Is strength training an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports? A scoping review of high-quality randomized controlled trials

Is strength training an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports? A scoping review of high-quality randomized controlled trials | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Is strength training an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports? A scoping review of high-quality randomized controlled trials Kalani Weerasinghe, Ranil Jayawardena, Andrew P Hills This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5753318/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Muscular strength that can be improved through maximal, explosive, and reactive training, reduces injury risk and enhances sport-specific performance in athletes. In team sports, increased strength boosts physical and neuromuscular function, delays fatigue, speeds recovery and optimizes technical execution and decision-making during competition. Therefore, this scoping review aims to explore existing intervention studies to understand the role of strength training (ST) as an effective strategy for preventing injuries and enhancing performance in team sports. Methods A comprehensive search was conducted in five databases (SciVerse Scopus, PubMed, Web of Science, SPORTDiscus, and CINAHL) from 2015 to 2024. Keywords related to strength training, injuries, and team sports were used in the search. We included randomized controlled trials (RCTs) assessing the effectiveness of ST in preventing injuries and enhancing performance in team sports. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale. Results This review included 15 RCTs involving team sports: soccer (n = 9), volleyball (n = 3), and one each for football, handball, and rugby. Participants had a mean age range of 12.7 to 25.8 years, with sample sizes varying from 20 to 652 athletes. Four studies demonstrated dual benefits, highlighting the ability of ST to simultaneously enhance biomechanical alignment, address muscle imbalances, and optimize both injury prevention and performance outcomes. Three RCTs focused solely on strengthening interventions for injuries reported that ST effectively reduced the incidence of sports injuries, including hamstring strains (n = 2), groin injuries (n = 1), and overall injuries (n = 4). Performance metrics such as sprint speed, jump height, muscle strength, and endurance were significantly improved with ST in eight studies. Conclusions ST can be considered an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports across different age groups and genders, as suggested by high-quality RCTs. Sports Medicine and Kinesiology Strength training injury prevention physiotherapy sports performance team sports Figures Figure 1 Figure 2 Figure 3 Introduction Muscular strength is the capacity to exert force against an external object or resistance [ 1 ]. Absolute and relative muscular strength are crucial factors influencing an athlete's injury rate and sports performance, significantly impacting their sport-specific abilities [ 2 ]. Enhanced muscular strength enables athletes to reduce the risk of injuries while simultaneously enhancing performance significantly [ 2 ]. Muscular strength can be improved through various training modalities, including maximal, explosive, reactive, and strength training (ST), as well as combinations of these training approaches [ 3 ]. ST incorporates various tools such as free weights, machines, resistance bands, plyometric exercises, resisted sprint drills, core stability workouts, and bodyweight movements [ 4 ]. Depending on the specific demands of their sport or event, athletes may need to generate significant force to overcome gravity and control their body mass (e.g., sprinting, gymnastics, diving), manage their body mass alongside an opponent’s (e.g., Football, rugby, wrestling), or manipulate equipment or projectiles (e.g., baseball, weightlifting, shot put) [ 2 ]. Team sports are particularly remarkable among various sports disciplines, as improvements in maximal strength, reactive strength, and explosive power have been demonstrated to positively impact performance and career longevity [ 5 ]. An effective ST program equips athletes with the physical foundation required to perform sports-specific skills during both training and competition [ 6 ]. It also helps ensure player availability by preventing and minimizing the incidence and severity of sports injuries [ 7 ]. Additionally, it enhances players' morphological, neuromuscular, and energy systems, delays the onset of fatigue during training and competition, accelerates recovery between sessions, and supports optimal technical execution and decision-making in competitive scenarios [ 8 ]. Recent research highlights that well-structured ST programs are essential for team sports athletes to enhance physical fitness and reduce injury risk systematically [ 9 ]. A randomized controlled trial (RCT) investigated the impact of a 12-week in-season ST program on physical fitness and injury rates in young elite female soccer players [ 10 ]. Findings revealed that non-contact injury rates during the season were significantly lower in the ST group (0.48/1000 hours of exposure) compared to the control group (CG) (2.62/1000 hours of exposure; p = 0.003) [ 10 ]. Similarly, another study demonstrated significant improvements in quadriceps-to-hamstring strength balance in both legs (p < 0.001) and a notably lower injury burden (p < 0.001; relative risk = 5.05) after a 12-week maximal ST program [ 11 ]. Another parallel trial assessed the effectiveness of the Nordic Hamstring Exercise (NHE) in reducing the incidence and severity of hamstring injuries among male amateur soccer players [ 12 ]. The results showed that the injury incidence was lower in the intervention group (IG) with 6 injuries (55%) compared to 18 injuries (72%) in the CG (p = 0.005). Additionally, the risk of hamstring injury was significantly reduced in the IG (11 cases) compared to the CG (25 cases; p = 0.005). The study concluded that incorporating the NHE protocol into regular amateur training significantly decreases the incidence and risk of hamstring injuries [ 12 ]. Moreover, ST has also been recognized as a crucial strategy for enhancing performance in team sports. Recent studies indicate a direct correlation between strength levels and high-intensity actions, such as sprinting and jumping, which are fundamental to sports performance [ 13 ]. One RCT investigated the impact of an eight-week resistance training program using elastic bands on performance-related outcomes in male volleyball players [ 14 ]. The results revealed significant improvements in the one-repetition maximum (1RM) (IG: 124.3 ± 26.8; CG: 97.15 ± 12.4; p < 0.001), countermovement jump (cm) (IG: 36.83 ± 4.0; CG: 31.62 ± 4.8; p < 0.05), and standing long jump (cm) (IG: 220.00 ± 26.0; CG: 190.54 ± 5.5; p < 0.001). The study concluded that elastic band-based training significantly enhances jump performance and other volleyball-related performance metrics [ 14 ]. Another trial aimed to evaluate the effects of core muscle strengthening on throwing velocity and core endurance in cricket players [ 15 ]. The results indicated that the ST group experienced a statistically significant improvement (p < 0.001) in throwing velocity, back extension, supine flexion, right and left lateral planks, and isometric prone planks compared to the non-strengthening group, as well as pre-and post-intervention within the ST group. The study concluded that six weeks of general core strengthening led to a notable increase in throwing velocity and core endurance in male cricket players [ 15 ]. There is a notable lack of comprehensive reviews that assessed the dual impact of ST on injury prevention and performance enhancement in team sports. One review highlighted a significant transfer of benefits from increased lower-body strength to sprint performance, with a large correlation (r = -0.77; p = 0.0001) between squat strength and sprint performance improvements [ 16 ]. This review concluded that the effect of resistance training on sprint performance (sprint ES = -0.87, mean improvement = 3.11%) holds practical value for coaches and athletes in speed-dependent sports [ 16 ]. However, no previous studies have comprehensively mapped the combined effects of strength training on both injury prevention and performance enhancement across various team sports. Given this gap in the literature, this scoping review aims to broadly explore and summarize existing high-quality randomized controlled trials to provide a better understanding of the role of strength training in preventing injuries and enhancing performance in team sports. Methods For this study, we followed Levac, Colquhoun, and O'Brien’s five-stage framework for conducting a scoping review [ 17 ]. The first four stages are detailed below, while the final stage is addressed in the results section. Although this is a scoping review, it was prospectively registered with the International Register of Systematic Reviews under PROSPERO registration number CRD42024610812 to enhance transparency and methodological rigor, ensuring alignment with established standards for evidence synthesis. 2.1 Identifying the research questions This review was guided by the following research questions: Is ST effective for injury prevention in team sports? Is ST effective for performance enhancement in team sports? What types of strengthening exercises have been developed and implemented in team sports? What research underpins these strategies? What are the strengths, limitations, and gaps in the highlighted strategies? A scoping review was deemed the most appropriate method to address these questions, as suggested in the guidelines for authors on selecting between a systematic or scoping review approach [ 18 ]. Unlike a systematic review, which seeks to answer a narrowly defined clinical question, a scoping review allows for a broader exploration of heterogeneous literature. This approach is particularly suited to examining the diverse strategies countries and teams have adopted to integrate ST for injury prevention and performance enhancement across multiple team sports. 2.2 Identifying relevant studies The search for relevant studies was conducted in three steps, following the guidelines published by Peter and colleagues [ 18 ]. First, a preliminary search was carried out in PubMed® to refine keywords and identify relevant databases. Based on this, we selected SciVerse Scopus® (Elsevier Properties S.A., USA), PubMed® (U.S. National Library of Medicine, USA), Web of Science® (v.5.4) (Thomson Reuters, USA), SPORTDiscus, and CINAHL® (EBSCO Information Services, USA) as our primary databases, as they are widely used in intervention studies in the sports medicine field. The search terms included "Strength training" OR "Resistance training" OR "Weight exercise" OR "Anaerobic exercise" AND "Injury" OR "Musculoskeletal" AND "Soccer," OR "Football" OR "Rugby" OR "Basketball" OR "Volleyball" OR "Handball" OR "Cricket" OR "Netball" OR "Baseball" OR "Softball" OR "Kabaddi". Medical Subject Headings (MeSH) terms were utilized where possible, and advanced search techniques were employed, such as title and abstract searches in all the databases. Only studies published in English and conducted on humans between December 1, 2015, and December 1December 1, 2024, were included. A manual search of reference lists from included articles was also performed to identify additional studies. 2.3 Study selection criteria Articles were selected based on specific inclusion and exclusion criteria using the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) framework [ 19 ]. Population (P) Studies focusing on professional athletes or individuals involved in team sports were included, while those involving non-athlete populations, recreational participants, or patients were excluded. Intervention (I) Intervention studies examining any form of ST (regardless of frequency, intensity, type, or duration) were included. Studies combining ST with other interventions were excluded. Comparator/Control (C) Studies with a comparator group receiving no ST intervention or a placebo were included. Studies comparing various types of ST interventions were excluded. Outcomes (O) Studies reporting injury-related or performance-related outcomes, such as anthropometric, biochemical, or physical measures, were included. Studies without direct links to these outcomes (e.g., biomechanical or sensory measures unrelated to performance) were excluded. Study Design (S) RCTs were included. Observational studies, animal studies, in vitro research, case reports, case series, reviews, and unpublished data were excluded. 