Efficacy of programs of muscle injuries prevention in Soccer

Muscle injuries are the most frequent in football and may lead to the end of a player’s career. Many studies have evaluated the effectiveness of prevention programs for all injury types. Few studies have evaluated the effects of exercise on muscle injuries.A documentary search was conducted in October 2022 from three databases: Medline via its PubMed interface, Google Scholar, and COCHRANE databases. We only included original articles published between October 2012 and October 2022 with a high level of evidence. The research was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. The target population consisted of professional and semi-professional footballers. The intervention in question was structured injury preventive protocols, including specific training or pre-established protocols such as the FIFA 11+ program, compared to each other or with regular training sessions. The main outcomes were the incidence rates of muscle injuries and severe injury in each group, as well as the time loss to injury.<br>Seven randomized controlled trials with a high level of evidence confirmed using the PEDRO scale were included. There were 3815 male professional football players. There was heterogeneity in the age, hours of exposure, and duration of the intervention. The prevention protocols used were FIFA 11+, bounding exercises, NHE, and stretching exercises. Structured exercises significantly reduce the severity of muscle injury and, consequently, time loss to injury.Despite the diversity of prevention programs, teams still lack standardized programs. Structured exercises, such as FIFA 11+ and bounding exercises, which combine strengthening, body kinesthesic awareness, and neuromuscular control, reduce the incidence and severity of muscle injury. FIFA 11+ is the first and most complete structured program, but lacks some exercises, such as adductor strengthening.This review showed the interest in structured exercises in reducing severity and time loss to injury in professional football players.

肌肉损伤是足球运动中发生率最高的损伤类型，甚至可能导致运动员职业生涯终结。既往已有大量研究评估了各类损伤预防方案的有效性，但针对运动干预对肌肉损伤影响的相关研究仍较为稀缺。
本研究于2022年10月依托三个数据库开展文献检索，分别为经由PubMed接口访问的Medline数据库、Google Scholar数据库以及科克伦（COCHRANE）数据库。本次检索仅纳入2012年10月至2022年10月期间发表的高证据等级原创性研究，且研究流程严格遵循《系统综述与荟萃分析首选报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses）标准。本研究的目标人群为职业及半职业足球运动员，所评估的干预措施为结构化损伤预防方案，包括专项训练或预设方案（如FIFA 11+训练计划），并将不同预防方案间或其与常规训练进行对比。本研究的主要结局指标为各组肌肉损伤与严重损伤的发生率，以及损伤导致的误工时长。

最终纳入7项经PEDRO量表（PEDRO scale）评定为高证据等级的随机对照试验，共涉及3815名男性职业足球运动员。研究对象在年龄、训练暴露时长及干预周期上存在异质性。本次研究所采用的预防方案包括FIFA 11+、跨步跳跃训练（bounding exercises）、NHE训练以及拉伸训练。

研究结果显示，结构化训练可显著降低肌肉损伤的严重程度，进而减少损伤导致的误工时长。尽管当前存在多种损伤预防方案，但足球队伍仍普遍缺乏标准化的预防方案。结合力量训练、本体感觉训练与神经肌肉控制训练的结构化运动方案（如FIFA 11+与跨步跳跃训练），可有效降低肌肉损伤的发生率与严重程度。其中FIFA 11+是首个且最为完善的结构化训练方案，但仍缺乏内收肌力量训练相关内容。

本综述证实，结构化训练可有效降低职业足球运动员的肌肉损伤严重程度并缩短损伤误工时长，相关干预措施的研究价值值得进一步关注。