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Comparison of the '11+ Kids' injury prevention programme and a regular warmup in children's football (soccer): a cost effectiveness analysis.

ABSTRACT: OBJECTIVE:To evaluate a potential reduction in injury related healthcare costs when using the '11+ Kids' injury prevention programme compared with a usual warmup in children's football. METHODS:This cost effectiveness analysis was based on data collected in a cluster randomised controlled trial over one season from football teams (under-9 to under-13 age groups) in Switzerland. The intervention group (INT) replaced their usual warmup with '11+ Kids', while the control group (CON) warmed up as usual. Injuries, healthcare resource use and football exposure (in hours) were collected prospectively. We calculated the mean injury related costs in Swiss Francs (CHF) per 1000?hours of football. We calculated the cost effectiveness (the direct net healthcare costs divided by the net health effects of the '11+ Kids' intervention) based on the actual data in our study (trial based) and for a countrywide implementation scenario (model based). RESULTS:Costs per 1000?hours of exposure were CHF228.34 (95% CI 137.45, 335.77) in the INT group and CHF469.00 (95% CI 273.30, 691.11) in the CON group. The cost difference per 1000?hours of exposure was CHF-240.66 (95%CI -406.89, -74.32). A countrywide implementation would reduce healthcare costs in Switzerland by CHF1.48 million per year. 1002 players with a mean age of 10.9 (SD 1.2) years participated. During 76 373?hours of football, 99 injuries occurred. CONCLUSION:The '11+ Kids' programme reduced the healthcare costs by 51% and was dominant (ie, the INT group had lower costs and a lower injury risk) compared with a usual warmup. This provides a compelling case for widespread implementation.

SUBMITTER: Rossler R

PROVIDER: S-EPMC6579489 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Comparison of the '11+ Kids' injury prevention programme and a regular warmup in children's football (soccer): a cost effectiveness analysis.

Rössler Roland R Verhagen Evert E Rommers Nikki N Dvorak Jiri J Junge Astrid A Lichtenstein Eric E Donath Lars L Faude Oliver O

British journal of sports medicine 20180821 5

<h4>Objective</h4>To evaluate a potential reduction in injury related healthcare costs when using the '11+ Kids' injury prevention programme compared with a usual warmup in children's football.<h4>Methods</h4>This cost effectiveness analysis was based on data collected in a cluster randomised controlled trial over one season from football teams (under-9 to under-13 age groups) in Switzerland. The intervention group (INT) replaced their usual warmup with '11+ Kids', while the control group (CON) ...[more]

PMID: 30131330

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Project description:BackgroundThe Fédération Internationale de Football Association (FIFA) 11+ Kids is an exercise-based injury prevention program developed by an international group of experts to prevent injuries among child soccer players.HypothesisIt was hypothesized that the FIFA 11+ Kids program would be more effective than performing a typical warm-up regimen in reducing overall injuries among soccer players aged 7 to 13 years.Study designA clustered randomized controlled trial.Level of evidenceLevel 1.MethodsA total of 94 boys' soccer teams, including 780 players, were randomly allocated into an experimental or control group. Complete datasets were collected from 45 teams (377 players) and 43 teams (363 players) in the experimental and control groups, respectively. The experimental group underwent the FIFA 11+ Kids program as a warm-up during training sessions and matches at least twice a week, and the control group continued performing their usual warm-ups. Participants were prospectively followed during 1 season (6 months). The primary outcomes included the incidence of overall and recurrent injuries and their mechanism and severity. The secondary outcome was the rate of compliance with the intervention program.ResultsA total of 43 injuries were reported in the experimental group in 50,120 hours of exposure (0.85 injuries/1000 exposure hours). A total of 86 injuries were reported in the control group in 42,616 hours of exposure (2.01 injuries/1000 exposure hours). The injury risk ratio was 0.43 (0.29-0.61), suggesting that the experimental group experienced 57% fewer injuries than those in the control group.ConclusionThe FIFA 11+ Kids program reduced overall injury rates in children playing soccer more than the usual warm-ups.Clinical relevanceThe results of this study provide evidence for children's coaches to consider including the FIFA 11+ Kids program in their warm-up regimen. Such a program may prevent injury risk and decrease absenteeism and injury-related financial burdens.

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:BackgroundAfter more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008.MethodsSystematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion criteria included: HIV prevention intervention, year for publication (2005-2008), setting (low- and middle-income countries), and CE estimation (empirical or modeling) using outcomes in terms of cost per HIV infection averted and/or cost per disability-adjusted life year (DALY) or quality-adjusted life year (QALY).ResultsWe found 21 distinct studies analyzing the CE of HIV-prevention interventions published in the past four years (2005-2008). Seventeen CE studies analyzed biomedical interventions; only a few dealt with behavioral and environmental/structural interventions. Sixteen studies focused on sub-Saharan Africa, and only a handful on Asia, Latin America and Eastern Europe. Many HIV-prevention interventions are very cost effective in absolute terms (using costs per DALY averted), and also in country-specific relative terms (in cost per DALY measured as percentage of GDP per capita).ConclusionThere are several types of interventions for which CE studies are still not available or insufficient, including surveillance, abstinence, school-based education, universal precautions, prevention for positives and most structural interventions. The sparse CE evidence available is not easily comparable; thus, not very useful for decision making. More than 25 years into the AIDS epidemic and billions of dollars of spending later, there is still much work to be done both on costs and effectiveness to adequately inform HIV prevention planning.

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.

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Comparison of the '11+ Kids' injury prevention programme and a regular warmup in children's football (soccer): a cost effectiveness analysis.

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Comparison of the '11+ Kids' injury prevention programme and a regular warmup in children's football (soccer): a cost effectiveness analysis.

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