2.4 Data extraction and charting Data were extracted by one investigator (KW) and independently verified by another (RJ) to ensure accuracy. Discrepancies were resolved through discussion. The extracted data included information on the first author, publication year, country, study design, sport type, gender and age of participants, sample size, intervention details (type, frequency, intensity, duration), and significant outcomes. Statistical significance was assessed by comparing intervention and control groups rather than within-group pre- and post-intervention differences. 2.5 Assessment of quality Although quality assessment is not typically mandatory in scoping reviews, it was conducted in this study to provide additional insights into the methodological rigor of the included studies. This was independently performed by two investigators using the Physiotherapy Evidence Database (PEDro) scale [ 20 ], a tool designed to objectively evaluate methodological quality. The scale assigns scores from 0 to 10, categorizing studies as 'poor' (0–3), 'fair' (4–5), 'good' (6–8), or 'excellent' (9–10). Any discrepancies in scoring were resolved through discussion to reach a consensus. Results The comprehensive search across multiple databases initially identified the following results: SciVerse Scopus® (n = 100 studies), PubMed® (n = 200 studies), Web of Science® (n = 400 studies), SPORTDiscus (n = 311 studies), and CINAHL (n = 1290 studies. After removing duplicate entries, a total of 2133 research articles were considered potentially relevant and subjected to eligibility screening. During the initial phase, titles and abstracts were carefully reviewed, resulting in 167 articles being shortlisted for full-text evaluation. To ensure the inclusion of all relevant literature, manual searching of references and related materials was also conducted, identifying an additional five studies. After obtaining and thoroughly reviewing the full-text articles, 15 studies were found to meet all predefined inclusion criteria. The detailed steps of the search and screening process are illustrated in Fig. 1, and this was performed following the guidelines provided by the Scoping Review Guideline for Conducting Searches, which align with best practices for evidence synthesis in the sport and exercise medicine, musculoskeletal rehabilitation, and sports science fields [ 21 ]. INSERT FIGURE 1 ABOUT HERE This review included 15 RCTs published between 2015 and 2024. The studies were conducted across various countries: one each from Iran [ 22 ], Australia [ 23 ], and the Netherlands [ 12 ]; two from Norway [ 24 , 25 ]; three each from Germany [ 10 , 26 , 27 ] and France [ 28 – 30 ]; and four from Spain [ 11 , 14 , 31 , 32 ] (Table 1). All the trials followed a parallel-group design, with two studies employing a cluster-randomized design at the team level [ 12 , 24 ]. Out of the 15 trials, one trial did not utilize a control group; instead, it assessed the effectiveness of a 10-week strength-training program targeting injury prevention by comparing outcomes between the experimental season and the control season [ 32 ]. The quality of the selected trials, as assessed using the PEDro scale, indicated that four trials were of fair quality [ 11 , 28 , 31 , 32 ], while the remaining 11 trials were of good quality [ 10 , 12 , 14 , 22 – 27 , 29 , 30 ] (see Supplementary Table 1). INSERT TABLE 1 ABOUT HERE Mean age of the athlete varied from 12.7 years [ 30 ] to 25.8 years [ 11 ]. The selected RCTs included a range of sample sizes, from as few as 20 subjects [ 11 ] to as many as 652 participants [ 24 ]. The sports represented across the studies varied, with handball [ 26 ], soccer [ 10 – 12 , 27 – 31 ], volleyball [ 14 , 22 , 25 ], rugby [ 23 ], and football [ 24 ] all being included. Notably, soccer appeared most frequently across these studies, with several trials focusing on both professional and semi-professional levels. The gender distribution varied, with most studies (n = 13) involving male athletes, although a few trials focused exclusively on female participants [ 10 , 31 ]. We categorized the trials included in this review into three types based on their outcomes: I) Studies assessing the effectiveness of ST for injury prevention in team sports, II) Studies assessing the effectiveness of ST for performance enhancement in team sports, III) Studies assessing the effectiveness of ST for both injury prevention and performance enhancement in team sports. I. Studies assessing the effectiveness of strength training for injury prevention in team sports Several studies demonstrated the effectiveness of ST programs in reducing injury rates among athletes in team sports. For example, Darragi et al. [ 10 ] implemented an in-season ST program for female soccer players. The intervention resulted in significant reductions in non-contact injuries (2 injuries in the IG vs. 11 in the CG, p = 0.003) and injury rates (0.48/1000 hrs vs. 2.62/1000 hrs, p = 0.003). Similarly, Harøy et al. [ 24 ] evaluated an adductor-strengthening program among male football players and found a significant decrease in groin injury risk (11.7% vs. 21.3%, p = 0.001). Horst et al. [ 12 ] also highlighted the benefits of NHE in reducing hamstring injuries (6 injuries in the IG vs. 18 in the CG, p = 0.005). These findings underscore the efficacy of tailored ST programs in mitigating injury risks in team sports. II. Studies assessing the effectiveness of strength training for performance enhancement in team sports ST interventions have been shown to significantly enhance athletic performance metrics in team sports. Hammami et al. [ 14 ] examined the effects of explosive-based training among male volleyball players, reporting significant improvements in 1RM strength (124.3 ± 26.8 kg vs. 97.15 ± 12.4 kg, p < 0.001) and jump performance (CMJ: 36.83 ± 4.0 cm vs. 31.62 ± 4.8 cm, p < 0.05). Similarly, Harries et al. [ 23 ] investigated periodized ST programs in rugby players, finding notable improvements in 1RM box squat strength and sprint performance (e.g., 10 m sprint: 1.808 ± 0.03 s for linear periodization vs. 1.729 ± 0.091 s for undulating periodization, p = 0.038). Additionally, Negra et al. [ 27 ] evaluated high-velocity resistance training in soccer players, observing enhanced vertical jump (CMJ: 27.41 ± 4.0 cm vs. 20.10 ± 3.0 cm, p < 0.001) and sprint performance (5 m sprint: 1.08 ± 0.06 s vs. 1.20 ± 0.06 s, p < 0.001). These studies highlight the role of ST in improving physical capacities critical for team sports performance. III. Studies assessing the effectiveness of strength training for both injury prevention and performance enhancement in team sports Several studies have illustrated the dual benefits of ST programs in preventing injuries and enhancing athletic performance. Ferri-Caruana et al. [ 31 ] investigated core and pelvic ST in female soccer players, reporting reductions in frontal plane projection angles (FPPA) and significant improvements in jump height for both unilateral and bilateral tests (e.g., bilateral jump height: 22.17 ± 3.4 cm vs. 21.30 ± 3.2 cm, p < 0.05). Durán et al. [ 11 ]implemented lower-extremity ST for male soccer players, which resulted in decreased injury burden (28.87 days/1000 h vs. 145.77 days/1000 h, p < 0.001) and reduced muscle imbalances. Moreover, Lahti et al. [ 29 ] demonstrated improvements in both sprint performance and peak power output in soccer players undergoing heavy sled training. These findings support the comprehensive benefits of ST programs that simultaneously enhance performance and reduce injury risk. Discussion To the best of our knowledge, this is the first scoping review conducted to evaluate the impact of ST on both injury prevention and performance enhancement in team sports. In summary, the findings highlight the significant role of strengthening exercises in reducing injury risks and enhancing athletic performance across various sports populations. The findings also demonstrate substantial reductions in the incidence of common sports injuries, such as hamstring and groin strains, and overall injury burdens in intervention groups compared to controls. Additionally, these exercises improved critical performance metrics, including sprint speed, jump height, flexibility, and functional stability. Further ST also enhanced biomechanical alignment, muscle imbalances and functional capacity, showcasing the versatility and effectiveness of these targeted exercise programs in optimizing both injury prevention and performance outcomes. Our study findings align with the key results of a systematic review and meta-analysis [ 33 ] that investigated ST interventions for sports injury prevention. The analysis revealed that a 10% increase in ST volume led to a reduction in injury risk by over four percentage points. It also concluded that higher training volumes and intensities were strongly associated with a decreased risk of sports-related injuries [ 33 ]. Another similar review found that strength training, including traditional resistance, eccentric, and flywheel training, can be considered an effective method for reducing injury risk in soccer players [ 34 ]. Based on their findings, they also recommended training strategies that incorporate multiple components (e.g., a combination of strength, balance, and plyometrics), including strength exercises, as effective for reducing noncontact injuries in female soccer players [ 34 ]. Additionally, the current body of research supports the use of eccentric training in sports, as it elicits unique physiological responses compared to other resistance exercise modalities [ 34 ]. Moreover, flywheel training, with its unique combination of concentric and eccentric contractions, offers specific advantages that may play a significant role in injury prevention. Similarly, another review evaluating the role of strengthening exercises in the prevention and management of lower extremity sports injuries reported that ST plays a critical role in the management and prevention of overuse injuries [ 35 ]. It not only enhances muscle performance, fitness levels, speed, and agility in sports but also reduces pain and supports faster recovery from injuries. Furthermore, another umbrella review summarized the effects of NHE on performance and injury prevention, indicating that NHE interventions had positive effects on sprint performance, muscle activation, eccentric strength, and muscle architecture (such as fascicle length, muscle thickness, and pennation angle) [ 36 ]. Additionally, NHE was found to be effective in preventing hamstring injuries, with a reduction of up to 51%. In conclusion, incorporating NHE into training, particularly during the warm-up phase, is recommended to enhance athletic performance and prevent hamstring injuries [ 36 ]. ST reduces the risk of injuries by improving muscle strength and joint stability [ 12 ]. It enhances muscle-tendon unit stiffness, corrects leg asymmetries, and reduces joint stress during high-intensity exercises [ 12 ]. Additionally, ST has been shown to optimize neuromuscular control through neural adaptations [ 37 ]. Specifically, high-resistance training accelerates nerve activity, enabling athletes to recruit motor units more quickly. This leads to faster activation of muscle fibres, which enhances maximal strength production in less time. Furthermore, strengthening the gluteal muscles contributes to lumbopelvic stability, which is essential in preventing hamstring injuries [ 38 ]. High-load ST also promotes neural adaptations that can improve running speed without increasing body mass [ 11 ] [Figure 2]. INSERT FIGURE 2 ABOUT HERE Strengths One of the main strengths of the paper is its comprehensive scope, which includes a wide variety of team sports, offering a generalizable perspective on the efficacy of ST across different athletic disciplines. The review also follows a comprehensive and structured methodology, adhering to Levac et al.’s five-stage framework for scoping reviews. This framework ensures a clear, transparent, and rigorous process for identifying and synthesizing relevant studies, which contributes to the reliability and validity of the findings. Furthermore, the review includes only studies from the last decade, capturing the most up-to-date evidence and reflecting contemporary training practices. Limitations Despite the strengths, this scoping