{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:50Z","timestamp":1789448570266,"version":"build-2803163510"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify the effectiveness of exercise-based injury prevention programmes (IPPs) in female team sports across overall, lower-limb, and site-specific injury outcomes, and to examine training dose and adherence as potential effect modifiers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomised controlled trials evaluating exercise-based IPPs in female team-sport athletes were synthesised. Risk ratios (RRs) were pooled using random-effects models. Subgroup analyses examined training frequency, session duration, weekly training dose, and adherence, while meta-regression was used to examine study-level associations with training dose and adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen unique trials involving 13,675 athletes were included. IPPs reduced overall injury risk by 35% (RR\u202f=\u202f0.65, 95% CI: 0.53\u20130.79), with a similar reduction in lower-limb injuries (RR\u202f=\u202f0.67, 95% CI: 0.53\u20130.86). Significant reductions were also observed for anterior cruciate ligament injuries (RR\u202f=\u202f0.62, 95% CI: 0.43\u20130.89) and ankle injuries (RR\u202f=\u202f0.59, 95% CI: 0.42\u20130.84). Exploratory subgroup analyses suggested larger effects at 4\u20135 sessions\/week (RR\u202f=\u202f0.47) and 21\u201330\u202fmin\/session (RR\u202f=\u202f0.42). Programmes providing 51\u2013120\u202fmin\/week were associated with greater risk reduction than those providing 1\u201350\u202fmin\/week (RR\u202f=\u202f0.48 vs. 0.80). Trials with adherence \u226575% showed a clear protective effect (RR\u202f=\u202f0.55), whereas those with lower adherence showed little evidence of benefit (RR\u202f=\u202f0.93). The certainty of evidence for the primary overall-injury outcome was low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exercise-based neuromuscular IPPs appear to reduce overall and lower-limb injury risk in female team sports, with protective effects observed for ACL and ankle injuries and the most consistent estimate for ACL injury. Greater weekly exposure was associated with larger risk reductions at the study level, whereas the continuous adherence meta-regression was not significant. These patterns should be interpreted as exploratory implementation signals rather than definitive thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      The systematic review was prospectively registered in PROSPERO (CRD420251236606). URL:\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251236606<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1950998","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:26:25Z","timestamp":1789446385000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of injury prevention programmes in female team sports: a systematic review and meta-analysis of hierarchical injury outcomes, training dose\u2013response relationships, and adherence"],"prefix":"10.3389","volume":"14","author":[{"given":"Jinfa","family":"Gu","sequence":"first","affiliation":[{"name":"Institute of Physical Education, Jiangsu Normal University","place":["Xuzhou, Jiangsu, China"]},{"name":"School of Physical Education, Henan Polytechnic University","place":["Jiaozuo, Henan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Ezhou Central Hospital","place":["Ezhou, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hengzhi","family":"Deng","sequence":"additional","affiliation":[{"name":"Faculty of Sports and Exercise Science, University of Malaya","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Nursing and Rehabilitation, Xi'an Jiaotong University City College","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Xiao","sequence":"additional","affiliation":[{"name":"School of Physical Education and Health, Zhaoqing University","place":["Zhaoqing, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruohan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute of Physical Education, Jiangsu Normal University","place":["Xuzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"645","DOI":"10.1007\/s40279-023-01950-w","article-title":"The effects of exercise-based injury prevention programmes on injury risk in adult recreational athletes: a systematic review and Meta-analysis","volume":"54","author":"Liddle","year":"2024","journal-title":"Sports Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s40279-022-01797-7","article-title":"Efficacy of multi-component exercise-based injury prevention programs on injury risk among footballers of all age groups: a systematic review and meta-analysis","volume":"53","author":"Ob\u00ebrtinca","year":"2023","journal-title":"Sports Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1560","DOI":"10.1136\/bjsports-2025-109946","article-title":"Gender- and\/or sex-specific considerations for sport-related injury: a concept mapping approach for the female, woman and\/or girl athlete injury pRevention (FAIR) consensus","volume":"59","author":"Crossley","year":"2025","journal-title":"Br J Sports Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e18910","DOI":"10.7717\/peerj.18910","article-title":"Effectiveness of FIFA injury prevention programs in reducing ankle injuries among football players: a systematic review","volume":"13","author":"Alhazmi","year":"2025","journal-title":"PeerJ"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s13102-017-0083-z","article-title":"The FIFA 11+ injury prevention program for soccer players: a systematic review","volume":"9","author":"Sadigursky","year":"2017","journal-title":"BMC Sports Sci Med Rehabil"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1136\/bjsports-2016-097066","article-title":"Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes","volume":"51","author":"Thorborg","year":"2017","journal-title":"Br J Sports Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1007\/s40279-023-01988-w","article-title":"Injury profile in youth female athletes: a systematic review and Meta-analysis","volume":"54","author":"Beech","year":"2024","journal-title":"Sports Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s40279-015-0404-x","article-title":"How effective are F-MARC injury prevention programs for soccer players? 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