Page 116 - JSOM Winter 2021

TABLE 1 Summary of Reviews Examining Injuries during High-Intensity Functional Training
Quality
Study Assessment,
Study Type of Retrieval Systems Inclusion Studies Reviewed: Total Points
(Year Published) Review Examined Criteria (number and type) a Conclusion (% of total points)
Poston et al. Narrative Not specified Not specified 6 military “…HIFT programs, including NA
9
(2016) (1 retrospective, CrossFit , pose similar or lower
®
5 prospective); potential for injury than many
3 civilian studies traditional PT activities…”
(all retrospective)
Meyer et al. Systematic PubMed CrossFit 3 retrospective “…Crossfit is comparable to 3 (43)
11
(2017) SPORTSDiscus studies studies other high-intensity exercise
CARL involving regimens in terms of…injury
adults rates…”
12
Klimek et al. Systematic PubMed Studies 3 retrospective “…injury risk from CrossFit 4 (57)
(2018) CINAHL Plus comparing studies training is comparable to
SPORTSDiscus injuries in Olympic weightlifting, distance
MEDLINE CrossFit to running, track and field, rugby,
EBSCOhost other types football, ice hockey, soccer, or
Cochrane (2) of exercise gymnastics.”
Academic search (2)
Tibana and Narrative Not specified Not specified 8 retrospective “…the estimated injury rate NA
10
Frade de Sousa studies; 9 case among athletes participating
(2018) studies involving in ECP is similar to the rate of
rhabdomyolysis injury in weightlifting and most
other recreational activities”
Claudino Systematic PubMed Studies 4 retrospective “…number of studies 4 (57)
13
et al. (2018) Web of Science involving studies, 2 case investigating CrossFit with a
Scopus CrossFit studies high level of evidence at low
Birme/Medline risk of bias is sparse. As a
SciELO result, these findings neither
firmly establish the benefits or
risks of CrossFit…”
Barranco-Ruiz Systematic PubMed Crossfit 7 retrospective “Finally, it seems that Crossfit, 6 (86)
et al. (2020) Web of Science studies studies; 2 Cross Training, or High-
14
SPORTDiscus reporting prospective studies; Intensity Functional Training
Scopus injuries 3 case studies methodologies involves a
similar risk of injury to other
sports.”
Gean et al. Systematic PubMed CrossFit or 5 retrospective “Back, shoulder and knee 4 (57)
15
(2020) Web of Science HIIT studies studies; 1 injuries are common with
LILACS reporting prospective study CrossFit but seem to occur at
injuries comparable rates with other
vigorous sports”
®
Rodriguez Systematic PubMed/MEDLINE CrossFit 21 retrospective “Crossfit training has an 6 (86)
et al. (2021) Embase studies studies; injury incidence rate similar to
16
Web of Science reporting 3 prospective weightlifting and powerlifting.”
Scopus injuries studies
SPORTSDiscus
CARL, Combined Arms Research Library; CINAHL, Cumulative Index to Nursing and Allied Health Literature; LILACS, Latin American and
Caribbean Health Science Literature; HIFT, high-intensity functional training; HIIT, high-intensity interval training; PT, physical training; NA,
not applicable (applies only to systematic reviews); SciELO, Scientific Electronic Library Online.
a Some authors specify different study designs within their reviews, but the definitions of retrospective and prospective studies used here are that
of Last et al. In some cases, individual studies were examined to properly determine the study design.
19

TABLE 2 Anatomic Locations of Injuries Cited in Reviews of High- was 35% ± 15%, with a range of 13% to 74%. In 14 studies
intensity Functional Training that reported injury rates, the mean ± SD was approximately
Study Investigations Anatomic Proportion of 3 ± 5 injuries/1,000 hours of training, with a range of 0.3 to
(Year Published) (n) Location Injuries (%) 18.9 injuries/1,000 hours. In six studies reporting injuries re-
Tibana and 5 Shoulder 20 quiring surgery, the mean ± SD prevalence was 6% ± 5%, with
Frade de Sousa Spine 18 a range of 2% to 16%. Four studies established that most inju-
10
(2018) Knee 12 ries were caused by weightlifting exercise, especially deadlifts,
Arm/Elbow 8 snatches, clean and jerks, and overhead presses. Other risk
Hand/Wrist 8
15
Gean et al. 3 Shoulder 12 factors included the time of participation in CrossFit (iden-
(2020) Back 7 tified in 10 studies), participation in competition (6 studies),
Knee 4 prior injuries (4 studies), weekly training frequency (4 studies),
Rodriguez et al. 11 Shoulder 26 male sex (3 studies), older age (1 study), alternating training
16
(2021) 6 Spine 24 loads (1 study), and not visiting a physical therapist on a reg-
3 Knee 18 ular basis (1 study).

114 | JSOM Volume 21, Edition 4 / Winter 2021