review has several limitations that need to be considered when interpreting the findings. As a result, the global applicability of the conclusions drawn may be limited, particularly regarding ST practices in countries with different training cultures. The review also faces challenges related to the heterogeneity of the included studies, with variations in the type, frequency, intensity, and duration of ST interventions. This heterogeneity can make it difficult to draw definitive, universal conclusions about the optimal design of ST programs. Recommendations Building on the findings of this review, several recommendations for future research can be made further to explore the role of ST in team sports. Future studies should focus on examining the long-term effects of ST on injury recurrence and sustained performance improvements over extended periods. This would provide valuable insights into the durability of ST benefits. Additionally, the review highlighted the variation in intervention types and their corresponding outcomes, suggesting that future studies should explore the comparative effectiveness of different ST modalities (e.g., eccentric vs. concentric exercises) to identify the most effective strategies for injury prevention and performance enhancement. Another important recommendation is to incorporate a broader range of athletic populations, including youth and amateur athletes, to assess the applicability of ST interventions across different experience levels and age groups. Further, future studies should explore the impact of combining ST with other types of exercise, such as flexibility or training or plyometric or agility, to better understand how multi-component programs can optimize athletic outcomes. Lastly, further scoping or umbrella reviews should be conducted with a variety of high-quality studies other than RCTs (Fig. 3). Conclusions ST programs can be considered an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports across different age groups and genders, as suggested by high-quality RCTs. The findings emphasize the importance of integrating structured, sport-specific, and evidence-based strengthening exercises into training regimens to optimize athletes' physical health and functional outcomes. Declarations Acknowledgements We would like to express our special thanks to Manoja Gamage, PhD candidate at the Queensland University of Technology, Australia, for her help in searching the Web of Science and Scopus databases. Funding Not applicable Conflicts of interest The authors declare no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Consent for publication Not applicable. Availability of data and materials Not applicable Ethical approval and consent to participate Not applicable Authors' contribution KW conceived and designed the study. KW and RJ searched databases. KW and RJ were involved in retrieving data. KW and RJ drafted the manuscript. KW, APH and RJ revised the paper. All authors provided critical feedback on the manuscript. All authors read and approved the final manuscript. References Morrissey MC, Harman EA, Johnson MJ (1995) Resistance training modes: specificity and effectiveness. Med Sci Sports Exerc 27(5):648–660 Suchomel TJ, Nimphius S, Stone MH (2016) The Importance of Muscular Strength in Athletic Performance. Sports Med 46(10):1419–1449 Andersen LL, Aagaard P (2006) Influence of maximal muscle strength and intrinsic muscle contractile properties on contractile rate of force development. 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Healthc (Basel). ;12(15) Kopper B, Csende Z, Sáfár S, Hortobágyi T, Tihanyi J (2013) Muscle activation history at different vertical jumps and its influence on vertical velocity. J Electromyogr Kinesiol 23(1):132–139 O'Sullivan L, Preszler J, Tanaka M (2022) Hamstring Injury Rehabilitation and Prevention in the Female Athlete. Int J Sports Phys Ther 17(6):1184–1193 Tables Table 1. Effects of strength training on injury prevention and sports performance enhancement Author, Year, Country Study design, PEDro score (out of 10) Sport, Level Gender, Age (years) Sample size (number), Intervention program Frequency, Time-period Results IG CG 1. Bauer et al., 2022, Germany [23] R, NB, P, 6 Handball, SE M, IG: 16.9±0.6, CG: 17.2±0.8 13, Cross curl-ups, Side bridges, Birddog exercise 13, RE 3 times per W, 6 W -Muscle endurance (s): (IG: 89.3 ± 23.8; CG: 60.6 ± 14.0); p < 0.001, for dorsal chain -Shoulder mobility/stability (%AL): (IG: 107.3 ± 8.3; CG: 97.2 ± 9.2); p=0.024. 2. Cadu et al., 2022, France [25] R, NB, P, 4 Soccer, E M, 25.6±3.5 23, NHE eccentric 23, RE 1 day per W, 21 W -Maximal eccentric strength ↑ in IG (+15.5% [25.5%], pre = 357.3 ± 95.0 N vs post = 390.7 ± 72.2 N); p = 0.049, -Hamstring IR ↓ by 2.7 (IG: 22%, 5/23 injuries; CG: 39%, 9/23 injuries); p = 0.12. 3. Darragi et al., 2023, Germany [10] R, SB, P, 6 Soccer, E F, 15.4 ± 1.9 IG: 14, FB in-season ST 16, RE 2 sessions per W, 12 W -NC injuries ↓ in IG (2 injuries) vs CG (11 injuries); p = 0.003, -Injury burden ↑ in CG (16.7 days/1000 hrs) vs IG (3.3 days/1000 hrs); p = 0.011 -Injury rate ↓ in IG (0.48/1000 hrs) vs CG (2.62/1000 hrs); p=0.003, -IIR during the competition period ↓ in IG (0.57/1000 hrs) vs CG (3.14/1000 hrs); IRR = 0.18, - Squat jump (cm) ↑ in IG (43.0 ± 8.1 to 47.9 ± 10.5) vs CG (42.8 ± 9.0 to 42.7 ± 10.0); p = 0.015, - CMJ (cm) ↑ in IG (22.7 ± 6.1 to 25.8 ± 8.4) vs CG (22.6 ± 6.1 to 22.7 ± 7.3); p = 0.001. 4. Durán et al., 2023, Spain [11] R, NB, P, 5 Soccer, SE M, 25.8±2.0 10, LE ST 10, RE 2 sessions per W, 12 W -Injury burden ↓ in IG (28.87 days/1000 h) vs CG (145.77 days/1000 h); p < 0.001. -Injury rate ↓ in IG (1.15 injuries/1000 h) vs CG (6.45 injuries/1000 h); p = 0.120, -Injury distribution (1-6 W): IG (1 injury) vs CG (3 injuries), (7-12 W): IG (0 injuries) vs CG (2 injuries), -Q–H imbalance: ↓ Right: IG: 45.41% ± 2.6 to 40.75% ± 2.1 vs. CG: 44.79% ± 2.3 to 44.81% ± 2.1; p < 0.001, ↓Left: IG: 44.00% ± 3.2 to 39.36% ± 2.0 vs. CG: 43.05% ± 1.9 to 42.99% ± 2.1; p < 0.001, -Abd-Add imbalance: ↓ Right: IG: 23.53% ± 6.6 to 13.19% ± 9.4 vs. CG: 16.83% ± 6.5 to 13.76% ± 8.3; p < 0.001, ↓Left: IG: 21.56% ± 5.4 to 12.56% ± 7.5 vs. CG: 14.76% ± 6.09 to 14.11% ± 6.7; p < 0.001. 5. Ferri-Caruana et al., 2020, Spain [28] R, NB, P, 5 Soccer, SE F, 16.2 ± 1.2 16, Pelvic and core ST a 2 sessions per W, 8 W -FPPA (dominant leg): ↓ IG (12.69° ± 5.8 to 5.59° ± 7.2) vs CG (13.04° ± 5.5 to 12.35° ± 8.7); p < 0.05, -FPPA (non-dominant leg): ↓IG (7.43° ± 7.1 to -0.58° ± 8.5) vs CG (10.41° ± 9.1 to 8.42° ± 8.6); p < 0.05, -Peak Hip Flexion Angle: ↑IG (65.13° ± 24.9 to 89.56° ± 15.1) vs CG (79.2° ± 19.9 to 83.2° ± 19.4); p < 0.05, -Peak Knee Flexion Angle: ↑IG (74.75° ± 13.7 to 89.69° ± 10.6) vs CG (81.9° ± 11.9 to 81.4° ± 9.0); p < 0.05, -Peak Ankle Dorsiflexion Angle: ↑IG (88.63° ± 4.4 to 87.31° ± 4.4) vs CG (86.1° ± 6.64 to 82.6° ± 5.06); p < 0.05, -Unilateral Jump Height (cm) (dominant leg): ↑IG (10.42 ± 2.5 to 11.75 ± 2.1) vs CG (11.44 ± 2.1 to 12.29 ± 1.4); p < 0.05, -Unilateral Jump Height (cm) (non-dominant leg): ↑IG (10.83 ± 2.8 to 12.04 ± 2.4) vs CG (11.83 ± 2.4 to 11.02 ± 1.9); p < 0.05, -Bilateral Jump Height (cm)↑IG (19.33 ± 4.7 to 22.17 ± 3.4) vs CG (20.54 ± 3.1 to 21.30 ± 3.2); p < 0.05. 6. Hammami et al., 2020, Spain [14] R, NB, P, 6 Volleyball, E M, IG: 14.86 ± 0.5, CG:1 4.74 ± 0.3 14, EBT ST (squats, jump squats, forward lunges, lateral lunges, and standing frontal stabilization) 13, RE 2 sessions per W, 8 W -1RM (Kg): (IG: 124.3± 26.8; CG: 97.15 ± 12.4); p < 0.001, -CMJ (cm): (IG: 36.83± 4.0; CG: 31.62 ± 4.8); p < 0.05, -SLJ (cm): (IG: 220.00± 26.0; CG: 190.54± 5.5); p < 0.001. 7. Harries et al., 2018, Australia [20] R, SB, P, 6 Rugby, SE M, 15-18 IG1: 8, Linear periodization IG2: 8 Daily undulating periodization 8, RE 2 sessions per W, 12 W -1RM box squat (Kg): (IG1: 171.2±41.2; IG2: 177.7±36.9, CG: 95.4±17.2); p <0.001, -10 m sprint (s): (IG1: 1.808±0.03; IG2: 1.729±0.091, CG: 1.781±0.079); p=0.038, -20 m sprint (s): (IG1: 3.189±0.080; IG2: 3.022±0.152, CG: 3.129±0.139); p=0.047, 8. Harøy et al., 2017, Norway [21] C-R, SB, P, 6 Football, SE M, 18-25 339, Adductor ST 313, RE 2 sessions per W, 10 W -Groin injuries % ↓ (IG: 13.5%; CG: 21.3%); p= 0.008, -Groin injuries risk ↓ (IG: 11.7%; CG: 21.3%); p = 0.001. 9. Horst et al., 2015, Netherlands [12] C-R, UB, P, 6 Soccer, Amateur M, IG: 24.5±3.6, CG: 24.6±4.1 292, NHE 287, RE 2 sessions per W, 10 W -Hamstring injuries ↓ IG: 6 injuries (55%), CG: 18 injuries (72%); p = 0.005, -Hamstring Injury Risk ↓ IG: 11 vs CG: 25; p = 0.005 10. Lahti et al., 2020, France, [26] R, NB, P, 7 Soccer, E M, 24.1 ± 5.1 IG1: 10, heavy sled ST with a load reducing maximal velocity by 50%. IG2: 10, heavy sled ST with a load reducing maximal velocity by 60% 13 1–2 sessions per W, 9 W -Sprint performance: 5-m split time (s): ↓ IG1 (1.39 ± 0.04 to 1.34 ± 0.04); p = 0.005, ↓ IG2 (1.39 ± 0.05 to 1.35 ± 0.04); p = 0.05, ↓ CG (1.38 ± 0.04 to 1.36 ± 0.04); p = 1.00. 10-m split time (s): ↓ IG1 (2.14 ± 0.06 to 2.07 ± 0.06); p < 0.001, ↓ IG2 (2.15 ± 0.08 to 2.09 ± 0.06); p = 0.001, ↓ CG (2.12 ± 0.06 to 2.10 ± 0.04); p = 0.76. 20-m split time (s): ↓ IG1 (3.43 ± 0.08 to 3.32 ± 0.10); p < 0.001, ↓ IG2 (3.45 ± 0.12 to 3.36 ± 0.10); p = 0.008, ↓ CG (3.41 ± 0.09 to 3.37 ± 0.08); p = 0.44. 30-m split time (s): ↓ IG1 (4.62 ± 0.10 to 4.49 ± 0.12); p < 0.001, ↓ IG2 (4.65 ± 0.17 to 4.56 ± 0.14); p = 0.021, ↓ CG (4.62 ± 0.12 to 4.56 ± 0.11); p = 0.33. -Pmax (W.kg⁻¹): ↑ IG1 (16.0 ± 1.66 to 17.3 ± 1.35); p = 0.011, ↑ IG2 (16.2 ± 1.31 to 18.1 ± 1.82); p < 0.001. ↑ CG (16.5 ± 1.27 to 17.0 ± 1.08); p = 0.70. 11. Mesfar et al., 2022, Norway [22] R, NB, P, 6 Volleyball, E M, IG: 14.4 ± 0.6, CG:14.5 ± 0.5 16, Contrast S ST 15 3-4 times per W, 8 W -Dynamic Balance (CS-YBT, %): IG: 93.90 ± 3.36 vs. CG: 78.85 ± 5.37; p = 0.01, -1RM (kg): IG: 80.57 ± 2.26 vs. CG: 58.48 ± 2.59; p = 0.01, -Single-Leg Hop Test (right leg, cm): IG: 145.00 ± 19.66 vs. CG: 107.52 ± 5.09; p = 0.01, (left leg, cm): IG: 124.27 ± 4.11 vs. CG: 108.79 ± 5.91; p = 0.01, CMJ height (cm): IG: 38.94 ± 3.96 vs. CG: 33.50 ± 3.91; p = 0.01. 12. Moradi et al., 2020, Iran [19] R, NB, P, 5 Volleyball, SE M, IG: 23.9±4.4 CG: 23.4±3.8 30, SJ ST using Thera Band 30, RE 3 sessions per W, 8 W -IR ROM ↑ IG: 0.55 vs. CG: 0.23; p = 0.001, -Functional strength ratio ↑ IG: 0.75; CG: 0.22; p = 0.021, - EMG values: Onset time for supraspinatus ↓ (IG: 0.44; CG: 0.76); p = 0.000, Onset time for infraspinatus ↓ (IG: 0.46; CG: 0.78); p <0.001, Activation of supraspinatus ↓ (IG: 0.32; CG: 0.56); p = 0.001, Activation of infraspinatus ↓ (IG: 0.35; CG: 0.58); p = 0.001, 13. Negra et al., 2016, Germany [24] R, NB, P, 5 Soccer, SE M, IG: 12.80 ± 0.2, CG: 12.74 ± 0.2 292, High-velocity ST 287, RE 2 sessions per W, 12 W -1RM half squat (Kg): (IG: 127.77± 15.2; CG: 90.00± 14.2); p < 0.001, -Vertical jump tests (cm): (CMJ: IG: 27.41± 4.0; CG: 20.10± 3.0); p < 0.001, (SJ: IG: 27.41± 4.0; CG: 20.10± 3.0); p < 0.001, -Horizontal jump tests (m): (SLJ: IG: 1.94±0.2; CG: 1.57± 0.08); p < 0.001, -Linear sprint test (s): (5 m sprint: IG: 1.08±0.06; CG: 1.20± 0.06); p < 0.001, 10 m sprint: IG: 1.90±0.08; CG: 2.09± 0.09); p < 0.001, 20 m sprint: IG: 3.39±0.17; CG: 3.68± 0.13); p < 0.001, 30 m sprint: IG: 4.86±0.2; CG: 5.23± 0.2); p < 0.001. 14. Raya-González et al., 2019, Spain [29] R, UB, P, 4 Soccer, E M, 18.6±0.1 27, no CG Experimental season: A ST program targeting injury prevention. Control season: RE 2 sessions per W, 10 W -Total muscle injuries ↓ in experimental season: 9 injuries vs control season: 15 injuries; IRR = 1.74, p <0.05 -Absence days due to muscle injuries: Total exposure: ↓ in the experimental season: 89 days vs. control season: 204 days; IRR = 2.29, p < 0.05. Training exposure: ↓ in the experimental season: 10 days vs. control season: 113 days; IRR = 11.33, p < 0.05. 15. Zouita et al., 2016, France [27] R, SB, P, 7 Soccer, Amateur M, 13-14 26, UL, LL, core ST 26, RE 2-3 sessions per W, 12 W -IR: 17/season ↓: IG: 4 injuries, CG: 13 injuries; p ≤ 0.05. -Injury rate per 1,000 h of exposure ↓ IG: 0.70 vs CG: 2.32; p ≤ 0.05. -Injury severity: IG:1 minimal (25%), 1 mild (25%), 2 moderate (50%), CG: 4 minimal (30.76%), 3 mild (23.07%), 5 moderate (38.46%), and 1 severe (7.69%). -Sprint performances (s): 10 m sprint: TG: T0: 2.16 ± 0.12, T1: 2.06 ± 0.1↓, T2: 2.06 ± 0.1↓; CG: T0: 2.2 ± 0.2, T1: 2.06 ± 0.1↓, T2: 2.1 ± 0.2; p ≤ 0.05. 20 m sprint: TG: T0: 3.3 ± 1, T1: 3.3 ± 0.4, T2: 3 ± 0.5↓; CG: T0: 3.7 ± 0.2, T1: 3.4 ± 0.2↓, T2: 3.3 ± 0.4; p ≤ 0.05. 