Effectiveness of XXXX and Anterior Cruciate Ligament Tear Prevention Programs: A Meta-Analysis.

@entity3331 @entity130
OBJECTIVE: Individuals frequently involved in jumping, pivoting or cutting are at increased risk of @entity3331 , including anterior cruciate ligament (ACL) tears. We sought to use meta-analytic techniques to establish whether neuromuscular and proprioceptive training is efficacious in preventing knee and @entity130 and to identify factors related to greater efficacy of such programs. METHODS: We performed a systematic literature search of studies published in English between 1996 and 2014. Intervention efficacy was ascertained from incidence rate ratios (IRRs) weighted by their precision (1/variance) using a random effects model. Separate analyses were performed for knee and @entity130 . We examined whether year of publication, study quality, or specific components of the intervention were associated with efficacy of the intervention in a meta-regression analysis. RESULTS: Twenty-four studies met the inclusion criteria and were used in the meta-analysis. The mean study sample was 1,093 subjects. Twenty studies reported data on knee @entity130 and 16 on @entity130 . Maximum Jadad score was 3 (on a 0-5 scale). The summary incidence rate ratio was estimated at 0.731 (95% CI: 0.614, 0.871) for @entity3331 and 0.493 (95% CI: 0.285, 0.854) for @entity130 , indicating a protective effect of intervention. Meta-regression analysis did not identify specific intervention components associated with greater efficacy but established that later year of publication was associated with more conservative estimates of intervention efficacy. CONCLUSION: The current meta-analysis provides evidence that neuromuscular and proprioceptive training reduces knee @entity130 in particular. Later publication date was associated with higher quality studies and more conservative efficacy estimates. As study quality was generally low, these data suggest that higher quality studies should be implemented to confirm the preventive efficacy of such programs.
