Sure Steps: Key Strategies for Protecting Basketball Players from Injuries—A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Search Strategy
2.2. Inclusion Criteria
2.3. Quality Assessment
2.4. Data, Variables, and Measures Reviewed
3. Results
3.1. General Injuries
3.2. Ankle Sprains
3.3. Anterior Cruciate Ligament
3.4. Sex
3.5. Age
3.6. Training Methods and Other Injury Prevention Strategies
3.7. Quality Assessment of the Studies
4. Discussion
4.1. General Injuries
4.2. Ankle Sprain
4.3. Anterior Cruciate Ligament
4.4. Sex
4.5. Age
4.6. Methods and Other Injury Prevention Strategies
4.7. Neuromuscular Training Effects
5. Conclusions
6. Practical Applications
Author Contributions
Funding
Conflicts of Interest
Appendix A
First Author, Reference | Aerts [36] | Emery [41] | Barber—Foss [37] | Cumps [40] | Eils [49] | Bonato [39] | McGuine [44] | Barrett [38] | Longo [43] | Pfeiffer [46] | Omi [45] | Hewett [42] | Stojanovic [47] | Emery [48] |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Did the study report the % of potential participants who were excluded OR the characteristics of participants who were excluded? | Yes | Yes | No | No | Yes | Yes | No | Yes | Yes | No | No | No | No | Yes |
Was the % of individuals participating based on a valid denominator reported [not volunteers interested]? | Yes | Yes | Yes | No | Yes | Yes | Yes | Yes | Yes | Yes | No | No | Yes | No |
Were the characteristics of the participants compared to non-participants or to the target population? | Yes | No | Yes | No | Yes | Yes | Yes | Yes | No | No | Yes | No | Yes | Yes |
Was a measure of the primary outcome with or without comparison to a public health goal reported? | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Was any within-group analysis conducted that allowed researchers to draw conclusions about how different subgroups responded? | No | Yes | Yes | No | No | No | No | Yes | No | Yes | No | Yes | No | Yes |
Did the study report the % of potential settings that were excluded OR reasons for exclusions? | Yes | Yes | No | No | No | No | Yes | No | No | No | No | No | No | No |
Did the study report the % of settings accepting participation? The denominator should not be volunteers indicating interest. | Yes | Yes | No | No | No | No | Yes | No | Yes | No | No | No | No | No |
Were the characteristics of those settings choosing to participate and those unwilling to participate described? | Yes | No | No | No | No | Yes | No | No | No | No | No | No | No | No |
Was the % of perfect delivery or sessions completed reported [e.g., adherence or consistency]? | Yes | No | Yes | Yes | No | Yes | No | Yes | Yes | No | Yes | No | Yes | Yes |
Was a measure of the primary outcome [with or without comparison to a public health goal] at >6 months after the final intervention by the study’s researchers reported? | No | No | No | No | No | No | No | No | No | No | No | Yes | No | No |
TOTAL | 8 | 6 | 5 | 2 | 4 | 6 | 5 | 6 | 5 | 2 | 3 | 3 | 4 | 5 |
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Author | Aim | Sample | Intervention Protocol | Outcome Measurement | Conclusion |
---|---|---|---|---|---|
Aerts et al. [36] | To evaluate the applicability of a jump-landing training program in basketball players using RE-AIM. | 24 teams from the Belgian national second division and regional divisions in Flanders (Belgium) aged between 15 and 41, male (n = 129) or female (n = 114) athletes. | 3-month exercise program based on jumping and landing 2 days a week for 10 min. 5 plyometric/strength body weight exercises x 8–10 reps each day. | Injury incidence in the control group was higher (rate = 5.4/1000 h) than in the intervention group (rate = 3.6/1000 h) (HR = 0.40 [95% CI = 0.16–0.99]). | It is an effective program for the prevention of lower limb injuries in basketball players. |