30 m sprint: IG: T0: 4.9 ± 0.3, T1: 4.8 ± 0.2↓, T2: 4.8 ± 0.3; CG: T0: 5 ± 1.1, T1: 4.8 ± 0.2↓, T2: 4.7 ± 0.3↓., -Jumping performances: SJ ↑IG (T0: 0.41 ± 0.1 to T2: 0.46 ± 0.2) vs CG (T0: 0.40 ± 0.1 to T2: 0.44 ± 0.1); p ≤ 0.05, CMJ ↑ IG (T0: 0.49 ± 0.1 to T1: 0.54 ± 0.2) vs CG (T0: 0.48 ± 0.1 to T1: 0.50 ± 0.1); p ≤ 0.05, 5JT ↑ IG (T0: 1.25 ± 0.1 to T1: 1.34 ± 0.1) vs CG (T0: 1.27 ± 0.1 to T1: 1.28 ± 0.1); p ≤ 0.05. Abd-Add: Abductor-Adductor, CG: Control Group, C: Crossover, C/L: Contralateral, CL: Control Leg, C-R: Cluster-Randomized Trial, DL: Dominant Leg, DF: Dorsiflexion, DS: Dynamic Stretching, EBT: Elastic Band Training, F: Female, h: hours, IR: Injury Risk, IG: Intervention Group, IG1: Intervention Group 1, IG2: Intervention Group 2, IIR: Injury Incidence Rate, IR: Incidence Rate, 5JT: Five Jump Test, KJ: Knee Joint, LE: Lower Extremity, M: Male, M: Months, MDS: Maximal Dynamic Strength, MIS: Maximal Isometric Strength, N: Newtons, NB: Not Blinded, NC: Non-Contact, NDL: Non-dominant Leg, P: Parallel, PEDro: Physiotherapy Evidence Database, Pmax: Maximum Power Output, Pt: Peak Torque, Q–H: Quadriceps-Hamstring, R: Randomized Trial, RE: Regular Exercises, Reps: Repetitions, 1RM: One Repetition Maximum, ROM: Range of Motion, S: Seconds, SB: Single Blinded, ST: Strength Training, UE: Upper Extremity, W: Weeks, NHE: Nordic Hamstring Exercise, FB: Full Body, FPPA: Frontal Plane Projection Angle Additional Declarations The authors declare no competing interests. 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A scoping review of high-quality randomized controlled trials\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMuscular strength is the capacity to exert force against an external object or resistance [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Absolute and relative muscular strength are crucial factors influencing an athlete's injury rate and sports performance, significantly impacting their sport-specific abilities [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Enhanced muscular strength enables athletes to reduce the risk of injuries while simultaneously enhancing performance significantly [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Muscular strength can be improved through various training modalities, including maximal, explosive, reactive, and strength training (ST), as well as combinations of these training approaches [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. ST incorporates various tools such as free weights, machines, resistance bands, plyometric exercises, resisted sprint drills, core stability workouts, and bodyweight movements [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Depending on the specific demands of their sport or event, athletes may need to generate significant force to overcome gravity and control their body mass (e.g., sprinting, gymnastics, diving), manage their body mass alongside an opponent\u0026rsquo;s (e.g., Football, rugby, wrestling), or manipulate equipment or projectiles (e.g., baseball, weightlifting, shot put) [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Team sports are particularly remarkable among various sports disciplines, as improvements in maximal strength, reactive strength, and explosive power have been demonstrated to positively impact performance and career longevity [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAn effective ST program equips athletes with the physical foundation required to perform sports-specific skills during both training and competition [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. It also helps ensure player availability by preventing and minimizing the incidence and severity of sports injuries [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Additionally, it enhances players' morphological, neuromuscular, and energy systems, delays the onset of fatigue during training and competition, accelerates recovery between sessions, and supports optimal technical execution and decision-making in competitive scenarios [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRecent research highlights that well-structured ST programs are essential for team sports athletes to enhance physical fitness and reduce injury risk systematically [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. A randomized controlled trial (RCT) investigated the impact of a 12-week in-season ST program on physical fitness and injury rates in young elite female soccer players [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Findings revealed that non-contact injury rates during the season were significantly lower in the ST group (0.48/1000 hours of exposure) compared to the control group (CG) (2.62/1000 hours of exposure; p\u0026thinsp;=\u0026thinsp;0.003) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Similarly, another study demonstrated significant improvements in quadriceps-to-hamstring strength balance in both legs (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and a notably lower injury burden (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; relative risk\u0026thinsp;=\u0026thinsp;5.05) after a 12-week maximal ST program [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Another parallel trial assessed the effectiveness of the Nordic Hamstring Exercise (NHE) in reducing the incidence and severity of hamstring injuries among male amateur soccer players [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The results showed that the injury incidence was lower in the intervention group (IG) with 6 injuries (55%) compared to 18 injuries (72%) in the CG (p\u0026thinsp;=\u0026thinsp;0.005). Additionally, the risk of hamstring injury was significantly reduced in the IG (11 cases) compared to the CG (25 cases; p\u0026thinsp;=\u0026thinsp;0.005). The study concluded that incorporating the NHE protocol into regular amateur training significantly decreases the incidence and risk of hamstring injuries [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMoreover, ST has also been recognized as a crucial strategy for enhancing performance in team sports. Recent studies indicate a direct correlation between strength levels and high-intensity actions, such as sprinting and jumping, which are fundamental to sports performance [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. One RCT investigated the impact of an eight-week resistance training program using elastic bands on performance-related outcomes in male volleyball players [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The results revealed significant improvements in the one-repetition maximum (1RM) (IG: 124.3\u0026thinsp;\u0026plusmn;\u0026thinsp;26.8; CG: 97.15\u0026thinsp;\u0026plusmn;\u0026thinsp;12.4; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), countermovement jump (cm) (IG: 36.83\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0; CG: 31.62\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8; p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and standing long jump (cm) (IG: 220.00\u0026thinsp;\u0026plusmn;\u0026thinsp;26.0; CG: 190.54\u0026thinsp;\u0026plusmn;\u0026thinsp;5.5; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The study concluded that elastic band-based training significantly enhances jump performance and other volleyball-related performance metrics [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Another trial aimed to evaluate the effects of core muscle strengthening on throwing velocity and core endurance in cricket players [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The results indicated that the ST group experienced a statistically significant improvement (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) in throwing velocity, back extension, supine flexion, right and left lateral planks, and isometric prone planks compared to the non-strengthening group, as well as pre-and post-intervention within the ST group. The study concluded that six weeks of general core strengthening led to a notable increase in throwing velocity and core endurance in male cricket players [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThere is a notable lack of comprehensive reviews that assessed the dual impact of ST on injury prevention and performance enhancement in team sports. One review highlighted a significant transfer of benefits from increased lower-body strength to sprint performance, with a large correlation (r = -0.77; p\u0026thinsp;=\u0026thinsp;0.0001) between squat strength and sprint performance improvements [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. This review concluded that the effect of resistance training on sprint performance (sprint ES = -0.87, mean improvement\u0026thinsp;=\u0026thinsp;3.11%) holds practical value for coaches and athletes in speed-dependent sports [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. However, no previous studies have comprehensively mapped the combined effects of strength training on both injury prevention and performance enhancement across various team sports. Given this gap in the literature, this scoping review aims to broadly explore and summarize existing high-quality randomized controlled trials to provide a better understanding of the role of strength training in preventing injuries and enhancing performance in team sports.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eFor this study, we followed Levac, Colquhoun, and O'Brien\u0026rsquo;s five-stage framework for conducting a scoping review [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The first four stages are detailed below, while the final stage is addressed in the results section. Although this is a scoping review, it was prospectively registered with the International Register of Systematic Reviews under PROSPERO registration number CRD42024610812 to enhance transparency and methodological rigor, ensuring alignment with established standards for evidence synthesis.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Identifying the research questions\u003c/h2\u003e \u003cp\u003eThis review was guided by the following research questions: Is ST effective for injury prevention in team sports? Is ST effective for performance enhancement in team sports? What types of strengthening exercises have been developed and implemented in team sports? What research underpins these strategies? What are the strengths, limitations, and gaps in the highlighted strategies?\u003c/p\u003e \u003cp\u003eA scoping review was deemed the most appropriate method to address these questions, as suggested in the guidelines for authors on selecting between a systematic or scoping review approach [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Unlike a systematic review, which seeks to answer a narrowly defined clinical question, a scoping review allows for a broader exploration of heterogeneous literature. This approach is particularly suited to examining the diverse strategies countries and teams have adopted to integrate ST for injury prevention and performance enhancement across multiple team sports.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e2.2 Identifying relevant studies\u003c/h3\u003e\n\u003cp\u003eThe search for relevant studies was conducted in three steps, following the guidelines published by Peter and colleagues [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. First, a preliminary search was carried out in PubMed\u0026reg; to refine keywords and identify relevant databases. Based on this, we selected SciVerse Scopus\u0026reg; (Elsevier Properties S.A., USA), PubMed\u0026reg; (U.S. National Library of Medicine, USA), Web of Science\u0026reg; (v.5.4) (Thomson Reuters, USA), SPORTDiscus, and CINAHL\u0026reg; (EBSCO Information Services, USA) as our primary databases, as they are widely used in intervention studies in the sports medicine field. The search terms included \"Strength training\" OR \"Resistance training\" OR \"Weight exercise\" OR \"Anaerobic exercise\" AND \"Injury\" OR \"Musculoskeletal\" AND \"Soccer,\" OR \"Football\" OR \"Rugby\" OR \"Basketball\" OR \"Volleyball\" OR \"Handball\" OR \"Cricket\" OR \"Netball\" OR \"Baseball\" OR \"Softball\" OR \"Kabaddi\". Medical Subject Headings (MeSH) terms were utilized where possible, and advanced search techniques were employed, such as title and abstract searches in all the databases. Only studies published in English and conducted on humans between December 1, 2015, and December 1December 1, 2024, were included. A manual search of reference lists from included articles was also performed to identify additional studies.