Saturday, June 27, 2020

Master List of Rehab Meta-Analyses

Master List of Rehab Meta-Analyses

       This article was inspired by Greg Nuckols' article that archives and gives brief interpretations of many of the meta-analyses relevant to the area of strength and hypertrophy development. This is an exceptional way to get a evidence-grounded birds-eye-view of a given field, although there is certainly nuances that can be lost if you only consider meta-analytic data. If you are not familiar with what a meta-analysis is I strongly suggest you read the introduction to Greg's article as understanding the hierarchy of evidence is critical for anyone wanting to use science to improve their understanding of the world. 

Without further ado, here is a running (and continually expanding) list of meta-analyses relevant to the field of sports and orthopedic rehab. Let me know in the comments what I am missing or if you have feedback on any of my interpretations! 

Table of Contents


The Effects of Injury Prevention Programs on the Biomechanics of Landing Tasks: A Systematic Review With Meta-analysis. Lopes et al. (2017) 
 
Modalities

Effect of blood‐flow restricted vs heavy‐load strength training on muscle strength: Systematic review and meta‐analysis. Grønfeldt et al. (2020)

Injury Prevention
Laureson 2016 + 2018

Modalities

Effect of blood‐flow restricted vs heavy‐load strength training on muscle strength: Systematic review and meta‐analysis. Grønfeldt et al. (2020)



Pathology Specific

Muscle Strains 

Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes. van Dyk et al. (2019) - Interpretation taken directly from Stronger by Science

The title of this meta-analysis is shockingly self-explanatory. Nordic curls dramatically decrease the risk of hamstrings strains in athletes.

ACL

The Effects of Injury Prevention Programs on the Biomechanics of Landing Tasks: A Systematic Review With Meta-analysis. Lopes et al. (2017)  - Interpretation taken directly from Stronger by Science

Injury prevention programs aimed at altering biomechanical profiles associated with ACL injury risk seem to be effective. Specifically, they seem to help increase knee and hip flexion angles during landing tasks (meaning people are absorbing force more effectively, rather than getting a big “shock” when they land), and decrease knee abduction moments (knee caving). The fact that landing mechanics are trainable is important information for coaches who train athletes (specifically female athletes in sports that require a lot of jumping).

Modalities

Effect of blood‐flow restricted vs heavy‐load strength training on muscle strength: Systematic review and meta‐analysis. Grønfeldt et al. (2020) - Interpretation taken directly from Stronger by Science

Low-load training (20-50% 1RM) with blood flow restriction produces strength gains that are not significantly different from strength training without blood flow restriction in more traditional intensity ranges (60-90% 1RM). However, the mean effect leans in favor of heavier training without BFR, and the difference would likely be larger in well-trained populations. However, if gaining strength is a primary training goal, and you choose to do low-load training for some reason, using BFR for your low-load training may not be a bad idea. A slightly older meta-analysis did find a significant difference in strength gains in favor of heavier traditional training; it also found that low-load training the BFR and heavier traditional training led to similar muscle growth.

Epidemiology

The epidemiology of injuries across weight-training sports. Keogh and Winwood (2017) - Interpretation taken directly from Stronger by Science

Bodybuilding has the lowest injury risk (0.24-1 injuries per 1,000 hours) and strongman and highland games have the highest injury risk (4.5-7.5 injuries per 1,000 hours), while weightlifting and powerlifting fall in the middle.

Spinal Surgery vs Conservative Care