女性团队运动中伤害预防项目的有效性：分层伤害结局、训练剂量反应关系及依从性的系统综述与Meta分析
简介
这项Meta分析纳入13项RCT、13675名女性团体运动运动员，评估运动性神经肌肉损伤预防方案的效果。该方案使总体损伤风险降低35%（RR 0.65），下肢损伤（RR 0.67）、ACL损伤（RR 0.62）及踝关节损伤（RR 0.59）风险均下降，且每周51–120分钟、依从性≥75%者获益更明显。提示ACL损伤预防需保证训练剂量与依从性，但证据等级较低…
英文摘要
OBJECTIVE: To quantify the effectiveness of exercise-based injury prevention programmes (IPPs) in female team sports across overall, lower-limb, and site-specific injury outcomes, and to examine training dose and adherence as potential effect modifiers. METHODS: Randomised controlled trials evaluating exercise-based IPPs in female team-sport athletes were synthesised. Risk ratios (RRs) were pooled using random-effects models. Subgroup analyses examined training frequency, session duration, weekly training dose, and adherence, while meta-regression was used to examine study-level associations with training dose and adherence. RESULTS: Thirteen unique trials involving 13,675 athletes were included. IPPs reduced overall injury risk by 35% (RR = 0.65, 95% CI: 0.53-0.79), with a similar reduction in lower-limb injuries (RR = 0.67, 95% CI: 0.53-0.86). Significant reductions were also observed for anterior cruciate ligament injuries (RR = 0.62, 95% CI: 0.43-0.89) and ankle injuries (RR = 0.59, 95% CI: 0.42-0.84). Exploratory subgroup analyses suggested larger effects at 4-5 sessions/week (RR = 0.47) and 21-30 min/session (RR = 0.42). Programmes providing 51-120 min/week were associated with greater risk reduction than those providing 1-50 min/week (RR = 0.48 vs. 0.80). Trials with adherence ≥75% showed a clear protective effect (RR = 0.55), whereas those with lower adherence showed little evidence of benefit (RR = 0.93). The certainty of evidence for the primary overall-injury outcome was low. CONCLUSION: Exercise-based neuromuscular IPPs appear to reduce overall and lower-limb injury risk in female team sports, with protective effects observed for ACL and ankle injuries and the most consistent estimate for ACL injury. Greater weekly exposure was associated with larger risk reductions at the study level, whereas the continuous adherence meta-regression was not significant. These patterns should be interpreted as exploratory implementation signals rather than definitive thresholds. SYSTEMATIC REVIEW REGISTRATION: The systematic review was prospectively registered in PROSPERO (CRD420251236606). URL: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251236606.