\u003c/p\u003e\n\u003ch3\u003e2.3 Study selection criteria\u003c/h3\u003e\n\u003cp\u003eArticles were selected based on specific inclusion and exclusion criteria using the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) framework [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePopulation (P)\u003c/strong\u003e \u003cp\u003eStudies focusing on professional athletes or individuals involved in team sports were included, while those involving non-athlete populations, recreational participants, or patients were excluded.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eIntervention (I)\u003c/strong\u003e \u003cp\u003eIntervention studies examining any form of ST (regardless of frequency, intensity, type, or duration) were included. Studies combining ST with other interventions were excluded.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eComparator/Control (C)\u003c/strong\u003e \u003cp\u003eStudies with a comparator group receiving no ST intervention or a placebo were included. Studies comparing various types of ST interventions were excluded.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eOutcomes (O)\u003c/strong\u003e \u003cp\u003eStudies reporting injury-related or performance-related outcomes, such as anthropometric, biochemical, or physical measures, were included. Studies without direct links to these outcomes (e.g., biomechanical or sensory measures unrelated to performance) were excluded.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eStudy Design (S)\u003c/strong\u003e \u003cp\u003eRCTs were included. Observational studies, animal studies, in vitro research, case reports, case series, reviews, and unpublished data were excluded.\u003c/p\u003e \u003c/p\u003e\n\u003ch3\u003e2.4 Data extraction and charting\u003c/h3\u003e\n\u003cp\u003eData were extracted by one investigator (KW) and independently verified by another (RJ) to ensure accuracy. Discrepancies were resolved through discussion. The extracted data included information on the first author, publication year, country, study design, sport type, gender and age of participants, sample size, intervention details (type, frequency, intensity, duration), and significant outcomes. Statistical significance was assessed by comparing intervention and control groups rather than within-group pre- and post-intervention differences.\u003c/p\u003e\n\u003ch3\u003e2.5 Assessment of quality\u003c/h3\u003e\n\u003cp\u003e Although quality assessment is not typically mandatory in scoping reviews, it was conducted in this study to provide additional insights into the methodological rigor of the included studies. This was independently performed by two investigators using the Physiotherapy Evidence Database (PEDro) scale [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], a tool designed to objectively evaluate methodological quality. The scale assigns scores from 0 to 10, categorizing studies as 'poor' (0\u0026ndash;3), 'fair' (4\u0026ndash;5), 'good' (6\u0026ndash;8), or 'excellent' (9\u0026ndash;10). Any discrepancies in scoring were resolved through discussion to reach a consensus.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe comprehensive search across multiple databases initially identified the following results: SciVerse Scopus\u0026reg; (n\u0026thinsp;=\u0026thinsp;100 studies), PubMed\u0026reg; (n\u0026thinsp;=\u0026thinsp;200 studies), Web of Science\u0026reg; (n\u0026thinsp;=\u0026thinsp;400 studies), SPORTDiscus (n\u0026thinsp;=\u0026thinsp;311 studies), and CINAHL (n\u0026thinsp;=\u0026thinsp;1290 studies. After removing duplicate entries, a total of 2133 research articles were considered potentially relevant and subjected to eligibility screening. During the initial phase, titles and abstracts were carefully reviewed, resulting in 167 articles being shortlisted for full-text evaluation. To ensure the inclusion of all relevant literature, manual searching of references and related materials was also conducted, identifying an additional five studies. After obtaining and thoroughly reviewing the full-text articles, 15 studies were found to meet all predefined inclusion criteria. The detailed steps of the search and screening process are illustrated in Fig.\u0026nbsp;1, and this was performed following the guidelines provided by the Scoping Review Guideline for Conducting Searches, which align with best practices for evidence synthesis in the sport and exercise medicine, musculoskeletal rehabilitation, and sports science fields [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"1\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eINSERT FIGURE 1 ABOUT HERE\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThis review included 15 RCTs published between 2015 and 2024. The studies were conducted across various countries: one each from Iran [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e], Australia [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], and the Netherlands [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]; two from Norway [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]; three each from Germany [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] and France [\u003cspan additionalcitationids=\"CR29\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]; and four from Spain [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] (Table\u0026nbsp;1). All the trials followed a parallel-group design, with two studies employing a cluster-randomized design at the team level [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Out of the 15 trials, one trial did not utilize a control group; instead, it assessed the effectiveness of a 10-week strength-training program targeting injury prevention by comparing outcomes between the experimental season and the control season [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. The quality of the selected trials, as assessed using the PEDro scale, indicated that four trials were of fair quality [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], while the remaining 11 trials were of good quality [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan additionalcitationids=\"CR23 CR24 CR25 CR26\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] (see Supplementary Table\u0026nbsp;1).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"1\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eINSERT TABLE 1 ABOUT HERE\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMean age of the athlete varied from 12.7 years [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] to 25.8 years [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The selected RCTs included a range of sample sizes, from as few as 20 subjects [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] to as many as 652 participants [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The sports represented across the studies varied, with handball [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], soccer [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR28 CR29 CR30\" citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e], volleyball [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e], rugby [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e], and football [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] all being included. Notably, soccer appeared most frequently across these studies, with several trials focusing on both professional and semi-professional levels. The gender distribution varied, with most studies (n\u0026thinsp;=\u0026thinsp;13) involving male athletes, although a few trials focused exclusively on female participants [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e We categorized the trials included in this review into three types based on their outcomes: I) Studies assessing the effectiveness of ST for injury prevention in team sports, II) Studies assessing the effectiveness of ST for performance enhancement in team sports, III) Studies assessing the effectiveness of ST for both injury prevention and performance enhancement in team sports.\u003c/p\u003e\n\u003ch3\u003eI. Studies assessing the effectiveness of strength training for injury prevention in team sports\u003c/h3\u003e\n\u003cp\u003eSeveral studies demonstrated the effectiveness of ST programs in reducing injury rates among athletes in team sports. For example, Darragi et al. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] implemented an in-season ST program for female soccer players. The intervention resulted in significant reductions in non-contact injuries (2 injuries in the IG vs. 11 in the CG, p\u0026thinsp;=\u0026thinsp;0.003) and injury rates (0.48/1000 hrs vs. 2.62/1000 hrs, p\u0026thinsp;=\u0026thinsp;0.003). Similarly, Har\u0026oslash;y et al. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] evaluated an adductor-strengthening program among male football players and found a significant decrease in groin injury risk (11.7% vs. 21.3%, p\u0026thinsp;=\u0026thinsp;0.001). Horst et al. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] also highlighted the benefits of NHE in reducing hamstring injuries (6 injuries in the IG vs. 18 in the CG, p\u0026thinsp;=\u0026thinsp;0.005). These findings underscore the efficacy of tailored ST programs in mitigating injury risks in team sports.\u003c/p\u003e\n\u003ch3\u003eII. Studies assessing the effectiveness of strength training for performance enhancement in team sports\u003c/h3\u003e\n\u003cp\u003eST interventions have been shown to significantly enhance athletic performance metrics in team sports. Hammami et al. [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] examined the effects of explosive-based training among male volleyball players, reporting significant improvements in 1RM strength (124.3\u0026thinsp;\u0026plusmn;\u0026thinsp;26.8 kg vs. 97.15\u0026thinsp;\u0026plusmn;\u0026thinsp;12.4 kg, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and jump performance (CMJ: 36.83\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0 cm vs. 31.62\u0026thinsp;\u0026plusmn;\u0026thinsp;4.8 cm, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Similarly, Harries et al. [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] investigated periodized ST programs in rugby players, finding notable improvements in 1RM box squat strength and sprint performance (e.g., 10 m sprint: 1.808\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03 s for linear periodization vs. 1.729\u0026thinsp;\u0026plusmn;\u0026thinsp;0.091 s for undulating periodization, p\u0026thinsp;=\u0026thinsp;0.038). Additionally, Negra et al. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] evaluated high-velocity resistance training in soccer players, observing enhanced vertical jump (CMJ: 27.41\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0 cm vs. 20.10\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0 cm, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and sprint performance (5 m sprint: 1.08\u0026thinsp;\u0026plusmn;\u0026thinsp;0.06 s vs. 1.20\u0026thinsp;\u0026plusmn;\u0026thinsp;0.06 s, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). These studies highlight the role of ST in improving physical capacities critical for team sports performance.\u003c/p\u003e \u003cp\u003e \u003cb\u003eIII. Studies assessing the effectiveness of strength training for both injury prevention and performance enhancement in team sports\u003c/b\u003e \u003c/p\u003e \u003cp\u003eSeveral studies have illustrated the dual benefits of ST programs in preventing injuries and enhancing athletic performance. Ferri-Caruana et al. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] investigated core and pelvic ST in female soccer players, reporting reductions in frontal plane projection angles (FPPA) and significant improvements in jump height for both unilateral and bilateral tests (e.g., bilateral jump height: 22.17\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4 cm vs. 21.30\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2 cm, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Dur\u0026aacute;n et al. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]implemented lower-extremity ST for male soccer players, which resulted in decreased injury burden (28.87 days/1000 h vs. 145.77 days/1000 h, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and reduced muscle imbalances. Moreover, Lahti et al. [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] demonstrated improvements in both sprint performance and peak power output in soccer players undergoing heavy sled training. These findings support the comprehensive benefits of ST programs that simultaneously enhance performance and reduce injury risk.