Sport-related Concussion Can be Prevented by Injury Prevention Program: A Systematic Review and Meta-analysis of Prospective, Controlled Studies

Background: Sport-related concussions (SRCs) have emerged as a global health concern in sports medicine. Effective injury prevention programs have the potential to reduce the risk of SRCs, but, their efficacy remains inconclusive. Therefore, the aim of this systematic review and meta-analysis was to evaluate the efficacy of injury prevention programs in preventing SRCs and to examine whether different intervention types (physical- vs. educational-based) and athletic exposure context (practice vs. match) influenced the efficacy of interventions. Methods: Six databases (PubMed, CINAHL, MEDLINE, SPORTDiscus, Scopus, and Embase databases) were searched in March 2024. Studies were included if (1) the physical training or educational intervention aimed to prevent SRC, (2) the incidence rate (IR) or other outcome data sufficient to calculate the IR for both the intervention and control groups were reported, and (3) the study employed a prospective design. Results: A total of eight studies were included in the analysis, involving 2571 participants (intervention group: n = 1281; control group: n = 1290). Current injury prevention programs primarily targeted male athletes in rugby, American Football, and soccer. The analysis revealed a significant reduction in SRC rate among athletes who received injury prevention programs (incidence rate ratio = 0.66, 95% CI [0.50–0.85], p =.002). The moderator analysis indicated that neither the type of intervention nor the exposure context significantly influenced the efficacy of the injury prevention programs. Conclusions: SRC prevention programs provided a significant protection effect, reducing injury rates by 34%. Importantly, their efficacy remains consistent across both physical training and educational-based programs, as well as in various exposure contexts. However, further prospective studies are needed to develop injury prevention protocols specifically for females and to investigate factors that may influence the efficacy of these interventions to enhance the prevention of SRC across various sports.