The Effects of Injury Prevention Programs on Ankle Injuries in Young Basketball Players: A Systematic Review

Background: Ankle injuries are the most prevalent type of injury among basketball players, and exercise-based prevention programs are commonly employed to mitigate their occurrence. Objective: This systematic review aimed to investigate the effectiveness of exercise-based injury prevention programs in reducing ankle injuries among young basketball players. Materials & Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The literature search was conducted in Web of Science, PubMed, and Scopus databases up to June 20, 2024. Additionally, the reference lists of included studies were manually searched to identify further relevant articles. Two authors independently selected studies, extracted data, and assessed methodological quality, with a third author resolving any discrepancies. The ROBINS-I and RoB-2 tools were used to evaluate the risk of bias in the included studies. The primary effect measure was the rate ratio (RR) for ankle injuries (intervention/control incidence per 1000 exposure hours); 95% CIs were calculated when exposure hours allowed. Given heterogeneity in program content/dose, we reported study-level estimates without pooling. Results: Six studies were included, comprising five randomized controlled trials (RCTs) and one non-RCT, with a total of 2318 participants and a mean age of 16.8 ± 2.4 years. Incidence rates ranged 0.27–3.54 injuries/1000 h. Study-level RRs favored the intervention in all trials: 0.24 (95% CI 0.07–0.86), 0.64 (0.46–0.88), 0.60 (0.36–1.01), 0.80 (0.13–4.79), 0.80 (0.19–3.35), and 0.34 (CI not estimable). Thus, 2/5 RCTs showed statistically significant reductions, one was borderline, and two were imprecise with wide CIs. Risk of bias was low to moderate overall. Conclusion: Exercise-based prevention, particularly through balance and neuromuscular programs, is linked to a reduction in ankle injury rates among young basketball players. Although the results consistently support this connection, the limited number of trials and differences in interventions make it challenging to produce reliable overall estimates. Therefore, larger and well-designed RCTs with standardized definitions for exposure and outcomes are needed.