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e To the best of our knowledge, this is the first scoping review conducted to evaluate the impact of ST on both injury prevention and performance enhancement in team sports. In summary, the findings highlight the significant role of strengthening exercises in reducing injury risks and enhancing athletic performance across various sports populations. The findings also demonstrate substantial reductions in the incidence of common sports injuries, such as hamstring and groin strains, and overall injury burdens in intervention groups compared to controls. Additionally, these exercises improved critical performance metrics, including sprint speed, jump height, flexibility, and functional stability. Further ST also enhanced biomechanical alignment, muscle imbalances and functional capacity, showcasing the versatility and effectiveness of these targeted exercise programs in optimizing both injury prevention and performance outcomes.\u003c/p\u003e \u003cp\u003eOur study findings align with the key results of a systematic review and meta-analysis [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] that investigated ST interventions for sports injury prevention. The analysis revealed that a 10% increase in ST volume led to a reduction in injury risk by over four percentage points. It also concluded that higher training volumes and intensities were strongly associated with a decreased risk of sports-related injuries [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Another similar review found that strength training, including traditional resistance, eccentric, and flywheel training, can be considered an effective method for reducing injury risk in soccer players [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Based on their findings, they also recommended training strategies that incorporate multiple components (e.g., a combination of strength, balance, and plyometrics), including strength exercises, as effective for reducing noncontact injuries in female soccer players [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Additionally, the current body of research supports the use of eccentric training in sports, as it elicits unique physiological responses compared to other resistance exercise modalities [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Moreover, flywheel training, with its unique combination of concentric and eccentric contractions, offers specific advantages that may play a significant role in injury prevention. Similarly, another review evaluating the role of strengthening exercises in the prevention and management of lower extremity sports injuries reported that ST plays a critical role in the management and prevention of overuse injuries [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. It not only enhances muscle performance, fitness levels, speed, and agility in sports but also reduces pain and supports faster recovery from injuries. Furthermore, another umbrella review summarized the effects of NHE on performance and injury prevention, indicating that NHE interventions had positive effects on sprint performance, muscle activation, eccentric strength, and muscle architecture (such as fascicle length, muscle thickness, and pennation angle) [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. Additionally, NHE was found to be effective in preventing hamstring injuries, with a reduction of up to 51%. In conclusion, incorporating NHE into training, particularly during the warm-up phase, is recommended to enhance athletic performance and prevent hamstring injuries [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eST reduces the risk of injuries by improving muscle strength and joint stability [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. It enhances muscle-tendon unit stiffness, corrects leg asymmetries, and reduces joint stress during high-intensity exercises [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Additionally, ST has been shown to optimize neuromuscular control through neural adaptations [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. Specifically, high-resistance training accelerates nerve activity, enabling athletes to recruit motor units more quickly. This leads to faster activation of muscle fibres, which enhances maximal strength production in less time. Furthermore, strengthening the gluteal muscles contributes to lumbopelvic stability, which is essential in preventing hamstring injuries [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. High-load ST also promotes neural adaptations that can improve running speed without increasing body mass [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] [Figure 2].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabc\" border=\"1\"\u003e \u003ccolgroup cols=\"1\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eINSERT FIGURE 2 ABOUT HERE\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eStrengths\u003c/h2\u003e \u003cp\u003eOne of the main strengths of the paper is its comprehensive scope, which includes a wide variety of team sports, offering a generalizable perspective on the efficacy of ST across different athletic disciplines. The review also follows a comprehensive and structured methodology, adhering to Levac et al.\u0026rsquo;s five-stage framework for scoping reviews. This framework ensures a clear, transparent, and rigorous process for identifying and synthesizing relevant studies, which contributes to the reliability and validity of the findings. Furthermore, the review includes only studies from the last decade, capturing the most up-to-date evidence and reflecting contemporary training practices.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eDespite the strengths, this scoping review has several limitations that need to be considered when interpreting the findings. As a result, the global applicability of the conclusions drawn may be limited, particularly regarding ST practices in countries with different training cultures. The review also faces challenges related to the heterogeneity of the included studies, with variations in the type, frequency, intensity, and duration of ST interventions. This heterogeneity can make it difficult to draw definitive, universal conclusions about the optimal design of ST programs.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations\u003c/h2\u003e \u003cp\u003e Building on the findings of this review, several recommendations for future research can be made further to explore the role of ST in team sports. Future studies should focus on examining the long-term effects of ST on injury recurrence and sustained performance improvements over extended periods. This would provide valuable insights into the durability of ST benefits. Additionally, the review highlighted the variation in intervention types and their corresponding outcomes, suggesting that future studies should explore the comparative effectiveness of different ST modalities (e.g., eccentric vs. concentric exercises) to identify the most effective strategies for injury prevention and performance enhancement. Another important recommendation is to incorporate a broader range of athletic populations, including youth and amateur athletes, to assess the applicability of ST interventions across different experience levels and age groups. Further, future studies should explore the impact of combining ST with other types of exercise, such as flexibility or training or plyometric or agility, to better understand how multi-component programs can optimize athletic outcomes. Lastly, further scoping or umbrella reviews should be conducted with a variety of high-quality studies other than RCTs (Fig.\u0026nbsp;3).\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eST programs can be considered an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports across different age groups and genders, as suggested by high-quality RCTs. The findings emphasize the importance of integrating structured, sport-specific, and evidence-based strengthening exercises into training regimens to optimize athletes' physical health and functional outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to express our special thanks to Manoja Gamage, PhD candidate at the Queensland University of Technology, Australia, for her help in searching the Web of Science and Scopus databases.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cstrong\u003eand consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contribution\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKW conceived and designed the study. KW and RJ searched databases. KW and RJ were involved in retrieving data. KW and RJ drafted the manuscript. KW, APH and RJ revised the paper. All authors provided critical feedback on the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eMorrissey MC, Harman EA, Johnson MJ (1995) Resistance training modes: specificity and effectiveness. Med Sci Sports Exerc 27(5):648\u0026ndash;660\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSuchomel TJ, Nimphius S, Stone MH (2016) The Importance of Muscular Strength in Athletic Performance. Sports Med 46(10):1419\u0026ndash;1449\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAndersen LL, Aagaard P (2006) Influence of maximal muscle strength and intrinsic muscle contractile properties on contractile rate of force development. 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J Sports Med Phys Fit 64(8):807\u0026ndash;815\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNunes H, Fernandes LG, Martins PN, Ferreira RM (2024) The Effects of Nordic Hamstring Exercise on Performance and Injury in the Lower Extremities: An Umbrella Review. Healthc (Basel). ;12(15)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKopper B, Csende Z, S\u0026aacute;f\u0026aacute;r S, Hortob\u0026aacute;gyi T, Tihanyi J (2013) Muscle activation history at different vertical jumps and its influence on vertical velocity. J Electromyogr Kinesiol 23(1):132\u0026ndash;139\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO'Sullivan L, Preszler J, Tanaka M (2022) Hamstring Injury Rehabilitation and Prevention in the Female Athlete. Int J Sports Phys Ther 17(6):1184\u0026ndash;1193\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Effects of strength training on injury prevention and sports performance enhancement\u003c/p\u003e\n\u003cdiv\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"1086\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003eAuthor,\u003c/p\u003e\n \u003cp\u003eYear,\u003c/p\u003e\n \u003cp\u003eCountry\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eStudy design,\u003c/p\u003e\n \u003cp\u003ePEDro score\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(out of 10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSport,\u003c/p\u003e\n \u003cp\u003eLevel\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eGender,\u003c/p\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003eSample size (number),\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eIntervention program\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eFrequency,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eTime-period\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003eResults\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eIG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003eCG\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e1. Bauer et al.,\u003c/p\u003e\n \u003cp\u003e2022,\u003c/p\u003e\n \u003cp\u003eGermany [23]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eHandball,\u003c/p\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003eIG: 16.9\u0026plusmn;0.6,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCG: 17.2\u0026plusmn;0.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e13,\u003c/p\u003e\n \u003cp\u003eCross curl-ups, Side bridges, Birddog exercise\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e13,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e3 times per W,\u003c/p\u003e\n \u003cp\u003e6 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-Muscle endurance (s): (IG: 89.3 \u0026plusmn; 23.8; CG: 60.6 \u0026plusmn; 14.0); p \u0026lt; 0.001, for dorsal chain\u003c/p\u003e\n \u003cp\u003e-Shoulder mobility/stability (%AL): (IG: 107.3 \u0026plusmn; 8.3; CG: 97.2 \u0026plusmn; 9.2); p=0.024.