Emery et al. [41] | To examine the effectiveness of a stability training program in reducing injuries in adolescent basketball players. | 920 basketball players between 12 and 18 years of age, male (n = 464) and female (n = 456). | 5 min stabilization exercise program during warm-ups using Wobble Board equipment each training day. 20 min home workouts, 5 days a week, for 1 year. | The protective effect found with regard to all injuries (RR = [0.8 95% CI; 0.57–1.11]), lower extremity injury (RR = 0.83 [95% CI; 0.57–1.19]), and ankle sprain injury (RR = 0.71 [95% CI; 0.45–1.13]) were not statistically significant. Compliance with the program was low (298/494 or 60.3%). | Basketball-specific balance training program was effective in reducing acute injuries in high school basketball. |
Barber-Foss et al. [37] | To determine the effects of a neuromuscular training program in high school and middle school athletes in 3 sports (basketball, volleyball, and soccer), both in all injuries and in knee and ankle injuries. | 474 girls (222 middle school, 252 high school; age = 14.0 ± 1.7 years, height = 161.0 ± 8.1 cm, weight = 55.4 ± 12.2 kg) | Neuromuscular training program 2–3 sessions per week of 10–25 min 13 bodyweight core, stabilization, and strength exercises 8–15 reps, 1–2 sets. | Regarding the basketball group: The overall injury incidence was lower for the intervention group (rate = 4.99/1000 h) than in the control group (rate = 7.22/1000 h). ARR = 40 (95% CI = 0.92, 4.54). Specific injury data for each sport are not displayed. | Neuromuscular core and stabilization training has a beneficial protective effect on injury incidence, demonstrated at all levels of competition. |
Cumps et al. [40] | To examine the efficacy of a 22-week stability and balance training program on the incidence of lateral ankle sprains. | 54 athletes, male (n = 37) and female (n = 17) (control, n = 27, 18.0 ± 2.7 years; intervention, n = 26, 17.7 ± 3.9 years). | 22-week training program using semi-globes (stabilization semi-globes), 3 days a week. 4 exercises each day, with variations in different positions Dribbling, passing, standing, and Aberdeen exercises on a bosu. | No significant differences were found, 3.54/1000 in the control group (95% CI: 1.23–5.85) and 1.19/1000 (95% CI: 0.15–2.25) in the intervention group. Analyzing the relative risk, significant differences were found in the intervention group with respect to the control group (RR = 0.30 [95% CI: 0.11–0.84]) and also in men (RR = 0.29 [95% CI: 0.09–0.93]). | Balance or stability training should be included as a part of the basketball players’ routine 2–3 times a week with a duration of 5 to 15 min. |
Eils et al. [49] | To investigate the effectiveness of a multi-station proprioceptive training program in reducing the incidence of ankle sprains. | 172 athletes (103 men and 69 women) from the seventh to the first German basketball division (professionals). | Ankle stability training (balance, passing ball, landing, single-leg jumping) Once a week and consisted of 6 exercises, for 20 min. | Higher incidence in the control group (1.66/1000 h vs. 4.69/1000 h, p = 0.012). Logistic regression was used to evaluate the risk of injury in the intervention group with respect to the control group. Odds ratio (OR) = 0.355 for the intervention group (OR = 0.355, [95% CI = 0.151–0.835, p = 0.018]). | A multi-station proprioceptive training program reduces the incidence of ankle sprains. |
Bonato et al. [39] | To evaluate the effectiveness of a neuromuscular training program in elite female basketball players. | 160 female Italian players over 18 years of age from a total of 15 teams. | Neuromuscular training with body weight, 2–3 sets. 4 general strength exercises, 2–3 sets, 5–12 reps, or 30″ isometric. 4 plyometric exercises, 1–3 sets, 12–20 reps. Speed and agility exercises, 4 basketball courts. | Injury incidence was lower for the experimental group with respect to the control group (rate = 1.66 vs. 4.69). There were significant differences for knee sprains (p = 0.037) and ACL (p = 0.038). There were no significant differences for ankle sprains (p = 0.507) and other types of discomfort such as muscular pain, lumbar pain, etc. | Self-weight neuromuscular training included in warm-up routines reduces the incidence of injury in elite female basketball players. |
