Strategies to prevent and manage running-related knee injuries: a systematic review of randomised controlled trials.

Autor:	Alexander JLN; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.; Evado Studios, Nelson Bay, New South Wales, Australia., Culvenor AG; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia., Johnston RRT; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia., Ezzat AM; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada., Barton CJ; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia christian@completesportscare.com.au.; Department of Physiotherapy, Podiatry and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	British journal of sports medicine [Br J Sports Med] 2022 Nov; Vol. 56 (22), pp. 1307-1319. Date of Electronic Publication: 2022 Sep 23.
DOI:	10.1136/bjsports-2022-105553
Abstrakt:	Objective: To evaluate the effectiveness of interventions to prevent and manage knee injuries in runners. Design: Systematic review and meta-analysis. Data Sources: MEDLINE, EMBASE, CINAHL, Web of Science and SPORTDiscus up to May 2022. Eligibility Criteria for Selecting Studies: Randomised controlled trials (RCTs) with a primary aim of evaluating the effectiveness of intervention(s) to prevent or manage running-related knee injury. Results: Thirty RCTs (18 prevention, 12 management) analysed multiple interventions in novice and recreational running populations. Low-certainty evidence (one trial, 320 participants) indicated that running technique retraining (to land softer) reduced the risk of knee injury compared with control treadmill running (risk ratio (RR) 0.32, 95% CI 0.16 to 0.63). Very low-certainty to low-certainty evidence from 17 other prevention trials (participant range: 24 -3287) indicated that various footwear options, multicomponent exercise therapy, graduated running programmes and online and in person injury prevention education programmes did not influence knee injury risk (RR range: 0.55-1.06). In runners with patellofemoral pain, very low-certainty to low-certainty evidence indicated that running technique retraining strategies, medial-wedged foot orthoses, multicomponent exercise therapy and osteopathic manipulation can reduce knee pain in the short-term (standardised mean difference range: -4.96 to -0.90). Conclusion: There is low-certainty evidence that running technique retraining to land softer may reduce knee injury risk by two-thirds. Very low-certainty to low-certainty evidence suggests that running-related patellofemoral pain may be effectively managed through a variety of active (eg, running technique retraining, multicomponent exercise therapy) and passive interventions (eg, foot orthoses, osteopathic manipulation). Prospero Registration Number: CRD42020150630. Competing Interests: Competing interests: AGC and CJB are Associate Editors of BJSM. (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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