TY - JOUR
T1 - Prevention strategies and modifiable risk factors for spine, chest, abdominal and/or pelvic injury and pain: a systematic review and meta-analysis for the Female, woman and girl Athlete Injury pRevention (FAIR) consensus
AU - Whittaker, Jackie L
AU - Schulz, Jenna M
AU - Galarneau, Jean-Michel
AU - Moore, Isabel S
AU - Ackerman, Kathryn E
AU - Butler, Miranda
AU - Dane, Kathryn
AU - Dubé, Marc-Olivier
AU - Ferraz Pazzinatto, Marcella
AU - Gomez, Christina D
AU - Hayden, K Alix
AU - Marmura, Hana
AU - Mizuta, Rami
AU - Mosler, Andrea Britt
AU - Schneider, Geoff
AU - Schneider, Kathryn J
AU - Sharma, Saurab
AU - Trease, Larissa
AU - Wilson, Fiona
AU - Thornton, Jane S
AU - Crossley, Kay M
AU - Emery, Carolyn A
N1 - Publisher Copyright:
© Author(s) (or their employer(s) 2025.
PY - 2025/8/31
Y1 - 2025/8/31
N2 - Objective: Investigate prevention interventions and potential modifiable risk factors (MRFs) for female/woman/girl athletes’ spine, chest, abdominal or pelvic injury and/or pain. Design: Systematic review with meta-analyses, semiquantitative analyses and Grading of Recommendations Assessment, Development and Evaluation. Data sources: MEDLINE, CINAHL, APA PsycINFO, CDSR, CENTRAL, SPORTDiscus, EMBASE, ERIC. Eligibility: Primary data studies with comparison group(s) assessing the association of prevention interventions and/or MRFs for spine, chest, abdominal and/or pelvic injury/pain with ≥1 female/woman/girl athlete in each study group. Results: Across 105 studies (n=11 interventions, n=92 MRFs, n=2 both, n=35 female/woman/girl-specific estimates) including 59 833 participants (23.7% females/women/girls) 9 injury/pain outcomes were assessed (n=74 low-back, n=14 back, n=13 neck, n=5 pelvis, n=3 thoracic, n=3 abdominal, n=3 trunk, n=2 rib, n=1 breast). Three prevention strategies (exercise, equipment, rule-change) and 22 MRFs were identified. High risk of confounding bias (Downs and Black quality assessment tool) was present in 92% and 63% of intervention and MRF studies, respectively. Considering female/woman/girl estimates, we performed meta-analyses (standardised mean-difference) on 4 MRFs (body mass, body mass index (BMI), weekly training hours, spinal flexion) for low-back pain (LBP) and semiquantitative analyses for one intervention (exercise), and 3 MRFs (yearly training load, hip motion, hip strength) for LBP. Very low-certainty evidence suggests no difference in body mass (g=0.28, 95% CI −0.06 to 0.62; I2=67.7%), BMI (g=0.22, 95% CI −0.25 to 0.69; I2=68.2%), weekly training hours (g=0.15, 95% CI −0.29 to 0.58; I2=45.6%) or spinal flexion (g=0.27, 95% CI −0.23 to 0.76; I2=40.4%) between female/women/girls athletes with and without LBP. Conclusions: There is limited knowledge about prevention interventions or MRFs for female/women/girl athletes’ spine, chest, abdominal and/or pelvic injury/pain. PROSPERO registration number: CRD42024479654.
AB - Objective: Investigate prevention interventions and potential modifiable risk factors (MRFs) for female/woman/girl athletes’ spine, chest, abdominal or pelvic injury and/or pain. Design: Systematic review with meta-analyses, semiquantitative analyses and Grading of Recommendations Assessment, Development and Evaluation. Data sources: MEDLINE, CINAHL, APA PsycINFO, CDSR, CENTRAL, SPORTDiscus, EMBASE, ERIC. Eligibility: Primary data studies with comparison group(s) assessing the association of prevention interventions and/or MRFs for spine, chest, abdominal and/or pelvic injury/pain with ≥1 female/woman/girl athlete in each study group. Results: Across 105 studies (n=11 interventions, n=92 MRFs, n=2 both, n=35 female/woman/girl-specific estimates) including 59 833 participants (23.7% females/women/girls) 9 injury/pain outcomes were assessed (n=74 low-back, n=14 back, n=13 neck, n=5 pelvis, n=3 thoracic, n=3 abdominal, n=3 trunk, n=2 rib, n=1 breast). Three prevention strategies (exercise, equipment, rule-change) and 22 MRFs were identified. High risk of confounding bias (Downs and Black quality assessment tool) was present in 92% and 63% of intervention and MRF studies, respectively. Considering female/woman/girl estimates, we performed meta-analyses (standardised mean-difference) on 4 MRFs (body mass, body mass index (BMI), weekly training hours, spinal flexion) for low-back pain (LBP) and semiquantitative analyses for one intervention (exercise), and 3 MRFs (yearly training load, hip motion, hip strength) for LBP. Very low-certainty evidence suggests no difference in body mass (g=0.28, 95% CI −0.06 to 0.62; I2=67.7%), BMI (g=0.22, 95% CI −0.25 to 0.69; I2=68.2%), weekly training hours (g=0.15, 95% CI −0.29 to 0.58; I2=45.6%) or spinal flexion (g=0.27, 95% CI −0.23 to 0.76; I2=40.4%) between female/women/girls athletes with and without LBP. Conclusions: There is limited knowledge about prevention interventions or MRFs for female/women/girl athletes’ spine, chest, abdominal and/or pelvic injury/pain. PROSPERO registration number: CRD42024479654.
KW - Gender
KW - Trunk
KW - Sport
KW - Rib
KW - Breast
UR - https://www.scopus.com/pages/publications/105014994473
U2 - 10.1136/bjsports-2025-109900
DO - 10.1136/bjsports-2025-109900
M3 - Review article
SN - 0306-3674
VL - 59
SP - bjsports-2025-109900
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
IS - 22
M1 - 109900
ER -