Injury prevention programmes with plyometric and strengthening exercises improve on-field performance: a systematic review

Importance Injury prevention programmes (IPPs) have been demonstrated to be highly efficacious in protecting young athletes from anterior cruciate ligament and other lower-extremity injuries. However, the effectiveness of these programme in practice has been limited due to poor adherence among coaches of organised sports teams. Objective A change in messaging from injury reduction to performance enhancement may be an effective strategy for improving adherence. We conducted a systematic review to address whether implementing IPP can also provide benefits on sports performance as measured by on-field tests. Evidence review Data Sources: PubMed, EMBASE and Cochrane Library databases were searched from January 2000 to August 2018. Study Selection: English-language studies were selected if they evaluated on-field performance testing before and after participation in the IPP or compared with another programme/control. No limitations were placed on study design or study population. Studies were excluded if they evaluated programme without an explicit focus on injury prevention or reported on injury risk factors that were not related to athletic performance. Study design Systematic review Data extraction Study design, population, sport and level, comparison group and duration/frequency of the IPP were extracted from full-text articles. The results of performance testing were summarised into the following categories: balance, sprinting, agility, jumping, physical fitness and sport-specific skills. Findings The evidence shows that IPP can have beneficial effects on measures of sports performance and physical fitness. Factors that resulted in significant improvement included longer frequency and duration of the programme, as well as inclusion of plyometric and muscle strengthening exercises. Conclusions There is a wide variety of measures used for athletic performance. IPPs that are done more frequently for longer durations and that include strengthening and plyometric exercises have been shown to improve athletic performance. Enhanced performance with tests that can be conducted on the field with existing equipment may help convince coaches and athletes to improve adherence with the IPP exercises. Level of evidence Level II