Sex differences in injury rates in team-sport athletes:A systematic review and meta-regression analysis

摘要

Background:Team-sport players have a particularly high injury risk.Although female sex is considered a risk factor,it is still unknown whether female and male team-sport players,in fact,differ in their injury rates.We aimed to compare injury rates between female and male players by systematically reviewing and meta-analyzing injury surveillance studies of both sexes in order to evaluate sex-specific differences in team-sport injuries.Methods:Studies that prospectively collected injury data for high-level female and male players(age≥16 years)in basketball,field hockey,football(soccer),handball,rugby(union and sevens),and volleyball were included.Two reviewers(AZ and ALR)independently assessed study quality and extracted data for overall,match,training,and severe injuries(>28 days’time loss)as well as data regarding injury locations and types.Incidence rate ratios(IRRs)were pooled in a meta-analysis,and meta-regression analysis was performed when 10 or more studies were available.Results:Of 20 studies,9 studies reported injury data from football,3 studies from rugby,3 studies from handball,1 study from basketball,1 study from field hockey,2 studies from volleyball,and 1 study from basketball and field hockey.For overall injuries,the pooled IRR=0.86(95%confidence interval(95%CI):0.76-0.98)indicated significantly more injuries in male than in female players.For injury location,the pooled IRR showed higher injury rates in male athletes than in female athletes for upper extremity,hip/groin,thigh,ande foot injuries.Female players had a significantly higher rate of anterior cruciate ligament injuries(IRR=2.15,95%CI:1.27-3.62)than male players.No significant sex-specific differences in IRR were found for match,training,severe injuries,concussions,or ankle sprains.Conclusion:Our meta-analysis provides evidence for sex-specific differences in the injury rates in team sports.Further epidemiological studies including both sexes in sports other than football are needed in order to strengthen the evidence.