The Effectiveness Of Warmup Programs For Lower Extremity Injury Prevention In Basketball: A Systematic Review

Abstract

PURPOSE: Given the many benefits of sports participation, leading experts have called for attention to factors that might inhibit youth participation. Basketball is the most popular team sport among youth in the US; the popularity of basketball translates to a large absolute number of basketball related injuries. The objective of this review is to evaluate the evidence to support the effectiveness of neuromuscular warmup-based strategies for preventing lower extremity injuries (LEIs) in basketball. METHODS: We conducted a systematic review of the literature. We searched the PubMed and Cochrane Library databases, and focused on English-language randomized controlled trials, non-randomized comparative trials, and prospective cohort studies. We included studies that tested neuromuscular and/or balance-focused warmup interventions among basketball players, and that assessed at least one type of LEI as a primary outcome. We critically appraised the quality of the included studies and abstracted data on the interventions, populations, exposures and outcomes. We contacted the authors of five of the studies to obtain details about the interventions or outcome data specific to basketball athletes. RESULTS: Thirteen studies testing neuromuscular interventions for LEI prevention in basketball athletes were included in this review. They reported significant protective effects for the following LEIs: ankle injuries (significant in 4/9 studies that assessed this outcome); ACL injuries (2/4 studies); a general knee injury outcome (1/5 studies); and overall LEIs (composite; 5/7 studies). Non-significant results were almost universally directionally favorable. CONCLUSIONS: Neuromuscular interventions that require minimal equipment are an appealing injury prevention strategy in youth sports. In soccer, the FIFA 11+ warmup program has been rigorously studied and proven effective when adoption and adherence is strong. Overall, the evidence is supportive of warmups for LEI prevention in basketball. However, most studies are underpowered, intervention components are varied, and adoption and adherence is often low. More work is needed to validate the necessary and sufficient warmup activities, and to maximize adoption and sustained adherence to these strategies over time.