the prevention of knee injuries. However, flaws in study design and implementation have limited the effectiveness of work in this field. A rigorously implemented research program is needed to address this critically important sports medicine problem.