Table 1 Study characteristics of included studies

Antcliff [26]

Expert Opinion

In 2015, Netball Australia introduced the KNEE injury prevention program to reduce the rate of lower limb injuries in netball, in particular knee and ankle injuries,

IPP

No results were specified

Attenborough [10]

Cross-Sectional

96 club and interdistrict netball athletes (24.1 ± 7.9y) undertook questionnaires to investigate the prevalence of ankle sprains, perceived and mechanical instability

EAS

70% of netball athletes with CAI regularly used external ankle support when participating in netball

Barnes [33]

RCT

16 university netball athletes (19.0y) were randomly allocated to a 6-week PROP (n = 8) and CONT (n = 8) to compare the effects of proprioceptive training on dynamic balance

IPP

PROP group demonstrated a statistically significant improvement in ANT, PMED, and PLAT direction of SEBT (p < 0.05)

Belcher [34]

RCT

77 junior netball athletes (15.9 ± 0.9y) were randomly allocated to a 12-week NSDW (n = 37) or PWU (n = 40) to compare the effects on peak force and landing performance

IPP

NSDW and PWU groups significantly reduced peak vGRF and LESS (p < 0.05). PWU had a significantly greater improvement in LESS compared to NSDW (p = 0.001)

Coetzee [27]

Cross-Sectional

1,280 elite netball athletes (age NS) undertook questionnaires and injury surveillance over a 4–6 day tournament to determine incidence rates and the influence of training habits

IPP

70 ankle injuries were reported (34% prevalence). More than half of injured netball athletes did not undertake core stability (51.7%), proprioceptive (59.0%), or neuromuscular and landing training (57.7%),

Elphinston and Hardman [35]

Observational

17 international netball athletes (age 25.9 ± 2.6y) with inexperience in detailed training prescription undertook injury surveillance over 2-years to determine the effects of a functional stability program

IPP

A significant reduction in ankle injuries (six to one) was observed between two calendar years

Franettovich-Smith et al. [46]

Prospective Cohort

269 community netball athletes (15.0 ± 5.0y) undertook questionnaires and injury surveillance over one season to determine incidence rates, mechanism, and predictor of injuries

EAS

NSF

44 ankle injuries were reported (26% prevalence). Netball athletes who implemented external ankle support had a three-fold increase in sustaining a lower limb injury compared to netball athletes who do not use taping or bracing (P < 0.001). No association was found between the age of netball shoes and lower limb injuries (p = 0.261)

Gianotti et al. [36]

Cross-Sectional

217 netball coaches (age NS) completed a survey following an NSDW education and resources course to assess its effectiveness on implementation

IPP

Most netball coaches read the NSDW booklet (79%), changed the way they coached (89%), used information from injury prevention programs (94%), and passed it on to their athletes (90%). 70% reported changes to their player’s landing, stopping, dodging techniques, and recovery procedures

Greene et al. [25]

Case-Crossover

10 elite netball athletes (18.3 ± 1.9y) completed a side-step cutting task to compare the effects of NSF, NSF + LUB, and HTF on ankle biomechanics

EAS

NSF

NSF + LUB recorded a significant reduction in SAG ankle excursion compared to NSF (p < 0.05). No difference was found between NSF, NSF + LUB, and HTF in SAG and FRO ankle excursion, moments, and GRF

Hopper [22]

Prospective Cohort

3,108 community netball athletes (age NS) undertook questionnaires and injury surveillance over a 14-week season to determine incidence rates and treatment strategies

T&R

92 ankle injuries were reported (57% prevalence). 66.3% received composite treatment and 33.7% were advised ice. 77.7% received advice. None were advised to rest. 14.1% were referred to a doctor or physiotherapist

Hopper and Elliott [23]

Prospective Cohort

228 state netball athletes (21.4 ± 3.7y) undertook questionnaires and injury surveillance over a 9-day tournament to determine incidence rates and characteristics of injuries

