Despite exercise‐based injury prevention programs (EIPPs) being widely researched and used, several randomized controlled trials (RCTs) have failed to show their protective effect on injury risk. This is potentially due to underappreciating the EIPP dose–response relationship, by not controlling the analysis for the injuries sustained during the early EIPP implementation period, before the EIPP becomes efficacious. To determine the dose–response relationship of EIPP by controlling for the effects of injuries sustained before it became efficacious. We conducted a secondary analysis of an RCT analyzing the EIPP efficacy in athletics over a 39‐week follow‐up on 840 athletes, by including only those with 100% response rate. We controlled the statistical analyses for a range of lengths of early EIPP implementation period by either excluding the athletes with early injuries (i.e., exclusion approach) or adjusting for the early injuries' effects (i.e., inclusion approach). We estimated the EIPP's dose–response relationship by measuring the EIPP's effect at each length of the controlled period. When we considered no early controlled period, the EIPP showed no effect (OR = 0.85 [95% CI: 0.67–1.09]; p = 0.209). However, both exclusion and inclusion approaches showed that the EIPP effect increased significantly after 5–6 weeks of controlled period. This relationship plateaued at 7–12 weeks of controlled period, peaking at 10 weeks with the exclusion approach (OR = 0.28 [95% CI: 0.16–0.48]; p < 0.001), and 7 weeks with the inclusion approach (OR = 0.37 [95% CI: 0.25–0.55]; p < 0.001). Acknowledging the dose–response relationship of EIPPs could help researchers to design and analyze RCTs and practitioners to plan EIPP implementation timely.Trial Registration: ClinicalTrials.gov Identifier: NCT03307434

中文翻译：

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基于运动的损伤预防计划的剂量-反应关系：对田径运动员 39 周随访的随机对照试验的二次分析


尽管基于运动的伤害预防计划（EIPP）已被广泛研究和使用，但一些随机对照试验（RCT）未能显示其对伤害风险的保护作用。这可能是由于低估了 EIPP 剂量反应关系，在 EIPP 生效之前没有控制对 EIPP 早期实施期间遭受的伤害的分析。通过控制 EIPP 有效之前所遭受的伤害的影响来确定 EIPP 的剂量反应关系。我们对一项 RCT 进行了二次分析，分析了 EIPP 对 840 名运动员进行 39 周随访后在田径运动中的功效，仅包括那些有 100% 缓解率的运动员。我们通过排除早期受伤的运动员（即排除法）或调整早期受伤的影响（即纳入法）来控制早期EIPP实施期的一系列长度的统计分析。我们通过测量 EIPP 在每个控制期长度的效应来估计 EIPP 的剂量反应关系。当我们考虑没有早期控制期时，EIPP 显示没有效果（OR = 0.85 [95% CI：0.67–1.09]；p = 0.209）。然而，排除和纳入方法均表明，5-6 周的控制期后，EIPP 效果显着增加。这种关系在受控期的 7-12 周达到稳定水平，采用排除方法在第 10 周达到峰值（OR = 0.28 [95% CI: 0.16-0.48]；p < 0.001），采用纳入方法则在第 7 周达到峰值（OR = 0.37 [95% CI: 0.25–0.55]；p < 0.001)。认识 EIPP 的剂量反应关系可以帮助研究人员设计和分析 RCT，并帮助从业者及时规划 EIPP 的实施。试验注册：临床试验。政府标识符：NCT03307434