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Meta-Analysis
. 2023 Nov-Dec;15(6):805-813.
doi: 10.1177/19417381231170815. Epub 2023 May 4.

Effectiveness of Injury Prevention Programs With Core Muscle Strengthening Exercises to Reduce the Incidence of Hamstring Injury Among Soccer Players: A Systematic Review and Meta-Analysis

Wesam Saleh A Al Attar  1 , Mohamed A Husain  2
Affiliations
Meta-Analysis

Effectiveness of Injury Prevention Programs With Core Muscle Strengthening Exercises to Reduce the Incidence of Hamstring Injury Among Soccer Players: A Systematic Review and Meta-Analysis

Wesam Saleh A Al Attar et al. Sports Health. 2023 Nov-Dec.

Abstract

Context: Muscles in the hamstring group are frequently injured in sporting activities. Injury prevention programs (IPPs), including eccentric training of the hamstrings, have proven to be of great value in decreasing the injury rate of hamstring muscles.

Objective: To examine the effectiveness of IPPs that include core muscle strengthening exercises (CMSEs) in reducing hamstring injury rates.

Data sources: This systematic review with meta-analysis was based upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search was conducted for relevant studies published from 1985 to 2021 using the following databases: Cochrane Library, MEDLINE, AMED, PubMed, Web of Science, and Physiotherapy Evidence Database (PEDro).

Study selection: The initial electronic search found 2694 randomized controlled trials (RCTs). After removing duplicate entries, 1374 articles were screened by their titles and abstracts, and 53 full-text records were assessed, of which 43 were excluded. The remaining 10 articles were reviewed in detail, from which 5 studies met our inclusion criteria and were included in the current meta-analysis.

Study design: Systematic review and meta-analysis of RCTs.

Level of evidence: Level 1a.

Data extraction: Two researchers independently completed the abstract review and performed full-text reviews. A third reviewer was consulted to reach a consensus if any discrepancies were noted. Details were recorded about the participants, methodological aspects, eligibility criteria, intervention data, and outcome measures, including age; number of subjects in the intervention/control group; number of injuries in each group; and the duration, frequency, and intensity of the training conducted in the intervention.

Results: The pooled results of 4728 players and 379,102 exposure hours showed 47% hamstring injury reduction per 1000 h of exposure in the intervention group compared with the control group with an injury risk ratio of 0.53 (95% CI [0.28, 0.98], P = 0.04).

Conclusion: The results indicate that CMSEs incorporated with IPPs reduce susceptibility and risk of hamstring injuries in soccer players.

Keywords: core muscle strengthening; hamstring injury rate; injury prevention programs; meta-analysis.

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Conflict of interest statement

The authors report no potential conflicts of interest in the development and publication of this article.

Figures

Figure 1.
Figure 1.
Flow diagram of the systematic steps in articles screened for inclusion.
Figure 2.
Figure 2.
Forest plot illustrating the effect of CMSEs versus controls on hamstring injury risk ratio. CMSE, core muscle strengthening exercises; CON, control; df, degrees of freedom; INT, intervention.
Figure 3.
Figure 3.
Funnel plots based on the study SE and log risk ratio in assessing publication.
See this image and copyright information in PMC

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References

    1. Ahmad CS, Redler LH, Ciccotti MG, Maffulli N, Longo UG, Bradley J. Evaluation and management of hamstring injuries. Am J Sports Med. 2013;41(12):2933-2947. - PubMed
    1. Akuthota V, Ferreiro A, Moore T, Fredericson M. Core stability exercise principles. Curr Sports Med Rep. 2008;7(1):39-44. - PubMed
    1. Al Attar WSA, Soomro N, Pappas E, Sinclair PJ, Sanders RH. Adding a post-training FIFA 11+ exercise program to the pre-training FIFA 11+ injury prevention program reduces injury rates among male amateur soccer players: a cluster-randomised trial. J Physiother. 2017;63(4):235-242. - PubMed
    1. Al Attar WSA, Soomro N, Pappas E, Sinclair PJ, Sanders RH. How effective are F-MARC injury prevention programs for soccer players? A systematic review and meta-analysis. Sports Med. 2016;46(2):205-217. - PubMed
    1. Al Attar WSA, Soomro N, Sinclair PJ, Pappas E, Sanders RH. Effect of injury prevention programs that include the Nordic hamstring exercise on hamstring injury rates in soccer players: a systematic review and meta-analysis. Sports Med. 2017;47(5):907-916. - PubMed

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