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A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of '11+ Kids': A Warm-Up Programme to Prevent Injuries in Children's Football.

ABSTRACT: OBJECTIVE:The objective of this study was to assess the efficacy of a newly developed warm-up programme ('11+ Kids') regarding its potential to reduce injuries in children's football. METHODS:Children's football teams (under 9 years, under 11 years, and under 13 years age groups) from Switzerland, Germany, the Czech Republic and the Netherlands were invited. Clubs were randomised to an intervention group and a control group, and followed for one season. The intervention group replaced their usual warm-up by '11+ Kids', while the control group warmed up as usual. The primary outcome was the overall risk of football-related injuries. Secondary outcomes were the risks of severe and lower extremity injuries. We calculated hazard ratios using extended Cox models, and performed a compliance analysis. RESULTS:In total, 292,749 h of football exposure of 3895 players were recorded. The mean age of players was 10.8 (standard deviation 1.4) years. During the study period, 374 (intervention group = 139; control group = 235) injuries occurred. The overall injury rate in the intervention group was reduced by 48% compared with the control group (hazard ratio 0.52; 95% confidence interval 0.32-0.86). Severe (74% reduction, hazard ratio 0.26; 95% confidence interval 0.10-0.64) and lower extremity injuries (55% reduction, hazard ratio 0.45; 95% confidence interval 0.24-0.84) were also reduced. Injury incidence decreased with increasing compliance. CONCLUSION:'11+ Kids' is efficacious in reducing injuries in children's football. We observed considerable effects for overall, severe and lower extremity injuries. The programme should be performed at least once per week to profit from an injury preventive effect. However, two sessions per week can be recommended to further increase the protective benefit. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT02222025.

SUBMITTER: Rossler R

PROVIDER: S-EPMC5948238 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of '11+ Kids': A Warm-Up Programme to Prevent Injuries in Children's Football.

Rössler Roland R Junge Astrid A Bizzini Mario M Verhagen Evert E Chomiak Jiri J Aus der Fünten Karen K Meyer Tim T Dvorak Jiri J Lichtenstein Eric E Beaudouin Florian F Faude Oliver O

Sports medicine (Auckland, N.Z.) 20180601 6

<h4>Objective</h4>The objective of this study was to assess the efficacy of a newly developed warm-up programme ('11+ Kids') regarding its potential to reduce injuries in children's football.<h4>Methods</h4>Children's football teams (under 9 years, under 11 years, and under 13 years age groups) from Switzerland, Germany, the Czech Republic and the Netherlands were invited. Clubs were randomised to an intervention group and a control group, and followed for one season. The intervention group repl ...[more]

PMID: 29273936

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Project description:IntroductionThe effects of the FIFA11+ programme (the 11+) on ankle and groin injuries and performance have remained questionable. The latter, particularly, has potentially reduced the implementation rate and applicability of the programme. This study aimed to evaluate the mid-to-long-term effects of the 11+ and a modified programme including football-specific exercises on injury prevention and performance improvement.Materials and methodsThree teams of the Iranian Youth League (division two) volunteered to participate in this study and were randomly assigned to two intervention groups (F11+; n = 29, M11+; n = 31) and a control group (n = 30). The F11+ followed the FIFA 11+ programme, whereas the M11+ performed modified exercises three times weekly as a warm-up protocol before training and competition through a football season. The control group carried out its routine warm-ups, including joggings, basic football drills, and static stretches, while having no injury prevention approaches. Lower extremity injuries, as well as exposure time for each player, were recorded. The football-specific performance was assessed using the Illinois Agility and Slalom Dribbling tests. ANOVA, Fisher Freeman Halton, and chi-square tests were used to analyze the data.ResultsInjury incidences differed significantly between groups (p = 0.02, C = 0.40), with M11+ reporting the lowest incidence. Significant differences between the pre- and posttest as well as differences between the groups for development over time were revealed for the Illinois agility and dribbling speed (p≤0.01). Both performance tests demonstrated a large time effect, as the effect sizes for time in agility and dribbling speed were 0.74 (CI = [0.66; 0.79]) and 0.86 (CI = [0.79; 0.87]), respectively. The effect size for the interaction can be categorized as medium, with 0.38 (CI = [0.25; 0.49]) for agility and 0.52 (CI = [0.40; 0.61]) for dribbling speed. M11+ showed the largest improvement in both.DiscussionMid-to-long-term application of a structured dynamic warm-up that integrates injury prevention and performance approaches may lower injury incidences and improve youth subelite players' performance. Although additional studies with larger samples are needed to prove the results of the current study, the amateur clubs/teams could integrate such twofold dynamic warm up into their routine training plan and benefit its advantages on injury prevention and performance improvement.