McGuine et al. [44] | To evaluate whether lace-up ankle braces reduce the incidence and severity of ankle sprains in high school basketball players. | The sample was 1460, male (n = 724) and female (n = 736) high school basketball players. | Participants wore lace-up anklets throughout the 2009–2010 season. | The incidence was higher in the control group (rate = 1.41/1000 h) than in the experimental group (rate = 0.47/1000 h) (HR = 0.32 (95% CI = 0.20–0.52; p < 0.01]). For players with previous sprains, the prevalence was higher in the control group (rate = 1.79/1000 h) than in the experimental (rate = 0.83/1000 h) (HR = 0.39 [95% CI = 0.17–0.90; p < 0.01]) | The use of lace-up ankle braces reduces the incidence, but not the severity, of ankle sprains in both previously uninjured basketball players and those who have already suffered an ankle sprain. |
Barret et al. [38] | To determine the influence of shoe type on the incidence of ankle sprains. | 569 college basketball players (91.7% men and 8.3% women) | Use of the assigned shoes throughout the season. High-top shoes or low-top shoes. | The incidence was 4.80/1000 h in high-top shoes, 4.06 × 10/1000 h in low-top shoes, and 2.69/1000 h in high-top shoes with inner tubes. There were no significant differences. | There is no strong relationship between the type of athletic footwear and the incidence of ankle sprains. |
Longo et al. [43] | To evaluate the effectiveness of the FIFA 11+ program in the prevention of injuries in basketball players. | The sample consisted of 121 male players of all categories from U12 to senior. | FIFA 11+ program in warm-ups for 9 months. 5 running technique exercises 6 strength exercises, 2–3 sets × 10 reps, or 20–30 s 3 jumping exercises, 3 sets each one across the court. 3 single-leg balance exercises x 2–3 sets each one | In the intervention group, injury rates were lower than those in the control group for general (0.95 vs. 2.16; p = 0.0004), training (0.14 vs. 0.76; p = 0. 007), lower extremity (0.68 vs. 1.4; p = 0.022), acute (0.61 vs. 1.91; p < 0.0001), and severe (0 vs. 0.51; p = 0.004), for trunk (0. 07 vs. 0.51; p = 0.013), leg (0 vs. 0.38; p = 0.007), and hip and groin (0 vs. 0.25; p = 0.023) compared to the control group. | Although the rate of knee and ankle injuries was not reduced, FIFA 11+ was able to reduce the severity of such injuries and the prevalence of overall and general lower extremity injuries. The FIFA 11+ warm-up program is effective in preventing injuries in elite male basketball players. |
Pfeiffer et al. [46] | To test the effect of a knee ligament injury prevention program with respect to the incidence of non-contact ACL injuries. | The sample consisted of 1439 female high school soccer, basketball, and volleyball players. | Performed a plyometric-based training program twice a week throughout the season. 4–6 plyometric exercises each session. | In the case of female basketball players, there was a very similar incidence between the control group (rate = 0.111/1000 h) and the experimental group (0.167/1000 h), and the difference was not significant. The odds ratio for all sports was not significant (OR = 2.05, p > 0.05), although the study does not present specific data for female basketball players. | A 20 min program based on plyometrics, landing, and decelerative mechanics performed twice a week does not reduce the risk of ACL injury in high school athletes. |
Omi et al. [45] | To determine the effect of a training program based on joint work on ACL injury incidence in female basketball players. | The sample was 309 female basketball players, NCAA Division II college athletes. | Incorporated a 3-day-a-week body weight training program. 5 strength exercises, 2 sets × 10–20 reps, or 30″ isometric 4 jump landing exercises x 10 reps. 2 balance exercises x 2 sets × 20–30 reps. | The incidence of all ACL lesions was higher in the observation period (rate = 0.25/1000 h) than in the intervention period (rate = 0.1/1000 h). The relative risk was much lower (RR = 0.38; 95% CI, 0.17–0.87; p = 0.017) with ARR (0.032, 95% CI, 0.027–0.037) and NNT (31.6, 95% CI, 27.1–37.7). With respect to non-contact ACL injuries, the incidence in the intervention period was lower (rate = 0.08/1000 h) than in the observation period (rate = 0.21/1000 h) with a relative risk reduction (RR = 0.37; 95% CI, 0.15–0.92; p = 0.026), and with ARR and NNT values of 0.024 (95% CI, 0.020–0.029) and 41.3 (95% CI, 34.6–51.3), respectively. | A hip-focused training program demonstrates significant reductions in the incidence of injury in female basketball players. |