EAS

19 ankle injuries were reported (37% prevalence). 34.4% of netball athletes reported were wearing tape or brace when playing netball

Hopper et al. [20]

Prospective Cohort

11,228 community netball athletes (age NS) undertook questionnaires and injury surveillance over a 14-week season across 5 years to determine incidence rates and treatment strategies

T&R

513 ankle/foot injuries were reported (84% prevalence). 68.8% received composite treatment and 31.4% were advised ice and rest following an ankle/foot injury. 56.9% received advice and a home exercise program. 27.1% were referred to a physician or physiotherapist

Hopper et al. [21]

Prospective Cohort

72 community netball athletes (age NS) undertook questionnaires and injury surveillance over a 14-week season to determine incidence rates and treatment strategies

T&R

RTS

13 ankle sprains were reported (59% prevalence). 76.9% were referred to a doctor or physiotherapist and received treatment. None returned to the following training session. All players missed at least one (46.8%), two (46.1%), and three (7.7%) training sessions. Most players missed zero (38.5%) one (15.8%) and two matches (38.5%). Very few missed three matches (7.7%)

Hopper et al. [28]

Case-Crossover

15 elite netball athletes (22.6 ± 4.2y) completed a jump-land task to compare the effects of LUB, NET, and BF on ankle biomechanics

EAS

LUB significantly reduced EMG activity of gastrocnemius and peroneal longus muscles compared to NET and BF (p < 0.007). No difference was found in peak vGRF and TTP between LUB, NET, and BF

Hopper et al. [37]

RCT

23 junior netball athletes (12.2 ± 0.9y) were randomly allocated to a 6-week NMT (n = 13) or CONT (n = 10) to compare effects on ankle biomechanics

IPP

NMT group significantly improved 10 m sprint, 20 m sprint, 505 agility, CMJ height, and peak power, NMST score and ANT, PMED, and PLAT directions of SEBT (p < 0.05)

Hume and Steele [24]

Prospective Cohort

940 representative netball athletes undertook questionnaires and injury surveillance over a 3-day tournament to determine incidence rates and characteristics of injury

EAS

NSF

44 ankle injuries were reported (14%). Approximately half of all netball athletes used taping (30.8%) or bracing (18.8%) during netball. Of the ankle injuries, 68.2% reported not wearing EAS, 54.9% wore mid-cut, and 35.7% sore low-cut footwear (35.7%). Very few wore high-cut footwear (9.5%)

Janse van Rensburg et al. [38]

Prospective Cohort

192 international netball athletes undertook injury surveillance over a 10-day tournament to determine incidence rates and characteristics of injury

RTS

8 ankle sprains were reported (17% prevalence). 75.0% returned to netball immediately following an ankle sprain. Ankle sprains resulting in time-loss were between 1–7 days (12.5%) and 8–28 days (12.5%)

Kearney [29]

Expert Opinion

In 2013, Netball New Zealand introduced the NSDW injury prevention program to reduce the rate of lower limb injuries in netball, in the particular knee and ankle injuries,

IPP

No results were specified

Masharawi etal. [30]

Case-Crossover

10 elite netball athletes completed a weight-bearing inversion test using an SRB and LUB to compare the effect on ankle kinematics

EAS

SRB and LUB significantly reduced ankle inversion angle before and after exercise, compared to no bracing (p < 0.001). No difference was found between SRB and LUB

Mason-Mackay et al. [31]

Case-Crossover

20 high school netball athletes completed drop-jump, drop-land, and netball-jump tasks with LUB and NS to compare the effect on ankle biomechanics and balance

EAS

LUB significantly reduced SAG ankle excursion during drop-jump, drop-land, and netball-jump tasks (p < 0.10). LUB increased ankle stiffness during drop-lands (p < 0.10). No difference was found in peak vGRF and TTP

Mckenzie et al. [39]