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e2. Cadu et al.,\u003c/p\u003e\n \u003cp\u003e2022,\u003c/p\u003e\n \u003cp\u003eFrance [25]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003e25.6\u0026plusmn;3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e23,\u003c/p\u003e\n \u003cp\u003eNHE eccentric\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e23,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e1 day per W,\u003c/p\u003e\n \u003cp\u003e21 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-Maximal eccentric strength \u0026uarr; in IG (+15.5% [25.5%], pre = 357.3 \u0026plusmn; 95.0 N vs post = 390.7 \u0026plusmn; 72.2 N); p = 0.049,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Hamstring IR \u0026darr; by 2.7 (IG: 22%, 5/23 injuries; CG: 39%, 9/23 injuries); p = 0.12.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e3. Darragi et al.,\u003c/p\u003e\n \u003cp\u003e2023,\u003c/p\u003e\n \u003cp\u003eGermany [10]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, SB, P,\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eF,\u003c/p\u003e\n \u003cp\u003e15.4 \u0026plusmn; 1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eIG: 14,\u003c/p\u003e\n \u003cp\u003eFB in-season ST\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e16,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2 sessions per W,\u003c/p\u003e\n \u003cp\u003e12 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-NC injuries \u0026darr; in IG (2 injuries) vs CG (11 injuries); p = 0.003,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Injury burden \u0026uarr; in CG (16.7 days/1000 hrs) vs IG (3.3 days/1000 hrs); p = 0.011 \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Injury rate \u0026darr; in IG (0.48/1000 hrs) vs CG (2.62/1000 hrs); p=0.003,\u003c/p\u003e\n \u003cp\u003e-IIR during the competition period \u0026darr; in IG (0.57/1000 hrs) vs CG (3.14/1000 hrs); IRR = 0.18,\u003c/p\u003e\n \u003cp\u003e- Squat jump (cm) \u0026uarr; in IG (43.0 \u0026plusmn; 8.1 to 47.9 \u0026plusmn; 10.5) vs CG (42.8 \u0026plusmn; 9.0 to 42.7 \u0026plusmn; 10.0); p = 0.015,\u003c/p\u003e\n \u003cp\u003e- CMJ (cm) \u0026uarr; in IG (22.7 \u0026plusmn; 6.1 to 25.8 \u0026plusmn; 8.4) vs CG (22.6 \u0026plusmn; 6.1 to 22.7 \u0026plusmn; 7.3); p = 0.001.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e4. Dur\u0026aacute;n et al.,\u003c/p\u003e\n \u003cp\u003e2023,\u003c/p\u003e\n \u003cp\u003eSpain [11]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003e25.8\u0026plusmn;2.0\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e10,\u003c/p\u003e\n \u003cp\u003eLE ST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e10,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2 sessions per W,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e12 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-Injury burden \u0026darr; in IG (28.87 days/1000 h) vs CG (145.77 days/1000 h); p \u0026lt; 0.001.\u003c/p\u003e\n \u003cp\u003e-Injury rate \u0026darr; in IG (1.15 injuries/1000 h) vs CG (6.45 injuries/1000 h); p = 0.120,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Injury distribution (1-6 W): IG (1 injury) vs CG (3 injuries), (7-12 W): IG (0 injuries) vs CG (2 injuries),\u003c/p\u003e\n \u003cp\u003e-Q\u0026ndash;H imbalance: \u0026darr; Right: IG: 45.41% \u0026plusmn; 2.6 to 40.75% \u0026plusmn; 2.1 vs. CG: 44.79% \u0026plusmn; 2.3 to 44.81% \u0026plusmn; 2.1; p \u0026lt; 0.001,\u003c/p\u003e\n \u003cp\u003e\u0026darr;Left: IG: 44.00% \u0026plusmn; 3.2 to 39.36% \u0026plusmn; 2.0 vs. CG: 43.05% \u0026plusmn; 1.9 to 42.99% \u0026plusmn; 2.1; p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Abd-Add imbalance: \u0026darr; Right: IG: 23.53% \u0026plusmn; 6.6 to 13.19% \u0026plusmn; 9.4 vs. CG: 16.83% \u0026plusmn; 6.5 to 13.76% \u0026plusmn; 8.3; p \u0026lt; 0.001,\u003c/p\u003e\n \u003cp\u003e\u0026darr;Left: IG: 21.56% \u0026plusmn; 5.4 to 12.56% \u0026plusmn; 7.5 vs. CG: 14.76% \u0026plusmn; 6.09 to 14.11% \u0026plusmn; 6.7; p \u0026lt; 0.001.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e5. Ferri-Caruana et al.,\u003c/p\u003e\n \u003cp\u003e2020,\u003c/p\u003e\n \u003cp\u003eSpain [28]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eF,\u003c/p\u003e\n \u003cp\u003e16.2 \u0026plusmn; 1.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e16,\u003c/p\u003e\n \u003cp\u003ePelvic and core ST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003ea\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\u0026nbsp;2 sessions per W, \u0026nbsp;\u003cp\u003e8 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-FPPA (dominant leg): \u0026darr; IG (12.69\u0026deg; \u0026plusmn; 5.8 to 5.59\u0026deg; \u0026plusmn; 7.2) vs CG (13.04\u0026deg; \u0026plusmn; 5.5 to 12.35\u0026deg; \u0026plusmn; 8.7); p \u0026lt; 0.05,\u003c/p\u003e\n \u003cp\u003e-FPPA (non-dominant leg): \u0026darr;IG (7.43\u0026deg; \u0026plusmn; 7.1 to -0.58\u0026deg; \u0026plusmn; 8.5) vs CG (10.41\u0026deg; \u0026plusmn; 9.1 to 8.42\u0026deg; \u0026plusmn; 8.6); p \u0026lt; 0.05,\u003c/p\u003e\n \u003cp\u003e-Peak Hip Flexion Angle: \u0026uarr;IG (65.13\u0026deg; \u0026plusmn; 24.9 to 89.56\u0026deg; \u0026plusmn; 15.1) vs CG (79.2\u0026deg; \u0026plusmn; 19.9 to 83.2\u0026deg; \u0026plusmn; 19.4); p \u0026lt; 0.05,\u003c/p\u003e\n \u003cp\u003e-Peak Knee Flexion Angle: \u0026uarr;IG (74.75\u0026deg; \u0026plusmn; 13.7 to 89.69\u0026deg; \u0026plusmn; 10.6) vs CG (81.9\u0026deg; \u0026plusmn; 11.9 to 81.4\u0026deg; \u0026plusmn; 9.0); p \u0026lt; 0.05,\u003c/p\u003e\n \u003cp\u003e-Peak Ankle Dorsiflexion Angle: \u0026uarr;IG (88.63\u0026deg; \u0026plusmn; 4.4 to 87.31\u0026deg; \u0026plusmn; 4.4) vs CG (86.1\u0026deg; \u0026plusmn; 6.64 to 82.6\u0026deg; \u0026plusmn; 5.06); p \u0026lt; 0.05,\u003c/p\u003e\n \u003cp\u003e-Unilateral Jump Height (cm) (dominant leg): \u0026uarr;IG (10.42 \u0026plusmn; 2.5 to 11.75 \u0026plusmn; 2.1) vs CG (11.44 \u0026plusmn; 2.1 to 12.29 \u0026plusmn; 1.4); p \u0026lt; 0.05,\u003c/p\u003e\n \u003cp\u003e-Unilateral Jump Height (cm) (non-dominant leg): \u0026uarr;IG (10.83 \u0026plusmn; 2.8 to 12.04 \u0026plusmn; 2.4) vs CG (11.83 \u0026plusmn; 2.4 to 11.02 \u0026plusmn; 1.9); p \u0026lt; 0.05,\u003c/p\u003e\n \u003cp\u003e-Bilateral Jump Height (cm)\u0026uarr;IG (19.33 \u0026plusmn; 4.7 to 22.17 \u0026plusmn; 3.4) vs CG (20.54 \u0026plusmn; 3.1 to 21.30 \u0026plusmn; 3.2); p \u0026lt; 0.05.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e6. Hammami et al.,\u003c/p\u003e\n \u003cp\u003e2020,\u003c/p\u003e\n \u003cp\u003eSpain [14]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eVolleyball,\u003c/p\u003e\n \u003cp\u003eE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003eIG: 14.86 \u0026plusmn; 0.5, CG:1 4.74 \u0026plusmn; 0.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e14,\u003c/p\u003e\n \u003cp\u003eEBT ST (squats, jump squats, forward lunges, lateral lunges, and standing frontal stabilization)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e13,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2 sessions per W,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-1RM (Kg): (IG: 124.3\u0026plusmn; 26.8; CG: 97.15 \u0026plusmn; 12.4); p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-CMJ (cm): (IG: 36.83\u0026plusmn; 4.0; CG: 31.62 \u0026plusmn; 4.8); p \u0026lt; 0.05,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-SLJ (cm): (IG: 220.00\u0026plusmn; 26.0; CG: 190.54\u0026plusmn; 5.5); p \u0026lt; 0.001.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e7. Harries et al.,\u003c/p\u003e\n \u003cp\u003e2018,\u003c/p\u003e\n \u003cp\u003eAustralia [20]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, SB, P,\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eRugby,\u003c/p\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003e15-18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eIG1: 8, Linear periodization\u003c/p\u003e\n \u003cp\u003eIG2: 8\u003c/p\u003e\n \u003cp\u003eDaily undulating periodization\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e8,\u003c/p\u003e\n \u003cp\u003eRE\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\u0026nbsp;2 sessions per W, \u0026nbsp;\u003cp\u003e12 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-1RM box squat (Kg): (IG1: 171.2\u0026plusmn;41.2; IG2: 177.7\u0026plusmn;36.9, CG: 95.4\u0026plusmn;17.2); p \u0026lt;0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-10 m sprint (s): (IG1: 1.808\u0026plusmn;0.03; IG2: 1.729\u0026plusmn;0.091, CG: 1.781\u0026plusmn;0.079); p=0.038,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-20 m sprint (s): (IG1: 3.189\u0026plusmn;0.080; IG2: 3.022\u0026plusmn;0.152, CG: 3.129\u0026plusmn;0.139); p=0.047,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e8. Har\u0026oslash;y et al.,\u003c/p\u003e\n \u003cp\u003e2017,\u003c/p\u003e\n \u003cp\u003eNorway [21]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eC-R, SB, P,\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eFootball,\u003c/p\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003e18-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e339,\u003c/p\u003e\n \u003cp\u003eAdductor ST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e313,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2 sessions per W,\u003c/p\u003e\n \u003cp\u003e10 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-Groin injuries % \u0026darr; (IG: 13.5%; CG: 21.3%); p= 0.008,\u003c/p\u003e\n \u003cp\u003e-Groin injuries risk \u0026darr; (IG: 11.7%; CG: 21.3%); p = 0.001.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e9. Horst et al.,\u003c/p\u003e\n \u003cp\u003e2015,\u003c/p\u003e\n \u003cp\u003eNetherlands [12]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eC-R, UB, P,\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eAmateur\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003eIG: 24.5\u0026plusmn;3.6,\u003c/p\u003e\n \u003cp\u003eCG: 24.6\u0026plusmn;4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e292,\u003c/p\u003e\n \u003cp\u003eNHE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e287,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2 sessions per W,\u003c/p\u003e\n \u003cp\u003e10 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-Hamstring injuries \u0026darr; IG: 6 injuries (55%), CG: 18 injuries (72%); p = 0.005,\u003c/p\u003e\n \u003cp\u003e-Hamstring Injury Risk \u0026darr; IG: 11 vs CG: 25; p = 0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e10. Lahti et al.,\u003c/p\u003e\n \u003cp\u003e2020,\u003c/p\u003e\n \u003cp\u003eFrance,\u003c/p\u003e\n \u003cp\u003e[26]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003e24.1 \u0026plusmn; 5.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eIG1: 10, heavy sled ST with a load reducing maximal velocity by 50%.\u003c/p\u003e\n \u003cp\u003eIG2: 10, heavy sled ST with a load reducing maximal velocity by 60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e1\u0026ndash;2 sessions per W,\u003c/p\u003e\n \u003cp\u003e9 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-Sprint performance:\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5-m split time (s): \u0026darr; IG1 (1.39 \u0026plusmn; 0.04 to 1.34 \u0026plusmn; 0.04); p = 0.005, \u0026darr; IG2 (1.39 \u0026plusmn; 0.05 to 1.35 \u0026plusmn; 0.04); p = 0.05, \u0026darr; CG (1.38 \u0026plusmn; 0.04 to 1.36 \u0026plusmn; 0.04); p = 1.00.\u003c/p\u003e\n \u003cp\u003e10-m split time (s): \u0026darr; IG1 (2.14 \u0026plusmn; 0.06 to 2.07 \u0026plusmn; 0.06); p \u0026lt; 0.001, \u0026darr; IG2 (2.15 \u0026plusmn; 0.08 to 2.09 \u0026plusmn; 0.06); p = 0.001, \u0026darr; CG (2.12 \u0026plusmn; 0.06 to 2.10 \u0026plusmn; 0.04); p = 0.76.\u003c/p\u003e\n \u003cp\u003e20-m split time (s): \u0026darr; IG1 (3.43 \u0026plusmn; 0.08 to 3.32 \u0026plusmn; 0.10); p \u0026lt; 0.001, \u0026darr; IG2 (3.45 \u0026plusmn; 0.12 to 3.36 \u0026plusmn; 0.10); p = 0.008, \u0026darr; CG (3.41 \u0026plusmn; 0.09 to 3.37 \u0026plusmn; 0.08); p = 0.44.\u003c/p\u003e\n \u003cp\u003e30-m split time (s): \u0026darr; IG1 (4.62 \u0026plusmn; 0.10 to 4.49 \u0026plusmn; 0.12); p \u0026lt; 0.001, \u0026darr; IG2 (4.65 \u0026plusmn; 0.17 to 4.56 \u0026plusmn; 0.14); p = 0.021, \u0026darr; CG (4.62 \u0026plusmn; 0.12 to 4.56 \u0026plusmn; 0.11); p = 0.33.\u003c/p\u003e\n \u003cp\u003e-Pmax (W.kg⁻\u0026sup1;): \u0026uarr; IG1 (16.0 \u0026plusmn; 1.66 to 17.3 \u0026plusmn; 1.35); p = 0.011, \u0026uarr; IG2 (16.2 \u0026plusmn; 1.31 to 18.1 \u0026plusmn; 1.82); p \u0026lt; 0.001.\u003c/p\u003e\n \u003cp\u003e\u0026uarr; CG (16.5 \u0026plusmn; 1.27 to 17.0 \u0026plusmn; 1.08); p = 0.70.