SPORTS MEDICINE
Prevention of Injuries Among Male Soccer Players- A Prospective, Randomized Intervention Study Targeting Players With Previous Injuries or Reduced Function
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(2):226 Am J Sports Med. 2008 Jun;36(6):1052-60. Epub 2008 Apr 3508 male soccer players were classified as high or low risk (LR) for injury using a number of questionnaires assessing previous injuries and health status. High risk (HR) patients were randomized to control or targeted training to assess its effect on injury occurrence throughout the season. LR patients had the lowest incidence of injury, while there were no differences between the two HR groups, which may have been due to the low compliance with targeted training.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
2/4
Randomização
3/4
Medidas de resultado
4/4
Inclusão/Exclusão
4/4
Descrição do tratamento
3/5
Estatística
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
Injuries are a common occurrence in competitive sport and some individuals may be at greater risk than others due to previous injuries and health status. Identification of high risk individuals may allow for prevention of injuries by using target specific training to strengthen weakened areas. This study attempted to identify patients at greater risk of injury and assess if target training can reduce the incidence of injury.
主な研究課題は何ですか？
Does a targeted exercise program for soccer players at high risk of injury reduce injury rates during the course of one season?
重要な知見は？
- No difference in mean player exposure to match play was found between the HR intervention group and the controls (p>0.05).
- There were a total of 505 injuries reported during the course of the study sustained by 283 of the players
- There were 82 injuries in the LR 216 in the HR control and 207 in the HR intervention group. No difference was found between the HR intervention and control group and HR control in terms of incidence of injury (RR: 0.94 (95% CI: 0.77 to 1.13); p=0.90).
- Injury Incidence rate was lower in the LR control group when compared to both HR groups (p=0.029)
- 45.8% of LR control and 58.5% of HR control were injured throughout the season (p=0.029)
- Injury rates per 1000 playing hours were 1.3 for LR, 2.8 for HR control, and 2.6 for HR intervention. A significantly lower injury rate was found for patients in the LR control group than either of the HR groups (p<0.05).
最も覚えておくべきことは？
Patients who were classified as high risk based on pre randomization questionnaires were at a greater risk of injury than those classified as low risk. This finding indicated the successful identification of players at greater risk of injury using the questionnaires. There were no difference between the HR control and intervention groups; however minimal compliance with targeted training might have been a confounding factor.
それが私の患者ケアにどのように影響するか？
Players at greater risk of injury can be identified using specific questionnaires dealing with previous injuries. Further studies with greater compliance are required to investigate the effect of targeted training on injury incidence among those at high risk.
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