Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes

N Van Dyk, FP Behan, R Whiteley - British journal of sports medicine, 2019 - bjsm.bmj.com
British journal of sports medicine, 2019bjsm.bmj.com
Research question Does the Nordic hamstring exercise (NHE) prevent hamstring injuries
when included as part of an injury prevention intervention? Design Systematic review and
meta-analysis. Eligibility criteria for selecting studies We considered the population to be
any athletes participating in any sporting activity, the intervention to be the NHE, the
comparison to be usual training or other prevention programmes, which did not include the
NHE, and the outcome to be the incidence or rate of hamstring injuries. Analysis The effect …
Research question
Does the Nordic hamstring exercise (NHE) prevent hamstring injuries when included as part of an injury prevention intervention?
Design
Systematic review and meta-analysis.
Eligibility criteria for selecting studies
We considered the population to be any athletes participating in any sporting activity, the intervention to be the NHE, the comparison to be usual training or other prevention programmes, which did not include the NHE, and the outcome to be the incidence or rate of hamstring injuries.
Analysis
The effect of including the NHE in injury prevention programmes compared with controls on hamstring injuries was assessed in 15 studies that reported the incidence across different sports and age groups in both women and men.
Data sources
MEDLINE via PubMed, CINAHL via Ebsco, and OpenGrey.
Results
There is a reduction in the overall injury risk ratio of 0.49 (95% CI 0.32 to 0.74, p=0.0008) in favour of programmes including the NHE. Secondary analyses when pooling the eight randomised control studies demonstrated a small increase in the overall injury risk ratio 0.52 (95% CI 0.32 to 0.85, p=0.0008), still in favour of the NHE. Additionally, when studies with a high risk of bias were removed (n=8), there is an increase of 0.06 in the risk ratio to 0.55 (95% CI 0.34 to 0.89, p=0.006).
Conclusions
Programmes that include the NHE reduce hamstring injuries by up to 51%. The NHE essentially halves the rate of hamstring injuries across multiple sports in different athletes.
Trial registration number
PROSPERO CRD42018106150.
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