A controlled prospective case control study of a prevention training program in female team handball players: the German experience

Background: Few authors have investigated the effectiveness of preventive intervention in European team handball. Purpose: The aim of the present study was to evaluate the effects of a prevention program on the incidence of injuries in female European team handball players.Study design: Prospective controlled study. Methods: Ten female handball teams (134 players) took part in the prevention program (1. Information about injury mechanism, 2. Balance-board exercises, 3. Jump training) while 10 other teams (142 players) were instructed to train as usual. Over one season all injuries were documented weekly. Results: Ankle sprain was the most frequent diagnosis in both groups with 11 ankle sprains in the control group and 7 ankle sprains in the intervention group (Odds ratio: 0.55, 95% confidence interval: 0.22-1.43). The knee was the second frequent injury site. In the control group 5 of all knee injuries were anterior cruciate ligament (ACL) ruptures (incidence: 0.21 per 1000 h) in comparison with one in the intervention group (incidence: 0.04 per 1000 h). Odds ratio was 0.17 with 95% confidence interval of 0.02-1.5. Conclusions: This study confirms that proprioceptive and neuromuscular training is appropriate for the prevention of knee and ankle injuries among female European team handball players.