Proprioceptive Training to Prevent Ankle Injuries in Basketball

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Eils E, Schröter R, Schröder M, Gerss J, Rosenbaum D. Multistation proprioceptive exercise program prevents ankle injuries in basketball. Med Sci Sports Exerc. 2010;42:2098-2105.EilsESchroterRSchroderMGerssJRosenbaumDMultistation proprioceptive exercise program prevents ankle injuries in basketball.Med Sci Sports Exerc2010422098-2105Objective: To investigate the effectiveness of a multistation proprioceptive exercise program for the prevention of ankle injuries in basketball players.Design: Cluster-randomized controlled unblinded trial, stratified by level of performance and sex, during 1 season of competition.Setting: Basketball leagues near Münster, Germany.Participants: Players were recruited from the 7 top basketball leagues. They all played basketball regularly. Players who wore braces or tape to stabilize the ankles or who had previously performed proprioceptive exercises were excluded. At baseline (n = 198), the groups were similar in incidence of previous injuries (control group, 46% vs training group, 48%) and anthropomorphic characteristics. Players in the control group were older than those in the training group (mean, 25.5 years vs 22.6 years) and participated in fewer sports activities per week (mean, 2.8 vs 3.5).Intervention: The control group continued with their normal workout routines. The teams in the training group did 6 progressive exercises once per week for 20 minutes. The 6 stations involved walking, balancing, jumping, and/or dribbling, using a balance beam, tilt board, inclined surface, soft or firm mat, or resistance strap, with or without a ball or partner. The exercises were introduced by a physiotherapist, and a detailed protocol, including correct posture, was also given to the coaches, whom the investigators contacted regularly during the season.Main Outcome Measures: The primary measure was occurrence of ankle injuries. All injuries were registered by the person in charge of the team, using an injury questionnaire. In the case of an ankle injury, the coach and player were contacted by the investigators and more details of the circumstances, severity, and medical diagnosis were obtained. An injury was defined as an event that forced the player to leave play and miss the next scheduled basketball activity. The main analysis included 90% of the players. Incidence of injury was calculated per 1000 sports participation sessions. Secondary measures were changes in postural sway and joint position sense, tested in 16 players (66% of the subsample).Main Results: Control group players had 21 ankle injuries and the training group had 7 injuries (overall mean participation, 55 training and match sessions), giving an injury rate per 1000 sport participations of 4.31 versus 1.53 for the groups, respectively. In logistic regression, the odds ratio (OR) for an ankle injury in the training group was reduced to 0.355 [95% confidence interval (CI), 0.151-0.835], with the number needed to treat (with the proprioceptive training regimen) to prevent 1 ankle injury being 7. Among all the players who had previously had an ankle injury, the OR for an injury was 1.6 (95% CI, 0.755-3.553; P = 0.212). The training group swayed less at posttest and were more accurate in estimating neutral joint position than at pretest (P < 0.05) but did not differ from the control group in any changes.Conclusions: A weekly session of proprioceptive exercise training was effective in lowering the rate of ankle injuries in recreational and professional basketball players.COMMENTARYAnkle injuries are the most frequent injury in basketball.

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