{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T18:53:48Z","timestamp":1793559228599,"version":"4.5.0"},"reference-count":68,"publisher":"BMJ","issue":"21","funder":[{"DOI":"10.13039\/501100003965","name":"The International Olympic Committee","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003965","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2025,8,19]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Examine potentially modifiable risk factors (MRFs) for female\/woman\/girl athletes\u2019 lower-extremity injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review with meta- or semiquantitative analyses and Grading of Recommendations, Assessment, Development and Evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>MEDLINE, CINAHL, APA PsycINFO, Cochrane Systematic Review Database, CENTRAL, SPORTDiscus, EMBASE, ERIC searched 30 October or 23 November 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility<\/jats:title>\n                    <jats:p>Primary data studies with comparison group(s) assessing the association of MRFs for sport-related lower-extremity injury(s) with \u22651 female\/woman\/girl per study group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across 195 studies (n=115; 58.9% female\/woman\/girl-specific estimates) including 1\u2009525\u2009662 participants (2.4%\u2009females\/women\/girls), eight injury outcomes were assessed (n=75 general lower-extremity, n=3 groin, n=6\u2009hip, n=17 thigh, n=88\u2009knee, n=17 lower-leg, n=27 ankle, n=9\u2009foot). Sixty-six MRF categories were identified. Substantial heterogeneity in MRFs and injury outcomes exists, with high risk of bias present in 37.4% of studies. Considering female\/woman\/girl specific estimates, we performed meta-analyses for 10 MRFs (body mass, x (BMI), weekly training distance, muscle strength, artificial turf, off-season plyometric training, readiness to return-to-sport, single-leg hop asymmetry, vertical drop jump peak knee flexion angle and ground reaction force) and semiquantitative analyses for 26 MRFs for a variety of injuries. Meta-analyses suggest no association between any lower-extremity strength outcome (g=0.01, 95% CI \u22120.11 to 0.14; I\n                      <jats:sup>2<\/jats:sup>\n                      =37.3%; very low certainty evidence) or artificial turf (Incidence Rate Ratio=0.97, 95% CI 0.88 to 1.07; I\n                      <jats:sup>2<\/jats:sup>\n                      =2.4%; low certainty evidence) and various lower-extremity injuries. Higher body mass (g=0.19, 95% CI 0.00 to 0.38; I\n                      <jats:sup>2<\/jats:sup>\n                      =71.7%) and\/or BMI (g=0.22, 95% CI 0.09 to 0.36; I\n                      <jats:sup>2<\/jats:sup>\n                      =37.0%) are associated with several lower-extremity injuries (very low certainty evidence).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review synthesises a large body of exploratory research, exposes important knowledge gaps and provides a foundation for understanding MRFs for female\/woman\/girl athlete lower-extremity injuries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>PROSPERO CRD42024486715.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-109902","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T17:20:15Z","timestamp":1757006415000},"page":"1499-1513","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Modifiable risk factors for lower-extremity injury: a systematic review and meta-analysis for the Female, woman and\/or girl Athlete Injury pRevention (FAIR) consensus"],"prefix":"10.1136","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6591-4976","authenticated-orcid":false,"given":"Jackie L","family":"Whittaker","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada"},{"name":"Arthritis Research Canada, Vancouver, British Columbia, 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