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437 The effectiveness of exercise interventions to prevent shoulder injuries in athletes: a systematic review and meta-analysis
  1. Johannes JW Swart,
  2. Nina Myburg,
  3. Olivier Benita
  1. The Wits-JBI Centre for Evidenced-Based Practice: a Joanna Briggs Institute Centre of Excellence, Pretoria, South Africa


Background The literature supports exercise to avert injuries in the lower extremity and injuries in general. Nevertheless, the utilisation of exercise strategies to prevent sports-related shoulder injuries remain unproven. This systematic review’s primary aim is to evaluate the effectiveness of exercise interventions to prevent shoulder injuries in athletes.

Methods Twelve (12) databases were searched from inception up until July 2021. The search identified nineteen (19) eligible studies that were included and critically appraised. Data extraction and synthesis followed the JBI Reviewer’s Manual for Systematic Reviews of Effectiveness and PRISMA guidelines. The data was synthesised utilising the JBI SUMARI to produce several meta-analyses.

Results The pooled results indicated a statistically significant result with moderate heterogeneity in favour of the application of exercise interventions to prevent shoulder injuries [0.73 (0.62 – 0.87) RR, 95% CI, P = 0]. An analysis of upper extremity injury shows a greater effect but with substantial heterogeneity [0.60 (0.52 - 0.68) RR, 95% CI, P = 0.001]. Heterogeneity was fully resolved with the removal of poor methodological studies and reveals a larger statistically significant effect [0.51 (0.36 - 0.71) RR, 95% CI, P = 0.002]. Subgroup analysis revealed a slightly greater effect for acute shoulder injuries [0.75 (0.58 – 0.96) RR, 95% CI, P = 0.024] compared to overuse injuries [0.75 (0.58 – 0.96) RR, 95% CI, P = 0.05]. Shoulder-specific programmes showed a statistically significant but inferior effect [0.80 (0.68 - 0.95) RR, 95% CI, P = 0.01] compared to general programmes [0.52 (0.35 - 0.76) RR, 95% CI, P = 0.001].

Conclusion This systematic review with meta-analysis supports and advocates for the use of exercise interventions to prevent shoulder injuries in sport. The programmes utilised can prevent both acute and overuse shoulder injuries. Exercise interventions designed to address the shoulder specifically were not superior to programmes targeting the shoulder incidentally.

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