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e11. Mesfar et al.,\u003c/p\u003e\n \u003cp\u003e2022,\u003c/p\u003e\n \u003cp\u003eNorway [22]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eVolleyball,\u003c/p\u003e\n \u003cp\u003eE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003eIG: 14.4 \u0026plusmn; 0.6,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCG:14.5 \u0026plusmn; 0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e16,\u003c/p\u003e\n \u003cp\u003eContrast \u003cdel cite=\"mailto:Andrew%20Hills\" datetime=\"2024-12-28T11:41\"\u003eS\u003c/del\u003eST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e3-4 times per W,\u003c/p\u003e\n \u003cp\u003e8 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-Dynamic Balance (CS-YBT, %): IG: 93.90 \u0026plusmn; 3.36 vs. CG: 78.85 \u0026plusmn; 5.37; p = 0.01,\u003c/p\u003e\n \u003cp\u003e-1RM (kg): IG: 80.57 \u0026plusmn; 2.26 vs. CG: 58.48 \u0026plusmn; 2.59; p = 0.01,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Single-Leg Hop Test (right leg, cm): IG: 145.00 \u0026plusmn; 19.66 vs. CG: 107.52 \u0026plusmn; 5.09; p = 0.01,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(left leg, cm): IG: 124.27 \u0026plusmn; 4.11 vs. CG: 108.79 \u0026plusmn; 5.91; p = 0.01,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCMJ height (cm): IG: 38.94 \u0026plusmn; 3.96 vs. CG: 33.50 \u0026plusmn; 3.91; p = 0.01.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e12. Moradi et al.,\u003c/p\u003e\n \u003cp\u003e2020,\u003c/p\u003e\n \u003cp\u003eIran [19]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eVolleyball,\u003c/p\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003eIG: 23.9\u0026plusmn;4.4\u003c/p\u003e\n \u003cp\u003eCG: 23.4\u0026plusmn;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e30,\u003c/p\u003e\n \u003cp\u003eSJ ST using Thera Band\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e30,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e3 sessions per W,\u003c/p\u003e\n \u003cp\u003e8 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-IR ROM \u0026uarr; IG: 0.55 vs. CG: 0.23; p = 0.001,\u003c/p\u003e\n \u003cp\u003e-Functional strength ratio \u0026uarr; IG: 0.75; CG: 0.22; p = 0.021,\u003c/p\u003e\n \u003cp\u003e- EMG values: Onset time for supraspinatus \u0026darr; (IG: 0.44; CG: 0.76); p = 0.000,\u003c/p\u003e\n \u003cp\u003eOnset time for infraspinatus \u0026darr; (IG: 0.46; CG: 0.78); p \u0026lt;0.001,\u003c/p\u003e\n \u003cp\u003eActivation of supraspinatus \u0026darr; (IG: 0.32; CG: 0.56); p = 0.001,\u003c/p\u003e\n \u003cp\u003eActivation of infraspinatus \u0026darr; (IG: 0.35; CG: 0.58); p = 0.001,\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e13. Negra et al.,\u003c/p\u003e\n \u003cp\u003e2016,\u003c/p\u003e\n \u003cp\u003eGermany [24]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, NB, P,\u003c/p\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eSE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003eIG: 12.80 \u0026plusmn; 0.2,\u003c/p\u003e\n \u003cp\u003eCG: 12.74 \u0026plusmn; 0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e292,\u003c/p\u003e\n \u003cp\u003eHigh-velocity ST\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e287,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2 sessions per W,\u003c/p\u003e\n \u003cp\u003e12 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-1RM half squat (Kg): (IG: 127.77\u0026plusmn; 15.2; CG: 90.00\u0026plusmn; 14.2); p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Vertical jump tests (cm):\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(CMJ: IG: 27.41\u0026plusmn; 4.0; CG: 20.10\u0026plusmn; 3.0); p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(SJ: IG: 27.41\u0026plusmn; 4.0; CG: 20.10\u0026plusmn; 3.0); p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Horizontal jump tests (m): (SLJ: IG: 1.94\u0026plusmn;0.2; CG: 1.57\u0026plusmn; 0.08); p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e-Linear sprint test (s): (5 m sprint: IG: 1.08\u0026plusmn;0.06; CG: 1.20\u0026plusmn; 0.06); p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10 m sprint: IG: 1.90\u0026plusmn;0.08; CG: 2.09\u0026plusmn; 0.09); p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e20 m sprint: IG: 3.39\u0026plusmn;0.17; CG: 3.68\u0026plusmn; 0.13); p \u0026lt; 0.001,\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30 m sprint: IG: 4.86\u0026plusmn;0.2; CG: 5.23\u0026plusmn; 0.2); p \u0026lt; 0.001.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e14. Raya-Gonz\u0026aacute;lez et al.,\u003c/p\u003e\n \u003cp\u003e2019,\u003c/p\u003e\n \u003cp\u003eSpain [29]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, UB, P,\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003e18.6\u0026plusmn;0.1\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 204px;\"\u003e\n \u003cp\u003e27, no CG\u003c/p\u003e\n \u003cp\u003eExperimental season: A ST program targeting injury prevention.\u003c/p\u003e\n \u003cp\u003eControl season: RE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2 sessions per W,\u003c/p\u003e\n \u003cp\u003e10 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-Total muscle injuries \u0026darr; in experimental season: 9 injuries vs control season: 15 injuries; IRR = 1.74, p \u0026lt;0.05\u003c/p\u003e\n \u003cp\u003e-Absence days due to muscle injuries:\u003c/p\u003e\n \u003cp\u003eTotal exposure:\u003c/p\u003e\n \u003cp\u003e\u0026darr; in the experimental season: 89 days vs. control season: 204 days; IRR = 2.29, p \u0026lt; 0.05.\u003c/p\u003e\n \u003cp\u003eTraining exposure:\u003c/p\u003e\n \u003cp\u003e\u0026darr; in the experimental season: 10 days vs. control season: 113 days; IRR = 11.33, p \u0026lt; 0.05.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 108px;\"\u003e\n \u003cp\u003e15. Zouita et al.,\u003c/p\u003e\n \u003cp\u003e2016,\u003c/p\u003e\n \u003cp\u003eFrance [27]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003eR, SB, P,\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003eSoccer,\u003c/p\u003e\n \u003cp\u003eAmateur\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 96px;\"\u003e\n \u003cp\u003eM,\u003c/p\u003e\n \u003cp\u003e13-14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e26,\u003c/p\u003e\n \u003cp\u003eUL, LL, core ST\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 72px;\"\u003e\n \u003cp\u003e26,\u003c/p\u003e\n \u003cp\u003eRE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e2-3 sessions per W,\u003c/p\u003e\n \u003cp\u003e12 W\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 336px;\"\u003e\n \u003cp\u003e-IR: 17/season \u0026darr;: IG: 4 injuries, CG: 13 injuries; p \u0026le; 0.05.\u003c/p\u003e\n \u003cp\u003e-Injury rate per 1,000 h of exposure \u0026darr; IG: 0.70 vs CG: 2.32; p \u0026le; 0.05.\u003c/p\u003e\n \u003cp\u003e-Injury severity: IG:1 minimal (25%), 1 mild (25%), 2 moderate (50%), CG: 4 minimal (30.76%), 3 mild (23.07%), 5 moderate (38.46%), and 1 severe (7.69%).\u003c/p\u003e\n \u003cp\u003e-Sprint performances (s): 10 m sprint: TG: T0: 2.16 \u0026plusmn; 0.12, T1: 2.06 \u0026plusmn; 0.1\u0026darr;, T2: 2.06 \u0026plusmn; 0.1\u0026darr;; CG: T0: 2.2 \u0026plusmn; 0.2, T1: 2.06 \u0026plusmn; 0.1\u0026darr;, T2: 2.1 \u0026plusmn; 0.2; p \u0026le; 0.05.\u003c/p\u003e\n \u003cp\u003e20 m sprint: TG: T0: 3.3 \u0026plusmn; 1, T1: 3.3 \u0026plusmn; 0.4, T2: 3 \u0026plusmn; 0.5\u0026darr;; CG: T0: 3.7 \u0026plusmn; 0.2, T1: 3.4 \u0026plusmn; 0.2\u0026darr;, T2: 3.3 \u0026plusmn; 0.4; p \u0026le; 0.05.\u003c/p\u003e\n \u003cp\u003e30 m sprint: IG: T0: 4.9 \u0026plusmn; 0.3, T1: 4.8 \u0026plusmn; 0.2\u0026darr;, T2: 4.8 \u0026plusmn; 0.3; CG: T0: 5 \u0026plusmn; 1.1, T1: 4.8 \u0026plusmn; 0.2\u0026darr;, T2: 4.7 \u0026plusmn; 0.3\u0026darr;.,\u003c/p\u003e\n \u003cp\u003e-Jumping performances: SJ \u0026uarr;IG (T0: 0.41 \u0026plusmn; 0.1 to T2: 0.46 \u0026plusmn; 0.2) vs CG (T0: 0.40 \u0026plusmn; 0.1 to T2: 0.44 \u0026plusmn; 0.1); p \u0026le; 0.05,\u003c/p\u003e\n \u003cp\u003eCMJ \u0026uarr; IG (T0: 0.49 \u0026plusmn; 0.1 to T1: 0.54 \u0026plusmn; 0.2) vs CG (T0: 0.48 \u0026plusmn; 0.1 to T1: 0.50 \u0026plusmn; 0.1); p \u0026le; 0.05,\u003c/p\u003e\n \u003cp\u003e5JT \u0026uarr; IG (T0: 1.25 \u0026plusmn; 0.1 to T1: 1.34 \u0026plusmn; 0.1) vs CG (T0: 1.27 \u0026plusmn; 0.1 to T1: 1.28 \u0026plusmn; 0.1); p \u0026le; 0.05.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbd-Add: Abductor-Adductor, CG: Control Group, C: Crossover, C/L: Contralateral, CL: Control Leg, C-R: Cluster-Randomized Trial, DL: Dominant Leg, DF: Dorsiflexion, DS: Dynamic Stretching, EBT: Elastic Band Training, F: Female, h: hours, IR: Injury Risk, IG: Intervention Group, IG1: Intervention Group 1, IG2: Intervention Group 2, IIR: Injury Incidence Rate, IR: Incidence Rate, 5JT: Five Jump Test, KJ: Knee Joint, LE: Lower Extremity, M: Male, M: Months, MDS: Maximal Dynamic Strength, MIS: Maximal Isometric Strength, N: Newtons, NB: Not Blinded, NC: Non-Contact, NDL: Non-dominant Leg, P: Parallel, PEDro: Physiotherapy Evidence Database, Pmax: Maximum Power Output, Pt: Peak Torque, Q\u0026ndash;H: Quadriceps-Hamstring, R: Randomized Trial, RE: Regular Exercises, Reps: Repetitions, 1RM: One Repetition Maximum, ROM: Range of Motion, S: Seconds, SB: Single Blinded, ST: Strength Training, UE: Upper Extremity, W: Weeks, NHE: Nordic Hamstring Exercise, FB: Full Body, FPPA: Frontal Plane Projection Angle\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Strength training, injury prevention, physiotherapy, sports performance, team sports","lastPublishedDoi":"10.21203/rs.3.rs-5753318/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5753318/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMuscular strength that can be improved through maximal, explosive, and reactive training, reduces injury risk and enhances sport-specific performance in athletes. In team sports, increased strength boosts physical and neuromuscular function, delays fatigue, speeds recovery and optimizes technical execution and decision-making during competition. Therefore, this scoping review aims to explore existing intervention studies to understand the role of strength training (ST) as an effective strategy for preventing injuries and enhancing performance in team sports.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA comprehensive search was conducted in five databases (SciVerse Scopus, PubMed, Web of Science, SPORTDiscus, and CINAHL) from 2015 to 2024. Keywords related to strength training, injuries, and team sports were used in the search. We included randomized controlled trials (RCTs) assessing the effectiveness of ST in preventing injuries and enhancing performance in team sports. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThis review included 15 RCTs involving team sports: soccer (n\u0026thinsp;=\u0026thinsp;9), volleyball (n\u0026thinsp;=\u0026thinsp;3), and one each for football, handball, and rugby. Participants had a mean age range of 12.7 to 25.8 years, with sample sizes varying from 20 to 652 athletes. Four studies demonstrated dual benefits, highlighting the ability of ST to simultaneously enhance biomechanical alignment, address muscle imbalances, and optimize both injury prevention and performance outcomes. Three RCTs focused solely on strengthening interventions for injuries reported that ST effectively reduced the incidence of sports injuries, including hamstring strains (n\u0026thinsp;=\u0026thinsp;2), groin injuries (n\u0026thinsp;=\u0026thinsp;1), and overall injuries (n\u0026thinsp;=\u0026thinsp;4). Performance metrics such as sprint speed, jump height, muscle strength, and endurance were significantly improved with ST in eight studies.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eST can be considered an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports across different age groups and genders, as suggested by high-quality RCTs.\u003c/p\u003e","manuscriptTitle":"Is strength training an effective physiotherapy-related strategy for injury prevention and performance enhancement in team sports? A scoping review of high-quality randomized controlled trials","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-13 17:34:18","doi":"10.21203/rs.3.rs-5753318/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"38469218-6d99-4aa8-83b3-acc987356e78","owner":[],"postedDate":"January 13th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":42316710,"name":"Sports Medicine and Kinesiology"}],"tags":[],"updatedAt":"2025-01-13T17:34:18+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-13 17:34:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5753318","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5753318","identity":"rs-5753318","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}