Injury prevention programs that include balance training exercises reduce ankle injury rates among soccer players: a systematic review

QUESTION: What is the effect of injury prevention programs that include balance training exercises on the incidence of ankle injuries among soccer players? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Soccer players of any age, sex or competition level. INTERVENTIONS: The experimental intervention was an injury prevention program that included balance training exercises. The control intervention was the soccer team's usual warm-up program. OUTCOME MEASURES: Exposure-based ankle injury rates. RESULTS: Nine articles met the inclusion criteria. The pooled results of injury prevention programs that included balance training exercises among 4,959 soccer players showed a 36% reduction in ankle injury per 1,000 hours of exposure compared to the control group with an injury risk ratio (IRR) of 0.64 (95% CI 0.54 to 0.77). The pooled results of the Fédération Internationale de Football Association (FIFA) injury prevention programs caused a 37% reduction in ankle injury (IRR 0.63, 95% CI 0.48 to 0.84) and balance-training exercises alone cause a 42% reduction in ankle injury (IRR 0.58, 95% CI 0.41 to 0.84). CONCLUSIONS: This meta-analysis demonstrates that balance exercises alone or as part of an injury prevention program decrease the risk of ankle injuries. PROSPERO CRD42017054450.