Injury Risk Factors and their Priority for Mitigation in Women’s Netball: A Systematic Review and Delphi Consensus

This study aimed to establish consensus on injury risk factors in netball via a combined systematic review and Delphi method approach. A systematic search of databases (PubMed, Scopus, MEDLINE, SPORTDiscus, CINAHL) was conducted from inception until June 2023. Twenty-four risk factors were extracted from 17 studies and combined with a three-round Delphi approach to achieve consensus. In round-one, experts listed perceived risk factors for injury in netball which were combined with the risk factors identified via the systematic review. In round-two and round-three, experts rated their level of agreement with each risk factor on a 5-point Likert scale (1-strongly disagree to 5-strongly agree). Consensus was defined as 80% agreement (with <10% in disagreement). In round-three, experts also rated the priority for mitigating the risk factor (1-very low to 5-very high). Nineteen experts participated in round-one and round-two, and sixteen participated in round-three (response rate 84%). One-hundred and nine risk factors for injury were identified by the systematic review and experts combined. Sixty-one risk factors reached consensus, categorised into five groups: ‘individual characteristics’ (n=22), ‘lifestyle’ (n=11), ‘training and competition’ (n=14), ‘sport science and medical provision’ (n=6) and ‘facilities and equipment’ (n=8). ‘Poor landing technique/mechanics’ had a median (interquartile range) mitigation priority rating of 5(1), while all others had median ratings of 3-4.5. This study identifies a range of risk factors for injury, provides focus areas for injury prevention, and highlights the importance of a multi-disciplinary approach to injury mitigation in netball.