Hewett et al. [42] | To evaluate the effect of a neuromuscular training program on the incidence of knee injuries in female soccer, basketball, and volleyball players. | The basketball sample consisted of 273 female players, all of whom were of high school age. | Program based on plyometrics during the preseason. 7–9 plyometric exercises, 20–30 s, or 5–10 reps | Examining non-contact injuries, a trend (p = 0.019) emerged, suggesting fewer injuries among trained female basketball players compared to those without training. Notably, the incidence of non-contact injuries in trained female athletes closely resembled that observed in males. | There are fewer non-contact injuries in female basketball players after performing a plyometric-based neuromuscular training program. |
Stojanovic et al. [47] | To analyze the effect of a warm-up based on neuromuscular training on the prevention of lower limb injuries. | The sample consisted of 57 players (male: n = 42; female: n = 15) between 18 and 29 years old in the regional category. | The warm-up combined the following: 5 running technique exercises x 2 sets. 2 agility exercises x 2 sets. 10 plyometric, balance, and strength exercises, 2 sets each one. | The intervention group experienced a significantly lower incidence rate of ankle sprain (IRR = 0.26, 95% CI = 0.05, 0.98, p = 0.02) and a lower incidence rate of knee injury (IRR = 0.32, 95% CI = 0.03, 1.78, p = 0.07) compared to the control group. With respect to general non-contact injuries, the intervention group experienced a significantly lower incidence rate compared to the control group (IRR = 0.26, 95% CI = 0.05, 0.98, p < 0.001). | Warm-up based on a multicomponent training program reduces the risk of lower limb injuries, more specifically ankle sprains and knee sprains in basketball players. |
Emery et al. [48] | To evaluate the effectiveness of a warm-up based on neuromuscular training on the incidence of ankle and knee injuries in basketball players. | Players between 11 and 18 years old from sixty-three teams (male: n = 442; female: n = 367). | The training program combined the following: 4 endurance exercises, 2 agility exercises, 5 strength exercises, and 2 balance exercises. | The SHRed injuries basketball program was effective against knee and ankle injuries (IRR = 0.64; 95% confidence interval (CI): 0.51, 0.79). There was no significant difference between the unsupervised group (IRR = 0.62; 95% CI: 0.47, 0.83) and the supervised group (IRR = 0.64; 95% CI: 0.49, 0.85). | The SHRed injuries basketball program is associated with a 36% reduction in injury incidence. Neuromuscular training programs for basketball players are recommended as a minimum standard to be met. |
Part 1. Mobility (about 2–3 min) |
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Part 2. Strength, core, and ankle stabilization (about 5–7 min) |
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Part 3. Agility (running technique drills and plyometrics) (about 4–6 min) |
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Antoranz, Y.; Sáez de Villarreal, E.; del Campo Vecino, J.; Jiménez-Saiz, S.L. Sure Steps: Key Strategies for Protecting Basketball Players from Injuries—A Systematic Review. J. Clin. Med. 2024, 13, 4912. https://doi.org/10.3390/jcm13164912
Antoranz Y, Sáez de Villarreal E, del Campo Vecino J, Jiménez-Saiz SL. Sure Steps: Key Strategies for Protecting Basketball Players from Injuries—A Systematic Review. Journal of Clinical Medicine. 2024; 13(16):4912. https://doi.org/10.3390/jcm13164912
Chicago/Turabian StyleAntoranz, Yoel, Eduardo Sáez de Villarreal, Juan del Campo Vecino, and Sergio L. Jiménez-Saiz. 2024. "Sure Steps: Key Strategies for Protecting Basketball Players from Injuries—A Systematic Review" Journal of Clinical Medicine 13, no. 16: 4912. https://doi.org/10.3390/jcm13164912