Psychological interventions used to reduce sports injuries: a systematic review of real-world effectiveness

OBJECTIVE: To systematically review studies examining the role of psychological interventions in injury prevention. The primary research question was: What is the real-world effectiveness of psychological intervention in preventing sports injuries? DESIGN: Mixed methods systematic review with best evidence synthesis. DATA SOURCES: CINAHL, MEDLINE, PsycARTICLES, PsycINFO, SPORTDiscus, Science Direct and PubMed. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials (RCT), non-RCTs that included a comparison group, before and after study designs and qualitative methods. Studies were required to outline specific unimodal or multimodal psychological interventions used in relation to injury prevention in the real-world setting. OUTCOME MEASURE: Studies were independently appraised with the Mixed Methods Appraisal Tool. RESULTS: Thirteen papers (incorporating 14 studies) met the eligibility criteria, of which 93% (13/14) reported a decrease in injury rates (effect size range=0.2-1.21). There was an overall moderate risk of bias in reporting (52%). There is a dominance of stress management-based interventions in literature due to the prominence of the model of stress and athletic injury within the area. SUMMARY/CONCLUSIONS: Psychological interventions demonstrate small (0.2) to large (1.21) effects on sports injury rates. The research area demonstrates a cumulative moderate risk in reporting bias (52%). PROSPERO REGISTRATION NUMBER: CRD42016035879.