Effectiveness of Multi-Component Interventions on Injury Risk Among Ice and Snow Sports Participants - A Systematic Review and Meta-Analysis
Authors: Fan Zhanjiang , Min Lanbin , He Wenbin , Yang Yaorong , Ma Wen , Yao Jiayi 
Published: January 2024

Abstract
Background: Ice and snow sports, inherently high-risk due to their physically demanding nature, pose significant challenges in terms of participant safety. These activities increase the likelihood of injuries, largely due to reduced bodily agility and responsiveness in cold, often unpredictable winter environments. The critical need for effective injury prevention in these sports is emphasized by the considerable impact injuries have on the health of participants, alongside the economic and social costs associated with medical and rehabilitative care. Consequently, the development and implementation of cost-effective injury prevention strategies are vital. Such strategies, when well-executed, can substantially reduce both the frequency and severity of injuries, thereby significantly enhancing the safety and long-term viability of these challenging sports.
Objective: The study's objective is to rigorously assess and statistically substantiate the efficacy of diverse injury prevention strategies in ice and snow sports, aiming to bolster future safety measures with solid empirical evidence.
Design: Systematic review and meta-analysis.
Methods: The overarching aim of this research was to meticulously aggregate and scrutinize a broad spectrum of scholarly literature, focusing on the quantifiable efficacy of diverse, multi-component intervention strategies in mitigating injury incidences within the realm of ice and snow sports. This endeavor entailed an exhaustive extraction of data from esteemed academic databases, encompassing publications up to September 30, 2023. In pursuit of methodological excellence and analytical rigor, the study employed advanced bias assessment methodologies, notably AMSTAR 2 and the GRADE approach, alongside sophisticated random-effects statistical modeling. This comprehensive approach was designed to ensure the utmost validity, reliability, and scholarly integrity of the study's findings.
Results: The study analyzed 15 papers including 9 randomized controlled trials, 3 case-control, and 3 cohort studies with 26,123 participants and 4,382 injuries. Findings showed a significant reduction in injury rates through various interventions: overall injury prevention (RR = 0.50, 95% CI 0.42-0.63), educational training (RR = 0.50, 95% CI 0.34-0.73), educational videos (RR = 0.53, 95% CI 0.34-0.81), protective equipment (RR = 0.64, 95% CI 0.46-0.87), and policy changes (RR = 0.28, 95% CI 0.16-0.49). Subgroup analysis revealed potential heterogeneity in compliance (p = 0.347). Compared to controls, multi-component interventions effectively reduced injury rates.
Conclusion: This study's findings substantiate the pronounced efficacy of multi-component interventions in diminishing injury occurrences in ice and snow sports, underscoring the imperative for future scholarly endeavors to engage in diverse, high-caliber experimental research. This approach is crucial to generate more reliable evidence, thereby informing and refining practical, evidence-based injury prevention strategies.