Clinical bottom line: The addition of a prevention program that incorporates proprioceptive or neuromuscular exercises to an athlete’s normal training warm-up is successful in reducing lower limb injuries. A prevention program appears to alter the neuromuscular risk factors and influence the basic elements of sports performance. Clinicians, coaches and athletes should be encouraged to participate in an injury prevention program to decrease the rate of injuries among players. Also, there is no consistent evidence that these programs cause any harm. The appropriate combination of components in a program remains unclear due to the wide variety used in the studies reviewed. There is no research that clearly identifies the most important components of an effective injury prevention program. Proprioceptive balance training, education, strength, flexibility and plyometrics were all components used in the articles reviewed. More research needs to be conducted to determine the effect of each component individually versus the effects of components combined.
Clinical scenario: In the recent clinical affiliations many young athletes receiving physical therapy for ankle and knee injuries they acquired during their sport season were encountered. These injuries caused significant time lost from sports participation, emotional distress and other negative outcomes. The question as to if a training program would be successful in decreasing the incidence of ankle and knee injuries in these athletes came about.
Clinical PICO: Population: Athletes age 15-30 Intervention: Neuromuscular and/or proprioceptive training programs Comparison: Control group not participating in training program Outcome: Ankle and knee injury incidence
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