Project description:BackgroundSoccer players incur injuries that typically affect their performance. Injuries are caused by intrinsic and extrinsic factors that call for multifactorial preventive interventions. The study examines the impact of the FIFA 11+ warm up programme on the incidence and severity of injuries in second division soccer players in Rwanda.MethodsTwelve teams (309 players) were randomised in the intervention group and 12 teams (317 players) in the control group using a cluster randomized controlled trial with teams as the unit of randomization. Intervention group teams implemented the FIFA 11+ soccer specific warm-up programme during training and matches at least three times a week over seven months of the Rwandan soccer season. Control group teams continued with usual warm up exercises. The primary outcome of this study was the overall incidence of training and match injuries. Injuries, training and match exposure as well as severity categories were recorded per the F-MARC guidelines.ResultsA lower proportion of players sustained injuries in the intervention group (52%) compared to the control group (63%) (Odd ratio: 0.7; 95%CI: 0.5-0.9). A significantly lower rate ratio was observed in the intervention group for overall (RR = 0.6; 95%CI: 0.5-0.8) and match (RR = 0.6; 95%CI: 0.5-0.8) injuries. Compliance to the injury prevention programme was 77%. In the intervention group, the incidence of injury was similar across all teams and across the medium and highly compliant teams. There was a statistically significant 55% and 71% reduction of the rate of moderate and severe injuries in the intervention group respectively.ConclusionThe 11+ warm up injury prevention programme resulted in a significant reduction in the odds of sustaining injuries. In addition, injuries sustained were less severe. The programme should be rolled out to all teams in Rwanda and may well result in a decrease in the incidence and severity of injury in similar contexts.Trial registrationPan African Clinical Trial Registry (PACTR201505001045388).

Project description:BackgroundInjury among soccer referees is rarely studied, especially with regard to differences in the quality level of the refereeing. Additionally, we have found no study that has reported injury occurrence during official physical fitness testing for soccer referees. The aim of this study was to investigate the frequency, type and consequences of match-related and fitness-testing related injuries among soccer referees of different competitive levels.MethodsWe studied 342 soccer referees (all males; mean age 32.9?±?5.02?years). The study was retrospective, and a self-administered questionnaire was used. In the first phase of the study, the questionnaire was tested for its reliability and applicability. The questionnaire included morphological/anthropometric data, refereeing variables, and musculoskeletal disorders together with the consequences.ResultsThe sample comprised 157 main referees (MR; mean age 31.4?±?4.9?years) and 185 assistant referees (AR; mean age 34.1?±?5.1?years) divided into: international level (Union of European Football Associations-UEFA) referees (N?=?18; 6 MRs; 12 ARs) ; 1st (N?=?78; 31 MRs; 47 ARs), 2nd (N?=?91; 45 MRs; 46 ARs); or 3rd national level referees (N?=?155; 75 MRs; 80 ARs). In total, 29% (95%CI: 0.23-0.37) of the MRs and 30% (95%CI: 0.22-0.36) of the ARs had experienced an injury during the previous year, while 13% (95%CI: 0.05-0.14) of the MRs, and 19% (95%CI: 0.14-0.25) of the ARs suffered from an injury that occurred during fitness testing. There was an obvious increase in injury severity as the refereeing advanced at the national level, but the UEFA referees were the least injured of all referees. The results showed a relatively high prevalence of injuries to the upper leg (i.e., quadriceps and hamstrings) during physical fitness testing for all but the UEFA referees. During game refereeing, the ankles and lower legs were the most commonly injured regions. The MRs primarily injured their ankles. The ARs experienced lower leg and lower back disorders. However, the overall injury rate was equal for both groups, with 5.29 (95%CI: 2.23-8.30) and 4.58 (95%CI: 2.63-6.54) injuries per 1000?hours of refereeing for MRs and ARs, respectively.ConclusionIn addition to the reported risk of injury during soccer games, physical fitness testing should be classified as a risk for injury among soccer referees. Special attention should be given to (I) lower leg injuries during games and (II) upper leg injuries during physical fitness tests. A higher physical fitness level and a qualitative approach to training are recognized as protective factors against injury. Subsequent studies should investigate the specific predictors of injuries among referees.

Dataset Information

A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of '11+ Kids': A Warm-Up Programme to Prevent Injuries in Children's Football.

Publications

A Multinational Cluster Randomised Controlled Trial to Assess the Efficacy of '11+ Kids': A Warm-Up Programme to Prevent Injuries in Children's Football.

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