RCT

81 youth netball athletes were randomly allocated to NSDW (n = 45) and TWU (n = 36) to compare the effects on performance measures

IPP

NSDW group recorded significant improvements in prone hold (p = 0.01), vertical jump (p = 0.01) and reduction in horizontal jump performance (p = 0.03)

Saad et al. [40]

Observational

66 community netball coaches were observed conducting 67 team training sessions across 4 clubs to assess implementation rates of the KNEE program

IPP

Implementation of the netball KNEE program was low in the 7–10-year (12%), 11–13-year (18%), and 14 + year (14%) age groups. 28% of teams completed warm-up and footwork exercises. Strength, balance, and agility-specific exercises were rarely performed

Saunders et al. [41]

Cross-Sectional

31 junior netball coaches completed a one-hour workshop and implemented a 6-week injury prevention program at team training sessions and completed a survey to assess benefits and barriers

IPP

Coaches reported subjective improvements in player’s athletic attributes (83%), landing technique (79%), and reduced knee and ankle injury risk (79%). Perceived coaching barriers included lack of player motivation (83%), ideas for training drills (79%), non-attendance (71%), and time (63%)

Sinclair et al. [32]

Case-Crossover

12 university netball athletes completed running, cutting, and vertical jumping tasks with NSF and MF to compare the effects on ankle biomechanics

NSF

MS significantly decreased time to peak loading and increased loading rate during running, cutting, and vertical jumping tasks (p < 0.05). MS significantly increased peak eversion angle during running (p < 0.05). No difference was found in SAG, FRO, and TRA ankle IC, excursion, and peak angles

Singh et al. [18]

Cross-Sectional

59 elite netball athletes (age NS) undertook questionnaires and injury surveillance during tournaments across 5 years to determine incidence rates and characteristics of injury

NSF

24 ankle sprains were reported (56% prevalence). Most netball athletes wore medium-cut footwear (60%). Low-cut footwear (37.3%) was more commonly worn than high-cut footwear (2.7%)

Smyth et al. [19]

Prospective Cohort

103 state netball athletes (U17 and U19) undertook questionnaires and injury surveillance during a 6-day tournament to determine incidence rates and characteristics of injury

RTS

14 ankle sprains were reported (14% prevalence). 28.6% resulted in time-loss following injury (no time specified)

Smyth et al. [42]

Mixed-Methods

39 state-team netball coaches, strength and conditioning coaches, and physiotherapists discussed the challenges associated with the implementation of the KNEE program

IPP

Eight common themes were identified including athlete (engagement and technique), staff (resourcing, prioritization, and supervision), and program (education, time constraints, flexibility, and adaptability) barriers

Smyth et al. [43]

RCT

53 sub-elite netball athletes completed single leg balance on an inversion tilt platform with S-NET (n = 26), HP-NET (n = 27) pre-and post-training to compare the effects on proprioception

EAS

Significant improvement in proprioception (AMEDA scores) with S-NET (p = 0.05) and HP-NET (p < 0.01). No significant difference was found between S-NET and HP-NET (p = 0.90)

White et al. [45]

Cross-Sectional

287 junior netball athletes completed a questionnaire on the attitudes, social norms, behaviour, and intention to learn a safe landing program

IPP

A high number of netball athletes reported learning a safe landing program being extremely helpful (54.4%), useful (57.8%), and good (46.7%). Netball athletes reported it would be extremely possible (39.0%), Netball athletes also felt that it was extremely possible (39.0%) that they could learn (41.1%) and intend on completing the program (32.1%) for every training session

White et al. [44]

Cross-Sectional

51 junior netball coaches completed a survey on the competency and benefits of teaching a safe landing program to their netball athletes

IPP

Most netball coaches reported being extremely positive a safe landing program would be beneficial (78%), valuable (71%), and positive teaching (59%). Fewer netball coaches felt extremely positive about their capabilities (31%), ability (47%), and having complete control (47%)