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Interventions with Insufficient Evidence for Recommendation: Physical Training and Sports Injury Prevention Guidelines U.S. Army Public Health Command (Provisional) Injury Prevention Warm‐Up and Cool‐Down Before and After Activity Evidence of the effectiveness of warm-up and cool- down activites on the prevention of injuries is lacking; therefore the JSPTIPWG cannot recommend for or against this intervention. The work group recommends that this specific research question be studied in military populations. Background: The JSPTIPWG made a conscious decision to isolate those activities that may or may not be performed in association with a warm-up. For example, stretching is a common activity often associated with a warm-up, but it is an activity that can be performed at any time during a training session. Therefore, stretching is considered a separate intervention apart from the warm-up and is discussed in an earlier paragraph of this report. Other types of activities like proprioceptive and neuromuscular activities also are associated with the warm-up and often are found when searching the literature for warm-up information. These types of activities may or may not be performed in association with the warm-up and also are considered a separate intervention (discussed earlier). A systematic review of warm-up activity found five studies, all of high quality (7–9 (mean=8) out of 11) and reporting sufficient data (quality score>7) on the effects of warming up relative to reducing injury risk in humans. Some of these studies included stretching among other activities. Three of the studies found that performing a warm-up prior to performance significantly reduced the injury risk, and the other two studies found that warming up was not effective in significantly reducing the number of injuries. Since the number of studies showing no effect in preventing injuries is nearly the same as those showing a positive effect, enough doubt is cast on the practice of warm-up such that the work group cannot recommend it at this time. However, there is insufficient evidence to discontinue the strategy as well. The recent review of literature provides a comprehensive reference list to which the reader is referred for the entire breadth of studies on warm-up and associated activity. **Information taken from Joint Services Physical Training Injury Prevention Work Group p. 83-166. References: Fradkin, AJ, Gabbe BJ, Cameron PA, Does warming up prevent injury in sport? The evidence from randomized controlled trials. J Sci Med Sport. 2006 Jun;9(3):214-20. http://usachppm.amedd.army.mil 2010
"Interventions with Insufficient Evidence for Recommendation "