Why does it work? Proposed biomedical effect mechanisms of exercise-based injury prevention programmes in football (soccer) and handball: a scoping review of 104 studies.

OBJECTIVE

To describe the proposed biomedical effect mechanisms in research on exercise-based injury prevention programmes in football (soccer) and handball.

DESIGN

Scoping review of randomised controlled trials (RCT), cohort studies and case studies.

DATA SOURCES: MEDLINE via PubMed, SPORTDiscus and Web of Science databases were searched from 2000 to 2024.

ELIGIBILITY CRITERIA: Studies were included if they described exercise-based injury prevention programmes in football (soccer) or handball and provided a biomedical rationale or proposition of effect mechanisms. Peer-reviewed studies of all ages and both sexes at elite, subelite or amateur level were eligible.

RESULTS

We included 104 studies (78 RCTs, 25 cohort studies, 1 case study) with sample sizes ranging from 10 to 4556 participants. Most studies (83%) were published after 2010, and interventions were reported to have an effect in 82% of the studies. Four main themes emerged describing the proposed effect mechanisms: neuromuscular control (47%), strength (39%), range of motion (11%) and physical fitness (3%). Definitions of key terms related to the intervention were provided in only 19% of studies, measurements of specific biomedical effect mechanisms were conducted in just 59% of studies.

CONCLUSION

Neuromuscular control and strength were the predominant proposed effect mechanisms for injury prevention programmes in football and handball. To better establish effect mechanisms of exercise-based interventions, future research should consistently define key terms related to the interventions and strive to identify and test causal mechanisms to optimise injury prevention programmes.