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i n f o p o e m s These InfoPOEMs® are selected by JNMA InfoPOEMS Editor Gregory E. Gilbert, MSPH, (Gregory.E.Gilbert@ gmail.com) and Associate InfoPOEMS Editor Amy H. Wahlquist, MS, from www.infopoems.com. InfoPOEMs® are created by experts who continuously survey medical journals worldwide. They identify and summa- rize valid and clinically applicable new evidence. For more information or to subscribe to e-mail alerts of InfoPOEMs®, please visit www.infopoems.com. STUDY LEVELS OF EVIDENCE (LOE) domized (concealed allocation) by From the Centre for Evidence-Based Specialized Training team to receive the specific training Medicine, Oxford. For the most up-to- Decreases Injuries or no intervention. One or 2 team date levels of evidence, see www.cebm. net/levels_of_evidence.asp) in Elite Athletes members were educated in the exer- cise program and were provided an Therapy/Prevention/Etiology/Harm: Clinical Question instruction booklet, balance boards, 1a: Systematic reviews of randomized Can a specific warm-up exercise balance pads and other materials. controlled trials program decrease injuries in elite The 30-minute program consisted 1b: Individual randomized controlled athletes? of 5–7 minutes of running exercise, trials 1c: All or none randomized controlled balance and body control exercises, trials Bottom Line plyometrics (jumping, hopping and 2a: Systematic reviews of cohort studies Injuries can be reduced by other explosive movements), core 2b: Individual cohort study or low- incorporating exercises specifically and lower-limb strengthening exer- quality randomized controlled aimed at improving proprioception, cises, and stretching. The exercises 2c: “Outcomes” research, ecological studies strength and balance. A 30-minute were performed 2–3 times per week exercise program performed 2–3 before the season and during a break, Diagnosis: times per week reduced the number and once weekly during the season. 1a: Systematic review of level-1 of noncontact leg injuries by 66% After adjusting for the number of diagnostic studies (LOE = 1b) scheduled hours of training and play, 1b: Independent blind comparison of an appropriate spectrum there were significantly fewer non- of consecutive patients, all of Study Design contact injuries, defined as an injury whom have undergone both the Randomized controlled trial requiring ≥1 day missed of practice diagnostic test and the reference standard, or a clinical decision rule (nonblinded) or play, in the trained group: 20 in not validated on a second set of the trained group versus 52 in the patients Funding control group (P<0.001). This differ- 1c: Absolute SpPins and SnNouts Government ence remained when all injuries were 2a: Systematic review of level >2 considered. Similar effectiveness has 2b: Independent blind or objective comparison, study confined Allocation been shown in adolescents who play to a narrow spectrum of study Concealed handball (BMJ. 2005;330:449-452). individuals, or a diagnostic clinical rule not validated in a test set Setting REFERENCE Outpatient (primary care) Pasanen K, Parkkari J, Pasanen M, et al. Neu- Prognosis: romuscular training and the risk of leg injuries 1a: Systematic review of inception in female floorball players: cluster rando
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