Exercise Interventions for the Prevention and Treatment of Groin Pain and Injury in Athletes: A Critical and Systematic
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SYSTEMATIC REVIEW
Exercise Interventions for the Prevention and Treatment of Groin Pain and Injury in Athletes: A Critical and Systematic Review Paula C. Charlton1,2 • Michael K. Drew1,3 • Benjamin F. Mentiplay2,5 Alison Grimaldi4 • Ross A. Clark5
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Ó Springer International Publishing Switzerland 2017
Abstract Background Groin injury is a common musculoskeletal complaint for athletes competing in a variety of sports. The extent to which exercise interventions incorporating external load are an appropriate option for the treatment and prevention of groin injury in athletes is not yet clear. Objectives The aim of this review was to describe and evaluate exercise therapy interventions and outcomes for the treatment and prevention of groin injury with specific attention to application of external load. Data Sources The databases Medline, PubMed, SPORTDiscus, Web of Science, and Cochrane were searched on 18 April 2016.
Electronic supplementary material The online version of this article (doi:10.1007/s40279-017-0742-y) contains supplementary material, which is available to authorized users. & Paula C. Charlton [email protected] 1
Clinical Physiotherapy, Department of Physical Therapies, Australian Institute of Sport, Leverrier Street, Bruce, ACT, Australia
2
Faculty of Health Sciences, School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia
3
Australian Collaboration for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, VIC, Australia
4
Physiotec Physiotherapy, Brisbane, QLD, Australia
5
Faculty of Science, Health, Engineering and Education, School of Health and Sport Science, University of the Sunshine Coast, Sippy Downs, QLD, Australia
Study Eligibility Criteria This review was registered as PROSPERO CRD42016037752 and a systematic search was conducted with the following inclusion criteria: any study design evaluating exercise interventions for the prevention or treatment of groin pain in athletes. Data Analysis Two independent authors screened search results, performed data extraction, assessed risk of bias using the modified Downs and Black appraisal tool and determined strength and level of evidence. Reporting standards for exercise interventions were assessed using the Consensus for Exercise Reporting Template (CERT). Results A total of 1320 titles were identified with 14 studies satisfying the inclusion criteria, four (29%) of which demonstrated low risk of bias. Ten (71%) studies utilised external load as a component of the exercise intervention. Reporting standards for exercise intervention scores ranged from 0 to 63%. Conclusion There is limited evidence from level 2 and 3 studies indicating exercise therapy may reduce the incidence and hazard risk of sustaining a groin injury in athletes. There is strong evidence from level 4 studies indicating exercise therapy is beneficial as a treatment for groin injury in athletes in terms of symptom remission, return to sport and recurrence outcomes. However, there
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