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La efectividad de las intervenciones de ejercicio para prevenir lesiones deportivas

 

Lauersen JB, Bertelsen DM, Andersen LB. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2014 Jun;48(11):871-7. 

Introducción

Existe cada vez mayor evidencia de que la actividad física es importante tanto en la prevención como en el tratamiento de algunas de las enfermedades más importantes de esta época, (1-3) como las enfermedades cardiovasculares, la diabetes, el cáncer, la hipertensión, la obesidad, la osteoporosis y la depresión. 

Aunque los niveles de actividad física de la población en general son una preocupación general, se han informado niveles crecientes de actividad física en el tiempo libre y participación deportiva en algunos grupos de población. (4) 

Las lesiones deportivas musculoesqueléticas son prácticamente la única contra de la actividad física. (5–7) El tratamiento de estas lesiones es difícil, lento y costoso, tanto para la sociedad como para el individuo. (8-10) Sin embargo, la prevención de las lesiones mediante diferentes programas de ejercicios como el entrenamiento de la fuerza, ejercicios de propiocepción, ejercicios de estiramiento y entrenamiento combinado (donde se realizan estos tipos de ejercicios), es bastante accesible. Esto agrega varios aspectos interesantes con respecto a la posible aplicabilidad y cumplimiento de estos programas.

Este estudio tuvo como objetivo determinar si los programas de ejercicios mensionados pueden reducir las lesiones deportivas musculoesqueléticas; y analizar el efecto por separado de cada uno de estos programas; diferenciando su capacidad de prevenir lesiones agudas y de las lesiones por uso excesivo.

Material y métodos

Esta investigación consistió en una revisión sistematica; para la cual se realizó una búsqueda en las bases de datos (PubMed, EMBASE, Web of Science y SPORTDiscus) y se obtuvieron 3462 articulos que estudiaron la relación entre distintos programas de ejercicios y lesiones deportivas musculoesqueléticas. 

Resultados

De los 3462 articulos se incluyeron 25 para este estudio. (26–50) La Tabla 1 resume las características de los mismos. En total se sumaron 26 610 participantes y las estimaciones del efecto se basaron en 3464 lesiones. 13 estudios se realizaron en adultos, 11 en adolescentes y un estudio incluyó a ambos.

Tabla 1 – Resumen de características del estudio

Discusión

El estiramiento no mostró ser efectivo en la prevención de lesiones deportivas musculoesqueleticas, en cambio, el entrenamiento de la fuerza si resultó ser muy efectivo. Los resultados de los estudios de estiramiento y entrenamiento de la fuerza fueron similares a pesar de que se utilizaron diferentes programas de ejercicios y los resultados de interés fueron diferentes. Esto quiere decier que se puede generalizar los resultados. El entrenamiento de propiocepción y los programas de entrenamiento combinado también fueron efectivos, pero los resultados fueron relativamente heterogéneos.

Los efectos de los ejercicios de estiramiento coinciden con los hallazgos de revisiones anteriores. (14, 15, 17, 18) Por lo tanto, no se apoya el uso del estiramiento para la prevención de lesiones deportivas musculo esqueléticas, ni antes ni después de la actividad física.

El entrenamiento de la fuerza mostró un mayor efecto en la prevención de lesiones que los ejercicios de propiocepción y el entrenamiento combinado, aunque los estudios de entrenamiento combinado incluyeron un componente de entrenamiento de la fuerza.

Los ejercicios mostraron ser efectivos tanto para prevenir las lesiones agudas como las lesiones por uso excesivo, aunque se observó que tienen mejores resultados en las lesiones por uso excesivo.

Conclusión

En general, se demostró que el ejercicio reduce eficazmente las lesiones deportivas musculoesqueléticas. El estiramiento no demostró ningún efecto beneficioso, mientras que los programas de entrenamiento combinado, ejercicios de propiocepción y el entrenamiento de fuerza, en ese orden, mostraron ser efectivos en la prevención de lesiones. El entrenamiento de fuerza redujo las lesiones a menos de un tercio, incluyendo tanto las lesiones agudas como las lesiones por uso excesivo, pero estas últimas se redujeron a casi la mitad. 

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