背景:冰雪运动,由于它们对身体的要求很高,所以本质上是高风险的,在参与者安全方面构成重大挑战。这些活动增加了受伤的可能性,很大程度上是由于身体在寒冷中的敏捷性和反应能力降低,往往是不可预测的冬季环境。受伤对参与者健康的巨大影响强调了在这些运动中有效预防受伤的迫切需要,以及与医疗和康复护理相关的经济和社会成本。在冰雪运动环境的背景下,运用伤害预防的E原则对干预措施进行评价,可以指导未来运动安全等健康促进干预措施在该领域的实施。如果执行得当,这种方法可以大大降低受伤的频率和严重程度,从而显著提高这些具有挑战性的运动的安全性和长期可行性。
目的:这项研究的目的是严格评估和统计证实不同伤害预防策略在冰雪运动中的有效性。旨在用坚实的经验证据支持未来的安全措施。
方法:系统评价和荟萃分析。
方法:本研究的首要目标是精心汇总和审查广泛的学术文献,专注于多样化的可量化功效,减轻冰雪运动领域伤害发生率的多成分干预策略。这项工作需要从受人尊敬的学术数据库中详尽提取数据,涵盖截至2023年9月30日的出版物。为了追求方法论的卓越和分析的严谨,这项研究采用了先进的偏见评估方法,特别是AMSTAR2和等级方法,以及复杂的随机效应统计建模。这种全面的方法旨在确保最大的有效性,可靠性,以及研究结果的学术完整性。
结果:15篇论文,包括9项随机对照试验,3个病例对照研究,和3项队列研究,26,123名参与者和4,382名受伤,进行了分析。研究结果表明,通过各种干预措施,伤害率显着降低:总体伤害预防(RR=0.50,95%CI0.42-0.63),教育培训(RR=0.50,95%CI0.34-0.73),教育视频(RR=0.53,95%CI0.34-0.81),防护设备(RR=0.64,95%CI0.46-0.87),和政策变化(RR=0.28,95%CI0.16-0.49)。亚组分析揭示了依从性的潜在异质性(p=0.347)。与对照组相比,多成分干预有效降低了损伤率。
结论:本系统综述和荟萃分析表明,多组分干预措施可以显著预防冰雪运动中的损伤。通过应用伤害预防的E原则,构建冰雪运动实际伤害预防研究框架,我们可以逐步转向系统范式,以更好地理解运动损伤的发展和预防。此外,运动损伤的预防是一个复杂而动态的过程。因此,未来的研究需要在不同场景下进行高质量的实验,以提供更可靠的证据,为从业人员和参与者提供有价值的相关预防信息,并在实践中帮助制定更有效的预防措施。
BACKGROUND: Ice and snow sports, which are inherently high risk due to their physically demanding nature, pose significant challenges in terms of participant safety. These activities increase the likelihood of injuries, largely due to reduced bodily agility and responsiveness in cold, often unpredictable winter environments. The critical need for effective injury prevention in these sports is emphasized by the considerable impact injuries have on the health of participants, alongside the economic and social costs associated with medical and rehabilitative care. In the context of ice and snow sports environments, applying the E principles of injury prevention to evaluate intervention measures can guide the implementation of future sports safety and other health promotion intervention measures in this field. When well executed, this approach can substantially reduce both the frequency and severity of injuries, thereby significantly enhancing the safety and long-term viability of these challenging sports.
OBJECTIVE: The objective of this study was to rigorously assess and statistically substantiate the efficacy of diverse injury prevention strategies in ice and snow sports, aiming to bolster future safety measures with solid empirical evidence.
METHODS: Systematic
review and meta-analysis.
METHODS: The overarching aim of this research was to meticulously aggregate and scrutinize a broad spectrum of scholarly literature, focusing on the quantifiable efficacy of diverse, multicomponent intervention strategies in mitigating the incidence of injuries within the realm of ice and snow sports. This endeavour entailed an exhaustive extraction of data from esteemed academic databases, encompassing publications up to September 30, 2023. In pursuit of methodological excellence and analytical rigor, the study employed advanced bias assessment methodologies, notably the AMSTAR 2 and GRADE approaches, alongside sophisticated random-effects statistical modelling. This comprehensive approach was designed to ensure the utmost validity, reliability, and scholarly integrity of the study\'s findings.
RESULTS: Fifteen papers, including 9 randomized controlled trials, 3 case‒control studies, and 3 cohort studies with 26,123 participants and 4,382 injuries, were analysed. The findings showed a significant reduction in injury rates through various interventions: overall injury prevention (RR = 0.50, 95% CI 0.42-0.63), educational training (RR = 0.50, 95% CI 0.34-0.73), educational videos (RR = 0.53, 95% CI 0.34-0.81), protective equipment (RR = 0.64, 95% CI 0.46-0.87), and policy changes (RR = 0.28, 95% CI 0.16-0.49). Subgroup analysis revealed potential heterogeneity in compliance (p = 0.347). Compared to controls, multicomponent interventions effectively reduced injury rates.
CONCLUSIONS: This systematic
review and meta-analysis demonstrated that multicomponent interventions significantly prevent injuries in ice and snow sports. By applying the E principles of injury prevention and constructing a framework for practical injury prevention research in ice and snow sports, we can gradually shift towards a systemic paradigm for a better understanding of the development and prevention of sports injuries. Moreover, sports injury prevention is a complex and dynamic process. Therefore, high-quality experiments in different scenarios are needed in future research to provide more reliable evidence, offer valuable and relevant prevention information for practitioners and participants, and help formulate more effective preventive measures in practice.